Just a Brief Discussion of the Economic Causes of Health Care Costs

The biggest generator of rising costs in health care is that, unlike other services, people do not pay for it directly, they use a third party that does not know the value of the service to the recipient or the provider, and must assume that all people are the same based on a some other criteria, the economic value to the payor of the service it did not receive nor did it request or experience delivery of. Thus the decision of price is made not based upon quality or the other myriad individual circumstances which might raise or lower the value of the services performed. Therefore, it is impossible for the market to properly set the price. The consumer is encouraged to over access the system do to hidden costs (a process known as moral hazard) and the provider is encouraged to do the most he can to justify the services rendered to ensure his costs are covered. This includes the costs of administrative staff who deal solely with the recovery of the cost of services from the third party payor, who pays others to determine what those services are worth, and to dispute the costs at times. The provider then has to wait several month to recoup his costs. All of these people have absolutely nothing to do with the delivery of health care, only with shifting money from one place to another. Like any bureaucracy, they siphon money from the system, removing it from the actual delivery of the service, driving up the price, despite not knowing the actual economic value.
And that, Constitutional arguments aside, emotional arguments disregarded as retarded (it was too tempting to rhyme that) is why centralized systems of health care drive up costs. The true solution is competition and realization that health insurance should be for emergencies, not oil changes.

A Few Additional Thoughts

Adding to my earlier blog post, which I'm certain you've all ready by now, there may be an interesting twist to the tax v. mandate decision in combination with the inability to force states to expand medicaid rolls. This would allow states to refuse compliance without penalty, cost shifting the additional millions onto the feds and making the plan unworkable unless the feds vote on a direct tax to cover the expenses they were passing on to the states. No one is going to intentionally bankrupt their state (minus California) on the program when they can cost shift to the feds without penalty. No fed is going to vote for the even more massive tax hike that would be needed to fund it. Roberts may have effectively gutted the funding for the program by holding the mandate as a tax.

Thoughts On Today's Supreme Court Action

Before the Minnesota Rates Case in 1913, it was questionable whether or not the Congress had the ability to grant rule making authority to an agency that operated under the Executive Branch. It was deemed in many respects as an abdication of law making authority to an branch of government that had no power to make laws. How far we've come. Today, the Supreme Court ruling upholding Obamacare has ensured that the Secretary of Health and Human Services and the Department she presides over are the most powerful branch of the federal government. The rule making authority of that branch, as laid out under the Affordable Care Act (how anyone could name it that without laughing is beyond me. It should be written in crayon on the cover) and its thousands of pages is immense. The Act essentially cedes most of the health care choices to be made in this country to that agency in Washington, D.C. Congress' investment of rule making authority in executive agencies has enabled the government to become more and more bloated to its current level, and no party is free from blame.

The Supreme Court today also said the individual mandate was not constitutional as an exercise of the Commerce Clause. The Court reasoned that this power was not sufficient to allow government to force people to participate in commerce. However, they, at least at first glance, expanded the power to tax to include punishing people who do not participate in commerce. If this strikes you as logically inconsistent, it may be because you have more than one operating brain cell. I will note that this is a first impression and I have not had time to review the nearly 200 page decision. I'm not sure if this decision was made because the arguments did not address the taxation power, which if the case would leave open another avenue of appeal on that issue.

Another potential question is that if the mandate is, in fact, a tax, it may not have been passed pursuant to the Constitution as that provision did not originate in the House of Representatives. All revenue raising bills are to originate from the House. I'm not optimistic that this will end up being much of an issue.

Another of the reported rulings is that the federal government may not punish state governments for not complying with expanding Medicaid rolls. This has the potential to seriously undermine the part of the expansion of coverage. States are going to look hard at this position as they look to the effect on their own budgets. This could result in serious blow back against the law from the individual statehouses.

Was the Court wrong? Technically, no. As the last word on what is and is not an act complying with the Constitution of the United States of America, the Court cannot be wrong. From a personal perspective, I see a massive expansion of federal power into an area I highly doubt the Founding Fathers ever would have conceived. But, that has been happening for 100 years now and frankly, I think all of it has been well outside the scope of the Constitution.

The political fallout is a different matter entirely. If the House can successfully pass a bill to repeal the Act, they will force the Democratic Senate to make a stand in favor of what is now not a mandate, but potentially the largest tax increase in U.S. history. I don't know how that will play out, but keep in mind, the large gains in the House and minor gains in the Senate by Republicans in 2010 came largely as a result of the health care debate. People who didn't like the mandate aren't likely to be more favorable to the idea if it is characterized as a tax which does the same thing. This could energize the Republicans and independents who disliked the law and result in a win for Republican presidential candidate Mitt Romney. Romney's campaign reportedly raised $1 million in just three hours after the decision. On the other hand, liberals...excuse me...statists may see this as a vindication of President Obama's policy and re-energize those who have been, to date, somewhat on the sidelines. We will see quickly if his donations pick up in a similar manner.

As a practical matter, the Bush tax rates are due to expire at the end of the year already, and with this massive tax raise coming, the economy stands to be hit hard at a time where it is least able to absorb the blow. If something isn't done, and soon, I'm not optimistic about the direction the economy will take. If Mitt Romney prevails in November, he can stop this by issuing waivers to all 50 states to comply with the Act. This is also likely to further the trend of a "jobless recovery". Employers are faced with a non-wage increase in the cost of employment that will discourage them from hiring new employees.

It is too early to say what effects this will have long term. The good thing is a precedent has been set on the limitation of the Commerce Clause, but the taxing authority of the Congress becomes an open question which may need resolution.

This is a long decision and to try and sum up the impacts here in a few paragraphs is an exercise in futility. But then, at this point, dialing back big government and restoring the Constitution feels the same way right now. I'm not going to stop doing that either.

Rubio Running the Rubicon

Senator Marco Rubio who is a potential candidate for Vice President on the Republican ticket was on the Daily Show with John Stewart. Here is a link to Part 1 of the extended interview. Mr. Rubio was fantastic with the interview, and honestly, if he's not the VP pick, I think it's a mistake, and it has nothing to do with the hispanic vote, he is just a wonderful candidate. I would also point out that John Stewart attempts to deflect categorization as a pundit claiming he's just a comedian. While he made some funny comments, it's pretty clear he's trying to have a serious policy debate and defend a liberal position. Rubio hands him his ass in the process, with Stewart becoming visible uncomfortable, shifting his legs and seating position, an indication he feels exposed. It's a beautiful thing to see.

The Presidential Monarch

Under monarchies, the crown was the state. As such, they embodied the law and could technically do no wrong. They determined what the law was, and at a whim, what it wasn't. That is the nature of fiat rule. America is a nation of laws, not of men. This ideal was articulated by no less than the second president of the United States, John Adams. President Obama has consistently shown his belief that he is a monarch, not a president.

Recently, the President waived enforcement of immigration laws against a class of 800,000 illegal immigrants in the United States. The excuse for this is "prosecutorial discretion". Prosecutorial discretion is not meant to waive enforcement of laws against a class of people, rather it is meant to be used on a case by case basis to accommodate for extraordinary circumstances. So that excuse is utter nonsense. It is instructive, however, to note that President Obama claimed he had done so because it was the "right thing to do" (more on that in a moment). Left unsaid, is that it was the right thing for him to do to ensure the Latino vote and shore up swing states in his rapidly flagging campaign. It is a bit curious that he had consistently said he didn't have the power to do exactly what he did.

Today, the United States Supreme Court ruled on the controversial Arizona immigration law. The most controversial tenet of the law was a provision that, if, during a lawful stop made for other reasons, an officer developed probable cause to believe that the person was not legally in the United States (i.e. no driver's license or insurance, doesn't speak English, has Mexican identification) was entitled to look into that persons immigration status and take appropriate action. While the Court struck down several provisions of the law, it unanimously upheld this provision. So, the Court unanimously said that police could investigate immigration status and report to federal immigration officials. However, President Obama instructed federal agencies to not cooperate with Arizona officials on immigration law. So the President, the man at the head of the branch responsible for enforcing the laws of the United States, has explicitly decided he will not do so on a law that has been expressly upheld by the United States Supreme Court. I cannot overstate the significance of this. Not since the FDR court packing scandal has a President shown such disrespect for the Supreme Court and the laws of the United States.

What effect does law have when the man meant to enforce the law believes he is above it? That he rules by fiat and whim? President Barack Obama is now the most dangerous threat to our Constitution which he swore to uphold. I warned about this man before he was President and those that listened, heard and understood. But my voice did not reach far, and it still doesn't. I can only hope someday it will.

And This Is How One Alienates One's Peers

Below is a copy of the email exchange I just had (omitting numerous kudos for the person I disagree with and attempted slapdowns of me) with the President of the national Worker's Insurance Litigation Group, of which I happen to be a member and practitioner. Next up, a copy of my application at McDonalds.

In response, I would suggest you look at the text of the email below. Nowhere is worker's compensation or any other similar issue mentioned. However, the author suggests that because the conservatives on the Court wrote the opinion they are "politicized and activist" and if I remember correctly, political opinion is supposed to be off the board here. Yes, insurance companies have moved to gut Louisiana's comp law, and thanks to some fine work by the LIWG, they headed off some of the more heinous provisions. I happen to believe that under a Constitutional analysis, the Supreme Court made the right decision in Citizens United. I believe it is absurd to think that corporations should be banned from having any say in how they are governed. I think there was something similar in the Boston Harbor a few hundred years ago with a similar theme. I believe markets benefits from an abundance of information, not from a restriction of it. I also seem to remember that the Texas comp system was gutted long before the Citizens United decision, as were others. I believe in the workers' compensation system as I believe the economic costs of doing business should be retained within the confines of the business and the consumer, not the society at large. Anyone with any knowledge of precedent could have seen the decision being handed down was going to happen under an analysis of the extension through the 14th Amendment of the Bill of Rights to the states. A state can only offer greater protections than those afforded, not less.

In all, this is the last I have to say on the subject and I will be leaving the group after 48 hours so that anyone who cares to may respond to me. But frankly, I'm sick of hearing political opinions here. If needs be, I will fight to retain and improve the workers compensation system on my own, because it is clear that this group does not reflect my values. And I'm damned happy Scott Walker won the recall.

Mark R. Ladd, Esq.
The Mark Ladd Law Firm, LLC
2511 St. Charles Ave., #501
New Orleans, Louisiana 70130
Tel : (504) 218-8348
Fax : (504) 324-0642

This e-mail, including attachments, is intended for the exclusive use of the addressee and may contain proprietary, confidential or privileged information. If you are not the intended recipient, any dissemination, use, distribution or copying is strictly prohibited.
If you have received this e-mail in error, please notify me via return e-mail and permanently delete the original and destroy all copies.

---

From: J.R. Boyd
To: WILG Members' ListServe
Sent: Monday, June 25, 2012 9:45 AM
Subject: [wilg] Fwd: [matamembers] Citizens United not revisited

List: wilg Sent by: Boyd, J. R. Search

From our state TLA.....yet another reason to place no trust in the ability of our nation's highest court to remain neutral. If anything, they are more politicized and activist, than any other court in its history....

JR

The Supreme Court's decision today is a blow to limiting the powers of corporations. See the decision below (yes that is the whole decision):

PER CURIAM.
A Montana state law provides that a "corporation may not make . . . an expenditure in connection with a candidate or a political committee that supports or opposes a candidate or a political party." Mont. Code Ann. §13--35--227(1) (2011). The Montana Supreme Court rejected petitioners' claim that this statute violates the First Amendment. 2011 MT 328, 363 Mont. 220, 271 P. 3d 1. In Citizens United v. Federal Election Commission, this Court struck down a similar federal law, holding that "political speech does not lose First Amendment protectionsimply because its source is a corporation." 558 U. S. ___, ___ (2010) (slip op., at 26) (internal quotation marks omitted). The question presented in this case is whether the holding of Citizens United applies to the Montana state law. There can be no serious doubt that it does. See U. S. Const., Art. VI, cl. 2. Montana's arguments in support of the judgment below either were already rejected in Citizens United, or fail to meaningfully distinguish that case.
The petition for certiorari is granted. The judgment ofthe Supreme Court of Montana is reversed.
It is so ordered.

JUSTICE BREYER, with whom JUSTICE GINSBURG, JUS-TICE SOTOMAYOR, and JUSTICE KAGAN join, dissenting.
In Citizens United v. Federal Election Commission, the Court concluded that "independent expenditures, including those made by corporations, do not give rise to corruption or the appearance of corruption." 558 U. S. ___, ___ (2010) (slip op., at 42). I disagree with the Court's hold-ing for the reasons expressed in Justice Stevens' dissent in that case. As Justice Stevens explained, "technically independent expenditures can be corrupting in much thesame way as direct contributions." Id., at ___ (slip op., at67--68). Indeed, Justice Stevens recounted a "substantial body of evidence" suggesting that "[m]any corporate independent expenditures . . . had become essentially interchangeable with direct contributions in their capacity to generate quid pro quo arrangements." Id., at ___ (slip op.,at 64--65).
Moreover, even if I were to accept Citizens United, this Court's legal conclusion should not bar the Montana Supreme Court's finding, made on the record before it, that independent expenditures by corporations did in fact lead to corruption or the appearance of corruption in Montana.Given the history and political landscape in Montana, thatcourt concluded that the State had a compelling interest in limiting independent expenditures by corporations. 2011 MT 328, ¶¶ 36--37, 363 Mont. 220, 235--236, 271 P. 3d 1,
2
AMERICAN TRADITION PARTNERSHIP, INC. v. BULLOCK
BREYER, J., dissenting
36--37. Thus, Montana's experience, like considerable experience elsewhere since the Court's decision in Citizens United, casts grave doubt on the Court's supposition that independent expenditures do not corrupt or appear to do so.
Were the matter up to me, I would vote to grant thepetition for certiorari in order to reconsider Citizens United or, at least, its application in this case. But given the Court's per curiam disposition, I do not see a significant possibility of reconsideration. Consequently, I vote instead to deny the petition.

J.R. Boyd
BOYD & KENTER, P.C.
1150 Grand Blvd.
Suite 700
Kansas City, Missouri 64106
(816) 471-4511 (p)
(816) 471-8450 (fax)

The Arab Spring Has Sprung Right Up Their Ass

Today the Muslim Brotherhood candidate, Mohammed Morsi, has been declared the winner of the Egyptian presidential election.  This is the outcome of the "Arab Spring" which sought greater democracy in Egypt.  The Muslim Brotherhood is a group that believes in the implementation of Shria law, which is not exactly what all the young folks in Tahrir Square were looking for.  The problem is that Cairo is not Egypt, and Egypt is not Cairo.  The young, semi-secular, liberal people who represented the majority of the protesters were not the majority of the voters.  The voters are mostly oriented towards Islamic religious views.  The voters handed the Muslim Brotherhood the Egyptian parliament, which was a proposition so scary to the military that they dissolved the body.  Then they wrote a Constitution designed to restrict the power of the Presidency because they knew that Mr. Morsi was going to win.  Scariest of all, Mr. Morsi reportedly said that Jerusalem should be the capital of the new Muslim caliphate.  Time to brush up on the book of Revelations, I suppose.

All of this goes to show that revolutions of the left almost always result in the status quo ante.  The Russian revolt against the czars produced the murderous Soviet regime.  The French Revolution resulted in the Great Terror.  The election of Barack Obama has resulted in a president who believes he has unbounded power.  Now the Arab Spring is resulting in the election of a terrorist to the Presidency of Egypt.  And the scariest part, was there was no way it was going to work.  Mr. Morsi's only opponent to emerge was the Prime Minister under the old regime that had just been toppled.  Has anyone checked on Libya lately?  Pure democracy is mob rule, which is why the United States' founders created a Republic with a representative democracy.  I usually end these posts with a joke or sarcastic remark, but damned if I can find anything funny about what's going on in the Middle East right now.

You Ever Get That Feeling You Forgot To Do Something

Ok, so it has been since June 5 since I posted anything on this blog. Yes, I'm lazy when I don't get feedback, which means that I need all one of you that read this blog to step up and say something so I know you're reading. Approved and recommended comments to my often insightful and witty posts include such things as "WOW", "Are you a God", and "I have an annoying itch down there". Let me know your thoughts in the coming weeks as I promise to average one post a day for the time being in the hopes that this becomes more than a mildly entertaining circus. Up next, the Egyptian Presidency, the Arab Spring and why I'm not planning on vacationing in the Middle East this century.

Elections Have Consequences....Unless That Consequence is a Democrat Losing

After President Obama won the 2008 election and unpopular policies began being pushed back at by Republicans, Democrats were consistently taking to the air using the phrase "elections have consequences" in order to imply Republicans were obligated to step aside and let such things as Obamacare and the stimulus pass. They were right. In 2010, Republicans racked up historic gains in Congressional elections as a result of the unpopular policies.

Meanwhile, Democrats couldn't take there own advice as they also lost several state governerships, most notably, in Wisconsin where Republican Scott Walker and a Republican held legislature passed legislation restricting some collective bargaining rights of public employees. Reaction was swift as Democrats, mindful that elections have consequences, moved to recall Mr. Walker and several Republican legislators. Tonight, that recall election moves forward and Democrats are already showing indications they have no intention of abiding by the consequences of another loss.

Only four hours into the voting, Democrats began complaining of phone calls to constituents in which they were supposedly told that if they had signed the recall petition, they did not need to vote. 400 attorneys are already lined up by Democrats to institute a recount. The Eric Holder Justice Department announced they would be keeping an eye on the voting as well, ensuring compliance with the Voting Rights Act. No word on whether or not that includes any New Black Panthers with billy clubs at polling places. All this as Mr. Walker went in to election day with an apparent lead.

At this point, it appears Mr. Walker will hold his seat. Whether or not Democrats will abide by the result remains in doubt.

Paul Krugman Apparently Engaged in Crack Market Stimulus

New York Times columnist and Nobel Prize winning economist (in much the same manner as President Obama is a Nobel Peace Prize winner (I think I just heard a drone)) Paul Krugman has apparently upped his recreational drug use. On ABC's "This Week" with George "Captain Collaboration" Stephanopoulos, Krugman had the nerve to call President Reagan the Keynsian (tax and spend) and President Obama the anti-Keynsian, and managed to do so with a straight face, which can only lead me to believe that the crack has finally killed what few brain cells he had before.

And Today's "Oh, Dear God" Moment

Politico dropped an unintentional bomb today covering the announcement that Mike Leavitt has been tapped by Republican Presidential candidate Mitt Romney to lead his transition team, should he win the election. Problem is, Mike Leavitt has been one of the few, and most vocal, Republicans to actively endorse the implementation of the Obamacare exchanges. This led RedState.com co-founder Ben Domenech to unleash on Twitter about Leavitt's record and vested self interest in the exchanges, along with an excellent blog post he wrote for Ricochet (highly recommend reading his post). The Twitter tsunami led to an official reaction from Mr. Romney's campaign saying that overturning Obamacare was the first priority, though they left out anything about the exchanges.

It's not as if Mr. Romney doesn't leave a bad enough taste in the mouths of fiscal conservatives and libertarians to begin with, picking this person opens him to the independent voter questioning if he's really any different from President Obama. Mr. Romney's record as governor of Massachusetts and the enactment of Romneycare in that state are already indications that his sentiments lean towards big government solutions over individual liberties. What happens when the man in charge of the transition team who has a financial stake in the establishment of the exchanges, which are dumps for government subsidies, has an influence, all assurances aside, on the policies which Mr. Romney would utilize to replace Obamacare? It is more important than ever that the Supreme Court strike down the Obamacare idiocy. If they don't, I hesitate to think what may lie on the horizon, regardless of who wins in November.

Food is a Hell of a Drug

Well, at least it is according to Alec Baldwin. Mr. Baldwin has come out in support of one of the most blatant nanny state advocates in New York mayor Michael Bloomberg (shock, he's a Democrat). Mr. Bloomberg, who has declared war on tobacco, salt, sugary drinks and trans fats, is seeking a ban on soft drinks over 16 ounces. In traditional hypocritical leftist fashion, Mr. Bloomberg did so at the same time as he supported an official "doughnut day".

Mr. Baldwin talks about how he recently dropped 30 pounds and was pre-diabetic. Yippee. He states the Mr. Bloomberg's intentions are good. Fantastic. Last I heard the road to hell is paved with good intentions. Benjamin Franklin once wrote "those who give up essential liberty to obtain a little temporary safety, deserve neither liberty nor safety". What do those who would sacrifice liberty to obtain a government that tells them how to eat? No food? Imagine if a nation running a healthcare system got it in its head to control diet as a means to keep down healthcare costs. These are the people who believe they know what is best for you, after all, they're smarter than you.

Guess Who's Not Coming To Dinner

Democrats have run wild accusing voter identification laws of being focused on tamping down minority participation in the voting process this last year. Some, such as Representative Barbara Lee (D. Cal.) have even taken to the House floor to denounce voter ID laws as being racist. The Justice Department has demanded that the implementation of such laws be blocked in such places as Texas and South Carolina. Surely the militantly egalitarian left, enraged by the pure racism of these clearly biased laws which require the use of identification to prove you can vote (or aren't voting for the third or fourth time, or that you are who you say you are) would never resort to....nah.

So, in Massachusetts, Democrats have decided to require voters to produce identification in order to vote in the state Democratic convention. MY GOD, THOSE RACIST BASTARDS!!