Tag: Medicaid

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litigation Tenth Amendment federalism U.S. Constitution

Planned Parenthood Gets the Boot

medicaid, Planned Parenthood, abortion, federalism, welfare, rights

Medicaid is a huge handout and also a massive burden, straining resources and tax revenues, and (of course) adding to the debt. It is also known for its complexity, a federal program run by the states. 

Some reformers, seeing the program as an over-complicated mess, yearn to “simplify” it by providing medical care as a “free” federal program. Others, concerned about the dangers of centralization and the obvious incompetence of bureaucracies far removed from taxpayers, advise collapsing Medicaid completely back to the states, to be organized and funded locally.

In this context, the Supreme Court’s ruling yesterday allowing South Carolina to remove Planned Parenthood from its Medicaid program is instructive.

“The majority opinion in the 6 – 3 decision in Medina v. Planned Parenthood South Atlantic was written by Justice Neil Gorsuch,” explains Matthew Vadum in The Epoch Times. “The new ruling reverses a federal appeals court decision that blocked South Carolina from excluding Planned Parenthood from the program.”

The key issue in the litigation regards a supposed right to choose medical providers: South Carolina, by dropping Planned Parenthood, was alleged to be abridging the right of recipients to choose their medical providers.

Remember that choosing your doctor was falsely promised by President Barack Obama in his medical insurance scheme — so, obviously, the option is highly valued by Americans. But is it a “right”?

“New rights for some mean new duties for others,” Justice Gorsuch wrote, elucidating a basic principle of legal philosophy. 

Applying the idea of rights to government handouts (in which taxpayers are on the hook) is a recipe for disaster. 

Applying federalism, on the other hand, makes not only constitutional sense, but — because the states are closer to both taxpayers and those in need — Common Sense.

I’m Paul Jacob.

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Illustration created with Krea and Firefly

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Accountability folly free trade & free markets general freedom moral hazard nannyism national politics & policies responsibility too much government

DumpCare

healthcare, Trumpcare, Obamacare, medicine, costs, regulations, Medicaid, single payer

Speaker of the House Paul Ryan insists that his “TrumpCare” plan to replace ObamaCare will decrease medical insurance rates. Others argue that his American Health Care Act will increase those rates. Likewise, he expects it to reduce strain on federal budgets; others deny this outright. The “coverage” issue is just as contentious.

TrumpCare is a mess because it is isn’t “DumpCare.” What’s needed is not yet another regulation-​plus-​subsidy system. We need repeal and then … more repeals.

Unfortunately, President Donald Trump has never really been on board with this. He has promised that no one would lose “coverage,” assuming that “coverage” is “health care.”

It is not. State charity programs like Medicaid (upon which ObamaCare relied way too much) are merely ways to pay for services. Dumping a gimcrack payment system is not the same as decreasing medical services. “DumpCare” wouldn’t dump care, only insane government.

For example, we know that health care outcomes for poor folks without Medicaid turn out to be better than poor folks with Medicaid.* Increasing the number of people on formalized subsidy programs is no panacea.

Besides, ObamaCare severely under-​delivered on “coverage.”

New programs, nevertheless, are traps, regardless of demerit: once you provide a benefit, folks come to rely on it and demand more — objecting when it’s taken away. Which is why few programs are ever repealed, despite failing to meet original expectations.

So far, the “small government party” hasn’t found the courage to actually limit government. Do Republicans really believe what they say, that fewer regulations and subsidies will lead to lower costs and better service?

It seems Republicans won’t take their own prescription.

This is Common Sense. I’m Paul Jacob.

 

* Oregon’s 2008 Medicaid “natural experiment” provides reasons to question the merits of the program. As the initial, randomized, controlled study found, “Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services.…”

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Common Sense

Weekend with Bernie: Sanders’ Eleven

Weekend with Bernie Sanders, http://cognitivebiasparade.prosite.com/, Paul Jacob, James Gill

Bernie Sanders has a horde of helpers. Consider the attached visual meme; “Occupy Democrats” seem to have captured Bernie’s philosophy: spend and meddle.

All of the spending in the first item of Bernie’s 11-​Step Economic Plan are best directed at the state level. Bernie voters should wonder: why haven’t politicians in the states kept up infrastructure?

There are reasons why some of us want to privatize more infrastructure: more responsible upkeep.

Bernie's PlanOh, and why hasn’t the doubled amount spent on public K‑12 schooling in my lifetime led to better schools or better-​educated grads?

Just let that one hang there, and then contrast it with the disaster the feds have made of college costs while trying to “make college more affordable.”

Expanding Medicaid in one plank, and making “healthcare available to all,” in another, I take as repetition for emphasis. But the fact that Bernie’s backers want to expand spending in programs that recently have seen dramatic expansion — Social Security (in the form of radically increased rates of disability retirements), Medicaid (Obamacare), and food stamp participation (SNAP) — even while the programs lurch into insolvency, along with the whole federal budget, sends up a red flag … for irresponsibility.

Then there’s all the fiddling with free employment contracts that they pretend helps the poor, but can’t: unionization, raised wage minimums, and “equal pay” … for, presumably, unequal work, since we already have laws enforcing equal pay for equal work.

Several points are vague enough that, as stated, I could jump on board: I, too, want to reform the tax code and … “close corporate loopholes.” So does, famously this week, Donald Trump.

But what I mean by this and what progressives like Sanders mean? Big differences, I suspect.

This is Common Sense. I’m Paul Jacob.

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Weekend with Bernie Sanders, http://cognitivebiasparade.prosite.com/, Paul Jacob, James Gill

 

Categories
free trade & free markets too much government

Resistance Is Not Futile

Who says signing up for Obamacare is all snarls and snafus?

Thirty-​year-​old law student Brian Mahoney already had a high-​deductible, low-​premium insurance plan. But the day the Obamacare exchanges went online, he decided to check it out. For him, unlike thousands of others, signing up was easy.

Great. Except that … Mahoney had been paying for medical insurance, and now he’s on Medicaid. The website told him he was eligible. Thus, the “success” here is the triumph of making a capable adult less self-​responsible and more dependent on government handouts.

And that’s bad. If we care about our freedom, what we must do is resist appeals, or demands, that we forfeit control over our lives — even if offered a mess of pottage in return. Refuse to cooperate with the bureaucrats and politicians. Not become martyrs, but resist to the extent that we can resist. Even if it’s, well, more than a tad inconvenient. Certainly we should not submit to new chains and crutches eagerly.

A reader at the Hot Air blog reports that when he asked his doctor about “about how our electronic records would be used and protected” under the Obamacare regime, the doctor replied: “We’re not keeping electronic records. We refuse to comply with Obamacare. We’re not switching over.”

Good for you, Doc. We need more like you.

I certainly don’t want my medical records in the hands of government … to name just one of the things having to do with me, my rights and my life that I don’t want government anywhere near.

This is Common Sense. I’m Paul Jacob.