McCook Daily Gazette. Jan. 24, 2013.
Health care bills will come due, best paid early
Health care is back on the front burner in Lincoln this session of the Legislature, with lawmakers set to consider expanding Medicaid coverage to as many as 159,000 Nebraskans by fiscal 2016.
The move would bring the state into line with the federal health care law, even though the U.S. Supreme Court has struck down the provision that would allow Washington to withhold funding from states that chose not to expand Medicaid programs.
At the same time, the Unicameral will consider a bill to pull back prenatal coverage for illegal immigrants, a law passed over Gov. Heineman's veto and which Heineman proposes defunding in his new budget.
Heineman is right to be concerned the federal government won't follow through with promised funding — we narrowly avoided the "fiscal cliff" and the coming months, with another battle over raising the debt ceiling likely and making progress against the federal deficit a dicey proposition at best.
If funded according to plan, Nebraska will be responsible for 10 percent of the new medical program by 2020, but if any real progress is made in cutting the federal deficit, health care spending will have to be part of the formula.
But proponents point out that failing to participate in the federal health care program will deprive Nebraska of funding it could receive from Washington, and would force more and more people to use the most expensive medical care delivered.
"We already pay for health care for the uninsured, but we do so in a way that guarantees the most expensive care, often sought in the emergency room," said Sen. Jeremy Nordquist of Omaha. "When a person seeks care in the E.R. and can't pay, the cost of that care is passed on to the provider, who passes the cost of care on to the insurer, who passes the cost of that care on to all Nebraskans with private insurance."
Nordquist and other supporters say the bill would eliminate the need for county medical assistance programs — costing $4.7 million in Douglas County, $2.8 million in Lancaster and $200,000 in Sarpy County.
Nordquist also wants to put $23 million away for the first three years, for a separate health care access fund to cover the share of Medicaid costs when federal contributions start to decline.
Sen. Bob Krist of Omaha, a Republican, noted that governors in Arizona, Nevada and New Mexico, also Republicans, are supporting the program.
"The time has passed to debate the merits of the act," Krist said. "The only debate or question left is whether the leadership in this state allows the federal government to keep our health care cash money, or seize the opportunities and bring those monies back to care for Nebraskans."
The truth is, we take care of anyone who shows up at an emergency room, regardless of whether they have a green card or an insurance card in their pocket.
The question that remains is simple: will we provide medical care when it is most economical and effective, or wait until it is too expensive and too late?
Omaha World-Herald. Jan. 28, 2013.
Another danger for military women
Now that Defense Secretary Leon Panetta is ending the official military ban on women in combat, perhaps the services will also move to more effectively address the painful issue of sexual assault within the ranks.
Panetta's decision opens thousands of additional jobs to military women and gives them more opportunities for promotion. It cancels a 1994 Pentagon regulation that kept women out of front-line infantry, artillery and other combat roles, although in reality some 20,000 women have found themselves in combat in Iraq and Afghanistan anyway; 800 have been injured and 130 have died. The decision opens the door for the individual services to put the changes into effect.
The issue of sexual abuse of both military women and men, often by their superior officers, was highlighted at a recent House Armed Services Committee meeting. The committee heard testimony on the situation at Lackland Air Force Base in Texas, where 59 victims, three of them men, have come forward to accuse dozens of drill sergeants and training instructors of sexual harassment and assault, rape and other offenses. So far, 32 sergeants and instructors have been disciplined for everything from rape to unprofessional relationships.
At the hearing, military leaders argued that the Air Force's Lackland investigation has led to some corrective actions. More female Military Training Instructors have been included in basic training; four instructors, at least one of them a woman, are assigned to two squadrons of recruits.
Rape and assault of enlisted women and men during basic training are almost common, according to a recent Washington Post report. The Defense Department has said that sexual assaults have been reported by as many as 1 in 3 female service members. The DOD estimated that in 2010, the latest year for which statistics are available, about 19,000 assaults occurred, of which only 3,200 were reported and 191 resulted in court-martial convictions.
Military women fail to report assaults for many reasons, including fear of retaliation and damage to their careers, inaction by superiors, who in some instances are their rapists, and other difficulties.
The No. 1 reason for the firing of military commanders in the past eight years is sexual misconduct, 78 of 255 dismissals since 2005, according to military statistics compiled by the Associated Press. Of the 18 generals and admirals fired in recent years, 10 were kicked out for sexual offenses.
One case is that of Brig. Gen. Jeffrey Sinclair, who was fired from his command in Afghanistan last year and is facing court-martial on charges of sodomy, adultery, pornography and similar offenses. Sinclair was arraigned last week at Fort Bragg, where he deferred entering a plea.
Last fall, Panetta ordered an ethics review of the factors that underlie the firings of command-level officers; Rear Adm. John Kirby, a Navy spokesman, suggested that his service is looking at why personal conduct has brought down so many officers. He and other military leaders agreed that poor leadership, bad judgment and ethical lapses, not operational mistakes, are becoming increasingly prominent factors.
A recommendation from the Service Women's Action Network deserves serious consideration: It suggests that military commanders who decide what cases should move forward are a big problem. Military lawyers, said Anu Bhagwati, are trained and have a greater appearance of impartiality. They should be making important legal decisions on sexual misconduct prosecutions.
In the spring of 2012, Panetta called for the Pentagon to support a "zero-tolerance culture" for sexual assault.
"I think we're on the path," said Michèle Flournoy, former undersecretary of defense for the Obama administration. "I think the last two defense secretaries have made this a very high priority and have very much held people accountable. But we've got a ways to go."
Gen. Martin Dempsey, chairman of the Joint Chiefs of Staff, says eliminating the ban on women in some combat roles may help with the sexual assault and harassment problems by creating a greater environment of respect for military women. "I have to believe the more we treat people equally, the more likely they are to treat each other equally," he said.
Nebraska's former U.S. senator, Chuck Hagel, has been nominated to become the next secretary of defense. The problem of sexual assaults in the military is ongoing and would fall right into his hands. If confirmed, he should become the force behind a military culture change that ensures service members, officers and enlisted personnel alike, are held accountable for committing or tolerating such offenses.
Scottsbluff Star Herald. Jan. 25, 2013.
We all benefit from a more educated society
Qualifying for the jobs of tomorrow is getting more demanding. There was a time when people could learn a traditional trade and open a shop of their own, but the evolution of the corporate world has made many entrepreneurial opportunities obsolete. Machines have taken over jobs that used to be done by humans.
More than ever, education is the doorway out of poverty. According to the Census bureau, the past decade saw a boom in educational attainment. From 2002 to 2012, the number of Americans with a doctorate grew by about 1 million, or 45 percent, while those who held a master's climbed by 5 million, or 43 percent.
But attainment grew at every level. The population with an associate degree rose by 5 million, or 31 percent. Those whose highest degree was a bachelor's degree grew 25 percent to 41 million. Meanwhile, the number of those without a high school or GED diploma declined by 13 percent, falling to 25 million.
Among workers 25 and older in 2011, average earnings were $59,415 for people with a bachelor's degree but no graduate degree, compared with $32,493 for people with a high school diploma but no college.
Gov. Dave Heineman has persuaded the University of Nebraska and state college systems to freeze tuition rates for two years, in turn offering them budget increases of about 4 percent each year from the general fund. That will make college more affordable for students and their families. Nebraska ranks 40th among the states on the proportion of state higher education funds used for student financial aid. Most of state higher education funds in Nebraska go to support institutional operations. The idea is to help the university system's four campuses attract more Nebraska students and meet ambitious enrollment goals, but also to boost the quality of the state's workforce.
The National Commission on Higher Education Attainment, a group of leading college and university presidents, points out that it's not enough to simply entice students to enroll. They say the nation faces an "unacceptable loss of human potential" when students never make it to graduation.
"We believe every institution must pay as much attention to the number of degrees it grants — completion — as it does to success in admissions and recruitment," the commission members said in a recent report. "It is now time for all colleges and universities to marshal the resources needed to make completion our strategic priority."
Campus leaders are urged to consider three main areas for reform: changing the campus culture, improving cost-effectiveness and quality, and making better use of data. The commission calls on college officials to make retention and graduation a priority, identifying struggling students and offering them more assistance along the way.
The underlying point isn't to enrich universities or even push failing students toward graduation. Somebody has to take over the demanding jobs of the future, including development of new medicines, technology and products that keep society moving forward. Making college affordable is only part of the solution. We have to make sure young people are adequately prepared before they get there, and that they can graduate with the skills necessary to take on the challenges of a complex and demanding business world.
Lincoln Journal Star. Jan. 24, 2013.
Crop insurance draws scorn
If there is any doubt about the generosity of the safety net provided for farmers with the help of the nation's taxpayers, consider this:
Despite a record nationwide payout of perhaps $15 billion because of drought and other crop losses last year, premiums for crop insurance actually will decrease next year for many farmers.
That's according to the administrator of the Risk Management Agency in the U.S. Department of Agriculture.
William Murphy said that in Nebraska, for example, the statewide average decrease in premiums for corn insurance will be about 6 percent.
The decline is due to new rate-making methodology recommended by Sumeria Systems Inc.
While the drop in premiums is excellent news for Nebraska farmers in the short-term, there's also a downside.
The news that premiums are going down for some farmers may add new voices to the chorus that is complaining about the crop insurance program. The Washington Post, for example, this week opined that "federally backed crop insurance has long since evolved into yet another form of corporate welfare, whose direct costs and perverse unintended consequences outweigh its purported public benefits."
Strident critics can be found even in the Corn Belt. As we noted in an earlier editorial, Iowa State ag economic Professor Bruce Babcock called crop insurance "Obamacare for corn" on the Stephen Colbert show.
Other critics include the conservative Heritage Foundation and a faction of Republicans in the House of Representatives that identifies with the tea party.
While one reason for the drop in 2013 premiums for some farmers is the new actuarial study, another reason is that rates generally are set on the basis of crop production averages over a period of decades. One single bad year doesn't carry that much weight.
What might change those calculations is continued drought because of climate change. Forecasts for the start of the growing season are not encouraging. More than 60 percent of the continental United States is in some stage of drought, compared to only 32 percent last year. Seventy-seven percent of Nebraska is in the most severe drought category.
For the moment, Nebraska farmers have the security of perhaps the most generous safety net they've ever had. Not only are farmers still collecting direct payments, taxpayers are paying, on average, more than 60 percent of crop insurance premiums.
The question is how long that safety net will be there. The spike in the cost of crop insurance has made it difficult to ignore.