The wrong Rx

A new study by State Budget Solutions shows our friends and neighbors in Utah would be devastated with the loss of 14,000-plus jobs in the state because of Medicaid expansion. We must do better!

You can read the study here.



Charity care is crucial to Utah’s health – Sutherland Soapbox, 9/9/14

MystethoscopeThis post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations.

Health care and health care policy have become daily news topics. You may have noticed Governor Gary Herbert promoting his Healthy Utah plan. Although this proposal is touted as an alternative to Medicaid expansion, it would require the approval of the president’s Secretary of Health and Human Services. So in other words, a state government initiative, funded by the federal government – as long as the money is there – will be run, and effectively guaranteed, by state government. Considering the federal government is already in debt up to its neck, we think this sounds like a really bad bet.

As a conservative organization, Sutherland Institute does not believe in government-driven health care. We do not believe health care is a right, but rather a personal responsibility, and yet we believe all people have a moral obligation to care for each other. It’s manifestly human – a moral good – to care for our neighbors.

For the past 12 years, Sutherland has argued that authentic charity care creates the right kinds of socioeconomic incentives to build community, heal class divisions, control health care costs and set an example for the rest of the nation. We also assert that the increase in Medicaid can be mitigated through the expansion and improvement of something that already exists: the impressive care currently being provided across our state by charity-care clinics, private-practice physicians and institutions serving the “working poor,” indigent and needy uninsured. Read more

Deseret News op-ed: Healthy Utah plan would hurt the most vulnerable Utahns

Waiting Room, by Vincent van Gogh

Waiting Room, by Vincent van Gogh

Good public policy requires three elements: doing the right things for the right reasons in the right ways. These elements are the difference between good policy and bad.

The proposed Healthy Utah Plan does some of the right things and for the right reasons. It seeks to help uninsured individuals acquire private health insurance (the right thing) for the sake of their own health as well as that of Utah’s economy (the right reasons). However, Healthy Utah would do this by pushing the most vulnerable Utahns further back in the health care access line.

It also relies on federal funding that cannot be sustained — jeopardizing funding for government services like education and transportation. You simply cannot do the right thing in the wrong ways and make good public policy.

Healthy Utah proposes to subsidize private health insurance for some 55,000 uninsured Utahns in the Obamacare “coverage gap.” In short, it takes them from the back of the line for access to health care and puts them at the front.

But what does that mean for the more than 300,000 low-income children, single parents and disabled Utahns — the most vulnerable of Utahns — who are on Medicaid now?

Click here to read the rest of this op-ed by Sutherland’s Derek Monson on the Deseret News website.

The next broken Obamacare promise

President Barack Obama, Vice President Joe Biden, and senior staff react at the White House as the House passes the health care reform bill.

President Obama, Vice President Biden and staff celebrate as the House passes the health reform bill.

Remember the lie of “if you like your health care plan, you can keep your health care plan”? Now, it seems, Obamacare’s “promise” of free preventive health care, such as checkups, screenings and immunizations, is also turning out to be something less than accurate.

As summarized in an informative Politico story on the issue, “as millions of newly covered people begin to seek that benefit [of free preventive health care], some are still getting stuck with bills.” This is because many people getting free preventive health screenings and tests (e.g., a colonoscopy) are still being charged for any preventive health care that comes along with it (e.g., immediate removal of not-yet-cancerous polyps found during the colonoscopy).

Just add it to the growing heap of Obamacare falsehoods, misstatements, and factual inaccuracies.

As someone who admires Ronald Reagan, I believe in the political principle of “trust, but verify.” But how do you apply that with an administration that has proven through both incompetence and misleading statements to be untrustworthy when it comes to its signature health care program?

Unnecessary licensing restrictions raise cost of health care

Medical toolsWhy do we have licensing laws that restrict who can treat patients as a doctor and perform medical procedures?

Ostensibly, it is for the health and safety of people who need to visit the doctor (i.e. everyone). We don’t want John Doe off the street opening up a medical clinic, calling himself a doctor, and handing out drugs or performing surgery.

So what does it mean when we find out that some licensing rules meant to protect our health have no connection with health outcomes, and in fact harm us by making medical services more expensive?

A recent study published by the National Bureau of Economic Research reported that medical licensing rules that allow only physicians – not nurse practitioners – to prescribe drugs to patients “do not seem to influence health care quality.” Changing these licensing regulations does not seem to impact health outcomes such as infant mortality rates.

However, these licensing restrictions are connected with higher health care costs. For instance, the study “shows that more rigid regulations increase the price of a well-child medical exam by 3 to 16%.” This happens through various mechanisms, such as requiring a parent (or the parent’s insurance company, which charges premiums to cover those costs) to pay the more expensive rate charged by a physician for their child’s checkups, in order to access that physician’s ability to prescribe any drugs needed.

When nurse practitioners are allowed to prescribe drugs, the cost of a well-child exam goes down because the time of the nurse practitioner is less expensive than that of a physician. And as the study suggests, this less expensive medical option is likely to come without significant negative effects on health outcomes.

Why does this matter to Utah and Utah families? In every legislative session, without fail, there is a raft of new proposals to heighten licensing restrictions to prevent people from providing various services.

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Sutherland’s position statement on Medicaid expansion

hiddenmoneySutherland Institute understands the perspective of those calling for Utah to follow Obamacare’s vision of Medicaid expansion. The argument sounds reasonable: Since Utahns are paying tax dollars to Washington, D.C., under Obamacare, then why shouldn’t Utah take every Medicaid expansion dollar it can get?

Sutherland also recognizes this as a moment for political courage and leadership. The decision regarding Medicaid expansion is an opportunity for Utah politicians to become statesmen and stateswomen: to rise above short-sighted concerns of moneyed special interests and well-intentioned advocates and, instead, take the long view recognizing the real risks that Obamacare’s Medicaid expansion creates for taxpayers and the neediest Utahns. This is a moment for Utah’s leaders to show why it is and will remain one of the best-managed states in the nation.

Medicaid expansion is an idea that sounds reasonable in the short term, but it’s not. Thoughtful consideration of the issue from a broader, long-term perspective leads to the undeniably logical conclusion that Medicaid expansion is imprudent, irresponsible policy for taxpayers and dishonest, harmful policy for Utahns in need.

Click here to read the rest of this position statement.

It’s naïve to believe Medicaid expansion promises

This post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations.

iStock_000002098320MediumI have long felt that Medicaid expansion is a central component of Obamacare. If President Obama can get more and more people on Medicaid, he is well on his progressive way to a single-payer health care system.

Obamacare is like a three-legged stool supported by the Obamacare mandates, the insurance exchanges, and Medicaid expansion. If we’re being honest with ourselves, voting to expand Medicaid is voting to expand Obamacare and, as we’re finding out more and more each day, Obamacare was sold based on half-truths, deceptions and outright lies.

We’re familiar with President Obama’s promise that if you like your health plan and your doctor you can keep them both, “period.” But in place of that promise we were delivered stories like Debra Fishericks’. A working grandmother in Virginia, Debra has fought kidney cancer for ten years and relied on her employer-sponsored insurance in that battle. She recently learned her insurance was being canceled because it doesn’t meet Obamacare’s standards. After a fruitless search for affordable options on, she is left asking “Will I have my same specialist? Will I have to search for other specialists? I have so many unanswered questions.”

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Stop sniping about website fiasco – focus on real health care issues

This post is a transcript of a 4-minute weekly radio commentary aired on several Utah radio stations.

Medical toolsI’ve watched with great interest how Obamacare seems to be crumbling right before our eyes. It has won every political hurdle it has faced from presidential elections to Supreme Court decisions. Who would have thought that the poor execution of a website would be its demise?

Of course, a true impression of the situation would have us admit that the website debacle has nothing to do with Obamacare as a policy – there is no relationship between the website problems and the veracity or goodness of Obamacare (unless we argue that anything the federal government attempts is doomed to failure – but that’s simply inaccurate).

Conservatives and other opponents of Obamacare make a huge mistake by not continuing to focus on its main defect. Obamacare will hurt freedom and Americans. It sounds reasonable, but it isn’t. It destroys any meaning of insurance and any balance between personal responsibility and true health insurance coverage. Conservatives need to argue that Obamacare is an entitlement, pure and simple. There is no concept of insurance underlying it. Forget insurance under Obamacare – insurance is dead. If anyone can be covered at any time with any pre-existing condition, the concept of insurance disappears forever.

This fatal flaw is exactly why Obamacare will lead quite naturally to single-payer government health coverage like the socialist systems in Canada and throughout Europe. If Obamacare is acceptable, there is no reason to avoid universal government health care. None.

As long as conservatives continue to miss the whole appeal of Obamacare, we will lose this fight.

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The unmasking of the new liberalism

Roman_masksThink back to late 2008. Many in the country cheered the coronation of the new liberalism: the über-confident, unstoppable, aggressive expansion of government powers, entitlements and welfare.

Flash forward to the present, as Washington Post opinion writer Charles Krauthammer describes it:

The centerpiece of this vision is, of course, Obamacare, the most sweeping social reform in the past half-century, affecting one-sixth of the economy and directly touching the most vital area of life of every citizen.

As the only socially transformational legislation in modern American history to be enacted on a straight party-line vote, Obamacare is wholly owned by the Democrats. Its unraveling would catastrophically undermine their underlying ideology of ever-expansive central government providing cradle-to-grave care for an ever-grateful citizenry….

This is the signature legislative achievement of the Obama presidency, the embodiment of his new entitlement-state liberalism. If Obamacare goes down, there will be little left of its underlying ideology.

It shouldn’t have, but the reality of the new liberalism has hit many Americans like a sucker punch to the gut, leaving them shocked, outraged and struggling for air. The most stunning part of the story is how quickly the new liberalism has been unmasked for what it is: a farce. It may even be in time to prevent our history from bumbling into the tragedy section.

More lies: the tax lie behind the ‘keep your coverage’ lie

iStock_000002098320MediumMost of the oxygen in the halls of punditry has been taken up lately by President Obama’s “If you like your coverage, you can keep your coverage, period” lie.

I say it’s a lie out of respect for the President. I think he’s intelligent enough to know what anyone who read or understood the bill – including his own staff and HHS – has known for the past several years: that it would force millions of people off their current plans and into more expensive policies with coverage that they don’t want or need in order to subsidize other people’s insurance.

Sure, he told Newsweek reporter Richard Wolff, “You know, I actually believe my own [B.S.],” but let’s give him the benefit of the doubt and assume even he wouldn’t fall for that whopper. So that means he made a rational if immoral decision to misrepresent the law rather than debate its true tradeoffs. The decision was immoral because it was a blatant in-your-face lie. But it was rational because Obamacare would never have passed had people known that it included a massive hidden tax based solely on age, health, and eligibility for membership in the he-man woman-haters club. And he wanted it to pass.

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