Healthcare reform, Wallstreet’s collapse and rebirth, unemployment and huge deficits. A hell of a time to finally get the kind of leader this country has needed for a decade. Money and American politics, money in American politics should be on center stage this summer. But it has been a big news cycle of deaths and so far from any upcoming election that only the wonks really seem to notice.
Here are the facts: our economy is in decline and unless we can find ways in which to generate greater economic activity at home, we are going to continue to fall further and further behind. 10% unemployment isn’t a surprise, unless you really believed what the politicians were saying (even Obama) when things looked the darkest. Wall Street can recover, but that doesn’t mean the American economy will recovery. Most of Wall Street’s numbers are based on trading, not production and what production these American companies are doing is overseas.
Regardless of how deep of a hole it seems to put us in we must have economic stimulus from the Federal Government. The complex issue is how we turn that stimulus not only into short term American jobs, but into making the American economy stronger, more competitive, greener. It seems such a logical thing to combine Obama’s idealism on these green issues with the economic needs of our country. But economic planning is complex and thwarted at every turn by special interests.
Time for true leadership in Washington and lets start by telling the truth.
Attorney Gordon Johnson
http://tbilaw.com
http://fishtail.tv
https://waiting.com
Date: 7/20/2009 10:08 AM
TOM RAUM,Associated Press Writer
WASHINGTON (AP) — The White House is being forced to acknowledge the wide gap between its once-upbeat predictions about the economy and today’s bleak landscape.
The administration’s annual midsummer budget update is sure to show higher deficits and unemployment and slower growth than projected in President Barack Obama’s budget in February and update in May, and that could complicate his efforts to get his signature health care and global-warming proposals through Congress.
The release of the update — usually scheduled for mid-July — has been put off until the middle of next month, giving rise to speculation the White House is delaying the bad news at least until Congress leaves town on its August 7 summer recess.
The administration is pressing for votes before then on its $1 trillion health care initiative, which lawmakers are arguing over how to finance.
The White House budget director, Peter Orszag, said on Sunday that the administration believes the “chances are high” of getting a health care bill by then. But new analyses showing runaway costs are jeopardizing Senate passage.
“Instead of a dream, this routine report could be a nightmare,” Tony Fratto, a former Treasury Department official and White House spokesman under President George W. Bush, said of the delayed budget update. “There are some things that can’t be escaped.”
The administration earlier this year predicted that unemployment would peak at about 9 percent without a big stimulus package and 8 percent with one. Congress did pass a $787 billion two-year stimulus measure, yet unemployment soared to 9.5 percent in June and appears headed for double digits.
Obama’s current forecast anticipates 3.2 percent growth next year, then 4 percent or higher growth from 2011 to 2013. Private forecasts are less optimistic, especially for next year.
Any downward revision in growth or revenue projections would mean that budget deficits would be far higher than the administration is now suggesting.
Setting the stage for bleaker projections, Vice President Joe Biden recently conceded, “We misread how bad the economy was” in January. Obama modified that by suggesting the White House had “incomplete” information.
The new budget update comes as the public and members of Congress are becoming increasingly anxious over Obama’s economic policies.
A Washington Post-ABC News survey released Monday shows approval of Obama’s handling of health-care reform slipping below 50 percent for the first time. The poll also found support eroding on how Obama is dealing with other issues that are important to Americans right now — the economy, unemployment and the swelling budget deficit.
The Democratic-controlled Congress is reeling from last week’s testimony by the head of the nonpartisan Congressional Budget Office, Douglas Elmendorf, that the main health care proposals Congress is considering would not reduce costs — as Obama has insisted — but “significantly expand” the federal financial responsibility for health care.
That gave ammunition to Republican critics of the bill.
Citing the CBO testimony, House Minority Leader John Boehner, R-Ohio, on Monday accused Democrats of “burying this budget update until after Congress leaves town next month.” He called the budget-update postponment “an attempt to hide a record-breaking deficit as Democratic leaders break arms to rush through a government takeover of health care.”
Late last week, Obama vowed anew that “health insurance reform cannot add to our deficit over the next decade and I mean it.”
The nation’s debt — the total of accumulated annual budget deficits — now stands at $11.6 trillion. In the scheme of things, that’s more important than talking about the “deficit,” which only looks at a one-year slice of bookkeeping and totally ignores previous indebtedness that is still outstanding.
Even so, the administration has projected that the annual deficit for the current budget year will hit $1.84 trillion, four times the size of last year’s deficit of $455 billion. Private forecasters suggest that shortfall may actually top $2 trillion.
The administration has projected that the annual deficit for the current budget year will hit $1.84 trillion, four times the size of last year’s deficit of $455 billion. Private forecasters suggest that shortfall may top $2 trillion.
If a higher deficit and lower growth numbers are not part of the administration’s budget update, that will lead to charges that the White House is manipulating its figures to offer too rosy an outlook — the same criticism leveled at previous administrations.
The midsession review by the White House’s Office of Management and Budget will likely reflect weaker numbers. But where is it?
White House officials say it is now expected in mid-August. They blame the delay on the fact that this is a transition year between presidencies and note that Obama didn’t release his full budget until early May — instead of the first week in February, when he put out just an outline.
Still, the update mainly involves plugging in changes in economic indicators, not revising program-by-program details. And indicators such as unemployment and gross domestic product changes have been public knowledge for some time.
Standard & Poor’s chief economist David Wyss said part of the problem with the administration’s earlier numbers is that “they were just stale,” essentially put together by budget number-crunchers at the end of last year, before the sharp drop in the economy.
Wyss, like many other economists, says he expects the recession to last at least until September or October. “We’re looking for basically a zero second half (of 2009). And then sluggish recovery,” he said.
Orszag, making the rounds of Sunday talk shows, insisted the economy at the end of last year, which the White House used for its optimistic budget forecasts, “was weaker at that time than anyone anticipated.” He cited a “sense of free fall” not fully recognized at the time.
“It’s going to take time to work
our way out of it,” the White House budget director told “Fox News Sunday.”
Even as it prepares to put larger deficit and smaller growth figures into its official forecast, the administration is looking for signs of improvement.
“If we were at the brink of catastrophe at the beginning of the year, we have walked some substantial distance back from the abyss,” said Lawrence Summers, Obama’s chief economic adviser.
Copyright 2009 The Associated Press.
Junior lifeguards mourn death of girl hit by boat
Brain injuries and boating? Yes, it is a serious risk factor. We have had cases of people being run over by boats, people with partial drowings, even people who have been injured by the torque of the wash from the back of a boat engine. Summer and boating comes with serious risk. Beyond the obvious of wearing a life jacket and avoiding alcohol when operating a boat, there are other things to watch for, including serious risk of carbon monoxide poisoning.
Attorney Gordon Johnson
http://tbilaw.com
http://subtlebraininjury.com
http://codamage.com
Date: 7/15/2009 3:45 PM
HUNTINGTON BEACH, Calif. (AP) — Lifeguards mourned and left flowers Wednesday at a makeshift memorial for an 11-year-old girl who was run down by a boat while training to be a lifeguard.
Allyssa Squirrell (Skwehr-EHL’) of Laguna Hills died in surgery Tuesday. An autopsy Wednesday concluded that she died of deep cuts to her back and her left leg, Orange County Sheriff’s Department spokesman Jim Amormino said.
“In all probability, she was struck by the boat’s propeller,” Amormino said.
Junior lifeguards showed up at the city’s marine safety headquarters to remember Allysa. Mourners left flowers, a candle, a pot filled with sand and shells, a pink dolphin-shaped balloon and a message reading “God bless you sweet child,” Amormino said.
Noah Glass, 11, wore his training uniform of white T-shirt and red trunks. He came with his father to place flowers.
“She was really nice and funny. We always played games together,” he told KABC-TV.
Allyssa was with a group of 20 to 25 junior lifeguards who were training beyond the surfline at Huntington Beach when she was struck at about 3 p.m. Tuesday.
The youngsters were practicing speed drops, jumping off the end of a moving boat in pairs. Allyssa and another girl successfully jumped, Amormino said.
The 28-foot boat circled back to pick up the junior lifeguards when it struck Allyssa. The other girl was not hurt, Amormino said.
The boat’s pilot apparently didn’t see the girls because they had not yet swum back to the main group and the seas were choppy, Amormino said.
Allyssa was halfway through an eight-week lifeguard course. Training was suspended Wednesday and grief counselors were made available for the trainees, Amormino said. The program was to resume Thursday.
The boat was piloted by Lt. Greg Crow, a 32-year veteran of the Huntington Beach Marine Safety Division who held a public safety medal of valor, Amormino said.
There also were two instructors, one in the boat and one in the water.
Crow, 53, was traumatized by the accident and is on leave, Amormino said.
He voluntarily submitted to a toxicology test that found no evidence of alcohol or drugs in his body, Amormino said.
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
http://tbilaw.com
http://subtlebraininjury.com
http://codamage.com
Date: 7/15/2009 3:45 PM
HUNTINGTON BEACH, Calif. (AP) — Lifeguards mourned and left flowers Wednesday at a makeshift memorial for an 11-year-old girl who was run down by a boat while training to be a lifeguard.
Allyssa Squirrell (Skwehr-EHL’) of Laguna Hills died in surgery Tuesday. An autopsy Wednesday concluded that she died of deep cuts to her back and her left leg, Orange County Sheriff’s Department spokesman Jim Amormino said.
“In all probability, she was struck by the boat’s propeller,” Amormino said.
Junior lifeguards showed up at the city’s marine safety headquarters to remember Allysa. Mourners left flowers, a candle, a pot filled with sand and shells, a pink dolphin-shaped balloon and a message reading “God bless you sweet child,” Amormino said.
Noah Glass, 11, wore his training uniform of white T-shirt and red trunks. He came with his father to place flowers.
“She was really nice and funny. We always played games together,” he told KABC-TV.
Allyssa was with a group of 20 to 25 junior lifeguards who were training beyond the surfline at Huntington Beach when she was struck at about 3 p.m. Tuesday.
The youngsters were practicing speed drops, jumping off the end of a moving boat in pairs. Allyssa and another girl successfully jumped, Amormino said.
The 28-foot boat circled back to pick up the junior lifeguards when it struck Allyssa. The other girl was not hurt, Amormino said.
The boat’s pilot apparently didn’t see the girls because they had not yet swum back to the main group and the seas were choppy, Amormino said.
Allyssa was halfway through an eight-week lifeguard course. Training was suspended Wednesday and grief counselors were made available for the trainees, Amormino said. The program was to resume Thursday.
The boat was piloted by Lt. Greg Crow, a 32-year veteran of the Huntington Beach Marine Safety Division who held a public safety medal of valor, Amormino said.
There also were two instructors, one in the boat and one in the water.
Crow, 53, was traumatized by the accident and is on leave, Amormino said.
He voluntarily submitted to a toxicology test that found no evidence of alcohol or drugs in his body, Amormino said.
Copyright 2009 The Associated Press.
Internet-based therapy shows promise for insomnia
Sleep issues and fatigue are one of the most common of symptoms after a concussion. Virtually everyone I represent has problems with sleep. Could the internet do more than keep us company in the middle of the night, but also improve our sleep?
Attorney Gordon Johnson
http://tbilaw.com
https://waiting.com
Date: 7/6/2009 4:00 PM
CARLA K. JOHNSON,AP Medical Writer
CHICAGO (AP) — Sleepless people sometimes use the Internet to get through the night. Now a small study shows promising results for insomniacs with nine weeks of Internet-based therapy.
No human therapist is involved. The Internet software gives advice, even specific bedtimes, based on users’ sleep diaries. Patients learn better sleep habits — like avoiding daytime naps — through stories, quizzes and games.
“This is a very interactive, tailored, personalized program,” said study co-author Frances Thorndike of the University of Virginia Health System, who helped design the software, called Sleep Healthy Using the Internet, or SHUTi.
Such software could one day be a low-cost alternative for some patients, Thorndike said. And it could be the only non-drug option for people who live in areas without trained specialists, she said.
Prior research has shown face-to-face cognitive behavioral therapy can have long-lasting results for insomniacs without the side effects of medication. The SHUTi program is based on that style of therapy, which helps patients change thinking patterns that contribute to poor sleep.
In the new study, released Monday in Archives of General Psychiatry, the researchers recruited 45 adults with moderate insomnia and randomly assigned 22 of them to try the Internet program.
The group who got the treatment woke up fewer times and spent fewer minutes awake during the night. The control group’s scores didn’t change. Even after six months, the Internet group’s scores remained improved.
The response was “fairly impressive and comparable to what you see with more intensive sorts of interventions,” said Jack Edinger, a sleep disorder specialist at Duke University Medical Center in Durham, N.C., who wasn’t involved in the study.
Participants were highly educated and had no sleep apnea or psychiatric problems. Testing the approach on a larger, more diverse group could determine which patients benefit most, Edinger said.
Shelby Harris, a sleep specialist at New York’s Montefiore Medical Center, said something valuable is lost in an Internet-based approach. A trained therapist can help patients stay motivated and identify anxieties keeping patients awake at night.
“There will certainly be people who prefer the face-to-face contact or do better with that type of therapy,” Thorndike said. “This will free up those limited resources for face-to-face therapy for the people who need it, benefit from it or would prefer it.”
The study was funded by a grant from the National Institute of Mental Health.
___
On the Net:
Archives of General Psychiatry: http://www.archgenpsychiatry.com
Copyright 2009 The Associated Press.
Attorney Gordon Johnson
http://tbilaw.com
https://waiting.com
Date: 7/6/2009 4:00 PM
CARLA K. JOHNSON,AP Medical Writer
CHICAGO (AP) — Sleepless people sometimes use the Internet to get through the night. Now a small study shows promising results for insomniacs with nine weeks of Internet-based therapy.
No human therapist is involved. The Internet software gives advice, even specific bedtimes, based on users’ sleep diaries. Patients learn better sleep habits — like avoiding daytime naps — through stories, quizzes and games.
“This is a very interactive, tailored, personalized program,” said study co-author Frances Thorndike of the University of Virginia Health System, who helped design the software, called Sleep Healthy Using the Internet, or SHUTi.
Such software could one day be a low-cost alternative for some patients, Thorndike said. And it could be the only non-drug option for people who live in areas without trained specialists, she said.
Prior research has shown face-to-face cognitive behavioral therapy can have long-lasting results for insomniacs without the side effects of medication. The SHUTi program is based on that style of therapy, which helps patients change thinking patterns that contribute to poor sleep.
In the new study, released Monday in Archives of General Psychiatry, the researchers recruited 45 adults with moderate insomnia and randomly assigned 22 of them to try the Internet program.
The group who got the treatment woke up fewer times and spent fewer minutes awake during the night. The control group’s scores didn’t change. Even after six months, the Internet group’s scores remained improved.
The response was “fairly impressive and comparable to what you see with more intensive sorts of interventions,” said Jack Edinger, a sleep disorder specialist at Duke University Medical Center in Durham, N.C., who wasn’t involved in the study.
Participants were highly educated and had no sleep apnea or psychiatric problems. Testing the approach on a larger, more diverse group could determine which patients benefit most, Edinger said.
Shelby Harris, a sleep specialist at New York’s Montefiore Medical Center, said something valuable is lost in an Internet-based approach. A trained therapist can help patients stay motivated and identify anxieties keeping patients awake at night.
“There will certainly be people who prefer the face-to-face contact or do better with that type of therapy,” Thorndike said. “This will free up those limited resources for face-to-face therapy for the people who need it, benefit from it or would prefer it.”
The study was funded by a grant from the National Institute of Mental Health.
___
On the Net:
Archives of General Psychiatry: http://www.archgenpsychiatry.com
Copyright 2009 The Associated Press.
A look at health care plans in Congress
Will Barack Obama’s legacy be more lasting on health care than Hillary Clinton’s? The next few months will likely tell us. The big controversy is going to focus on whether there is a “public option.” The attackers of reform claim that if there is a public plan, then the private insurers will adversely affected. With an 80 plus percent growth in premiums and a 400% growth in profits during the Bush years, we can certainly hope they will be.
I don’t want to give up my health insurance coverage, but I sure wouldn’t want to be without any coverage, which is where an increasing number of American’s find themselves. Pressure must be put on all Democratic Senators to side with their constituents, not the insurance lobby in Washington to get what the people need, finally, this time.
Attorney Gordon Johnson
http://tbilaw.com
https://waiting.com
Date: 7/6/2009 3:31 AM
The Associated Press
A look at health care legislation taking shape in the Democratic-controlled House and Senate as President Barack Obama pushes to overhaul the system, cover nearly 50 million uninsured Americans and reduce costs. Many of the details are still being negotiated and any final health care bill would have to meld proposals from the House and Senate.
___
HOUSE DEMOCRATS
WHO’S COVERED: Around 95 percent of Americans would be covered. Illegal immigrants would not receive coverage.
COST: Unknown.
HOW’S IT PAID FOR: Cuts to Medicare and Medicaid; $600 billion in unspecified new taxes, likely including new levies on upper-income Americans.
REQUIREMENTS FOR INDIVIDUALS: Individuals required to have insurance, enforced through tax penalty with hardship waivers.
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Certain small businesses are exempt.
SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get subsidies to help them buy coverage.
BENEFIT PACKAGE: A committee would recommend an “essential benefits package” that includes hospitalization, doctor visits, prescription drugs and other services. Out-of-pocket costs limited to $5,000 a year for individuals, $10,000 for families. Health insurance companies can offer several tiers of coverage, but all plans must include the core benefits. Insurers wouldn’t be able to deny coverage based on pre-existing conditions.
GOVERNMENT-RUN PLAN: Plan with payment rates initially modeled on Medicare to compete with private insurers.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new National Health Insurance Exchange open to individuals and, initially, small employers; it would be expanded to large employers over time.
CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded to cover all individuals with incomes up to 133 percent of the federal poverty level ($14,404). Currently Medicaid eligibility varies by state, but childless adults are ineligible no matter how poor, and in some states parents with incomes well under the poverty line still aren’t covered.
___
SENATE HEALTH, EDUCATION, LABOR AND PENSIONS COMMITTEE
WHO’S COVERED: Aims to cover 97 percent of Americans.
COST: About $600 million over 10 years, but it’s only one piece of a larger Senate bill.
HOW’S IT PAID FOR: Another committee is responsible for the financing.
REQUIREMENTS FOR INDIVIDUALS: Individuals required to have insurance, enforced through tax penalty with hardship waivers.
REQUIREMENTS FOR EMPLOYERS: Employers who don’t offer coverage will pay a penalty of $750 a year per full-time worker. Businesses with 25 or fewer workers are exempted.
SUBSIDIES: Up to 400 percent poverty level.
BENEFIT PACKAGE: Health plans must offer a package of essential benefits recommended by a new Medical Advisory Council. No denial of coverage based on pre-existing conditions.
GOVERNMENT-RUN PLAN: A robust new public plan to compete with private insurers. The plan would be run by the government, but would pay doctors and hospitals based on what private insurers now pay.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Individuals and small businesses can purchase insurance through state-based American Health Benefit Gateways.
CHANGES TO MEDICAID: Medicaid would be available to individuals with incomes up to 150 percent of the federal poverty level.
___
SENATE FINANCE COMMITTEE
WHO’S COVERED: Around 97 percent of Americans. Illegal immigrants would not receive coverage.
COST: Around $1 trillion over 10 years.
HOW’S IT PAID FOR: Possible sources include cuts to Medicare and Medicaid; about $300 billion in revenue from taxing employer-provided health benefits above a certain level; and about $300 billion in revenue from a requirement for employers to pay into the Treasury for employees who get their insurance through public programs.
REQUIREMENTS FOR INDIVIDUALS: Expected to include a requirement for individuals to get coverage.
REQUIREMENTS FOR EMPLOYERS: In lieu of requiring employers to provide coverage, lawmakers are considering penalties based on how much the government ends up paying for workers’ coverage.
SUBSIDIES: No higher than 300 percent of the federal poverty level ($66,150 for a family of four).
BENEFIT PACKAGE: The government doesn’t mandate benefits but sets four benefit categories — ranging from coverage of around 65 percent of medical costs to about 90 percent — and insurers would be required to offer coverage in at least two categories. No denial of coverage based on pre-existing conditions.
GOVERNMENT-RUN PLAN: Unlike the other proposals the Finance Committee’s will likely be bipartisan. With Republicans opposed to a government-run plan, the committee is looking at a compromise that would instead create nonprofit member-owned co-ops to compete with private insurers.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: State-based exchanges.
CHANGES TO MEDICAID: Everyone at 100 percent of poverty would be eligible. Between 100 and 133 percent, states or individuals have the choice between coverage under Medicaid or a 100 percent subsidy in the exchange. The expansion would be delayed until 2013, a late change to save money — the start date had been 2011.
___
HOUSE REPUBLICANS
WHO’S COVERED: The House GOP’s plan, in outline form for now, says it aims to make insurance affordable and accessible to all. There aren’t estimates about how many additional people would be covered.
COST: Unknown.
HOW’S IT PAID FOR: No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.
REQUIREMENTS FOR INDIVIDUALS: No mandates.
REQUIREMENTS FOR EMPLOYERS: No mandates; small business tax credits are offered. Employers are encouraged to move to “opt-out” rather than “opt-in” rules for offering health coverage.
SUBSIDIES: Tax credits are offered to “low- and modest-income” Americans. People who aren’t covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance.
BENEFIT PACKAGE: Insurers would have to allow children to stay on their parents’ plan through age 25.
GOVERNMENT-RUN PLAN: No public plan.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.
CHANGES TO MEDICAID: People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private p lan if they prefer.
___
OBAMA CAMPAIGN PROPOSAL
WHO’S COVERED: All children and many now-uninsured adults.
COST: Estimates as high as $1.6 trillion over 10 years.
HOW’S IT PAID FOR: Obama proposed cuts within the health care system and raising taxes on households making more than $250,000 annually.
REQUIREMENTS FOR INDIVIDUALS: Unlike his Democratic primary opponent Hillary Rodham Clinton, Obama did not propose an “individual mandate.” Instead he would have required all children to be insured, making it the parents’ responsibility.
REQUIREMENTS FOR EMPLOYERS: Large employers would have been required to cover their employees or contribute to the costs of a new government-run plan.
SUBSIDIES: Obama proposed giving subsidies to low-income people but didn’t detail at what level.
BENEFIT PACKAGE: Insurers participating in a new health exchange would have had to offer packages at least as generous as a new public plan. All insurers would have been prohibited from denying coverage based on pre-existing conditions, and would have had to cover children through age 25 on family plans.
GOVERNMENT-RUN PLAN: A new public plan would have offered comprehensive insurance similar to that available to federal employees.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new National Health Insurance Exchange where individuals could buy the new public plan or qualified private plans.
CHANGES TO MEDICAID: Would have expanded Medicaid eligibility, but didn’t specify income levels.
___
Sources: Associated Press research, Kaiser Family Foundation, Lewin Group.
Copyright 2009 The Associated Press.
I don’t want to give up my health insurance coverage, but I sure wouldn’t want to be without any coverage, which is where an increasing number of American’s find themselves. Pressure must be put on all Democratic Senators to side with their constituents, not the insurance lobby in Washington to get what the people need, finally, this time.
Attorney Gordon Johnson
http://tbilaw.com
https://waiting.com
Date: 7/6/2009 3:31 AM
The Associated Press
A look at health care legislation taking shape in the Democratic-controlled House and Senate as President Barack Obama pushes to overhaul the system, cover nearly 50 million uninsured Americans and reduce costs. Many of the details are still being negotiated and any final health care bill would have to meld proposals from the House and Senate.
___
HOUSE DEMOCRATS
WHO’S COVERED: Around 95 percent of Americans would be covered. Illegal immigrants would not receive coverage.
COST: Unknown.
HOW’S IT PAID FOR: Cuts to Medicare and Medicaid; $600 billion in unspecified new taxes, likely including new levies on upper-income Americans.
REQUIREMENTS FOR INDIVIDUALS: Individuals required to have insurance, enforced through tax penalty with hardship waivers.
REQUIREMENTS FOR EMPLOYERS: Employers must provide insurance to their employees or pay a penalty of 8 percent of payroll. Certain small businesses are exempt.
SUBSIDIES: Individuals and families with annual income up to 400 percent of poverty level ($88,000 for a family of four) would get subsidies to help them buy coverage.
BENEFIT PACKAGE: A committee would recommend an “essential benefits package” that includes hospitalization, doctor visits, prescription drugs and other services. Out-of-pocket costs limited to $5,000 a year for individuals, $10,000 for families. Health insurance companies can offer several tiers of coverage, but all plans must include the core benefits. Insurers wouldn’t be able to deny coverage based on pre-existing conditions.
GOVERNMENT-RUN PLAN: Plan with payment rates initially modeled on Medicare to compete with private insurers.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new National Health Insurance Exchange open to individuals and, initially, small employers; it would be expanded to large employers over time.
CHANGES TO MEDICAID: The federal-state insurance program for the poor would be expanded to cover all individuals with incomes up to 133 percent of the federal poverty level ($14,404). Currently Medicaid eligibility varies by state, but childless adults are ineligible no matter how poor, and in some states parents with incomes well under the poverty line still aren’t covered.
___
SENATE HEALTH, EDUCATION, LABOR AND PENSIONS COMMITTEE
WHO’S COVERED: Aims to cover 97 percent of Americans.
COST: About $600 million over 10 years, but it’s only one piece of a larger Senate bill.
HOW’S IT PAID FOR: Another committee is responsible for the financing.
REQUIREMENTS FOR INDIVIDUALS: Individuals required to have insurance, enforced through tax penalty with hardship waivers.
REQUIREMENTS FOR EMPLOYERS: Employers who don’t offer coverage will pay a penalty of $750 a year per full-time worker. Businesses with 25 or fewer workers are exempted.
SUBSIDIES: Up to 400 percent poverty level.
BENEFIT PACKAGE: Health plans must offer a package of essential benefits recommended by a new Medical Advisory Council. No denial of coverage based on pre-existing conditions.
GOVERNMENT-RUN PLAN: A robust new public plan to compete with private insurers. The plan would be run by the government, but would pay doctors and hospitals based on what private insurers now pay.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Individuals and small businesses can purchase insurance through state-based American Health Benefit Gateways.
CHANGES TO MEDICAID: Medicaid would be available to individuals with incomes up to 150 percent of the federal poverty level.
___
SENATE FINANCE COMMITTEE
WHO’S COVERED: Around 97 percent of Americans. Illegal immigrants would not receive coverage.
COST: Around $1 trillion over 10 years.
HOW’S IT PAID FOR: Possible sources include cuts to Medicare and Medicaid; about $300 billion in revenue from taxing employer-provided health benefits above a certain level; and about $300 billion in revenue from a requirement for employers to pay into the Treasury for employees who get their insurance through public programs.
REQUIREMENTS FOR INDIVIDUALS: Expected to include a requirement for individuals to get coverage.
REQUIREMENTS FOR EMPLOYERS: In lieu of requiring employers to provide coverage, lawmakers are considering penalties based on how much the government ends up paying for workers’ coverage.
SUBSIDIES: No higher than 300 percent of the federal poverty level ($66,150 for a family of four).
BENEFIT PACKAGE: The government doesn’t mandate benefits but sets four benefit categories — ranging from coverage of around 65 percent of medical costs to about 90 percent — and insurers would be required to offer coverage in at least two categories. No denial of coverage based on pre-existing conditions.
GOVERNMENT-RUN PLAN: Unlike the other proposals the Finance Committee’s will likely be bipartisan. With Republicans opposed to a government-run plan, the committee is looking at a compromise that would instead create nonprofit member-owned co-ops to compete with private insurers.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: State-based exchanges.
CHANGES TO MEDICAID: Everyone at 100 percent of poverty would be eligible. Between 100 and 133 percent, states or individuals have the choice between coverage under Medicaid or a 100 percent subsidy in the exchange. The expansion would be delayed until 2013, a late change to save money — the start date had been 2011.
___
HOUSE REPUBLICANS
WHO’S COVERED: The House GOP’s plan, in outline form for now, says it aims to make insurance affordable and accessible to all. There aren’t estimates about how many additional people would be covered.
COST: Unknown.
HOW’S IT PAID FOR: No new taxes are proposed, but Republicans say they want to reduce Medicare and Medicaid fraud.
REQUIREMENTS FOR INDIVIDUALS: No mandates.
REQUIREMENTS FOR EMPLOYERS: No mandates; small business tax credits are offered. Employers are encouraged to move to “opt-out” rather than “opt-in” rules for offering health coverage.
SUBSIDIES: Tax credits are offered to “low- and modest-income” Americans. People who aren’t covered through their employers but buy their own insurance are allowed to take a tax deduction. Low-income retirees younger than 65 (the eligibility age for Medicare) would be offered assistance.
BENEFIT PACKAGE: Insurers would have to allow children to stay on their parents’ plan through age 25.
GOVERNMENT-RUN PLAN: No public plan.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: No new purchasing exchange or marketplace is proposed. Health savings accounts and flexible spending plans would be strengthened.
CHANGES TO MEDICAID: People eligible for Medicaid would be allowed to use the value of their benefit to purchase a private p lan if they prefer.
___
OBAMA CAMPAIGN PROPOSAL
WHO’S COVERED: All children and many now-uninsured adults.
COST: Estimates as high as $1.6 trillion over 10 years.
HOW’S IT PAID FOR: Obama proposed cuts within the health care system and raising taxes on households making more than $250,000 annually.
REQUIREMENTS FOR INDIVIDUALS: Unlike his Democratic primary opponent Hillary Rodham Clinton, Obama did not propose an “individual mandate.” Instead he would have required all children to be insured, making it the parents’ responsibility.
REQUIREMENTS FOR EMPLOYERS: Large employers would have been required to cover their employees or contribute to the costs of a new government-run plan.
SUBSIDIES: Obama proposed giving subsidies to low-income people but didn’t detail at what level.
BENEFIT PACKAGE: Insurers participating in a new health exchange would have had to offer packages at least as generous as a new public plan. All insurers would have been prohibited from denying coverage based on pre-existing conditions, and would have had to cover children through age 25 on family plans.
GOVERNMENT-RUN PLAN: A new public plan would have offered comprehensive insurance similar to that available to federal employees.
HOW YOU CHOOSE YOUR HEALTH INSURANCE: Through a new National Health Insurance Exchange where individuals could buy the new public plan or qualified private plans.
CHANGES TO MEDICAID: Would have expanded Medicaid eligibility, but didn’t specify income levels.
___
Sources: Associated Press research, Kaiser Family Foundation, Lewin Group.
Copyright 2009 The Associated Press.
Move to child’s home major adjustment for senior
Date: 7/3/2009 8:14 AM
ADRIAN SAINZ,AP Real Estate Writer
From deciding where grandma will sleep to knowing her preferred bed time, turning a home into three-generation household takes plenty of planning and frank discussions that can be difficult.
Family psychologists, social workers and relocation specialists are seeing more seniors moving in with their grown children due to financial concerns. The recession has led to increasing job losses and shrinking savings accounts, forcing many seniors to change their retirement plans and consider moving in with their grown children temporarily, or permanently.
Multigenerational households made up 5.3 percent of all households last year, up from 4.8 percent in 2000, AARP reports.
In many cases, such a move is difficult and painful, in others it’s a relatively seamless transition. To make it as easy as possible, grown children and their parents, and often grandchildren as well, need to work out details of the transition.
“It’s an incredibly complicated situation,” says Marsha Frankel, a social worker with Jewish Family & Children’s Service of Greater Boston.
Changes in a senior’s living arrangement — whether living independently or in an assisted living facility — can come suddenly, especially if eroded investments or job loss makes their current situation unaffordable. The unemployment rate for workers aged 55 and older hit 7 percent last month, almost double the rate a year ago, data released Thursday showed.
In fact, about one in 10 people aged 50 and older live either with their grandchildren or their parents, according an AARP survey of more than 1,000 respondents 18 and older released in March.
Sixteen percent of respondents 55 and over reported that moving with their family or a friend was necessary in the past six months. Among those 18 and over who say they are likely to make such a move, 34 percent cited a loss of income as a reason for the move, 19 percent cited a change in job status and 8 percent blamed home foreclosure.
When considering a move, seniors should honestly asses their relationship with their child and his or her spouse. A strained relationship could lead to conflict.
For many seniors, the last time they lived with their children was when they were teenagers whose lives needed direction and discipline, said Nancy Wesson, author of “Moving Your Aging Parents.” It’s the same for the adult child, who may have resented being told what to do all the time and rebelled against mom or dad as a teen.
“A lot of those dynamics are hiding in wait” and surface when the senior parent moves in, Wesson says.
But the relationship has now changed — both parties are adults and will need to adjust their approach to a more patient, communicative partnership.
If a senior decides to make the move, the first step is obvious but absolutely necessary: Have a family conference to discuss how everyone’s life is going to change. AARP suggests the household should also have regular conferences, perhaps once a week after dinner or on a weekend afternoon, to discuss the next week’s schedule.
Families can set up a three-month trial period and should have a backup plan in case the move just does not work.
“The key issue is everybody communicating and things being spelled out in advance,” Frankel says.
A key point of discussion is realizing how much care the senior requires in their daily lives, and how the younger family members are going to help.
It’s important for the senior to retain some control of their lives to keep from feeling isolated. A grown child should refrain from taking over every little aspect of the parent’s life and micromanaging their parents to the point of frustration.
“That’s offensive and they don’t appreciate it,” said Wesson, a senior relocation specialist. “It hurts their feelings. Involve them as much in the process as they are willing to handle.”
Preparing the home for the move is a big step. Homeowners should know if the house can accommodate someone who has trouble climbing stairs. Clutter should be removed from walking areas, and lighting can be improved to deal with any vision loss by the senior.
A grandchild who is being displaced from their usual bedroom should know ahead of time. Bed times might have to be adjusted. Times for having friends over should be established in advance.
The living space in the home should accommodate for Dad’s Favorite Chair, and everyone should have their own designated places, whether it’s to read or watch TV or do homework, AARP suggests.
Homeowners should review their insurance documents or make sure the senior is added to coverage in case there’s a household injury.
Also, the entire household should talk about finances. Seniors with a job, leftover savings or monthly Social Security checks can contribute some money for groceries, utilities or even the mortgage.
However, money doesn’t have to change hands. A more active senior could drive the grandkids to school, baby-sit twice a week or do the grocery shopping. Such routines provide consistency and help life go more smoothly.
But, as the senior gets older, he or she may not be able to drive any more and can’t help out in the household anymore. Adult children and their parents should look down the road and determine what the next step should be if the level of required care becomes too time-consuming.
“People often just think in the moment, that they’re in a financial crunch,” Frankel says. “What happens when mom has been putting her money into the household and suddenly needs more care? Those are the kinds of things that really get to be looked at and create all kinds of problems.”
These and other issues can be obstacles, but a situation in which a senior moves in with their children and grandchildren also can be a blessing: It can bring families closer together.
Multigenerational households should take advantage and try to eat meals together, look at family photos, and plan outings in which everyone participates. A grandmother’s or grandfather’s experience can be invaluable to a younger person who is willing to listen.
“It brings cross generational closeness that you can’t achieve when you are not living together,” said Elinor Ginzler, AARP’s housing expert.
Copyright 2009 The Associated Press.
ADRIAN SAINZ,AP Real Estate Writer
From deciding where grandma will sleep to knowing her preferred bed time, turning a home into three-generation household takes plenty of planning and frank discussions that can be difficult.
Family psychologists, social workers and relocation specialists are seeing more seniors moving in with their grown children due to financial concerns. The recession has led to increasing job losses and shrinking savings accounts, forcing many seniors to change their retirement plans and consider moving in with their grown children temporarily, or permanently.
Multigenerational households made up 5.3 percent of all households last year, up from 4.8 percent in 2000, AARP reports.
In many cases, such a move is difficult and painful, in others it’s a relatively seamless transition. To make it as easy as possible, grown children and their parents, and often grandchildren as well, need to work out details of the transition.
“It’s an incredibly complicated situation,” says Marsha Frankel, a social worker with Jewish Family & Children’s Service of Greater Boston.
Changes in a senior’s living arrangement — whether living independently or in an assisted living facility — can come suddenly, especially if eroded investments or job loss makes their current situation unaffordable. The unemployment rate for workers aged 55 and older hit 7 percent last month, almost double the rate a year ago, data released Thursday showed.
In fact, about one in 10 people aged 50 and older live either with their grandchildren or their parents, according an AARP survey of more than 1,000 respondents 18 and older released in March.
Sixteen percent of respondents 55 and over reported that moving with their family or a friend was necessary in the past six months. Among those 18 and over who say they are likely to make such a move, 34 percent cited a loss of income as a reason for the move, 19 percent cited a change in job status and 8 percent blamed home foreclosure.
When considering a move, seniors should honestly asses their relationship with their child and his or her spouse. A strained relationship could lead to conflict.
For many seniors, the last time they lived with their children was when they were teenagers whose lives needed direction and discipline, said Nancy Wesson, author of “Moving Your Aging Parents.” It’s the same for the adult child, who may have resented being told what to do all the time and rebelled against mom or dad as a teen.
“A lot of those dynamics are hiding in wait” and surface when the senior parent moves in, Wesson says.
But the relationship has now changed — both parties are adults and will need to adjust their approach to a more patient, communicative partnership.
If a senior decides to make the move, the first step is obvious but absolutely necessary: Have a family conference to discuss how everyone’s life is going to change. AARP suggests the household should also have regular conferences, perhaps once a week after dinner or on a weekend afternoon, to discuss the next week’s schedule.
Families can set up a three-month trial period and should have a backup plan in case the move just does not work.
“The key issue is everybody communicating and things being spelled out in advance,” Frankel says.
A key point of discussion is realizing how much care the senior requires in their daily lives, and how the younger family members are going to help.
It’s important for the senior to retain some control of their lives to keep from feeling isolated. A grown child should refrain from taking over every little aspect of the parent’s life and micromanaging their parents to the point of frustration.
“That’s offensive and they don’t appreciate it,” said Wesson, a senior relocation specialist. “It hurts their feelings. Involve them as much in the process as they are willing to handle.”
Preparing the home for the move is a big step. Homeowners should know if the house can accommodate someone who has trouble climbing stairs. Clutter should be removed from walking areas, and lighting can be improved to deal with any vision loss by the senior.
A grandchild who is being displaced from their usual bedroom should know ahead of time. Bed times might have to be adjusted. Times for having friends over should be established in advance.
The living space in the home should accommodate for Dad’s Favorite Chair, and everyone should have their own designated places, whether it’s to read or watch TV or do homework, AARP suggests.
Homeowners should review their insurance documents or make sure the senior is added to coverage in case there’s a household injury.
Also, the entire household should talk about finances. Seniors with a job, leftover savings or monthly Social Security checks can contribute some money for groceries, utilities or even the mortgage.
However, money doesn’t have to change hands. A more active senior could drive the grandkids to school, baby-sit twice a week or do the grocery shopping. Such routines provide consistency and help life go more smoothly.
But, as the senior gets older, he or she may not be able to drive any more and can’t help out in the household anymore. Adult children and their parents should look down the road and determine what the next step should be if the level of required care becomes too time-consuming.
“People often just think in the moment, that they’re in a financial crunch,” Frankel says. “What happens when mom has been putting her money into the household and suddenly needs more care? Those are the kinds of things that really get to be looked at and create all kinds of problems.”
These and other issues can be obstacles, but a situation in which a senior moves in with their children and grandchildren also can be a blessing: It can bring families closer together.
Multigenerational households should take advantage and try to eat meals together, look at family photos, and plan outings in which everyone participates. A grandmother’s or grandfather’s experience can be invaluable to a younger person who is willing to listen.
“It brings cross generational closeness that you can’t achieve when you are not living together,” said Elinor Ginzler, AARP’s housing expert.
Copyright 2009 The Associated Press.