Trump’s Bad Example of How Not to Tackle America’s Spending Issues and Lack of Fiscal Responsibility3/20/2017 Problem solving starts by addressing the biggest sources of the problem before struggling to fix less troublesome areas. Buying a new vehicle with low gas mileage for the sole purpose of saving money does not make financial sense. Eliminating the grocery budget, because the family is spending too much on restaurants and coffee shops, is ineffective, counterproductive, and foolish. Saving money by asking family members to drink less water when dad takes hour-long showers, the pool is left uncovered in the sun, and the faucets leak is just ludicrous. Similarly, the Trump Administration’s focus on small line items and small-budget agencies to cut $54 billion to save money from a Federal Budget of nearly four trillion dollars and bolster an already inefficient, wasteful Military Budget is an example of how not to solve a budget issue.
Decades of unbalanced Federal Budgets have created nearly a $20 trillion National Debt for America. While Bill Clinton was the last US President to lead a successful campaign to address the National Deficit and Debt, Paul Ryan's very sobering 2012 Budget proposal, The Path to Prosperity: Restoring America's Promise, showed exactly how much government the US could afford without increasing tax revenues. Unfortunately, it was a partisan budget based solely on “Conservative” priorities that fueled political polarization and dysfunction. Because Ryan’s approach was to hijack the US Federal Budget to push Right-wing priorities, it failed to solve America’s fiscal issues. Even if he and Trump can now impose such a plan on the American People, the next US President and Congress will undo their changes with added costs. Fiscal responsibility is needed, but it requires a politically, as well as fiscally, balanced Budget that actually tackles the sources of the problem.
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Healthcare, or health insurance to be more precise, makes up a large portion of the employer-derived income 178 million Americans rely upon. Costing annauly somewhere around $18,000 for an average family, health insurance represents up to a fourth of what someone with a median income of $52,000 actually makes with coverage and taxes. Recognizing the bottom 90% of Americans make an average of $30,000 per year, health insurance is a major living expense that they can only afford with help. Prior to Obamacare reforms, more and more Americans were losing their employer-sponsored health insurance, experiencing increased out-of-pocket-expenses, and losing benefits. Today, the trend has largely been supplanted by a growing reliance on government subsidies in the form of tax credit and expanded government-sponsored health insurance, e.g. Medicaid.
As a portion of income, this means the income people drive from work and the economy is stagnating and, even, shrinking. Ideally, the loss of employer-sponsored health insurance would translate into increased cash payments. By not taxing health benefits and affording employers generous tax incentives for providing their employees health insurance, however, government has distorted the value of healthcare for decades, thereby allowing employers to pay their employees less in actual dollars by providing health benefits. Because health benefits are also somewhat of an equalized payroll expense for all employees, lower-valued workers cannot expect to capture the cost of their health insurance in their pay checks. This means a loss of employer-sponsored health insurance is a major loss of income for workers. The trend away from employer-sponsored healthcare also underscores the failure of the economy to deliver average Americans the income they need to maintain a modern lifestyle. The U.N. Economic and Social Commission for Western Asia (ESCWA) has issued a report concluding that Israel imposes an “apartheid regime” on the Palestinian People. Hardliner Israeli supporters immediately condemned and delegitimized the report, the UN Commission, and those who wrote the report in the harshest of terms. Apartheid was a dark period in South African history when the powerful white minority brutally oppressed and tortured the black majority, so the use of the analogy is particularly troubling while it places Israel in the same category as the tyrannical monarchs and dictatorships of the world that thoroughly suppress their populations. For anti-Israeli forces, this is an affirmation of their criticism. For most, this troubling report raises a pivotal question: does Israel really treat the Palestinian People that bad.
Racism, including institutionalized racism, is a global issue and can be found in almost any country. A closer look at how other nations treat their disenfranchised minorities and majorities, such as India where the caste system continues to dehumanize millions, might lead to the same conclusion. Because Israel is a point of contention in the Middle East and the US aggressively supports Israel, Israel is being singled out that. Whether one agrees with this conclusion or not, however, Israel is not kind to the Palestinian People. Under traditional wisdom, supporters need to control the “message” to shape the world’s perception of Israel. By suppressing criticism of the Israeli government’s policies, opposition and threats to Israel can be suppressed. The problem with this traditional wisdom is that the suppression of dissent actually tends to inspire greater criticism, opposition, threats. The Genetic Information Nondiscrimination Act of 2008 (GINA) prohibits employment discrimination based on genetic information, including when it comes to health insurance. It was a rare proactive effort by Congress to secure the rights of citizens before they could be threatened by economic forces and technological advances. While GINA outright bans discrimination based on genetics, the law also ensures discrimination is banned in practice by prohibiting employers from requiring involuntary genetic testing and/or coercing voluntary participation in genetic testing. The Preserving Employee Wellness Programs Act is, however, challenging the safeguards of GINA. Under the proposed legislation, employees could stand to receive a 30% reduction in their healthcare premiums, if they participate in a voluntary wellness program that includes genetic testing. Due to economic forces, this would likely translate into a 30% increase for the premiums of everyone, but only those who do not participate in the program would have to pay the penalty.
In practice, the proposed legislation would pressure employees to sacrifice their right to privacy for their economic interests. Privacy rights exist, in part, to safeguard individuals from what others might do with private information. Although it is logical to charge people more when they use more, the primary reason for health insurance is to make healthcare accessible to those who cannot afford the care they need when they cannot afford it. When it comes to health care, genetic testing offers insurers a greater understanding of their clients potential needs. When it comes to higher premiums for those with increase genetic risks, genetic testing becomes a means of minimizing costs as well as maximizing profits and bonuses by sacrificing those in need. Genetic testing is not, however, the only newly obtainable information that insurers can use to discriminate nor are insurers while employers are not the only ones who can use private information to discriminate and cause harm. Health insurance is supposed to make healthcare more accessible by making healthcare affordable to average income individuals and families. Unfortunately, the costs of healthcare and health insurance, along with deductibles and co-pays, have grown to the point an escalating number of businesses and individual cannot even afford health insurance. Legislative efforts like the Patient Protection and Affordable Care Act, a.k.a. Obamacare, and the American Health Care Act, are intended to address this growing problem. While Obamacare favors tax credits and the expansion of medicaid aimed at helping lower-income individuals and families acquire coverage, the American Health Care Act largely seeks to ease the cost of health insurance across the socioeconomic spectrum, which means the greatest tax benefits go to higher income individuals and families.
Both approaches reinforce the “subsidy mentality” feeding the National Debt and government overreach instead of addressing the affordability of healthcare. Where Obamacare was largely designed to address the issue of access to health insurance for those unable to afford or buy insurance, which was theoretically supposed to help contain costs in the long run by giving people access to far cheaper preventative care, and required followup legislation, the American Health Care Act embraces a “scarcity mentality,” which treats healthcare as a non-renewable resource in need of rationing, by reversing the Medicaid expansion and gutting the “essential health benefits” standards provided by Obamacare. Health insurance reform and healthcare reform need to move beyond the subsidy mentality and the scarcity mentality to actually address the issue of healthcare affordability. |
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April 2020
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