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Lisa Morris - Medicaid expansion makes our mission more achievable

Just last month, the Lakes Region Partnership for Public Health expressed its support for Medicaid expansion in N.H. and explained how extending health care to the identified population is aligned with the Partnership's community-based mission.

Now that the Legislature's Special Session has failed to reach consensus on an expansion plan, the Partnership is reiterating its support for Medicaid expansion, given the critical impact such a move would have in the Lakes Region and on their health outcomes. The Partnership is hopeful that the Legislature can find common ground on this issue when it reconvenes in January.

Since the Affordable Care Act originally envisioned Medicaid expansion to be mandatory, no one foresaw that individuals who are not currently eligible for Medicaid but have incomes below $11,000 annually, are not eligible for health insurance subsidies on the Exchange and as a result, do not have access to affordable health insurance anywhere. The numbers are staggering. In N.H., approximately 40,000 people will be ineligible for a subsidy (In Belknap County, it's 1,980 people). That means that a young, underemployed worker in Laconia who suffers from asthma may miss days from work, try over-the-counter remedies to manage symptoms and may eventually end up in the emergency room with a full-blown asthma attack. Were Medicaid expansion in place, this individual would receive ongoing preventive care from a physician, be able to stay at work and avoid a costly, crisis-driven trip to the emergency room.

The Legislature wisely attempted to expand N.H.'s Health Insurance Premium Payment (HIPP) program that allows individuals to stay on employer-sponsored health plans with Medicaid picking up the cost differential to make it affordable for the employee. This is a win-win for all involved: the state saves money by not fully enrolling an individual in Medicaid; the employer has a healthier workforce; the employee has continuity of care with an affordable plan. Hopefully, this provision will be retained in the version of expansion that finally passes the Legislature.

The Partnership supports keeping individuals on employer-sponsored plans when possible especially because the Affordable Care Act mandates that such plans provide 10 "essential benefits". Too many employer-provided plans are catastrophic in nature: the deductibles and co-pays are so high that, while they pay catastrophic expenses and may keep a family from losing their home, covered individuals cannot afford routine, preventive care that helps them avoid those medical catastrophes.

The Partnership is especially supportive of the inclusion of substance abuse and mental health services in the provision of care under Medicaid expansion. Our Lakes Region communities are struggling to meet these needs for local individuals. Expanding Medicaid would not only mean our providers would receive reimbursement for services, but it would engage more underserved populations. Many of these individuals are currently being seen repeatedly in our emergency rooms. With Medicaid coverage and continuity of care, management of their symptoms, medication and behaviors could better be achieved.

The Lakes Region Partnership for Public Health's mission remains "to improve the health and well being of the Lakes Region." Medicaid expansion makes that mission more achievable as health benefits would be extended to many Lakes Region residents in need of dependable, available health coverage. Medicaid expansion would be good for the Lakes Region.

For more information and/or to receive enrollment assistance in the Health Insurance Marketplace, please contact the ServiceLink Resource Center in your area. ServiceLink's toll free number is 1-866-634-9412. To find a location www.servicelink.org.

(Lisa Morris is executive director of the Lakes Region Partnership for Public Health. She wrote this column on behalf of the LRPPH Board of Directors.)

Last Updated on Wednesday, 31 December 1969 07:00

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Kimon Koulet - Plan to achieve and succeed

The Lakes Region has a rich heritage: it has communities, large and small, that have contributed to New Hampshire's growth and status as one of the best places to live in the United States. Its lakes, rivers, mountains, and forests form a landscape that draws hundreds of thousands of visitors each year. Its independent communities also understand the importance of shared responsibility and interdependence.

Before us lies the future. Will the Lakes Region build on its heritage, enhancing the lives of Lakes Region residents and make our communities strong, attractive, vibrant places to live, work, and play? We know tomorrow will be dramatically different than today. If it is to be better, coordinated local and regional planning will help to assure it is. As the planning adage goes, if we fail to plan, we plan to fail.

It has been a privilege to serve the Lakes Region for nearly 30 years and I have witnessed numerous changes: physical, economic, cultural, and political. From the tourism renaissance in Meredith to the sprawling regional shopping complex at Tilton Junction, significant alteration of the landscape has occurred. Broad state and regional plans may help portray the kind of society we want; though, specific, local community plans often make their contribution in ways that are more meaningful to its residents. While another comprehensive watershed management plan for our largest lake waits to occur, several smaller watershed plans have emerged as communities and watershed associations have taken the lead to ensure that local water supplies are adequate for drinking and recreation. What was once a one-day four-town household hazardous waste collection has morphed into a twice a year twenty-four community summer tradition to clean up the environment, and the creation of a permanent household hazardous product facility in Wolfeboro. Where funding for regional transportation planning was nearly non-existent, the LRPC now has an essential role in the statewide process to improve our roads and promote multi-modes of travel. We just completed the region's second comprehensive economic development strategy. Countless other local and regional plans have stirred the imagination, and led to numerous incremental steps in our communities that reflect our heritage as well as our attitude and political will about the type of place we want to enjoy in the future.

Former president Dwight Eisenhower once said that the plan is nothing, planning is everything. There is truth to that. For example, if you think that the sidewalks in Gilford village, advocated by school-aged children, or the cleanliness of our lakes and rivers, or the preservation of village squares in places like Hebron or Sandwich, or the connecting trails between Laconia to Danbury, or the downtown revitalization in process in Bristol all occur by chance, please guess again. Planning is at its most elegant when positive changes seem naturally occurring, often through the steadfast work and community involvement with local planning boards and the LRPC.

Town and regional planning have proven to be valuable community and regional processes year after year. In today's highly competitive, nano-second world, it is easy to become distracted. We need to stay focused on where our future lies. We, the people, receive the government and the rules from those we elect and appoint. My observation is that good government and planning result from visionary leadership and persistent, selfless service over many years; with many people sharing common goals and a willingness to make things happen. As my tenure as executive director draws to a close, I encourage you to remain engaged for the well-being of your community. If you are so inclined, take the next step and help your friends and neighbors living in the next town over or across the lake; there is where regionalism lives and where your stewardship is prized. We have much to be grateful for, and more importantly, much more to do. Best wishes meeting tomorrow's challenges ... Go Lakes Region!

(Kimon Koulet is the retiring executive director of the Lakes Region Planning Commission.)

Last Updated on Tuesday, 24 December 2013 06:10

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Froma Harrop - Reality comes with risks

The honchos at A&E, professing shock that an old Southern redneck from their reality TV hit "Duck Dynasty" made the sort of homophobic remarks one would expect from an old Southern redneck, yanked Phil Robertson off the show. A culture war skirmish ensued.
Gay rights groups condemned Robertson, who shared his raw opinions in a GQ Magazine interview. Religious conservatives, meanwhile, accused A&E of censoring the Louisiana duck hunter. What Robertson said, they noted, is right there in scripture, in Corinthians I.
Naturally, the politicians jumped in. "I remember when TV networks believed in the First Amendment," said Louisiana Gov. Bobby Jindal. "It is a messed-up situation when Miley Cyrus gets a laugh, and Phil Robertson gets suspended."
For the record, governor, Cyrus (who gained fame for shaking her raised rear end on TV) got not a laugh from me, but a retch. And I did find it odd that A&E would suspend a rural Bible Belt dweller from a "reality" show for saying what many like him really think — as gross as was his way of putting it.
And as inconsequential. Almost no one cares about homosexuality anymore, including most young conservatives. Outside some swampy precincts, the right to gay marriage is rapidly becoming the law of the land. Last week, same-sex couples lined up to tie the knot in, of all places, Salt Lake City.
Also, for the record, Robertson's reading of Corinthians accurately included "adulterers" among those to be denied entry into heaven. Such concerns evidently did not deter the hunter's fellow Louisianans from re-electing Republican David Vitter, a confessed adulterer, to the U.S. Senate in 2010. (In 1999, Vitter succeeded Bob Livingston in the House, after the representative resigned for having been caught cheating on his wife.)
Adultery may ban one from heaven, but it seems a lesser barrier to holding elective office in Washington. In his tweet defending the "Duck Dynasty" patriarch, Vitter emphasized the free speech part, not the Corinthians passage. That was wise.
Until this controversy flared, I had never seen "Duck Dynasty," using the freed-up TV time to watch old "Frasiers." Thus, I've been pondering how the hyperelitist Crane brothers would have responded to the "Duck Dynasty" to do. I envisioned Frasier making a clueless reference to a Royal Pan-Seared Duck Breast recipe using his signature pomegranate sauce.
The down-home Southern duck hunting culture would have seemed as exotic to the Seattleites as the caviar-binging Crane brothers would probably be to the bayou Robertsons. (Keeping categories straight, "Frasier" is sort-of fiction, and "Duck Dynasty" sort-of reality.) The brilliance of both shows is the characters' comic capacities for self-mockery.
As for freedom of speech, A&E hasn't taken anyone's away. Its executives have every right to suspend Robertson from its programming for violating its code of conduct — or for overdoing the camouflage prints. This is business, you know, and if A&E wants to demand that its crotchety old Louisiana duck stalker be politically correct and a macrobiotic vegan besides, it may do so.
The question is why the network went this far. Why can't it respond to what it considers offensive views by simply announcing that A&E finds them offensive? It's hard to see the point of punishing this redneck, who seems as much no-school as old-school.
The "Frasier" brothers protected their snooty sensibilities by steering clear of shopping malls and Olive Gardens. Those jarred by Southern crackers speaking their minds might likewise try avoidance. (Was I just politically incorrect using the word "cracker"?)
Or they should make peace with the obvious risk that if you watch reality TV, reality is (sometimes) what you get.

(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 Tuesday, 24 December 2013 06:04

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Bob Meade - A ridiculous rumor

What follows was sent to me by an old classmate. I have searched the Internet trying to find the author but without success. The story touches the heart . . . it's what I call a "life lesson". Please take a moment to read it . Today, December 24th, is the eve of Christmas day. It's not too late to make a difference in someone else's life. Gift cards to any number of department, drug, and grocery stores are available at many merchants, and the receipt of one of those cards may make a difference in someone's life. If you don't have a particular someone in mind, your pastor, or the Salvation Army, or St. Vincent de Paul, or any number of other organizations probably do.

Make a difference . . . and have a Merry Christmas . . .

Grandma and Santa Claus . . .

I remember my first Christmas adventure with Grandma. I was just a kid. I remember tearing across town on my bike to visit her on the day my big sister dropped the bomb: "There is no Santa Claus," she jeered. "Even dummies know that!"

My Grandma was not the gushy kind, never had been. I fled to her that day because I knew she would be straight with me. I knew Grandma always told the truth, and I knew that the truth always went down a whole lot easier when swallowed with one of her "world-famous" cinnamon buns. I knew they were world-famous, because Grandma said so. It had to be true.

Grandma was home, and the buns were still warm. Between bites, I told her everything. She was ready for me. "No Santa Claus?" she snorted...."Ridiculous! Don't believe it. That rumor has been going around for years, and it makes me mad, plain mad!! Now, put on your coat, and let's go."

"Go? Go where, Grandma?" I asked. I hadn't even finished my second world-famous cinnamon bun. "Where" turned out to be Kerby's General Store, the one store in town that had a little bit of just about everything. As we walked through its doors, Grandma handed me ten dollars. That was a bundle in those days. "Take this money," she said, "and buy something for someone who needs it. I'll wait for you in the car." Then she turned and walked out of Kerby's.

I was only eight years old. I'd often gone shopping with my mother, but never had I shopped for anything all by myself. The store seemed big and crowded, full of people scrambling to finish their Christmas shopping. For a few moments I just stood there, confused, clutching that ten-dollar bill, wondering what to buy, and who on earth to buy it for. I thought of everybody I knew: my family, my friends, my neighbors, the kids at school, the people who went to my church.

I was just about thought out, when I suddenly thought of Bobby Decker. He was a kid with bad breath and messy hair, and he sat right behind me in Mrs. Pollock's grade-two class. Bobby Decker didn't have a coat. I knew that because he never went out to recess during the winter. His mother always wrote a note, telling the teacher that he had a cough, but all we kids knew that Bobby Decker didn't have a cough; he didn't have a good coat. I fingered the ten-dollar bill with growing excitement. I would buy Bobby Decker a coat! I settled on a red corduroy one that had a hood to it. It looked real warm, and he would like that.

"Is this a Christmas present for someone?" the lady behind the counter asked kindly, as I laid my ten dollars down. "Yes, ma'am," I replied shyly. "It's for Bobby."

The nice lady smiled at me, as I told her about how Bobby really needed a good winter coat. I didn't get any change, but she put the coat in a bag, smiled again, and wished me a Merry Christmas.

That evening, Grandma helped me wrap the coat (a little tag fell out of the coat, and Grandma tucked it in her Bible) in Christmas paper and ribbons and wrote, "To Bobby, "From Santa Claus" on it. Grandma said that Santa always insisted on secrecy. Then she drove me over to Bobby Decker's house, explaining as we went that I was now and forever officially, one of Santa's helpers.

Grandma parked down the street from Bobby's house, and she and I crept noiselessly and hid in the bushes by his front walk. Then Grandma gave me a nudge. "All right, Santa Claus," she whispered, "get going." I took a deep breath, dashed for his front door, threw the present down on his step, pounded his door and flew back to the safety of the bushes and Grandma. Together we waited breathlessly in the darkness for the front door to open. Finally it did, and there stood Bobby.

Fifty years haven't dimmed the thrill of those moments spent shivering, beside my Grandma, in Bobby Decker's bushes. That night, I realized that those awful rumors about Santa Claus were just what Grandma said they were — ridiculous. Santa was alive and well, and we were on his team.

I still have the Bible, with the coat tag tucked inside: $19.95.

May you always have love to share, health to spare and friends that care . . . and may you always believe in the magic of Santa Claus!
Life isn't about waiting for the storm to pass . . . it's learning to dance in the rain!

(Bob Meade is a Laconia resident)

Last Updated on Wednesday, 31 December 1969 07:00

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Froma Harrop - Security vs. Privacy

This week, a guard insisted on looking into my handbag as I entered Radio City Music Hall to see the Christmas Spectacular. He had absolutely no reason to suspect me or the hundreds of other patrons whose bags he similarly inspected of carrying guns or explosives. But none of us objected to the incursion.

Speaking for myself, I didn't want to get blown up by a terrorist or other psychopath bent on mayhem in this iconic and people-packed venue. A minor invasion of my handbag seemed a fair trade-off.

Finding a proper balance between security and privacy is no easy task. And Federal District Court Judge Richard J. Leon did not make progress in his attack on the National Security Agency program of collecting Americans' phone call records. In the ruling, Leon held that founding father James Madison would have been "aghast" at the government's alleged encroachment on liberty. He must have one powerful Ouija board.

In ordering the government to stop collecting phone data of the two plaintiffs in the case, Leon handed fundraising ammo to the various fringe interests pushing the public's hysteria buttons for their own advancement. It happens that a higher legal source, the Supreme Court, decided in 1979 that the public should have no expectation of privacy on their telephone "metadata." After all, the phone company has this information. Metadata refers to the numbers dialed and length of calls — not what is said.

Leon's logic was not universally admired. "Smith v. Maryland is the law of the land," remarked David Rivkin, a lawyer in the former President George H.W. Bush's White House. "It is not for a district court judge to question the validity of a Supreme Court precedent that is exactly on point."

Leon oddly argued that the Court didn't foresee the age of massive mobile phone use or that government computers would hold onto the metadata for five whole years. This may be so, but phone companies still have this information, so what should our expectation of privacy be?
Yes, the surveillance program does sound creepy. But in fact, these are computers shuffling the data for worrisome patterns. Humans can't peek at the content without a court order.

When it was revealed that the NSA was spying on foreign allies, such as German Chancellor Angela Merkel, several leaders cried foul. Note that their U.N. resolution protesting such surveillance is largely symbolic. It's common knowledge that the Chinese, Russians and terrorist groups, among others, observe no niceties over privacy. Those not fully engaged in the war for information risk both economic and physical attack.

The lead plaintiff in Leon's case was Larry Klayman, a right-winger known to call Obama and his backers "wildly ultra-leftist, atheist, anti-Judeo-Christian, anti-white and Muslim." That's when he's feeling diplomatic. Seeking to share the "glory" from way-out-left is Glenn Greenwald, chief promoter of NSA leaker Edward Snowden. Greenwald's bankroller happens to be PayPal tycoon Pierre Omidyar, whose company, it turns out, has also been handing its data over to the NSA.

A more worldly and opposite view of these activities comes from Omidyar's co-founder at PayPal, Max Levchin. Conceding on the "Charlie Rose Show" that the data collection seems "unpleasant," "intrusive" and "controversial," Levchin said that compromises must be made in the name of national security.

The foreign-born Levchin further noted that having lived under Russian domination, he regards the U.S. government's intentions as essentially benign. "National Security is just not to be trifled with," Levchin added. "We've seen what happened on Sept. 11, and I think people who forget that are fooling themselves." One suspects most Americans would agree with him.

(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

Hits: 152

 
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