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It takes only two things to keep people in chains: The ignorance of the oppressed and the treachery of their leaders..
Let’s agree on two points:
Keep those points in mind as we walk through an article that appeared in the Feb. 22, 2017 issue of NPR’s “SHOTS.”
Following each quoted section of the article, we will ask a question. See how many of those questions you can answer.
GOP Considers Trimming Health Law’s 10 Essential Benefits
By Michelle Andrews
As Republicans look at ways to replace or repair the Affordable Care Act, many suggest that shrinking the list of services that insurers are required to offer in individual and small group plans would reduce costs and increase flexibility.
Immediately we should ask, “Why do Republicans want to replace or repair ACA?”
Many “deficiencies” of ACA have been proffered, and one would think that correcting those deficiencies would be a prime goal. Yet, seemingly the prime goal is to cut or eliminate the program, not to improve it for the benefit of the people.
Seema Verma, who is slated to run the Centers for Medicare & Medicaid Services in the Trump administration, noted at her confirmation hearing that coverage for maternity services should be optional in those health plans.
Given that the federal government has the unlimited ability to fund benefits, how does making coverage for maternity services optional improve ACA?
How does this advance the federal government’s mandate to “benefit and protect its people?”
The Affordable Care Act requires that insurers who sell policies for individuals and small businesses cover at a minimum 10 “essential health benefits,” including hospitalization, prescription drugs and emergency care, in addition to maternity services.
The law also requires that the scope of the services offered be equal to those typically provided in the coverage that businesses offer their employees.
The law requires the Monetarily Sovereign federal government to offer services equal to those typically provided by monetarily non-sovereign businesses.
Are we expected to believe it is difficult for a government that never can run short of dollars, to offer what a business that can run short of dollars, offers?
“It has to look like a typical employer plan, and those are still pretty generous,” says Timothy Jost, an emeritus professor at Washington and Lee University Law School in Virginia.
Since the 10 required benefits are spelled out in the Affordable Care Act, the law would have to be changed to eliminate entire categories or to make them less generous than typical employer coverage.
And since Republicans likely cannot garner 60 votes in the Senate to do that, they will be limited in changes that they can make to the ACA.
Still, there’s room to “skinny up” the requirements in some areas by changing the regulations that federal officials wrote to implement the law.
Why would a government that can afford anything, and is charged with the duty to benefit and protect its constituents, even consider “skinnying up” benefits? Why make them “less generous”?
Shouldn’t the government instead, look for ways to improve benefits to the populace?
The law requires that plans cover “rehabilitative and habilitative services and devices.” Many employer plans don’t include include habilitative services, which help people with developmental disabilities such as palsy or autism maintain, learn or improve their functional skills, via speech or occupational therapy or other support services.
Federal officials issued a regulation that defined habilitative services and directed plans to set separate limits for the number of covered visits for rehabilitative and habilitative services. Those rules could be changed.
“There is real room for weakening the requirements” for habilitative services, says Dania Palanker, an attorney and assistant research professor at Georgetown University’s Center on Health Insurance Reforms, who has reviewed the essential health benefits coverage requirements.
Why would a government that can afford anything, “weaken” the benefits to disabled people, most of whom would find habilitative services a financial burden, and whose very life is a struggle?
Pediatric oral and vision care requirements, another essential health benefit that’s not particularly common in employer plans, could also be weakened, says Caroline Pearson, a senior vice president at the consulting firm Avalere Health.
And why would our government that can afford anything not want to provide pediatric oral and vision care to Americans?
The health law requires all individual and small group plans to cover “mental health services and treatements for substance use disorders.”
The Obama administration said that means those services have to be provided at “parity” with medical and surgical services, meaning plans can’t be more restrictive with one type of coverage than the other regarding cost sharing, treatment and care management.
“They could back off of parity,” Palanker says.
Why do the Republicans not want the government to provide these services to Americans?
Prescription drug coverage could be tinkered with as well. The rules currently require that plans cover at least one drug in every drug class, a standard that isn’t particularly robust to start with, says Katie Kieth, a health policy consultant and adjunct professor at Georgetown Law School.
That standard could be relaxed further, Keith says, and the list of required covered drugs could shrink.
Why force the money-limited public to pay for prescription drugs when the federal government is not money-limited and easily could pay?
Republicans have discussed trimming or eliminating some of the preventive services that are required to be offered without cost sharing. Among those is covering birth control without charging women anything out of pocket.
Why cut preventative benefits? Isn’t prevention better than cure? How does this improve the plan?
Before the health law passed, just 12 percent of health policies available to a 30-year-old woman on the individual market offered maternity benefits, according to research by the National Women’s Law Center. Those policies that did offer such benefits often charged extra for the coverage and required a waiting period of a year or more.
The essential health benefits package plugged that hole very cleanly, says Adam Sonfeld, a senior policy manager at the Guttmacher Institute, a reproductive health research and advocacy organization.
“Having it in the law makes it more difficult to either exclude it entirely or charge an arm and a leg for it,” Sonfield says.
Maternity coverage is often offered as an example of a benefit that should be optional, and that’s what Verma has advocated.
If you’re a man or too old to get pregnant, critics of the requirement say, why should you have to pay for that coverage to be included in your policy?
But if the government pays, that man doesn’t pay. So, why should women be denied those benefits?
But that a la carte approach is not the way insurance is designed to work, says Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute. Women don’t need prostate cancer screening, she points out, but they pay for the coverage anyway.
“We buy insurance for uncertainty and to spread the costs of care across a broad population so that when something comes up, that person has adequate coverage to meet their needs,” Blumberg says.
Blumberg is correct as per private insurance, in which we all pay for hundreds of benefit coverages we don’t use so that the few coverages we do use will be available. That is what private insurance is all about.
Your private insurance may cover cancer care, but even if you never get cancer, you still pay for the whole policy.
But, we’re not even talking about private insurance. We’re talking about federally funded insurance (or insurance that should be federally funded).
And this brings us to the fundamental problem with all discussions about ACA: The program was created under the pretense that the federal government’s finances are like your and my finances — the pretense that the federal government can run short of dollars, just like you and me.
So young healthy people are forced to fund ACA coverages they likely won’t use for many years, as is the case with privately funded insurance.
This is known as “The Big Lie,” the purpose of which is to make the public believe their lives cannot be improved because the government doesn’t have enough money.
There is a solution, a simple solution, an affordable solution, a solution that increases benefits to the American public rather than cutting benefits.
The solution is: Federally funded, comprehensive Medicare for every man, woman, and child in America. (Step #2 of the Ten Steps to Prosperity, below).
Phone your Washington Congressperson and tell him/her to stop cutting benefits, stop telling the Big Lie, and start representing your interests.
Rodger Malcolm Mitchell
The single most important problems in economics involve the excessive income/wealth/power Gaps between the have-mores and the have-less.
Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.
Implementation of The Ten Steps To Prosperity can narrow the Gaps:
Ten Steps To Prosperity:
1. ELIMINATE FICA (Ten Reasons to Eliminate FICA )
Although the article lists 10 reasons to eliminate FICA, there are two fundamental reasons:
*FICA is the most regressive tax in American history, widening the Gap by punishing the low and middle-income groups, while leaving the rich untouched, and
*The federal government, being Monetarily Sovereign, neither needs nor uses FICA to support Social Security and Medicare.
2. FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (H.R. 676, Medicare for All )
This article addresses the questions:
*Does the economy benefit when the rich can afford better health care than can the rest of Americans?
*Aside from improved health care, what are the other economic effects of “Medicare for everyone?”
*How much would it cost taxpayers?
*Who opposes it?”
3. PROVIDE A MONTHLY ECONOMIC BONUS TO EVERY MAN, WOMAN AND CHILD IN AMERICA (similar to Social Security for All) (The JG (Jobs Guarantee) vs the GI (Guaranteed Income) vs the EB (Guaranteed Income)) Or institute a reverse income tax.
This article is the fifth in a series about direct financial assistance to Americans:
Why Modern Monetary Theory’s Employer of Last Resort is a bad idea. Sunday, Jan 1 2012
MMT’s Job Guarantee (JG) — “Another crazy, rightwing, Austrian nutjob?” Thursday, Jan 12 2012
Why Modern Monetary Theory’s Jobs Guarantee is like the EU’s euro: A beloved solution to the wrong problem. Tuesday, May 29 2012
“You can’t fire me. I’m on JG” Saturday, Jun 2 2012
Economic growth should include the “bottom” 99.9%, not just the .1%, the only question being, how best to accomplish that. Modern Monetary Theory (MMT) favors giving everyone a job. Monetary Sovereignty (MS) favors giving everyone money. The five articles describe the pros and cons of each approach.
4. FREE EDUCATION (INCLUDING POST-GRAD) FOR EVERYONE Five reasons why we should eliminate school loans
Monetarily non-sovereign State and local governments, despite their limited finances, support grades K-12. That level of education may have been sufficient for a largely agrarian economy, but not for our currently more technical economy that demands greater numbers of highly educated workers.
Because state and local funding is so limited, grades K-12 receive short shrift, especially those schools whose populations come from the lowest economic groups. And college is too costly for most families.
An educated populace benefits a nation, and benefitting the nation is the purpose of the federal government, which has the unlimited ability to pay for K-16 and beyond.
5. SALARY FOR ATTENDING SCHOOL
Even were schooling to be completely free, many young people cannot attend, because they and their families cannot afford to support non-workers. In a foundering boat, everyone needs to bail, and no one can take time off for study.
If a young person’s “job” is to learn and be productive, he/she should be paid to do that job, especially since that job is one of America’s most important.
6. ELIMINATE FEDERAL TAXES ON BUSINESS
Businesses are dollar-transferring machines. They transfer dollars from customers to employees, suppliers, shareholders and the federal government (the later having no use for those dollars). Any tax on businesses reduces the amount going to employees, suppliers and shareholders, which diminishes the economy. Ultimately, all business taxes reduce your personal income.
7. INCREASE THE STANDARD INCOME TAX DEDUCTION, ANNUALLY. (Refer to this.) Federal taxes punish taxpayers and harm the economy. The federal government has no need for those punishing and harmful tax dollars. There are several ways to reduce taxes, and we should evaluate and choose the most progressive approaches.
Cutting FICA and business taxes would be a good early step, as both dramatically affect the 99%. Annual increases in the standard income tax deduction, and a reverse income tax also would provide benefits from the bottom up. Both would narrow the Gap.
8. TAX THE VERY RICH (THE “.1%) MORE, WITH HIGHER PROGRESSIVE TAX RATES ON ALL FORMS OF INCOME. (TROPHIC CASCADE)
There was a time when I argued against increasing anyone’s federal taxes. After all, the federal government has no need for tax dollars, and all taxes reduce Gross Domestic Product, thereby negatively affecting the entire economy, including the 99.9%.
But I have come to realize that narrowing the Gap requires trimming the top. It simply would not be possible to provide the 99.9% with enough benefits to narrow the Gap in any meaningful way. Bill Gates reportedly owns $70 billion. To get to that level, he must have been earning $10 billion a year. Pick any acceptable Gap (1000 to 1?), and the lowest paid American would have to receive $10 million a year. Unreasonable.
9. FEDERAL OWNERSHIP OF ALL BANKS (Click The end of private banking and How should America decide “who-gets-money”?)
Banks have created all the dollars that exist. Even dollars created at the direction of the federal government, actually come into being when banks increase the numbers in checking accounts. This gives the banks enormous financial power, and as we all know, power corrupts — especially when multiplied by a profit motive.
Although the federal government also is powerful and corrupted, it does not suffer from a profit motive, the world’s most corrupting influence.
10. INCREASE FEDERAL SPENDING ON THE MYRIAD INITIATIVES THAT BENEFIT AMERICA’S 99.9% (Federal agencies)Browse the agencies. See how many agencies benefit the lower- and middle-income/wealth/ power groups, by adding dollars to the economy and/or by actions more beneficial to the 99.9% than to the .1%.
Save this reference as your primer to current economics. Sadly, much of the material is not being taught in American schools, which is all the more reason for you to use it.
The Ten Steps will grow the economy, and narrow the income/wealth/power Gap between the rich and you.