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There are three major reasons why there are conversations about trying to be more eco-friendly. The first reason is to better protect the environment. The second reason is to try to come up with cost saving measures. The third reason is because we don’t want to run out of the natural resources that bring us this energy.

Refinery in GTA on New Years Day
Ryan via Compfight

Asking if we could really run out of energy is kind of a strange question, because energy in some form will always be out there. The question probably should be whether we’ll have access to the types of energy we have access to now, or the catalyst for that energy. That will provide a much different answer, and one that we all need to address as we go forward with our green initiatives.

In general, oil comes from plant and animal life that has decayed over millions of years, coalesced and become oil. That’s pretty much a simplification of things, but for our purposes it will do. There’s a lot of that inside the earth, which has been a good thing. The problem is that there are more people now than at any other time in known history, and we’re going through oil at an alarming rate. It’s also something we can’t reproduce, so if we happen to go through it all that’s pretty much that.

Some of it happens to be in areas that are protected natural resources. There are some who believe that it’s more important that we access the oil than it is to preserve the environment. Right now that’s not as big an issue, but it could one day if the financial situations don’t improve. And if that happens, then it means we will probably go through our reserves even faster.

So then what about the sun? The sun will still be around for at least a few billion more years, but that’s not really the issue (since Earth might not be). The issue is twofold.

One, even right now solar energy costs a lot of money to try to capture and store. Technology has not moved as fast as one would’ve expected in making the cost lower, so it’s still not all that widespread.

Two, even if we could capture all the suns energy, we would still need other resources such as substances for lubrication. There may be some scientists working on that problem, and if they can find something else that can be used that’s a good thing, but we have to hope that whatever they come up with is still safe for the environment and for the rest of us.

What about wind, hydro, and nuclear power? To an extent all of those are limiting as well. There aren’t enough places in the world where you can set up a dam to create power from water in enough abundance. The same goes for wind, plus the technology is still limiting as far as how much energy it can capture. Nuclear power also requires being near enough to a large water source so that you can keep the reactors cool. It’s also somewhat dangerous as you know.

Right now, all the other forms of capturing energy still require one main component; oil. If we can improve these other energy sources, we might be in a position where we require less oil, maybe even being more cost effective and lass of a financial burden to we, the consumers. It’s something we still have to think about right now as we move forward with our energy initiatives.

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Every American gets Medicare coverage when they turn 65. However, there are different versions of Medicare, each with its own unique rules. That can be confusing because the financial impacts of each are different also. Let’s take a better look at this.

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Pennsylvania National Guard via Compfight

Medicare has 4 coverage options, with different rules within each one. Let’s take a look at each of these in more detail.

Medicare Part A covers inpatient stays at both hospitals and nursing homes. Coverage isn’t complete, however, as each type of coverage has limitations. Let’s look at hospital stays first:

Medicare is the primary insurance for inpatient coverage unless you’re still employed. It covers all normal hospitalization charges at 100% except for deductible amounts. Those deductible amounts change every year, yet have some standard rules:

The standard Medicare deductible is a flat fee and covers the first 60 days of a hospital stay. If you leave the hospital and go back within 90 days, you won’t have to pay another deductible amount as long as you stay less than a total of 60 days from the first visit. If you leave the hospital after that and stay out at least 90 days, if you go back into the hospital that deductible amount will be all that’s owed again.

If you’re in the hospital from 61 to 90 days, there’s what’s called Coinsurance Days, in which case you pay 1/4th of whatever the deductible amount is every day until you reach 90 days. The same rules for discharge apply if you go back in within 90 days.

If you’re in the hospital from 91 to 150 days, you’ve gone into what’s known as Lifetime Reserve Days. In this case, you pay 1/2 of the standard Medicare deductible every day until you reach 150 days, at which point coverage ends. The same rules apply for discharge with one major difference. If you have a second long stay and reach 91 days, your lifetime reserve days don’t start over. This means if you had to dip into 10 days of lifetime reserve you only have 50 left, no matter what the circumstances are.

Strangely enough, Medicare does cover maternity services if a patient is on social security and covered by Medicare as well.

With nursing homes, the rules are slightly different. Medicare Part A covers the first 20 days in full, and then days 21 through 100 will have a daily co-pay amount. Not everyone who goes into a nursing home has to be a permanent resident, though. If you have to go to a nursing home for specific rehabilitation treatment Medicare will cover those services.

Medicare Part B covers outpatient services, and there’s a monthly fee to get coverage. It doesn’t cover everything, however. There’s no coverage for podiatry or dental services, although it will cover that if you’re in an accident that requires surgery and doesn’t involve work or motor vehicles. It covers rehabilitation services as long as a patient is getting better; Medicare doesn’t cover any maintenance services whatsoever. Medicare also won’t cover any services that don’t match up with an approved diagnosis, although these services can always be appealed.

Medicare Part C refers to Medicare HMO plans, and you can only apply for this coverage if you’re Medicare eligible. Since these plans are insurance plans on their own behalf, they may cover things Medicare doesn’t cover, but they must cover everything a traditional Medicare plan covers.

Medicare Part D refers to prescription medication coverage. This isn’t a standard plan across the board, as the rules differ from plan to plan and state to state based on which medications are being addressed, based on different groupings. Once again this is a paid plan based on the types of pharmaceuticals you might need.

Luckily, there are many supplemental insurance plans, including Medicaid, that can help cover any expenses Medicare doesn’t cover.

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Well, it seems the worm has turned in a very strange way, and I have to admit that I’m feeling a little bit smug about it all.

The Supreme Court is going to be looking at a provision in the Affordable Care Act to see if the Internal Revenue Service overstepped its authority. The provision was to give tax credits to health exchanges that provided the coverage for the now nearly 9 million people who’ve signed up for it.

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The reason for the case is that Congress is usually the entity that passes tax law and determines how credits work. The question is whether passage of the ACA allowed the IRS to take on this role or not.

The reason I’m kind of smug? Because back in 2012 I stated in post titled 4 Financial Implications Of The Health Care Bill that hospitals would do well under this bill because more payments would come to them on high cost procedures and long term stays.

There were many hospital finance people who lamented that this act was going to hurt them. It turns out that, per this story from CNBC, I was right on that front. Seems many hospitals are now worried that the Supreme Court could overturn what the IRS has done, the ACA could be crippled enough to make it go away, and hospitals will be thrown back into the old system where they’ll once again be scrambling for cash. If people wanted hospitals in their communities to close or merge with other hospitals and now have to drive further for some services, you should be celebrating… maybe…

You know what else in interesting? It seems that many of the states that had Republican governors who said that they weren’t going to allow the ACA in their state, which was their right, not only ended up bringing it into their states but now are worried themselves that it could go away and cause them problems with coverage as well.

Not only the states, but Republican politicians are also worried, though more about their political future than the people themselves (my opinion). For instance, this from the LA Times:

Ultraconservative Sen. Ben Sasse (R-Neb.) laid out the consequences starkly this week in a Wall Street Journal op-ed. “Chemotherapy turned off for perhaps 12,000 people, dialysis going dark for 10,000. The horror stories will be real. What will happen next is predictable: A deluge of attacks on Republicans for supposedly having caused this.”

Wow; what a turnabout eh? So, what’s your take on this? Here’s mine.

Like almost everything else, it’s going to come down to partisan politics. I predict a 4-4 split, which once again will leave it all up to Chief Justice Roberts, who made the deciding vote that allowed the ACA to go live in the first place. Here’s the thing; the entire thing pinges on just a few words in the entire bill; does the Supreme Court throw out an entire bill that could affect so many millions of people because of a few words?

I don’t know, but since I’m on a winning streak I’ll go out on a limb and say no. It would be an amazing move, knowing how many lives it would affect. Not that the Supreme Court has always gone the route of the populace, but it’s rare that they’ve taken extraordinary steps against people (Dred Scott and Jim Crow laws notwithstanding).

So, we’ll see. I do have a personal stake in this since, because of the ACA, I now have coverage. At the very least I might not have coverage and save about $1,000 a month, which is a double edged sword because anything catastrophic that happens to me will be back on the citizens of my state. If this law is taken away… I can live with that.

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