Topic: Government and Politics

WSJ: How ObamaCare Punishes the Sick

In today’s Wall Street Journal, I discuss new economic research showing ObamaCare is making health insurance worse for patients with high-cost medical conditions.

Republicans are nervous about repealing ObamaCare’s supposed ban on discrimination against patients with pre-existing conditions. But a new study by Harvard and the University of Texas-Austin finds those rules penalize high-quality coverage for the sick, reward insurers who slash coverage for the sick, and leave patients unable to obtain adequate insurance…

If anything, Republicans should fear not repealing ObamaCare’s pre-existing-conditions rules. The Congressional Budget Office predicts a partial repeal would wipe out the individual market and cause nine million to lose coverage unnecessarily. And contrary to conventional wisdom, the consequences of those rules are wildly unpopular. In a new Cato Institute/YouGov poll, 63% of respondents initially supported ObamaCare’s pre-existing-condition rules. That dropped to 31%—with 60% opposition—when they were told of the impact on quality.

Republicans can’t keep their promise to repeal ObamaCare and improve access for the sick without repealing the ACA’s penalties on high-quality coverage.

The lesson is clear. To repeal ObamaCare, opponents need to talk to voters about how the law is reducing the quality of health insurance and medical care for the sick.

Read the whole thing.

The End of Self Government?

In Federalist 39, James Madison asks whether the 1787 Constitution

be strictly republican. It is evident that no other form would be reconcilable with the genius of the people of America; with the fundamental principles of the Revolution; or with that honorable determination which animates every votary of freedom, to rest all our political experiments on the capacity of mankind for self-government.

The political scientist John DiIulio, Jr. answers ten questions about big government. He shows that regulations and spending by the federal government have risen a lot over the past half century. At the same time, representatives of the people have less control over the people who implement big government. The feds delegate implementation to state and local governments and contractors. These “agents of the people” by and large, he argues, do a poor job.

DiIulio concludes that Americans “want big government benefits and programs, but they do not want to pay big government taxes and they prefer not to receive their goods and services directly from the hand of big government bureaucracies.” Add some lobbying by contractors and state and local officials, and you have big, incompetent government.

DiIulio recalls Alexander Hamilton’s claim that “the true test of good government is its aptitude and tendency to produce a good administration.” That’s a Hamiltonian thing to say!

Madisonian things ought also be said. The U.S. Constitution promised republican self-government, not efficient tax collection and a skilled civil service. The government DiIulio outlines involves so many people doing so much that elected representatives can hardly be expected to control this vast administrative state. The old hope for republican liberty too has been diminished by the rise of big government.

New Study on Low-Income Housing Subsidies

A new study at Downsizing Government looks at low-income housing aid. Howard Husock of the Manhattan Institute examines the history of federal aid and discusses problems with current policies, particularly rental subsidies and public housing.

One problem is that housing aid is costly to taxpayers. The federal government spent $30 billion on rental subsidies (Section 8 vouchers) and almost $6 billion on public housing in 2016.

Another problem is that housing aid and related rules are costly to urban communities. Howard argues that federal interventions undermine neighborhoods, encourage dependency, and create disincentives for long-term maintenance and improvements in housing.

No Side Is ‘Shameful’ in Trump’s Change to Transgender Bathroom Policy

President Trump’s administration has rescinded the Obama administration’s “Dear Colleague” letter requiring that public schools let transgender students use the bathrooms and locker rooms of their choice. It was probably the right thing do, and there was nothing “shameful” about the decision: equally decent people can, and do, have competing views of what is good.

There is no reason, of course, to believe anything other than that the Obama administration’s initial guidance was well-intended, driven by a desire to see transgender students empowered to make decisions for themselves about who they are. It is also absolutely a legitimate worry that school districts might discriminate against transgender students.

But equally decent people could feel very uncomfortable sharing a bathroom or changing room with someone of the opposite biological sex — sex-based privacy has been a time-honored norm — and could also have religious objections to such mixing. What about their rights? There were also legitimate worries about the legality of the order, delivered as a sudden reinterpretation of long-standing regulations.

Finally, societal evolution takes time. It may well be better to let smaller units (states, communities, families) grapple with and adjust to social change than suddenly impose one vision of the good on everyone.

Of course, there may be no solution in a diverse school or district that equally respects the values and desires of all. This is a major reason that school choice is so crucial: it enables families and educators to freely choose the values they want taught and respected, rather than government choosing one side to win and the other to lose.

Rio’s Olympic Disaster

“The legacy of the Rio Olympics is a farce,” writes sports columnist Nancy Armour in USA Today. She continues:

The closing ceremony was six months ago Tuesday, and already several of the venues are abandoned and falling apart. The Olympic Park is a ghost town, the lights have been turned off at the Maracana and the athlete village sits empty…. the billions that were wasted, the venues that so quickly became white elephants, the crippling bills for a city and country already struggling to make ends meet…

She notes that more and more cities are realizing that Olympic games are glamorous but not economically sound. I made that point two years ago when Boston withdrew its bid to host the 2024 Summer Olympics:

Columnist Anne Applebaum predicted a year ago that future Olympics would likely be held only in “authoritarian countries where the voters’ views will not be taken into account” — such as the two bidders for the 2022 Winter Olympics, Beijing and Almaty, Kazakhstan.

Fortunately, Boston is not such a place. The voters’ views can be ignored and dismissed for only so long.

The success of the “10 people on Twitter” and the three young organizers of No Boston Olympics should encourage taxpayers in other cities to take up the fight against megaprojects and boondoggles — stadiums, arenas, master plans, transit projects, and indeed other Olympic Games.

I cited then some of the evidence about the impact of the Olympics on host cities:

The critics knew something that the Olympic enthusiasts tried to forget: Megaprojects like the Olympics are enormously expensive, always over budget, and disruptive. They leave cities with unused stadiums and other waste.

E.M. Swift, who covered the Olympics for Sports Illustrated for more than 30 years, wrote on the Cognoscenti blog a few years ago that Olympic budgets “always soar.”

“Montreal is the poster child for cost overruns, running a whopping 796 percent over budget in 1976, accumulating a deficit that took 30 years to repay. In 1996 the Atlanta Games came in 147 percent over budget. Sydney was 90 percent over its projected budget in 2000. And the 
Athens Games cost $12.8 billion, 60 percent over what the government projected.”

Bent Flyvbjerg of Oxford University, the world’s leading expert on megaprojects, and his co-author Allison Stewart found that Olympic Games differ from other such large projects in two ways: They always exceed their budgets, and the cost overruns are significantly larger than other megaprojects. Adjusted for inflation, the average cost overrun for an Olympics is 179 percent.

In the latest edition of Cato Policy Report, Flyvbjerg examined “the ‘iron law of megaprojects’: over budget, over time, over and over again.”

Brazil has great resources, great ambitions, and great problems, including a vast corruption scandal that has taken down numerous public officials including President Dilma Rousseff. But the lives of its people will not improve through grandiose projects. Brazil needs financial reform, tax and regulatory reform, fiscal reform, and more. Megaprojects are not the road to prosperity.

Donald Trump’s “Rules of Civility and Decent Behavior”

As any pedantic patriot can tell you, there’s really no such thing as “Presidents’ Day”–the official name for the federal holiday we celebrated on Monday is “Washington’s Birthday.” And it wasn’t the first president’s actual birthday, which is today, February 22.

Washington had his faults, but, especially when compared to most of those who followed him, he provided an admirable model of probity and restraint. The teenage Washington copied in his own hand 110 precepts on etiquette: “The Rules of Civility and Decent Behavior in Company and Conversation,” and, as I noted recently, they make for a pretty stark contrast with the deportment of 1600 Pennsylvania’s current occupant. So, in honor of Washington’s (actual) Birthday, contemplate the distance between our first president and our 45th, with a selection of Washington’s “Rules”–and Trump’s:

Washington’s “Rules”:

Shew Nothing to your Freind that may affright him.

Speak not when you Should hold your Peace

do not Presently play the Physician if you be not Knowing therein.

Undertake not what you cannot Perform but be Carefull to keep your Promise.

Trump: “I will give you everything. I will give you what you’ve been looking for for 50 years. I’m the only one” (campaign rally, North Dakota).

Margaret Thatcher’s $3 Trillion Revolution

Margaret Thatcher came to power in 1979 determined to revive the stagnant British economy with market-based reforms. During her 11 years as prime minister, she deregulated, cut marginal tax rates, repealed currency exchange controls, and tamed militant labor unions.

However, it was privatization that became Thatcher’s most important and enduring economic legacy. She popularized the word privatization and oversaw the sale to the public of British Airways, British Telecom, British Steel, and British Gas, and other major businesses.

Spurred by the success of Thatcher’s reforms, privatization swept the world. Governments in more than 100 countries moved thousands of state-owned businesses to the private sector. Since the Iron Lady’s campaign to give ownership of Britain’s economy back to the people, more than $3.3 trillion of government businesses have been privatized around the world.

I take a look back at Thatcher’s privatization reforms in this month’s Cato Journal.

What is the relevance for U.S. policymaking today? Many types of businesses that Britain privatized are still partly or fully owned by governments in this country, including airports, seaports, postal services, air traffic control, electric utilities, and passenger rail. So there is an opportunity here for our leaders to spur growth and innovation by adopting Thatcher’s playbook.

But privatization is important for more than just the economic benefits. Thatcher said privatization is also about “reclaiming territory for freedom” and ensuring that “the state’s power is reduced and the power of the people enhanced.”

In toasting Margaret Thatcher in Washington, February 27, 1981, President Ronald Reagan said “everywhere one looks these days the cult of the state is dying.” Thatcher’s privatization program would help make that promise come true.

The photo shows the free-market friends at the White House, February 28, 1981.