Some of the richest and most powerful people in the world were asked by Wharton researchers to assess a set of risks likely to disrupt life as we know it — risks that could bring the downfall of governments and destroy economies.
Of more than two dozen catastrophic scenarios, the group of global titans said these were their biggest concerns:
1) Income inequality, which threatens social and political stability as well as economic development.
2) Increasing numbers of extreme weather events which cause massive damage to property, infrastructure and the environment.
3) Chronic unemployment, which coincides with a rising skills gap and high underemployment, especially among the young.
4) Climate change, specifically the failure of government and industry to take action to protect threatened people and businesses.
5) The escalation of large-scale cyber-attacks.
As far as #2 goes (which goes with #4 as far as I’m concerned), I give you this (lots of talk with no commitment to anything, of course).
And as far as Davos and its supposed laser-focus on unemployment (#3), I give you this (it will take smart, targeted government spending, people, which is what it has taken all along – we did this under FDR and we did this under Bill Clinton…yes, I know this is a broken record).
Oh, and as far as cyber security is concerned (#5), I’ll let the Davos geniuses figure that out on their own, since it apparently hits their pocketbooks more directly than the other items on the list (at least this post-Davos item was positive, though).
House Republicans will hear from legendary college football coach Lou Holtz, GOP message maven Frank Luntz, conservative journalists and pollsters and education experts at their annual retreat in Maryland this week.
The House Republican Conference will also hear Rachel Campos Duffy — wife of Rep. Sean Duffy (R-Wis.) — talk about “reaching every corner of America.”
Of course they’ll hear from Frank Luntz (let’s see, maybe, instead of the “Tea Party,” we can have a “grass roots” gathering called the “Patriot Party,” with Rick Santelli yelling out the alarm as he once did here.)
As far as Rachel Campos Duffy is concerned, she’s the wife of a guy who once said he “struggled” on his congressional salary of about $174 grand (and he spent more than $106 grand on personal use automobiles, both noted here). Her husband also got heat here (rightly so) for his vote to end Medicare (“voucherizing” it, despite what he said to a constituent) and continue tax cuts for the rich. And he also favored “immigration reform” without a path to citizenship here.
And Lou Holtz? He’s a climate change denier, of course (here). He also was such a good sport when Alabama blew out Notre Dame a little over a year ago here (umm, maybe the “Fighting Irish” couldn’t “run the ball” because Alabama was kicking their collective butt…hard to do that when you’re losing). Besides, I thought he didn’t want anything to do with politics any more, having been quite rightly burned for endorsing former Repug Senator and race-baiter Jesse Helms here.
I’m sure it doesn’t need to be pointed out yet again that this is nothing but more “kabuki” from the Beltway media-political-industrial complex. The party in power in the U.S. House has had over three years to come up with a plan to create actual jobs with a decent living wage and grow the economy for real. They haven’t. They can’t.
And they never will.
But even judged on the terms of (David) Remnick’s praise (of The New Yorker, who recently wrote an article about Number 44), Obama is in deep, second-term trouble. The president who embraces complexity is now besieged by complexity on every front. The U.S. health-care system has not responded as planned to the joystick manipulations of the Affordable Care Act. On the evidence of the article, Obama and his closest advisers are in denial about the structural failures of the program — the stingy coverage, narrow provider networks, high deductibles and adverse-selection spirals already underway in several states.
How can the coverage be “stingy” when it includes an expansion of Medicaid to cover those who weren’t covered before (here, with the only obstacle being Republican governors who won’t allow Medicaid expansion, or, in the case of our own “Space Cadet” Tom Corbett, doing so with ridiculous strings attached such as proof of looking for employment)? And as noted here concerning “narrow provider networks”…
About a third of insurance companies opted out of participating in the exchanges in states where they were already doing business, according to a recent report by McKinsey & Co. About half of states — which include about a third of the non-elderly insured population — will see a “material decline” in competitors, says McKinsey, while the other half of states will have about the same or more insurance choices on the exchanges.
I read this as follows: as more enroll on the exchanges, more health care insurance providers will decide to offer plans on the exchanges. The carriers will go where the customers are, one of the things Gerson and his ilk are loathe to acknowledge, of course.
As far as “high deductibles” goes, I give you the story of lifelong Arkansas Republican Butch Matthews here, who, after doing some actual fact-checking and research, discovered that “his local Blue Cross Blue Shield (BCBS) provider confirmed that he would be able to buy a far better plan than his current policy while saving at least $13,000 per year (by enrolling on an exchange).”
And I’ll be honest – I don’t know exactly what an “adverse selection spiral” is; if and when Gerson ever decides to explain it, I’ll update this post accordingly (and for what it’s worth, here is a link to Remnick’s article in The New Yorker).
As noted here, though, I think it’s safe to say that Gerson isn’t exactly an impartial observer on this issue anyway.
Tom Gialanella, 56, was shocked to find out he qualified for Medicaid under ObamaCare. The Bothell, Wash., resident had been able to retire early years ago, owns his home outright in a pricey Seattle suburb and is living off his investments.
He wanted no part of the government’s so-called free health care. “It’s supposed to be a safety net program. It’s not supposed to be for someone who has assets who can pay the bill,” he said.
And after reading the fine print, Gialanella had another reason to flee Medicaid — the potential death debt.
Cue the scary-sounding music (and leave it to the Foxies to fund somebody whose exceptional life circumstances dovetails perfectly into their “big gumint is baaaad” narrative).
In response, I believe the following should be emphasized from here…
The Seattle Times published an article on Dec. 15, under the headline “Expanded Medicaid’s fine print holds surprise: ‘payback’ from estate after death,” that said: “If you’re 55 or over, Medicaid can come back after you’re dead and bill your estate for ordinary health-care expenses.” The Times is right that the state of Washington has this power, but it was not in the “fine print” of the Affordable Care Act (as the story itself makes clear).
All states have had the option since Medicaid began in 1965 to recover some Medicaid costs from recipients after they die, as the Department of Health and Human Services explains in a2005 policy brief. In 1965, it was optional and states could only recoup Medicaid costs spent on those 65 years or older. That changed in 1993, when Congress passed an omnibus budget bill that required states to recover the expense of long-term care and related costs for deceased Medicaid recipients 55 or older. The 1993 federal law also gave states the option to recover all other Medicaid expenses.
The Affordable Care Act did nothing to change existing federal law. It did, however, expand the number of people who are eligible for Medicaid, so there will be more people on Medicaid between the ages of 55 and 65, and, therefore, potentially more estates on the hook for Medicaid expenses after the beneficiary dies.
Is this a problem? I suppose, but let’s address it constructively through legislation (yeah, good luck with that with those jokers in charge of the House) instead of fear mongering for a change, OK?
And of course, this Dan Springer character, being a good little wingnut, tried to gin up more SOLYNDRA! nonsense here.
Like many other people I’m sure, this issue hits home. My dad smoked until his last days; I’ll never forget the look of anxiety on his face when he wondered whether or not I’d purchased his carton of Tareyton’s while I was out running other errands so he could break open a pack and light one up on the front porch (during the days near the end when it was dangerous for him to drive anymore because of a variety of ailments and my mom said he couldn’t light up in the house any more, partly because it got ridiculous having to redo the paint and wallpaper every few years from the stains of cigarette smoke).
Yes, I probably should not have caved and tried to stand up to him on this, but I could tell that, though he was able to kick other bad habits, he would not have been able to do it with this one. And yes, nobody points a gun at anyone and tells them to smoke; there is an element of choice. But I don’t think that absolves us of trying to reach out to people if we think they can be reached on this subject (not as a would-be “reformer,” but as an interested and caring observer).
And last year, we went through something like this with another beloved family member. My mother-in-law had been suffering with adenocarcinoma for the last year or so, but it got progressively worse as the cancer metastasized (unlike my dad, she had given up smoking years ago, though she had smoked for many years prior to that). It went from her lung to her liver and spread all over the place. There were multiple rounds of chemo and radiation which definitely bought time, but made her physically sicker in the bargain.
The decline was gradual – first periodic hospital visits for procedures, then shorter stays, then longer stays and more procedures, then trying to do physical therapy to the point where she could endure more treatments, then finally to the point where she couldn’t even go through PT anymore, to the point where she finally couldn’t come home from the rehabilitation facility and slipped into a coma.
It was truly hard to find anything positive in this experience, but one thing I can say without reservation is that she received fine care from Vitas at Nazareth Hospital in Philadelphia. We remain ever grateful to the staff for their constant attention to Mom during her final days.
The day we said goodbye at Vitas (prior to the viewing and the funeral), we tried our best to console one another and go on with our lives in as normal a manner as we could. We drove off in separate cars, and as I left the parking lot, I saw a line of what appeared to be thin, twenty-something young women who (I assume) were done their shift at the hospital, standing in line in mid-afternoon waiting for what I guess was the 20 bus running up Roosevelt Boulevard.
And at least four of them were smoking.
If only you knew, I thought to myself, as I turned at the light and headed for home.