Tag: aca

If Thomas Edison Had to Submit His Innovations to Medicare, You Would Be Reading This by Candlelight

Two articles in the Washington Post sparked these two poor, unsuccessful letters to the editor. First this:

I’m no Republican, but “‘Innovation advisers’ chosen for ideas to improve health care, cut costs” [Jan. 21] gives short shrift to those who oppose the new health care law’s Center for Medicare and Medicaid Innovation when it reports, “Some Republicans have questioned the value of investing in experimentation to produce results at a time of limited resources.”

If some critic of the law actually said, “Resource limitations prevent us from investing in innovations that stretch resources further,” please do print it. I could use the laugh. But that’s not why critics oppose the Center.

The argument against the health care law’s efforts to promote innovation is that they won’t work. The Congressional Budget Office recently reported that out of dozens of supposed Medicare innovations, only one met its goal of saving taxpayers money. That pilot program ended 16 years ago. Medicare has yet to adopt it program-wide.

This is an important debate. Readers deserve to hear both sides, not caricatures.

And then this:

Recent coverage of the new health care overhaul [“‘Innovation advisers’ chosen for ideas to improve health care, cut costs,” Jan. 21; “Center for Medicare and Medicaid Innovation aims to cut health-care costs,” Jan. 26] let defenders make outlandish claims about government efficiency, but gave short shrift to critics.

Government is not more innovative than private health insurance. It was private health plans that developed important innovations like prepayment, bundled payments, pay-for-performance, and penalties for medical errors. Government adoption typically lags private insurers by decades. In the rare instance where Medicare successfully tests an innovation (read: bundled payments for heart bypass surgery), it goes nowhere. If Thomas Edison had to submit his innovations to Medicare, you would be reading this by candlelight.

We don’t need more pilot programs to tell us that Medicare blocks innovation. What we need is a little skepticism when presented with the latest Bureau of Government Efficiency.

Stop Using Slippery-Slope Arguments? Where Would that End?

Richard Thaler writes in the New York Times:

Justice Scalia is arguing that if the court lets Congress create a mandate to buy health insurance, nothing could stop Congress from passing laws requiring everyone to buy broccoli and to join a gym…Can anyone imagine Congress passing a broccoli mandate law, much less the court allowing it to take effect?

Yes annnnd…yes. Next question.

Surely, the justices have the conceptual resources to draw a distinction between the health care market and the market for broccoli. And even if they don’t, then all the briefs, the zillions of blog posts and a generation’s worth of economic literature can help them.

If drawing a constitutionally meaningful distinction between the markets for health insurance and broccoli is child’s play for Thaler, he should school all the brief- and blog-post-writers who so far have failed. That would have been a more productive use of his thousand words than his build-up to this thesis:

If you are opposed to a policy, state your case based on the merits — not on the imagined risk of what else might happen down the road. The path of that road is so unpredictable that it may even produce a U-turn.

Good grief. Slippery-slope arguments are about principles. As in, “If you concede this principle because you don’t mind the result here, you will no longer have it to protect you against that bad result there.” Thaler’s thesis would lead, for example, to all manner of civil-liberties violations by the state because there simply isn’t enough political support to protect all the civil liberties of various minorities. But Thaler doesn’t want us to think about things like consequences or the future.

The potential for U-turns makes no more sense as an argument against invoking slippery slopes principles, because principled arguments can help generate the U-turn that opponents of, say, ObamaCare want to see.

I take silly arguments like this to be evidence that ObamaCare supporters are in complete panic mode.

Gov. Christie Vetoes ObamaCare Exchange — ‘At This Time’

Today, New Jersey Gov. Chris Christie (R) became the latest governor to throw sand in the gears of ObamaCare, issuing an eleventh-hour veto of a bill to create an ObamaCare Exchange in New Jersey. An excerpt from his veto message:

While I am unwilling to approve the establishment of a statewide health insurance exchange at this time, I am mindful that the requirements of the Affordable Care Act still stand today and I intend to fully oversee New Jersey’s compliance in a responsible and cost-effective manner should its constitutionality ultimately be upheld by the Supreme Court… My Administration will continue this work and stands ready to implement the Affordable Care Act if its provisions are ultimately upheld.

Christie suggests he isn’t yet convinced that Exchanges are per se harmful. He also seems to suggest that if the Supreme Court upholds the law, creating an Exchange might be the best course for the state and that refusing to do so would put the state out of compliance with federal law–neither of which is true. But the veto message contains enough wiggle room for Christie to come out hard against any future ObamaCare Exchange.

Here’s hoping the Supreme Court renders all of this moot.

Did You Read the Federalist Papers in College? Grad School? Law School?

In the Wall Street Journal, Peter Berkowitz says you probably didn’t. And it shows:

It would be difficult to overstate the significance of The Federalist for understanding the principles of American government and the challenges that liberal democracies confront early in the second decade of the 21st century. Yet despite the lip service they pay to liberal education, our leading universities can’t be bothered to require students to study The Federalist—or, worse, they oppose such requirements on moral, political or pedagogical grounds. Small wonder it took so long for progressives to realize that arguments about the constitutionality of ObamaCare are indeed serious.

Explains a lot, really.

Medicare Fraud Posse Cackles as If They Laid an Asteroid

What the media blare:

Levinson Snags $515 Million in Health Care Fraud

More than 100 Charged in Massive Medicare Fraud Busts in 7 Cities in Scams Totaling $452 Mil

What I hear:

Drip … … … . drip … … … … .

Why? As the latter article notes, “authorities have targeted fraud that’s believed to cost the government between $60 billion and $90 billion each year.” So add up those two figures, which include frauds that occurred in multiple years, and you get somewhere between 1.1 percent and 1.6 percent of the amount that Medicare and Medicaid enable criminals to steal from taxpayers in a single year.

Neither article makes it clear how paltry these anti-fraud efforts are. But at least the former article asks:

So what is it about the government’s health care programs that make them such inviting targets for white collar criminals?

I answer that question here, and in this video:

Alabama Gov. Vows to Veto ObamaCare Exchange

According to WSFA-12 News, Alabama legislators are working on legislation to create an ObamaCare Exchange. But:

Governor Robert Bentley [R] will likely veto the bill.

“This legislation is premature.  The federal government has yet to establish clear guidelines for a health insurance exchange,” said Deputy Communications Director Jeremy King, in a statement to WSFA 12 News.  “Also, the federal government has extended some deadlines for putting an exchange together.  Plus, the U.S. Supreme Court has not yet ruled on the constitutionality of the federal health care law.   If Supreme Court justices strike down the law as the Governor hopes they will, there will be no need for such an exchange.  Either way, there is no need to establish an exchange at this point,” the statement went on to say.

“Doing so without clear guidance from Washington would simply be a guessing game.  Also, there would still be time in the 2013 session to set up an exchange if the law is upheld.  If this legislation is approved in the current session, a veto can be expected.”

Full story and video here.