Monday, December 19, 2005
Forsaking the poor at Christmas: The real scandal
There is a Christmas scandal this year, but it's not the controversy at shopping malls and retail stores about whether their displays say "Merry Christmas" or "Happy Holidays." The real Christmas scandal is the budget proposed by the House of Representatives that cuts health care, and other assistance to low-income families - while further lowering taxes for the wealthiest Americans and increasing the deficit for all of our grandchildren.
Last week, hundreds of religious leaders and faith-based organizers who daily serve the poor braved the cold for what was meant to be a political protest but became a revival and prayer meeting in the United States capital. This was the culmination of a yearlong effort by people of faith to teach our nation's political leaders that "a budget is a moral document." In the final stages of the budget process, after praying and making their best arguments from afar, they decided to take their prayers and presence to the steps of the Cannon House Office Building.
After some powerful preaching on the steps and a press conference that was more like a revival, they continued their praying and singing in front of the entrance, symbolizing the denial of access to Congress for low-income people. "Come walk with us!" they said as they invited members of Congress into their neighborhoods to meet the people who will be most effected by their votes on a budget that virtually assaults low-income families. They sounded like a choir (and a good one at that) as they sang Christmas carols while being arrested, handcuffed, put into buses, and taken to a large holding cell roughly a mile away.
The text they kept repeating at the Capitol Christmas vigil was from the book of Luke -- the best words ever about the true meaning of the coming of the Christ child. Mary, the mother of Jesus, herself a poor woman from an oppressed race and an occupied country, prophesied in her powerful prayer of thanksgiving -- the Magnificat -- about the Messiah she carried in her womb.
"My soul magnifies the Lord, and my spirit rejoices in God my Savior, for he has looked with favor on the lowliness of his servant. Surely, from now on all generations will call me blessed; for the Mighty One has done great things for me, and holy is his name. His mercy is for those who fear him from generation to generation. He has shown strength with his arm; he has scattered the proud in the thoughts of their hearts. He has brought down the powerful from their thrones, and lifted up the lowly; he has filled the hungry with good things, and sent the rich away empty."
On Capitol Hill, Mary would be accused of class warfare for uttering such words, but they still bear the true meaning of Christmas. And the budget and tax cuts being proposed by House leaders directly reverse the priorities of Mary. Instead of filling the hungry with good things and sending the rich away empty, this budget would fill the rich with good things and send the hungry away empty!
The vigil in Washington, DC, was followed by more than 70 vigils in more than 30 states. We prayed for a change of heart in our Washington leaders, we prayed for the poor families we serve, and we prayed that those elected to represent us act to protect the common good in ways consistent with the Christmas message of hope.
Last week, hundreds of religious leaders and faith-based organizers who daily serve the poor braved the cold for what was meant to be a political protest but became a revival and prayer meeting in the United States capital. This was the culmination of a yearlong effort by people of faith to teach our nation's political leaders that "a budget is a moral document." In the final stages of the budget process, after praying and making their best arguments from afar, they decided to take their prayers and presence to the steps of the Cannon House Office Building.
After some powerful preaching on the steps and a press conference that was more like a revival, they continued their praying and singing in front of the entrance, symbolizing the denial of access to Congress for low-income people. "Come walk with us!" they said as they invited members of Congress into their neighborhoods to meet the people who will be most effected by their votes on a budget that virtually assaults low-income families. They sounded like a choir (and a good one at that) as they sang Christmas carols while being arrested, handcuffed, put into buses, and taken to a large holding cell roughly a mile away.
The text they kept repeating at the Capitol Christmas vigil was from the book of Luke -- the best words ever about the true meaning of the coming of the Christ child. Mary, the mother of Jesus, herself a poor woman from an oppressed race and an occupied country, prophesied in her powerful prayer of thanksgiving -- the Magnificat -- about the Messiah she carried in her womb.
"My soul magnifies the Lord, and my spirit rejoices in God my Savior, for he has looked with favor on the lowliness of his servant. Surely, from now on all generations will call me blessed; for the Mighty One has done great things for me, and holy is his name. His mercy is for those who fear him from generation to generation. He has shown strength with his arm; he has scattered the proud in the thoughts of their hearts. He has brought down the powerful from their thrones, and lifted up the lowly; he has filled the hungry with good things, and sent the rich away empty."
On Capitol Hill, Mary would be accused of class warfare for uttering such words, but they still bear the true meaning of Christmas. And the budget and tax cuts being proposed by House leaders directly reverse the priorities of Mary. Instead of filling the hungry with good things and sending the rich away empty, this budget would fill the rich with good things and send the hungry away empty!
The vigil in Washington, DC, was followed by more than 70 vigils in more than 30 states. We prayed for a change of heart in our Washington leaders, we prayed for the poor families we serve, and we prayed that those elected to represent us act to protect the common good in ways consistent with the Christmas message of hope.
Friday, December 16, 2005
Senior voters not happy with the president
Americans remain unhappy with President Bush, but his approval rating rose slightly, a new Wall Street Journal/NBC News poll found. "Bush's overall approval rating was 39%, down from 50% as he entered his second term earlier this year but up a hair from his 38% approval in November."Key finding: "In a period of broad-ranging public discontent, that among senior citizens stands out as most worrisome for Republicans aiming to keep control of the House and Senate in the fall... By a 65% to 19% margin, Americans age 65 and above disapprove of the performance of Congress; those under 65 are also negative but less lopsidedly, 58% to 27%. Moreover, senior citizens say by 47% to 37% that they want Democrats rather than Republicans to win control of Capitol Hill." Full poll results are available.
Medicare's payment chaos
Chaos and confusion is not limited to Medicare's new prescription drug benefit. It is rampant in the way Medicare is administered. This month, as Congress, the executive branch, and the American Medical Association (AMA) fight over how to pay doctors, it is evident evn to those who don't pay attention that micromanagement of such a complex system needs to be reformed.
Here is what has been happening: Under the current payment scheme, doctors face a 4.4 percent pay cut next year due to unforeseen cost growth coupled with a legislatively set pay scale. Doctors have warned the Center for Medicare and Medicaid Services (CMS) that the pay cut threatens patients' access to care. CMS administrator Mark McClellan has an idea how to resolve the problem (a bad idea, but an idea nevertheles), but he does not have the authority to do so; only Congress does. (Home care is in another pay battle, but the AMA battle is symptomatic of the broader problem.)
In Congress, the House and Senate have come to very different solutions from one another, and from CMS, as it debates this year's budget reconciliation bill. McClellan has argued that doctors participating in Medicare should commit to CMS's new pay-for-performance (P4P) system to encourage higher-quality care before they are promised additional pay. He says that if the doctors agree to submit data on their performance, then a pay raise can go into effect. What he doesn't say is that study after study shows variable pay for performance doesn't work as intended. In fact, headlines of late suggest P4P mainly encourages criminal activity.
Meanwhile, the House of Representatives, the Senate and the president all have their own plans, each with their own nuances. Regardless of what should be done about provider payments, it is abundantly clear that this is not working. The debate should not be happening as part of budget negotiations in Congress. The role of Congress should not be that of micromanaging payments and benefits.
Here is what has been happening: Under the current payment scheme, doctors face a 4.4 percent pay cut next year due to unforeseen cost growth coupled with a legislatively set pay scale. Doctors have warned the Center for Medicare and Medicaid Services (CMS) that the pay cut threatens patients' access to care. CMS administrator Mark McClellan has an idea how to resolve the problem (a bad idea, but an idea nevertheles), but he does not have the authority to do so; only Congress does. (Home care is in another pay battle, but the AMA battle is symptomatic of the broader problem.)
In Congress, the House and Senate have come to very different solutions from one another, and from CMS, as it debates this year's budget reconciliation bill. McClellan has argued that doctors participating in Medicare should commit to CMS's new pay-for-performance (P4P) system to encourage higher-quality care before they are promised additional pay. He says that if the doctors agree to submit data on their performance, then a pay raise can go into effect. What he doesn't say is that study after study shows variable pay for performance doesn't work as intended. In fact, headlines of late suggest P4P mainly encourages criminal activity.
Meanwhile, the House of Representatives, the Senate and the president all have their own plans, each with their own nuances. Regardless of what should be done about provider payments, it is abundantly clear that this is not working. The debate should not be happening as part of budget negotiations in Congress. The role of Congress should not be that of micromanaging payments and benefits.
Tuesday, December 13, 2005
An anti-TABOR primer and talking points
In Wisconsin, a misguided (or malevolent) group of legislative leaders is pushing a TABOR amendment to the state’s constitution. They are supported by various national organizations such as Americans for Prosperity and Americans for Tax Reform.
They like to say we're over-taxed here, but according to the Institute for Wisconsin’s Future, individual state taxes have remained consistent for the past 25 years. If we wanted to either reduce individual tax burden or do more for our citizens, we could ask our "corporate citizens" to carry their fair shar: Wisconsin is ranked 50th among all states -- yes, dead last -- in business taxes.
The facts show that TABOR in Wisconsin would do irreparable damage to the state’s education system and in particular harm homeowners and working families. More importantly, the patients and providers of home health care (and the families and communities of both) will suffer greatly under TABOR.
Here are some talking points to help you fight back:
What is the Taxpayer Bill of Rights?
The Taxpayer Bill of Rights (TABOR) is a set of constitutional provisions that limit revenue growth for state and local governments (counties, cities, towns, school districts and special districts) to the rate of inflation plus population growth and requires that any tax increase be approved by the voters of the affected government.
Who is pushing TABOR?
The primary proponent of TABOR is an individual named Grover Norquist, president of Americans for Tax Reform. Norquist has recently gained national interest with his close ties to Jack Abramoff, who is under criminal investigation for his lobbying activities, part of which evolve out of his collection of over $82 million in fees from Native American tribes and their casinos over four years. The architect of TABOR is a Coloradan by the name of Doug Bruce. The pro-TABOR movement is coordinated and heavily funded by the Washington, D.C.-based Americans for Prosperity. These well financed anti-tax national organizations and individuals fund and promote false promises of economic prosperity and tax relief to local organizations and legislators.
TABOR forces states to adhere to a strict, unrealistic and irresponsible formula
Using overall population growth, as TABOR proponents do, fails to account for variations in growth in different sectors of the population that require specific spending programs, like the elderly, school age children, and incarcerated individuals.
TABOR proponents use the Consumer Price Index as the inflation measure to capture the cost structure facing governments. However, the Consumer Price Index measures consumer purchases of items such as cars, food and housing. Governments, on the other hand, purchase “goods” such as health care, emergency services, roads, schools and so on. Thus consumer purchases do not accurately reflect the cost of public services, particularly when considering the escalating costs of items such as health care, which inevitably will lead to setting budget levels lower than the actual need.
They like to say we're over-taxed here, but according to the Institute for Wisconsin’s Future, individual state taxes have remained consistent for the past 25 years. If we wanted to either reduce individual tax burden or do more for our citizens, we could ask our "corporate citizens" to carry their fair shar: Wisconsin is ranked 50th among all states -- yes, dead last -- in business taxes.
The facts show that TABOR in Wisconsin would do irreparable damage to the state’s education system and in particular harm homeowners and working families. More importantly, the patients and providers of home health care (and the families and communities of both) will suffer greatly under TABOR.
Here are some talking points to help you fight back:
What is the Taxpayer Bill of Rights?
The Taxpayer Bill of Rights (TABOR) is a set of constitutional provisions that limit revenue growth for state and local governments (counties, cities, towns, school districts and special districts) to the rate of inflation plus population growth and requires that any tax increase be approved by the voters of the affected government.
Who is pushing TABOR?
The primary proponent of TABOR is an individual named Grover Norquist, president of Americans for Tax Reform. Norquist has recently gained national interest with his close ties to Jack Abramoff, who is under criminal investigation for his lobbying activities, part of which evolve out of his collection of over $82 million in fees from Native American tribes and their casinos over four years. The architect of TABOR is a Coloradan by the name of Doug Bruce. The pro-TABOR movement is coordinated and heavily funded by the Washington, D.C.-based Americans for Prosperity. These well financed anti-tax national organizations and individuals fund and promote false promises of economic prosperity and tax relief to local organizations and legislators.
TABOR forces states to adhere to a strict, unrealistic and irresponsible formula
Using overall population growth, as TABOR proponents do, fails to account for variations in growth in different sectors of the population that require specific spending programs, like the elderly, school age children, and incarcerated individuals.
TABOR proponents use the Consumer Price Index as the inflation measure to capture the cost structure facing governments. However, the Consumer Price Index measures consumer purchases of items such as cars, food and housing. Governments, on the other hand, purchase “goods” such as health care, emergency services, roads, schools and so on. Thus consumer purchases do not accurately reflect the cost of public services, particularly when considering the escalating costs of items such as health care, which inevitably will lead to setting budget levels lower than the actual need.
TABOR hurts taxpayers and fosters corruption
- Regardless of occasional rebates, families end up paying the same or more for fewer quality services.
- Under TABOR, power is shifted from the average citizen (who can influence the decision making process by voting for or against a candidate) to big money interest groups that can push forward their agenda.
- TABOR pits first responders against educators against health care professionals and so on to fight for funding for their programs.
- TABOR encourages politicians to fund their pork barrel projects instead of the services that matter most to Wisconsin.
- TABOR stifles government’s ability to provide for citizens.
- Under TABOR a state’s legislature would be constitutionally prohibited from spending above the TABOR limits, even if revenues exist to fund such spending.
- TABOR threatens a state’s ability to respond to emergencies. If a Hurricane Katrina-like event occurred, a TABOR would make it impossible for a legislature to make sufficient emergency funds available immediately.
- TABOR fails to account for the fact that some investments that are costly in the short term will have returns for the state in the long run.
- TABOR creates disincentives for efficiency by mandating return of surplus funds; thus, agencies will spend everything they receive if they have no opportunity to channel funds to areas of unmet needs.
- Once in a state’s constitution, TABOR is difficult to remove.
- Placing a restrictive tax and expenditure limitation such as TABOR in a state constitution makes changing or removing such a restriction from state law extremely difficult. It took Colorado more than a decade be able to suspend TABOR.
In 1992, Colorado became the only state to experiment with a TABOR.
On November 1, 2005, individuals from the business community, faith community, various political parties, advocates and even one time supporters of TABOR all organized to put an end to it in Colorado. Why?
- From 1991 to 2003, the percent of low-income children without health insurance rose from 15 to 27 percent. During that same period of time, the national rate of uninsured children declined.
- In 2001, funding for health care programs in Colorado became so depleted that the state was forced to suspend its requirement that school children be fully vaccinated because the state could not afford to buy the vaccines.
- Per pupil funding for K-12 education has declined more than $400 in relation to the national average.
- Colorado ranks 48th in the nation for the amount of state tax funds devoted to higher education as a proportion of total state personal income.
- Since June 2002, state funding for libraries has been cut more than 79 percent.
- After over a decade of TABOR, Colorado now ranks 44th in K-12 expenditures, 46th in high school completion rate, 36th in average teacher salary, and 41st in highway maintenance.
- Before 2002, the state contributed funds to help farmers with the cost of agricultural product inspection fees. After the state cut support, local farmers now shoulder the entire cost of these public safety inspections. For many agricultural producers these inspection fees have increased an average of 500 percent.
- Over the last four years, Colorado reported a total loss of 68,000 jobs. In that same period of time, the eight other Mountain Region states reported a median job growth rate of 4.5 percent.
Sunday, December 11, 2005
Quick ways to speak up on health issues
Stir It Up has an action item for those of you with kids, or those of you concerned about the health of kids (so, just about everyone, I hope). Obviously nutrition is a big concern for parents, and the cafeterias at most schools simply don't offer nutritious food. Stir It Up tells you what you can do to help make lunch at school more nutritious!
The American Humane Association is asking President Bush to direct Surgeon General Carmona to prepare a comprehensive report on child abuse and neglect in this country. Join them in their call to make Americans aware of the scale of Child Abuse in this country. According to them, 100 children per hour suffer from neglect and abuse in this country.
Join PEER in telling the EPA that they shouldn't be using human beings as test subjects by clicking here. This one has a time limit!! We only have until December 12th for this one!! That's tomorrow!!
Support the "Fair Share For Health Care" Act by signing this petition. This law would require dead-beat corporations (like Wal*Mart) to provide a minimum health care benefit to their employees or be forced to pay into state health care funds so taxpayers aren't forced to subsidize a multi-billion dollar corporation.
The Campaign for Tobacco-Free Kids is asking for donations, but giving some bracelets in return. The bracelets say 1200, asking you to remember the 1200 Americans that die from tobacco use and second hand smoke each year!! You can donate and get your bracelets here!
The American Humane Association is asking President Bush to direct Surgeon General Carmona to prepare a comprehensive report on child abuse and neglect in this country. Join them in their call to make Americans aware of the scale of Child Abuse in this country. According to them, 100 children per hour suffer from neglect and abuse in this country.
Join PEER in telling the EPA that they shouldn't be using human beings as test subjects by clicking here. This one has a time limit!! We only have until December 12th for this one!! That's tomorrow!!
Support the "Fair Share For Health Care" Act by signing this petition. This law would require dead-beat corporations (like Wal*Mart) to provide a minimum health care benefit to their employees or be forced to pay into state health care funds so taxpayers aren't forced to subsidize a multi-billion dollar corporation.
The Campaign for Tobacco-Free Kids is asking for donations, but giving some bracelets in return. The bracelets say 1200, asking you to remember the 1200 Americans that die from tobacco use and second hand smoke each year!! You can donate and get your bracelets here!
Wednesday, December 07, 2005
What's our role, our culpability, in all of this?
David corn makes some very fine points about the economy -- and about our morals -- in his latest piece. They have heavy implications, of course, for the people served by home care. Here's an excerpt:
Perhaps Americans also know—or feel—that wage growth has lagged behind GDP growth. Or that the growing economy is a hot-money economy fueled by reckless borrowing (which could be read as a sign of national fading glory). Nervous Nellies like Alan Greenspan warn that, despite the recent economic growth, Bush is driving the federal budget off a cliff by creating trillions of dollars of debt that will have to be paid off after he leaves office. The current fiscal policy and the ballooning federal deficits, Greenspan claims, are "unsustainable." The outgoing Federal Reserve chairman is mostly fretting about a budget crunch that will be provoked by Medicare and Social Security obligations. But he also has noted that the growing trade deficit—and the spiraling cost of servicing it—poses a serious threat. A friend who is building a private equity fund for emerging markets summed up the macro situation for me this way: "What a great system. The Chinese lend us money to buy their goods. Then we have to pay back the loans with interest. They make money off us on both ends." Who are the better capitalists?
If the American economy is being hollowed out in age of globalization, do the traditional numbers—jobs produced, the unemployment rate—have the same meaning as they did in days of greater stability? Job creation may be up for the moment. But long-term job security and right-now health care security are less certain. Middle-class Americans can no longer expect to remain in a well-paying job for decades, as many American workers once assumed they would. Consider this: GM recently announced it will be dumping 30,000 jobs and closing several plants. Shortly after that, I heard CNN anchor Miles O'Brien gushing about a Toyota truck plant being built in San Antonio, Texas, that will create up to 2000 jobs paying $9 to $11 an hour. That's about $20,000 a year—much less than what unionized autoworkers have made. Despite O'Brien's enthusiasm, this is hardly a tit for GM's tat.
Sure, some job creation is better than none. But considering the United States needs to create about 160,000 jobs a month to keep even with population growth, 215,000 is not a remarkable number. (Bush last week claimed credit for 4.5 million new jobs created in the past two and a half years. That's just about the keep-even number of 4.8 million or jobs.) Given all the legitimate concerns an American can (and should) have about the country's future economic well-being, the recent job spurt is not enough to warrant cries of "Thank you, George Bush." You don’t have to be a worrywart to wonder if Bush is ignoring—or exacerbating—trends that will undermine America’s traditional economic dominance. Many economists—Morgan Stanley’s Stephen Roach and Max Sawicky , to name a few—are sounding the alarm that if America doesn’t change its borrowing ways, the nation is in for a hard landing.
Then, there's the war. Bush depicts it as an action crucial for the survival of the nation. Yet the nation—or much of it—does not buy that, and most Americans are alienated from an endeavor that is fundamentally redefining the country's relationship with the rest of the globe. They are not paying for the war. Nor are they rushing to join this grand effort. Recruitment has become a problem for the military. And the party that most supports the war—the Republicans—refuses to ask well-heeled American citizens to finance this project, which war-backers liken to World War II and the Cold War. In fact, the GOPers push for more tax cuts for the wealthy, while seeking to reduce public funds for health care for the poor, food stamps, school lunches and other programs that benefit low-income people. Think about it. The elites of America—the people who enjoy the benefits of this nation more than anyone—are generally content to sit back, pocket the Bush tax cuts and do nothing to encourage their children to sign up for this noble crusade. Is there not a whiff of end-of-empire decadence to this? But let's not blame only the top-dwellers. This society across the board (certainly, much of the media) pays more attention to the new Xbox 360 than daily developments in Iraq.
One cynical TV show host recently groused to me: "Nobody cares about the war. I don't do shows on the war. It's all about getting through the holidays. Shopping—that's what people care about." A shop-til-we-drop economy and a war that is sold on the cheap. Are these signs of increasing national greatness? Or—bah, humbug-—perhaps something else? Let's ask the folks at the mall.
David Corn is the Washington editor of The Nation . Read his blog at http://www.davidcorn.com.
Perhaps Americans also know—or feel—that wage growth has lagged behind GDP growth. Or that the growing economy is a hot-money economy fueled by reckless borrowing (which could be read as a sign of national fading glory). Nervous Nellies like Alan Greenspan warn that, despite the recent economic growth, Bush is driving the federal budget off a cliff by creating trillions of dollars of debt that will have to be paid off after he leaves office. The current fiscal policy and the ballooning federal deficits, Greenspan claims, are "unsustainable." The outgoing Federal Reserve chairman is mostly fretting about a budget crunch that will be provoked by Medicare and Social Security obligations. But he also has noted that the growing trade deficit—and the spiraling cost of servicing it—poses a serious threat. A friend who is building a private equity fund for emerging markets summed up the macro situation for me this way: "What a great system. The Chinese lend us money to buy their goods. Then we have to pay back the loans with interest. They make money off us on both ends." Who are the better capitalists?
If the American economy is being hollowed out in age of globalization, do the traditional numbers—jobs produced, the unemployment rate—have the same meaning as they did in days of greater stability? Job creation may be up for the moment. But long-term job security and right-now health care security are less certain. Middle-class Americans can no longer expect to remain in a well-paying job for decades, as many American workers once assumed they would. Consider this: GM recently announced it will be dumping 30,000 jobs and closing several plants. Shortly after that, I heard CNN anchor Miles O'Brien gushing about a Toyota truck plant being built in San Antonio, Texas, that will create up to 2000 jobs paying $9 to $11 an hour. That's about $20,000 a year—much less than what unionized autoworkers have made. Despite O'Brien's enthusiasm, this is hardly a tit for GM's tat.
Sure, some job creation is better than none. But considering the United States needs to create about 160,000 jobs a month to keep even with population growth, 215,000 is not a remarkable number. (Bush last week claimed credit for 4.5 million new jobs created in the past two and a half years. That's just about the keep-even number of 4.8 million or jobs.) Given all the legitimate concerns an American can (and should) have about the country's future economic well-being, the recent job spurt is not enough to warrant cries of "Thank you, George Bush." You don’t have to be a worrywart to wonder if Bush is ignoring—or exacerbating—trends that will undermine America’s traditional economic dominance. Many economists—Morgan Stanley’s Stephen Roach and Max Sawicky , to name a few—are sounding the alarm that if America doesn’t change its borrowing ways, the nation is in for a hard landing.
Then, there's the war. Bush depicts it as an action crucial for the survival of the nation. Yet the nation—or much of it—does not buy that, and most Americans are alienated from an endeavor that is fundamentally redefining the country's relationship with the rest of the globe. They are not paying for the war. Nor are they rushing to join this grand effort. Recruitment has become a problem for the military. And the party that most supports the war—the Republicans—refuses to ask well-heeled American citizens to finance this project, which war-backers liken to World War II and the Cold War. In fact, the GOPers push for more tax cuts for the wealthy, while seeking to reduce public funds for health care for the poor, food stamps, school lunches and other programs that benefit low-income people. Think about it. The elites of America—the people who enjoy the benefits of this nation more than anyone—are generally content to sit back, pocket the Bush tax cuts and do nothing to encourage their children to sign up for this noble crusade. Is there not a whiff of end-of-empire decadence to this? But let's not blame only the top-dwellers. This society across the board (certainly, much of the media) pays more attention to the new Xbox 360 than daily developments in Iraq.
One cynical TV show host recently groused to me: "Nobody cares about the war. I don't do shows on the war. It's all about getting through the holidays. Shopping—that's what people care about." A shop-til-we-drop economy and a war that is sold on the cheap. Are these signs of increasing national greatness? Or—bah, humbug-—perhaps something else? Let's ask the folks at the mall.
David Corn is the Washington editor of The Nation . Read his blog at http://www.davidcorn.com.
Tuesday, December 06, 2005
Alaska's self-directed personal care has implications for Wisconsin
Alaska is tightening rules for a program that provides personal care in the home for thousands of Alaskans who are elderly or have disabilities. Changes adopted last week require caregivers to have prior approval from the state before delivering services. A doctor must certify the care is needed. Clients must undergo regular assessments by a state contractor to create a plan of care. Some services may be limited.
Regulators say they hope to save money and improve accountability in the state-funded program, which has gotten attention for soaring costs -- up from $8 million in 2001 to $80 million this year. The state expects the new rules to stabilize the cost this coming year.
The changes are controversial and some who provide personal care say they worry frail and ill Alaskans will wait too long to get essential in-home help with basic needs.
Alaska altered the program four years ago to allow people in need to manage their own care and hire friends, neighbors and relatives as caregivers. The lax rules invited abuse, according to state officials.
The implications for Wisconsin's Family Care program, frothy-mouthed drive toward "cash-and-carry care" and ongoing Medicaid budget woes are as numerous as they are obvious. Is anyone paying attention?
Regulators say they hope to save money and improve accountability in the state-funded program, which has gotten attention for soaring costs -- up from $8 million in 2001 to $80 million this year. The state expects the new rules to stabilize the cost this coming year.
The changes are controversial and some who provide personal care say they worry frail and ill Alaskans will wait too long to get essential in-home help with basic needs.
Alaska altered the program four years ago to allow people in need to manage their own care and hire friends, neighbors and relatives as caregivers. The lax rules invited abuse, according to state officials.
The implications for Wisconsin's Family Care program, frothy-mouthed drive toward "cash-and-carry care" and ongoing Medicaid budget woes are as numerous as they are obvious. Is anyone paying attention?
