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.

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.

This Is Not Legislation Without Consequences

In October I posted an article based on an opinion piece from The New York Times. The New York Times article was posted October 6th and told the story of a man who was addicted to marijuana. Yes, despite what you have been told, addiction to marijuana is a real thing. The people pushing for the legalization of marijuana are very similar to the people who for years tried to tell us that smoking tobacco had no negative impact on the smokers’ health. This month Imprimis (the monthly magazine of Hillsdale College) posted a more disturbing article about the effects of marijuana. I strongly suggest that you follow the link and read the entire article. I will try to summarize parts of it here.

The article reports:

Over the last 30 years, psychiatrists and epidemiologists have turned speculation about marijuana’s dangers into science. Yet over the same period, a shrewd and expensive lobbying campaign has pushed public attitudes about marijuana the other way. And the effects are now becoming apparent.

Almost everything you think you know about the health effects of cannabis, almost everything advocates and the media have told you for a generation, is wrong.

They’ve told you marijuana has many different medical uses. In reality marijuana and THC, its active ingredient, have been shown to work only in a few narrow conditions. They are most commonly prescribed for pain relief. But they are rarely tested against other pain relief drugs like ibuprofen—and in July, a large four-year study of patients with chronic pain in Australia showed cannabis use was associated with greater pain over time.

They’ve told you cannabis can stem opioid use—“Two new studies show how marijuana can help fight the opioid epidemic,” according to Wonkblog, a Washington Post website, in April 2018— and that marijuana’s effects as a painkiller make it a potential substitute for opiates. In reality, like alcohol, marijuana is too weak as a painkiller to work for most people who truly need opiates, such as terminal cancer patients. Even cannabis advocates, like Rob Kampia, the co-founder of the Marijuana Policy Project, acknowledge that they have always viewed medical marijuana laws primarily as a way to protect recreational users.

As for the marijuana-reduces-opiate-use theory, it is based largely on a single paper comparing overdose deaths by state before 2010 to the spread of medical marijuana laws— and the paper’s finding is probably a result of simple geographic coincidence. The opiate epidemic began in Appalachia, while the first states to legalize medical marijuana were in the West. Since 2010, as both the epidemic and medical marijuana laws have spread nationally, the finding has vanished. And the United States, the Western country with the most cannabis use, also has by far the worst problem with opioids.

The article also notes:

After an exhaustive review, the National Academy of Medicine found in 2017 that “cannabis use is likely to increase the risk of developing schizophrenia and other psychoses; the higher the use, the greater the risk.” Also that “regular cannabis use is likely to increase the risk for developing social anxiety disorder.”

…These new patterns of use have caused problems with the drug to soar. In 2014, people who had diagnosable cannabis use disorder, the medical term for marijuana abuse or addiction, made up about 1.5 percent of Americans. But they accounted for eleven percent of all the psychosis cases in emergency rooms—90,000 cases, 250 a day, triple the number in 2006. In states like Colorado, emergency room physicians have become experts on dealing with cannabis-induced psychosis.

Cannabis advocates often argue that the drug can’t be as neurotoxic as studies suggest, because otherwise Western countries would have seen population-wide increases in psychosis alongside rising use. In reality, accurately tracking psychosis cases is impossible in the United States. The government carefully tracks diseases like cancer with central registries, but no such registry exists for schizophrenia or other severe mental illnesses.

On the other hand, research from Finland and Denmark, two countries that track mental illness more comprehensively, shows a significant increase in psychosis since 2000, following an increase in cannabis use. And in September of last year, a large federal survey found a rise in serious mental illness in the United States as well, especially among young adults, the heaviest users of cannabis.

According to this latter study, 7.5 percent of adults age 18-25 met the criteria for serious mental illness in 2017, double the rate in 2008. What’s especially striking is that adolescents age 12-17 don’t show these increases in cannabis use and severe mental illness.

A caveat: this federal survey doesn’t count individual cases, and it lumps psychosis with other severe mental illness. So it isn’t as accurate as the Finnish or Danish studies. Nor do any of these studies prove that rising cannabis use has caused population-wide increases in psychosis or other mental illness. The most that can be said is that they offer intriguing evidence of a link.

Please read the entire article. Remember how hard the tobacco lobby worked to keep pushing smoking cigarettes as cool, glamorous, and not hazardous to your health. The marijuana lobby is following the same pattern. You have been warned.

Somehow They Don’t Seem Overly Concerned

Optics do matter in politics. However, some of our politicians are so accustomed to the media covering up their antics that they don’t even worry about the optics anymore. This was obvious last weekend when thirty Democrats headed out for a fun weekend in Puerto Rico despite the continuing government shutdown.

On Friday The Washington Examiner posted an article about the weekend trip.

The article reports:

Some 30 Democratic lawmakers left the government shutdown behind Friday on a chartered flight to Puerto Rico for a winter retreat with 109 lobbyists and corporate executives during which they planned to see the hit Broadway show “Hamilton” and attend three parties including one with the show’s cast.

Those attending the Congressional Hispanic Caucus BOLD PAC winter retreat in San Juan planned to meet with key officials to discuss the cleanup after Hurricane Maria at a roundtable Saturday.

But the weekend is packed with free time for the members and their families on the trip.

“We are excited for you to join us for CHC BOLD PAC’s 2019 Winter Retreat in San Juan, Puerto Rico! Each year, this retreat serves as a way for our CHC BOLD PAC Members and friends in the D.C. community to come together to escape the cold and discuss our shared priorities for a stronger and more prosperous country,” said a memo on the trip.

Some 109 lobbyists and corporate executives are named in the memo, a rate of 3.6 lobbyists for every member. They include those from several big K Street firms, R.J. Reynolds, Facebook, Comcast, Amazon, PhRMA, Microsoft, Intel, Verizon, and unions like the National Education Association.

What chance does the average American citizen have in getting the ear of his Congressman when lobbying groups can do this sort of thing?

The press release regarding the event is predictable–it blames President Trump for the shutdown and explains that the event was scheduled months before the shutdown. President Trump is at least partially responsible for the shutdown, but another aspect of the shutdown is the refusal of Representative Pelosi to negotiate. Having thirty of your Democrat Congressmen running off to Puerto Rico to party when the government is shut down does not make good political optics. I wonder if the American people will notice.

The Circle Of Money

Why is the federal government giving money to groups that lobby the federal government? This defies common sense. It is, however, a neat deal for those involved–legislators get money for their political campaigns in return for channeling federal money to the organizations that sponsor the Political Action Committees (PAC) that give them the money. It’s a good deal if you are part of it, and a bad deal for America and American taxpayers.

Investor’s Business Daily posted an article yesterday about this practice.

The article points out the insanity of what is going on:

Latest lobbying disclosure documents indicate Planned Parenthood spends at least $2 million a year directly lobbying Congress and state legislatures. And this year, as PP fights to retain its umbilical cord — no pun intended — to the Federal Treasury, the number’s going way up.

But the official lobbying expenditures don’t include tens of millions of other political spending. According to a recent analysis by Conservative News Service, “Planned Parenthood’s affiliates spent $26 million on public policy this past year, while the national office spent $31.3 million on building ‘advocacy capacity.'”

The mission of all this spending? The answer is obvious: to persuade Congress to continue to provide the organization with federal tax dollars.

So what we have here is an organization that receives at least half a billion dollars a year from taxpayers, and some of that money is used to lobby Congress to give them more taxpayer money.

The icing on the cake is that the money is borrowed from Japan and China. We have to pay interest on it.

The article details the problem:

Is it any surprise that under this racket it has become almost impossible to cut the budget or to balance receipts with expenditures? This is a common practice. The unions do it. The legal public aid community does it. Welfare organizations do it.

To be fair, it isn’t just left-wing groups that receive taxpayer dollars and lobby. So do corporations. Defense contractors run lobbying campaigns year-round to persuade Congress to spend more money on this weapon or that. Companies that have received the bulk of the funding for the Export Import Bank are bankrolling the PR campaign to keep the institution from closing down.

We will never curb government spending as long as we allow this kind of abuse of our system. The problem is not lobbying–that is and should remain legal. The problem is government-supported lobbying. That is ridiculous.

A Disturbing Video From Florida

On Friday the Weekly Standard reported on a committee hearing in Florida where the state is considering a bill to require abortionists to provide medical care to an infant who survives an abortion.

This is part of the video of that hearing:

The article reports:

Alisa LaPolt Snow, the lobbyist representing the Florida Alliance of Planned Parenthood Affiliates, testified that her organization believes the decision to kill an infant who survives a failed abortion should be left up to the woman seeking an abortion and her abortion doctor.

“So, um, it is just really hard for me to even ask you this question because I’m almost in disbelief,” said Rep. Jim Boyd. “If a baby is born on a table as a result of a botched abortion, what would Planned Parenthood want to have happen to that child that is struggling for life?”

“We believe that any decision that’s made should be left up to the woman, her family, and the physician,” said Planned Parenthood lobbyist Snow.

When questioned further, Ms. Snow simply stated that she was not a physician or an abortion provider and could not provide further information.

I have no comment.

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Following The Money Trail On Solyndra

Image representing Solyndra as depicted in Cru...

Image via CrunchBase

Every now and then I post an article about a story that I totally do not understand. This is one of those times. If anyone reading this can shed some light on what actually happened in this case, please comment.

Yesterday the Washington Times posted an article about the list of creditors in the Solyndra bankruptcy case. The Solyndra bankruptcy case is already being looked at closely because of the amount of government money loaned to the company despite indications that the company’s business plan was not viable. Now the “creditor matrix,” a document which is a standard filing in a bankruptcy case, reveals that the California Democratic Party is listed as a creditor of Solyndra.

The article at the Washington Times reports:

The company (Solyndra) had its own in-house team of lobbyists, but it also hired three other Washington lobbying firms: McAllister & Quinn, Washington Tax Group and McBee Strategic Consulting.

Many of the lobbyists previously worked in government for Democratic and Republican lawmakers alike. They included former aides to lawmakers such as Sen. Alfonse D’Amato, New York Republican; Sen. Maria Cantwell, Washington Democrat; and House Minority Leader Nancy Pelosi, California Democrat.

From 2008, when the company spent $160,000 on lobbying, to 2010, when it spent $550,000, lobbying expenditures increased nearly 250 percent, according to the Center for Responsive Politics.

It makes you wonder how much money actually went into producing a product.

Please follow the link to the article at the Washington Times. There are a lot of questions about Solyndra–including why its executives pleaded the Fifth Amendment when they were called before Congress. The article in the Times also points out some very interesting connections between some of the people involved in this company and major donors to the Obama campaign.

 

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