Let’s talk “entitlements”

MoonHowler

 

 

A month or so ago I posted a letter from my friend Bear who was on a rant about the use of the word ‘entitlements.’  I agreed with him which brought out a fury of people telling me what the word ‘entitlement’ meant.   You know, it isn’t the word ‘entitlement.’  It is the way most people SAY entitlement and what it is grouped with. 

Americans are entitled to Medicare and Social Security, or at least most of them are.  There are probably some exceptions.  My problem comes from the snarl people have when they talk about those taking ‘entitlements.’  Those under 50 often unknowingly go into facial contortions when they utter the word.  Why?  If you are entitled to something, why do others resent it so much?  They will be entitled also…one of these days. 

I think the other thing that bothers me so much is that Medicaid is thrown in along with other forms of what we used to call ‘welfare’ to the ‘entitlements’ conversation.   Now that is just down right irritating because many of the folks pulling from these programs haven’t paid in the thousands upon thousands of dollars that those of us who are entitled to Medicare and Social Security  have paid.    Maybe its the Medi- prefix that just make people relate Medicare and Medicaid.

To those of us who are getting close or who are already there, we resent like hell being lumped in with the medicaid crowd.  Call me an elistist.  I really don’t care.  I worked for years and I paid into both Social Security/FICA and Medicare for what seems like forever and what also seemed like a lot of money.

If MediCARE and Social Security are going to be called ‘entitlements’ then MediCAID and other social programs need to be called something else.  I know that ‘welfare’ isn’t politically correct but neither is ‘entitlement.’  

Do you resent ‘entitlements’ and if so, which ones?  Do you think they will be there for you?  How about the programs for poor people?  Do you resent those?  What do we do about those less fortunate?  Are they entitled to various government programs that most of them have not paid in to?

NOW, THEREFORE, BE IT RESOLVED…..

MoonHowler

‘NOW, THEREFORE, BE IT RESOLVED’ is the crux of any resolution.  In this case, there are 4 key directives.   They  tell us what is going to be done.  All the ‘whereases’ are justifications.

The day before yesterday the  Center on Budget and Policy Priorities (CBPP) released its report which claries the fiscal impact , if any, of the expansion of Medicaid.  Click here to see the entire report.

Poverty Guidelines

10 Components of the Healthcare Bill

In talking this out, why do we need a resolution to do any of this?  Just do it over time and report back.  Can’t the BOCS just direct Ms. Peacor to make a statement after the dust has settled and the ink has dried on the Legislation?   isn’t that what is supposed to happen anyway?

Why all the fanfare?  Why the proclamations from the court house steps and from the Tea Party Rally?  Creating an Opt Out Resolution which doesn’t even opt out  seems like bad business as usual.  What is the price tag for all this investigation?  What is the price tag for pulling people off of their regular jobs to do all this busy work?

The red print is from Moonhowlings.

The Directives from the ‘Resolution:’

NOW, THEREFORE, BE IT RESOLVED that Prince William Board of County Supervisors requests that the Department of Social Services, assisted by County staff:

1.     Estimate the additional population eligible for Medicaid in Prince William County as of January 1, 2014 according to the provisions of the PPAC and the regulations which will probably be promulgated by the federal government to implement the PPAC; and

It will be difficult to estimate the county demographics for Jan. 1, 2014.  The best we will be able to do is estimation. Estimations may be extrapolated from other existing data.  However, the estimations  are not exact.  Furthermore there are benefits that cannot easily be quantified:

According to News and Messenger:

The 2008 American Community Survey reported that [the county’s] poverty rate was 5.2 percent in 2008, less than half the statewide rate of 10.2 percent and about one third the national rate of 13.2 percent,” according to the quarterly report.

The county’s median household income in 2008, according to ACS figures, was $88,724, leading to its rank of 16th in terms of wealth among the largest counties in the United States. Per capita income in the county for 2008, meanwhile, came in at $36,049, according to the quarterly report.

2.      Estimate the additional financial burden to the County taxpayers for additional administration of benefits for the newly expanded, less-sensitive population; and

What is a less-sensitive population?  A family of 4 making $29,000 is hardly rolling in the lap of luxury.  What is involved in administering Medicaid?  Processing an application, verifying eligibility, enrolling the person/family into the Medicaid program according to the guidelines is pretty much it.  Is there a hidden process we don’t know about?

  • The additional cost to the states represents only a 1.25 percent increase in what states would have spent on Medicaid from 2014 to 2019 in the absence of health reform.
  • The federal government will assume 96 percent of the costs of the Medicaid expansion over the next ten years, according to an analysis of CBO estimates.
  • And having more people covered as a result of the Medicaid expansion and other provisions in the health reform law will reduce state and local governments’ current spending on other services for the uninsured, such as mental health services.

3.  . Work with private health care providers to estimate the magnitude of the reduction of

Working with private health care providers?  Which party will these providers belong to?  How will they be selected?  This information will be anecdotal at best.  Didn’t Linda Chavez warn us about using anecdotal  documentation rather than scientific data?

Why should we expect there to be a reduction of available health care options for the Medicaid population?

Why isn’t the BOCS attempting to bring more medical services to the county?  Aren’t these businesses we are trying to attract?

4. Advise the Commonwealth and the federal government that unless additional resources are found at the federal and state levels of government to fund the administration of the expansion of Medicaid, that Prince William County will be forced to raise taxes on County residents or slash strategic services in order to fund eligibility workers to administer the massive expansion in the eligible population which will become effective on January 1, 2014 enrollment of newly covered beneficiaries.

Gobbledeegoop?  What did that paragraph just direct?  Talk about obsfucation.  Geez.

When will we advise the Commonwealth and the federal government?  According to the  CBPP study:

Contrary to claims made by health reform critics, the Medicaid expansion does not pose substantial financial burdens on states. The additional state spending that will result from the expansion is only 1.25 percent of what states would have spent in the absence of health reform, but it will cover 16 million more people, which will help reduce states’ costs for other programs and bring numerous other benefits to the states. The federal government will pick up most of the costs of the Medicaid expansion, overall making it a good deal for the states.

And…..(and let’s put that Peacor woman to work)

AND, BE IT FURTHER RESOLVED that the Prince William BOCS directs the County Executive to:

  1. Estimate the increased cost burden the PPAC will have on the County’s provision of health insurance to its employees; and
  1. Provide comment to the Federal government as regulations and procedures are written which implement the Health Reform legislation in order to ensure that the impacts on local governments both from the significant expansion of Medicaid and from the implementation of other sections of the legislation are fully articulated.