Goodman Institute

If public opinion polls are the guide, Joe Biden has been the worst president since Richard Nixon. Here’s why that may be true. Most of the time, presidents have only a marginal impact on the economy. Consequently, they should be judged not on what happened on their watch, but what they did or didn’t do relative to what happened. The economy did well during the Biden years. But not because of Biden’s policies toward business enterprise. It was in spite of them. More.

The trick is not to cut spending. The trick is to cut spending in a way that leaves people at the bottom of the income ladder at least as well off – if not better off – than they are today. Writing at Forbes, John Goodman asks: why not let Medicaid enrollees buy health care the way they buy food with Food Stamps? That would give beneficiaries the opportunity to access walk-in clinics and urgent care centers rather than going to the emergency room.

He also asks, why not let enrollees have an HSA from which they pay a modest month fees to direct primary care doctors, who provide 24/7 access to all primary care? Currently, when people enroll in Medicaid, their visits to the ER increase by 40%. All told, Goodman says we can reduce health care spending by $7 trillion over 10 years – with most of the gain going to taxpayers.

Because of government regulation, no insurer in our health care system wants a sick person. No employer. No commercial insurer in the (Obamacare) marketplace. No Medicaid managed care plan. And no safety net institution. The exception is the Medicare Advantage program, where risk adjustment makes the healthy and the sick equally attractive from a financial point of view. Unique in our health care system, MA plans specialize in such chronic conditions as diabetes, heart disease, cancer, etc. These MA plans actually seek to enroll patients that conventional health insurance would like to avoid. More.