Saturday, March 25, 2017

Obamacare as a pre-existing condition
AKA - a now intractable entitlement

A large part of Donald Trump's successful campaign for the Presidency derived from a promise to repeal Obamacare.

Unfortunately, he also promised universal health care under the most wonderful health insurance plan we'd ever seen. He promised to keep, and even expand, the popular parts of Obamacare while repealing the unpopular parts - and at lower cost.

Consistent with those inconsistent promises, the post-election policy proposal was to keep the most costly popular parts of Obamacare. For example, coverage for pre-existing conditions, coverage for 26 year olds under their parents' family plan, and federally decreed coverages many insured neither want nor need.

The bill that Paul Ryan delivered was an attempt to satisfy Trump's promises.

"Moderate" Republicans wouldn't vote for a bill that removed pre-existing condition protection, etc.. The Freedom Caucus stood firm for repeal, and wouldn't vote for a bill with Obamacare holdovers. Trump said, "Take it or leave it."

So, is it Trump who's at fault for the bill's failure? Ryan? The Freedom Caucus?

I think it's the "moderate" Republicans in the House, but give Trump an assist. The core sin of Obamacare was to further insert government control into the health insurance market. By accepting Obamacare's core principle, Mr. Trump encouraged GOP House "moderates" to insure "repeal" would degenerate into tinkering about the edges.

Tax reform next?

Friday, March 24, 2017

American Health Care Hacked

Instead of mandates and fines for not buying health insurance the American Health Care Act provides a 30% increase in premiums. Instead of means based subsidies there are age based tax credits.

Left in place are mandated coverage for pre-existing conditions and extension of coverage to 26 year old 'children'. Because these are popular. So are unicorns. The cosmetologists behind the GOP health insurance plan can't be bothered to point out any connection between these policies and insurance premiums. Because insurance premiums are not popular.

The President promised health insurance would be made available across "the [state] lines." Trump’s website said he would “ask Congress to immediately deliver a full repeal of ObamaCare” on day one. So much for those promises on day sixty three.

A few of the Obamacare decreed coverages, like maternity insurance for males, are removed, but only after strong objection from the Freedom Caucus; people who know how to spell 'repeal.'

This bill, in all its superficial wordplay, is capitulation to the core principles of Obamacare. It puts the GOP stamp of approval on policies the GOP derided as socialist as recently as six months ago.

Now, the Great Negotiator, who insists this is a "wonderful" health care bill, has said "take it or leave it" - after threatening those who are trying to get him to keep his promises.

If anything good is to arise from this debacle it will only come from the courage of a handful of people who still believe in a free market. Better to take the President up on his offer to do nothing than to accept this travesty.


Monday, March 13, 2017

Trumpcare Phase III, Title XX/XY

The FDA does not allow 23andMe to offer medical interpretations of its $199 human genetic mapping service. Oh, you can get ancestry information, but no information about your own genetic tendencies or disease markers unless you yourself decode the raw data. Because you, or 23andMe, might misinterpret it.

Meanwhile, a Republican Member of the US House of Representatives (Virginia Foxx [R-NC-5]) has introduced H.R. 1313, a bill which would allow your employer sponsored health plan access to your genetic profile under the pretense heading of "employee workplace wellness programs, including programs that utilize a health risk assessment, biometric screening, or other resources".

This started under ObamaCare, where employers are allowed to add up to 30%, or more, to your health insurance premium if you don't "volunteer" for their "workplace wellness program." These programs typically look for, and monitor, health conditions such as weight, smoking and blood glucose.

H.R. 1313 takes the pre-existing condition question to the next level - pre-existing tendencies - and with the added heredity information, one can also imagine employer diversity programs based on your DNA inheritance. The good news is Elizabeth Warren might not have been counted as a minority on the Harvard faculty, no matter which boxes she checked. Every other application I can think of is bad news.

Outrageous.

"The right of the people to be secure in their persons, houses, papers, and effects, against unreasonable searches and seizures, shall not be violated..."


Cosponsors:
Rep. Walberg, Tim [R-MI-7]
Rep. Stefanik, Elise M. [R-NY-21]
Rep. Mitchell, Paul [R-MI-10]

Sunday, March 12, 2017

Leave Obamacare alone

Just let it crash and burn on its own. That is at least preferable to the GOP proposal to place it under new ownership being pushed by Paul Ryan and Donald Trump.

The Trump supporters who railed against the 'GOPe' should be angrier than the rest of us, since the Art of the Trumpcare Deal strongly suggests the GOPe is still in charge.

Actually, following the script of redefining subsidies into tax credits and claiming there's a real difference, maybe we should rename GOPe. Call it GOPino. Actually, it's arguable that there is nothing significant left of the GOP, anyway.

Here's a partial list from Jeffrey Tucker of things health care reform should accomplish. Not one of them is in the GOPino proposal.
  1. Government should not be determining what is or must be insured. That should be up to the consumers to decide.
  2. Government should not interfere in contractual relationships between providers and purchasers of insurance, whether individuals or businesses.
  3. Prices for medical services need to be completely decontrolled, and the convoluted market-rigging by a conspiracy of providers, insurers, and government welfare bureaucracies must be ended.
  4. Government should not mandate coverage by employers or privilege employer-provided coverage over individually purchased coverage. Third-party payment should be an option.
  5. Government should not mandate that insurers accept all comers at the same price; that system makes a mockery of the whole idea of insurance itself.
  6. Discrimination for “pre-existing conditions” should not be a criminal act but rather a rational consideration for determining premiums.
  7. Government should not restrict who gets to try their hand at providing insurance; entry and exit need to be competitive too.
  8. Government should never force anyone to pay for a service that he or she does not want. You say coverage is a human right? It’s a human right for a person to refuse coverage.
  9. If you want to get serious about fixing the system, the byzantine pharmaceutical system has to go. Again, let the consumers decide, and, while we are at it, there should be complete free trade in medicine.
  10. The 100-year old medical credential monopoly that has so severely restricted entry into the profession should be dismantled. The market is fully capable of assuring quality, and remember too that there is not one definition of quality.
Those are all fixes to problems big government created. Rather than address that, Trump and Ryan are saying if we don't pass Trumpcare it will hurt Republicans. Ryan:
“I do believe that [2018 will be a "bloodbath" for Republicans] if we don't keep our word to the people who sent us here, yeah,” Ryan told CBS News’s “Face the Nation,” when asked if he agreed with Trump’s reported comments about the 2018 midterm elections.
Who cares?

I do believe he's right, but not in the way he thinks. This only makes sense in a Clintonian world where the definitions of "keep" and "word" depend on the meaning of the word "is."

Trump's Voters Have Been Betrayed on Healthcare, Bigly.

So has everyone else.

Thursday, March 09, 2017

Saccharine of the masses

I used to think steel was the poster child for the evils of protective tariffs, perhaps because of my disgust with Dubya when he used steel tariffs to solicit votes in Pennsylvania.

I flirted with the ethanol tariff example as an alternative, because the $0.54 a gallon tariff on Brazilian cane ethanol was so outrageously high - and so thoroughly hypocritical when our elected representatives were simultaneously subsidizing corn ethanol as a partial solution to the energy crisis and 'global warming'.

Then again, because of the availability of precision, in-depth analysis of Reagan’s motorcycle protectionism on behalf of a single company, and the fact that even the Gipper could betray his stated principles, those tariffs were a brief contender as quintessential.

Lately, perhaps because of the long history of sugar tariffs and that they've been in the news, I’m leaning toward sugar as the best example of protectionist perfidy.

These four examples cover agriculture, heavy industry, and manufacturing, so there’s not much room to argue in favor of protectionism on any sectoral basis.

IAC, I think this article on sugar wonderfully illustrates the corrupt crony-capitalist nature of protectionism - from protecting slave owners to why Nabisco would move Oreo manufacturing to Mexico to farmland prices in Minnesota to causus belli for the Spanish-American war - all while screwing over American consumers and enriching lobbyists in order for politicians to buy votes.

Protectionism is accepted because the Yuge economic damage is unseen, the insidious moral erosion is smothered in populist platitude, and the proponents are organized while the victims are not.

Without economic freedom there is NO freedom, and whatever example of protectionist venality is used to reveal its pillages, protectionism itself is the poster child for the armed robbery of economic freedom.

Update 5:25PM.
A friend writes:
"If I want to sell widgets to buyers in Canada, and Canada puts a tariff on my widgets, is there free trade?," as if the point were that without fully free trade we shouldn't remove our tariffs.

I haven't been clear enough.

My clarifying response:
"No, because Canada is interfering with the trade.

My point is that just because Canada indulges stupid policies doesn’t mean we have to. We should not ‘retaliate’ because that hurts our economy, our people, our morals, and our jobs.

When I said, “Aw, come on, all the other kids are doing it!” to my mother she said (as your mother probably said to you) some variation of, “If all the other kids were hitting themselves in the head with a hammer, should you?”"

Friday, March 03, 2017

Sweet reason?

Nope.

You probably shake your head in wonder at the stupidity of the Philadelphia politicians who imposed this tax on the soft drink industry: Pepsi is laying off up to 100 workers in Philadelphia and blaming a 2-month-old soda tax.

Distributors and grocery stores are likely to follow: Philadelphia’s Soda Sellers Say Tax Has Reduced Sales by as Much as 50%.

If you understand the Philadelphia political folly, but still support protectionist tariffs in the name of preserving U.S. jobs, intellectual consistency demands that you explain federal import duties on sugar in the same terms: U.S. Trade Policy Gouges American Sugar Consumers.

According to a 2006 study by our own Commerce Department, “For each one sugar growing and harvesting job saved through high U.S. sugar prices, nearly three confectionery manufacturing jobs are lost.

One-fifth of one percent of U.S. farms are the beneficiaries of this protectionism, and consumers pay around $1.3 billion annually to support them - not including the cost of federally mandated, corn-based ethanol in our gasoline. Which brings us to another sugar related protectionist tariff: Brazilian (cane-sugar) ethanol attracted a 54 cent a gallon tariff until 2012, while we simultaneously subsidized corn "food as fuel", raising prices on everything from tortillas to steak.

Claims by the sugar industry that Mexico is selling sugar below cost are ludicrous, Mexico is selling it above average world cost. That, and the Brazilian tariff, is what “fair trade” means to U.S. farm lobbyists and the Trump administration.