Category Archives for Healthcare

On Taking a Stand Against Racism and Antisemitism

Published in Woonsocket Call on August 27, 2017

Morris Nathanson, an 89-year-old who served in the United States Navy in World War II, was outraged for President Trump’s failure to strongly speak out against the hateful philosophy of neo-Nazis, white nationalists, Ku Klux Klan (KKK) and militia groups exhibited at a violent protest that escalated out of control in the streets around the University of Virginia campus in Charlottesville, Va.

Growing up Jewish, Nathanson is horrified about the growing racism and antisemitism so visibly flaunted at the Charlottesville rally and seen throughout nation. Before the Second World War, his parents had escaped the violent pogroms in Russia, ultimately settling in a three decker house with relatives in Pawtucket. Family members who remained in Europe were killed, victims of the Holocaust, he said.

“It’s is indefensible,” says Nathanson, an Eastside resident who in an internationally acclaimed artist and semi-retired restaurant designer, for Trump to not outright denounce the neo-Nazi groups. He warns, “We must recognize the growth of the neo-Nazi movement for what it is, a terrible disease that must be eliminated.”

The jarring historical imagery of the torchlight procession of supporters of Adolf Hitler moving through the Wilhelmstrasse in Berlin on the evening of January 30, 1933, came to life for Nathanson and millions of Americans last weekend when hundreds of neo Nazis, white nationalists, KKK, militia members and other right-wing groups gathered for a “Unite the Right” rally in Charlottesville, Va. Carrying tiki torches, flags with swastikas and confederate flags, they came to the City’s Emancipation Park to ostensibly support a protest against the removal of a statue of Civil War confederate General Robert E. Lee. But it was really an opportunity to display their strength.

Battle Lines Drawn

On the evening of Friday August 11 at 10:00 p.m., the torch bearing marchers, some wearing Nazi-style helmets, carrying clubs, sticks and round makeshift shields emblazoned with swastikas and other Fascist symbols, and others entered the one-block square in downtown Charlottesville, the site of the controversial monument, chanting “Jews will not replace us”, “Blood and Soil” (a Nazi rallying cry), “White Lives Matter,” along with homophobic, racists and misogynistic slurs. Heavily armed militia members, carrying semi-automatic weapons and dressed in camouflage military fatigues came to support and embolden their fellow extremist groups that identify as the “alt-right”.

At the site of the controversial monument in the City’s park and surrounding streets, throughout Friday evening and Saturday, August 12, members of alt-right groups opposed counter-protestors including Antifa, a far-left militant political movement that opposes fascist groups, members of Black Lives Matter, and church groups along with others who oppose racial bigotry and antisemitism. During the weekend rally, it was reported that 15 people were injured. On Saturday, James Alex Fields Jr., a 20- year-old, drove his gray Dodge Challenger into a group of counter-protesters, killing 32 year old Heather Heyer and injuring 19 other counter-protestors. Two Virginia State Police officers, monitoring the protests, died when their helicopter crashed.

Immediately following the rally on Saturday and the death of Heyer, Trump went to Twitter and posted an opened ended statement, calling the nation to “condemn all that hate stands for.” Following this tweet, on Sunday, August 13, he issued a statement at his golf club in Bedford New Jersey, stating, “We condemn in the strongest possible terms this egregious display of hatred, bigotry and violence on many sides.”

Trump Vacillates on Who’s to Blame

On Monday, August 14, intense political pressure would force Trump to make a statement at the White House to strongly condemn KKK and neo-Nazi groups after he blamed violence at the Charlottesville, Va., two days earlier in a tweet on “many sides”

By Tuesday August 15, Trump had backed off his public scolding of America’s hate groups At an impromptu press conference held at Trump Tower, he cast blame for Charlottesville’s violence equally on the “alt-right” and “alt-left” counter- protestors. “You had a group on one side that was bad, and you had a group on the other side that was also very violent,” Trump said, noting that “Nobody wants to say that, but l say it.”

“Not all of those people were neo-Nazis and white supremacists, believe me,” says the president, noting that some protestors wanted to stop the removal of the Robert E. Lee statue. Some were “nice people” he stated.

“So this week, it’s Robert E. Lee, I noticed that Stonewall Jackson’s coming down. I wonder, is it George Washington next week? And is it Thomas Jefferson the week after. You know, you really do have to ask yourself, where does it stop?” said Trump.

Trump’s comments that not all rally marchers were neo-Nazis or white supremacists caused a political tsunami, with critics pointing out that these individuals marching with the neo-Nazis were not “nice people”. It was guilt by association.

The two former Bush Presidents joined world leaders, GOP and Democrat Senators, Governors, and rank-and-file Republicans, Democrats, and Fortune 500 Executives to chastise Trump for his failure to speak out against Nazi and white supremacist ideology and that his comments trivialized the antisemitism and racism of these extremist alt-right groups.

Even the members of the Joint Chiefs of Staff, the senior uniformed military leaders in the United States Department of Defense who advise the President, posted tweets denouncing the alt-right extremists and blaming them for Saturday’s bloody violence in Charlottesville.

However, white supremacists took Trump’s Charlottesville statements as an endorsement to their legitimacy and acceptance to allow their members to become more visible in society. David Duke, a white nationalist and former Imperial Wizard of the KKK, tweeted, “Thank You Mr. President Tamp; God Bless You for setting the record straight for All Americans.” The Daily Stormer, a neo-Nazi website, quickly called Trump’s statements on blaming both sides a sign that he implicitly supported their goals and objectives.

The Increasing Visibility of Racism and Antisemitism

Ray Rickman, 65, Executive Director of the nonprofit Stages of Freedom, says, “I am deeply worried about the piercing images of men marching with Nazi torch lights on the University of Virginia campus. These men were screaming “Jews won’t replace us.” It was Nazi Germany all over again. The idea of seeing a Nazi flag, the most vicious symbol of antisemitism on American soil, is almost unbelievable to me. All of this is followed by the deeply divisive comments from Mr. Trump”, says the long-time Rhode Island activist.

“This man in the White House has shown total disrespect for the millions of American soldiers both living and dead who died to save the world from the Nazis,” adds Rickman, noting that “It’s the first time since Woodrow Wilson that a president has refused to condemn racism after such an act of violence.”

Rickman says that the neo-Nazi groups used the Charlottesville gathering as a public show of force and to promote hatred. “Maintaining the Robert E. Lee Monument was just an excuse to attack Jews and Blacks,” he says, noting that the three-day protest was planned as a “hateful rally by people who hate people of color and Jews. It is as simple as that.”

One of the most interesting aspects of beliefs held by General Lee was that he was not in favor of raising Confederate monuments, says Rickman, noting that in 1869 he wrote that it would be wiser “not to keep open the sores of war but to follow those nations who endeavored to obliterate the mark of civil strife.”

Combating Intolerance and Hatred

While both GOP and Democrat lawmakers lambasted Trump’s choice of words for laying the blame of violence at the Charlottesville rally on both the far right demonstrators and counter protestors, there were some who remained silent or defended his comments, saying his words were adequate.

With the increased public visibility of the neo-Nazis, white supremacist and other hate groups, if Trump fails to use his national bully pulpit, and the moral authority of the Office of the Presidency to steadfastly condemn hate groups, national and state elected officials and Americans of all walks of life must take on this responsibility.

In response to the violent weekend in Charlottesville, Va., the Illinois Senate adopted a resolution, sponsored by Sen. Don Harmon, D-Oak Park, urging law officials to recognize white nationalists and neo-Nazi groups as terrorist organizations.

Nathanson, who in 1965 marched with Martin Luther King in Selma, Alabama to fight racism, calls for organizing rallies at the state and national level to “reduce the damage of Trump’s comments.”

It would be an appropriate time to remember the speech given by Martin Niemoller, a German Lutheran minister who opposed the Nazis and was sent to several concentration camps. He survived the war and explained:

First they came for the Jews. I was silent. I was not a Jew.
Then they came for the Communists. I was silent. I was not a Communist.
Then they came for the trade unionists. I was silent. I was not a trade unionist.
Then they came for me. There was no one left to speak for me.

 

Social Security, Medicare Are Solvent…at least for Now

Published in Woonsocket Call on July 16, 2017

Just days ago, a released annual federal report, the 2017 Annual Report of the Board of Trustees of the Federal Old-Age and Survivors Insurance and Federal Disability Insurance Trust Funds, says the nation’s Social Security and Medicare programs continue to work, are fiscally solvent, but future fixes will be needed to maintain their long-term actuarial balance.

The Social Security Administration’s (SSA) annual snap shot of the fiscal health of Social Security and Medicare, two of the nation’s largest entitlement programs, released on July 13, is important to millions of beneficiaries. According to the federal agency, in 2017 over 62 million Americans (retired, disabled and survivors) received income from programs administered by SSA, receiving approximately $955 billion in Social Security benefits.

The Good News

The trustee’s report projects that Social Security will be financially solvent until 2034 (unchanged from last year), after which SSA can pay 77 percent of benefits if there are no changes in the program. The 269-page report also noted that the Medicare Trust Fund for hospital care has sufficient funds to cover its obligations until 2029, one year longer than projected last year, then 88 percent afterward if nothing is done to strengthen the system’s finances

The trustees report says that there is now $2.847 trillion in the Social Security Trust Fund, which is $35.2 billion more than last year — and that it will continue to grow by payroll contributions and interest on the Trust Fund’s assets.

Social Security Administration efficiently manages its entitlement program, says the trustee report. The cost of $6.2 billion to administer to program in 2016 was a very low 0.7 percent of the total agency’s expenditures.

The trustee’s project a 2.2 percent cost-of-living adjustment (COLA) for Social Security beneficiaries in 2018, the largest increase in years. In addition, Medicare Part B premiums will also remain unchanged next year. Most beneficiaries pay a monthly premium of $134 (this amount increases for those with higher incomes.)

Social Security is “Stable and Healthy for Now”

According to the National Committee to Preserve Social Security (NCPSSM), the recently released trustee’s report confirms that the federal entitlement program is “stable and healthy for now,” while acknowledging there will be future challenges if “corrective action is not taken.”

“Forty percent of seniors (and 90 percent unmarried seniors) rely on Social Security for all or most of their income. The average monthly retirement benefit of $1,355 is barely enough to meet basic needs, and the Trustees’ latest projected cost-of-living increase of 2.2 percent will not keep pace with seniors’ true expenses. Under these circumstances, any benefit cuts (including raising the retirement age to 70 as some propose) would be truly painful for our nation’s retirees,” says Max Richtman, NCPSSM’s president and CEO, in a statement responding to the release of the federal report.

“Opponents of Social Security may once again try to use this report as an excuse to cut benefits, including raising the retirement age,” warns Max Richtman. “We must, instead, look to modest and manageable solutions that will keep Social Security solvent well into the future without punishing seniors and disabled Americans,” he says.

Depending on what the final Senate health bill looks like, the legislation could reduce the solvency of Medicare by two years, say Richtman. “The National Committee opposes the GOP health plan and rejects efforts to privatize Medicare. We advocate innovation and continuing efficiencies in the delivery of care, allowing Medicare to negotiate prescription drug prices, and restoring rebates the pharmaceutical companies used to pay the federal government for drugs prescribed to “dual-eligibles” (those who qualify for both Medicare and Medicaid) – in order to keep Medicare in sound financial health,” he says.

Safeguarding and Expanding Social Security Benefits

In a statement, Richard Fiesta, Executive Director of the Washington, DC-based Alliance of Retired Americans, notes that the Trustees project that the Social Security Disability Insurance (SSDI) trust will be fully solvent until 2028, five years longer than last year’s report. “In light of this data, it makes no sense that the President’s FY 2018 budget seeks to cut Social Security Disability Insurance funding by $63 billion,” he says.

Despite the trustees’ strong report, Fiesta believes that improvements can be made that would benefit all workers and retirees. His organization supports safeguarding and expanding Social Security benefits, providing a more accurate formula for cost-of-living adjustments, and lifting the cap on earnings for the wealthiest Americans.

Fiesta adds, “reining in the prices of prescription drugs would strengthen Medicare for the future and reduce costs to retirees.”

AARP CEO Jo Ann Jenkins, in a statement, calls for bipartisan action in Congress and the Trump administration to ensure the strong fiscal health of Social Security and Medicare programs. “Social Security should remain separate from the budget. Medicare can improve if we reduce the overall cost of health care, rather than impose an age tax, and if we lower prescription costs, instead of giving tax breaks to drug and insurance companies,” she says.

Finally, in a statement, Nancy Altman, President of Social Security Works, also chairing the Strengthen Social Security Coalition, says that this year’s trustee’s report clearly indicates that the nation can fully afford an expanded Social Security. Altman says that polling continues to show that Americans support expanding the program’s benefits.

Altman believes the Social Security program can solve the nation’s “looming retirement income crisis, the increasing economic squeeze on middle-class families, and the perilous and growing income and wealth inequality.” So, when confronting these challenges, she says, “the question is not how can we afford to expand Social Security, but, rather, how can we afford not to expand it.”

Ensuring the Long-Term Solvency of Social Security

Those nearing retirement or retired will be assured existing Social Security benefits, promises the 2016 Republican Party Platform. “Of the many reforms being proposed, all options should be considered to preserve Social Security. As Republicans, we oppose tax increases and believe in the power of markets to create wealth and to help secure the future of our Social Security system,” says the Platform. Simply put, the GOP opposes the raising of payroll taxes on higher income taxpayers to stabilize or expand Social security and supports privatization, allowing Wall Street to control your Social Security benefits.

On the other hand, last year’s Democratic Party Platform opposed Social Security cuts, privatization or the weakening of the retirement program, along with GOP attempts to raise the retirement age, slash benefits by cutting cost-of-living adjustments, or reducing earned benefits. The Democratic Platform called for taxing people making above $250,000 will bring additional funding into the entitlement program.

Congressional gridlock has not blocked legislation from being introduced to fix the nation’s Social Security program. According to Social Security Works, over 20 Social Security expansion bills have been introduced in the House and Senate since 2015. Recently, the Social Security 2100 Act, introduced by Rep. John Larson (D-CT), has 162 House cosponsors —around 85 percent of all Democratic representatives. Similarly, around 90 percent of Senate Democrats are on record in favor of expanding, not cutting Social Security.

Many consider Social Security to be the “third rail of a nations politics.” Wikipedia notes that this metaphor comes from the high-voltage third rail in some electric railway systems. Stepping on it usually results in electrocution and the use of the term in the political arena refers to “political death.” With the Social Security and Medicare programs now on firm financial footing, it is now time for Congress to seriously consider legislative actions to ensure the longevity and expansion of these programs. When the dust settles after the upcoming November 2018 elections, we’ll see if Social Security is truly “a third rail.”

AARP Scorecard: Taking a Closer Look at Rhode Island’s Long-Term Services and Support to Older Adults

Published in Woonsocket Call on June 18, 2017

With America’s baby boomers beginning to turn age 80 in 2026, days ago the Washington, DC-based AARP released Scorecards detailing how each state spends its dollars on long-term services and supports (LTSS) to assist older adults and adults with disabilities. The report findings revealed a need for state legislatures to quicken the pace of improving LTSS for their older residents. LTSS include assistance with activities of daily living provided to older adults and people with disabilities who cannot perform these activities on their own because of physical, cognitive, or chronic health conditions. The types of assistance include such things as help with bathing, dressing, managing medications, preparing meals, and transportation, as well as support for family caregivers.

The latest comprehensive state-by-state Scorecard report was funded by AARP Foundation with support of the nation’s leading organizations behind quality long-term care, The Commonwealth Fund and SCAN Foundation. This is the third edition of the Scorecard, initially released in 2011 and again in 2014.

AARP’s 2017 report, “Picking Up the Pace of Change: A State Scorecard on Long-Term Services and Supports for Older Adults, People with Physical Disabilities, and Family Caregivers (“Scorecard”), released on June 14, finds that although Rhode Island and most states have taken small steps to make some progress, this pace of change overall remains too slow and has not kept up with demographic demands.

“This Scorecard sounds the alarm, but it also provides a range of tools states can use to spark new solutions and create systems that are aligned with the new realities of aging and living with a disability,” said Susan Reinhard, RN, PhD, Senior Vice President and Director, AARP Public Policy Institute. “The proposed cuts to Medicaid—the largest public payer of long-term assistance—would result in millions of older adults and people with disabilities losing lifesaving supports.”

“This new Scorecard shows that it’s time for all states to accelerate care improvements for older adults and people with disabilities,” said Bruce Chernof, MD, FACP, President and CEO of The SCAN Foundation. “States that consistently rank at the top have strategically planned for their aging population across the main sectors of health, housing, transportation and family caregiving.”

Like previous two LTSS scorecards, states are ranked on their performance in five categories: Affordability and access, Choice of setting and provider; Quality of life and quality of care; Support for family caregivers; and Effective transitions between nursing homes, hospitals and homes. Within the five categories, states are scored on their performance in 25 specific indicators, including such things as Medicaid spending, nursing home cost, home health aide supply, antipsychotic medication use in nursing home residents, long nursing home stays, employment rate of people with disabilities, and support of working caregivers.

But this year, AARP has made changes in LTSS Scores in the way information is presented on its interactive website (www.longtermscorecard.org), making it easier for a user to customize data to suit their specific needs. Visitors to the Scorecard site will be able to access videos, called Impact Stories, that show how improving on the Scorecard can impact the lives of real people.

Users can also download Promising Practices as well as Emerging Innovations (updated throughout the year) that state officials can use as they work to improve their long-term care delivery systems.

Rhode Island Improves in Delivering LTC Services

In the 2017 AARP report, Rhode Island ranks 32nd overall when it comes to meeting the long-term care needs of older residents and people with disabilities, but showed improvement in all but one Scorecard category. AARP warns more must be done, at an accelerated pace, to meet changing demographic demands. Rhode Island ranks 22nd nationally Support for Family Caregivers and 24th in Quality of Life & Quality of Care. The state ranks 35th in Effective Transitions – the only category in decline

“The vast majority of older Rhode Islanders want to live independently, at home, as they age—most with the help of unpaid family caregivers,” says Kathleen Connell, State Director of AARP Rhode Island, which serves more than 138,00 members age 50 and older in the state. “Even facing tight budgets, Rhode Island is making progress to help our older residents achieve that goal. However, this Scorecard shows we have more to do, and we need to pick up the pace.”

According to Connell, today, unpaid family caregivers provide the bulk of care for older Rhode Islanders in part because the cost of long-term care remains unaffordable for most middle-income families. In Rhode Island, more than 134,000 residents help their aging parents, spouses and other loved ones stay at home by helping with bathing and dressing, transportation, finances, complex medical tasks like wound care and injections, and more. The value of this unpaid care totals about $1.78 billion.

“When it comes to helping older Rhode, Islanders live in the setting of their choice, family caregivers take on big responsibilities,” explains Connell. “Many juggle full-time jobs with their caregiving duties; others provide 24/7 care for their loved ones. With every task they undertake, these family caregivers save the state money by keeping their loved ones out of costly nursing homes – most often paid for Medicaid. They have earned some basic support.”

“That’s why AARP Rhode Island has fought for Caregiver, Advise, Record, Enable (CARE) Act; caregiver temporary leave insurance; and caregiver tax credits, adds Connell.

Rhode Island has made progress to improve long-term services and supports for older adults and people with disabilities, as highlighted in this Scorecard. But, proposals in Washington, D.C. to drastically cut federal Medicaid funding would threaten these advancements, likely resulting in our most vulnerable citizens losing the lifesaving supports that they count on,” says Connell.

“The single strongest predictor of a state’s long-term care system is the reach of its Medicaid long-term care safety net,” says Connell, noting that’s why AARP fights to expand services provided at home and in the community, by shifting funds away from and more expensive nursing home care. “While the percent of long-stay nursing home residents hospitalized within a six-month period has decreased, the Scorecard highlights additional serious issues related to institutional care in Rhode Island, such as residents with pressure sores and residents with low care needs],” she notes.

While Rhode Island has improved its rank from 50th to 44th in the percentage of Medicaid long-term care dollars for older adults and people with physical disabilities that support care provided at home and in the community—the care setting that most Rhode Islanders prefer—the Scorecard spotlights areas that call for improvement, including choice of setting and provider; and effective transitions.

Specifically, the percent of

• Medicaid and state-funded LTSS going to HCBS;
• Medicaid LTSS users first receiving services in the community;
• People with 90+ day nursing home stays successfully transitioning back to the community;
• Nursing home stays lasting 100 days or more.

“This Scorecard gives us a snapshot of how well Rhode Island serves our older residents, those with disabilities, and family caregivers—and shows us where we must sharpen our focus to better assist hardworking Rhode Islanders,” concludes Connell. “We will continue to work with the governor, legislative leaders and policymakers to take the actions needed now to protect our expanding needs.”

Connell says that of the 25 Scorecard indicators, many may be improved through state policy changes, pointing to the importance of AARP’s multi-state advocacy campaign, launched in 2014, to help older Americans live independently, at home, and the family caregivers that support them.

Director Charles Fogarty, of Rhode Island’s Division of Elderly Affairs, sees the importance of AARP’s Rhode Island’s Scorecard, to evaluate progress in meeting the needs of older Rhode Islanders. “This report reinforces what we already know: while Rhode Island is showing improvements in some areas, there is still much to be done to provide the level of care and services our seniors deserve. Our improved ranking from 50th to 44th in the percentage of Medicaid long-term care dollars spent on home and community care options is a step in the right direction,” says Fogarty.
“We must continue to build upon the success of Reinventing Medicaid and move towards rebalancing of the long-term care system while preserving access and quality of care for older Rhode Islanders,” adds Fogarty.

AARP Scorecard Snap Shot of the National Delivery of LTSS

Washington State and Minnesota are top-ranked states again (followed by Vermont, Oregon and Alaska), but all states lag in helping care for the nation’s growing populations of older persons with people aging and living with disabilities.

AARP’s LTSS Score card noted that the bottom ranking states were Indiana, (No. 51), Kentucky (No. 50, Alabama, (No. 49), Mississippi, (No. 48), and Tennessee (no. 47).

According to researchers, overall, states made incremental LTSS improvements since the previous report in 2014, but the pace of change has been slow and uneven. However, two states—Tennessee and New York—showed the most improvement across measures since the last Scorecard.

States made the most significant progress in reducing inappropriate ‘off label’ use of antipsychotic medications among nursing home residents and increasing support of family caregivers.

In general, states showed the most significant declines in employment rates for people with disabilities and rates of transitioning long-stay nursing home residents back into the community. Notably, the majority of states showed no real change on ‘Affordability and Access,’ meaning that the cost of LTSS over time continues to be much higher than what the majority of families can afford.

Herb Weiss, LRI’12 is a Pawtucket writer covering aging, health care and medical issues. To purchase Taking Charge: Collected Stories on Aging Boldly, a collection of 79 of his weekly commentaries, go to herbweiss.com.