Equality of sacrifice needed in health care reform

eq of sac

Image by Shutterstock

Legislators, both Republicans and Democrats, like to say they support small businesses. It’s one of the easier stands to make. According to the U.S. Census Bureau, small businesses account for nearly 50 percent of private-sector employment and 64 percent of all new job creation.

For many, it’s also the American dream to own a business. The challenge and freedom to control one’s destiny is why there are so many new ventures each year.

Small businesses are an economic force, and the many constituents running them are people that lawmakers would like to keep happy.

That is, until health insurance enters the conversation. Then, it seems that legislators are intent on making decisions that harm these entities.

Many small business owners and their employees rely on the individual market to secure health insurance. Obamacare has devastated this group—people who are working and striving to provide a comfortable standard of living for their family but aren’t able to pay $1,400 or more in monthly premiums for deductibles of $10,000 and higher.

The Republicans’ first plan to replace Obamacare involved eliminating the requirement to carry insurance but continuing the practice of covering all pre-existing conditions for those who do purchase insurance. It doesn’t take an economist to figure out that keeping high-risk factors and then spreading them among an even smaller pool of participants doesn’t pencil out.

Former President Bill Clinton was wrong when he said that Obamacare was the, “craziest thing in the world.” The Republicans’ initial replacement plan was the craziest.

Here in Iowa, Republican Reps. Rod Blum and David Young, along with Democratic Rep. Dave Loebsack stated that they would not support the measure. Republican Rep. Steve King approved of it, although he at least championed the removal of several Obamacare mandates that have contributed to soaring premiums in the individual market.

Iowa can be proud that most of its U.S. representatives acted sensibly. Many from other states, though, put party loyalty ahead of constituent loyalty and were dangerously close to pushing through a health care “fix” that would have made the already bad situation of Obamacare even worse. The measure was never brought to a vote, but it showed what little, serious thought lawmakers put into an issue that does not directly affect them and their personal and generous taxpayer-funded health insurance.

Lee Iacocca helped to coin the phrase, “equality of sacrifice.” In the early ‘80s, as head of the failing Chrysler Corporation, he reduced his executive salary to $1 for one year and in return asked his many union employees to take a pay cut in order to keep the company afloat. In “Iacocca: An Autobiography,” Iacocca said, “Although my reduced salary didn’t mean I had to skip any meals, it still made a big statement in Detroit. I discovered that people accept a lot of pain if everybody’s going through the chute together. If everybody is suffering equally, you can move a mountain.”

Health care reform is a mountain that needs to be moved. Perhaps all 535 members in Congress should agree that whatever health care plan they come up with must also apply to them.

If small businesses must suffer, legislators can stand in solidarity with the self-employed and suffer along with them. Premiums may remain high while we’re seeing our way through this disaster, but the pain may feel not quite as sharp knowing that those in Washington, D.C. are going through it too.

If lawmakers had some skin in the game, maybe they’d be able to show genuine concern for small businesses and come up with a health care plan that makes sense.

A Lenten offering of being fully present

Jesus Martha Mary

Image by Nancy Bauer/Shutterstock.

Finding a balance in life seems to be a never-ending challenge. There’s the work-play balance, spend-save balance, picking your battles-choosing your compromises balance, and many more.

One challenge that I’ve become increasingly aware of is the balance between digital presence and personal presence—social media or “social me.”

Social media is efficient. We can get a lot of communicating done with our smart phones and laptops, and we’re doing more and more of it. The Statistics Portal estimates that in 2016 the average person spent almost two hours daily on digital social networking.

Social me is not so efficient. When there are moments of downtime scattered throughout the day, I reach for my smart phone to fill in that time and check in on Facebook friends and family. Personal phone calls and visits don’t always make the cut. It’s just too easy to like and scroll.

We’re wired to our devices when really, we humans are wired for real connectivity. Too much social media can make us more efficient with our relationships, but less effective. Most of us would much rather receive the warmth of a phone call or visit from a friend than a sterile like on our Facebook status.

Nobody would want to go back to the days before digital communication. Our life is better with technological advances. Sometimes a comment on Facebook is all the time we have to let someone know that we’re thinking of them. And that’s something. Being on the receiving end of those comments is also appreciated.

But back to balance. Five or 50 “likes” still isn’t equal to one real and meaningful conversation where we are listened to and heard. Digital presence is fine if it doesn’t usurp personal presence. Time spent on social media should at least not surpass time spent enjoying phone calls and visits.

Recognizing my own increasing use of social media, I decided to make Lent the time to cut back on keypads and ramp up on personal conversations. Like any habit, it’s been surprisingly hard to make an adjustment. My goal is to limit my daily social media time to the same amount of social me time that I’m able to treasure—to find a balance. Electronic conversations still happen, but not more so than the personal ones.

In the Gospel of Luke, Jesus teaches how important it is to be fully present to others. He visits two sisters, Martha and Mary. Martha busies herself with tasks in an effort to be a good hostess, while Mary sits at Jesus’ feet and listens intently to him. And of this Jesus says, “Mary has chosen the better part…” Offering food and drink remains a great act of hospitality, but it is not more important than listening to and connecting with your guest.

Social media will never be a suitable substitute for “social us.”

It’s time to go for the gold in education

gold-medal-usaEducation reform and the reduction in poverty must be tackled simultaneously to improve our education system.

The Organization for Economic Cooperation and Development launched the Program for International Student Assessment in 2000 as a tool to assess education achievement on an international level. In 2000, there were just 41 countries reporting data. That year, the United States ranked 16th in reading, 20th in math, and 15th in science. Finland, Canada and New Zealand took first, second and third in reading while Hong Kong, Japan, and the Republic of Korea took the top three spots in math and science.

The 2015 PISA report included data from 70 countries. The United States ranked 23rd in reading, 39th in math and 25th in science. Singapore and Hong Kong were the education heavyweights.

Americans are more competitive than that. We want the gold, the silver, or at least the bronze—not 39th.

But when it comes to education, we tend to lose our all-in, competitive drive to succeed and instead fall back on protective, territorial natures.

New Education Secretary, Betsy DeVos, has received blistering opposition from teachers’ unions and others. Lily Eskelsen Garcia, President of the National Education Association, said that she is, “…dangerously unqualified and lacks the experience we demand…”

But teaching experience hasn’t historically produced exceptional results in this leadership role. During the first 15 years of the PISA report, Rod Paige, a former superintendent for the Houston Independent School District, served as Education Secretary during the Bush Administration and Arne Duncan, a former CEO of Chicago Public Schools, served for the Obama Administration. Going from 20th in math out of 41 countries in 2000 to 39th in math out of 70 countries in 2015 is not an improvement, despite having very qualified and experienced educators at the helm.

DeVos gave a less than stellar performance at her confirmation hearing, but one theme that stood out was her desire to empower parents. Nobody cares more about the education of our children than their parents. Maybe it’s time to allow them greater decision-making through school choice. If private schools were to receive public funds, though, it should be required that these institutions—just like public schools—be non-selective in accepting students and be accountable and transparent through standardized and reported testing.

The competitive scramble for those finite, public dollars could affect infrastructure. High performing schools may expand. Low performing schools may close. One thing that won’t change is that we will always have parents who want the best for their kids, students who want the opportunity to realize their full potential, and teachers who want to help them reach their dreams. The particular building in which they accomplish that is less important.

But even a monumental decision to implement school choice wouldn’t solve the poverty factor. Teachers have been telling us for a long time that student poverty is one of the greatest challenges they face in successfully educating our youth.

According to both the OECD and UNICEF, the United States has one of the highest relative (less than one-half the nation’s median income) childhood poverty rates among developed nations. The argument that poverty is affecting the success that teachers have in the classroom has merit, and it’s not the job of the educator to fix that. That responsibility belongs to our legislators.

Legislators must do everything possible to bring good-paying jobs to their state. For those families still struggling in low-paying jobs, an immediate increase in the minimum wage to $9.00 could be a real help. Small businesses have shown that reasonable increases can be absorbed.

It’s tough to instantly produce good-paying jobs, but raising the minimum wage is entirely within their power. Until legislators increase the minimum wage, they cannot sincerely say that they are doing their part to improve education.

We must do something different to better compete at the international level on education. School choice has been talked about for decades. Perhaps the time has come to act instead of talk. Trusting parents, instead of the government, to make education choices for our youth might be the sea change that is needed.

If we can make bold moves and reduce poverty, maybe we could even medal at the 2030 PISAs.

 

New Hampton Middle School bond referendum: If you can afford it, pass it

chalkboard

Image by Shutterstock.

It’s a no-brainer to construct a new school building when it’s both reasonable and necessary.

Reasonable means the property tax increase is modest.

It’s tougher to nail down what is necessary. The first thing that comes to mind is when enrollment is skyrocketing and there simply isn’t enough physical space for students. Another obvious necessity is when buildings have been damaged or destroyed by floods or tornadoes. Or, older buildings may have reached a point where they have become unsafe or are so costly to maintain that building new would make greater economic sense.

After a clear defeat of an earlier referendum that would have increased property taxes at $3.20 per $1,000 valuation, the committee now proposes a more modest plan with a more reasonable price tag. The property tax increase of $1.60 per $1,000 valuation would mean that the New Hampton district would continue to have the second lowest school property tax within its conference. It’s just one slot away from being the cheapest, and being the cheapest isn’t always a badge of honor. Sometimes, it’s a dubious one.

According to the school’s website, the assessed value of the average home is $105,098. The taxable value (less than the assessed) of such a property translates into an annual increase of $88 or $44 every March and September.

Raising taxes is always a serious matter. For some, they are struggling just to meet their current financial obligations. A “no” vote from these individuals can be understood and respected. For many others, finding an additional $44 every six months is achievable without tremendous sacrifice.

The tax increase seems relatively reasonable. But is a new middle school necessary?

The New Hampton school district has faced declining—not increasing—enrollment, although it may be stabilizing now. And, its buildings have not been ravaged by an act of nature. The building is evidently safe, or students wouldn’t be allowed to be in them. Maintenance costs are significant, but less than building new. You’re still, though, left with a building that is more than 100 years old.

Perhaps it’s not a dire necessity to build new, but even if it’s not—voting “yes” is a legitimate choice because wants and desires can have real merit too.

Teachers are under pressure to produce results. Parents, legislators and society have the correct and high expectation that our children will become critical thinkers, learn and test well, and be sufficiently prepared for the option of college upon high school graduation.

Any employee, in any workplace, is under pressure to produce results. Employers expect it, but know they must provide employees with the tools they need in order to be successful.

The tools teachers need to become more successful are to have learning spaces where there can simultaneously be independent work in one part of the room, collaborative work in another, and guided instruction for those needing either extra help or given greater challenges in another section. It’s an effort that helps to give every child what is needed, when they need it.

That takes space, and the new facility would provide more of it.

The number one way to improve academic success for all children remains putting a great teacher in every room, no matter the setting. But even great teachers appreciate having tools that help them do their job successfully.

Building a new middle school near the existing high school would also create a more consolidated campus, which creates efficiencies and has many logistical advantages for families. A newer and more expansive school structure will be more impressive to those who have gained employment in the region and who are trying to determine the best community in which to reside and the best school district for their family.

Another thing the New Hampton school district has going for it is that there will likely always be a school in its town. It is the largest town in the county. Unlike some struggling, smaller schools, one question it doesn’t have to answer is whether or not there’s a chance the school will close. That’s huge. Investments made in the New Hampton district will benefit generations to come.

This school referendum isn’t a no-brainer, but it does have plenty of merit. Better facilities at a reasonable cost can validate a “yes” vote.

As long as you can afford the buck sixty.

Electoral College works best with swing states

electoral-mapSwing states get a candidate’s time and money during presidential campaigns. Safe states don’t. Even delegate-heavy states that are certain to go Democratic or Republican are less important to the campaign than states with fewer delegates that could flip either way. Picking up three, six or more toss-up delegates are important in the race to 270.

And so, some heavily populated states and their many voters feel left out of the process in electing a president. This is one reason why, they argue, the Electoral College should be abolished and replaced with a popular vote.

Of course, the popular vote would have the opposite effect. Candidates would concentrate nearly all of their time in the heavily populated states of California, Texas, New York and Florida, with little concern for the rest of the country. According to the U.S. Census Bureau, half of our country’s population is contained within just nine states. The popular vote could never work in a just manner for all 50 states, for that reason alone.

It’s evident that with either system, somebody feels left out. The problem, though, isn’t the system. It’s the voting pattern of the electorate. The question that needs to get answered is, “Why is any state consistently “safe” for one party or another?”

Candidates use polling and voting history to determine the safeness factor of a particular state. Neither strategy is foolproof, as the 2016 election showed. It helps, though, to explain why a candidate may visit one state only once and travel to another a dozen times.

The voting patterns of several of our largest states—California, Texas and New York—have been very predictable. In the last six presidential elections, Californians (55 delegates) and New Yorkers (29 delegates) voted Democratic. Texans (38 delegates) voted Republican in the last six elections. These states are so reliable that less attention is given to them.

Florida is different. It has a sizeable amount of delegates at 29, but it’s a swing state. In the last six elections, it voted Democratic three times and Republican three times. As candidates, both Donald Trump and Hillary Clinton made numerous trips to the state. Floridians’ voices and concerns were heard, because the state could have easily tipped either way.

Perhaps the people of California and New York are perfectly happy with their consistent liberal vote and Texans with their repeated conservative choices. That is their right.

And it is the right of presidential candidates to strategically use their time and resources in a way that will achieve 270 electoral votes. It’s not a flaw in the electoral system to do that. It’s a lack of diversity of thought in safe states that leaves its voters largely ignored.

Iowans tends to lean Democratic in presidential elections, but still voted twice for the Republican candidate in the last six contests.

It takes a sizeable amount of the electorate to vote in such a way that the vote swings back and forth between a Democratic or Republican winner. That’s a lot of independent thinking, and it’s a good thing.

In the perfect world, all 50 states would be swing states—every single one a wild card because each would be filled with voters who have diversity of thought and who aren’t pigeonholed as a sure Democratic or Republican win.

No one party has all the answers, all the time.

In Iowa, and other swing states, voters get that.

“Buyer beware” is necessary to help contain health care costs

value-and-priceSome people, who had never cast a ballot before, voted in this past election solely as a protest to the financial burden that Obamacare had placed upon their families. Voting is a good tool, but there’s something more immediate that can produce good results in containing health care costs—taking personal responsibility.

Consumers think in terms of caveat emptor, or buyer beware, when purchasing all sorts of goods. Not much is purchased without asking, “What’s this going to cost and what value will I receive?”

That basic question gets left out many times when purchasing (non-emergency) health care services. In the past, individuals didn’t see the need. Most insurance plans had small deductibles.

But that’s changing, particularly in the individual health insurance market. Opting for $5,000 or $10,000 deductibles is necessary, just to get the monthly premium down to an affordable rate.

There are, though, a couple of things that all individuals can do to help reduce health care costs.

Get used to asking your doctor for an estimate on what a particular procedure will cost. Having the money talk with your physician might feel a bit uncomfortable, but those feelings dissipate when you realize the damage that can be done to your pocketbook by remaining uninformed.

For example, knee and hip replacements are becoming increasingly common among our aging population. What’s not common is any type of standardized pricing for this procedure. Insurance provider, Blue Cross Blue Shield, in its report called, “A Study of Cost Variation for Knee and Hip Replacement Surgeries in the U.S.,” found that total knee replacement surgeries could vary between $16,772 and $61,585 within the same geographical market.

Asking a few questions could save not just hundreds or thousands of dollars, but tens of thousands of dollars.

After receiving an estimate from your provider, utilize price transparency websites as much as possible to verify that estimated costs are within an acceptable, average range. Although price transparency in the health care field has been met with some legal challenges, most states are continuing to move forward with providing or referring some type of informational system.

The Health Care Incentives Improvement Institute monitors states and their health care price transparency efforts. In its annual “Report Card on State Price Transparency Laws,” it gave Iowa a “F.”

Iowa is not alone. Only seven states were given passing grades. Many failed because pricing data collected was insufficient or in an incorrect format, quality of care data was left out, websites were not easily navigable, or sites were not even up and running at the time the report was issued.

Iowa does not have a state all-payer claims database. The Iowa Hospital Association does provide some pricing comparisons on its website, www.iowahospitalcharges.com, but its data is based upon prices charged, not actual payment received from negotiated insurance contracts. It also lacks quality of care comparisons.

Still, it can be of some help. After first searching for “musculoskeletal system,” and then selecting knee replacements, its data show that even within the Cedar Valley there can be a $10,000 swing in average charges for knee replacements of comparable difficulty.

More information is better, but having some comparison data is better than having none at all. It’s a start.

A knee replacement surgery is a high-cost procedure. Patients may fall into the trap of thinking that pricing doesn’t matter because the $5,000 or $10,000 deductible will be exhausted, and insurance will pick up the rest. But many insurance plans require a patient co-pay percentage of ten or 20 percent, after the deductible has been reached, which can become quite costly. Many other procedures will fall below the deductible threshold, meaning the patient will pick up 100 percent of the tab.

If all health care consumers got into the habit of making smart purchasing decisions, premiums and deductibles could come down for everyone.

It may seem harsh to arm yourself with a “buyer beware” mentality in the health care field. Health care, after all, is no more onerous than any other industry.

At the same time, it’s no less.

Clinton’s history of corruption, without consequences, should be a deal breaker

trump-2

Historically, voters send an individual to the White House who is in good standing on Election Day. Most serve their country well.

Sometimes, though, the president surprises and disappoints citizens by committing a potentially impeachable act after being sworn in. Voters don’t have a crystal ball and can’t predict what any elected official will do, once in office.

This election, though, voters know before marking their ballot that Hillary Clinton has committed wrongdoings so serious that they would likely be impeachable offenses had she committed them as president.

The Watergate Articles of Impeachment show uncanny similarities between the actions of President Nixon and those of presidential candidate, Hillary Clinton.

The articles charged Nixon for, “Withholding relevant and material evidence or information from lawfully authorized investigative officers and employees of the United States,” and also, “Interfering or endeavoring to interfere with the conduct of investigations by the Department of Justice of the United States, the Federal Bureau of Investigation,…and Congressional Committees.”

Clinton stated that she, “never received nor sent any material that was classified” on her private email server while Secretary of State, a claim the FBI found to be untrue. Also, Clinton’s emails were deleted after she received a congressional subpoena. And Clinton’s phones were destroyed with hammers, according to an FBI report.

There is the unseemly defense that she may have been unaware of what was happening or couldn’t remember what happened in the State department, for which she had final authority, as she repeatedly testified. But that could make her the most unknowing and forgetful person to seek the highest office in the land. If not brazenly corrupt, then completely incompetent.

Remarkably, the FBI has characterized this behavior as carelessness. For the average citizen, it would likely be considered felonious.

For Nixon, it caused him to resign from the presidency. But for Clinton, she’s still on path to ascend to the Oval Office.

It seems that Hillary Clinton is above the law, that the rules don’t apply to her, and that she receives special treatment instead of consequences.

Donald Trump is a flawed candidate, as well, with a cringe-worthy communication style. But although he’s not a great talker, he is a hard worker.

He sees the work that needs to be done in this country including appointing Supreme Court justices who will defend and uphold the Constitution, rebuilding our nation through a strong military and strong trade agreements that will benefit American workers, and repealing Obamacare and reducing regulations that are strangling small businesses and the jobs they create.

Most importantly, though, he’s called attention to the corruption in politics and the bias in the mainstream media for liberal candidates. Our country won’t have a chance to accomplish anything until these two wrongs get righted.

The Center for Public Integrity reports that 430 individuals working in the journalism field made political donations and that nearly all of the money, or about 96 percent, benefited Clinton. The donation totals were relatively small: $382,000 for Clinton and $14,000 for Trump. But the money isn’t the biggest problem. It’s the mindset of the journalists, who control the airways and the newspapers—who hold the extremely powerful role of telling voters what to think about. And those journalists have invested financially, and emotionally, in a Clinton win.

The mainstream media is no longer the trusted, watchdog press that it used to be.

If the numbers aren’t damaging enough, recall the imagery of the hug that moderator Rachel Maddow, of MSNBC, gave Hillary Clinton after a Democratic debate.

The press is hugging Clinton. Figuratively, literally and financially.

It seems that Hillary Clinton, if not outright corrupt, is a benefactor of corruption. Positive changes won’t happen with her.

My father had a way of sharing his wisdom and then ending with, “Don’t ever forget that.” One of those teaching moments came when I was quite young, and it stuck with me. He told me that I wasn’t better than anyone else. But at the same time, nobody—(including a presidential candidate)—was better than I was.

And he’s still right.

Hillary Clinton is not above the law.

I’m not sure if Donald Trump can make America great again, but he correctly understands the best way to start—by draining the swamp of corruption.