$1T in Medicaid Cuts That Leave Beneficiaries Better Off

$1T in Medicaid Cuts That Leave Beneficiaries Better Off

John Goodman identifies 12 reforms to Medicaid that will Allow Republicans to reach their budget goals without reducing any real benefit for enrollees. Among the  ideas: let enrollees buy medical care the way they buy food with food stamps, have a heath savings account and have access to 24/7 direct primary care. More

Why Can’t Every School be a Magnet School?

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?

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?

What’s Next for the Democratic Party?

They might start by asking, Why are some voters Democrats in the first place? Those who so identify, I believe, tend to think differently than the typical Republican voter on five dimensions. More.

Where DOGE and the Tax Bill Intersect

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

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

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.

What the GOP Should Be Doing About Medicaid

What the GOP Should Be Doing About Medicaid

In his latest commentary at Forbes, John Goodman explains a huge, missed opportunity by House Republicans.

They should have focused on why Medicaid does such a poor job of meeting the needs of the enrollees. Then, they should have explored ways of making Medicaid better and reducing spending at the same time. This would have been a very positive message to voters.

Let’s hope this turns around in the Senate. More.

What Price for Drugs?

What Price for Drugs?

When was the last time you saw a news headline announcing that a cancer patient died because she couldn’t afford a drug that could have saved her life? I bet you haven’t. Why? Because it doesn’t happen. At least not in this country. President Trump doesn’t understand the market for drugs. He is not alone. Most people don’t understand it. Here is John Goodman’s contribution to clear thinking:

  1. In Part I, he asks readers to imagine a free market for drugs, in which drug manufacturers are given a patent for a certain length of time. The patent allows drug companies to charge a monopoly price. But by price discriminating, they insure that almost no one goes without a lifesaving drug.
  2. In Part II, he asks how free market health insurance would cover expensive drugs. People who are more risk averse would purchase “top up” plans to pay for drugs conventional insurance finds not cost effective.
  3. In Part III, he shows that both public insurance and unwisely-regulated private health insurance face perverse incentives to favor the healthy over the sick. Reforms are suggested.
House Republicans Love HSAs

House Republicans Love HSAs

Industry experts believe that the House reconciliation bill would result in 20 million more Americans having a Health Savings Account. Among the changes, Bronze and catastrophic plans sold in the (Obamacare) exchanges would automatically qualify for HSAs. And people could use their HSA to pay the monthly premium of a direct primary care doctor of their choosing – providing 24/7 primary care.

However, John Goodman says that for the same CBO score, the Senate could make the bill much better. More.

What the Debt Deal Ignored

What the Debt Deal Ignored

A month ago, Social Security’s Trustees published their annual reportTable VIF1, buried deep in the Appendix, where no one looks, is the statement that Social Security’s unfunded liability is $66 trillion. This measure of Social Security’s red ink is not just gargantuan on its own. It’s $13 trillion larger than it was just three years ago. More

Social Security Sues invalid for Money He Received 21 Years Ago, At Age 11

Social Security Sues invalid for Money He Received 21 Years Ago, At Age 11

Roy Farmer of Grand Rapids Michigan has Cerebral Palsy. He’s 32. In 2019, out of the blue, he received a claw back letter from Social Security demanding he repay $4,902 that his (now deceased) mother received back when he was 11. Roy has spent over three years appealing this judgement. He’s been denied twice. More from Kotlikoff Forbes editorial.

Our Fiscal System Needs Reform

Our Fiscal System Needs Reform

Over half of working-age Americans face lifetime marginal tax rates (including direct taxes and loss of entitlement benefits) above 43 percent. One in ten in the bottom fifth face tax rates above 70 percent, effectively locking them into poverty. For some would-be-workers, the tax rates exceed 100 percent.

Extremely high LMTRs reflect the complete loss of family benefits, in the current and future years, from programs such as Medicaid – which ends benefits abruptly if one’s income or assets exceed specific thresholds by even one dollar. More.

Social Security’s Massive Malfeasance

Social Security’s Massive Malfeasance

Social Security has committed and continues to commit huge fraud against 13,000 plus widow(er)s who collectively have been swindled out of $130 million. Those are the figures of Social Security’s own Inspector General.  More

America’s Fiscal Gap

America’s Fiscal Gap

That’s the difference between the federal government’s spending commitments and its income – looking indefinitely into the future. Closing the gap through time requires an immediate and permanent 41.3 percent increase in all federal taxes or an immediate and permanent 35.3 percent cut in all non interest federal spending. More

Social Security Benefits: Heads They Win, Tails You Lose

Social Security Benefits: Heads They Win, Tails You Lose

One disabled lady was clawed back for over $300,000 for a mistake that Social Security admitted in writing was theirs! If she doesn’t repay, Social Security will almost always stop sending people like her a single penny until they pay “what they owe.” This can take years or decades.  More

House Republicans – Raise the Debt Limit, But Stick to Your Fiscal Guns. Our Country Is Dead Broke!

House Republicans – Raise the Debt Limit, But Stick to Your Fiscal Guns. Our Country Is Dead Broke!

Our country’s fiscal gap is 7.7 percent of GDP. This means we need to collect 7.7 percent more in taxes, every year starting now, to cover all the future spending the CBO projects. Alternatively, we need to immediately and permanently lower the path of federal spending by 7.7 percent of each future year’s GDP. Or we can do neither of these things and dig an even deeper hole for our kids.  More

Social Security Benefits: Heads They Win, Tails You Lose

Social Security Claws Backs $34K from a Disabled Blind Worker for “Overpayments” Going Back 23 Years!

Social Security sends out more than 2 million clawback letters every year. Why so many clawbacks? Simple. Social Security doesn’t have the data it needs to correctly calculate benefits for tens of millions of us. Or it has the information on day 1, but doesn’t process it. Or it inputs the wrong information. Or it mixes up your earnings record with someone else’s. Or it makes the wrong benefit calculations. I’ve seen all of this and more. More

ObamaCare still desperately needs fixing

ObamaCare still desperately needs fixing

The American Rescue Plan injects new life into ObamaCare with more generous subsidies, expanded eligibility and premium limits that make insurance more affordable. Unfortunately, the stimulus proposal just passed by Congress does nothing to correct the most serious...

Letter to the Commissioner

Letter to the Commissioner

Congratulations on limiting the amount by which a beneficiaries benefits may be clawed back because of Social Security ‘s own mistakes. More needs to be done however. More.

Before Heretics Were Persecuted

Before Heretics Were Persecuted

The first 300 years of Christianity were troubled times. As Christians, inspired by their new faith, created churches all over the Roman Empire, they were persecuted and often cruelly executed because they refused to make sacrifices to the Roman gods. The persecutions were not continuous, and some Roman governors made a point of tolerating Christians, but the threat was always there.

One threat they did not face, however, was persecution by other Christians. Christianity was such a fledgling religion that it had no clear hierarchy or even ruling group immediately after the Apostles died. It had no orthodoxy and no political power in those early years.

That would change.

Battles or Logistics? How Wars are Won

Battles or Logistics? How Wars are Won

“Infantry wins battles; logistics wins wars.” This statement is attributed to World War I commanding general John J. Pershing (although I have yet to find the source). Military logistics means getting soldiers and equipment in place for battle or replacing causalities and destroyed equipment.

Who ‘Saved’ Our Forests?

Who ‘Saved’ Our Forests?

Postcard above shows Biltmore Estate in 1915. From the Karl Larson Photograph Collection (PhC.205), courtesy of the State Archives of NC. It makes a good story. In the late 1800s demand for wood was insatiable—for houses, for ships, for fuel, for railroad ties....

They Shouldn’t Have Created Charitable Foundations

They Shouldn’t Have Created Charitable Foundations

You’ve probably heard that Henry Ford II resigned from the board of the Ford Foundation because it had veered far away from its donor’s intent.  In his 1976 resignation letter, Ford (grandson of Ford Sr.) wrote: “In effect, the foundation is a creature of capitalism—a...

Why Did the Europeans Win?

Why Did the Europeans Win?

My last post, “Land Grants or Land Grabs,” revealed that most federal land that started land-grant universities had been taken from Indians. I  received some constructive pushback. But that feedback reminded me of a question, Why did the Europeans invade the New World in the first place and conquer Native Americans, rather than Native Americans invading Europe and conquering Europeans?

Land Grants or Land Grabs?

Land Grants or Land Grabs?

You may have seen a statement similar to this one on a university website: “NC State University . . . respectfully acknowledges that the lands within and surrounding present-day Raleigh are the traditional homelands and gathering places of many Indigenous peoples, including eight federally and state-recognized tribes. . . .” Such statements are not purely the result of gracious sentiments. NC State’s acknowledgment and many others were added after a troubling study appeared. It was “Land-Grab Universities,” published in 2020 by High Country News, an environmentally oriented nonprofit newspaper in the West.

Small Gems in State History Lore

Small Gems in State History Lore

If you grew up in the United States, you probably took a course in middle school or junior high about your state’s history. I don’t remember a thing about my class except a frantic late-night scramble to finish my “Missouri Scrapbook,” full of notes, photographs, postcards, mementos, etc. My guess is that you didn’t learn a lot from state history classes, either. Am I wrong?

Wood Wars on the Susquehanna

Wood Wars on the Susquehanna

This is a guest column by Jay Schalin, senior fellow at the James G. Martin Center for Academic Renewal. Born in Pennsylvania, he responded to my request for “state stories.” The uplands of northern Pennsylvania were a wild and wooly place in the early years of our...

China’s Decades-Long Tragedy

China’s Decades-Long Tragedy

We are witnessing one of the greatest ironies of modern history: the population policy of the Chinese government. The state’s coercive one-child policy—complete with forced birth control, sterilizations, late (even caesarean) abortions, and likely infanticide—began...

How the Barbarians Won

How the Barbarians Won

Have you ever thought about the difference between the biblical Jesus who said that the meek will inherit the earth and the Christ in whose name the Crusaders warred against Muslims and Jews?

These examples are, of course, at the extremes of Christianity—Jesus’ love of the least-favored people versus triumphant soldiers who went to war with the cross on their flags. But the image of Christians conducting wars and inflicting pain still jars us, and it is impossible for Christians to approve of those who took over Jerusalem in 1099 and massacred Muslims and Jews in the process.

How did this transformation take place?

Goodman and Saving: Budget Deal’s Trillion Dollar Surprise

Goodman and Saving: Budget Deal’s Trillion Dollar Surprise

The most significant federal entitlement reform in our lifetime was a little noticed provision that Democrats included in the Affordable Care Act. The provision was a cap on Medicare spending, similar to the cap Republicans proposed for Medicaid last summer.

Saving on CNBC: FED is holding 20% of federal debt

Saving on CNBC: FED is holding 20% of federal debt

The Federal Reserve System is holding 20% of the federal government’s publicly held debt. It also is holding a lot of bank reserves. For every dollar of required reserves, banks have deposited $12 at the FED.

Gramm and Saving in the Wall Street Journal: Fed Task is Precarious

Gramm and Saving in the Wall Street Journal: Fed Task is Precarious

The Fed balance sheet contains 20% of all publicly held federal debt and 34% of the value of all outstanding government-guaranteed mortgage-backed securities. As the economy returns to normal growth, getting rid of those assets risks runaway inflation or a crippled recovery or both.

Saving: Are Republicans Too Stingy with Medicaid?

Saving: Are Republicans Too Stingy with Medicaid?

Before the Senate voted on a “skinny” alternative to Obamacare, it was considering the House version of repeal and replace – called the Better Care Reconciliation Act (BCRA).

Saving on CNBC: FED is holding 20% of federal debt

The Federal Reserve’s Accountability Deficit

The Federal Reserve enjoys extraordinary independence from the elected branches of government, based on the well-founded fear that politicians cannot be trusted with the power to print money and manipulate interest rates.

Tom Saving has a new book

Tom Saving has a new book

Tom Saving has a new book called A Century of Federal Reserve Monetary Policy: Issues and Implications for the Future.

Gramm and Saving in the WSJ: The Fed has lost its ability to control interest rates

Gramm and Saving in the WSJ: The Fed has lost its ability to control interest rates

Writing in the Wall Street Journal, former Sen. Phil Gramm and Goodman institute Senior Fellow Thomas Saving write “Never in the Fed’s 105-year history has it had less control over market interest rates than it has today…. To expect the Fed to hold interest rates above or below the market rate under these circumstances is not only naive but dangerous.”

Health Reform: There Is Something for Everyone to Love… and Hate

Health Reform: There Is Something for Everyone to Love… and Hate

Why is it controversial to expand the physician supply, creating more competition? Doctors oppose it, just like they oppose expanding the scope of practice for nurse practitioners. Doctors don’t want me to be able to see a nurse practitioner or physician assistant for a wart on my toe unless that NP/PA works for them.

How did doctors get so powerful? In the first half of the 20th Century, the American Medical Association (AMA) waged a largely successful battle to close medical schools that trained competing physicians. …. More than half of American and Canadian medical schools were closed….  Thus, the job of a physician was yanked out of reach of all but the smartest, most disciplined, wealthy elites.

The 60 Percent Solution to Reforming Healthcare

The 60 Percent Solution to Reforming Healthcare

Can we transform the entire health care system by empowering the roughly 60 percent of patients who are in private health plans? That’s the premise of a new book I just read by Todd Furniss (@TFurniss on Twitter). The author ofThe 60% Solution: Rethinking Healthcare, believes there are five major reforms necessary to empower patients and help them get better care at better prices. These include: (1) change governance, (2) modify health savings accounts (HSAs), (3) clear prices, (4) standardize accounting and information technology in the medical industry and (5) emphasize primary care.

Herrick: States Should Ban These Lab Scams

Herrick: States Should Ban These Lab Scams

There is a new health care scam spreading across rural America that could cost you plenty. Large commercial labs like Quest Diagnostics and LabCorp do not have locations in every small town. As a result, many rural hospitals perform lab work for both their inpatients and outpatients in the local community.

Herrick: Future Pandemics Require Better Access to Primary Care

Herrick: Future Pandemics Require Better Access to Primary Care

When Americans become ill or have a health complaint, they often schedule an appointment with a primary care provider (PCP). PCPs are often the first line of defense in the battle against the onset of seasonal outbreaks of colds, flu or more serious problems like COVID-19.

Herrick: Could Free-Market Medicine Respond Better to Pandemics?

Herrick: Could Free-Market Medicine Respond Better to Pandemics?

Many people have come to believe that the only way to protect Americans against future pandemics is to turn over control of our health care system to the government. The folly of this view was apparent when the U.S. Centers for Disease Control & Prevention (CDC) utterly failed as the monopoly supplier of COVID-19 diagnostic testing kits. When the first cases appeared, about half of the test kits failed and replacements were slow in coming.

How Obamacare Made Things Worse for Patients With Preexisting Conditions

How Obamacare Made Things Worse for Patients With Preexisting Conditions

One of the strange features of the national health care conversation is how it has evolved. What is often referred to as Obamacare began as an attempt to insure the uninsured. In fact, the initial Congressional Budget Office estimates predicted the Affordable Care Act would be largely successful in doing just that. Yet it was the Senate’s Democratic leader, Chuck Schumer of New York, who identified the political problem with that goal early on. About 95% of those who vote already have insurance, Schumer noted. So Obamacare was promising to spend a great deal of money on people who don’t vote.

Response to Coronavirus Reflects Trump’s Plan to Radically Reform Health Care

Response to Coronavirus Reflects Trump’s Plan to Radically Reform Health Care

Critics of President Trump’s response to the coronavirus crisis characterize it as knee-jerk, spur-of-the-moment, and grasping at any straw within reach. In fact, many of the executive actions we have seen in the past few days reflect a new approach to health policy that has been underway almost since the day Donald Trump was sworn into office.

What’s Behind the Vaccine Slowdown?

What’s Behind the Vaccine Slowdown?

What’s behind the slowdown in vaccinations? The consensus among experts is those not yet vaccinated either 1) don’t want the vaccine 2) harbor some doubts about vaccine safety or efficacy, or 3) simply lack the motivation to find vaccine providers and make an appointment. Vaccine hesitancy accounts for about one-third of adults. For example, the Kaiser Family Foundation ran a survey in April that found 15 percent of respondents who had not received the vaccine plan to “wait and see.” Another 6 percent will get vaccinated “only if required,” and 13 percent refuse to get the vaccine. 

Correcting Misconceptions of Health Care Reform

Correcting Misconceptions of Health Care Reform

One reader posed the question, how does the tax break for employee health insurance harm our health care system? Short answer: over time the practice reduced competition, which weakened cost-control and resulted in health care inflation three times that of consumer inflation. Consider this: once covered by generous health plans, workers cared less about what medical care cost because their health plans paid most of the tab. Employers didn’t care what things cost because they were passing on the costs to workers (indirectly) in lieu of higher cash wages. Third party administrators (TPAs), who manage the benefits for employers, didn’t much care what things cost because they were passing on the costs to employers with a mark-up. The more money spent, the more TPAs earn.

How a Questionable Drug Turned into a Goldmine at Taxpayers’ Expense

How a Questionable Drug Turned into a Goldmine at Taxpayers’ Expense

On June 7th the U.S. Food and Drug Administration approved a new drug to treat early-stage Alzheimer’s disease. Is this good news for patients suffering with Alzheimer’s disease? Probably not and certainly not for taxpayers. The clinical trial data found little evidence the drug works. One Phase 3 clinical trial showed a slight slowing in cognitive decline, while the second clinical trial failed to show any improvement.

The $3.5T Spending Mistake

The $3.5T Spending Mistake

Congressional Democrats are proposing to spend an enormous amount of taxpayer dollars on what the New York Times calls a “cradle to the grave” addition to U.S. social welfare. When budgeting shenanigans are ignored, the Committee for a Responsible Federal Budget estimates that the full cost is not the $3.5 trillion that has been widely advertised, but at least $5.0 trillion and possibly as much as $5.5 trillion.

Gorman: US Hospitals are Safer

Gorman: US Hospitals are Safer

A frequent criticism of US hospitals is the charge of excessive adverse medical events,  sometimes leading to avoidable deaths. How do our hospitals compare to hospitals in national health care systems? Quite well. The percent of patients who experience an adverse event is twice as high in Canada, three times as high in Britain and four times as high in New Zealand. 

Linda Gorman Study: Obamacare Dollars Wasted

Linda Gorman Study: Obamacare Dollars Wasted

The percent of the population with private health insurance actually declined during the eight years of the Obama presidency, according to a study by health economist Linda Gorman.

Gorman: Obamacare has been extremely wasteful

Gorman: Obamacare has been extremely wasteful

The federal government spent $341 billion from 2014 through 2016 on subsidizing individual coverage so that people would buy it (Not counting the money spent on state and federal exchanges).

Gorman in Forbes: Will Tax Reform Kill People?

Gorman in Forbes: Will Tax Reform Kill People?

You know you are in the silly season when the charges against sensible tax reform become more and more outrageous. The silliest and most outrageous is based on this causal reasoning: The Republican tax measure repeals the Obamacare mandate, requiring people to purchase health insurance; without the mandate, fewer people will insure; and without insurance, more people will die.

Against Medicaid Expansion

Against Medicaid Expansion

Expanding Medicaid to the relatively healthy might make sense if it improved general health. But there is little evidence it does. In Oregon, for example, a first-of-its-kind controlled trial tracked individuals who applied for Medicaid through a lottery. After two years, there was no discernible difference in the physical health of the winners and losers. More

Hidden Traps in the IRA Bill’s Drug Provisions

Hidden Traps in the IRA Bill’s Drug Provisions

In the near future, the elderly and the disabled will face a double whammy: higher premiums for Part D drug insurance and higher prices at the pharmacy. This is on top of negotiated prices (and the consequent drop in new drug production) which will kick in later in the decade.

John Goodman and Linda Gorman explain why this will happen in The Hill.

America’s Fiscal Gap

Leftists in Colorado Seem Poised to Try Again for Single Payer Health Insurance

Last time around, the idea was rejected by almost 79% of the voters. And for good reasons. British Columbia’s single payer system is so mismanaged it pays for cancer patient radiation treatments in Bellingham, Washington.  Its hip replacement wait can be almost a year… Because Canadian patients wait twice as long as recommended for MRI scans, those who can afford it pay cash for quick service at US imaging centers in border cities like Buffalo, NY and Bellevue, WA. More.

Our Gravest Peril

Our Gravest Peril

ObamaCare? Stagnant economy? Crushing debt? Foreign ­policy fecklessness may trump them all. Commentary by Pete du Pont January 21, 2014 Source: Wall Street Journal America's most worrisome problem may not be the failed takeover of our healthcare system. It may not be...

Our Gravest Peril

The Great Destroyer

ObamaCare wreaks havoc on health care, the economy, American freedom and Obama's presidency. Commentary by Pete du Pont November 25, 2013 Source:The Wall Street Journal Polls show an increasing majority of Americans dislike President Obama's health­care law and...

Our Gravest Peril

Hillary Will Run

How could she not? Commentary by Pete du Pont October 29, 2013 Source: Wall Street Journal Hillary Clinton is going to run for president in 2016. Granted, she is exhibiting even more coyness than most presidential prospects, and yes, the media are filled with those...

Our Gravest Peril

The Beltway Stalemate

Democrats and Republicans have never had such a conflict of visions. Commentary by Pete du Pont September 26, 2013 Source: The Wall Street Journal The debate about military action in Syria seems over for now, and Washington is back in campaign mode. We have a...

Our Gravest Peril

Obama’s Foreign Failure

The world hasn't lived up to his Pollyannaish expectations. Commentary by Pete du Pont August 27, 2013 Source: The Wall Street Journal Barack Obama entered the White House with the promise of restoring our nation's standing in the world. Suffering from war fatigue and...

Our Gravest Peril

Second­-Term Nightmare

ObamaCare's chickens come home to roost. Commentary by Pete du Pont July 27, 2013 Source: The Wall Street Journal Talk about being between a rock and a hard place. The Obama administration and its allies in Congress are faced with the challenge of trying to convince...

Our Gravest Peril

Obama’s Anti-­Energy Agenda

He threatens to cut off the fuel the economy needs. Commentary by Pete du Pont July 01, 2013 Source: The Wall Street Journal Not surprisingly, President Obama and Speaker John Boehner have different views on energy policy, differences brought into stark contrast by...

Our Gravest Peril

Obama’s Scandalous Legacy

He has given Americans new reason to distrust the government. Commentary by Pete du Pont May 28, 2013 Source: The Wall Street Journal It's too early to tell if May will be remembered as marking the beginning of a failed second term for President Obama, but it is clear...

Our Gravest Peril

The Left’s “Wars”

The Left’s “Wars” Commentary by Pete du Pont March 28, 2014 Source: The Wall Street Journal The midterm elections are just over seven months away and the left has unleashed its usual rhetoric about the Republican "war on women." It's baseless political pandering of...

Our Gravest Peril

Global Warming Heats Up

The public could use an honest debate. Commentary by Pete du Pont February 27, 2014 Source: The Wall Street Journal Global warming is back. Not actual global warming, as the decade­long trend of little to no increase in temperatures continues. But the topic of global...

Our Gravest Peril

The Real Inequality Problem

It isn’t that some people are wealthy but that others are struggling. Commentary by Pete du Pont April 28, 2014 Source: The Wall Street Journal Among the too numerous frustrations of the political process is that a lot of smart and talented people spend their time and...

What Price for Drugs?

What Price for Drugs?

When was the last time you saw a news headline announcing that a cancer patient died because she couldn’t afford a drug that could have saved her life? I bet you haven’t. Why? Because it doesn’t happen. At least not in this country. President Trump doesn’t understand the market for drugs. He is not alone. Most people don’t understand it. Here is John Goodman’s contribution to clear thinking:

  1. In Part I, he asks readers to imagine a free market for drugs, in which drug manufacturers are given a patent for a certain length of time. The patent allows drug companies to charge a monopoly price. But by price discriminating, they insure that almost no one goes without a lifesaving drug.
  2. In Part II, he asks how free market health insurance would cover expensive drugs. People who are more risk averse would purchase “top up” plans to pay for drugs conventional insurance finds not cost effective.
  3. In Part III, he shows that both public insurance and unwisely-regulated private health insurance face perverse incentives to favor the healthy over the sick. Reforms are suggested.
How the Barbarians Won

How the Barbarians Won

Have you ever thought about the difference between the biblical Jesus who said that the meek will inherit the earth and the Christ in whose name the Crusaders warred against Muslims and Jews?

These examples are, of course, at the extremes of Christianity—Jesus’ love of the least-favored people versus triumphant soldiers who went to war with the cross on their flags. But the image of Christians conducting wars and inflicting pain still jars us, and it is impossible for Christians to approve of those who took over Jerusalem in 1099 and massacred Muslims and Jews in the process.

How did this transformation take place?

$1T in Medicaid Cuts That Leave Beneficiaries Better Off

$1T in Medicaid Cuts That Leave Beneficiaries Better Off

John Goodman identifies 12 reforms to Medicaid that will Allow Republicans to reach their budget goals without reducing any real benefit for enrollees. Among the  ideas: let enrollees buy medical care the way they buy food with food stamps, have a heath savings account and have access to 24/7 direct primary care. More

China’s Decades-Long Tragedy

China’s Decades-Long Tragedy

We are witnessing one of the greatest ironies of modern history: the population policy of the Chinese government. The state’s coercive one-child policy—complete with forced birth control, sterilizations, late (even caesarean) abortions, and likely infanticide—began...

Why Can’t Every School be a Magnet School?

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

Before Heretics Were Persecuted

Before Heretics Were Persecuted

The first 300 years of Christianity were troubled times. As Christians, inspired by their new faith, created churches all over the Roman Empire, they were persecuted and often cruelly executed because they refused to make sacrifices to the Roman gods. The persecutions were not continuous, and some Roman governors made a point of tolerating Christians, but the threat was always there.

One threat they did not face, however, was persecution by other Christians. Christianity was such a fledgling religion that it had no clear hierarchy or even ruling group immediately after the Apostles died. It had no orthodoxy and no political power in those early years.

That would change.

House Republicans Love HSAs

House Republicans Love HSAs

Industry experts believe that the House reconciliation bill would result in 20 million more Americans having a Health Savings Account. Among the changes, Bronze and catastrophic plans sold in the (Obamacare) exchanges would automatically qualify for HSAs. And people could use their HSA to pay the monthly premium of a direct primary care doctor of their choosing – providing 24/7 primary care.

However, John Goodman says that for the same CBO score, the Senate could make the bill much better. More.

What the GOP Should Be Doing About Medicaid

What the GOP Should Be Doing About Medicaid

In his latest commentary at Forbes, John Goodman explains a huge, missed opportunity by House Republicans.

They should have focused on why Medicaid does such a poor job of meeting the needs of the enrollees. Then, they should have explored ways of making Medicaid better and reducing spending at the same time. This would have been a very positive message to voters.

Let’s hope this turns around in the Senate. More.

Let’s Not Blame Jane Jacobs

Let’s Not Blame Jane Jacobs

My late husband and I had a running debate over which force mattered the most: downtown landowners who wanted to keep up rents (Rick’s view) or urban planners (my view). Rick, the economist, may well have been right—especially about the devastation of Boston that goes back to the 1950s—but planners are at fault, too. That’s the subject of this post.