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Archive for July 3rd, 2012

I’m not sure whether this is a post about America’s dismal future if Obamacare is allowed to take root or whether this is a post about bureaucrats ripping off taxpayers.

But I do know that it shows that the insiders take care of themselves quite nicely when the government seizes more control of a nation’s healthcare sector.

Here’s a report from the UK-based Telegraph about how bureaucrats at a Scottish branch of the National Health Service are bilking taxpayers.

National Procurement, a branch of the NHS National Services Division, arranged for staff who are deemed to be “regular users” of cars for business to get the cars through a taxpayer-backed vehicle-leasing scheme. …Figures provided by National Procurement in response to a Freedom of Information request showed that…one in eight members of staff, had used the 4x4s and convertibles to drive to work. Much of the insurance, petrol, road tax and leasing is funded by the state.

And we’re not talking cheap automobiles. Keep in mind, when you read this next passage, that £25,000 is almost $40,000.

One employee was leased a £27,000 Mercedes, while three other workers have been driving £23,000 S-line Audi A3 sports cars. Another employee received a £28,300 Audi TT. Since the beginning of this year, five new cars have been leased to staff, including a four-door BMW worth more than £30,500. Other leased vehicles include another Audi sports car worth more than £25,000 and three Range Rover Evoques costing up to £29,500.

So how do they work this scam? Simple, they take needless trips.

…staff have had to clock up a minimum of 5000 business miles during office hours to qualify for the scheme. …A department source told the Herald newspaper that some members of staff were using their leased cars for 80-mile round trips between National Procurement’s two offices, in Larkhall, Lanarkshire, and South Gyle in Edinburgh, even though there are adequate video conferencing facilities at both locations.

One hopes that this scandal in a Scottish branch is an exception and that most bureaucrats don’t behave in a similarly reprehensible fashion.

But given the bloated size of the National Health Service bureaucracy, it’s more likely that this is just the tip of the iceberg.

There is an entitlement culture in most government bureaucracies, and I would be shocked in the paper pushers and memo writers hadn’t figured out how to manipulate the system

And since there are more than 1.6 million of them, the magnitude of the fraud is presumably enormous.

The obvious follow-up question is whether taxpayers in the United Kingdom are getting some good value from this army of cosseted bureaucrats?

Unfortunately, that’s not the case. Here are some chilling excerpts from a story in the Daily Mail.

NHS doctors are prematurely ending the lives of thousands of elderly hospital patients because they are difficult to manage or to free up beds, a senior consultant claimed yesterday. Professor Patrick Pullicino said doctors had turned the use of a controversial ‘death pathway’ into the equivalent of euthanasia… There are around 450,000 deaths in Britain each year of people who are in hospital or under NHS care. Around 29 per cent – 130,000 – are of patients who were on the LCP. Professor Pullicino claimed that far too often elderly patients who could live longer are placed on the LCP and it had now become an ‘assisted death pathway rather than a care pathway’.

Here are a couple of horrifying examples.

Professor Pullicino revealed he had personally intervened to take a patient off the LCP who went on to be successfully treated. He said this showed that claims they had hours or days left are ‘palpably false’. In the example he revealed a 71-year-old who was admitted to hospital suffering from pneumonia and epilepsy was put on the LCP by a covering doctor on a weekend shift. Professor Pullicino said he had returned to work after a weekend to find the patient unresponsive and his family upset because they had not agreed to place him on the LCP. ‘I removed the patient from the LCP despite significant resistance,’ he said. ‘His seizures came under control and four weeks later he was discharged home to his family,’ he said.

In other words, government-run healthcare in the United Kingdom is a great scam if you’re an insider. But not such a good deal if you’re someone who needs, well, healthcare.

Sort of makes you wonder what Paul Krugman was thinking when he wrote, “In Britain, the government itself runs the hospitals and employs the doctors. We’ve all heard scare stories about how that works in practice; these stories are false.”

I guess the English newspapers are making up stories to denigrate their own nation. If you want to see more of these “false” stories, click here, herehereherehereherehereherehere, here and here.

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Back in April, I explained that I would accept a tax increase if “the net long-run effect is more freedom, liberty, and prosperity.”

I even outlined several specific scenarios where that might occur, including giving the politicians more money in exchange for a flat tax or giving them additional revenue in exchange for real entitlement reform.

But I then pointed out that all of those options are unrealistic. And I’ve expanded on that thesis in a new article. Here’s some of what I wrote for The Blaze.

The no-tax pledge of Americans for Tax Reform generates a lot of controversy. With record levels of red ink, the political elite incessantly proclaims that all options must be “on the table.” This sounds reasonable. And when some Republicans say no tax hikes under any circumstances, there’s a lot of criticism about dogmatism. Theoretically, I agree with the elitists.

So does that make me a squish, the fiscal equivalent of Chief Justice John Roberts?

Nope, because I’m tethered to the real world. I know that there is zero chance of getting a good agreement. Once you put taxes “on the table,” any impetus for spending restraint evaporates.

But even though I’m theoretically open to a tax hike, I am a de facto opponent of tax increases for the simple reason that we will never get a good deal. We won’t get sustainable spending cuts. Not even in our dreams. We won’t get real entitlement reforms. Even if we hold our breath ‘til we turn blue. And we won’t get the “Simpson-Bowles” tax reform swap, where taxpayers give up $2 of deductions in exchange for $1 of lower tax rates. Let’s not kid ourselves. In other words, reality trumps theory. Yes, there are tax-hike deals that would be good, but they’re about as realistic as me speculating on whether I’d be willing to play for the New York Yankees, but only if they guarantee me $5 million per year.

I then point out that a budget deal inevitably would lead to bad policy – just as we saw in 1982 and 1990.

Here’s the bottom line: There is no practical way to get a good deal from either the Democrats in the Senate or the Obama Administration. Notwithstanding the good intentions of some people, any grand bargain would be a failure that leads to higher spending and more red ink, just as we saw after the 1982 and 1990 budget deals. The tax increases would not be relatively benign loophole closers. Instead, the economy would be hit by higher marginal tax rates on work, savings, investment, and entrepreneurship. And the entitlement reform would be unsustainable gimmicks rather than structural changes to fix the underlying programs. Ironically, when a columnist for the New York Times complained that Republicans were being unreasonable for opposing tax hikes, she inadvertently revealed that the only successful budget deal was the one in 1997 – the one that had no tax hikes!

The last sentence is worth some additional commentary. As I explained in a previous post, the only bipartisan budget agreement that generated a balanced budget was the 1997 pact – and that deal lowered taxes rather than increasing them.

Some people try to argue that Bill Clinton’s 1993 tax hike deserves some of the credit, but I previously showed that the Administration’s Office of Management and Budget admitted – 18 months later! – that the nation would have triple-digit budget deficits for the foreseeable future.

What changed (and this is where Bill Clinton deserves credit) is that the nation enjoyed a multi-year period of spending restraint in the mid-1990s.

And when policy makers addressed the underlying disease of too much government spending, they solved the symptom of red ink.

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