Mike Kueber's Blog

December 31, 2011

Out with 2011

Filed under: Philosophy — Mike Kueber @ 10:27 pm
Tags: ,

I’ve often claim to place a lot of stock in self-examining one’s life.  In fact, I recently blogged about the subject, and the next book on my pile of books is titled, “Examined Lives, from Socrates to Nietzsche.”     Since today is the last day in 2011, it is probably a good time to do some examining.

Actually NY Times columnist David Brooks prompted me to get a head start on self-examining a few weeks ago when he asked his older readers the following:

  • If you are over 70, I’d like to ask for a gift. I’d like you to write a brief report on your life so far, an evaluation of what you did well, of what you did not so well and what you learned along the way. You can write this as a brief essay or divide your life into categories — career, family, faith, community, and self-knowledge — and give yourself a grade in each area.”   

Although I wasn’t old enough to qualify, I responded to Brooks for the fun of it.  But that was a full-life evaluation.  Today I am focused on 2011.

My major life event in 2011 was the birth of my twin grandchildren.  This event confirms what I have felt forever about the importance of family.  I saw “forever” because I am becoming a fan of evolutionary biology, and that science says that the genes I was born with pointed me in the family direction.  Of course, valuing family goes beyond having as many kids (and grandkids) as possible.  It means having kids who are flourishing, and as 2011 ends each of my kids is flourishing in his own unique way.  As Jackie Kennedy said, “If your children don’t have successful lives, nothing else matters.”

My work life (as a 58-year-old retiree) has not flourished.  Although my days have been full with blogging and my fitness regimen, I’m beginning to feel like I should be doing something more productive with my next few years.  Must be that North Dakota work ethic finally kicking in.

Another problem with 2011 is that I have drifted away from most of my work friends from USAA, and blogging has not been conducive to finding replacement friends.  While working at USAA, I would often pontificate on the importance of personal relationships, but then during 2011 I started thinking that those relationships could be replaced by reading and writing.  That thinking needs to be re-examined.

And finally, I have been divorced and living alone since 2006 (not counting my sometime roommate-sons Tommy and Jimmy).  Having a roommate is nice, so my thinking may change when Jimmy leaves for college, but until then I subscribe to the lyrics in a 1999 country song by Lace – “I don’t want a woman I can live with; I want a woman I can’t live without.”  But I do think that woman is out there.

Citizens United takes effect in Iowa

Earlier this year, I blogged about a recent Supreme Court decision, Citizens United, that authorized corporations and and rich people to spend unlimited amounts of money advocating for a specific candidate, provided that the spending is not formally coordinated with the candidate’s campaign.   The Citizens United decision was based on the constitutional right of free speech.  Although many people, mostly Democrats, expressed grave concern about the decision – President Obama said, “this ruling strikes at our democracy itself.” – I downplayed its significance in my blog:

  • As George Will suggested decades ago – don’t limit the speech, just require full disclosure of who is paying for the speech.  Then let the voters decide.  I realize that many think my view is impractical and Pollyannaish – that American voters aren’t capable of avoiding manipulation by slick marketing – but I believe we can rise to the occasion.

Unfortunately, according to an article in the NY Times, my view is being refuted by the Republican presidential campaigns in Iowa.  The Times article reports that a super-PAC supporting Mitt Romney has blanketed the state with negative ads on Newt Gingrich and the ads are having a devastating effect on Gingrich’s campaign.  Even if my previous suggestion that American voters are “capable of avoiding manipulation by slick marketing” remains true, there remains a fundamental flaw that the super-PACs have an unfair advantage because of their virtually unlimited spending.

The $2,500 limit on individual contributions to presidential campaigns was designed to prevent rich people from being able to buy out-sized influence with campaigns.  Just imagine how much influence a rich person or a corporation can buy with a $1 million contribution to a super-PAC that supports the candidate.

The Times article reports that, while Mitt Romney’s campaign is clearly benefiting from the super-PAC attack ads on Newt Gingrich, Romney is not being tarred as the guy responsible for going negative.  Instead, he can accurately assert that he has no control over the super-PAC spending.  But the article also points out that Romney has been a bit disingenuous in bemoaning the out-sized influence of super-PACs:

  • “In recent days, Mr. Romney has tried to distance himself from the group. ‘We really ought to let campaigns raise the money they need and just get rid of these super PACs,’ Mr. Romney said on MSNBC.  But in July, Mr. Romney appeared before dozens of potential donors to Restore Our Future at an organizational meeting, effectively blessing its work.”

I’m not sure what the answer is.  Typically, I believe that incorrect Supreme Court decisions should be corrected by a constitutional amendment.  But I don’t think the result of Citizens United was incorrect.  If George Soros wants to spend $100 million on TV ads saying what a great president Barack Obama is, I think he should have that right.  Similarly, if the Koch brothers want to spend $100 million on TV ads saying what a horrible president Barack Obama is, they should have that right.

So, until Mitt Romney or someone else comes up with a constitutional way to “just get rid of these super PACs,” I think we are stuck with them.  Rich people will be able to buy more free speech than the rest of us.

December 30, 2011

Wikipedia and tax mediation for a frugal retiree

During college or law school, I was taught that there is a critical difference between tax avoidance and tax evasion – avoidance is legal and OK; evasion is illegal and not OK.  Wikipedia, however, seems to have blurred that distinction in the last sentence of the following definitions:

  • Tax avoidance is the legal utilization of the tax regime to one’s own advantage, to reduce the amount of tax that is payable by means that are within the law. The term tax mitigation is a synonym for tax avoidance. Its original use was by tax advisors as an alternative to the pejorative term tax avoidance. The term has also been used in the tax regulations of some jurisdictions to distinguish tax avoidance foreseen by the legislators from tax avoidance which exploits loopholes in the law. The United States Supreme Court has stated that “The legal right of an individual to decrease the amount of what would otherwise be his taxes or altogether avoid them, by means which the law permits, cannot be doubted.”  Tax evasion, on the other hand, is the general term for efforts by individuals, corporations, trusts and other entities to evade taxes by illegal means. Both tax avoidance and evasion can be viewed as forms of tax noncompliance, as they describe a range of activities that are unfavorable to a state’s tax system.

If I may digress from my taxing subject for a minute, this morning I heard Doug Gottlieb, a substitute host on Mike & Mike’s sports talk show on ESPN2 rely on Wikipedia for the historical origins of the marathon and then gratuitously slam Wikipedia by saying that, because the info came from Wikipedia, it might be right and it might be wrong.  What an ugly thing to say!  Although Wikipedia may not have all of the overlapping validations of most reference sources, I have found it to be highly reliable and exceptionally well written.  The paragraph above on tax avoidance is typical.  That was a cheap shot, Doug, unless you are prepared to give us examples of you being misled by Wikipedia.

Back to my subject of “tax mitigation,” a lot of retirees with a moderate amount of assets don’t realize that the U.S. tax code allows them to earn a relatively sizable amount of income without paying any taxes.  Here is how:

  • The personal exemption and standard deduction for a single person combine to about $10,000 so that amount of income is tax free.
  • The Bush tax cuts allow people in the 10% or 15% tax bracket to pay $0 on capital gains.  For a single person, the 15% bracket changes to 25% with income of $35,000.

Thus, according to my calculations, an individual can earn income of $10,000 and take out capital gains of $35,000 and still pay no taxes.  If you need more than $45,000 a year to live on, you simply consume some of the assets that resulted in the capital gains.  Sweet!

Although I think the Bush tax cuts should be eliminated for everyone, not just the rich, I endorse Mitt Romney’s suggestion that the capital gains tax should be eliminated for everyone except the rich.  Providing an incentive for wage-earners (the proletariat) to become asset-owners (the bourgeoisie) would be a good thing.

December 29, 2011

For those who don’t like taking orders – Discharge Against Medical Advice

Filed under: Law/justice,Medical — Mike Kueber @ 4:28 pm
Tags: , , , ,

As one of my favorite presidents (Bush-43) famously said, “When I was young and foolish, I was young and foolish.”  An example of this occurred in my life when I was a novice attorney working in Huntsville and living in Austin.  One night, I was driving my girlfriend’s (later she became my wife and ex-wife) so-called motorcycle – a 125-cc Honda – and collided with a guy in an intersection who made a left-turn in front of me.  I was knocked unconscious and dragged for a long distance before the other guy dislodged me and vanished into the night. 

Initially, my doctor thought I was only scrapped up, but later they discovered I had a non-displaced cervical fracture, which required extreme immobilization for a few days.  As with most people, I became enormously anxious to get out of the hospital, and my doctor kept putting it off.  Finally, on the day that I was certain to be discharged, my doctor never came by on his rounds.  In a fit of frustration, I checked myself out and went home.

According to Wikipedia, there is a term for what I did – Against Medical Advice, or AMA:

  • “Sometimes known as DAMA, Discharge Against Medical Advice, is a term used with a patient who checks himself out of a hospital against the advice of his doctor. While it may not be medically wise for the person to leave early, in most cases the wishes of the patient are considered first. The patient is usually asked to sign a form stating that he is aware that he is leaving the facility against medical advice, and the AMA term is used on reports concerning the patient.  This is for legal reasons in case there are complications to limit liability on the part of the medical facility….  When a patient checks out against medical advice, the patient’s insurer may not pay for subsequent stays for the same condition.”

Although I earlier said that my personal DAMA was an instance of being young & foolish, I actually believe in the concept.  I suspect this belief is rooted in my 60s, libertarian values.  People from my generation don’t like big institutions telling us what to do, even if they are right. 

Further, although the U.S. Constitution does not specifically address false imprisonment, the Fourth Amendment prohibits unreasonable search & seizure, which has been interpreted to mean that individuals have a valid cause of action if they can prove: (1) willful detention, (2) without consent, and (3) without authority of law.

So for years, I have been telling my DAMA story to anyone who will listen – i.e., “you don’t have to kowtow to the Man.”  But my son, Mikey, who is now a resident ER doctor at the Mayo Clinic, recently told me that they actually have security to prevent people from discharging themselves if they are a risk to themselves or to the community.  That sounds like a police state that I am unfamiliar with, something that certainly deserves more investigation.

Surprisingly, one of the best DAMA resources on the internet is an article on the Mayo website that discusses the scope of the problem – approximately 2% of hospital discharges are DAMA – the reason for them, and methods to minimize them, but nothing about police or security:

  • At the heart of the problem is an ethical dilemma for physicians. When a patient wishes to leave against medical advice, this may be contrary to the physician’s attempt to do what is believed best for the patient. The struggle is between patient autonomy and physician beneficence.”

After a painstaking search of the internet, I concluded that hospitals do not have a right to hold patients against their will unless they think the patients are mentally incapable of making their own decision.  Patient autonomy wins over physician beneficence.

Following my search, I asked my son to validate my conclusion, and he confirmed, with one caveat (that drunk were mentally unsound) and with one exception – i.e., that hospitals were required to report gunshot wounds to the police and hold the patient until the patient arrived.  We know that New York has a similar law because one hospital got in trouble for not following the law when a famous athlete was involved in a shooting:

  • On November 28, 2008, Burress suffered an accidental self-inflicted gunshot wound to the right thigh in the New York City nightclub LQ when his Glock pistol, tucked in the waistband of his sweatpants, began sliding down his leg; apparently in reaching for the gun he inadvertently depressed the trigger, causing the gun to fire. However, the Manhattan District Attorney stated Burress was in fact wearing jeans. The injury was not life-threatening and he was released from an area hospital the next afternoon. Two days later, Burress turned himself in to police to face charges of criminal possession of a handgun. It was later discovered that New York City police learned about the incident only after seeing it on television and were not called by New York-Presbyterian Hospital as required by law. New York Mayor Michael Bloomberg called the hospital actions an “outrage” and stated that they are a “chargeable offense”. Bloomberg also urged that Burress be prosecuted to the fullest extent, saying that any punishment short of the minimum 3½ years for unlawful carrying of a handgun would be ‘a mockery of the law.’ Burress had an expired (concealed carry (CCW)) license from Florida, but no New York license.”

Burress went to jail; how much you want to bet that no one from NY-Presbyterian did?

December 27, 2011

My pet epiphany

Filed under: Culture,Philosophy — Mike Kueber @ 6:58 pm
Tags: ,

People, like me, who grew up on a farm tend to think of animals as nothing more than an economic product to make money on.  If you can’t make money on it, you don’t want it.

Family pets aren’t held that same low standard, but most farm families are unwilling to spend very much money on their pets.  A sick or injured pet is more likely to be “put to sleep” than to receive expensive medical treatment.

Until this morning, that practice has always made sense to me.  Why should a person spend hundreds or thousands of dollars on a dog or cat when there are countless other dogs and cats waiting to be rescued?

My thinking on this issue changed when my ex-wife posted something on Facebook last night about her pet dog Zoey being dropped at the ER vet because of several seizures.  That is when I experienced my epiphany.  This is a free capitalistic country, and we don’t begrudge people who choose to spend their money on a cruise or a McMansion.  Why should we denigrate someone who gets more happiness out of their pet’s restored health than they get out of a more expensive car?

In hindsight, this seems so obvious that I don’t know how I missed it for so long.

December 26, 2011

Are voters paying attention yet?

Filed under: People,Politics — Mike Kueber @ 1:39 pm
Tags: , ,

Although the media continually carps about how little the public pays attention to politics, it is amazing how dynamic public opinion has been toward the Republican presidential candidates.  For several weeks at a time, we have had a so-called flavor of the week – from Bachmann to Perry to Cain to Paul and most recently to Gingrich.  As soon as candidates become the flavor of the week and are scrutinized, they inevitably shrivel up like a raisin.

The scrutinization of Newt has been unprecedented for the past two weeks, with a barrage of negative ads from other candidates and super-PACs.  So if the voters are paying attention, you would expect his chances for winning the nomination to be dropping precipitously, and you would be right. 

According to the latest Intrade.com odds, Mitt Romney now has a 70% chance of winning the Republican nomination, whereas Gingrich and Paul have dropped to about 8%, Huntsman – 5%, Perry – 2%, and Bachmann – 1%.

Looks like I won’t need to drive to Iowa this week to save Mitt’s bacon.

ABA-approved law schools

Filed under: Law/justice — Mike Kueber @ 12:15 pm
Tags: , ,

It always seemed to me that professional schools, like law schools and medical schools, were a racket because they enabled certain lucrative, prestigious occupations to limit the number of individuals who would be allowed to enter the field.  This practice seemed un-American, but I suspected corrupted government official were ultimately responsible for sanctioning it.

A recent article in the NY Times goes a long way toward explaining how the lawyers enforce their monopoly.  Principally, states require that all lawyers graduate from law schools approved by the ABA (American Bar Association), and then the ABA requires that law schools have expensive libraries and full-time tenured (i.e., expensive) faculty, while discouraging night schools for part-time students.  All of this results in high costs, which severely limit the creation of new law schools or the ability of a existing law school to economically provide an individual with a legal education. 

The article suggests that legal education in America is afflicted with a one-size-fits-all problem – i.e., all J.D.s are essentially Cadillac degrees.  By contrast:

  • “Britain, on the other hand, has a long menu of options, including a tier of professionals called legal executives, who are licensed after getting the equivalent of a community college degree. Counsel is also available from nonlawyers at a variety of nonprofits. And you can buy a simple divorce over the Internet for a set fee, or pay for customized legal advice, online or by phone.”

That sounds like a good idea for our state legislatures to consider.  Not all legal problems need a lawyer with a Cadillac degree.  The problem is that most legislatures are stuffed with lawyers with J.D.s, and they have no interest in opening up their profession to more competition.  Perhaps those lawyer-legislators should speak their piece and then recuse themselves from the voting.



December 25, 2011

Sunday Book Review #56 – The Time of our Lives by Tom Brokaw

Filed under: Book reviews — Mike Kueber @ 7:26 pm
Tags: ,

Perhaps my feelings about The Time of our Lives are colored by my holiday blues because, although it is ostensibly a collection of common-sense nostrums for getting America on the right track again, I was much more interested in his nostalgic look back at the lives lived by America’s “greatest generation,” a term he coined with his 1998 book, The Greatest Generation.  

Regarding Brokaw’s common-sense nostrums, I found them to be reasonable for a center-left pundit, but there is nothing really new or insightful.  Rather they read like something simple from “Mr. Smith Goes to Washington.”  If Congress were stocked with a bevy of politicians who were pragmatic like Brokaw (especially if you added more than a few from the center-right persuasion), Congress would undoubtedly function much better.  But if you read The Time of our Lives (subtitled “A Conversation with America”) hoping to learn some astute, unique policy solutions, you will be disappointed.

Among the memorable comments in the book:

  • While talking to President Obama in Europe, “I suggested that he try to find a solitary moment the next day when he would be in … the American cemetery on a bluff above Omaha Beach.  ‘Walk through those headstones with just your thoughts and be prepared to have your knees buckle.’….  The lingering lesson of Omaha Beach is the deeply affecting value of common cause supported by uncommon valor against monstrous tyranny.  It is a lesson that need not be reserved for great wars alone.”  WWII was one of the two great influences on Brokaw’s life.
  • “When young people with obvious aptitude announce they’re going to college to be a ‘mass comm’ (mass communications) major, adding that they hope to be an anchor on a news program shortly after graduation, I have to temper my reaction.  While I try not to discourage them…. It’s his life after all, but does America need another marketing executive rather than another scientist?”  We don’t need another investment banker, either.
  • On the growing income gap – “Those who had surrendered the [American] dream, however they defined it, were earning as much as $50,000 a year, while those who still believed in the dream were making $75,000 and up annually….  At a time when we need to be strong at our weakest points to deal with global competition, an economic civil war would be fratricidal.”  Aside from the debt crisis, income inequality is America’s major problem. 
  • “Used potatoes didn’t stay on my palate in my grown-up years, but I still have leftover guilt.  I cannot easily discard still-edible food at the end of a meal, and as a result our refrigerator is a jumble of small containers of odds and ends.  Leftovers were really a metaphor for the larger issues of money management and the ever-present fear that another Great Depression was just around the corner.”  The Great Depression was an ever greater influence on Brokaw’s life than was WWII.
  • Doc Auld [his father-in-law] and the banker had the means to build something much grander for their families, but modesty and proportion – not showing off – was an unspoken rule.  When Doc bought two productive farms nearby, there was no resentment; that made sense.  But if they had built what came to be called a McMansion, the community would have collectively wondered what had happened to the man they thought they knew.”  I have always wondered about this issue.  My recollection is the same as Brokaw’s, but I wonder if that was a mid-America value because I often read about well-to-do people in the South and East historically being more ostentatious.
  • On foreign policy, Brokaw decries the fact that national security receives much less attention that “heated arguments about same-sex marriage, the legalization of marijuana, and the real and overblown indiscretions of some candidates.  That was a shameful commentary on the substance and nature of modern politics and campaigns.”  As someone who believes that politics ends at the water’s edge, I emphatically disagree with Brokaw.  Arguing foreign policy and national security is above the pay-grade of most Americans; let’s not politicize it any further.
  • When his mom and dad retired to California, on a winter night his dad would step out onto their balcony overlooking the beautiful trees and bushes and say, “’If the boys in Bristol could see me now,’ a reference to his hardscrabble hometown on the northern prairie of South Dakota.”  I have often mentioned the same sentiment.  Although I am far and long removed from Aneta, North Dakota, I still measure my life against the values of that community.  Not that I won’t disagree with some of those values on principle, but fundamentally Aneta and North Dakota are my lodestar.

The Time of our Lives touches on the gamut of policy issues, but does not provide great insights to policy wonks.  Rather it works best as a nostalgic reminder of what made America great.  To paraphrase Alex de Tocqueville, “America is great because Americans are good.  When Americans are no longer good, America will no longer be great.”

December 21, 2011

Some good decisions re: the implementation of ObamaCare

Filed under: Issues,Medical,Politics — Mike Kueber @ 11:57 am
Tags: , ,

A couple of months ago, I posted an entry in my blog titled “ObamaCare takes shape.”  In the entry I reiterated a major concern about ObamaCare, and then reported on a recent development that had somewhat ameliorated the concern.  Now this past week, the Obama administration has given us further good news about its implementation of this controversial program. 

My major concern with ObamaCare, in addition to the unconstitutional individual mandate, is that the law appears to require gold-plated coverage for everyone.  This concern is based on a provision in the law that requires HHS Secretary Sebelius to define a mandatory package of preventive, diagnostic, and therapeutic services and products called “essential health benefits.”  ObamaCare provides that this package of essential benefits should be “equal to the scope of benefits provided under a typical employer plan.”  In my blog entry, I described my concern as follows:

  • My concern is that employee health coverage, especially when unions are involved, is often gold-plated, and it is nonsensical to make gold-plated coverage the minimum standard for a welfare-type program like ObamaCare, especially if we are trying to restrain over-utilization.

And I described the ameliorating development as follows: 

  • Today, the NY Times reported that a shocking display of common sense and good judgment may prevent my fears from materializing. According to an article in the Times, the Institute of Medicine (IOM), in providing the Secretary of HHS with a framework for deciding what coverages should be deemed essential, recommended that (1) the cost of providing the coverage should be considered so that the policy remains affordable, and (2) ‘a typical employer plan’ should be that of a small employer, not of medium or large employers, who tend to provide more generous (expensive) coverage.”

So what is the further good news this week?  The good news was reported by the Washington Post in an article titled, “Feds would allow states to tailor basic health benefits under Obama’s overhaul.”  The article reports that the Obama administration was adopting the IOM’s recommendation regarding small-employer coverage as a minimum or floor:

  • The new proposal would let states pick a benefits package from several federally approved options. Those range from benefits offered to federal and state employees to the most popular small business plans in the state and to a large health maintenance organization, or HMO.

An article in the NY Times took a similar take on this development.  In an article titled, “Health Care Law Will Let States Tailor Benefits,” the Times reported:   

  • In a major surprise on the politically charged new health care law, the Obama administration said Friday that it would not define a single uniform set of “essential health benefits” that must be provided by insurers for tens of millions of Americans. Instead, it will allow each state to specify the benefits within broad categories.”

Neither article, however, makes it clear how the small-business coverage will be reconciled with the ObamaCare requirement that “the benefits package must include such fundamentals as inpatient and outpatient care, emergency services, maternity and childhood care, prescription drugs, preventive screenings and labs.  It must also cover mental health and substance abuse treatment, as well as rehabilitation for physical and cognitive disorders, and dental and vision care for children.”  As the Post article noted, “such additional benefits are often not fully covered by frugal plans that are now the best that many small businesses can afford.”

Fortunately, due to the wonders of the internet, we have access to a news release and detailed bulletin issued last Friday by the Department of Health and Human Services, and these documents answer the questions left unanswered by the Times and Post. 

According to the news release:

  • Consistent with the law, states must ensure the essential health benefits package covers items and services in at least ten categories of care, including preventive care, emergency services, maternity care, hospital and physician services, and prescription drugs.  If a state selects a plan that does not cover all ten categories of care, the state will have the option to examine other benchmark insurance plans, including the Federal Employee Health Benefits Plan, to determine the type of benefits that will be included in the essential health benefits package.”  

The bulletin provides even more detailed guidance:

  • Section 1302(b) of the Affordable Care Act directs the Secretary of Health and Human Services (the Secretary) to define essential health benefits (EHB)….  Section 1302(b)(1) provides that EHB include items and services within the following 10 benefit categories: (1) ambulatory patient services, (2) emergency services (3) hospitalization, (4) maternity and newborn care, (5) mental health and substance use disorder services, including behavioral health treatment, (6) prescription drugs, (7) rehabilitative and habilitative services and devices, (8) laboratory services, (9) preventive and wellness services and chronic disease management, and (10) pediatric services, including oral and vision care.”
  • “The statute distinguishes between a plan’s covered services and the plan’s cost-sharing features, such as deductibles, copayments, and coinsurance. The cost-sharing features will determine the level of actuarial value of the plan, expressed as a “metal level” as specified in statute: bronze at 60 percent actuarial value, silver at 70 percent actuarial value, gold at 80 percent actuarial value, and platinum at 90 percent actuarial value.”
  • “Generally, according to this analysis, products in the small group market, State employee plans, and the Federal Employees Health Benefits Program (FEHBP) Blue Cross Blue Shield (BCBS) Standard Option and Government Employees Health Association (GEHA) plans do not differ significantly in the range of services they cover. They differ mainly in cost-sharing provisions, but cost-sharing is not taken into account in determining EHB.  Similarly, these plans and products and the small group issuers surveyed by the IOM appear to generally cover health care services in virtually all of the 10 statutory categories.”
  • “One of the challenges with the described benchmark plan approach to defining EHB is meeting both the test of a “typical employer plan” and ensuring coverage of all 10 categories of services set forth in section 1302(b)(1) of the Affordable Care Act. Not every benchmark plan includes coverage of all 10 categories of benefits identified in the Affordable Care Act (e.g., some of the benchmark plans do not routinely cover habilitative services or pediatric oral or vision services). The Affordable Care Act requires all issuers subject to the EHB standard in section 1302(a) to cover each of the 10 benefit categories.  If a category is missing in the benchmark plan, it must nevertheless be covered by health plans required to offer EHB. In selecting a benchmark plan, a State may need to supplement the benchmark plan to cover each of the 10 categories.  We are considering policy options for how a State supplements its benchmark benefits if the selected benchmark is missing a category of benefits.  The most commonly non-covered categories of benefits among typical employer plans are habilitative services, pediatric oral services, and pediatric vision services.”
  • “Below, we discuss several specific options for habilitative services, pediatric oral care and pediatric vision care. Generally, we intend to propose that if a benchmark is missing other categories of benefits, the State must supplement the missing categories using the benefits from any other benchmark option.” 

Thus, it appears that the Obama administration is shifting away from its “one size fits all” strategy and is granting states the flexibility needed to craft an affordable insurance policy that satisfies its needs.  The law does not allow flexibility re: gold-plated coverage for habilitative services, pediatric oral services, and pediatric vision services, and perhaps that can be fixed by amendment.  Further, the administration still needs to address the issue of cost-sharing (co-insurance, co-pays, deductibles), and state flexibility will be needed there, too.  But HHS Secretary Sebelius should be commended for her recent decisions in the implementation of ObamaCare.

p.s., Washington Post columnist Robert Samuelson just came out with a lengthy column suggesting the Sebelius’s action was good politics, but bad policy.

December 20, 2011

Congressional service as a stepping stone to riches

Filed under: Issues,Politics — Mike Kueber @ 11:27 am
Tags: ,

The New York Times recently published an interesting article on the so-called revolving door between Congress and lobbying.    The focus of the article was not only on the financial rewards from lobbying that awaited congressmen (and their staffers), but also on the dominance of former Democratic congressmen in the lobbying business.  The article suggested that this dominance will make it more difficult for President Obama and the Democrats to convince voters that the Democratic Party is the party of the 99%. 

Technically, I think it is misleading to label this problem a “revolving door” because, unlike executive-branch employees who often go in and out of the private service, it is not common for congressmen to return to elective office after soiling their money-grubbing hands by lobbying.   A notable exception is Newt Gingrich, who claims he was a consultant, not a lobbyist.

Regarding the lucrative nature of lobbying, the article noted:

  • “When Washington politicians leave office, many, if not most, no longer return home. Instead, they head straight to the lucrative world of K Street, the nation’s lobbying corridor, which runs through the heart of Washington. A former member of the House or Senate with even modest seniority can now expect to walk into a job paying up to $1 million or more a year – and much more when bonuses are paid for bringing in new clients.”

As a native of North Dakota, I was already painfully aware of this career path.  The state has been represented for two decades by three career politicians – Senators Dorgan and Conrad and Representative Pomeroy (who attended the University of North Dakota with me).  Dorgan recently retired, Pomeroy was retired by the voters, and Conrad is going to retire next year.  Do you think they are going retire to North Dakota?  According to Wikipedia:

  • Dorgan is now co-chair of Government Relations Practice for the Washington, DC law firm Arent Fox.  He also serves as a Senior Fellow at the Bipartisan Policy Center, where he focuses on issues related to energy policy.  Dorgan is also a co-chair of BPC’s Energy Project.”
  • “[O]n the last day of Pomeroy’s 18-year stint as North Dakota’s at-large congressman, K Street giant Alston & Bird announced that he was joining the firm’s health care lobbying division.  Pomeroy joined former Senate Majority Leader and presidential candidate Bob Dole at Alston & Bird.”

The Times article is consistent with a posting to my blog a few weeks ago titled, “The Revolving Door Keeps Spinning”:    

  • A couple of weeks ago, I blogged about the problem of a revolving door between government service and lobbying.  The posting was prompted by a 60 Minutes segment on Jack Abramoff, a corrupt lobbyist who went to jail.  Abramoff suggested that, instead of hyper-focusing on campaign contributions and gifts, Congress should prohibit its members and staffers from ever working for lobbyists.  I endorsed Abramoff’s suggestion, and added that, “Public service should not be a temporary assignment on your personal road to wealth and affluence.  Eliminate the revolving door.  When you are done serving, go back home.  Otherwise, there is too much conflict of interest.”





Next Page »