Always say less than necessary.
Robert Greene
Political Potpourri
- Health Care
I do not know how the mainstream media (ABC, NBC, CBS, New York Times, Washington Post, etc.) can possibly consider themselves professional, in all due seriousness. Media Research Center does a decent job pointing out some of these things, but we have a media that COMPLETELY fails to address questions like 60 cents of every federal dollar goes to pay senior and Medicaid entitlements, and just the senior part includes over $40T in unfunded liabilities. Nobody is pointing out the fact that popular benefits like preexisting conditions means socializing personal expenses--driving up other people's premiums. Nobody is talking about the fact of voluminous and/or missing regulations, nearly two dozen new taxes, mismatched benefits and costs, the cost-shifting between Medicare and ObamaCare, etc. Nobody talks about how new Medicaid and ObamaCare related expansions further extends public financing of the sector in an environment where the trend of government financing is going past 50%. Nobody questions funding of expensive new benefits, where the medical personnel (family doctors in particular) are going to come from to service newly insured people and their "free" benefits. Nobody questions superficial comparisons between ObamaCare and RomneyCare or how health care under RomneyCare has failed to deliver long-promised savings in comparison to other states or how additional states (Oregon comes to mind) ration care based on dubious politically popular priorities.
With the possible exception of Chris Wallace of Fox News Sunday (whose questioning of political spin is more consistent across the board) and occasionally George Stephanopoulos of ABC (e.g., the health care tax/penalty debate with Obama comes to mind), I'm not seeing any of the moderators (especially David Gregory of MTP) question talking points. In particular, although there are several idiotic talking points that no intelligent person really believes that really annoy me, the one that really sets me off is this preposterous talking point about ObamaCare lowering the deficit. Where do you start with this crap? First, you have the most spendthrift Democratic politicians in history--whom don't bat an eye over running an unprecedented 4 trillion-plus dollar deficits and think the only thing wrong with spending is that there's not enough of it and cuts are limited to military spending--lecturing us on the deficit. Let us simply assume for the sake of argument that ObamaCare (with a couple of dozen new taxes) cuts the deficit by about $100B. That's over TEN YEARS. We're talking $10B per year when the federal government is spending something like $3.7T trillion a year. So these idiotic politicians take their kaleidoscope accounting of dubious assumption CBO models, mismatched costs and benefits and double counting (never mind the fact that there are huge costs in setting up and maintaining a new federal bureaucracy and we don't even know the full costs of regulations and mandates, likely to add at least hundreds of billions of costs--passed along, of course, to policyholders). I HATE with a passion the fact that most American voters ARE ABSOLUTELY CLUELESS about the HIDDEN COSTS, which the Democratic politicians exploit for political gain. The indisputable fact is that a government which pays one of 2 dollars in an inflation-bound sector bears the lion's share of blame for premium increases. AND YET THESE DEMAGOGUES ARGUE THAT GOVERNMENT IS UNIQUELY POSITIONED TO MANAGE COSTS IN THE SECTOR. You have snake oil promotion of "free" preventive care and "closed doughnut holes" of prescription drug policy as if nobody pays for these things and all these gullible people falling for it. When you push up demand with the scarce resources of the health care sector, the result is obvious: INFLATION. It's an indirect form of taxation. (This goes beyond the Fed's loose money policy pushing up general prices in the economy, also a form of taxation.) Let's review: progressive politicians set policies which exacerbate sector costs and eventually result in higher insurance premiums. Progressive politicians then try to get elected promising to control the very cost increases they're responsible for! It's like the fact the Fed's easy money policy propped up two major asset bubbles over the past 15 years, and the progressives' response is to double down on the Fed's responsibilities!
Now let's talk about the disingenuous windbag legal plunderer of Maryland, Martin O'Malley. I lost track of how many times he repeated the "freeloader" sound bite (which the Democrats have gleefully attempted to co-opt from Mitt Romney; more on that shortly) Just to provide a context for discussion: the Democrats, as a matter of ideology, wanted to expand Medicaid (over and beyond "real" poverty) as part of ObamaCare. Medicaid's funding in principle is split between the feds and the states (it's probably the biggest line item in most states' budgets). The Democrats through ObamaCare attempted to engage in extortion to force states to go along with their unilateral increase in Medicaid eligibility: go along with it or lose all Medicaid sharing, period (which would blow most states' budgets wide open). To sweeten the deal (remember the shady wheeling and dealing over Gator-Aid, Cornhusker Kickback, and the Louisiana Purchase?), the Democrats decided to add a teaser carrot: we'll pay for most of the increases in your share of NEWLY ELIGIBLE FROM EXPANDED CRITERIA over the first 10 years of ObamaCare, not unlike a drug pusher trying to hook a customer for life. There are no promises after 10 years--a cash-strapped federal government (as if we aren't already there, borrowing 40 cents on the dollar!) may drop down to its original 50-50 split arrangement in the future. [One point to keep in mind: the recently authorized mandate could compel people who are eligible for Medicaid under traditional criteria to enroll, which means states can expect their Medicaid costs to rise EVEN if they take advantage of SCOTUS' striking down the Democratic extortion policy described above to reject the criteria expansion.] From my perspective, all government individual benefits net of one's contributions (e.g., payroll taxes) is a form of freeloading. and the government freeloads to the extent that doctors and providers have to subsidize the care of government program participants from their other paying customers.
Going back to tax-and-spender O'Malley, he started hammering home on his talking point about how he is taking advantage of every drop of general taxpayer money he can suck from the federal teat (he's not shy about taking advantage of Texas' share of "new" Medicaid share dollars), providing a "competitive advantage" (do you realize how much I hate a professional politician like O'Malley disingenuously trying to co-opt concepts from business and economics?) Yeah, highly taxed and regulated Maryland is going to lure people away from business-friendly Texas, the state which got the lion's share of new Congressional seats from the recent census? I don't think so. Maybe a freeloader state like Maryland, drafting off the spendthrift Congress, will attract newly eligible freeloaders.... Maryland's day of reckoning will come with the federal government's day of reckoning. Got the point, O'Malley? You are the mother of all freeloaders: stop using the term 'freeloaders'.
The moderators have completely ignored the fact of half-baked ObamaCare, a massive bill that literally none of the politicians whom passed it understand (other than occasional references in that regard). In fact, progressives try to make a business case for ObamaCare, suggesting that businesses need to control their costs, etc. This is so ideologically muddled one hardly knows where to begin. First, businesses are aware of compensation costs, but the only reason businesses have gotten involved is because of government policy which created a tax dodge to pay lip service to bad economic policy, i.e., wage and price controls. Businesses see compensation as a whole--not just wages, but benefits. That is, if it pays wages of $60K and benefits of $40K, a component of which is out-of-control health care expenses, it could simply say, I'll give you $100K and you can find health care and other benefits on your own. So the argument doesn't really work. The value of the $100K worker is based on supply/demand considerations.
My personal judgment is the ability of government to control health care costs is sheer hubris. It has materially violated free market principles: it subsidizes employer-supplied insurance through tax policy, it does not vest the participant in cost containment, it perverts the concept of insurance by covering ordinary expenses, it restricts if not bans marketing policies across state lines (in fact, it contradicts the intent of the Constitution in this regard which explicitly wanted to promote a free market across the states by restricting protectionist taxes between states). We have seen how a government monopoly of health care works: government regulation is a poor substitute for a competitive free market. We see politically influenced rationing priorities, etc. Even if we don't have a single-payer system, we have an emerging government-dominated system, i.e., economic fascism. Medicaid expansion on its own will shrink the private market.
I could go on for pages on related themes, but I want to finish with an alternative pet peeve: Romney's political spin on RomneyCare and relevant conservative defenses. First, Romney should know better than to talk about "freeloaders" when it's government policy responsible for freeloading (e.g., government guarantees for free care). Romney should also realize that comprehensive insurance mandates are dysfunctional, exacerbating actuarial trends (like an aging population increasing demand for medical services). It costs a heck of a lot more to insure in Massachusetts, versus, say, Utah; he should realize that an honest appraisal requires looking as to what is different between Massachusetts and Utah that accounts for the cost difference (and it's NOT that Utah doesn't regulate health care), and you have to start by looking at public policies like benefit mandates. Benefit mandates (and policies, like guaranteed issue and community rating) correlate with health insurance costs. When policies basically create punitive premium levels for lower-risk individuals (e.g., young healthy people), we have supply/demand issues, e.g., the higher the price, the fewer the number of participants. If you limit mandates to major medical issues (e.g., high cost conditions like cancer) where risks are relatively low across the population, you eliminate the distortions we are currently seeing. Remember, if everyone pays ordinary expenses, using insurance to cover them unduly drives up demand (i.e., I might as well get certain unnecessary medical services done or whatever because they are "free") and simply adds administrative costs to the process, not to mention pushing-on-a-string government subsidies for lower (vs. major) medical care. It makes more sense to focus any necessary public resources on major medical, a prime reason for medical cost-related bankruptcies.
So, Mr. Romney, the real point is NOT to use the coercive power of government to drive registration for this perverted concept of "insurance" (really, bundled health care products and services) but to address the perverse government policies unduly driving up insurance costs, leading healthier risks to drop coverage because government is discriminating against them to subsidize older, sicker individuals. If government is going to subsidize older, sicker individuals, it should do so directly and not do so in an intellectually dishonest, more subtle, hidden fashion.
From my perspective, RomneyCare is bad public policy because it addressed more superficial issues, failed to address public policy problems, and scapegoats people whom are being required to assume an unfair share of the burden. That's why on multiple occasions I've suggested using broad-based consumption taxes to underwrite catastrophic expenses. If the government wants to subsidize high cost individuals--do it directly and not force other policyholders to make up the difference. If the government wants no lifetime caps, it should reimburse private insurance carriers for costs, say, beyond a $2M benefit total. You don't force it on another policyholders. This is Business 101, and I blame Mitt Romney for not communicating the issue effectively. He understands free market principles.
Finally, one of the talking points Romney and a host of conservative media types (I think I've read Ann Coulter and Byron York, among others, raising the points in question) has been, it's okay for states to impose purchase mandates, but not the national government. In part this is based on a state's mandate under the Constitution to regulate health (among other things).
A typical comparison is mandated auto insurance. We can talk the usual points of driving being a privilege, not a right, etc. The point is that a car can be dangerous, causing bodily injury and property damage.If a driver with no assets hits me with a car, who will pay for my resulting health costs? A government could tax drivers directly or alternatively require them to assume financial responsibility through auto insurance. But unlike health "insurance", auto insurance does not cover ordinary expenses like gasoline, oil changes, part replacements, etc.
Major medical problems are not like auto insurance; I can decide not to drive a car I own. Health problems can reflect a number of factors, including genetic factors beyond my control. (Sure, I can aggravate those costs with an unhealthy lifestyle or pursuing high risk hobbies.)
What federal courts have decided in the Footnote 4 era is beside the point; my personal position is the state regulation of health has more to do with dealing with controlling the spread of contagious diseases, particularly in public areas, or general issues of health risks like air, water or food toxicity. The issue I have has more to do stealth government control on a more comprehensive basis.
The problem I have with state regulation is that it is just as coercive and arbitrary as federal regulation. So a simplistic "it's okay for states but not the federal government to have purchase mandates" is a violation of free market principles. I just brought up RomneyCare. How is it more acceptable that I have to pay a tax for not purchasing something like health insurance, simply because I live in the wrong state? Suppose the state loads up comprehensive benefit mandates or implements policies like guaranteed issue or community rating? This is NOT the free market--if I am self-insuring my medical expenses and paying them out of pocket--and not paying bureaucratic costs of another payer--why should the government care? I'm not "freeloading"; I would only be "freeloading" if I refused to pay for it through current resources or a loan repayment plan.
I would argue that the conservative point of view is to respect economic liberty and free market positions, not validate dysfunctional protectionist state regulations.
- GOP Veep Selection
This shouldn't even be close: any intelligent person would have to pick Bobby Jindal, Louisiana's governor. (I should point out this blog, throughout its history, has seen Jindal as a potential Presidential or VP pick.).Why? First, we have the fact of the SCOTUS ObamaCare decision: Jindal is uniquely positioned; he has specific experience with relevant policies before winning public office. This has changed the political landscape. Jindal, who passed on the option to go to medical school, is probably more knowledgeable about Medicaid or Medicare reform than any politician in the country. Second, Jindal is probably the smartest politician in America today and is, hands down, the best debater of any politician I've heard to date (including Romney). I listened to two post-SCOTUS decision Sunday talk soup podcasts where Jindal was paired off against progressives and Jindal was able to return fire with a thorough knowledge of the facts.
Felix Sanchez Keeps His Promise
to Late Grandma:
400M Hurdles Gold Metal #2
Thirty-four year old Dominican American Felix Sanchez promised the grandmother whom raised him up before she died that he would earn a second gold medal to follow up his initial gold in 2004. He kept his promise.
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| Courtesy of AP Photo/Martin Meissner |
She Got the Guillemette Dive Flop Right
The ACLU, Pizza and the Future of Data Privacy:
Thumbs UP!
Musical Interlude: My Favorite Groups
Frankie Valli and the Four Seasons, "Working My Way Back to You"
