Columnist.
If you ever doubted the inability of the federal government to protect you from harm, events of the past few weeks should have been a clincher. While Congress was dithering about a background-check-for-gun-buyers bill, President Obama was out on the hustings -- in full campaign mode -- trying to gin up support for it. Listening to the president, you could easily be misled into thinking that the bill before Congress would actually have prevented the multiple shootings at Newtown, Connecticut, and other shooting tragedies. In fact, none of the bills being considered in Congress would have prevented a single mass shooting in recent years, had they been law at the time of these incidents.
The best way to understand the Affordable Care Act (ObamaCare) is to realize that it confers large benefits on some people and imposes large costs on others.
Robert Cooke-Deegan knows exactly how to scare insurance companies. When he discusses the results of his study, titled "Genetic Testing for Alzheimer's and Long-Term Care Insurance," with industry executives, they become "heated," he says. "They say that this could put them out of business!" What Cooke-Deegan and his fellow researchers discovered is that people who take a genetic test to find out if they have traits that lead to Alzheimer's are five times more likely to purchase long-term care insurance, which would cover most of their expenses if -- or in all probability when -- they need years of nursing home care. It's like taking out a million-dollar life insurance policy the day before you know that you're going to die. The stock market would call it "trading on insider information."
In Britain they are mourning the death of Margaret Thatcher. They are also celebrating. Celebrating? Yes, celebrating.
The Obama administration is encouraging state governments to expand their Medicaid programs to access a pile of new federal funding. But in doing so the administration is promising more than those federal funds can probably deliver: economic growth. The White House, hospitals, and the unions that represent hospital employees often argue health care spending is good for the economy. They tout the benefits of "economic activity" that additional Medicaid funds might create. The federal stimulus of 2008 is cited as an example; for three years -- 2008 to 2010 -- the federal government paid a larger share of Medicaid spending. Purportedly, health care spending creates jobs, and efforts to slow spending would harm job creation.
One of the worst features of the American health care system is the sorry state of medical malpractice law. Fewer than 2 percent of injured patients ever file a lawsuit. Of those that do, only one in 15 receives compensation. More than half of every dollar goes to cover the cost of litigation, rather than to the injured and their families. Ironically, the medical malpractice system is inordinately focused on whether someone was at fault when an injury or accident occurs. Of the estimated 187,000 deaths and 6 million injuries that occur in hospitals each year, about one in four are considered negligent (malpractice). Another one-fourth (such as certain types of infections) is judged to be "preventable," even though no one is guilty of negligence. Almost half of adverse medical events are "acts of God" -- no one was at fault and there is no obvious way of preventing them.
Over the next 10 years health reform will impose upon us about $1 trillion in new taxes and it will take another $716 billion out of Medicare, imperiling access to care for the elderly and the disabled according to Medicare's Office of the Actuaries. It will impose a mandate to buy health insurance on most people and fine us if we don't comply. It will compel all but the smallest employers to provide insurance to their employees and fine them if they don't. ... The federal government will regulate the kind of insurance we must have, tell us where we must get it and regulate how much we pay for it as well. Many will ask, "What are we getting in return for all this?" I would like to turn that question around. After doing all these things, "What problems will be left unsolved?"
The labor market is one of the most regulated markets in our economy. Minimum wage laws effectively tell teenagers they cannot work unless they can produce $7.25 an hour. When the ObamaCare mandate kicks in next year, that hurdle will climb to more than $15 an hour for many potential employees. OSHA regulations dictate what risks workers may and may not take while on the job. Wage and hour laws dictate what wage rate a worker can accept in order to be able to work at nights and on weekends. Those same laws tell many parents they can't take off to see their kid's soccer game and make up the time in the next pay period.
It's hard to believe almost any budget numbers coming out of Washington, D.C., these days. The reason? The Obama administration is cooking the books. Okay, it's not actually violating any law. But perhaps it should be against the law for the Office of Management and Budget to do what it routinely has been doing: putting out budget forecasts that everyone inside the Beltway knows are not real. If a private CPA did that, he would lose his license to practice. Here's the backstory. Health care spending in this country has been growing at twice the rate of growth of our income on a real, per capita basis. Although there has been modest slowing during the Great Recession, that's been the trend for the past 40 years and the United States is not unique. Our health care spending growth rate is in the middle of the pack among developed countries.
Firms are awash with cash, but they're not hiring. What's going on? One place to look for an explanation is the policies of the Obama administration. President Obama's proposal to increase the minimum wage and the health insurance employer mandate are combining to destroy job opportunities for young, unskilled workers in cities and towns across the country. The minimum wage, currently set at $7.25 an hour, will jump to $9 an hour and be indexed going forward if the president gets his way. The Affordable Care Act (ObamaCare) is already the law of the land and its effects are being felt right now, even though the employer mandate doesn't go into effect until next January.
The Democratic Party has two reliable groups of adherents: the rich and the poor. Not all of the rich, of course. Not all of the poor, either. But a large swath of wealthy people, especially those whose wealth was inherited rather than earned, wouldn’t dream of voting for a Republican. Ditto for a large number of poor people who have discovered how to sign up for various welfare programs and intend to remain on the dole for the rest of their lives. What do these groups have in common? Nothing. They rarely meet. And if they did they wouldn't like each other.
President Obama is said to have made the case for a liberal public policy agenda in his State of the Union speech the other night. But what is liberalism? The conventional view is that liberalism is an ideology. In fact it is a sociology. An ideology is a set of ideas that cohere. Socialism is an ideology. So is libertarianism. Suppose I told you that socialists believe the government should nationalize the steel industry and the auto industry. You would have no difficulty inferring what their position is on nationalizing the airline industry. Right? Suppose I told you that libertarians believe in a free market for tinker toys and ham sandwiches. You would have no difficulty inferring that they also believe in a free market for Rubik's Cubes.
Why have the Republicans been unable to propose an alternative to ObamaCare? Anyone can criticize. Where is the Republican alternative? Okay, I'll grant some exceptions. Newt Gingrich had a comprehensive health plan in last year's Republican primary. It was my plan. Four years ago John McCain had a comprehensive health reform. That was also basically my plan. Mitt Romney oversaw health reform in Massachusetts. That was a Heritage Foundation plan. Yet none of these ideas has garnered the support of the Republican rank and file. Why not?
People who have been around for a while all seem to agree. Never in living memory has the atmosphere on Capitol Hill and in Washington, D.C., generally been so toxic. I don't find this to be true out in the hinterland. The country as a whole is divided politically. But it's not obviously more divided than it was 50 years ago. The toxicity of politics is a D.C. phenomenon. What's more, the polarization is worse among the elites. It seems that the more education they have, the more polarized people become. Why is that?
There was a time, not long ago, when both Republicans and Democrats agreed that something had to be done about entitlement spending -- especially spending on the elderly. But no longer. Although he promised in his first run for the presidency to reform Social Security, Medicare and Medicaid, Barack Obama seems increasingly unwilling to do any of that now. The leftwing of the Democratic Party seems increasingly shrill in its insistence that there is no need for any fundamental reform of entitlement spending. Even in the left-of-center think tanks and on the liberal blogs, one finds increasing denial that any fundamental change is needed.
Most people would place me on the political right. Yet when it comes to health care, I am more egalitarian than almost everybody on the left. I always have been. By that I mean I am more egalitarian than the defenders of the British National Health Service (NHS) and the defenders of Canada's system of socialized medicine. I'm also more egalitarian than Paul Krugman and the leaders of the Physicians for a National Health Program.Not only that, but a great many Republicans agree with my approach to health care -- even as they oppose ObamaCare. One thing that adds to so much confusion is that people on the left have a huge investment in seeing themselves as more altruistic and more caring than everybody else. Paul Krugman, for example, refers to the Republican Party as the party of Scrooge and sees most elections as Dickensian morality plays -- even though research shows that right-of-center folks are actually more generous than folks on the left, on the average.
The Republican Party is in danger of another big loss. This time, they could lose the House of Representatives, giving the Democrats control of both chambers as well as the White House. The Democratic Party cannot possibly achieve this victory on its own. We are experiencing the slowest recovery in our nation's history. Economic growth is tepid. The job numbers are awful. Millions of people are out of work precisely because of the policies of the Obama administration. Ask any employer, any banker, any investor -- regardless of party affiliation -- and you are likely to hear the same stories. ObamaCare is making companies reluctant to hire. Dodd/Frank financial reform is making banks reluctant to lend. President Obama's continuing threat to raise taxes is making investors reluctant to invest. Labor policy and environmental regulations are compounding these negative factors.
Am I the only one who thinks it is immoral to bring children into the world if you don't have the means to support them? I must be one of the few. I rarely see anyone else make the point. Before anyone objects, let me concede up front that a lot of things in life are unpredictable. Women become pregnant despite their best efforts to avoid it. Women can lose their husbands from accidents, war and even homicide. Few of us have a tenured job. Few of us are safe from the economic reversal that would attend the loss of a job.
President Obama made a remarkable statement to John Boehner in the middle of their negotiations leading up to the fiscal cliff. "We don't have a spending problem," the president said. We have "a health care problem." To put this in perspective, almost every economist familiar with the federal government finances views our national health care problem as a spending problem. In fact, it is THE spending problem. If the federal government were not buying health care, we wouldn't have a long term deficit.
Why is the recovery from the Great Recession so slow?
