First postbailout budget wrapped up

first_imgBy Elias HazouTHE 2014 budget, passed by the House last night, features cutbacks across the board as an effectively broke state tightens the belt to meet the debt targets of an international rescue package.The budget – the first since Cyprus was bailed out by international lenders – was trimmed by 10 per cent compared to 2013, with expenditures (excluding cash flows and interest payments) coming to €5.6bn.On the revenues side of the balance sheet, the government expects to raise €6.6bn (excluding cash flows), compared to €7bn in 2013, a drop of 5.5 per cent.Next year is forecast to be the toughest yet, with the economy shrinking by 3.9 per cent, and the jobless rate rising to a staggering 19.5 per cent.Meanwhile the public deficit will come to 5.4 per cent of Gross Domestic Product (GDP). The number to watch is the debt to GDP ratio, which for 2014 shoots up to 123 per cent, compared to 114 per cent this year.And expenditures on servicing the public debt are calculated to jump to €782m, an increase of 13 per cent on 2013.The civil service payroll, the largest drain on public finances, is to be reduced by 1.5 per cent overall. In 2014 the state will spend €2.563bn on civil servants’ salaries, compared to €2.605bn this year.The first of ‘fiscal discipline’ budgets until 2016 – the end of the bailout programme – sees cuts to welfare spending, to be slashed to €836m from €962m (minus 13 per cent).Revenues from direct taxation are projected to reach €2bn, an increase of 4.4 per cent on 2013. Meanwhile the budget provides for additional remuneration cutbacks in the broader public sector, pension contributions by certain categories of civil servants, and an increase in the fuel consumption tax, among others.Additional savings – though not major in absolute terms – will be generated after a last-minute agreement yesterday between the government and the main civil servants union PASYDY. Under the deal – incorporated into the budget – the shift allowance for public sector workers employed on a shift system (nurses, civil aviation, electricity technicians) are to be trimmed by an additional 10 per cent, over and above a 15 per cent reduction enforced this year. It also provides for an extra 15 per cent cut to the nightshift allowance.Overtime in the public sector will not be paid for work on weekdays, while the overtime rate for working Sundays is slashed from 2.0 to 1.3 times.As widely expected, ruling DISY, DIKO and the European Party were in favour of the budget, joined by independent MP Zacharias Koulias. AKEL, the Greens and the Citizens’ Alliance voted against, while socialists EDEK abstained. The final tally stood at 30 in favour, 20 against and four abstentions.“This is a budget based on the counter-intuitive logic that the solution to the problems of the economy lies in more austerity,” AKEL MP Stavros Evagorou said in remarks before the plenum.He added: “Austerity means deeper recession, and deeper recession calls for – according to the recipe of the memorandum – even more austerity.”A combination of deficit spending by the previous administration, and massive losses incurred by Cypriot banks due to the Greek debt crisis, led to the island’s exclusion from international markets and necessitated a €10bn bailout in March of this year.In 2008, when AKEL came to power, the public deficit was €450m, but soared to €1.357bn the following year, then flying off the charts to €2.295bn in 2010.You May LikeLivestlyChip And Joanna’s $18M Mansion Is Perfect, But It’s The Backyard Everyone Is Talking AboutLivestlyUndoPopularEverythingColorado Mom Adopted Two Children, Months Later She Learned Who They Really ArePopularEverythingUndoKelley Blue BookYou Won’t Believe How Affordable These Ford Car Models AreKelley Blue BookUndo Pensioner dies after crash on Paphos-Polis roadUndoCruise passenger airlifted to Paphos hospitalUndoRemand for pair in alleged property fraud (Updated)Undoby Taboolaby Taboolalast_img read more

UCY deal on sustainable energy reached as part of Qatar visit

first_imgTEXAS A&M University in Qatar has signed an agreement with the Research Centre for Sustainable Energy (FOSS) at the University of Cyprus.The agreement forms part of the official visit President Nicos Anastasiades to the State of Qatar and the Qatar-Cyprus business forum.FOSS Research Centre for Sustainable Energy Director, Doctor George Georgiou, said, “this agreement provides a first class opportunity for the two institutions to explore synergies in fields of mutual interest such as solar energy, smart grids, distributed generation, natural gas etc.”The agreement seeks to expand research endeavours in the sustainable energy arena and was signed at the University’s Engineering building on Monday. It will encourage the enrolment of qualified students in new academic programs, explore opportunities to exchange faculty for joint teaching and research programs and explore avenues for strengthening relationship and furthering excellence in education in both Qatar and Cyprus.“This agreement to cooperate with the Research Centre for Sustainable Energy at the University of Cyprus represents an exciting opportunity for Texas A&M at Qatar to expand its international collaborations in research areas of immediate interest to the State of Qatar. We welcome this opportunity to work with our colleagues in Cyprus,” Kenneth Hall, assistant dean for Research and Graduate Studies at Texas A&M at Qatar said.Texas A&M at Qatar Assistant Dean for Research and Graduate Studies, Docter Eyad Masad, said, “This agreement emphasises the strong commitment of Texas A&M in Qatar toward promoting worldwide cooperation in exploring new research opportunities important to the development of Qatar and its economy.”You May LikeLivestlyChip And Joanna’s $18M Mansion Is Perfect, But It’s The Backyard Everyone Is Talking AboutLivestlyUndoPopularEverythingColorado Mom Adopted Two Children, Months Later She Learned Who They Really ArePopularEverythingUndoKelley Blue BookYou Won’t Believe How Affordable These Ford Car Models AreKelley Blue BookUndo Pensioner dies after crash on Paphos-Polis roadUndoCruise passenger airlifted to Paphos hospitalUndoRemand for pair in alleged property fraud (Updated)Undoby Taboolaby Taboolalast_img read more

Turkish Cypriots say gas find could be obstacle

first_imgThe Turkish Cypriot chief negotiator on Wednesday played down the prospect of a quick solution in the Cyprus peace talks with his Greek rivals, warning that the discovery of natural gas in the region was possibly more of an obstacle than of help.Kudret Ozersay was in Paris to discuss the negotiation process, with Pierre Levy, Director of the European Union Division at the French Ministry of Foreign Affairs. Greek Cypriot negotiator Andreas Mavroyianis was also due to meet Levy.“These meetings gave Mr. Levy the occasion to take stock of the negotiation process and its perspectives with its interlocutors. France’s support to the settlement of the Cyprus problem was reaffirmed,” said a statement from the ministry.Cyprus peace talks were re-launched in February but have not made much headway. US Vice President Joe Biden said in a landmark visit to Cyprus on May 22 that the leaders had agreed to speed up the slow-moving talks by meeting twice a month. They had only met one other time since the February 11 start to the talks, although they had fixed another meeting for June 2 days prior to Biden’s visit.But speaking to reporters in Paris, Ozersay said the next phase of talks was uncertain, the first time either side has warned of possible trouble ahead.“We are against the idea of talks just for talks. We don’t want to be the prisoners of that. We don’t know what will be the next stage, there isn’t a roadmap that we have agreed on,” Ozersay said.The recent discovery of natural gas under the sea between Cyprus and Israel has added a new dimension to the island’s strife and also heightened tensions between the two sides.The significance of the find has been amplified by the Ukraine crisis and its possible impact on Russian gas supplies to Europe.“The fact that one community – one of the co-owners – is treated as if they were eligible to do whatever they want about hydrocarbons without getting the consent of the other, it cannot help the Cyprus problem, on the contrary it could be a kind of obstacle,” Ozersay said.Power sharing, redrawing property boundaries and the claims of thousands of displaced persons are key issues in the conflict. Any agreement must be put to separate referendums.“Our counterpart is unwilling to accept fully the convergences that were agreed, (and) they want to change some of these convergences that were (agreed) before,” Ozersay said, declining to give specific details.“This is something disturbing for us and we’re not happy to see this.”He repeated previous claims that the Greek Cypriot side was trying to review convergences brokered in previous peace talks between 2008 and 2012 on issues such as competencies of a future Cyprus federal government and on the functioning of the economy.Ozersay said there had been broad progress on issues ranging from federal legislature to a federal judiciary and a federal police.“So far we achieved certain progress on certain issues. Is it sufficient? No.”He also said both sides had failed to agree on the fate of Varosha, the fenced-off ghost town in Famagusta. “We failed (on Varosha). I don’t want to go to more details why, but we failed,” he said.President Nicos Anastasiades wants the return of Varosha to be a confidence-building measure with discussions on that to run parallel with the negotiations for a comprehensive settlement. However the Turkish Cypriot side has made its opposition to this clear, saying Varosha would be part of an overall deal.During Biden’s visit, the US Vice President tried to help the two sides clinch a deal that would allow experts to enter Varosha and study its condition.In the build-up to his visit, reports were rife that Biden would announce a first “small” confidence-building measure on Varosha, where the US would fund a team of international experts to develop a master plan on the rejuvenation of the fenced area.When Biden met Anastasiades and Turkish Cypriot leader Dervis Eroglu last Thursday night, the dinner lasted three hours- an hour over schedule- prompting rumours agreement had been reached on opening Varosha to the experts.However, no breakthrough was announced, leaving Biden to say the US encourages the leaders to discuss a package on Varosha and Famagusta. According to Foreign Minister Ioannis Kasoulides the next day, it was not possible to agree due to certain demands of the Turkish Cypriots which were not only unacceptable but also made in bad faith, he said, adding that they wanted the inclusion of a special reference that the international experts could be foreign or Turkish Cypriot, but explicitly not Greek Cypriot.(Reporting by Reuters and Cyprus Mail staff) You May LikeLivestlyChip And Joanna’s $18M Mansion Is Perfect, But It’s The Backyard Everyone Is Talking AboutLivestlyUndoPopularEverythingColorado Mom Adopted Two Children, Months Later She Learned Who They Really ArePopularEverythingUndoKelley Blue BookYou Won’t Believe How Affordable These Ford Car Models AreKelley Blue BookUndo Pensioner dies after crash on Paphos-Polis roadUndoCruise passenger airlifted to Paphos hospitalUndoRemand for pair in alleged property fraud (Updated)Undoby Taboolaby Taboolalast_img read more

Fluctuating temperatures to continue showers forecast

first_imgThe weather is set to continue its up and down movement over the coming days, either being higher than average for this time of year, or lower than the average, which is around 30C inland and 25C along the coast during May.The met office says the dust in the atmosphere will continue until Monday while later Sunday they have not ruled out isolated showers. The evening will bring more clouds with temperatures falling to 15C inland, 17C on the coast and 10C in the mountains.On Monday temperatures will rise to 32C inland, 29C on the south and east coasts, 26C on the west coast and 24C in the mountains. By Tuesday, cloud cover is set to increase bringing the likelihood of more isolated rains, especially in the mountains. The same conditions will prevail on Wednesday and Thursday with the temperature falling just below the average for the time of year.You May LikePopularEverythingColorado Mom Adopted Two Children, Months Later She Learned Who They Really ArePopularEverythingUndoLivestlyChip And Joanna’s $18M Mansion Is Perfect, But It’s The Backyard Everyone Is Talking AboutLivestlyUndoEditorChoice.comIf You See Square Waves In The Ocean Get Out Of The Water ImmediatelyEditorChoice.comUndo Concern over falling tourism numbersUndoPensioner dies after crash on Paphos-Polis roadUndoCypriot tycoon launches ‘Bank of Cannabis’Undoby Taboolaby Taboolalast_img read more

Economy expands 39 in 2017 Cystat says

first_imgCyprus’s economic output increased last year 3.9 per cent compared to 2016, which is the highest since 2008, the statistical service said.In nominal terms, the economy expanded 5.5 per cent, to €19.2bn, which is almost €1bn higher compared to that of 2016, Cystat said in a statement on its website on Friday.Cystat also revised the 2016 growth rate from 3 per cent to 3.4 per cent.You May LikePopularEverythingColorado Mom Adopted Two Children, Months Later She Learned Who They Really ArePopularEverythingUndoLivestlyChip And Joanna’s $18M Mansion Is Perfect, But It’s The Backyard Everyone Is Talking AboutLivestlyUndoSmart Tips DailySeniors With No Life Insurance May Get A $250,000 Policy If They Do ThisSmart Tips DailyUndo Pensioner dies after crash on Paphos-Polis roadUndoCypriot tycoon launches ‘Bank of Cannabis’UndoThree arrested in connection with hotel theftsUndoby Taboolaby Taboolalast_img read more

Rep Hughes reading to students in Muskegon

first_img09Mar Rep. Hughes reading to students in Muskegon Tags: #SB Categories: Hughes News,Newscenter_img Lawmaker kicks off March is Reading monthState Rep. Holly Hughes of Montague, kicked off March is Reading month by visiting several schools in Muskegon County where she shared her favorite childhood books with elementary students. Rep. Hughes interacted with the kids on a variety of topics, answering questions and sparking interesting discussion about the stories. Rep. Hughes toured the school facilities and met with staff and parents.last_img

Rep Iden encourages anglers to drop a line for free on Feb

first_img01Feb Rep. Iden encourages anglers to drop a line for free on Feb. 13 and 14 State Rep. Brandt Iden encourages anglers to get out to the nearest lake to participate in Free Fishing Weekend, which will take place on Feb. 13 and 14.Free Fishing Weekend is an event hosted twice each year by Michigan’s Department of Natural Resources – once in February, and again in June. On Feb. 13 and 14, fishermen and women are not required to carry a license while fishing. As most Michigan lakes are frozen solid in February, the winter weekend event is traditionally used for ice fishing.“As an outdoorsman myself, I know firsthand how relaxing it can be to go fishing in one of Michigan’s many lakes,” said Rep. Iden, R-Oshtemo. “I hope many others in our community get the chance to take part in this event.”Because Michigan temperatures were generally mild until mid-January, Rep. Iden encourages anglers to take extra safety precautions when venturing out onto the ice.A full listing of current and upcoming Free Fishing Weekend activities can be found online at www.michigan.gov/freefishing.### Categories: Iden News,Newslast_img read more

Rep Sheppard joins Michigan House in approving record funding for K12 schools

first_img State Rep. Jason Sheppard of Temperance joined his Michigan House colleagues in approving a state budget plan that includes $100 more per student for the state’s K-12 public schools.“We are proposing record amounts of money for our local schools, and it is the right place to invest taxpayer money,” Sheppard said after this week’s vote. “Our schools are Michigan’s future.”Highlights of the House budget plan include:Allocating the highest funding in state history for K-12 schools with a proposed $14.3 billion, while improving access to jobs of the future with a focus on career and technical education.Making life better in communities across Michigan by adding money for road repairs, public safety, parks and other programs to improve our daily lives through a 5 percent increase in revenue sharing for local governments.Increasing funding for public safety by adding 100 more Michigan State Police troopers.Making health care more effective and efficient, with an enhanced focus on improving mental health care.Paying down school retiree debt and adding to state government’s main savings account for tough times, pushing that emergency fund above $1 billion.The bills now go to the Senate for consideration.####The school budget is House Bill 4313.The state budget is House Bill 4323. Categories: News,Sheppard News 03May Rep. Sheppard joins Michigan House in approving record funding for K-12 schoolslast_img read more

Is Medicare an ATM for the Unscrupulous

first_imgShare1TweetShare1Email2 SharesJune 18, 2015; Washington PostLast year, in a Los Angeles courtroom, seventy-one-year-old Rodolfo Fernandez testified that he had a power wheelchair in his garage. He neither wanted it nor needed it. One day, a “recruiter” showed up at his door, asked him a few questions, and took him to a physician who prescribed a wheelchair for him. Medicare pays close to $5,000 for such assistive devices; they cost around $840. The recruiter received a finder’s fee of $800 and the physician involved pocketed the rest. One L.A. doctor collected more than $23 million for over 100 power wheelchairs and other equipment that patients did not need—and sometimes didn’t even receive. In 2011, a Miami healthcare executive was sentenced to 50 years in prison for submitting more than $205 million in such phony claims. The Washington Post published a startling expose on the Medicare scams last year. Criminals like these have gotten away with millions just by slipping past Medicare’s plethora of blind spots.As the national debate over Medicare’s future escalates, its detractors have argued that the healthcare bureaucracy is fraught with abuse and fraud. Adding fuel to their fire is the Justice Department’s recent arrest of 243 people accused of bilking $712 million in Medicare payments. The department’s investigation targeted doctors and nurses as well as providers of psychotherapy, home care, drugs, physical therapy, and medical equipment, many of whom were in collusion with unscrupulous characters. The charges include conspiracy to commit healthcare fraud, violating the anti-kickback statute, money laundering, and aggravated identity theft.The arrest is the latest and largest crackdown in an eight-year campaign against healthcare fraud. In 2007, the Medicare Fraud Strike Force was created to root out cheaters of the system. Since that time, over 2,300 people have been charged with falsely billing Medicare for more than $7 billion.At a news conference announcing the bust, FBI Director James B. Comey said, “If you want to find criminals, you follow the money. In this case, we followed the money and found criminals who were attracted to doctor’s offices, to clinics, to hospitals to nursing homes in search of what they viewed as an ATM, an ATM that was a freebie to them but is actually filled with taxpayers’ money.”The aforementioned Washington Post article described the scope of the enormous problem. The agency processes approximately $4.9 million claims a day and is required to make payments in thirty days, relying on the honor system. Without adequate resources, only about three percent are reviewed.The nationwide scams have not been limited to wheelchairs. In Miami, the owners of a mental health treatment center have been accused of billing tens of millions worth of intensive therapy for patients, many of whom, because of severe dementia, could not even communicate. Actually, the patients were just being moved to different locations. In Michigan, a physician allegedly traded prescribed unnecessary narcotic painkillers for the use of patient IDs to generate additional false billings. His addicted patients were held hostage when the doctor threatened to cut off their medications.A big portion of the scammers has targeted the relatively new Medicare Part D, the prescription drug benefit program. Investigators are on the trail in a big way. HHS Inspector General Daniel Levinson noted in Modern Healthcare that costs in Medicare Part D reached $121 billion last year. “Our focus on Medicare Part D continues because more than 41 million Americans depend on that program, and its integrity must be protected,” Levinson said.In the same Modern Healthcare article, Patrick Burns, co-director of the Taxpayers Against Fraud Education Fund, said that prosecuting fraud in Part D can sometimes be more difficult than in other areas of Medicare because Part D payments are capitated, rather than fee-for-service.While the arrests are significant, Burns is not as impressed as others over the crackdown, which targets small time “fraudsters” while ignoring big business. “Nobody goes to jail. Nobody loses their job. […] They hammer the little guys, which they should, but they give the thumbs up and the big wink to the biggest liars, cheats and thieves.”The biggest losers? Those who pay into Medicare, whether they like it or not.—G. Meredith BetzShare1TweetShare1Email2 Shareslast_img read more

Struggling Maine Health Insurance Cooperative Not Allowed to Close

first_imgShare2TweetShareEmail2 SharesMarch 23, 2016; Portland Press HeraldCommunity Health Options, one of the 23 nonprofit health insurance co-ops established under the Affordable Care Act, has had its troubles. After $7 million in profits in 2014 (its first year of operation), it lost $31 million in 2015 and has budgeted to lose at least $43 million in 2016. To address the losses, it initiated $11 million in administrative cuts, including rolling back part of the executive pay increases authorized after 2014’s profitable year.Maine’s Division of Insurance had reached an agreement with Community Health Options to place the nonprofit cooperative into receivership and help it restructure. However, the U.S. Centers for Medicare and Medicaid Services (CMS) rejected the plan because it included terminating as many as 17,000 policies—15 to 20 percent of policies currently in force—violating the ACA’s “guaranteed issue” provisions that protect people with insurance from having their coverage terminated.Community Health Options’ problems stem, in part, from a key aspect of its success—selling more policies to people who need them. Unfortunately for the insurance cooperative, many of the newly insured needed more covered health services than expected, so premiums paid did not cover the costs of services. NPQ discussed similar issues of pricing insurance and “adverse selection” in the failure of Utah’s insurance cooperative.Eric Cioppa, Maine’s insurance superintendent, is frustrated by the federal action but is continuing to work with CMS and Community Health Options to find a way to address losses while maintaining coverage.Although not specifically mentioned in Maine’s case, one potential source of relief may be the class action lawsuit filed by Oregon’s cooperative, Health Republic Insurance Company.Whether through litigation or other remedies, Cioppa has a valid point when he wrote in a letter to federal officials: “Because CMS’s decision has precluded my ability to act as proposed, CMS now must share responsibility for the risk of an outcome we all very much hope to avoid.”In the worst-case scenario where Community Health Options’ “enhanced oversight” status and attempts to restructure fail, can CMS force an insolvent insurer to continue operating? If so, whose money would pay claims? If CMS attempts to force Maine’s state government to make good on policies and payments, expect more lawsuits and strife.—Michael WylandShare2TweetShareEmail2 Shareslast_img read more

A Nonprofit Option for this CountyOwned Nursing Home

first_imgShare3TweetShare13Email16 SharesApril 10, 2017; WCIA-TVChampaign County, Illinois, has been struggling to determine the future of the county-owned Champaign County Nursing Home. As NPQ reported in February, local officials and community members were weighing options including a property tax increase to support the nursing home and sale to a for-profit entity. A consultant’s report recommended that the county enter into partnership with a consortium of existing nonprofit healthcare organizations.The county’s voters rejected the property tax increase and voted to have the county sell or dispose of the nursing home in an April 4th election. In the wake of the vote, there are still many hurdles to overcome.There are continuing concerns in the community about the quality and local orientation of the nursing home and its care, especially should it be sold to a large regional provider. Opponents of the county vote rallied under a slogan of “Our Seniors: Not for Sale.”The county board must still vote to sell or transfer the property, which requires a two-thirds vote to pass. One board member cites the difficulty in finding a buyer, especially without the rejected property tax proceeds as a contribution to a public-private partnership. Board member Josh Hartke said, “It’s extraordinarily hard for me to believe that were going to find a [nonprofit] to pay us 12 million dollars for that building and do something that does what that building does.”Even with the public vote supporting a sale, it’s not clear that the county has the legal authority to sell the nursing home, much less find a willing buyer who would be able to sustain the nursing home’s operations as well as the county has done. Why the legality of the sale has not been determined is not addressed in news reports, though it would seem to be an obvious question for a county government and its administration to ask. The county board plans to put together a group – they weren’t even sure what to call the group—with a mission to “research the nonprofit option” and check with the state’s attorney to determine the legalities associated with a potential sale.Long-term care facilities and the organizations that own and operate them are working in an increasingly challenging environment, facing difficulties including increasing demand, shrinking financial margins from reimbursements for Medicaid-paid residents, a shortage of workers in direct care positions, and state regulation that places limits on the location and number of nursing home beds. It’s not surprising that Champaign County is seeking to divest itself of its nursing home. The county is also learning how difficult it can be to accomplish that divestiture even after a public vote and the apparent commitment of county leaders to accomplish the task. In the meantime, the nursing home stays open and its residents, and the county’s residents, wait for the next chapter to be outlined.—Michael WylandShare3TweetShare13Email16 Shareslast_img read more

Next Up AllPayer Healthcare Featuring Maryland and Ben Jealous

first_imgShare53TweetShare9Email62 SharesBy Jzhang17 (Own work) [CC BY-SA 4.0], via Wikimedia CommonsJuly 24, 2017; The InterceptAs Trump has recently realized, captured simply when he spoke with the New York Times, “Once you get something, it’s awfully tough to take it away.” He’s referring, of course, to the sense that, in the U.S., many of us are getting attached to the idea of having access to adequate healthcare. The Intercept recently reported that a new Associated Press poll found that 62 percent of people in the U.S. “now agree the federal government has a responsibility to provide health coverage to all Americans, up from 52 percent in March.”Though it may not come from political leadership at the federal level any time soon, the states, as we’ve seen with other important issues, are taking the lead in giving the people what they want. One state in particular, Maryland, is primed to make some headway in universal health coverage. As Dan Morhaim, a House of Delegates member and physician, said, “I think the political system would be willing to take that on if the person who argued for it won the election.”Luckily, there is a “prominent gubernatorial candidate” in Maryland’s upcoming election who may fit the bill: former NAACP president Ben Jealous, who has “ardently endorsed single-payer.” In a recent event where Jealous received an endorsement from Sen. Bernie Sanders, the candidate said, “We have the opportunity in this state to make sure that we don’t have any more neighbors burying loved ones because they didn’t have access to health care.”If elected, Jealous would have a lot on his side in establishing a single-payer health system.Maryland’s legislature has a robust Democratic supermajority.It has no two-thirds requirement to raise taxes.It has no budgeting rules mandating state spending.While states need federal waivers to incorporate programs like Medicare into a state-run program, Maryland is the only state to already have one.The federal waiver enables a unique system known as all-payer rate setting.Maryland is the only state where all hospitals must charge the same rate for services to patients, regardless of insurance.Maryland has been setting hospital reimbursement rates for 40 years through its Health Services Cost Review Commission.So far, its system has created the lowest rate of growth in hospital costs in the U.S.In 2014, Maryland added global budgeting, where every hospital gets a total revenue number for the year, which incentivizes hospitals on better outcomes, or keeping people healthy rather than treating illnesses.According to a January Health Affairs study, the state is “meeting or exceeding” its goals.All-payer rate setting, wherein “all third parties pay the same for hospital services,” has served as the basis of universal health care in several industrialized nations, including France, Germany, Japan, Switzerland, and The Netherlands. They have found that it controls costs “far better than America’s fragmented system.” All-payer reduces overhead for hospitals and insurers, and the Affordable Care Act caps the profits insurers can make; both lower hospital costs, which results in lower premiums.Joshua Sharfstein, a Maryland physician and Associate Dean for Public Health Practice and Training at the Johns Hopkins Bloomberg School of Public Health, said, “I think you can combine alternative payment approaches with single payer, but you don’t hear about that much…In some ways, it’s more radical [than single payer] if you’re able to get the incentives right.”Shelly Hettleman, a member of the House of Delegates from Baltimore, said, “I am not hearing a groundswell of support for a single-payer system or radically redoing what we currently do. My constituents want to fix the system rather than totally reinvent it.”However, that’s exactly what Maryland could potentially do: “reinvent health care outcomes by merely tweaking the system.”This may be that rare strategy that crosses party lines. Kansas Republican Jerry Moran, whose opposition to the federal health bill effectively killed it, said, “We must now start fresh with an open legislative process to develop innovative solutions that provide greater personal choice, protections for pre-existing conditions, increased access and lower overall costs for Kansans.”The Intercept reports that “even Vincent DeMarco, who flat-out rejected the notion of state-level single payer, agreed. ‘If we can do that, we can achieve the same goals in a way that’s doable,’ DeMarco said.”Further, a recent Baltimore Sun op-ed by Morhaim on decoupling health insurance from employment “got a wider response than he’s ever seen. ‘My email box flooded,’ Morhaim said.”Other states are already looking at Maryland as a model: “Pennsylvania has adopted global budgeting for rural hospitals” and “Vermont moved to an all-payer accountable care organization, where providers are paid based on health outcomes for the population.” But, as The Intercept concluded, “the true test of Maryland-style all payer is whether it can support universal coverage for every resident.” However, Maryland already has a low number of uninsured—6.7 percent in 2015.Jealous would be expected “to put single payer at the top of his agenda,” and he’s an experienced and successful politician, having “helped legalize same-sex marriage, abolish the death penalty, and pass a state version of the DREAM Act.” In fact, Democratic primary opponents are already moving in his direction. Alec Ross, a Hillary Clinton adviser, supports a public, state-based option, and State Senator Rich Madaleno said he would treat healthcare as a human right.”—Cyndi SuarezShare53TweetShare9Email62 Shareslast_img read more

Federal Efforts to Address Opioid Epidemic Remain Haphazard

first_imgShare11Tweet7ShareEmail18 SharesPhoto: Elvert BarnesMarch 13, 2018; WFYI IndianapolisFor nearly six months since declaring the opioid crisis a public health emergency, President Trump and his administration have done little but fan the flames of public outrage over the ever mounting death toll. Notably, after declaring a public health emergency, Trump did not even request any federal funding to address the issue. Making matters worse, an Obama-era law that designated a billion dollars in state opioid crisis assistance runs out this year, and there has been no sign that Trump will ask Congress to renew this funding. As time goes on and more Americans fall victim to the opioid epidemic, advocates are left wondering what the Trump administration is doing to address this health crisis.While pouring resources into solving the crisis would make sense, the president’s 2018 budget proposed to cut funding from key agencies, such as the Substance Abuse and Mental Health Services Administration (SAMHSA), which works to address opioid addiction, specifically in programs related to substance abuse prevention and mental health treatment. Keith Humphreys, a Stanford University professor of psychiatry and Obama-era policy advisor to the Office of National Drug Control Policy (ONDCP), says, “The administration’s impulse seems to be not to spend more—in fact, to spend less.”Humphreys goes on to say, “It’s very hard to make sense of. I mean, it’s like closing a fire station in the middle of a wildfire.”The Trump administration has made some tiny attempts to salvage the situation. The Centers for Medicare and Medicaid Services (CMS) announced a policy change shortly after the emergency was declared to broaden Medicaid eligibility for coverage of residential drug treatment through a state Medicaid waiver. With this waiver, states can request CMS to pay for residential drug treatment at facilities with over 16 beds. In states without a waiver, residential treatment is only Medicaid-eligible at facilities with less than 16 beds. As Medicaid waivers must be budget-neutral, this is a way to increase the number of beds available to low-income residents in need of substance abuse treatment without increasing expenditure on the part of the federal government. President Trump also signed the Interdict Act, which gave border agents more tools for detecting synthetic opioids like fentanyl, which make up a growing proportion of opioid use.While treatment for those addicted to opioids is sorely needed, President Trump seems more focused on penalties for who he calls the “pushers and drug dealers,” even suggesting the death penalty for drug dealers during the recently held White House Opioid Summit. The Trump administration is pushing a public awareness and education campaign to prevent people from using opioids in the first place. Some sources say this campaign will not be led by the experts at the ONDCP, but rather Trump’s advisor, Kellyanne Conway.President Trump also suggested an interest in the federal government pursuing lawsuits against pharmaceutical companies that manufacture opioids, saying, “A lot of states are doing it, but I keep saying, if the states are doing it, why isn’t the federal government doing it? So that will happen.” As NPQ has covered, states, localities, and American Indian nations have already filed over 200 lawsuits against pharmaceutical companies for damages caused by the opioid epidemic. Causes of action include creating a public nuisance, deceptive marketing, lax monitoring of highly suspicious opioid orders by pharmacies, and unjust enrichment through unfair business practices. Federal participation in these efforts would likely be welcomed by participating plaintiffs.Other steps by the Trump administration, though, are headed in the wrong direction, particularly those that focus on criminalization and fear. Years of data show that tougher penalties for drug dealers and “Just Say No” campaigns do not work. In fact, the D.A.R.E. campaign famously resulted in an increase of drug use. NPQ has covered the downfall of this program as well as Attorney General Jeff Sessions’ attempts to resurrect this failed program.Mark Kleiman, professor of public policy at NYU Marron Institute of Urban Management, argues a penalty-based system is not the solution.We have done the experiment with extreme mass incarceration to shrink the drug market and it failed. Between 1980 and today, the number of drug dealers behind bars has gone up by a factor of 30 and the prices of heroin and cocaine have fallen more than 90 percent. So, the problem with putting drug dealers in prison is there is another drug dealer in there to take his place.The only penalty that might work is litigation against manufacturers of opioids. NPQ has covered in detail the growing number of lawsuits against Purdue Pharma—and potentially the Sackler family itself—among other opioid manufacturers. While civil suits absolutely paved the way for litigation, they were ultimately not very successful. However, as NPQ’s Steve Dubb indicated, if a “class” can be defined to bring a class action lawsuit against opioid manufacturers, like the litigation against tobacco companies in the 1990s, then government suits have a good chance of enforcing penalties and gaining funds that could be used to pay for treatment.Although President Trump’s statements appear to miss the mark when it comes to solving the crisis, the plans laid out by HHS Secretary Alex Azar and HUD Secretary Ben Carson at the White House Opioid Summit focused heavily on increasing access to treatment and providing community support, as well as research into non-addictive painkillers. This seems to be supported by funding, which is great news for advocates and those working on the frontlines of opioid treatment. As NPQ has previously reported, resources are critically needed not only for treatment but also for exhausted frontline staff and volunteers to continue their important work with opioid victims.In an NPR interview, Surgeon General Jerome Adams gives communities a glimmer of hope, indicating that funding will not only be restored but increased to federal agencies such as SAMHSA in fiscal year 2019: “The Trump administration is supporting increasing funding for drug courts. The Trump administration has also tripled the amount of funding going to SAMHSA for treatment from just under $500 million to $1.5 billion. The president has requested and Congress is moving through the largest allocation for opioid treatment and response in the history of the United States—$6 billion.”Surgeon General Adams goes on to say, “Communities need to be talking about how best to spend that money and making sure on a state and local level they are asking for and getting that money from SAMHSA and through Medicaid waivers and through all the different mechanisms that we have to funnel that money down to communities.”—Sheela NimishakaviShare11Tweet7ShareEmail18 Shareslast_img read more

Headed in the Wrong Direction The UKs Approach to Poverty through the

first_imgShare6TweetShareEmail6 SharesPAUL FARMER / Poverty can be Eradicated BillboardNovember 16, 2018; New York TimesWhile the Trump administration and Theresa May argue over trade policies, they do agree on an approach to fighting poverty.Over the decades, Great Britain has approached the needs of those at the bottom of the economic ladder with a consistent vision that mirrors that of President Trump and other US conservative policymakers. In the UK, government funding has been reduced in order to spur self-support, encourage work, and decrease reliance on outside assistance. As public and nonprofit leaders in the US keep up their often-heated debate about what our policy should be, the case study of the UK’s experience should prove instructive.After years of reduced public funding, and with increased reliance on the nonprofit sector to patch a frayed safety net, what are the results? According to Philip Alston, the United Nation’s Special Rapporteur on extreme poverty and human rights, for Britain’s poor, things are bad and heading in the wrong direction. Following a 12-day visit, Alston concluded that poverty has gotten worse and current policy is failing.In the United Kingdom, 14 million people, a fifth of the population, live in poverty. Four million of these are more than 50 percent below the poverty line, and 1.5 million are destitute, unable to afford essentials. After years of progress, poverty is rising again…in the fifth-richest country in the world, this is not just a disgrace, but a social calamity.[…]Government policies have inflicted great misery unnecessarily, especially on the working poor, on single mothers struggling against mighty odds, on people with disabilities who are already marginalized, and on millions of children who are locked into a cycle of poverty from which many will have great difficulty escaping.The New York Times summarized some changes in the UK in just the past 8 years:“Since 2010, the Conservative government has announced…nearly $40 billion…in cuts to welfare payments, housing subsidies and social services.”“Although overall poverty levels have remained fairly constant under the Conservative government, most measures show that poverty has risen among children and working families.”“The use of food banks almost doubled between 2013 and 2017. Families that receive benefits are now over $2,600 worse off every year, according to an analysis by the Child Poverty Action Group, an advocacy group.”With funding reduced for local governments, those services for which they had been responsible have had to be sharply reduced, with people in poverty feeling the harshest impact. The burden for softening that impact has fallen on Britain’s nonprofit sector which, as NPQ has previously reported, has struggled to fill the resource gap. “The number of nonprofit organizations working alongside government has decreased sharply as their funding declines…a thousand children’s centers have closed, leaving families trying to navigate a complex system without a map.”According to Alston, “I was told time and again about important public services being pared down, the loss of institutions that would have previously protected vulnerable people, social care services that are at a breaking point, and local government and devolved administrations stretched far too thin.…The voluntary sector has done an admirable job of picking up the slack for those government functions, but that work does not relieve the government of its obligations.”One focus of Britain’s efforts that is being replicated by conservatives in the US is an increased use of technology to streamline systems and cut overhead costs. Eligibility for government supports depends on the ability to continuously document eligibility requirements using online systems. Alston found this approach creates “an online barrier between people with poor digital literacy and their legal entitlements…the ‘test and learn’ approach to the rollout treats claimants like guinea pigs and can wreak havoc in real peoples’ lives.” This mirrors what the Washington Post found when it looked at Medicaid reforms in Arkansas, which similarly demanded ongoing electronic certification and put people’s health at risk.The British government, naturally, disagrees with Alston’s findings. According to an emailed response to the Times, the UK Department of Work and Pensions says, “With this government’s changes, household incomes have never been higher, income inequality has fallen, the number of children living in workless households is at a record low and there are now one million fewer people living in absolute poverty compared with 2010.”Poverty in Britain remains very real. Those within the nonprofit sector see the impact of austerity-based public policies up close and personal on those who fall between the cracks. They struggle for funding as the need for help rises. Great Britain’s experience can help American policymakers—the ones who can break out of their political silos—prevent human pain and suffering. The question is whether there are enough who are ready.—Martin LevineShare6TweetShareEmail6 Shareslast_img read more

Irish public broadcaster RTÉ could look to develop

first_imgIrish public broadcaster RTÉ could look to develop pay services and international services as it seeks to develop catch-up and video-on-demand, according to Muirne Laffan, managing director, RTÉ Digital.Speaking at the IP&TV World Forum yesterday, Laffan said there “may be an opportunity for a pay model” on some platforms as well as opportunities to develop international services. “It is difficult [to develop services] in a market of our size, which is about one and half million homes,” she said.Laffan said that the lack of standardisation and the need to develop new versions so its existing RTÉ Player online service for different platforms was a major challenge in a small market like Ireland. RTÉ is currently developing versions of its player for Samsung, LG and Philips. But even if manufacturers covered some of the cost there  was still a significant internal development cost for broadcasters, she said. Laffan said that it made no sense to develop a platform for 50,000 viewers.Laffan said  RTÉ has launched a plus one channel and a news channel originally developed for mobile, as well as its two linear and four radio services, on the country’s digital-terrestrial platform, Saorview. “It’s our objective to make sure we deliver our services wherever the audience wants them,” she said. “We need to bring VOD to DTT.”She said that RTÉ Player, which is currently available to enable online viewing, should be launched on DTT, but RTÉ needed other broadcaster to launch their services on the platform to make it viable. Only about 20% of viewers use the terrestrial platform to receive services, while the remainder receive services via satellite or cable.Laffan said that for DTT to be a success, it had to embrace “more innovative services such as VOD”.Laffan said that the player would be launched on UPC’s cable service in May. A version of the player is available on PlayStation games consoles.last_img read more

Ziggo has launched a new ondemand platform to sho

first_imgZiggo has launched a new on-demand platform to showcase professional content that hasn’t got a distribution deal in place.The EU1 on-demand service will offer content that has been made by professional film and TV programme makers to the Dutch cable operator’s customers.EU1 started as an online initiative that sees all rights to content being retained by the maker.  Everyone that works on a EU1 project shares the profits of any money earned from it. From the profits made, 90% goes to the makers while EU1 receives a reimbursement of 10%.“Ziggo is always searching for content that offers emotion and inspiration to the customer. What’s more, customers really want to share that experience and those emotions. EU1 gives customers the opportunity to do this and that is why Ziggo supports this initiative. EU1 is available, without extra costs, for every Ziggo customer with an interactive receiver,” Ziggo said.last_img read more

Pay TV subscribers in Spain and Italy declined las

first_imgPay TV subscribers in Spain and Italy declined last year, but overall numbers for Western Europe were up, spurred by strong growth in Germany, according to new research.The Digital TV Research numbers contrast with those from Informa Telecoms & Media, which recently reported that cumulative pay TV subs fell in Western Europe for the first time ever in 2012.Informa reported that there were 92.6 million subs in the region while Digital TV puts the number at 94.1 million.The latter said that the growth it reports comes as Germany added 689,000 pay subs in 2012 and France 347,000. It estimates an overall 1 million subscriber increase in Western Europe last year and adds there will be a similar increase in 2013.Italy was down 428,000 over the year and Spain by 350,000 and report author Simon Murray said both will suffer further subscriber reverses this year and next before returning to growth in 2015.Region-wide, there will be 6.9% growth in pay TV subs between 2012 and 2018, taking the total north of 100 million for the first time ever. That will take pay TV penetration to 57% in Western Europe although there will be wide disparities by territory with, for example, almost full penetration in the Netherlands and just 24% in Spain.By platform digital cable will grow by 14.7 million subs and IPTV by 6.5 million across that timeframe. Pay DTH subs will increase by 2.5 million and pay DTT subscriptions will fall by 187,000 to 7.4 million.Simon Murray, report author, said that despite the growth overall pay TV revenues will remain flat: “The main reason for this is that ARPU is falling in most countries and on most platforms. The pay TV arena is becoming more competitive as new platforms launch and as cable operators upgrade their networks to offer bundles and advanced services such as HD channels and DVRs.”last_img read more

Video solutions and content delivery firm Elementa

first_imgVideo solutions and content delivery firm Elemental Technologies is set to stage what it claims will be the world’s first public demonstration of live 4K HEVC encoding in Japan this weekend. Japanese telco K-Opticom Corporation will use Elemental video processing platform to power real-time video streaming of the Osaka Marathon Sunday in live 4K Ultra HD high-efficiency video coding (H.265/HEVC).The footage will be recorded on Sony PMW-F55 CineAlta 4K cameras located at the midpoint and finish line of the racecourse. Each camera will be mounted with an AJA Ki-Pro Quad, which will send source content to Elemental systems via live 3G-SDI interfaces.Elemental Live will encode the footage and stream it over K-Opticom (K-OPT) optical fibre networks to an NTT Docomo decoder. Final rendering will take place on an 84-inch Sony 4K Bravia TV, with the public able to view the 4K coverage in a special K-OPT exhibit at the International Exhibition Centre Building in Osaka, said Elemental.“With resolution four times that of HD, demand for 4K content on high-quality, large-format screens is increasing. The advanced K-OPT optical fibre network combined with the power and flexibility of Elemental’s software-based architecture is vital to meeting this demand and to enabling this unprecedented experimental transmission,” said Takao Fujino, President of K-Opticom – a subsidiary of the Kansai Electric Power Company that provides fibre optic services for the Kansai Region of Japan.Keith Wymbs, VP of marketing for Elemental added: “The stunning images and high quality of 4K are best showcased at a world-class sporting event like the Osaka marathon. Elemental’s award-winning H.265 codec makes it possible to smoothly transmit 4K images across wideband networks provided by operators like K-Opticom.”last_img read more

Sky Italia is launching a number of new features t

first_imgSky Italia is launching a number of new features to enhance its service in the run-up to the holiday season.The 21st Century Fox-owned pay TV operator is launching a restart service, allowing viewers with a My Sky HD box connected to the internet to restart a programme that has already started. The service will initially be available for content in the Sky Cinema package.Sky is also launching Sky Link, a small device to connect My Sky HD set-tops wirelessly to the internet.Other new features on the platform include Mosaic for Kids, a dedicated interactive user interface that will enable viewers to see what is on air on all 27 kids services on Sky Italia, and a range of new features for the Sky Go mobile TV service.Sky Go users will now be able to limit the use of bandwidth and data traffic over 3G by choosing between three options – standard, reduced – providing lower video quality – and only audio, which provides the soundtrack to shows only. Sky will also provide a dual-audio function that enables users to choose to view linear and on-demand content either in Italian or in the programme’s original language.last_img read more