Jefferson Station and the thing about Healthcare Reform

20140905_jeff_1024The acquisition has become quite commonplace in recent years, from sports stadiums and entertainment venues to infrastructure basics like roadways and railway stations.  Naming rights, long reserved for notable philanthropists placing a family name on hospitals, university halls, museums and libraries, are now a convenient – though costly – method to promote brand recognition and consumer confidence.

Earlier this month SEPTA announced the naming of Market East Station to Jefferson Station in a deal between the regional transportation provider and the Jefferson Health SystemThomas Jefferson University Hospital is only two blocks south of Market East.

The naming deal follows an earlier arrangement to rename the Broad Street Subway station at Pattison Avenue “AT&T Station” and previews a future naming rights deal with their Verizon or Comcast for Suburban Station.

http-planphilly-com-sites-planphilly-com-files-dsc_0027_2-jpg.752.502.sFacility naming deals are an easy way for cash-strapped or opportunistic entities to raise funding from wealthier, healthier corporations.  In the overall scheme of things, it’s a no-brainer for a constantly short-funded regional utility, like SEPTA, to use its captive commuter audience as a way to raise needed capital.

SEPTA’s five-year deal with AT&T cost the communications company $5.4 million, although SEPTA only received $3.4 million.  It’s advertising agent made out very nicely, pocketing $2 million in the deal.

But what of a hospital spending $4 million to buy branding rights all in the name of product recognition?  To me, it speaks to several interesting questions and one Big Duh observation.

First off, the obvious question … Is it prudent, necessary or progressive for a medical provider to seek publicity of this sort at what most would consider a sizable chunk of cash?  Arguments could be made that such attempts at name recognition promote Jefferson as a top-class service provider, educational institution, and research facility.

Yet, I would think that’s a tough nut to crack since Jefferson is already a renown regional name.  Once you get outside the Philadelphia region it’s hard to figure exactly what naming a railway station adds to the Jefferson brand.   How many prospective medical students or established medical professionals would actually be swayed by a name on a subway marquee?

artmax_178They might even look at such largesse as a needless and wasteful expenditure in a research-heavy profession where funding often determines how much a dedicated research professional can accomplish.

On another level, it’s difficult to ignore what equipment, expansion of service, or community involvement could be financed with that $4 million marquee grab.

Jefferson’s argument might be that all testing, diagnostic and treatment equipment is sufficiently updated and in top-level performance condition.  Yet I would be willing to bet you can find a few areas of their network that might very well be begging for additional investment, updating, and manpower.  From that point-of-view, buying a railway station would seem like an unnecessarily extravagant expense to anyone who consumes Jefferson medical services.

Which brings me to my real reason for making so much more out of a relatively small ball approach to the Naming Rights Game …

Healthcare reform … REAL healthcare reform … The kind of healthcare reform we did not get in the Affordable Care Act.  The kind of healthcare reform that would make a difference to those who consume and those who are forced to pay big premiums, big deductibles, and large shares of those Usual, Customary, and Reasonable costs.

Affordable was supposed to be the key word ...

Affordable was supposed to be the key word …

My Big Aha Moment was in the realization that if the Jefferson Health System has $4 million to spend on a subway station, they certainly have a lot of other money available for a lot of other non-medical investments!

This is not an attack on JHS alone though.  This I’m certain is the same financial truth that can be found in any large, successful medical system, be it in Philadelphia or Dallas or Nashville.  I have never hidden my contempt of the ACA, mostly because of the way it was birthed … forced in hurried fashion through a brow-beat Congress.  And as “healthcare reform” it wasn’t real reform at all … Not even close in any way, shape, or form.

Real healthcare reform would have addressed the REAL problem with healthcare … The Cost!  All the SEPTA-JHS deal did was highlight the crux of the healthcare problem … Medical services that are so expensive that a hospital has a few million lying around to buy a subway station name.

All the ACA did was dump more people into a system that costs way too much.  Logic would dictate that if you want to provide medical coverage to more people the trade-off should be reducing the costs – if at all possible – of the services to be provided.

Can anyone imagine saying that medical costs in this country were affordable prior to the passing of the ACA?  Obviously not, since “Affordable” was the first word they thought of when they created the Affordable care Act!  Yet no significant action was taken to make healthcare more affordable prior to adding millions to the Well-Care portion of U.S. healthcare (i.e. that segment of healthcare that the uninsured COULD NOT AFFORD to use, resorting to Emergency Rooms as their sole source of healthcare once they became sick).

Wouldn’t it have made more sense to take a long, deep look into the cost structure and profit margins of American healthcare BEFORE adding a significant new market for services that would only see demand and usage skyrocket with the passage of the ACA?  Would it not have seemed a reasonable approach to restructure medical costs in a way that potential savings might have paid for many new ACA subscribers?

The SEPTA-Jefferson Health System deal suggests that it would have been on both counts.  Not that we were ever given the chance to find out …

 

Well, health and maybe a good game of railroad Monopoly ...

Well, health and maybe a good game of railroad Monopoly …

 

 

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Turnout in the Horsham 1-3 is approaching 10% (84 voters).  Not sure whether to be relieved that we might hit my 125 prediction or go take a nap …

Both maybe ….?

* * * * * *

So Pennsylvania’s DOMA (Defense of Marriage Act) was struck down today.  Am I a bad person for not caring … Neither celebrating or belaboring …

is it OK that I never cared what others do in the privacy of their own world to express whatever love they feel?

Is it OK that accepting the concept of Personal Liberty, brought here in The Declaration of Independence – that makes this country so strong – leads me to the conclusion that I should have no feeling or take no action one way or the other?

Is it OK to be of the mind that I have way too much to manage in my own life to have the time, energy, or desire to manage everyone else’s life?

Can I rightfully believe that we have way too many and much more important issues and problems facing us than this?

DOMA’s dead?  Wonderful …

Now can we get some REAL problems solved?!?

 

The Power of Pancakes

pancakes2IHOP declared today to be National Pancake Day.  It says so on my Facebook feed, so it must be important.  It is also Happy Faschnaut Day, a.k.a. Donut Day.

National Carb Days are almost semi-religious holidays for corporate Big Carb evolving from fear for the dawning of the Christian Lenten season, where Catholics in good standing will forsake the siren calls of the IHOP/Dunkin Donut/soft pretzel triumvirate.

Well, maybe not so much the latter in this area.  That’s a Philly thing.  We can only go so far in demonstrating our devotion.  We barely survived edicts of meatless Fridays, which tended to put an economic crimp in the local cheesesteak economy.

In any the case, the point of this post is to celebrate the mystical properties of the pancake!  Any connection with National Pancake Day is purely coincidental.

I say this because I witnessed the Power of the Pancake this weekend!

The story has its genesis in the struggle of addressing the needs for elderly parent care.  There is never an easy solution to the question, what do you do when parents are aging to the point where more focused supervision is required?

My experience includes the breadth of care options available, from Independent Living through intensive, full-time managed care to end-life hospice services.  There are blessings and curses with each choice.

Our latest experience and challenge is the decision to invite our last parent to join us in our home.  My father-in law in a good guy, one I have always gotten along with though he has his blustery side and bouts with stubbornness.

When the choice was presented, I agreed easily enough, although there was a bit of anxiety about how such an arrangement might change a home dynamic with which we were all comfortable.  My wife’s piece-of-mind over a relative living alone was enough to persuade me.

KOQ-571.tifOur solution was to remodel our basement in recognition of my FIL’s desire to remain as autonomous as possible.  So autonomous in fact that his new digs are the nicest in our home (just in case your first impression was an episode right out of the King of Queens)!  The transition however has been anything but seamless.

We had to move him in earlier that expected and before his new palace was in move-in shape.  The remaining construction and approaching holidays made the situation a bit dicier, resulting in a hangover that threatened our expectations for limited disruption to the established household routine.

The difficulties which developed involved the usual sources of close-proximity conflict … mismatched expectations, fumbled communications, and the tendency to avoid rocking anyone’s boat at all costs.  Growing frustrations however required that the situation be addressed sooner rather than later; before the atmosphere we were trying to protect turned fetid, breeding anger.

I was tasked with being the Diplomat of Harmony.

My solution?  Breakfast!

nrAjVpmpU4T94vbK4Wmnt7_CmRKB49G7m-wiN6BxBqf03Octsc48KiZUqOpxXfhzNtnR=s151So this past weekend I invited my FIL out for breakfast at Hatboro Dish!  I did not tell him the reason for the invite.  Found out later he was suspicious, thinking we were going to through him out.  (Insert link for King of Queens episode)

Carol, not a fan of Big Breakfast, opted to let the guys hammer things out at an establishment full of sharp objects.

As we sat down, Jim dithered over the menu options.  I chose the bakery-quality cinnamon roll French toast, which is made by Lochel’s Bakery a few hundred feet up York Road, and Jim chose the pancakes … with strawberries … and whipped cream … soon to be marinated in maple syrup poured from a jar, not emptied from cheap plastic packaging.

Did I mention he’s diabetic?  However, it’s my belief that once you get to a certain age, you should be free to enjoy whatever you can, reasonably and safely.  I let him enjoy his loaded pancakes.

Once we finished our morning meals, it was time for The Talk.  Dreading the moment I put all my cards on the table, I wasn’t sure how Jim would take the challenge.  Changes had to be made.  But addressing them would not necessarily be easy.

What I found out though was that Jim was as unsettled about what was going on as we were.  We had a factual, very honest discussion of expectations vs. reality as it existed.  It was more relaxed than I had anticipated … a friendly, direct, unemotional conversation about how to improve the home situation.

Our discussion couldn’t have gone better.  Almost immediately function and comfort returned to our home!

Now this pleasant outcome could be attributed to a number of things –  personality traits, mindsets, shared values – that helped us at the breakfast table that day.  Either way you look at it, it’s hard to have a bad morning when looking over a stack of pancakes!

Welfare reform through Transitional Living Funds

U.S. REP Sheila Jackson Lee (TX-18)

U.S. REP Sheila Jackson Lee (TX-18)

OK, OK … I know a lot of people are having a really hard time digesting U.S. Representative Sheila Jackson Lee‘s suggestion that the benefits many of the poor accumulate under “Welfare” should be re-branded to as “Transitional Living Funds“.

Now, putting aside the fact that few people – other than Liberals – would be tricked by simply renaming a Government give-away to some other seemingly innocuous term, I think Representative Lee is actually onto something!

The key to my intrigue is that very first word.

Of the three primary definitions of the word TRANSITION in the Merriam-Webster dictionary, let’s look at the most commonly used.  (The third deals with “musical modulation”.)

TRANSITION: 1. a : passage from one state, stage, subject, or place to another :  change;  b :  a movement, development, or evolution from one form, stage, or style to another … 2. an abrupt change in energy state or level (as of an atomic nucleus or a molecule) usually accompanied by loss or gain of a single quantum of energy … TRANSITION

I think she’s on to something!

Transitional Living Fund would suddenly become exactly what they were intended to be for most healthy individuals not strapped with insurmountable life problems … a means for surviving extremely difficult times in life, where one stares into the bleak abyss of abject poverty through no fault of their own.

Those individuals by definition could now be expected – under this new definition of welfare – to change, to seek ways to improve their lot in life, and maybe – EGADS! – be held to a minimal level of Personal Responsibility!

They might be asked to do what any reasonable person would be expected to do when faced with severe life challenges.  They would be given a LIMITED period of time – Let’s say a year. – to TRANSITION themselves towards a better way of life; a plan for their future and their families future success; a job.

After that Transitional Period they would be expected to pass onto a more stringent period of Personal Progress.  Maybe they could still receive some of all of their TLF benefits PROVIDED that they continue to follow a program intended to find them a suitable job and their TLF benefits would be offset by whatever wages they are able to earn.

Think about it … Personal Improvement, a way out of the morass of poverty and helplessness.  Heck, it even sounds like Progressiveness!  And what Liberal doesn’t embrace that term?!?

Nah … It’ll never happen!

But a big “Thank You!” to REP Sheila Jackson Lee for trying!

Montgomery County Republicans: Healing acts, and a recipe for Success

PA State Rep Mike Vereb

PA State Rep Mike Vereb

On a cold night in early December the Montgomery County (PA) Republican Committee took another big step towards dumping a decade of internal discord by the side of the road.  The rifts that seemed insurmountable only a few months ago, have been bridged and will finally begin to fade from memory.  The Party can push on to a brighter future.

And no peeking backwards is allowed …

As new Co-Chair of the MCRC Finance Committee, Bob Asher stated during October’s MCRC love fest, ” … we can’t have any more rearview mirrors on the bus.”  Asher, along with his Co-Chair compadre, Vahan Gureghian will form a solid backbone for future Republican success in Montgomery County.

The struggles that have faced the Montgomery County GOP in recent years have been expensive, costing opportunities for leadership of County Government; control of County Row Offices; and a growing disadvantage to Democrat registration numbers.  In addition, the infighting has cost the County GOP dearly in unity and focus.

Then suddenly the skies cleared; the feud was over!

In the days leading up to the annual MCRC dinner in October, that would feature an appearance by Governor Tom Corbett, the leaders of the Montgomery County Republican Committee put differences aside to form a much stronger alliance, and created a powerful mechanism for promoting Republican ideals that have made Montgomery County among the choicest counties in which to live.

Finance Co-Chairs Vahan Gureghian and Bob Asher with Governor Corbett

Finance Co-Chairs Vahan Gureghian and Bob Asher with Governor Corbett

Then out of the blue MCRC Chairman Robert Kerns submitted his sudden resignation leaving the County GOP leaderless at a crucial time, a crisis that threatened to undo all the progress the Party had recently made.

And into the breach stepped Pennsylvania State Representative Mike Vereb!

Vereb has served in the Pennsylvania House of Representatives since 2007, and has run successfully for re-election in 2008, ’10 and ’12.  Previous to his successful run for the PA State House, he worked in the West Conshohocken Police Department and served as President of the West Norriton (PA) Board of Commissioners.

Now, I haven’t been much of a regular attendee at the Montgomery County Republican Committee events despite my membership as a Horsham Republican committeeman.  High-powered politics is not my forté.  I prefer to observe, comment (Hence the blog!) and support in whatever way I can those whose values and policies I agree with.

Those who stumble from time-to-time on this tiny slice of the internet super-megatropolis may be familiar with some of my more pointed rants and ravings when it comes to issues like wayward Liberal logic or deception, poor leadership, and – more recently – the dangerous tendency by my political party when it comes to marginalizing its moderate wing of thought.

If it comes to this, so be it!

If it comes to this, so be it!

That last point is one that’s been weighing on my mind for quite some time.  For me, the issue illustrates just how willing the GOP is – on both regional and national levels – to take seriously the depth and breadth of viewpoints existing within those who labor for the ideals the Party represents.

It has been a discouraging to hear constantly that only Big C Conservatives speak truly to the important issues of the day.  That, if you do not share their vision, you are not pure somehow as a Republican.  That only those who hold tight to the hard Right vision are worthy of expressing their views.

Worse from my point-of-view, it’s really very, very bad politics, particularly in a region where so many Moderates live, work and raise families.  And when it comes to Electoral Math, it certainly does not improve the chances of success Nationally.

It was with this mindset I resisted the idea of attending Mr. Vereb’s unchallenged rise to the MCRC Chairmanship.  That was until he made a somewhat personal appeal that I attend such an important event. (OK … It was simply a personal Facebook plea, but nonetheless …)

So on a chilly night in early December I schlepped out to the Westover Country Club to see what would happen for myself.  I wanted to HEAR the message that would come from the prospective Chairman.

I was quite pleasantly surprised!

Chairman Vereb recognized that the Party had become complacent, living off past victories, and not consistently or effectively communicating its message.  It’s a message that should ring loudly for many, including our Democrat neighbors, who have chosen Montgomery County as the place to live for its good schools, safe communities and low taxes.

The message to be stressed is that these things do not occur by accident.  That such development was the result of excellent leadership, sound policies, and effective management.  That throughout the County these successes resulted from decades of Republican stewardship.

The strategy worked quite well for Horsham Republicans on Election Day 2013.

imagesThe message should be a tone-setter for all efforts to promote Republican leadership, the foundation for MCRC efforts to win elections in those areas where the Party’s leadership has a demonstrated record of Success.

At this point of Vereb’s speech, I still wasn’t really totally listening.  It was what Mike said next grabbed me and convinced me the County GOP is headed towards much, much better days!

” … the best interests of our party must always come before personal agendas. … we must be inclusive and welcoming not only of different ideas about how to effectively promote our party and its candidates, but as to what the practical policy goals of our party must be.”

Music to my ears … But the best what yet to come.

“No political party ever expanded its base by requiring unquestioned adherence to a single ideology or perspective. … We are residents of a diverse county in one of the most diverse states in our nation …”

A lesson with which those at the highest reaches of the Grand Old Party will someday have to come to grips.  To win elections – and with that the opportunity to lead, to shape, to find success – the Republican Party has to maximize its philosophical reach to those of moderate economic and social viewpoints.

“Demanding uniformity from our fellow Republicans will only invite electoral losses and policy disasters.  However, by accepting reasonable differences of opinion we will be better positioned to achieve our overall goal of electing Republicans who will make sure government operates efficiently, effectively and is responsive to the interests of hard-working taxpayers.”

Now, to be honest, I’m not entirely sure whether Vereb was speaking of outside political fortunes or the exorcism of past Committee sectarian conflict, but I chose to interpret his message on the broader political stage.

The simple fact is that Republicans can not be politically successful in the four suburban counties surrounding Philadelphia without embracing some moderate social and economic views.  So the MCRC must find a way to accommodate such thinking in concert with traditional Big C Conservative ideals.

A challenging task?  Certainly … But Mike Vereb’s take on diversity, inclusiveness, and Republicans of all stripe working together to extol the civil virtues of Republican leadership to voting taxpayers, who enjoy living in Montgomery County, sure sounds like a recipe for Success!

A Moderate trapped in RINO land

UnknownNo one wants to be unpopular, unwanted, or – worse – to feel used and abused.  Yet for a significant portion of the Republican Party, many are encouraged to express their political beliefs only on Election Day.  But when it comes to discussing the direction of the Party nationally and the Country in general, they better toe the most Conservative of party lines or prepare to be labeled.

For the past several years, it has become clear to self-described “moderate Republicans” that we are to sit quietly in the back; keep our thoughts to ourselves; and let the “real” Republicans make the grown-up decisions!

Yes, we are the RINOs (Republicans In Name Only).  And it’s getting more than a little tiring.

Used to be that various permutations of the Republican value set were welcomed in the development of the GOP platform.  We share the same values that fought slavery; checked the spread of post-WWII Communism; and punished the protagonists of radical Islamic terror.

We were welcomed in a strong coalition that valued – above everything – an efficacious American system of government.  Smaller bureaucracy, productive budgets and spending, and compassionate solutions to social problems were the mantras of Goldwater and Reagan that we all worked towards.

It was a coalition of minds, accepting of moderately divergent views toiling in unison on core values we all shared.

rino-republicansNow, you dare not step off the strict Conservative reservation or risk the dreaded RINO label!  This is an issue I have spoken of before in frustration at the lack of cooperation nationally and the loss of American governance.

In a recent article for the Providence Journal, Froma Harrop asked where have all the moderate Republicans gone?

Oh, we are here all right, hunkered down in our fox holes; reluctant to poke our heads above ground level.  We seem to make such inviting targets.

Many like me, who live in largely suburban-metropolitan areas where some of us have evolved politically over time from the Liberal leanings of youth towards more conservative views on matters of economics and national ideals, have taken solace in the age-old adage that “All politics are local.”  We work to keep our communities on sound fiscal footings, our schools and municipal infrastructures efficient and lean, our neighborhoods safe; and try to apply those same principles to County and State government.

But we dare not speak of our moderate approaches to social issues and the process of pragmatic governance, particularly on a National level.  Because if we do, we know immediately where we stand with the more assertive Voices of the GOP.

RINO!  You would think we were traitors to The Cause.

Certainly, if The Right wanted to portray us as CINOs (Conservative In Name Only), I wouldn’t complain.  CINO sounds more pleasant than RINO too!  But in the “good old days” you could indeed be less than Big C Conservative and still be considered a stand-up Republican.

Not so much any more.

Harrop makes a point which I believe go directly to the GOP Losses in the last two Presidential elections.  Both John McCain and Mitt Romney were weak (McCain) or weakened (Romney) candidates once they went head-to-head with Barack Obama.

Unknown

Shouldn’t be what a national Republican primary looks like

McCain was a horrible presidential candidate, although it’s difficult to believe he could have beaten the first African-American candidate regardless.  Instead, he was simply the last Crash Test Dummy to survive the 2008 GOP Primary Candidate Roast.  It wasn’t even that he was “conservative enough” to win the Party’s pageant.  He was simply smart enough to stay on the periphery and survive the carnage.

In Romney’s case, for an election he should have been well-positioned to win, he was faced with the choice of moving hard to the Right to win the nominating campaign.  Then he was faced with the prospect of a convention revolt to bring in a more Conservative nominee.

When he had finally nailed down the GOP’s endorsement, he was not only unrecognizable as the successful, bipartisan Governor of perhaps the most Liberal state in The Union, he had stumbled into several verbal traps that plagued his campaign throughout the National Election!

Defeat snatched from the jaws of Victory!

Used to be our moderate positions were viewed as the route to effective compromise, the bridge from one Far Side to the other Far Side.  The way efficient Governance was effected.

Not so much anymore …

Now we’re the ones stuck in No Man’s Land watching the rockets screaming over head between the Right and the Left.  That is when BOTH sides aren’t trying to outflank us and pick us off!

True story …

In the Spring of 2012 and the run-up to the Presidential Election, I was asked to participate in a TV show involving a round-table discussion of political issues, where two Democrats were to be paired off against two Republicans.  It was a small local cable access station in Abington, PA; and the gig lasted all of two shows before the Producer up and retired.  But I was flattered, and it was a trip just to be asked.

The experience was fun.  I held my own despite the nerves.  But it was clear that I was the more moderate of the two Rs participating that night.

After the first episode taped, my far more Conservative Republican counterpart and I went out to eat.  And our dinner conversation revolved around our various positions on a number of political and social issues.  When I wasn’t asked back for the second episode, but was mistakenly sent an e-mail with the agenda for episode 2.  I checked around and found out that my spot had been taken by a much more conservative Tea Party member.

The message – to me at least – was pretty clear.  Not Conservative enough …

Does he look scared?!?

If it comes to this, so be it!

Returning to Harrup’s question, my theory is that the RINOs – us RINOs – have tired so much of the frenetic fire fights, many of us have simply dropped out of the National Debate.  We draw fire from one side simply through association with a more conservative set of governing ideals with which we agree.  Then we get outflanked by those who believe us to be not “conservative enough” across the board.

No longer is it good enough to say we support a strong National Defense, the right to bear arms, and the need for sane, sustainable economic policies.  No, we must toe the entire line, including those positions on social issues which many of us believe weaken our beliefs in the sanctity of Individual Freedoms.

Every new iteration of the GOP seems to pull farther and farther away from us.  The Tea Party has a funny way of concerning itself with issues that never would have crossed the minds of the original Boston Tea Party contingent.

Libertarians appear to be the most attractive alternative until their dogma on international relations and geopolitical theory threatens a short-sighted return to a 1920s mindset, which turned into a World War disaster in the decades to follow.  And who wants that?!?

So what’s a RINO to do?

  1. Keep working the Local political scene to protect what you have and keep your streets and neighborhoods safe.
  2. Promote those core Republican values as they relate to Government, Economics, and the Rights of the Individual.  You may not agree with the recent strategy and tactics of national Republicans, however that’s no reason to abandon the economic values and limited government approach that makes the most sense locally.
  3. Don’t back down from the kind of conservatism you believe is best for the Country as a whole.  Moderate is not a dirty word!
  4. Cooperate at the County and State level with fellow Republicans and like-minded Democrats to promote Business growth and expansion, more jobs, lower taxes, and compassionate solutions to social problems.
  5. Be mindful that taking pride in the concept of Individual Liberty requires the Freedom for individuals to define their own way of life on their own terms, according to their own set of values.
  6. And above all, always wear your helmet and body armor; and keep your head down!

If you appreciate the core values of true Conservatism, remember that it’s easier to instigate change from the inside.  A true Conservative would not leave because they are disenchanted with Leadership.  They fight for what they believe in!

There's power in numbers

There’s power in numbers

The Corbett approach to Medicaid sanity

images-2

Once a month the Horsham Republican Committee meets to discuss political developments – both local and regional; to strategize on political organizing within Horsham Township; and to update the Committee on issues of Party management.

To be honest, the meetings can be a bit dry, and that’s even if you’re a bit of a political junkie.  It’s not often that we get into REAL political discussions that provide interesting insights into the issues of the day.

This past Wednesday was different with a small but animated gathering of committee representatives (who represent township Republicans in matters of Party interest), local Republican pols, and the local Party leadership.

My keenest interest is always with the progress – or lack thereof – in Horsham Township’s redevelopment plan for the NAS-JRB Willow Grove property.  At present the Horsham Local Redevelopment Authority (HLRA) is awaiting the approval of its redevelopment plan, which was submitted in the Spring of 2012.

It’s been a year-and-a-half, and no decision as yet from the U.S. Navy.  The Federal Government, which must review and approve the plan before fully vesting the HLRA with redevelopment authority, indeed takes its time when mulling over any decision.  In this case, the Navy, charged with the responsibility of conducting an Environmental Impact Statement (EIS) has met delays in completing their evaluation.  The plan – due this Fall – will not be ready until Winter at the earliest.

Which means, look for it in the Spring or Summer.

The Navy blames the effects of sequestration.  But frankly, as a federal employee, I can speak confidently that, if it wasn’t the effects of sequestration, it would have been something else that would delay such a huge and complex evaluation.  No, not unexpected at all …

Several other issues were also touched on briefly as updates from Harrisburg.

  • Movement on Pennsylvania’s transportation bill, which is seeing progress in the State House after the Senate passed their version earlier in the year.  The biggest hurdle would be in reconciling the two versions as passed, particularly to the level of funding.  There are roughly $5 billion in infrastructure improvements that have been underfunded for decades and well overdue for remedial action.
  • Pension reform at the State level is getting much discussion.  With the State’s two pension plans (state employees, public school employees) underfunded by $47 billion (!) and projected to grow to $65 billion without action, Governor Corbett has moved pension reform to the top of his list of priorities.  Currently, the biggest reform under consideration is moving new employees in both categories into 401(k)-type programs that are similar to those found in the private sector.
  • A brief discussion on the national Affordable Care Act (Obamacare) revealed one persistent problem in Pennsylvania’s rural health services … Finding doctors to work in the less income-lucrative areas of rural Pennsylvania.  This has long been a problem nationwide, not just in PA.  One solution, proposed by the Corbett Administration in its recent proposal for expanding Medicaid as part of its ACA compliance, is a student loan forgiveness program for any doctors who agree to spend a specified amount of time in Pennsylvania’s more doctor-needy areas.
PA Governor Tom Corbett

PA Governor Tom Corbett

The discussion I found most interesting this night dealt with the recent Corbett Administration proposal for expanding Medicaid.  Some of the facts and issues covered …

  • All state-run Medicaid programs vary in benefits and costs from state-to-state.  The terms of Medicaid coverage are negotiated by each state individually.  Passage of the ACA effectively “locked in” every state’s specific Medicare program in whatever form it existed at the time.
  • After eight years of Ed Rendell’s Democrat Administration in Harrisburg, Pennsylvania’s current Medicaid program is one of the most generous – if not THE most generous – state program in the U.S.  This goes a long way towards explaining why some states, such as New Jersey and Arizona are more willing and able to accept the ACA-mandated expansions required for full state participation in federal-run healthcare exchanges.
  • Currently the State and Federal governments combine to spend about $19 billion a year to cover 2.2 million Pennsylvanians on Medicaid!  $19 billion …!!
  • The federal government’s ACA Medicaid expansion financial contribution maxes out at 90% after three years of fully funded coverage. That 10% unfunded liability equals an additional estimated  $200 million – as a minimum – that will have to be covered by the Pennsylvania state budget!
  • Even before any ACA-mandated Medicaid expansion, Pennsylvania estimates Medicaid costs will grow by $400 million in fiscal year 2013-2014.
  • A Rand Corporation study showed that Pennsylvania would save roughly $154 million a year by not expanding Medicaid coverage.

So it’s pretty easy to see why the Corbett Administration is not all that anxious to get on board an ACA-mandated Medicaid expansion.

As with the Philadelphia School District’s annual funding crisis, the Corbett Administration has taken a very responsible approach to any expansion of the financial commitment falling to Pennsylvania’s tax payers.  The Governor realizes that without reforms accompanying this constantly growing financial responsibility, the economic health of the State will be threatened.

images-3In the Philly school crisis, by which you can calibrate your calendar each year, additional funding was offered to the City through negotiations with Mayor Michael Nutter’s administration.  The catch was that the settlement required reforms that call for concessions by the Philadelphia teacher’s unions.

Concessions are necessary on the cost-side of the Philadelphia school issue, if the cycle of funding crisis followed by funding crisis is ever to be broken.  You should not be surprised in realizing that funding solution never really had a chance to succeed.

As for the Medicaid expansion, the facts are that without serious reforms in the way the Pennsylvania program is managed, the state’s’s tax payers and businesses will be on the hook for that rather significant $200 million hole in the Pennsylvania budget … on top of the projected $400 million shortfall for FY13-14 … plus all other projected increases.  Cost reform is essential to Pennsylvania’s future fiscal sanity.

There’s also the very real possibility that the Federal government may not be able to uphold even its 90% Medicaid expansion funding as promised.  And what happens then? 

For these reasons, the Corbett Administration’s approach to the ACA federal exchange and Medicaid expansion proposal should be lauded as the kind of fiscal sanity one should expect from their Governor.