Tag: Reuters

More Proof ObamaCare Is a Sop to Industry

Reuters has helpfully published another article demonstrating that ObamaCare’s biggest cheerleaders are the insurance and drug industries.  That’s because, barring repeal and despite the Obama administration’s fatuous rhetoric about standing up to the special interests, ObamaCare will shower those industries with massive subsidies.  Excerpts follow.

Health Overhaul Should Press Ahead: Industry
By Susan Heavey

Thu Nov 11, 2010 1:39pm EST

NEW YORK (Reuters) - Repeal reform? No thanks, say health insurers, drugmakers and others looking for a clearer picture of the U.S. healthcare market after the bruising passage of the controversial overhaul law…

The new healthcare law created “a stable, predictable environment, however painful it has been in the short term,” GlaxoSmithKline Plc’s (GSK.L) Chief Strategy Officer David Redfern said at the summit in New York.

“When you are running a business, the hardest thing is changing policy and a changing environment because it is very difficult to plan, predict and ultimately invest in that sort of scenario,” he said, echoing other speakers.

True enough.  How’s a firm supposed to develop a business plan around uncertain taxpayer subsidies?

Health officials must still hammer out how to implement the law and finalize hundreds of new rules and regulations. Many such details are key, as the sector looks to adjust its business for 2011 and beyond.

Wait, I thought the law created a “stable, predictable environment” and repeal would create uncertainty.  Hmmmm.

“Anti-reform made good talking points before the election,” said the Department of Health and Human Services’ Liz Fowler, adding that people “will find more to like than to dislike” in the law once it is more in place.

Boy, they just won’t let go of that chestnut, will they?  Remember: voters need re-education, not the Obama administration.

Even insurers, which were vilified by Democrats in passing the reforms, said they don’t want a repeal, even as they push for clarity on forthcoming rules and seek additional changes.

Cigna Corp CEO David Cordani and Aetna Inc President Mark Bertolini both urged the nation to move forward on the overhaul.

Even the insurance industry is against repeal?  The folks whose products the law will force 200 million Americans to purchase?  Never saw that coming.

Since the start of 2009, the Morgan Stanley Health Care Payor index has risen 75 percent, outperforming a roughly 35 percent rise for the broader Standard & Poor’s 500 index.

You don’t say.

Unlike insurers[!], drugmakers have escaped largely unscathed under the law, although there is still incentive to shape it.

You don’t say.

Dear Health Care Journos, There’s Nothing Free about ObamaCare

The Obama administration announced yesterday its plans for implementing ObamaCare’s mandate that consumers purchase first-dollar coverage for preventive services.  The press release reads (emphasis added):

Administration Announces Regulations Requiring New Health Insurance Plans to Provide Free Preventive Care

Of course the administration would emphasize that consumers will pay nothing for these services at the moment of service, and elide the fact that this mandate will increase their health insurance premiums. The administration’s use of the word “free” is what we call spin.

What’s surprising–and more than a little disappointing–is that journalists and headline writers at major media organizations would repeat the administration’s spin, as if the government really is giving away free stuff:

  • New York Times: “Health Plans Must Provide Some Tests at No Cost…free coverage…free screenings…free preventive services…”
  • Los Angeles Times: “Healthcare law offers preventive care at no cost”
  • Politico: “New rules: Free preventive care…free under new federal guidelines.”
  • Reuters: “Healthcare overhaul mandates free preventive care…no extra cost to consumers…Medicare patients will have access to free prevention services…”
  • Wall Street Journal: “White House Unveils Free Preventative Services…services that will be free to consumers…free preventive care…free preventive care…”

Each use of “free” and “no cost” in these excerpts is false, even within its original context.  There’s no such thing as a free lunch. Everything has a cost.  No government can change that.  Mandating that insurers cover certain services does not magically make them free.  Consumers still pay, just in the form of higher health insurance premiums and lower wages.

The Wall Street Journal (in paragraph six), The New York Times (paragraph seven), Reuters (paragraph 16), and the Los Angeles Times (paragraph 19 or so) do mention that consumers will pay for this mandate in the form of higher premiums–but that doesn’t make the untrue stuff true.  It just makes the article internally inconsistent.  Moreover, the Los Angeles Times incorrectly suggests that the higher premiums would be offset by lower out-of-pocket spending.  (The change in premiums will be larger due to moral hazard and administrative costs.)  And Reuters mentions higher premiums only vaguely, and as if insurers would bear that cost.  Each article also repeats the administration’s spin that spending more on preventive care would reduce health care costs, without mentioning that the Congressional Budget Office and other health care researchers dispute that claim.

Journalists need to be very careful with terms like “free” and “no cost.”

$98 Billion in Improper Payments

The Obama administration and its allies in Congress want the federal government to expand its role in subsidizing health care. We are told that this expansion will restrain rising health care costs. But an OMB report yesterday that the government made $98 billion in improper payments last year – $55 billion of which came from Medicare and Medicaid – ought to raise suspicions about that claim.

According to Reuters, OMB Director Peter Orszag told reporters that the embarrassing figures from Medicare and Medicaid demonstrate the need for health care reform. I would concur if “reform” meant reducing the government’s role in health care. However, he means the opposite, which raises the question of how giving more money to an already waste-prone and bureaucratic federal health system can possibly make sense for the economy.

The administration has promised to cut down on improper payments with the aid of a new executive order. According to the Associated Press:

Under the executive order, every federal agency would have to maintain a Web site that tracks improper payments, error rates and outstanding payments. If an agency doesn’t meet targets for reducing error rates for two years in a row, the agency director and responsible official will have to directly report to OMB to explain the delinquency and new actions they will take.

Somehow I doubt this will amount to much of a deterrent. The AP also said the administration plans to impose penalties on government contractors who receive improper payments. But last month it was reported that “the Department of Defense awarded nearly $30 million in stimulus contracts to six companies while they were under federal criminal investigation on suspicion of defrauding the government.”

Democrat Tom Carper, chairman of the Senate subcommittee on federal financial management, seemed to partly understand the broader meaning of the improper payment estimates:

It goes without saying that these results would be completely unacceptable in the private sector, as they should be in government, especially at a time of record deficits…Unfortunately, these numbers may still be just the tip of the iceberg since they don’t even include estimates for several major programs, including the Medicare prescription drug plan.

Yes, Senator, which is precisely why bigger government – be it stimulus, bail outs, or health care reform – is an inferior option to letting the marketplace provide for our wants and needs.

Carper is also right about the $98 billion figure being the “tip of the iceberg.” As has been noted here before:

The Government Accountability Office estimates that the two major government health programs are currently losing a combined $50 billion annually to such payments. But that estimate probably low-balls the actual losses. Harvard’s Malcolm Sparrow, a top specialist in health care fraud, estimates that 20 percent of federal health program budgets are consumed by improper payments, which would be a staggering $150 billion a year for Medicare and Medicaid.

See this essay for more on fraud and abuse in government programs.

1,000 Troops = $1 Billion/Year

There is a useful math lesson buried near the end of Greg Jaffe and Karen DeYoung’s widely discussed story on an Afghan war game that the Obama administration is using to weigh the costs and risks of competing strategies.

One question being debated is whether more U.S. troops would improve the performance of the Afghan government by providing an important check on corruption and the drug trade, or would they stunt the growth of the Afghan government as U.S. troops and civilians take on more tasks that Afghans might better perform themselves. Another factor is cost. The Pentagon has budgeted about $65 billion to maintain a force of about 68,000 troops, meaning that each additional 1,000 U.S. soldiers in Afghanistan would cost about $1 billion a year.

I haven’t seen this figure before, and it is based upon a back-of-the-envelope calculation that might be undone by economies of scale. It is not obvious, for example, that the first 1,000 troops would cost the same as the last 1,000. Still, it is a reasonable estimate that is apparently being used inside of the Obama administration.

Accepting the number as basically accurate, the question then turns to “Is it worth it?” That can only be answered by weighing the opportunity costs.

If the Obama administration goes along with Gen. Stanley McChrystal’s request for more troops, and therefore chooses to spend additional money on this mission, the administration is saying, in effect, that an expanded troop presence will do more to prevent a repeat of 9/11 than if the money had been spent on countless other missions and programs ostensibly directed to the same purpose.

Count me a skeptic. There is considerable evidence that a large-scale and open-ended troop presence is counterproductive to fighting terrorism. Meanwhile, there have been a number of highly effective counterterrorism programs that cost far, far less than even $1 billion a year. The proponents of a huge troop increase in Afghanistan obviously disagree, and thus implicitly claim that $40 billion is money well spent (for reference, the entire Dept. of Homeland Security budget for FY 2010 will total $42.8 billion).

Let the advocates for a larger troop presence attempt to make that case. At least now we have a tangible measure for weighing competing options. Thanks to Jaffe and DeYoung for shedding some light on a previously under-reported statistic.

I Would Rather You Just Said “Thank You, Private Schools,” and Went on Your Way…

Some well-known bloggers are being terrible bullies, beating up on private schools.

Felix Salmon kicks things off by hoping the government tightens the definition of a “charitable” organization and begins taxing private schools who don’t “do a bit more to earn it.” Matt Yglesias agrees that private schools are mooching deadbeats and ups the ante, calling them actively harmful as well. Finally, Conor Clarke at The Atlantic agrees, but makes the other two look like panty-waists by proposing the government radically narrow what is considered a charity in the first place.

Yglesias even has the temerity to indict private schools for the failure of NYC public schools:

And as best one can tell, their main impact on the common weal is negative, drawing parents with resources and social capital out of the public school system and contributing to its neglect. You’d have to believe that New York City’s public schools would be both better funded and free of this kind of nonsense if a larger portion of the city’s elite were sending their kids to them.

Really? Would we have to believe what Yglesias says? No, it’s not “the best one can tell.” According to the evidence, Yglesias’ breezy, offhand accusation is demonstrably wrong. Increased competition from private schools actually improves public school performance.

And the more kids who leave public to go private, the more money the schools have for the kids who remain.

What ingrates. They complain about the lost tax revenue while dismissing out of hand the billions of dollars that parents and donors spend every year to educate children outside the government system. They dismiss the fact that these parents and donors are saving taxpayers in the neighborhood of $60 Billion a year based on current-dollar public school spending and the number of kids in private schools.

Finally, if this is all about rich people getting a free ride, why aren’t these guys screaming about means-testing public schools? Why shouldn’t we charge rich parents tuition to attend public schools? If a charitable deduction for private schools is so bad, why isn’t a free public education even worse?