Meanwhile, out here in the Real World of the Working Class, folks like
my mother-in-law face an uncertain future. Tomorrow she will
celebrate her 91st birthday. Even as my wife wades through the
multiple forms required in order to qualify her mother for SSI and
Medicaid, Service Doors are beginning to close.
My mother-in-law is currently living with us. She wants to "go home",
but it is more and more evident that she cannot live alone. Her short
term memory is like a pot of mush, Just in the weeks she's been here,
we can see the downward spiral. But by monitoring her meals and
making sure she takes her medications, she is returning to her former
physical fitness. And she really wants to "go home". She might be
okay for the short haul, if we can afford enough in-home assistance.
But all of the organizations providing such services are charging $30
per hour, and their service providers must be given at least 2 hours
at a time. My mother-in-law would need a person 7 days a week, to
arrive in the morning to assist her in taking her morning pills, a
shower and preparing breakfast as well as setting up lunch. Prior to
bedtime she would need another person to arrive to make certain that
she takes all of her evening pills, and gets into bed safely.
Assuming that this pattern held for the next 12 months, it would cost
$43,800. But of course this most likely would not stay at the present
level. Besides, her remaining annuity has only $10,000. When this
money is spent, she will need to fall back on SSI and Medicaid. That
is, if there are any openings in the programs.
Cathy and I have visited clients in most of the nursing homes, and the
few adult foster care facilities in our area, and we have found none
of the ones that my mother-in-law qualifies for, to be close to
minimal existence. My mother-in-law never dreamed that she would live
to be over 90. She had begun having Grand Maul seizures about 15
years ago, and was failing fast. Cathy took over the task of getting
her mother the sort of medical help she needed, relocate in an
apartment closer to our home, and set up her medications. Cathy and
her sister took turns taking their mother shopping and to doctor's
appointments. Cathy handles all of her mother's financial needs and
fills out all of the required forms each year, in order to make
certain her mother continues to be on the Section 8 program.
Currently, if she were to give up her apartment, my mother-in-law
would be removed from Section 8 housing. Getting back on the Program
would never happen. Cathy explored the possibility of the Program
placing her mother on some sort of "holding Pattern", so the state
could save their hefty portion of the monthly rent. But no way would
they justify what we thought would be a savings to the Program. As of
today, all the paperwork has been filed. Sow we wait. If she
qualifies, and if the Program continues to exist, and to accept new
enrollees', she may be able to stay in her apartment for a few more
months. At 91(tomorrow) her long range goals are rather short. But
even with diminished ability to stay focused on doing the most basic
activities, she wants to remain independent and maintain a sense of
dignity.
Unfortunately Dignity and Independence are not part of the thought
process of the American Corporate Empire. Worshiping the Golden Calf
leaves no room for compassion, especially compassion for the Working
Class.
Carl Jarvis
On 7/15/17, Bonnie L. Sherrell <blslarner@xxxxxxxxxx> wrote:
This is from the Vox website:
Buried in Senate Republicans’ new health care bill is a provision to throw
about
$1 billion at states where premiums run 75 percent higher than the national
average.
Curiously, there’s just one state that meets this seemingly arbitrary
designation: Alaska.
That state also just so happens to be represented by Sen. Lisa Murkowski, a
crucial Republican swing vote who has spent months threatening to torpedo
the
entire Obamacare repeal effort over her concerns about Medicaid cuts.
Nobody believes this special fund was created to give Alaska alone a big
boost
through sheer coincidence. Reporters on the Hill have taken to calling the
carve-out to help Alaskans the “Polar Payoff,” the “Kodiak Kickback,” and
even
the “Juneau Jackpot” — a special gift to the state, inserted by Senate
Majority
Leader Mitch McConnell to win Murkowski’s vote.
“They really, really, really need Lisa Murkowski to vote for this, and
they’re
thinking this may help,” said Timothy Jost, a health care expert and a
professor
emeritus at Washington and Lee University.
The big question right now is whether the approximately $1 billion in
additional
health spending for Alaska will be enough to win over Murkowski to a bill
that
would gut Medicaid and result in about $1 trillion less health spending for
America overall.
How the “Kodiak Kickback” works
The Kodiak Kickback is responsive to a very real problem for Murkowski’s
constituents in Alaska: extraordinarily high premium rates in the state.
As Vox’s Sarah Kliff has documented, Alaska in the past struggled with high
and
rapidly increasing premiums that put the state’s Obamacare exchanges on the
verge of entering a death spiral. To avert it, the state started paying
back
insurers for especially high claims. Premiums stabilized, and the Trump
administration just decided to let Alaska spend the savings.
But premiums in its Obamacare marketplace are still high, and the current
Republican health bill would make subsidies for most low-income people much
skimpier. A midlevel plan in the state’s Obamacare marketplace cost $905 in
2017
— partly because Alaska’s isolation makes it difficult to get patients to
specialty doctors, and partly because such a large percentage of its
population
uses health insurance provided through the Bureau of Indian Affairs.
“It’s because they have a very small market and because health care is very
expensive in the state,” Jost said. “The Alaskans in the individuals markets
is
a pretty small group of people, and when you have a really small risk pool
it
doesn’t take many high-cost cases for premiums to soar for everybody.”
Senate Republicans’ newest bill includes a special $182 billion fund that
will
give the Department of Health and Human Services broad latitude to help
stabilize the Obamacare markets. This fund, which has increased as the vote
on
the bill draws near, is intended to reassure moderate Senate Republicans
worried
about its impact on the individual markets.
But to make sure it helps Alaska — and, perhaps, its moderate senator —
lawmakers added a new clause to that special fund this week that will
require at
least 1 percent of it be spent on states where premiums run 75 percent
higher
than the national average. One percent may not sound like a big number, but
we’re talking about Alaska, which only has 700,000 people. The state is
still
set to receive nearly $2 billion over 10 years.
“One percent of a multibillion-dollar fund could be very helpful for
Alaska,"
Sen. Dan Sullivan (R-AK), Murkowski’s Senate counterpart, told the Alaska
Dispatch News.
Murkowski could determine the fate of the entire bill
Right now, as Vox’s Dylan Scott explains, Senate Republicans can afford to
lose
zero additional votes on their health care bill. All Democrats oppose it, as
do
two Republican senators — Rand Paul (R-KY) and Susan Collins (R-ME).
In other words, Murkowski alone could kill the bill when McConnell brings it
to
the floor on Tuesday on a “motion to proceed” vote. But so far, she isn’t
revealing her planned vote one way or another.
In an interview last month with Bloomberg, Murkowski insisted that she
wouldn’t
be swayed by any effort to buy her off if she still opposed the overall
bill.
“Let’s just say that they do something that’s so Alaska-specific just to,
quote,
‘get me,’” she said in June. “Then you have a nationwide system that
doesn’t
work. That then comes crashing down and Alaska’s not able to kind of keep
it
together on its own.” It’s worth noting that Murkowski ran for Senate over
McConnell’s wishes in 2010 and doesn’t owe him much by way of her political
success.
Nothing else, though, has changed in the bill. Murkowski has primarily
expressed
opposition to the bill’s Medicaid cuts, but McConnell has preserved those
steep
cuts. And as the Center for American Progress’s Topher Spiro points out,
the
bill would still have devastating impacts on Alaska’s 185,000 Medicaid
recipients despite the “Polar Payoff”:
Republicans’ health care bill will cost Alaska Medicaid recipients about $3
billion. In exchange, they’re trying to buy off Murkowski with far less in
funding for the Obamacare exchanges. We’ll know soon if it worked.
----
Bonnie L. Sherrell
Teacher at Large
"Then do not be too eager to deal out death in judgement. For even the very
wise cannot see all ends." LOTR
"Don't go where I can't follow."
We gave the Goblin King control of our nation!