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?

Earning my presidential vote: entitlements

Social Security was once considered the “third rail” of American politics: touch it and you die. But I would contend that we have added Medicare, Medicaid, and perhaps Obamacare to that description. Republicans talked tough about repealing Obamacare through defunding it, but chickened out when the threat of being blamed for a government shutdown became the price to pay. But knowing the toll these programs take on our budget and idea of limiting government, I only need one bullet point for this one.

  • The next president should set in motion the eventual sunsetting of Social Security, Medicare, Medicaid, and Obamacare. If states are dumb enough to try this stuff, that’s their problem. But “promote the general Welfare” did not mean cradle-to-grave dependence on the federal government for support.

To re-introduce the candidates, we begin with Darrell Castle of the Constitution Party, then it’s Jim Hedges of the Prohibition Party, Tom Hoefling of America’s Party, Gary Johnson of the Libertarian Party, and independent Evan McMullin. Johnson is on the Maryland ballot; the rest are write-ins but their votes will count. And if you want to start this series from the beginning (this is the ninth part) you can go here and I link to each succeeding part in turn. At stake is thirteen points, which is the second-highest individual total.

Castle: Would repeal Obamacare and replace it with a “free market solution.”

Poor would be best helped on a voluntary basis. No provision for it in Constitution – money is not ours to give. (“Iron Sharpens Iron” radio show)

Hedges: “A financial foundation must be provided to those who cannot work.” There must be affordable housing, basic medical care, and convenient public transportation for all.

“We advocate an actuarially sound federal Social Security System.” (party platform)

Health care should be a state-level concern, but will address “inefficiency” from insurance company overhead and profits. (party platform)

Hoefling: All of the “entitlements” you list are unconstitutional. James Madison, the father of the U.S. Constitution: “I cannot undertake to lay my finger on that article of the Constitution which granted a right to Congress of expending, on objects of benevolence, the money of their constituents.”

We have a moral obligation to care for our older folks, and any who cannot care for themselves. But it is immoral to usurp power, and to rob our children and grandchildren in order to keep the socialist Ponzi scheme going.

We survived and thrived for 300 years in this country without socialism, by acting as Christians. We’re going to have to learn to do that again, one way or another. Because, within the space of the next eight or nine years, we’re going to see our government go completely insolvent trying to pay for “entitlements” and interest on the debt. In fact, the Congressional Budget Office has said that by 2025 the ENTIRE budget will have to go to those two things, with nothing left over for anything else. That is bankruptcy, on a Biblical scale. (response to question on Facebook)

Johnson: Johnson has personally endorsed privatizing Social Security, too — an idea favored by some Republicans (but not Donald Trump). This arrangement would let Americans self-direct their Social Security retirement funds through personal investment accounts, allowing them to buy stocks, for instance.

Johnson also favors raising Social Security’s Full Retirement Age from the current maximum of 67 to either 70 or 72. “Look, it’s [the Social Security Trust Fund] insolvent in the future. It’s going to be insolvent. It has to be addressed,” he told The Washington Examiner in July. Whether Americans could afford to hold off claiming until 70 or 72 to receive full benefits, however, is a real question, considering the majority of beneficiaries today start taking their Social Security money at the earliest age they can, age 62.

And Johnson would like to see Social Security begin “means testing that’s very fair.” Translation: The amount people receive in Social Security retirement benefits would be based on their financial well-being at the time they apply. Today, your benefit is based purely on your previous earnings.

Johnson would repeal Obamacare “in a heartbeat” if given the opportunity, he has said. “If the GOP bill lowers costs and improves care, I’ll sign it,” Johnson proclaimed in a CNN Libertarian Town Hall in June. On Joe Rogan’s podcast in May, Johnson blamed Obamacare for his health insurance premiums quadrupling “and I have not seen a doctor in three years,” he added. “I wish I didn’t have to have health insurance to cover myself for ongoing medical need.”

He wouldn’t have to under his main health care proposal.

Johnson would like to get rid of health insurance as we know it. Instead, Americans would buy health insurance only for catastrophic events and illness.

He believes a free-market system would lead to more affordable health care with price transparency and open competition. This system, Johnson told Rogan, “would probably cost about one-fifth of what it currently costs. We would have Gallbladders ‘R’ Us. We’d have gallbladder surgery for thousands of dollars as opposed to tens of thousands of dollars. We’d have Stitches ‘R’ Us, we’d have X-Rays ‘R’ Us. We’d have the radiologists next to X-Rays ‘R’ Us to read those X-rays.”

As for Medicare, Johnson told 60 Minutes correspondent Steve Kroft, “We’re not looking to eliminate Medicare. We do believe in a safety net.” But, he said to The Washington Examiner, “Medicaid and Medicare both need to be devolved to the states.” Johnson has referred to those programs as “the worst runaway expenditure in the federal government today.”

When he was governor, Johnson has said, “I oversaw the reform of Medicaid in New Mexico. Changed it from a fee-for-service model to a managed care model. Improved on the delivery of health care in New Mexico and saved hundreds of millions of dollars.” Johnson has maintained that if the federal government had given New Mexico 43% less money for Medicaid and put him in charge of the delivery of health care to the poor there without “all the strings and mandates that went along with their Medicaid money,” he could have done it.

As president, Johnson has said, he’d balance the federal budget partly by letting states restrict eligibility for Medicaid. (excerpts from Forbes article by Richard Eisenberg)

McMullin: Obamacare has failed American families, driving up costs and reducing access to quality healthcare. With costs running into the trillions, Obamacare is also sinking America further into debt while imposing hundreds of billions of dollars of new taxes. By emphasizing competition and innovation instead of government controls, we can build a modern health care system that delivers accessible, affordable, and high-quality care. We can also protect vulnerable populations, including patients with preexisting conditions. Real healthcare reform means putting patients, families, and doctors first.

Obamacare has proven incapable of controlling the growth of healthcare costs, which take an increasing cut out of workers’ paychecks or even force them to give up insurance. Major insurers are pulling out of Obamacare exchanges because the program is so poorly designed and so full of complex regulations that the insurance companies are losing money despite vast federal subsidies. The cost of those subsidies will be $1.2 trillion over the next 10 years, or an average of $120 billion per year. The program will also impose more than $200 billion in penalties on workers and employers – and still 33 million Americans won’t have health insurance.

We must repeal Obamacare as soon as possible, replacing it with a more streamlined, pro-market approach to insurance. The few positive elements of Obamacare, such as guaranteed coverage for pre-existing conditions, could easily be incorporated into a new program in a much more efficient manner.

The heart of any Obamacare replacement should be a tax credit for every household that does not have insurance through an employer. Instead of the government defining a long list of benefits every insurance plan must have, customers should be able to tell insurance companies what they want. This will spur competition and ensure that the tax credit is sufficient to purchase any number of different plans. Allowing the purchase of insurance across state lines would also increase competition and bring down costs. Finally, encouraging the use of Health Savings Accounts (HSAs) will help create more educated consumers who seek treatment from efficient and high quality providers.

Medicare plays an indispensable role in providing health care for America’s senior citizens; it must be put on a sound financial footing so that all Americans have access to high-quality care in their retirement years. The only way to preserve Medicare for the next generation is to get hold of the runaway costs that threaten the program’s viability while spurring massive growth of the federal debt and deficit.

Established 50 years ago, Medicare hasn’t adapted to an aging population with a rising life expectancy. Instead of covering 1 in 10 Americans, the program now covers 1 in every 6—or 50 million men and women—who spend close to 20 years as Medicare patients, up from just 15. At the same time, relentless inflation in medical costs has led the cost of coverage to triple. Whereas payroll taxes and premiums once covered 70 percent of costs, the government now spends $700 billion per year while collecting only $100 billion from Medicare payroll taxes.

Without reform, Medicare and other entitlements will push our government to the edge of bankruptcy. Evan McMullin is not afraid to challenge the status quo in order to put Medicare on a sound footing for the future.

The way to reform Medicare is encourage competition and innovation by putting patients, families, and doctors for first. The key to reform is premium support, a system in which all beneficiaries would receive a uniform subsidy toward the purchase of coverage from competing health plans, including the option of traditional Medicare. This approach would give seniors greater freedom to choose the plan that best suits their needs, while spurring competition among plans to provide the best quality care at the most efficient price.

To promote informed decision-making by beneficiaries, the federal government must develop and distribute user-friendly publications that enable beneficiaries to compare plans, estimate out-of-pocket costs, and assess the quality of competing providers. By making informed decisions, beneficiaries can encourage a cycle of competition and innovation that leads to better outcomes for all.

Medicaid’s purpose is to provide lower-income Americans with the health care they need but can rarely afford. Despite its tremendous cost, there is little evidence that Medicaid is actually improving the overall health of the citizens it insures. The program should be reformed substantially, so that it continues to fulfill its critical mission without pushing our national debt past the breaking point.

When first established in 1966, Medicaid covered just 2 percent of the population. Today it covers more than 20 percent—almost 70 million men, women, and children. Obamacare alone has pushed 12 million individuals onto Medicaid. The annual cost of the program has risen to $550 billion, an increase of $200 billion under President Obama. The cost per beneficiary has also risen sharply to more than $7,000 per year.

Along with other entitlements, Medicaid is pushing our government to the edge of bankruptcy. Evan McMullin is prepared to demand accountability from Medicaid, in order to bring costs under control while delivering better health outcomes for Medicaid patients.

Despite having a different purpose than Medicare, Medicaid would also benefit from reforms that emphasize competition and innovation while putting patients, families, and doctors first. Currently, individual states rely on federal matching funds for Medicaid. This leads to inefficiency because the system rewards states for spending more instead of spending more wisely.

Instead, there should be a cap on federal support. This can be accomplished by giving states block grants instead of federal matching funds, or by giving states a fixed dollar amount for each individual enrolled in Medicaid. The advantage of the latter is that in the event of an unexpected increase in enrollment—because of a recession, for example—states will be able to handle the change.

This would be complemented by paring back the extensive restrictions that Washington places on state Medicaid programs, which discourage innovation and prevent states from taking full responsibility for outcomes. Medicaid could also become far more responsive to patient needs by creating a separate program for disabled and elderly recipients, whose needs are far different from able-bodied adults and their children.

Together, these changes provide a promising way to increase the accessibility of healthcare to Medicaid participants. Right now, many doctors refuse to accept Medicaid patients because reimbursements rates are so low. These reforms point the way toward ensuring that Medicaid patients become valued customers, not second-class citizens. (campaign website)

**********

If I could have gotten more depth out of Darrell Castle, I would have likely scored him higher. Philosophically he’s correct that we should be our brother’s keeper, but I would like to know how he gets from point A to point B. 5 points.

The statist tendencies of Prohibition candidate Jim Hedges come through in this answer. It is not the government’s job to provide the items he specifies, at least not according to my Constitution. No points.

Tom Hoefling has a great answer, and it’s the honest truth: the system as is will be unsustainable. More detail on how he would address the issue would be good, but he also has a correct philosophy. 10 points.

Gary Johnson wisely takes the first baby steps toward some of my goals: privatizing Social Security, devolving Medicare and Medicaid to the states, and repealing Obamacare. I would expect this from a Libertarian, although in the case of Social Security it’s tempered somewhat with changes in retirement age and the gimmick of means testing. It’s a good policy overview rather than a philosophical one. 9.5 points.

This topic is another example of a “tinker around the edges” philosophy of Evan McMullin. Instead of reforming the programs and slapping yet another Band-Aid on a gaping wound, the idea should be one of addressing the very function of a program that the government shouldn’t be involved with. He would unnecessarily consign yet another generation to the slavery of governmental dependence because eventually the reforms will need reforms of their own. 3 points.

I have just two more categories to go. Tonight I will discuss the role of government and tomorrow will be the intangibles and final decision.

Seeking action on Medicare

The mailing had everything needed for the shock value: a worried-looking senior citizen juxtaposed over a stack of paper stamped “DENIED.” “Worried About Government Bureaucracy Restricting Your Medicare?” it asked. If the piece of paper could listen I would tell it that I’m not even counting on having Medicare when I get to that age, but I figured this may be a fun bit of research and exploration to do. “Okay, I’ll bite,” I thought.

The mailing came to both my wife Kim and I as two separate “families” and was paid for by the American Action Network (AAN). So my first question was obvious: who is the American Action Network? According to Wikipedia, the AAN is “a nonprofit issue advocacy group based in Washington, D.C. which promotes center-right public policy. It was established in 2010 by Fred Malek and Norm Coleman as a 501(c)(4) organization.” On their behalf, the AAN argues its “primary goal is to put our center-right ideas into action by engaging the hearts and minds of the American people and spurring them into active participation in our democracy.” So the heart must be the center and the mind must be right?

In essence, it’s a group similar to one I pointed out last week, Americans for Limited Government. AAN may have fancier digs and a larger mailing list and donor base, but they are just another of the thousands of issue advocacy groups orbiting around the capital region – one that has $1.7 million to spend on sending a piece that specifically asked me to, “Tell Congressman Andy Harris to Continue His Fight to Protect Your Medicare.” Since both Kim and I are registered as Republicans, I’m thinking the list was culled to specifically target GOP voters and it wouldn’t shock me if they also narrowed this mailing to only reach those over 50 (as Kim and I both are.) According to AAN, 61 districts in 27 states were targeted for the advocacy campaign, for a total cost (with print and digital ads) of $4.8 million.

To be specific, the mailing advocated the passage of two bills: H.R. 1190, which is better known as the Protect Seniors’ Access to Medicare Act of 2015, and H.R. 5122, which doesn’t have a fancy title but is intended “To prohibit further action on the proposed rule regarding testing of Medicare part B prescription drug models.” Harris (as well as every other Republican present, and 11 Democrats) voted for the former bill last year, but it’s been bottled up in the Senate.

H.R. 1190 has two purposes: one is the termination of the Independent Payment Advisory Board (or, in the words of Sarah Palin, the “death panels”) while the other cuts billions of dollars in spending on the Prevention and Public Health Fund over the next decade. But because Barack Obama isn’t going to agree with this anyway, it’s apparent that the bill will go nowhere in the Senate (they won’t even make it past the cloture vote.)

The second bill, H.R. 5122, would eliminate spending on a proposed rule, which is 33 pages to explain that the Department of Health and Human Services wants to try a new method of payment for certain drugs administered to Medicare patients as a trial program. The overall idea is to encourage the use of lower-priced drugs, since the authors of the rule contend the providers use more expensive medications to take advantage of a flat 6 percent reimbursement rate. As an experiment, the rate would go down to 2.5% plus a flat $16 additional reimbursement. After its introduction the bill has apparently sat in a desk drawer someplace because no vote has been taken on it.

Yet AAN objects to both bills, and ”calls on seniors to advocate for two key legislative priorities: (1) H.R. 5122, to prevent the Obama Administration from changing the Medicare Part B payment policy for treatments, and (2) H.R. 1190, to repeal the Independent Payment Advisory Board (IPAB). Both bills will block bureaucrats from imposing harmful changes to Medicare that could threaten seniors’ access to care.”

So I investigated further, and found a missive Coleman wrote last month about this and other issues. Among the things Coleman said:

Despite assurances that ObamaCare would be the end all, be all, for health care reform in America, we now know that it is simply collapsing in on itself.  Insurers are fleeing the system - premiums are increasing - and recent court rulings have undermined the credibility of the financial assumptions used by liberals to justify the creation of ObamaCare.

All this is true. Yet Coleman goes on:

In the end, America doesn’t need only to reform government.

We need to reform the notion that government is the solution to our problems or the key to our future prosperity.

Again, truer words have never been spoken. But the premise of the AAN mailing is that of protecting a government program by appealing to the beneficiaries. (A subsidiary site operated by AAN and promoted on the mailing makes this clear: DontCutOurMedicare.com.) If government isn’t the solution to our problem, one would think AAN would be looking to repeal Medicare entirely (over a relatively lengthy sunset period, of course) to truly reform the notion that Americans should depend on our government for health care or feel entitled to it. At the very most, the idea of Medicare should be no more than a state-level initiative – if the people of Maryland want a lavish senior care program, let them adopt it as their own. However, those in Delaware may feel differently.

So the definition of “center-right” seems to be the same sore subject that millions of Donald Trump voters used as their excuse to vote against the “establishment.” While they have selected a deeply flawed vessel to amplify their message, it seems those frustrated voters are looking more for the “right” than the “center,” since all the center seems to be is the maintenance of a failed status quo.

On the other hand, one can argue that their objection is not about government involvement, but instead only a complaint about the originator of the idea. They don’t seem to have the same issues with the Medicare Part D program enacted under Republican President George W. Bush – which is, in some respects, similar to the pilot program H.R. 5122 seeks to defund because Part D tends to reward the usage of less expensive medication. It’s still the federal government subsidizing health care, but it was done in the name of a centrist ”compassionate conservatism” instead of the leftward ”fundamental change to America.”

To me, it’s very ironic that a group which wants to back away from the idea that our government is a solution sends out a directive to appeal to our very conservative representative to maintain a costly government entitlement program. Even more so, those who complain “don’t touch our Medicare” would be the first to object to expanding eligibility to cover those over 50 years of age, in part because it’s Hillary Clinton’s idea. (Trump seems to favor the Medicare status quo with a few tweaks, which may explain why much of the AAN target audience is his support base.)

Perhaps the most interesting aspect of this is figuring out where they got $4.8 million for the campaign. We have a few clues, but the backers of this group aren’t being very public about it. So if they were looking for exposure, I suppose this piece is added value to them. But I must say: the “center” of their “center-right” really comes out with this one, particularly if you consider the center as our current situation – a President pulling to the left and Congress mildly countering to the right. Then again, to AAN we are only a “democracy” anyway, so at the moment the people want largesse from the public treasury, with AAN’s large donors perhaps trying to preserve their cut of the proceeds.

While those on the Left, such as writer Igor Volsky, celebrated Medicare as a success and believe the issue is settled, I happen to think those Volsky cites who argued against the concept when it was first proposed over 50 years ago were proven correct. Volsky also quotes an exchange between then-Congressman Mike Pence and journalist Andrea Mitchell:

Rep. Mike Pence (R-IN) explained his opposition to a new public health care option by arguing that Medicare spending has exceeded actuarial estimates from 1965. As Andrea Mitchell pointed out, somewhat jokingly, “I don’t know if you want to go back to Indiana and campaign against Medicare.”

Obviously those on the center-right don’t want to, so it’s going to take decades of re-education on the concepts of liberty and personal responsibility to counter the effects of the entitlement mentality society we live in today. Some may consider Medicare a success and wish it saved, but to achieve the rightsizing of government we need it’s clear Newt Gingrich was correct: Medicare does need to “wither on the vine.” Given the sheer number of insurance companies that now cater to the senior market, the problem Medicare was created to “solve” can easily be addressed by the private sector.

The first post-GOP teaching moment

It was about seven or eight years ago that I first came in contact with the group called Americans for Limited Government. One of their projects that I participated in for awhile was called Liberty Features Syndicate, which (as the name implied) was a syndication service that generally catered to small newspapers. For perhaps a year, I was one of their writers and every so often I would find out one of my 600-word columns was placed in some small-town newspaper. That was a neat experience, particularly the very first time when I found out my column was in a Kentucky newspaper fitting that description. For a moment I thought I was destined to be the next Ann Coulter. (Now I’m glad I’m not.) They also do the NetRightDaily site, which is where I first discovered Marita Noon as they also carry her weekly op-ed. Somewhere in their archives I’m sure most of my columns survive.

All that has gone by the wayside, but I remain Facebook friends with current ALG president Richard Manning. Over the last few months, though, I’ve been dismayed to see how a group which claims to be for limited government has climbed aboard the Trump train. A case in point was something they posted last week, which I want to use as an educational tool. It’s called “Trump’s the nominee, deal with it.” I’m going to go through it a little at a time and share my thoughts as we go.

Donald Trump is the nominee and the establishment is going to have to deal with it. These anonymous GOP sources speculating on what the process would be if Donald Trump chose to withdraw from the race for president should be identified and forever run out of the GOP.

I find this rhetoric to be disheartening and a little disingenuous. Manning should remember that 56% of the Republican voters did not support Trump, but when it came time for that group to be represented at the RNC Convention Trump was right there with the “establishment” to shut it down. It was a coordinated effort, so don’t tell me Trump is not part of the establishment when it serves his purpose, and vice versa. Personally, I believe the whole “Trump will withdraw” story is wishful thinking on the part of some, but given his meteoric personality it’s not outside the realm of possibility. If anyone deserves to be “forever run out of the GOP,” though, it’s the Trump/RNC “enforcers” who were at the convention intimidating the grassroots supporters of needed rule changes. That action was one of the reasons I left the party leadership.

Where were they when Mitt Romney was outed telling donors that 47 percent of the people were on government assistance, creating the exact class warfare narrative that the Democrats craved? These anonymous, cowardly whiners were more than likely busily making fortunes at the GOP trough.

Probably the same place they were when Trump alienated women voters with his remarks about Megyn Kelly – except those weren’t surreptitiously recorded like Romney’s remarks were. The Democrats are going to attempt their tactics of division regardless of what the Republican nominee says. The one thing to criticize Romney for? He was off by 2 points – it was actually 49 percent. One would think that a group advocating limited government would embrace that fact as a reason to begin work on the issue. The truth hurts sometimes.

The only reason that this circular firing squad story exists is because the D.C. establishment class cannot get over that Jeb lost and with his loss, their every four-year financial windfall went away. And that’s the ugly truth, Donald Trump’s real failure is his unwillingness to spend millions in consulting fees to keep the GOP consulting vultures at bay. If these consultants had not lost the popular vote in five of the past six presidential elections, they might have some validity in their concerns, but they are proven losers, and Trump doesn’t like losers.

This is perhaps Manning’s best point, but by making it about Trump he makes a mistake. Trump may not be using the consultant class, but the problem is that he’s losing just like in the other five elections (and the current polls track similarly to theirs.) If Trump were running at 60% in the polls Manning would have a great point, but the only thing about Trump at 60% is his negatives. We should hope that the consultant class withers on the vine, but the way to do that is through limiting government so there’s less financial incentive to be a consultant.

So, now they are all-in in trying to stop Trump, and by fostering speculation that he might drop out, they give their cohorts in the mainstream media the excuse to replay some mistakes that Trump has made and the campaign is trying to move on from.

They don’t have to replay mistakes because Trump creates a fresh batch on an almost-daily basis.

It is time to root out these conspirators to elect Hillary Clinton president, and not allow them to hide under the cloak of invisibility that cockroaches and vermin depend upon.

Someone really needs to do an exhaustive study on how many Democrats crossed over in the open primaries to help make Trump the GOP nominee. Oh, wait, those aren’t the conspirators Manning is referring to? My contention all along is that the only candidate Hillary could beat was Donald Trump, so I suppose the real conspiracy was within the group that talked Trump into running when there were already several in the race – remember, Trump was among the last to announce.

For the rest of us, Donald Trump is the only chance to end the Obama expansion of federal government power, his disastrous EPA regulations, Obamacare and his use of the enforcement powers of the Executive Branch as weapons against his political enemies.

For Trump, any and all of these will eventually be negotiable except for the last one. Given the ferocity of his attacks against his former Republican foes, I don’t doubt that Trump has an “enemies list” of his own, and it won’t be all the groups who have tormented conservatives the last eight years. The conservatives will remain in the crosshairs because Trump didn’t need party unity anyway.

Moreover, The Donald yo-yos between wailing about “draconian rules” regarding federal land and advocating the federal government remain in control of it. His stated health care plan repeals Obamacare, but he also vowed to make a deal with hospitals to take care of the poor at government expense. EPA regulations are bad unless you’re pandering to Iowa corn farmers.

In short, I truly don’t see any real support for limited government from Trump, which makes me wonder why ALG is involved in this election. To be honest, I’m sure Americans for Limited Government is a relatively modest group, living on a comparative shoestring as one of many thousands of advocacy groups around Washington, D.C. (That in and of itself is rather ironic. If they don’t like the inside-the-Beltway culture perhaps their headquarters should be in flyover country.) They take Trump’s outsider image to heart, even though he has donated thousands of dollars to political candidates on both sides.

But simply being an outsider with little political experience does not necessarily equate to limited government. And while some argue that with Trump we at least have a slim chance of success, let me remind you that failure to constrain government will once again be a Republican trait if Trump wins and governs on a platform where Obamacare is replaced by other government involvement, regulations are addressed in a capricious manner, and entitlements like Social Security and Medicare are off limits to needed reform, let alone the true limitation of government that can be achieved by sunsetting the programs over a multi-decade period to provide an orderly transition.

I use this as a cautionary tale about consistency. If you believe the group’s mission statement, it’s a curiosity to me why they involved themselves in this race:

We are leaders in identifying, exposing and working with Congress and state legislatures to prevent the continued expansion of government. Never shying away from the big issues, ALG is perpetually ahead of the issue curve taking on issues like the $100 billion International Monetary Fund line of credit while others are still trying to spell IMF. This aggressive, non-partisan approach to the threats posed by an ever expanding government to our basic freedoms gives us the ability to honestly present the limited government perspective both inside the beltway and most importantly around the country.

It’s clear to me that neither Donald Trump nor Hillary Clinton will lift a finger to limit government; rather, they will rearrange the deck chairs on the Titanic. I can understand the fear of Hillary Clinton being a third term of Barack Obama, but who’s to say Donald Trump wouldn’t be a third term of George W. Bush, where government expanded at an alarming rate, too? There were several other candidates who were willing to begin the process of rightsizing the federal Leviathan, but Trump prevailed as the “Republican, not the conservative” nominee. It’s troubling to me that the folks at ALG let party override principle and fear take the place of common sense.

So despite the admonition of Manning and friends, the only nonsense we need to stop is continually claiming that not voting for Trump is a vote for Hillary. One can be #NeverTrump and #NeverHillary at the same time. There are other candidates out there who hew closer to the principles of limited government, and one of those things which holds them back is the perception that no one other than a Republican or Democrat can win. In the end, the decision is up to the voters, so what ALG needs to do is return to stressing the value of limited government rather than shill for one flawed candidate against another.

The case against Trump (part 2)

Since I finished part 1 last week, we’ve had a lot of developments in the race: Trump picked outgoing Indiana Governor Mike Pence to be his running mate (or did he actually make the selection?) and came up with an awful logo (that lasted one day) to celebrate. Meanwhile, the RNC apparently succeeded in binding their delegates to this dog of a ticket. (My question: how did our Maryland Rules Committee members vote? I believe Nicolee Ambrose, who has fought in that committee before, voted the proper way and against the RNC/Trump minions. Yes, they are shamefully now one and the same.)

Update: Indeed, both Maryland members voted properly, and Nicolee Ambrose is urging members to reject the Majority Rules Report.

So the question may be moot, but I’m going to press on for the record so I can point back at this and say “I told you so.” Not that it will do a whole lot of good, of course, but maybe people will listen to reason in the future. It’s worth a try.

Just as a refresher, the five issues I have left over are taxation, immigration, foreign policy, entitlements, and role of government.

Trump came up with a decent taxation plan during the campaign – maybe not all that I would want, but an improvement. But he later admitted that all of it was up for negotiation, so let me clarify: the rates will not go down for many taxpayers, but the increases that made the package “revenue neutral” in his words will remain. Those on the low end of the scale may get the “I win!” form but the rest of us in the middle will lose, again.

I’m tempted to save immigration for last because that was the first important issue for Trump and the one that propelled him from celebrity sideshow to true contender. Americans, indeed, want something done about the influx of foreigners and a large part of that is building a wall at the border. But it’s not my most important issue and I still run this blog, so it goes in order.

The first crack in the Trump immigration façade for me was the idea of building a “big, beautiful door” in the wall to promote legal immigration. Then I found out Donald was an advocate of what’s called “touchback” immigration, which is a fancy way of saying he’ll give amnesty. And I can see it already: in a “grand deal” to get the wall built, Trump will eliminate the “touchback” part – because it’s oh so hard for these immigrants to be uprooted and return to their homeland – for the promise that a wall will get built. News flash: we were promised this in 2006, but the Democrats (along with a few squishy Republicans) reneged on the deal. We see how Congress acts, and regardless of what Trump may say this is not a promise he would keep. Bank on it.

I know Trump did a sort of catch-all address on foreign policy some months back, but his criticism of the Iraq war (and accusations about soldiers therein) gives me pause. That’s not to say we are always right, but there is a little bit of hindsight he’s taking advantage of here. If Iraq were a thriving nation and American bulwark in the Middle East such as Israel is, I seriously doubt Trump would say word one about it being a bad idea. That’s the sort of person I take him to be.

It’s very possible to lump both entitlements and the role of government into one statement, reportedly made by Trump in New Hampshire back in 2015 and relayed by Andrew Kirell at Mediaite:

The Affordable Care Act, “which is a disaster,” he said, “has to be repealed and replaced.” That line drew applause.

“Whether it is we are going to cut Social Security, because that’s what they are saying,” he continued. “Every Republican wants to do a big number on Social Security, they want to do it on Medicare, they want to do it on Medicaid. And we can’t do that. And it’s not fair to the people that have been paying in for years and now all of the sudden they want to be cut.”

So will it be fair when the train goes off the tracks and millions of younger Americans are left with nothing? Trump is 70 years old, so (as if he really needed it) if Social Security runs out in 2030 he’ll likely be dead anyway. But I will be 66 years old and hoping to retire at some point, although thanks to the Ponzi scheme of Social Security all that money my employers and I grudgingly gave to the government over forty-plus years will long since be pissed away. And the more I deal with the “Affordable” Care Act, the less affordable I find it. The repeal is fine, but the replace should be with the old system we liked, not some new government intrusion.

In sum, it became apparent to me early on that despite his appeal as an outsider, Donald Trump is far from an advocate of limiting government. If he should win in November, conservative Republicans will likely be in the same precarious position they were often placed in by George W. Bush: it’s difficult to go against a president in your own party even if he goes against party principles.

The Republican Party I signed onto back in 1982 when I first registered to vote in Fulton Township, Ohio was ably represented by Ronald Reagan at the time: strong defense, lower taxes for all Americans, and a moral clarity of purpose that included the concept of American exceptionalism. Yet Reagan also intended to limit government; unfortunately he wasn’t as successful in that aspect because he always worked with a Democrat-controlled House (and usually Senate.) I often wish that Reagan could have worked with the early Gingrich-led House and a conservative Senate – we may have beat back a half-century of New Deal and Great Society policies to provide a great deal for all Americans who wished to pursue the opportunities provided to them.

I don’t know how we got Donald Trump as our nominee, although I suspect the early open primaries (and $2 billion in free media) may have helped. Democrats may have put together their own successful “Operation Chaos” to give Republicans the weakest possible contender. (And if you think that’s a recent concept, I have a confession to make: in my first Presidential primary in 1984 I requested a Democrat ballot so I could vote for Jesse Jackson, who I perceived as the Democrat least likely to beat Ronald Reagan in the general election. Not that I needed to worry.) It’s worth noting that the defeat of “Free the Delegates” also resulted in the defeat of some measures designed to reduce the impact of open primaries.

Alas, the GOP may be stuck with Trump as the nominee. So my message for the national Republican Party from here on out is simple: you broke it, you bought it. The mess is on you and I’m washing my hands of it.

Programming note: Over the next four days – in addition to her regular Tuesday column – I will run a special four-part series sent to me by Marita Noon, but originally written by John Manfreda, who normally writes on the energy sector like Marita does. She ”spent most of the day (last Thursday) updating it, reworking it, and cleaning it up,” so I decided to run it as the four parts intended during the Republican convention.

I intend it as a cautionary tale, so conservatives aren’t fooled by a smooth-talking charlatan ever again. Don’t worry, I have a couple things I’m working on too so I may pop in this week from time to time if I feel so inclined. But I trust Marita and this seems quite relevant and enjoyable, so look for it over the next four afternoons…probably set them to run at noontime (how appropriate, right?)

The end of the GOP campaign

Imagine, if you will, a gathering of one lady and 15 distinguished gentlemen. Nine of them had served as the governor of their state, most for multiple terms. Another five have served the nation in its highest legislative body, while one was a world-renowned neurosurgeon and the lady worked her up to CEO of a large hi-tech corporation.

Now, if you’ve ever watched the movie Caddyshack, imagine the character Al Czervik (Rodney Dangerfield’s character) – loud, bawdy, and obnoxious. Our version of Al, bullying his way into this genteel affair, was Donald Trump. Yet he emerged victorious, in part due to that brash personality but also thanks to a heaping helping of populist rhetoric that sounded so good 40 percent of the Republicans voted for him. (That’s assuming, of course, our side hasn’t been hoodwinked by a massive version of Operation Chaos – and given the number of people who switched their registration from Democrat to Republican or voted in open primaries, I wouldn’t put it past them.) I say “sounded good” because, by and large, his rhetoric had the depth of a cookie sheet.

One upshot of this in Maryland is that the state Republican Party was poised to exceed one million members for (I believe) the first time ever. (As of the end of March, the MDGOP had 997,211 voters, which was an increase of about 16,000 from February – so the trend may have put them over the top.) But that success will be short-lived with Trump, who has disgusted so many erstwhile Republicans that a decrease of 50,000 Maryland Republicans in the next couple months isn’t out of the question.

So now I am hearing the old complaint that not voting for Trump will be a vote for Hillary. No, for conservatives, not voting for Trump will be a repudiation of the direction the Republican Party has taken since Barack Obama took office, and arguably since Ronald Reagan left.

You see, if Congress had shown any stones whatsoever, rank-and-file Republicans would not have felt the need to shake things up by electing an outsider as President. Perhaps Ted Cruz would not have felt the need to run for President in the first place, and the Republican nomination may well be coming down to a contest between two or three of those governors, or perhaps another Senator or the CEO with business experience.

Instead we get Trump, who basically ignores one leg of the conservative stool by praising Planned Parenthood and giving short shrift to religious liberty. Limited government doesn’t seem to be his bag either, since he’s pledged to let Social Security and Medicare go without reforming them and pandered to Iowa farmers by promising to keep ethanol subsidies going. Where most GOP candidates run right in the primary and tack to the center for the general election, Trump is already in the middle so he will likely soften some of his more conservative positions as part of the flexibility in getting the deal done. It’s getting to the point where Trump and Clinton are not all that distinguishable from each other.

And about getting those deals done. Conservatives have wanted a border fence for more than a decade; in fact, the authorizing legislation was passed under President Bush. So why do I think that The Donald will get his fence once he promises to Democrats he will create a bigger, more beautiful door for it? Since he’s the de facto head of the Republican Party now, when is he going to negotiate with Congressional Republicans and work in a more conservative direction? Perhaps the twelfth of never? We will get the “touchback” amnesty, but then the Democrats will just say “forget the touchback part.”

Finally, to borrow a phrase from another movie, I find Donald Trump to be like a box of chocolates, because you never know which one you’ll get. He’s not exactly the poster child for consistency so a Trump administration would be a constant guessing game.

I suppose my advice to voters in those remaining primary states is to show up and vote your conscience if you’re not a Donald Trump supporter. Don’t change parties yet, and get out and vote for Ted Cruz, John Kasich, or anyone else but Trump. Keeping him under 50% of the overall national vote would be a good way to send a message that we’re not sold on Trump as the nominee.

You have to give Donald Trump credit for one thing: he was smart enough to run in a dysfunctional political year. In that case, he has been the perfect candidate – too bad voters like me were looking for order after the disarray of the last eight years. And I will say: had I written this last night, the word “campaign” would not have been in the title. But the Grand Old Party may want to prepare for some stormy days ahead.

Odds and ends number 77

It will be on the light side this time, but this is probably the lightest news week on the calendar as many of the productive people in the country take an extended vacation. Having Christmas and New Year’s Day both fall on a Friday really assists in that effort because the average worker only has to take 3 or 4 vacation days rather than a full week – as an example I had both Thursday and Friday off this past weekend and will be off Friday, too. Long story short, the government and newsmakers are pretty much off for several days with the minimum of paid time off insuring a long 11-day break.

So I’m going to begin with news that came out recently from the Center for Immigration Studies that confirmed what millions of observers have long suspected: we aren’t ejecting illegal immigrants from the country like we used to. No one is talking about all 11, 13, 20, 30, or whatever million there are, but just over 235,000 - not even half of the number just four years ago. Jessica Vaughan of CIS noted in testimony before the Senate that:

This willful neglect (regarding deportation) has imposed enormous costs on American communities. In addition to the distorted labor markets and higher tax bills for social welfare benefits that result from uncontrolled illegal immigration, the Obama administration’s anti-enforcement policies represent a threat to public safety from criminal aliens that ICE officers are told to release instead of detain and remove. The administration’s mandate that ICE focus only on the ‘worst of the worst’ convicted criminal aliens means that too many of ‘the worst’ deportable criminal aliens are still at large in our communities.

Even if Donald Trump personally supervised a border wall and made Mexico pay for it, deportations continuing at that rate would take decades to clear out those here illegally, giving those at the bottom of the list for removal time to have anchor babies and otherwise game the system to stay put. It’s a waiting game that Americans and those law-abiding immigrants wishing to enter are losing quickly.

Obviously the first steps any new administration would need to take not only involve revoking all the pro-illegal alien policies of the Obama administration but putting an end to birthright citizenship for non-citizens and cracking down on employers who knowingly employ illegals. In one stroke I’m for pissing off both the Democrats and the pro-amnesty Chamber of Commerce types.

Immigration – and its potential for bringing in a new generation of government-dependent first-generation voting residents (I hesitate to call them Americans as they are slow to assimilate) isn’t as much of a cause for concern for Robert Romano of Americans for Limited Government as is the death of the Republican voter.

I’ve brought up this question in a different form before, as I have pointed out the Reagan Democrats of 1980 were comprised of a large number of blue-collar lunchbucket types who were probably approaching middle age at the time. Brought up as Democrats with the idealism of John F. Kennedy and the union worker political pedigree, they nonetheless were believers in American exceptionalism – for them, the American malaise was a result of Jimmy Carter capping off a decade or more of failed liberal policies both here and abroad.

As Romano points out, many in the Silent Generation (which was the base of the Reagan Democrats as they reached middle age in the 1970s) are now gone. At around 29 million, it is well less than half of the Baby Boomers or Millennials. (I notice that Generation X isn’t mentioned, but they are certainly larger than the Silent Generation as well. At 51, I could be considered a tail-end Baby Boomer but I identify more with Generation X.)

Yet the question to me isn’t so much Republican vs. Democrat as it is “regressive” statist vs. conservative/libertarian. I worry more about the number of producers (i.e. those who work in the private sector) vs. the number of takers (public sector workers + benefit beneficiaries). The number of takers is growing by leaps and bounds - chronic underemployment to the point people still qualify for food stamps or housing assistance plays a part, as does people getting older and retiring to get their Medicare and Social Security. I’ll grant it is possible (and very likely) some straddle both categories, particularly older workers who qualify for Medicare, but as a whole we have a bleak future as an entitlement state without some sort of drastic reform. This example probably oversimplifies it, but you get the picture.

At least I’m trying to be honest about it instead of using the faulty reasoning of the Left, as Dan Bongino sees it. Sometimes I wonder if its a game the liberals play in the hopes that we waste and exhaust ourselves trying to refute all the bulls**t they spew rather than come up with new, good ideas.

Perhaps more importantly, though, Bongino in a later article makes the case that government surveillance is not the terrorism panacea people make it out to be.

I’m not willing to sacrifice my liberty, or yours, for a false sense of security, Ironically, those defending this egregious, government-enforced evaporation of the line between the private and public self cannot provide any evidence of this metadata collection process intercepting even one terror plot.

After 9/11, Congress adopted the PATRIOT Act, which was supposed to be temporary. Given that we are in the midst of a Long War against Islamic-based terrorism, there is some need for scrutiny but Bongino has a point – are we trying to get someone inside these terror cells?

Finally, I want to pass along some good news. If your house is like mine and uses heating oil, you can expect to save $459 this winter compared to last. (Having well above-average temperatures in December meant I made up for the “extra” 100 gallons I had to get to make it through a chilly spring.) But as American Petroleum Institute’s Jack Gerard also points out, investing in energy infrastructure is a key to maintaining these savings in the long run – and has the added benefits of an economic boost.

We often talk about infrastructure in terms of transportation, where public money is used on projects generally used by the public for enhanced commerce. As I was told, traffic bottlenecks were common in Vienna before they finished the bridge over the Nanticoke River in 1990 as well as in Salisbury until the completion of the U.S. 50 portion of the bypass a decade or so ago. Now traffic flows more freely, time and fuel are no longer wasted, and people are just that much more likely to visit our beach resorts. (The same process is occurring on Maryland Route 404 and U.S. 113 as widening makes that traffic more bearable.)

But this can also occur in the private sector as a future investment, and this is what Gerard is referring to. Most are familiar with the story regarding the Keystone XL pipeline, but the same sort of opposition rose up to the Mid-Atlantic Power Pathway, a transmission line once slated to run through Wicomico and Dorchester counties on its way to the Indian River generating plant in Delaware. Slack demand and other infrastructure improvements were cited as factors in killing MAPP, but the process of dealing with environmental issues likely played a larger role.

Regardless, you can bet your bottom dollar that any sort of fossil-fuel based infrastructure would be opposed tooth and nail by a certain class of people who believe all of our electricity can come from so-called “renewable” sources, and that power will magically run directly from the wind turbine to the outlet in your living room. I see nothing wrong with private investment trying to make lives better, so if another natural gas pipeline is what Delmarva needs to succeed and some private entity is willing to pay for it, well, let’s start building.

Just as I built this post from the debris of my e-mail box, we can make our lives better with our natural resources if we don’t shoot ourselves in the foot.

The consolidation of responsibility

It started out so innocently, somewhat like a warm late-summer day did almost a decade-and-a-half ago. But somehow things became so much bigger and darker.

There’s no doubt a Facebook disagreement pales ever-so-greatly in comparison to 9/11, but the reauthorization of the James Zadroga 9/11 Health and Compensation Act became yet another excuse for partisan bickering, with many of these comments criticizing the heartless Republicans. It’s certainly not hard to garner sympathy for the families of those who were affected by the fall of the Twin Towers.

Yet being the adult in the room isn’t always the most popular thing.

I have no problem with state and local funding of first responders provided they can justify the need for it. Salisbury and Wicomico County are in the process of ironing out a long-standing disagreement over the city providing fire and EMS services for outlying areas close by the city. (Due to haphazard annexation, there are significant pockets of county population completely or nearly fully surrounded by the city limits. I used to live next door to a county resident while I lived within the city limits – the city limit split our shared driveway. The house I lived in literally was the single piece of property that made that relatively large neighborhood area a county island.)

But I would like to know how it became the federal government’s responsibility to take care of these first responders to begin with. It seems to me that this act of terror was equated with an act of war and first responders were elevated to a status not unlike our veterans. And while the families of these firemen and police officers have suffered greatly as these first responders have, there should already have been a state-based workman’s compensation program in place. In short, they are deserving but it’s not the federal government’s place to pay these bills because they had no contract with Uncle Sam like veterans have. Saying so, though, makes one out to be a bad guy.

Beyond this, there is the question of what role the federal government should take.

It seems to me anymore that we assume the federal government will always be our backstop, there to cover us in the event of disaster. Because of this, we aren’t preparing ourselves for a world where the government can’t or won’t be able to help us. How many people have based their retirement dreams on the fact that Social Security and Medicare will always be there, despite the math that equates both to Ponzi schemes? I haven’t checked in several years because I had a lengthy unintentional hiatus from full-time work, but I don’t think it would take too many years for me to go through the amount I had taken out of my checks over the years for Social Security.

At some point, we need to have the cord cut. The question is whether we will have the willpower to do it ourselves or simply have the rug pulled out from under our feet without warning or a chance to prepare. Those who seem to think we can stay on the same course when it comes to the direction of our federal government are sadly deluded. Donald Trump may be the GOP frontrunner, but he has the wrong approach to entitlements. (By the way, I think I’m really doing a disservice by referring to them as “entitlements” because I would like to know exactly where in the Constitution these programs are. Would you consider yourself entitled to Donald Trump’s wealth if you did nothing to earn a portion of it? That’s what the government seems to think.)

For the families of these first responders things will turn out all right because it’s likely the provision will be placed in a must-pass appropriations bill and we will be paying for these luckless police officers and firemen until they pass away. It’s not really our federal government’s proper place, but giving out money to people we deem deserving always feels good. Things will feel great until the day the golden goose lays dead from exhaustion.

This little experiment we embarked upon almost 250 years ago was supposed to be one where government was limited, with authorization to only do a small number of tasks. Somehow we have come to a point where government is unlimited and unchecked. This 9/11 example, to me, buttresses the old adage, “A democracy will continue to exist up until the time that voters discover that they can vote themselves generous gifts from the public treasury.” The same seems to go for what we thought was a constitutional republic.

2016 Dossier: Entitlements

September 20, 2015 · Posted in Campaign 2016 - President, National politics, Politics, State of Conservatism · Comments Off 

While the category of entitlements is worth 13 points, the only people who would get all thirteen are the ones who would embark on an orderly sunsetting of all the familiar entitlements: Social Security, Medicare, Medicaid, and Obamacare. I don’t think any of the contenders would go that far, but we’ll see.

But it also helps to tell me about their vision of the role of government, for the perfect candidate would be most interested in limiting the size and scope of government to a Constitutionally appropriate level. Those who are most willing to divest power to the states and stay out of their affairs will do best. That last part is worth 14 points but also depends quite a bit on previous categories such as education and taxation, among others, as well as fiscal responsibility.

We will then be down to the catch-all category of intangibles and the coveted monoblogue endorsement.

Since he dropped out of the race, I’m off the hook for Rick Perry. That’s sad because he was tracking as a dark horse in my race. Nevertheless, I soldier on with 16 contenders now.

It’s pretty much given that GOP contenders would drop Obamacare like a bad habit, so the question is: what comes after?

  • Among other things, Jeb Bush‘s plan would shift the program to the states, with the federal government maintaining a hand in catastrophic coverage and tax credits for premiums.
  • Ben Carson is a strong supporter of health savings accounts, which have the benefit of allowing people to share their burden. His idea is to have the government fund each for $2,000 per year.
  • Chris Christie hasn’t put forth a replacement plan – but he expanded Medicaid in New Jersey under Obamacare.
  • Allowing people to buy health insurance across state lines through the Health Care Choices Act is the Ted Cruz plan.
  • “Let’s try the free market,” says Carly Fiorina, with states managing their own high-risk pools.
  • Jim Gilmore thinks there are good things about Obamacare, such as the ban on denial for pre-existing conditions and coverage by parents to age 26 but he thinks states can handle those. He would favor a proposal offered by Rep. Tom Price in 2013 that encouraged interstate sale of insurance, premium tax credits, and HSAs.
  • Lindsey Graham isn’t specific about “cost-effective, market-driven reforms” aside from favoring association plans.
  • I think the Mike Huckabee solution is to pass it on to the states.
  • As he has in other areas. Bobby Jindal has an exceptionally comprehensive plan to replace Obamacare.
  • John Kasich would adopt what he calls the “Ohio Model” nationwide.
  • Whatever George Pataki does to replace Obamacare, it would include the pre-existing condition regulations.
  • Rand Paul favors HSAs, allowing insurance to be sold across state lines, and a tax deduction for all health care expenses.
  • Tax credits and regulatory reform highlight the Marco Rubio plan.
  • Rick Santorum has backed HSAs, tax credits, and selling insurance across state lines but now advocates “federal support for everybody to be able to go out and get the plan they want.”
  • Through a spokesman, Donald Trump‘s campaign vowed to make insurance available across state lines and give individual tax relief.
  • Scott Walker plans to revert authority to the states and install sliding-scale tax credits based on age to go with the HSAs and selling policies across state lines.

On Medicaid:

On Medicare:

  • The left cried that Jeb Bush wished to “phase out” Medicare. Alas, he wants to protect it.
  • HSAs may be the panacea for Medicare, too. Why not? Ben Carson seems to have one solution.
  • Means-testing, increasing the eligibility age, and standardizing deductibles make up the Chris Christie plan.
  • Ted Cruz opposed the “doc fix” bill because he wanted reforms to give seniors “more power and control.”
  • The same “get our house in order” argument applies here for Carly Fiorina.
  • I found nothing to pin down Jim Gilmore‘s position.
  • Means-testing and raising the eligibility age are reform starting points for Lindsey Graham.
  • “I will kill anything that poses a threat” to Medicare (as well as Social Security), Mike Huckabee thunders.
  • Premium support and Medigap reform highlight Bobby Jindal‘s plan.
  • John Kasich argues entitlements have to be “innovated” to survive.
  • George Pataki would increase co-pays.
  • Rand Paul sponsored Medicare reform legislation in 2013 that would have voucherized Medicare, but he’s supposedly backing off that a little bit now.
  • The Marco Rubio vision for Medicare would involve a premium support system, based loosely on Medicare Advantage.
  • Rick Santorum would change it via increasing the eligibility age or changing the COLA structure.
  • Because it’s “not fair,” Donald Trump won’t cut Medicare (or Medicaid.)
  • In 2013 Scott Walker was in favor of cutting Medicare (and Social Security) but it would likely fall on younger workers.

Social Security proposals seemed to fall into three tiers. Most candidates, with the exceptions of Gilmore, Huckabee, Jindal, and Trump, would raise the retirement age. But few (Bush, Christie, Paul, Rubio, and Santorum) advocated for means testing and fewer still (Cruz, Jindal, and perhaps Kasich) had the guts to advocate for partial privatization. Ben Carson even went a bit farther with the idea to allow for wealthier seniors opting out (although it sounds like the money paid in would be forfeited.)

I wasn’t expecting high scores, so it’s no surprise my best candidate has just 7 points.

  • 7 points – Bobby Jindal
  • 6 1/2 points – Ted Cruz
  • 6 points – Ben Carson, John Kasich
  • 5 points – Rand Paul, Scott Walker
  • 4 1/2 points – Jeb Bush, Lindsey Graham, Marco Rubio
  • 4 points – Rick Santorum
  • 3 points – Chris Christie, Jim Gilmore, George Pataki
  • 2 points – Carly Fiorina, Mike Huckabee
  • 1 point – Donald Trump

Next will be the last major category, role of government.

The context for Jindal

We weren’t really paying a whole lot of attention in these parts, but today Bobby Jindal became what he hopes is the lucky 13th candidate to seek the Republican nomination for President. And it didn’t take long for our friends, the Democrat “hacktivists,” to take a few potshots in an e-mail titled “Bobby Jindal for president? Really?”:

Take a look at our Bobby Jindal primer:

  • He’s one of the least popular governors in the country: Under his failed leadership, nearly 1 in every 5 people in Louisiana lives in poverty.
  • He’s one of the architects of the scheme to turn Medicare into a voucher system.
  • He will say anything to please the Tea Party base, like denying climate science and championing extremists like the guy from Duck Dynasty.

Really, that’s all you’ve got? Granted, Jindal doesn’t have overwhelming approval numbers in Louisiana – earlier this year, he was polling in the 20s at home, but had significant positive ratings elsewhere. Jindal was popular enough to win 66% of the vote in his 2011 re-election campaign, though. It’s not unheard of for a governor to lose polling momentum in a second term as he had 50 percent approval two years ago. And if failed leadership involves cleaning up a corrupt state, I’ll take some in Maryland.

As for the poverty rate, it is roughly the same in Louisiana as it was in 2000. Under governors of both parties it has stayed around 20 percent, with the low point occurring under Jindal’s watch in 2010. In those terms it is not too distinct from its southern peers.

It’s worth noting that the same poll that had Jindal at 50 percent also polled on his decision not to expand Medicaid. And don’t let them fool you: nothing would happen to Medicare until 2024 at the earliest, and, as Paul Ryan explains, this is a program to allow more choice. We know the Democrat hacktivists think they know what’s best for us but I like having choices, thank you.

But I loved that last bullet point. I don’t believe the climate “science” either because there’s too much money at stake for those who parrot the government line to state otherwise; moreover, there are the inconvenient truths that the Earth has been warmer and cooler than it is today for extended periods before the industrial revolution. In short, we don’t have a damn thing to do with it but people want us to think so in order to tax and control us. Yet it’s working, so don’t tell anyone it’s a con.

And “that guy from Duck Dynasty” happens to be a pretty successful Louisiana-based businessman. You could be friends with worse people, like suspected child molesters. To the extent Phil Robertson is “extreme” is the extent he is God-fearing.

With all that, I’m starting to like Jindal a little more. Really. Let’s face it: the Democrats have nothing except the scandal-plagued Clinton family and the walking failure that is Barack Obama. They can’t even get Jim Webb on the same page.

So if you need a good laugh, just wait for the Democratic “hacktivists” to speak up. You’ll get one.

The law of unintended consequences strikes again

One hopes this will be a cruel April Fools’ joke, but for many on the Eastern Shore it may only be a cruel reality.

Delegate Christopher Adams shared the bad news:

United Health Care has decided to dramatically narrow their network of pharmacies on the Eastern Shore effective April 1st. This new decision will cause residents to drive upwards of 30 miles to get a prescription filled and be the end of the local pharmacy.

It appears that this is another one of those “hidden” consequences of OBAMACARE and Gov. O’Malley’s decision to make Maryland first with implementing OBAMACARE.

Nevertheless, driving 30 miles to get a prescription filled by one of the State’s “favored” pharmacists is wholly unacceptable. I am meeting with United Health Care tomorrow in a first step to ultimately reverse or greatly modify this decision.

According to a source in the know, the Maryland Department of Health and Mental Hygiene sets the criteria for considering a patient to be “covered” and it depends on their location, stating,”as long as pharmacies are within 10 miles in urban, 20 miles in suburban and 30 miles of patients in rural communities the standards for access to care are met.” So if you are in a town like Crisfield, where the nearest “chain” drugstore is the Rite Aid in Princess Anne or Pocomoke City – each about 20 miles away – you are “covered” but it’s not nearly as convenient as a local independent pharmacy. On the Lower Shore stores of the big three chains (CVS, Rite Aid, and Walgreens) are only found in Berlin, Cambridge, Delmar, Ocean City, Pocomoke City, Princess Anne, and Salisbury. It leaves large coverage gaps in rural areas which may have a pharmacy no longer used for the Medicare programs.

Obviously United Healthcare can choose whoever they want to be in their networks. But the problem with the health care system we are slowly, surely, and not necessarily willingly adopting is that cost is the primary consideration, not patient care. It’s been true ever since we’ve had a third party paying for our medical expenses, but it wasn’t so long ago that we had many more options for our care. Those days are now over as some former providers have left the state, leaving us with fewer from which to choose.

What Adams points out is that Martin O’Malley’s decision to jump right ahead with a fairly restrictive state exchange is now making life more difficult for the people it was supposed to help. Obviously there’s a lot of recovery needed on a national scale just to get back to a system which most were satisfied with, even though some chose not to participate by not purchasing health insurance and some could not afford it. Now while everyone is supposed to have health insurance (or pay a tax penalty) we find that care is even more expensive and difficult to obtain.

Chris isn’t going to get a lot of answers, I’m afraid, because it appears the die has been cast. And as a state legislator his impact on the national argument is small. But even if some of the independent pharmacies in under-served areas are added back in, it would be a step in the right direction. There may be a chain drugstore on every corner in Salisbury, but some of the smaller towns still cling to their local drugstore because it’s a sufficient size to cover the small market of a little village.

Thirty miles is a long way to go to get a prescription. That may be necessary for a need late at night or on a weekend, but for most refills and common items it shouldn’t be a requirement.

Getting to know…the real me?

August 11, 2014 · Posted in Campaign 2014, National politics, Politics · Comments Off 

This will be a fun little post.

In an effort to have further blog fodder (and sometimes a good laugh) I’m on the mailing list of the Democratic National Committee.

So on Saturday I received an e-mail with the subject line “Getting to know you.” I found out a couple neat little tidbits about that “powerful, dedicated community” on that side of the spectrum:

  • 853,185 have been on their e-mail list for five years. I think I’m one of them, but that number seems surprisingly low. They must cull their list based on response/open rate.
  • 11 people signed up as Barack Obama and “think they are pretty funny.” Hey, with the history of failed hard drives around Washington, D.C. perhaps Barack Obama was being intentionally redundant or he simply wanted to tailor the message to his multiple favorite vacation spots.

And they “consider me a critical part of their team.” Well, I am pretty critical about their intentions, motives, and methods of operation.

But the idea behind the e-mail was to flesh out the information they have on me. I actually trashed the e-mail then decided to bring it back because I was curious what they wanted to know. Truthfully, I was disappointed.

They already had my first and last name, along with my e-mail address (duh!) And of course, they know I live in the 21804 zip code so things are pegged to Maryland. The character string attached to the link has all that, along with the particular e-mail date they would harvest the information from.

So those things are spotted. The next information they wanted was my phone number. Since most people use cell phones, there was also an opt-in checkbox to receive “periodic automated text messages and calls on my mobile number from the DNC.”

The next items were my birthday and gender. I’m thinking they are going to tailor specific messages to specific people – if I had put down “female” my e-mail would be filled with items dealing with the so-called “war on women.” Older folks would certainly be given the usual scare tactics about cuts to Social Security and Medicare, although it’s likely their targeting is a little more sophisticated. It will be interesting in my case to see how messages change when I make it to a half-century next month and slide into a different age category.

The next item asked where I primarily got my news: internet news sites, newspapers and magazines, TV, social networks like Facebook or Twitter, e-mail, or friends and family. It’s surprising they ask this considering they cater to the low-information crowd.

Finally, they asked where I go for my updates on Democratic candidates and races: the DNC, local campaigns in my community, the state Democratic party, the DCCC (House Democrats), the DSCC (Senate Democrats), the Democratic Governors Association, or friends and family. Interestingly, the DNC Services Corporation didn’t include the local news or internet.

Obviously I get similar e-mails from the Republican side as well. But one thing they often ask for that these Democrats don’t are the issues I’m most interested in. To me, that would seem like a missed opportunity for the other side until you figure out that they are on the wrong side of practically everything, and often focus on issues of little actual importance: witness the whole “Redskins” name controversy, for example. If thousands of people came back and said we needed to do something about securing the border, those Democrats have no solution.

So they didn’t get anything else out of me: just name, rank, and serial number. Maybe “Barack Obama” needs to transform into a 25-year-old woman just to see what kind of soap they try to sell her.

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