Sunday, July 8, 2018

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Editorial - Do Poor People Have a Right to Health Care?

The 16 Kentuckians who recently won a lawsuit challenging the legality of Medicaid work requirements include a law student with a rare heart condition, a mortician with diabetes, a mother of four with congenital hip dysplasia and a housekeeper with rheumatoid arthritis. It’s a mixed bunch, united by two grim facts: They live at or below the federal poverty level, and they’re caught in the cross hairs of a debate over what society owes its neediest members.
Their lawsuit argued that insisting that people work a certain number of hours a month in order to receive Medicaid benefits, like other requirements the state was planning to demand, is illegal because it runs counter to Medicaid’s purpose — to ensure that low-income people have access to decent care. The lawsuit also contended that such requirements would imperil the plaintiffs’ health by depriving them of the only medical insurance they could afford. The new rules, which would have stripped recipients of their benefits if they failed to meet monthly hours-worked quotas and strict reporting standards, were simply oblivious to the realities of low-wage living in Kentucky, and America in general.
On June 29, two days before those requirements were to take effect, a District Court judge ruled decisively for the plaintiffs, calling the Department of Health and Human Services “capricious” for approving Kentucky’s plan at the beginning of the year and lambasting Secretary Alex Azar for failing to consider the impact the measures would have on those in need. “The record shows that 95,000 people would lose Medicaid coverage,” Judge James Boasberg wrote in his decision. “And yet the Secretary paid no attention to that deprivation.”
Those statements are but the latest salvo in a protracted national reckoning over Medicaid, a program that has been in place for more than half a century and now insures one in five Americans, or roughly 74 million people. In January, the federal government announced that it would reverse decades of precedent and allow states to tie Medicaid coverage to work requirements. The move is part of a wider conservative-led campaign to restrict the number of people who benefit from social safety-net programs. It also reflects persistent national ambivalence over the question of whether health care is a human right or an earned privilege — and, if the latter, how “earned” should be defined.
Nearly a dozen other states are planning to put into effect programs like the one now blocked in Kentucky. The future of those initiatives is uncertain. As the Kentucky ruling makes plain, the arguments underpinning them are fatally flawed.
For instance, proponents say that work requirements fulfill the edicts of Medicaid because gainful employment is key to healthy living — higher earnings have been tied to longer life spans, and unemployment to shorter ones. That correlation is valid, but backward: Health is a prerequisite to employment, not the other way around. Medical problems are a common cause of job loss among the poor, because low-wage jobs offer few accommodations or protections for workers who become suddenly or chronically ill. Likewise, the argument that work requirements will help contain costs and keep Medicaid afloat seems fair enough on its face. States across the country are facing real strain as they try to rein in health care costs in general, and cover their share of Medicaid expansion in particular. But work requirement programs will not be cheap. Kentucky officials say theirs would save the state $2.4 billion in the first five years, but nearly half of that savings would be spent ensuring that the state’s million-plus Medicaid recipients comply with the new rules.
Even the basic ideological argument for work requirements — that people should earn their government benefits — collapses under scrutiny. Numerous analyses have indicated that a clear majority of Medicaid recipients who can work already do work. Of the 9.8 million working-age Medicaid recipients who are not employed, the vast majority have physical limitations or provide full-time care to young or elderly family members; just 588,000 of them are able to hold jobs but are currently unemployed, according to a 2017 report. And most of those are actively looking for work.
Surely H.H.S. officials have seen this data.
They must also be familiar with the evidence indicating that punitive work requirements are ineffective. During welfare reform under Presidents Ronald Reagan and Bill Clinton, similar edicts disrupted people’s benefits without improving their employment prospects. In the Trump era, it has been repeatedly estimated that more working people would be culled from Medicaid’s rosters over paperwork violations than nonworking people for failing to find jobs. And both state and federal health officials may have heard that at least one state has found a way to help Medicaid recipients secure decent jobs without threatening their health insurance. In 2015, Montana implemented a bipartisan, state-funded employment initiative that offers Medicaid recipients a range of services, including career counseling, on-the-job training and tuition assistance. The program is voluntary — people can sign up when they enroll in Medicaid — and it’s paired with targeted outreach so that those who stand to benefit most from the program are aware of their options. So far, more than 22,000 Montanans have participated, and employment among nondisabled Medicaid recipients is up 9 percent in the state.
Given all this, it would seem that the Trump administration’s push to enact work requirements is aimed not at improving health, or even at cutting costs — there are more effective ways to do both — but rather at stigmatizing Medicaid, a program that has become less maligned in recent years, as more Americans have become insured under it. In one 2017 poll, 74 percent of respondents said they had a favorable view of Medicaid.
But while most Americans agree that poor people should have health insurance, they also believe that people of all income levels should earn their benefits — the same poll from last year found that 70 percent of respondents supported Medicaid work requirements. That paradox, of increasing support for Medicaid amid lingering suspicion toward Medicaid recipients, underscores persistent questions about how Americans view those in need. With advocacy groups vowing to file challenges similar to the one that prevailed in Kentucky, and with the state’s governor, Matt Bevin, saying he will exhaust every appeal and potentially end his state’s Medicaid expansion program altogether, those questions are almost certainly headed to the Supreme Court. Hopefully the justices, despite the high court’s impending rightward lurch, see through the conservative myths about Medicaid and do right by the program’s recipients.
A country’s deepest values are reflected in how it treats its most vulnerable citizens. So as officials consider the future of Medicaid, they must ask themselves: Is this how America is going to be?

Albert R. Hunt: Come on, Obama, get back into the political game

He’s the only one who possibly can reach younger voters, angry activists and suburban women simultaneously.
To the annoyance of many Democrats, former President Barack Obama has largely floated above the political fray instead of actively leading the anti-Trump brigade. He’s told associates that he doesn’t want to aggravate political polarization and wants to preserve his credibility by speaking out only selectively and on key occasions.
If that’s the case, now is such a time.
He doesn’t need to sound the alarm about President Donald Trump’s bad policies and vicious behavior. Others are doing that.
Instead, it’s the right moment for Obama to lay down a marker for Democrats, subtly warning against moving to extremes in response to Trump. Liberals, he thinks, need to “mix idealism with practicality,” according to an article last month in New York magazine. Actually, in this political season, mainstream Democrats have done well in contested primaries. A New York congressional contest last month in which a young socialist defeated a Democratic House leader has been widely and wrongly over-interpreted by both opponents and enthusiasts as a sign that Democrats are veering left.
But Democrats are making some mistakes that Obama could help correct. In response to Trump’s policy of separating immigrant children from their families, politicians including Sens. Kirsten Gillibrand of New York and Elizabeth Warren of Massachusetts have called for eliminating the Immigration and Customs Enforcement agency. Trump relishes that debate, which deflects attention from his abuse of children. There’s also pressure on Democrats to insist that the only way to improve the health-care system is to turn it over to the government, and to demand Trump’s impeachment now.
Obama could make his presence felt as midterm congressional elections approach by pushing back without picking fights. He could call for building on the Affordable Care Act, his signature health-care measure, instead of scrapping it in favor of a single-payer system. He could recommend letting the investigations of Trump by special counsel Robert Mueller and others play out before considering impeachment. He could urge that the focus on immigration issues be redirected toward helping children and families instead of fear-mongering. And by his calm example he could remind allies to respect civility even in turbulent times.
The 44th president’s standing is such that he’d provide some cover for Democratic candidates who are being pressured by the party’s left wing on these issues.
He’s the only one who possibly can reach younger voters, angry activists and suburban women simultaneously. Bill and Hillary Clinton have lost credibility; Warren doesn’t want to alienate the left; House Speaker Nancy Pelosi is worrying about holding on to her leadership job if Democrats take the House, and Senate Minority Leader Charles Schumer wouldn’t be taken seriously by these constituencies. It’s a mistake for Obama to ignore the elements in his party who believe, as the historian Sean Wilentz has written, that “the only way to fight right-wing populism is with left-wing populism.”
Trump is losing the border war politically, so when critics attack an enforcement agency instead of the policymaker, it plays into his hands. Likewise, Republicans are on the defensive on the big health-care issues, having misled the country for eight years in their assault against universal health insurance and having turned to a president who cares little about the topic. Changing the subject to debating the merits of what would be an immensely complicated, expensive and controversial single-payer system throws these Republicans a life raft.

Video - International and domestic impact of U.S. tariffs on Chinese imports

Video - Fareed Zakaria GPS - 7/8/18

Pashto Music Video - Da Speen Jabeen Da Pasa | Ranra Khan

#MuzaffargarhBhuttoKa - #PPP - kitne maqbool hain Bhutto ..

Video - #MuzaffargarhBhuttoKa - Bhutto - Benazir

#PPP - #MuzaffargarhBhuttoKa - Bilawal Ki Soorat Main Bhutto Nazar Aya

پیپلز پارٹی عوام کو لاوارث نہیں چھوڑے گی ،بلاول بھٹو - #MuzaffargarhBhuttoKa

پیپلز پارٹی کے چیئرمین بلاول بھٹو زرداری نے کہا ہے کہ ہم نے جیلیں بھی کاٹی ہیں اور حکومت بھی کی ہے، ہم عوام کو لاوارث نہیں چھوڑیں گے،جدوجہد کو جاری رکھیں گے۔
مظفر گڑھ میں جلسہ عام سے خطاب میں پی پی چیئرمین نےکہا کہ پیپلز پارٹی نے پہلے بھی خدمت کی،آج بھی یہی جذبہ ہے،ہم شہیدوں کا خون ضائع نہیں ہونے دیں گے۔
ان کا کہناتھاکہ اس ملک کی ہر ماں کا خیال رکھنا میری ذمہ داری ہے،میرا مقابلہ پسماندگی ،بھوک اور غربت سے ہے،عوام کے حقوق حاصل کرکے رہوں گا۔
بلاول بھٹو نے یہ بھی کہا کہ ہر جگہ عوام نے پرجوش استقبال کیا ،میں وعدہ کرتا ہوں بینظیر کسان کارڈ کا اجراء ہوگا ۔
انہوں نے مزید کہا کہ مشرف کے ظلم کے بعد بلوچستان میں آزادی کا نعرہ لگ رہا تھا،سندھ میں پاکستان نہ کھپے کے نعرے لگ رہے تھے ایسے مشکل وقت میں صدر زرداری نے وفاق سنبھالا۔

Video - #MuzaffargarhBhuttoKa - #PPP Chairman Bilawal Bhutto addresses a huge public gathering at Khan Garh in Muzaffargarh

#Pakistan - OP-ED - Waris Mir’s battle against Zia

By Bashir Riaz

History will remember the decade-long dictatorial era of General Ziaul Haq (from 1977 to 1988) as the time when the fundamentalism bacteria started germinating in the marrow of this country, before turning into a cancer and finally eating out the vitals of our socio-political system.
Our social life is marred by various arbitrary interdictions and taboos imposed on us by sanctions of the clergy. The Zia regime promoted fundamentalism in Pakistan which subsequently strengthened extremist forces in society. Therefore, the Zia Martial Law is rightly held responsible for spreading the menace of terrorism and extremism in this country.
The rapid rise of the fundamentalist mindset and its influence on the national politics has no relevance to its support in the masses, keeping in view its meager presence in the elected parliament. However, the fact remains that the backers of the extremist ideology keep growing in our society with every passing day, almost three decades after Zia’s elimination in a plane crash. And that is why we must remember Prof Waris Mir.
Waris Mir, a professor at the Mass Communication Department of Punjab University, Lahore, although a beacon known and valued highly for his contribution to the field of journalism, has yet many facets to his personality that are worth idealisation. A top flight writer of his time, he was a Seer who wrote not only for the generation that was reading his writings on multi-dimensional issues, but also for the posterity that was yet to open its eyes in this social setup. “While a writer is penning down his concerns, he is not only writing for that particular day or era — he is rather putting together pieces of history for the posterity. But in this age [of Zia dictatorship], when the journalist/writer is not ‘allowed’ to put into black and white what the truth is, what element of precision or accuracy is he going to secure through writings?…. with enchained expression, it is not only the voice of the writer that is muffled but of that entire generation…”, so wrote Waris Mir in one of his articles in 1985.
Waris Mir’s greatest contribution to the decade of retrogression was that he challenged the gospel truth being indoctrinated through state media as the national premise. At that time, the Islamic Goebbels of General Zia’s military regime had firmly established that the founding fathers of Pakistan wanted religion to be the doctrinal spirit of the state and that the PNA movement of 1977 was a mandate of the people for it to be made the source of law and life in the state. Waris Mir confronted this official truth by proving through his well-researched and scholarly dissertations that the type of discriminatory and anti-people laws being enforced by the ruling junta at that time were not even correspondent to Islam itself. Islam, as he interpreted it, was more progressive than Zia’s Goebbels had deemed it to be.
Waris Mir’s greatest contribution to the decade of retrogression was that he challenged the gospel truth being indoctrinated through state media as the national premises
His finest contribution was a series of articles on women’s rights titled as Kya Aurat Aadhi Hai? (Is women half a human?) These articles, which were later published in a book form, castigated the clergy-sponsored and Zia-backed basis of the discriminatory laws against women, particularly repugnant of which was the new law of evidence which gave unequal significance to the testimony of men and women. Waris Mir also proved in the same series of articles that the family laws promulgated by the Ayub regime were closer to the spirit of Islam than the chauvinistic legislation being proposed by the Jamaat-e-Islami at that time. Waris Mir also defended westernised educated women and their right of coming out of their cloister and the rights of the working woman at the work place. His best loved columns during those days were written about some sensitive issues like the press freedom, referendum, non-party based elections and constitutional amendments.
From 1977 till his death on July 9, 1987 at the young age of 48, Prof Waris Mir was doing what he called establishing a tradition of rational discourse. In this period, he dwelt at length on the complex theme of development of thought in various cultures and the requisites of the state like fundamental human rights and civil liberties granted in the west and made men responsible for it. The recurring pattern in the writings of this period is enumeration of the objective conditions these ideas were up against and then a proposal of a mode of their application in our circumstances. The writings during this time were totally secular in spirit. They were also a cause of greater discomfort to the rulers because they presented a dissenting worldview.



Having racked up unsustainable bills in supporting Beijing’s infrastructure master plan, Islamabad is bailed out by China to the tune of US$1 billion – leaving it more dependent than ever on its ‘all-weather ally’. 
last-ditch Chinese loan may have temporarily rescued Pakistan from a foreign exchange reserves crisis, but experts say Islamabad’s growing dependence on Beijing has become as much a liability as it is an asset.
The US$1 billion emergency loan released in the last week of June boosted Pakistan’s reserves enough to cover two months of imports, which have reached unsustainably high levels largely – and ironically – because of Islamabad’s commitment to the Belt and Road Initiative, Beijing’s plan to link Eurasia in a China-centred trading network.

What do you get if you cross Pakistan’s Game of Thrones and China’s Belt and Road?

Pakistan’s imports of machinery have spiked as it takes on US$19 billion of power and infrastructure projects for the China-Pakistan Economic Corridor (CPEC) project that will link the Chinese province of Xinjiang to the Arabian Sea through Pakistan. Valued at up to US$62 billion and expected to be fully operational in 2030, the trade corridor is the largest component of the plan.In the first two years of the CPEC project, up to June 2017, Pakistan’s imports of machinery and transport equipment jumped 51 per cent to US$15.5 billion. Meanwhile, the economic relationship with China remains one-sided. While neither government has released detailed bilateral trade statistics, Pakistan’s imports of Chinese goods and services topped US$6.6 billion in the July-December 2017 period, nearly 10 times the volume of Pakistan’s exports to China.
Why borrowers on China’s belt and road will go from euphoria to depression
“Pakistan’s dependence on China has increased startlingly,” said A.A.H. Soomro, senior adviser for Tundra Fonder, a Stockholm-based emerging markets fund manager.
In addition to US$6 billion in financing for CPEC projects granted over the last two and a half years, China loaned Pakistan’s Finance Ministry more than US$5 billion during the financial year 2017-18. That is equivalent to half of Pakistan’s total foreign funding.
“Pakistan’s dependence on China for its economic stability is growing and how dependent it has become is obvious – US$5 billion in non-CPEC funding is a huge sum in Pakistan’s current situation,” said Mohiuddin Aazim, an economic analyst in Karachi. Pakistan, he said, had no choice but to turn to China because having refused to join the Saudi Arabia-led coalition waging a war in Yemen, it could no longer rely on Middle Eastern allies, whose own finances were weakening anyway. US assistance to Pakistan has petered out because of disputes over cross-border terrorism into Afghanistan and India. Pakistan narrowly avoided being placed on the “blacklist” of countries considered complicit in terrorist financing and money laundering by the Financial Action Task Force following a complaint by the US, Britain and France.
What could be worse than Belt and Road? A copy of Belt and Road
“We have no choice but to look to China, even outside CPEC, when we are in trouble. This also suits China because, by offering us non-CPEC external financing, it can be seen in Pakistan as a real, though gradual, replacement for the US,” Aazim said. Since CPEC’s launch, consumption has thrived, largely due to improvement in electricity supplies from power generation projects. Pakistan’s economic growth accelerated to 5.6 per cent in the financial year 2017-18 from four per cent in 2014-15. But the corresponding external pressures have weighed on Pakistan’s economy, prompting the Asian Development Bank to downgrade its growth forecasts to about 5.1 per cent in 2018-19.
Pakistan’s external payments position has suffered as it overestimated its ability to arrange financing to plug gaps widened by spiralling imports and falling exports, stagnant remittances, and the loss of US financial assistance for counterterrorism operations. Its projections for foreign direct investment inflows have also proven too optimistic. Pakistan’s current account deficit has risen to nearly US$16 billion for the first 11 months of financial year 2017-18, from just US$4.86 billion for all of 2015-16. To bridge the deficit, the country has depleted its gross forex reserves to US$16.2 billion at the end of June, from a peak of US$23.5 billion in October 2016.
Why English law could rule on China’s belt and road disputes
Soomro said China had secured advantageous terms for CPEC, but these were not to blame for Pakistan’s forex woes. “The investment was necessary, even if these lucrative returns were unwarranted and anti-competitive,” he said. To boost exports, the central bank has devalued the rupee to the US dollar by about 15 per cent, making Pakistan’s currency the worst performer in Asia this year. It has also raised its policy lending rate by 75 basis points since January to 6.25 per cent to cool domestic consumption.
Without China’s billion-dollar loan, Pakistan’s forex reserves would have dipped beneath the two-month minimum needed for further loans from the World Bank.
This would have had serious implications for its ability to secure affordable loans from international markets. Moody’s last month downgraded Pakistan’s credit rating to negative from stable. To help its “all-weather” ally through to the completion of the “early harvest” phase of CPEC in late 2019, China will have to commit even larger levels of funding. The People’s Bank of China agreed in May to extend a currency swap agreement by three years and double it to 20 billion yuan.
Should Pakistan be alarmed as BFF China gets pally with India?
But further Chinese loans may not be so easily forthcoming unless Pakistan commits to structural economic reforms similar to those called for by the International Monetary Fund (IMF) under a US$6.6 billion loan disbursed between 2013 and 2017, according to the Global Times newspaper. “It’s possible we’re entering a virtuous cycle in which Chinese loans promote the development of the CPEC, and this then improves Pakistan’s debt repayment ability,” the Chinese state-owned tabloid said in May. “However, the South Asian country may need to propel economic reforms to ensure the effectiveness of the loans and allow the local economy to benefit more from CPEC projects. It is hoped that people will learn a lesson from the IMF’s operations,” it warned.
It would fall on Pakistan’s next government, due to take office after a general election on July 25, to decide whether to seek an emergency balance of payments bailout from the IMF. This would entail the disclosure of at least the headline terms of CPEC financing – something which China does not want to be made public.
Alternatively, the new administration could attempt to forestall a return to the IMF, because it would entail politically unpopular “ruthless” structural reforms to Pakistan’s economy and further increase the country’s external financing burden, analyst Aazim said. “It is a case of damned if we do, damned if we don’t,” he said. ■

#Pakistan - #PMLN - NAB finally arrests Safdar after he appears at PML-N rally in Rawalpindi

Captain (retd) Safdar arrived in Rawalpindi on Sunday to surrender himself to the National Accountability Bureau (NAB). At around 4:50pm, he was arrested by the authorities.

However, workers of the PML-N pulled Captain (retd) Safdar away from the NAB team. He was whisked away from the area in party leader Chaudhry Tanveer’s car.
Before surrendering himself, he held a rally in Liaquat Bagh, where he waved to supporters from the hatch of a jeep. He was sentenced to one year in jail by an accountability court in the Avenfield case.
Speaking to SAMAA TV, he said Nawaz Sharif’s only crime is that he wants to take Pakistan forward. There are people who do not want Pakistan to progress, he said, adding that he believes the Panama Papers case is a fake case. People know what the case is really about, he said.
Former prime minister Nawaz Sharif’s son-in-law said he would surrender himself to the authorities because it was a matter of honour.
Commenting on the rally, SAMAA TV Analyst Adnan Adil said that the PML-N does not have the ability to gather enough people to rally on the streets and truly agitate the authorities because its supporters are mainly from the business community.
At 4pm, teams from NAB and the police arrived at Murree Road to arrest Captain (retd) Safdar. PML-N supporters thronged the area, blocking the way for the teams. Captain (retd) Safdar is likely to be taken to the NAB office after his arrest and will be presented before an accountability court on Monday. He will later be shifted to the Adiala Jail.
Speaking to the media in London, Nawaz said they will follow the due process in this situation.

PPP chairman enjoys the people’s support; his convoy’s stoppage is shameful: Aseefa Bhutto

The daughter of Muhtarma Benazir Bhutto Aseefa BhuttoZardari has
condemned the stoppage of the convoy of PPP Bilawal Bhutto Zardari by Punjab Police. In her Twitter message she said, “Who controls Punjab police? The same forces that tried to stop @BBhuttoZardari in #Lyari. Will never learn from history. BBZ enjoys the people’s support, he will never be a puppet leader. 2013 was rigged RO election, obviously forces trying to do the same for 2018”