Saturday, July 7, 2012

HEALTH CARE REFORM: SOME SANITY PLEASE!

Like many Americans I’ve been watching the goings on in Congress re. the passage of the Patient Protection and Affordable Care Act (PPACA) and then the recent Supreme Court ruling that upheld key provisions of that act.  Having said that, the affirmation by the Supreme Court was a close vote and apparently on technical grounds. How do I feel about the PPACA?  For me the act and my take on it continues to be a work in progress.  I’m learning something new each day though referencing the title of this post; I have come to some conclusions but note - only after a lot of inquiry. Having said that who knows what will happen to the PPACA after November?

I’m struck by the ever escalating, visceral, sky-high emotions generated by the health care reform issue and what the Republicans sneeringly call “Obamacare”.  A Friend recently posted support for health care reform on his Facebook page and was greeted with the “F” word and other obscenities and all from so-called “Friends”. It also appears that no matter which side you are on, many are not familiar with the details or consequences of this plan. If we are not already there, it appears we have the potential to become a house divided.
 
Before I started research for this post I really didn’t know enough to comment intelligently on PPACA except feeling that reformation of the health care system in our country was absolutely imperative, if not the most important issue facing us.  As a former Human Resource Director watching the spiraling costs of health care and then trying to manage that in the context of a company benefits program was a great if not impossible challenge.  We routinely experienced annual double digit increases in our health care costs and wondered where the money was going to come from to pay for those benefits.  It came from higher deductibles, increased contributions by our Employees and the company, all complicated by shrinking margins and a diminishing bottom line though those costs were, not surprisingly, ultimately passed on to our customers.

We realized then, as today, that many folks were working with us just for the health care benefits.  Couple that understanding with our desire to be the employer of choice, we knew we had to be spot-on with our total employment package.  Without a comprehensive benefits program we weren’t going to be competitive in the hiring process, able to retain our top employees and failing that, the quality of our products and company’s reputation would ultimately suffer. 

Now you don’t have to be a rocket scientist to understand that there are substantial blocks of our citizenry without any health insurance though we as taxpayers will still ultimately pay for their health care (pay me now or later).  So what to do about it?  Rather than sitting back and waiting for the end of days the PPAA looks to have great merit despite what the Republicans are saying.  Indeed, most of what they are saying appears to be cherry picking and taking out of context statements from the Congressional Budget Office (CBO), good ole political spin or downright lies. We have accessed the non-partisan PolitiFact (Tampa Bay Times) and Factcheck.org a project of the Annenberg Public Policy Center of the University of Pennsylvania and will include some of their observations in this post. 

Every US President since Theodore Roosevelt (who first made health care a major issue in 1912) has tried to affect some degree of reform in our health care system and, believe it or not, that includes George W. Bush (Happy 66th Birthday!).  Most administrations haven’t been up to the task though many made small inroads to reform like Bush’s Medicare Prescription Drug, Improvement, and Modernization Act.  Reality: Today despite these enhancements the US is spending more than any other developed country and ranks last in the quality of our health care.  While we concede that our infant mortality and low life expectancy rates are due in part to the dynamics of our culture and our diversity, they do reflect negatively on our health care system.  Something is broken

The health care crisis begs a solution and with that locomotive quickly bearing down on us we feel that the PPACA is a start. We are exasperated that the Republicans can do nothing more than rip apart carefully crafted, passed and vetted legislation rather than offering a reasonable alternative proposal.  What’s even more confusing is the reality and irony that Romney created and installed a very successful health care program when Governor of Massachusetts that was touted at that time as, The Conservative Answer.  Romney and the Republicans instead of embracing their Massachusetts success now try and distance themselves from the program despite that great success.  While Romney and the Republicans are now doing the dance that the Massachusetts model would not work in all states, they would probably prefer to have it both ways.  From their perspective to admit success and up their accomplishments in Massachusetts would be tantamount to conceding the election to Obama. Their tact? To always forward an agenda of limited government and state’s rights issues even though many states would probably never implement any health care reform requiring some form of additional federal assistance. 

The success of health care reform in Massachusetts despite similar, substantial condemnation makes it Romney’s Achilles’ heel (Santorum sure felt that way) and makes his criticism of what he calls Obamacare seem all the more contradictory.  Jon Gruber, PhD, professor of economics at the Massachusetts Institute of Technology (MIT) who helped Romney and Obama policy makers write both the Massachusetts and National laws states that, “The federal reform is simply a more ambitious version of the Massachusetts reform...”  David Cutler, Harvard economics professor who also helped policy makers draw up the law further offered, “Within three years, we should see that the federal reform has covered the uninsured and The Massachusetts law has turned out to be a success.  People have gotten coverage. They got coverage at the rate we thought, and at the cost we thought.”  Well, the Massachusetts model is already a resounding success.

Since the ranks of uninsured Americans have risen overall for four straight years and given all the debate surrounding the PPACA, I was trying to figure out just how many Americans are really uninsured but couldn’t put a finger on an accurate number.  Still can’t…  Gallup reported last month that 17.1 percent of Americans have no health insurance, up from 16.8 percent in 2010. It would appear that figure includes undocumented aliens.  Since most Americans (like me) feel that we have no responsibility to provide health coverage for illegal aliens, out those figures come. We should note that many in this classification get medical care on our nickel through health clinics and ERs. So, we subtract the estimated 11.2 million undocumented and illegal US immigrants from our current population of 313,827,000 souls and we reveal a current figure of 302,627,000. Given that the percentage quoted by Gallup also includes illegal aliens we adjusted and reduced that percentage by .04% to 16.97% and will use that as our basis to make the following computation.  So, an uninsured 16.9% of our current legal population of 302,627,000 equals an estimated total uninsured population of 51,143,963? Yikes!

These figures are absolutely unfathomable though honestly I haven’t seen credible evidence to discount them. Optimistically, this appears to be a snapshot in time, an average of any given day, week or month.  Any debate about health care means we must account for those who may be uninsured but are in transition or receive medical care elsewhere witness state and federal public healthcare screenings and services that includes Medicare and Medicaid, S-CHIP, etc.  In addition, I know there are young people enjoying good health who have little or no insurance and others who can afford to be insured but have chosen to opt out. Having said this, we do concede that even if we back out millions more, the uninsured figure is still just too high.  Many health care professionals and advocates speculate that the number is probably around 49 million Americans.

All this leads us back to the Republicans and Mitt Romney who have been successful in scaring the hell out of the American Public by providing speculation and claims on the ramifications of PPACA. They have already come under the heavy scrutiny of the aforementioned PolitiFact, FactCheck.org, Fact Checker (the Washington Post) and other like non-partisan, “consumer advocate” organizations who have found fault with many of their statements. 

We counsel and encourage a prudent evaluation of all assertions and statements from both sides of the aisle and note that all politicians including the Democrats and Obama have not escaped their scrutiny.  They are good, reliable yardsticks which taken in context are an important part of our system of checks and balances. Read their opinions and come to your own honest conclusions.  We note that many Republicans or Democrats when confronted with the truth disagree by merely throwing the ball back into the court of these organizations, labeling them as either “right wing” or “leftist” and therefore biased. Our opinion is that approach is intellectually weak and patently dishonest.

So, why address these issues now?  Well, I hear them bandied about in water cooler conversations and in a did you hear mode it’s apparent that folks believe that if stated – they must be true?  Let’s take a look at a few of the Romney and Republican claims about “Obamacare.”

20 MILLION PEOPLE WILL LOSE THEIR HEALTH INSURANCE?

Romney stated that "Obamacare … means that for up to 20 million Americans, they will lose the insurance they currently have, the insurance that they like and they want to keep."

Politifact Response – “That number is cherry-picked, and he’s wrong to describe it as only including people who "like" their coverage, since many of those 20 million will be leaving employer coverage voluntarily for better options. Romney also ignores that under the status quo, many more people today "lose" coverage than even the highest, cherry-picked CBO estimate. We rate his statement False.

DEATH PANELS

This was the offering of our least favorite hockey mom, “phony pioneer girl” and caribou murderer, Sarah Palin, who back in 2009 conjured up the existence of Death Panels that would ultimately determine whether seniors and the disabled were worthy of care and, if not, essentially providing a death sentence for them.  As reported by the esteemed and highly respected Leonard Pitts, Jr. of the Miami Herald, Palin has resurrected this assertion in a recent post, "Though I was called a liar for calling it like it is, many of these accusers finally saw that Obamacare did in fact create a panel of faceless bureaucrats who have the power to make life-and-death decisions about health-care funding.”  Of course, Palin doesn’t mention who these folks are and isn’t likely to do so as they don’t exist.

We suspect that Palin may have seen the 1976 movie, Logan’s Run one too many times.  The movie portrays a seeming idyllic society in 2274 run by a computer where citizens given a polluted earth live out their lives in the pursuit of pleasure in an enclosed dome.  Turns out that given the lack of room, on their 30th birthday all are required to submit to a quasi-religious ceremony known as Carousel where they are “renewed” to what end they do not know.  Carousel is nothing more than a huge bug zapper in zero gravity synched to music. Contrary to being reborn all 30ish citizens become so much carbon dust. Those who do not submit are hunted down and executed. There is much more to this movie and the statement about a future repressed and dystopian society. Though we may wish otherwise, we don’t though remain confident that there are no bug zappers waiting for us when we turn 65 or become a “burden on society.”

Back to real life - the U.S. Department of Health and Human Services, which oversees Medicare has confirmed time and time again that it has no age limit for treatment, there are no death panels, nor will there be.  Palin continues to do public service by opening her mouth validating the Republican defeat in 2008. As Leonard Pitts opined Palin’s death panel claims are, “about fear and the shameless manipulation thereof for political gain.”

Politifact gave this fabrication a Pants on Fire rating and honored this as their lie of the year in 2009.  FactCheck.org concurred.

Oh, by the way for the record, I eat meat, have a leather couch (and chair) and wear leather shoes and belts.  My grandfather was Range Master at the Massasoit Gun Club and for five years I shot expert (left-handed) in the NRA Junior program.  I have hunted and if required I would probably shoot an animal for food (I love venison), maybe even shelter but not for fashion, and unlike Palin, not for fun. Palin shot the caribou for her contrived and now cancelled TV show and for pure political spin.  The hunters I know think she is a fake, a wannabe that broke every cardinal rule of hunting.  Thanks for letting me rant…

OBAMACARE A GOVERNMENT TAKEOVER OF HEALTH CARE

We have heard this one offered by many Republicans including New Jersey Governor, Chris Christie.  Hoping to bring some inclusion into our post we were going to leave it at that.  It became clear, however, that this is one of the major claims and assertions brought by the Republicans.  So, we are going to lay this one at the feet of all such proponents within the GOP.  You know who you are.  Your numbers are legion…

By referring to the PPACA as "a government takeover of health care," Republicans are repeating a claim that’s been debunked so many times by various news organizations and non-partisan health care advocates as to heap ridicule on them for repeating it. Since the Republicans keep repeating this claim it’s clear they don’t care and like the way it plays politically.   

PolitiFact contacted seven health care experts from across the country and all reached the same conclusion that while the national reform greatly expands federal involvement, the law is largely built upon the existing private health insurance industry.  The PPACA “does not take over hospitals, and it does not offer government-sponsored insurance to all. It relies overwhelmingly on the free market, leaving in place employer-provided insurance and the popular Medicare program for people over age 65. It offers credits to Americans of modest means to help them buy private insurance.”

By no means is it a government takeover and PolitiFact recognized this claim as their 2010 Lie of the Year. Pants on Fire!  FactCheck.org concurred.

OBAMACARE WILL KILL JOBS!

We have heard this one for several years emanating from the US Chamber of Commerce, the National Federation of Independent Business (NFIB), Rush Limbaugh and many Republicans especially current Speaker of the US House of Representatives John Boehner who in a recent several minute speech repeated this claim 14 times.  Mitt Romney now proudly carries the “Kills Jobs” standard and repeats this claim wherever he goes. 

Politifact offers, “The NFIB report doesn’t appear to take into account the subsidies in the health care law, only the costs. Specifically, the Urban Institute report noted that firms with fewer than 50 workers will receive $4.5 billion in employer subsidies in the form of tax credits. Taking both premiums and assessments into account, "small businesses would save 8.7 percent compared with their current premium contributions," the report said. This means that smaller firms would actually have "lower costs of labor and should be more willing to expand employment."

Medium-sized firms, for their part, would find their premium costs drop modestly, though individual companies that do not already offer health care coverage could see notable cost increases. And large firms would see an increase in premium costs by about 1 percent overall.”

Henry Aaron, health care expert at the Brookings Institution has added that employment decisions are not as cut-and-dried as critics suggest. Aaron has noted that increased usage of the health care system because of the law should create jobs within the health care industry itself. These job gains should partially offset potential job losses elsewhere.  Aaron further offered that given all of these factors, "The rhetorical hysteria explicit in the term ‘job killer’ is enough to make one despair for rational public debate."

Politifact continues, "The US Chamber of Commerce (or anybody else) has failed to prove that it will, and the best projections we’ve seen, based on how the law is actually written, do not suggest that the law will "kill" jobs. A close look at the studies cited by the Chamber of Commerce in support of the ad -- as well as other independent analyses of the health care law -- provide little, if any, evidence that the health care law will result in a significant net number of job losses. We rate the statement False.” FactCheck.org concurred.

We could go on with predictably the same results addressing other absurd claims against PPACA though let’s address one more doozer of a claim and close this post out. 

OBAMACARE REPRESENTS THE LARGEST TAX INCREASE IN THE HISTORY OF THE WORLD

Politifact responded to this claim from many though attributes this one primarily to one of Rush Limbaugh’s grander rants (OK, my characterization), “The health care-related tax increases are smaller than the tax increase signed into law by President Ronald Reagan in 1982 and a temporary tax signed into law in 1968 by President Lyndon B. Johnson. And they are significantly smaller than two tax increases passed during World War II and a tax increase passed in 1961.

Politifact does concede that, “The tax increases in the health care legislation do reverse a trend of federal tax cuts and represent the first significant tax increases since 1993. But they are not the largest in the history of the United States.

And -- despite what Limbaugh said -- that means they cannot be the largest ever in the history of world. Limbaugh's inflated rhetoric takes a wrong claim and puts it into the realm of the ridiculous. We rate it Pants on Fire.”  Fact Checker and FactCheck.org concurred.

Conclusion: Our caution and the purpose of this post is to keep an open mind and investigate the claims made by all politicians, Republican, Democrat, Libertarian, Green, etc. If it’s not obvious political spin look beneath the surface for the truth of the matter. Seek out respected, unbiased sources that don’t have a vested interest - save the truth. Use your common sense and separate reality from fantasy.
 
If I believed half of the claims referenced in this post, I’d be mad as hell too.  I would arm myself with the real facts and then pass the message on to Friends, Family, anybody else who would listen to me and then run to the polls to express my views. If, as many are reporting, that the Republicans fully intend to gut Medicare - a benefit I have literally invested in and paid for with a lifetime of work, then you haven’t seen anything yet. I suspect that will be the reaction of many Seniors who represent a substantial, dynamic and viable block of voters.   

Leonard Pitts' appropriately summed up the current political spin, talking head mind-set that has corrupted the public domain in a recent article responding to Palin’s resurrection of her absurd Death Panel claims.
  
"Not long ago, if you told a whopper like Palin's and it was as thoroughly debunked as hers was, that would have ended the discussion. These days, it is barely even part of the discussion. These days, facts seem overmatched by falsehood, too slow to catch them, too weak to stop them…

Indeed, falsehoods are harder to kill than a Hollywood zombie. Run them through with fact, and still they shamble forward, fueled by echo chamber media, ideological tribalism, cognitive dissonance, a certain imperviousness to shame, and an understanding that a lie repeated long enough, loudly enough, becomes, in the minds of those who need to believe it, truth…

It seems that not only are facts no longer important, but they are not even the point. Rather, the point is the construction and maintenance of an alternate narrative designed to enhance and exploit the receiver's fears, his or her sense of prerogatives, entitlement, propriety and morality under siege from outside forces…

This is the state of American political discourse… where a sense of dislocation, disaffection, and general been-done-wrongness has become sine qua non, coin of the realm, lingua franca of the true believers — and of their true belief in the desperate need to turn back the unrighteous Other and his unwelcome change…

The result of which is that Americans increasingly occupy two realities, one based on the conviction that facts matter, the other on the notion that facts are only what you need them to be in a given moment…"

I embrace Pitt’s sentiment but also hope that we have time to stop this runaway train by embracing the mantle of truth.  No more wink and nods or blind acceptance of “tsunamis of misinformation that swamps all serious political thought.”  Listen and act responsibly and hold people accountable for their words and actions. On that we can all agree then get along with the work of life and live a little more humanely in the process.

Aye,

Ned Buxton

Special thanks to Kay Plumb author of Shadow in the USA, illustrated by Bob Hobbs for permissions to use their Eagle at the Podium graphic.  Well done, Aye. NB

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