Archive for the ‘Health, Welfare & Entitlements’ Category
SAFRA-ficed?
Here’s a quick, preliminary reaction to the higher-education portion of the mammoth health-care reconciliation bill. I could find I’m wrong about some stuff as I delve more deeply into the bill’s language, but it appears that much of the out-of-control spending that would have occurred under the odious Student Aid and Fiscal Responsibility Act has been axed under reconciliation. SAFRA, it appears, has been sacrificed, though to bring to life an even more destructive demon.
Unfortunately, some of SAFRA survived. While a great deal of the spending has been stripped out, reconciliation would still tighten the federal government’s already iron grip on college financing. It would also plow billions more into Pell grants despite decades of evidnece that schools just eat such increases by raising prices. And don’t be fooled by the deceptive accounting in which administrative costs for guaranteed lending are counted as mandatory, but for direct lending as discretionary. When one fully accounts for the costs of going to all direct lending the estimated savings drop from $19.4 billion to $14.4 billion between 2010 and 2019, a sizable chunk of change for a nation so in debt it needs to save every penny it can.
Filed under: Education and Child Policy; General; Health, Welfare & Entitlements
Lies, Damned Lies, and CBO Estimates
Washington is buzzing with news that the Congressional Budget Office has a new cost estimate for the President’s proposal to further expand the federal government’s control over the health care system. The White House is doubtlessly pleased because the takeaway message, as blindly regurgitated by the Associated Press, is that a giant new entitlement program is going to “drive down red ink:”
The Congressional Budget Office estimated the legislation would reduce the federal deficit by $138 billion over its first 10 years, and continue to drive down the red ink thereafter. Democratic leaders said the deficit would be cut $1.2 trillion in the second decade – and Obama called it the biggest reduction since the 1990s, when President Bill Clinton put the federal budget on a path to surplus.
Michael Cannon already has explained that the cost estimate is fraudulent because of what it leaves out, so let me explain why it is fraudulent because of what it includes. The CBO has a very dismal track record of getting the numbers wrong, in part because there is no attempt to measure how a bigger burden of government has negative macroeconomic effects, but also because the number crunchers do a poor job of measuring the degree to which people (recipients, health care providers, state and local politicians, etc.) will modify their behavior to become eligible for other people’s money. The problem is compounded by similar mistakes for revenue estimates from the Joint Committee on Taxation, which (like CBO) makes no attempt to capture macroeconomic effects and has a less-than-stellar history of predicting behavioral responses.
If the legislation passes, we will get more spending, more taxes, and more debt. Equally troubling, we will get more dependency. That’s good for Washington and bad for the country.
Filed under: Government and Politics; Health, Welfare & Entitlements; Tax and Budget Policy
Yet. Another. Fraudulent. Cost Estimate.
House Democrats claim that a not-yet-released Congressional Budget Office report puts the cost of their revised health care overhaul at $940 billion over the next 10 years.
Though I have yet to see the CBO score, I’ll bet anyone a fancy lunch that it does not claim the legislation would cost the federal government just $940 billion from 2010 through 2019.
As former Congressional Budget Office director Donald Marron has explained over and over, the figure that Democrats consistently cite for the cost of their bills is only the CBO’s estimate of the cost of federal spending related to the expansion of health insurance coverage. It is not the full cost to the federal government, because each bill also spends taxpayer dollars on other items.
Marron examined the CBO’s March 11 score of the bill that passed the Senate on Christmas Eve, and found an additional $96 billion of spending over 10 years. If the most recent iteration of ObamaCare is similar, then new federal spending in that bill would be approximately $1.036 trillion — pushing the total over the president’s spending target.
Anyone care to take me up on that fancy-lunch wager?
Moreover, the on-budget costs of the legislation probably account for only 40 percent of the total costs. The other 60 percent come from the private-sector mandates. But Democrats have systematically suppressed any estimates of those hidden taxes, probably because such an estimate would reveal the full cost of the legislation to be closer to $2.5 trillion over the next 10 years.
It has been 272 days since Democrats introduced the first complete version of the president’s health plan. We still haven’t seen an honest cost estimate.
Filed under: Cato Publications; General; Health, Welfare & Entitlements
Would ObamaCare Improve Public Health? Probably Not.
George Avery is an assistant professor of public health at Purdue University. In today’s Daily Caller, Avery rebuts claims that the Obama health plan would improve public health:
The idea that health care contributes significantly to population health is both intuitively appealing and untrue….
In fact, federal “reform” often hurts the public health system. Both public health and health care experts have criticized Medicare and Medicaid, enacted by Congress in 1965, for changing the focus of health care practitioners from prevention to treatment….
Requiring all Americans purchase health insurance, which the current bills hope to do, would not address the underlying socio-economic issues at the root of most public health problems….
Indeed, access to health care can help individual patients, but can also aggravate some public health problems…. High rates of surgical intervention increase the risk and spread of drug resistant infections like MRSA.
Avery is the author of the Cato Institute briefing paper, “Scientific Misconduct: The Manipulation of Evidence for Political Advocacy in Health Care and Climate Policy.”
Filed under: Cato Publications; General; Health, Welfare & Entitlements
Is Obama Losing David Brooks?
New York Times columnist David Brooks, President Obama’s biggest fan among self-proclaimed conservatives, has been plunged into the depths of despair by the latest machinations of Obama and his congressional allies:
Deem and pass? Are you kidding me? Is this what the Revolutionary War was fought for? Is this what the boys on Normandy beach were trying to defend? Is this where we thought we would end up when Obama was speaking so beautifully in Iowa or promising to put away childish things?
Yes, I know Republicans have used the deem and pass technique. It was terrible then. But those were smallish items. This is the largest piece of legislation in a generation and Pelosi wants to pass it without a vote. It’s unbelievable that people even talk about this with a straight face. Do they really think the American people are going to stand for this? Do they think it will really fool anybody if a Democratic House member goes back to his district and says, “I didn’t vote for the bill. I just voted for the amendments.” Do they think all of America is insane?
Filed under: Government and Politics; Health, Welfare & Entitlements
David Goldhill: “A Democrat’s Case For ‘No’”
David Goldhill has done it again.
You may recall his article, “How American Health Care Killed My Father,” from the September 2009 issue of The Atlantic.
Now, at HuffingtonPost, he comments on the health care legislation that may soon face a final vote (of some sort) in the House:
[C]ontinuing our Party’s almost unquestioned conflation of health insurance with health care, the central feature of the proposed “reform” is further extension of our flawed insurance-based system…[D]espite the Administration’s recent heated rhetoric, most of the entrenched health industry interests are quietly or openly in favor of this bill. Should the bill become law, I suspect we will look back at it as an industry bailout…
How…can Democrats in the depths of a recession support a massive tax increase on middle-class job creation…? How…could we justify diverting even more of middle class income to support our broken system of care, further starving families of funds for all their other needs? Most uninsured Americans lack insurance only temporarily; how many of them would trade lesser lifetime job prospects and lower disposable income for the short-term retention of health insurance?…
If the legislation had any real prospect of controlling health care spending, would the pharmaceutical industry be funding the “yes” campaign?
As a former Democrat who hung door knockers for Michael Dukakis in 1988, I know the heavy heart with which he writes. Read the whole thing.
Watch the video to hear Goldhill’s story:
Will More Centralization Improve Education Standards?
Matt Ladner of the Goldwater Institute takes a good long look at national education standards on the Jay Greene blog. What, he asks, can we learn from the 1990s welfare policy debate and its outcomes?
Filed under: Education and Child Policy; Health, Welfare & Entitlements
Obama’s Populism a Hoax: ObamaCare Is a Sop to Big PhRMA
From the invaluable Tim Carney:
The Obama team regularly dismisses opponents as industry lackeys. The Democratic National Committee blasted out e-mails this week warning that “for every member of Congress, there are eight anti-reform lobbyists swarming Capitol Hill” and “Congress is under attack from insurance lobbyists.”
But drug industry lobbyists, according to Politico, spent the weekend “huddled with Democratic staffers” who needed the drug lobby to “sign off” on proposals before moving ahead. Meanwhile, we learn that the drug lobby is buying millions of dollars of ads in 43 districts where a Democratic candidate stands to suffer for supporting the bill. The doctors’ lobby and the hospitals’ lobby are also on board with the Senate bill.
So the battle at this point is not reformers versus industry, as Obama would have you believe. Rather, it is a battle between most of the health care industry and the insurance companies.
(And the insurers are not opposed to the whole package. On the bill’s central planks — limits on price discrimination, outlawing exclusions for pre-existing conditions, a mandate that employers insure their workers and a mandate that everyone hold insurance — insurers are on board. They object mostly that the penalty is too small for violating the individual mandate.)
Filed under: General; Government and Politics; Health, Welfare & Entitlements
House Procedure–and Transparency in Collapse
Over on the WashingtonWatch.com blog, I’ve laid out in the simplest terms I could what’s going on in terms of procedure with health care overhaul legislation. The post, called “What is Deeming, Anyway?“, comes in at a mere 900 words… If you’re a real public policy junkie, you might like it.
But what about the transparency oriented processes that President Obama and leaders like Speaker Pelosi promised the public? Recall that the Speaker promised to post the health care bill online for 72 hours before a vote back in September.
There was debate about whether she stuck to her promise then. And it was probably a one-time promise. It’s almost certain that she will not do so now. If she lines up the votes to pass the bill, the vote will happen. Right. Then.
What about President Obama’s promise to put health care negotiations on C-SPAN? The daylong roundtable debate on health care was an engaging illustration of what happens when you do transparent legislating. Voters got a clearer picture of where each side stands—and perhaps saw that there actually is some competence on both sides of the aisle. Some competence.
The health care negotiations going on right now are the ones that matter. This is when the most important details are being hammered out. This is when the bargaining that draws the public’s ire is happening. But I’m not seeing it on C-SPAN.
President Obama’s promise may have been naive, but that doesn’t excuse breaking it. The inside negotiations going on this week represent an ongoing violation of the president’s C-SPAN promise.
And there’s good reason to anticipate that the president will violate his Sunlight Before Signing promise as well. This was his promise to post bills online for five days after he receives them from Congress before signing them into law. Read the rest of this post »
Filed under: Health, Welfare & Entitlements; Telecom, Internet & Information Policy
Will Kucinich’s Vote Help ObamaCare?
Whether Rep. Dennis Kucinich’s (D-OH) “aye” vote will help pass ObamaCare depends on whether he asked for something in return.
Jane Hamsher of FireDogLake reports, “Kucinich told Obama that he wants a full ERISA waver [sic] and a public option in exchange for his vote.” If he gets either of those things in the reconciliation “fixer” bill, then that will trigger a backlash. His “support” could undermine the whole process.
It really depends on what kind of a negotiator Kucinich is. If he’s a good negotiator, it hurts ObamaCare. If he’s a lousy negotiator, it helps.
AP: Obama Misleads Voters about ObamaCare’s Effects on Premiums
Buyers, beware: President Barack Obama says his health care overhaul will lower premiums by double digits, but check the fine print…
The [Congressional Budget Office] concluded that premiums for people buying their own coverage would go up by an average of 10 percent to 13 percent, compared with the levels they’d reach without the legislation…
“People are likely to not buy the same low-value policies they are buying now,” said health economist Len Nichols of George Mason University. “If they did buy the same value plans … the premium would be lower than it is now. This makes the White House statement true. But is it possibly misleading for some people? Sure.”
Nichols’ comments are also misleading — which makes the president’s statement not just misleading but untrue.
Under ObamaCare, people would not have the option to buy the same low-cost plans they do today. That’s the whole problem: under an individual mandate, everybody must purchase the minimum level of coverage specified by the government. That minimum benefits package would be more expensive than the coverage chosen by most people in the individual market. Their premiums would rise because ObamaCare would take away their right to choose a more economical policy.
Note also that the CBO predicts premiums would rise by an average of 10-13 percent in the individual market. Consumers who currently purchase the most economic policies would see larger premium increases.
Finally, the Obama plan would also force millions of uninsured Americans to purchase health insurance at premiums higher than current-law premium levels, which they have already rejected as being too high. Their premium expenditures would rise from $0 to thousands of dollars. Yet the CBO counts that implicit tax as reducing average premiums, because those consumers are generally healthier-than-average. Only in Washington is a tax counted as a savings.
Filed under: Cato Publications; General; Health, Welfare & Entitlements
Questions for Thoughtful ObamaCare Supporters, Part III
I’ve already posted two series of such queries. But every day brings new questions to mind. So here are a few more:
- What does it say that pharmaceutical-industry lobbyists are meeting with House Democrats to write this legislation behind closed doors? Or that the pharmaceutical industry is preparing to spend millions of dollars on advertisements in support of the legislation?
- Does it trouble you that a former federal judge writes, “Under Article I, Section 7, passage of one bill cannot be deemed to be enactment of another“?
- Does it trouble you that Speaker Pelosi says of the proposed “deeming” strategy, “I like it because people don’t have to vote on the Senate bill“? (Emphasis added.)
- What does it say that left-of-center The Washington Post editorializes that the Democrats’ endgame seems “dodgy” and “threatens to turn into something unseemly and, more important, contrary to Democrats’ promises of transparency and time for deliberation”?
- What does it say about the feasibility of the Obama health plan that Speaker Pelosi is drawn to the “deeming” strategy, which she once opposed in a court of law?
The Bill Is Deemed Passed
Today’s question at Politico Arena is:
Should Democrats be worried that health care could be subject to a successful court challenge?
My response is:
I’m the first in my family not to be a lawyer. But Mike McConnell’s article seems compelling to me. As he notes, Article I, Section 7, of the Constitution requires that a bill must pass both houses of Congress to become a law. Duh. And for those who have trouble with that concept, he goes on: “As the Supreme Court wrote in Clinton v. City of New York (1998), a bill containing the ‘exact text’ must be approved by one house; the other house must approve ‘precisely the same text.’”
So the “deemed passed” rule doesn’t seem to be constitutional. Then the interesting question is, Will the Supreme Court strike down a major piece of welfare-state legislation just because Congress didn’t dot all the i’s and cross all the t’s. After all, some of us think the Supreme Court has failed to strike down legislation whose substance violates the Constitution. Would it be more forthright on a procedural issue? Would it dare to tell the political branches that they can’t have the health-care program they worked on for 14 months, negotiating careful and complicated compromises in both houses?
But then, the reason that Democrats are contemplating such an audacious scheme is precisely that they can’t find a bill that a majority of the House will vote for. So this wouldn’t be like the Supreme Court striking down Franklin Roosevelt’s Agricultural Adjustment Act, which passed Congress quickly and overwhelmingly in May 1933. It would not involve the Supreme Court standing up to the unified political branches. Rather, it would only require the Court to tell Congress that they have to actually pass bills before they become law, which apparently a majority of the House is not prepared to do.
Filed under: Government and Politics; Health, Welfare & Entitlements; Law and Civil Liberties
Massachusetts Treasurer Blasts RomneyCare and, Equivalently, ObamaCare
Massachusetts state treasurer and recent Democrat Timothy Cahill has harsh words for the health plan foisted on his state and the identical plan that President Obama is trying to foist on the nation. From The Boston Globe:
“If President Obama and the Democrats repeat the mistake of the health insurance reform here in Massachusetts on a national level, they will threaten to wipe out the American economy within four years,” Cahill said in a press conference in his office.
Echoing criticism leveled by congressional Republicans in recent weeks, Cahill said, “It is time for the president, the Democratic leadership, to go back to the drawing board and come up with a new plan that does not threaten to bankrupt this country.”
[T]he state’s health insurance law…Cahill said, “has nearly bankrupted the state.”
Cahill said the law is being sustained only with the help of federal aid, which he suggested that the Obama administration is funneling to Massachusetts to help the president make the case for a similar plan in Congress.
“The real problem is the sucking sound of money that has been going in to pay for this health care reform,” Cahill said. “And I would argue that we’re being propped up so that the federal government and the Obama administration can drive it through” Congress.
Commonwealth Connector, the independent state agency established to help residents find the health insurance, has “totally failed,” to create competition and connect people with affordable insurance, Cahill said, pointing out that 68 percent of the residents it serves receive subsidized care.
“We haven’t done anything about driving down costs,” Cahill said. “We haven’t helped small business. We haven’t changed the way we pay for health care and the way we deliver it.”…
Asked for solutions today, Cahill said he would seek to “level the playing field” between hospitals that charge different rates for similar procedures, seek to increase competition by allowing health insurance companies plans to sell plans across state lines, and would slash benefits mandated under state law.
For more on the Massachusetts health plan, see “The Massachusetts Health Plan: Much Pain, Little Gain.”
Filed under: Cato Publications; Health, Welfare & Entitlements
If the House Enacts the Senate Health Care Bill without Voting on It…
…are we under any obligation to obey it? The answer may be no.
Democrats are considering a scheme that would “deem” the Senate health care bill to have passed the House if a separate event occurs (specifically: House passage of a budget reconciliation bill). That strategy has been named after its contriver, House Rules Committee chair Louise Slaughter (D-NY). House Speaker Nancy Pelosi (D-CA) says of this scheme: “I like it because people don’t have to vote on the Senate bill” (emphasis added).
Not so fast, says former federal circuit court judge Michael McConnell in The Wall Street Journal:
Under Article I, Section 7, passage of one bill cannot be deemed to be enactment of another.
The Slaughter solution attempts to allow the House to pass the Senate bill, plus a bill amending it, with a single vote. The senators would then vote only on the amendatory bill. But this means that no single bill will have passed both houses in the same form. As the Supreme Court wrote in Clinton v. City of New York (1998), a bill containing the “exact text” must be approved by one house; the other house must approve “precisely the same text.”
Democrats have already hidden 60 percent of the cost of the Senate bill, effected an obscenely partisan change in Massachusetts law to keep the bill moving, pledged more than a billion taxpayer dollars to buy votes for the bill, and packed the bill with an unconstitutional individual mandate and provisions that violate the First Amendment. It’s almost as if, to paraphrase comedian Lewis Black, Democrats spent a whole year, umm, desecrating the Constitution and at the last minute went, “Oh! Missed a spot!”
And these people want us to put our trust in government.
Filed under: Cato Publications; General; Government and Politics; Health, Welfare & Entitlements
More on the Last-Shot Strategy
Related to my post below on whether last-second shots with time expiring, while good for basketball, might be bad for governance, Steven Horwitz offers a compelling hypothetical in academic governance at Coordination Problem:
…Nonetheless, the leadership insists this curriculum change is crucially important to the future of the institution and if only the Faculty Senate would pass it and put it in place, the faculty and students would then realize just how good it is. In fact, the faculty leadership, working with the clear approval of the president and VPAA, are now scouring Roberts Rules of Order to find a series of sure-to-be controversial parliamentary maneuvers to get the Faculty Senate to approve the new curriculum without it ever going to the full faculty, and possibly without the Faculty Senate ever actually taking a clean vote on it. The president, meanwhile, is going around to students and alumni telling them how important this new curriculum is and, in the process, criticizing the faculty opponents by charging they have self-interested reasons for defending the status quo, even as the new curriculum proposal contains the aforementioned special deals for some of the faculty supporters.
The faculty as a whole and the student body continue to oppose the new curriculum by a consistent majority.
Having considered this hypothetical scenario, here are my questions for you my friends:
Would you consider this a legitimate way to pass a new curriculum? If the faculty leadership in conjunction with the administration were to ram this through by questionable parliamentary procedure and over the objections of a clear majority, do you think this new curriculum would have any legitimacy? …
Filed under: Government and Politics; Health, Welfare & Entitlements
More Questions for Thoughtful ObamaCare Supporters
Last week, I posted a series of questions that I hoped would get supporters of ObamaCare thinking.
I received a brief response from the Center for American Progress’ Matt Yglesias on Twitter. The Guardian’s Sahil Kapur provided a thorough response, and even posed a question in return.
I appreciate Kapur’s effort, and plan to respond. But before I do, I wonder if he (or any other thoughtful ObamaCare supporter) would answer just a few additional questions:
- What does it say that Democrats are having this much trouble getting their health care legislation through Congress even after hiding 60 percent of its cost?
- What does it say that Virginia’s legislature, including its Democratically controlled Senate, has approved legislation blocking the Obama plan’s centerpiece? Or that 31 other states are considering legislation or amending their constitutions to do the same?
- What does it say that veteran and centrist health economist Alain Enthoven writes, “The American people are being deceived...the bills in Congress…do little or nothing to curb [health care] expenditures. When the American people come to understand that ‘reform’ was not followed by improvement, they are likely to be disappointed.”
- What does it say that some Democratic pollsters are in open revolt against ObamaCare?
- What do you make of Yuval Levin’s observation that, in order to enact ObamaCare, Democrats must “amend a law that doesn’t exist yet by passing a bill without voting on it“?
- What does it mean if Democrats decide that ObamaCare will die if it faces a simple, up-or-down, majority vote in the House?
Filed under: Government and Politics; Health, Welfare & Entitlements
Axelrod: ‘Louisiana Purchase’ Somehow Not One of Those Corrupt, State-Specific Bribes
The House leadership plans to hold a vote, more or less, on the Senate health care bill this week. President Obama says he wants to “ge[t] rid of many of the provisions that had no place in health care reform — provisions that were more about winning individual votes…than improving health care.” White House spokesman Robert Gibbs says Democrats will “take the pot-sweetening out of the process.” Yet Democrats have decided to retain the Senate bill’s $300 million subsidy for the state of Louisiana, commonly known as the “Louisiana Purchase,” and other state-specific bribes pot-sweeteners.
On ABC News’s This Week yesterday, Obama advisor David Axelrod argued that the “Louisiana Purchase” is not targeted solely at Louisiana:
The president does believe that state-only carve-outs should not be in the bill. There are things in the bill that apply to groupings of states…for example…what has been portrayed as a provision relating to Louisiana says that if a state, if every county in a state is declared a disaster area, they get some extra Medicaid funds. Well, that would apply to any state…
Sure, in theory. But as ABC News reported in November, the bill speaks of “certain states recovering from a major disaster” and “spends two pages describing what could be written with a single world: Louisiana.”
Axelrod would have us believe that after Senate Majority Leader Harry Reid (D-NV) wrote the best darned bill he could, he slapped his head and said, “Omigosh! The way I worded this one subsidy provision, it would only apply to Louisiana — the home state of a senator whose vote I need! Gee whiz, what are the odds??” Using Axelrod’s rationale, if Reid had included a $10 billion pension for “all African-American former presidents,” that would not be an Obama-only pot-sweetener because it would apply to any African-American former president.
Filed under: Government and Politics; Health, Welfare & Entitlements
Last-Second Shots
On Sunday the University of Kentucky Wildcats saved their SEC tournament championship on a second-chance shot with 0.1 seconds left on the clock.
That’s a great way to win a basketball game, but not a good way for Congress to impose 2000 pages of federal rules on one-seventh of the American economy.
Filed under: Government and Politics; Health, Welfare & Entitlements
Gagging on SAFRA
With national curriculum standards now getting some real attention, I haven’t been able to give the plan to shove bankrupting student aid legislation down our thoats via health-care reconciliation the scourging it deserves. I will soon, but until then this “Water Cooler” piece from the Washington Times should slake your thirst. Here’s a choice quote:
Watching the Democrats create two massive pieces of rotten legislation by themselves is bad enough, but piling them together is like watching someone make an enormous Dagwood sandwich with mysterious fillings and make you eat the mile high concoction in one sitting.
Darn — acckkk! — right!
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