During the botched rollout of the Affordable Care Act, it's been hard to defend the law, much less to call it "great." But great it is — for the American economy and for the American people, rich ones included.
The program has already succeeded in one of its key backbreaking missions: to curb the exploding costs of health care. The president's Council of Economic Advisers issued a report this month containing lots of good news on that front. Since Obamacare was passed in 2010, the growth in health care spending has slowed to the lowest rate on record for any three-year period since 1965. "If half the recent slowdown in spending can be sustained," the report says, "health care spending a decade from now will be about $1,400 per person lower than if growth returned to its 2000-2007 trend."
The authors further note that the benefit will go to workers in the form of fatter paychecks and to taxpayers as federal and state governments cut projected spending on health care. Another plus would be more jobs as employers feel less burdened by the cost of covering their workers.
What about the recession? One may reasonably ask whether the economic downturn was responsible for cutting the growth rates of medical spending. Yes, but not by much, the authors respond. They note that the slowdown has persisted well beyond the end of the recession. Very importantly, it also applied to Medicare, a government program whose elderly beneficiaries are more insulated from a weak job market. And the growth in prices for health services (different from total spending) has eased significantly.
Here's how the health care reforms did it:
— They reduced the overpayments to private insurers' Medicare Advantage plans and the price increases for providers.
— They're promoting new payment models, whereby medical providers are being financially rewarded for giving good care in an efficient manner. Under the old setup, providers could enhance their incomes by pumping up the volume of visits, tests and other services.
The reforms encourage the growth of "accountable care organizations." The more efficiently these groups of medical providers operate the more money they get to keep.
— Hospitals with high readmission rates are penalized. This is also a quality issue for Medicare beneficiaries, who are often discharged with inadequate planning for post-hospital care. Under a perverse set of incentives, hospitals were making more money when elderly patients returned. The taxpayers, of course, picked up the bills.
— Changes in Medicare should spill over into the private sector, generating even more savings. Medicare's payment structure is often the starting point in negotiations between private insurers and medical providers.
What about the rich? All this conservative talk about Obamacare's "redistributing" wealth to the less well-off ignores this reality: Every time medical spending rises, so do the taxes (of those who pay income tax) and the premiums for those who buy their own coverage. I mean, who do you think has been paying for all those uninsured people showing up at expensive hospital emergency rooms for free care?
For those worried about federal deficits, here are some encouraging numbers, courtesy of the Affordable Care Act: The Congressional Budget Office recently cut its projected Medicare and Medicaid spending in 2020 by $147 billion. It expects the reforms overall to reduce the deficit by more than $100 billion from 2013 to 2022.
All this great stuff has been obscured by the bungled launch of the federal government's HealthCare.gov website. Once it is up and running, the conversation should turn in a more positive direction. Those who read the advisers' report won't have to wait that long. Google "Council of Economic Advisers" for a copy.
(A member of the Providence Journal editorial board, Froma Harrop writes a nationally syndicated column from that city. She has written for such diverse publications as The New York Times, Harper's Bazaar and Institutional Investor.)
Last Updated on Wednesday, 31 December 1969 07:00
The president, a man of color, was elected twice, to the highest office of the most prosperous and powerful nation the world has ever known. In each election, he received enormous support from white people.
Oprah Winfrey, a woman of color, created an empire that provides her earnings of $300 million a year. She has amassed a total net worth of $2.9 billion, to a great extent because of her skills and abilities and the respect and admiration she earned from her mostly white female audiences.
Two people of color. One became the president of our country and the other became a household name while building a communications and entertainment empire. Both achieved their positions of stature, in part, because of the backing and support of the country's white population.
If a person achieves a large measure of success, it is not because of the color of their skin, it is often because of their vision, intelligence, daring, work ethic, tenacity, and so on. Businesses succeed and businesses fail . . . every single day. Great athletes win and lose . . . every single day. Students ace and disgrace . . . every single day. Some scale the mountain peak and others fall off the cliff . . . every single day. And, those yeas and nays are not because of the color of their skin . . . it is because of their skills and abilities.
Oprah Winfrey recently told a British interviewer that the president's detractors may be so because of the color of his skin. She didn't offer an opinion that he might be an inept manager. Nor did she opine that he may be deceitful, or cunningly adept at creating divisions among the people. No, his failures, or the divisions among the people, are because of the color of his skin.
The mere mention of racism creates a tension between the races that may not have existed before the statement was made. Why? Because it immediately demands one side defend itself lest they be branded as a racist. How does one prove they don't have racist thoughts or intentions?
Our system of laws requires that the government, or the one making a charge of wrong-doing by another, must be able to prove beyond a reasonable doubt, the allegation of wrong-doing. The one charged with wrong-doing has a right to challenge the veracity of the charges made against him or her. For Miss Winfrey, or anyone, to in any way imply a charge of racism, they should be required to name names and offer proof, and be prepared for legal rebuttal by the person so charged.
During World War II, there was a slogan, "Loose lips sink ships". Today, the "loose lips" make unfounded charges of racism and those charges are creating unnecessary divisions and animosity among the people; sinking our society with incivility as an alibi for failure.
Over the last few years, our country has become more divided than at any time in my lifetime. When President Obama was elected, most people hoped that his election would continue our country's progress on the road to ever improving race relations. It was an opportunity to show people of color that, as Martin Luther King, Jr. so famously said, people would be judged by the content of their character, not by the color of their skin.
What has happened though, is that too many people use the color of the president's skin as a shield against legitimate criticism. The president himself, and many of his senior advisors and supporters, have hurled invectives and used "street talk" to demonize any opposition. Some of the disrespect from street talk, and sloganeering such as "Bin Laden's dead, General Motors is alive." appears to have even incited rioters in the middle east who, when our embassy in Cairo was under siege, were chanting, "We are one and a half billion Bin Ladens."
Racism exists . . . in all nations and in all peoples, and every effort should be made to minimize and, hopefully, eliminate it. Racism by the Nazis resulted in over six million Jews being murdered. Europe is again growing in anti-Semitism and the influx of middle-eastern immigrants is imposing an unwanted multi-cultural problem that could well be called racism. The middle east is rife with intolerance and racism against all who are not Muslim. We hear and read of Christian Churches being burned to the ground in Egypt and of Christians fleeing across borders to avoid being murdered. Israel is under constant siege as some Muslim leaders have expressed their desire to wipe Israel off the map and drive the Jews into the sea. They view the United States as the great satan. And Iran progresses towards becoming a nuclear power.
Think of that deeply ingrained racism described above and then ask yourself, can you justify calling someone a racist because of a disagreement over policy or performance?
Wake up before it's too late.
(Bob Meade is a Laconia resident.)
Last Updated on Monday, 25 November 2013 07:45
There were 96 residential home sales in October in the 12 towns covered by this Lakes Region real estate report. The average sales price came in at $350,760 and the median price point was $209,250. Last October we posted 97 sales at a lower average of $287,919. We just had three straight months of hundred plus sales, so our yearly sales numbers should look pretty good if we finish out the year strong. This sure feels better than going in the other direction.
With Thanksgiving coming right up, I thought I would focus a little bit on the most important room of the house on that day; the kitchen. More precisely; the "gourmet kitchen." Obviously, you need to cook a turkey for Thanksgiving, unless you take the easy route and go to Hart's Turkey Farm. That, however, could interrupt watching the football games which in my house is contrary to the true meaning of Thanksgiving. I have a long standing tradition established in my early childhood of watching , what was then, Tom Landry's Cowboys and the hapless Lions play their annual Thanksgiving Day games. Those were the days! The only things that have changed are there are three games to watch now and the Cowboys are almost always the hapless ones.
Anyway, if you are going to cook a turkey, you should have a gourmet kitchen to cook it in unless you've got one of those outdoor deep fryers that will turn the whole thing into one big chicken nugget in seconds flat. But what is a gourmet kitchen exactly? Well, no one seems to know exactly, but real estate agents use the term a lot. According to the Urban Dictionary, a gourmet kitchen is "an abstract term used by realtors to add appeal to listings. Theoretically, it refers to a higher-end kitchen, but it has become used so loosely, that there are no clear defining factors that separate a 'gourmet kitchen' from a 'kitchen.'"
While there may be no exact definition of a "gourmet" kitchen, you can usually tell when you are in one. High end appliances such as Viking, Subzero, Wolf, and Bosch are a must. Six burner gas stoves, double ovens, convection ovens, warming drawers, pizza ovens, wine refrigerators, high end cabinetry, granite or other high end countertops, plenty of work space, center islands, and pantries are all key components fancy food loving buyers look for.
Now some people say realtors use the term "gourmet kitchen" too much so. So, I thought I'd take a look to see how many great gourmet kitchens are available right now on the MLS. Much to my surprise, of the 911 current listings in Belknap County, there were only a measly 14 kitchens that were touted as "gourmet" when I search for that term! Shocking, to say the least. Surely there are more than that; after all, we do get the cable cooking shows here. Where are Rachael Ray, Gordon Ramsey and Emeril when you need them?
You apparently don't have to spend a fortune to get a gourmet kitchen in a house. I found one in a $239,000 house in Meredith, but it might be a little suspect as there were no pictures of the kitchen on the MLS. Maybe the chef there was a guy named Boyardee?
Other gourmet kitchens were found at 28 Boulder Drive in Belmont (listed at $399,900), 62 Secord Road in Gilmanton ($495,000), 65 Cotton Hill Road in Belmont ($595,000), and a real nice one at 90 Minge Cove in Alton ($1.795 million.) There are hundreds of homes out there with absolutely stunning kitchens, but searching for them by using "gourmet" as a search term won't bring up all of them. Check with your realtor to find out which homes have that truly special kitchen you've been looking for. Undoubtedly, he knows several great examples of designer kitchens because he's been to open houses where he has chowed down in one or two of them... It's a rough job, but that's what we have to do! Bon Appétit ...
Please feel free to visit www.lakesregionhome.com to learn more about the Lakes Region real estate market and comment on this article and others. Data was compiled using the Northern New England Real Estate MLS System as of November 19, 2013. Roy Sanborn is a realtor at Four Seasons Sotheby's International Realty and can be reached at 603-455-0335.
Last Updated on Friday, 22 November 2013 09:09
New Hampshire stands at a critical juncture in the health care debate and the choices are clear. Do we proactively begin the process repairing our current failing, perhaps terminal, health care system or do we declare defeat and allow New Hampshire to buckle under this broken system's immense pressure. I believe legislators are elected to solve problems, not fight tired partisan battles that place politics over people. Therefore, it's my intention to partner with my colleagues in the New Hampshire Senate who are focused on long-term solutions and not short term, half-hearted fixes with arbitrary deadlines.
It's clear both chambers of the New Hampshire Legislature believe adults between 19 and 64, with incomes below 138 percent of the federal poverty line (individuals earning less than $16,800 and a family of four living on less than $32,500 per year) should have access to health insurance. Encouraging preventive care, made possible through insurance, has the potential to radically reduce emergency care and improve a person's quality of life. Increased access to health insurance will also significantly reduce charity care in New Hampshire and in turn save hospitals upwards of a half billion dollars. Bad debt and unsustainable charity care operate as hard hitting economic anvils on hard working New Hampshire families, health care providers and our local economy.
In working towards health care solutions for our working poor and those struggling with paying insurance premiums, we must also be cognizant of always working towards fostering more competition in the health insurance marketplace, helping reduce premium costs for New Hampshire's business community and developing a health care performance matrix that measures success. Most importantly, there must be an increase, if not maintenance, of local control in health care decisions. New Hampshire control, alongside the establishment of safeguards in case the federal government doesn't fulfill its promises, are the keystones to a plan I will support.
We are in a position to make real substantive changes in New Hampshire's health care landscape. It will take compromise from both chambers and both sides of the political aisle. A "take it or leave it" approach will poison the process. I look forward to working with my fellow legislators who appreciate that standing idle is not an acceptable strategy and who are seeking solutions to tough issues that best serve our state and its hard working citizens.
(Laconia Democrat Andrew Hosmer represents District 7 in the New Hampshire Senate.)
Last Updated on Thursday, 21 November 2013 12:00
Sometimes it pays just to go away. You could ask Jim Skinner about that. He was CEO of the hamburger behemoth, McDonald's, pulling down a hefty $8.8 million in pay. Last year, though, Skinner retired, and, rather than getting a gold watch, he was given a load of gold — so large that even a Brink's armored truck would have been too small to haul it all away. His salary of $753,000 was the least of it. The Big Mac chain also served up $1.7 million to the chief in stock and $3 million in option awards. Then it slathered on another $10.2 million in retirement pay. All that was topped by a super-rich dessert: $11.6 million in "incentive pay."
What? Why does a guy with millions already on his food tray need any incentive to do his job? Maybe because Skinner found it hard to stomach the biggest part of his job, which was to pay poverty wages to McDonald's workers, shove thousands of them onto food stamps and other programs paid for by taxpayers, and lobby aggressively to prevent any increases in the minimum wage or any tax hikes on uber-rich elites like him.
It's dirty work, but Skinner did it, finally skipping away with a 2012 pay package totaling $27.7 million. Yet, in the phantasmagoric plutocracy of CorporateLand, too much is not enough. Last year, for the first time ever, the 10 highest-paid CEOs in America hauled in at least $100 million each, even as the great majority of workaday families have lost income.
This gaping (and ever-widening) inequality is the greatest threat to our society's cohesion. Too few people now control an unconscionable and untenable share of America's money and power, using it to grab more of both for themselves. They can build a $100-million wall, but it won't be high enough to hide their greed from the rest of us.
But there's an added dimension to this inequality that you might find especially interesting: Not only are low-wage corporations overly generous to their top dogs, but so are you and I. For example, I'm sure you'll be as delighted as I am to know that we — all of us taxpayers together — contribute day-in and day-out to the very big global cause of Supersizing McDonald's.
The world's largest hamburger chain is a particularly needy charity case, because without your and my generous tax support, the Big Mac bosses in charge would have to pay a living wage to their 860,000-plus American workers. But, thanks to us, the $27 billion-a-year hamburger-flipping flim flammers can get away with paying poverty wages — and then send their workforce to get food stamps, Medicaid, child welfare payments, public housing and other tax-funded poverty benefits. This public subsidy of the Golden Arches adds up to a very golden $1.2 billion a year. What a creative business plan! Who says giant corporations aren't enterprising?
Well, sniff the chain's top executives; we operate on razor-thin profit margins, so we can't afford to throw money at workers. Really? Last year's $5.6 billion in profits doesn't sound thin to me. Also, note that McDonald's more than tripled the pay of its new CEO last year, elevating him from $4.1 million to $13.8 million.
But what really galls its workers (whose low wages and forced part-time schedules mean they average less than $12,000 a year) is that the taxpayer-subsidized profiteer laid out a fat $35 million in October to add a brand new executive jet to its corporate fleet. This one is a "Bombardier 605" with the full package of luxurious amenities, and it cost $2,500 an hour to fly it.
Just flying one hour on the Bombardier cost more than the combined hourly wages of more than 300 McDonald's workers. Remember, you're subsidizing this. Aren't you just "Lovin' it," as the chain's ad slogan puts it? To tell McDonald's CEO that this is immoral, go to OurFuture.org.
(Jim Hightower has been called American's most popular populist. The radio commentator and former Texas Commissioner of Agriculture is author of seven books, including "There's Nothing In the Middle of Road but Yellow Stripes and Dead Armadillos" and his new work, "Swim Against the Current: Even Dead Fish Can Go With The Flow".)
Last Updated on Wednesday, 31 December 1969 07:00