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A few well-written words can convey a wealth of information, particularly when there is no lag time between when they are written and when they are read. The IPS blog gives you an opportunity to hear directly from IPS scholars and staff on ideas large and small and for us to hear back from you.



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Entries tagged "Medicare"

If Health Care Reform Falls, Look in the Mirror

April 1, 2012 ·

Supporters of Obama's health care reform are "keeping a stiff upper lip" reports The Hill as reaction to three tough days of oral argument and questioning on aspects of President Obama's Affordable Care Act (ACA).

	Supreme Court rules on ObamaCare. Illustration by DonkeyHotey.The entire health reform effort seems to hang in balance, dangerously. It looks like a very real possibility that Americans who do and will need health care, and who do or will have health conditions -- i.e., pretty much everyone -- will again be excluded from coverage for pre-existing conditions and others priced out of coverage at alarming rates if the unusually conservative and ideological Supreme Court backs the GOP.

It didn't have to be this way. We had the power to make things different. In fact, we still have the power to make things different.

As poorly as the administration calculated, strategized, composed and communicated their reforms, they did what Administrations do. They brought industry to the table, they excluded single payer advocates, they vastly overestimated their ability to bring the other side on board, they vastly underestimated the extreme ideology that opposed reform and they botched the messaging of all of it.

Candidate Barack Obama campaigned on universal coverage. He told would-be supporters that, if he were "starting from scratch," single-payer would be ideal. Indeed, he even understood that the only true reform, that would sufficiently control costs and actually achieve universal coverage, was a single payer, government-sponsored health care system. The evidence is overwhelming that only such a system can achieve those goals.

President Barack Obama however, not only quickly abandoned any thought of a fight for a true universal system, he set his left flank where he wanted to end up: the public option. In addition to current private plans, geographical regions would have another choice, a "public option" which would have the power of the federal government behind it to negotiate down premiums. Absent a single payer system, there could be some real cost savings this way and, some thought, an opening to a future single payer system. Though perhaps this weak option is all one could expect from a centrist administration, it was not what progressives and the Democratic base either really wanted nor should have fought for.

But progressives did fight for the public option. With some notable exceptions, almost exclusively. Instead of being the rallying grassroots campaign and reasonable solution desired by all progressives, universal, single-ayer health care became the pariah of the organized progressives, scoffed at and scorned as unachievable.

It should have come with no surprise that starting where you want to end in a negotiation is a sure way to not get what you want. Progressives could have not only kept their integrity, but they could have provided a left flank as a foil for the administration. Centrist Dems and less-extreme Repubs could have seen a public option as a place to go. The administration should have allowed it, encouraged it, engaged it, used it. Progressives should have fought like hell for it.

No one can say that the outcome then would have been the public option, or wouldn't have. No one knows what the political climate could have been with a strong, organized fight from progressives for Medicare for all. But without a strategy that included such a fight, it could easily have been predicted that public option would not be the outcome.

If we had ended up with a single-payer system, then of course the "individual mandate problem" is non-existent. Even if we had ended up with a "public option," we would not have had this the question before the Supreme Court this spring. Justice Kennedy himself suggested so in his comments that the Individual Mandate problem could be avoided by a tax funded single payer national health service.

So, while progressives, Democrats, Americans who want affordable health care for all of us go forward wringing our hands and "keeping a stiff upper lip," blaming the misinformed conservative ideologues in Congress, in the Supreme Court, in Tea Party get-ups, perhaps we should take a long look in the mirror.

This is a fight for the most basic value a society can have. Will we care for our people or let them become sick, bankrupt, disabled and die unnecessarily because we failed to fight for an affordable quality health care system that covers everyone. Will we slash every other government program virtually out of existence to fund an ever-escalating for-profit insurance system? Isn't it time to fight for Medicare for all?

All Those Who Care: Campaign Launch Shows Depth of Interdependence

July 19, 2011 ·

Interdependence is the single word that embodies the Caring Across Generations (CAG) campaign, for me. 

Solidarity!  Faith!  History!  Unity!  Women! These are the words that resonated with other supporters of the movement.  In a circle in the ballroom of the Washington Hilton last week, we shouted our words and stood with our hands entwined, linked together by our common vision for transforming the culture of care.  The circle marked the end of the Care Congress and the beginning of a movement.

Jessica Lehman, leadership organizer for Hand in Hand: The Domestic Employers Association, and herself an employer of home health aides shared her personal care story.  She described how the care giving relationship is more than people caring FOR her: “Interdependence is what Caring Across Generations is all about,” said Lehman.

As the more than 700 person crowd divided into “tracks,” for the afternoon, the erupting fervor did not dissipate. A highly energized ACTION group proceeded to Capitol Hill to testify on the importance of protecting Medicare and Medicaid and to hear from Senators Al Franken (D-MN) and Sheldon Whitehouse (D-RI) on these issues.

Sen. Franken speaks out in support of Caring Across Generations. Photo by Jobs with Justice.

The other half of the Congress attendees stayed at the hotel and attended workshops. I attended one about movements and organizing. I felt invigorated after collaborating to outline steps that can be taken to build a care movement that is premised on the ideal of showing dignity and respect to all persons. To hear and see individuals who hold a forward way of thinking about care relationships has and will continue to spur the movement for reform.

One such “care narrative” came from Rahnee Patrick, a disabled woman and disability rights activist. Individuals with disabilities are continuously in a “negotiation for independence,” she described. Even though a person helps to care for her body she, herself, “brings a lot to the table.” The care relationship is not a passive exchange. All individuals have agency over their wants and needs. Those calling upon care services do not hide the fact that dependence and interdependence are ingrained in the human condition. Understanding this connection and placing value on the relationships developed through their work is what allows domestic workers to feel proud of the direct care services they provide.

Another care narrative that is often overlooked is the unpaid kin care relationship. The 2011 AARP study, “Valuing the Invaluable,” finds that family caregivers often place their own health on the backburner to ensure that a loved one is well cared for. Juggling the care needs of an elderly or disabled family member with the demands of work can be strenuous and, if not well managed, can lead to burnout.  To avoid burn out without compromising the quality of care being provided working hours may be scaled back.  This approach, however, is not entirely favorable.

Hundreds of thousands of dollars in income are lost in a lifetime, the AARP study reports, of caregivers scaling back work hours. An alternative approach, suggests Susan Mintz of the National Family Caregivers Association is to broaden our definition of “family” and extend care relationships into the community. 

The Caring Across Generations campaign is acknowledging the many forms of caregiving relationships, including unpaid family and friends providing care for loved ones. One of the policy proposals that the CAG campaign is evaluating in order to support individuals and families, is a tax credit for caregivers (along with other supports like social security credits, paid work leave, and expanding access to subsidies).

When our society begins to show care workers, seniors, and persons with disabilities dignity and respect, we can overhaul the current image of care and being to sculpt a new care story, one that reflects our values and acknowledges the many forms of caregiving relationships.

Jessica Cutcliffe is an intern at the Break The Chain Campaign, a project of the Institute for Policy Studies.

A Winning Strategy: Voters in Upstate New York Rebuke Radicalism

May 26, 2011 ·

Earlier this year, New York’s 26th House district was left without representation following the resignation of conservative Republican congressman Chris Lee. You remember Lee. He was the congressman who was forced to resign after it was revealed that he had posted shirtless photos of himself, a married man, in the personals section Craigslist. In the bid to replace him were two conservatives, Republican Jane Corwin and Tea Partier Jack Davis. Also on the ticket was Democrat Kathy Hochul.

The 26th district is the most conservative House district in New York and one of the most reliably Republican districts in the nation. Indeed, it hasn’t elected a Democrat in half a century. Yet last night, Hochul, the Democrat, scored a victory. She did so by making the Republican effort to dismantle Medicare the central issue of the campaign.

The Ryan Budget gave Hochul a win and Democrats a celebration. Creative Commons photo by BuffaloPundit.

Medicare has been one of the most successful social programs in the history of the nation. It is a program that seniors desperately need. But the House budget committee chairman’s draconian budget proposal would dismantle Medicare, as we now know it. Today Medicare is a guaranteed healthcare insurance program for elderly Americans. Under the conservative plan, Medicare would be transformed from government guaranteed health insurance to a voucher-like program that would not cover the costs that many seniors will face when confronted with health problems. When Paul Ryan initially introduced his plan it was hailed as courageous and innovative by conservatives in the mainstream media. We were told that Ryan was being brave by starting a conversation. The voters in New York disagreed. They know that there is nothing courageous about cutting programs that help those in need. They know there is nothing brave about cutting taxes for the wealthy, while telling everyone else to fend for themselves.

The Republicans have now tried to claim that the Ryan budget was just a marker. Meaning that it is a starting point. This is utter nonsense. The entire House Republican conference, with the exception of four members, voted for the budget. They cannot just sweep their support for dismantling Medicare under the carpet. And there’s no hiding from their goal of forcing American seniors to pay more for deductibles and co-payments, as will inevitably happen when the cost of healthcare skyrockets and the premium support, offered in the conservative budget, fails to keep up with the rise.

The Congressional Budget Office has estimated that seniors would have to pay up to two-thirds of the cost for their insurance, as opposed to the 25 percent they pay now. No one should be surprised; the conservatives always seek, during tough economic times, to shift the onus to the elderly, middle-class, working class and poor, instead of to the economic elites — the ones who should be sacrificing the most during this sluggish economic recovery. If last night’s election was any indication, the American people are finally waking up to this reality. 

Juan Thompson is a student at Vassar College and a current intern at IPS. 

Paul Ryan's Path to Prosperity: A Redefinition of the Role of Government

April 5, 2011 ·

It is mindboggling to see Ryan’s budget being considered in its current form.  Although it is true that our current budget deficit is a serious problem that needs to be tackled (although I staunchly still believe that the unemployment crisis at hand should be priority numero uno), the fact that he can actually actively promote a plan to privatize Medicare shows that people’s views of the role of government are changing. And by expressing support for the plan proposed by Ryan, you are inherently supporting Ryan and his Tea Party-backed GOP’s view of a smaller, privatized government.

From my understanding, most people who support the privatization of government argue that the private sector is much more suited to providing services and goods to its people because they believe that the government is inefficient. In their view, social safety net programs like Medicare and Social Security are plagued with excess, redundancy and waste and unnecessarily increasing our national debt.

Although it is true that entitlement spending programs like Medicare, Medicaid, and Social Security make up a lot of what our federal government spends annually, the rising costs of these programs are due to the fact that there are many Baby Boomers retiring, and a lot of these retirees are living longer. With 84 percent of wealth in this country controlled by the richest 20 percent, people can’t expect that a regressive payroll tax system is sufficient to support Medicare, Medicaid, and Social Security. A new revenue stream for these programs needs to be introduced if we want to keep these programs--and people want to keep these programs

Privatizing our social safety net is the opposite of what needs to be done to lower the costs of these programs and improve their efficiencies. Sure, by privatizing it, the government won’t need to pay a single dime for it, and we will all be seeing our income taxes decrease because it is not the taxpayer’s responsibility to pay for these programs. However, the Congressional Budget Office has shown that a complete privatization of Medicare (in the form introduced by Ryan) would increase the cost of health care for the poor and the elderly who are usually the beneficiaries of Medicare.

Furthermore, have people not been following all the nasty things that for-profit corporations are up to these days? Not only have many of these for-profit corporations like General Electric, Bank of America, and Verizon been tax dodging, contributing to the ever increasing federal debt, but it is exactly this for-profit mentality that has propelled Wall Street bankers to use people’s savings to invest in risky derivatives that has contributed to our current economic crisis.

I know these companies won’t be the ones responsible for providing health care and services if our social safety net is privatized, but for-profit corporations are driven by the same mentality of profit maximization no matter what industry they are in. These corporations have no national allegiance. Contributing to the common good is only a priority to them if it brings them more money.

A vote in support of Ryan’s plan is a vote indicating that private for-profit corporations are better suited at providing the basic needs for those who are most vulnerable. How can anybody seriously believe that is true?