«Expanding Medicaid will be costly for most states. The authors of The Patient Protection and Affordable Care Act of 2010 (Obamacare) threatened to strip all federal funding for states’ Medicaid programs if they refused to expand the entitlement.
But 27 states filed suit over Obamacare and the Supreme Court struck down this threat as coercive, making the Medicaid expansion optional for states. Now, governors and state legislatures are debating whether to expand or not, as the above presentation shows. As Nina Owcharenko notes, Medicaid needs reform, not expansion.
Of course, states are tempted by the offer of new federal dollars. But, as Heritage expert Drew Gonshorowski writes:
The Medicaid expansion represents a massive increase in federal and state spending. Although some claim that states could experience savings, it is clear that this is the exception, not the rule. Expanding Medicaid will ultimately cost states in the long run.
For a breakdown of state-by-state costs, click here.
While Members of Congress are arguing about defunding parts of Obamacare, the rubber is meeting the road in the states. Governors and state legislatures are sweating decisions about setting up government health care exchanges and expanding the Medicaid program.
While the offer of additional federal money for Medicaid is tempting for many governors and legislatures, it is a trap. And it is just one of the reasons Obamacare doesn’t work.
The Medicaid expansion is a crucial part of Obamacare that is supposed reduce the number of uninsured. But adding millions of people onto an already strained program doesn’t help anyone. The Medicaid program is already struggling to provide care to its core obligations—a diverse group of low-income children, disabled people, pregnant women, and seniors. So dumping more people into the program will make matters worse. Research shows that Medicaid enrollees already have worse access and outcomes than privately insured individuals.
This will have real effects on America’s needy, including children. Dr. Hal Scherz has seen the problems Medicaid creates firsthand. He practices in the only pediatric urology group in the state of Georgia, and more than half of his practice is made up of Medicaid patients.
But Medicaid already doesn’t cover the costs of many procedures, and expanding the program is only going to stretch the doctors’ even further—while they get paid less. It is unlikely that care providers like Dr. Scherz will be able to keep treating such high numbers of Medicaid patients under this scenario—which means less access to care for children who need it.
Thankfully, Georgia is not expanding Medicaid right now. But that doesn’t mean Medicaid is doing well, even in states that aren’t expanding. Due in part to low reimbursement, one in three doctors already refuses to accept new Medicaid patients.
Medicaid is a problem for patients—and it’s also a major problem for states that are struggling financially. As Heritage’s Nina Owcharenko explains:
Today, Medicaid consumes over 23 percent of state budgets, surpassing education as the largest state budget item. As Medicaid spending continues to rise, other important state priorities such as education, emergency services, transportation, and criminal justice are squeezed.
In fact, 40 out of the 50 states are projected to see higher costs—not savings—from expanding Medicaid.
Medicaid needs serious reforms to serve the people it was intended to serve. Expanding it under Obamacare is not the answer.
Last week I got a chance to call in to American Family Radio and speak on air to Tony Evans who is President of the Family Research Council and I asked him if Arkansas should take the deal that Obama is putting forth. He replied that the federal government has always tried to sucker states in with sweet deals then later the states are on the hook for millions of dollars they can not afford.
The Medicaid expansion is touted by proponents of Obamacare as a “no-brainer.” While it is true that some states may see projected savings, it is erroneous to claim that this experience applies to every state.
Proponents predict that by expanding Medicaid states will be able to reduce payments to health care providers, such as hospitals, for uncompensated care. As a matter of fact, nationally, the opposite is true:
40 of 50 states are projected to see increases in costs due to the Medicaid expansion.
The majority of states see costs exceed savings when the federal match rate is lowered after the first three years. From there, state costs continue to climb, dwarfing any projected savings.
State savings are concentrated in large states. New York is estimated to see $33 billion in savings, while Massachusetts is estimated to save $6 billion over 10 years. Because of the design of their current programs, these states have a unique opportunity to restructure their programs and transfer significant cost to the federal ledger. (continues below chart)
Of course, even these savings are highly speculative. They assume that uncompensated care costs actually decrease under a Medicaid expansion. Analysis of other states shows that this is not always the case. In fact, in Maine, uncompensated care continued to grow.
Furthermore, the assumed reductions in state supplemental payments to providers for uncompensated care are conditional on state lawmakers enacting explicit payment cuts. Depending on policies adopted by state lawmakers, those reductions could be higher or lower—or even zero—if a state does not enact payment cuts.
Under Obamacare, it is even more implausible to assume states would be able to cut uncompensated care funding. That’s because any state payment cuts would have to be imposed on top of Obamacare’s federal payment cuts. Obamacare cuts federal Medicaid “Disproportionate Share Hospital” (DSH) funding by $18.1 billion and Medicare DSH funding by $22.1 billion over the years 2014–2020.
Therefore, Haislmaier predicts, “governors and state legislators should expect their state’s hospitals and clinics to lobby them for more—not less—state funding to replace cuts in federal DSH payments.”
The Medicaid expansion represents a massive increase in federal and state spending. Although some claim that states could experience savings, it is clear that this is the exception, not the rule. Expanding Medicaid will ultimately cost states in the long run.
See the breakdown for each of the 50 states and the District of Columbia here:
A Kaiser Foundation/Urban Institute study from November 2012 projected the cost and coverage effects of the Medicaid expansion over the first nine years (2014–2022). Of particular interest to state lawmakers are the study’s projected changes in state expenditures associated with each state adopting the Medicaid expansion. However, the Kaiser/Urban study reports only the net effects for each state on a cumulative basis.
The Heritage microsimulation model was used to replicate the Kaiser/Urban study—applying the same assumptions and using the same data sources—but reported the results in disaggregated form.
Consistent with the Kaiser/Urban methodology:
Growth paths are estimated contingent on model-estimated enrollment growth for all 50 states. These growth paths are then benchmarked to the Urban/Kaiser aggregate results.
We model that adults between 100 percent and 138 percent of the federal poverty level already enrolled in Medicaid as part of an optional population are funded by the enhanced federal match rates for the expansion population. Additionally, states that currently provide limited Medicaid benefits to adults in the same income range also receive the expansion match rates for providing full Medicaid coverage to those adults. As a result of these assumptions, states with already low uninsured rates among the expansion population are projected to be “winners” under the Medicaid expansion.
We apply to state supplemental payments to providers for uncompensated care the Kaiser/Urban assumptions that state funding accounts for 30 percent of total funding and that state funding is eventually reduced by one-third.
It is important to note that the assumed reductions in state supplemental payments to providers for uncompensated care are not automatic but are conditional on state lawmakers enacting explicit payment cuts.
The estimates also do not reflect the fact that many states could achieve additional savings by reducing Medicaid income eligibility for adults to federally mandated minimum levels, thus making the affected individuals eligible instead for federally subsidized exchange coverage.
Both provider payment cuts and changes to income eligibility require separate policy decisions by state lawmakers. Furthermore, state lawmakers could make changes to either or both policies regardless of whether they elect to implement the Medicaid expansion.
Like the Urban Institute’s Health Insurance Policy Simulation Model, which was used to produce the original study, Heritage’s microsimulation model is comprised of data from the Current Population Survey and Medical Expenditure Panel Survey.
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According to a recent poll, 74 percent of likely voters are extremely or very concerned about the current level of government spending. And 58 percent think the level of spending is unsustainable.
Is the public right? Is Washington bankrupting America? Some facts from the video:
Spending per household has risen over 40 percent in the last 10 years and is set to do so again in the next 10 pushing debt (and interest on the debt) to unprecedented levels. But that’s just a result of PAST spending…
Our government owes $106 trillion in FUTURE spending commitments – that cannot be paid for.
We can solve it, but politicians will have to make tough choices. Increasing taxes can’t do the trick ($106 trillion is equivalent to taking all of the taxable income from every American nine times over), nor is it fair to saddle taxpayers with a problem created by government irresponsibility.
We need real spending reform. Merely returning to the spending per household levels of the 1990s would balance the budget in three years.
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President Obama c/o The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
The fact that “the price of hospital care and higher education” has risen much faster than the cost of other goods is not an exogenous variable. Why do those costs rise so much faster? Becausethe government purchases them, reducing or eliminating the normal effects of supply, demand, and competition.
In today’s Washington Post Lawrence Summers demonstrates with mathematics that you can’t shrink the federal government — as long as (he doesn’t say) you don’t change the tasks you assign to it. True enough, if the government is still going to engage in “sustained deployments” of our military across the globe, and provide retirement income and health care to tens of millions of people, then the size of government isn’t going to shrink. But surely those are the issues we should be debating.
Michael Cannon below notes another key point in Summers’s argument:
[I]ncreases in the price of what the federal government buys relative to what the private sector buys will inevitably raise the cost of state involvement in the economy. Since the early 1980s the price of hospital care and higher education has risen fivefold relative to the price of cars and clothing, and more than a hundredfold relative to the price of televisions.
I would elaborate on Michael’s response. The fact that “the price of hospital care and higher education” has risen much faster than the cost of other goods is not an exogenous variable. Why do those costs rise so much faster? Because the government purchases them, reducing or eliminating the normal effects of supply, demand, and competition. I wrote about this in a 1994 article reprinted in my book The Politics of Freedom responding to an argument made by the economist William Baumol and the scholar-statesman Daniel Patrick Moynihan:
Moynihan identifies a number of services afflicted with Baumol’s disease: “The services in question, which I call The Stagnant Services, included, most notably, health care, education, legal services, welfare programs for the poor, postal service, police protection, sanitation services, repair services . . . and others.” He points out that many of those are provided by government and posits that “activities with cost disease migrate to the public sector.”
But maybe he has it backwards. Maybe activities that migrate to the public sector become afflicted with cost disease. The conservative magazine National Review, which, surprisingly, seems to accept Moynihan’s thesis, has inadvertently supplied us with some evidence on this point.
Ed Rubinstein, National Review‘s economic analyst, writes, “For more than three decades health-care spending has grown faster than national income. . . . The trend in health-care costs is no different from that of other services.” He cites education and auto repair as examples. However, the numbers Rubinstein provides don’t support his–or Moynihan’s–point. Look at the accompanying figure.
The cost of auto repair, a service provided almost entirely in the private sector, has barely outpaced inflation. The cost of medical care increased twice as fast as inflation. Government’s share of medical spending increased from 33 percent in 1960, when the chart begins, to 53 percent in 1990. Meanwhile, the cost of education, almost entirely provided by government, increased three times as fast as inflation–despite the constant complaints about underfunded schools.
The lesson is clear: Services provided by government are afflicted with Baumol’s disease in spades. Services provided in the private sector, where people spend their own money, are much less likely to soar in cost.
Medical care is a good area in which to test this theory because over the past 30 years it has been paid for in three different ways: out-of-pocket spending by consumers; insurance payments, mostly provided by employers; and government payments. As out-of-pocket spending declines in importance, medical inflation heats up. And private-sector spending on medical care rose only 1.3 percent a year between 1960 and 1990, while government spending rose more than three times as fast–4.3 percent a year.
When services are provided privately, and consumers can decide whether to purchase them, or choose another provider, or do without, there’s a powerful incentive to improve productivity and keep costs down. Stagnant productivity in government-run services reflects not so much Baumol’s disease as what we might call Clinton’s disease, the notion—even now, in 1994—that government can provide services more efficiently and cost-effectively than can the marketplace.
Now, I think Larry Summers knows this. He knows that when consumers don’t face full costs for services, they tend to consume more of them without worrying about the cost. So he knows that these costs could come down, if only we moved these services into the market, or at least found ways to get consumers directly concerned with costs. He should rethink his claims about the inevitability of more expensive government. These realities are in fact choices, decisions that voters and taxpayers can change.
Thank you so much for your time. I know how valuable it is. I also appreciate the fine family that you have and your commitment as a father and a husband.
Sincerely,
Everette Hatcher III, 13900 Cottontail Lane, Alexander, AR 72002, ph 501-920-5733, lowcostsqueegees@yahoo.com
Americans see the problem with the religious liberty violation at the leading edge of Obamacare implementation, according to a new poll released by Rasmussen Reports this week.
The poll shows that by a margin of 46–41, likely American voters support a religious exemption for churches, religious organizations, and businesses from Obamacare’s anti-conscience Health and Human Services (HHS) mandate. Sadly, the coercive dictates of the Obamacare bureaucracy don’t hold the same respect for conscience and religious freedom.
The Obamacare anti-conscience mandate, which forces almost all employers to provide and pay for coverage of abortion-inducing drugs, contraception, and sterilization, is accompanied by an offensively narrow religious exemption that effectively covers only formal houses of worship. Countless other employers—such as religious social service providers, schools, and business owners—are forced to pay for the mandated drugs and services regardless of religious or moral objections.
The consequences for non-compliance are steep. Hefty government fines—to the tune of millions of dollars for some companies—threaten not only employers’ religious freedom but their livelihoods.
Americans’ wariness over forcing employers to pay for mandated services in conflict with their deeply held beliefs is a concern shared by more than a few federal judges. Just last week, a fourth federal court halted enforcement of the anti-conscience mandate against a business owner. Tyndale House Publishers, one of the nation’s largest Bible retailers, won a preliminary injunction against the mandate that would have forced the for-profit company to pay for abortion-inducing drugs in its employee health plan in violation of the business’s Christian principles. Three other family-owned businesses—Hercules Industries, Weingartz Supply Company, and O’Brien Industrial Holdings—have also won preliminary injunctions against the mandate.
Many Americans—and certainly the more than 110 plaintiffs suing over the mandate—understand the offensiveness of the rule’s current, miniscule religious exemption. But concern over the mandate’s assault on religious freedom isn’t merely caused by the narrowness of this particular religious exemption. The root of the mandate’s disregard for Americans’ freedoms is found in the broader coercion of an invasive health care law that dictates what insurance companies must cover, what employers must provide, and what individuals must purchase.
Under a one-size-fits-all, government-controlled health care system, conflicts with religious freedom and individual liberty are only likely to increase.
In a separate Rasmussen poll from earlier this year, more than half of likely voters admitted they hadn’t personally felt any impact of the health care law, much of which won’t be implemented until 2014. Americans have yet to experience the full weight of Obamacare’s countless, liberty-crushing mandates that will crush individual choice in health care and place burdensome costs on businesses and individuals.
The anti-conscience mandate’s assault on religious freedom is only one of the first tastes of Obamacare’s coercive takeover of the health care system. The fact that almost half of likely voters recognize the need to protect employers’ religious freedom should signal greater concern for future dictates from a law that cedes discretion over personal health care decisions and consumer choice to unelected bureaucrats.
This mini-documentary from the Center for Freedom and Prosperity Foundation explains that “third-party payer” is the main problem with America’s health care system. This is why undoing Obamacare, while desirable, is just a small first step if we want to reduce costs and boost efficiency
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President Obama c/o The White House
1600 Pennsylvania Avenue NW
Washington, DC 20500
We were told that Obamacare would not provide for abortions two years ago and now we are told it will. That is probably the biggest sticking point with me.
<:time datetime=”2012-07-10T18:01:57+00:00″ pubdate>Published: 06/04/2012 at 8:30 PM
Chelsea Schilling is a commentary editor and staff writer for WND.
Dr. James Dobson is taking a defiant stand on Obamacare and issuing a loud and clear message to President Obama: “I WILL NOT pay the surcharge for abortion services. … So come and get me if you must, Mr. President. I will not bow before your wicked regulation.”
The evangelical Christian author and founder of Focus on the Family minced no words when he accused Obama of deceiving the American public in his exclusive WND column, “The president’s Obamacare lies.”
Dobson notes that the president issued the following statement on the night of Sept. 9, 2009, when he gave an address to a joint session of Congress in an effort push members of the House and Senate to pass his health-care bill:
“And one more misunderstanding I want to clear up – under our plan, no federal dollars will be used to fund abortions, and federal conscience laws will remain in place.”
However, he said, “The speech was filled with promises and assurances that have proved to be shockingly false, and the president’s premise was based on deception.”
In numerous speeches, Obama assured his pro-choice constituency that coverage for abortion would be “job one” within his health-care plan, he noted.
“I knew from deep within my soul that the president was not being truthful about this matter of life and death,” Dobson recalled, noting that Rep. Joe Wilson, R-S.C., was so outraged by what he was hearing that he blurted out, “You lie!”
By March 2010, the Obama administration had officially approved the first instance of taxpayer-funded abortions under Obamacare – giving Pennsylvania $160 million to set up a new “high-risk” insurance program under a provision of the legislation in preparation for a $5 billion national roll-out.
“The Big Promise of Sept. 9 had already been abandoned,” Dobson lamented.
He also observed that Obama fought language in the legislation that would prohibit federal subsidies for abortion: “This was his plan all along, and pro-life advocates were kept in the dark.”
Earlier this year, Secretary of Health and Human Services Kathleen Sibelius announced an expansion of Section 1303 of the Obamacare law requiring millions of Americans to pay a minimum surcharge for abortion services. The amount to be remitted will be a minimum of $12 per year, but could be much more.
“When an insurance company provides coverage for abortion, it MUST charge all employees an amount sufficient to cover the costs of abortion services, even by those who are horrified at the thought,” Dobson explained. “No one can opt out of the provision. That is now written into the law.”
Furthermore, the Department of Health and Human Services has announced that businesses and non-profit organizations – including churches and Christian colleges and universities – must provide free contraceptives and abortion pills with health insurance.
“When Catholic and evangelical church leaders objected strenuously to this assault on religious liberty, the president simply announced an ‘accommodation,’ requiring insurance companies to pay for the contraceptives,” Dobson explained. “Of course, they will pass the expense along to their customers, and employees will all be in the abortion business.”
He said President Obama never intended to protect the conscience clause and even canceled President Bush’s executive order guaranteeing doctors, nurses and health professionals would not be forced to act against their beliefs.
“Abortion is an integral part of Obamacare, and babies will die because of it,” Dobson wrote in his column. “Citizens never had an opportunity to be heard on the matter. The abortion component of the health-care bill will go into effect in January 2013. After that date, you could be forced unwittingly to support the killing of babies.”
But Dobson vowed to take a stand against Obama’s “wicked” surcharge, come what may:
I want to be very careful regarding what I am about to write now. It will not be said flippantly or with malice, but it will reflect the passion of my heart.
I believe in the rule of law, and it has been my practice since I was in college to respect and honor those in authority over us. It is my desire to do so now. However, this assault on the sanctity of human life takes me where I cannot go. I WILL NOT pay the surcharge for abortion services. The amount of the surcharge is irrelevant. To pay one cent for the killing of babies is egregious to me, and I will do all I can to correct a government that lies to me about its intentions and then tries to coerce my acquiescence with extortion. It would be a violation of my most deeply held convictions to disobey what I consider to be the principles in Scripture. The Creator will not hold us guiltless if we turn a deaf ear to the cries of His innocent babies. So come and get me if you must, Mr. President. I will not bow before your wicked regulation.
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Thank you so much for your time. I know how valuable it is. I also appreciate the fine family that you have and your commitment as a father and a husband.
Sincerely,
Everette Hatcher III, 13900 Cottontail Lane, Alexander, AR 72002, ph 501-920-5733, lowcostsqueegees@yahoo.com
Dr. Barbara Bellar – Obamacare Summed Up in One Sentence
Illinois Women For Romney/Ryan Victory Rally Speaker ~ Dr. Barbara Bellar.
She received a standing ovation after her speech at our Rally on Aug 21st, 2012.
“Dr. Bellar is a small business owner, physician, Veteran Army Major, professor, and attorney. She can make a difference and will serve with distinction and integrity.”
“Barbara is a new voice for Illinois. She is no one’s puppet, no one owns her so she can just do the right thing.” You can trust her integrity and personal/professional ethics!
They’re right, though they probably don’t realize the seriousness of that looming crisis.
Here’s what you need to know: America’s fiscal crisis is actually a spending crisis, and that spending crisis is driven by entitlements.
More specifically, the vast majority of the problem is the result of Medicaid, Medicare, and Social Security, programs that are poorly designed and unsustainable.
The Medicaid program imposes high costs while generating poor results. This Center for Freedom and Prosperity Foundation video explains how block grants, such as the one proposed by Congressman Paul Ryan, will save money and improve healthcare by giving states the freedom to innovate and compete.
This Center for Freedom and Prosperity Foundation video explains how a “premium-support” plan would solve Medicare’s fiscal crisis and improve the overall healthcare system. This voucher-based system also would protect seniors from bureaucratic rationing. http://www.freedomandprosperity.org
There are two crises facing Social Security. First the program has a gigantic unfunded liability, largely thanks to demographics. Second, the program is a very bad deal for younger workers, making them pay record amounts of tax in exchange for comparatively meager benefits. This video explains how personal accounts can solve both problems, and also notes that nations as varied as Australia, Chile, Sweden, and Hong Kong have implemented this pro-growth reform. www.freedomandprosperity.org
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Regular readers know I’m fairly gloomy about the future of liberty, but this is one area where there is a glimmer of hope.
The Chairman of the House Budget Committee actually put together a plan that addresses the two biggest problems (Medicare and Medicaid) and the House of Representatives actually adopted the proposal.
The Senate didn’t act, of course, and Obama would veto any good legislation anyhow, so I don’t want to be crazy optimistic. Depending on how things play out politically in the next six years, I’ll say there’s actually a 20 percent chance to save America.
I watched the video by the Democrat National Convention on 9-6-12 that showed your beautiful wife saying about your family: “We sit around the dinner table (with our kids) and he is he last to be asked, ‘Oh yeah, how was your day Dad?’ You know really he is an afterthought.”
As a father and a husband I want to thank you for demonstrating to others that men need to keep their priorities straight.
Entitlement spending will bury this country if we do nothing about it.
Some policymakers have difficulty understanding competition’s role in health care. There is a historical reason: With a legacy of third-party micromanagement, something like Medicare Part D—a program where about 1,100 drug plans compete for enrollees—is remarkably foreign. Several analysts cite this program as a marked success for competition in health care. However, a recent Kaiser Family Foundation issue brief claimed that the effect of competition was overstated and unclear.
Interestingly, the arguments intended to downplay the role of competition actually provide evidence that Medicare Part D competition is working. Consider these examples.
Departure from original cost projections. There was a difference between budget projections and actual spending in Part D, which can be explained partly by an overestimate of Part D enrollment; still, market competition clearly provided savings. Enrollment in Medicare Part D was lower than the original Congressional Budget Office projections over the past six years by an average of 7.1 million people per year. Research calculations show, however, that this effect can account for only 17 percent of the difference in actual cost.
Prescription drug costs. One example of competition working is the “flat price trend.” In other words, people substitute their brand-name prescriptions with generics in order to save money. For example, if a patient was taking Niaspan, which averages around $125 for a prescription, he could switch to Niacin, a generic version, which costs $70 on average for the same refill. Many Medicare beneficiaries switch to generics just for this reason. Although brand-name drugs have experienced a modest increase in price, this generic effect has kept prices of prescription drugs relatively constant. Hence, spending grows more slowly.
Those who downplay the role of competition claim that such behavior is not competitive, but understanding this behavior in a context without competition is simply impossible. As Joseph Antos of the American Enterprise Institute points out, “If we paid for each individual prescription the way we pay for each individual health service, there would be no incentive for drug plans to encourage the use of generics over brands.” Competition in Medicare Part D allows individual choice to play a role in prescription drug consumption. This directly encourages generic substitution, since individuals seek out the best value.
Few patients switching plans. Another critique of competition is that a general reluctance to switch plans “reflects the large number of plan choices available combined with the costs in terms of time and energy of doing research and of actually making a switch.” This claim, taken from behavioral economics, does not negate a person’s price sensitivity. Experience with the Federal Employees Health Benefits Plan (FEHBP) shows that about 5 percent of patients switch plans each year. This reluctance to switch reflects well-documented satisfaction with plan choices. This only proves that people make decisions based on many factors, including how much they like their plans.
Considering the growth figures in Medicare, competition appears to be working. Spending in Medicare Parts A and B has grown at an average of 4.9 percent over the past six years, while Medicare Part D grew at 2.8 percent. Imagine if total Medicare spending grew at 2.8 percent—as opposed to its actual growth rate of 8.7 percent. This is the effect of market-based reforms. For example, if Heritage’s Saving the American Dream plan had been implemented five years ago, annual Medicare spending growth would have likely topped out at 3.5 percent.
In health care, competition allows individual behavior to drive down costs and constrains spending without top-down mandates that ultimately limit choice and freedom. A fundamental shift toward reform that focuses on consumer choice and market competition, like Heritage’s Saving the American Dream plan, is good not only for the federal budget, but also for the individual who desires to secure the best value for his or her health care dollars.
_______________
Thank you so much for your time. I know how valuable it is. I also appreciate the fine family that you have and your commitment as a father and a husband.
Sincerely,
Everette Hatcher III, 13900 Cottontail Lane, Alexander, AR 72002, ph 501-920-5733, lowcostsqueegees@yahoo.com
Max Brantley of the Ark Times takes on Michael Cannon of the Cato Institute today concerning Obamacare. I have posted many links to Cannon’s articles in the past on my blog and on the Arkansas Times liberal blog. The finest article written in my estimation was written on Nov 20, 2012 and here is a link to it. No one has acted like Cannon’s ideas had any chance of working out since the Arkansas Times Blog is made of primarily of Obama supporters.
Below is a portion of the post by Brantley followed by links to some of the past articles and videos by Cannon I have posted before.
Posted by David Ramsey on Fri, Dec 14, 2012 at 12:23 PM
Michael Cannon of the Cato Institute
Today’s the big day for states to decide whether they want to run their own health-insurance exchange or have the federal government do it. Arkansas opted earlier this week for a partnership.
It looks like states will split pretty evenly across the country, with around 20 running their own exchanges, around 20 ceding control to the feds, and the rest opting for a partnership. There’s been a fair amount of fuss over this decision but it probably won’t impact consumers much one way or the other.
We’ve noted that it’s a bit curious that Republican lawmakers, usually strongly in favor of more state control, have led the charge against state-run exchanges.
In the runup to the deadline for the exchange decision, a few conservatives, like Douglas Holtz-Eakin — Director of the Congressional Budget Office under George W. Bush — started to make the ideologically coherent argument that, however much they hate Obamacare, states are better off with more control. Most movement conservatives stronglyrejected these ideas.
Why? Conservatives are devoted to a give-no-quarter approach to Obamacare. Michael Cannon, the Cato Institute’s health-care point man, wrote recently in the National Review that accepting the law amounted to “Vichyism.”
And, they think, it’s not just lost causism. In addition to hoping that it will disrupt the smooth implementation of the law, Cannon wants states to say no to the exchange because he believes that a constitutional challenge can be raised against subsidies provided on the federal exchanges (the law doesn’t explicitly mention subsidies via a federal exchange because lawmakers anticipated that states would run the exchanges). The argument is pretty flimsy, but flimsy arguments have given proponents of the Affordable Care Act reason to sweat before.
The state of Oklahoma has already filed a lawsuit in federal court along these lines and the Wall Street Journal has also floated the idea. Here’s a good summary of Cannon’s Hail Mary play.
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Earlier posts about Michael Cannon’s works on Obamacare:
Sen. Max Baucus admits the PPACA conditions tax credits on state compliance Published on Sep 21, 2012 by Michael F. Cannon I really don’t know the answer to this question and would love it if someone would enlighten me. This article below from the Cato Institute makes the case that States can stop Obamacare from […]
It seems that Obamacare is going to go down according to this article below: GOP Vows to Keep Fighting IRS’s Illegal ObamaCare Taxes if Obama Wins Posted by Michael F. Cannon Roll Call reports that if President Obama wins re-election, House and Senate Republicans will hold votes on rescinding his illegal IRS rule that unlawfully […]
Cato’s Michael F. Cannon Discusses ObamaCare’s Individual Mandate Is Michael Cannon of the Cato Institute right about states blocking Obamacare, factchecker says he is wrong. I Have Been False* Posted by Michael F. Cannon *According to PolitiFact. In an unconscious parody of everything that’s wrong with the “fact-checker” movement in journalism, PolitiFact Georgia (a project of […]
Michael Cannon on Medicare and Healthcare You want to know the real truth about Obamacare then check out these videos and articles linked below: American people do not want Obamacare and the regulations that go with it March 7, 2012 – 8:02 am In this article below you will see that the American people do not […]
Gerard Matthews wrote on March 21, 2012 in the Arkansas Times: Children cannot be denied coverage because of a pre-existing condition. Young people can stay on their parents’ health insurance plan until they are 26 years old. Preventive services, which will ultimately help control health care costs, have been added to some plans at no […]
Michael Cannon on Medicare and Healthcare In his article, “Medicaid and the consequences,” Arkansas Democrat-Gazette, March 20, 2012, (paywall), Brummett admits, “Medicaid will break the bank of state government if we don’t do something.” However, he never gets around to saying that Obamacare is going to ruin the state financially. It will expand this failing […]
Michael Cannon on Medicare and Healthcare You want to know the real truth about Obamacare then check out these videos and articles linked below: American people do not want Obamacare and the regulations that go with it March 7, 2012 – 8:02 am In this article below you will see that the American people do not […]
Is Washington Bankrupting America? Uploaded by BankruptingAmerica on Apr 20, 2010 Be first to receive our videos and other timely info about economic policy. Subscribe at http://www.bankruptingamerica.org ————————- According to a recent poll, 74 percent of likely voters are extremely or very concerned about the current level of government spending. And 58 percent think the […]
I have been writing President Obama letters and have not received a personal response yet. (He reads 10 letters a day personally and responds to each of them.) However, I did receive a form letter in the form of an email on June 15, 2012. I don’t know which letter of mine generated this response so I have […]
President Obama c/o The White House 1600 Pennsylvania Avenue NW Washington, DC 20500 Dear Mr. President, I know that you receive 20,000 letters a day and that you actually read 10 of them every day. I really do respect you for trying to get a pulse on what is going on out here. I see […]
Michael Cannon on Medicare and Healthcare President Obama c/o The White House 1600 Pennsylvania Avenue NW Washington, DC 20500 Dear Mr. President, I know that you receive 20,000 letters a day and that you actually read 10 of them every day. I really do respect you for trying to get a pulse on what is […]
When I travel, particularly overseas, I run into a lot of people who are totally confused about the American healthcare system.
For all intents and purposes, they think the United States relies on the free market and that government (at least in the pre-Obamacare era) was largely absent.
So they are baffled when I tell them that nearly one-half of all health expenditures in America are directly financed by taxpayers and that the supposedly private part of our healthcare system is massively distorted by government interference and intervention.
When explaining how government has screwed up private health insurance, I talk about third-party payer and how genuinely private insurance works for home ownership and automobiles. And I cite examples of genuine free markets for cosmetic surgery and even (regardless of your views) abortion.
But from now on, I think I will simply tell people to watch this superb video from Reason TV.
Three years ago, Dr. Keith Smith, co-founder and managing partner of the Surgery Center of Oklahoma, took an initiative that would only be considered radical in the health care industry: He posted online a list of prices for 112 common surgical procedures. The 51-year-old Smith, a self-described libertarian, and his business partner, Dr. Steve Lantier, founded the Surgery Center 15 years ago, after they became disillusioned with the way patients were treated at St. Anthony Hospital in Oklahoma City, where the two men worked as anesthesiologists. In 1997, Smith and Lantier bought the shell of a former surgical center with the aim of creating a for-profit facility that could deliver first-rate care at a fraction of what traditional hospitals charge.
The major cause of exploding U.S. heath care costs is the third-party payer system, a text-book concept in which A buys goods or services from B that are paid for by C. Because private insurance companies or the government generally pick up most of the tab for medical services, patients don’t have the normal incentive to seek out value.
The Surgery Center’s consumer-driven model could become increasingly common as Americans look for alternatives to the traditional health care market—an unintended consequence of Obamacare. Patients may have no choice but to look outside the traditional health care industry in the face of higher costs and reduced access to doctors and hospitals.
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This shows how a true free market operates. Efficiency and low prices are the norm, and consumers get a good deal.
But that’s a minor gripe. You should share this post with any and all fuzzy-headed friends and colleagues and tell them this is how smoothly the market would work if the government simply would get out of the way.
If we want this kind of system to be the rule rather than the exception, we need to scrap the healthcare exclusion in the tax code as part of a switch to a simple and fair flat tax. That will help bring some rationality to the health insurance market and address the part of the third-party payer crisis caused by indirect government intervention.
P.S. As this poster cleverly illustrates (and as Ronald Reagan correctly warned in the second video of this post), government is the problem, not the solution.
The Daily Hatch 