Obama Health Care

What should be the defining principle of the Koroma administration National Development Strategy is balance. President Koroma cannot expect to eliminate national development challenges through a unilateral political agenda, to do everything and coordinate everything based on his All People’s Congress (APC) party ideology. His APC party with its “corporate agenda” for Sierra Leone rolled over the incumbent Sierra Leone People’s Party (SLPP) in a run-off that reflected the expectations and desires of a majority of Sierra Leoneans for far-reaching socio-economic change, institutional reform and full inclusion of the mostly youth and indigenous poor. If Koroma is to succeed to reduce Sierra Leone’s grinding poverty and the creation of a more effective, inclusive and just state, however—and he must if his leadership is going to be different from the SLPP administration it replaced—he will need to set priorities and consider trade-offs and show understanding and offer support as he grapples with explosive issues of judicial reforms, corruption and development policy.

The strategy strives for balance in three areas: between trying to prevail in eliminating corruption in his government and preparing for other contingencies; between institutionalizing capabilities such as nongovernmental engagement and supporting the relevance of NGOs as development stakeholders and maintaining NGO’s existing organizational independence and strategic edge in terms of advancing national development objectives through community involvement; and between retaining those cultural traits that have made grassroots involvement in development work possible and discouraging behaviors of NGOs that hamper their ability to do what needs to be done. “In its broadest sense, the term “nongovernment organization” [NGO] refers to organizations (i) not based in government; (ii) not created for financial or material gain; but (iii) created to address concerns such as social and humanitarian issues of development, individual and community welfare and well-being, disadvantage, and poverty, as well as environmental and natural resources protection, management, and improvement” (Asian Development Bank).

Strategic Thinking

The Koroma administration’s ability to deal with performance problems of NGOs will depend on its capacity in handling corruption in government. To be blunt, to fail—or to be seen to fail—in addressing corruption in government would be a disastrous blow to the APC party credibility, both among party supporters and voters and among opposition adversaries. Sierra Leoneans want to see serious effort to address corruption and the injustices of the legal system in the country—and the people of Sierra Leone have lost all patience in this regard. Still, there will continue to be high expectations for Koroma’s zero-tolerance against corruption to be seen to work in Sierra Leone.

Given its endemic nature, corruption, poverty, and the tragic history of violence, Sierra Leone in many ways poses an even more complex and difficult long-term challenge—one that, despite a strong rhetorical effort, will require significant determination and commitment to punish drastically for crimes of corruption for some time. And given the country’s ever changing political game, the resounding victory of Ernest Koroma in the 2007 run-off elections could prove just another wrong turn along the road going nowhere. Sierra Leoneans have already started to question the leadership of Koroma, who in his inauguration in September 2007 announced his zero-tolerance stance against corruption, but “has not had a lot of luck with his cabinet” (The Africa Report). The instances of presumed corruption and shady dealings [the controversial Income Electrix power deal, the suspended Transport Minister Ibrahim Kemoh Sesay 700kg haul of cocaine deal, and the Attorney General Abdul Serry-Kamal Seventy Five Billion Leones Wanza saga] confirm the self-seeking and predatory activities of APC officials, “and that despite the best intentions announced by President Koroma, he [seems to] lack the moral standing and political backbone to implement his ‘zero-tolerance’ policy for corruption and his call for accountability of his cabinet” (The New People Newspaper).  Koroma still has to demonstrate he is following a drummer different from that of every Sierra Leonean leader of the past 45 years.

What is dubbed the war on corruption is, in grim reality, a prolonged, nationwide conventional campaign—a struggle between the forces of blatant corruption and those of moderation. Direct ACC engagement will continue to play a role in the long-term effort against corrupt officials in government and the private sector. But over the short term, a determined leadership may have to use draconian rules of engagement to ending corruption in Sierra Leone. Where possible, what the ACC calls prompt service in addressing corruption cases  should be subordinated to concrete measures by a strong presidency aimed at definitely promoting better governance, economic programs that spur development, and efforts to address the grievances among the discontented which justified the civil conflict that so badly destroyed the social fabric of Sierra Leone over the years. It will take the active engagement as well of NGOs in a collaborative effort over a long time to educate, rebuild and advance infrastructural development objectives.

Sierra Leone is unlikely to experience another civil war—justifiable by the injustices resulting from bad governance and rampant corruption—anytime soon. But that does not mean it may not face similar challenges in a variety of locales. Where possible, a government strategy is to employ indirect approaches—primarily through building the capacity of partner NGOs and their administrative processes—to prevent festering problems from turning into crises that require costly and controversial direct civil conflict. In this kind of effort, the capabilities of the government’s allies and NGO partners may be as important as its own, and building their capacity is arguably as important as, if not more so than, the partisan bickering the government has to deal with.

The recent past vividly demonstrated the consequences of failing to address adequately the dangers posed by bad governance. Rebel networks found sympathy among Sierra Leoneans and strength within the chaos of social breakdown. The small-arms infested State quickly collapsed into chaos and criminality and the worst of catastrophes befell the Sierra Leone homeland—towns and villages were reduced to rubble by rebel attacks as a result of the failed State. The kinds of capabilities needed to deal with such a historically dismal scenario cannot therefore any longer be played down with political rhetoric. Even the smallest of crimes of corruption should require stringent and uncompromising methods of investigations and punishment to avoid this failed State scenario. As Transparency International chair Huguette Labelle has noted, “Stemming corruption requires strong oversight through parliaments, law enforcement, independent media and a vibrant civil society. When these institutions are weak, corruption spirals out of control with horrendous consequences for ordinary people and for justice and equality in societies more broadly” (NGLS Go Between).

In many ways, the country’s national development capabilities are still coping with the consequences of the 1990s, when, with the complicity of the civil war, key instruments of the government of Sierra Leone regulatory mechanisms were reduced or allowed to wither on the corridors of power.  

“Sierra Leone has been a major recipient of foreign aid since the end of a devastating 11-year civil war in 2002. But government, donors and citizens are all questioning how effectively this aid is being used. Allegations of misappropriation of donor funds, both by government actors and NGOs, threaten this inflow. One of the government’s principal partners, the British Department for International Development, withheld aid in protest against such anomalies, for most of 2007 and early 2008 (Fofana/IPS, Freetown). Besides, the Government of Sierra Leone has not maintained a constructive relationship with NGOs.  However, the global push towards reducing poverty has created a new convergence among development practitioners and policymakers as the means of increasing access to new initiatives that will promote good governance and help reduce poverty. Citizen participation has increasingly been taken seriously to increase opportunity for lower income and other excluded populations whose interest are marginalized in classic representative institutions to influence policymaking processes. The government is beginning to appreciate the relevance of civil society in development—that community development lies at the heart of a strong, association-based civil society.

In this regard, the Koroma administration can assume more of the tasks of fostering effective collaboration with local and international NGOs for peace, security and development. To truly achieve victory as the High Level Forum on Aid Effectiveness defined it –“to bring new voices into a review of how aid is managed, and to sketch out a course for greater transparency, accountability and ultimately impact on the lives of the world’s poor—to attain a political objective” (Fofana/IPS, Freetown)–the Sierra Leone Government needs an NGO Coordination Unit whose ability to facilitate the diversion of huge donor funds to the NGO community is matched by its ability to use active evaluations and reviews as learning tools for itself and its development partners.  “The role of the Sierra Leone Association of NGOs (SLANGO), formed in January 1994, to coordinate NGO activities in order that efforts are not duplicated and resources not wasted” (BNET Business Network) has to be differentiated from what the NGO Unit at MODEP is doing; also to understand SLANGO’s relevance in development work.

Given these realities, the NGO Unit of MODEP has, however, been seen to make some impressive strides in recent years. “The revised National NGO Policy following the wide range of consultations held at national and regional levels with the involvement of all stakeholders especially the NGO Community, Line Ministries and Civil Society in the preparation of the policy [was a laudable effort]. The NGO Unit facilitated several meetings with other ministries particularly the Ministry of Finance, the National Revenue Authority (NRA), the Ministry of Labor and other stakeholders to discuss among other things: Duty Free Concessions, Resident/Work Permits and Taxation etc.” (NGO Unit/MODEP).

It can also be suggested that a New Development Operations Manual for a New National Development Strategy is developed to incorporate the lessons of recent years in NGO service delivery doctrine. “Train and equip” programs will allow for quicker improvements in the development capacity of partner organizations. And various initiatives should be undertaken that will better integrate and coordinate government efforts with civilian society agencies as well as engage the expertise of the private sector, including nongovernmental organizations and academia.

Organizational Problems in Perspective

Even as international NGOs hone and institutionalize new and modern management methods, the Sierra Leone Government still has to contend with the organizational challenges posed by local NGOs. The images of NGOs seen by many local people as corrupt and undeserving of support are a reminder that these Civil Society Organizations (CSOs) and their management processes do still matter.  NGOs in the country should be seen to improve their and several partners’ documentation of results, including the development of good monitoring indicators.

In addition, there is the potentially toxic mix of inadequate financial management of NGOs and inadequate reporting on budgetary issues to the Government of Sierra Leone’s NGO Unit. What all these problems portend is that the monitoring of development aid continues to be a major challenge for Sierra Leone and that a thorough framework of monitoring both recurrent and development activities must be put in place. The Government of Sierra Leone cannot take these organizational issues of NGOs for granted and needs to invest in the programs, platforms, and personnel that will ensure their relevance as development stakeholders.

But it is also important to keep some perspective. As much as the MODEP’s NGO Unit has come up with revised policy regulations with collated information in respect of funds disbursed by donors to NGOs for the implementation of programs it must be remembered that what is driving MODEP is a desire to exorcise the sloppy performance of NGOs over the years and to make them more relevant as development stakeholders—not an ideologically driven campaign to micro manage NGOs in the country. “Understandably, the logic behind massive NGO presence in Sierra Leone was to create a civic culture, pluralize the political, economic and social arena and bridge the gap between the masses and the State. So NGOs thus act as intermediaries between, what donors call ‘the unorganized masses’ and the State and are expected to represent the people and express their voices in policymaking. In fact, among NGOs is a small sector of voluntary organizations that genuinely monitor regimes, engage in advocacy on behalf of the poor and serves as watchdogs in ensuring that government contractors deliver services”.

It is true that the Poverty Reduction Strategy Paper (PRSP) with clear link to the Millennium Development Goals (MDGs) is the main focus of Government and its development partners. “The PRSP calls for pro-poor sustainable growth. However, achieving this means maintaining macro-economic stability IMF-style with low inflation and strict fiscal deficits, despite research by CSOs and development agencies which seriously question the poverty impact of these types of policies” (European Network on Debt and Development). NGOs’ participation was recognized in the process. NGOs could now play an active role in the implementation process by shifting their interventions and assistance from relief/humanitarian programs to sustainable infrastructural development programs. Answerability and transparency, adequate financial management and adequate budgetary reporting are to be the watch words in the new dispensation.

NGOs in Sierra Leone may have their organizational problems, but they can be quite relevant stakeholders in promoting people’s participation in poverty reduction programs. Use of funds has not been cost effective for most NGOs but the thematic areas most of these NGOs focus on (health, education, skills development, micro-finance, skills training, etc.), are relevant for the end users that are often poor and vulnerable children, youth and women. These are priority support areas that are in accordance with Sierra Leone’s development priorities and the PRSP as well international development agencies’ priorities.

Now that the performance bar has to be raised for the government and NGOs following their dismal performance in terms of handling aid money, the Sierra Leone Government must now endeavor to maintain a credible strategic relationship with NGOs through effectively evaluating, reviewing and monitoring their activities. Toward this end, the steps the NGO Unit at MODEP is taking to return excellence and accountability to NGO stewardship are commendable. Presidential and Parliamentary oversight may also be necessary for a more reliable and sustainable NGO Unit coordination effort.

When thinking about the range of strengths, weaknesses, opportunities and threats (SWOT) of non-governmental organizations as development partners in Sierra Leone it is reasonable to understand that NGOs come in many shapes and sizes. Data used in the SWOT analysis stem from multiple sources including statistical reports, literature review, regulations and policies, and research articles by NGO professionals. These findings should provide a valuable reference for the Government and the international development community who are interested in developing excellence in the civil society organization which interestingly can provide some feed back into the effectiveness aspects of the development analysis.

Strengths

Grassroots (local) NGOs

• Have a positive presence on the ground.
• Demonstrate ability to seek common ground and commitment to poor and marginalized grassroots populations.
• Enjoy confidence and trust of local populations.
• Have experience-based knowledge of cultural, political and socio-economic conditions of indigenous populations.
• Understand vulnerabilities unique to local beneficiaries.
• Can achieve extreme flexibility with fewer resources and lower costs.
• Possess valuable experience, content and fundamental working knowledge about local trade issues and business contacts in their field.

International NGOs

• Have global appeal and have developed industry-wide reputation for positive work.
• Good at generating and mobilizing resources and core competencies for their operations.
• Ability to resolve issues of legitimacy and to address political and policy constraints.
• Ability to harness expert opinion to influence public opinion and policy-makers.
• Have paid core staff to ensure the quality of project work.
• Possess valuable experience, content and fundamental working knowledge about international trade issues and the labor market and business contacts in their field.

Weaknesses

Grassroots (local) NGOs

• May have limited financial and expert resources to support end-user development.
• May have limited strategic perspectives and weak linkages with other actors in development.
• May have limited managerial and organizational capacities.
• May sometimes miss the big picture on macro perspectives on capital markets, economy and geopolitics vis-à-vis community development.
• Indigenous NGO operators may be prone to corruption.
• Because of their voluntary nature, there may be questions regarding their accountability and credibility.
• May have difficulty managing operations on financially sustainable basis.
• Are not sustainable on membership fees alone.

International NGOs

• Some advocacy NGOs working to influence the policies and practices of governments, development institutions have limited implementation capacity.
• Questions sometimes arise concerning their motivations and objectives, and the degree of accountability they accept for the ultimate impact of policies and positions they advocate. Sometimes accused of “selling out” when they work with government or corporations.
• May find it hard to placate or manipulate special interests.
•  Suffer fluctuations in maintaining non-profit donations revenue streams.
• May have limited experience with poor populations and operations may not reflect the needs of communities.

Opportunities

Grassroots NGOs

• Can effectively work with community partners to assess local problems and opportunities and to promote export development programs.
•  Ability to implement successful training programs and advance participatory development.
• Ability to integrate their local expertise and experience in health and education initiatives in community development programs.
• Can be clearing-houses for local trade information.

International NGOs

• Ability to work out credible partnerships with government and private corporations to mobilize public opinion to increase influence on poverty reduction programs and trade issues.
• Effective at bringing the voice of efficient organizational practices into NGO work in developing countries.
• Ability to contribute sector-specific expertise to help producers add value, improve quality and find new export markets.
• Quite familiar with political and social accountability mechanisms that complement their interventions and advocacy work.

Threats

Grassroots NGOs

• Isolated and poorly coordinated efforts may have negative program outcomes.
• Lackluster relationship with trade and export development corporations causing unsustainable initiatives and lack of trade development solutions.
• Lacks technical capacity to connect poor people with trade and export opportunities.I

International NGOs

• Tendency to ignore the voices of the poor represented by the experience and professional input of local agencies when defining the dialogue and public understanding of trade and development issues.
• Inclination to compete by lobbying against one another thereby distracting policy-makers on major issues.
• Often accused of hijacking the macroeconomic policy making dominated by technocrats and external consultants in the process.

Overall, by sorting the SWOT issues of grassroots (local) and international NGOs into planning categories one can obtain a system which presents a practical way of assimilating the internal and external information about NGO work in Sierra Leone, delineating short and long term priorities, and defining and developing coordinated, goal-directed actions, and allowing an easy way to build management teams which can achieve the objectives of development growth and the essence of civil society. In reality, as the philosopher Michael Ignatieff has noted “without civil society, democracy remains an empty shell”. One can expect to see the efficacy of Civil Society Organizations to influence members of the wider public that adhere to their values and beliefs to engage in development programs at State and community levels.

Therefore, notwithstanding local NGO’s relatively dismal record they are still clearly quite relevant to the development equation. NGOs strengths can be harnessed with well coordinated capacity building programs.  Conversely, international NGOs can develop a partner strategy of supporting and working through strong professional local partners as an effective tool for having a greater development impact than being a self-implementing agency. NGOs can also be very effective as learning organizations by providing important support to build their own staff’s and partners’ capacities, through individual training activities, annual partner meetings and conferences, learning exchange between partners, and partner self-assessments of training needs.  Moreover, NGOs can also be very effective with regular active evaluations and reviews as learning tools for themselves and their partners.

Just as one can expect learning should be at the heart of these organizations, so too, should the Government of Sierra Leone seek a better balance in the portfolio of capabilities it has—the types of programs against corruption in government fielded, the punishment in place for crimes of corruption, the training done.

Moreover, given the development challenges Sierra Leone is struggling with—and given, for example, the struggles to field up hospitals and clinics, schools and colleges, maintenance of urban and rural roads, and the HIV threats to the society—the time has come to think hard about how to institutionalize the capabilities of NGOs and get them adequately fielded quickly. The NGO policy modernization programs of the NGO Unit at MODEP should seek a 99 percent solution to the organizational limitations of NGOs in the country and to build the kind of innovative thinking and flexibility capable of supporting rigid development processes.

Sustaining Organizational Performance

The ability to fight corruption in government and empower NGOs sometimes simultaneously fits squarely within the finest traditions of good governance, more so because adequate financial management, including adequate reporting on budgetary issues is key to sustained organizational performance of NGOs. For most NGOs in Sierra Leone, unsatisfactory practices with regard to vehicle and fuel use, procurement procedures and weak financial reporting and accounting are weaknesses which are also typical issues in bad government. Improving documentation of results, including the development of good monitoring indicators is also essential for sustaining organizational performance. The non performance of NGOs is coming at a frightful human, financial, and political cost. There has to be organizational improvements in government so that NGOs can be more resourceful and relevant to the development equation.

One of the enduring issues the NGO Unit at MODEP’s struggles with is whether personnel and organizational systems designed to coordinate the work of NGOs in the country will be able to reflect the importance of advising, training, and equipping NGOs in Sierra Leone—something still not considered a career-enhancing path for the best and brightest organizational development experts.  Another is whether the revised policy regulations can be adapted well enough and fast enough to empower NGOs—or, more significant, to build the capacity of local NGOs to make them more resourceful.

One can make the argument in favor of institutionalizing NGO skills and the ability to conduct stability and support operations. This has to be done and is necessary for maintaining the current advantage of the relevance of NGOs as development partners. Apart from recent revisions of NGO policy regulations there has been no strong, deeply rooted constituency inside MODEP or elsewhere for institutionalizing the capabilities necessary to support NGO work in Sierra Leone—and to quickly meet the important needs of civil society organizations engaged in development work in Sierra Leone.

Think of the important work of NGOs in Sierra Leone.  NGOs often make the impossible possible by doing what governments cannot or will not do especially when new challenges crowd the national agenda. Increasingly, NGOs operate outside existing formal frameworks, moving independently to meet their goals and establishing new standards that governments, institutions, and corporations are themselves compelled to follow through force of public opinion.

Some humanitarian and development NGOs, for instance, have a natural advantage because of their perceived neutrality and experience. Amnesty International – Sierra Leone Section, for example, (as listed on the webpage directory of NGOs maintained by UNDP Sierra Leone promotes and protects human rights through advocacy and human rights education—maintaining documentation on human rights abuses and violations carried out during the ten year rebel war in Sierra Leone which proved helpful to the TRC in Sierra Leone. Other groups such as the Campaign for Good Governance (CGG) is a democracy-supporting NGO in Sierra Leone which promotes the building of democratic institutions, transparency and accountability in government, active citizen participation in the political process, voter education, human rights, and the rule of law. The Catholic Youth Organization (CYO) organizes religious, educational, social and cultural programs to meet the spiritual, mental and recreational needs of members. The Centre for Coordination of Youth Activities provides training in leadership, peace building, skills development, and community development. The Kailahun District Development Foundation (KADDF), a district-wide non-governmental organization offers viable solutions to the pervasive problems of poverty and serves as a clearinghouse for outside agencies interested in carrying out programs in the Kailahun district. The Sierra Leone Adult Education Association (SLADEA) helps to reduce the high rate of illiteracy among adults in the non-formal sector; to enlist the co-operation and support of other NGOs with a view to motivating various forms of people’s participation especially women and youth in national development; to achieve public recognition and support for non-formal education sector. FORUT’s thematic areas (health, education, skills development, micro-finance, skills training, etc.), are relevant for the end users that are often poor and vulnerable children, youth and women. Action Aid is one of the largest NGOs operating in Sierra Leone promoting food security through agricultural programs to ensure seeds are available and crop production continues.

There is no doubt, therefore, that modernization programs will continue to have, and deserve, strong institutional and parliamentary support. There has to be the enabling environment needed to make sure that the capabilities needed for the complex organizational issues of NGOs also has strong and sustained institutional support over the long term. The need for an NGO Unit establishment that can make and implement decisions quickly in support of NGOs working in Sierra Leone is necessary.

In the end, the NGO capabilities needed cannot be separated from the cultural traits and the management structure of the institutions the Sierra Leone Government has: the signals sent by how funds are managed, what projects are funded, what skills are used to implement projects and how personnel are trained. As Foreign Minister Lloyd Axworthy has said, “Clearly, one can no longer relegate NGOs to simple advisory or advocacy roles. . . . They are now part of the way decisions have to be made.”

As Yale professor Steve Charnovitz has observed, NGO involvement seems to depend on two factors: the needs of government and the capabilities of NGOs. A good democracy encompasses all NGOs which strive to create formal but flexible systems fostering dynamism and self-adjustment. NGOs ought to be a part of the alternative development paradigm, because the State, its institutions, and public policy, are unable to address a host of issues of underdevelopment all alone.

Evidently, there are many NGOs today in Sierra Leone in different shapes and forms with substantial amounts of donor and individual funds being diverted through them for developmental purposes. These NGOs are thought to be participatory, community-oriented, democratic, cost effective, and better at targeting the poorest of the poor, although in recent years, the nimbus of righteousness around NGOs has almost disappeared, and there is wide acknowledgement of their inability to deliver what is expected from them. Many lessons, however, about NGOs in Sierra Leone present themselves. Two of the most important are an understanding of organizational challenges and a sense of determination to change. The determination and national reach of NGOs has been an indispensable contributor to national peace and stability. The NGO Unit at MODEP should be clear about what effective organizational management by competent operators of NGOs can accomplish. No matter what their aims, all organizations share two things in common: They are made up of people, and certain individuals are in charge of these people. NGOs therefore need strong managers to lead its staff toward accomplishing development goals. And these managers are more than just leaders—they are problem solvers, cheerleaders, and planners as well.

Think of the intricacies of management, for instance. No matter what type of organization they work in, NGO executives are generally responsible for a group of individuals’ performance. As leaders, they must expect their fellow workers to work earnestly to reach common NGO goals. As the management guru Peter Drucker said, “Executives owe it to the organization and to their fellow workers not to tolerate nonperforming individuals in important jobs.”

In national affairs, “aid can work where there is good governance,” the United States Congressional Representative Lee H. Hamilton wrote in his book on – A Legacy of Honor: The Congressional Papers of Lee H. Hamilton, U.S. House of Representative 1965-1998 Indiana Ninth District, “… and usually fails where governments are unable or unwilling to commit aid to improve the lives of their people.” It is thus believed any responsible National Development Strategy for Sierra Leone should provide a balanced approach to enhancing responsibilities and preserving the relevance of NGOs as development partners.

Kenday S. Kamara
http://www.articlesbase.com/non-profit-organizations-articles/a-balanced-strategy-reprogramming-ngos-and-enhancing-their-relevance-as-development-partners-in-sierra-leone-741482.html

President Obama has won the great health care battle. Give him his due. But on the way, he didn’t take any prisoners, at least not amongst the evil health insurers.
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Mocking critics, President Obama promoted the historic health care reform bill that he signed last week.
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What do people think about Obama Care, and what does it hold for the future of most people in America?  It seems that most who were not in favor of Obama care before it became law are still not too impressed.  Some feel that jobs that are offered once the recession ends will be far less likely to offer health insurance, mostly due to the costs involved.

For many people, the healthcare plan is one that isn’t easy to understand.  Some feel that the ones who will benefit most from Obamacare are those who are now uninsured and earn incomes that are below the poverty line.  For the first time, it is believed that many American families (those between 133% and 400% of the poverty line) will be able to afford health insurance.  Families with incomes of up to 133% of the federal poverty level will receive expanded Medicare coverage.

What a big majority of people do not understand about Obamacare is that subsidies will be unable to make health insurance affordable, which means they will still be forced to buy a policy – or, face a stiff fine of $695 from the IRS.  Small and large business owners that fail to provide insurance for their employees face fines as large as $2,000 for every worker in their employ.

Many people feel that Obamacare has been shoved down their throats, regardless of whether this is what Americans want or not.  There are ramifications of the true meaning of Obamacare that many people are totally unaware of, and facts regarding the “reform” that Democrats do not want people to know about.  Here are a few of those facts:

Obamacare cuts Medicare by $523 billion, and increases insurance premiums by approximately 10% for those who are not insured by their employers.

This healthcare plan will cause 9 million people to lose the insurance they have at the current time; when all is said and done, and the bill fully implemented, 23 million individuals will remain without insurance in the year 2019.

Obama care raises taxes on small businesses by about $569 billion; it also creates a new marriage penalty with investment taxes and new income.

Allows the IRS the power to fine those who do not purchase government-approved insurance, and raises the already out-of-control deficit by $260 billion over the next 10 years when all components of the bill are included.

While it is clear that many people will benefit from health insurance coverage, it is also evident that Obama care will cost big time in other areas.  Many Americans do not like the fact that it seems the freedom to choose or make decisions about health care is being taken right out of their hands, and handled by the federal government.

There are many little “hidden” details regarding Obama care; the funny thing is, while it benefits one person it detracts in another area.  Take for example the change that allows children up to the age of 26 to remain on their parents policy.  What if that child is covered on an employer policy where the parent works, and the employer would rather offer coverage that doesn’t allow what may appear to be lazy children on the policy?  It’s just too bad for the employer.

With Obama Care, what happens if you are a health insurance provider and want to raise premiums to cover cost increases?  It could be that you will be denied by the Secretary of Health and Human Services, if they deem the increase is unreasonable.

It appears that Obama Care has its good points and bad, and only the future can determine if it comes out successful in the end.

Markets are in an ugly, bearish mood in 2008. They are down 20% on average across the world. So what are the markets telling us? Is it that we are in a recession, depression or an economic trough? Or is it that monetary, fiscal and trade policies in the major countries, especially the US, are wrong. Count on the latter and discount the former. Markets are telling us some very important lessons.

It is doubtful that with full employment, strong corporate profits; increasing net incomes of 5% per year, and 5% GDP growth world-wide, that the economy – any economy – is in a recession. An economic downturn or less than robust growth certainly, but not a full recession of two subsequent quarters of negative GDP growth. So if the economy is not as bad as the media experts keep telling us that it is, why are markets retreating at a panicked rate?

Markets are sending three important messages. The first has to do with taxation levels. Tax levels across the industrialised world are far too high. Government share of GDP keeps rising, not falling, and in the US and Europe governments now consume 35% and 44% respectively, of the total gross economy. So when it appears that the US Democrats, poised to win the next election, constantly discuss raising taxes, tariffs and putting trade agreements in jeopardy, the markets will sell off.

When politicians in the US and Europe discuss increasing spending to offset economic weakness, the markets send a second important message. Fiscal stimulus which means handing people money and cheques, paid for with deficits and debt and ergo higher taxes, damages the economy. This demand-side Keynesianism has always been a failure.

From ‘Great society’ make-work projects like digging holes or building roads, to mailing cheques to people, fiscal stimulus does nothing to stimulate real private sector business activity. It simply transfers money from one group of people to another, and takes money from the right hand and gives it to the left hand. The end effect is actually negative, and like papering over dirty walls full of holes, fiscal stimuli are ephemeral measures which do nothing to address the real economic problems and threats to longer term economic growth.

The third point the markets are sending is that monetary policy is confused. As the economy slows, which it is surely doing in the US and Europe, two great and opposed ideas come into focus. Inflation as given by record high gold, oil and commodity prices, not to mention rising health, education and food costs, is a threat. High interest rates are needed to tame inflation, but such rates deter economic growth and capital investment.

What markets don’t like is when central banks are indecisive, weak, or contradictory. The US central bank or Federal Reserve is a case in point. For some reason this central bank has decided that it must talk more, provide forecasts and reveal all its details to public scrutiny. The end result is predictable.

Every time the Fed talks it sends markets lower. The very nature of a central bank makes simple forecasting and easy analysis impossible. So they must talk in code and hedges. Markets don’t like uncertainty. In this regard central banks would be better off saying less and doing a little more. In times of an economic slowdown and inflationary risk, the central bank must necessarily lower rates but only to prudent levels. It must also loosen monetary policy and provide some capital stimulus.

Neither the European nor the American central bank is doing what markets expect. The European central bank is concerned about inflation far more than it is about economic growth – which is its single mandate. So rates if they come down in 2008 will come down too little and too late to stimulate the economy. In the US, the central bank has bizarrely loosened money supply; lowered rates to unacceptably low levels thereby deflating the U$ and generating inflation. This plan is not something that any prudent central bank should be doing. US rates must rise to ward off 7% inflation and restore confidence in the US$, but given that the US is in an election year, the earliest rate support for the U$ will come in 2009 – by then inflation will already have destroyed literally trillions of dollars in wealth. Inflation is after all just another tax. The markets view all of this rather dimly. Markets recognise that a US election will offer up cheap populism including spending promises and certainly under Hussein Obama massive tax increases.

The predictable result of poor central bank and fiscal management is a market sell off.

Certainly other factors affect the markets. The 1% or worse of US mortgage debt going bad, along with the associated financial instruments or derivatives, is a good reason for market concern. When the financial and banking system comes under duress the markets will sell off. There is a direct corelation between the health of the financial system and market performance.

Yet when viewed in context these problems are reasonably minor. Of the 10 major economic sectors, 8 are healthy and have posted reasonably strong results in 2008 and are set to have good years in 2009. Corporate and income growth are certainly slowing along with general economic growth, but a massive general recession it is not. We are witnessing another crisis of confidence in central banks and politicians and this is reflected in a pretty mild economic downturn.

One of the signal lessons of the Great Depression was that governments cause economic contractions. The 1929 stock market crash occurred because of massive tax increases, higher tariffs, and more government spending. Investors saw what was going to happen and sold off in anticipation of lower profits and economic growth. Capitalism per-se had nothing to do with the onset of the 1930s Depression. Bad government fiscal and monetary policy and the rigid inflexibility of the Gold Standard caused the Depression.

The same rules apply today. The markets are anticipating a rancorous victory in 2008 by the European socialist party of the United States. When that transpires taxes and tariffs and government spending will rise. Every time an American politician or the US central bank discusses ‘stimulus’ or ‘solving’ economic problems, the market sells off. The message is clear.

What we need are tax cuts on income and investments, lower interest rates and more liquidity. This stimulates economic growth, not government handing out money to people. Populist politics might make good TV with air-head talk about hope, change, renewal, and ‘stimulus’, but it is the anti-thesis of what markets need and expect.

That in summary is why 2008 will be a rough year overall for investors. Simply put – we are in an election cycle and have incompetent central banks to contend with.

C. Read
http://www.articlesbase.com/news-and-society-articles/falling-bear-markets-are-sending-some-important-messages-681932.html

There’s been some talk lately about the government banning the popular acai berry supplements, possibly putting the kibosh on one of the best super foods out there.

I’m all for some change, I hope President Barack Obama really pulls this country out of the gutter. But I hope he doesn’t put new regulations into the market that stops us Americans from getting what we want with our money.

The government is even trying to ban some really popular vitamins because people are doing some shady things to sell them. Scams are true in all markets, especially in the food and drug business. But due to the popularity of the acai berry explosion, an acai berry conspiracy might not be too far from the truth.

Go find the bad eggs I say — don’t penalize the rest of us because some jerks are giving acai berries a bad name with their pyramid schemes and scams.

We as Americans have to take care of ourselves anyway, a little simple reading can help you avoid the scams and purchase the berries through a good seller.

My wife went online to buy acai berries, and she loves them. And I love them since she’s looking hotter than she has in years. But she did what I suggested and read up on the super food. She even wound up getting finding a place to get free acai berries.

She said she did find a lot of acai berry scams, but it was easy to see which people were just saying anything to get her to buy. She also made sure to look up each company before buying anything, not to mention reading all the fine print. The berries are definately worth paying for after the free trial is over. Every American deserves to know about the “hidden costs” with some acai berry offers. If you don’t want to pay, cancel before your trial period is over!

Tell your lawmakers not to treat us Americans like morons, tell them we can make our own decisions about what we buy and can educate ourselves on those internet scammers.

Don’t let the government take your rights away!

Get Free Acai Berries @ http://www.freeacaiberries.com

Kelsey Carson
http://www.articlesbase.com/supplements-and-vitamins-articles/will-the-man-ban-acai-berries–742852.html

It is highly likely that you have seen ads where employers are wanting medical billing and coding professionals. They are two of the most important careers in the healthcare industry, which is in high demand.

Though surely this is not the first time that you have heard about these terms, but do you really know what a medically billing and coding person does?

Both medical billing and coding belong to the group of service providers to doctors, who are too immersed in their professions to have the time to file for insurance claims to get paid for their services. Most patients today are tied with health insurance companies who pay for their healthcare needs. But how does the doctor get paid? They have to file claims for reimbursements for the services rendered to their patients. It is at this juncture that the medical billing and coding professionals step in.

A person knowledgeable in medical billing and coding is usually considered an expert in his field because of their highly-developed skills. These professionals are remunerated according to their training, experience, skills and the effective application of these skills. It is said that a medical billing or coding person can earn any where between $33,370 and $415,061 annually. This kind of income surely attracts many ambitious individuals in this field.

Which are the people or institution who seeks the help and support of medical billing and coding personnel? These would normally include physicians, clinics, hospitals, and patients in handling allied health issues. Also included are various medical offices and health insurance companies, and many more allied institutions. According to the US Bureau of Labor Statistics, medical billing, coding and health information technicians are among the ten fastest growing careers in the healthcare industry.

It is important however to note that entering either medical billing of coding profession is an easy task. These jobs require a high degree of skill, expertise and experience in handling several important and critical areas of healthcare management including billing and accounts receivable, medical office management, insurance claims processing, submitting claims, etc.

The whole process of medical billing and coding would start much ahead of the patient actually turning up at the medical center and finishes long after the patient has been diagnosed and prescribed medicines. This is to avoid any delay, inaccuracy or miscommunication during filing for insurance claim.  Hence it is important to verify and rectify the insurance benefits much before the patient lands up at the clinic. After the doctor has seen the patient, his observations are recorded in the medical record which is converted into appropriate codes for coding the insurance claim.

While undoubtedly medical billing and coding can become a very challenging career it could be rewarding too if you can become an expert in the field. With proper education and training, the sky is the limit as far as your personal achievements are concerned in this field.

One of the best parts about this profession is that depending on the company that you work for, you could do the job from home too. This is a very viable option for many who enter this profession. All you need to do is to consult your local college or adult education center and make enquiries about the details about their medical billing and coding programs.

Marlon Dirk
http://www.articlesbase.com/personal-finance-articles/a-career-in-medical-billing-and-coding-727482.html

There is a storm brewing in America. It has the power to ruin lives directly and indirectly. The storm will wreak more havoc than any natural disaster in history. The name of the storm is not a common name like Katrina. This storm’s name is called “America’s Health Care Crisis.” The early signs are already here. Just consider these facts:

* Every 30 seconds, someone in the United States files bankruptcy due to a serious health problem.

* According to a Harvard University study, 50 percent of all bankruptcy filings in the United States are the direct result of medical expenses.

* Health care spending in the U.S. is more than $1.8 TRILLION!

* In 2003, the U.S. spent 15.3% of its Gross Domestic Product (GDP) on health care.

* Premiums for employer-sponsored health insurance in the U.S. have risen five times faster than workers’ earnings since 2000.

* Experts predict retiring elderly couples will need a conservative $200,000 to pay for basic medical services and most experts agree that the number is probably closer to $300,000.

With the cost of services going up, the demand for those services is also increasing. Consider the following:

* Cancer rates have exploded from 1 death in 20 in 1910 to 1 death in 3 in 2006.

* Diabetes Type 2 (adult onset) has exploded by 600% in just the last generation.

* Heart Disease deaths went from obscurity in the early 1900’s to the #2 killer in America.

* Stroke moved from obscurity to the #3 killer and the #1 cause of disability in the US.

* Auto-immune disorders like Chronic Fatigue and Fibromyalgia have become commonplace.

Why is this happening? What could be the common link? Many experts believe it is what we eat. Not just the types of food and how they are prepared, but the actual nutritional content. Over a 10-year period, the potassium level in oats and buckwheat dropped by two-thirds. That means you need to eat three bowls of oatmeal to get the same potassium as one bowl gave you just ten years ago. Think about you and your children – over the last ten years you and they have eaten the same amounts of food but with much less nutritional content. In the fifty years between the 1940s and the 1990s, nutrient values for protein, calcium, phosphorus, iron, riboflavin, and ascorbic acid declined in at least 43 garden crops.

What’s the answer? What can we do to add nutrition back into our diets and our bodies? What can we do to keep from spending all our savings on medical bills? How can we continue to enjoy an active lifestyle well into our senior years?

The answer is simple: Supplement.

Even the FDA, along with a growing number of nutritionists and medical experts agree that nutritional supplementation is the key to leading a healthy and fit life. Read why more and more people are being proactive about improving their health and at the same time they are fighting the effects of aging. I encourage you to examine the nutritional content of your current diet. You can definitely look and feel better with proper nutrition.

As we get older, many of us start taking more and more medications. Consider that while Americans comprise only five percent of the entire world’s population, we consume ONE-HALF OF ALL the prescription drugs manufactured WORLD WIDE! That is more than 3 billion prescriptions each year. Prescription drug expenses are the fastest growing health care costs increasing by more than 15% each year since 1998.

The pharmaceutical industry has done a great job at convincing people that drugs are intended to cure disease. But if prescription drugs were the answer to health, why aren’t we the healthiest nation on Earth? In spite of all the drugs, the physicians, and the hospitals, Americans are getting heavier; the rate of diabetes, heart disease, and cancer are rising; and we have one of the highest infant death rates in the world.

We need to transition from our over-reliance on drugs and believing that taking a pill is the ‘solution’ to finding and treating what caused the disease in the first place. It is certainly fair to say that traditional medicine can do amazing things – especially in treating trauma and infectious disease. But for promoting health, traditional medicine is ineffective and extraordinarily expensive.

Many in the wellness industry work very hard spreading the word that it is much better (and cheaper!) to prevent disease than to treat it after it occurs. Preventing disease and fighting the effects of aging are two of the primary reasons why many people take supplements and how they become proactive about improving their health. By putting yourself into a state of optimal health, you feel better, have more energy, and increase the quality of your life.

Ronald Godlewski
http://www.articlesbase.com/health-articles/how-to-avoid-the-high-cost-of-healthcare-286876.html

I have been working on the battle for affordable health coverage for all for the longest time, and some people actually view me an authority in this area. I have worked with the employed, unemployed, and retired on getting affordable medical coverage, so let me tell you how things stand in the fight. Most people probably already have an idea that it can be very hard to find access to low priced health coverage. Unless your employer covers you, or you are a civil servant, you will probobly be overpaying for your health care coverage, and possibly alot more than you would think. For this reason, many people across the state and across the country are trapped in dead end jobs in the hopes of keeping their affordable medical coverage. Although they are not doing satisfying work, or advancing their careers, they have to stay with the same old gig because, if they do not, they will lose their health insurance and be in real trouble.

Among the people without low priced medical coverage are many children in this country. Let us face it, despite being the very richest country in the world, we have failed many of our citizens, even children, in not providing them with the access to affordable health coverage which is certainly, quite literally, a matter of life and death to multiple. Without affordable health insurance and good nutrition, masses of of the poorest are chronically sick and struggling with their medical expenses, unable to pay which it is that they owe, and so always under the crushing weight of poverty.

Although there are plenty reformists who are actually industry flunkies claiming that all is very possibly needed is most definately a little reform to insure affordable medical insurance, anyone who has been on the front lines like I have been will tell you the bare truth. The best route to low priced health care coverage is most definately obvious, and has been obvious for a good long time. As a nation, we just can not go without having single payer health care coverage any more. With single payer health care, every citizen of the country will be guaranteed well priced medical insurance, paid through their taxes. Although some people say that it can be too high priced to add a new service, it will be, in fact, much cheaper than paying private, for-profit industries to insure us as we do now. It may quite be really the natural solution to each and every one of our low priced medical insurance problems faced in America every today.

Christopher Taylor
http://www.articlesbase.com/finance-articles/an-opinion-on-affordable-health-coverage-140601.html

While reformers are far from pleased with the initial rollout of President Obama’s drug policy agenda, treatment activists can at least point to a significant change in the federal stance on clean needle exchange programs. Unlike former President Bush, who supported a ban on federal funding of such public health programs, Obama’s agenda, as spelled out at Whitehouse.gov, calls for rescinding the ban in an effort to save lives by reducing the transmission of HIV/AIDS. “The President,” according to the agenda, “supports lifting the federal ban on needle exchange, which could dramatically reduce rates of infection among drug users.”

Opponents of needle exchange say the effort is similar to the medical marijuana movement—a stealth strategy for the legalization of drugs. However, as I wrote in an earlier post, the administration’s support of needle exchange is a timely recognition that cities like Vancouver and San Francisco are already experimenting with the notion of safe drug injection sites. (Part of the argument in favor of such sites is the opportunity for clean needle exchanges.)

Under the heading “Civil Rights,” the White House web site has also signaled support for the expanded use of drug courts to allow non-violent offenders into “the type of drug rehabilitation programs that have proven to work better than a prison term in changing bad behavior.” The agenda also calls for the reduction of sentencing inequities (“President Obama and Vice President Biden believe the disparity between sentencing crack and powder-based cocaine is wrong and should be completely eliminated”).

An article in the Drug War Chronicle notes that “reformers may find themselves pleased with some Obama positions, but they will be less happy with others. The Obama administration wants to reduce inequities in the criminal justice system, but it is also taking thoroughly conventional positions on other drug policy issues.”

To wit, marijuana. Activists were hoping for a clear demonstration of support for the use of medical marijuana. So far, that hasn’t happened. Marijuana is not mentioned at all in the relevant sections of the online policy agenda, though the document is known to be a work in progress.

Nonetheless, it might be well to heed the advice offered by the U.K.’s Transform Drug Policy Foundation: “Lifting the disgraceful needle exchange funding ban is a good start considering we are only in day one—and the generally pragmatic tone bodes well. Can we be cautiously optimistic? Yes we can.”

Dirk Hanson
http://www.articlesbase.com/politics-articles/obama-to-lift-ban-on-needle-exchanges-742855.html