A few thoughts on the prospects to “repeal and replace” Andy Harris (and Obamacare, too)

The other day I noticed on social media that our Congressman, Andy Harris, had put up a post explaining his vote for Trumpcare 2.0, the “repeal and replace” bill for Obamacare. (Most people refer to it as the American Health Care Act, or AHCA.) At the time I saw this there were 1,043 comments on his post and probably 80 to 90 percent of them were negative. I can guarantee you that 80 to 90 percent of his district doesn’t oppose his vote, but thanks to this so-called “Indivisible” movement we are seeing some of the most seriously squeaky wheels get the grease that comes from taking 30 seconds to write the linguistic equivalent of “you suck!” on his wall. So I took about five to ten minutes to write my response, because there was a little research involved.

1,043 comments, mostly from people who probably didn’t vote for Andy in the first place, vowing he’s going to lose in 2018. Y’all need about 139,000 more folks.

In terms of repealing the disaster known as Obamacare, this was the correct vote, We have a long way to go in the process and it’s way too early to say what will happen in the Senate (except that regardless of what it is, Maryland’s Senators will vote no.)

Oh, and by the way, I just checked out that Allison whats-her-name and if she’s praising NARAL she’s not getting too far in this district. Most of us stand for life.

Also, since you are on the subject of town halls up and down the thread, could you get those aforementioned Senators down here to have one? Interesting how I never hear anyone clamoring for that.

I have to admit I was only being semi-flippant when it came to “Allison whats-her-name” because I had closed my window and honestly didn’t feel like looking it up. Her name is actually Allison Galbraith and she makes her living from, of all things, steering companies to government contracts. I kid you not.

But to begin this piece I want to address the two people who replied directly to my comment, whose names are Gail Jankowski and Bill Schwartz. I’m going to quote their opening sentences here, ladies first.

Gail: We will get MORE than enough votes to replace him because more and more constituents are learning just how negatively this AHCA will affect them!

Bill: Maryland is a Blue State and we need to ensure that the first district is fairly represented.

I’m sure Gail and Bill are nice enough people, and in her case she gets bonus points for (at least presumably, judging by the surname) marrying into a Polish family. (By the same token, I won’t take any points from Bill just because his ancestors insisted on unnecessary consonants.) But they seem to have a slim knowledge of political reality.

What the vast majority of people “know” about the AHCA comes from the talking points being fed to them from the media, which isn’t exactly a set of unbiased observers. But the 2018 campaign won’t begin in earnest for another 15 to 16 months, and what I’ve found out over the years, Gail, is that the issue you may think will drive the electorate this far out isn’t always the one that is front and center by the time people really begin to pay attention, let alone when votes are cast. The big difference between the era of the TEA Party eight years ago in the Obama administration and the Indivisible movement now is, while both are having a discussion about health care as a topic in the off-year before the election – although Obamacare was more dominant in the fall and winter of 2009 – the economy was much, much worse back then. If the economy is in good shape come the fall of 2018, the AHCA will be a minor issue by comparison. People generally vote with their pocketbooks, and the reason the 2010 election was such a wave was the pent-up outrage at an administration that addressed health care before job creation and the economy. (The sticker shock effects of Obamacare were the reason for the 2014 wave election, since it took effect in earnest that year.)

So if the economy remains in decent shape, the AHCA will be so minor of a concern by then that Andy Harris will once again get his 60-65% of the vote and cruise to victory. You see, Bill, Maryland is indeed (and unfortunately) such a blue state that our previous governor and the Democrats got greedy – or at least as greedy as their incumbent Democrat Congressmen would allow them to be. I’ve made this point before, but if the composition of the First Congressional District were the same in 2008 as it became in 2012, Andy Harris would be on his fifth term. By erasing the northern half of Carroll County from the previous configuration of the Sixth Congressional District and adding it to the First, it assured whoever the GOP puts up in the First District will win because the plurality of the state’s Republican voters now reside in the First, and it’s by a factor of almost 50% more than any other district. So based on the electorate of the district the First is fairly represented. (The rest of the state? Well, they are just poorly represented, but I’m working on that.)

So now let me turn to another aspect of social media. My friend Sarah Meyers, who describes herself as a proud moderate Democrat (and is a member of our county’s central committee) was distraught about the passage of the American Health Care Act, claiming, “The Republican House just voted to allow insurance companies to deny me healthcare.”

Now I’ll set aside the false conflation of actually having health care provided and paying for it, since there are other methods of doing so out there, but my response essentially noted that she is in the minority of people who are net beneficiaries of the ACA in terms of paying less. Those who get their insurance through their employer are paying far more, a fact that she chalked up to the “greed” of the insurance companies. But the “greed” is tempered by the fact that group insurers have to pay out 80 to 85 percent of their premium income on medical care, leaving the remainder for “administration, marketing, and profit.” Since neither administration nor marketing are free, one can presume these insurers are not rolling in profit. This “medical loss ratio” is part of the ACA and may be one reason why insurers are dropping out of the business.

One of the next arguments I got was that the ACA “saves lives,” presumably because those who could not afford insurance or were no longer being tossed off for the various reasons of pre-existing conditions, lifetime limits, and so forth were being covered. But the evidence of this is anecdotal at best, and rather dubious in the amount of inference that has to be made. It truly depends on the source, but the best scholarly guess is a net wash. Even some of the partisans concede it’s a bogus argument. And while there’s always the emotional appeal of someone who can come out and claim they are a survivor because they had health insurance through Obamacare, it’s pretty difficult to speak with someone who didn’t because Obamacare made their deductible too expensive.

The most radical solution offered up was the old single-payer bromide, from local leftist Chuck Cook:

Single payer is the only solution, and it has been proven to work in every single industrialized first world nation on the planet… except ours. We are the outlier due to conservative ideology that honors the wealth of billionaires over the health of children.

Uh…..no. Honestly, we’re very close to having a single-payer system in place here given the lack of competition in many places and tight regulations on the health insurance industry in terms of how much they can make, what they must cover, and how they conduct their business. Basically it would be a Medicare/Medicaid for All system and you can just ask a doctor (whose Medicare reimbursement increased a whopping 0.24% this year, with Medicaid reimbursement being a fraction thereof) how they like it or check out study outcomes, as the left-leaning Kaiser Family Foundation did recently, noting…

Multiple studies, though not all, have documented improvements in beneficiaries’ self-reported health, reduced stress and anxiety, and improved quality of life following Medicaid expansions. The Oregon Health Insurance Experiment, which used a research design that is considered the gold standard, compared the experience of adults who gained and adults who did not gain Medicaid coverage through a lottery that allocated a limited number of new Medicaid “slots” for low-income uninsured adults in the state. The study found that Medicaid improved self-reported mental health and reduced clinically observed rates of depression by 30% relative to the uninsured group. The findings related to impacts on physical health were mixed. Medicaid increased the detection of diabetes and use of diabetes medication, but did not have a statistically significant effect on control of diabetes, high blood pressure, or high cholesterol. The researchers note that the study did not have sufficient statistical power to detect changes in these measures, and also that factors including missed diagnosis and inappropriate or ineffective treatments, among others, could mitigate the impact of coverage on clinical outcomes.

…to see if this meets your definition of “proven to work.” For me it’s lacking.

I think both sides agree, though, that the problems with the system are defined simply: access and cost. The government’s solution was twofold: one side was to force everyone into the insurance market whether they wanted to be or not (hence, the “shared responsibility payment”) so that the healthy people would balance out the sick and the other side was to try and make preventative care cost nothing out of pocket, but the problem with that is doctors aren’t going to work for free because they have families to feed, too. And thanks to all of the billing and coding concerns we have with modern government medicine, a good percentage of the staff in any doctor’s office is the overhead required to deal with billing and not there for patient care. (It’s akin to the number of administrators in a school system who don’t educate children.) In other words, “free” is the extra $2,000 on your deductible or $40 a week out of your paycheck.

One analogy often used as a comparison to health insurance is auto insurance, which is also mandatory in most states (New Hampshire is the lone holdout.) However, when you buy auto insurance it does not cover oil changes, new tires, and other mechanical issues. Similarly, the original intent of health insurance was to cover the medical bills in case you were hospitalized, as opposed to supplemental insurance like AFLAC which covers other expenses.

The idea of insurance is that of calculating and sharing risk among as many participants as possible. Let’s say you have a group of 1,000 40-year-olds whose lives are all insured for $100,000 and you know four of them will die on the average in a given year. You then know your premium pool will have to be set to $400,000 plus an amount set aside for the off-chance of a year where more than 4 die, plus administrative expenses, plus a little for shareholders. If you assume those other expenses total $300,000, then each participant would pay $700 a year to be insured for $100,000 if they die, which they may find is a prudent and affordable hedge against that risk as they have families to support. It would be impossible for a group of 2 or 10 to be able to do this, but over a thousand people it’s very attainable.

However, what we now have with health insurance isn’t truly insurance because there is so much mandated coverage and the risks are highly unpredictable. Nor are they being shared among all the participants equally because some are paying themselves through their employer, some are being subsidized for their coverage by the government, and others are completely on the government dime. Because a large amount of the money comes from funds never seen by the buyers (deducted from their checks, or just plain subsidized) they don’t much care what treatment costs, just their premiums and deductibles.

So let me return to the car insurance analogy. You have to have car insurance, and it has to be minimum coverage, but after that the market is relatively free and there are a whole lot of competitors. If you get tired of Allstate because they raised your rates 50% for no good reason, there’s always Progressive. When Flo gets too annoying, Jake from State Farm will be happy to help. If you don’t like them, we have local independent agents. They compete on price, coverage, and service – so why can’t that be the case with true health insurance, too? And what I mean by “true health insurance” is that you select what you want to cover from the options provided by the companies, or you can skip it altogether. (Or, the option for employers to provide group coverage can be left in place as well, as I’ll get to in a moment.)

I can already hear the Sarah Meyerses of the world screaming “but pre-existing conditions!” Yes, there can be high-risk pools created for those at the state level, or even groups of states can create a compact to make the pool even larger and share the cost among more people. If states want to create incentives for employers to provide insurance, that’s fair game as well. I happen to think the Tenth Amendment is the part of the Constitution that’s supposed to be most flexible, allowing states to do a large number of things that should be off-limits to the federal government. I may or may not agree with them, but that is their right to do so. There’s very little need for federal involvement in health care at all – certainly nowhere near the amount we have now.

I’m sorry to break this to Chuck Cook, but the United States isn’t like the rest of the “industrialized first world.” We are a constitutional republic where the federal government is intended to be limited, not maximized and in control of everything. (It’s also worth mentioning that the wealth of our billionaires – and the talent of a lot of other, less well-to-do American people – is quite often freely given to assist in promoting the health of people both here in America and around the world. Here’s a great local example.) So the idea that we don’t have single-payer health care is one of those rare things that’s still a feature of ours and not a bug. That’s not to say it can’t stand some serious improvement, though.

Let’s just see if we can’t make it more in conformance with what our great American experiment in liberty is supposed to be all about, mmmmkay?

A look ahead: 2017

Last year I did this in three parts, but to me that may be overkill this time around. Consider that 2017 is not an election year, so if anything we will not see much on that front until the latter stages of the year as the campaigns for 2018′s state elections ramp up. And because all but one of our local officials are first-term representatives in their respective offices, it’s likely they will wish to continue in office. Bear in mind, though, on the Senate side longtime House member Addie Eckardt will be 75 and Jim Mathias (who is in his second term as Senator after one-plus in the House) will be 67 by the time the next election comes around, so they are likely closer to the end of their lengthy political careers than to the beginning. And thanks to Wicomico County voters who passed the referendum this past November, 2017 will be the year we formally set up the elections which will net the county its first fully-elected Board of Education in late 2018.

Speaking of the local BOE, we still have an appointed board until that election and the two members whose terms expire this year are both Democrats who are term-limited. I suspect the local Democrats will try and send up names of people who will run for seats in 2018 to gain that incumbency advantage – as envisioned, though, these will be non-partisan elections. And the final say goes to the state Secretary of Appointments, who over the years hasn’t always been kind to those we preferred, either. Or, conversely, since the incumbents serve until their successors are appointed, we may see a long stalling technique, too. It will be interesting to see how that plays out, but I’ll bet those who are appointed will use that tenure as a springboard for eventual election.

Elsewhere in Wicomico County as 2016 comes to an end, it appears the city of Salisbury and Wicomico County are working out their issues rather well. The biggest sticking point remains fire service, and it’s relatively likely the city is going to see more of a reimbursement from the county when it comes to that – perhaps to the tune of up to $2 million a year. It’s possible there may be something to cut to make up for this, but as the county has increased its debt in the last few years to build several schools it leaves less room for spending cuts to make up the difference. If the city receives $2 million annually that would equate to about a 3 or 4 cent property tax increase for county residents. There’s also the chance that a tax differential or rebate may be on the table in order to reimburse city residents, as they pay the same tax rate as county residents. Wicomico is one of only three counties in the state that choose not to provide a tax differential to their municipalities.

But there is another factor to consider. Back in June the number of people working in Wicomico County set an all-time high of 52,010, eclipsing a mark that had stood for nearly a decade (July 2006.) That record lasted a month, as July came in at 53,668. While the number of jobs has finally reached where we were a decade ago, bear in mind the labor force is about 1,000 larger – so unemployment is in the 5.5% range rather than 4%. Even so, that extra number of people working – a number which year-over-year between 2015 and 2016 has fluctuated quite a bit but usually comes in at 1,000 or more additional workers in 2016 – means there’s more revenue to the county from income taxes so paying the city of Salisbury may not be such a heavy lift. The question for 2017 will be whether these economic conditions continue and whether Wicomico County will want to spend every “extra” dime on items which are unsustainable in rougher economic times.

That same question goes for the state, but the trend there has been for more spending. Democrats in the General Assembly added millions in mandated spending to the state budget and it’s a sure bet they will try again this year. Add to that the general belief that year 3 of a Maryland political cycle sees the most ambitious agenda put forth – it’s time for those incumbents to bring home the bacon and burnish their re-election chances the next year – and you can bet that paid sick leave will pass, Radical Green will have its day (perhaps with a fracking ban, which would devastate Western Maryland), and any Hogan veto will be promptly overridden. It’s certain that they will leave enough time in passing these controversial bills to do so. We’ve already seen battle lines drawn with the counter-proposal from Governor Hogan on paid sick leave and the social media-fueled drive to repeal the “Road Kill Bill” that Democrats passed over Governor Hogan’s veto in the spring of this year.

The wild card in state politics, though, comes from national politics. It’s not because we had the well-publicized answer to an extremely nosy press – if only they paid as much attention to some of Martin O’Malley’s foibles and scandals! – that Larry Hogan wasn’t going to support his (nominally at best) fellow Republican Donald Trump, but the idea that Donald Trump may actually do something to cut the size and scope of government. (Military contractors, particularly, have reason to worry.) And because Maryland’s economy is so dependent on the federal government, to a shocking and sickening degree, we know that if Trump begins to make cuts it will hurt Maryland the most. Given the typical bureaucrat CYA perspective, it explains perfectly why four of the five jurisdictions Trump did worst in - the only five which came in below his 35% statewide total – were the four counties closest to the District of Columbia (MoCo, PG, Charles, and Howard. Baltimore City was the fifth.) While I am entirely a skeptic on this, there seems to be the belief that Trump will take a meat cleaver to the budget and thousands of federal and contract workers will be cast aside because of it.

And in a situation where revenues are already coming up short of forecast, a recession in the state’s biggest jurisdictions, coupled with the mandated spending Democrats keep pushing through, will make it really, really difficult on Larry Hogan going into 2018. You will be able to judge who has the most ambition to be Governor by who carps the longest about these cuts.

While the Dow Jones stalled this week in an effort to breach the 20,000 mark by year’s end, the rise in the markets echoes consumer optimism - even as fourth quarter GDP forecasts turned a little bearish, consumers still feel a little better about the state of our economy. If we can get the 4% GDP growth Donald Trump promised we may see some of these fiscal crises take care of themselves.

Yet there was also a sentiment in 2016 that the world was going mad: consider all the terror attacks, the seemingly unusual number of and extended shock over high-profile celebrity deaths, and a general turning away from that which was considered moral and proper to that which fell under the realm of political correctness, wasn’t a “trigger” and didn’t violate the “safe spaces” of the Millennial “snowflakes.” (I can’t resist linking to this one I wrote for The Patriot Post.) At some point the pendulum swings back the other way, but in most cases that takes a life-changing event like 9/11 or Pearl Harbor. I’d prefer a much softer transition but a transition nonetheless.

As I see it, the key word for 2017 will be leadership: if the current elected officials and new President have it and use it wisely to the benefit of our county, state, and nation “so help me God” things will be okay. If not, well, we’ve seen that movie for about eight or ten years already and we will continue to slouch toward Gomorrah.

State’s rights? Hardly.

Simply put, it’s been a brutal week for those who believe in right in America.

First of all, those of us in Maryland who had been anywhere from pleased to excited that the state elected a Republican governor when it was thought impossible found out Larry Hogan was not superhuman, just flawed and prone to health ailments like the rest of us. We all hope that he can beat back cancer and finish out his term, but the nagging question will surely remain if he chooses to run for re-election in 2018.

But that paled in comparison to having a Supreme Court which can’t read plain language in the law but can elect to reshape the meaning of words to suit a politically correct fancy. Aside from Justices Alito, Scalia, and Thomas, the SCOTUS blew it twice.

Here’s the problem with both instances: in each we had a varying number of states that chose to do their own thing. In the former instance, most of the states elected to go with the federal Obamacare exchange; in theory giving up the premium subsidy that was supposed to be a sweetener of the pot for Obamacare. Most of these had no desire to set up a state exchange, while a few saw the trainwreck that was Obamacare coming. (Just look at all the issues Maryland had in setting up its state exchange as a prime example.) It was a key flaw among many in the law but six Justices decided the intention was there and states without their own exchanges could still take advantage of the federal tax break. I guess it all depends on what the meaning of “is” is.

So now we’ll have Democrats crowing that it’s the law of the land and that we should deal with it. If this is so then I guess all those exemptions built into the law for various groups and businesses should be immediately eliminated, too. (I also wish they felt that way about illegal immigration.) I’m not naive enough to believe that has any chance at occurring, but it seems to me that states should be taking the lead. After all, the first state to have an Obamacare-style insurance mandate was Massachusetts and that was their right.  No one from the federal judiciary stopped them from trying it, but let Arizona try to enforce federal law on border security and immigration and all hell breaks loose.

And then we have the gay “marriage” decision. No court is going to tell me that marriage is anything other than between a man and a woman, period, end of sentence. Granted, some churches accept that particular ceremony and I suppose that’s their right, as far-fetched as that may appear to be. I’m not ashamed to meet my Maker and say that I believe marriage is only between a man and a woman – some may call me a bigot, but they can hang on to any delusion they want.

Yet we went through this in Maryland – the gay lobby tried and failed a couple times to get the same-sex marriage bill through the General Assembly before they conned a couple centrist RINOs into voting for the bill (note they had more than enough Democrats who could have voted for it, but there were some who wouldn’t touch it.) It passed by one or two votes, thousands upon thousands of concerned citizens managed to get it on the ballot via a referendum, and it squeaked by after a President changed his mind and it had the good fortune to be on the ballot in a high-turnout year. (If it was on the ballot this year I suspect the referendum would have gone the other way.) The point is, though, that Maryland made this decision. It was the wrong one, but now in all but one or two cases (Maryland being one, and I think Minnesota the other) the will of the people has been thwarted somewhere by a state or federal court. Either you had a case like California where voters ended the practice only to have it restored by an activist court or you have the SCOTUS decision today that eliminated the preference of the 14 states where same-sex “marriage” was not on the books.

And again I come back to the fact that states don’t seem to have any autonomy anymore when it comes to social issues. Over the last half-century states that had laws against abortion, gay marriage, and various other “blue laws” have had them taken away by societal mores and activist judges. The question is where this all stops. Are states now just lines on a map as Maryland counties seem to be as they are sucked deeper and deeper into the Annapolis-based morass?

The other sad event held over from last week was the Charleston church shooting, which was apparently caused by a Confederate flag. At least this is what you would be led to believe from the coverage. If South Carolina wants to remove it from their statehouse lawn it’s their business – however, if any state is tied in with the War Between the States it would be South Carolina since the battle began there. So being in the Confederacy is part of their history, just as the behind-the-scenes struggle to keep Maryland in the Union is part of ours. Both Maryland and Delaware were slave states.

Yet there’s something else about this whole scenario that I find interesting. The stated purpose of Dylann Roof in opening fire in that church was to begin a race war. In most cases where someone strikes out against oppression, though, it is generally from the side being oppressed – hence, you have groups which range from relatively peaceful like the NAACP  to more radical entities akin to the Black Panthers all working to advance the black race. Roof may have felt intimidated by his perception that whites were getting the short end of the stick, but in the wake of nonstop coverage of Ferguson and Baltimore it’s not a giant leap to come to that conclusion.

But rather than postulate about the typical role reversal and saying what if a black gunman entered a white church, perhaps you should ponder this: whites kill hundreds of blacks a day all over the nation and hardly a word is said. The biggest race war being perpetrated right now is blacks killing themselves, whether through homicide or abortion. Instead of going on a wild goose chase and blaming the flag of a failed insurrection of 150 years ago – during which the slaves that were freed were only those in states which had seceded, not the border states which stayed in the Union – each of us needs to look inward and ask ourselves if this is really the republic we intended to live in.

America has changed while most of us were sleeping. It’s time to wake up.

Making the intentions known

June 15, 2015 · Posted in All politics is local, Business and industry, Campaign 2018, Maryland Politics, Politics · Comments Off 

I don’t think I have ever heard of someone making their intentions known for a local office three years before the filing deadline, but today I received word from 2014 gubernatorial candidate Ron George that he’s running again…for Maryland Senate.

But in a way this move makes sense. Let’s hear what he had to say in a release today:

(George) was drawn out of the district during redistricting after receiving more votes than either Speaker Michael Busch or Senator John Astle. He was in the process of moving closer to his Main Street business when he was approached by former constituents and elected officials who urged him to run.

Mr. George says, “I intend to build on my record of strong constituent service, fiscal responsibility, and constructive solutions to the problems of the district and state. I look forward to bringing fiscal conservative-solution oriented government to the State Senate.”

As for the early start, George said, “I know the district and its citizens well, but I want to knock on every door and hear from each person. The early start will also help in meeting our fundraising goals.”

Fair enough. I’m sure some Republicans were disappointed that they did not oust Senator John Astle from his seat, as Don Quinn lost by fewer than 1,200 votes out of nearly 44,000 cast. It’s a winnable seat, and George correctly noted he outpolled both Astle and Speaker Busch in 2010 as the leading vote-getter in that former configuration of District 30.

This move may also tend to push people out of the Senate race; however, the current District 30 already has two Republican delegates (Herb McMillan in District 30A and Seth Howard in District 30B. It also has Speaker Busch, who actually had fewer votes than McMillan but still finished comfortably in second place.

It also gives George an opportunity to dust off some of his old campaign rhetoric that didn’t play as well with a conservative statewide electorate:

While serving in the General Assembly, Mr. George was nicknamed the Green Elephant for solutions for the environment that did not raise taxes or hurt farmers, watermen, local businesses, or residents along the bay. These solutions included energy net metering and wind energy that supplemented the grid and other energy sources while lowering energy bills.

That tends to play better in Anne Arundel County than on places like the lower Eastern Shore.

So our friends in the Anne Arundel County GOP have one less seat to worry about as far as finding a fairly strong candidate goes. While a lot can happen in three years, it should make for an interesting race should this come to pass.

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