Relevant and even prescient commentary on news, politics and the economy.

Sequester Impact: 1 In 7 Seniors Struggle With Hunger

Crooks and Liars Diane Sweet writes about the impact the Sequester is having on something I used to do when working part time at an assisted care and nuring home in Bensonville, Illinois while pursuing my first BA. “Meals on Wheels” would bring a meal a day to the elderly. Since some were apartment-bound with no way to get to a store; potentially, this was their only meal for the day. Often times, I was also the only face they might see that day. In My Datsun 510 (college transportation), I would make a dozen or so stops when I did this. I can vouch for the gratitude I received from making the deliveries.

While Social Security has kept many afloat in today’s economy, 15% of the elderly still live in poverty as determined by the supplemental measurement.

65 and older poverty

As Diane Sweet points out, the Sequester has only made it worst for seniors who depend on this and other programs to make ends meet and to bring them the simplest of things . . . a meal and a face at the door.

Sequester Impact: 1 In 7 Seniors Struggle With Hunger

sequestercuts

Sequester cuts will total $1.2 trillion through fiscal year 2021. This year there is a 5.3 percent cut, totaling $85 billion. The cuts are indiscriminate and will impact nearly every federal program. Here are some of the ways this year’s cut is affecting food and hunger programs:

Meals for needy seniors lost in programs like Meals on Wheels (MOW): 4 million

Savings from cut of 4 million meals: $10 million

Rise in Medicaid costs due to cut of 4 million meals: $489 million

Net cost to U.S. federal budget due to cut of 4 million meals: $479 million

Loss of senior meals, California: 750,000

Loss of senior breakfasts, Palm Beach County, Fla.: 240 daily

Loss of senior meals in group dining facilities, Detroit suburbs and several counties: 86,000

Loss of home-delivered and group dining senior meals, La Crosse County, Wis.: 6,000

Ellie Hollander, president and CEO of the Meals on Wheels Association of America: “The real impact of sequester is that our programs don’t have the ability to expand to meet the growing need. We should be investing in these programs to ensure our seniors have the nutritious meals they need to remain healthy and independent.”

Patricia Hoeft, director of senior center nutrition, the Mid-East Area Agency on Aging (Missouri): “How do I decide which 300 seniors aren’t going to eat that day?”

Meals on Wheels recipient, home delivery program, La Crosse County, Wis.: “These meals are sometimes the only meal that I have a day. I don’t drive, so I have to rely on others to get around to doctors’ appointments. I only get $16 a month for food.”

References:

- “Sequester Impact: 1 In 7 Seniors Struggle With Hunger” Diane Sweet Crooks and Liars
- “Hunger and the Sequester, By the Numbers” Bill Moyers “What Really Matters”
- “A State-by-State Snapshot of Poverty Among Seniors: Findings From Analysis of the Supplemental Poverty Measure” The Henry J Kaiser Family Foundation

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Medicaid Expansion in Michigan

States refusing to expand Medicaid to 133% of FPL has repercussions for those making less than 100% FPL. The PPACA was intended to setup State Exchanges where people could buy healthcare insurance and if they had an income beyond 133% FPL (Federal Poverty Level). Subsidies in the form of a tax credit would be given to each participant (sent to insurance carrier) based on their income. Remember, I said the PPACA was designed for those with incomes >133% FPL? While those with incomes >100% FPL can get subsidized healthcare insurance in the Exchanges, those with incomes <100% FPL can not get subsidized healthcare insurance in the exchanges and they would be covered by Medicaid. The states threatening to not expand Medicaid will leave a hole in healthcare insurance coverage. If the states do not expand Medicaid for single and childless married adults and expand it for married adults with children with incomes <100% FPL, they will not be able to get subsidized coverage on the exchanges either. Many state legislatures are not mentioning this to the constituency in the hope they can blame it on the PPACA, President Obama, and the Democrats. Here is how it is playing out in the State of Michigan . . .

“the expanded program would cover as many as 450,000 Michiganders, according to projections. Michiagn State Senator Hune said there is evidence that about half of those in the expanded income category already have coverage of some kind” Press and Argus local newspaper. Michigan State Senator John Hune (my district) is worried about adding 450,000 more uninsured people to Medicaid if they expand it under the PPACA . I could understand the concern if:

• It was not funded. The Medicaid expansion is fully funded up to 100% for the first 3 years and gradually drops to 90% in 2020. The 90% still exceeds the unenhanced Federal Government Medicaid funding of 66% presently given to Michigan for Medicaid. Federal Medical Assistance Percentage (FMAP) for Medicaid and Multiplier, State Health Facts, The Henry J. Kaiser Foundation.

• The State of Michigan already covered adults with and without children up to 100% of FPL. Michigan does not cover up to 100% of FPL for any adult. Jobless Adults with children are covered under Medicaid if they are <37% of FPL. Working adults with children are granted Medicaid coverage at <64% of FPL. Single adults were once covered at <35% FPL if jobless and <45% FPL if working. The program is closed for single adults and married childless adults. Adult Income Eligibility Limits at Application as a Percent of the Federal Poverty Level (FPL), January 2013 The Henry J. Kaiser Foundation.

Recently, the Republican dominated Michigan State Senate went on vacation rather than voting, leaving the PPACA Medicaid Expansion issue to be decided upon when they return in Fall. State of Michigan Senator Hune’s reasoning was the lack of time (two days) to decipher the Medicaid Expansion. Now this happened in an automotive state where people who work in the automotive industry usually end up losing vacation and holiday time when a production line shuts down or a shipment needs to go out. Myself, I have faced such issues when managing a $200 million/year warehouse for a major Tier One. We hung around until the issue was resolved. This is also happening 2 years after the PPACA has passed, been decided as constitutional by SCOTUS, and rolled out piece meal. So why can’t they give up a couple of days and give it a yes or no vote?

The Republican dominated Michigan State Senate and “other opponents” to the PPACA are not acknowledging the resulting hole in coverage which the PPACA will not cover. Those people who do not have an income of at least 100% FPL will not be eligible for PPACA subsidies in the State Insurance Exchanges. For example, a working women with one child making $10,000 per year is at 64% of FPL and is ineligible for a subsidy to assist in paying the ~$4,900 insurance premium levied from the State Insurance Exchange. Pre-SCOTUS PPACA June 2012 decision, the Federal Government could force states to expand the Medicaid coverage by withholding funding already allocated to states for Medicaid. Since the 5-4 majority SCOTUS ruling, SCOTUS determined the Federal Government and Congress can not force states to expand Medicaid. Using the Kaiser Interactive Subsidy Chart, one can see in the chart below, the working Michiganders caught between 36% of FPL and 100% of FPL would not be eligible for PPACA Subsidies in the eventual Michigan Healthcare Insurance Exchange.

Subsidy1

So why is Michigan State Senator John Hune so concerned about the addition of these Michiganders to Medicaid when there is no other comprehensive coverage for those with income < 100% FPL; secondly, the funding is at 100%, drops to 90% in 2020, thirdly it is a net gain for Michigan; and finally Medicaid improves upon what they may now have (telemarketed mini-meds) and would result in healthier workers? Perhaps, Senator Hune is attempting to appease a Tea Party constituency as his reasoning otherwise lacks common sense. Missing out on the funding for additional Medicaid coverage is only one aspect of the issue as there other gains to be realized from expanding. Michigan’s Economy Will Benefit from Expanding Medicaid, Families USA and Michigan Consumers for Healthcare points to a host of other benefits Michigan will forgo if it does not expand Medicaid.

• In 2016, the new federal dollars would support approximately 18,000 new jobs across all sectors of Michigan’s economy, a 0.32 percent increase over the number of current jobs in the state. This is not limited to health care jobs. Because of the multiplier effect (described above), jobs would be created in a wide range of business sectors throughout the state.

• The increased federal funding and jobs created are projected to increase economic activity in Michigan by nearly $2.1 billion starting in 2016.

• From 2013 through 2022, the Medicaid Expansion could save Michigan ~$350 million in uncompensated cost, as more people would be insured. This would offset the decreased percentage in 3 years.

• Hospitals also absorb uninsured healthcare costs. It is estimated another $317 million could be saved with the Medicaid expansion.

• In 2008, the costs of uncompensated care increased family health insurance premiums by an estimated $1,017.

• Increased state revenue from more people working.

• In this conservative get a job or get out of the state of Michigan, insured constituents would be healthier and more productive in jobs.

Solely because of politics, the Republican held Senate in Michigan is stonewalling the Medicaid Expansion at the expense of thousands (6,000 in Livingston County alone) of their constituents. Again as taken by Henry J. Kaiser Foundation, there are 1.9 million people in Michigan who have incomes <100% FPL who would not be eligible for subsidies on the PPACA State Insurance Exchange. Only adults with children are eligible today for Medicaid and only if their income is a much lower percentage than 100% FPL.

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The PPACA Sky is Falling . . .

Chicken Little

Quelle Surprise, The White House Administration has decided to give “some” companies with >50 employees a one year extension in order to prepare and comply with the PPACA mandate. Given the amount of resistance the PPACA has received from the states in preparing for it and the House of Representatives, this delay should come as no surprise at all. While everyone has rushed into the fray claiming it is proof the PPACA is failing, the delay impacts a fraction of the employers with >50 employees. 94 – 96% of the ~200,000 employers who fall into this qualification already offer comprehensive healthcare insurance. The delay was to allow the 4 to 6% of the employers (8,000 to 12,000 employers) time to decide what they will offer. Former health policy administrator Ezekiel Emanual had this to say as reported by Bloomberg Health-Law Employer Mandate Delayed by U.S. Until 2015:

“Former White House health policy adviser Ezekiel Emanuel, now vice provost at the University of Pennsylvania, said today on MSNBC’s Morning Joe that the delay of implementation of the employer mandate will impact a limited number of companies. ‘I actually don’t think this is that big a deal,’ he said.

‘The provision only applies to employers who have 50 or more employees’, Emanuel said. He estimated that there are 200,000 total employers in the U.S. impacted and that “94 percent already offer health insurance” to employees.

‘We need to look for 2020 rather than moment to moment for changes in the system,’ Emanuel said.

Obama has confronted opposition from Republicans at every turn of the law, which passed Congress with only Democratic votes and was later challenged before the U.S. Supreme Court.

Only 16 states have agreed to set up the new exchanges, or marketplaces to sell insurance to people who don’t get it at work. Twenty-four states have refused to expand Medicaid, as called for under the law, according to Kathleen Sebelius, Obama’s secretary of health and human services.

Congressional Republicans, who have vowed to try to repeal the law, have refused Obama’s requests for about $1 billion more to help enact the statute and ensure it runs smoothly. Instead, they’ve started multiple investigations into the implementation.

Nor is this the first time Obama has been forced to scale back the law’s features. In March, the administration said small businesses wouldn’t be able to give their workers a choice of health plans in exchanges set up just for them. In January, a plan to create new nonprofit insurers in states was curtailed after Congress capped funding for the companies.”

Reports of companies limiting workers to 30 hours per week to avoid offering them healthcare insurance has been in the news with food chains and WalMart leading the way. It does not quite work that way as reported by Maggie Mahar at Health Beat Blog; The Employer Mandate is Postponed: What Does This Mean For Obamacare? Is Ezra Klein Right–Should the Employer Mandate Be Repealed?. Maggie goes on to say:

As I explained in a recent post, what the critics don’t seem to understand is that the ACA requires that employers offer health benefits if they have “30-time full-time employees or full-time equivalents.” Two workers who put in 15 hours a week equal one full-time equivalent. In other words, the government doesn’t count heads, it counts hours. To figure out how many “full-time employees and full-time equivalents” a business owner has, the government will add up the hours that all of his employees work, and then divide by 30.

The employer who cuts 12 of his 40 full-time employees to part time, and hires another 12 part-time employees to fill in the holes in his work schedule will wind up with 28 full-time workers and twelve “full-time equivalents.”

He will not have to insure the part-time workers, but he will be required to offer benefits to the 28 who actually work 30 hours a week.

As far as WalMart, people are already complaining about the lack of stocked shelving and service. This plays into the hands of WalMart competitors such as Target and Costco who appear to have their employees well being in mind. Should the Employer Mandate be removed. Some interesting commentary from Maggie Mahar. In 2009, Ezra Klein argued against the employer mandate and recently the same argument surfaced again.

“Again he quotes CBPP: ‘The employer mandate and penalties ‘would likely influence employer decisions about which of their employees to let go when they trim their workforces to cut costs, such as during a recession’ Workers from low-income families would cost the firm significantly more.’

Yesterday Klein repeated the argument, writing that ‘Eliminating” the employer mandate, or at least utterly overhauling it is probably the right thing to do.’

Maggie: I disagree. I admire both Klein’s Wonkblog and the CBPP, and applaud most of what each have written about health care reform. But in this case the argument is based on the false assumption that employers will choose to pay a penalty of $2,000 to $3,000 per employee rather than provide insurance. What both Klein and CBPP overlook is what Klein himself has explained in the past:

‘People simply misunderstand why employers offer health-care benefits. They’re not doing it as a favor to employees. . . Employers offer health insurance because employees demand it. If you’re an employer who doesn’t offer insurance and your competitors do, you’ll lose out on the most talented workers. An employer who stopped offering health benefits would see his best employees immediately start looking for other jobs.’

Research also shows the health benefits improve productivity and reduce absenteeism. As I pointed out: not long ago:: “This explains why 95% of employers with more than 30 workers offer insurance.”

The sky has a long way to fall before it hits your head. Do not be fooled by the commentary lacking substance. The habitual naysayers and pols are having a field day with this revision in implementation when the problem is only a small portion of the total. Most employers are ready to go forward.

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Productivity & Effective Demand: An Intriguing and Disturbing Story . . .

Edward Lambert at Effective Demand; Effective Demand = Effective Labor Income/(cu*(1-u)) points to the result of an economy left to maximize Profits at the expense of Labor. I have my own version or underlying causes of this issue and Edward gives the economic side of it.

I am going to show a graph of Productivity against Effective demand. It is an intriguing and a disturbing graph. Let me start by giving the equation for the productivity used in the graph.

Productivity = real compensation per hour: business sector/(labor share: business sector * 0.78)

The data for this equation comes from this graph at FRED.

The equation for effective demand is…

Effective Demand = real GDP * (labor share: business sector * 0.78)/TFUR

TFUR (total factor utilization rate) = capacity utilization * (1 – unemployment rate)

Let me just show the graph and then start explaining . . .

Productivity and Effective Demanda

The graph shows quarterly data from 1967 to the 1st quarter of 2013. The red dashed line is a trend line for the data. We can see that from 1967 to 1997, the plot stayed very tight on the trend line. There were deviations from this line during times of shocks and recessions. But it is very interesting how closely the plot followed the trend line before 1997.

Before 1997, the plot going below the trend line was associated with a recession. The explanation of this is that effective demand rises more during a recession because of more available capacity of labor and capital. At the same time. productivity tends to fall behind the trend line due to rising labor share, not falling real compensation.

When the plot goes above the trend line, productivity is ahead of effective demand. Productivity rises due to labor share settling down and real compensation rising. Effective demand tends to stay still during the expansionary phase of a business cycle. The economy grows up to the effective demand limit and then gets set for a contraction.

We used to have a balance between productivity and effective demand. The economy moved directly on top of the trend line for many many quarters. And now the economy has lost that balance. Since the late 90′s it is a fleeting moment when productivity and effective demand come together on the trend line.

Before 1997, there was very little movement away from the trend line. Then something unusual happened between 1997 and 2001, the dotcom bubble years. The plot went progressively below the trend line even though there was no recession. Productivity was rising during these years, but effective demand was rising at such an unusual rate that productivity could not keep up with it. Effective demand was being artificially created and inflated. The recession of 2001 followed the same unusual path as before the recession.

In 2002, the economy had to make an adjustment. Productivity had to rise or effective demand had to fall. During the housing bubble years (from 2002 to the quarter right before the 2008 recession), productivity rose, while effective demand basically stayed steady. The plot went back above the trend line showing that productivity was beyond the capacity of effective demand and that productivity was at a non-sustainable level. The economy sustained this high level of productivity in the face of low effective demand for a few years, but eventually the correction would come in 2008. The correction was a collapse.

Look at where the economy is now. Since the end of 2010, the plot has barely moved from a productivity just below 1.4 and an effective demand around $14.1 trillion. The plot is way above the trend line and has been just sitting in the same spot for over 2 years. Effective demand is too low for the current productivity in the US. This is an economic bomb building energy that will eventually go off when real GDP approaches $14.1 trillion.

A friend of mine had a dream a few nights ago, where a spirit said that the economy is dying. The graph above would lead one to think the same.
Think about it… where can the economy go now from here?
There are 2 options . . .

Option #1 looks at the equation for Productivity: You have to lower productivity by increasing labor share in relation to real compensation.

1. If you lower real compensation, labor share would fall, but it would have to fall slower than real compensation. Keep in mind though that a lower labor share would lower effective demand too, which would work against the objective. However, if labor share actually rose in the face of lowering real compensation, you would see an economic contraction. So lowering real compensation is not a good option.
2. On the other hand, if you raised labor share faster than raising real compensation, productivity would come down as effective demand increased from higher labor share. This is a safe and sensible way to correct the huge imbalance we find ourselves in.

Option #2 looks at the equation for Effective Demand: You have to increase effective demand back up to $16 trillion. There are two options here as well.

1. Utilization of labor and capital would have fall. (TFUR in the equation above would have to fall.) This would mean a rise in unemployment, which would mean another collapse.
2. Labor share would have to rise. This would also have the beneficial effect of lowering productivity, as long as real compensation rose moderately.

As we can see, the only real option to avert another collapse is to raise labor share of income. This is not likely as businesses are even now fighting an increase in just the minimum wage. Businesses are trying to maximize their profits and do not want to raise labor costs. Yet this objective of theirs is going to kill the economy.

The graph above shows that there is a bomb ticking, and it is a bigger bomb than we saw in 2008. Higher productivity in the face of low effective demand is unsustainable. Yet, we have been sustaining it for over 2 years now with an incredible expansionary monetary policy in the face of an incredibly low labor share of income.

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SCOTUS Rules Again . . .

As found on our Open Thread of June 28, 2013, jurisdebtor decided to leave a gem behind. Juris debtor can be found on his Blog J.URIS D.EBTOR, My Own Meanderings Through Economics, Law, and Policy Having been in the courts for the last decade, I find this to be a good interpretation of what one might expect from the courts. It is never what you believe it to be coming from the gods dressed in black sitting behind their pulpit looking down at you (there is distinct reason for this). The days of Gideon are forever past (happy fiftiest Gideon in 2013). Try writing SCOTUS yourself today.

Don’t Let DOMA Fool You — the Supreme Court is Restricting Your Rights By David Cole, Washington Post, 6/28/2013. As taken from the Open Thread, jurisdebtor posts David Cole’s appraisal of SCOTUS decisions as rendered by the Kennedy Court (my interpretation).

The Supreme Court’s 5 to 4 decision to strike down a key part of the Defense of Marriage Act was undeniably historic, a victory not just for gay rights advocates but for anyone committed to advancing equal rights in America.

It was also an anomaly.

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Ms. Wendy Davis Goes to Austin, TX

As if the scene was taken out of “Mr. Smith Goes to Washington”, the 13 hour filibuster by Texas State Senator Wendy Davis succeeded in killing SB537 by minutes. The vote failed to happen in the allotted time killing the bill for the time being. While filibustering the passage of the bill, Texas State Senator Wendy Davis could not visit bathroom facilities, take a sip of water, lean on any pedestal or desk, receive assistance from anyone else, and had to remain on issue.

“On Monday, the Texas State House voted overwhelmingly to pass a draconian proposal Texas SB537 that would ban all abortions after 20 weeks, as well as adding stringent new restrictions on how clinics get licensed. The intent was clear: Supporters of the bill, known as SB 5, openly acknowledged that the law would have closed 37 of the state’s 42 clinics, leaving hundreds of thousands of women in Texas and neighboring states like Oklahoma with no way to access abortion care. With a conservative majority in the State Senate and the support of Governor Rick Perry, the measure seemed certain to become law.”

The vote happened at 12:02 PM two minutes too late to be passed. Attempts to postdate the time to earlier than 12:00 PM by Republicans met with challenges from the Democrats and the Media until the time was conceded.

Raised by a single mom and at 19 a single mom herself, Texas State Senator Wendy Davis has been leading the charge for women’s choice. The impact of her challenges has been felt with her offices allegedly being fire-bombed due to her support on Planned Parenthood. 31% of the women in Texas are uninsured. The passage of this bill would have closed down 37 of the 42 abortion clinics in Texas leaving residents of Texas and Oklahoma with few places to turn to.

The closure would not only place an undeserved economic burden on pregnant women who would have no place else in which to turn. The closures would have come on top of state-directed counseling designed to discourage them from having the procedure, a mandatory ultrasound where the provider describes the fetal image and a mandatory 24-hour wait.

It is not too often we see a person with the courage literally take a stand in a hostile environment for what they believe is right.

Mr. Smith: “I always get a great kick out of that part of the Declaration of Independence. Now you are not going to have a country that can make these kind of rules work, if you do not have men that learned to tell human rights from a punch in the nose.”

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The Solution to the Economy: Raise Social Standards and Social Efficiency

Guest post by Edward Lambert as taken from his Blog Effective Demand

Yes, the economy is a concern. There are problems to sort out. The problems run deep. What is the solution?

The solution to the problems of the economy will be found through “Social Efficiency” and raising the social standards that have been declining through the years. I will present 3 examples of lowered social efficiency, grade inflation in schools, the minimum wage and finally low interest rates. My purpose is to show that nominal interest rates need to rise, but that real wages must rise in unison too. 

Grade Inflation at Yale University

Let’s go to Yale University and see an example. Yale is currently working on a solution to its grade inflation. Grade inflation is when more students get A’s than before.

“…a full 62 percent — nearly two-thirds — of grades awarded in Yale College, the university’s undergraduate school, are A or A-. (That wasn’t case four decades ago, when just 1 out of 10 grades awarded fell in the A range.)”

Grade Inflationb

This quote is taken from an article about the problem of grade inflation at Yale. There is a comment below that article by Adam Glover. . .

“What do they call the person who graduates first in their medical class? Doctor
What do they call the person who graduates last in their medical class? Doctor
Rather than worrying about grades, I’m more concerned that students are sacrificing real learning for a better GPA.”

The problem is that standards, and more importantly, Social Standards of quality have been lowered. The issue of grade inflation at Yale is just one isolated example of declining Social Standards around the world. Just this week we see cheating in the schools of China is rampant, even as parents try to bribe teachers so their children get better grades.

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Obamacare – Fear – Mongers Poison Minds; Hatred Blinds

Maggie Mahar at Health Beat Blog Obamacare – Fear – Mongers Poison Minds; Hatred Blinds” writes about the confusion about, the anger at, and the mischaracterization of the PPACA by every day people, medical workers, and politicians. Having myself presented the facts to rebut assumptions and fallacies, I find her comments interesting and on the money. Most who nit-pick on the PPACA have no obtainable and immediate alternatives in hand to replace the PPACA leaving a return to what was in place previous to its passage. The healthcare industry and Congress has done nothing to improve the situation pre-PPACA. There is no evidence they would move forward with a better alternative to the PPACA if it was repealed.

Maggie’s words:

Judith Mayer Lynn, uninsured and battling breast cancer, should be a fan of the Affordable Care Act1. Instead, Bloomberg reports, she know little about it. When Bloomberg interviewed the 56-year-old she was unaware of subsidies in the law that will help people like her buy coverage in 2014,. “Lynn didn’t know the Affordable Care Act requires insurers to pay for prescription drugs, hospital stays and other services she has spent the last two years scrimping to afford. Nor did she realize she can no longer be denied a policy due to her illness”.

When told of the benefits, “Lynn remained unconvinced, skeptical of insurers and government alike. ‘It’s a joke,’ she said. ‘There’s going to be loopholes in all of these provisions.1’”

If you showed Lynn the list of “essential benefits” that insurers will have to include in the policies they sell to people like her, could you persuade her to read the list—and explain where she saw the holes? Probably not, as her mind is closed to a discussion. In an interview at an Access to Healthcare office in Las Vegas, Lynn said she was unaware of those benefits — and didn’t trust Obama to produce them anyway.

The Poison: Hatred

Perhaps, I should not be surprised. We live in a nation where in 2009, a U.S. Congressman felt free to shout out “You Lie” during a televised presidential speech to a joint session of Congress2. (President Obama had just said that the legislation would not mandate coverage for undocumented immigrants. This is, of course, correct. South Carolina Rep. Joe Wilson (R) later apologized.)

Yet that did not stop another Congressional Republican from calling out the President earlier this month. In a scathing speech on the floor of the House3, Rep. Jim Bridenstine (R-OK) derided President Obama as a “dishonest, incompetent, vengeful liar” who lacks a “moral compass.” Bridenstine cited HHS Secretary Kathleen Sebelius’ efforts to promote enrollment in the Affordable Care Act as one reason President Obama is “not fit to lead.” Bridenstine did not apologize. Instead the next day, he told a talk show host that he had “gotten great encouragement” for his remarks from fellow Republicans. I have followed U.S. politics for many years. Never have I seen a president so hated — not Nixon, not LBJ at the height of the War in Vietnam.

Politicians Are Not Alone in Teaching Americans Not to Trust Obamacare

Lynn recalls one of her surgeons telling her that he was leaving the business because the health-care law dictates what he can charge patients1. This the Bloomberg article notes is “something the legislation doesn’t do.“ Why would a surgeon claim that the Affordable Care Act will be setting his rates? Presumably, he reads newspapers. How could he be so uninformed?

“There is a lot of distrust,” Sherri Rice, chief executive officer at Access to Healthcare explains. When her nonprofit group began asking members about the ACA last month, about half knew little about its provisions and another quarter were “furious” about it, she told Bloomberg. Such anger makes it difficult to think clearly—or take in information. This may explain why Lynn’s surgeon thinks that under the ACA he will be told what he can charge patients. Perhaps he too is so “furious” that the facts don’t register. Hatred blinds.

Educating the Public

The Brookings Institute’s Henry J. Aaron is one of many who blames the Obama administration for not doing a better job of educating the public. “We haven’t seen a lot of energy from the administration on public education. They ceded the field to those who were largely hostile to the bill to frame it in the public’s mind1.”

“Framing”

Aaron is right that Obamacare’s opponents have “framed” the issue. They have outspent supporters by 5-to-1 on TV ads, according to advertising analyst Kantar Media1. But their idea of “framing” is to define an idea with a catchphrase. If some facts do not fit into the frame, they are ignored explains linguistics professor George Lakoff. The “frame” becomes a lens through which conservatives invite us to see policy issues. For example, Laskoff observes, the phrase “tax relief” creates a context, signaling that taxes are bad and this is why we need “relief.” “Obamacare” is, itself a frame, which suggests that the Affordable Care Act will create a “nanny-state,” with the president becoming a national nanny who will tell us what we must do.

When you are lying, repetition is important. (Goebbels used this technique to his advantage) Laskoff points to a speech by Rick Santorum where he repeatedly refers to the President “not listening to the voice of the American people” (14 times) “because he knows better than you” (5 times)4, and is using the Government to run your lives by taking away your “rights” (10 times), and “freedoms.”(12 times “Death panel” became one of the most successful frames. Conservatives favor sound bites that are short, snappy and click shut like a box. Like advertising slogans, they are designed to make people stop thinking.

More, progressive formulations encourage thought. Often, they raise questions5: is health care a “right”, a “privilege”, or a “moral responsibility”—something that, we as a civilized society, we owe to each other? “Individual responsibility” is a phrase that conservatives favor. Each of us is responsible for ourselves, period. By contrast, “shared responsibility” opens the mind to consider the possibility5 that employers, employees, government, and the health care industry itself should share in funding universal healthcare.

Television Ads

It is difficult to explain Obamacare in a one-minute TV ad because health care reform turns on the details–thousands of details. And often, these are interlocking details: you cannot understand one without understanding the next paragraph in the legislation. For example: If you are self-employed, unemployed or work for an employer who does not offer benefits you will be able to purchase your own coverage in the Exchanges — marketplaces where insures will be regulated and will not be able to charge you more if you suffer from a pre-existing condition. If you earn less than $46000, you will be eligible for a government subsidy in the form of a tax credit that will help you pay the premium.

That is just one fact—and it I took me a full paragraph to convey a fairly accurate basic description of who will be eligible for a tax credit.

The definition also raises questions. For example, a reader might well ask; If I have to wait until I get a tax credit (when I pay my 2014 taxes in April of 2015) how will I pay the premiums on my insurance at the beginning of 2014? The answer is that the IRS will forward the money to your insurer in 2014, estimating how large your subsidy should be based on your 2013 income. Then when you file your 2013 taxes in 2014, you and the government will settle. If your 2014 income turned out to be lower than expected, the government may have underestimated your subsidy, and will owe you money. If, on the other hand, you earned more than expected, the subsidy may have been larger than it should have been, and you will owe the government money. To me this sounds fair; but, it doesn’t fit into a sound bite. I spent two paragraphs explaining it.

If a reader were skimming a newspaper story he might not take in those two paragraphs — especially if he already had heard conservatives “frame” the idea that you might own the government money as a “tax credit trap.” The phrase suggests that the tax credit is a trick leaving many Americans with what redstate.com calls “surprise tax bills5” in the spring of 2015.

Suddenly the tax credit does not sound like such a good deal – unless you took the time to read the full explanation.

In October, the Public Will Need a Crash Course in Obamacare

Let us return to the idea to the idea that the Obama administration has done a poor job of educating the public. “For the last couple of years, the Obama administration has done too little to explain what was in the law, and to mobilize support,1” says Henry Aaron. Bloomberg observes that in April of 2013 U.S. health secretary Kathleen Sebelius “offered a different take on timing: “’It didn’t make sense for the U.S. to contact the uninsured long before they can actually sign up for coverage1.’”

I think Sebelius may well be right. Americans are not interested in poring over the many details of Obamacare when it seems a distant possibility. (Polls show that Conservative diatribes have convinced many that the law already was repealed.) People will be much more interested in listening to the facts about the ACA in October, when it is becomes clear that the law is a reality, and that they are faced with a decision. Should I sign up for insurance? Right now Republicans are telling them that, under reform coverage will be unaffordable. Often they throw out numbers like “30% increases.” Here the fear-mongers are speculating about the cost of insurance premiums in the Exchanges where individuals buy their own insurance. But keep in mind, only a small minority of Americans will purchase coverage in these Exchanges

The majority of Americans work for large companies and are offered tax benefits at work. The Congressional Budget Office tells us that Obamacare will have a “negligible” effect on their premiums6.

As for premiums in the individual Exchanges, today Democrats cannot tell you exactly how much your coverage will cost if you buy your own insurance in 2014. This makes it difficult to rebut claims that costs will skyrocket. Everything will depend on your age, your sex, your income, where you live—and how insurers decide to price their products. They will be competing for market share, and will be trying to calculate how to price their product to attract young, healthy customers.

Premiums in the Exchanges: Much Will Depend On Where You Live

In states like New York, insurers now have to follow rules that are very similar to the regulations in the Affordable Care Act. As a result, it is unlikely that individuals buying their own insurance will have to pay more than they do today. In fact, they will probably pay less because in the Insurance Exchanges they will be part of a large group, and thus the insurer’s administrative costs will be lower. In addition, if an individual earns less than $46,000 he will be eligible for a government subsidy, which will slash his premiums.

On the other hand if the customer is a healthy 30-year-old male who lives in a state where insurers are allowed to charge women three times as much as they would charge a man for exactly the same policy and where they charge someone suffering from a pre-existing condition four times as much; the 30-year old man who is purchasing insurance in the Exchange may well be asked to shell out significantly more than he does today. This is because, under reform, he, his sister, and his mother (who suffers from diabetes) will find themselves on a level playing field: Insurers will not be able to gouge his sister or his mother.

(Put that way, reform doesn’t sound so bad does it? Even a progressive can use words such as “gouge” and “level playing field” to “frame” the issue.) Then again, consider how many words I needed to explain the variables that will determine whether your premiums will go up or down in the Exchanges.
It is much, much easier just to scream “sticker shock.”

In October, the Administration Will be Able to Offer Specifics

In the fall, progressives will have an easier task. They will be able to say: “Here in North Carolina an individual will be able to choose from a menu of five plans that range in price from $____to $____a year. Here are the details on the co-pays and deductibles. You will notice that in the plans where premiums are lower, co-pays are higher. In all of these plans your total out-of-pocket spending will be- capped at $6500 a year — no matter which plan you choose, or how much care you need.”

Armed with this information, reform’s supporters will be able to answer the false claims that you are hearing today. (This is why the fear mongers are now becoming louder and more hysterical—as we approach October they know their days are numbered.) “Enroll America” also will point out that: “different plans use different provider networks—you will find a list of their networks here. Some plans charge more because they think that you will pay more for their networks of hospitals and doctors. But they may be wrong: some customers will choose one of the less expensive plans.”

In October, progressives will put premiums in the contexct of subsidies, explaining that “If you are single and earn X, you will receive a government subsidy of $______ . If you are a 40-year-old couple with one child earning Z, you will receive a tax credit of $_____.” When Obamacare’s supporters have hard numbers, and can spell out what reform will mean for YOU and your family, uninsured, self-employed and unemployed Americans will be much more eager to learn about the details of healthcare reform. This is when they will be ready for a crash course in Obamacare.

Educating the Public: Reaching Out at the Right Time

As Joanne Peters, an HHS spokeswoman told Bloomberg: “Our outreach will kick into high gear this summer leading into the fall1, when we’ll be talking to Americans across the country to prepare them to enroll in coverage beginning October 1. Our deliberative tactics build on the lessons we’ve learned, including reaching people with the right message at the right time, when it’s time for them to act.”

“You want outreach and communications with real intensity in the six months when people can go online and sign up1,” adds Tara McGuinness a White House spokeswoman, referring to the open enrollment period that begins in October 2013 and runs through March 2014. In six months, “Enroll America” should be able to get the facts out there to most of the people who, at that point, will want to hear more about how “Obamacare” might help them. Granted, reformers still will have to contend with the conservative crusade to poison our minds by planting seeds of suspicion. This campaign has been going on since 2009. That’s four years of misinformation and outright lies.

Nevertheless in October of 2014, when “Enroll America” has the facts on pricing, I am hopeful that mainstream journalists will at last feel able and willing to call misinformation what it is: “a lie.”

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What do Americans Really What?

This simple ~ 4 minute recording comes from Colin Gordon’s “Growing Apart A Political History of American Inequality” . Yves Smith at Naked Capitalism picks up on it also. It is a good read in its entirety. Economists View also has it on today’s links.

The video portion below gives a snap shot of what US citizens believe to be equitable in the split of wealth, what they believe to be reality, and compared to what is truly occuring in the US. Most miss the reality of the split and opt for something less going to the wealthy.

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“Profits Without Production”

For me, Profits Without Production equates to Profits sans Direct Labor Input. In most manufacture in the US today, Direct Labor Input is an extremely small ~10% of the Cost of Manufacturing which will vary up and down dependent upon the industry. (For the accountants and the purists, this does not include customary or legislative benefits which I categorize as Overhead. Drucker and many other consultants [including myself] have repeatedly pointed out that whacking labor to reduce the costs of manufacturing is akin to beating a dead horse and this cost has been dropping because of efficiencies since the sixties. It no longer represents the mountain of cost even though it has been fictionalized and demonized by Delphi’s Miller while Delphi was angling for bankruptcy in the last decade.) Maybe I have not searched in the right areas or blogs to read up on this topic; but, Paul Krugman in his latest article dicusses what I believe has become more wide spread in the US over the last decade, Profits Sans Labor or as he points to Production. Yet this is a growing trend and I have not seen much on the topic of Profits sans Labor or Production.

“You can argue that Apple earned its special position — although I’m not sure how many would make a similar claim for … the financial industry… But here’s the puzzle: Since profits are high while borrowing costs are low, why aren’t we seeing a boom in business investment? …

Well, there’s no puzzle here if rising profits reflect rents, not returns on investment. A monopolist can, after all, be highly profitable yet see no good reason to expand its productive capacity. . . .”

While it is possible to produce a part without direct labor input to it with automated machines, my point in particular is about the rise of profits in certain industries (if one could call them such) with no direct labor input or material product in the end. Paul points to the financial industry as having spectacular profits as a percentage of the whole and most recently at 30% of Corporate Profits in the US. Pre-2008 Wal Sreet/TBTF recession, the percentage of corporate profits coming from the financial industry was even higher at 40%. Given not much has changed in the financial industry with new regulations and transparency of transactions, I suspect the financial industry will recoup this high with the government’s backing after almost committing self destruction in 2008.

“From 1990 to 2006, the GDP share of the financial sector in the broad sense increased in the United States from 23% to 31%, or by 8 percentage points. The figures on profits are even more striking. For example, the financial services industry’s share of corporate profits in the United States was around 10% in the early 1980s but peaked at 40% last year.How might the current financial crisis shape financial sector regulation and structure?

While I agree with Paul Krugman on the problem of growing monopoly rents or the profits without investment, I think he misses the larger picture. The growth of profit without production is coming at the expense of labor input and has been going on for a longer time than just recently. The financial industry has become gambling professionals with its CDS, naked CDS, etc. involving little or no investment in production or labor. That excessive profit-taking has expanded into nonfinancial industry such as Apple is no surprise. The tax rate supports such action by companies. Why should they invest?

Perhaps, I take it a bridge too far with Mr. Krugman’s comments; but until companies begin to expand utilizing Labor input, the problem with unemployment and a shrinking Particiaption Rate are not going to go away. In the end, we may yet reach the the Fed’s 7% unemployment goal as Participation Rate shrinks and U3 is determined from its smaller base.

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