By Alyssa Katz
During the real estate bubble, older urban neighborhoods across the nation, from Atlanta to Baltimore to Cleveland to Sacramento and countless communities in between fell victim to a devastating plague of predatory lending and mortgage fraud.
This was enabled by Wall Street’s bottomless appetite for financing home loans, lenders’ lax standards, and corruption among mortgage brokers and appraisers. Brokers set up borrowers with subprime mortgages knowing they were too big to pay, while organized mortgage fraud rings convinced lenders to issue mortgages for far more than homes were worth, pocketed the proceeds, and left boarded-up foreclosed houses behind.
But the bursting bubble has not brought relief to suffering neighborhoods. On the contrary, communities already hard-hit by mortgage fraud and subprime foreclosures are now enduring the next wave of profiteering: the selling of vacant and foreclosed real estate to speculators.
A few of the purchasers are doing a service by fixing foreclosures up and renting them out. But far too often the foreclosed homes stay vacant and derelict as they’re flipped from one buyer to another.
In areas with bottomed-out real estate markets, prospectors see an opportunity to profit from devastation. Houses are being re-sold at tremendous mark-ups -- sometimes upward of 1,000 percent -- under “rent-to-own” contracts, whose holders bear the responsibilities of homeownership but few of the rights. These foreclosed houses are purchased in bulk, sight unseen, by investment companies far away from the community.
The companies selling the foreclosed real estate are the middle men known as mortgage servicers. During the real estate bubble, investment banks bundled mortgages into securities. Servicers work on behalf of investors in those securities, collecting monthly payments from borrowers and distributing the proceeds. But when payments stop coming, servicers move to foreclose – and once the property is vacant, they decide what happens next. Most move to sell it off as quickly as possible, rather than spend substantial sums on upkeep -- and on advancing those monthly payments.
In hard-hit foreclosure zones across the nation, servicers have so much real estate to dispose of that they auction it in bulk for as little as a few thousand dollars a property. These fire-sale prices too often attract buyers who exhibit little concern for neighbors or neighborhoods. One foreclosed house in Atlanta burned down last year, but that didn’t stop a Florida servicer, from selling its scorched remains to a Utah speculator for $1,000.
This transaction is far from an exception. All over the country, servicers are dumping property that is uninhabitable and a hazard to neighbors.
As such wreckage accumulates so do crime, garbage dumping, and other ills that push high-foreclosure neighborhoods into downward spirals. Residents have no idea where to turn for help. Servicers operate in the shadows: their names are not searchable in public records, and once they sell a property their obligations for its upkeep ends. Their only responsibility is to maximize profits for investors in the mortgage-backed securities. As long as foreclosed properties fetch the best possible price at auction those investors are satisfied, however dire the outcome for neighborhoods.
Mortgage servicers must now step up and exercise responsibility to communities. The eight biggest servicers are divisions of financial institutions — Bank of America, Chase, Wells Fargo, Citigroup, GMAC, PNC, SunTrust, and U.S. Bancorp — that have received billions in federal bailout funds. Two others, American Home Mortgage Servicing and Ocwen, receive aid from the Federal Reserve. Four additional entities that sell foreclosed real estate — Fannie and Freddie, the FDIC and the Federal Housing Administration — are run directly by the federal government. All of these institutions receiving federal support should be required to dispose of foreclosed homes in a way that stabilizes battered neighborhoods.
One model is the nonprofit National Community Stabilization Trust, which works with servicers to offer vacant homes for sale to nonprofit organizations and other developers with track records in neighborhood revitalization. That voluntary effort should become mandatory for servicers benefiting from federal aid. A program governing responsible sales of foreclosures, as part of neighborhood recovery plans will make it possible for mortgage servicers to do the right thing for neighborhoods.
Local courts also have a role to play. Judges can follow the model set in Cleveland, where Hon. Ray Pianka ordered Wells Fargo to bring foreclosed houses into compliance with housing codes before selling them.
Mortgage servicers are in an unenviable position, stuck with the expensive mess bankers left behind. But the fate of fragile communities is in their hands. Government at the federal and local level must now require them to help neighborhoods recover from the foreclosure catastrophe.
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Katz is the author of Our Lot: How Real Estate Came to Own Us and a reporter for the Nation Institute Investigative Fund.
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Copyright (C) 2009 by the American Forum. 9/09
ARIZONA EDITORIAL FORUM
By Fr. Glenn B. Jenks
The setting was a beautiful small white pueblo-style Episcopal Church located 35 miles north of Phoenix. Every morning, a group of Hispanic migrant day workers, numbering between 35 and 65, would gather in the church parking lot before sunrise. They were greeted by several church volunteers who had already set out the coffee and the day-old pastries donated by a couple of local coffee shops.
The Day Worker Ministry of this small church was started in an effort to provide a solution to a difficult situation in the town of Cave Creek.
The town had a problem with literally dozens of migrant workers walking in groups along the roads and streets. The town council was frustrated because, while the migrants were not committing any crimes, their mere presence aroused the ire of local residents. That was when Good Shepherd of the Hills Episcopal Church stepped up and offered itself and its facilities to operate a day worker center, away from the streets and local businesses.
In this way, the Day Worker Program of the Church was born. It operated successfully for almost nine years. It helped workers get medical and dental care. The program weeded out "trouble makers," alcoholics and drug users, so that when someone hired a worker they could have confidence that the person they hired was safe, reliable and honest.
Not surprisingly, over time the church became very controversial. For some, it was perceived as having provided a creative solution to a difficult problem. Others felt that by operating this ministry the church itself had become the problem. The local newspaper called the church and its priest the "bad shepherds," and much worse, for befriending what the paper referred to as these "vermin."
In time, a local motorcycle group began picketing the church on Sunday mornings, shouting obscenities with bull horns, and intimidating parishioners as they came to church. This strained relations among members of the church, some were willing to accept the criticism as the cost of doing the Gospel, and others were bothered by the "bad press" and the controversial image the church had acquired. Some left the church, while others joined because of the program.
Mounting pressures from some who wanted all "illegals" thrown out of town finally succeeded in attracting the attention of the Sheriff of Maricopa County, Joe Arpaio. The Sheriff targeted the church and decided to make an example of it and its ministry. As a participant in the Department of Homeland Security's (DHS) 287(g) program, the Sheriff's department had trained 160 deputies to detain dangerous offenders suspected of being in the country illegally.
Sheriff Arpaio ordered his deputies to park near the entrance of the parking lot and to follow any car with a brown-skinned person in it. They were to pull them over for the slightest infraction. The deputies would stop the car, require the brown skinned person to prove their legal residence, and when they could not they were arrested immediately turned over to Immigration and Customs Enforcement (ICE) which deported those who could not prove citizenship. Eventually, the day worker program shut down for good.
Church Leaders, along with other Valley Interfaith Project Leaders, reacted to the Sheriff's disregard for the guidelines in his 287(g) agreement by challenging DHS and ICE to fulfill their oversight obligations. DHS was provided with evidence showing the Sheriff and his deputies violating terms of the 287(g) agreement.
The experience of Good Shepherd of the Hills Church reveals that there is tension in our communities about immigration. However, enforcement only approaches to immigration that trample on civil and religious rights only exacerbate our problems. What we need is a workable solution that upholds our values and moves us forward together. We need comprehensive immigration reform.
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Jenks is a retired rector at Good Shepherd of the Hills Episcopal Church.
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Copyright © 2009 by the Arizona Editorial Forum. 9/09
TEXAS LONE STAR FORUM
By Frances Deviney, Ph.D.
New Census Bureau data shows that for the 10th year in a row Texas has the highest rate of uninsured children in the country, with one of every six kids uninsured. Nearly one of every four Texas kids lived in poverty in 2008 (e.g., $17,600 for a family of three).
As troubling as these numbers are, this data likely under represents the extent of the current problem for two important reasons.
First, the latest Census data does not cover 2009, and unemployment has been rising sharply in Texas this year, from 6.4 percent in January to 7.0 percent in July (the most recent month available). Economists tell us that poverty rises with rising joblessness and that increase is sharper for vulnerable groups like children.
Second, even once the data catches up to the recession, child poverty is likely even deeper than shown in these figures. The federal poverty measure is badly outdated and excludes many families struggling to cover basic expenses, effectively disqualifying them from receiving available food or housing assistance.
The Measuring American Poverty Act would update the poverty measure to include more realistic expenses (including health care and child care) and help us to accurately measure the effectiveness of our poverty reduction programs, such as Food Stamps (now known as the Supplemental Nutrition Assistance Program). Shouldn’t we know how many people really need help and whether our help does any good?
Decisionmakers need reliable, relevant information to get the best results from public programs, but our policymakers and administrators use antiquated measurements and data to make decisions and assess performance. To ensure our public structures reach the people who need them most, we need an accurate measure of poverty in America, and we need Americans to fill out their 2010 Census forms in the spring.
That is why we must plan early for the upcoming 2010 Census. Most people do not realize that the accuracy of data personally affects them. Most major federal funding decisions (and many state and local ones) rely at least in part on Census data, including funding for early childhood education, schools, roads, environmental protection, health care, and nutrition. And the number of representatives we have in Congress is directly related to an accurate count of our fast-growing population.
If you belong to a business or community service organization, you can partner with the 2010 Census to help increase participation, which will give your organization better data on customers or clients in your area. If you are an educator, elected official, part of a faith-based organization, or are simply a proud member of your community, you will be crucial in spreading the word about the importance of filling out the census forms next spring, ensuring Texas kids and families are accurately represented when decisions are made in Washington.
Most people understand the need for reliable, relevant data. Everyone from hospitals to businesses to sports teams rely on data collection and analysis to measure and improve their performance. None of these groups would be satisfied with outdated or incomplete measures of performance.
Improving the quality of data – counting what counts – helps ensure our public programs work and gives us the ability to evaluate them, continue to support them if they are effective, adjust them if needed, or eliminate them if they are ineffective. In short, good data leads to better decisions. Without them, decisionmakers are left in a vacuum, forced to either ignore growing problems or make changes based on assumption and anecdote.
Only by counting yourself in can you make sure that kids count too.
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Deviney is director of Texas KIDS COUNT, a project funded by the Annie E. Casey Foundation and housed at the Center for Public Policy Priorities.
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Copyright (C) 2009 by the Texas Lone Star Forum. 9/09
MISSISSIPPI FORUM
By Louis Miller
The Mississippi Sierra Club, AFL-CIO and NAACP strongly oppose Mississippi Power Company’s (MPCO) proposal to build a $2.4 billion dollar ‘clean coal’ plant and adjoining mine in Kemper County.
Mississippi Power’s arguments for the plant are built on three myths that have little or no basis in fact.
The truth is that the Kemper coal plant: 1. is unnecessary; 2. is astronomically expensive and will drive up customer bills; and 3. would be a major polluter.
Let’s start with Myth No. 1. MPCO argues that South Mississippi will run out of electricity if this plant is not built. This is not true. Mississippi currently has independently-owned power plants that can supply almost three times the amount of power the entire state requires at peak times. But MPCO refuses to purchase power from these plants except on rare occasions.
Twelve natural gas-fired power plants sit idle 85 percent of the time but could provide up to 7,993 megawatts of power, according to the Public Service Commission (PSC). MPCO’s proposal would produce less than 600 megawatts of power.
Myth No. 2 is that the plant will not raise the bills of MPCO’s customers. The price tag for the plant is $2.4 billion -- and rising. This represents by far the largest capital expenditure ever put into an electric utility’s customer rate base in the history of our state.
A PSC expert testified this year that if the cost of the Kemper plant were “allowed to be put into rates, then Mississippi Power’s rates would increase substantially as compared to rates of today”
MPCO’s wants consumers to foot the bill for this $2.4 billion plant upfront, even if they never use the electricity. MPCO spent hundreds of thousands of dollars lobbying the state legislature to change state law to allow the cost of this plant to be shifted from stockholders to customers. If this plant makes financial sense, MPCO shareholders should fund it.
Myth No. 3 is that the Kemper coal plant is “clean coal.” MPCO’s proposal involves digging up 45 square miles of Kemper County for strip mining, displacing hundreds of residents while destroying streams and wetlands. Five hundred acres would become a dump for toxic coal ash from the plant. The plant itself would be classified as a major air polluter under the federal Clean Air Act.
MPCO proposes to capture and sell 65 percent of the carbon dioxide emissions from the plant. However, the company does not yet have anyone to buy this carbon dioxide, and until a buyer is secured, MPCO will not commit to this reduction in emissions in its air permit. Alternatively, consumers would bear the cost of disposing of these emissions.
The Kemper plant will also emit up to 63pounds of mercury per year, despite new technologies used. Over time, that’s enough toxic mercury to contaminate thousands of water bodies and millions of pounds of fish. When whole river systems in Mississippi are already so contaminated with mercury that the fish pose a danger to pregnant women, why allow more contamination when there are better alternatives? Just improving efficiency in energy use could prevent the need to expand capacity for years.
The citizens of Mississippi should reject this dirty, expensive and unnecessary coal plant proposal. On October 5th the Mississippi Public Service Commissioners will begin hearings to decide the fate of this proposal. It’s time to say: “Thanks but no thanks,” we can do better.
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Miller is Sierra Club Senior Regional Representative, Mississippi.
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Copyright (C) 2009 by the Mississippi Forum 9/09
NEW MEXICO EDITORIAL FORUM
By Miriam Komaromy, MD
When I walked into the exam room, a thin, pale, middle aged man was sitting patiently in a chair waiting for me. Mr. Richards (not his real name) politely explained that he needed medicine for his heart, and gave me a list of the medications he was supposed to be taking. I asked about his living situation, and he told me he had been living in shelters for the past two years.
As he responded to my questions I learned this man was an engineer who had been employed by a prominent technology firm. When he had developed diabetes in his late 30s he quickly developed severe complications, including damage to his vision, and later heart trouble. He could no longer perform his work duties. He lost his job and then his health insurance. He became depressed and withdrawn, and eventually his wife left him. His health care bills bankrupted him and he lost his home. He had applied for disability benefits, but was turned down.
As this man’s story unfolded I felt my stomach clench with anxiety for what would happen to him. Unfortunately I had very little to offer. As a physician who has worked all of my adult life caring for low-income and uninsured patients, I have so often been in a position to apply a band-aid—in this case, arranging for him to receive a month’s worth of his medicine free of charge—but not a solution to the huge problems that face my patients on a daily basis. In order to get in to see a health care provider at my clinic he had stood in line for over an hour in the heat on two successive days, waiting to find out if we would have an available appointment. Tonight he would walk a long distance alone on the street, vulnerable because of his poor eyesight, and would sleep on a cot in a shelter.
I was struck all over again by the cruelty of a so-called health care “system” that offers health insurance only to those who are employed. For this man, illness had caused the loss of his health insurance, and now lack of health insurance and adequate medical care was allowing his disease to progress unchecked. It was undoubtedly shortening his lifespan, and was creating a situation in which we as taxpayers will all pay the enormous costs of providing care for him as he becomes so severely disabled that he requires hospitalization, heart surgery, and perhaps dialysis. Yet, we as a nation have not been willing to pay the upfront costs that could help this man and so many others to get the care that could help prevent or slow disease complications and extend functional years of life.
Who are we as a people? How have we allowed it to become the norm that our citizens go hungry, sleep on the street, and do not have access to basic medical care? Nations vastly poorer than ours choose to treat health care as a basic human right and thus provide health care for all citizens.
We each know deep down that a sudden twist of fate could land us in a devastating situation like my patient Mr. Richards. The Reverend Martin Luther King, Jr., once said, "Of all forms of inequality, injustice in health care is the most shocking and inhumane." Paradoxically, in our country health insurance seems largely to be reserved for the healthy.
We are coming to an historic moment, when we finally have a president who is willing to put all of his weight behind passing comprehensive health care reform. The outcome though, is not guaranteed. Most worrisome is the backlash against the option of a public health care plan. The so-called “public option” would help to loosen the stranglehold that the private insurance industry has on our health care system. It would offer meaningful competition to for-profit insurers, would help to reduce costs for medical care, and would provide comprehensive insurance similar to Medicare.
Now is the time to let our voices be heard: Comprehensive health care reform with a public health insurance option is not just what we want, but what we demand.
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Dr. Komaromy is a former medical director of Albuquerque Health Care for the Homeless.
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Copyright © 2009 by the New Mexico Editorial Forum. 9/09
MISSISSIPPI FORUM
By Rachel Ann Hicks
Long lines at polling places made big headlines last election cycle. Though remarkable, many expected the unusual Election Day waits which were caused by a record number of Americans participating in the democratic process.
More surprising though were the pre-Election Day polling lines: due to the new national trend known as in-person early voting, thousands of Americans lined up to vote before Election Day.
Like voters in Arkansas, Georgia, and Tennessee, Mississippi should join in and adopt in-person early voting because it will improve democratic participation -- and, therefore, democracy -- in Mississippi.
Despite experiencing our highest voter turnout during the last presidential election cycle, Mississippi’s rate of voter participation still leaves us below the national average for 2008. Historically, the news is even worse. Turnout statistics from the last two midterm elections, 2002 and 2006, show Mississippi ranked last or next to last nationally. Although more Mississippians vote in our gubernatorial election years than in midterm election years, voter participation in these important state races lags that of states whose officials are elected in the same year as the president.
Low voter turnout sends a signal to our elected officials that they do not need to be accountable to all of their constituents. Unless all registered voters express their desires through the ballot box, we undermine a fundamental principle of American democracy -- that our government is “of the people, by the people, for the people.”
Currently, Mississippi only allows absentee voting, in which the voter is required to give a reason for not voting on Election Day. While absentee voting must continue in Mississippi for voters with extended absences from the state, early voting has distinct advantages. Not only are early voters not required to state a reason for voting before Election Day, they also cast the same ballot (on the same equipment) available to their precinct’s Election Day voters, rather than an absentee ballot.
Furthermore, according to the Early Voting Information Center, states with early voting report high levels of voter satisfaction with the process; many early voters identify convenience as their primary reason for supporting the procedure. Lengthening the time that voters may cast a regular ballot increases the convenience of voting both by allowing voters more flexibility in their schedules and by shortening the lines on Election Day. Working Mississippians, who may find it difficult to stand in long lines on one specific day in the middle of the week, may find the convenience of early voting particularly appealing.
In fact, early voting is most likely to impact Mississippi’s elections for state and local office, the very elections that most deeply affect our day-to-day lives. Researchers find that though early voting does not increase participation rates among new voters, it may increase turnout in lower-intensity elections among regular voters — voters who regularly vote in presidential elections. Increasing the convenience of voting may increase turnout in important state and local elections that do not fall on presidential election years.
Mississippi needs early voting. Because early voters are no more likely to be Democrats or Republicans, early voting is not about empowering a particular political party but about empowering the electorate. With a more engaged citizenry, Mississippians can expect a more responsive and effective government. It’s time for our state leaders to support early voting: it’s good for Mississippi’s democracy.
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Hicks is the executive director of Mississippi First, a civic advocacy organization.
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Copyright (C) 2009 by the Mississippi Forum 9/09
NORTH CAROLINA EDITORIAL FORUM
By Rev. J. George Reed and Chris Liu-Beers
Across North Carolina, nearly everyone agrees that the current immigration system is broken. So if the system is broken, why do we continue pouring money into it? Instead, we should take this historic opportunity to fix it.
Many politicians are saying that they want to address the root causes of our immigration situation, but they go on to talk only about increased enforcement. Of course, we are a nation of laws and the rule of law should be upheld. But experience and common sense show us that merely building a bigger wall won’t work because enforcement alone does not deal with the root causes. If we’re going to address the causes of immigration, we need to have a serious conversation about factors like American trade policy (including NAFTA) and the lack of opportunity in many “sending” countries. When NAFTA went into effect in the mid-1990’s, its unfair trade provisions allowed U.S.-subsidized corn to flood the Mexican market, bankrupting nearly 2 million Mexican corn farmers virtually overnight. This major economic disaster had a big impact on immigration into the U.S. from Mexico.
The bottom line is that Congress and the President basically have three options for addressing immigration – and only one of them will work. 1) Allow the current immigration mess to deteriorate further, a prospect that frustrates the vast majority the American people. 2) Hold out for the ugly fantasy that we are going to get rid of 12 million undocumented immigrants, a prospect as unrealistic as it is un-American. 3) Move forward with a comprehensive plan that restores the rule of law, gets people in the system, makes employers play by the rules, and creates a stable, sustainable and legal system of immigration.
Since we’re not going to deport 12 million people, we need comprehensive immigration reform that includes a path to citizenship in order to assimilate new Americans. We already know that building a bigger wall won’t help. We’ve tried that for the last few years with nothing to show for it. What we need is an orderly system that works for both immigrants and our country.
Comprehensive reform is the only practical and sensible way to ensure that all workers are here legally, unscrupulous employers cannot undercut their honest competitors, fairness is restored to the labor market, and enforceability and justice are restored to the rule of law. It will lift wages for workers, restore tax fairness, and create a level playing field for law-abiding employers.
Despite the clamoring of a noisy minority, polling data consistently shows that American voters support comprehensive reform over an enforcement-only approach. A recent national poll found that when voters are given the details of comprehensive reform, 86 percent support Congress passing comprehensive reform, while only 7 percent strongly oppose the plan.
So what should comprehensive immigration reform look like? The solution to our current broken system must include:
- The reunification of families and preservation of our family immigration system;
- A way for people to get in the system with legal status so they get on a path to citizenship, learn English, and become part of society;
- A coherent and fair legal system that respects the value of due process;
- A logical, viable system for regulating legal immigration; and
- Effective, humane border and interior enforcement that respects everyone’s rights and keeps communities safe without forcing people into society’s shadows.
As members of the faith community, we believe that we have the opportunity to fix our nation’s broken immigration system and uphold our deepest values at the same time. The command to welcome the “stranger” echoes in our ears as immigrant families and workers are living in a state of fear due to increased raids, deportations and anti-immigrant sentiment. Our religious traditions call us to love our neighbor as ourselves, and we believe this applies to immigrants as much as anyone else.
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Reed is executive director of the North Carolina Council of Churches, an ecumenical, non-partisan, statewide organization. Liu-Beers is a program associate with the North Carolina Council of Churches and works on immigration issues.
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Copyright (C) 2009 by the North Carolina Editorial Forum. 9/09
By Willie J. Parker, MD, MPH
Despite the shouting and name-calling at the town hall meetings, I remain hopeful about health care reform. I have no other choice. As an obstetrician-gynecologist, I spent years learning how to keep women healthy. Too often, I find myself telling patients with easily treatable conditions that I can’t help them -- they don’t have the money to get well. Denying women care and watching them suffer rips me apart. That’s why I’ve become an ardent advocate for health care reform.
I am not talking about withholding the latest, cutting-edge, exorbitantly priced medications or treatments. No -- I’ve had patients whose health insurance doesn’t cover such basic health needs as Pap smears and birth control prescriptions. And forget about having a baby -- many insurance policies don’t cover prenatal care or labor and delivery, or they treat pregnancy as a pre-existing condition.
As a country, we need to give women a better chance at staying healthy. Through health care reform, Washington could guarantee affordable reproductive health care to every woman and every girl in the nation, no matter who is insuring her.
Recently I had a patient, Celia, who made too much money to qualify for Medicaid. Her employer didn’t offer insurance. She had fibroids, a common condition of the uterus. But because Celia couldn’t afford to see a doctor, her fibroids grew unchecked to the point of interfering with her monthly cycles. She bled so heavily that she became severely anemic. I had to send her to the ER where she was hospitalized to receive a blood transfusion.
Celia’s hemorrhaging was an unnecessary risk to her health. Moreover, the hospital paid for her trip to the ER, the kind of expenditure that makes health care more expensive for everyone. If she had health coverage, her fibroids could have been managed by a solution as simple as birth control pills, sparing the toll her illness took on her family, her coworkers, and everyone else who depends on her.
As a physician, I could take some satisfaction in helping Celia get better -- not so with Maureen, the mother of four I saw some years ago. I gave Maureen her first pelvic exam ever. She was 29. I found a large growth on her cervix that was almost certainly cancer, yet I could not do a biopsy or otherwise continue her treatment because she could not pay for it.
Maureen had no insurance and little money. Like many of my fellow doctors in situations like this, I tried desperately to find funding for her. I came up empty. I ended up feeling I had done something immoral by telling Maureen about a potentially deadly medical problem she could do nothing about.
For Celia, Maureen, and every other woman, reproductive health is at the core of their well-being. Yet insurance companies treat reproductive health care as a luxury and charge accordingly. Some make a woman pay as much as 45 percent more than a man for an individual policy, only because she happens to be female. Health care reform must treat women’s health as a rule, not as an exception. We must change American health insurance so that it covers women’s needs at prices they can afford.
As a nation, we can no longer dismiss Celia’s and Maureen’s situations as “woman problems.” Women make up half our population. Their reproductive health cannot be separated from their overall health, and their overall health impacts their families, their jobs, and our society as a whole. Congress must place reproductive health care at the center of reform. Women should have affordable access to pelvic exams, cancer and STD screenings, contraception, prenatal care, miscarriage treatment, maternity services, and abortion care. Helping women stay healthy will help us all.
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Parker, MD, MPH, is a board member of Physicians for Reproductive Choice and Health and an obstetrician-gynecologist in Washington, DC.
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Copyright (C) 2009 by the American Forum. 9/09
OHIO FORUM
By Alice Faryna, MD
Despite the acrimonious debate, there is actually consensus on both sides of the political aisle -- our current health care system is seriously flawed, dysfunctional and requires major change.
As Congress prepares for a final reconciliation, we are bombarded with messages containing language designed to either persuade or frighten us.
In a country as diverse as ours, we need to find common ground for deeply held beliefs and values. Values held by most Americans are quality, affordable, choice and American. Surveys consistently find that over two thirds of Americans favor health care access for all Americans, even if it means a major government role. The words government health care had a negative response, yet the same people wanted a choice of private and public plans.
Recent messages from politicians say they favor a uniquely American solution. Unfortunately, we already have a unique system. Our system costs twice as much as those of most other wealthy nations and fails to cover almost 50 million of us. Since World War II, our health system has relied on employer-based coverage purchased from private for-profit health insurers.
Our uniquely American employer-based private health insurance solution is unraveling. Any employer-based system is particularly vulnerable to economic downturns. Since the current recession began, tens of millions of Americans have lost their jobs and therefore their coverage. Even before the recession, the percentage of employers offering health benefits was falling. Only the expansion of public insurance like Medicaid and SCHIP prevented an even worse epidemic of lost coverage.
Health care costs have continued to soar at twice the rate of the Gross Domestic Product. Employers have responded by asking employees to pay a greater portion of insurance premiums and larger co-pays and deductibles.
Over a million American families fall into bankruptcy each year partly due to large health care bills. Even those with employer-based insurance are at risk since over 70 percent had insurance at the start of the bankrupting illness. Consumer Reports National Research Center released a January 2009 survey of over 2,000 Americans who regularly take medications. It shows that 22 percent have delayed a doctor visit, 18 percent put off a recommended procedure, 17 percent declined a test, 16 percent delayed filling a prescription and another 16 percent stopped taking a medication due to costs.
Other wealthy countries cover all of their citizens for about half of what we spend. Some are entirely public programs. Others like Germany and Switzerland allow private companies to offer insurance products, but they do not allow them to operate for profit. In these countries, universal coverage creates a large stable risk pool which combined with government run insurance or strictly regulated not-for-profit private insurers results in lower costs, better health outcomes and no bankruptcy from medical debt. These countries have covered everyone with high quality care at a more affordable price.
The House proposal retains many of our uniquely American flaws: preserving a for-profit system and relying on private insurance competition to bring down premiums. The proposal does contain new regulations that require insurers to take all applicants regardless of gender or health status, and guarantees the renewal of existing policies.
However, the much debated public option, originally conceived to ensure real competition, is at risk. In order to avoid a government takeover of health care, the proposal dictates the creation of a new bureaucracy -- the Health Insurance Exchange -- to help bewildered consumers choose an insurance plan. Our tax dollars will be spent on subsidies for low wage earners who cannot afford insurance but will be required to purchase private or public insurance.
Wouldn’t it be simpler and more efficient to allow people to buy into Medicare and set the premium at a level that covers costs? This “uniquely American” solution serves our seniors well. Medicare has proven to be a durable and reliable insurance program that has controlled health care costs better than private insurance exchanges. We know Medicare works. Medicare, unlike private insurance, allows you to choose any doctor or use any hospital. However, the insurance industry asserts that competing with Medicare is not a choice they will allow; calling it unfair and not on a level playing field.
We must continue to ask tough questions. For example, in a year where private insurance companies are posting record profits, why is the taxpayer being asked to subsidize them in order to cover the uninsured? Why isn’t a public option like Medicare a choice for everyone? Real reform must cover everyone and controls costs.
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Dr. Faryna is a retired internist and an organizer for the Ohio chapter of Physicians for a National Health Program.
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Copyright (C) 2009 by the Ohio Forum. 9/09
NEW MEXICO EDITORIAL FORUM
By Sandra Penn, MD, FAAFP
I believe in evidence. As a Western-trained physician, I was taught that half of what I learned in medicine would be proved wrong and that I would have to continue to study, learn and seek evidence that what I was doing continued to be appropriate.
When I came into medicine in 1973, Medicare had already proved itself. Seniors were able to get care as they never had before. By the time I started practicing in the 1980’s, Diagnostic Related Groups was changing the payment system for hospital care because physicians had cleverly moved some diagnostics into in-patient procedures and thus kept patients in hospital longer. Changing the payment system, it was clear, would change the amount that was charged.
During my eight years in private practice, I often wrestled with insurance companies about how they paid. Each company had a different requirement and I would be encouraged to see a person many times for a lesser rate rather than allowing me to charge more and have a longer visit. The insurance companies delayed payment because a single block was not checked on their form, driving up my office expenses because I had to hire more staff to service their forms. Medicare, at least, remained the insurer of all my patients over 65, thus reducing the number of changes I had to make when my patients were forced to switch insurances. That experience has driven me for the last 20 years to be an advocate for health payment reform (I am no longer in family practice although I still do primary care).
The last eight years have seen the deterioration of our health care and our safety net. A safety net is essential because our country has not provided us with the universal, accessible, accountable and affordable health care that is enjoyed by the rest of the developed world.
Now, here we are with a Democrat in the White House, a Democratic majority in the Senate and the House and I listen and cringe as they give away, not even “Medicare for All,” but just a public plan option! What, pray tell, is wrong with us?
Insurance companies claim they can’t make a profit if there is a public plan. President Obama shot back that UPS and FEDEX are doing well despite the competition of the U.S. Post Office. Why should anyone be concerned that some insurance company is not making a profit when their profit is often floated on denying people care?
Evidence shows that a majority of physicians support a national health plan. Research data over the past few years finds that Americans would pay more in taxes so that everyone would have health insurance. Yet, the few screaming people disrupting town hall meetings are being attended to more than the majority.
Our elected officials are negotiating away our well-earned chance to join the rest of the civilized world by offering our citizens at least the chance of being insured.
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Dr. Penn is a primary care physician in Albuquerque.
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Copyright © 2009 by the New Mexico Editorial Forum. 9/09
By Brian Miller
Every year, we celebrate Labor Day to honor the work of everyday Americans who built this country brick by brick, community by community. It’s an honorable holiday that pays tribute to honorable work.
While it’s always good to give thanks, we need much more than well wishes and a cheer of support. We need to ensure that the rules that govern our economic system, whether those rules come from Wall Street or from Washington, treat all Americans, particularly those who are the backbone of our economy, with dignity and respect. That’s what Labor Day is truly about.
From the time the first Labor Day was held, Americans understood that even what we call a “free” market still has rules that govern its actions; rules that can either work for or against the average American. That’s why they fought for a more just set of rules, a fight that ultimately led to the 40-hour workweek, the first minimum wage laws, the abolition of child labor, and workplace safety standards.
Over the last 30 years, we’ve seen the pendulum swing back the other way. While many of the victories won in those early years still stand, we’ve seen an erosion of the right of workers to organize, the weakening of worker and public safety standards, and wholesale rollback of our tax system’s more progressive elements.
All we have received in return is a shift in fortunes to the wealthiest individuals in our economy, with little or none of the promised “trickle down” for the rest of America.
From 1947 to 1979, when our country grew as a whole and prosperity was broadly shared, we saw incomes rise across all income groups. As measured using the bottom, middle, and top 20 percent of income-earners, the incomes of the bottom grew by 116 percent, the middle grew by 111 percent, and the highest income-earners saw their income rise by 86 percent. That’s what broad prosperity looks like.
By comparison, from 1979 to 2005, income growth was almost entirely focused on the top income-earners. The bottom group actually saw their incomes decline slightly; while the middle group saw their incomes grow by only 15 percent. Meanwhile, the top group of income-earners saw a 53 percent growth of income. The top 1 percent alone saw their incomes grow by 81 percent. While income and wealth grew at the top, the rest of America was treading water.
In fairness, many Americans were excluded from this earlier period of broad growth, particularly African-Americans and other people of color. By the time some of the nation’s most oppressive and racist policies were done away with, incomes at the bottom had already stagnated, leaving few opportunities for people of color to advance. Nonetheless, history shows that when the rules that govern our economy are designed well, Americans in all income groups can share in the prosperity. That should be our goal.
The good news is that Americans are waking up and demanding change. Public awareness of economic inequality has never been higher, and the economic crisis has pulled back the curtain on the failed policies of the past.
Now is the time for average Americans to take back the reins of government. Several key issues will likely come up in Congress soon that can help restore a more broadly-shared prosperity and strengthen the common good.
First, we must repeal the Bush tax cuts for the wealthy. Those unnecessary and damaging tax cuts helped fuel the massive budget deficits we now face, while exaggerating the income and wealth disparities.
Second, we must preserve a strong and effective federal estate tax. This fall, Congress will begin debating the future of the estate tax. A strong estate tax is essential to an economy that rewards hard work and not just the fortune of one’s birth.
Third, we need to help working families hold onto their homes, the single most important asset for most low and middle-income families, amidst the current housing crisis. Additionally, we need to support policies that enable low-income families, and particularly people of color who were left out of earlier economic booms, to attain home ownership and build assets.
With a comprehensive strategy for rebuilding our middle class, we can do more than pay lip service to the work of Americans on Labor Day. We can instead genuinely and honestly show our commitment to honoring the work of all Americans by passing policies that help lower and middle-income Americans share in the nation’s prosperity.
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Miller is executive director of United for a Fair Economy, a national organization that works to build awareness of the dangers of vast inequalities of wealth and power, and ultimately foster policies that lead to a more broadly-shared prosperity. To learn more visit www.faireconomy.org.
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Copyright (C) 2009 by the American Forum. 9/09
MISSISSIPPI FORUM
By Mary Margaret Bollinger
Those of us who experienced the 1993 health care debate should remember the “Harry and Louise fear of change” ads that were used to incite public opposition and defeat health care reform efforts.
Most of the changes the ads warned would come with the Clinton proposal, happened anyway: HMOs and insurance plans limited which doctors patients could see, what hospitals they could go to, and what treatments they could receive. Costs went up, more people lost coverage, Medicare costs continued to increase at an unsustainable rate, and everybody with coverage is paying more for it.
The same “fear” strategy is being used this time as our troubled economy, skyrocketing costs, and the sinking quality of American health care drive the current health care reform effort.
We worry that if everybody has access to health care -- universal coverage -- our own access to health care will somehow be lessened and we will pay more even though we know that everyone who currently has health insurance has seen those costs escalate faster than inflation for more than a decade. We worry that we will not have access to the newest tests and the latest procedures. We worry that we will not have access to the physicians we want to see -- even though that access is limited now as Mississippi has the lowest doctor-to-person ratio in the country.
The best argument for universal coverage is that, by providing more preventive care, it will help drive health care costs down by keeping people healthier in the long run. The man with undiagnosed and untreated high blood pressure dramatically increases his chances of a crippling stroke. The child with asthma whose parents cannot afford the medication or regular doctor visits is more likely to miss school and to end up with an expensive hospitalization. The woman who puts off a mammogram because her insurance does not cover it or she has no health insurance dramatically increases the chances that breast cancer will kill her because treating the disease when it can first be detected is cheapest and has the best odds for success.
The reform we should all be pushing for should include regulation so that insurance companies play fair and cover people with existing conditions. There should be mandates so that most employers continue to offer coverage to their employees, and tax credits and subsidies so that working families who really cannot afford health coverage can get it. And there should be competition -- the public option -- so that we really can get more for our money. The public option should make available for buy-in the government programs that work now: Medicare, the Veterans Affairs system, and the health insurance that members of Congress have.
A recent Wall Street Journal poll found that, when they learned what is in the health care bill in Congress, clear majorities supported the basic components: universal coverage, a public option, paying for the changes with increased taxes on high income Americans and employer contributions.
Some for-profit health insurance companies, who have been making record profits since the last health care reform effort, are trying to convince Americans once again that change will make things worse, not better. This time Harry and Louise are on to them; they are pushing for change along with a long list of large and small business associations, and health care advocates including the American Medical Association. About 14,000 Americans are losing health coverage every day. Continuing down this unsustainable path without serious health care reform is what we really have to fear.
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Bollinger is a former tax attorney in Jackson.
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Copyright (C) 2009 by the Mississippi Forum 9/09
