Thursday, May 27, 2010

Heath Care Debate, Just Put Your Fingers in Your Ears and Hum

The health care debate is something I am really glad I was not in the US to see. I think if I had been there I would have gone into the woods, put my fingers in my ears and hummed. It looked ugly, real ugly, and I still have yet to see a news article that tells me what the new health care bill means. Fortunately Peace Corps was kind enough to send us a summary to help put us out-of-towners back into the loop.

On March 23, 2010, President Obama signed into law the “Patient Protection and Affordable Care Act,” Public Law 111‐148, a complex piece of legislation.

Of particular interest to employees with children is the requirement that health insurance carriers allow adult children to stay on their parents' health care plan until they turn 26, instead of removing them from the policy when they turn 22. The effective date of this provision is the first day of the plan year that is six months following enactment of the law.

Other Highlights
The law will extend health insurance coverage to approximately 32 million Americans who are currently uninsured, making insurance available to an estimated 95 percent of non‐elderly citizens by 2019.

Starting in 2014 and by 2016, citizens must purchase insurance or pay a penalty. The penalty will be $95 in 2014, $325 in 2015 and in 2016 the greater of $695 or 2.5 percent of income. Families will pay half the amount for children, up to a cap of $2,250 per family. After 2016, penalties are indexed to the Consumer Price Index. Subsidies to purchase insurance in the form of tax credits are provided to individuals making up to $43,000 and to families of four making up to $88,000, or 400 percent of the federal poverty level. There is a hardship exemption for poorer Americans.

Health insurance exchanges will be created to make it easier for the self‐employed, the unemployed and small businesses to purchase less expensive coverage. The law would establish 50 insurance marketplaces, administered by the states, with insurance coverage that meets new federal standards. Small businesses with 25 employees or less and average wages of less than $50,000 will qualify for tax credits of up to 50% of the costs of providing health insurance.

Employers are not required to provide health insurance coverage, but the law penalizes companies that do not provide coverage if they have 50 or more employees (full‐time equivalents). The penalty is a tax of $2,000 per employee. However, assistance is provided for mid‐size businesses by exempting the first 30 employees when calculating the tax. For example, a business with 51 employees would pay the $2,000 penalty on only 21 (51‐30) employees for a total of $42,000 instead of $102,000. Waiting periods before insurance takes effect will be limited to 90 days.

Insurance companies will be prevented from denying coverage for pre‐existing conditions, cancelling coverage for sick people, having unlimited out‐of‐pocket expenses and charging higher premiums based on a person’s medical history or gender.

Medicaid would be expanded to cover everyone with income less than 133 percent of the federal poverty level‐‐$29,327 for a family of four.

Medicare prescription drug coverage: Under current law, Medicare stops covering drug costs after more than $2,830 is spent, but starts paying again after an individual’s out‐of‐pocket expenses exceed $4,550. Under the new law, seniors who hit the gap (so‐called “donut hole”) this year would get $250 to help cover the costs of their medications. Starting in 2011, they would receive a 50‐percent discount on brand‐name drugs, with the cost borne by the drug industry. In subsequent years, the discounts would expand and begin covering generic drugs, with the expense picked up by the Government. By 2020, the discounts would reach 75 percent.

Over the next 10 years, the cost of the plan is projected to be $940 billion and to decrease the federal deficit by $143 billion. To pay for the plan, Medicare outlays will be reduced by eliminating waste, fraud and abuse. Starting in 2013, single taxpayers making $200,000 or more and couples earning $250,000 or more will see a 0.9‐percent increase in Medicare payroll taxes and a 3.8‐percent Medicare tax on unearned income. Starting in 2018, a 40‐percent tax will be imposed on insurance companies providing high‐level (so‐called “Cadillac”) plans valued at more than $10,200 for individuals and $27,500 for families. The thresholds are higher for retirees and employees in high‐risk professions ($11,850 for individuals and $30,950 for families).

Major Provisions With Effective Dates

Within 90 days of enactment
Provides access to high‐risk pools for individuals who have no insurance because of pre‐existing conditions.

Within six months
Prohibits insurers from rescinding policies to avoid paying medical bills when a person becomes ill.
Prohibits insurers from denying coverage to children (under the age of 19) who have pre‐existing conditions.
Prohibits insurers from imposing lifetime caps on coverage.

Within a year
Provides a $250 rebate to Medicare prescription drug plan participants whose initial benefits have been exhausted.
Requires new plans to provide coverage for preventive services without co‐pays. All plans must comply by 2018.

Requires individual and small group market insurance plans to spend 80 percent of premium dollars on medical services. Large group plans will have to spend at least 85 percent.

Imposes limits on contributions to flexible spending accounts to $2,500 per year, indexed by the Consumer Price Index in subsequent years.
Increases the Medicare payroll tax and extends the tax to dividends, interest and other unearned income for individuals earning more than $200,000 and joint filers making more than $250,000.
Requires health plans to implement uniform standards for electronic exchange of health information to reduce paperwork and administrative costs.
Eliminates the Employer Medicare Part D deduction for subsidizing prescription drug plans for eligible retirees.

Requires most employers to provide coverage or face penalties.
Requires most people to obtain coverage or face penalties.
Provides subsidies for families earning up to 400 percent of the federal poverty level, or approximately $88,000 a year, to purchase health insurance.

Imposes a 40‐percent tax on high‐end insurance policies.

Expands health insurance coverage to 32 million Americans.

Tuesday, May 18, 2010

'Beauty Scho....' I'm mean 'Peace Corps Dropout'

Our group started with 18 people. 10 Rural Economic Development (RED); 8 Municipal Services Development (Muni)

Recently we lost our 5th member of the RED group; Munis are still holding strong. So we're down to 13.

I was pondering this and the song 'Beauty School Dropout' from Grease popped into my head.

And so I present this rendition to you in honor of my former companions.

Your story sad to tell,
A twenty-something ne'er do well,
Most mixed up non-delinquent on the cuadra!
Your future's so unclear now,
What's left of your career now?
Can't even get a trade in on your smile!

Angels: (La lalala lalala lalala...)

Peace Corps dropout,
No readjustment allowance for you.
Peace Corps dropout,
Missed your IST and flunked cutting bamboo!
Well at least you could have taken time, to wash and clean
your clothes up,
After spending all that Guarani to have your vecino fix your baño up!

Baby get moving (Baby get movin),
Why keep your feeble hopes alive?
What are you proving (What are you provin)?
You've got the dream but not the drive.

If you ET, you could join the grad pool

Cash in on your airline ticket and go back to studying at the school!

Peace Corps dropout (Peace Corps dropout),
Hanging around the chipa store.
Peace Corps dropout (Peace Corps dropout),
It's about time you knew the score.

Well they couldn't teach you anything,
You think you're such a trail blazer,
But no Paraguayan would go to you unless he was a drunkard!

Baby don't sweat it (Don't sweat it),
You're not cut out to hold the job.
Better forget it (Forget it),
Who wants their Mapa mundial done by a slob?

Now your bangs are curled, your lashes whirled, but still the
world is cruel.
Wipe off that angel face and go back to grad school!

Baby don't blow it,
Don't put my good advice to shame.
Baby you know it,
Even Dear Abby'd say the same!

Now I've called the shot, get off the block, I really gotta fly!
Gotta be going to that, Caña shop, in the sky!

Peace Corps dropout (Peace Corps dropout)
Go back to grad school
Peace Corps dropout (Peace Corps dropout)
Go back to grad school
Peace Corps dropout (Peace Corps dropout)
Go back to grad school....

Monday, May 17, 2010

Tickle Tickle

March of the Ants:

In my last house I had a rat problem. I could hear them running back and forth, scratching at the wood paneling, chasing one another and tumbling around, skweaking and fighting. I also had roaches, which were so big I think they were mice when I heard them scampering around on the floor or in my dresser.

In my new house I still have some roaches, and they still sound like small mice…which is why I keep a can of Raid next to my bed. However I have discovered I may have an ant problem as well.

For the second time, there were so many ants (HUGE ants btw)crawling in the ceiling above my bathroom that they started falling through the cracks. It’s raining ants hallelujah, it’s raining ants. They made me think of the computer game Lemmings…Fall, and walk and walk and walk.

I’ve already dealt with a ceiling that did let actual rain on me during bad weather, but I think the ants are a little more off-setting.

I took my can of Raid, designed for roaches, but has proven itself on crickets, ants, grasshopper, etc and I sprayed into the ceiling. I then heard the sound of THOUSANDS of tiny feet scuttling on the wood above me. The ants continued to fall out of the ceiling but they were writhing around instead of walk, walk, walking.

I avoided the bathroom for the rest of the night and woke up to carnage the next morning. Impressive. No pitter patter of little feet since then.

This little incident however, does not compare to the first night I stayed in my new house.

Prequel: March of the Spiders:

Carly was still living in the house when I moved in; she had about a week left but my host family needed me to leave to make room for the new renters they had found. I set up my mattress on a tarp on the garage floor and laid down to go to sleep.

After a little while I felt something on my arm, figured it was a mosquito, smashed it, the tickle went away, and I went back to trying to sleep. A minute or two pass and I start to feel the tickle again, smack, tickle goes away….tickle tickle….I turn on my flashlight and see that the perp is a small, almost transparent spider, smack. Tickle tickle. WTF! Another spider! So I take my flashlight and shine the beam down the length of my body and mattress. Dozens of little transparent spiders are crawling all over me and the bed. EEEEK!!!!

After quickly getting out of bed and brushing off the spiders I can see, I go to Carly’s bedroom and ask if I can sleep in the queen-sized with her. After she removes the spiders on my back and in my hair, we try to go to bed again.

I felt phantom tickle tickles all night long.