What happened to Deloitte’s refund? @GovRaimondo @repmorgan @JohnDePetroshow “The Department of Human Services said it expects to spend nearly $6 million more than planned, mainly because of higher staffing required to deal with the UHIP computer fiasco.” https://t.co/zCRpWDeoWb
— InLittleRhody'sphere (@LittleRhody9) November 17, 2017
What if the “spike” in HealthSource reflects job loss and the tidal wave of Medicaid is permanent and swelling?
Fortunately, this hasn’t been much of a topic of conversation in Rhode Island (yet): Wesley Smith describes how…
Once a society generally accepts killing as an appropriate response to suffering, there are few limits to the kind of “suffering” that will qualify for extermination.
The Netherlands shows the danger. Permitted in a decriminalized form since 1972–and formally legalized in 2002–euthanasia deaths are skyrocketing.
Because it hasn’t been of immediate relevance at the level of news to which I devote most of my attention, I haven’t completely worked through my thoughts on assisted suicide. As tends to happen with emotional matters that are closely tied to ideological or religious beliefs, people typically focus on the extreme cases that align with their first reactions. On one end is the person facing an imminent and horrible death who wants to take his own life. On the other end is a doctor having family members hold down a woman who wakes up and resists being killed.
So, one axis in a multidimensional spectrum could address such circumstances of each case, including degree of suffering, permanence of the condition, and imminence of natural death. Another axis would be the degree of assistance, ranging from none at all through offering advice through the provision of supplies all the way to execution with dubious consent. There may be other axes to consider.
According to my beliefs, nothing on this field is moral, but that does not necessarily mean everything must be criminalized and vigorously enforced. In that regard, I find yet more reason to regret how integral we’ve allowed government to become. To the extent that libertarians can cite an expansion of individual liberty, it seems always to be in these areas of personal destruction, which is to say when libertarians find common cause with progressives.
If government weren’t involving itself in the question of children’s lemonade stands, we mightn’t feel as compelled to write a policy on the tougher moral disagreements. Similarly, if the fine details of employers’ insurance benefits weren’t up for national policymakers, so too might states and localities be able to draw different lines on other issues.
Jeff Hunt puts forward evidence from five-years of experience with legalized marijuana suggesting that states should think twice before implementing or considering such policies.
— OSTPA (@OSTPA1) November 4, 2017
To be fair, this is the sort of thing one expects a governor to say when an institution, particularly a public utility, falls short of expectations at a time during which people are relying on it, as Shaun Towne reports for WPRI:
[Democrat Governor Gina] Raimondo’s office on Wednesday said the governor has directed the Division of Public Utilities and Carriers (DPUC) Administrator Macky McCleary to assess National Grid’s storm preparedness and restoration efforts.
To ensure National Grid’s attention is focused on the ongoing restoration, Raimondo’s office said the review will begin once all homes and businesses are back online.
“Rhode Islanders should expect the lights to come on when the switch is flipped. National Grid owes Rhode Island families and businesses a swift response when power goes out and thoughtful planning to prevent outages when storms are forecasted,” Raimondo said in a statement Wednesday.
Unfortunately, it’s not so easy for a politician to position herself in opposition to inadequate services when this is also news, as reported by Susan Campbell, also on WPRI:
On the first day of open enrollment for health insurance, a glitch prevented hundreds of customers from reaching HealthSource RI.
About 300 calls were routed incorrectly, due to a change that was made to the agency’s phone menu Tuesday night, according to Brenna McCabe, a spokesperson for the agency.
Add the following to the list of reasons government should remain small enough that it’s actually possible for politicians to run it well: It doesn’t help when the people’s elected representatives have less than zero credibility for complaining about the disappointing performance of other organizations.
Coming in at 36th, clearly Rhode Island could be doing worse when it comes to sexually transmitted diseases, although the map that Trent Wilson provides for his post on BackgroundChecks.org has the Ocean State as a darker spot in the midst of the rest of New England, all of which are in the best 10.
Using data from the Centers for Disease Control (CDC), Wilson finds that Rhode Island improved by two spots from last year’s iteration, although it appears the cause is that other states’ rates of chlamydia and gonorrhea increased at a higher rate.
One notable factor is that rates of STDs appear to correlate most significantly with wealth. At least in New England, one could suggest that it isn’t even just wealth, but the broader assessment of economic health and freedom from dependence captured by the RI Center for Freedom & Prosperity’s Jobs & Opportunity Index (JOI). The northern New England states are leading the region (in the good way), with a gap to Massachusetts and Connecticut and then another gap to Rhode Island.
The picture is worse for Rhode Island, too, if we go beyond the two diseases that Wilson used for his score. According to the CDC’s 2016 data, Rhode Island may be 27th and 44th in the country for chlamydia and gonorrhea, respectively (with 1 being the worst), but we’re 12th in the country for primary and secondary syphilis. D.C. McAllister points out on PJ Media that the lion’s share of these cases nationwide are found among men who have sex with men.
The relative rankings of New England states drive home the interacting responses of culture and economics, with Rhode Island lagging. Reorienting our policy toward healthy families, away from special interests, would have broadly beneficial effects without having to be judgmental in a negative way about alternative lifestyles. Without this positive component, public policy runs the risk of encouraging harmful behavior by alleviating its consequences. We can and should help people who are suffering, no matter the cause, but dragging down those who’ve avoided suffering and burdening families shrinks the contrast.
Many college graduates over the past few decades will have come across live painting performances, in which the artist makes a performance out of the craft. My recollection is that the guy I saw back in 1993 was a bit of a pioneer (Denny Dent, I think), and part of his set involved pretending to mess up a painting of Jimi Hendrix only to flip it over and reveal the work as a success. The image of him flipping that painting over comes to mind when I read news like this, in the Providence Journal:
The Cranston Police Department and Cranston Public Schools are working together to implement a program that will help identify homes of children with autism spectrum disorders and intellectual disabilities.
The goal is to improve safety for children, and parents have the option to include their children in the registry, according to a news release from the chief of the Cranston Police Department, Col. Michael J. Winquist. Parents who wish to participate may fill out a form on the department’s website. Forms are also being distributed through the city’s public schools.
Yes, it’s well intentioned and voluntary. But… but… I can’t help but think of CBS’s proclaiming Iceland’s supposed progress in “eliminating Down syndrome” by aborting unborn children who have it and the constant push to implement and expand legalization of euthanasia around the world.
While I wouldn’t criticize the city for implementing the program, or residents for utilizing it, I think it’s important to pause and recognize that the picture being painted in our culture has all the features of a truly terrifying portrait and may only require a flip to reveal where it was going all along.
You need not look far to find a crisis waiting to happen, the "opioid" crisis has been going on in different… https://t.co/YNiawQrs2c
— Michael Morse (@mmorsepfd) October 27, 2017
Garbage. Excuse to raise money. Already a premium tax on O'Care in RI. State prevented NeighborhoodHealth from off'g lower prem plan last yr https://t.co/ttXqDzDvI3
— OSTPA (@OSTPA1) October 25, 2017
Rhode Islanders may be getting used to the evidence of decline, but when a hospital closes, it carries with it an especial sense of foreboding. Ted Nesi reports on WPRI.com:
Care New England’s board voted Monday night to close Memorial Hospital after a proposed takeover deal for the cash-strapped facility fell through, the company revealed Tuesday. …
Fanale said Memorial currently employs roughly 700 people, some of them part-time, and jobs are likely to be found for some of them at Care New England’s other facilities. “We’re not going to be able to save every one, but to the extent we’re able to [we will],” he said. He also emphasized that patient safety will be a priority as the hospital winds down. …
Memorial is licensed for 290 hospitals beds, but in recent months it has had just 15 to 20 inpatients a day. “It leaves you in a devastating situation,” Fanale said.
This is sad to see, but we live in a state in decline. Add this story to other obvious warning signs, like the closure of Rhode Island retail staple Benny’s. On a broader scale, recall that the RI Center for Freedom & Prosperity’s Jobs & Opportunity Index (JOI) showed the Ocean State dropping to 49th in the country, from its five-year perch at 48th. Even seemingly unconnected stories like the Warwick teacher sick outs are part of the story; after all, the underlying cause in that city (and most of the state) is plummeting enrollment.
These are the sorts of things you see when government attempts to structure society around government-heavy services provided to people who otherwise have no reason to live here. The government plantation model doesn’t work; government can’t be a state’s core industry.
Falsity and truth in teacher’s unions, ObamaCare, and the Boy Scouts.
In the past couple days, I’ve skipped over a few articles that would have made for easy posts because, frankly, the bias of the American news media has become so egregious that it’s not even interesting to point out anymore. Even relatively straight reporting on President Trump’s actions tends to be slathered with subjectivity meant to instruct readers not on what has happened or what some policy will do, but to signal how they’re supposed to feel about it.
One article on which I almost posted yesterday was Amy Goldstein’s Washington Post piece, appearing in a watered-down version in today’s Providence Journal, on President Trump’s Affordable Care Act executive order. Online, the Projo disappeared the article and sent the link to an entirely different AP release. Take a look at this paragraph as originally posted:
The White House and allies portray the president’s move to expand access to “association health plans” as wielding administrative powers to accomplish what congressional Republicans have failed to achieve: tearing down the law’s insurance marketplaces and letting some Americans buy skimpier coverage at lower prices. The order is Trump’s biggest step to carry out a broad but ill-defined directive he issued his first night in office for agencies to lessen ACA regulations from the Obama administration.
If this is an outlier in the mainstream coverage of President Trump, it isn’t by much.
This trend among journalists brings to mind the over-production of pop/rock music in the early ’70s. The Beatles were famously unhappy with Phil Spector’s saturation of Let It Be with orchestration. When George Harrison remastered All Things Must Past 15 years ago or so, the liner notes expressed his urge to “free the songs” from all of the layers of sound, and demos of the songs released with the Beatles Anthology albums give a wistful sense of what could have been.
In other words, the current style of reporting on the president as a sort of fad for adding layers of virtue-signaling editorial content to reporting. Luckily there are (metaphorical) hard rock and folk trends running alongside the schlock if you know where to look.
How might the urge to keep guns out of the hands of imbalanced people relate to debate about allowing physician-assisted suicide?
Accepting luxuries for those who can afford them and freedoms for those who disagree.
News that sexually transmitted diseases are on the rise is being reported as if it’s inexplicable, but it’s not really a new observation. This is from Bill Tomison and Julianne Lima on WPRI:
The number of people in Rhode Island who have sexually transmitted diseases – especially chlamydia, gonorrhea, and syphilis – is way up, according to the Rhode Island Department of Health. The trend is being seen nationwide, too, according to the Centers for Disease Control and Prevention. …
Put together, it’s a ten-year high in the three STDs, the Rhode Island Department of Health’s Joseph Wendleken said on Wednesday. He called it “very disturbing.”
The reason why STDs are skyrocketing is not clear. Condoms and other forms of protection are more accessible than ever.The theory is that more people are taking part in risky sexual behavior and meeting more potential casual sex partners through the surge of online or app-based dating.
For those willing to look, these trend have popped up with reference to STDs as well as teenage pregnancies. Most typically, however, the subject gets media attention in the context of trying to write off abstinence-only sex ed programs, so effects like that described above are downplayed because it runs contrary to the mainstream narrative.
The culture changes in an atmosphere of sex-promotion, and at the end of the day, the culture wins. The underlying message of the condoms, condoms everywhere approach is that the urge toward sex cannot be resisted, which intrinsically contains rationalization for not resisting the urge for better-feeling non-prophylactic sex.
So, what do we end up getting? More attempts to fix consequences, without consideration of the ever-broadening scope of those consequences — things like government-subsidized health care to provide screening and medicine that might reduce the likelihood of HIV infection, not to mention expanded funding for abortion.
From my wonky perspective, this is the most important part of Mike Stenhouse’s health care–related op-ed in today’s Providence Journal:
I believe that a two-pronged approach to health care can ensure affordable access for every American. First, let patients determine what level of coverage they need by repealing most government mandates. Health services and insurance have become unaffordable because of rapidly expanding government interference in the market. The free market did not create our health-care crisis; over-regulation did. Increased transparency and consumerism, as well as major tort reform, could reduce medical liability risks and further drive down costs.
Second, subsidies or vouchers for low- and middle-income Americans to purchase private insurance is a benefit a wealthy society such as ours should provide. If we pool all of the federal and state dollars currently allocated to health care — and eliminate wasteful government bureaucracies — we can subsidize sustainable, lower-cost, high-quality private health care for those who need assistance.
I’ve been arguing for this for about as long as health care policy has been a visible national topic of conversation. Allow catastrophic-coverage plans that protect people in the case of… umm… catastrophe, and route everything else through health savings accounts that have some sort of tax favorability for those who contribute to them (whether the plan owner, an employer, or some sort of benefactor), from which Americans pay directly for health care services.
Such a program would cover everybody for the unpredictable worst, and it would preserve the utility of a pricing mechanism. People would know what they’re paying for services and could decide whether any given procedure was worth the money. Moreover, as a society, we could better understand what we’re funding when we deposit money into the accounts of our disadvantaged neighbors. We could look at the cost of providing everybody with catastrophic coverage plus some basic preventative and emergency care, and then we could debate what additional services ought to be covered through the welfare program.
Meanwhile, employers, private charities, and others could make similar decisions for people in whom they take an interest. Of course, this wouldn’t allow progressives to control our lives or siphon money from our health care.
Dan McLaughlin points out a… let’s say… significant caveat about that study showing trillions in “cuts” to states in the latest Senate GOP health care proposal:
The study finds a $215 billion-over-seven-years reduction in spending from 2020-2026, but then jumps up to $489 billion when one more year is added, and ends up at $4.15 trillion by 2036. Why? Because Graham-Cassidy provides funding through 2026, then requires an affirmative reauthorization of the block grants after that. Avalere treats that “funding cliff” as if Congress has barred future funding. (“As the bill does not appropriate block grant funding to states after 2026, Avalere does not assume any state block grant funding available from 2027 onwards.”) Even over the full 17-year time horizon, as CAP Health Care analyst Topher Spiro confirmed to me on Twitter, the study assumes $1 trillion in cuts from the changed funding formula, meaning that 75% of the projected “cuts” are attributable entirely to the program requiring further authorization by Congress by 2026.
So, basically, researchers with integrity would have limited their time line to the period actually covered by the legislation. When 2026, either the program would be working well and therefore be easily renewed or it wouldn’t be working well and Congress would have to come up with something else. But the objective of this study — which the long window of itself strongly suggests — was clearly to stoke fear and gin up outrage.
Of course, as I emphasized last week, what really ought to be scaring Americans is the cost of ObamaCare if nothing is done. Somehow, that angle doesn’t make it into the reporting, though.
With Rhode Island’s own Democrat congressional delegation, particularly Senator Sheldon Whitehouse, signing on for Socialist Senator Bernie Sanders’s single-payer, Medicare-for-all health care plan, Betsy McCaughey’s recent New York Post article is worth a read for its turning of the tables.
Details on how Sanders’s plan would actually work, notably with regard to paying for it, are sparse, but McCaughey teases out some implications of concern. For one thing, according to McCaughey, private health care would be made illegal. Everything would have to go through the government system. Consideration of UHIP and DCYF in Rhode Island and the Veterans Health Administration nationally (to pick just three examples) make that prospect terrifying.
Perhaps even more significant, though, is this:
BernieCare guarantees you hospital care, doctors’ visits, dental and vision care, mental health and even long-term care, all courtesy of Uncle Sam. Amazing, right? But read the fine print. You’ll get care only if it’s “medically necessary” and “appropriate.” Government bureaucrats will decide, and they’ll be under pressure to cut spending.
That’s because Sanders’ bill imposes an annual hard-and-fast dollar limit on how much health care the country can consume. He makes it sound simple — Uncle Sam will negotiate lower prices with drug companies. Voilà. But driving a hard bargain with drug makers won’t make a dent in costs. Prescription drugs comprise only 10 percent of the nation’s health expenditures.
Consider this “hard-and-fast dollar limit” in the context of another national controversy over the debt ceiling and debate of the Senate GOP’s latest health care proposal, which would limit the expansion of government spending on health care, a prospect that Democrats and the media elite (not just news, by the way) are endeavoring to tar as inhumane. How can it be cruel to limit government spending on health care, but just dandy to ration health care generally?
The quick (if specious) answer may be that government spending accrues to the vulnerable and disadvantaged, but that argument dissipates if the wealthy are barred from supplementing their own care. Single-payer simply becomes the government providing care for services that and to people whom it considers worthy.
Another GOP ObamaCare reform proposal, and another wave of studies and news reports that tilt the numbers so Americans can’t see how desperately necessary reform is.
Rather than have government embark on a War on Loneliness, we should start unraveling the policies that make loneliness a greater problem.
A friend of mine has a favorite story about a coworker — both in a career for highly intelligent professionals — who seemed sincerely convinced that the government could help the economy by building jet airliners and flying them into the ocean. Obviously, that’s an extreme iteration of a common economic ignorance that one would hope would cause most people to pause and think, “No, wait, that can’t be right.”
The anecdote came to mind while reading an AP story by Ricardo Alonso-Zaldivar, about the big ObamaCare increases facing those who receive no subsidies for their individual plans:
“We’re caught in the middle-class loophole of no help,” said Thornton, a hairdresser from Newark, Delaware. She said she’s currently paying about $740 a month in premiums, and expects her monthly bill next year to be around $1,000, a 35 percent increase.
“It’s like buying two new iPads a month and throwing them in the trash,” said Thornton, whose policy carries a deductible of $6,000.
The point that needs to be stated is that it doesn’t make the waste any more palatable when other people are receiving those two trash-destined iPads per month courtesy of the U.S. government. The number of people throwing out metaphorical iPads for which they’ve paid may be small, but adding all of the subsidies up amounts to a lot of airplanes at the bottom of the ocean.
Of course (to be fair), all that money isn’t just producing garbage but is buying insurance against risk, albeit at an exorbitant cost with unjustifiable increases. Acknowledging that the money is buying something, however, only directs our attention back to the underlying injustice: The government is just forcing some Americans to buy something for other Americans… and undermining our rights and increasing our overall risk in order to do so.
The progressive agenda is an assault on the human workplace. Indeed, Rhode Island is engaged in a battle of ideas. The progressive vision is transforming the Ocean State, right before our eyes, into an anti-human-work hell.