Sweet Home Politics

Monday, October 22nd, 2018   |   Español

Author Archives: Jennifer Marsden

  1. Hidden Costs of Stagnant Minimum Wage

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    This past week I was speaking with a group of small business owners and professionals in Dothan. One business owner felt that an increase in the Alabama minimum wage will make them need to raise prices at least a little, but that prices for all goods were already going up even without a wage hike, so maybe minimum wage workers needed higher pay. Another noted that very few people in Alabama get only minimum wage: the men who do yard work or home repairs for these professionals are getting a lot more than $8/hour (even the neighbor boy who dog sits for us gets more than that).

    Probably the only employers in Alabama paying minimum wage are larger companies like Wal-Mart or corporate franchises for fast food. With rising prices, minimum wage is not enough to take care of the costs of living, even in low cost Alabama. Despite inflation of 11% over the last 5 years, the minimum wage has not been increased since 2009. I look at it this way: when I last earned minimum wage, that $3.35 bought what is now worth $9.70, not the current minimum wage of $7.25. Many families with children supported by a minimum wage worker will qualify for food stamps and their children will qualify for Medicaid. Health insurance for the parents can cost 1/3 to 1/2 or more of the annual pay of a minimum wage worker so the parents have to go without if their company does not provide health insurance.

    Alabama tax payers support these minimum wage workers (and their employers, who get a worker for less than they really cost to feed, house, and get medical and child care) with food stamps, public housing, child care assistance, Medicaid for the children, and unpaid emergency room costs when an uninsured worker has a serious medical problem. As many have pointed out, the profits from Alabama tax payers picking up the tab for these costs go directly to the owners of the companies which pay minimum wage because they do not have to bear the burden of higher wages.

    An old economic maxim is this: give a rich man a raise and he’ll probably put the money away for later; give a poor man (or woman) a raise and they’ll buy Baby shoes! Every increase in minimum wage will come straight back into the Alabama economy; not the case for big businesses that continue to see skyrocketing corporate earnings. If we do not raise the minimum wage, we should consider asking employers to contribute a little more to the state funds that support those minimum wage employees who receive state benefits because of their lower wages. As it stands, those stingy employers are just forcing the rest of us to subsidize their profit margin.

    We all recognize that raising the minimum wage may contribute a little bit to inflation, but maybe it’s time for some wage inflation instead of just price inflation!

  2. Medicaid Expansion Studies: Follow the Money (Jennifer Marsden)

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    There’s a new study out on Medicaid Expansion in Alabama from Troy University. It finds different conclusions from two prior studies from the University of Alabama and the University of Alabama at Birmingham. Articles on this study, and the new study’s authors, point out that the two prior studies were funded by the Alabama Hospital Association.

    Of course, the authors deny any bias in their own research at Troy University’s Johnson Center, which is funded by the Koch brothers, a banking charity and the center’s namesake, Manuel H. Johnson, who held the Koch Chair for International Economics at George Mason University.

    I was taught, and I am still learning how true it is, that in politics you must follow the money; this holds true in medicine and in research as well. It is likely true that the Alabama Hospital Association, hoping to encourage Gov. (Dr.) Bentley to expand Medicaid and thereby keep more of their member hospitals open, was happy with the results of the first two studies.

    So what is the benefit for the Koch brothers, and other super-rich industrialists, if Alabama does not expand Medicaid? They have funded commercials (the creepy Uncle Sam puppet/doctor and many others) to convince young people not to get health insurance in a clear attack on the Affordable Care Act. They have funded other ACA misinformation efforts and support many other right wing goals. By reputation the Koch brothers want all of America to be like Alabama: low wage, nonunion, no benefits. Reversing the Affordable Care Act, if that were somehow possible, will save a lot of money on labor and pension costs.

    Do the Koch brothers have health insurance? Do they see doctors? Have they offered to pay for the medical care of any of those who avoided signing up for affordable health care after the Koch brothers’ commercials convinced them it was a bad idea? Some may tell you that the Kochs had nothing to do with many of these expenditures, but if you follow the money, you see that many of them derive financial support from Koch funded front organizations. By the way, “Koch” (pronounced “coke”) is German for “cook” and we should not have to eat what they are cooking up!

    Now, I am no economist, only a family doctor and Army veteran. But follow the money. Are the researchers biased? Does who funds your research determine your results? Certainly your politics (except maybe in mathematics) and prior research topics may determine who wants to fund your future research. I may be biased since more insured people would mean more paying patients.

    Aside from money it’s frustrating when patients without insurance can’t afford to follow my advice. It’s also exasperating to hear about people who can’t even afford to see a family doctor. And it is heartbreaking to hear about people who, waiting for care they don’t yet have the money to pay for, die.

    Follow the money for yourself. Do you have a small hospital near you that has closed or is about to close? Do you and all of your family and friends (anyone who might ask you for money if they need it for medical care) have affordable health insurance and medical care? If you do, did you know that you pay inflated costs in insurance and in taxes to help hospitals cover expenses when they provide emergency care to people who never pay for it? Do you or your relatives work in healthcare and now have to drive further (or take a job out of state) for work? Do we want to become a third-world country where people die if they don’t have money or health insurance? This is already happening to people in Alabama.

    Whether expanding Medicaid is revenue neutral or not, costs us more right off, costs us in 3 years or even saves money, what these economists and Doctor Bentley leave out of the equation is that up to 300,000 more Alabama citizens will have health insurance. Again, follow the money. Do you believe that funded hospitals are a good idea in your county or is it better to support the ideals of the super-rich?

    When I speak to Alabamians across the state, nearly all of them want to be sure that their families have the ability to obtain healthcare when they need it — regardless of how fat or skinny their wallets are. You should not have to follow your own money to help you decide to seek medical care; to decide if you should live or die. So I ask you: what is best for Alabama, what is best for you? I have personally and publicly asked Governor Doctor Bentley to expand Medicaid to cover these deserving hard-working Alabamians, expand healthcare jobs, and keep community hospitals in this state from closing.

    That would be Good Medicine for Alabama!

  3. What Alabamians Need to Know about the Affordable Care Act (Jennifer Marsden)

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    The news is full of healthcare stories. What does this mean for you and the people you care about?

    First off, do you have health insurance now? If it is Medicare, Medicaid,ALL Kids or Tricare, you do not need to change anything. But if you get it through work or privately, you need to pay attention.

    The new Affordable Care Act (ACA) — sometimes referred to as ObamaCare — may affect your insurance or your tax bill and it might even save you money. Although I am not happy with the ACA, it will continue in one form or another so the more we know about it the better.

    Some employers will stop offering health insurance because the ACA offers it to everyone now. Larger employers will eventually pay an extra tax if they do this. It would be a good idea to check with your workplace if they have not let you know. However you will be able to enroll in ACA plans at the time your work insurance ends, even if this is outside the usual enrollment periods — from now until March 31 and for a shorter period at the end of 2014.

    Insurance policies that did not cover all of the required essential benefits under the law will no longer be offered. The insurance companies can continue existing policies (grandfathered policies) but it is inefficient for them to have very few people on a certain plan. The newer policies will often cost more: they are covering more health problems, and the insurance companies are still nervous about how much all the new people they expect to enroll will end up costing.

    It is uncertain if costs will go up or even down a little once the insurance companies know more in a few years. The new law does require the insurance companies pay out 80% of their charges as health care and they must refund the excess to us, so maybe you’ll see a refund next year.

    If you do not have work based health insurance, or if that coverage is expensive for you, you should check out the cost for insurance through the ACA Marketplace. Families with income between 100% and 400% of the poverty index- for one person about $12,000 to $46,000, for a couple about $15,000 to $62,000, and for a family of four about $23,000 to $94,000- may qualify for reduced cost health insurance through the ACA Marketplace.

    You will only be able to get the subsidies in the Marketplace, and they can be thousands of dollars a year for some families. Even my family would save money if we didn’t get Tricare insurance.

    Three good ways to do this quickly are these websites: “See plans before I apply” on www.healthcare.govValue Penguin’s Alabama Exchange Plan Comparison, or Kaiser Family Foundation’s subsidy calculator.

    The other aspect of the new law is the tax penalty if you choose not to get health insurance and you are eligible for a plan costing less than a certain percentage of your income. Whatever your political views, having health insurance is important. It would be a shame to need it and not have it especially if the costs were very low for you, and you have to pay an extra tax to do so.

    Gov. Bentley and many other Republican governors added an ironic twist to this story when they took advantage of the Supreme Court ruling that states can decide whether or not to expand Medicaid (to cover all adults under 133% of the poverty index). The ACA subsidies stop under 100% of the poverty index, except for some legal immigrants.

    So here in Alabama we have responsible families or single people without children, US citizens, unemployed or working at minimum wage and unable to get full time work, who do not qualify for Medicaid nor for the ACA subsidy because they make TOO LITTLE. Their neighbors making a few thousand dollars more or who are not US citizens may be getting reduced cost Marketplace insurance. I have been asking Gov. Bentley to change this as have many others in the state. If you fall into this trap let the governor know about your situation.

    I told you that people with Medicare,Tricare or Medicaid have few changes. But what about the rest of your family? Have you ever had a child or grandchild ask you for money to buy medicine or to pay for a doctor’s appointment or surgery? If you get your family members to check out how the new law affects them (and maybe even help them pay the new premiums) it might save you a lot of money, and a lot of heartache.

    With changes in health insurance and healthcare costs, possible tax penalties, and possible savings or cost increases from the new law we all want to be better informed. Please look into how the new law will affect you and your family. When it comes to your health, knowledge is the best medicine.