Posts tagged with: medicaid

pills and billsWhile Michelle Obama grows vegetables in the White House garden, her husband’s administration grows every government program it can. At The Federalist, Sean Davis gives 12 reasons why Medicaid should not be expanded.

Since Medicaid is a health care program, we should see some improvements in American’s health, right? Not so, and this is Davis’ first reason why we should not consider expanding this program.

According to an extensive, randomized study of people who enrolled in Oregon’s 2008 Medicaid lottery, Medicaid doesn’t improve the health outcomes of its patients, even after controlling for major health predictors like income and pre-existing health status. The researchers tracked the health progress of people who were admitted into the program and who people who applied but did not get selected by the lottery. According to the researchers, one of whom helped craft Obamacare, while the program led to people using more health services, those services didn’t actually make them physically healthier…

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A recent speech by U.S. Senator Marco Rubio laid out what his press office terms “Conservative Reforms for Combating Poverty.” It began well and had a nice line or two emphasizing the role family breakdown plays in perpetuating generational poverty, but then it went all technocratic and wobbly.

So, for instance, at one point he argued that a lack of education is one reason for the decline of marriage among the poor, noting that “64% of adults with college degrees are married, while only 47% of those with a high-school education or less are.” How does he know that being married doesn’t make one more likely to pursue higher education, or that both tendencies aren’t caused by something else? (more…)

Want to help the poor? Promote a free market in health care. That’s the argument made by John C. Goodman, author of the new book Priceless: Curing the Healthcare Crisis.

Timothy Dalrymple recently talked with Goodman about the best approach for restoring free-market pricing mechanisms into the market for medical care and health insurance:
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A video surreptitiously filmed during one of Mitt Romney’s private fundraisers was leaked and captured the Republican presidential nominee talking to donors last April in a Florida home (watch below) during a very candid moment.

While Romney states the facts and opinions as he sees them regarding the prevalent public welfare culture in America, he quotes figures that will surely stir animosity from within the Obama administration and his loyal Democratic voters.

Here’s a summary of what Mitt Romney told his campaign donors:

There are 47 percent of the people who will vote for the president no matter what…There are 47 percent who are with him, who are dependent upon government, who believe that they are victims, who believe the government has a responsibility to care for them, who believe that they are entitled to health care, to food, to housing, to you name it. ..They will vote for this president no matter what… And so my job is not to worry about those people. I will never convince them [that] they should take personal responsibility and care for their own lives. What I have to do is convince the five to ten percent in the center, that are independents, that are thoughtful, the look at voting one way or the other…

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Yesterday Senator Harry Reid finally proposed a budget plan – one week before the United States is set to default. It is about time that Senate Democrats joined President Obama and House Republicans in offering a concrete budget proposal; however, their budget plan passes the buck onto future generations.

The government cannot continue to leave budget woes to future generations, and this is exactly what Senator Reid is trying to do. In fact, after viewing a video found on his website, he seems rather proud of the fact that his budget proposal doesn’t touch the three largest entitlements—Social Security, Medicare, and Medicaid—which alone consist of 40 percent of federal spending in 2010 (entitlement spending makes up 57 percent of federal spending). Instead of making the tough call, proposing reforms and cuts to spare future generations from the large financial burden these programs bring, the Senate Democrats are deciding to continue with things as they are. Judging by the current financial state of the U.S. this is rather problematic.

The Senate Democrats’ budget proposal disregards the principles of stewardship. By not cutting or reforming entitlements they are not looking long term to ensure the creation of a strong and stable economy for our children and grandchildren.  Jordan Ballor in his commentary “Do Less with Less: What the History of Federal Debt and Tax Leverages Teaches” offers a pretty common sense solution for Senator Reid:

Raising taxes without such assurances, even for such a critical cause as the public debt crisis, is pure folly. To really address the structural deficits at the heart of the federal budget, particularly with respect to entitlement programs like Social Security, Medicare, and Medicaid (which together accounted for 40 percent of federal spending in 2010), the government simply needs to find ways to do less with less.

Entitlements have greatly contributed to our deficit problem, and a sound budget solution will recognize their contribution to the deficit and look to rectify the situation.

As Samuel Gregg articulates in “Deficit Denial, American-Style” the U.S. must pay off its debt if it hopes to economically grow and flourish:

After examining data on 44 countries over approximately 200 years, two economists recently found evidence suggesting that developed nations with gross public debt levels exceeding 90 percent of GDP (i.e., America) find that their medium-growth rates fall by one percent, while average growth declines by an even greater proportion.

The United States can begin down the path of prosperity by shrinking government and doing less with less and fostering an economic climate that is strong and vibrant for future generations.

Also see the Acton Institute’s  Principles for Budget Reform which can be viewed by clicking here.

 

 

 

Blog author: jmeszaros
posted by on Wednesday, July 20, 2011

John Boehner recently stated, in the debt-ceiling talks, that “We’re going to continue and renew our efforts for a smaller, less costly and more accountable government,” which most Americans agree with in principle.  However, citizens say that keeping benefits the same for the three big programs, Social Security, Medicare, and Medicaid, is more important than taking steps to reduce the budget deficit by a margin of 60 percent compared to 32 percent for Social Security, 61 compared to 31 percent for Medicare, and 58 compared to 37 percent for Medicaid.

So Americans purportedly want thriftier government, but still want benefits? What gives?  Part of the problem, according to James Kwak, is “the idea that there is one thing called ‘government’–and that you can measure it by looking at total spending–makes no sense.”

What Kwak means is that total expenditure is a misleading measure of the “size” of government. He presents this example:

The number of dollars collected and spent by the government doesn’t tell you how big the government is in any meaningful sense. Most government policies can be accomplished at least three different ways: spending, tax credits, and regulation. For example, let’s say we want to help low-income people afford rental housing. We can pay for housing vouchers; we can provide tax credits to developers to build affordable housing; or we can have a regulation saying that some percentage of new units must be affordably priced. The first increases the amount of cash flowing in and out of the government; the second decreases it; and the third leaves it the same. Yet all increase government’s impact on society.”

So increased spending (or decreasing it) does not necessarily mean the “size” of government has grown (or shrunk). Think how regulation is synonymous with big government, but it does not involve a tax or direct spending of any kind.

In fact, “big” government is often viewed through the lens of regulation, rather than cost. For instance, Kwak explains:

When people say government is too big, they often have in mind something like the Consumer Financial Protection Bureau–a regulatory agency that tells businesses what they can and can’t do…the CFPA’s budget is about $300 million, or less than one-hundredth of one percent of federal government spending.”

Again the divergence between cost and “bigness” is seen.  The CFPA may be viewed as “big,” intrusive, and unnecessary but it is not large in terms of cost like Social Security and Defense spending.

Kwak states, “popular antipathy toward the regulatory state has been translated into an attack on popular entitlement programs.”  Many people dislike certain government regulations and, due to the budget debate, dislike of regulation, the amount of government spending, and specific government programs may have become accidentally intertwined.

As mentioned before, Americans view Social Security, Medicare, and Medicaid as important and worth preserving.  Kwak elaborates: “Rationally speaking, your opinion about Social Security or about Medicare should be based on how much you put in and how much you get out–not on the gross size of the program, and not on how big the rest of the federal budget is. Yet instead the total size of the budget has become the driving force behind potential structural changes in Social Security and Medicare.”

Kwak suggests that “we should make decisions on a program-by-program basis, just like a business is supposed to do.”  His advice is: “If there’s a program that the American people, through our democratic system, agree will provide benefits greater than its costs, we should do it, independently of the existing spending level. And if there’s a program that isn’t covering its costs, we should kill it.”

Instead of focusing on a generality, “government size”, our elected officials should evaluate programs on a cost-benefit level.  Then government agencies that are viewed as too costly or intrusive (the CFPA) could be eliminated and government programs that are viewed as beneficial (SS, Medicare), but need reform, can be focused on in an unbiased way and not be harmed by the “too big” generality.

Jordan Ballor, in a blog post for Acton, wrote: “All government spending, including entitlements, defense, and other programs, must be subjected to rigorous and principled analysis.”  Indeed, although the American people think Social Security, Medicare, and Medicaid are beneficial, 52 percent think Social Security needs significant reform, 54 percent think Medicare needs reform, and 54 percent, likewise, for Medicaid.  However, without having a clear definition of what “too big” means, successful retooling will be difficult to achieve.

Ballor added: “This means that the fundamental role of government in the provision of various services must likewise be explored. This requires a return to basics, the first principles of good governance, that does justice to the varieties of governmental entities (local, regional, state, federal) and institutions of civil society (including families, churches, charities, and businesses).”  True reform requires not simply legal and budgetary change, but a reevaluation of what entities perform certain services, as Ballor suggested.

The Acton Institute is committed to real budget reform, and, to make sure that programs, like Social Security, are evaluated fairly and reformed properly, the United States should make sure it clearly defines the costs and benefits of individual programs before taking drastic action.

Another election has come and gone, and once again the balance of power has significantly shifted in Washington, D.C. and statehouses across America.  Tuesday’s results are, I suppose, a win for fans of limited government, in that a Republican House of Representatives will make it more difficult for President Obama and his Democrat colleagues in the Congress to enact more of what has been a very statist agenda.  But even with the prospect of divided government on the horizon, we who believe in individual liberty and the principles of classical liberalism still have much to be concerned with.  Perhaps the primary concern is whether or not those Republicans who were swept into office—not due to any real love of the electorate for the Republican Party, but rather due to anxiety over the direction the Democrats have taken the country—will be able to hold to the principles of limited government and individual liberty that so many of them claimed to espouse during the campaign, or whether those principles will be abandoned in a mad pursuit of power.  Forefront in the mind of every lover of liberty should be Lord Acton’s famous maxim: “Power tends to corrupt, and absolute power corrupts absolutely.”

My sincere hope is that with Americans deeply dissatisfied with both major political parties and finding that the government is either unable or unwilling to solve the major fiscal and social problems that we face, people will begin to re-think their basic assumptions about the role of government in American life.  For decades, the default assumption has been that the government is a force for good and can be a driver of positive social change.   Witness Social Security, Medicare, the Great Society, the War on Poverty, etc.  All of these programs were designed by experts to alleviate some pressing social need, and were assumed to be the right thing to do.  After all, who wouldn’t want to help the poor and elderly to live a fuller, better life?  And yet, as the years went by, all of these programs—though well-intentioned by their creators—have failed to achieve their lofty goals.  The Social Security “trust fund” is devoid of funds and packed with IOUs left by politicians who, over the years, have spent the money promised to seniors on other programs.  Medicare, Medicaid, and other government health care programs have warped the economics of health care, paying doctors less and less and therefore driving up the cost of private insurance in order to make up the difference.  Obamacare is little more than an attempt by the government to solve a cost crisis—created in large part by government intervention—with even more extensive government intervention into the market.  We already know how that story ends.  And as for the Great Society and the War on Poverty, trillions of dollars over the years simply failed to alleviate poverty in America, and in many cases only created deeper, more entrenched social problems.

It is clear by now to anyone who cares to look that massive government intervention into society tends to do more harm than good, no matter how well intentioned the interventionists are.  Government has its place—no arguments for anarchy are to be found here—but the government must be limited to its proper place.  The genius of the American founding came in the limitation of the national government to certain enumerated functions, leaving the people at liberty to take care of the rest of life as they saw fit.  The respect for individual liberty and the acknowledgement that the rights of citizens were not granted by the state but were granted to individuals by God himself provided a firm foundation for the vibrant growth and strength of the United States in the coming centuries.  As a people, we need to realize that the further we move away from those founding principles and the more we cede our liberty to governmental agents in return for a promise of security, the less likely it is that we will remain strong, vibrant, and free.

At the Acton Institute 20th Anniversary Celebration, Acton President Rev. Robert A. Sirico reminded us of the roots of human dignity and the importance of individual liberty during his keynote address:

My new column on health care was published in the Detroit News today. Full text follows:

As the health care debate moves to the U.S. Senate, much of the focus has been on how the Catholic bishops’ support of the amendment by U.S. Rep. Bart Stupak, the Menominee Democrat, to prohibit the use of tax dollars to fund abortion was a major victory for the pro-life side. The bishops urged the House of Representatives, through local parishes and in a Nov. 6 letter, to ensure that “needed health care reform legislation truly protects the life, dignity, health and consciences of all.”

All people of good will, all those who value human life and dignity, should cheer this development.

But there’s more to this health care juggernaut that should give us reason to oppose it in its current form. We should first be concerned with the vast expansion of government reach into the private lives of millions of Americans.

This “reform” will create a system that will put bureaucrats in charge of personal health care decisions — not doctors. It will give the federal government an avenue to nationalize more than 15 percent of the U.S. economy, putting bureaucrats and elected officials in the role of manager and regulator — much as we’ve seen in banking and automobiles.

Amazingly, with the push for a $1 trillion-plus health care package and the attendant debt, we may soon see Canada with lower government spending (as a percent of gross domestic product) on heath care than the United States. All this, too, is a threat to human dignity.

What will this heavy burden of government spending and regulation have on U.S. health care innovation and competitiveness, which has to date pioneered so many advances? How many medical research and development firms would leave our shores under threat of higher taxes and regulation?

All the assurances from President Barack Obama that health care reform will not add “even one dime to our deficit over the next decade” seem more fantastic with every passing day.

A new report shows that projected Medicaid cuts, on which rests much of the financial funding for health care reform, would prove to be so onerous to hospitals and nursing homes that they would simply stop taking such patients. The report, by the chief actuary for Medicare and Medicaid, also questions how doctors and hospitals would cope with an additional 30 million people to the ranks of the insured, many of them into public health programs.

As it’s been said, if you think health care is expensive, wait until it’s free.

I also worry about the crowding out effect that this vast expansion of the government into health care will have on voluntary charitable action. Somewhere along the line, we have lost sight of the fact that charity and health care was not an invention of Washington bureaucrats.

How did the more than 600 Catholic hospitals and clinics, and many more hospitals bearing the names Jewish, Presbyterian, Methodist, Adventist and Baptist, get built in this country? It wasn’t through the sufferance of government.

Faith is the source of these works, not policy initiatives. Faith, because it involves the entire scope of the human person, body and soul, has not only a larger claim on our allegiance but a deeper commitment to our well-being. Our faith communities know us as persons, not as welfare case numbers or voting blocs.

The effect of the proposed massive expansion of government and vast increase in federal debt is unknown, but if the experience of other countries is any guide, it will lay a crushing burden on the lives of future generations.

The Senate health care reform package should be scrapped. The ill-conceived plan will break the budget, provide fewer opportunities for market-driven health care solutions and limit those who want to practice real charity.