Sunday sermon-ettes, the sequel

Good Sunday morning all and enjoy the day. A few tidbits have been bouncing around in my head, so I will commit them to writing for your review and critique. The tidbits are light on religious tone.

Guns and butter: For some reason, in the US we spend more time discussing protecting the right to own a 34th assault weapon than feeding 34 people. We have far too many food deserts in our country where the closest food is a convenience store. Far too many in our country are undernourished. Yet, pick up any local paper on any day of the week, and you will find multiple gun killing stories. Better gun governance is essential, but it is a nonstarter with the NRA who is more interested in gun sales. I think our priorities are off.

Kicking poor people in the teeth: Along those same lines, our President is pushing the Republicans in the Senate to vote on whether to kick 22 million Americans in the teeth or 34 million, many of whom are in poverty or near poverty. It should be noted the President said he would not touch Medicaid. I guess that detail escapes him in his desire to have a photo op of him signing something.

Brexit is a hard pill to swallow: The word Brexit sounds like one of those new fangled drugs to cure something you did not know you should worry about. I think voters were not told the whole story and many are wishing they had a do over. As foretold, the financial companies who based their EU regional business in London, are making definitive plans to move. Bank of America just announced a move to Dublin, Citigroup is moving folks to Frankfurt and other places, and Japanese banks are doing likewise. While I  understand the desire to fully govern your future, the UK is harming its future growth. That is not just my opinion, but that of financial experts.

Shrinking to greatness is not a good strategy: Speaking of financial growth, limiting relationships with other countries is not conducive to growth. And, a venture capitalist noted that what creates jobs is customers. Plus, when we discuss global trade, we need to reflect the whole picture and that is the foreign owned companies who make things here with American workers. Why? Selling big durable products is more cost effective and less risky if they are not shipped from abroad. Just ask BMW, Toyota, Husqvarna, Michelin, Mercedes, Volvo, Mitsibishi, etc. about their plants here in the US.

The bible says many things: There is a minister who upsets a few applecarts by preaching that the bible should not be cherry-picked to support points of view. His obvious example is in Genesis where God tells Adam and Eve to go forth and multiply and then gets mad at them when they like being naked with each other. The question is how did they know how to go forth and multiply? The minister’s premise is we should take away the overarching messages that are taught therein and remember the context of when the bible was written.

So, on that note, go enjoy your day, whether you choose to practice your multiplication tables or not.

 

Tuesday’s Gone with the Wind

With a shout out to one of my favorite Lynyrd Skynyrd’s songs “Tuesday’s Gone with the Wind,” here are a few tidbits for this Tuesday.

It should not be lost on anyone that two of the biggest players in wind energy are two of the largest manufacturing companies in the world – Siemens and GE. With Iowa at almost 1/3 of its electricity provided by wind and oil rich Texas at 13% and the largest US wind energy state, this is much more than a breeze and just shy of a gale.

What the ranchers and farmers in the Midwest and in other areas have learned, is leasing their land to wind mills earns annual income and let’s them continue to use the land. In North Carolina, for example, one farmer leased his farm for eleven wind mills for annual income of $55,000. With the variability of profit margin associated with working the land, this adds some stability.

Thinking of a different kind of wind, the Senate leader is a particularly blowhard. Now, that the third effort to revise the Senate ACA repeal and replace has fallen apart, he is still reluctant to take the more appropriate path. Rather than working with all members of the Senate following normal procedure for legislation, he now is talking about a full repeal vote, without replacement. Not only is that malfeasance in my view, it runs contrary to the wishes of most Americans. The fact the President suggested it does not improve the veracity of the idea.

Folks, please pay attention to the good and bad things happening. We can no longer assume our elected leaders will act with the necessary diligence and stewardship.

 

 

 

A few suggestions on ACA Reform

Since the House and 13 Senate Republicans have decided not to listen to the American majority or review actual data, here are a few suggestions on reforming the ACA. The ACA is imperfect and seeing higher premiums than expected in some places, but critics overlook three key things. It has dramatically reduced the number of uninsured, it has introduced positive benefit requirements to all plans including employer sponsored ones and its premiums are even higher due to Republican Senators stiffing insurers.

What should we do about improving the ACA? First, do not pass any variation of the ill-conceived AHCA bill passed by the House. It is obvious the gang of thirteen GOP male Senators are not listening to the American majority. For what it is worth, here is what this retired benefit consultant, actuary and manager suggests for consideration.

– Pay insurers for the amounts promised them under the ACA to take on initial adverse risk (as was done when Medicare Part D was rolled out) and invite them to stay or return to the exchanges. Part and parcel with this change is to restore the risk corridor funding for adverse selection going forward. This will bring premiums down.

– Fully expand Medicaid in the remaining 19 states. The National Governors Association advocates the positives of Medicaid expansion with Ohio Governor and former Presidential candidate John Kasich calling it a “no brainer.” This will help rural hospitals, economies and residents as well as others in more urban settings.

– Reduce eligibility to Medicare to age 62. This will reduce the overall risk profile under the exchanges and Medicare since the added Medicare population is older than the average exchange population it would leave and younger than the Medicare population it would be joining.

– Where competition in the exchanges is nonexistent with only one provider, offer a public option through Medicare or a variation therefrom. The pricing needs to be fair when contrasted to the lone offering as you want provide viable choice, but not drive the lone insurer away

– Finally, I would suggest we evaluate the efficacy of all fee arrangements under the ACA. Which ones make sense to continue, which ones make sense to alter, and which ones should be shelved or replaced?

It would also be helpful for naysaying for the sake of a party position to cease. Some impressionable people have refused to consider the ACA because a politician told them not to saying it was horrible or in a death spiral. People need to be mindful that health care and insurance are complex and politicians are offering advice in areas for which they are not licensed or knowledgeable to do so.

To be frank, I would rather see us go down the path of a national health insurance model. Yet, that is s tough sell in this country. So, improving the ACA is the better course versus what is being discussed. Plus, the strategic expansion of Medicare noted above will permit us to study this option and expand or contract it based on its measured veracity.

 

 

 

Monday, Monday

With this famous Mamas and the Papas’ song in my head, have the best of weeks. Here are a few random musings to start off the week.

The new sleight of hand approach being used by the US President on Russiagate is “It is his fault I cheated.” In essence, his predecessor chose not to make public the verified Russian meddling in the Presidential election due to the polarized political climate. While I understand his logic, I disagree with his silence. Yet, his choice does not alter the fact the newly elected President is at the very minimum an unwitting participant in the meddling and, as yet to be proven, a known colluder. Either way, he cheated, but that is consistent with his history.

Speaking of cheating, having clandestine discussions about health care reform does not give off the impression what you are doing is on the up and up. David Brooks, the conservative pundit, said on Friday that a key reason for the secrecy is there is no overriding mission to what is being done. Also, it could be construed as cheating to sabatoging the Affordable Care Act by not giving money promised to insurance companies to reimburse them for the initial adverse risk they took on. These actions harmed people as premiums went up even more and some companies left the market because they were stiffed.

The reason the “Black lives matter” movement started has been in evidence even more of late. Apparently, in terms of police shootings, they don’t. I would not want a police officer’s job as it is very dangerous. And, there are many, many fine officers. Yet, there have been too many actions taken that seem to fly in the face of reasonable use of force. Why must shots be taken? Why must so many shots be taken? Why must the shooter shoot to kill? When I see seven, twelve, sixteen shots are fired, I find that excessive. We must have honest review by all parties and better training. Too many Black men are dying and yes, their lives do matter.

These reflections turned quite sobering. I hope everyone stays safe and travels safely this week. And, don’t forget to hug your loved ones and tell them how you feel.

 

 

 

While we are asking questions

There will be a great deal written about Former FBI Director James Comey’s testimony under oath. I emphasize the last two words of the preceding sentence. The President and his advocates’ rebuttals will not be under oath, at least at this time, so we should remember this fact.

Yet, it got me to thinking about asking various people a question under oath to see how they would fare. In no particular order:

Senator Marco Rubio, you have bragged on playing a heavy role in the federal government stiffing insurance companies for taking on adverse risk under the ACA. Can you explain to Americans why they must suffer with higher insurance premiums for you to score political points?

Senator Mitch McConnell, The New York Times reported that just before the 2012 election, you had a report by the Congressional Research Service buried that concluded trickle down economics does not work. In light of the recent failures of that approach in Kansas, where tax rates have just been increased to pay for services, does that seem dishonest to hide such information from Americans, especially since the President’s tax plan had some of Kansas’ ideas?

Former President Barack Obama, do you feel remorse about not pushing the Simpson-Bowles Deficit Reduction plan back when it might have gotten some footing and we could have done more with our debt?

Former Senator and Secretary of State Hillary Clinton, while you may have reason to raise issues about the election, would you say that you ran a poor campaign, not focusing on states that you took for granted such as Wisconsin, Michigan and Pennsylvania while you tried to win states like Arizona? Do you feel you let your opponent speak to the disenfranchised voter more than you did?

Senator Ted Cruz, you single handedly shut down the government in October 2013, almost causing us to default on our debts until ten female senators broke the impasse. Do you feel that showed you as part of the problem with Washington? Why should we trust your judgment?

President Donald Trump, since you have been shown to lie about 70% of the time as a candidate and incumbent and your five biographers all note you have a problem with the truth, why should we believe what you say just about anything?

There are more folks I would like to ask questions of. Let me know some of yours.

 

Celebration for passing a bill may have been premature

With a White House eager to claim legislative victory, there was a celebratory bash after the Republican led House passed the AHCA by a squeaker of margins 217 to 213. The bill has been vilified by several advocacy groups like the AMA, American Cancer Society and AARP and it has still not been scored by the Congressional Budget Office. The bill is also dead in the water in the Senate “once it gets sent there.”

Wait a minute, the last sentence said “once it gets sent there.” To the surprise of some Republican House members, the AHCA bill has not yet¬†been sent to the Senate. Why, you might ask? Since the House did not wait for the CBO to score the cost and impact of the bill on the numbers of uninsured, it cannot be included in the budgeting process, and would thus require 60 votes, not 51 to pass in the Senate. The whole idea was to sneak the bill through this process, so it did not need the super-majority of 60 votes, which it cannot achieve.

Unless the CBO scores this where it saves a threshold amount of the budget, it may not qualify. So, the House leadership has not yet sent the AHCA to the Senate. If they did and the CBO results were not favorable, the House would have to start over. Again, I should reiterate that this bill cannot get even the 51 votes needed due to the impact on Medicaid. As we speak, about two dozen state governors are beseeching the Senate about not harming Medicaid. Unlike the House, the Senate is actually listening.

So, the victory lap on mile 250 of the Indy 500, may have been premature. Voting on something without knowing its impact is not the wisest course of action and is unbecoming of a legislator we trust to do our homework.

 

ACA truths Republicans don’t want you to know

The Affordable Care Act is an imperfect and complex law, but it is actually working pretty good. It does need improvements, but a few of its imperfections have been heightened by our Republican friends in Congress and in state legislatures. Yet, they do not want you to know about these actions, some of which are quite devious and harmful to Americans. To be frank, this subterfuge frustrates me as people are harmed as the GOP tried to waylay the law.

What has not been reported very much in main stream news is Senator Marco Rubio’s successful efforts to stiff insurance companies. These companies were promised additional funding for taking on excessive bad risk, called adverse selection. This was done successfully when the Medicare Part D plans were rolled out. By stiffing the carriers, the insurance companies had to raise premiums even more than they otherwise would have. Some even left the exchanges as this action hurt their bottom line. Let me say this plainly. Senate Republicans screwed Americans with higher premiums to try and strangle the ACA. Rubio even bragged about this on the campaign, so please Google “Senator Marco Rubio and risk corridors” to read about what he did.

On the state level, 19 Republican led states chose not to expand Medicaid, a key component of the ACA. 31 states who did so are seeing fewer personal bankruptcies and better hospital accounts receivables. Republican John Kasich, who expanded Medicaid as Governor in Ohio and ran for President, said “Medicaid expansion is a no brainier.” I would have likely voted for Kasich had he won the GOP nomination.

Then there is the naysaying that has been facilitated by the 50 plus repeal votes. Far too many folks never gave the ACA the benefit of the doubt. It is imperfect and the exchanges were rolled out horribly, for which I blame former President Obama. Yet, this law has made a huge difference in the lives of many Americans.

Finally, what is ironic is the ACA is built off a Republican idea. This is a key reason Republicans don’t have a good replacement. In fact, former Senator Jim DeMint, the initial Tea Party leader, strongly advocated Romneycare, on which the ACA is loosely based, for the whole country. He even wrote a letter to President Bush advocating for it. Yet, when Romney ran for President in 2012, DeMint said both Romneycare and the ACA were unconstitutional. This hypocritical change of heart can be easily found by Googling “Senator DeMint and Romneycare.”

People need to know the truth. This is not false news as our President likes to claim. Please research these facts and read as much as you like. Then, ask your representatives to start governing with real information and look to help Americans. I strongly recommend we do not repeal the ACA and improve the law. To do otherwise, is poor form for those who hindered it at the expense of Americans.