Saturday, November 28, 2009

Paul W. Thiesen on health care reform

With the increasing cost of health care, the government's answer is to socialize it without looking at the root causes of the increasing costs. If the government had applied root-cause analysis, it would discover that it was the source of rising costs as it has tried to regulate health care since the 1960s. Socializing health care will only increase costs and reduce services.

What should happen is a review of government regulations to discard those that are restrictive. One example of this is to allow all insurers to compete in all states; this is the only way to achieve the goal of choice and competition. But unless the citizens speak up, government will go on to serve special interests that only serve a few at the cost of the people.

Government-run health care has never reached the goal of targeted costs and services whether at a national level (Medicare) or state level (Massachusetts/Tennessee). If the tests have all failed on smaller scales, then why would we attempt to expand it to a national level?

Paul W. Theisen
Aiea

Friday, November 20, 2009

Oprah Winfrey Show to end in 2011

CHICAGO (AP) — Holding back tears, Oprah Winfrey told her studio audience Friday that she would end her show in 2011 after a quarter-century on the air, saying prayer and careful thought led her to her decision.

Winfrey told the audience that she loved "The Oprah Winfrey Show," that it had been her life and that she knew when it was time to say goodbye. "Twenty-five years feels right in my bones and feels right in my spirit," she said.

Winfrey, 55, is widely expected to start up a new talk show on OWN: The Oprah Winfrey Network, a joint venture with Discovery Communications Inc. that was first announced last year. It will replace the Discovery Health Channel and debut in some 80 million homes.

Monday, November 16, 2009

defining moment for health care reform

O.K., folks, this is it. It’s the defining moment for health care reform.

Past efforts to give Americans what citizens of every other advanced nation already have — guaranteed access to essential care — have ended not with a bang, but with a whimper, usually dying in committee without ever making it to a vote.

But this time, broadly similar health-care bills have made it through multiple committees in both houses of Congress. And on Thursday, Nancy Pelosi, the speaker of the House, unveiled the legislation that she will send to the House floor, where it will almost surely pass. It’s not a perfect bill, by a long shot, but it’s a much stronger bill than almost anyone expected to emerge even a few weeks ago. And it would lead to near-universal coverage.

As a result, everyone in the political class — by which I mean politicians, people in the news media, and so on, basically whoever is in a position to influence the final stage of this legislative marathon — now has to make a choice. The seemingly impossible dream of fundamental health reform is just a few steps away from becoming reality, and each player has to decide whether he or she is going to help it across the finish line or stand in its way.

For conservatives, of course, it’s an easy decision: They don’t want Americans to have universal coverage, and they don’t want President Obama to succeed.

For progressives, it’s a slightly more difficult decision: They want universal care, and they want the president to succeed — but the proposed legislation falls far short of their ideal. There are still some reform advocates who won’t accept anything short of a full transition to Medicare for all as opposed to a hybrid, compromise system that relies heavily on private insurers. And even those who have reconciled themselves to the political realities are disappointed that the bill doesn’t include a “strong” public option, with payment rates linked to those set by Medicare.

But the bill does include a “medium-strength” public option, in which the public plan would negotiate payment rates — defying the predictions of pundits who have repeatedly declared any kind of public-option plan dead. It also includes more generous subsidies than expected, making it easier for lower-income families to afford coverage. And according to Congressional Budget Office estimates, almost everyone — 96 percent of legal residents too young to receive Medicare — would get health insurance.

.. this is the moment of truth. The political environment is as favorable for reform as it’s likely to get. The legislation on the table isn’t perfect, but it’s as good as anyone could reasonably have expected. History is about to be made — and everyone has to decide which side they’re on.

-- Paul Krugman

public plan projected to cover 2%

What's all the fuss about? After all the noise over Democrats' push for a government insurance plan to compete with private carriers, coverage numbers are finally in: Two percent.

That's the estimated share of Americans younger than 65 who'd sign up for the public option plan under the health care bill that Speaker Nancy Pelosi, D-Calif., is steering toward House approval.

"The public option is a significant issue, but its place in the debate is completely out of proportion to its actual importance to consumers," said Drew Altman, president of the nonpartisan Kaiser Family Foundation. "It has sucked all the oxygen out of the room and diverted attention from bread-and-butter consumer issues, such as affordable coverage and comprehensive benefits."

The latest look at the public option comes from the Congressional Budget Office, the nonpartisan economic analysts for lawmakers.

It found that the scaled back government plan in the House bill wouldn't overtake private health insurance. To the contrary, it might help the insurers a little.

The budget office estimated that about 6 million people would sign up for the public option in 2019, when the House bill is fully phased in. That represents about 2 percent of a total of 282 million Americans under age 65. (Older people are covered through Medicare.)

The overwhelming majority of the population would remain in private health insurance plans sponsored by employers. Others, mainly low-income people, would be covered through an expanded Medicaid program.

To be fair, most people would not have access to the new public plan. Under the House bill, it would be offered through new insurance exchanges open only to those who buy coverage on their own or work for small companies. Yet even within that pool of 30 million people, only 1-in-5 would take the public option.

Lou Dobbs leaves CNN

CNN's Lou Dobbs stepped down from his controversial role as an advocacy anchor at the network at the end of his show Wednesday night, saying he plans to seek a more activist role.

"Over the past six months, it has become increasingly clear that strong winds of change have begun buffeting this country and affecting all of us, and some leaders in media, politics and business have been urging me to go beyond the role here at CNN and to engage in constructive problem-solving as well as to contribute positively to a better understanding of the great issues of our day and to continue to do so in the most honest and direct language possible," Dobbs said during his 7 p.m. broadcast.

Dobbs, 64, said he had discussed the issue with CNN President Jonathan Klein, who had agreed to a release from his contract "that will enable me to pursue new opportunities."

Dobbs, who is the last of the 29-year-old network's original anchors, said he was considering "a number of options and directions."

He cited the growth of the middle class, the creation of jobs, health care, immigration policy, the environment, climate change and the U.S. military involvement in Iraq and Afghanistan as "the major issues of our time."

In an e-mail to CNN staff members, Klein described the parting as "extremely amicable," and said Dobbs' replacement would be announced soon.

Dobbs was with Cable News Network from its initial broadcasts in 1980, acting as chief economics correspondent and host of the business program "Moneyline."

His coverage of the 1987 stock market crash won him the George Foster Peabody Award for excellence in broadcasting. That was one of many awards he received while at CNN, including an Emmy for Lifetime Achievement that he received from the National Academy of Television Arts and Sciences in 2005.

Dobbs left the network in 1999 to found SPACE.com, a Web site devoted to space-related subjects. He returned to the network in 2001 as anchor and managing editor of CNN's Moneyline News Hour, which became Lou Dobbs Tonight. He also acted as lead business news anchor for CNN/U.S. and CNNfn, the forerunner of CNNMoney.

During his second stint at CNN, Dobbs positioned himself as "tough, relentless, independent," lashing out at what he described as the deficiencies and "partisan nonsense" of both major political parties, and injecting advocacy journalism into his coverage of topics ranging from free trade to immigration.

His no-holds-barred, sometimes acerbic style brought him a loyal following, but also attracted controversy both to him and to the network, especially over the subject of illegal immigrants.

Dobbs will continue as anchor of The Lou Dobbs Show, a daily radio show that began in March 2008 and is distributed to more than 160 stations nationwide by United Stations Radio Networks Inc.

***

In his first TV interview since resigning abruptly Wednesday night, former CNN anchorman Lou Dobbs told Bill O'Reilly Monday that it was the presence of President Barack Obama in the White House as much as a commitment to fact-based, objective presentation at CNN that led to his troubles with management in recent months.

While pointing out that Dobbs had criticized both the George W. Bush administration and Obama White House on matters of immigration, O'Reilly asked Dobbs why it wasn't a problem then, but it is a problem now for CNN.

“You know, I discern more of a difference between then, which was under the Bush administration whom I was criticizing, and now, when it is the Obama administration and an entirely different tone was taken," Dobbs said.

furlough fridays

[12/5/09] Both the governor and an attorney who filed a lawsuit seeking to end Furlough Fridays are blaming the Hawaii State Teachers Association for blocking a deal that would restore lost public school days.

"The only obstacle at this point is the teachers union," attorney Eric Seitz said yesterday at a press conference. "The public needs to know and teachers need to know how badly the teachers union is acting in this matter."

Seitz said he plans to add the HSTA as a defendant in a class-action lawsuit seeking to end Furlough Fridays.

Meanwhile, Gov. Linda Lingle called on the union to continue bargaining next week or put her proposal to end the furloughs up for a vote.

HSTA President Wil Okabe countered that it is the Governor's Office that has dug in its heels.

"The governor and her team have shown no flexibility and have adopted a take-it-or-leave-it approach," Okabe said in an e-mail statement. "The HSTA has made viable offers to provide an interim solution, but they have all been summarily rejected by the governor."

Okabe said the governor's proposal would force schools to operate with a skeleton staff, without administrators, health aides, security and others.

"We will not return on furlough days if it means that the quality of instruction will (be) severely degraded or the health and safety of our students will be put at risk, all of which would be the case under the governor's proposal," Okabe said.

***

[11/25/09] this week I have a letter from Abe, who wanted to make a point about teachers’ involvement in the current furlough fiasco.

“I am a teacher and when the union rep came to talk to us, she told us we could accept the offer, or we could go on strike. If we had gone on strike, we probably would have missed more than 17 days. We also faced the possibility that schools would just shut down because (Governor) Lingle had only released enough money to run the schools until December.

No teacher was presented with, “What do you want to do about it?” They told us this is the best offer we can get, if not we will go on strike, or the schools will just shut down, because the money has not been released to run them. The reason so many teachers ratified the contract is not because they were happy to do it, it’s because they felt it was the lesser of all evils.

***

[11/16/09] Gov. Linda Lingle plans to eliminate 27 Furlough Fridays at Hawaii's public schools by tapping the so-called rainy day fund and switching teacher training days to class time.

She said yesterday her plan would restore stability among families and allow the state to focus on quality of education rather than the number of days students are in school.

Under Lingle's plan, furlough days would be restored starting Jan. 1 by using $50 million from the fund, formally the Emergency and Budget Reserve Fund, and converting noninstructional hours to instructional hours, totaling 15 school days. Noninstructional time includes Wednesday afternoons, when students are let out early to allow for staff meetings.

Parents, state legislators and the teachers union praised Lingle's plan, saying it is a step in the right direction.

"I'm glad that she came around and is making education a high priority," said Garrett Toguchi, chairman of the state Board of Education.

***

[11/13/09] Education Secretary Arne Duncan says that because of the furloughs, Hawaii faces "a heck of a challenge" in qualifying for $20 million to $75 million in federal funds under the Obama administration's $4 billion "Race to the Top" grant program.

Duncan said he is "highly aware" of the actions taken by Hawaii to close public school classrooms 17 days this academic year and an equal amount next year because declining tax revenues have contributed to an estimated $1 billion shortfall in Hawaii's state budget.

He added that the actions of Gov. Linda Lingle, the Hawaii State Teachers Association and the state Board of Education mean eliminating 10 percent of island school days. He said, "To have Hawaii eliminate 10 percent of their day(s) is mind-boggling."

***

[11/11/09] It is not the kind of publicity Hawaii wants, but the state's decision to shut public schools for 17 Furlough Fridays has made a big media splash.

"Hawaii's Children, Left Behind," declared the headline of a New York Times editorial. At the Washington Post, education columnist Jay Mathews wrote a piece with the scathing title "Idiocy in Paradise: Hawaii Handles School Budget Cuts Badly."

***

[10/29/09] As a public school teacher I am unapologetic about the decision to accept furloughs over layoff or pay cuts. Let's recap the last year.

***

[10/26/09] Misunderstanding persists about the Hawaii State Teachers Association contract with the state, which was recently ratified. This is apparent in quotes from several individuals appearing in Star-Bulletin articles, as well as in the letters to the editor. Some writers have seized upon misinformation to attack the HSTA, going so far as to state that HSTA negotiated a new contract with no pay cuts to teachers.

Several writers and even a former governor appear to think the DOE could have balanced its budget merely by cutting teacher salaries. This is simply wrong. It takes a lot more than the money for teacher salaries to run schools. It takes millions of dollars to keep the lights on and the computers and other electrical equipment running and campuses safe. It takes money to operate cafeterias and other services.

Teachers may run their classrooms, but custodians, administrators and a lot of staff are required to keep an entire school operating effectively and safely. These workers also need to be paid. The DOE cannot balance its budget by cutting teachers salaries 8 percent, while continuing to keep schools open the same number of days, with all of the other labor and operational costs that entails.

-- Wil Okabe is president of the Hawaii State Teachers Association

[10/25/09] Gov. Linda Lingle startled other leaders on Friday when she said she goofed by allowing the school teacher furloughs and then blamed the union and Department of Education for approving them.

"I assumed that they would do what was in the best interest of the students, and I don't think they did.

"Looking back, I think it would have been better to stand up and say, 'Well, we just can't settle it this way,'" Lingle said Friday as parents of hundreds of public school students rallied in the Capitol rotunda to protest furloughs.

Wil Okabe, Hawaii State Teachers Association president, yesterday shot back saying furloughs were Lingle's idea as was the 14 percent DOE budget cut that prompted them.

"Let's be honest. The governor got the furloughs ... she asked for. And now the community is angry, she wants to point the finger at others," Okabe said.

* * *

The state's decision to save money by shutting down Hawaii's public schools for 17 Fridays this year has angered parents so much that they are planning to march on the Capitol next week, and some are considering lawsuits.

"When I first heard about the furloughs, we were all shocked and furious because this is going to have the largest impact on the students, and they, of course, are defenseless," said Debbie Schatz, who has a sixth-grader at Aikahi Elementary.

"So parents and community members, an amazing amount of them, are coming forward and voicing their opinions."

A new organization, Hawaii Education Matters, is planning a march at the Capitol from 10 a.m. to 1 p.m. Oct. 23, the first scheduled "Furlough Friday" for public schools. Its Web site is hosting a petition drive to "Stop Furlough Fridays." The petition is addressed to the governor, Legislature, Department of Education, school board and teachers union.

"None of us are political activists," said Jennifer Moy, volunteer coordinator for Hawaii Education Matters, formed three weeks ago in response to the furloughs. "We're pretty new at this. We just want a better education for our kids. Our goals are to have the class time restored and to give parents a voice in the debate."

***

[10/19/09] Sandra Togashi is "angry and upset" and feeling the squeeze from all sides. She teaches social studies at Kawananakoa Middle School and has two children in public school.

"Furloughs personally affect my 143 students, my own children, my colleagues and me as a single parent," Togashi says.

So she is watching Hawaii's leaders closely for their response to Furlough Fridays, a budget-cutting plan that is shaping up as a political disaster.

***

[9/23/09] Hawaii's public school year will have 17 fewer instructional days under a two-year contract ratified yesterday by the Hawaii State Teachers Association.

The reduction will result in a 7.94 percent pay cut for teachers, as the state attempts to ride out a slow economy and balance its public education budget.

The ratification came with criticism from union President Wil Okabe, who said last night the state should have maintained a commitment to the children and funded their education at appropriate levels with 180 days of instruction.

Okabe said the union is asking state legislators to do the right thing and restore the educational budget.

Saturday, November 14, 2009

Cal Thomas on heath care

(or Cal Thomas on the CATO Institute on health care)

The CATO Institute remains a primary resource for ideas that will work in reforming health insurance. It recommends four steps Congress could take and the public should demand.

(1) give Medicare enrollees a voucher and let them choose any health plan on the market that fits their needs, not what the government dictates. Vouchers would be means-tested, would include Medicare spending and are, says CATO, the only way to protect seniors from rationing.

(2) Congress should reform the tax treatment by allowing large health savings accounts. This would reduce the number of uninsured Americans, would free workers to buy secure health coverage from any source, and would effectively give workers a $9.7 trillion tax cut without increasing the deficit;

(3) Congress should breakup state monopolies on insurance and clinician licensing. CATO estimates allowing people to buy insurance from other states could cover one-third of the uninsured without new taxes or government subsidies.

(4) Congress should reform Medicaid and the State Children’s health Insurance Program (S-CHIP) the way it reformed it in 1996 when it block-granted the programs. This would help reduce the deficit and encourage states to target resources to those most in need.

Wednesday, November 04, 2009

Hawaii's health care

Imee Gallardo, 24, has been scooping ice cream at a Häagen-Dazs shop at Waikiki Beach for five years, and during that time the shop has done something its counterparts on the mainland rarely do: it has paid for her health care.

Ms. Gallardo cannot imagine any other system.

“I wouldn’t get coverage on the mainland?” Ms. Gallardo asked. “Even if I worked? Why?”

Since 1974, Hawaii has required all employers to provide relatively generous health care benefits to any employee who works 20 hours a week or more. If health care legislation passes in Congress, the rest of the country may barely catch up.

***

Some politicians have hailed Hawaii's law, which mandates businesses provide health insurance for employees working more than 20 hours a week, as a model for national health care reform, but Slom said there is a reason no other states have adopted it.

"It's a job destroyer," he said. The law is an added burden for small businesses, and it would force companies to shift full-time employees to part-time or not fill openings, he said.

Obama departs from Bush on pot

The Obama administration will not seek to arrest medical marijuana users and suppliers as long as they conform to state laws, under new policy guidelines to be sent to federal prosecutors Monday.

Two Justice Department officials described the new policy to The Associated Press, saying prosecutors will be told it is not a good use of their time to arrest people who use or provide medical marijuana in strict compliance with state laws.

The new policy is a significant departure from the Bush administration, which insisted it would continue to enforce federal anti-pot laws regardless of state codes.

Fourteen states allow some use of marijuana for medical purposes: Alaska, California, Colorado, Hawaii, Maine, Maryland, Michigan, Montana, Nevada, New Mexico, Oregon, Rhode Island, Vermont and Washington.