Medicare for All – monoblogue

Where’s the reset button?

It’s fascinating to me how sometimes the most random things inspire me to write. First of all, it has to be a topic which is interesting to me and secondly there has to well up in me a feeling that I would have something relevant to add to the conversation. So I was sitting with laptop in lap the other night and saw two articles – a John Mauldin article posted by my friend Bob Densic and a Forbes piece by Carol Frazier – back-to-back on my social media and thought it a sign. So go ahead and read them, I’ll wait patiently for your return.

Sobering enough? I thought they were. They paint a much different picture than the good tidings promoted by the current administration, but they aren’t as pessimistic as one may think aside from the means of solution to the perceived problem.

The paragraphs that finally inspired this piece came from Jack Kelly’s Forbes post:

Ironically, the younger generations may be in for a windfall in the future. As their Baby Boomer parents pass away, they stand to receive a large inheritance. It could be the largest wealth transfer in American history.
The catch is that if the market goes down appreciably or crashes, like in the 2008 financial crisis, the parents will sell their stocks at fire-sale prices and there won’t be much left over for their children. If all of the Boomers start selling their homes when they retire—which they are now doing in large numbers—to downsize their lifestyles, housing prices may collapse. This will also lessen the amount of money that could be transferred over to their kids.
“Why Young Voters Are Embracing Bernie Sanders And Democratic Socialism,” Jack Kelly, Forbes, February 5, 2020.

From the sounds of these articles, the problem seems to be that those who are struggling are having issues with several different expenditures, number one being student loans but also the costs of rent and health insurance. So when Bernie Sanders, Elizabeth Warren, et. al. go out and pledge to wave a magic wand and eliminate two of those three expenses by forgiving student loans and “Medicare for All,” well, that’s an appeal which sounds mighty good to those who wrestle with these things each month.

I’m no Boomer, but I did live through a time when I was relatively fresh out of college, newly married with a five-year-old daughter by another father, and wished to pursue the American Dream of home ownership. The year was 1990, just 30 years ago. Of course, we didn’t have a large nest egg for a down payment but there were programs out these to assist those in our situation.

However, the bank told us no. They took one look at our credit and said, “work on paying this stuff off and come back in a year.” So we did. It meant we had to be more diligent with our finances but we pulled it off and a year later we bought our first house – which was a better one than the place we were denied.

Having said that, let me tell you about that house: it was nothing fancy to look at. The biggest criteria we had was to live in the high school district we believed would give our then-second grader the best possible educational outcome. So we were willing to settle for a three-bedroom, one-bath home on a 25′ x 120′ lot that was built in 1925, in a nice neighborhood of similar houses. We made it into the desired school district by five blocks.

It’s worth adding that, at the time, I was also paying off student loans. However, the rules for student loans were different back then, as were the rules for being a success: it was widely understood that success could be achieved in modest, incremental steps. The large house in the suburbs wasn’t out of play, but it was assumed to be your step to take after establishing equity in a starter house. You stepped your way up through newer and newer second-hand cars or bought the low-priced base model Ford or Chevy before you got to the car you really wanted out of the showroom. And while life for me has taken its share of unexpected twists and turns, the Michael at age 55 isn’t really all that far away from what the Michael at age 25 expected him to be – it’s just that the cast of characters has expanded and the stage has changed. Overall, I don’t have a ton of bells and whistles and I’m quite cool with that.

So consider this perspective of expectations as you read on with my analysis, and let’s go back to the blockquote. While my parents aren’t Boomers (they are part of the Silent Generation as they both are in their eighties as of next month) they do have a house and someday it will be passed on to my surviving brother and I (my other brother passed away nearly a decade ago.) Whether he decides it’s a fine place for him and his wife to relocate to (and buys me out) or if we just sell it and split the proceeds, yes, it may be a nice nest egg. Now I can’t speak for him, but as long as the house isn’t underwater (figuratively and/or literally) my wife and I will do just fine.

Naturally I realize not everyone is as fortunate as I am with regard to that potential windfall, but it’s worth pointing out that my parents weren’t (and still aren’t) bells and whistles types either. We had the modest two-bedroom, one-bath house until I was seven and it got to the point the second bedroom was just too small for kids nine, seven, and three to share. Yes, there were two cars in the driveway but oftentimes at least one of them was second-hand, and the rare family vacation was often a week at a rented cottage on one of Michigan’s many inland lakes. But we had food on the table and a roof over our head, culminating in their dream of a house on enough land to placate the ball-playing needs of three growing boys – five acres was plenty enough.

That’s how I was taught, and while I didn’t take those Depression-era lessons completely to heart, I remembered enough to be prudent at times when the chips were down as I made my way in life.

So let me return to Kelly for a moment:

A combination of crushing student loan debt, low-wage jobs and escalating home and rental costs has a huge impact on Millennials and Gen-Zers. If a person does not feel financially secure nor confident about their future, it’s natural to hold off making big commitments, such as getting married, purchasing their first home and having children. These things were once taken for granted by older generations. Now, it’s a hard-to-reach and nearly impossible dream for many people.
“Why Young Voters Are Embracing Bernie Sanders And Democratic Socialism,” Jack Kelly, Forbes, February 5, 2020.

I think Kelly definitely overstates the “taken for granted” because older generations were taught that achieving those milestones took hard work, patience, and sacrifice.

No one is putting a gun to your head to take out student loans in order to afford college. There are several alternatives:

Begin your college career at a more affordable state school or community college
Attend part-time and work full-time
Embark on a career that doesn’t require a college degree, such as a trade
Join the armed forces and eventually attend on the GI Bill

Yes, this is a sacrifice in some respects – but perhaps it’s better to sacrifice now when the stakes are low than chain yourself to decades of debt.

When it comes to the other two aspects Kelly cites, getting married and having children, we’ve often found that the younger generation does this in the wrong order by having the kids first. Now while I remind you I keep a (pretty much) family-friendly, PG-rated shop here, I have to bend the rules for a moment for a reminder:

Guys: think with the head on your shoulders, not the one between your legs.
Ladies: you have the ultimate say in the matter, and I’m not talking about abortion as birth control. If you don’t want to have a child yet, then keep those legs together.
I don’t care what brand of condom you use, if you’re on the Pill, or whatever method you may think will cheat the inevitable. It’s gonna fail. Remember, when it comes to birth control, only abstinence works 100 percent of the time it’s tried.

And let’s talk about high rent and health insurance costs. Has it ever occurred to our little snowflakes that perhaps part of the problem with high rent is the overhead a landlord has to deal with: taxes, upkeep, perhaps his own mortgage? A landlord also has to build in a little bit of cost for the possibility someone skips on their rent or trashes the place before they go. Yet if you can get something that may not be the newest thing in the hot development but otherwise fits your needs, that’s a little extra to save for a down payment.

Regarding health insurance, let’s just say that thanks to health insurance being mandated, there are a lot of greedy little tongues trying to lap up that manna from heaven called taxpayer money. Some of it comes from Medicare and Medicaid, and some of it comes from subsidies. Plus don’t forget that some medical payments come from dollars you weren’t taxed on. The system hasn’t been a free market in decades, which makes it way more expensive than it would be in a simple fee-for-service world. Indeed our system is broken but Medicare for All isn’t the fix for it.

I’m well past 1500 words of advice here, so I suppose it’s time to cut to the chase: the appeal of socialism is the desire to have reward without responsibility. Working to build up savings isn’t fun, and there is no shortage of people who will tell you that’s old-fashioned and the debt isn’t really that bad. Waiting for marriage to consummate a relationship is a sure ticket to being socially outcast in this day and age, but perhaps in thirty years you’ll find out your marriage is a strong one because you built it on the ground of waiting until you had the emotional part down to begin with the physical part. Now that you have a rock-solid family unit that was raised properly you can look back and laugh about it.

Perhaps I am the worst person ever to give all this advice, but in five and a half decades on this rock I’ve kind of figured out that maybe our parents and the values and morals instilled into them by previous generations were (by and large) right.

The path to socialism is the path to an epic fail. Don’t doubt me. If we’re dumb enough to set foot that way, I fear for this land I love.

Odds and ends number 87

Returning after a nearly five-month hiatus, it’s another edition of my occasional series of items that require anything from a couple sentences to a few paragraphs. Some of it is leftover campaign stuff from this time around, but I’m going to reach back to my 2016 GOP choice to start this off.

Too often, I get an e-mail from Bobby Jindal that links to a piece behind the Wall Street Journal paywall. I like Bobby but I really don’t need to read the WSJ daily, so I miss out on being able to share. In this case, though, I was pleased to see him at National Review, which doesn’t have a paywall. And that’s good because when he points out:

Democrats point to the supposedly existential threat of climate change and the nation’s allegedly inhumane immigration system as reasons to give them control of Congress this November. Yet their failure to prioritize these issues and pass legislation when they controlled the White House, the Senate, and the House during Obama’s first two years in office belie their seriousness. Republicans are currently demonstrating a similar hypocrisy by failing to act on their supposed political priorities, including repealing Obamacare and reducing federal spending and borrowing. Even more dangerously, Republican failure to advance significant conservative solutions to the problems voters care about is setting the stage for Democratic overreach.

(…)

A majority of voters still prefer effective conservative market-based solutions to their real-world problems, but they will settle for government subsidies and dictates as a second-best solution if Republicans fail to offer an alternative. Republicans’ failure to address rising health-care costs when they were last in the majority led directly to Obamacare, and their failure to act today will result in a single-payer system. It all seems fine now, but remember this moment if and when we get single-payer.

As we are seeing in Maryland, single-payer isn’t a great selling political point – yet. But we’re also seeing the Democrats chip away at this by re-branding it as Medicare for All. One irony of entitlement reform as often proposed on both sides is that fixing Medicare will be the impetus for expanding it to a younger and younger age cohort, meaning people my age may soon get it – and entitlement-addled Millennials will soon be following suit because they’ll whine that they don’t have what their parents do, even though the parents have actually paid the Medicare tax for much of their working lives.

But if a market-based solution gains traction – perhaps making personal health insurance premium payments fully tax-deductible (as employer-based insurance payments already are paid pre-tax) would be a good interim step – the advantages of the private market would remain.

Another good step toward private enterprise might be addressing this disparity, as detailed by Hayden Ludwig at the Capital Research Center:

For a republic founded on states’ rights, the federal government owns a lot of American land. In 2017, the Department of the Interior reported federal ownership of 640 million acres—about 28 percent of the United States. Of that, only 2 percent is composed of military bases and training ranges managed by the Department of Defense. Much of the rest – a staggering 246 million acres – is concentrated under a single agency: the Bureau of Land Management, an agency of the Interior Department.

Even if you consider that there are a number of long-standing national parks in the West, the overuse of the 1906 Antiquities Act, especially by Democrat presidents, to create “no-go zones” for development, free use by agricultural interests, or energy exploration means that land isn’t being placed at its highest and best use. But they don’t seem to be resistant to using the land for the boondoggle of solar energy.

Did you know that for each megawatt of solar power created, the subsidy is over $40? That’s not me talking, but a University of Texas study cited by my old friends at Americans for Limited Government. Speaking on solar energy, author Richard McCarty writes:

After years of generous, taxpayer-funded subsidies, solar energy is still unable to compete on a level playing field with coal, natural gas, and nuclear power. Regrettably, solar energy’s higher costs have a human impact making it tougher for less affluent people to stay cool in summer and warm in winter. With so many affordable, reliable energy resources in this country, there is just no excuse for the government to be mandating and subsidizing green energy production.

Of course, if you’ve read my work regularly over the last 12-plus years, you have likely figured out I’m dubious about solar energy being a viable option in many areas of the nation. Obviously it could work off-grid and there’s no doubt the sun is an effective source of warmth in arid areas that enjoy abundant sunshine, such as the deserts in our Southwest, but in most other areas we’re hit-or-miss when it comes to solar power. (Case in point, today’s rainy day with a declining amount of daily sunshine not helping matters.) So while we still have the abundant fossil fuel resources, why not use them?

We don’t know whether Election Day will turn out sunny or cloudy weather-wise, but one thing I do know is that statist advocates like Joe Biden are backing candidates who they think will make their task easier. This is a snippet from a recent e-mail from the Biden-created American Possibilities:

(In June), in the latest threat to our right to vote, the Supreme Court gave the state of Ohio permission to kick thousands of voters off their rolls this fall based on how frequently they’d voted in the past. And now, you better believe that other states around the country are going to be emboldened to try the same thing.

Michael, if there’s anything we’ve learned this past year, it’s that we can’t always predict the future – but we can shape it.

And right now one of the very best ways we can help save voting rights in the United States is by electing strong Secretaries of State, the folks responsible for overseeing elections, all across the country.

So today, I’m endorsing four of these folks – each of them someone who understands that democracy is about making it easier, not harder, for every single one of us to have our say.

What Ohio was doing wasn’t terribly strict – I’ll let CNN explain:

Ohio law allows the state to send address confirmation notices to voters who have not engaged in voter activity for two years. If a voter returns the notice through prepaid mail, or responds online, the information is updated. If the notice is ignored and the voter fails to update a registration over the next four years, the registration is canceled. (Emphasis mine.)

So this purge of the rolls is after SIX years of inactivity to me isn’t all that hardline – particularly in a state like Ohio, which not only has balloting every year (primary and general for federal, state, and county offices in even-numbered years, primary and general for municipal and township offices and school boards in odd-numbered years, plus special elections for tax levies as needed) but also makes it fairly easy to get an absentee ballot and has a generous early voting schedule that actually makes Maryland look like pikers. If you’re not interested in participating after at least 12 (and probably closer to 15 to 20) opportunities to vote, it’s pretty likely you won’t.

And I think that law is good protection – I didn’t want someone claiming to be me to vote in my stead when I left the state. I seem to remember contacting my old Board of Elections once I registered here after the 2004 election to make sure they took me off the rolls. (Despite being here, that year I voted absentee in Ohio because I arrived after Maryland’s registration deadline in mid-October. If it weren’t a Presidential election, I probably would have skipped it.) Biden wants Secretaries of State that will not take the time to prune lists of ineligible voters and allow for same-day registration.

That’s straight out of the Democrat playbook, as expressed by DNC Chair Tom Perez:

Democrats are doing all we can to make sure that every eligible voter can exercise their constitutional right at the ballot box. That’s why we’re encouraging all states to offer same-day voter registration and the ability to register as a Democrat to vote in Democratic primaries. (Emphasis in original.)

Can you say Operation Chaos 2020?

Remember, it’s not the votes that count but who counts the votes. Ask Norm Coleman.

Since I brought up Ohio, it’s also the base for a pro-life advocacy group called Created Equal. Something they’re doing as their ministry is taking the pro-life message to the streets, as they detail in a video series they’re promoting called Preborn Defenders 101. It may be a good reference for others who share the pro-life philosophy – as they note, “our training is not theoretical. It is tested and tried in the fires of the public forum.”

(Public service announcement in that vein: the annual fundraising dinner of the Eastern Shore Pregnancy Center comes up next month.)

Hopefully that dinner won’t conflict with the second scheduled Senatorial debate, which I found out about by accident: the Neal Simon campaign was announcing their second television spot – obviously they can afford it. As they describe the commercial:

The ad presents Simon as a strong, independent voice who will work for all Marylanders in Washington, and criticizes the two political parties and its leaders for playing partisan games that are dividing Americans and blocking progress.

I don’t know about either strong or independent, given the composition of those who donated to him, but they sure had to spin the recent Goucher Poll (slightly edited for spacing purposes):

———-

If you are writing something about the Goucher poll today or this week, the Neal Simon, unaffiliated candidate for the US Senate, campaign can provide a comment/quote, if you like.

Key components here are the following in our mind:

Momentum is a powerful force and it is beginning to swing our way:
- In campaigns, nothing is more powerful than momentum and we feel like it is on our side and we are just getting going.
- In 2 weeks, we expect to see another statewide poll, and we believe our numbers will prove that we are gaining momentum
During a campaign, support for candidates either rises or falls: we are rising, our opponents are falling:
- Our message resonates with voters, and as a result of our campaign, the Republican and Democratic candidates have seen their support decline.
- We have gone from 0% to 8% – Neal had no name ID when this started – the media is not covering our news, we have to buy exposure (that is an entire other topic).
- If you look at other state-wide races like AG, the Republican is polling at the rate of registered R voters. Campbell is polling way lower than that.
- Neither Cardin nor Campbell has enthusiasm – we went up 8 points, they went down. Neal is the only candidate with any kind of momentum.
- Cardin has 56%, but 60% of people polled are registered democrats
- Campbell polled at 17%, with 26% registered republican voters in the state.
- As more voters see our ads, hear our message, and meet Neal on the campaign trail, support for major party candidates will continue to decline. Neal looks forward to the debate on October 7 to speak directly to the people of Maryland.

———-

What this shows to me is that Republicans (most of whom did not vote in the primary) may be operating under the belief that Neal is the endorsed Republican candidate. Normally the two dominant parties are on television, but in this case Campbell’s fundraising has been anemic (in all likelihood because donors believe he has no chance; alas, a self-fulfilling prophecy) while Simon lent his campaign more money than all the Maryland Republicans in federal races – except Andy Harris – have on hand combined.

So the bite out of the GOP total is coming from having a candidate that voters may well believe is the GOP nominee, running as a populist outsider in the vein of Larry Hogan. If anything, though, Simon should be taking from the Democrat’s total because his political philosophy is more aligned with them. That’s the only way he’s going to win, anyway. But Neal does need some percentage of independents and unaware Republicans to win.

By the same token, Tony Campbell’s extremely narrow path to victory comes down to this: Simon draws enough Democrat and independent support from Ben Cardin to split their vote, with common-sense independents and a strong GOP turnout backing Campbell. Maybe it’s time for Larry Hogan to work for the Republican team that consists of himself, Craig Wolf for Attorney General, Tony Campbell for Senate, and whatever local candidates are there for his stops – the only reason Larry and crew needs to be on the Eastern Shore is to back Mary Beth Carozza over the guy who voted to overturn Hogan’s veto 5 times in 7 key votes over the last three years.

It may make conservatives sick to their stomach to run the kind of campaign that gloms onto the moderate Hogan’s popularity, but the time for conservative principles comes when they actually govern, not on the campaign trail in a state that doesn’t know better (yet. I can only push back the frontiers of ignorance just so quickly.)

Now that my mailbox is empty, I suppose I can put this post to bed. It’s been fun putting this one together.

How much will it cost? (Part two of a multi-part series)

I really didn’t mean to take so long between part one of this series and part two, but because the second item on the Ben Jealous for Governor issue list is health care – and there’s a claim out there that his plan will cost Maryland a staggering $24 billion a year, according to analysts at the state’s Department of Legislative Services – I was hoping to see the actual evidence before I wrote the next part. But my trips to the DLS website have been fruitless, leading me to believe that there were a couple cowboys at the DLS who chose to leak this to the Sun.

So before I say this will cost $24 billion a year, I suppose the best thing to know is how we would pay for this program called “Medicare-for-All.” Here’s how Jealous explains the key benefit for the majority of us who are under employer-sponsored plans:

This system will end premiums for participants, reducing costs to most employees and employers. It will be important to create a system that ensures covered employees also see the benefit of this change. MD-Care will explore creating safeguards to ensure that employer savings are passed down to the workers in increased wages, and guarantee that workers see real savings instead of having all of the gains captured by employers no longer paying premiums. (Emphasis mine.)

It’s worth pointing out that health insurance as a employer fringe benefit is a relatively new phenomenon, one that began when wages were frozen during World War II. Since workers (generally those belonging to unions) could not receive wage increases, the measure to circumvent this prohibition was the inclusion of health insurance – with the added bonus of employer-paid premiums being non-taxable income.

Basically what Jealous wants to do is enforce a raise to workers who currently receive these benefits, whether deserved or not. That seems to me a good way to kill jobs in the state.

And stop me if you’ve heard this one before:

Those who want to keep their existing Medicare program will be able to.

Bear in mind, of course, that Medicare is not free. Those of us who work for a living see that little category on our pay stubs – mine actually calls this “Medicare Employee” – and every couple weeks a few dozen dollars added to that total. I guess that’s the down payment on what we have to pay when we get to the age where we can presumably sign up and collect on Medicare, which isn’t really free but has a bewildering array of premiums, deductibles, and co-insurance payments. So to say Medicare-for-All is “free health care” or “single-payer” is clearly a misnomer because there are three payment sources: your pocket, the generosity of those who pay the taxes but don’t use the service, and (in the case of the federal government) a massive amount of IOUs.

Jealous then cites a Kaiser Family Foundation estimate that health care in Maryland costs $51 billion a year (at least it did in 2014) and proclaims:

This is simply unsustainable, and MD-Care offers an opportunity to finally get costs under control. Administrative savings could quickly add up to billions of dollars in Maryland and fully expanding the All-Payer model would finally allow us to bend the “cost curve” in medical spending. In addition, by ensuring the plan is designed properly to reduce costs and maximize federal dollars, we can further reduce the healthcare burden on Maryland taxpayers.

So wait a second: this is Maryland’s plan, but we’re expecting everyone else to pony up and pay more for it? Yeah, that will fly like a lead balloon.

And I’m not sure where “administrative savings” (if administration is 8% of health care cost, that’s $4 billion for Maryland) comes from when people who work for those eeeeeevil insurance companies (mainly paid for with private-sector dollars) are repurposed as government employees who are paid from the public till, to wit:

This plan and the Maryland All-Payer Model Progression Plan call for widespread use of emerging new titles in healthcare such as coordinators and community health workers to ensure that high risk populations are being treated properly (and at lower cost). This offers an opportunity to minimize the net disruption to employment by ensuring job retraining and preferences for those who previously worked at private insurance companies. Instead of thousands of workers in Maryland being paid to deny access to care, they can now be paid to provide healthcare.

In addition, there is going to be a need for administrative employees to ensure that Maryland is complying with all federal law so we can continue to draw down dollars for Medicare, Medicaid, CHIP, and the ACA.

So much for saving on administration; in fact, given the lavish government payroll that seems to be a cost increase.

Speaking of cost increases, here’s where it gets important:

There is no question that any plan will have significant cost savings compared to current healthcare spending, while also moving most healthcare dollars away from the insurance companies and into the plan. These variables will determine the final cost of the plan and the revenue requirements. Among other revenue options the advisory panel will consider:

Income Based Premium Paid by Employers

This premium would be a deductible business expense, meaning this plan will have the same tax advantage status as employer provided healthcare. However, it is unknown how businesses will react to this, and significant input from the Maryland business community will be needed. Businesses would have predictable health insurance costs instead of double-digit increases with no end in sight.

Sales Tax

Having some portion of the plan paid for by a sales tax would have several advantages, including capturing revenue from non-Marylanders. It would also reduce the amount of revenue needed on the payroll side, thus reducing the taxation burden on new employment. At the same time, a sales tax is regressive by nature, so any tax increase on working Marylanders would have to be measured against the net benefits received from this plan.

Non-Payroll Income Premium

A non-payroll income premium would ensure that the most financially successful in Maryland pay their fair share of taxes. The advisory panel will need to study the tax sensitivity of these higher earners to ensure that any increase doesn’t result in significant population shifts in the region to avoid any changes to the Maryland income tax system.

I can tell you exactly how business will react to the first one, Ben: they will close their doors and/or leave. Those that have to stay will be hiring fewer people, and they have the perfect incentive:

We will also look at ways to ensure that small businesses and new companies succeed under this plan. This could mean exempting small businesses and start-ups from additional taxes associated with MDCare depending on revenue or firm age. The advisory panel will work with the small business community to design an exemption that makes the most sense.

One surefire way to cut revenue to fit under the limit: close a few locations, let go a few workers, and fold the business into a newly-formed holding company.

Because of that possibility, my thinking on this is that Jealous would go with a blending of options two and three: perhaps an increase in the sales tax from 6% to 8% and a reprisal of the infamous “millionaire’s tax” that will cause capital to flow out of the state.

Assuming that the roughly $4.6 billion collected by the state in sales taxes in FY2017 is a valid figure, a sales tax increase to 8% would cost taxpayers roughly $1.1 billion a year, and $5.5 billion over five years. A millionaire’s tax would be perhaps a $500 million cost to taxpayers over 5 years.

But that won’t begin to cover this program – not when spending is $51 billion a year now, and probably $70 billion when it’s “free.” (That is if you can find a provider – only 7 of 10 providers accept new Medicare patients.)

The most truthful statement made from Ben on the subject is this one, a throwaway line on his “Path to Medicare for All“:

When the ACA was written, Democrats were overly concerned with the optics and not enough with the actual mechanics of the bill.

Yes, we had to pass it to know what was in it. Likewise, we have no idea if that $24 billion cost is anywhere close to reality but it is likely that state revenues will take a significant hit as private-sector businesses throw in the towel.

Next up in this series will be Criminal Justice, a platform that likely has more holes in it than Swiss cheese.