It's not my intent to trash Obamacare (a.k.a., The Affordable Care Act or ACA). Provisions already in effect really have made health care more affordable and accessible for many Americans. But other families and individuals are still out of the loop. While insurance carriers can no longer impose lifetime caps on their policy-holders, or reject them for pre-existing conditions, there's precious little control over the premiums that carriers can impose, at least for now.
The state-coordinated insurance exchanges scheduled to kick in next year, with mandated coverage and available subsidies may help a lot. But judging from what I've understood, the various plans will probably be more expensive and cumbersome to administer than the single-payer option. With its near-total reliance on private-sector health insurance providers, the system is still very much profit-driven. Conversely, universal health care would be tidier and less costly to maintain. It works reasonably well across the pond. (In Germany, the carriers are non-governmental, but also non-profit).
Another potential obstacle: the coverage mandate for businesses with more than 50 employees. Having just been postponed for a year, it's now scheduled to take effect in 2015. I've read mixed reviews about this measure and honestly don't know what the impact might be. (The vast majority of domestic businesses don't come close to approaching that 50-employee threshold, yet a few growing enterprises could conceivably roll over that hump).
In the meantime, many congressional Republicans are still obsessed with their compulsion to repeal the ACA in its entirety. It's what now, their 41st attempt? The Republicans have been aided in their effort to hobble Obamacare by an organization called the National Federation of Independent Businesses (NFIB). (Despite the name, the NFIB is funded largely by four very generous donors, who account for well over three million dollars of their war chest of several million).
Last year, the NFIB was the lead plaintiff involved with a Supreme Court appeal to trash the ACA: National Federation of Independent Businesses vs. Sebelius. This effort didn't succeed; a 5-4 majority, including Chief Justice John Roberts, upheld the individual mandate. However, Justice Roberts switched his position in regard to Medicaid expansion.
The individual mandate remains intact, but individual states now have the right to opt out of expanded Medicaid coverage for their poorest residents. (These are folks whose income is too low to qualify for the exchanges. Without Medicaid expansion, they'd remain unprotected). It appears as if over 20 states have rejected it outright, while another few are still deliberating. This, despite the fact that the new Medicaid recipients would be fully funded by the federal government for the first two years. Beyond that time, the states are expected to kick in small, but increasing increments until they're capped at the rate of 10% in 2022.
Because many state budgets are in the red, fiscal hardship could be cited as an excuse for some states to deny their residents desperately needed Medicaid coverage. Changing the terms of such coverage to full federal funding for the foreseeable future might be worth considering.
Thereafter, any state legislatures still refusing to accept Medicaid expansion would be doing so for buck-naked ideological reasons. The only rights really being compromised would be those of the folks denied decent health care.
Just a thought.
Monday, September 16, 2013
Wednesday, September 4, 2013
U.S. Military Action in Syria = More Grief
The decision whether or not to use military force in Syria is a tormenting one. Persuasive arguments can be made pro or con. Ideally, the disempowerment of Bashar al-Assad would be a cause for celebration if the political climate was stable. Atrocities against fellow Syrians committed by his regime appear to be well-documented by organizations such as Doctors Without Borders. (The United Nations report is still pending).
Supporters of military action seem to believe that Assad will think twice about committing monstrous acts against his own citizens. But many skeptics are concerned that U.S. attacks could stiffen his resolve instead, possibly accelerating the level of his brutality. Providing military aid to Syrian rebels might have been a viable alternative if they were relatively unified. But ideologically, they're all over the map, ranging from democrats to proponents of organizations like Al Qaeda.
We'd be going it alone. Nations initially perceived as compromising a "coalition of the willing" are no longer so willing. The British Parliament has opted out of the coalition by a margin of 13 votes. Prime Minister David Cameron, an avid supporter of the effort, graciously conceded, declaring that Great Britain would not contribute to a military campaign in Syria. (Some of his critics believe that he shouldn't have given up so quickly). The Arab League seems to be backing away from any commitment as well. With Security Council opposition from Russia, the United Nations is also a no-go.
Last year, Obama declared that the use of chemical weapons constituted a "red line" which should never be crossed. In retrospect, that was probably not a wise statement. Now, proponents of intervention state that if nothing is done, we'll be perceived as weaklings and all hell will break loose. Well, all hell seems to be breaking loose as it is. It's a civil war! Foreign (U.S.) intervention could very easily add a new dimension to that civil war, causing it to spill over the borders (e.g.: Attacks on Israel and Turkey with the certainty of reprisals). Is that really a desireable outcome?
Loss of life is tragic and leaves a terrible void for those who survive. Should it really matter if the cause of death is from toxic chemicals, missiles, or bullets? Or possibly some other method of torture? (Check out an earlier post on this blog dated 4/26/13: "The Heartbreak of Drone Warfare").
The last documented attack on civilians with chemical weapons occurred in 1988, in the Kurdish town of Halabja, courtesy of Saddam Hussein --- who at the time was still considered our good buddy. No one objected. However, the Organization for the Prohibition of Chemical Weapons (OPCW), a non-governmental body, wasn't established until 1993. 191 nations (including Russia and Iran) have signed the organization's Chemical Weapons Convention (CPC). Only five have not; one of those five is Syria.
Incidentally, a napalm attack on a school near Aleppo, in rebel territory, has recently been reported. What napalm does to human beings is horrifying. But our own hands are not unsoiled; the United States used it on the Vietnamese. Many of those who were severely burned by napalm were civilians, including women and children.
One more item to consider: No one proposed an intervention in Argentina during the late 1970s. Yet the atrocities committed by the military dictatorship there were well-known. Their most adamant critics were kidnapped, bound and gagged, trundled aboard airplanes, and dropped into the Atlantic while still alive. Prior to their abductions, the victims' children were snatched away from them, and forcibly placed for adoption by families that supported the junta. Again, no one raised their voices.
The military option worries me for two reasons:
1) Needless fatalities caused by U.S. attacks could very likely alienate former supporters. A few might even be driven to seek bloody revenge; think Dzokhar Tsarnaev, the surviving brother charged with the massacre at the Boston Marathon. He was very clear about his motive, stating that Americans killed his fellow Muslims in Iraq and Afghanistan.
2) Although Secretary of State John Kerry, among others, has insisted that our action would be limited, what happens if things don't go according to plan? Is there even an exit plan? Kerry did state that there'd be no use of ground troops, but when the subject of unanticipated hypothetical situations was mentioned, he waffled.
Alternatives? There really are no easy answers. Assad can be tried and convicted in-absentia by the International Criminal Court in The Hague. An international effort can (and should) be focused on further isolating him. Meanwhile, hundreds of thousands of displaced Syrians are in need of humanitarian aid.
In concert with the international community, that's something we could to be doing.
Supporters of military action seem to believe that Assad will think twice about committing monstrous acts against his own citizens. But many skeptics are concerned that U.S. attacks could stiffen his resolve instead, possibly accelerating the level of his brutality. Providing military aid to Syrian rebels might have been a viable alternative if they were relatively unified. But ideologically, they're all over the map, ranging from democrats to proponents of organizations like Al Qaeda.
We'd be going it alone. Nations initially perceived as compromising a "coalition of the willing" are no longer so willing. The British Parliament has opted out of the coalition by a margin of 13 votes. Prime Minister David Cameron, an avid supporter of the effort, graciously conceded, declaring that Great Britain would not contribute to a military campaign in Syria. (Some of his critics believe that he shouldn't have given up so quickly). The Arab League seems to be backing away from any commitment as well. With Security Council opposition from Russia, the United Nations is also a no-go.
Last year, Obama declared that the use of chemical weapons constituted a "red line" which should never be crossed. In retrospect, that was probably not a wise statement. Now, proponents of intervention state that if nothing is done, we'll be perceived as weaklings and all hell will break loose. Well, all hell seems to be breaking loose as it is. It's a civil war! Foreign (U.S.) intervention could very easily add a new dimension to that civil war, causing it to spill over the borders (e.g.: Attacks on Israel and Turkey with the certainty of reprisals). Is that really a desireable outcome?
Loss of life is tragic and leaves a terrible void for those who survive. Should it really matter if the cause of death is from toxic chemicals, missiles, or bullets? Or possibly some other method of torture? (Check out an earlier post on this blog dated 4/26/13: "The Heartbreak of Drone Warfare").
The last documented attack on civilians with chemical weapons occurred in 1988, in the Kurdish town of Halabja, courtesy of Saddam Hussein --- who at the time was still considered our good buddy. No one objected. However, the Organization for the Prohibition of Chemical Weapons (OPCW), a non-governmental body, wasn't established until 1993. 191 nations (including Russia and Iran) have signed the organization's Chemical Weapons Convention (CPC). Only five have not; one of those five is Syria.
Incidentally, a napalm attack on a school near Aleppo, in rebel territory, has recently been reported. What napalm does to human beings is horrifying. But our own hands are not unsoiled; the United States used it on the Vietnamese. Many of those who were severely burned by napalm were civilians, including women and children.
One more item to consider: No one proposed an intervention in Argentina during the late 1970s. Yet the atrocities committed by the military dictatorship there were well-known. Their most adamant critics were kidnapped, bound and gagged, trundled aboard airplanes, and dropped into the Atlantic while still alive. Prior to their abductions, the victims' children were snatched away from them, and forcibly placed for adoption by families that supported the junta. Again, no one raised their voices.
The military option worries me for two reasons:
1) Needless fatalities caused by U.S. attacks could very likely alienate former supporters. A few might even be driven to seek bloody revenge; think Dzokhar Tsarnaev, the surviving brother charged with the massacre at the Boston Marathon. He was very clear about his motive, stating that Americans killed his fellow Muslims in Iraq and Afghanistan.
2) Although Secretary of State John Kerry, among others, has insisted that our action would be limited, what happens if things don't go according to plan? Is there even an exit plan? Kerry did state that there'd be no use of ground troops, but when the subject of unanticipated hypothetical situations was mentioned, he waffled.
Alternatives? There really are no easy answers. Assad can be tried and convicted in-absentia by the International Criminal Court in The Hague. An international effort can (and should) be focused on further isolating him. Meanwhile, hundreds of thousands of displaced Syrians are in need of humanitarian aid.
In concert with the international community, that's something we could to be doing.
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