FLORIDA: 25 Reasons NOT to Take Federal Dollars to Expand Medicaid

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Monday, The Florida Legislature opened a special session to decide on the state budget and debate how Florida should move forward in regards to our healthcare future. The Senate offered a plan that supporters, including many business interests, sugarcoated in conservative buzzwords such as “a free market approach,” even though the plan is anything but. As we say here at The James Madison Institute, pro-business isn’t always pro-free market. House Republicans and Governor Rick Scott, for good reason, oppose expanding federal control and a flawed program in our state. The Senate approved its plan Wednesday and the House is set to debate the bill today and vote on it this Friday [May 5th].

The Tampa Bay Times recently released an editorial giving 25 reasons Florida should take the money and encouraging Floridians to “tell (lawmakers) to listen to the powerful moral and financial arguments for taking the money and providing access to affordable health care.” Yes, there is a powerful moral and financial argument to be made. Yes, solutions exist to provide access to affordable healthcare. No, the Times does not have the right answers for either.

As Forbes opinion editor, senior fellow at the Manhattan Institute for Policy Research, and friend of JMI, Avik Roy points out, “Progressives have long enjoyed wielding the straw man. “If you oppose expanding Medicaid,” they say, ‘you oppose health care for the poor. Plain and simple.’ But the truth is, if you support expanding Medicaid, you’re doubling down on a failed system, one that shuts the door on real reforms that could provide quality health care to those who most need it.”

The James Madison Institute offers “25 Reasons NOT to Take Federal

Dollars to Expand Medicaid.” Share our infographic today and tomorrow through social media. RT on Twitter here. Share through Facebook here. Find on our website here.

  1. Medicaid already takes up more than 30% of Florida’s budget: Currently, Medicaid takes up more than 30 percent of Florida’s budget and crowds out other public priorities such as education, public safety and infrastructure.
  2. Medicaid payment rates are well below market rates:Payments to healthcare providers under Medicaid are well below market rates. Exasperating this system would be anathema to free-market reforms in healthcare.
  3. The federal government is already $18 trillion in debt; Obamacare costs rise daily:The federal government is $18 TRILLION in debt with the cost of Obamacare rising daily, requiring even more money from taxpayers to feed the beast.
  4. The supply of doctors accepting Medicaid is shrinking: As a consequence of federal Medicaid price controls, the supply of doctors that will accept Medicaid patients is shrinking — this shrinkage will become more rapid under an expansion of Medicaid.
  5. Medicaid expansion leads to greater use of ERs, not less: A March 2015 survey of 2,098 emergency-room doctors showed Medicaid recipients newly insured under the health law are struggling to get appointments or find doctors who will accept their coverage, and consequently wind up in the ER.
  6. Arkansas’s “private option” costs state taxpayers tens of millions: Medicaid expansion is not working in Arkansas. The Arkansas legislature passed a “private option” healthcare plan similar to what the Senate in Florida is proposing and the price tag is rising by the month under Obamacare’s Medicaid expansion and state taxpayers will now have to pay tens of millions to cover the unexpected costs. The proposed plan in Florida could cost far more than projections indicate.
  7. Mandated premiums create inefficiencies in supply and demand for healthcare services: When premiums for healthcare plan participants are mandated and set by legislative action, it is nothing more than market distorting price controls, which ultimately create inefficiencies in the supply and demand for healthcare services
  8. Feds won’t approve Senate’s special waivers; Florida left with traditional Obamacare expansion: The Senate’s plan includes a requirement that enrollees work, attend classes or prove they are seeking work in order to maintain eligibility for healthcare coverage. However, to date the federal government has rejected all state-run expansion plans with a work requirement. They will deny this special waiver and we’ll be left with traditional Medicaid expansion.
  9. Oregon study revealed Medicaid enrollees hardly better off than uninsured: Medicaid expansion is not working in Oregon. In Oregon, a study was conducted among Medicaid enrollees that found Medicaid “generated no significant improvements in measured physical health outcomes.”
  10. Medicaid Expansion will do nothing to lower cost of overall healthcare delivery: Medicaid expansion would not lead to any type of price transparency in healthcare delivery, which does nothing to help lower the cost of healthcare delivery.
  11. Medicaid expansion does not lead to better health outcomes for the poor: Research consistently shows Medicaid patients frequently receive inferior medical treatment, are assigned to less-skilled surgeons, receive poorer postoperative instructions, and often suffer worse outcomes for identical procedures than similar patients both with and without health insurance.
  12. New Hampshire feels the financial burn and is reconsidering Medicaid expansion: Medicaid expansion is not working in New Hampshire. According to the National Association of State Budget Officers’ annual report, in New Hampshire Medicaid grew from 24 percent of the overall state budget in 2012 to 27 percent in 2014. In January 2015, the state’s Department of Health and Human Services announced that it was $82 million over budget, thanks to Obamacare, Medicaid expansion and to the original Medicaid program expanding with additional enrollees. Lawmakers are now deciding whether to continue the expanded Medicaid program which sunsets in 2016.
  13. The federal government’s promises aren’t reliable: The U.S. Supreme Court told the federal government mandating Medicaid expansion was unconstitutional. However, they admitted this year that if Florida didn’t expand Medicaid under Obamacare, they would not be incentivized to continue the Low Income Pool funding. If they would pull funding from some of the most vulnerable in the system, what wouldn’t they do?
  14. Florida taxpayers will foot the bill for billions: Florida taxpayers will be responsible for a tab of billions of dollars as the federal government requires increasing shares from Florida’s budget after a certain point if the state expands Medicaid under Obamacare. Even if the federal government keeps its “promise” on the funding percentage, Florida taxpayers will be responsible for 10 percent of the total cost of expansion, a tab that will run into the billions based on even the most conservative estimates.
  15. Having health insurance isn’t the same as receiving healthcare:Medicaid is socialized health insurance, not access to healthcare. There is no guarantee that just receiving socialized insurance means an individual receives quality service.
  16. The majority of the Medicaid expansion population consists of working-age adults: The overwhelming majority of the Medicaid expansion pool are made up of childless, able-bodied, working-age adults. Expanding a failing entitlement program for this population will only lock people into the cycle of dependence.
  17. Medicaid expansion creates a perverse disincentive to improving one’s financial status: In many cases, making just a few more dollars per year will actually cost a person thousands in copayments, deductibles, and out-of-pocket expenses resulting in being pushed out of Medicaid rolls.
  18. Illinois faced unanticipated cost increases in the billions:Medicaid expansion isn’t working in Illinois. Forbes’s Akash Chougule reports, “Health officials originally estimated it would cost $573 million from 2017 through 2020 when the state’s funding obligation kicked in. But nearly 200,000 more people enrolled in the program in 2014 than originally projected. State budget officials were forced to revise their cost estimates to $2 billion—more than triple initial estimates.”
  19. Medicaid will cost Florida way more than anticipated: The cost projections for a Medicaid expansion in Florida are unreliable and grossly underestimated. Several states are experiencing the financial strain of Medicaid enrollment figures well higher than initial projections.
  20. Medicaid expansion wouldn’t necessarily result in more coverage or access to care: Florida’s own Medicaid director stated that he couldn’t guarantee the expansion would result in more coverage or access to care.
  21. Medicaid expansion increases private insurance rates: Expanding Medicaid rolls will inevitably distort the risk pool causing private insurance premiums to rise, effectively shifting more of the cost of expansion onto taxpayers and those not receiving Medicaid benefits.
  22. Ohio taxpayers face a $400 million bill: Medicaid expansion isn’t working in Ohio. Ohio’s Medicaid expansion is expected to be nearly $1 billion over budget in June. With Ohio on the hook for 10 percent of the expansion’s cost by 2020 (if the federal government keeps its promise) that will result in an annual cost of over $400 million for Ohio taxpayers.
  23. Expanding Medicaid will likely increase fraud: Medicaid expansion will increase the amount of fraud and abuse within an already strained government program
  24. The systemic issues in the healthcare system will not go away:Expanding Medicaid does absolutely NOTHING to address systemic issues facing Florida’s healthcare system that impact everyone.
  25. Dependency cycle will expand beyond true safety net intent: 
    The idea behind the safety net programs has always been to serve individuals in need, while providing mechanisms to pull out of dependence into productivity, not to create generations of citizens who know nothing except government reliance. By expanding Medicaid to populations that are outside the typical safety net composition, we effectively enlarge and encourage the cycle of dependency to grow and become more ingrained in our culture.

EPA: Hydraulic Fracturing is No Threat to Drinking Water

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Hydraulic fracturing, when done correctly, is safe and saves Americans money. The science says so.

EPA looked at scientific studies, government, NGO, and industry data and concluded that hydraulic fracturing has not had “widespread, systemic impacts on drinking water.”

For those of us closely involved in the debate over shale energy, this report simply reaffirms what previous science has shown, as Katie Brown explains at Energy In Depth:

EPA’s study actually builds upon a long list of studies that show the fracking process poses an exceedingly low risk of impacting underground sources of drinking water.  It corroborates a “landmark study” by the U.S. Department of Energy in which the researchers injected tracers into hydraulic fracturing fluid and found no groundwater contamination after twelve months of monitoring. It is also in line with reports by the U.S. Geological Survey, the Government Accountability Office, the Massachusetts Institute of Technology, and the Groundwater Protection Council, to name just a few.

“The results of EPA’s exhaustive new analysis of hydraulic fracturing should not come as a surprise,” Christopher Guith, senior vice president for policy at the Institute for 21st Century Energy, said. “As the scope of America’s shale oil and gas opportunities have become understood, states and industry have developed regulatory environments and practices that ensure that hydraulic fracturing is done safely.”

In light of EPA’s study, some people have some reevaluating to do:

This study shows that states are successfully regulating hydraulic fracturing and duplicative federal rules aren’t needed. “Shale energy development continues to be a major economic driver of our economy, and it is critical that the federal government does not layer on duplicative and unnecessary regulations,” said Guith.

As for hydraulic fracturing opponents, they need to stop denying the science.

Meet Sean Hackbarth @seanhackbarth Follow @uschamber

EDITORS NOTE: The featured image is courtesy of a hydraulic fracturing site located atop the Marcellus shale rock formation in Pennsylvania. Photographer: Ty Wright/Bloomberg.

Caitlyn Jenner is only skin deep

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I did an interview with ABC Channel 7 journalist Alix Redmonde about Caitlyn (formerly known as Bruce) Jenner. You may watch my interview with Alix by going here. In video journalism not everything I or others interviewed said is published, so I wanted to expand on my thoughts about Caitlyn Jenner as well as the comments by transgender “Jimmy” featured in the ABC report.

I asked my wife what she thought of Bruce becoming a faux woman. Her initial response was that it was all about the money. Bruce needs to pay for his/her medical bills and provide, at least for the short term, a revenue stream. While this is certainly a rational short term answer, what else could be a reason for this drastic “transformation”.

I titled this column “Caitlyn Jenner is only skin deep” because that is what Caitlyn’s sexuality is, skin deep. Caitlyn is still Bruce, the only thing that has changed is the outward appearance of Bruce. Caitlyn’s outward appearance is a facade, it is an outward appearance that is maintained to conceal a creditable reality, the fact that Caitlyn is genetically still is a Y chromosome male. The reality is that Caitlyn is a man and Bruce can never change that reality. When I heard about Caitlyn I thought about Michael Jackson and how he tried in the 1980s to surgically become more white. Michael Jackson wanted to become something he is not.

That is the fundamental issue – trying to become what you are not. But at what cost?

I recently reviewed Alex Garland’s film Ex Machina. I wrote:

This film is disturbing because is shows how humans without a conscience (morality) can, when given the chance, pass along their lack of morality to a machine.

[ … ]

At the end of the movie Ava escapes from the laboratory. To achieve this escape she deceives Caleb and kills both Nathan, its creator, and Caleb. Perhaps the most telling scene in the film is at the end when Ava finds previous versions of itself and begins to take the skin off of a previous robot and puts the skin on itself to look more human.

You see for Ava being human is only skin deep. Ava lacks the conscience (morality) of a human. Nathan did not learn the lesson of Issac Asimov’s book “I Robot.” Machines are just that, machines. To believe otherwise is fool hardy at the least and deadly at the worst.

Humans must control their urges to use technology to become God, as Caleb points out to Nathan. Robots must never be allowed to act alone. Think of the film The Terminator. You see machines may have a goal but lack a soul.

The doctors, psychiatrists and others who have encouraged Bruce to become Caitlyn are using technology to become God, but this time with a human being. Just because we can use technology to create a faux woman, should we?

This video by Bill Finlay titled “Bruce Jennercide” explains the tragedy of the misuse of technology by man:

I asked Jack Rigby, a psychologist living in Australia who, “[I]n my early practice before I went sane many decades ago,  I worked with many, many homosexuals”: What is the social redeeming value of homosexuality, exactly? Jack wrote:

Utterly none. Individual homosexuals can be constructively integrated to the rest of the population by simply conforming to normal social mores and exercising discretion.

The interesting observation I made over many decades of association with sexually aberrant people, was that these people almost instinctively recognize others of the same state without any obvious physical indications.

However, in recent decades in the fractured Society in the West, there has been a very strange situation develop in which small numbers of Homosexuals have formed politically obnoxious very public and virulently demanding groups .

This is creating a very dangerous situation for the great bulk of homosexuals who live quiet and integrated lives because there will be, without question, a violent mass backlash against them in the not distant future as has always happened in the past throughout the history of all races, Religions and Societies.

I actually have a great deal of concern for the number of the normally integrated ones who will be innocently caught up in the eventual reaction of Society to these strident, insane  anti-social demands of the entirely unstable violent few, whose intolerable antics and demands have already surpassed any reasonable level of public tolerance.

This transformation is disturbing because is shows how humans without a conscience (morality) can, when given the chance, pass along their lack of morality to a man. You seem Jimmy, the transgender in the ABC video report, believes that Caitlyn will advance the LGBT cause. I fear the opposite is true. Society will eventually react to “these strident, insane anti-social demands of the entirely unstable violent few, whose intolerable antics and demands have already surpassed any reasonable level of public tolerance.”

Society will not accept Caitlyn. Only a few radicals will.

RELATED ARTICLES:

Psychiatrist: Transgender Is a Mental Disorder; Sex Change Biologically Impossible

Repentant Transsexual Warns Jenner: The “Hangover is Coming”

Et Tu, Bruce?

The good homosexual versus the bad homosexual — Assimilation versus Radicalization

The Special Treatment Homosexuals Demand

Small Numbers of Homosexuals have Formed Politically Obnoxious very Public and Virulently Demanding Groups

“I Had Sex Change Surgery and Regret It”: What Bruce Jenner, Diane Sawyer, and You Have to Hear [+video]

COURAGE?! Growing Outrage Over Gender-Bender Jenner Being Chosen Over Lauren Hill, Combat Vet Noah Galloway for ESPY Award

Anthrax Released: Should we be concerned?

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US Army Dugway Proving Ground Main GateThe abrupt news that live anthrax samples  had been shipped from the U.S. Army Dugway proving ground to laboratories in the U.S., an air base in South Korea and possibly Australia came as a reminder to Americans and the world that biological warfare  training exercises might lead to troubling inadvertent releases. Fortunately, 22 military personnel exposed at the south Korean  airbase are being treated with the antibiotic Cipro. However, this latest release of a BW agent has caused both the U.S. Army bio-warfare directorate and the CDC to review safety precautions, packaging and procedures for the transmission of possible live anthrax spores and why samples had not been made inert?

The BBC reported that the U.S. military has ordered a review of how it handles anthrax after discovering more cases of live samples being accidentally sent to labs:

Live anthrax samples were believed to have been sent to a total of 24 labs, in 11 U.S. states as well as South Korea and Australia, the Pentagon said.

The Pentagon says that there is no known risk to the general public.

Experts in bio-safety have heavily criticized the lapse and called for improved precautions.

Symptoms of anthrax exposure include skin ulcers, nausea, vomiting and fever, and can cause death if untreated.

News of the live shipments first emerged on Wednesday, as the U.S. said it had accidentally shipped live anthrax spores from Utah to labs in Texas, Maryland, Wisconsin, Delaware, New Jersey, Tennessee, New York, California and Virginia, as well as an air base in South Korea.

Those shipments took place between March 2014 and April 2015, a U.S. official said, according to Reuters.

On Friday, the Department of Defense said it had identified “additional inadvertent live anthrax shipments”, including a suspect sample sent to Australia from a batch of anthrax from 2008.

It is not clear when that sample was shipped to Australia.

The military has ordered all of its labs that have previously received inactive anthrax samples to test them. In addition it is advising all labs to cease working with these samples until told otherwise.

Shortly after 9/11, the American public concern over bio-terrorism was raised  by the release of Anthrax in powdered form in letters sent to members of Congress and randomly to private persons. 22 persons were sickened, 5 died, the U.S. Senate building was shut down and inspected.  Anthrax exists naturally, but more powerful variants have been developed synthetically by dual use laboratories in rogue states like Iran, North Korea and Assad’s Syria.  Bio-warfare laboratories have been established by Al Qaeda and ISIS has been rumored to have obtained access to materials in Syria, as well. Remember the arrest in Afghanistan, prosecution and conviction in the U.S. of Brandeis University and MIT trained scientist, “Lady Al Qaeda”, Aafia Siddiqui .  There is also evidence that Iran’s terrorist proxy, Hezbollah may have been transferred BW capabilities and agents  by Syria that could be deployed against America’s ally , Israel and globally through major transportation nodes in Europe.

Jill Bellamy van Aalst(3)

Dr. Jill Bellamy

We asked Dr. Jill Bellamy, noted expert on biological warfare and threat reduction about this latest incident.  We have published articles by Dr. Bellamy on Syrian, Hezbollah, Al Qaeda and Iranian BW programs in both the NER and our blog the Iconoclast.

She commented:

Clearly from a bio-safety perspective this is a very serious breach of protocol and demands a full and transparent investigation. As anyone who works with inactivated anthrax would be routinely vaccinated with AVA, exposure from a clinical perspective is probably not as much of a concern as the general public may believe. Of course if anyone outside military labs the live anthrax was sent to and persons who have not been routinely vaccinated were exposed, this would be concerning. I would worry about the time frame from exposure. It appears from the reports that we are talking about several weeks or months during which the anthrax was shipped. It is probably a good sign that none of the labs has reported a laboratory acquired disease or LAD. If exposure is known Cipro (ciprofloxacin hydrochloride) is given for inhalation anthrax and usually a 60 day course is advised. The lab workers in these labs  would surely  have all been vaccinated, so how much of a health risk it poses is debatable.

The bio-safety side is more worrying. CDC and a number of other labs have previously had exposures from the accidental handling of live anthrax. There are very stringent regulations in place for the shipping and transport of live agents. It is doubtful there was any risk to public health during the transport as this would be handled by the military. What is more problematic is that the research done  at US Army labs and Dugway proving ground  are critical to national security.  Incidents like this feed an uninformed section in non-proliferation circles who then call for the closing of these labs or hype the danger they pose to the general public. It makes it more difficult to assure the public that such labs are a vital aspect to protecting citizens from BW attacks and ensuring vaccines and therapeutic countermeasures are available and stockpiled in the event of a deliberate attack. Hopefully this is an incident we will learn a great deal from in terms of bio-safety training, protocols and bio-security.

EDITORS NOTE: This column originally appeared in the New English Review. The featured image is of  microscopic anthrax spores. Source: Reuters.

Who Should Choose? Patients and Doctors or the FDA? by Doug Bandow

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Good ideas in Congress rarely have a chance. Rep. Fred Upton (R-Mich.) is sponsoring legislation to speed drug approvals, but his initial plan was largely gutted before he introduced it last month.

Congress created the Food and Drug Administration in 1906, long before prescription drugs became such an important medical treatment. The agency became an omnibus regulatory agency, controlling everything from food to cosmetics to vitamins to pharmaceuticals. Birth defects caused by the drug Thalidomide led to the 1962 Kefauver-Harris Amendments which vastly expanded the FDA’s powers. The new controls did little to improve patient safety but dramatically slowed pharmaceutical approvals.

Those who benefit the most from drugs often complain about the cost since pills aren’t expensive to make. However, drug discovery is an uncertain process. Companies consider between 5,000 and 10,000 substances for every one that ends up in the pharmacy. Of those only one-fifth actually makes money—and must pay for the entire development, testing, and marketing processes.

As a result, the average per drug cost exceeds $1 billion, most often thought to be between $1.2 and $1.5 billion. Some estimates run more.

Naturally, the FDA insists that its expensive regulations are worth it. While the agency undoubtedly prevents some bad pharmaceuticals from getting to market, it delays or blocks far more good products.

Unfortunately, the political process encourages the agency to kill with kindness. Let a drug through which causes the slightest problem, and you can expect television special reports, awful newspaper headlines, and congressional hearings. Stop a good drug and virtually no one notices.

It took the onset of AIDS, then a death sentence, to force the FDA to speed up its glacial approval process. No one has generated equivalent pressure since. Admitted Richard Merrill, the agency’s former chief counsel:  “No FDA official has ever been publicly criticized for refusing to allow the marketing of a drug.”

By 1967 the average delay in winning approval of a new drug had risen from seven to 30 months after the passage of Kefauver-Harris. Approval time now is estimated to run as much as 20 years.

While economist Sam Peltzman figured that the number of new drugs approved dropped in half after Kefauver-Harris, there was no equivalent fall in the introduction of ineffective or unsafe pharmaceuticals. All the Congress managed to do was strain out potentially life-saving products.

After all, a company won’t make money selling a medicine that doesn’t work. And putting out something dangerous is a fiscal disaster. Observed Peltzman:  the “penalties imposed by the marketplace on sellers of ineffective drugs prior to 1962 seem to have been enough of a deterrent to have left little room for improvement by a regulatory agency.”

Alas, the FDA increases the cost of all medicines, delays the introduction of most pharmaceuticals, and prevents some from reaching the market. That means patients suffer and even die needlessly.

The bureaucracy’s unduly restrictive approach plays out in other bizarre ways. Once a drug is approved doctors may prescribe it for any purpose, but companies often refuse to go through the entire process again to win official okay for another use. Thus, it is common for AIDS, cancer, and pediatric patients to receive off-label prescriptions. However, companies cannot advertise these safe, effective, beneficial uses.

Congress has applied a few bandages over the years. One was to create a process of user fees through the Prescription Drug User Fee Act. Four economists, Tomas Philipson, Ernst Berndt, Adrian Gottschalk, and Matthew Strobeck, figured that drugmakers gained between $11 billion and $13 billion and consumers between $5 billion and $19 billion. Total life years saved ranged between 180,000 and 310,000. But lives continue to be lost because the approval process has not been accelerated further.

Criticism and pressure did lead to creation of a special FDA procedure for “Accelerated Approval” of drugs aimed at life-threatening conditions. This change, too, remains inadequate. Nature Biotechnology noted that few medicines qualified and “in recent years, FDA has been ratcheting up the requirements.”

The gravely ill seek “compassionate access” to experimental drugs. Some patients head overseas unapproved treatments are available. The Wall Street Journal reported on those suffering from Lou Gehrig’s disease who, “frustrated by the slow pace of clinical drug trials or unable to qualify, are trying to brew their own version of an experimental compound at home and testing it on themselves.”

Overall, far more people die from no drugs than from bad drugs. Most pharmaceutical problems involve doctors misprescribing or patients misusing medicines. The deadliest pre-1962 episode involved Elixir Sulfanilamide and killed 107 people. (Thalidomide caused some 10,000 birth defects, but no deaths.) Around 3500 users died from Isoproterenol, an asthmatic inhaler. Vioxx was blamed for a similar number of deaths, though the claim was disputed. Most of the more recent incidents would not have been prevented from a stricter approval process.

The death toll from agency delays is much greater. Drug analyst Dale Gieringer explained:  “The benefits of FDA regulation relative to that in foreign countries could reasonably be put at some 5,000 casualties per decade or 10,000 per decade for worst-case scenarios.  In comparison … the cost of FDA delay can be estimated at anywhere from 21,000 to 120,000 lives per decade.”

According to the Competitive Enterprise Institute, among the important medicines delayed were ancrod, beta-blockers, citicoline, ethyol, femara, glucophage, interleukin-2, navelbine, lamictal, omnicath, panorex, photofrin, prostar, rilutek, taxotere, transform, and vasoseal.

Fundamental reform is necessary. The FDA should be limited to assessing safety, with the judgment as to efficacy left to the marketplace. Moreover, the agency should be stripped of its approval monopoly. As a start drugs approved by other industrialized states should be available in America.

The FDA’s opinion also should be made advisory. Patients and their health care providers could look to private certification organizations, which today are involved in everything from building codes to electrical products to kosher food. Medical organizations already maintain pharmaceutical databases and set standards for treatments with drugs. They could move into drug testing and assessment.

No doubt, some people would make mistakes. But they do so today. With more options more people’s needs would be better met. Often there is no single correct treatment decision. Ultimately the patient’s preference should control.

Congress is arguing over regulatory minutiae when it should be debating the much more basic question: Who should decide who gets treated how? Today the answer is Uncle Sam. Tomorrow the answer should be all of us.

Doug Bandow

Doug Bandow is a senior fellow at the Cato Institute and the author of a number of books on economics and politics. He writes regularly on military non-interventionism.

Health Insurance Is Illegal by Warren C. Gibson

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Health insurance is a crime. No, I’m not using a metaphor. I’m not saying it’s a mess, though it certainly is that. I’m saying it’s illegal to offer real health insurance in America. To see why, we need to understand what real insurance is and differentiate that from what we currently have.

Real insurance

Life is risky. When we pool our risks with others through insurance policies, we reduce the financial impact of unforeseen accidents or illness or premature death in return for a premium we willingly pay. I don’t regret the money I’ve spent on auto insurance during my first 55 years of driving, even though I’ve yet to file a claim.

Insurance originated among affinity groups such as churches or labor unions, but now most insurance is provided by large firms with economies of scale, some organized for profit and some not. Through trial and error, these companies have learned to reduce the problems of adverse selection and moral hazard to manageable levels.

A key word above is unforeseen.

If some circumstance is known, it’s not a risk and therefore cannot be the subject of genuine risk-pooling insurance. That’s why, prior to Obamacare, some insurance companies insisted that applicants share information about their physical condition. Those with preexisting conditions were turned down, invited to high-risk pools, or offered policies with higher premiums and higher deductibles.

Insurers are now forbidden to reject applicants due to preexisting conditions or to charge them higher rates.

They are also forbidden from charging different rates due to different health conditions — and from offering plans that exclude certain coverage items, many of which are not “unforeseen.”

In other words, it’s illegal to offer real health insurance.

Word games

Is all this just semantics? Not at all. What currently passes for health insurance in America is really just prepaid health care — on a kind of all-you-can-consume buffet card. The system is a series of cost-shifting schemes stitched together by various special interests. There is no price transparency. The resulting overconsumption makes premiums skyrocket, and health resources get misallocated relative to genuine wants and needs.

Lessons

Some lessons here are that genuine health insurance would offer enormous cost savings to ordinary people — and genuine benefits to policyholders. These plans would encourage thrift and consumer wisdom in health care planning,  while discouraging the overconsumption that makes prepaid health care unaffordable.

At this point, critics will object that private health insurance is a market failure because the refusal of unregulated private companies to insure preexisting conditions is a serious problem that can only be remedied by government coercion. The trouble with such claims is that no one knows what a real health insurance market would generate, particularly as the pre-Obamacare regime wasn’t anything close to being free.

What might a real, free-market health plan look like?

  • People would be able to buy less expensive plans from anywhere, particularly across state lines.
  • People would be able to buy catastrophic plans (real insurance) and set aside much more in tax-deferred medical savings accounts to use on out-of-pocket care.
  • People would very likely be able to buy noncancelable, portable policies to cover all unforeseen illnesses over the policyholder’s lifetime.
  • People would be able to leave costly coverage items off their policies — such as chiropractic or mental health — so that they could enjoy more affordable premiums.
  • People would not be encouraged by the tax code to get insurance through their employer.

What about babies born with serious conditions? Parents could buy policies to cover such problems prior to conception. What about parents whose genes predispose them to produce disabled offspring? They might have to pay more.

Of course, there will always be those who cannot or do not, for one reason or another, take such precautions. There is still a huge reservoir of charitable impulses and institutions in this country that could offer assistance. And these civil society organizations would be far more robust in a freer health care market.

The enemy of the good

Are these perfect solutions? By no means. Perfection is not possible, but market solutions compare very favorably to government solutions, especially over longer periods. Obamacare will continue to bring us unaccountable bureaucracies, shortages, rationing, discouraged doctors, and more.

Some imagine that prior to Obamacare, we had a free-market health insurance system, but the system was already severely hobbled by restrictions.

To name a few:

  • It was illegal to offer policies across state lines, which suppressed choices and increased prices, essentially cartelizing health insurance by state.
  • Employers were (and still are) given a tax break for providing health insurance (but not auto insurance) to their employees, reducing the incentive for covered employees to economize on health care while driving up prices for individual buyers. People stayed locked in jobs out of fear of losing health policies.
  • State regulators forbade policies that excluded certain coverage items, even if policyholders were amenable to such plans.
  • Many states made it illegal to price discriminate based on health status.
  • The law forbade associated health plans, which would allow organizations like churches or civic groups to pool risk and offer alternatives.
  • Medicaid and Medicare made up half of the health care system.

Of course, Obamacare fixed none of these problems.

Many voices are calling for the repeal of Obamacare, but few of those voices are offering the only solution that will work in the long term: complete separation of state and health care. That means no insurance regulation, no medical licensing, and ultimately, the abolition of Medicare and Medicaid, which threaten to wash future federal budgets in a sea of red ink.

Meanwhile, anything resembling real health insurance is illegal. And if you tried to offer it, they might throw you in jail.

Warren C. Gibson

Warren Gibson teaches engineering at Santa Clara University and economics at San Jose State University.

FDA-generated Stevia Myth

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One recent “viral” email making the rounds claims that the natives of Paraguay have used the intense sweetener stevia as a contraceptive and that it can cause infertility. This raises suspicions because primitive societies are known for performing fertility rites so that women will reproduce. Primitive societies generally would never do just the opposite and seek a contraceptive method.

The FDA works hand in glove with the sweetener manufacturers, also warns that a supposed infertility effect is ascribed to stevia (with no data to back this claim), and has so far refused to assign it the GRAS (Generally Recognized as Safe) designation.

I have been translating patents relating to sweeteners for about 35 years and it would be hard to maintain that I am not a specialist on this subject. Interestingly, while patents relating to aspartame and sucralose (artificial sweeteners sold, for ex, as NutraSweet or Equal and as Splenda) often mention the known untoward effects of these substances, none of the patents (Japanese, German, Chinese, French, etc.) that I have translated mention any health drawbacks of stevia. If you try to tell a Japanese, for example, that you think stevia is unsafe, they will think you are insane. Their medical profession does its homework and would never fail to report any untoward side effects of stevia if there were any.

Stevia is a natural sweetener whose sweet principles (stevioside and rebaudioside) are the only intense sweeteners in nature without an off-taste. (Licorice, for ex, is also a natural sweetener but its sweet principle glycyrrhizin has a peculiar off taste. Non-intense sweeteners, or bulk sweeteners, are generally sugar alcohols such as xylitol, mannitol, maltitol, etc., and we aren’t discussing them here).

Stevia is a plant that grows to about a foot or more and its leaves are sweet. I have grown it myself to sweeten my coffee.

It is indigenous to Paraguay and the natives have been using it as a sweetener for years.

It is grown in various parts of South America, Asia and elsewhere, and is marketed in various countries. I believe it is available in the U.S. but the FDA refuses to classify it as GRAS. This is highly unusual because almost all natural substances that have been used for centuries in any country are automatically classified as GRAS by the FDA unless the native people who have used it have reported side effects. No Guarani Indians have issued such reports and they have used it for centuries. Further, according to the EUFIC, stevia sweeteners are approved for use in many countries including Japan, Korea, Taiwan, China, Russia, Mexico, Argentina, Colombia, Peru, Paraguay, Uruguay, Brazil and Malaysia.

So why might the FDA be out of step with the world?

Well, both Splenda and Nutrasweet / Equal are sold by American companies (JW Childs, Boston, and Merisant). In the case of Splenda, there is a British component in a joint venture, namely, Tate and Lyle, but Johnson & Johnson also sells it.

On the other hand, aspartame, which is known to be harmful to phenylketonurics and actually carries an FDA warning to that effect, is listed as GRAS by the FDA.

This is very suspicious to me.

Here is what Wikipedia says, raising more suspicion.

In 1991, after receiving an anonymous industry complaint, the United States Food and Drug Administration (FDA) labeled stevia as an “unsafe food additive” and restricted its import [THIS IS OUTRAGEOUS. AN ‘ANONYMOUS’ COMPLAINT DOES NOT MERIT SUCH A RESPONSE! — DON],.[40][59][60] The FDA’s stated reason was “toxicological information on stevia is inadequate to demonstrate its safety.”[61]

Since the import ban in 1991, marketers and consumers of stevia have shared a belief that the FDA acted in response to industry pressure.[40] Arizona congressman Jon Kyl, for example, called the FDA action against stevia “a restraint of trade to benefit the artificial sweetener industry”.[62] To protect the complainant, the FDA deleted names in the original complaint in its responses to requests filed under the Freedom of Information Act.[40]

Stevia remained banned until after the Dietary Supplement Health and Education Act of 1994 forced the FDA in 1995 to revise its stance to permit stevia to be used as a dietary supplement, although not as a food additive – a position that stevia proponents regarded as contradictory because it simultaneously labeled stevia as safe and unsafe, depending on how it was sold.[7]

Early studies prompted the European Commission in 1999 to ban stevia’s use in food in the European Union pending further research.[63] In 2006, research data compiled in the safety evaluation released by the World Health Organization found no adverse effects.[33] Since 2008, the Russian Federation has allowed stevioside as a food additive “in the minimal dosage required”.[51]

In December 2008, the FDA gave a “no objection” approval for GRAS status to Truvia (developed by Cargill and The Coca-Cola Company) and PureVia (developed by PepsiCo and the Whole Earth Sweetener Company, a subsidiary of Merisant), both of which use rebaudioside A derived from the Stevia plant.[64] However, FDA said that these products are not Stevia, but a highly purified product [THAT IS NONSENSE. STEVIA IS NEVER SOLD IN UNPURIFIED FORM. IT TASTES TOO BITTER FOR THAT. IN FACT, IN THE BUSINESS, STEVIA SWEET PRINCIPLES ARE SIMPLY CALLED STEVIA. THIS IS JUST AN EXCUSE FOR THE FDA TO WRIGGLE OUT OF ITS ORIGINAL BAN ON THE PRODUCT!–DON].[65] In 2012, FDA posted a note on its website regarding crude Stevia plant: “FDA has not permitted the use of whole-leaf Stevia or crude Stevia extracts because these substances have not been approved for use as a food additive. FDA does not consider their use in food to be GRAS in light of reports in the literature that raise concerns about the use of these substances. Among these concerns [NOTE: BASED ON AN ANONYMOUS REPORT, AS STATED ABOVE BY FDA. THAT IS OUTRAGEOUS BEYOND BELIEF–DON] are control of blood sugar and effects on the reproductive, cardiovascular, and renal systems.”[66]

So how has this stevia scare affected me personally? Right now, I am now sipping ice tea sweetened with stevia.

A Thousand Ways to Die

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Does a day go by when we are not warned about something that might do us harm or kill us?

I recently received an email from the Surgeon General of the United States in which he said, “Yesterday, I had the opportunity to meet with President Obama, EPA Administrator Gina McCarthy and health care professionals to discuss climate change. We talked about the impact of climate change on public health and the importance of prevention.”

The prevention of what? Climate change?

In the five thousand years of human civilization, there has never been, nor will ever be, a way to “prevent” climate change. This is not to say that earlier cultures didn’t try to solve drought or other weather-related problems by sacrificing the occasional virgin. We look back at that and regard it as primitive in the same way we find the notion of American Indians doing “rain dances” to induce a downpour to help the crops to grow a thing of the past.

The politicization of “climate change”, a planetary phenomenon that goes back about a billion or so years ago when the Earth took on its present atmosphere and weather patterns tells you everything you need to know about the White House and those who think they can tell outrageous lies to Americans, knowing at least half of them will believe those lives.

You’re not going to die from the “climate”, but what kills Americans is well known.

The good news is that we’re living longer lives than the generations that preceded us.

We can determine what we eat and how much. Some of us thrive on exercise and others do well by ensuring they get a good night’s sleep. There are behaviors we should avoid, but their harm can be traced from a lack of moderation. People who opt for genuinely bad behavior such as drug addictions or alcoholism are simply ruining their own lives and those who care about them.

The obstacles to a long, healthy life often involve factors over which we have no control. These include family histories of illness, genetically passed on from generation to generation.

There are some fifteen most common causes of death in America and they range from diseases of the heart (28.5%) down to homicide (0.7%). That’s right. Even though our media is filled with news of homicides and popular culture features murder, the likelihood of suffering death that way is very small.

Disease of the heart (28.5%) and malignant tumors (22.8%) are responsible for more than 50% of the annual death toll. Other leading causes drop off dramatically by comparison. They include cerebrovascular diseases (6.7%), chronic lower respiratory disease (5.1%), and accidents (4.4%).

On my Facebook page I asked my friends to list some of the things they have been warned about over the years. The list included salt, bacon, processed meats, eggs, soft drinks, saccharin, sugar substitutes, margarine, and chocolate. I have no doubt you can think of other things you’ve been told to avoid. Now, not including things like gluten or peanuts that activate allergic reactions in some people, these and comparable things are not likely to kill you. My rule of thumb has always been to eat the real, the natural food product like butter and avoid the substitutes.

I have no doubt that people have died from smoking. Cigarettes have long been called “coffin nails” in acknowledgment of the way too much smoking can affect one’s lungs. That said, I have smoked for some fifty years and a good cigar is daily pleasure. My Father smoked a pipe for just as long and lived into his 90s. My Mother who taught the art of gourmet cooking, complete with every delicious sauce and method of preparation you can imagine, lived until age 98. An international authority on wine, she would remind her students that you can find it mentioned frequently in the Bible. It is a healthy addition to your diet.

While we are constantly being warned against everything as a potential cause of death, you might find it of interest to learn that the American Medical Association conducted several research studies in the last decade, concluding that approximately 225,000 Americans died from their medical treatments!

Unnecessary surgeries caused 12,000 deaths and hospital medication errors killed 7,000. The odds of dying from an infection you pick up in the hospital is impressive; some 80,000 deaths were attributed to that, but the largest number of deaths, 106,000, were attributed to “negative effects of drugs.” To put it another way, “doctor-induced deaths are the third leading cause of death in the U.S. after heart disease and cancer.”

While we live daily with warnings about everything from the air we breathe to the water we drink (both quite clean), the Centers for Disease Control and Prevention (CDC) collects data on mortality, including suicide. In 2013, suicide was the tenth leading cause of death in America. Someone committed suicide every 12.8 minutes. From 1986 to 2000, suicide rates had dropped from 12.5 to 10.4 deaths per 100,000 people. It is back up to 12.6, mostly involving people 45 to 64 years old, as well as those over 85 and older. The rate among men is four times higher than women and whites killed themselves (14.2) far more often than blacks (5.4) and Hispanics (5.7).

While the White House is adding to our stressful lives with utter nonsense about “climate change”, claiming it is affecting our health, there’s another group, those in charge of the United nations Framework Convention on Climate Change (UFCC), whose greatest concern is the fact that there are some seven billion of us on planet Earth whom they blame for eating too much and using too much of its energy resources.

“Obviously less people would exert less pressure on the natural resources,” said Christiana Fiqueres, the Executive Secretary of the UNFCC. You can translate to mean that there are those at the United Nations who wouldn’t mind if a new plague came along to kill off thousands or if famine did the same thing.

You will live a lot longer if you figure out how to reduce the levels of stress in your life; if you eat well, but moderately; and if you avoid overdoing anything you know can harm you.

Don’t listen to the fear-mongers. In the words of Mr. Spock, live long and prosper.

© Alan Caruba, 2015

Hawaii’s $205 Million Obamacare Exchange Implodes

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by Alexander Hendrie, Americans for Tax Reform.

Despite over $205 million in federal taxpayer funding, Hawaii’s Obamacare exchange website will soon shut down.  Since its implementation, the exchange has somehow failed to become financially viable because of lower than expected Obamacare enrollment figures. With the state legislature rejecting a $28 million bailout, the website will now be unable to operate past this year.

According to the Honolulu Star-Advertiser the Hawaii Health Connector will stop taking new enrollees on Friday and plans to begin migrating to the federally run Healthcare.gov. Outreach services will end by May 31, all technology will be transferred to the state by September 30, and its workforce will be eliminated by February 28.

While the exchange has struggled since its creation, it is not for lack of funding. Since 2011 Hawaii has received a total of $205,342,270 in federal grant money from the Department of Health and Human Services (HHS). In total, HHS provided nearly $4.5 billion to Hawaii and other state exchanges, with little federal oversight and virtually no strings attached.

Despite this generous funding, the exchange has under performed from day one. In its first year, Hawaii enrolled only 8,592 individuals – meaning it spent almost $23,899 on its website for each individual enrolled. Currently over 37,000 individuals are enrolled in Hawaii’s exchange – well below the estimated 70,000 enrollees that is required to make the website financially viable. Unfortunately, taxpayers will have to hand out an additional $30 million so that Hawaii can migrate to the federal system.

This is not the first time that a state exchange has failed, and taken millions of dollars in federal funds down with it. Earlier this year, Oregon’s state exchange was officially abolished at an estimated cost of $41 million. Cover Oregon, as it used to be known received $305 million in funds from HHS but failed to produce a workable website months after the 2013 November deadline. The debacle has promoted numerous federal agencies and organizations to investigate allegations of inappropriate political interference from then Governor Kitzhaber’s 2014 reelection campaign.

Hawaii now joins Oregon, Massachusetts, Maryland, Vermont, New Mexico, and Nevada as cautionary tales in government central planning. With so many failed state exchanges, questions need to be asked about the haphazard allocation of billions of dollars in taxpayer funds and the complete lack of oversight.

EDITORS NOTE: The featured image is courtesy of Shutterstock.

Marijuana-induced psychotic episodes triple in Germany since 2000

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The number of patients admitted to hospitals with psychotic episodes after consuming marijuana in Germany has tripled since 2000, from 3,392 then to 11,708 in 2013. More than half were younger than age 25.

Andreas Bechdolf, chief of medicine for psychiatry and psychotherapy at the Berlin Urban Hospital, heads the Center for Early Intervention and Therapy, which focuses on adolescents. “The truly awful thing is that it often takes years before young adults with psychoses receive treatment, and many feel stigmatized,” he says. “It often takes another year from the point they start hearing voices before they finally take the step to open up to a doctor.”

His center works with several hundred patients ages 18 to 25 and the vast majority—from 80% to 90%—smoked marijuana regularly before their treatment began. Most were addicted.

Adolescents who smoke marijuana on a regular basis before age 15 are six time more likely to suffer from psychosis in later years. At first, they are unable to concentrate or put thoughts together. The meaning of once-familiar words is obscured. “Perceptions begin to change. Colors become more intense. A car that is 10 meters away might seem to be right in front of you.”

These early symptoms develop over three or four years, Bechdolf says. Then “acoustic hallucinations” appear, voices that unveil secrets or continuously comment on a person’s shortcomings. They feel they are being followed or spied on.

“Those who stop smoking pot have a very good chance of being healed,” Bechdolf says. But continued therapy on an outpatient basis after release from the hospital is key, he points out.

Read the full article here.

Texas and Kansas File Amicus Briefs Supporting Florida’s Lawsuit Against Expansion Of Obamacare

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AUSTIN – Governor Greg Abbott today filed an amicus brief in support of Governor Rick Scott and the State of Florida’s lawsuit against the Obama administration’s unlawful attempt to coerce the State of Florida into a massive expansion of Medicaid under the Affordable Care Act. Governor Abbott released the following statement:

“The federal government has overstepped its constitutional authority and ignored the Supreme Court’s decision in NFIB v. Sebelius, where the Court held that Congress could not coerce States into accepting a massive expansion of an already broken and bloated Medicaid program. The State of Texas will exercise its constitutional right to refuse Medicaid expansion, and we support the State of Florida’s effort to do the same.”

“[The Department of Health and Human Services (HHS)] has threatened to withhold from Florida billions of dollars in Medicaid payments, and it has issued similar threats to Texas, Kansas, and others,” wrote Governor Abbott in the amicus brief. “These threats are surely just the beginning of a nationwide campaign to hold hostage federal waiver dollars in those States who are standing firm on their constitutional right to refuse the new Medicaid.

“No litigant should be put to the choice of surrendering its day in court against an agency that is violating the constitution, or facing unjustifiable retaliation by the same agency in the future. HHS’s public reasons for harassing Florida do not withstand scrutiny. The agency picked this fight with Florida in an unlawful attempt to isolate, intimidate, and coerce, [and] the court should grant Florida’s request for declaratory and injunctive relief.”

To view the amicus brief in its entirety, click here.

Dr. Ben Carson Answers the Clamoring of Millions of Americans to Run for President

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MERRIFIELD, Va./PRNewswire/ — Citing the critical need to heal a nation more bitterly divided politically than it has been at any time in the past 150 years, Dr. Ben Carson on May 4th in Detroit announced his candidacy for the 2016 Republican presidential nomination.

“As a world-renowned neurosurgeon, Dr. Carson knows a thing or two about healing,” said John Philip Sousa IV, co-founder and chairman of The 2016 Committee, the political action committee originally formed to draft Carson into the presidential race. “I know I speak for millions of Americans in thanking Dr. Carson for entering this race and pledging to support his candidacy.”

“Dr. Carson’s candidacy represents the best and really the only opportunity we have to heal America and to bring Americans back together again under the banner of our Constitution,” Sousa added.

The Committee has been at the forefront of the movement urging Dr. Carson to run for president. Starting in August of 2013, it conducted  a petition campaign that ultimately collected more than 500,000 signatures from Americans urging Dr. Carson to enter the race. The Committee operates full time offices in Iowa and New Hampshire, and chairmen are in place in nearly every state coordinating more than 30,000 volunteers nationwide. The Committee has raised more than $16 million from more than 150,000 individual donors since 2013.

“For two years, Dr. Carson has said that if people clamored for him to run for president, he would have to answer their call,” said Vernon Robinson, The 2016 Committee’s campaign director. “Well, they indeed clamored, and he has answered them. But our work is far from over.  We will continue growing the massive grassroots network in pace to support Dr. Carson’s candidacy, and look ahead toward key Republican presidential straw polls and the September debate at the Ronald Reagan Presidential Library.”

“Dr. Carson’s candidacy will build on the massive grass-roots network that sprang up to encourage him to get into the race in the first place,” Robinson said. “He’s in it to win it, and we’re with him all the way.”

Dr. Carson is consistently among likely Republican voters’ top picks for the nomination. In one recent CNN survey, Dr. Carson placed second behind Mitt Romney but ahead of other likely contenders including formerFlorida Gov. Jeb Bush and New Jersey Gov. Chris Christie. Dr. Carson finished an impressive second place in the 2014 Bloomberg/Des Moines Register presidential poll of likely caucus-goers, and scored an overwhelming victory in the Polk County Republican Dinner in Des Moines in August. He also won the Linn County, Iowa, midterm caucus straw poll in January 2014.

The now-retired Dr. Carson chose Detroit for his announcement because that’s where he grew up and because he wanted to use the bankrupt city as a metaphor for President Obama’s failed economic policies. He says his campaign will speak out against Mr. Obama’s radical left-wing agenda, because he loves his country and wants to save it.

About The 2016 Committee

The 2016 Committee, formed expressly to draft Dr. Carson into the race for the 2016 Republican presidential nomination, was founded in August 2013. Going forward, it will work to raise awareness of Dr. Carson’s qualifications, and will engage grass-roots conservative activists on behalf of his candidacy to provide the margin of victory for Ben Carson. For more information, visit www.2016committee.org or connect on Twitter@DraftRunBenRun or Facebook.com/RunBenRun.org.

The Chart that Could Undo the Healthcare System: Skyrocketing costs are being driven by bureaucracy

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For a larger view click on the image.

This chart looks remarkably similar to a chart that tracks the growth of the administrative class in higher education. And that’s no accident. As the physician who shared the chart writes:

[The chart] outlines the growth of administrators in healthcare compared to physicians over the last forty years. And, it includes an overlay of America’s healthcare spending over that same time. Take a look at the yellow color. A picture is worth a thousand words, isn’t it?

You see, when you have that much administration, what you really have is a bunch of meetings. Lots of folks carrying their coffee from place to place. They are meeting about more policies, more protocols to satisfy government-created nonsense. But, this type of thing in healthcare isn’t fixing things. It’s not moving the needle.

What moves things is innovation.

Innovation, indeed. But it’s not easy to innovate in stagnant, hyper-regulated, captured sectors.

In Tyler Cowen’s 2011 book the Great Stagnation, he argued that the areas that were stagnating the most are education, healthcare, and government. Writing about Cowen’s book in his Wall Street Journal blog, Kelly Evans says:

A particular challenge we confront is that our progress as a society — chiefly, in extending and improving lives — is now at a point in which it appears to be undercutting our potential for further advancement. Part of this, Mr. Cowen observes, stems from well-meaning efforts to do more with education, government, and health care that instead seem to have backfired and left us with noncompetitive institutions closer to failing us than to serving us well.

With respect to healthcare, this chart gives us an indication of why these efforts are backfiring: The more an industry becomes like a regulated utility, the more administrators are required to enforce the regulations and administer the programs. And they, as well as the programs they administer, are expensive. All manner of distortions follow, and the costs of healthcare go up proportionally.

There also seems to be perverse incentives associated with subsidy: The more resources you dump in, the more expensive that industry becomes. You might shift the costs around on unsuspecting groups (like taxpayers), but in almost every case we see premium hikes and tuition increases in both of these industries, despite (or rather because of) the truckloads of federal largesse.

But they will have to stop at some point — one way or the other.

The US healthcare system has become something of a Frankenstein monster, with pieces stitched together ad hoc by regulators and special interests. The ACA seems to have ignored most of what really needed fixing and doubled down on the worst aspects of our system. Price transparency, affordability, innovation and competitive entrepreneurship have all gotten worse, not better. And the beast has grown to take over more than 17 percent of GDP.

(And if you think 17 percent is about right, consider that in Singapore healthcare takes up less than 3 percent of GDP.)

The trouble with any further healthcare reform is that a massive coalition of special interests in multiple sectors has formed as a husk around the entire industry — a care-tel, if you will — and they will be very difficult to dislodge.

Max Borders

Max Borders is the editor of the Freeman and director of content for FEE. He is also co-founder of the event experience Voice & Exit and author of Superwealth: Why we should stop worrying about the gap between rich and poor.

Women Making Waves Encouraging and Mentoring Young Girls

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Women Making Waves CEO and Founder Ashley Le Grange makes her first appearance on The Show. This extraordinary young woman created an organization that encourages and mentors young girls on how to stay on the right path and avoid the all too common perils prevalent in the current societal environment.

Please assist Women Making Waves with a generous financial contribution BETWEEN 5:00 pm Tuesday May 5 and 5:00 pm Wednesday May 6, 2015.

Your contribution will be matched by 25% during this 24 hour period!

Could You Spot a Potential School Shooter?

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In April 1999, we were all stunned by the news that Eric Harris and Dylan Klebold had attacked and killed students at Columbine High School in Littleton, Colorado and, more recently, in December 2012, that Adam Lanza, after killing his mother at home, then massacred twenty-six staff and students at Sandy Hook Elementary School in Newtown, Connecticut. These events evoke dread of potential events, a quest to understand why they occurred, and ways to avoid further comparable killings.

Cover - School ShootersPeter Langman has authored “School Shooters: Understanding High School, College, and Adult Perpetrators.” It offers very little comfort, but only because this psychologist, widely recognized for his expertise, is refreshingly honest.

“Many people seek to reduce school shootings to a bite-sized explanatory chunk, but the phenomenon defies easy analysis,” says Langman. “There is no one cause of school shootings, there is no one intervention that will prevent school shootings, and there is no one profile of a school shooter.”

He offers a wealth of information about forty-eight shooters He divides them into “Psychopathic shooters” whom he describes as “profoundly narcissistic, arrogant, and entitled; they lacked empathy, and met their needs at other’s expense” and ”psychotic shooters” who “suffered from schizophrenia or a related disorder. They were out of touch with reality to varying degrees, experiencing hallucinations or delusions.”

“Unlike the psychopathic and psychotic shooters, who generally came from well-functioning, intact families, traumatized shooters endured chronic abuse as children. They grew up in violent, severely dysfunctional homes.” Most fell into the first two categories.

I would like to offer the reader some comfort that school shooters can be “spotted” in advance, but in most the cases that Langman cites, they looked like everyone else in any school. Only if one of them was to confide his plan was there any opportunity to intervene and then only if he was reported.

Among the psychopathic category “at least 75 percent (nine out of twelve) had body issues. Many of these physical characteristics had a direct bearing on perceived manliness, including short stature, thin build, chest deformity, and fear of sterility” leading Langham to suggest a link between feeling weak or damaged and extreme narcissism. It is widely believed that bullying is linked to these events, but Langham notes that while about forty percent were harassed only one targeted a bully. While there is concern these days about bullying in schools, it is mostly due to a heightened awareness, not because there is more or less of it than has ever existed.

One thing does stand out, however, “nearly all shooters had bad educational experiences, including academic difficulties (failing classes, repeated grades, not graduating) or disciplinary problems…at least 92 percent had negative academic or disciplinary experiences.” And then there’s this: “At least 38 percent of shooters had relatives who worked or volunteered in schools.”

Another common factor was that “at least half of the perpetrators engaged in substance abuse (illegal drugs, prescription drugs, or alcohol.) In addition, “at least 42 percent of the shooters had a history of legal troubles, including arrests, contempt of court, and loss of a driver’s license.”

“Many shooters had trouble getting or holding jobs.” This was particularly true of the older shooters. Charles Whitman, an American engineering student at the University of Texas, gained infamy when in August 1966 he killed his wife and mother in their homes and later that day went to the Austin campus where he killed sixteen people and wounded 32 others over the course of ninety minutes, firing from the observation deck of the main building before being killed by an Austin police officer.

To academic and employment problems, add romantic failures. “Most shooters either failed to establish any romantic or sexual relationships or else suffered breakups or rejections that contributed to their anguish and anger.”

It should surprise no one that a number of the shooters “had specific role models for violence, including serial killers, mass murders, and other school shooters.” Most of them were psychotic, whereas the psychopaths “felt no need to attach themselves to a source of power; they were the source of power.”

Out of this densely documented book Langham concludes “There is no one way to prevent school shootings.” What also emerges is the fact that “Most school shooters leave a trail of warning signs that are either not noticed or not responded to.”

What the shootings are not about is gun ownership. Many of the shooters came from families that owned guns and used them for hunting or sport shooting. They had little reason to regard them as instruments with which to kill people other than their own twisted psychological interpretation.

What I came away with was the conclusion that the shooters are people we would all easily identify as “losers.” Beyond that, there is no specific way of identifying them, only suspicions of their capability to do the unthinkable.

© Alan Caruba, 2015