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Hillary Clinton, the Supreme Court and a Progressive Future

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Many of us disagree with Hillary Clinton on a number of issues, in some cases intensely. But there is one overarching reason we should be vigorously supporting her election: The future of the Supreme Court is at stake.

At the risk of opening old wounds, not voting for Al Gore contributed, in part, to the emergence of a right wing Court. In his 8 years Obama has been able to prevent the one vote conservative majority widening to 5. And if the Republican Senate had not, in an unprecedented move, refused to vote on Obama's current nominee for Scalia's seat, next January the new Court would have a slim one vote liberal majority.

Ginsburg is 83, Kennedy is 80, and Breyer will be 78 in mid August. Since 1971, the average age of retirement for a Supreme Court justice has been just under 79 years.

This means that aside from filling Scalia's seat the new President likely will make 3 additional nominations in his or her first term, 4 in all. That is the largest number since FDR's second term, when 5 New Deal Justices set a new course for a Court that for a generation had repeatedly thwarted progressive legislation at the state and national level. We have social security, a federal minimum wage, the right for workers to organize, school integration and many more such policies because of those new Justices (plus FDR's threat in early 1937 to pack the Court, a threat that led one conservative Justice to change his vote).

We know the numbers, but many seem to think the future of the Supreme Court is simply one more issue to be evaluated, no weightier than others. Indeed, only at 11:15 PM on the first day of the Democratic Convention was the status of the Supreme Court briefly discussed by Bernie Sanders. Hillary mentioned it even more briefly the last day of the convention.

The Supreme Court can enable or disable our work. In the last decade the Justices have made it much harder to challenge wealth and power, to nurture the weak and assist the poor, to extend social justice to minorities, to reduce violence, stop discrimination, and defend the right to vote.

One could write a book about the recent work of the Supreme Court and its impact on a progressive future, but to make the conversation concrete let me offer a small sample of what the Court has wrought.

*Democracy*: The Supreme Court's most infamous and widely discussed intervention occurred in 2010 when it overturned a corporate campaign spending ban first advanced by Teddy Roosevelt. The infamous Citizens United decision allowed corporations and unions to spend unlimited amounts of money, much of it "dark money", hidden from public scrutiny.

Citizens United changed the nature of American democracy. In the first five years after the decision one billion dollars poured into super PACs, $600 million of which came from just 195 donors and their spouses. Between 2006, before the Court decision, and 2014, after the decision, independent expenditures increased 25 fold.

In 2014 the Court allowed unlimited individual contributions. Both decisions were by a 5-4 vote. Dissenting Justice Breyer predicted, "If the court in Citizens United opened a door today's decision may well open a floodgate."

And so it has. In 2012 the Republican National Committee and its two Congressional campaign committees spent a total of $657 million. In early 2015 the Koch brothers announced that they and their friends would spend $889 million on the 2016 election. That is buying an awful lot of dirty tricks, non-profit front organizations, lawsuits and, dare I say, candidates.

There is much talk about the need to reverse Citizens United, but that can't be done through Congress. Only a Constitutional Amendment or a Supreme Court reversal can. The chances of the former are infinitesimal. If Hillary Clinton wins the chances of the latter are quite good.

In 2008, the Supreme Court ended 150 years of laws and policies that steadily expanded the electorate when it upheld an Indiana law requiring a photo ID. The vote was 6-3 when Justice Breyer voted with the conservative majority. The Justices conceded that those least likely to have state-issued identification are disproportionally poor and nonwhite. The state had offered no examples of voter fraud that would have been prevented with voter ID.

Since the Supreme Court decision, at least 23 states have either introduced more restrictive voter procedures or tightened those in operation.

In 2013 the Supreme Court upped the ante by allowing states to require proof of citizenship in order to register to vote. Earlier this year Kansas and Georgia and Arizona became the first to adopt that requirement.

In 2013, by a 5-4 vote the Supreme Court effectively struck down the heart of the Voting Rights Act of 1965 (VRA) freeing the nine covered states and dozens of counties in New York, California and South Dakota to change their election laws without advance federal approval.

Even when we are able to defend our democracy, our victories have been fragile. In 2015 the Court upheld the right of citizens to take authority over redistricting out of the legislature and invest it in an impartial commission. That same year the Court overturned an Alabama law that racially gerrymandered election districts. Both decisions were by a 5-4 vote, easily reversible by a new Court.

*Corporate power*. Several decisions by the Supreme Court have increased the power of corporations over workers and consumers.

In 2001 the Court interpreted a 1925 federal law allowing arbitration among businesses as a preemption of state laws protecting the right of workers to access the traditional judicial system. They did this despite the clear language of the original law: "nothing herein contained shall apply to contracts of employment of seamen, railroad employees or any other class of workers engaged in foreign or interstate commerce."

In 2011 the Court overturned a California law prohibiting arbitration clauses that ban class action suits. Class action suits offer one of the few ways to truly penalize corporations for misbehavior yet today it is all but impossible to successfully litigate a class action suit. On the third anniversary of the Supreme Court decision Public Citizen identified 140 cases decided between 2011 and 2014 in which the judges cited the Supreme Court rulings as justification for dismissing a class action

In 2013 the Court overturned a California law making arbitration contracts that contained "unconscionable" provisions unenforceable. Astonishingly, the Court concluded that even if the arbitration procedure is designed in such a way as to make it impossible for a worker or consumer to win, the results of arbitration are still legally enforceable.

The 2001, 2011 and 2013 decisions were all decided by a 5-4 vote.

Today employment and consumer contracts routinely contain forced arbitration clauses that prohibit access to the traditional justice system. Unlike that system, arbitration is governed by corporate-friendly rules. As Catholic University of America law professor Peter B. Rutledge notes, "Arbitrators do not have to follow precedent. Arbitrators also are not bound by the same rules of evidence and procedure as courts. Often there is no transcript, and arbitrators are not obligated to provide detailed findings of fact and conclusion of law in their awards." Complainants can be forced to travel thousands of miles and put up thousands of dollars up front to attend an arbitration proceeding.

Another way the Supreme Court can expand corporate power is by weakening the ability of workers to wield collective power.

Scalia's death earlier this year resulted in a series of 4-4 votes. One tie vote resulted in a victory for workers when it left intact the decision of the U.S. Court of Appeals for the 9th Circuit upholding a California law requiring non-union workers to pay their "fair share" of the collective bargaining costs. The decision affects 8 northwestern and western states. If Scalia, or another likeminded Justice were on the bench the resulting 5-4 decision overturning California's law could have meant the demise of a nearly 40-year-old Supreme Court precedent that applies to more than 5 million public employees in 23 states and the District of Columbia.

*Gun control*. In 2007 and more broadly in 2010, the Court overturned 70 years of precedent when it declared that the Second Amendment applied to individuals, not militias. It was a watershed moment and made gun control infinitely more difficult. Since then, rather than gun control initiatives we have largely witnessed a race between states to see which can make guns most ubiquitous and conspicuous. The only remaining sacrosanct areas at this writing appear to be churches, courts and legislatures. The two Court decisions were by a vote of 5-4.

*Immigration*. In 2016 a 4-4 tie left in place a decision of the U.S. Court of Appeals for the 5^th Circuit overturning a 2014 executive order that allowed as many as five million unauthorized immigrants who were the parents of citizens or of lawful permanent residents to apply for a program that would spare them from deportation and provide them with work permits.

*A Woman's Right to Choose*. In 2014 the Court made it more difficult for poor women to prevent pregnancy when it held that privately held businesses could be exempt from the Obamacare requirement that insurance cover contraception based of the company's religious beliefs. The vote was 5-4. Justice Ginsburg warned in her dissent of the potentially broad impact of the Court's decision, given the attitude of religions toward women and gay people, "The Court's expansive notion of corporate personhood invites for-profit entities to seek religious-base exemptions from regulations they deem offensive to their faiths."

One of the Court's final rulings this year overturned a Texas law that would have effectively ended access to legal abortion for millions of women. The vote in this case was 5-3 because Kennedy voted with the Court's four liberal Justices. Two new Justices could reverse that decision. Donald Trump has promised to nominate Justices who would rule against the right choose.

*Discrimination*. In 2011 the Supreme Court dismissed a gender discrimination suit by thousands of women across the nation against Walmart. The Court threw out more than 40 years of class action jurisprudence by ruling that class members must prove they have suffered the same injury, not just a violation under the same law. The vote was 5-4.

In 2015, in a case involving discrimination against minorities in housing, the Supreme Court did uphold the traditional standard for deciding whether discrimination has occurred: Complainants must identify a business practice that has a disproportionate effect on certain groups of individuals while not being defensible by sound business considerations. The Court had been asked to substitute a much higher standard proof of "intentional discrimination." The vote was 5-4.

*Justice*. In 2009 the supreme court ruled that prisoners have no constitutional right to DNA testing even though at the time such testing had already played a role in 240 exonerations, according to the Innocence Project at Cardozo Law School. In 103 of those cases, the testing also identified the actual perpetrator.

*Health Care*. A new liberal Justice could make even our victories much sweeter. The American Care Act was upheld by the Supreme Court in 2012 by a 5-4 vote when Justice Roberts, surprisingly, voted in favor. But the Court rejected the Act's Medicaid expansion mandate. Almost 8 million people lack health insurance as a result.

The Supreme Court meets only 6 months a year. The media dutifully reports the decisions, debates the meaning for a day or two and then moves on. We're not exposed to the cumulative impact nor the long term consequences.

Supreme Court decisions reach into every aspect of our lives, both political and personal. The very structure of how we govern, our ability to elect progressive candidates and enact progressive policies is determined by their interpretation of the constitution and legal precedents. There have been activists Courts of all stripes but none, at least since the early1930s has been as determining of our ability to make a progressive future as this one.

In this election, removing the Supreme Court as a key obstacle in the way of achieving a fair and just future should be the goal that spurs our activism and our ballot choice.

 

 

 

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 3 hours ago.

JetBlue Offers $99 Flights To Cuba

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JetBlue Airways Corp. said it will launch commercial flights to Cuba on August 31, 2016. The company will begin flights from its Fort Lauderdale hub to the three Cuban cities of Santa Clara, Camagey and Holguin. The low-cost carrier's fares begin at $99 one way and includes Cuban government-required health insurance. Reported by RTTNews 2 hours ago.

What It Will Take To Start Relocating Refugees From World's Largest Camp

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The Kenyan government’s decision in May to close the world’s largest refugee camp sent shockwaves through the humanitarian aid community. But the United Nations refugee agency, UNHCR, has put out a new appeal to donors for additional funds to help relocate and reintegrate Somali refugees from the Dadaab refugee camp.

There are 343,043 refugees in Dadaab ― the majority are originally from Somalia, but refugees from Sudan, Ethiopia and Kenya live there as well. The U.N. set up the camp in 1991 for those escaping Somalia’s civil war.

The UNHCR initially appealed for $369.4 million to address the humanitarian needs of about 1.1 million internally displaced Somalis and close to 1 million Somali refugees living in Djibouti, Ethiopia and Kenya. Now, it’s appealing for an additional $115.4 million to address, among other priorities, the needs of Somalis in Dadaab. 

The new funds will go partly toward effectively moving some refugees back to Somalia and relocating others to another refugee camp in Kenya.

The UNHCR hopes to move about 50,000 Somalis to their homeland, but only those who have volunteered to go. 

While many Somalis are reluctant to return to Somalia, the UNHCR is incentivizing refugees with benefits packages.

Their travel costs would be covered, and each Somali who goes back gets $200, regardless of family size, a move that might encourage large families to return, according to UNHCR. Each family would also get a stipend of the same amount to help cover basic needs.

If the UNHCR meets its appeal goal, it’s proposing supplying six months of food to returnees and $25 per child for education services.

UNHCR may also consider providing health insurance for returnees.

“UNHCR is committed to ensuring that all returns to Somalia are voluntary and carried out in dignity, safety and with the protection of refugees paramount at all times,” Valentin Tapsoba, UNHCR’s Africa bureau director, said in a statement.

But even some destitute refugees say those kinds of packages aren’t enough of a motivator to go back to the country they fled.

Part of the issue is that 20 years of conflict has left the country bereft of public services such as schools and healthcare, according to the Guardian.

A 20-year-old refugee from Somalia, who didn’t give his name, told CNN that his parents lost all of their land and property during the war. He said even giving $1,000 to start a new life in Somalia all over again wouldn’t suffice.

“I agree no one has to live in a refugee camp all their life,” he told CNN. “It’s not correct morally, but then if you’ve left your home 25 years ago, going back is like going back to a new place.” 

In addition to taking some refugees back to Somalia, UNHCR also plans on relocating Somalis and non-Somalis to the Kakuma refugee camp in Kenya, which houses South Sudanese, Congolese, Rwandan and Burundian refugees, according to CNN.

The Kenyan government is intent on closing the Dadaab camp due to security challenges posed by militant terror group Al-Shabaab, but aid groups say there’s no established link between any terror activity and Dadaab. 

The UNHCR’s goal is to reduce the population of Dadaab by 150,000 by the end of 2016. 

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 55 minutes ago.

Democrats Uniting, But Wounds Linger

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AP Photo/Paul Sancya

Clinton and Sanders campaign signs are held during the second day of the Democratic National Convention in Philadelphia, Tuesday, July 26, 2016. 

The scene at the Democrats’ gathering in Philadelphia this week looked downright peachy compared with the problem-plagued Republican National Convention in Cleveland. But that doesn’t mean the anger and disappointment of Bernie Sanders voters can be shunted aside. This is a profile of a tiny sliver of the forces within the Democratic Party that want to see more left-wing results than what we’ve been getting for the past 40 years. 

Tensions ran especially high on Monday and Tuesday, and were palpable both in the Wells Fargo Center and on the streets. The sidewalks of Philadelphia were the scene of occasional confrontations between the two factions. On Tuesday night a 5,000-person column marched down south Broad Street, a combination of diehard Sanders supporters, socialists, and Black Lives Matter activists. Fights broke out, and a few people burned American flags. In the end, the marchers dissipated, leaving behind a vivid illustration of divisions in their wake.

The discontent on display, spurred in large part by the WikiLeaks release of internal DNC communications, prompted Chris Hayes of MSNBC to tweet about the possibility of a real insurgency within the Democratic Party that would push it to the left. “What's clear is that the Democratic Party is not too far from a total Tea-Party style takeover,” Hayes wrote. “If IF Sanders wing can bring over black D[emocrat]s.”

During my week reporting on these developments, I sat down with several Sanders delegates from Kentucky to find out more about the frustration boiling up inside the Democratic Party.

Two of them, Kyle West and Maria Kupper, went to college with me. We hadn’t seen each other in almost eight years, and I didn’t recall either of them being particularly political in school. But like many Sanders supporters who graduated during the Great Recession, they say the solutions being offered by establishment Democrats don’t fully address their needs.

“We graduated in 2009,” explains West, 30. “To us that whole suburban corporate money thing, which was the promise of what we would have one day, it was gone forever.”

The regular Kentucky delegation was split this week almost exactly in half between Sanders supporters, 27, and Clinton supporters, 28. (She eked out a win there in the primary, although it was closer than even the tight Massachusetts race.) The state’s five superdelegates all supported Clinton as well.

From what I heard sitting with them and their friends in the Windsor Suites, right down the street from City Hall, the Kentucky delegation was riven by the WikiLeaks revelations at the beginning of the week. The tension on Philadelphia’s streets and in the convention hall could be felt in this hotel suite as well.

The trip from Louisville to Philadelphia took this group 12 hours, and while they drove they learned first the news that Hillary Clinton had selected Tim Kaine as her running mate, and then that WikiLeaks had released a trove of DNC emails that proved what Sanders backers had complained about for months—that outgoing DNC chair Debbie Wasserman Schultz and others on the committee had improperly looked for ways to help Clinton win the nomination.

“We all thought we were inevitably going to see some tension on Monday at the convention, but WikiLeaks changed everything,” says Kupper, 29. “I was livid. Why would I unite with the Democrats when they clearly have been trying to undermine the man we’ve been working for, volunteering for, donating our $20 to instead of getting drinks on a Friday night?”

For Sanders backers in the Kentucky delegation, that sense of betrayal ran deep. When all the delegates arrived at the Windsor on Monday, the Sanders and Clinton camps weren’t even speaking. It ended up taking days for the tension to dissipate, which made for some awkward mornings around the breakfast spread.

“We worked our asses off and then get stabbed in the back by our own party,” says Jacob Drake, 34 (with whom, for those keeping track at home, I did not go to college). He says that it isn’t just newcomers like himself who have been enraged by the antics of Debbie Wasserman Schultz. Drake says that there are people who have voted Democratic for 40 years back in Kentucky who are tempted to break with the party.

At a Socialist Convergence event on Wednesday evening, Jill Stein, who received rapturous applause, praised Sanders but claimed that he’d “run up against the limits of what you can do in a counterrevolutionary party.” The Green Party and other factions that have given up on the Democrats (or never cared for them to begin with) were a loud presence in Philadelphia. But these ticked-off Kentucky delegates didn’t seem to be going Green.

Stein’s call doesn’t seem to be resonating beyond the diehard Bernie-or-Bust people, who made themselves heard during the convention (“Jill not Hill!”) but seem to be a distinct minority nationwide. Pew recently found that 90 percent of the Sanders voters it polled said they would vote for Clinton in the general election. Their outsize presence in Philadelphia this week is probably a testament to the fact that the delegates and protestors who are in town are the hardest of the hardcore—and not representative of the rank-and-file Sanders backers.

Kupper, for one, says she hasn’t yet decided if she can bring herself to vote for Clinton in November. (The Kaine pick was also a big turnoff to her; if Warren had been Clinton’s running mate, Kupper says, her vote would have been locked up.)  But that doesn’t mean Kupper won’t be voting for Democrats down ticket. In fact, she hopes to volunteer for other Democrats when she gets home.

“I am going to make sure that in Kentucky we don’t lose our House seats,” says Kupper, referring to the six-seat advantage Democrats hold in the state assembly. “I’m planning on volunteering and doing whatever I can. I know how important the local level is, whereas who I vote for president in Kentucky doesn’t matter so much.”

Since 1972, Kentucky has only gone for the Democratic presidential candidate three times: Jimmy Carter in 1976 and Bill Clinton in 1992 and 1996. Meanwhile the Democrats are hanging on to the state assembly, but seem to have largely lost control of state politics for the first time in generations. (Republicans control the state Senate and the governor’s mansion.) The 2015 executive race was a terrible blow to the party and to these delegates. West had been receiving health care coverage through Kynect, the health insurance exchange set up under Obamacare, which incoming Republican Governor Matt Bevin began to dismantle upon taking office.

On the streets of Philadelphia, some of the Bernie-or-Bust people I spoke with denied any substantial difference between Clinton and Donald Trump (as did Jill Stein). The people I spoke with from the Kentucky delegation really didn’t like Clinton, but they also know what it’s like to live under the ultra-right Republican Party, and reject the argument that Clinton and Trump are equivalent. They don’t seem to want to abandon the Democratic Party, or drop out of politics. But they want to see Sanders’s political revolution bear fruit locally and see more progressives start to run in local elections, from state Senate to school board.

“I think the Democratic Party should be very, very concerned about the base,” says Kupper grimly. But despite her anger over the DNC’s actions in the primary, she also seems hopeful and energized by the convention. “If I hadn’t come here to Philadelphia I would not have seen across the country people who feel the same way as us. This is first time in my life I have totally felt part of a movement.” Reported by The American Prospect 24 minutes ago.

The President's Assessment of the Affordable Care Act

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I was recently reading a July issue of the Journal of the American Medical Association (JAMA) when a special communication written by Barack Obama, J.D., caught my eye (JAMA; Published online July 11, 2016). It was the first article I had ever read in a medical journal that was written by a president of the United States. JAMA is a much respected medical journal which usually presents peer-reviewed articles relating to medical research. However, the journal will publish special commentaries written by experts relating to timely medical issues.

At first, I was taken aback by the President writing in a medical journal whose readership was pretty much limited to physicians. It seemed like he was using his "bully pulpit" to try and convince us that the Affordable Care Act (ACA) was well on the way to meeting its goal of increasing the number of people with health insurance, decreasing the costs of health care, and increasing the quality of the care provided. Seeing as there are about 850 thousand practicing physicians in the United States (based on a 2010 analysis of the Federation of State Medical Boards data base), I wondered why he was limiting his audience to such a select few. I then saw several related articles in newspapers and magazines commenting on the President writing an article in a medical journal. It is clear that the claims of the article did reach the general public which was probably the plan to begin with.

The conclusions of the President's article are that the ACA has lowered the number of people who do not have health insurance, access to health care has improved, financial security for those on Medicaid has improved, and health itself, based on a survey of nonelderly adults, has also improved.

There is no argument that the ACA has lowered the number of people who do not have health insurance. Allowing young adults to stay on their parents insurance policy until they are 26, increasing the number of people eligible for Medicaid, and the individual mandate requiring health insurance or paying a tax (penalty), have all contributed to lowering the number of uninsured from 49 million people in 2010 to 29 million in 2015. Some argue that the improving economy has also had a role in allowing more to afford health insurance, but, clearly, the ACA is helping in this regard.

The claims that access to care and the financial security for those on Medicaid has improved are based on another article in JAMA which presents data on self-reporting telephone surveys in adults aged 18-64 years (JAMA 2015; 314(4):366-74). There is a subjective bias in these types of surveys whereby those in favor of the ACA are more likely to respond. Objective measures such as claims data and health care outcomes would have been more convincing but were not done in this article. All of the authors in the cited article were employees of Health and Human Services (HHS) and HHS reviewed and approved the article before submission. Bias seemed obvious.

Despite the claimed progress that has occurred under the ACA, the President would like to see policy makers (Congress?) take steps to improve the Health Insurance marketplace, increase financial assistance for Marketplace enrollees, reduce prescription drug costs, and institute a public plan option for areas devoid of individual market competition for health insurance plans.

The article reads like a political speech. The President claimed that shortcomings of the law were due to lack of funding, excessive oversight, and relentless litigation by the Republicans. He also took special interests to the woodshed especially the pharmaceutical industry which opposes any change to drug pricing "no matter how justifiable and modest, because they believe it threatens their profits." Talk about a "straw man".

In the article, the President asks Congress to give the federal government the authority to negotiate prices for certain high-priced drugs. There is no law that I am aware of that would prevent this negotiation from happening right now. I think what the President really wants is to regulate what pharmaceutical companies can charge. He also wants the Congress to keep the Independent Payment Advisory Board (IPAB) from any type of legislative review. The role of the IPAB is to determine what and how much Medicare and Medicaid will pay for. The last I checked, we have a free market economy where suppliers of a product are allowed to charge what the market will bear. Competition in the market place, not the government, is the best way control costs.

As an academic surgeon, I was also bothered by the fact that this opinion piece failed to properly acknowledge those who were involved in the research upon which the article relied. Usually, these people are named as co-authors. Instead, they are named in a small paragraph just before the reference section. All were employees of the Executive Office of the President and there were no physicians in the group. Again, bias was obvious.

The Affordable Care Act is failing. Some insurance companies are bailing out as they are experiencing financial losses. Some larger companies are trying to merge but are being blocked by the government who are afraid of monopolistic practices. Healthy people are not participating in the numbers expected since the tax penalties of abiding by the individual mandate are less than the insurance premiums and copays and there is no penalty for waiting until the need for insurance arises (community rating). Two thirds of the Obamacare Co-ops have withdrawn and two more are threatening to leave. They could not continue to sustain financial losses while still meeting their obligations to their policy holders.

The Public Plan option raised in the President's article is really just a single payer system. The plan was mentioned deep in the article and stated that Congress should consider it for those facing limited insurance market competition. As insurance companies bail out of this market, more people could become eligible for this option. Maybe that's what the President wanted all along. Socialized medicine has been tried in other countries; it usually results in a two tiered system. Those who can afford to pay will be able to get timely and high quality care. Those who cannot afford to pay will be put on a waiting list and the care provided will be regulated by the government. I cannot be convinced that the government will be better at taking care of my patients than I am.

As with most medical journals, the authors and contributors have to disclose any conflicts of interest so the readers will have this information as they read the article. For this article, the conflict of interest disclosure sends the reader to a website:

https://www.whitehouse.gov/sites/whitehouse.gov/files/documents/oge_278_cy_2015_obama_051616.pdf.

This brings you to President Obama's financial disclosure report; nothing is said about the other contributors.

Lawyers are trained to present the evidence that is most favorable for their client's position. President Obama is a graduate of Harvard Law School. The jury is still out.

Darryl Weiman's web site is www.medicalmalpracticeandthelaw.com

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 23 minutes ago.

MAXIMUS to Host Job Fair in Rochester on August 3rd

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--(BUSINESS WIRE)--MAXIMUS:   WHEN: Wednesday, August 3, 2016 from 11:00 a.m. - 6:00 p.m.   WHERE: Monroe Community College R. Thomas Flynn Campus Center 1000 East Henrietta Road Rochester, New York 14623   WHY: MAXIMUS is expanding our program and customer contact center operations in Rochester, NY. These operations will provide support and administrative services for several state health insurance programs.   We are hiring for our new Tech Park location. We are looking for customer service sp Reported by Business Wire 5 minutes ago.

The New York Times Had Trouble Fact-Checking Hillary's Speech - Here's Why

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The New York Times Had Trouble Fact-Checking Hillary's Speech - Here's Why While Hillary Clinton's acceptance speech emphasized "I sweat the details of policy," The New York Times is forced to admit as it began its fact-checking, she delivered a *speech that was remarkably without hard facts*...



Much of her address was a mix of* descriptions of her upbringing, assertions of her opinions and generalized attacks on Donald J. Trump*. She talked about marching “toward a more perfect union” and said Mr. Trump “doesn’t like talking about his plans.” *And even when she said “I love talking about mine,” she offered few concrete numbers or assertions to examine.* Instead, she spoke in general terms about making “college tuition-free for the middle class” and giving “a boost” to small businesses.



There were, however, a few factual assertions that could be checked — so we did:



*CLAIM*: “Children like Ryan kept me going when our plan for universal health care failed, and kept me working with leaders of both parties to help create the Children’s Health Insurance Program that covers eight million kids in our country.”

*FACT CHECK*: This is true. Mrs. *Clinton has at times claimed full credit for the program*. But by saying in the speech that she “worked with leaders of both parties to help create” the program, her statement fits with the facts. And the health insurance program does currently serve 8.1 million children, according to Medicaid.

 

*CLAIM*: “Our economy is so much stronger than when they took office. Nearly 15 million new private-sector jobs.”

*FACT CHECK*: This is true. Since early 2010, when the economy stopped losing jobs every month, 14.8 million jobs have been added in the longest streak of private-sector job growth in history. *Critics say job growth would have been higher if a different set of economic policies were in place, but that is impossible to prove.*

 

*CLAIM*: There are now “20 million more Americans with health insurance.”

*FACT CHECK*: This is largely true. According to a recent report by the Department of Health and Human Services, about 20 million Americans have gained health coverage under the Affordable Care Act from its passage in 2010 to early 2016. *However, critics argue that the law has caused premiums to rise, sometimes drastically for people who already had health insurance.*

 

*CLAIM*: There is now “an auto industry that just had its best year ever.”

*FACT CHECK*: This is largely true. Auto sales in the United States reached a new high in 2015, with about 17.4 million vehicles sold. That represented a 5.8 percent increase from 2014. But the auto industry has changed significantly. Detroit’s Big Three automakers have a much lower market share than they once did. *Auto manufacturing also employs fewer people than it used to, although there have been gains since the Great Recession.*

 

*CLAIM*: “More than 90 percent of the gains have gone to the top 1 percent.”

*FACT CHECK*: This depends on the time frame you consider. From 2009 to 2012, the top 1 percent of families captured 91 percent of total real family income growth, according to Emmanuel Saez, an economist at the University of California, Berkeley. *But over a longer period of time, the picture looks less lopsided: From 2009 to 2015, 52 percent of the income gains went to the top 1 percent, according to Mr. Saez.*

 

*CLAIM*: “In Atlantic City, 60 miles from here, you will find contractors and small businesses who lost everything because Donald Trump refused to pay his bills.”

*FACT CHECK*: This is true. Several news organizations have documented many specific instances where contractors say Mr. Trump or his organization refused to pay them for work they had done, in Atlantic City and elsewhere. *Mr. Trump and his representatives say that if those payments were not made, it was because the work that was done was unsatisfactory.*

 

*CLAIM*: “Trump suits in Mexico, not Michigan. Trump furniture in Turkey, not Ohio. Trump picture frames in India, not Wisconsin.”

*FACT CHECK*: This is partly true, though without much context. Fact-checkers have found several examples of Trump clothing like suits, ties and shirts that have labels showing they were made in places like Mexico, Bangladesh and China. *But some have labels showing they were made in the United States, and as of 2014, the clothing and footwear association reported that 97 percent of all clothing and 98 percent of all footwear was imported from overseas.* Some of Mr. Trump’s furniture is made in Turkey.



Source: New York Times Reported by Zero Hedge 21 hours ago.

Until Universal Health Care Coverage, We Have Medicaid to Combat Health Injustices

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At the Democratic National Convention in Philadelphia this week several prominent speakers highlighted the need for universal health care, which they said could be achieved by expanding the reach of the landmark Affordable Care Act (ACA).

But why should our country make such an investment? Simply put, the pursuit of liberty and happiness requires health - and not just for the wealthy. Right now great health disparities fester in our country, affecting people who have systematically been denied quality health care because of race, ethnicity, socioeconomic status, gender, age, mental health, physical disability, sexual orientation and gender identity. The U.S. Department of Health and Human Services (HHS) has been reporting and updating information about these disparities for many years. HHS's studies show that health outcomes vary according to geography, such as in southern states that have not expanded Medicaid, but that different zip codes in the same metropolitan area may have significantly different access to health. The low income neighborhoods fare much worse than other neighborhoods on access to health care and the opportunity to be healthy.

If health disparities cannot be overcome and health injustice persists, our society suffers, and communities are rightly angry. Health disparities and injustice keep those communities mired in poverty and unable to achieve their potential to help make this a stronger country - one where genuine equality and liberty for all thrive.

Just this week, Lannis Hall, Arnold D. Bullock, Angela L. Brown and Graham Colditz, in a piece for The New York Times highlighted the fact that African American men die of prostate cancer at much higher rates than white men. The authors noted that many physicians do not screen black men for prostate cancer because, four years ago, the U.S. Preventive Services Task Force recommended that physicians should halt routine prostate screenings for all men. The problem with that recommendation, as the authors noted, is that the Task Force's guidance was based on clinical studies that did not include enough black men. The result is fatal health care for black men, cutting short their valuable lives.

In June, a Georgetown University report found that African Americans in Washington, D.C. are "six times more likely than whites to die from diabetes-related complications." The report, by Professors Maurice Jackson and Christopher King, also found that black men in D.C. live "15 fewer years than their white counterparts and are three times more likely to die of prostate cancer."

Socioeconomic forces are fueling those troubling disparities, such as the fact that black families in the District are "3.5 times more likely to live below the poverty line." Poverty contributes to health disparities in ways that we cannot totally eradicate with clinical health care, but the Medicaid program gives us important tools for the battle.

Fifty-one years ago on July 30, President Lyndon B. Johnson signed Medicaid, a federal and state program, into law as an amendment to the Social Security Act. Today, Medicaid is the primary public health insurance program for people with low incomes, covering nearly 70 million people, including more than a quarter of the children in the United States. Children eligible for Medicaid are entitled to comprehensive, periodic physical, developmental, and mental health assessments and services. Medicaid's coverage for children also includes case management services to assist young children and their families with gaining access to medical, social, educational and other services. And finally, Medicaid must coordinate with other state and federal public health, educational, food and nutrition and related programs to help ensure child health.

Medicaid is our nation's strongest tool to combat health disparities, moving us, albeit slowly, toward a day when all people have the ability to attain the highest level of health. As executive director of the National Health Law Program, founded in 1969 to fight for access to quality health care for low income people, I can tell you firsthand that securing the rights that Medicaid guarantees is an ongoing battle, but one well worth the fight. At NHeLP we see lawmakers and conservative advocacy groups who strive to limit access to Medicaid, for myriad reasons, though politics is often a major driver. For example, the ACA provides states the ability to expand Medicaid to low-income individuals, who are not elderly or disabled. Thirty one states and D.C. have expanded Medicaid pursuant to the ACA, but nineteen states have rejected health care for their low income residents and some have attempted to expand Medicaid by changing it in troubling ways. Kentucky Governor Matt Bevin is seeking a waiver from the federal government to tie work requirements to Medicaid coverage, a qualification that we know accomplishes nothing good and leaves health care out of reach for the people who need it most. All states have great leeway in administering Medicaid, but they must do so within federal guidelines; the Centers for Medicare and Medicaid (CMS) have rejected such proposals, and they should continue doing so. Medicaid is a unique program aimed at providing the most vulnerable among us quality health care - again, it's one of our few tools to combat health disparities. Indeed a study released this spring by HHS shows that Medicaid expansion is helping low-income individuals to finally access treatment for mental illnesses or substance use disorders. According to the HHS report, nearly 30 percent of individuals in the states that expanded Medicaid were using their coverage to obtain treatment for behavioral health needs.

There are many factors that produce and perpetuate health disparities, including lack of access to adequate housing. In the words of U.S. Housing and Urban Development Department Secretary Julián Castro, "housing is health care." Secretary Castro in early July announced $2.4 million in grants to assist more than 1,200 low-income individuals living with HIV/AIDS to help ensure they can remain in their homes. The secretary noted that research "shows that a stable home is critical to health of persons living with HIV/AIDS, and results in better health and reduced transmission of the disease. The combination of housing assistance and supportive services are critical to sustaining housing stability, promoting better health outcomes, and increasing quality of life, which promotes self-sufficiency efforts for those able to transition to the private housing market."

Health disparities do not result from a single cause and we cannot fix them with a single cure, but we must use the tools we have effectively as we continue to push for more solutions. On this anniversary of Medicaid, let's celebrate the fact that this noble government program is a major tool that we can use even more creatively to battle health disparities. Health justice for all people is what is ultimately needed. Until that day comes, far too many people in our country will be unable to enjoy liberty.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 19 hours ago.

DNC convention: Helping others vs. helping yourself; This is the warm Clinton we’ve wanted

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Helping others vs. helping yourself After reading several stories about the presidential candidates, I am left with a sense of accomplishment [“‘We can all rise together’,” Page One, July 29]. It seems that Hillary Clinton has done many things for others, from forging the children’s health-insurance plan and helping farmers in rural New York to […] Reported by Seattle Times 14 hours ago.

Depression Types, Treatment and News: Mental Health Awareness Highlighted During National Minority Health Awareness Month 2016

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One of the world's major problems today is mental health. With endless crimes, tragedies, calamities, and racial tensions that are happening nowadays, people are becoming more at risk to develop mental illnesses such as depression. This kind of illness affects everyone. However, a research study suggests that depression is more frequent among members of minority groups than among Whites due to greater health burdens and lack of health insurance. Reported by Christian Post 11 hours ago.

Obamacare May Actually Be Saving You Money, Study Shows

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Without the Affordable Care Act, you could be paying much more for health insurance. Reported by Motley Fool 1 day ago.

Basic insurance packages affordable for all

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(MENAFN - Khaleej Times) The health insurance cover is compulsory for all Dubai residents, their dependents, the elderly and their domestic workers. A poll run by Khaleej Times i... Reported by MENAFN.com 16 hours ago.

7 Life Lessons Our Kids Can Learn from Hillary Clinton's Historic Nomination

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You have probably seen the Clinton campaign ad.  You know, the one where Donald Trump disparages women, encourages violence against protesters, claims he could shoot up Times Square and his supporters would still vote for him, makes racist comments about Mexicans, and mocks a disabled reporter.  (If not, click here or see below.)   We have all heard Trump say these things, almost to the point of becoming desensitized to them.

But what about our children?  The ad is particularly devastating in that it shows the faces of children watching Trump on TV.  It shows that they are listening and taking in the words and the message.  Trump, in essence, says and does things that we as parents try to teach our children not to do.  The ad (entitled “Role Models”)  next displays this message “Our children are watching.  What example will we set for them?”

And then, the ad concludes with the words of Hillary Clinton herself, who is saying during a speech (again, as children watch on TV), “Our children and grandchildren will look back at this time, at the choices we are about to make, the goals we will strive for, the principles we will live by.  And we need to make sure that they can be proud of us.”

We have heard a lot about the horrifying things that Donald Trump has said and done―both during his campaign and over the course of a lifetime.  It almost goes without saying that these things―bullying, incitement to violence, racism, misogyny, xenophobia―are lessons we do not want our children to learn.  But what about Hillary Clinton’s campaign, and the things that she has said and done over the course of her lifetime?  What does her historic nomination teach our children (and us) about life and the principles we want them to learn?  The media has done little to distill these for us (except to note the self-evident, highly significant truth that at least one woman has been able to achieve the previously unattainable).  So, here are seven other life lessons (the first being that kids should dream big, that even a girl from a middle class upbringing can grow up to be president) that our kids can take away from Hillary Clinton’s extraordinary life and nomination.  It wouldn’t hurt to point these out to our sons and daughters and show them how Clinton’s story is, in many ways, a model well worth following

*1. Perseverance Pays Off*

Clinton is the poster child for the motto, “If at first you don’t succeed, try, try again.”   Her perseverance has been one of her most important character traits over the course of her adult life.  When she took on as First Lady, the thankless, impossible job of tackling universal health care and failed, she could have given up and retreated into a more traditional role.  Instead, she worked with members of Congress to find common ground and enact the Children’s Health Insurance Program, providing health care insurance to millions of children.   When she lost the nomination in 2008 to Barack Obama, she could have thrown up her arms in despair and lived out the rest of her life in comfort.  Al Gore did just that in 2000 when he narrowly lost the election to George W. Bush.  Instead, Clinton picked herself up, dusted herself off, and returned to public service, working directly for the man who had defeated her.  And then, put herself through the same grueling schedule and withering criticisms by running for the nomination again four years later.  Lesson taught?  If you give up, there is no chance at success, so why not persevere and try again.

*2. Nobody Is Perfect But That’s OK/Own Up to Your Mistakes*

Clinton has been around the block―many times.  She has been in the public spotlight since the early 1990s and, as a woman ahead of her time, has endured a particularly harsh, brightly lit, and cynical spotlight at that.   Could anyone come out of that without making some mistakes?  Of course not.  Do we expect our kids to be perfect and never make mistakes?  Do we never make mistakes ourselves?  Of course not.  Clinton has made her fair share of mistakes and her political enemies have always tried to make hay of those mistakes.  However, Clinton has also been unusual on the political scene by keeping an open mind and when she sees she was indeed wrong about something, she will admit it.  She will grow and learn from her mistakes and change either her way of thinking or try to make things right.  Male politicians on the whole seem to struggle with admitting to mistakes and instead dig in deeper and double down.  Changing one’s mind in the face of reason or admitting you made a mistake and sincerely apologizing for it is not a sign of weakness, but a sign of strength and it’s a great lesson for our children.

*3. Ignore Naysayers*

How is it possible that Clinton holds her head up every day and forges ahead despite people yelling “Lock her up!” (and that’s just the Bernie-or-Busters)?  How can she work towards making a change to a deeply entrenched idea (like, disabled children can’t be educated in the public school system, or a woman’s place is in the home with her husband) when people all around her are saying it’s impossible, it’s not worth the effort, it’s just plain wrong?  Somehow she can block it out because she is secure in her values and in her heart knows she is doing the right thing.

*4. Stand Up to Bullies*

Clinton spoke during her acceptance speech at the DNC about how her mother―herself a tough cookie who had to fend for herself at a very young age―taught Clinton always to stand up to a bully.  When you’re relatively small, or weak, or female, it’s easy to be intimidated by those who seek to shut you down through force―physical or emotional.  Clinton’s defiance in the face of men―most recently, Donald Trump―who seek to bully her is another great life lesson for all of us.

*5. Listen to & Learn from Others*

While Clinton can block out a lot of unfair, politically motivated noise, she somehow maintains her ability to let in voices of reason and constructive criticism.  She also has never become so powerful that she forgets to listen, or has stopped listening, to those people who are weak and powerless and downtrodden.  Those who are closest to her and her advisors marvel at how she can truly listen to the plight of individual men, women, and children while on the campaign trail and immediately try to help solve their problem.  She does this by listening and not just hearing what they have to say.

*6. Have Confidence in Your Abilities/Dare to Be Different*

To be a college woman in the 1970s, the first student commencement speaker at your school, a student at an old boy’s club like Yale Law School, a political activist that poses as a housewife and mother to uncover school segregation in the South, and a First Lady that pushes the envelope like no one before her, etc., etc., etc., you have to be both very confident in your own abilities and also willing to go out on a limb and try another pathway.  Girls and women have always struggled with these things.  We allow ourselves to be talked over at meetings, needlessly apologize for our words and actions, doubt ourselves at every turn.  Clinton’s life history teaches all of us that we shouldn’t psych ourselves out and rather to trust our instincts and values to make change when we feel something is wrong and needs to be fixed.

*7.  Empathize with Others*

Clinton gave a speech when she was First Lady saying that what the world needed was more “love and kindness.”  She was crucified in the press for it.  This was yet another of her ideas that was ahead of its time.  She was right, of course.  What an antidote for the hatred and divisiveness peddled by her opponent than some love and kindness for our fellow humans.  When Clinton talks about “love and kindness” what she really means is that we need more empathy.  We need to be able to step into the shoes of a single pregnant mom living in poverty or the child of an illegal immigrant who is terrified he will be deported.  We need to see that saying racist things leads children who are African-American or of Mexican descent to feel devalued and ashamed of themselves and their ancestors.  We need to understand that “Black Lives Matter” because all lives should matter but do not, even in 2016.  We need to empathize more and judge less.  What a great life lesson for all of us.-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 10 hours ago.

Retirement Advisor Jeremy Keating Reviews the Role of Insurance in Retirement Planning

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In the latest installment of his retirement series, “The Retirement Formula: The Retiree’s Guide to What You Don’t Know,” financial advisor Jeremy Keating discusses the role of insurance in retirement planning.

SAN DIEGO, Calif. (PRWEB) August 01, 2016

In the latest chapter of his “The Retirement Formula: The Retiree’s Guide to What You Don’t Know” retirement advisory series, San Diego financial advisor Jeremy Keating of Capital Income Advisors (CIA) discusses the  important role insurance plays in retirement planning.  

In the retirement planning process, considering contingencies that can derail a retirement plan, either before, during, or after retirement, is critical to protecting one’s nest egg. Contingencies can include underperforming investments; an employer’s bankruptcy reducing an anticipated pension benefit; divorce; unemployment; medical expenses not fully covered by insurance; disability; the need for long-term care, or the death of a spouse.

Fortunately, insurance is available for some of these contingencies to reduce the impact they may have on an individual’s overall finances, including his or her retirement plan.

By discussing the different types of insurance that can help keep a retirement plan on track, Keating says pre-retirees and retirees can better prepare for the unexpected.

Health Insurance

Medical expenses can deplete a large portion of an individual’s income, even when he or she has insurance. A 2012 Deloitte survey found that 24 percent of total healthcare expenses of higher-income individuals went to out-of-pocket medical expenses.

“While health insurance is expensive, being without health insurance can be devastating,” Keating says. “A study published in 2009 from the American Journal of Medicine reported that illness or medical bills contributed to 62.1 percent of bankruptcies filed in 2007.”

Further, less than 25 percent of patients were uninsured when they filed for bankruptcy but 40 percent had experienced a lapse in coverage in the two years prior to filing. Many reported that they understand the importance of health insurance, either intuitively, from personal experience, or based on the experience of family, friends, and coworkers.

Maintaining some level of health insurance can reduce both the immediate impact of medical expenses and the long-term impact on an individual’s finances. Critical illness insurance may help supplement a client’s health insurance coverage. When the insured is diagnosed with a covered condition, these benefits can help pay living expenses, supplement health insurance or disability income insurance benefits, or continue contributions to a retirement savings plan. Coverage is available for specific diseases or conditions that are selected when the insurance policy is purchased.

The Patient Protection and Affordable Care Act is making major changes to health insurance in the United States, although its contribution in the event of a devastating medical condition is unknown at this time. The advisor and client should try to anticipate if any additional coverage will be needed, and plan to have resources to pay for it.

Life insurance

Life insurance can be a valuable part of a secure retirement plan. Protecting the financial security of one’s family is important. The goal of retirement planning is to maintain the same standard of living an individual or couple enjoyed throughout their working years. Permanent life insurance can help not only with final expenses and burial costs, but with protecting a surviving spouse and family members with financial security.

Permanent life insurance provides lifelong protection, and the ability to accumulate cash value on a tax-deferred basis. Unlike term insurance, a permanent insurance policy will remain in force for as long as one continues to pay their premiums.

Permanent life insurance may also provide several solutions for an overall retirement strategy. Ten reasons why permanent life insurance can benefit a retirement portfolio include:

1. It can cover final expenses and burial costs for the policyholder.
2. It can provide a surviving spouse and family members with money to cover estate and inheritance taxes.
3. It can replace lost income in the event of the policy holder's death, even if the deceased was already retired
4. It can replace all or a part of a surviving spouse or partner’s pension benefits, which may be especially important for retirees who have come to depend on the deceased’s full Social Security or other pension income.
5. It can help a surviving spouse pay off a mortgage or other debts that remain.
6. It can financially support dependents, such as aging parents or a loved one with special needs.
7. It can help protect or create a legacy, for instance by providing the funds needed to meet tax liabilities from taxable retirement accounts.
8. It can provide continued coverage, especially when an employer-sponsored group life insurance coverage ends upon retirement.
9. It can provide withdrawals or loans to supplement retirement income.1
10. It may offer riders that could potentially allow the policy holder to accelerate the death benefit (while they’re living) to use for any reason, should they become chronically or terminally ill.
11. It may offer additional benefits that can help provide a surviving spouse and/or family with financial security,

While paying the monthly premiums may not be appealing, when one considers that life insurance is an investment that is not subject to market volatility, offers tax-free withdrawals and no penalty for withdrawing before a certain age, and can help diversify one's portolio, it could be a smart decision.

Disability insurance

Most people carry disability insurance to supplement their income in the event they lose work due to sickness or injury. Disability insurance can be a game changer for pre-retirees and retirees.

“Disability may be the most misunderstood insurance product on the market, since it has a lot of moving pieces and it’s complicated, Keating says. “It is also expensive, but that is no reason to discount it.”

According to Keating, between the ages of 25 and 65 the chances of becoming disabled are much higher than the chances of dying. Many people rely on a company disability policy, but most of these policies don't adequately cover income loss. Policies have many qualifiers, perhaps the most important being "any occupation" versus "own occupation" coverage.

An "any occupation" policy is stricter, and pays out only if the policy holder can not work in any job reasonably suitable for them. "Own occupation" policies pay if the policy holder is unable to perform their current job. That's an important distinction for professionals—for example, surgeons, who would want to be compensated if they injured a hand and could no longer perform surgical procedures.

“Many people lack adequate disability coverage,” Keating says, “If there is no group plan in place at work, the number of people covered is really pretty low.

"For someone still working, especially in a one-income household, disability is as important as life insurance. People have to protect their income."

Group disability policies generally cover 60 percent of income, but that percentage can vary. Some may offer short-term coverage or benefits may not start immediately, in which case a supplemental policy makes sense.

“The obvious question is, what if something happens to you, and your family is left without an income stream?”

Ultimately, the type of insurance one chooses has to do with factors such as cash flow, discretionary income, age and financial objectives, according to Keating.

Some statistics to consider when discussing insurance options with a financial advisor include:· 30 percent of American households have no life insurance.
· About 100 million workers are without private disability income insurance.
· Sixty-eight percent of adult Americans have no savings earmarked for an emergency.
· Thirty-three percent of consumers believe they do not have enough life insurance (LIFE 2013 Insurance Barometer Study)
· Seventy percent of people over age 65 will require some long-term care at some point in their lives.

Under Social Security, individuals can retire for disability at any age provided they have worked and received 10 years (40 quarters) of credit and have been covered under the system for at least 20 quarters (five years) out of the last 40 quarters (10 years), ending with the quarter in which the disability occurred.

For people who retire before their full retirement age, this is important. Unless they carry disability insurance individually, if they do become sick or disabled, they could be in trouble.

For example, if a person retires at 50 and becomes disabled at age 54, they can look back 10 years and see they were covered under the system for six years and can begin drawing Social Security right right away, without having to wait until age 62. Consider the same scenario but change the age at which the individual becomes disabled to 56, and now there’s a problem. They only have four years of credit over the last 10 years, meaning they were covered for only 16 quarters, not 20, quarters out of the last 40. Therefore, they are not eligible to receive Social Security disability benefits. Making matters worse, they must wait another six years for their Social Security retirement benefits to begin.

Having to postpone one’s Social Security benefits could make a big difference in their ability to survive comfortably.

Insurance plays an important role in retirement. Pre-retirees and retirees should plan ahead and get expert advice in making sure their insurance needs are met.

To learn more, visit the Capital Income Advisors website, email jkeating(at)capitalincomeadvisors(dot)com, or call (800) 875-1986.

About Capital Income Advisors:

The primary focus at Capital Income Advisors is retirement planning. Jeremy Keating and the CIA team of advisors treat their clients as they would treat members of their own family. CIA strives to help create sound retirement income strategies for men and women in or nearing retirement, thereby instilling confidence that their retirement income will last as long as they do.

Capital Income Advisors serve all of Northern and Southern California, all across Texas including, Houston, Dallas, Austin, San Antonio, Midland, and the New York Tri State area. CIA offers retirement income strategies, wealth accumulation, asset protection, annuities, life insurance, tax minimization strategies, long-term care, IRA and 401(k) rollovers.

### Reported by PRWeb 17 hours ago.

The Five Worst Roberts Court Rulings

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(Photo: AP/Evan Vucci)

Supreme Court Chief Justice John Roberts in the foreground arrives before President Barack Obama's 2016 State of the Union Address on Capitol Hill on January 12.

In a by-now familiar applause line, Bernie Sanders told Democrats gathered at the Democratic National Convention last week that the Supreme Court’s 2010 Citizens United v. FEC ruling is “one of the worst Supreme Court decisions in the history of our country.” And this is not an instance where Sanders conflicts with the conventional wisdom of the party establishment either. Not only Senator Elizabeth Warren but Democratic presidential nominee Hillary Clinton have consistently railed against the case as a symbol of the corporate takeover of democracy, and so have countless grassroots activists.

All this makes sense given the extent to which wealthy interests have been permitted to dominate American politics and policy. After all, big money has the potential to disrupt virtually every aspect of the progressive agenda, from environmental regulations to the minimum wage and health care. But the left’s fixation on Citizens United overlooks many Roberts Court decisions that were as bad or even worse. In fact, Citizens United arguably does not rank in the top five rulings handed down during the Roberts era.

So what were the five worst Roberts Court rulings? This list relies on two criteria. First, how plausible was the legal argument? And second, how negative was the policy impact of the decision? By these measures, Citizens United doesn’t quite qualify as the worst work of the Roberts Court.

Let’s take the first criterion, plausibility. On this score, the First Amendment questions at the heart of campaign financing are genuinely difficult. Indeed, on the very narrow question presented by the case—whether the federal government could suppress the broadcast of an anti-Hillary Clinton movie—Citizens United was arguably correct to answer “no.” What makes the decision a bad one is that the Court went far beyond what was necessary to decide that issue. Nevertheless, the constitutional arguments made by the Court had more basis in text and precedent than the Roberts Court’s five absolutely worst decisions.

On the question of the ruling’s impact, the actual fallout from Citizens United has probably been overrated. Politicians such as Sanders and Clinton can justifiably use that decision as a synecdoche for all of the restrictions the Court has placed on the government’s ability to regulate campaign financing. But the more important campaign finance decision remains the 1976 case Buckley v. Valeo. There’s plenty wrong with Citizens United, as I have argued. But the five absolutely worst Roberts Court decisions are these, in descending order of indefensibility:

*1. Shelby County v. Holder. *The Roberts Court’s evisceration of the most important civil-rights legislation passed since Reconstruction was its lowest moment. The impact of the decision to reverse a key part of the Voting Rights Act is anti-democratic, allowing numerous illegal voter-suppression schemes to go into effect, and making it much more difficult to stop them. But what makes Shelby County especially egregious is its threadbare legal reasoning, which can’t even be called “constitutional law.” The Constitution unambiguously gives Congress the power to enforce the 15th Amendment. The “equal sovereignty of the states” doctrine that the chief justice used to trump Congress’s explicit powers is a Roberts invention, and he has yet to identify any constitutional basis or Supreme Court precedent for it. Even setting aside his failure to base it on the text of the Constitution, Roberts’s argument—that Congress once had the relevant power but no longer does because the statute was too effective at protecting the rights it was intended to—defies logic. As Justice Ruth Bader Ginsburg noted in a dissent that gets the better of the Roberts majority opinion on every point, this argument makes as much sense as “throwing away your umbrella in a rainstorm because you are not getting wet.”

*2. NFIB v. Sebelius. *This case is generally seen as a liberal triumph because Chief Justice Roberts ultimately decided not to rule Barack Obama’s signature domestic policy achievement unconstitutional. But its Medicaid expansion holding might actually belong at the top of list. In terms of its policy impact, it would be hard to identify a worse decision in the history of the Supreme Court. Thousands of people a year will literally die because Roberts re-wrote the Medicaid expansion of the Affordable Care Act to make it much easier for states to opt out. According to Roberts, Congress could offer money to the states and place conditions on giving the money to expand Medicaid, but it could not withdraw existing Medicaid funding if states declined it. As a legal argument, it’s not quite as bad as the one in Shelby County. It’s imaginable that federal spending power might stray so far afield from a law as to unconstitutionally coerce the states—though it’s hard to picture any Congress passing such a law. As applied to this case, though, it’s quite absurd. If Congress had simply repealed the Medicaid Act of 1965 (which had been modified and expanded many times) in 2010, that would have been plainly constitutional. If Congress had repealed Medicaid I, passed the new Medicaid expansion, and made accepting federal money contingent on accepting the ACA’s conditions, this would be constitutional. So what sense does it make to say that Congress can’t make all existing Medicaid subsidies contingent on accepting the new conditions? It doesn’t.

Some people will object that this case shouldn’t make the list because two Justices nominated by Democrats—Stephen Breyer and Elena Kagan—joined the majority on this question. But it’s almost certain that these votes were strategic. It’s enormously unlikely that either Kagan (who ruthlessly attacked the Medicaid expansion argument during oral arguments) or Breyer (who has arguably the broadest conception of federal power of any justice in Supreme Court history) would have provided the fifth vote for it. But even if they had … well, they would have been dead wrong.

*3. Connick v. Thompson. *This case involved an almost-certainly innocent man who spent 18 years in prison largely because the state illegally suppressed exculpatory evidence. According to a 5–4 decision written by Justice Clarence Thomas, however, nobody in the prosecutor’s office could be held accountable for this egregious, willful rights violation. The impact of this case—making it more likely that innocent people will be railroaded into prison—is self-evidently terrible. And legally, it’s worth noting that the Supreme Court was not enforcing a constitutional or statutory requirement—this extreme level of prosecutorial immunity is a judicially created standard that the Court is free to modify or abandon at any time. It certainly should have in this case.

*4. AT&T Mobility v. Concepcion. *In this case, the Court held (in an opinion written by the late Justice Antonin Scalia) that federal law preempted California’s limits on forced-arbitration agreements. This decision makes it much harder for consumers to get effective remedies when companies rip them off. If the text of Federal Arbitration Act did, in fact, explicitly prevent California’s regulations, that wouldn’t be the Court’s fault—but it doesn’t. If you’re in the mood for dark comedy, contrast Scalia reading nonexistent policy requirements into federal arbitration law here with the hyper-literal reading of the law he tried to use to strip health insurance from millions of people in King v. Burwell. For a similarly bad anti-consumer decision, see American Express v. Italian Colors.

*5. Arizona Free Enterprise Club's Freedom Club PAC v. Bennett. *I actually think that this, not Citizens United, is the very worst of the Roberts Court’s campaign-finance decisions. The Court struck down an Arizona law that gave matching funds to candidates based on the money raised by their opponents. Citizens United at least presents a real First Amendment issue, because the government was accused of setting out to restrict speech. Arizona’s public funding for candidates, conversely, did no such thing—it expanded speech rather than suppressing it. Since public financing is the most viable means legislatures have to counteract the domination of politics by the wealthy, making it more difficult for states to do so is a big deal, and the arguments that Arizona’s provision of matching funds violates the First Amendment were nonsensical. As Justice Kagan observed in dissent, “Except in a world gone topsy-turvy, additional campaign speech and electoral competition is not a First Amendment injury.”

A few dishonorable mentions that didn’t make this list include District of Columbia v. Heller, which held that bans on the possession of handguns for self-defense violated the Second Amendment. While most liberals abhor the ruling’s restrictions on the ability of the state to enact gun control measures, the Roberts Court’s legal argument in Heller isn’t ridiculous, and at least so far, its impact has been modest.

Other Roberts Court misfires include the decision allowing employers to refuse legally mandated contraceptive coverage to their employees in Hobby Lobby v. Burwell; a series of decisions that restricted employees’ ability to bring anti-discrimination lawsuits; a ruling that upheld arbitrary strip searches of people arrested for minor, nonviolent offenses; and the Court’s creation in Clapper v. Amnesty International of a First Amendment catch-22.

As Sanders observed in his DNC speech, the implications of who sits on the Supreme Court go well beyond a few high-profile issues like abortion. And with one vacant seat and several justices on the verge of leaving the Court, the Court is about to move substantially in one direction or another. If Hillary Clinton and a Democratic Senate are able to replace Scalia, the Court will swing in a more liberal direction favorable to environmental, reproductive health, criminal justice, consumer protection and other progressive priorities. If Donald Trump wins and is able to replace the Scalia seat and at least one of Breyer, Ginsburg, or Kennedy, the Court will continue down the disastrous path set by Chief Justice John Roberts. Citizens United and the Supreme Court’s other campaign-finance rulings will be important parts of the constitutional agenda. But so will a long list of other very important issues. Reported by The American Prospect 15 hours ago.

Caregiverlist® Announces Maine Nursing Home Rating and Cost Index for July 2016

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Maine seniors needing a long-term nursing home stay in their state will pay roughly $91,980 per year, the average annual cost based on the semi-private room daily rates of 110 nursing homes in Maine . Medicare does not pay for long-term care, while Medicaid, for low-income seniors does pay for an ongoing stay in a nursing home.

Chicago, Illinois (PRWEB) August 01, 2016

Maine nursing home rates are the 10th highest in the nation, with an average annual cost of approximately $91,980 (based on semi-private rooms), or $7,657 per month per month.

Maine seniors needing nursing home care can now view the most recent ratings and costs of nursing homes in their area by using the interactive Caregiverlist® Nursing Home Directory. This month’s update of the Maine Caregiverlist® Index, indicates that the average cost of both private and semi-private nursing homes in Maine is $264 per day. Of the 110 total nursing home in Maine, well over half (77) rate 4-stars or better.

Caregiverlist® Rating Criteria National Averages for Maine Nursing Homes

July 2016, National Averages Weighting for Rating

2 hours, 28 minutes: C.N.A. Hours per Resident per Day                40%
15.7%: Long-stay Residents with Increasing Activities of Daily Living Needs    20%
1.0% Short-term Residents with Pressure Sores (Bed Sores)            20%
Overall Medicare Star-Rating Score                            20%

July 2016 Caregiverlist® Maine Nursing Home Rating and Cost Index

Snapshot:
Total Number of Nursing Homes: 110
Average Private Room Price: $276
Average Semi-Private Room Price: $252

Caregiverlist Nursing Home Star Rating:
5-Star: 15
4-Star: 62
3-Star: 27
2-Star: 1
1-Star: 5
Average : 3.3 (out of 5) stars

The Caregiverlist® rating combines 4 criteria to calculate an overall star-rating with a 5-star rating as the highest and a 1-star rating as the lowest score, as rated against the results for the total number of nursing homes.

Maine seniors and their families must remember that nursing homes have become an extension of a hospital stay and many times Medicare health insurance will authorize a hospital discharge directly to a nursing home for rehabilitation after a major medical event has occurred. This means researching the right nursing home ahead of time will ease the transition should a medical emergency occur.

Because seniors must private pay for a nursing home if needing care beyond the number of days Medicare will reimburse (usually only up to 100 days), many seniors also explore senior home care and assisted living options. Some assisted living centers also provide nursing home care.

Seniors who prefer to age at home may choose professional in-home senior care, based on cost and level of care needed. The hourly rate for senior home care in Maine can range from $16 to $34 per hour, depending on the location and level of care required, with the added benefit of one-on-one assistance. “We have been able to help families stretch their savings to cover elder care costs and at the same time provide compassionate care that goes above and beyond in the home,” says Sonia Garcia of FirstLight Home Care of Southern Maine. “We become part of the family and offer a safe, engaging and nurturing care that lessens the worry for families.” A quality home care agency will also conduct the necessary background check and provide all liability and worker's compensation insurance protections and payroll taxes as required by law.

Seniors should review the ratings and costs of nursing homes in their area and then visit the nursing homes which meet their budget parameters. Ratings for nursing homes are only a starting point and while the Caregiverlist® Index calculates a custom rating based on the most important criteria for quality, Medicare will only begin auditing the nursing home’s submitted information for C.N.A. staffing next year. Right now all of the information for the nursing home ratings is self-reported.

View Caregiverlist's most recent at-a-glance Maine Nursing Home Cost Infographic here.

About Caregiverlist®
Caregiverlist.com® is the premier service connecting seniors and professional caregivers with the most reliable senior care options, highest quality ratings and outstanding careers nationwide. Founded by senior care professionals, Caregiverlist® delivers the efficiencies of the internet to senior care companies by providing online job applications, caregiver training, background checks and industry news. Seniors and caregivers can access senior service information “by state,” view nursing home costs and star-ratings and learn about all senior care options and quality standards. For more information, please visit http://www.caregiverlist.com. Reported by PRWeb 14 hours ago.

Challenging the Stereotype Angry White Guy for Trump

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As what the press has dubbed, “Hillary Clinton’s Blue Collar Bus Tour,” travels across Pennsylvania and Ohio, I want to tell you about two angry white men I met at the Democratic National Convention last week.

The press would have you believe that all of the angry white men are Trump supporters. This is the stereotype: They are high school educated, gun-totin’, flag-wavin’, bigots who love the bragging, swaggering bully in Trump. 

But that’s an easy story. Those guys are easy to find. They fill Donald Trump’s stadiums. It’s true they’re out there. But what’s also true is that there’s a huge number of high school educated white men who don’t go to Trump rallies. They aren’t flag waving bigots. These are guys who only carry guns when they are hunting. They’re angry, all right. They’re angry at being associated with Trump.

Two of them were delegates to the Democratic National Convention last week. Both will be voting for Hillary Clinton and both will be urging their union brothers and sisters to do the same. They are Jim Savage, who is a member and past president of USW Local 10-1, where most members work at Philadelphia Energy Solutions, and Richard Ray, who is a retired member of the USW at Owens-Illinois Inc., having worked at plants in both North Carolina and Georgia.

For Ray, backing Trump would be antithetical to his life-long commitment to organized labor.

*Richard Ray *

Ray joined the American Flint Glass Workers union when he got a job with the Owens-Illinois Glass Co. in Durham, N.C. when he was 20 years old.  Six months later, he was elected shop steward. He held elected union offices for the next 49 years, all the way up to president of the Georgia State AFL-CIO, always in the not-so-union-friendly South. He became a member of the USW when the glass workers and the steelworkers merged.

Ray devoted his life to helping the group, getting better wages, benefits and working conditions for his union brothers and sisters. The most vital value to union members, he explains, is “we.” The idea, he said, is that everybody helps improve life for everybody: “We are all in it together.”

“With Trump, though, it is always, me, me, me,” Ray said. What is most important to Donald Trump is Donald Trump.

It is true, Ray noted, that Donald Trump is very rich, that he has done very well for himself. For the “me.” But he has also gone bankrupt repeatedly. And when he did, he protected himself at the expense of working guys and small contractors. Trump paid pennies on the dollar to electricians and bricklayers and other skilled laborers. Lots of small contractors in New Jersey lost their family businesses because Trump didn’t pay what he owed them. 

“He is the only one who came out smelling like a rose,” Ray told me. Trump wasn’t thinking of the other guy like a union brother or sister would. He was just thinking of Donald Trump.

The same is true with Trump’s signature products like suits and ties. Trump could have thought of the “we” and made a little bit less money for himself by manufacturing those products in America. But he didn’t. He makes them off shore with exploited foreign labor.

And right now Trump could be helping unemployed Americans, caring about the American “we,” but instead he is applying for 78 visas to bring in foreign nationals to work at his Mar-a-Lago resort in Florida. 

Ray told me that, by contrast, when he listens to Hillary Clinton, he hears the opposite. Even her slogan is “stronger together.”

He noted that when Hillary Clinton left an Ivy League law school, she could have taken a high-paid job with a law firm and just made money for herself, the way Donald Trump did when he left the Ivy League Wharton School. But instead, Hillary Clinton began working for children with disabilities. And she has been laboring to help people ever since, including securing health insurance for low income children when she was First Lady.

“I don’t think it has ever been about ‘me’ for Hillary Clinton,” Ray told me. “It has always been about we.”

Ray is a no stereotype southern working class white man voting for Trump. He will be working hard over the next four months to make sure his union brothers and sisters, his neighbors, friends and acquaintances all see that stereotype is as repulsive as he does.  

Savage is no stereotype rust belt working class white man voting for Trump. Vice president of the Philadelphia AFL-CIO, Savage came to the convention as a Bernie Sanders delegate because his mission is economic justice. He said he switched his allegiance to Hillary Clinton easily because she has supported organized labor her entire political life.

*Jim Savage*

Savage told me that he has fought throughout his life as a labor leader for economic justice and thought that racial justice would just naturally come along with it. But it has not.

“Economic justice doesn’t mean shit if it is only for a certain sector,” he told me last week. This is personal for Savage because he has both white grandchildren and black grandchildren. He wants them all to have the same opportunities. And he wants them to be treated equally in all areas of society.

He is deeply offended by racist comments Donald Trump has made. And he is deeply offended that people assume that because he is a white working class man that he is a Trump supporter.

“We need economic justice for all people, for people’s wives and daughters and neighbors,” Savage said. And that is why he is a white, working-class man supporting Hillary Clinton. 

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 12 hours ago.

Challenging The Stereotype Angry White Guy For Trump

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As what the press has dubbed, “Hillary Clinton’s Blue Collar Bus Tour,” travels across Pennsylvania and Ohio, I want to tell you about two angry white men I met at the Democratic National Convention last week.

The press would have you believe that all of the angry white men are Trump supporters. This is the stereotype: They are high school educated, gun-totin’, flag-wavin’, bigots who love the bragging, swaggering bully in Trump. 

But that’s an easy story. Those guys are easy to find. They fill Donald Trump’s stadiums. It’s true they’re out there. But what’s also true is that there’s a huge number of high school educated white men who don’t go to Trump rallies. They aren’t flag waving bigots. These are guys who only carry guns when they are hunting. They’re angry, all right. They’re angry at being associated with Trump.

Two of them were delegates to the Democratic National Convention last week. Both will be voting for Hillary Clinton and both will be urging their union brothers and sisters to do the same. They are Jim Savage, who is a member and past president of USW Local 10-1, where most members work at Philadelphia Energy Solutions, and Richard Ray, who is a retired member of the USW at Owens-Illinois Inc., having worked at plants in both North Carolina and Georgia.

For Ray, backing Trump would be antithetical to his life-long commitment to organized labor.

*Richard Ray *

Ray joined the American Flint Glass Workers union when he got a job with the Owens-Illinois Glass Co. in Durham, N.C. when he was 20 years old.  Six months later, he was elected shop steward. He held elected union offices for the next 49 years, all the way up to president of the Georgia State AFL-CIO, always in the not-so-union-friendly South. He became a member of the USW when the glass workers and the steelworkers merged.

Ray devoted his life to helping the group, getting better wages, benefits and working conditions for his union brothers and sisters. The most vital value to union members, he explains, is “we.” The idea, he said, is that everybody helps improve life for everybody: “We are all in it together.”

“With Trump, though, it is always, me, me, me,” Ray said. What is most important to Donald Trump is Donald Trump.

It is true, Ray noted, that Donald Trump is very rich, that he has done very well for himself. For the “me.” But he has also gone bankrupt repeatedly. And when he did, he protected himself at the expense of working guys and small contractors. Trump paid pennies on the dollar to electricians and bricklayers and other skilled laborers. Lots of small contractors in New Jersey lost their family businesses because Trump didn’t pay what he owed them. 

“He is the only one who came out smelling like a rose,” Ray told me. Trump wasn’t thinking of the other guy like a union brother or sister would. He was just thinking of Donald Trump.

The same is true with Trump’s signature products like suits and ties. Trump could have thought of the “we” and made a little bit less money for himself by manufacturing those products in America. But he didn’t. He makes them off shore with exploited foreign labor.

And right now Trump could be helping unemployed Americans, caring about the American “we,” but instead he is applying for 78 visas to bring in foreign nationals to work at his Mar-a-Lago resort in Florida. 

Ray told me that, by contrast, when he listens to Hillary Clinton, he hears the opposite. Even her slogan is “stronger together.”

He noted that when Hillary Clinton left an Ivy League law school, she could have taken a high-paid job with a law firm and just made money for herself, the way Donald Trump did when he left the Ivy League Wharton School. But instead, Hillary Clinton began working for children with disabilities. And she has been laboring to help people ever since, including securing health insurance for low income children when she was First Lady.

“I don’t think it has ever been about ‘me’ for Hillary Clinton,” Ray told me. “It has always been about we.”

Ray is a no stereotype southern working class white man voting for Trump. He will be working hard over the next four months to make sure his union brothers and sisters, his neighbors, friends and acquaintances all see that stereotype is as repulsive as he does.  

Savage is no stereotype rust belt working class white man voting for Trump. Vice president of the Philadelphia AFL-CIO, Savage came to the convention as a Bernie Sanders delegate because his mission is economic justice. He said he switched his allegiance to Hillary Clinton easily because she has supported organized labor her entire political life.

*Jim Savage*

Savage told me that he has fought throughout his life as a labor leader for economic justice and thought that racial justice would just naturally come along with it. But it has not.

“Economic justice doesn’t mean shit if it is only for a certain sector,” he told me last week. This is personal for Savage because he has both white grandchildren and black grandchildren. He wants them all to have the same opportunities. And he wants them to be treated equally in all areas of society.

He is deeply offended by racist comments Donald Trump has made. And he is deeply offended that people assume that because he is a white working class man that he is a Trump supporter.

“We need economic justice for all people, for people’s wives and daughters and neighbors,” Savage said. And that is why he is a white, working-class man supporting Hillary Clinton. 

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 10 hours ago.

The Real Reckoning

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In her speech accepting the Democratic nomination, Hillary Clinton said the nation was at "a moment of reckoning."

She's right, but the reckoning is not simply the choice voters face this fall between her and Donald Trump. The real reckoning is larger and it will extend beyond Election Day.

Yet Washington insiders expect a return to politics as usual.

I'm already hearing Republicans dismiss Donald Trump as a weird aberration. "Ordinarily, Trump wouldn't have stood a chance," a Republican operative told me. "He won because he didn't have a clear opponent until the very end. And Cruz is almost as crazy as Trump."

I get a similar story from Democrats trying to explain Bernie Sanders. "His campaign was a freak," a longtime Democratic adviser told me. "Hillary will be elected and then Washington will go on as if nothing happened."

They want to return to business as usual because many of them make their bread on that business -- working for big corporations, Wall Street, or wealthy individuals as political consultants, lobbyists, corporate lawyers, government-relations specialists, public-relations specialists, trade association staff, and paid experts.

But Donald Trump isn't just an aberration and Bernie Sanders wasn't just a flash in the pan. Both, in very different ways, reflect a crisis in our political economy.

In a Gallup poll taken in mid-July, before the conventions, 82 percent said America was on the wrong track. In an NBC News/Wall Street Journal poll just before that, 56 percent said they preferred a candidate who would bring sweeping changes to the way the government functioned, no matter how unpredictable those changes might be.

The major issue the public is reacting to isn't terrorism or racism. We didn't see these numbers after 9/11. We didn't even get these sorts of responses in the late 1960s, when American cities were torn by riots and when the Vietnam War was raging.

It's the rigging of our economy -- the increasingly tight nexus between wealth and political power. Big money has been buying political clout to get laws and regulations that make big money even bigger.

As Hillary Clinton said in her acceptance speech, "I believe that our economy isn't working the way it should because our democracy isn't working the way it should."

She's correct, but she didn't finish the logic. Democracy is not working the way it should because it's being corrupted by big money. That big money is altering the rules of the game to generate even bigger money.

Americans now pay more for pharmaceuticals than the citizens of any other advanced nation because Big Pharma is setting the rules -- extending the life of drug patents, prohibiting Medicare from using its bargaining power to get lower drug prices, and blocking consumers from buying cheaper drugs from Canada.

We pay more for Internet service, health insurance, airline tickets, and banking services because the increasing market power of key players in these industries lets them raise prices. Antitrust enforcement has been systematically weakened.

The biggest Wall Street banks continue to reap the financial benefits of being too big to fail. Hedge-fund partners make bundles from confidential information, trading on which used to be illegal.

CEOs cash in their stock options and grants just when they pump up the value of their company's stocks with buybacks. It's allowed because laws and regulations have been loosened.

Trade agreements are now designed to protect the intellectual property and foreign assets of giant corporations, but nothing is done to protect the incomes of Americans who lose their jobs to foreign competition.

This is business as usual in Washington.

Hillary Clinton has a long list of good proposals for helping average working people, but none of them is going anywhere if Washington stays the same and the economic game remains rigged.

Instead, Americans will become even more angry and cynical.

That's the real reckoning -- hers and ours.

Donald Trump didn't come from nowhere. He is the loudest and clearest warning shot across the bow of the current American political economic system.

Hopefully he'll lose in November. But unless that warning is heeded, the dark anger that has produced him will produce another homegrown demagogue, possibly far worse.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 8 hours ago.

Does The U. S. Ration Health Care?

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It is a widespread myth, long a meme, among conservatives and many in the public that national health insurance would be "government run" health care with rationing of services, as opposed to the free market offering more choice without rationing.

Here are examples of this deceptive, misguided, and uninformed mantra:· In the debate over the Affordable Care Act in 2009, Sarah Palin, former governor of Alaska and candidate for vice president, had this to say about the ACA's coverage of physician visits for seniors to discuss living wills and other end-of-life issues:· Who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down's Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil. (1)· This concern by Sally Pipes, president and CEO of Pacific Research Institute, a right-wing think tank:· Once the government takes over the healthcare system, it's nearly impossible to undo the damage. That's why U. S. lawmakers must repeal and replace Obamacare sooner than later. Canada proves that single-payer health care inevitably results in rationing and lost lives. Government-run health care is one Canadian import we should turn away. (2)
These kinds of views presume that our free market-based system offers full choice of health care without rationing--completely untrue.*Rationing in our present multi-payer system*
These are some of the many ways that we ration health care in our largely private, under-regulated for-profit health care marketplace:
· By insurance status. Six years after the passage of the ACA, we still have almost 30 million uninsured. Among the uninsured, tens of thousands die each year because of lack of health insurance. (3) There are also tens of millions of underinsured without access to necessary care.· By high prices and unaffordable costs. The costs of health insurance and care have reached more than25,000 a year for a typical family of four insured by an average employer-sponsored PPO (4), having doubled over the last ten years--clearly a huge burden when we consider that the median household income is now about53,000.· By decreased choice and access. Even with the ACA, insurers have many ways to limit choice and access to care, including high-deductible plans (annual deductibles of5,000 for an individual and10,000 for families are part of bronze policies), narrow networks without coverage of out-of-network costs, high co-insurance for specialty drugs, restrictive definitions of medical necessity, and denial of services.· By employers' cutbacks. There has been a large cost shift from employers to employees in employer-sponsored health insurance as employees find themselves with higher deductibles, higher coinsurance, and a higher share of premiums. (5)· An underfunded, tattered "safety net." Political decisions in 20 states rationed care by not expanding Medicaid under the ACA, leading to a projection that more than 7,000 people will die without access to necessary care in those states. (6) Moreover, the ACA resulted in a Medicaid coverage gap affecting almost 5 million Americans who fell in between eligibility requirements of the ACA and the states, and consequently had no insurance. (7).
*Rationing in countries with national health insurance*
Countries with universal access provide comprehensive benefits with greater efficiency and value, at far less cost than in the U. S., and also with better outcomes. (8)

It is useful and necessary to "ration" services that are not efficacious or cost effective based on scientific evidence, as is done successfully by such countries as the United Kingdom, with their National Institute for Health and Care Excellence (NICE). We do the opposite with our industry-friendly FDA approval process. One good example of that is the FDA's approval of a 23 mg dose of the Alzheimer's drug Aricept despite the lack of clinical evidence that it is better than a 10 mg dose and without concern that patients taking the larger dose stopped taking it twice as often due to adverse side effects. (9)

*Conclusion*
All health care systems ration care one way or another. There are good ways and bad ways to do it. Ours is a bad and irrational way. It allows for excess, often inappropriate and ineffective care for those who can pay and exclusion of those who suffer worse outcomes due to lack of access and affordability. It is unfair and inhumane when so many millions of Americans cannot gain access to necessary care because of financial barriers. As a result, we have a system of rationing based on ability to pay without regard to medical need. Moreover, we still have no significant containment of prices and costs of health care as well as the worst health care outcomes compared to ten other advanced countries, including Canada. (8)

Without looking at the experience of countries around the world with one or another kind of universal coverage, opponents of single-payer national health insurance (NHI) claim that it will ration care to their detriment. But they deny or seem unaware that we already ration care way beyond what NHI would do. This denial is a moral blind spot for our society, as our country still does not recognize health care as a human right, as do most other industrialized countries around the world.

The rising burden of health care costs is unsustainable for patients, families, and taxpayers. We will have to deal with it sooner than later. When that time comes, we will have to take a societal perspective in deciding, based on scientific evidence, what services can be provided for all Americans, not just the most affluent among us.

John Geyman, M.D. is the author of The Human Face of ObamaCare: Promises vs. Reality and What Comes Next and How Obamacare is Unsustainable: Why We Need a Single-Payer Solution For All Americansvisit: http://www.johngeymanmd.org

*References: *
1. Palin, S. as quoted by Drobnic, A. Sarah Palin falsely claims Barack Obama runs a 'death panel.' Politifact, Truth-o-meter, August 10, 2009.

2. Pipes, S Don't import Canada's ideas on health care. Real Clear Politics, April 28, 2015.

3. Wolfe, S Outrage of the Month. 50 million uninsured in the U. S. equals 50,000+ avoidable deaths each year. Health Letter 28 (1): 11, January 2012.

4. Milliman, 2015 Milliman Medical Index. May 2015.

5. Spiro, T, Calsyn, M, O'Toole, M. The great cost shift: Why middle-class workers do not feel the health care spending slowdown. Center for American Progress, March 3, 2015.

6. Dickman, SL, Himmelstein, DU, McCormick, D et al. Health and financial harms of 25 states' decision to opt out of Medicaid. Health Affairs Blog, January 30, 2014.

7. Appleby, J, Gorman, A. Obamacare enrollment: second year even tougher. Kaiser Health News, October 6, 2014.

8. Davis, K, Stremikis, K, Squires, D et al. Mirror, mirror on the wall, 2014 update: How the U. S. Health System Compares Internationally. The Commonwealth Fund, June 16, 2014.

9. Holzer, B. FDA ignores negative feedback on Alzheimer's drug Aricept. Public Citizen News 31 (4): 20, 2011.

-- This feed and its contents are the property of The Huffington Post, and use is subject to our terms. It may be used for personal consumption, but may not be distributed on a website. Reported by Huffington Post 7 hours ago.
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