The State of Florida is subpoenaing nearly two dozen medical and academic organizations that have pushed transgender sex change treatments onto children as part of an ongoing lawsuit against a new Medicaid rule.
The Florida Agency for Health Care Administration (AHCA) subpoenaed 20 organizations in November to obtain information about their internal decision-making and leadership structure for pushing hormone treatments and transgender surgeries on minors, the Daily Caller has learned. The organizations signed onto a lawsuit against the state, which implemented a new rule in August to no longer cover “gender-affirming” care with Medicaid.
“Gender-affirming” care is a euphemism for treatments and procedures that facilitate sex changes, like hormone treatments or sex change surgeries.
Transgender rights groups are suing Florida over its Medicaid ban on gender-affirming care.
Their argument: the ban violates the federal equal protection clause & prevents an estimated 9,000 state Medicaid enrollees from receiving gender-affirming care.https://t.co/aBnHK5UfdH
Activists filed a preliminary injunction request against the rule, but a federal judge denied the request in October. Judge Robert Hinkle ruled that the question at hand was one for the Medicaid statute, not the Constitution.
The organizations being subpoenaed by the AHCA include the American Pediatric Association, American Academy of Child and Adolescent Psychiatry, American Medical Association, American Psychiatric Association, Pediatric Endocrine Society, Society for Adolescent Health and Medicine and Yale University.
Yale is included in the list, despite being an educational institution and not a medical organization, due to the involvement of Yale professors in pushing against the new rule. All 20 of the organizations being subpoenaed have either promoted or employ individuals who promote “gender-affirming” care for minors.
Court documents show that the AHCA wants information on those organizations’ stance on “gender-affirming” care, policies adopted to treat gender dysphoria, side effects associated with those policies and treatments, how the organizations are organized and how many of their members voted to support those policies and why the organizations wanted to file an amicus brief in the Florida case.
The formal request includes documents related to membership deliberations, gender dysphoria and “gender-affirming” care and the Florida lawsuit, Dekker v. Marstiller.
The plaintiffs in the suit have argued that the new Medicaid rule violates the equal protection clause of the U.S. Constitution. Two of the four plaintiffs that the suit was filed on behalf of are 12-year-old children. For now, Florida is now one of ten states that does not cover sex-change treatments under Medicaid.
http://drrich.wpengine.com/wp-content/uploads/logo_264x69.png00The Daily Callerhttp://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngThe Daily Caller2022-12-14 14:08:312022-12-14 15:03:12EXCLUSIVE: Florida Subpoenas Organizations Pushing Transgender Care On Children In Lawsuit
The New York State Supreme Court ruled Tuesday that New York City cannot fire employees for not getting vaccinated against COVID-19, dealing a blow to Democratic Mayor Eric Adams’ pandemic policy.
The court ordered the city to reinstate all fired employees and grant them backpay, citing the fact that being vaccinated against COVID-19 does not stop an individual from catching or spreading the virus, and thus being vaccinated does not grant enough community-wide benefit to warrant a mandate. The health commissioner “acted beyond his authority” by issuing an indefinite vaccine mandate rather than a temporary one, according to the court.
🚨🚨🚨🚨🚨 NY State Supreme Court reinstates all fired unvaccinated employees, orders backpay, says the state violated rights, acted arbitrary & capricious, notes:“Being vaccinated does not prevent an individual from contracting or transmitting Covid-19.”https://t.co/nvOsWfa56Spic.twitter.com/WhH4wje2bQ
Adams said earlier this year his administration would not bring back workers who had been fired due to being unvaccinated. Roughly 1,400 workers were ultimately let go, including a number of firefighters and police officers. Adams came under fire for not allowing an exception to the mandate for those workers after he granted one to celebrities who were competing in sports or putting on performances in the city.
“States of emergency are meant to be temporary,” the court said in its ruling. “The question presented is whether the health commissioner has the authority to enact a permanent condition of employment during a state of emergency.”
The court ultimately found that the commissioner did not have that right.
Many COVID-19 vaccine mandates were put in place based on the rationale that the vaccines could drastically reduce the chances of a person becoming infected or transmitting the virus if they were infected, so getting vaccinated was not only a benefit to the individual getting the shots, but everyone around them.
However, as more data emerged to indicate that the vaccines are only marginally effective at stopping spread, particularly against newer variants of the virus, that rationale became less convincing. The New York Supreme Court pointed this out in its decision, saying “being vaccinated does not prevent an individual from contracting or transmitting COVID-19… the Petitioners should not have been terminated for choosing not to protect themselves.”
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A federal judge ruled Wednesday that Florida can move forward with a new rule barring Medicaid funds from being spent on sex-changes and other transgender-related care.
A group of transgender rights organizations filed a preliminary injunction request against the rule after it was implemented by the Florida Agency for Health Care Administration in August, but Judge Robert Hinkle ruled against the request Wednesday. Hinkle stated that the challenge to the rule wasn’t a constitutional one, rather a question about the Medicaid statute.
Transgender advocates had alleged that the rule, which prevents the state from covering most “gender-affirming” care via Medicaid, violated the equal protections clause of the constitution. “There’s nothing wrong with the state saying they will approve treatment for this and not that,” Hinkle determined. “The question here is about the Medicaid statute.”
Gender-affirming care is a euphemism for treatments that facilitate sex changes. The Florida rule covers procedures including sex-change surgeries, behavioral therapy and hormone therapy.
The groups that filed the suit did so on behalf of four plaintiffs, two of whom are 12-year-old children. Florida has taken steps to push back on the promotion of transgenderism to children in recent months, including via the highly contentious Parental Rights in Education law.
One witness who testified for the state was New Jersey resident Yaakov Sheinfeld, whose 18-year-old daughter began the process of gender transition on the advice of a therapist who diagnosed her with gender dysphoria. Sheinfeld said his daughter’s anxiety and depression never went away, even after the “gender-affirming” care began, and she ultimately died of a drug overdose.
Florida is now one of ten states that doesn’t cover sex changes and related care under Medicaid.
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Nearly 20% of gay men who are contracting monkeypox in the U.S. reported having 10 or more partners in the three weeks before symptom onset, according to a new Centers for Disease Control and Prevention (CDC) report.
Virtually all monkeypox cases in the U.S. which have data available, 99%, are in men, the report also found, and 94% are in men who have sex with other men. The overwhelming majority had multiple sexual partners in the weeks leading up to their symptoms.
In addition to the 19% of men who said they had 10 or more partners over the three weeks preceding symptoms, 40% reported having two to four partners and 14% reported five to nine partners. 38% reported having group sex at a festival, group sex event or sex party.
The data was pulled from a sample of 358 men who contracted monkeypox for which data was available on recent sexual behaviors. That represents about 12% of all confirmed monkeypox cases in the U.S. between May 17 and July 22, the time period which the report covers. Age and gender identity data was available for 41% of all cases nationwide.
Of the 334 cases for which HIV status was known, 41% of patients were HIV-positive. Only 8% of patients were hospitalized, and there were no reported deaths. There remain zero confirmed deaths caused by monkeypox in the United States or Europe in 2022.
The Biden administration declared a public health emergency due to monkeypox last week, after the World Health Organization had already done so in July. Critics have accused the administration of not acting fast enough to respond to the outbreak, particularly as it regards vaccine procurement and distribution.
Data from the CDC, as well as the WHO and European health authorities, have increasingly shown that the virus is almost exclusively spreading within the homosexual male community, with some outlier cases within other demographics. Still, health authorities are engaged in intense debate over how to target messaging on the risks associated with monkeypox due to fears of directing stigma toward gay and bisexual men.
In its latest report, released Friday, the CDC admits “public health efforts should prioritize gay, bisexual, and other men who have sex with men.” However, the agency still does not recommend that gay and bisexual men have fewer sexual partners in its guidance on safe sex during the monkeypox outbreak. The WHO made that recommendation last month.
http://drrich.wpengine.com/wp-content/uploads/logo_264x69.png00The Daily Callerhttp://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngThe Daily Caller2022-08-07 14:05:542022-08-07 14:06:24CDC: One-In-Five Gay Men Who Got Monkeypox Had Sex With 10 Or More People Before Getting Infected
A “harm reduction” clinic that received grant funding from President Joe Biden’s Department of Health and Human Services (HHS) is distributing crack pipes to addicts in New York City, the Daily Caller confirmed Wednesday.
New York Harm Reduction Educators (NYHRE), a part of OnPointNYC, was awarded nearly $400,000 in grant money from the Biden administration in May to further its services for drug addicts, government records show. Biden officials denied reports that the grant money could fund distribution of crack pipes, but a visit to NYHRE’s office revealed that the organization still offers the smoking paraphernalia to addicts.
OnPointNYC operates two drug use sites, one of which NYHRE runs in East Harlem. After spending about 10 minutes on paperwork with basic information Wednesday evening, staff at the facility provided a Daily Caller reporter a smoking kit containing a crack pipe, condoms and lubricant.
A second Caller reporter returned Thursday and yet again, within minutes, staff provided another crack pipe. A staffer directed the reporter to back rooms for addicts to use drugs under supervision, where the reporter witnessed individuals smoking and injecting various substances.
A second Caller reporter returned Thursday and yet again, within minutes, staff provided another crack pipe. A staffer directed the reporter to back rooms for addicts to use drugs under supervision, where the reporter witnessed individuals smoking and injecting various substances.
The reporter, citing claustrophobia, asked if she could step outside to smoke. A staffer denied the request because the facility is located next to a “school.”
The facility is directly across the street from the Association To Benefit Children, a childcare facility for underprivileged kids in the New York area.
Prior to those visits, the Caller reached out to NYHRE and OnPointNYC on multiple occasions to ask if the organization was still distributing crack pipes, receiving no response. A PBS segment aired December 2021 highlighted that the organization was distributing crack pipes at the time, before the latest Biden grant.
NYHRE provides other services aside from harm reduction, including HIV and hepatitis testing, safe sex education and counseling services. It has received various government grants dating back to 2001 for some of these other services, a review of HHS grant documents shows. This year’s grant is the first “harm reduction” grant the group has received as part of a new administration initiative under Biden’s American Rescue Plan to support “harm reduction” efforts. The so called “safe smoking kits” are a key plank in “harm reduction” efforts across the country.
In addition to the drug and sex paraphernalia, a staffer at NYHRE gave the Caller an ID card after registering personal information. According to that staffer, an individual caught with drugs by police in the city could show that card to avoid punishment.
The Biden administration denied in February that it was giving grants to fund distribution of crack pipes, following a Washington Free Beacon report that HHS had closed applications for funding to do so.
“No federal funding will be used directly or through subsequent reimbursement of grantees to put pipes in safe smoking kits,” HHS Secretary Xavier Becerra said in a statement.
“The goal of harm reduction is to save lives. The Administration is focused on a comprehensive strategy to stop the spread of drugs and curb addiction, including prioritizing the use of proven harm reduction strategies like providing naloxone, fentanyl test strips, and clean syringes, as well as taking decisive actions to go after violent criminals who are trafficking illicit drugs like fentanyl across our borders and into our communities.”
An HHS spokesperson told the Daily Caller the funds from this grant are still prohibited from being used for any federally illegal activity or equipment, including drug paraphernalia like crack pipes. NYHRE has not yet tapped into the grant money they were awarded, and once they do so, the organization must provide specific details on how the money will be spent so HHS can approve it.
“No federal funding is used directly or through subsequent reimbursement of grantees to purchase pipes in safer smoking kits. Grants include explicit prohibitions of federal funds to be used to purchase drug paraphernalia,” the spokesman said. “As the United States confronts record overdose numbers, the Biden-Harris Administration is focused on a comprehensive drug control policy focused on stopping the illicit flow of drugs like fentanyl and evidence-based policies that reduce overdoses and save lives.”
The administration has embraced “harm reduction” — which can include supplying drug paraphernalia and in some cases drugs themselves — as a strategy for treating addiction. The effort facilitates drug use in a safer setting for addicts than they might otherwise use, and offers clean equipment for drug use to prevent the spread of disease.
In total, the SAMHSA grant awarded almost $10 million to 25 different organizations. The grant recipients are disproportionately located in New York and California, not areas within the rust belt hardest hit by the overdose epidemic. Six of the 25 grants went to harm reduction groups in New York state. The Daily Caller has not confirmed which of the other 24 organizations have provided, or still provide, safe smoking kits or crack pipes to addicts.
The Substance Abuse and Mental Health Services Administration (SAMHSA), which awarded the grants, did not respond to multiple requests for comment from the Daily Caller, including questions about whether the agency knew NYHRE distributed crack pipes when it awarded them the grant or how it is ensuring that taxpayer funds don’t go to the distribution of smoking equipment.
A federal judge struck down the Centers for Disease Control and Prevention’s (CDC) mask mandate for public transportation Monday.
District Judge Kathryn Kimball Mizelle of Florida’s middle district ruled that the mask mandate exceeds the CDC’s statutory authority under the Administrative Procedure Act, according to court documents. The lawsuit challenging the mandate was initially brought in July 2021 by the Health Freedom Defense Fund.
*MASK MANDATE FOR PLANES, TRAINS OVERTURNED BY FLORIDA JUDGE
Mizelle, an appointee of former President Donald Trump, ruled that the CDC’s order “violates the procedures required for agency rulemaking under the APA” and remanded the mandate order back to the CDC.
The judge who just overturned the mask mandate on airplanes is Kathryn Kimball Mizelle. 35-years-old, former Clarence Thomas clerked, appointed by Trump and confirmed by the Senate right before the lame duck session ended in 2020. pic.twitter.com/lu6ck1FIvT
The Biden administration has continued to extend the temporary mask mandate order throughout the pandemic, most recently announcing last week that the order would be extended at least 15 more days into May. With all 50 states and most localities having dropped their indoor mask mandates earlier this year, the federal mandate forcing Americans to mask on planes, trains and other public transit is one of the last remaining COVID-19 restrictions still in place.
Earlier this year, 21 states sued the Biden administration in an attempt to end the mandate. Biden’s CDC has come under further scrutiny for continuing to apply the public transportation mask mandate, citing the threat of the BA.2 Omicron subvariant of the coronavirus, while ending Title 42 and relaxing immigration enforcement, citing the reduced impact of the pandemic at this time.
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Natural immunity from prior infection granted stronger levels of protection against the Delta variant of COVID-19 than vaccination alone, the Centers for Disease Control and Prevention (CDC) said in a study released Wednesday.
Before Delta became dominant, individuals who had natural immunity were experiencing higher case rates than individuals who were only vaccinated, the study found, but after Delta took hold, those with natural immunity caught COVID-19 less frequently than those who were only vaccinated.
The study examined four categories of people — unvaccinated and vaccinated who survived a previous COVID-19 infection, and unvaccinated and vaccinated who had never been infected — in California and New York between May and November 2021. The highest case rates were among those who had neither been vaccinated or previously infected. The most protection against infection and hospitalization was in those who had both been vaccinated and survived an earlier bout with the virus.
The agency cautioned that the data in question only measured results against the Delta variant and that Omicron may present new challenges that alter the calculus of natural immunity versus vaccination.
Biden administration officials and some public health experts have repeatedly downplayed the effectiveness of natural immunity against COVID-19, but this study is only the latest to indicate that recovery from prior infection can at least rival, if not surpass, that offered from vaccination alone. Most research has shown that for maximum protection against reinfection or severe illness, those who were previously infected should still get vaccinated.
There are numerous national, state and local policies that require, and in some cases laws, that require Americans to self-quarantine and for businesses to shut down in order to reduce the spread of the Wuhan Flu also known as COVID-19.
Dr. John Ioannidis became a world-leading scientist by exposing bad science. But the COVID-19 pandemic could prove to be his biggest challenge yet.
In a wide-ranging interview with Greek Reporter published over the weekend, Ioannidis said emerging data support his prediction that lockdowns would have wide-ranging social consequences and that the mathematical models on which the lockdowns were based were horribly flawed.
Ioannidis also said a comprehensive review of the medical literature suggests that COVID-19 is far more widespread than most people realize.
“There are already more than 50 studies that have presented results on how many people in different countries and locations have developed antibodies to the virus,” Ioannidis, a Greek-American physician, told Greek Reporter. “Of course none of these studies are perfect, but cumulatively they provide useful composite evidence. A very crude estimate might suggest that about 150-300 million or more people have already been infected around the world, far more than the 10 million documented cases.”
So, if COVID-19 is far more widely spread then why don’t we stop the lockdown and allow Americans to get back to work?
Dr. Ioannidis stated:
“Major consequences on the economy, society and mental health” have already occurred. I hope they are reversible, and this depends to a large extent on whether we can avoid prolonging the draconian lockdowns and manage to deal with COVID-19 in a smart, precision-risk targeted approach, rather than blindly shutting down everything. Similarly, we have already started to see the consequences of “financial crisis, unrest, and civil strife.” I hope it is not followed by “war and meltdown of the social fabric.” Globally, the lockdown measures have increased the number of people at risk of starvation to 1.1 billion, and they are putting at risk millions of lives, with the potential resurgence of tuberculosis, childhood diseases like measles where vaccination programs are disrupted, and malaria. I hope that policymakers look at the big picture of all the potential problems and not only on the very important, but relatively thin slice of evidence that is COVID-19.”
Under President Trump our hospitals have the necessary equipment and personnel to deal with COVID-19.
Eleven of the 12 states (including the District of Columbia) with the highest COVID-19 fatality rates are traditional blue states. Leading the way, unsurprisingly, is New York, which posted the highest deaths, total (31,346) and per capita (1,611 per 1M).* New Jersey is not far behind New York, however (1,478/1M). These states are followed by Connecticut, Massachusetts, Rhode Island, and the District of Columbia. Just one red state—Louisiana, seventh highest with 680/1M—cracked the top twelve.
[ … ]
The question is, why?
After all, blue states tended to have the most stringent lockdowns. Indeed, eight red states—Arkansas, Iowa, Nebraska, North Dakota, South Dakota, Oklahoma, Utah and Wyoming—declined to issue stay-at-home orders at all (though some took less severe measures).
None of these states were among the states hardest hit by COVID-19.
As more people mingle more will become infected, however more will survive with the antibodies needed. As more people are tested for COVID-19 we will have more positives results for the virus. Most of those tested positive will recover completely from the virus.
So, is it better to allow people to mingle and get infected or not? This is a personal decision on each American. Government should not be mandating. Rather government should get out of the way.
If you have symptoms of COVID-19 go to the hospital. If you don’t feel well because you have the flu, or any other notable social diseases, stay home.
http://drrich.wpengine.com/wp-content/uploads/logo_264x69.png00Dr. Rich Swierhttp://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngDr. Rich Swier2020-07-05 07:21:582021-05-22 07:13:15Is it better for people to mingle and allow them to be infected with COVID-19?
“If the Supreme Court rules that Obamacare is out,” President Donald Trump said last week, “we’ll have a plan that is far better than Obamacare.”
Democrats couldn’t believe their luck. They still were reeling from special counsel Robert Mueller’s finding that the Trump campaign neither conspired nor coordinated with Russian efforts to interfere in the 2016 elections.
Now the president was changing the subject from collusion (a suddenly awkward topic for Democrats) to health care (which helped them capture dozens of House seats last November).
Besides, the president really doesn’t have a plan that is far better than Obamacare, or any plan at all. Right?
A look at his fiscal year 2020 budget shows that the president has a plan to reduce costs and increase health care choices. His plan would achieve this by redirecting federal premium subsidies and Medicaid expansion money into grants to states. States would be required to use the money to establish consumer-centered programs that make health insurance affordable regardless of income or medical condition.
The president’s proposal is buttressed by a growing body of evidence that relaxing federal regulations and freeing the states to innovate makes health care more affordable for families and small businesses.
Ed Haislmaier and I last year published an analysis of waivers that have so far enabled seven states to significantly reduce individual health insurance premiums. These states fund “invisible high risk pools” and reinsurance arrangements largely by repurposing federal money that would otherwise have been spent on Obamacare premium subsidies, directing them instead to those in greatest medical need.
By financing care for those with the biggest medical bills, these states have substantially reduced premiums for individual policies. Before Maryland obtained its waiver, insurers in the state filed requests for 2019 premium hikes averaging 30 percent. After the federal government approved the waiver, final 2019 premiums averaged 13 percent lower than in 2018—a 43 percent swing.
Best of all, Maryland and the other waiver states have achieved these results without increasing federal spending or creating a new federally funded reinsurance program, as House Speaker Nancy Pelosi, D-Calif., has proposed to do.
State innovation also extends to Medicaid. Some states have sought waivers permitting them to establish work requirements designed to help Medicaid recipients escape poverty.
Arkansas, for example, last June began requiring nondisabled, childless, working-age adults to engage in 80 hours of work activity per month. The program defined “work activity” broadly to include seeking a job, training for work, studying for a GED, engaging in community service, and learning English.
More than 18,000 people—all nondisabled and aged 30-49—were dropped from the rolls between September and December for failing to meet these requirements. The overwhelming majority did not report any work-related activity. All became eligible to re-enroll in Medicaid on Jan. 1. Fewer than 2,000 have done so, suggesting that most either don’t value the benefit or now earn enough to render them ineligible for Medicaid.
Nonetheless, last week a federal judge ordered Arkansas to drop its Medicaid work requirement, a requirement that would likely improve lifetime earnings of Medicaid recipients.
Administration efforts to relax federal rules to benefit employees of small businesses also were nullified last week by a federal judge.
Most uninsured workers are employed by small firms, many of which can’t afford Obamacare coverage for their employees. The Labor Department rule allowed small firms to band together, including across state lines, giving them purchasing power comparable to that of big businesses.
A study of association health plans that formed after the new rule took effect last September found that they offered comprehensive coverage at premium savings averaging 23%. The court ruling stopped that progress in its tracks.
Waivers and regulations that benefit consumers are susceptible to the whim of judges and bureaucrats, which is why Congress should act on the president’s proposal.
It closely parallels the Health Care Choices Proposal, the product of ongoing work by national and state think tanks, grassroots organizations, policy analysts, and others in the conservative community. A study by the Center for Health and the Economy, commissioned by The Heritage Foundation, found that the proposal would reduce premiums for individual health insurance by up to 32 percent and cover virtually the same number of people as under Obamacare.
It also would give consumers more freedom to choose the coverage they think best for themselves and their families. Unlike current law, states could include direct primary care; health-sharing ministries; short-term, limited-duration plans; and other arrangements among the options available through their programs.
Those expanded choices would extend to low-income people. The proposal would require states to let those receiving assistance through the block grants, Medicaid, and other public assistance programs apply the value of their subsidy to the plan of their choice, instead of being herded into government-contracted health maintenance organizations.
Outside groups that helped develop the proposal, which is similar to the president’s, are looking to refine it by incorporating other Trump administration ideas like expansion of health savings accounts, health reimbursement arrangements, and association health plans. They’re also reviewing various administration ideas to reduce health care costs through choice and competition.
The president really does have “a plan that is far better than Obamacare.” Congress should get on board.
Just two short years after the end of the Obama administration’s disastrous policies, America is once again thriving due to conservative solutions that have produced a historic surge in economic growth.
The Trump administration has embraced over 60 percent of The Heritage Foundation’s policy recommendations since his inauguration. But with the House now firmly within the grips of the progressive left, the victories may come to a screeching halt.
Why? Because they are determined more than ever to give the government more control over your lives. Restoring your liberty and embracing freedom is the best thing for you and the country.
President Donald Trump needs all of the allies he can find to push through the stone wall he now faces within this divided government. And the best way you can partner with him is by becoming a member of his greatest ally in Washington: The Heritage Foundation.
Will you activate your membership with a tax-deductible gift today?
EDITORS NOTE: This Daily Signal column is republished with permission.
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Why is Trump attacking the House Freedom Caucus? He has tweeted that “we must fight them.”
My first thought: this is inevitable. Destiny is unfolding before our eyes!
There is the obvious fact that the Freedom Caucus was the reason the GOP’s so-called replacement for Obamacare went down to defeat. They fought it for a solid reason: it would not have reduced premiums or deductibles, and it would not have increased access to a greater degree of choice in the health-insurance market.
These people knew this. How? Because there was not one word of that bill that enabled the health care industry to become more competitive. Competition is the standard by which reform must be judged. The core problem of Obamacare (among many) was that it froze the market in an artificial form and insulated it from competitive forces.At minimum, any reform must unfreeze the market. The proposed reform did not do that.
That means the reform would not have been good for the American people. It would not have been good for the Republican Party. And then the chance for real reform – long promised by many people in the party – would have been gone.
Trump latched on to the proposal without understanding it. Or, other theories: he doesn’t care, he actually does favor universal coverage even if it is terrible, or he just wanted some pyrrhic victory even if it did nothing to improve the access.
The Freedom Caucus killed it. And I’m trying to think back in political history here, is there another time since World War Two that a pro-freedom faction of the Republican Party killed a bill pushed by the majority that pertained to such a large sector and dealt with such a hugely important program?
I can’t think of one.
What this signifies is extremely important. We might be seeing the emergence of a classically liberal faction within the GOP, one that is self consciously driven by an agenda that is centered on a clear goal: getting us closer to an ideal of a free society. The Caucus isn’t fully formed yet in an ideological sense, but its agenda is becoming less blurry by the day. (And please don’t call them the “hard right wing.”)The old GOP coalition included nationalists, militarists, free enterprisers, and social conservatives. The Trump takeover has strained it to the breaking point. Now the genuine believers in freedom are gaining a better understanding of themselves and what they must do.
For the first times in our lives! Even in our parents’ and grandparents’ lives!
The Larger Picture
Trump is obviously not a student of history or political philosophy, but he does embody a strain of thinking with a history that traces back in time. I discussed this in some detail here, here, and here, among many other places. The tradition of thought he inhabits stands in radical opposition to the liberal tradition. It always has. We just remain rather ignorant of this fact because the fascist tradition of thought has been dormant for many decades, and so is strangely unfamiliar to this generation of political observers.
So let us be clear: this manner of thinking that celebrates the nation-state, believes in great collectives on the move, panics about the demographic genocide of a race, rails against the “other” invading our shores, puts all hope in a powerful executive, and otherwise believes not in freedom but rather in compliance, loyalty, and hero worship – this manner of thinking has always and everywhere included liberals (or libertarians) as part of the enemy to be destroyed.
And why is this? Liberalism to them represents “rootless cosmopolitanism,” in the old Nazi phrase. They are willing to do business with anyone, move anywhere, and imagine that the good life of peace and prosperity is more than enough to aspire to in order to achieve the best of all possible worlds. They don’t believe that war is ennobling and heroic, but rather bloody and destructive. They are in awe of the creation of wealth out of simple exchanges and small innovations. They are champions of the old bourgeois spirit.To the liberal mind, the goal of life is to live well in peace and experience social and financial gain, with ever more alleviation of life’s pains and sufferings. Here is magic. Here is beauty. Here is true heroism.
The alt-right mind will have none of this. They want the clash, the war, the struggle against the enemy, big theaters of epic battles that pit great collectives against each other. If you want a hilarious caricature of this life outlook, no one does it better than Roderick Spode.
This is why these two groups can never get along politically. They desire different things. It has always and everywhere been true that when the strongmen of the right-Hegelian mindset gain control, they target the liberals for destruction. Liberals become the enemy that must be crushed.
And so it is that a mere few months into the presidency of this odd figure that the Freedom Caucus has emerged as a leading opposition. They will back him where they can but will otherwise adhere to the great principle of freedom. When their interests diverge, the Freedom Caucus will go the other way. It is not loyalty but freedom that drives them. It is not party but principle that makes them do what they do.To any aspiring despot, such views are intolerable, as bad as the reliable left-wing opposition.
Listen, I’m all for working with anyone to achieve freedom. When Trump is right (as he is on environmental regulation, capital gains taxes, and some other issues), he deserves to be backed. When he is wrong, he deserves to be opposed. This is not about partisanship. It is about obtaining freer lives.
But let us not languish in naïvete. The mindset of the right-wing Hegelian is not at all the same as a descendant of the legacy of Adam Smith. They know it. We need to know it too.
Jeffrey Tucker is Director of Content for the Foundation for Economic Education. He is also Chief Liberty Officer and founder of Liberty.me, Distinguished Honorary Member of Mises Brazil, research fellow at the Acton Institute, policy adviser of the Heartland Institute, founder of the CryptoCurrency Conference, member of the editorial board of the Molinari Review, an advisor to the blockchain application builder Factom, and author of five books. He has written 150 introductions to books and many thousands of articles appearing in the scholarly and popular press.
https://drrichswier.com/wp-content/uploads/rand_amash_massie_mini-e1490994106655.jpg317640Foundation for Economic Education (FEE)http://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngFoundation for Economic Education (FEE)2017-03-31 17:06:252017-04-03 07:16:20Why Is Trump Waging War on the Freedom Caucus? by Jeffrey A. Tucker
There’s plenty of reason for free marketers to be skeptical of proposals, like the ones emanating from Democratic presidential candidate Bernie Sanders and hinted at by Republican Donald Trump, that would create a single-payer healthcare coverage system in the United States.
But, if only because these proposals have resonance with the public, they’re certainly worth debating. A rational debate depends on getting the facts straight and there’s one fact that both left and right often get wrong: “single payer” healthcare of the sort Bernie Sanders proposes isn’t universal in the developed world and the US system isn’t particularly free-market by the standards of peer nations.
Although definitions vary slightly, a single payer healthcare system is one where a single entity — a government-run insurance plan — pays all bills for a variety of medical care, and private payment for these same services is more-or-less banned.
Among the G-7 countries, only one nation, Canada, actually maintains such a system. One other, Italy, has a pretty similar system but allows much more private payment, and, because of the low standards of public hospitals, nearly everyone who can afford private insurance carries it.
Japan maintains a government-run healthcare plan, but it has so many gaps that most families find a need to carry private insurance to cover things like cancer-treatment related costs the public system excludes.
Germany, like the United States, has an employer-state hybrid system with heavy regulation of insurance companies.
France has a “dominant payer” system, where one quasi-governmental entity (CNAMTS) pays many bills, but about 90 percent of the population maintains private coverage as well, and most people pay something out of pocket each year.
The United Kingdom, finally, directly administers almost all medical personnel and facilities through a single governmental entity in each of the home countries. This is a “single provider” system.
Except in the United Kingdom, furthermore, there are significant numbers of people in all of these countries who report problems paying for needed medical care. This percentage is higher in the United States and Germany, intermediate in France, and lower in Canada. The UK only achieves its apparently enviable results because of long waiting lists for many procedures and health care rationing systems that are pretty close to the fictional “death panels” some conservatives claimed were part of Obamacare.
The American system as it exists isn’t unusually free market either. The German, French, and Japanese systems — where consumers much more frequently shop around for insurance plans they like rather than having the government or an employer chose — offer more consumer choices than most Americans enjoy. Even though taxpayers pick up a very large portion of the bills, the French practice of publically providing the prices of medical procedures makes that system feel a lot more like a free market than anything most Americans see day-to-day.
There are lots of valid criticisms of the United States’ healthcare system. The difficulty the poor or uninsured sometimes have in getting needed medical care is one of them. Some problems of the US health care system stem from lifestyle and cultural factors that organization and payment mechanisms can’t impact. But the lack of a single-payer system in the United States isn’t unusual in the slightest nor is the system we have particularly free-market.
Any debate should start by acknowledging both of those facts.
Eli Lehrer is president and co-founder of the R Street Institute, a free-market think tank.
https://drrichswier.com/wp-content/uploads/hillary-bernie-e1453493975824.jpg361640Foundation for Economic Education (FEE)http://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngFoundation for Economic Education (FEE)2016-01-22 15:21:492016-01-22 15:22:39No, the Rest of the World Doesn’t Use ‘Single Payer’ by Eli Lehrer
Those refugees with latent tuberculosis are admitted to the U.S. and some who are being treated for active tuberculosis may also gain entry.
We have an entire category here at RRWon refugee and immigrant health (286 previous posts!) and I’ve maintained for years that health problems coming into the US with refugees and the cost of treating the myriad diseases and chronic conditions could ultimately be more significant to your community than a terrorist attack might be.
That said, here is an informative article (hat tip: Joanne) from The Journal of Family Practice a few years ago which goes over the issues facing the medical community as we ‘welcome’ over 100,000 refugees and asylum seekers to America each year.
Pay special attention to the sections on Tuberculosis and HIV (there is no longer a bar to admission for HIV/AIDS and refugees are no longer even tested for it in advance of admission). Other big medical issues include intestinal parasites and hepatitis. And, of course mental health.
In 2012 we posted a film describing how refugees with active TB were being prepared for entry into the U.S., here.
Here is how the Journal of Family Practice article opens:
Refugees arrive in the United States with complex medical issues, including illnesses rarely seen here, mental health concerns, and chronic conditions such as diabetes and hypertension.
I encourage all of you working in ‘pockets of resistance’ to be sure to do your homework on health issues, including mental health issues. According to Anastasia Brown of the US Conference of Catholic Bishops, 75% of Iraqis entering the US have mental illness. See Journal of Migration and Human Security report, here.
The Centers for Disease Control also has important information on its website, here.
And, in the past we have noted that both Texas and Minnesota health departments have lots of good information about refugee health on their websites, and I expect some other states do as well. If your state health department does not report on refugee medical problems that is something you should be advocating for where you live.
Hundreds of thousands people will lose their insurance plans as a raft of health insurance cooperatives (CO-OPs) created by the Affordable Care Act will cease operations.
Just last week, CO-OPs in Oregon, Colorado, Tennessee and Kentucky announced that they would be winding down operations due to lower than expected enrollment and solvency concerns (although the one in Colorado issuing the state over the shutdown order). They join four other CO-OPs that have announced that they would be closing their doors.
In total, only 15 out of the 23 CO-OPs created by the law remain. These closures reveal how ill-advised this aspect of the ACA was both in terms of lost money and the turmoil for the people who enrolled in them. The eight that have failed have received almost $1 billion in loans, and overall CO-OPs received loans totaling $2.4 billion that might never get paid back.
In addition, roughly 400,000 people will lose their plans.
Proponents of the CO-OPs believed that they would be able to offer lower premiums than for-profit insurers because they did not have the same profit motive, but even non-profit insurers cannot operate at a financial loss indefinitely.
When they were created, these CO-OPs had no customers, no experience in setting premiums, no networks and limited capital. The government tried to subsidize the early period of uncertainty by disbursing loans to help with startup and solvency issues, and money from other provisions like risk corridors would dampen losses in the initial years.
Lower than expected payments from the risk corridors have exacerbated the issues facing some of these CO-OPs, who were counting on substantial payments to stay afloat. But this is hardly the only factor contributing to their struggles, some of them the product of other government policies like delaying employer mandate penalties and giving states the option to allow transitional policies through 2017.
Some of these later developments could not have been anticipated, but many analysts, including Cato scholars, were skeptical about the prospects of CO-OPs from the beginning. Even some ACA supporters recognized the flaws inherent in the CO-OP design: Paul Krugman derided them as a “sham” and in a 2009 interview Professor Timothy Jost said could not see how a CO-OP “does anything to control costs.”
There have been multiple warning signs that many CO-OPs were in trouble. Earlier this year The Centers for Medicare and Medicaid Services sent letters to 11 CO-OPs placing them on “enhanced oversight” due to financial concerns, and a 2014 report from the HHS Office of Inspector General found that “most of the 23 CO-OPs we reviewed had not met their initial program enrollment and profitability projections,” and that the government “had not established guidance or criteria to assess whether a CO-OP was viable or sustainable.”
These CO-OPs were not a good idea at inception and were always going to face many obstacles to success. Multiple changes to the law since they were established have exacerbated these problems, and already struggling CO-OPs have folded. Competition is indeed vital in health insurance markets, but the CO-OPs were a bad way to try to foster this competition.
With these closures, billions of taxpayer dollars could be lost and hundreds of thousands of people will discover that the “if you like your plan, you can keep it” promise does not apply to them.
https://drrichswier.com/wp-content/uploads/obamacare-wiley-the-fox.jpg390600Foundation for Economic Education (FEE)http://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngFoundation for Economic Education (FEE)2015-10-27 06:25:562015-11-06 08:52:32One-Third of Obamacare Co-Ops Shut Down by Charles Hughes
I have long argued that the FDA has an incentive to delay the introduction of new drugs because approving a bad drug (Type I error) has more severe consequences for the FDA than does failing to approve a good drug (Type II error).
In the former case, at least some victims are identifiable and the New York Times writes stories about them and how they died because the FDA failed. In the latter case, when the FDA fails to approve a good drug, people die but the bodies are buried in an invisible graveyard.
In an excellent new paper (also here), Vahid Montazerhodjat and Andrew Lo use a Bayesian analysis to model the optimal tradeoff in clinical trials between sample size, Type I and Type II error.
Failing to approve a good drug is more costly, for example, the more severe the disease. Thus, for a very serious disease, we might be willing to accept a greater Type I error in return for a lower Type II error. The number of people with the disease also matters. Holding severity constant, for example, the more people with the disease the more you want to increase sample size to reduce Type I error. All of these variables interact.
In an innovation, the authors use the US Burden of Disease Study to find the number of deaths and the disability severity caused by each major disease. Using this data, they estimate the costs of failing to approve a good drug. Similarly, using data on the costs of adverse medical treatment, they estimate the cost of approving a bad drug.
Putting all this together the authors find that the FDA is often dramatically too conservative:
We show that the current standards of drug-approval are weighted more on avoiding a Type I error (approving ineffective therapies) rather than a Type II error (rejecting effective therapies).
For example, the standard Type I error of 2.5% is too conservative for clinical trials of therapies for pancreatic cancer — a disease with a 5-year survival rate of 1% for stage IV patients (American Cancer Society estimate, last updated 3 February 2013).
The BDA-optimal size for these clinical trials is 27.9%, reflecting the fact that, for these desperate patients, the cost of trying an ineffective drug is considerably less than the cost of not trying an effective one.
(The authors also find that the FDA is occasionally a little too aggressive, but these errors are much smaller: for example, the authors find that for prostate cancer therapies the optimal significance level is 1.2% compared to a standard rule of 2.5%.)
The result is important especially because, in a number of respects, the authors underestimate the costs of FDA conservatism.
Most importantly, the authors are optimizing at the clinical trial stage assuming that the supply of drugs available to be tested is fixed. Larger trials, however, are more expensive, and the greater the expense of FDA trials, the fewer new drugs will be developed. Thus, a conservative FDA reduces the flow of new drugs to be tested.
In a sense, failing to approve a good drug has two costs: the opportunity cost oflives that could have been saved and the cost of reducing the incentive to invest in R&D.
In contrast, approving a bad drug, while still an error, at least has the advantage of helping to incentivize R&D (similarly, a subsidy to research incentivizes R&D in a sense mostly by covering the costs of failed ventures).
The Montazerhodjat and Lo framework is also static: there is one test and then the story ends.
In reality, drug approval has an interesting asymmetric dynamic. When a drug is approved for sale, testing doesn’t stop but moves into another stage, a combination of observational testing and sometimes more RCTs — this, after all, is how adverse events are discovered. Thus, Type I errors are corrected.
On the other hand, for a drug that isn’t approved, the story does end. With rare exceptions, Type II errors are never corrected.
The Montazerhodjat and Lo framework could be interpreted as the reduced form of this dynamic process, but it’s better to think about the dynamism explicitly because it suggests that approval can come in a range for forms — for example, approval with a black label warning, approval with evidence grading, and so forth. As these procedures tend to reduce the costs of Type I errors, they tend to increase the costs of FDA conservatism.
Montazerhodjat and Lo also don’t examine the implications of heterogeneity of preferences or diseases morbidity and mortality. Some people, for example, are severely disabled by diseases that on average aren’t very severe — the optimal tradeoff for these patients will be different than for the average patient. One size doesn’t fit all.
In the standard framework, it’s tough luck for these patients. But if the non-FDA reviewing apparatus (patients/physicians/hospitals/HMOs/USP/Consumer Reports, and so forth) works relatively well — and this is debatable, but my work on off-label prescribing suggests that it does — this weighs heavily in favor of relatively large samples but low thresholds for approval.
What the FDA is really providing is information, and we don’t need product bans to convey information. Thus, heterogeneity (plus a reasonable effective post-testing choice process) mediates in favor of a Consumer Reports model for the FDA.
The bottom line, however, is that even without taking into account these further points, Montazerhodjat and Lo find that the FDA is far too conservative, especially for severe diseases. FDA regulations may appear to be creating safe and effective drugs, but they are also creating a deadly caution.
Alex Tabarrok is a professor of economics at George Mason University. He blogs at Marginal Revolution with Tyler Cowen.
https://drrichswier.com/wp-content/uploads/hospical-hallway-e1441545977501.jpg426640Foundation for Economic Education (FEE)http://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngFoundation for Economic Education (FEE)2015-09-06 09:27:592015-09-06 09:46:41A Deadly Caution: How the FDA’s Precautionary Principle Is Killing Patients by Alexander Tabarrok
James O’Keefe, founder of Project Veritas, reports:
It has been over a year since the truth about the VA’s abysmal and unacceptable practices were thrust to the forefront of American politics, and yet there has been no discernible change in this bureaucratic nightmare. Our nation’s veterans deserve so much more and this continued mistreatment of our nation’s heroes is a troubling trend that shows no signs of any, let alone imminent, improvement.
Watch Project Veritas’ latest undercover video below showing that after more than a year of significant public outcry over incredibly long wait times, which in numerous cases resulted in the deaths of veterans, the VA is still failing to meet the basic needs of our veterans. Project Veritas investigative journalists captured on hidden camera a host of VA doctors, staffers, and one top official speaking about the many problems that persist at the VA despite official claims to the contrary.
Among the outspoken was Dr. Kristoffel Dumon, a general surgeon for the VA in Philadelphia, who told a Project Veritas undercover journalist that the VA has a “culture of unaccountability at every level.”
In this latest Project Veritas video, VA Undersecretary and Brigadier General Allison Hickey was captured on hidden camera saying that once veterans enter “the appeals process all bets are off, the only solution to that is changing the law or more people.”
A Project Veritas journalist also spoke with Scott Westguard, a VA contractor, who said on hidden camera that “it’s messed up, it’s dysfunctional, it’s incapable of getting the job done because people are there simply picking up the paycheck. There’s no accountability.”
Project Veritas also caught up with Dr. Raul Zambrano, a VA Medical Officer in the VISN & Network Office, who stated that: “we’re way below water in terms of the ability to supply, to meet the requests that’s demanded.”
It’s been 16 months since we learned of the waiting time scandal at the VA. In our last video covering the VA scandal, we identified that 22 of our nation’s heroes were dying by their own hands each day, as opposed to on the battlefield. Our first VA video has already been used to brief Congressmenabout overprescribing dangerous medications to veterans at a recent hearing on Capitol Hill.
In this video, we reveal some of the key underlying flaws within the VA which clearly make the system seem absolutely broken. Our veterans clearly deserve better.
https://drrichswier.com/wp-content/uploads/veterans-administration.jpg312628Dr. Rich Swierhttp://drrich.wpengine.com/wp-content/uploads/logo_264x69.pngDr. Rich Swier2015-07-06 07:55:022015-07-06 08:18:16U.S. Veterans Administration: Still “Dysfunctional” with “Unaccountability at Every Level”