A recent article published here on Occasional Planet stated that the Republican debates last Thursday night were not as much of a clown car as expected. A friend of mine watched the Republican debates and had a similar take on how the Republicans sounded.

However, the realities of the world in which we live came home to roost for him the following day. Conversations with, and requests from, several people repeatedly burst the bubble of the mean-spirited economic policies that all of the GOP candidates share.

No sooner had his alarm clock gone off at 7:30, when a twenty-four year old friend of his called and reluctantly asked if he could have $350, because his children’s clothes had been destroyed in a fire at their mother’s house. And since he was going to take the boys, two and four years old, into his own new apartment, he needed money for a bunk bed and a microwave. This was hardly the first call my friend had received from the twenty-four year-old. The young man was now working one full-time job and another part-time, but since the paychecks were erratic, he had needed money for a monthly bus pass. A few days earlier, he needed help paying his cell phone bill; he had to stay in touch with his employers, his children and day-care, as he was juggling the responsibilities of essentially being a single parent. Prior to this, my friend had been helping the young man pay off fines from a myriad of North St. Louis County jurisdictions, where he had been found guilty of what we now call “poverty crimes.”

My friend couldn’t help but wonder how different things would have been for his friend if he was living in a European democracy or Canada. In these industrialized countries with a large measure of socialism in their economic policies, there is an awareness that for all of us, there are times in our lives when “shit happens,” and an economic safety net is necessary in order to seamlessly help people through difficult times.

According to the “Republican Seventeen,” when rough times occur in the U.S., people should either declare bankruptcy or pull themselves up by their boot-straps. What these Republicans fail to recognize is that if you’re poor, you really can’t declare bankruptcy. And as for pulling yourself up by your boot-straps, well that only works if you have boot straps. The twenty-four year old friend of my friend is working his butt off, well over twelve hours a day, but still has not been able to catch up basic expenses, much less to begin saving.

Later that day, my friend received a call from another of his friends. She’s sixty-five years old and not in good health. Her Social Security can get her through two, perhaps, three weeks of the month. Now she was calling my friend because she had four  prescriptions waiting for her at Walgreen’s. She did not have money for the co-pays. My friend helped her out with those co-pays. This happened while the Republicans were urging cutbacks in Social Security.

This friend of mine has repeatedly helped others and rarely complains.

But I am outraged by how callous our society can be, with that meanness mainly fueled by Republicans. Because so many in our society see charity as an adequate substitute for social justice, those in need are repeatedly placed in positions where they have to go into “asking” mode. “Asking” can easily become begging. Republicans repeatedly fail to do the math; charity can provide only 3 to 5 percent of the costs of an adequate safety net.

In so many sectors of our society, the power elite seems to think that begging should be a normal part of the human experience. It can be those citizens among us who do not have the economic wherewithal to adequately support themselves; it can be college students who can only secure their education if they assume long-term burdening debts; and it can be our political leaders, who bombard us continuously with dire requests for money in support of their campaigns.

Yes, most of those Republicans sounded articulate. The media was quick to pick that up. What the mainstream press continuously refuses to do is to say that the basic tenet of the modern Republican Party is meanness. No matter how well they phrase their words, they are still mean.

The post You can be mean and still sound rational appeared first on Occasional Planet.

The Centers for Medicare and Medicaid Services (CMS) has just released new rules, the first in over a decade, for Medicaid managed programs. These rules “would cap insurer profits, require states to more rigorously supervise the adequacy of plans’ provider networks, encourage states to establish quality rating systems for plans, allow more behavioral healthcare in institutional settings and encourage the growth of managed long-term care.”

Changes also include a new rule that would create a Medical Loss Ratio of 85 percent, similar to regulation imposed on private insurance plans. This requires insurers to spend at least 85 percent of their revenue on medical care—not for administrative costs or profits.

Sounds good, right? Well not exactly!

Under the new rules, Medicaid plans would not be required to rebate the difference if they spend less than 85 percent on patient care. And how many plans currently meet this benchmark? According to the Kaiser Family Foundation, only one in four plans came close to spending 85 percent on actual care.

The new rules would require Medicaid plan provider networks to have time and distance standards. Patients would need to have access to hospitals, primary-care physicians and OB-GYNs. Why should we be concerned? As a Modern HealthCare article states, “The CMS mostly punted the task of overseeing network adequacy to the states, despite their history of lackluster oversight.”

What does this mean for Missouri and for health care advocates? Currently, three managed-care companies provide services to approximately 400,000 Medicaid participants in Missouri. Under the new budget passed by the Missouri legislature, nearly 200,000 additional Medicaid patients will be moved to managed-care plans.

As managed-care plans expand in Missouri, including to our rural communities that already lack sufficient services, it means we need to be vigilant. We need to pressure our Missouri state officials and our legislators to insist that care comes before profits and that quality services are available to patients.

We welcome the new rules, but we must work to see that they are implemented.

The post New rules for Medicaid managed care: What do they mean for Missouri? appeared first on Occasional Planet.

Mitt Romney says he’s not worried about the poorest people in America, because they have a safety net. President Obama didn’t even mention poverty in his 2012 State of the Union Address. Well, politicians and candidates may not be thinking about poverty, but a lot of real people are out there living in it—and their numbers are growing. So, how far down on the economic food chain does an individual or a family need to be in order to be considered “poor enough” for safety-net programs?   On Jan. 26, 2012, the U.S. Department of Health and Human Services [HHS] published its annual poverty guidelines.

HHS extrapolates its poverty guidelines from figures compiled by the U.S. Census Bureau. The most recent Census numbers offer a lot of discouraging news:

-Real median household income in the United States in 2010 was $49,445, a 2.3 percent decline from the 2009 median.

-Using the Census’ “threshold” measurement, the nation’s official poverty rate in 2010 was 15.1 percent, up from 14.3 percent in 2009 ─ the third consecutive annual increase in the poverty rate. There were 46.2 million people in poverty in 2010, up from 43.6 million in 2009 ─ the fourth consecutive annual increase and the largest number in the 52 years for which poverty estimates have been published.

HHS’ 2012 poverty guidelines reflect that negative picture. The guidelines—whose purpose is to set the parameters for eligibility for needs-based programs—are, obviously, critical numbers for many individuals and families. A wide variety of federal and state agencies use these guidelines [and multiples of them, such as 125%, 150%, etc.] to determine who qualifies for assistance. Examples are Head Start, the Children’s Health Insurance Program [CHIPS], the Low-Income Home Energy Assistance Program and the Supplemental Nutrition Assistance Program [SNAP] and dozens of others.

In addition, some state and local governments use the federal poverty guidelines in some of their own programs and activities.  Examples include financial guidelines for child support enforcement and determination of legal indigence for court purposes.  Some private companies (such as utilities, telephone companies, and pharmaceutical companies) and some charitable agencies also use the guidelines in setting eligibility for their services to low-income people.

Here are the 2012 guidelines, and the same chart for 2011, for comparison. These are the real-life numbers for millions of Americans. I’d like to see Mitt Romney and all of the others who enjoy waging war on poor people look a safety-net-qualified American in the eye and say that there’s nothing to worry about. As for the rest of us, let’s compare these numbers with our own situations and try to imagine how well we and our own families might be doing at, say 150% of the HHS poverty guideline for 2012.

The post How poor do you have to be to qualify for the safety net in 2012? appeared first on Occasional Planet.