Yet Another Vacation

Too close to the last one I know, but this one will be short.  Out of touch and out of country until October 5.  No blogging, tweeting, Facebooking, etc.

InsureBlog: Another ObamaCare© Myth Debunked

"ObamaCare imposes a tax on the sale of your primary residence of 3.8 percent."  I have heard this myth many times, often in conservative "grassroots" environments, and was planning to debunk it today.  I guess I'm not the only one who was hearing it.  Hat tip to the good folks at the InsureBlog, who note that there is enough (rotten) read meat in ObamaCare that we should not have to make things like this up.

InsureBlog points us to the Tax Foundation's debunking of this myth.  As I suspected, this derives from a misunderstanding of the actual tax hike, which is a newly increased Medicare tax of 3.8 percent on households with incomes of $250,000 or more.

The real harm that this tax will do to our nation's prosperity is not that the government will skin you when you sell your home.  It is that the higher rate is not only on salary or other labor income, but on capital gains and other types of investment income.  This will inhibit capital formation and pull down economic growth.

According to Stephen J. Entin and colleagues at the Institute for Research on the Economics of Taxation (IRET), this Medicare surtax will reduce GDP growth by 1.3 percent annually, and bring about reduced wages.

Massachusetts' 2nd Largest Carrier Drops Medicare Advantage

Harvard Pilgrim Health Care will bail out of Medicare Advantage, causing 22,000 seniors in Massachusetts to lose their Medicare benefits, according to the Boston Globe (hat tip to Avik Roy).

This is a direct consequence of ObamaCare - and one that I anticipated last December in a study of Medicare Advantage.

Orange County Register Opposes California Health-Insurance Exchange

The Orange County Register has editorialized against the two bills that would establish a health-insurance "exchange" under ObamaCare in California.  I had a lengthy interview with the writer last week and the editorial quotes me at length, for which I'm grateful.

These are the bills which we urge Governor Schwarzenegger to veto by September 30.  The OCR, rightly, calls the exchange a "poison pill."

Read more here.

FDA: Cash-Strapped Crusader or Bloated Bureaucracy?

A letter I wrote to the Wall Street Journal, referring to my latest study of the FDA, and the harms it causes.

SEIU Protects Criminals Working as Home-Health Aides

Los Angeles Times has a devastating feature on the union protecting criminals whom the state sends in to take care of disabled people dependent on Medi-Cal.

I've previously addressed this issue here.

Providing Health Care to Trapped Chilean Miners

The miners who survived the collapse of the mine in Chile have some unique health challenges.  I'm involved in a discussion of the economics of it over at John Goodman's Health Policy Blog.

The GOP Pledge on Health Care: "Repeal" is Great, "Replace" Needs Work

Let’s start with the good news: The GOP has pledged to repeal Obamacare “immediately” (see page 27 of the Pledge), which means it will be the first legislative order of business on Monday, January 3, 2011, if the GOP takes the House.

When it comes to “replace,” however, the Republican alternative is still significantly malformed. Indeed, there’s more than a whiff of big-government Republican in it. It completely ignores the single most important reform to private health insurance: Amend the tax code to give individuals, instead of our employers, ownership of our non-taxable health dollars.

Read my entire response at National Review Online.

Column in The Hill: ObamaCare Will Reduce Choice of Health Plan

Addressing only the issue of the Medical Loss Ratio, I demonstrate how ObamaCare will lead to less choice amongst health plans: My op-ed in The Hill.

What is the Future of Unionized Government Retiree Benefits?

I gaze into my crystal ball over at John Goodman's Health Policy Blog.

Governor Schwarzenegger Should Veto the Health-Insurance Exchange Bills

This month's Capital Ideas column explains how the legislation proposing ObamaCare's exchanges for California would reduce choice and increase costs, urging governor Schwarzenegger to veto it by September 30.  It's a beefier version of my San Francisco Examiner op-ed from a few days ago.

Read more here.

Orszag Versus Medicaid

Peter Orszag, former director of the White House Office of Management and Budget, has landed a gig as a contributing editor to the New York Times. On Sunday, he had an interesting article arguing that Medicaid funding was raiding public finances that should go to higher education.

Unfortunately, he errs in describing Medicaid, as I discuss at National Review Online.

Will Our Children Be Better of Than We Are? Productivity in Health Care and Other Sectors

In a recent poll, two thirds of respondents stated that they thought that their children would have a lower quality of life than they themselves.  One problem is that health spending is devouring so much of our incomes, but productivity is not increasing.

I suppose that this may be fundamental, to some degree I think that there are significant limits to increasing the productivity of a primary-care practitioner. (Although there is a lot of technological innovation in health care waiting to explode if and when the government gets out of the way, so I may be wrong).

However, there are some parts of health care where productivity has increased dramatically, e.g. cardiac surgery. (Indeed you only have to go back a few decades for longitudinal measurement to become meaningless, because the practices were so different.)

Read the entire thread at John Goodman Health Policy Blog.

Today's AP-GfK Poll Shows ObamaCare Still in the Tank

The Associated Press has engaged in a little journalistic malpractice in reporting the latest poll that it produces with GfK Roper. According to reporter Alan Fram, “Obama is winning increased public approval for health care . . .“

Well, no: In the actual poll, 41 percent of respondents reported “total support” to the question, “In general, do you support, oppose, or neither support nor oppose the health care reforms that were passed by Congress in March?” (p. 47), the same result as in the March poll. Plus, the shares of respondents who ”strongly support” versus “somewhat support” are within one percentage point of where they were in March.

To find the ”increased public support” that Mr. Fram reports, you have to go back to September 2009, when ”total support” was only 34 percent. All the positive movement took place between September and October, after which it hovered around 40 percent until a significant bump to 45 percent in June 2010, now vanished.

Read my entire column at National Review Online.

San Francisco's Fast-Food Toy-Ban Good for Bureaucracy, Not Waistlines

A few weeks ago, Santa Clara County passed a measure intended to reduce child obesity by fining restaurants for offering toys as part of meal promotions. San Francisco has responded with a similar measure that won’t help the kids slim down, but is guaranteed to fatten up already-bloated government.

The real force behind this legislation is the Public Health Department, which has been growing for the past three years, fueled by the Healthy San Francisco program. This program taxes small businesses, primarily restaurants and retailers, that can’t afford to offer health benefits.

The public health bureaucracy devoured $36 million of these taxes, for fiscal year 2008-09, while spending only $11 million reimbursing medical providers and pharmacies. The rest went to nonmedical spending, including $8 million on salary and benefits for new bureaucratic positions.

Read my entire column at the San Francisco Examiner.

ObamaCare Will Dramatically Reduce Choice in Private Health Insurance

One of the ways in which ObamaCare will reduce individuals’ and businesses’ choices of health insurance is through regulating the Medical Loss Ratio (MLR), a relatively simple concept: Take the amount of dollars an insurer spends on medical care and divide it by the total premiums. For example, if an insurer earns $10 million in premiums and spends $8.5 million on medical claims, its MLR would be 85 percent. Under ObamaCare, policies that cover large businesses will have to achieve an MLR of 85 percent, while those for small businesses and individuals will have to achieve an MLR of 80 percent.

That shouldn’t be too hard, should it?

Actually, the MLR can be quite complicated – especially when the government gets involved. Suppose, for example, an insurer invests in information technology that it gives to providers in its network in order to improve co-ordination of care. Is that a medical cost? Also, health insurers pay taxes. Although these taxes are obviously not medical costs, is it appropriate for the government to punish an insurer that pays higher taxes, which are revenue to the government?

Read my entire analysis in the latest Health Policy Prescription.

California's ObamaCare Health-Insurance "Exchange" Will Slash, Not Boost Choice

California is "leading the nation" once again.  Unfortunately, it's galloping in the wrong direction, with the Legislature passing bills to establish a health-insurance "exchange" to allow politically appointed bureaucrats to decide what health plans Californians will be able to get under ObamaCare.

Gov. Schwarzenegger would be well advised to veto the legislation, as I've written in a column in the San Francisco Examiner.

Read the entire article here.

Doctors and Patients Need Medical-Malpractice Reform

Several states have shown how to reign in an industry of medical-malpractice litigators that is out of control.  In a recent op-ed in the Orange County Register, my colleague Lawrence McQuillan and I describe and advocate the most important ones.

Read the entire column here.

On Vacation until September 13, 2010

Please fight the good fight without me!

Did Senator Baucus's "Experts" Read the Bill?

I doubt that it surprises anyone that Senator Max Baucus did not read the ObamaCare bill that he navigated through the Senate, but we should all be surprised that he has no shame in admitting it in a town hall meeting that he hosted last week with the U.S. Secretary of Health and Human Services (HHS), Kathleen Sebelius. Indeed, he appears proud of the fact that he did not “waste” time reading the bill, but delegated it to “experts.”

Many of the bill’s supporters have been walking away from it recently. An August 19 report on “A Communications Perspective” for ObamaCare, prepared for the pro-ObamaCare lobbying group Families USA (and leaked to Politico.com), significantly reframes the mission of ObamaCare’s supporters.

Read more here.

"Three "R's" Against ObamaCare

My colleague Jeff Anderson has coined a winning slogan for the continuing struggle against Obamacare: “Repeal and replace.” But there’s another R: resist!

Anticipating repeal, governors have significant opportunities to put sand in the gears of Obamacare. Two have recently taken exemplary action: Read more here about Governor Heineman of Nebraska, governor Pawlenty of Minnesota and what governor Schwarzenegger should do in California.