Topic: General

Goldhill: ObamaCare to Hurt Those It Purports to Help

Another excerpt from David Goldhill’s new book Catastrophic Care: How American Health Care Killed My Father – And How We Can Fix It:

If the ACA places more of the burden of health care on the poor and the middle class, diverts resources into waste and unnecessary treatments, coddles an industry culture of dangerous sloppiness, and crowds out all other social priorities, then it will have actively hurt the very people it was intended to help.

Goldhill is the CEO of the Game Show Network, a member of the board of the Leapfrog Group, and will speak at a Cato forum on his book tomorrow, Wednesday, September 18, from 12-1:30 p.m. at the Cato Institute. The Brookings Institution’s Kavita Patel and I will provide comments.

Click here to register.

A Democrat Reexamines His Party’s Position on Health Care

An excerpt from David Goldhill’s new book, Catastrophic Care: How American Health Care Killed My Father – And How We can Fix It

I’m a Democrat and once held views about health care common in my party. But the more I’ve looked at our system, the more I’ve come to believe that the obsessions of our political debate – universal access, health insurance regulation, cost control – are irrelevant to the real problems that have created our mess…

[T]he frustrating reality is that despite more than sixty years of government efforts – representing the work of both political parties – we are moving further and further away from what we want. Prices are higher, more people are excluded from needed care, more excess treatments are performed, and more people die from preventable errors. Why?

Goldhill explains why at a book forum on Catastrophic Care this coming Wednesday, September 18, from 12-1:30pm at the Cato Institute. Click here to register.

Missouri Lawmakers Override Veto to Enact Good Samaritan Law

In January, Missouri legislators introduced the “Volunteer Health Services Act.” The bill expands health care access for low-income residents by eliminating the regulatory barriers Missouri previously imposed on out-of-state doctors and other clinicians who want to provide free charitable care to Missouri’s poor. Yes, every state government prevents some doctors from giving away free medical care to the poor. As I wrote in “50 Vetoes:” 

Volunteer groups like Remote Area Medical engage doctors and other clinicians from around the country to treat indigent patients in rural and inner-city areas. States often prevent these clinicians from providing free medical care to the poor because, while they are licensed to practice medicine in their own states, they are not licensed to practice medicine where Remote Area Medical is holding its clinics.

Remote Area Medical has had to turn away patients or scrap clinics in California, Florida, and Georgia…After a tornado devastated Joplin, Missouri, Remote Area Medical arrived with a mobile eyeglass lab, yet state officials prohibited the visiting optometrists from giving away free glasses.

It appears that Missouri legislators, if not the governor, have learned their lesson. The legislature approved the Volunteer Health Services Act in May, and sent it to Gov. Jay Nixon (D), who vetoed it. But yesterday, both the Missouri House and Senate voted to override the governor’s vetoMissouri now joins states like Tennessee, Illinois, and Connecticut that have enacted similar Good Samaritan laws. 

The Missouri law also shields clinicians from liability for simple negligence in malpractice actions. I’m not a really a fan of letting legislatures shield doctors from liability for their own negligence. In my view, doctors and patients should choose and adopt their own med-mal rules via contract. But this part of the law may have little effect. Missouri’s Volunteer Health Services Act still leaves clinicians liable for injuries resulting from gross negligence, and judges and juries may weaken this shield by stretching the definition of “gross” negligence.  

Rather than enact massive and unaffordable new entitlement programs like ObamaCare’s Medicaid expansion, states should follow Missouri’s lead and eliminate this and other barriers that government puts in the way of getting health care to the poor.

(HT: Patrick Ishmael of the Show-Me Institute.)

Halbig Plaintiffs Request Preliminary Injunction

Halbig v. Sebelius is one of two federal lawsuits challenging an illegal IRS rule that attempts to issue ObamaCare’s tax credits in the 34 states that have opted not to establish one of the law’s health insurance “exchanges.” Yesterday, attorneys for the Halbig plaintiffs filed a motion for a preliminary injunction, requested a hearing on that motion before October 1, and filed a second motion also seeking to expedite the case. The first motion requests:

an Order enjoining [the government], pending resolution of the litigation, from applying the IRS regulations extending eligibility for premium assistance subsidies under the Patient Protection and Affordable Care Act to individuals who purchase health coverage through Exchanges established by the federal government.

If the court grants that request, ObamaCare implementation will come to a screeching halt.

The Halbig plaintiffs make a compelling case that the IRS is violating federal law, and that the court must resolve the issue before January 1, 2014. If a resolution comes after that date, the plaintiffs will be irreparably injured because they “will be forced either to comply with the ACA’s individual mandate or risk incurring a penalty, and…will further be entirely and forever precluded from purchasing catastrophic coverage for 2014.” In addition: 

the balance of the equities and public interest both cut strongly in favor of resolving the legal validity of the IRS Rule now, before billions of taxpayer dollars are illegally expended and before employers make unalterable benefit decisions premised on the Rule. If a ruling invalidating the IRS Rule is delayed until after these events, the result would be utter chaos…It serves everyone’s interests—those of Plaintiffs, the Government, and the public alike—to obtain a prompt ruling on the legal validity of the IRS Rule, so that there will be no need subsequently to confront the logistical nightmare of trying to unscramble and undo the unlawful expenditure of billions of federal dollars. [Emphasis in original.]

Even if the government ultimately prevails, as health-benefits expert Thomas Haynes explains in a supplemental filing, it would unnecessarily and irreparably injure some employers and employees if that happens in 2014 instead of 2013. Brokers who are aware that the availability of these tax credits is uncertain in 34 states will counsel employers not to adjust their employee benefits to take advantage of that still-uncertain new landscape. Those employers and employees would then be locked into spending more on health insurance in 2014 than they would if the litigation had been resolved in 2013. 

The Obama administration, however, is in no hurry. In Halbig, for example, government lawyers have blown through the legal deadlines for responding to key plaintiff motions, deadlines that passed months ago. Indeed, they appear to be using every tactic at their disposal to guarantee these cases will not be resolved this year.

Whether the Obama administration’s lawyers simply have a lot on their plate, or are intentionally trying to prejudice judges against ruling for the plaintiffs – by guaranteeing that such a ruling would result in maximum chaos – a preliminary injunction is in order. 

The Syria AUMF: Be Careful What You Vote For

Whatever his motivations, it’s good that President Barack Obama has departed from past practicelet the Tomahawks fly and Congress be damnedand gone to the people’s representatives so they can stand and be counted. 

But, as I note in today’s Washington Examinerthat vote isn’t without danger. The draft authorization for the use of military force the administration circulated Saturday is strikingly broad. And if we know anything from the history of past AUMFs, it’s that presidents will push the authority they’re given as far as language will allow—and possibly further. 

In his Rose Garden press conference Saturday, Obama said “we would not put boots on the ground.” The action he’s contemplating would be “limited in duration and scope.” Just a “shot across the bow”—a light dusting of cruise missiles.  

The draft AUMF says no such thing:

  • It authorizes the president to use U.S. “armed forces,” not just air power. 
  • He can do that “as he determines to be necessary and appropriate,” so long as it’s “in connection” with use of unconventional weapons in Syria—and again, he determines what connection exists.
  • It doesn’t limit him to striking Syrian government forces, and it doesn’t limit him to Syria. It’s loose enough, as former Bush Office of Legal Council head Jack Goldsmith points out, to allow the president to wage war against Iran or Hezbollah in Lebanon, so long as “he determines” there’s some connection to WMD in Syria.
  • And it doesn’t contain a “sunset clause” time-limiting the authority granted—which means that authority will be available for future presidents as well. 

As a reminder, here’s LBJ announcing his decision to go to Congress for the Gulf of Tonkin Resolution, piously intoning that “we Americans know, though others appear to forget, the risks of spreading conflict. We still seek no wider war.”

 

The More Things Change, the More They Stay the Same

The following headlines were on a magazine cover I saw over the weekend: 

  • “Why People are Mad at Washington” 
  • “Less Zip in Business” 
  • “Republican Split” 
  • “New York on Brink Again” 
  • “Mideast War Jitters” 

With, perhaps, the exception of the headline about New York, one could easily conclude that the magazine is a current issue. However, that’s not the case. The cover actually belongs to the June 21, 1976 issue of U.S. News & World Report.

 

My parents kept it because that was the day I was born. Evidence, I believe, that God has a sense of humor. I can’t help but wonder though: will headlines in another 37 years be that much different?