Monday, December 30, 2013

Political game playing in 2014. GOP issues may have diminishing returns.

Welcome to 2014 and the year of the mid term elections to the Senate and House in November.  There are enough trial balloons released  in media talk shows lately  laying out party game plans, we can get  an  idea of what to expect. 
2014 is  likely to be consumed by  mostly  posturing  and positioning. Any sound and fury  will signify very little earth shaking  legislative action between now  and 2016  since both sides have indicated they have dug in with their respective hard line  approaches   The budget deal has already been struck. Only the debt ceiling debate looms which will be mostly a vehicle for both political parties to rally their bases.
Expect the Democrats to go on the offensive to propose tackling  the widening gap between the rich and the rest with this recovery making  a mockery of a trickle down theory.  Bucked up by Pope Francis’ new emphasis on caring for “the least of these”,   they will wrap old issues such as unemployment benefits ,food stamps, and minimum wage increases in moral  tones.   Minimum wage increase has  a chance of adoption since  libertarians and some Tea Party members see it  as a way to reduce  the entitlement state. 
Expect the GOP to be  against whatever President Obama wants,  and not for much other than cutting government services, reducing   the deficit, and maybe pieces of  immigration reform to garner more Hispanic votes. Issues such as the economy, the  deficit, and Obamacare could initially be their hottest  topics. However, there is a danger in  relying on those two issues because they  may  have diminishing returns as November approaches.
 Increasing  Obamacare signups will make repeal, taking away benefits so many will have realized, an  untenable political strategy and the GOP will likely shift  to nibble, repair, and sabotage.  Rehashing their old  ideas for replacement  that  failed the effective test over the last four years is not a promising  exercise.
 To make their case for “repair”,  we can expect Republicans  to continue to dramatize the health care law’s warts  and the plight of  those who drew the short stick.  We can expect the supporters of Obamacare to return fire with anecdotes of successes and  to delay  implementation of  more minor  sore points.   The advantage of the battle of the anecdotes will go to Democrats since the numbers of those benefiting will far outweigh the disgruntled and the 85%  of the population on employer’s insurance or Medicare and Medicaid will have seen little change before November 2014. Their plans have already adjusted to the new law.
The GOP could make   the limp  economy an issue, but that, too, has diminishing returns. The economy  is growing and the forecast is that it will continue to improve. The better it gets, the less voters will care. The Democrats could  counter   that the economy grew in spite of    the  GOP’s putting brakes on it.   The government shutdown   reduced the growth rate by   3/10 of percent and the sequester  by 0.7 percent by July 2013, and resulting pain triggered the back tracking  budget  deal in December. Further weakening the GOP will be   the split in their party between the ideologically hide bound Tea Party  shutdowners and the more pro business  establishment that will erupt in the February  debt limit debate  and  again in their  primaries.
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Saturday, December 21, 2013

Obama administration ought to fight GOP anecdotes with their own anecdotes, the best antidote to GOP cherry picking

In 2014, GOP's tactic to  kill Obamacare will be propaganda by anecdote.  While the figures of the winners in health care reform will far outweigh the losers, the Obama administration should also fight fire with fire to put some perspective on the issue.  It is not just enough to rely on people's experience to spread the good word to their friends and relatives in order to debunk the GOP's scare tactics of  distortions, and misinformation,  scary predictions, and cherry picked stories of the disgruntled.  The Obama administration needs to humanize the success stories in a way that those who benefit relate to the majority who do.
For example,  I received this email from one of those middle aged males living in Connecticut who got bounced off his individually purchased catastrophic health policy. While he has just received a reprieve for a year  from either being fined for not finding another policy,  he decided to go ahead and sign up through his state's exchange.  Here in a nutshell is his experience:

"Finally enrolled in CT Health Exchange program and bought insurance.  I had a very good experience and the web site was super easy to use.  Took much less time than I anticipated.  There were not a lot of choices, but the choices were decent – certainly compared to what I had before.  I purchased an Anthem Blue bronze plan for about 50% of what my “paper” plan from Golden Rule cost.  Insurance has a four star rating.   Let’s see how things work out with them, but at the age of 49, I am pretty happy with what I got.  Can’t say the same thing for any of the folks in the Red States – especially those who could qualify for Medicaid but their own governors would prefer them to continue to access care in the emergency rooms….what a joke."

While it is estimated three million holders of individual policies that were not in conformity with Obamacare standards got notices this fall, the administration believes that only 500,000 of them would have problems affording a replacement or would qualify for a subsidy for their new policies. For that reason, they tweaked and delayed parts of the Affordable Care Act, to allow them to continue with their old policies for a year without a penalty, to be able to sign up  through the exchanges for low cost  catastrophic insurance that was in conformity with  Obamacare standards, including free cancer screenings and no co-pays for check ups and other preventative measures. This same opportunity had originally been restricted to those under 30 and "hardship" cases.  This is in no way a "fundamental change", as shrill voices from the anti health care forces claimed, because of the few impacted.  What the administration needs to do is to tout the other 2.5 million who did find a more affordable, better policy and shout their success stories to the rafters.

60% of those under 65 in the US receive insurance through their employers.  In a passing conversation with a benefits provider to major Colorado corporations, I asked him what will happen in 2014.  He replied," little change. Major employers had already made the adjustments. " In fact, recently the annual increase  in employer provided insurance, which had been climbing years before the Obamacare law was as much as 9% a year..had decreased to around 3.5%...the lowest in years.  In spite of some GOP flame throwing, that costs had risen by $2, 500 per family per year, fact checkers blew some good holes in that assertion that it was due to Obamacare.  It is just too soon to tell, they conclude.   The administration needs to provide anecdotes to make their case.

What really aggravates me is the whine  that you cannot keep your own doctor and then claim the President lied again.  What about those 30 million, too, who never had a doctor until now  because they could not afford insurance for either lack of means or pre-existing conditions?  That is a number that should overwhelm any of the disgruntled and their stories need to be touted to the high heavens.

Besides, anyone who changed jobs or their employer changes plans before Obamacare, knows that consumers are always seeking new doctors anyway.  Besides, most affected with having to find a new plan already have a large range of choices, depending on their location...and those choices of providers are the usual brand names.  The administration needs to make that case with anecdotes.  

For us seniors who listened to the Obamascarers, that $400 billion was robbed from Medicare Advantage to help pay for Obamacare for others... the anecdote should come from those like me: I saw no difference this year during open enrollment  and my Medicare advantage plan was unchanged. I got it this year at the same price.  No one I know has had their plugs pulled by some death panel either.  For the fact checkers:  the life of Medicare was extended by 12 years due to the cost savings built into the law.    These stories  to be told by those who have actually experienced the impact of the law.  

This story telling will take some money, given the amount of advertising poured into the airwaves by anti Obama and anti Obamacare forces.  The insurance companies have a great stake in making sure Obamacare brings 30 million new customers into coverage by them.  That is one source of funding. The other is the bully pulpit of the administration and its supporters.  So far the bully part has been .a whisper ...of what it should be and instead, the mistake is being made just to rely on word of mouth by those who have benefited by the new law.  Perception that most have benefited and the rest are a minority of grouches can not be left up to "buzz".  For the sake of protecting their legacy, to fight off GOP's efforts to sabotage Obamacare with "repairs", and to do better in the 2014 midterms, using anecdotes  is the right antidote.



Sunday, December 15, 2013

School shootings hit too close to our home. Why Colorado again? What will work?.

Too often we see television news about another  school shooting. Is this the new normal? Why Colorado…again?     If the tragedies of Sandy Hook, Aurora, and  Columbine  did not move legislators  to make it more difficult for those who have mental health issues to get access to guns, what will work?
 We grieve at a distance for the shooting  victims with  heartfelt sympathy and relief that our own children are safe and far away. In the past twelve  months, all of this became too close to home for our family.  
The shooting at Arapahoe High in Centennial last Friday  shook our family for the second time. Our granddaughter, Heidi, is a junior there, but her mother  had text me within an hour of the event   she had received word from  her daughter, our beloved granddaughter, that she  was safe. We now pray for the shooter’s emotional and physical victims.
The night before, we proud grandparents had attended Arapahoe’s annual holiday concert in the school auditorium  and we focused on  Heidi, first chair cellist in the school orchestra.   How normal, so normal, it seemed that night.  The next day traumatized us.
Our 11 year old grandson, Max,  attending a school 15 minutes from Newtown’s Sandy Hook exactly a year ago, huddled under his desk, locked down,  in that tragic morning. Heidi and Max will never look at life quite the same again.
 School shootings have   become a part of school life…a new normal.   Heidi’s mother teaches elementary  school in the part of Jefferson County that feeds into Columbine, the template for disturbed youth to carry out their anger/revenge  fantasies.  Her school and others across the US  constantly drill  for dealing with  such  incidents and like all teachers, she is on the front line with the awesome burden of protecting  her students.
 There is a pattern nationwide..  Shooters  were or had been students in the schools . They were young adult males in a period of brain development  when many mental health  issues kick in. The schools were   in upper or middle  income white suburban neighborhoods.    Over 62% of Colorado  families with children   dwell  in  suburbs  vs  35% nationally,  so “why Colorado?”  may be a matter of demographics .  Perhaps sociologists can  make more sense of this.
 What works? Law enforcement has learned  from each incident and it paid off in Arapahoe High  Their response limited the carnage. Tactical training for responders, in-school armed  police, student drills and teacher leadership  worked. If the copy cats  conclude this method of  acting out will not be  successful,  perhaps the  epidemic may fade.   We can hope.
Better mental health care is imperative.  Economic barriers are being reduced.  All health insurance must  cover mental health treatment  thanks to the Affordable Care Act requirements. This year, the Colorado legislature approved Gov. John Hickenlooper’s proposal that funds  hot lines for concerned families and individuals seeking help and resources,  provides walk in clinics  at  local venues,  and a public education campaign. Last week, $100 million in federal assistance was allocated to mental health support programs. Parents are learning from media coverage  to spot  danger signs and the necessity of early intervention.  All of those measures will  help. None will keep our children and grandchildren 100% safe,  but if they reduce  deaths from shooter  incidents, hooray.