The Medicaid Fallacy

As are many states, the Maine legislature is fighting tooth and nail to expand Medicaid under the hope that if more people have health-care coverage, the more healthy the population will be. In reality it is the opposite. You may ask how can that be. The short answer is Medicaid drives up costs and produces poorer medical treatment outcomes. That sounds backwards doesn’t it. Lets take a closer look to see why.

Medicaid is a publicly funded health insurance program run by the state and subsidized by the federal government. The Federal government matches Maine’s spending at 61.8% That means for every dollar Medicaid spends 61.8 cents comes from Washington. There is no cap on this subsidy so the more Maine spends, the more Washington pitches in.

Because of the matching fund formula states like Maine are reluctant to adopt cost-reducing policies. This creates a bias in favor of maintaining or expanding the program. Additionally, any savings a state realizes must be shared equally with the federal government, further reducing incentives to cut costs.

Medicaid payments for care vary from 58% to 75% of what private insurance pays for the the same care. In addition excessive and complex paperwork result in late payments or denial or payment. As a result Doctors are reluctant to accept Medicaid clients. Or the reduced reimbursement fee is passed on to patients with private insurance. The end result is an over all reduction the availability of health care for Medicaid recipients.

Medicaid contributes to poorer treatment outcome. Limited access to doctors and treatment are likely to cause patients to put off seeing doctors and are more likely to use emergency care. Medicaid recipients are three times more likely to use emergency room than patients with private insurance. As a result patients on Medicaid have a greater frequency of a late diagnosis. As a result patients on average stay an extra three days in hospital visits over patients with private insurance. The mortality rate among Medicaid patients is twice that of a patient with private insurance.

Last but not least Medicaid has shown no overall positive effect on health for the general population. Data from the Oregon Study ( a two year randomized controlled study) suggests that Medicaid has no real impact o the over all health of Oregon’s population. The two year study revealed that there was no change in hypertension or high cholesterol. In fact the risk of diabetes increased. The only positive outcome was a reduction in depression.

Instead of expanding Medicaid it should be at a minimum be reformed. For example, replacing the matching grant formula with fixed payment will give states freer reign to adopt reform without seeking permission and give states stronger financial incentives and greater ability to manage their programs. By using block grants you can create a fixed grant, that is indexed to inflation. Block grants do not increase as program spending increases. This gives states a stronger incentive to control costs without penalizing them.

In conclusion Medicaid is the largest public health program for low-income individuals and families. Expanding Medicaid recipients will add significantly to the cost of health care and will result in lower patient outcomes for the poor enrolled in Medicaid and no significant change in the overall health of Mainers. Clearly private insurance is a better alternative. it should be the goal of the federal and state government to exit the insurance market all together and let free markets and consumers control costs.

Sources: “Oregon Experiment – Effects of Medicaid on Clinical Outcomes” New England Journal of Medicine and “The Economics of Medicaid” Mercatus Center


Freedom of Association

The article referenced below is a great example of one class of individuals having rights over another. A photographer is being forced to shoot a lesbian wedding. Somehow I don’t think that is how it is supposed to work. But then I guess freedom of association was thrown out long ago with the advent of civil rights.

Don’t get me wrong, I have nothing against people living their lives as they see fit. I don’t care about your sexual preferences, race or religion. Its really none of my business. But its supposed to work both ways.  In this example if someone refuses to do business with you for whatever reason that may be , it is simply an opportunity for another entrepreneur to step in.

I recall wanting to rent a house many years back. Just before signing the lease, the owner told me he and his wife did not want to rent to me because they felt it was immoral to have an unmarried couple living on their property. Could I have complained? Was it inconvenient? Yes to both questions. But then why would I want to associate with people that draconian? Instead I respected their beliefs and their right to use their property as they see fit. So I looked for another house to rent. On that note, I cannot imagine how well the photo shoot would turn out. Would you want someone to photograph your wedding against their will?

The Constitutional Right to Conscript a Wedding Photographer

Alternatives to Government Services

Here is an interesting column I stumbled across entitled “How Neighbors are Better than Government Services” The following two paragraphs really stand out:

“The United States were deliberately constructed to minimize control by establishing mere framework within which individuals could voluntarily operate without being violated by others. We’re light years away from that concept now… in fact, in many ways we are less free than China, Cuba, or Russia. How? Bureaucracy.

Bureaucracy is fundamentally opposed to voluntary action. Bureaucracy is governance by non-elected officials. Those officials are paid by funds taken involuntarily from private individuals under threat of imprisonment and/or theft of property.”

To read the original article click here.

The Ten Principles of a Free Society:

1. Rights belong to individuals, not groups; they derive from our nature and can neither be granted nor taken away by government.

2. All peaceful, voluntary economic and social associations are permitted; consent is the basis of the social and economic order.

3. Justly acquired property is privately owned by individuals and voluntary groups, and this ownership cannot be arbitrarily voided by govenments.

4. Government may not redistribute private wealth or grant special privileges to any individual or group.

5. Individuals are responsible for their own actions; government cannot and should not protect us from ourselves.

6. Government may not claim the monopoly over a people’s money and government must never engage in official counterfeiting, even in the name of macroeconomic stability.

7. Aggressive wars, even when called preventive, and even when they pertain only to trade relations, are forbidden.

8. Jury nullification, that is, the right of jurors to judge the law as well as the facts, is a right of the people and the courtroom norm.

9. All forms of involuntary servitude are prohibited, not only slavery but also conscription, forced association, and forced welfare distribution.

10. Government must obey the law that it expects other people to obey and thereby must never use force to mold behavior, manipulate social outcomes, manage the economy, or tell other countries how to behave.

~ Ron Paul, “Liberty Defined”

Can the Republicans Be Saved From Obsolescence?

What a very interesting article. It resonates with me to my core. It speaks of a GOP that is out of touch with Americans. A party that seems self centered and blind to today’s reality and doomed to be trivialized because of its greed, inability to connect to today’s American and a lack of vision.

Data shows many Americans, especially our youth, are very much in favor of limited government AND the freedom to live our lives without interference of government. Or as Jefferson so eloquently put it “… the pursuit of Happiness.” The problem is the GOP is perceived as old and close-minded.

Many people voted for Obama even though his views are contrary to their beliefs. You have to ask why that is. The author provides us with plenty of proof the issue is an out of touch and out of date GOP.

Until the GOP changes this perception it will be marginalized and irrelevant. That is until there is a generational change in leadership. Something that will not take place for at least another ten to twenty years. Until then the our country will move further from the ideals we hold dear; liberty and prosperity for all by a very cleaver and organized left wing. Wake up GOP!

Can the Republicans Be Saved From Obsolescence?

The Absurdity of It All

The 126th legislature, as of this writing, has posted 86 bills. In addition, our state government has a $35 million dollar shortfall. Both Republicans and Democrats are arguing. One side claims children will starve and the elderly will freeze to death if we don’t raise taxes. The other side calls for more efficient government and less fraud and abuse. Both want to borrow to pay the bills. Neither wants to look address the real problem; failing programs and an overbearing government that has inserted itself in every facet of our lives.

A quick review of a few of those bills reveals how deep our government has indeed inserted itself. It demonstrates how we have allowed a body of people in Augusta to control every aspect, if not every detail of our lives.

  • LD2: Resolve, Regarding Legislative Review of Portions of Chapter 252: Rules Governing Certification of Seed Potatoes in the State of Maine, a Major Substantive Rule of the Department of Agriculture, Conservation and Forestry
  • LD5: An Act To Make Changes to the Potato Marketing Improvement Fund
  • LD9: An Act To Allow the Maine Potato Board To Have Access to Information Regarding the Potato Tax
  • LD6: An Act To Prohibit a Requirement That a Superintendent Reside in the School Administrative Unit
  • LD12; Resolve, Directing the Department of Transportation To Add a Reference to the Katahdin Trail to the Sign for the First Newport Exit on Interstate 95 North
  • LD13: Resolve, Directing the Maine Turnpike Authority To Place Signs Directing Motorists to Berwick Academy

You have to think their responsibilities are unfathomable. They include the power to decide how to grow and market potatoes, where school superintendents are permitted to live and what signs should be mounted on the side of our roads and highways. All kidding aside, can anyone see the absurdity of all this?

Obviously politicians have happily made us their wards. They are now our nanny’s treating us like children, unable to make decisions for ourselves. They have taken away the power and the incentive for us to think and make decisions for ourselves. And, we are guilty of letting them.

As far as I know, farmers have been able to grow and market their products for hundreds of years. I’m also pretty sure local communities can determine for themselves where Superintendants can live. Do we really want 188 strangers making decision for us? Or are we adults capable of taking responsibility for our own lives.  If not, then we are no longer free. I prefer to believe the later.

The Fiscal Cliff: A Game of Charade

The United States was saved from a fiasco that would have devastated our very lives. Thank goodness! We should all contact our Representatives and praise them for averting yet another crisis. </sarcasm>

Now lets look at reality for just a moment. There was no crisis. It was a game of charades. We simply need to spend less than we take in. Not rocket science, not even advanced economics.

So who did win? Why all the hullabaloo? With all of this effort someone must have gained something? Well lets take a look at corporate America. Better yet, lets zero in on the entertainment industry. In fact lets look at just one entertainment corporation; Disney.

Included in the bill was the renewal of the American Jobs Creation Act of 2004.  In this act was buried a tax credit for the film industry. Specifically they will receive a tax deduction for the first $15 million dollars used to produce each movie or TV show filmed in the United States. Ka-ching! The tax deduction  jumps to $20 million if filming takes place in a low-income community. Ka-ching! For family friendly Disney that meant $110 million in 2010, $183 million in 2011 and is projected to be $200 million in 2013. Since the ACT was passed in 2004, Disney received a total of $718 million in public dollars while earning $40.9 billion in revenue.

All the while Congress and the President squabble about Millionaires who don’t pay their fair share. An amount, by the way, that would be consumed in less than two weeks. With all of our fiscal woes, corporate welfare continues in mass. In the mean time our government continues to borrow $600+ Billion annually to pay its debt, indefinitely.

I don’t know about you, but I’m outraged. I’m tired of this crony capitalism. Where politicians and corporate executives continue to thrive, while we get an occasional bone thrown our way. Don’t get me wrong, I’m not looking for handouts. I want us to get our debt in order and a fair and equitable tax system. Is that not reasonable?



The Blind Men and the Elephant

John Godfrey Saxe (1816-1887)

It was six men of Indostan
To learning much inclined,
Who went to see the Elephant
(Though all of them were blind),
That each by observation
Might satisfy his mind.

The First approached the Elephant,
And happening to fall
Against his broad and sturdy side,
At once began to bawl:
“God bless me! but the Elephant
Is very like a WALL!”
The Second, feeling of the tusk,
Cried, “Ho, what have we here,
So very round and smooth and sharp?
To me ’tis mighty clear
This wonder of an Elephant
Is very like a SPEAR!”

The Third approached the animal,
And happening to take
The squirming trunk within his hands,
Thus boldly up and spake:
“I see,” quoth he, “the Elephant
Is very like a SNAKE!”

The Fourth reached out an eager hand,
And felt about the knee
“What most this wondrous beast is like
Is mighty plain,” quoth he:
“‘Tis clear enough the Elephant
Is very like a TREE!”

The Fifth, who chanced to touch the ear,
Said: “E’en the blindest man
Can tell what this resembles most;
Deny the fact who can,
This marvel of an Elephant
Is very like a FAN!”

The Sixth no sooner had begun
About the beast to grope,
Than seizing on the swinging tail
That fell within his scope,
“I see,” quoth he, “the Elephant
Is very like a ROPE!”

And so these men of Indostan
Disputed loud and long,
Each in his own opinion
Exceeding stiff and strong,
Though each was partly in the right,
And all were in the wrong!

James Madison and the Game of Ping Pong

As you know, James Madison was the author of our Constitution. With his strong command of history, he knew what worked and what did not. He also knew while power corrupts, if individual liberty was to survive, we must have a strong central government. Something that seems at odds with one another.

To use the language of the day, Madison feared government rule would be exploited by factions (groups). He understood when given power, people use it for their own gain. His dilemma; to draft a constitution that was strong enough to hold the states together but at the same time prevent any one group from having power. He concluded that to prevent this concentration of power he would need to create a republican form of government divided into four branches. These branches are Congress; House of Representatives and the Senate, the Executive branch and the Judicial branch. Thus creating a situation where each branch would check the power of the other. His solution to split the power among several groups produced a balance between the tyranny of the majority rule and the tyranny of the minority.

Were Madison here today I fear he would be disappointed. The division of power he sought to prevent happened anyway. In fact, I think it is worse than he envisioned it could be. Imagine a ping-pong table. On the one side we have the progressives and on the other neoconservatives. Today when one faction is in control, we are subject to their ideology, their beliefs and their rules. When the other side has control their beliefs and ideology are the rule of the land. When this happens, we create a schizophrenic society that no longer knows right from wrong or good from bad.

Hillsdale College offers a free on-line course: The Constitution 101. I encourage you to sign up.

Awesome Week at Work!

Its been a terrific week for me at the office.  It is rare that I get to work on technical projects. I’m usually saddled with day to day operations as well as other mundane tasks like policies or other paperwork.

Our agency is still very much driven by paper. I imagine most healthcare providers are in the same boat. But we are trying to make the leap to using on-line forms. I have several ideas on the subject; using a hosting service, having it developed in house  and outsourcing the project. And am exploring each option.

We have a developer on our team, but he is swamped with projects as it is. So I thought I’d try to broaden my knowledge of WordPress. I am new to WordPress and I have been impressed with what I have been able to do with little knowlege and skill. For example I created widgets for signing up for newsletters, added social media links for Facebook and Twitter, etc. But I know WordPress is far more capable than being just a blog.  I know this because of the plethora of websites already in existence built on WordPress. And a quick search for plug ins and themes confirms this.

So on Monday I started working on a proof of concept. In other words a small version of the production model I hope to create. In doing so I am searching for and trying out various plugins. I did find a free plug in that works nicely. It is simple to use and does a marvelous job of formatting the from so that it is pleasing to look at. However it lacks certain functions. The forms need to include  functions such as; multiple authorizations, digital authorization and encryption.

I’ve purchased my first “professional” plugin called Gravity Forms. i chose it based on the number of features it includes that match my requirements. Right of the bat I noticed forms design is not as simple as the free plug in. This does not surprise me. It does have a learning curve but I am not intimidated as of yet.  I’m sure those that have development experience will  find it simple.

I’ve spent the last three days playing and have reached my limit.  I’m at a point where some things don’t work as expected and others are more difficult to figure out. But that is why I’m in IT, I love the challenge. I do look forward to a weekend of doing something with my hands and will be fresh for next week.