Doctor Eclectic

Doctor Eclectic
Doctor Eclectic

Sunday, December 29, 2013

Military Commissaries - My 200th Post

Norfolk Naval Base Commissary 2007
When Mary and I married we went immediately (no honeymoon) to my first Duty Station, MCRD San Diego. We had so little money we had to borrow to pay the trucker to deliver our wedding presents from Wisconsin.  One of the first lessons Mary was taught by the other Dental Officer wives was how to save money by shopping at the Commissary, the best of which was a ferry ride to Coronado.  On the first trip she was admonished to continue shopping since they only made the trip once every two weeks.  She had to explain that she had spent her budget and had no more to spend until the next payday.

How she managed to not only put food on the table but develop into a gourmet cook remains a mystery.  She continues to shop at Commissaries to this day.

The idea of a commissary in the United States started as early as 1825 and by 1867 both Officers and Enlisted could purchase groceries for themselves and their families at cost.  The operation was in response to two factors, first from earliest times there were always opportunistic civilian merchants who took advantage of the military stationed in remote areas and second, the variances and vagaries of the cost of groceries in areas where the military was stationed, with no choice in the matter.

In 1899 the first foreign shore commissary was opened in the Philippines, the country were Mary and I had our first contact with an overseas commissary.  The different in off-shore operation was essentially a rationing of the goods available.  While a commissary in a large base in CONUS may stock over 11,000 items, we were restricted to about a tenth of that when we were there in 1963 and not too much more when we returned in 1983.  I do remember on our first tour that one of the items at Christmas time were Christmas trees, a welcome connection to families left at home.

DeCA Logo
In 1990 Congress established the Defense Commissary Agency, which combined the commissary operation of the Joint Services and set a 5% surcharge to assist in maintaining the infrastructure of the operation.  It is important to note that not then, not before and not until recently was any thought given to making the operation self-supporting, in contrast to the Exchange system.  It is estimated that the commissary privilege saves a family of four, $4,000 a year. A savings that allows many to survive on a poverty-level salary.  Mary tells me that it is a common sight to see military wives using food stamps for their purchases.

So I was surprised and hugely disappointed to hear that one of the items in the discussion of how to trim the DoD budget, now that some choice can be made in savings rather than the across-the-board cuts of the Sequester, was to triple the surcharge, close several commissaries, or possible eliminate the system, forcing military families on to the economy!

This is not only greatly short-sighted and a huge betrayal of trust, it is also one more indication that Congress does not understand the motivation that supports an all-volunteer force.  Of course why should that be a surprise when we now have less than 15% of our politicians who have ever served: and that includes many who were drafted.

I am hopeful that when the members of Congress return from their holiday they may reflect of the ludic racy of making a change in a policy set when many of their states were wilderness being protected by the soldiers-in-arms with those who they are now disenfranchising of promised and expected life-style elements.

Recently Bill Cosby was interviewed on NPR and covered how war has changed, in his characteristic, humorous, but thoughtful way.  In my next Post I’ll take off from his reflections with some of my own thoughts and observations.  It should be fun.  Please come join me.

Saturday, December 21, 2013

The Milk Cliff

As I understand it we are poised to go over the Milk Cliff on January 1, 2014, with the retail price of milk likely to double.  Holy Cow!  How did that happen?

Seemingly lost in the media discussion of the ACA, Sequester, and the budget compromise is any discussion of passing a Farm Bill, much less confronting the question of Immigration.

The Farm Bill is a piece of legislation that is presented as a modification of laws controlling all matters regulated by the Department of Agriculture, both foreign and domestic.  The bill is introduced in a soft five-year cycle, which explains why it does not seem to have the urgency of a budget bill.

Interestingly, in 1949 the bill included a component that allowed the government to subsidize dairy farmers by purchasing dairy products at $38.54 per hundredweight, which remains higher than the current price of approximately $18.  The subsidy remained essentially the same through the last iteration in 2008, allowing such programs as school lunches to proliferate.

And therein lays the problem.  Programs like the Title 1 school meals and food stamps have become controversial.  Not that they don’t do good.  As local Chairman of the American Institute of Wine and Food, I was well aware of their Days of Taste ® Program , which in Orange County meant we went into Title 1 Schools for two days, the first of which was spent in teaching food values, how to read labels, and the progression of food from farm to table.  The second day we gave them money and took them to the local Farmer’s Market where they shopped for their families.  I found out that WIC coupons were legal tender at the Market. 

When I surveyed my table of eight, after making the dressing for the communal Harvest Salad that followed out trip to the Market, I found that six of the eight had eaten fast food the night before, one had eaten Chinese (which was probably fast food) and one had eaten nothing.  The School Lunch program was their main source of nutritious meals.


First U.S. Food Stamps - 1939
But dairy also is a large component of the SNAP (Food Stamp) Program allowing the $135 per week to have higher purchasing power on nutritious meal planning.  Review of the 2008 Food, Conservation, and Energy Act was due for replacement by September 2013.  Since the rolls of food assistance has grown to more than 15% of the population or 47.7 million Americans at a cost of almost $75 billion a year,  there were serious concerns about how to control the costs inherent in continued subsidies.  A consequence was a plan to discontinue dairy subsidies entirely in the newly considered bill.

Opposition was so divided yin the Congress, that an extension was made until the end of the year.  But to the best of my knowledge that means that by the time Congress returns from the Holiday recess, we will have fallen over the Milk Cliff.
G. W. Bush
The House has done no further action since the proposed bill failed to pass in June 2013.  The senate passed their bill in June 2013, but it has received no support from the House, essentially because it does not address the Food Stamp issue.

Before I started on this post, I wanted to find out how much milk costs in today’s market.  I didn’t want to repeat President H. W. Bush, who may have lost his reelection because he didn’t know the price of milk.  Turns out it is about $2.99 a half gallon at the local supermarket and about a dollar less when Mary buys it at the Camp Pendleton Commissary.

Double that and milk is more expensive by far than gas.

While I usually try to keep my observations objective and not political, I find myself less concerned that  Barrack Obama has increased his gray-hair quotient by putting more people on food support than I am about how his actions have increased the gray in my hair since his election.

In my next post I will cover another somewhat political issue:  what about the military commissaries?  I would hope you will find that interesting.

Thursday, December 12, 2013

Navigators

Covered CA Home Page
I had hoped for some content information of what Navigators in Covered California, the California form of the ACA learn to help enrollees find the best plan for their needs in the Exchange, but after 7 telephone calls and one unanswered email, I must depend on what was released to the press about two weeks ago.  On one call I was put into queue as number 456 with an estimated wait time of 28 minutes.  I watched as the queue numbers ratcheted down and the wait time adjusted.  When it got to 5 and then 2 and finally 1 with a 3-second expected wait I suddenly received a message that the phones had stopped working and was encouraged to write the afore-mentioned non-responded email.

But I think I understand the concept.
In their November 30,Press Release Covered CA is pretty specific that Navigators exist.  They say:

SACRAMENTO, Calif. — Covered California™ has reached milestone levels in the number of professionals trained to help consumers, face to face, as they obtain affordable, quality health insurance through the agency’s online marketplace.

“We are adding in-person assisters by the hundreds each week,” said Covered California Executive Director Peter V. Lee. “Our presence in neighborhoods across the state is strong — and growing. Certified Enrollment Counselors, Certified Insurance Agents and county eligibility workers provide consumers with personal, secure and competent help in selecting a health insurance plan that fits their medical needs and budget.”
I have heard Peter V. Lee speak twice and he is exceptionally transparent in his message.  I also serve on several committees in the industry, including AHIP and NADP, both of which are trusted spokespersons for the insurance side of the ACA.

So, I was disappointed that I could not find out more about training than I did.  I am intrigued by several questions:

      1.      What is the potential growth of this group, called Certified Enrollment Counselors in California?

2.      What is the salary, and are there Supervisory and Managerial positions? (Think TSA growth in the years since 9/11).

3.      I know the Brokers involved are arms-length from any insurance company connection, is this true of the Enrollment Counselors?

4.      Is the work seasonal, like Tax Preparers?

5.      How have they recruited 6,000+ counselors, certainly not by fielding requests? Are they political appointments?

Ferdinand Magellan
I am sure the Navigators are not allowed comment on the problems inherent in the Act itself.  Like how can coverage be tailored to one’s lesser needs and still be affordable? How will the Exchanges absorb what is becoming large numbers of people who previously were covered by their employers?  And the big one: How can health coverage that varies so greatly from state to state, including what will be a covered Medicaid population and how will the children’s oral health benefit be defined, be termed a national Health Plan?
Ptolemy's map
It remains to be seen whether the December 23rd deadline will be extended, and how the insurance carriers will be able to handle enrollment.  I hope for the best and expect that the final product will be much different than what was in the 7,000 pages passed into law.

I remain curious as to the certification process for the enrollment counselors.  I believe the Navigators may find the cartography of the process showing the Sea Serpents pictured on the ancient maps.

Thanks to a very active and knowledgeable nephew, I now have four links you might find interesting that answer some of my questions:
1.   How many for how much?
2.   How safe is the Personal Health Information?
3.   How do you get into the system?
4.   How distanced from bias are the Navigators?

Somewhat depressing!

For my next Post I intend to take a serious/humorous look at what is being called the Milk Cliff.  I hope to see you there.

Tuesday, December 3, 2013

Privatization

A few weeks ago I posted on my Blog an article on a process called “Eminent Domain”.  I wrote and cited references for occasions where the conversion of private property to public use, or even the process of making zoning changes to increase public revenues had unintended and often unfair consequences.

San Francisco
Today on NPR there was a feature story regarding eviction of San Francisco residents, some of whom have been at the same location for more than twenty-seven years, in order to increase tax revenues and to upscale the demographics of the residents.

My single sister moved in her early career as an architect to North Beach in San Francisco.  She gave up her car and mid-western life style for the opportunity of life in a legendary urban city.  I visited her several times over the years and her joy was almost palpable.  Eventually she moved across the Golden Gate to the first and last home she would own.

As I listened to the commentator describe the forced exodus that would bring an end to rent-controlled living, I felt the description of “losing the artists and Bohemians who have described the city” was not far off the mark.

Last week I chatted up a Puerto Rican lawyer, while attending the Greater New York Dental Meeting.  He mentioned that his father, in the export business, had an office/residence only a few blocks from where we were at, near Times Square.  His rent was $75/month until 1985!  The controlled rent was costing the city, literally hundreds of thousands of dollars a year.

San Francisco wants their dollars!

In smaller cities those dollars are the backbone of the education system, the statistics which were released today show little improvement in comparison with other countries and even a serious reduction in math proficiency.

Philadelphia school room
A week ago or so, NPR featured the inner-city schools of Philadelphia and cast a concerned attitude over the privatization of the schools to profit and non-profit entities, many of whom receive their funding from state-supported Charter schools.  True, about one-third of the funding comes from the private sector; much from Foundations, but the consequence has been a serious negative change in the funding of the schools who teach the Black minority.  One single Black mother with three children and a mid-level job says there is no way she could afford to send her children to Charter school.

She also is concerned about the likelihood that entitlements, such as food stamps, are coming under increased scrutiny.

My interest in the subject of Privatization was sparked also by a solution to the California prison crisis, which is privatizing incarceration.  On one hand I find that a promising arrangement, especially since I have a modest investment in the CXW Correction company which has gained more than a third value in the 2 ½ years since I bought it, but it doesn’t bring jobs to California, and it doesn’t address the social problem of whom are we incarcerating?

So, if there is a point to this post, it would be to increase the transparency when changes are made to ownership or use of property, and that we should take a qualified, but serious look at what might be the unintended consequences of change.
In my next Post I plan to research what is happening to the field that has coined a new name since the ACA rollout; namely, what is a “Navigator” and how could I become one?  I think you’ll find it interesting.