Category Archives: Health Care

No to Broccoli Mandate, Yes to Health Insurance Mandate?


I was looking over the latest Reason-Rupe poll and found something strange: 87 percent of people think a federal broccoli mandate would be unconstitutional, while 62 percent think a health insurance mandate would be unconstitutional. That’s a 25 percent difference even though the basic principle is exactly the same. These two mandates were compared during this week’s Supreme Court oral arguments on the health care bill.

Over at the Daily Caller, I go over some possible explanations for the different results and conclude:

Public opinion has precisely nothing to do with whether a policy is a good idea or not; anyone who thinks otherwise would do well to read Shirley Jackson’s short story “The Lottery.” But since I think that government should not have the power to mandate that people buy certain products — think of the lobbying and rent-seeking by companies that stand to benefit! — it is heartening that the majority of Americans think the same way as I do about broccoli. And, to a lesser extent, health insurance.

More importantly, we’ll soon find out how the Supreme Court polls on the broccoli mandate issue. Er, health insurance mandate. Same principle.

Read the whole thing here.

Supreme Court Hears the Health Care Case


Over at CNN, law professor Ilya Somin explains why he believes the health care bill is unconstitutional, and the Supreme Court should strike it down. He argues on commerce clause grounds:

[E]very previous case expanding the commerce power involved some sort of “economic activity,” such as operating a business or consuming a product. Failure to purchase health insurance is neither commerce nor an interstate activity. Indeed, it is the absence of commerce.

If Congress could use that clause to regulate mere failure to buy a product on the grounds that such inaction has an economic effect, there would be no structural limits to its power.

In other words, the real question being decided is whether or not there are limits to Congress’ power. If Congress has unlimited power, the insurance mandate stands. If there are limits to Congress’ power, it has to be struck down. It’s pretty easy to see that this case will have consequences far beyond the piece of legislation that sparked the case.

It’s too early to tell how it will turn out. Today is the first of three days of oral arguments, and the Court probably won’t release its decision until June.

In the meantime, a bit of advice to court watchers of all ideological stripes: don’t confuse the Constitution with constitutional law. They are very different things. That’s why this case really could go either way.

CEI Podcast for February 16, 2012: Washington’s Prescription Drug Shortage


Have a listen here.

Patients are suffering from a nationwide shortage of more than 260 different prescription drugs, many of them for different types of cancer. Senior Fellow Greg Conko explains why the biggest culprit for the drug shortage is Washington. DEA and FDA regulations make it difficult to ramp up supply, or to change prices to more accurately reflect demand.

CEI Podcast for February 2, 2012: The FDA’s Latest Power Grab

Have a listen here.

Fellow in Consumer Policy Studies Michelle Minton breaks down the FDA’s behind-the-scenes push to regulate dietary supplements nearly as strictly as prescription drugs.

If Air Travel Worked Like Health Care

This video is based on article by National Journal‘s Jonathan Rauch, which you can read here. I also recommend Rauch’s excellent book Government’s End.

No Such Thing as an Average Cancer Patient

My colleague Greg Conko has an excellent piece in today’s Wall Street Journal. Greg doesn’t think it’s right that the FDA is denying terminally ill patients access to potentially life-saving treatments.

The latest case in point is a drug called Avastin. It is approved for treating several types of cancer. But the FDA is moving to revoke its approval for treating breast cancer. This has, understandably, upset many breast cancer patients and their doctors.

The heart of the matter is who shall be in charge of treatment decisions. Should it be patients and doctors? Or should the FDA decide for them?

Greg thinks a decentralized approach is better. Different patients will react to the same drug in different ways. A doctor can see if Avastin works or not for a patient, and they can make the right decision from there. The FDA relies on averages and medians for making its approval decisions, ignoring individuals. The trouble with that is, as Greg points out, there is no such thing as an average cancer patient.

A few weeks ago, I interviewed Greg about Avastin and the FDA here.

CEI Podcast for May 31, 2011: FDA Rescinds Approval of Breast Cancer Drug

 

Have a listen here.

Senior Fellow Greg Conko breaks down the fight over Avastin, a drug used to treat several types of cancer. The FDA is poised to rescind Avastin’s approval for treating breast cancer. It will retain its approval for other cancers. This will make life difficult, and possibly shorter, for some breast cancer patients. Conko believes this battle boils down to one question: who decides which treatments patients can use? Will it be the FDA, or doctors and patients?

Reforming Medicare

My former colleague Dan Mitchell has some good ideas for reforming Medicare.

6 Pages of Legislation, 1,000 Pages of Regulation

HHS is about to issue over 1,000 pages of new regulations stemming from last year’s health care bill. That’s not a huge surprise, considering the bill is about 2,000 pages long.

But these regulations all come from a 6-page section covering accountable care organizations, or ACOs.

According to Politico, John Gorman, who runs a health care consulting firm, “expects a 1,000-page rule to come out on Thursday, March 31—because he doesn’t think HHS will want to deal with releasing the regulations on April Fool’s Day.”

Understanding the Health Care System

One of the worst parts of the current health care system is its sheer complexity. Because most of the payments are made by third parties, the paperwork burden is enormous. Co-pays, deductibles, ever-shifting networks, and so on. Unfortunately, that complexity is about to get a lot worse because of this year’s health care bill. Check out this flow chart of what the health care system will look like once Obamacare is implemented:

You can also download a PDF version of the chart that allows you to zoom in more closely. It’s worth taking a few minutes to look at all the agencies and bureaucracies in greater detail.

This chart was released by Rep. Kevin Brady, a partisan Republican. But whatever your politics, you should be wary of any scheme as grandiose as Obamacare. This represents a re-ordering of one sixth of the American economy.And not only is the government tasked with making this flow chart flow smoothly. It is also tasked with fighting two land wars in Asia. With delivering the mail. With developing new energy technologies. With overhauling the nation’s entire financial system. No organization can do all those things and do them well. Doesn’t matter how talented and well-meaning the people behind it are. It is beyond the limits of anyone’s ability to plan.

As Dan Mitchell points out, real health care reform would have just two parties to most transactions: buyer and seller.

There are two other things I’d like to see. One is that health insurance should not be linked to your job. Under both the current system and Obamacare, if you lose your job, you lose your insurance at exactly the time you need it most. This can be done by treating employer-provided insurance exactly the same as individual insurance in the tax code. Employer-provided insurance is currently given special treatment.

Real reform would also fundamentally change the way we use health insurance. The purpose of insurance is to insure against unexpected risks. Your annual physical does not fit that description. Having insurers pay for routine, expected expenses is like using your auto insurance to pay for a tank of gas and a car wash. No wonder premiums are so high. Health insurance isn’t really insurance. It’s pre-paying for your health care. And it also has one whopper of a principal-agent problem that explains a large portion of why health costs are so shockingly high.