Balancing the Budget with a Fog of Words

Words hide personal costs: ‘CHIP, Medicaid, Medicare, 100% of poverty ($20,400 for a family of three), covered benefits and ‘CSRs.’ Those programs are targeted to be reduced to balance the federal budget. At the same time current taxes on corporations and insurer will be repealed. Those tax cuts range from $95 billion to $580 billion and will go to corporations and some individuals.*

Yet, who really balances the budget? The child whose family earns $20,500 a year not $20,400? Or the The Medicaid nursing home resident who has no resources, home or relative? Where do Medicaid nursing home residents go? Medicare does not cover long-term nursing home care. Only Medicaid or some private insurance pay for long-term nursing home care. Long-term nursing home care is $5,000 to $7,000 per month.

Who is on Medicaid? Nearly 20% are children; 21% are seniors; 40% are blind or disabled and 19% are adults. ** Even Medicare cuts are proposed, but indirectly, in how it will pay physicians. In one awful year in the 1990’s, Mississippi was going to balance its state budget by cutting 13,000 Medicaid nursing home beds. Medicaid is jointly funded by the federal governments and the states.  If federal funds are cut, state funds will also be lost.

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Abandoning Our Children: Hiding Facts in Language?

My last blog lamented cuts to the Children’s Health Insurance Program (CHIP). The program is based on family income or “percent of poverty” allowed income. l

 In 2017, poverty income for a family of three could not be more than $20,420 per year. States can increase that to no more than 200%  of poverty, or $40,820 per year.  This language hides the raw facts of incomes for  families.  How many people with do know who could live on those incomes: For a full report, including charts (scroll down in article), see:

We can turn our backs on many things, but can we turn our back on our children?  You can make a difference to stop these cuts by contacting your elected officials at the national and state levels.  I urge you to do so.

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“A Kiss to the Donor Class”

The current Republican tax reform proposal: “…is not aimed at growth. It is not aimed at the middle class. It is at every turn carefully engineered to deliver a kiss to the donor class.”  (former chief of staff at the Congressional Joint Committee on Taxation in the NY Times), Nov. 30, 2017 (link below).

The current proposal,if passed as is, would, among other things, cut over 35 million children and pregnant women from  the Child Health Insurance Program that funds health care and social services for the neediest of children and their families.  35 million people is slightly less than the population of California with 39 million but more than Texas with 28 million people.

The direct and indirect consequences? Continue reading

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Old? Poor? Disabled? Poor Children? Mental Health or Addiction? Our National Shame

Over the last 3 years in Seattle, Washington over 12, 000 people received $10 million dollars in free medical and dental services. The services were provided by volunteer doctors, dentists and social workers, among others. There was a modest admission fee.  Care was on a first come, first served basis only.  Information flyers were available in several different languages.  Dental and vision care were included, but could not be provided completely on the same day.  We should express sincere gratitude and thanks to hospitals, health insurers and the foundation and corporate donors that made this possible as well as the  many physicians, dentists, social workers and other health professionals who donated their time.

BUT, why should we have such events?

We have fought endless fights over health care since Teddy Roosevelt if not earlier. In 1854 when asked for some federal support for the mentally ill, President Franklin Pierce said mental health was not a national problem.  States should take care of it. In 1869 the Supreme Court ruled: “insurance is not commerce” and therefore should be regulated by the states not the federal government.   When Teddy Roosevelt called for national health insurance in the 1920’s it was labeled ‘Socialist.’  He lost that election as a third party candidate.

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Alzheimer’s Disease Innovation in Japan

I don’t usually do this, but I find this article and innovation fascinating. My mother and Great Aunt had Alzheimer’s Disease so it is always on my radar.  Japan is considered one of the leaders in Alzheimer’s care.  I hope you find this article of interest:

If you would like me to send links to other articles I find of interest–good or bad–please let me know.  I scan stories every day.  Best,  Kathleen

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A Tale of A Stroke: Two People’s Love, Courage and Community– from Millionaire to Medicaid

Nearly 15  years ago I met and have gotten to know another health care journalist–Mary Koch. We have kept in contact over these many years and I had the honor of meeting her and her husband, who has since died after living for 15 years with a “locked-in” stroke.

He was totally dependent on others. He could not move, eat or speak.  His stroke, however, did not impact his intelligence or awareness. He had been a prominent journalist and newspaper publisher in Washington State. He was still totally aware and mentally alert yet “locked-in” physically.

They spent 15 miraculous years together in their home after his stroke. They created their own  ‘language.’ Their courage meant he could stay in their home with people he loved and who loved him. And with the love and support of their community.  Here is her blog about their experience. This blog struck my  health care reform soul. Mary’s story is one person’s personal story as only one who has lived it can tell.

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Rates, Regulations and Body Parts

Years ago I wrote an article about our Rates, Regulations and Body Parts approach to health care.  This approach has caused thousands of  legislative bills and laws for specific coverage and rates. A few examples include: 

  • Mental health
  • Children’s health
  • Medicaid and Medicare coverage
  • Medicare and Medicaid physician rates
  • State and federal insurance rates and regulations
  • Private insurance policies and rates
  • Veterans’ health
  • Disability coverage
  • Insurance networks
  • Addiction coverage
  • Women’s health and maternity care
  • End Stage Renal Disease
  • Large employers such as Microsoft or General Motors,  are exempt from state insurance regulations and state insurance taxes.

And consider this: Continue reading

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Interesting Stories on ER Costs and More

I am in the throes of moving, but I found this article of interest, especially since it originates with a hospital north of Spokane, Washington. Not quite in my backyard, but close enough to be of interest.  I don’t have time for commentary, except to say this is not restricted to Washington state or Spokane.  It is the problem of defined networks. If the doctor is not in the network the patient pays the bill whether they are in control of where they are seen or by whom.

Too often too many patients have no choices or voice.  I find the particularly mean spirited–billing people for something beyond their control because where they received care that was not in their network. This at a time when they could have no say in where they were going and who they were going to see.

There is something very, very wrong with this picture.   Here’s the story.  You may also find the other articles interesting as well.

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Medicare, Medicaid and Republican Proposal: What It Means for You


Insurance is the law of large numbers. Without a long dissertation—here are some basics:  You need many healthy people to offset the costs of sicker people. You need healthy people to offset the costs of older and often sicker people.  Having everyone in one plan would lower the costs for everyone by spreading the risk.  That’s health care insurance.

Poor people tend to be less healthy, so their costs of care are often more than those who are not poor. Seniors are more expensive simply because they are aging.  The poor and the old are on Medicaid.  Medicaid is a major issue in current proposals.  Nearly 2/3 of Medicaid costs are for seniors and disabled  in nursing homes.  Over 64% of all people in nursing homes are on Medicaid. They are on Medicaid because Medicare does not cover long-term nursing home care.  Most people cannot afford long term care which can be $5-$7,000 a month.  Women, children represent and single adults are only 1/3 of Medicaid costs.

               In one horrific case in 2003, one state contemplated cutting 13,000 Medicaid nursing home beds to balance the state’s budget.  I double checked and called the governor’s office that confirmed this.  After back and forth fights with the legislature that did not happen. The fact this was even considered is chilling. Medicaid is funded by both the state and the federal government.  When state budgets get tight, Medicaid is often on the chopping block. With a growing aging population more people will be cut from Medicaid or alternatives found.

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Our Life, Liberty and Pursuit of Happiness

Our country is founded on essential rights: we are created equal; we all have equal protection under the law and we all have  the right to life, liberty and the pursuit of happiness. Health care is essential to those rights

We have national standards for banking, transportation and insurance solvency. National standards for health care have failed since 1869 and  the original Supreme Court ruling that  health care is not commerce.  The Affordable Care Act created national benefit standards for the first time, except for Medicare and Medicaid.

Fear of government interference in costs and benefits drives opposition to national standards. Briefly:

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