Thursday, September 21, 2017

Hutchinson's Angle on the Graham Plan

Governor Asa Hutchinson has come out as a strong supporter of a bill sponsored by South Carolina Senator Lindsey Graham. The bill is touted as an "Obamacare Repeal". That is going too far but it does repeal many of the parts of Obamacare which were considered most onerous. That includes the individual mandate and the employer mandate to maintain coverage. The plan also gives the states far more flexibility than the original program. So I would call it an Obamacare Reform bill. It does not repeal the measure, just some specific provisions in it. It does the rest of its function in a different way. It leaves FEDGOV in the business of funding health care for able-bodied adults if the states approve it (which 31 of 50 have when FEDGOV was paying all the bills).

The nineteen states that stayed off of Obamacare, at least the Medicaid expansion for able-bodied adults part, would gain money under this bill. Those states that expanded Medicaid, like Arkansas, would lose money. All states would get money from the Feds under this program, even those that did not vote to expand Medicaid. I consider that a bad part of the plan because it gets all states hooked on federal money that is unsustainable and which the feds are not even promising past 2026. The states could either take their money in a block grant, or a specific amount per person enrolled on Medicaid. This does not count the elderly or the disabled. They would be paid under traditional Medicaid, whose costs the Governor has been aggressively attempting to cut even while spending for Obamacare Medicaid expansion has soared.

The Feds are treating those two Medicaid programs differently, but activists keep trying to lump all Medicaid together. Eventually that is going to be an issue because those two programs are actually competitors, not allies. They fund health care for two different groups of people- one the able-bodied and the other disabled and elderly. Sooner or later people with disabled children for example are going to figure out this divide- Asa Hutchinson and the politicians already have.

Here is what I know: Governor Asa Hutchinson, and really the whole Republicrat establishment in Arkansas, is in a fiscal trap if something does not change. They structured things to take as much free money from D.C. as they possibly could when D.C. was paying 100% of the bills. But that "free" money was just a trap to get states to expand Medicaid. Now the state has to start paying a share of that bill and 1) they don't have the money even if the feds match 90% and 2) the feds don't have the money to keep their empty promises and match 90% going forward.

The Graham bill will rescue the political establishment in Arkansas. Not the citizens mind you because the new plan will fail too, but it will give them cover for getting out of the old plan. The Governor noted that the Graham plan "does not require the states to spend any money". So this tells you what he is going to do. He is going to do what they have been doing- take every penny from the next generation that FEDGOV will let him have so long as the state does not have to spend any money themselves. It is still being added to our tax and debt load of course, but the entity of state government prospers regardless of what happens to the individual taxpayers within that entity. He is just concerned that his department is still able to hand out money without any of it coming from their budget. If it comes from your budget, or your children's because debt is propping up this whole thing, then it appears to be no cause for the republicrats to worry.

Yes he will have to cut benefits to do this. At this point I don't see anyway out of a reduction in benefits anyway. It is just a question of an orderly collapse or a disorderly one. The original plan was never going to work. It was only a question of whether the state would renege on its pledge to pay 10% of the new bills starting in 2020 or if the FED was going to renege on their promise to pay at least 90% of those bills. It looks like both are attempting to default on those promises now. Some of us warned them against implementing such a long term disaster in order to get the early money. Now they have raised expectations about what government is supposed to do for people, but they cannot afford to come close to meeting those expectations. I favor the Pea Ridge option but that would require politicians accepting the limitations of government action and all special interests currently making money out of government intervention in health care to take a hit, so don't hold your breath.

Wednesday, September 20, 2017

Primaries are Special Elections

I know a lot of people who are upset at the corruption in our government, both state and federal. The font from which corruption draws its succor is of course government spending. That is, the more money government spends, the more that will be spent on patronage, graft, cronyism, and bribery. People who want ever more spending from government may not like this connection, but the connection is very real.

I know only a few people who are actively trying to do something about these things. Those are the ones I empathize with the most. They are not just complaining about it, they are attempting something like self-government. The people who run the looting-machine that government has become hate it when citizens organize and try to self-government. They have constructed an elaborate series of ruses and obstacles to prevent that from happening. Hold that thought while I bring to mind another recurring problem.....

Special Elections are routinely used by the insiders to pass tax increases and borrowing schemes which would not pass in a general election. The idea is that even though these tax increases benefit only a few at the expense of the majority, the people most directly benefiting from the tax increase are highly motivated to show up and vote for it. Those who are paying for it are only being robbed of a little bit each so they have less to gain from voting. Thus the promiscuous use of special elections leads to more taxes, spending, and government than most voters approve of.

Now those of us who actually want to do something are divided into two schools of thought. Some think that we should "take over" the Republican Party and make it do what it has claimed to stand for over the last five decades. Others of us, me included, think that it is one of those ruses designed to sap the energy and money of those seeking to limit government and it has proven that so many times that by now we should realize that it is time to start something new. It is easy to show that a national political party is the wrong sort of vehicle if your goal really is to limit government.

What this boils down to tactically is that some think that the way to change things is to enter "outsider" candidates in a party primary. I think taking on a party's favorite candidate in their own primary is the worst possible place you could challenge them. The filing fee of your candidate will wind up going to the campaign of the establishment guy you were hoping to beat!

If you will think about it, a primary election is a "special election". And like all special elections, those who disproportionately benefit from the current system have more incentive to show up and vote than the average voter who is only being robbed "a little bit each time". For example, imagine that there was a special election whose purpose was put a one-time $2 tax on every American to give $100 of tax money to every American with an Irish surname. You might think this proposal highly unfair and are against it, but it is worth more than $2 of trouble for you to take time out and go vote, so maybe you don't vote. Murphy and Finnegan will show up to vote! Twice each if election official O'Donnell will let them get away with it.

The exact same argument as to why we should not have special elections is the same reason we should not try to change things by going through the primary of a corrupt party whose leaders band together against honest people and whose primary elections are dominated by those on the take. And since the Democrats rarely have contested primaries the Democrat voters on the take will not hesitate to cross over and vote for the establishment Republican in order to freeze out a challenger who threatens the gravy train. Remember the Trent Lott vs. McDaniel senate primary in Mississippi a few years ago?

Party primaries are special elections, and special elections are the life-blood of special interests. If you want to take on the establishment of a party, do it smart, do it in the general, not in their own primary! I mean, conservatives have been putting all of their eggs in the Republican basket since the 1980s and its only gotten worse not better. Isn't it time to invest just a little bit of effort into something else? My friends and I at Neighbors of Arkansas have a plan to do just that, and we invite you to help by getting nine of your friends to sign a petition to put an alternative on the ballot. Or you can keep doing the same thing people have been doing for the last fifty years and expecting a different result.....

Wednesday, September 13, 2017

It's How You Spin It - Numbers for Uninsured

So the Census Bureau released numbers about insurance rates in Arkansas. The left is claiming that they prove how wonderful Obamacare has been in Arkansas. I look at the same numbers and think how few people have actually been helped considering how much trouble it has been for the rest of us, and how catastrophic it will be when this unsustainable system finally goes away.

The chart shows that when we first implemented Obamacare in Arkansas in 2013 about 14.5% of people interviewed did not have health care insurance at that time. There are lots of reasons for that but the biggest one is probably that a lot of young people are healthy and felt that they had no need for health care insurance. After all, the state has been giving it away since 2013 and signing up everyone they can and still about 8.5% don't have health care insurance. It is very likely that the bulk of those people are just those who are not bothering to get it because they don't feel they need it, even if they are so poor that the can get it paid for by the rest of us or so wealthy that they should be able to afford it and face a penalty from the IRS if they don't.

So all of the controversy and rate increases and losing our doctors for the rest of us has been so that at most six percent of the population gets covered. The number is probably less than that because if you look at the trend line before Obamacare was imposed the uninsured rate was already declining from 2010 through 2013. It looks like it would have gone down to about 13% rather than 14.5% by now if we had just left things alone. So that means that all of this hassle has been for the benefit of around 4.5 percent of the population. That is not counting the insurance companies and hospitals who are gathering in taxpayer money hand over fist.

Also, the rate of uninsured seems to be leveling off. In other words about everyone that wants it has it. We are not going to get the number down to zero uninsured, even giving it away to the poor. Even before Obamacare Arkansans provided health care for poor children, the poorest of the poor adults, the disabled, and the elderly. The only group expected to provide for their own health insurance was able-bodied adults.  Most of us did. This program and all the expense and trouble it caused was about getting 4.5% of the population of able-bodied adults a welfare benefit paid for by the rest of us and the children of the next generation. That doesn't even count that it is fiscally unsustainable and is in a slow collapse anyway- who knows how many will be caught in the fallout when that happens. I suppose if you throw enough taxpayer dollars at a problem you are bound to help a few people, but I question whether we have gotten our money's worth on this one.

Saturday, September 09, 2017

Who Is and Isn't a 'Real Republican'

Conduit for Action recently put up a piece that got a lot of attention called "In Defense of Governor Asa Hutchinson." The article was the furthest thing from a defense. It started with a run-down of all the ways that Hutchinson crossed not only the conservatives which are alleged to be the base of the Republican Party, but even moderates and liberals who are against corruption or downright idiocy ingovernment. For example when he, over the objection of legislators, awarded a contract to a vendor which submitted a bid $20 million dollars higher than the current vendor who had been providing the service without deficiency. Maybe the displaced vendor failed to "donate" to the right PACS?

After the long list of shady and/or leftist actions by the Governor the article finally got to the one thing that they were defending him for. They have heard more and more conservative activists complain that Hutchinson is not a "real Republican" because of issues like the ones that cropped up on that list. But they "defended" him by saying that he is a "real Republican" because the State Republican Party accepted his filing fee! Then they ended with the somewhat cryptic statement "this is what primaries are for."

Independent free-thinking persons will have slight disagreements from time to time and I have a disagreement with my friends at Conduit on their reasoning here. Asa Hutchinson is not a "real" Republican simply because the party accepted his filing fee. The whole point of distinguishing "Republicans" from "Real Republicans" is that some activists believe that there are people abusing the label and filing as Republicans even though they have no commitment to the agreed-on platform or what the vast bulk of the people who vote Republican want. So simply because they took his filing fee does not make him a "Real Republican".

However, the fact is that he is the realist of real Republicans. By that I mean that he accurately and fully represents what Republican leaders have actually done (as opposed to what they said when they campaigned) on a regular basis for a long period of time. He is a real Republican. He has served in very prominent roles for Republican administrations. And the "leadership" of the Republican party does the same kinds of things that he does. He does the kinds of things that leading Republicans have been doing for decades now.

That is because he is one of them and that is what the Republican party now in fact is, no matter what longtime conservative activists want it to be in their fantasies or think of it as in their fading memories. I hate to sound harsh, but the activists who insist that the Republican Party is something different than what Asa Hutchinson is and does are indulging in absurd delusion that we can no longer afford. Remember when you used to be critical of your Democrat neighbors because they refused to see that their party had changed? Well that's you now.

The only thing that might actually save it is for you to leave it and support other brands. At this point, staying is enabling. They have no reason to change anything so long as you continue to support their brand instead of another brand. I am a part of a group, Neighbors of Arkansas, who are seeking ballot access. We are not quite a political party in the traditional sense of the word. We are more like a network of citizens than a formal hierarchy. Starting Sept. 22nd, we will be circulating petitions to get on the ballot. I ask you to go to the link and print off one petition and get nine other voters to sign it and mail it in to us. If you want to do more, get in touch with us, but if we all do a little, it will add up to a lot.


Wednesday, September 06, 2017

Sorting Out Governor's Claims on Medicaid Spending

The report was titled "Governor touts $175 million reduction in Medicaid spending last fiscal year" and it was in, of all places, the Arktimes Blog. They were suspicious, but short on specifics as to why. Poor though that is, it was still a step up over the establishment media in this state which simply reports these claims from the Governor as fact without any discernible attempt at actual journalism. I look at the bright side though, if they actually did what they are telling you their job is, then there would be no need for citizen bloggers like me to inform the public of the wide gap between Government claims and the real situation.
Not that I am saying that the Governor is lying. What he is saying may be technically true, you just have to listen to him real closely in order to avoid being misled. Nor can he fairly be blamed for putting what he is doing in the best possible light. Human beings are going to do that. But what is supposed to happen now is that the "watch dogs" of the media are supposed to come along and tell you the rest of the story. And that's where the system is failing. The Governor has an approval rating which is far higher than it would be if we had a functioning media in this state. By "functioning" I mean functioning in the traditional way that the media is supposed to- calling politicians on claims that are too skewed or misleading. The media we have now does function- to prop up and support the system we currently have in place regardless of whether it deserves it or not.
So first of all, when the Governor says that they had a $175 million reduction in Traditional Medicaid spending this does not mean that we spent $175 million less than the year before. It means that we spent less than was budgeted for this line item. That is, we did not spend as much as we planned to spend. It is actually unclear from the report whether we spent less on Traditional Medicaid in 2017 than we did in 2016. Now $175 million is a lot of money and if we really "saved" that much this year without spending less than we spent in 2016 then it would be an indication that our budgeted spending increases were pretty ridiculous. I can't tell if that happened or not from the Governor's report and it seems that none of his groupies in the state's media pool bothered to ask.
But the real thing you have to be careful of is that the Governor specified that traditional Medicaid spending was going down. You see, even though legislators like Davy Carter (and even Charlie Collins who is on the Governor's task force engineering these cuts) claimed that "The Private Option/Arkansas Works" were not expanding Medicaid, they were expanding Medicaid. They just didn't expand traditional Medicaid. Instead, they opened up a whole new strain of Medicaid Program. One whose primary goal was to siphon off money from D.C. to fund health insurance coverage for able-bodied adults. Other categories of people were and are served by the traditional Medicaid program.
So you have this new Medicaid program which is, no matter what they call it this year, the expansion of Medicaid for able-bodied adults authorized by Obamacare. Then you have traditional Medicaid which pays groups like developmentally disabled adults, the blind, nursing home care for the elderly, Autism therapy, and health care for many children via ARKIDS. So, new Medicaid is health coverage for able-bodied adults. Old Medicaid is for vulnerable people in our society like children, the aged, and the handicapped.
Total Medicaid spending has not been reduced in Arkansas. In fact it has increased dramatically over the last few years. This is because spending for the new Medicaid program for able-bodied adults has grown tremendously while the cuts are coming from the traditional Medicaid program. A look at the payment structure reveals why. Uncle Sam has paid all the bills for this new Medicaid program up until recently, and still pays for 95% of it now. For traditional Medicaid FEDGOV only pays around 70% of the tab.
Think about that. If the state spends more on Obamacare-Medicaid then Uncle Sugar pays for 95% of it, while he only pays for 70% of traditional Medicaid. So as near as I can tell what the Governor and most of the legislature have been doing is slashing the traditional Medicaid budget for blind people, for kids with autism, for children, and for the disabled, and instead putting every dollar they can in a mushrooming budget for the new Obamacare-Medicaid program for able-bodied adults. They are doing this because the program's incentives are set up so perversely that they can scam more money from Washington if they do this.
Not that FEDGOV really has the money to pay for all of this. They are borrowing it from the Chinese et al to buy votes now and plan on sticking the next generation of children with the tab. I don't complain about having the social programs, I know that with humanity in its current state we are better off with some social spending than without it. But by all means let each generation fully pay for whatever level of spending it finds appropriate. What we have now is people who are telling themselves how wonderful they are to vote to stick today's babies with a crushing amount of debt so that they can hand out social benefits. Even if the social program is good, the way we are paying for it is not.
If you or the ones you love are served by traditional Medicaid, expect more belt tightening to come- all so that able-bodied adults can get their health care for free. The "Provider Led Shared Saving Entity" (PASSE) is a convoluted new model by which the state wants to invent a middle-man to say "no" to traditional Medicaid spending. That is how I see it so far. That way the parents won't be mad at the Governor and legislators like Collins who are slashing the budget for blind people and poor children to pay for Obamacare. The state won't be telling the parents "no" directly anymore. Nor will the providers. Parents are supposed to be mad at this entity the state and the providers created instead. That model swings into operation next month I believe. Then the "savings" from traditional Medicaid to pay for new Medicaid will be even greater.
People who are served by these programs have to take a hard look at what is going on and decide if they are going to continue with this attitude that "all Medicaid is good Medicaid" and stick together with the Obamacare-Medicaid beneficiaries That model usually works but here the result is that the people who counted on traditional Medicaid are taking all the pain and the Obamacare-Medicaid gaining all the benefits. It is time to make some hard choices about which served group is most worthy of those dollars and advocate accordingly.