Monday, December 30, 2013

Rhode Island starts paid family leave law; CA law documented; "moral hazard" controversy over paid family leave continues

Rhode Island, starting Jan. 1, will require employers to allow workers several weeks of paid family leave for childbirth (or adoption) or to take care of seriously ill relatives (usually elderly parents).
Brigid Schulte has a story in the Washington Post Monday, p A3, link here
This article appears to discuss state laws that would apply to all employers, not just state and municipal public employees.
There is very little movement in this area at the federal level.
There would be objection in that people who do not have children are subsidizing those who do (including their marital sex).  But paid family leave has been common in most western European countries for years without causing a controversy about “moral hazard”.  Furthermore, the laws would protect workers with ill parents, and the childless or only children are more likely to need the benefit when applied to caring for aging parents.

Paid family leave could be a bigger for salaried exempt workers.  If someone can't come to work (and doesn't continue working at home), others might have to work more hours, sacrificially, without compensation at all. 
Paid family leave could have been very helpful to me in 1999, when my own mother suddenly needed coronary bypass surgery, although the decision to do the surgery was viewed controversial at the time by some of her doctors.  We hired home health aides to do the eldercare, after two weeks in an SNF nursing home for rehab, where she was put at risk by carelessness by staff with respect to medical instructions.  I’ll probably come back to this incident again in future posts.
California’s Paid Family Leave Law from 2010 (up to 55% of pay to a maximum benefit) is described here by Kerianne Steele. 
In California, job protection still comes from the FMLA or the CFRA (regular family leave) law, and health benefits are not automatically covered. It's interesting that the California law will allow time to bond with a biological, natural or even foster child. 

Saturday, December 28, 2013

Extended unemployment benefits expire; some GOP pundits plays scrooge on the issue, saying some people should accept a lower station in life

On this last Saturday of 2013, as the extended unemployment benefits for millions of Americans expire as part of the “budget final solution”, Brad Plummer of the Washington Post offers “7 things to know about expiring jobless benefits”, link here.
The biggest concern is that people remain unemployed a long time, they become less employable.  Their skills atrophy.  Employers, rationally or not, see the as personally “the biggest losers”.  And conservatives preach that long term unemployed should just swallow their pride and start over as minimum wage workers. It’s tough love time.  Seantor Jon Kyl of Arizona made some typical comments, as reported by Huffington, here
It seems there will be political pressure in January to restore some of the benefits.
I had to toy with the low wage market (so well documented by Barbara Ehrenreich in her 2001 book “Nickel and Dimed”   One of the issues that comes up in this market is hucksterism, the ability to “sell” and manipulate people, “overcome objections” and “create urgency” which is often false.  I ran into this both selling concert subscriptions over the phone, and as a debt collector.
It’s disturbing to see how this has gone, with desperate telemarketing schemes (barely within the law), and email spam schemes.  People simply do not like to be approached to buy things from salespersons;  this is a massive cultural change from my parents’ generation, where “sales people” were better respected.
Some people might feel drawn into selling unusual products or services that, however legal, might be unsettling, and require permanent appearance changes.  Imagine trying to sell tattoo services, or even (as a male) "No no". 
And at the same time, manufacturing goes offshore, as does a lot of software support, although in recent years there have been spotty but encouraging signs that some manufacturing will return to the US as China and other countries find it harder to deal with the problems of exporting cheap labor.
All of this is colored by the debate over the minimum wage, which many cities (including Washington DC) have been trying to increase locally, but the end result will be fewer jobs. 
Noam Chomsky could be right.  There are elements of eventual warfare in all this.

Friday, December 27, 2013

Health exchanges hire college students to troll bars to sell health insurance to "invincibles"

State exchanges are hiring college and graduate students to try to sell health insurance to the “young and healthy” to support the whole mandatory coverage idea in Obamacare.  And employees are expected to troll bars and restaurants late at night, sometimes in less safe parts of many cities, to try to get young adults to sign up.  Often, the employees sign the people up as they have more dedicated technical connections to the somewhat unreliable servers.  The story about selling to “young invincibles” by Ariana Eunjung Cha is here
The Washington Post, on Christmas Day, described the work of a Howard University student working for DC Health Link,  trolling restaurants in NE Washington at night, not a really safe idea.  I wouldn’t want to do this. 
It reminds me of the way insurance companies approached retirees to sell Medicare Advantage and even long term care insurance.

The premiums being charged the young adults sound too high.  Hospitals just shouldn’t be charging $500 a stitch for emergency room injury patches.  But young adults do have accidents, do sometimes get testicular or breast cancer, or unusual sarcomas or lymphomas, or even HIV.  And they are exposed to meningitis (and I want to emphasize that the new “Type B” vaccine needs to get approved and get to campus health departments quickly.   

Sunday, December 22, 2013

Fareed Zakaria says that the needs of the poor is a more pressing problem than middle class stagnation in the US

Fareed Zakaria today, on his CNN Global Public Square program, encouraged viewers to visit his Washington Post perspective, “The ‘defining challenge’ of helping the poor”, link here Zarkaria argues that the problem if the poor is somewhat separate from middle class income stagnation,  chronic unemployment in much of the middle class, and the growing aloofness and wealth share of the super rich.  In some ways, he argues, the United States is actually closer to egalitarianism than much of “quasi-socialist” Europe.
Indeed the Bible, including the New Testament, the Torah and the Koran all accept the idea that the poor will always be around and that inequality in any dynamic society is unavoidable.  And it seems to be constantly encroaching.  Yet, as far back as 1974, after the oil shocks, I recall the appearance of a book by Paul and Anne Ehrlich from Ballantine, “The End of Affluence” with a chapter called “The New Poor”. 
So while it seems that poverty at first begs for public policy solutions, ultimately it has a personal aspect that is unavoidable.  I can recall a local teenager preaching about this at a testimonial in 2012 (Drama blog, Feb. 26, 2012).  When confronted by someone asking for a handout or a hand up directly, it is hard to respond.  There are indeed some “professional pandhandlers”, and sometimes stopping to assist involves some real risk.  (That can cut both ways.  I have a posting on this on the “Bill Boushka” blog Feb. 25, 2009.  Once, I got a lift from two strangers, on Md. US 301, in September 1992, when I got separated from my group while on a bike hike, after a storm in Delaware.) 
The hardest thing in the “personal involvement” issue is communication with the person who needs help.  I often find that a “poor” person doesn’t see or experience the world cognitively the way I (or my contemporaries in modern culture) would, and doesn’t understand “personal responsibility” the way one has to in an individualistic society.  And a lot of the reason the person doesn’t is luck and circumstance.  There could be genetics involved, or simply a background where the person did not learn from parents or schools how to function in our world.  So the person has fallen into a cycle of poverty, and meets indifference from others.  

Friday, December 20, 2013

Visit the Rubenstein Gallery's "Records of Rights" at the National Archives

Yesterday I visited the David M. Rubenstein Gallery and its Records of Rights at the National Archives in Washington DC.
No photography is allowed inside the Archives, but practically every poster or visual element is available online, here. The material is public domain and can easily be photographed from the web. 

The gallery presents the same history of civil rights available at the Newseum and at the Smithsonian (which will house an African-American history museum starting in 2015).  There are photographs from the Birmingham incidents, the Selma march, and the March on Washington.  In the early 1960s, Alabama seems to have been the very worst state with respect to segregation, with Mississippi not far behind, and perhaps also Arkansas.

There is also a large collection of documents, going back to the Magna Carta, but tracing the course of discriminatory laws often used against minorities and immigrants until after the Civil Rights movement. 
Some of the items receiving particular detail are the 15th Amendment, the 19th Amendment, the unratified Equal Rights Amendment for women (and the arguments that were used against it), the deed for the gift of the Statue of Liberty, and the Chinese Exclusion Act. 

I covered on the LGBT blog yesterday the documents on the rights to privacy and sexuality.

Monday, December 16, 2013

A tour of the sites of Nat Turner's Slave Revolt and Bacon's Rebellion, in southern VA

In trying to document the history of civil rights by travel, as much as practical, I visited a couple sites in Virginia, south of the James River, on Sunday afternoon.

One of these was “Bacon’s Castle”, between Surry and Smithfield VA, about fifty miles SE of Richmond (on the other side of the James from Jamestown).  The home is one of the oldest standing brick structures in colonial America, dating from 1665, in Jacobean style.  The living quarters look simple compared to colonial Williamsburg.  Indoor photography is not allowed, but a brochure includes indoor pictures of the rooms.  The history is important, because “Bacon’s Rebellion” in 1676 (100 years before independence) was one of the first uprisings against a British colonial governor (Berkeley) for failing to help the colonists defend themselves against native American.  But a modern person can turn this around and maintain that it is an early episode that shows that America was founded in part by taking away land and territory and “conquering” native Americans, leading to bad karma, or at least to today’s reservation system.

Another forty miles, back to the SW, almost on the North Carolina line, is the town of Courtland, founded in 1886, but previously called “Jerusalem”.  The town contains some of the relics of Nat Turner’s Revolt or Slave Rebellion of 1831, including the Rebecca Vaughan House and Mahone’s Tavern.  See the TV blog entry for Nov, 5, 2013 of the PBS “Many Rivers to Cross” episodes.  The Vaughan house is on a platform and appears to have been moved, and apparently is going to be part of an outdoor forestry group museum.  The placard says that the House marks the last place where white slave owners were killed.  The incident shows that gross injustice, to which people born into a system of privilege are often oblivious, sometimes is remedied by direct conflict or a “purge”.  Slave owners sent reinforcements from North Carolina.  The rebellion would be seen as terrorism today, and it probably added to racist laws in the years leading to the Civil War, including the returning of slaves who had escaped to the north, perhaps to their kidnapping (as in the movie “12 Years a Slave”, movies blog Oc. 19. 2013), and also precluding the education of slaves.

The Revolt happened after the sky turned green, apparently because of a volcanic eruption in the Pacific Northwest, but Turner took the sky as a sign/ 

The wiki for the Revolt is here.

Note the curious "Victory Baptist Church" in Courtland (aka Jerusalem),  I have been to a similarly named church in the Pleasant Grove area of Dallas, TX. 

Friday, December 13, 2013

Freelance artists in New York finding their own guild health coverage being cancelled to force them as "healthies" into the individual Obamacare market

Artists, writers, musicians, filmmakers and the like, who have been getting health insurance from their own voluntary associations built with the freelance market, are finding that their policies are getting cancelled, and that the individual market coverage available to them will be much more expensive, offer fewer doctors, and require more copays. 
But the reason for the cancellations or declinations is not directly that the old policies failed to meet the legal requirements of Obamacare. It’s more about the idea that under the Affordable Care Act, these “freelancers” are all individuals, responsible for their own insurance, so they are forced to “play” into the market, often as the “healthy young adults” needed to provide premium support for the sick.  So they are limited now in their ability to organize to pay for their own insurance.  Of course, you can argue they are paying for their own future care a few decades hence. Or they’re paying for that horrific bicycle accident or unusual cancer.
Anemona Hartocollis has the New York Times story today here. The Kaiser Family Foundation is also covering the problem here
Many of the artists tended to be politically liberal and support Obama and the initiative for his Affordable Care Act.
I do wonder how about his affects guilds in Hollywood like SAG and WGA, even though the news story focused on New York State, which has so far declined to allow the associations to continue offering the older policies during Obama’s new grandfathered grace period.

Wednesday, December 11, 2013

Is Congress playing Scrooge on extended unemployment benefits?

In The Washington Post on Wednesday, December 11, 2013, Ruth Marcus gives a strong tonguelashing on p. A19, “That Scrooge Rand Paul”, titled online “Rand Paul shows no heart for the unemployed”, link here.  He's probably not the only one in Congress, at least the GOP. 

Marcus does give some heed to Rand’s ideas of “moral hazard”, but points out that in a poorly functioning economy, with a weaker middle class (“Inequality for All”), the idea of taking away benefits really won’t incentivize grunt work, it will just cause homelessness.
Oh, yes, I recall the implorations of previous recessions.  Yup, “do grunt work, turn to friends and family.” 

After my own career “imploded” (so to speak) at the end of 2001, I learned what it was like to interview for menial, low wage jobs, some involving hucksterizing, and thinking this was my new moral place, after “re-education”.
I was told by ING that my unemployment could not start while severance was being paid, but later the state of Minnesota told me they had been wrong.  But I was qualified for $11,600 in benefits, payable for a period over 12 months, starting at any time, reduced  by other income and stopped any week in which I worked for more than 32 hours. I had a part time job selling for the Minnesota Orchestra and then full time as a debt collector (irony), so I stretched it out.  I wound up collecting “only” $6500.
I wonder if social media or Internet presence could be looked at as interfering with a job search, according to regulations.  That wasn’t much of an issue in 2002, but I did bring it up at one of the “Minnesota Workforce” classes, which (once a week, for two hours, somewhere on Lyndale Ave. in Minneapolis) were mandatory.  

Update: Later Wednesday

A tentative budget deal reported today from the committee does not extend unemployment benefits. 

I "paid" $1 to a homeless man on Dupont Circle for that picture above.  I guess that's the "free market",  I have no way of knowing if he was genuinely homeless or panhandling.  

Friday, December 06, 2013

Flood insurance reform is very double-edged. and may not work well for many working-class river communities

Letters to the Editor of the Wall Street Journal have a lot to say about how the Biggert-Waters Act of 2012 (the Flood Insurance Reform Act of 2012) affects non-wealthy homeowners, especially those how live near rivers in working class communities.
FEMA has a page on the Act, which warns that premiums for flood insurance can increase for some but not all homeowners, link here.

Some indignant homeowners weigh in on Journal, p. A18, here  and refer to a WSJ editorial Dec. 2 “Flooding Taxpayers Again.”
Wright Flood covers the “NFIP basics” of flood insurance reform here.

Much of the DC and northern Virginia area, where I live, is hilly with many homes 50-100 feet above any moving water (although civil engineers routed some small streams into underground culverts in the 1950’s – maybe that’s a time bomb, or maybe the practice could even cause sinkholes).  When I lived in Dallas, my Pleasant Grove condo was about a half mile from a stream, but the area was much flatter.  There is a tendency to scoff at people who “take risks” by buying property close to water, but they aren’t always “rich” and many times, in mountain hollow communities in Appalachia (I drive through them all the time) there is no real choice.  And there’s no real way to avoid risk for people raised along the Gulf Coast or in the southern plains, and with climate change, the risk to insular homeowners will gradually increase.
Should “luckier” homeowners become prepared to shelter others?  Will this become a civic expectation in the future?

Thursday, December 05, 2013

Fast food workers working on government property as contractors make a good point in demonstrations

Fast food workers are walking off the job around the country today, and the one-day strikes particularly aim at federal installations, where organizers say that the federal government is lax on contractors and that many employees of contractors wind up on public assistance, especially Medicaid and food stamps, making this a lose-lose policy even for the consuming public and taxpayer.

People have the impression that fast-food work is mostly teens and high school students, where wages don’t matter.  In many locations and smaller towns across the country, that obviously isn’t true.
It’s interesting to me to notice McDonalds tearing down and rebuilding old stores for little apparent reason while there are wage controversies. 

It’s hard to imagine who would want to own one of these franchises. 

Wages at the new Wal-Marts in Washington DC remain controversial, as politicians say that higher super-minimum wage laws in the District and Maryland will drive business to Virginia, which is much less likely to cooperate politically because of its “red state” politics away from the DC suburbs, Richmond and Tidewater cities.  

Wednesday, December 04, 2013

Obama warns on income disparity, GOP keeps punting to "family values"

President Obama today, in a brief speech, called great income inequality a drag on the economy and possibly a national security threat, at least at home, making the world dangerous and unstable for more Americans.  That view, painting crime as a kind of class warfare, has sometimes been expressed on the Left, as for instance by Noam Chomsky. USA Today has a story here
On the other hand, the Examiner (which now prints only weekly) offers an article by Michael Barone, “Will GOP propose tax cuts to strengthen two-parent families?”, link here
The article didn’t exclude same-sex couples.  But the hint is that people are less interested in having families and marriages at all because of hyperindividualism.  But the case can be made that there are fewer families because wages are not increasing.  Actually, it would seem that lower wages would particularly decimate the one-earner two-parent family of the past.
Media reports indicate that Congress may well let extended unemployment benefits stop on Dec. 31.
In the background, don’t forget about the idea of “National Service”.  An old CNN story (“Where will you give your year of service?”) from June 2013 about the “Plan of Action” popped up on my iPad today and rather startled me.   

I In fact, Dana Milbank, Sundary, wrote an op-ed calling to a return to military conscription here, and a reader wrote to the Post Thursday that "compulsory" service should offer alternatives in the usual modes of national service where there are developmental needs, like the Peace Corps.

I And in The Washington Times, Thursday, Andrew Napolitano ({Pope Francis should be saving souls, not pocketbooks" writes (article link)   "Traditional Catholic social teaching imposes on us a moral obligation to become our brothers' keepers ... If you give until it hurts, freely out of love and seek nothing temporal in return, you have built up treasure in Heaven."  Giving "until it hurts" means giving "when it costs you something" in terms of your own life purposes, according to a local minister here.   He gives an example that it is better to teach a man to fish than just to feed him with "Free Fish".  (Yup, "Reid Rainbow" even has a point there in his satirical video on the idea.)  Here it gets personal.  It is easier to help (and sometimes teach) others with whom you already communicate or have some psychological stake, however distant and non-material or even unperceived by the recipients in normal terms.  I don't find that challenging. What gets tough is dealing with people who just live in a different world altogether, with whom I have no personal contact and share no thought processes.  That is so much of our underclass today, even in this country.  I do live in that world where "Nobody notices."  

Monday, December 02, 2013

Latest studies: you really can't be "fat" and healthy at the same time (NBC)

Can one be overweight and healthy if one’s “numbers” are good?  Not according to the latest study, as reported tonight on NBC News.  Body Mass Index, or fat percentage, is itself a “linearly independent” risk factor for earlier death – cancer and heart disease.

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There was a standing joke in the early 1970’s when I started working, about the male form. “Wait until he gets married.”  When men got regular meals and didn’t have to compete anymore for a mate, they let go.  That was hardly always true.  In those days, “beauty” was much more the province of women only than it is today.
Anecdotally, when I was a substitute teacher, it really appeared that the leaner people did better in school.  And obesity was more common in low income populations than high income.  And in my observation it appeared more common in Latino teens than in African-American or White, as it is with Native Americans who suddenly eat a western diet of processed foods.
If you feed that wild red fox that comes into the yard, he’ll get diabetes.  As long as he lives on what he can kill (snakes, mice, birds and eggs), he says healthy.  Isn’t that the Zuckerberg Diet?  

Sunday, December 01, 2013

Obamacare presents a "solidarity" paradox

This Sunday morning (World AIDS Day) at Sunday School, there was a bit of a paradox expressed in the way societies approach the problem of “the common good”.
The early Christians, the teacher said, lived a communal life and shared things with little concern about money.  Yet, they did not survive very well as a group. (That’s debatable.) 
With health care, we have a lot of ideas about what is going wrong.  We resent paying higher premiums for services we individually won’t need.  But we resent paying for other people’s emergency room bills when they don’t have insurance.  We won’t get out of being our “brother’s keepers” if we are serious about valuing human life.
One person said that there could be free health care for everyone.  It comes from God. The problem is that we have a banking system and a Federal Reserve.

Another person said that without a profit motive and money, no one would have the incentive to develop medications like protease inhibitors.

Someone, we have to learn how to “pull together” the teacher said, and survive and prosper as a fellowship and group, more than a collection of individuals.  

Saturday, November 30, 2013

Sea Stars (by no means "free fish") plagued by mystery wasting disease, turning to "goo" - an environmental warning?

There is a mysterious disease that is turning starfish into “goo”.  Fox News has a typical story here
Starfish cannot become “free fish” because they aren’t fish at all;  they are from a rather bizarre phylum called echinoderms (class Asterozoa).  But their population is important to the ocean ecosystem upon which our seafood chain ultimately depends.
If it is a virus, it would indeed be bizarre, that a virus can liquefy animal tissue although Laurie Garret, in her 1990s book “The Coming Plague” described Ebola virus as capable of doing that to human internal organs. 
Some speculate that the disease has something to do with warming oceans and acidity.

There were a couple of smaller epidemics in the 1980s and 1990s, but nothing like the die-off up and down the entire West Coast in 2013.  
Maybe video filmmaker and actor Reid Ewing should add 30 seconds or so of coverage about this catastrophe  to his satirical “Free Fish” (2012) short film (Movies blog, May 13, 2013).  The video does mention that some sea birds are dying because of eating human plastic waster, or regurgitating it into the mouths of chicks.  No doubt, plastic isn’t good for the “fish” themselves. He mentions sea horses, and almost gets around to saying that the males sometimes carry the young.  As for jellyfish – yes, the filmmaker is better looking (much so) than a coelenterate in biology lab – but then there is nearly extraterrestrial horror of the box jellyfish (particularly near Australia), with perhaps the deadliest poison known, and a biological derivation that seems alien. 
Wikipedia attribution link for image of starfish (Sea Star( regrowing arms.  Second picture (my own), Pacific Coast north of San Diego, near nuclear power plant, May 2012.  

Friday, November 29, 2013

Latest issue of Time gives more details on how Obamacare is stalling

The Nov. 29 issue of Time Magazine has a big article on Obamacare, with a lead story by Kate Pickert, “Is your plan in play?” I couldn’t find the specific article online yet (even with the paywall), but it’s worth seeing in print, on p. 30. 

Smaller employers really are getting squeezed, as are some individuals. Particularly hurt are some individuals who had managed to get bare-bone plans while working part time, or often slipping below 30 hours a week.  Many such plans are being dropped.
Obamacare is supposed to spread the risk of health care to everyone, but Pickert reports that larger employers are likely to get even stricter on employee wellness, which would suggest that people with poor “numbers” (like BMI, glucose or blood pressure) can still be charged more, which defeats the idea of the ACA.

Is it unfair for a single male to have to subsidize the maternity coverage of others?  Is it fair for others to subsidize treatment for a serious STD (like HIV)?  We saw that question in the 80s.  Is it fair for us all to “subsidize” contraception, mental health overage, or even drug and alcohol treatment?
In previous decades, single people with stable large employers had it pretty good.  They didn’t pay much out of pocket on premiums or treatment, regardless of “fairness”. 

Wednesday, November 27, 2013

Supreme Court will decide whether "corporations" are like people when it comes to freedom of religious practice and speech

The Supreme Court will consider whether for-profit companies can claim “freedom of religion” (or of religious speech) under the First Amendment and refuse to offer coverage of some kinds of contraceptives to employees under Obamacare because of perceived religious objections of the ownership or workforce.  The controversy would probably only to privately held companies.
Churches and non-profits have a recognized freedom of “religious speech”, but the same right has never been recognized for profit-making companies, although generally (to the objections of the Left) the Court has recognized corporations as being like “people” (as if they were cats).  Insurance companies owned by faith-related groups might be affected, also.

The main plaintiffs are Hobby Lobby and Conestoga.  Both companies say that covering ordinary contraceptives are OK with them, but the companies object to covering use of Plan B and Ella as “abortifacients”.  Hobby Lobby also objects to covering intrauterine devices.
Robert Barnes covers the issue on p. A4 of the Washington Post Nov. 27.  
Personally, I would have reservations about making coverage for contraception mandatory.  I can understand the need to make everyone “share” the cost of pregnancy (we always have in the workplace, but the actual cost has been very low), and I wouldn’t think this coverage would cost much. But insurance should be about protecting people from major catastrophes;  mandatory portions of it shouldn’t deal with personal decisions and behaviors.

Are employers in this case imposing their views on associates?  I probably wouldn't see it that way. I've covered this before, but I generally would not work for an employer whose values I was at odds with (or vice versa).  In my own past, this led to some conflict over the military gay ban. 
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Pete Williams reports for NBC on the clip above. 

Tuesday, November 26, 2013

Universities, students pressure their portfolios and pension funds to eschew dirty energy

Students are pressuring their colleges (and the pension funds of universities) to invest green, and to develop portfolios that avoid fossil-fuel energy companies – big oil – according to Steven Mufson in the Washington Post, p. A10, today, Tuesday, November 26, 2013, link here

Analysts say that oil companies would have to be held to extracting about one third of their proven reserves, which serve as assets on their financial balance sheets, to keep global warming by 2100 down to 2 degrees C or 3.8 F.  

I held Exxon-Mobil for years (since 1977) and it did well for me, until my financial advisor sold it in a restructuring.My parents and relatives did well with energy and utility stocks and at least one natural gas well in Ohio. Quite literally, energy stocks provided stability for retirement and paid for eldercare. 
Would similar pressures be put on companies that practice mountatintop removal?

Universities have been active in pressuring other social policy changes, such as refusing to allow military recruiters on campus during the time of “don’t ask, don’t tell”.   

Sunday, November 24, 2013

Ted Cruz calls Obamacare a kind of "Robin Hood"

Saturday, CNN’s Chris Cuomo interviewed Texas Senator Tea Party and challenged Cruz to answer the question, if we started over on healthcare, what is supposed to happen to the currently uninsured, who cannot get reasonable health insurance because of pre-existing conditions, and wind up with unpayable medical bills (especially emergency rooms) that everyone else pays anyway (unless they are on Medicaid, which doesn’t always work). 
Cruz fired back and said, many people who did have individual health insurance have lost it.  So he says that Obamacare plays Robin Hood, taking something away from one person to give it by force to another.
It’s debatable how many people have really lost existing coverage and will have to pay much more under the new system. In states with their own exchanges, the experience is better, but even in these states, there have been some problems, as with a report on a woman in Washington State Nov. 19. 
Another question is, why did RomneyCare, started in Massachusetts under a Republican governor, work reasonably well, when it isn’t working nationally?

Imagine if the Obamacare idea carried over into other areas.  Suppose every blogger had to carry liability insurance if he blogged in the open, just because cyberbullying has happened to some people.  

Thursday, November 21, 2013

"Re-homing" of difficult foreign children highlights adoption, child-care crisis

It is often said that you cannot “un-adopt” a child, or return a child who turns out to be severely disabled or challenged or difficult to handle. (I think Nebraska passed a controversial law to allow parents to surrender difficult children a few years ago.)  But the New York Times today (Thursday, November 21, 2013) described the practice of “re-homing” difficult children, mostly adopted from foreign countries, in an article on p. A17 by Nicholas D. Kristof, “When children are traded”, link here
Apparently, off the books, the practice is rather widespread, with horrific consequences for children. 
Reuters is reported to be preparing a detailed series on the problem.
It’s also interesting to note that Russia is not allowing adoption of children in the US, but that appeared as part of its recent anti-gay law, and is probably really motivated by its concerns over slow birth rates and population loss.

A number of years ago, ABC 20-20 covered the challenges of adopting children from post-Communist Romania.
Is the fact that many relatively well-off adults or couples choose not to have children at all or become involved in raising them morally relevant?  

Tuesday, November 19, 2013

Woman in Washington State, touted as an Obamacare success story, is double-crossed by the exchange.

Just one day after a glowing report about how well Obamacare was working in states that ran their own exchanges, comes a disaster from Washington State.
The woman involved in Jessica Sanford, who was contacted at least twice by the exchange and told her premium would raise significantly, after processing errors, and then finally she was told her family wasn’t available for a federal tax credit.
She wound up with a “silver” plan of $390 a month, or “bronze” (with very high deductibles” for $324 a month. 
The CNN news story (here) doesn’t mention whether she lives in the Seattle area, or along the populated I-5 corridor, or in the rural interior where costs ought to be a bit lower. 
The single mother has a teenage son.  
I seem to remember paying about $30 out of pocket for my own premiums at ING in 2001.  RMA, where I worked a while (in St. Paul, MN) in 2003, offered employee-only insurance for $49 a month.  Generally, when I was at ING, people paid four or five times what single people paid for family coverage, with the employer picking up the rest.  While the employer offered family coverage (and started to do so for same-sex couples while I worked there), I don’t know how well it subsidized the premium for family members.  I remember hearing that some employees paid something like $300 a month out of pocket for complete family coverage. 
It seems that family coverage has always been very expensive.  It’s interesting to ponder in the individual market whether single males subsidize maternity care when they can’t possibly need it (where presumably they would in a family plan).  Perhaps my premiums did subsidize it, but if so, it probably cost me only about $2 a month then. 

I will add, as I have noted, that my plan was very good at getting the very best surgical care quickly when I had an accident in 1998.  I’ll also add that in my own experience, with both retiree health insurance and later with Medicare Supplemental from UHC, as well as prescription drugs, coverage has been very effective with no questions on claims.  

Monday, November 18, 2013

Individual consumers in states that run their own exchanges seem to have much better experience with Obamacare

Obamacare (or the Patient Protection and Afforable Care Act) is working relatively well in states that set up their own exchanges, at least in Washington, Kentucky and Connecticut, according to a Washington Post story on p. A23 Monday November 18, 2013, by Jay Inslee, Steve Beshear, and Daniel P. Malloy, “How we got Obamacare to work”, link here. The story took surprising effort to find on the Post site even when searching for “Obamacare”.
The writers point out cases where, on state run exchanges, consumers were able to find superior products quickly, allowing them to keep their own doctors and often more coverage for less money.  They point out that it is the attitude of state politicians that determine whether this will work.  Instead, in many states, politicians have wanted to treat this as a kickball.  Then the failure of the federal site in these states (as well as a refusal to accept extension of Medicaid coverage) led to a self-fulfilling cycle. 
The authors point out that it is up to states as to whether to allow insurance companies to keep old policies for one more year, as Obama has asked them to do. So far, Arkansas, Rhode Island, and Vermont, and Washington have refused to allow the extension, as with the New York Post story here  or Mediate, here,  Only Arkansas (among these denier states) doesn’t have its own exchange yet.  Forbes has a map on which states have exchanges here.  New York State is considering whether it can allow the extension.  States that run their own exchanges (including NY) have less reason to accept the extension. 

Picture: Whiteface (Adirondacks, NY, Aug. 2012).  

Update: Nov. 20

The Washington Post reports that Minnesota also is refusing to allow the extension. 

Friday, November 15, 2013

Insurers will be hit by anti-selection with Obamacare grace period extension, unless there are more subsidies

The Wall Street Journal is reporting Friday morning, in a front page story by Timothy Martin, Christopher Weaver and Joe Kamp, that insurance companies are somewhat unprepared for Obama’s policy decision, announced Thursday, to allow insurance companies to keep “non-compliant” individual insurance policies in place through Sept. 30, 2014, giving consumers more time to find adequate compliant replacements.

Obama stressed that insurance companies are not ordered to keep them, because companies stop selling some kinds of policies all the time.

The president announced the change in policy at noon on Thursday. 
One of the WSJ links is here

Many leading Democrats, as well as insurance executives, have expressed concern that anti-selection will be a bigger problem in 2014 than had been expected, and the government may subsidize excess claims somewhat.  

Picture: my own topical cream, for actinic keratoses on my face from sunlight, costs Medicare almost $1000.