This zero-sum discourse needs to stop

What does zero-sum discourse mean? It means framing topics in terms of who wins and who loses. I fault politicians, pundits and reporters for this mindset. This mindset preceded the current White House incumbent, but he views most everything through a very short-term transactional lens. Did I win?

The dilemma in discussing who wins and loses on actions, speeches or tweets is it takes the focus away from the issues. Does this decision help or hurt the people, environment or region?

I heard a news discussion on whether the US pulling out of the Iran nuclear deal helps or hurts Trump’s image? That is the wrong question among many better questions. Does it make the US safer? Does it make the world safer? Are we harming our relationships with our allies? Are we making a fact based decision as other leaders are questioning the veracity of this decision? And, so on.

Whether it is healthcare, debt, taxes, environment, financial protection, etc., I do not care who wins or loses politically. When people care too much about winning or losing, I can tell you who gets screwed – it is the people they represent.

Americans want Congress to address healthcare, with the majority saying to fix Obamacare. Instead, the President and leaders in Congress have sabotaged it over the past three years making premiums even higher. They want to see it politically fail while screwing American people.

I am tired of the lack of collaboration. I am tired of the abuse of factual information. And, I am tired of this zero-sum discourse. To be frank, our leaders need to stop trying to keep their job and start doing their job.

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That healthcare thing

In more than a few surveys, the majority of Americans have noted that healthcare is a key dinner table issue. In several surveys, shoring up and stabilizing the Affordable Care Act (ACA) is preferred by a smaller, but still majority of Americans, than its repeal.

With a background of being a former benefits actuary, consultant and manager of benefits, here are a few facts and observations that I encourage you to research and verify.

– The ACA borrows from a Republican idea implemented by Governor Mitt Romney in Massachusetts which was advocated by de facto Tea Party leader Senator Jim DeMint for the whole country. Some elements can be found in a healthcare idea of Senator Bob Dole when he ran for President in 1996. These are reasons Republicans had a hard time with other ideas to repeal and replace it.

– The ACA is designed to require employer and public plans to offer certain minimum level benefits. The non-employer benefits are delivered through healthcare exchanges of policies and the expansion of Medicaid for people near or in poverty (32 states and the District of Columbia elected to do this).

– The biggest benefits of the ACA are guaranteed issue and renewability of coverage and the premium subsidy for people with incomes up to 4 x poverty limit. If you or a child has a preexisting condition, guaranteed issue and renewability are huge benefits.

– The botched roll out of the online exchanges sits at the feet of President Obama. For this to be such an important issue, it deserved better planning. The online exchanges are doing much better now, but you don’t get a second chance for a first impression. And, this poor roll out was used as fodder to nay-say the program, even though the problems were fixed.

– The ACA has experienced higher premiums due to adverse selection (pent-up demand and more high risk than better risk customers), but it is frustrating that the Republican Senators and President have masked their role in making premiums even higher. Senator Marco Rubio led an effort to strip 89% of the funding to insurers for initial adverse selection a couple of years ago and President Trump stripped out funding for co-pays and deductibles for lower paid people last year. Both of these changes cause premiums to increase even more than they otherwise would have.

– The lack of expansion of Medicaid in 18 states means the ACA is still not fully implemented. Per The Commonwealth Fund, this implementation would help people, rural hospitals and state economies. GOP Presidential candidate John Kasich called Medicaid expansion a no-brainer when he did it in Ohio as Governor.

The ACA is not perfect, but it is working OK. It could work even better if it were stabilized and improved. Taking away the mandate will be harmful and cause premiums to go up even more. What troubles me in our zero-sum game of politics is we are foregoing improving an imperfect law, which we have done countless times before on major changes. The way I see it, Congress and the President own this law now. If it fails, people should look to them asking why did they let it happen. This impacts people.

I have mentioned before several changes to consider. National healthcare is not going to happen in our country as it is too political and the healthcare industrial complex is strong. Yet, I advocate expanding Medicare in a targeted way down to age 62 (or maybe 55). Unlike the more complex Medicaid, Medicare actually works pretty well and strips out the profit load embedded in insurance premiums. This will reduce exchange premiums and Medicare premiums, as it makes both audiences younger on average.

I think we need to reconstitute the adverse selection and co-pay subsidies to insurers. The federal government needs to repay insurers they stiffed and invite insurers who left back into the exchanges. I would also recommend the remaining states expand Medicaid and I would add back the mandate for coverage, even though this feature is unpopular. If there are areas where competition is not significant, select use of Medicare (or Medicaid) could be deployed in those counties.

There are other changes that should be considered, but we need to shore this thing up. Congress and Mr. President, the ball is in your court as well as the legislatures for those eighteen states.

 

Keep on pushing forward ladies

Disillusioned by tribal politics and a President who has reduced civil discourse to a new low and untruthfulness to a new high, it was nice to get outdoors and participate in the second Women’s March in my city. My wife and I joined some friends and over 5,000 more marchers to hear important messages about pushing women and human issues forward.

I am very encouraged by the 26,000 women who have moved ahead with running for office. We need more women in all forms of government as they are woefully underrepresented. Some of the highlights from the speeches in addition to the above are as follows:

– while the push for equality was mentioned most, I was impressed by a Muslim American woman, Rose Hamid who spoke of equity, to value our differences in perspectives and not let fear of the unknown drive wedges between us. Hamid gained notoriety for sitting quietly in a Trump campaign event, until she was escorted out.

– I was appalled to hear a statistic that I had written about a couple of years ago continues to get worse – we have an increasing rate of maternal mortality around childbirth and our global ranking on this statistic is even more negative. A key driver is the lack of healthcare insurance access and education in too many areas of the country.

– I was troubled by the increasing statistics around domestic violence. Locally, the first four homicides of the year in my city were related to domestic violence. Men and women need to help women get out of relationships where signals are apparent. And, better education for boys and girls need to occur that violence is not the answer to relationship conflict.

– I am encouraged by the unifying voices from various fabrics of our culture regarding the need to treat everyone with dignity and respect. And, we must listen to each other and glean points of view. We are listening to respond, not hear.

– I am encouraged by the recognition to act and not just talk or tweet. One speaker said the quote, which may have been made by Rosa Parks, that “even the mighty oak tree was once a nut that stood its ground.” So, don’t worry if someone is calling you a nut.

I have often written about the tough-to-read book “Half the Sky,” by Nicholas Kristof and Sheryl WuDunn about the plight of women and girls around the globe. The Chinese proverb is “women hold up half the sky.” Not only is it the right thing to do, but treating women with dignity, respect and equality is the economic best thing to do. Otherwise, a country or area is competing with only 1/2 of its intellectual capital.

As our country enters its 104 consecutive month of economic growth and closes out its seventh consecutive year of 2 million plus jobs added, we should celebrate our economic success, but it is not bearing fruit equitably for everyone. Our economic classes have become more disparate and women remain relatively underpaid. Plus, with significant pay disparity, women are subject to more sexual harassment to keep better paying jobs or get better work scheduling for their parental duties.

So, let’s applaud this push by women. We will all benefit with more female voices being heard and heeded. That sky is heavy without the extra half holding it up.

 

If I see you on the trails

I long ago ceased my running and have been a walker and hiker instead. Often, I will go to one of the four trails in parks near my home. If you see me on the trails, you will see a friendly, but tall 59 year old man. Yet, I understand why women running alone will pause when they see me coming towards them.

The news of the day only heightens the concern women must have in the workplace. Similarly, they must be diligent when away from the crowds. I do my best to be overly friendly when walking on the trails, but I am a big guy and people don’t know me from Adam. Female joggers and walkers have to be on the guard.

Since I walk the trails quite often, allow me to offer some advice as this old man and father sees it. Please do not run or walk alone. It is that simple. There have been too many stories where lone women have been attacked. A dog will help, but another person is even better.

Another piece of advice may be harder to follow. Shed the music and earpieces. Sound is a good indicator of trouble, so when it is blocked by music, one of your senses is disabled. I know of several stories where the assailant came up from behind. Another sad story is a woman running at night on a street did not realize a truck passing had a trailer, so she stepped off the curb after the truck passed only to be killed by the trailer. If she had been without earpieces, she might have heard the trailer. Plus, it is not uncommon for a runner to dart in front of a car when listening to music.

The final piece of advice is to avoid running at night or dusk. It is hard to see you, first and foremost, but it is harder to see the assailant. The best option is to run or walk at a park with a crowded parking lot. If yours is the only car, it is best to avoid the trail that day. It gives me pause when I am the lone car.

I have come across some interesting things along the paths. I saw about eight deer earlier this week. I have seen snakes and been spooked by rustling squirrels and birds. I have yet to see any bears, although there have been more sightings in the city. I have witnessed what I think was a police/ informant meeting, which hastened my pace. I have seen people who have given me pause. And, I have seen too many women jogging alone.

Be safe and happy trails.

The President almost did something good, then…

People need to know that our President is not big into details, nor does he care to be. He is not very conversant on healthcare or the Affordable Care Act, for example. Yet, he almost slipped up and accomplished something good. Alas, he changed his position within 24 hours.

Just last week, he signed two executive orders to help healthcare in the US. Neither order would be very helpful and both will cause premiums to go up under the ACA. In fact, he said if we eliminate the subsidies for deductibles, co-pays and co-insurance on people making less than 2 1/2 the poverty level it would just hurt the insurer’s profits. That simply is not true, as our deficit would go up by $20 Billion per annum and people without subsidies would see premium increases.

But, while this was going on, Senator Chuck Schumer kept telling him about the bipartisan effort of Senators Lamar Alexander and Patty Murray that would stabilize and improve the ACA. Their efforts would restore the subsidies that Trump wanted to do away with. Insurers were pricing 2018 premiums higher sans these subsidies,

Trump encouraged Alexander while Schumer did the same with Murray. The President actually did the right thing, as Alexander and Murray were going about their business in the right way with hearings and committe meetings. This is how legislation should be done, which has been lost on our two Congress chamber leaders.

When Alexander/ Murray announced they reached agreement, the President was supportive. Alexander actually thanked the President for his role in making it happen. Yet, just after Alexander called to thank him, Trump changed his mind and now does not support it. Less than 24 hours had elapsed.

Of course, his support may change and Alexander/ Murray are not done yet, but Trump had a chance to take credit for helping Americans. This could have been a helpful major piece of legislation, which is missing from his tenure. Alas, he realized he would be helping the ACA and he had to destroy it. That is what he promised to his base. While imperfect, the ACA is not broken, but it does need improvements. If it eventually fails, it is on this President and Congress’ shoulders.

Any more questions?

For over two years, I have been amazed at how a man, who is so consumed with himself and has given so little regard to the plight of others, can become the President of the United States. He convinced far too many people, whose voice has not been heard, that he was on their side. Unfortunately, they did not pay attention to his history which reveals he has only one cause – himself.

Yesterday, this man decided to kick poor people one more time, stripping subsidies under the ACA for deductibles, co-pays and coinsurance for those who qualify because of low wages. This man owns the imperfect, but working ACA. He has sabotaged it from the get go picking up the baton the GOP Congress gave him, so if the ACA fails as a result, it is on his and GOP leadership’s shoulders.

A few weeks ago, he rolled out the outline of his tax plan that uses sleight of hand with a small tax break for the middle class, while eliminating the Alternative Minimum Tax, Estate Tax above $5 million in value, and the ACA tax on wealthy people, while cutting the individual and corporate tax rates. This is a clear windfall for the “haves” with a little gain for the “have-nots.”

Next, we should consider his proposed defunding of programs to retrain displaced coal miners. At the same time, he was enabling coal owners to invest in digging more coal with fewer workers. An energy expert said, “Trump is not for coal miners, he is for coal owners.” The dilemma is the current and former coal workers don’t know this.

The focus on fossil fuel and attack on environmental regulations is another slap at the disenfranchised. They tend to be the ones who feel the brunt of environmental rollbacks. A rancher in Montana, who has successively fought against the oil companies, notes that he cannot name one western town that has benefited long term after the oil rush abates. He said “all of the money goes back to Houston and Calgary.” The ranchers and farmers are left holding the bag to fix all the environment problems.

Speaking of environmental calamities, after much better responses to hurricanes in Texas and Florida, the response to the hurricanes which devastated Puerto Rico has been slow and fraught with problems. Yet, after pronouncing what a great job he was doing, Trump has continually harangued people in need, actually verbally and physically insulting them when he visited and afterwards.

Finally, the President’s attack on civil liberties, protest and free speech is the coldest dagger of all. He is basically telling everyone to “believe no one else but me.” His actions and words say he will squelch these unpatriotic troublemakers. To me, he is saying how dare they question what is going on in this country or what I am doing?

Well, I dare ask one question to everyone. Do you have any more questions about whose bread is being buttered by this President?

Are you going to believe me or your own eyes?

The man residing in the White House has basically told his followers that everyone else is lying, only believe me. By itself, that is a pretty audacious claim, yet when the man’s history is reviewed, truthful is not the word his biographers or business relationships would use to define the man. Yet, his fans still follow his lead.

It is very difficult to manage the response to three major hurricanes. Yet, don’t lie to people and tell them everything is going well in Puerto Rico, when it is obviously not. As the Mayor of San Juan said bluntly, “we need to get our shit together.” The better answer would have been for the man in the White House to say we have been slow to get help to people, but here is what we are going to do about it. This same Mayor was ticked off today when a DHS person said Puerto Rico is a “good news story.”

The same man is trying to ram a tax cut through that may offer some relief for middle class families, but who is he kidding? The percentage reductions for the top of the house are substantively more than for the middle class. Abolishing things like the estate tax (which already does not exist on the first $5 million of inherited assets) and the Alternative Minimum Tax (which is what most of these high earners pay) is a windfall. And, let us not look past the comment that a tax cut that will impact the debt by $2 Trillion will create sufficient economic growth to pay for that increase. If we can grow our way out of the problem, let’s cut the taxes to 0%.

The same man has echoed the party line that the ACA has failed, but there are a couple of things he is not letting on. It is not failing, but needs improvement. And, it could be doing even better if it were not for the sabotaging done by the man and his party. Premiums are even higher and carriers are fewer in part due to the efforts of the Republican Party leadership, including the man in the White House. The sad part is most Americans have no clue about this sabotoging role, but it is entirely true.

Finally, just a thought to consider. Why did the man in the White House refer to African-American protestors who civilly made a statement taking a knee during the national anthem as “sons of bitches,” yet made no such references to torch bearing White Supremacists chanting “blood and soil” and carrying Nazi slogans? Then, he said his words had nothing to do with race, yet that is why these men risked their careers by protesting.

On this latter point, my wife shared with me the comments of a third generation soldier. He said he, his father and his grandfather fought people who were not permitted to civilly protest their leadership in WWII, Korea and Vietnam. To him, to see the man in the White House criticize Americans for exercising their rights of civil protest, citing the reason to condemn them so as not to offend the flag or the military, is what this soldier fought against.