Thursday, May 23, 2013

Ciao

Summer is the time when one sheds one's tensions with one's clothes, and the right kind of day is jeweled balm for the battered spirit.  A few of those days and you can become drunk with the belief that all's right with the world.  ~ Ada Louise Huxtable


I won't be blogging this Summer. Accordingly, I've shut down comments on the blog.

Monday, May 20, 2013

Natural, as well as necessary

The truth is that it is natural, as well as necessary, for every man to be a vagabond occasionally. - Samuel H Hammond

I’ve been feeling rather bitter because my liberal friends - who support Obamacare - get their health insurance through their employers while I buy mine individually. I believed that this meant I would have to give the IRS information about my income and health insurance while they would not. It looks like I was wrong. According to Avik Roy at The Corner (and do read the longer post at Forbes):

To enforce the individual mandate, the IRS needs to know whether or not you have purchased insurance this year. It will also need to know the specific insurance policy you have, in order to ensure that it meets Obamacare’s “minimum essential coverage” requirement.

To enforce the employer mandate, the IRS needs the same information from employers in terms of the specific policies employers purchase for their workers, and also the hours worked by every part-time employee. In addition, your employer will need to know what your household income is, in order to ensure that the coverage it offers you is “affordable” to you by the law’s definition.
This makes me feel less bitter about my friends (it’s probably a sign of a serious moral failing that I rejoice to know they, too, will fall under the watchful eye of the IRS). However, it also made me realize something I had known but not fully understood before: The individual mandate means no one has the right to be left alone any longer.

Let’s say I work until I’m 50 and save my money. I then decide to retire and become a vagabond. I convert my savings to cash and keep it in a no-interest checking account. I live off the cash, never earning a salary or interest or capital gains. I have no reason to interact with the Federal government since I owe no taxes. I do not maintain a residence which means I have no reason to interact with State or local government. I can, if I want, legally step outside the grid.

Under Obamacare, that will change. I now must interact with the IRS. I have to tell them how much money I make and what health insurance I purchase. If I do not purchase health insurance, they will fine me. I can no longer legally step outside the grid.

That seems to me to be a terrible loss. I know that very few people want to take that step but I believe we have lost something precious by making it impossible for people to do so without breaking the law. How did we end up in a situation where my life is now subject to my government’s beck and call?

Everybody drink

On Face The Nation this past Sunday, Bob Schieffer asked Senator John Cornyn if Attorney General Eric Holder should step down. Cornyn replied:

You know, I-- I've lost confidence in the attorney general a long time ago over his cover-up over the fast and furious investigation. And the bogus claim of executive privilege when Congress tried to get to the bottom of that, which in part resulted in him being the first attorney general held in contempt of Congress. I think it's past time for him to go and for the President to appoint somebody who the public can have confidence in.

I was struck by Cornyn inserting the Fast and Furious operation into his answer because it’s not the first time I’ve noticed a Republican, questioned about one of the Administration’s current problems, bringing up Fast and Furious. I hadn’t really been paying attention - although I will going forward hence the title of this post - so I can’t cite previous instances but it always seems to be done in passing. I don’t know what it means, if anything, but it’s an interesting way to keep an old, presumably dead scandal in front of the public.

Catastrophic again

A post at The Corner about unintended consequences of Obamacare got me thinking about health insurance again. The post is worth reading (although it’s bad news for people like me with significant health problems) but that’s not what I’m thinking about. I’m thinking about this from Megan McArdle:

Certainly, this [the Oregon Medicaid study] bolsters my belief that health insurance should provide financial protection from catastrophic events, not wrap-around first-dollar coverage.  Those who used to read me on The Atlantic may recall that the McArdle Plan for Healthcare involved the government picking up the tab for any medical expenses above 15-20% of income: simple, progressive, and aimed at the actual problem we know health insurance can fix.  Unfortunaely, Obamacare made that sort of coverage functionally illegal.  

That kind of plan tied to income would be great but it’s unlikely to happen while Obama is President.* What might be possible, though, is to modify Obamacare to permit true catastrophic health insurance. You know, the kind Secretary Sibelius is so clueless about. Perhaps the Republicans could agree to pass something the Democrats and Obama want if and only if the bill to do so includes a modification that adds catastrophic insurance policies as one of the options under Obamacare. Ideally, I’d like to see these with a range of deductibles: $1,000; $5,000; $10,000; $15,000; and so on. That way they would be available to people with a range of incomes.

Presumably the cost for a catastrophic plan would be less than for those that cover doctor’s visits for annual exams, flu shots, dropping a pot lid on your toe (don’t ask), and kids with colds. That might encourage people to purchase catastrophic plans which would increase our sensitivity to the cost of medical care and that, in turn, might actually decrease spending on health care a little.**

*****

Notes:

* I haven’t found a lot of specifics on the “McArdle Plan for Healthcare” but my impression is that she would set a single percentage to be spent on health care before government coverage kicks in. If I were going to take a serious look at this kind of policy, I’d considered percentage brackets, with those who have less money having to spend a lower percentage of their income before the government steps in - much like the brackets we now have for income tax rates.

** Under this modification to Obamacare, as opposed to the McArdle Plan, the insurance companies would still insulate people from true health care costs. When I get a medical procedure, my insurance company decides how much my provider will be paid. So long as insurance companies continue to do so, the insured will continue to pay less than the true cost - and the uninsured will continue to pay more.

*****

Reading:

These were the Atlantic posts I found that talk about the “McArdle Plan for Healthcare”. They date from February of 2010.

The Benefits of Health Benefits - This began as a response to an Ezra Klein post. The Klein post has links to a number of other McArdle posts, all of which are interesting.

The Limited Benefits of First Dollar Health Care Coverage- Follow up to previous post.

Wednesday, May 1, 2013

Breathtaking

I want to revisit an article I referenced in my “Three problems” post. In that post, I wrote about how the National Center for Public Policy Research, a conservative think tank, believed that food stamps should not be used to buy junk food:

Not only should people know how their tax dollars are being spent, but food stamps shouldn’t pay for junk food at all, the National Center for Public Policy Research said Friday. [snip]

...said David Almasi, the National Center’s executive director. “When it comes to public assistance, I want people buying what they need with my money and not what they desire.”

My conclusion was that under the Lifelong Endowment, this wouldn’t be an issue because:

... everyone can spend their Lifelong Endowment money however they want. If they want to get all their calories from Coke and chocolate bars, that’s their business. That takes care of Almasi’s problem.

The more I thought about it, though, the more uncomfortable I got. Why shouldn’t people be able to spend their food money however they want right now?

I did a little more poking around and discovered that it’s not just the National Center for Public Policy Research that is concerned about how food stamp recipients are spending their food dollars:

Seven journalist and government watchdog organizations have called on the Agriculture Department to release information on how much money retailers that accept food stamps make from the program and what products food stamp dollars are purchasing. [snip]

The organization heads who signed the letter were from the National Freedom of Information Coalition, the Society of Professional Journalists, the Association of Health Care Journalists, Investigative Reporters & Editors, the Association of Food Journalists, the National Association of Science Writers, and the Reporters Committee for Freedom of the Press.

The Association of Health Care Journalists reports that:

This information could show which businesses benefit from the program and also inform public policy debates about obesity and its causes... [snip]

According to “Food Stamps: Follow the Money” a report by the advocacy group EatDrinkPolitics, the data Morisy obtained showed that in one year, “nine Walmart Supercenters in Massachusetts together received more than $33 million in SNAP dollars – over four times the SNAP money spent at farmers markets nationwide.”

And the letter sent by the seven organizations states that:

Additionally, the USDA does not disclose which products are purchased with SNAP dollars – or how much is spent on each product, in aggregate – information that is extremely relevant to the public-policy debate about causes and health consequences of obesity, particularly in children. As medical professionals and policy makers call for limits on the use of food stamps to buy “junk food” and soft drinks, data about the type and healthfulness of food purchases is necessary to inform the discussion.

This arrogance on the part of the seven organizations that wrote the letter as well as on the part of the National Center for Public Policy Research is breathtaking. What business is it of theirs - of mine, of anyone’s - where people spend their food money and what food they spend it on? Receiving public assistance does not render someone an idiot, a child, or a pawn of the evil Walmart. Those getting food stamps remain perfectly capable of deciding where and how to spend their food dollars.

And who decides what is and isn’t the right food? I suspect the seven organizations would classify “the right food” as that bought at farmers markets (which will make for interesting eating in Massachusetts in the winter) and the kinds of fresh, organic, sustainably farmed foods that eat up money twice as fast as Walmart’s frozen vegetables (which they probably consider all to the good since poor people eat too much anyhow). The National Center for Public Policy Research, on the other hand, might tend toward some modified version of the draconian “50-pound bags of rice and beans, blocks of cheese and all the powdered milk you can haul away” approach, perhaps supplemented with the very Walmart frozen vegetables so disdained by the seven organizations. The first group is doing this for the food stamp recipients’ own good health; the second for their own good moral fiber. Yet somehow they both end up claiming the right - nay, the obligation - to tell other people what to do and how to live.

I believe that even people on food stamps are smart enough to make their own decisions about what they eat. If they choose badly then they, just like everyone else, will have to live with the consequences of their decisions. Being poor is tough enough; let’s not make it tougher by treating the poor like naughty children who must be forced to eat their vegetables and sent to bed without dessert.