From Watchdog Wire:
Starting a business in Detroit is still difficult – Real estate costs may be low but apparently the red tape is still very thick. I attended a panel discussion on Friday morning where some policy analysts were discussing Detroit. Andrew Moylan of the R Street Institute remarked that due to all the regulations and bureaucracy, it’s easier to open a restaurant in New York City than it is in Detroit. That needs to change and it has to change for people to make investments in the city.
From the Times-News:
The National Taxpayers Union and R Street say their poll of 400 Idahoans showed from 52 to 68 percent opposed to the “Marketplace Fairness Act,” depending on how the question was worded, with 20 percent to 32 percent in favor. Although conservatives and independents were the strongest opposed, a majority of self-described liberals opposed the legislation too. The poll had a 4.9 percent margin of error.
“When it comes to Internet tax schemes like the Marketplace Fairness Act, Idaho overwhelmingly support the common sense position that the Internet should exist to improve their lives and their communities, rather than plug the budgets of other states,” said Andrew Moylan, executive director and Senior Fellow at the R Street Institute.
Most Idaho voters, whatever their political stripes, don’t want a sales tax on online purchases. That’s the finding of a new poll commissioned by free market public policy organization the R Street Institute and the National Taxpayers Union, a nonpartisan advocacy group that promotes lowering taxes. The groups polled Idaho voters on a federal effort to extend…
From the Spokesman-Review:
That’s the legislation the National Taxpayers Union opposes. In announcing its poll today, which the group said was conducted June 3-4, included 400 likely Idaho voters and has a margin of error of 4.9 percent, the group said, “When it comes to a federal law allowing out-of-state tax collectors to reach into the pockets of Idaho’s online merchants, by a 52-32 percent margin Gem State voters have a resounding and simple answer: Just, no!” The poll results were announced today by the NTU and the R Street Institute, a Washington, D.C.-based “free-market think tank” that’s in the midst of a 20-state tour to announce similar poll results.
What appears to be a rather horrifically botched execution in Arizona should give additional pause to those (me included) who continue to support the death penalty. This and other significant problems with lethal injection — including the growing evidence that it probably isn’t anywhere close to painless — means that it’s simply a barbaric practice that really ought to be ended posthaste. Given ongoing problems — and the existence of many surer, less error-prone methods of execution — there’s no reason to continue it. If shooting, hanging and other forms of execution make people queasy, well, that’s fine; the death penalty should be used very rarely and only for people who have committed truly horrific acts.
Insofar as some people who want to abolish the death penalty are trying to use the problems with lethal injection to advance their goal, I’d say, “all power to them.” Problems with the way we execute people are, indeed, a pretty good reason to rethink the death penalty overall. I’m more of the “mend it don’t end it” school, and on that front, NYU’s Robert Blecker has some very good ideas. They’re well worth reading.
Global warming is not the reason why Chicago’s 1800s-era sewer system occasionally floods people’s basements, despite Washington Post propaganda to the contrary. Instead, the culprits are the age of Chicago’s sewer system and the city’s tremendous population growth since the 1800s.
Utilizing global warming alarmists’ same tired playbook of mischaracterized anecdotes, the Washington Post published an article this morning highlighting the story of a Chicago woman whose basement flooded when the city’s aging sewage system could not adequately discharge water during a strong rainstorm. According to the Post, because sewage overflow occurred and because global warming is also occurring, global warming must be to blame for such unwelcome sewage overflow.
The facts tell a completely different story. Chicago has the oldest sewage system among large American cities. As the Post acknowledged, Chicago’s sewage system is ancient and obsolete, “designed to absorb rain nearly 120 years ago.” Of course, 120 years ago, Chicago’s population barely topped 1 million people. Today, Chicago’s population is nearly 3 million people.
Chicago sits on a flat plain that makes effective water and sewage removal particularly problematic. The Chicago River used to be “little more than a creek” that swelled dramatically during rainfall or snowmelt events. Despite its small size, the river accomplished its natural purpose well, quickly discharging excess water into nearby Lake Michigan.
As the city grew, however, civil engineers in the 1800s devised a scheme that reversed the flow of the Chicago River and required the city’s sewage and water overflow to traverse a much longer route into the Mississippi River basin. Sewage overflows during rain events occurred almost from the start. According to the Encyclopedia of Chicago, “With Chicago’s continued growth, this system could not maintain the reversal under adverse weather conditions.” These sewage systems failures, of course, began long before humans drove SUVs and derived electricity from coal-fired power plants.
Objective data and peer-reviewed studies show no increase in high-flow (flooding) events for streams and rivers still in a predominantly natural state. The only increase in flooding occurs in rivers and streams altered by human population growth and civil engineering, as is the case with the Chicago River. Unless one chooses to argue that global warming causes human population growth, especially in urban areas, there is absolutely no link between increased global warming and flooding events like those that occur in Chicago.
Indeed, Chicago’s sewage failures stand in stark contrast to those of other cities that more effectively upgrade their sewage systems and sewage capacities to keep pace with urban water demands. Even woefully managed Detroit has reduced its sewage overflow events by 80 percent since 1995. One cannot claim global warming is to blame for Chicago sewage overflow events unless one similarly claims global warming deserves credit for the dramatic decline in Detroit sewage overflow events.
Even in Chicago, sewage overflow events are poised to largely become a thing of the past. As the Post acknowledged, the city is in the process of expanding its sewage capacity, which should triple by the end of next year. By 2029, the city’s sewage capacity will be more than 600% of current capacity.
When Chicago’s sewage overflow events soon become a thing of the past, will the Washington Post credit global warming? Don’t bet on it.
[Originally published at Forbes]
In a 2-1 decision in the case of Halbig v. Burwell, a three-judge panel of the U.S. Court of Appeals for the District of Columbia Circuit has ruled that the Internal Revenue Service cannot interpret the Affordable Care Act, also known as Obamacare, as allowing subsidies for those Americans who purchase health insurance from the federal health insurance exchange known as Healthcare.gov. This is because the text of the law specifies that subsidies or tax credits are available for insurance purchased on state-created exchanges.
Later on Tuesday, the Fourth Circuit Court of Appeals ruled oppositely: that the subsidies are permissible for the federal exchange. More in this in a moment.
Should the D.C. Circuit’s ruling ever actually take effect, this would mean that those who purchased Obamacare insurance in a state that did not create its own exchange but instead relied on the federal exchange must cover the full cost of their insurance rather than have others pay for some share of it. (What a novel concept in Barack Obama’s America!)
A lower court had ruled that the intent of the law was to permit subsidies for insurance purchased on either a state or federal exchange, but the panel ruled otherwise: “Because we conclude that the ACA unambiguously restricts the section 36B subsidy to insurance purchased on Exchanges ‘established by the State,’ we reverse the district court and vacate the IRS’s regulation.”
The ruling comes down to the permissibility of the IRS to interpret the law under a relatively lenient standard: “we will uphold an agency action unless we find it to be ‘arbitrary, capricious, an abuse of discretion, or otherwise not in accordance with law.’”
Despite language that clearly states that tax credits apply to insurance purchased on a state exchange, the IRS’s relevant regulation allowed them “regardless of whether the Exchange is established and operated by a State (including a regional Exchange or subsidiary Exchange) or by HHS.”
Standing for the case came not due primarily to the subsidy issue but rather the not entirely obvious fact that permitting subsidies on the federal exchange also “significantly increases the number of people who must purchase health insurance or face a penalty” through the individual mandate provisions of Obamacare.
According to the D.C. Circuit’s opinion, the impact on employers through the employer mandate is even more significant: “If credits were unavailable in states with federal Exchanges, employers there would face no penalties for failing to offer coverage. The IRS Rule has the opposite effect: by allowing credits in such states, it exposes employers there to penalties and thereby gives the employer mandate broader reach.”
The potential impact of the ruling cannot be overstated. About two-thirds of the 8 million Americans who (we are told) have purchased health insurance through an exchange did so through Healthcare.gov because only 14 states have functioning state-based exchanges.
The D.C. Circuit majority closes their opinion with a paragraph that is worth reading in its entirety:
We reach this conclusion, frankly, with reluctance. At least until states that wish to can set up exchanges, our ruling will likely have significant consequences both for the millions of individuals receiving tax credits through federal Exchanges and for health insurance markets more broadly. But, high as those stakes are, the principle of legislative supremacy that guides us is higher still. Within constitutional limits, Congress is supreme in matters of policy, and the consequence of that supremacy is that our duty when interpreting a statute is to ascertain the meaning of the words of the statute duly enacted through the formal legislative process. This limited role serves democratic interests by ensuring that policy is made by elected, politically accountable representatives, not by appointed, life-tenured judges.
This is a fascinating bit of legal writing: On one hand, the judges suggest some sympathy for those Americans who are being put through uncertainty and perhaps even harmed financially by the panel’s obviously correct ruling. On the other hand, they issue a warning that doing anything other than what they did — standing up for the plain meaning of the law’s language — would be anti-democratic.
The warning has a very specific audience: the other judges of the D.C. Circuit Court of Appeals.
A party to a case may request an en banc hearing where the entire court rules, rather than just the 3-judge panel. In a press conference on Tuesday morning, White House Press Secretary Josh Earnest (one of the most ironically named public officials in memory) said that he anticipates that the Department of Justice “will ask for a ruling from the full D.C. Circuit.”
Late last year, anticipating this very moment, Senate Majority Leader Harry Reid changed Senate filibuster rules in order to permit the packing of this court with liberals. The court had been evenly divided between Republican and Democratic appointees and it was well known that the court did not have enough work to support even its existing judges. But the Obama administration knew that this day would come and that they would need an unbalanced court to defend the unconstitutional, poorly conceived, and poorly written law that is considered this president’s “signature achievement” — a dubious compliment at best.
An en banc hearing of a court with seven Democrat appointees and four Republican appointees is likely to overturn the panel because liberals, as constituted in 2014, simply do not believe in the rule of law. It is therefore unsurprising that Josh Earnest sounded unconcerned, even dismissive of Tuesday’s ruling: “For those who are keeping score, we’re still ahead two to one here.”
Earnest was referencing the fact that lower courts have ruled for the government in this case. There are other cases making their way through the appellate process now. If the D.C. Circuit en banc reverses its own panel and if the other circuits rule in favor of the government — which seems more likely than not — that would leave the possibility for the Supreme Court to refuse to hear the case.
Typically, the Supreme Court will “grant cert” when the circuits are divided, though it also takes many cases where an appeals court is simply wrong (in the opinion of a majority of the Justices). So while the Obama administration will work hard to get an en banc reversal of the panel to prevent a split among the circuits, the resolution of the question is most likely to hinge on whether Chief Justice John Roberts is looking for an opportunity to reverse his error in NFIB v. Sebelius in which he upheld the constitutionality of Obamacare — or whether he does not want to go through that morass again.
Should the Supreme Court take the case, it would suggest that Roberts has reconsidered and that a 5-4 opinion along the same lines as Tuesday’s D.C. Circuit ruling would eventually issue.
In that case, the entire structure of Obamacare will fall under its own cost and the enormous and impermissible differences between the operations of insurance exchanges in some states versus in other states. Unsubsidized millions will cancel their insurance. The resulting massive decline in revenue as well as actuarial changes in the composition of the insured (since the sickest will likely keep their insurance regardless of subsidy) will create a financially unsustainable system — or rather will hasten the recognition of socialized medicine as unsustainable. The political turmoil will also be enormous — but necessary and perhaps ultimately beneficial as long as the left is prevented from using another crisis to increase the size and scope of government.
The D.C. Circuit’s opinion, written by Judge Thomas Griffith, is obviously correct to anyone who believes that laws mean what they say and that, as concurring Judge A. Raymond Randolph notes, quoting Justice Brandeis, when a law omits something, it’s not a judge’s job to fix it: “What the government asks is not a construction of a statute, but, in effect, an enlargement of it by the court.… To supply omissions transcends the judicial function.”
Just try to tell that to the judges just appointed to the D.C. Circuit Court of Appeals by President Obama and permitted by Harry Reid’s changing generations of Senate protocol in order to protect Obamacare from this very occurrence.
And just try to tell that to the judges of the Fourth Circuit Court of Appeals, based in Richmond, which, just a few hours after the D.C. Circuit’s opinion was released, ruledunanimously that that tax credits for the federal exchange are in fact legal. Their ruling was based on a claim that “the applicable statutory language is ambiguous and subject to multiple interpretations.” Clearly these people went to the Bill Clinton school of English and are unsure whether “state” means “state.”
While the dispute among the circuits would normally point to the Supreme Court taking the case, the near certain en banc hearing in the D.C. Circuit and the likely overturning of the panel means that the Supreme Court may not face divided circuit opinions pushing them to hear the cases. In that case, the chances of the case being heard hinge almost entirely on whether John Roberts wants to revisit Obamacare — something I very much doubt.
While today’s ruling is welcome, it is far from dispositive.
It’s too early for champagne — and there may well never be occasion for a bigger celebration if John Roberts is not looking for vindication. But for the welcome reminder that Obamacare is fundamentally flawed and that it’s not a judge’s job to fix a bad law, we can at least pop open your favorite beer or pour a nice glass of Pinot Noir (or, if you prefer, Amarone) and toast the fact that all is not yet lost.
[Originally published at the American Spectator]
In the spirit of the adage that it’s better to ask for forgiveness than beg for permission, the Native American Iipay Nation of Santa Ysabel, Calif., has launched a real-money online poker site open to California residents.
The move comes as legislation remains stalled in the state Legislature, even though California is viewed as arguably the most profitable state for online wagering.
The actual legality of the site may come down to the murky laws of tribal sovereignty, which, when read broadly, grant federally recognized American Indian tribes substantial independence from state jurisdiction. This permits tribal nations to operate their own councils, police and courts and, of course, casinos. Tribes, however, are not completely exempt from all state laws, and, like all states, are subject to federal law. The Iipay Nation, part of the Kumeyaay tribe, argues that it is permitted to offer online gambling based on its sovereignty, as well as the provisions of the federal Indian Gaming Regulatory Act (IGRA).
Its poker site, privatetable.com, reportedly launched Monday, July 21. A visit to the site shows that there is a mechanism for depositing money. Online poker analyst Marco Valerio reported he was able to register. After doing so, he received a notice that deposits would only be accepted from California residents logging in within the state. This differs slightly from online sites legal in New Jersey, Nevada and Delaware, where your residency does not matter, only your location.
The Iipay Nation’s decision to move forward adds some excitement to the push for online poker and, ultimately, house-banked casino games. The poker situation has been contentious in California, because tribal interests have been in conflict with owners and operators of smaller poker rooms, which fear being put at a disadvantage if online licensing requirements are set too high. But if other tribes attempt to follow the Iipay’s example, online poker may fast become a fait accompli on the Golden State. I say let’s get those virtual cards in the air!This work is licensed under a Creative Commons Attribution-NoDerivs 3.0 Unported License.
The subject of tax inversion, in which American firms avail of lower tax rates in foreign countries by merging companies in those countries, has become very topical in the last couple weeks thanks to a decision by Abbvie, a drug company, to merger with Shire, an Ireland-based firm and move its headquarters overseas. One of at least 47 tax inversions in the last decade, the Abbvie-Shire deal is the largest such action yet, worth $54 billion. Perhaps unsurprisingly, President Obama and Democrats in Congress have become apoplectic with rage at the audacity of a business making a prudent decision to escape bloodsucking taxes.
The president has spewed a load of bile at all tax inverters, saying that they “are essentially renouncing their American citizenship so that they can ship their profits overseas to avoid paying taxes—even as they benefit from all the advantages of being here in America.” Treasury Secretary Jack Lew has echoed this sentiment, calling for businesses to not move abroad and to show “economic patriotism” (a terms that carries some unsettling notes of mercantilism). Obama and co. have decided that this subject is a major voter-winner in the run-up to the midterms, so be ready for more business-bashing in the months ahead.
What is so strange about the attitude of Obama and his cronies is that they seem dead set on blaming the businesses for “not playing fair” and running off to more business-friendly lands. But that is exactly what America has traditionally done to other countries. As a president set on making America a more “responsible” player on the world stage, he turns to threats of economic violence awfully quickly. He seems perfectly at home using America’s economic clout to aid American business abroad through entities like the Export-Import Bank. Apparently, businesses are only “patriotic” when they are friendly to his administration.
Also, whatever happened to Obama’s whole “corporations aren’t people” shtick? Are we to believe that a corporation has a duty of patriotic loyalty (economic or otherwise) but is not entitled to speech? Or is he referring to the managers and owners who took the dastardly action of defending their private interests against the anti-business, anti-market attitudes of the present administration? Whatever Obama means, he is totally off the mark.
The simple fact is that business is international. Corporations are frequently not solely of one country, and they certainly are not the exclusive property of one country. Moving to a friendlier climate is not reason to further restrict free trade, exact ruinous retroactive regulations, and to attack the businesses that are simply responding to economic pressures. Yet those are the exact responses the Obama administration is considering.
The problem with the way Obama and his friends in Congress are responding to tax inversion is that they are blaming the businesses for responding to pressures created by the government. America has prospered thanks to its open economy and the easy business environment it nurtured. Those advantages have been eroded by the twin forces of increasing taxes and regulations at home and their relative decline abroad.
Businesses leaving is a sign that something has to change. Obama should take the hint and start restoring free enterprise to America. If he continues down the path he’s treading, he will only succeed in driving more firms overseas.
“The presence of conflicted members on [the FDA Tobacco Products Scientific Advisory Committee, TPSAC] irrevocably tainted its very composition and its work product” and “the committee’s findings and recommendations…are, at a minimum, suspect, and at worst, untrustworthy.” So ruled federal judge Richard Leon this week.
A lawsuit by Lorillard et al. claimed the FDA appointment of TPSAC members Neal Benowitz, Jack Henningfield and Jonathan Samet was “arbitrary, capricious, an abuse of discretion and otherwise not in compliance with the law” because they had conflicts of interest. The evidence was abundant and uncontested. Here are excerpts from the judge’s opinion:
Since the 1980s, Dr. Benowitz has consulted for numerous pharmaceutical companies about the design of the NRT and other smoking-cessation drugs. He consulted for affiliates of Pfizer, Inc. and GlaxoSmithKline (GSK) as to such products, even while serving on the TPSAC…Dr. Benowitz has also served as a paid witness for lawyers suing tobacco-product manufacturers. He testified as a paid expert witness while serving on the TPSAC, and…he was designated to testify in 585 pending tobacco cases.
Before and while serving on the TPSAC, Dr. Henningfield consulted for GSK and other drug companies as to NRT and other smoking-cessation drugs. He also had ownership interest in a company that was developing a patented NRT drug. Dr. Henningfield has testified as an expert for GSK and for lawyers suing tobacco-product manufacturers… he was designated to testify in 350 pending tobacco cases.
Dr. Samet received grant support from GSK at least six times, including in 2010. He also led the Institute for Global Tobacco Control, funded by GSK and Pfizer. Dr. Samet also testified for lawyers suing tobacco-product manufacturers…he was designated to testify in two pending tobacco cases.
Judge Leon’s ruling notes that the composition of TPSAC is different from other FDA advisory committees, because the enabling legislation bans any expert “who received ‘any salary, grants, or other payment or support’ from any tobacco company in the 18-month period prior to serving on the TPSAC.”
TPSAC was structured to exclude qualified authorities who have had industry support. Experts with industry support are not precluded from serving on other FDA advisory committees, in which scientific issues are more important than industry demonization.
Judge Leon noted that the provision should apply evenly to any conflict of interest:
If Congress deemed that past remuneration from tobacco companies constituted a conflict of interest, it stands to reason that past remuneration from direct competitors of those companies, such as manufacturers of smoking-cessation drugs, would also constitute a conflict of interest.
Judge Leon’s ruling bars the FDA from using a 2011 TPSAC report on menthol, and it also “enjoins the FDA to reconstitute TPSAC’s membership so that it complies with the applicable ethics laws.” Dr. Samet is the only conflicted member remaining on TPSAC, as chair (until 2016). Another member, Claudia Barone, may have a conflict, because she received a Pfizer Educational Grant through 2013 and was appointed to the TPSAC on April 1, 2014.
Although the ruling applies specifically to committee actions on menthol cigarettes and dissolvable products, it is relevant to all TPSAC activities until conflicted members are removed.
It is common for experts to be co-opted by financial support from organizations committed to a tobacco-free society, a euphemism for the obliteration of the tobacco industry (an objective that is at odds with the principle of regulation). Any individual who is funded by organizations such as the American Cancer Society, the American Heart Association, the American Lung Association, the National Cancer Institute, the Centers for Disease Control and Prevention, or the Robert Wood Johnson Foundation should be ineligible for membership on TPSAC.
The American presidency has grown in power almost continuously since the outbreak of World War II. The executive has risen from being simply the chief magistrate of the government to be being a quasi-legislative force, a leader who pushes an aggressive legislative agenda as well as enforcing the laws passed by the legislature. The president is frequently referred to as “the most powerful person in the world,” or “the leader of the free world.” Such appellations represent far more than good PR. They are statements of fact that the president of the United States has drastically more power and authority than any other individual on Earth.
For that reason certainly, presidents should be restricted to a single term of office. After the Second World War it became clear that a president with no term limits could accrue enormous personal power through networks of patronage in Congress and through a monopoly on judicial appointments. During his more than three terms in office, Franklin Roosevelt used the power of the presidency to significantly truncate the power of the other branches of government. No president in history had ever enjoyed such unrestricted power.
A Lack of Self-Restraint
The Constitution was framed with the expectation that the country’s leaders would behave justly in office and would not seek to build permanent bases of power. Presidential self-restraint was a tradition started by George Washington, the so-called Cincinnatus of the West, who led his nation through its early turbulent years and then returned to his fields as a private citizen. It was that example to which Washington’s successors looked for guidance. So long was his shadow that for 150 years those who came after him did not seek a third full term of office.
That changed with FDR, who decided that the country needed his leadership more than it needed the propriety of self-restraint. Opinion is fiercely divided on the wisdom and rectitude of Roosevelt’s decision, but what was certain to the leaders of Congress after his death and the accession of Harry Truman was that such a decision should not again be permitted. The 22nd Amendment to the Constitution was passed in 1951, restricting presidents to serve a maximum of two terms in office. The amendment was meant to create an electoral environment in which a president could serve eight years, but not cling to power indefinitely.
One and Done
Certainly, the two-term limit is better than no limit. However, it is not enough. There are three crucial reasons that the president should be limited to a single term. The first reason was alluded to earlier in this article, that the president’s much increased power in the contemporary political landscape demands an even greater restriction on his ability to dominate the public arena. Whereas the legislature and judiciary are composed of many competing views, with members of various parties and outlooks represented, the executive speaks with a single voice. In Congress, even the party leaderships are not the sole centers of power, with factions and alternative nexuses of influence forming throughout that branch of government. Executive power, on the other hand, rests solely in the hands of the president. The president has full power over the policies of the executive branch of government. The cabinet, which is a critical part of the executive in practice, is directly answerable to the president, and can be dismissed if they are uncooperative or otherwise incur the president’s displeasure. Presidents should be elected to fulfill their constitutional duty, not to grow their power and the power of their office. Making the presidency a “one and done” business would act as a useful balancer to the tilting landscape of contemporary American politics.
The second reason is an outgrowth of the increased presidential authority, namely the increased power of incumbency. More than just the name recognition and patronage channels created by senators and congressmen, the sheer grandness of the office of president makes it one that is hard to assail from the outside. A challenger in an election necessarily has to go toe-to-toe with the most powerful person in the world. That is a daunting challenge. A sitting president has had years to lead the mightiest nation on Earth. It is hard to beat that, even if the president is unpopular in his own right. The problem this situation creates is that it makes it exceptionally hard to get rid of a sitting president. Sure, the president will still be gone for good after another four years, but a lot of damage can be done in that time. The very nature of the presidency skews the electoral field so far that elections to unseat a president are definitionally unfair.
What’s more, presidents probably should not be campaigning for office at all. That is the third reason to restrict presidents to one term. When a president takes office for the first time, he has a relatively brief window in which to enact his policy aims before he has to focus most of his energies on getting reelected. Once reelected, presidents frequently run out of steam. The result is a presidency that is, when at its most energetic, is focused myopically on the retention of power. A one-term limit would serve to galvanize presidents to be focused on issues, not on power. It would dispose of the lost years spent campaigning for reelection in which presidents are out to protect themselves, not serve the people.
A Hard Sell
Getting a constitutional amendment underway that would limit the president in this way would be an arduous endeavor. The Constitution is hard to change at the best of times, and an amendment that takes away powers from the president can never meet smooth sailing. The hope for such a policy must rest in people waking up to the inherent flaws in the system as it is. Certainly this past election threw a lot of the problems into stark relief. Now it is a matter of showing how things would be better if Obama, or any president, had to strut their hour upon the stage without hope of an encore.
When it comes to winning at the polls, hoodwinking voters by confusing the issues is a strategy that has stood the test of time. This November, Propositions 45 and 46 on California’s general election ballot will again test the efficacy of that approach in a venue particularly ripe for manipulation – the initiative process.
California’s initiative process is a product of the so-called “progressive era” of the state’s politics. Republican Gov. Hiram Johnson led the charge for the use of various direct appeals to the electorate (initiative, referendum and recall) when he ran for office in 1910. In 1911, voters gave approval to the new governor’s proposals.
Johnson’s levers of direct democracy have gone through periods of heavy use and disuse over the past century in California. According to the Public Policy Institute of California, most initiatives are met with failure. Of late, voter reluctance has turned into outright cynicism. They perceive the initiative process, in particular, to be beholden to special interests. Relatedly, Californians also have struggled with voting for initiatives because of their complexity. It is easy to understand why.
Initiatives often focus on issues that defy easy explanation. While the narratives crafted for voters focus on vague but positive constructs of the purported outcomes, highly technical legal elements undergird and give meaning to initiatives.
In an effort to avoid confusion among the electorate, there are 14 states that limit initiatives or constitutional amendments to “single subjects.” While seemingly straightforward, the application of such rules is anything but.
In California, the word “subject” remains unmoored from statutory or constitutional definition. Thus, it has fallen to the courts to craft the necessary meaning. Unfortunately, the result has been calamitous. California’s single-subject rule centers on a “reasonably germane” test that is exceedingly lax. For example, Propositions 45 and 46 have qualified for the November ballot, even though both clearly include “second” subjects.
Prop 45 is nominally an initiative focused on the prior approval of health insurance rates. Still, the property/casualty industry in California would be well-served to pay careful attention, because Prop 45′s language goes further:
“With respect to health, automobile and homeowners insurance, the absence of prior insurance coverage…shall not be a criterion for determining…rates, premiums or insurability.”
In a throwback to California’s automobile insurance portable persistency discount rating battles (Prop 17 and Prop 33), the initiative’s backer, Consumer Watchdog, is making a move to further circumscribe the use of automobile insurance persistency discounts. One wonders, prospectively, whether the currently admissible practice of offering non-portable persistency discounts will be challenged under the auspices of Consumer Watchdog-friendly precedent.
As deceptive and dangerous as Prop 45 is, Prop 46 may pose an even greater threat. It focuses on increasing the amount of non-economic damages recoverable under the Medical Injury Compensation Reform Act (MICRA). Such a change is of great significance to health-care providers, insurers and trial attorneys, but means little to the average voter. For this reason, proponents of the initiative included a second “hot button” subject, a provision to force drug tests on doctors.
In the words of the initiative’s chief proponent, including the drug-test provision was the “ultimate sweetener.” According to the Los Angeles Times, “when his group brought the proposal before focus groups…’the only thing that made them light up was drug testing of doctors.”‘
Compounding the confusion in the single-subject test is the fact that a partisan elected official, the attorney general, drafts initiative descriptions. In the case of Prop 46, Kamala Harris has opted to obfuscate the true purpose of the initiative by not mentioning MICRA until the fifth and final sentence of the initiative’s description. How does that look?
It would be in the best interests of California’s direct democracy for the California Supreme Court, should it have a chance, to attach greater significance to its ruling that one of the purposes of the single-subject doctrine is “to minimize the risk of voter confusion and deception.” In the cases of Prop 45 and 46, confusion and deception reign. As a result, California’s democracy suffers.This work is licensed under a Creative Commons Attribution-NoDerivs 3.0 Unported License.
Who says bipartisanship is dead?
We recently had 57 Senators and 152 House members – (obviously) culled from both Parties – sign letters to Barack Obama Administration Secretary of Commerce Penny Pritzker. In which they expressed concern about inexpensive Korean steel being in mass quantities imported here.
Interestingly, they express this concern within the context of their appreciation of the greatness and import of…fracking. The oil and gas extraction method that is hurtling us towards energy independence – in spite of the Left’s vociferous, irrational opposition. Steel is, of course, a vital component of fracking. This same sentence appears in both letters:
The discovery and production of shale gas in the United States is a strategic benefit for both America’s economic and energy security.
See – bipartisanship. The environmentalist loons should take a flying leap.
Why is the bipartisan contingent concerned about the cheap Korean steel dumping? American job loss.
U.S. steel producers employ 8,000 workers across the country making OCTG. Each of these jobs supports seven additional jobs in the supply chain and the steel produced for the U.S. energy market accounts for approximately ten percent of domestic production.
They are diagnosing a real problem – foreign countries dump all kinds of oft-subsidized products here. But they are prescribing the wrong long term solution. To truly fix this – for the world and forever – we need less government. Both here and abroad.
In actual free markets – domestic and global – consumers benefit from the least expensive goods produced by the most efficient companies. But we have nothing remotely resembling free markets – either domestically or globally.
This steel situation is a fabulous example of the high cost of terrible domestic government policy. The damage being done by government to domestic manufacturing and production has been awful and increasing – for decades. As government piled on ever higher taxes and more and more laws and regulations, more and more domestic production became internationally-manufactured imports.
We have the industrialized world’s absolute highest corporate income tax rate. The cost of the regulations we dump on businesses is simply stunning – more than $1.8 trillion per year. And then we wonder why less and less people want to do business here.
If I invite you into my house, and then beat you about the head and shoulders with a bat – I should at least have the decency to not act surprised when you get up and leave.
Korea can make steel – and then ship it half way round the world – and still price it below our domestic production in part because they are abusing trade laws. But also because our domestic price of government is so incredibly huge.
Congress is responsible for the gi-normous tax and regulatory burdens on our businesses. They should get their own House (and Senate) in order.
Cut and reform dramatically the tax code, cut way back the regulatory uber-thicket – and rein in the unelected regulatory agencies that are each and every day piling more and more burdens on business.
Our government is smothering us. It needs to allow us up for air.
The survey, conducted by the National Taxpayers Union and the R Street Institute, asks specifically about the Marketplace Fairness Act that passed the U.S. Senate in 2013 and has languished in the House of Representatives since then.
But officials from the two organizations said that they hope the results can inform Colorado lawmakers as well if they consider taking any further steps to allow state officials to go after these retailers and make them apply local sales taxes to the prices of their goods.
“I think that this does have implications to the state level as well,” said Andrew Moylan, executive director of the Washington, D.C.-based R Street Institute, a free-market think tank. “I think that this suggests that this is a powerful issue that has been lying dormant … I think that people are overlooking the strength of this issue because of the potential backlash.”
From the Sacramento Bee:
This is misguided enthusiasm, said Ian Adams, a policy analyst specializing in insurance markets for R Street Institute, a libertarian think tank. “Overhauling the levees makes sense for existing residents, but not as a basis for further development…
…Federal flood insurance data is illuminating. Over the life of a 30-year mortgage, homes in Natomas have a 26 percent chance of flooding. In the free market, insuring a $300,000 home in Natomas with $280,000 in coverage would cost about $21,000 annually. The cost under the federal government’s National Flood Insurance Program is $353 annually – what Adams calls “a massive transfer of risk from a small percentage of homeowners onto the backs of all U.S. taxpayers.”Read more here: http://www.sacbee.com/2014/07/22/6572292/bruce-maiman-building-again-in.html#storylink=cpy Read more here: http://www.sacbee.com/2014/07/22/6572292/bruce-maiman-building-again-in.html#storylink=cpy
By Nancy Thorner –
The Heartland Institute attracted an overflow crowd at its headquarters’s library at 1 S. Wacker Drive, #2740, Chicago, IL, for an event on Thursday, July 17th at 5:30 p.m. The event was billed by The Heartland Institute as “An Evening with Stephen Moore and Travis H. Brown,” co-authors with Dr. Arthur B. Laffer and Rex A. Sinquefield, to discuss their new book An Inquiry into the Nature and Causes of the Wealth of States. Steve Forbes, Chairman and Editor-in-Chief of “Forbes Media,” referred to the book as “a bible for state and local leaders who truly want rapid economic growth. It will profoundly, positively change politics and economics in America.”
The book makes a positive argument for tax reform through an analysis of the economic growth or malaise resulting from the tax policies employed by states over a fifty year period. These four policy variables are analyzed that can have enormous effects on the financial well-being of states and individual residents:
- Personal and corporate income tax rates
- Total tax burden as a percentage of personal income
- Estate and inheritance taxes
- Right-to-work laws
The book’s final chapter of “An Inquiry into the Nature and Causes of the Wealth of States” deserves special attention, as it rebuts the criticism directed against the book and its authors for the ideas and analyses presented therein. The first of fourteen rebuttal arguments refutes those who believe that “Taxes and Other Supply-Side Policy-Variables Don’t Affect Population and Gross State Product Growth.”
About co-authors Moore and Brown
Co-author Stephen Moore founded and served as president of the Club for Growth from 1999 to 2004. He was a member of the Wall Street Journal editorial board and frequently opines on the pages of their op-ed section. In 2014 the Heritage Foundation announced that Moore would become its chief economist. Moore is known for advocating free-market policies and supply-side economics. Having grown up in New Trier Township, Illinois , Moore graduated from New Trier High School in 1978.
This is the second visit by co-author Travis H. Brown to The Heartland Institute. On Oct. 30, 2013, he gave a presentation at a Heartland Authors Series luncheon about his solo best-selling book How Money Walks, that explores how wealth and people move between the states. Mr. Brown is the CEO and co-founder of Pelopidas, LLC, a St. Louis-based public affairs and advocacy firm, a frequent contributor to Forbes.com, and a nationally sought-after speaker who regularly appears on national media outlets, including CNBC and Fox New Business.
Steven Moore’s thoughts
Just what was the impetus that inspired Stephen Moore to be on board as one of four co-authors of “An Inquiry into the nature and Causes of the Wealth of States? When traveling around the country, Mr. Moore noticed that red states were getting redder and the blue states bluer. Further observed was how different the blue states were from red states in their cultural views and economic policies. It was like being in two different countries. Furthermore, Democrats were becoming an endangered species in red states, while Republicans were becoming the same in blue states.
When considering the four largest states population-wise, Texas, California, Florida, and New York, there are two red (Texas and Florida) and two blue (California and New York). The four states combined are of great importance to this nation, as one in every three Americans live in one of the four most populated states. But why are Texas and Florida outpacing CA and New York in both population and economic growth? Might it be because red states have adopted Reganomics while blue states are bogged down in Obamanomics? Factors such as taxes, drilling for resources, Right to Work status, and how the economy is regulated in each state do matter. Consider the job growth in all four of the most populated states over the last twenty years: Texas (58%); Florida (44%); New York (zero net growth); and California (12%).
Moore spoke about debating New York Times Paul Krugman over why people move from Point 1 to Point 2. To Paul Krugman there is a simple explanation. It’s all about sunshine and weather. But this doesn’t explain the surge of individuals from CA to Houston, Texas. Three moving vans move to Houston from places in CA for every one van that travels from Houston to CA. This didn’t happen by chance. Accordingly, Texas has added one million jobs or 40% of the total job gains in the U.S., while CA has lost one-half million jobs.
Moore believes that if Illinois lowered its income tax rate and became a Right to Work state it would see tremendous economic growth. As Moore reflected, “Liberal states and cities must either change or die like Detroit.” According to Moore, the governor’s race in IL is the most important race in the nation come November. If Quinn is re-elected, Illinois will keep on its downward trajectory toward certain death.
Travis Brown’s thoughts
In evaluating research compiled over the last fifty years, Illinois has experienced a bleeding of state income with most of it occurring in Cook County. It is easy to be fooled about Chicago. How we love the amenities and the reasons for being here in Chicago, but facts convey another story.
Without the tremendous job growth in Texas, as already noted, things would likely be much worse now with possibly a flat rate of growth nationally, rather than the dismal 2.9% U.S. GDP realized in the first quarter of 2014. Temporary, urgent tax hikes are often used by many states — described by Brown as a “tax on work” — as a way to cure problems. How then can it be explained that the nine states having a zero price on work (no state income tax) perform better than those having a state income tax? Often forgotten is that throughout one-half of this nation’s history, there were no taxes. The state of New Jersey once had no income tax. Now New Jersey levies state taxes at rates ranging from 1.4 percent to 8.97 percent, assessed over progressive income brackets.
New Jersey’s current economic situation, as the one here in Illinois, gives validity to this statement that no state has ever taxed its way into prosperity. Instead, high state tax rates have resulted in mass migration from states having an income tax to those states without income taxes. California’s income tax rates are the highest in America, reaching an astronomical 13.3 rate, which explains why people are moving out of California. According to Brown, one out of every five individual employed in this nation resides in states with a zero income tax. They include: Alaska, Florida, Nevada, South Dakota, Texas, Washington and Wyoming. States with nearly no income tax are Tennessee and New Hampshire New Hampshire. A dichotomy: Liberals love jobs but they dislike business!
As to what happens when taxes increase on work, Brown used the analogy of the cigarette tax, questioning what happens when cigarette taxes increase? The outcome is that less cigarettes are sold, which results in less tax revenue. But because of the competitive market people can buy cigarettes somewhere else like out of state. The same happens when the price on work is raised. There is less work due to the loss of jobs, which results in decreased tax revenue.
Regarding the presidential election of 2016, Travis Brown related how the most important thing is to beat HER in 2016. The use of HER produced some perplexed looks until Brown explained that Hillary may not be the choice of all Democrats. Elizabeth Warren is becoming the darling of many on the party’s far left wing. Speaking on Friday, July 18, at Netroots Nation, a convention for liberal bloggers and activists, Warren got the crowd more fired up than Vice President Joe Biden was able to do the day before when she outlined the 11 tenets of progressive policies which should define the Democratic agenda. Those who doubt Elizabeth Warren can overtake Hillary Clinton in popularity must only look back to the big upset in 2008 when Obama, virtually an unknown, beat Hillary.
Question and Answer Period
A lively discussion followed the remarks by Stephen Moore and Travis H. Brown. Of merit were the following responses given by Moore and Brown to questions entertained from those in attendance.
- The mobility of tax payers is part of the American dream. Individuals move up and down tax brackets as incomes change. It is important to keep the price on work as low as possible to stem job losses. In states where income tax rates are high, people are leaving for other states. Unfortunately Colorado is becoming a blue state as CA residents migrate to Colorado and continue to vote Democratic. The same is happening to New Hampshire, which used to be a red state, as residents from Massachusetts flee to N.H. taking their Democratic allegiance with them.
- With the highest corporate tax in the world at 35%, the U.S. is essentially putting a tariff on everything it produces. This is resulting in companies moving abroad where tax rates are lower. In essence, we are exporting American jobs abroad, an unpatriotic thing to do!
- Walgreen is being pressured to ditch its US headquarters in Deerfield, IL, for Europe. The Drugstore chain Walgreen Co. (WAG +2.55%) has come under intensifying shareholder pressure to use its large ownership stake in the Swiss-based Alliance Boots as a justification to re-domicile in Europe and reduce its U.S. tax bill, according to a Financial Times report. The company’s tax rate of 37.5% could drop to 20% overseas.
- Chicago is even worse than Detroit in its overall debt level when it should be a world class city. A major drawback is that the Democratic Party is owned by the Chicago Teachers Union. Even some Republicans are guilty of the same. It is thought that Mayor Rahm Emanuel should have stood up to CTU president, Karen Lewis, who might be a formidable candidate for mayor to unseat Mayor Emanual now that Toni Perwinkle has indicated her disinterest in running for the mayoral office.
- Rick Snyder was cited as a governor who has turned around Michigan in his first term in office. Even though Michigan has lost the car industry, cars are still produced in the U.S. but in other states, mostly southern “Right to Work” states.
- On the whole Northeast states are being bleed to death as its residents migrate to other states because of the heavy tax burdens placed on citizens and businesses. This has resulted in Northeast states losing political power (seats) in the U.S. House. It was noted, however, that despite losing House seats, each state still has two senators.
- Without hesitation, both Moore and Brown predicted that if Republicans take over the governorship here in Illinois, things will change for the better. Moore and Brown met with Republican candidate Bruce Rauner before their Heartland appearance and liked what Rauner had to say for turning the state around. If Pat Quinn wins in November, Illinois will completely fail as a state and will bleed to death.
- Not to be forgotten: Government spending is taxation and consists of the spending of something that is yours!
It was nice to see Illinois Republican legislators Jeanne Ives (42nd Representative District) and Tom Morrison (54th Representative District) in attendance.
St. Rep. Tom Morrison (R-Palatine), author Travis Brown (c) and Nancy Thorner (r)
Check out these coming events sponsored by The Heartland Institute:
Ninety percent of the people living in sub-Saharan Africa do not have electricity and lack light to study and work by, refrigeration to prevent food spoilage and power to operate equipment that could multiply their productivity.Having recently returned from The Heartland Institute’s 9th International Conference on Climate Change held in Las Vegas from July 7-9, “Just Don’t Wonder About Global Warming, Understand It,” I was privileged to hear some of the world’s hundreds of leading climate scientists and researcher discuss the latest state of global warming science, all who question whether manmade global warming” will be harmful to plants, animals, or human welfare.
Eight hundred participants were on hand to hear 64 speakers from 12 different countries (14 countries if counting the moon with Astronaut Walter Cunningham and Washington, D.C.) despite the fierce heat of Las Vegas in July. At one point 4,000 individuals were listening to the conference as it was streamed live from the conference website in Las Vegas.
This year’s delegates’ speeches showed how the myths of the climate alarmist are false, which shatters the often quoted 97% consensus figure given for those who believe most of the warming since 1959 was man-made. On the contrary, only 0.5 percent of the authors of 11,944 scientific papers on climate and related topics over the past 21 years have said they agreed that most of the warming since 1950 was man-made. Furthermore, according to the RSS satellite record (Remote Sensing Systems), there has been no global warming for 17 years and 10 months.
Obama’s statements conflict with scientific findings:
The above conclusions conflict with the statements made by President ObamaOn Tuesday, May 6, when he warned that “people’s lives are at risk” because of man-made climate change proclaimed during a series of interviews with National and Local television meteorologists. “Not only is climate change a problem in the future, it’s already effecting Americans,” Obama told CBS News, warning that the phenomenon was “increasing the likelihood” of floods, droughts, storms and hurricanes.
Even the U.N.’s International Panel on Climate Change (IPCC) has said in its last two reports that there has seen no particular change in the frequency or severity of floods worldwide. Neither are droughts getting worse (the fraction of the world’s land under drought has fallen for 30 years), nor are hurricanes getting worse (combined frequency, severity and duration has been at or near the lowest in the 35-year satellite record).
There was an element of truth, however, to be found in President Obama’s remarks on Tuesday, May 6, but as happens time and again, Obama’s spoken version of the truth amounted to fantasy. Instead of putting people “lives at risk” by failing to take drastic measures to curb CO2, millions of people are dying because Western policies seem more interested in carbon-dioxide levels than in life itself.
Such was the topic of the final panel discussion, “Panel 21: Global Warming as a Social Movement,” on Wednesday afternoon before adjournment of Heartland’s 9th Annual International Conference on Climate Change.
The distinguished panelists included E. Calvin Beisnert, Ph.D., Founder and National Spokesman of the Cornwall Alliance; Paul Driessan, J.D. senior policy advisor with the Committee For A Constructive Tomorrow and Center for the Defense of Free Enterprise; and Peter Ferrara, J.D., general counsel of the American Civil Rights Union at the Heartland Institute. Minnesota State Rep. Pat Garofalo was the Moderator, a Republican member of the Minnesota House of Representatives representing District 588.
Panelists Beisnert, Driessan and Ferrara laid out a convincing message how climate alarmists, as environmentalists, view people primarily as polluters and consumers who use up Earth’s resources and poison the planet in the process, rather than being good stewards. It might even be said that environmentalism is the new face of the anti-human, “Pro-Death” agenda. Through the bogus “crises” of man-made global warming, affordable and reliable energy and other modern blessings are being denied to the developing world. This despite the $3.5 billion spent around the world to combat climate change. Worth reading is an opinion piece by Caleb S. Rossitger, updated May 4, 2014, “Sacrificing Africa for Climate Change.” Change.”
Social Impacts of Reducing Carbon Emissions:
- 90% of the people living in sub-Saharan Africa do not have electricity and lack light to study and work by, refrigeration to prevent food spoilage and power to operate equipment that could multiply their productivity. Environmentalists’ oppose building large power plants and electric grids. Each American accounts for 20 times the emissions of each African. With 15% of the world’s population, Africa produces less than 5% of carbon-dioxide emissions. Shouldn’t real years added to real lives trump the minimal impact that African carbon emissions could have on a theoretical catastrophe?
- Because of the lack of electricity, two to three million women and children die annually from lung disease around the world from burning wood and dried dung to cook their food or heat their huts.
- Another one to two million people die annually from malaria since the banning of DDT.
- Where energy is available, regulation of greenhouse gas and other environmental regulations drive up the cost of basic necessities such a food, fuel and electricity, stifling economic growth and costing jobs.
- America’s ethanol policy alone is estimated to cause nearly 200,000 premature deaths every year in the developing world by limiting the amount of corn for human consumption, which, in turn, raises its purchase price.
- Golden corn seeds could end Vitamin A deficiency in millions of children. Genetically produced rice with Vitamin E is also available. Even so, eight million children have died since the invention of this life-saving rice out of fear of using genetically enhanced food items.
- Proposed caps on emissions, and so-called renewable energy mandates, would cost our nation millions of jobs and hundreds of billions of dollars per year. Even though Americans are wealthy by world’s standards, poor and single-income families in the U.S. would be hardest hit, while much poorer people around the would suffer even more if required to restrain greenhouse gas emissions.
- A carbon tax on Cap and Trade is a regressive tax which would hit hardest the poor among us. The poor already pay a higher proportion of their income for energy, plundering the poor, as would state mandates for wind and solar power, which would result in higher energy costs over what is currently being provided by power plant now under fire by the EPA for CO2 emissions linked to Global Warming.
- Wealth increases more when the overall global temperature is warmer and furthermore correlates with happiness, better health, and longevity. The more we do to fight Global Warming, the less off the poor will be in poorer nations, with higher rates of disease and death.
If this nation really cared about the poor, our government would stay off the Global Warming bandwagon and use the billions currently being spent to combat EPA fuel emissions standard, which have no effect, and instead put the billions to where it would do the most good fighting disease and poverty. Building fossil fuel plants and a grid to provide electricity to all the houses around the globe where dung and wood are still burnt in the absence of electricity, would cost 1/2 billion a year less than compliance with EPA’s fuel emission standards.
Evident is that those who control carbon control our lives. Shutting down power plants could carry some health benefits by reducing the risk of asthma and heart attacks in areas near the plants, but will cutting carbon emissions from existing power plants by about 25% from 2012 levels by 2020 make the planet healthier? Greenhouse gasses would still escape into the atmosphere from around the world? Hence, cutting carbon emissions would be a drag on this nation’s economy. See this article by Sally Deneen for National Geographic,“One Key Question on Obama’s Push Against Climate Change: Will It Matter”, for further clarification.
Global Warming could rightly be called a social movement, a big green and government movement, not unlike the “Population Bomb” which warned of mass starvation of humans in 1970′s and 1980′s due to overpopulation, and which advocated immediate action to limit population growth.
The emphasis on Climate Change as a urgent threat, propagated by President Obama and being carried out through the EPA, is in actuality a weapon of mass destruction and a war on women and children. Alarmists use threats as a way to justify their power to decide how much energy is available for use by humanity throughout the world. As such, big green with its eco-friendly measures appears callous to human destruction.
It is not being denied that global temperature have risen over the last 150 years or more, but it is mostly a natural occurrence, and certainly within the range of natural climate variability over the centuries; i.e. the Medieval Warm Period, an interval from approximately AD1000 to AD1300. During that time many places around the world exhibited conditions that seem warm compared to today. Heartland and the scientists it works with have never promoted “denial of a changing climate.” The climate is always changing. The question is whether man’s contribution to climate change rises above statistical noise and whether it is a crisis.
The issue of Climate Change is the greatest moral and ethical battle of our time. We must stand up for the tyranny resulting from the seizure of that which powers our civilization, sufficient energy production at an affordable cost. Without this availability, the global death toll will rise before is decreases due to the dark forces of a Climate Change fantasy.
View here videos of all Speakers and Panel Discussions at Heartland’s 9th International Conference on Climate Change.
Most veterans get most of their medical care from private doctors through Medicare or private insurance. Just think what those secret waiting lists would be like if they didn’t!
Still, a VA-like system for all has been proposed as a replacement for our unsustainable current system—at least until the recent scandals broke.
One enormous difference between the VA and Medicare is that veterans are free to go elsewhere—if they pay privately. Some veterans use their VA doctor only to get free medications.
Medicare patients, on the other hand, are trapped. There is virtually no private coverage available to persons over 65 to replace Medicare—President Lyndon Johnson wiped it out to prevent competition with “his” beloved system. There are only policies to “supplement” Medicare. And Medicare patients can’t just pay out of pocket for a “covered” service they can’t get otherwise, say because the Medicare-allowed price is too low—unless they see a doctor who is opted out of Medicare or disenrolled. For doctors, Medicare is all or nothing, so most doctors are still enrolled.
Most people don’t care about that—not yet. Who would want to pay for something that is free?
So it’s a good idea to look at those “free” (taxpayer-paid) VA services.
In an online survey by the Association of American Physicians and Surgeons (AAPS), less than two percent of 1,000 respondents said care at the VA was the equivalent of the care in the private sector or a model for the entire U.S. medical system. Only 4 percent said it was “generally good, but uneven.” A bare majority (52 percent) said that VA care was “good in some areas, but fraught with many serious problems,” and 22 percent responded that it was “ok if you can get it, but access is seriously limited.” Nearly 20% checked “other” and suggested a term equivalent to “poor.” One said “hard to tell how bad because they destroy or hide records.”
Only about 9 percent of respondents said the problems could be “fixed” by firing people, and less than 3 percent by large increases in funding. The main problems, elaborated on in the more than 200 comments, are a huge, rigid bureaucracy and the “VA way” at the “VA Spa.”
The bureaucracy interferes with care and punishes anyone who calls attention to problems. The main concern of the unionized workers appears to be to leave work on time. This means that surgery cannot be scheduled to start much later than 1:00 p.m. The response to a request to call a “code” for a patient who has had a cardiac arrest might be “I’m on break” or “it’s not my job.” Staff might record normal vital signs every 4 hours on a patient discovered to be dead and cold when physicians make morning rounds.
“No VA employee, however incompetent, could ever be fired,” stated one physician. Another said, “Incompetence is accepted…, and keeping quiet about it is the accepted norm.”
There are many dedicated physicians and workers who truly care about the veterans, rather than seeing them as “something to be endured in order to receive a paycheck.” And some facilities, mostly associated with medical schools, are described as excellent. But they seem to be exceptions to the rule.
“Basically, patients need a doctor advocate in the private sector,” one respondent commented.
And what will happen to the private sector under ObamaCare? Reformers want to abolish fee-for-service payment (payment for doing work) and replace it with VA-style incentives: a steady paycheck with “bonuses” for making the numbers look good. The VA’s electronic medical record is said to be particularly good for tracking those metrics, though private doctors complain that they cannot get a useful, accurate record for a VA patient, if they can get any record at all.
ObamaCare’s Independent Payment Advisory Board will soon be clamping down on total Medicare expenditures, and then private expenditures also. It is already “fraud” to provide a “medically unnecessary” service to a Medicare patient, and physicians can be excluded from all ObamaCare health plans for not “performing” as the bureaucrats think they should.
Doctors may be soon escaping to the VA, instead of the other way around. But patients will have nowhere in the U.S. to go.