Doctor Visits Drop 20%—Life Expectancy for the Poor Drops 5%

Image from Flickr, by Metro Centric

Pretty much everyone I talk to at work or in my neighborhood has been raving about how wonderful Obamacare is going to be. Granted, most of these people are liberals (I do live in San Francisco, after all). And they are correct that Obamacare will offer some advantages over the status quo, particularly for women’s reproductive health, as I described in a recent post. It will also no doubt provide coverage for many who currently lack it.

Overall, however, it is primarily just a huge giveaway to the big insurance companies. By requiring that everyone purchase coverage, it will increase the insurers’ customer base and, therefore, their profits. It does little to reign in skyrocketing costs and profiteering. There will continue to be millions of Americans who still cannot afford coverage even with the subsidies or who refuse to purchase the mandated coverage for other reasons. Those who already receive coverage through their employers will continue to see greater and greater out of pocket expenses each year, which will further erode their take home pay and living standards. And, worst of all, we continue to see thousands of excess deaths each year because people are still not receiving adequate preventative and long term care for chronic and infectious diseases.

One of the problems with Obamacare is that it does not adequately address the skyrocketing costs, which are a product of the profit-driven basis of our healthcare system. The most expedient way to remove the profit-motive and reign in costs is to create a single payer plan in which health care costs are collectivized through progressive taxation and provided to everyone through the government free of charge whenever needed.

Since that option was never allowed onto the table in the first place, the powers that be have come up with an alternative that keeps profits high and quality of service low: Increase copayments and decrease services in exchange for lower premiums. The rationale is that lower premiums increase the chances that people will be able to afford a plan and thus have coverage for emergencies. But higher copayments discourages people from using their plans except for real emergencies, thus undermining personal, as well as public, health. For example, when copayments are high, people are less likely to go in for preventative care and physicals, and more likely to suffer through undiagnosed symptoms in hopes they’ll go away on their own, all the while infecting their colleagues and schoolmates. This also leads to more emergency room visits, when symptoms that could have been easily treated with medication, had they been promptly diagnosed, escalate into acute or life threatening conditions.

Between 2001 and 2010, the number of doctor visits for Americans between the ages of 18 and 64 declined by almost 20%, according to the U.S. Census Bureau. This was due a combination of factors, including increased copayments for those with healthcare coverage and an increasing number of people who lost coverage through unemployment or unaffordable increases in private policy premiums. A recent study in the journal Health Affairs found that life expectancy for the poorest Americans fell dramatically between 1990 and 2008. Life expectancy fell from 78 to 74 years for white women without a high school diploma, and from 70.5 to 67.5 years for men in this group. This decline in life expectancy was likely due, at least in part, to the declining access to, and quality of, healthcare.

Obamacare may result in more Americans having healthcare coverage, but it will not result in greater access or quality. Many employers will simply stop covering employees, forcing them to purchase plans on the open market which will end up being more expensive and provide poorer coverage. According to the WSWS, up to 20 million Americans could lose employer-provided coverage by 2019. Those who retain employer coverage will continue to see increased copayments and out of pocket contributions to their premiums, as overall costs continue to outpace inflation. This will translate into fewer doctor visits and increased preventable deaths.

Meanwhile, the majority of Americans will see a continued decline in their standard of living, as healthcare costs continue to eat away at their net income. This could further erode overall health and longevity as people spend less on healthy foods, fitness, preventative care and leisure to compensate for their dwindling incomes.

California Democrats Robbing Kids to Enrich the Wealthy

Huck/Konopacki Labor Cartoons

Friends and colleagues often assume I’m a Democrat based on my criticisms of the Ed Deform movement or the political system. I try not to feel insulted by this name-calling, but then feel bad that my arguments were weak enough to lead them to this embarrassing conclusion.

When I’m feeling masochistic, I’ll correct them by saying that I do not support either party, and end up having to list recent “betrayals” by popular Democrats. Of course, they are not really betrayals. Anyone who is really paying attention can see that the Democrats, like the Republicans, are members of the same class of bosses, bankers, lawyers and landlords who monopolize all the wealth and social power. While the Democrats may pay lip service to the concerns of unions, women, the LGBT community and other “interest” groups, their policies never threaten (and general bolster) the ability of the capitalist class to increase their profits and wealth.

Thus it should be no surprise that California’s Democratic leaders in the legislature are preparing to vote this week on a Pension Deform bill for public sector employees that was proposed 10 months ago by Democratic Governor Jerry Brown. The revised plan includes raising the retirement age to 62 and increasing employee contributions to 50%, according to the SF Chronicle. It would also cap pensions at $132,000 per year.

The $132k cap might seem reasonable. After all, who makes this kind of money? The cap wouldn’t affect teachers, bus drivers, nurses or the vast majority of public sector employees, at least not for now. However, while a $132k annual salary might seem large by today’s standards, it will become a relatively low salary within a few years due to inflation. Also, even calculated in today’s dollars, a $132k salary would only yield $66,000 per year in benefits for a retiree—(salary multiplied by 0.02 multiplied by 25 years of service)—a decent income if your home is paid off or if you are living in an inexpensive community. In San Francisco, however, a retiree could easily spend more than one-third of this just on housing costs.

Union Busting 101

This pension “reform” legislation is a dual purpose bill. It not only forces workers to pay for the greed of Wall Street (the pension “crisis” is primarily due to investment losses caused by the economic meltdown), but it also drives a wedge into the unions by dividing veteran workers, who will retain most of their current pension benefits, and younger workers who will pay more out of pocket and receive fewer benefits and have to work longer to earn them.

Indeed, the legislation can be seen as an attack on our children, making it much harder and riskier for them to retire, while also lowering their standards of living prior to retirement by sapping more of their take home pay to cover their increased pension contributions. By forcing them to work longer and capping their benefits, they will have fewer healthy years to enjoy their retirements and less to live on. Gov. Brown proudly declared that the changes would make public employee pension benefits for future hires lower than when he took office in 1975, the SF Chronicle reported. 

The unions are arguing that any changes to pensions must be collectively bargained. Many are already preparing lawsuits and ballot initiatives to oppose the legislation, since it undermines existing contract agreements and usurps unions’ power to negotiate this important benefit. I have not heard of any that are asking their members to prepare for a strike action, which will likely be necessary to reverse this juggernaut.

If they fail to halt this legislation, there a two-tiered system will be created, with new hires getting a worse pension plan imposed on them by the state and veteran employees maintaining a better pension plan and the right to collectively bargain any future changes. When younger workers recognize that they are getting a raw deal compared with their veteran colleagues, they may see their unions as impotent or biased against them, especially if the unions do not take aggressive job actions to halt the legislation. This would make it harder to organize and mobilize them for other workplace struggles, thus weakening the overall strength of the unions.

The legislation could also lead to future collective bargaining problems for current employees. For example, even though the legislation allows current employees to negotiate increases in their contributions, this “privilege” implies that legislators intend to ask for increased contributions. Current employees may therefore find themselves in the position of having to choose between raises or pay cuts, increased health care contributions and/or increased pension contributions in future contract negotiations.

A Gift to Wall Street and the Wealthy

Ultimately, any cuts to public employee pensions will be made not to save the program, as legislators and pundits are fond of saying, but to preserve record low tax rates for the wealthy. As long as unfunded pension liabilities can be covered through increased employee contributions and through reduced and delayed benefits, there is no need to raise taxes on the wealthy or to threaten state spending that benefits their businesses.

None of the political parties are friends of working people. Lesser evil, perhaps, but at what cost? Real wages and living standards have been steadily declining for the majority of Americans for the past 40 years. During this time the Democrats have either sat idly by and enjoyed the ride or voted for policies that have hastened the trend.

Bumper Crop of Working Seniors

“All Used Up,” performed by Utah Phillips

As pensions are gutted, retirement ages raised, and nest eggs still enfeebled by the recession, more and more people are finding they cannot afford to retire. The New York Times reported this week that recent Labor Department figures show that the percentage of workers toiling on past the age of 65 is at a record high.

For the first time in 30 years, more than 10% of men over the age of 75 were employed, while nearly 5% of women that age were working. At the same time, employment for men under 55 fell sharply during the recession and is only now starting to recover, while the number of unemployed women under the age 55 hit its lowest level in two decades.

The Times also reported that overall household net worth declined by 15% during the recession—one of the reasons why so many people no longer can afford to retire.

America Eats Its Young (And Some Of Its Old)

One out of every 13 California seniors aged 50 or older is at risk of hunger, according to a recent report the AARP Foundation (American Association of Retired Persons) reviewed in the Bay Citizen. However, according to the Columbus Dispatch, a similar number (7.5%) of seniors is at risk of hunger nationally. There has been a 79% increase in elder hunger over the past decade, with the greatest increase occurring between 2007 and 2009.

The seniors who are most at risk, not surprisingly, are the poor, blacks and Latinos, and those with few family connections. According to the Dispatch, only 2% of white seniors faced constant hunger, while 7% of black seniors did.

As disturbing as these numbers are, it is important to place them into the proper context. According to the USDA, 85.5% of American households were food secure throughout the entire year in 2010, meaning that they had access to sufficient food for all members of the household to live healthy and productive lives. This means that 14.5% of American households were not food secure, nearly double the rate for seniors, suggesting that as poor and hungry as our seniors are, the young are even worse off. According to the report, children were insecure at some times during 2010 in 9.8% of households, which was down slightly from 10.6% in 2009.

However, even these data do not reveal the full extent of the problem. Considering that many families have several children, the 9.8% of households with hungry children probably had several hungry children, or a rate of childhood hunger far higher than 9.8%. Indeed, according to the Feeding America website, 20% of the children in 40 states lived in food insecure households (32.3% in Washington, D.C. and 29.2% in Oregon) in 2009. Others report that as many as 1 in 4 American children go to bed hungry on a regular basis.

Of course it is deplorable that anyone is going hungry in what most Americans consider the richest and greatest country in the world. It is even worse that we allow our most vulnerable to starve. Yet, even with the increase in elder poverty and hunger, older Americans on average are still getting wealthier on the backs of younger Americans. Census and Pew Foundation reports indicate that while the incomes and wealth of younger Americans have stagnated or declined over the past few decades, those for baby boomers and the elderly have been increasing (see “Kid Janitors Don’t Solve Poverty,” by Mike Males). This has occurred through legislation, changes to the tax structure, cuts to social programs and general wage declines, particularly for those just entering the workforce.

This has resulted not only in a net decline in wealth and income for young adults, but hunger and privation for their children, since they are the one who are having children. However, the cuts that have allowed older Americans to increase their wealth have also affected low income seniors and they are hurting, as well (just not to the same extent as children and young adults).

Older Americans Are Sabotaging Our Children's Future

Older Americans are sabotaging young people's future, according to YouthFacts author, Mike Males. Youth today express for greater tolerance and community ideals than their parents and grandparents generations, while older Americans exhibit increasing racial and religious bigotry, material selfishness, drug abuse and criminality.

• Take the issue of gay rights, for example, where 18-29 year-olds in Alabama are more supportive of gay marriage than seniors in Massachusetts.
• Or mixed marriages, where only 36% of whites over the age of 65 would be o.k. with a family member marrying a person of a different ethnicity (compared to almost 100% support by those born after 1980).
• Or greed, where 60% of seniors oppose slower growth in their retirement benefits in order to avoid higher taxes for younger generations
• Or misbehavior, where Americans over the age of 45 abuse drugs and commit crimes at a higher rate than any generation ever, according to FBI crime statistics