“Plan” is in quotes because as of now, it’s not legislation – just a list of programs and funding mechanisms that are very much a work in progress. It’s anyone’s guess if any legislation will actually become law…although as of now it seems a bit less likely.

Ed note – in my view the provisions of the legislation wouldn’t have much effect at all as they don’t address many of the core issues driving gun violence – except it would allow Dems to say they got a bill passed, and Republicans to tell independent moms that they care about kids.

Gun violence is a public health issue; it fits right into the purpose of public health, namely “reducing and preventing injury, disease, and death and promoting the health and well-being of populations through the use of data, research, and effective policies and practices.”

What’s appalling to me (a gun owner and hunter) is this:

• More kids are killed by guns than by car accidents – child seats and restraints are the law in most if not all states because elected officials recognized kids were being killed and maimed in accidents.
• This is especially true for Black kids – guns have been the leading cause of death for black boys over 15 for more than a decade.
• Laws were passed decades ago to protect kids from lead paint.
• Backyard pools must be fenced in most areas.
• Kids can’t buy alcohol or tobacco products because of health risks.
• When guns are present, suicides are far more likely to result in death; in fact there are far more gun deaths by suicide than homicide.

Yet most states do pretty much nothing to protect kids from gun violence – in fact in many states laws have been passed that increase the risk to children.

The holdup seems to be about two things; so-called red flag laws and the “boyfriend loophole”.

Red flag laws allow for/enable the temporary seizure of weapons and/or prevent weapons purchases by individuals deemed to be a danger to themselves or others. States with effective red flag laws have saved lives; “58 people who threatened mass shootings were disarmed during the first three years of California’s six-year-old red flag program. At least 12 school shootings were averted.”

GOP Senators are raising due process concerns; that is, they want to make sure individuals have their day in court before their guns are taken away.

More problematic is that there are 31 states without red flag laws; Sources indicate a GOP Senator assured his colleagues that “there would be no federal mandate to implement the laws”. Without that “mandate” the red flag provision would be pretty much toothless; states that have been busy making it easier for anyone to get and carry firearms wouldn’t be affected.

Sure those states wouldn’t get the federal funding needed to implement the red flag provisions, but elected officials would tout their willingness to refuse those dollars s evidence of their steadfast opposition to any gun control measures.

The “boyfriend loophole” is also problematic…today unmarried partners who commit domestic violence can buy/keep firearms while spouses who commit domestic violence can’t. (Note it’s not merely “threaten”…in most cases a spouse has to actually do something violent to potentially lose their guns.)

Health care payers

Behavioral health is how this affects health plans and payers.

All kids should be screened for BH concerns – no matter where they live. Care should be provided where needed. This will require additional funding, changes in benefit design for Medicaid, duals, and exchange/group health, and more behavioral health clinicians.

Of course this is politically driven…

Sen. Kevin Cramer, R-ND, on Tuesday. “I think we’re more interested in the red wave than we are in red flags, quite honestly, as Republicans and we have a pretty good opportunity to do that,” seemingly a reference to the possibility of Republicans taking control of Congress this fall.

Nice to see a politician publicly state that he cares more about votes than public safety.

What does this mean for you?

Depends – do you have kids? 

A couple days ago NCCI’s Laura Kersey penned a piece about key legislative trends, one of which was Single-Payer health insurance. Good research work.

First, let’s define “single payer”. “Single Payer” – by definition – is government-financed and government-managed health insurance. (note Ms Kersey focused on state efforts; for reasons I’ll discuss below states CANNOT have a “single payer”.

Single Payer is a catch-all term for universal health insurance coverage. In some cases there isn’t a “single payer” in an entire nation – our neighbor to the north being one example, Switzerland and Germany are two others. In Canada, each Province is it’s own single payer; in the two European countries there are a variety of independent companies that provide health coverage. Taiwan has one payer for all residents.

There are a LOT of different versions of “single payer”; a discussion is here. Pretty much every country with Single Payer is unique, each with its own nuances. For example,

• most don’t have government-employed healthcare providers; in many single payer systems, physicians, therapists, hospitals and other providers are private.
  • The UK is an exception; providers are (mostly) employed by the government
• many are not government-operated; in many systems private insurers contract with the government to handle administration of health insurance – similar to our Medicare
  • Again the UK is an exception

Typically:

• the government sets pricing/reimbursement policy and actual prices – similar to our Medicare
• funding comes from some combination of employee, employer, and other taxes; in some countries, insureds pay some form of premiums – similar to our Medicare
• it covers everyone
• there is little to no paperwork for patients/consumers; all that is handled by the administrative agency
• there are minimal or no deductibles, copays, or co-insurance requirements
• people can buy into supplemental insurance through private insurers

Ms Kersey’s article notes several states have pending or tabled legislation related to single payer.

A key issue here is a very large chunk of spend in each state – as in more than half – comes from the Feds. Thus, unless a state gets waivers from the Feds (which will never happen) exempting Medicare and Medicaid from that state’s Single Payer program, most of the medical dollars aren’t going to be in that state’s program.

I’d suggest how Single Payer would affect comp depends on two core issues:

• whether care for occupational injuries/illnesses is covered by Single Payer, and
• whether there is a universal fee schedule.

If WC care is included under Single Payer, it is likely work comp would evolve to an indemnity-only system. This currently exists in several other countries, and seems to work pretty well.

If WC medical care is NOT included in Single Payer, the impact would be driven largely by the presence – or absence – of a universal fee schedule. 

Without that universal fee schedule, providers would likely continue to do their revenue maximization thing, although they’d supercharge those efforts. Why? Because reimbursement from all other payers would drop significantly, and providers would look to comp to replace as much of that lost income as possible.

What does this mean for you?

There will NEVER BE A STATE-BASED OR STATE-SPECIFIC SINGLE PAYER PROGRAM.

Your kids will never be safe, not as long as pretty much anyone can buy and own and use guns designed only to kill people.

The slaughter has become commonplace…so “normal” that one can now buy casket wraps specifically for kids. 

credit Cara Anthony, Kaiser Health News

Guns were the leading cause of death among children in 2020 – more kids were shot and killed than died in car accidents.

This year alone 3,044 students aren’t going to graduate because they were shot to death. Thousands of parents and grandparents and neighbors and friends live with their loss – every minute of every day. 

The slaughter of little kids in Texas and elderly Black Americans in Buffalo tore away the comfortable numbness, replacing it with sadness beyond measure…yet somehow we pushed through. A colleague wrote this in an email; “I”m surprised at how much of business life just continued without comment.” That’s on us – each of us.

Here are two things that must be done.

1. Make background checks effective.
   In the decade since Sandy Hook, we have made zero progress in improving or expanding background checks on gun buyers.  The current process is clearly an abject failure, rendered toothless by “compromise” in Congress. The reality is:
   1. minimal information is required
   2. Background checks aren’t done at gun shows or for private sellers, so anyone can buy a gun in a private transaction.
   3. there are loopholes and gaps that enabled multiple mass killings perpetrated by individuals who never should have been allowed to buy a gun
   4. “The bar for denying someone on mental health grounds is very high, requiring that a person has been declared unsound or involuntarily confined to a psychiatric institution by a court or other authority.”
   5. If the FBI (the Federal entity responsible for background checks) can’t make a decision within 3 days, the firearm purchase is automatically allowed.
   6. Many states, the US military, and other data suppliers tasked with sending information to the FBI fail to keep their records complete and up to date, rendering the information they supply to the FBI questionable at best.
   7. What you can do – Please sign this petition, and learn more here.
2. Ban weapons designed to kill people.
   A good friend, former Green Beret and Vietnam combat veteran said this:As a nation we’ve got to come together and force our politicians to take up the challenge of eliminating the absurdly easy access by civilians to military weaponry and equipment. As someone who has owned guns for over 60 years and carried a shortened M-16 (actually called a CAR-15) for 19 months in combat, I’m saying that there is no reason for a non-military or law enforcement citizen to have a weapon that was intended only for killing other humans. What legitimate non-combat purpose does a 30 round stick magazine or 100 round drum magazine of 5.56mm ammunition have? Why are body armor and Kevlar military helmets permitted to be readily sold to the public with no questions about their intended use? How does one justify needing a 40 round magazine for a pistol? There truly must be a reckoning with our elected officials on both sides of the aisle to force the question of what their honest priorities are: the safety of our people or the continuance of their career funding by arms merchants, gun lobbies and a very small minority of highly vocal citizens who will fulfill their desires no matter what the cost to our society.
   What you can do: Support the Brady Plan.

What does this mean for you?

Take 5 minutes to help prevent a lifetime of grief. Support the Brady Plan