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ObamaCare Enrollment Falls Short of CBO Predictions

On Tuesday, the Centers for Medicare & Medicaid Services announced that 9.9 million people had signed up for insurance on the ObamaCare exchanges.  “These numbers are consistent with HHS’s effectuated enrollment target of 9.1 million for the end of 2015,” the press release stated.

While it’s true that the Obama Administration did predict over 9 million people enrolling in the exchanges for 2015, the Administration has never explained why the exchanges have fallen short of predictions from the Congressional Budget Office. (Although, when enrollment in 2014 exceeded CBO predictions, Obama did say, “It’s working a little bit better than we anticipated — certainly, I think, working a lot better than many of the critics talked about early on.”)

Anyway, here is what the CBO predicted in various reports:


If the ObamaCare exchanges enrolled 9.9. million, then they fell about 18 percent short of CBO’s final prediction for 2015.  Don’t expect to see any of the media mention that.  And don’t expect the MSM to question whether the exchanges will reach 21 million in enrollment in 2016. Whatever goal the Administration sets is good enough for them.


Apple CEO Tim Cook Criticized by Justin Danhof on Fox Business

The U.S. Securities and Exchange Commission should be investigating an email from Apple CEO Tim Cook to CNBC’s Jim Cramer under its Fair Disclosure regulations, Free Enterprise Project Director Justin Danhof told Neil Cavuto today on the Fox Business Network. Is it perhaps Cook’s liberal cronyism that has the SEC looking the other way?

Cook also refused to comply with a Justice Department court order earlier this summer. Watch Justin’s entire interview below. 


Project 21 Members Dominate Media Discussions About 'Black Lives Matter'

Recently the news media has been abuzz with stories about the Black Lives Matter movement and its possible connection to the recent trend of murdered police officers.  And right smack in the middle of the media discussions have been several members of our Project 21 black leadership network.


This past Friday, September 4, the Fox News Channel’s “Kelly File” held a discussion entitled “Black Lives Matter and 2016.”  Project 21 members Stacy Washington and Bishop Council Nedd II were part of the lively discussion.

They began their comments by defending the majority of police officers in light of threats from members of the Black Lives Movement.

Are such threats against police common or simply anomalies?  Stacy recounts the horrific behavior she witnessed firsthand in Ferguson, MO, as protestors stood before police and threatened their wives and families.

Finally, during a discussion of ways the black community can avoid future violence and poverty, Council argued for the importance of training children correctly, and Stacy noted the need for strong fathers within the family structure.

Stacy was on television twice on Friday night.  In addition to “The Kelly File,” she appeared on NewsmaxTV’s “The Daily Wrap,” where she again shared her firsthand experiences in Ferguson, MO, and asked the cutting question, WHICH black lives matter?  According to Stacy:

In St. Louis just a couple of weeks ago we had a 93-year-old Tuskegee veteran robbed twice by two sets of black men in Ferguson. We had a nine-year-old girl shot to death on her bed as she did homework… Not a peep from Black Lives Matter… Why didn’t THOSE black lives matter? Why weren’t there protests for that?

Two days earlier, Stacy appeared on NewsmaxTV’s “The Steve Malzberg Show” to discuss the Iran deal, Kentucky Clerk Kim Davis and whether Black Lives Matter is a hate group.  

Regarding whether the Iran deal is pandering to Iran rather than representing American interests: “We don’t do our foreign policy based on how other people feel [but] now we’re going to govern through feelings… Feelings don’t matter in war.”

Regarding Black Lives Matter: “Their rhetoric of late has sounded a lot like a hate group. I would not call them a hate group, but I think they need to tone down their language.”

Stacy wasn’t the only Project 21 member with multiple media appearances last week.  Carl Pittman knew fallen Harris County Deputy Darren Goforth personally, and he responded to Goforth’s murder and other recent murders of law enforcement personnel on several radio and television shows.

On August 31, Carl was interview by Dr. Drew Pinsky on HLN’s “Dr. Drew” show.

“The political leadership has literally approved of bad behavior,” said Pittman. “A lot of people are taking this as some sort of green light to go out and continue to act in these lawless ways, and I fear we are going to see this get much much worse before it gets better.”

Pittman was also interviewed on NewsMaxTV’s “The Hard Line” on September 3. 

“I do believe the rhetoric that we’ve heard as of recently - the march where they were chanting ‘Pig in a Blanket, Fry ‘Em Like Bacon’ - that is very very dangerous rhetoric where someone that might be easily manipulated might follow through and try to carry something like that out,” said Pittman.



Unemployment News a Hollow Victory - About Those Jobs Numbers for August

When the monthly jobs report from the Obama Administration came out last Friday, there was unwarranted celebration at the White House.  Any “good” news truly rings hollow – that’s what Project 21 member Derryck Green thinks.

Case in point, the labor force participation rate – the number of people who are actually working or looking for work – is stuck at a low that has not been seen since the Carter era.  And it’s this unsettling factor that is likely driving down the official unemployment rate rather than robust job creation.

The stock market initially cratered in the news of the jobless report.  Yet Obama celebrated.

There’s a staggering, underreported crisis affecting the American workforce, and Obama seems to be ignoring it while he twists the report into something he’s using to threaten a veto of any forthcoming budget bill from Congress daring to cut spending.

Black is white.  Up is down.  Day is night.  Hollow victories are being treated as if they are major breakthroughs.

Trying to make some sense of it all is Derryck with his monthly “About Those Jobs Numbers” report for August’s unemployment report:

Based on a recent report from the federal Bureau of Economic Analysis, officials at the U.S. Department of Commerce determined that the second quarter of 2015 saw GDP grow at a rate of 3.7 percent.  This is above the initial estimate of 2.3 percent.

It’s a hollow victory for the Obama Administration, which constantly seems to be on the lookout for alleged “good” news it can report about its stewardship of the American economy that the Preisdent promised to fix seven long years ago.

But the celebration should be tempered.  When the revised GDP output from the first quarter is taken into consideration, the economy’s growth is only a measly 2.25 percent for the year.

Consider the continuing crisis of American unemployment.  Private payroll processor Automatic Data Processing (ADP) estimated the private sector created 190,000 jobs in August, which is above July’s revised number of 177,000 but still below the 210,000 jobs that analysts were expecting.

According to the federal Bureau of Labor Statistics, only 173,000 jobs were created last month.

Despite this poor showing, the unemployment rate nonetheless was reported to have fallen to 5.1 percent.  Based on the pallid job creation numbers, it certainly wasn’t due to expanded hiring.

One of the obvious reasons the jobless rate dropped is because people stopped looking for work and are no longer counted among the unemployed.  The back-to-school season may also be responsible for the some of the unemployment rate drop.

Though economists sought out by reporters will no doubt cheer what they have perpetually regarded as an economy on the mend, this economy has allegedly been improving for six years while managing to never recover back to pre-recession levels.  Other economic indicators, as they usually do, demonstrate the economy is nowhere near recovered despite the spin of the Obama Administration and its allies in the media.

While the official unemployment rate reported in the media and hailed by President Obama and his supporters was at 5.1 percent for August, it is relatively unknown to most that there’s an alternative jobless rate that is more than double that.  The U-6 rate, a measure that is considered to be a better indicator of the complete employment situation because is measures those looking for work as well as those who are underemployed and have quit looking for work altogether, is a sky-high 10.3 percent.  For a good portion of the Obama presidency, this U-6 rate has doubled the official rate.

This jobless rate is a hollow victory.  Obama cannot legitimately claim the employment situation is getting better when one considers the devil in the details.

And, as usual, the demographic groups the President considers to be his base didn’t fare well compared to the general population.  Women’s unemployment, for instance, was at 4.7 percent.  That sounds good, but this rate is still worse that during the George W. Bush Administration.

For blacks, the rate ticked up to 9.5 percent.  For black teens, the unemployment rate went up almost three points to 31.3 percent.  For Hispanics, the jobless rate was 6.6 percent.

In all, more than 94 million Americans were not in the workforce in August, including more than 56 million women.  The civilian labor force participation rate of 62.6 percent for the third consecutive month – a 38-year low (that’s October, 1977, to be precise!).

These statistics alone make it certain that the jobless situation is much, much worse than official reports.  The month Barack Obama was inaugurated, the labor force participation rate was 65.7 percent and the unemployment rate was 7.8 percent – with roughly 80.5 million people not in the workforce.  Now, the number of people not in the workforce has jumped 15 million, and the labor force participation rate is 3.1 percent lower.  Yet the unemployment rate is a little more than two percent lower.

It sounds like Common Core math to me.

It’s a hollow victory.

And things aren’t getting better elsewhere in the economy.  For example:

  • According to consultancy firm Challenger, Gray and Christmas, employers planned to cut 41,186 workers from payrolls in August.  This is a 61 percent decline from the 105,696 jobs that were cut in July.  Based on their data, this brings the jobs cuts for 2015 to date to 434,554.
  • Data from a recent Gallup poll shows more Americans are losing confidence in the economy.  According to Gallup, the U.S. Economic Confidence Index “slid three points to -17 after also declining three points the prior week.  This is the lowest the index has been since September 2014, and comes as international markets struggle amid volatility in China’s stock market.”
  • The U.S. manufacturing sector lost 17,000 jobs last month, the first decline in this sector since 2013.  On the same low note, the nation’s service economy added more than 26,000 jobs for bartenders and waiters.  So, if those who have given up hope in finding work or those who aren’t working full-time need to cry in their beers over the poor economic situation, there are enough bartenders and waiters to accompany a very large pity party.
  • A study conducted by the left-leaning National Employment Law Project noted that take-home pay for American workers was either stagnant or had fallen since the so-called recovery began back in 2009.  The greatest declines were among the lowest-paid workers such as those in the home health care, food preparation and retailing sectors.  Jobs without great wages is certainly a hollow victory.  At least that’s what the left always says, right?
  • The Congressional Budget Office (CBO) says that, because of record tax revenue and plateaued spending, the federal deficit and debt were reduced to $426 billion in fiscal year 2015.  This marks the lowest deficit of Obama’s reign.  At the same time, however, the CBO predicts that by 2018 spending will increase while the economy slows once again, making the debt unsustainable.  And Obama is threatening to veto any budget from Congress and shut down the government if lawmakers don’t increase spending.
  • Wall Street didn’t react too kindly to the less-than-stellar jobs report.  The Dow Jones Industrial Average fell more than 272 points – or 1.7 percent – ending the week at a loss of over three percent, according to the Wall Street Journal.  This ends a particularly bad two weeks for the Dow, which dropped significantly during the past two weeks of August as a reported result of China’s weak economic outlook.  Hollow.
  • The national average for a price of gas is $2.42, the lowest price per gallon for a Labor Day weekend since 2004.  AAA predicts the national average for gas to be at or below $2 per gallon at Christmas.  OK – so there is some good news!

Despite the reported drop, the fine print shows that the August jobs numbers weren’t good news.  And, while more and more Americans find themselves on the outside of the workforce looking in, President Obama seems disconnected from his duty to help manage our nation’s economic recovery.  Instead, he’s busy renaming mountains and continuing to push the scam of “climate change.”  He’s taking selfies (again), and lying to the world about how great his Iran deal will be (well, great for Iran; read it).

In other words, it seems Obama appears willing to ride out the remaining months of his presidency as an absent leader, taking what amounts to taxpayer-funded vacations and likely securing donations for his presidential library while his administration enacts more economy-killing regulations prolonging the financial suffering of more and more Americans. 


Yes, Obama, Premiums Are Going Up

Back in early Summer when some insurers on the exchanges requested hefty premium hikes for 2016, one lefty pundit counseled, don’t pay too much attention to scare stories about gigantic increases in Obamacare premiums next year.”  One reason, he said was that a “few months from now, the real rate increases—the ones approved by state and federal authorities—will begin to trickle out.”

President Obama agreed with him:

“My expectation is that they’ll come in significantly lower than what’s being requested,” he said, saying Tennesseans had to work to ensure the state’s insurance commissioner “does their job in not just passively reviewing the rates, but really asking, ‘OK, what is it that you are looking for here? Why would you need very high premiums?’”

And how has that worked out?  According to the Wall Street Journal:

That commissioner, Julie Mix McPeak, answered on Friday by greenlighting the full 36.3% increase sought by the biggest health plan in the state, BlueCross BlueShield of Tennessee. She said the insurer demonstrated the hefty increase for 2016 was needed to cover higher-than-expected claims from sick people who signed up for individual policies in the first two years of the Affordable Care Act.

Several regulators around the country agree with her, and have approved all or most of the big premium increases sought by the largest health plans in their states for the new sign-up season that begins Nov. 1.

As the below graphic from the WSJ shows, of the 10 insurers asking for an average premium increase above 10 percent, half have had their rates approved by regulators, three are still pending, and only two have been denied—and one that was denied had requested a 12 percent hike and had a 10 percent increase approved by regulators.


As I warned, “Ignore the premium hikes at your own risk.


Veterans Health Administration: Over 300,000 Not Served

A new report from the Veterans Affairs Office of Inspector General found that as “of September 30, 2014, over 307,000 pending ES [Enrollment System] records were for individuals reported as deceased by the Social Security Administration.” That’s about one-third of those who are the VA’s waiting list.

Am I shocked?  Well, yes.  I’m surprised it’s that low.

It’s been well known for a while now that the VA has had trouble getting timely treatment to veterans. Unfortunately, the report is unable to shed light on a very important question:

However, due to the data weaknesses identified in…we cannot determine specifically how many pending ES records represent veterans who applied for health care benefits or when they may have applied. [Italics added.]

This occurred because VHA [Veterans Health Administration] lacked adequate procedures and management oversight to identify and implement necessary updates to the individual’s status and the method for identifying deaths was inadequate. Unless VHA adopts effective procedures to identify individual deaths and takes action to improve the data integrity of ES, it cannot accurately and reliably report on the status of pending applicants, enrollees, and other beneficiaries in the VA health care system. 

Thus, we don’t know how many of those 307,000 veterans died because they had trouble getting health care.  But it’s probably a safe guess that more than a few did.

Remember back when the VA had the best health care system in the country?  I’ll bet that intellectuals like Phillip Longman do. 


A Rare Moment of Agreement on Immigration

On August 26, Project 21’s Kevin Martin appeared on the talk show of liberal host Thom Hartmann, who was having his usual fun mocking conservatives.  However, on the issue of immigration, we heard a rare response from Hartmann: “I agree with you.”

Specifically, Hartmann and Martin were agreeing that comprehensive immigration reform should include the prosecution of employers who hire illegal immigrants.  They also agreed that people of color are disproportionately hurt by unchecked immigration.

Earlier in the program, Hartmann and Martin and the other panelists discussed whether more gun restrictions would have saved the lives of Virginia journalists Alison Parker and Adam Ward.  Martin was outraged by the idea that he should have to undergo counseling before being allowed to own a gun, when the burglar breaking into his house didn’t have to jump through the same hoop.

Also discussed on the RT Network’s “The Big Picture with Thom Hartmann”: the Fight for 15 movement that calls for a $15/hour minimum wage, Social Security privatization and whether Alabama’s closing of DMVs affects the procurement of voter IDs.


You Can Rate Anything on the Internet--Anything!

If you thought you could only rate things like hotels, books or plumbers on the internet, well then this screenshot will edify you:

One gentleman gave Greensville a really bad review, and, well, he should know:

Google isn’t the only place you can rate a prison.  Here’s Yelp:


Apparently, Pocahontas is much better than Greensville:

Back to regularly scheduled health care blogging tomorrow.


Three ObamaCare Co-Ops Down, 20 To Go

Under ObamaCare, health Co-Ops—non-profits that provide insurance—are allowed to receive federal grant money to start up operations in the ObamaCare exchanges.  There are 23 such Co-Ops.

Or, rather, there were.  In January, the state insurance regulator of Iowa decided to liquidate CoOportunity Health, which served Iowa and Nebraska.  Basically, the money CoOportunity collected in premiums couldn’t cover its medical claims.  The cost to taxpayers: $146 million.

Last week, Nevada Health Co-Op announced it would be discontinuing business at the end of this year. “’It is with deep sadness that based on challenging market conditions, the Board made a painful decision to wind down operations of the Nevada co-op at the end of the year,’ co-op member and Board Director Stacey Hatfield said in a statement.”  

And it is with even deeper sadness that I announce this cost taxpayers $65 million in federal solvency loans.

I wonder, was it really “challenging marketing decisions” that were the problem, or was this just a bad idea from the word go?  As Ed Haislmaier of the conservative Heritage Foundation put it, “It was a badly done attempt to reinvent the wheel with some genius deciding to make it oval instead of round.”

That comes on the heels of the failure of the Louisiana Health Cooperative back in July.  This one, though, had a typical Louisiana twist:

Louisiana Health Cooperative’s then-Chief Executive Officer Terry Shilling signed a $4 million, four-year contract with a consulting firm last year in which he is a principal, according to documents obtained by the Washington Examiner….

The Examiner also found that Louisiana Health Cooperative’s leadership ranks include seven of Shilling’s business associates, and the new co-op agreed to pay an additional $3.3 million annual fee to the consulting firm, which is registered in Georgia as Beam Partners.

Besides Shilling, individuals from Beam fill three of Louisiana Health Cooperative’s director positions, two vice president slots and the chief financial officer. Eight of the top 11 co-op managers are from Beam.

On top of the $4 million contract and $3.3 million annual consulting fee, Louisiana Health Cooperative also agree to an additional 20 percent “performance fee” to be paid to Shilling’s firm….

Louisiana Insurance Commissioner Jim Donelon told the Examiner his department would take a look at any conflicts of interest concerning the contract, saying, “that is a matter under review.”

Well, let’s hope that if he finds criminal wrong-doing, he can get back some of those consulting fees.  It would offset the $66 million in taxpayer loans Louisiana Health Cooperative received.

And the future for most of the remaining 20 Co-Ops?  Not too rosy, according to reports for A.M. Best, Standard and Poor’s, and the Office of the Inspector General for the Department of Health and Human Services. 


Savings of ObamaCare's ACOs Declined 28 Percent!

One of the, ahem, “reforms” ObamaCare introduced to Medicare was Accountable Care Organizations (ACOs).  ACOs were supposed to save money for taxpayers and improve the quality of care for Medicare beneficiaries.  (To understand what an ACO is, go here.)

In 2013, ACOs saved Medicare about $492 million.  If that savings was extended to all Medicare beneficiaries (not just those in ACOs), I estimated it would save Medicare about one percent (0.96 percent to be exact).

Early last week the Centers for Medicare & Medicare Services boasted that “Medicare ACOs Provide Improved Care While Slowing Cost Growth in 2014.”  For the Shared Savings ACO program, total “net savings to the Medicare Trust Funds was $465 million.”  For the Pioneer ACO program, it’s not clear how much Medicare saved, although a good guess is about $38 million, since total savings were $120 million and 11 of the Pioneer ACOs qualified for “shared savings payments of $82 million.”  That’s a total savings to taxpayers of $503 million ($485 million + $38 million).

How much savings would that generate if all 54 million Medicare beneficiaries were in ACOs?  There were about 7.8 million people in ACOs in 2014, which means the ACOs saved about $64.64 per beneficiary ($503 million divided by 7.8 million).  Multiply $64.46 by 54 million and you get about $3.5 billion.  That $3.5 billion represents about 0.69 percent in savings of the roughly $505 billion Medicare budget.

Since 2013’s projected savings was about 0.96 percent, then the savings rate for ACOs has declined by about 28 percent ((.69-.96)/.96).  

In conclusion, and I’m just guessing here, but I don’t think this ACO idea is going to solve Medicare’s $41 trillion unfunded liability problem.


A Perspective on Harris County Deputy's Death by a Project 21 Member Who Served with Him

Last Friday, Harris County Deputy Darren Goforth was essentially executed as he fueled his patrol car in a Houston suburb.  The alleged shooter, who walked up and shot the unsuspecting deputy while he was standing and then fired several more rounds after he fell, is now in custody and will face capital murder charges.

Details are still sparse and there has been no declared motive, but a major focus is that the deputy was white and the shooter is black.

It comes as radical activists are loudly condemning police in general for alleged harsh disparate treatment of blacks.  Officers have become targets of violence apparently incited by this anger in jurisdictions other than this Texas county.  Despite the danger to law and order and civil society, this radical rhetoric seems to be condoned by liberal political leadership that may go as high as the Oval Office.

Project 21 member Carl Pittman is a criminal investigator for the Harris County Sheriff’s Office, where he has served since 2001.  Pittman knew Deputy Goforth, and he has made this statement about the shooting and its ramifications he believes are related to it:

The loss of any innocent life is tragic, regardless of race.

Unfortunately, there are those in our country – within our government and outside of it – who have fueled a war against law enforcement officers.  They have made officers out to be uncaring, calculating killers of minorities – especially blacks.  They want to name streets after and march in the name of people who have done nothing but act badly.

We are out of time.  Deputy Darren Goforth is out of time.

Darren put on his uniform a few evenings ago and left his family with an expectation and a right to return to them.  But he didn’t leave without knowing the risk.  In fact, he was the very definition of bravery.

Knowing the risk, he went anyway.  But a coward – a menace to humanity with a blatant disregard for law and order – decided to steal the future that belonged to Darren with his wife and children.

This rhetoric of “black lives matter” is very incomplete – and, yes, very racist.  I am greatly offended!

My God, what have we become?  You see, all lives matter – regardless of the color.

Where is the outrage from the Obama White House?  Where is the condemnation from the race-baiting Reverend Sharpton?  You two have this blood on your hands.  You have divided this nation because it suited your sick agendas.

As I see it, there are truly only two races of people – good and bad.  Does this black murderer killing this white deputy somehow make you feel better?

I am from the old school.  God forgives, but his warriors arrange his appointments.  This is a call to arms to all law enforcement officers to keep protecting and serving the good people of all colors in our communities.  You took an oath to do so, and to hunt those down and bring to justice those who wish to destroy us.

To the evil ones who wish to start a war against the righteous – don’t start something that you are ill-prepared to finish.

Rest in peace, Deputy Darren Goforth.  We’ve got it from here!


Are Amputees Medicare's Next Victims?

Let me start this blog post with a thank you to Brad Knollenberg and AccessRX America for doing an interview with me about my book, Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physician.  The interview focuses a lot on the Part D portion of Medicare and how it impacts community pharmacists.  The issues surrounding community pharmacists were not my area of expertise, so thanks to Brad for providing me with a lot of information.  Interview is here.

On other matters, the Centers for Medicare & Medicaid Services (CMS) has proposed new regulations for Medicare’s treatment of amputees.  Although the issues are complicated, in short the new regulations will likely make it harder for amputees to qualify for prosthetic limbs.

From the theory advanced in my book, this is fascinating—although from the perspective of amputees, it must be unnerving, to say the least.  As I argue in Medicare’s Victims, the sickest are often likely to be victims of Medicare because they lack political power—that is, they lack the ability to influence Congress on Medicare policy. First, not that many people get seriously ill in a given year, seldom enough to amount to much at the ballot box. Second, they are seldom in any condition to be organizing, protesting, donating to Congressional campaigns, etc. that are the sorts of things that can persuade Congress to make changes in Medicare policy. 

There are only about 2 million amputees in the U.S., and not all of them are on Medicare.  That’s probably not enough to have much impact at the ballot box.  On the other hand, most amputees don’t have a debilitating illness.  They can engage in protesting, getting media attention and other activities that can influence Congress.  And they are not alone in this fight, as prosthetic manufacturers aren’t crazy about the proposed rules either.

Right now, the Amputee Coalition and the American Orthotic and Prosthetic Association are fighting CMS.  It will be interesting to see who prevails.


Rubio's Health Care Plan: Economics vs. Politics

It is often the case that good economics makes bad politics, and vice-versa.  That is evident in the part of Senator Marco Rubio’s health care plan that deals with the employer-based tax exclusion for health insurance.

Rubio’s plan proposes a refundable tax credit for purchase of insurance on the individual market.  It also proposes reducing the employer-based tax exclusion gradually over a period of 10 years until its value is equal to that of the tax credit.

John C. Goodman shows why this is a good idea by explaining what is wrong with the current employer-based system:

Under the current system employers can spend an unlimited amount on health insurance with pretax dollars. Wages are taxed. Health insurance is not taxed. So the 150 million people who get their health insurance at work can all lower their taxes by receiving more of their compensation in the form of health insurance instead of wages. For someone in the 40% tax bracket, the ability to buy insurance with pre-tax amounts to a 40% federal tax subsidy. Insurance can be worth no more than 61 cents on the dollar and still look attractive to this employee.

No wonder our system is so wasteful.

With a fixed sum tax credit, we subsidize the core insurance that we want everyone to have and leave employees and their employers free to purchase additional insurance with after-tax dollars. When that occurs, they are unlikely to spend an additional dollar on health insurance unless they get a full dollar’s worth of value.

Goodman likes Rubio’s plan so much he concludes, “My only quibble with Sen. Rubio is that he wants to take 10 years to level the playing field between employer and individual purchase. Ten Years? Let’s do it tomorrow.”

Over at National Review Online, James Capretta is less enthused.  While he acknowledges that Rubio’s plan is “fair” in that people with employer-based insurance and individual insurance would get the same tax break, he warns that, “it is more vulnerable to political attack than the Walker approach because it would create some uncertainty about the continued viability of existing employer plans. For that reason, it seems likely that the Walker approach to tax credits would hold up better over time, especially when the inevitable attacks come from Obamacare’s defenders.”

Economically, Goodman is right.  Getting rid of the employer-based tax exclusion would eliminate a huge inefficiency in our health care system, and the sooner we do it, the better our health care system will be.

Yet making the switch quickly would almost certainly create a substantial backlash.  About 169 million people receive their insurance via their employers, and changing the tax system quickly would likely cause many of them to lose their current insurance.  Doing that would make the consumers who lost their insurance in late 2013 look like a day in the park.

I suspect that’s why Rubio chose to do it gradually over ten years.  Yet that still might not be enough to avoid political problems.  As Capretta notes, there would still be a great deal of uncertainty as to whether people could keep their employer-based health insurance.

Nevertheless, it’s good that Rubio is tackling this issue.

FYI: NCPPR has a spreadsheet listing Rubio’s, Scott Walker’s and a host of other conservative/libertarian plans that lays out how each plan tackles important issues such as tax-treatment of health insurance, pre-existing conditions, and Medicaid.  A glossary is provided here for those not familiar with various health-care policy terms.  


In Memoriam: Whitney Ball

WhitneyBallCroppedWWe at the National Center for Public Policy Research were saddened to learn today of the death of Whitney Ball, the founder and CEO of DonorsTrust and an indefatigable fighter for liberty and limited government.

Unlike many, we cannot claim the honor of having been close friends of Whitney’s, but we did work with her many times over the years and can testify firsthand that her work was extremely valuable to many, many important efforts and organizations.

It is often said that many of the most significant contributors to any movement are the people whose names you rarely hear. So it was in the case of Whitney Ball.

Whitney left us too young, at 52, after keeping breast cancer from its victory over her life here on Earth for many years. Her friends say she fought breast cancer with cheerfulness and optimism, and thus she is an inspiration to us not only for her many public contributions, but in the way she conducted her private life as well.

The group she founded, DonorsTrust, has issued a statement and a collection of statements from others who knew her better than we did. Whitney did a great deal in this life to serve our movement, our families, our liberties and our nation. Please take a moment now to visit their “Remembering Whitney Ball” page in her honor.


That's Okay. New Mexico's ObamaCare Exchange Will Be Just Fine with Fewer Insurers

In early June, Mother Jones writer Kevin Drum stated, “don’t pay too much attention to scare stories about gigantic increases in Obamacare premiums next year.”  One reason, he said was that a “few months from now, the real rate increases—the ones approved by state and federal authorities—will begin to trickle out.”

Indeed, that has now happened in New Mexico.  Blue Cross and Blue Shield New Mexico (BCBSNM) had requested an average rate increase of over 50 percent for its exchange policies.  But early last week, the “Office of the Superintendent of Insurance denied the company’s 51.6 percent rate increase request.” 

I suggested, back in June, that such denials were not going to be a common occurrence, and they may still not be.  But, for the sake of argument, let’s say Drum-1, Me-0.

Yet it will likely prove a pyrrhic victory for the left.  As I also noted at the time, 

let’s suppose that state and federal regulators take their machetes to the proposed rate hikes. That won’t be good for the exchanges either. If an insurer needs a 35 percent increase in a policy’s premium to cover costs, and regulators won’t allow the premium to rise more than 20 percent, chances are the insurer will take big losses on that policy again in 2016. If that happens too many times, the insurer will cut its losses and leave the exchange. Fewer insurers means less competition, which will cause premiums to rise even more in the long run.

Here is BCBSNM’s response to the denial of their requested rate increase: “Blue Cross Blue Shield told the Albuquerque Business First they might leave the New Mexico Health Exchange. The insurance company says it isn’t able to offer sustainable rates without increasing premiums.” 

But that’s no problem said Martin Hickey, CEO of the New Mexico Health Connections, another insurer on the New Mexico exchange.  If BCBSNW leaves, “We’ll certainly be ramping up and we’re confident that we’ll be able to take lots of new members,” said Hickey.

Of course, New Mexico Health Connections will eventually have to ask for hefty premium hikes if it receives many of BCBSNM’s sicker customers.  But Hickey probably realizes that won’t be much of a problem, since if BCBSNM leaves, there will only be four insurers on the New Mexico exchange.  Regulators will be loath to risk  reducing that number to three by rejecting a large rate increase request Health Connections.


Danhof's Criticism of Apple's Tim Cook Highlighted by Rush Limbaugh and Fox Business Network

Is Tim Cook failing as the leader of Apple? He certainly seems hypocritical about gay rights when he calls Indiana discriminatory while doing business with Iran. Justin Danhof, director of the Free Enterprise Project, told host Neil Cavuto on the August 5 episode of Fox Business Network’s “Cavuto Coast to Coast” that Tim Cook also does not have the trust factor that Steve Jobs had, and the company’s lack of transparency about projects in development is hurting the business.

Danhof’s exchange with Cavuto was picked up just a few hours later by Rush Limbaugh, who aired a portion of the segment on his show and featured it on his website.


A Word About the Economy: “Stagnant”

Another month has come and gone with not a lot of good economic news for Americans.

Obama and his supporters might cheer at official unemployment figures that are slowly edging toward five percent like they do for other alleged economic progress, but they fail to note things such as low workforce participation and extremely high unemployment among black teens who are being denied valuable training opportunities.

And how about all those people dependent on government assistance?

How can these not indicate an economic crisis?

Project 21 member Derryck Green, who regularly covers the economic stewardship (or lack thereof) on the part of the Obama Administration, uses the word “stagnant.”

To follow is Derryck’s “About Those Job Numbers” report for July:

As has been the case throughout the Obama presidency, the economy hasn’t gotten the attention it deserves. The dangerous mixture of his obvious incompetence and adherence to a strict leftist ideology has made President Obama a destructive national embarrassment on too many issues to keep count.

When the economy does get mentioned, the news is spun tight and fast so the American people won’t get catch on about Obama’s poor economic leadership. 

Don’t expect this month to be any different.

To begin with, the U.S. Department of Commerce released its revised gross domestic product (GDP) numbers for the first quarter of this year as well as its initial GDP estimates for the second quarter.  Initially, the GDP reportedly contracted in the first quarter.  But now, as a result of some probably creative calculations, Commerce officials now claim the economy actually grew at a 0.6 percent rate in the first quarter.

As for the second quarter approximations, Commerce expects the economy grew at a 2.3 percent rate — below the 2.6 percent expectation.

If that weren’t bad enough, Commerce Department officials also said that economic growth between 2012 and 2014 was revised downward 0.3 percent — to two percent growth annually.  That means that, for the past six years, the economy has only grown at a rate of 2.2 percent annually.  That’s the worst six-year economic growth in the past 70 years.

Initial reports on private job creation was underwhelming according to the independent payroll processor ADP, which estimated July’s job creation at an underwhelming 185,000 jobs — far below the 215,000 that were initially predicted.  Adding to that, June’s job creation numbers were revised downward to 229,000 from an original estimate of 237,000.

At the federal Bureau of Labor Statistics (BLS), it was reported that July’s non-farm job creation at 215,000 — right around what analysts expected.

The BLS also said that the unemployment rate held at 5.3 percent, with more than 93 million people not in the workforce.

The alternative U-6 unemployment rate — a more accurate indicator of the nation’s jobless rate because it factors in the underemployed and those discouraged enough that they’ve stopped job-hunting — was 10.4 percent.

The unemployment rate for blacks, which has generally been twice the rate of the national rate, was 9.1 percent.  Black teen unemployment thankfully dropped below 30 again for one of the few times in the Obama presidency to 28.7 percent.

The unemployment rate for women, who’ve also faired poorly in the Obama economy, was 5.3 percent — with 124,000 more women having left the workforce since last month.  Now, more than 56,000,000 women are no longer in the workforce.

The Latino jobless rate was 6.8 percent.

And, last but not least, the labor force participation rate for July is 62.6 percent — once again reaching a 38-year low.

Overall, the poor economic stewardship of Barack Obama and his administration is seen in a flurry of bad financial news:

  • According to the Census Bureau, the second quarter of 2015 saw homeownership rates drop to 63.4 percent — the lowest since 1967.
  • The number of Americans on food stamps is at record levels.  More than 45 million people have been on the Supplemental Nutrition Assistance Program (SNAP) for 48 straight months.  This includes more than 22 million households.
  • According to a report released by the Annie E. Casey Foundation, Barack Obama’s alleged economic “recovery” has now put more children in poverty than the actual recession.  During the recession, roughly 18 percent of American children lived in poverty.  In 2013, that number had risen to 22 percent.  Sadly, black children suffered disproportionately with 39 percent of black kids living in poverty.
  • According to Pew Research data, the lack of full-time jobs is forcing more than 20 million Millenials — adults between the ages of 18-34 — to live with relatives rather than living on their own.
  • Hourly wage growth was essentially stagnant in the second quarter.  It increased only 0.2 percent — an all-time low.

None of this news is good, no matter how the Obama Administration may try to spin it.  Too many people remain unemployed, as evidenced by the BLS’s own numbers — including the Jimmy Carter-era labor force participation rate.

And Obama’s answer to the poor economic situation he created?  Aside from ignoring it?

Obama announced this week he wants to increase economy-killing regulations with the help of the EPA under the guise of cleaning our air.  It’s expected such regulation will significantly increase the costs of household energy bills to the tune of $1 trillion, costing the economy over $2.3 trillion in economic growth.

Obama promised a fundamental transformation of America — and this is exactly what it looks like.  Just not in a good way.


ObamaCare Is a Very Inefficient Way to Deliver Health Care

In late July, the political left celebrated a new study from the Journal of the American Medical Association that purported to show that people are getting better care under ObamaCare.  Johnathan Cohn claimed that the study is “one more reason to think Obamacare is not the fiasco that critics claim it to be.”

Actually, the study gives us quite a few more reasons to think that ObamaCare is very inefficient.

The study, “Changes in Self-reported Insurance Coverage, Access to Care, and Health Under the Affordable Care Act,” used data from a Gallup survey to examine how the ObamaCare exchanges and the Medicaid expansion effected the number of insured, access to a physician, access to medication, ability to afford care, how many people were in fair or poor health, and the percentage of days in the last month a respondent’s activities were limited by poor health.  The study found improvements in all of those categories.  For example, since January 2014, when both exchange policies and the Medicaid expansion went into effect, the number of uninsured has dropped by 7.9 percentage points and those who had no personal physician dropped by 3.5 percentage points.

Success?  Well, depends on how you look at it. John Graham at the Independent Institute had a diferent take. He stated that the study means “56 percent of those who got insurance under Obamacare still lack access to a personal physician.”  (Here’s the math: 1-(3.5/7.9)= .557.)

Here is how ObamaCare fares on all of the measures:

In addition to 56 percent of those who have gained insurance having no personal physician, about 70 percent don’t have easy access to medicine, well over half are still in fair or poor health, and just shy of four in five have not seen a decline in the number of days that poor health have limited their health.  The only measure which ObamaCare apologists might crow about is the “cannot afford care” measure, but that is still over 30 percent. That’s really something, given that over the time period the JAMA study examined the federal government spent about $60 billion on premium subsidies and the Medicaid expansion.

The study also provides further evidence (as if we needed any) that private insurance works better than Medicaid:

There was plenty of evidence prior to ObamaCare that expanding Medicaid might not be such a good idea, but what does evidence matter when there is a society that needs fundamental change?

Indeed, given the way the political left has spun this study, it seems that evidence matters very little at all.


Book: Medicare Harms Patients And Impairs Doctors

Some housekeeping chores I didn’t get to last week.  First, thanks to Richard Eisenberg, who did an interview with me about Medicare’s Victims: How the U.S. Government’s Largest Health Care Program Harms Patients and Impairs Physicians, that appeared at both Forbes and PBS’s Next Avenue.  Here’s a bit from the interview:

And you also say a lack of coordination of care leads to undertreatment for Medicare patients, especially regarding pharmaceutical use and cancer. Tell me about this.

It can get very confusing with medications, doctors appointments and treatments. It helps to have a coordinator. Medicare doesn’t pay for care coordination, so there’s no incentive to coordinate care, except with the Medicare Advantage program. Without coordination of care, there’s a higher rate of hospital readmission.

When Medicare was established, if you were 65 or older, there wasn’t much you could do for some of these medical conditions. No one anticipated you could keep people alive for decades. Medicine has evolved, but Medicare hasn’t adapted.

Next, thanks to Allan Wallace and the Pittsburgh Tribune.  Wallace gave Medicare’s Victims a nice little review on the Tribune’s Review page.  A few days later the Tribune ran an editorial entitled “Medicare @ 50: Sick, getting sicker,”  that included these paragraphs:

David Hogberg, an analyst for the National Center for Public Policy Research, has documented how Medicare rules and regulations harm patients and doctors in his new book, “Medicare’s Victims.” That betrays the original Medicare legislation’s prohibition against federal interference in doctor-patient relationships, he reminds.

Mr. Hogberg calls Medicare “a sick program … that needs to be seriously revamped.” And the longer that unjustified optimism about this big-government mess delays reform, the longer that taxpayers, hospitals, doctors and patients will suffer.

Cool!  And thanks!


Why ‘Medicare-for-All’ Is A Terrible Idea

Yesterday I had another article at The Federalist examining Robert Reich’s push for single-payer health care, a.k.a. “Medicare-for-All.”  This was one of the more enjoyable pieces I’ve written in a while, so here is an excerpt:


And what is Reich’s solution to [rising costs]? As he states at the beginning of the article, “Medicare offers a way to reduce these underlying costs—if Washington would let it.”

I can see it now: You are slapping your forehead, exclaiming, “If Washington would let it! Why didn’t I think of that?!”

Well, Washington won’t let Medicare make such changes because it is filled with groups such as hospital and physician associations that have a vested interest in keeping a cash cow like Medicare largely the way it is. Those vested interests don’t care for the competition that would arise if Medicare started changing what it paid for.

Plus, why Medicare’s lower administrative costs is a silly argument, erroneous health care comparisons, why the sickest people will suffer under such a scheme, and more.