Monday, September 30, 2013

Obamacare in Grand County

For Colorado  blog readers, the resources cited  are those mostly  you can also contact.

 Obamacare and Grand County
One  hurdle in acceptance of Obamacare has been  overcoming confusion and  ignorance about what it means for” me and my family.”   Information coming from Washington speaks in generalities and  generic  provisions, but some aspects of  health care coverage vary   from state to state,  county to county, and individual to individual.  The result has been that the public has become a target for anti health care reform advocates who  take advantage  of  ignorance to feed fear.
As of October 1 we all now have an opportunity to find out  what health care reform means for each of us in Grand County even if   the government is shut down or if  there is a delay in funding. The offices and websites will still be running regardless. It will not take another year to understand it. It will be clear to you immediately if you contact the offices  and websites already  operating  and open for business.
Coverage for those who enroll by December 15, 2013 will begin January 1, 2014 or affordable subsidized coverage would be kicked to January 1,  2015, if the GOP ever gets it way.  Delay of funding would not kill it. It would  just make it more expensive  with administrative costs continuing while  only the more  well-off would be  able to afford premiums since there would be no subsidies to lower the monthly charges.
 In a   government shutdown , the Congressional Budget Office says  the reform law implementation can continue because it is an entitlement.  President Obama has promised to use his  power to move funds around to pay  personnel to administer it.
If you receive insurance from a large employer or government entity, or you are on Medicaid or Medicare already, there will be little if any  change and you will not be able to go to  the market place exchanges to get subsidized  insurance,  nor do you need to reapply.  Obamacare has already closed much of the Medicare drug donut hole and added ten years to Medicare’s  life .  
Like all health insurance per Obamacare, large business provided insurance  is already bound by the consumer protections (no more caps, must cover pre-existing conditions, no  more co-pay cancer screenings, no more higher premiums for women than for men or  overcharging for administration fees .) Overcharges were already  refunded to the insured this year.  
In Grand County individuals earning less than  $15,856  or $30 thousand for a family of four will be covered by  expanded Medicaid.  Individuals earning between $15, 856  a year and $45,960  and families of four earning between $32,499 and $94,200  may qualify for reduced cost premiums  per  income level. For those who earn more, the premiums for coverage bought through the exchanges have the cost advantages of  a large group plan competing  on a level playing field  for your business. All will have a choice of plans through Access Health Colorado, Anthem Blue Cross and Blue Shield HMO, Colorado HealthOP, Rocky Mountain Health Plans, and UnitedHealthcare. There are a wide variety of coverage levels within their plans.
  For those currently uninsured in Grand County, much information can be found at  www.connectforhealthco.com, including the ability to sign up for insurance. The site gives  the range of rates and plan comparisons. Their telephone number is 1 855-752-6749.  You can also  visit Northwest Colorado Community Health, 416 Byers, in Hot Sulphur Springs.   For  Medicaid information,  go to www.Colorado.gov/PEAK or call 1-800-221-3943 .
Small business owners with less than 50 employees are not required to provide health insurance.   There is helpful information about   small business group rates  at the connectforhealthco.com site and you may qualify for a tax credit if you offer insurance to your employees. Open enrollment in all  business and personal plans ends March 31, 2014.

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Sunday, September 22, 2013

The GOP has set the table for class warfare and a Democratic feast with their threat to shutdown the government and defund Obamacare




Shades of 1995, 1996, and 2011. It has become a bad Republican habit. The GOP threatens   to shut down  government  unless they get their way. In the 1990’s the issue was about wanting to cut Medicaid and Medicare. In 2011, it was the debt ceiling. In 2013 Republicans  want to  deprive 30 million people of affordable health care. This also sets the stage for upcoming elections to make class warfare the substance of the battles.
The GOP has set the table upon which the Democrats can feast. Republicans seem perpetually  obsessed with  reducing the size of government even if  the programs attacked give the middle class a hands up.   When  formulating any tax policy, their bottom line is to protect the top one or two percent from any hit to their bank accounts.  Those principles seem to be ideologically applied to about every piece of legislation they encounter.
Do not think the middle class is oblivious.   According to this September’s NBC/Wall Street Journal poll, “Democrats continue to be seen as the party that is most looking out for the middle class. They lead (Republicans) on the question by 17 points. “
There are two issues on the Congressional table that  do not leap out to voters as middle class issues, but they are, and the GOP is vulnerable on both.  Obamacare is indeed  a middle class issue  and  so is shutting down the government. It is just that the Democrats have not articulated those issues as affecting the middle class.  They could easily.
Those with higher incomes can manage to pay medical bills without going bankrupt and they not only can weather a beating in their stock portfolios, they have thrived post recession. A middle class American family 24 years ago was making more than  a middle class family made last year.  The top 1 percent took more than one-fifth of the income earned by Americans, one of the highest levels on record since 1913, when the government instituted an income tax .A disparity that wide is fertile grounds for discontent.
Obamacare gives  the middle class  security that, regardless of their health condition, their income, or their employment situation now or in the future, they will be able to afford health insurance that will also provide preventative care and contains consumer protections from some bad insurance company practices.
September 30 is when the government runs out of money.   The first opportunity  to  apply  for Obamacare coverage is the next day..  The timing is not accidental. The Tea Party perpetrators of the strategy hope   to defund or delay Obamacare as part of their resolution allowing government to pay their bills  before the public  can learn  hands on that  health care reform  benefits them. It is easier to defund something the public does not yet  have or understand than later  to take away something that is already an appreciated benefit. They may be tilting at windmills, though, because the President holds the veto pen.
Government  shutdown affects  a  middle class  that is hoping for economic growth,   more jobs, and sound retirement plans. Congressional Budget Office Director Douglas Elmendorf warned that a “long broad shutdown” could “drag an already weak economy”.  U.S. Chamber of Commerce President Thomas Donohue said “It is insane not to raise the debt ceiling”. Chief Economist for the National Association of Credit Unions: “We basically would default on our debt, interest rates would go through the roof, and we’d fall into another recession.” As  investment guru Warren Buffett said last week of a threatened shutdown : that is “pretty (expletive) dumb.”  
A shutdown is also a dumb political move.  Per a September  CNN/ORC International Poll "Only a third would consider President Barack Obama responsible for a shutdown, with 51% pointing a finger at the GOP.



Sunday, September 15, 2013

Obama's foreign policy: Neither by masterful design nor by accident




The whiplash of events last week that led to the agreement with Russia and got us off the hook of a risky military strike against Syria  has me  wondering whether President Obama was a  chess master  doing what  he had planned all along or simply a beneficiary of  dumb luck.  This is the stuff that books piled  upon university courses are made of.
One take away could be that it was neither check mating nor dumb luck.  It was the flexible use of  tactics  in changing circumstances to support a pragmatic strategy   to reach a stated  foreign policy goal.
Many  of the goals had long been enunciated by Candidate Obama:  it was no more boots on the ground,  a military withdrawal from Iraq, Afghanistan, and ending military meddling in other middle eastern countries’ business.  If  use of   military muscle would actually help meet those goals, it should be limited  and with  an international effort with backing of our allies and neighbors of the region affected.   We should work with those who have common national   interests at stake in that particular situation, if not in all issues. It was this stated policy that won Obama the Democratic Party nomination over Hillary Clinton, who had voted for military intervention in Iraq.
 It was that same policy for which the GOP had criticized Obama as “leading from behind” or “weakening American power and its exceptionalism” . That is   until many Republicans  about faced, demanding  we should not take  leadership in Syria, wait for the UN, and  not use our military might.
So far, Pres. Obama is being consistent with Candidate Obama. He is making good on his withdrawal from Afghanistan and Iraq.  An international coalition and limited, but effective action in oil producing  Libya worked to bring regime change  with no long term use  of our boots.
Syria is an even better  example of Obama’s goals.  It was to be a short term action, though it kept Congress and  Assad  guessing if it was just a shot across the bow, a pin prick, or actually  taking out airfields and means of delivery of chemical weapons. Our missiles off shore spoke to a meaningful strike.  The latter appears to have gotten both Russia’s and Assad’s attention because that would have shifted the balance of the civil war to the rebels’ advantage. 
Mutual  self interest of Russia and the US was identified. We  share a common enemy…al Qaeda like fighters. Neither of us wanted to see them win the civil war, though the US approach was the tricky job of arming the moderate rebels with small arms, while neighboring Sunni nations provided the heavy anti tank  supplies.  Russia, with its Caucus problems, was beginning to fear that US military action might jeopardize Assad and  that the chemical weapons would end up in the wrong hands.     A peaceful solution was  discussed by Presidents Putin and Obama at the G20 in the  week of September 5.
 Sending the issue to Congress before the G20  provided a  delay  to give this a chance to work out, though Obama appeared to miscalculate the intensity of Congress’ opposition and or  world opposition to forming a coalition of the willing. If he had taken any lesson from the UK’s parliamentary vote against intervention, it was not to take the issue to Congress and  to strike immediately instead. That is reason to believe referral to Congress  was a delaying tactic, giving   time to meet face to face with Pres. Putin and to gain his support for a UN resolution.  
While the UN deal does not include military consequences if Assad fails to comply, the US has made it clear it reserves the right of unilateral attack and to continue to arm moderate rebels. Our guns are still cocked and pointed.









Monday, September 9, 2013

Two moralities: clash or complement? One immoral act may be the only way to achieve the moral goal of peace



Pope Francis’ plea for peace in Syria and a day of prayer last Sunday defined what much of the world fervently hopes is the end result of what is an appalling civil war. Almost simultaneously The White House released video clips of children and old people gassed and dying from an attack of chemical weapons, weapons  that the world proclaimed were above and beyond the norms of civilization a hundred years ago and agreed  to ban them for use in war forever. 
  The Pope saw the use of force to be immoral; the Obama administration saw the use of chemical weapons as immoral.   This appears to be  an unsolvable  moral dilemma that gives  shelter to both sides, to  those who oppose US limited intervention in Syria  and the rationalization for the advocates who want to strike.  It is not.   To use one immoral act may be the only way to achieve the moral goal of peace.
Peace, defined as a negotiated end to the conflict that stops the slaughter,  is a wish, a prayer, and a hope, but to get there may require more violence.  So many are  expressing  a belief that if the world put pressure on the Assad regime, embargoes, or so many of the non violent strategies tried to change the behavior of Iran or North Korea, Assad would find his way to the negotiating table.
 It is  not just any  negotiation we should seek. It is negotiation in good faith that would end the conflict and also protect the Christian and Alawite  minorities in Syria from being wiped out by  Sunni  victors.  The specter  of the ethnic cleansing of the Balkan wars  has been  invoked as the reason to protect the Assad regime from collapsing because of US intervention.
That view is  neither logical nor is the goal achievable.  The question  is how can anyone from the outside of Syria convince Bashar al Assad that it is in his interest to negotiate in good faith?  So long as he has allies of Russia and Iran to supply  him with weapons or trading partners in China, embargoes and economic pressure or world condemnation  would not work.  So long as he perceives he is winning, that he controls every major urban city, as he does now, why should he give away  ground or power?
Something must change. Either the West arming the moderate opposition or a strike that would take out Assad’s air and delivery systems so that the playing field is so leveled the futility of continued bloodshed will be obvious to both sides.  The sad part is that combatants who holster their WMD will still draw out the shed of civilian blood for a long time with conventional methods, but a strategic strike by missiles and air that levels the playing field  would have quicker results.  What about collateral damage of missile and air strikes? It all depends upon the surgical skill of those able to carry out the mission, and only the US has that  capability.
 That is the lesson of the NATO intervention in Bosnia in the 1990’s.  Until airstrikes took down the Serbian air force ,  the Bosnian Serbs/Serbia itself, saw no reason to come to the table.  The massacre of 7,000 men  in the killing fields of Srebrenica and the shelling of Sarajevo and  Dubrovnik caused moral outrage throughout the world , but  moral condemnation was not enough.  The reality of those desperately  seeking or keeping power is that they only understand the use of sticks and stones, because words would never hurt them. The skill of US armed forces, without boots on the ground, kept resulting civilian casualties to a bare minimum and resulted in the Dayton accord that ended the bloodshed while protecting  the minorities.
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