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

Merry Christmas

Back down from the mountains where it was snowing yesterday, a silent beauty. Sitting in my daughter’s kitchen drinking a cup of Keurig manufactured coffee. The household is quiet as I think about the events of the last months and attempt to pen a few words.

Washington is still shut down and one man pouts. Thousands of people suffer the impact of a hurricane in Puerto Rico, floods in the South, and wild fires in California due to our impact upon the environment. Legislatures in Wisconsin, North Carolina, and Michigan are still trying to steal an election from the voters. There is no peace amongst the peoples of this world and many live in poverty.

If this message finds you more fortunate than those around you or others in the world today, it is Christmas today and a time to give of yourselves in celebration of this day. Peace to you and family and I hope this note finds you good in health and prosperous.

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Man of The Year

“WASHINGTON (The Borowitz Report)—Capping an extraordinary 2018, Donald J. Trump announced on Thursday that he had been named Man of the Year by the terrorist organization known as ISIS.

Trump made the announcement after receiving the news from the leader of ISIS, Abu Bakr al-Baghdadi, whom Trump called ‘a terrific, fabulous guy.’

‘I got along great with him, and he said a lot of nice things about me,” Trump said. “He said ISIS didn’t even consider anyone else.’

Trump, who is expecting to receive an official Man of the Year plaque from ISIS in the next few weeks, said that the award ‘came as a total surprise to me.’

‘It’s a particularly impressive honor when you consider ISIS was co-founded by Hillary and Obama,’ he said.”

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Neoliberalism as Structure and Ideology

Neoliberalism as Structure and Ideology

As someone who has looked at the world through a political economic lense for decades, I am restless with the “cultural turn”.  Once upon a time, it is said, the bad old vulgarians of the left believed that economic structure—the ownership of capital, the rules under which economies operate and the incentives these things generate—were everything and agency, meaning culture and consciousness, were nothing.  The latter was sometimes claimed to be derivative of the form.

Then we had a cultural turn.  Now it seems it’s all about consciousness and ideology, of which economic structures are a pale reflection.  Neoliberal ideology is said to have seeped its way into the heads of intellectuals, journalists and politicians—perhaps even the public at large—and this explains things like deregulation, privatization and the ubiquity of outsourcing and global value chains.  It’s even possible to have 500-page treatises about the failures of capitalism that make no reference at all to the empirical structure of the economy, only modes of thought, as I point out here.

According to this view, the various failings of our society, from the inability to act on climate change to mass incarceration to the imposition of market logic on higher education, all converge as consequences of neoliberal hegemony.  But what is neoliberalism?  It is usually described as a philosophy, born sometime between the fall of the Hapsburgs (Slobodian) and the postwar convening of the Mont Pèlerin Society (Mirowski et al.), and surely there is truth to these well-documented accounts.  But should we understand the past four decades or so as primarily the product of a sea-change in thought, the end result of these precursor currents?

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The Gender Pay Gap

The most recent year for reported year-round earnings data available for full-time workers revealed the gender earnings gap to be 20 percent between men and women or said a different way women earned 20 percent less than men (Hegewisch 2018).

The earnings gap between women and men has been measured (in the past) by taking a snapshot of both genders who have worked fulltime year-round and in a given year. Reviewing a 15-year period from 2001 through 2015, The Institute for Women’s Policy Research examined the different labor force experiences of women and men. The report “The Slowly Narrowing Gender Wage Gap” showed 28 percent of women and 59 percent of men worked consistently full-time, year-round between 2001 and 2015.

In previous reports, it has been stated women earn 80 cents to every dollar a man would make which understates the pay inequality issue for women. Looking only to full time women labor leaves many of them out of the picture when compared to men. Some of the highlights coming out of this study:

“Women today earn just 49 cents to the typical men’s dollar, much less than the 80 cents usually reported.” Total earnings are measured across a 15-year period for all workers, not just full time workers, and who have worked at least one year. Earnings for women were 49% of the earnings for men in 2015. Over the 15-year period, progress or gains in salary for women versus men has slowed when compared to the previous 30 years.

“The cost of taking time off from the labor force is high.” Women taking one year off from work resulted in annual earnings 39% less than women who worked the 15-year period. When compared to a 15-year period starting in 1968 the 2001 through 2015 period saw a 12% decrease in pay. Men were also penalized; but, it was not to the same degree as women much of the time.

“Strengthening women’s labor force attachment is critical to narrowing the gender wage gap.” At nearly twice the rate of men, 43% of women had at least one year off with no earnings over the last 50 years. Polices such as paid family and medical leave and affordable child care can help woman participation rate improve and men to share unpaid time off.

“Enforcement of equal employment opportunities and Title IX in education is critical to narrowing the wage gap.” Enforcement would assist women in gaining access to those higher paying fields which are now off-limits and has been for decades.

Expanding policies and programs to other parts of the country beyond what a few states have done or adopting national policies could help close the comprehensive, long-term earnings gap in the United States and equalize women’s pay with men’s across the lifetime.

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100 Percent Of US Senate Against MBS

100 Percent Of US Senate Against MBS

Wow. Sometime ago here, I called for Crown Prince of the Kingdom of Saudi Arabia, Mohammed bin Salman bin Abdulaziz al Sa’ud, (MbS) to be rmoved from his position. How he is punished beyond that for his crimes, I do not care, especially as I think being prevented from becoming the King of Saudi Arabia will be for him the worst punishment.

So for once the US Senate agrrees with me, 100%, really. Hey, I have to cheer such an event that has never happened brfore and probably will not again. Yay! The US Senate has voted 100% to declare that MbS is guilty for ordering the murder of Kamal Khashoggi. They are right. He is guilty guilty guilty.

He needs to be removed, and the sooner the broader Saudi royal family figures this out and moves to replace him, the better, really, for the world as a whole, given the ongoing important role that nation plays in the world economy worldwide. It is clear thart he came to power thanks to Jared Kushner and the Trump admin, who supported his coup removal of his predecessor, Mohammed bin Nayef bin Abdulaziz al Sa’ud, who was deeply respected by US mil-intel apparati. MbS had become Defense Sec and was able to send his guys to MbN’s palace and imprison him until he gave up and let MbS replace him as Crown Prince. None of this would have happened without Trump and Jared Kushner approving of it, which they did.

 

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Department of Education to Cancel $150 million in Student Loans

CNN, Thursday: The Department of Education will implement a rule known as the Borrower Defense to Repayment created during President Obama’s Administration and blocked by Secretary of Education Betsy DeVos in 2016. The rule or regulation grants federal loan forgiveness automatically for students who could not complete their education due to the schools shutting down before their education was completed while they were enrolled. Unfortunately students are not eligible if they moved to another school to complete their education. The later part sounds ridiculous to me as a fraud is a fraud regardless of where you end up. Anyway, it is a partial victory for a minority of students caught up in the bad student loan environment. Given the magnitude of the issue, more than 1,400 schools closed between 2013 and 2015 stranding many students with excessive loans and an incomplete education by for-profit schools. 15,000 former students are impacted by the court’s ruling and mandate to complete the forgiveness process.

The Michigan Queen of For-Profit Charter Schools who also draws on the local taxes to pay for the unaudited costs of the schools blocked this rule when she took office giving For-Profit so called colleges and mostly bankrupt a chance to challenge (why?) the ruling. 18 states and the District of Columbia took exception to Betsy and the Department of Education blocking the relief to students defrauded by colleges. The Judge ruled in October against the Department of Education, Betsy, and the For-Profit College industry. In December, The Department of Education decided to begin the debt cancellation process and not appeal. The cancellation will take 30 to 90 days to complete or 3 -6 months over all from October 2018? How quick they move.

Meanwhile Ms. DeVos through a spokesperson says: “she ‘respects the role of the court’ but still believes that many provisions in the Obama rule are ‘bad policy.’ The department will continue the work of finalizing a new rule that protects both borrowers and taxpayers.”

Ms. DeVos is promoting a new rule which would proportion the amount of education received from the school against the cost of a completed education and also compare it to earnings of those who completed their education. She conveniently forgets, no completion, no earnings at that level acquired from a complete education. Her comment justifying such actions moves from talking of “saving taxpayers money” to talking of “saving the government money.” Anything to pay down the deficit created by this administration.

Another hypocrisy, bankruptcy protection for business, Trump, and individuals but little or no protection for students.

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Heads Up on Out of Network ER Doctors, etc. in 2019

Last December 2017, Envision Healthcare Corporation paid an approximate $30 million to settle allegations for subsidiary EmCare doctors getting bonus payments for admitting patients to hospitals when it was not necessary.

History:

A subsidiary of Envision, EmCare is a provider of physician services to emergency departments, inpatient services for hospitals, acute care surgery, trauma and general surgery, women’s and children’s services, radiology / teleradiology programs and anesthesiology services. If you have ever been hospitalized, Radiology is one service which always seems to have someone other than the hospital billing you. One study of billing practices of 194 hospitals in which EmCare handled billing and was out-of-network; the average out-of-network billing rate was 62% higher than the national average of 26%. When EmCare’s billing was compared to that of a competitor TeamHealth, the latter’s billing in other hospitals was less and there was a smaller increase in out-of-network service billing.

If you remember a while back, Rusty and I would discuss the ongoing consolidation of hospitals, clinics, and pharmacies. The reasoning behind the consolidation was to have enough market clout when negotiating with insurance and Medicare. Having a larger presence and being able to set pricing nationally and regionally is a big factor in the rising cost of healthcare.

Envision is the biggest player in staffing ERs and Anesthesiology departments with 6% of the $41 billion emergency department and hospital-based physician staffing and 7% of the $20 billion anesthesiologist staffing. Two-thirds of all Emergency Departments (ED) do some type of outsourcing even if it is short term.

Present:

United Healthcare insurance is pitted against Envision’s practice of over pricing for it’s 25,000 emergency doctors, anesthesiologists and other hospital-based clinicians charge to patients and pass through. The disagreement over pricing and how it is paid for by insurance as billed by 3rd party providers will spill over into patients being billed more frequently for higher prices not accepted by insurance.

UnitedHealthcare’s 27 million privately insured patients could face expensive and unexpected doctor bills as of 2019 if Envision doctors become out-of-network for United Healthcare. According to the research group NORC at the University of Chicago more than half of Americans have received an unexpected medical bill. In another study by economists from the Federal Trade Commission in 2017, 1 in 5 emergency-room admissions resulted in a surprise out-of-network bill.

While the ACA increased the numbers of people insured, approximately 20% of people have problems paying medical bills largely because healthcare is still rising faster than most other costs and income. One source of increased costs has been the billing from out-of-network doctors billing patients utilizing in-network facilities such as hospital Emergency Departments. NEJM recently published a Yale Study by Zack Cooper, Ph.D., and Fiona Scott Morton, Ph.D. (Out-of-Network Emergency-Physician Bills — An Unwelcome Surprise) reported on the increased occurrence of surprise-billing for out-of-network services.

Patients typically do not choose to use out-of-networks doctors or facilities. They will choose an in-network facility and expect an in-network doctor(s) to care for them. Healthcare insurance expects its buyers to use in-network services or pay a penalty for not doing so. When one arrives at an in-network Emergency Department, they expect to be cared for by an in-network doctor. I have yet to hear a doctor on duty offering up he or she is not employed by the hospital but instead by a third party. The patient is not aware of in-network or out-of-network issues until they get the bill. The market place is not working for the customer and the doctor still gets the business regardless of the price and there is no competition from other facilities or in negotiated pricing due to having insurance. The third party employer knows this issue as well as the hospital. The only fool in the room is the patient waiting to be cared for and be used. Insurance will pay a portion of the cost or negotiate with the hospital for a price. The third party company employing the doctor may yet charge the patient for the balance of the costs associated with the doctor and at a higher percentage than normal. The uncovered and unexpected higher cost is the rub.

The authors of the Yale study analyzed the claim’s data of a large commercial insurance company insuring tens of millions of people, focusing on ED visits for people under 65 years of age, occurring between January 2014 and September 2015, and at hospitals registered with the American Hospital Association. They chose hospitals with over 500 ED visits and identified the Hospital Referral Region (HRR). Utilizing the breakdown criteria yielded “more than 2.2 million ED visits Broken in 294 of the 306 HRRs, covering all 50 states, and capturing more than $7 billion in spending.” The map of the United States (above) is a pictorial representation of the data.

Summarizing their finding and estimating cost impact, Yale: “of the 99.35% of ED visits occurring at in-network facilities, 22% involved out-of-network physicians. The greater than 1 in five ratio (22%) masks a significant geographic variation in surprise-billing occurrence to patients among HRRs. 89% and 62% of surprise-billing rates occur in McAllen, Texas and St. Petersburg, Florida as compared to Boulder, Colorado and South Bend, Indiana with the surprise-billing rate there near zero.”

Envision questions the validity of the study and blames United Healthcare for not paying the billing and claiming insurance is the problem. Insurance coverage is a problem; but, it is not of the same magnitude when one starts to look at the increase in costs of $1 trillion from 1996 to 2013 of which 50% was due solely to price increases.

Additional Costs?:

And yes there are “potential” extra costs for patients who are treated by an out-of-network ER physician or any out-of-network service. In one hospital I was in, Radiology was out of network as well as one surgeon. Both negotiated a rate with United Healthcare. Then too, this was written into the ESI policy. I had no choice in doing in-network as I came through the ER each time and was too ill to decide and/or go to another hospital.

In a Kaiser/New York Times Survey: Among the insured with problem medical bills, a quarter (26%) said they received unexpected claim denials and about a third (32%) say they received care from an out-of-network provider that their insurance wouldn’t cover. The out-of-network charges were a surprise for a large majority: 69 percent were unaware that the provider was not in their plan’s network when they received the care.

The same NEJM/Yale study which had looked ay frequency of surprise Out-of-Network Emergency-Physician Bills also looked at the costs of the bill and what was left over for patients to pay. On average, in-network emergency-physician claims were paid at 297% of Medicare rates. For reference in the Yale study, the authors used other medical disciplines as a benchmark. Orthopedists are paid at 178.6% of Medicare rates for knee replacements and internists are paid at 158.5% of Medicare rates for routine office visits. The Yale study showed out of-network emergency physicians charged an average of 798% of Medicare rates resulting in a calculated, potential, and additional cost for patients. The difference between the out-of-network emergency physician charge and 297% of the Medicare rate for the same services in the patient’s location could be billed for an average balance of $622.55 (unless their insurer paid the difference). It is also important to note that the potential balance bills can be extremely high; the maximum potential balance bill faced by a patient included in our data set was $19,603.

The suggested solution from the study was for states to require hospitals to sell a bundled ED care package that includes both facility and professional fees. In practice, that would mean that the hospital would negotiate prices for physician services with insurers and then apply these negotiated rates for certain designated specialties. The hospital would then be the buyer of physician services and the seller of combined physician and facility services. If physicians considered the hospital’s payment rates too low, they could choose to work at another hospital.

The hospital, doctors, and the insurance companies would compete for the best package to service the patients utilizing them. In the end, this is a stopgap measure until healthcare costs can be brought under control in a better manner.

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Michigan’s Lame Duck Republican Legislature

Michigan Electablog “Lame Duck Republican Majority at work in Michigan.”

Accrued Sick Time: This was one of the proposals not allowed to go to the ballot. Why? Because if it passed and it would have, Repubs would have needed 2/3rds vote to overturn it. Instead they passed it before November 6th and now they are altering it by taking coverage responsibility from over 93% of Michigan’s firms. The threshold for exemption from the law was raised from 5 in the proposal to 50 in proposed legislation.

Out of 173,309 businesses in Michigan, 162,003 firms have fewer than 50 employees.

The amount of required leave will be cut in half from 72 to 36 hours. It will also take hundreds of hours of work to accrue a few days of leave as employees must work 40 hours to earn an hour of leave instead of the 30 established in the citizens-backed initiative.

One Fair Wage: Michigan Senate Republicans voted to gut the minimum wage increase.

An amendment to the minimum wage increase passed earlier this year to deny voters a chance to vote on the citizens-backed initiative as a Proposal. Instead Senate Bill 1171 will add eight years to the deadline for increasing the minimum wage to $12, from 2022 to 2030. Tipped workers will be hurt the most with their pay capped at $4 an hour.

Unions: In an effort to stop union leaders from being able to take paid leave to do their jobs as union stewards, etc. Republican Senator Marty Knollenberg introduced Senate Bill 796. Democratic Senator Vincent Gregory had this to say about the bill:

“Bills like this only serve one purpose, they are just another step in the systematic destruction of unions and workers’ rights. Union leave time arrangements are an efficient, cost-effective way to quickly resolve employee disputes, disciplinary issues and other matters, and they help not just workers but also management.”

Puppy Mills: State legislators are working to protect puppy mills by ensuring they can continue to sell puppies to Michigan pet stores. House Bills 5916 and 5917 narrowly passed the Michigan House of Representatives last Thursday. It now goes to the Senate.

Ohio based Petland is the backer of these bills. Over 280 localities across the country have passed laws to prohibit the sale of puppies in pet stores, in order to protect animals and consumers. Petland has gone state-to-state lobbying lawmakers to shield the corporation from local regulation. In the past two years, they have failed in Florida, Georgia, Tennessee, and Illinois.

Recycling aluminum and PET. District 17 House Representative Joseph Bellino:The bill removes aluminum and PET plastic away from community-based recycling systems. Rerouting these materials into local recycling programs would provide the boost recyclers need to sustain their programs and expand access to even more communities.”

What he fails to say is that ALL of the returned containers are now recycled. If the 1976 “Bottle Bill” is repealed, many of those returned containers would end up in landfills.

Wetlands: Michigan State Republican Senator – Escanaba Tom Casperson proposed Senate Bill 1211 redefining which wetlands require state Department of Environmental Quality permission to modify or fill and doubling the size threshold at which regulation is required, from 5 acres to 10 acres.

Senate Bill 1211 would remove 70,000 wetlands statewide from protection totaling about a half-million acres. In most Michigan counties, it would include about half of their remaining wetlands. These wetlands, lakes and streams can be filled, dredged, and constructed on without a permit according to Tom Zimnicki, agriculture policy director for the Michigan Environmental Council.

Mackinaw Tunnel: Lame Duck Republican Gov. Rick Snyder struck a tunnel agreement in October with the Canadian oil transport giant. The company would pay to build a $350-million tunnel beneath the straits that would encase a replacement pipeline to prevent a spill and allow the existing line to be decommissioned. The state is also expected to kick in $4.5 million in infrastructure costs for the tunnel.

To bypass environmental approvals and accelerate required land condemnation, Snyder wants the tunnel overseen and owned by the Mackinac Bridge Authority.

• Finally, Staff Allocations: Newly elected Democratic Senator Jeff Erwin revealed; Democratic members of the state Senate are given $129,700 plus two staff benefit packages (for two staff members.) Republican senators, in sharp contrast, are given $212,700 plus four staff benefit packages (for FOUR staff members). Democratic Senators get HALF of the staff and 61% of the financial resources of Republican Senators to run their offices.

These allocations are hold overs from the budgets created by outgoing Senate Majority Leader Arlan Meekhof. According to Irwin, legislative staff salaries range from $25,000-$75,000 with some exceptions. “As a minority member, I have learned, we can buy benefit packages from the Senate business office and squeeze a third staff member into that budget as long as the salaries are less than the total,” he told me.

I guess we will have to pound them into the ground again.

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Is the “Green New Deal” a Marxist Plot?

At the CEPR blog, Beat the Press, Dean Baker and Jason Hickel are debating degrowth. Dean makes the excellent point that “claims about growth” from oil companies and politicians who oppose policies to restrict greenhouse gas emissions, “are just window dressing.” I also agree, however, with the first comment in response to Dean’s post that his point about window dressing could be taken much further.

I would add that economic growth is window dressing for what used to be referred to much more aggressively as “man’s triumph over nature” or the “control of nature.” Climate change deniers are more forthright about this connection between aggression and so-called growth: “Is “Strive on — the control of nature is won, not given” a controversial statement? What does it mean for science if it is?” asks Linnea Lueken at the Heartland Institute website.

Scattered throughout his writings, Donald Winnicott made fleeting but intense criticisms of “sentimentality.” “Sentimentality is useless for parents,” he remarked in a 1949 article on the analysis of psychotic patients, “as it contains a denial of hate, and sentimentality in a mother is no good at all from the infant’s point of view.” The inference he drew from this observation was that “a psychotic patient in analysis cannot be expected to tolerate his hate of the analyst unless the analyst can hate him.”
In a 1946 article on the treatment of juvenile delinquents, he warned against “one of the biggest threats” to the use of psychological methods in the management of young offenders was “the adoption of a sentimental attitude towards crime:

If advances seem to come but are based on sentimentality, they are valueless; reaction must surely set in, and the advances had better never have been made. In sentimentality there is repressed or unconscious hate, and this repression is unhealthy. Sooner or later the hate turns up.

The most thorough discussion by Winnicott of his aversion to sentimentality is probably his 1939 article, “Aggression and its roots.” As it is only three paragraphs, I quote it in its entirety:

Finally, all aggression that is not denied, and for which personal responsibility can be accepted, is available to give strength to the work of reparation and restitution. At the back of all play, work, and art, is unconscious remorse about harm done in unconscious fantasy, and an unconscious desire to start putting things right.

Sentimentality contains an unconscious denial of the destructiveness underlying construction. It is withering to the developing child, and eventually it can make him need to show in direct form destructiveness which, in a less sentimental milieu, he could have conveyed indirectly by showing a desire to construct.

It is partly false to state that we ‘should provide opportunity for creative expression if we are to counter children’s destructive urges’. What is needed is an unsentimental attitude towards all productions, which means the appreciation not so much of talent as of the struggle behind all achievement, however small. For, apart from sensual love, no human manifestation of love is felt to be valuable that does not imply aggression acknowledged and harnessed.

He might well have added, “And I’m not so sure about sensual love.”
This all may sound somewhat arbitrary and speculative but actually it is a very compressed and jargon-free application of Melanie Klein’s developmental theory of the self. What Klein referred to as the depressive position involves an infant’s feeling of “guilt” — or in Winnicott’s less extravagant terminology, “concern” — about its aggressive fantasies toward its mother. In Klein’s rather lurid account of the infant’s aggressive fantasy:

The phantasied attacks on the mother follow two main lines: one is the predominantly oral impulse to suck dry, bite up, scoop out, and rob the mother’s body of its good contents.… The other line of attack derives from the anal and urethral impulses and implies expelling dangerous substances (excrements) out of the self and into the mother.… These excrements and bad parts of the self are meant not only to injure the object but also to control it and take possession of it.

Whether or not the infant has such unconscious aggressive fantasies about the mother’s body, Rex Tillerson, when he was CEO of Exxon, expressed similar, fully-conscious ones, “My philosophy is to make money. If I can drill and make money, then that’s what I want to do…” Robert White-Stevens, the corporate-designated nemesis of Rachel Carson following the publication of Silent Spring, exemplified the “control of nature” faction of science:

Miss Carson maintains that the balance of nature is a major force in the survival of man, whereas the modern chemist, the modern biologist and scientist, believes that man is steadily controlling nature.

White-Stevens’s vision of a “feeble creature” penetrating “every corner of the planet,”  and “contest[ing] the very laws and powers of Nature, herself,” could have been written as a Kleinian parody of the of the infantile arrogance of scientistic triumphalism:

Within the past 100 years, man has emerged from a feeble creature, virtually at the mercy of Nature and his environment, to become the only being which can penetrate every corner of the planet, communicate instantly to anywhere on earth, produce all the food, fiber, and shelter he needs, wherever he may need it, change the topography of his lands, the sea and the universe and prepare his voyage through the very arch of heaven into space itself.

This is the stuff that science is made of, and man has learned to use it. He cannot now go back; he has crossed his Rubicon and must advance into the future armed with the reason and the tools of his sciences, and in so doing will doubtless have to contest the very laws and powers of Nature herself. He has done this already by expanding his numbers far beyond her tolerance and by interrupting her laws of inheritance and survival. Now, he must go all the way, for he cannot but partially contest Nature. He has chosen to lead the way; he must take the responsibility upon himself.

But I digress. What does all this have to do with economic growth? Again, as Winnicott explained, “aggression that is not denied, and for which personal responsibility can be accepted, is available to give strength to the work of reparation and restitution.” However, “[i]n sentimentality there is repressed or unconscious hate, and this repression is unhealthy. Sooner or later the hate turns up.” Indeed, the hate does turn up at the Heartland Institute, where the “Green New Deal” is exposed as the “Old Socialist Despotism.”If it fails to acknowledge the primitive aggression of “man’s triumph over nature” that lies beneath the reparation of adopting environmentally-friendly policies, the debate between degrowth and green growth risks descending into sentimental bickering about the window dressing in the hotel on the edge of the abyss.

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Increase in Uninsured Children

I get the alerts from Georgetown University Center for Children and Families weekly. The news much of the time is a reflection of the number of attacks on families and children who have lesser means to provide for healthcare themselves and depend upon Medicaid, ACA, and CHIPS for care. Since the election of Trump, McConnell and Ryan have been strutting around like the cocks on the walk demonstrating their machismo as they hold women, children and families hostage. Tough guys both and it is easy to threaten women and children.

For the first time in a decade, the number of uninsured children rose in the US. It is not much of a surprise to me as Republicans made it miserable for many in states which did not expand Medicaid, held CHIPS hostage, and threatened those applied to become citizens with denial if they used the nation’s healthcare.

Some Stats:

The Georgetown University Center for Children and Families:

– An estimated 276,000 more children were uninsured in 2017 than in 2016
– Three-quarters of the children who lost coverage between 2016 and 2017 live in non-expansion Medicaid coverage states for parents and low-income adults. The uninsured rates for children increased at almost triple the rate in non-expansion states compared to Medicaid expansion states.
– Nine states experienced statistically significant increases in their rate of uninsured children (SD, UT, TX, GA, SC, FL, OH, TN, MA).
– Texas is #1 again. Texas has the largest share of children without health coverage with more than one in five uninsured children in the U.S. residing in the state.
– States with larger American Indian/ Alaska Native populations tend to have higher uninsured rates for children than the national average.

Some History:

The funding for CHIP expired September 2017 and Republicans and Trump were playing cat and mouse with Democrats to extend it while they looked for ways to repeal the ACA or weaken it. As Joan Aker the Executive Director of the Center for Children and Families stated;

“The majority of uninsured children are already eligible for Medicaid or CHIP but are not currently enrolled. The name of the game here is to make sure that families are aware that their child has a path to coverage and that these kids get enrolled and stay enrolled.”

2017 was tumultuous for families dependent on Medicaid, CHIPs, and the ACA. Added to this was Trump’s hostility towards immigrant families. 25% of the children living in the United States have a parent who is an immigrant. For “mixed status” families, the fear of interacting with the government deters them from enrolling their children in government sponsored health coverage.

Conclusion:

Again, Joan Akers of the Center for Children and Families: “The nation is going backwards on insuring kids and it is likely to get worse.”

If we can get the Democrats in the House off their butt and start to represent “their constituents” as determined by the founding fathers who designed the House to represent the population, we may be able to put in place the foundation for future healthcare gains. Instead, we have the House Representatives playing the secret ballot game for House Speaker with a promise of a Dean Wormer double-secret ballot come January.

Under Trump, Number Of Uninsured Kids Rose For First Time This Decade

by run75441 (Bill H)

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