Republican Health Care Fiasco, Part II

John C. Goodman

“Only a few years ago, the party was united behind three reforms that are consistent with individual empowerment and limited government: (1) a universal health refund that transfers all government tax and spending subsidies to ordinary citizens each year with no strings attached other than the requirement that it be used for health care, (2) a flexible Health Savings Account that allows people to manage some of their own health care dollars and (3) pre-existing condition protection for people who lose their insurance because of government policies.

For well over a decade House Speaker Paul Ryan (R-WI) was a steadfast supporter of all three ideas, including replacing tax and spending subsidies for health care and health insurance with a universal tax credit. John McCain ran on these ideas in the 2008 election. The legislative embodiment of McCain’s plan was the Patients Choice Act, which Ryan cosponsored in 2009 along with Devin Nunes (R– CA) in the House and Tom Coburn (R–OK) and Richard Burr (R–NC) in the Senate.”

“The American Health Care Act (AHCA), proposed by the House leadership, was not about health care. It was about taxes. Over and over, Ryan said he needed to do health reform before tax reform. In particular, he said he needed to reduce Obamacare taxes by $1 trillion and to reduce spending by more than $1 trillion.

As noted, a tax cut tied to health care is part of good health reform. But the Ryan tax cut wasn’t tied to health care. It consisted of repealing the very revenues that were funding Obamacare. (See below.)  Since the tax cut took money out of the system, the spending cuts paired with it also removed money from the system.”

Source: Republican Health Care Fiasco, Part II

Rand Paul Blasts Republicans for Repealing Obamacare with Budget – YouTube

Great tutorial that can get you up-to-speed on the budget and how it won’t balance under current trajectory.  Senator Paul explains a simple way to balance and control the debt.

 

David Goldhill on Cost Drivers and Price Distortions in Healthcare

Minus the introduction and Q&A, the 45 -50 minute presentation is well worth your time. Engaging delivery and compelling case to consider… the cost drivers and distortions come from HOW we access and bill, as opposed to WHAT services are actually exchanged or provided. The key to understanding healthcare costs and pricing is to acknowledge that the answer is contained within our insurance card…and the processes it dictates and the tax/regulatory environment that it operates in. It is kind of like hiding something right out in the open; we look for clues everywhere except for what’s right in front of us. We tend to point fingers at easily identifiable components but fail to see what links them.

Landslide Vote against Single-Payer Healthcare Confirms that Switzerland Is an Outpost of Rationality in a Statist Continent | International Liberty

I’m a huge fan of Switzerland, largely because its voters approved a spending cap that should be a role model for other nations.

It’s called the “debt brake” and it has helped reduce the burden of government spending in Switzerland at a time when most nations in Europe have been moving in the wrong direction.

But that’s not the only reason I like Switzerland.

I also appreciate the fact that Swiss voters seem to be much more sensible than voters in other nations.

In Switzerland, by contrast, voters are sensible where it counts most – in the voting booth.

Earlier this year, 76 percent of voters rejected a minimum wage hike.

Back in 2010, nearly 60 percent of voters shot down a class-warfare proposal for higher taxes on the rich.

And they’ve done it again. In a recent referendum, they defeated a government-run healthcare system by a landslide.

Source: Landslide Vote against Single-Payer Healthcare Confirms that Switzerland Is an Outpost of Rationality in a Statist Continent | International Liberty

Best Kept Secret In Washington DC: The Future Of Medicare – Forbes

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John C. Goodman

The fact that Medicare has been put on a sound financially footing – for the first time in its history – has never appeared in any official government announcement. Ditto for the fact that the disabled and the elderly may bear a heavy cost along the way.

These facts have not been in the headlines of any major newspaper. They have not been addressed in any news article. To my knowledge they have never been discussed in any opinion editorial. Even more surprising, they are repeatedly ignored by scholars and in scholarly reports at think tanks around the country (other than my own).

Eerie as it may seem, the entire country has been acting as though these incredible public policy changes have never occurred.

Here is a third thing l bet you don’t know. Although Republicans have criticized the “Obama cuts in Medicare spending” as threatening access to care for the elderly, the GOP alternative essentially does exactly the same thing.

What no one bothered to discuss was the much bigger budget story: an enormous reduction in future Medicare spending and its impact on the health and financial well-being of the 54 million people in Medicare.

Here is a bit more detail.

Source: Best Kept Secret In Washington DC: The Future Of Medicare – Forbes

Can The Government Make Doctors Better Doctors? – Forbes

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John C. Goodman

You can take this to the bank. Every innovation in the production of every good or service – anything that lowers costs or increases quality – originates on the supply side of the market. There has never been a successful innovation that originated on the demand side.

This principle applies to health care in spades. For as long as I have been in health policy – more than 30 years – I have been dealing with non-doctors who have a deep, abiding desire to tell doctors what to do. Yet I don’t know of any example anywhere in the world where this approach has ever worked.

If the definition of insanity is repeating the same thing over and over again and each time expecting a different result then “insanity” is the appropriate word here. The Obama administration has spent millions of dollars on pilot programs and demonstration projects in a fruitless attempt to discover how to better practice medicine. It has spent millions more trying to herd Medicare patients into Accountable Care Organizations – super HMOs with financial incentives to hit quality measures. That hasn’t worked either.

Source: Can The Government Make Doctors Better Doctors? – Forbes

Power To The People: Can We Privatize The Welfare State? – Forbes

John C. Goodman

John C. Goodman

Government insurance for the elderly is invariably run like a Ponzi scheme. Payroll taxes paid by workers are not invested for future benefits. Those tax revenues are spent the very day, the very hour, the very minute they arrive in the Treasury’s bank account. The U S experience is not unique. Social insurance is run like a Ponzi scheme in most countries around the world.

In the United States, the Social Security Actuaries publish an annual accounting of the unfunded liability in Social Security and Medicare. Looking indefinitely into the future, the unfunded liability in Social Security is almost $28 trillion. That’s the difference between the promised benefits for future generations of retirees minus expected taxes dedicated to fund those benefits. That’s more than twice the size of the official outstanding debt of the U.S. government…

In 1960, nearly two-thirds of the families in the bottom fifth of the income distributions were headed by someone who worked. By 1991, only one-third of these households were headed by someone who worked and only 11% worked full time. Early on in the War on Poverty, the federal government’s own studies showed the devastating effects it was having. In the guaranteed income experiments of the 1970s, for every $1 of extra welfare given to low-income persons, they reduced their labor earnings by 80 cents.

via Power To The People: Can We Privatize The Welfare State? – Forbes.