Category Archives: Governance of the Government

October 30, 2017 · 9:01 am

New York City Has a Fiscal Crisis…Right Now!

 

We often hear about out of control unfunded pension liabilities, but NYC government employee’s health insurance is also a ticking time bomb.

The Citizens Budget Committee estimates the current and future retirees now have an unfunded health insurance liability of $95 billion.  And, this figure will grow at an unprecedented rate per year, generating an unfunded liability of $175 billion in ten years.

Let’s put that in perspective.  This year’s total budget is estimated at $87 billion, so unfunded health care alone in ten years will be equal to 200% of this year’s total city budget.

And, we can add the pension liability of an estimated $100 billion, and you have unfunded pension and health insurance liabilities that in ten years will be more than three times this year’s total budget.  This will require a budget in 2027 of equal to 400% of our current budget to fully fund these liabilities.

New York City provides its employees the most generous pension and health plans than any other major city in the United States.

Mayor de Blasio doesn’t seem to be worried.  He is campaigning with Bernie Sanders later today.  Perhaps he believes Bernie’s “Medicare for All” will become law and bail out the city….but who will pay the bill?  We think you know who will be stuck with the tab.

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Filed under Governance of the Government, Healthcare, New York City

March 16, 2017 · 7:43 am

The Fourth Estate Is Out of Control…

 

One could argue the last truly independent and highly trusted news people were Walter Cronkite and Edward R. Morrow. People listened and trusted them.

Media changed everything. Ratings are king and trusted sources be- damned unless the ratings are present to support them.

It was never more evident than Rachel Maddow’s breathless revelation of the totally unremarkable tax returns of President Trump. She opened with thirty minutes of rumors and innuendo and culminated her rambling in a “revelation” that revealed absolutely nothing. It was, frankly, embarrassing.

How can we return to the days when we trusted Cronkite, Morrow, and yes, Senators Everett Dirksen and Patrick Moynihan? Can we ever return?

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Filed under Governance of the Government, Politics

November 16, 2015 · 10:37 am

ACA-Obamacare Review

The ACA (Obamacare) was designed to provide health insurance to many of the estimated 40 to 60 million uninsured Americans. Has it succeeded? At the risk of sounding like a politician instead of a health care provider, the answer is “yes and no”.

Yes, many previously uninsured Americans now have insurance.   But the offering has fallen far short of expectations of enrollment and more importantly in the benefits it provides.

For the lower income Americans, they can now access an affordable health insurance plan. They can then receive a physical examination as a determination of their current health status along with recommendations to get or stay healthy. The issue is the plans. The deductibles are so high, most insured’s cannot afford ongoing treatment.

Often the deductibles range from $2,000 to $5000 per year. Rarely does a patient incur those levels of charges to satisfy the deductible. Therefore, after their physical, they basically do not have any health insurance unless they suffer a catastrophic event such as hospitalization.   We believe this type of high limit deductible coverage is still important to financially safeguard the patients against those significant health events. Many others believe ongoing routine health care is simply out of reach.

The New York Times covered this important disparity in detail. You can read their excellent analysis and in depth reporting at New York Times

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Filed under Governance of the Government, Healthcare

March 16, 2015 · 7:49 am

Congressional Dysfunction Threatens Seniors Health Care…..Yet Again

Most seniors have never heard of the acronym SGR that in healthcare parlance means Sustainable Growth Rate.

The wisdom of congress passed this particular piece of legislation in 1997.  Its purpose was to control the cost of Medicare through a complex formula that controlled escalating costs.

The problem is simple; it doesn’t work and has really never worked.  Congress however, has never been able to come to grips with it and continues to pass “kick the can down the road” legislation rather than fixing it.  In 2010 alone, the proverbial can was kicked five times.

We now find ourselves staring down the barrel of a gun once again.  If congress doesn’t act by the end of March, Medicare reimbursements to doctors will be cut by 21%.

What does this mean?  Docs won’t be happy, in fact they have about had it with Medicare as evidenced by a growing group of them who will no longer accept Medicare.

A colleague of ours voiced his thoughts recently.  It went something like this….”I began to accept Medicare even though I felt their reimbursement rate was low and didn’t properly compensate me for my time and expenses.  However, they paid promptly and didn’t harass me with a million questions about why I used one treatment versus another” He has since changed his mind.  His comments now complain that reimbursement, which was never fair, has been reduced.  He now receives letters from Medicare questioning his judgment, and he is facing not just another cut, but a long delay in receiving anything.  He has had it and will not longer accept Medicare patients.

If congress fails to act (again) by March 31st, doctor’s treating Medicare patients will face a 21% reduction in their reimbursement rate.  Could you afford a 21% pay cut.

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Filed under Governance of the Government, Healthcare, Politics

March 5, 2014 · 9:35 am

Statehouse Trumps City Hall

Governor Cuomo came out yesterday with a strong endorsement of New York City charter schools. He was responding to a 10,000 plus demonstration of charter school parents and students and against the much smaller union organized rally. www.NYPost.com

Perhaps fairness will reign in this ongoing battle that appears to be union organizers and supporters vs. concerned parents and corporate funding for better education.

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Filed under Children, Education, Governance of the Government, New York City

March 1, 2014 · 4:52 pm

Two Enemies of Good Government

Ideologues and Political Rhetoric without Action

Good governing only comes with compromise, and ideologues seem to lack the common sense that they can’t prevail at all times.  Simply stated they are incapable of compromise.  Rhetoric without action can be worse since nothing is there to be discussed, modified and ultimately agreed.  Great pronouncement speeches are soon forgotten without the requisite follow through of action.

We have all witnessed these two shortcomings in our politicians, and unfortunately our well-intended new Mayor of New York seems to embrace both.  His Pre-K stance on tax the rich as the only path to offering universal Pre K even though the state has offered to fund it, is an excellent example of an ideologue that refuses to compromise, even when he is getting most of what he wants. He then goes on to embrace the second failing of rhetoric without action by announcing multiple projects and trashing existing ones without any specific plans to launch or improve them.  Take your pick, a rejuvenated Sandy, a “reset” of mid-town zoning, specifics on Pre-K, etc.

I for one am also tired of hearing the new mayor was elected with a 73% mandate.  Let’s take a quick look at those pesky facts:  There are 4.6 million registered voters in New York City.  Only 1.02 million actually voted which is only 22.2 % of eligible voters.  Of this 22.2 percent he did receive 73% of the vote.  This translates, mathematically and factually into 16.3 % of the vote of New York City voters…hardly a mandate.

However, it was clearly a mandate by the unions of New York City.  If 75% of the 300,000 union members of NYC voted for DeBlasio and their partner/spouse also voted for him, along with one parent or parent-in-law, that group alone would have accounted for almost the entire vote he received.  And, let’s not forget, union members are democrats, they vote regularly, and the new Mayor was promising retroactive pay increases.  They totally supported him and if the truth were known, single handedly, elected him. This calculation would leave 3.0 million registered voters who did not cast a vote (shame on them) and gave the Mayor his often-stated “mandate”.

The mayor must start delivering.  Compromise on the Pre-K, and you’ll be lauded and known as the Mayor who gave everyone Pre-K not the Mayor who compromised away his tax increase.  Release specifics on projects and “resets” that make sense and then follow through.

And, a few more thoughts Mr. Mayor.  Those nasty one-percenters are at their desk in the financial district long before your first meeting is scheduled and they show up on time, each and every day.  They are not 40 to 60 minutes late for their scheduled meeting and certainly not for their first of the day.  You’d be surprised to see how active the “street” is at 6AM or 7AM each morning.  Try getting up one morning and checking it out.  You’ll find the “other city” you often refer to up and working very hard long before you’ve had your first cup of coffee.

And above all, don’t become the Mayor Ed Koch spoke of in his memorable words:  “The people have spoken…and now they must be punished”

Good Luck Mr. Mayor.  Everyone really does want you to succeed, as that would be best for the city we all love.  But, you’ll have to get up early, show up on time and avoid the two enemies of good government.

 

 

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Filed under Governance of the Government, New York City, Politics