Obamacare and Drug Abuse

From a Wall Street Journal op-ed, come a couple of very telling statistics regarding the opioid addiction epidemic.

…overdose deaths per million residents rose twice as fast in the 29 Medicaid expansion states—those that increased eligibility to 138% from 100% of the poverty line—than in the 21 non-expansion states between 2013 and 2015.

And

There were also marked disparities between neighboring states based on whether they opted into ObamaCare’s Medicaid expansion. Deaths increased twice as much in New Hampshire (108%) and Maryland (44%)—expansion states—than in Maine (55%) and Virginia (22%). Drug fatalities shot up by 41% in Ohio while climbing 3% in non-expansion Wisconsin.

This also reflects…interestingly…on those Republican Representatives and Senators who chose to vote against rolling back the Medicaid expansion part of Obamacare.

We’ll See

In an unprecedented move against North Korea, China on Monday issued an order to carry out the United Nations sanctions imposed on the rogue regime earlier this month.

Of course, in the days immediately following the first meeting between President Donald Trump and the People’s Republic of China President Xi Jinping, just after Trump’s inauguration, the PRC acted like it was going to start honoring then-existing sanctions against northern Korea.

That turned out to be just an act.  Is the present “order” serious, or is it just another empty gesture?

We’ll see, indeed.

Rule of Law

The DC Circuit Court stacked by President Barack Obama (D) seems to be iffy on the thing.  In an appeal concerning whether the monies the Federal government pays to health care plan providers as subsidies so the plan providers will hold down premiums and deductibles can actually be paid—the funds never were appropriated by Congress, so the payments aren’t legitimate, ruled the trial court—the Circuit Court ruled in part:

The States have shown a substantial risk that an injunction requiring termination of the payments at issue here…would lead directly and imminently to an increase in insurance prices, which in turn will increase the number of uninsured individuals for whom the States will have to provide health care[.]

That may well be true, and if true, it would be unfortunate.

However.

The law is clear: monies not actually appropriated by Congress cannot be spent by the Federal government—the money, in a very real legal sense, does not exist.  It’s also illegal to take funds from other, actually extant, appropriations to spend on non-appropriated-for activities.

The decisions whether to appropriate, and then to spend, are solely political decisions, and judges cannot—may not under our Constitution—decide in any way other than what the law actually says; in particular, they don’t get to rule in accordance with what they wish the law to say.  Doing the latter is nothing other than judge-made law.

In this case, the appellate court plainly has chosen rule by men—via judge-made law, here—over rule of law.

A Bit More on Health Care Coverage

Senator Susan Collins (R, ME) is worried about health care plan availability to our poor, which she thinks would be endangered were President Donald Trump to act on his thoughts regarding cutting off the funds the Feds pay to health coverage plan providers to get them to charge (artificially) lower deductibles and copays from the poor.

It really would be detrimental to some of the most vulnerable citizens if those payments were cut off. They’re paid to the insurance companies, but the people that they benefit are people who make between 100% and 250% of the poverty rate.

Couple things about this. One is that folks making more than the poverty rate…aren’t poverty-stricken.

The other is that, if the money really is intended to help folks pay for health care coverage plans, the money should go directly to those folks and not to the insurance companies. That way there would be no loss to internal friction in the middlemen of health care plan providers—a friction loss extant even in the most honest and well-intended of providers.

And one more: these aren’t insurance companies selling insurance policies.  It isn’t insurance when risks are transferred by Government fiat and at fees that bear no relation to the risks being transferred.

Collins knows these things full well.

Obamacare and Choice

There are 3,142 counties and equivalents (Louisiana has parishes, Alaska has boroughs, three States each have an independent city, Virginia has 38 of them, and State of Rhode Island and Providence Plantations does things entirely differently) in the US.

The Centers for Medicare and Medicaid Services expects that 40 of those counties will have no health care coverage plan providers at all in 2018, and 1,332 of those counties—over 40% of them—will have only one such provider.

Not to put too fine a point on the matter, but this is not choice.  This also drives home the lie of “If you like your doctor, you can keep your doctor; if you like your insurance plan, you can keep your insurance plan.”

Obamacare’s implosion is in full swing, it’s happening rapidly, and Republicans are fiddling.  They can bleat that it’s all Progressive-Democrats’ fault, that the Progressive-Democratic Party owns Obamacare to their heart’s content.  It’s irrelevant.  The Republican Party has been running on repeal and replace for the last four election cycles, and they now have majorities in both houses of Congress, and they have the White House.  The Republicans own repeal and replace—and they own the failure to make even the first syllable of progress toward that worthy end.

Timid Republicans need to find their courage and get on with the business.  Along these lines, others who demand that it all be done at once—both right damn now and in a single bill—need to recall the lessons of Obamacare as a single, all-at-once, almost right damn now bill, and they need to keep in mind political realities: Republicans in the Senate don’t have the filibuster-proof majority the Progressive-Democrats had for most of the time they were putting together their bill.

Repeal and replace can’t, won’t, and shouldn’t happen in a single bill.  It’ll need to occur as a series of bills, although those bills need to be passed in quick succession as politics go: over the course of a couple of Congressional sessions, or at most over two Congresses.

Senators Susan Collins (R, ME) and John McCain (R, AZ) are desperate to return to “regular order,” to negotiate with Progressive-Democrats and to hold hearings.  Fine.  Do that.  Those hearings need not take longer than a couple of weeks—especially if the Senate (read: Republicans) get rid of the ridiculous 2-hour per day limit on hearings—and the negotiations can be done similarly quickly, particularly since the Progressive-Democrats have shown they won’t seriously negotiate.

But get after it.  Republicans need to stop dithering, stop playing with their…fiddles…and get on with the business.  They have their own choice to make regarding their place in Government and in the nation.