Week 5 Blog -- Healthcare

It seems more fitting for non-profits to handle health care than the private-sector as they make their decisions for the well-being of the people rather than for profit.   Non-profit health care includes hospitals, nursing homes, blood and organ banks, disease charities such as the american cancer society, and even health insurers such as blue cross (O'Neill 99). According to non-profit nation, America's thirty thousand non-profit health organizations had $385 billion dollars in revenue (O'Neill 91). While the non-profit sector does alleviate some problems, the current structure favors the private sector; they have vast amounts of money that they are able to use to influence legislature for example. The picture above seems to show the number of components surrounding health care which has led to the mess we have today.

The article "Value of Nonprofit Health Care" laid the basic arguments for why non-profits are more suitable for handling health-care. It stated some alarming facts, such as two-thirds of Americans did not know whether their health insurance was public or private, and of that group 80-90% did not care. Unlike for-profit hospitals, non-profits use the earnings to reinvest in the organization such as by improving quality, service, and efficiency.The remaining profits are used for community benefits to help reach out to groups who could not otherwise afford services and serve in areas where little profit exists. Non-profits typically provide the services at a lower cost and are less likely to mislead consumers. More research and innovation comes from non-profit groups. Rather than researching drugs such as Viagra they would be more inclined to research cancer treatments providing a greater benefit to society. Further, they would focus on a cure, rather than long term drug use that would only alleviate symptoms (allowing them to sell more drugs). Overall, it has been proven that greater satisfaction comes from non-profits, and that they provide higher quality care. The stigma surrounding non-profits is largely false as they operate much similarly to the for-profit entities but with better intentions.

While I feel like non-profits are a better solution than the private sector the best option would be  a government run system. The U.S. system is ineffective as a third-party payer system. The first and second parties are the medical providers and the patients. The third party is the insurance provider who pays the costs such as private insurance (employee or individually purchased) or public insurance (medicaid, medicare, SCHIP, and Vetrans (TRICARE, CHAMPVA). Only 13% of U.S. medical expenses are paid out of pocket (Leete). The insurance company would then collect money either as a deductible, co-payment (fixed amount), or coinsurance (percentage amount). It is interesting to think that the U.S. is the only democratic capitalist industrialized country without national health insurance and with largely privately funded health care (Leete). The U.S. could adopt a single payer system such as in Canada or a nationalized system like the U.K. A nationalized system seems possible as only 1/6 people are without health care in our country meaning that they are covered one way or another. It is more likely than not that the remaining could afford care or are eligible for Medicaid (for the low income) or medicare (for elderly and disabled). The link below explains how government programs and insurance work in-depth if you are interested in learning more.

http://www.census.gov/hhes/www/hlthins/methodology/definitions/cps.html

Further, the bureaucracy and administrative costs surrounding health-care are another problem; everyone needs health care and in the end people do whatever it takes to get it. Many choose to take certain jobs that they are overqualified for just to recieve coverage for their family. It is a complex game the insurance company plays approving some claims and denying others, limiting how many visits someone can have, and telling someone which treatments they are covered under. It creates a paperwork headache dealing with referrals and having to go through your primary care physician every time you need to see a specialist. Preventative care could actually save money and we already pay for emergency services. Opponents argue that providing universal health care would be too costly. This is largely false, currently the U.S. is spending a greater amount of its GDP than the countries within the E.U. having universal health care. It really makes me question where all the money has gone. The graph below helps compare the United States spending compared to that in the U.K. It shows a continuing divergence from the European countries and a steep rise in costs during recent years.

The health care system in the United States is an absolute failure.  Government run health care could cut out the insurance company which makes a business out of denying claims. Personally, I feel like the government would be much more trusted in providing insurance; there would be less money lost to lobbying and political campaigns, investor profits, and executive bonuses. There would be a lot less denying of claims on technicalities. Health care is one area where the free-market should stay out. It is just such a complex sector that many become confused. Lets look at adoption services for example. If someone were making money by selling children it could lead to problems such as baby snatching. Simply, profits are getting in the way of someones well-being. It seems like an area such as this would need heavy regulation to make it work but the better solution would be to allow the public and non-profit sectors to take on this role. Where is the regulation surrounding health care? The complex structure surrounding the various components of this sector creates a mess, government health care is the solution, simply purifying this sector that amounts for 13% of our GDP. The below pie chart shows where the money goes, but it doesn't account for investor profits, and the money spent in areas such as lobbying, and exectutive bonuses.

The two questions that are asked in regard to health care reform. First, is the quality of care better? And what will it cost? Well, looking at other countries and how they provide care, Europeans love their health care, and they have a much greater amount of coverage than we do. The second question, in addressing costs, we already spend much more than they do and without the same results. We could copy their model of health care and introduce cost saving measures. We could have different tiers to our health care system, everyone receiving basic health care (such as medicade), and those contributing more could have a greater amount of coverage.  We could stop costly treatments such as excessively spending money on prematurely born babies or keeping someone on life support. Simply, allocating this amount somewhere else could provide a greater amount of social well-being. It is crazy to think that 65% of someones lifetime health care expenses are spent during the last 30 days of their lives. Perhaps we should simply judge when and when not to treat someone since it draws from an insurance pool meant for everyone (death panels?). If someone wanted to spend their own money that is one thing but in the case of life support maybe pulling the plug would be the better option.

Here is a link to the the Affordable Health Care for America Act. As well, here is a video by the Henry J. Kaiser Foundation, this which explains many of the important aspects of this Act.
http://docs.house.gov/rules/health/111_ahcaa.pdf

Works Cited:

Leete, Laura. "Health Care Finance and Reform." Policy and Planning Analysis. University of Oregon. Eugene, OR. 01, 02, 2011. Lecture.

Social Services -- Blog # 4

Deemed as morally fit, social services are widely accepted and admired; they provide a safety net for those in need. It is interesting the wide array of social services that exist such as day care, emergency and relief services, community food services, and homeless shelters (O'Neill 73). It is important to note that while these organizations are private, currently sixty percent of the revenue comes either directly or indirectly from the government under grants, performance contracts, and fee for service agreements (O'Neill 77). The alternative to this would be the "European Model" where the government provides all the services (O'Neill 82). I feel like the duel approach is best, it encourages both public and private funding, and this leading to a greater amount of social services overall.

I looked into what types of grants are available and how to apply for them. It turns out that there is a search engine that assists you in finding out what kinds of grants are available. The Service Coordinators in Multifamily Housing Program for example had $31,000,000 in available federal grant money. The website also had tools on registering your agency as well as grant writing tools.  This website really put it into perspective how much grant money is out there and how easy it is to get as long as you meet the requirements. Non-profit nation stated that 12.4 billion dollars was allocated in government grants to social service organizations in 1997 alone (O'Neill 78).


 http://www.grants.gov/search/category.do


Given government support of social service organizations, it is important to note the issues involved as public dollars from taxes are supporting private organizations.  In the supreme court case, Boy Scouts v. Dale, it upheld the exclusion of homosexuals from the organization. This demonstrates just one example how the government is supporting discrimination by giving tax payer money to these organizations. In this case, it was ruled that allowing homosexuals into the organization would violate its founding principles; it just seems unclear where to draw the line. It was decided under the first amendment freedom of speech which seems to run in conflict with the 14th amendment of equal protection. Let it be noted, that the government controls the grants, and controversial organizations would likely receive less funds. The City of San Francisco excluded the salvation army from social service contracts, this since it did not extend benefits to "unmarried partners", such as the gays and lesbians (O'Neill 85). A case brief outlines the opinions of the court below for Boy Scouts v. Dale.

http://www.oyez.org/cases/1990-1999/1999/1999_99_699

It seems that the government and private organizations each have a role in providing welfare. For example, the  food stamps program in Oregon, and food for lane county both are oriented towards feeding those in need. What I  like about food for lane county, those who need help are able to access it quickly; there is no formal application process that approves and denies participants. In contrast, the food stamp program through the state of Oregon has a number of requirements for someone to become eligible, and there are further requirements dictating how much someone recieves. There was a calculator on their website listed here that calculates how much someone receives https://apps.state.or.us/fsestimate/. The food stamp program functions as supplementary income, it seems that while most people do actually need the help, there are a number of those who simply qualify and therefore abuse the system. Below I listed links to the food stamps program and food for lane county to compare the two programs which seem to have similar goals.

http://foodforlanecounty.org/
http://www.oregon.gov/DHS/assistance/foodstamps/foodstamps.shtml

I thought it was interesting how federal policy regarding social service organizations has changed over time. Prior to the 1930's and 1940's, it was a different time with far less problems than today; the common help came from family at that time. The new deal began the role of the government in providing the social services in light of the great depression. The government role transitioned to private organizations during the Reagan era of the 1980's. However, it seems that federal programs were cut, and the same allocation of funds did not go towards supporting the private sector. It seems that this trend continued until recently with Obama using the government to create large scale programs. The 1.3 trillion dollar stimulus package greatly increased the role of government programs as well as social service organizations. I think it is interesting how we are trying to stimulate the economy but cut the national debt at the same time.

Outlined in non-profit nation, the private sector often complains about non-profits, in that they crowd out business. For example, the YMCA could hurt a local fitness club, and in a town where there may not be enough room for both to exist. Personally, I feel like non-profits are focused on efficency, and they provide a good or service at a cheaper rate than private industy. If this is harmful to the priate sector, it does not occur on a  large scale, and it seems like those receiving help would not get it otherwise. Looking into the efficiency of non-profits I researched ELAW using the Guidestar search engine. I thought it was interesting that the executive director, Harvard alumni, gave up large six figure salaries to work with ELAW. It just goes to show how cause oriented organizations are able to attract skilled workers who give up higher wages elsewhere to do some good in the world.

Week 3 -- Religous Organizations, Philanthropy, and Tax Exemption

This past week, during class and from the book Nonprofit nation, we learned the basics surrounding religious organizations.  Foremost, religious organizations are the largest part of the non-profit sector; there are 375,000 registered organizations in the United States (O'Neill 53). Religion influences many lives, forty percent of the American populace attend religious services weekly, and religious organizations are considered the most trusted institution in the United States (O'Neill 62).  Survey results show that American's trust religious organizations more than the government, unions, and the media (O'Neill 62). While the statistics do not surprise me, I feel that since religious organizations shape the society which we live in, greater regulation should exist as it has taken on non-traditional roles such as hospitals, education, and social services. A hospital could refuse to give a patient emergency contraception, a school could expel a homosexual student, and a social service organization such as a homeless shelter could impose mandatory religious services. As religious organizations crowd out other institutions, and given the non-profit status, would the government exceed its powers if it were to regulate?

Religious Organizations are entrenched in the traditions and culture which have influenced and shaped today's society both negatively and positively. For example, the temperance movement of the 19th and 20th century's, extensive attention to urban poor during the progressive era, and today taking stances on faith based issues (O'Neill 62-63). It seems that religious belief plays a role in voting today, making it difficult to make policy on controversial issues such as abortion, homosexuality, and stem cell research.  Religious organizations do advocate a particular ideology and this has influenced decision making in the political arena, it is questionable the tax exempt status in its current form, and the lack of regulation such as with financial information. The question becomes even more difficult when religious and political messages become blurred together. 

In class, the distinction was made between advocating on issues versus a candidate which would qualify as campaign intervention. A religious organization can advocate on the right to life but only crosses the line when it takes a direct political stance. An absolute must read for this class is a tax guide for churches and religious organizations available from the IRS. http://www.irs.gov/pub/irs-pdf/p1828.pdf It states a distinction between issue "advocacy" and "campaign intervention" (IRS 9). It pointed out that referencing a candidate by name, stating approval and disapproval for actions, and referencing voting would make the speech political in nature (IRS 9). There are a number of loop holes surrounding advocacy, for example, a religious organization could post a link on their website. Further, GOTV efforts are allowed by 501(c)3 organizations, this making bias an issue. Importantly, it is noted that 501(c)3 organizations are not all together barred from political activity, but if they choose to engage in campaign intervention they may do so at the penalty of a 10% excise tax. Further, political activity such as lobbying cannot serve as the a 501(c)3 organizations primary function for more than four years, it would subject it's entire income during that period to tax. Furthermore, a major aspect surrounding religion that concerns me is the lack of financial accountability surrounding religious organizations; they are not required to file reports with the IRS and other governmental agencies. 

According to Nonprofit Nation, 85-90% of revenue comes from donations, and this amounting to $85 million dollars in 2000 alone (Hodgkinson and Weitzman, 1993). The remaining 10-15% comes from grants, endowment income, net profit from auxiliary services, and with facilities rental (Hodgkinson and Weitzman, 1993). The book notes a trend towards secularism.  It will be interesting to see the role religious organizations play in the future, perhaps a greater allocation of resources will go to social functions, such as health, social services, and international aide. Given the amount of assets held by churches, and the tax exempt status, it seems that religious organizations will have a lasting influence on society.

Reflecting on the additional reading, it was noted that when reducing the estate tax, it hurts charitable donations. If the tax rates were higher then many would choose to donate to tax exempt charities to see that their money went farther. Given that many of those in Congress come from privileged backgrounds, and that they are an extremely wealthy group, it seems unlikely that lawmakers will look favorably at raising tax rates on the estate tax. Next, given the recession, it seems habits have changed surrounding charitable donations. Donations are directly linked to the performance of the stock market, and when there is less money, many simply can't afford to donate. Lastly, it should be noted that is unlikely that cutting tax exempt status would contribute to significantly lessening the national debt, this as charities and government often serve duel purposes.

Great Smokey Mountains National Park

The Great Smokey Mountain National Park is part of the Blue Ridge Mountains, a division of the larger Appalachian chain; it is located on the border between Tennessee and North Carolina at 35°41′0″N 83°32′0″W. It encompasses 814 square miles making it one of the largest protected areas east of the Mississippi river. The mountain building process began over a billion years ago making these mountains some of the oldest on earth. To many, the geological features may not be noticeable. A naturalist from the park once exclaimed "what geology ... we don't actually have any in this park!". What he meant was that the geological features were not obvious in the great smokey mountains national park. The mountains are a product of uplift and prolonged erosion. Moist air from the gulf of Mexico helped create dense forests and a smokey haze cover many of the geological features.  Below is a map pinpointing the location of the smokey mountains between North Carolina and Tennessee. 

Foremost, after forming a basement complex, the major geological forming event was the deposition of the Ocoee supergroup. The Ocoee Supergroup contains a number of fossils including tribolites, bryozoans, ostracodes, pelmatozoans, algae, and agglutinated forrminifers; it indicates a Silurian or younger age. The low-grade metamorphic rock of the walden creek group has helped date the park.  This data contradicts older ideas that the Walden Creek Group dated to the Neoproterozoic age. This shows an example of how the fossil record is used in a relative dating method to determine the age of rock. 


Tribolite fossils as shown in the picture below one of the most common fossils found in the park The tribolites made their first appearance during the early cambrian era. They finally died out in the permian 250 mya. There were 17,000 species of trilobites during the paleozoic time. The numerous fossils available have helped date the great smokey mountains.

The next major process which occurred was the crustal rifting and deposition of  Paleozoic rock causing sentiments to collect and creating thousands of feet of oceanic sedimentary rock. Sentiments collected in an oceanic trench are shown in the picture below. 
 

The majority of the rocks in the Great Smokey Mountains were formed by accumulations of clay, silt, sand, gravel, and minor amounts of calcium carbonate in flat-lying layers occurring over millions of years. The younger rocks of sedimentary origin formed during the Paleozoic Era, 450 to about 545 million years ago. The oldest sedimentary rocks were formed during the Proterozoic Era some 800-545 million years ago. Vast amounts of unconsolidated clay, silt, sand, and pebbles were washed down into lowland basins from adjacent highlands during that time. 


Rocks of the old highlands were over one billion years old, and were similar to the ancient granite and gneiss found in the southeastern parts of the park. These early sites of ocean bottom deposition were formed along the ancient margin of the North American continent as an older and larger supercontinent broke apart.
Igneous rocks are present but only a limited amount can be found in the park. The two main igneous rocks found are granites and gneiss. Granites usually have a medium to coarse-grained texture. Gneiss rocks are usually medium to coarse-foliated and largely recrystallized. They often have large quantities of minerals including mica and chlorides. 

 

 

Later, due to tectonic plate activity, the super continent of Pangea was formed. This the start to uplift during the Paleozoic era. The great smokies became the crest of a major mountain belt stretching across Pangaea.

The Alleghenian orgeny is a mountain forming event occuring 300-350 mya during the Carboniferous period. When the continents of Africa and North America collided it exerted massive stress making whattoday we call the Eastern Seaboard. There was a transfer of igneous and sedimentary rock into metamorphic due to the collision. These concurrences caused thrust faults and some strike-slip faults as well as folding. It is possible that at the peak of mountain building, the Appalachians could have been much higher, perhaps even high than present day Himalaya. The stresses caused faults called thrust faults and strike-slip faults are shown below. A thrust fault is a type of fault, or break in the Earth's crust across which there has been relative movement, in which rocks of lower stratigraphic position are pushed up and over higher strata. They are often recognized because they place older rocks above younger.

A strike-slip fault is where the two forces move parallel to each other as shown below.

Data by the U.S. Geological survey shows that the orogenic crust was formed after a crustal magma source. Orogeny refers to the forces and events which deformed the earth and this caused by tectonic plate movement. This created orgenic belts of deformed rocks.

The last process involved in forming the great smokey mountains was erosion which uncovered many of the older rocks. Erosion helped shape the ridges and valleys and uncovered many of the older rocks. This occurred during the mesozoic time and erosion continued throughout Cenozoic time. This shaping the mountains closely to their current form today.

 Noting on a few of the key features in the park. The most visited location in the smokies is Clingmans Dome, it consists of lightly metamorphosized rock, and much of this which is Sandstone. These sedimentary rock types are most noticeable on rocky outcrops and in large boulder piles.  Clingmans Dome is the highest mountain in the smokies, it has an elevation of 6,643 feet, and is the highest point of the 2,174 mile Appalachian trail. Below is a picture of the sandstone which is visible on the bank of east creek within the park.

Next, here is a structure map of Cades Cove in the Great Smoky Mountains National Park, another attraction in the park. Cades cove shows a thrust sheet that displays the rocks beneath the sheet. It shows a window within the Proterozoic Ocoee rocks where Paleozoic rocks of the Ordovician Knox Group are exposed.

Works Cited




Great Smokey Mountains A Visitors Guide. Great Smokey Mountains. , 2011. Web. 14 Feb 2011. <http://www.smokymountainsvisitorsguide.com/index.html>. 

Harris, Ann, Ether Tuttle, and Sherwood Tuttle . Great Smokey Mountains National Park. Geology of National Parks 6th Edition. Dubuque: Kendal and Hunt Publishing Company, 2009. 821-834.

A Guide to the Orders of Trilobites . Web. 14 Feb 2011. <http://www.trilobites.info/>

King , Phillip, and Arthur. "The Great Smoky Mountains-Their Geology and Natural History." Scientific Monthly 71.1 n. pag. Web. 14 Feb 2011.

United States Department of the Interior. Great Smokey Mountains. , 2011. Web. 14 Feb 2011. <http://www.nps.gov/grsm/index.htm>.

Introductory Post

Hello Blogging World! The purpose of this blog is to write about the various components of the nonprofit sector and reflect upon them. The non-profit sector plays a number of important roles, it bridges the gap between the public and private sector, and it has a number of areas including advocacy, social services, research funding, and religious organizations; these to name just a few examples. I hope to further my knowledge of non-profits through writing this blog and build upon the content discussed in PPPM 240. Specifically, I am interested in the legal aspects surrounding the non-profit sector, organizational structure of nonprofits, funding aspects, and the different tax classifications surrounding this sector. 

My name is Carson Quam and I am double majoring in Political Science and Public Planning, Policy, and Management (PPPM).  I am a current volunteer with Partners of the Americas, a student exchange program,  it allows for high school students from Costa Rica and Oregon to travel for a two month stay in the other country. Partners of the Americas has 120 different chapters in the United States. Within this program I help provide information on the Oregon to Costa Rica exchange, helping inform students and parents about travel, and preparing prospective students for travel. Additionally, I am part of a selection committee, and I evaluate candidates for travel through a series of interviews.

I am taking this course as it is critical to understand the non-profit sector, it is likely that my future jobs will involve working with non-profits, this as they are intertwined with a number of other aspects. According to nonprofit nation, 1.8 million registered non-profit organizations are formally recognized in the United States alone. It accounts for 2 trillion dollars worth of funds and 5-10% of the United States economy.  Understanding the history of non-profits was interesting for me, it showed how they first emerged, as wealthy individuals began foundations to give back to those who helped them build their fortunes.  I found the lecture interesting when hearing about endowments and how schools like Harvard had vast amounts of funds from wealthy alumni donating over the years. Expanding on the historical aspects, the growth of non-profits in the United States seemed to occur with the post WWII economic boom as the industrial sector was left unharmed. Next, the social activism of the 60's and 70's largely contributed to growth of the non-profit sector. Today, Bill Gates and Warren Buffet are encouraging other billionaires to donate their fortunes, and they have began a worldwide "giving pledge".  This should create lasting change and allow for large influxes of cash that individual governments would be unwilling to provide.

Concluding thoughts, discussed during the lecture, we spoke about whether it was fair or not to have tax exempt status for non-profits.  Nonprofits are given little regulation, and 2/3rds are organized under 501 (c) tax status, this lumping them together as one.  Taking religious organizations for example, perhaps their social services role could have 501 (c) tax exempt status, but when advocating for an ideology, it could be taxed similar to campaign donations.  One example, Planned Parenthood accepts donations for both health care, and for political advocacy for the right to choose. The health care is tax exempt, but the advocacy for the right to choose is not. Perhaps religious organizations among others should be subject to the same rules.

It seems that in allowing tax exempt status, it involves the government, and when practices by these organizations become discriminatory they should forfeit tax exemption and lose funding such as through grants. For example, if a religious school expels a homosexual student, they have every right to do so as a private organization. The problem arises is when the government is supporting this discrimination by allowing tax exemption and giving grants. It seems to come in conflict with issues of equal access protected under the 14th amendment if a religious organization were to receive these types of funding.