Wednesday, November 04, 2015

The Fraudable Care Act

ObamaCare is not healthy. Saddled with side effects from fraud to canceled plans, the sickening reality is that government-driven health care delivers higher costs, more uncertainty and the potential to put insurance plans in a death spiral.

Undercover investigators from the Government Accountability Office created 18 false identities and successfully received subsidized coverage or Medicaid for all but one of them. This, despite the use of nonexistent Social Security numbers, fake birth certificates and other false documentation. Seto Bagdoyan, director of forensic audits at GAO, reported that “eligibility determination and enrollment process remains vulnerable to fraud.” One fictitious applicant not only received subsidized coverage from the federal marketplace, but also two state exchanges at the same time. Officials told Bagdoyan “there is no current process to identify individuals with multiple enrollments through different marketplaces.” What’s especially troubling is that the GAO discovered similar vulnerabilities to fraud during its 2013-14 investigation.

Duplicate coverage drives up the cost, as some people received subsidies for private insurance while enrolled in Medicaid. In addition, states incorrectly qualified some people for Medicaid despite their income exceeding the required income levels.

While one of the GAO’s fictitious applicants received three insurance policies, other real-life Americans are in round three of enrolling after losing their health insurance plans not once, but twice. Nine out of 23 co-ops set up to enroll people in ObamaCare have died and 11 more are on life support, causing families to switch plans again. National Review reports:

    "Over 600,000 people who enrolled in co-op health plans will lose their insurance at the end of this year. Many of them were forced into the co-ops to begin with when Obamacare canceled their private insurance policies in 2013, meaning they will have lost their health insurance twice because of the law."

Taxpayers have dished out over $1 billion for the nine failed co-ops. That would be a steep price for success, but to pay that much for fiascos is particularly onerous — especially during stagnant economic conditions.

Dollars get in the way of dreams, even in liberal Vermont, home to presidential candidate Bernie Sanders, the avid fan of Scandinavian-style socialism. Late last year, Vermont Governor Peter Shumlin abandoned his vision of single-payer health care. “In my judgment," he said, "the potential economic disruption and risks would be too great to small businesses, working families and the state’s economy.” By disruption, Shumlin means an 11.5% payroll tax and an additional income tax hike up to 9.5%.

Despite this expensive lesson, Colorado is now considering single-payer. Yes, the same state that brought us the “Brosurance” keg stand ad promoting the Affordable Care Act and the Colorado Pot Guide for the “weed enthusiast” is voting next month to decide whether to replace ObamaCare with ColoradoCare, funded by a 10% payroll tax hike (a.k.a. a $25 billion increase). Investor's Business Daily reports that Colorado HealthOP, built with $72 million in federal loans, collapsed after losing $23 million in its first year. Before its demise, it had sought rate increases of up to 24% for the following year.

The collapse of Colorado HealthOP dumped more than 80,000 people off their insurance policies. Now these folks have to start shopping again in November, or face the consequences.

Meanwhile, an alarming number of doctors are looking for new jobs. Forbes reported that even before ObamaCare was implemented the mere thought of more government control in the health industry caused physicians to consider packing it in. A survey by the Doctor Patient Medical Association Foundation “reveals that 83 percent of physicians surveyed are thinking of quitting because of Obamacare.”

The Affordable Care Act is not affordable; it’s fraudable. But this isn't surprising since the entire enterprise was founded on fraud and deceit. As that notorious health insurance redesigner and MIT professor Jonathan Gruber pointed out, “Lack of transparency is a huge political advantage.”

While hawking ObamaCare, then-House Speaker Nancy Pelosi famously declared, “We have to pass the bill so you can find out what is in it.” And on the campaign trail, Barack Obama repeatedly assured voters, “If you like your doctor you can keep your doctor. Period.” Now Americans don't like what they're finding. They're not only losing their doctors but also their insurance policies as co-ops collapse.

It’s important to remember that ObamaCare is not about health care as much as it's about money and power. It created a massive redistribution of insurance dollars — a “tax,” as Supreme Court Justice John Roberts bluntly termed it.

ObamaCare was brought to you by Democrats without a single Republican vote, not because the GOP doesn’t care about health, but because Republicans accurately predicted the side effects of government intrusion into the health insurance business. Democrats now own ObamaCare.

It doesn’t have to be this way. There are many options, including the eight common-sense suggestions of Whole Foods CEO John Mackey, who endorsed ideas such as transparent costs, HSAs, interstate insurance commerce, tort reform, equalizing tax laws and repealing government mandates. Several GOP presidential candidates have workable alternatives, as well.

America can get healthier. But not with ObamaCare, which has routinely and repeatedly violated the foundational principle of healing: First, do no harm.



Foreign Policy and the Constitution

Excerpt from a long article by Arkansas Senator Tom Cotton, a lawyer and a military veteran

The Founders believed the violation of major foreign commitments was a chief source of friction and war in international relations. In fact, Federalist 3 recognized only two sources of war: direct violence and the breach of treaties. Thus the Constitution requires that a major foreign commitment that binds our nation have a broad consensus among the people, and not result from the parochial interests of a minority or even a narrow majority. As matters of war and peace, treaties should reflect a strong Union, not a divided nation.

This principle led to the Treaty Clause, which empowers the president to negotiate treaties, but requires two-thirds of the Senate to approve them and—if necessary—to demand changes. This extraordinary requirement is really just an ongoing expression of the original decision to form a Union. And it has produced a system in which treaties routinely go through many iterations and rounds of negotiations, even after initial signature by the president. Treaties throughout our history carry scores of conditions, reservations, and amendments added by Congress, precisely to ensure widespread acceptance among the people.

This was in fact how the first treaty ratified under the Treaty Clause played out. The Jay Treaty with Britain—negotiated by a co-author of The Federalist—only gained Senate approval on the condition that Jay rework the treaty to add a clause regarding trade between the United States and the British West Indies.

Another principle of foreign policy rooted in the Constitution is that the Union must have a strong military, but one that is at the same time restrained and subject to the control of the people.

At the time of the Founding, a powerful and restrained military was something of an oxymoron. Federalist 11, for instance, states that a strong military—and in particular a strong navy—is vital not only to deter aggression, but also to secure and expand international trade. Yet Federalist 26 recognizes that military might has historically posed a grave threat to individual liberty. This presented what seemed to be a Hobson’s choice between a strong military and a weak military, both of which would threaten liberty over time.

But our Founders charted a way out of this dilemma. The Constitution empowered the president, as commander-in-chief, to defend against attack and take decisive military action where necessary. At the same time, it entrusted the people’s representatives in Congress with a wide range of foreign affairs powers as a means of fostering prudence, democratic control, and protection against tyranny. Thus only Congress can raise and support armies; only Congress may declare war and invoke the legal obligations and protections that this state of international relations confers; only Congress regulates foreign commerce, and with it control over important levers of influence with foreign nations in order to better relations, exact costs, and prevent war.

Under President Obama, there has been considerable drift away from all three of these principles. And that drift has contributed to the general drift of U.S. foreign policy. Even former President Carter has said, “I can’t think of many nations in the world where we have a better relationship now than when he took over.” Our interests are threatened, our alliances are stressed, our honor is stained, and our adversaries are increasingly tempted into new episodes of adventurism and aggression.

The most recent example of this drift is the Iran nuclear deal. This is a major arms-control agreement with a mortal enemy—an enemy with the blood of thousands of Americans on its hands, and for whom “death to America” is a foreign-policy bedrock. And the agreement goes to the heart of the gravest threat facing the world: a terror-sponsoring state armed with nuclear weapons. It is precisely the type of agreement that the Founders intended to be tested and refined by the treaty process. It is precisely the type of agreement implicating matters of war and peace that must be supported by a widespread consensus of the American people.

But the President didn’t submit the Iran nuclear deal as a treaty. From the beginning, his intention was to circumvent the people’s representatives and obligate the U.S. to the ayatollahs by a mere executive agreement. Instead of rallying two-thirds of the Senate to support the deal, he relied on a tiny, partisan minority to protect his executive agreement from the judgment of the American people.

This is dangerous and nearly unprecedented. Executive agreements are and should be reserved for technical matters. Among the first executive agreements in our history were the 1792 agreements between the United States and other nations to coordinate mail delivery. Executive agreements have also traditionally been used to assign claims and debts between nations. These issues are low-stakes, and are not breeding grounds for armed conflict. They are akin to deciding whether cars will drive on the right or left side of the road. That’s why they do not need to be tested by a supermajority vote.

Nuclear weapons agreements are different. The dividing line between subjects reserved for treaties and subjects reserved for less formal scrutiny is not precise at the margins. But this isn’t anywhere near the margins. Historically, major arms control agreements that bind the U.S. have almost invariably been reached through treaty. One notable exception was the Agreed Framework with North Korea negotiated under President Clinton in 1994, which aimed at keeping North Korea from becoming a nuclear power. I doubt President Obama would like to cite the North Korea case as precedent—although it surely is a precedent in its contempt for Congress, and likely in its failure as well.

Why did President Obama ignore the Treaty Clause? The answer is stunning. Secretary of State Kerry lamented in testimony to Congress that it is “physically impossible” to get a treaty through the Senate in these polarized times. Of course, this logic could apply to any politically inconvenient part of the Constitution. Moreover, Secretary Kerry must have forgotten that, as chairman of the Senate Foreign Relations Committee, he guided a nuclear arms control treaty with Russia to ratification less than five years ago.

The simple fact is that the President ignored the Constitution because he knew the Senate would reject his deal. This disregard for the Treaty Clause is the height of hubris. It mistakes tunnel vision for principle, closed-mindedness for superior wisdom, and personal legacy for the vital national interest. The nuclear deal with Iran is a travesty, one that betrays our close friend Israel, provides billions for Iran’s campaign of terror, and paves the way for Iran to obtain nuclear weapons capability.

Besides the immediate damage to our national security, the deal also damages the foundational principle that major foreign commitments should be backed by a broad consensus of the people as reflected by Congress. This episode, added to the North Korea example, will make it extremely tempting for future presidents to avoid the expenditure of political capital required to pass a treaty. Presidents will be tempted to reach expedient deals on momentous issues, deals that divide rather than unite the nation.

As we think about our future and new strategies, it would serve us well to look back at old truths. We must hold fast to foundational principles. We must continue our rich foreign policy tradition, and vigorously fight any efforts to undermine it.



For more blog postings from me, see  TONGUE-TIED, EDUCATION WATCH INTERNATIONAL, GREENIE WATCH,  POLITICAL CORRECTNESS WATCH, AUSTRALIAN POLITICS, and Paralipomena (Occasionally updated) and Coral reef compendium. (Updated as news items come in).  GUN WATCH is now mainly put together by Dean Weingarten. I also put up occasional updates on my Personal blog and each day I gather together my most substantial current writings on A WESTERN HEART.

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