Saturday, March 11, 2017

Life with Chronic Conditions: Affordable Care Act-What to Know, What to Do

At the end of February, the President voiced his frustration in dealing with the campaign promise of “repeal and replace” the Affordable Care Act (ACA). "Nobody knew health care could be so complicated," he said. Really?

 On March 6, House Republicans issued a proposed replacement for the ACA. Basically this is a compromise bill, which  reflects how difficult a task it is to reverse a major welfare program, which has significant support by many in the public. Note- there is no precedent in Congress for reversing a major program of social benefits once it has taken effect and reached millions of Americans. If they are successful, what this means for other programs, such as social security and Medicare remain to be seen.

Both sides of the aisle have problems with the bill. Referred to as “Obamacare Lite,” “ Obamacare 2.0,” or “Republican Welfare” by Republican conservatives, Democrats are calling it “Trumpcare.” Four key Republican Senators said they would oppose any new plan that would leave millions of Americans uninsured. Senator Majority Leader, Charles E. Schumer state, “Trumpcare doesn’t replace the Affordable Care Act, it forces millions of Americans to pay more for less care.” ‘Trumpcare’ will make health insurance in America measurably worse in just about every way and likely leave more Americans uninsured. It does, however, greatly benefit the very wealthy and special interests.” Also coming out against the bill are various doctor, nurses and hospital associations, along with state, city and county governments.

While the President has warned the Republicans that they’d be looking at a “bloodbath” in 2018-the next major election- if they don’t repeal and replace, organizations like AARP are in strong opposition. We oppose the American Health Care Act. It would weaken Medicare and raise costs for older Americans. Tell your Member of Congress that you oppose the American Health Care Act: action.aarp.org/voteno

The Guardian provided a succinct summary, The bill would eliminate the individual mandate, which requires Americans to have health insurance or pay a fine; cut the number of people insured under Medicaid; and allow insurance companies to charge the elderly up to five times more than the young. It would require insurers to cover so-called pre-existing conditions, but would allow them to add a 30% surcharge to premiums if people go without insurance for too long.

WHAT REMAINS:
• Young adults-up to age 26-can remain on parents health plan
• Insurers cannot deny coverage or impose higher fees on people with pre existing conditions.
• Ends lifetime caps on coverage
• Keeps the same essential health benefits under the current law. Insurance companies would still have to cover 10 health services, including maternity coverage, prescription drugs and mental health care. State Medicaid plans, however, would not have to meet this requirement after Dec. 31, 2019.

WHAT CHANGES:
• No penalties for American failing to have health insurance. However, for those without insurance, insurers would be allowed to impose a surcharge of 30% for those who have a gap between health plans of more than 63 days.

• Planned Parenthood would be ineligible for Medicaid reimbursements or federal family planning grants. The goal is to force Planned Parenthood to eliminate abortions from their services, which only makes up 3% of their services and receives no federal funding to start with.

• Refundable tax credits would include both age as well as earnings, meaning bigger credits for older and poorer Americans. Tax credits ranging from $2,000 per year for those under 30 to $4,000 per year for those over 60. The full credit would be available for individuals earning up to $75,000 a year and up to $150,000 for married couples filing jointly. The credits would phase out for individuals earning more — for each $1,000 in additional income, a person would be entitled to $100 less in credit, meaning a 61-year old could make up to $115,000 and still receive some credit. Compared with the ACA’s subsidies, the tax credits would go to more people but provide less financial help to lower-income people, according to Larry Levitt, senior vice president of the Kaiser Family Foundation.

•  Medicaid expansion will be phased out and be replaced with a per-person sum paid to the states.

• It delays until 2025, the “Cadillac tax” – a levy on the highest cost employer-provided plans.

• Older people will have to pay more for health insurance. Under Obamacare, insurers can charge older people up to three times more than younger people for insurance. Under the Republican plan, this limit will rise to five times more.

• While Obamacare helped millions of previously uninsured Americans obtain healthcare, the proposal would reverse that trend, leaving many without health coverage. The more market-oriented driven approach of the bill will impact the poor the worst, with the number being reduced under Medicaid.

WILL IT PASS INTO LAW?
On Thursday, the bill cleared two House committees, Ways and Means and the Energy and Commerce Committees, while Trump and others tried to deal with the backlash. It will now be heard by the Budget Committee and remains on track to land on the House floor by the end of March. Many, from both parties are questioning the lightning-fast process as well as the content of the bill, to say nothing of the fact that the nonpartisan Congressional Budget Office estimate of how the bill affects the federal deficit and the number of insured Americans has yet to be released.

The Republicans control both the House and Senator by narrow majorities. Already there are indications that more moderate Republicans think it goes too far, while more conservatives think it doesn’t go far enough. Assuming that the Democrats vote against it, just three Republican defections in the Senate would be enough to defeat the bill.

That said, anything can and will happen, so be proactive.

WHAT YOU CAN DO: MAKE YOUR VOICE HEARD
Congress and Elected Officials
5 Calls:  Spend 5 minutes, make calls. Calling is the most effective way to influence your representatives. 5 Calls gives you contacts and scripts so calling is quick and easy. A glance on the homepage shows you how many calls are needed per action item. Then, when you click on an item, the site offers the phone number(s), the reason why it’s important, and the script to use while on the call. The site is also personalized to your location, if you enter your address or zip code. 5 Calls is a volunteer effort and is open sourced.

Call to Action: With a simple user interface that’s accessible via the desktop or mobile web, Call To Action has a singular purpose: it makes it easy to find your representatives and place a phone call to their office. It even provides simple scripts to help you get started.

Calling Congress: Representatives and various committee members primarily respond to voters in their district. Realistically, you can’t vote for them so they don’t feel obligated to represent your viewpoint.  However, you can contact friends, family and anyone else you know that reside in states/districts where they can help influence voting. If you have unique information that helps to support a congressional viewpoint, they may take your phone call or e-mail. While it’s helpful to target who their specific representatives on a given committee might be, you can refer contacts to Senate and House member lists or to use 5Calls or Call to Action.

When You Call: It is important to let them know why you are calling and what issue you are calling about. You will sometimes be able to speak directly to your senator or representative, but more often you will speak to a staff person in the member's office. This person keeps track of how many people called and their positions on issues, and provides a summary to the member. Be assured that your call does count, even if you are not able to speak directly to your senator or representative. A good reference on the importance of calling is How to Stop the ACA Repeal-And Drive Your Congress Representative Crazy 

Indivisible Guide: Former congressional staffers reveal best practices for making Congress listen.

Connect with State and National Condition Specific Groups
• State & National Groups: Organizations like Planned Parenthood,  medical condition organizations e.g. American Lung Association, environmental groups  already have campaigns underway. Indivisible  provides a directory of groups taking action. Just plug in your zip code and how far you want to search. Joining these groups, or even just registering for free e-mail news will help you coordinate local campaigns with national efforts. Be selective in what groups you join as you can quickly be overwhelmed.

Women’s March on Washington:  Check their website as they are now posting 10 Actions 100 Days for specific ways you can make a difference. They even have a free down loadable card to make it easier for you to do that. 

Social Media
• Check Before You Post or Send: There is a lot of misinformation out there and it’s changing rapidly. Don’t be a source of “alternate news.” Get the facts not the emotion. A good site to use is FactCheck.org 

• Facebook: Check, check, check. If you see something that you want others to see, Cut and Paste instead of “forwarding” after you’ve checked for accuracy. Don’t over post as people start ignoring you. Avoid a constant barrage of “canned” messages. Check out How to Get the Most Out of Your Personal Facebook page 

• Twitter: The Presidents favorite medium. It’s not for everyone, but if it’s for you than work it.

OTHER RESOURCES
Introducing the American Health Care Act: Download the bill, plus see the GOP’s over view of it.  








Tuesday, March 7, 2017

Take a Break: Make Paper Ferns and other plants

By the calendar, spring is two weeks away, but Vermont cares little for dates and so we know it will be awhile before we see spring flowers, let alone ferns. I was captivated by a Fern Mobile and starting thinking about Fiddle Head ferns (they sprout around Mother’s Day) and so came up with the following projects to try. They’re lovely as potted plants, mobile, or a background bouquet for other paper flowers

 • In keeping with St. Patrick’s Day Potted Paper Clovers  


Not interested in today’s activity, go to the Take a Break Pinterest Board. and pick out something else.

Saturday, March 4, 2017

Make a Difference Where You Live

Since the election, let alone inauguration, the onslaught of negative information, angst and fear is overwhelming. While it may make for great SNL ratings, the long-term effect of a continuing barrage of this type of news isn’t healthy. This is not to say you should just ignore what’s happening. That’s not smart either as there is too much at stake. Rather, limit what and how much you read or listen to so that you know what’s going on without becoming traumatized by it. Check sources for accuracy and please, the situation is bad enough without reposting canned messages from various groups to Facebook and other social media sites. Not only are many of the messages shaming and damaging, it's not helping to further our ability to work together to create strong and diverse communities that support all of us.

Recently, my community has been heavily impacted by fire, which resulted in my writing on my Facebook page. It is amazing how obsessed one can become over the current political situation. Two fires in our town, made me realize once again that it all starts in our homes and communities and we need to take care of these first and foremost. If they're in order, the rest will fall in line.

Some of the most effective and sustained changes come from the grass roots up and the individual can make a difference. The “power of one” can move mountains.

 Change is about action. Leaders and good followers are both needed To that end, below is a guide to aid you in helping families, communities, and ultimately the country thrive. Note that in an effort not to repeat myself too much, as I’ve dealt with aspects of this before, there are a lot links to previous posts/topics that relate. If it seems like there is more on “purchasing power” it’s because I haven’t really covered that topic before.

LITTLE THINGS MAKE A BIG DIFFERENCE: Small acts- such as a kind word, a helping hand or being present during someone’s difficult day-can be major changes in other peoples’ lives. Take the first step. Check out


For family and friends who may be sick on injured, check out the following:
 
LET YOUR VOICE BE HEARD: Vote! Write/call your local and national representatives on issues that concern you. Work with condition specific organizations (e.g. American Lung Association) to lobby for health care changes that will make a difference. Run for local office and/or support someone who is running and shares your viewpoints. Donate/volunteer for organizations that work to keep air and water clean. Participate in how your town, state and country is governed. 

PURCHASING POWER: When, where and how you shop can have an impact so become an empowered and careful consumer. Not only will this be helpful to your wallet, but you can make political statement, aid the environment, and reduce waste as well as unnecessary clutter.

Is it a Need or a Want: We are continually assaulted by a constant barrage of advertisements, from many different sources, about what you must have in order to be happy, content, valued etc. Stuff does not make you happier.

We have gone from investing in good quality products to the over consumption of mass-produced goods, many of which are not needed and are designed for a short life. Disposable doesn’t mean it disappears.

So before you make a purchase of any type, ask yourself the following questions:
• Do I have something that already could serve the same purpose or is it something I could borrow or could I make it myself? Do I really need it?
•  How will I recycle, compost it or reuse it when I’m finished with it? Our landfills are rapidly overflowing, thrift stores are bulging with unwanted and discarded items, and third world countries are being negatively impacted by not only our consumerism, but our need to “do good” by foisting our excess on them. Is Your old T-shirt hurting African Economics? 

Buy to Last a Life Time: If we make purchases that are designed to last a life time, be repaired and even passed on to the next generation, we can help reduce the problem occurring in landfills all over the country.

Sustainable Purchasing: Our purchases have a wide array of hidden impacts-environment, health and even social, check out the following links about healthy and sustainable purchasing:
Environmental Working Group’s Consumer Guides: Includes a wide array of ways to find out what’s harmful and what’s beneficial such as cosmetics (they rate 80,000 personal care products) Healthy Cleaning products (ranks 2,000 household cleaning products) and even Rate Your Plate (rates over 80,000 products). 

When you shop reduce packaging by bringing your own bags (recycled t-shirts make great totes) even for bin items.

Shop Local, State, Country: The dollar you invest in your community is an investment in your surroundings, so ultimately it’s an investment in your self. However, not all communities offer everything. Shop locally, your state and your country.  Check these lists for made in the USA

Experience Over Things: There is a large body of research that has concluded that experiences are a better buy than things. Traveling to an interesting place will provide more lasting satisfaction than upgrading your car, even if they cost about the same amount. That sounds strange at first, because a car lasts longer than a two-week vacation. But the vacation involves anticipation ahead of time as well as memories afterward. The vacation is more likely to be with someone else, and social activities tend to promote happiness more than solitary activities. Experience Over Things: The Future of The Consumer Economy 

PREVIOUS POSTS RELATING TO THIS TOPIC

Wednesday, March 1, 2017

Take a Break: Enjoy the 2017 Oscar Winners

 
One of my favorite categories is the animated short films. Read more about this year’s nominees An In-Depth Look at This Year’s Oscar Nominated Animated Shorts  and watch some of them at the links below

• Winner Piper 

Blind Vaysha 

                                                                          Pearl 

 

If you prefer other aspects of the Oscar winners, check out Where to Watch All of ThisYears Nominated films 

 Not interested in today’s activity, go to the Take a Break Pinterest Board. and pick out something else.

Friday, February 24, 2017

Holding You in the Light: A special way to support someone

This past week one of our community elders died. Her name was Patti and though she was in her 90s, her messages of support and hope were timeless.  Whenever we would end our conversations, be it by e-mail or in-person, she would always say, “I’m holding you in the light.”

I interpreted this expression differently depending on our discussion. Sometimes I think she meant it as a means to protect me, other times it was a voice of encouragement, yet always it was her way of letting me know that I was wrapped in love and support.

Quakers use this expression when they intend to pray for someone, or as one Quaker put it when we want for someone what God wants for them—peace and healing and well-being and soundness of mind and body and spirit. Though we often say it very casually, without much thought, ideally, it is more than just words.

About 18 months ago, a friend was dying and a group of us were trying to assist his Mom in caring for him. It was challenging and overwhelming for Julie. We couldn’t always be at the house, but we wanted her to know that we loved and respected what she was trying to do. We gave her a bracelet and with it a note, An elder in our community ends her e-mails and conversations by saying “I’m holding you in the light.” We’ve found comfort, warmth, love and support in this old Quaker saying. It is with that in mind that we are send you the enclosed bracelet to be a tangible reminder that we are holding you in the light. “

Not only was Julie touched by the gift, but she wore the bracelet a lot, often touching it and turning the beads. This simple gesture provided a tangible reminder that we cared about her.


Asking someone how they feel and if they are okay is very caring, but adding the reminder that you are “holding them in the light” just kicks it up a notch. 

To my friend Patti, many thanks for the years you held me in your light and life. It meant a great deal to know that your sheltering presence was there for me. I will miss it.