Monthly Archives: February 2014

On inequality, Obama is talking to Alabama

You could almost hear the collective groan in deep-red Alabama when President Barack Obama, in his State of the Union address, reminded Americans of what he has long said was one of the nation’s most pressing challenges.

“Today, after four years of economic growth, corporate profits and stock prices have rarely been higher, and those at the top have never done better,” Obama said. “But average wages have barely budged. Inequality has deepened. … Too many Americans are working more than ever just to get by; let alone to get ahead.”

The Alabama groans were expected. For six years, our elected officials have force-fed us a political diet that lacks any substance but the certainty that everything Obama says or does is wrong, and maybe evil.

Alabama’s groans at Obama’s words on the collapsing middle class, however, were misplaced. More than almost any other state, we feel the consequences of a four-decade trend in which the rich — blessed with capital and opportunity — have gotten richer and everyone else has struggled. Like him or not, Obama is fighting for Alabamians when he fights against inequality.

Obama’s description of growing income polarization is accurate. Corporations get it, and many are struggling to cope with it. In Decatur, we recently have lost two retailers that depended on the middle class: Sears and JC Penney. The disposable income of the companies’ traditional customer base is dwindling.

Some retailers, however, are doing great. Never better, thank you. High-end stores like Nordstrom and hotels like Four Seasons are powering ahead, reports the New York Times. The most nimble companies, like G.E. Appliances and Darden restaurants, are pushing high-end brands that appeal to the wealthy customers who still have disposable income.

Forty percent of all personal consumption expenditures in 2012 — up from 27 percent in 1992 — came from the top 5 percent of earners. The bottom 80 percent of earners accounted for only 39 percent of personal consumption expenditures in 2012, down from 47 percent in 1992.

Alabama — with more than one in five living in poverty and with a per capita income that is 42nd in the nation — should be especially disturbed by this trend. In a nation that has the greatest income inequality in the industrialized West, Alabama’s income disparity — its gap between the haves and have-nots — is greater than all but four states. And even corporate America should worry, as it is forced to market its products to an ever-smaller percentage of the population.

If our politicians have new ideas on how to reverse a trend that is undermining our economy and depriving Alabamians of access to capital and opportunity, they should speak up. If all they have to offer is attacks on Obama, they need to get out of the way.

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Filed under Alabama politics, Income inequality, obama, Uncategorized

Alabama needs to embrace ACA

This was my response to a friend who opposes the Affordable Care Act. I first sent him this story of what is happening in Kentucky, a state seeing remarkable success with the ACA despite similar demographics. Kentucky, of course, embraced the reforms as a long-overdue way to help its citizens while stimulating its economy and saving its hospitals.

I continued as follows:

Alabama is not working well, which was the state government’s goal. We have not expanded Medicaid — and note that the KY story involved the working poor, who do not have Medicaid in Alabama. The state has done nothing to curb the BCBS monopoly and it refused to create its own anti-monopoly exchange or promote the federal exchange, so BCBS remains the only significant player and controls premiums.

In Decatur we don’t have it quite so bad yet because Huntsville/Decatur Morgan hospitals are trying to provide diagnostic tests and specialized care to the uninsured, usually after a referral from the Free Clinic. (In the Kentucky story, note that diagnostic tests and specialized care were the biggest pre-ACA problems.) In talking to hospital officials, though, it is clear that can’t continue. Decatur Morgan is not breaking even; HH barely is. They are not required to provide MRIs or cancer screens or most cardio tests. All the hospital is required to do is stabilize the patient and send her home. The specialists are not required to see the uninsured patients at all, and fewer and fewer are willing to see them.

When 17% of our population has essentially no access to health care, it is inevitable that the transition will be difficult for everyone — doctors, hospitals, insured patients. Many uninsured have been struggling with untreated illnesses for years, and they will strain the health infrastructure initially. Those who have been previously denied insurance due to preexisting conditions will put upward pressure on premiums for everyone.

The transition also is difficult because the ACA is a major overhaul of a huge and complex system. There are dozens of minor changes that would make it work better, but the U.S. House does not want it to work better.

I avoid saying this publicly, but you’re a friend: For me, it comes down to my acceptance of Christ’s teachings. We have the ability to heal the sick and give them an opportunity to become productive members of society. We have the ability to treat diabetes and prevent its horrific consequences. We have the ability to alleviate painful conditions that ruin the quality of life for thousands of Alabamians. Nobody gets healthcare for the fun of it, so we are not even creating the “dependency” issues that cause our governor such consternation.

ACA has plenty of problems. Its initial rollout, as you mentioned, was a disaster. The pre-ACA status quo, however, was an affront to everything I believe in. While the vote ended up being partisan, ACA was formulated by both parties and numerous experts. Short of a politically untenable single-payer system, it’s our best shot.

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Filed under Alabama politics, Health care, Medicaid, Obamacare