Tuesday, June 27, 2017

Congressional Attack on Medicaid

There’s not enough talk about Medicaid now. The Republican health care legislation in both House and Senate versions makes big changes in Medicaid funding, but most Americans don’t realize how it will affect their families. It’s worth going beyond the over-simplifications of political ads to think about how we as citizens might be affected.

As my mother slowly declined in her 90s, she required more help in her daily life. She had a health care aide visit her own home daily for longer and longer periods of time. Then she lived with us, again with a daytime home care aide, a wonderful woman who became part of the family. After several years of slow decline, she needed more round-the-clock care than we could deliver, and moved into a nursing home, where she lived another four years.

My parents both worked all their lives, were careful savers, and had long-term care insurance. My mother’s financial resources lasted exactly to her death. Had she lived one more month in the nursing home, we would have had to apply for Medicaid to pay for her. Knowing that she could stay where she was and continue to get full care, even though she was running out of money, was an important comfort to all of us.

My father-in-law suffered with Alzheimer’s for 12 years. My mother-in-law took care of him for as long as she could, and then he spent 7 years in nursing homes with considerable daily care. He had done very well professionally, retiring as president of an envelope company with a generous pension. When his company was bought out a few years later, that pension was changed to a one-time payout, enormously reducing his lifetime benefits. I think that allowing companies to abrogate their promises to retirees is scandalous, but that’s another story.

In any case, his years of nursing care were paid by Medicaid. I don’t know exactly what was spent, but the average cost of the last five years of care for an Alzheimer’s patient in America is over $320,000, about $65,000 per year.

Medicaid is our country’s largest government health care program, bigger than Medicare, covering over 70 million people. That financial help for health care is targeted at the less affluent and the elderly. Here are the Americans covered by Medicaid: half of all births; 39% of all children; 30% of all adults with disabilities and 60% of all disabled children. Medicaid pays for nearly two-thirds of all Americans living in nursing homes. Although Medicaid is often thought of as a program for the poor, many of those in nursing homes, as in my family, were solidly middle class until paying for nursing care ate up all their savings.

Only 6% of Medicaid recipients are in long-term care, but because it’s expensive and continuous, that care accounts for nearly half of all Medicaid spending. These costs are shared by the federal government and the states, with each state having its own rules about spending.

Both Republican health care bills include giant cuts to federal Medicaid spending, about $800 billion over the next 10 years, according to the Congressional Budget Office. Although it’s hard to be precise, the bill would cut total federal Medicaid spending by about 25%, something candidate Trump promised he would not do. Individual states could either raise more money to make up the difference by increasing taxes or cut benefits to people who need health care.

The $800 billion Medicaid cut is nearly exactly the amount that the Republican legislation would give to affluent taxpayers in tax cuts. The new taxes on individuals making over $200,000 a year, that paid for the expansion of health care insurance under Obamacare, would be eliminated.

Think this is fake news based on the biased mainstream media? Here is what Republicans say about the Republican health care bill. Three Republican governors signed a letter to the Senate about the Senate bill: “It calls into question coverage for the vulnerable and fails to provide the necessary resources to ensure that no one is left out, while shifting significant costs to the states. Medicaid provisions included in this bill are particularly problematic.” Nevada Senator Dean Heller said, “I cannot support a piece of legislation that takes insurance away from tens of millions of Americans and hundreds of thousands of Nevadans.”

But those are not the priorities of Republicans in Congress. Both House and Senate Republicans created bills which do take insurance away from millions of Americans. They are cutting taxes on the rich by reducing care for the poor and the elderly.

Former Governor of Arizona Jan Brewer, a Republican, said, “We’re going to pay for it one way or another; there are no free lunches.” She’s wrong. The Republicans in Congress want the poorest and oldest Americans and their families to pay more for health care, while the rich get the free lunches.

Steve Hochstadt
Jacksonville IL
Published in the Jacksonville Journal-Courier, June 27, 2017

Tuesday, June 20, 2017

Thinking like a Father

I’m writing this on Father’s Day. I like Father’s Day, despite the commercialism that overwhelms all of our special days. Children should honor their fathers every day, but it’s nice to have a day set aside to think about fathers, just as for mothers.

Although celebrating Father’s Day in June was an American invention, a day honoring fathers has been a Catholic tradition for many centuries. St. Joseph’s Day celebrates the idea of fatherhood.

The first attempt to create a secular day for fathers was the result of a terrible mining disaster, an explosion in the mines of Monongah, West Virginia, on December 6, 1907, which killed at least 360 men, and possibly as many as 500. Grace Golden Clayton, who lived nearby, was at the time mourning the loss of her own father, a preacher, and she suggested honoring the hundreds of dead fathers to her pastor. Another influence was the very recent inauguration of a Mother’s Day celebration in May in another West Virginia town by Anna Jarvis, who wanted to honor her mother, a Civil War peace activist. But it wasn’t until President Lyndon Johnson proclaimed the third Sunday in June as Father’s Day in 1966 that it became official.

Besides inspiring Grace Clayton to honor all fathers, the Monongah mining disaster led to a public clamor for government oversight of the dangerous mines. In 1910, Congress created the U.S. Bureau of Mines to reduce mine explosions with a system of inspections by field officers. Father’s Day and Mother’s Day are linked to peace activism and government regulation.

My children are grown up and ready to have children of their own. My hands-on fathering is intermittent and often long distance. No use in trying to raise my children any more – advice on dealing with life’s challenges is now more appropriate.

But one way I can be a good father is to try to insure that my children, and their children, can achieve their dreams in a healthy world. My generation has not done well in preserving the world, probably being responsible for more pollution of the air, land and sea than any other generation. On the other hand, baby boomers also contributed to the public efforts to control pollution in countless ways, from regulating automobile exhaust, to recycling, to cleaning up our rivers.

Those efforts continue, but a new threat, recognized only within the most recent decades, could make our children’s lives harder, more dangerous, and less enjoyable. Climate change is already creating human problems around the US. In northern Alaska, some villages will have to be moved inland as the sea rises. In the Rocky Mountains, some of the country’s largest forests are dying from heat and drought. In Louisiana, the residents of Isle de Jean Charles are being offered $48 million to move from their homes, because rising seas have already washed away most of their island. In California, the worst drought in a thousand years cost farmers billions in lost income. Western wildfires are expected to expand as temperatures rise.

Thinking like a father means recognizing these threats to our children’s happiness and doing everything we can to protect them. Instead, many men are doing the opposite. They refuse to believe any evidence about the existence of climate change, its causes, and the damage it is doing to human life already. They apply their intelligence to obfuscation, misdirection, and outright lying, because they don’t like the political consequences of global warming. Except for those who have been deluded by this anti-environmental campaign, these men are only hoping for delay.

Five years ago, one of the world’s leading climate scientists appeared before Congress to tell our political leaders that climate change will produce more severe droughts, wider wildfires, bigger storms, and rising sea levels. Republican Senator Jim Inhofe from Oklahoma responded, “The global warming movement has completely collapsed.” Since then, 2014 was the hottest year on record, then 2015 broke that record, then 2016 got even hotter.

But Inhofe, and the others who say they know better, still sing the same tune. They are not thinking like fathers, but like sons. They are rooted in the past, denouncing everything that points to changes in our world, repeating forever that we don’t need to do anything in the face of this unprecedented threat.

When the weatherman forecasts rain, a good father sees that his children wear protective clothing. When the weatherman forecasts a thunderstorm, a good father keeps his children safe inside. When the weatherman forecasts a tornado, a good father leads everyone to the basement.

Now the world’s weathermen and weatherwomen forecast rising seas, more severe storms, more frequent drought and heat waves. Yet those poor fathers ignore their children’s futures. They don’t deserve to be honored on Father’s Day.

Steve Hochstadt
Jacksonville IL
Published in the Jacksonville Journal-Courier, June 20, 2017

Tuesday, June 13, 2017

The Amazing Mind of Donald Trump

An amazing mind says amazing things. Trump says many amazing things, but not because they’re brilliant or clever or funny or heart-stopping. His words are amazing for their ignorance, their cluelessness, and perhaps most of all because he thinks he is profound. His words reveal the real Trump and so they are worth listening to.

Nobody knew health care could be so complicated.” At the bottom of that is “I didn’t know health care could be so complicated.” Political health care discussions have been going on all Trump’s life, from before the creation of Medicare in 1965. But because he didn’t know it, nobody knew it. His amazing ignorance is matched by an amazing assumption of superiority – nobody knows things that he doesn’t know.

For Trump there are no experts whose knowledge would be useful to him. Scientists, historians, intelligence operative, generals, legal scholars, and other politicians have nothing to offer him that he doesn’t already know.

He was widely quoted and widely ridiculed for this amazing statement on a June 2015 Fox News interview: “There’s nobody bigger or better at the military than I am.” He’s better because he knows more, as he said in November 2015: “I know more about ISIS than the generals do. Believe me.”

Trump knows more than scientists about most scientific subjects. He has claimed that scientists are wrong about the dangers of fracking and the lack of danger of vaccines. He finds perils in light bulbs: “Remember, new ‘environment friendly’ lightbulbs can cause cancer. Be careful-- the idiots who came up with this stuff don’t care.” Wind farms are health hazards, too.

How does Trump know what he claims to know? He has said at many times that he doesn’t read books because he is too busy. Tony Schwartz, ghostwriter of “The Art of the Deal”, said that he “never saw a book on Trump’s desk, or elsewhere in his office, or in his apartment” in the 18 months he spent with Trump.

He reads newspapers, even those he constantly labels “fake news”, like the New York Times and the Washington Post. But when he makes speeches, he only cites them to say they are making things up.

His comments about science often reveal how he knows so much: he finds internet articles by cranks and quacks, who advance outlandish ideas that he likes. He doesn’t care whether they are true or false, just that they appear to support ideas he is pushing.

Whom does Trump cite when he wants to back up what he claims? He said that the National Enquirer should win the Pulitzer Prize for reporting. The Enquirer endorsed Trump during the Republican primaries and ran stories which denigrated his opponents. He said they “have a very good record of being right.” He was probably pleased about their stories that Ted Cruz and Mario Rubio were cheating on their wives, and that the Obamas were always about to get a divorce.

He likes Infowars hosted by Alex Jones, one of America’s leading conspiracy theorists, who also supported Trump during the campaign. Jones promoted the “theories” that our government blew up the World Trade Center, that gun control advocates created the “hoax” that 20 children were killed at Sandy Hook Elementary School in 2012, and that the government is poisoning our water with fluoride. Jones strongly pushed the idea that Obama was born in Africa, which Trump used to vault himself to political prominence. He was an early proponent of the claim adopted by Trump that millions of illegal aliens voted for Hillary Clinton. He claimed that “Obama Surveilled Entire Trump Family For 8 Years”, including Trump’s children, even before he ran for President.

Breitbart might be Trump’s favorite source of “news”. Steve Bannon took over the site when Andrew Breitbart died suddenly in 2012. Bannon became Trump’s chief strategist three months before the 2016 election, encouraging him to see the entire mainstream media as purveyors of “fake news”.

Fact-checkers of Trump’s speeches and tweets constantly discover that he gets facts wrong and tells lies. They don’t go further to figure out where he gets his information. Trump doesn’t mostly make up the untruths he tells the world. He takes them from these professional spreaders of political lies.

Our President spreads nonsense from nonsense sites. Alex Jones has that our government is supporting “homosexuality with chemicals so that people don't have children”. But in court trying to win a custody case against his former wife, Jones’ lawyer said, “He’s playing a character. He is a performance artist.” His lawyer said Jones is as serious about his political claims as Jack Nicholson was when he played the Joker.

But Trump takes his “news” from supermarket tabloids and their internet equivalents. He said, “You can’t knock the National Enquirer. It’s brought many things to light, not all of them pleasant.”

Here’s what is unpleasant. Presidential policy is based on nonsense.

Steve Hochstadt
Jacksonville IL
Published in the Jacksonville Journal-Courier, June 13, 2017