Saturday, June 27, 2015

On same sexmarriage and Thomas Jefferson on changing laws and Constitution to meet changing times

I am indebted to my friend, Denver councilman Kevin Flynn for the following post and the wisdom of Thomas Jefferson.  We often forget that the Constitution in a framework on which our democracy is hung. The issues of the founding fathers are not always the same issues today, but the principles are the same and the decision by the Supreme Court on gay marriage is such an example.  The oft noted abrupt change in public opinion toward same sex marriage and action taken by so many states had the Supreme Court catching up with  majrotity attitudes.
"I am certainly not an advocate for frequent and untried changes in laws and constitutions. I think moderate imperfections had better be borne with; because, when once known, we accommodate ourselves to them, and find practical means of correcting their ill effects.
"But I know also, that laws and institutions must go hand in hand with the progress of the human mind. As that becomes more developed, more enlightened, as new discoveries are made, new truths disclosed, and manners and opinions change with the change of circumstances, institutions must advance also, and keep pace with the times. We might as well require a man to wear still the coat which fitted him when a boy, as civilized society to remain ever under the regimen of their barbarous ancestors." - Jefferson to H. Tompkinson (AKA Samuel Kercheval), July 12, 1816


Why the Supreme Court's decision on Obamacre care does not make the law more popular

The Supreme Court's decision regarding Obamacare was not one following public opinion, like their decision on gay marriate, but was the reading of the law in context of legislative intent and the essential goal of affordability for all of those who could not afford insurance before.  The law is more popular than before but still not popular by the majority, especially Republicans.   Here is the dilemma: Many more in the US are covered by Medicaid, Medicare, and employer provided insurance than are not. Only 18% were uninsured before the ACA; around 14% now in its second year...with heavier penalties yet to kick in. It is not surprising that those already insured  do not see that Obamacare benefitted them and are only beginning the realize that their friends and relatives are benefitting and no harm was done to them.  This is a case of caring for a minority of citizens and a failure for the insured to see any benefits to them. There are benefits, but if the Administration failed in selling Obamacare, it was to make a strong enough case of how Obamacare benefitted the already insured.

That premiums "soared" or the cost would sink us in the mud of a deficit are bogus fear tactics by die hard enemies of Obamacare.  Premiums have risen, but not to the extent in the past...and a part of that is indeed due to Obamacare.  Obamacare's ability to promote competition was crippled when the public option...a government lower cost insurance plan...was removed from the legislation because that kind of competition would have forced private insurers to adjust the cost of their plans.   There are other cost savings in Obamacare and still a measure of apples to apples comparison of health plans causing participating private plans to compete in price.  The requirement that all plans provide preventative care and checkups without co-pays cannot be discounted since those without insurance were the ones who were more expensive to cover when they turned up unbearably  ill in the emergency room. The result is that health care costs to be covered by government, such as Medicaid and Medicare will be less than otherwise without Obamacare.In fact, years were added to Medicare's life because of Obamacare and the deficit will be less because of it too, per the Congressional Budget Office.  More are paying into the system and fees and taxes charge also reduce costs. The cost shift of charity care to the insured premiums will be reduced, as well.

 http://www.politifact.com/truth-o-meter/article/2013/aug/19/will-obamacare-hurt-medicare-advantage/  

http://talkingpointsmemo.com/livewire/medicare-solvent-four-years-longer-obamacare

http://acasignups.net/15/06/19/cbo-aca-repeal-federal-deficit-increase-353b-or-137b-over-next-decade-net-loss-24m-insured

http://wallethub.com/edu/rates-of-uninsured-by-state-before-after-obamacare/4800/

http://thehill.com/policy/healthcare/236248-poll-obamacare-approval-ticks-up

Thursday, June 25, 2015

Court ruling in favor of Obamacare benefits consumers and both political parties

On a decisive 6 to 3 vote, King v Burwell, the US Supreme Court ruled that the legislation implementing Obamacare was constitutional and that the legislative intent that federally administered  insurance could be subsidized.  What this means for consumers is that 6 million subscribers through the federal system will maintain their affordable health insurance and that for everyone else, the rates would not soar.  The subscribers most affected were those who lived in the 35 states that did not set up their own health insurance exchanges through which Obamacare could have been  administered on a state basis. 

Consumers everywhere in the US, regardless of which state, will continue to benefit.
Per healthcare.gov, On average, consumers enrolled in the Marketplace are receiving $3,260 per year in taxcredits, or $272 each month. About 8 in 10 consumers could find coverage for $100 orless with tax credits through the Marketplace.

 Kaiser Health had predicted that all insurance rates would have increased eventually more than predicted otherwise if the Court did not uphold the Obamacare law. The Congressional Budget Office also predicted a hit in the long term to the deficit if the law was overturned because indeed there were cost savings built into Obamacare  to the health care system that aided the flattening of the cost curve. Costs were held down by less charity care,  greater competition, and built in preventative care.  With fewer consumers unable to pay their bills and with more consumers getting preventative care and checkups without copays, the entire system would see lower costs than if the Obamacare system were not viable.
Colorado would not have been immediately affected since Colorado was one of the states that set up the state exchange. But in the future, the lack of participation of so many in health insurance in general would have set up conditions that might have made Obamacare financially unsustainable since the whole system depended upon a large number of healthy as well as sick making the pool of insurers large enough to attract even healthy payers.  Our own state health exchange has also come under fire for administrative and financial problems and there is talk of abandoning the state exchange and moving its customers to the federal exchange if the Court ruled in favor of Obamacare.  There is now a plan B, a fallback to the federal exchange, if the state exchange is put on ice by our state legislature.  I would hope the State exchange would survive because its administration is closer to home than Washington, and the State legislature has some control over it.
Politically both Democrats and the GOP can breathe a sigh of relief.  The Obama health care legacy is secure. The GOP would not have to face 6 million hardship stories of those who had to drop insurance and feel  pressure to find an alternative to replace Obamacare.  After years of trying, they have never come up with a comparable replacement.  One of their dumbest  proposals, to remove the individual mandate (already upheld by the Court) and mandates on employers, would have eventually destroyed the system since only the sick would have subscribed, the pool would have had less healthy paying for the sicker, and the cost would have spiraled into its eventual death. Their State legislatures are also off the hook for finding some state funds to keep the subsidies going.  Most of the states not having state run exchanges are red states, so the political uproar would have been more severe in a presidential election year.

For those in the GOP decrying the SCOTUS decision, they offer some very misleading reasons:
That Obamacare caused soaring premiums (in fact premium increases have been less than before Obamacare) and the costs are going to be outrageous (in fact, Obamacare will lower the deficit over time per the CBO).  For the sources and reasons, see the independent, non partisan factcheck.org
http://www.factcheck.org/2015/06/scotus-ruling-fallout/

A version of this blog appeared in the www.skyhidailynews.com July 3, 2015

How the ACA benefits all consumers who have health care insurance from any source:
A list from the White House: https://www.whitehouse.gov/sites/default/files/docs/health_reform_checklist.pdf

 http://www.coloradohealthinstitute.org/blog/detail/the-aca-lives-and-one-chi-report-dies

http://coloradostatesman.com/content/995830-us-supreme-court-ruling-deals-another-defeat-obamacare-foes

http://blogs.wsj.com/washwire/2015/06/19/facing-the-fallout-from-a-king-v-burwell-ruling/

http://acasignups.net/15/06/19/cbo-aca-repeal-federal-deficit-increase-353b-or-137b-over-next-decade-net-loss-24m-insured



Sunday, June 21, 2015

The Charleston church massacre and the power of organized religion


The massacre of nine devout members of the African-American Emanuel AME Church in Charleston, South Carolina, last week was horrific.   The response to it could have gone either way,  either rioting in anger as so much of our long hot spring produced in response to indignation of injustice, or in another direction.  Thanks to the sincerely heartfelt response of Gov. Nikki Haley and Charleston Mayor Joe Riley, the other direction prevailed. Above all, the Christian teaching of the area pastors not to return anger with anger, shaped the attitude of those who had every right to be angry.  The result: the hate filled killer’s goal of creating a race war was not only not realized, the opposite occurred as White and Black congregants joined hands in singing “We Shall Overcome”.   The power of organized religion deserves our nation’s deepest gratitude.
The power of religion was also manifested in another hero whose action resulted in the quick apprehension of the perpetrator, tamping down fears he would strike again, and giving the justice system the ability to act quickly.  The White North Carolina florist employee, Debbie Dills, spotted, reported, and tailed the suspect for 35 minutes until law enforcement made the arrest. She gave credit for her actions to God working through her.
I grew up in the eastern Oklahoma Bible belt where it was a requirement of social acceptance to be an active Christian member of a church with unquestioned faith in God.  When I later saw more of the world, I realized that organized religion could be a force for good or evil, and it could even promote violent division of races and citizens.

We so often hear organized religion as being the cause of conflict. In fact, the haters from the Klan to Bosnia, ISIS, and Syria invoked or enlisted organized religions, cherry picking phrases from their Holy books, to give legitimacy to their atrocities.
But in Charleston, organized religion this time was the agent of peace.   Since the 1950’s Black churches led the fight for civil rights. Their successful movement drew on and caused redefinition of   the Constitutional amendment protecting equal rights to vote.  To succeed, it needed the technique of Rev. Martin Luther King’s peaceful civil disobedience and the communications, networking, and leadership provided by such churches as Emanuel AME.
 Our Constitution does not grant absolute rule to the majority. If the majority vote in the South always got its way, the Civil Rights movement resulting in the 1965 Voting Rights Act would never have happened.  Constitutional amendments and Court interpretations have given greater opportunity for the minorities to get their voices heard. Recent actions by Southern states dominated by White legislatures and White voters to pass laws making it more difficult for minorities to vote are shameful, especially when leaders like Texas Governor Rick Perry justifies it because “ it was passed by the people of Texas” .
 Especially inspirational last week was that White churches have realized that an attack on them is an attack on their religion as well, and they joined hands with their religious Black brothers and sisters in Charleston. The killers’s action was to give a mission to all churches to end the South’s racial divide.
http://www.ibtimes.com/voting-rights-act-2015-rick-perry-offended-hillary-clintons-texas-voter-id-law-1954456

A version of this appeared in the www.skyhidailynews.com , June 27, 2015