Experts address candidates’ health care plans

first_imgAlthough the Supreme Court upheld the constitutionality of the Affordable Care Act (ACA) this summer, the debate over the future of American health care continues to be a major issue, especially as the outcome of Tuesday’s presidential election could potentially change the trajectory set by the ACA. If President Barack Obama wins reelection, he will focus on the implementation of fundamental elements of the ACA beginning in 2014, including affordable insurance exchanges and a significant expansion of Medicaid, according to Dr. Aaron Carroll, the director of the Center for Health Policy and Professionalism Research. But Jim Capretta, a fellow at the Ethics and Public Policy Center and author of “Why Obamacare is Wrong for America,” said the ACA will lead the country down the road to ineffective, expensive health care reform due to a large-scale centralization of power by the federal government, a move Republican candidate Gov. Mitt Romney opposes. “It’s indisputable that the main aim of the ACA is to use the federal government’s regulatory, taxing and spending authority to reshape the health care system and move massive amounts of political power out of the hands of employers and private citizens and states to the federal government,” he said. “The government is now in the driver’s seat of the health care system … where it can direct what people do in terms of health care.” Capretta said he thinks that shift in power could prove treacherous in its future consequences. “Anyone who’s worked around the political process knows that things like this have a certain inevitable trajectory. First of all, bureaucracies never cede power,” he said. “Once power is moved to the federal government, it will only expand over time. “The federal government is a one-size-fits-all structure that doesn’t have the authority to be nimble in managing a big enterprise like the health care system, and it will dictate terms … that don’t recognize the diverse nature of the country and very different views on quality health care.” Rather than dictating every health care decision Americans make, Carroll said the ACA sets a standard of universal coverage and gives people options to expand that coverage if desired. “The idea that the federal government is taking over everything is a bit overblown in the sense that they’re just setting baselines. They’re absolutely not saying, ‘You can’t get this or that coverage.’ They’re just saying, ‘You can’t have less coverage than this,’” Carroll said. “Individual states can do as much as they like above that baseline.” In terms of state power in health care reform, Capretta said decentralizing power from the federal government to state governments, as Romney has proposed, would promote freedom of choice among consumers and help strengthen the market for private health care. “Romney wants to push the health care system towards a market-driven approach instead of centralizing power at the federal level and do so in a way where the federal and state governments oversee the marketplace, ensure that it operates fairly on behalf of consumers and then try to empower people to make choices for themselves,” he said. More specifically, the issue of entitlement reform has come into heavy questioning in the context of increased government influence on the health care system. “Throughout the campaign, Romney has signaled that he will take entitlement reform very seriously as president,” Capretta said. “Obama has signaled that he doesn’t want to make structural changes to either of the major health entitlement programs, so there’s a big difference between the two candidates in this regard.” But Carroll said Obama actually prioritized Medicare and Medicaid reform in the ACA. Although Medicare often takes the national spotlight in presidential and other political debates, Carroll said the differences in the two candidates’ policies on Medicaid are actually “much sharper,” with Obama and the ACA stipulating a “massive expansion” of Medicaid to include 16 million additional people beginning in 2014 and Romney proposing to change Medicaid into a block grant program that provides funds to states to pay for care. “[The block grant program] saves money by severely restricting how quickly the size of the block grant goes up. A low cap will be set, so the amount of money spent on Medicaid under Romney will be much lower than otherwise predicted,” Carroll said. “Unless there’s some magic, that means there will have to be fewer people covered or the benefits will be far less.” Critics of the ACA often point to the Medicaid expansion as a huge drain on government and taxpayer resources, but Carroll said the program’s insurance plans cost less per person than providing subsidies to people to buy private insurance. “If it was cheaper to give people subsidies, that’s what the ACA would have done because no one wants to spend more than they need to on care,” he said. “The reason we have Medicaid is because certain groups of people can’t afford private insurance.” Contrary to the common perception of Medicaid beneficiaries as people who choose not to work, Carroll said the program mostly covers the most vulnerable Americans who are generally unable to work: children, pregnant women, the elderly, the blind and the disabled. “It’s not as if they’re people who should be working and are not. They’re people who can’t work for some reason, so insurance is incredibly expensive for them,” he said. “The amount of Medicaid funds spent on the blind and the disabled is huge, much higher than what’s spent on kids, and private insurance would cost a fortune because anyone rating them would see that their care is vastly more expensive than the average person.” Thus, considering Medicaid funding cuts or a repeal of the program’s expansion under the ACA brings up a fundamental ethical question, Carroll said. “If you’re thinking about cutting Medicaid severely, you have to ask yourself which of those groups you think should be working harder,” he said. “Which should be getting off their butts and earning more money and pulling themselves up by their bootstraps?” Although critics may view Obamacare and its call for expanded coverage as a violation of individual decision-making in health care, Carroll said the problems in the American health care system are not individualized. “It’s logically consistent to take the libertarian view and say everybody makes individual choices about health care,” Carroll said. “But the problem arises when people get sick, go to the emergency room and are charged for care they can’t afford. When people can’t pay, the rest of society has to pick up the bill. It’s not individualized, and eventually we’re all responsible for the millions of dollars in uncompensated care that gets spread out among people.” More than shared responsibility, Capretta said the American health care system needs an injection of free-market sensibility to operate more efficiently. “What’s needed most in health care is the discipline that comes from a functioning marketplace, a point Romney made in the first debate,” Capretta said. “That doesn’t mean the discipline from market forces can’t also be coupled with a proposal that provides relatively stable and relatively universal insurance.” Based on the example of uncompensated care being paid for by taxpayers, Carroll said he is not convinced of the power of free-market economics to solve the country’s health care reform issues. “You can let the free market try to take care of [health care reform], but it doesn’t work, and the same argument can be made for states,” Carroll said. “States have been free to act on health care reform – Massachusetts did several years ago – but the vast majority of states are not controlling this problem, so when the problem isn’t controlled, the public has to pick up the bill, and that’s when government often steps in.” On both sides of the political spectrum, Carroll said, the power of the free market and the private insurance system has certain limitations. “Because [Americans] will eventually take care of [uncompensated care], the next-best solution is to get people into the government health system because it’s not being controlled by market forces,” he said. “Even the right will acknowledge that the government should step in when the free market and private insurance can’t or won’t get the job done.” Romney has come under fire for not specifying what he would do after threatening to repeal the entire ACA if elected, but Capretta said the lack of a detailed plan creates flexibility. “Obviously, Romney’s plan is more of a vision than a detailed legislative proposal at this point, and I don’t discount the notion that a lot of details are being left out. But I think his broad vision is relatively clear,” he said. “His framework leaves lots of room for some details to be filled in later.” But Carroll said the alternative to the ACA might not be as perfect as Romney may consider his theory to be. “It’s not as if you have the choice between the ACA and some awesome free market utopia,” he said. “It’s the ACA or what we had before, which wasn’t working and hasn’t been working for a long time.”last_img read more

I’m sick of fintech taking credit union business

first_img 144SHARESShareShareSharePrintMailGooglePinterestDiggRedditStumbleuponDeliciousBufferTumblr,Shana Richardson Shana Richardson began her career in financial technology with the Texas Credit Union League. Here, she managed the turnkey, pre-screen Auto Loan Recapture™ program, and later assumed broader responsibilities as … Web: Details The Fintech revolution has been around for a while now, so why hasn’t the CU industry reskinned their model to remain competitive?Credit unions have been playing a game of catch-up with banks for many years, and now the new kid on the block— Fintechs —are here to present even more of a headache. On December 31, 2016, Prosper Funding had approximately $22.3 million in unrestricted cash and cash equivalents and $32.8 million available for sale investments at fair value.  Their marketplace facilitated $2.2 billion in Borrower Loan originations during 2016, and as of December 31, 2016, $8.3 billion in Borrower Loan originations since it first launched in 2006. Sure, delinquencies and charge-offs have gone up, but all commensurate to Prosper’s growth between 2015-2016 with an estimated net return of 7.86 percent for January 2017. Lending Club ended the year with a servicing portfolio of $11.1 billion, up 24 percent from the same period last year, and delivered $1.8 billion of principal and interest payments to investors throughout the 4th quarter of 2016 with cash, cash equivalents, and securities available for sale totaling $803 million, with no outstanding debt. What’s even more worrisome is that Lending Club’s venture into auto lending is still young and has a lot of potential if it gains serious traction.Both companies sell consumer lending and deposit products to exactly the same prime-rated consumer credit segment that banks and credit unions do.   As members continue to shift to using Fintech products and services, credit unions will need to update outdated legacy business model practices — and fast. Gone are the days when people were comfortable dealing with just a single entity for all their financial needs. There are over 100 million Americans that belong to a credit union, and the loans-to-shares ratio stood at 79.5 percent in the fourth quarter of 2016, up from 77.5 percent in the fourth quarter of 2015. We have opportunity galore and a whole bunch of new ideas to embrace — and fast.Here’s the thing: Fintech startup founders think and approach consumer lending through customer needs and expectations. As they say, it’s all about the customer. Why can’t the customer design the lending product that suits their needs? Credit unions are too focused on the tactical aspects of their business model, such as better loans, fees, and branch locations. This is why crowdfunding and even payday lending became so popular. It is easier to start a Kickstarter campaign and receive necessary product funding than to go to a credit union branch and ask for a loan! PayPal is the undisputed leader in digital payments in the U.S. and Europe, while Apple Pay and Android Pay have taken over the top spots for in-store mobile payments all around the world.The glacial pace at which credit unions have moved banking online has left them vulnerable. The credit union ROA as a national average peaked at 0.84% in 2012 and was 0.76% last year.  Furthermore,  annual regulatory cost impacts on the credit union industry in 2014 were $6.1 billion or 0.54 percent of assets —which is a huge part of the problem for not-for-profits. AWESOME!!!Fintech has easily captured the P2P lending and wire transfers market, with an increasing number of startups reaching out to customers in a more personalized manner through innovative means. Fintech firms have unbundled the services offered by credit unions and even fused them together to be their verticals, focusing on simplifying the experience for users. It’s this expertise in delivering convenience that makes Fintech appealing.The new online lenders have made the loan application process much more customer-friendly. Instead of walking into a branch and spending hours filling out paperwork, borrowers can complete online applications with lenders like Lending Club and Kabbage in minutes and from their laptop or phone at any hour of the day. Approval times are cut to days or, in some cases, a few minutes, fueled by data-driven algorithms that quickly pre-qualify borrowers based on a handful of data points such as personal credit scores, Demand Deposit Account (DDA) data, tax returns, and three months of credit union statements.To catch up and fight back, credit unions will need to use third-party suppliers or acquire Fintech startups for education and mutual benefit.Embracing these themes and creating the right foundations will allow credit unions to disrupt their own business model rather than sit on the sidelines watching challenger models destroy them.Credit unions need to up their game by:Allowing members to send money and receive money like popular online Venmo.Stay updated across all devices with real-time push-notifications and transactions.Fintechs are leveraging existing software to help people and businesses make better financial decisions through budgeting, predictions, and other types of programs that they offer.  Credit unions will need to offer various software to their members to help them make better decisions and save massive amounts of time through analytics, accounting, budgeting, prediction, and decision- making software.Fintech innovators understand the struggle people face when they have to interact with credit union services. It’s past time, then, that we took a good, hard look at what their members really need and want.  We must create a better customer experience through truly customer-friendly design — or lose out to the new kids on the block.last_img read more

Extended hours in Ripley County for tax payments

first_imgVersailles, In. — The Ripley County Treasurer’s Office has announced expended office hours during tax collection.Monday, November 6 through Wednesday, November 8 the office will be open from 8 a.m. to 4 p.m. On Thursday, November 9 and Monday, November 13 the office will be open from 8 a.m. to 6 p.m. The office will be closed on Friday, November 10.Taxes are due by Monday, November 13. For more information please call 812-689-6352.last_img

ELA lotteries recognises mkodo as a trusted developer

first_img Keith O’Loughlin: The four pillars supporting state lottery success for Scientific Games November 28, 2019 Share Stuart Godfree – mkodoMobile innovation studio mkodo has underlined its status as a technology developer for the global lottery sector by securing ‘associate membership’ to the European Lottery Association (ELA).Joining the ELA’s membership, mkodo will uphold the association’s guiding mandate to ‘promote sustainable gaming models for the benefit of society’.Updating stakeholders, Stuart Godfree, Managing Director and Co-Founder of mkodo, explained the importance of joining the ELA’s body of over 100 national lotteries and their suppliers.“This is great news for mkodo as it further strengthens our position as one of the premier suppliers within this sector and we’re very proud of the work we do within the lottery industry,” Godfree commented.Operating as a mobile development studio, mkodo has over a decade of experience working with national lottery suppliers delivering projects and products for the likes of Danske Spil, the Atlantic Lottery Corporation, British Columbia Lottery Corporation and Western Canada Lottery Corporation.Godfree added: “We look forward to working together with the ELA and its members to help establish and develop industry best practices, as well as share ideas on the opportunities and challenges in the evolving lottery technology sector.”mkodo’s membership, which has been approved by ELA’s Executive Committee Members, is expected to be fully ratified by their General Assembly in June 2020. Related Articles Will Whitehead, mkodo: Achieving sportsbook and casino differentiation through UX April 29, 2020 StumbleUpon Submit mkodo agrees £7.8m sale to Pollard Banknote Canada December 3, 2019 Sharelast_img read more