The Medicare proposal in U.S. Congressman Paul Ryan's budget plan, Path to Prosperity, is superior to the status quo, or anything proposed by President Obama. However, it is somewhat vaguer - and might differ significantly - from the high standard for reform that Ryan set himself last year, in Roadmap for America's Future.
Read this month's Health Policy Prescription here, or as a column at Newt Gingrich's Health Reform Report.
Research and commentary from a former senior executive in the U.S. Department of Health & Human Services
Tuesday, April 26, 2011
Monday, April 25, 2011
Rhode Island's Medicaid Waiver's Big Influence
The Providence Journal ran a column by me that explained how Rhode Island's Medicaid waiver - which capped federal matching funds in exchange for giving more flexibility to the state, is succeeding and sets an example for the nation. Read it here.
(It is based on an article that PRI published earlier this month, here.)
(It is based on an article that PRI published earlier this month, here.)
Tuesday, April 19, 2011
BayBio2011 Conference!
Every once in a while, they let me out of my policy-wonky cage and let me mix with real entrepreneurs - the ones who make the world work. Wednesday will be one of those times.
It's been a while since I've focused on medical innovation, so imagine my surprise when I was graciously invited to participate in the BayBio2011 conference. I'll be there Wednesday and (hopefully) Thursday, too. I'll be tweeting madly, so please follow #baybio2011.
It's been a while since I've focused on medical innovation, so imagine my surprise when I was graciously invited to participate in the BayBio2011 conference. I'll be there Wednesday and (hopefully) Thursday, too. I'll be tweeting madly, so please follow #baybio2011.
Monday, April 18, 2011
Overturning the Individual Mandate in Court Does Not End Obamacare
In the Orange County Register, I make the case that an individual mandate and penalty, as instituted by Obamacare, are not really different than the status quo, whereby the government subsidises employer-monopoly health benefits. Read it here, and please don't be spooked by the math!
Friday, April 15, 2011
To The Board of the California Health Benefits Exchange: An Apology and A Correction
On April 8, I published an entry that described Obamacare Health Benefit Exchanges as "flailing and failing."
Well, yours truly was also flailing and failing.
Well, yours truly was also flailing and failing.
Thursday, April 14, 2011
Colorado Republicans for Obamacare?
Colorado’s Health Benefits Exchange legislation, which would implement Obamacare in the state, was “mortally wounded,” but is being brought back to life by none other than the Republican majority leader in the state house of representatives, Amy Stephens, according to the Denver Post’s Tim Hoover.
Exchanges are the vehicles through which the gusher of cash from Obamacare’s tax hikes will be laundered into subsidies to favored health plans, payments to vendors and consultants, and salaried jobs for political appointees.
To be sure, this is not what the conservative Stephens thought she was doing. The bill was rolling happily along a couple of weeks ago, when the state’s liberty groups caught wind of it and convinced Stephens to “test” whether or not this was actually an Obamacare-enabling exchange, by offering an amendment that the exchange could only start up if the state got a waiver from Obamacare. Needless to say, the legislation failed the test, and the bill’s supporters pulled it in order to get to work on Stephens.
Exchanges are the vehicles through which the gusher of cash from Obamacare’s tax hikes will be laundered into subsidies to favored health plans, payments to vendors and consultants, and salaried jobs for political appointees.
To be sure, this is not what the conservative Stephens thought she was doing. The bill was rolling happily along a couple of weeks ago, when the state’s liberty groups caught wind of it and convinced Stephens to “test” whether or not this was actually an Obamacare-enabling exchange, by offering an amendment that the exchange could only start up if the state got a waiver from Obamacare. Needless to say, the legislation failed the test, and the bill’s supporters pulled it in order to get to work on Stephens.
Friday, April 8, 2011
Obamacare Exchanges: Flailing & Failing
(This post has been corrected from its initial version, with an apology. Please see here.)
The most disappointing news on the Obamacare front these days is that at least two Republican governors cannot wait to implement Obamacare in their states. Apparently, one Republican state senator in Oklahoma has finally decided to prevent an Obamacare exchange bill from reaching Gov. Mary Fallin for signature. Fair enough, but how did it get this far in the first place?
In Virginia, Gov. Bob McDonnell has forced amendments to prevent health plans participating in his state’s Obamacare exchange from covering abortions — at least, that’s what he thinks he’s done. In fact, U.S. Secretary of Health & Human Services Kathleen Sebelius will decide whether Virginia’s health plans will cover abortions, because she’s the one who will certify the exchange — or not. Because 100 percent of Obamacare’s subsidies to individuals in the exchanges come from the federal government, Sebelius’s whims will decide the rules governing the cash flows. Virginia will simply be stuck with paying salaries to the bureaucrats and fees to the vendors and consultants who operate the exchange.
The most disappointing news on the Obamacare front these days is that at least two Republican governors cannot wait to implement Obamacare in their states. Apparently, one Republican state senator in Oklahoma has finally decided to prevent an Obamacare exchange bill from reaching Gov. Mary Fallin for signature. Fair enough, but how did it get this far in the first place?
In Virginia, Gov. Bob McDonnell has forced amendments to prevent health plans participating in his state’s Obamacare exchange from covering abortions — at least, that’s what he thinks he’s done. In fact, U.S. Secretary of Health & Human Services Kathleen Sebelius will decide whether Virginia’s health plans will cover abortions, because she’s the one who will certify the exchange — or not. Because 100 percent of Obamacare’s subsidies to individuals in the exchanges come from the federal government, Sebelius’s whims will decide the rules governing the cash flows. Virginia will simply be stuck with paying salaries to the bureaucrats and fees to the vendors and consultants who operate the exchange.
Ryan's Medicare Reform Falls Short
A slightly different version of my analysis of the other day, at John Goodman's Health Policy Blog.
ObamaCare Exchange Will Hurt New Hampshire
I'm not sure that I know what the Executive Council of New Hampshire is, but I'm disappointed that they took federal money to start working on an Obamacare Health Benefits Exchange. One of the Executive Councillors, Christopher T. Sununu, has written a column opposing an ObamaCare exchange.
Read it here. It expresses my views almost exactly.
Read it here. It expresses my views almost exactly.
Obamacare Health Benefit Exchange?
Actually, this is a painting by George Tooker called Government Bureau, from 1956. But I think we'll have to retitle it unless we defeat Obamacare before the exchanges are up and running in 2014.
Thursday, April 7, 2011
Romneycare's Popularity Plummets
Grace-Marie Turner speaks for many in expressing frustration with Mitt Romney’s inability to let go of his failed Massachusetts health-care “reform.” President Obama himself has frequently asserted that Obamacare is partly based on the so-called conservative ideas encompassed in Romneycare. New polling results from the Bay State might make the president rethink this approach, and give Romney more confidence to admit his error.
A recent poll from Suffolk University and WHDH-TV reports that 49 percent of respondents do not believe Romneycare has helped, while only 38 percent believe that it is working. Fifty-four percent said that Romney’s signing the law likely hurt his presidential chances, while only 22 percent believed that it helped.
A recent poll from Suffolk University and WHDH-TV reports that 49 percent of respondents do not believe Romneycare has helped, while only 38 percent believe that it is working. Fifty-four percent said that Romney’s signing the law likely hurt his presidential chances, while only 22 percent believed that it helped.
Clarifying Ryan's Medicare Reform
As yesterday’s uncritical cheerleading of Paul Ryan’s budget proposal dies down, one of his loudest fans has taken a closer look. Yesterday’s Wall Street Journal editorial asserted (incorrectly) that Ryan’s proposal “means that at age 65 you would be able to keep your same insurer, with the feds paying for that insurance instead of your employer.”
As I’ve already noted, that was a feature of last year’s Roadmap, not this week’s proposed budget. The Wall Street Journal corrected the record in today’s editorial, which clarifies that “the subsidies will flow through Medicare, only to regulated insurers and government-approved plans. It does not go as far as Mr. Ryan’s previous ‘roadmap’ which offered direct cash vouchers for individuals who preferred to buy insurance themselves.”
As I’ve already noted, that was a feature of last year’s Roadmap, not this week’s proposed budget. The Wall Street Journal corrected the record in today’s editorial, which clarifies that “the subsidies will flow through Medicare, only to regulated insurers and government-approved plans. It does not go as far as Mr. Ryan’s previous ‘roadmap’ which offered direct cash vouchers for individuals who preferred to buy insurance themselves.”
Wednesday, April 6, 2011
Federal Obamacare Exchanges Are A "Phantom Menace"
Many advocates of individual choice in health care chide me for my unrelenting approach to states legislating Obamacare Health Benefits Exchanges. "If our state doesn't legislate an exchange, the federal government will impose one on us, and that will be even worse," say these well-meaning folks.
According to Joe Coletti of the John Locke Foundation, "I believed this myself until recently. Now I know this is a phantom menace."
Read Mr. Coletti's article here.
According to Joe Coletti of the John Locke Foundation, "I believed this myself until recently. Now I know this is a phantom menace."
Read Mr. Coletti's article here.
Rhode Island's Medicaid Waiver Survives Scrutiny
Rhode Island, the smallest state, is wielding big influence against federal control of health care. Other states would do well to take notice.
Federal taxpayers pay about 53 percent of Rhode Island’s Medicaid costs. This has created a perverse incentive for state politicians to increase dependency on Medicaid in order to capture more federal funds. A solution is to convert the funding formula, known as FMAP (Federal Medical Assistance Percentages), to a per-head block grant to the states. Unfortunately, under the Obama administration, things have moved in the wrong direction.
The “stimulus” bill of February 2009, increased Rhode Island’s match to about 64 percent. Originally a short-term measure, this excessive leverage was extended through this June. Fortunately, Rhode Island succeeded in crafting a mechanism to restrain out-of-control Medicaid growth. In August 2008, Governor Carcieri tasked his Secretary of Health and Human Services, Gary Alexander, to apply for a “Global Consumer Choice Compact Waiver” from the federal government.
Federal taxpayers pay about 53 percent of Rhode Island’s Medicaid costs. This has created a perverse incentive for state politicians to increase dependency on Medicaid in order to capture more federal funds. A solution is to convert the funding formula, known as FMAP (Federal Medical Assistance Percentages), to a per-head block grant to the states. Unfortunately, under the Obama administration, things have moved in the wrong direction.
The “stimulus” bill of February 2009, increased Rhode Island’s match to about 64 percent. Originally a short-term measure, this excessive leverage was extended through this June. Fortunately, Rhode Island succeeded in crafting a mechanism to restrain out-of-control Medicaid growth. In August 2008, Governor Carcieri tasked his Secretary of Health and Human Services, Gary Alexander, to apply for a “Global Consumer Choice Compact Waiver” from the federal government.
Ryan Flinched on Medicare
Path to Prosperity, Paul Ryan’s budget proposal, beats a significant retreat from last year’s Roadmap for America’s Future. The Roadmap contained a very precise “payment” (in Ryan’s words) of $11,000 — to be adjusted for future inflation by a factor combining changes in the Consumer Price Index and changes in medical prices — for future Medicare beneficiaries who are now under 55 years of age. Furthermore, you could have taken the “payment” and used it to “to pay for one of the Medicare certified plans, or any other plan, such as those offered by former employers or available from the private market” (p. 51).
ObamaCare - Live Your Carefree Lifestyle!
Just had to share this very funny spoof from Mark Skousen.
Monday, April 4, 2011
No Obamacare Health Benefit Exchange for Pennsylvania
My column in the Bloomsburg Press-Enterprise enjoining the Keystone State to shun an Obamacare Health Benefits Exchange.
I am beating the drum insistently on this because Governor Corbett's Administration might fall off the fence the right way on this issue, according to local sources.
I am beating the drum insistently on this because Governor Corbett's Administration might fall off the fence the right way on this issue, according to local sources.
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