Written on 26 November 2017.

   We’re hearing a lot about healthcare and Medicaid these days, and Medicare remains in the background as Congress seeks to reform the Affordable Care Act.

   If you’re over the age of 65 or caring for someone with a disability, you have at least some familiarity with Medicare and Medicaid. You probably know that your lifetime of work entitles you to Medicaid and Medicare to help cover medical costs.

   But when it comes down to the nitty-gritty details, you may feel a bit confused. What’s the difference between the 2? Who falls under Medicare and who falls under Medicaid? Do you have to pay for benefits? How much do you pay? Frankly, it can be a bit overwhelming.

   We’re going to clear up any confusion and give you a simple, clear breakdown of the 2 programs and what’s included in each.

   While this article certainly won’t make you an expert, it will help you more easily navigate a world that seems complex and confusing.

What Is Medicare?

   Medicare is a federally facilitated health insurance program for adults 65 and older, as well as some younger people with disabilities or individuals with end-stage renal disease (ESRD). The law was signed by President Lyndon B. Johnson in 1965 and was created as a way to help older adults cover the cost of medical care.

   When he signed the bill, Johnson said: “In 1935 the passage of the original Social Security Act opened up a new era of expanding income security for our older citizens. Now, in 1965, we are moving once again to open still another frontier: that of health security. For an older person, good health is his most precious asset. Access to the best our doctors, hospitals, and other providers of health service have to offer is his most urgent need.” 

   Since the inception of Medicare, it has also been expanded to cover a few other groups, including those who:

• Have received at least 24 months of Social Security disability benefits or a disability pension from the Railroad Retirement Board (RRB).
• Have permanent kidney failure (ESRD) and need routine dialysis or a kidney transplant.
• Have amyotrophic lateral sclerosis (Lou Gehrig’s disease).

   In 2003, President George W. Bush signed the Medicare Modernization Act (MMA) into law, which created the Medicare Part D program to provide prescription drug subsidies for those on Medicare.

   When Bush signed the bill, he said: “[…] Our government is finally bringing prescription drug coverage to the seniors of America. With this law, we’re giving older Americans better choices and more control over their healthcare, so they can receive the modern medical care they deserve.”

   Prior to turning 65, an individual must get his or her insurance through his or her employer, his or her spouse’s employer, or an individual policy. Without pursuing one of these options, the uninsured person may have to pay a fee, often called a “penalty” or “individual mandate.” However, when you turn 65, you are eligible for Medicare. You can use Medicare as your only insurance option or in tandem with insurance you have through an employer, spouse, or former employer.

   Medicare is broken down into several different parts.

   Together, Parts A and B are called Original Medicare. Part A provides assistance for hospital bills. Most people have already paid their Part A premiums through their taxes (assuming they’ve worked in the U.S. for at least 10 years).

   Part B provides assistance for doctor’s visits, as well as other medical services such as screenings for particular diseases. Some things covered by Part B include:

• Durable medical equipment (canes, walkers, manual wheelchairs and power mobility devices, etc.).
• Doctor and nursing services such as yearly wellness visits.
• Medically necessary X-rays, as well as laboratory and diagnostic tests.
• Outpatient hospital services.
• Some ambulance services.
• Drugs to support organ transplants.
• Prosthetic devices.
• Specific vaccinations such as flu and Hepatitis B shots.
• Outpatient maintenance kidney dialysis treatments.

   Enrollment in Part B is voluntary and does require paying a small monthly premium and annual deductible. If you have additional insurance through an employer or spouse, it may be unnecessary to enroll in Part B since you have that additional coverage. However, if you don’t enroll and don’t have another policy, you could find yourself paying higher out-of-pocket costs.

   Before turning 65, most people get health insurance through group plans offered by their employer or their spouse’s employer. People who are self-employed or who don’t have health insurance through their job may buy individual policies on their own.

   Part C, which is also known as Medicare Advantage, is a type of Medicare plan provided through private insurance companies that combines Parts A and B (and usually includes Part D, too). These plans can be customized to fit an individual’s needs and cover hospital visits, doctor’s visits, and prescription drugs.

   Part D plans are private plans that give assistance to people who have Parts A and B. This assistance helps them pay for prescription drugs, and the premium is a small amount each month.

   It is essential to remember that Medicare doesn’t usually cover every health expense. Some services, such as dental and vision, don’t fall under the traditional Medicare umbrella and must be either covered through private plans or Medicare Advantage. Unless you have additional insurance or fall into a low-income bracket, you will probably still pay some premiums, deductibles, and copays.

   Medicare usually only covers a small portion of a skilled nursing facility stay. If the requirements are met, Medicare will fully cover the first 20 days of a stay and then only partially cover the next 80 days.

   An example of one of these requirements is that a patient typically must have been hospitalized for 3 consecutive days. Additionally, the care provided must be seen as medically necessary.

   Medigap plans are purchased through private companies and cover expenses not covered by Original Medicare. As Kiplinger notes: “Beneficiaries of traditional Medicare will likely want to sign up for a Medigap supplemental insurance plan offered by private insurance companies to help cover deductibles, copayments, and other gaps. You can switch Medigap plans at any time, but you could be charged more or denied coverage based on your health if you choose or change plans more than 6 months after you first signed up for Part B.”

What Is Medicaid?

   Unlike Original Medicare, which is administered strictly by the federal government, Medicaid is a joint program administered both by the federal and state governments. Each state must:

• Determine who is eligible.
• Determine the scope of what Medicaid covers outside of mandatory eligibility groups, such as low-income families.
• Set payment rates.
• Administer the program.

   States must also decide what services are covered by their Medicaid plans. However, there are some federal standards that must be met by every plan. The services that must be included are:

• Inpatient and outpatient hospital services.
• Doctor services.
• Family planning services and supplies.
• Rural health clinic services.
• Home healthcare for eligible individuals.
• Prenatal care.
• Vaccines for children.
• Nursing facility services for individuals over age 21.
• Lab and X-ray services.
• Pediatric and family practitioner services.
• Nurse-midwife services.
• Federally qualified health center (FQHC) services and ambulatory services.
• Early and periodic screening, diagnostic, and treatment (EPSDT) for children under age 21.

   There are also numerous Medicaid services that states can provide and receive matching funds from the federal government. The services often include prescription drugs, rehab and physical therapy, transport services, and more.

   Because each state sets its own eligibility standards, qualification can depend on income, age, pregnancy status, disability status, citizenship, and other factors. To see if you qualify, you’ll need to research your state’s particular requirements.

   Each state sets its own Medicaid eligibility guidelines. The program is geared toward people with low incomes, but eligibility also depends on meeting other requirements based on age, pregnancy status, disability status, other assets, and citizenship.

Dual Qualification

   Approximately 8.3 million people in the United States qualify for both Medicare and Medicaid. Often, those who qualify for both programs are those in poorer health who need more care than either program can provide on its own.

Despite these challenges, it is worth seeing if you qualify if your expenses aren’t covered by Medicare alone. The independent agents with HealthMarkets have experience with both Medicare and Medicaid. They can help determine if you are eligible, as well as assist with plan enrollment.

Conclusion

   Hopefully, Medicare and Medicaid will remain in place, as they offer valuable care to those in vulnerable positions at little to no cost.

   And while it certainly can be confusing to navigate, people at companies such as HealthMarkets can help find what’s best for you—whether you’re eligible for Medicare or qualify for both Medicare and Medicaid. HealthMarkets’ agents are experienced in helping those who are eligible for Medicare or both Medicare and Medicaid find the plan that meets their needs.

   Everyone deserves healthcare. Lyndon B. Johnson recognized that when he signed Medicare and Medicaid into law. George W. Bush understood that when he enacted Part D plans.

   We wholeheartedly agree.

John Hawthorne

Written on 12 November 2017.

   Deutschland hat Probleme im Umgang mit dem Islam.  Seit 1960 hat die Zuwanderung von Moslems dazu geführt, dass der Islam zur drittgrössten Religionsgemeinschaft in Deutschland aufstieg. Seit Jahren wird gestritten, ob der Islam “zu Deutschland gehört” oder nicht. Die Predigten in den Moscheen und der Islamunterricht an Schulen sind heisse Themen. Wer darf predigen, wer darf unterrichten? Und in welcher Sprache? So erfindet Deutschland mühevoll eine Islampolitik, getrieben vor allem von CSU und AfD. Dabei ist so vieles, was in Deutschland diskutiert und verhandelt wird, anderswo längst als durchgeführte Politik gelebt worden, nicht ohne Erfolg: in der Sowjetunion.

   Edward Lemon, ein amerikanischer Spezialist für Religionsfragen in Zentralasien, beschreibt in unserem Artikel die nach anfänglicher Repression pragmatisch gewordene Islampolitik der Bolschewisten, ihre Ergebnisse und ihre Beibehaltung in den heutigen zentralasiatischen Staaten.

   Interessant ist dabei der Unterschied, den die Sowjets machten, zwischen “gutem” und “schlechtem” Islam, wie ihn beispielsweise die Salafisten praktizieren. Gehört Proselytismus zum “schlechten” Islam? Wahrscheinlich. Überträgt man das Denkschema auf eine Situation in einem muslimisch dominierten Land mit einer christlichen Minderheit. Dann würde analog Missionsarbeit “schlechtes” Christentum darstellen, vor allem, wenn der christliche Glaube heimlich praktiziert und gelehrt wird.

   Die Sowjets erkannten den Islam zwar als kulturelles Erbe der asiatischen Völker an, fürchteten ihn aber als potentiellen Rivalen oder Kritiker des laizistischen Staats. Nur staatliche Imame predigten daher in staatlichen Moscheen und lehrten staatliches Gedankengut in staatlichen Medressen. Mit einigem Erfolg: noch heute hat der Salafismus in Zentralasien relativ wenige Anhänger.

   Die Gestalter deutscher Islampolitik könnten erkennen, wessen Rezepten sie folgen, wenn sie sich in die Geschichte des Umgangs der Sowjets mit ihrer muslimischen Minderheit vertiefen würden. 

Ihsan al-Tawil

Written on 21 November 2017.

CHAIRMAN PAI CIRCULATES DRAFT ORDER TO RESTORE INTERNET FREEDOM AND ELIMINATE HEAVY-HANDED INTERNET REGULATIONS

WASHINGTON, November 21, 2017—Federal Communications Commission Chairman Ajit Pai released the following statement on his draft Restoring Internet Freedom Order, which was circulated to his fellow Commissioners this morning and will be voted on at the FCC’s Open Meeting on December 14:

   “For almost twenty years, the Internet thrived under the light-touch regulatory approach established by President Clinton and a Republican Congress. This bipartisan framework led the private sector to invest $1.5 trillion building communications networks throughout the United States. And it gave us an Internet economy that became the envy of the world.

   “But in 2015, the prior FCC bowed to pressure from President Obama. On a party-line vote, it imposed heavy-handed, utility-style regulations upon the Internet. That decision was a mistake. It’s depressed investment in building and expanding broadband networks and deterred innovation.

   “Today, I have shared with my colleagues a draft order that would abandon this failed approach and return to the longstanding consensus that served consumers well for decades. Under my proposal, the federal government will stop micromanaging the Internet. Instead, the FCC would simply require Internet service providers to be transparent about their practices so that consumers can buy the service plan that’s best for them and entrepreneurs and other small businesses can have the technical information they need to innovate.

   “Additionally, as a result of my proposal, the Federal Trade Commission will once again be able to police ISPs, protect consumers, and promote competition, just as it did before 2015. Notably, my proposal will put the federal government’s most experienced privacy cop, the FTC, back on the beat to protect consumers’ online privacy."

(More here)

Donald Trump is planning to ruin the Internet. The FCC's repeal is certain to draw a legal challenge from advocates of net neutrality. Many Democrats and some internet firms argue that without the rules, internet providers will threaten the openness of the internet. (The Independent)

Written on 12 November 2017.

   It is a common assumption that the Bolsheviks, after consolidating their hold on power, sought to destroy Islam in Central Asia and elsewhere in the Soviet Union. But Islam during the Soviet era was not so much eradicated as it was institutionalized and rendered subordinate to the state.

   The first decades of Soviet rule were indeed harsh ones for the faithful in Central Asia. Soviet authorities carried out a far-reaching campaign in the late 1920s, dubbed the hujum, which sought to overhaul the traditional way of life, focusing on the de-veiling of women and the closure of mosques.

   Soviet attitudes toward Islam started shifting in the 1940s. At the height of World War II, in 1943, the Soviet government authorized the establishment of SADUM, the Spiritual Administration of the Muslims of Central Asia and Kazakhstan. The hajj was legalized in 1945. And one of Central Asia’s most important seats of Islamic learning, the Mir-i-Arab madrassa in Bukhara, reopened in 1946.

   Under SADUM, religion was tightly controlled; SADUM appointed clerics, published books and organized international conferences to showcase the region as a model for the compatibility of socialism and Islam.

   Only a certain form of Islam was deemed compatible with socialism. This “good” Islam was represented by the state-appointed clergy and did not require Muslims to practice religion, or even believe in God. As Adeeb Khalid has persuasively argued, Soviet officials promoted Islam as part of Central Asia’s national heritage, a way of distinguishing locals from outsiders, yet framed religion in a manner that did not counterpose it against the interests of the Soviet system.

   Conversely, “bad” Islam was characterized as being implacably opposed to the secular Soviet order – dogmatic by nature and used by individuals to trick uneducated citizens into abandoning their ideals. It was likewise seen as operating in spaces beyond the gaze of officials, especially in “underground” mosques often housed in local teahouses or on collective farms. For the Soviets, Islam tended to be seen as a dangerous social force, and a threat to their power. Thus, it was something that needed to be closely managed.

   This bifurcated view of Islam persists today among many members of government across the region, even 26 year after the Soviet Union’s collapse. Contemporary state policies towards Islam more closely resemble late Soviet practices, than post-Stalin era policies resembled pre-war Soviet ones.

   Two incidents in Tajikistan, separated in time by almost 30 years, highlight this reality.

   The first involved 73-year-old Kurbon Mannonov, a representative of the Islamic Renaissance Party of Tajikistan in the town of Nurek, who was arrested in the summer of 2015 along with a dozen other local men. A 13-minute video produced by the Ministry of Internal Affairs accused Mannonov of “illegally spreading religious ideas” and “attempting to establish an Islamic State” through his clandestine activities in Tajikistan.

   The second occurred back in 1986, when Soviet authorities detained Abdullo Saidov, a driver at the Kurgan-Tyube Equipment Inventory-Taking Bureau. Saidov was among 40 individuals arrested for allegedly spreading “religious propaganda.” According to authorities, Saidov’s crime was essentially telling people to stop watching television and to ignore secular holidays; “step by step he slipped into antisocial positions and became socially dangerous.” Saidov would later rename himself Said Abdullo Nuri and go on to become a founder of the Islamic Renaissance Party of Tajikistan in 1990.

   Like authorities during the late Soviet era, officials in Central Asia today tend to view Islam through the lens of security. While state-sanctioned Islam is a source of legitimacy for Central Asia’s autocrats, unmanaged Islam poses a potential threat to stability.

   Of course, Central Asian leaders today like to have it both ways when it comes to religion. When independent states emerged in Central Asia in 1991, the leaders sought to enhance their stature among their respective populations by being quick to highlight their Islamic identity.

   Uzbekistan’s long-time leader Islam Karimov swore his presidential oath on the Koran in 1992. Meanwhile, Turkmenistan’s Saparmurat Niyazov made the hajj to Mecca the same year. All of the republics guaranteed freedom of religion in their constitution. Mosques reopened. Links with the rest of the Islamic world were re-established. Students began studying in madrassas in other parts of the Muslim world, and missionaries arrived to spread awareness of Islam.

   But despite this change in form, the substance of post-independence state narratives on Islam continues to echo the practices and attitudes of the late-Soviet era. Secularized officials and members of well-educated elites tend to see it as backwards and antithetical to social progress. According to one Tajik state-employed journalist, while “knowledgeable and well-educated people are making progress in the fields of nanotechnology and astrophysics, mullahs are talking about the length of beards, and the space between people’s feet while they pray.”

   Where state-sanctioned Islam forms a part of national identity, practices that fall beyond its reach are often deemed “foreign.” State officials in Uzbekistan, Tajikistan and Kyrgyzstan have warned against “foreign influences,” including women wearing hijabs and men wearing beards, arguing that it leads people to terrorism. Interestingly, the national clothing that they promote in its stead was codified during the Soviet Union.

   And as was the case during the Soviet era, “underground” movements, operating beyond state control, are of particular concern for authorities. Although scholars who have conducted research on radicalization in Central Asia have pointed to the ambiguous role religion seems to have played in the lives of terrorists from the region, governments continue to argue that unmonitored Islamization leads to radicalization. Authorities are quick to blame most security incidents in the region on “Islamic extremism,” often presenting flimsy evidence to substantiate these claims.

   State management of religion now, as in the Soviet Union, is assertively secular; the state tightly controls religion and largely tries to remove it from the public sphere. Following the fall of the Soviet Union, each Central Asian state created institutions to replace the function of SADUM, controlling the appointment of imams. Each Central Asian state has passed legislation to restrict the activities of religious groups. Governments have banned groups as diverse as the Salafis, Jehovah’s Witnesses and Islamic Renaissance Party of Tajikistan. Central Asia’s Muslims continue to worship in a controlled space, viewed as a potential threat by the government.

   Not only did 70-plus years of Soviet rule shape the way governments think about the links between religion and security, it also heavily influenced the way citizens practice religion in Central Asia. Ironically, as the anthropological research of Johan Rasanayagam in Uzbekistan, David Montgomery and Julie McBrien in Kyrgyzstan and Helene Thibault in Tajikistan, has shown, the Soviet experience in Central Asia rendered Muslims remarkably resistant to mobilization by extremist groups.

   Most practicing Muslims remain supportive of or ambivalent toward the secular state, rather than being set on its destruction. For many believers, Islam is about security, but not usually in the way that challenges the prevailing order. Instead, Islam provides a framework that allows many in Central Asia to find meaning and certainty in an insecure world characterized by social change, economic hardship and political dysfunction.

Edward Lemon -- Originally published by EurasiaNet.org