Tag Archives: Government health care

Sedgwick County Health Department: Services provided

Sedgwick County government trimmed spending on health. What has been the result so far?

During last year’s Sedgwick County budget hearings, there were warnings that trimming spending on health would decimate the health department’s ability to provide services. But after six months, that hasn’t been the case.

Sedgwick County Health Department services provided. Click for larger.
Sedgwick County Health Department services provided. Click for larger.

The nearby table shows measures of services provided for the first six months of this year compared to the same period the year before. The source of this data is the Sedgwick County Health Department, with my added column calculating the percent change. For most categories of service, the amount provided has risen or fallen slightly. The exception is WIC, the Women, Infants, and Children program. Participation in this program has fallen in Sedgwick County every year since peaking in 2010, mirroring the national trend.1

Average Monthly WIC Participation per 1,000 population, Sedgwick County


Notes

  1. KansasHealthMatters.org. Average Monthly WIC Participation per 1,000 population. Available here.

Inspector General evaluates Obamacare website

The HHS Inspector General has released an evaluation of the Obamacare website HealthCare.gov, shedding light on the performance of former Kansas Governor Kathleen Sebelius.

The Office of Inspector General for the Department of Health and Human Services has released a report titled HealthCare.gov: Case Study of CMS Management of the Federal Marketplace. An excerpt from the executive summary holds the main points:

What We Found

The development of HealthCare.gov faced a high risk of failure, given the technical complexity required, the fixed deadline, and a high degree of uncertainty about mission, scope, and funding. Still, we found that HHS and CMS made many missteps throughout development and implementation that led to the poor launch. Most critical was the absence of clear leadership, which caused delays in decisionmaking, lack of clarity in project tasks, and the inability of CMS to recognize the magnitude of problems as the project deteriorated. Additional HHS and CMS missteps included devoting too much time to developing policy, which left too little time for developing the website; making poor technical decisions; and failing to properly manage its key website development contract. CMS’s organizational structure and culture also hampered progress, including poor coordination between policy and technical work, resistance to communicating and heeding warnings of “bad news,” and reluctance to alter plans in the face of problems. CMS continued on a failing path to developing HealthCare.gov despite signs of trouble, making rushed corrections shortly before the launch that proved insufficient. These structural, cultural, and tactical deficiencies were particularly problematic for HealthCare.gov given the significant challenges of implementing a new program involving multiple stakeholders and a large technology build.

The problems are not solved. Challenges remain, the report says, including “contract oversight, the accuracy of payments and eligibility determinations, and information security controls.”

Who is responsible for the debacle? In a hearing before Congress, HHS Secretary and former Kansas Governor Kathleen Sebelius said “hold me accountable.” View a video clip below, or click here to view at C-SPAN.

Cost of restoring quality of life spending cuts in Sedgwick County: 43 deaths

An analysis of public health spending in Sedgwick County illuminates the consequences of public spending decisions. In particular, those calling for more spending on zoos and arts must consider the lives that could be saved by diverting this spending to public health, according to analysis from Kansas Health Institute.

Kansas Health Institute is concerned about proposed reductions in public health spending in Sedgwick County. Sunday it released a fact sheet titled Decreases in Public Health Spending Associated with More Deaths from Preventable Causes, subtitled “Analysis of how proposed public health funding reductions in Sedgwick County could lead to more preventable deaths over time.”

Kansas Health Institute infographic
Kansas Health Institute infographic
KHI’s analysis is based on the paper “Evidence Links Increases In Public Health Spending To Declines In Preventable Deaths,” Glen P. Mays and Sharla A. Smith, Health Affairs, 30, no.8 (2011):1585-1593, available here. Excerpts from the paper are below. KHI summarizes the findings of the paper as: “In short, the research showed that increased spending by local public health agencies over the thirteen-year period studied was linked to statistically significant declines in deaths from some preventable causes such as infant mortality, heart disease, diabetes and cancer.”

KHI developed a model based on the paper’s findings to conclude that the proposed reductions in spending on public health in Sedgwick County would result in the deaths show in the nearby table from their fact sheet. The total of these numbers is an additional 65 deaths per year.

Perhaps in response to these findings, two Sedgwick County Commissioners have proposed eliminating the proposed cuts. To help understand the effects of this spending, I duplicated the analysis performed by KHI. I took the proposed increases in spending (or reductions in cuts) and subtracted the spending for public health, leaving $1,019,499 in spending that loosely qualifies as “quality of life” spending. It’s for things like the zoo, Exploration Place, economic development, and the like.

Sedgwick County spending analysis based on Kansas Health Institute model. Click for larger version.
Sedgwick County spending analysis based on Kansas Health Institute model. Click for larger version.
As can be seen in the nearby illustration, if this quality of life spending was instead spent on public health, we could save 43 lives per year. Based on the methodology used by KHI, this is the human cost of restoring only the proposed cuts to quality of life spending in Sedgwick County. If we were to use the totality of quality of life spending, or even just a subset like the $5.3 million spent on an elephant exhibit, the cost in human lives is large. This, of course, assumes that the KHI methodology is valid and reliable.

In its summary, the KHI report states: “Budget decisions have real consequences.” Those supporting spending on quality of life issues instead of public health have some explaining to do.

Excerpts from Mays et al.

“On balance, there is very little empirical evidence about the extent to which differences in public health spending levels contribute to differences in population health. Several cross-national studies have found weak and conflicting associations between spending and health outcomes at a national level.”

In a section titled “Limitations” the authors note “Several limitations of this analysis are worthy of emphasis. Although we used strong statistical controls to address possible sources of bias, it remains possible that factors distinct from, but closely correlated with, public health spending may explain some of the observed associations between spending and mortality.”

Also, “Local public health activities may have important and perhaps more immediate effects on these other indicators of health … this analysis may underestimate the health consequences of changes in local public health spending.”

In conclusion, the authors write: “Our analysis supports the contention that spending on local public health activities is a wise health investment. Increasing such investments in communities with historically low levels of spending may provide an effective way of reducing geographic disparities in population health. However, more money by itself is unlikely to generate significant and sustainable health gains.”

‘Love Gov’ humorous and revealing of government’s nature

A series of short videos from the Independent Institute entertains and teaches lessons at the same time.

Lov Gov trailer exampleThe Independent Institute has produced a series of humorous and satirical videos to present lessons about the nature of government. The Institute describes the series here:

Love Gov depicts an overbearing boyfriend — Scott “Gov” Govinsky — who foists his good intentions on a hapless, idealistic college student, Alexis. Each episode follows Alexis’s relationship with Gov as his intrusions wreak (comic) havoc on her life, professionally, financially, and socially. Alexis’s loyal friend Libby tries to help her see Gov for what he really is — a menace. But will Alexis come to her senses in time?

There are five episode (plus a trailer). Each episode is around five minutes long and presents a lesson on a topic like jobs, healthcare, and privacy. The episodes are satirical and funny. They’d be really funny if the topic wasn’t so serious. I recommend you spend a half-hour or so to view the series.

The link to view the video series is here.

Medicaid found to increase, not decrease, emergency room usage

Those who continue to call for the expansion of Medicaid in Kansas should be aware of this astonishing finding, which contrary to what the conventional wisdom has told us about health care.

For years, it has been the number one talking point of Obamacare supporters. People who are uninsured end up getting costly care from hospitals’ emergency rooms. “Those of us with health insurance are also paying a hidden and growing tax for those without it — about $1,000 per year that pays for [the uninsureds’] emergency room and charitable care,” said President Obama in 2009. Obamacare, the President told us, would solve that problem by covering the uninsured, thereby driving premiums down. A new study, published in the journal Science, definitively reaches the opposite conclusion. In Oregon, people who gained coverage through Medicaid used the emergency room 40 percent more than those who were uninsured.

Continue reading at New Oregon Data: Expanding Medicaid Increases Usage Of Emergency Rooms, Undermining Central Rationale For Obamacare

Krugman on solutions to health care

Following are excerpts from New York Times columns by economist and Nobel Laureate Paul Krugman. You may tweet your reaction to him at @NYTimeskrugman.

Well, I know about a health care system that has been highly successful in containing costs, yet provides excellent care. And the story of this system’s success provides a helpful corrective to anti-government ideology. For the government doesn’t just pay the bills in this system — it runs the hospitals and clinics.

No, I’m not talking about some faraway country. The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate. (Health Care Confidential, January 27, 2006)

“You see, we actually have a real live case of impressive cost control in health care: the VA system.” (Medicare and the VA, May 27, 2009)

What Mr. Romney and everyone else should know is that the V.H.A. is a huge policy success story, which offers important lessons for future health reform.

Many people still have an image of veterans’ health care based on the terrible state of the system two decades ago. Under the Clinton administration, however, the V.H.A. was overhauled, and achieved a remarkable combination of rising quality and successful cost control. Multiple surveys have found the V.H.A. providing better care than most Americans receive, even as the agency has held cost increases well below those facing Medicare and private insurers. Furthermore, the V.H.A. has led the way in cost-saving innovation, especially the use of electronic medical records.

What’s behind this success? Crucially, the V.H.A. is an integrated system, which provides health care as well as paying for it. So it’s free from the perverse incentives created when doctors and hospitals profit from expensive tests and procedures, whether or not those procedures actually make medical sense. And because V.H.A. patients are in it for the long term, the agency has a stronger incentive to invest in prevention than private insurers, many of whose customers move on after a few years. (Vouchers for Veterans, November 13, 2011)

Medicaid expansion: The impact on the federal budget and deficit

From Kansas Policy Institute.

Medicaid Expansion: The Impact on the Federal Budget and Deficit

By Steve Anderson

Medicaid.gov Keeping America HealthyThe problem with the uninsured is not going to be solved by expanding Medicaid. Even amongst Medicaid’s staunchest proponents you’ll be hard pressed to find any who will claim it to be the equivalent of high quality private health insurance coverage. The number of federal senators and representatives that choose to exclude their staffers from Obamacare shows that many Washington politicians understand the quality of government insurance plans Medicaid and Obamacare represent. The simple fact is, that health insurance is not to be confused with health care.

Medicaid’s proponents can only claim anecdotal claims of improving health outcomes of recipients. Even in pre-ObamaCare Medicaid, beneficiaries largely do not access available preventable care services. In fact, a Harvard University study shows that emergency room visits actually increased by 40 percent for Medicaid recipients in Oregon after their expansion. Citizens would do well to remember, a “decrease in ER visits” was a key selling point of ObamaCare generally and Medicaid expansion specifically. ER visits are the most expensive form of care. When these increased visits are paid for by Medicaid, the taxpayers are picking up BOTH the state and federal portion of the high cost of emergency room visits. This flies in the face of the Obama Administration’s claim that Medicaid expansion would actually save money by limiting this sort of behavior.

It doesn’t stop there and this is the part that hardly anyone has mentioned, and what the Obama Administration would rather you not know — a staggering number of those enrolling in ObamaCare will actually be sent to Medicaid and not be in the private market. And by “private market” we mean one established and controlled by government.

The following charts are the pre-Medicaid expansion projection of revenues versus expenditures from the Congressional Budget Office. They were completed before the decision by 25 states and the District of Columbia to expand eligibility.i

The three lines with the steepest slopes and therefore the fastest growing expenditures are Medicaid, Unemployment payments (called Income Security) and Other Programs. The U.S. House of Representatives has addressed the unemployment expense growth by bringing the program back to its original intent – to provide a safety net between jobs. Other Programs will be largely controlled if current trends hold and extension of the various “stimulus” programs are curtailed. However, the one that is going to accelerate with expansion and is larger than the other two combined in total state and federal expenditures is Medicaid. At least 3.9 million of Obamacare participants are expected to be enrolled in Medicaid and 19 million nationwide overall will be added to Medicaid in the next year. A 35 percent increase in Medicaid participants.ii Picture these two charts with 35 percent greater additional costs for the Medicaid entitlement and you have an idea how problematic this is for the federal budget and deficit. Is it any wonder that President Obama has started to back track from the claim that the federal government—which let’s not forget, is funded by you the taxpayer — will pay all the costs for 3 years and 90 percent thereafter. Instead, his administration and he himself talk about blended rates that will transfer a sizeable portion of the cost to state budgets.iii Despite his promises to the contrary.

The Impact on the Kansas State Budget

Even the leftist Center on Budget and Policy Priorities, which typically finds spending citizens’ tax dollars an event to celebrate, is cautioning that the “blended rate” shift by the President will “likely prompt states to cut payments to health care providers and to scale back the health services that Medicaid covers for low-income children, parents, people with disabilities, and/or senior citizens (including those in nursing homes). Reductions in provider payments would likely exacerbate the problem that Medicaid beneficiaries already face regarding access to physician care, particularly from specialists.”iv This analysis actually left out the administrative cost of expansion that is largely being absorbed by the states. If anything, this suggests that reality will be more dire than CBPP’s predictions.

KPI’s own cost study of Medicaid expansion, conducted by a sitting member of the Social Security Advisory Board and former chief economist at the Federal Reserve in Cleveland, shows that Kansas taxpayers can expect to pick a $600 million tab if Medicaid is expanded. Hardly the “free money” that the Kansas Hospital Association has tried to foist on your family. They’ve even hired a former George W. Bush cabinet secretary to aggressively lobby for this “free money.” They’ve also yet to explain what services they recommend the state cut to fund the expansion and if their members are willing to pick up the additional costs when “blended rates” almost certainly take effect.

As a taxpayer you are going to pay for this on both the federal and state level and you deserve answers when any special interest groups come asking for more of your money.

http://directorblue.blogspot.com/2011/01/liberals-democrat-party-will-split-if.html
ii http://www.bloomberg.com/news/2014-01-02/obamacare-s-medicaid-expansion-may-create-oregon-like-er-strain.htm
iii http://www.cbpp.org/cms/index.cfm?fa=view&id=3521
iv Ibid

Medicaid found to increase, not decrease, emergency room usage

This is an astonishing finding, and contrary to what the conventional wisdom has told us about health care.

For years, it has been the number one talking point of Obamacare supporters. People who are uninsured end up getting costly care from hospitals’ emergency rooms. “Those of us with health insurance are also paying a hidden and growing tax for those without it — about $1,000 per year that pays for [the uninsureds’] emergency room and charitable care,” said President Obama in 2009. Obamacare, the President told us, would solve that problem by covering the uninsured, thereby driving premiums down. A new study, published in the journal Science, definitively reaches the opposite conclusion. In Oregon, people who gained coverage through Medicaid used the emergency room 40 percent more than those who were uninsured.

Continue reading at New Oregon Data: Expanding Medicaid Increases Usage Of Emergency Rooms, Undermining Central Rationale For Obamacare

Exchange data security breaches don’t require notification

The breach of consumer data at Target has brought the issue of data security in focus. Yesterday a senator called for more protection and accountability for consumers and retailers. The following story from Watchdog.org tells us that government does not want to hold itself to the standards it wants the private sector to observe. There has been legislation proposed. Rep. Diane Black [R-TN6] has introduced H.R. 3731: Federal Exchange Data Breach Notification Act of 2013, whose title is “To require an Exchange established under the Patient Protection and Affordable Care Act to notify individuals in the case that personal information of such individuals is known to have been acquired or accessed as a result of a breach of the security of any system maintained by the Exchange.”

Feds not required to report security breaches of Obamacare exchange website

By 

HACKED OFF: Hackers or careless bureaucrats could cause private information to be spilled across the Internet. But the federal government, unlike most states, don't have to tell users when they have been compromised.

HACKED OFF: Hackers or careless bureaucrats could cause private information to be spilled across the Internet. But the federal government, unlike most states, don’t have to tell users when they have been compromised.

By Eric Boehm | Watchdog.org

Americans who buy health insurance through the federal Obamacare exchange website could have their personal information stolen by hackers and never even know it.

Most of the state-run health exchange websites will be covered by state laws that require notification when government databases are breached by hackers. But there is no law requiring notification when databases run by the federal government are breached, and even though the Department of Health and Human Services was asked to include a notification provision in the rules being drawn up for the new federal exchange, it declined to do so.

Other protections for individuals’ privacy, like the Health Insurance Portability and Accountability Act, or HIPAA, do not apply to the government-run exchange, only to health providers and insurance companies operating within the exchange.

Privacy advocates and cyber-security experts have had concerns about the lack of a federal notification law for years and hope the scrutiny of the Obamacare exchange will finally bringchange.

“The notification requirement is a very important part of overall security,” saidDeven McGraw, director of the Health Privacy Project at the Center for Democracy and Technology. “People should be told when their information is at-risk.”

The lack of a notification requirement is particularly bad for the health insurance exchange website because of all the questions surrounding the site’s security. Poor security, coupled with the website’s high-profile problems, could make it a target for hackers either seeking to steal identities or embarrass the government.

Unfortunately, security is often an afterthought for the government, said David Kennedy, CEO of TrustedSEC, an Ohio-based cyber-security firm. Kennedy has testified before Congress about security threats in the Obamacare exchange and the need for notification laws.

“All we need is something that says if the federal government is breached, all we have to do is alert the public,” he told Watchdog.org. “Healthcare.gov is just one website of hundreds that have had these issues going back through the years.”

Together it creates a possible nightmare scenario. Without strong security on the front end, the hastily built and not fully operational website could become a treasure trove for hackers looking to steal identities. But without any laws requiring that those victims be notified by the federal government users of the Federal health exchange will be in the dark about any potential security breaches of their private data.

When the federal Obamacare exchange was being developed by HHS prior to its troubled launch on Oct. 1, experts told the department that it should include a data-breach provision in its policies for the website even though one was not required under federal law.

The department flatly declined to do so.

The final rules for the exchanges were approved on March 27, 2012, meeting of HHS officials, according to the Federal Register.

At that meeting, two commenters asked HHS to ensure the exchanges would promptly notify affected enrollees in the event of a data breach or unauthorized access to the exchange’s databases. One suggested that a full investigation be launched each time such a breach occurred, with the goal of holding hackers legally and financially accountable for breaking into the website.

The department’s response: “We do not plan to include the specific notification procedures in the final rule. Consistent with this approach, we do not include specific policies for investigation of data breaches in this final rule.”

Since there is no federal notification requirement, breaches of any and all federal databases can occur without the public ever being informed.

The only way to find out a hack has occurred is when the government decides to disclose it — as several federal law enforcement agencies did last month in response to attacks from Anonymous, a group of super-hackers who threatened to take down the FBI website and others.

But hacks that happen behind the scenes —potentially stealing everything from Social Security numbers to Department of Homeland Security watch lists — never have to be reported.

“That’s alarming because there could be a number of federal databases that are compromised already and we don’t know about it,” Kennedy said. “The exchange is part of a bigger problem.”

Federal privacy protections contained in HIPAA also do not apply to the databases created by the federal exchange website, McGraw said, even though health insurers doing business through the exchange must be HIPAA compliant.

In other words, the health plan itself is covered by HIPAA and any breaches of security that affect a consumer who has purchased a specific plan would have to be reported. But the process of choosing and purchasing a plan through the federal exchange — along with any information entered into the federal exchange as part of that process — is not subject to HIPAA protections.

“The problem with the exchanges is that they are such new entities, and they are so unique that existing laws don’t really cover them,” McGraw said.

But 48 states have laws on the books requiring that they give notification to individuals who may have had personal information stolen or leaked from a government database. Many states require that government agencies and departments alert the state attorney general so investigations can be launched.

In states that opted to run their own health insurance exchanges, those laws generally cover security breaches of the exchanges, McGraw said, though it depends on the specific wording of each state law.

Those state laws are how data breaches of several state-level health insurance exchange websites have come to light.

In September, Watchdog.org reported on a data breech of the Minnesota health exchange — known as “MNsure” — that potentially affected as many as 2,400 people.

In Florida, concerns about data breaches of the state-run exchange website prompted Gov. Rick Scott to send a letter to Congress saying Floridians would not exchange privacy for insurance.

On the federal exchange, such breaches are possible, maybe even likely, since the site was launched without comprehensive testing of the security controls for the system.

A Sept. 27 memo to Medicare chief Marylin Tavernner said insufficient testing of the website before the Oct. 1 launch “exposed a level of uncertainty that can be deemed a high risk,” the Associated Press reported in October.

Even though the federal government does not have to report any breaches of security, at least a few already have occurred.

The most high-profile case so far is that of Thomas Dougall, a South Carolina lawyer who had his personal information accidentally leaked to another person after using the Obamacare exchange last month.

We logged on and compared some prices,” Dougall later told Fox News’ Greta Van Susteren. “We came home last Friday night to have a young man from a completely different state calling to tell me that when he logged on … he got all my personal information in exchange.

Dougall only found out about that breach of security because the recipient was kind enough to give him a call.  Without a requirement that the exchanges report such problems — whether the result of nefarious hackers or glitches in the programming — it is impossible to tell how many other Americans have had their private information released by the federal exchange.

Kennedy said he would not recommend that anyone use the federal exchange until it is more secure and until breaches of security are reported.

“I would say think twice about it, at least until we get more details,” he said.

Kennedy says he supports universal health care and his criticisms of the website are not rooted in political motivations. But the former U.S. Marine whose firm provides computer security to several Fortune 100 companies says there have been “zero changes” to the security of the health insurance exchange website in the run-up to the much-touted Dec. 1 re-launch.

Congress has debated a federal notification law in each of the past three years, but one has never been passed.

In July, during a hearing of the House Committee on Energy and Commerce, lawmakers heard testimony from a variety of experts who explained the need for a federal breach notification requirement.

David Thaw, a law professor at the University of Connecticut who specializes in cyber-security and the legal framework around it, said data breach notification laws, combined with comprehensive data security, are an essential part of protecting consumers and businesses.

I analogize the effects of breach notification alone to locking the bank or vault door while leaving a back window wide open,” he said.

With the federal health insurance exchange, there are questions about whether the vault door has been adequately locked.

But there is no doubt that the back window is still wide open.

Boehm is a reporter for Watchdog.org and can be reached at [email protected]. Follow him on Twitter @EricBoehm87

Study: Kansas premiums to spike following Obamacare rollout

From Kansas Watchdog.

Study: Kansas premiums to spike following Obamacare rollout

By 

ON THE RISE: A new report from the Heritage Foundation says Obamacare premiums are significantly higher in Kansas compared to average rates before the rollout of the new health care law.

By Travis Perry, Kansas Watchdog

OSAWATOMIE — Good news: Kansas landed in the top 10 in a recent study conducted by the conservative Heritage Foundation! Bad news: It’s for massive insurance premium hikes because ofObamacare.

Kinda puts a damper on things, huh?

As I said, before dashing your optimism with harsh reality, Kansas is among the top 10 states to possibly see the largest premium increases following the rollout of the federal health care exchange, according to a recent report from Heritage’s Center for Data Analysis. In a nutshell, the report states Obamacare health premiums available to Kansans will be higher than existing policies.

According to the Heritage report, the average premium for a 27-year-old Sunflower State resident will rise from $87.40 to $200.14, a massive 129 percent bump. This gives Kansas the unfortunate privilege of boasting the sixth-highest increase for young people nationwide.

The news gets slightly better for other groups, but not by much. Average premiums for a 50-year-old adult could increase from $198 to $341.08 (72.3 percent increase), while a family of four may see an increase from $553.92 to $676.05 (22 percent increase).

“Many families and individuals will face this reality as they apply for coverage, and the implications of experiencing sticker shock are important to consider if enough people choose not to sign up for coverage for various reasons,” policy analyst Drew Gonshorowski wrote in the Oct. 16 report.

The massive increase in premiums for young people should be especially concerning, as they’re the one group Obamacare can’t afford to do without. The successful implementation of the Affordable Care Act depends heavily on the young and healthy signing up to help pay for the elderly and infirm.

It’s important to note the Heritage study compares premium prices straight-up, not including government subsidies designed to decrease the cost to low-income individuals and families.

“This analysis represents the change in unsubsidized rate levels,” Gonshorowski wrote. “The purpose of this research is to provide further details on the changing premium levels across the country.”

Source Report: How Will You Fare in the Obamacare Exchanges?

Contact Travis Perry at [email protected], or follow him on Twitter at@muckraker62.

A letter to the U.S. Senate regarding the federal government shutdown

From KochFacts.com.

Dear Senator,

A great deal of what you read and hear about Koch Industries is erroneous or misleading. Indeed, there was false information presented about Koch on the Senate floor by Senate Majority Leader Reid, who claimed yesterday that Koch was behind the shutdown of the federal government in an effort to defund the Affordable Care Act or “Obamacare.” Because several of you have asked what our position is on this issue, we want to set the record straight and correct this misinformation.

Koch believes that Obamacare will increase deficits, lead to an overall lowering of standards of health care in America, and raise taxes. However, Koch has not taken a position on the legislative tactic of tying the continuing resolution to defunding Obamacare nor have we lobbied on legislative provisions defunding Obamacare.

Instead, Koch has focused on educating the public about reducing our nation’s debt and controlling runaway government spending. We believe that Congress should, at a minimum, keep to sequester-level spending guidelines, and develop a plan for more significant and widespread spending reductions in the future. We also believe that Congress should work to rein-in rampant government spending so that it becomes no longer necessary to continually raise the debt ceiling.

Congress should focus on these efforts: balancing the budget, tightening and cutting government spending, curbing cronyism, and eliminating market-distorting subsidies and mandates.

We are hopeful this sets the record straight and that in the future Senator Reid and other politicians will stop misrepresenting and distorting Koch’s positions.

Sincerely,
Philip Ellender
President, Government & Public Affairs
Koch Companies Public Sector, LLC

ObamaCare employer mandate delayed, start of train wreck?

aspirin-bottleScheduled to take effect on January 1, the employer mandate portion of the Affordable Care Act (ObamaCare) has been delayed for one year.

Curiously, this announcement was made on an obscure Treasury Department blog, along with articles titled “Meeting, and Exceeding, Our Small Business Procurement Goals in FY 2012” and “In Case You Missed It: Top Executives Say U.S. Is #1 for Foreign Direct Investment.”

The employer mandate requires those who employ more than 50 full time-equivalent employees to provide insurance or pay a penalty. Cato Institute’s Michael D. Tanner notes the general problem, and a specific problem based on the decision to delay the employer mandate:

In postponing the implementation of the Affordable Care Act’s employer mandate until after the 2014 mid-term elections, the Obama administration has tacitly admitted what critics of the law have long contended: that Obamacare is unworkable and would be a significant burden for American business and the economy at large. Stay tuned for further dominoes falling.

Actually, the Administration’s decision to postpone the employer mandate may make a bad situation worse. Because the individual mandate remains in place, workers may now face a situation where they must purchase their own insurance or pay a penalty because their employers don’t provide coverage. In effect, the administration’s decision shifts the cost from employers to workers. This hardly seems fair, and may force the administration to rethink the individual mandate as well. (And So the Obamacare Train Wreck Begins … )

Will the implementation of other parts of ObamaCare be delayed? I think it seems likely. But: Section 1513 AVC states, regarding the employer mandate: “The amendments made by this section shall apply to months beginning after December 31, 2013.” So does the administration have the legal authority to make changes like this?

uninsured-estimates-2013-05

Also: For all the wrenching debate and changes, there will still be many uninsured people. Here’s a chart based on the Congressional Budget Office May 2013 estimate of the effects of the Affordable Care Act on health insurance coverage.

This is just the start of discovery of pathologies built into ObamaCare. Here’s Avik Roy explaining an incentive contained within the employer mandate:

The strong penalty vs. the weak penalty

The employer mandate actually consists of two different penalties, based on two different categories of employer behavior. These originate from Section 4980H of the Affordable Care Act. Subsection (a) requires steep penalties for employers who offer no coverage at all. Subection (b) requires modest penalties for employers who offer “minimum essential coverage under an eligible employer-sponsored plan.” This difference — between the strong penalty in 4980H(a) and the weak penalty in 4980H(b) — is crucial to understanding how things will play out in the future.

Under the strong penalty, in which an employer “fails to offer to its full-time employees…the opportunity to enroll in minimum essential coverage,” and “at least one full-time employee” enrolls in an exchange, the employer has to pay a fine of $2,000 times the total number of full-time-equivalent employees at the firm, minus 30. (The employer mandate only applies to firms with 50 or more full-time-equivalent workers.) So if you employ 50 workers, that’s a fine of 20 * $2,000 = $40,000. And the fine isn’t tax-deductible, adding to the pain.

Under the weak penalty, in which an employer does offer “the opportunity to enroll in minimum essential coverage,” but that coverage doesn’t meet Obamacare’s requirements for affordability or actuarial value, and at least one worker enrolls on an exchange instead, the fine is $3,000 times the number of workers who enroll on the exchanges. So, if you employ 50 workers, and three of them get coverage on the exchange instead, the fine is a much lower 3 * $3,000, or $9,000. (Technically, in subsection (b), employers pay the lesser of the weak penalty or the strong penalty, but this in most cases should be the weak penalty.)

So: Employers avoid the strong penalty and gain eligibility for the weak penalty by offering “minimum essential coverage.”

Roy goes on to explain that “minimum essential coverage” means coverage my any insurance plan that can legally be sod in a state, including plans that provide limited coverage or services. Roy writes that companies may offer these bare-bones plans to their employees and escape the penalties.

This behavior, which federal officials have confirmed is allowed, evidently wasn’t considered by officials, writes Roy: “Nonetheless, Obamacare’s designers expressed surprise that employers would do such a thing. ‘Our expectation was that employers would offer high quality insurance,’ said Robert Kocher, a former Obama health care adviser. It wouldn’t be the first time that the law’s authors didn’t recognize how economic incentives actually work.”

Economic incentives are what makes the world work. They’re based on human behavior, and that isn’t easily changed, even to suit Barack Obama’s desires.

The future of Obamacare, now he tells us

This is a sad commentary on the state of politics and governance in the U.S., from the Boston Globe:

Unencumbered by the political pressures of a reelection campaign, Baucus is in a position to call out both the failure of federal officials to prepare for implementing Obamacare as well as the unintended consequences of its complex regulations.

A short while ago, before U.S. Senator Max Baucus announced his retirement, U.S. Representative Mike Pompeo of Wichita noticed the incongruity of Baucus complaining about a law he passed, tweeting the following:

Following are excerpts from a letter Pompeo sent to Baucus, followed by the entire letter.

My shock wasn’t because I disagreed: You’re right to say this legislation has led to great uncertainty for hard-working Americans, small business owners, and families. No, I was shocked because you wrote this bill. I was saddened because your acknowledgment of the harm caused by PPACA has come so late.

No one in the country bears more responsibility for the complexity of this law than you. When your supermajority couldn’t pass the bill using normal procedures, you and your Senate colleagues rammed through the final legislation by using parliamentary gimmickry. Then, in the House, Speaker Pelosi cheerfully urged members to pass the legislation “in order to find out what’s in it.” This was not good policy-making, and now we’re seeing the consequences.

Secretary Sebelius’s implementation of the law is certainly flawed, but the policy process produced a law that could not possibly be implemented successfully. As legislators, it is our responsibility to write bills that clearly explain our meaning and have achievable goals. By your own admission, this law is a disaster.

You drafted it, you twisted arms to get it passed, and, until now, you have lauded it as a model for all the world. Your attempts to pass the buck to President Obama’s team will not work, nor will they absolve you of responsibility for the harm that you have brought via this law.

Download (PDF, 125KB)

ObamaCare explained: What could go wrong?

An Illinois State Senate candidate who happens to be a physician diagnoses and explains the problems with the Affordable Care Act, also known as ObamaCare. Here’s a transcription of what Barbara Bellar said:

Let me get this straight: We’re going to be gifted with a healthcare plan we are forced to purchase,
and fined if we don’t,
which purportedly covers at least 10 million more people,
without adding a single new doctor,
but provides for 16,000 new IRS agents,
written by a committee whose chairman says he doesn’t understand it,
passed by a congress that didn’t read it but exempted themselves from it,
and signed by a president who smokes,
with funding administered by a treasury chief who didn’t pay his taxes,
for which we will be taxed for four years before any benefits take effect,
by a government which has already bankrupted Social Security and Medicare,
all to be overseen by a surgeon general who is obese,
and financed by a country that’s broke.

So, what the blank could possibly go wrong?

Kansas and Wichita quick takes: Thursday March 8, 2012

Candidate representatives at Pachyderm. This Friday’s meeting (March 9th) of the Wichita Pachyderm Club features Republican presidential candidate spokespersons. In addition, Lora Cox, Executive Director of the Sedgwick County Republican Party will be on hand to answer questions regarding the mechanics of Saturday’s Republican Party Caucus. … The public is welcome and encouraged to attend Wichita Pachyderm meetings. For more information click on Wichita Pachyderm Club.

Sedgwick County pre-caucus rally. Friday afternoon (March 9th) Kansans for Liberty is producing a pre-caucus rally at Century II. Ron Paul is scheduled to appear. There will be other speakers and live entertainment, say event organizers. Tickets are $25. For more information, see Kansans for Liberty.

Libertarian ideals. The Winfield Courier criticizes U.S. Representative Mike Pompeo for his bill that would eliminate all tax credits for energy, writing “This is a case of putting libertarian ideals ahead — far ahead — of the interests of our region and our state.” But the libertarian ideals of personal liberty, economic freedom, and free markets ought to be all that government concerns itself with. … This is not the only way this op-ed is misinformed on facts. The anonymous author writes: “New, life-changing technologies, from the railroads to the Internet, have long had the active support of our national government.” But: Consider the railroads. The government-subsidized railroads involved in the transcontinental project went bankrupt. Only The Great Northern Railroad, which was built without government subsidy, was profitable and not a burden on the national treasury. (See Interfacing with Obama’s Intercontinental Railroad). Shame on the Winfield Courier so being so misinformed on U.S. history and the proper role of a limited government.

High Kansas taxes. Kansas Reporter covers more of the Tax Foundation’s report on the high cost of Kansas business taxes: “A new national study says Kansas business owners pay some of the highest taxes in the country. … Kansas businesses that are 3 or fewer years old pay the third-highest total taxes in the nation among all 50 states and Washington, D.C., the study found. Older businesses, such as Midway Wholesale, pay the fourth-highest totals. The findings contrast sharply with previous surveys, including some by the Tax Foundation, that put Kansas closer to the midpoint in regard to tax burden. As recently as January, for example, the foundation released its latest compilation of its Business Tax Climate Index, which put Kansas almost dead center — in 25th place — among lightest- to heaviest-taxed states. ‘Those surveys focus on tax policies, such as what types of taxes do states have or what are their tax rates,’ said Scott Hodge, the foundation’s president. ‘This new study looks at the issue from a business’ viewpoint and what they actually pay.'” … More at New study finds KS tax loads worse than reported.

Harm of individual mandate explained. In the following short video, Elizabeth Price Foley of the Institute for Justice explains the harm of the individual mandate that is the centerpiece of the Patient Protection and Affordable Care Act (Obamacare). She explains that if the U.S. Supreme Court fails to strike down the individual mandate, there will be nothing to stop Congress from forcing people into other contracts against their will — employment contracts or union membership, for example. If we still have a constitutional republic in which the federal government’s powers are limited, then the Court should strike down this law. More information on IJ’s brief is contained in this press release.

Huelskamp on spending, health information database, and Buffett

Addressing members and guests of the Wichita Pachyderm Club last Friday, U.S. Representative Tim Huelskamp of the Kansas first district updated the audience on national spending and debt, a health information database that poses privacy risks, and Warren Buffett’s taxes.

On being a new member of Congress, Huelskamp said people ask me “is Washington everything you thought it would be?” And I answer yes — and much worse.

He told the audience that the Washington Post newspaper has identified him as a member of the “Apocalypse Caucus,” a group of twenty lawmakers that have voted no for almost everything, including raising the debt ceiling. The Post says these lawmakers would be willing to shut down the government simply to make a point. Huelskamp told the audience “The point we need to remember is there is an apocalypse ahead unless we rein in spending, unless we rein in this president, unless we rein in the regulations.”

Huelskamp said that for every dollar spent in Washington, 41 cents is borrowed money. And while some in Washington say that there is a plan to get things under control, he said this is not happening yet.

He described a budget committee hearing in which four economists testified. He asked how long do we have until we reach the point of no return such as Greece is at presently, where they can’t pay back their debt? The first economist, a conservative, said “act as if you have no time left.” The other three economists — moderates and liberals — said they agreed with the first economist’s assessment.

During a series of budget negotiations in the spring, Huelskamp said that initially House leadership had started with the idea of cutting $100 billion. But that number was thought to be too much, and eventually Congress and the president settled on cuts of $25 billion. But the actual spending that was cut was only $350 million, or just about one-third of a billion dollars.

Huelskamp described the debt ceiling negotiations in the summer as a situation where the president had to have Congress’s permission to raise the debt ceiling. But he said Congress agreed to no cuts at all, despite having this power. He didn’t want to vote to just “kick the can down the road,” and that’s why he voted against raising the debt ceiling in August.

He also told of hearing from a high-ranking Chinese official at a budget committee hearing. The official — Huelskamp reminded the audience that China is a communist country — told the committee members the things they would have to do with the budget. While Huelskamp agreed with the official’s assessment of what the U.S. needed to do with its budget, he wondered how do we get in this position, where we turn over, often, our sovereignty to foreign nations.

Huelskamp cited a national poll that found that 48 percent believe the American dream is dead. In his town hall meetings — he’s held about 70 so far — he estimates 90 percent believe the American dream is gone, or soon to be gone. “Most Americans, including Kansans, as optimistic as we are, are worried about what’s going on in Washington. And they don’t know who to blame, and they’re going to start blaming everybody. I’m one of the few who believe the American dream is still alive and well.”

Switching topics, Huelskamp described former Kansas Governor Kathleen Sebelius, now Secretary of Health and Human Services, as the third-most powerful person in Washington, due to her position implementing national health care.

Regarding health care, Huelskamp is troubled by a database HHS is proposing that will be used to regulate insurance companies. If insurance companies sign up healthy people, they will be taxed, and they will receive subsidies for insuring sick people. Huelskamp said the only way to determine this behavior by insurance companies — are they insuring the healthy or sick? — is by looking at the health insurance histories of the individual people each company insures. He views this as a threat to patient privacy.

According to Wichita Eagle reporting, HHS will collect only information that is not personally identifiable.

But in a Washington Examiner op-ed on this topic, Huelskamp wrote: “The federal government does not exactly have a stellar track record when it comes to managing private information about its citizens.” He provided several examples of data being lost.

As ObamaCare is evolving in the rule-making process overseen by Sebelius, we can’t be sure what requirements, regulations, or uses might be found for this patient health history data.

On Warren Buffett, Huelskamp said that Buffett sheltered $24 million from taxation on his most recent tax return. “Mr. Buffett doesn’t want Mr. Obama to have his money, either. It’s called hypocrisy. He doesn’t trust him with his money. Which is why — you’ve got to give him credit — he’s planning to give every single last dime to charity.”

Kansas and Wichita quick takes: Friday September 23, 2011

Downtown Wichita site launched. As part of an effort to provide information about the Douglas Place project, a proposed renovation of a downtown Wichita office building into a hotel, a group of concerned citizens has created a website. The site is named Our Downtown Wichita, and it’s located at dtwichita.com.

Keystone pipeline hearing, bus trip. On Monday the United States Department of State will hold hearings in Topeka concerning a proposed petroleum pipeline. Says Americans for Prosperity: “Our great country has an opportunity to complete a project that would provide billions of dollars in economic activity, create thousands of high-paying manufacturing and construction jobs, and at the same time take a significant step toward providing for greater U.S. energy security and independence. … Because the project originates in Canada and would provide a pipeline extension to the Gulf Coast, through Kansas, the project requires State Department approval. TransCanada owns the Keystone pipeline, which currently runs from Canada to Oklahoma. … It has finally received tentative approval from the Environmental Protection Agency and now sits before the State Department. The State Department is holding a hearing in Topeka on Monday, September 26th from noon to 3:30pm and 4:00pm to 8:00pm at the Kansas ExpoCentre, located at the corner of Topeka Blvd. and 17th Street South.” … To help citizens attend this unusual hearing, AFP has organized a free bus trip from Wichita. The bus will load from 7:30 am to 8:00 am at the Lawrence Dumont Stadium Parking Lot. It will return to Wichita around 7:00 pm. Lunch is provided. For more information on this event contact John Todd at [email protected] or 316-312-7335, or Susan Estes, AFP Field Director at [email protected] or 316-681-4415.

Health care reform. “Lt. Governor Jeff Colyer spent nearly two hours with the Legislature’s Joint Committee on Health Policy Oversight Monday explaining the imperative and complexity of solving problems with government health care he likened to a Rubik’s Cube. The challenge of the 1974 puzzle and the current Medicaid and health care debate is finding a way to align multiple facets of each side without upsetting another side.” More from Kansas Watchdog at Public Health Care System Reform a Governmental Rubik’s Cube .

Pompeo defends against Obama’s attack on aviation. “Rep. Mike Pompeo (KS-04) spoke on the floor of the U.S. House of Representatives in defense of the general aviation community, which is so important to job sustainability and job growth in South Central Kansas.” Video from C-Span is at Pompeo House speech on aviation.

Wichita corporate welfare opposed. This week the Wichita City Council granted another forgivable loan. Thank you to John Todd for appearing and offering testimony opposing the loan. In his remarks, Todd said: “Over the past few months, I have watched a majority of this council fall into the trap of trying to buy customer business with free-money economic development schemes out of the public treasury. This program might work if the public treasury held unlimited funds and the public gifts were offered to every business owner on an equal basis. … In 1887 President Grover Cleveland vetoed a bill that would have given $10,000 for seed to farmers in drought-stricken Texas saying something to the effect that he could not be a party to taking money out of the treasury to benefit one group of people at the expense of another group, no matter how worthy the cause, stating that it is the responsibility of citizens to support the government and not the responsibility of government to support the people. Cleveland further issued a challenge for private charitable giving for the farmers. A number of newspapers adopted the relief campaign and in the end Americans voluntarily donated not $10,000 but $100,000 to the afflicted farmers. I would suggest a similar publicly driven voluntary relief campaign in lieu of the forgivable loan you are considering today to see if there is public sentiment to charitably fund this local economic development project.” … I’ve been told what the target company really needs is relief from a regulatory trap.

The trap of job creation. Today on C-SPAN’s Washington Journal program, Rhone Resch of the Solar Energy Industries Association appeared. He promoted solar energy as great for creating jobs, telling viewers that solar energy creates more jobs per megawatt than any other form of power generation. This illustrates the trap that politicians and those who benefit from government subsidy usually fall into: that more jobs is a good thing. Wouldn’t it be much better if we could generate all the electricity we wanted using fewer jobs? Then these surplus employees could be put to work on something else — or simply enjoy leisure. … A few years ago an editorial written by a labor union official appeared in Kansas, praising the job-creating power of wind energy. In response, I wrote “After all, if we view our energy policy as a jobs creation program, why not build wind turbines and haul them to western Kansas without the use of machinery? Think of the jobs that would create.” … In a video produced by the Cato Institute, Caleb Brown explains the problems with relying on government and its spending for jobs: “Politicians and entrepreneurs face different problems. Entrepreneurs care about creating wealth, both for their customers and themselves. This means getting more output with fewer inputs. Politicians often care more about maximizing inputs like labor, even when that job creation could make all of us materially worse off. It would be easy for the president and Congress to create new jobs: They could simply ban the use of computers, farm machinery, or any other labor-saving device. But that would clearly raise prices … It’s hard to see how that improves anyone’s standard of living.”

Kansas and Wichita quick takes: Wednesday August 3, 2011

Debt ceiling. What is the real value of the debt ceiling? Has it ever constrained the growth of government debt, until now? Thomas Sowell in Debt-Ceiling Chicken: “Some people may have been shocked when the credit-rating firm Moody’s recently suggested that the debt-ceiling law be repealed, in order to avoid fiscal crises which can throw world financial markets into turmoil that can injure countries around the world. Anyone who wants to show that Moody’s is wrong should be prepared to show the actual benefits of the debt-ceiling, not its goals or hopes. That will not be easy, if possible at all. … The national debt-ceiling law should be judged by what it actually does, not by how good an idea it seems to be. The one thing that the national debt-ceiling has never done is to put a ceiling on the rising national debt. Time and time again, for years on end, the national debt-ceiling has been raised whenever the national debt gets near whatever the current ceiling might be. Regardless of what it is supposed to do, what the national debt-ceiling actually does is enable any administration to get all the political benefits of runaway spending for the benefit of their favorite constituencies — and then invite the opposition party to share the blame, by either raising the national debt ceiling, or by voting for unpopular cutbacks in spending or increases in taxes.”

Was August 2nd a deadline? All through the debate over raising the federal debt ceiling it was taken as granted that the deadline — the day the U.S. Treasury would run out of money — was August second. U.S. Representative Tim Huelskamp, who is in his first term representing the Kansas first district, has released data that shows otherwise. A chart on his website shows a declining balance in the treasury, but projections show a positive balance far past August second.

Despite drag of government health care, Canada thrives. The unemployment rate in Canada has fallen, GDP growth is healthy, and there were no bank bailouts. It has been able to reduce the size of its government relative to its economy, writes Jason Clemens in Why Canada Is Beating America: It shrank government, and now unemployment and debt are declining: “Total government spending as a share of the economy peaked at a little over 53% in 1993. Through a combination of spending cuts in the 1990s and spending restraint during the 2000s, it declined to a little under 40% of GDP by 2008.” … For 2010, government spending at all levels in the U.S. amounted to 36.22 percent of GDP, according to the Bureau of Economic Analysis. While that compares favorably with Canada’s level, the trend in the U.S. is for spending to increase, having risen from 30.82 percent in 2004. … According to Clemens, the success of Canada’s economy is in spite of its government health care, not because of it: “The unavoidable challenge is the country’s health-care system. … Canada devotes a relatively high share of its economy to health care without enjoying commensurate outcomes. Of the 28 countries in the Organization for Economic Cooperation and Development (OECD) that have universal access, Canada has the sixth-highest rate of health spending as a share of its economy.” It would be one matter if Canadians enjoyed good results from all this health care spending. “But Canadians’ access to care is poor, despite high spending. The country ranks 20th of 22 OECD countries for access to physicians. … Waiting times for treatment continue to worsen.” … Liberals in the U.S. point to Canada as a model for government health care, but the actual situation is not one that we should aspire to.

Kansas government website revamped. Kansas has remodeled its main website, kansas.gov. Besides a new look, I think a useful feature will be the use of a Google site-specific search feature. These generally work very well, applying the power of the popular and effective search engine to a specific website. Time will tell as to whether the design is useful. The state does not have a good record in recent times of website redesigns, as the effort to replace the legislature’s website right as the session started was a disaster. The press release with other details is at New State Web Portal Provides Better Experience, Mobility.

Demand is not the problem. A recent letter to the Wichita Eagle started with “The only thing that creates jobs is demand for product.” This idea of economic wealth deriving from consumer demand is a Keynesian concept, and we’ve seen over and over the wreckage that Keynesian economics leaves on countries — starting with our own efforts to cure the Great Depression to the failing economic policies of President Barack Obama. It’s also curious to blame economic stagnation on the absence of desire of people for more stuff. People want more stuff — that’s human nature. It is by producing more that we create the wealth necessary to satisfy our demands. Production benefits from capital formation, and the policies of the United States are not favorable for this. … The author also promotes increasing exports while at the same time urging Americans to buy only U.S.-made products. This ignores the fact that trade — no matter who the trading partner — is a source of wealth. Both parties are made better-off through trade; otherwise the transaction would not take place.

Debt ceiling bill. A budget cut only by Washington standards. “Throwing in the towel.” All the angst over the past month seems to have produced very little in the way of meaningful reform. Here several Cato Institute policy experts comment on this week’s lawmaking. “This week’s bipartisan deal to raise the debt limit and achieve some spending reductions will do little in the way of actual spending cuts, defers all the tough decisions on spending and debt to a “SuperCongress” committee and will do little to protect the United States credit rating. Cato Institute Senior Fellows Dan Mitchell and Jagadeesh Gokhale and Director of Tax Policy Studies Chris Edwards comment on the debt deal.”

Kansas and Wichita quick takes: Wednesday June 29, 2011

We have tried that before. Burt Folsom, who has written a book on Franklin Roosevelt’s economic policies and spoke in Wichita on that topic, warns us of the folly of government spending as a means to economic recovery. Henry Morgenthau, Secretary of the Treasury to FDR, said this seven years into the New Deal: “Now, gentlemen, we have tried spending money. We are spending more than we have ever spent before and it does not work.” … Some have charged that this quotation is a fabrication, but Folsom has the proof in his article We Have Tried Spending Money. … The quotation by Morganthau continues with: “And I have just one interest, and if I am wrong … somebody else can have my job. I want to see this country prosperous. I want to see people get a job. I want to see people get enough to eat. We have never made good on our promises. … I say after eight years of this Administration we have just as much unemployment as when we started. … And an enormous debt to boot.”

How can the Fed be so clueless? Investor’s Business Daily: “Federal Reserve Chairman Ben Bernanke says he’s puzzled by the failure of the economy to respond to our government’s many ministrations. Which explains much of why our economy is such a mess. … Not to be rude, but can the nation’s top banker really be so clueless? Anyone with half a lick of common sense looking at our economy knows what’s wrong: We’ve spent the better part of three years with government making the most extraordinary interventions in the economy in our nation’s history. Government spending, as a share of the economy, has soared 25%. Regulations, many of them arbitrary and foolish, such as the ban on incandescent light bulbs, have never been more numerous.” … The piece goes on to list many of the unwise policies the government has followed: ARRA stimulus, TARP, GM and Chrysler, Dodd-Frank, etc. In conclusion: “A handful of bureaucrats can never set prices or allocate goods or decide what should be made as efficiently as millions of people acting in their own interest through a free and open market. Our policymakers seem to have forgotten this. They make statements that indicate they don’t know the damage their policies are doing or they are willfully oblivious to them.”

Deficit is probably worse than thought. “We should be prepared for upward revisions in official deficit projections in the years ahead — even if a deal is struck,” writes Lawrence B. Lindsey in The Wall Street Journal. The reasons why projects of deficits are too optimistic are three: The interest rates being contemplated for Treasury borrowing are probably too low, the growth rates for the economy are too large, and the long-run costs of ObamaCare are way too low. Writes Lindsey: “There is no way to raise taxes enough to cover these problems. The tax-the-rich proposals of the Obama administration raise about $700 billion, less than a fifth of the budgetary consequences of the excess economic growth projected in their forecast. The whole $700 billion collected over 10 years would not even cover the difference in interest costs in any one year at the end of the decade between current rates and the average cost of Treasury borrowing over the last 20 years.” He recommends long-term reduction in entitlement spending as the only cure. See The deficit is worse than we think: Normal interest rates would raise debt-service costs by $4.9 trillion over 10 years, dwarfing the savings from any currently contemplated budget deal..

Blue pill or red pill? “Great expectations” are placed on the hope of Comparative Effectiveness Research (CER) as a way to save money on health care costs, both in the private and public sector. Now a report published by Manhattan Institute finds that this technique, despite its appealing name and promise, may not be the magic pill that President Obama is relying on: “This result seems counterintuitive: How can it be that, when a CER study shows no difference between two drugs, limiting coverage for the more expensive drug could actually increase costs?” The report explains that individuals are different, and what applies to the “average” patient may not be right for a large number of other patients. A second reason is “variance in dependence in patient responses across therapies.” The report provides illustrations of where CER-based policies cost more. … Concluding, the executive summary states: “Our results suggest that CER will not fulfill its promise unless it is implemented differently by researchers and understood differently by policymakers. Simply put, seeking the treatment that is most effective on average will not improve health or save money. However, CER can be conducted in a way that takes difference and dependence into account and measures their effect. If CER is applied in this way — as a tool for matching individual patients to the best treatments for those individuals — it will realize its potential to reduce costs without inhibiting freedom of choice for doctors and patients.” … The report is Blue Pill or Red Pill: The Limits of Comparative Effectiveness Research

Even quicker. “For the roughly four million homeowners who have fallen behind on their mortgage payments, the federal government is offering yet another remedy: free money to catch up on their loans.” See SmartMoney: More Money for Struggling Homeowners. … The Kansas Department of Health and Environment (KDHE) has issued a boil water advisory for the city of Waterville, which is located in Marshall County. I guess there’s no water in Waterville today. … Strong public support found for “Cut, cap, and balance,” a program to bring the federal budget under control. See National Taxpayer Union: New Poll Highlights Public Support for Cut, Cap and Balance. … Rasmussen: “Most voters continue to feel America needs to do more to develop domestic gas and oil resources. They also still give the edge to finding new sources of oil over reducing gas and oil consumption.” … Becker on Speculators: “Put differently, speculation tends to be stabilizing when speculators are making money because they have correct expectations about price movements, and destabilizing when they are losing money because their expectations turn out to be wrong. Given that the fundamentals imply large price movements from rather small shocks to supply and demand, and that successful speculation tends to moderate price movements, it is hard to believe that speculation has played a major role in causing the large swings in oil prices.” Do you hear that, Bill O’Reilly?