Time For A Check-up: Four Years of Obamacare

This past month marked the four-year anniversary of President Obama signing the Affordable Care Act into law. It’s been a bumpy ride for both parties, with Republicans struggling to devise convincing alternatives and Democrats dealing with delayed deadlines and faulty websites. Both sides have their respective success and horror stories, and have carefully selected the data that serves them best for the upcoming midterm elections.

Amongst all this kerfuffle and brouhaha, rarely do we take the time to step back and look at the last four years with perspective. Perhaps a more comprehensive look at the landscape of Obamacare will help gain a more meaningful understanding of its effects.

The whole idea behind a nationalized healthcare revolution was that consumers were frustrated with the market approach as it stood. Issues like pre-existing conditions, required emergency room care, Medicare and Medicaid emerged as the hot-button issues that the government saw as problems only they could fix. But therein lies one of the major problems.

Nationalized healthcare was a response to the need for healthcare  insurance, not primarily a need for increased healthcare quality. This seems to have created a sense of cognitive dissonance in the minds of many Americans, as the concept of government-run healthcare does not and cannot mean better service. Sure some individual premiums may go down, but the kind of quality healthcare that consumers are looking for will inevitably be found wanting.

As to the overall success of the law to date, Democrats have boasted an approximated 6 million sign ups ever since the administration learned how to create a website. 6 million? Sounds like a big number. However, an overwhelming minority are first-time holders, according to reports by McKinsey & Co. When this is combined with the number of enrollees who have yet to actually pay for their plan and those who just signed up for Medicaid, 6 million becomes very insignificant very quickly.

In addition, according to a recent study by Pew Research, Obamacare’s approval rating is below 50% in the vast majority of demographic categories. And it still hasn’t even taken full effect! With how much difficulty the administration has had just getting the law off the ground amongst multiple delays and technical difficulties, the thought of implementation is nothing short of frightening. And over half of the country seems to agree.

So how has the ACA fared in its pediatric checkup?

  • The compromises for cheap service are detrimental.
  • Initial traction is fractional.
  • Overall approval is dismal.

Unfortunately, it’s going to take more than a Platinum Plan to cover this system. Four years out, we’re learning the hard way that insurance coverage is not the same thing as health care.

And for fun, check out The Heritage Foundation’s spoof on the Obamacare ad campaign to get covered:

Pay No Attention to the (Old) Man Behind The Curtain

Image from savvysugar.com

Image from savvysugar.com

During the 2008 presidential race, Barack Obama and his minions revolutionized the campaign landscape with their methods targeted at young voters. Millennials were bombarded with messages around every corner. From memorable memes to hip hashtags, the strategy of the left made the right’s look older than, well, John McCain. They even roped in some of the year’s hottest celebrities to promote catchy slogans like “Vote or Die,” because who wouldn’t want to take serious political advice like that from the well-informed likes of Paris Hilton?

Paris Hilton

Needless to say, the effort paid off, with young voters making a significant contribution to Obama’s landslide margins. However, in the years since that groundbreaking election, the administration’s image of your friend’s cool parents who have iPads and watch Breaking Bad is finally showing its true wrinkles, due in large part to the very competitive advantage that got it into the White House in the first place: technology.

The most obvious example is health care. If liberals really had an administration of hipsters, the one thing they should be able to pull off is a website, while smoking a pipe and wearing kitschy prescription-less glasses, of course. But alas, the very person in charge of the project, Health and Human Services Secretary Kathleen Sebelius, has had zero answers for the ongoing bugs that have plagued the process. Not to mention Nancy Pelosi’s interview on the Daily Show, where she blatantly said she didn’t know why the government couldn’t just contract out the website’s construction. Interesting thought for a liberal news show to suggest the government use the market for help with policy implementation. Imagine that.

Moreover, America has also learned that one man has the power to bring national security to its knees with a few clicks of a mouse. Just Google Edward Snowden for more details. Examples like these reveal the true nature of big government and a disappointing reality for its former millennial supporters.

The generation that bought into the Hope and Change movement is seeing a gap between what the free market has done to improve their daily lives and the jungle of government bureaucracy. When consumers get the latest smart phone, tablet, or laptop, they expect things to work as they should. You open the box, press the button, and go. If a product line malfunctions, the company would be destined for bankruptcy. Thanks to the magic of competition in the free market, we as consumers are simply used to things working like they should.

As the liberal agenda unravels at its seams, Gen Yers are becoming increasingly disillusioned to the mixed messages of big government. No matter how many college basketball brackets or Lil Wayne references the President makes, they are matched by the Vice President’s comments of not being a “technology geek” and manufactured smile. Thanks to the past five years, we have seen the consequences of gross government overreach and the unveiling of remarkably sub-standard products.

So how can government usher itself into the twenty-first century? Come out from behind the curtain, and let those who have set the standard of excellence in this country do what they do best.

Lincoln’s Logs Part I: Simple Division

AbeLincoln

This is the first essay in a three-part series commemorating the history surrounding theLincoln-Douglas debates and their relevance today.

One hundred and forty-five years ago this month, Abraham Lincoln rose from his seat to address a packed house at the Illinois State Capitol building. In front of a thousand hopeful delegates, he delivered perhaps one of the most powerfully forgotten speeches of his career and, perhaps, our nation’s history.

It was not his address at Gettysburg, it was not his proclamation of emancipation, it was not his first or second inaugural speech. For all intents and purposes, the context did not require any historic words to be uttered. Nevertheless, in true Lincoln fashion, his content superseded the occasion.

It was his acceptance speech for the Republican Senate nomination in Illinois that roused a lanky, unorthodox Abraham Lincoln to thunderously deliver his “House Divided Speech”, which served as an appetizer to his historic bouts with Stephen Douglas a few months later. Referring to the country’s blatant divide over the issue of slavery, Lincoln cited a well-known Biblical phrase as his thesis,

“A house divided against itself cannot stand”

He proceeded to argue that the nation stood at a crossroads, those in favor of slavery and those opposed. As a result, its people must decide which road to take or risk the potentially fatal consequences. Lincoln reassured his audience of his confidence that the “Union” would not fall, but it would surely choose a path. A path begotten from contention, conflict, and “crisis”.

Lincoln then mapped out the uphill battle that he and those present must face in order to blaze a new path of freedom for those enslaved under the supposed constructs of liberty. Verdicts had been made, statutes had been passed, and norms had been established, each posing their own unique obstacles. But his firm words laced with moral fortitude seemed to render the odds obsolete. With a bold conclusion exposing the truth of his rival Douglas’ plans to merely leave slavery up for each state to decide, Lincoln called upon his party to remember their roots, remember their original purpose, and adamantly oppose both a compromise of practicing slavery as well as its outright exercise.

crossroads

Image from http://crossroadsdenver.wordpress.com/

Our nation currently stands at a similar crossroads. With the ever-intrusive hand of the federal government relentlessly regulating, mandating, and manipulating its way into millions of its citizens’ lives, it is clear that our house is not united. Apart from the usual debates between Democrat and Republican which forge strong policy, we have seen an administration blatantly disregard the wishes of its people and states in favor of a predetermined agenda.

For example, the Affordable Care Act has received overwhelming backlash from the states, many of which have opted to not even participate in the lose-lose exchange programs offered by the policy. In fact, just weeks after the policy passed the House, polls found that close to half of voters were opposed to it. An unprecedented law, shrouded in controversy, unread by most of its supporters, and opposed by nearly half of the American public still managed to squeeze by our nation’s legislature and become the law of the land.

So what is our response? How do we make sense of such monstrosities to freedom? Shall we look to our respective parties? Even Lincoln’s fellow Republicans did not fully agree with his notions. Shall we wait and hope for a fearless leader to emerge? History has proved the pitfalls of such power. What then? Perhaps the words of a lanky, unorthodox, one-time grocer familiar with defeat but never influenced by its suggestions can provide some guidance as to which path we shall take.

This path cannot be chosen by the poetic advice of Robert Frost, nor can it be chosen merely by the words of a persuasive orator. Perhaps it takes a unified body with a clear purpose and unwavering sense of right to correctly lay a new path. Perhaps it takes a house.

*Top image from http://evanjsegal.authorsxpress.com/tag/abraham-lincoln/

States Call Obamacare’s Bluff

Imagine you’re asked to go to dinner, and your dinner date chooses your entire meal for you (of course, he claims his choices are the best the menu has to offer, regardless of your gluten allergy or dislike of rare beef). You enjoy the meal regardless your impending indigestion—until the check arrives. He asks you to pick up the whole tab and, while you’re at it,  leave a generous tip.

Beyond ObamacareAccording to state policy analyst Nicole Kaeding, this scenario is a lot like the state-run healthcare exchanges suggested by the Patient Protection and Affordable Care Act (Obamacare). An exchange is a government-controlled, Web-based health insurance marketplace. But unlike an innovative, free marketplace that adjusts to consumer demand, a government-run exchange will be fraught with regulations and mandates. Not to mention a slew of tax increases and increased costs carried by consumers and business-owners in the state.

Today is the deadline for states to decide whether or not they will build a state-run healthcare exchange or leave the set up of exchanges to the architects of the federal program, the Department of Health and Human Services.

On Wednesday, Governor Corbett of Pennsylvania announced that his state will refuse to implement a state exchange . The Commonwealth Foundation’s blog explains why this is a good choice for Pennsylvania and other states:

1. A state-run exchange offers only the illusion of state control. The Department of Health and Human Services can change regulations at any time, effectively having complete control over state governments in regards to health insurance regulations.

2. Costs would be borne by state taxpayers. States will shift the administrative costs to consumers through a new user fee or higher premiums. Some states have estimated this cost to be between $30 and $50 million per year. To fund the federal exchange, HHS will impose a 3.5 percent fee (tax) on all insurance plans sold on the exchange-a charge that will certainly make insurance that much more costly.

3. Exchanges don’t create more robust competition. The mandates and regulations tied to the federally-approved exchanges means less competition, as all health care plans will be pretty much the same.

4. Exchanges won’t lower the cost of insurance. While the law was intended to make health care more “affordable,” the real-world evidence suggests that isn’t happening. Even the most ardent Obamacare backers recognize that “premium growth, although slower than in years past, continues to outpace inflation and wage growth.”

Here is the run-down of where other states stand on exchanges from ABC News:

  • 23 states that have opted out: New Jersey, South Carolina, Louisiana, Wisconsin, Ohio, Maine, Alabama, Alaska, Arizona, Georgia, Pennsylvania, Kansas, Nebraska, New Hampshire, North Dakota, Oklahoma, South Dakota, Tennessee, Texas, Wyoming, Montana, Indiana, and Missouri.
  • Utah already has an exchange, and is still waiting to see if HHS and the White House are going to impose rules and regulations on their existing system.
  • 19 states are establishing state-based exchanges: California, Colorado, Connecticut, Washington, D.C., Hawaii, Idaho, Iowa, Kentucky, Maryland, Massachusetts, Minnesota, Mississippi, Nevada, New Mexico, New York, Oregon, Rhode Island, Vermont, and Washington.
  • 6 federal-state partnerships: Arkansas, Delaware, Illinois, Michigan, North Carolina, and West Virginia.
  • Virginia and Florida are undecided.

Governors Reject Parts of Obamacare: The Moral & Economic High Ground

We’ve been told by the highest court in the land that the Affordable Care Act is indeed constitutional. Well, shoot… But there is still a bit of good news: the states can refuse to expand the Medicaid rolls without being penalized by the federal government. This essentially gives them (the states) an escape clause.

Is this that rarest of things, the perfect prenup? It appears to be. States with governors who recognize the inherent moral and economic problems in taking money from Peter in order to pay for Paul’s medical expenses can refuse to expand to Medicaid without worrying about having their existing Medicaid funding rescinded.

Governor Rick Scott of Florida issued a statement saying:

Florida will opt out of spending approximately $1.9 billion more taxpayer dollars required to implement a massive entitlement expansion of the Medicaid program.

Governor Rick Perry of Texas, in a letter to Health and Human Services Secretary Kathleen Sebelius, stated:

Medicaid is a failed a program. To expand this program is not unlike adding a thousand people to the Titanic. You’re going to further drive this country into debt. You don’t expand a program that is not working already.

The criticism we’re hearing from the Left is that those governors planning on rejecting outright the additional Medicaid funds (Perry, Scott, Haley, Jindal, et al) from the federal government are in states with the highest rates of uninsured people. Thus, the states that stand to benefit the most are the ones choosing to opt out. This drives advocates of big government programs crazy. Why would people act ‘against their own economic interest?!?’

This argument comes around every time someone votes not to tax someone else who has more money. If you flip this question on its head, or place it in another context other than government taxation, you could phrase it like this: ‘Would you use force to take what someone else had earned in order to pay for your own bills?’ As soon as we take away the veil of legitimacy provided by the state, we see the sort of person who poses that sort of question for what they really are – thugs who misuse the force of government.

Even last week’s Economist didn’t quite phrase it right. Referring to the states that intend to take additional Medicaid funding as “happy to accept Washington’s cash,” it forgets that Washington HAS no cash except what it takes from individuals to begin with. Refusing to expand Medicaid might not be the best move politically, and it might bring some pain in the short term, but it is a principled move on the part of the governors. More should consider doing likewise.

Check out this video from the late, great Nobel Laureate Economist Milton Friedman:

What does the SCOTUS ruling mean for freedom?

John Tillman from the Illinois Policy Institute breaks down today’s Supreme Court ruling upholding the Affordable Care Act: “the government now has unlimited powers through taxation.” What’s next? Repeal and replace this terrible Act.

Who watches the watchman? You do!

Government regulations and laws can be bad in at least three ways. First, they can simply be bad on their face. Obamacare, for example, requires people to buy something (health insurance) simply because they are alive. Call it a tax on breathing. Second, they might have been created questionable legislative practices. A law that both set the state budget for funding of public schools and outlaws happy hours would violate a constitutional requirement that each law have only one subject. Finally, they can be carried out for the benefit of a few rather than the public, as when the mayor’s family is awarded a large no-bid contract.

“Transparency tools” can be helpful in all three circumstances, by exposing the workings of government to the public. These tools can bring about public pressure that can change bad laws or practices. I can’t guarantee that they’ll always be effective. But as “60 Minutes,” Andrew Brietbart, James O’Keefe and the progressive muckrakers of old have shown, exposing questionable practices to the light of day can bring good results.

FOIA

The basic principle of transparency is embodied in FOIA, or the “Freedom of Information Act.” According to www.FOIA.gov, “any person has a right, enforceable in court, to obtain access to federal agency records.” While the Act is a federal law, many states and local government have some version of it as well.

A lot of government information is already on the web, but if what you’re looking for is not there, you can “FOIA” the appropriate agency for it. Tell the agency what you want to know, what format you’d like it in, and how much you’re willing to pay for it. (Governments are free to charge you for research time and photocopying expenses.) Note that you won’t always get what you want, as agencies may claim that national security or the privacy concerns of employees take precedence. Don’t know how to start? FOIA.gov has lots of information, including links to 100 different agencies to help you get started.

The Federal Register

While we’re being swamped with laws, we’re drowning in regulations. For example, the Obama Administration is EPA regulations to conduct what some people have called a “war on coal,” rather than seeking federal laws. The Federal Register is the place to look for existing and proposed federal regulations on coal and just about anything else. If a proposed regulation is open to public comment, you can even put in your two cents.

Sunshine Review

If you want to expose the working of state or local government, the Sunshine Review is your friend. You can find information there about how FOIA and Open Meetings laws apply to your state.

You can also get information about state budgets, including salaries of public employees, public pension obligations, and, my “favorite,” money that local and state governments take from taxpayers to lobby state and federal officials.

The Sunshine Review grades states, counties, cities, and school districts on their transparency practices. Units of government that do an outstanding job are honored with a Sunny Award. For example, the State of Illinois website gets an “A” for including budgets, audits, and recent contracts, which are a just a few of the points on a checklist the site applies.

Franklin Center

If you read a newspaper these days, you’re more likely to find stories about Hollywood celebreties, sports, or self-help articles than you are about the workings of government. Investigative reporting is a dying art, but the Franklin Center for Government & Public Integrity has stepped into the gap. It has professional journalists who follow state and local government, and it also trains citizen-journalists. If you look at nothing else on this site, visit the state resources page.

The Franklin Center operates Watchdog.org, which is a platform of journalists to publish their news about political developments in the various states. The center also operates some state-specific watchdog sites, such as Cal Watchdog and Texas Watchdog.

If the United States is to be a self-governing republic rather than a government-knows-best country, citizens must keep watch over public officials. These tools can help in that task. As Supreme Court Justice Louis Brandeis wrote, “Sunlight is said to be the best of disinfectants; electric light the most efficient policeman.”

John R. LaPlante as a senior fellow of the Free Market at the Center of the American Experiment and a contributor to TheMichiganView.com.

Make the Government Compete for Citizens

A book review by John R. LaPlante

Many Republicans cheered, or at least assented, when the federal government took on more powers during the presidency of George W. Bush. (See: the Patriot Act.) Democratic Party partisans, meanwhile, have taken the same tack after their own party took control the White House. (See: ObamaCare.)

But the political stars eventually realign, and then you may not be so happy with what happens. So a better approach is to support limits on government. There are various ways to do that. One is to hope for wise and benevolent rulers who won’t overstep their boundaries. (Good luck with that!) Another is to lay out in law what government can’t do, through spending limits or a Bill of Rights. Still another is to divide the power that government has among competing institutions.

In his book, “Power Divided is Power Checked,” Jason Lewis calls for reducing the power of the federal government over the states, drawing on the concept of “competitive federalism.” In brief, it means that the federal government manages national defense and foreign affairs, while the states make the laws and rules on other topics. People vote with their feet for the approach to government that suits them best.

Lewis explains how competitive federalism started (the Federalist Papers), how it has become weakened (by presidents, congresses and the Supreme Court), and how it might be strengthened once again. Along the way he talks about how federalism (or its lack) works itself out on issues such as minimum wage laws, the Americans with Disabilities Act, environmental regulations, the definition of marriage, and gun control. The book is a mini-seminar on the history of judicial interpretation, with some trips into political history along the way.

Lewis says:

Federalism has always been the sine qua non of limited government because it offers the only real safety valve from an overreaching government: the ability to flee.

Ironically, the federal government has weakened federalism by growing itself at the expense of the states.

Federal expansion has happened in several ways, including an open-ended reading of the “general welfare” and “interstate commerce” clauses of the U.S. Constitution. (Not surprisingly, advocates of the Patient Protection and Affordable Care Act—“ObamaCare”—often cite these clauses to support the law.)

Another example is the development of the “incorporation doctrine,” by which federal courts use the Bill of Rights and the Fourteenth Amendment to strike down state laws. The Amendment, enacted in 1868 in the aftermath of the Civil War, was meant, in Lewis’ words, “to constitutionalize the end of slavery in America.” That was the good news. The bad news: It has meant a diminished role for states, a larger role for the federal government, and increasing social conflict, as the cliché, “don’t make a federal case out of it” falls onto the dust heap of history. These days, it’s hard to think of something that can’t be the subject of a federal case.

Lewis is inspired by James M. Buchanan, a professor emeritus at George Mason University. In his essay, “Federalism and Individual Sovereignty,” Buchanan says that competitive federalism has a few benefits:

  1. It minimizes the risk of an oppressive central government, since much power is diffused to the states.
  2. It minimizes the power of state governments as well, by putting them into competition with each other.
  3.  It’s easier for a citizen to be effective in a smaller community than a large one.

Lewis closes his book with a look at ways of limiting federal power, especially against the states. He considers and dismisses several options. He ends by proposing a constitutional amendment—to be brought to the national debate by state legislatures, naturally—that strips the federal government of most of its power and even allows for secession. Many if not most Americans will find it fanciful or dangerous, but when we consider the political health of “we the people” today, some bracing words may be what we need.