Monthly Archives: July 2011

President Refuses to Blink in Game of Chicken Over Nation’s Credit-Budget Crisis: America to Congress, Compromise!

By Talib I. Karim, Esq., Health and Law Contributing Reporter

To read the story in the Afro, click here.

Facing a “debt-magetton”— a crisis in which the nation risks defaulting on its debt obligations, destroying its AAA credit rating, and increasing the federal government’s borrowing costs—President Obama is squared off in a virtual “game of chicken” against Republicans led by House Speaker John Boehner of Ohio.  And as for now, it appears that the President is not blinking.

The Obama White House has worked with Congressional leaders to reach a “Grand Deal” consisting of a “balanced” array of spending cuts and revenue increases.  Yet, from the very beginning, Republicans have stood virtually unanimous in their opposition to any deal that includes taxes, even for the very rich.

Some such as Senate Republican Leader Mitch McConnell (KY) have loathed any deal that would undermine their “primary mission” to defeat President Obama and take back the White House.

Yet, a deal of the magnitude desired by the President was taking shape till late last week.  To extend the nation’s credit-borrowing cap for an additional two years, the President offered to slash over $1 trillion in defense and other discretionary spending, $650 billion in Medicare, Medicaid and other entitlement programs, and eliminate $1.2 trillion in federal tax loopholes, breaks and deductions.

And in the President’s opinion, his proposal was even still tilted too-heavily towards cuts than revenues.

According to Mr. Boehner, this inclination of the President was likely the cause for the collapse of the grand deal.  Even though Republicans were willing to compromise their “all cuts-no revenue” position, the deal broke down when the President pushed for $400 billion in more revenue stated Boehner at a July 22 press conference (http://www.youtube.com/user/JohnBoehner?blend=1&ob=5#p/u/0/DFR0uFXmcq4).

With the deal nixed, Congressional Republicans and Democrats scrambled to offer new debt-cap increase proposals.

Monday, Speaker Boehner proposed a plan to immediately lift the nation’s $14.3 trillion debt-spending limit by $1 trillion in exchange for over $1.2 trillion in federal spending cuts.  A second $1.6 trillion borrowing-authority increase would come next year, provided the White House approves an additional $1.8 trillion in spending cuts, for $3 trillion in total cuts.  This measure would also require a vote in both houses of Congress on the Republican balanced-budget amendment.

Later in the week,the Speaker modified his plan after the non-partisan Congressional BudgetOffice stated that the measure would technically increase rather than decreasethe federal debt.  On this news, Mr.Boehner introduced a revised plan calling for a lower debt limit level, to $900 billion, withaccompanying spending cuts of about $917 billion over the next decade.

Senate Majority Leader Reid also offered a measure cutting $2.7 trillion in federal spending and raising the debt limit by $2.4 trillion in a single step — enough borrowing authority for two years.  The legislation also establishes a new special joint committee of Congress charged with recommending additional savings that would be voted upon before the year’s end.

Neither the Republican nor the DemocraticCongressional proposals increased revenues,as demanded by President Obama, and at press time, analysts expect neither billwill become law without significant compromises by Members of Congress from bothleading political parties.

In the face of these proposals, the President took to the airwaves Monday in a prime time speech to the nation.  Rather than compromising his principles, once again, and announcing his support for one of the two Congressional plans to raise the debt-cap without a “balanced approach” of spending cuts and tax increases, the President instead mobilized his base urging them to contact their congressional representatives to seek support for a “balanced” deal that extends the debt-cap beyond next year, cuts the budget, and increases taxes and other revenues.

Said the President in his Monday night address, “I’m asking you all to make your voice heard.  If you want a balanced approach to reducing the deficit, let your member of Congress know.  If you believe we can solve this problem through compromise, send that message” (http://www.youtube.com/watch?v=O08VHT6TsRM&feature=channel_video_title).

Apparently, the President’s message was heard as the switch-board at the Capitol was jammed for the entire day.

Ralph Everette, president of the Joint Center for Political Affairs, a DC-based think tank, believes that ultimately Republicans will blink and compromise.  “My sense is that most people hope the President is ultimately going to be able to broker a deal that is fair to all segments of our society.  I believe that what is right will ultimately carry the day.”

If the Republicans continue to play chicken and refuse to flinch, the entire nation will suffer, not just the least-off, but particularly them, says Internal Medicine Specialist Dr. Gary J. Sheppard, Chairman of the NMA’s Board of Trustees. “African American physicians believe we cannot balance budget off the back of those who are sick.  There has to be cuts, however there must also be sufficient revenue to avoid undue harm to those who need government the most” said Sheppard.

Beyond the sick, the cuts-only approach also threatens the nation’s overall economic growth contends Hillary Shelton, Vice President for Public Policy with the NAACP. According to Shelton, the solution lies in ending the tax-cuts of President George W. Bush, which cost the American people $400 billion a year for ten years ($4 trillion in total).

“Currently, we are more than $3 trillion in debt, if we ended the cuts, in two years, we would be nearly a third of the way of eliminating our deficit, you do the math,” stated Shelton.

Medicare Cuts Could Bankrupt Health System in Nation’s Capitol: Physicians Weigh Arrest to Call Attention to Potential Financial Tsunami

By Talib I. Karim, Contributing Health Writer

To read the story in the Afro, click here

While the President and Congressional Republicans negotiate how much to cut out of Medicare, Medicaid, and Social Security in exchange for raising the nation’s debt limit, one of the biggest losers could be the system of privately owned hospitals, clinics, and health centers that provide health care service to the 600,000 residents of the Nation’s Capitol. 

Although budget negotiators remain huddled in the White House and on Capitol Hill hammering out the details of legislation to raise the debt-ceiling, and possibly, also balance the federal budget, some predict cuts to health spending that could mean financial ruin for hospitals, medical practices, and other health care resources.

According to the DC Hospital Association, hospitals in the District are already overburdened in light of the amount of unreimbursed care to those needing services but cannot pay.

“Cuts [to federal health spending] are not good for patients, the health delivery system, nor physicians; they make no business sense,” explains Dr. Leonard Weather, a practicing gynecologist and President of the National Medical Association (NMA).  Dr. Weather’s group, the nation’s largest association of African American physicians, is sounding the alarm about the impact of the federal debt negotiations on the eve of its national conference starting this weekend at the Washington Convention Center.

From a business sense, any cut to payments to health providers is completely “illogical” asserts Dr. Weather, who has managed a Gynecological health care practice for 28 years.  According to Weather and his group, physicians and hospitals in the Nation’s Capitol and around the country are barely remaining afloat.  “Physicians are lucky to make ends meet, often working without pay.  Further reductions may cause medical practices and hospitals to reduce hours, layoff employees, and even close their doors,” suggests Dr. Weather.

Spending cuts that reduce access to care and compromise the quality of the care delivered will help neither patients nor the economy, Dr. Weather  predicts.  “Fewer doctors would mean that more people will be forced to utilize emergency rooms, which may result in poorer health outcomes and more expensive care,” the NMA’s President asserts.

Ultimately, the proponents of “balancing the federal budget” through cutting health spending are merely shifting the unavoidable burdens of public health to states, businesses and average Americans, contends the NMA. 

Businesses and health practitioners like Dr. Weather have cause for alarm as nearly all the proposals being seriously discussed for raising the nation’s spending limit call for deep health care spending cuts.

The President favors a “balanced” deal to increase the debt-cap by reducing government spending and increasing tax and other revenues.  This “shared sacrifice” according to President Obama’s recent Weekly Address “means spending less on domestic programs,” like Medicare and Medicaid.  In fact, the President has suggested a 3:1 formula for balancing the budget—$3 in cuts to federal health and other programs (along with interest costs) for every $1 in taxes and other “revenue increases.”

Republican Congressional leaders have differing ideas for addressing the debt-ceiling crisis.  The plan favored by House Budget Committee Chairman Paul Ryan (R-WI) would balance the budget through $30 billion in Medicare cuts, transforming Medicaid into a program of block-grants to the states (that some fear could be used by the states for other non-health purposes) and slashing funding by over $250 Billion for elderly, disabled, and poor.

If House Majority Leader Eric Cantor (R.-VA) had his way, he would impose staggering reductions of federal DSH funds (reimbursements to hospitals that care for poor patients who cant pay), reduce support for state Medicaid programs, and slash federal programs supporting nursing homes and rural hospitals.

Many mostly-newly elected Tea Party Republicans oppose any debt-cap deal, instead they are pushing a systemic solution proposing a “Cut, Cap and Balance” budget amendment. This measure would require a supermajority vote of Congress for the federal government to raise its debt ceiling and/or implement other major budget changes such as deficit spending,  increasing taxes, and spending more than 18% of the nation’s GDP.  While not directly detailing cuts to Medicare and similar programs, according to the White House, the bill could result in severe cuts to health education, Medicare and Social Security.

All these cuts would be disastrous according to NMA’s Dr. Weather.  To prevent a tsunami-like financial catastrophe to the health system here in the District and nation, Weather and NMA leaders are exploring “creative” means of communicating their concerns to the President and other budget negotiators

With nearly 7,000 doctors, nurses, and other supporters arriving into town for the NMA conference, Dr. Weather is even gauging support amongst his fellow physicians for a sit-in (like that led by District Mayor Vince Gray) at the White House gates to convey their opposition to cuts jeopardizing their patients and businesses.  “We have to do something,” said Weather.

Catania Scrutiny Puts Breaks on $10 Million Medicaid Settlement: Dental Services to Poor, Disabled At Risk

By Talib I. Karim, Esq. (Contributing Writer and Health Finance Lawyer)

To read the story in the Afro, click here

A week ago, District-based Chartered Health Plan was within days of ending a complicated lawsuit against the District. The suit sought $14.9 million in reimbursements for dental insurance Chartered provided to disadvantaged and disabled children under the D.C. Medicaid program. According to the D.C. Department of Health Care Finance (DHCF), which contracts with Chartered and another company to offer managed care health insurance to over 200,000 residents, the District was obligated to reach a settlement with Chartered to the tune of just over $10 million.

Today, the settlement is on hold and being reviewed by Irvin Nathan, the District’s Attorney General. What happened in a span of a week? No one from the District government will say for sure, but apparently, the chill on the Chartered deal appears to be the work of D.C. At-Large Councilmember David Catania.

Catania, a former Republican who shed his party affiliation due to the GOP’s opposition to same-sex marriage, chairs the DC Council committee that oversees Medicaid and is widely believed to wield near-veto power over virtually all aspects of the District’s health care system, a multi-billion dollar operation.

Some advocates, such as one dental health professional who asked not to be identified, believe that Catania’s influence over DC health agencies such as DHCF is too far-reaching. However, according to Ben Young, Chief of Staff to Catania, scrutinizing deals between the District and managed care organizations (MCOs) such as Chartered is “what [his boss] was elected to do.” Young states that for years Chartered has been earning record profits off of its managed care business, citing a 2008 audit showing that Chartered’s profits were 15 percent (or approximately $15 million) well beyond the 2 percent profit margin that is the industry standard (known as the medical loss ratio). “Thus when the District required Chartered to expand dental health care insurance for EPSDT (Early and Periodic Screening, Diagnosis, and Treatment) children, and they cried about not having enough money, we said ‘tough, so what.’ Chartered is a company that entered into a risk-based contract, where they assumed the risk for services, despite the cost.”

Chartered’s take is that this is no way to treat a partner in the complex job of providing health care to the most vulnerable, according to Chartered’s court filings. Chartered representatives declined to offer direct statements for this article.

“Under any fixed-price contract, the District is required to set prices that ‘provide for assumption of a reasonable proportion of the risk by the contractor.’… Thus, if the proportion of the risk born by the contractor becomes unreasonable, the contractor is entitled to an equitable adjustment,” stated Chartered in a motion to the District of Columbia Contract Appeals Board, appealing the Board’s decision that the District did not breach its contract.

At the heart of this dispute between D.C. and Chartered is another case, Salazar v. District of Columbia. The court ruled in the 18-year landmark class action lawsuit brought by attorneys with Terris, Pravlik & Millian that the District was obligated to offer preventive dental care among other services to Medicaid children.

As a result of this court order, the District obligated Chartered to expand its Medicaid coverage of dental services to children. In fact, according to Kathleen Millian, lead Salazar attorney, the terms of the order were incorporated into theDistrict’s MCO contract with Chartered, resulting in an “explosion” in the number of District children receiving free dental services, in the words of Catania’s aide, Young.

Yet, according to Chartered, the significant expansion of dental services was not properly calculated when the rates were set for how much it and other MCOs would be paid for insuring the District’s Medicaid population. As a consequence, Chartered contends that it covered $17 million more in services than what was bargained. Even Young admits that the Council only budgeted an additional $1.5 million for the expanded Medicaid dental services.

But Catania disputed last week’s proposed settlement, saying it was a retroactive pay increase.  And, as for now, “the Chartered settlement is dead,” said Young.

Millian, the Salazar lawyer hopes that Catania’s scrutiny into this deal does not put a thaw on the District’s inclination to settle rather than litigate class action cases brought on behalf of the poor like hers. And where the Council chooses toprobe into such settlements, Millian urges DC Mayor Vincent Gray to stand up to the scrutiny rather than backing down. “Public accountability and transparency are important in resolving such major disputes,” she said.

Family Celebrates Ties Discovered, Maintained By On-line Connections

By Talib I. Karim, Esq., Contributing Writer

To read this article in the Afro, please click here.

Each summer, particularly around the 4th of July, the Washington area hosts hundreds of family reunions.  While many of the families who reunite in the region have long established bonds built over generations, today, through technology, families are celebrating bonds created and maintained online.

According to Joyce Rose with the Howard University Department of Afro American Studies, family reunions gained mass appeal following the 1976 television hit series “Roots,” based upon the book penned by the late historian Alex Haley.  This series’ depiction of an African American family able to trace its roots to a West African village served as inspiration for generations of Americans, of all races.  “Roots” not only revealed a family’s ties to Africa, it also brought to light complicated relationships between people who found their way to America from places such as Europe, Africa, and Asia to create this melting pot of a nation.

One outgrowth of “Roots” was the increased interest in the study of genealogy, the science of family lineage and ancestry research.  Traditionally, genealogical research has required tedious research and documentation using census records, birth and death certificates, and even plantation records.  Many of these records are found in depositories in Washington, DC, such as the Library of Congress according to James Sweany, with the Library’s Local History & Genealogy Reading Room.  “Until recent years, most researchers who wished to access the Library of Congress’ vast resources had to visit the library in person.  However, many of our library’s records have been digitized and made available on our website (loc.gov).”

Recently, public interest in genealogy has been reignited through social media sites, family research portals, and even TV shows.  These media have made the craft of family research easier and more accessible to those without years of formal training.  Sites such as Ancestry.com and FamilySearch.org offer software tools for building family trees and cataloging other family historical resources.  A Google search of such genealogy sites registers 47,800,000 hits.

Often families run into a dead end due to missing historical records.  However, through the use of modern DNA research, families can now overcome gaps in written records and even locate their family’s original homelands.

Gina Page has made DNA based family research into a profitable business.  Her company, AfricanAncestry.com has collected over 25,000 DNA samples from Africa.  Using this data, Page’s firm can help those with ties to the African continent trace their ancestry to their present-day country of origin, with a 99% success rate in about 6 weeks.

The Manuel-Wiseman-Scott-Malone clan typifies how today’s technology is helping people in the Washington area make family connections around the world.   Offspring of Theodore Manuel and Donna Scott serve as the clan’s foundation.

As the story goes, Mr. and Mrs. Manuel lived in Memphis, TN around the 1930s and had five children.  Over time, most of the Manuel offspring migrated north to Detroit.  As with many families, many of the Manuel siblings had children, some of whom were born out of multiple marriages and other relationships. “All these factors contributed to a break in family ties,” says Verneda Manuel Blair, the last living of the Manuel siblings, and the clan’s matriarch.  Mrs. Blair’s brother, Dr. Talib Karim Muhammad (a.k.a. Theodore George Manuel, Jr.) , formed a family that ultimately included 14 children.  However, as a result of their father’s evolutionary life, which ended in 1997 shortly after he was elected to the Memphis City Council, Dr. Muhammad’s children never lived in the same household and three lost contact completely with the others.

Some of Dr. Muhammad’s offspring found their way to the DC area, with four attending Howard University.  Two years ago, as the Manuel-Wiseman-Scott-Malone clan began planning for their 2011 family reunion, Dr. Muhammad’s family began actively searching for the remainder of their siblings using  the internet.  “As a computer forensics specialist, I made a hobby of mining the net for traces of my siblings,” said Hassan Karim, one of Muhammad’s 13 remaining children. “Last year, my sister Aeesha’s mother read a Facebook post written by one of my relatives, and within days, we were reunited,” Karim explains.

The family’s next online family reunion came in the form of an Ancestry.com “leaf.”  Subscribers to the Ancestry.com database receive email updates, known as “leaves,” whenever new information is located.  Through such a “leaf,” Karim learned that the last of his missing siblings had been married and changed their names.  With this information, the Karim siblings tracked down thier two sisters and were reunited, first by email, then by phone.

Last weekend, the eldest of the newly found siblings, now known as Rayvn Manuel, celebrated a reunion with nearly  100 family members at activities held at the Arlington,VA Renaissance Hotel.  “Now I’ve made these connections, my new family and I plan to use technology to maintain our bonds and finish building our family tree,” said Ms. Manuel.

Ultimately, the Manuel-Wiseman-Scott-Malone clan plans to publish its family tree in a book for submission to the Library of Congress, thus preserving the family’s ties in the Nation’s archives.

Members of the Manuel-Wiseman-Scott-Malone Clan at Family Reunion Banquet, Renaissance Hotel, Arlington, VA, June 24, 2011 (Kim Johnson)

To read this article in Afro, please click here.