The mission of Lakes Region Partnership for Public Health is "to improve the health and well being of the Lakes Region through ... public health improvement activities." The expansion of Medicaid coverage to citizens in the region would be a public health action of immense consequence.
The Commission to Study Expansion of Medicaid Eligibility has recommended that N.H. expand its Medicaid program to cover uninsured adults with annual incomes up to approximately $15,900, about 4,000 of whom live in Belknap and Carroll Counties. The majority of these individuals are young adults between the ages of 18 and 40 who are under-employed and struggling to get by. They work as wait staff, janitors, classroom aides, in construction and in grocery stores as critical components of our local economy, but without access to a critical benefit.
Without access to health insurance, they pass up preventative care that would help them avoid medical crises. When a crisis does occur, these individuals must use the emergency room: the most expensive health intervention and one that provides no follow-up care to ensure that the patient continue on the road to recovery. We at the Partnership believe that extending Medicaid coverage to this population benefits more than just those 4,000 individuals.
Individuals with health insurance coverage see their physician for preventative care and remain healthier throughout their lives. The N.H. Center for Public Policy Studies has found that insured individuals are almost twice as likely to see a doctor regularly as the uninsured. The insured are five times more likely to have a colon cancer screening than the uninsured. Those with chronic illnesses such as diabetes or asthma can manage their symptoms more effectively and avoid medical crises when covered by insurance. With access to health coverage, these individuals have fewer absences from work or school, have healthier pregnancies and children and are able to participate in community activities. Health insurance coverage for this population could free up our emergency room resources to be able to treat real emergencies quickly and more efficiently. Our local physicians will get reimbursed for seeing these patients, reducing the cost shifting that leads to higher overall costs for everyone.
The commission was careful to recommend that individuals with access to health insurance through their employers stay on that plan rather than switch to Medicaid. The commission also recommended protecting New Hampshire from unsustainable expense should the federal government alter its level of financial support for the expanded population.
As the Partnership collaborates with colleagues such as LRGHealthcare, Genesis Behavioral Health, Lakes Region Community Services and Central NH VNA & Hospice, among others, toward our mutual goal of a healthy region that encourages healthy living practices, we envision the expansion of Medicaid coverage as a step vitally important to assuring all of our residents the opportunity to meet these healthy lifestyle goals.
(Lisa Morris is executive director of the Lakes Region Partnership for Public Health (LRPPH) in Laconia. She wrote this column on behalf of the LRPPH Board of Directors.)
Last Updated on Friday, 01 November 2013 08:57
Where are Americans moving, and why? Timothy Noah, writing in the Washington Monthly, professes to be puzzled. He points out that people have been moving out of states with high per capita incomes — Connecticut, New York, Massachusetts, Maryland — to states with lower income levels.
"Why are Americans by and large moving away from economic opportunity rather than toward it?" he asks.
Actually, it's not puzzling at all. The movement from high-tax, high-housing-cost states to low-tax, low-housing-cost states has been going on for more than 40 years, as I note in my new book "Shaping Our Nation: How Surges of Migration Transformed America and Its Politics".
Between 1970 and 2010, the population of New York state increased from 18 million to 19 million. In that same period, the population of Texas increased from 11 million to 25 million.
The picture is even starker if you look at major metro areas. The New York metropolitan area, including counties in New Jersey and Connecticut, increased from 17.8 million in 1970 to 19.2 million in 2010 — up 8 percent. During that time, the nation grew 52 percent.
In the same period, the four big metro areas in Texas — Dallas, Houston, San Antonio, Austin — grew from 6 million to 15.6 million, a 160 percent increase.
Contrary to Noah's inference, people don't move away from opportunity. They move partly in response to economic incentives, but also to pursue dreams and escape nightmares.
Opportunity does exist in the Northeastern states and in California — for people with very high skill levels and for low-skill immigrants, without whom those metro areas would have lost, rather than gained, population over the last three decades.
But there's not much opportunity there for people with mid-level skills who want to raise families. Housing costs are exceedingly high, partly, as Noah notes, because of restrictive land use and zoning regulations.
And central city public schools, with a few exceptions, repel most middle-class parents.
High taxes produce revenues to finance handsome benefits and pensions for public employee union members in the high-cost states. It's hard to see how this benefits middle-class people making their livings in the private sector.
Moreover, Noah's use of per capita incomes is misleading, since children typically have no income and many in the Northeast and coastal California are childless. If you look at household incomes, these states are far closer to the national average.
As economist Tyler Cowen points out in a Time magazine cover story, when you adjust incomes for tax rates and cost of living, Texas comes out ahead of California and New York and ranks behind only Virginia and Washington state (which, like Texas, has no state income tax).
Critics charge that Texas's growth depends on the oil and gas industries and is weighted toward low-wage jobs. But in fact, Texas's low-tax, light-regulation policies have produced a highly diversified economy that from 2002 to 2011 created nearly one-third of the nation's highest-paying jobs. In those years, its number of upper- and middle-income jobs grew 24 percent.
Liberals like Noah often decry income inequality. But the states with the most unequal incomes and highest poverty levels these days are California and New York. That's what happens when high taxes and housing costs squeeze out the middle class.
As Noah notes, "Few working-class people earn enough money to live anywhere near San Francisco."
This leaves a highly visible and articulate upper class willing, in line with their liberal beliefs, to shoulder high tax burdens and a very much larger lower class — many of them immigrants — available to serve them in restaurants, landscape their gardens and valet-park their cars.
There's nothing wrong with living in a high-rise, restaurant-studded, subway-served neighborhood (I do). It's great that America offers more such options than one and two generations ago.
But it's foolish to try to cram everyone into such surroundings, as the Obama Department of Housing and Urban Development (as Terry Eastland reports in the Weekly Standard) and California Governor, Jerry Brown, are trying to do.
Noah notes correctly that fewer Americans have been moving recently. That's always true in times of economic distress (the Okies' trek along U.S. Route 66 to California's Central Valley in the 1930s was a memorable exception, not the rule).
But they continue to move to the low-tax states that are providing jobs and living space where they can pursue their dreams and escape places that burden them with high costs and provide few middle-class amenities in return.
(Syndicated columnist Michael Barone is senior political analyst for The Washington Examiner, is a resident fellow at the American Enterprise Institute, a Fox News Channel contributor and co-author of The Almanac of American Politics.)
Last Updated on Friday, 01 November 2013 08:52
I was looking through an MLS spreadsheet to see what might be out there for bargains when I ran across an unusual listing in Center Harbor that had an assessed value of $713,300 and a list price of just $299,900. I thought to myself that this might be a steal on a waterfront until I saw the address listed as 41 Kelsea Ave. While Kelsea Ave may be close to the bay, if it were to become waterfront we would likely be praying for the rain to stop. It just so happens that this property would be the perfect place to do that because it is a church! So if you are looking for a truly unique residence at a great price, this might be it!
The property at 41 Kelsea Avenue consists of a quintessential white Catholic Church built in 1907 and an attached two bedroom, custom built home built in 2004. The 63' x 34' church hall features beautiful stained glass and woodwork while the home features a top-of-the line kitchen with Viking appliances, custom cabinetry, stone fireplaces, walnut flooring, and a sunroom that contains a 12' x 7' lap pool. There is a total of 5,600' of heavenly living space. The property is zoned residential/commercial so what would you run for a business here? I'm thinking of establishing a church for those who have faith in real estate. There must be a tax deduction in there somewhere.
This property is not new to the market and was listed by the previous owner for $917,000 back in March of 2010 and it was listed several more times and found no buyers even when reduced down to $695,000. It is now owned by the friendly Bank of America who could no longer wait for a miracle on earth and foreclosed on the property thus it is now offered at a mere 42 percent of the tax assessment.
Another property that appears to be a potentially good deal is at 869 Province Road in Gilmanton. This 1,286 square foot, open concept cape was built in 1994 and while it has just one bedroom and one and a half baths it has an unfinished second floor that's ready for sheet rock. The home features a large eat-in kitchen, master suite, a great four-season sunroom with cathedral ceilings and a gas stove, and a two car garage. The house sits on a 6 acre country lot. The home is on the market for $175,000 which is 80 percent of the tax assessed value of $219,800. This is a short sale so third party approval is required.
Another property worth a look is at 26 Mountain Vista Drive in New Hampton. This is a three bedroom, three bath, contemporary home with 2,464 square feet of living space that was built in 1986 on a 2.86 acre lot. This home is just minutes to downtown Meredith and features an open floor plan, lots of light, beamed ceilings, a master suite, fireplace, three decks, and some great mountain views. This home is also a short sale and is on the market for $189,900 or 70 percent of the tax assessed value of $270,700. Might just be worth a look?
Finally, if you are looking for a waterfront cottage on a great little lake, check out the property at 98 Upper Suncook Lane in Barnstead. This 40s vintage, two bedroom, seasonal cottage has 1,000 square feet of space and sits just steps to the water. It sits on a .19 lot with 85' of frontage that affords beautiful views of the lake and gorgeous sunsets. This property is offered at $199,000 or 62 percent of the tax assessed value of $318,900. Don't wait until next spring, it will be gone...
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. Roy Sanborn is a realtor at Four Seasons Sotheby's International Realty and can be reached at 603-455-0335.
Last Updated on Friday, 01 November 2013 07:56
The very fine public servant, Russ Feingold, cautioned against the steady slippage of our democracy toward autocracy back in October 2001, when he stood tall as the only U.S. Senator to vote against the Patriot Act. Warning that its anti-democratic provisions would create a nation "where the government is entitled to open your mail, eavesdrop on your phone conversations, or intercept your email communications," Feingold rightly concluded: "That country wouldn't be America."
So here we are, having devolved from the founders' principled insistence on erecting the strongest palisades for the defense of the people's personal liberties — to now having a secret government inside our borders and inside our lives. The National Security Agency is running a labyrinthine, secret, extravagant, unconstitutional and out-of-control electronic surveillance operation that targets you.
Yes, you! And me. Its not just German Chancellor Angela Merkel and other head-of-state allies who are furious that this veracious nest of snoops has been listening-in on their private conversations for years, but also everyone living in our own Land of the Free. We citizens have been redefined by our government as suspects.
Not that NSA officialdom actually thinks that you, Mr. Upright or Ms. Doright, are terrorists or even "persons of interest" — but, then again, you might be. So, the spook bureaucracy has unilaterally chosen to create an elaborate, electronic Rube-Goldbergish spy matrix that (A) appropriates and agglomerates everyone's "metadata" — a geek term defined as data that provides information about other data — channels it into (B) banks of rapidly spinning supercomputers that (C) analyze your and my terrorist inclinations, based on (D) the phone calls we make and get, (E) e-mails we send and receive, (F) websites we visit and topics we Google, (G) Facebook friends and pages we like, and (H) credit card expenditures and bank transactions we make.
Even the code-names of NSA's array of electronic eyes are almost comically Orwellian: PRISM, Tempora, XKeyscore, and — my favorite — Boundless Informant.
But all this, and for what? To make you and me safe from terrorists, the hierarchy chants in unison. Constantly pointing to 9/11, the spies and their political henchmen solemnly assert that, hypothetically, bulk surveillance of every American might have, possibly could have, maybe would have stopped that horrific plot. But the phone conversations that mattered in that case were those that did NOT happen — the breakdown in communication between the CIA and the FBI, and between FBI headquarters and its local agents.
When the top brass of U.S. SpyWorld did a dog-and-pony show for the House intelligence committee on June 18, they claimed that "dozens" of terrorist attacks had been prevented since 9/11 by NSA's SuperVac programs. Dozens? "More than 50," clarified NSA's director. But wait, how many of those were plots for terrorist attacks on our soil? "A little over 10," he mumbled. That's it? Years of scooping up ALL metadata on EVERY American to find only 10 plots?
Moreover, he was able to name only four of those 10, and none were serious threats to do major harm to Americans. In fact, one involved a bombing in India, one is a questionable case of $8,500 ostensibly sent to terrorists in Somalia, one was actually uncovered by regular police work, and the fourth was not a plot to attack the U.S., but to send funds abroad to al-Qaida. For this, we should shred our Bill of Rights?
"We've got congressional oversight and judicial oversight," Obama said to a reporter on Sept. 13, then expressed exasperation that people don't have faith in the system, "And if people can't trust not only the executive branch, but also don't trust Congress and don't trust federal judges to make sure that we're abiding by the Constitution, due process, and rule of law, then we're going to have some problems here."
Well, yes sir, you do have some problems, BIG ones. Obama and the surveillance establishment are proposing a bit more "disclosure" to fix the agency's PR problem. But that's just warmed over B.S. We can't give him — or Congress — a pass on this. It's too big, too destructive of our values and self-respect. NSA's domestic spy matrix and the Patriot Act itself confront us as a multi-eyed, hydra-headed, democracy-devouring monster. Forget disclosure; the monster must be dismantled.
(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
The first reports in early May of 1960 were that a U.S. weather plane, flying out of Turkey, had gone missing. A silent Moscow knew better. After letting the Americans crawl out on a limb, expatiating on their cover story, Russia sawed it off.
Actually, said Nikita Khrushchev, we shot down a U.S. spy plane 1000 miles inside our country flying over a restricted zone. We have the pilot, we have the camera, we have the pictures. We have the hollow silver dollar containing the poisoned-tipped needle CIA pilot Francis Gary Powers declined to use.
Two weeks later, Khrushchev used the U-2 incident and Ike's refusal to apologize to dynamite the Paris summit and the gauzy Spirit of Camp David that had come out of his 10-day visit to the USA. Eisenhower's reciprocal trip to Russia was now dead.
A year later, President Kennedy would be berated by Khrushchev in Vienna. The Berlin Wall would go up. And Khrushchev would begin secretly to install nuclear missiles in Cuba, 90 miles from Key West.
Had there been no U-2 incident, would the history of the Cold War have been different? Perhaps.
Yet, while there were critics of launching Power's U-2 flight so close to the summit, Americans understood the need for espionage. Like us, the Soviets were installing ballistic missiles, every single one of which could incinerate an American city.
Post 9/11, too, Americans accepted the necessity for the National Security Agency to retrieve and sift through phone calls and e-mails to keep us secure from terror attacks. Many have come to accept today's risks of an invasion of their privacy — for greater security for their family. And there remains a deposit of trust among Americans that the NSA, the CIA and the Defense Intelligence Agency are not only working for us, they are defending us.
How long Americans will continue to repose this trust, however, is starting to come into question. Last week, we learned that a high official of the U.S. government turned 200 private phone numbers of 35 friendly foreign leaders, basically the Rolodex of the president, over to the NSA for tapping and taping. Allied leaders, with whom America works toward common goals, have for years apparently had their private conversations listened to, transcribed and passed around by their supposed U.S. friends.
Angela Merkel has apparently been the subject of phone taps since before she rose to the leadership of Germany and Europe. A victim of the East German Stasi, Ms. Merkel is not amused.
We are told not to be naive; everyone does it. Spying, not only between enemies but among allies, is commonplace. This is how the world works. Deal with it.
But why are we doing this? Is it all really about coping with the terrorist threat? Or is it because we have the ability to do it, and the more information we have, even stolen surreptitiously from friends and allies, the better? Gives us a leg up in the great game of nations.
U.S. diplomats say that one of their assignments abroad is to know what the host government is thinking and planning politically, economically, strategically. That this is an aspect of diplomacy. But relations among friendly nations are not unlike the NFL. While films are taken of rival teams' games and studied, scouts observe practices, and rumors are picked up of injuries, there are lines that most opposing NFL teams do not cross. The lines of unethical conduct and criminality.
To learn that an owner or coach of one NFL franchise had wiretapped the home phones of coaches and players of a Super Bowl rival would, if revealed, be regarded as rotten business.
What kind of camaraderie, cooperation or friendship can endure in an environment where constant snooping on one's closest friends is accepted practice?
In the Nixon White House, there were serious leaks that revealed our secret bombing of Communist sanctuaries in Cambodia to protect our troops, and of our fallback position in the strategic arms talks. Wiretaps were planted on aides to Henry Kissinger and White House staffers who had no knowledge of what had been leaked. Relationships were altered, some poisoned for a lifetime.
Why should we not expect a similar reaction among foreign friends who discover their personal and political secrets have been daily scooped up and filed by their American friends, and found their way into the president's daily intelligence brief?
The Cold War was a clash of ideologies and empires for the future of the world. Men took drastic measures to preserve what they had. At the end of the Cold War, the old tactics and measures were not set aside, but improved upon, and now are no longer restricted for use against the likes of al-Qaida, but against allies.
At the Cold War's end, the late Ambassador Jeane Kirkpatrick talked hopefully of America becoming again "a normal country in a normal time." Seems as though the normal times are never coming back.
(Syndicated columnist Pat Buchanan has been a senior advisor to three presidents, twice a candidate for the Republican presidential nomination and the presidential nominee of the Reform Party in 2000. He won the New Hampshire Republican Primary in 1996.)
Last Updated on Wednesday, 30 October 2013 08:37