#medicare and employer coverage

[organicbeing]

Easy SIDE HUSTLE- EASY MONEY

Would you like to become a Fronter and work with me? I will pay you $20 per person every Friday, directly to your email with an E-gift card, that I sign up for an ACA health insurance plan. Most of our plans, if people qualify, are zero-FREE monthly premium! Easy side hustle. They must be age 18-63. No Medicare, Medicaid, VA, Tri-care or employers’ coverage. I am licensed in 27 states. There…

[coredocuments01]

Qualified Small Employer HRA Plan Document

With a Qualified Small Employer HRA Plan Document, small employers can decide what they'll contribute to their employees' health care costs, up to an annual maximum that is set by the IRS. Employees pay their provider or insurance company for their health care costs, and then submit proof of payment to be reimbursed by the QSEHRA. Reimbursement is tax-free.

[lockea]

So file this under the "why the fuck didn't this get publicized?"

TIL that in the US if you are on SSDI (which is the government disability in the US) you can return to work without losing your benefits or your income from the government. There's a few hoops to it, but this is such a game changer for my family where my spouse receives and needs social services.

Basically, if you receive disability in the US, but you think you might be able to return to work, even if you aren't sure if you'll be able to handle it, you can trial returning to work for at least 9 months WITHOUT losing your disability income or medical coverage. If you succeed in your trial employment, you may lose your payments, but you do NOT lose Medicare coverage (Medicaid is subject entirely to your income, so you may lose it). As you come off of SSDI, it's a gradual ramp down.

If you don't succeed during the trial -- there's no penalty! You tried, but it didn't work, and you lost nothing for trying.

If you do succeed during the trial but later need to stop working again, you have an expedited claim to reinstate your disability payments. What isn't said in the pamphlet, it that in the new claim you may even INCREASE what you are getting because you'll have paid more into the system (this is because social security pays out based on how much you pay into it).

This is... everything... and my spouse has been on disability since BEFORE WE STARTED DATING, yet this change was published in January of 2024. And I heard nothing about it. I'm literally so excited for my spouse right now. They've wanted to go back to work but have been terrified they won't be able to maintain it and we'll lose the medical coverage they receive. This really is a game changer for us...

You can read the policy guide here: https://www.ssa.gov/pubs/EN-05-10095.pdf

I know we're voting for two bad choices in November, but remember that one choice would have slashed payments for disability or eliminated SSDI altogether and the other very quietly made it easier for us to try and bring ourselves out of poverty without losing our medical coverage and care that we desperately need. Is it perfect? NO! But at least we have this now in addition to mandatory Cost of Living increases for SSDI every year.

[living400lbs]

"Discrimination based on body size is common and persistent in American workplaces — but it's largely left out of diversity and inclusion training, and overlooked in employment law.

Why it matters: There's an economic cost to not being thin.

"Weight stigma is present at every stage of the employment cycle," says Rebecca Puhl, a professor at the department of human development at the University of Connecticut. It's harder to get hired, promoted and paid."

From

Note also : we don't have a way to make fat people permanently thin. Medicare’s Search for Effective Obesity Treatments: Diets Are Not the Answer (PDF) by UCLA reviews 31 studies on diets and recommended that Medicare not cover diet programs because they are not effective enough to be worth Medicare coverage.  News articles summarized these findings here and here.

For more about being fat, see https://living400lbs.com

[sonicenvy]

I had another conversation with someone who didn't have health insurance today about ACA that she didn't know existed as an option. Ever since I got my first ACA plan last year after turning 26 I have been a big ACA fan because this piece of landmark legislation is the reason I have health insurance instead of being in thousands of dollars of medical debt. It bugs the ever living shit out of me whenever I see internet leftists saying things like "the ACA didn't do anything because it is not medicare for all." It really speaks to me about the privilege that these people likely have because they're not noticing the amount of monumental positive change and harm reduction that was made by the bill.

The ACA is a bill that is comprehensive, and walks, talks, and chews gum at the same time, and I think a lot of people who are either a.) too young to remember how health insurance in this country worked before the ACA or b.) have not had to get government subsidized health insurance because they have always had either their parents' insurance or employer insurance really and truly don't get it. I am obviously too young to remember how healthcare worked before the ACA because I am under 30, but I do have a mom who works in healthcare and lots of older relatives that talk about it a lot so I was pretty familiar with the concept despite this.

I am low-income, in school, and have an employer that doesn't offer me employer subsidized plans, so the ACA quickly became pretty important to me as a person with lifelong disability, higher than normal cancer predisposition and a need for lifelong psychiatric care.

Also, if you are in your 20s but under 26 and still on your parents' health insurance? Bam! You are directly benefiting from the ACA. Before the ACA you would not have been able to be on your parents insurance plan in your 20s.

Some things that the ACA did:

Made it affordable for people who are above the medicaid income limit and/or self-employed to independently purchase health insurance. Before the ACA premiums for independently purchased health plans could be $500+ for individual plans! If you were one of the many Americans who worked multiple part-time jobs that did not provide PT employees with insurance, you were basically fucked and uninsured. If you were a small business or self-employed, you were also fucked. The creation of the healthcare dot gov health insurance marketplace, which is open to anyone was a massive success of the bill, and millions of Americans benefit from it. During open enrollment (or after a specific life event such as "turned 26," or "became unemployed") a person can log on to health care dot gov, see a wide range of plans, and purchase one. The government then provides you with a premium subsidy (which is what your employer does for you if you have an employer plan) to lower the cost of the premium. Subsidies are calculated based on a person's income so people with lower incomes get higher subsidies.

Obviously there is some nuance, and a coverage gap with ACA plans for individuals who make above $60,000 (and are not a small business obtaining a group contract with an insurance company) where premiums are still very expensive because they are ineligible for the majority of the premium tax subsidy, which is a major ACA weakness, but for everyone in the $30,000-$55,000 gap and for owners of small businesses that want to offer plans for their employees, the benefits are huge. I am able to get a PPO with a low deductible, low OOP for less than $200/mo in premiums! There is exactly zero way that I would have been able to do that if I were trying to get insured pre-ACA.

Made it so that insurance companies could not discriminate against patients with so-called pre-existing conditions — so basically if you are disabled, the insurance company can no longer: a.) decline to provide you coverage or b.) increase your premiums/ reduce your plan benefits because you have a disability or get something like, oh, idk, FUCKING CANCER. Like there were people who got cancer and found out that their insurer dropped them because they did not want to pay out for expensive cancer treatment. That was a thing that was legal for health insurance companies to do before the ACA, and they fucking did that. The pre-existing conditions clause was one of the biggest benefits that has been touted since the beginning of the bill's conception and passage. Under the ACA, all health insurance companies are banned from denying plan applications for any reason, or from revoking plan coverage for any reason that isn't "patient stopped paying their premium." Made it so that children could stay on their parents' health insurance plans until they were 26 instead of being booted at 18. Made it so that all plans must provide some level of coverage for a list of specific EHBs (Essential Health Benefits) such as "emergency room care," "prenatal and pregnancy related care," "preventative care such as doctor recommended cancer screenings for patients" "office visits with general practitioners," etc.

If you have an marketplace plan or medicare/medicaid, that plan MUST provide you with contraceptives at no cost to you regardless of whether or not you have met your deductible. Democrats also wanted this to be true for all other plans, but unfortunately in 2014, whacko religious conservatives got themselves an exemption for "companies with fervently held religious beliefs against contraception" from providing this coverage in their employer subsidized plans in the bullshit case of Burwell v. Hobby Lobby Stores, Inc., which was decided by a conservative majority vote in the Supreme Court. A case which had other broad and shitty implications btw, and which is yet another example of why allowing weird conservatives to get elected to the presidency is bad for America. btw, in the original intention of the ACA they wanted to also include mandatory coverage for abortion services. Unfortunately, the Republicans (and a group of stupid pro-life dems who suck, and to my knowledge are not in congress now) torpedoed this provision despite Nancy Pelosi's best efforts and refused to pass the bill at all as long as this provision remained in it. Reason #10000000 Republicans suck.

Lots more that I'm not naming here, but I hope you get the idea. My point is that even though ACA was not a medicare for all bill, it was a landmark (and very needed) piece of healthcare reform legislation that changed a lot about the landscape of health insurance in America. Tragically, right wing and far left smearing of it has obscured the truth about the many good things that the bill did do. Was it perfect? Absolutely the fuck not! Even Obama himself admits this. What it was was a major victory against injustices in the system, and a massive piece of harm reduction legislation, and I wish that more Americans credited it for the things it did do.

Dems managed to get the bill passed with the vast majority of their highest priorities still in it despite major republic ratfuckery combined with a minority of independents and dems who sucked. Pelosi walked circles around these fuckers day and night to get this bill passed, and I for one am deeply grateful. Because of the ACA I can get the healthcare that I desperately need as a disabled person with higher than normal cancer risk. I can get my desperately needed medications and see all of my doctors because of this piece of legislation. I was able to get surgery to remove CANCER from my body becuase of this legislation, so yeah, fuck everyone going "the ACA is bad because it's not perfect medicare for all." Girl (gender neutral), I (and many other people) would not be surviving if it were not for this bill, and I for one, think that that is a whole heck of a lot better than all of us dying because y'all want to wait for perfect legislation. Harm reduction is good and is an important step on the road to bigger and better change. Universal health care has risen to more popular and broad public opinion/knowledge because the ACA passed.

Yeah, anyways this is rant about how fucking stupid anti-ACA people are. To deny the gains of meaningful healthcare reform is a clear sign of privilege, ignorance, and tunnel vision that lets perfect be the enemy of good or better.

This is also a post about a clear and obvious way that Dems are infinitely different (and better) than republicans. Voting dem is harm reduction. Not voting, voting third party or protest write in voting is a vote for republicans. And republicans??? They give exactly zero shits about anyone other than themselves. They support stupid and insane religious conservative politics, and look to fuck over the American people (and everyone else abroad) at every turn because they don't believe in helping people; their convictions are all about hate, prejudice, fearmongering, and a right-wing Christian Theocracy. They would rather see millions of people die than give dems a win, because they are spiteful and hateful. They want us to be afraid, disengaged, disorganized and fighting one another, because their ideas, convictions and beliefs are deeply unpopular, and if we organize against them, they will lose.

[dreaminginthedeepsouth]

LETTERS FROM AN AMERICAN

April 3, 2023

Heather Cox Richardson

On Saturday, April 1, the emergency measures Congress put in place to extend medical coverage at the beginning of the Covid-19 pandemic expired. This means that states can end Medicaid coverage for people who do not meet the pre-pandemic eligibility requirements, which are based primarily on income. As many as 15 million of the 85 million people covered by Medicaid could lose coverage, although most will be eligible for other coverage either through employers or through the Affordable Care Act. The 383,000 who will fall through the cracks are in the 10 states that have refused to expand Medicaid.

The pandemic prompted the United States to reverse 40 years of cutbacks to the social safety net. These cuts were prescribed by Republican politicians who argued that concentrating money upward would promote economic growth by enabling private investment in the economy. That “supply side” economic policy, they said, would expand the economy so effectively that everyone would prosper. In 2017, Republicans passed yet another tax cut, primarily for the wealthy and for corporations, to advance this policy.

As the economy fell apart during the coronavirus pandemic, though, it was clear the government must do something to shore up the tattered social safety net, and even Republicans got on board fast. On March 6, 2020, Trump signed the Coronavirus Preparedness and Response Supplemental Appropriations Act, allocating $8.3 billion to fund vaccine research and give money to states and local governments to try to stop the spread of the virus. On March 18, he signed the Families First Coronavirus Response Act, which provided food assistance, sick leave, $1 billion in unemployment insurance, and Covid testing. On the same day, the Federal Housing Administration put moratoriums on foreclosure and eviction for people with government-backed loans.

On March 27, Congress passed the Coronavirus Aid, Relief, and Economic Security Act (CARES), which appropriated $2.3 trillion, including $500 billion for companies, $349 billion for small businesses, $175 billion for hospitals, $150 billion to state and local government, $30.75 billion for schools and universities, individual one-time cash payments, and expanded unemployment benefits.

Trump signed another stimulus package on April 24, 2020, which appropriated another $484 billion. And on December 27, 2020, he signed another $900 billion stimulus and relief package.

When he took office, President Joe Biden promised to rebuild the American middle class. He and the Democratic Congress began to shift the government’s investment from shoring up the social safety net to repairing the economy. On March 19, 2021, he signed the American Rescue Plan into law, putting $1.9 trillion behind economic stimulus and relief proposals.

Biden signed the Infrastructure Investment and Jobs Law, also known as the Bipartisan infrastructure Act, on November 15, 2021, putting $1.2 trillion into so-called hard infrastructure projects: roads and bridges and broadband.

On August 9, 2022, he signed the CHIPS and Science Act, putting about $280 billion in new funding behind scientific research and the manufacturing of semiconductors. And days later, on August 16, Biden signed the Inflation Reduction Law, putting billions behind addressing climate change and energy security while also raising money to pay for new policies and to reduce the deficit by raising taxes on corporations and the wealthy, funding the Internal Revenue Service to stop cheating, and permitting Medicare to negotiate with pharmaceutical companies over drug prices.

This dramatic investment in the demand side, rather than the supply side, of the economy helped to spark record inflation, compounded by supply chain issues that created shortages and encouraged price gouging. To combat that inflation, the Federal Reserve has been raising interest rates. Numbers released Friday show that inflation cooled in February, suggesting that the Federal Reserve is seeing the downward trend it has been hoping for, although there is concern that the sudden decision of the Organization of the Petroleum Exporting Countries (OPEC) this weekend to slash production of crude oil might drive the price of oil back up, dragging prices with it.

That investment in the demand side of the economy also meant that the child poverty rate in the U.S. fell almost 30%, while food insufficiency fell by 26% in households that received the expanded child tax credit. The U.S. economy recovered faster than that of any other G7 nation after the worst of the pandemic. Wages for low-paid workers grew at their fastest rate in 40 years, with real income growing by 9%. MIddle-income workers’ wages grew by only between 2.4% and 3.9% after inflation, but that, too, was the biggest jump in 40 years. Unemployment has fallen to its lowest level since 1969, and a record 10 million people have applied to start small businesses.

This public investment in the economy has attracted billions in private-sector investment—chipmakers have planned almost $200 billion of investments in 17 states—while it has also pressured certain companies to act in the public interest: the three major insulin producers in the U.S., making up 90% of the market, have all capped prices at $35 a month.  

As the economy begins to smooth out, Biden and members of his administration are touting the benefits of investing in the economy “from the bottom up and the middle out.” They have emphasized that they are working to support unions and the rights of consumers, taking on “junk fees,” noncompete agreements, and nondisparagement clauses. After the collapse of the Silicon Valley Bank, the administration has suggested that deregulation of banking institutions went too far, and Biden has continued to push increased support for child care and health care.

A recent Associated Press–NORC poll shows that while 60% of Americans say the federal government spends too much money, they actually want increased investment in specific programs: 65% want more on education (12% want less); 63% want more on health care (16% want less); 62% want more on Social Security (7% want less); 58% want more spending on Medicare (10% want less); 53% want more on border security (23% want less); and 35% want more spending on the military (29% want less).

This puts the political parties in an odd spot. A week ago, Biden and members of the administration began barnstorming the country to highlight how their policy of “Investing in America” has been building the economy: “unleashing a manufacturing boom, helping rebuild our infrastructure and bring back supply chains, lowering costs for hardworking families, and creating jobs that don’t require a four-year degree across the country,” as the White House puts it.

Meanwhile,  the Republicans are doubling down on the idea that such investments are a waste of money, and are forcing a fight over the debt ceiling to try to slash the very programs that the administration is celebrating. Ignoring that the 2017 Trump tax cuts and spending under Trump added about 25% to the debt, they are focusing on Biden’s policies and demanding  that the government balance the budget in 10 years without raising taxes and without cutting defense, veterans benefits, Social Security, or Medicare, which would require slashing everything else by an impossible 85%, at least (some estimates say even 100% cuts wouldn’t do it).

As David Firestone put it today in the New York Times: “Cutting spending…might sound attractive to many voters until you explain what you’re actually cutting and what effect it would have.” Republicans cut taxes and then complain about deficits “but don’t want to discuss how many veterans won’t get care or whose damaged homes won’t get rebuilt or which dangerous products won’t get recalled.” Firestone noted that this disconnect is why the House Republicans cannot come up with a budget. “The details of austerity are unpopular,” Firestone notes, “and it’s easier to just issue fiery news releases.”

LETTERS FROM AN AMERICAN

HEATHER COX RICHARDSON

[conscienceincommand]

The Strike Movement in Health Care

Observations On the Political Economy of Care and the Need for Class Organization

Since the start of this year, there has been continued resistance to further attacks to public health and to the poor staffing and pay for health care workers, but in a dispersed and disunified form.

Residents and interns at Mount Sinai in New York City went on strike, nurses in California went on strike across Oakland and Berkeley went on strike, and now nurses at Rochester General Hospital in New York will likewise go on strike. Since 2020, stoppages in the health care sector have made up 50% of all workers out on strike—a fact kept out by the media monopolies just as it lauds these same “heroes.” It is necessary to assess this situation to give force and continuity to the struggle.

The balance of force between the workers in the hospitals on the one hand and the government, the labor boards, the union bosses and the hospital administration on the other is not favorable to the former in this current conjuncture. This all must be taken into account when looking at the project of restructuring being carried out by management, with layoffs and hospital closures picking up along with an unprecedented trend towards monopolization within the sector.

This trend presents workers with restructuring based on the following: mobility, division, increase in the pace and speed of work with already limited staff, and the consequence of poor health care that comes with it. This is how the bourgeois intends to economize, making us available to be moved anywhere and to once.

What will also be discussed is how opportunism, through the bosses of the health unions and the Democratic Party, has helped to promote pacifism and class reconciliation in the face of increased militarization against health care workers. Without this implicit threat of violence and persecution for striking they wouldn’t be able to maintain this crisis. There has to develop a capacity towards a General Strike which repudiates those who push conciliatory agreements and that rejects the linkage to the State, and that demands a reversal of those “reforms” that attack the working class as a whole.

THE CRISIS FACING THE HEALTH SYSTEM

There have been decades of attacks on public spending in Medicare, Medicaid and other public health insurance programs, as the State has moved to privatize public insurance as well as it’s few remaining places of provision and to assist in the monopolization and concentration of the health care industry into the smaller hands. This restructuring uses the language of “reduction of inpatient hospital care” and “reversing high utilization rates,” all representing the squeezing of the working class when they come in as patients, but also representing work-speedups on staff as the unrelenting pressure to decrease the length of stay and to work more patients relative to the total number of workers on a unit in a given shift is pushed.

There is sentimentality in discussing what health care use to be like, though there is no need to nurse the wound of yearning for something thrown temporarily as a scrap. In the post-WW2 period, U.S. imperialism became the dominant political and economic bloc. It exported capital to the oppressed countries to generate super-profits and through the over-exploitation of the workers there, was able to provide a very privileged layer of workers higher wages and superior health care plans: this was the labor aristocracy. Through the expansion of commercial, employer-based coverage for these more privileged workers, as well as through the establishment of the public insurance system, new hospitals were constructed and bed capacity was expanded. However, this period ended/continues to end, with the general rate of profit pushing downwards in spite of the surplus value extracted from the dominated countries, making it no longer possible for capital to allocate significant amounts of money to public health. This represents a break from the welfare and self-legitimization policy which characterized the imperialist state’s approach in that expansionary period (the “liberal” period).

The decrease in available beds and staffing has worsened with each and every successive economic crisis and each consolidation of a smaller health system by a larger one. This period of imperial decline has meant an ongoing, painful process of limiting care for all who can’t afford it, particularly for the lower classes. According to the American Hospital Association, the number of inpatient hospital beds declined by an extraordinary 39% between 1981 and 1999. The purpose was to raise profits by increasing ‘census’ (the number of occupied beds) while also rushing to empty those few remaining beds. It was also focused on hospitalizing only for specialized procedures, while ignoring admitting for other more general needs, even if the latter could result in more acute problems if left unattended to. But management’s goal of 90% occupancy meant that hospitals no longer had the capacity to absorb patient influx when COVID-19 first hit.

2020 in the USA will be a year never forgotten by anyone: unemployment reached close to 17 millions in just 3 weeks, with the application for unemployment insurance reaching over 10 million. This unprecedented loss of jobs as a result of the crisis in overproduction, and years of disinvestment by the government from health care, came with the introduction the novel COVID-19 virus, which served as an element of destruction of the productive forces as a biological weapon of the ruling class. How did the virus serve the bourgeoisie in this way? Faced with capitalism’s overproduction crisis, where ever increasing portions of the population are surplus to capital, unable to be used as a workforce reserve or as consumers, permitted the virus to be weaponized to eliminate that part of the population. Indeed, by the “end” of the COVID-19 emergency order, 2.6 million more workers had “disappeared” from the labor market.

With even the capitalist media unable to ignore the death toll and the struggles of health care workers as they protested the scarcity of PPE on their units, the State was forced to make concessions to ameliorate the situation by temporarily suspending the usual medical-industrial and insurance rules of patient billing and reimbursement, and also provided subsidies to the for-profit hospitals and clinics to make up for their losses in suspending such rules. The waiving of all sorts of rules boosted coverage for patients, and was paid for with CARES Act funding and advanced Medicare payments.

However, this peace came to an end as the economy was declared to be entering a period of relative stability—and with that stability, these subsidies ended. By 2022 hospitals came complaining to Congress – as inflationary pressures started to pick up, there was a 184.57% loss in their operating budgets. In a report by Kaufman Hall they found that the median operating margins for about 900 large hospitals in the first half of that year were negative and lower than prior years. Kaiser Permanente in California reported a loss of $4.5 billion, and UPMC in Pennsylvania reported that they had lost $916 million. The largest cost in that period: labor costs and continued occupancy of beds In health care, while the provision of services is done privately in “nonprofit” hospitals and revenues are sopped up privately as well, they are dependent on increased State collaboration and support to enact their plans of squeezing more from workers and patients.

Pressured by this and needing to maintain the maximum profit for their health care monopolies, the imperialist State, through their corporativist levers within the health care industry, has now decided to suspend reforms that are now too costly for the capitalists. What was permitted to exist for the 26 months that the COVID emergency order was in place was to be now over. What forms does this new period of attacks appear as?

Hastening the general move from the hospital as a place where people are diagnosed or expected to recover -> to skilled nursing, inpatient acute rehab and “long term care hospital” facilities instead

They are introducing greater mobility, job combinations, speed ups, and increased intensity of work as a response to lower staffing, and are putting in hiring freezes

The greater use of military and police management of strikes in partnership with union leadership

“DEHOSPITALIZATION”

The entire discussion in medical policy circles about “length of stay” promotes the “dehospitalization” status quo as it stands and is pushed by hospital administration—it is a form of rationalization of health care labor, seeking to not just catalog all the motions of hospital workers and timing them to devise the most “efficient” flow of motion possible, but to also diminish preoperative and recuperative days that patients have. If, through straining existing staff on a unit, it is possible for 4 RNs and 2 nursing assistants to have 24 patients and discharge all of them under 10 days, then that is all the floor will have, and it will be management’s expectation that within that given abstract period of time, such an allocation of labor will produce that result.

The previous model as conceived in a hospitalization period for surgery patients would consist of 1) a period prior to intervention which consisted of diagnostic investigation; 2) the period of the intervention itself; 3) the post-operative period in which the patient was rehabilitated and then discharged. Today the 1) and 3) period are increasingly offloaded to “med-express” clinics and nursing facilities for each category, respectively. The diversion from this old model can be seen with how coronary artery bypass grafting (CABG) procedures are done. The period of recovery from this procedure use to be a week or more, today nurses, therapists and social workers document and track a 3 day post-operative period, with the expectation that on day 3 or 4 the patient will have their estimated discharge date.

The much vaunted “preventive health” policies which the government promotes has translated into a greater restriction of the already deplorable levels of assistance with which workers can access outside of the hospital. Corresponding to the reduction in the number of inpatient admissions and the worsening of the already precarious state of patient services has been a progressive reduction in employed staff and requalification (with all the effects this entails for us) in a forced march of hospital workers who can be utilized in the most functional way.

Reducing the “LOS” (Length of Stay) has now been a key indices judging the productivity of workers in health systems as they enlarge to buy out more hospitals and clinics.

MOBILITY AND DIVISION

Mobility can be seen as an instrument of the bourgeoisie in dividing and dismembering our workplace to make for the most efficient use of our labor power for the objectives of our bosses. When used here it is not just meaning to literally be ‘mobile’, to move, it means making the labor force more elastic and to give it multiple duties to do at once. Mobility is used because they will never want to increase the total number of workers, but want to make the most efficient use of the limited number already employed.

This is done most popularly, internally, through deciding to “float” nurses to other units within a given shift, even if they are not familiar with the patients on that unit. They are rushed to fill the plugs of an increasingly understaffed hospital. This is done by mandating overtime which is done, again, to similarly not have to hire more. Nurses are finding themselves working in units where the amount of assistance required by those with serious illness and in need of treatment is ever increasing while the workforce is cut closer to closer to the bone. Consequently, the constant physical effort, from the perspective of worker’s own health, overtime results in occupational illnesses. 

In fact, this means of mobility (the use of an enormous mass of overtime hours) is a major method of mobility. Even in “unionized” hospitals their contracts do not enforce maximum limits and instead introduce provisions on the possibility of forcing workers to perform obligatory overtime, further enabling administrators to cover the chronic personal deficiency in each unit without having to hire even one more proletarian. Who knows how many new jobs could be generated with the amount of overtime hours nurses work!

Another method of mobility is the use of nursing assistants and nursing students. If clinical coordinators who compile shift schedules know that trainees or less trained staff are available on a given day, they immediately busy themselves letting other managers know that nurses have “excess rooms.” These younger workers have a precarity in their role, which is expressed in their selection to do the more physical work of direct care (assisting in bathing patients, taking them to the bathroom, helping patients transfer from bed to seat, etc), in the potential of expulsion from school if they display defiance or disagree to do certain tasks.

Likewise, for environmental services workers, the precarious positions they find themselves in as the rush to empty the hospital takes place is very apparent in their limited staffing and rush to fill rooms: health care workers know very well what it means to do wound care and place a central line in a room that has not been appropriately disinfected! The savings of the hospital are being made at all of our expense. This concerns not only hospital workers but also that of all the workers, particularly those inactive ones who are permanently disabled or retired, who are taken ill. In the precarious hygienic situation created by management, they end of contracting other illnesses. The cry of “length of stay” is made into a self-fulfilling prophecy – “because of our drive to empty beds and cut staff, we can’t keep our facilities clean enough, so you are endangered just by staying here!”

This is also done by dividing the workplace— hiring travelers and per diem RNs for temporary periods. While this use to be lucrative (and in some areas, still is) the disappearance of subsidies has resulted in many travel nurses having their pay with their new contracts reduced significantly. It is done by the hiring of Licensed Practical Nurses (LPNs) and Nursing Assistants and re-assigning/combining their roles to be more expansive, while RNs are increasingly entering clinical information to EPIC on computers while retaining the need to follow their patients closely.  These divisions within the hospital professionally create discord and are attempts to foreclose on unity between health care workers, when some are paid greatly more in spite of doing the same work as others.

Within hospitals and across the health care system itself there is an aggravation of the differences in pay and privileges as a result of “dehospitalization” creating different tiers in the reproductive chain outside of hospitals as well. In nursing facilities and inpatient rehab, as well as home health and personal care agencies, where patients convalesce for longer periods at and more direct care occurs, there are often less skilled and thus lower paid workers. It is coincidentally here where the aged and highest acuity patients are also stored, who invariably are treated like objects in a storagehouse in no large part because of the deliberate disinvestment from this tier and the chronic cutting of staff from here as a result of the lower wages. While the largest health systems are where there has been the largest health care strikes in the last year, in a majority of states in the USA, the greatest number of health care workers on strike on a state-by-state level have been at nursing homes.

MILITARIZATION OF HEALTH CARE

The activation of the National Guard and Defense of Defense (DoD) for major strikes has ramped up to an alarming level, with unprecedented coordination among companies and the State to ensure that armed scabs are safely brought in. Under the guise of “disaster readiness” during COVID-19, militarization has been the decisive weapon for the imposition of the project of restructuring that we’ve described above. To understand how it has become standard practice and permeated the whole of the sector, means to take account of a transformed situation. The margins by which opportunists have deluded themselves that the interests of the proletariat can be advanced, that “democratic spaces” can be used, has been transformed or wiped out by the ongoing crisis—and the deployment of armed forces is proof of this.

2020-2022 in particular saw the development of a strong movement determined to conquer back much of what was lost over the years, with the use of police detectives, Pinkertons (private security), and National Guardsmen representing the bourgeois apparatus consolidating itself around a project of political and physical circumvention of health care workers and their organization. Yet even among “socialists” there isn’t a single action (beyond a strongly worded statement or complaint) shouted at the Democratic and “progressive” governors who have often been the face of this project.

All the most advanced proletarians in the health care sector must act decisively to come to terms with this reality, if they want to be capable of facilitating the rebirth and the renewal of the struggle against restructuring under the prevailing conditions. It is necessary to build a stable organization of struggle, protected as much as possible from the blows of repression, which implements--from within the unions and from without—a worker program by all means at the level of the current confrontation and within its relations of force. This is not about adventurist posturing, or organizing the struggle around certain objectives without adequately preparing the workers for the consequences of implementing those objectives, but of building organization which can impose the proletariat’s right to health care.

TOWARDS CLASS ORGANIZATION

There must be formed proletarian organization which reasserts the need for unions and other health organizations which are class conscious and combative—struggle committees (SCs) would be this form. They could serve as a point and network of discussion (investigation, concrete analysis), of organization and of struggle around the content of a workers’ program that seeks to settle accounts with the ongoing process of restructuring not just locally (through its application in the many hospitals we work in), but nationally on a political stage. These can serve the function of what is needed in each workplace—all of which are being subjected to the “reforms” described above.

There are many demands that can be taken up in this period which can be turned into slogans: Fight Mobility, Fight Mandated Overtime, Tools Used to Intensify Exploitation and Maintain the Hiring Freeze! Equal Pay for Equal Work-Fight the Wage Differentiation Policy!

Fight against the miserable enforcers of anti-proletarian policies, who have taken raises and management positions to act as the lapdogs of management as they implement the capitalist directives for restructuring health care. They are part of a capillary network of command and control in the hospitals.

Fight against surveillance and systematic checks to our timecards for the slightest infractions of being seconds to a minute over, fight the “real-time tracking systems,” which serve not to keep patients safe but to harass and harm the “dangerous” elements on our floor who don’t bow down before the exploitation of the company.

Build up the ability to deal heavy blows against the command control of the apparatus, build the maximum extent of strength and unity through the front organizations of health care workers (the revolutionary unions and committees).

Build links with all democratic and communist militants in SCs countrywide, until replicated in every hospital and able to breathe life into a new front nationally that can coordinate larger struggles. Relentlessly fight and regain life and form with a strategic perspective in mind, doing political education and applying it to planning. Through building strength, make the objectives of a new program that aims to defend ourselves and our patients from the for-profit health care that stems from the old society around us, with it’s repulsive relations of production, of production based on exchange value. Impose the proletarian right to health care.

[mariacallous]

The COVID-19 pandemic revealed tragic shortcomings in the American public health system, but it also posed a major challenge to our social safety net programs, from Medicare and Medicaid to Unemployment Insurance to Social Security, and more.

A new report by a working group that we co-chaired at the National Academy of Social Insurance indicates that the safety net was surprisingly resilient in some areas, but that the pandemic also reinforced existing inequalities and revealed system shortcomings. To be ready for the next crisis, America should act now to streamline program administration, increase responsiveness, and reduce disparities.

Despite the closing of many government offices, dedicated workers ensured that programs remained operational, albeit with disruptions and delays. Social Security and Unemployment Insurance benefits continued to be paid, and Medicare and Medicaid continued to finance health care.

Surprisingly, COVID did only limited financial damage to Social Security and Medicare. Because the economic recovery was unexpectedly fast, the dip in payroll taxes to fund these programs was briefer and shallower—and program spending was lower—than projected. COVID reinforced the downward trend in claims for Social Security Disability Insurance benefits, as office closures hindered new applications. Medicare spending also fell, as patients delayed non-urgent care. Despite the spike in COVID-related admissions, overall hospital admissions dropped 30%.

Beyond the existing safety net programs, Congress took further actions to mitigate the financial and health calamity. It increased and extended unemployment benefits and provided sizable lump-sum benefits to most Americans. Together with the Child Tax Credit (now expired) and increases in Supplemental Nutritional Assistance Program benefits, these changes helped cut poverty in 2021 by 15% overall and by 46% for children. Changes in Workers’ Compensation provided income assistance and health insurance coverage. Eviction moratoriums mitigated the risk of homelessness for many. Fears that such generous assistance would undermine workers’ incentive to seek new jobs proved largely unfounded, as employment rebounded faster than anticipated.

Congress also extended health care coverage, increasing the share of Medicaid costs borne by the federal government for states that maintained enrollment and liberalizing refundable tax credits for health insurance exchange plans. Between these provisions and the faster-than-expected rebounding of employment-based health insurance, the proportion of non-elderly Americans without insurance in 2021 fell to 10.3%, a historic low. Because Medicare and Medicaid typically pay providers less than private insurers, Congress shored up hospital finances by creating a fund to offset the influx of COVID patients covered by these programs (though the fund was not particularly well targeted to struggling hospitals).

Overall, our social insurance programs did what they were supposed to—though, without congressionally enacted changes, there would have been much greater financial distress. Although the targeting of benefits to those most in need was imperfect, enough cash and in-kind assistance went out to sustain consumer demand, supporting a U.S. economic recovery that was faster than that of many other countries.

Despite these successes, serious failures meant that millions of people suffered much more dire financial as well as health consequences than they might have. The failures of our public health system—from lack of sophisticated monitoring, data, and infrastructure supporting rapid deployment of resources to shortages of supplies addressing foreseeable needs—are well documented, and were major contributors to the shocking 1.3 million deaths due to COVID in the U.S. The death rate of Medicare beneficiaries in nursing homes was thirteen times that of Medicare beneficiaries living elsewhere, and disproportionately higher for African Americans and Hispanics than for whites.

Our social insurance infrastructure was also woefully lacking—particularly the management of unemployment benefits. Archaic computer systems, lack of data and overworked staffs resulted in delays in the delivery of aid to the tsunami of new applicants. Confusion about eligibility rules and lack of information (such as for those not filing tax claims) led to many not receiving benefits for which they were eligible. Insufficient data also meant that aid could not be targeted based on past earnings or economic hardship. Thus, while congressional actions helped mitigate financial hardship, they were often poorly timed and poorly targeted.

The pandemic illustrated once again that those who are least well protected against adverse events in normal times suffer the most during emergencies. Those from low-income or underserved areas suffered disproportionately, as did those from racial and ethnic minority groups. There were not only unconscionable disparities in mortality and adverse health outcomes, but also in access to financial support.

The National Academy of Social Insurance report not only documents the performance of the system under COVID but presents practical and practicable ways to prepare for future health (or economic, environmental or geopolitical) emergencies.

Many of the crucial steps undertaken by Congress could be implemented in a more streamlined and effective way if automatic triggers were enacted now, such as additional Medicaid financing for states that maintain enrollment during emergencies or extended unemployment insurance benefits. Other temporary measures could be made permanent, such as changing regulations about telemedicine or scope-of-practice restrictions.

All of these options could be better supported by modernized infrastructure to allow efficient program administration and the collection of data to allow better benefit targeting. The digital divide further amplified health and access disparities during shut-downs. Adequate internet communication is an essential element of both health and safety net systems.

Our social insurance programs provide a vital safety net at all times but never more crucially than during national emergencies. COVID revealed how very important these programs are to health and economic survival—and also ways that we can shore them up before the next emergency arrives. It behooves us to do so.

[freeworldallahexecutivembaclass]

50 Cent executive MBA Class Omari Hardwick style class it's a style and look GQ man of the year and time magazine man of the year New York City man of the year and America's man of the year Allen Henry aka Free World 🌎 2019 , 2020 , 2021 , 2022 and again 2023 and did I mention I won the Nobel memorial prizes twice 2019 and 2021 for economic sciences and the Nobel peace prize 🏆 with good company like Martin Luther King JR he won his back then I won it a couple years ago and I'm still living and yeah Martin Luther King Jr is my role model he has a class of excellence politics and style about him that I love I champion MLK they don't give him enough props

50 Cent executive MBA Class Omari Hardwick style class it's a style and look

Suits and ties

The town go back to 50 Cent and I get a piece of the action ( New York City ) As an MBA conducting my business in New York the 16th captain and current captain of New York City I made NY Yankees history , thank you .

And I'm going for riverside drive

The new ferry Sports centurion museum and factories for manufacturing and production .

And I'll take Manhattan at least the great parts of it to conduct business as a mover and shaker And Queens business centers .

Then I also am going global with my business and music and betterment movement .

In return I draw up politics to fix up the Bronx , Brooklyn , Harlem , Staten Island and Queens

Politics - ✓Living wages minimum wage increase and tax cuts ✓Job safety and secure in occupation act ✓Fair chance act to compete for jobs ✓Increased employment opportunities in New York City for the formerly incarcerated and full time and permanent employment for people on human resources administration public assistance Into full stable employment with union protection securing their job and future .

New York City accomplishments

I got hotels for the homeless in New York City 2021

I got Amazon workers their union contract

I got Starbucks workers their union contract

I got the minimum wage increased from $ 11 dollars an hour to $ 15 dollars to $ 17 dollars an hour

I got the fair chance to compete for a job act of 2019 in New York City and California hopefully other cities and countries are going to follow suit

I legalized marijuana in New York City

I cleaned up fox square in Brooklyn , NY

Free college education in New York City

Free gym membership for people on Medicare

Citi bikes for New Yorkers

Benefit monetary assistance increase for snap and cash assistance recipients

Rikers Island tablet program podcasts and video games for inmates in jail to help stop crime violent crime in prison and to help rehabilitate the guy or woman and stop the back and forth of them going to jail . The tablet have podcasts and programs for Job Search legal research and books to read to help them become better citizens in the free society .

Laws I'm proposing

Job Safety and secure act - 2022

Fair banking act - 2022

Retirement investment plan for employees IRA act - 2022

Ready , willing and able Expansive territory act - 2023

Riverside drive Expansion project act - 2023

The new ferry from New Jersey to New York City - 2023

School sports culture expansion Act Copperas Cove , Texas

Rikers Island schooling expansion act Added on Basic education classes on Rikers Island on the tablet , college programs on the program , online school on the Tablet . -2023

NYCHA ( New York City Housing projects ) plans and ideas for improvement

The New Trench town rock - 2021 , 2022 , 2023

And many other pitches and proposals rebuilding the workforce , wages and structure of New York city and cities like New York .

Next order of business : My Plans for infrastructure in a utopian society hotels jobs pay raise on citizens paycheck from 15 $ - 17 $ dollars minimum wage pay to 19$ dollars to 20$ dollars an hour to better provide for all costs emergencies uncovered insurance payments due to partial health care coverage and full union membership granted to employees of any company free education grants and school loans payment plans

Pay raise for school teachers in every city at junior high school , high school and elementary school level since they are stewards of our children's future .

Pay raise for civil service workers and Civil service exams made and updated daily to the public , school crossing guards , correction officers , supervisors , probation officers , construction site supervisors .

Pay raise for day care workers

Free day care services for temporarily unemployed mothers and fathers

Pay raise for city fire fighters and police officers .

Job contractors fulfilling contracts with back to work public assistance programs that train and employ job candidates without their high school diploma or GED and granting them full employment with full medical and medicare coverage union membership and back to school Acces Vocational rehabilitation counseling and restoration of financial aid assistance for non violent crimes like drug sellers and abusers to stop recidivism to prison and to cure an addiction to a habit of committing perpetual crimes thus creating repeat offenders .

Jobs moving back to inner cities through the effort of study and research groups from urban planning courses from their neighboring colleges .

Tax abatement and financial incentives and business incentives and tax breaks .

Joe Biden and vice president Kamala Harris should include this law into all of their plan for cleaning up America I'm glad to see it go beyond New York City and other counties in New York I want to share this honor with author Michelle Alexander who I did my research from her book about mass incarceration of the black and Latino community and the political office and my friends that help put this law in place I reached out to hopefully stop the recidivism to prison and hopefully to help some of my friends and people that go back and forth to jail because they couldn't get a job due to the felonies on their record I recommend a certificate of relief of disabilities to all people returning to society if they haven't given you one go get it from your county's or borough courthouse it works wonders .

Next order of business : Tax cuts to help the everyday person keep more of their check in their pockets cut the tax rates in New York City by 4 percent I see it as New York State taxes % 8.82 to % 4 percent and business tax cuts to create more jobs Proposal For a Wage increase of $ 22 dollars an hour Including : Fire safety directors Security guards Librarians Fed Ex workers UPS workers Ready Willing and able with free vocational grants from access vr programs they should hire vocational rehabilitation counselors and job developers finding permanent housing and permanent job placement after the clients training Stock Clerks and cashier's at major stores like Gristedes , C Town , met foods , Burlington coat factory wage increase for all warehousing and factory workers jack pallet and forklift training for people with no experience and a starting salary at $ 17 - 19 $ dollars an hour and it increase with more time on the job how about the first year at that base salary of $ 17 - 19 $ dollars and on the even of that year the employee gets an raise of $ 2 dollars more on their check and other financial incentives as cash allocation from their check for newly place employee mutual fund packages besides with other benefits that said company is offering this helps to place that company on the stock market grant their employees preferred stock options from their company that they work for at that current moment and because of the huge huge employee buy in it is like the employers are investing in their employees and their stores and company .

Educational requirements for jobs posted is less than a high school diploma but the job candidate has to be in a vocational program or GED preparation course half or full time hours .

Civil service jobs and exams posted weekly .

Sales professional salary plus commission on sales and stock options for mutual funds packages as bonuses with an wage increase to $ 19 dollars to $ 21 dollars an hour .

Newly added benefits to a job description benefits an employer on jobs posted give to their employees an employer get to hold back cash or take money out of an employees check to put towards a mutual funds stock fund option to help that client make more money as a second job the municipals funds and stock and funds and stock and then you gotta get hedge funds option packaged in to help the employees money make more money for them talk about overtime whew and at the same time that local market and store owner can put his company on the stock market and give out public shares thus in the end making it a good investment a regular place of shopping in a family like environment it is like getting to know your deli clerk , butcher , bakery attendant again only this time you are making money with the people you are spending money with Think about it that in turns build better communities better stores customer relationships safer neighborhoods and the beautifying of economically depressed environments more money for your kids college tuition school supplies newer roads being built leading to and from better neighborhoods and businesses and this is a future that we all as fellow New Yorkers can build together .

New Infrastructure plans

Widening sidewalks for more bikes and outdoor cafes - for the Harlem and Brooklyn New York City's 🏙️🌆 all over the world .

Reducing CO2 emissions

Clean up riverbank and riverside and create stores and entertainment on the water - using waste water management and sewage clean up and stopping illegal toxic poisons dumping in the water .

Repair tunnels , bridges and roads and rerouting towards businesses .

The waterside of any community is the gathering point for recreation .

Create projects to treat 100 % waste water and all illegal dumping and teach people how to care about their rivers - clean up the rivers and water in Brazil .

Conservation create more parks out of swamp lands did you know Central Park 🏞️ in New York City was once a swamp .

Emperor Dom Pedro abolished slavery in Brazil .

Brazil city inner city neighborhoods the slums a place of great fun and adventures - put in place street lamps , electricity , internet , sewage and running water .

Follow Tokyo model - Cleanliness of streets and cleanliness of public transportation , extensive railroads , largest economy , rich soil .

Japan leads in global transition to automation , electric cars and humanoids robots .

Create programmed robots as student tutors with programmed subjects in library centers in group discussion rooms .

Own Hydrogen stations like it is a gas station ⛽

Tokyo is a technology super power of inventions .

Research Tokyo bay aqueduct deal traffic eased and congestion eased by 11 billion dollars mega project that was 1/3 bridges and 2/3 tunnels created out of dry lands .

Japan runs on a seafood diet Urban rail network 40 million train riders a day everyday .

Former trash lands being converted to parks and will even host the Olympics .

Need trucks that drive by each community that sprays an air borne vaccine to help people's well being and longevity of their lives , cutting nicotine habits and controls appetite .

London and New York command center for global economy .

Hydrogen powered vehicles hydrogen oxygen electricity water .

Tokyo most advanced major city with automation and robots that help people regardless of age and nationality .

Need robots that teach Feng shu , tai chi , Kung Fu , Robot doctors , nurses for mental health and surgeons .

Running water and water pumps for Mexico city tap water for each house in Mexico city 🏙️ .

Funding for water fixes .

Study Croton aqueduct - water distribution system cures housing areas with poor sanitation and no running water also cures poor hygiene practices .

Women suffrage and worker's rights in those countries are important .

Water for Bangledash ( Dhaka ) water distribution systems water pumps and clean running water so that the people can cook clean and drink safe healthy water while also having water to wash their clothes

Cleaning the garbage islands in River bank estimated $ 10 - $ 20 million dollar job of cleaning up Riverside drive water from that stink smell and the debris and garbage Bottles

Straws

Plastic bags Pipes

Bandages

Toys

Pollution

And I propose The City of New York build the new ferry Riverboat for harbor crossing to New Jersey be placed on Riverside Drive it Save commuters time and money on transportation from and to New York City creation of Job opportunities , New architecture of communities in New York city restoration of environmentally depressed neighbors like the Grand Concourse neighborhood in the Bronx , New York City thus bringing more jobs to that neighborhood and creating economic vitality for all New Yorkers . New electric trains and platforms on the outside train on 149th street on Grand Concourse in Bronx , New York City .

Pimp my ride TV Show Car dealership on river bank

Environmental impact report : Production and manufacturing factories on Riverbank Harlem Riverside drive bring if not millions of Jobs back to New Yorkers but definitely thousands of jobs back to the city of New York Car museum

ESPN sports center Sports centurion museum celebrating 100 years and better of sports museum with pictures and memorabilia from baseball ⚾ 🏀 , basketball , soccer ⚽ , cricket , rugby , 🏈 football , NASCAR car racing , 🐴 Horse racing And maybe the Olympics on Riverbank Factory and car lot on Riverside Drive in Harlem

New York City Factory : Products in manufacturing ( making the products ) Warehouse 1_ Post cereal Honey bunches of oats , Kelloggs corn flakes cereal Warehouse 2_ Car manufacturing Car parts Warehouse 3_ Bread factory Warehouse 4_ Electronics appliances factory Warehouse 5_ Boat 🚢 manufacturing facility Warehouse 6_ 👟 Sneaker factory

Warehouse 7_ Railroad train track factory

This is for young mothers without any help in the house feed your babies good food 🥝 so they grow up and play sports and make their mom proud 🪴. It is never too late for your education learn with your kids use free daycare services and self learn any skills you need to increase your value in the employment market .

[thenewwei]

Here are some thoughts on Germany/Italy/Austria and my European trip generally:

In general, I had a great time. Everyone I met was friendly, and I did make new friendships. Hopefully they’ll last.

Here are some questions and answers, from good to not so good:

Do you like Europeans?

Of course, I love everybody! Whether they love me back or not, depends.

Do Americans travel in Europe?

Yeah, they do. I met quite a few Americans on my travels in Europe, and most accents I heard were American.

Is the system better here?

I would say in general, it is. Food and general costs are pretty much the same as in the US, gas is a little higher (I actually thought it was significantly lower until I realized it was in liters!), rent is usually lower than NYC but like everywhere it depends where you are.

But your food costs are in-built, there’s no extra sales tax or tips. Universal health care, longer vacations and not paying for an active military helps a lot. I doubt there are too many law suits in Europe either. It was ethnically diverse everywhere I went, even in smaller cities I could get Thai, Vietnamese food, whatever. Nowhere is the quality as good as NYC, but they have it.

Train strikes are common, there was another one in Germany on this trip and it cost me an extra night of rent and I had to change my plans. Public transportation is easy to navigate, though it’s generally more expensive than NYC. Can’t say anything about tolls, parking etc.

And despite staying in plenty of “poor” neighborhoods, I never really felt unsafe, except for once in Turin, and I just avoided that area.

The one major positive we have is texting. Texting is expensive in Europe, and almost everyone here uses WhatsApp (ironically, an American company). Almost everyone texts in America if you have a smartphone, it’s usually included.

Do Europeans know anything about Americans, and what are misperceptions?

Their knowledge is nearly totally based on anti-American propaganda and movies/Netlix shows (almost all of which are set amongst wealthy Californians). They know basics, usually negative, but rarely specifics.

The first question I was asked by multiple Europeans (and an Australian) when I mentioned I was from NYC was the “homeless” problem based on the belief that homeless shelters are either expensive or non-existent. Homeless shelters are free in NYC, last I checked, though you do need to create a plan with a case worker to ultimately get out of one. We also have Section 8 housing, rent control, Mitchell-Lama apartments, a rent moratorium during the pandemic and a million other programs to assist with admittedly crazy housing costs.

Yes, we have had a significant homeless problem since the pandemic, but that was mainly due to closed mental hospitals during the De Blasio admin—it wasn’t a significant issue in the 20-25 years before the pandemic, though we did always have some homeless people, including entire families and children—I mean it’s a city of 8-10 million people, some people will always fall through the cracks.

Granted, the average NYer doesn’t know anything about these issues either, but it’s significant that almost every person, mostly educated young people, mentioned this issue to me as soon as I said I was from NYC. Also, I saw plenty of homeless people in European cities, especially Salzburg, even as it was claimed that wasn’t an issue here.

The real issue in NYC now is crime, gang shootings, crazy people pushing people in front of train tracks and punching people in the face, and house fires, but no one mentioned those to me. Also not significant issues before the pandemic, though they’ve always been there to an extent.

The other constantly mentioned issue is the lack of universal health care. True, the system is horrible on multiple levels and ideally should be made universal and reformed, but I have comprehensive coverage through my employer, and most people do. Poor people have Medicaid, seniors have Medicare, the disabled have Social Security disability. A terrible, greed-based system for sure that could put you in the hole if you have to individually buy coverage, but it’s also not like no one has coverage.

The border/migrant crisis—complex for sure, but their general perception of an American is a tall muscular white guy with an AK-47 shooting migrants at the border, and that’s not exactly true. But then, most Americans don’t know anything about the complexities of our immigration system, whether legal or otherwise.

Gun/school shootings. Of course true and horrible, though there was a shooting in Belgrade, Serbia, while I was there, and there have been shootings in Germany and Norway, I think. There are also riots all the time in France. Also almost all shootings in NYC occur using illegal guns. But yeah, there’s no other country on Earth where mass shootings happen regularly, yet we’re politically powerless to stop it (assault weapons, etc.).

Americans pay low taxes. Scandinavians always mention their 32% tax rate that pays for everything. I pay nearly 50% in NYC and I don’t even make that much. Or get that much. But most of my salary is paid through taxes, so I’m not complaining. But tax rates depend on where you are in the USA. Sales taxes are added everywhere and property taxes are a killer too.

Our tax dollars also help defend Europe’s security, and nearly all of Germany’s security. Things are easier when you don’t have to pay for bombs.

Almost no one knows that the USA is one of the most ethnically, culturally and linguistically diverse nations on Earth, a nation of immigrants, and the most charitable people too, by far. In NYC, more than 800 languages are spoken, and we have tons of social programs. Apparently, Americans are Bible-toting idiots who can only speak English, and badly. Plus we hate immigrants.

Everyone hates America, but no has any particularly logical or fact-based reason for it.

Do Europeans love India and Indians?

Yes, they do. The trend of wanting me to identify with India over America continued on this trip.

Are Europeans socialists? Are Europeans nationalists?

I noted on my last trip in 2015 that nearly all Europeans I met worked in marketing of some type (among Germans there were also engineers and academics/potential academics). This time, I mostly met people in various teaching-based professions, or at least people who are in and out of it.

What they do constantly market are their countries. Their number one goal is to sell their country to you so you will hopefully move there. I mean I don’t know many Americans who are constantly pitching America. Maybe because we’re constantly told by our media how horrible our country is, but more likely it’s because we’re a country that values individualism over patriotism.

European women are almost universally like this, men are definitely more critical. One German waiter in Augsburg told me he thought Germany was “hopeless” because Germans aren’t welcoming. He contrasted this with Ireland, where he apparently visited, and where they will welcome you into their homes and give you tea. He was happy because I was the first person to speak English to him in weeks. I certainly do not think Germany is hopeless, but it’s another example of how European men tend to be more negative and realistic about their countries, and less wedded to them, culturally and otherwise.

Germans will ghost you

Yes, it’s not just an American phenomenon. I was ghosted by a couple of women who I’ve corresponded with for years and thought were my friends/acquaintances who would at least meet me or show me around their respective cities while I was in town. Nothing romantic or anything. I think ghosting is disrespectful and dishonorable, but I’m pretty old school, and it is what it is, moving on. But I wasted a couple of days this way when I could have done other things or gone to other places. Whatever.

Will you be back?

Probably not so soon, though I do love both Berlin and Milan. I would definitely go back to both locations, and I do want to explore more of northern Italy specifically, esp. Bologna and cities around it, and the beach towns around Genoa. I realize I definitely prefer the urban though. I had an allergic reaction in Italy and a cold in Germany. Next year, probably back to the Greek Islands and Turkey/Istanbul.

[kp777]

By Jake Johnson

Common Dreams

Feb. 27, 2023

A new analysis released Monday shows that insurance giants are benefiting hugely from the accelerating privatization of Medicare and Medicaid, which for-profit companies have infiltrated via government programs such as Medicare Advantage.

According to the report from Wendell Potter, a former insurance executive who now advocates for systemic healthcare reform, government programs are now the source of roughly 90% of the health plan revenues of Humana, Centene, and Molina.

Over the past decade, Potter found, the seven top for-profit insurance companies in the U.S.—the three mentioned above plus UnitedHealth, Cigna, CVS/Aetna, and Elevance—have seen their combined revenues from taxpayer-backed programs soar by 500%, reaching $577 billion in 2022 compared to $116.3 billion in 2012.

"The big insurers now manage most states' Medicaid programs—and make billions of dollars for shareholders doing so—but most of the insurers have found that selling their privately operated Medicare replacement plans is even more financially rewarding for their shareholders," Potter wrote. "In addition to their focus on Medicare and Medicaid, the companies also profit from the generous subsidies the government pays insurers to reduce the premiums they charge individuals and families who do not qualify for either Medicare or Medicaid or who work for an employer that does not offer subsidized coverage."

Potter noted that the top insurance giants, a group he dubbed the Big Seven, now control more than 70% of the Medicare Advantage market, which has grown rapidly in recent years. According to the Kaiser Family Foundation, more than 28 million people were enrolled in a privately run Medicare Advantage plan last year—nearly half of the Medicare-eligible population.

An ardent critic of Medicare Advantage, Potter said in an interview with The American Prospect on Monday that the program "is a big contributor to the excessive spending" in Medicare.

"It needs to be ended," Potter, executive director of the Center for Health and Democracy, said of Medicare Advantage, whose major players frequently overbill the federal government and deny patients necessary care. The program is run by private insurers with government money.

Read more.

[11bountyhunters]

During World War II, when wage and price controls were in effect, employers added health coverage as a benefit in lieu of salary increases, and in 1954 their contributions to health plans were determined untaxable income for their employees. For this basic reason, even today—three generations later—most Americans’ health insurance is tied to their place of employment.

- Chapter 2 of The Law of Healthcare Administration, 9th edition

The paragraph goes on to say that because of this, it’s next to impossible to change the system because it works! And people are resistant to change.

So when I said we needed to gut our healthcare system in order to replace it with something better, I suppose it was naive of me to think we just needed to gut Medicare and Medicaid. No, we need to completely rip out everything and start again from the ground up.

[jyoti-dutta]

What is health insurance

Health insurance is a type of insurance that provides coverage for medical and healthcare expenses. It works by paying for some or all of the costs associated with healthcare services, including doctor's visits, hospitalizations, prescription drugs, and medical procedures. In exchange for regular premium payments, health insurance policies help to protect individuals and families from the high costs of medical care. There are several types of health insurance plans available, including employer-sponsored plans, individual plans, and government-sponsored plans such as Medicare and Medicaid. Different plans offer different levels of coverage, and may require different out-of-pocket costs such as deductibles, copays, and coinsurance.

[claeysgroup]

Your Best Medicare Option: Supplement, Advantage Plan, or Employer Coverage? How would you feel if your insurance agent told you he has a medical insurance plan for you that is an 80 / 20 plan (meaning, you just pay 20% of the medical costs) and has a monthly premium of only $164.90? In today’s market, you would consider that a good deal, right? And you might feel that having to pay only 20% of your future medical costs is a good risk for that premium. Medical Coverage that Risks You $60,000?!!! But suppose you buy that plan and then discover that, in a worst case scenario, your risk could be as much as $60,000 in a calendar year! How would you then feel about that plan?! That “plan” describes Original Medicare. (For more specifics on Original Medicare, see my blog post, How Does Medicare Work?) ...via Claeys Group Insurance Services - Tyler, TX Medicare Insurance Agency

[ausmovenz]

How To Move To Australia From New Zealand – Frequently Asked Questions

So you’ve made the decision to pack up the house and move to Australia. It’s both exciting and daunting at the same time. A move to Australia can be life changing for many but there are things you need to know about moving to Australia from NZ. In this article we cover the frequently asked questions about moving to Australia to help you prepare.

Quick Links

Things to consider before you go

Where are the most popular places in Australia?

What insurance do I need?

What can’t I take to Australia?

What are the shipping times to Australia?

Things to consider before you go

Before moving to Australia, New Zealanders should consider several key factors: visa requirements under the Trans-Tasman Travel Arrangement, sufficient funds for initial set-up and monthly living expenses, healthcare options including Medicare and private insurance, and compliance with Australian laws regarding employment, taxation, and driving. Planning ahead and understanding these aspects can ensure a smoother transition. For detailed assistance, Ausmove provides expert relocation services from New Zealand to Australia.

For more information read our article Moving to Australia? Things to consider before you go

Where are the most popular places in Australia?

New Zealanders moving to Australia are favoring several destinations. These cities are favorites among New Zealanders for their economic opportunities, lifestyle advantages, and the presence of established Kiwi communities, which will help you settle in more easily. These are some of the most popular destinations for New Zealanders moving to Australia.

Sydney is popular for its iconic landmarks like the Sydney Opera House and beautiful beaches.

Melbourne most famous for its cultural diversity, vibrant arts scene, and excellent dining options.

Brisbane with its warm climate, offers a relaxed lifestyle, and proximity to the Gold Coast and Sunshine Coast.

Perth is known for its sunny weather, beaches, and a growing job market.

Adelaide is praised for its affordability, wine regions, and festivals.

Australia’s favorable climate, lifestyle, and proximity to New Zealand make it an attractive destination for many New Zealanders seeking a change. Each city offers unique opportunities and lifestyles catering to different preferences and needs.

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What insurance do I need?

While it is not a legal requirement to have insurance to ship your household items to Australia via container, it is highly recommended. Some shipping companies may require you to have insurance as part of their service agreement. This is to protect both parties in case of any unforeseen issues during transit.

Insurance offers you peace of mind knowing that your valuable household items are insured, taking away the stress of moving your possessions to Australia. It also ensures that you won’t suffer a significant financial loss if something goes wrong. Insurance policies for shipping household items typically cover a range of scenarios, including damage due to loading and unloading, water damage, fire, and other risks specific to sea transport. Comprehensive coverage can protect you from a variety of potential problems.

When considering insurance for shipping your household items, it’s important to assess the value of your belongings, determine the total value of the items you are shipping to ensure you get adequate coverage.

When you choose Ausmove for your relocation to Australia, we want you to sleep well at night whilst your shipment is in transit. That’s why we arrange marine insurance cover for your household goods and personal effects.

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What can’t I take to Australia?

The Department of Agriculture, Fisheries and Forestry (DAFF) is responsible for protecting Australia from unwanted pests and diseases. The importation of some products is subject to specific conditions, while some products and items are not permitted entry into Australia.

Ausmove recommends you do everything possible to follow the regulations and be aware of anything that may be denied entry or incur additional costs; for example, fresh fruit and vegetables, live plants, cane and wicker furniture, soiled goods untreated wood items and many others. Ausmove staff are experts in their field so please ask us for advice and ensure you do your homework and get across the regulations. This website is recommended reading on the regulations and process for importing goods: Importing goods – DAFF (agriculture.gov.au)

What are the shipping times to Australia?

There are lots of factors influencing door to door transit times, these can include changes to shipping schedules, port delays, backlogs during holiday periods and industrial action in Australia. Here are some guidelines that allow for delays in Australian customs and quarantine clearances. They include the full transit time from the arrival of our packers in NZ to delivery day across the Tasman.

Sole use container shipment Generally 4-6 weeks but longer for Perth bound shipments.

Groupage or shared container shipment Depending on freight availability allow 6-12 weeks. In most instances Ausmove can give you a sailing date, as we have a lot of volume.

Airfreight shipment This is the fastest option and usually takes up to 2 weeks.

Moving you to Australia from New Zealand FAQs

Ausmove’s FAQ page provides key information for Kiwis moving to Australia, covering common questions about shipping household goods, vehicles and pets, customs clearance, and the benefits of using professional packing services to avoid delays and additional costs. You can view our FAQs here.

For detailed information on Ausmove’s services and expertise visit www.ausmove.co.nzor call (09) 360-4777.

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Republican vice presidential nominee J.D. Vance has shared some details about the Trump-Vance campaign’s health care plan, and it appears to allow insurers to charge more for preexisting conditions. Vance gave details on NBC’s Meet the Press on Sunday, where he told Kristen Welker that Donald Trump’s plan involves “deregulating insurance markets, so that people can actually choose a plan that makes sense for them.” This would appear to roll back some of the Affordable Care Act, which got rid of insurance companies’ ability to deny coverage based on preexisting conditions. Prior to President Obama’s legislation, it was difficult to get affordable health care coverage except through Medicare, Medicaid, or employer-based plans. While health care plans were available outside of that, insurers sought profits by weeding out people likely to require medical care. Vance said that under Donald Trump’s plan, Americans wouldn’t be put “into the same risk pools.” In other words, healthier young people wouldn’t be in the same risk pool as older people more likely to need medical care, lowering costs for younger Americans. But doing so, as Vance suggests, would come at the expense of much higher charges for everyone else—especially older Americans and those with pre-existing conditions. Right now, the law allows insurance companies to bill older people up to three times as much as they do for the young, Vance is talking about making that gap even higher. It’s much worse than Trump’s answer about his health care plan during last week’s presidential debate, when the former president said that he had “concepts of a plan” and was widely mocked. Vance’s plan existed before the ACA, and left many Americans, particularly with preexisting conditions, stuck with expensive plans that didn’t cover their issues. The ACA was passed 14 years ago, and despite multiple efforts to repeal the plan or gut its provisions, Republicans have been largely unsuccessful. It appears that they also still don’t have any ideas to replace it except restoring the previous flawed system, which would put many Americans at risk of losing coverage. Democrats need to sound the alarm.