Objections to Medicare-for-All — and the first, necessary step

Twitter: @rodgermitchell; Search #monetarysovereignty
Facebook: Rodger Malcolm Mitchell

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It takes only two things to keep people in chains: The ignorance of the oppressed and the treachery of their leaders..
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The Republicans put forth their “Health Care Only for the Rich” plan, and saw the public, for some strange reason, not wanting health care to be available only for the rich.Image result for rich government poor people

So now, after 7 years of searching for an idea, the GOP is searching for an idea.

We long have recommended Step #2 of the Ten Steps to Prosperity: FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (See below). The Federal government, being Monetarily Sovereign, easily can fund the whole program, without any FICA collections.

Financially, the solution is a no-brainer. The federal government can afford it; the public is strapped for funds. So who should pay?

But a recent article in The Week describes problems other than mere finances. Here are some excerpts, along with our comments:

Why ‘Medicare for all’ is easy to say and near impossible to do
David Faris

Bernie Sanders premised his primary campaign in large part on a radical promise to ditch Obama’s signature legislative achievement in favor of extending Medicare to all Americans.

The phenomenal success of Sanders’ insurgent socialist campaign proved again that the ACA was unpopular in large part because millions of Americans think the state should be doing more rather than less. 

Yet there are a number of important questions about any single-payer plan that remain not just unanswered, but mostly unasked.

Let’s imagine that, somehow, progressives succeed in enacting “Medicare for all.” What does the transition period look like between the passage of such legislation and its full implementation?

What would happen to the health insurance companies that employ over half a million people? Would they be compensated for their losses?

Health insurance companies still could exist, though in a much-reduced form. They could provide coverage for those who do not like Medicare, either because they believe it to be too restrictive in its coverages, or because their doctors won’t accept it, or for other reasons.

If people have a choice between free health care from Medicare or paid health care from private insurance, most will choose free, but some will chose private.

So yes, like many industries through the years, the health care insurance industry will shrink. Think of the coal industry.  And the record-pressing companies.

And, when was the last time you used a public land-line telephone? Their manufacturers must be feeling the pinch.

Most industries that continue to exist today have become more efficient (i.e. use fewer people and more machines). Business evolves.

What would happen to the medical debt of doctors who would almost certainly face diminished economic prospects under single-payer? (Most Americans think physicians are rich — true in some cases — yet many doctors rack up over $200,000 in debt to attend medical school.)

These problems are not the fault of Medicare or of any future Medicare-for-All.  They result from the Big Lie, the ridiculous claim that somehow our Monetarily Sovereign federal government can run short of its own sovereign currency, so it needs to husband its financial resources.

For that reason, Medicare underpays doctors, a situation in need of change, whether or not Medicare-for-All is instituted.

And medical school, like all other schools, should be free.  See: Free education for everyone.  Again, this has nothing to do with Medicare-for-All.

Primary care doctors and rural areas — generally pay the worst and already have trouble attracting physicians for that very reason. What happens to the supply and demand of care when tens of thousands of doctors earn less?

And yet again, why pay them less? This has nothing to do with single payer.

Do we have even remotely the civilian bureaucratic know-how we would need to scale Medicare up to the entire 320-million-strong population of the United States? The Centers For Medicare and Medicaid Services employ more than 6,000 people. That number would probably need to be, conservatively, quadrupled.

That probably was one of the objections to the original Medicare.  Yet here Medicare is, functioning better than most federal programs.  It is far more difficult to begin a program from scratch than to expand an existing, functioning program, which federally funded, Medicare-for-All would do.

And note the concern about hiring more people, juxtaposed against the concern about insurance companies firing people.  Strange.

Remember that a committed and well-intentioned Democratic administration had trouble just setting up a website for a tiny fraction of the number of people who would be covered by a new single-payer system.

Running a nationalized health care system would be considerably more complicated than cutting monthly Social Security checks to people.

A Medicare-for-All  website would be nearly identical to the currently, well-functioning Medicare website.  The primary difference would be simply handling more people — an easily solved Internet problem, not a program problem.

Political questions abound as well. Republicans spent seven years hammering ObamaCare, which remained mired in negative approval ratings.

Medicare, by contrast, is not “mired in negative approval ratings.” Medicare-for-All transfers people from the less-loved ACA program to the highly appreciated Medicare program.

Americans who just months ago were complaining about the ACA’s deductibles and coverage options were faced with the prospect of losing their insurance coverage altogether, along with their right to be covered if they have a pre-existing condition.

ObamaCare has drifted into majority approval, and the Republicans’ hot, hastily conceived, cruel, vindictive mess of an alternative was opposed by a whopping 3-1 majority.

A similar problem would vex Democrats almost immediately, in the same way that it did when they got to work on the ACA in the first place. It’s what happens when various stakeholders in existing, complex, and flawed processes realize that their interests are deeply threatened.

The above is a rather pitiful argument for never making any big changes. It was true of Medicare, Social Security, Medicaid and enlisting women, blacks, and gays into the military, and going to the moon.

The maximal version of “Medicare for all” would involve, in a quite literal sense, stripping hundreds of millions of people of their existing private insurance coverage.

No, it would give people the choice of free health care insurance vs. paid-for health care insurance. Undoubtedly, more people would select free, but some people might prefer what the private insurance companies offer.

No one would be “stripped.”

There are only three hundred million people in all of America, so the notion that “hundreds of millions of people” would lose health insurance is laughable or outrageous, depending on one’s sense of humor.

The GOP has waged a scorched-earth campaign against the ACA and has failed spectacularly. For Democrats, launching another huge, divisive struggle over health care would be like if Truman had decided to go ahead and fight the Soviets over Eastern Europe at the conclusion of WWII.

What a ridiculous analagy. No, it isn’t like that at all (though then, the Soviets were weak).  The first step would be to convince the populace that the Big Lie indeed is a lie.  Once people understand Monetary Sovereignty, the institution of Medicare-for-All would be a “why-have-you-waited-so-long?”

Bottom line: Medicare-for-All is a natural outgrowth of Monetary Sovereignty. The only reason not to adopt it is the affordability myth, the notion that taxpayers would have to pay for it.

Once people understand that they would not have to pay for other people’s health care, and that yes, for a Monetarily Sovereign nation, lunch really can be free, objections to Medicare-for-All would melt like a snowman in a summer sun.

Rodger Malcolm Mitchell
Monetary Sovereignty

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The single most important problems in economics involve the excessive income/wealth/power Gaps between the have-mores and the have-less.

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.

Implementation of The Ten Steps To Prosperity can narrow the Gaps:

Ten Steps To Prosperity:
1. ELIMINATE FICA (Ten Reasons to Eliminate FICA )
Although the article lists 10 reasons to eliminate FICA, there are two fundamental reasons:
*FICA is the most regressive tax in American history, widening the Gap by punishing the low and middle-income groups, while leaving the rich untouched, and
*The federal government, being Monetarily Sovereign, neither needs nor uses FICA to support Social Security and Medicare.
2. FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (H.R. 676, Medicare for All )
This article addresses the questions:
*Does the economy benefit when the rich can afford better health care than can the rest of Americans?
*Aside from improved health care, what are the other economic effects of “Medicare for everyone?”
*How much would it cost taxpayers?
*Who opposes it?”
3. PROVIDE A MONTHLY ECONOMIC BONUS TO EVERY MAN, WOMAN AND CHILD IN AMERICA (similar to Social Security for All) (The JG (Jobs Guarantee) vs the GI (Guaranteed Income) vs the EB (Guaranteed Income)) Or institute a reverse income tax.
This article is the fifth in a series about direct financial assistance to Americans:

Why Modern Monetary Theory’s Employer of Last Resort is a bad idea. Sunday, Jan 1 2012
MMT’s Job Guarantee (JG) — “Another crazy, rightwing, Austrian nutjob?” Thursday, Jan 12 2012
Why Modern Monetary Theory’s Jobs Guarantee is like the EU’s euro: A beloved solution to the wrong problem. Tuesday, May 29 2012
“You can’t fire me. I’m on JG” Saturday, Jun 2 2012

Economic growth should include the “bottom” 99.9%, not just the .1%, the only question being, how best to accomplish that. Modern Monetary Theory (MMT) favors giving everyone a job. Monetary Sovereignty (MS) favors giving everyone money. The five articles describe the pros and cons of each approach.
4. FREE EDUCATION (INCLUDING POST-GRAD) FOR EVERYONE Five reasons why we should eliminate school loans
Monetarily non-sovereign State and local governments, despite their limited finances, support grades K-12. That level of education may have been sufficient for a largely agrarian economy, but not for our currently more technical economy that demands greater numbers of highly educated workers.
Because state and local funding is so limited, grades K-12 receive short shrift, especially those schools whose populations come from the lowest economic groups. And college is too costly for most families.
An educated populace benefits a nation, and benefitting the nation is the purpose of the federal government, which has the unlimited ability to pay for K-16 and beyond.
5. SALARY FOR ATTENDING SCHOOL
Even were schooling to be completely free, many young people cannot attend, because they and their families cannot afford to support non-workers. In a foundering boat, everyone needs to bail, and no one can take time off for study.
If a young person’s “job” is to learn and be productive, he/she should be paid to do that job, especially since that job is one of America’s most important.
6. ELIMINATE FEDERAL TAXES ON BUSINESS
Businesses are dollar-transferring machines. They transfer dollars from customers to employees, suppliers, shareholders and the federal government (the later having no use for those dollars). Any tax on businesses reduces the amount going to employees, suppliers and shareholders, which diminishes the economy. Ultimately, all business taxes reduce your personal income.
7. INCREASE THE STANDARD INCOME TAX DEDUCTION, ANNUALLY. (Refer to this.) Federal taxes punish taxpayers and harm the economy. The federal government has no need for those punishing and harmful tax dollars. There are several ways to reduce taxes, and we should evaluate and choose the most progressive approaches.
Cutting FICA and business taxes would be a good early step, as both dramatically affect the 99%. Annual increases in the standard income tax deduction, and a reverse income tax also would provide benefits from the bottom up. Both would narrow the Gap.
8. TAX THE VERY RICH (THE “.1%) MORE, WITH HIGHER PROGRESSIVE TAX RATES ON ALL FORMS OF INCOME. (TROPHIC CASCADE)
There was a time when I argued against increasing anyone’s federal taxes. After all, the federal government has no need for tax dollars, and all taxes reduce Gross Domestic Product, thereby negatively affecting the entire economy, including the 99.9%.
But I have come to realize that narrowing the Gap requires trimming the top. It simply would not be possible to provide the 99.9% with enough benefits to narrow the Gap in any meaningful way. Bill Gates reportedly owns $70 billion. To get to that level, he must have been earning $10 billion a year. Pick any acceptable Gap (1000 to 1?), and the lowest paid American would have to receive $10 million a year. Unreasonable.
9. FEDERAL OWNERSHIP OF ALL BANKS (Click The end of private banking and How should America decide “who-gets-money”?)
Banks have created all the dollars that exist. Even dollars created at the direction of the federal government, actually come into being when banks increase the numbers in checking accounts. This gives the banks enormous financial power, and as we all know, power corrupts — especially when multiplied by a profit motive.
Although the federal government also is powerful and corrupted, it does not suffer from a profit motive, the world’s most corrupting influence.
10. INCREASE FEDERAL SPENDING ON THE MYRIAD INITIATIVES THAT BENEFIT AMERICA’S 99.9% (Federal agencies)Browse the agencies. See how many agencies benefit the lower- and middle-income/wealth/ power groups, by adding dollars to the economy and/or by actions more beneficial to the 99.9% than to the .1%.
Save this reference as your primer to current economics. Sadly, much of the material is not being taught in American schools, which is all the more reason for you to use it.

The Ten Steps will grow the economy, and narrow the income/wealth/power Gap between the rich and you.

MONETARY SOVEREIGNTY

America won. Now is our chance to get health care right

Twitter: @rodgermitchell; Search #monetarysovereignty
Facebook: Rodger Malcolm Mitchell

…………………………………………………………………………………………………………………………………………………………………………..
It takes only two things to keep people in chains: The ignorance of the oppressed and the treachery of their leaders..
………………………………………………………………………………………………………………………………………………………………………………

After more than 7 years of ridiculous political posturing, and more than 50 votes, the Republicans presented a meaningless and a truly horrible plan that America hated. So Trump et al predictably threw in the towel as bullies always do when faced with defeat.

The plan the Republicans presented would have screwed virtually everyone except the rich, who would have been rewarded — a perfect score for the extreme right, who consider the poor to be lazy “takers.”

Image result for the working poor
Too “lazy” for health care?

 

But, before rational minds rejoice too much, let’s address the fact that the ACA is itself a lousy plan. It is an expensive, Rube Goldbergian, basket-case of little competing fixes, that punish some poor to reward other poor — all unnecessarily.

The federal government, being Monetarily Sovereign, never can run short of dollars, and in fact, creates new dollars every time it pays a bill. So why are we asking people to pay for something the government should fund?

Eventually, when every terrible scheme to “save-the-government-money-by-costing-the-public-money” has failed, and health care still is lacking in America, perhaps we finally will come to the only plan guaranteed to work: Federally funded Medicare and long-term care for every man, woman, and child in America (Step #2 of the Ten Steps to Prosperity — below).

We already know how to do Medicare.  We have been doing it for many years, and the vast majority of people who have Medicare like it. So functionally, we would have no difficulty expanding this program, with which we have great experience, to our younger people.

And I’m not talking about the Bernie Sanders program, that is based on not costing the federal government “too much.”

Posted March 24, 2017 11:47 am Amarillo Globe-News
Letter: Single-payer health insurance is the right medicine 

Insurance works because everyone pays a premium so everyone can be given care as needed.

Imagine a health care system where every dime went to health care and none to lawyers and insurance companies for their expenses and profit. They tell us that this competition is necessary for us to receive the best product at the best price.

How about a fantasy world where health care providers are competing for your health care dollar? I am talking about single-payer health insurance. Premiums and charges go to one place, and that place pays the providers.

Then we could say, “spend your money here because we offer the best thing you can do with your money and we will take care of you.”

No, not the kind of single-payer system where doctors and hospitals compete for dollars — that sort of competition simply would lead to worse care. The hospital with the fewest nurses, and the doctor who packed in the most patients would win.

We should have a system in which the federal government is generous enough in its payments, to allow for better doctoring, and to encourage more students to enter medicine.

It would be a health care system generous enough to reduce the trend for “boutique” doctors, who charge flat fees in advance.

It would be a health care system in which 100% is funded by the federal government, so that no one would even have to think twice about the cost of consulting a doctor or going to a hospital or taking medicine.

Remember, every dollar paid by the government increases Gross Domestic Product, and costs you nothing. (That’s right. Taxpayers don’t pay for federal spending.)

Until we rid ourselves of the twin myths that reduced federal spending benefits the economy, and increased federal spending is “unsustainable,” we forever will create plan after plan that costs too much and leaves too many people out.

Obamacare is garbage. Trumpcare was even worse garbage. So we now have settled for the lesser of two garbages, all because of ignorance.

As a last resort, after all the wrong steps have been taken, and we are exhausted with failure, let’s be smart: Enact federally funded Medicare and long-term care for every man, woman, and child in America.

That would help “make America great again.

Rodger Malcolm Mitchell
Monetary Sovereignty

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..

The single most important problems in economics involve the excessive income/wealth/power Gaps between the have-mores and the have-less.

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.

Implementation of The Ten Steps To Prosperity can narrow the Gaps:

Ten Steps To Prosperity:
1. ELIMINATE FICA (Ten Reasons to Eliminate FICA )
Although the article lists 10 reasons to eliminate FICA, there are two fundamental reasons:
*FICA is the most regressive tax in American history, widening the Gap by punishing the low and middle-income groups, while leaving the rich untouched, and
*The federal government, being Monetarily Sovereign, neither needs nor uses FICA to support Social Security and Medicare.
2. FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (H.R. 676, Medicare for All )
This article addresses the questions:
*Does the economy benefit when the rich can afford better health care than can the rest of Americans?
*Aside from improved health care, what are the other economic effects of “Medicare for everyone?”
*How much would it cost taxpayers?
*Who opposes it?”
3. PROVIDE A MONTHLY ECONOMIC BONUS TO EVERY MAN, WOMAN AND CHILD IN AMERICA (similar to Social Security for All) (The JG (Jobs Guarantee) vs the GI (Guaranteed Income) vs the EB (Guaranteed Income)) Or institute a reverse income tax.
This article is the fifth in a series about direct financial assistance to Americans:

Why Modern Monetary Theory’s Employer of Last Resort is a bad idea. Sunday, Jan 1 2012
MMT’s Job Guarantee (JG) — “Another crazy, rightwing, Austrian nutjob?” Thursday, Jan 12 2012
Why Modern Monetary Theory’s Jobs Guarantee is like the EU’s euro: A beloved solution to the wrong problem. Tuesday, May 29 2012
“You can’t fire me. I’m on JG” Saturday, Jun 2 2012

Economic growth should include the “bottom” 99.9%, not just the .1%, the only question being, how best to accomplish that. Modern Monetary Theory (MMT) favors giving everyone a job. Monetary Sovereignty (MS) favors giving everyone money. The five articles describe the pros and cons of each approach.
4. FREE EDUCATION (INCLUDING POST-GRAD) FOR EVERYONE Five reasons why we should eliminate school loans
Monetarily non-sovereign State and local governments, despite their limited finances, support grades K-12. That level of education may have been sufficient for a largely agrarian economy, but not for our currently more technical economy that demands greater numbers of highly educated workers.
Because state and local funding is so limited, grades K-12 receive short shrift, especially those schools whose populations come from the lowest economic groups. And college is too costly for most families.
An educated populace benefits a nation, and benefitting the nation is the purpose of the federal government, which has the unlimited ability to pay for K-16 and beyond.
5. SALARY FOR ATTENDING SCHOOL
Even were schooling to be completely free, many young people cannot attend, because they and their families cannot afford to support non-workers. In a foundering boat, everyone needs to bail, and no one can take time off for study.
If a young person’s “job” is to learn and be productive, he/she should be paid to do that job, especially since that job is one of America’s most important.
6. ELIMINATE FEDERAL TAXES ON BUSINESS
Businesses are dollar-transferring machines. They transfer dollars from customers to employees, suppliers, shareholders and the federal government (the later having no use for those dollars). Any tax on businesses reduces the amount going to employees, suppliers and shareholders, which diminishes the economy. Ultimately, all business taxes reduce your personal income.
7. INCREASE THE STANDARD INCOME TAX DEDUCTION, ANNUALLY. (Refer to this.) Federal taxes punish taxpayers and harm the economy. The federal government has no need for those punishing and harmful tax dollars. There are several ways to reduce taxes, and we should evaluate and choose the most progressive approaches.
Cutting FICA and business taxes would be a good early step, as both dramatically affect the 99%. Annual increases in the standard income tax deduction, and a reverse income tax also would provide benefits from the bottom up. Both would narrow the Gap.
8. TAX THE VERY RICH (THE “.1%) MORE, WITH HIGHER PROGRESSIVE TAX RATES ON ALL FORMS OF INCOME. (TROPHIC CASCADE)
There was a time when I argued against increasing anyone’s federal taxes. After all, the federal government has no need for tax dollars, and all taxes reduce Gross Domestic Product, thereby negatively affecting the entire economy, including the 99.9%.
But I have come to realize that narrowing the Gap requires trimming the top. It simply would not be possible to provide the 99.9% with enough benefits to narrow the Gap in any meaningful way. Bill Gates reportedly owns $70 billion. To get to that level, he must have been earning $10 billion a year. Pick any acceptable Gap (1000 to 1?), and the lowest paid American would have to receive $10 million a year. Unreasonable.
9. FEDERAL OWNERSHIP OF ALL BANKS (Click The end of private banking and How should America decide “who-gets-money”?)
Banks have created all the dollars that exist. Even dollars created at the direction of the federal government, actually come into being when banks increase the numbers in checking accounts. This gives the banks enormous financial power, and as we all know, power corrupts — especially when multiplied by a profit motive.
Although the federal government also is powerful and corrupted, it does not suffer from a profit motive, the world’s most corrupting influence.
10. INCREASE FEDERAL SPENDING ON THE MYRIAD INITIATIVES THAT BENEFIT AMERICA’S 99.9% (Federal agencies)Browse the agencies. See how many agencies benefit the lower- and middle-income/wealth/ power groups, by adding dollars to the economy and/or by actions more beneficial to the 99.9% than to the .1%.
Save this reference as your primer to current economics. Sadly, much of the material is not being taught in American schools, which is all the more reason for you to use it.

The Ten Steps will grow the economy, and narrow the income/wealth/power Gap between the rich and you.
MONETARY SOVEREIGNTY

The one solution to the Obamacare (ACA) problem that neither party talks about

Twitter: @rodgermitchell; Search #monetarysovereignty
Facebook: Rodger Malcolm Mitchell

………………………………………………………………………………………………………………………………………..
It takes only two things to keep people in chains: The ignorance of the oppressed and the treachery of their leaders..

…………………………………………………………………………………………………………………………………………………………………………………..

Let’s agree on two points:

  1. The fundamental purpose of a government is to benefit and protect its people.
  2. The U.S. government, being Monetarily Sovereign, never can run short of its own sovereign currency, the U.S. dollar. Even if federal taxes were $0, the U.S. still could pay any financial obligations denominated in dollars. Your taxes do not pay for federal spending.

Keep those points in mind as we walk through an article that appeared in the Feb. 22, 2017 issue of NPR’s “SHOTS.”

Following each quoted section of the article, we will ask a question.  See how many of those questions you can answer.

GOP Considers Trimming Health Law’s 10 Essential Benefits
By Michelle Andrews

As Republicans look at ways to replace or repair the Affordable Care Act, many suggest that shrinking the list of services that insurers are required to offer in individual and small group plans would reduce costs and increase flexibility.

Immediately we should ask, “Why do Republicans want to replace or repair ACA?”  

Many “deficiencies” of ACA have been proffered, and one would think that correcting those deficiencies would be a prime goal. Yet, seemingly the prime goal is to cut or eliminate the program, not to improve it for the benefit of the people.

Why?

Seema Verma, who is slated to run the Centers for Medicare & Medicaid Services in the Trump administration, noted at her confirmation hearing that coverage for maternity services should be optional in those health plans.

Given that the federal government has the unlimited ability to fund benefits, how does making coverage for maternity services optional improve ACA?

How does this advance the federal government’s mandate to “benefit and protect its people?”

The Affordable Care Act requires that insurers who sell policies for individuals and small businesses cover at a minimum 10 “essential health benefits,” including hospitalization, prescription drugs and emergency care, in addition to maternity services.

The law also requires that the scope of the services offered be equal to those typically provided in the coverage that businesses offer their employees.

Image result for benefit for the peopleThe law requires the Monetarily Sovereign federal government to offer services equal to those typically provided by monetarily non-sovereign businesses.

Are we expected to believe it is difficult for a government that never can run short of dollars, to offer what a business that can run short of dollars, offers?

“It has to look like a typical employer plan, and those are still pretty generous,” says Timothy Jost, an emeritus professor at Washington and Lee University Law School in Virginia.

Since the 10 required benefits are spelled out in the Affordable Care Act, the law would have to be changed to eliminate entire categories or to make them less generous than typical employer coverage.

And since Republicans likely cannot garner 60 votes in the Senate to do that, they will be limited in changes that they can make to the ACA.

Still, there’s room to “skinny up” the requirements in some areas by changing the regulations that federal officials wrote to implement the law.

Why would a government that can afford anything, and is charged with the duty to benefit and protect its constituents, even consider “skinnying up” benefits? Why make them “less generous”?Image result for benefit for the people

Shouldn’t the government instead, look for ways to improve benefits to the populace?

The law requires that plans cover “rehabilitative and habilitative services and devices.” Many employer plans don’t include include habilitative services, which help people with developmental disabilities such as palsy or autism maintain, learn or improve their functional skills, via speech or occupational therapy or other support services.

Federal officials issued a regulation that defined habilitative services and directed plans to set separate limits for the number of covered visits for rehabilitative and habilitative services. Those rules could be changed.

“There is real room for weakening the requirements” for habilitative services, says Dania Palanker, an attorney and assistant research professor at Georgetown University’s Center on Health Insurance Reforms, who has reviewed the essential health benefits coverage requirements.

Why would a government that can afford anything, “weaken” the benefits to disabled people, most of whom would find habilitative services a financial burden, and whose very life is a struggle?

Pediatric oral and vision care requirements, another essential health benefit that’s not particularly common in employer plans, could also be weakened, says Caroline Pearson, a senior vice president at the consulting firm Avalere Health.

And why would our government that can afford anything not want to provide pediatric oral and vision care to Americans?

The health law requires all individual and small group plans to cover “mental health services and treatements for substance use disorders.”

The Obama administration said that means those services have to be provided at “parity” with medical and surgical services, meaning plans can’t be more restrictive with one type of coverage than the other regarding cost sharing, treatment and care management.

“They could back off of parity,” Palanker says.

Why do the Republicans not want the government to provide these services to Americans? 

Prescription drug coverage could be tinkered with as well. The rules currently require that plans cover at least one drug in every drug class, a standard that isn’t particularly robust to start with, says Katie Kieth, a health policy consultant and adjunct professor at Georgetown Law School.

That standard could be relaxed further, Keith says, and the list of required covered drugs could shrink.

Why force the money-limited public to pay for prescription drugs when the federal government is not money-limited and easily could pay?

Republicans have discussed trimming or eliminating some of the preventive services that are required to be offered without cost sharing. Among those is covering birth control without charging women anything out of pocket.

Why cut preventative benefits? Isn’t prevention better than cure? How does this improve the plan?

Before the health law passed, just 12 percent of health policies available to a 30-year-old woman on the individual market offered maternity benefits, according to research by the National Women’s Law Center. Those policies that did offer such benefits often charged extra for the coverage and required a waiting period of a year or more.

The essential health benefits package plugged that hole very cleanly, says Adam Sonfeld, a senior policy manager at the Guttmacher Institute, a reproductive health research and advocacy organization.

“Having it in the law makes it more difficult to either exclude it entirely or charge an arm and a leg for it,” Sonfield says.

Maternity coverage is often offered as an example of a benefit that should be optional, and that’s what Verma has advocated.

If you’re a man or too old to get pregnant, critics of the requirement say, why should you have to pay for that coverage to be included in your policy?

But if the government pays, that man doesn’t pay.  So, why should women be denied those benefits?

But that a la carte approach is not the way insurance is designed to work, says Linda Blumberg, a senior fellow at the Health Policy Center at the Urban Institute. Women don’t need prostate cancer screening, she points out, but they pay for the coverage anyway.

“We buy insurance for uncertainty and to spread the costs of care across a broad population so that when something comes up, that person has adequate coverage to meet their needs,” Blumberg says.

Blumberg is correct as per private insurance, in which we all pay for hundreds of benefit coverages we don’t use so that the few coverages we do use will be available. That is what private insurance is all about.

Your private insurance may cover cancer care, but even if you never get cancer, you still pay for the whole policy.

But, we’re not even talking about private insurance.  We’re talking about federally funded insurance (or insurance that should be federally funded). 

And this brings us to the fundamental problem with all discussions about ACA: The program was created under the pretense that the federal government’s finances are like your and my finances — the pretense that the federal government can run short of dollars, just like you and me.

So young healthy people are forced to fund ACA coverages they likely won’t use for many years, as is the case with privately funded insurance.

This is known as “The Big Lie,” the purpose of which is to make the public believe their lives cannot be improved because the government doesn’t have enough money.

There is a solution, a simple solution, an affordable solution, a solution that increases benefits to the American public rather than cutting benefits.

The solution is: Federally funded, comprehensive Medicare for every man, woman, and child in America. (Step #2 of the Ten Steps to Prosperity, below).

Phone your Washington Congressperson and tell him/her to stop cutting benefits, stop telling the Big Lie, and start representing your interests.

Rodger Malcolm Mitchell
Monetary Sovereignty

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The single most important problems in economics involve the excessive income/wealth/power Gaps between the have-mores and the have-less.

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.

Implementation of The Ten Steps To Prosperity can narrow the Gaps:

Ten Steps To Prosperity:
1. ELIMINATE FICA (Ten Reasons to Eliminate FICA )
Although the article lists 10 reasons to eliminate FICA, there are two fundamental reasons:
*FICA is the most regressive tax in American history, widening the Gap by punishing the low and middle-income groups, while leaving the rich untouched, and
*The federal government, being Monetarily Sovereign, neither needs nor uses FICA to support Social Security and Medicare.
2. FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (H.R. 676, Medicare for All )
This article addresses the questions:
*Does the economy benefit when the rich can afford better health care than can the rest of Americans?
*Aside from improved health care, what are the other economic effects of “Medicare for everyone?”
*How much would it cost taxpayers?
*Who opposes it?”
3. PROVIDE A MONTHLY ECONOMIC BONUS TO EVERY MAN, WOMAN AND CHILD IN AMERICA (similar to Social Security for All) (The JG (Jobs Guarantee) vs the GI (Guaranteed Income) vs the EB (Guaranteed Income)) Or institute a reverse income tax.
This article is the fifth in a series about direct financial assistance to Americans:

Why Modern Monetary Theory’s Employer of Last Resort is a bad idea. Sunday, Jan 1 2012
MMT’s Job Guarantee (JG) — “Another crazy, rightwing, Austrian nutjob?” Thursday, Jan 12 2012
Why Modern Monetary Theory’s Jobs Guarantee is like the EU’s euro: A beloved solution to the wrong problem. Tuesday, May 29 2012
“You can’t fire me. I’m on JG” Saturday, Jun 2 2012

Economic growth should include the “bottom” 99.9%, not just the .1%, the only question being, how best to accomplish that. Modern Monetary Theory (MMT) favors giving everyone a job. Monetary Sovereignty (MS) favors giving everyone money. The five articles describe the pros and cons of each approach.
4. FREE EDUCATION (INCLUDING POST-GRAD) FOR EVERYONE Five reasons why we should eliminate school loans
Monetarily non-sovereign State and local governments, despite their limited finances, support grades K-12. That level of education may have been sufficient for a largely agrarian economy, but not for our currently more technical economy that demands greater numbers of highly educated workers.
Because state and local funding is so limited, grades K-12 receive short shrift, especially those schools whose populations come from the lowest economic groups. And college is too costly for most families.
An educated populace benefits a nation, and benefitting the nation is the purpose of the federal government, which has the unlimited ability to pay for K-16 and beyond.
5. SALARY FOR ATTENDING SCHOOL
Even were schooling to be completely free, many young people cannot attend, because they and their families cannot afford to support non-workers. In a foundering boat, everyone needs to bail, and no one can take time off for study.
If a young person’s “job” is to learn and be productive, he/she should be paid to do that job, especially since that job is one of America’s most important.
6. ELIMINATE FEDERAL TAXES ON BUSINESS
Businesses are dollar-transferring machines. They transfer dollars from customers to employees, suppliers, shareholders and the federal government (the later having no use for those dollars). Any tax on businesses reduces the amount going to employees, suppliers and shareholders, which diminishes the economy. Ultimately, all business taxes reduce your personal income.
7. INCREASE THE STANDARD INCOME TAX DEDUCTION, ANNUALLY. (Refer to this.) Federal taxes punish taxpayers and harm the economy. The federal government has no need for those punishing and harmful tax dollars. There are several ways to reduce taxes, and we should evaluate and choose the most progressive approaches.
Cutting FICA and business taxes would be a good early step, as both dramatically affect the 99%. Annual increases in the standard income tax deduction, and a reverse income tax also would provide benefits from the bottom up. Both would narrow the Gap.
8. TAX THE VERY RICH (THE “.1%) MORE, WITH HIGHER PROGRESSIVE TAX RATES ON ALL FORMS OF INCOME. (TROPHIC CASCADE)
There was a time when I argued against increasing anyone’s federal taxes. After all, the federal government has no need for tax dollars, and all taxes reduce Gross Domestic Product, thereby negatively affecting the entire economy, including the 99.9%.
But I have come to realize that narrowing the Gap requires trimming the top. It simply would not be possible to provide the 99.9% with enough benefits to narrow the Gap in any meaningful way. Bill Gates reportedly owns $70 billion. To get to that level, he must have been earning $10 billion a year. Pick any acceptable Gap (1000 to 1?), and the lowest paid American would have to receive $10 million a year. Unreasonable.
9. FEDERAL OWNERSHIP OF ALL BANKS (Click The end of private banking and How should America decide “who-gets-money”?)
Banks have created all the dollars that exist. Even dollars created at the direction of the federal government, actually come into being when banks increase the numbers in checking accounts. This gives the banks enormous financial power, and as we all know, power corrupts — especially when multiplied by a profit motive.
Although the federal government also is powerful and corrupted, it does not suffer from a profit motive, the world’s most corrupting influence.
10. INCREASE FEDERAL SPENDING ON THE MYRIAD INITIATIVES THAT BENEFIT AMERICA’S 99.9% (Federal agencies)Browse the agencies. See how many agencies benefit the lower- and middle-income/wealth/ power groups, by adding dollars to the economy and/or by actions more beneficial to the 99.9% than to the .1%.
Save this reference as your primer to current economics. Sadly, much of the material is not being taught in American schools, which is all the more reason for you to use it.

The Ten Steps will grow the economy, and narrow the income/wealth/power Gap between the rich and you.

MONETARY SOVEREIGNTY

Ten Steps to Prosperity: Step 2. Federally funded Medicare — Parts A, B & D, plus long-term care — for everyone

Twitter: @rodgermitchell; Search #monetarysovereignty
Facebook: Rodger Malcolm Mitchell

It takes only two things to keep people in chains: The ignorance of the oppressed and the treachery of their leaders.

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If you were to select the single best measure of a nation’s greatness, you would be hard-pressed to find one better than the healthcare of its people.

Background:

As we learned previously, our Monetarily Sovereign nation never can run low on its own sovereign currency, the U.S. dollar, and also has the unlimited ability to determine the value of the dollar (i.e. prevent inflation).

Further, federal deficits build the economy, while federal surpluses or deficit reductions (i.e. “austerity”) weaken the economy. Given those facts, what should the federal government do.  More generally: What is the purpose of government?

The fundamental purpose of any government is to enhance the wellbeing of its people — all its people — rich and poor, old and young, strong and weak.

In this series describing the Ten Steps to Prosperity, we suggested eliminating FICA as the first Step. For the second Step, we suggest:

Step 2: Federally funded Medicare — Parts A, B & D, plus long-term care — for everyone

Fortunately, most of the hard work is done.  We already know how to do Medicare. We have encountered and addressed all the functional difficulties. No operational mysteries remain.

We now need to do just four things:

  1. Change the minimum age of recipients to zero
  2. Change Part D to a federally funded program, rather than a private insurance funded program.
  3. Expand Medicare benefits to include even those benefits now covered by private Supplementary insurance.
  4. Fund long-term care insurance.

Image result for long term care

The purpose is to make affordability a non-issue. There is no moral justification for the richer being able to afford better healthcare than the poorer. Under American law, all people are to be treated equally.

A courtroom judge who habitually gives better outcomes to rich claimants and rich defendants is in violation of the law. Similarly, a police officer, a firefighter, a public librarian, should not offer better treatment and service to the rich.

Yes, of course, it happens.  But, it’s illegal and more importantly, it’s immoral.

Further,  there is no economic justification for some Americans having no healthcare insurance or incomplete healthcare insurance. Poor health leads to costly absences and poor work performance from school and from work. In short, sick students and sick employees do not do well.

Simply improving American health would improve education, and improve business productivity and efficiency.

There is not a single, logical reason why the U.S. federal government does not underwrite healthcare for all. As Americans we all deserve it; as people we all need it. Our businesses would benefit from it.  And our Monetarily Sovereign federal government can afford it.

The U.S. federal government does not keep dollars on hand to pay bills. Instead, it creates dollars, ad hoc, by paying bills.

Funding “Medicare for all” would cost the federal government nothing.

Why? Because after paying for “Medicare for all,” the federal government would still own exactly the same number of dollars as it owned before it paid. Spending is cost-free to a Monetarily Sovereign govenment.

By contrast, today, our private sector, i.e our economy, absorbs a huge cost burden of healthcare.

In an earlier post, we described H.R. 676, Medicare for All. Here are some excerpts from that post:

Look around the world, and you will see the “best” nations providing the best health care and the “worst” nations providing the worst health care.

The U.S. Declaration of Independence says, “. . . [all men] are endowed by their Creator with certain unalienable Rights, that among these are Life, Liberty and the pursuit of Happiness.” Surely, good health is part of that trio.

Because private healthcare insurers do not provide affordable coverage to the broad populace, Medicare and Medicaid were great improvements. But the problem of significant uninsured and underinsured remains.

For a nation that views itself as the world’s leader in most things, this is unacceptable.

Obamacare, aka “Romneycare,” was an attempt to include more people, but it is a complex, convoluted, inefficient program no one fully understands, and it still leaves many uninsured.

For years, I have favored providing full Medicare for everyone — a Medicare coverage so complete that neither Medicaid nor supplemental policies would be necessary.

And such a bill exists — almost. It is H.R. 676, Medicare for All:
“To provide for comprehensive health insurance coverage for all United States residents, improved health care delivery, and for other purposes.”

Some features of the bill:

All individuals residing in the United States (including any territory of the United States) are covered under the Medicare For All Program entitling them to a universal, best quality standard of care

The health care benefits under this Act cover all medically necessary services, including at least the following:
(1) Primary care and prevention.
(2) Approved dietary and nutritional therapies.
(3) Inpatient care.
(4) Outpatient care.
(5) Emergency care.
(6) Prescription drugs.
(7) Durable medical equipment.
(8) Long-term care.
(9) Palliative care.
(10) Mental health services.
(11) The full scope of dental services, services, including periodontics, oral surgery, and endodontics, but not including cosmetic dentistry.
(12) Substance abuse treatment services.
(13) Chiropractic services, not including electrical stimulation.
(14) Basic vision care and vision correction (other than laser vision correction for cosmetic purposes).
(15) Hearing services, including coverage of hearing aids.
(16) Podiatric care.

No deductibles, copayments, coinsurance, or other cost-sharing shall be imposed with respect to covered benefits.

The Program shall pay physicians, dentists, doctors of osteopathy, pharmacists, psychologists, chiropractors, doctors of optometry, nurse practitioners, nurse midwives, physicians’ assistants, and other advanced practice clinicians.

Medicare for All not only would cover everyone, but by eliminating deductibles, co-payments and coinsurance, it eliminates the need to shop around for additional coverages, or even to worry about which form of Medicare to acquire.

Finally, “Medicare for All” simplifies America’s healthcare. In addition to eliminating the “middleman” (the healthcare insurance agencies) there would be:

  1. No need for a complex, convoluted, expensive supplementary plan like ACA (Obamacare)
  2. No need for Medicaid
  3. No need for the massive medical and long-term care functions of the Department of Veterans Affairs.
  4. No need for expensive, long-term care insurance policies.

It would be the simplest possible plan: Everyone would receive care according to their needs. Period.

In short, we currently have aImage result for obama medicaid expansion status system in which there is a high cost to the public, for mediocre or no service (orange colored states) to a significant percentage of Americans .

We should replace it with a system in which there is no cost to anyone, for far better service to all Americans: Federally funded, comprehensive Medicare — Parts A, B & D, plus long-term care — for everyone.

 

Rodger Malcolm Mitchell
Monetary Sovereignty

………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………………..

The single most important problems in economics involve the excessive income/wealth/power Gaps between the have-mores and the have-less.

Wide Gaps negatively affect poverty, health and longevity, education, housing, law and crime, war, leadership, ownership, bigotry, supply and demand, taxation, GDP, international relations, scientific advancement, the environment, human motivation and well-being, and virtually every other issue in economics.

Implementation of The Ten Steps To Prosperity can narrow the Gaps:

Ten Steps To Prosperity:
1. ELIMINATE FICA (Ten Reasons to Eliminate FICA )
Although the article lists 10 reasons to eliminate FICA, there are two fundamental reasons:
*FICA is the most regressive tax in American history, widening the Gap by punishing the low and middle-income groups, while leaving the rich untouched, and
*The federal government, being Monetarily Sovereign, neither needs nor uses FICA to support Social Security and Medicare.
2. FEDERALLY FUNDED MEDICARE — PARTS A, B & D, PLUS LONG TERM CARE — FOR EVERYONE (H.R. 676, Medicare for All )
This article addresses the questions:
*Does the economy benefit when the rich can afford better health care than can the rest of Americans?
*Aside from improved health care, what are the other economic effects of “Medicare for everyone?”
*How much would it cost taxpayers?
*Who opposes it?”
3. PROVIDE AN ANNUAL ECONOMIC BONUS TO EVERY MAN, WOMAN AND CHILD IN AMERICA, AND/OR EVERY STATE, A PER CAPITA ECONOMIC BONUS (Social Security for All) (The JG (Jobs Guarantee) vs the GI (Guaranteed Income) vs the EB (Guaranteed Income)) Or institute a reverse income tax.
This article is the fifth in a series about direct financial assistance to Americans:

Why Modern Monetary Theory’s Employer of Last Resort is a bad idea. Sunday, Jan 1 2012
MMT’s Job Guarantee (JG) — “Another crazy, rightwing, Austrian nutjob?” Thursday, Jan 12 2012
Why Modern Monetary Theory’s Jobs Guarantee is like the EU’s euro: A beloved solution to the wrong problem. Tuesday, May 29 2012
“You can’t fire me. I’m on JG” Saturday, Jun 2 2012

Economic growth should include the “bottom” 99.9%, not just the .1%, the only question being, how best to accomplish that. Modern Monetary Theory (MMT) favors giving everyone a job. Monetary Sovereignty (MS) favors giving everyone money. The five articles describe the pros and cons of each approach.
4. FREE EDUCATION (INCLUDING POST-GRAD) FOR EVERYONEFive reasons why we should eliminate school loans
Monetarily non-sovereign State and local governments, despite their limited finances, support grades K-12. That level of education may have been sufficient for a largely agrarian economy, but not for our currently more technical economy that demands greater numbers of highly educated workers.
Because state and local funding is so limited, grades K-12 receive short shrift, especially those schools whose populations come from the lowest economic groups. And college is too costly for most families.
An educated populace benefits a nation, and benefitting the nation is the purpose of the federal government, which has the unlimited ability to pay for K-16 and beyond.
5. SALARY FOR ATTENDING SCHOOL
Even were schooling to be completely free, many young people cannot attend, because they and their families cannot afford to support non-workers. In a foundering boat, everyone needs to bail, and no one can take time off for study.
If a young person’s “job” is to learn and be productive, he/she should be paid to do that job, especially since that job is one of America’s most important.
6. ELIMINATE CORPORATE TAXES
Corporations themselves exist only as legalities. They don’t pay taxes or pay for anything else. They are dollar-transferring machines. They transfer dollars from customers to employees, suppliers, shareholders and the government (the later having no use for those dollars).
Any tax on corporations reduces the amount going to employees, suppliers and shareholders, which diminishes the economy. Ultimately, all corporate taxes come around and reappear as deductions from your personal income.
7. INCREASE THE STANDARD INCOME TAX DEDUCTION, ANNUALLY. (Refer to this.) Federal taxes punish taxpayers and harm the economy. The federal government has no need for those punishing and harmful tax dollars. There are several ways to reduce taxes, and we should evaluate and choose the most progressive approaches.
Cutting FICA and corporate taxes would be a good early step, as both dramatically affect the 99%. Annual increases in the standard income tax deduction, and a reverse income tax also would provide benefits from the bottom up. Both would narrow the Gap.
8. TAX THE VERY RICH (THE “.1%) MORE, WITH HIGHER PROGRESSIVE TAX RATES ON ALL FORMS OF INCOME. (TROPHIC CASCADE)
There was a time when I argued against increasing anyone’s federal taxes. After all, the federal government has no need for tax dollars, and all taxes reduce Gross Domestic Product, thereby negatively affecting the entire economy, including the 99.9%.
But I have come to realize that narrowing the Gap requires trimming the top. It simply would not be possible to provide the 99.9% with enough benefits to narrow the Gap in any meaningful way. Bill Gates reportedly owns $70 billion. To get to that level, he must have been earning $10 billion a year. Pick any acceptable Gap (1000 to 1?), and the lowest paid American would have to receive $10 million a year. Unreasonable.
9. FEDERAL OWNERSHIP OF ALL BANKS (Click The end of private banking and How should America decide “who-gets-money”?)
Banks have created all the dollars that exist. Even dollars created at the direction of the federal government, actually come into being when banks increase the numbers in checking accounts. This gives the banks enormous financial power, and as we all know, power corrupts — especially when multiplied by a profit motive.
Although the federal government also is powerful and corrupted, it does not suffer from a profit motive, the world’s most corrupting influence.
10. INCREASE FEDERAL SPENDING ON THE MYRIAD INITIATIVES THAT BENEFIT AMERICA’S 99.9% (Federal agencies)Browse the agencies. See how many agencies benefit the lower- and middle-income/wealth/ power groups, by adding dollars to the economy and/or by actions more beneficial to the 99.9% than to the .1%.
Save this reference as your primer to current economics. Sadly, much of the material is not being taught in American schools, which is all the more reason for you to use it.

The Ten Steps will grow the economy, and narrow the income/wealth/power Gap between the rich and you.

MONETARY SOVEREIGNTY