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Archive for the ‘Health Care’ Category

I’ve been fretting for a long time that poorly designed entitlement programs are going to turn America into a decrepit welfare state.

Medicare obviously is a big part of the problem, but the fraud-riddled Medicaid program may be even worse.

The program is a nightmare for both federal taxpayers and state taxpayers.

In an article for the Daily Caller, John Graham of the Independent Institute has some very grim analysis of the fiscal black hole otherwise known as Medicaid.

In 2014, total Medicaid spending is projected to grow 12.8 percent because Obamacare has added about 8 million dependents. A large minority of states have chosen to increase residents’ eligibility for Medicaid by expanding coverage to adults making up to 138 percent of the federal poverty level. Unfortunately, more states are likely to expand this welfare program. This is expected to result in a massive increase in the number of Medicaid dependents: From 73 million in 2013 to 93 million in 2024. Medicaid spending is expected to grow by 6.7 percent in 2015, and 8.6 percent in 2016. For 2016 to 2023, spending growth is projected to be 6.8 percent per year on average. This comprises a massive increase in welfare dependency and burden on taxpayers.

But the actual numbers may be worse than these projections.

…official estimates often low-ball actual experience. This is because it is hard to grapple with how clever states are at leveraging federal dollars. …The incentive lies in Medicaid’s perverse financing merry-go-round. In a rich state like California, for example, the federal government (pre-Obamacare) spent 50 cents on the dollar for adult dependents. So, if California spent 50 cents, it automatically drew 50 cents from the U.S. Treasury. And most states had a bigger multiplier. Which state politician can resist a deal like that? …The situation will deteriorate because Obamacare’s Medicaid expansion significantly increases states’ perverse incentives to game Medicaid financing. …Newly eligible Medicaid beneficiaries will be fully financed by the federal government for 2014 through 2016. Then, it slides down until the federal government funds 90 percent of their costs starting in 2020, with the states footing 10 percent. Recall the cunning with which states developed ways to abuse federal taxpayers when they could only double their money from Uncle Sam. The new normal is that they will be able to get nine times their money!

By the way, these numbers would be even worse if it wasn’t for the fact that many states refused the lure of “free” federal money to expand Medicaid.

So what’s the solution? Graham suggests federalism is the answer.

A reform in the right direction would be to get rid of the federal match in favor of a block grant, based on a simple measurement of the population in each state, and precisely define a limited federal commitment.

He’s exactly right, at least in the short run.

Let’s copy the success of welfare reform and turn over a fixed amount of money – along with concomitant authority and responsibility – to state governments and let them figure out the best way of delivering health care to lower-income populations.

In the long run, of course, I’d like to phase out the block grant so that states are responsible for both collecting the money and providing the services.

But before we get to the point of adopting health care policies for an ideal libertarian society, we first have to stop the bleeding (or, to be more accurate, hemorrhaging) and stabilize the program.

And that’s why I fully agree that the federalism approach, in the form of block grants, is the right policy.

Here’s my video on the topic.

And since I’m sharing videos, I can’t resist commenting on the latest “Gruber-gate” scandal. The MIT professor and Obamacare insider (he got $400,000 of taxpayer money to help design the plan) has become an embarrassment for the left because he has been caught on tape saying that the legislation relied on deception. He even said that proponents of Obamacare took advantage of the “stupidity” of American voters.

You can watch the most well-know example by clicking here. But he also denigrated supposedly “stupid” Americans in this video.

I want to defend one small component of Gruber’s statement.

But I want to be completely clear that I’m not defending his elitist disdain for ordinary Americans. Indeed, I don’t think voters are stupid. Instead, to the extent they’re uninformed, it’s the result of serial dishonesty from Washington or because they’ve decided it’s not worth their time to pay attention to the crowd in DC (the “rational ignorance” hypothesis).

The part of Gruber’s statement that has merit is that he’s talking about the fact that there’s a big loophole in the tax code for fringe benefits. To be more specific, tens of millions of Americans get part of their compensation in the form of fringe benefits such as health insurance. Yet while workers are taxed on their “cash” income, they are not taxed on their “fringe benefit” income (a policy sometimes called the “healthcare exclusion”).

And this has created, over time, a very inefficient system of over-insurance.

To understand why this system doesn’t make sense, just think about your homeowner’s insurance or auto insurance. Those policies, unlike health insurance, work reasonably well and costs remain relatively stable. Why is there a big difference?

The difference is that employee income that is diverted to health insurance avoids both income tax and payroll tax, so there is a significant monetary incentive for gold-plated plans. And these plans often include insurance coverage for ordinary medical expenses, which contributes to the problem of third-party payer.

No wonder health insurance is so costly. After all, imagine what would happen to the price of your homeowner’s insurance if it had to cover the cost of a new couch? Or repainting the hallway? Or what about the cost of your auto policy if it covered the cost to fill up with gas or get an oil change?

We instinctively recognize that this would be insanely inefficient and expensive, yet that’s how our health insurance system operates thanks to a giant tax preference.

So Gruber was right to say it’s a problem. And I’ve even said that addressing the exclusion is a very tiny silver lining in the awful dark cloud of Obamacare.

But now that I’ve bent over backwards to say something nice, now let me point out that Gruber (and Obama and other statists) didn’t have the right solution. Yes, they wanted to cut back on the tax exclusion, but only because they wanted to use the money for other purposes (such as subsidies that also exacerbate the third-party payer problem).

The right approach, by contrast, is to phase out the healthcare exclusion and use every penny of revenue to “pay for” lower tax rates. That way you get a win-win situation for the economy. A more rational, market-based healthcare system and a less punitive tax code for productive behavior.

Now that we’ve addressed a serious point, let’s laugh about the fact that Gruber’s comments have created a big headache for the White House. We’ll start with this Steve Kelley cartoon.

And here’s Gary Varvel’s take on the honesty of the Obama White House on the topic of health care.

Last but not least, Lisa Benson optimistically suggests that the serial dishonesty of Obamacare supporters may be undone by the Supreme Court.

Which would be poetic justice, since Professor Gruber also was caught on tape – over and over again – stating that Obamacare only allowed subsidies for people getting insurance policies through state-based exchanges.

And now the Supreme Court will decide whether those subsidies, notwithstanding statutory language, can be provided via the federal exchange.

Though I’m not holding my breath since certain Justices on the Court already have demonstrated that they’re willing to put politics above the law.

P.S. Just in case I wasn’t sufficiently clear, good tax reform also is good health reform. That was one of the points I made in my tax reform speech at the Heritage Foundation and I suspect I’ll continue making that argument until we win or I’m dead (and I don’t want to take odds on which happens first).

P.P.S. On a more upbeat note, the House of Representatives approved budgets in 2011, 2012, 2013, and 2014 that assume Medicaid gets block-granted to the states. So that reform may actually happen while I’m still breathing.

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Wow, Barack Obama and the Democrats suffered a thermonuclear butt kicking. This was 1994 and 2010 put together.

When the dust settles after recounts and run-offs, it appears that the GOP will have picked up 9 Senate seats. That’s one more than I predicted, and I thought I was probably overstating the GOP wave.

The House results are equally remarkable. There are a handful of close races that haven’t yet been decided, but it seems that Republicans will control at least 246 seats and may even hit or exceed my prediction of 249 seats. And that estimate at the time was way too high, based on what almost all the experts were predicting.

So what lessons, if any, can we learn from these results (other than that I do a decent job of predicting mid-term elections)?

1. Obama has been a disaster for his party. At their high point in 2009, Democrats controlled 60 seats in the Senate and 257 seats in the House of Representatives. But thanks to unpopular and misguided policies such as Obamacare and the faux stimulus, the President created conditions for GOP landslides in 2010 and 2014. And don’t forget that Republicans also have made huge gains in state legislatures during Obama’s presidency. I already joked that libertarians were going to give the President a “man of the year” award for reawakening interest in the principles of liberty, but Republicans may want to give him an even bigger award and make it official rather than satirical.

2. Obamacare is still deeply unpopular. It appears that at least 17 Democratic Senators since 2010 have been replaced by anti-Obamacare Republicans. That’s a remarkably large number of casualties. And don’t forget what happened to House Democrats in 2010. Some advocates of government-run healthcare claim that voters are no longer agitated about Obamacare and that Republicans didn’t make it a big issue. But if that’s the case, why did Republicans dramatically increased their focus on Obamacare as the elections got closer?

If you want an example of whistling past the graveyard, considering this blurb from an article in The Hill last April.

White House senior adviser Dan Pfeiffer on Sunday rejected the suggestion that Republicans will take control of the Senate in the midterm elections, saying that the GOP argument to repeal ObamaCare is a “political loser.”

I wonder what he would say if asked about Obamacare today?

3. The government shutdown was almost certainly a net plus for the GOP. Back in 2011, I explained that Republicans could play hard ball, largely based on what really happened during the 1995 government shutdown. And in 2013, I again defended a shutdown, pointing out that voters probably wouldn’t even notice that some government offices were closed, but they would remember that the GOP was branding itself as the anti-Obamacare party. The establishment, by contrast, thought the shutdown was a disaster for Republicans. Here’s some of what one academic wrote last October.

…the shutdown leveled the House playing field in a rather unexpected manner. …in a Congressional election today, Democrats would retake the House with >90% probability and a 50-seat margin.

And remember that many establishment Republicans felt the same way, excoriating Senator Cruz and others who wanted a line-in-the-sand fight over government-run healthcare. The moral of the story isn’t that shutdowns necessarily are politically desirable, but rather that it’s very important for a political party to find visible ways of linking itself to popular causes (such as ending Obamacare, fighting big government, etc).

4. Voters still hate taxes. I’m stunned that Governor Brownback won reelection in Kansas, but I’m even more surprised that pro-tax Democrat gubernatorial candidates lost in deep-blue states such as Maryland, Illinois, and Massachusetts. The one common theme is that voters – when given a real option – generally prefer candidates who will let them keep more of their money. We also can learn something by reviewing the outcome of various ballot initiatives. By a 2-1 margin, Tennessee voters amended their constitution to prohibit an income tax from every being adopted. And by a 3-1 margin, Georgia voters made sure the top tax rate could never be raised. On the other hand, more than 60 percent of voters in Illinois voted for an advisory referendum that called for a class-warfare tax hike (even though they voted for a governor who will block that from happening).

A few other observations.

Scott Walker’s victory, along with the outcome of gubernatorial races in places such as Michigan and Illinois, suggests that unionized state bureaucrats no longer have carte blanche to pillage taxpayers. Or at least they no longer have the necessary political muscle to endlessly line their pockets at the expense of the overall electorate.

Rand Paul gets points for the most clever political satire of the evening, popularizing the #hillaryslosers hashtage along with some amusing images. Here’s the one for Kentucky.

Let’s close by reveling in some Schadenfreude. Here are some excerpts from a story in the Washington post in early 2013.

President Obama…is taking the most specific steps of his administration in an attempt to ensure the election of a Democratic­-controlled Congress in two years. …Obama, fresh off his November reelection, began almost at once executing plans to win back the House in 2014, which he and his advisers believe will be crucial to the outcome of his second term and to his legacy as president. …Obama has committed to raising money for fellow Democrats, agreed to help recruit viable candidates, and launched a political nonprofit group dedicated to furthering his agenda and that of his congressional allies. The goal is to flip the Republican-held House back to Democratic control, allowing Obama to push forward with a progressive agenda on gun control, immigration, climate change and the economy during his final two years in office… Obama has committed to eight fundraisers for the Democratic Congressional Campaign Committee this year… The president has also pledged to put his formidable campaign organization, now known as Organizing for Action, behind Democratic House candidates and to find ways to share its rich trove of voter data with the party’s campaign committee. …“If 2012 was a referendum on President Obama, then 2014 will be a referendum on the tea party Congress,” Israel said. “And the president and House Democrats are joined at the hip on this.”

Gee, things didn’t exactly turn out the way Obama hoped.

But Congressman Israel was right. Obama and the Democrats were joined at the hip.

Now the big question is whether voters will get a clear choice between big government and small government in 2016. If they do, this hypothetical poll shows the outcome.

But if it’s another Tweedle Dee vs Tweedle Dum election, then Washington’s ruling class will win regardless.

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It’s time to extend the tradition of sharing politics-related Halloween humor on October 31.

Though this is only my fourth year, so maybe it’s not quite a tradition yet.

Nonetheless, we’ve had some good material.

There were two Halloween posts in 2011, including a cartoon about what happens when kids trick-or-treat at a statist’s house, as well as a comic’s very clever and amusing analysis of taxes and Halloween.

In 2012, I shared several Halloween-themed cartoons, mostly about Obama’s spendaholic tendencies.

Last year, Obamacare was the unifying theme in the cartoons I shared.

This year, we have six more political cartoons.

The first bunch focuses on scary political figures.

We’ll start with a cartoon from Henry Payne, who suggests that Democrats are the ones who are most fearful of Obama.

Larry Wright, meanwhile, warns children that some costumes won’t produce much candy.

But Obama isn’t the only hobgoblin scaring people. Here’s Hillary Clinton, courtesy of Ken Catalino.

The following Halloween cartoons all share a common theme, which is that Obamacare is generating much higher prices for health insurance.

Here’s Steve Breen’s contribution. Democrats are scared, to be sure, but consumers are the real victims.

Lisa Benson weighs in. I particularly like the candy bar in the cartoon.

Last but not least, Gary Varvel has a similarly amusing perspective.

Thought there is a serious point to make about this last cartoon.

The White House appears to be hiding some of the negative effects of Obamacare until after the election. Here’s some of what the U.K.-based Daily Mail has reported.

The open enrollment period for federal Obamacare plans will begin more than a month later than it did last year, with this year’s start date coming after the midterm elections. …the White House and the Department of Health and Human Services have said politics aren’t at play. …Still, the move has the added convenience of allowing insurers to keep next year’s rates a secret until voters have already cast their ballots for or against Democrats who voted for or support the health care law.

Gee, that’s convenient…if you’re a Democratic political operative.

Not surprisingly, some folks are skeptical.

In a statement released last Friday Americans for Prosperity President Tim Phillips claimed, ‘the President sold ObamaCare to the American people on the false promise that it would make health care more accessible and more affordable for those who needed it most. ‘Sadly, ObamaCare has actually put affordable health care even further out of reach for millions of Americans,’ the conservative non-profit head claimed.The administration’s decision to withhold the costs of this law until after Election Day is just more proof that ObamaCare is a bad deal for Americans.’

For what it’s worth, I share these concerns. By arbitrarily deciding what parts of Obamacare to enforce and when to enforce them, the White House already has made a mockery of the rule of law.

So what’s another politically motivated change in the rules, a la Argentina?

P.S. Now let’s shift to the elections. A few days ago, I made my initial projections for the House and Senate elections that will take place on Tuesday.

I predicted that Republicans would control the Senate 52-48 and the House 246-189.

Having looked over some of the polling data, I’m going to stick with my Senate prediction.

Though I’ve made a change. I still think the GOP will win the same 8 seats that I projected last time, but now I’m predicting that Republicans will hold on to their seat in Georgia while losing a seat they hold in Kansas.

So still a net gain of 7 seats for the GOP.

Here are the Senate seats that will change hands.

2014 Senate Elections

I also admitted last time that I’m not overly confident in my predictions and that the final outcome could be anywhere between 52-48 Democrat control and 55-45 Republican control.

In other words, I thought there were a bunch of races that could go in either direction.

For what it’s worth, I think the trend is against the Democrats, so I’ll now predict that the final results will be somewhere between a 50-50 split (in which case Biden casts the tie-breaking vote) and 56-44 GOP control.

In the House of Representatives, the pro-Republican trend leads me to predict the GOP ultimately will have 248-187 control, which would be the most Republicans since 1930.

P.P.S. Just as I warned last time, don’t hold your breath waiting for big changes in policy if the GOP winds up in control of both chambers of Congress.

Even assuming they want to do the right thing, Republicans won’t have the votes to override presidential vetoes. So there won’t be any tax reform and there won’t be any entitlement reform.

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Years ago, I shared a very funny poster that suggests that more government is hardly ever the right answer to any question.

Yet in Washington, the standard response to any screwup by government is to make government even bigger. Sort of Mitchell’s Law on steroids.

And that’s exactly what’s happening with the Ebola crisis. The bureaucracies that have received tens of billions of dollars over the years to preclude a crisis are now expecting to get rewarded with more cash.

Governor Jindal of Louisiana debunks the notion that more money for the bureaucracy is some sort of elixir. Here’s some of what he wrote for Politico.

In a paid speech last week, former Secretary of State Hillary Clinton attempted to link spending restraints enacted by Congress—and signed into law by President Obama—to the fight against Ebola. Secretary Clinton claimed that the spending reductions mandated under sequestration “are really beginning to hurt,” citing the fight against Ebola: “The CDC [Centers for Disease Control and Prevention] is another example on the response to Ebola—they’re working heroically, but they don’t have the resources they used to have.” …In recent years, the CDC has received significant amounts of funding. Unfortunately, however, many of those funds have been diverted away from programs that can fight infectious diseases, and toward programs far afield from the CDC’s original purpose. Consider the Prevention and Public Health Fund, a new series of annual mandatory appropriations created by Obamacare. Over the past five years, the CDC has received just under $3 billion in transfers from the fund. Yet only 6 percent—$180 million—of that $3 billion went toward building epidemiology and laboratory capacity. …While protecting Americans from infectious diseases received only $180 million from the Prevention Fund, the community transformation grant program received nearly three times as much money—$517.3 million over the same five-year period. …Our Constitution states that the federal government “shall protect each of [the States] against Invasion”—a statement that should apply as much to infectious disease as to foreign powers. So when that same government prioritizes funding for jungle gyms and bike paths over steps to protect our nation from possible pandemics, citizens have every right to question the decisions that got us to this point.

What Governor Jindal is describing is the standard mix of incompetence and mission creep that you get with government.

Bureaucracies fail to achieve their stated goals, but also divert lots of resources to new areas.

After all, that’s a great way of justifying more staff and more money.

Especially since they can then argue that they need those additional resources because they never addressed the problems that they were supposed to solve in the first place!

Here are some excerpts from a story in the Washington Free Beacon, starting with some whining from the head bureaucrat at the National Institutes of Health, who wants us to be believe that supposed budget cuts have prevented a vaccine for Ebola.

“Frankly, if we had not gone through our 10-year slide in research support, we probably would have had a vaccine in time for this that would’ve gone through clinical trials and would have been ready,” said NIH Director Francis Collins, blaming budget cuts for his agency’s failure to develop a vaccine for the deadly virus.

Yet take a look at how the NIH has been squandering money.

However, the Washington Free Beacon has uncovered $39,643,352 worth of NIH studies within the past several years that have gone to questionable research. For instance, the agency has spent $2,873,440 trying to figure out why lesbians are obese, and $466,642 on why fat girls have a tough time getting dates. Another $2,075,611 was spent encouraging old people to join choirs. Millions have gone to “text message interventions,” including a study where researchers sent texts to drunks at the bar to try to get them to stop drinking. The project received an additional grant this year, for a total of $674,590. …The NIH’s research on obesity has led to spending $2,101,064 on wearable insoles and buttons that can track a person’s weight, and $374,670 to put on fruit and vegetable puppet shows for preschoolers. A restaurant intervention to develop new children’s menus cost $275,227, and the NIH spent $430,608 for mother-daughter dancing outreach to fight obesity. …Millions went to develop “origami condoms,” in male, female, and anal versions. The inventor Danny Resnic, who received $2,466,482 from the NIH, has been accused of massive fraud for using grant money for full-body plastic surgery in Costa Rica and parties at the Playboy mansion.

Origami condoms?!? I’m almost tempted to do a web search to see what that even means, particularly since there are male, female, and anal versions.

But even without searching online, I know that origami condoms have nothing to do with stopping Ebola.

The Centers for Disease Control also have a long track record of wasting money. Here are some odious details from a Townhall column.

So now the federal health bureaucrats in charge of controlling diseases and pandemics want more money to do their jobs.

Gee, what a surprise.

Maybe if they hadn’t been so busy squandering their massive government subsidies on everything buttheir core mission, we taxpayers might actually feel a twinge of sympathy. At $7 billion, the Centers for Disease Control 2014 budget is nearly 200 percent bigger now than it was in 2000. …Yet, while Ebola and enterovirus D68 wreak havoc on our health system, the CDC has been busying itself with an ever-widening array of non-disease control campaigns, like these recent crusades: Mandatory motorcycle helmet laws. …Video games and TV violence. …Playground equipment. …”Social norming” in the schools. …After every public health disaster, CDC bureaucrats play the money card while expanding their regulatory and research reach into anti-gun screeds, anti-smoking propaganda, anti-bullying lessons, gender inequity studies and unlimited behavior modification programs that treat individual vices — personal lifestyle choices — as germs to be eradicated. …In 2000, the agency essentially lied to Congress about how it spent up to $7.5 million earmarked each year since 1993 for research on the deadly hantavirus. …The diversions were impossible to trace because of shoddy CDC bookkeeping practices. The CDC also misspent $22.7 million appropriated for chronic fatigue syndrome and was investigated in 2001 for squandering $13 million on hepatitis C research.

By the way, you may be wondering why we have both the National Institutes of Health as well as the Centers for Disease Control.

Is this just typical bureaucratic duplication?

No, it’s typical bureaucratic triplication, because we also have the Office of the Assistant Secretary for Preparedness and Response at the Department of Health and Human Services.

And as Mollie Hemingway explains in The Federalist, this additional layer of bureaucracy has been MIA on Ebola, perhaps because the head bureaucrats diverted funds to a political crony.

…nobody has even discussed the fact that the federal government not ten years ago created and funded a brand new office in the Health and Human Services Department specifically to coordinate preparation for and response to public health threats like Ebola. The woman who heads that office, and reports directly to the HHS secretary, has been mysteriously invisible from the public handling of this threat. And she’s still on the job even though three years ago she was embroiled in a huge scandal of funneling a major stream of funding to a company with ties to a Democratic donor—and away from a company that was developing a treatment now being used on Ebola patients.

Here are some additional details.

…one of HHS’ eight assistant secretaries is the assistant secretary for preparedness and response, whose job it is to “lead the nation in preventing, responding to and recovering from the adverse health effects of public health emergencies and disasters, ranging from hurricanes to bioterrorism.” …“Lurie’s job is to plan for the unthinkable. A global flu pandemic? She has a plan. A bioterror attack? She’s on it. Massive earthquake? Yep. Her responsibilities as assistant secretary span public health, global health, and homeland security.” …you might be wondering why the person in charge of all this is a name you’re not familiar with. …why has the top official for public health threats been sidelined in the midst of the Ebola crisis?

Perhaps because of the scandal.

You can—and should—read all about it in the Los Angeles Times‘ excellent front-page expose from November 2011, headlined: “Cost, need questioned in $433-million smallpox drug deal: A company controlled by a longtime political donor gets a no-bid contract to supply an experimental remedy for a threat that may not exist.”…The donor is billionaire Ron Perelman, who was controlling shareholder of Siga. He’s a huge Democratic donor… The award was controversial from almost every angle—including disputes about need, efficacy, and extremely high costs.

So what’s the bottom line?

The Progressive belief that a powerful government can stop all calamity is misguided. In the last 10 years we passed multiple pieces of legislation to create funding streams, offices, and management authorities precisely for this moment. That we have nothing to show for it is not good reason to put even more faith in government without learning anything from our repeated mistakes.

And that’s the most important lesson, though a secondary lesson is that big government means big corruption.

Big government is incompetent government.

Writing for The Federalist, John Daniel Davidson puts everything in context, explaining that big, bureaucratic states don’t do a good job.

The government’s response to the outbreak has exposed the weakness of the modern administrative state in general, and the incompetence of the White House in particular. …The second nurse to contract Ebola, Amber Vinson, traveled from Cleveland to Dallas on a commercial flight Monday and checked herself into the hospital Tuesday with Ebola symptoms. She called the CDC before she boarded the flight and reported she had a temperature of 99.5—yet CDC officials didn’t stop her from boarding the plane. …Thus continues a pattern of crippling naiveté and ineptitude from the White House on…the Ebola outbreak. On the press call, Frieden explained that you can’t get Ebola from sitting on a bus next to someone who’s infected, but if you have Ebola then don’t use public transportation because you might infect someone. …whether it’s funding or regulation, it’s becoming clear that government “everywhere putting its hands to new undertakings” isn’t working out all that well. …In a hundred years, when Americans read about the U.S. Ebola outbreak of 2014 and antiquated government agencies like the FDA that hampered the development of a vaccine, they’ll laugh at us. …Likewise, future Americans will probably scoff at us for thinking our FDA, in its current form, was somehow necessary or helpful, or for how the Department of Health and Human Services could spend almost a trillion dollars a year and yet fail to prevent or adequately respond to the Ebola outbreak.

And if you want a humorous look at the link between bloated government and incompetent government, Mark Steyn nails it.

Since we’ve shifted to humor, somebody on Twitter suggested that this guy is probably in line to become Obama’s new Ebola Czar.

Last but not least, here’s the icing on the cake.

I mentioned above that we have bureaucratic triplication thanks to NIH, CDC, and HHS. And I joked that the guy in the Holiday Inn might become the President’s new Czar, creating bureaucratic quadruplication (if that’s even a word).

Well, that joke has now become reality. The Washington Examiner is reporting that Obama has named an Ebola Czar. But the guy in the video will be sad to know he didn’t make the cut.

President Obama has chosen Ron Klain, former chief of staff for two Democratic vice presidents, as his Ebola czar, the White House said Friday. …In choosing Klain, Obama is selecting a D.C. insider and veteran of numerous political battles to spearhead a campaign with major implications on his own legacy and how Democrats fare in the November midterms.

Great. I’m sure a lobbyist and former political operative will have just the skills we need to solve this crisis.

I’m going out on a limb and predicting that he’ll say the solution is more money and bigger government. And we know how that turns out.

Yup, it’s a bird, it’s a plane, it’s government man to the rescue!

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In the last few months of 2013, Obamacare suffered a series of embarrassing setbacks dealing with everything from a clunky website to plan cancellations to the White House feeling compelled to arbitrarily ignore the law.

Since that time, though, people seem to have adapted to this new burden.

But adaptation doesn’t mean approval. There are still serious problems with Obamacare, as evidenced by the fact that the Obama Administration has postponed implementation of various provisions 38 times!

However, the White House wants us to believe the law is a success, even if that requires statistical contortions.

So let’s look at the record.

My Cato colleague Mike Tanner argues that Obamacare has been a disaster, writing for Townhall that “…in the last year we’ve also seen plenty of bad news for consumers, providers, employers and taxpayers.”

In his column, he looks at various groups and assesses whether Obamacare has succeeded or failed.

What about universal coverage?

…the best estimates suggest that roughly 8 million people gained insurance under ObamaCare, but roughly half of those were enrolled in Medicaid (outside of the exchanges), which isn’t really health-care reform so much as adding people to government welfare. And it still leaves 41 million American adults uninsured.

That doesn’t sound too impressive, particularly when you consider all the damage that Obamacare has imposed.

What about keeping your health plan?

…roughly 6 million Americans were kicked off their insurance because their plans failed to offer a lengthy-enough maternity stay, didn’t provide sufficient drug and alcohol rehabilitation benefits or otherwise fell short of the insurance that federal bureaucrats thought that they should have. …on average, ObamaCare plans were worse than the plans they replaced, in terms of both providers covered and cost-sharing. A new wave of cancellations is about to begin as well.  …In several states, insurers have dropped plans that they offered on the exchanges or even withdrawn from the market altogether. And if that was not bad enough, Americans with employer-based insurance may find out their insurance has to be changed starting next year.

So we pay more and get less, while also dealing with lots of uncertainty.

What about consumers?

If judged against President Obama’s promise that health-care reform would save us all at least $2,500 through lower premiums, ObamaCare deserves an F. …In states where the individual market was not already dysfunctional, there were significant premium increases.

So the President was lying? I’m shocked, shocked.

What about taxpayers?

This summer the Congressional Budget Office announced that it had given up trying to score the cost of ObamaCare, given the frequency with which the administration was making unilateral changes to the law. …roughly 85 percent of those enrolled through exchanges are receiving subsidies, higher than predicted. Overall, the best estimates suggest the law will cost $2.63 trillion over the next 10 years. That will be paid for by $1.38 trillion in new taxes and at least $1.25 trillion in additional debt.

Imagine that. A new entitlement is going to be a fiscal boondoggle. Who could have predicted that outcome?

What about jobs?

…surveys from Federal Reserve Banks in New York, Philadelphia and Atlanta confirmed that businesses are cutting employment and shifting workers to part-time positions because of ObamaCare. According to the New York Fed, 21 percent of manufacturers and 17 percent of service companies have reduced the size of their workforce because of the law. In addition, roughly 20 percent of both manufacturers and service companies said that they have shifted workers from full- to part-time jobs.

The overall impact on employment could be as high as two million workers.

But there is a tiny sliver of good news. Or, to be more accurate, there’s a tiny sliver of not-as-bad-as-we-thought news.

…some costs are lower because so many states have chosen not to expand Medicaid.

In other words, the Obama White House thought it could bribe states to expand the welfare program that provides health care.

And some statist governors, such as John Kasich, rolled over for Obama.

But many states realized it would be a long-term fiscal disaster to expand Medicaid, notwithstanding promises that Washington would pick up the tab in the short run.

Let’s close with a video on one of the more bizarre aspects of Obamacare. Apparently, people are getting screwed out of their healthcare plans because of strange rules that all plans have to fit within certain bands.

I can’t imagine why the politicians wanted the law to work this way, other than the statist instinct to micro-manage other people’s lives. You have to watch the video to grasp the inanity of the policy.

And if all this isn’t sufficiently depressing, keep in mind that the White House wants to use your tax dollars to bail out the big health insurance companies.

P.S. I’ve written several times about the horrifying practice of “civil asset forfeiture,” which happens when the government decides to seize the property of people without bothering to convict them of any crime.

Well, now we have a humorous – yet still outrageous – look at the practice from John Oliver.

If you want some additional (and more substantive) analysis of asset forfeiture, watch videos here, here, and here.

And if you want to increase your blood pressure, read horror stories about government theft here, here, here, here, and here.

No wonder even the people who first developed the program now want to shut it down. And it is encouraging that there finally is a backlash against this odious practice.

P.P.S. If you like Oliver’s humor, here’s his very funny analysis of how Obamacare is working in Oregon.

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I’m a huge fan of Switzerland, largely because its voters approved a spending cap that should be a role model for other nations.

It’s called the “debt brake” and it has helped reduce the burden of government spending in Switzerland at a time when most nations in Europe have been moving in the wrong direction.

But that’s not the only reason I like Switzerland.

I also appreciate the fact that Swiss voters seem to be much more sensible than voters in other nations.

Every so often I see polls, for instance, suggesting that French voters overwhelmingly want less government spending. But then they go out and elect statist presidents such as Sarkozy and Hollande.

In Switzerland, by contrast, voters are sensible where it counts most – in the voting booth.

Earlier this year, 76 percent of voters rejected a minimum wage hike.

Back in 2010, nearly 60 percent of voters shot down a class-warfare proposal for higher taxes on the rich.

And they’ve done it again. In a recent referendum, they defeated a government-run healthcare system by a landslide.

Here are some excerpts from an AFP report.

Swiss voters on Sunday rejected a plan for a seismic shift from the country’s all-private health insurance system to a state-run scheme. Referendum results showed that almost 62 percent of voters had shot down a reform pushed by left-leaning parties. …”The Swiss population does not want a single national scheme,” said the Swiss Insurance Association. “Our health system is among the top performers in the world. Competition between health insurers and freedom of choice for clients play a major role in this,” it added. …The rejection of the plan by nearly two-thirds of voters is a major blow for pro-reform campaigners, given that opinion polls had shown the ‘No’ vote was likely to be around 54 percent. In a 2007 referendum, 71 percent of voters rejected similar reforms. …for Switzerland’s cross-party government and its right- and centre-dominated parliament, the current system has proven its mettle and is debt-free, unlike the health services of France, Italy or Britain.

Though it seems that speaking French is somehow linked to economic illiteracy.

German-speaking regions voted against the plan, while their French-speaking counterparts were in favour.

Back in 2011, I wrote that there were five reasons why Switzerland was better than the United States.

But perhaps I wasn’t being sufficiently enthusiastic. Over at Being Classically Liberal, there’s an article entitled “9 Reasons Libertarians Should Love Switzerland.” Here’s the bottom line.

The Swiss are rich, happy, gun-owning, peace-loving people. The country has one of the freest market economies in the world and a relatively small and very decentralized government which hasn’t waged war since the early 19th century. In this libertarian’s eyes, Switzerland might just be the most awesome country in existence.

I’m agnostic on whether Switzerland is the “most awesome.” Hong Kong and Singapore, for instance, have smaller government.

That being said, Switzerland is much better on both guns and federalism.

And if you believe in grading on a curve, the burden of government spending in Switzerland is far smaller than it is in neighboring nations.

So it is a very admirable place.

Though I haven’t given up on America quite yet. And if I ever do, I’ll still choose Australia over Switzerland.

P.S. While it is encouraging that Swiss voters overwhelmingly rejected a single-payer healthcare scheme, I should acknowledge that their current system is not exactly libertarian Nirvana since it mandates that households purchase a health insurance policy.

P.P.S. But I don’t want to close on a bad point, so I’ll simply call your attention to the fact that Switzerland has one of the lowest levels of welfare spending among industrialized nations.

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People sometimes think I’m strange for being so focused on the economic harm that results from third-party payer. But bear with me and we’ll see why it’s a very important issue.

If you’re not already familiar with the term, third-party payer exists when someone other than the consumer is paying for something. And it’s a problem because people aren’t careful shoppers when they have (proverbially) someone else’s credit card.

Moreover, sellers have ample incentive to jack up prices, waste resources on featherbedding, and engage in inefficient practices when they know consumers are insensitive to price.

I’ve specifically addressed the problem of third-party payer in both the health-care sector and the higher education market.

But I’ve wondered whether my analysis was compelling. Is the damage of third-party payer sufficiently obvious when you see a chart showing that prices for cosmetic surgery, which generally is paid for directly by consumers, rise slower than the CPI, while other health care expenses, which generally are financed by government or insurance companies, rise faster than inflation?

Or is it clear that third-party payer leads to bad results when you watch a video exposing how subsidies for higher education simply make it possible for colleges and universities to increase tuition and fees at a very rapid clip?

That should be plenty of evidence, but I ran across a chart that may be even more convincing. It shows how prices have increased in various sectors over the past decade.

So what make this chart compelling and important?

Time for some background. The reason I saw the chart is because David Freddoso of the Washington Examiner shared it on his Twitter feed.

I don’t know if he added the commentary below, or simply passed it along, but I’m very grateful because it’s an excellent opportunity to show that sectors of our economy that are subsidized (mostly by third-party payer) are the ones plagued by rising prices.

It’s amazing to see that TVs, phones, and PCs have dropped dramatically in price at the same time that they’ve become far more advanced.

Yet higher education and health care, both of which are plagued by third-party payer, have become more expensive.

So think about your family budget and think about the quality of PCs, TVs, and phones you had 10 years ago, and the prices you paid, compared with today. You presumably are happy with the results.

Now think about what you’re getting from health care and higher education, particularly compared to the costs.

That’s the high price of third-party payer.

P.S. This video from Reason TV is a great illustration of how market-based prices make the health care sector far more rational.

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