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The official blog of the National Center for Public Policy Research, covering news, current events and public policy from a conservative, free-market and pro-Constitution perspective.

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Bloomberg's Food Police Take Over DC

In an opinion piece in today’s Daily Caller, I explain how Mayor Michael Bloomberg’s food police have developed a strong foothold in Washington, DC, in an effort to use the government to change how you eat.

If you liked Mayor Bloomberg’s approach to controlling how New Yorkers eat, you are going to love what federal nutrition nannies are planning for the entire U.S. population.

The top brass of Bloomberg’s food police, now top Obama administration health officials, are preparing dietary guidelines for the entire country. Despite the name, the guidelines are more than just suggestions on what to eat. A range of federal programs, from SNAP to military food allowances, are pegged to model diets based on the“guidelines.”

Yet minutes from the closed-door meetings of the Dietary Guidelines Advisory Committee reads like a wish-list for food police and environmental activists.

The architect of many of New York City’s nanny-state polices, Dr. Sonia Angell, now runs the Noncommunicable Disease Unit for the Centers for Disease Control and Prevention (CDC). The CDC is headed up by Bloomberg’s former health department chief, Dr. Thomas Frieden.

In invited testimony to the Dietary Advisory Guidelines Committee in March, Dr. Angell boasted about her work in New York City and how it should be a model for not only new guidelines, but new bans.

Angell’s case in point: the City’s artificial trans-fats ban in restaurants. She used the evolution of the policy to elucidate her thinking about educational campaigns recommending voluntary dietary changes (bad), versus government enforced bans on ingredients (good).

Dr. Angell explained that the City’s 2005-2006 “market-based voluntary strategy” encouraging the reduction of trans-fats in restaurants was entirely ineffective, so City officials believed “we had, if not an ethical responsibility, certainly a public health responsibility to take action.”

She touted the benefits of bans, which change “the entire food supply to a default that is a healthier default. It isn’t about individual decision-making anymore, that’s taken out of it.”

Please see the full piece here.


The Left Agrees: Liberals Don't Know What They are Talking About

SalonandSlateLogosAt least in this case, it's true. Turns out Salon, a left-wing website so rabid it routinely refers to conservatives as "wing-nuts" in headlines and prints opinions so bizarre I read it just to gawk, agrees with me on one point: Slate's Jamelle Bouie has no idea what he is talking about.

Too bad not only Slate, but newspapers across the U.S. such as New York Newsday and the Salt Lake Tribune, and presumably others, ran Bouie's column as if it had merit.

Hello? Aren't editors supposed to fact-check?

By the time both the conservative National Center for Public Policy Research and the left-wingnut Salon say a piece is wrong -- and for the same reason! -- there's strong reason to question the merits of a piece.

There are thousands of people of all political persuasions who would gladly write opinion pieces for major newspapers -- newspapers should never settle for writers who are loose with the facts. (If they do, what is the point of having newspapers at all?)

For those who didn't already see it, here's my blog post from yesterday criticizing Bouie's work.

Here's how Salon criticized Bouie:

...left-leaning opinionators frequently go after education topics with all the sophistication of a high school cheerleader on game day.

The latest example of this is from Jamelle Bouie who waded into the current controversy about the Common Core the other day with a piece on Slate. Sizing up the controversy over new standards as exclusively a matter of “conservative tribalism” versus “President Obama’s embrace of it,” Bouie decided I’m with Obama. And, That’s it.

By conflating differences of opinion over the new standards with Republican objections to light bulb regulations, the Koch Brothers war on solar energy, and George Will’s disdain for mass transit, Bouie assigned disputes over the Common Core to the category of other polarized issues that liberals are supposed to contest against conservative troglodytes.

Nowhere does Bouie consider that maybe some liberals have problems with the Common Core and that maybe there are some good reasons for their concerns..."

Yes. Maybe there are good reason for their concerns. The left's concerns, and the right's concerns.

Bouie proved he knows little about criticism of Common Core or the politics and economics of the light bulb ban. Furthermore, his evidence that the right dislikes expensive mass transit programs only because the left likes them was both scant and contradicted by his own comment ("to the right-wing, mass transit is just another liberal attempt to force Americans into a kind of brutalist conformity").

Understanding issues and analyzing actual concerns takes more work than writing pieces with a simplistic left-good; right-bad meme. Maybe that's too much to expect from Slate.

But perhaps there's hope. If you had asked me yesterday, I would have said it was too much for Salon.


Liberals Don't Know What They are Talking About

ALT TAGTea Party activists have a message for all of government

Liberals claim we conservatives pick our issues based on opposition to Obama, not on principle.

They don't know what they are talking about.

Take Slate writer Jamelle Bouie and his article, "Conservative tribalism: Mass transit. Common core. Light bulbs. Conservatives hate these things for no better reason than liberals like them."

Bouie's thesis can be found in his title. What's scant is evidence to back up the idea that we conservatives are engaged in, as he says, a "near-senseless... reaction... that's consumed the whole of conservative politics."

Opponents of Common Core, for example, are said to dislike it because Obama does. News to you? Certainly news to me, and I suspect news to the very many people who have peppered me with anti-Common Core emails, Facebook posts, Tweets and the like for years now. I assume Obama's name has come up once in a while, but I can't remember any specific instance.

Bouie's evidence? He says his thesis is "easy" to prove: The Republican governor of Louisiana changed his opinion on Common Core, and the New York Times claims that this is so. That's proof?

A look at the New York Times piece finds no evidence that Obama's views are the main ones driving grassroots opposition to Common Core. The Times just says so. Worse for Bouie, late in its piece, the Times contradicts itself, printing that opposition to Common Core stems from two things: 1) opposition to a federal takeover of education (not, then, any presidential administration specifically), and 2) opposition from teachers unions, "who are trying to sever any connection between test results and teacher evaluation." Teachers unions, of course, are very pro-Obama.


Based on the materials I see from the grassroots, it is the content of the Common Core curriculum that animates most Common Core opponents.

Then Bouie reports on the light bulb standards. He knows less about that controversy than he does about Common Core:

Take light bulbs. In 2007, Congress approved—and President Bush signed—strict efficiency standards for incandescent light bulbs. The practical impact was to make 100-watt bulbs obsolete: an inconvenience, but not a huge imposition. In any case, the rule wouldn’t take effect for a few years, giving homes and businesses a chance to adjust.

Industry groups grumbled, but there wasn’t any outrage. That changed in 2011, after a Tea Party–fueled Republican Party took the House of Representatives in a landslide victory over the Democratic Party. This coincided with the implementation of the efficiency standards, and the result was a caterwaul of right-wing rage.

A few facts:

  • The de facto light bulb ban was part of a massive energy bill with many provisions that received far more media coverage than the light bulb ban. Most Americans who later opposed the ban had no idea the bulb ban was even in that legislation -- that is why they expressed no opposition at the time.

  • The light bulb ban makes obsolete many more bulbs than the standard 100-watt incandescent.

  • Grassroots opposition to the light bulb standards is widespread and bipartisan. What Bouie describes as "a caterwaul of right-wing rage" against the ban includes 72 percent of all Americans, according to a January 2014 Rasmussen poll. That's a lot of right-wingers!

ALT TAGFor many liberals, the answer is "no."

  • Bouie assumes the Obama Administration has been fighting for the light bulb ban -- otherwise there would be nothing on this issue for we nasty, Obama-obsessed right-wingers to be reacting against. But that's wrong. The Obama Administration barely cares.

  • And finally, Bouie's biggest whopper: "Industry groups grumbled..." Does Bouie understand anything about this issue? Industry groups pushed the ban in the first place. This is well known. The only time industry was known to grumble was when the House of Representatives later stripped funding for enforcement of the ban.

The underlying message of Bouie's piece is that conservatives do not have values and principles that stand on their own; we simply develop our views in opposition to whatever the left believes. He and his fellow travelers (as Bouie is hardly the only liberal to be running with this thesis) do not understand conservatism at all. I suspect that's intentional. Reporting what we really think would require liberals to rebut us -- or agree with us. It typically can't do the former, and it is unwilling to do the latter.

Perhaps Mr. Bouie and his ilk should spend more time in self-reflection.


Project 21's Nedd Suggests Clippers Sacrifice for a Sterling Solution

Los Angeles Clippers owner Donald Sterling is under fire for taped comments, recently released by TMZ, in which he implored his girlfriend (who is of black and Mexican heritage) to “not to bring [black people] to my games.”

It’s not the first time Sterling has fended off allegations of racism, and he has even paid fines for civil rights violations.  This is the last straw for some people such as NBA Hall of Fame player Magic Johnson, who says he will boycott games while Sterling remains the owner of the team.

Some people are suggesting that the team itself should rebel in protest of Sterling’s remarks.  Project 21’s Council Nedd II is one of them.  Council said:

Sometimes the fight for equality is actually a fight.  Sometimes we must sacrifice things that are important to us for a larger purpose.

Is Clippers guard Chris Paul’s job with the team more important than the job of anyone else who has ever boycotted their own employers for making comparable comments or because of some perceived injustice?

Because the Los Angeles Clippers are a legitimate NBA championship contender – and not in spite of that fact – is the reason Paul and other Clippers players should consider boycotting their games until there are some answers and some sort of resolution regarding the outrageous comments of Clippers owner Donald Sterling.

It’s especially pressing since Sterling has a history of such behavior.

It cannot be forgotten that the biggest gains in civil rights were made when people sacrificed the most, not when people sacrificed nothing.

Of course, I heard Jesse Jackson chime in on the Sterling issue and make a very faulty syllogism connecting Sterling with this week Supreme Court decision regarding the rights of voters in the states to determine government policies on preferences and some imagined increase in racism in our nation.  This doesn’t help.

Additionally, it seems the sports commentators want to make this a special circumstance.  They obviously don’t want the Clippers to boycott their games because so much is at stake.  Does Clippers power forward Blake Griffin have more at stake than Medgar Evers, James Earl Chaney or literal scores of other nameless people who have sacrificed in the past?

The fact that Donald Sterling is a competent businessman and public figure and has yet chosen to make these comments in this day and age make them that much more reprehensible.

That is all the more reason for the Clippers players to protest.


Black Conservative Calls Nevada Rancher Cliven Bundy “Retro, Not Racist”

Project 21 member Nadra Enzi has these comments about the rise and fall of Nevada rancher Cliven Bundy and the reaction to him among conservatives:

After listening to – and laughing at – Cliven Bundy’s infamous interview it was obvious that his frame of reference regarding black folks is stuck in the 1960s.

Such comic cluelessness makes him retro, not racist.  I didn’t hear any of menace usually associated with other statements that deserve to earn the racist label.

Black folks are understandably incensed, and conservative ones are no exception.  Alan Keyes is a notable dissenter on this topic.

This reminds me of the break in right wing ranks after Nelson Mandela died.

Many white conservatives (with the notable exception of Newt Gingrich) denounced Mandela as a terrorist.  Despite the state-sanctioned terrorism of apartheid, conservatives couldn’t forgive him for taking up arms against white people.

His Marxism was also another epic sore point.

Bundy now offers a similarly seismic dividing-line moment.

Bundy’s white conservative supporters criticize black peers for reacting more to loaded phrases such as “colored people” and “negro” than loaded federal guns and suspected government overreach.

Charles Krauthammer, however, is a notable white conservative exception.  He doesn’t support Bundy and questions why anyone would.

My original take on Bundy remains the same: he’s a befuddled senior citizen uncomfortable in and unprepared for the national spotlight.

The fact he shares retro racial nomenclature with Harry “Negro Dialect” Reid only reinforces this perception.

Cliven Bundy is a “Mandela Moment” for conservatives.  We should agree to disagree on him and move on up to other issues!


Black Conservative Schools Liberals About Supreme Court Race Case

Project 21 co-chairman Horace Cooper engaged and easily beat arguments posed by Washington Post columnist Eugene Robinson and substitute host Joy Ann-Reid on the 4/22/14 edition of MSNBC’s “Hardball.”

While Robinson and Reid fixated on the ideas that racism remains a clear and present danger to minority advancement and that diversity plays such an important role that it can be an overriding factor in government processes such as school admissions, Cooper stuck to legal findings and actual facts — including the stated objective of Dr. Martin Luther King, Jr.

Cooper said:

The truth of the matter is, the policy is looked upon skeptically by a majority of the population and — as Justice Breyer and the rest of that six-two majority made clear — there was no showing that the state of Michigan had been affirmatively going out of its way to engage in segregation or any form of discrimination.


Joe Hicks of Project 21 Talks Supreme Court's Schuette Decision on NBC

After the U.S. Supreme Court ruled by a 6-2 margin to allow a voter-passed constitutional amendment outlawing race preferences in state-administered matters such as school admissions and government hiring to stand, Project 21 member Joe Hicks discussed the meaning of the decision and the liberal misperceptions of modern American society that brought about the challenge to the amendment in the first place in a syndicated segment aired nationwide on local NBC affiliates on 4/22/14.

Joe said:

We live in a time — with a black president and a black attorney general — when to make the kind of claims that people are being discriminated against, are being prevented from entering into positions in a university or a job at a hospital or public employment project simply no longer makes sense.


Project 21 Members Discuss Supreme Court’s Race Ruling on American Urban Radio

Members of the Project 21 black leadership network discussed the U.S. Supreme Court ruling in the case of Schuette v. Coalition to Defend Affirmative Action on American Urban Radio Network on 4/22/14.

In the decision, the Court upheld a Michigan state constitutional amendment banning race preferences in state matters such as government contracting and hiring as well as state school admissions.  It overturns a lower court ruling, noting that Michigan’s state constitutional amendment does not violate the U.S. Constitution’s “equal protection” clause.

Both Project 21 co-chairman Horace Cooper and member Shelby Emmett pointed out that race preferences are a tool of the past that is no longer appropriate and that the focus of reformers today should be on fixing the poorly-performing government-run schools that leave kids unprepared for higher education.


ObamaCare Whac-A-Mole!

The “skinny networks” of physicians and hospitals in many ObamaCare exchange plans are really beginning to rankle patients, so much so that the political class feels increasingly compelled to do something.

In Washington State, Insurance Commissioner Mike Kreidler said “companies need to justify those narrow networks.”  He is proposing new rules that “would make it harder for insurers to thin out their networks. He says consumers should have some basic safeguards: You shouldn’t have to drive too far or wait too long for care, and you should be able to find the specialists you need.”

By limiting insurers ability to offer fewer benefits and forbidding them to offer lifetime or annual limits on policies, insurers tried to keep premiums down by reducing the networks in exchange plans.  Now Washington wants to “fix” that problem, and it surely won’t be the last if stories from California are any indication.

Unfortunately this becomes like a game of “Whac-A-Mole,” where a new problem pops up in response to politicians and bureaucrats try to tamp down on an older one.  Kriedler is already getting an earful about the new mole:

But Kreidler quickly found himself under a minor siege from board members like Bill Hinkle.  

“This is called the Affordable Care Act, not the Accessible Care Act,” said Hinkle, a former state lawmaker.

Board member Bill Baldwin lobbed a string of adjectives at Kreidler’s proposal: “burdensome,” “bureaucratic,” “complicated,” “excessive,” “countercompetitive,” “counterproductive” and “kind of Big Brother.”

Sydney Smith Zvara of the Association of Washington Healthcare Plans says the new rules would require stacks of paperwork, including thousands of maps.

“The sheer weight and volume of the administrative and reporting requirements that come along with that have the effect of just smothering the ability to provide more innovative networks,” Zcara said.

Extra paperwork won’t be the only added cost.  Expanding a network means paying physicians and hospitals more to entice them to join.  That, of course, will be reflected in higher premium costs.  Apparently, one of the requirements for being elected Insurance Commissioner of Washington State is an unshakable belief that government can do magic:

Kreidler says he doesn’t believe prices will increase. He sees himself as walking a fine line, but with his compass oriented decidedly toward the consumer.

The best way to protect the consumer is to remove the barriers to market competition.  But bureaucrats seldom think that way.

Final thought:  If back in 2009 an ObamaCare supporter had said this “is called the Affordable Care Act, not the Accessible Care Act,” what do you think the chances are it would have ever become law?


Video: Supreme Court Upholds Michigan's Ban on Race Preferences; Video Explains the Issues Before the Court

The U.S. Supreme Court today, in the case of Schuette v. Coalition to Defend Affirmative Action, upheld the state of Michigan's decision, made by referendum in 2006, prohibiting preferential treatment in public employment, education and contracting based on "race, sex, color, ethnicity or national origin."

Last October 16, the day after the U.S. Supreme Court heard oral arguments in the case decided today, the Project 21 black leadership network held a policy luncheon featuring Jennifer Gratz, the executive director of the Michigan Civil Rights Initiative. Gratz was the plaintiff in the 2003 case of Gratz v. Bollinger that found the University of Michigan's race conscious admissions policy violated the Constitution's Equal Protection Clause.

This is an excellent video to view for a quick education on the issues and events surrounding the case decided today.

Project 21 also issued a press release on the Schuette decision this morning after it was handed down, featuring the comments of Project 21's two co-chairmen, Cherylyn Harley LeBon and Horace Cooper. LeBon and Cooper also moderated the discussion in the video:

Supreme Court on Path to Ending Race Preferences

Ruling in Schuette Case Paves Way for More Equal, Less Divided America

Black Activists in Favor of Ending Quotas Available for Comment

For Release: April 22, 2014

Contact: David Almasi at (202) 543-4110 x11 or (703) 568-4727 (text-enabled) or or Judy Kent at (703) 759-7476 or

WASHINGTON, DC - Attorneys and activists with the Project 21 black leadership network are pleased about today's U.S. Supreme Court decision on race preferences, and hope the Court's latest ruling on race-conscious school admissions policies will become decisive in finally ending government-enforced rules creating arbitrary demographic quotas.

"Today, the Supreme Court moved us closer to the colorblind principle that Martin Luther King advocated and that is embedded in the 14th Amendment," said Project 21 Co-Chairman Horace Cooper, a former constitutional law professor. "I'm pleased that the principle of treating all Americans the same under the law can go forward in Michigan."

ALT TAGThe Court ruled 6-2, with Justice Kagan not voting.

In the case of Schuette v. Coalition to Defend Affirmative Action, which was argued before the U.S. Supreme Court last October, the justices considered whether the 6th Circuit Court of Appeals correctly voided an amendment to the Michigan state constitution, passed by voters in 2006, prohibiting preferential treatment in public employment, education and contracting based on "race, sex, color, ethnicity or national origin." The Michigan Civil Rights Initiative, which became Section 26 of the state's constitution after its enactment, was supported by 58 percent of Michigan voters. It was struck down, however, by the 6th Circuit in 2012.

Project 21 submitted an amicus brief to the Supreme Court in the Schuette case written and joined by the Pacific Legal Foundation, noting that "[t]he clear effect of Section 26 is to prohibit the State and its political subdivisions from adopting race- and sex-based preference programs." The brief also presented factual data about how the prohibition of race-based preferences in California increased diversity and minority retention rates. Similar to Michigan, California voters outlawed race preferences in public college and university admissions in 1996.

Project 21 held a meeting of experts to discuss the case featuring Jennifer Gratz, the executive director of the Michigan Civil Rights Initiative after the Court's oral arguments. Gratz was the plaintiff in the 2003 case of Gratz v. Bollinger that found the University of Michigan's race conscious admissions policy violated the Constitution's Equal Protection Clause. Her talk and the discussion following can be viewed online here.

"It remains to be seen as to whether this is the definitive ruling which will eliminate racial preference policies," said Project 21 Co-Chairman Cherylyn Harley LeBon, a former senior counsel for the U.S. Senate Judiciary Committee. "But I am encouraged that we are moving towards creating an equal playing field where the government does not choose the winners and inadvertent losers."

The rest of the press release is available here.


ObamaCare Protects Widows and...Whoops!

Over two dozen widows of Madison County, Alabama employees received health insurance via their deceased husbands’ policies.  Then along came ObamaCare’s grandfather regulations.  Here’s WHNT with the rest of the story:

A few widows—wonder why they couldn’t get an exemption to ObamaCare’s rules?  Here’s a wild guess:  They don’t have anywhere near the political clout that labor unions do.  

In other news, enrollment in exchange policies in Georgia isn’t looking so good:

Georgia insurers received more than 220,000 applications for health coverage in the Affordable Care Act’s exchange as of the official federal deadline of March 31, state officials said Wednesday. - See more at: 

Insurance Commissioner Ralph Hudgens, though, said premiums have been received for only 107,581 of those policies, which cover 149,465 people.

“Many Georgians completed the application process by the deadline, but have yet to pay for the coverage,” Hudgens said in a statement Wednesday.

Some of that discrepancy is likely due to the late surge in enrollments which is undoubtedly inflating the number of people who haven’t paid their premium.  But with such a high number, chances are good that the number of enrollees in Georgia who don’t pay their premiums will be higher than much-touted 20 percent.  

As goes Georgia, so goes the nation? Well, no.  The rate of non-payment could be much lower in other parts of the country.  We’ll just have to wait and see if Georgia is an aberration or a warning sign.

Finally, Politico has a good run down on the Obamacare numbers, although it repeats the RAND numbers uncritically.  (For more problems with the RAND survey, go here.)  Despite that, it’s worth reading.


Black Activists Lament Later Tax Freedom Day

April 21 is “Tax Freedom Day.”  It commemorates the day when all taxpaying Americans have collectively earned enough to settled up the tab for what Uncle Sam demands from them in tribute.

From here on out, the American people can reasonably consider it possible to now begin to work to pay their own rents and mortgages, buy food, settle their auto and tuition loans and maybe save for a vacation or their retirement — among other things.

It is estimated that American taxpayers will have been forced to render around $3 trillion to the federal government in taxes in 2014.  This does not count the additional $1.5 trillion in taxes required to be paid to state governments (which could alter individuals’ actual date of tax freedom).

The total tax bill paid by the American people this year is estimated to amount to over 30 percent of earnings — more than is expected to be spend on food, shelter and clothing over the course of the year in total.

Tax Freedom Day is three days later than last year and eight days later than in 2012.  According to the Tax Foundation, this year’s late date is because of “the country’s continued slow economic recovery.”  And, if the calculations were to also include the costs of federal borrowing, Tax Freedom Day would be an even later May 6!

Members of the National Center’s Project 21 black leadership network — a hard-working, tax-paying group of individuals — is outraged at being in debt to the government for such a growing number of days each year.

For example, Project 21 member Hughey Newsome, a financial expert with a Harvard MBA, noted:

More and more, Americans are seeing their paychecks go to fund growing government activity.

While Tax Freedom Day is getting later and later (this year, it’s April 21), what Americans actually get from government does not seem to grow.

Today, we debate over whether or not private businesses should be forced to pay a higher minimum wage, yet government is not holding itself accountable for the shortage of people that come out of public schools prepared for 21st century jobs.  Today, we debate over extending unemployment benefits for longer periods, yet government is not holding itself accountable for hundreds of billions of dollars of stimulus that never worked as intended.  Today, we prepare to pay even more taxes in coming years to pay for a massive health care law, yet nobody seems to be able to say that health care costs will shrink for most Americans because of it.

It is unfortunate that Tax Freedom Day gets later and later, yet blame must be shared because there are not enough people speaking out for the taxpayer to make sure those who claim these extra funds are held accountable.

Another Project 21 member demanding accountability is Derryck Green, who writes a monthly blog post on the state of the economic recovery for this blog called “About Those Jobs Numbers…”  Derryck said:

This year’s Tax Freedom Day is three days later than last year’s, which was five days later than the previous year’s Tax Freedom Day.  Depending on which state you live in, you still may have several more days before you can declare your “freedom.”

Think about that.  We’re past the midway point of April, and we’re just now settling the nation’s tax bill — which is above $3 trillion.

Since this economic recovery isn’t what it was promised — the country still has more than 11 million people unemployed and tens of millions more who’ve given up the hope of finding work, full-time or otherwise — Tax Freedom Day will likely be at a later date next year than it is this year.

This means that next year, just like right now, fewer people will probably be working longer to settle our continually rising tax obligations.

This is economic oppression, and it sounds more like slavery than freedom.

Also weighing in is new Project 21 member M.J. Koskinen, a former nonprofit executive.  Maia said:

America, can you hear the sucking sound of food being taken out of the mouths of children whose misfortune in life is having been born to parents who work?

Happy Tax Freedom Day!

But, before pulling out the red, white and blue streamers and the “I love America” bumper stickers, please keep in mind that this day is only meaningful insofar as one can accept its premise: that the tax burden legitimately represents the actual cost of governance.

The fact is, it does not.  A significant portion of this tax burden represents the cost of maintaining the ambitions of a progressive government whose political survival depends upon the maintenance of the flow of wealth from productive Americans to others.  It is a kind of “economic osmosis” where the Obama Administration not only gets to regulate how much comes out of our pockets but how much of it flows into their own and those Americans of their choosing.

That being said, Tax Freedom Day — whether calculated on a national level or for each individual state — should be recognized as a tool highlighting the crisis created by the agenda of punitive liberalism, underscoring the fact that the three-fifths of Americans who pay its taxes must labor one-third of the year to discharge that burden.  And that’s the 111 days leading up to April 21st. 

Trust me, if progressives had their way, Tax Freedom Day would likely extend to July 4th.  Actually if they really had their way, I imagine it would be as late as Thanksgiving or even later — like Christmas.  Considering this belief, I would want to make a snarky comment about coal being found in taxpayers’ holiday stockings.  But the Obama Administration is against coal!


Obama's Enrollment Triumph A Pyrrhic Victory

Today I have an article in The Federalist titled “Why Obamacare’s Enrollment Triumph Will Prove Fleeting.”  In it a look at many of the same issues I did in yesterday’s blog post on Obama’s phony numbers.  But I expand it to include a look at the 8 million enrollment figure.  For example:

The U.C. Berkeley Center for Labor Research and Education recently estimated that just under one-fifth of enrollees on Covered California would leave the exchange for Medicaid. Combined with people who left because they gained employer-based coverage, the Center found that Covered California would retain about 57.5 percent of current enrollees.

If that occurs across all exchanges,then the final enrollment number will be closer to 4.6 million.  Of course, not every state is California (thank goodness), so the amount of churn due to Medicaid and employer-based coverage will vary across the nation.  Yet those factors will cause the eight million figure to be revised downward as the year goes on.

As a result the enrollment number will be revised downward over the coming months:

Each time that happens in the coming months, the media will hark back to the President’s victory dance.  For a public that doesn’t much trust Obama on health care, each revision will likely erode that trust a little further.  They will also provide his political opponents with more opportunities to claim Obamacare isn’t working as well as the President claimed.

Read it all here.


Obama Administration Uses Bogus Insurance Coverage Figures

Well, put on your shocked faces my friends.  The Obama Administration sent out an email about an hour ago touting all of the accomplishments of ObamaCare and—are you sitting down for this?—the email contained phony statistics!

You can see the email here.  Here is the second bullet point:

3 million young adults gained coverage thanks to the Affordable Care Act by being able to stay on their parents plan.

Regular readers of this blog know that about two weeks ago NCPPR released a study showing that the 3 million number was bogus.  It used both private and public sources of coverage and had not been updated since June 2012.  Correcting the numbers show that not more that 2.64 million young adults have gained coverage via their parents plan.  

Additionally, using Census Bureau data (the Administration used a survey from the Centers for Disease Control), showed that not more than 258,000 young adults had gained coverage under their parents plan.  I concluded that “we have no clue how many young adults have gotten coverage this way, and the numbers flying around are too unreliable for the president or anyone else to be using.”  Guess the President didn’t get the message.

(Avik Roy has more on the problems with the “3 million” figure.)

Near the end of the email the Administration uses this whopper:

Up to 129 million Americans with pre-existing conditions – including up to 17 million children – no longer have to worry about being denied health coverage or charged higher premiums because of their health status.

That was based on a study by the Dept. of Health and Human Services that included “pre-existing conditions” like arthritis, asthma and high cholesterol to boost up the number of people who could be denied insurance to absurd heights.

That fact is that research on the pre-existing conditions shows that barely one percent of the population is ever denied insurance for a pre-existing condition.

Further evidence that the 129 million number is rubbish was supplied by ObamaCare’s own high risk pool, set up for people with pre-existing conditions prior to the exchange.  Known as the Pre-Exising Condition Insurance Plan, it never enrolled much more than 107,000 people.  That’s about .04 percent of the under 65 population.

The HHS study was even too much for and PolitiFact. said the number wasn’t true “because number who would be truly at risk of losing health insurance or paying more money is much smaller.”  Of those 129 million, supposed 17 million were children.  When President Obama used the 17 million figure, Politifact called it “mostly false.”

This Administration has shown itself to be utterly shameless in hawking bogus statistics, but sometimes they get caught when the press holds it to account, as it did with the pay gap nonsense.  It’s time for the media to start questioning the Administration’s statistics on ObamaCare.


More Medicaid Melarky

Sally Kohn of the Daily Beast points to some new state polls showing that majority in those states favor Medicaid expansion.  From this she concludes: “A core part of Obamacare is popular in states from Kansas to Georgia where Republicans are blocking it. They’ll pay come November.”

Uh, yeah.  No doubt Democrats will want to hit Republicans over the head for not going ahead with the ObamaCare Medicaid expansion thereby reminding voters that they, the Democrats, support Obamacare.  Good luck with that!

On a more serious note, the polls, conducted by Public Policy Polling do find majorities in Florida, Georgia, Kansas, Kentucky, Maine, Pennsylvania and a plurality in Virginia are in favor of Medicaid expansion:


But here is how PPP asks the question (the same for all states): “Kansas is eligible to receive new federal funding to pay for health care through the Medicaid program. Do you think the Kansas state government should accept this federal funding to expand Medicaid coverage, or not?”  That comes pretty close to suggesting that it is free money.  Of course, there is no such thing.  What if the question mentioned that within a few years the state would have to kick in 10 percent of the cost and there is no guarantee that it won’t be more in future years?  Or perhaps PPP could have mentioned that expanding Medicaid means paying higher federal taxes and/or more federal debt?  Mentioning trade-offs in poll questions usually produce different results, sometimes dramatically. And, of course, there are always trade-offs.


Not Even a Clinton Compromise Can Persuade Strident Voter ID Critics

Does Bill Clinton really want to suppress the black vote?

And why, for that matter, is civil rights hero Andrew Young apparently willing to discourage minority, elderly and student from going to the polls?

At least that’s what would be said of these guys were conservative.

But both of these popular liberal icons are effectively putting their political legacies on the line by endorsing a plan that seeks to work with existing voter ID laws.

Clinton calls the idea, which calls for adding photos to Social Security cards in order to meet certain states’ requirements for a valid ID as well as bringing people without valid proof of identity into the 21st century, “a way forward that eliminates error” that helps end controversy threatening to “paralyze and divide a country with significant challenges.”

This very simple plan — adding photos to cards that every American citizen is required to sign up for — was promoted by the group WhyTuesday? and endorsed by Clinton and Young (who chairs that group) during events last week at LBJ presidential library marking the 50th anniversary of the passage of the Civil Rights Act of 1964.

Easy peasy, right?!

Even former president Jimmy Carter is said to support the proposal.  But there was one very prominent liberal who wasn’t interested in talking about this voter protection proffer coming from the left: President Barack Obama.  When a reporter asked for the President’s reaction to this potential political breakthrough, White House spokesman Jay Carney had no comment — begging off a response because they needed “to review all the implications.”

Obama’s really been no help at all.

While Clinton and Young are earnestly seeking a suitable compromise that will promote clean elections and provide dignity for those lacking the full representation that can come with having valid identification, Obama’s most recent contribution to the voting rights debate (also last week) was to take the stage at Al Sharpton’s National Action Network convention and stir up fears that conservatives were actually suppressing peoples’ votes by demanding that ballots not be left open to fraud.  Obama complained that lawmakers promoting polling place protections to help secure the votes of law-abiding Americans from fraud are actually “pass[ing] laws to make it harder, not easier, to vote.”

The notion of putting photos on Social Security cards certainly isn’t the most foolproof plan, nor does it meet with complete conservative acceptance.  Senator Rand Paul (R-KY), for example, fears it would create a national ID card.  Having a card with ones’ valuable Social Security number featured so prominently may also increase privacy concerns.  And, in California, Michael Hiltzik of the Los Angeles Times pointed out that there are more Department of Motor Vehicle offices in California — where people can get traditional state-issued identification — than Social Security Administration offices.

Clearly, current laws may already be the best laws.

There’s also the not so insignificant factor that all of these existing laws — all enacted at the state level — would need to be changed to include the newly-designed Social Security card.  It’s a fair bet, however, that legislators would be amenable to this additional form of identification considering that some current laws allow the use of hunting licenses.

But Hiltzik, in his criticism, seemed more concerned that Clinton and Young coming to the table to try to work out a solution is “effectively a capitulation to the Republicans’ hopelessly dishonest and deceitful voter ID laws.”

So forget giving Americans the basic tool to get over the voter ID hurdle, as critics would suggest exists with this simple and commonsense request for proof of identity.  Forget about the notion that this new federally-issued photo ID could help people vote as well as help them travel, bank and more easily engage in day-to-day activities in a world that is more security-conscious.  No — it’s giving an inch to conservative lawmakers who have enacted (or still seek to enact) a method for people who want to vote to prove they are who they say they are.

While not endorsing the plan advocated by Bill Clinton and Andrew Young, members of the National Center’s Project 21 black leadership network do see the merit in both coming to the table and seeking out a solution to the divide between those who want safe voting and those who would allow ballots to remain susceptible to fraud.  From Obama, they see an unwillingness to compromise and a zealousness to exploit the issue for political expediency.

Project 21 member Hughey Newsome, who recently wrote on the voter ID issue for the Daily Caller, said:

President Obama and the White House are accused of politicizing voter ID laws and using charges of voter suppression for their own partisan gains.

It’s actually hard to reach any other conclusion about it when one considers the proposal backed by former president Bill Clinton and former Atlanta mayor Andrew Young and the lack of White House enthusiasm.

Putting photos on Social Security cards would help address any lack of state-issued IDs in minority communities and provide a means that could be used to verify voter authenticity and help with daily business needing ID nowadays.

The White House’s silence on this proposal seems to show that politics, not solutions, is the goal.

Project 21 co-chairman Horace Cooper, a former congressional leadership staff member and constitutional law professor who also met with United Nations officials on the topic of voter ID in 2012, added:

More and more Americans now recognize the importance of ensuring that measures are undertaken to guarantee that only lawful, eligible voters participate in the electoral process.

The actions by Mayor Young and President Clinton demonstrate how bipartisan and commonsense these efforts are.

Opposition to this new proposed form of voter ID seems to be based on one of two theories — that it is politically effective to pretend that minorities are facing limits on voting or letting phony voters participate on Election Day assures left-wing political victories.

Project 21 member Kevin Martin, a Navy veteran and former state employee in Maryland, said:

Without fail, progressives talk about how elections should be fair and equitable for all.  But when lawmakers make an effort — such as with voter ID laws — the same progressives almost always level unfounded charges of racism.

Progressives will argue that an ID requirement for voting amounts to a poll tax and is unfair for the poor, minorities and the elderly.  They’ll also claim that voter fraud and identity theft doesn’t readily exist despite examples that prove otherwise.

Pia Farrenkopf’s mummified remains were recently found in Michigan.  Experts estimate that she died in 2008, but records indicate that she voted in 2010.  Melowese Richardson actually admitted and served time in jail in Ohio for, in part, voting for President Obama more than once and for more than herself in 2012 (and in past elections).  Despite this admission, Al Sharpton — instead of denouncing Richardson for her crimes — embraced her at a recent rally that condemned voter protection laws.

This isn’t right.

Progressives have not given logical reasoning to oppose voter ID laws — especially now that Bill Clinton and Andrew Young are willing to come to the table and offer their own ways to work with current ballot protection laws.

It is long past time for progressives to distance themselves from the lies and disinformation and embrace the facts.  The fair and equitable elections they claim to support are best safeguarded when a person shows up to vote with a photo ID that proves their identity.

top photo credit: iStockPhoto


Myth: America Had A Free-Market Health Care System Prior To ObamaCare

It appears that the second greatest trick the Devil ever pulled was convincing lots of Americans that they had a free-market health care system prior to ObamaCare.  That became evident after I received this tweet the other day:

That fact is even prior to ObamaCare the U.S. did not have anything close to a free-market in health care. To see this, it’s best to examine the government interventions in health care and then ask to what extent other markets have that level of interference.  

1. Tax Exclusion For Employer-Provided Insurance.  The tax exclusion was the result of wage controls during World War II—employers couldn’t attract employees by raising wages, so they attracted them by offering tax-free health insurance—and was formalized into law in the 1950s.  It’s long been known the tax exclusion encourages employees to purchase more insurance than they otherwise would, since every extra dollar put into insurance is tax free while every extra dollar of income is taxed at the marginal rate.  More generous coverage leads to overuse of health care.  It also creates other inefficiencies, such as letting the employer choose insurance for the employee, instead of the employee finding the insurance that best suits him.  Number of other markets where you get a tax break for buying a product but only if you buy it through your employer? Zero.

2. ERISA.  The abbreviation for the Employee Retirement Income Security Act, it permits companies that self-insure to avoid having to conform their insurance to state regulations.  Since usually only large firms—100 employees or more—are capable of self-insuring, it gives large firms an advantage over other firms.  (For more on ERISA, go here.) ERISA, combined with the tax exclusion, also results in a three-tiered system of health insurance: 1. Larger firms that can self-insure avoid state regulations and make use of the tax exclusion; 2. Small firms that can still make use of the tax exclusion but must buy insurance that conforms to state regulations since they seldom can self-insure; and 3. The individual market in which individuals get no tax break for insurance and must follow state regulations.  Number of other markets that have a three-tiered system for a service or product? Zero.

3. McCarran-Ferguson.  This law dates back to 1945 and it has the effect of allowing states to prohibit the sale of insurance across state lines.  This protects states from having to engage in regulatory competition—i.e., which state can come up with the lightest regulations that make the cost of selling insurance cheaper—and protects big insurers in those states from having to face out-of-state competition.  The loser in all this is the consumer who must buy more costly insurance.  Number of other markets where you cannot buy a product or service out of state? Zero. 

4. STARK  The STARK laws, named after former-Congressman Pete Stark, prohibit physicians from receiving Medicare or Medicaid payments for any medical facility they have an ownership stake in.  Obviously, this makes it very difficult for physicians to own medical facilities.  Stark first targeted physicians who owned or were partial owners of their own labs.  It reached its culmination under ObamaCare which forbids Medicare and Medicaid payments going to hospitals owned by physicians.  The supposed justification for this was physicians would encourage patients to overuse health care, thereby putting more strain of government budgets.  The evidence for this has always been shaky.  The likely reason is that big lab companies and big hospitals wanted to stamp out competition.  Yet physicians are often best-suited to own medical facilities because they spend so much time working in them.  This gives physicians the experience to know how a hospital can improve its service for patients.  Ownership enables them to to put that knowledge into practice.  Unfortunately, the STARK laws largely end that sort of innovation.  Think of it this way: It would be the same as having laws that say attorneys can’t own law firms, auto mechanics can’t own car repair shops, bankers can’t own a bank, and so on.  Think that would improve or hinder those markets?  Number of other markets in which practitioners can’t own their facilities? Zero.

5. Medicare, Medicaid and Other Government Programs.  In 2012 the U.S. spent $2.793 trillion on health care.  Medicare, Medicaid, S-CHIP, Veterans Affairs and other government programs accounted for almost $1.098 trillion of that.  So, just under 40 percent of our health care expenditures go through government where politicians and bureaucrats decide how they are spent instead of physicians and patients making such decisions exclusively.  Number of other markets where government controls at least 40 percent of the resouces: I can think of a few, such as education and defense.  In most other markets consumers control most of the resources.

That is an incomplete list. There are plenty of other federal laws that apply to health care and health insurance such as CLIA, COBRA, HIPAA, the HMO Act and the Mental Health Parity Act. (Am I forgetting a few?  Probably). Then there are laws on the state level like benefit mandates, certifcate of need, and, in some states, guaranteed issue and community rating.

Few other markets have anywhere near the government interference and meddling that health care does.  And, remember, all of this came into being well before ObamaCare.  

The best way to describe the health care market in the pre-Obamacare days was a government mis-managed market.  The best way to describe health care under Obamacare is a government mis-managed market on steroids. But no one can accurately describe the market prior to Obamacare as “free.”  It doesnt’ square with the facts.

For more on this see Greg Scandlen’s “100 Years Of Market Distortions.”

UPDATE: For even more on this, see Rituparna Basu’s “The Broken State of American Health Insurance Prior to the Affordable Care Act.”


Why do the Left's Stories about the Death of Charlene Dill Leave Out So Much Information?

Coreg by GSKCoreg, one of many drugs prescribed for heart conditions, is made by GlaxoSmithKline, which has a program to help low-income people receive its medicines free or nearly free, for those who qualify for help.

David Hogberg wrote a blog post this morning on Medicaid and the deaths of Charlene Dill and Deamonte Driver. I have a few thoughts to add.

David pointed out to stubborn leftists exploiting this poor woman's death that Medicaid is no panacea. Even had Charlene Dill had Medicaid coverage, she may not have been able to see a doctor. He notes that in Florida, only 60% of doctors* will see new Medicaid patients. He also notes the semi-famous case of Deamonte Driver, a Maryland boy who died of an infection related to an abscessed tooth. The left has exploited Deamonte's death in a call for government-run health care, ignoring both the fact that Deamonte's family had Medicaid coverage, and also that countries with single-payer health care, such as Britain, have notoriously poor dental care (see my 2009 book with Ryan Balis, PDF version available free here, for stories of desperate Britons pulling out their own teeth because that country's National Health Service never gets around to treating them).

David, however, kindly accepted the left's version of the Charlene Dill story, but it has gaps bigger than the alleged one they decry about Medicaid. Maybe all those gaps, if filled, would make the case the leftists want to make stronger -- but if so, why isn't the left filling them?

Here's what Think Progress -- which probably did more than any other outlet to promote the Charlene Dill story after it initially was brought out by a press conference by SEIU Local 1991 (which has been campaigning for Medicaid expansion) -- wrote about it:

Charlene Dill, a 32-year-old mother of three, collapsed and died on a stranger’s floor at the end of March. She was at an appointment to try to sell a vacuum cleaner, one of the three part-time jobs that she worked to try to make ends meet for her family. Her death was a result of a documented heart condition — and it could have been prevented. Dill was uninsured, and she went years without the care she needed to address her chronic conditions because she couldn’t afford it.

Under the health reform law, which seeks to expand coverage to millions of low-income Americans, Dill wasn’t supposed to lack insurance. She was supposed to have access to a public health plan through the law’s expansion of the Medicaid program. But Dill, a Florida resident, is one of the millions of Americans living in a state that has refused to accept Obamacare’s Medicaid expansion...

...Dill made about $9,000 annually by babysitting, cleaning houses, and selling vacuum cleaners...

Here are a few of the questions none of the left-wing articles and diatribes I saw addressed:

  • Dill, described as a single mother in most articles, actually was married (in fact, Dill was not her married name, but I'm sticking with "Dill" for this story for the sake of the family's privacy). Was Dill's reported $9,000 annual income (some stories said $11K) the family income, or hers alone? The stories imply it was hers alone.

  • If Medicaid had been expanded in Florida, would Dill have qualified, given that any income her husband earns would have been taken into consideration?

  • What was Dill's actual, legal cause of death and why do none of the stories report it?

  • What are the unnamed medications Dill allegedly would have been taking had she had Medicaid coverage? What is the certainty that these medications would have prevented her death? Would Medicaid have covered them? What did they cost?

  • Why do many, if not all, of the stories fail to mention that the state of Florida has a program to help people who are ill and uninsured, but whose income falls above Medicaid's eligibility levels? If Dill had a life-threatening condition that could have been fixed with medication, and could not afford to pay for the drug or drugs herself, did she apply for help from this program?

  • Pharmaceutical companies have programs to help low-income people receive medications they otherwise cannot afford. Did Dill apply for help from this source, from charities, from other family members or elsewhere?

Charlene Dill's close friend, Kathleen Voss Woolrich, the person responsible for circulating her story to the left, blames Florida Governor Rick Scott (R) for Dill's death. She also complains of being uninsured herself, and has said in social media, "I'm uninsured. Too much for medicaid, too little for a subsidy. I cannot get infusions I need to stay well. I could die of respiratory failure." An interesting coincidence -- though entirely possible, I concede -- that two close friends, both young adults, need Medicaid for ongoing conditions to survive.

Woolrich is an SEIU organizer. The SEIU claims to be very pro-health insurance. Why isn't the SEIU providing health insurance to Kathleen Voss Woolrich?

pliersOur book Shattered Lives describes people in government-run health care systems pulling out their own teeth with pliers. These people have health insurance, but inadequate health care.

Many leftists yearn for health systems like those in Britain and Canada, where everyone is promised health insurance, but health care, not so much. We think these leftists would be wise to heed the admonition: Be careful what you wish for.

Which brings us to Deamonte Driver, the boy used by the left to argue for government-run health care who had Medicaid coverage but who died because he did not get medical attention in a timely manner. I agree with David Hogberg's comments on this, although I do think two things are worth noting: 1) the temporary "lapse" in the Driver family's Medicaid coverage reportedly occurred not because of taxpayer parsimony but because the Driver family didn't turn in a necessary address change to Medicaid (and the lapse was rectified when the family did so); and 2) David's reference to Deamonte's mother's parenting skills. I concur in his assessment overall, but remind him that no stories mention Deamonte Driver being a virgin birth -- though, admittedly, I've never seen a story that mentions a father. It takes two to create babies, and unless Deamonte's father was dead or genuinely incapacitated, he shares equal responsibility for what happened. The news media gives us entirely too many sob stories about single parents without explaining either that the missing parent is dead or why children are being raised by a only one of the two people who brought them into this world.

*This post was edited to reflect the fact that the correct number is 60%, as I originally wrote 40% in error, and to add the information that the SEIU originally brought the Charlene Dill story to the news media.


ObamaCare Medicaid Expansion: The Cruelty Of False Hope

I was on the Thom Hartmann show last night discussing Medicaid.  I wasn’t as sharp as I wanted to be, so I hope you’ll let me make up for that here.

Hartmann pointed to the example of Charlene Dill.  Here’s lefty William Hamby on that tragic case:

…in Florida, Charlene Dill has paid the ultimate price for this political screwing over of the poor. Anything but “lazy,” she worked three jobs as a single mother. She had a documented heart condition that was treatable, but could not afford to go to the doctor. 

….The Republican stonewalling of the ACA is hard to see as anything other than willful evil. It goes much deeper than one dead woman in Florida. We’re talking about millions of people who are suffering, right now, today, with conditions that are treatable. Some will die, and others will live in pain that could be prevented. People will lose their jobs over their illnesses. Some will lose their houses. Families will be torn apart. This is real world suffering that is directly caused by Republicans.

Dill may not have been able to go to the doctor even if she’d had Medicaid.  Over 30 percent of doctors are refusing to see Medicaid patients.  If she lived in Wyoming, she’d be in luck.  Close to 99 percent of doctors their take new Medicaid patients.  But she lived in Florida, where just over 40 percent refuse to do so.  So, had Florida expanded Medicaid, Dill very well could have died anyway.

That happened to Deamonte Driver.  For a refresher on Driver, go here.  Driver died from complications related to an absessed tooth.  He had Medicaid, but his mother, Alyce, could not find a dentist willing to take Medicaid.  Interestingly, Deamonte’s brother, DeShawn, was also having problems with his teeth.  It was hard not to read between the lines of this story and realize that it was not only a failure of Medicaid, but also possibly of a mother who probably should not have been a parent also society’s fault.

Furthermore, the best data we have, the Oregon Medicaid experiment, found almost no improvement in health outcomes from expanding Medicaid.  In short, expanding Medicaid means expanding a costly program whose benefits are questionable at best.

Hamby argues that not expanding Medicaid is evil but, I wonder, which is more evil? Not expanding a costly yet ineffective program, or expanding that program and giving the Charlene Dills and Deamonte Drivers of the world false hope?


Government Wants You To Have Choices--As Long As You Make The 'Right' Choice

Hat tip to Walter Russell Mead who points to this article in the New York Times about physicians in Texas who have switched to “all-cash” (that is, they don’t take insurance) practices:

For 12 hours a day, the waiting room at Dr. Gustavo Villarreal’s family practice is packed with patients who pay a flat $50 fee for the convenience — or necessity — of a walk-in, quick-turn doctor’s visit….

“It had always been affordable and possible to maintain a practice with what insurance and patients paid, but about 10 or 15 years ago, you started seeing a decline” in revenue, said Dr. Villarreal, who switched his traditional family practice to its current business model in 2012.

But, as Mead warns, “now that Obamacare is swelling the ranks of the comprehensively insured, doctors who don’t take insurance are increasing the pressure on the system. There’s a hint in the NYT piece that other doctors think it’s irresponsible for their colleagues to stop taking insurance just as the Obamacare rollout promises to strain practices and hospitals past capacity.”  I’ll include the “hint” at the end of the post.

Restricting the choice of patients to use direct pay physicians—something that won’t happen soon, but is a very real threat the longer Obamacare remains in place—is not limited to Obamacare.  A while back NCPPR published a study I did on physicians in Medicare.  In it, I recounted the story of Dr. Juliette Madrigal-Dersch who runs a cash-only practice near Austin, Texas.  When she initially began her practice, she took Medicare but not other forms of insurance.  Eventually she decided to drop Medicare.  Here are the hoops she has to go through to stay out of Medicare:

To leave Medicare, you actually have to do quite a bit of paperwork,” [Dr. Madrigal] said. She turned to the Association of American Physicians and Surgeons (AAPS), an interest group that in recent years has helped physicians exit Medicare. The AAPS recommends that the physician first tell her Medicare patients that she is leaving Medicare. Second, the physician must file an affidavit stating that while she is opting out of Medicare she “will provide services to Medicare beneficiaries only through private contracts,” and “will not submit a claim to Medicare for any service furnished to a Medicare beneficiary during the opt out period.” The affidavit must be sent to all of the private companies that handle Medicare claims in the physician’s state.

The physician must then fill out a separate contract with each of her Medicare patients stating that the patient understands that the physician has opted out of Medicare. It states that the patient must accept “full responsibility for payment of the physician’s charge for all services furnished by the physician.” The patient must also understand “that Medicare payment will not be made for any items or services furnished by the physician that would have otherwise been covered by Medicare if there was no private contract and a proper Medicare claim had been submitted.” The patient must sign this contract in order to continue to be treated by the physician.

Even though she dropped out of Medicare, Dr. Madrigal’s hassles with the government haven’t ended. The “opt-out” period only lasts for two years, so Dr. Madrigal must re-file up-to-date affidavits biennially. She must make sure that her Medicare patients sign new contracts every two years as well.

That is the nature not just of Medicare or Obamacare, but of government in general.  It may let consumers and providers have choices, but they must be the correct choices as defined by the politicians and bureaucrats.  Making choices outside the government system, even when it is legal, is frowned upon, and so politicians and bureaucrats make getting out as cumbersome as possible.  

Doing something like forcing physicians to accept exchange policies won’t happen in the current policial environment.  Any politician suggesting that would likely get hammered this November, if not November 2016.  But political environments change, and when health care is no longer the salient issue it is today, politicians will try to slip regulations into large bills that begin us on the path of forcing physicians to take exchange policies.  

It’s another reason why repealing Obamacare is so important.

Here’s the part of the Times article that hints at trouble for physicians with all-cash practices:

Some health care specialists worry that if too many practitioners choose this path, the state could be left struggling to find doctors to accommodate patients with insurance as the federal health care overhaul is making such coverage mandatory for most Texans. So far, efforts to enroll Texans in the federal insurance marketplace — crucial to the success of the Affordable Care Act — have made a small dent in the state’s uninsured population, which has reached 6 million, according to United States Census Bureau data. The federal Department of Health and Human Services reported that 295,000 Texans had signed up for insurance coverage in the federal marketplace as of March 1.

“We have to find ways of stretching the current number of primary care doctors to meet that demand,” said Dr. Clare Hawkins, president of the Texas Academy of Family Physicians. “Direct primary care goes in the other direction.”