Trying To Get It Right

Dale Folwell is the State Treasurer of North Carolina. He was responsible for getting the state out of debt to the federal government unemployment benefits program (over the objections of many Democrats) and is now working to bring transparency to health benefits for state workers (again over the objections of Democrats and some Republicans).

The Carolina Journal reported on June 17th that Mr. Folwell is actually  making some progress.

The article reports:

With a deadline just 13 days away, Community Care Physician Network, North Carolina’s largest network of independent physician clinics, announced Monday, June 17, it signed on to the State Health Plan’s cost-cutting Clear Pricing Project.

Community Care Physician Network is associated with 2,500 primary care clinicians, pediatricians, family medicine physicians, obstetricians/gynecologists, psychiatrists, psychologists, nurse practitioners, and physician assistants. The group has more than 880 practices statewide. The network treats more than 2.5 million North Carolinians, including 700,000 Medicaid beneficiaries.

“Their physicians are leaders in our state in developing the highly regarded medical home model. They’re known nationwide for high quality care, patient satisfaction and by using their innovative, collaborative approach to drive down costs,” Folwell said in a news release announcing the move.

Folwell says health care costs must be reduced immediately. The State Health Plan is only 3% funded, has $35 billion in unfunded liabilities, and will become insolvent in 2023. The Treasurer’s Office projects taxpayers could save $258 million and plan members $57 million annually under the Clear Pricing Project. The changes take place in 2020. Providers have until June 30 to join the project.

“It made good sense to us,” Conrad Flick, Community Care Physician Network co-president, said of linking with the reconstructed plan. “We’re dedicated to our communities and our patients, and focused on providing them with better and more cost-effective health care.”

The article concludes:

The N.C. Healthcare Association, the lobbying arm of hospitals and large health systems, continues to oppose Folwell’s plan. The group pushed for passage of House Bill 184 to halt the reforms and launch a two-year study instead. The House passed the measure, but it has gotten no traction in the Senate.

Hospitals say the cost-cutting features of Folwell’s plan jeopardize the survival of rural hospitals. Folwell said most rural hospitals will be better off financially under the plan, and nine of 10 primary care physicians will get more money.

Montana is among a handful of states that use the reference-based pricing model for their state health plans. Officials there told Carolina Journalthe results are positive.

Dale Folwell is attempting to bring the same sort of fiscal sanity to healthcare in North Carolina that he brought to unemployment benefits. Let’s hope that he is successful.

We Need To Get Healthcare Right

Yesterday Issues and Insights posted an article about ObamaCare 10 years out.

The article reports:

Based on polling data, Obamacare has been a miserable failure, and Obama will be far from the last president to grapple with this issue.

The most recent Wall Street Journal/NBC News poll finds that health care is at the top of the nation’s priority list, with 24 percent of respondents listing it as their top priority for the federal government. Next on the list is immigration, at 18 percent, and after that, economic growth at 14 percent. 

The poll also found that 42 percent list health care as either their first or second choice on the priority list.

Back in June 2008, when Obama was running for president, only 8 percent rated health care as a top priority, just 20 percent as their first or second priority. Of course, the economy was in a recession and the country at war with Iraq, both of which weighed heavily on the public’s mind at the time.

But even in earlier years when the economy was doing well, health care ranked far lower on the list of priorities than it does today. In June 2006, only 14 percent ranked it as No. 1 on their list. A year later, 15 percent said it was their top priority.

The public has not been impressed with ObamaCare:

An ongoing Gallup survey finds that the public was actually more satisfied with their own coverage and quality of health care in 2007 than they were in 2018. Other surveys find cost remains a major complaint.

The article lists a few problems with ObamaCare:

It has done nothing to slow, much less reverse, the rising cost of health care. In fact, Obamacare itself caused premiums in the individual market to more than double in its first four years.

…National health spending, which was 16.3 percent of GDP in 2008, is now 17.9 percent and is slated to hit 19.4 percent by 2027. Per-capita spending on healthcare jumped from $7,898 to $10,739 over those years.

Far from driving the deficit down, Obamacare is pushing federal red ink up. The Congressional Budget Office has calculated that repealing Obamacare would cut the deficit by some $473 billion in the first 10 years

Rather than admit failure, the Democrats simply want to throw more money at it.

The article concludes:

Naturally, because of these failures, the Democrats’ answer is to dump even more taxpayer money into government-run health care programs, with most now favoring a $32 trillion plan developed by socialist Bernie Sanders to have the government nationalize the entire health insurance industry.

Only in government, and only among fans of big government, are massive failures like Obamacare rewarded with still more government. 

Bad Day at Black Rock

Below is a guest post by Raynor James, an eastern North Carolina resident who has followed the debate on North Carolina House Bill 184 very closely:

Tuesday, April 3rd was a sad day in the North Carolina House of Representatives.

Let me tell you about it. Dale Folwell is North Carolina’s Treasurer. He’s a very popular fellow for all the right reasons. He did a good job when he served in the North Carolina General Assembly. He got North Carolina’s unemployment insurance out of debt to the Federal Government when he served in Governor McCrory’s administration, an accomplishment that continues to save North Carolina’s employers significant sums annually. He’s known as a problem solver.

North Carolina’s State Health Plan (which pays for medical expenses of current and retired state employees) is seriously underfunded and is projected to be bankrupt by the year 2023.When Dale Folwell was elected Treasurer, many who voted for him expected him to solve the Plan’s problems as its administration was in the Treasurer’s portfolio.

Enter HB-184 which if implemented will tie the Treasurer’s hands and not allow corrective action to be taken while a committee studies the situation.

HB-184 was debated on the floor of the House April 3rd. Let’s look in on how some conservative House members tried to kill the bill.

First, Representative Michael Speciale offered two amendments to the bill. Representative Speciale’s first amendment would give the Treasurer a vote on the study committee and would make it impossible to expand the size of the committee (something that is sometimes done when the “powers that be”don’t like the direction a committee seems to be taking).

That amendment passed by a vote of 106 to 5.

Representative Speciale’s second amendment would remove Section 2 from the bill. Section 2 requires that Blue Cross-Blue Shield continue to be used during the study period.

It also prevents the Treasurer from switching the Plan to using referenced based pricing for medical services to the Plan during the study period.That amendment failed by a vote of 88 to 23.

During debate on HB-184 itself, Representative Larry Pittman cited a memo from the Plan’s Board of Trustees that projects that the plan will be out of money in 2023, and said that we can’t wait on a two year study. He talked about how hospital groups were groaning about how burdensome the Treasurer’s planed payment changes would be on them [tie pricing of medical services to 172% of the average Medicare pays for the same service], and pointed out how well funded many hospitals are. In support of his assertion, Representative Pittman mentioned that the hospital at East Carolina has given $10 million dollars to fund a stadium.

Representative Pittman asked that members not pass the bill and added that when Treasurer Folwell had requested info from the hospital groups, they had sent him the schedules he asked for with page after page blacked out. “They might as well have slapped him in the face and spit on him,” Representative Pittman said.

He continued by saying passage of the bill would hurt both members of the Plan and taxpayers who pay the freight and pointed out that members of the Plan are also taxpayers, so they get hit two ways.

He stated that Dale Folwell is “competent” and “honest” and renewed his request by saying, “Defeat this bill.” Representative Michael Speciale said, “We’re told that if we don’t pass this bill, the sky will fall; we’ll lose our rural hospitals.” He went on to say that they’d heard the same thing when he was trying to get rid of the CON [Certificate of Need] laws [which did not pass] and shortly thereafter they closed one of the hospitals in my district.”

“I hear fake news ads” [on the topic of rural hospitals closing if HB-184 doesn’t pass] when I drive in my district.”

Representative Speciale went on to say that Dale Folwell got the people together who are opposing him [mainly large hospital groups] and asked how much waste, fraud, and abuse there is in the system. The answers they give him ran from 12% to 25%, so he took a middle number and asked them to figure out how they could reduce costs by 15% and said that they needed to get together again as soon as that was done.

After that meeting, Treasurer Folwell tried to set follow up meetings, and time after time he was stonewalled.

Representative Speciale continued, “Now we’re faced with $33 to $36 billion dollars in unfunded liabilities. If we don’t allow him to cut costs, how are we going to cut costs because it’ll be on us!”

“Dale Folwell has increased what would be going into rural hospitals. He’s compromised, but they won’t budge an inch.If we do not pass this bill, then the hospital lobby will sit down and talk to him. Let the state Treasurer do what he was elected to do. Throw the politics aside and vote NO!

Representative Keith Kidwell said, “For the last 10 years, health care costs have gone up and up. We asked Treasurer Folwell to handle it. Let’s not bobble him,or we’ll be faced with taking $235 million to $509 million [dollars] from the general fund to deal with the problem AND $1.1 billion will be added to the unfunded liability.”

“HB-184 will cost us a ton of money!” “Cut through partisanship and look at the numbers! We HAVE to block this bill!’

In spite of those eloquent pleas and others, too, HB-184 passed 75 to 36, and it will now be sent to the North Carolina Senate where it is hoped that wiser voices will prevail.

If you’d like to hear the whole debate, you can go to the NC General Assembly website at which NC House sessions are archived.

Thank you, Raynor. This is a picture of what is going on in the North Carolina state legislature. President Eisenhower warned about the military-industrial complex. What we see here is the result of intense lobbying by the healthcare-industrial complex. We need to stop this bill.

Good News On Healthcare

The Daily Signal posted an article today about President Trump’s plan to reform healthcare (which obviously starts with the removal of ObamaCare).

The article reports:

A look at his fiscal year 2020 budget shows that the president has a plan to reduce costs and increase health care choices. His plan would achieve this by redirecting federal premium subsidies and Medicaid expansion money into grants to states. States would be required to use the money to establish consumer-centered programs that make health insurance affordable regardless of income or medical condition.

The president’s proposal is buttressed by a growing body of evidence that relaxing federal regulations and freeing the states to innovate makes health care more affordable for families and small businesses.

Ed Haislmaier and I last year published an analysis of waivers that have so far enabled seven states to significantly reduce individual health insurance premiums. These states fund “invisible high risk pools” and reinsurance arrangements largely by repurposing federal money that would otherwise have been spent on Obamacare premium subsidies, directing them instead to those in greatest medical need.

By financing care for those with the biggest medical bills, these states have substantially reduced premiums for individual policies. Before Maryland obtained its waiver, insurers in the state filed requests for 2019 premium hikes averaging 30 percent. After the federal government approved the waiver, final 2019 premiums averaged 13 percent lower than in 2018—a 43 percent swing.

The article explains that the President’s plan is similar to another proposed plan:

It closely parallels the Health Care Choices Proposal, the product of ongoing work by national and state think tanks, grassroots organizations, policy analysts, and others in the conservative community. A study by the Center for Health and the Economy, commissioned by The Heritage Foundation, found that the proposal would reduce premiums for individual health insurance by up to 32 percent and cover virtually the same number of people as under Obamacare.

It also would give consumers more freedom to choose the coverage they think best for themselves and their families. Unlike current law, states could include direct primary care; health-sharing ministries; short-term, limited-duration plans; and other arrangements among the options available through their programs.

Those expanded choices would extend to low-income people. The proposal would require states to let those receiving assistance through the block grants, Medicaid, and other public assistance programs apply the value of their subsidy to the plan of their choice, instead of being herded into government-contracted health maintenance organizations.

We can do better at healthcare. Either one of these proposals would be a great start.

The Real Numbers

On Friday The Daily Signal posted an article about the consequences of winding down ObamaCare. It seems that the press and the Congressional Budget Office lied to Americans about the consequences of repealing ObamaCare.

The article reports:

According to a report by the Centers for Medicare and Medicaid Services released Wednesday, the Congressional Budget Office wildly overestimated the number of people who would lose their health insurance with the repeal of the individual mandate penalty.

Initial estimates from the Congressional Budget Office said 14 million would drop off their health insurance coverage due to the elimination of the individual mandate. Then, during the height of the 2017 debate over repeal, progressives touted a leaked number from the Congressional Budget Office claiming that 22 million people would “lose” their insurance if Congress repealed the law.

However, as health care analyst Avik Roy pointed out, what made this number so high was the inflated number of people expected to lose their insurance due to repeal of the mandate—about 73 percent to be exact. So, it wouldn’t be 22 million Americans losing their insurance. Most of those in the projection would simply be choosing to opt out of insurance.

And it turns out even that wasn’t true. A far smaller number of Americans appear to be opting out of insurance since the individual mandate’s repeal. Only 2.5 million more people are expected to go without insurance in 2019 due to its repeal, according to the latest report, and that number is expected to decline in the years ahead.

Putting the government in charge of healthcare is always a bad idea. Economist Milton Friedman once stated, “If you put the federal government in charge of the Sahara Desert, in 5 years there’d be a shortage of sand.” The government is not responsible for providing healthcare to anyone. Charitable hospitals and charitable organizations are welcome to take on that responsibility, but government healthcare is nowhere to be found in the U.S. Constitution.

The article further states:

Doug Badger, a visiting fellow in domestic policy studies at The Heritage Foundation, told The Daily Signal that Congressional Budget Office analysis has been a chronic problem.

“When it comes to the individual mandate, CBO has never let the facts affect their wildly inaccurate estimates. CBO continued to forecast that millions of insured Americans would suddenly become uninsured if the mandate were repealed,” Badger wrote in an email to The Daily Signal. “CBO’s faulty estimates misled the public into believing that repealing Obamacare would lead to a vast increase in the number of uninsured. Bad estimates produced bad policy.”

Many conservatives are fed up with the deference shown to the agency, given it’s poor track record and track of transparency. Reps. Mark Walker, R-N.C., and Jim Jordan, R-Ohio, suggested in 2017 that it’s time to stop “blindly” following the agency’s predictions.

“The value of having outside experts review legislation cannot be understated,” they wrote for the Washington Examiner. “But continuing to hinge congressional actions on the projections of an agency that has proven to be so consistently wrong does a disservice to not only members trying to represent their constituents, it primarily does a disservice to the public.”

I wrote in 2017 that perhaps we should be more skeptical toward the findings of independent agencies like the Congressional Budget Office. It seems those doubts were valid.

People based their votes on the information they were given. It is a shame that a government agency provided inaccurate information.

Have We Passed The Point Of Being Able To Have A Serious Discussion Of Issues?

On Friday, The Daily Signal posted an article that provides some background information on Stacey Abrams.

These are some basic facts about Ms. Abrams listed in the article:

1. She ‘Wouldn’t Oppose’ Noncitizen Voting  –  she did support the idea of non-citizens voting to local elections, but the fact remains that people who are here illegally are breaking the law and should not have voting rights.

2. She Wants to Turn Georgia Blue – that’s not all that unusual, but her approach in somewhat interesting.

3. She Wants to Promote ‘Race and Gender’ Issues – has anyone else noticed that promoting race and gender issues divides us rather than unites us?

4. She Was Endorsed by Planned Parenthood – just for the record, Planned Parenthood receives on average approximately $500 million a year in taxpayer funds. How much of that money is essentially laundered and spent on campaign contributions?

5. She Is ‘Sick and Tired’ of Free Market Role in Health Care – actually health care worked very well until the government got involved – people were taken care of and the cost was not prohibitive.

6. She Says ‘Liberal’ Is a Good Word – that is her privilege.

7. She Says the AR-15 Doesn’t Belong in Civilian Hands – Don’t look for her to support the Second Amendment.

And finally:

8. She Is a ‘Romance’ Novelist – she writes sexually explicit romance novels under the name of Selena Montgomery.

The comments in bold type are from the article. Other comments are mine.

This is the person the Democrats have chosen to respond to the State of the Union address.

This Really Shouldn’t Be A Surprise

A few years ago, I moved from Massachusetts to North Carolina. There was some culture shock. One part of that shock was the gun culture of some of the South. I grew up in a house where no one hunted, so the whole gun thing was very foreign to me. One of the first things I did was to take a gun safety course to education myself. I learned a lot and began to understand why the Second Amendment is so important to our freedom. Unfortunately the leaders in the Commonwealth of Massachusetts have not yet gotten that message.

Yesterday The Gateway Pundit posted the following headline, “Boston Mayor’s Office to Force Doctors to Identify and Document Patients Who Own Guns.” Wow. What is the Mayor’s office doing collecting information from doctors?

The article reports:

Here are three of the top goals for health care legislation outlined by his office:

Involving doctors in gun safety: This act would require medical professionals to ask patients about guns in the home, and bring up the topics of gun safety. The goal, Boston Police Commissioner William Gross said, is to identify those at risk for domestic violence, suicide or child access to guns in order to guide people to mental health counseling, resources or other help. “We’re just asking them to help identify ways to save lives,” Gross said.

The fact that a patient owns guns would not be put in their medical record, and is not intended to have physicians help solve crimes.

Chief of Health and Human Services Marty Martinez said that while the program is already common practice at many of the city’s community health centers, legislation would broaden the program statewide.

Does anyone actually believe that gun ownership would not be made part of a patient’s medical record? If the measure is supposed to save lives, what action are the doctors supposed to take after they have determined that a person has guns in the house?

I may be paranoid, but this seems like a back door approach to finding out who has guns so that the guns might be taken away later.

My, How Times Change

Remember when the Democrats told us that ObamaCare was not a step in the direction of government-controlled single-payer healthcare? Well, that statement is now inoperative.

The Washington Examiner reported the following yesterday:

House Budget Committee Chairman John Yarmuth, D-Ky., has asked the Congressional Budget Office to analyze the effects of shifting all healthcare costs onto the federal government, a first step toward the “Medicare for all” legislation sought by progressives.

…Yarmuth said in a statement that his request for the score is aimed to inform House hearings on “single payer,” proposals. Such hearings would be the first step in the process toward passing legislation enacting single payer systems, a top goal pursued by progressives like Sen. Bernie Sanders, I-Vt., and Rep. Alexandria Ocasio-Cortez, D-N.Y.

The article concludes:

The study concluded that overall spending, not just government spending, would be $2 trillion less compared to where spending is projected under the current healthcare system, but that would come mostly through cutting payments that hospitals and other providers were getting from private insurance by about 40 percent. Higher taxes may be under consideration to have Medicare payments align more closely with those of private insurers.

Sen. John Barrasso, R-Wyo., had asked CBO to score the Medicare for All Act introduced by Sanders. In taking up various requests, CBO analysts tend to focus on bills that are closer to passage.

If you read this blog on a regular basis, you have seen this quote before, but here it is again:

Milton Friedman, “If you put the federal government in charge of the Sahara Desert, in five years there’d be a shortage of sand.”

Britain has single-payer health care. In March 2017, The Daily Wire posted an article about the problems with the British health care system.

These are some of the highlights from the article:

“Pressure on all services is rising and care is increasingly being rationed. Waiting lists should not be rising, and yet they are,” said Mark Porter, council chair of the British Medical Association (BMA).

“Doctors always want to deliver the best possible care for our patients, but we can’t continuously plug gaps by penny pinching and poaching from elsewhere in an overstretched NHS.”

…A study conducted by the London School of Hygiene and Tropical Medicine concluded that around 750 patients a month – one in 28 – pass away due to subpar quality of care, which includes “inattentive monitoring of the patient’s condition, doctors making the wrong diagnosis, or patients being prescribed the wrong medicine.” In other words, patients needlessly die as a result of the incompetence of the NHS.

For example, in January an elderly woman died from cardiac arrest after waiting 35 hours on a trolley because there was a shortage in hospital beds. A 73-year-old man also died from an aneurysm in the same hospital as he languished in the waiting room.

Please follow the link above to read the entire article. Note that single-payer health care is government-controlled. Do you really want the government controlling your health care?

Six Major Challenges In 2019

On December 28th, Investor’s Business Daily posted an editorial listing what their editors considered would be the top six issues of 2019. The title of the editorial is, “Will 2019 Be Happy? It Depends On How Washington Handles These 6 Challenges.” I suspect that is true.

The editorial lists the six items:

1. The Federal Reserve

2. Trade

3. Immigration

4. The Coming Budget Battle

5. Slaying The Regulatory Dragon

6. Fixing Health Care ‘Reform’

Here are some of the observations from the editorial on each item:

The Fed has raised its benchmark funds rate eight times over two years in pursuit of a “neutral” rate. Its most recent rate hike, coming about a week before Christmas, was followed by a steep decline in stocks and growing concerns that the economy might fall into recession next year if the central bank follows through on its plan to raise rates at least twice more.

It’s of more than academic interest that all 11 of the U.S. recessions since World War II were preceded by a sharp run up in Fed rates. Every one of them. It’s not a record of which to be proud.

…Despite bitter criticisms, President Trump successfully concluded a “new Nafta” deal with both Canada and Mexico covering $1.3 trillion in trade. The deal closes a number of holes in the old Nafta, increasing U.S. access to Canadian dairy markets, for instance, while also making cars tariff-free if 75% of their parts are made in the U.S., Canada or Mexico. All three countries signed off on the deal. The only question is, will it ever go into effect?

With Democrats controlling Congress and just six months for the trade deal to go into effect, some worry that major changes will be requested. President Trump has asked that either the new U.S.-Mexico-Canada Agreement be approved outright, or revert to the pre-Nafta trading rules. Congressional Democrats may even challenge Trump’s right to make a deal, putting the so-called USMCA in limbo. Stay tuned.

…With Americans eager to control immigration, as polls repeatedly show, Democrats may decide that negotiation rather than confrontation is a better tactic. That could mean a deal for a pathway to citizenship for the millennial illegal immigrant “dreamers,” many of whom have lived in the U.S. for most of their lives despite not having citizenship. With an estimated 22 million illegals in the U.S., many states are eager to gain some stability in our immigration policy.

…This year’s budget battle over funding the wall will likely pale in comparison to next year’s. The continued growth in entitlements, compounded by the sharp rise in interest payments, thanks to the Fed’s rate hikes, will balloon the deficit. The Congressional Budget Office’s last official projection pegged the deficit for 2019 at $981 billion. It will likely end up topping $1 trillion.

…But as we’ve pointed out many times, the problem isn’t tax cuts, it’s the unwillingness of anyone in Washington — including Trump — to deal with entitlement programs that have swamped the federal budget. Trump and the GOP will have to stand firm on taxes next year, while grappling with a rising tide of debt that will soon surpass $21 trillion.

…ObamaCare limped along for another year, with premiums for 2019 falling, overall, after years of massive double-digit increases. Trump took several steps to improve ObamaCare. The most important fix was to breathe life back into the short-term insurance market that President Obama tried to snuff out to protect the ObamaCare exchanges. Unfortunately, since Republicans blew their chance at repeal, the best we can hope for is that Trump will continue to tweak the law where he can. But he shouldn’t shy away from fighting for more free-market reforms. Should Democrats resist, or start pushing for socialized “Medicare for all,” it will create an opportunity for Trump to paint Democrats as big-government extremists.

The article concludes:

The coming year will be eventful, with many of Trump’s main initiatives set for action by Congress — a Congress, as we noted, that won’t be as friendly to Trump as the last one. Whether Trump and the Democrats can, as the bumper sticker says, coexist, or whether the Trump agenda founders on a never-ending stream of congressional investigations and hearings on the White House, remains to be seen. We guarantee it won’t be boring.

Get out the popcorn.

Misleading Voters In The Hope Of Winning Elections

Investor’s Business Daily posted an editorial on Friday about misleading claims about ObamaCare by Democrats running for office.

The editorial reports:

Democrats want health care to be a major deciding issue in the midterm elections and are spending a fortune running campaign ads. Too bad most of the ads make the false claim that Republicans would take away protections for pre-existing conditions.

From January to July, Democrats spent some $17 million for 56,000 health care ads on behalf of Senate candidates, according to USA Today.

The Wesleyan Media Project reported that 44% of all the ads for congressional Democrats focused on health care. In Senate races, half of the ads were on health care, and another 16% on prescription drug costs.

One of the claims in the ads is that Republicans want to deny insurance to those with pre-existing conditions. This is a scare tactic.

The editorial explains the Republican plan for dealing with those who have pre-existing conditions (The article notes that the individual market comprises just 7% of the total insurance market. And of those, only a much smaller fraction had ever been denied coverage due to pre-existing conditions before ObamaCare.):

One GOP idea was to create subsidized high-risk pools for those whose health needs would truly make them ineligible for coverage. Another was to provide protections for those who maintain continuous coverage. That would prevent people from gaming the system by waiting until they’re sick to buy insurance. (In contrast to ObamaCare, which encourages people to game the system.) Still another was to expand access to group coverage by removing needless government restrictions on “association health plans.”

Whatever anyone thinks of the Republican alternatives, it’s clear that ObamaCare’s approach is failing. Its rules and mandates led to double-digit price increases year after year, which have priced millions of families out of the insurance market altogether. (So much for guaranteed coverage.) Those who can afford ObamaCare coverage have no choice but to enroll in HMO-style plans with extremely high deductibles. (So much for making insurance “affordable.”)

The GOP proposals aren’t perfect, a point we made in this space many times. But ObamaCare as it exists today is a disaster. It promises affordable coverage, but makes it impossible for millions to get it. And it requires massive taxpayer subsidies to bring individual insurance within reach of anyone.

Unfortunately voters who are not well informed may believe the lies being told. Hopefully enough people have been negatively impacted by ObamaCare to see through this ploy.

Those Nasty Unintended Consequences

On Monday, Investor’s Business Daily posted an editorial detailing the impact of ObamaCare on doctors.

The editorial reports:

A year before ObamaCare became law, an IBD/TIPP Poll warned that it would lead to doctor shortages because many would quit or retire early. New evidence shows that our warnings were dead on.

A recent report from the Association of Medical Colleges projects doctor shortages of up to 121,300 within the next 12 years. That’s a 16% increase from their forecast just last year.

Not only are medical schools having trouble attracting doctors (New York University plans to offer free tuition to its med students), but current physicians are cutting back on patient visits, retiring early or switching careers.

An article in a recent issue of the Mayo Clinic Proceedings says that nearly one in five doctors plan to switch to part-time clinical hours, 27% plan to leave their current practice, and 9% plan to get an administrative job or switch careers entirely.

The editorial cites one possible reason for the declining number of doctors:

One of the big drivers of doctor exits, by the way, is the Obama administration’s “electronic health records” mandate, which was supposed to vastly improve the quality and efficiency of care.

It’s had the opposite effect. A Mayo Clinic survey found that the EHR mandate is reducing efficiency, increasing costs and paperwork hassles, and pushing more doctors to quit or retire early.

A Harris Poll found that 59% of doctors say the current EHR system foisted on them by the Obama administration needs “a complete overhaul,” and 40% say it imposes more challenges than benefits.

ObamaCare continued what had been a long and sorry trend in health care. Government-imposed rules designed to fix some problem in the system instead generated mountains of new administrative work.

The result has been that while the number of physicians in the country has climbed modestly over the past three decades, the number of health care administrators exploded.

This is an illustration of the consequences of government interference in the free market. The free market isn’t perfect, but it is the best way to keep prices down, innovation up, and industries (and professions) moving forward.

The Next Step After Failure To Repeal ObamaCare

Investor’s Business Daily posted an article today about the consequences of the Republicans’ failure to repeal ObamaCare.

The article states:

Many Democrats and their ideological allies are using the congressional recess to crow about the GOP‘s defeat — and dream about replacing Obamacare with a bonafide single-payer system.

Sen. Bernie Sanders, I-Vt., has promised to introduce a single-payer bill next month. “I have no illusions that . . . suddenly we’re going to see a Medicare-for-all, single-payer passed,” he said last week. “Why is the United States the only major country on earth not to guarantee health care to all people?”

Several folks within the senator’s sizeable political following have hinted that support for single-payer will be a “litmus test” that will determine whether they will get behind Democratic candidates — or primary them.

So what does single-payer healthcare mean? The Medicare for All plan that Senator Sanders introduced during his presidential run would cost $2.5 trillion — nearly double what the Sanders campaign claimed. Another study by the Urban Institute found that the plan would increase spending by $32 trillion over the next decade.

The article further reports:

Last November, Colorado voters rejected Amendment 69, a ballot initiative that would have created a single-payer system in the state, by an 80-20 margin. An independent analysis revealed that the plan would have run a deficit of $253 million in its first year — and $7.8 billion by 2028.

Bernie Sanders’s own state of Vermont experienced similar sticker shock. The plan under consideration in the Green Mountain State would have cost $4.3 billion — nearly 90% of the entire state budget.

To cover that tab, payroll taxes would have surged 11.5%; income taxes would have increased 9%. Consequently, in 2014, Democratic Governor Peter Shumlin shelved the plan, deeming it “unwise and untenable.”

The article reminds us that the way to make single-payer more economical is to ration care. That is not an improvement to the healthcare Americans received before President Obama ruined it for the majority of Americans.

The article concludes:

The median Canadian, for example, waits nearly five months to get treatment from a specialist after receiving a referral from his general practitioner. That is more than twice the wait of 25 years ago.

The United Kingdom’s single-payer system offers more of the same. At the end of June, 4 million people were waiting for care. That is the highest figure in a decade.

Is this really the path the United States wants to go down? According to a June Pew survey, only 33% of Americans think single-payer health insurance is a good idea. But that number is up 12 percentage points since 2014.

It should come back down, once Americans realize that single-payer means paying a lot more for a lot less health care.

It is long past time for the Republicans to repeal ObamaCare.

 

Losing Health Insurance Because You Want To

Yesterday National Review posted an article about the claims the Congressional Budget Office (CBO) is making regarding the number of people who would lose their health insurance if ObamaCare were repealed.

The article states:

Do you want to repeal every word of Obamacare and replace it with nothing? CBO says 22 million fewer people would have health insurance. Do you prefer replacing Obamacare with a system of flat tax credits, in which you get the same amount of assistance regardless of your financial need? CBO says 23 million fewer people would have health insurance. Do you prefer replacing Obamacare with means-tested tax credits, like the Senate bill does, in which the majority of the assistance is directed to those near or below the poverty line? CBO says 22 million fewer people would have health insurance.

22 million, 23 million, 22 million—these numbers are remarkably similar even though the three policies I describe above are significantly different. Why is that?

Thanks to information that was leaked to me by a congressional staffer, we now have the answer.

Nearly three-fourths of the difference in coverage between Obamacare and the various GOP plans derives from a single feature of the Republican bills: their repeal of Obamacare’s individual mandate. But the CBO has never published a year-by-year breakout of the impact of the individual mandate on its coverage estimates.

So actually, a large percentage of the people who would lose insurance coverage if ObamaCare is repealed would choose to lose coverage because they would no longer be penalized for not having insurance. Basically, the CBO report is spin! There is also the matter of ObamaCare requiring people to pay for coverage they don’t need. Generally speaking senior citizens do not need maternity coverage or pediatric dental coverage. They should not be asked to pay for it!

“Don’t Throw Me Into The Briar Patch”

Joel Chandler Harris was an American author who wrote the Uncle Remus stories. Some of these stories later became an animated film by Walt Disney called “Song of the South.” One of the characters in these stories was Br’er (“brother”) Rabbit, who when captured by Bre’r Fox pleads, “Don’t throw me into the briar patch.” Of course, Br’er Rabbit has grown up in the briar patch, is quite at home there, and sees the briar patch as an escape route. So why in the world is a political blog talking about Br’er Rabbit and the briar patch? Because I believe the story of Br’er Rabbit and Br’er Fox totally explains the current healthcare debate.

Let’s look at the healthcare debacle strictly through a political lens. The best outcome for the Republicans (with a Republican President) is the complete failure of ObamaCare–rising costs, escalating premiums, denial of healthcare to senior citizens and young people, etc. Theoretically, President Trump has tried to avoid this. Had this failure occurred under a Democratic President, the solution would have been single-payer socialistic medicine. Under a Republican President, a free-market solution may be possible, but only after the total failure of ObamaCare. As premiums rise and health insurance and healthcare become more difficult to obtain, voters may get angry enough to remove from office those who had blocked the repeal of ObamaCare. I suspect that much of the Tea Party is already there. Because the Republicans could not repeal ObamaCare, it is still the Democrat’s policy. That may be exactly where the Republicans wanted it.

So where are we now in the healthcare debate?

The Gateway Pundit is reporting today that there is no possibility of repealing and replacing ObamaCare and there is no possibility of repealing ObamaCare over the next two years.

The article reports news from two sources:

From Bloomberg News:

GOP Senators Susan Collins, Shelley Moore Capito and Lisa Murkowski said Tuesday they’ll oppose a repeal of the Affordable Care Act. McConnell said late Monday the Senate would vote on a repeal with a two-year delay to give Congress time to agree on a replacement, but he could afford to lose no more than two Republican votes to advance the measure.

Repealing the law now and then hoping for a replacement “would create great anxiety for individuals who rely on the ACA,” Collins of Maine told reporters in Washington. “I believe it would cause the insurance markets to go into turmoil.” She said she would oppose bringing a repeal bill up for debate.

Capito of West Virginia said she would refuse to take up a repeal plan without an adequate replacement. “I did not come to Washington to hurt people,” she said in a statement.

Murkowski of Alaska also said she wouldn’t vote to take up a repeal-alone measure.

From the Washington Examiner:

House Republicans on Tuesday were seething with anger over the Senate GOP’s late Monday decision to pull the plug on a bill to repeal and replace Obamacare.

Lawmakers leaving the House GOP’s weekly conference meeting said feelings of exasperation and anger have set in, now that the Senate has dropped plans to vote on an Obamacare replacement bill this month.

“There is a lot of frustration, borderline anger I guess, at what really has to be described as some level of incompetence to be able to get together and get something done,” Rep. Mark Walker, R-N.C., who heads the conservative Republican Study Committee, told the Washington Examiner.

I am not sure the Democrats are celebrating the fact that the Republicans could not repeal ObamaCare–now the Democrats are stuck with a healthcare plan that is rapidly crashing.

 

When The Numbers Just Don’t Add Up

This was posted by a friend on Facebook:

This seemed like a reasonable question, so I did some research. On December 2016, CNN Money posted the following:

Nearly 6.4 million Americans have selected Obamacare policies through the federal exchange for coverage starting Jan. 1, federal officials announced Wednesday. That’s 400,000 more than had selected policies a year ago.

Under the proposed repeal and replace ObamaCare bill, the rate of growth of Medicaid will be cut–Medicaid will still grow, but more slowly. The goal is to create a program that will create a rate structure that allows more Americans to pay for their own health insurance. I am not thrilled with the current bill in the Senate, but passing it may be a necessary evil if we are to avoid single-payer or socialized medicine (which would be the result of the total collapse of ObamaCare which is rapidly approaching).

Just Repeal–Don’t Replace

The current ObamaCare bill is rapidly collapsing. It was designed that way. The plan was that Hillary Clinton would get elected and we would move to single-payer (totally government-controlled) healthcare. The fact that Donald Trump got elected and isn’t playing the Washington establishment’s games is a problem for those that want government healthcare. That is one of the reasons they are trying so hard to demonize him and get rid of him.

The Washington Free Beacon posted an article yesterday about the current state of ObamaCare.

The article reports:

Roughly 41 percent of counties in the United States could have only one insurer participating on the Affordable Care Act exchanges next year, according to a new analysis from Avalere Health.

This percentage is up from the lack of participation in 2017, when roughly one-third of counties, or 33 percent, had only one insurer participating on the exchanges.

According to their count, there will be 47 counties that will have no insurer participating on the exchange leaving about 34,000 consumers with no choice.

…”In addition to the cost of premiums, insurer decisions around whether or not to offer plans in the exchanges will impact shoppers,” said Caroline Pearson, senior vice president of the group. “Consumers will see fewer choices on the exchange again in 2018, with some counties at risk of having no options.”

This is not what success looks like. ObamaCare has been a failure. The best replacement would be to let the free market rule. Tax credits could be used to help lower income people afford health insurance, but the free market would make healthcare more affordable for everyone.

There are a few principles that would reform healthcare in a way that would benefit everyone–portability across state lines, tort reform, high risk pools for people with pre-existing conditions, and letting the companies with the actuary tables determine rates. The government does not have a stellar record when it comes to running things. There are very few government programs that are not wasteful, inefficient, and expensive. We don’t need another government money pit. It’s time to repeal ObamaCare. Then the debate on its replacement can begin.

Throw The Bums Out–All Of Them

The Republicans still don’t get it. They were voted in to repeal ObamaCare and let the free market apply to all Americans. Well, according to an article in The Conservative Review today, they haven’t figured that out yet.

The article reports:

How many times have conservatives criticized Democrats in Congress for exempting themselves from feeling the full effects of Obamacare?

Well, now Republicans in Congress have done the same thing, exempting themselves and their staff from the effects of their own proposed health insurance legislation.

The GOP’s proposed reforms to the Affordable Care Act will permit states to apply for waivers to repeal Obamacare regulations driving up the cost of premiums — regulations like the essential benefits mandates and community rating requirements. The tentative proposal is a compromise between the Freedom Caucus conservatives who want to see Obamacare fully repealed and the party moderates who want Obamacare regulations to remain in place. On the face of it, the idea is “if you can’t fix it, federalize it.”

Unless the Republican Party fully repeals ObamaCare and puts Congress under the same healthcare program as the rest of America, they will be voted out of office as soon as possible. I will work hard to do this. If they are going to do the same corrupt things and the Democrats, why should we vote for them? Who do they actually represent? Thank God for the Freedom Caucus. May they stand strong again.

The article concludes:

Republicans are trying to sell something to the American people they don’t want to buy themselves. Is it any wonder 50 percent of Americans have “little or no confidence” in the Republican plan to reform health care? Not even Republicans believe in it!

The Politics of Abortion

Hot Air posted an article today about a recent statement by Democrat National Committee Chairman Tom Perez.

The article reports:

Democratic National Committee chairman Tom Perez became the first head of the party to demand ideological purity on abortion rights, promising Friday to support only Democratic candidates who back a woman’s right to choose.

“Every Democrat, like every American, should support a woman’s right to make her own choices about her body and her health,” Perez said in a statement. “That is not negotiable and should not change city by city or state by state.”

“At a time when women’s rights are under assault from the White House, the Republican Congress, and in states across the country,” he added, “we must speak up for this principle as loudly as ever and with one voice.”

Has anyone really thought this through? They are fighting for a woman’s right to kill her child because the child is inconvenient, not perfect, not wanted, etc. I am sure it is simple coincidence that one of the major contributors to Democratic political campaigns is Planned Parenthood, a million dollar business that performs the majority of abortions in America.

As I have previously stated, I do not support making abortions illegal–there may be times when an abortion is necessary to protect the live of the mother. However, I don’t believe that abortion should be a multi million dollar industry. Planned Parenthood specializes in abortion. They provide minimal healthcare for women in other areas. Planned Parenthood is a major contributor to Democratic political campaigns. The Democratic Party is simply protecting a major source of their funding.

It is time to re-evaluate abortion in America.

This is a picture of abortion in America in 2016 (from the Guttmacher Institute):

As you can see, the majority of abortions in America are performed on poor minority women. Our goal should be to help these women with birth control–not kill their children.

 

 

Why The Support For Repealing ObamaCare Was Not There On Friday

Yesterday The Conservative Review posted an article about the fact that Speaker of the House Paul Ryan pulled the bill to repeal ObamaCare because there were not enough votes to pass it. Well, that’s what happens when you change the rules in the middle of the game.

The article quotes a statement made by Speaker Ryan in January of 2016 after Obama vetoed the bill:

It’s no surprise that someone named Obama vetoed a bill repealing Obamacare, and we will hold a vote to override this veto. Taking this process all the way to the end under the Constitution. But here’s the thing the idea that Obamacare is the law of the land for good is a myth. This law will collapse under its own weight or it will be repealed. Because all those rules and procedures Senate Democrats have used to block us from doing this that’s all history. We have shown now that there is a clear path to repealing Obamacare without 60 votes in the Senate. So next year if we’re sending this bill to a republican president it will get signed into law. Obamacare will be gone … [emphasis added]

But the bill they sent to the Republican president (Donald Trump) was not the same bill that they had sent to President Obama.

The article concludes:

This week, Speaker Ryan should abandon his RINOcare bill and bring the 2015 reconciliation bill to the floor of the House for a vote.

It’s time to stop the bait and switch.

Donald Trump is the elected President of the United States. One of the reasons he was elected was that the voters were tired of the kind of behavior illustrated by Speaker Ryan. The problem Friday was the broken promise of Speaker Ryan–it was not the Freedom Caucus who expected Speaker Ryan to keep his word.

I Guess Things Didn’t Go As Planned

ObamaCare is touted as one of the crowning achievements of the Obama Administration. Like some of the other achievements touted, the benefits are somewhat questionable. The two main promises of ObamaCare–if you like your healthcare plan, you can keep it, and if you like your doctor, you can keep him–have not really worked out as claimed. Now the claim that ObamaCare has cut the cost of health insurance seems to be in doubt as well.

Forbes Magazine posted an article on Thursday disputing the claims of Loren Adler and Paul Ginsburg of the Brookings Institution that health insurance premiums have decreased under ObamaCare. The authors cite a 2014 Brookings study that concluded premiums have increased.

The article reports:

While I will discuss the relevant evidence of the ACA’s effect on premiums in depth, there are three data points worth emphasizing. First, unlike Adler and Ginsburg’s approach, Brookings 2014 study used actual data and found that “enrollment-weighted premiums in the individual health insurance market increased by 24.4 percent beyond what they would have had they simply followed…trends.” Second, S&P Global Institute found that average individual market medical costs increased substantially between 2013 and 2015, up an estimated 69%. Third, 2014 insurer data shows that premiums for individual market Qualified Health Plans (QHPs), ACA-compliant plans certified to be sold on exchanges, were much higher than premiums for individual market non-QHPs, mostly plans in existence before 2014 that did not comply with the ACA. Relative to non-QHPs, insurers collected more than $1,000 per enrollee in higher premiums and more than $2,300 in higher premium revenue per enrollee in 2014 after accounting for large premium subsidy programs for their QHPs.

The article includes the following graph:

PMPM Chart - Mercatus

The data shows a huge increase in PMPM costs in the individual market between 2013 and 2015. According to S&P, PMPM costs increased 38% between 2013 and 2014, and another 23% between 2014 and 2015. The two-year increase (69%) is the product of the two single-year increases.

…It is worth noting that the individual market includes both ACA-compliant plans as well as non-ACA-compliant plans. If only ACA-compliant plans were included in the post-2013 data, the spike would likely be much larger.

I do wonder how much of this will be reported by the mainstream media. The fact that most people will experience this on a personal level means that the public will become aware of it.

 

 

 

Another Reason Your Votes Matter

On Friday, The Federalist posted an article about ObamaCare explaining where we are and where President Obama would like to go next in American healthcare. It really isn’t good news.

The article reports:

President Obama recently published an overview of the results of ObamaCare in the Journal of the American Medical Association.

It’s a pretty extraordinary article, because in important ways it acknowledges that ObamaCare has basically failed—and it lays the cards on the table for what we always knew was going to be his next step.

…Forcing insurers to cover people who are already sick and to charge them the same rates as healthy people has jacked up insurance premiums for everyone else. So because the law didn’t make insurance affordable, Congress has to make it affordable by heavily subsidizing it with even more of the taxpayers’ money.

Obama also somewhat vaguely acknowledges the problem of rising deductibles. One way of staunching the rise in premiums has been to offer plans with very high deductibles—the amount a person has to pay upfront before his insurance kicks in to cover the rest. This keeps the premiums affordable at the cost of making the actual care less affordable by whacking you with huge payments if you actually get sick. Last year, the New York Times acknowledged that under ObamaCare, “sky-high deductibles…are leaving some newly insured feeling nearly as vulnerable as they were before they had coverage…. ‘We have insurance, but can’t afford to use it.’”

Obviously ObamaCare is not working in a way that is helpful to the American people. So what happens next? Don’t say you weren’t warned–you were.

The article explains the next step:

Like I said, this was predictable and predicted from the very beginning, but now it’s all out in the open. ObamaCare was always just an exercise in planned obsolescence, cobbling together a system nobody really thought was going to work, just so they could exploit its failures to push for the socialized medicine they really wanted all along. It’s telling that in this article, Obama boasts that the Affordable Care Act has increased the number of people who are insured, but his own data shows that the biggest driver of that is an expansion of Medicaid, which is not insurance but welfare—the system he wants for everyone.

As I noted back in 2009, a decade-long exercise in deliberately wrecking private health insurance is the most callous and destructive way to pursue that goal.

If that surprises you, look at Venezuela. When has the Left ever shied away from smashing everything to pieces in pursuit of government power? So we shouldn’t expect anything different here.

If we are going to stop this runaway train, and it is not assured that we can, the only possible solution is to elect people in November who do not support socialized medicine. How do you find this people? You look at the voting records of anyone who was in Congress when ObamaCare was passed. You listen to the statements of the candidates.

I have one final note. ObamaCare was passed through a budget reconciliation process rather than as a standard bill. This was because that type of bill could not be filibustered in the Senate. No Republicans voted for HB3590, the predecessor to ObamaCare, or the reconciliation. Senator Scott Brown of Massachusetts (who was voted in after Ted Kennedy’s death) never got a chance to vote on ObamaCare because the Attorney General of Massachusetts delayed the certification of the election until after any Senate vote would be taken. The shenanigans involved in passing ObamaCare in the first place were disgraceful. It is also disgraceful that the Republican House of Representatives has not made a serious effort to defund ObamaCare. We need to elect people who will end ObamaCare and bring the free market into healthcare. Then America will have a strong healthcare system that serves all Americans.

Numbers Don’t Lie

The numbers on ObamaCare are now starting to come out. They don’t look good. Power Line Blog posted an article yesterday about the latest statistics. National Public Radio collaborated with Harvard’s T.H. Chan School of Public Health and the Robert Wood Johnson Foundation to survey Americans’ recent experience with health care.

Here are two graphs from the article:

ObamaCareStatisticsWhen you look at the numbers, ObamaCare is not a success.

Time For New Management

Yesterday The Washington Examiner posted a story yesterday that illustrates the poor management of the Veteran’s Administration.

The story reports:

The Department of Veterans Affairs’ Office of Inspector General (OIG) on Wednesday confirmed that more than one-third of the people thought to be seeking eligibility for VA benefits are deceased, and said many of them have been dead for more than four years.

The OIG report confirms the worst fears of members of Congress, whosaid in July that they would investigate unsubstantiated claims that thousands of veterans died before they ever became eligible for VA benefits.

Scott Davis, a VA employee and whistleblower, has dismissed the findings of the OIG. He claims that the independent investigator has no way of knowing how many veterans died seeking care. That may be, but if the number is one veteran, that is one too many.

The article states:

“We can’t say what’s what because of flaws in the enrollment system, and the flaws exist basically because the people responsible for fixing it haven’t,” he (Scott Davis) said.

Davis said the main official responsible for the VA’s Health Eligibility Center, Stephanie Mardon, should be fired for keeping such poor records, which even the OIG said is hurting efforts to get care to veterans. “Overstated pending enrollment records create unnecessary difficulty and confusion in identifying and assisting veterans with the most urgent need for health care enrollment,” it said.

But Davis also said the OIG report gives the VA, and the Obama administration, the tools it needs to start fixing the problem.

In July of 2014, Robert A. McDonald became Secretary of Veterans Affairs. It seems to me that there needs to be a way of mapping whatever progress he is making in fixing the problems the Veterans Administration has had in recent years. If things have not changed by July 2016, it is time to consider either replacing Secretary McDonald or disbanding the Veterans Administration and allowing veterans to seek medical care outside of the Veterans Administration at the same cost.

Some Perspective From The Federalist Website

The Federalist posted the following statistics:

AbortionStatisticsThe article also included the following statement by The U.S. Conference of Catholic Bishops:

It has long been troubling to many Americans that the nation’s largest abortion network, performing over a third of all abortions, receives over half a billion taxpayer dollars a year. This concern has rightly grown in recent years.

The most recent revelations about Planned Parenthood’s willingness to traffic in fetal tissue from abortions, and to alter abortion methods not for any reason related to women’s health but to obtain more “intact” organs, is the latest demonstration of a callousness toward women and their unborn children that is shocking to many Americans.

The Catholic Church comes to this issue from a perspective rooted in experience. Catholic charitable agencies and pregnancy help centers have helped countless pregnant women find life-affirming alternatives to abortion. Our hospitals and other health facilities are second to none in providing quality health care for women.

We support the legislative proposal to reallocate federal funding, so that women can obtain their health care from providers that do not promote abortion. It is my sincere hope that you will be able to help advance this goal by supporting S. 1881.

The Senate did not vote to defund Planned Parenthood, but I suspect that the issue will come up again. It is time for the government to stop funding a group whose founder wanted to eliminate all ‘inferior human beings’ and create a race of thoroughbreds. Somehow that idea sounds vaguely familiar, and it didn’t end well the last time it was tried.

 

 

Some Unintended Consequences Of Federal Government Overreach

Yesterday I attended a meeting of the Joint Legislative Education Oversight Committee in Raleigh, North Carolina. There were a number of items discussed–the Read to Achieve program, Charter Schools in North Carolina, the Founding Principles Act, and the complications in hiring substitute teachers caused by the implementation of ObamaCare. Yes, ObamaCare has made it more difficult for schools in North Carolina to hire the substitute teachers they need. Why? Because ObamaCare requires that every person working thirty hours a week be given health care.

ObamaCare requires that health benefits be extended to non-permanent full-time employees in North Carolina who traditionally have not been eligible for coverage under the State Health Plan. ObamaCare also complicates things for retired certified teachers covered under their retirement health plans. If they are substitute teaching more than 29 hours a week, they have to be covered by their employers and are no longer eligible for their retirement health care benefit.

There were two suggestions made for legislative options that would solve this problem, but my point is this, “How is it that the federal government created a problem for a state that has to be solved with a new state law?” What is the federal government doing saying anything about a state’s health care policies? The shortage of substitute teachers in North Carolina is only one of many reasons we need to rein in the federal government.

The Tenth Amendment states:

The powers not delegated to the United States by the Constitution, nor prohibited by it to the states, are reserved to the states respectively, or to the people.

From Healthcare to Common Core, it is time to get the federal government out of the states.