Berwick on ACOs

In the latest New England Journal of Medicine, Medicare chief Dr. Donald Berwick describes, "Launching Accountable Care Organizations -- The Proposed Rule for the Medicare Shared Savings Program".

Naturally, he couches the new government guidelines in flowery language such as "shared decision making about diagnostic and therapeutic options", "integrated organization that supports expending resources on programs to improve quality and reduce the provision of unnecessary services", and "a central role for health information technology in enabling the organization to manage population health".

But if you want a translation of what those nice-sounding buzzwords mean, take a look at the 3/22/2011 Washington Times OpEd by physicians David Gratzer and Jason Fodeman, "Obamacare: One year later".

They translate some of the bureaucrat-ese and explain how the Obama Administration's real agenda is massive government intrusion into the doctor-patient relationship.

Unfortunately, this is not an April Fool's joke. But if Americans maintain their opposition to ObamaCare, we can have the final say, rather than letting men like Berwick have the last laugh...

Catron on AARP Plunder

In yesterday's AmSpec, David Catron shines the light on a little known conflict of interest involving the American Association of Retired Persons (AARP) and health insurance.

Here is an excerpt from his piece, "The American Association for Retiree Plunder":

it was something of surprise when AARP announced its support for ObamaCare in the fall of 2009. Why would a financial conglomerate so dependent on insurance-related revenue endorse a bill that promised to wreck the health insurance industry? Then, the penny dropped. One of the ways the Democrats proposed to "pay" for their health care law was by cutting the Medicare Advantage (MA) program by $200 billion. This would inevitably drive many carriers out of the MA market and herd millions of seniors back to the more expensive coverage of traditional Medicare.

How would that benefit AARP? Traditional Medicare imposes much higher deductibles and co-pays on its beneficiaries than does MA, and the vast majority of AARP's revenue derives from sales of "Medigap" policies that purport to cover those out-of-pocket expenses. In other words, the AARP endorsed a law that does real financial harm to seniors in order to reap a crop of new customers when ObamaCare guts Medicare Advantage...

Two members of the Ways and Means Committee, Rep. Wally Herger (R-CA) and Rep. Charles Boustany (R-LA) have announced a hearing to be held this Friday: "AARP is known for being the largest and most well known seniors' organization in the country. But what Americans don't know is… that the AARP brand dominates the private Medicare insurance market"...

Only about 20% of its $1.3 billion in annual revenue comes from membership dues. In other words, AARP earns nearly $1 billion per year by endorsing various products and services sold to its members. More than 65% of that tsunami of cash arrives in the coffers of this "seniors' lobby" in the form of royalty payments "for lending its name to policies sold to its members by private insurers."

Similarly, Catron notes that the AARP was able to receive a much-coveted waiver from strict new insurance payment regulations:

And, although ObamaCare requires MA plans to spend 85 percent of premium revenue on medical claims, the Democrats lowered the bar for AARP's Medigap policies to a mere 65 percent. This is perhaps what the "advocacy group" was getting at when, in response to the announcement of the upcoming hearing, it posted the following statement on its website: "AARP has a long-standing and good working relationship with Congress."

(Read the full text of "The American Association for Retiree Plunder".)

This sort of cronyism government favoritism is inevitable whenever the government exceeds its proper function of protecting individual rights, and instead starts picking economic winners and losers -- in this case, in the health insurance sector.

Thank you, David Catron, for shedding some much-need light on yet another "unintended consequence" of ObamaCare.

Interview With RomneyCare Author Jonathan Gruber

The 3/29/2011 Washington Post has an interesting interview with RomneyCare author Jonathan Gruber, an MIT economist.

Among some of the tidbits.

First, Gruber was definitely aware of the argument about the individual mandate being an infringement of freedom. However, MA Governor Romney was concerned about the alleged "free rider problem". And Gruber states:

What I'd like to think carried the day was that I pointed out that without the mandate you would spend the same money and cover fewer people.

Also:

It is equally true in Gruber's mind that without the Massachusetts example, Obama's individual mandate plan in all likelihood would not have passed. He says that as the federal health care plan emerged, the Massachusetts plan was "widely discussed." And he should know. He was first called in as an unpaid consultant to work on Obama's health care plan, then as a paid consultant to HHS to work on health care modeling, and then as a paid consultant working with Congress to develop the bill.

Finally, Gruber

...finds it 'depressing' that Romney now feels compelled to distance himself from [the MA plan].

As the Washington Post interviewer Jennifer Rubing concludes:

1) Romney championed the individual mandate, overriding concerns about personal freedom

2) The plan today is pretty much the same as what Romney signed into law

3) Without it in all likelihood we wouldn't have ObamaCare today.

That might sound like a reason for Democrats to vote for him, but in a Republican presidential primary all of that may be the death knell of the Romney candidacy.

This is yet another example of the fact that what happens at the state political level can eventually have an enormous effect at the national level. If you want to see how ugly the legislative sausage-making can get, read the whole interview.

(Via Instapundit.)

The Next Stage in Massachusetts

So now that the Massachusetts health care experiment has failed, what's next? In this 3/1/2011 essay, John Calfee discusses both the past and the future in "The Massachusetts Health-Reform Mess".

First, the problems we already know about:

Coverage increased from about 88% to 96%. But the number of emergency room visits, which everyone expected to drop once people had to purchase insurance, is still going up...

Despite an individual insurance mandate, thousands of consumers wait to purchase coverage until they require costly procedures and then exit after paying a modest penalty. That makes insurance more expensive for everyone else.

And the proposed response to these continually escalating costs:

Gov. Patrick introduced a bill that will impose de facto price controls on everyone from solo primary care doctors to prestigious academic hospital systems. An 18-member board will decide how and how much providers should be paid, and the bill gives regulators the power to force private insurers to accept these fiats. Some 30 states experimented with such rate-setting in the 1970s and '80s. Except for Maryland, all of them—including Massachusetts—deregulated in the 1990s because costs rose even as quality and choice declined.

In a mere four years, Massachusetts has demonstrated that the most important effects of its reform arise not from the letter of the law but from the law's unintended and unpredictable consequences. The state is lurching from one crisis to another as it attempts to construct a system vastly different from any seen before or anything contemplated when reform was first passed. Health care in the state is evolving toward a state-run version of Medicare combined with government reorganization of the delivery of medical care.

(Read the full text of "The Massachusetts Health-Reform Mess".)

Controls breed more controls. The signs are already clear in Massachusetts. And unless we repeal ObamaCare, this will be the unhappy future for the rest of the United States as well.

Quick Links: Ralston, Mandatory Medicare, Affordable Clinics

In the 3/23/2011 Orange County Register, Richard Ralston of AFCM explains why "Waste abounds with Obamacare". In particular, he notes that "Obamacare will waste our money, but that cost is insignificant compared to our wasted freedom, wasted medicine and wasted lives."

The 3/24/2011 Wall Street Journal reports that a federal judge has ruled that senior citizens may not freely opt out of Medicare. If they do so, they'll have to forfeit their Social Security benefits.

Hence, unless seniors are wealthy enough to absorb that financial penalty, they must receive their care on government terms -- and their doctors must practice according to government guidelines. (Via Dr. Beth Haynes.)

On a more positive note, the 3/25/2011 Northern Colorado Business Report describes how the GeneralCare Medical Clinic in Fort Collins, CO provides affordable quality care -- by bypassing the insurance middleman.

This is precisely the sort of innovative business model that will be jeopardized by mandatory insurance. (Via Brian Schwartz.)

Wolf: Loudest ObamaCare Cheerleader Wants Out

Dr. Milton Wolf has a new OpEd in the 3/25/2011 Washington Times, "Loudest Obamacare Cheerleader Wants Out".

Here's an excerpt:

Becoming the most hypocritical politician in America is not an easy goal to achieve, but New York’s Rep. Anthony Weiner, a Democrat, is up to the task.

Earlier this year, the Obama administration began rewarding its union friends and others with an escape from the clutches of Obamacare. Now one of the most outspoken Obamacare supporters -- the man who actually said, "I wrote the bill... the bill and I are one" wants his own "get out of jail free" card from this abominable law.

Congressman Weiner wants a waiver for New York City, to join the long list of other waivers already granted by the Administration:

HHS acknowledges issuing 1,040 "get out of jail free" cards to unions and other friends. Five states have been graced with their very own Obamacare waivers, including Massachusetts, New Jersey, Ohio, Tennessee and, newest pampered friend, Maine. Why Maine? According to the administration, Obamacare "has a reasonable likelihood of destabilizing the Maine individual health insurance market."

As Dr. Wolf notes:

[I]ts pay-for-play, politics-as-usual scheme is enriching administration cronies on the backs of everyone else. As Mr. Weiner said, "A lot of people who got waivers were... people who are our friends."

(Read the full text of "Loudest Obamacare Cheerleader Wants Out".)

So ObamaCare supporters acknowledge that it's wrong for large urban areas like New York City, small rural states like Maine, and Midwestern "heartland" states like Ohio.

The natural question is, why should the rest of America put up with it?

Catron: Obamacare and the Law's Delay

In today's AmSpec, David Catron updates us on the Obama Administration's attempts to delay the consideration of challenges to ObamaCare. Ostensibly, they claim that the various rulings against their health plan have no legal merit.

But in his piece, "Obamacare and the Law's Delay", Catron puts his finger on their real reasons:

So, if Obamacare is going to wind up before the Supreme Court sooner or later -- and there is virtual unanimity among constitutional scholars that it will -- what does the administration hope to gain from its transparent delay tactics?

First and foremost, it gives the health "reform" law time to metastasize. If Obamacare has another year and a half to spread throughout our health care system, the justices may well decide that it would be too disruptive to strike down the entire law. This consideration certainly figured in Judge Hudson's December ruling, in which he ignored the absence of a severability provision in the law and chose to strike down only the mandate. Likewise, the Supreme Court has already demonstrated in a recent ruling on the Sarbanes-Oxley accounting law that severability is situational.

Beyond buying time for Obamacare to put down roots, the DOJ may be hoping to put off the day of reckoning until the President has the opportunity to adjust the left-right balance of the Court.

At present, it doesn't look like any of the conservative justices are planning to retire, but Justice Scalia just turned 75 and younger men than he have unexpectedly left the Court for a higher tribunal. In 1953, Chief Justice Fred Vinson died suddenly at 63. This, as it happens, is the age of Clarence Thomas...

(Read the full text of "Obamacare and the Law's Delay".)

I had heard of the first reason, but had never considered the second reason -- but it makes perfect sense once pointed out.

As Catron reports in his blog HealthCareBS, the Supreme Court will meet soon to consider the Virginia attorney general's request for expedited action.

And although Supreme Court judges are theoretically immune from politics, they can't help but be influenced by the overall political climate.

So this is all the more reason for Americans to keep up the political pressure on their legislators (especially some of the wavering Republicans) to oppose and defund ObamaCare.

Quick Links: Scherz, Gratzer, NYC

Dr. Hal Scherz of Doc4PatientCare explains, "Obamacare One Year Later - What It Means for Doctors is What it Means for You". (Via Dr. Richard Armstrong.)

In the 3/21/2011 Investor's Business Daily, Dr. David Gratzer notes that despite years of "reform" efforts, health costs keep rising. He discusses the real culprit at: "Medical Care's Real Problem: The Tax Code".

One of ObamaCare's biggest supporters wants a waiver for all of New York City. (Via Amanda Teresi.)

IWV Video Contest Winners

See them here!

The 12 Worst Features Of ObamaCare

The 3/22/2011 Investor's Business Daily has an nice OpEd by David Hogberg listing, "The 12 Worst Features Of ObamaCare".

Here are the first few items:

1. 1099
2. Surprises, Surprises
3. Waivers
4. More Waivers?

(Read the whole thing for the full list and supporting details.)

The problems of ObamaCare are becoming increasingly apparent to everyone. It's time for the GOP to do what Americans elected them to do and kill this atrocity!

Hsieh in TOS: Health Care and the Separation of Charity and State

The Spring 2011 issue of The Objective Standard has published my latest short article, "Health Care and the Separation of Charity and State".

Here is the opening:

If someone in America needs medical care but cannot afford it, should he rely on charity or should others be forced to pay for it? President Obama and his political allies say that Americans should be forced to pay for it. Forcing some Americans to pay medical bills for other Americans, says Obama, is a "moral imperative" and "the right thing to do."

Throughout the health-care debate of 2010–11, Obama repeatedly referred to government-run health care as "a core ethical and moral obligation," arguing that, "No one should die because they cannot afford health care, and no one should go broke because they get sick." In speeches, he repeatedly cited the story of Natoma Canfield, an Ohio cancer patient without health insurance, as a justification for his health-care legislation.

Many of Obama's supporters on the political left made similar moral claims. Vanderbilt University professor Bruce Barry wrote in the New York Times that, "Health insurance in a civilized society is a collective moral obligation." T. R. Reid, former foreign correspondent for the Washington Post, called universal health care a "moral imperative." Ezra Klein, another writer for the Washington Post, agreed that it is an "ethical obligation."

But all such claims are wrong -- morally wrong...

(Read more of "Health Care and the Separation of Charity and State".)

TOS subscribers can read the full piece online. Non-subscribers can purchase PDF's for $4.95 at the article website.

Update: Thank you, David Catron, for the link at HealthCare BS!

Update: Thank you, Dr. Milton Wolf, for the link at Wolf Files!

Haynes on Berwick

The 3/20/2011 PajamasMedia has published an OpEd by Dr. Beth Haynes of The Black Ribbon Project, "Vilifying Dr. Berwick -- for the Wrong Reasons".

Here is the opening:

If you don't like ObamaCare, you probably really don’t like Donald Berwick, the current administrative head of Medicare and Medicaid.

You know him. He's the one who’s "in love" with the Britain's National Health Service, the guy who insists that we "must -- must -- redistribute wealth," and tells us that, since rationing is unavoidable, we’d best do it "with our eyes open."

But in regards to government-funded health care -- including Medicare and Medicaid -- Dr. Berwick is right, so it does no good to shoot the messenger.

(Read the full text of "Vilifying Dr. Berwick -- for the Wrong Reasons".)

Dr. Haynes is right -- Berwick holds terrible ideas, but he's also a symptom of the much deeper disease of statism. He merely exemplifies it in a particularly open and clear fashion. But the underlying idea that government can and should guarantee health care as some sort of "right" must be fought in all forms.

(I also appreciated Dr. Haynes clarification of the distinction between free markets and rationing. For more on this point, I highly recommend the essays by Ari Armstrong, "The Market Does Not Ration Health Care: Voluntary Exchange Is Not Rationing (Part 1)" and the related Part 2.)

Quick Links: Pilot Programs, Death, Destruction

John Goodman explains, "Why Pilot Programs are a Waste of Time and Money".

His analysis is especially applicable to the Obama Administration pilot programs for "Accountable Care Organizations" and "Medical Homes".

In the 3/17/2011 New York Post, Betsy McCaughey says the government should, "Stop telling us where to die".

The 3/16/2011 Investors Business Daily quotes Senator Orrin Hatch on ObamaCare, "It would be hard to devise a more economically destructive piece of legislation".

Kudos To The Lucidicus Project

Congratulations to the Lucidicus Project for being named a finalist in the Sam Adams Alliance 2011 "Sammies" award to honor pro-freedom activists around the country!

From the Lucidicus Project website:

The Lucidicus Project is an independent educational initiative whose mission is to help medical students and the general public learn more about the case for free markets and individual rights in medicine.

We raise money to provide books to students who are entering medicine, nursing, and other healthcare-related professions. By giving away our self-defense kit, we help the doctors of tomorrow learn to stand up for the right to practice medicine in a free market and a free society. We also regularly publish editorials on healthcare policy and provide commentary and links through social media. The project was founded in 2005 and is based in Boston, Massachusetts.

Jared and Becky Rhoads have also written numerous editorials.

I'm glad they're getting the attention they deserve. If you wish to support their work, you can donate here.

Dr. Beth Haynes on Health Care Freedom

Dr. Beth Haynes of the Black Ribbon Project discusses how to defend health care freedom:



In particular, she discusses that ObamaCare is wrong not just from the economic and medical perspectives, but also from a moral standpoint.

Thank you, Dr. Haynes, for making such a strong principled defense of freedom!

If you like her work, feel free to donate to the Black Ribbon Project.

Free Markets and Pre-Existing Conditions

One of the supposed rationales for government-run "universal health care" is that Americans with pre-existing conditions are unable to get insurance coverage.

However, in a 3/10/2011 blog post at Forbes ("The Road to Socialized Medicine Is Paved With Preexisting Conditions -- Part 2"), Don Watkins and Yaron Brook of the Ayn Rand Institute discuss the fact that insurance is a service that must be created by rational thought and effort. Compelling insurers to cover all patients regardless of pre-existing conditions would violate the rights of those who provide that service and would destroy the remnants of the private insurance market.

The current problems of pre-existing conditions are caused by bad government policies that unfairly favor employer-based health insurance, which results in insurance being artificially linked to one's job.

Watkins and Brook also discuss some ways in which a free market for insurance service would address the issue of pre-existing conditions. In particular, they linked to an excellent public policy paper published by the Cato Institute, "Health-Status Insurance: How Markets Can Provide Health Security" (PDF and HTML versions).

For more on how free markets can address the issue of pre-existing conditions, please also see my article in the Fall 2009 issue of The Objective Standard, "How the Freedom to Contract Protects Insurability".

Instead of more government controls over health insurance, we need to repeal the existing ones and let insurance companies operate in a fully free market.

Quick Links: Suicidal Insurers, Placebos, Unintended Consequences

Dr. Rich of CovertRationing notes that, "Once Again, Insurance Companies Attempt to Save Obamacare".

Too many of them still think the individual mandate will be their path to survival. Those who take that position are not on the side of patients and doctors -- and not friends of freedom.

The UK newspaper Guardian reports: "Half of all German doctors prescribe placebos, new study shows".

Hey, at least they're cheaper than actual medications! And in a socialized medical system, that's going to be important. (Via Dr. Matthew Bowdish.)

The March 9, 2011 Wall Street Journal describes the latest "unintended consequence" of ObamaCare, "In Health Law, Rx for Trouble".

Wolf: Run, Democrats, Run

Dr. Milton Wolf notes that the Democrats are on the wrong side of history in his latest column, "Run, Democrats, Run".

A couple of nice quotes:

The free market is the most powerful engine of human prosperity in the history of mankind and today's Democrats stand desperately in its way to appease those who are enriched by big government at the expense of everyone else. It’s not by coincidence that the most prosperous and powerful nation the world has ever known grew out of the cradle of democracy. Freedom, after all, is the core of the free market. It's the freedom for you to control your own resources and with them, your destiny...

American Democrats are in defiance of history and common sense. As Canadian and British patients flee government-run socialized health care, Democrats rush to implement Obamacare. As once-impoverished nations become wealthy by manufacturing goods for Americans, Democrats and their union allies are aiding them by raising manufacturing costs here at home. As Asian auto companies make cars people actually want, President Obama nationalized car companies and is now bribing you with your own money to buy an electric clunker nobody wants. As our competitors understand the elegantly simple yet profoundly powerful concept of supply and demand, Mr. Obama implements an oil-drilling moratorium and rushes toward $5 per gallon gasoline.

(Read the full text of "Run, Democrats, Run".)

The Democrats are on the wrong side of history. The big question is whether the Republicans will choose to be on the right side...

Did the FDA Lie to Congress about Genetic Testing?

Wired asks, "Did The FDA's Jeffrey Shuren Mislead A Congressional Hearing?"

A video posted yesterday on FDABlog appears to show Jeffrey Shuren, Director of the FDA’s Center for Devices and Radiological Health, providing misleading information to a 2010 Congressional hearing into the direct-to-consumer (DTC) genetic testing industry.

The timing of the video's release is no coincidence: we currently sit in the middle of yet another FDA-engineered spectacle on DTC genomics, which seems likely to generate a recommendation that all health-related genetic tests be offered only through a clinician gate-keeper, so the integrity of the FDA's approach to the industry is an important question.

More details here at FDAblog.org.

The FDA becoming more aggressive in its attempts to obstruct the consumer genetic testing industry. But if these accusations are true, this is a new low for them.

(I covered some of this in my 2010 PajamasMedia piece, "Should You Be Allowed To Know What's In Your DNA?")

Catron: A Thousand Points of Blight

In his latest AmSpec piece, David Catron details the cronyism and favoritism of the ObamaCare waivers. Here are excerpts from, "A Thousand Points of Blight":

Last October, it came out that the Obama administration had been issuing ObamaCare waivers to a list of unions and corporations that correlated rather suspiciously to the donor rolls of the Democratic National Committee. The indignation caused by this news increased proportionally as the total number of special dispensations grew to 111 by November and to twice that amount in December. And there was general outrage when an additional 507 new waivers were posted to the approval list the day after Obama's State of the Union Address.

The list now includes more than 1,000 unions and other entities. Thus, several Republican committee chairmen in the House are interested in all of those visits the President received during the run-up to the final ObamaCare vote.

Yet the Obama administration is stonewalling requests for information on these waivers were granted. For an administration that talked about "transparency", their actions indicated otherwise:

According to Bob Bauer, who ironically needed a waiver from the President's famous "ethics pledge" in order to qualify for the post of White House Counsel, complying with congressional oversight just involves far too much work: "To provide all possible information encompassed by your request... would constitute a vast and expensive undertaking."

The letter also contained this familiar-sounding passage: "To the extent you are also seeking documents reflecting internal deliberations and communications; it also would implicate longstanding Executive Branch confidentiality interests."

Why does this sound familiar? It is how the Bush White House responded to initial questions from Congress about Vice President Cheney's "secret meetings" with those evil oil industry executives.

(Read the full text of "A Thousand Points of Blight".)

As Glenn Reynolds might ask, "Remember the 'fierce moral urgency of change'?"

Quick Links: WaiverMania, Transparency, Licensing

HotAir notes that, "ObamaCare waivers soar past 1,000".

And CNBC reports that the state of Maine is getting a waiver!

On the more positive side, economist/blogger Mark Perry describes a "fundamental shift" for some hospitals now providing more transparent pricing.

This information will be especially helpful for patients with HSAs (Health Savings Accounts) seeking the best value for their money. I hope this trend spreads outside of Michigan! (Link via Kelly V.)

Brian Schwartz at PatientPower links to this Boulder Daily Camera piece opposing licensure requirements for naturopathic doctors.

Those arguments would apply equally well to eliminating government licensing of MDs, as elaborated in more detail by Professor Shirley Svorny in this 2008 paper, "Medical Licensing: An Obstacle to Affordable, Quality Care".

Hsieh LIJ OpEd: Socialized Medicine in Theory and Practice

The March 2011 issue of Liberty Ink Journal has just published my latest OpEd, "Socialized Medicine: Theory Versus Practice".

Here is the opening:

An old joke runs, "In theory there is no difference between theory and practice. In practice there is." Nowhere is the gulf between theory and practice more clear than in socialized medical systems around the world. Why is this the case, and what can Americans learn from this?

Advocates of government-run "universal" healthcare claim that it provides patients with the medical care they need in a timely, efficient fashion, without concern for ability to pay. However, a closer examination of these supposed utopias of government-run healthcare in Canada and Europe reveals the exact opposite...

(Read the full text of "Socialized Medicine: Theory Versus Practice".)

I'd again like to thank Stephanie Anderson (editor-in-chief) and Tobin Spratte (managing editor) for the opportunity to appear in LIJ. Liberty Ink Journal is a Colorado-based publication that has as its goal, "to restore the Republic to a constitutionally limited government that protects rather than infringes upon our rights".

They also published my piece, "What Kind of Healthcare Competition Do We Want?", in their February 2011 issue.

Update: Thank you, Charlie Martin, for the PajamasMedia link!

And thank you, Glenn Reynolds, for the Instapundit link!

Wolf: Obamacare Vital Signs Starting To Fade

Dr. Milton Wolf has a new OpEd in the 3/8/2011 Washington Times, "Obamacare Vital Signs Starting To Fade". Here is the opening:

Obamacare is living on borrowed time, and even its most ardent supporters are beginning to realize it. That's why they're racing to implement -- and entrench -- as much of the plan as possible before the laws of economics and the laws of the land and voters catch up.

They're like a deadbeat renter starting a remodeling project after being evicted but before the police escort them from the premises in hopes that it gives them squatter's rights. Meanwhile, two unrelated but devastating events have caused the ground to shake beneath the feet of Obamacare supporters...

(Read the full text of "Obamacare Vital Signs Starting To Fade".)

The good Dr. Wolf is absolutely right. ObamaCare is unsustainable in the long-run -- but its supporters still hope to make it a fait accompli. Hence, Americans must keep up the pressure on our elected officials.

To borrow a phrase from Dr. Beth Haynes, we must be the "calcium in the spines" of Congress to delay and obstruct ObamaCare as vigorously as possible until either the Supreme Court kills it outright or Congress repeals it outright.

The tide may be turning, but battle is not yet won...

Fighting For Freedom At the State Level

Greg Scandlen recommends that Americans who want to get involved and help move this country in the right direction do so by helping their state-level free market think tank.

For example, Colorado has the Independence Institute. Their Health Care Policy Center is run by Linda Gorman, and I've been a long-time friend of Brian Schwartz who runs their health policy blog PatientPower.

Their Second Amendment Project is run by David Kopel, who has written extensively about gun rights.

Overall, I like much of what the Independence Institute does and I'm glad they are here in Colorado.

One way to find similar organizations in your state is through directory listing of the State Policy Network (search by state in the pull down menu.) Of course, you should do your due diligence to ensure that your state/regional think tank supports your values. But if they do, Scandlen notes that you can help by contributing money as well as expertise.

The states are going to be key battlegrounds in the fight for American freedom. There's never been a better time to jump into the fray!

Light Posting Notice

Admin note: Blogging may be light/sporadic this upcoming week due to external obligations.

Vinson Update: Catron, Haynes, Kerr

Federal judge Roger Vinson issued the "clarification" to his anti-ObamaCare ruling yesterday that had been requested by the Obama administration.

David Catron gives a nice overview at, "Judge Vinson Fails to Apply the Two-By-Four" at AmSpec. In particular, Catron pointedly asks:

All of which begs the following question: Why, then, did he not apply the two-by-four?! It is already blindingly obvious that this particular beast does not respond to reason. This was clearly demonstrated by the utter contempt with which the administration treated Vinson's January order. And such behavior is by no means limited to the various ObamaCare challenges...

It may be that Vinson is giving the executive branch one last chance to abide by the rule of law.

Dr. Beth Haynes of the Black Ribbon Project offers her own take at, "Judge Vinson Rules! (again)". Her interpretation:

Judge Vinson recognizes the complexity of the case, and that it will not be resolved until the Supreme Court finalizes its interpretation. Although the plaintiffs are suffering injury under continuation of the law, given the mixed current rulings (see below) and the uncertainty of the final ruling, the disruption will be greater if the law is halted while under appeal.

And law professor Orin Kerr notes the following in his recent blog post:

DOJ is willing to abide by the 7 day deadline Vinson imposed... And commenter Joe has a pretty good explanation of why: After DOJ complies with Vinson’s order, the case will be in the Court of Appeals and Judge Vinson won't have any control over the pace of the case. Sounds sensible.

Things are about to get interesting...

ObamaCare Driving Insurers From Markets

The Galen Institute has published a new report on the harms caused by ObamaCare, "Negative Consequences of Health Law Force Health Insurers to Withdraw from Markets Across the Country" (PDF).

The piece is fairly short (4 pages plus references). The new laws are affecting multiple sectors, including children-only insurance, Medicare Advantage, Group Insurance, and Individual Insurance.

Galen summarizes their report as follows:

The impact of new rules on health insurance is causing people throughout the country to "lose the coverage they have now" and to have many fewer options.

We all keep hearing the news in a drip-drip-drip of reports, but it seems particularly stark when you pull together in one paper, as we have done, the number of companies that have withdrawn from various markets in response to new rules. This leaves customers with fewer options of affordable coverage in an increasingly non-competitive market.

(Via IBD.)

Health Wonk Review At Lucidicus

Jared Rhoads of the Lucidicus Project is hosting the latest "Health Wonk Review".

Go check it out!

Hsieh DP LTE on ObamaCare Savings

The March 3, 2011 Denver Post has published my latest LTE on ObamaCare.

I was responding to an earlier OpEd by Dr. Ned Calonge of the Colorado Trust claiming huge cost savings to Colorado under ObamaCare.

Here is my LTE reply as published by the Denver Post:

Questioning the savings under health reform

Re: "In Colorado, health care reform means lower costs," Feb. 23 guest commentary.

The cost savings that Dr. Ned Calonge and The Colorado Trust are counting on under Obamacare are unlikely to materialize. After Massachusetts adopted a similar "reform" plan in 2006, health insurance premiums went up at double the national average -- not down. Similarly, Medicare chief actuary Richard Foster recently told Congress that the new health law is unlikely hold down costs for the federal government. If it won't save money for the feds, it's unlikely to save money for Colorado. Finally, the national plan relies on an "individual insurance mandate" of dubious constitutionality -- and a gross infringement of individual freedoms.

We’re more likely to see John Elway come out of retirement and quarterback the Broncos to another Super Bowl than see any of Dr. Calonge's promised cost savings.

Paul Hsieh, M.D., Sedalia

Quick Links: Some Choice, DNA Paternalism, MA

Avik Roy of Forbes notes, "Obama: States Should Be Able to Opt Out of Obamacare -- By Imposing a Single-Payer System". Some choice...

Wired reports: "American Medical Association: You Can't Look At Your Genome Without Our Supervision". Yet another reason I'm not a member of the AMA. (Via Dr. Matthew Bowdish.)

In the 3/1/2011 Wall Street Journal, John Calfee notes that Massachusetts hasn't learned from history. It's about to make the age-old of mistake of trying to solve problems created by government controls by imposing more government controls.

Here's an excerpt from, "The Massachusetts Health-Reform Mess":

Gov. Patrick introduced a bill that will impose de facto price controls on everyone from solo primary care doctors to prestigious academic hospital systems. An 18-member board will decide how and how much providers should be paid, and the bill gives regulators the power to force private insurers to accept these fiats. Some 30 states experimented with such rate-setting in the 1970s and '80s. Except for Maryland, all of them -- including Massachusetts -- deregulated in the 1990s because costs rose even as quality and choice declined.

In a mere four years, Massachusetts has demonstrated that the most important effects of its reform arise not from the letter of the law but from the law's unintended and unpredictable consequences. The state is lurching from one crisis to another as it attempts to construct a system vastly different from any seen before or anything contemplated when reform was first passed...

(Read the full text of "The Massachusetts Health-Reform Mess".)

FDA Hindering Medical Innovation

In the 2/18/2011 New York post, Dr. Robert Goldberg notes that history shows that government is ill-suited for drug invention. In fact, in the case of Avastin, the NIH and the Food and Drug Administration actually hindered medical progress.

More details in his OpEd, "O's Bogus Rx for Medical Innovation".