Senator Mike Lee’s focus on ‘putting families first’ — Sutherland Soapbox, 2/24/15

family beach sunsetThis post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations. The podcast can be found at the bottom of this post.

Much has been said over the past several weeks about the number of significant leadership positions now occupied by Utah’s elected representatives in the nation’s capital and in organizations with national scope and influence. In addition to several House members occupying key roles in the U.S. Congress, with Republicans taking control of the Senate in the recent election, the longest-serving member of the delegation, Sen. Orrin Hatch, became the Senate president pro tempore, a position that puts him third in the line of presidential succession behind the vice president and the House speaker. Further, Governor Gary Herbert serves in the leadership of the National Governors Association, where he will soon become the chair; Salt Lake City Mayor Ralph Becker currently is president of the National League of Cities; and state Senator Curtis Bramble is the president-elect of the National Conference of State Legislatures (NCSL), a bipartisan organization serving the nation’s 7,383 state lawmakers and more than 20,000 legislative staff.

Today, I’d like to focus on U.S. Senator Mike Lee. As recently reported in the Deseret News, while visiting the state, prominent political pollster Frank Luntz “said Lee’s position as head of the Senate steering committee that acts as a conservative caucus, along with key assignments held by the other five members of Utah’s all-GOP congressional delegation, gives Utah outsized influence. [Quoting Mr. Luntz:] ‘Utah’s got the most powerful delegation in Washington … [i]t’s incredible that this is a small state with an oversized delegation.’”

Senator Lee is consistent in focusing on a particular priority. In his words: “America’s crisis of unequal opportunity is the greatest challenge facing the United States today. We need to start developing a new conservative reform agenda that restores equal opportunity to the families and communities from whom it has been unfairly taken.”  Continue reading

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Support religious liberty: stand up to the ‘no compromise’ approach to nondiscrimination

Utah_State_Capitol_2008Supporters of a “no compromise” approach to LGBT nondiscrimination argue that we already have sufficient protections for religious liberty. They cite the First Amendment and Utah’s majority-Mormon population to bolster their case. Unfortunately, their argument is undermined by the realities of “no compromise” approaches to nondiscrimination law.

The facts and details of the experience of a Salt Lake City police officer and his role at the Salt Lake pride parade in 2014 are a case in point. This officer arranged, as is common police practice, a swap of duties with another officer working the parade. In the officer’s view, his original entertainment/celebratory role of doing motorcycle maneuvers at the head of the pride parade amounted to endorsing values that his conscience and faith disagreed with. Instead, the officer sought to perform a public safety role, such as protecting parade watchers from traffic. The officer had fulfilled similar public safety duties on other occasions for Salt Lake LGBT rallies.

Because the officer had the temerity to ask that his religious views and values be treated with tolerance, respect and equality, his employer caricatured him as a bigot to the media, questioned his willingness to perform his duty and put him under internal investigation. This officer asked for religious liberty and was met with injustice and intolerance. And all of this happened in our own backyard. Continue reading

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Nondiscrimination legislation requires balance, extreme care

Balancing_act_News reports suggest there is still an ongoing debate about how to balance calls for changes to state discrimination laws (which would expand the reasons businesses and property owners could not deny housing or employment) with the need for robust religious liberty protections.

At the time leaders of The Church of Jesus Christ of Latter-day Saints held a press conference calling for laws protecting religious liberty, Sutherland Institute noted its support for the balanced approach the church endorsed.

It is safe to assume that few, if any, people of faith in Utah want anyone to be denied a job or a place to live just because those people’s actions or beliefs are contrary to the beliefs of the religion. Religious groups, both churches and charities operating in accordance with religious principles, merely want to ensure that those who represent them as leaders and employees live lives consistent with those principles.

Sutherland Institute has consistently urged strong religious protections that allow churches, unaffiliated religious organizations and individuals to live in accordance with their religious beliefs in every aspect of their lives. Any legislation on this topic should protect this vital principle.

At the same time, the Legislature needs to exercise extreme care when introducing new terms, like “sexual orientation” or “gender identity,” into the law.

The latter requires particular caution since definitions in previous legislation could be read to allow a person to identify as a person of another sex for short periods of time, going back and forth between genders and asking for accommodations in facilities, etc., possibly from day to day. Legislation should be crafted to provide clarity and prevent undue burdens on employers or the privacy of employees, customers, and others.

Even the “sexual orientation” language, if not appropriately qualified, can present challenges for religious liberty. Continue reading

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Testimony on SB 153 (Access to Health Care)

sutherland file pictures 007Testimony presented by Stan Rasmussen, Sutherland Institute director of public affairs, on Feb. 17, 2015, before the Senate Health and Human Services Standing Committee regarding SB 153 (Access to Health Care): 

Thank you, Mr. Chair, and good morning, Senators. Stan Rasmussen representing Sutherland Institute.

We think SB 153 represents a wise approach that balances meeting the immediate needs of individuals with significant health problems against the need to be cognizant of and cautious about the very detrimental impact that expanding the Medicaid program will have on those currently in Medicaid – the hundreds of thousands of disabled individuals and low-income single parents and children that Healthy Utah would leave behind in traditional Medicaid – as well as on the long-term fiscal outlook of the state.

For these reasons, we strongly encourage your support of this bill.

Thank you.

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Is apple pie next? — Sutherland Soapbox, 2/17/15

A_Wreath_to_Mama_1876This post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations. The podcast can be found at the bottom of this post.

Motherhood and apple pie, as the idiom suggests, are things we can all agree on — they’re archetypes of all that’s good and wholesome.

Well, apple pie now has some high-placed enemies, and even motherhood’s not getting the respect it used to; a certain kind of motherhood at least.

As a number of commentators have noted, the president’s plan to help middle-class families unveiled in the State of the Union speech has a blind spot. As family scholar W. Bradford Wilcox explains:

The president’s plan would triple the existing child-care tax credit to $3,000 for two-earner families with children under 5 and a combined income of less than $120,000, and it would establish a new $500 credit for families in which both spouses work. The plan would provide tax relief—which would no doubt help with the cost of child care, commuting, etc.—to middle-class families with both parents in the workforce. But families who choose to have a parent at home would see none of this tax relief.

The hopefully unintentional slight followed an awkward statement last year during a speech on Women and the Economy where the president—while endorsing paid family leave, better daycare and early childhood education—said: “sometimes, someone, usually mom, leaves the workplace to stay home with the kids, which then leaves her earning a lower wage for the rest of her life as a result.  And that’s not a choice we want Americans to make. ”

So, perhaps motherhood’s still okay as long as mother doesn’t shirk paid work to do it.

G.K. Chesterton pointed out the flaw in this line of thinking in 1920:

If people cannot mind their own business, it cannot possibly be more economical to pay them to mind each other’s business, and still less to mind each other’s babies. It is simply throwing away a natural force and then paying for an artificial force; as if a man were to water a plant with a hose while holding up an umbrella to protect it from the rain. . . . Ultimately, we are arguing that a woman should not be a mother to her own baby, but a nursemaid to somebody else’s baby. But it will not work, even on paper. We cannot all live by taking in each other’s washing, especially in the form of pinafores.

It would actually be easy to avoid the problem of singling out the choice to remain at home to care for children for less favorable treatment. Professor Wilcox notes that an idea proposed by Senators Mike Lee and Marco Rubio would expand “the child tax credit to $3,500 from its current $1,000 and extending it to payroll taxes” which would treat all parents the same, regardless of whether there are one or two wage earners in the home.

Utah’s policies have some blind spots regarding single-income families as well. For instance, if a parent who chooses to forego paid employment is divorced, the law “imputes” non-existent income to that person that will offset the obligations the spouse who caused the divorce would have had. This means a decrease in the amount that would be available to the stay-at-home parent, making it more likely that person will have to leave home for paid work. From a purely practical perspective, it might be wise for a divorced spouse to find other sources of income given the possibility that support might not be paid or might not be adequate, it hardly seems like good policy for the state to assume that the only appropriate thing for a parent who has been at home with the children to do is to get back into the workplace and have children shift for themselves as quickly as possible. Maybe that result can’t be avoided but it need not be mandated.

Policy makers need to be reminded that mothers, and sometimes fathers, who sacrifice to care for children in the home are making an incalculable contribution not only to their children and their family but to society at large. They deserve respect and appreciation and even help, not to have their choice hedged up by those who are blind to all but market values.

For Sutherland Institute, I’m Bill Duncan. Thanks for listening.

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Ex-CDC chief: Policies that reduce alcohol availability reduce alcohol-related problems

Everyone_take_a_drinkIn an op-ed published Feb. 12 in The Salt Lake Tribune, Dr. James O. Mason challenged a previous Tribune editorial, which said, “No doubt Utah sees benefits from having a lower rate of alcohol consumption and fewer drinkers, but the state should give credit where it is due: its people, not its liquor laws.”

Disputing this assumption, Dr. Mason responded,

In other words, they [the S.L. Tribune editorial board members] hoped to convince readers that Utah’s lower rate of alcohol consumption has everything to do with religious demographics and little to do with Utah’s alcohol policies and laws. Legislators should understand the science behind this controversy before making any changes to Utah’s laws.

How can we measure the impact of religious culture versus alcohol laws in explaining Utah’s low rate of alcohol-related problems? Perspective might be gained by examining the state’s experience with tobacco control. In 1986, Utah’s adult smoking rate of 18.2 percent was the lowest in the nation. … Fast-forward to 2012 when the smoking rate had fallen to 10.6 percent. What explains how Utah’s smoking rate was cut, almost in half, within a 26 year period? Was it increased religious fervor? An influx of Mormons? No, the explanation lies elsewhere.

He then noted,

Between 1986 and 2012, Utah, like most other states, adopted a variety of evidence-based tobacco control strategies which were recommended by the Centers for Disease Control and Prevention (CDC). Experts from the CDC claimed comprehensive tobacco control policies would dramatically reduce smoking. The recommended strategies included increasing cigarette taxes, aggressive indoor clean air laws, youth access restrictions, access to smoking cessation services and anti-smoking media campaigns. Utah legislators took a gamble and followed the recommendations. What was the result? The smoking rate in Utah was cut almost in half. Public health policies, rather than religion, produced this decline.

Could it be that public health policies likewise contribute to Utah’s lower rates of alcohol problems? Informed legislators will get answers from experts employed at authoritative organizations. Numerous researchers’ careers have focused on which, and to what extent, various alcohol control policies work. They set a high bar for labeling a policy as “evidence-based” or “best practice.” The CDC’s online document, “Community Guides: What Works to Promote Health,” and the World Health Organization’s book, “Alcohol: No Ordinary Commodity” rate the relative effectiveness of select alcohol policies. These documents describe the rating methodology and carefully reference the studies used to generate their recommendations.

Continuing,

These reports don’t recommend prohibition, but they do convey the clear message that, collectively, policies which reduce alcohol availability such as the number and location of retail outlets, hours of sale and the price of drinks, substantially reduce the number of alcohol-related problems. Maybe Utah’s alcohol control policies aren’t so screwy after all. One prominent alcohol policy researcher called them the “envy of the nation.”

In conclusion, Dr. Mason asserted,

Utah legislators are being pressured by special interest groups to loosen the state’s alcohol regulations. Some claim economic gains will result with loosened policies. Rather, if loosened, the costs to society will far exceed projected economic gains. Legislators should be wary of industry lobbyists who, 30 years ago, tried to convince lawmakers that Salt Lake City could never get the Winter Olympics unless the state dismantled its alcohol policies. Those lobbyists were wrong. They are also wrong in claiming that Utah’s alcohol policies do nothing to reduce the negative health, social and economic impact of alcohol abuse. Thoughtful analysis by experts suggests that alcohol control policies work [emphasis added].

The op-ed also noted that Dr. Mason is a former executive director of the Utah Department of Health and a former director of the CDC.

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On Point video: Taxes and education in the Legislature — 2/12/15

 

Watch as Utah GOP party officer Michelle Mumford and political consultant Michelle Scharf discuss the latest in Utah politics and the 2015 Legislature in this edition of On Point presented by Sutherland Institute.

Click the image above to watch, or if you prefer a podcast, it can be found at the bottom of this post.

You can watch all the half-hour On Point videos here on Sutherland’s YouTube channel.

Use this link to subscribe to the On Point podcast on iTunes.

Or use this link to subscribe to the RSS feed.

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The research so far: Mom + Dad still best for kids

Family_playing_a_board_gameIn past decades, a large body of research has developed focused on the question of what family structures are most likely to promote child well-being. The basic consensus — based on comparisons of children raised by married biological parents, single parents, divorced parents, stepparents, etc. — is that children fare best, on average, when raised by their own biological parents in a stable marriage.

More recently, a different body of research suggests that this consensus would not apply if the population being compared were children raised by same-sex couples. In other words, the claim is that children raised by same-sex couples fare no differently than children raised by a biological mother and father. If true, this would be an important finding since the research on stepparenting (the situation most analogous to same-sex couples parenting a child, since at most one member of the couple would be biologically related) would seem to point in a different direction.

Of course, the importance of this finding, if established, would extend beyond the academy since the claim of “no differences” has been relied on by courts that have found that the U.S. or state constitutions require same-sex marriage. Indeed, the Supreme Court’s DOMA opinion seems to rely on this literature by implication in suggesting that children being raised by same-sex couples are harmed by the inability of the couple to claim the status of marriage, rather than inquiring whether any difficulties these children experience may come from separation from one or both biological parents or from a lack of relationship with either a mother or father.

Discordant notes

There has been some serious criticism of the same-sex parenting studies, however, because a number of analysts, representing diverse views on the political implications, have noted problems with sample sizes, non-random samples, poor or nonexistent comparison groups, etc. (See here, here, here, here and here.)

In 2012, Dr. Loren Marks at Louisiana State University published a detailed analysis of the studies relied on by the American Psychological Association for its support of same-sex marriage and found that the flaws in that research were so significant as to seriously call into question the validity of any conclusions derived from it.

Far more interesting was a new study released in the same journal as Dr. Marks’ report which attempted to correct the shortcomings of the previous literature by drawing on a much larger, representative sample, comparing child outcomes on more significant measures, and avoiding the problem of relying on reports of the adults raising the child. This study (and a follow-up study, using different comparison groups in response to critics of the initial research) demonstrated significant increases in problems for children raised by same-sex couples as compared to children raised by married biological or adoptive mothers and fathers.

This study, and to a lesser extent similar studies (here and here and here) suggesting children raised by same-sex couples don’t fare as well as children raised by married mothers and fathers, have been subjected to a firestorm of attacks (see also here, here, and here), including much ad hominem rhetoric and an apparently unprecedented and certainly highly unusual campaign of harassment and intimidation.

New studies

Now, three new studies by sociologist Paul Sullins, who teaches at the Catholic University of America, add to the data that seem to undermine the claim of “no differences.” Continue reading

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Testimony on SB 164 (Medicaid expansion)

sutherland file pictures 007Testimony presented by Derek Monson, director of public policy, Sutherland Institute, on Feb. 11, 2015, before the Senate Health and Human Services Committee of the Utah Legislature regarding SB 164 (Access to Health Care Amendments):

Thank you, Mr. Chair and members of the committee. I am Derek Monson, policy director for Sutherland Institute, and I appreciate the opportunity to present our viewpoint on this important issue to you.

I would like to draw your attention to what we think is a basic policy issue regarding Senator Shiozawa’s bill. That is its impact on the people for whom the Medicaid program was actually designed to serve: disabled Utahns and low-income single parents and children.

Both thoughtful analysis and fact suggest that Sen. Shiozawa’s bill will increase the difficulties and suffering of the more than 300,000 disabled Utahns and low-income single parents and children currently in Medicaid. This is not a partisan or ideological issue. While Sutherland recognizes this problem, so do nonpartisan research organizations that argue in favor of Medicaid expansion, such as the RAND Corporation.

Neither is this just a theoretical question. In Oregon, so many people were added to the ranks of the insured through Medicaid expansion, basically overnight, that doctors and hospitals were forced to “lock out” Medicaid patients and make them “wait months for medical appointments,” as reported by the Associated Press. And in Arkansas, which expanded Medicaid using private insurance subsidies just like Healthy Utah envisions, a legislative committee heard testimony last April from state officials that providers are more “anxious” to serve newly privately insured patients than traditional Medicaid patients.

And why shouldn’t they be? In Arkansas as well as in Utah, the typical private insurance policy pays providers better than Medicaid does. And as basic economics teaches us, people respond to price incentives. The enactment of Healthy Utah clearly says to providers that they ought to prioritize the health care needs of the estimated 89,000 Medicaid expansion enrollees over the needs of the 300,000 single mothers, disabled Utahns and children left behind in traditional Medicaid. Utah’s most vulnerable will find it more difficult to find a doctor, and they will suffer longer waiting in line for needed surgeries and more intensive health care services.

Good public policy, on the other hand, would put traditional Medicaid enrollees on the same health care access footing as Medicaid expansion enrollees and everyone else, rather than excluding them and by so doing making their lives worse. Additionally, good public policy would not say to uninsured Utahns that we intend to care for their needs, only to toss them into the street the moment Washington, D.C., gets jittery about their finances. We don’t think that reflects the Utah values of providing service and helping to our neighbors in need, even when it’s difficult to do so.

In short, if “doing the right thing” means putting Medicaid expansion on the backs of disabled Utahns, single mothers and their children, then this is the bill for you. If, on the other hand, you think that serious public policy proposals should recognize and address the negative impacts they are likely to have on Utah’s most vulnerable, then I would encourage you to not vote in favor of SB 164 until it at least includes some attempt to address this critical issue.

Thank you.

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Moral standards and redemptive values — in Hollywood? Yes! Sutherland Soapbox, 2/10/15

b

reel

This post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations. The podcast can be found at the bottom of this post.

Hollywood is just a cesspool of filth rotting our souls and ruining our children. Or at least that’s a narrative we often hear, right? While the entertainment industry does produce its fair share of garbage, there is a lot to celebrate.

This past weekend, a few of my Sutherland Institute colleagues and I had the chance to attend the 23rd Annual Movieguide Awards in Hollywood. The awards gala honors films that feature high moral standards and redemptive values. In attendance were directors, producers, actors and studio executives for films such as “Big Hero 6,” “The Hobbit: The Battle of the Five Armies,” “Mr. Peabody & Sherman,” “Unbroken,” and “Muppets Most Wanted.” Stevie Wonder even made a surprise musical appearance.

But the thing that stood out to me most was the economics of moral creative content. And I’m not talking about moral content in the form of an in-your-face, condemning-you-to-the-fires-of-hell sermon disguised as a movie. That stuff just doesn’t work. If you want to preach, be a preacher. If you want to teach, be a teacher. But if you want to be a filmmaker, you better learn how to entertain. That is, after all, why most people go to the movies. To have fun. To be entertained. And perhaps, along the way, folks might also be inspired, outraged or moved to action. The trick is to elicit that emotion without alienating the audience. And the movies honored at the Movieguide Awards did just that. And that’s where the economics comes in.

During the event, Movieguide presented a statistical analysis of the biggest box office movies of 2014, as they have done for decades. Their analysis shows where the real money is. Of the 25 highest grossing films of 2014, only four were rated R. Movies with a very strong Christian, redemptive or moral worldview raked in $2.2 billion, while movies with a very strong non-Christian worldview earned less than half a billion dollars.

As I list off the top-10 grossing films of 2014, think of all of the funny, inspiring, amazing and entertaining moments from these films. Continue reading

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Senator Hillyard has it right on raising the rainy-day fund cap

Utah_State_Capitol_2008Last week, Senator Lyle Hillyard posted to The Senate Site that he and Representative Dean Sanpei would be sponsoring legislation to raise the limits on the general and education rainy-day funds (or budget reserves) which are currently at 8 percent and 9 percent of the previous year’s budget, respectively. Their proposal would raise these limits to 9 percent of the last year’s budget for the general rainy-day fund, and 11 percent for the education rainy-day fund.

This proposal is the right thing to do for Utah taxpayers and families. It is prudent and wise fiscal policy, and Sutherland Institute supports it.

First, as Sen. Hillyard correctly notes, this policy change will “help us live and provide a stable budget in less-certain times.” As Utah’s experience during the most recent recession suggests, having a healthy source of one-time funds set aside in savings gives policymakers the flexibility and financial cushion needed to make modest (and healthy) cuts to government spending. Just as important, if not more so, building up sufficient savings protects Utahns from being forced to accept truly harmful policies – such as deep spending cuts to essential programs and services and/or significant, economically damaging tax increases.

In other words, having significant one-time savings set aside protects recession-ravaged Utah taxpayers and families from further short-term harm, such as cuts to things like safety-net services. It also protects them from spending cuts or tax increases that generate short-term gain (balancing Utah’s budget) in exchange for long-term loss (fewer jobs, less household income and slower economic growth).

Second, while Utah’s pre-recession rainy-day fund savings were significant, the Great Recession showed that they were, by themselves, inadequate. The recession required policymakers to end or reallocate certain one-time budget items – cash-funded road and building construction/maintenance, for example – instead of further cutting other government programs and services. In effect, these one-time budget items were treated as informal rainy-day funds, in order to avoid more damaging spending cuts elsewhere. There is no guarantee that these fiscal cushions will be available in the future. For instance, economic circumstances or other spending needs may not allow the Legislature to return to previous levels of cash funding for roads and buildings. This makes lifting the caps on rainy-day funds a prudent way to maintain sufficient budget reserves in the face of this uncertainty.

For these and other reasons, Sutherland Institute supports the Hillyard/Sanpei proposal to raise the current caps on state rainy-day funds. We hope that the Legislature and the governor will enact this prudent fiscal policy change into law.

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A right to discriminate?

ReligiousSymbolsA common accusation made by those who oppose robust protections for religious liberty is that proponents are seeking a “right to discriminate.” The common form this argument takes is that religious liberty is already protected (say, by the First Amendment to the Constitution: “Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof”) so any other concession is asking too much — it would be dangerous or scary, a license to pick and choose what laws to comply with*; it would be a right to discriminate.

Discrimination in this context is, basically, denying a person a job or a place to live or refusing to provide goods or services normally provided in the course of doing business.

To assess the validity of this accusation, some background is helpful, though necessarily I will paint with a broad brush. Religious people believe they are accountable to God in every aspect of their lives. Acting on this principle is what constitutes the “exercise of religion.” There are at least five possible categories of organizations or people who could benefit from religious liberty protections.

First are churches. The basic liberties they seek are to teach their doctrines, provide sacraments or ordinances, build and maintain places of worship and select official representatives (clergy) without interference. These aims, which may be thought of as the core religious rights, are typically protected by interpretations of the U.S. Constitution. For instance, in 2012, a unanimous Supreme Court rejected a claim from the federal government that it should be able to second-guess a church selection of a teacher in a religious school. The fact that the current administration pushed this attempt all the way to the Supreme Court is concerning, but that claim lost and there’s reason to believe that at least for now, these core religious functions are protected from direct government interference.

That’s not to say there won’t be non-governmental interference with these function, like vandalism, threats, slander, etc. Continue reading

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On Point video: 2015 Legislature gets into its groove

Watch “Holly on the Hill” blogger Holly Richardson and Michelle Mumford, former assistant dean at BYU Law School, discuss the first week of the 2015 Legislature – including the topics of Medicaid expansion, gas tax, police-community relations, education funding, religious freedom and nondiscrimination legislation – during the latest On Point broadcast. Click the image above to watch, or if you prefer a podcast, it can be found at the bottom of this post.

You can watch all the half-hour On Point videos here on Sutherland’s YouTube channel.

Use this link to subscribe to the On Point podcast on iTunes.

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Medicaid: A disconnect between debate and reality, Sutherland Soapbox, 2/3/15

 

Photo: Caremate

Photo: Caremate

This post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations. The podcast can be found at the bottom of this post.

I want to discuss a topic of significant political news reporting this week: how should Utah deal with Medicaid expansion, as allowed and encouraged by Obamacare.

The proposals for expanding Utah’s Medicaid program being considered by the Utah Legislature are varied, including a plan for full Medicaid expansion using the traditional Medicaid program; Governor Herbert’s alternative plan for full Medicaid expansion under Obamacare using private health insurance; and the Health Reform Task Force recommendation to avoid Obamacare altogether and opt for a targeted expansion to the “medically frail.”

The defining feature of the debate can be summed up in one word: “complexity.” Health care generally is an extremely complex policy issue – whether morally, fiscally, economically or politically. Add to that the fact that we’re talking about health care for low-income Utahns, and the fact that the debate stems from an unpopular law named after a liberal sitting president, and the complexity and difficulty increases exponentially.

It should come as no surprise then that finding the right way forward has been hard to come by. Simply put, there is no easy answer to the question of Medicaid expansion. For our part at Sutherland, we think the federal involvement and restrictions on Medicaid policy make this herculean task nearly impossible, because the feds shoot down the ideas that hold the most potential to generate support.

But an even bigger problem with Medicaid policy and debate is the misguided focus on all sides about what Medicaid is and should be. First and foremost, Medicaid is and should be a response to poverty in society – an anti-poverty program, not a health care program. Another way of putting it is that we created Medicaid in the first place because poverty made health care unaffordable for some, not as a response to issues of public health.

But Medicaid policy and debate ignores this fundamental issue. Instead of trying to address the poverty of the poor, the debate focuses on improving health care for the poor. As a result, Medicaid policy obsessively focuses on the symptoms of the problem, such as access to doctors, payment rates for providers and costs to taxpayers, rather than on the problem itself, which is that poverty makes needed health care inaccessible and unaffordable for low-income Utahns. This disconnect between political debate and human reality drives much of the complexity of Medicaid policy debates, as liberals intuitively understand and focus on the symptoms of poverty and conservatives intuitively understand and focus on the problems created by programs like Medicaid.

A big part of the solution is to recognize and accept that Medicaid should be an anti-poverty program, not a health care program. The latter approach means that Medicaid will be a failure as policy if all it does is provide health care coverage to low-income Utahns, while doing little or nothing to help them get out of poverty. What’s more important, this new approach is likely to be better for society and the common good on all levels.

It is better morally because Medicaid will actually improve the lives of poor Utahns, by helping them get the education, life skills and networks they need to rise out of poverty, rather than naively assuming we’ve solved their problems by cutting a check for their medical bills. It is better fiscally because it provides a financial commitment from taxpayers that lasts only until an individual or family rises out of poverty, rather than an unending entitlement that adds to federal deficits and eats up ever-larger portions of state budgets. It is better economically because it means helping low-income Utahns become more prosperous and economically productive, while limiting the economic resources required to get and keep them in that position. And it is better politically because both liberals and conservatives are voicing understanding of the need to address poverty.

So what does this approach mean for dealing with Medicaid expansion today? It means Utah should focus on a minimal expansion of the current flawed approach to Medicaid, such as the targeted proposal for the medically frail, and then get back to the drawing board to reform Medicaid into a program that uses health care to combat poverty. Only then will we get a Medicaid program that is actually solving real problems, rather than just chasing after the next symptom.

For Sutherland Institute, I’m Derek Monson. Thanks for listening.

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Vaccination: the debate that shouldn’t exist

measlesVaccines have fallen victim to their own success. They have worked so incredibly well that no one remembers the reality of the diseases that vaccines have kept at bay, and instead too many people, out of fear, focus on a very few bad outcomes.

The granddaddy of the anti-vaccine accusations, the infamous Wakefield study from 1998 – which claimed a link between the MMR (measles-mumps-rubella) vaccine and autism – was a fraud.

Unfortunately it gave rise to an anti-vaccine movement, sped on its way by well-meaning parents (and others) with the best of intentions. Alarmed by the rise in autism cases, they looked for ways to reduce the chances of their children being affected by this disorder – especially if they already had family members with autism.

As the mother of an autistic 13-year-old, I empathize utterly. I’ve read many books, considered different treatments, and agonized over what I might possibly have done during pregnancy and birth to trigger autism in my son.

But fraudulent and misguided “science” has resulted in real harm. Resources that had to be spent in debunking this study and its fallout are resources that could not be used to direct scientific research into far more promising avenues. Who knows how much this unnecessary disaster has delayed real answers? How much time, money, effort and emotion have been wasted on this rabbit trail … and how much harm has it caused by casting aspersions on vaccines?

I fear that if parents choose not to vaccinate their children, the choice will ultimately be taken away from everyone. Don’t give the government a reason to mandate vaccinations. Be smart enough to do it of your own volition – and out of compassion for not-yet-vaccinated infants and the very few who really are medically unable to get vaccines.

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