Common Dreams – Informed Comment https://www.juancole.com Thoughts on the Middle East, History and Religion Sat, 21 Jan 2023 05:10:31 +0000 en-US hourly 1 https://wordpress.org/?v=5.7.8 ‘Cancel This Failed Experiment’: Physicians Tell Biden HHS to End Medicare Privatization Pilot https://www.juancole.com/2023/01/experiment-physicians-privatization.html Sat, 21 Jan 2023 05:02:21 +0000 https://www.juancole.com/?p=209583 By Jake Johnson | –

( Commondreams.org) – A national physician group this week called for the complete termination of a Medicare privatization scheme that the Biden White House inherited from the Trump administration and later rebranded—while keeping intact its most dangerous components.

The program “presents a threat to the integrity of traditional Medicare, and an opportunity for corporations to take money from taxpayers while denying care to beneficiaries,” said Physicians for a National Health Program.

Now known as the Accountable Care Organization Realizing Equity, Access, and Community Health (ACO REACH) Model, the experiment inserts a for-profit entity between traditional Medicare beneficiaries and healthcare providers. The federal government pays the ACO REACH middlemen to cover patients’ care while allowing them to pocket a significant chunk of the fee as profit.

The rebranded pilot program, which was launched without congressional approval and is set to run through at least 2026, officially began this month, and progressive healthcare advocates fear the experiment could be allowed to engulf traditional Medicare.

In a Tuesday letter to Health and Human Services Secretary Xavier Becerra and Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure, Physicians for a National Health Program (PNHP) argued that ACO REACH “presents a threat to the integrity of traditional Medicare, and an opportunity for corporations to take money from taxpayers while denying care to beneficiaries.”

The group, which advocates for a single-payer healthcare system, voiced alarm over the Biden administration’s decision to let companies with records of fraud and other abuses take part in the ACO REACH pilot, which automatically assigns traditional Medicare patients to private entities without their consent.

CMS said in a press release Tuesday that “the ACO REACH Model has 132 ACOs with 131,772 healthcare providers and organizations providing care to an estimated 2.1 million beneficiaries” for 2023.

“As we have stated, PNHP believes that the REACH program threatens the integrity of traditional Medicare and should be permanently ended,” Dr. Philip Verhoef, the physician group’s president, wrote in the new letter. “Whether or not one agrees with this statement, we should all be able to agree that companies found to have violated the rules have no place managing the care of our Medicare beneficiaries.”

Among the concerning examples PNHP cited was Clover Health, which has operated so-called Direct Contracting Entities (DCEs)—the name of private middlemen under the Trump-era version of the Medicare pilot—in more than a dozen states, including Arizona, Florida, Georgia, and New York.

PNHP noted that in 2016, CMS fined Clover—a large Medicare Advantage provider—for “using ‘marketing and advertising materials that contained inaccurate statements’ about coverage for out-of-network providers, after a high volume of complaints from patients who were denied coverage by its MA plan. Clover had failed to correct the materials after repeated requests by CMS.”


Homage to Medicare and Medicaid: Sculpture Art. Via Pixabay.

Humana, another large insurer with its teeth in the Medicare privatization pilot, “improperly collected almost $200 million from Medicare by overstating the sickness of patients,” PNHP observed, citing a recent federal audit.

“It appears that in its selection process [for ACO REACH], CMS did not prevent the inclusion of companies with histories of such behavior,” Verhoef wrote. “Given these findings, we are concerned that CMS is inappropriately allowing these DCEs to continue unimpeded into ACO REACH in 2023.”

While the Medicare pilot garnered little attention from lawmakers when the Trump administration first launched it during its final months in power, progressive members of Congress have recently ramped up scrutiny of the program.

Last month, Sen. Elizabeth Warren (D-Mass.) and Rep. Pramila Jayapal (D-Wash.) led a group of lawmakers in warning that ACO REACH “provides an opportunity for healthcare insurers with a history of defrauding and abusing Medicare and ripping off taxpayers to further encroach on the Medicare system.”

“We have long been concerned about ensuring this model does not give corporate profiteers yet another opportunity to take a chunk out of traditional Medicare,” the lawmakers wrote, echoing PNHP’s concerns. “The continued participation of corporate actors with a history of fraud and abuse threatens the integrity of the program.”

Our work is licensed under Creative Commons (CC BY-NC-ND 3.0).

Via Commondreams.org

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Rights Advocates Alarmed Over Israel’s New ‘Fascist, Racist, and Settler’ Government https://www.juancole.com/2022/12/advocates-alarmed-government.html Fri, 30 Dec 2022 05:08:20 +0000 https://www.juancole.com/?p=209098 By Jessica Corbett | –

( Commondreams.org ) – Global concerns about the new Israeli government—especially what it means for Palestinians—continued to grow Thursday as Benjamin Netanyahu took the oath of office to again serve as prime minister, this time leading the most far-right and religiously conservative coalition in the country’s history.

“The occupation and apartheid in the occupied Palestinian territories have made Jewish supremacy the de facto law of the land and the new government seeks to adopt this into their official policy,” groups warned.

The embattled leader was sworn in following a 63-54 vote of confidence in his new government by the Knesset, Israel’s parliament. He has appointed 30 ministers and three deputy ministers from his Likud party as well as Noam, Otzma Yehudit (“Jewish Power”‘), Religious Zionism, Shas, and United Torah Judaism.

“It is already clear that the emerging coalition will be disastrous for human rights between the Jordan River and the Mediterranean Sea.”

The coalition finalized Wednesday features “a mix of an ultra-Orthodox and right-wing bloc,” with some of the most “right-wing politicians we’ve seen,” Al Jazeera‘s Sara Khairat reported Thursday from West Jerusalem, as protesters gathered. “They were on the fringes of politics and now here they are on the main stage.”

Some ministry appointments were only possible because of a pair of laws passed by the Knesset on Tuesday—one enabling Aryeh Deri of Shas to serve as minister of the interior despite his recent tax fraud conviction and another allowing Religious Zionism’s Bezalel Smotrich to take on multiple posts.

“These laws… dovetail with Netanyahu’s own attempt to escape potential liability for his long-running corruption/bribery trial,” wroteMondoweiss‘ Jonathan Ofir. “If such exceptions can be made for Smotrich and Deri and cemented into law, this paves the way for the same being done for Netanyahu, when the need arises.”

Another controversial pick is Otzma Yehudit’s Itamar Ben-Gvir, the new national security minister, who in 2007 was convicted of incitement to racism against Arabs and supporting a terrorist organization. As Common Dreamsreported last week, the government reached a deal to lift the ban on parliamentary candidates who incite racism.

In a joint statement Thursday, several advocacy groups said that “it is already clear that the emerging coalition will be disastrous for human rights between the Jordan River and the Mediterranean Sea.”

“Previous Israeli governments have already entrenched military control over millions of Palestinians, severely harmed their human rights, and made the possibility of a just future more difficult,” they continued. “The senior figures in this new government have made it clear that they intend to exacerbate this trend and advance dangerous measures.”

The organizations—including Adalah, B’Tselem, Breaking the Silence, Peace Now, and Physicians for Human Rights Israel (PHRI)—warned that “the occupation and apartheid in the occupied Palestinian territories have made Jewish supremacy the de facto law of the land and the new government seeks to adopt this into their official policy.”

“As the mask slips away, we will continue to stand firm to protect the human rights of the most vulnerable population in the region,” the groups concluded. “We call on everyone for whom the future of this place is important to stand together with us.”

Warning of the coalition’s determination “to hurt the vulnerable, discriminate, and withhold medical care from migrants, Palestinians, and queer people,” PHRI declared in a series of tweets Thursday that “it’s time to resist.”

On the eve of his inauguration, Netanyahu had laid out the new government’s agenda—and made clear that expanding illegal settlements in occupied Palestinian territory is a top priority.

“The Jewish people have an exclusive and inalienable right to all parts of the land of Israel. The government will promote and develop settlement in all parts of the land of Israel—in the Galilee, the Negev, the Golan, Judea, and Samaria,” the agenda states.

University of Michigan professor Juan Cole noted at his blog Informed Comment that a Jordanian newspaper called the exclusive Jewish right plank of Netanyahu’s platform “the execution of the Palestinian people.”

Cole added that “since Netanyahu has no intention of ever granting Israeli citizenship to the three million Palestinians living under Israeli military rule, the formal annexation of their territory would cement Israel’s apartheid system of racial difference,” a warning echoed by many other critics.

After Netanyahu tweeted the agenda’s lines about land rights in Hebrew, Palestinian-American writer Yousef Munayyer responded, “Say it in English so your apartheid apologist buddies over here can understand it.”

Munayyer also highlighted the silence of the United States government on the matter—while U.S. Ambassador to Israel Tom Nides congratulated Netanyahu and proclaimed, “Here’s to the rock solid U.S.-Israel relationship and unbreakable ties.”

In a Thursday statement, U.S. President Joe Biden said in part that “I look forward to working with Prime Minister Netanyahu, who has been my friend for decades, to jointly address the many challenges and opportunities facing Israel and the Middle East region.”

While Biden did not explicitly address any concerns about Israel’s new far-right government, he added that “as we have throughout my administration, the United States will continue to support the two-state solution and to oppose policies that endanger its viability or contradict our mutual interests and values.”

In a Twitter thread, Sina Toossi of the Center for International Policy noted that the U.S. government has long “turned a blind eye to human rights abuses committed by its allies” and asserted that “the new Netanyahu government in Israel will make the U.S. double standard on human rights even more blatant and egregious.”

Philip Weiss wrote Thursday for Mondoweiss that “the deafening silence” from some U.S. Zionist organizations shows they “are clearly upset” that Netanyahu ignored calls not to move foward with a coalition that “includes fascistic and racist/messianic convicted criminals, because it would damage U.S.-Jewish relations and provide ammunition to anti-Zionists.”

Weiss also highlighted that “the leading Jewish anti-Zionist group leaped on the new Israeli government today to catalyze Jewish support for democracy in Israel and Palestine.”

As he pointed out, Judith Butler of the U.S.-based Jewish Voice for Peace said that “the political conflicts at Jewish dinner tables across the diaspora are a sure sign that the consensus on the ‘democratic’ character of the state of Israel has broken apart.”

Butler continued:

The new government in Israel has proved to be the most shamelessly racist in its history. Yes, but racism has been there from the beginning, a founding credo… Of course, it is good that we are shocked by Israeli racism, now increasingly shameless, for the world should not be this way. And yet, many of us are coming late to this sense of shock and outrage. It is time to act now, knowing that it has been time to act for a very long time!

The United Nations Office of the High Commissioner for Human Rights (OHCHR) announced earlier this month that “150 Palestinians have been killed in the occupied West Bank by Israeli forces so far this year, including 33 children,” the region’s highest death toll since the U.N. started keeping track in 2005.

Three U.N. special rapporteurs condemned the surging violence by Israeli forces and settlers, along with the unlawful occupation more broadly.

“Illegal settlement poses a corrosive threat to Israeli society as a whole,” they said, “and unless Israeli forces abandon this dominant settler mindset and rightfully treat Palestinians in the occupied territory as protected persons, Israel’s deplorable record in the occupied West Bank will likely deteriorate further in 2023.”

The experts added that “no peaceful settlement can be pursued under Israel’s repressive occupation: a reality that should be a wake-up call for all decision-makers.”

This post has been updated with comment from U.S. President Joe Biden and Sina Toossi.

Via Commondreams.org

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Medicare Dis-Advantage: Shortchanging the Patients While Enriching the Insurer https://www.juancole.com/2022/08/advantage-shortchanging-enriching.html Wed, 31 Aug 2022 04:02:06 +0000 https://www.juancole.com/?p=206679 By Leonard Rodberg | –

( Commondreams.org) – Advocates of universal health care are currently battling the effort by corporate forces, both outside and within the Medicare, to privatize the portion of the program that is now fully public.

There should be no out-of-pocket barriers to care when it is needed. The existence of these costs is why so many Medicare recipients opt for a private Medicare Advantage plan. However, this, and all such efforts to privatize the public Medicare program, harm patients and steal from the public purse. Medicare Advantage must be ended, and any new privatization efforts, like ACO REACH, must be opposed.

These corporate interests aim to insert between Medicare and the medical professionals who actually provide care a private, for-profit corporation—through the controversial (and recently rebranded) privatization scheme called ACO REACH—which will be paid for each Medicare recipient “aligned” with an affiliated provider. Those for-profit ACO REACH providers will benefit not only by receiving more from Medicare than it pays its affiliated providers, but also they will share any “savings”—that is, reductions in care—they generate as profit.

We must recognize that the fight against the privatization of Medicare is a two-front war: against privatization through Medicare Advantage and through the ACO REACH program.

Nearly half of all Medicare recipients are now in private Medicare Advantage insurance plans, rather than the traditional public Medicare program. It is widely recognized that Medicare Advantage costs the federal government too much. At the same time, it is seldom noted that these plans provide patients too little. The federal Medicare program pays more to private Medicare Advantage insurers than it spends for comparable patients in public traditional Medicare. However, even with these overpayments, far less money is available to take care of patients in Medicare Advantage plans than is available to take care of the same kinds of patients in public Medicare.

Those who are healthy benefit from the low cost of Medicare Advantage plans, as long as they remain healthy. For those who become sick, Medicare Advantage offers only cut-rate medicine, and they will suffer.

When patients are covered by Medicare, not only are Medicare’s funds available but, in addition, there are supplemental payments for medical care and additional funds for hospital services. These payments are made either out of pocket by the patient or, more often, by private supplemental insurance or “Medigap” plans. Those extra funds are not available for patients in Medicare Advantage plans—federal rules do not permit supplemental insurance for Medicare Advantage recipients. The only funds available to care for them are payments made by the federal government to the Medicare Advantage plan, along with whatever copayments are charged by these plans to their members when they have to use health services.

Medicare Advantage plans are solely dependent on the federal payment for their revenue. As discussed below, this payment is, on average, somewhat greater than what Medicare spends on recipients of public Medicare. On the other hand, the funds available to pay for actual health care services under Medicare Advantage plans—that is, to be paid to doctors and hospitals who provide those services—are limited by the substantial overhead expenses and profits of the insurance companies which operate these plans. In net, as shown below, the average private Medicare Advantage plan has about 24% less money to spend on actual health services than is spent, per patient, in traditional public Medicare.

Health Care Spending for Medicare Recipients

In traditional Medicare, the Medicare program pays most of the bill—80% for medical services under Part B; a larger but more complicated portion for hospital services under Part A. Either the patient or, more frequently, an insurance company providing supplemental or Medigap coverage pays the rest. How large is that payment? As a current example, the Centers for Medicare and Medicaid Services (CMS) spends an estimated $11,953 in Medicare payments for the average recipient in New York State. At the same time, the New York City government has been spending $600 million per year purchasing this supplemental coverage for its 245,000 Medicare-eligible retirees and their dependents, or $2,450 per recipient. That spending goes to a private insurer whose average overhead is, according to the Kaiser Family Foundation, 14% of its revenue. The supplemental spending on actual health care services is then 86% of $2,450, or $2,107 per recipient. Taking New York City’s payment as an average figure for the cost of the Medicare supplement, total spending on health care per Medicare recipient is $14,060, about 17.6% above what the federal government spends directly.

Health Care Spending for Members of Medicare Advantage Plans

What is spending for health care services under Medicare Advantage? These plans receive a monthly risk-adjusted payment from the federal government for each person in their plan. According to MedPAC, this payment today averages 4% more than what is spent by traditional Medicare on its patients of equivalent health status. Initially, during the George W. Bush years, this excess was larger, but under Congressional pressure to contain spending, it has been gradually reduced. Medicare Advantage members are not permitted to purchase supplemental insurance, so this total (in New York’s case, $12,431) is all that is available to pay for their care. Assuming the average Medicare Advantage overhead of 14%, this means that $10,691 is available to be spent, per member, on health care services in Medicare Advantage plans. So Medicare Advantage plans have just 76% of the funds that are available to provide care for comparable recipients of traditional Medicare. This is shown in the figure below.

How Medicare Advantage Plans Limit their Spending

Medicare Advantage plans are required to provide all the benefits of traditional Medicare but, using these figures, they have only 76% of the money spent on patients in traditional Medicare. As a result, they have to limit what they spend on health care services. They do so in a variety of ways: (1) recruiting members from locations, and with methods, likely to yield a healthier-than-average population; (2) extensive use of deductibles and copays, which shifts the cost from themselves to the patients; (3) reduced use of health services since patients, faced with these added financial barriers, will avoid seeking care they might be considering; (4) extensive requirements for prior authorization of potentially expensive treatments and procedures, leading to payment denials and delays (traditional Medicare requires prior authorization only for selected costly medications and the purchase of some expensive medical devices); and (5) paying doctors and hospitals less than traditional Medicare, thereby limiting the providers who are in-network and, therefore, available to patients in these plans.

One result of these extra expenses and the limitations on receiving care is that individuals in Medicare Advantage plans who become seriously ill transfer preferentially to traditional Medicare as soon as they can. Of course, the Medicare Advantage plans don’t discourage this exodus of high-cost patients.

Together, these techniques create the spending reductions Medicare Advantage plans need so that, with just three-quarters of the funds available to provide services, they can still show substantial profits. Indeed, Medicare Advantage has become the most profitable sector of the health insurance industry.

Conclusion

This is the convoluted privatized system we have created in the name of encouraging “choice” in health plans for our oldest citizens. Those who are healthy benefit from the low cost of Medicare Advantage plans, as long as they remain healthy. For those who become sick, Medicare Advantage offers only cut-rate medicine, and they will suffer. Medicare and Medicare Advantage are often described as if they are equivalent, but they are not. Less money means less care, and lower quality care.

Since care under Medicare Advantage plans is so deficient, why do so many choose it rather than public Medicare? The answer is straightforward: Medicare Advantage plans cost the average person less (usually, they have $0 premium). Public Medicare requires cost-sharing; it pays just 80% of medical bills and a similar portion of hospital care, leaving the rest to the patient in the form of deductibles and copays. Further, it places no limit on out-of-pocket costs. Many buy private supplemental Medigap plans to protect themselves, or receive this coverage through their unions. Members of Medicare Advantage plans tend to be healthier than the average Medicare recipient, and they face these costs only when they need substantial amounts of care.

Beyond this, there is 80/20 rule: In any population, 80% are reasonably healthy; most of the money is spent on the other 20% who need significant amounts of medical care. As a result, most people won’t use very much health care in any one year and will be satisfied with their coverage. It is the sick who suffer the inadequate care available in Medicare Advantage plans and who return, if they can, to traditional Medicare.

Whither Medicare?

The cost-sharing required in Medicare should be eliminated, as it is in all proposals for universal Medicare for All plans. There should be no out-of-pocket barriers to care when it is needed. Other countries with universal care have shown that costs can be contained without requiring that their patients have “skin in the game.” There would then be no reason for anyone to choose a private plan and no excuse for creating an over-expensive, under-providing private alternative to an equitable, comprehensive public Medicare program.

Leonard Rodberg is Professor Emeritus of Urban Studies at Queens College/CUNY and Research Director of the NY Metro Chapter of Physicians for a National Health Program.

Via Commondreams.org


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On Their 57th Anniversary, Medicare and Medicaid Remain Under Threat https://www.juancole.com/2022/07/anniversary-medicare-medicaid.html Fri, 29 Jul 2022 04:02:29 +0000 https://www.juancole.com/?p=206054 By Max Richter | –

( Commondreams.org ) –

You may wonder why former President Harry Truman is sitting close by while President Lyndon B. Johnson signs Medicare and Medicaid into law in the iconic 1965 photograph. Or why Harry Truman received the first-ever Medicare card. The reason is that Truman first proposed a Medicare-like system in 1945—but it took two decades, another Democratic president, and a Democratic supermajority in Congress to overcome opposition from political conservatives and the health industry. As we celebrate 57 years of Medicare and Medicaid successes on July 30th, it is vexing that these two vital programs continue to be in the cross-hairs of GOP opponents.

Democratic proposals to protect and expand Medicare and Medicaid have received almost ZERO support from the GOP, while proposals to privatize and cut benefits have originated with Republicans.

Today, elderly and low-income persons can truly say that—thanks to these two landmark programs—they are free from fear of not having health insurance.

Before Medicare was enacted, 56% of American seniors had no health insurance. Retirees were no longer covered by their employers. Private insurers considered them a “particularly bad risk” and rejected them as customers or charged premiums almost no one could afford. The uninsured elderly had to rely on family, friends, or charity to cover medical bills. More than one in four seniors went without medical care altogether.

Low-income Americans suffered a similar plight prior to the enactment of Medicaid. The poor had “limited access to healthcare, relying heavily on charity care and public hospitals,” according to Modern Healthcare. While those deemed the “deserving poor” might receive care through community and religious organizations, “able-bodied (low income) people needing healthcare were generally out of luck.”

A crowning achievement of LBJ’s Great Society, the enactment of Medicare and Medicaid affirmed that the federal government had a legitimate—and moral—obligation to ensure that the most vulnerable among us could obtain health coverage like everyone else. A truly Great Society would refuse to leave the poor and the old out in the cold when they needed care.

“No longer will older Americans be denied the healing miracle of modern medicine,” said President Johnson upon signing Medicare and Medicaid into law. “No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years.”

Unfortunately, Medicare and Medicaid faced opposition from a vast majority of Republican members of Congress from the beginning. None other than Ronald Reagan warned in a 1965 radio address that “one of the traditional methods of imposing… socialism on a people has been by way of medicine.” Reagan promised that if Medicare and Medicaid were enacted, “One of these days you and I are going to spend our sunset years telling our children… what it once was like in America when men were free.”

In fact, the opposite occurred. Today, elderly and low-income persons can truly say that—thanks to these two landmark programs—they are free from fear of not having health insurance. Neither program is perfect. Federal programs of this scope must continually be updated to reflect present realities. However, public support for Medicare and Medicaid is unequivocal. Here are some of the things that our volunteers and supporters have told us over the past few years:

“I had cancer. Without Medicare, I would have been dead.”

“As someone with several chronic conditions, I have a great peace of mind because Medicare and Medicare supplemental insurance pay my health care bills.”

“My son is a special-needs child. Medicaid was our saving grace in terms of having medical insurance.”

“My mother had an aneurysm. If she didn’t have Medicaid, she would not have been able to recover at home quickly and comfortably.”

Some 76 million Americans are covered by Medicaid, which not only provides health insurance for low-income people, but pays more than 60% of the cost of long-term care services and supports for seniors. Roughly 64 million Americans—most of them over 65 years of age—are enrolled in Medicare. That’s about 140 million examples of how Americans with chronic and acute health conditions—who otherwise might not be able to obtain private insurance—can get the health care they need thanks to the vision of President Lyndon Johnson and the U.S. Congress in 1965.

We all should applaud these achievements and the resulting health improvements and increased longevity of our oldest citizens—right? Instead of simply being able to celebrate this 57th anniversary, though, seniors’ advocates are having to fight to preserve these life-saving, poverty prevention programs. That’s because elite, well-funded, and powerful conservative interests who oppose Medicare and Medicaid continue their efforts to undermine both. During the Trump administration, Republicans renewed their calls to “block grant” Medicaid, which would have forced the states to slash benefits and trim their rolls of insured citizens. Democrats have been able to stop those efforts for now.

As for Medicare, instead of voicing outright opposition, adversaries now pay lip service to preserving Medicare. (President Trump famously promised “not to touch” Medicare but proposed to cut the program by billions of dollars in successive White House budgets.) Today, many conservatives focus on privatizing Medicare. The privatization effort got a running start through the Medicare Advantage (MA) program, which was created by the Medicare Modernization Act of 2003. (It’s the same law that forbade Medicare from negotiating prescription drug prices with Big Pharma.)

Medicare Advantage was supposed to save taxpayers money by providing more cost-effective care than the traditional Medicare program. Instead, MA insurers have benefitted handsomely from federal overpayments and fraudulent diagnostic “upcoding.” As multiple news reports and investigations have confirmed, Medicare Advantage insurers overbilled the government to the tune of $34 billion dollars in 2018-2019 alone. They’ve also increased profits by denying medically warranted pre-authorization requests and refusing to reimburse providers for valid claims.

Likewise, Part D prescription drug prices have continued to rise dramatically, hurting seniors on fixed incomes while Big Pharma profits climb ever higher. In 2021, major pharmaceutical CEOs raked in over $292.6 million while 2.3 million seniors were unable to afford at least one doctor-prescribed medication. How ironic that the fiscal conservatives who blast Medicare spending on seniors are at the same time shamefully silent while MA insurers and drug makers reap record profits from the program.

The reason you will likely only hear Democrats marking the anniversary of Medicare and Medicaid is that these programs began with them; they have endured because of them; and the future of both programs depends on electing members of Congress who will strive to continue them.

Meanwhile, private interests recently have gained a bigger foothold in the publicly-run, traditional Medicare program. When Accountable Care Organizations (ACOs) were established through the Affordable Care Act they were intended to improve coordination of care of chronic conditions by having Medicare contract directly with providers to improve quality of care. Over time, for-profit investor driven groups have insinuated themselves into the program. A new initiative begun during the Trump era (later rebranded as ACO/REACH by the Biden administration), provides substantially increased financial incentives for reducing costs. Seniors’ advocates are rightfully concerned that this will draw more private entities into traditional Medicare and could eventually lead to additional problems akin to what’s been taking place in the Medicare Advantage program.

For years, Democrats have been the only force behind expansion plans for traditional Medicare to cover basic hearing, vision, and dental care. President Biden included these in his initial Build Back Better plan, but vision and dental care were later dropped in Congressional negotiations. Hearing care coverage and expanded Medicaid home and community-based services also perished after Senator Joe Manchin withdrew his support. In an effort to salvage some of their expansion efforts, Congressional Democrats recently sent a letter to the Centers for Medicaid and Medicare Services (CMS) urging that the program broaden the rules for “medically necessary” dental care to cover seniors with various health conditions affecting their teeth.

As for Medicaid, the Biden administration continues to encourage states to expand their programs under the Affordable Care Act. About a dozen red states still refuse to expand their Medicaid programs, denying coverage to millions of uninsured, low-income residents—even though the federal government offers the states extra funding for expansion.

Let’s be very clear, Democratic proposals to protect and expand Medicare and Medicaid have received almost ZERO support from the GOP, while proposals to privatize and cut benefits have originated with Republicans. The reason you will likely only hear Democrats marking the anniversary of Medicare and Medicaid is that these programs began with them; they have endured because of them; and the future of both programs depends on electing members of Congress who will strive to continue them. Seniors who value these crucial, life-saving programs should bear this in mind when casting their votes in November. As we mark this 57th anniversary, let’s re-commit to protecting the two greatest pillars of the Great Society.

Max Richtman is president and CEO of the National Committee to Preserve Social Security and Medicare. He is former staff director at the United States Senate Special Committee on Aging.

Licensed under Creative Commons (CC BY-NC-ND 3.0).

Via Commondreams.org

Featured image: via Pixabay.

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‘Huge Climate Victory’ as Judge Blocks Biden’s Oil Lease Sale in Gulf of Mexico https://www.juancole.com/2022/01/victory-blocks-bidens.html Sat, 29 Jan 2022 05:04:09 +0000 https://www.juancole.com/?p=202684

“The Biden administration must end new leasing and phase out existing drilling,” said one advocate. “Anything less would be a gross failure of climate leadership.”

By Jake Johnson | –

A federal judge late Thursday blocked the Biden administration’s massive oil and gas lease sale in the Gulf of Mexico, a significant win for environmentalists as they work to prevent the Interior Department from handing public lands and waters over to the fossil fuel industry.

In his 68-page decision (pdf), Judge Rudolph Contreras of the U.S. District Court in Washington, D.C. wrote that the Biden administration violated federal law by not adequately accounting for the emissions impact of the sale, which would have been the biggest offshore oil and gas lease sell-off in the country’s history.

“This is a huge victory for our climate, endangered whales, and Gulf communities.”

Climate groups characterized the sale—held just days after the COP26 summit in Glasgow—as the equivalent of “lighting the fuse of a massive carbon bomb.”

“The Department of the Interior acted arbitrarily and capriciously in excluding foreign consumption from their greenhouse gas emissions calculation,” Contreras, an Obama appointee, found.

The Biden Interior Department, which now must conduct a fresh environmental review, had relied on an analysis completed under the Trump administration, which was teeming with allies of the fossil fuel industry.

Brettny Hardy, senior attorney for Earthjustice—a group that sued the Biden administration over the lease sale—applauded the judge’s decision Thursday and said that “we simply cannot continue to make investments in the fossil fuel industry to the peril of our communities and increasingly warming planet.”

“Interior should use its next five-year leasing plan to protect our coastal communities and public waters and offer no new offshore leases,” Hardy added. “We can no longer afford to do anything less.”

On the campaign trail, President Joe Biden pledged to ban new oil and gas leasing on federal lands and waters, a promise that climate advocates cautiously applauded while demanding more ambitious action. One of the first executive orders Biden signed as president directed the Interior Department to pause all new oil and natural gas leasing on public lands and offshore waters.

Yet, over the past 12 months, the Biden administration has approved drilling permits at a faster rate than its oil-friendly predecessor. According to new federal data, the Biden administration signed off on more than 3,550 permits for oil and gas drilling on public lands in its first year in power.

Around a quarter of all U.S. greenhouse gas emissions—which Biden has promised to slash—come from fossil fuel extraction on public lands.

Administration officials insist they’ve been hamstrung by a Trump-appointed federal judge who, in a June ruling, blocked Biden’s temporary pause on new drilling leases. But climate groups argue the judge’s order did not require the administration to move ahead with the huge lease sale in the Gulf of Mexico—a conclusion echoed by the Biden Justice Department.

Following Contreras’ ruling on Thursday, Kristen Monsell of the Center for Biological Diversity said she is “thrilled the court saw through the Biden administration’s horribly reckless decision to hold the largest oil lease sale in U.S. history without carefully studying the risks.”

“This is a huge victory for our climate, endangered whales, and Gulf communities,” said Monsell. “New oil leases are fundamentally incompatible with addressing the climate emergency, and they’ll cause more oil spills and harm to wildlife and people in the Gulf.”

“For the sake of our climate and frontline communities,” she added, “the Biden administration must end new leasing and phase out existing drilling. Anything less would be a gross failure of climate leadership.”

Jake Johnson is a staff writer for Common Dreams.

Licensed under Creative Commons (CC BY-NC-ND 3.0).

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Eye of Fire as Ocean burns in Gulf of Mexico foretells Earth Future if we Keep Burning Fossil Fuels https://www.juancole.com/2021/07/mexico-foretells-burning.html Sun, 04 Jul 2021 04:04:08 +0000 https://www.juancole.com/?p=198708

“Having to put out a fire in the middle of the Gulf of Mexico feels just too difficult to believe. And yet…”

By Julia Conley, staff writer | –

( Commondreams.org) – A fire that raged for hours in the Gulf of Mexico Friday offered the latest illustration of the climate emergency and the urgent need to end fossil fuel extraction and invest instead in burgeoning renewable energy industries.

An underwater gas pipeline controlled by Mexico’s state-owned oil company, Petroleos Mexicanos, also known as Pemex, burst in the early morning hours, sending flames “resembling molten lava” to the water’s surface.

Video shows fire in Gulf of Mexico after gas pipeline rupture | ABC7

The “eye of fire,” as news outlets and observers on social media called the blaze after Pemex publicized the incident Friday night, happened about 150 yards from a drilling platform in the Ku-Maloob-Zaap offshore field. According to Bloomberg, the field produces more than 700,000 barrels of oil per day.

It took emergency workers about five hours to put out the flames.

“Having to put out a fire in the middle of the Gulf of Mexico feels just too difficult to believe,” tweeted HuffPost editor Philip Lewis. “And yet…”

“The frightening footage of the Gulf of Mexico is showing the world that offshore drilling is dirty and dangerous,” Miyoko Sakashita, oceans program director for the Center for Biological Diversity, told the Washington Post. “These horrific accidents will continue to harm the Gulf if we don’t end offshore drilling once and for all.”

“These horrific accidents will continue to harm the Gulf if we don’t end offshore drilling once and for all.”
—Miyoko Sakashita, Center for Biological Diversity

Pemex has seen production declining recently, according to Bloomberg, with output falling every year for the past decade and a half and putting the company into $114 billion in debt.

Entrepreneur and fair wage advocate Dan Price catalogued several of the past week’s climate-related emergencies, including the fire in the gulf as well as deadly heatwaves in the Pacific Northwest and Canada, which sparked outraged calls for climate action in recent days.

“The Gulf of Mexico is on fire, it’s 112 degrees in Portland, roads and rails are crumbling from the sun, wildfire and hurricane season are here in record time and people are concerned about the cost of going green,” said Price. “COMPARED TO WHAT?”

The pipeline burst days after undercover journalists released footage of lobbyists from fossil fuel giant ExxonMobil, in which the lobbyists discussed their fight against climate science and their reliance on centrist lawmakers such as Sens. Joe Manchin (D-W.V.), Kyrsten Sinema (D-Ariz.), and Jon Tester (D-Mt.) to ensure the failure of far-reaching climate action legislation.

The progressive advocacy group RootsAction released a version of the Gulf of Mexico fire footage with images of the centrist lawmakers.

“This is our future,” the group said of the image of the world’s largest gulf on fire. “Don’t forget who is responsible.”


Our work is licensed under Creative Commons (CC BY-NC-ND 3.0).

Via Commondreams.org

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Sounds Like Fascism: Florida’s DeSantis to Collect Political Views of Professors to defund “Hotbeds of stale Ideology” https://www.juancole.com/2021/06/floridas-political-professors.html Sun, 27 Jun 2021 04:01:05 +0000 https://www.juancole.com/?p=198580

The law bars universities from “shielding” students from “offensive” views, raising questions about retaliation for professors who enforce respectful classroom conduct.

By Julia Conley, staff writer | –

( Commondreams.org) – Democratic lawmakers and educators nationwide are expressing alarm over legislation signed this week by Florida Gov. Ron DeSantis which is ostensibly aimed at ensuring college students and educators in the state feel permitted to express a variety of political views—and which critics say could end up punishing professors whose opinions don’t line up with those of the state’s right-wing leaders.

DeSantis on Tuesday signed House Bill 233 into law, requiring more than three dozen public colleges and universities in Florida to conduct yearly surveys of their students’ and faculty members’ beliefs to determine the institutions’ levels of “intellectual freedom and viewpoint diversity.”

The state university system and board of education will be tasked with creating the surveys, which will ask whether campus community members “feel free to express their beliefs and viewpoints.”

“[Faculty members] with controversial views, be they liberal or conservative, may find themselves increasingly vulnerable to political or ideological pressure, including from legislation like this.” —AAUP

The law is vague regarding how state authorities can proceed if a university is found to be insufficiently welcoming to certain viewpoints; state Rep. Spencer Roach, a Republican who sponsored the bill in the House, told the Chronicle of Higher Education the survey results “could shape whatever action a university president may want to take or whatever action a future legislative body may want to take.”

At a news conference on Tuesday, DeSantis said his government could intervene if it finds universities to be “hotbeds for stale ideology”—without specifying what that ideology might be—and suggesting funding cuts could ensue.

“That’s not worth tax dollars and not something we’re going to be supporting moving forward,” the governor said.

The law does not ensure that surveys will be taken anonymously, raising concerns that faculty members could also face retaliation if they express progressive views or share that they would not welcome certain viewpoints—for example, discriminatory or abusive comments directed at a student—in their classrooms.

Under the law, students will also be permitted to record professors without their consent “in connection with a complaint,” according to the Chronicle.

The measure “sounds like fascism to me!” tweeted Democratic state Rep. Anna V. Eskamani.

The legislation bars universities from “shielding” community members from views that they “may find uncomfortable, unwelcome, disagreeable, or offensive,” noted the American Association of University Professors (AAUP).

“But does this mean that a professor could be barred from enforcing respectful and appropriate classroom conduct by students?” the group asked.

AAUP senior program officer Anita Levy called the law “a solution in search of a problem,” while a union representing 20,000 college instructors in Florida questioned state Republicans’ claims that the public university system is currently chilling free speech rights in classrooms.

The United Faculty of Florida has seen no rise in complaints against university instructors regarding their attitudes toward left-leaning viewpoints versus conservative opinions, or vice versa, union president Karen Morian told the Chronicle.

The AAUP pointed out that the University of Florida poured hundreds of thousands of dollars into campus safety measures in 2017 when Richard Spencer, a white nationalist, spoke at the school.

“Such expression is already protected by the First Amendment, as the state’s universities have recognized,” the organization said.

If DeSantis and state Republican legislators were truly concerned about ensuring “viewpoint diversity” on college campuses, the AAUP said, they would not threaten funding cuts but would instead “consider increasing funding for higher education so that a larger proportion of the faculty might be offered the prospect of tenure, which protects a faculty member’s right to free expression.”

“As it is, with nearly three-fourths of all U.S. faculty on short-term contingent contracts, often subject to arbitrary non-renewal, those with controversial views, be they liberal or conservative, may find themselves increasingly vulnerable to political or ideological pressure, including from legislation like this,” the group said.


Our work is licensed under Creative Commons (CC BY-NC-ND 3.0).

Via Commondreams.org

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Bonus Video added by Informed Comment:

MSNBC: “DeSantis Vows To Defund Colleges For Being Too Liberal”

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A Complete Waste of Money’: Fossil Fuel Industry Takes At Least $50 Million in Covid Aid Despite Financial Struggles Long Before Outbreak https://www.juancole.com/2020/05/financial-struggles-outbreak.html Sun, 03 May 2020 04:03:16 +0000 https://www.juancole.com/?p=190663 By Julia Conley, staff writer | –

(Commondreams.org) – “We need to be getting checks directly to workers, including in the fossil fuel industry—not hoping money ‘trickles down’ through corrupt companies that consistently prioritize their CEOs.”

“The idea that oil workers are getting a paycheck is great,” 350.org co-founder Jamie Henn said. “The worry is that the money’s going to the top and not going to filter down.”

Three coal companies with ties to President Donald Trump are among a number of fossil fuel firms which have taken millions in dollars in coronavirus relief funds, according to new reporting by The Guardian and corporate watchdog Documented.

According to a review of aid through the Paycheck Protection Program (PPP), which was meant for small businesses that are struggling as a result of the coronavirus pandemic, fossil fuel companies have taken at least $50 million in loans from the program, and may be able to forgo paying taxpayer money back.

The three coal companies with ties to the White House are Rhino Resources, a coal mining company formerly run by Trump’s Mine Safety and Health Administration head David Zatezalo; Hallador Coal, where Trump’s former EPA administrator, Scott Pruitt, is now a lobbyist; and Ramaco Resources, whose CEO is on the Trump administration’s National Coal Council.

The companies are taking between $8.4 and $10 million from the program to cover payroll and other expenses.

Jamie Henn, co-founder of the environmental action group 350.org, was sympathetic to the needs of rank-and-file fossil fuel employees whose paychecks should be protected as other workers’ are, but expressed reservations about fossil fuel companies receiving aid.

“The idea that oil workers are getting a paycheck is great,” Henn said. “The worry is that the money’s going to the top and not going to filter down.”

The Guardian published its report a day after the Federal Reserve announced changes to its Main Street Lending Program, which will now allow larger oil and gas companies with significant debt to use government loans to pay off debt they had before the pandemic.

“These changes directly reflect demands from polluters and their favorite members of Congress,” Lukas Ross, senior policy analyst with environmental group Friends of the Earth, said Thursday. “Long before the coronavirus, the drillers were in deep trouble. Now frackers want to pay back their debts with our money. Trump’s big oil bailout must be stopped.”

Oil industry lobbyists wrote to the Federal Reserve earlier this month, asking for the industry to be included in the Main Street Lending Program.

A week later, Greenpeace noted, oil prices were plummeting to below $0 per barrel as demand for gasoline fell due to the pandemic and corresponding global economic shutdowns.

The drop in demand for oil, Greenpeace and other climate campaigners said, bolstered the case for a “green recovery” and a “safer economy.”

But despite warnings from critics like the Institute for Energy Economics and Financial Analysis (IEEFA), the Trump administration is reportedly considering a larger bailout for the fossil fuel industry, including bridge loans.

“The U.S. government could make loans to oil and gas companies, essentially making taxpayers investors in the industry,” reported The Guardian.

The IEEFA said this week that loans for an industry which “had long been in financial distress” would be “a complete waste of money.”

Some fossil fuel companies have also taken advantage of tax relief provisions under the CARES Act relief bill passed in March. Missouri-based coal company Peabody Energy said it would collect an alternative minimum tax refund of $24 million in 2020 and defer payment of $18 million in owed taxes.

“The federal money Congress appropriated should be going to help small businesses and frontline workers struggling as a result of the pandemic,” Sierra Club legislative director Melinda Pierce told The Guardian, “not the corporate polluters whose struggles are a result of failing business practices and existed long before Covid-19 entered the public lexicon.”

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Featured Photo: CGP Grey/Flickr/cc)

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When you Work for Corporations you Don’t Care about People: How Wisconsin GOP Forced in-person Voting in the Midst of a Pandemic to Suppress Urban Dem Vote https://www.juancole.com/2020/04/corporations-wisconsin-suppress.html Wed, 08 Apr 2020 04:04:54 +0000 https://www.juancole.com/?p=190182

“People are being forced to risk their lives to place their vote or fulfill their right as an American to vote.”

By Jessica Corbett, staff writer | –

(Commondreams.org) – As footage of Wisconsin’s crowded polling stations flooded the internet Tuesday, public health officials and civil rights advocates condemned the state’s Supreme Court and Republican legislative leaders for allowing in-person voting during the coronavirus pandemic and thwarting Democratic Gov. Tony Evers’ last-minute efforts to address voter safety concerns.

“These are dangerous times for democracy.”
—Aquene Freechild, Public Citizen

“It’s not going to be a safe election. People are going to get sick from this,” Brook Soltvedt, a 60-year-old textbook editor who is in charge of running the polling place at Thoreau Elementary School in Madison, Wisconsin’s capital, told The Cap Times.

Soltvedt added that though she thinks “the city has done about the best that they can do,” she worries that the election will cause voter confusion and health consequences. In an effort to protect her 77-year-old husband, Soltvedt said she plans to “strip in the garage, put my clothes in the washer, and go downstairs for two weeks.”

After days of Wisconsin’s Republican Assembly Speaker Robin Vos and Senate Majority Leader Scott Fitzgerald resisting widespread demands to delay in-person voting and expand absentee voting—like other states have done—Evers on Monday issued an executive order to postpone the election until June 9. However, the order was overturned by the state Surpreme Court Monday night.

The right-wing U.S. Supreme Court added insult to injury on Monday, overturning a lower court ruling that extended the deadline for absentee voting. Absentee ballots must be postmarked Tuesday or returned to a polling place or local clerk’s office by 8 pm. Local leaders have expressed worries that due to a backlog of requests, residents may not receive absentee ballots in time to vote.

“What that meant was that, for a substantial portion of the electorate, Election Day presented a harsh choice,” John Nichols wrote Tuesday in a column for The Cap Times. “Those who had applied for absentee ballots but not yet received them, and those who had not applied for an absentee ballot by last Friday’s deadline, were forced to decide whether to risk exposure to the coronavirus in order to exercise their right to vote.”

Nichols denounced the dilemma faced by voters as “unreasonable” and characterized Vos and Fitzgerald as “legislative charlatans” who “threw tantrums at a point when everyone else was working to save lives, keep people healthy, stabilize the economy, and preserve democracy.”

“Tony Evers did his part,” wrote Nichols. “Vos, Fitzgerald, and the [state] Supreme Court majority failed us.”

Other concerned individuals and advocacy organizations issued similarly scathing critiques of Wisconsin’s lawmakers and high court while circulating on social media footage of longs lines at the limited polling stations that were able to open.

“Today there are five Milwaukee polling locations open. Usually there are 180 sites,” tweeted the group March for Our Lives. “There’s no way to skirt around it; this is wrong. People are forced to gather in long lines at central locations in the midst of a pandemic. Wisconsinites deserve better.”

Aquene Freechild, co-director of Public Citizen’s Democracy Is For People Campaign, said in a statement about the Wisconsin election that “these are dangerous times for democracy.”

“Vos and Fitzgerald know that, with only five polling locations open in the Democratic stronghold of Milwaukee, holding the election now will suppress the Democratic vote more than the GOP vote,” Freechild added. “That outcome will skew votes for some statewide elections, such as for the state Supreme Court, to their party.”

In a statement Tuesday, Harvard Law School professor and Equal Citizens founder Lawrence Lessig said, “That partisan politics would drive partisan leaders to force citizens to choose between accelerating a pandemic and exercising their right to vote is outrageous.”

Teasing an episode of the Intercepted podcast to be released Wednesday, journalist Jeremy Scahill—who grew up in Wisconsin—tweeted an audio clip of Milwaukee Health Commissioner Dr. Jeannette Kowalik explaining that “unfortunately it’s not” safe to tell voters to go to the polls.

“People are being forced to risk their lives to place their vote or fulfill their right as an American to vote. It’s just unbelievable that we are even having this conversation right now,” Kowalik said. She added that it has been “disheartening” to work behind-the-scenes on this issue and some people in positions of power in Wisconsin “are killing people by the decisions that they’re making.”

Service Employees International Union (SEIU) president Mary Kay Henry tweeted a video from a Milwaukee polling site and wrote that “this is a deliberate attempt by WI GOP to exclude voters, to limit participation, [and] to undermine democracy.”

In a lengthy Twitter thread, AFL-CIO president Richard Trumka, declared that “it’s unconscionable that Wisconsin voters are being forced to choose between their health amid a pandemic and their constitutional right to vote.”

“It’s unconscionable that Wisconsin voters are being forced to choose between their health amid a pandemic and their constitutional right to vote.”
—Richard Trumka, AFL-CIO

“Taking away the fundamental right to vote that so many have fought and died for is disgraceful. Democracy in our country is dying, and those meant to uphold our Constitution have failed miserably in their duty,” Trumka added. “Working people see what’s happening, and we’re not going to stand for it in November and beyond.”

Common Cause Wisconsin called Tuesday “a day that will live in infamy.” The group’s director, Jay Heck, said in a statement that “Wisconsin is the only state in the nation that has failed to step up and respond responsibly and safely to the current national health pandemic emergency. We have seven months until the general election and there is time to fix these issues before November to ensure we are protecting public health and the right to vote.”

Voters who participated in Wisconsin’s Tuesday election weighed in on local races as well as the Democratic presidential primary contest between Sen. Bernie Sanders (I-Vt.)—who spoke out against the state Supreme Court decision—and former Vice President Joe Biden, who remains the frontrunner and recently claimed that in-person voting could be done safely.

Election officials across Wisconsin took various steps to protect voters. Palmyra Clerk/Treasurer Laurie Mueller told the Milwaukee Journal Sentinel that the village’s sole polling place was moved to a bigger location.

According to the newspaper:

Mueller said a volunteer at the door is spray-sanitizing everyone’s hands as they enter, and voters are being instructed to take a pen to vote and then either throw it away or take it home with them.

Poll workers outfitted with masks and gloves are working behind sneeze guards made by the village’s public works employees. There are Xes on the floor at 6-foot intervals.

“We have a person wiping down the poll booths after everyone votes,” Mueller said, “and then randomly wiping down other areas in the voting location.”

Via Commondreams.org

Our work is licensed under a Creative Commons Attribution-Share Alike 3.0 License. Feel free to republish and share widely.

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Bonus Video added by Informed Comment:

The Young Turks: “Wisconsin Election PROVES Government Doesn’t Work For You”

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