The Progressive Ensign

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Category: Teacher Wages

Hospitals Cut Non-Compete Deals With Insurers

Image: wbur.org

Hospitals are the number one cost in health care nationwide at $1 trillion per year.  Healthcare is close to 20 % of the U.S. annual GDP.  Physician and clinical services are second followed by prescription drugs.

Sources: Centers for Medicare and Medicaid Services, The Wall Street Journal – 9/19/18

Hospitals are at the center of the most intense and high care treatments for surgeries, interventions, procedures and emergency care.  Most must take Medicare payments if they are to have a wide enough patient population to support their business. Yet, Medicare reimbursements often don’t cover the actual costs of treatment.  Hospitals look to employer – insurer plans and cash customers to make up the difference.

The Wall Street Journal investigated a number of hospital – insurer contracts and found in some cases the hospitals and insurers were cutting contracts which included non-compete clauses.  Thus, if a hospital had a dominant position in a patient market, it would require that the insurer not insure patients of their competitor.  Clearly, a restraint of trade, causing employer plans to pick up the balance, and in some cases where doctors were affiliated with hospitals employees were having to pick up the extra cost. Employers have seen premiums from insurers going up to handle the extra cost of these sweetheart deals.

These close partnership deals between hospitals and insurers create higher costs where services are much cheaper outside of the hospital in a doctor’s office.

Sources: Health Care Cost Institute, The Wall Street Journal – 9/19/18

Instead of hospitals steering patients to their doctors for many services, they provide the services on an outpatient basis at a much more expensive price. Insurers pick up the outpatient cost and then charge employers and patients higher premiums than necessary.

Next Steps:

 We have supported the Affordable Health Care Act provisions requiring insurers to insure all patients with existing conditions, and other patient oriented options.  However, this law is only the first step in reforming the healthcare industry, rigorous enforcement of anti-trust laws needs to take place to eliminate practices like these non-compete agreements.  We call for transparency in pricing of all drugs, and the relationship between drug manufacturers and pharmacies. We recommended in earlier posts that all Americans should have access to good quality health care, beginning with a healthcare account at birth. Then, as the patient takes a job, employer plans can be used, but always between jobs or disability the patient is covered.  Medicare should be the first line of insurance for all from birth with employer plans supplementing the main plan.  Medicare should have complete negotiating rights with drug manufacturers to get the best price for all patients.  All health care for profit companies should be barred from buying back stock and wasting money on executives which is better spent reducing prices and increasing the quality of care.

We Have A Duty to Provide, Protect and Promote the Common Good

 

Image: Your Little Planet

Today’s discussion of the Common Good is focused on a point that arose this week from a court case where the parents of children in Detroit sued the city school district for better teachers, classroom conditions and funding.  The basis of the suit was that it was a ‘constitutional right’ that all children should have a fair and equal education regardless of income.

Unfortunately, as much as we would like to see education as a ‘right’ it is not mentioned in the U.S. Constitution or the Bill of Rights. The judge held that there was no ‘right’ to a quality education. The 14th Amendment does require states when they provide public education to offer equal access to all students – equal quality is not specifically defined.  We see education as Madison and Jefferson did as a key pillar of the government where a well-informed citizenry will make wise choices about who would lead their government.  We have outlined in an earlier post that we see Education as the Fifth Estate, after the Fourth Estate, The Press and the three main branches of federal government – The Executive, Congress and The Supreme Court.  Then, it follows that as a country we have a duty and responsibility to ensure that all children have a equal opportunity for a high quality education and access to learning institutions.

We do not really talk much in our society anymore about duty to country – or duty at all.  We are indoctrinated constantly about ‘my right’ to this and that.  While it is important that we have key rights ensured by our Constitution and courts, duties need to be in balance and in many ways ensure that rights can be sustained.

What do we ask of our young people graduating from high school in regard to supporting the freedoms and rights they enjoy?  Universal service for every 18 year old as they do in Switzerland, or universal military service as Israel requires?  What sacrifices do we expect our people to take on at any age?

In WWII, the Korean War, Vietnam War, and Middle East Wars, American men and women fought alongside each other to ensure the freedoms we enjoy and to protect the freedom and welfare of others.  The wealthy fought along with the poor as a team, to survive in a hostile environment against a common enemy. They shared this life changing experience, learned how to depend on each other to survive and discovered what they had in common. Today, young people serving in the armed forces are making sacrifices and sometimes putting their lives on the line, yet the vast majority of our forces are comprised of poor or working class men and women from rural regions of the country.  We are not all sharing the duty of defense across classes.

Everyday there are citizens across classes serving our country, as many people do volunteer work in all types of ‘duty’ based work at churches, non- profits and relief groups.  Some sacrifice themselves and time in environmental protection efforts that support good stewardship of the earth that we all live in and enjoy.

So, when we look to ‘get our rights’ in court, we may need to look to how to make duty more of a core value in our culture and in particular business culture.  As we have observed our country is essentially run by Corporate Nation States, they must change their attitude, behavior and operating practices focused on their duty to all the people not just their executives and customers. Everything a corporation does in some way impacts the Common Good. We are the people these corporations serve, and we should expect nothing less than socially responsible behavior from the executives running these huge Corporate Nation States.

Teachers Protest Lack of Financial Support

 

Photo: the74million.org

North Carolina teachers protest today asking for school funding increases to be used for school nurses and an increase in per student funding now just 39th nationally, following their colleagues in West Virginia. In West Virginia teachers were successful at achieving a 5 % raise.  Other teachers in Kentucky, Oklahoma, Colorado and Arizona have gone on strike for raises or more school funding.

Sources: National Education Association, Vox – 3/18/18

Teachers have actually been losing income since the Great Recession when inflation is considered, it is little wonder that they are fed up with districts not paying them a fair wage to live at a middle class standard of living.

The Department of Education reports that 94 % of all teachers have to purchase their own supplies for their classrooms at an average of $479, adding insult to their lack of pay. Today, it is a 24 hour 7 day a week job, answering emails from students and parents, and responding to text messages at all hours. As education becomes more critical to get a good job, parents are even more demanding of their children’s instructors putting constant pressure on under resourced teachers.

How do our teachers’ salaries and raises compare with other developed countries?  Japan, Korea, Ireland, Poland, Canada are way ahead of us in offering raises of 75% to almost 60 % in providing raises for elementary teachers over the last 15 years versus the US at 25 %.

Sources: OECD, Education Week – 6/2014

If we want to provide the opportunities for our children to have good careers, in whatever field they choose we need to be making a much larger investment in our education system from kindergarten through college.

Next Steps:

Robert Reich, former Secretary of Labor for President Clinton and Professor at UC Berkeley sees part of the salary issue in the source of funds for our schools.  The school systems evolved from local cities and districts mostly funded by local property taxes. Wealthy districts in California spend about 3 times the funding or poorer districts.  When school foundations are considered the disparity is even greater and rich parents receive a tax deduction as well.  We see a need to provide funding primarily across states (which some states do supplement poorer districts) but equally across the country.  In OECD countries they invest in their students equally with even more funding provided to poorer districts. In the US only 14 % of the funding for local district schools comes from the federal government. OECD governments provide 54 % of the funding for local districts.  We need to get serious about the future of our children and provide consistent national funding for education.  Increasing taxes on corporations who have the lowest tax rates since the 1980s would be a good place to start since they are sitting on $1 trillion in cash mostly in off shore accounts or using their profits to do stock buybacks compensating executives at 300 % of their average workers’ pay. Especially, in America’s Heartland our young people are not receiving the education they need to build careers, and businesses in their communities to make thriving regions after being hit with many businesses shutting down or moving overseas.

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