Friday, May 6, 2011

Life After High School

Yesterday, over 60 students from Proctor and Herkimer High Schools took control of their future. As part of the 2011 Youth Summit, these youth talked and learned about one of life’s scary leaps: moving on from high school.

After years of schooling, it’s hard to know where and how to get to the next step. There are questions about what the next steps should be - Enter a trade? Try for college? What skills do I need to get there? Who can help me learn those skills? What challenges are out there? Sessions throughout the day highlighted the connections between education, employment, and personal character development. Presenters offered resources on how to shake hands and look an employer in the eye, stay out of trouble, and how to transition to college.

To the students that demonstrated leadership in participating – it’s your life, and we’re confident that you can create the future you want. It’s time to start opening doors.

Tuesday, May 3, 2011

3 Questions to Ask When Considering Healthcare Proposals

Watch, listen, or read any news source and you’ll come across opinion and news about the healthcare debate. It’s not too surprising – after all health care is about 17.3 % of our Gross Domestic Product (GDP). It’s also approximately a quarter of the federal budget. Beyond the impressive finances – this is our health we’re speaking of.

With the complexity of our lives it’s easiest to make a gut judgment about what to think of the healthcare proposal based on two questions: 1) do I trust the source and 2) what effect will this proposal have on me and my family. We’re all busy, but we must do better. Consider the following:

1. Who takes the financial risk?
Since not everyone has the same healthcare needs and we can’t predict the future, so there is considerable financial risk for individuals. Once a situation arises, not everyone knows what the medical costs will be. A pregnancy, for example could cost $5,000 or over $1 million in the baby’s first year for complications. Consider in any proposal - who takes this risk – the individual, taxpayers, citizens, the employer, doctors? How large is the risk pool and how is it shared and who decides? When does the risk fall to the individual or collective?

2. Is the focus on limiting expenses or improving quality of life?
The World Health Organization in 1948 stated that “health is a state of complete physical, mental and social well-being, and not merely the absence of disease or infirmity.” However, many proposals start from a cost perspective – how can we reduce costs or keep premiums low. This approach often pits different types of cuts against each other: large and sweeping vs. small and targeted but with the same goal: control costs. A less common approach focuses on improvement to quality of life with a focus on outcomes and access – how can we ensure that children with asthma have control over breathing? Does a person have access to effective therapies to recover from an accident? These questions bring us towards solutions such as home and community based services that provide a higher quality of life. Cost savings may be also be achieved, because prevention is frequently more cost-effective.

3. Does this proposal suggest that healthcare is a right or a privilege?
Proposals generally start from one of two premises – either healthcare is a right or a privilege. On the “rights” side healthcare is a service you should be guaranteed access to regardless of means. For example, when a person entering an emergency room receives care regardless of ability to pay. Alternately, on the “privilege” side, healthcare is a service that each person should “earn” through contribution. These proposals focus on employer-based and private sector solutions where individuals can earn better healthcare by different career choices.

Once you’ve asked yourself these questions about each proposal you read, you may find that perhaps you’ve changed your mind. Proposals often contain a mix of these, but trend to one side or the other. We all may answer these questions differently – the most important one though is did we ask some in the first place.

How do you decide?

Monday, May 2, 2011

Proposed Rip in the Safety Net

A plan to change Medicare was recently proposed that would fundamentally change how future recipients may receive these federal health benefits.

As far back as 1945, Harry S. Truman outlined what he hoped would be a “comprehensive prepaid medical insurance plan for all people”. However, as time passed, the scope of this plan began to narrow. When it was learned through a national survey that only 56% of Americans 65 years of age and older had health insurance, the Social Security Act, signed 20 years later by Lyndon B. Johnson, established Medicaid, which was meant to fulfill the health care needs of low income Americans, and Medicare which became the primary channel for senior citizens and some individuals with disabilities to obtain broad health care coverage.

Medicare has been the favored “health care safety net” for most seniors since its inception 46 years ago, and thoughts of effectively changing that health care program has many seniors, and future seniors, very concerned. Under a proposed plan that is currently under consideration in Congress, those who are 55 or older would remain in the current Medicare system, those under 55 would receive subsidies that would steadily lose value over time. The ‘under-55’s’ would become part of a new Medicare program that has fixed ‘spending caps’. Any health care expenses beyond those spending caps would become the responsibility of the consumer either through the purchase of supplemental health care plans or paid for out of pocket. The revised plan suggests that starting in 2012 the Medicare program would be reworked into a system that would provide future seniors with "vouchers," direct payments to subsidize private health insurance plans rather than the current Medicare-direct payment for seniors’ medical bills. There has also been great concern over whether insurers would readily accept the majority of seniors.

The intended changes to Medicare have caused confusion and anger, primarily because many Americans worry that they may not be able to obtain future medical care for their needs. The way to fix American healthcare is not to take it away from people. Restricting access to healthcare while reducing services for the poor and the elderly are not justifiable even if they balance the Federal budget, (which they won’t.) We have to decide what kind of America we want to retain and refuse to put the health and well-being of millions of Americans at risk by the wholesale cutting of essential social programs. America’s fiscal health cannot be achieved by eroding health care.