Mike Kueber's Blog

June 25, 2015

While I was on vacation – Confederacy and ObamaCare

Filed under: Law/justice,Politics — Mike Kueber @ 10:32 pm
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While I was on vacation in North Dakota (totally off my computer and non-ESPN television), two significant events broke, and I am only now catching up on them.

The first event concerned a murder in South Carolina of nine black churchgoers by a white supremacist, and the ensuing public reaction.  Inexplicably, the murder caused a mass movement to ostracize anything related to the antebellum South, especially the display of the Confederate flag.

Today the movement spread to San Antonio, where our leading politician, Julian Castro, boldly asked that Robert E. Lee high school be renamed.  I am not being facetious in using the term “boldly” because Castro doesn’t typically act precipitously before checking on the direction of the wind, and there has been a lot of backlash to his suggestion.  I suspect his action is directed more for nationwide approval, and he doesn’t have to worry about aggravating the piddling number of local alumni of Robert E. Lee HS.

Personally, I have always been torn by my affection for the Confederacy as a symbol of states’ rights and my deference to black people who resent it as a symbol of slavery.  Because of that conflict, I don’t think governments should memorialize the cause, but we should be able to memorialize valiant conduct of individuals like Lee.  Hell, we Americans seem to have reasonable opinion of Patton’s WWII adversary Rommel, the Desert Fox.

The second event was the Supreme Court rejection of an argument that federal exchanges for ObamaCare should not be allowed to give subsidies.  Although the argument seemed strong to me (Scalia thinks the name ObamaCare should be changed to ScotusCare because the Supreme Court has twice saved it), the NT Times confidently declared that the argument was preposterous. I’ve long been in the camp of those wanting to end ObamaCare, but admit that the GOP has not suggested what should replace it.  All Americans are entitled to healthcare, and it doesn’t make sense to route so many people to an emergency room with nonthreatening problems.

An aspect of this matter, however, that has not received much attention is that the premium subsidy that is provided to millions of Americans is really welfare – i.e., needed-based government expenditures.  Romney referred to the 47% of Americans who live off government benefits, but that includes Social Security.  It would have been more interesting to focus on needs-based benefits – welfare – because America might be reaching a critical mass of those people, too, and then America will begin to resemble a socialist country – i.e., from each according to their ability, and to each according to their needs.

November 21, 2014

President Obama unilaterally addresses America’s immigration mess

Last night, President Obama spoke to the American people about an Executive Action that he was taking to deal with America’s immigration mess. Conservatives are apoplectic because the president is taking actions that the American Congress has refused to take – i.e., he is legalizing (a) almost four million illegal immigrants who are parents of American citizens and (b) several hundred thousand more who came here as children.

The Department of Homeland Security has issued a legal memorandum – “The Department of Homeland Security’s Authority to Prioritize Removal of Certain Aliens Unlawfully Present in the United States and to Defer Removal of Others” – explaining why the president’s action is not an illegal abrogation of congressional powers.  Essentially, it says that temporarily deferring action for some illegal immigrants is a reasonable use of executive discretion. Interestingly, the memo makes a distinction between deferring action against the illegal-immigrant parents of children born in America (sometimes called anchor babies) and the parents of DREAMERS (illegal-immigrant children who were previously granted deferred action under DACA by President Obama):

  • The decision to grant deferred action to DACA parents thus seems to depend critically on the earlier decision to make deferred action available to their children. But we are aware of no precedent for using deferred action in this way, to respond to humanitarian needs rooted in earlier exercises of deferred action.”  [Wouldn’t it be ironic if DREAMERS, who were granted deferred action because, as minors, they weren’t personally culpable for their illegal entry, could serve as an anchor for their parents, who were in fact culpable for their illegal entry?] 

My initial inclination is to join the partisan outrage against this unilateral action by our newest Imperial President, but I must admit that ever since I ran for Congress in 2010, I have supported immigration reform that would include legalization of illegal immigrants who have lived in America for 5-10 years. Although these people initially came to America illegally, legalization is fair because our country has allowed them to establish roots. President Obama’s action did not go as far I would if I were emperor for a day.

But neither is President Obama emperor. He may be empowered as the chief executive to prioritize his efforts against illegal immigration, but in my opinion he isn’t empowered to legalize (work permits, etc.) illegal immigrants.

Ed Gillespie, who almost pulled off the senatorial upset of 2014, issued an op-ed piece today in the NY Times suggesting that the new GOP Congress needs to not just repeal ObamaCare, but also needs to pass an ObamaCare alternative.  I suggest they should do the same with respect to immigration. And if President Obama vetoes it, the 2016 election can be a referendum.

Wouldn’t it be wonderful to see more policy arguments and less obstruction and dysfunction?

October 30, 2014

Go Public – marketing government services

Filed under: Education,Medical — Mike Kueber @ 12:33 am
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Last month, there was an article in the Express-News describing a multi-district program – Go Public – to better market the public schools in San Antonio.  My initial reaction was that our financially strapped schools should be spending money on teaching students, not on marketing. Indeed, the article even reported that a school board trustee was similarly minded:

  • Until last month, Schertz-Cibolo-Universal City ISD was one of the few traditional districts with students in Bexar County that hadn’t joined Go Public. Its board voted 4-3 to participate after a lengthy debate that included Trustee George Ricks asking how the district was going to benefit from its $15,000 contribution and questioning its appropriateness as a public expenditure. “Are we trying to steal students away from private schools?” he asked.

But another board member had a different opinion:

  • The district should promote itself, board member Gary Inmon argued. “If you don’t get the positive word out, the negative word sticks, which really does hurt the entire system,” he said.

Although marketing seems wasteful to us Pollyannaish idealists, the practical person must accept that marketing is needed for government programs to compete successfully against private options. E.g., the post office, military employment.

I think there is a difference, though, when I see marketing of welfare programs, like food stamps. Yes, the SNAP program should be readily accessible and the use of food stamps should not be demeaning, but I don’t think government should be spending money encouraging people to avail themselves of welfare benefits they are entitled to. As JFK said, “Ask not what your country can do for you; ask what you can do for your country.”

How does this apply to the marketing of Healthcare.gov?  ObamaCare seems to be a hybrid.  Much of it is designed to improve the health-insurance industry for everyone, but as a practical matter, most of the coverage for those previously uninsured is merely an expansion of welfare – Medicaid.  I don’t think the voters want to see a lot of ObamaCare marketing.

November 8, 2013

Mental-health insurance and ObamaCare

Filed under: Insurance,Issues,Medical,Politics — Mike Kueber @ 8:11 pm
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Yesterday, an article in the New York Times proclaimed that recent ObamaCare regulations have completed “a generation-long effort to require insurers to cover care for mental health and addiction just like physical illnesses.”  Although most Americans were probably unaware of this effort, I was aware of it because I remember learning many years ago at a previous employer about the generous mental-health coverage that was required in all employer-provided health insurance (ERISA).

At that time, the federal government had already interjected itself into micro-managing the contents of ERISA-based health insurance.  ObamaCare extends that micro-management into individually-purchased health insurance.

Back then, when I heard about this mandatory coverage (I believe Senator Al Gore was a big proponent), I was opposed for both personal and economic reasons.  The personal reason was that I knew someone who had been going to a therapist almost her entire life, and this treatment didn’t seem necessary.  Instead, it seemed she enjoyed having someone she could talk to.  The economic reason was that people who wouldn’t consider obtaining mental-health treatment shouldn’t be required to contribute to the insurance pool to pay for such treatment.  Ditto – maternity coverage.

America is not ready for socialism (from each according to their ability, to each according to their needs).

October 29, 2013

Saturday Night at the Movies #85 – The Waiting Room

Filed under: Movie reviews — Mike Kueber @ 3:44 am
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The Waiting Room is a 2012 documentary about life in a hospital emergency room in Oakland, CA.  The situs of this emergency room is Oakland’s Highland Hospital, which Wikipedia calls a safety-net hospital, i.e., the place where uninsured people go to receive free medical care – a/k/a county or public hospitals.  If ObamaCare succeeds (with everyone becoming insured), these hospitals should become more like other hospitals because virtually everyone will be insured.

The film was exceedingly well received by critics, with 100% of the 32 critics on Rotten Tomatoes liking it.  The audience reception was a bit less, at 76%.  I agree with the critics because the movie was surprisingly balanced.  There are no heroes and no villains.  The customers are real and not particularly sympathetic.  The employees are neither jaded nor Pollyannaish; instead, they are trying to do the best they can with what they have.

Even though there is nothing overtly political about The Waiting Room, the unavoidable conclusion that most viewers will come to is that something needs to be done to ensure that the uninsured are treated more efficiently and humanely in America.  But, as Libertarian John Stossel has warned, most people have a troubling tendency to respond to any bad situation with the comment, “government needs to do something about that.”  Well, government can’t prevent all bad situations if it intends to protect an individual’s right to be self-reliant.  County hospitals seem to create the right balance between individual self-reliance and societal safety-net.

So, ultimately, my position on self-reliance vis-à-vis government beneficence is unchanged, but now I have some faces in mind along with abstract concepts.

October 24, 2013

ObamaCare – temporary glitch or systemic failure

Filed under: Economics,Issues,Medical,Politics — Mike Kueber @ 1:41 pm
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There has been much talk the past few days about the problems associated with the federal government’s ObamaCare exchanges.  This publicity suggests that public radio’s David Martin Davies was correct last week when he suggested that the TEA Party was shooting itself in the foot with its shut-down of the federal government.  According to Davis, the shut-down was distracting the public from ObamaCare’s embarrassing crash.  Now, with the shut-down over, there is no bigger story in America than the ObamaCare exchanges.

The initial debate seemed to have conservatives arguing in a knee-jerk fashion that the implementation failure was only an example of all that was wrong with ObamaCare, while the liberals countered that the problems with on-line implementation had nothing to do with the substance of the law.  Eventually, though, the debate has gravitated toward the real issue, which was the title of a pro-con op-ed piece in today’s SAEN:

On the side of temporary glitch is NY Times columnist Paul Krugman.  On the side of systemic failure is Washington Post columnist Michael Gerson.  Both Krugman’s and Gerson’s columns tend toward picking straw man arguments and then debunking them.  Near the end of Gerson’s column, however, he makes a broader point that resonates with me.  He refers to Friedrich Hayek’s point about a fundamental flaw of central planning, which is the inability to consider all of the relevant information.  By contrast, the free market has the marvelous ability to do just that.

And that is why ObamaCare needs to go away.

January 25, 2013

More problems with ObamaCare

Filed under: Issues,Medical,Politics — Mike Kueber @ 9:20 pm
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Back in November, I blogged about some growing pains as ObamaCare took shape.  The post was prompted by HHS publishing regulations that, in addition to dictating standard policy coverages and requiring coverage for pre-existing conditions, severely limited the ability of insurance companies to accurately price the policies.  Specifically, the regulation provided:

  • Premium can vary based on age (3:1), tobacco use (1.5 to 1), family size, and geography.  All other factors – such as pre-existing conditions, health status, claims history, duration of coverage, gender, occupation, and small employer size and industry – are prohibited.

Today, more than two months later, there is an Associate Press article in the Express-News that describes a potentially huge problem with the interplay of the two authorized pricing factors – age and tobacco use.    According to the article, the age limitation on pricing will cap the annual price of a 60-year old’s policy at $10,172, with a tax credit for someone making $35k taking the price down to $3,325.  But the tobacco-use surcharge of 50% or $5,086, with no additional tax credit allowed, will bring the final price back up to $8,411 or 24% of this person’s income.  That’s not affordable.

This sort of snafu is inevitable in a program this big and new, and numerous tweaks will be necessary.  But as I pointed out in my blog a few weeks ago when discussing the possibility that the employer fine of $2,000 might be low enough that employers in masse will abandon employee health insurance, congressional Republicans are in no mood to tweak ObamaCare to help it work properly.   

I don’t know how this will play out, but gosh, it would have been nice if ObamaCare had been passed by a bipartisan majority.

January 3, 2013

ObamaCare comes to life as Frankenstein

As ObamaCare was being debated in Congress, one of President Obama’s most specious defenses of the initiative was that if you liked you current health insurance, as the vast majority of Americans did, then you would be able to keep that health insurance under ObamaCare.  That defense was specious because it was based on two false premises:

  1. It assumes that Americans purchase the type of health-insurance policy that they want.  That is not true for Americans who get their insurance policy through their employer (56% of Americans aged 26-64, according to an article in Politico).   Thus, if the employer decides to change the policy or eliminate employee health insurance, employees would not be able to keep their current policy.
  2. For those Americans who have individual health-insurance policies, it assumes that private insurance companies will continue to offer their current health-insurance policies.  That is not true because ObamaCare requires that all health-insurance policies must conform to the new mandatory coverages as prescribed by the federal government.  Thus, it is no exaggeration to say that health-insurance policies that pre-dated ObamaCare will cease to exist.

Not surprisingly, the mainstream media was complicit in this failure to question these patently false assumptions, as they seemed to go along with Pelosi’s suggestion that we need to implement the law first and then later we can we learn how it will work.  Unfortunately, the learning process may be sooner rather than later.

Just in the last few weeks, I have been hearing from multiple sources, including a senior executive for a medical-services provider, that large employers are moving quickly to drop employee health insurance and have their employees obtain ObamaCare coverage through insurance exchanges.  The ObamaCare law attempted to discourage such a movement by placing a $2,000 fine per employee on large employers who fail to offer health insurance, but large employers are apparently deciding that they would be better off paying the fine. 

If a few large employers go this route, the others will be at a competitive disadvantage if they don’t follow the same route.  And if large employers drop health insurance despite a $2,000 fine, you can imagine what small employers will do.  Employee health insurance could easily go the way of private pensions. 

If there is a mass exodus of employers from group health insurance, I suspect President Obama will want to increase the fine to $3,000 – $5,000.  Good luck with that so long as Republicans have a majority in the House or an ability to filibuster in the Senate.

November 29, 2012

How do the progressives propose to fix Medicare/Medicaid?

Filed under: Economics,Issues,Politics — Mike Kueber @ 2:07 pm
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One of the most fatuous charges made by Democrats during the recent presidential election was that Republicans plan to eliminate Medicare “as we know it.”  That charge is fatuous because every sentient person knows that Medicare as we know it is unsustainable and must be reformed.  At least, I thought every sentient person knew that. 

Before the election prompted both sides into making ridiculous statements, the conventional wisdom was that, because Social Security, Medicare, and Medicaid comprised such a large percentage of federal spending, the out-of-control federal deficit could not be tamed without making significant changes to those entitlement programs.  Everyone agreed on that.

Post-election, however, I have read a series of disturbing reports indicating that progressives/liberals are opposed to making significant changes to those programs.  Huh?  That doesn’t make any sense, but for some reason the mainstream media doesn’t press these people to explain their nonsensical position. 

An explanation for the media’s negligent conduct can, perhaps, be found in today’s editorial in the NY Times.  In that editorial, the Times asserts that neither Medicare or Medicaid can be touched without “hurting the most vulnerable Americans.” 

So, if the Times opposes any cuts, how does it propose to bring fiscal sanity to these programs?  Ironically, it suggests something that reminds me of the Republican plan to balance the budget through so-called dynamic scoring – i.e., a booming economy.  The Times claims that the costs of Medicare and Medicaid will become manageable in the future because ObamaCare will reform healthcare in America by making it better and more efficient.

There may have been a time in America’s past when we could afford to make economic decisions on the basis of what George H.W. Bush called voodoo economics, but that time is passed.  Neither party should be presenting budgetary proposals that depend on rosy, highly speculative scenarios.     

 

November 26, 2012

Another losing year for the Post Office – $15.9 billion

A few days ago, a column in the Washington Post by Joe Davidson, an apologist for the federal bureaucrats, lamented Congress’s mistreatment of that venerable federal institution, the U.S. Post Office by declaring:

  • It is only appropriate that Congress act to solve a postal financial crisis that legislators had a big hand in creating. More than $11 billion of the $15.9 billion loss, by far the biggest chunk, comes from required payments to pre-fund retiree health benefits. These payments are unique to the Postal Service, and they have nothing to do with mail delivery. USPS has defaulted twice on those payments since August. Without those payments, the net loss would have been $2.5 billion, not good, but more manageable.

Only in Washington would it be considered unfair to require an employer to pre-fund retiree health benefits.  You would think that any sentient American would have learned the stupidity of Social Security’s pay-as-you-go arrangement, but apparently that is not true of the denizens of Washington.

Coincidentally, the book currently on top of my reading list is Freedom Manifesto by Steve Forbes and Elizabeth Ames, and its first chapter is titled, “FedEx or the Postal Office?”  According to the authors, the U.S. Postal Service is the perfect example of service provided by a government bureaucracy – long lines and sluggish service – while FedEx exemplifies private enterprise – efficiency, reliability, and most importantly, innovation.

All of which invites the post-ObamaCare question – what if America’s healthcare industry ends up looking less like FedEx and more like the Post Office?

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