Where Health Insurance is Headed, a Krugman "gem," Doing Something in Syria and a Canadian Interloper

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Health Care Needs a Fix

The Affordable Care Act has enabled many millions of Americans to obtain real health insurance for the first time in their lives, enabling them to have real healthcare rather than depending on visits to ERs or worse, ignoring symptoms and going untreated.

Its accomplishments include (1) requiring insurers to provide coverage regardless of pre-existing conditions, (2) enabling dependents up to age 26 to remain on their parent’s health insurance plans, (3) establishing cost guidelines for health care providers and (4) subsidizing the cost of health insurance through state-run Medicaid programs for low income families.

But the ACA has not worked well in other ways.  It is dependent on the private health insurance industry to provide policies to individuals, who are mandated to purchase coverages from these private insurance companies or pay a tax penalty.    Many young and healthy individuals have found it less expensive to pay the penalty than to purchase health insurance.  Unfortunately, older and sicker people have purchased it in great numbers.  This “mix” has caused some insurance companies to cease providing policies under the Act’s provisions (through State-run and Federal purchasing exchanges) and many, to keep premiums low, have offered policies with very large deductibles and co-payments.  This, along with unregulated prescription drug costs, have resulted in “sticker shock” when Americans get their bills from health care providers.

But these negatives are not present within the framework of Medicare, which is what most Americans age 65 and older have as their primary health insurance programs.  Of course, Medicare is not free.  Those covered under it pay premiums, usually deducted from Social Security payments, and the Federal government must also subsidize it from tax revenues.

 

The only involvement of private health insurance companies in Medicare is (1) to sell supplementary insurance to fill Medicare’s gaps, (2) to sell a wide a choice of prescription drug plans and (3) to sell Medicare “Advantage” plans where the insureds sacrifice an element of choice in how their health care is delivered for an all-encompassing lower premium, often paid entirely by the Federal government.   Thus, there is a vast difference between Medicare and Obamacare, the Affordable Care Act.  Those on Medicare have a better deal!

Bernie Sanders actually wanted to do away with the Affordable Care Act and make everyone eligible for Medicare.  This would basically wipe out the private health insurance industry, except for the supporting roles described in the preceding paragraph.  We would then have a “single payer” plan, and that payer would be Medicare or whatever the government chose to call it.  This would be a very costly program, although Sanders, and some health insurance economists, claim its total cost would be less than what we are paying for health care through private companies today.  Ultimately, it is inevitable that we will end up with a program approaching, but not quite realizing, Medicare for all.  But don’t hold your breath.  Read on.

Hillary Clinton has proposed making those age 55 and older eligible for Medicare.  Of course, this would be complicated since such individuals are not yet on Social Security.  They would have to purchase the plan and further tax increases certainly would also be necessary.  Most importantly, however, this would take many older, and sicker, people out of the pool of individuals purchasing private insurance through the Affordable Care Act’s exchanges.  Taking these age 55 to 64 folks into Medicare would reduce premiums for those remaining to purchase Obamacare private insurance and hopefully, bring still more younger and healthier people into the program.

I foresee that perhaps there might be a periodic change in such a program whereby the age at which the opportunity to select Medicare as one’s health insurance choice would periodically drop, perhaps one year annually, until ultimately, everyone would have the opportunity to opt for and purchase Medicare coverage!  The private health insurance industry, being more expensive since it involves making a profit, would then wither away. 

This leads to the question as to whether health care, in general, should be an area where profit-making, along with providing a service, should even be a factor.  And this includes the pharmaceutical industry.   Is more government regulation of that industry, and the rest of health care, on the horizon, and would that lead to a government takeover of all aspects of health care?  Would that be good or bad?  

There has to be a middle ground, a balance somewhere, and it will be determined, I believe, over the next quarter of a century.  The absence of what used to be the Republican Party, over those years, may make reaching this balance easier. 

 For that, Democrats and others who will back such a "single payer" plan will owe their thanks to one person, Donald Trump.

Jack Lippman

                                                            

Krugman! 

Last week, New York Times columnist Paul Krugman concluded one of his columns by stating that “…today’s increasingly multiracial, multicultural society is a nightmare for people who want a white, Christian nation in which lesser breeds know their place.  And those are the people Trump has brought out into the open.”  And I might add that the place out from which “Dangerous” Donald has brought them is the woodwork, where many of them have been hiding, crawling and breeding since the Civil War.

JL

                                             

Now They Have to Import Conservatives! 

I recently received an email captioned "The Donald Trump Video Every Jew MUST Watch!"  So I watched it.  It was a shallow, fifteen minute diatribe by notorious Canadian ultra-conservative Ezra Levant (who comes across as your mild-mannered harmless second cousin) appealing to Jews in the United States to vote for Donald Trump for a variety of reasons, including his Jewish grandchildren, and filled with tired old accusations that Democrats, particularly Clinton and President Obama, were no friends of the Jews nor of Israel. 

Levant is known for his right-wing Zionist views which is just fine, but that does not entitle him to inject himself into our politics with an emotional message intended to appeal to the very gullible among us who are ready to agree with anything they believe is "kosher" because of the presence of a Magen David, literally or figuratively, in it.   And that's what Levant figuratively does, waving the Israeli flag in the face of American voters!   And it raised a few questions in my mind which I directed to Levant in an email to which I doubt he will reply.  You can watch Levant's message by clicking here.   And here is what I asked him in my email.

1.  If Donald Trump is so good for the Jews, how come he has appointed an anti-Semite like Stephen Bannon, who didn't want his kids going to private school with Jews, to run his campaign?

2.  If Donald Trump is so good for the Jews, how come he hasn't firmly denounced the support of avowed anti-Semites like David Duke and other white supremacists, about whom months ago, he said he didn't know anything.

3.  As someone who isn't even a citizen of the United States, why are you getting involved in our Presidential election?  Really, it's none of your business.

4.  Do you really believe that voters should vote for what they perceive as being good for their personal religious beliefs rather than what is good for their country?  The United States is not the Islamic Middle East.  You seem to be confused about this.
  JL

                        

Humanitarian Action Demanded in Syria 

It’s time that the political parties in the United States, and their candidates, spoke out about what is going on in Syria.  Too many innocent people, many of them children, are being killed there.  It is time that this slaughter be ended.  Military and political considerations should be put aside and a humanitarian solution given the highest priority.

To start this, an international conference should be assembled.  Mid-level diplomatic representatives from the United States, Russia, Turkey, Iran, Iraq and a major Sunni nation such as Saudi Arabia or Jordan should attend, as well as, of course, the Syrian government.  The Iraqi delegation must include Sunnis and Kurds, even though the government in Baghdad is primarily Shia.   A possible place for such a meeting might be Dubai or Cairo.

The agenda must include (1) the cessation of bombing and shelling of civilian areas, (2) the removal of all military installations from civilian areas and (3) the establishment of refugee centers, schools and hospitals in areas from which all military activity is prohibited.   Failure of any of the participants to agree to this kind of agenda would mark them as enemies of real peace in the Middle East and as deserving of condemnation as is the Islamic State, which all of them ostensibly oppose.

Once such a conference achieves a “humanitarian” victory in Syria, further diplomatic steps should follow in an effort to resolve political issues without resorting to military measures, other than those directed as eradicating the Islamic State … and that too should proceed along the guidelines suggested above.

It might be anticipated that such a “humanitarian” approach might result in unwarranted criticism of Israel, something which is automatic among Muslim states.  It is clear, however, that the military measures resorted to by Israel, only after extensive warnings to civilian populations, were only necessitated by the intentional placement of military targets in the midst of civilian environments.  Should this issue arise at the suggested meeting, it would be the role of Israel’s friends there to point this out.

And while on this subject, the United States has agreed to, and is in the course of accepting, 10,000 throroughly "vetted" immigrants from the carnage in Syria as a humanitarian gesture. European nations, less richly endowed than our country, are doing much more.  These people once had homes and jobs there, and children going to school each day, but all of that has been wiped out.  Other than Native Americans, there is no one in the United States who is not descended from immigrants who came here for similar reasons. There has always been some sort of "Golden Door" in this country. 


"I lift my lamp beside the golden door." ... from the famous Emma Lazarus poem

And those who scream to keep them out, fearing they are terrorists, are only repeating what was said about other immigrant groups since the Nation's founding; they forget that Americans themselves are immigrants or their descendants.  Shame on them.

JL

                                      

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