https://www.commondreams.org/view/2011/03/19-0


Nuclear Nightmare


by Ralph <https://www.commondreams.org/ralph-nader>  Nader 

CommonDreams.org <http://www.commondreams.org> : March 19, 2011

The unfolding multiple nuclear reactor catastrophe in Japan is prompting
overdue attention to the 104 nuclear plants in the United States-many of
them aging, many of them near earthquake faults, some on the west coast
exposed to potential tsunamis.

Nuclear power plants boil water to produce steam to turn turbines that
generate electricity. Nuclear power's overly complex fuel cycle begins with
uranium mines and ends with deadly radioactive wastes for which there still
are no permanent storage facilities to contain them for tens of thousands of
years.

Atomic power plants generate 20 percent of the nation's electricity. Over
forty years ago, the industry's promoter and regulator, the Atomic Energy
Commission estimated that a full nuclear meltdown could contaminate an area
"the size of Pennsylvania" and cause massive casualties. You, the taxpayers,
have heavily subsidized nuclear power research, development, and promotion
from day one with tens of billions of dollars.

Because of many costs, perils, close calls at various reactors, and the
partial meltdown at the Three Mile Island plant in Pennsylvania in 1979,
there has not been a nuclear power plant built in the United States since
1974.

Now the industry is coming back "on your back" claiming it will help reduce
global warming from fossil fuel emitted greenhouse gases.

Pushed aggressively by President Obama and Energy Secretary Chu, who refuses
to meet with longtime nuclear industry critics, here is what "on your back"
means:

1. Wall Street will not finance new nuclear plants without a 100% taxpayer
loan guarantee. Too risky. That's a lot of guarantee given that new nukes
cost $12 billion each, assuming no mishaps. Obama and the Congress are OK
with that arrangement.

2. Nuclear power is uninsurable in the private insurance market-too risky.
Under the Price-Anderson Act, taxpayers pay the greatest cost of a
meltdown's devastation.

3. Nuclear power plants and transports of radioactive wastes are a national
security nightmare for the Department of Homeland Security. Imagine the
target that thousands of vulnerable spent fuel rods present for sabotage.

4. Guess who pays for whatever final waste repositories are licensed? You
the taxpayer and your descendants as far as your gene line persists. Huge
decommissioning costs, at the end of a nuclear plant's existence come from
the ratepayers' pockets.

5. Nuclear plant disasters present impossible evacuation burdens for those
living anywhere near a plant, especially if time is short.

Imagine evacuating the long-troubled Indian Point plants 26 miles north of
New York City. Workers in that region have a hard enough time evacuating
their places of employment during 5 pm rush hour. That's one reason
Secretary of State Clinton (in her time as Senator of New York) and Governor
Andrew Cuomo called for the shutdown of Indian Point.

6. Nuclear power is both uneconomical and unnecessary. It can't compete
against energy conservation, including cogeneration, windpower and ever more
efficient, quicker, safer, renewable forms of providing electricity. Amory
Lovins argues this point convincingly (see RMI.org). Physicist Lovins
asserts that nuclear power "will reduce and retard climate protection." His
reasoning: shifting the tens of billions invested in nuclear power to
efficiency and renewables reduce far more carbon per dollar
(http://www.nirs.org/factsheets/whynewnukesareriskyfcts.pdf
<http://www.nader.org/exit.php?url_id=485&entry_id=2251> ). The country
should move deliberately to shutdown nuclear plants, starting with the aging
and seismically threatened reactors. Peter Bradford, a former Nuclear
Regulatory Commission (NRC) commissioner has also made a compelling case
against nuclear power on economic and safety grounds
(http://www.nirs.org/factsheets/whynewnukesareriskyfcts.pdf
<http://www.nader.org/exit.php?url_id=485&entry_id=2251> ).

There is far more for ratepayers, taxpayers and families near nuclear plants
to find out. Here's how you can start:

1. Demand public hearings in your communities where there is a nuke,
sponsored either by your member of Congress or the NRC, to put the facts,
risks and evacuation plans on the table. Insist that the critics as well as
the proponents testify and cross-examine each other in front of you and the
media.

2. If you call yourself conservative, ask why nuclear power requires such
huge amounts of your tax dollars and guarantees and can't buy adequate
private insurance. If you have a small business that can't buy insurance
because what you do is too risky, you don't stay in business.

3. If you are an environmentalist, ask why nuclear power isn't required to
meet a cost-efficient market test against investments in energy conservation
and renewables.

4. If you understand traffic congestion, ask for an actual real life
evacuation drill for those living and working 10 miles around the plant
(some scientists think it should be at least 25 miles) and watch the hemming
and hawing from proponents of nuclear power.

The people in northern Japan may lose their land, homes, relatives, and
friends as a result of a dangerous technology designed simply to boil water.
There are better ways to generate steam.

Like the troubled Japanese nuclear plants, the Indian Point plants and the
four plants at San Onofre and Diablo Canyon in southern California rest near
earthquake faults. The seismologists concur that there is a 94% chance of a
big earthquake in California within the next thirty years. Obama, Chu and
the powerful nuke industry must not be allowed to force the American people
to play Russian Roulette!  

Ralph <http://www.nader.org/>  Nader is a consumer advocate, lawyer, and
author. His most recent book - and first novel - is, Only The Super-Rich Can
Save Us <http://www.amazon.com/dp/1583229035?tag=commondreams-20/ref=nosim>
. His most recent work of non-fiction is The Seventeen Traditions
<http://www.amazon.com/dp/0061238279?tag=commondreams-20/ref=nosim> 

http://www.commondreams.org/headline/2011/03/28-1


Dems: Potential Cuts to Medicaid Outlined by Administration 'Cruel'


by Mike Lillis 

The
<http://thehill.com/blogs/healthwatch/medicaid/152023-dems-question-hhs-menu
-of-medicaid-cuts>  Hill: March 28, 2011

An Obama administration letter outlining potential Medicaid cuts to help
states balance their budgets was "cruel" and "disappointing," according to
several prominent Democrats.

The lawmakers are concerned the letter will encourage states to clip health
coverage for some of the country's poorest people amid a poor economy when
they could use the benefits most.

"It's cruel," said Rep. Dennis Kucinich (D-Ohio), "and it's nothing you
would expect from a Democratic administration."

The potential for cuts highlights the pickle facing federal lawmakers as
they try to expand healthcare coverage while simultaneously reining in
soaring healthcare costs. It underscores the pressures on state leaders to
balance budgets during a period of high unemployment and deflated revenues.
It accentuates the structural flaw plaguing Medicaid, which often sees
enrollment spike during bad economies when states can least absorb the extra
costs. And it foreshadows potential troubles with the new health reform law,
which leans heavily on an enormous Medicaid expansion to cover millions of
uninsured Americans in the years to come.

The controversial letter, sent to the nation's governors last month by
Health and Human Services (HHS) Secretary Kathleen Sebelius, acknowledges
the severe budget conditions tormenting states and offers "new tools and
resources to achieve both short-term savings and longer-term sustainability"
under Medicaid.

The suggested strategies are wide-ranging, including efforts to rein in
fraud, shift patients into managed care and encourage generic drugs in lieu
of name brands. But atop the list are ways states can scale back
non-mandatory benefits and shift higher costs onto Medicaid patients.

"While some benefits, such as hospital and physician services, are required
to be provided by State Medicaid programs, many services, such as
prescription drugs, dental services, and speech therapy, are optional,"
Sebelius wrote. "In addition, States may add or increase cost sharing for
services within limits."

The message was a response to an earlier letter from 33 governors asking
Sebelius to lift a provision of the new reform law - called the maintenance
of effort (MOE) requirement - preventing states from trimming Medicaid rolls
ahead of the law's broad 2014 expansion.

Mary Kahn, spokeswoman for the Centers for Medicare and Medicaid Services
(CMS), said the Sebelius letter "does not encourage states to drop coverage,
it simply outlines the flexibility available to states under current law."

But some liberal lawmakers say even that was a step too far. Kucinich, a
long-time advocate for a single-payer healthcare system, is wondering why
the country's most vulnerable populations should shoulder the burden of
state efforts to balance budgets.

"When you consider that - in a for-profit healthcare system, about 30
percent, and as much as 33 percent, of all spending goes for corporate
profits, stock options, executive salaries, advertising, marketing,
processing paperwork - it's cruel," Kucinich said of the HHS letter.

Rep. Elijah Cummings of Maryland, the top Democrat on the House oversight
committee, was also critical. Focusing specifically on Medicaid dental
coverage, he said the HHS letter is "disappointing," and called on the
agency "to revisit" its reminder that certain dental services are optional
under the program.

"Dental care is something that's easy to resolve. I'm talking about stuff
like sealants; I'm talking about check-ups; simple things," Cummings said.
"I would hope that [Sebelius] would revisit that, and instead of making it a
second-tier or third-tier health priority, she would put it on the first
level."

The lack of dental care in Medicaid can have tragic consequences. In 2007, a
12-year-old Maryland boy named Deamonte Driver was hospitalized when
bacteria from an abscessed tooth spread to his brain. Six weeks, two
operations and hundreds of thousands of dollars later, he died. An $80
procedure might have saved him, but his mother couldn't find a dentist who
would accept his insurance plan. It was Medicaid.

Because dental coverage for kids is mandatory under Medicaid, states cannot
cut those services in search of budget savings. But they can eliminate
dental coverage for adults, and cut reimbursement rates for doctors and
dentists that can affect patients of all ages.

Jocelyn Guyer, co-executive director at Georgetown University's Center for
Children and Families, an advocacy group, called the latter option "a
back-door strategy" for cutting costs that can also erode access to care.

"They end up just pulling out people's teeth," Guyer said, "because it's
cheaper."

Guyer noted that the HHS letter didn't contain anything that Medicaid
experts - both advocates and state officials - don't already know. Still,
she said she was "surprised they put the benefit cuts first" among the
cost-saving options.

Medicaid, a federal-state partnership, is a prominent target for state
budget hawks not only because it represents an enormous chunk of state
budgets, but also because the low-income beneficiaries tend to hold much
less sway politically than better-heeled special interests.

The Center on Budget and Policy Priorities (CBPP), a liberal policy group,
says 31 states have already slashed public health benefits to balance
budgets in response to the recession, with most of those cuts targeting
Medicaid. Additionally, CBPP has identified at least 23 states that have
proposed additional Medicaid cuts in their coming-year budgets.

Mike Leachman, a CBPP analyst, said many state officials are focusing their
deficit-reduction efforts disproportionately on Medicaid because they've
taken tax hikes off the table.

"Many governors," he said, "are proposing much deeper cuts than are
necessary."

The debate over further cuts comes at a time when access to care under
Medicaid is already at remarkably low levels. Only about 40 percent of
physicians accept all new Medicaid patients, versus 58 percent for Medicare
patients, according to a 2009 study from the Center for Studying Health
System Change, which randomly surveyed more than 4,700 physicians.

Gaining access to dental care is even tougher. A 2007 survey by the American
Dental Association found that fewer than 27 percent of respondents treated
Medicaid-insured patients.

The reason is no mystery: Medicaid payments, despite a 12 percent increase
between 2003 and 2010, represent just 69 percent of what Medicare pays for
the same services, said Stephen Zuckerman, health policy analyst at the
Urban Institute.

"This is serious stuff," Cummings said. "It's not just [about] the Deamonte
Drivers of the world."

Other House Democrats downplayed the significance of HHS' menu of Medicaid
cuts. Rep. Henry Waxman (Calif.), senior Democrat on the Energy and Commerce
Committee, said Sebelius was simply reminding states of their ability to
make changes to Medicaid - "even reductions that I don't think would be
wise."

"She was interpreting the law for them in a way to show there are things the
states can do - there are services that are optional, there are populations
that are optional," Waxman said. "I wouldn't want to see a state not cover
pharmaceuticals for the Medicaid population, but they do have that option.
If they took that option, they wouldn't be spending their state share on
what I think is an essential part of medical care - but it's their
prerogative."

Rep. Frank Pallone (N.J.), senior Democrat on the Energy and Commerce health
subcommittee, agreed. He said the Sebelius letter "essential shows that
there's flexibility" for states trying to balance budgets.

"I'd rather have this flexibility than have people dropped from the
program," Pallone said.

As the debate rumbles on, HHS is sending teams across the country to help
local Medicaid officials devise ways to control costs. Eighteen states have
requested help thus far, said CMS' Kahn, but the outreach program is just
getting started, and CMS officials "haven't done extensive work yet."

 

 

 

 



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