The Washington Post reports that a doctor in Texas bilked Medicare and Medicaid out of $375 million. That’s a lot of money, but improper payments represent somewhere between 10 and 20 percent of total spending on these two health programs. Thus, more than $100 billion of taxpayer funds could be going down the drain each year.
The top‐down and bureaucratic Medicare and Medicaid systems are perfectly designed for scamming. For example, the government processes 1.2 billion Medicare claims each year by computer, generally without human eyes checking them for accuracy. The Texas doctor apparently just bombarded the system with fake claims, and it took the government six years to catch him.
The ease of ripping off federal health programs is one reason why these Soviet‐style programs should be radically restructured. It would harder to perpetrate major scams on Medicare if it were a bottoms‐up and more market‐oriented system based on vouchers. Federal spending on health programs ought to be cut, and reducing fraud through restructuring would be one way to do it.
For more on fraud in federal subsidy programs, see here.
For more on restructuring Medicard and Medicaid, see here.
Karl Rove’s and Ed Gillespie have written a piece arguing that the conventional wisdom is wrong because a) foreign policy can be made into a big issue in the 2012 presidential campaign, and b) Obama is vulnerable on the subject. I did not find the piece persuasive at all, and my disagreement with it has produced not just a podcast on the subject, but an appearance on bloggingheads. The University of Kentucky’s Robert Farley and I discuss a range of subjects, from the Rove/Gillespie piece, to burning Qurans in Afghanistan, to the future of U.S.-China relations. To give you a flavor, here’s a clip where I denounce the GOP foreign policy establishment:
For what it’s worth, I think the only way to solve the problem I identify above is a decades‐long project to build a counter‐counterestablishment of foreign policy thinkers who could staff the foreign policy wing of a notionally sensible GOP presidential candidate. I have not yet read this book, but in reading reviews of it, my understanding is that it does a good job describing how the neocons built their counterestablishment, which I think by now has essentially become the establishment. The neoconservative insurgency benefited from remarkable largesse from their funders, a large bench of aspiring policy professionals, and a sharp‐elbowed ability to successfully fight within bureaucracies. If people wish to reverse the course of GOP foreign policy, I suspect a similar effort will be needed on the part of realists. (We’re working on it. Happy to talk to any Democrats, too.)
For the entire bloggingheads video, go here. For my podcast on the Rove/Gillespie piece, go here. For my prior denunciation of the Beltway foreign‐policy establishment, here.
My thanks to Farley and the bloggingheads people for having me on.
Cato senior fellow Randy Barnett (also, of course, a Georgetown law professor and the “intellectual godfather” of the Obamacare litigation) blogs the results of a new USA Today/Gallup poll: 72% of Americans (including 56% of Democrats and 54% of those who think “the healthcare law is a good thing”) think the individual mandate is unconstitutional. This follows a Rasmussen poll showing that a majority of Americans favor repeal and an AP poll from August that found 82% to opine that the federal government “should not have the power to require all Americans to buy health insurance.”
Now, no court should rule a given way simply because a majority—even an overwhelming majority—of people want it to. Indeed, the judiciary is by design the non‐political branch of government, one often required by the Constitution to reach counter‐majoritarian results. But to the extent that in this unprecedented litigation over an unprecedented assertion of federal power, where the outcome could turn on whether something is “proper”—the intepretation of which term may depend on concepts such as “legitimacy” and “accountability”—the sustained, strong views of the public may, at the margins, matter.
Are you listening, Justice Kennedy Supreme Court?
New legislation signed Wednesday by Arizona governor Jan Brewer doubles the old $500 cap on tax credits for individual taxpayer donations to k‐12 tuition granting organizations. The Arizona program, upheld last year by the U.S. Supreme Court (in ACSTO v. Winn), cuts taxes on those who make donations to k‐12 tuition scholarship organizations. The result is that the donation costs the taxpayer nothing, but it brings a wide range of new educational options within reach of families all across the state by helping them to pay independent school tuition.
As I found in a statistical analysis of school choice programs, education tax credit don’t generally result in suffocating regulation being imposed on independent schools, so they really do expand access to a free educational marketplace. The same can’t be said for other private school choice programs, so the expansion of Arizona’s tax credits is truly welcome news.
Of course in order to keep up with leaders in the field, Arizona needs to take one more step: add a clause to the program that allows it to grow automatically as long as more parents want tuition assistance for their kids. Florida leads the way in this regard, with an education tax credit program that grows every year as long as demand is nearing the limits imposed by its current caps.
Since these programs save money as well as spreading educational freedom, what are we waiting for?
Federal programs almost never die. Bureaucrats and their big‐government allies are still trying to cobble together an American national ID.
But leaders in the states continue to fight. In this case, it’s Michigan state representative and House transportation committee chairman Paul Opsommer (R‐DeWitt). In response to a recent report citing state compliance with REAL ID “benchmarks,” he’s put out a scathing report that was written up in the River Country (MI) Journal.
“The things we have done in Michigan, like making sure illegal aliens cannot get driver’s licenses, we are doing independently of REAL ID, and we are not interested in allowing the federal government to have permanent control over our licenses,” said Opsommer. “You can bet your bottom dollar that at some point if Obamacare is not repealed that the federal government will adopt new rules in the future requiring the cards’ use for access to healthcare. You can bet they will require it to buy a firearm. You can bet they ultimately want to put RFID chips into all these and share our full data with Canada, Mexico, and beyond. If we don’t repeal Title II of the REAL ID Act, all we are doing is putting off the ‘I told you so’ moment for a few years down the road.”
The tensions that the Framers of the Constitution designed into our governmental structure are doing their work through Rep. Opsommer.
“State documents should be state documents, and federal documents should be federal documents,” he says.
“If the federal government is bent on having a national ID card, they need to get their own house in order and start to make federal passports more secure and more affordable. Quit trying to outsource your own mismanagement of the federal passport system onto the states and let us get onto the business of issuing our own safe and secure sovereign driver’s licenses.”
The bureaucrats will keep at it at least until the Congress defunds REAL ID. But they’ll keep bumping into the likes or Rep. Paul Opsommer.