Author Archives: tom

The Justice Chronicle, Volume 22: King v. Burwell: What Does It Mean?

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Thursday morning at breakfast the Today Show broke into its programming to announce a decision in the case of King v. Burwell. By a 6-3 decision the justices found for the defendant.

I’ve been disturbed at the news coverage on this. Virtually all the reporting makes it sound like a boxing match: Who won and who lost. I’m willing to bet that an embarrassingly small percentage of the population could name the case (King v. Burwell) or the issue that the court decided today.

The implications were clear: had the court found for the plaintiff the Affordable Care Act would likely not have been able to survive. So what were the particulars of the case?

The Affordable Care Act (ACA), also called “Obamacare” was signed into law in 2010 and mandated that nearly everyone purchase health insurance. Many of us work for companies that provide us with adequate health insurance, but many companies don’t If you’re a part time or per diem employee you may not get health care from your company. If you work for a small business they may not afford to pay for health insurance. If you’re under 65 and not employed (for any reason) you have nobody to provide you health insurance.

You’ve always been able to buy a health insurance policy on your own, but for many people that was not an option. Premiums were prohibitively high, and you can be denied for a host of pre-existing conditions. I have sleep apnea and before the ACA I would have been excluded from any private health coverage.

The ACA mandated that health insurance companies not exclude anyone for pre-existing conditions. Health insurance companies (rightly) argued that this doesn’t work for them because under this system nobody would buy health insurance until they needed it (much as you can’t buy fire insurance when your house is already on fire). The mandate was necessary as this provided health insurance companies a larger base of customers. That’s the basis of insurance: most people who buy insurance don’t need it and this pays for the minority who does.

But there was still another problem: a large percentage of our population still couldn’t afford to purchase health insurance. We can’t tell people they have to buy health insurance if they simply can’t afford to. Because of this the ACA provided subsidies for people whose earnings fall below a certain level.

The ACA wanted the states to participate in this and made this deal: if your state wishes, it can set up a health insurance exchange. For those eligible for subsidies, the federal government will pick up all of the cost for the first few years and most of the cost from then on. If a state refused to set up an exchange, the federal government would set one up. I believed that most states would see the value in setting up exchanges. I was wrong. Only 16 states set up exchanges and the rest depended on the federal government.

That’s all fine, but here’s where we get into the current lawsuit. Most of us get our health insurance through our employers and our employer pays part of the premium. For people who get their insurance through these exchanges, paying the full premium would be overly burdensome, and the ACA provides subsidies to help people buy insurance. Buried deep in the legislation is the phrase that subsidies are only available to people who purchase their health insurance on an exchange “established by the State.”

The plaintiffs argued that these subsidies are only valid for health insurance exchanges established by one of the 16 states, and that if you live in one of the states that doesn’t run its own exchange, you are not eligible for subsidies.

Frankly that would have sent the entire ACA into a death spiral. People in those 34 states would lose insurance because they couldn’t afford to purchase it. The loss of premiums would have made it much more difficult for insurance companies in those states to continue to provide coverage and many of them would stop providing insurance in those states at all.

In the majority ruling the Court found for the defendants, arguing that if this phrase meant to apply only to those 16 states, the seeds of its own destruction would have been written into the law. In other words this can’t have been the intent of the authors because they never would have written legislation whose implementation was impossible.

Simply put this was the last, desperate act of a group of people who don’t like President Obama, don’t like anything he supports, and hoped against hope that they could convince the Supreme Court to strike it down. Fortunately it didn’t work.

It Was Seventy One Years Ago Today: D Day

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June 6, 1944 is a day most members of the Greatest Generation will never forget. By 1944 everyone knew that Allied Forces stationed in England would need to make an amphibious landing on the coast of France. Nobody (or at least almost nobody) knew where or when.

The English Channel is a little over 20 miles wide at its narrowest (in the Strait of Dover) and Adolf Hitler, among others, believed the invasion would start there, in Calais. It didn’t.

The invasion instead was south of Calais, near the villages of Caen and Bayeux. They hoped to join their forces at St. Lo.

It was chaotic from the very beginning. The weather was not cooperative and many of the paratroopers were dropped far from where they were supposed to be.

Nevertheless, this day was ultimately successful. The Allied troops were able to claim a beachhead and begin the march toward Berlin. Ten months later the Nazis surrendered and Europe was once again free from tyranny (at least those countries not conquered by the Soviet Union.

I’ve spoken with several of the troops who landed at Normandy that day. Their memories continue to move me to tears. I can’t help but know that the first few waves landed and understood that their jobs were to use up all the Nazi bullets. I remember one man telling me that they were told to get off the transport boat and start marching: if the man next to you goes down, don’t try to help him. Just keep marching. He defied that order when the guy next to him walked off the transport boat and stepped into a divot in the ocean and fell in over his head (and was in danger of drowning). This man told me he defied orders by grabbing the collar of his buddy and dragged him back up.

He also told me that during the transport he saw the soldiers doing several things. Some were praying the rosary, some were staying silent, and some were playing dice. It’s hard to imagine being on a transport, as a teenager or young adult, knowing this may well be the last day, or the last hour of your life. By sunset on this day, 71 years ago, they were all grateful to be alive.

I’m grateful too.

The Election 2016 Chronicles Volume 1: Countdown to Election 2016

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As many of you know, every four years I begin to track those who are running for President. And even though the election is over 17 months away, the campaign is beginning in full swing.

As I write this the race for the nomination for the Democrats is a small field. But the race for the Republican nomination is a much more open field. In the past I’ve gone to pains to include those who seek the nomination in other parties or those who run as independents.

Running against the current of common sense I’ve done it again. If you scroll down the left side of this page you’ll see those I’ve listed. I have a few criteria. I won’t list anyone who hasn’t declared. Several candidates in both parties are “exploring” whether or not to run; I’ll include them when they declare.

There are several smaller parties who run candidates and I begin with their web pages. Again you need to declare to be included.

By far the independents are the hardest group to track. I’ve developed this criteria for this list: you have to be eligible to be president (ie, 35 years old and a U.S. citizen by birth) and you have to have a web page. I know this probably discriminates against candidates who are not computer literate, but since I depend on computer searches, it’s the best I can do. If you write to me and tell me you’re running, I’ll include you.

Let the races begin.

The Money Chronicles Volume 12: Managed Care is Often Unmanageable

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Last month Nancy’s father suffered a stroke. He’s 96 and in otherwise remarkable health and his recovery is optimistic. It’s been an emotional roller coaster that happens to nearly every family at one time or another, and God knows I’ve been witness to it thousands of times in my role as a hospice chaplain.

In the last four weeks I’ve also found there is a learning roller coaster to this. We purchase insurance for all sorts of things: our life, our homes, our cars. But we also buy insurance for our health and that’s an entirely different equation.

We buy car insurance in the hope that we’ll never need it. In the off chance we do need it, we’re pretty certain what it will do. If we wreck the car our insurance will fix or replace it. Case closed. Same with homeowner’s insurance.

But health insurance is a different animal altogether. It’s fairly expensive and most of us don’t pay the entire premium ourselves. Because of a series of random events, we expect our employers to pay the lion’s share and they do. Before the passage of the Affordable Care Act millions of Americans could not afford health insurance. If they got sick or injured they showed up in a hospital emergency room and made a horrible bargain: fix me and hope I can repay you.

If you couldn’t, it was a lose/lose situation. The hospital wouldn’t get reimbursed for the care they provided and sued the patient. The patient, who couldn’t pay, filed for bankruptcy and destroyed their ability to ever borrow money again. Result: the hospital needed to find another way to achieve financial solvency and the patient spent his life stuck in a cycle of poverty.

Bottom line: if you didn’t have insurance you owed whatever the hospital claimed you owed with almost no ability to negotiate.

But if you did have insurance you were gold. Your insurance company would pay for whatever happened to you. You may have a small copay but it’s at best a small percentage of the cost of caring for you.

And here’s what you didn’t know: your insurance company has the ability to negotiate how much they pay. They will pay less than the cost of caring for you because the hospital can recoup the difference with the individuals who can’t negotiate.

I’ve written this article because we received a bill from Scripps Memorial Hospital for Al’s stay there. He suffered his stroke on the evening of Saturday, April 18th. We brought him to the emergency room that evening where they admitted him. He stayed there until the afternoon of Wednesday, April 22nd.

We were pleased with his health and pleased with the staff and have nothing but nice things to say about the staff at Scripps Memorial. We weren’t sure how much it would cost but we all agreed it was worth it.

A few days ago we got the total. The total cost for his stay was $49,773.00 and the copay was $700.00. Truthfully, that seemed like a good deal for us. The copay was 1.4% of the bill. We were pleased with the insurance.

But there was another line in the bill. Turns out the insurance company didn’t pay $49,073.00. They paid $11,536.56. They have enough patients that they can play hardball with the hospital and negotiate a reduced rate.

In the end it pays off for everyone. The hospital is able to be profitable receiving $11,536.56 from the insurance company and $700.00 from Al (for a total of $12,236.56). Truthfully it’s a win/win/win. The hospital can live with a reimbursement of $12,236.56, the insurance company can afford to pay $11,536.56, and Al can afford to pay $700.00.

But for someone in the exact same position without insurance, they don’t have the option of paying $12,236.56. Their bill is $49,073.00 and the hospital expects every dime. If it’s not paid right away it goes to a collection agency. These patients and families are in an untenable situation: they are willing to pay whatever they can but they just can’t pay enough.

The passage of the Affordable Care Act provides health insurance for many who had been left outside. There are still those who gamble against needing health insurance but that number is much lower. To the extent that many candidates for the Republican nomination promise to repeal the Affordable Care Act, we can assume that they choose loose/loose over win/win/win.

As Al’s son in law I’m grateful to be part of the win/win/win.

On This Day 150 Years Ago: A Bad Day

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My last post celebrated a good day: the day the Civil War ended. Our newly reunited nation rejoiced and nobody was more grateful than our President, Abraham Lincoln. Even before the war ended he was outlining the plan to bring back the states that wanted to secede. He articulated a process that would echo the Biblical parable of the Prodigal Son.

In one of the cruelest twists in American history, a man who hated Lincoln killed him 150 years ago today. John Wilkes Booth first devised a plan to kidnap the president as a bargaining chip to force the Union to ransom him in return for Southern emancipation. When the South surrendered on April 9th, Booth’s plan lost its purpose. Booth, a frequent actor at Ford’s Theater, found out on the morning of April 14th, that President Lincoln would attend the play This American Cousin that evening. He took that opportunity to kill Lincoln instead of kidnapping him. The plan was greater than that. He devised a plan where he would kill President Lincoln. George Atzerodt would kill Vice President Andrew Johnson, and Lewis Powell would kill Secretary of State William Seward.

George Atzerodt got drunk and didn’t attempt to kill Johnson, Powell was able to wound but not kill Seward, and only Booth carried out his mission.

Booth was shot to death on April 26th. Azerodt and Payne were executed on July 7th (along with Mary Surratt and David Herold)

On This Date 150 Years Ago the Civil War Ended

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On April 9, 1865 two men met at Appomattox Court House and signed a document that silenced thousands of guns and ended possibly the worst era in our history.

Confederate General Robert E. Lee (1807-1870) surrendered the forces of the Confederate States of America to Ulysses S. Grant (1822-1885) and the Grand Army of the Republic.

Four years earlier the nation was torn apart when eleven states succeeded from the union in an effort to preserve states’ rights and slavery. Neither side expected the other to last long and both expected to win the war handily. The union didn’t think the confederates had the resources or commitment to fight a long war and the confederates didn’t think the union had the desire to preserve the union. They were both wrong.

By the winter of 1865 the nation was in shambles. About 620,000 soldiers died from combat, disease, or starvation. The confederates suffered the lion’s share and its troops were starving. General Lee recognized that he had no choice and asked for terms of peace. He had no idea what that would mean for him or his troops.

General Grant rose to the occasion. He told General Lee that his troops could go home (and not be prisoners). His officers could keep their sidearms. And the union troops fed the starving confederate troops. You can read more about this in an article written by Douglas Brinkley.

In fairness this was not their first meeting. They were both graduates of West Point (Lee in 1829 and Grant in 1843). They fought together in the Mexican American War from 1846 to 1848. As a matter of fact when they met at Appomattox they began to talk about that war.

Libraries have been written about this day but I have two recommendations. Bruce Catton (1899-1978) wrote several books on the Civil War and his last volume recounts the last days of the war. It’s called A Stillness At Appomattox. My next recommendation is a work of fiction that details a man who is walking home from the war. Cold Mountain by Charles Frazier gripped me from page one.

Rand Paul: And Now There Are Two

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A few days ago we learned that another Republican is running for President. Rand Paul, a senator from Kentucky announced his candidacy.

Many of us find this interesting as Rand is more of a Libertarian than a Republican. He is the son of long time Libertarian Ron Paul. Ron ran for President in 2008 and 2012 hoping for the Republican nomination and wasn’t nominated.

Nobody can deny Rand’s (or Ron’s) libertarian beliefs. Rand has long believed that the government does too much, spends too much, and interferes too much in the lives of ordinary people. And there is popular support for this. If you asked most Americans if the government is too powerful, many would say yes.

But this is one of those areas where popular support begins to decline as more information enters the scene. Rand denies this but he once claimed that the 1964 Civil Rights Act was just an overreach. You can read an interesting article in the Washington Post.

I’m paraphrasing this but Senator Paul indicated that while he supports the Civil Rights Act he is troubled by the idea that the government has the right to tell private companies they had to do business with someone if they don’t want to. The interviewer then asked if he thought Woolworth’s (a popular five and dime store that often contained lunch counters that refused to serve blacks in the south) should be able to refuse service to Martin Luther King. The senator responded that he would never patronize a store that discriminated and that racism is a horrible sin. He believes that any business that discriminates would not stay in business long.

I disagree. In the past few weeks we’ve seen business announce they will not do business with homosexuals and they appear to have at least some support. Much as I don’t like to think about this, I believe there is enough latent racism in this country to allow businesses to discriminate on the basis of race and stay in business.

But with regard to Senator Paul I am troubled by issues that most people aren’t thinking about. Senator Paul opposes much of the regulatory power held by government agencies. So let’s talk about a few:

  • The Food and Drug Administration: They make sure that the food we eat and the medications we administer are safe. It was founded in 1906, in no small part, after the publication of The Jungle by Upton Sincliar. A true libertarian believes that the government has no right to interfere with your relationship with your butcher or pharmacist. Me, I’m happy to know my food is safe and I’m really taking the medication I think I’m taking.
  • The Federal Deposit Insurance Corporation: In the 1930s (the Great Depression) about 9000 banks failed in the United States. Everyone who kept their money in those banks lost it all. The FDIC was founded in 1933. If you keep your money in an FDIC insured bank, your money (up to $250,000) is insured if the bank fails. In turn the bank is required to follow FDIC rules. Without the FDIC you could never deposit your money in a bank and be sure it’s safe.
  • The National Park Service: If you want to purchase Yosemite Valley or Appomattox Court House (where the Civil War ended) and develop condos, what right does the government to tell you that you can’t? And why does the government even own land at all?

Rand Paul has a rough road ahead: he needs to convince his fellow Libertarians he will remain true to their values while convincing Republicans that he will stand with them on issues that most Libertarians don’t care about (like Marriage Equality).

Soon I’ll be listing the candidates for President in 2016 on the left side of this page. Stay tuned.

The Justice Chronicles, Volume 21: Discrimination and Homophobia is Alive and Well in Indiana

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The latest darling of the 24 hour news cycle today brings us to the state of Indiana. On March 26, 2015 Governor Mike Pence signed into law the Religious Freedom Restoration Act. In the last 4 days the reaction has been strong on both sides. Sometimes I wonder if I’m the only one who asks this, but what does the law actually do? Glad you asked. You can find the text of the law here. Props to the Legal Information Institute housed at the law school of Cornell University for providing the text of this law.

The law states that if you believe homosexual relationships are sinful on religious grounds you should not be required to do business with homosexuals. Proponents of this law point to a bakery in Indianapolis called 111 Cakery. In 2014 a gay couple asked the bakery to provide the cake for their commitment ceremony (marriage was not legal at the time). The owners refused on the grounds that their religious beliefs prohibited them from participating in what they felt was a sinful act. The bakery has since gone out of business.

The RFRA states that religious freedom is a right granted in the U.S. Constitution. It further states that laws that are neutral toward religion may burden religious exercise and these burdens should not be in place unless there is a compelling justification.

In other words, government can pass a law that does not appear to violate someone’s religious beliefs and may yet nonetheless do so. In those cases there needs to be an exemption that does not compel someone to do something that violates his or her religious beliefs.

That sounds fine in the abstract but not in the execution. I dug into the text of this law and found this definition of “religious exercise”:

The term “religious exercise” includes any exercise of religion, whether or not compelled by, or central to, a system of religious belief. The use, building, or conversion of real property for the purpose of religious exercise shall be considered to be religious exercise of the person or entity that uses or intends to use the property for that purpose.

Individual religious exercise, therefore, does not require the backing of an existing denomination. You can be as racist, misogynist, homophobic or just plain mean as you want and claim religious exercise, even if your faith doesn’t.

Proponents of this law insist this is about religious freedom and not about discrimination. Since I’ve spent virtually all of my adult life in the field of religion I’m sure they take my support for granted.

They shouldn’t. I grew up in the South and witnessed discrimination from an early age. I also witnessed religious people who used faith to justify discrimination and were just as shameless. They argued that God justified segregation by claiming that those of African descent were the children of Ham described in Genesis 9:25.

Today almost nobody will admit to finding this racism acceptable but 50 years ago many did. Hopefully 50 years from now nobody will point to religious beliefs to justify homophobia, but that won’t happen unless we stand up today to condemn the RFRA.

Governor Pence and nearly everyone who is running for the Republican nomination for President swears this isn’t about discrimination but we’re not fooled. Homophobia is rapidly declining in the population but those who hide behind religion still control a disproportionate share of funding for candidates. We need to stand up for the inclusion that all legitimate religions profess.

Let’s all work to make homophobia just as distasteful as racial discrimination.

The Justice Chronicles, Volume 20: Sodomy As a Capital Offense? Really?

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Several decades ago I had a conversation with my college roommate Rob Duston. At the time he was a student at the University of Virginia Law School, also known as Mr. Jefferson’s Law School.

For reasons I don’t remember our conversation turned to the topic of sex and what was prohibited in the Commonwealth of Virginia. Half as a joke Rob told me that “everything is illegal in Virginia except with your wife in one position.” I thought he was kidding.

Since then I’ve learned that sexual positions and partners occupy way too much time and energy in the lives of our legislators. In 1986 the Supreme Court found, in the case of Bowers v. Hardwick that states can pass laws that prohibit sex between homosexual, consenting adults. Fortunately it was overruled in 2003 by the case of Lawrence v. Texas.

Most of us believe that sexual orientation is not a choice but a given and that we should all be allowed to marry our soulmate, regardless of whether or not that person is the opposite sex or same sex. I’m blessed that I live in a society where my orientation is socially acceptable (and so is my wife’s) but I recognize, acknowledge, and love those whose orientation calls them to someone of the same sex. Many of these children of God have trusted me enough to share their stories with me and I’m grateful for that trust.

But we also live with the fact that there are those, even those in power, who feed into their own fear and turn it into discrimination. They believe that orientation is a choice and those who choose to be homosexual will be condemned by God.

As if that isn’t enough, they believe that those of us who are heterosexual will be condemned to Hell if we dare to tell homosexuals that they are loved. They believe that we will be condemned because we give them “false hope” that God loves them.

Enter Matt McLaughlin. He is a lawyer from Huntington Beach, California and an alleged Christian. He is collecting signatures for a ballot initiative that would make sodomy a capital offense. He even states that they should be put to death by “bullets to the head or any other convenient method.”

OK, I’m a Christian and believe that my life works best when I live in harmony with God’s plan for me. But I don’t believe that my salvation depends on my hating the people Matt McLaughlin hates. If salvation is based on love and inclusion (as Jesus believed) I don’t believe that I have to choose sides on marriage equality. I have dozens of gay friends who I expect to see in Heaven. I pray they will be there because of love.

And I pray they love their husbands and wives as much as I love my wife.

Ted Cruz Throws His Hat Into the Ring: Let the Campaign Begin

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On November 14, 2016 we will all go to the polls to elect our next president. Nineteenth months before that day we have our first confirmed candidate. Today Ted Cruz announced his candidacy at Liberty University, the college founded in 1971 by Rev. Jerry Falwell.

Ted is well known by anyone who follows politics. He is currently the junior Senator from Texas. His conservative credentials are legendary: he wants to repeal the Affordable Care Act and abolish the Internal Revenue Service. He argues against same sex marriage and ending the embargo with Cuba. Among Christian conservatives (who largely populate Liberty University) he brings strong credentials.

But he also brings some challenges. First and foremost his popularity is an inch wide and a mile deep. Those who like Ted Cruz like him a lot. But while they may be wealthy, there aren’t many of them. I’m sure this troubles them, but every voter in this country gets the same number of votes: 1. The wealthy Christians in this country may be able to generously fund his campaign but can only vote for him once.

The irony of this keeps me warm at night but there’s no way around this: Ted wasn’t born in the United States. I wrote about this in a previous post. In 2008 there was (and still is) a vocal and stupid minority that claims President Obama isn’t a legitimate president because he was born in Kenya. Nobody questioned that his mother was born in Kansas but the “fact” that he was born in Kenya prevents him from being our president.

You have to know where I’m going with this: how can the birthers claim that Barack Obama can’t be a legitimate president because they allege he was born in Kenya, and yet support Ted Cruz when everyone knows he was born in Canada?

In any case, the 2016 campaign has begun. In years past I’ve listed presidential candidates on the left side of this page. I’ve attempted (at great sacrifice) to list everyone who is running for president, not just the major candidates. I’ll do this again for the 2016 campaign but not yet. Ted is the only major candidate to announce, and I’ll wait for a larger field to announce.

Keep looking for more candidates. And let’s celebrate that we live in a country that allows us to choose our leaders.