Paul Krugman is leaving Princeton next year to join the faculty of the Graduate Center, City University of New York and be near Zabar’s. I don’t blame him. If I was nearer to retirement I might consider moving back towards Ann Arbor to be closer to the academic atmosphere of the University of Michigan Zingerman’s.
Liberal Values Defending Liberty and Enlightened Thought
Paul Krugman Leaving Princeton To Be Closer To Zabar’s
February 28, 2014 — Ron ChusidConservative Horror Stories About Small Business No More Valid Than Their Other Horror Stories
February 28, 2014 — Ron ChusidWith millions now receiving health care coverage through the Affordable Care Act we are seeing that the horror stories being spread by conservatives are not true. There are no death panels. We do not have a government making health care decisions as people signed up under “Obamacare” are receiving the same types of insurance (except with more comprehensive coverage) than was present before. Those of us who received letters that our old insurance was canceled have replaced our old plans with better plans, and for most people the out of pocket costs are lower. The horror stories about people with greatly more expensive or less comprehensive coverage are being debunked whenever the facts are examined. Now we are seeing the same types of misinformation being spread about insurance for small business.
This story about a restaurant chain adding a 1 percent surcharge for health care to cover its employees is getting the conservatives all excited. This shows a lot about both how gullible these conservatives are along with their warped priorities.
This is clearly political posturing by a businessman who has become upset about the Affordable Care Act from right wing misinformation. The mandate for small business has not even come into effect yet. When the mandate does come into effect, there will also be tax breaks and credits to make this more affordable. This fee has nothing to do with actual charges. Besides, as the story points out, “Thirteen other Gator’s Dockside restaurants, which are run by a different firm and its franchisees, are not implementing the fee.” This adds further reason to question why this owner found reason to add this fee on now.
Lots of people are using Obamacare to justify increasing prices but this does not mean that this is true. I had a supplier increase their prices in July 2013 blaming it on higher costs because of the Affordable Care Act, claiming they could not get by without the increase. I subsequently changed to a different supplier who managed to offer me significantly lower prices.
However, for the sake of discussion, even though they are probably overestimating the cost, let’s assume this is correct. It is still political grandstanding to make this a separate item on the bill. Lots of businessmen might have objected to the Iraq war, but did not put on a separate surcharge for the portion of their taxes which went to pay for the war.
Even if this probably inflated number is correct, would it be all that bad if people paid an extra twenty cents for a meal to provide health care coverage for the employees? Conservatives show their priorities when the whine about this extra charge but ignore all the extra people who will receive health care coverage. Besides, I would prefer that people handling my food are healthy.
Even if their selfish concern is that they might have to pay an extra twenty cents here and there, they are also forgetting that they are already paying money because of all the people working in restaurants and elsewhere who are currently not insured. The price to cover the unemployed is factored into medical bills. It results in increasing their insurance premiums and increasing taxes because of government programs which help reimburse hospitals for care of the uninsured. In the long run other health care costs will go down as the number of uninsured is decreased.
We are also bound to hear complaints that health care premiums for many small businesses will go up once they start providing health care coverage which is compliant with the requirements of the Affordable Care Act. Some increases in premiums are inevitable because small businesses purchasing insurance have been in a similar (sinking) boat as those buying insurance on the individual market. Double digit increases have been common and just being a year or two later would mean an increase.
Many small businesses could only afford to purchase policies which were no better than the junk policies often sold on the individual market which did not provide meaningful coverage. I have seen many patients with insurance policies which only provided limited coverage for out-patient services as opposed to hospitalizations, or vice versa. I have seen patients whose insurance policies covered two office calls a year, and then they reached their limit. How many people consider both annual limits and life time limits when comparing polices under the Affordable Care Act to their older, less expensive insurance? How much more is it worth for insurance which has no limitations for per-existing conditions and which never can be canceled should someone become sick?
It will cost more to provide more comprehensive coverage than was available to small business in the past, but it does not appear that the cost will be a serious problem, even before we factor in the tax breaks being offered. I’m finding that the premiums for the insurance I provide to my employees is going to go up, but by a relative modest amount considering how much better the policy is compared to what I could afford to provide in the past.
Health care coverage has always been expensive, and we will always have to deal with this fact. Despite this, and all the fake horror stories from the right wing, we are finding that both people buying insurance on the individual market (as I do for my family) and buying insurance for small business (as I do for my employees), are doing much better than before the Affordable Care Act. Those of us who have checked out the actual numbers as to what insurance costs and have compared what is covered are certainly not fooled by the right wing horror stories. Despite people like Ted Cruz still talking about trying to repeal the Affordable Care Act, far too many people are benefiting from health care reform to take repeal seriously.
Cross posted at The Moderate Voice
Why Do Republicans Hate Veterans?
February 27, 2014 — Ron ChusidSenate Republicans have blocked a Democratic proposal to increase veteran’s benefits. The Hill reports:
Senate Republicans stopped Democrats from advancing a bill that would have expanded healthcare and education programs for veterans.
In a 56-41 vote Thursday, the motion to waive a budget point of order against the bill failed, as Democrats fell short of the 60 votes needed to overcome the Republican roadblock.
GOP Sens. Dean Heller (Nev.) and Jerry Moran (Kan.) voted with Democrats.
Senate Majority Leader Harry Reid (D-Nev.) refused to allow a GOP substitute amendment to get an up-or-down vote because it included Iran sanctions, which he said were unrelated to veterans’ issues.
“I hope all the veterans groups have witnessed all the contortions the Republicans have done to defeat this bill,” Reid said Thursday. “Shame on Republicans for bringing base politics into a bill to help veterans.”
Why do I have a sense of deja vu in reading this story? Maybe because it has become quite common for Republicans to pretend to support the vets while opposing benefits backed by Democrats. A quick Google search for Republicans oppose veterans benefits brought up plenty of hits from previous examples.
Veterans–one of many groups who vote against their self-interest when they vote for Republicans.
Rand Paul Blocks Surgeon General Nomination For Calling Guns A Health Threat
February 26, 2014 — Ron ChusidRand Paul has placed a hold on Dr. Vivek Murthy, Obama’s nominee for Surgeon General, because of calling guns a significant public health threat. Paul stated, “As a physician, I am deeply concerned that he has advocated that doctors use their position of trust to ask patients, including minors, details about gun ownership in the home.”
As I have discussed before, this position is based upon recommendations of medical organizations which are justifiably concerned about the health risks of gun violence in this country. Following the Newton shootings fifty-two medical organizations including the American Medical Association, American Psychiatric Association, American College of Physicians, American College of Surgeons, American Academy of Family Physicians and American Academy of Pediatrics sent a letter to President Obama requesting such intervention.
The text of the letter (pdf here) follows (emphasis mine):
The undersigned medical organizations, together representing the vast majority of practicing physicians and medical students in the United States, share the nation’s grief and sadness over the recent tragic school shootings in Connecticut. As physicians, we see first-hand the devastating consequences of gun violence to victims and their families. We offer our experience and expertise in finding workable, common sense solutions to reduce the epidemic of gun violence—indeed the overall culture of violence—in America. We also urge the nation to strengthen its commitment and resources to comprehensive access to mental health services, including screening, prevention, and treatment.
The investigation into the Connecticut shootings is still continuing, and the issues surrounding such violence are often complex and can vary significantly from case to case. Strategies for preventing gun-related tragedies must also be complex and carefully considered. The relatively easy access to the increased firepower of assault weapons, semi-automatic firearms, high-capacity magazines, and high-velocity ammunition heightens the risk of multiple gunshot wounds and severe penetrating trauma, resulting in more critical injuries and deaths. Even for those who manage to survive gun violence involving these weapons, the severity and lasting impact of their wounds, disabilities and treatment leads to devastating consequences for families affected and society, and contributes to high medical costs for treatment and recovery. Renewing and strengthening the assault weapons ban, including banning high-capacity magazines, would be a step in the right direction.
Many of the deaths and injuries resulting from firearms are preventable. More resources are needed for safety education programs that promote more responsible use and storage of firearms. Physicians need to be able to have frank discussions with their patients and parents of patients about firearm safety issues and risks to help them safeguard their families from accidents. While the overwhelming majority of patients with mental illness are not violent, physicians and other health professionals must be trained to respond to those who have a mental illness that might make them more prone to commit violence. Funding needs to be available for increased research on violence prevention in general, and on the epidemiology of gun-related injuries and deaths in particular, as well as to implement available evidence-based interventions. Of equal importance is providing sufficient access to mental health services. While we strongly supported the passage of the Mental Health Parity Act of 2008, unfortunately, the promise of better access top psychiatric treatment will not be a reality absent requisite federal and state funding. This effort should be combined with an education campaign that reduces the stigma of seeking mental health services.
Newtown, Connecticut has now been added to the sad litany of recent mass shootings, including Columbine, Virginia Tech, Fort Hood, Arizona, and Aurora. As we come together as a nation to mourn the most recent victims of senseless gun violence, we must make a real and lasting commitment to work together on meaningful solutions to prevent future tragedies. We stand ready to work with Congress and the Administration to make progress in protecting our communities, especially our children, from this epidemic of violence.
We would expect that a nominee for Surgeon General would support the recommendations of these medical organizations. Discussing the presence of guns in the home does not mean these medical organizations are advocating banning guns. Medical organizations recommend that physicians ask about a wide variety of potential risks. When we ask patients about use of seat belts we are not seeking to ban automobiles. When we ask elderly patients about electrical cords which could present a risk for falls we are not seeking to ban electric lights. When we discuss keeping medications safe and out of the hands of children we are not seeking to ban medications.
Think Progress has more on how Rand Paul’s view is out of step with that of the medical profession:
The idea that gun violence is a danger to public health is utterly uncontroversial among doctors’ groups, academic institutions that focus on public health, and children’s safety advocates. Although Paul criticizes Murthy’s position that physicians and pediatricians should ask patients about the presence of guns in their households, the American Medical Association (AMA) adopted a resolution in 2011 officially opposing any law that bars doctors from having open conversations about gun safety and the risks of having firearms in a household with their patients.
In fact, just yesterday, the American Academy of Pediatrics (AAP) issued new guidelines recommending that households with children who are diagnosed with depression should remove guns and ammunition from their homes entirely.
Not only would Obama’s nominee for Surgeon General be making recommendations in the mainstream of medicine today, Murthy’s views are consistent with those of Reagan-appointee for Surgeon General C. Everett Koop who has written about the dangers of gun violence.
Cross posted at The Moderate Voice
Republican Health Care Proposal Would Remove Employer Coverage From One Million And Increase Deficit
February 25, 2014 — Ron ChusidThe Affordable Care Act is a great idea in principal, increasing the number of people with coverage and eliminating the abuses from insurance companies which had destroyed the individual market. So far it has been working out well as policy beyond the initial IT glitches. Republicans have repeatedly brought up horror stories, but each time they have turned out to be false when the details were examined (see here and here). Considering the complexity of the law it is certainly possible that some of the details might be improved upon. It also would not be surprising if the Affordable Care Act had aspects which might need changes considering the manner in which it was passed after the Democrats lost sixty votes in the Senate (in these days in which sixty votes are needed to pass anything of consequence over a Republican filibuster). Rather than passing the House bill, which I thought was better, or going to a Conference Committee to work out the differences between the two bills, it became necessary for the House to pass the Senate bill without any changes.
Republicans have been complaining a lot, but have not been very successful in suggesting improvements. Their overall health care proposals, on the rare times they bring one up, would increase out of pocket expenses for most Americans while increasing the number of uninsured. Republicans are now promoting a bill with some adjustments to the Affordable Care Act. Their plan is to change the definition of a full time employee from thirty to forty hours per week in order to reduce the impact of the requirement for companies with over fifty full time employees to provide insurance or pay a penalty.
The Congressional Budget Office came out with their analysis of this bill today (pdf here). The result would be to 1) reduce the number of people receiving coverage thorough employers by one million people, 2) increase the number of people obtaining coverage through Medicaid, CHIP, or the exchanges by between 500,000 and one million, and 3) decrease the number of insured by up to 500,000. As a consequence of the costs from these changes, the deficit would be increased by $25. 4 billion between 2015 and 2019. The deficit would be increased by $73. 7 billion between 2015 and 2024.
The irony here is that after the Republicans have made a lot of noise about policy cancellations (ignoring the fact that most of those who had policies canceled wound up receiving better coverage at a lower cost) it has repeatedly been their plans which would lead to more people losing insurance coverage. Another irony is the name of this Republican plan: The Save American Workers Act. How are they saving workers by reducing the number who receive health care coverage?
Cross posted at The Moderate Voice
Quote of the Day: Bill Maher on Democrats and Republicans
February 25, 2014 — Ron Chusid“New Rule: This Valentine’s Day Americans must remember that politicians are like a box of chocolates. We bite into them to find out what’s on the inside only to discover that Democrats are too often soft and gooey and Republicans are mostly nuts.” –Bill Maher
Fake Right Wing Claims Of Losers Under The Affordable Care Act
February 24, 2014 — Ron ChusidLast week I looked at the right wing’s inability to present losers under Obamacare. There certainly are some losers in a major overhaul of the healthcare system, however they just don’t help the Republicans with their line of attack. The losers, i.e. people paying more in premiums, are affluent Americans who don’t qualify for subsidies but, as I pointed out in the previous post, we still receive significant improvements in coverage to offset higher premiums which we can afford to pay. The types of people the Republicans portray as losers to gain sympathy for their argument have repeatedly been shown to not be losers under Obamacare once the facts are revealed. Anybody with serious medical problems such as cancer is far better off since the Affordable Care Act was passed, regardless of how the Republicans try to twist the facts.
Paul Krugman revisited this issue today, comparing the false claims of losers under the Affordable Care Act to the right wing claims of non-wealthy people being losers under the “death tax.” Krugman wrote:
I’m not sure whether conservatives realize yet that their Plan A on health reform — wait for Obamacare’s inevitable collapse, and reap the political rewards — isn’t working. But it isn’t. Enrollments have recovered strongly from the law’s disastrous start-up; in California, which had a working website from the beginning, enrollment has already exceeded first-year projections. The mix of people signed up so far is older than planners had hoped, but not enough so to cause big premium hikes, let alone the often-predicted “death spiral.”
And conservatives don’t really have a Plan B — in their world, nobody even dares mention the possibility that health reform might actually prove workable. Still, you can already see some on the right groping toward a new strategy, one that relies on highlighting examples of the terrible harm Obamacare does. There’s only one problem: they haven’t managed to come up with any real examples. Consider several recent ventures on the right:
■ In the official G.O.P. response to the State of the Union address, Representative Cathy McMorris Rodgers alluded to the case of “Bette in Spokane,” who supposedly lost her good health insurance coverage and was forced to pay nearly $700 more a month in premiums. Local reporters located the real Bette, and found that the story was completely misleading: her original policy provided very little protection, and she could get a much better plan for much less than the claimed cost.
■ In Louisiana, the AstroTurf (fake grass-roots) group Americans for Prosperity — the group appears to be largely financed and controlled by the Koch brothers and other wealthy donors — has been running ads targeting Senator Mary Landrieu. In these ads, we see what appear to be ordinary Louisiana residents receiving notices telling them that their insurance policies have been canceled because of Obamacare. But the people in the ads are, in fact, paid actors, and the scenes they play aren’t re-enactments of real events — they’re “emblematic,” says a spokesman for the group.
■ In Michigan, Americans for Prosperity is running an ad that does feature a real person. But is she telling a real story? In the ad, Julia Boonstra, who is suffering from leukemia, declares that her insurance has been canceled, that the new policy will have unaffordable out-of-pocket costs, and that “If I do not receive my medication, I will die.” But Glenn Kessler of The Washington Post tried to check the facts, and learned that thanks to lower premiums she will almost surely save nearly as much if not more than she will be paying in higher out-of-pocket costs. A spokesman for Americans for Prosperity responded to questions about the numbers with bluster and double-talk — this is about “a real person suffering from blood cancer, not some neat and tidy White House PowerPoint.”
Even supporters of health reform are somewhat surprised by the right’s apparent inability to come up with real cases of hardship. Surely there must be some people somewhere actually being hurt by a reform that affects millions of Americans. Why can’t the right find these people and exploit them?
The most likely answer is that the true losers from Obamacare generally aren’t very sympathetic. For the most part, they’re either very affluent people affected by the special taxes that help finance reform, or at least moderately well-off young men in very good health who can no longer buy cheap, minimalist plans. Neither group would play well in tear-jerker ads.
No, what the right wants are struggling average Americans, preferably women, facing financial devastation from health reform. So those are the tales they’re telling, even though they haven’t been able to come up with any real examples.
Even the healthy young people are able to buy catastrophic insurance policies which, once subsidies are considered, will often cost less then their current minimalist plans.
Cross posted at The Moderate Voice
