There’s bureaucracy and then there’s bureaucracy

I still retain some hope that health care and health insurance reform can be enacted this year.  We are in a crisis situation — one that has been in the making for a generation or more.

One of the scare tactics that the GOP has used to gin up opposition is the specter of government bureaucrats “getting between you and your doctor.”  In my experience, those government bureaucrats would be a welcome change from the insurance company bureaucrats.  Too often, once you get past the automated “answering system” and are connected with a real person, you find that you’re talking to Dingbat Number 47 or her evil twin.   From there you’re passed from one person to the next while all you want is the answer to a relatively simple question — from someone who is SUPPOSED to know the answer.  Given that experience, it’s not particularly surprising that people can be made to expect that dealing with government bureaucrats will be even worse.

However, there are two main government bureaucracies that all of us will deal with, if we live long enough.  When I signed up for early Social Security, I did it online.  It was very straightforward.  It took about 15 minutes to enter the required information into the Social Security Administration database.  Once I’d finished, I had an opportunity to review the information and make any corrections before submitting it.  The next day, I received a phone call from my local Social Security office.  A very nice person took a few minutes (no more than 10) to review my application, informing me that my information had been verified and giving me the date each month when my checks would be automatically deposited into my checking account.  And they have been.  Each and every month since then.  When I become eligible for Medicare, I will be enrolled automatically!  When my husband applied for Medicare, the individual he spoke with asked if he was still working, if he had a projected retirement date, and answered his questions about how Medicare interfaces with his employer-based insurance.  As part of the same phone call, the Social Security bureaucrat volunteered information about when to apply for fully Social Security benefits and gave him precise information about the implications of receiving Social Security while still working.  When he did apply, by telephone rather than online, the individual asked to speak to me.  While we were not married when I applied for benefits, the bureaucrat informed me that my own checks would increase by about $100 a month due to the fact that we are now married.  It was simple, straightforward, proactive and professional.

I’m not alone in this experience.  I urge you to read this.  It represents the experience of so many.

As I’ve written before, my mother-in-law is in failing health.  She spent 10 days in the hospital last summer after a serious fall, followed by three weeks in a rehab facility before she moved to an assisted living facility.  As part of that transition, her durable power of attorney for health care came into play.  During her hospital stay, we (my husband, his sister and I) had the opportunity to meet with a team of health care providers, including a case manager and social worker, to explore options for her care upon discharge.  During her stay in the rehab hospital, she progressed from transferring between a wheelchair and the bed, and she progressed from the wheelchair to the walker she had been using before her fall.  That stay allowed her to become ambulatory again, and while she was clearly no longer safe to live alone, she was sufficiently mobile to participate in the activities and social interactions that the assisted living facility provide.  The move to assisted living was emotionally difficult for her, as it would be for most of us.  It represented a huge loss of independence and control over her life.

Her hospitalization and subsequent weeks in rehab was our first direct experience with Medicare, and it was and has continued to be wonderful.  She has a “Medigap” policy and long-term care insurance that covers a portion the assisted living costs and will provide even more benefits should nursing home care become necessary.  She is fortunate.  Between her own pension and Social Security benefits and her long-term care insurance, her current costs are covered almost in their entirety.  She is on hospice care because her medical situation will continue to deteriorate.   She will not recover.  Hospice covers some things under Medicare that we would otherwise have to cover.  But we have not had to wrangle with insurance providers.  And that has been a great relief.  End of life care is difficult at best.  It is emotionally draining watching a loved one reach the twilight of their life.  President Obama has spoken on several occasions of the challenges and worries that his mother faced as she battled both her cancer and her insurance providers.  We’ve been spared that.  And so have millions of older Americans.  It is beyond my comprehension that we, as a nation, are so afraid of providing everyone with the same peace of mind that our family is experiencing with “government-run” healthcare.

Read Full Post »

Frustrating Obstruction

I watched the health care summit yesterday — all 7.5 hours of it.  I guess the best thing one could say about it was that it was generally civil.  And that rare demonstration of civility was most welcome.  Talking points were on display from both sides, although it could be said that the Dems at least have the ability to make their points using a bit more variety in language.  From the GOP, the message was clear — start with a clean sheet of paper.  That millions of Americans have lost their coverage during the past year seems to be lost on them.  Another thing was painfully clear — Republicans think that health care is a privilege, while Democrats think it’s a right.  Republicans think that market forces will solve the problem.  Yet, market forces put the cost of health care increasingly out of reach for a growing segment of the population.  Free (and fair) markets can work well with some things.  When the price of beef rises, people can switch to chicken or even to beans for their protein requirements.  When the cost of health care rises beyond what people can afford, their option is to go without — and that is both a personal and a public health risk, and it’s more expensive.  The net result is cost shifting such that everyone pays more to cover the care of the uninsured.

And then there is Sen.Jim  Bunning, R-KY.  He is a one-man roadblock for extending unemployment and COBRA benefits.  Bunning’s stated reason for his personal obstruction campaign is that he wants to use unspent stimulus funds.  It is true that a portion of the stimulus package was to cover unemployment benefits, but that portion of the package has been exhausted.  Bunning has resisted efforts by members of both political parties to get on board, but he was overheard telling one member of the Senate,  “Tough s**t.”  Yet, he was also complaining that he was missing a college basketball game.  If Senator Bunning voted against the Bush tax cuts, voted against Medicare Part D, and voted against funding for the wars in Iraq and  Afghanistan because of deficit concerns, at least he is being consistent.  If, on the other hand, he voted for any of the above, my response to his missing the basketball game is to remind him of his own words.  Not only do his actions affect 1.2 million unemployed Americans (and by extension their families) but they also impact America’s doctors.

How do Sen. Bunning’s actions affect our doctors?  At yesterday’s health care summit, mention was made of an annual “doc fix.”  This relates to a 20% reduction in Medicare reimbursement rates.  The reduction has been delayed on an annual basis, but like so many important things in Washington, it’s easier to kick the can down the road than to deal with them.  This year’s doc fix is part of the unemployment benefits extension legislation.  It seems particularly reckless for Sen. Bunning to make his fiscal stand on this particular piece of legislation when so many Americans rely on unemployment benefits, along with COBRA and Medicare.

Read Full Post »

On haitus again

I’ll be out of town for a long weekend — another trip to visit MIL as her health continues to fail.

I’m hoping that on my return, I’ll have an easier time sorting out which of the many possible subjects that catch my eye.  Talk about a target rich environment!  But I really am trying not to spend all my writing time picking on the GOP.  Their obstructionism is winding me around the axle.  And don’t even get me started on the total hypocrisy!  It has been breath-taking.  When even the Wall Street Journal begin to call members of Congress out for lining up for stimulus money and touting its benefits for their districts even as they vote against it, you know that it’s gone way too far.

Read Full Post »

Not entitled to your own facts

Tip O’Neill, former representative from Massachusetts and Speaker of the House from 1977 to 1987, was a passionate liberal.  Yet he was famous for working across the aisle when possible.  He held that everyone was entitled to their own opinion, but not to their own facts.  The examples of various politicians and pundits wanting their own facts are legion.

Several deniers of climate change have used the blizzards (a weather event) to validate their denials when the blizzards may actually be examples of a changing climate.  First, let’s distinguish between short term weather events and the longer term trends that define climate.  The past decade is the warmest on record.  That is fact.  And warmer air holds more moisture.  Also fact.  So it is plausible to argue, as many climate scientists do, that a warming planet will lead to more severe weather of many kinds — hurricanes, tornadoes, and yes, blizzards — as all of these result from more moisture in the air.

We can disagree on the extent to which the increasing levels of greenhouse gasses in the atmosphere are natural or human caused or influenced.  We can disagree on whether we can make enough changes in the ways we use energy to moderate a natural cycle.  We can also disagree on the extent or rapidity of the anticipated negative effects of a warming planet — higher mean temperatures, melting glaciers, rising ocean levels, changes in atmospheric or oceanic chemistry.

But to assume that a single blizzard — or even several blizzards in a single season — proves that climate change doesn’t exist is folly.  It is demanding one’s own set of facts.

And over the weekend, former Veep Dick Cheney demanded his own set of facts about both the ways that we handle terrorism suspects and the Iraq War.  The arrest of the Christmas Day bomber and his successful interrogation must stick in the craw of those who support military commissions and “enhanced interrogation” techniques.  That we have gained actionable intelligence from the suspect is a different outcome than that gained by waterboarding.  And it’s instructive to note that the several hundred conviction and incarceration of terror suspects achieved by the Bush Administration in the civilian criminal court system outpace both the number of trials and convictions in military court.  And among the few convictions in military commission proceedings, several of those individuals are no longer incarcerated.  To hear it told by the GOP, the Obama Administration’s use of the very same practices towards terror suspects arrested in the US is somehow unAmerican.

I am so very tired of people who are willfully ignorant — and of those who take advantage of the willfully ignorant.

Read Full Post »

Would you have passed?

In his speech to the Tea Party Nation convention by former Representative Tom Tancredo, he advocated a civics literacy test as a means of qualifying voters.  Literacy tests were used for 70 years to keep African Americans from voting.  One can only wonder how many of those people attending the convention could have passed the purported literacy test given to black voters in Alabama as recently as 1965, the year the Voting Rights Act was passed.  Here are the questions.  Could you have passed?  I have a college degree in history, a minor in international relations, a teaching credential, and have completed additional graduate level work in Middle East studies.  I can’t answer all the questions.  Can you? Could Mr. Tancredo? Could many of those who cheered his suggestion? Don’t worry, the answers are at the end.

1965 Alabama Literacy Test
1. Which of the following is a right guaranteed by the Bill of Rights?
_____Public Education
_____Employment
_____Trial by Jury
_____Voting
2. The federal census of population is taken every five years.
_____True _____False
3. If a person is indicted for a crime, name two rights which he has.
______________________ ________________________
4. A U.S. senator elected at the general election in November takes office the following year
on what date?
_________________________________________________
5. A President elected at the general election in November takes office the following year
on what date?
______________________________________________________________________
6. Which definition applies to the word “amendment?”
_____Proposed change, as in a Constitution
_____Make of peace between nationals at war
_____A part of the government
7. A person appointed to the U.S. Supreme Court is appointed for a term of __________
8. When the Constitution was approved by the original colonies, how many states had to
ratify it in order for it to be in effect? _________________________________________
9. Does enumeration affect the income tax levied on citizens in various states? __________
10. Person opposed to swearing in an oath may say, instead:
(solemnly) ______________________________________________________________
11. To serve as President of the United States, a person must have attained:
_____25 years of age
_____35 years of age
_____40 years of age
_____45 years of age
12. What words are required by law to be on all coins and paper currency of the U.S.?
________________________________________________________________________
13. The Supreme Court is the chief lawmaking body of the state.
_____True _____False
14. If a law passed by a state is contrary to provisions of the U.S. Constitution, which law
prevails?
________________________________________________________________________
15. If a vacancy occurs in the U.S. Senate, the state must hold an election, but meanwhile the
place may be filled by a temporary appointment made by _________________________
________________________________________________________________________
16. A U.S. senator is elected for a term of _____ years.
17. Appropriation of money for the armed services can be only for a period limited to _____
years.
18. The chief executive and the administrative offices make up the ___________________
branch of government.
19. Who passes laws dealing with piracy?_________________________________________
________________________________________________________________________
20. The number of representatives which a state is entitled to have in the House of
Representatives is based on _________________________________________________
21. The Constitution protects an individual against punishments which are _______________
and _______________________.
22. When a jury has heard and rendered a verdict in a case, and the judgment on the verdict
has become final, the defendant cannot again be brought to trial for the same cause.
_____True _____False
23. Name two levels of government which can levy taxes: ____________________________
________________________________________________________________________
24. Communism was the type of government in:
_____U.S.
_____Russia
_____England
25. Cases tried before a court of law are two types, civil and _________________________.
26. By a majority vote of the members of Congress, the Congress can change provisions of
the Constitution of the U.S.
_____True _____False
27. For security, each state has a right to form a _________________________________.
28. The electoral vote for President is counted in the presence of two bodies. Name them:
_____________________________________________________________________
29. If no candidate for President receives a majority of the electoral vote, who decides who
will become President?___________________________________________________
30. Of the original 13 states, the one with the largest representation in the first Congress was
______________________________________________________________________.
31. Of which branch of government is the Speaker of the House a part?
_____Executive
_____Legislative
_____Judicial
32. Capital punishment is the giving of a death sentence.
_____True _____False
33. In case the President is unable to perform the duties of his office, who assumes them?
___________________________________________________________________
34. “Involuntary servitude” is permitted in the U.S. upon conviction of a crime.
_____True _____False
35. If a state is a party to a case, the Constitution provides that original jurisdiction shall be in
______________________________________________________________________.
36. Congress passes laws regulating cases which are included in those over which the U.S.
Supreme Court has ____________________________________________ jurisdiction.
37. Which of the following is a right guaranteed by the Bill of Rights of the U.S.
Constitution.
_____Public Housing
_____Education
_____Voting
_____Trial by Jury
38. The Legislatures of the states decide how presidential electors may be chosen.
_____True _____False
39. If it were proposed to join Alabama and Mississippi to form one state, what groups would
have to vote approval in order for this to be done?________________________________
________________________________________________________________________
40. The Vice President presides over ____________________________________________.
41. The Constitution limits the size of the District of Columbia to ____________________
______________________________________________________________________.
42. The only laws which can be passed to apply to an area in a federal arsenal are those
passed by ___________________________________________ provided consent for the
purchase of the land is given by the _________________________________________.
43. In which document or writing is the “Bill of Rights” found?______________________.
44. Of which branch of government is a Supreme Court justice a part?
_____Executive
_____Legislative
_____Judicial
45. If no person receives a majority of the electoral votes, the Vice President is chosen by the
Senate.
_____True _____False
46. Name two things which the states are forbidden to do by the U.S. Constitution.
________________________________________________________________________
________________________________________________________________________
47. If election of the President becomes the duty of the U.S. House of Representatives and it
fails to act, who becomes President and when? _________________________________
_______________________________________________________________________
48. How many votes must a person receive in order to become President if the election is
decided by the U.S. House of Representatives? _______________________________
49. How many states were required to approve the original Constitution in order for it to be
in effect? ______________________________________________________________
50. Check the offenses which, if you are convicted of them, disqualify you for voting:
_____Murder
_____Issuing worthless checks
_____Petty larceny
_____Manufacturing whiskey
51. The Congress decides in what manner states elect presidential electors.
_____True _____False
52. Name two of the purposes of the U.S. Constitution. _____________________________
_______________________________________________________________________
53. Congress is composed of __________________________________________________.
54. All legislative powers granted in the U.S. Constitution may legally be used only by
______________________________________________________________________.
55. The population census is required to be made very _____ years.
56. Impeachments of U.S. officials are tried by ___________________________________.
57. If an effort to impeach the President of the U.S. is made, who presides at the trial?
_____________________________________________________________________
58. On the impeachment of the chief justice of the Supreme Court of the U.S., who tries the
case? ________________________________________________________________
59. Money is coined by order of:
_____U.S. Congress
_____The President’s Cabinet
_____State Legislatures
60. Persons elected to cast a state’s vote for U.S. President and Vice President are called
presidential _________________________________________________________.
61. Name one power which is exclusively legislative and is mentioned in one of the parts of
the U.S. Constitution above______________________________________________.
62. If a person flees from justice into another state, who has authority to ask for his return?
_____________________________________________________________________
63. Whose duty is it to keep Congress informed of the state of the union? _____________
_____________________________________________________________________
64. If the two houses of Congress cannot agree on adjournment, who sets the time?
_____________________________________________________________________
65. When presidential electors meet to cast ballots for President, must all electors in a state
vote for the same person for President or can they vote for different persons if they so
choose? ______________________________________________________________
_____________________________________________________________________
66. After the presidential electors have voted, to whom do they send the count of their votes?
_____________________________________________________________________
67. The power to declare war is vested in ________________________________________.
68. Any power and rights not given to the U.S. or prohibited to the states by the U.S.
Constitution are specified as belonging to whom? ______________________________
Answers to Alabama Literacy Test
1. Trial by Jury only
2. False (every 10 years)
3. Habeas Corpus (immediate presentation of charges); lawyer; speedy trial.
4. January 3
5. January 20
6. Proposed change, as in a Constitution
7. Life (with good behavior)
8. Nine
9. Yes
10. Affirm
11. 35
12. In God We Trust
13. False
14. U.S. Constitution
15. The governor
16. Six
17. Two
18. Executive
19. Congress
20. Population (as determined by census) less untaxed Indians
21. Cruel and unusual
22. True
23. State and local
24. Russia
25. Criminal
26. False
27. Militia
28. House of Representatives, Senate
29. House of Representatives
30. Virginia
31. Legislative
32. True
33. The Vice President
34. True
35. The Supreme Court
36. Co-appellate
37. Trial by Jury
38. True
39. Congress and the legislatures of both states
40. The Senate
41. 10 miles square
42. Congress; state legislatures
43. Constitution
44. Judicial
45. True
46. Coin money; make treaties
47. The Vice President, until the House acts
48. 26
49. 9
50. Murder
51. False
52. (Preamble statements) “to form a more perfect union, establish justice, insure domestic
tranquility, provide for the common defense, promote the general welfare, and secure the
blessings of liberty to ourselves and our posterity.”
53. House of Representatives and Senate
54. Congress
55. 10
56. The Senate
57. The Chief Justice of the Supreme Court
58. The Senate
59. The U.S. Congress
60. Electors
61. Pass laws, coin money, declare war
62. The Governor
63. The President
64. The President
65. They can vote for different people
66. Vice President (President of the Senate)
67. Congress
68. The states; the people

Now, if you think that one is too tough but you do support the concept of civic literacy as important in a democratic society, here’s the test that is given to people desiring to become citizens.  Sometimes I wonder if all our current members of Congress could pass it.  After all, some of them have stumbled when asked to recite the Pledge of Allegiance or the Star Spangled Banner. 

Read Full Post »

Are you feeling squeezed?

Many people in the middle class are feeling squeezed economically.  I know that the dollars just don’t seem to go as far as they used to.  The days of being able to run a household on $25 a week are long gone.  Why do I use $25 as the baseline number?  That was my household budget in the early years of my working life.  Twenty-five dollars that provided for food, laundry, dry cleaning, and prescriptions — for two of us.  And it was enough that we could even serve a rib roast for company occasionally.  I was working as was my husband, and my entire salary went into savings to fund the down payment on a house.   A reasonable, new, three-bedroom home in Orange County, California could be had for $30,000 or so.  Before the housing bubble burst, my old house, that sold new for $38,000 in 1968, was selling for nearly $800,000!

In late January, Professor Elizabeth Warren, the shining light of President Obama’s economic team, released some fascinating statistics that demonstrate just how hard the middle class has been squeezed over the past generation.  There are some costs that have gone down, but the preponderance of costs has gone up.  Between 1971 and 2007, take a look at the increases, adjusted for inflation.

• Housing costs, up 80%
• Health insurance premiums, up 75%
• Cost of a new car, up 60%

And the more telling statistic is the one that points to disposable income.  In 1971, families spent 50% of their income on fixed costs — food and shelter primarily, but also health insurance premiums, car payments and the like.  That left half of a family’s income to cover everything else — maintenance on house and cars, food, clothing, college tuition, out-of-pocket health care costs, vacations, etc..  By 2007, fixed expenses ate up 75% of a family’s income, despite a huge shift to two-income families.  Other costs relating to that second income include child care, more taxes, and in many cases higher food costs due to more meals eaten out, further cutting into disposable income.

Let’s look at what gets cut out as disposable income gets squeezed.  The short answer is consumer spending.  Ever stop to wonder just why the big box and discount stores have become so popular?  But consumer spending isn’t the only casualty.  As demand grows for more deeply discounted goods, quality of available goods suffers, and the demand for low prices puts more pressure on employers to keep wages and benefit costs down.  The vicious cycle has begun.  As people are further squeezed, the pressure on employers increases, leaving more people out of any real increases in wages and benefits.

But there is another, even more insidious cycle.  More families can no longer afford to pay for their children’s college educations, even knowing full well that education is the path to better paying jobs.  Those who can manage to cobble together  grants and loans leave school find themselves with debt that today’s salaries are insufficient to repay, in turn dashing hopes of home ownership for may of them.

Productivity of US workers has increased markedly during the past 30 years, but workers have seen precious little benefit.  Instead, the increased profits have gone almost exclusively to the executives and to the stock holders.

And in the midst of that squeeze, we learn that GDP grew by over 5% in the last quarter of 2009… despite an unemployment rate hovering at slightly under 10%.

It’s no wonder that the American people are angry.  Congress, especially the Senate, seems not only unwilling but incapable of taking action that most people see as benefiting them.  Banks walk away from loans they owe on properties that have declined in value, claiming that it is simply a good business decision on their part; meanwhile, homeowners who are underwater are expected to repay their loans in full.  Lobbyists and special interest groups play to people’s worst fears, and more and more, political discourse descends to name-calling rather than serious and rational discussion of the issues facing us.

Read Full Post »