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Homeless Scare Numbers
The National Center on Family Homelessness has generated headlines today by releasing a report that claims “one in 50 children is homeless in the United States every year.” That would be a total of 1.5 million homeless children, a truly shocking figure. The number is all the more shocking because the U.S. Department of Housing and Urban Development says there actually only 671,000 people were homeless in 2007 (the last year for which data is available), of which only about 249,000 were people in families. Assuming even one adult per family would mean there were around 166,000 homeless children, far too many, but also far fewer than 1.5 million.
What accounts for the discrepancy? First, the National Center uses an incredibly broad definition of homeless. For example, in addition to those we usually think of as homeless (those living in shelters or on the streets), they also include people “Sharing the housing of other persons due to loss of housing, economic hardship, or a similar reason.” Under this definition, when your out-of-work in-law crashes on your couch, he’s homeless. The National Center also includes people “living in motels, hotels, trailer parks, or camping grounds,” children awaiting foster care placement, and children of migratory farm workers. And, a child needs only to fall into one of these categories for a single day to qualify as homeless.
Second, this study, like the HUD study as well, are not actual counts of the homeless, but estimates and extrapolations based on reports by various government agencies. The Census Bureau does attempt to do an actual head count of the homeless (170,000 in 2000), but that estimate is both out-of-date and generally criticized as an undercount. Still, going from that estimate to 1.5 million homeless children seems quite a stretch.
Homelessness is clearly a problem, and for the children involved, a tragedy, but scare headlines are a poor substitute for thoughtful public policy.
He Has a Point
Stung by accusations that he is a “socialist,” President Obama pointed out to two New York Times reporters that, “it wasn’t under me that we started buying a bunch of shares of banks. It wasn’t on my watch. And it wasn’t on my watch that we passed a massive new entitlement -– the prescription drug plan — without a source of funding.”
Not to defend Obama’s unprecedented increase on government spending or plans to involve the government in almost every area of our lives…but he does have a point. As I pointed out in Leviathan on the Right, the Bush administration’s brand of big-government conservatism was, at the very least, the greatest expansion of government from Lyndon Johnson to, well, Barack Obama.
Looking to a Failed Model for Health Care Reform
CNN health care correspondent Sanjay Gupta, who was briefly considered for surgeon general in the Obama administration, reports that the administration is looking to Massachusetts as a model for its forthcoming health care reform proposal. That model would involve an individual mandate, an employer mandate, a “connector” with increased insurance regulation, and massive subsidies for the middle class.
Given that the Massachusetts plan is expected to run $2-4 billion over budget over the next 10 years, has failed to come close to universal coverage, has done nothing to reduce health care costs (indeed, may have driven up insurance costs), and has actually led to increased wait time for primary care physicians, that may not be the best model out there. In fact, perhaps the Obama administration might like to look at studies by David Hyman and me detailing the Massachusetts model’s many problems.
Has He Read the Book?
At yesterday’s White House Summit on Health Care Reform, President Obama had this to say:
If there is a way of getting this done, where we’re driving down costs and people are getting health insurance at an affordable rate and have choice of doctor, have flexibility in terms of their plans, and we could do that entirely through the market, I’d be happy to do it that way.
Well, Mr. President, may I recommend Healthy Competition: What’s Holding Back Health Care and How to Free It for a detailed proposal for how to accomplish this without turning one-seventh of our economy and some of our most important, personal, and private decisions over to the tender mercies of the federal government.
Of course, as my colleague Michael Cannon points out, no one who supports free market proposals to drive down costs and give consumers greater choice of providers and insurers was actually invited to the summit.
The ball is back in your court, Mr. President.
Hmmmm, Why Would That Be?
Weak Health Care Stocks Drag Market Lower
– Associated Press, February 26, 2009
Obama Proposes $634 Billion Fund for Health Care
– Washington Post, February 26, 2009
So the government wants to take over one-seventh of the U.S. economy and the market drops. I’m shocked.
David Brooks Unhinged
David Brooks went completely off the deep end last night in critiquing Louisiana Governor Bobby Jindal’s Republican response to Barack Obama’s address to Congress. According to Brooks, “in a moment when only the federal government is big enough to actually do stuff- to just ignore all that and just say ‘government is the problem, corruption, earmarks, wasteful spending,’ it’s just a form of nihilism.”
Now, I thought Jindal’s speech was rather banal and poorly delivered, but since when is it nihilism to oppose “corruption, earmarks, and wasteful spending”? Apparently, government should just do “stuff.” It doesn’t really matter whether that “stuff” is good or not, whether it will actually stimulate the economy or not. And of course, there is no problem with the fact that that “stuff” includes a government takeover of our health care system, an unworkable and expensive energy policy, an extension of a federal education policy that has failed to educate our children, higher taxes, greater debt, and more spending on just about everything. To oppose all of that is “nihilism.”
Then count me as a nihilist – or maybe I just believe in liberty.
The Truth about Medical Bankruptcies
During his speech to Congress last night, President Obama declared that health care costs “causes a bankruptcy in America every thirty seconds.” His numbers are just a little bit off.
If what President Obama said were true, there would be approximately 1.05 million health care related bankruptcies in this country every year. However, in 2007 (the last full year for which there is data available, there were a total of only 815,000 non-business bankruptcies nationwide. Moreover, according to a study by Dr. Ning Zhu at UC-Davis, only 5 percent of bankruptcies are caused by medical bills. That suggests that in 2007 there were about 41,000 health care related bankruptcies. Too many, to be sure, but a far cry for 1.05 million.
Haven’t we learned from those weapons of mass destruction in Iraq that facts matter when a president says we absolutely have to do something now?
Obama Retreats from Third Rail
President Obama has stared the need for entitlement reform in the face — and immediately blinked.
For a brief moment it appeared that Obama was willing to take on one of his party’s most prized shibboleths: the idea that there is nothing wrong with Social Security and Medicare that repealing the Bush tax cuts won’t fix. But faced with a rebellion by House Speaker Nancy Pelosi and the net-roots left, it is clear the president now plans to put off any serious effort to reform those programs.
But facts are stubborn things. The combined unfunded liabilities of Social Security and Medicare top $100 trillion. Indeed, without reform, Social Security will begin running a deficit within eight years, by 2017. And Medicare faces a deficit even sooner. If current trends continue, Medicare and social Security, along with Medicaid, will consume 28 percent of GDP by mid-century.
Obama has the opportunity to show that he truly represents a change from Washington politics as usual. If he retreats from obvious challenges so easily, he will fail.
Sebelius at HHS
The New York Times and others are reporting that Kansas Governor Kathleen Sebelius will be President Obama’s choice for HHS secretary. Obama’s first choice for secretary of HHS, former Sen. Tom Daschle, was an expert on health care reform; indeed, he had written a book on the topic, which laid out specific ideas, and provided fodder for opponents of Obama’s reform plans. Sebelius represents a very different approach. While she is a former state insurance commissioner and dealt with health programs as governor, she is associated with few specific proposals.
A preliminary look at her record suggests that she is a member of what my colleague Michael Cannon calls the Church of Universal Coverage, and has regularly pushed for the expansion of government programs such as Medicaid and SCHIP. She sought to have Kansas taxpayers cover all children up to the age of five, but her proposal was rejected by the legislature. She also has been sympathetic to the ideas of both an employer mandate (she imposed a mandate for companies receiving state contracts) and an individual mandate. As insurance commissioner she had a reputation for supporting increased regulation. Nothing surprising in this record at all.
An interesting question will be whether Sebelius will also inherit Daschle’s role as White House “health czar,” or whether that position will go to Daschle’s coauthor, Jeanne Lambrew, currently the “deputy czar.” If Sebelius doesn’t get the second post, expect health care reform to be driven out of the White House, while Sebelius, generally given high marks for bipartisanship, tries to corral moderate Republican votes.
Update–2012 GOP Contenders and the Stimulus
Louisiana Governor Bobby Jindal has indicated that he may refuse $4 billion in federal funds that his state is scheduled to receive under the stimulus bill that President Obama signed this week.
Earlier South Carolina governor Mark Sanford said he would turn down the money. Alaska governor Sarah Palin has also suggested she may say no to stimulus funds.
On the other side, of course, Florida governor Charlie Crist was perhaps the most ardent Republican proponent of the stimulus bill. (Mitt Romney opposed the stimulus, but since he is no longer a governor he doesn’t face the difficult decision of whether to put principle above “free” federal money).
Who knows, Republicans in 2012 might actually have candidates who are (or at least want to be) fiscal conservatives.
I Believe in Non-Political Government Comparative-Effectiveness Research (and in the Tooth Fairy, Santa Claus…)
My colleague Michael Cannon has been writing about the folly of government-sponsored comparative effectiveness research. Now, in an article in the Journal of the American Medical Association (subscription required), John Kraemer and Lawrence Gostin add another cautionary note for those who believe that the government’s decisions will be based on science and not on politics. In particular, the authors discussed how the Connecticut Attorney General has attacked the Infectious Disease Society of America (IDSA) for recommending against the use of long-term antibiotics to treat “Chronic Lyme Disease.” Although the IDSA based its non-binding recommendation on the overwhelming scientific evidence, the International Lyme and Associated Diseases Society (ILADS), a well connected and media-savvy advocacy group for those with Lyme disease protested, taking its case to the Connecticut political establishment. As a result, Connecticut Attorney General, Richard Blumenthal sued the IDSA under the state’s anti-trust laws.
Political institutions are by definition political. A government body deciding on the comparative-effectiveness or cost-effectiveness of medical treatments will inevitably base its decisions as much on politics as on science.
The Beginning of the End of Welfare Reform?
As if there were not enough reasons to oppose the Big Boondoggle, otherwise known as the stimulus bill, it appears that Democrats have slipped in a provision that would take the first steps toward undoing the 1996 welfare reform.
A provision of the bill would establish a $3 billion “emergency fund” for states to use to pay for increases in their welfare rolls. Significantly the legislative language would reward states for increasing their caseloads, regardless of whether the increase was due to increased unemployment or other economic conditions or simply because the state loosened its work requirements or time limits. It also shifts the base for states caseload reduction bonuses in a way that will discourage states from holding down the growth in welfare. And, while the grant does not eliminate welfare reform’s central concept of replacing the individual entitlement to welfare with a state block grant, it certainly weakens the foundation.
This effort to undermine welfare reform, should not be seen in isolation. As an Illinois State Senator Barack Obama was highly critical of the 1996 reform. Recent articles and editorials in the New York Times have signaled a new campaign on the Left to restore welfare to its pre-96 rules. And, of course, the stimulus bill also dramatically increases non-cash welfare benefits like Medicaid and food stamps.
I’m not sure that when the American people voted for change, they were really seeking a return to 40-years of welfare failure.
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