Archive for the Health Care Category

Michael McConnell

Read his column at Reuters: “These are significant rulings in support of federalism and the ideal of limited government. They will reverberate in litigation for years to come.”

And a post over on the Volokh Conspiracy blog: “The Supreme Court’s Spending Clause holding, which commanded seven (!) votes, may be the most important aspect of yesterday’s health care decision, from the perspective of constitutional federalism.”


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Scott Atlas

The future of American health care

Americans must realize that the Patient Protection and Affordable Care Act was justified by a truly cynical mischaracterization of America’s medical system, obfuscating its renowned excellence despite the facts about superior access, more choice, and unsurpassed disease outcomes thoroughly documented in the world’s medical literature. It is a law that was further justified by massive exaggerations of the magnitude of the uninsured population and the cost of care for those without insurance, and by repeating the false claim equating no insurance with no access to care. A series of mistruths, cast to frighten Americans and undermine the greatest medical system in the world, all put forth as the premise for justifying a social program that begins the path toward the single payer system long dreamed about by liberals and favored by our president.

And somehow, despite all of these facts, most of the mainstream media has remained silent about the sad reality that the law fails by all estimates, including the government’s own, to address the costs of America’s health care, the single most urgent problem burdening the US health care system and the main reason necessitating change in the first place.

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Over the next week, Advancing a Free Society will publish a series of pieces related to the Supreme Court’s decision in National Federation of Independent Businesses v. Sebelius. The Forum will cover the law, the medicine, the economics, and the politics surrounding this landmark ruling.

Below, renowned legal scholar and Hoover Senior Fellow Richard Epstein reviews the decision on the Medicaid expansion. According to Epstein, this decision is “welcome,” although not perfect, after the “unhappy performance” of Chief Justice Roberts on the individual mandate.

Earlier today, Hoover research fellow Bill Whalen provided his assessment of what this generally unexpected Supreme Court decision means for the presidential campaigns and, perhaps, Election Day.

Follow The Hoover Forum on the Supreme Court’s health care ruling by subscribing to the Advancing a Free Society RSS feed or subscribing to the new Hoover Daily Report.

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Richard Epstein

Unlike his unhappy performance with the individual mandate, the Chief Justice wrote a far more compelling decision when he struck down key portions of the Medicaid mandate. This provision has been largely overshadowed by the nonstop controversy over the individual mandate, but make no mistake about it: the issue is huge. Most observers regarded this issue as a dead loser for the states, who lost (to a series of dreadful opinions) in the lower courts. But the seven to vote in favor of striking this down comes as a real, but welcome, shocker.

To back up for the moment, Medicaid is one of this nation’s growth industries, where expenditures right now are in the hundreds of billions of dollars. The Medicaid expansion is poised to increase that perhaps another $100 billion. Under the ACA, the federal government hopes to achieve that expansion in coverage by a combination of the carrot and the stick. The carrot is the willingness to cover up to 90 percent of the additional funds, so long as the states pick up the remainder of the money and the additional expenses to cover the population that earns between 100 and 133 percent of the poverty line. The threat is that the states that don’t want to play ball lose not only the matching federal money, but also their entire Medicaid allotment under the existing program, often in the billions of dollars.

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Charles Blahous

Today Avik Roy of Forbes kindly provided me with a forum for responding to some of the questions that have arisen about my study showing that the 2010 health care reform law will add substantially to federal deficits.

The full paper, again, is here.

The Forbes blog is here.

Excerpts from the Forbes blog post:

The paper was subject to a double-blind peer review process, which means I did not know who was reviewing the paper, and the reviewers did not know who had written it.  Prior to this review process, I also independently had the paper reviewed by several fellow federal budget and health care financing experts to confirm that the analysis was correct.  Few of the criticisms of the paper have been substantive. I do not believe the few substantive criticisms hold water for the following reasons:

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Scott Atlas

The Picture of Health

From the facts, we know that Americans enjoy outstanding access and quality in their health care system. The only real “crisis” in America’s health care today is the unsustainable, increasing burden of health care costs on the government budget and the economy. The federal budget is directly affected by the rising cost of health care in two major ways: first, Medicare and Medicaid outlays increase as the population ages and as medical practice expands along with more advanced interventions; and second, tax subsidies for health care are massive, and they increase as the cost of tax-sheltered insurance rises.

According to the Centers for Medicare and Medicaid Services (CMS), total health spending has reached about $2.6 trillion, amounting to 17.6 percent of GDP in 2010. Although part of the rise results from a predictable growth in the number of aged beneficiaries, more of it is attributed to the way costs per beneficiary are expected to continue growing faster than per capita GDP. National health spending is expected to rise 5.8 percent per year from 2010 through 2020, culminating in a 19.8 percent share of GDP by 2020.

If such excess growth—as economists call it—continues as projected, federal spending on health care alone will approach the total amount collected in federal tax revenues within fifty years.

Continue reading Scott Atlas…

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Jack Goldsmith

Just about every player in connection with the President’s remarks about the Supreme Court seem to me to be acting oddly or imprudently.

What a terrible idea for the President to charge the Supreme Court with an “unprecedented, extraordinary step” of judicial activism if it strikes down parts of the health care law.  It was not a bad idea because it constituted bullying of the Court.  It was a bad idea – at least from the President’s perspective – because it makes it harder for the Justices to rule in favor of the President’s position.  After his very public criticism, a vote to uphold the law by the Justices who sharply questioned the law at oral argument will invariably be seen as cowing to the President – an appearance, I am confident, the Justices very much want to avoid.  In other words, by questioning the Justice’s independence, the President made it harder for the Justices whose votes he needs to act in his favor.  That, I suspect, is why the President has tried to walk back his remarks.

Also surprising to me are conservative protests that the President has crossed the line in criticizing the Court as activist.  President Obama was entirely accurate when he said: “I’d just remind conservative commentators that for years what we’ve heard is, the biggest problem on the bench was judicial activism or a lack of judicial restraint — that an unelected group of people would somehow overturn a duly constituted and passed law.”  However imprudent and impolitic the President’s remarks, he was in essence mouthing a central conservative complaint about the judiciary since the 1950s.  (I realize that matters are more complicated than this, but during the Obama years many conservatives have indeed been moving away from a jurisprudence of restraint.)  Conservatives were on firmer ground in criticizing the inaccuracy of the president’s claim that striking down the health care law “would be an unprecedented, extraordinary step of overturning a law that was passed by a strong majority of a democratically elected Congress.”  And of course it is odd for President Obama to implicitly embrace judicial restraint as a matter of principle.

Continue reading Jack Goldsmith…

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Michael McConnell

O’s ugly ‘warning’

By all accounts, President Obama’s lawyers did a poor job of defending the constitutionality of his signature health-care-reform law in the Supreme Court last week. So he’s rearguing the case himself. On Monday, he declared that it would be an “unprecedented, extraordinary step” for the court to overturn a law “passed by a strong majority of a democratically elected Congress.”

This statement is puzzling, to say the least. It is by no means “unprecedented” or “extraordinary” for the court to strike down the act of a democratically elected legislature.

Has the president not heard of Roe v. Wade (1973), where the court invalidated the democratically enacted laws of all 50 states? And even Marbury v. Madison (1803), which struck down a section of the First Judiciary Act?

How about INS v. Chadha (1983), where the court invalidated over 200 statutory provisions, many enacted by overwhelming bipartisan majorities?

Is the president unaware that the court in recent years has declared unconstitutional the Line Item Veto Act (struck down in 1998), major portions of the Sentencing Reform Act (2005), the Religious Freedom Restoration Act (1997) and two different attempts at campaign-finance law (in 1976 and 2010) — just to name some of the most prominent?

Continue reading Michael McConnell…

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Paul Gregory

As a writer on Soviet planning, I am struck by its parallels with Obama Care.  Both believe their planning is “scientific” and executed by “the best of the best,” who know what is best for ordinary people. Both types of planning commissars suffer Hayek’s “fatal conceit” – the belief that they can plan incredibly complex economic systems. Their “scientific” plans, however, fall apart under the weight of unintended consequences as ordinary people circumvent their genial rules and instructions.

The New York Times’ Mr. Health Care Mandate features economics professor cum scientific planner, Jonathan Gruber. After the Supremes’ brutal questioning, the Times probably felt that Obama Care needed a boost from Gruber, who, by his own admission, “knows more about this law than any other economist.” It was to Professor Gruber that the White House turned to design its new health care law.

Continue reading Paul Gregory…

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