Increasing your activity to 150 minutes a week could prolong your life expectancy by more than three years, according to Vitality health insurance. Reported by Crawley Observer 13 hours ago.

THOUSAND OAKS, California ― Maryann Hammers is likely to die from ovarian cancer someday. But she hopes someday won’t come anytime soon.

Hammers, 61, received the diagnosis in late 2013, and doctors told her that it was stage 3-C, which meant that she could live for many years with the right treatment and a little luck. So far, she’s had both. She’s in remission for the second time, and her last course of chemotherapy ended a year and a half ago. But recent blood tests detected elevated levels of a protein associated with tumors, she explained when we met a few weeks ago. “Maybe it’s a fluke,” she said. “I hope so. I kinda feel like the clock is ticking.”

If the cancer is back, Hammers said, she may need surgery similar to her two previous operations — “gigantic surgeries, gutted like a fish and hospitalized for many days.” Chemotherapy would likely come next, plus medication, hospitalization, and home care. But Hammers considers herself lucky because she’s been able to get treatment at City of Hope, a highly respected Southern California cancer research and treatment center, and luckier still that she’s been able to pay for the treatment with insurance — an Anthem Blue Cross policy she bought through Covered California, the exchange her state created under the Affordable Care Act.

To hear President Donald Trump, House Speaker Paul Ryan and other Republicans tell it, Obamacare has been a disaster, even for those who obtained coverage through the law. Hammers has a very different perspective. She’s a freelance writer and editor, which means she has no employer-provided insurance. In the old days, if she’d gone shopping for a policy with her cancer diagnosis, she would have struggled to find a carrier willing to sell her one.

I'm terrified. ... Do you know how easy it is to use a million dollars when you're getting cancer treatment?
Maryann Hammers, Thousand Oaks, California
And it’s not just the pre-existing condition guarantee, which even critics like Trump say they support, that Hammers has found so valuable. The Affordable Care Act requires insurers to cover a wide range of services and treatments — which, in her case, has included multiple shots of Neulasta, a medication that boosts white blood cell counts and typically costs several thousand dollars per injection. The law also prohibits annual or lifetime limits on benefits, which, as a long-term cancer patient, she would be a prime candidate to exceed. 

Policies with such robust coverage inevitably cost thousands of dollars a year, more than Hammers could afford on her own — particularly since battling the disease has cut into her work hours. But the law’s generous tax credits discount the premiums and help with the out-of-pocket costs, too. “Without the Affordable Care Act, I honestly do not know what I would have done,” she said.

The coverage Hammers has today still isn’t as good as what she had years ago, when she worked for a company that provided benefits. But it’s better than what she had in the years right before the cancer diagnosis, when she was buying insurance on her own. The latter plan covered fewer services and came with out-of-pocket costs high enough to discourage her from getting checkups. Obamacare’s introduction of free preventive screenings led her to schedule a long-overdue colonoscopy. During routine preparation for that procedure, a physician first felt a lump in her abdomen.  

Sometimes Hammers wonders whether, with less sporadic doctor visits, the cancer might have been caught a little sooner. “But I couldn’t afford a fat doctor’s bill. And I thought I was super healthy.”

These days, something else looms even larger in her mind — the possibility that Trump and the Republican Congress will repeal the health care law without an adequate replacement, or maybe with no replacement at all.  

“I’m terrified — isn’t that crazy?” Hammers said. “My biggest source of stress right now isn’t the fact that I have incurable cancer. It’s the prospect of losing my insurance.”

What American Health Care Used To Look Like

To appreciate the significance of stories like Hammers’ and what they say about the Affordable Care Act, it helps to remember what used to happen to people like her before the law took effect. By 2009, when President Barack Obama took office, roughly 1 in 6 Americans had no health care insurance, and even the insured could still face crippling medical bills. As a reporter covering health care during those years, I met these people. Some of their stories stand out, even now, because they capture the old system at its callous, capricious worst.

Gary Rotzler, a quality engineer at a defense contractor in upstate New York, lost his family coverage in the early 1990s when he lost his job. He ended up uninsured for two years, while he juggled stints as an independent contractor. His wife, Betsy, made do without doctor visits even after she started feeling some strange pains. By the time she got a checkup, she had advanced breast cancer. Desperate efforts at treatment failed. After she died, Gary, a father of three, had to declare bankruptcy because of all the unpaid medical bills.

Jacqueline Ruess, a widow in south Florida, thought she was insured. But then she needed expensive tests when her physicians suspected she had cancer. Although the tests were negative, the insurer refused to pay the bills because, it said, a brief episode of a routine gynecological problem in her past qualified as a pre-existing condition.

Tony Montenegro, an immigrant from El Salvador living in Los Angeles, was uninsured and working as a security guard, until untreated diabetes left him legally blind.

Marijon Binder, an impoverished former nun in Chicago, was sued by a Catholic hospital over medical expenses she couldn’t pay.

And Russ Doren, a schoolteacher in a Denver suburb, believed he had good insurance until the bills for his wife’s inpatient treatment at a psychiatric hospital hit the limit for mental health coverage. The hospital released her, despite worries that she was not ready. A few days later, she took her own life.

The Affordable Care Act of 2010 was an effort to address these kinds of problems — to carry on the crusade for universal coverage that Harry Truman had launched some 60 years before. But precisely because Obama and his allies were determined to succeed where predecessors had failed, they made a series of concessions that necessarily limited the law’s ambition.

They expanded Medicaid and regulated private insurance rather than start a whole new government-run program. They dialed back demands for lower prices from drugmakers, hospitals and other health care industries. And they agreed to tight budget constraints for the program as a whole, rather than risk a revolt among more conservative Democrats. These decisions meant that health insurance would ultimately be more expensive and the new system’s financial assistance would be less generous.

Still, projections showed that the law would bring coverage to millions while giving policymakers tools they could use to reduce medical costs over time. When the Senate passed its version of the legislation in December 2009, then-Sen. Tom Harkin (D-Iowa) described the program as a “starter home” with a solid foundation and room for expansion.

Where Obamacare Failed And Where It Succeeded

Seven years later, Trump and the Affordable Care Act’s other critics insist that the program has been a boondoggle — that the Obamacare starter home needs demolition. Some of their objections are philosophical, and some, like the persistent belief that the law set up “death panels,” are fantastical. But others focus on the law’s actual consequences.

High on that list of consequences are the higher premiums and out-of-pocket costs that some people face. The new rules, like coverage of pre-existing conditions, have made policies more expensive, and Obamacare’s financial aid frequently doesn’t offset the increases. A “rate shock” wave hit suddenly in the fall of 2013, when insurers unveiled their newly upgraded plans and in many cases canceled old ones — infuriating customers who remembered Obama’s promise that “if you like your plan, you can keep it,” while alienating even some of those sympathetic to what Obama and the Democrats were trying to do.

I’ve interviewed plenty of these people, too. A few weeks ago, I spoke with Faisuly Scheurer, a real estate agent from Blowing Rock, North Carolina. She and her husband, who works in the restaurant business, were excited about the health care law because they’d struggled to find decent, affordable insurance. They make about $60,000 a year, before taxes, with two kids and college tuition looming in the not-distant future, she said.

In late 2013, they checked out their options and learned that, after tax credits, coverage would cost $360 a month. Scheurer said she remembers thinking, “OK, that is really tight. But if the benefits are good, we are going to have to skimp on other things to make it work.” Then she learned about the deductible, which was nearly $13,000 per year. “My disappointment was indescribable.”

The Scheurer family ultimately decided to remain uninsured. They’re not the only ones, and that has weakened the system as a whole. The people eschewing coverage tend to be relatively healthy, since they’re most willing to take the risk of no coverage. That’s created big problems for insurers, which need the premiums from healthy folks to offset the high medical bills of people with serious conditions.

Many insurers have reacted by raising premiums or pulling out of some places entirely, leaving dysfunctional markets in North Carolina and a handful of other states. Just this week, Humana, which had already scaled back its offerings, announced that it was pulling out of the Affordable Care Act exchanges altogether. At least for the moment, 16 counties in Tennessee don’t have a single insurer committed to offering coverage in 2018.

Trump, Ryan and other Republicans pounced on the Humana news, citing it as more proof of a “failed system” and the need for repeal. That’s pretty typical of how the political conversation about the Affordable Care Act has proceeded for the last seven years. The focus is on everything that’s gone wrong with Obamacare, with scant attention to what’s gone right.

And yet the list of what’s gone right is long.
·
In states like California and Michigan, the newly regulated markets appear to be working as the law’s architects intended, except for some rural areas that insurers have never served that well. Middle-class people in those states have better, more affordable options.·
It looks like more insurers are figuring out how to make their products work and how to successfully compete for business. Customers have turned out to be more price-sensitive than insurers originally anticipated. In general, the carriers that struggle are large national companies without much experience selling directly to consumers, rather than through employers.·
Last year’s big premium increases followed two years in which average premiums were far below projections, a sign that carriers simply started their pricing too low. Even now, on average, the premiums people pay for exchange insurance are on a par with, or even a bit cheaper than, equivalent employer policies — and that’s before the tax credits.·
The majority of people who are buying insurance on their own or get their coverage through Medicaid are satisfied with it, according to separate surveys by the Commonwealth Fund and the Henry J. Kaiser Family Foundation. The level of satisfaction with the new coverage still trails that involving employer-provided insurance, and it has declined over time. But it’s clearly in positive territory 
And then there’s the fact that the number of people without health insurance is the lowest that government or private surveys have ever recorded. When confronted with questions about the people who gained coverage because of the law, Republicans often say something about sparing those people from disruption ― and then argue that even those who obtained insurance through the law are suffering and no better off. This claim is wildly inconsistent with the experience of people like Maryann Hammers ― and, more important, it’s wildly inconsistent with the best available research.People are struggling less with medical bills, have easier access to primary care and medication, and report that they’re in better health, according to a study that appeared in the Journal of the American Medical Association in 2015. The number of people forgoing care because of costs or being “very worried” about paying for a catastrophic medical bill dropped substantially among the newly insured, Kaiser Foundation researchers found last year when they focused on people in California.

A bunch of other studies have turned up similar evidence, All of them gibe with a landmark report on the effects of Massachusetts’ 2006 insurance expansion, which was a prototype for the national legislation. Residents of that state experienced better health outcomes and less financial stress, according to the study published in the Annals of Internal Medicine.

“Though it’s had no shortage of controversies and stumbles, there’s really no denying that the ACA has created historic gains in insurance coverage,” said Larry Levitt, a senior vice president at the Kaiser Foundation. “With better coverage that has fewer holes, access to health care has improved and many have better protection from crushing medical bills.”

What Repeal Would Really Mean

Reasonable people can disagree about whether these achievements justify Obamacare’s costs, which include not only higher premiums for the young and healthy but also hefty new taxes on the wealthiest Americans. That’s a debate about values and priorities as much as facts.

What’s not in dispute, or shouldn’t be, is the stark choice on the political agenda right now.

Democratic lawmakers still argue for the principle that Truman laid out in 1948: “health security for all, regardless of residence, station, or race.” They think the Affordable Care Act means the U.S. is closer to that goal and that the next step should be to bolster the law ― by using government power to force down the price of drugs, hospital services and other forms of medical care, while providing more generous government assistance to people who still find premiums and out-of-pocket costs too onerous. Basically, they want people like Faisuly Scheurer to end up with the same security that people like Maryann Hammers already have.

Some Republicans talk as if they share these goals. Trump has probably been the most outspoken on this point, promising to deliver “great health care at lower cost” and vowing that “everybody would be covered.” But other Republicans reject the whole concept of health care as a right. Although it’s theoretically possible to draw up a conservative health plan that would improve access and affordability, these aren’t the kinds of plans that Republicans have in mind. 

There’s a face to this law, there’s a face to people that are going to be affected by it.
Angela Eilers, Yorba Linda, California
Their schemes envision substantially less government spending on health care, which would mean lower taxes for the wealthy but also less financial assistance for everybody else. Republicans would make insurance cheaper, but only by allowing it to cover fewer services and saddling beneficiaries with even higher out-of-pocket costs. The result would be some mix of more exposure to medical bills and more people without coverage. If Republicans repeal the Affordable Care Act without replacing it ― a real possibility, given profound divisions within the GOP over how to craft a plan ― 32 million more people could go uninsured, according to the Congressional Budget Office.

That would mean real suffering, primarily among those Americans who benefit most from the law now ― the ones with serious medical problems, or too little income to pay for insurance on their own, or both.

Jay Stout, a 20-year-old in Wilmington, North Carolina, is one of those people. He was in good health until a head-on car collision nearly severed his arm and landed him in the hospital for more than a month. Surgeries and rehabilitation would have cost him hundreds of thousands of dollars that, as a community college student working part-time as a busboy, he could never have paid — if not for the Blue Cross plan that his mother had bought through the Affordable Care Act. When we spoke a few weeks ago, he told me the insurance has been “irreplaceable” and that losing it “would be totally devastating.”

Meenakshi Bewtra had never had a serious health problem until her first year at the University of Pennsylvania medical school, when she developed severe gastrointestinal problems — the kind that forced her into the hospital for two months and drove her to drop out of school. Her insurance lapsed, which meant that her GI issues became a pre-existing condition. She eventually found coverage and today she’s a professor of medicine at Penn, where she moonlights as an advocate for universal health insurance.

“For the first time, I truly understood what comprehensive health insurance meant,” Bewtra said, remembering what it was like to become fully covered. “I did not have to worry about how many times I saw a doctor, or how many lab tests I had to get, or having to ration out medications.”

Angela Eilers, who lives in Yorba Linda, California, isn’t worrying about her own health. It’s her daughter Myka who has a congenital heart condition called pulmonary stenosis, which makes it more difficult for the heart to pump blood to the lungs. The little girl has required multiple surgeries and will need intensive medical treatment throughout her childhood.

In 2012, Angela’s husband, Todd, was laid off from his job at an investment firm. Since going without insurance was not an option, they took advantage of COBRA to stay on his old company’s health plan. It was expensive, and Eilers recalled panicking over the possibility they might not be able to pay the premiums. “I remember sitting at the table, thinking of plans. What would be our plan? One of them was … giving up our parents rights to my mom, because she has really good health insurance.”

Eventually her husband started his own consulting business, and that gave them the income to keep up with premiums until 2014 — when they were able to obtain coverage through the Affordable Care Act. Today they have a gold plan, one of the most generous available, for which they pay around $20,000 a year. Even though they make too much to qualify for financial assistance, they’re grateful for the coverage. Seven-year-old Myka has already run up more than a half-million dollars in medical bills. In the old days, before Obamacare, they would have worried about hitting their plan’s lifetime limit on benefits. 

The family’s coverage has become more expensive over the years. They wish the price were lower, but they’re also not complaining about that. “I’m thankful that the letter was a premium hike, rather than ‘Sorry, we are not going to cover your daughter anymore,’” Angela Eilers said.

When she thinks about the possibility of Obamacare repeal, she wonders if Trump and the Republicans understand what that would really mean. “There’s a face to this law, there’s a face to people that are going to be affected by it,” Eilers said. “It’s not me, it’s not him, it’s her. She’s only 7. And through no fault of her own, why should she suffer? And she’s not the only one.”

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-- 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.

Constituents of Rep. Tom Reed (R-N.Y.) flooded two town hall meetings on Saturday to confront and boo the congressman over the GOP’s vows to repeal the Affordable Care Act, also known as Obamacare, and strip public funding from Planned Parenthood.

One event was supposed to take place in a senior center, but it moved outside because so many people showed up.


In upstate New York, Rep. Tom Reed's first town hall of the day has been moved outside because the crowd is so big pic.twitter.com/PaanJstFOe

— Thomas Kaplan (@thomaskaplan) February 18, 2017

Attendees loudly booed Reed when he said he did not support public funds for Planned Parenthood.

“I do not support taxpayer-funded paying of abortion,” Reed said, prompting boos. A woman in the front of the crowd immediately fact-checked his remark.

“You, an elected official, [are] giving misinformation,” she said. “Right now, our taxes do not pay for abortions. They pay for mammograms, they pay for birth control.”

“Planned Parenthood, less than 3 percent of the services they provide is abortion. And none of that 3 percent is funded by you,” she added.

Indeed, the Hyde Amendment, passed in 1976 by Congress, prohibits the use of public funds to pay for abortions, so there is no “taxpayer-funded paying of abortion.”

The constituents also booed loudly when Reed offered details on what a replacement for Obamacare could look like. They jeered when he called the Affordable Care Act a “failing system” and suggested that a new system would give more Americans health savings accounts. Most Americans can’t afford to put aside the money required for these accounts.

The crowd chanted in unison, “How can the poor get savings accounts?”

When Reed said this could be fixed simply by growing the economy, the crowd booed loudly again. 

At a second town hall meeting later in the day, Reed said Americans would get tax credits to pay for health insurance, according to the Buffalo News. When the audience asked how those credits would be used, Reed replied, “That is something we’re still working on.”


Tom Reed asked for the bill number of the ACA replacement. He doesn't provide one — because the House's plan doesn't exist as a bill yet.

— Thomas Kaplan (@thomaskaplan) February 18, 2017

The crowd also pushed Reed to pressure President Donald Trump to release his tax returns. Reed was one of 23 Republicans who voted against legislation to request Trump’s tax returns from the Treasury Department.


"Do your job!" the crowd chanted at Rep. Tom Reed this morning after a question about seeking Trump's tax returns pic.twitter.com/J4YBY7g7ow

— Thomas Kaplan (@thomaskaplan) February 18, 2017

The event on Saturday was the latest of a number of recent town hall meetings in which constituents have angrily confronted GOP elected officials about their efforts to repeal the Affordable Care Act.

Earlier this month, Rep. Tom McClintock (R-Calif.) left a town hall with a police escort after constituents confronted him. Rep. Jason Chaffetz (R-Utah) also faced chants of “Do your job” and “Your last term” at a town hall last week. Rep. Dave Brat (R-Va.) complained that “women are in my grill” over Obamacare repeal. Brat has since walked back the comment, which offended many.

The angry confrontations have prompted some Republicans to cancel town hall appearances altogether.

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-- 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 6 hours ago.

Wearing a fitness tracking device could earn you cash from your health insurance company. At first, this sounds lucrative for the people who participate, and good for the companies, who want healthier insurance customers. But it’s not quite so simple. Under the program, people who have certain health insurance coverage plans with UnitedHealthcare (NYSE: UNH) can elect to wear a Fitbit (NYSE: FIT) activity tracker and share their data with the insurance company. The data would be analyzed by… Reported by bizjournals 3 hours ago.

Wearing a fitness tracking device could earn you cash from your health insurance company. At first, this sounds lucrative for the people who participate, and good for the companies, who want healthier insurance customers. But it’s not quite so simple. Under the program, people who have certain health insurance coverage plans with UnitedHealthcare (NYSE: UNH) can elect to wear a Fitbit (NYSE: FIT) activity tracker and share their data with the insurance company. The data would be analyzed by… Reported by bizjournals 3 hours ago.

There are many theories about how Donald Trump was elected president. One explanation is to take a saying that Trump is fond of and flip it: Many Americans had lost so much—decent jobs, a secure retirement, their homes, and the confidence that their children will be better off than they are—they got tired of losing and took a chance on a candidate who promised to be on their side. But Trump’s pledges on the campaign trail—to create 25 million good jobs, help working-class Americans get ahead, and end the days of “hedge fund guys getting away with murder [while] the middle class are getting absolutely destroyed”—are taking a back seat to the interests of Wall Street, the wealthy and the far right.

Sen. Charles Schumer (D-N.Y.) noted that it took only an hour on Inauguration Day for Trump’s “populist words delivered on the steps of the Capitol to ring hollow.” Minutes after he was sworn in, Trump overturned a mortgage fee cut, making it harder for low-income Americans to buy a home. Just weeks into his presidency, he made it easier for Wall Street to prey on people’s retirement savings and, while surrounded by Wall Street bankers, signed an executive order gutting Wall Street reforms enacted after the Great Recession.

When he accepted the Republican nomination, Trump said he would deliver for the “forgotten men and women of our country”—laid-off factory workers and communities crushed by the shifting economy. The penthouse populist audaciously claimed: “I am your voice.” But there is a big disconnect between what Trump says and what he does. Tick through his advisers, Cabinet choices and Supreme Court nominee, and there’s nary an advocate for the working-class voters Trump courted. He has surrounded himself with a who’s who of businesspeople and billionaires who have amassed huge wealth by outsourcing, cutting and automating jobs, and slashing workers’ salaries, pensions and health insurance—elites who have prospered as America’s “forgotten men and women” have fallen further behind.

Treasury Secretary Steven Mnuchin made a fortune foreclosing on homeowners like a 90-year-old woman who was targeted for a 27 cent payment error. Wilbur Ross, the secretary of commerce, has been called a vulture investor for squeezing profits from troubled companies by slashing jobs and gutting pensions. Trump’s secretary of education, Betsy DeVos, has spent decades—and many millions—lobbying to destabilize and defund public schools in order to expand for-profit charter, virtual, private and home schools. Secretary of Health and Human Services Tom Price was confirmed despite concerns over his practice of introducing legislation to benefit companies he has invested in. And if Price gets his way, 18 million Americans in the next year alone, including millions of children from low-income families, will lose access to healthcare through the Affordable Care Act and the Children’s Health Insurance Program.

While, in a victory for workers, Andrew Puzder withdrew from consideration as secretary of labor, other key confirmations remain, notably Neil Gorsuch for a lifetime appointment to the U.S. Supreme Court.

People for the American Way describes Gorsuch as a “judge who has dependably acted to protect the interests of big businesses at the expense of ordinary Americans.” Among the examples PFAW cites is the Hobby Lobby case, in which Gorsuch ruled that corporations are people and so can use their religious beliefs to deny employees insurance coverage for contraception. And, in the “freezing trucker” case—in which a truck driver was fired after he left his disabled vehicle to find help and escape subzero temperatures—Gorsuch again sided with the corporation rather than the employee.

We’ve never seen anything like the Trump presidency. The administration’s strategy to flood the zone with Twitter attacks, alternative facts and appalling executive orders is dizzying—and that’s the point. Trump wants us to be off balance. He wants to do what he wants, without checks and balances. But that plan has been disrupted by a citizenry that is rising up to be that check and balance. From the 5 million callers who overwhelmed the Senate switchboard to protest DeVos’ nomination, to the worldwide women’s marches, the hundreds of actions in public schools across the country in support of immigrant rights, airport protests of the travel ban, and Jews and Muslims rallying together to say “Never again!”

True populists listen to the people. Instead of repeating the preposterous claim that he is the voice of the people, Trump should listen to what we’re saying. We want real economic opportunity. We need affordable, high-quality health care. We support good neighborhood public schools. We cherish freedom and pluralism. And we will stand up against hatred, discrimination and bigotry. Until January 2017, most Americans had only been spectators to dire assaults on democracy. Given the real and present threat, we’ve become active participants in its defense and fortification.-- 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 9 hours ago.

The insurance programme has been extended to Sharjah and northern emirates as well, except Abu Dhabi. Reported by Khaleej Times 13 hours ago.

The biggest player in the city’s health insurance market has tightened its approval process for reimbursing “excessive health procedures” at private hospitals, prompting worries that patients’ rights could be undermined. Other insurance companies are expected to follow the lead of AIA, whose health insurance premium has increased by more than 10 per cent annually due in part to medical claims abuse, according to insurance sector lawmaker Chan Kin-por. The news surfaced... Reported by S.China Morning Post 13 hours ago.

The majority of Americans support compensating living kidney donors for the financial and medical consequences associated with organ donation.

Ann Arbor, MI (PRWEB) February 20, 2017

Compensating live kidney donors is supported by 85.7% (±2.0% margin of error) of adults in the United States according to a study by Acumen Health Research Institute (AHRI). The form of compensation varies. Most support compensating donors for all out-of-pocket costs. Others prefer offering the donor a fixed payment of up to $50,000, or providing them with additional health insurance to cover health risks following the donation. Such compensation would foster more equitable kidney donations, which are now primarily limited to those who can afford to pay these expenses up front.

The results suggest support for amending the National Organ Transplant Act (NOTA), which currently prohibits compensation for organ donation. “Such an amendment would save lives and needs to be moved forward quickly,” said Amy Morlock, Managing Director, AHRI.

Patients waiting for a kidney suffer from significantly reduced quality of life and increased healthcare costs.(1)(2) Each day, about 11 people die waiting for a kidney and 13 become too sick to remain on the waiting list. Approximately 100,000 Americans are on the waiting list for a kidney transplant. It is estimated that less than 20,000 of these patients will receive a kidney transplant this year.(3)

Compensating kidney donors also has the potential to reduce healthcare costs for patients and society overall. Patients on dialysis have healthcare costs of over $75,000 per year.(2) Studies have found that transplant patients derive a savings in healthcare costs of approximately $250,000 per patient over a five-year period.(4)

World Kidney Day is March 9, 2017. One objective of World Kidney Day is to "encourage transplantation as a best-outcome option for kidney failure, and the act of organ donation as a life-saving initiative."(5) Amending NOTA would be a step towards promoting this objective.

AHRI is a non-profit research organization committed to improving healthcare through population based studies. For more information visit http://www.acumenhealthresearch.org.

References
(1)Lee YJ, Kim MS, Cho S, Kim SR. Association of depression and anxiety with reduced quality of life in patients with predialysis chronic kidney disease. Int J Clin Pract. 2013;67(4):363-8.
(2)Fry-Revere S. Congress can save thousands of lives by repealing the prohibition against paying organ donors. Forbes. Oct 24, 2014. Available at http://www.forbes.com/sites/realspin/2014/10/24/congress-can-save-thousands-of-lives-by-repealing-the-prohibition-against-paying-organ-donors/#32ecef93411a. Accessed January 30, 2017.
(3)United States Department of Health and Human Services. National Data-based on OPTN data as of February 13, 2017.
(4)Rees MA, Schnitzler MA, Zavala E, et al., Call to develop a standard acquisition charge model for kidney paired donation.
(5)http://www.worldkidneyday.org/about/world-kidney-day/ Reported by PRWeb 18 hours ago.

LONDON, February 20, 2017 /PRNewswire/ -- It is that time of year when offers of university places start to drop into electronic mailboxes around the world. Higher education is big business now, p... Reported by FinanzNachrichten.de 17 hours ago.

Good morning, Orlando! Wearing a fitness tracking device could earn you cash from your health insurance company. While at first, this sounds lucrative for the people who participate, and good for the companies that want healthier insurance customers, it’s not quite so simple. Under the program, people who have certain health insurance coverage plans with UnitedHealthcare (NYSE: UNH) can elect to wear a Fitbit (NYSE: FIT) activity tracker and share their data with the insurance company. The data… Reported by bizjournals 14 hours ago.

ORLANDO, Fla.--(BUSINESS WIRE)--GE Healthcare has uncovered $2 billion1 of actionable health insurance claim denials for its customers since January 2016. Of the $2 billion, approximately 30 percent of those denials result from coding issues, costing providers on average between $9 and $24 million per year. Another 19 to 22 percent of those denied claims stem from eligibility discrepancies, resulting in an average of $6 to $15 million in lost revenue. Also among the top culprits for actionable Reported by Business Wire 6 hours ago.

Harmony Healthcare, a leader in Human Capital Management solutions, is proud to announce that Cyndi Thomas, one of the pioneers of the contract coding/revenue cycle staffing industry, is the new Chief Development Officer.

Tampa, Florida (PRWEB) February 20, 2017

Harmony Healthcare, a leader in Human Capital Management solutions, is proud to announce that Cyndi Thomas, one of the pioneers of the contract coding/revenue cycle staffing industry, is the new Chief Development Officer.

Cyndi is an accomplished Revenue Cycle staffing and solutions professional with over 20 years of experience implementing, managing and developing client relationships as a top performer for several industry leading organizations.

Cyndi worked her way up the corporate ladder, starting as a recruiter, which gave her hands-on experience understanding Consultant’s needs, to becoming company President. Cyndi has led many organizations, giving her an insight and understanding that Christopher Brown, CEO of Harmony Healthcare, said raises her “knowledge network and reputation to legendary status. This is a great day for me personally, as she has always been one of my heroes in the space.” Harmony’s VP of Client Solutions, Brandon Martin, added, “I am thrilled to reunite with Cyndi, she brings matchless industry wisdom and an authentic approach that resonates with everyone she works with.”

Cyndi brings a unique perspective to the challenges that organizations face with human capital management. In preparation for the conversion to ICD-10, Cyndi was recruited by a large hospital system to develop a coding education and work transition program to address the health system’s staffing challenges. This internal coder development program became one of the most successful in the nation and has been a model for personnel development and human capital management.

Cyndi’s passion for people, combined with her ability to understand the client’s needs, makes her the perfect choice to lead the Harmony Healthcare client development team. Cyndi’s goal as Chief Development Officer is to continue doing what she does best: mentoring staff, sharing her insights, developing lasting business relationships and exceeding the client’s expectations.

Learn more about Cyndi Thomas https://harmony.solutions/revenue_cycle/cyndi-thomas-chief-development-officer/

About Harmony Healthcare
Harmony Healthcare provides interim, outsourcing, project management and reviews, as well as direct-to-hire solutions for clients. The company specializes in hiring Revenue Cycle and Health Information professionals for client facilities. The company’s experts are highly trained, can spot problems and lead a client organization through the best processes, procedures and solutions.

With a large breadth of expertise, the company is able to provide support in areas ranging from clinical documentation improvement and coding to auditing and GSA government compliance at Veterans Administration hospitals and U.S. military bases.

Harmony employs more than 500 people and has staff at client sites across the United States. The company maintains low turnover by providing 100 percent covered health insurance, paid time off, paid travel expenses and keeping the back-office operation inexpensive.

Harmony Healthcare also boasts a #418 ranking, with a three-year sales growth of 922 percent, on the 2016 Inc. 500 list.

“Harmony Healthcare was founded on the principals of integrity, character, hard work and discipline.”

Learn more about Harmony Healthcare https://harmony.solutions/

About Christopher Brown
With a career marked by a sharp entrepreneurial eye and the love of a good challenge, Brown founded Harmony Healthcare in 2010 after recognizing just how revolutionary the change from paper to digital medical records would be for healthcare facilities. His company helps clients solve problems associated with digital medical records and health information management that have coincided with the change in the way healthcare facilities collect patient information, code it, communicate with insurance companies and collect revenue in a timely manner.

Brown learned some of his best leadership lessons from the well-known, much-loved, and highly successful UCLA Basketball Coach John Wooden. Many of Wooden’s words of wisdom apply both on and off the basketball court. “It’s not what you do, but how you do it,” is one of Brown’s favorite quotes from Wooden.

His 2001 book, “Insights, A guide to Successful Recruitment Strategies and Training” is a comprehensive guide to recruitment, staffing and human resources training. Learn more about Christopher Brown https://harmony.solutions/revenue_cycle/cbrown/ Reported by PRWeb 6 hours ago.

This article appears in the Winter 2017 issue of The American Prospect magazine. Subscribe here. 

Employers are increasingly dispensing with fixed working-time schedules, and turning to on-demand, just-in-time, and “gig” work instead. Some on-demand working time is involuntary: An employer imposes a fluctuating schedule on a worker who would prefer to have regular hours. Involuntary scheduling is becoming increasingly common in the retail, restaurant, hotel, and janitorial sectors, and even in some professional occupations. Other on-demand work is voluntary in the sense that workers choose their own hours or projects, but employers do not provide the benefits of employee status. These workers provide services that are often coordinated by computer platforms such as Uber, TaskRabbit, Mechanical Turk, and Handy. The nominally voluntary nature of their work schedules conceals a disparity of bargaining power, which tends to favor employers.

On-demand workers do not fit the mold of regular, full-time employees. Some have multiple employers, often with ad hoc schedules. Some work off-site, or move from site to site, and never even see their employer. Many work for subcontractors on a long and complex supply chain. Others are regularly on-site at a particular workplace and have specified hours but are classified by their employer as “independent contractors.”

The various forms of on-demand work tend to defeat the protections of our system of labor regulation, which assumes that employees have regular payroll employment. Seemingly, unions are also not much help, since they, too, are based on the assumption of regular jobs. But if we dig a little deeper, there is a long history of unions protecting their members from employers’ efforts to force workers to bear all the risks and costs of fluctuating demand. This is true in industries as varied as construction, airlines, hotels, and entertainment.

Some of these are unions that organize and collectively bargain under the terms of the National Labor Relations Board. But others, in the world of so-called alt-labor, use worker centers, associations, and other worker-empowerment strategies that are not technically unions. If the Trump administration changes rules and laws to weaken traditional unions—which it is almost certain to do—these new strategies become that much more important.

 

*The Challenge of Just-in-Time Scheduling*

Just as airlines adopted variable pricing in the late 1980s to fill all the seats on planes, firms in the retail, restaurant, and hotel sectors in the last ten years have adopted complex staffing algorithms to predict customer flows and minimize personnel costs. Large companies in those sectors use complex software provided by specialty workforce management firms to predict their staffing needs so that they never have more employees than necessary on any given day. As a result, those employers give their workers schedules that can change on short notice. One leading staffing firm claims it can predict staffing demand in a retail store down to 15-minute intervals so that there is never excess staff, even for a few minutes.

With just-in-time scheduling, an individual worker in any given week could work five hours on Monday, four hours on Tuesday, none on Wednesday, seven on Thursday, none on Friday or Saturday, and four on Sunday. Moreover, that individual might not know until the prior week what her schedule will be for the week coming up. A New York Times editorial in 2015 reported that “[a]ccording to federal data, 66 percent of food service workers, 52 percent of retail workers and 40 percent of janitors and house cleaners have at most a week’s notice of their schedules.”

Colin@TheTruthAbout/Creative Commons

A California car whose driver offers rides for ride-sharing services Uber, Lyft, and Sidecar. 

Just-in-time scheduling is brutal for employees. Employees in the retail sector complain that they cannot plan their lives. It becomes impossible to arrange child care when one doesn’t know what hours one will be working. Moreover, because most retail, restaurant, and hotel work is part-time and low-paid, those workers often want to take second jobs or enroll in training programs but cannot do so because of their constantly shifting and unpredictable hours.

Just-in-time scheduling is particularly widespread among younger workers. A 2014 study of adults between the ages of 26 and 32 found that 41 percent of hourly workers reported that they only learn of their weekly work schedules one week or less in advance, and the majority have schedules fluctuate each week. Low-paid part-time workers have the highest likelihood of experiencing short notice and fluctuating hours. The occupations in which workers were most at risk were food-service workers (90 percent), retail workers (87 percent), home health-care workers (71 percent), and janitorial and housekeeping workers (66 percent).

Some worker advocacy groups, including the Retail Action Project, Jobs With Justice, and the National Partnership for Women and Families, have attempted to address the problem of short and unpredictable hours by promoting fair-scheduling legislation at the local, state, and federal level. The City of San Francisco adopted an ordinance in 2014 that requires employers to give employees two weeks’ notice and to compensate the workers for last-minute changes. Proposed federal legislation, the Schedules that Work Act, would require employers in the retail, hotel, and cleaning industries to give workers two weeks’ notice, and to pay the affected employees for changes on short notice.

Business groups oppose fair-scheduling legislation, claiming it deprives them of necessary flexibility. Because business groups may well defeat fair-scheduling legislation in all but the most progressive localities, it is important to consider another approach. Unions have long been a force for greater worker control over scheduling.

 

*Unions and Schedule-Bidding*

Airlines have unpredictable and frequently changing demand for workers. Weather conditions and mechanical problems can cause flight cancellations or delays on very short notice. Moreover, airlines frequently make adjustments to their flight routings and equipment deployment, so staffing levels fluctuate.

In the face of the airlines’ variable staffing needs, the flight attendants unions, when they first formed in the 1940s, devised a job-bidding system to give the workers some stability in their work schedules. Under the bidding system, the airlines are required to prepare a roster of assignment schedules each month that are termed “lines of flying.” The lines are composed of multiple “trips”—flight sequences that begin and end at the worker’s home base. The sequences can be simple round trips, or they can be a sequence of flights that spans several days and involves flights to a series of cities. The workers are presented with the available lines each month, and bid for the ones that offer the schedules they prefer.

Flight attendants who want to be home every night bid for lines that have flights that leave and return on the same day, such as an East Coast shuttle. Those who want to be home for a special occasion, such as a child’s birthday, or who want to take a class that meets on a certain day each week bid to have those dates off. Some might want to work early in the month and have time off later in the month. Each can bid for a schedule package that meets his or her priorities. Also, some lines involve more hours of work than others and offer additional pay. Thus, those who want to maximize their month’s earnings can bid for the more lucrative trips. All the bids are submitted each month and awarded on the basis of seniority.

Airlines also need to have some workers on call for last-minute changes. The unions’ contracts provide for some lines to include specified times a flight attendant will be on call, for which they are paid a minimum hour guarantee when they are on call. The contracts limit the amount of on-call work.

AP Photo/Hans Pennink

Even if gig workers are not ultimately determined to be “employees,” there have been attempts by drivers to form organizations that give them some elements of union representation, such as Uber drivers joining the New York Taxi Workers Alliance. Here, Bhairavi Desai, executive director of the Alliance, speaks to reporters. 

The flight attendants unions’ schedule-bidding system has worked for many years, with occasional negotiated modifications. It has enabled flight attendants to achieve predictability in their schedules and plan their lives accordingly, even when the employers’ staffing needs are unpredictable and variable, while serving the airlines’ need for reliable staffing. The point is that the entire burden of fluctuating schedules is not placed on the workers.

The flight attendant bidding model could be adapted to other industries that have variable staffing needs. For example, retail stores could offer their workers an array of specified schedule options each month, for which the workers would bid. Some schedule options could include a limited amount of additional “on-demand time”—a pre-specified time period during which a worker would have to be available if called in with 24-hour notice. The workers who had schedules that include on-demand time would be paid their regular pay if they were called in, or they would be paid something for the hours they were required to be on demand. This would enable retail workers to plan their lives and yet enable the retailers to have the flexibility they claim they need. The same computer algorithms that make it so easy for employers to vary workers’ schedules could be modified to give workers more of a say. This is not a technical issue, but a question of bargaining power.

 

*Unions for Gig Workers*

Gig work raises many difficult issues under labor laws. Because these workers choose their hours and provide their own tools (such as Uber drivers’ cars), the companies claim the workers are independent contractors, not employees. Yet, unlike conventional independent contractors, gig workers are subject to the selection, direction, monitoring, and discipline of their employing entity.

There is currently litigation in many state and federal courts on the issue of how gig workers should be classified. In June 2015, the California Commissioner of Labor found that an Uber driver was an “employee” and entitled to the benefit of state labor laws requiring expense reimbursement. In a similar vein, in the summer of 2016, the New York Labor Department ruled that two Uber drivers were entitled to workers’ compensation under New York law. Several cases are also pending in federal courts on whether gig workers are employees or independent contractors under federal employment laws. There are also cases pending before the National Labor Relations Board that pose the question of whether Uber drivers or Postmates delivery workers are entitled to the National Labor Relations Act’s protection for engaging in collective action. Last October, the employment tribunal in the U.K. ruled that Uber drivers are employees and entitled to minimum wage, rest breaks, and holiday pay.

If gig workers in the United States are found to be independent contractors rather than employees, they cannot benefit from federal and state laws guaranteeing overtime pay, minimum wages, expense reimbursement, rest breaks, healthy and safe working conditions, workers’ compensation, unemployment compensation, employer contributions to Social Security, protection against discrimination, or the right to form a union. Moreover, as independent contractors, any collective action they might take to change their working conditions could make them liable for antitrust violations.

Although gig workers value control over their time, many have raised serious complaints about their jobs and working conditions. For example, despite earning decent money at the outset, many Uber drivers complain that after six months of driving 400 to 500 miles a day, their cars require such expensive repairs that their actual earnings are close to minimum-wage level. Drivers also complain that Uber periodically cuts the rates it charges customers and increases the percent it takes, thereby reducing drivers’ incomes. They also complain that the customer ratings system is tyrannical, forcing them to accommodate rude, abusive, and drunken customers just to avoid getting penalized for a low rating.

Some labor policy analysts and academics have argued that workers who get task assignments from computer platforms represent a new type of worker that fits neither the category of employee nor of independent contractor. For example, Seth Harris and Alan Krueger used the example of Uber drivers to argue that there should be a new category called “independent workers” for platform workers, who would be entitled to some of the rights but not all the protections available to employees. Ross Eisenbrey and Lawrence Mishel of the Economic Policy Institute disagree. They challenge the Harris-Krueger analysis and maintain that Uber drivers fit within the existing categories of employees and should therefore come under existing labor laws. Former NLRB General Counsel Craig Becker argues that adding a new category such as independent worker does not solve any problem, but rather compounds the classification problem. If there were three categories instead of two, he contends, there would be more disputes and litigation about which category an individual working relationship fits.

The controversy over the proper classification of Uber drivers casts a shadow over efforts for all gig workers to unionize. If the litigation is resolved in favor of employee status, however, there are models of unionization and organization that could preserve the drivers’ control of their working time and freedom to drive for more than one service, yet also address their other concerns.

 

*Embedded Contract Bargaining*

Gig work has, in fact, a lot in common with project work by craft workers in fields such as construction, who are hired for a specific job but may not have an ongoing relationship with the entity that employs them. In the building trades, a union contract does not guarantee hours of employment, but it does govern wages and benefits, as well as apprenticeship and other elements of work.

A successful, lesser-known model for sporadic but recurring project work can be found in film and television industry trades, such as lighting design, sound engineering, or on-location transportation. The International Alliance of Theatrical Stage Employees (IATSE) engages in a form of collective bargaining that I call “embedded contract bargaining.” It works as follows: The union negotiates a Basic Agreement between an IATSE local and an association of theaters that spells out a few terms of the labor-management relationship, and for certain others, requires employees covered by it to make their own deals. The Basic Agreement includes union recognition, as well as terms such as health and safety at theater workplaces, employer provision of housing during out-of-town production assignments, transportation costs for out-of-town locations, and employer contributions to the joint pension and health funds. It also sets minimum pay per day worked. However, the agreement contains no seniority, just cause, or arbitration provisions—no provision for job security at all. To the contrary, it assumes that workers will be hired on an as-needed basis, working from job to job, sometimes more than one job at a time.

Freelancers Union/Creative Commons

Freelancers Union members at a rally in Albany, New York. 

One significant aspect of the IATSE Basic Agreement is that it includes another embedded agreement, a one-page agreement, negotiated between the theater employer and the individual employee, that sets the level of pay and other terms relating to compensation for the employee on the specific job. The embedded agreement also authorizes a dues check-off on behalf of the relevant IATSE local.

Such contracts do not guarantee jobs, nor a specific level of income, but the minimal terms and area-wide benefit fund ensure workers a living wage and decent benefits. Embedded contract bargaining, in this model, could provide some protection for labor standards for platform and gig workers, if they could amass enough power to compel employers to sign agreements.

 

*Associational Unions*

Even if gig workers are not ultimately determined to be “employees,” there have been attempts by drivers to form organizations that give them some elements of union representation. For example, in New York City, a large number of Uber drivers have joined the New York Taxi Workers Alliance (NYTWA), an organization that maintains a school for drivers, assists drivers with traffic tickets, and lobbies the Taxi and Limousine Commission on behalf of drivers. The NYTWA is engaged in litigation seeking to get Uber drivers classified as employees under both federal employment laws and the National Labor Relations Act.

In December 2015, the City of Seattle enacted an ordinance to permit for-hire drivers to unionize and bargain collectively for better compensation rates and other contract terms. The stated goal of the ordinance is “[l]eveling the bargaining power between for-hire drivers and the entities that control many aspects of their working conditions.” It is based on the city council’s finding that:

Business models wherein companies control aspects of their drivers’ work, but rely on the drivers being classified as independent contractors, render for-hire drivers exempt from minimum labor requirements that the City of Seattle has deemed in the interest of public health and welfare, and undermine Seattle’s efforts to create opportunities for all workers in Seattle to earn a living wage.

The Seattle ordinance does not decide the question of whether the drivers are independent contractors or employees. Rather, it establishes a procedure for drivers to select an exclusive driver representative (EDR) who will be the sole representative of for-hire drivers operating in the city for a particular on-demand company. The director of the city’s Finance and Administrative Services receives petitions from groups seeking designation as the EDR, and determines whether a particular company has sufficient support among drivers for that company to be so named. Once an EDR is certified, the EDR and the company hiring those drivers—the “driver coordinator”—are required to meet and bargain over vehicle standards, safe driving practices, the nature and amount of payments to be made, minimum hours of work, and other conditions. After reaching agreement, the parties submit the agreement to the director for review, and if it is found to be compliant, then it is final and binding on all parties. If the parties fail to agree, then the ordinance provides for interest arbitration.

Last March, the U.S. Chamber of Commerce challenged the Seattle ordinance in court. In its complaint, it contended that the ordinance violated the Sherman Antitrust Act by authorizing for-hire drivers to form illegal cartels, and that it violated the National Labor Relations Act by regulating matters that lie within the exclusive jurisdiction of the National Labor Relations Board. On August 9, a federal district judge dismissed the lawsuit on the grounds that the ordinance had not yet been implemented so the chamber had not been harmed by it, and hence lacked standing to sue. The judge left the door open for the chamber to re-file the suit at a later time.

Marie Kanger Born/Shutterstock

Striking workers and supporters protest against low wages and charge that Walmart retaliates against employees who push for better working conditions in Chicago.

The City of Seattle is currently drafting regulations for the implementation of the ordinance, so it has not yet gone into effect. Once it does, litigation will undoubtedly resume. The antitrust and preemption issues posed by the ordinance are complex, and it is not clear how they will be decided. However, if the ordinance is ultimately upheld, it opens the door for a new form of unionism that could be meaningful for gig workers.

 

*Freelance Workers*

Yet another group of voluntary on-demand workers are freelancers. Unlike gig workers, freelance workers are truly independent contractors. They create a good or a service at their own expense, find a customer, decide what to charge, and keep the proceeds. They work for themselves and do not usually have employees. They include commercial artists, writers, editors, computer programmers, and other technological fields.

Despite their autonomy, freelance workers experience several kinds of problems. First, as individual producers, they have difficulty obtaining pension and affordable health insurance because they are not eligible for favorable group rates. Second, as independent producers, they rely on the integrity of their contracting counter-parties to receive their pay. The most prevalent complaint of freelance workers is that the entities with which they contract often delay paying them or fail to pay altogether. Yet freelance workers do not have a simple way to recover their fees. Because they are not “employees,” they are not covered by the Fair Labor Standards Act. While they can go to court for breach of contract, doing so is expensive, time-consuming, and often sullies their reputation and prevents them from getting future work. Furthermore, they often work without a written contract, making it practically impossible to prevail.

The Freelancers Union, based in New York City, has taken the lead in addressing these concerns. The Freelancers Union is not actually a union, but is a worker center that advocates on behalf of freelance workers. One of its primary activities is operating a health insurance and pension fund specifically designed for freelancers, giving them access to favorable group insurance rates and enabling them to obtain affordable social protection.

The Freelancers Union also lobbies for legislation on behalf of freelancers. On October 27, 2016, it achieved a major victory in the New York City Council with the enactment of the Freelance Isn’t Free Act. The act provides that anyone utilizing a freelancer’s services must give them a written contract if the job is for more than $800 over four months, and that anyone who fails to pay on time is liable for double damages.

Although legislation like the Freelance Isn’t Free Act is an enormous step forward for freelance workers, it may not solve all the problems of nonpayment. To benefit from the act, freelancers still must go to court to collect their fees, and many may be reluctant to do so because of time, expense, and reputational considerations.

One service a workers’ association could provide to freelance workers would be to operate their own dispute resolution system to provide a fair and accessible forum for processing claims. An example can be found in the Independent Film and Television Alliance (IFTA), an organization that includes screenwriters, film producers, directors, and others in the industry. IFTA is a trade association and not a union. It lobbies on behalf of the independent film industry, runs an annual marketplace where filmmakers, film producers, and film marketers come together, and operates an arbitration system for resolving disputes within the industry. IFTA has developed detailed arbitration procedures and maintains a roster of carefully selected arbitrators from around the world. It acts as the administrative agent for the arbitrations—receiving pleadings, setting timetables, deciding discovery requests, and resolving disputes about how the procedures should operate. This service is invaluable to its members because it enables them to resolve disputes without generating the expenses or ill-will that would otherwise result from a formalized legal proceeding. Many of the organization’s members claim that the dispute resolution system is the primary benefit the organization has to offer. If organizations of freelance workers offered fair, inexpensive, and expeditious arbitration to resolve payment disputes, it would help make a reality of the fact that “freelance isn’t free.”

The rise of new types of work relations poses a challenge to our existing model of unionization. However, new forms of organization can be developed, and older ones restructured, to address today’s transient, casualized, and precarious workforce. Organization is necessary not only to protect the individuals involved, but also to constitute a voice for workers in the political process. As the experience with the airlines, entertainment unions, and unions representing freelancers has shown, the idea that new forms of technology such as digital platforms must invariably weaken worker bargaining power is a convenient myth. Efforts to convert employment to on-demand work is an old story, and workers regain rights whenever they are strong enough to organize.

With the very rich becoming ever richer, money translates into power. The tilt of income and wealth has gone hand in hand with banking deregulation, tax code changes, relaxation of antitrust laws, and the weakening of worker protections. The labor movement is the only institution with the potential to counter this power shift and provide new forms of worker protection to match new forms of work organization.

  Reported by The American Prospect 16 hours ago.

As Trump vilifies the press, the courts, immigrants, Muslims, Democrats, protestors and anyone who disagrees with him, it isn’t hard to imagine a modern day Mussolini... or worse. But, an even greater threat lies in the Republican’s march towards full control of state government. If they get there, they will have the frightening power to amend the Constitution into their own authoritarian image... or Ayn Rand’s.

Republicans now control 32 state legislatures and 33 governorships. They have majorities in both state legislative chambers as well as the governorships in 25 states. The Democrats have total control in only six states and legislative control in two more (see here).

If Republicans achieve veto-proof control in 38 states, they can do something that has never been done before ― hold a constitutional convention, and then ratify new amendments that are put forth. To date all amendments have been initiated from Congress where two-thirds of both houses are required. In either case 38 states would be needed to ratify the amendments. The Republicans are well on their way.

We know what they are likely to do: end collective bargaining, outlaw abortion, forbid progressive income, estate and Wall Street taxes; prohibit class action law suits, privatize social security, guarantee “free choice” in all school systems, and so on. They would do what they’ve always wanted to do ― outlaw the New Deal and its social democratic programs. And if they get crazy enough, they could end separation of church and state and undo other portions of the Bill of Rights.

A paranoid fantasy? Just say President Trump.

*How did we get here?*

Ask the corporate Democrats who have turned losing into an art form.

Since 2008, they have lost 917 state legislative seats. Explanations range from Koch brothers funding to gerrymandering, to voter suppression to the rise of the Tea Party. All partially true.

The Democrats also shoulder a good deal of the blame. Ever since Bill Clinton triangulated into NAFTA and away from working people, the Democratic party’s embrace of financial and corporate elites have become the norm.

Hillary Clinton took $225,000 per speech from Goldman Sachs not because she was corrupt. Rather, this is simply the way the political game is played. You raise money from rich people, and then you back away from attacking their prerogatives while still trying to placate your liberal/worker base. Getting rich along the way is to be expected.

But as economist Jamie Galbraith put it, ultimately it is not possible for the Democrats to be both the party of the predators and the prey.

*The failure and rebirth of progressivism?*

The amazing acts of resistance popping up all over prove that the progressive spark is alive and well. Even seniors at the Progressive Forum in Deerfield

Beach, Florida are planning to put their bodies on the line to stop ICE raids.

While raising hell all over the country, we also should re-examine how our strategies and structures may have contributed to the rise of the right. After all, this electoral coup happened on our watch.

*Silo Organizing*

Here’s our working hypothesis for how progressives contributed to the rise of the right: We have failed to come out of our issue silos to build a national movement that directly confronts runaway inequality.

For more than a generation progressive organizations have shied away from big picture organizing around economic inequality. Instead we’ve constructed a dizzying array of issue silos ― environment, LBGQ, labor, immigration, women, people of color, criminal justice and so on. We are fractured into thousands of discreet issues, enabled by philanthropic foundations that are similarly siloed.

Few of our groups focused on the way Wall Street and corporate elites strip-mined the economy. Very few of us mobilized around the great crash. Few of us noticed as the CEO/worker income gap jumped from 45 to 1 in 1970 to an incredible 844 to 1 by 2015. We collectively missed how this growing economic inequality was causing and exacerbating nearly all of our silo issues.

We didn’t connect the dots.

Most importantly, we failed to grasp how runaway inequality was alienating millions of working people who saw their incomes decline, their communities whither and their young unable to find decent jobs.

While the Tea Party and the right had a clear message ― big government is bad ― progressives had little to say collectively about runaway inequality.

*Enter Occupy Wall Street*

By the summer of 2010, the progressive failure was painfully obvious. After Wall Street had robbed us blind and crashed the economy, a Democratic president was about to enter a “grand bargain” with the Republicans to promote austerity. Think about this: While Wall Street got bailed out in full, Obama and the Democrats were about to cut Social Security. Amazing.

Then out of nowhere came Occupy Wall Street. (Out of nowhere is correct because the actions did not originate from any of our progressive silos.) In six months there were 900 encampments around the world. Thankfully, “We are the 99%.” shifted the debate from austerity to inequality.

Unfortunately, Occupy believed in spontaneous political combustion and shunned any and all organizational structures and agendas. Social media, consensus decision making, horizontal anti-organizing, and anti-leadership were to carry the day. In six months they were gone.

Meanwhile the traditional progressive groups watched it rise and fall from the outside. We were spectators as we continued to press forward in our issue silos.

*Enter Bernie Sanders*

We got a second chance. Bernie Sanders, an independent socialist with a clear social democratic agenda, decided to challenge Hillary Clinton, the presumptive nominee. At first, few of us took him seriously. After all, he’d been around for 40 years, saying the same things but never gaining any traction outside of Vermont.

But like Occupy, he and his message hit a nerve, especially among the young and among disaffected working people who were entirely fed up with the corporate Democrats.

In a flash, Sanders did the impossible. He beat Hillary in several primaries. He drew much larger crowds. He even raised more money from small donors than the Clinton machine could raise from the rich. Progressive unions like the Communications Workers of America and National Nurses United went all in. For a few months the dream looked possible.

But too many other large unions and liberal issue groups committed early to Clinton, thinking she would win easily. That would allow them to gain more access for their issues and for themselves. Didn’t happen.

Trump toppled the Clinton machine in the Rust Belt. Some say he did so with a toxic combination of racism, sexism and xenophobia and that certainly was the case for a good portion of his vote. Others are certain that Comey and Putin made the difference.

But in the Rust Belt Trump won because he picked up millions of those who previously had voted for Obama and Sanders. It is highly likely that runaway inequality, and the trade deals that exacerbated it, defeated Clinton in the Democratic strongholds of Wisconsin, Michigan, and Pennsylvania. In Michigan alone Hillary received 500,000 fewer votes than Obama. (see here)

*What now?*

We need to turn the marvelous anti-Trump resistance into a common national movement to that binds us together and that directly confronts runaway inequality. We need to come out of our silos because nearly every issue we work on is connected by growing inequality.

Such a movement requires the following:

*1. A common analysis and agenda:* As we’ve written elsewhere, resisting Trump is not enough. We need a proactive agenda about what we want that goes beyond halting the Trump lunacy.

The Sanders campaign offered a bold social democratic agenda to young people in particular. Progressive should be able to build broad support around a Robin Hood Tax on Wall Street, free higher education, criminal justice reform, humane immigration policies, Medicare for All, fair trade, real action on climate change, and a guaranteed job at a living wage for all those willing and able*.*

*2. A common national organization:* A big problem. We have no equivalent to the Tea Party. We have no grand alliance that links unions, community, groups, churches and our issue silos. There are excellent websites like Indivisible that are successfully encouraging widespread resistance on the congressional level. But they consider themselves to be purely defensive against Trump.

There are hundreds of demonstrations popping up all over but no organizational glue to hold them together. There’s Our Revolution ― an outgrowth of the Sanders campaign ― that is still getting its sea legs. But to date we have no common center of gravity that is moving us forward organizationally.

Ideally we should all be able to become dues paying members of a national progressive alliance. We should be able to go from Paterson to Pensacola to Pomona and walk into similar meetings dedicated to fighting for our common agenda to reverse runaway inequality. Perhaps the hundreds of town hall meetings will head that way? It’s too early to tell.

*3. An education infrastructure: *The Populist movement of the late 19th century waged a fierce battle against Wall Street. It wanted public ownership of banks and railroads. It wanted livestock and grain cooperatives. It wanted a progressive income tax on the rich and public banks. The organization grew by fielding 6,000 educators to explain to small farmers, black and white, how the system was rigged against them and what they could do about it.

We need about 30,000 educators to hold similar discussions with our neighbors about runaway inequality, how it binds us together and what we can do about. (If you’re interested in getting involved see here.)

*4. A new identity:* Our toughest challenge. For 40 years we’ve been conditioned to the idea that runaway inequality is an immutable fact of life ― the inevitable result of automation, technology and competitive globalization. Along the way, neoliberal (free market) values shaped our awareness.
·
We accepted the idea that going to college meant massive debts for ourselves and our families;·
That there was nothing abnormal about having the largest prison population in the entire world;·
That it was part of the game to pay high deductibles, co-pays and premiums for health insurance;·
That it was OK for the super-rich to hide their money off-shore;·
That there was nothing to be done about chronic youth unemployment, both rural and urban, other than to try harder and pull themselves up.·
That it was perfectly natural for a factories to pick up and flee to low wages areas with no environmental enforcement;·
And that somehow private sector jobs, by definition, were more valuable to society than public ones.
These mental constraints have got to go. We got here as the result of deliberative policy choices, not by acts of God. We need to reclaim a basic truth: the economy should work for its people and not the other way around.

Most importantly, we have to relearn the art of movement building which starts in our own minds ― we have to believe that it is both necessary and possible, and that each and every one can contribute to it.

We desperately need a new identity ― movement builder.

Is this so difficult to imagine?

Les Leopold, the director of the Labor Institute, is currently working with unions and community organizations to build the educational infrastructure of a new “reversing runaway inequality” movement. His new book Runaway Inequality: An Activist Guide to Economic Justice serves as a text for this campaign. All proceeds go to support these educational efforts. For more information, contact him at LesLeopold@aol.com.

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-- 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.

According to the Kaiser Family Foundation, about half of the U.S. population is covered by employer-sponsored-insurance. Reported by Mondaq 15 hours ago.

There are many challenges to farming: It's often grueling work that relies on unpredictable factors such as weather and global market prices. But one aspect that's often ignored: health care costs. Reported by NPR 14 hours ago.

The presidency of popular vote loser Donald Trump is now one month old. There have been a few hiccups ― if hiccups mean mind-bogglingly stupid missteps ― that demonstrate exactly what an in-over-his-head amateur Trump actually is. By comparison, the Trump Administration thus far has made Wile E. Coyote actually look like the super genius he sometimes claims to be.

Other presidents have had problems getting their nominees confirmed by the Senate, although it really is satisfying to watch the implosion of Andy Puzder, a nominee to run the Labor Department who has a record of holding laborers in contempt—the human ones, at least. However, if that had been Trump’s biggest problem, he’d be on par with his predecessors. It wasn’t.

Let’s start with the fact, pun intended, that this president and his surrogates have been caught in so many lies that the media, as Amanda Marcotte explains, is grappling with how to cover them without also amplifying them. We’ve all heard that 1984 is back on the best-seller list, but don’t forget the specifics of what that book described: a regime that could proclaim that 2+2=5 and make you believe it. While Trump can’t punish you for not believing the sun was shining when it was actually raining, he certainly has no compunction about proclaiming such a thing ― even though you can watch a video that shows otherwise. Having a president that divorced from reality causes real trauma.

The biggest story this week is the one that centers around the resignation of Trump’s National Security Advisor Michael Flynn, who found himself out of a job after only 24 days, the shortest tenure by far of any of the 25 people to serve in that position. It is a huge story on many levels, not the least of which is that it provides further evidence of the incompetence of a leader who would give such a sensitive position to a certifiable conspiracy theorist who uttered so many untrue things during his tenure as the head of the Defense Intelligence Agency that his colleagues referred to them as “Flynn facts.”

Here are a couple of other things that stand out about this story: First, although the Trump administration says he had to go because he lied and thus had lost the president’s trust, Trump had known about the lies for weeks before actually getting rid of him. As the New York Times reported:

But other aides privately said that Mr. Trump, while annoyed at Mr. Flynn, might not have pushed him out had the situation not attracted such attention from the news media. Instead, according to three people close to Mr. Trump, the president made the decision to cast aside Mr. Flynn in a flash, the catalyst being a news alert of a coming article about the matter.

Let that sink in for a minute. Second, this is much bigger than Michael Flynn. The Trump team has been in close contact with Russian intelligence officials for months now, including during the campaign. It’s not just Flynn that’s been whispering to Vladimir Putin’s crew.

Despite Trump’s fantasies about his White House running like a “fine-tuned machine,” the reality is that, as of Friday at noon, he still has ten Cabinet spots open—more than any previous president four weeks into his term. Going beyond the numbers, the level of dysfunction has grown so severe that the retired admiral whom Trump tapped to replace Flynn as National Security Advisor turned him down specifically because of that dysfunction, describing the job to a friend as “a shit sandwich.” High-level officers almost never turn down a president asking them to serve, so this is a real indictment of Trump.

As for the president’s press conference on Thursday, CNN’s John King said that a Republican senator texted him the following: “[Trump] should do this with a therapist, not on live television.” That’s Trump Trauma.


Barack Obama wasn’t a perfect president. But what the “No Drama Obama” nickname meant was that he understood the necessity of doing things the right way.

Then there’s the small matter of conducting a sensitive foreign policy strategy session in “full view of fellow diners” at his Mar-a-Lago resort, rather than, oh, maybe going into another frickin’ room, let alone a truly secure location. Asking whether these guys know what they hell they are doing is a legitimate question. We’ve reached the point where John McCain said this week: “As far as national security is concerned, this White House is in disarray.” It’s not just politicians. Here’s what Gen. Raymond “Tony” Thomas, who’s only the guy in charge of Special Operations Command, had to say: “Our government continues to be in unbelievable turmoil. I hope they sort it out soon because we’re a nation at war.” If that’s what he says out loud, you can only imagine what he’s thinking.

Meanwhile, what has the Trump administration actually accomplished? Their Muslim travel ban caused tremendous turmoil and provoked widespread protests, only to be blocked by a unanimous court ruling issued by judges appointed by both Democratic and Republican presidents. More incompetence. More trauma. And these are just the worst of the things Trump has done.

As for legislation, he has signed exactly one piece that’s of any significance. It rolls back an Obama-era regulation that forced corporations involved in the oil and mining business to reveal any money they give to other governments. Because that’s how you make America great again.

Now, let’s revisit a different era, one that seems like almost another lifetime—the time when Barack Obama was president of the United States. To be sure, any White House can take time to find its sea legs, so let’s compare Trump not to the President Obama who’d been on the job for a while. Let’s look at what each accomplished in the first month.

First and foremost, the Obama White House wasn’t a chaotic dumpster fire. That may be a low bar to clear, but it’s an important one. Our intelligence officials weren’t afraid to share important information with him because they didn’t trust him with it. To clarify, that appears to be what’s happening with our current president, although the intelligence higher-ups have denied the damning information reported in the Wall Street Journal.

President Obama also signed into law a number of important measures that actually benefited Americans. On his 10th day in office, he signed the Lilly Ledbetter Fair Pay Act, which, according to the National Women’s Law Center, has made “a critical difference” for women facing discrimination in how they are paid at work. On his 16th day, he signed an expansion to the Children’s Health Insurance Program (once known as S-CHIP) that paid for health insurance coverage for 4 million additional children. And exactly four weeks into his presidency, the stimulus package became law. And those are just the best things Obama did.

Barack Obama wasn’t a perfect president. But what the “No Drama Obama” nickname meant was that he understood the necessity of doing things the right way, of staying focused on what was important, and of having a White House that acted rationally and made decisions based on the facts. The Trump Trauma in which we are now living results from a White House that is out of control, and which operates on the basis of emotion rather than what actually works. What we are seeing with our very eyes is the meaning of the phrase “the fish rots from the head.”

And that’s no joke.

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If the Affordable Care Act, also known as Obamacare, is repealed without a comprehensive replacement almost 630,000 people living in the U.S. congressional districts that make up South Florida, are expected to lose coverage, according to a recent analysis. Nationwide, between 20 million to 30 million people may lose their health insurance, according to the analysis by Charles Gaba, a Michigan-based healthcare analyst and owner of acasignups.net. Gaba looked at congressional districts across the… Reported by bizjournals 6 hours ago.

I have spent three decades defending human rights around the world. I have seen the many ways that human rights and democratic principles get trampled or undermined. In the United States, I have fought abusive policies by Democratic and Republican presidents alike. Having seen so much, I am not prone to hyperbole. But for the first time, I am worried for the future of America’s democratic system.

U.S. President Donald Trump is still in the early days of his presidency, but a number of his actions have set off warning bells for me. It is not clear that he appreciates and accepts the checks and balances and day-to-day accountability that are essential parts of democracy.

In other parts of the world, I have seen a lack of such appreciation erode democracy, its form respected but its substance undermined. I have seen democratically elected leaders use their popularity to silence the media, rein in civil society, compromise the judiciary and curtail the public’s ability to limit executive overreach. To avoid this unraveling, I have come to understand the importance of not only democratic laws and institutions but also democratic culture.


Without checks, Trump is susceptible to the classic populist claim that his insight into the will of 'the people' justifies trampling on the rights of real people.

Trump has already shown contempt for this culture. Rather than mount a serious defense of his policies, he has contorted the truth ― even lied. Rather than answer critical media questions, he has called journalists enemies. Rather than simply disagree with a judicial ruling, he has disparaged a “so-called judge” for having the temerity to rule against him. Rather than respect internal dissent, he has tried to sidestep or silence it. Rather than open his finances to scrutiny, he has hidden his tax returns and refused to separate himself from his business interests.

Without these checks, Trump seems susceptible to the classic populist claim that his insight into the will of “the people” justifies trampling on the rights of real people ― perhaps the most important limits on presidential power. That tendency was already on display during the campaign. Instead of respecting the individual differences of a diverse society, Trump belittled those who value that diversity.  

Now that he is in the White House, the consequences are already being felt. Trump’s sweeping ban on travel to the United States, issued without any effort to tailor it to an actual terrorist threat, would impose enormous hardship on tens of thousands of people, mostly Muslims, whose visas would suddenly be worthless.  His suspension and radical reduction of refugee admissions to the United States is felt by many of the world’s most helpless people.  His threatened deportation of undocumented migrants ― anyone who entered the United States unlawfully would qualify ― could uproot millions of people with deep family and community ties. And he is substantially cutting back on the procedures that allow migrants to cite those ties in an effort to avoid deportation. 

He has nominated a Supreme Court justice who espouses a concept of “religious liberty” that has been used to justify discrimination against gays and lesbians. Women’s access to abortion and basic health services is in jeopardy. People in ill health fear loss of their newly won health insurance. And though he now appears to have backed away, the president has casually toyed with resuming torture.

Yes, Trump won the Electoral College and thus the presidency. Yes, millions of people who felt government was not serving them voted for a man who vowed to shake things up. But “draining the swamp” should not come at the expense of the rights and protections that represent America’s highest aspirations.  


Experience elsewhere teaches us that [autocratic governments] can arrive with extraordinary speed, signaled not by tanks surrounding the presidential palace but by the erosion of democratic norms.

Most people in the United States have no experience with autocratic government, but experience elsewhere teaches us that it can arrive with extraordinary speed, signaled not by tanks surrounding the presidential palace but by the erosion of democratic norms. We may take comfort in the strength and vigor of the U.S. democratic system, with its many checks and balances, but we should resist complacency, because each has its fragility.  

A professional, free and fair press, for example, has a vital role to play, but it is not immune to official intimidation or the diversion of “alternative facts.”

A fiercely independent judiciary is essential, but judges are susceptible to pressure and intimidation. They will need courage to defend rights if the president persists in promoting abusive policies. Many organizations and grassroots movements are showing signs of vitality in defense of rights but will need organization and solidarity across affected communities and party lines, the discipline to be guided by principle rather than mere opposition and endurance.

Government officials throughout the executive branch have already begun to speak out, some at the risk of their jobs. That highest form of public service should continue even if surveillance and attacks on whistleblowers make dissent difficult.

And, of course, elected officials ― foremost, the members of the president’s own party ― have essential responsibilities. We have become inured to partisanship in an era of divided government, but when fundamental democratic values are at stake, petty politics should be set aside.  


The U.S. democratic system is still strong. But the time for heightened vigilance is now.

The rest of the world can help, too. Given America’s power, there is a tendency to come to terms with its leader, whoever that is. But the United States has influence beyond that of any other nation. All rights-respecting governments have an interest in promoting a positive U.S. example.

While Trump is heading in a dangerous direction, it is too soon to say where he will end up. The U.S. democratic system is still strong. But the time for heightened vigilance is now. The responsibility falls on us all.type=type=RelatedArticlesblockTitle=Related on WorldPost... + articlesList=58a72f19e4b07602ad543d15,588cc159e4b0cd25e490491b

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