“First Do No Harm”: It’s Time To Rethink The Oath Of Office For People We Vote To Represent Us
First do no harm. That’s a tenet of medical ethics that future doctors worldwide are taught in medical school.
If only the people we elect to represent us were required to take such an oath when they’re sworn into office.
Because they aren’t, folks in Florida are facing having to pay far more for health insurance over the next two years than necessary. And health insurance executives will be laughing all the way to the bank.
Florida state lawmakers, in their ongoing efforts to block the implementation of Obamacare in the Sunshine State, recently passed a law that will allow health insurance companies to gouge Floridians more than any corporate boss dreamed was possible.
And if that weren’t bad enough, insurers will actually be required by law to mislead their Florida customers about why they’re hiking their premiums.
Republicans, who control the governor’s office as well as both houses of the Florida legislature, were confident the U.S. Supreme Court would declare the Affordable Care Act unconstitutional. Not only did they vote to prohibit the state from spending money to implement a law they just knew would be overturned by the high court, they refused to accept money from the federal government that would have enabled the state’s department of insurance to do a better job of regulating health insurers and enforcing new consumer protections in the law.
When the Supreme Court shocked Obamacare opponents last year by upholding the law, Florida lawmakers were in a pickle.
Their response? They passed a bill that prohibits the state’s Office of Insurance Regulation from protecting consumers from unreasonable rate increases for two years.
I learned about what is essentially a “first do as much harm as possible” bill in a letter the nine Democrats in the Florida congressional delegation sent to U.S. Secretary of Health and Human Services Kathleen Sebelius earlier this month pleading with her to step in to protect Floridians by taking an active role in regulating rate increases in the state.
The lawmakers said intervention by HHS was urgently needed because of a law signed in May by Gov. Rick Scott that specifically prohibits Insurance Commissioner Kevin McCarty from doing his job of reviewing rate increases and rejecting those he and his staff determine are unjustifiably high.
Until the passage of SB 1842, McCarty had the power to do that. Florida state lawmakers who voted for the bill, including a few Democrats who seemed to think HHS has more authority than it does, took the position that since the federal government was requiring insurance companies to be more consumer friendly, the federal government should assume the responsibility of enforcing the new consumer protections in Obamacare. The problem is that Congress gave the federal government no such additional powers. As a consequence, HHS really can’t take over what is still a state responsibility. And since Florida turned down the federal money that McCarty would have used to do his job, Floridians appear to be out of luck.
Last month, McCarty’s office said insurance premiums for individuals in Florida would be significantly higher than they are now. In their letter to Sebelius, the state’s congressional Democrats wrote that those increases are “not a coincidence, but rather the product of a cynical and intentional effort by Gov. Scott and the Florida legislature to undermine the Affordable Care Act and make health insurance premiums on the Florida Health Insurance Marketplace more expensive by refusing to allow the insurance commissioner to negotiate lower rates with companies or refuse rates that are too high.”
As PolitiFact noted in a recent analysis of the charges made by the Democrats in their letter (which PolitiFact ruled are true), the states that have authority to approve or disapprove rates were “able to extract significant reductions.” PolitiFact cited a Palm Beach Post story which noted that Maryland’s insurance department had used its regulatory powers “to push rates for next year’s premiums down by as much as a third.”
As Florida CHAIN, a state advocacy group, pointed out when Scott signed SB 1842, the law not only blocks McCarty’s office from protecting consumers, a provision in the law actually requires insurers to send deceptive and misleading notices about rate increases to consumers — and to blame Obamacare for them.
“The only ’public education’ of any sort authorized by the Legislature related to the ACA (Affordable Care Act) is a requirement … that insurers send extremely biased and incomplete notices this fall about the ACA and its effect on policyholders’ rates,” Florida CHAIN said in a statement.
“The sole purpose of the requirement is to create ‘sticker shock’ that can be blamed on the ACA. There will be no mention of the many uncertainties or any other relevant factors, such as past rate increases or how actual rates will be reduced for many by the availability of premium tax credits (to low and middle income earners.)”
So not only will many Floridians be harmed by SB 1842, they will, by law, be misled about who caused the harm.
Maybe it’s time to rethink the oath of office for people we vote to represent us.
By: Wendell Potter, The Center for Public Integrity, August 19, 2013
“More Sickening Than Stomach Flu”: With The Help Of ALEC, Corporate Greed Is Making Us Sick
The failure of our corporate and political leaders to make sure every worker gets good health care is causing some unpleasant consequences — like widespread stomach flu.
Ill workers often spread illness, because millions of employees who deal directly with the public are not covered by paid sick leave policies. So, when they come down with something like the stomach flu, they tend to drag themselves to work, rather than going to bed until they recover, since staying home means a loss of pay — or even the loss of their jobs.
Low-wage workers in the restaurant industry are particularly vulnerable and, since they handle food, particularly threatening. Nearly 80 percent of America’s food service workers receive no paid sick leave, and researchers have found that about half of them go to work ill because they fear losing their jobs if they don’t. As a result, a study by the Centers for Disease Control finds that ill workers are causing up to 80 percent of America’s stomach flu outbreaks, which is one reason CDC has declared our country’s lack of paid sick leave to be a major public health threat.
You’d think the industry itself would be horrified enough by this endangerment of its customers that it would take the obvious curative step of providing the leave. But au contraire, amigos, such huge and hugely profitable chains as McDonald’s, Red Lobster and Taco Bell not only fail to provide such commonsense care for their employees, but also have lobbied furiously against city and state efforts to require paid sick days.
Ironically, the top corporate executives of these chains (who are not involved in preparing or serving food to the public) are protected with full sick leave policies. For them to deny it to workers is idiotic, dangerously shortsighted — and even more sickening than stomach flu.
But what about our lawmakers? Where’s the leadership we need on this basic issue of fairness and public health? To paraphrase an old bumper sticker: “When the people lead, leaders will follow. Or not.”
Not when the “leaders” are in the pocket of corporate interests that don’t like where the people are leading. Take Gov. Scott Walker of Wisconsin, who never met a corporate pocket too grungy to climb into. This story starts in 2008, when the people of Milwaukee took the lead on the obvious need for a program allowing employees to earn a few days of paid sick leave each year, to be used if they fall ill or must care for a sick family member. Seven out of 10 Milwaukee voters approved that measure in a citywide referendum.
Corporate interests, however, sued to stall the people’s will, tying the sick leave provision up in court until 2011. By then, the corporations had put up big bucks to put Walker into the governorship — and right into their pocket. Sure enough, he dutifully nullified the Milwaukee vote by passing a “state pre-emption” law, autocratically banning local governments from requiring sick leave benefits for employees.
Just three months later, Walker’s pre-emption ploy was the star at a meeting of ALEC, the corporate front group that brings state legislators into secret sessions with CEOs and lobbyists. There, legislators are handed model laws to benefit corporations — then sent home to pass them. At a session overseen by Taco Bell, attendees got copies of Walker’s no-paid-sick-leave edict, along with a how-to-pass-it lecture by the National Restaurant Association. “Go forth, and pre-empt local democracy!” was the message.
And, lo, they did. Bills summarily prohibiting local governments from passing paid-sick-leave ordinances are being considered in at least 12 states this year, and Arizona, Florida, Indiana, Louisiana, Kansas, Mississippi and Tennessee have already passed theirs.
Florida’s process was especially ugly. Organize Now, a coalition of voters in Orlando, had obtained 50,000 signatures to put a sick leave referendum on last November’s ballot. But, pressured by the hugely profitable Disney World empire, county commissioners arbitrarily removed it from the ballot.
The scrappy coalition, however, took ‘em to court — and won, getting the referendum rescheduled for a 2014 vote. Disney & Gang scuttled off to Tallahassee this year to conspire with Gov. Rick Snyder and GOP legislative leaders. Quicker than a bullet leaves a gun, those corporate-hugging politicos obligingly delivered a “kill shot” to Orlando voters by enacting a Walkeresque state usurpation of local authority.
By spreading Walker’s autocratic nastiness from state to state, money-grubbing low-wage profiteers are literally spreading illness all across our land.
By: Jim Hightower, The National Memo, August 14, 2013
“Suppressing The Vote”: For The GOP, “Integrity Of The Ballot” Is A Deceptive Myth
Now that the U.S. Supreme Court’s hyper-conservative faction has neutered the Voting Rights Act, Republican officials around the country have re-energized their campaign to block citizens of color from voting.
Florida Gov. Rick Scott surprised no one last week when he announced that he would resume a controversial and clearly partisan purge of the voting rolls, supposedly to clear them of non-citizens. Nor is there any shock in the decisions by officials in Texas, Alabama and Mississippi to proceed with harsh new voter ID laws.
While Republicans contend the new laws and purges are necessary to protect the integrity of the ballot, that stale defense no longer merits extensive debate. It’s obvious that GOP activists have but one purpose in changing laws that affect voting and registration: putting up obstacles that might suppress the franchise among voters who usually support Democrats.
Actually, a few have admitted as much. Last year, Republican Mike Turzai, House majority leader in the Pennsylvania legislature, bragged about the passage of a strict new voter ID law, claiming it would “allow Gov. Romney to win the state of Pennsylvania.” Though Romney lost Pennsylvania on his way to overall defeat, the state’s GOP chairman still said earlier this year that voter ID “probably helped a bit” in cutting President Obama’s margin of victory from 2008.
A similar admission came from Republican campaign consultant Scott Tranter when he spoke at a post-election analysis hosted last December by the Pew Center on the States. He dismissed the idea of bipartisan cooperation to eliminate the long lines and other dismal conditions that had plagued voting in many areas.
“… At the end of the day, a lot of us are campaign professionals and we want to do everything we can to help our sides. Sometimes we think that’s voter ID, sometimes we think that’s longer lines, whatever it may be,” Tranter said.
Not that you needed those admissions to know that the GOP-led campaign to “protect the integrity of the ballot” is phony, the 21st-century version of the poll tax. Remember when Alan Wilson, South Carolina’s Republican attorney general, claimed last year that hundreds of dead people had voted in his state?
Ah, never happened. As you might expect, zombies have little interest in electoral politics. State authorities investigated and found no — zip, zero, zilch — zombie voters there.
Wilson made his claims in defense of a strict new voter ID law, one of the GOP’s more popular methods for suppressing the franchise. Supposedly, the requirement for showing state-sponsored identification, such as a driver’s license, would prohibit not only the dead but also other unworthies who claim to be legitimate voters. There is just one problem with that theory: Voter impersonation is virtually non-existent.
But voter ID laws do serve the purpose for which they are actually intended. They pose an obstacle for thousands of elderly and poor Americans who lack driver’s licenses, most of whom tend to support Democrats.
Florida, where Scott is proceeding with his purge, is a particularly interesting case. According to Florida Democratic strategist Steve Schale, the state has gained 1.5 million registered voters since 2006. Of those, 61 percent are blacks or Latinos, both strong constituencies for the Democratic Party. It’s no wonder, then, that Florida Republicans have worked so hard to block the franchise among those voters.
You may have noticed, though, that voter suppression hasn’t helped the GOP win presidential elections in the last two cycles. Indeed, their tactics may have given Obama the winning edge in Florida in 2012: Black voters were so angered by obvious attempts to discourage them from voting that they turned out in huge numbers, enduring long lines.
Given that reality, some conservatives believe the GOP should give up its emphasis on blocking the ballot. As The New York Times‘ Ross Douthat has written: “the GOP is … sending a message to African-Americans that their suspicions about conservatism are basically correct, and that rather than actually doing outreach to blacks, the right would rather not have them vote at all.”
Indeed, there is no reason for black voters to believe anything else.
By: Cynthia Tucker, The National Memo, August 11, 2013
“A Pattern For The Court”: SCOTUS’s Meaningless Death Penalty Rules
Monday evening, the state of Florida executed John Errol Ferguson. This was not an act of injustice because Ferguson was innocent—he brutally killed eight people. It was an act of injustice because Ferguson was mentally ill. The Eighth Amendment forbids his execution.
In 2008, the Supreme Court held that a person cannot be executed if he or she is insane at the time of his or her execution. To the extent that the term has meaning, it’s hard to imagine that it doesn’t apply to Ferguson, who experts have testified has a “genuine belief” that he is the “prince of God” and has the power to control the sun. Stephanie Mencimer of Mother Jones details Ferguson’s history of mental illness:
Ferguson’s story, and long-documented record of mental illness, starts back in 1965, when records show Ferguson was suffering from hallucinations. In 1971, he was committed to a state mental hospital after being diagnosed as a paranoid schizophrenic. For the next several years, court-appointed doctors repeatedly reported that Ferguson was psychotic and in need of long-term hospitalization.
In 1975, a court-appointed psychiatrist reported that Ferguson was “suffering from a major mental disorder and is extremely dangerous to himself and others. He is dangerous to the point where he is considered homicidal … He should be in a maximum security ward … He should not be released under any circumstances.”
As Mencimer goes on to explain, Ferguson was nonetheless released from custody, a decision and failure of judgment that cost eight people their lives. Yet Florida continues to deny the obvious about Ferguson’s paranoid schizophrenia. Despite its earlier command, the Supreme Court allowed him to be executed without comment.
This kind of outcome is becoming a pattern for the Court, as we saw earlier this year with respect to its formal holding that executing someone with a severe mental handicap violates the Eighth Amendment. The Supreme Court’s prohibition on executing the mentally handicapped or severely ill have become more of a Potemkin village façade of fairness than the real thing because of its refusal to define or enforce any kind of substantive standard to determine whom the rule applies to. The Court’s deference to state determinations—no matter how implausible they are—means that the only states that won’t execute those with severe mental incapacities are those already committed not to doing so. Any state that lacks that commitment can proceed as before.
This is illustrative of the larger problem with the death penalty: The American criminal-justice system does not appear capable of rationally designating only those most clearly culpable of heinous crimes for execution. It remains true, in the memorable phrase of Justice Potter Stewart, that capital punishment as applied by the states is “cruel and unusual in the same way that being struck by lightning is cruel and unusual.” Some people are executed while others found guilty of more horrible crimes in the same state are not, and some people who are executed are probably not guilty of anything. The Supreme Court’s occasional gestures towards making the death penalty less arbitrary have done almost nothing to alter this fact.
And yet, as Sarah Muller of MSNBC points out, not only is Florida refraining from tightening its procedures, it’s actively seeking to speed up executions with its “Timely Justice Act.” It’s become increasingly hard to imagine that the Supreme Court will stand in the state’s way, which will have the effect of making an already unjust and error-prone process for killing people even more so.
By: Scott Lemieux, The American Prospect, August 7, 2013
“Purposeful Republican Misrepresentation”: Read This Before You Believe The Obamacare Premium Spike Hysteria
While some states are reporting lower than expected health care premiums in the exchanges established by the Affordable Care Act, a growing number of Republican-controlled states — like South Carolina, Ohio, Indiana, Florida and Georgia — are garnering screaming headlines about huge premium spikes under the law.
Calculating premium rates is a complicated and tedious task that will vary greatly among states and is open to interpretation and manipulation by both supporters and opponents of President Obama’s health care law. Generalities are particularly hard to draw, as the law will impact Americans differently: the new regulations will lead some younger people to may pay more than they’re contributing now, but will save older and sicker people hundreds, if not thousands of dollars a month.
Still, since Republicans are politically motivated to portray the proposed premium increases in a negative light and the media is far more interested in sensational claims about Obamacare failing, coverage of the new rates often leads readers with the mistaken perception that the law is coming off the tracks. Below is a short guide that will help you identify if someone is misrepresenting how much premiums will increase under Obamacare:
1. Do the premiums account for subsidies?
Most articles about premiums for health insurance in the exchanges relegate information about the Affordable Care Act’s tax credit subsidies to the lower two thirds of the piece, thus presenting the top rates as the actual amount families and individuals will be required to pay.
In reality, the number of applicants who are eligible for sliding-scale tax credits will vary — the credits are available to people making less than four times the poverty line — but the Congressional Budget Office (CBO) estimates that out of the 7 million Americans expected to enroll in coverage in 2014, 6 million will be eligible for subsidies. Those with incomes up to 400 percent of the Federal Poverty Line (FPL) will also see reduced the out-of-pocket limits.
Maryland officials, for instance, project that three-fourths of enrollees will receive assistance. In 2014, the average subsidy will be $5,510 and will increase in the years ahead.
2. What is the state comparing the new premiums to and does it break down the increases by the available levels of coverage?
While states like New York or California have already enacted strict regulations that mirror many of the new rules in the Affordable Care Act, others (like Indiana or South Carolina) allow insurers to sell skimpy bare-bones high deductible plans that provide little actual coverage.
Comparing the comprehensive plans that will be available in the exchanges (and the individual market) to the existing coverage is like likening a Lexus to a bicycle — yes, the car is more expensive, but it is in a whole different category of transportation. Under the law, all new insurance plans have to offer essential health benefits like prescription drug and mental health services.
3. Are cheaper coverage options mentioned?
Last month, state officials in Indiana announced that premiums for individual policies would be 72 percent higher than the premiums people currently play. But a closer look at the data revealed that the state wasn’t issuing actual premiums, but calculations for “allowed cost” or “the cost of insurance before calculating how much individuals would pay out-of-pocket, because of co-payments and deductibles.” The actual premiums turned out to be much lower.
What’s more, the numbers were averages of all plans in the exchange — from bronze plans that cover 60 percent of health care costs to platinum plans, which pay for 90 percent — and were not representations of the prices actual families will pay. Past experience in Massachusetts shows that consumers are very price conscious and will gravitate towards the cheaper bronze or silver plans. (In Massachusetts, 84 percent enrolled in bronze or silver policies.)
A catastrophic plan will also be available to those up to age 30 in the individual market. In Nevada, this coverage will be available for less than $100.
4. Has the state done all it could to reduce premiums?
Approximately two dozen states allow the state insurance department or commission “the legal power of prior approval, or disapproval, of certain types of rate changes” and under the Affordable Care Act, the federal government has offered grant funding “to help with rate review activities.” States like Maryland — which has some of the strongest rate-setting laws in the country — claims to have used its authority to deny rate increases to reduce the proposed premiums by “more than 50 percent.” Oregon regulators also slashed carriers’ rate requests by as much as 35 percent.
By: Igor Volsky, Think Progress, August 5, 2013
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