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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Let’s fix the larger gun death problems

Mass shootings are very tragic and heart wrenching. Homicides are also tragic. Yet, the biggest gun problem and another tangible and avoidable problem make up between 60% and 70% of annual gun deaths in America. The lion’s share of gun deaths in America are suicides. Last year, over 23,000 of the 38,000 plus gun deaths were suicides. This ratio is not unusual and tracks pretty well year in and year out.

The other much smaller, but more avoidable gun death problem is accidental shootings. And, tragically the ones doing the shooting or getting killed are children who come across a weapon. To lose a child is the worst nightmare I could possibly imagine. But, to lose one because you did not put away your gun, is even more traumatic. The gun owner has to live with the guilt. While accidental shootings are about 2% of gun deaths, they seem to be ones we should be able to avoid irrespective of one’s fervor for the 2nd Amendment.

After each mass shooting, there is concern registered by kids and parents about not letting this happen again. The people for and against more gun control go into camps with some saying now is not the time, while the others asking when is the time. I must give a huge amount of credit to the Parkland kids and others around the country who are forcing action. But, outside of a little lip service in Washington, nothing tangible happens. They may regret inaction come November.

These past few months, the barest of minimum change was done, but there was the President of the United States speaking before the NRA convention last week. He was the one who taunted Congress representatives for not standing up to the NRA. These were obviously just words, which we should be used to by now. With this said, I do give kudos to Florida who acted a little more demonstrably than DC.

To prevent more suicides, background checks on all sales with elongated waiting periods are needed. Doctors must be permitted to ask patients if there is a gun in the house as the propensity for suicide is much higher than one without. All it takes is an impulse and it is over. We must add more psychologists and counselors to schools. The greater gun risk is a depressed student taking his or her life. And, we should expand Medicaid in the remaining 18 states along with its mental health benefits.

As for the accidental shootings, the majority of states require guns to be locked up at home, but why do not all states have such a requirement? I have shared this before, but I asked my father-in-law to lock up his weapon, as I did not want his grandkids around a loaded weapon. He did so. One idea that has merit is requiring a finger printed trigger, where only the owner can use the weapon.

Please note that none of the above speaks of taking weapons away. These steps would help reduce the number of suicides and accidental shootings. Even if the number is only 100, 500 or 1,000, those are lives saved. Isn’t this what it’s all about?

 

 

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.

 

Trying to solve that gun death thing

I am hopeful, but not optimistic that tangible change will be enacted by Congress to reduce the risk of gun deaths in America. The kids who are protesting have already brought on some change with Dick’s Sporting Goods, Walmart and Kroger announcing changes on gun sales policy and other companies eliminating discounts offered NRA members.

If change occurs it will likely be the result of the retailers paving the way and dragging Congress along. What we may end up seeing is something like integrated background checks and an age 21 restriction on assault weapons. We may see some funding for more security in schools. While these changes would help,  they are not near enough to help reduce most gun deaths and respond to what the significant majority of Americans want per repeated surveys. Here are a few thoughts:

– Let’s start with data and ask the CDC to track gun death data, which has been forbidden by Congress since the late 1990s. Then, we can measure progress of various initiatives.

– Next, we can ask for background checks on all gun transactions which should be a given since most Americans favor this. Plus, if someone is credibly reported on by a reasonable number of concerned citizens and a potential problem is deemed possible, the police must be able to seize weapons while more indepth review is undertaken via a legal process.

– Next, we could have an elongated waiting period, again favored by most Americans. Two-thirds of gun deaths are suicide, with suicide being the top reason for gun death in most states. Waiting a few more days will hopefully reduce impulsive suicides and may flag something.

– Then, we can address the mental health aspects. We could start by changing the law passed by Congress last year adding mentally disabled Social Security recipients to the eligible gun rolls. We could stabilize the exchanges under the Affordable Care Act and encourage Medicaid expansion both which have mental health benefits. We could also add funding for more school counsellors and psychologists which many states pulled back on. This could go part and parcel with funding more security in schools.

– Finally, we could reduce accidental deaths with more required training and finger printed triggers, so kids won’t do damage with weapons they find.

Personally, I would ban all assault weapons and bump stocks, but that is a hard sell in America.  I would not arm teachers as the solution to school gun deaths is not introducing 700,000 weapons to campuses, which would increase risk and not solve a problem. Shooting at someone shooting back at you is not something many are up to, especially if outgunned and in a chaotic environment. Let’s add security staff and measures.

Whatever we do, we must holistically addresses all gun deaths. I did not touch on poverty, drug industry, entertainment violence and lack of civility that cause gun violence. But, we must invest in these areas. What do you think? Am I off base? Do you have other ideas?

And the band played on

Earlier this week, a fifteen year old decided that he should bring a gun to school in Marshall County, Kentucky. Two teens are dead and 18 more are wounded. Less noticed is that there were 81 other shooting incidents that same day in America leaving 28 dead and 40 wounded per the LA Times.

Per the New York Times, the Marshall County shooting was the eleventh on school grounds just this year, with three occurring the very same week in Winston-Salem, NC, New Orleans, LA and Italy, TX, Just toward the end of last year, there were shootings at the following high schools:

– 9/13/2017: Freeman High School in Rockford, WA where a 15 year old killed one and wounded three students.

– 9/20/2027: Mattoon High School in Mattoon, IL where a 14 year old wounded one student.

– 12/7/2017: Aztec High School in Aztec, NM where a 21 year old former student killed three students.

The two horrific shooting tragedies last year at a church in Texas and concert in Las Vegas were not enough to elicit action – now isn’t the time to make knee jerk actions we were told by serious minded leaders in the pocket of the NRA. I am still dismayed that after Sandy Hook Elementary shooting which killed twenty-six, now was not the time was said then as well.

Well, let me ask a simple question. When is the time? How many children, teens and adults have to die for it to be time. The LA Times reports that 60% of Americans want  gun laws to be stricter. An Elon Univeristy survey a couple of years ago pegged universal background checks and elongated waiting periods at even higher rates of preference by Americans.

To be brutally frank, we are well passed time. For those who give the standard NRA fed response that certain changes would not stop certain crimes, the answer is “obviously doing nothing isn’t preventing them either.” Politicians it is time to stop worrying about keeping your job and start doing your job. We need leaders to think  more like parents and grandparents and less like politicians scared of lobbyists.

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.

 

A few straightforward suggestions to fight poverty

“If incarceration had come to define the lives of men from impoverished black neighborhoods, eviction was shaping the lives of women. Poor black men were locked up. Poor black women were locked out.”

The above quote comes from the Pulitzer Prize winning book “Evicted” by Matthew Desmond. Its subtitle is also telling – “Poverty and Profit in the American City.” The dilemma is we have a poverty problem that stretches from urban to rural America. Yet, it manifests itself daily in the eviction courts of American cities and towns, whether it is from apartments, houses or mobile homes.

The book speaks of how fragile the rental community is regardless of race, yet the black community tends to have a higher rate of exposure to evictions in urban areas. Unexpected expenses, transportation problems, and tragedies can push people paying a very high portion of their rent over the edge and out the door. Ideally, 30% of family income should be toward housing and utilities. Too many of these folks are paying well above that percentage.

It should be noted that there are other drivers of fragility. Some have opioid and other dependencies. Some are fragile due to too many children that stretch the budgets of even the best planners. Some are in downward spirals with unsupportive landlords. And, many of those unexpected expenses that arise are healthcare related.

What are some suggestions to remedy these issues? Based on my experience as a volunteer Board member helping working homeless families and my reading, I would like to throw out some ideas for consideration.

First, we need to talk more about it. America has a huge disparity in distribution of wealth which is not talked about enough by leaders. Where and to whom one is born are greater predictors of success as the American Dream  has waned for too many.

Second, we need to fund more family planning efforts not less. There is a high correlation between poverty and large families. When family planning is funded and birth control access and education are increased, poverty declines, system health care costs decline and abortions decline.

Third, more mechanisms to reduce evictions need to be in place and funded. Crisis assistance funds show success in helping keeping the electricity on and, when funded, reducing the number of evictions. Stopping homelessness (or fragility) before it starts can make a huge difference and will have a positive echo effect.

Fourth, we must invest in impoverished  areas making them more suitable for families both with opportunity and resources. In their absence, crime and other poor influences fill the void.

Fifth, while I have concerns about the new Tax law with its impact on debt and heavy emphasis on the wealthy and corporations, a huge opportunity was missed when we could have added an increase in the minimum wage tying it to automatic increases due to wage inflation. I worry that less money than expected by the law’s drafters will end up in the hands of workers.

Sixth, we must address our opioid crisis in America. To be frank, cutting access to healthcare and mental care insurance benefits are not the answer. We must stabilize access and cost of healthcare, yet opposite measures have been taken in the past few years under the guise of political gain.

There are many more ideas, but these will help. On the investing front, many locations have seen success with using historical tax credits leveraging private money. There is a concept called ABCD (Asser Based Community Development) which shores up or repurposes an deteriorated asset creating jobs.

But, first we need to talk about this real and pervasive problem.