Posts Tagged ‘social security’
Monday, January 16th, 2012
Baby boomers may not like it — and whoever wins the White House this year — but the Medicare that our parents knew and love is destined to change. And it’ll be like it or lump it.
With more than 1.5 million baby boomers enrolling in Medicare every year, the program’s future is one of the most crucial economic issues for anyone who currently is 50 or older. Healthcare costs are the most erratic part of retirement expenses, and Medicare remains a great deal for retirees, who often get benefits worth significantly more than the payroll taxes they paid while working. “People would like to have what they used to have. What they don’t seem to understand is that it’s already changed,” said Gail Wilensky, a former Medicare administrator. “Medicare as we have known it is not part of our future.”
Consider these numbers. Medicare’s giant trust fund for inpatient care is expected to run out of money in 2024. When that happens, the program will collect only enough payroll taxes to pay 90 percent of benefits. Additionally, researchers estimate that as much as one-fifth and even two-thirds of the more than $500 billion that Medicare now spends every year is spent on treatments and procedures of little or no benefit to patients.
Representative Paul Ryan (R-WI), chairman of the House Finance Committee, is leading the charge on changing Medicare. Ryan’s current proposals will not impact people now 55 or older would not have to make any changes. But how would it work? Would it save taxpayers’ dollars? Would it shift costs to retirees, who are least able to afford it? Will Congress ultimately end traditional Medicare? These questions are still waiting for answers. “I’m not sure anybody has come up with a formula on this that makes people comfortable,” said health economist Marilyn Moon, who formerly served as a trustee overseeing Medicare finances.
The White House’s preference is to keep the existing structure of Medicare while “twisting the dials” to control spending, said Medicare trustee, economist Robert Reischauer of the Urban Institute think tank.
Ryan’s original approach would have put 100 percent of future retirees into private insurance. His most recent plan, written with Senator Ron Wyden (D-OR), would keep traditional Medicare as an option, competing with private plans.
Writing for AARP, Ricardo Alonzo Zaldiver says that, “This could mean more Medicare recipients joining private insurance plans (currently, only about 25 percent of Medicare recipients are in private ‘Medicare Advantage” plans, while the other three-quarters participate in the traditional, government-run Medicare program). A new voucher-for-private-Medicare plan would be available to anyone currently under 55.
“It could also mean keeping the existing Medicare structure but making certain tweaks to control spending. Under President Obama’s healthcare overhaul, the Independent Payment Advisory Board could force Medicare cuts to service providers if costs rise above certain levels and Congress fails to act. Obama has said he’ll veto any plan to cut Medicare benefits without raising taxes on the wealthy. During failed budget negotiations last summer, he indicated a willingness to gradually raise the Medicare eligibility age to 67, revamp co-payments and deductibles in ways that would raise costs for retirees, and cut payments to drug makers. ‘For the 76 million baby boomers signing up over the next couple of decades, it will pay to be watching.’” President Obama has promised that he will veto any plan to cut Medicare benefits without raising taxes on the wealthy.
The Chicago Sun-Times offers this sage advice: “Fix Medicare, ignore scare talk.” According to writer Steve Huntley, “I’ve contributed to Medicare every year of its existence. Yet, it’s a myth that seniors have paid the costs of their Medicare services, as demonstrated by the research of economists Eugene Steuerle and Stephanie Rennane of the Urban Institute think tank. Their study showed that a two-income couple earning $89,000 a year would pay $114,000 in Medicare taxes during their careers but could expect to receive $355,000 in medical care in retirement. They could get prescriptions, doctor visits and hospital services valued at three times their contribution to Medicare.
“Medicare combined with Medicaid and Social Security add up to an entitlement time bomb – they’ll consume all tax revenues by 2052, according to a Heritage Foundation analysis – for the people who’ll be stuck with the bill: working Americans. In 1950, there were 16 taxpaying workers for each retiree; by the time the baby boomers all retire, there will be two workers for each retiree. Entitlement reform has to happen.”
Tags: baby boomers, Co-payments, Congress, deductibles, Gail Wilensky, Heritage Foundation, Independent Payment Advisory Board, Medicaid, Medicare, Medicare Advantage plans, President Barack Obama, Representative Paul Ryan, Robert Reischauer, Senator Ron Wyden, social security, Urban Institute
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Tuesday, November 29th, 2011
Is 90 the new 85? The number of Americans over the age of 90 has skyrocketed from 720,000 in the year 1980 to more than 1.9 million in 2010, according to the Census Bureau, which notes that “over the next four decades, this population is projected to more than quadruple.” Driven by improvements in healthcare, the trend presents challenges. The Census Bureau notes that “a nation’s oldest-old population consumes resources disproportionately to its overall population size, and its growth has a significant impact on societal and family resources, including pension and retirement income, healthcare costs, and intergenerational relationships.”
According to the study, “People at very old ages are also expected to live longer. Today a person 90 years of age is expected to live on average another 4.6 years (versus 3.2 years in 1929–1931), and those who pass the century mark are projected to live another 2.3 years. Women aged 90+ outnumber 90+ men nearly 3 to 1.”
The downside is that people aged 90-plus are more likely to live in poverty or have disabilities, creating a new challenge to already strained retiree income and healthcare programs.
Richard Suzman, director of behavioral and social research at the National Institute on Aging, said “A key issue for this population will be whether disability rates can be reduced. We’ve seen to some extent that disabilities can be reduced with lifestyle improvements, diet and exercise. But it becomes more important to find ways to delay, prevent or treat conditions such as Alzheimer’s disease.”
“Given its rapid growth, the 90-and-older population merits a closer look,” said Wan He, a Census Bureau demographer and one of the report’s authors. “The older people get, the more resources they consume because of healthcare, and disability rates significantly increase. This creates demands for daily care, and for families the care burden increases dramatically.”
People in this demographic are more likely to have at least one disability, live alone or live in a nursing home. They’re also more likely to be female, because women typically are longer-lived than men, and are likely to be poor. “But increasingly people are living longer and the older population itself is getting older. Given its rapid growth, the 90-and-older population merits a closer look. The implications for the family and our society of this growing population are likely to be significant,” according to the authors.
The poverty issue cannot be understated because it becomes more likely as a person ages. From 2006 to 2008, 14.5 percent of people 90 and older lived in poverty, drastically more than the 9.6 percent of those 65 to 89 who were considered poor. The annual median income for people aged 90 and older was $14,760, as measured in inflation adjusted dollars. Nearly half of that income — 47.9 percent — came from Social Security, and 18.3 percent came from retirement pensions. Fully 92.3 percent of those 90 and older received Social Security income.
And where do these nonagenarians live? According to Census figures, smaller states had the highest shares of their older Americans who were at least 90. North Dakota had approximately seven percent of its 65-plus population older than 90. It was followed by Connecticut, Iowa and South Dakota. When considering absolute numbers, the retirement havens of California, Florida and Texas led the nation in the 90-plus population, each with more than 130,000.
By 2050 – just 39 years from now – the number of Americans 90 or older could total nine million. “I think it’s going to grow even faster than predicted in the report,” Suzman said. Someone who lives to 90 today is likely to live almost another five years, the study noted. Additionally, a person who lives to celebrate a 100th birthday is likely to live another 2.3 years. Women aged 90 and older outnumbered men by 3 to 1, according to the study. Nearly 80 percent of those women are widows, while more than 40 percent of the men are married.
Edmund H. Duthie, a professor of medicine and chief of the division of geriatrics and gerontology at the Medical College of Wisconsin, said the census numbers point to a sobering fact: Retirement may be longer than people expect. “Are you going to outlive whatever you put aside?” Duthie said. “Most people wouldn’t think that if you retired at 60, you may have a third of your life to live.” Duthie said it was unclear how the nation’s obesity epidemic might affect longevity as well as chronic illness. America, he said, remains concerned with rates of dementia and how society will cope with the problem. “The science base of what we do with the oldest old is something that we’re lacking,” he said. “We can measure cholesterol and blood pressure, but what does it mean in a 90-year-old? We need to be enrolling these oldest old in studies to understand more about what to do.”
Tags: Alzheimer’s Disease, Census Bureau, Century mark, Chronic illness, Dementia, Disabilities, healthcare costs, Intergenerational relationships, National Institute on Aging, Nonagenarians, Pensions, Pete Seeger, Poverty, Retirement income, social security
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Monday, November 7th, 2011
Despite rumors to the contrary, the basic monthly premium for Medicare will be less than anticipated in 2012. The new Part B premium, which covers outpatient care, will be $99.90 a month for 2012, approximately $7 less than projected as recently as May. In other words, the majority of senior citizens will pay $3.50 more a month next year, instead of $10.20, as forecast earlier. Some younger retirees who enrolled recently will actually see their rates go down. They have been paying as much as $115.40 a month. Instead, they’ll also pay $99.90 next year. The primary reason for the lower-than-expected premiums is a result of the interaction between Social Security cost-of-living adjustments (COLA) and Medicare.
“Thanks to the Affordable Care Act (ACA), Medicare is providing better benefits at lower cost,” said Health and Human Services Secretary Kathleen Sebelius. She reassured seniors that they have nothing to fear from the healthcare law, and described keeping premiums in check as “pretty remarkable.”
Some Republicans do not see the connection between Medicare premiums and the ACA. “Lower Medicare premiums are being driven by lower-than-average Medicare spending due to the slow economy” – not the healthcare law, said Antonia Ferrier, spokeswoman Senator Orrin Hatch (R-UT), the ranking Republican on the panel that oversees Medicare.
Part B premiums have been frozen at the 2008 level of $96.40 a month for about 75 percent of Medicare beneficiaries because of a lack of a Social Security COLA during the recession. Social Security recently announced a raise of an average of $39 a month for 2012. The Part B premium is of great interest to the 48 million people covered by Medicare. Average premiums for prescription coverage and for popular Medicare Advantage plans will stay flat or dip slightly for 2012, but fewer beneficiaries opt for those benefits. In May, government experts forecast that Medicare premiums would rise to $106.60 for 2012. At that time, they were also estimated a Social Security COLA of just 0.7 percent – but it turned out to be a larger 3.6 percent increase. As a result, rising Medicare costs could be spread among many more people, resulting in smaller individual increases.
“Thanks in part to the Affordable Care Act, people with Medicare are going to have more money in their pockets next year,” added Donald Berwick, MD, administrator of the Centers for Medicare & Medicaid Services (CMS). “With new tools provided by the Affordable Care Act, we are improving how we pay providers, helping patients get the care they need and spending our healthcare dollars more wisely.”
Advocates for senior citizens also were pleased with the smaller rise in Medicare Part B premiums. “The payment reforms enacted over the past few years, including those in the Affordable Care Act, in addition to crackdowns on fraud, waste and abuse, are partially responsible for the increased optimism about Medicare’s financial health, the lower-than-predicted Part B premium and an almost unheard-of drop in the Part B deductible,” said Joe Baker, president of New York-based Center for Medicare Rights. “These developments help show the promise of the ACA’s delivery system reforms, and why we must let them do their job in the coming years.”
AARP echoes that sentiment. “Millions of America’s seniors are struggling with higher expenses – particularly higher healthcare costs, lower incomes, depleted savings and reduced home equity or homes lost to foreclosure, and this small increase is welcome news,” noted David Certner, AARP’s legislative policy director.
Writing in Family Practice News, Alicia Ault takes issue with the way HHS is tying the low increase to healthcare reform. According to Ault, “Part B premiums are calculated to cover one-fourth the cost of physician services, plus a contingency margin that is essentially equivalent to an insurer’s reserve. This has nothing to do with health reform; it’s been a statutory requirement since, well, for a long time. And the contingency margin is always dependent on what happens with the Sustainable Growth Rate (SGR) formula. CMS assumes every year that the SGR will be overturned, so that calculation also has nothing to do with health reform. For an administration that prides itself on transparency, it seems to have done little today to pull back the curtain on Medicare spending — even as Dr. Berwick said that transparency itself had led to lower costs.”
Tags: AARP, Center for Medicare Rights, Centers for Medicare and Medicaid Services, Cost-of-living adjustments, Department of Health and Human Services, Donald Berwick, Family Practice News, Kathleen Sebelius, Medicare Advantage, Medicare Part B, Outpatient care, Patient Protection and Affordable Care Act, Premiums, Senator Orrin Hatch, senior citizens, social security, Sustainable Growth Rate formula
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Wednesday, September 7th, 2011
Although some people are convinced that federal Supplemental Security Disability Income (SSDI) program for severely disabled children is a boondoggle, a four-year-old boy diagnosed with severe ADHD is an excellent example of how the program works. The boy’s case workers said there wasn’t much they could do for him. “We were at a standstill,” said the boy’s mother, who was barely scraping by as a single parent of two. When doctors recommended she enroll her son in the SSDI program, her situation quickly improved. A $674 monthly payment helps pay for her son’s day care, a private tutor and medications. Most importantly, SSDI made the boy eligible for Medicaid, which provided access to the doctors he needed.
“I can see a light in his eyes again,” according to the mother. “He just looks so much happier.” The SSDI program for children is expanding rapidly, with the largest increase among kids with mental, behavioral and learning disorders, including ADHD, speech delays, autism, and bipolar disorder.
Even though the program benefits children in need, it is generating Congressional criticism. The Boston Globe created a backlash that called the children’s SSDI program “The Other Welfare” and followed several families whose children’s eligibility for the program was open to discussion. Several of the families believed that they had to medicate their children with psychotropic drugs in order to qualify for the benefit. The series spurred Representative Geoff Davis, (R-KY), Representative Richard E. Neal, (D-MA), and Senator Scott Brown, (R-MA), to ask for an investigation by the Government Accountability Office (GAO), which is expected to be released by the end of the year. In a letter to the GAO, the three lawmakers expressed concern about “recent reports in the media and elsewhere” that “have identified potentially alarming practices…(that raise) numerous concerns, including the potential for fraud and abuse in the program.” Some Congressmen are not waiting for the GAO study results and have twice proposed limiting SSDI benefits. The House budget resolution proposed that the government could save $1.4 billion over 10 years by reducing incentives in the SSDI program “for parents to place their children on medication solely to receive SSI benefits.”
Advocates for children have rallied against the potential cuts. The largest advocacy groups, including the Bazelon Center for Mental Health Law, the American Psychiatric Association, the American Academy of Pediatrics, and Children and Adults with Attention Deficit/Hyperactivity Disorder, have formed a coalition to protect the SSDI program for kids and are lobbying Congress.
At present, SSDI provides cash assistance and Medicaid to the families of 1.2 million low-income kids who have severe disabilities, at a cost of $10 billion a year. The program has grown by nearly 40 percent over the last nine years. “Cutting the SSI program could have disastrous consequences for families, many of which already are struggling well below the poverty line,” according to Rebecca Vallas, a lawyer with Community Legal Services, a non-profit that is part of the coalition. Vallas says the increase in the SSDI program is due to a national increase in child poverty and improved access to healthcare for kids, who get diagnosed earlier and more frequently with disabilities that might otherwise be ignored.
It’s not only kids who benefit from SSDI. Recently, the Social Security Administration added 12 new conditions to its “compassionate allowances list,” including several heart ailments. Applicants who have any of the 100 conditions on the list are fast-tracked and can have a decision as quickly as two weeks. For other people, the length of the disability process can be measured in months — or even years. “When you have a catastrophic experience and you lose 50 percent of your income, it can mean that you’re selling your house, that you may not be able to support yourself. That’s so depressing for the patient,” said Karla Robeson. Social Security is in the process of determining new conditions to add to the compassionate allowances list, though they’re getting more difficult to pinpoint, said Social Security Commissioner Michael Astrue.
Not everyone is supportive of the SSDI program. Writing on Slate, James Ledbetter, a widely respected financial journalist, says that “They are the recipients of Social Security’s Disability Insurance, a somewhat obscure federal program that nonetheless eats up nearly $200 billion a year. SSDI began in 1956 and was intended to provide benefits for people between 50 and 64 who’d been in the workforce but had developed ‘any medically determinable physical or mental impairment which can be expected to result in death or to be of long-continued and indefinite duration.’ At the end of the first year, there were 150,000 Americans receiving SSDI benefits. As Congress serially widened the eligibility criteria — by age, by type and duration of impairment — that number began to grow. Enrollment hit one million adults in 1966; by the end of 1977 it was 2.8 million; and today it’s more than eight million ex-workers, plus another million disabled adult offspring and disabled widows and widowers. SSDI represents, as the authors of a 2006 economics journal paper put it, a ‘fiscal crisis.’ Equally distressing, it also represents public policy run amok. Over the last few decades, a program that was designed to help a relatively small group of people who were fatally sick or permanently unable to work has evolved into a backdoor welfare program in which a huge number of people are paid not to get jobs. How huge? Nationwide, we’re talking about well over four percent of the adult population. In some states — Alabama, Arkansas, Kentucky, Maine, Mississippi, and West Virginia — the rate exceeds six percent. These millions of workers extricated from payrolls represent untold billions in tax lost revenues and all manner of desperately needed economic activity (consumption, home purchases, etc.).”
Tags: ADHD, American Academy of Pediatrics and Children and Adults with Attention Deficit/Hyperactivity Disorder, American Psychiatric Association, autism, Back-door welfare program, Bazelon Center for Mental Health Law, Behavioral disorders, Bi-polar, Compassionate allowances list, Congress, Disabled children, Governmental Accountability Office, Learning disorders, Medicaid, Mental disorders, Michael Astrue, Psychotropic drugs, Representative Geoff Davis, Representative Richard E. Neal, Senator Scott Brown, social security, Social Security Disability Insurance
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Tuesday, August 2nd, 2011
At a time when concern about federal deficits and the national debt are growing, few quarrel with the need to reform Medicare. The health insurance program for seniors and people with certain disabilities accounts for 15 percent of the federal budget – in third place behind Social Security and defense spending. That share is rising as healthcare costs continue to rise and more baby boomers retire, threatening the program’s long-term solvency.
Several of the most prominent solutions under discussion largely derive their savings by shifting a greater share of the cost onto beneficiaries. The plan sponsored by Representative Paul Ryan (R-WI) and passed by the House of Representatives would significantly cut Medicare spending by capping the government’s contribution to the program and transforming it into a system of “premium supports” given to seniors to help subsidize their purchase of private insurance plans, with seniors paying additional costs. This would double out-of-pocket spending by the average senior to $12,500 each year, according to Congressional Budget Office estimates.
The ability of a majority of seniors to shoulder that burden appears dubious. Just five percent of Medicare beneficiaries make $80,000 or more, a figure that includes any income from a spouse. For the 47 percent of seniors who are at or close to poverty, on average they are already spending nearly 25 percent of their budgets on healthcare, according to an analysis by the Kaiser Family Foundation.
“There’s this impression that there’s a great deal of wealth among the Medicare population, this image of wealthy seniors playing golf and enjoying their retirement years,” said Tricia Neuman, director of the Kaiser Family Foundation’s Medicare Policy Project.“But while some are lucky to do so, many are living on a fixed income, struggling to make ends meet…with really limited capacity to absorb rising costs.”
According to the Kaiser Family Foundation’s report, raising Medicare’s eligibility to 67 in 2014 would generate an estimated $5.7 billion in net savings to the federal government, but also result in an estimated net increase of $3.7 billion in out-of-pocket costs for 65- and 66-year-olds, and $4.5 billion in employer retiree healthcare costs. In addition, the study projects that the change would raise premiums by about three percent both for those who remain on Medicare and for those who obtain coverage through health reform’s new insurance exchanges. The study assumes both full implementation of the health reform law and the higher eligibility age in 2014 in order to estimate the full effect of both the law and the policy proposal. In the absence of the health reform law, raising Medicare’s age of eligibility would result in an increase in the uninsured, according to other studies, as many older Americans would have difficulty finding affordable coverage in the individual market in the absence of Medicare. With health reform, virtually all 65- and 66-year-olds would be expected to obtain alternative sources of coverage.”
Healthcare remains a major focus of budget talks on Capitol Hill,Senator Mark Kirk (R-IL) recently told the American College of Surgeons (ACS). Every group that relies on federal funding should expect a 10 to 20 percent drop in that funding. When Dr. L.D. Britt, president of the ACS, warned that such cuts could send some healthcare providers into a “tailspin,” Kirk responded that “the tailspin is the U.S. economy. There is a new audience at play,” Kirk said, referring to U.S. creditors. “The judgments they render, they are swift and severe.” Kirk is optimistic that a solution to the country’s debt-ceiling dilemma “will have a way of concluding itself one day before the August 2 deadline.”
Tags: American College of Surgeons, baby boomers, Congressional Budget Office, Defense spending, Deficits, healthcare costs, Healthcare insurance exchanges, healthcare reform, House of Representatives, Kaiser Family Foundation, Low-income senior citizens, Medicare, Medicare Policy Project, Private insurance plans, Representative Paul Ryan, Senator Mark Kirk, social security
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Monday, July 25th, 2011
Baby boomers are more concerned with the ways that aging impacts their physical and mental health than the role it plays in their appearance. Fully 65 percent of baby boomers – who are currently between the ages of 47 and 65 — expressed concern with their health, with 26 percent focused on retaining their mental faculties. Just eight percent mentioned appearance as their biggest aging concern.
Boomers also are slightly less active than the previous generation. Just 57 percent started a regular exercise program in 2010. Of those who exercise regularly, 35 percent are walkers. Nearly 4.3 million adults 50 or older used illicit drugs in the last year, according to a report from the federal Substance Abuse and Mental Health Services Administration. According to the agency, substance abuse in this age group could create public health challenges over the next decade.
Boomers are in less agreement about whether their longer lives will be better than the previous generation: 49 percent expect a better life than their parents, while another 25 percent believe it will be about the same. Another 26 percent expect that the quality of their lives will be worse than their parents.
Although younger adults believe that 60 is the start of old age, Baby Boomers strongly disagree. The median age they cite is 70. Twenty-five percent of Boomers insist you’re not old until you’re 80. “In my 20s, I would have thought the 60s were bad, but they’re not so bad at all,” said Lynn Brown, 64, a retired legal assistant and grandmother of 11 living near Phoenix. Boomers – 77 million strong — are celebrating their 47th through 65th birthdays in 2011. In general, they are more optimistic about their futures than past generations. Americans born in the population boom that followed World War II are more likely to be energized about the positive aspects of aging, such as retirement, than worried about the negatives, such as poor health.
“The findings that midlifers who are worried about aging are focused more on their health over physical looks may seem surprising to some — but then when you see stunning boomer role models like Susan Sarandon and Helen Mirren, it all makes sense,” said Cindy Pearlman, entertainment writer for the Chicago Sun Times and best-selling author of “The Black Book of Hollywood Beauty Secrets” series, and regular contributor to LifeGoesStrong.com’s Style channel. “Even in a town like Hollywood, where you’d expect nips and tucks everywhere you turn, many celebrities are saying that the secret to looking great at any age is accepting the inevitable changes that the years bring, while staying in shape and embracing your own sense of style.”
Many baby boomers have no problem working till they’re 65 or 70 as long as they’re not doing heavy lifting. A majority are enthusiastic about aging and have less concerns about physical ailments than their parents’ generation. Tom Beumont understands that the current status of Social Security will require him to work longer, but he is fine with that. “We kind of learned from our parents…we have a more diverse background and we also exercise more so that’s more important to us”, Beumont said.
Cindy Black, a nurse, said a lot of the people she sees at a clinic work too much. “I think we are burning the candle at both ends. They went to bed earlier back then and drank more water,” Black said. Black said that while baby boomers exercise more than their parents and drink and smoke less, their fast paced lifestyle has a price. According to Black, Boomers might end up working themselves to death, literally. “They laugh when I tell them this but they need to go to bed by 10 o’clock.”
Baby Boomers are also concerned about their independence. Boomers primarily worry about losing their independence because of illness, while 44 percent are concerned about experiencing memory loss. Approximately 41 percent have concerns about remaining financially self-sufficient. The hedonistic Boomer generation forever changed the social scene with the dawning age of the flower child, and the explosion of the sexual revolution during the 1960s and 1970s.
Just 18 percent of Boomers worry about dying, while another 22 percent are moderately concerned about it. More than two-thirds expect to live to at least age 76, and one in six expects to live into their 90s.
Tags: Aging, baby boomers, Chicago Sun Times, Cindy Pearlman, Healthcare, Helen Mirren, LifeGoesStrong.com's Style channel, mental health, Physical health, retirement, social security, substance abuse, Substance Abuse and Mental Health Services Administration, Susan Sarandon, The Black Book of Hollywood Beauty Secrets"
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Thursday, July 7th, 2011
Few news stories have provided more compelling testimony about how the nation’s healthcare system fails millions of people is the report that a North Carolina man robbed a local bank of just $1 so that he could have multiple healthcare problems treated in jail. Richard James Verone, a 59-year-old unemployed man with multiple health issues, robbed a local bank so he could go to prison and receive treatment for his conditions — he said it was the only way he could get healthcare.
Verone has an undiagnosed growth in his chest, two ruptured back discs, and a foot problem. His medical condition made working difficult after his 17-year career as a Coca-Cola delivery driver ended. He tried living off savings and part time jobs, but that proved inadequate. He applied for Social Security but only received food stamps with no resolution to his medical problems. When robbing the bank, Verone gave the teller a note explaining that he only wanted $1. He did not want to frighten anyone and was not doing it for the money. After the teller handed him a dollar, Verone said “I’ll be sitting right over here on the chair waiting for the police.” When the police arrived, Verone was sitting on a sofa inside the bank. “I’m sort of a logical person and that was my logic,” Verone said. “If it is called manipulation, out of necessity because I need medical care, then I guess I am manipulating the courts to get medical care.”
Verone faces charges for larceny from a person, which is unlikely to keep him behind bars for more than one year. He is being held in Gaston County Jail, where he has already been seen by several nurses, on a $2,000 bond. If his sentence is too short, Verone said he plans to rob again.
“The pain was beyond the tolerance that I could accept,” Verone said. “I kind of hit a brick wall with everything.” Verone said he “exercised all the alternatives” before the bank heist. As the day approached, Verone paid his last month’s rent, donated his furniture and moved into a hotel. Before going to the bank, he mailed a letter to the Gaston Gazette outlining his plans. According to the letter, “When you receive this, a bank robbery will have been committed by me. This robbery is being committed by me for one dollar,” he wrote, wanting to make clear that the motive for his crime was strictly medical and not monetary. “I am of sound mind but not so much sound body.”
Writing in the San Francisco Chronicle, John Thorpe says that “After depleting his life savings and realizing he had, literally, nowhere else to turn, Verone committed the crime, hoping he could get the medical care that he so desperately needs. This is what America has come to? Otherwise honest folks, with nowhere to turn in life, have to resort to fake-robbing a bank with the hopes they’ll be arrested so they can receive medical care? There is absolutely no reason for an allegedly civilized country, particularly one as wealthy as America, to pass the buck on providing healthcare for everyone. Yes, everyone: the employed and the unemployed; the sick and the healthy; old and young. Before you scream ‘oh no, socialism!!!’ stop and consider what you mean by that. How do socialist systems pay for healthcare? Taxes are collected from businesses and citizens, and a portion of those taxes go to cover the healthcare costs of everyone in the plan – in other words, everyone in the country.
“How do health insurance systems pay for healthcare?” Thorpe asks. “Premiums are collected from businesses and employees, and a portion of those premiums go to cover the healthcare costs of everyone in the plan. The difference between the two? Socialized care costs less (because it has a much larger pool of people to draw from), covers everyone at all times, and prevents people from purposefully committing crimes to get treated. Insurance systems ARE socialized systems, except they don’t cover everyone and allow a corporation – an entity that neither receives nor provides the medical treatment – to skim a profit off the top. In what sort of twisted mind is that the rational way to provide medical care? It’s not like the marketplace can rationally set prices for healthcare. A dying man has no ability to check prices and compare services before deciding which hospital he’ll take his heart attack to.”
Robert Oak of the Economic Populist, agrees with Thorpe. “He (Verone) got his healthcare and how many others are committing felonies so they can get food, shelter and medical attention to save their lives? If we cannot get universal single payer, perhaps all of America should behave as Verone did, so finally, we could all get some healthcare. What’s wrong with this picture?”
Suzy Khimm of Mother Jones, points out that the cost of caring for Verone for the year that he is likely to be incarcerated does not come cheaply. “The story is telling not just because it shows the sad desperation of uninsured Americans who have trouble finding healthcare — but also how costly it is to leave such problems unattended. James Verone may have only robbed the bank of one dollar, but the cost of jailing him for just one year in North Carolina is over $23,000, not to mention the legal fees his case will rack up as well. Similarly, if he wasn’t in prison, and his health problems worsened, he could end up in an emergency room, where the state would again have to help foot the bill if he couldn’t pay. Insuring him would likely be the cheapest option — which is one reason why Democrats have made universal coverage a priority under federal health reform.”
Verone concludes “I didn’t have any fears. If you don’t have your health you don’t have anything.”
Tags: Economic Populist, Food stamps, Gaston County, Gaston Gazette, healthcare insurance, Jail, Mother Jones, North Carolina, Richard James Verone, San Francisco Chronicle, Single-payer healthcare coverage, social security, socialized medicine
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Wednesday, May 11th, 2011
Mississippi Governor – and possible presidential hopeful — Haley Barbour and other Republican governors recently demanded that Medicaid, the state-federal health program that covers 50 million poor and disabled, be transformed into block grants. House Republicans have vowed to tackle expensive programs like Medicaid to cut federal spending. Any attempt to turn Medicaid into block grants – federal lump-sum payments to states – raises many questions. Democrats argue that a move of this type could result in loss of healthcare coverage for millions who are poor, sick and old.
Representative Fred Upton (R-MI), chairman of the House Energy and Commerce Health Subcommittee said to expect House bills on the Medicaid program’s maintenance-of-effort requirement and block grant funding to states. Because Medicaid is an entitlement program, all Americans who are eligible are guaranteed coverage. The federal government, which foots the bill for approximately 60 percent of Medicaid’s cost, is committed to helping the states cover costs; in return, it requires them to cover certain groups of people and provide specific benefits. For example, children, pregnant women who meet explicit income criteria and parents with dependent children must be given coverage.
“The governors have requested flexibility in the way they serve Medicaid patients,” Representative Joseph Pitts (R-PA), the Health Subcommittee’s chairman said. “They maintain they can provide the service better and cheaper, so we’re looking to give them that flexibility and change this maintenance-of-effort provision. I won’t be specific on the block grants, but we’re having discussions with governors.” Pitts’ comments followed a Health Subcommittee hearing in which HHS Secretary Kathleen Sebelius answered extensive questions about the Obama administration’s fiscal 2012 budget and the Patient Protection and Affordable Care Act.
Why are the block grants important? When the new healthcare law goes into full effect in 2014, approximately 16 million additional people will become eligible for Medicaid. The debate, which cuts to the heart of the social contract between the government and its citizens, has implications for the other large entitlement programs — Social Security and Medicare. In 2010, the federal government spent $1.5 trillion on those programs, or approximately 43 percent of the federal budget, according to the Congressional Budget Office. Speaker of the House John Boehner (R-OH) said House Republicans’ upcoming budget proposal would cut Social Security and Medicare, despite the political risk of taking on such popular programs. Democrats are skeptical. Changing Medicaid into a block grant means “you have no guarantee that people who are now covered will continue to be covered, or whether (the states) will simply cut back on their Medicaid program,” said Representative Henry Waxman, (D-CA), who is a primary defender of the program.
Tags: Block-grant funding, Centers for Medicare and Medicaid Services, Community-based attendant services, Congressional Budget Office, Democrats, Department of Health and Human Services, Dr Donald Berwick, Governor Haley Barbour, House Energy and Commerce Committee, House of Representatives, Kathleen Sebelius, Maintenance of effort requirement, Medicaid, Medicare, Obama administration, Patient Protection and Affordable Care Act, Representative Fred Upton, Representative Henry Waxman, Representative John Boehner, Representative Joseph Pitts, Republicans, Social contract, social security
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Wednesday, March 23rd, 2011
With the power shift in the House of Representatives, Medicare, Medicaid and Social Security are being targeted in proposed budget cuts designed to bring down the deficit. “It will likely be the first time you see a House have a prescription for Social Security, Medicare and Medicaid,” House Majority Leader Eric Cantor (R-VA) said at the Federation of American Hospitals’ annual public policy conference and business exposition in Washington.
Mississippi Governor Haley Barbour, a Republican, said that members of Mississippi’s Medicaid program saw its enrollment drop approximately 23 percent to 580,000 beneficiaries from 750,000 after the state started requiring beneficiaries to establish their eligibility in person. Barbour began this practice in his first year as governor in 2004. Senator Orrin Hatch (R-UT), the ranking Republican on the Senate Finance Committee, slammed the Patient Protection and Affordable Care Act (ACA), noting that its expansion of Medicaid will “bankrupt” the states, which already have strained budgets. Hatch also cited Congressional Budget Office figures that say the ACA’s Medicaid expansion will cost taxpayers $435 billion over the next decade.
President Barack Obama said his proposed 2012 budget was a “down payment,” on cutting the federal budget deficit, and said that more work is needed to address “long term challenges”. Cantor said that on “individual items” there were “probably some areas of agreement” between the President and Republicans. “But we can’t keep taking the savings and going to spend it,” he said. “The object here is to cut.” According to Cantor, the President’s plan “just misses the mark of living up to the expectations” Obama laid out in his State of the Union speech in January. Asked if Cantor expected adjustments to Social Security and Medicare, Cantor said he was “hopeful that we can get some cooperation from [Senate Majority Leader] Harry Reid [D-NV] and the President, because these are programs that touch the lives of every American and we don’t want, nor can we, make these changes by ourselves.”
Writing on the Huffington Post, Richard Eskow took an alarmist tone, saying that “entitlement reform” is a euphemism for allowing the elderly to die if they become ill. “’The President’s budget punts on entitlement reform,’ reads a statement by House Republicans. ‘Our budget will lead where the President has failed, and it will include real entitlement reforms.’ ‘You have to do entitlement reforms if you are serious about this budget,’ according to Representative Paul Ryan (R-WI).” Eskow counters “Reality check: Nobody’s proposing ‘entitlement reform.’ That term is a cloaking device for some very ugly intentions. It’s a meaningless manufactured phrase cooked up by some highly-paid consultant, and it diminishes the sum total of human understanding every time it’s used. The phrase is a euphemism for deep cuts to programs that are vital and even life-saving for millions of elderly and poor people, but it’s politically unpalatable to say that. So it became necessary to come up with yet another cognition-killing term designed to numb us from the human toll of our political actions. ‘Entitlement reform’ is the new ‘collateral damage.’”
The Washington Post’s Ezra Klein is more diplomatic in his assessment of the possibility of entitlement reform. “We’ll see. I wouldn’t be surprised if Obama has his name on a broader deficit-reduction bill at this time next year. If he takes the deficit away from Republicans before 2012, his reelection campaign becomes considerably easier. And on a less cynical level, his administration is stocked with deficit hawks — the same folks who actually balanced the budget under Bill Clinton. And similarly, Republicans want to deliver on the deficit-reduction promises they’ve made to their base. In theory, everyone’s incentives and ideologies are pointing in the same direction. That’s a good sign for progress.”
Tags: Centers for Medicare and Medicaid Services, Congressional Budget Office, deficit, Deficit hawks, Dr Donald Berwick, Entitlements, Ezra Klein, Federal budget, Federation of American Hospitals, Governor Haley Barbour, House of Representatives, Medicaid, Medicare, President Barack Obama, President Bill Clinton, Representative Eric Cantor, Representative Paul Ryan, Republicans, Senate Finance Committee, Senator Harry Reid, Senator Orrin Hatch, social security, State of the Union speech
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Thursday, January 13th, 2011
One of Illinois’ newest Congressman – Republican and Tea Party favorite Joe Walsh, who represents the 8th district that consists of Chicago’s far northwest suburbs – has refused to accept the government-sponsored health insurance plan that typically covers lawmakers. “I don’t think congressmen should get pensions or cushy healthcare plans,” he said. Walsh’s wife is not thrilled with her husband’s decision; because she has a pre-existing medical condition, she is now forced to hunt for a pricey individual policy. So far, Representatives Bobby Schilling (R-IL) and Mike Kelly (R-PA) have joined Walsh in turning down congressional healthcare coverage.
Representative Joseph Crowley (D-NY) called the Republicans’ bluff, writing a letter to GOP leaders asking that they refuse their federally subsidized coverage. “If your conference wants to deny millions of Americans affordable care, your members should walk that walk.” Crowley sent his letter to incoming Speaker of the House John Boehner (R-OH) and Senate Minority Leader Mitch McConnell (R-KY).
Walsh’s stated legislative goals are repealing President Obama’s healthcare legislation and making major changes to Social Security and Medicare. Additionally, Walsh believes that reducing the size, scope and power of government is an end in itself. “An end in itself,” he said. “I think we were sent to D.C. to cut spending and grow the economy. We have to talk about cutting real programs” – as well as agencies — “like the Department of Energy and Department of Education.”
Tags: Bobby Schilling, Department of Education, Department of Energy, GOP, healthcare reform, Illinois, Illinois 8th Congressional District, Individual policy, Joe Walsh, John Boehner, Joseph Crowley, Medicare, Melissa Bean, Mike Kelly, Mitch McConnell, Pensions, Pre-existing medical condition, President Barack Obama, social security, Tea Party, Washington D.C.
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