Tag: Barack Obama

Contraceptives Mandate Brings ObamaCare’s Coercive Power into Sharper Focus

President Obama is catching some well-earned blowback for his decision to force religious institutions “to pay for health insurance that covers sterilization, contraceptives and abortifacients.” You see, ObamaCare penalizes individuals (employers) who don’t purchase (offer) a certain minimum package of health insurance coverage. The Obama administration is demanding that coverage must include the aforementioned reproductive care services. The exception for religious institutions that object to such coverage is so narrow that, as one wag put it, not even Jesus would qualify. HHS Secretary Kathleen Sebelius reassures us, “I believe this proposal strikes the appropriate balance between respecting religious freedom and increasing access to important preventive services.” Ummm, Madam Secretary…the Constitution only mentions one of those things. The Catholic church is hopping mad. Even the reliably left-wing E.J. Dionne is angry, writing that the President “utterly botched” the issue “not once but twice” and “threw his progressive Catholic allies under the bus.”

As I wrote over and over as Congress debated ObamaCare, anger and division are inevitable consequences of this law. I recently debated the merits of ObamaCare’s individual mandate on the pages of the Wall Street Journal. Here’s a paragraph that got cut from my essay:

We can be certain…that the mandate will divide the nation. An individual mandate guarantees that the government—not you—will decide what medical services you will purchase, including contraceptives, fertility services that result in the destruction of human embryos, or elective abortions. The same apparatus that can force Americans to subsidize elective abortions can also be used to ban private abortion coverage once the other team wins. The rancor will only grow.

Or as I put it in 2009,

Either the government will force taxpayers to fund abortions, or the restrictions necessary to prevent taxpayer funding will reduce access to abortion coverage. There is no middle ground. Somebody has to lose. Welcome to government-run health care.

The same is true for contraception. The rancor will grow until we repeal this law.

ObamaCare highlights a choice that religious organizations – such as the United States Conference of Catholic Bishops, where my grandfather served as counsel – have to make. Either they stop casting their lots with Caesar and join the fight to repeal government health care mandates and subsidies, or they forfeit any right to complain when Caesar turns on them. Matthew 26:52.

Let the Market Cut Medicare?

The center-right consensus is that in order to balance the budget and improve health care, Congress needs to overhaul Medicare using some form of voucher or premium support.  Whereas the current program offers an essentially unlimited subsidy for medical care, under these options Congress would give each enrollee a fixed subsidy with which they could purchase private health insurance.  But how should Congress determine the size of these fixed subsidies?

The House GOP approved a budget under which Congress would pick the amount.  Beginning in 2022, all new enrollees would receive a voucher.  The average voucher amount would be equal to the average amount Medicare currently spends per enrollee in 2011, adjusted for overall inflation.  Congress would adjust the actual voucher amount for each enrollee based on health status and income, so some enrollees would receive larger and some would receive smaller vouchers.  But since the average voucher would grow at the rate of inflation (i.e., about 2.5 percentage points slower than per-enrollee Medicare spending currently grows), this approach would reduce Medicare spending over time.

A drawback of this approach is that opponents can (and do) demagogue it, claiming that the vouchers would be insufficient and seniors would die for lack of medical care.  This demagoguery ignores two important factors.

First, as Peter Orszag and President Obama themselves loved reminding us during the ObamaCare debate, there is lots of wasteful spending in the Medicare program.  Orszag frequently cites the Dartmouth Atlas, which estimates that one third of Medicare spending is pure waste.  Since the amount of the House GOP’s vouchers would be based on per-enrollee Medicare spending, they would essentially give Medicare enrollees 50 percent more money than they would need to purchase all the beneficial medical care that Medicare currently provides.  The vast amount of wasteful Medicare spending is a disgrace.  But when converting to a voucher system it’s an absolute boon, because it provides a huge margin of safety.  It means that enrollees could reduce their medical consumption by one third without harming their health.

Second, the anti-reform demagogues presume that vouchers would do absolutely nothing to make health care more efficient.  Vouchers would make the nation’s 50 million heaviest consumers of medical care cost-conscious in a way they have never been before.  Like an old man trying to send back soup at a deli, they will force providers to cut costs and thereby make their vouchers go farther.

It is because of this second factor that Yuval Levin proposes a different way of setting the voucher amount(s).  Levin proposes to use a competitive-bidding process.  Under this approach, everyone in Medicare would receive a voucher equal to the second-lowest bid that health plans submit to provide a standard package of benefits.  Enrollees could then apply their voucher to any private plan or even a government-run plan.  Under this approach, enrollees would still be cost-conscious: if the health insurance policies they choose cost more than the voucher amount, they would have to make up the difference; if the policies cost less, they would keep the savings.  Levin argues that this cost-consciousness would also lead enrollees to put pressure on providers to cut costs, and therefore the amount of the second-lowest bid would automatically grow at a slower rate than per-enrollee spending under the current Medicare program.  ”In such a system,” Levin writes, “the premium-support benefit would grow exactly as quickly as required to provide a comprehensive insurance benefit, since the growth rate would be determined by a market process rather than a preset formula. ” Voila!  The competitive forces of the market would cut Medicare spending.

The best evidence that competitive bidding will reduce Medicare spending is that the durable medical equipment manufacturers have fought efforts to impose it on them.  So while I’m not hostile to the idea, I don’t think it’s an improvement over the House GOP plan.

First, Levin calls competitive-bidding “the Confident Market Solution” because he is confident that markets will reduce the cost of health care.  I’m confident of that too.  But I’m also confident that rent-seeking will be present in Medicare, no matter what reforms Congress enacts.  I am far less confident that markets will reduce costs faster than rent-seeking will increase them.  My sense is that politicians will be much more likely to hold the line on rent-seeking if they actually draw one.

Second, House Budget Committee chairman Paul Ryan (R-WI) crafted a House budget that proposed to reduce the growth of Medicare spending using hard, score-able numbers.  Hundreds of House members likewise stuck their necks out by voting for it.  The Confident Market Solution essentially undercuts those folks by telling them they should not have done something so bold and courageous.  Levin is no doubt correct that a competitive-bidding process that doesn’t specifically commit Congress to reducing Medicare spending growth is more politically feasible than a voucher plan that does.  When politicians choose the more politically perilous option, however, reformers should tell the world why that was the right thing to do.

Third, Levin would include a public option in the competitive-bidding system.  I am also confident that the government would heavily subsidize that health plan until it drove private insurers (and any hope of cost-cutting innovations) out of the market.

I’ve discussed what I think is a better approach to Medicare reform here and here.

John McCain: Ever Confused, Always for War

Sen. John McCain has exhibited personal courage, but his geopolitical judgment is uniformly awful.  Over the last 30 years there has been no war or potential war that he has opposed.  In 2008 he wanted to confront nuclear-armed Russia over its neighbor Georgia, which started their short and sharp conflict.  It would have been ironic had the Cold War ended peacefully, only to see Washington trigger a nuclear crisis in order to back Georgia as it attempted to prevent the territories of Abkhazia and South Ossetia from doing what Kosovo did with U.S. military aid:  achieve self-determination (by seceding from Georgia).

Now Senator McCain is banging the war drums in Libya.  But he seems to have trouble remembering who are the good guys and who are the bad guys.

Although now crusading against Moammar Qaddafi, two years ago he joined Sens. Joe Lieberman and Lindsey Graham in Tripoli to sup with the dear colonel.  There the three opponents of tyranny whispered sweet nothings in the dictator’s ear, offering the prospect of military aid.  After all, the former terrorist had become a good friend of America by battling terrorists.

Andrew McCarthy reported on the sordid tale from the WikiLeaks disclosures:

A government cable (leaked by Wikileaks) memorializes the excruciating details of meetings between the Senate delegation and Qaddafi, along with his son Mutassim, Libya’s “national security adviser.” We find McCain and Graham promising to use their influence to push along Libya’s requests for C-130 military aircraft, among other armaments, and civilian nuclear assistance. And there’s Lieberman gushing, “We never would have guessed ten years ago that we would be sitting in Tripoli, being welcomed by a son of Muammar al-Qadhafi.” That’s before he opined that Libya had become “an important ally in the war on terrorism,” and that “common enemies sometimes make better friends.”

Obviously, that was then and this is now.  Along the way Senator McCain and his fellow war enthusiasts realized that Qaddafi wasn’t a nice guy after all.  Who knew?  I mean, he had only jailed opponents, conducted terrorist operations against the United States, and initiated a nuclear weapons program.  So earlier this year they demanded that the United States back the rebels, the new heroes of democracy. 

Until now, anyway.

Anyone who has covered civil wars won’t be surprised to learn that the insurgents aren’t always playing by Marquess of Queensbeerry rules.  Indeed, the opposition is united only by its hatred of Qaddafi.  It includes defectors, including  Qaddafi’s former interior minister who was just assassinated under mysterious circumstances; jihadists and terrorists, some of whom fought against U.S. forces in Iraq; tribal opponents of Qaddafi; and genuine democracy advocates devoted to creating a liberal society.  Unfortunately, there is no guarantee that the good guys will win any power struggle certain to follow Qaddafi’s ouster.

The Obama administration claimed to enter the war to protect civilians.  Yet NATO has occasionally threatened to bomb the rebels if they harm civilians.  Reports of summary executions and looting by insurgent forces have emerged.  Now Senator McCain has written the opposition a letter—more polite than sending a drone, I suppose—demanding that the Transition National Council stop being mean to former Qaddafi supporters.

Reports the British Independent newspaper:

In his letter to the TNC, dated 20th July, Senator McCain, writing as “your friend and supporter,” pointed out “recent documentation of human rights abuses committed by opposition figures in the western Libyan towns of al-Awaniya, Rayayinah, Zawiyat al-Bagul, and al-Qawalish”. He continued: ” According to Human Rights Watch, a highly credible international non-governmental organisation, rebel fighters and supporters have damaged property, burned some homes, looted from hospitals, homes and shops, and beaten some individuals alleged to have supported government forces.

“I am confident you are aware of these allegations…. It is because the TNC holds itself to such high democratic standards that it is necessary for you and the Council to take decisive action to bring any human rights abuses to an immediate halt.”

Who would have imagined that a civil war could be nasty and that not everyone who opposes a dictator is a sweet, peace-loving liberal?  Certainly not John McCain.

The point is not that Qaddafi is a nice guy.  The world would be a better place if he “moves on,” so to speak.  But there’s no guarantee that a rebel victory will result in a liberal democracy dedicated to international peace and harmony.  And there’s nothing at stake that warrants involving the United States in yet another war in a Muslim nation—the fifth ongoing, if one counts the extensive drone campaigns in Pakistan and Yemen, along with Iraq and Afghanistan.

When Senator McCain urges Washington to bomb or invade the sixth Islamic state, which is inevitable given his past behavior, it would be worth remembering how he has managed to be on every side of the Libya issue, supporting tyranny before he opposed it.  When it comes to war, the best policy is to do the opposite of what he advises.  Only then will America find itself finally at peace.

Parallels to 1995 in Spending Fight

The American welfare state has been in crisis for decades. Many of the problems faced in 1995 fight have become less tractable problems today. John Samples comments in yesterday’s Cato Daily Podcast.

One notable difference between 1995 and today, Samples says, is that the GOP of 1995 kept Social Security off the chopping block for spending cuts.

Subscribe to the podcast here (RSS) and here (iTunes).

‘Cut, Cap and Balance,’ the Debt Ceiling and Federal Spending

Cato Institute scholars Daniel J. Mitchell and Chris Edwards evaluate the plans offered by Republicans for lowering federal spending using a so-called “Cut, Cap and Balance” proposal that would make small cuts to federal spending in the short run, cap federal spending, and balance the federal budget using a tax-limited balanced budget amendment to the Constitution.

Barack Obama, Luddite?

In the video clip above, President Obama blames America’s current unemployment problem on… automation. ATMs and airport kiosks are singled out.

These words could only be uttered by someone who knows very little about economics or the history of human progress. In fact, they could only be uttered by someone who has never reflected on this question before in his  life. Because if you reflect for one moment, you come up with this glaringly obvious counterfactual: we use a lot more  labor-saving technology today than in previous generations, and yet we also employ far more people. Therefore, increased automation does not lead to decreased national employment.

If you do more than just think for a second – if you read an economic history book, for instance – you discover that increased automation doesn’t even necessarily lead to decreased employment in the industry being automated! The classic example is the 19th century British textile industry. The so-called “Luddites” smashed automated looms fearing that they would lead to rampant unemployment in their industry. But, as the new technology proliferated, textile industry employment rose. Among other reasons, increased efficiency drastically lowered the prices of textile goods, that shot demand through the roof, and to meet the new demand new workers were required to operate and maintain the new machinery.

There are other examples, of course, and the president will save the American people a great deal of hardship, and himself further embarrassment,  if he familiarizes himself with them. Here’s a good brief introduction from the British Secretary of State… under Margaret Thatcher.

Update:

For those having trouble viewing the video, here is a transcript of the relevant Q&A:

Q: Why, at a time of record profits, have you been unable to convince businesses to hire more people Mr. President?

A: [….] the other thing that happened, though, and this goes to the point you were just making: there are some structural issues with our economy, where a lot of businesses have learned to be a lot more efficient with a lot fewer workers. You see it when you go to a bank and there’s an ATM, you don’t go to a bank teller. Or you go to the airport, and you’re using a kiosk instead of checking in at the gate.

Obama/West Relationship Status Update: ‘It’s Complicated’

Cornel West feels jilted. In an article on him at Truthdig, Princeton’s Professor of African-American Studies and Religion criticizes President Obama for being ungrateful for West’s service to his campaign.

Much of the article reads like post-breakup grumblings. West describes how Obama never calls him back, “but then a month and half later I would run into other people on the campaign and he’s calling them all the time. I said, wow, this is kind of strange. He doesn’t have time, even two seconds, to say thank you or I’m glad you’re pulling for me and praying for me, but he’s calling these other people.”

Most interesting are West’s criticisms of Obama’s presidency. Like many former supporters, Professor West feels betrayed by Obama’s “same as the old boss” policies. In order to explain this, West engages in the quixotic pursuit of pathologizing President Obama. As Ilya Somin and Jonah Goldberg point out, this is oddly reminiscent of Dinesh D’Souza’s recent book, The Roots of Obama’s Rage, and equally confusing. Run-of-the-mill liberal policies from a liberal president don’t need extensive and convoluted explanations.

Pathologizing political opponents is a difficult and largely self-serving task. Although there are many reasons we believe what we do, it does healthy intellectual discourse a disservice to classify opponents rather than try to refute them. Honest disagreements should not be relegated to the pages of the DSM-IV. Usually, this strategy only helps you feel better about your beliefs. While you have reason and arguments supporting your beliefs, all your opponent has is a long line of racial confusion and societal pressures.

According to West, President Obama (“my brother Barack Obama”) “has a certain fear of free black men” caused by his mixed-race background that has made him always “fear being a white man with black skin.” Obama comes from “Kansas influence, white, loving grandparents, coming out of Hawaii and Indonesia, when he meets these independent black folk who have a history of slavery, Jim Crow, Jane Crow and so on, he is very apprehensive.” Thus, “he has a certain rootlessness, a deracination.”

As Gene Healy has consistently pointed out, President Obama needs no explanation. In the era of the imperial presidency we have presidents who become imperious. Big surprise. What does need an explanation, however, is why Cornel West, an unquestionably intelligent man, still finds this surprising.

Or perhaps he doesn’t. The most striking thing said by West in the article is this: “The tea party folk are right when they say the government is corrupt. It is corrupt. Big business and banks have taken over government and corrupted it in deep ways.” Now, I don’t expect to see Professor West at Glenn Beck rallies, but maybe his disappointment in Obama will lead him to stop believing that the problems with government are personal rather than institutional—that is, that government can be fixed if we just put the right people in office.

Or maybe he’ll just support the next candidate who returns his phone calls.