Wednesday, June 8, 2011

Resisting Federal Encroachments: Founders v. Today

“Prudence, indeed, will dictate that Governments long established should not be changed for light and transient causes; and accordingly all experience hath shown, that mankind are more disposed to suffer, while evils are sufferable, than to right themselves by abolishing the forms to which they are accustomed. But when a long train of abuses and usurpations, pursuing invariably the same Object evinces a design to reduce them under absolute Despotism, it is their right, it is their duty, to throw off such Government, and to provide new Guards for their future security…”
The Declaration of Independence – 1776
Why not read those words again before you move ahead with this blog. Do they sound extreme to you? I mean, “throw off such government;” that certainly sounds extreme, doesn’t it? Or does it?
Throwing off the chains of oppressive government meant taking up arms to the Founders. They did not have the protection of a Constitution they had dutifully adopted, endorsed, and wished to defend.
The Founders cited the primary reason for establishing government to be to “secure these [unalienable] rights,” the God-given rights to life, liberty and the pursuit of happiness (translated in the Bill of Rights and the Fourteenth Amendment to mean, the right to own property). Simply, a government that no longer defends life, liberty, and property, said the Founders, must be thrown off.
“The individual mandate is outside Congress’ Commerce Clause power, and it cannot be otherwise authorized by an assertion of power under the Necessary and Proper Clause. It is not Constitutional,” [i] wrote Federal Judge Roger Vinson. (Vinson ruled on the individual mandate to purchase health insurance required by the Affordable Care Act of 2010, passed by Democrats in Congress, and signed by President Obama.) Other judges have disagreed with Vinson, and the Supreme Court will ultimately decide.
When Congress acts in such a manner so as to attack liberty and property, as Vinson stated clearly in his ruling, what should we as citizens do? Well, if we agree that no one should be coerced by government to purchase something they may not want (in this case, health insurance), maybe we should resist? Sam Adams and the other Declaration signers would cheer us on.
Has the time come to resist?
The Declaration speaks of “a long train of abuses and usurpations” as a critical element in deciding whether to “throw off such government…” Judge Vinson’s decision looked back at how Congress has butchered, sliced, and diced the enumerated powers of the Commerce Clause; mostly since the 1930s. Vinson identified a train of ever-increasing, ever-broadening Congressional encroachments on private commerce. He quoted the Congressional Research Service and the Congressional Budget Office, both of which stated the individual mandate is an unprecedented expansion of the reach of the Commerce Clause.
When Congress decides to tell us that we must purchase health insurance has their action crossed the line into tyranny, or is that too strong of word? Would you supply me with an alternative? And is this a one-time assertion of power, or evidence that Congress intends to continue a long train of usurpations?
When you view the growth of government under the light of the Founders’ reasoning, and then under the scrutiny of history (including recent history), you see the “long train of abuses and usurpations” upon which the Founders based their claim to independence. The Founders chose to fight a hot war of rebellion as their answer, but resistance can take many other forms long before war becomes the only option. This is one of the chief blessings of our United States Constitutions.
What methods of resistance?
We express resistance to tyranny at the ballot box. We elect individuals to represent our views. If our view is that Congress does not have the power to force someone to purchase health insurance, we will resist Congressional tyranny by electing a different Congress. In fact, we started that process through the 2010 election, and hopefully, will continue it in 2012. So elections are an alternative to taking up arms, as an expression of resistance – God be praised.
Are there other ways to resist tyranny beyond the next election?
Lawsuits, such as the one Judge Vinson ruled upon, are one way to resist. Another is to ask state and federal lawmakers that are currently serving to use every possible legal scheme of which they can conceive to resist all federal encroachments on liberty. It means asking lawmakers to scrutinize all legislation related to the Affordable Care Act of 2010, searching for any instance in which they dare to challenge the federal government by taking no action, or taking adverse action.
There is an ultimate form of resistance to tyranny that falls short of the Founders’ resort to arms: If millions of Americans choose en masse to resist laws that threaten unalienable rights to life, liberty, and property, Congress and the Courts will notice. Perhaps, if the individual mandate stands, we should incite millions of Americans to drop health insurance coverage as a form of civil disobedience; sort of like dumping tea into Boston Harbor.
On the other hand, millions of Americans may remain indifferent. Today’s elected state lawmakers may choose, instead, to capitulate to Congress. If so, James Carville may prove to be right when he said recently, “…we’re going to start to see civil unrest in this country. I hate to say that, but I think it’s imminently possible.”[ii]


[ii] Carville, J. (2011) “Carville: There Will be Civil Unrest—Over Economy.” Newsmax.com. June 6, 2011. http://www.newsmax.com/InsideCover/Carville-Obama-Clinton-civilunrest/2011/06/06/id/398990. Retrieved June 8, 2011.

Wednesday, June 1, 2011

Who should ration health care?


“Racer,” you may have already said, “why resort to false, emotional words like ‘ration’ when what we need is a serious discussion about health care reform?”

Easy. Rationing is an essential element of the ACA way. 

Fifteen commissioners, each earning $165,000 a year, will do the rationing. They are called the Independent Payment Advisory Board, and are foundational to how ObamaCare will function.

President Obama and the Democratic members of Congress, in passing the misnamed Affordable Care Act of 2010 (ACA), took $500 billion away from future Medicare payments. They did this knowing that more than 78 million Americans are beginning to qualify to enroll in Medicare. What happens when less money is available for more people? You choose your favorite term: I use the appropriate one: It’s called rationing.

Make no mistake about it. Rationing will happen as  revenue fails to keep up with cost of care. 

Medicare Revenue is directly linked to the expansion (or retraction) of the economy, except that President Obama does not believe this. Instead, he believe there is a finite amount of money, and the role of politicians is to divide it up.

The way to divide up a finite amount of money in Medicare is to ration care. The instrument to accomplish this is the Independent Payment Advisory Board (IPAB). This 15-member board, set up under the ACA, will decide what care will be allowed to be provided to Medicare enrollees, and what will be denied. Denial of care is called rationing.

It is true that there are other forms of rationing. If a person has no money, and there are not medical providers willing to care for that person, it is called rationing. But the Affordable Care Act will create more of this type of rationing, not less. Why? Because the ACA discourages individuals from becoming physicians. If there are no doctors, there is no health care – well, professional health care.

If a person has prepaid health coverage (some call it insurance), and the insurance company or Health Maintenance Organization (HMO) is in charge of deciding who gets what coverage, that is a form of rationing. But it is far different from the way the IPAB functions. There is at least some competition among health care insurance companies to provide coverage for individuals. If there would be only one insurance company, it could dictate – yes, dictate – who will get what care, when, where, and under what conditions. This is precisely what the IPAB will be able to do, because Medicare is single payer, government-run health care – it has no competitor. 

Repeat it. Tell the truth. ObamaCare, the ACA, is the process to ration health care. First, to senior citizens on Medicare, and then to the rest of society (as Exchanges give way to single payer systems, and as Accountable Care Organizations submit to the federal paymaster).

We start to fix this by repealing the IPAB. And the requirement for Exchanges. And the individual mandates. We fix it by expanding access to consumer-directed health care, Health Savings Accounts, and medical entrepreneurism. 

We cannot, absolutely cannot waste our time trying to fix the ACA. It cannot be fixed. It must be rationed out of existence.

Health care  decisions are the realm of patients, their families, and doctors. Communities join this process voluntarily. This is the way to pursue rational decisions about health care.

Sunday, May 29, 2011

A Father and Daughter Deploy to Afganistan

What ideas are so strong that Americans fight and die for them?
Today I stood in church next to a father and daughter, both members of the United States Army. The pastor asked them to stand and be recognized: They are both to soon deploy to Afghanistan.
Wow. Why do people volunteer for military service?
He introduced another man, an ex-Marine, whose combat ribbons and medals would cover the entire breastplate of uniform. Among other things, the Marine flow #2 on the Blue Angels. The glory from flying those Blue Angel airshows pales in comparison with the Marine’s war record.
Incredible. For what reason did this man risk his life time and again?
I served four years in the Air Force during Vietnam, but am humbled by the service of these others.
What drove me to enlist in the Air Force, knowing that Vietnam awaited, if the military so chose to send me? An honest answer includes my preference not to be drafted into the Army. Yet, I had a heart full of patriotism and love for America, and wanted to do my part (I know, these are old-fashioned ideas to modernists, and maybe even sound silly).
A few weeks ago, I asked a close friend of mine to list three non-negotiable issues for me. I asked, “If you served in the Minnesota legislature, tell me three issues where you would draw the line.”
He responded with life – he is prolife. And the other two resembled freedom and pursuit of happiness. Good answers.
What about you? The answers you give are the reasons we go to war, did you know that? These are the issues that make America different, and special. Life. Liberty. The Pursuit of Happiness.
Our founding fathers wrote that governments are created to protect inalienable rights, and when governments attack those rights or refuse to defend them, it is our right, and in fact, our duty to throw off “such government” and establish new forms that seem better suited to us to defend our inalienable rights. Heavy stuff, right? This is why America’s founding citizens went to war with England. And it is the same reason we fight for America today.
Now comes the tough question. Do you believe it? Do you believe that life, liberty, and the right to own property (pursuit of happiness) are willing to defend and protect, even to the point of sacrificing your life, fortune, and sacred honor? If you answer “yes,” then take some time to evaluate how you are doing so today, and how you might be doing the opposite.
I can think of one major problem that threatens our liberty: our increasing dependence on government, and more specifically, for our health care. I’ve spent the last six years studying this, and am convinced that too many of us are willing to defer to Big Government on this critical issue.
When the federal government controls all of health care, your life, liberty, and pursuit of happiness will be in total jeopardy.
I cannot imagine anyone willing to fight and die for single payer health care, can you? Such a thought would shake the hearts of America’s founders, and of the millions who have fought and died for our liberty.

Wednesday, May 25, 2011

Elections that go our way have consequences - Sometimes we don’t like them


During the summer and fall of 2010, I traveled across Minnesota – and other states – to deliver a message to professional health insurance agents: Get involved in this election, because the next legislature will decide what kind of health insurance exchange you will have.

A funny thing happened on the way to the election. Minnesotans sent conservative Republicans to the state capital, and created a GOP majority. Not surprising, most of the new legislators are committed conservatives – and they refuse to create health insurance Exchange.

Without the votes of the freshmen legislators, the ones for whom many of us campaigned so vigorously, the Exchange went nowhere. It could resurface in a special session, or next year. But there is no indication the freshmen legislators would change their vote.

We elected principled conservatives and they actually voted that way (or in this case, withheld their vote). Elections have consequences, even when they go our way.

Consider the alternative. If we had not elected conservatives, Gov. Dayton would have signed an Exchange bill early in the session. We know what it would look like. These are some of the features of a bill passed by a liberal legislature and a liberal governor (who is on record supporting single payer):
1.       All health insurance sold in Minnesota would go through the Exchange.
  1. Health insurance agents would have no role in the Exchange.
  2. Health insurance agents would either go out of business or sell different lines of insurance.
I am not making this up. I have seen the bill offered by Minnesota liberals. If you believe in a market-based health insurance system, and especially, if you believe in the health insurance agent system, you will not like what liberal legislators and a liberal governor give you.

Last summer, I risked my health and safety, driving and flying thousands of mile, to ensure the new legislatures across the country would protect a private market health insurance system. I lectured insurance agents, and tried to motivate them to engage in the process to avoid a liberal legislature and liberal governor. We won, but our win resulted in the unexpected consequence that legislators would actually do what they said they would do.

The conservative governor candidate lost by several thousand votes – a tiny fraction of the total. If he had won, everything would have been different except one thing (and about this I speculate): With Tom Emmer as governor, and a conservative GOP legislature, there would be no Exchange bill passed in Minnesota.

So if you believe that your state needs an Exchange, don’t elect principled conservative legislators because, well, they will do what they promised to do: They will oppose “ObamaCare” on every level.
This leaves you with the very risky strategy of electing a moderate or liberal legislator and governor that you will work like crazy to influence, hoping to secure a market-friendly Exchange. After that, if successful, you will have committed yourself to electing the same kind of folks for the next decade, and then work to maintain your influence.

Conclusion: Elections have consequences. If you do not want to fight the Exchange, or fight “ObamaCare,” then do not elect conservatives. But, the trade-off is twofold: 1) You will work your fanny off for the rest of your carreer to influence legislators in order to protect your preferences, and 2) You will be more highly taxed, and have a more activist government than you might otherwise prefer.

I made up my mind decades ago: Three first principles - Life, Liberty, and the right to private property (pursuit of happiness).

Friday, May 13, 2011

Medicare Funds Dining

This short article will change how you perceive Medicare. You will realize how vital Medicare is to our economy, but you will view this in a new light. (maybe, like me, it will seem ironic and a bit troublesome.)
Walk into your favorite family restaurant. In Minnesota, I mean Perkins, but this will be true at Denny’s. Huddle House, even McDonalds. The best time is between 9:00 AM and 2 PM. Look around for people who appear to be 65 or older.
My bet is that “seasoned citizens” far outnumber the others. It is safe to assume that almost all of those older folks are Medicare enrollees. The fact is, without Medicare, some of them would be “pushing up grass” (to quote Rush Limbaugh).
Instead, there they are, some of them every day, or several times a week, eating a price-discounted breakfast or lunch, sipping on a “senior coffee,” and having a great time. At 63, I think I can say this openly: I love old people, especially when they’re having a great time.
The idea struck me, as it will strike you now, that without Medicare and Social Security, most older Americans would have barely enough money for necessities – like home-cooked food, and shelter (and health care).
Think of it. Without Medicare and Social Security, many older folks might have to rely on younger people, maybe even live with them. Our society decided decades ago to ensure that grandparents remained independent from their adult children. About this, I make no value judgment, but it has created an irony, and a very expensive one that at. Every American aged 30 or younger today owes $289,000 just to pay the unfunded Medicare debt.
You might be thinking that I have this all wrong. After all, don’t we pay Social Security and Medicare taxes on income to prepay our own cost of government retirement benefits? Well, no. The taxes we pay today pay the cost of benefits for today’s retirees. It won’t be long when two income earners will be required to pay the Social Security cost of one retiree. Today’s young people will receive Social Security and Medicare from children not yet born.
But thanks to Medicare, since it protects older folks from financial catastrophe due to illness, there is money for a daily trip to Perkins. There is also money for Branson, time shares, golf, a winter home, Starbucks, shopping malls, travel, symphonies, and most church donations. Without Medicare, young working Perkins’ servers, paying income, Social Security, and Medicare taxes, would have no job at all. (Or, wait a minute. Maybe they would have a better job. We can’t know that.)
A Boston actuary calculated that each Medicare recipient will spend about $250,000 more in health benefits that they paid into the system. By my calculations that will buy 41,650 Perkins lunches at the senior discounted price of $6.00.
To add a little fun to your next trip to Huddle House, see if the older fellow at the next booth orders off the senior discount menu. Thank you President Lyndon Johnson for Medicare.

Thursday, May 12, 2011

Medicare makes dining possible


This short article will change how you perceive Medicare. You will realize how vital Medicare is to our economy, but you will view this in a new light. (maybe, like me, it will seem ironic and a bit troublesome.)

Walk into your favorite family restaurant. In Minnesota, I mean Perkins, but this will be true at Denny’s. Huddle House, even McDonalds. The best time is between 9:00 AM and 2 PM. Look around for people who appear to be 65 or older. 

My bet is that “seasoned citizens” far outnumber the others. It is safe to assume that almost all of those older folks are Medicare enrollees. The fact is, without Medicare, some of them would be “pushing up grass” (to quote Rush Limbaugh).

Instead, there they are, some of them every day, or several times a week, eating a price-discounted breakfast or lunch, sipping on a “senior coffee,” and having a great time. At 63, I think I can say this openly: I love old people, especially when they’re having a great time.

The idea struck me, as it will strike you now, that without Medicare and Social Security, most older Americans would have barely enough money for necessities – like home-cooked food, and shelter (and health care). 

Think of it. Without Medicare and Social Security, many older folks might have to rely on younger people, maybe even live with them. Our society decided decades ago to ensure that grandparents remained independent from their adult children. About this, I make no value judgment, but it has created an irony, and a very expensive one that at. Every American aged 30 or younger today owes $289,000 just to pay the unfunded Medicare debt.

You might be thinking that I have this all wrong. After all, don’t we pay Social Security and Medicare taxes on income to prepay our own cost of government retirement benefits? Well, no. The taxes we pay today pay the cost of benefits for today’s retirees. It won’t be long when two income earners will be required to pay the Social Security cost of one retiree. Today’s young people will receive Social Security and Medicare from children not yet born.

But thanks to Medicare, since it protects older folks from financial catastrophe due to illness, there is money for a daily trip to Perkins. There is also money for Branson, time shares, golf, a winter home, Starbucks, shopping malls, travel, symphonies, and most church donations. Without Medicare, young working Perkins’ servers, paying income, Social Security, and Medicare taxes, would have no job at all. (Or, wait a minute. Maybe they would have a better job. We can’t know that.)

A Boston actuary calculated that each Medicare recipient will spend about $250,000 more in health benefits that they paid into the system. By my calculations that will buy 41,650 Perkins lunches at the senior discounted price of $6.00.

To add a little fun to your next trip to Huddle House, see if the older fellow at the next booth orders off the senior discount menu. Thank you President Lyndon Johnson for Medicare.

Tuesday, May 10, 2011

Exchanges are not the same as the Federal Employee Health Plan

Exchange supporters talk about the Exchange as the same model as government employees “enjoy” through the Federal Employee Health Benefit plan (FEHB). But it is not true.
The Affordable Care Act (ACA) of 2010 requires all 50 states to launch health insurance exchanges by January 1, 2014. If they do not, the federal government will do it for them. Exchanges, its supporters allege, will make health insurance more accessible for the masses.
FEHB officials brag that government employees have hundreds of insurance options from which to choose. True enough, at least for individuals that live in multiple states at the same time. But for real humans who can only live in one place at a time, there are only a handful of choices, just like normal non-government employees.
The FEHB plan uses what is called a defined contribution model (others call it a voucher). Simply, the government gives its employees a defined per-month amount that the employee can use to purchase their health insurance.
The federal employee can apply their voucher to the purchase of the few plans available to them in the state in which they reside. If the employee chooses an option that costs more than what the government allows, the employee pays the difference.  
ACA-supporters claim that private employers and employees would relish the same opportunity afforded federal government employees in the FEHB plan.
The Massachusetts Connector, in its never-ending attempt to entice more people to enroll, modeled a program after the FEHB plan. “[Private] employers would offer employees a fixed ‘voucher’ and allow them to choose any plan or carrier [in the Connector]. This was a failure and was discontinued.”[i]
Why did the Connector’s private employer voucher system fail? It provides a clue as to why FEHB’s plans are different from those owned by normal, non-government employees.
Government employers pay much more of the employee’s health insurance cost than private employers pay for their employees. The Employee Benefit Research Institute (EBRI) found in 2008 that the employee health benefits paid by governments cost 235 percent more than those paid for by private employers. In other words, private employers insure 2.35 employees at the same cost as the government insures one.[ii] (Are you surprised?)
Perhaps just as startling are the differences in overall employee compensation. Government employees enjoy a 151 percent more generous compensation package than the private sector employees that pay the taxes to support them.[iii]
The government employee premium subsidy for FEHB plans is large enough to cover most of the cost of a family health insurance policy. Private employers cannot afford to subsidize family health insurance to the same extent as the federal government does in the FEHB plan.
In Minnesota, for instance, state taxpayers subsidize 100 percent of an employee’s health insurance cost for the basic plan, and the employee pays only 15 percent of the dependent’s premium. Total premiums for both exceed $16,000 a year – thank you taxpayers.
Private employers may pay 50-80 percent of an employee’s premium, but many pay far less for dependent coverage. And very few small group Minnesota employers provide family coverage at $16,000 a year. Only government employers can afford such luxuries.
An Exchange FEHB-type voucher plan could only work if it provided much less expensive coverage than Federal employees “enjoy.” Most private employers could never provide funding for the family coverage common to the FEHB plans .
The Massachusetts Connector has already demonstrated that a FEHB plan does not work for private employers. Soon after states or the federal government launches Exchanges, we will all understand the same fact.
After all, the primary purpose of the Exchange is to enroll people in tax-subsidized health insurance. The end game is to create more dependency on government.


[i] A Massachusetts’ government insider, whose identity is protected, provided this insight.
[ii] Fronstin, P. (2008) “Benefit Cost Comparisons Between State and Local Governments and Private-Sector Employers.” Employee Benefit Research Institute. Washington, DC. June 2008, Vol. 29, No. 6, p. 3.
[iii] Ibid.