2010 – The Year of the Brutes! And 2011?

The National Public Radio news program “All Things Considered” declared 2010 – The Year of Mean.

NPR, not a media outlet to go too far out on a limb, couched their declaration in a bit of tongue in cheek satire.

But even NPR couldn’t shy away from the question underlying the truth of their observation.

Brute

What kind of country are we becoming?

I toyed with a number of labels for this “mean” movement.  Evil-doers was already taken.  Tyrants or oppressors?  No, not yet.  Pigwidgeons had some appeal despite its association with Harry Potter.  A pigwidgeon is described as a stupid and contemptible elf.  But pigwidgeons are not normally nasty, just stupid; so pigwidgeon may work for a certain ex-half-governor but not for the broader movement.

Meanie is too wimpy.  The word caitiff has some appeal.  Webster describes it as a “base and despicable person, a mean and wicked man”.  To add to the word’s appeal, it also describes a certain kind of vampire.  But this blog is not likely to catapult the word “caitiff” into the popular lexicon.  So I continued my search.

Ruffians didn’t seem inclusive enough.  It may describe some of the gun-toting extremists in the movement, but not John Boehner.

So I settled on brutes.  I am open to other words, but for now, it’s brutes.

Brutes

2010 saw the brutes attack a variety of issues and concerns of working Americans, but my focus is health care.

Their cause gained some momentum in the first month of 2010 when the Democrats lost the seat held by the long time champion of universal health care, Ted Kennedy.  Scott Brown (R-MA), with support from the brutes, ambushed the Democrats by upending their  feckless candidate, Martha Coakley.

It is a sad commentary on American politics when a Senate majority of 59% is not considered a safe margin to pass anything.

Are we becoming a country of minority rule instead of majority rule?

The Brutes and health care reform

Health care reform ultimately did pass in 2010.  It was indeed an historic achievement.

It was not a great bill, but it does make an effort to expand access to care, contain costs and improve health care quality.  Given its poor foundation (the current health care and insurance industries), it should be no surprise that the result is less than ideal.

It was an important milestone in American politics.

One of the groups that stands to benefit significantly is young Americans.  Employers are now required to permit young adults to stay on their employer-sponsored plans to age 26.  Together with other significant reforms, the bill supporters claim that it will cut the number of uninsured in America by half.

The Brutes and working Americans

Almost all of these people are on the fringes of the working middle class.  They may work for an employer, sometimes several employers, but none of them offer health insurance.  They may be sick and trying to get back to work.  They may be young and trying to enter the work force.  They may be entrepreneurs who are not only drawing on their bank accounts to start new businesses, but also banking that their health will sustain them until their businesses can.

The brutes don’t like these Americans.  They prefer tax breaks for the rich.

Are we becoming a country that is turning its back on the people whose backs build this country?

The Affordable Care Act has a number of initiatives designed to make the market for health insurance more transparent and therefore more accessible.

The brutes don’t like government regulation.  Therefore they want to repeal the Affordable Care Act.

Are we becoming a nation that places ideology ahead of practical solutions?  Isn’t that what toppled the Soviet Union?

The future of America?

As a result of the 2010 Congressional elections the brutes will now be able to parade their disdain for working Americans and their bias for the rich and powerful on a more prominent stage.  I don’t expect 2011 to be less mean.

I can only hope that the true nature of the brutes will become exposed for all to see.

Maybe then we can cast the meanness and the brutes aside and move America forward.

Photo credit:   Lonnie Dunkin III

Health Care Reform and Age-26 Dependents

Outdated machinery

Outdated machinery

We spend too much on health care administration here in the United States.  Everyone seems to concede that.

But those numbers only look at the layers of administration in the insurance industry, and physician and hospital billing to that industry.  Most of us feel that burden when we encounter the health care industry.

Employer waste

Employers spend a lot of their money trying to make the health care system work – for them.  They do provide health care coverage for approximately 60% of Americans.

The changes brought about by health care reform is reminding us just how much of employer resources don’t get counted toward health care. Continue reading

Will PPACA Increase Employer Health Insurance?

Can you really trust computers?

The New England Journal of Medicine recently reported on a Rand study that concludes that the Accountable Care Act will result in a large net increase in employer-sponsored insurance offers.  They predict that the number of workers getting insurance from their employers will rise from the current 60% to 86%.KFF dw_09_08_2010

The Rand study was based on computer modeling.  Is there reason to think that the model is based in reality?

Yes and No

The study itself points to the reality of the experience in Massachusetts where employer based coverage increased after passage of a similar health reform initiative.

In addition, there is this little quirk in the recently released Kaiser Family Foundation 2010 Employer Benefit Survey.

Katherine Hobson writes about it on her blog at the Wall Street Journal. Continue reading

PPACA Raises Barriers to State Single Payer Efforts

Last week’s post highlighted encouraging initiatives in several states to implement a single payer system within a single state.

This was always a daunting challenge even before health reform.  The Patient Protection and Affordable Care Act has raised the bar even higher.

Hawaii

Hawaii

ERISA and its preemption

Before PPACA a legal hurdle called the ERISA preemption severely hamstrung state health reform efforts.  For those of us in the employee benefits profession, ERISA, including its preemption clause, is our bible or at least our Deuteronomy.

ERISA was passed by Congress in 1974 to regulate employee benefit plans.  The preemption clause precludes states from regulating employee benefit plans.  There were two exceptions to that preemption and both are instructive. Continue reading

Single Payer is Not Dead

The single payer movement was not invited into the national health reform debate.

But they are not going away.

July 30, 2010 was the 45th anniversary of Medicare.  Activists across the country took the opportunity to remind us that Medicare works for older Americans and it can work for the rest of us.

[youtube]http://www.youtube.com/watch?v=H2JyxM1vUkc[/youtube]

Medicare at 45

The Obama administration took the opportunity to tout improvements in Medicare as a result of the Patient Protection and Affordable Care Act (PPACA):

  • More benefits, especially preventative benefits
  • More tools to fight fraud and abuse
  • Lower drug cots for seniors
  • Improved quality of care through pilot programs that encourage more integrated and coordinated care delivery Continue reading