Friday, April 25, 2014

Monday, April 14, 2014

US wins world PR polls; grab your passports and get a different perspective

(A version of this posting appears in the print edition of the  May 9 2014)
President Obama may not have won the world’s chest thumping award, but he polling near to where he stood  when he was first elected and  Obama has a much higher favorable rating than did his predecessor, George W Bush  .  As standing in the world goes,  per Gallup’s poll  of 137 countries,  US leadership had the highest approval ratings of five global powers (Germany, China, The European Union..and at the bottom, Russia). Good PR counts for something. Credibility and respect from the rest of the world ‘s streets  affect how their leaders behave. 
  “ Feckless”, “ leader from behind”,” weak”, “ “diminishing US power”, “ carrying a soft stick, but speaking loudly” are epitaphs slung at Obama.    A Pew Research Center poll, November 2013,     found  that “ 80 percent of Republicans (and 56 percent of Democrats) said they believe that the U.S. is less respected by other countries than in the past.” 
While Americans want less global involvement, world perception of US leadership did take a dip, but it improved in 2013.  The Gallup poll   found “ median approval of U.S. leadership across …. 130 countries stood at 46%, up from 41% in 2012” It was 49% at the beginning of Pres. Obama’s presidency .  George W Bush polled  in the 25% approval range  in 2008. The lowest opinions  of the US are held currently  in the middle East, but Asia and Europe improved the most from 2012.
A survey of global attitudes released by Pew in July 2013 found that  “half or more of those surveyed in 2013 expressed a favorable opinion of the U.S. in 28 of the 38 nations polled. That’s markedly better than under Obama’s predecessor, George W. Bush. In its 2008 poll, Pew found only nine of 23 nations polled reported half or more residents with a favorable opinion of the U.S.”
Why?   There are plenty of reasons why   Pres. Obama’s popularity should continue low  in the middle East. He got Bin Laden, pulling off  a sneak incursion into Pakistan.  He urged Western style democracy but did not do much to back movements in Egypt and elsewhere and he appeared powerless to shape the results. Gitmo was not closed down. Helping Syrian rebels  was a well intentioned beginning, but it was too late: Al Qaeda affiliates hijacked it from  the moderates.    Ben Ghazi never landed in Obama’s lap, but the messaging  was bungled .
 Elsewhere,  Obama’s threat of sanctions  to stop Russia from keeping Ukrainians from choosing their own destiny have  not yet been backed by    Europe enough to be effective (Germany may change that, per recent Bloomberg News reports) .Snowden disclosed US spying. Our relations with Russia fell apart. Still, per Gallup polls, improvement came because of our success in helping Myanmar open up to democracy and our improving relations with Iran.
A common thread of  these successes and failures  illustrate  President Obama’s oft stated intent of  working through alliances, pulling out of past conflicts ,giving diplomacy a chance first, quietly using the military and covert big sticks, and letting emerging democracies shape their own destinies. These policies have at least won him the world’s PR war.

Sunday, April 13, 2014

3 ideas I like to reduce health care costs...from a conservative source

Three ideas I like...from a conservative source, Fiscal Times
All make sense...but the drug patent restrictions will be lobbied to its death. The malpractice concept of arbitration or some way around expensive mal practice suits have long been advocated by some in the American Medical Association. However, that, too, may get strong lobby push back from trial lawyers. None of this will be easy, but it is worth the effort.

We Can Find Consensus on Health Care Cost Reforms - Yahoo News

Saturday, April 12, 2014

Medicare visions: A skunk in the GOP's woodpile

“Did you hear that Obamacare is taking away billions from Medicare?” my husband exclaimed, with a tinge of  panic in his voice.
“Where have you been? I have heard that one repeated every year since Obamacare was proposed”, I, the family consumer advocate,  retorted. “Look, I said, we both are one of 28% on Medicare Advantage   that combines Medicare and Medigap.   But most likely we will see no change, Medicare Advantage will continue. At least that is what a survey made by the Kaiser Family Foundation (KFF) found. Regardless, our Medicare benefits will not change, either.”
“ Won’t our Medicare Advantage premiums go up?”  he countered.
“  I am not sure because as KFF reported, there are many elements that go into determining costs.They only went up a tiny bit this year, like in past years..  What I am sure of is that the Medicare Advantage insurance providers had been raking in more from the government  than it cost for government  to administer Medicare . Those excessive subsidies were cut . Even Rep. Paul Ryan, the GOP House guru on budgets, kept cuts to Medicare Advantage in his  2012 planning. Besides, did you notice you had lower co-pays  for your prescriptions, and no copays for  checkups and cancer screenings? That was one of the Obamacare  benefits to seniors, closing the donut hole,  and repeal would put us back to where we were before.
“  Medicare patients were getting charged for   repeat tests and unnecessary readmissions .  Now hospitals have to share test records electronically and since 2012 they  had to pay penalties for excessive readmissions.  Readmission rates have taken a dive.   That  cuts costs to Medicare.
“In fact,  Congress’ own independent  Congressional Budget Office predicted  all of these measures will add a decade of life to Medicare. Those who want to repeal Obamacare  will just be making the time sooner  when we must do something to prop Medicare up.
Hubby: “So what happens when Medicare goes broke…shouldn’t we make some changes now? What about privatizing Medicare and making people pay more for premiums, giving them money to go buy their own insurance, and cut out government administration?
“ There’s a skunk in that woodpile”, I answered.  “Ryan’s  newest plan (passed by the House this April); DOA in the Senate) would have given seniors of a choice between keeping Medicare and vouchers (premium support) and not guarantee any of that would keep up with inflating medical costs, increase the retirement age, and the wealthy would not qualify for benefits.  We know from Obamacare, even private insurance had sticker shock. Health insurance companies  are allowed  by law to collude to set prices and benefits, making free market competition  no guarantee of lower prices. Ryan claims savings (meaning cuts) to Medicare would be $129 billion over 10 years.
“Privatizing Medicare is  not the only way to go. Simpson Bowles deficit reduction  Commission proposed keeping Obamacare and  government provided Medicare that would keep up with costs. Like Ryan’s, though, they would increase the retirement age and not provide benefits to the wealthy.
“ Don’t worry, though, no politician would ever make changes affecting those already having Medicare or near retirement age; they want your vote”.
Sources tapped for the comments above:  
Washington Post, February 27,2013, “Health law’s rules help hospitals cut patient readmission rate”

Who speaks for the poor? Not the GOP; not the loudest are the Democrats; bless the ones that do.


When Rep. Paul Ryan first proposed weakening the social safety net in a budget proposal in 20,12    ,the Catholic Bishops called it “immoral”.  That was even before Pope Francis reset priorities of the Catholic Church to care about the poor. Ryan’s newest budget passed by the House this month (and DOA in the Senate), reduces food stamps by $125 billion  and restricts access of the near poor to health care by repealing Obamacare and reducing Medicaid.If his first proposal was immoral, the 2014 version  is beyond immoral. Who is speaking for the poor these days?,

  Not The GOP, many of whom oppose even raising the minimum wage, so low now even full time workers live in poverty. Not Republicans who support    laws making  it harder for the poor without affordable  and easy access to drivers’ licenses and birth certificates or convenient voting hours to raise their voices .Not the GOP House members including the GOP Colorado Representatives who voted for Ryan budget this month, that would have  cut  food stamps while cutting  taxes for the rich.

 Growing  up in Oklahoma in the 1950’s, I  heard many  rationalize opposing government assistance  by blaming  the poor themselves,  opining African Americans  were lazy or undeserving.. Racist attitudes coloring opposition to  welfare still linger into recent times  per  a study of  many public opinion polls reviewed by Arizona State University.

 Pres. Johnson’s  War on Poverty  and civil rights legislation were  the reaction  to the injustice and  fueled by the long hot summer riots of the late 1960’s . America learned that the poor could get attention even if they did not have a political voice. But there were also abuses as some gamed the  new welfare system .

  Reality check: Welfare reform in the 1990’s  put more  to work. Those left receiving  food stamps now, per the US Department of Agriculture, are mostly kids  (47 percent are under age 18)and elderly (8%). . Three-quarters of food stamp recipients are families with children.    
  The charity community is  doing what they can , but sometimes the food bank cupboard is bare..Hunger plagues 1 out of 5 kids who do not know where the next meal is coming from and government through school lunch programs and food stamps make up part of the  difference.  

 Many of the states with the largest number of poor have  state houses dominated by the GOP yet whose budgets are the most dependent on federal money for social programs. They have  the greatest need and the least will to provide .Leaving   states to use their own resources with federal block grants masking diminished federal contributions to Medicaid, as Ryan’s budget does, would  further divide this country  between the have  and  have nots..

 Even the Democratic Party has  focused priorities  on issues supporting the middle class.
 The voice of the poor was further overwhelmed by recent Supreme Court decisions that  gave corporations the same right as individuals to contribute political campaigns (Citizen's United), and a recent decision (McCutcheon v FEC) that made it much easier for the wealthy to  spread their  influence around.

So who is left as the strongest voice for the poor? Some in the  faith community and Pope Francis and God bless them.

Sources tapped for this blog:

Friday, April 11, 2014

Russia's Ukraine policy's unintended consequence: Europe's energy independence

Whatever the outcome, the Crimea  and Ukraine crises have made western Europe painfully  aware that they had become so dependent on Russian gas and oil , they were unable to react forcefully. Russia had become the master of their foreign policy souls. A western European backlash, to seek more energy independence, would  mean unintended long term  consequences  for Russia.
Our family has been dismayed at the return of  tense relations with Russia. Post Communism so many of our east European friends have enjoyed the warming of relations, the freedom to immigrate or travel, and a much improved standard of living.  However, we also have been close hand observers of  Europe’s recent and ever increasing dependence on Russian gas and oil. One third of Western Europe’s  energy comes from Russia and other countries once in the Soviet sphere of influence depend 100% on Russian oil and gas.
  Much of our family is related by marriage and blood to Austrians and Croatians and over the past 40 years we have made nearly annual trips to that part of the world.  We have observed  Croatia’s  increasing dependence  on Russian energy.  In Croatia, my sister in law’s apartment is   heated by its gas. (around 30% of Croatia’s natural gas is Russian).  On their   Dalmatian coast, Russia’s  Gazprom has recently bought  service stations to fuel the tourist trade.
 On a  trip through Romania three years ago, we crossed the  Ploiesti oil fields,  site of  World War II air battles.    Rusting oil refineries and storage tanks dotted the fields and a large pipeline carrying Russian oil   bordered   it.  “ But why?””, I asked our guide,  remembering  Romania was once a famous oil producer. “ It is cheaper to get it from Russia”, he replied.
That viewpoint is changing, however. Romania is 25 to 35% dependent on Gazprom gas, but it has 15 years worth of gas reserves itself, which it will  soon begin tapping . Their energy prices will rise, but they have already planned to take advantage of lower consumption to gain more energy independence.
SETimes  ( shed more light on the dilemma facing  Europe using oil and gas policy  to bridle Russian ambitions.   Boycotting  Russian oil and gas could backfire on them.   Gazprom is the sole provider of their energy for Poland, Hungary, Slovakia, Bulgaria, Finland, and the Baltic states. Albania, Bosnia and Herzegovina, Kosovo, Macedonia, Moldova, Montenegro and Serbia also are strongly dependent on Russian gas.
 Petro policy can also backfire on the Russians. 53% of Russia’s annual gas export pipelines cross the Ukraine. Control of the Ukraine is critical to them.. But any loss of Western  markets could  seriously damage the Russian economy  fed heavily  by petro income and diminish  Putin’s domestic support..

In June the EU will present a plan for reduction of  energy dependence on Russia, including developing more renewables and  their own shale gas, increase imports of  liquified natural gas from Qatar and the US,  improving pipeline infrastructure within the EU and reviving  eastern European gas fields.    While the plans will take time to realize, just the threat of implementation being formalized now  should give Russia some serious second thoughts as they ponder the  long term unintended consequences of their  recent policies.

A version of this was published in the today...print and on line.

Russia’s unintended Ukrainian fallout |

Russia’s unintended Ukrainian fallout |  My column published April 18, 2014

Note: April 16, 2014;  FiscalTimes thinks that unlike in the past, Europe  this time will actually take action to establish an EU energy policy and that they can call Putin's buff because they have large reserves of gas after a mild winter.

From SETimes April 16

Kremlin threatens gas supplies to Southeast Europe

Several nations receive Russian gas via Ukraine. In other business news: Albania's credit rating sees improvement and Turkey's military spending surpasses Canada.
The EU says Russia should not politicise its contractual shipments of gas. [AFP]
In a letter to several Southeast European nations, Russia's President Vladimir Putin threatened to shut off gas supplies to Ukraine. The letter, which is intended to increase pressure on Kiev as Kremlin-backed troops stir insurgency in eastern Ukraine, warned of action unless Ukraine starts repaying its debt and unless the EU agrees to joint talks with Russia on the country's economic future. The European Commission responded in a statement and said it expects suppliers to stick to their commitments. The letter was sent to 18 European heads of states that depend on Russian gas transit via Ukraine, includingBulgariaCroatiaGreeceRomaniaBosnia and Herzegovina (BiH), MacedoniaMoldova,Serbia and Turkey.

My View: Shameless, deceptive ads flood Colorado |

My View: Shameless, deceptive ads flood Colorado |

Wednesday, April 2, 2014

Shameless and deceptive anti Obamacare ads flood Colorado

Indeed, an anti Senator Mark Udall ad  running in our market says  Obamacare ( ACA) is “about people”, but the” people” referenced in the ad  are  not  about the   7.1 million who signed up for private insurance through federal and state ACA exchanges  ,  or in Colorado 277,149,  who signed up  as of  March 31 for either commercial health insurance or Medicaid’s expanded version. The anti Udall ad shamelessly exaggerates  the numbers as "millions and millions"    who  could  not sign up after their insurance policies were cancelled .  The GOP mantra,”repeal Obamacare” ,  means that coverage  would be taken away from those “people” for whom it worked to get covered, especially  nasty for the 9 .3 who never had  health insurance before.
A Rand Corporation's study reported in the LA Times, March 30, 2014 (Obamacare has led to health coverage for millions more people), found that  4.5 million previously uninsured adults signed up for state Medicaid programs which were expanded to include more by the ACA, 3 million young adults took advantage of the ACA provisions allowing them to stay on their parents' insurance.. 9.5 million who got insurance thanks to ACA provisions were previously uninsured.

The ACA made it possible for at least 15 million to get insurance. if one adds the 7.1 million plus who bought insurance through the state and federal exchanges,  exchanges, the 4.5 million who got Medicaid  thanks to its expansion, and the 3 million young adults who now could stay on their parents' plans,   15 million is a number in the ball park.

Ads have already begun in Colorado, tying Udall to Obamacare (ACA), attempting to bring attention to the fewer who drew the short stick instead of the far more who benefitted.    One, against Obamacare, sponsored by the Koch Brothers, was very deceptive,.  That one featured an angry woman who lost her individual insurance and was suffering, though that she could find alternatives was never even suggested.
 The “about people ad” is a good example of hyping the ACA shortcomings, claiming   “millions and millions” lost their insurance and could not get a replacement. The Washington Post fact checker hit that one hard. ( Per a recent survey by the Rand Corporation,  fewer than a million people who had health plans in 2013 cancelled  are not uninsured  now.  the Rand survey reported in the same LA Times article above.  "We are talking about a very small fraction of the country" who lost coverage, said Katherine Carman, a Rand economist who is overseeing the survey.,0,5472960.story#ixzz2xkg9oyA7   That is  certainly a negative for those in that predicament, but it is  not the “millions and millions” the ad claims.
 Most deceptive was  the claim in the ad that Obamacare forced persons to pay more for less coverage .  Come, come. T he reason those who had individually purchased catastrophic policies got the discontinue notices  was because it did not offer enough coverage Obamacare deemed basic. 

It is such a shame hospitals will see cuts to government subsidies, whines another   ad, implying reduction in  Medicare services to your parents and grandparents. Here’s why that line is so deceptive : so many more will now have health insurance,  uncompensated charity care hospitals must cover  is less; and that hospitals will be held to higher standards, such as reducing readmissions due to sloppy infection prevention practices and unneeded, repetitive tests.
In fact, The Congressional Budget Office projects that a decade has been added to the life of Medicare due to the cost saving measures. Of course,  no benefits are being cut  by Obamacare and traditional Medicare is preserved.  Even Medicare Advantage serving 28% of seniors is projected to continue.
Expect future ads to claim Obamacare “is” not working because “in the future” premiums will soar as insurance companies drop out for lack of customers or not enough healthy sign up, causing a “death spiral”    Those are scare tactics.   The ACA foresaw that and insurers will be subsidized to keep policies low until the free-riders feel the pain of ever increasing penalties in the next couple of years. The Congressional Budget office estimates it will take three years for all qualified to sign up. Even if young, invincibles fail  to constitute 40% of the sign ups, mid 20%s will still be enough for the “death spiral” not to happen, per the Kaiser Family Foundation. ( March 31, 2014, "Obamacare numbers coming in huge: Here's a guide to GOP excuse-making) .
From Kaiser Family Foundation ( are mostly wrong)
"How about the percentage of young people? Everyone seems focused on that.  Young people benefit the risk pool because they are healthier, but it’s really the percentage of healthy people that make or break the risk pool. Even if enrollment of young adults stays where it is – at about one-quarter instead of 40%, which our analysis shows they make up among potential enrollees – premiums would only increase by two to three percent. Though even that isn’t quite right, since many insurers expected this and already built it into their premiums.  Nevertheless, news organizations continue to hammer enrollment by young adults as if it were the sole make-it or break-it factor to the health of the risk pools and, in some news reports, the law.  There  are no data yet on the overall health of enrollees because the law no longer allows insurers to collect that data in order to exclude people with pre-existing conditions from coverage."

For a very comprehensive fact check similar to this, go to  published 4/11/2014

Tuesday, April 1, 2014

Now that 7 million signed up for Obamacare, what should Democratic candidates be saying now

Now that 7 million have signed up for Obamacare,  it is time that Democrats stop running away from the issue and stand up to their voting record.  My suggested talking points for Democratic candidates in swing states and districts:
“15 million now have affordable health insurance, whether signing up through the exchanges, by  Medicaid expansion, or buying it through their insurance agent. 9 million of those never had health insurance before. This is the beginning and it may take three years for everyone else to join in, but the GOP wants to take it away from you now. That’s what happens if they get their way to  repeal the whole law. They want you to return to the days when you could go bankrupt or lose your home over medical bills you could never pay.

“I know there are some rough edges to the law and we need to go back and fix those, but you need to know what principles, essential benefits required to be covered by insurance,  and  parts of the law I will fight to keep for both those who get their insurance through their employers and those who do not:

1.       Pre existing conditions must be covered
2.       Kids must be able to stay on their parents’ plan until they are 26
3.       Lifetime caps on coverage must be eliminated
4.       Women cannot be charged more than men; women’s reproductive health must be covered
5.       Insurance cannot be dropped when you get sick
6.       We cannot charge co-pays for cancer screenings…including mammograms, prostate, and colon screenings
7.       All insurance should be required to  cover  essential services such as: ambulatory patient services, emergency services, hospitalization,  and newborn care, mental health and substance use disorder services, including behavioral health treatment, prescription drugs, rehabilitative and habilitative services and devices, laboratory services, preventive and wellness services and chronic disease management ,pediatric services, including oral and vision care

8.       80% of premiums must be used to cover benefits
9.       Providers, hospitals should be rewarded for efficient, good service, but they should not be rewarded for repeat admissions, duplicative tests

10. Premiums must be kept affordable based upon income levels, and available for those near poverty who cannot  afford to pay for private insurance .
11. The financial sustainability  of the program must be preserved and not undermined.

If there are better ways to achieve these goals, I am open to them.”