DLGWGTW: October 29, 2017

October 29, 2017 · Posted in Business and industry, Culture and Politics, Don't Let Good Writing Go To Waste, Maryland Politics, National politics, Politics, Senator Watch · Comments Off on DLGWGTW: October 29, 2017 

In the spirit of “don’t let good writing go to waste,” this is a roundup of some of my recent social media comments. I’m one of those people who likes to take my free education to a number of left-leaning social media sites, so my readers may not see this.

This week I’m splitting this feature in half, with one half tonight and the other half on Tuesday night after I stamp my thoughts on the Wicomico Lincoln Day Dinner tomorrow.

Regarding a letter to the Daily Times chastising Andy Harris’s health care votes:

If the writer is a member of “Regressive Maryland” (as I like to call them) it’s doubtful she has ever voted for Harris anyway. So she’ll be disappointed again when Andy gets his 60% or more of the vote in our nicely gerrymandered Republican district.

In a nutshell, instead of encouraging people to be insured by perhaps making the premiums fully deductible or allowing standard, basic policies to be sold nationwide, the government decided to make it mandatory to have insurance. And guess what? If you are forced to be in a market, what do you think the prices will do?

The federal government needs to be out of health insurance – stat.

I have a lot of fun writing responses to the House Minority Whip Steny Hoyer when he gets his inane commentaries up – like this one in the wake of the Las Vegas shooting.

I’ll out myself as a so-called “right winger” (I prefer the term Constitutional, liberty-minded conservative myself) but here’s a pro tip: arguing in ALL CAPS isn’t getting the job done.

The reason Steny’s stayed in office so long is the way his district is gerrymandered to include a large chunk of PG County. That saved his bacon early on and subsequent redistricting (as well as the growth of Charles County as a bedroom suburb of PG County) keep him there. There was once a proposal to split the Eastern Shore up and put the lower half in his district, but I’m sure he wanted no part of that. We don’t think he makes a whole lot of sense.

Now, as for a time to debate gun control: the left-wing malcontents couldn’t even wait for the full accounting of dead and wounded (or all the facts surrounding this incident) until they were screaming about gun control. But what if he had driven a truck into the crowd, or planted a shrapnel bomb? Would you be caterwauling for truck control or nail control?

Simply put, a gun is a tool and its usual job is protecting the bearer. Sometimes it’s used for the wrong purpose, as it was this time. So in my view the discussion shouldn’t be about guns, but about God. What drives a man to violate the basic commandment of “thou shalt not kill” because he has a hatred for a group? Well over 90% of people who own guns have at least the basic understanding of their power and also have the sense to know right from wrong – you know, that whole “thou shalt not kill” thing?

One rumor has it that this assailant was a member of several anti-Trump online groups. I see more vitriol about our current President (a guy I didn’t vote for) than I have about the last two combined. Last time I checked, no one from that evil right wing pulled out an arsenal and tried to mow down Obama supporters in numbers like this guy did – and I’m sure it could have been done 100 or more times.

So how about we debate self-control and leave guns out of it? I can sit and stare at the whole arsenal this guy had all day, but since I would have no intention under any normal circumstance to pick it up there’s no harm done.

Or how about the Avoidable Care Act? I responded to one commenter who threw shade on the idea of selling insurance across state lines as a Republican “panacea”:

You make a fair assessment, but there is one area you’re discounting. At the time the study was done, the federal mandates of Obamacare were already being put into place, so states weren’t going to be terribly innovative about what they did. In order for something like this to work there has to be a minimum of federal regulation as well – the less, the better.

Remember, the concept of Obamacare came about at a state level and I think that is where the solutions lie. Here in Maryland we will likely always be a nanny state, so a company that wants to sell here would have to enact policies that match up to our laws. On the other hand, a state like Texas could be more lenient. Yet if someone could create the most bare-bones policy possible with a robust physician network and a la carte features (like I wouldn’t need maternity coverage but may want more enhanced mental health coverage because this government drives me crazy) they may pick up enough of a risk pool around the country to make insurance affordable. Then it would be up to consumers to demand their states give them more choice by relaxing their regulations.

Yet there could be advantages to even allowing policies to be sold across state lines – people are price-conscious. I live maybe two miles from the Delaware border so if there was a policy available there which had a network that extended here into Salisbury (very possible because we have the largest regional hospital) it would be to my advantage to do so – it’s the same reason you see all the stores that sell furniture and other portable big ticket items clustered just across the line in tax-free Delaware, and the largest Royal Farms chainwide cigarette seller being the store out in the middle of nowhere but literally 50 yards into Virginia and its 30 cent per pack tax (compared to $2 in Maryland) right on a main highway.

I agree selling across state lines isn’t a complete panacea, but it would be a useful tool in the toolbox.

Then after another comment complained about Trump opening the door for the insurance industry, Big Pharma, and doctors to raise rates I set her straight, too.

If the first word of (the writer)’s initial statement had been “Obama” that would have been solid gold truth. When people are forced to buy a product and lobbyists write the regulations, what incentive is there to “bend the cost curve”? Think of how much you pay a month for auto insurance because the state forces you to have it – the only saving grace is that they set comparatively few regulations on policies so there is competition to help give people a bit of a break.

I don’t spare our junior Senator when he plays the class envy card, either:

It seems to me cutting the brackets from 7 to 3 and eliminating a batch of deductions few people take IS simplifying the tax code. But of course any GOP plan is “tax cuts for the wealthy” to you. News flash: they pay the largest share of taxes.

Personally I think the FairTax is the best way to go but that doesn’t allow for nearly as much government modification of behavior.

After someone whined that cuts should be spread in a “more equitable manner” I added:

When you pay the most, you get the most benefit. Let’s get more numbers and throw away the class envy card, as I have.

Later on I added as a status:

Three facts for future reference when responding to Chris Van Hollen, Ben Cardin, Steny Hoyer, Allison Galbraith, etc. Per the Tax Foundation:

The share of income earned by the top 1 percent of taxpayers rose to 20.6 percent in 2014. Their share of federal individual income taxes also rose, to 39.5 percent.

In 2014, the top 50 percent of all taxpayers paid 97.3 percent of all individual income taxes while the bottom 50 percent paid the remaining 2.7 percent.

The top 1 percent paid a greater share of individual income taxes (39.5 percent) than the bottom 90 percent combined (29.1 percent).

So when they talk about “tax cuts for the wealthy” and “not paying their fair share,” well, here are the actual numbers. If you want “Atlas Shrugged” just keep raising tax rates on productive people.

You know, I can see why some of our representatives run out of patience with people. One example at a Michigan townhall meeting was made into a story by the real Faux News, the Shareblue website. So I said my piece:

Gee, were the eight people in the back who were clapping and cheering the question offended? Out of a crowd of what looked like 75 to 80 people you all could muster 10? Pretty sad.

Now instead of picking up the video halfway through like your share did, I watched the whole thing. Walberg answered the question respectfully only to be shouted down near the end because a select few didn’t like the answer.

Did he handle it well? Could have been better, but I’m not as worried about him as I am the mental state of some of those commenting here. And you may want to ask yourself regarding North Korea: who enabled them to get nukes in the first place?

For that I was accused of being an idiot who voted for him. Try again.

Sorry, I don’t live in Michigan (although I grew up close by his district – Tecumseh is maybe a half-hour from Toledo.) But yes, I have my own Congressman nowadays who’s pretty good – it’s the two lame Senators I’m stuck with that are the problems.

But again to my point: who enabled North Korea to get nukes in the first place?

You know, they never answered my question.

Okay, let me wrap up this one with something lighter. We all have opinions on baseball uniforms, so this was mine in response to a poorly written piece that I’d be ashamed to put my name on.

I don’t know which was worse…the writing, editing, or fact she could have picked another dozen as good and definitely some straight-up bad ones…Padres in brown and gold first come to mind on the bad side. On the other hand I actually liked the Seattle Pilots jersey given the style at the time. Better than what the Mariners first wore.

And maybe it’s a product of growing up in the 1970s but I was more impressed when teams actually went to the colored jerseys than when they simply swapped out the road gray for light blue. It didn’t work well for the Cardinals, Twins, Rangers, or Phillies, but a little better for the Brewers, Cubs, Blue Jays (I liked the split-letter font too) and Royals. It was so-so for the Expos and Mariners.

I will say that the Astros rainbow jerseys spawned a couple imitators from local high schools in my area, so someone liked them.

And yes, as a Tigers fan there is no beating the Olde English D as a classic.

True dat. Look for the next installment on Tuesday and I’ll pretty much be caught up.

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?

Some thoughts I have on Trumpcare

I don’t quite think I have to reintroduce myself to all of you, but it truly has been a long time since I sat down and wrote a piece for the consumption of my readers. (Editing Cathy’s last piece and writing two articles for the Patriot Post doesn’t really count for that purpose, nor does updating my Shorebird of the Week Hall of Fame page to add a couple player moves.) Unfortunately, things won’t improve on that front for some time, but the opportunity which presented itself to take my writing time was one I could not pass up.

But in this interregnum, we were given the bill to “repeal and replace” Obamacare, and since we are told President Trump has threatened to find primary opponents for any Republican who opposes it, I think I’m safe in calling this package Trumpcare. It’s still a government entitlement because there was a replace added with the repeal, and that already put a strike against it in my book.

The document I am going to base my initial impressions on will be the “talking point” document put out by the House GOP. To be honest, I really don’t have time at this point to read the original 123-page bill in depth, although I downloaded it for future reference and glanced through it to help with this piece. I look at this website as what the House Republicans are using as their chief selling points to the bill, so presumably this is their vision for federally-sponsored health care going forward. We have lived under Obamacare for about three years (as I recall, the major provisions did not all take effect before 2014, although some were in place shortly after the bill passed in 2010) so we know its effects: sizable increases in insurance premiums, a massive expansion of Medicaid (paid for in large part by Uncle Sam) to ratchet up the number of people with health insurance, subsidies for those who have less than a certain income yet are forced onto or choose to partake in the individual insurance market, the reduction in the number of competing insurance companies in many areas of the nation (some have just one insurer available to them), and the virtual elimination of catastrophic health insurance plans as insufficient for the needs of those insured. There were also a number of regulations and restrictions on insurers put in place, key among them the requirement of children being covered under a parent’s policy through the age of 26 and the elimination of discrimination based on pre-existing conditions.

With this massive incursion into private industry, for the first time the federal government required purchase of a product under penalty of law – those who chose not to buy health insurance were subject to a “shared responsibility payment” collected by the Internal Revenue Service. Imagine if you had to buy a car every four years whether you were happy with the one you had or not, and you may have the idea of how people felt about this. Obviously the economics of it were to make everyone pay a little something, but that’s not the way a free country is supposed to work for something that’s not essential to core functions of government.

Here are some of the provisions within the American Health Care Act (AHCA):

  • It “dismantles” the Obamacare taxes on prescription drugs, over-the-counter medications, health insurance premiums, and medical devices.

Okay, so far so good, although I suppose the definition of “dismantle” is in the eye of the beholder. I glanced through that section of the bill and it looks like this would not take effect immediately but at the end of this year. As a whole, individuals may see a little bit of savings but it won’t be something they will notice.

  • It eliminates the individual and employer mandate penalties.

This is perhaps the best news of all, but there is one huge catch to this: instead of paying this as a tax provision, you would have to pay a penalty to the insurance company in the form of a surcharge on premiums if you start up insurance again after not having it for a period of time. And that catch basically negates the whole benefit of removing the IRS from the equation, although I suppose an insurer could use the waiver of this surcharge as an incentive to bring people in.

  • It maintains the prohibition on charging more or denying insurance based on pre-existing conditions.

I have a big problem with this – not that it wouldn’t necessarily benefit me because I have asthma but because the idea for an insurance company is to make a profit by balancing the risks shared by the vast pool of policyholders with the expenses incurred by reimbursing those insured for loss. If someone is very likely to be a net loss to the insurer because they have a pre-existing condition, it should be the right of the insurer to refuse service. After all, banks don’t lend money at the prime interest rate to people who have poor credit records or no verifiable means of income because that would put their capital at too much risk for the return, so they either refuse the customer outright or charge an interest rate commensurate with the risk. That should be the right of a private insurer, too.

I was reading on social media that Maryland once had a high-risk pool for such patients, which was bankrolled by the state. While it’s not the use of taxpayer money that would be my most favorite, it is a state’s right to do so if they chose and there was nothing wrong with that system because it wasn’t directly competing with the private sector.

  • It keeps the provision of dependents being on their parents’ plan until they are 26.

This is another bad feature of Obamacare that should be buried with the rest of it. If you are 26 you should be able to stand on your own two feet and either be working for someone who offers insurance or be able to afford a plan on your own. (Or choose not to have insurance, which would be your right – although not necessarily recommended.)

  • AHCA also establishes what it calls a Patient and State Stability Fund.

Over the next nine years, the federal government will give out $100 billion to the states to assist them with their goals of insuring every citizen. I read quickly through this section and there are some provisions that give me heartburn: there are strings attached to the expenditure of the money and the states are required to come up with a larger and larger portion of matching funds for whatever they use the money for, up to 50 percent by the end of the program in 2026 – assuming, of course, this doesn’t become a more perpetual giveaway (which I’m convinced it will.) There is $15 billion allocated to this over the next two years and $10 billion per year after that, and I’m sure states will say this isn’t enough because they like that financial crack of Uncle Sugar’s money.

  • Modernize and strengthen Medicare by transitioning to a “per-capita allotment.”

The legalese on this one is beyond my scope of comprehension, but to me the idea of modernizing Medicare would be that of sunsetting it, not strengthening it.

  • Enhance and expand Health Savings Accounts.

One of the better features, although it would be even better with the free transfer of money between HSAs and other entities such as an IRA or 401 (k). If you needed more money in a particular year you should be able to move it without penalty.

  • A monthly tax credit for those who can’t afford insurance, up to $14,000 per year.

A subsidy under a different name. Basically they are replacing one tax scheme with another, still targeted to particular people.

All in all, I think the repeal should take place without the replace. It seems to me that we had a whole political movement and a bumper crop of angst spring up over the last eight years because people did not want any part of the government interference in their health care that Obamacare brought to us. Over that time, we lived with the disappointment of Republican excuses: “we’re only one half of one third of government,” “we have the House and Senate but the President won’t sign this,” “we can’t defund because there would be a government shutdown,” and so forth. After 2016, there was a Congress and President who campaigned on repeal, and yet you give us this?!?

A better alternative may be the plan presented by Senator Rand Paul, although it’s not perfect either. But it’s better than the GOP alternative, which is a great letdown for those of us who waited for the moment to eliminate the (not so) Affordable Care Act.

The replacement

For whatever reason, these days I get a lot more e-mail from the Democratic Party than I do the Republicans. (Perhaps the GOP stuff ends up in my junk mail somehow?) A lot of the time the Democrats’ stuff is comedy gold, although they are getting more than enough mileage out of vilifying the already easy to vilify Donald Trump.

Now I’m going to do something I try not to do here, and that is accept their word as gospel for the sake of argument. Lord only knows what kind of Astroturf George Soros, Peter Lewis, and other big-money far-left donors can gin up for rent-a-mobs, but as I said this can suffice as their case. This is an excerpt from an e-mail I got today.

Republicans are frantically trying to dodge their constituents who want answers about what’s going to happen to their health care.

Virginia Congressman Dave Brat recently complained that “since Obamacare and these issues have come up, the women are in my grill no matter where I go.” Another Virginia Republican, Congresswoman Barbara Comstock, skipped out on “office hours” with her constituents after dozens showed up to ask about her Obamacare replacement plan.

When Arkansans showed up at Senator Tom Cotton’s office to ask about their health care, staffers locked the door and turned them away. Sixteen constituents showed up at Congressman Peter Roskam’s office in West Chicago to voice their concerns about repealing the Affordable Care Act and were told their meeting had been abruptly canceled. Congressman Mike Coffman from Colorado was caught on camera sneaking out of a constituent event through a side door to avoid his constituents’ questions about health care.

After more than 200 people submitted questions for a Facebook town hall with Sen. Thom Tillis, the senator logged off 11 minutes into the 30-minute event.

The Affordable Care Act is more popular than ever. Millions of Americans are reaping the benefits of access to affordable care — and 30 million stand to lose their health care if the law is repealed.

Again, this all may be “fake news” but here’s something that’s not fake: those who don’t want Obamacare repealed are probably the few profiting off of it at the expense of the many, which constitutes a great deal of working America. Since the RCP average has tracked the question in 2009, there has never been a majority in favor of Obamacare. To say it’s “more popular than ever” is true to the extent that it’s less of a dog than it has been.

And the other “fake news” is that oft-repeated claim that Americans will lose their health care if the Affordable Care Act is repealed, and that’s not so. It’s federal law that emergency care has to be provided regardless of ability to pay. Nor is this considering how many people have decided to take their chances with the tax penalty since it would be less expensive than health insurance.

So this is a message to Republicans who are getting cold feet about repealing Obamacare: find yourself a fire and warm them up – let’s do this thing. The Democrats are so full of crap their eyes are brown: America wants Obamacare to be gone!

Yet there is the question of cost, because medical expenses are, well, expensive. I have a theory on that, though, and it relates to a similar phenomenon in another aspect of life.

Look at the cost of college tuition as an example. To some, the cachet of a degree at a prestigious university is irresistible, and they will pay whatever it takes to get it. Some people who are more academically suited to a state university still demand to go to an Ivy League school, and those schools know this. They also know that a) these students will likely go many thousands in dollars in debt, and b) they get paid up front by the federal government. Whether the student pays back his or her loans or not is immaterial to them because they got their money, and because of that these schools are padding their tuition and fees because they can. Maybe it’s to increase their endowments, but oftentimes it’s to provide non-educational amenities.

Let me share a story with you. I went to college from 1982-86 at Miami University in Oxford, Ohio. It was selected because it had the program I sought to major in and was in-state so my tuition was lower – although higher than most others, as it had the reputation of being the best state school in Ohio academically. (So there was a little bit of cachet factor, too.) Very nice campus, relatively solid education. I would have been happy to see my older daughter go there, but she had other plans.

My wife at the time was a non-traditional student who had gone to another school before having the older daughter in question (I’m her stepdad.) So, after we married, she enrolled at the University of Toledo, which is more of a commuter school. Yet one thing they had was a state-of-the-art recreation center, paid for by the state since UT is a state school, too. I got to enjoy the facilities on occasion since my ex was a student, and they were nice. Soon enough, all of the other state schools were getting in line to have similar facilities put up and sometime in the 1990s, well after I graduated, Miami got theirs. While it may have been beneficial for the small percentage of those who majored in physical education, the real reason these were put up was so each of these state universities would have something to attract students. More students = more tuition and fees = job security for the thousands of university employees. And as I said: they got their money up front, never mind the students were saddled with debt for a decade or more. (As I recall, I didn’t finally pay my student loans off until 2001 or so.)

Now look at the medical field. Obamacare placed it in a similar position to that of state universities because it was flush with federal cash – as originally envisioned, people would either have their medical care paid for directly by the federal government (Medicaid) or they would give insurance companies a captive audience with relatively few choices via the exchanges. Insurance companies, in turn, were supposed to have “risk corridors” and other accounting tricks and bailouts to make them whole – the only people who would be left holding the bag would be the ones who actually paid for the insurance, and many of them on the individual market received subsidies from Uncle Sam, too as well. No wonder it cost a trillion dollars a year.

The weakness of the Obamacare system is that there’s no real incentive to cut costs. Yet there are two groups of beneficiaries who stand to lose the most if the ACA is repealed: those who are getting the subsidies or “free” insurance from the government and those providers who have been able to just keep raising prices because there’s a massive pot of money they want to get their paws into. Therein lies the rub: Obamacare is now in a place where it cannot be just cut cold turkey – there has to be a year or two transition period, and of course that gets into election time.

It’s worth reminding readers that Obamacare has its roots in what some dubbed Romneycare: the insurance mandate Massachusetts put into place several years before. To be quite honest, that is where the solution lies. Perhaps it would be appropriate to block-grant funding to states for a interim period of up to three years and allow them to tailor their own programs and set up funding mechanisms. States can choose to have all the bells and whistles or they can choose to invest their resources elsewhere, and that’s the way it should be. I think this would take care of most (but not all) of those who are getting the largest benefits. The others can vote with their feet if they so choose: government is not supposed to be all things to all people.

On the cost side, I think any and all federal insurance coverage mandates should be scrapped, allowing states to set their own systems and priorities. Now it can be argued that having 50 different systems would be difficult for a health insurance provider to navigate, but auto insurers already do this. There are advocacy groups out there that suggest how states can streamline the process by being similar to other states, so I suspect most states will have health insurance requirements that are fairly similar. Maryland may have the extreme in required coverage on one end while Texas may be the flip side. Because of this, I’m not sure selling insurance across state lines is necessarily doable in the respect that I can’t buy a Texas policy living in Maryland. But states should be encouraged to allow insurance products that reflect everything from the catastrophic coverage health insurance was originally to the Cadillac plans that pay for everything, even your hangnail or gender reassignment surgery.

So, the replacement for Obamacare is a more free market and freedom of choice to participate. Sorry, Democrats, but Obamacare has to go to help make America a healthy nation again. If Andy Harris has a townhall, hopefully he will stand his ground and make the case for repeal.

Is it any wonder people feel like they are barely treading water?

This week is the week many of us get our bad news. Yes, health insurance premiums are going up again.

While I haven’t been at my new job long enough to really compare rates and coverage, we were informed ours was increasing by an unspecified percentage – I think it’s in the 5 to 10 percent range if my memory of the old rates serves. Meanwhile, my fiance’s employer is seeing increases of between 10 and 13 percent, depending on plan.

Knowing that, I pulled out a calculator and did some quick number-crunching. Based on a 10 percent increase and her rates for a family plan, I deduced the annual deduction would increase by over $1,100.

Now stop and think for a minute. In these days of tight belts but comparatively low inflation otherwise, the average wage-earner gets an increase of 3% this year. Let’s say you are a median wage-earner in this region, which is just under $40,000 – I’ll make it 40 large for easy figuring. If you figure that 3 percent raise is $1,200, it means almost all of that raise was swallowed by your insurance increase. So much for that vaunted $2,500 annual premium decrease.

And so much for your family vacation, putting aside money for college, and those nice little extras. Add in the increasing deductibles and co-pays and it seems like you got no raise at all – in fact, you may wonder how you will make it through a month when everything seems to be increasing by 3% a month. (Granted, we are catching a break with gas prices edging back down – a $1 decrease per gallon is like a tax-free $400 to $600 annual raise.)

Now I don’t blame the insurance companies because they have to keep themselves in business at a time when there are more and more mandates placed on them. (For example, I’m sure a few pennies of that increase go to covering in-vitro fertilization for same-sex couples, which this month became yet another mandate under state law.)

So if you’re wondering why you can’t seem to get ahead, this little bit of basic math may be an explanation.

Redefining marriage wasn’t enough. Now some in Maryland want to redefine birth.

By Cathy Keim and Michael Swartz

The twin byline is present because Cathy came to me with her thoughts on these bills, writing up a post quoting Delegate Parrott at some length along with some of her thoughts. I liked the direction of the piece, but thought I could add more and she was amenable to the changes. So here you go.

Recently Delegate Neil Parrott sent out a newsletter that had some information about two “shockingly bad bills” that are about to pass in the General Assembly. We had both heard from Robert Broadus with Protect Marriage Maryland about the first bill, but Delegate Parrott alerted us both to the second bill. Both have more or less passed under the radar in a session which has focused more on the budget, gubernatorial appointments, and environmental regulations.

In his message to constituents and other interested observers, Delegate Parrott stated:

Two shockingly-bad bills…are on their way to passing.

(snip)

HB 838/SB 416 is going to cause your health insurance rates to go up, when Maryland already has some of the highest health insurance premiums in the nation. This bill forces Maryland insurance companies to cover the cost of expensive In-Vitro Fertilization (IVF) treatments ($12,500 each time) for same-sex married couples.

Our high insurance costs in Maryland are primarily due to the great number of insurance mandate laws already in effect, and this new bill will simply make the problem worse. Governor Hogan and I both support leading Maryland towards more fiscally-responsible laws and policies, and the voters overwhelmingly agreed in the last election. However, the majority of Delegates and Senators still voted to create more complex and unnecessary insurance mandates in our flawed health system.

(snip)

Under current Maryland law, a husband and wife must donate their own sperm and egg to be eligible to receive insurance benefits for IVF treatments. If the couple requires a donation of an egg or sperm, IVF treatments would not be covered under current Maryland law. Under this new law, a same-sex couple would obviously need to get a sperm donor to have a child. This is a very unequal situation.

Same-sex couples have been allowed to adopt or have children, but many studies have been done that confirm that children born into a family with a mother and a father do the best in all measures – economic, social, educational, and emotional. Not only does this law create an unequal and less-stringent requirement for same-sex couples, but our insurance premiums will also be paying to have a child brought into the world to a situation where they will most likely be statistically worse off than other children. By passing this law, we are intentionally putting a child into a “family” where a father will knowingly be absent.

This sort of social engineering and fiscally-irresponsible law-making, solely for the pleasure of adults without any regard for the children that will grow up in these situations, is reprehensible. What homosexuals cannot do naturally, the General Assembly has now mandated must be provided by all insurance plans, creating a false sense of equality, with little to no regard for the children who will be negatively affected.

This leads to the concern of what could come next if this bill is passed. Will the General Assembly pass a mandate requiring insurance companies to cover the costs of hiring a surrogate to carry the child for male, same-sex marriages? (Emphasis in original.)

As Cathy wrote Sunday, our culture is under attack to redefine and destroy every institution that has sustained us as a nation since our founding. Marriage and our families are worth defending. The progressives only exist to tear down. We are the ones that believe in ideals that are true and good and have stood the test of time. When this country is a faint memory, the family will still exist. They may destroy our culture, but they cannot destroy truth. The family is the basic building block of society. Despite the malice and ridicule heaped upon the traditional family with a father, mother and children living and growing together in love, the family will still survive.

Delegate Parrott has made the case, as Cathy has before, that children do best when raised in a home with a married mother and father. Why should the state pay to circumvent this?

Senator Jim Mathias and Delegate Sheree Sample-Hughes both voted for this bill. When somebody says the Eastern Shore is conservative, just remember to check how Senator Mathias and Delegate Sample-Hughes vote.

The second bill that Delegate Parrott wrote about was HB862/SB743, which as Delegate Parrott notes:

…allows people to rewrite history. It would allow someone who gets a note from their doctor saying they are transitioning from male to female or from female to male to literally change the gender on their birth certificate. The new birth certificate would not even indicate that it has been “Amended,” as is the case when an individual decides to legally change their name. The change would not require that the individual has had a sex-change operation, but just relies on hormone therapy and how the person feels at the time. The change caused many of the legislators who work in law enforcement to question how they could even solve crimes given these false records. For example, suppose they are looking for the DNA of a male, but all they have is a female suspect.

Changing factual birth records without leaving a record of the change could have significant and harmful consequences for our society and is simply irresponsible policy.

Senator Mathias also voted for this bill as did Delegates Carl Anderton, Jr. and Sample-Hughes. Needless to say, we’re both disappointed with Delegate Anderton’s vote as he represents us in Annapolis. We would have expected this out of his predecessor, but Carl was supposed to be different.

At this point in time these bills are on their final step to passage, and it seems like the skids are being greased as the House versions of the Senate bills are passing without any amendments – this is important because no conference would be necessary.

Yet besides the many objections Delegate Parrott raised, both bills also raise a number of ethical questions about child rearing. Regardless of who has to pay for in vitro fertilization, there’s also the ongoing concern about the rights of the third party which needs to be involved with any same-sex attempt at creating progeny – either the surrogate mother for a gay couple or the sperm donor for the lesbian pair.

And much like the Hobby Lobby situation with abortifacient drugs, there’s a legitimate question of whether a religiously conscientious business should be forced to cover this procedure since it involves two partners of the same gender. It’s a situation which becomes quite complicated and I feel this is needlessly so.

As for the birth certificate bill, it would be more palatable if there was a notation of amendment. A law such as this may open the door to parents who are trying to raise a child as if it were the opposite gender (such as this recent case) to amend his or her birth certificate as a minor.

We believe that gender is not a mistake, nor was it an error that a person of each gender was required to create a new life. Even with in vitro fertilization, there’s no escaping the need for a male to do his part and a female to be the willing host for the embryo.

While there is an element of humanity in the selection of gender, I think I speak for Cathy when I say we believe that it was our Creator who made the ultimate decision as to whether we were male or female. Taking hormones, undergoing genital mutilation surgery, and identifying as someone of the opposite gender doesn’t change the fact one was born with the chromosomes and genitalia of a particular gender in all but a few extremely rare cases. It’s what the birth certificate should reflect.

However, it’s likely these bills will pass the General Assembly, so we call on Governor Hogan to use his veto pen on these ill-considered measures. And it’s all but certain these votes will be among those I use for the monoblogue Accountability Project later this spring.

Too clever by half?

It’s unfortunate the press conference wasn’t a couple weeks earlier, because the announcement had all the makings of a great April Fool’s joke. Unfortunately, the joke has been on Maryland taxpayers so earlier today Congressional candidate Dan Bongino and gubernatorial candidates David Craig and Ron George made their endorsement of Anthony Brown for governor of the Nutmeg State, Connecticut.

Having it on April Fool’s Day may have helped with media coverage, though. The main rags of the Baltimore Sun and Washington Post didn’t give the rally any coverage aside (at least not yet) with the only mention a three-day old piece in the Sun.

Be that as it may, I get the point that the tongues were firmly in cheek this morning. Then again, people like me only represent maybe one percent of the electorate and aside from perhaps a slight thought about the monetary aspect of the money blown on the initial iteration of the Maryland Health Connection website, those who have maintained their health insurance throughout may just shrug their shoulders. We’re all used to government boondoggles. The joke may be lost on them.

In an effort to make news out of this, Ron George put out a release noting “Ron George joins Dan Bongino to Endorse Brown/Ulman for Connecticut.” The first paragraph packs most of the punch:

When Obamacare was rammed through a partisan Democratic Congress, no one was happier than Maryland Lieutenant Governor Anthony Brown. He leapt at the opportunity to get out from behind his boss’ shadow and prove why he was the most capable candidate for the next Governor of Maryland. Two years and $260 million taxpayer dollars later, Anthony Brown is dodging any and all responsibility for the failed Maryland Health Exchange and is part of an administration that is actively covering up this massive scandal. Anthony Brown’s solution to the mess he created is simply to spend hundreds of millions more in taxpayer dollars to adopt the “Connecticut” model of government-run health insurance.

Naturally, Ron didn’t mention David Craig, who was also there – as shown on his Facebook page.

Jeannie Haddaway, David Craig, and Ron George attend a rally endorsing Anthony Brown for governor of Connecticut, April 14, 2014. Photo from Craig campaign.

Honestly, I’m not sure this is more than a blip on the radar. But as time goes on, the question which really should be asked is whether the Connecticut system, which was designed for a state roughly half Maryland’s size, will fit out of the box. More importantly, where will the extra millions needed to make this work come from? We’re already a long way in the hole just to buy the original pig in the poke, so what will give? Will it be insurance rates, reimbursements to providers, or the old standby of sticking it to future generations by raiding other funds and bonding to backfill the hole?

It’s almost too bad Doug Gansler didn’t stop by to make it a bipartisan backing of Brown for governor of Connecticut. Instead, he’s choosing to spend a little money on a simple website which asks the question “did Anthony Brown come clean today?’ (It’s also handy for gathering contact information via the attached “petition.”)

If we really wanted to improve the prospects for those who rely on health insurance coverage in Maryland, how about talking about measures which could open the market up more? After all, Barack Obama allowed some to keep their “substandard” plan that they liked, so what are the standards now? Make everything available, from bare-bones catastrophic coverage on the one side to something that pays for two hangnails a month among the other elements of a “Cadillac plan” on the other, and the market will find its level. I’ll bet it doesn’t waste millions of our tax dollars, either.

Update: Added David Craig:

Today’s announcement was an opportunity to highlight the failed policies of the last seven years and Anthony Brown’s inability to successfully lead Maryland’s healthcare exchange.

Jeannie and I believe the best solution to this disaster is for Anthony Brown to resign like Kathleen Sebelius, the former HHS Secretary.

Ceding the field

August 6, 2013 · Posted in Business and industry, Delmarva items, Maryland Politics, National politics, Politics · Comments Off on Ceding the field 

I can’t really say I predicted this, since I more or less just added a quick dose of my opinion to a post the other night by stating the obvious: “rates will either have to increase, or insurers will cede the field. Neither is a good choice, but that’s where we are going.”

But reports yesterday stated that Aetna, a leading Maryland health insurer, is indeed pulling out as it was denied the rate increase needed to stay profitable in Maryland given the uncertainty of the state’s insurance situation. While those who hold policies through Aetna may be able to continue on, a significant portion will have to shop in the newly-created state exchange at a time when rates are much more expensive – up to 83 percent, according to a release put out by gubernatorial hopeful David Craig:

Craig announced today that Marylanders can expect a dramatic increase in health care insurance premiums under Obamacare, calling it a “massive new tax.” Maryland’s least expensive Obamacare plan will be 83% higher than the lowest-cost plan sold in the state this year. The analysis comes from a Government Accountability Office report that compares rates this year to what the Maryland Insurance Administration announced they will be under the new state exchange scheduled to launch October 1.

The state’s insurance agency locked down rates with private carriers last month and the new exchange for individuals is marketed as the “Maryland Health Connection.”

“What we have here is Maryland’s health disconnection,” said Craig. “This entire contraption will fall apart unless untold thousands of healthy people inexplicably decide to go online and buy expensive insurance instead of making a car payment. Private insurance carriers are not participating and not enough healthy, working people will either, and this is not going to work.”

Craig also commented on the Aetna situation.

It is deeply troubling that Maryland has yet again soured relations with major employers and job creators. Another company acquires one of Maryland’s last remaining Fortune 500 companies and takes their business elsewhere because regulators tell them what to charge. This irony is lost only on the one-party political machine in Annapolis.

Fellow gubernatorial candidate Ron George also weighed in:

This insurance exchange is already resulting in expensive rate increases for cash-strapped Maryland families. Maryland currently has one of the lowest discretionary income rates in the country, and this exchange will take more money away from your family vacation, school funds and holidays.

Noting that the exchange, which is supposed to increase competition, is comprised of just seven companies owned by only four separate entities, George went on:

This is a classic example of the Democratic machine in Annapolis picking winners and losers based on political relationships instead of free market realities. Additionally, the higher costs to businesses will lead to less job creation. Also, many physicians are now considering earlier retirement.

Perhaps the biggest problem with the exchanges is the broad coverage they have to provide. Marc Kilmer of the Maryland Public Policy Institute illustrates this well in a recent Baltimore Sun op-ed, pointing out that:

To be fair, the lowest-cost plans for sale today are not the same as the lowest-cost plans that will be sold in the exchange. The exchange plans will be much more comprehensive. Many of the cheapest health insurance plans available for sale in the individual market today have high deductibles and may not cover as many situations as do the other plans. But that’s not a bad thing — it gives Marylanders choices in prices and in how much risk they’re willing to carry themselves or put on the insurer. For most Marylanders, the cheaper plans are excellent choices, but for some Marylanders they’re not.

Currently, you can also buy both the cheap plans and the comprehensive plans in the individual market. But you won’t have the choice to buy high-deductible, low-cost plans in the exchange. You have to buy a plan that is designed by bureaucrats and politicians in Washington and Annapolis.

These plans basically come as a one-size-fits-all, take it or leave it proposition with a limited variety of choices – remember, there are only seven approved players in the game, and just four if you consider just the separate entities. Vanilla, chocolate, strawberry, and butter pecan might be great for most, but if you prefer cookie dough like I do you’re out of luck.

And what happens when the exchanges only have six insurers? Or three? Unless new entries can figure out a way to make a profit, they’re not going to get into the game. Perhaps they can build wind turbines on the side to gain the state’s favor?

The point is our system was flawed, but the solution is equally (if not more) flawed because of the heavy hand of government. Why not come up with some true free-market solutions – for one, allowing insurance to be sold across state lines so we can buy a policy out of a state with fewer mandates – and let the market dictate its direction? Not in Martin O’Malley’s and Anthony Brown’s Maryland.

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