John Goodman’s Commentaries
Inside the Liberal Mind: The Tensions of Modern Political Thought
Why Can’t Every School be a Magnet School?
For many years, magnet schools were the only public schools that competed for students. And the experience as been very positive. So why can’t every school do that? John Goodman argues that every public school should be able to specialize in what it does best and compete for students. More
What Should Republicans Do About Medicaid?
There is tremendous waste in the program. That means that Congress can make the program work better for beneficiaries and at the same time free up trillions of dollars to help fund the tax bill. The reforms include Roth Health Savings Accounts, 24/7 direct primary care, and access to a competitive medical marketplace. More
What’s Next for the Democratic Party?
Where DOGE and the Tax Bill Intersect
On the one hand, Elon Musk has been given a goal of reducing government waste by the Trump administration. On the other hand, congressional Republicans are desperate to find ways to cut spending in order to pay for a high-priority tax bill. The intersection of these two goals creates a rare opportunity to institute reforms that would be very hard to accomplish under ordinary circumstances. More.
Cutting Government Waste
There is a great deal of waste in our entitlement programs. And by cutting out waste, we can make these programs work better for the people who depend on them.
Take Social Security. Last year the agency said it has identified 2 million beneficiaries who have been overpaid. It has sent them “clawback” letters, demanding Uncle Sam’s money back. In some cases, the claims go back several decades, and the amounts can be more than $300,000. More
Assessing the Biden Presidency
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.
Cutting out Government Health Care Waste
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.
Why We Need Health Insurance Companies
Our health care system is replete with perverse incentives. If they are not checked, our premiums and taxes will consume ever more of our national income. Canada checks them by limiting resources. Doctors must send their patients to the hospital for simple x-rays. And the country ranks 25th out of 29 developed countries on the number of MRI scanners per person. In the US, private health insurers perform the task – by requiring preauthorization for certain services and denying claims for medically unnecessary procedures. Despite some problems, our system works much better. More.
Why Are So many People Angry at Health Insurers?
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.