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Free Clinics Try To Fill Gaps As COVID Sweeps Away Job-Based Insurance

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3 years ago

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TUPELO, Mississippi — Joe Delbert hadn’t needed the Tree of Life Free Clinic in three years.

The 55-year-old man, who moved to Tupelo from Georgia to take care of his dying father nearly four years ago, found manufacturing work that came with health insurance. But last month, he joined 26 million other Americans who have lost their jobs because of COVID-19 in the past five weeks.

With the job went Delbert’s health coverage — and the money to pay for medications to control his diabetes and cholesterol. Insulin alone would cost him $600 a vial. Delbert said he would be sunk without the free clinic, which opens twice a month to provide health care at no charge to anyone without insurance.

“My medications are so expensive,” Delbert said. Because of the medication assistance, he added, “I can keep my head above water.”

Typically, three rows of benches outside the clinic are filled hours before it opens. Forty volunteers coordinate paperwork, eye screenings and prescriptions. A dental clinic performs extractions based on referrals from the clinic. Through the eight hours it is open each month, the Tree of Life provides basic medical care for 175 patients, fills around 700 prescriptions and provides dental services for 30 patients.

But at the beginning of March, Dr. Joe Bailey, the clinic’s founder, consulted with local infectious disease specialists and pulmonologists to figure out how the clinic could continue to safely care for its patients as COVID-19 spread.

“They advised us to close, but I didn’t have the heart to do that,” Bailey said. “We came up with a workable compromise.”

Now, though the Tree of Life continues to open twice each month, its operations are far from routine. Patients wait in cars for the volunteer physicians to review their charts and pull together prescription refills. Volunteer medical staff cannot do physical checkups. The dental clinic is closed because the state health department ordered all elective dental care to be deferred.

The same 10 volunteers handle each session to minimize exposure for others. Six of them are over 50, with Bailey and retired cardiologist Dr. Mike Boland both 73. They’ve tried to get coveted N95 masks but do not have any personal protective equipment, known as PPE, beyond gloves and two boxes of basic disposable masks.

Across the country, other free and charity clinics are facing similar challenges as the need for them will only grow larger as more people lose their job-based insurance and struggle to pay their bills.

To adapt, the clinics are turning their delivery models on a dime, said Nicole Lamoureux, president and CEO of the National Association of Free & Charitable Clinics, which represents 1,400 organizations. Some clinics are like the Tree of Life, focusing on medication refills. Some screen patients for fever before they come in for appointments. Others are trying to establish telemedicine options, even as such clinics have been left out of federal relief packages thus far.

“It doesn’t matter if they have a $1 million budget or $95,500,” Lamoureux said. “There’s no federal funding and no access to PPE.”

Still, charity clinics are finding ways to continue their free care.

“Our role is to help people stay as healthy as they can during a scary time,” Lamoureux added. “Without that service, they would be going to the ER, no question.”

Surge Of Need Looming

The Tree of Life operates out of a West Main Street building provided rent-free by neighboring Calvary Baptist Church in this city of 38,000 in northeastern Mississippi. It sees anyone without public or private insurance, regardless of residency, work requirements or immigration status, drawing patients from around the region. In 10 years, the clinic has recorded more than 22,000 patient visits.

“It has exceeded our wildest expectations,” said Bailey, a retired gastroenterologist. “The need is greater than I anticipated.”

Yet on April 18, the clinic handled just 224 prescriptions, including 74 bottles of insulin. Bailey worried people are going without at a time when it’s most important for people with diabetes and hypertension to stay healthy.

“Ordinarily, we have 25 to 30 new patients each time,” Bailey said. “We had two or three.”

The clinic can take new patients who need help getting refills to keep their chronic conditions stable if Bailey feels he can safely prescribe to them. But the volunteers are limited in what else they can do, given the lack of protective equipment.

“We can’t do complete physicals or blood tests,” Bailey said. “We try to provide what they need. It’s not ideal.”

Charity clinics are bracing for a tsunami of new patients, though, because so many people have lost health insurance and income, Lamoureux said. The influx could come as donors and foundations are forced to scale back clinic funding because of the economic downturn.

“They see a wave coming,” she said.

Although economists can track layoffs via new unemployment claims, tracking the uninsured in real time is trickier, as each worker can carry insurance for multiple family members, and some are able to shift to other sources of coverage. An analysis by the Economic Policy Institute estimated that 9.2 million workers were at risk of losing their health insurance coverage.

Joe Delbert of Tupelo, Mississippi, is relying on the Tree of Life Free Clinic for access to diabetes and high blood pressure medicine for the first time in three years. He lost his health insurance when he was laid off from his job manufacturing car parts. (Michaela Morris for KHN)

Jaqueline Vance of Pontotoc, Mississippi, falls in the Medicaid coverage gap. She doesn’t earn enough to get insurance through her work as a school bus monitor but makes $100 too much to qualify for Medicaid. (Michaela Morris for KHN)

The Coverage Gap

Before COVID-19, Mississippi had a high rate of uninsured: 18% for adults ages 19-64 compared with 12% nationally, according to the Center for Mississippi Health Policy. The state did not expand Medicaid eligibility under the Affordable Care Act and very few able-bodied adults can qualify under the state’s requirements.

“We anticipate we will see a lot more people falling into the coverage gap,” said Roy Mitchell, executive director of the Mississippi Health Advocacy Program, a nonprofit that operates a help line for consumers with Medicaid, ACA and private health insurance issues. “It will only get worse.”

He does not see how the state can continue to avoid expanding Medicaid eligibility on ideological grounds as the long-term effects of the pandemic and economic disruption hit Mississippi families and rural hospitals.

“Right now, the state needs every tool to fight coronavirus and stay safe,” Mitchell said.

Jacqueline Vance was trapped in the coverage gap even before the COVID-19 pandemic. The 37-year-old Pontotoc, Mississippi, resident has acute asthma, sarcoidosis, fibromyalgia and coronary artery disease.

“I make $100 too much for Medicaid,” Vance, who works as a school bus monitor, said as she waited at the Tree of Life clinic.

With her weak lungs, she needs to stay as healthy as possible. The ER is the last place she needs to be.

“This is really scary for me,” Vance said.

Delbert, the man who joined the uninsured after losing his manufacturing job last month, said that he hopes he will soon be back at work but that he is deeply grateful for the Tree of Life.

“They were here for me when I couldn’t help myself,” Delbert said. “This is a really big help to the community.”

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By: Michaela Gibson Morris
Title: Free Clinics Try To Fill Gaps As COVID Sweeps Away Job-Based Insurance
Sourced From: khn.org/news/free-clinics-try-to-fill-gaps-as-covid-sweeps-away-job-based-insurance/
Published Date: Thu, 30 Apr 2020 09:01:01 +0000

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Retirement Planning

Ends-of-the-World Every Year Since 1970

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3 years ago

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August 14, 2020

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There always has been and always will be a reason not to invest or not to stay invested. This is all the mainstream media reports to us. Below you will find a list of some of the worst global events each year since 1970. I have some commentary to follow.

1970: War: US troops invade Cambodia.
1971: Civil Unrest: Anti-war militants march on Washington.
1972: Political: Start of Watergate Scandal.
1973: Economic: OPEC raises oil prices in response to US involvement abroad.
1974: Political: Nixon resigns as President of the United States.
1975: Political: Multiple assassination attempts on President Ford.
1976: World: Ebola virus.
1977: Political: Government shutdowns.
1978: Market: U.S. Dollar plunges to record low against many European currencies.
1979: World: Iranian militants seize the U.S. embassy in Teheran and hold hostages.
1980: Economic: Inflation spiked to a high of 14.76%.
1981: Political: President Reagan assassination attempt.
1982: Economic: Recession continues in the U.S. with nationwide unemployment of 10.8%.
1983: Economic: Unemployment in the U.S. reaches 12 million.
1984: Economic: 70 U.S. banks fail during the year.
1985: World: Multiple airplane hijackings around the world.
1986: World: Chernobyl Nuclear Power Station explodes.
1987: Market: DOW drops by 22.6% on October 22.
1988: Environment: Awareness of global warming and the greenhouse effect grows.
1989: Environment: Exxon Valdez dumps 11 million gallons of crude oil into Prince William Sound.
1990: World: Persian Gulf War starts.
1991: World: Mass shooting in Killeen, TX.
1992: Human Rights: Los Angeles riots following the death of Rodney King.
1993: Terrorism: World Trade Center bombing.
1994: World: Mass genocide in Rwanda.
1995: Terrorism: Oklahoma City bombing.
1996: Terrorism: Olympic Park bombing.
1997: World: Bird flu.
1998: World: Multiple U.S. embassy bombings.
1999: World: Columbine shooting.
2000: Economic: Start of the Dotcom Market Crash.
2001: Terrorism: Terrorist Attacks in NYC, DC & PA.
2002: Economic: Nasdaq bottomed after a 76.81% drop.
2003: World: The U.S. invades Iraq.
2004: World: The U.S. launches an attack on Falluja.
2005: World: Hurricane Katrina
2006: World: Bird flu.
2007: Economic: Start of the Great Recession.
2008: Economic: Great Recession continues.
2009: Economic: S&P bottomed after a 56.8% drop.
2010: Market: Flash crash.
2011: Market: Occupy Wall Street and S&P downgrades U.S. Debt.
2012: Political: Fiscal cliff.
2013: Political: Taper tantrum.
2014: World: Ebola virus.
2015: World: Multiple mass shootings.
2016: Political: Divided U.S. Presidential election.
2017: World: North Korea testing nuclear weapons.
2018: Economic: U.S. & China trade war.
2019: Economic: Student loan debt reaches an all-time high of $1.4 trillion.
2020: World: COVID-19.

While many of these events were undoubtedly terrible (and there are certainly others not named here that were worse), most of these were broadcast as end-of-the-world events for the stock market. Despite that attention, it is worth noting that these were, for the most part, one-time events. In other words, most faded into the newspapers of history. We moved on.

Obviously, some caused monumental shifts in the way the world works. Just think about how much air travel continues to be impacted by the events of 9/11. But, outside of the resulting inconveniences (if we want to call safety protocols inconveniences) associated with air travel, flying is safer than ever before.

Take a look at just about any of the events and you will find there are many that people will hardly remember. My point here isn’t that these events are to be ignored or that they were easy to stomach at the time, but that they have become a distant memory.

I want to also make the point that we should expect these types of negative events. As investors, we know these types of crises, economic catastrophes, and global phenomena are going to happen.

But in almost all cases, here is what we can say in the next breath – this too shall pass.

Will there be legal, humanitarian, economic, or some other aid required as a result of these events? Almost certainly the answer is yes, but that doesn’t mean it they won’t eventually fade into history.

Lastly, what’s worth noting is how the market has performed over these last 50 years despite the continual advertisements of the world crashing down around us. On January 2, 1970, the Dow Jones stood at 809 and the S&P at 90 -> those are not typos. These same indexes have grown (not including dividends) to 26,387 and 3,232 respectively. Amazing, no?

Perhaps what gets overlooked more than anything else is what separates the above one-time negative events from the positive stories that go largely ignored over our lifetimes. And that is a story worth telling. See the companion post below:

Unheralded Positive Events Every Year Since 1970

Stay the Course,
Ashby

Retirement Field Guide Mission:

“To help 10 million people make better retirement decisions.”

If you would like to join us in achieving our mission, I hope you will consider sharing our site if you have found it helpful in your own retirement planning.

This post is not advice. Please see additional disclaimers.

The post Ends-of-the-World Every Year Since 1970 appeared first on Retirement Field Guide.

—————–

By: Ashby Daniels, CFP®
Title: Ends-of-the-World Every Year Since 1970
Sourced From: retirementfieldguide.com/ends-of-the-world-every-year-since-1970/?utm_source=rss&utm_medium=rss&utm_campaign=ends-of-the-world-every-year-since-1970
Published Date: Tue, 04 Aug 2020 13:26:19 +0000

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Wildfire prone property insurance bill in California due for hearing

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3 years ago

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August 14, 2020

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The post Wildfire prone property insurance bill in California due for hearing appeared first on Live Insurance News.

The bill is expected to be heard in upcoming weeks as opposing sites prepare for major battle.

A new California bill, the outcomes of which will have a lot to say about coverage for wildfire prone property in the state, will soon be headed for hearing. The hearing is expected to be a heated one as strong opposing opinions have the opportunity to be voiced.

Opponents of this bill are calling it a direct attack on consumer protections in insurance.

That said, proponents of the bill claim it is the best method for making coverage available to wildfire prone property in California. The bill in question is Assembly Bill 2167. It was written by Assemblyperson Tom Daly (D-Anaheim). If it passes,it will create the Insurance Market Action Plan (IMAP) program. The IMAP program is meant to protect residential properties.

So far, AB 2167 has progressed quickly, when taking into consideration that a chunk of the legislature has been considerably restricted by pandemic crisis precautions. It was first presented in early June and backers have been saying that it was brought forward in good timing and that it has all the momentum it needs to be passed.

That said, AB 2167 has not been without opposition. In fact, it has faced considerable opposition, having been called an attack on Proposition 103, insurance consumer protection law. California Insurance Commissioner Ricardo Lara lobbed that argument at it, calling it an “insurance industry wish list, with nothing to help consumers,” and Consumer Watchdog, whose founder, Harvey Rosenfeld, was the original author of Proposition 103.

The insurance industry strongly supports the bill, saying it will help wildfire prone property coverage.

Insurance organizations such as the American Property Casualty Insurance Association and the Personal Insurance Federation both support AB 2167. The bill also has the support of the California Association of Counties (CSAC), as well as Fire Safe Councils of California, and the CalFIRE union.

The Consumer Federation of America, another watchdog organization, has predicted that if AB 2167 passes, it will cause 40 percent increases in insurance rates. On the other hand, insurance groups claim that the bill offers owners of wildfire prone property a greater opportunity for choice and competition among insurance companies based on coverage and premiums while avoiding the limitations and high costs associated with FAIR Plan coverage.

The post Wildfire prone property insurance bill in California due for hearing appeared first on Live Insurance News.

—————–

By: Marc
Title: Wildfire prone property insurance bill in California due for hearing
Sourced From: www.liveinsurancenews.com/wildfire-prone-property-insurance-bill-in-california-due-for-hearing/8549884/
Published Date: Fri, 14 Aug 2020 09:00:14 +0000

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Is this the last hurrah for bonds?

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3 years ago

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August 13, 2020

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Recently, I have written quite a bit about the long-term return expectations for investing in bonds. See here, here, here and here.

Spoiler alert: I don’t think it’s good.

But long-term bonds this year have been quite an amazing story as the COVID pandemic has caused the Fed to take historically monumental actions. As a result, we’ve watched long-term Treasuries tear the roof off the market. For instance, a 20+ Year Treasury Bond ETF (name withheld for compliance purposes) is up more than 31% YTD as of July 31st.

That is insane!

But there is a good reason for this increase shown below.

The red circle shows a decrease in the 30-year Treasury rate of almost 40% over a span of six months. That’s practically unprecedented with only two periods (2008 and 1981-1982) having similar declines over such short periods.

But this begs the question: Is this the last hurrah for bonds as a driver of any meaningful return? Below is the 30-Year Treasury rate over the last 40+ years.

For what it’s worth, people have been forecasting the end of the bond bull market since 2012 (maybe even earlier) and yet it has continued despite those predictions. But at some point, the bond party will come to an end.

The Fed has been clear that they are going to keep rates stable until at least 2022 which means this may not change for a little while longer. Or in the near term, I could even see the high returns continuing if we experience pandemic economic shutdown round two.

But, I can’t see a world where this is the case for much longer than that – most importantly over the span of a 30-year retirement.

The official end of the bond bull market depends on a recovery from the pandemic economy as well as a few other factors causing rates to rise. But when they do, it seems likely to me that this may be the last great hurrah for bonds for quite some time.

The question is when to get off that train and that undoubtedly requires a personal answer.

Stay the Course,
Ashby

Retirement Field Guide Mission:

“To help 10 million people make better retirement decisions.”

If you would like to join us in achieving our mission, I hope you will consider sharing our site if you have found it helpful in your own retirement planning.

This post is not advice. Please see additional disclaimers.

The post Is this the last hurrah for bonds? appeared first on Retirement Field Guide.

—————–

By: Ashby Daniels, CFP®
Title: Is this the last hurrah for bonds?
Sourced From: retirementfieldguide.com/is-this-the-last-hurrah-for-bonds/?utm_source=rss&utm_medium=rss&utm_campaign=is-this-the-last-hurrah-for-bonds
Published Date: Wed, 12 Aug 2020 13:47:16 +0000

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