PAGE A4, KEIZERTIMES, MARCH 17, 2017
KeizerOpinion
KEIZERTIMES.COM
Who deserves
health care?
By DON VOWELL
Is there someone you think
should not be able to see a doctor?
The new proposal hopes to improve
access with the exception of 45
million or so (American
exceptionalism?), who
can’t or won’t afford
it. It is a question we
must answer according
to our humanity rather
than political affi liation,
ideology, or income
level. We need to ask
instead how we’ve
decided that some Americans don’t
deserve health care.
Almost all other industrialized
nations pay much less to provide
universal health care. They have
made a conscious decision that a
healthy citizenry makes a healthy
nation. Should I care about your
health? Should you care about
mine? In most other countries
the answer is a compassionate and
fi scally pragmatic, “yes.”
Now there is a push to repeal
the Affordable Care Act
and
put in place a system that would
reduce the number of insured by
24 million and increase premiums
by 15-20 percent in 2018-2019.
The selling point is a reduction of
$337 billion in costs over 10 years,
that reduction delivered by less
“customers” served, paying higher
premiums.
House Speaker Paul Ryan on
the CBO analysis: “This report
confi rms that the American Health
Care Act will provide massive tax
relief, dramatically reduce the defi cit
and make the most fundamental
entitlement reform in more than a
generation.”
He neglected to mention for
whom tax relief is massive, or that
the defi cit is reduced in proportion
to the numbers of Americans
denied health care.
Many of the 24 million no longer
insured will be those simply willing
to gamble on their continued good
health, or no longer able to afford
the increased premiums. They are
free to make that decision because
there is no longer a penalty for
going without coverage. With fewer
young, healthy enrollees, insurance
companies may be less willing to
offer coverage plans if the sick and
the elderly are not seen
as a profi table customer
base.
The
idea
that
competition will lower
costs and provide better
plans seems patently
silly. Instead it has given
us the $650 Epipen
and Martin Shkreli,
who raised the price of Daraprim
from $13.50 to $750.00 overnight.
Leaving health care to the tender
mercies of insurance companies
and the pharmaceutical industry
has given us the highest per capita
costs in the world.
This is our decision to make:
Should American health care policy
be designed for the benefi t of the
sick and injured or the benefi t of
for-profi t providers?
I care about the health of my
family. I even care a little about
the health of those on Pettygrove
Court. Should I also care about the
health of those on Dearborn Ave.?
Wheatland Rd.? Maybe I should
care about the health of everyone
in Oregon. It may be a failure of
mine if a kid in inner-city Chicago
ends up in the emergency room for
lack of routine wellness care. To
paraphrase just a tiny bit, “Truly I
tell you whatever care you provided
for the least of these brothers and
sisters of mine, you did for me.”
Medical care has been around
since biblical times. Is it now a
business opportunity?
Though
we allow it a major stake in our
decisions, health insurance as a
for-profi t industry hardly even
existed before World War II. One
of its principal effects has been to
drive low income Americans to
the very costly services of hospital
emergency rooms. Is there no more
humane way to provide health care
for all?
a box
of
soap
Resistance from both sides
By DEBRA J. SAUNDERS
This should be the moment Presi-
dent Donald Trump cleans up Obam-
acare with a broad smile on his happy
face.
He won the Electoral College—and
as his predecessor Barack Obama liked
to say, “Elections have consequences.”
Trump’s Republican Party
controls the House and
the Senate, which should
mean there are no sand
traps or water hazards on
his golf course.
Problem is, Trump fi nds
himself in the land where
it’s often easier to vote no
than to vote yes. Members of his own
political party and conservative think
tanks became standouts because of
their principled opposition to Obam-
acare. Now their party wants them to
support a plan championed by House
Speaker Paul Ryan that doesn’t live up
to their pre-2017 rhetoric.
The House plan keeps two popu-
lar provisions of the Affordable Care
Act—adult children can stay on their
parents’ health plans up to age 26 and
insurers can not deny coverage based
on pre-existing conditions.
Ryan reconfi gures other provisions.
His House plan ends the individual
mandate that required most adults to
get coverage or pay a fi ne; instead it
requires insurers to add a 30 percent
surcharge for individuals who allowed
their coverage to lapse. Some conserva-
tives complain that the surcharge is a
mandate by another name.
The House plan ends premium sub-
sidies, but replaces them with tax cred-
its for middle-income earners who buy
their own coverage. That’s a different
form of entitlement spending, critics
say.
Probably the hardest change politi-
cally is a switch to a formula that tells
insurers they can’t charge older con-
sumers more than three times what
they charge young adults. The House
plan would allow health care provid-
ers to charge seniors up to fi ve times
what they charge 20-somethings—a
change offset by higher tax credits for
Americans aged 60 to 65. The new for-
mula should make cover-
age more attractive to the
youth market the system
desperately needs.
The Affordable Care
Act reimbursed 31 states
that increased their Med-
icaid enrollment for fami-
lies earning up to 138 per-
cent of the poverty level. The House
plan would continue the full federal
subsidy until 2020, when the system
would switch to block grants for states.
Conservative critics want to end the
full federal subsidies in 2018. Trump
has signaled he is open to accommo-
dating them.
The House plan would end Obam-
acare taxes on medical devices and so-
called Cadillac health plans. The GOP
plan also would end the employer
mandate that the right sees as a job-
killer.
Rachel Bovard of the Heritage
Foundation summed up the opposition
when she said, “If you ask the average
American person what Obamacare re-
ally means, it means that the insurance
plans that they used to have that they
liked were canceled and replaced with
plans that cost you know 20, 30, 50,
100 percent more than they used to.”
She doesn’t see the Ryan plan deliv-
ering pre-Obamacare health care. The
tax credits, she added, “will just give
people money.”
It especially angers the right that the
Ryan plan rewards the 31 states that
expanded their Medicaid rolls, rather
than reward states that did not.
Bovard sees an easy remedy—let
Congress pass the same repeal measure
that both the Senate and House passed
in 2015.
Bad idea, countered House Major-
ity Leader Kevin McCarthy at a recent
press conference: “If you just repealed
the bill, you would double your pre-
miums and you would collapse the
market.”
McCarthy did not add that when
Congress passed the repeal bill, Re-
publicans knew that Obama would
veto it. They had nothing to lose.
McCarthy stood with Committee
chairmen Greg Walden of Energy and
Commerce, Kevin Brady of Ways and
Means and Diane Black who chairs
the Budget Committee. These are the
Republicans who have to do the heavy
lifting—and they know that means
not losing moderate Republicans who
want low-income families to feel se-
cure about their health care.
“Sometimes when you have push-
back on one side and the other side
from a political spectrum, you might
have found the sweet spot,” McCarthy
argued.
At a Politico event Thursday, Senate
Majority Leader Mitch McConnell
suggested Republicans have to get out
of their default position of “sparring”
and get into “governing mode.”
Sparring has become the domain of
Democrats. During the Obama years,
they were outraged at Republican
obstructionism. Now they call their
obstructionism “resistance”—without
even a hint of irony.
Health giant Humana has an-
nounced it will exit the exchanges in
2018. Last month Aetna CEO Mark
Bertolini told the Wall Street Journal
that Obamacare has entered a “death
spiral.” Trump’s election win has al-
lowed the left to dodge the bullet it
created.
(Creators Syndicate)
City looking at McNary parking
allows those costs to be paid back
over 20 years or upon sale of the
property. Information on sidewalk
LID is available from the Community
Development Department.
Before school, there is noise and
traffi c clogging Newberg. According
to the Chief, police have been
monitoring the area regularly. He
explained that traffi c congestion is
not generally a ticketable offense.
The city paid for the traffi c signal at
Chemawa, which helped ease problems
there. Our police department does not
have the staffi ng capacity to monitor
the three high school entrances plus
the two middle schools and about
nine elementary schools; Gubser
Elementary has a similar problem to
the congestion on Newberg. We have
been strongly urging the school district
to come up with a short term plan for
more parking while preparing for site
upgrades in the future.
An d there are some issues or
concepts that have been proposed
which may work but are not as simple
as they seem.
Opening another gate at the end of
Orchard Street would ease congestion
with an additional access point. But
students would be walking straight
right into traffi c on Celtic Way. The
future site plan could add sidewalks
and realign the roadway, but it is not
safe to do currently.
A “No McNary Parking” zone has
been repeatedly proposed as a simple
solution to the problem. It is true that
the signs are cheap and easy to put up.
However, as our city staff has explained
several times, the signs alone do not
provide enforceable violations that
will stand up in court, and the signs
inconsistently deny people the use of
a public right way. The street belongs
to the people of Keizer. Parking in
front of a person’s home is not reserved
space. We can ask students to not park
there. We can ask people attending
sporting events to not park there. But it
is a public right of way and we cannot
legally deny people the right to use
it. Other jurisdictions that have tried
voluntary compliance have all had to
go to an enforceable program. Another
option our staff proposed is limited
time parking, such as a three hour limit
during the day. But, again, this would
have to apply to ALL vehicles, as the
residential and non-residential vehicles
would not be distinguishable without
a permit.
When there is a need established to
restrict public parking on public streets,
cities across the country have developed
residential parking zones. The program
like the one in Salem for areas around
North Salem and South Salem High
Schools has provided clear vehicle
identifi cation, parking preference
on public streets for residents, and is
legally enforceable. See this link (www.
cityofsalem.net/residents/parkingservices/
documents/residentialpermit.pdf)
to
show how those zones are established
and the program for residents to
purchase parking permits. In order to
reserve public right of way as parking
for residents, there is a cost to establish
and enforce the program. We do not
have such a program in place, but I
am forwarding this information to
the Planning Commission and Traffi c
Bike Pedestrian Commission to
consider the matter. If such a program
is established, guidelines and costs
would be established for designating
residential parking zones.
The city staff and Council know that
school overcrowding has led to safety
and livability problems for students,
residents and families. I am committed
to working with you all to achieve
effective and equitable solutions.
(Don Vowell gets on his soapbox
regularly in the Keizertimes.)
Keizertimes
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The city has received numerous complicated and require coordination
complaints about the high school traffi c with the school or neighbors. And
and parking on and around McNary some problems are directly connected
High School. The safety and livability to the overcrowding, so the city
for people living in our neighborhoods is actively participating in the site
and the safety and access for our Keizer planning process with the district.
Issues that the city can
students to get to school
directly solve include:
are very important to us.
Cars were parked
In order to let people
in muddy gravel areas
know what is going on, I
around a house near the
felt it would help to write
school. It turned out not
an open letter and share
to belong to a resident but
the issues and options we
was public right of way so
are facing.
the city did appropriate
Students are having
maintenance to take care
more diffi culty getting
of the mud.
safely to McNary High
Parking by the fi re
School. All the entrances
hydrant: The curb has
are crowded as the more
been painted to clearly
than 2200 students plus
mark the no-parking
staff members converge
zone around the fi re
on the school. Parents
hydrant which makes it
have contacted the Traffi c
an enforceable violation
Safety Commission and
Cathy Clark
to park there.
me about making it safer
Littering: School staff,
for students to walk, bike
or drive. And residents living in areas students, including student leadership
around the school have faced problems and some of the neighbors have been
keeping the trash picked up on a
over the years from littering to drugs.
The Salem Keizer School District regular basis. I agree with everyone’s
is aware of the problems and our frustration with trash - the mere idea
city manager and police staff have of being so self-absorbed that one does
been working with the district not put trash into appropriate bins is
regarding school overcrowding and beyond my comprehension. And we
the neighborhood impacts. Until the all appreciate people who volunteer
school and its parking are expanded, to clean up and take pride in our
we are committed to work with their community.
A resident raised the issue of towing
administration to help solve issues as
cars that are blocking driveways and
they arise.
Recently, the majority of issues as a result, we found an inadvertent
have been centered on Newberg change in our ordinances in the 90’s
Drive. Some we have been able to that is now being corrected to give our
resolve quickly because the city has the police the authority to call for towing
authority to take action. Some are more in that situation.
from the
mayor’s
desk
other
views
Blocked driveways have been an
issue, particularly for one neighbor
who has been blocked in and was
written up for being late to work.
With Newberg Drive being an
unimproved street, some driveways are
not clearly defi ned. We can work on
ways to clearly and consistently mark
the driveways. That would provide
objective, enforceable spaces for no
parking. I am asking our Community
Development Department to bring
information on options to both
Traffi c Bike Pedestrian and Planning
Commissions. Their recommendations
will then be provided to residents who
have driveways that are not clearly
defi ned.
There are some issues that need to
be handled by the residents with the
help of the city:
Newberg Drive is dark. Keizer
neighborhoods are each covered by
their own street lighting district paid for
by the residents. Older neighborhoods
like Newberg Drive were built without
them, but may at any time establish
a street lighting Local Improvement
District to install lights and pay for
their operation each year. Those of us
who live in neighborhoods that have
street lights are willing to do so because
we value the safety and security they
provide. I encourage residents on
Newberg and throughout Keizer to
all seriously consider putting in street
lights if you don’t have them.
Newberg Drive also has no
sidewalks. We have a long list of
sidewalk projects to build and are
getting projects built each year as funds
allow. In the meantime, neighborhoods
may form a local improvement district
program to build sidewalks. The LID