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County participation quickly approved; what could go wrong?

To The Daily Sun,

At a recent meeting chaired by the commissioner of state Health and Human Services, federal and state revisions to Belknap County's services were revealed.

As part of a statewide agreement to accept $150 million from the federal government over a five-year period, we are expected to build our service delivery capacity through the first year of the five-year cycle and to change the way services are delivered, and for how they are compensated, in the remainder of the five-year period.

An Integrated Delivery Network will form the administration vehicle in geographical consonance with the health delivery networks and not by county. In the case of Belknap County, we are in IDN 5, which stretches from just north of Concord up to Thornton. Thornton may be described as remote and at the foothills of the White Mountains.

In exchange for accepting our share of the $19.5 million in statewide funding to build infrastructure, Belknap County agrees to perform according to standards set by state Department of Health and Human Services and by the federal Center for Medicaid and Medicare Services.

Reading from the Community­ Driven Project Menu, this will mean (unspecified) county nursing home transitions and enhanced care coordination for high risk, high utilizing, and chronic condition populations. Words, as we know, mean whatever we choose for them to mean. These particular words should strike fear into the hearts of those who are the most vulnerable in our society — the aged and infirm.

It was suggested by a county commissioner of long experience that the only ways to achieve meaningful cuts to nursing home expense is to reduce the daily rate and/or the number of allowable beds. A reduction in nursing home beds was last achieved some 20 years ago under Commissioner Morton.

In the instance of Belknap County, capacity shrank from 65 beds per elderly population of 1,000 to 40 beds per 1,000. Thus, it is at least plausible that a further reduction could be made, which suggestion did not draw a denial from either Commissioner Meyers or his deputy.

There is a lot more to this project than what can be presented here, including many missed deadlines for implementation of Medicaid Phase 2. When this second phase is complete, Belknap will be compensated for elder care, not by the state nor the federal government directly, but by some managed-care organization who will receive funds, and, it is hoped, disburse them to the county. We enter this brave, new world not kicking and screaming but instead with the willing compliance of two of the three member Board of Belknap County Commissioners.

Having received notice of the Delivery Service Reform Incentive Program waiver program late in the day on April 3; they proceeded to approve county participation the very next morning at a regularly scheduled commission meeting. What could possibly go wrong?

Dick Burchell

Belknap County Commissioner
Gilmanton Iron Works

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Obama's positive impact on lives pales in comparison to capitalism

To The Daily Sun,

It is a common tool of leftists, and apparently some "centrists" like Alan Vervaeke (see his April 14 letter), to claim to want to "disagree without rancor" while filling their letters with personal attacks, insults, and slanders.

Hoping to limit the responding personal attacks, insults and slanders, I will address only two of his statements deserving correction.

Despite what Jefferson or Madison might have said about our Constitution being a "living document," nothing in our Constitution authorizes a majority of Supreme Court justices to "modernize" or update our Constitution.

The Constitution wouldn't have been approved had it been anticipated that unelected Supreme Court Justices could change the Constitution. That would be contradictory to the Constitution's intent which is to limit the federal government's power.

Nevertheless, the Constitution's authors and approvers recognized that future changes would be needed. See Article V of the Constitution for the specifics, which include requiring ratification by three-fourths of the states.

Topic 2. Vervaeke slanders everyone who opposes President Obama's policies. By the time he was elected, it was clear that Obama's policies (big government, redistributionist, etc.) would be harmful to Americans, American interests, and world stability. And this has proven to be the case despite the fact that President Obama has gotten almost everything he wanted from Congress (to the consternation of voters who elected people promising to oppose and stop his destructive policies).

The Republican tradition is to provide opportunities, protect freedoms, ensure the rule of law and equal protection of the law, and limited, constitutional government. These traditions are the opposite of, and explain the opposition to President Obama's policies. (It was Clinton's campaign that created the birther and religion, etc. questions which have been fueled by Obama's behavior.)

For seven years President Obama has held the most powerful position in the world, supported with nearly a $4 trillion budget. Yet, after seven years of Obama policies, the rich (especially Obama contributors) are richer while the rest of us are poorer. Redistribution is a tool to increase the power and wealth of politicians, not the people in general.

Despite all his power, President Obama's positive impact on the lives of people has been minuscule (perhaps non-existent) compared to capitalism, which he hates, which in the last 20 or 30 years has improved the lives of almost every human.

If President Obama actually cared about people rather than pursuing his own power and wealth, he would support and praise the policies that actually enable people to prosper, the policies that lead to economic growth, protection of private property, the rule of law, and limited constitutional government.

Don Ewing
Meredith

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