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.

What Does This Say About Our Values?

I am strongly pro-life. I believe that the only time an abortion should be performed is when the pregnancy presents a physical threat to the mother. Those instances are rare and could easily be dealt with in a hospital. Those instances would also not result in a multi-million-dollar abortion industry.

Yesterday The Washington Examiner reported that the Democrats had blocked a vote on a bill called the Born-Alive Abortion Survivors Protection Act (S.311). Because of Senate rules, a bill needs 60 votes in order to be brought to the floor to be voted on (that is based on the idea of a filibuster except people no longer stand up and talk for hours). Republican Ben Sasse wanted a vote on S.311, but there were only 53 Senators in favor of voting for the measure (translated loosely that means that there were only 53 Senators willing to go on the record on treating infants who survive abortions). The bill was not perfect. There were some things I would have been very uncomfortable with–I don’t like the idea of doctors being sued or arrested for actions taken in the operating room. However, it seems strange to me that people would be more likely to help a puppy found on the side of the road than a baby who survived and abortion attempt. Most Republicans voted for a vote on the bill. A few Democrats voted for a vote.

In view of recent statements by the Governor of Virginia and the Governor of New York on abortion, some form of this bill is probably necessary. I hope we will see some form of the bill pass in the future. However, it is a sad commentary on our society that a stranded puppy would be more likely to receive care than an aborted baby.

Do We Really Want To Do This?

On February 15th The Washington Examiner posted an article with the following headline: “‘Medicare for All’ would require obesity laws.” I wonder if the few Americans who actually support the idea of ‘Medicare for All’ understand that would be part of the deal (along with drastic increases in taxes, long waits for medical care, and a reduction in the quality and quantity of medical care available).

The article notes:

At 36.2 percent, the American obesity rate is the 12th-highest in the world and first among OECD countries. Of every European nation with universal healthcare, only the United Kingdom (27.8 percent) and Hungary (26.4 percent) come within 10 percent of the American obesity rate.

In Germany, France, Portugal, and Sweden, the national obesity rates are 22.3 percent, 21.6 percent, 20.8 percent, and 20.6 percent respectively. And in Denmark and Italy, fewer than 20 percent of people are obese.

Like it or not, we live in a country where ordering a salad at a fast food place often costs more than ordering something less healthy. Unless Americans are willing to change their eating habits significantly, Medicare for All would be a disaster.

The article concludes:

The country under single-payer will make former Mayor Michael Bloomberg’s soda taxes and food-nannying look like child’s play. Everything from your sugar consumption to your alcohol would become a matter of public regulation, and the public would not only have the power but also the moral right to regulate how people live.

Of the 2.6 million deaths in the U.S. per year, 300,000 are caused by obesity. It’s one of the single greatest drivers of avoidable healthcare spending, costing the country around $200 billion annually.

Progressives may call this fat-shaming. But it’s really just public health and economics.

Keep your hands off my Bo-Jangles!

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?

Good News For American Families

The Washington Examiner posted an article today about changes made to the current federal regulations regarding healthcare insurance.

The article reports:

Last Wednesday, Health and Human Services Secretary Alex Azar announced a finalized rule granting consumers greater access to affordable health insurance policies. Under the new rule, people will be allowed to purchase short-term, limited-duration health insurance plans for periods as long as 12 months. Currently, the maximum period allowed is only three months. Plans can be renewed after the 12-month period, but they cannot extend beyond 36 months.

Short-term health insurance plans are significantly cheaper than most Obamacare plans because they don’t include many of the costly essential health benefits mandated under federal law and because they are sold for a limited duration. These plans do not provide comprehensive coverage, but they are an excellent option for people who are relatively healthy but can’t afford to pay for an outrageously priced Obamacare plan.

This means that a family whose insured member is changing jobs or between jobs can get coverage at a reasonable price. The plans cannot extend for more than three years, but hopefully Congress will find its backbone and totally repeal ObamaCare by then.

The article further states that although premiums under ObamaCare have risen drastically, that is not the entire problem:

Premiums are not the most important cost to consider, however, because some people who purchase health plans through an Obamacare exchange receive large subsidies to help offset their plan’s high premiums. A much more important factor is the high cost of deductibles and other out-of-pocket costs. The average family enrolled in a Silver Plan will pay a maximum of $13,725 for out-of-pocket expenses, with Silver Plan deductibles increasing by 13 percent in just the past year alone.

Working families can’t afford to pay more than $13,000 to cover out-of-pocket expenses. In fact, health insurance this expensive is virtually useless.

The high costs associated with an Obamacare plan are a big reason why the Centers for Medicare and Medicaid Services predicts about 600,000 Americans will sign up for a new short-term health insurance plan next year. By 2022, CMS expects 1.6 million to be enrolled in a short-term plan.

The article concludes:

The healthcare system is failing, and has been for decades. Despite the promises made by former President Barack Obama and the congressional Democrats who passed Obamacare into law, the legislation has only made things worse. Congress needs to pass a bill to repeal and replace Obamacare. But since that has yet to occur, the Trump administration is doing everything it can to help young people and working families gain affordable coverage. It’s great to finally have a presidential administration that’s truly committed to reducing health insurance costs rather than appeasing far-left activists in the Democratic Party.

True.

Dismantling ObamaCare One Rule At A Time

One of the mixed blessings about the way ObamaCare was passed was the fact that it was an unread law passed strictly along party lines (Democratic Party) and then filled in by Executive Order and orders from the Health and Human Services Department. Many of the mandates and other parts of ObamaCare were not written into the law, but came later. One of the advantages of that fact is that what was put in place by Executive Order can be taken away by Executive Order. Since the Republicans in Congress have broken their promise to the voters to repeal ObamaCare, President Trump is taking it apart piece by piece.

Today Red State posted an article showing the latest piece to go. The article included the following tweet by the President:

The article explains:

President Donald Trump plans to sign an executive order later this week that would allow people to pool together and purchase group insurance plans, according to The New York Times.

Association health plans allow groups such as community organizations, churches or professional associations to purchase health plans together. Many insurance companies oppose this kind of pooled purchase, as they argue the plans take healthy patients out of the individual markets.

The executive order is the first step in President Trump’s plan to issue another directive that would allow people to purchase insurance across state lines, though it is still unclear if he has the authority to do so.

“I am considering an executive order on associations, and that will take care of a tremendous number of people with regard to health care,” President Trump said late September, according to The New York Times. “I’ll probably be signing a very major executive order where people can go out, cross state lines, do lots of things, and buy their own health care…It’s going to cover a lot of territory and a lot of people — millions of people.”

Letting the free market reign in health insurance is a giant step back to sanity. Health insurance companies are in business to make a profit, which they are entitled to, and they use actuary tables to calculate those projected profits. If you bring back competition, they will have to compete with each other in the area of pricing, and all Americans will benefit. This is a big step toward making health insurance affordable for everyone. The less the government is involved in health insurance and healthcare, the better it is for all of us.

Remember what Milton Friedman said:

If you put the federal government in charge of the Sahara Desert, in 5 years there’d be a shortage of sand.

Let’s get the government out of health insurance.

If It’s Not About Money, Exactly What Is It About?

We have all heard the story of little Charlie Gard who is in the hospital in Britain suffering from mitochondrial depletion syndrome, a rare genetic disorder that causes brain damage and prevents muscles from developing. His parents want to remove him from the hospital and seek treatment in America. The hospital (under the British healthcare system) wants to let him ‘die with dignity.’ The parents have offers of medical treatment and care from the Vatican and from medical facilities in America. The parents evidently have the financial means to get him where he needs to be to receive the treatment. Taking him from the hospital where he currently is creates no financial burden for the hospital. So why won’t the hospital let the parents take Charlie Gard out of the hospital? To me, that is the million dollar question.

The American Thinker posted an article today about the impact of single-payer socialized health care on innovation and alternative medicine. The article reminds us that the passage of ObamaCare in 2009 helped establish the idea that health care is a right.

The article includes the following:

The day after the Obamacare vote, the senior member of the House of Representatives, Rep. John Dingell (D-MI), a strong supporter of government-run health care since he first got elected to the Congress in the mid-1950s, appeared as a guest on a local Detroit radio program. I learned about the Dingell interview courtesy of someone in Detroit who heard the broadcast and posted a comment about it at a blog that I stumbled upon. After some research, I was able to identify the Detroit talk show — it was the Paul W. Smith program on radio station WJR — and locate an audio file of the Dingell segment on WJR’s Web site before it scrolled offline.

Sure enough, as he gleefully celebrated the passage of Obamacare on Smith’s program, Dingell blurted out that the Democrats had finally learned how “to control the people:”

The harsh fact of the matter is when you’re going to pass legislation that will cover 300 [million] American people in different ways it takes a long time to do the necessary administrative steps that have to be taken to put the legislation together to control the people.

As I previously noted, the hospital in Britain has no financial interest in keeping Charlie Gard as a patient until he dies–in fact, that is probably against their financial interest. It would seem that ‘control’ might be the only obvious reason for their policy–they don’t want to allow Charlie’s parents to control the medical care their child receives.

The article further reminds us:

Nationalized mandated health care has always been a goal of the collectivist, statist, communist model of governance.

Writing in 2007 in National Review Online, Mark Steyn put it succinctly:

Socialized health care is the single biggest factor in transforming the relationship of the individual to the state.

The article concludes:

It remains to be seen if a new effort by the parents to appeal the court’s decision will prevail. In the meantime, the case illustrates several points. In a socialized, single-payer medical system like the one that has been in place in the UK since the NHS was mandated in 1948, the patient — or in this case, his parents — is not in control; the medical bureaucrats under the color of law have the final say over one’s life and death.

It is also noteworthy that innovative options that might help a patient like Charlie are emanating not from Britain — where socialism and the NHS have hindered medical innovation and impaired successful treatment outcomes — but from the United States, where the practice of medicine has yet to fall under the complete and suffocating yoke of socialism.

We are at a crossroads right now in America. We have a choice. Are we going to be the country envisioned by our Founding Fathers that was a beacon of freedom to the world or are we going to trade our freedom for government control sold to us under the guise of benefits. If the Republicans do not repeal ObamaCare, we can expect to see cases like Charlie Gard begin to appear in America.

 

The Truth About The Current Healthcare Bill

Yesterday the Independent Journal Review posted an article about some of the lies we are being told about the current healthcare bill. I don’t support the current bill, but I resent the fact that lies are being used in an attempt to discredit it.

The article explains how the numbers are being twisted:

The current repeal and replace bill is a bad bill. ObamaCare needs to be fully repealed and the government needs to get out of health insurance. Let the people who understand actuary tables run healthcare. The only provision the government needs to make is to insure that high-risk pools are set up (and made affordable) for the people that need them. Healthcare should be available across state lines, tort reform is needed, and tax credits given to lower-income families to help pay for insurance. Otherwise, the government needs to let the free market to work.

 

The Facts You Need To Fight The Current Spin

Yesterday Investors.com posted a story about what the repeal of ObamaCare will actually mean. The story separates the lies we are being told from the actual truth.

These are the five main points from the story:

  1.  Repealing ObamaCare will not add 20 million to the number of people without health insurance.
  2.  Repealing ObamaCare will not increase the deficit–leaving it in place with significantly increase the deficit in coming years.
  3.  Repealing ObamaCare will not mean that people with pre-existing conditions cannot get health insurance–the replacement plans being considered will have a place a way to cover pre-existing conditions.
  4. Repealing ObamaCare will not increase health costs. The article points out that the rate of increase in premiums for employer-provided insurance had also slowed before ObamaCare took effect. The shift in the employer market toward Health Savings Account plans — which Democrats hate — is largely responsible for that.
  5.  The claim that the voters do not want ObamaCare repealed is also false. The passage of ObamaCare strictly along Democratic Party lines lead to the loss of the House of Representatives by the Democrats in 2010, the loss of the Senate by the Democrats in 2014, and the loss of the Presidency by the Democrats in 2016.

Please follow the link above to read the details of the above points. We need healthcare to be allowed to function under a free-market system with as little interference from the government as possible. That will provide the most cost-efficient and most available healthcare for everyone.

Some Notes On Romneycare And Healthcare In Texas

I could have figured this out without the chart below posted at Yahoo News:

One of the main things that makes the difference in the Texas health insurance premiums is the law passed on Texas regarding medical lawsuits.

According to the article:

Perry’s most significant achievement on health care was a successful 2003 attempt to convince voters, over the determined opposition of trial lawyers, to amend the Texas Constitution to cap non-economic medical malpractice damages at $250,000 from a physician and $500,000 from hospitals and other providers: an issue that most physicians believe is at the heart of what drives wasteful health spending.

The article also points out some of the other factors involved in Governor Perry’s successful healthcare reform in Texas–the legislature Governor Perry was dealing with in Texas was made up of conservative Republicans, when Romneycare was passed in Massachusetts, Governor Romney was dealing with a liberal Democrat legislature.  Governor Romney probably prevented Romneycare from being even worse than it is.  The other thing to consider is that generally the cost of living in Massachusetts is higher than the cost of living in Texas.  The article cites a CNBC survey that ranks Texas eighth-best, and Massachusetts ninth-worst, for cost of living.

The article also has a chart showing how the law in Texas has impacted malpractice claims:

I think the chart above is one of the best arguments for tort reform that I have seen.

Please follow the link to the article at Yahoo News–there is a lot of good information there and also a few very illustrative charts.

The article concludes:

As I said at the top, who you favor between Romney and Perry will depend in large part upon what your priorities are in health care policy. My personal view is that universal coverage is meaningless, if the ultimate consequence of universal coverage is that people can’t afford, or gain access to, basic health care. It is Rick Perry’s Texas that has done more to keep the growth of health costs down, and we should spend more time drawing lessons from his Lone Star State.

Governor Romney is a very nice man.  I think he did a reasonable job as governor of Massachusetts, but I for one am ready for a Rick Perry in the White House.