Monthly Archives: May 2019

Would expanding Medicaid in Alabama bankrupt the already cash-strapped state budget and further sink our country into unsustainable levels of national debt? “When you expand Medicaid, the administrative costs and the cost of expansion will eventually swamp the state,” warned U.S. Rep. Gary Palmer (R-AL). “It has in other states. Illinois is about to go bankrupt.” States that expanded Medicaid have signed up more than twice as many “able-bodied adults” than expected and per-person costs have exceeded original estimates by a whopping 76%, according to a 2018 report by the Foundation for Government Accountability. This led to cost overruns of 157%, the report showed, with Medicaid now accounting for one of every three state budget dollars.

The Medicare for All plan embraced by leading 2020 Democrats appears more lavish than what other advanced countries offer, compounding the cost but also potentially broadening its popular appeal. The plan from Vermont Sen. Bernie Sanders would charge no premiums, copays or deductibles, allowing only limited cost-sharing for some prescription drugs. It would cover long-term care, dental, vision, hearing coverage and much more. But while other countries do guarantee coverage for all (but with often significant restrictions in access to actual care), the promised benefits vary significantly—and none are as comprehensive. [Supporters of the plan might want to read this scathing review of a book, “The Socialist Manifesto,” that chronicles the disasters that have ensued from this utopian political philosophy.]

Dr. Chuck Blahous, who testified (with Grace-Marie Turner) before the House Rules Committee last month on Medicare for All, lists key findings:

• New federal costs under M4A would be unprecedentedly large
• We do not know how or whether the federal government could successfully finance its additional spending under M4A
• The projected additional costs of M4A’s coverage expansion would exceed the potential savings from eliminating private health insurance administration
• Current M4A proposals would sharply cut payments to health providers while increasing health service demand, most likely causing supply shortages, and disrupting Americans’ timely access to health care, and
• The costs of M4A would be borne most directly by health providers and those most in need of health services.

In a year already marked by a wide variety of congressional health care legislation, Sens. Lamar Alexander, R-Tenn., and Patty Murray, D-Wash., on Thursday released the details of a plan they hope will help bring down health costs and eliminate surprise medical bills for patients. Alexander and Murray are the chair and ranking member, respectively, of the Health, Education, Labor and Pensions Committee.

“These are common-sense steps we can take, and every single one of them has the objective of reducing the health care costs that you pay for out of your own pocket,” Alexander said in a statement. “We hope to move it through the health committee in June, put it on the Senate floor in July and make it law.”

In Britain, both health insurance and the delivery of health care is socialized. But the NHS is no paradise. Open a random edition of a British daily newspaper and you will likely encounter an article about some egregious problem that the NHS has failed to solve. For example: NHS doctors routinely conceal from patients information about innovative new therapies that the NHS doesn’t pay for, so as not to “distress, upset or confuse” them; terminally ill patients are incorrectly classified as “close to death” so as to allow the withdrawal of expensive life support; NHS expert guidelines on the management of high cholesterol were intentionally not revised after becoming out of date, putting patients at serious risk in order to save money.

The latest liberal policy idea would effectively end all private health care for many Americans. The proposal, the Medicare for America Act, first appeared as a 2018 paper by the Center for American Progress. It’s been called “the Democratic establishment’s alternative” to Sen. Bernie Sanders’s single-payer scheme and has been framed as a moderate proposal. But the bill is anything but moderate. When Rep. Rosa DeLauro (D-CT) reintroduced Medicare for America legislation on May 1, she included a new, radical provision. The revised bill prohibits any medical provider “from entering into a private contract with an individual enrolled under Medicare for America for any item or service coverable under Medicare for America.” Essentially, this would bar program enrollees from paying for health care with their own money.

Even when the Supreme Court tells a government labor union that it can’t do something, there’s no guarantee that the union will comply. In its 2014 Harris v. Quinn decision, the Court ruled that an Illinois law forcing home health-care workers—paid with Medicaid funds—to shell out cash to labor unions was unconstitutional. That should have ended unions’ ability to collect fees from these workers—many of whom were not really professionals but were receiving a small subsidy from Medicaid to care for disabled family members at home—unless the workers agreed to join the union.  The administration announced it will enforce the ruling.