Monday, January 06, 2014

Cruising the Web

Michael Greve responds to Dan Balz's article about how the states are becoming more and more polarized from each other as they adopt red and blue policy models. Greve talks up the benefits of competitive federalism. When I teach federalism in my government classes, the kids soon realize that every advantage of federalism could be turned around and, viewed from a different perspective, as a disadvantage. While Balz might dislike the competition between the states, Greve points out the real advantages to having states experiment with different policies so we can observe the results and policy-makers can adjust accordingly.
· Competitive federalism reveals information. We can debate the abstract advantages of “red” or “blue,” “American” and “European” social models until the cows come home: there’s no substitute for observing the actual effects in real life.

· Competitive federalism satisfies preferences. A thoroughly blue or red United States would leave one half of the country very unhappy. That’s not true under federalism—not when preferences are heterogeneous across states and (relatively) homogeneous within states. As, increasingly, now.

· Competitive federalism reveals preferences and reduces ignorance. People move across states lines in response to a ton of factors (climate, jobs, housing costs…)—many of which are policy-dependent. “Foot-voting” is a pretty good political feed-back mechanism: sooner or later, (state) politicians will pay attention. And as my colleague Ilya Somin has argued in a recent book, there’s no incentive to cast an informed vote for the House, Senate or President; so people vote in near-total ignorance. They don’t vote that way with their feet, for obvious reasons.
Just as competition in the marketplace of products helps consumers get an amazing variety of new and useful products, so can competition in the marketplace of ideas help us sort out what works and what doesn't and what the consequences of each are.

Now OSHA is going after the family farm, despite explicit federal laws to prevent it from doing so. Of course, does anyone in this administration think that the actual statutory language matters to what they decide they want to do?

The White House website is still promising that "you can keep your own insurance" and trying to debunk the reality that people will not lose their insurance as a result of Obamacare. I guess reality truly does bite and the Obama administration just can't adjust to the real-life consequences of what they have done to millions of people.

Maybe the administration can take a look to another one of those doses of reality that people are going to have to get used to under Obamacare. As AP reports, it's not as easy under the new healthcare regime for families to adapt to some of the most fundamental changes in their lives like covering a new baby under their existing health care plan.
Insurers say computerized "change in circumstance" updates to deal with family and life developments were supposed to have been part of the federal system from the start.

But that feature got postponed as the government scrambled to fix technical problems that overwhelmed the health care website during its first couple of months.

"It's just another example of 'We'll fix that later,'" said Bob Laszewski, an industry consultant who said he's gotten complaints from several insurer clients. "This needed to be done well before January. It's sort of a fly-by-night approach."...

The question-and-answer circular says parents with a new baby will be told to contact their insurer directly "to include the child immediately" on their existing policy.

After the federal system is ready to process changes, parents will have to contact the government to formally bring their records up to date. Albright said parents will be able to add a new child to their policy for 30 days.

Having a baby could increase a family's monthly premiums, but it could also mean that the parents are eligible for a bigger tax credit to help with the cost. Under some circumstances, it could make the child or the family eligible for Medicaid, a safety-net program that is virtually free of cost to low-income beneficiaries.
What used to be accomplished with a simple phone call to one's insurance company now is going to enter more people into the wonderful world of bureaucracy. And if a family now finds itself thrown into Medicaid, they can get used to another set of problems as they find out that their physicians may no longer agree to treat them. As David Catron writes today, the plans of the Obama administration to provide coverage for poor people by putting them into Medicaid involves a major problem: doctors don't want to treat Medicaid patients.
This is the cruelest deception of the “reform” law. As Roy phrases it: “There’s a massive fallacy at the heart of Medicaid and therefore at the heart of Obamacare. It’s the idea that health insurance equals health care.” And, as is usually the case with the deliberately deceptive fallacies promoted by the Democrats, the target victims are poor Americans. Just as Obamacare’s Medicare Advantage cuts will be felt primarily by low-income seniors, its Medicaid fraud will hurt the country’s most vulnerable patients. It will restrict their access to doctors and reduce the quality of what little care they receive.

This is not speculation. Even if the patients covered by Medicaid had a reasonable chance at access to primary care, there are mountains of data demonstrating that they would receive lousy care. Countless studies, including the “Oregon Experiment” whose results were published in the New England Journal of Medicine last May, have shown that health outcomes for Medicaid patients are no better than those enjoyed by the uninsured. In fact, as Scott Gottlieb has pointed out in the Wall Street Journal, being covered by Medicaid is demonstrably worse for your health than having no coverage at all.

Of course, the entire project relies on people being able to actually sign up for Medicaid. As the Washington Post reports, HHS somehow haven't been able to enroll many poor people through into Medicaid because of problems in the website.
More than 100,000 Americans who applied for insurance through and were told they are eligible for Medicaid or the Children’s Health Insurance Program (CHIP) remain unenrolled because of lingering software defects in the federal online marketplace, according to federal and state health officials.

To try to provide coverage to these people before they seek medical care, the Obama administration has launched a barrage of phone calls in recent days in 21 states, advising those who applied that the quickest route into the programs is to start over at their state’s Medicaid agency.
So now the website can't handle something that the federal government has been handling since the 1960s. But don't worry, they're working on that. And then there are the people who don't want Medicaid who are being signed up for Medicaid. the son of a senator.

Do they go out of the their way to annoy and provoke people?
VA officials in Iowa City, Iowa told representatives of the American Legion that they could not hand out gifts to veterans wrapped in wrapping paper that featured the term “Merry Christmas.”

Additionally, the VA Medical Center in Augusta, Georgia — which treats veterans — banned Christmas carolers from singing Christmas songs with religious references in public areas.

The Dallas VA Medical Center blocked local schoolchildren from giving Christmas cards to veterans because some of the cards included the terms “Merry Christmas” and “God Bless You.” A similar incident occurred in Montgomery, Alabama, where the VA Medical Center blocked veterans from receiving gift bags that included the term “Merry Christmas.”
George Will is exactly right - the best argument that conservatives have going for them are the results of liberal policies in action.
Oh, there is nothing better for American conservatism than periodic examples of untrammeled liberalism.
Of course, often when conservatives have complete control over both the executive and legislative branches, whether on the federal or state level, they also go too far. That is why a system of checks and balances that also gives minorities a role in government is still the best form of government, or at least the least bad.

Now Obamacare is threatening volunteer firefighters since it mandates that even volunteers get health insurance.

Megan McArdle explains why Obamacare won't cut health care costs. Yet another promise broken.

Boeing employees make a vote for common sense over unions.

One senator is suing the Obama administration over its provision of Obamacare exemptions to members of Congress and their staffs despite the explicit wording of the actual law. We'll see how this works out.