THE CHEAPEST ROUTE SAYS GLOBAL WALL STREET----YOU BETTER STAY AS HEALTHY BECAUSE YOU AIN'T GETTING INTO OUR PROFIT-DRIVEN GLOBAL HEALTH TOURISM FOR THE 1% AND THEIR 2% HOSPITALS.
GLOBAL WALL STREET REALLY, REALLY, REALLY DOES NOT WANT TO TAKE CARE OF HUMAN CAPITAL FOLKS!
Health & Human Services
A ‘Wraparound’ System of Care for Schools
Several school systems are implementing so-called wraparound programs in an effort to help troubled kids, families and communities.
by Jonathan Walters | March 11, 2014
Elementary school students get lunch at a school in Osceola County, Fla., where 71 percent of students are eligible for free or reduced price meals. MCT/George Skene
If you've spent any time following education policy these days, you probably know that Common Core Standards are the topic du jour. Depending on political leanings, people either love them or hate them. But even the most brilliant, focused and politically embraceable education reform initiative will fail if kids flat out aren't ready to learn when they show up at school each day because they're not getting what they need at home.
The importance of supporting potentially troubled kids in school was a key part of an interesting panel conversation on education reform held last month during Governing's annual Outlook in the States & Localities conference in Washington, D.C. The panel featured Roy Romer, former governor of Colorado; Randy Weingarten, president of the American Federation of Teachers; and Elaine Weiss, head of the Economic Policy Institute's Broader Bolder Approach to Education initiative, which is aimed at moving the educational debate beyond didactics and to the ground-level realities of the well-being of kids and families.
As everyone on the panel pointed out, kids who show up at school hungry, tired, scared or in poor health -- and whose home lives might be in shambles -- aren't going to learn very well, regardless of the core course work or the quality of the teachers. Making matters worse, there's a good chance that these kids will be flat out disruptive in school, compounding the problem.
Fortunately, there are some school districts that are tackling this problem: In Cincinnati, the district has fully embraced the concept of "wraparound schools," or schools that house a variety of support services aimed at getting kids everything from food to health care to counseling in order to ensure that all students are ready to pay attention and perform in the classroom.
But true wraparound schools are much more than that, says Weiss of the Economic Policy Institute. As a first step, she says, wraparound schools certainly do look at the "opportunity gaps" that exist for some students, whether it's as basic as getting them a backpacks to carry around school work and supplies, or as complicated as ensuring they get decent dental care. But the best wraparound programs are those that involve families and whole communities in looking out for the complete health and well-being of students and their families.
"A lot of educators complain that they can't engage parents," says Weiss. "So you have schools that are open from 8 a.m. to 5 p.m., and teachers say they can't get parents involved? Well, maybe that's because the parents are working." As a solution, Weiss points to wraparound schools that have a coffee and meeting room for parents who walk their kids to school, along with schools that have evening hours so that working parents have a chance to engage.
Good wraparound programs go even further. A lot of parents in many school districts never graduated from high school or don't speak English, so some wraparound programs offer English and high school equivalency classes. "Some are even offering things like tax preparation clinics in the evening," says Weiss.
Ultimately, it's all about engagement and coordination. Schools that are serious about the wraparound movement actually have dedicated staff who do nothing but coordinate parent and community involvement, social and health services, and the day-to-day learning environment. So while the educational world may at presently consumed by the debate over Common Core Standards, several schools are addressing the real building block to learning: Ensuring kids are healthy and secure.
Now the right wing is hawking HEALTH SAVINGS ACCOUNTS----which are of course what MEDICARE was-----MEDICAID was our Federal tax dollars coming back to our communities for low-income health care----that's the point----the right wing does not see ANY TAXES PAID BY WE THE PEOPLE as coming back to WE THE PEOPLE and our community as services---they see it all going to boost global corporate profits.
CLINTON/BUSH/OBAMA have been working to make the poor pay taxes these few decades. The NEW DEAL policies placed tax burden on corporations and the rich while allowing the poor tax freedom to give opportunity to grow wealth. Obama and Clinton neo-liberals started this movement to POOR PAYING TAXES by calling these SAVINGS ACCOUNTS taken from paychecks of poor as bootstrap paying for health care. Obama called it myRA------he created created structures where low-income had to provide community services to access health care. As Obama Republicans now want to send to global Wall Street to use as FODDER these 21st Century 401K/IRA accounts that no one will ever see again. Where PAYROLL TAXES pre-paid our health insurance----now they are going to tell the poor who already get almost nothing in wages that SAVINGS ACCOUNTS will be there when they need them.
This policy was already MOVING FORWARD under Obama and for Trump lovers-----these policies are United Nations written and installed in all Foreign Economic Zones bringing America in line with all other developing third world nations.
Health savings accounts may flourish under Trump
Tom Anderson | @bytomanderson
Wednesday, 16 Nov 2016 | 8:30 AM ETCNBC.com
President-elect Donald Trump and Republican lawmakers want to expand access to health savings accounts. If that happens, people who use these tax-advantaged plans to pay for health costs as well as investors who treat HSAs as another retirement option could benefit.
Trump has proposed making it easier to pass on HSAs to heirs while House Republicans want a nearly-twofold increase in contribution limits.
"We feel the election outcome certainly seems to lean more favorably toward HSAs, however, it may take time for that to play out," said Jon Robb, senior vice president of research and technology at HSA consulting firm Devenir.
Americans had opened 18.2 million HSAs as of June 30, up 25 percent from a year earlier, according to Devenir. Assets had grown to an estimated $34.7 billion by June, up 22 percent year over year. (See chart below.)
HSAs, introduced in 2003, offer you triple tax advantages.
First, contributions to the account are tax-deductible. Second, those contributions can be invested and grow tax-free. Third, withdrawals aren't taxed as long as you use them for qualified medical expenses.
If you use an HSA to pay for unqualified medical expenses, the tax penalty is 20 percent, unless you are 65 or older, when you can take money out for whatever you want, but the withdrawals will still be subject to regular income taxes.
A drawback of HSAs is that they are paired with a high-deductible health plan.
Such a plan means you'll have to pay a deductible of at least $1,300 for individual coverage and $2,600 for families. The maximum annual out-of-pocket costs for these plans are $6,550 for individuals and $13,100 for families.
In 2017, you (and your employer) can contribute up to $3,400 to an HSA for individuals and $6,750 for families. Account holders age 55 and older can contribute an extra $1,000.
HSA proposals on the table
The Trump administration and Congress would have to hammer out details next year before any changes to HSAs could be made.
The president-elect has proposed HSAs "would become part of the estate of the individual and could be passed on to heirs without fear of any death penalty." Currently, there is no tax penalty for HSAs inherited from a spouse, but those inherited from someone other than a spouse are included in an heir's income.
House Speaker Paul Ryan and fellow Republicans want to increase the HSA contribution limits to the maximum out-of-pocket limits for high-deductible health plans. So if those rules were in effect next year, the individual HSA limit would rise to $6,550 from $3,400 and the family contribution limit would grow to $13,100 from $6,750.
House Republicans also want to allow spouses to make catch-up contributions to the same HSA account and permit qualified medical expenses incurred before HSA-qualified coverage begins to be reimbursed from an HSA as long as the account is established within 60 days.
"HSAs can be a bipartisan force that drives better outcomes for all." -Michael Trilli, senior consultant at Aite GroupAnother way the Trump administration and Congress could juice the adoption of HSAs would be by repealing the so-called Cadillac tax.
The tax is a key part of the Affordable Care Act, levying a 40 percent excise tax on high-cost health plans. The tax is scheduled to go into effect 2020. Last year, a divided Congress pushed back the start of the tax by two years.
"The employer Cadillac tax could be abolished immediately and will propel HSAs," said Michael Trilli, senior consultant at financial services consulting firm Aite Group. "HSAs can be a bipartisan force that drives better outcomes for all."
However, Trilli worries that while HSAs have been popular as employee benefits, the accounts have struggled to gain traction among people who are not offered them in the workplace. He sees government subsidies, similar to those provided by employers, as a way get more consumers to start contributing their own funds to HSAs and an area of potential bipartisan compromise.
"Nearly half of employers may offer a high-deductible health plan within two years." -William Ziebell, executive vice president at insurance brokerage Arthur J. Gallagher & Co.Regardless of what a Trump administration or Congress does with HSAs, you will probably hear more about them at your workplace.
"Nearly half of employers may offer a high-deductible health plan within two years," said William Ziebell, executive vice president at insurance brokerage Arthur J. Gallagher & Co.
His prediction is based on a survey Gallagher did of 3,107 U.S. employers in March. The survey found that about 31 percent of employers offer an HSA-compatible health plan now and 15 percent said they are likely to adopt those health plans by 2018.
How to pick an HSA
Unlike the flexible spending accounts, you don't have to "use it or lose it" with an HSA.
In fact, more than three-quarters of HSA account holders withdrew less than they contributed last year, and 24 percent didn't touch any money from their accounts, according to a Fidelity Investments analysis of the more than 500,000 accounts it administers.
Your employer may direct you to sign up with their preferred HSA provider, but if you are enrolled in a qualified high-deductible health plan, you can choose whatever provider you want. However, if employers only offer matching HSA contributions to their preferred provider, it makes sense to stick with them.
HSAs can travel with you if you change jobs or insurers. Just like with any retirement account, fees and investment options matter.
Use this HSASearch to comparison-shop for more than 320 providers.
"Whenever feasible, we recommend that clients leave their HSAs alone to grow and to not use the funds," said Wade Chessman, a certified financial planner and president of Chessman Wealth Strategies in Dallas. "It's really the perfect investment ... pretax in and tax-free out."
Trump will MOVE FORWARD a United Nations ONE WORLD ONE GOVERNANCE universal health care----single-payer-----preventative health care for all just as Clinton/Obama were---global labor pool workers already have what is called INTERNATIONAL HEALTH INSURANCE that will be brought here to US and indeed it will cover our immigrant citizens but not with health care looking like America---with health care looking third world. Obama and Affordable Care Act restructured our health system to do just this----with global 1% and their 2% getting our first world quality health care all Americans received ----and 99% of Americans joining the global labor pool in ONE WORLD ONE UNIVERSAL PREVENTATIVE HEALTH CARE. Trump is not using the term UNIVERSAL CARE because he moved left------universal care IS THE RIGHT WING HEALTH CARE POLICY written to end our US quality care access to all care needed.
'The apparent gap between what Trump appears to be proposing (universal coverage) and what Republicans have supported (universal access) isn’t nearly as wide as many analysts think. This gap is both narrow and bridgeable: There are policies that can ensure universal access to health insurance while also putting our nation on the path toward universal coverage.
Any market-based replacement for the ACA should include four key elements to move us toward universal coverage'.
We want to shout to our immigrant citizens that they pay SOCIAL SECURITY AND MEDICARE PAYROLL TAXES and they should receive same level of care as US citizens with Medicare---sadly that will move to the gutted of funding MEDICAID FOR ALL---RIGHT WING UNIVERSAL CARE.
Trump wants health ‘insurance for everybody.’ Here’s how the GOP can make it happen.
President Donald Trump smiles. (Win Mcnamee/Bloomberg)
By Lanhee J. Chen and Tevi D. Troy February 2Lanhee J. Chen is a research fellow at the Hoover Institution and director of domestic policy studies in the public policy program at Stanford University. Tevi D. Troy is chief executive of the American Health Policy Institute and was deputy secretary of health and human services from 2007 to 2009.
Donald Trump’s statement that his preferred replacement for the Affordable Care Act (ACA) would provide health “insurance for everybody” surprised those who have followed the contentious debate over the health-care law since its passage in 2010. Rep. Tom Price (R-Ga.), Trump’s nominee for health and human services secretary, signaled agreement with the president when he said during his confirmation hearing that a Republican replacement for the ACA should cover more people.
In recent years, though, Republicans have emphasized that gains in insurance coverage should not be the sole barometer by which health-care reform is measured. Rather, they have said, the affordability of that coverage is the key to a better health-care system with fewer uninsured Americans. The ACA’s cardinal sin is its focus on access first, while doing little to address cost.
As a general matter, the conservative focus on lowering health-care costs first is exactly right. Yet Trump was also right to argue that the ACA’s replacement ought to have universal coverage as a goal. Democrats should not be allowed to claim this health-care moral high ground uncontested.
For too long, Republicans have shied away from calling for “universal coverage” because they’ve equated it with the Democratic push for a government-run, single-payer health-care system. But that simply isn’t the case. Market-based reforms can both lower costs and lead to health insurance coverage for more Americans. Indeed, any health-care reform that can’t compete with the ACA on coverage is sure to face significant political headwinds. It also would make it far less likely that Democrats can be persuaded to support replacement legislation. Perhaps most important, this is a fight that conservatives can — and should — win.
The starting point for this seemingly audacious claim is the fact that the ACA has been a significant failure even for those who value universal coverage above all else. While the law has unquestionably decreased the number of uninsured people in the United States, the Census Bureau reported last year that 29 million remained without health coverage in 2015. (About a quarter of these were undocumented immigrants or residents of states that opted against the Medicaid expansion.) In 2015, the Internal Revenue Service found that 19.2 million taxpayers either paid the individual-mandate penalty or received hardship exemptions from that mandate — meaning that tens of millions of people went without health insurance, primarily because it’s too expensive.
Kellyanne Conway, a senior aide to President Trump, told CBS on Jan. 22 that Trump wants to replace “Obamacare with a more patient-centric, free-market solution.” (Reuters)Republicans have traditionally been more comfortable talking about the importance of ensuring that every American has access to quality, affordable health insurance. Indeed, “universal access” has been a relatively noncontroversial way for conservatives to avoid making promises about how market-based health-care reform would affect the number of Americans who remain uninsured after the passage.
The apparent gap between what Trump appears to be proposing (universal coverage) and what Republicans have supported (universal access) isn’t nearly as wide as many analysts think. This gap is both narrow and bridgeable: There are policies that can ensure universal access to health insurance while also putting our nation on the path toward universal coverage.
Any market-based replacement for the ACA should include four key elements to move us toward universal coverage.
First, it should expand access to consumer-directed coverage arrangements such as health savings accounts coupled with high-deductible insurance plans. These products not only help reduce costs but also give consumers greater control over their own care. Such increased control incentivizes individuals to do what consumers do best: make value-based decisions that collectively drive down costs and improve quality.
Second, assistance should go to those who need it but be tailored to their individual situations. Low-income Americans should have access to a more innovative and modern Medicaid program, while the working poor should have access to a tax subsidy to help them afford private plans.
Third, those with preexisting conditions should have access to mechanisms, such as properly funded high-risk pools, to help them both acquire and afford coverage.
Finally, the federal government should allow for alternative pathways to private, tax-preferred coverage, by allowing health plans to be sold across state lines, as well as by giving unions, churches and other civic organizations the opportunity to offer coverage to members.
Taken together, these policies provide a powerful set of tools to both drive down health-care costs and expand coverage to every American. Trump and the Republican Congress have a remarkable opportunity not only to do away with the ACA and all of its shortcomings but also to put in place reforms that will truly improve our health-care system. Republicans in Congress should not hesitate to embrace Trump’s call for universal coverage. Indeed, they should work with the new administration to pass legislation to make this goal a reality.
PLEASE REMEMBER UNIVERSAL HEALTH CARE WAS WRITTEN BY RIGHT WING HERITAGE FOUNDATION TO END PUBLIC HEALTH CARE ---MEDICARE AND MEDICAID----BY CREATING A PRIVATE HEALTH SYSTEM BASED ON REDUCING HEALTH COSTS BY MAKING INSURANCE AND DEDUCTIBLES TOO HIGH SO THE AMERICAN PEOPLE COULDN'T AFFORD IT.
That is from where the term AFFORDABLE came---see as well the INSURANCE MANDATE came from right wing Heritage because it sends a steady stream of profit. Having our ability to pay increasing insurance costs from global health systems tied to how much access we receive
'Heritage has shaped American public policy in major ways, from Reagan’s missile-defense initiative to Clinton’s welfare reform: Both originated as Heritage proposals. So, too, did the idea of a universal health-care system based on a mandate that individuals buy insurance'.
The Fall of the Heritage Foundation and the Death of Republican Ideas
How the Heritage Foundation went from the intellectual backbone of the conservative movement to the GOP's bane—and how it's hurting the party's hopes for a turnaround
- Molly Ball
- Sep 25, 2013
The story of the conservative movement that has come to dominate the Republican Party over the last four decades is inextricably intertwined with the story of the Heritage Foundation. In that time, it became more than just another think tank. It came to occupy a place of special privilege—a quasi-official arm of GOP administrations and Congresses; a sponsor of scholarship and supplier of legislation; a policy base for the party when out of power. Heritage has shaped American public policy in major ways, from Reagan’s missile-defense initiative to Clinton’s welfare reform: Both originated as Heritage proposals. So, too, did the idea of a universal health-care system based on a mandate that individuals buy insurance. Though Heritage subsequently abandoned it, the individual mandate famously became the basis of health-care reforms proposed by Massachusetts Governor Mitt Romney and President Barack Obama.
"They're destroying the reputation and credibility of the Heritage Foundation. The respect for their policy work has been greatly diminished."These days, Heritage has a different crusade. The foundation’s president, the confrontational former Senator Jim DeMint, spent the last month touring the country, drawing cheering crowds as he demanded that Republican politicians insist that Obamacare be defunded—and denouncing those who wouldn’t go along. “Republicans are afraid,” DeMint told NPR. “And if they are, they need to be replaced.” The foundation’s three-year-old activism arm, Heritage Action, spent half a million dollars on online ads targeting 100 Republican House members who didn’t sign on to the defund crusade (“Tell Representative Tom Cole to Stop Funding Obamacare”).
With imposing buildings flanking the Capitol on both sides and a budget of more than $80 million, Heritage looms large in the Washington professional right. More than just another nonprofit peddling legislative ideas, it has become the de facto policy arm of the congressional conservative caucus. “The Heritage Foundation is where policy agendas are set and tactics are developed hand-in-hand with Hill staff,” a rival researcher wrote last year, describing Republicans in Congress as essentially “outsourcing” their policy work to the foundation.
Unique among nongovernmental organizations, Heritage’s Center for Data Analysis has the number-crunching capacity to compete with the White House’s Office of Management and Budget and the Congressional Budget Office in using sophisticated modeling to assess legislation’s impact on the economy. When Representative Paul Ryan drafted his conservative budget proposal in 2011, he submitted it to Heritage as well as to the CBO to be “scored.” (Heritage scored it more favorably.)
Nothing better symbolizes Heritage’s integration with Republican policymaking than its longtime partnership with the Republican Study Committee, a conservative caucus in the House that, at 172 members, now claims the majority of the House GOP. Heritage and the committee were both founded in 1973 with the involvement of Ed Feulner, then a Republican congressional staffer. After leaving the Hill, Feulner served as Heritage’s president until DeMint took the reins this year.