The first entry I wrote on this blog after the introductory post was about the debt ceiling, in that post I mentioned that Republicans would hold a vote on raising the debt ceiling hostage in exchange for something but that ultimately they were bluffing and would vote to raise it even if Dems did nothing (you can read that post here). I still feel today as I did then that the Republicans are bluffing and that Democrats really don't have to address their demands and when the time comes that they have to vote in August enough of them will cross the aisle, and take the bullet for their party, to ensure the ceiling is raised. But in light of new events this week regarding bipartisan negotiations I felt it was important to revisit the issue and provide more insight into what Republicans really stand for.
Scheduled this week were four bipartisan negotiation sessions on the debt ceiling led by Vice President Joe Biden. Republican attendees of these negotiations included House Majority Leader Eric Cantor and Senate Minority Whip Jon Kyl who both decided to walk out of talks on Thursday. Why did they walk out of negotiations? Because Democrats wanted to propose increasing revenue in addition to spending cuts. That's right, because Democrats wanted to take a serious and balanced approach to the debt ceiling negotiations and evaluate all possible solutions Republican leaders felt that to be so unreasonable that they could no longer participate in negotiations. And this behavior continues to prove a point I make all the time, Republicans represent the wealthiest of Americans and don't care about the middle-class.
Just to be clear, raising the debt ceiling doesn't mean that we have to increase spending as it is the budget that controls spending. Raising the debt ceiling ensures that we are able to "pay our bills" to those that we have already borrowed from and to cover new borrowing that stems from budgets. Spending debates are better left for when Congress plans the next budget, but Republicans insisted that the debt ceiling vote should be used to address spending and the Democrats have capitulated. Democrats have been open to cuts proposed by the GOP in these negotiations including cuts to Medicare (provider-side cuts), cuts to the Pell Grant program, and other cuts that are tough for Democrats to swallow. But as soon as Dems propose cutting tax subsidies to Big Oil, eliminating tax loopholes for corporations who don't currently pay federal taxes, and shifting some tax subsidies that go to those making over $500,000 a year to the middle-class the Republicans walk out. Republicans want the middle-class, the elderly, and children to carry the economic burden. We've seen it in their budget proposal and bills that have been passed in the GOP led House. Not once has the GOP ever asked the wealthy and corporations to sacrifice anything this session. Not once. I've written about this before and I'm sure you've read articles about this but it's worth repeating here. CEOs and corporations are doing better now than they ever did before 2008 while the middle-class continues to struggle and all the GOP can come up with are cuts to programs working Americans, children and the elderly depend on, cuts to things that protect the middle-class and balking at any proposal that those who are doing very well pay a few percent more in taxes (or any taxes at all in some cases).
Their motive is to take care of those who fund their campaigns but they claim that they don't want to burden the "job creators." Supply-side economics (aka trickle-down economics) doesn't work, we've tried it and it costs us jobs and creates recessions. I was talking with my Dad the other day and he heard somebody explain the GOP's theory this way, and I think it's the most simplistic way this can be illustrated:
Let's say that I'm a CEO of a company that produces Widgets and last year we produced 150,000 Widgets but only sold 148,000 Widgets. I still have 2,000 Widgets sitting in my warehouse that I can't move. The economy isn't doing great and unemployment is up so the GOP gives my company (and me personally) a tax cut, not only do they give me a tax rate cut they also give my company a tax holiday reducing our tax rate to 5% for this year. Bitchin!!! I can hire a bunch of new employees to help us make more Widgets! But wait, I couldn't even sell the 150,000 Widgets we produced last year so if I hire more employees and can produce 250,000 Widgets I can still only sell 149,000. If I hired more people just because I got a tax cut my investors would hang me by my thumbs! I like my job so I'll just use the tax cut to by up more company stock and inflate the value of my company instead.
That's how supply-side economics works, you can give corporations all the tax breaks you want but without demand they're not going to produce any more than they can sell and in turn will not hire any more workers. To get the economy going you have to invest in jobs. Most Republicans know this, they oppose tax hikes on the wealthy and corporations because they fund their campaigns not because they think it will create any new jobs. But if they say that they can't get you to vote for them.
Republican leadership walked out of debt ceiling negotiations because they don't even want to hear anything about closing tax loopholes or raising taxes on the wealthy but before they left they made sure that Dems agreed to cuts that would harm middle-class Americans. Another reason they walked out was to shove the issue to Obama so that when they eventually do vote to close tax loopholes or raise taxes they can just blame it on the President and say that they had no choice because the debt ceiling had to be raised. Because as I've said before they will raise the debt ceiling but they're going to position themselves to their political advantage first.
Friday, June 24, 2011
Wednesday, June 22, 2011
Upholding The War Powers Act
I've been putting off writing a blog entry on this topic for a week or so now, partially because I've been busy but primarily because I hoped there would be some new development regarding Libya making what follows irrelevant. But as you probably are aware we have passed the 90-day mark for our operation in Libya and are continuing operations even though the War Powers Act requires that all actions cease after 90 days if there is no authorization from Congress.
The War Powers Act was passed by Congress in 1973 in an effort to check presidential powers after US commitment to armed conflict is undertaken without congressional authorization. It requires the President to notify Congress of committing US forces within 48 hours and allows operations to continue without approval from Congress for 60 days, beyond which an additional 30 days are allowed for withdrawal. The 90 day period from when we began action in Libya expired on the 20th. The President has expressed that the War Powers Act is a valid law, unlike some previous presidents who have questioned its constitutionality, but he claims that US involvement in Libya is exempt from the War Powers Act as it is a NATO mission. Although Mr. Obama isn't the first President to push the limits of the War Powers Act I am not aware of any administration continuing action beyond the 90-day period without congressional approval.
I am supportive of our efforts in Libya and I believe that President Obama did the right thing by using US resources in helping stop what would have been mass genocide. I can also understand the point that the President is making by claiming that NATO operations are exempt from the War Powers Act but I disagree with this assessment. There are certain obligations of NATO members when another member of NATO is the victim of hostilities but Libya is not a part of NATO and actions within that country certainly do not directly and immediately threaten our NATO allies. Even if another NATO member was the victim of hostilities I believe that as a nation we have a right to determine the extent of our involvement through Congress not by unilateral action of a President. Although NATO requires support in those types of situations it does not require military assistance. There are times when the President must act unilaterally due to time constraints, in today's world violence can flare-up with little notice and waiting on approval from Congress could cost lives, but there must be limits and conditions to that power and that's exactly what the War Powers Act was intended for.
Although I feel that President Obama is wrong on continuing action without congressional approval the blame is not his alone, Congress has failed to meet its obligation to check presidential power. Nowhere in the War Powers Act does it require Congress to wait for the President to do anything before they vote to continue or cease military involvement. The President is only required to brief Congress and even if the President fails to do this Congress can still act. There are some who have claimed that the President has failed to inform Congress of his actions, this is false, the administration has had continuous briefings with Congress to keep them informed of operations. And to be fair there have been members of Congress who have proposed bills dealing with Libya, but these have failed to pass as they do not have support from congressional leadership from either side of the aisle.
Congress must act and authorize the President to continue operations in Libya, failure to do so will set a dangerous precedent rendering the War Powers Act invalid. Just because congressional leaders agree with what we are doing in Libya doesn't mean that they will be in favor of any future conflict that extends past the authorized 90-day period and now that the precedent has been set it will be difficult to resolve the issue through the courts. If leaders in Congress feel the War Powers Act is out-dated then fix it or pass a new law but either way they can't let the Act die. We cannot create a situation where one person can make open-ended war, our voice is through Congress and they need to ensure we as citizens remain relevant.
The War Powers Act was passed by Congress in 1973 in an effort to check presidential powers after US commitment to armed conflict is undertaken without congressional authorization. It requires the President to notify Congress of committing US forces within 48 hours and allows operations to continue without approval from Congress for 60 days, beyond which an additional 30 days are allowed for withdrawal. The 90 day period from when we began action in Libya expired on the 20th. The President has expressed that the War Powers Act is a valid law, unlike some previous presidents who have questioned its constitutionality, but he claims that US involvement in Libya is exempt from the War Powers Act as it is a NATO mission. Although Mr. Obama isn't the first President to push the limits of the War Powers Act I am not aware of any administration continuing action beyond the 90-day period without congressional approval.
I am supportive of our efforts in Libya and I believe that President Obama did the right thing by using US resources in helping stop what would have been mass genocide. I can also understand the point that the President is making by claiming that NATO operations are exempt from the War Powers Act but I disagree with this assessment. There are certain obligations of NATO members when another member of NATO is the victim of hostilities but Libya is not a part of NATO and actions within that country certainly do not directly and immediately threaten our NATO allies. Even if another NATO member was the victim of hostilities I believe that as a nation we have a right to determine the extent of our involvement through Congress not by unilateral action of a President. Although NATO requires support in those types of situations it does not require military assistance. There are times when the President must act unilaterally due to time constraints, in today's world violence can flare-up with little notice and waiting on approval from Congress could cost lives, but there must be limits and conditions to that power and that's exactly what the War Powers Act was intended for.
Although I feel that President Obama is wrong on continuing action without congressional approval the blame is not his alone, Congress has failed to meet its obligation to check presidential power. Nowhere in the War Powers Act does it require Congress to wait for the President to do anything before they vote to continue or cease military involvement. The President is only required to brief Congress and even if the President fails to do this Congress can still act. There are some who have claimed that the President has failed to inform Congress of his actions, this is false, the administration has had continuous briefings with Congress to keep them informed of operations. And to be fair there have been members of Congress who have proposed bills dealing with Libya, but these have failed to pass as they do not have support from congressional leadership from either side of the aisle.
Congress must act and authorize the President to continue operations in Libya, failure to do so will set a dangerous precedent rendering the War Powers Act invalid. Just because congressional leaders agree with what we are doing in Libya doesn't mean that they will be in favor of any future conflict that extends past the authorized 90-day period and now that the precedent has been set it will be difficult to resolve the issue through the courts. If leaders in Congress feel the War Powers Act is out-dated then fix it or pass a new law but either way they can't let the Act die. We cannot create a situation where one person can make open-ended war, our voice is through Congress and they need to ensure we as citizens remain relevant.
Friday, June 17, 2011
The Alienable Right Part II: Medicare
Earlier this month I wrote an entry titled The Alienable Right Part I: Medicaid with the hope of educating readers on Medicaid and dispelling many of the misconceptions of that program. More broadly The Alienable Right series is intended to highlight how we have failed to completely meet the Right to Life that was listed in the Declaration of Independence, placing a spotlight on programs that are meeting this promise, defending those programs that are under attack, and promoting my views on where healthcare should be in this country. I humbly submit Part II of this series which focuses on Medicare.
I'm sure you've seen a lot of coverage in the news lately regarding Medicare and the GOP's plan to eliminate the program as we know it and replace it with a voucher system. If you have read my post on the GOP's plan you will recall that, if enacted, it would raise the out-of-pocket costs of future retirees from the currently projected 27% to 68% without addressing the rising costs of healthcare. Medicare is one of the few programs the government actually got right and it is a program that is vital to our seniors and to all of us who will become seniors.
Medicare was first created in 1965 and is a social insurance plan that is available to US citizens ages 65 and older and is funded by the payroll tax and premiums deducted from Social Security checks. It is also available to certain other groups including those who collect Social Security Disability Insurance. Medicare is broken down into different groups referred to as "parts."
Part A: This part covers hospital stays.
Part B: Covers outpatient services and items not covered under Part A.
Part C: Also know as Medicare Advantage, Part C was created in 1997 to allow seniors to have Medicare via private insurance as opposed to enrolling in Parts A and B and includes prescription drug coverage.
Part D: Created in 2006 this allows those enrolled in Parts A or B to enroll in a Prescription Drug Program which is administered by private insurance.
The intent of Medicare was to provide affordable medical care to citizens 65 or older who traditionally were unable to afford the inflated premiums and co-pays offered by private insurance. During the Kennedy administration it was noted that only 56% of seniors had health insurance, this was due in large part because of cost both on the part of seniors and insurance. Many insurers did not offer coverage to seniors or did so at unaffordable rates, this was because seniors required greater care and would not have a long life expectancy if enrolling in an insurance plan at an older age, therefore insurance companies charged high premiums to offset these costs to remain profitable. Now I normally don't stand up for private insurance but in this case I do not find them at fault for that practice, their primary goal as a business is to make a profit and seniors in need of care would have eaten away at those profits and required higher premiums. Medicare was the answer to this problem, it was a way to provide affordable insurance to seniors and ensure that more than 56% of them had access to care. Medicare is not a "free" medical program as many think, there are out-of-pocket costs including coinsurance and premiums. On average Medicare covers 80% of the medical costs of enrolees and coverage varies based on income level.
Medicare has met its intended goal, according to the Employee Benefit Research Institute Medicare covered 96.1% of the elderly in 2001 while only 0.8% were without insurance. I mentioned previously that the government actually got this program right, they've managed to insure nearly all of our nation's seniors and have done so efficiently. There are a lot of numbers floating around as to what the administrative costs of Medicare are, many site 1% or 2% but I am more inclined to believe that number is closer to 6%. But just think about that for a minute, the government has found a way to insure a large percentage of the population while only spending 6% on overhead compare to 20% or more by private insurance. Now it's not that private insurance is wasting a lot more money it's just that the business of private insurance requires more cost than the government requires. This program works, but the GOP wants to kill it.
As I've written about previously the GOP wants to take this efficient program that insures over 96% of seniors with an average out-of-pocket cost of 20% (less if enrolled in supplemental insurance) and turn it over to private insurers, the same private insurers who charged unaffordable premiums prior to the introduction of Medicare. According to the Congressional Budget Office if the GOP's plan is enacted by the time my generation becomes eligible instead of paying 27% out-of-pocket for medical care we will be paying 68% of our healthcare costs. It is unrealistic to think that entire generations will be able to save the additional half million or million dollars needed to cover these additional costs. Their plan also does not address how increases in healthcare costs will be handled, it is still open-ended as to whether or not the voucher will increase in kind. I suspect it will be up to seniors to come up with the extra dollars to cover the increased costs. It is no secret that private insurance has wanted to get their hands on seniors dollars ever since Medicare was enacted (see Medicare Parts C and D) and Republicans are ready to hand the elderly over on a silver platter, I guess that's what hundreds of millions of dollars a year spent lobbying and funding campaigns will get you.
I do believe there are ways to reduce what the government spends on Medicare and we can do so without placing the burden on the backs of our seniors. The Democrats were able to find a way to save $500 billion in Medicare costs over the next 10 years in the Affordable Care Act and did so without affecting Medicare recipients. Another proposal is just common sense and the reason it hasn't been accepted by Republicans is because the pharmaceutical companies have them in their pockets; that proposal is government negotiated prescription drug costs. That's right, as of right now the government is not allowed to negotiate prescription drug costs, the GOP made sure this restriction was included in Medicare Part D. If the government were allowed to negotiate prescription drug costs just as the VA does it would save tens of billions of dollars each year, several hundred billion in savings over the next 10 years.
Medicare is a necessary program for our nation's seniors, it literally saves lives and is one of the few ways our government has recognized that healthcare should be a right and not a privilege. We cannot allow those in government who are funded by private insurance destroy this program, we cannot go back to a time when only 56% of our seniors had health insurance. If Medicare is replaced and replaced with a voucher system I would surmise that the rate of insured would actually fall below 50% and in the end the government will be paying for the cost of those uninsured, repealing Medicare just doesn't make sense and ultimately won't save us any money.
I'm sure you've seen a lot of coverage in the news lately regarding Medicare and the GOP's plan to eliminate the program as we know it and replace it with a voucher system. If you have read my post on the GOP's plan you will recall that, if enacted, it would raise the out-of-pocket costs of future retirees from the currently projected 27% to 68% without addressing the rising costs of healthcare. Medicare is one of the few programs the government actually got right and it is a program that is vital to our seniors and to all of us who will become seniors.
Medicare was first created in 1965 and is a social insurance plan that is available to US citizens ages 65 and older and is funded by the payroll tax and premiums deducted from Social Security checks. It is also available to certain other groups including those who collect Social Security Disability Insurance. Medicare is broken down into different groups referred to as "parts."
Part A: This part covers hospital stays.
Part B: Covers outpatient services and items not covered under Part A.
Part C: Also know as Medicare Advantage, Part C was created in 1997 to allow seniors to have Medicare via private insurance as opposed to enrolling in Parts A and B and includes prescription drug coverage.
Part D: Created in 2006 this allows those enrolled in Parts A or B to enroll in a Prescription Drug Program which is administered by private insurance.
The intent of Medicare was to provide affordable medical care to citizens 65 or older who traditionally were unable to afford the inflated premiums and co-pays offered by private insurance. During the Kennedy administration it was noted that only 56% of seniors had health insurance, this was due in large part because of cost both on the part of seniors and insurance. Many insurers did not offer coverage to seniors or did so at unaffordable rates, this was because seniors required greater care and would not have a long life expectancy if enrolling in an insurance plan at an older age, therefore insurance companies charged high premiums to offset these costs to remain profitable. Now I normally don't stand up for private insurance but in this case I do not find them at fault for that practice, their primary goal as a business is to make a profit and seniors in need of care would have eaten away at those profits and required higher premiums. Medicare was the answer to this problem, it was a way to provide affordable insurance to seniors and ensure that more than 56% of them had access to care. Medicare is not a "free" medical program as many think, there are out-of-pocket costs including coinsurance and premiums. On average Medicare covers 80% of the medical costs of enrolees and coverage varies based on income level.
Medicare has met its intended goal, according to the Employee Benefit Research Institute Medicare covered 96.1% of the elderly in 2001 while only 0.8% were without insurance. I mentioned previously that the government actually got this program right, they've managed to insure nearly all of our nation's seniors and have done so efficiently. There are a lot of numbers floating around as to what the administrative costs of Medicare are, many site 1% or 2% but I am more inclined to believe that number is closer to 6%. But just think about that for a minute, the government has found a way to insure a large percentage of the population while only spending 6% on overhead compare to 20% or more by private insurance. Now it's not that private insurance is wasting a lot more money it's just that the business of private insurance requires more cost than the government requires. This program works, but the GOP wants to kill it.
As I've written about previously the GOP wants to take this efficient program that insures over 96% of seniors with an average out-of-pocket cost of 20% (less if enrolled in supplemental insurance) and turn it over to private insurers, the same private insurers who charged unaffordable premiums prior to the introduction of Medicare. According to the Congressional Budget Office if the GOP's plan is enacted by the time my generation becomes eligible instead of paying 27% out-of-pocket for medical care we will be paying 68% of our healthcare costs. It is unrealistic to think that entire generations will be able to save the additional half million or million dollars needed to cover these additional costs. Their plan also does not address how increases in healthcare costs will be handled, it is still open-ended as to whether or not the voucher will increase in kind. I suspect it will be up to seniors to come up with the extra dollars to cover the increased costs. It is no secret that private insurance has wanted to get their hands on seniors dollars ever since Medicare was enacted (see Medicare Parts C and D) and Republicans are ready to hand the elderly over on a silver platter, I guess that's what hundreds of millions of dollars a year spent lobbying and funding campaigns will get you.
I do believe there are ways to reduce what the government spends on Medicare and we can do so without placing the burden on the backs of our seniors. The Democrats were able to find a way to save $500 billion in Medicare costs over the next 10 years in the Affordable Care Act and did so without affecting Medicare recipients. Another proposal is just common sense and the reason it hasn't been accepted by Republicans is because the pharmaceutical companies have them in their pockets; that proposal is government negotiated prescription drug costs. That's right, as of right now the government is not allowed to negotiate prescription drug costs, the GOP made sure this restriction was included in Medicare Part D. If the government were allowed to negotiate prescription drug costs just as the VA does it would save tens of billions of dollars each year, several hundred billion in savings over the next 10 years.
Medicare is a necessary program for our nation's seniors, it literally saves lives and is one of the few ways our government has recognized that healthcare should be a right and not a privilege. We cannot allow those in government who are funded by private insurance destroy this program, we cannot go back to a time when only 56% of our seniors had health insurance. If Medicare is replaced and replaced with a voucher system I would surmise that the rate of insured would actually fall below 50% and in the end the government will be paying for the cost of those uninsured, repealing Medicare just doesn't make sense and ultimately won't save us any money.
Thursday, June 9, 2011
Why Are Guns Off Limits?
March was the 30th anniversary of the assassination attempt on President Reagan in which then Press Secretary James Brady was severely wounded and permanently disabled. Yesterday marked the 6 month anniversary of the Tuscon, Arizona shootings by Jared Lee Loughner that killed six and wounded 14 others including Representative Gabrielle Giffords. Six months after this incident there has been no new gun control laws passed to help prevent this type of event from happening again and no real effort to renew the "Brady Bill," a gun control law named after the aforementioned James Brady which expired in 2004. So I have to ask, why do guns always appear to be off limits?
The Second Amendment to the US Constitution guarantees among other things "the right of the people to keep and bear Arms (and that right) shall not be infringed." I don't think that there can be any argument that the citizens of the United States don't have a right to posses firearms or that firearms of all types can be outlawed, I feel that the Constitution clearly demonstrates this. I have no problems with firearms in general, in fact I've enjoyed recreationally and as part of my former career firing off rounds from shotguns, .22s, handguns, and various assault rifles over the years. I don't generally take issue with homeowners having a firearm in their house for protection as long as they've been properly educated in firearm safety and employ commonsense safeguards. But anytime an "anti-gun" activist or politician puts forward an idea to restrict sales of certain types of firearms or to establish some sort of safety regulation there is this irrational over-the-top outrage from "pro-gun" advocates and associations such as the National Rifle Association (NRA). Even when such calls for regulation come in the immediate aftermath of a tragedy like the on in Tuscon.
At 10:10am on January 8, 2011 Jared Lee Loughner, armed with a 9mm pistol, opened fire on Representative Giffords and other bystanders at a Tuscon area Safeway. Loughner was eventually subdued by civilians on site prior to the arrival of law enforcement. By the time the smoke cleared 6 people were killed including 9-year-old Christina Taylor Green. Loughner wasn't apprehended by armed citizens, nobody drew a gun on Mr. Loughner nor fired at him, he was subdued by multiple bystanders when he had to stop to reload. As we now know Jared Loughner had loaded his pistol with a 30 round magazine, known as a "high capacity" magazine. Would 9-year-old Christina still be alive today if Loughner only had access to a standard 10 round magazine? Tough to say, but we do know that casualties would have been significantly less if he was limited to 10 rounds, 20 people were shot that day and that number could have easily been cut in half if high capacity magazines were still outlawed. That's right I said still outlawed. From 1994 to 2004 high capacity magazines such as the one Jared Loughner used in Tuscon were illegal thanks to the Brady Bill, but that law was allowed to expire in 2004 and congress has made no serious effort to renew it.
There were calls to again outlaw high capacity magazines soon after the nation learned of the facts that Loughner used a 30 round magazine and was apprehended only after he had to stop to reload . Within a few weeks of this tragedy Chris Cox, Executive Director of the NRA's Institute for Legal Action, wrote an op-ed piece that included a once sentence statement acknowledging the tragedy while the 8 paragraphs that followed promoted the need for high capacity magazines like the one that Loughner used to kill 6 people. This is where I disconnect from gun-rights groups such as the NRA. High capacity magazines had been outlawed for a period of 10 years with no issue, I don't know of a single incident where a law abiding citizen in the US needed a 30 round magazine to defend him or herself during that period and in fact I feel that only criminals benefit when these magazines are legalized. In Virginia the rate of handguns seized by police with high capacity magazines was 10% during the period when they were illegal, that rate jumped to 22% after the law had expired. Restricting magazine capacity in no way infringes on an American's right to posses a handgun, it is just a commonsense measure to help prevent mass killings by criminals.
There have been some new gun control laws proposed in both the House and Senate this session, but none of them have made it out of committee for a vote due to the lobbying efforts of gun manufacturers, sellers, and the NRA. HR 591 would require anyone selling firearms at gun shows to be licensed and to conduct criminal background checks with each transaction. This bill does not prevent any law-abiding citizen from purchasing or selling firearms, all it does is allow the government to know who is selling firearms (because they would have to be licensed) and ensure that violent criminals and terrorists are unable to obtain firearms at gun shows. How can any rational and reasonable person be against this? It is still stuck in committee. HR 1552 would prevent anyone who was convicted of a violent crime as a juvenile from being able to purchase firearms, this is already the law for someone who commits a violent crime as an adult. I don't think that it would be unreasonable to expect that somebody who has demonstrated that they are unable to control their temper and has a history of violence towards others would be unfit to posses a firearm. This bill is still stuck in committee. HR 645 is a bill that would overrule the District of Columbia's decision to not allow residents to own handguns or ammunition for handguns, and it would overrule DC's decision to require residents to register all firearms. I guess government overreach is okay in certain circumstances if you're a Republican. I don't think that it is unreasonable for a city to require it's citizens to register their firearms, especially a city that has the highest per-carpita murder rate. They even mention that DC has the highest per-capita murder rate in the bill and they attempt to use that to justify looser gun restrictions for DC! Can you believe it?! HR 1181 requires anybody who is not allowed to own a firearm be included on the instant criminal background check system and that criminal background checks would be required for all firearm sales. Really, do I have to say it? I don't think it's unreasonable to expect that we have a database listing all those who aren't allowed to have firearms (kind of like a no-fly list for guns) or that we have to make sure somebody is allowed to actually buy a gun before selling it to them, especially when we can do so instantly. This does not infringe on any law-abiding citizen's right to own a firearm. It's a commonsense approach to keeping firearms out of the hands of criminals and terrorists.
It's been six months since the tragic killings in Tuscon, Arizona and 6 years since the Brady Handgun Violence Prevention Act or "Brady Bill" has expired and we still don't have any new firearm laws or many continuations of Brady Bill provisions. Guns should not be "off-the-table" on the floors of the House and Senate as they appear to be currently. I'm sure you've heard the adage "guns don't kill people, people kill people" but why are some standing against legislation that would keep guns out of the hands of those particular "people" the adage refers to?
The Second Amendment to the US Constitution guarantees among other things "the right of the people to keep and bear Arms (and that right) shall not be infringed." I don't think that there can be any argument that the citizens of the United States don't have a right to posses firearms or that firearms of all types can be outlawed, I feel that the Constitution clearly demonstrates this. I have no problems with firearms in general, in fact I've enjoyed recreationally and as part of my former career firing off rounds from shotguns, .22s, handguns, and various assault rifles over the years. I don't generally take issue with homeowners having a firearm in their house for protection as long as they've been properly educated in firearm safety and employ commonsense safeguards. But anytime an "anti-gun" activist or politician puts forward an idea to restrict sales of certain types of firearms or to establish some sort of safety regulation there is this irrational over-the-top outrage from "pro-gun" advocates and associations such as the National Rifle Association (NRA). Even when such calls for regulation come in the immediate aftermath of a tragedy like the on in Tuscon.
At 10:10am on January 8, 2011 Jared Lee Loughner, armed with a 9mm pistol, opened fire on Representative Giffords and other bystanders at a Tuscon area Safeway. Loughner was eventually subdued by civilians on site prior to the arrival of law enforcement. By the time the smoke cleared 6 people were killed including 9-year-old Christina Taylor Green. Loughner wasn't apprehended by armed citizens, nobody drew a gun on Mr. Loughner nor fired at him, he was subdued by multiple bystanders when he had to stop to reload. As we now know Jared Loughner had loaded his pistol with a 30 round magazine, known as a "high capacity" magazine. Would 9-year-old Christina still be alive today if Loughner only had access to a standard 10 round magazine? Tough to say, but we do know that casualties would have been significantly less if he was limited to 10 rounds, 20 people were shot that day and that number could have easily been cut in half if high capacity magazines were still outlawed. That's right I said still outlawed. From 1994 to 2004 high capacity magazines such as the one Jared Loughner used in Tuscon were illegal thanks to the Brady Bill, but that law was allowed to expire in 2004 and congress has made no serious effort to renew it.
There were calls to again outlaw high capacity magazines soon after the nation learned of the facts that Loughner used a 30 round magazine and was apprehended only after he had to stop to reload . Within a few weeks of this tragedy Chris Cox, Executive Director of the NRA's Institute for Legal Action, wrote an op-ed piece that included a once sentence statement acknowledging the tragedy while the 8 paragraphs that followed promoted the need for high capacity magazines like the one that Loughner used to kill 6 people. This is where I disconnect from gun-rights groups such as the NRA. High capacity magazines had been outlawed for a period of 10 years with no issue, I don't know of a single incident where a law abiding citizen in the US needed a 30 round magazine to defend him or herself during that period and in fact I feel that only criminals benefit when these magazines are legalized. In Virginia the rate of handguns seized by police with high capacity magazines was 10% during the period when they were illegal, that rate jumped to 22% after the law had expired. Restricting magazine capacity in no way infringes on an American's right to posses a handgun, it is just a commonsense measure to help prevent mass killings by criminals.
There have been some new gun control laws proposed in both the House and Senate this session, but none of them have made it out of committee for a vote due to the lobbying efforts of gun manufacturers, sellers, and the NRA. HR 591 would require anyone selling firearms at gun shows to be licensed and to conduct criminal background checks with each transaction. This bill does not prevent any law-abiding citizen from purchasing or selling firearms, all it does is allow the government to know who is selling firearms (because they would have to be licensed) and ensure that violent criminals and terrorists are unable to obtain firearms at gun shows. How can any rational and reasonable person be against this? It is still stuck in committee. HR 1552 would prevent anyone who was convicted of a violent crime as a juvenile from being able to purchase firearms, this is already the law for someone who commits a violent crime as an adult. I don't think that it would be unreasonable to expect that somebody who has demonstrated that they are unable to control their temper and has a history of violence towards others would be unfit to posses a firearm. This bill is still stuck in committee. HR 645 is a bill that would overrule the District of Columbia's decision to not allow residents to own handguns or ammunition for handguns, and it would overrule DC's decision to require residents to register all firearms. I guess government overreach is okay in certain circumstances if you're a Republican. I don't think that it is unreasonable for a city to require it's citizens to register their firearms, especially a city that has the highest per-carpita murder rate. They even mention that DC has the highest per-capita murder rate in the bill and they attempt to use that to justify looser gun restrictions for DC! Can you believe it?! HR 1181 requires anybody who is not allowed to own a firearm be included on the instant criminal background check system and that criminal background checks would be required for all firearm sales. Really, do I have to say it? I don't think it's unreasonable to expect that we have a database listing all those who aren't allowed to have firearms (kind of like a no-fly list for guns) or that we have to make sure somebody is allowed to actually buy a gun before selling it to them, especially when we can do so instantly. This does not infringe on any law-abiding citizen's right to own a firearm. It's a commonsense approach to keeping firearms out of the hands of criminals and terrorists.
It's been six months since the tragic killings in Tuscon, Arizona and 6 years since the Brady Handgun Violence Prevention Act or "Brady Bill" has expired and we still don't have any new firearm laws or many continuations of Brady Bill provisions. Guns should not be "off-the-table" on the floors of the House and Senate as they appear to be currently. I'm sure you've heard the adage "guns don't kill people, people kill people" but why are some standing against legislation that would keep guns out of the hands of those particular "people" the adage refers to?
Thursday, June 2, 2011
The Alienable Right Part I: Medicaid
"We hold these truths to be self-evident, that all men are created equal, that they are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness." You should recognize that line, it's the one famously penned by Thomas Jefferson and is found in the preamble to the Declaration of Independence. One could argue that a lot of Rights listed as guaranteed by our Founding Fathers still have not come to fruition, but one that I feel has gone most glaringly unfulfilled is the Right to Life. That's right, if you do not have the means to obtain medical care in this country it's your problem, tough luck, don't expect the government to help you, start digging your grave. Well that's the views of some in this country anyway. The current philosophy of healthcare in America is that it is a privilege, not a right.
I've worked in the medical field my entire career and went into medicine because I felt that it was a calling for me to play at least a small part in improving the quality of life for others. Even though I've transitioned from the clinical environment to the corporate one my goal has always been to contribute to helping others and my conviction is that everybody has a right to receive care regardless of their station in life. Unfortunately there are some in this country who do not share my views, in fact there are enough people in this country who view healthcare as a privilege that even in 2011 the United States remains the only large western nation without universal healthcare. I suppose something that's good enough for the rest of the developed world isn't quite good enough for us Americans. I could write an entire book about the attack on healthcare in this country, but I'm going to break-up this broad topic into multiple parts with this first part covering the much attacked and much misunderstood program called Medicaid.
Recent events in the US House, Florida, and New Jersey have motivated me to finally write a blog discussing Medicaid. Earlier this year the Florida Senate proposed cutting Medicaid by more than $1 billion and Gov. Christie of New Jersey is lowering the maximum qualifying income level of Medicaid recipients from from the current $24,645 to the ludicrously low $5,317. Of course who can forget the House GOP budget proposal that would cut federal Medicaid contributions to states. I think all of this begs the question, what's so bad about Medicaid? First let us get a better understanding of what Medicaid is and who it helps.
Medicaid is a healthcare program offered cooperatively by the federal and state governments to the disabled, children of low-income families, and older Americans requiring nursing home care (along with a few other categories). The predominant misconception about Medicaid is that it is for the poor, critics infer that the "poor" are freeloaders who are scamming the system. Having a low income alone does not qualify a person for Medicaid, it is a combination of low income paired with falling into certain eligibility groups such as those listed above.
According to the Social Security Administration (SSA) children of low-income families make up 53% of all Medicaid recipients. That's worth repeating, children make up 53% of all Medicaid recipients, just think about that the next time you hear someone decrying Medicaid and championing huge cuts to it. The disabled make up 16% of Medicaid recipients, these are people who may not be able to work or who do not have the capacity (mental or physical) to live on their own and require nursing home care or live in group homes. So more than two-thirds of Medicaid recipients are children and the disabled. The SSA goes on to say that 41% of Medicaid funds went to nursing home care in 2008.
One of the primary arguments against Medicaid is that people scam the system, but it is quite difficult to scam Medicaid as there isn't any financial benefit to do so, you do not receive any type of direct payment from the Medicaid program, any payments from the program are made directly to the medical provider. Let us remember that one of the requirements to be eligible for Medicaid is low-income (again, not the sole requirement) and you have to prove your income level to the government thus demonstrating that you cannot afford private insurance. So it's not folks who just don't want to purchase health insurance, those are primarily recent college grads, it's those who cannot afford insurance for their children or because they're disabled and cannot work to earn enough for private insurance. Another argument for cutting Medicaid is cost but the problem is that there really isn't much to cut. I'm sure that there is some level of waste in the program as there is in most programs, but I would venture to guess that waste is minimal and that most dollars are going directly to care. What is really driving up the cost of Medicaid are healthcare costs that are driven up by private insurance, that is the source of the problem and cutting Medicaid funding to cash-strapped states will not help the bottom line and in fact would probably cost the government more money. Again 41% of Medicaid funds go to nursing home care, how much more would it cost the government when patients can no longer stay in nursing homes after Medicaid is cut and have to live out the rest of their lives in a hospital instead? Or how about the children who make up 53% of Medicaid recipients, if they get cut how much more will it cost the government when they no longer have access to preventative care and make a trip to the ER each time they get sick and stick the taxpayers with the bill?
So if Medicaid actually goes to people who truly need it and if you can't really scam Medicaid and it would probably cost the government more in healthcare dollars to cut Medicaid then why propose cutting it? Because the recipients of Medicaid are easy targets. As we've seen two-thirds of Medicaid recipients are children and the disabled, throw in the aged in nursing homes (another 8%) and you have a group of people who can't vote, people who essentially don't have a voice. An America where we throw our children, disabled, and elderly under the bus in an effort to save (not really) the government a few bucks is not the America our founding fathers envisioned. They were serious about that right-to-life thing and private insurance has been very successful in convincing us that Medicaid, and more broadly universal healthcare, is something we don't want. It's time for us to pull our head out of the sand, do some reflection about or morals and priorities and finally stand up and speak for those who cannot speak for themselves. We must defend Medicaid.
For more information on Medicaid check out the Centers for Medicare and Medicaid Services (CMS) website.
I've worked in the medical field my entire career and went into medicine because I felt that it was a calling for me to play at least a small part in improving the quality of life for others. Even though I've transitioned from the clinical environment to the corporate one my goal has always been to contribute to helping others and my conviction is that everybody has a right to receive care regardless of their station in life. Unfortunately there are some in this country who do not share my views, in fact there are enough people in this country who view healthcare as a privilege that even in 2011 the United States remains the only large western nation without universal healthcare. I suppose something that's good enough for the rest of the developed world isn't quite good enough for us Americans. I could write an entire book about the attack on healthcare in this country, but I'm going to break-up this broad topic into multiple parts with this first part covering the much attacked and much misunderstood program called Medicaid.
Recent events in the US House, Florida, and New Jersey have motivated me to finally write a blog discussing Medicaid. Earlier this year the Florida Senate proposed cutting Medicaid by more than $1 billion and Gov. Christie of New Jersey is lowering the maximum qualifying income level of Medicaid recipients from from the current $24,645 to the ludicrously low $5,317. Of course who can forget the House GOP budget proposal that would cut federal Medicaid contributions to states. I think all of this begs the question, what's so bad about Medicaid? First let us get a better understanding of what Medicaid is and who it helps.
Medicaid is a healthcare program offered cooperatively by the federal and state governments to the disabled, children of low-income families, and older Americans requiring nursing home care (along with a few other categories). The predominant misconception about Medicaid is that it is for the poor, critics infer that the "poor" are freeloaders who are scamming the system. Having a low income alone does not qualify a person for Medicaid, it is a combination of low income paired with falling into certain eligibility groups such as those listed above.
According to the Social Security Administration (SSA) children of low-income families make up 53% of all Medicaid recipients. That's worth repeating, children make up 53% of all Medicaid recipients, just think about that the next time you hear someone decrying Medicaid and championing huge cuts to it. The disabled make up 16% of Medicaid recipients, these are people who may not be able to work or who do not have the capacity (mental or physical) to live on their own and require nursing home care or live in group homes. So more than two-thirds of Medicaid recipients are children and the disabled. The SSA goes on to say that 41% of Medicaid funds went to nursing home care in 2008.
One of the primary arguments against Medicaid is that people scam the system, but it is quite difficult to scam Medicaid as there isn't any financial benefit to do so, you do not receive any type of direct payment from the Medicaid program, any payments from the program are made directly to the medical provider. Let us remember that one of the requirements to be eligible for Medicaid is low-income (again, not the sole requirement) and you have to prove your income level to the government thus demonstrating that you cannot afford private insurance. So it's not folks who just don't want to purchase health insurance, those are primarily recent college grads, it's those who cannot afford insurance for their children or because they're disabled and cannot work to earn enough for private insurance. Another argument for cutting Medicaid is cost but the problem is that there really isn't much to cut. I'm sure that there is some level of waste in the program as there is in most programs, but I would venture to guess that waste is minimal and that most dollars are going directly to care. What is really driving up the cost of Medicaid are healthcare costs that are driven up by private insurance, that is the source of the problem and cutting Medicaid funding to cash-strapped states will not help the bottom line and in fact would probably cost the government more money. Again 41% of Medicaid funds go to nursing home care, how much more would it cost the government when patients can no longer stay in nursing homes after Medicaid is cut and have to live out the rest of their lives in a hospital instead? Or how about the children who make up 53% of Medicaid recipients, if they get cut how much more will it cost the government when they no longer have access to preventative care and make a trip to the ER each time they get sick and stick the taxpayers with the bill?
So if Medicaid actually goes to people who truly need it and if you can't really scam Medicaid and it would probably cost the government more in healthcare dollars to cut Medicaid then why propose cutting it? Because the recipients of Medicaid are easy targets. As we've seen two-thirds of Medicaid recipients are children and the disabled, throw in the aged in nursing homes (another 8%) and you have a group of people who can't vote, people who essentially don't have a voice. An America where we throw our children, disabled, and elderly under the bus in an effort to save (not really) the government a few bucks is not the America our founding fathers envisioned. They were serious about that right-to-life thing and private insurance has been very successful in convincing us that Medicaid, and more broadly universal healthcare, is something we don't want. It's time for us to pull our head out of the sand, do some reflection about or morals and priorities and finally stand up and speak for those who cannot speak for themselves. We must defend Medicaid.
For more information on Medicaid check out the Centers for Medicare and Medicaid Services (CMS) website.
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