United States – 2018 Mid Term Elections

January 17, 2018

United States – 2018 Mid Term Elections

Padmini Arhant

The public issues directly affecting ordinary citizens would determine Congressional elections outcome this year.

The issue such as restoring net neutrality wrongfully repealed by FCC currently awaiting Congressional bipartisanship in the bill introduced under The Congressional Review Act (CRA) in the United States Senate is just short of one vote to reach 51 votes in the simple majority process. The bill would then proceed to the House of Congress and finally to the White House.

Those who aspire to Make America Great Again and interested in maintaining majority rule in the House and Senate would place people needs and rights over special interests, political party and personal career. The net neutrality is not partisan matter as it affects citizens across the spectrum with or without political affiliation.The internet freedom is the last bastion in claiming United States a free country with the first amendment protecting free speech enabled via internet in the easy unrestricted and uncensored access to internet in the Information Age.

The DACA legalizing resident status for the Dreamers with the path to citizenship is pragmatic offering a permanent solution. The immigration policy accommodating border security with the Wall appears to be acceptable with bipartisan backing that includes DACA and border security.

The White House shying away from this opportunity to seal the deal is hard to comprehend especially President Donald Trump campaign in 2016 pledging to get things done averting government shut down and gridlock in Congress. Now when the White House is presented the moment to do so, the administration backing away with unconvincing explanations reflect the Washington contagion effect on members to miss the flight allowing the issue to linger on adding to economic liability and social dilemma.

In other matter, the federal proposal to verify Californians citizenship in the 2020 Census survey likely to inhibit significant immigrant population from participation as there are many awaiting citizenship following permanent resident status that do not qualify them until completion of five years residency in total since obtaining green card in the United States. The rule differs from other western nations like Australia with only two years requirement of continuous residency post permanent resident approval.

The White House step would further exclude other legal residents in different immigrant category contributing to the state and federal income tax depriving them from Congressional representation. These unwanted maneuvers adds to the contentious immigration debate stalling the current government funding bill in Washington D.C.

The White House census move possibly contracting representation in the House of Congress combined with substantial financial loss in federal funding for the State of California is an unnecessary quest and pronounce unique gerrymandering in the mid term election year.

California is not only the largest economy in the nation, the golden state with vast immigrant population also ranks within top ten in the global economy. The federal interception to alter political configurations leading to under representation or lower count forcing the state to lose a seat in Congress and billions of dollars in federal funds as a result of this experiment is unwise besides not being prudent in political as well as economic terms.

Similarly, the Department of Justice (DOJ) Attorney General Jeff Sessions targeting actions adopted by California and other states in legalizing medical marijuana to alleviate pain and suffering among young and old patients diagnosed with life threatening illnesses like cancer and other disease undermines state autonomy in evaluating the benefits and costs on such decisions.

In case the argument is to leave the medical marijuana intact and focus on concerns about recreational marijuana use, even then the federal intervention on citizens lifestyle regardless of potential harm in long term use conflict with democratic system and practicality.

One might say alcohol consumption that exists in various proportions causing health hazards for those exceeeding the limit should perhaps be included in the federal law on marijuana. The same topic could be extended to unhealthy junk food prevalent in the daily diet for urban and poorer segments in society. The lifestyle choices should be left to citizens discretion with adequate health warnings and information rather than imposing regulations that would only prompt illegal approach with no real data on sale and consumption.

On Obamacare, as discussed in length on this website regarding this health care law, the legislation failed to hold the key players – the health care industry comprising corporations and medical foundations in health care management along with Big Pharma and the other being the health insurance industry in meeting their end of the bargain to make health care affordable.

The health care costs and life dependent prescription drugs for cancer and terminal disease is alarming due to extraordinary profits aimed and reaped with price gouging on the rise by big pharmaceutical companies prioritizing mega profitability over patient care and survival.

The problem not addressed in the Affordable Care Act aka Obamacare is leaving patients and families to choose between medical expense and essential items like food and basic needs with insurance coverage unable to match the rapidly increasing price tag on these medications. When major companies in the pharmaceutical industry are positioned to exploit the situation against market affordability, consumers dealing with life and death scenario are vulnerable to soaring price enhancing corporate profits at consumers plight that ultimately impact demand.

Accordingly, the Carers Act in the health care law would be appropriate to streamline burgeoning drug and health care costs making health crisis management and wellness programs truly affordable.

In conclusion, America can become great only when representation in government and society is committed towards progress leaving behind none with fairness and equality guaranteed through individual freedom and economic prospects for all.

Thank you.

Padmini Arhant

Author & Presenter PadminiArhant.com

 

 

 

 

 

 

 

United States – Affordable Care Act (ACA) aka Obamacare

October 14, 2017

United States – Affordable Care Act (ACA) aka Obamacare

Padmini Arhant

The Affordable Care Act (ACA) aka Obamacare has been discussed in detail on this site. Please refer to posts related to this topic.

The recap on ACA – The mandatory insurance tied to penalty proved extremely profitable to insurance industry with no obligation on insurance providers in skimming premiums or expanding coverage.  On the contrary, the insurance offered today under ACA has high deductibles on treatment for various health conditions not necessarily pre-existing and some procedures required to treat certain health issues are not covered regardless of the health plan available in the market place.

Not surprisingly, those against amending the health care law i.e. Obamacare are not in touch with reality and pledged to establishment rules and symbolic trends at vast majority expense.

The mandatory subscription enforced in the existing Obamacare is unethical and undemocratic especially in the absence of commitments from insurance industry to meet their end of the bargain.

The compulsory insurance subscription enforced via Obamacare is rejected by many citizens opting to pay the unconstitutional and illegal penalty rather than enriching the industry barely offering coverage to subscribers on variety of health problems experienced by them.

When industries in the economic sector and politics join forces for vested interests exploiting ordinary citizens, the market economy sustainability is challenged woefully affecting businesses aimed at mega profitability beyond affordability.

The consumer force determines business success or failure and industry survival. In resistance to any modifications and fair adjustments of Obamacare at congressional level due to political partisanship, the industry is ultimately taken up to tasks to comply with standards and maintain reliability barring policies set to protect major shareholders and top 1% windfall guaranteed in Obamacare.

Average citizens do not have the luxury as the privileged class to squander hard earned savings without any value in return.

Health is critical and taxpayers tax dollars expended wisely in universal health care with comprehensive plan could not be a tall order for an industrialized nation allocating disproportionate spending on military and nuclear weapons as well as foreign aid to affluent allies while leaving citizens entirely at health care merchants and insurers mercy with legislations overwhelmingly favoring campaign financiers from the industry.

The unique position among lawmakers to defend industries agenda neglect constituents plight allowing major companies in the health care industry to evade responsibility on rising costs and declining health package.

In terms of lawmakers in the U.S. Senate vote to rectify anomalies in Obamacare, the reasons from them do not reconcile with their trajectory. The Senator posing with terror factions responsible for terrorizing and killing thousands of innocent children, women and men in Syria having reservations on Obamacare amendment reflect personal issues with incumbent administration rather than genuine concern for the people affected under current health care law.

Unfortunately, prioritizing individual gains at public loss is the convention in politics fostering waywardness in the extraordinary conditions imposed on citizens in the hyped health care reform short on benefits and delivery making Affordable Care Act / Obamacare anything but affordable.

Anything in ACA defense only project the content of law missing in practicality that in itself invalidate the legislation not binding on all sides to be meaningful and effective.

Health care for all in the appropriate disbursement of tax funds in caring for the sick, elderly and healthy of any age is significant to qualify for advanced nation status.

Peace to all!

Thank you.

Padmini Arhant

Author & Presenter PadminiArhant.com

Spouse in Divine Mission

 

 

 

 

 

 

 

 

 

 

 

 

 

Affordable Care Act aka Obamacare

September 22, 2017

Affordable Care Act aka Obamacare

Padmini Arhant

The affordable care act aka Obamacare is anything but affordable. The law overwhelmingly favoring health insurance industry with mandatory subscription tied to penalty upon failure to do so is undemocratic and unethical. 

Anyone in good conscience would not endorse a law that burdens average citizens to bear the costs on ever increasing health care expenses due to unregulated industry profit margins exceeding market affordability.  

The Affordable Care Act allows free ride to health care and insurance industry with no obligations to rein in surging premiums and diminishing coverage despite compulsory insurance subscription.  Obamacare is bonanza for insurance industry with 35 million subscribers forced into plans barely meeting minimum health care requirements like annual exam and consulting visits to doctor’s office not to mention higher deductibles and copayments.  Meanwhile, the propagated advantages of the law such as accepting patients with pre-existing conditions are not only charged exponentially by insurance providers but also the costs are transferred to healthy subscribers in the expense reallocation. 

In short, the affordable care act is a proof of successful lobby from the health care and insurance industry rewarding those complicit in the enactment of law that is inadequate in coverage and enforces subscription beyond reasonable means to enable insurance industry control over patient care and health management. 

Politics playing central role in upholding laws that are favorable to campaign financiers viz. health sector in this instance at electorate financial woes and losses impact economy and electoral outcome. 

The lawmakers focused on loyalty towards SuperPac for re-election often forget voters dissatisfaction expressed through ballots on issues not addressed responsibly and in worst case scenarios rejected for misplaced priority.

Congressional and administration actions would be meaningful and effective upon legislations passed to alleviate problems of ordinary citizens as regular taxpayers expecting their tax dollars to be invested in their health, education and job security besides infrastructure and clean environment.

The disproportionality enrich industries with policies entirely benefitting them.

Setting aside political alliance and affiliations, the Affordable Care Act or Obamacare replacement eliminating mandatory subscription is the preliminary step towards health care reform. The shared responsibility between state, federal and health industry in offering quality health care meeting basic to advanced health coverage is the standard any system could provide excluding none regardless of socio economic background. 

The cost factor in a market economy allowing choices via healthy competition would promote decent health care options currently unavailable due to major stakeholders monopoly in the industry. Universal health care is dismissed on the notion of extraordinary costs and liability originating from health industry practice and strategy to maintain status quo.

The contemporary law bearing on the industry is negligible shifting the responsibility on subscribers i.e. the insured to comply with various demands limiting affordability. The incentives to the industry are far greater to accommodate enrollment in health care plan that are not necessarily distributed down the line to end consumer. As a result the healthy and those experiencing health problems are faced with escalating price and insurance industry maneuvered eligibility criteria.

United States joining nations that pay attention to citizens health and well being made possible with investment in best medical care for all is prudent to improve failing health and tax structure. 

Thank you.

Padmini Arhant

Author & Presenter PadminiArhant.com

Spouse in Divine Mission 

The Affordable Care Act Reality 

July 30, 2017

The Affordable Care Act Reality 

By Padmini Arhant

The Affordable Care Act became comprehensively effective in 2014 and not 2010.

The subsidies to Insurance companies are not passed over to end consumer as co-payments and deductibles have been higher despite the law.

The premiums have not been cheaper while the insurance industry has been rewarded with 35 million subscribers through mandatory subscription.

There is no penalty on Insurers unlike on subscribers and employers on non-compliance.

The constant slogan on 20 million losing insurance would happen under the current law. The reason is the funding enabled largely on higher payroll taxes and individual mandates burdening small business, the middle income groups, the youth and healthy population.

The fiscal budget for 2018 on mandatory spending covering Medicare and Medicaid costs at $582 billion and $404 billion respectively are expected to rise further with bulk of the payments derived from general tax revenues becoming the primary source. The current 43% would soon increase to 62% affecting the younger groups, the middle class and baby boomers in work force.

There are already proposals to hike taxes for the income bracket between $150,000 – $300,000 in the tax reform bill sparing those earning above the target income to accommodate anamolies in the present health care bill that would exacerbate consumer spending with ripple effects on retail business and the economy.

Politics punishing the middle class and lower income neither qualifying for Medicaid nor benefiting from tax credits with health insurance premiums exceeding qualifying deductions is economically unsustainable with inevitable backlash from the electorate.

The ACA needs amendments in these areas with facts and figures reconciling reality.

Thank you.

Padmini Arhant

Author & Presenter PadminiArhant.com

Spouse in Divine Mission

 

 

 

 

 

 

 

 

United States – Health Care Bill

July 26, 2017

United States – Health Care Bill

By Padmini Arhant

The latest unsuccessful attempt to pass health care bill is perhaps due to lack of coordination and substance not in adherence with requirements.

The main aspects of the bill for robust health care law starting from eliminating mandates with penalty, Medicaid expansions not contractions, reviewing tax features for balanced appropriations, addressing opioid funding and state autonomy for health care benefits to suit respective needs with or without federal assistance.

The existing law enforcing penalty for failure to subscribe insurance and coverage lapse is pro-industry and neglect reality related to unfortunate and unpredictable circumstances that happens in life forcing people into unaffordability. There is a need for law to be flexible and democratic rather than the present conditions binding on the middle and lower income group who do not qualify for Medicaid.

With the current partisanship on this crucial bill, the focus is shifted from strengthening health care benefits to preserving  industry profitability against affordability burdening healthy citizens and segments unable to meet legislative and industry criteria.  Any reservations are seemingly political than practical.

United States fiscal budget FY 2018 –  Medicare and Medicaid costs under Mandatory spending are $582 billion and $404 billion respectively per The Office of Management and Budget. Mandatory Spending Control Mechanisms, Congressional Budget Office.

Medicare Hospital Insurance program entirely funded by payroll taxes right now alongside Supplementary Medical Insurance program and drug benefit provided by combination of payroll taxes and premiums making up 57 percent and the balance 43 percent from general tax revenues contributing to budget deficit. The long term appears costlier with escalating healthcare costs demanding 62 percent from general tax revenues to fund Medicare. The irony is the Affordable Care Act largely dependent on higher payroll taxes shifting the burden from the wealthy to younger population in the work force and small businesses – usually in the front line dealing with challenges during economic downturn.

Neither the present law nor the proposed health care bill demonstrate courage to rein in on ever rising health care costs with monopoly in health care, insurance and pharmaceutical industry confirming the political status on legislations passed to favor oligarchy over ordinary citizens.

No matter how the existing health care law and embattled legislation are viewed and interpreted, the average and healthy citizens are penalized for political reasons with little or no concern on the economic impact and real experience not propagated information with serious ramifications to follow. 

Thank you.

Padmini Arhant

Author & Presenter PadminiArhant.com

Spouse in Divine Mission

————————————————————————–

Health Care – Prevention is better than Cure. This article is dedicated to all Americans regardless of age, gender, socioeconomic background and importantly health status. The podcast on this article will be available shortly. The topic will continue further on funding medicaid expansion, opioids epidemic and health industry regulation. 

By Padmini Arhant

All citizens need health care access without having to differ medical consultation and treatment programs or going overseas witnessed in the trend created by unaffordable hospitalization and medical care costs in the United States.

United States with GDP per capita approximately $51,000 for 2016 and California @ $59,000 remaining the largest economy in the nation with $2.3trillion GDP – 12.43% of National GDP $18.5 trillion struggling to afford health care for all understandably frustrates citizens in the state that also clarifies escalating health care costs and insurance premiums in parallel with no point of intersection.

Taxpayers having the option to allocate pretax earnings towards health savings account is critical for health maintenance choosing the best suitable plan that fits their budget and health needs.

Medicaid Expansions for the poor, lower and middle income groups eliminating current caps to permit significant percentage of population not meeting present criteria would produce healthy results in cutting expenditure that is otherwise keeping them from dependable health plan.

Medicaid for basic to complete recovery based on individual medical conditions would save healthcare spending arising from neglected and preventable health issues costing patients, insurance and the states alike.

The topic will resume on Medicaid funding with dissection of federal and state disposable income, wasteful spending that could be divested in citizens health care and more.

———————————————————————————————————————————————–

Health care law – The Affordable Care Act in the United States is not quite affordable for many due to health care costs constantly on the rise along with insurance premium. With health insurance covering only certain percentage on health bill the remaining is expected to be paid by patient. This is apart from copayment and deductibles on the related item.

The law is claimed to protect 20 million people who are brought under the ambit via mandatory subscription tied with penalty on failure to do so. This enactment proved a bonanza to health insurance companies in their deal to offer coverage for a price not nearly meeting average consumer purchase power.

Then there are issues with insurance companies declining coverage on some ailments not necessarily pre-existing and when they do cover, they are not without terms and conditions to an extent of transferring the burden on to consumer.

Under the existing health care law, the provisions to allow subscriptions for patients with pre-existing illness and extension on dependent children until 25 years of age pegged to parents or primary subscribers is a partial relief and again the price is not any cheaper as insurance premium is twice or more than regular cost for subscribers with any pre-existing symptoms or treatment.

The insurance companies with different tier plans covering 60% – 80% maximum and the rest left for consumer to contend with, the bottom line is health care and insurance industry exorbitant price makes it difficult for modest income consumers to absorb significant portion of the bill.

The Affordable Care Act focus limited to health insurance subscription while allowing health care and insurance industry to maintain extraordinary gains with soaring costs beyond consumer affordability reflects monopoly in a market economy.

Ordinarily the price determined in a market economy based on demand and supply together with competitiveness from multiple providers contributes to price adjustment and consumer price index.

Health care being vital for survival and wellbeing, the rapid escalation in costs against controlled inflation deprives citizens with basic and contingency subscriptions from affordable care.

Again, any subsidy and discounts are usually offset with treatment vs. drug costs rather than comprehensive package covering entire medical expense inclusive of medicines and any other requirements enabling full recovery.

The argument that tax credits for out of pocket medical expenditure paying towards any surplus typically works in favor of higher income bracket while middle and lower income group with relatively less taxable income falling short to take advantage of deductions in annual return.

Another development in health care practice now is the insurance industry run health care centers and medical foundations hiring medical professionals and practitioners safeguarding insurance company policy on quantity over quality in patient consultation keeping accessibility to necessary medical exam and procedure to bare minimum or unavailable.

Similarly, the tradition on insurance company approval every step of the way is continued with any refills on prescription drugs not linked to opioids also left at the insurance company discretion overriding medical advice and illness status.

Unfortunately, the Affordable Care Act inability to address these persisting problems pose a greater challenge for average consumers forced into compulsory insurance subscription benefitting the insurance industry more than the subscriber.

Furthermore, the enrolment of consumers with pre-existing situation is hardly a loss for health insurance company since payments towards ongoing treatment to patients in this category are compensated by young and healthy individuals’ subscription under current law.

On health management, the middle aged healthy subscribers routine physical exam every two years also restricted with insurance company protocol requiring payment for lipid profile viz. cholesterol and other critical blood tests to rule out any potential disease. These rules are enforced on insurance plan across the board and not confined to lower or higher payment plan.

The prevalent health care woes outlined above are factual leading to worse scenarios for many struggling to stay alive in the heavily profit oriented environment.

The debate on nothing wrong with aiming for jumbo profits is possible in full employment and fair income distribution economy in contradiction to reality.

The argument has no meaning in economic situation where profitability exceeds affordability widening the gap between haves and have nots especially in economically disadvantaged segments and amongst income group both young and old with the former starting life and latter nearing retirement on meager savings or none at all.

———————————————————————————————————————————————

What needs to be done? 

SOLUTION

Any legislation – present or future only concerned about health insurance, health care and pharmaceutical industry profits unaffected rain or shine need to pay attention to the system being not quite effective in delivering service to the most vulnerable as well as others not receiving the value for money in protecting health and life.

The antitrust law compliance facilitating more competition is the fundamental course to curb ever increasing costs on minimal to prolonged medical care including prescription drugs and any medical device.

Tax breaks matching employer contribution to employee and those with dependents would create a flexible plan.

Tax credits with full deductions for self-employed and small business owners enable more choices for consumers in the market place.

Medical Savings Account (Medi-Fund) – Financial institutions like banks, credit unions and cooperatives set up accounts exclusively for medical expense with better interests on deposits and lower borrowing rate would ease expense for families having members suffering from minor to major illness. The funds are to be FDIC insured to prevent risks and guarantee anytime withdrawal for medical purpose. The ATM debit card for medical use would serve well during emergency.

Students unable to stay on parents or guardians’ insurance plan should be eligible for federal and state medical grants together with college or educational institution initiated private endowments for student medical aid.

Senior Citizens – Expanding Medicare as well as covering drug costs with choices to buy through government agency sponsored pharmacy. Additionally, any retailers discount on prescription drugs qualifying for tax rebate would also be helpful.

Medicaid Expansion under Obamacare – Supreme Court decision allowing States to exercise discretion based on voluntary Medicaid expansion emphasized status quo. As such Medicaid expansions are made possible by lower and middle-income tax payers and not the wealthiest of the wealthy in the economy.

As explained in the article below  – any subsidies and premium tax credits capped at 138% and 400% of federal poverty level (FPL) to qualify for Medicaid and tax deductions under Obamacare enables marginal members provided their taxable income is sufficient to offset credits again excluding higher medical expenses for patients with pre-existing conditions and those pre-disposed to any genetic disorders.

Thank you.

Padmini Arhant

Author & Presenter PadminiArhant.com

Spouse in Divine Mission

 


Health Care Bill – Myths and Facts

By Padmini Arhant

The heated debate on Health Care Bill pending votes in the United States Senate arguably attracts attention and tension.

Health Care Bill – Understanding the details would perhaps ease friction allowing focus on appropriate action.

OBAMA CARE:  Taxes, subsidies to insurance customers, Medicaid expansion program.

Obamacare requiring all Americans to subscribe to health insurance or pay tax penalty – A bonanza for health insurance industry bringing 35 million subscribers with mandatory insurance law tied to penalty.

The media reporting that repeal is expected to sharply increase the number of people who don’t have insurance which could in turn lead insurers to raise premiums.

This means the insurance for those unable to subscribe Obamacare compulsory insurance is essentially paid by healthy insured customers enabling health care industry mega profitability.

Obamacare mandate on large employers to offer health insurance or be fined.  Most corporations were offering some form of health insurance to employees negotiated in salary benefits prior to Obamacare rule. The penalty factor guarantees health insurance industry revenue.

In a real democracy and market economy choices combined with competition would facilitate affordability rather than mandatory law favoring monopoly in health care and health insurance industry. 

Health coverage to the poor – Medicaid criteria.

Prior to Affordable Care Act – In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states the program covers all low-income adults below a certain income level.

Obamacare Medicaid eligibility is based on income at or below 138% of federal poverty level (FPL).

Department of Health and Human Services determined FPL is used to evaluate Medicaid eligibility. The FPL is defined as set minimum gross income a family needs for survival that includes food, clothing, transportation, shelter and other essentials…allowing for inflation every year. The poverty level data is presented according to family size beginning with single person in a household upto family of 10 i.e. a couple with eight children. Then onwards the amount is incremental for additional person in a family.

FPL figures are released in January of the year.  FPL for 2017 for single person household is reported as $13,860. The single person would qualify for Medicaid under Obamacare with income level at $19,127 (i.e. 138% of FPL $13,860 for 2017).

Obamacare premium tax credit and cost sharing reductions supposedly leads to Medicaid eligibility.

Premium tax credits are generally available to people with household incomes between 100 and 400 percent of the federal poverty level (FPL) and are based on factors such as plan rates where you live.

In this instance, the single person household seeking premium tax credit would qualify upon annual income anywhere between $13,860 to $55,440 – this would be affordable when tax payable is more than insurance costs including deductibles and out of pocket payments.

Where does that leave others who neither belong in 138% FPL nor 400% FPL for premium tax credit and instead reminded of heavy penalty for not subscribing to health insurance?

The cost sharing reductions usually shifted on to subscriber by insurance industry given the insurance costs and health industry extraordinary profit margins not addressed in Obamacare or GOP health care bill.

GOP bill offering reimbursements for at least two years  to health insurance companies on the assumption of major loss to insurance providers for subsidies that reduce out-of-pocket costs for low income customers of Obamacare plans proves industry winning favor from both left and right of the political aisle.

Subsidies to reduce out-of-pocket costs for low income customers. The subsidies never affect insurance industry as no reduction in health insurance costs experienced with distribution across consumer base that penalize the healthy to bear expense. Even otherwise the subsidies are eventually paid for by middle income tax payers in the state and national economy. 

Thank you.

Padmini Arhant

Author & Presenter PadminiArhant.com

Spouse in Divine Mission