Mar 30, 2012

Sick over GOP Resistance to Affordable Care Act

I've spent several hours listening to the Supreme Court arguments regarding the constitutionality of health care reform as approved under the Affordable Care Act.  It was actually nauseating at times to listen to Paul Clement pull no stops in defending the insurance industry's interests under the guise of defending 26 republican states.   How can that man look in the mirror each day?  Maybe he doesn't....

The most obnoxious moment for me was when he said,  "I think there are other options that are available. The most straightforward one would be to figure out what amount of subsidy to the insurance industry is necessary to pay for guaranteed issue and community rating. And once we calculate the amount of that subsidy, we could have a tax that's spread generally through everybody to raise the revenue to pay for that subsidy."   

 I guess he worries about those HMO executives who earn a mere 14 million a year in salary.  If their companies were forced to provide guaranteed issue policies to the uninsured, they might see a drop in their profit margins and have to live like the rest of us.  If Medicaid is expanded in all states, via the aid of the federal government to the tune of about 90%,  please tell me why it's more objectionable to the GOP than bailing out the banks? 

I am extremely concerned about the pending supreme court decision.  If the ACA is defeated I think I will lose all  sense of pride and allegiance to my country.  It will be more than just a major blow.  I am just hoping against hope that the ACA is upheld. 

In one of the professional publications I receive,  there was a synopsis of the ACA written by John E. McDonough, DPh, MPA,  Professor of Health Policy and Management, Harvard University School of Public Health, Boston, Massachusetts.   I'm going to cut and paste it below.  After reviewing it,  I challenge anyone to find a rational reason to advocate its defeat. 

Title I. Quality, Affordable Health Care for All Americans

This title fundamentally changes the nature and operation of private health insurance in the United States. Beginning in 2014, no health insurer will be able to sell or rate coverage based on an individual''s medical history; most Americans will be required to obtain health insurance; and substantial financial subsidies will be available to low- and moderate-income Americans to help them afford the cost of health insurance. Most states will operate new "health insurance exchanges" to make shopping for health insurance easier. Small businesses and individuals can shop these insurance exchanges for competitive rates. Other important changes in health insurance, including the banning of lifetime and annual benefit limits, were implemented in 2010.

Title II. The Role of Public Programs

This title creates substantial changes to Medicaid, the federal-state program for many low-income persons. Beginning in 2014, all lower-income individuals will be eligible to enroll in their state's Medicaid program, not just those who fit into categories such as disabled, children, or parents. For the first time, Medicaid will become a more uniform national program with uniform eligibility and enrollment standards as well as quality improvement requirements.

Title III. Improving the Quality and Efficiency of Health Care

This title establishes new mechanisms to improve the quality of medical care in the United States by making it more efficient and effective, and more patient-centered. Medicare will be improved with the addition of new preventive benefits for enrollees; and the Medicare Part D drug benefit will be made more affordable by closing the coverage gap known as the "donut hole." Medicare's rate of growth will be lowered to provide about $450 billion in savings between 2010 and 2019, which should fund about half the cost of the ACA.

Title IV. Prevention of Chronic Disease and the Improvement of Public Health

Title IV is the most ambitious law ever passed to promote healthier lifestyles for all Americans and to prevent disease and disability. A National Prevention, Health Promotion, and Public Health Council will devise a national prevention strategy, backed up by a $13 billion Trust Fund. Evidence-based clinical preventive services will be provided in most public and private health insurance policies without cost-sharing. Chain restaurants will be required to post the calorie content of their foods.

Title V. Healthcare Workforce

This title establishes a National Healthcare Workforce Commission to analyze and plan for workforce needs and to make recommendations to congress and the administration. Support is provided to expand the healthcare workforce, especially in primary care. Major expansions for community health centers and the National Health Service Corps are funded.

Title VI. Transparency and Program Integrity

Title VI provides new authority to federal and state agencies to combat fraud and abuse in Medicare, Medicaid, and private health insurance. Drug companies and medical suppliers will report most gifts and other gratuities to physicians for public release on a federal Website. The Patient Centered Outcomes Research Institute is established as a public-private entity to support research on comparative clinical effectiveness. New transparency requirements on the nursing home industry will provide information to protect and empower patients and their families. The Elder Justice Act provides a national framework to combat violence, neglect, and financial exploitation of senior citizens.

Title VII. Improving Access to Innovative Medical Therapies

This title directs the US Food and Drug Administration to develop a regulatory pathway to permit the development, manufacture, marketing, and sale of biosimilar biologic products, generic-like versions of biopharmaceutical drugs. It also ends anticompetitive efforts to keep generic drugs off the market, and offers drug discounts to hospitals and communities that serve low-income patients.

Title VIII. CLASS: Community Living Assistance Supports and Services

This title authorizes a new national and voluntary long-term disability insurance program to provide workers with daily cash payments and support if they become permanently and temporarily disabled. People who enroll in CLASS must pay premiums for a minimum of 5 years. The funding is flexible and can be used for a range of services. No tax money will be used to fund this program. Its only permitted financing source -- enrollee premiums -- must be sufficient for at least 75 years if the Health and Human Services Secretary is to launch the program.

Editor's Note: The Obama administration announced on October 15 that it was abandoning plans for CLASS. Congress is expected to quickly draft legislation to repeal the provisions of this title.

Title IX. Revenue Provisions

This section covers the financing for slightly less than half the cost of the ACA. Key provisions establish new Medicare taxes on high-income wage earners, as well as new taxes on pharmaceutical manufacturers, health insurance providers, and medical device manufacturers. Also included is an excise tax on high-cost, employer-provided health insurance; changes to health savings accounts and other individual health accounts; and a 10% tax on indoor tanning services.

Title X. Strengthening Quality, Affordable Healthcare for All Americans

The final title in the act is the "Manager's Amendment," which includes amendments and additions to Titles I-IX, reflecting the unusual legislative process leading to passage of the ACA. Additional changes to Titles I-X were approved in a separate measure called the Health Care and Education Reconciliation Act (HCERA) signed into law by President Obama 1 week after he signed the base law on March 23, 2010. This title also reauthorizes the Indian Health Care Improvement Act, which provides healthcare to American Indians and Alaskan natives.

Mar 29, 2012

Artist Exhibition and Auction

You are  invited to an exhibition of paintings by noted local artist,  Marjorie Freiburghaus, being held April 4th through April 7th,  at the chapel and adjacent locales in Valle Escondido,  from 1:00 pm to 5:00 pm.


Ms. Freiburghaus has exhibited in multiple galleries in Panama City where she’s frequently commissioned  for private pieces.  She’s gaining popularity in Boquete, as well,  for her colorful abstract, scenic, and folk depictions. 


This event is a benefit to raise funds for oncology treatment.  Nineteen works will be displayed and available for purchase.   On the final day of the event, there will be an auction for any remaining pieces,  between 4 pm and 6 pm.


For additional information call:  720-2454 (Valle Escondido) or you can email me at

Mar 28, 2012

Law 11 of 3/26/12---The Indians Won

According to TVN  local news sources,  this past Monday,  3/26/12,  President Martinelli signed and sanctioned  Law 11,  which also carries the signature of the Minister of Commerce and Industry, Ricardo Quijano.   This law establishes a special regimen of protection of mineral, water, and environmental resources of the Ngobe Bugle comarca and its defined, annexed areas in accordance with Law 10 of 1997.  It further recognizes the soverignty of the indigenous over these resources.  The new law cancels and prohibits concessions for the exploration, exploitation, and extraction of mineral resources and prohibits the alteration of river mouths, channels, and tributaries.  It also prohibits private appropriation of water sources.  Any future discussion or proposals regarding the establishment of hydroelectric plants must be approved by a general, regional or local congress and later submitted to a referendum of all entities involved.   The new law also obliges any future hydroelectric projects to dedicate 30 per cent of the benefits locally,---5 percent to the indigenous community and 25 per cent to the affected people, be they indians or local campesinos [rural residents].  It also establishes regulations regarding which indigenous organizations and persons are authorized to make decisons for the community.   The law will go into effect as soon as it is inscribed in the Official Gazette. 

Apparently the law underwent two debates in the National Assembly before acquiring the Presidential signature, so it should pretty much be official unless this political party plays the same games as previously and fails to get the law inscribed.  Given all the national and international attention, however, it seems it would be very difficult to sweep under the rug.

A great victory for the indigenous, and for the environment!

Mar 26, 2012

A Good Time Not to Be "Rich"

There have been a string of violent home invasions in Chiriqui in the last two weeks---three of them occurring in the last 8 days.  Information and details of each incident have been kept very close to the cuff, but apparently the victims are being pistol-whipped and the homes robbed.  The last incident, two nights ago, reportedly involved attempted rape. 

A community meeting is being held tomorrow at the BCP Tuesday market to discuss the matter.  As one resident told me,  "Everyone and their dog will be there."  Not me.  I'll just wait for the Cliff Notes  version to trickle down and try to figure out where and/or how I should get involved.   At this point the criminals seem to be running the show.  They have been smart enough to not strike more than once in any area and are spacing the invasion sites in towns sufficiently far enough from each other to catch everyone off guard. 

To the best of my knowledge, the recent victims have been expats, and the homes have been in Volcancito, Los Nances (Caldera), Portrerillos and Las Olas (Playa Barqueta).  The Boquete expat community has been very vocal about guns for personal protection while  living in gated communities.

Uhhh, right.   What Panama needs about now--- more gun-toting seniors living in expat islands...

I don't understand why people from first world environments have to immigrate to poorer countries  to lord it over the locals, flaunt their privilege, and then loudly complain when they are victimized.  And don't get me started re: the most obnoxious man I've ever encountered anywhere  appearing at the El Rey Supermarket in David today to verbally abuse a poor,  uninvolved, unsuspecting  stock boy because he found a rotting peach amidst the produce.  I've never been so ashamed to be even remotely associated with anyone--if only by language and country of origin.

I'm sure there will be lots said in the local forums following tomorrow's meeting.  Frankly I wish all the people with the entitled personalities would take a flying fulcrum and get the hell out. 

I honestly feel for the unfortunate victims of the brutal attacks.  But, maybe if we would all just assimilate instead of alienate,  we wouldn't be having community meetings about dealing with such sequelae. 

Mar 15, 2012

Time to Update, I Guess

Just where does the time go? It's been about 3 weeks since my last post, and it seems like only 3 days. The Jazz Festival came and went. It was very successful despite indigeneous protest demonstrations that kept a lot of people from coming that had planned to do so.   I didn't go to the opening parade,  but did attend the jam session on Saturday night at Amigos and went to the Sunday performances.  Great music  both places.  Lots of dancing at Amigos...At one point I was holding my own with two twenty-something Panamanian lads.   Sunday evening had dinner with friends at a new Peruvian restaurant that opened where Culturas used to be.  This new place is a vast improvement over Culturas.  Hope they are able to stay in business.   The location has not had a good history.  But the food and ambiance was great, and I'd like to go again.  I think the name of the restaurant is Casona del Cuzco.   I recommend it!

Currently my time is being absorbed with house renovations and educating an Amigos de Animales rescued cat that I've named Romeo.   A sick friend has learned she needs to undergo radiation therapy, but is maintaining a positive outlook and making the most of things.  I'm trying to provide whatever support I can.   Have also taken on some volunteer work teaching English.   My days have been quite filled, and right now, boredom is appealing.  Will try to keep more current on the posts, however.    Romeo is learning not to scratch the furniture, and sends his hellos.