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“Pinhead Density Arguments”: There Was A Reason Conservatives Once Supported The Individual Mandate

Of all the arguments being waged over the Affordable Care Act — or, as the Obama campaign now likes to refer to it, “Obamacare” — the one dominating the Supreme Court this week is perhaps the most conceptually trivial.

The individual mandate requires consumers to purchase health insurance in order to eliminate the problem of free riders — people who don’t purchase insurance until they get sick or injured or those who never purchase insurance and end up passing on to the rest of us the costs of care they can’t afford. Detractors argue that the mandate unconstitutionally infringes on personal liberty by forcing Americans to purchase health insurance. But compare it to three ways of addressing the free- rider problem in health care that are clearly, indisputably, constitutional:

• Single payer: The federal government increases income taxes and, in return, guarantees everyone government-provided health-care insurance. There is no option to opt out of the taxes. This is how most of Medicare works, though the insurance kicks in only after you turn 65.

• Late-enrollment penalty: The single-payer approach only holds for “most of” Medicare because the Medicare Prescription Drug Benefit works a bit differently. For every month that you don’t enroll after becoming eligible at age 65, your premium rises by one percentage point.

• Tax credits: Under various health-care proposals — including the plan of Rep.Paul Ryan (R-Wis.) — the tax code is changed to give families a tax credit for purchasing private health insurance. Families that choose to go without insurance, or simply can’t afford it, would not receive the tax credit.

All of these plans share the same basic approach: They impose a financial penalty, either before or after the fact, on those who forgo health insurance. Single payer does it through taxes, Medicare Part D through premiums and Ryan’s plan through tax credits.

Now consider the individual mandate. Here’s how it works: Starting in 2016, those who don’t carry insurance will be annually assessed a fine of $695 or 2.5 percent of their income, whichever is higher.

Skeptics of government should clearly prefer the individual mandate to single payer. In fact, the individual mandate was developed by conservative economist Mark Pauly as an alternative to single payer. “We did it because we were concerned about the specter of single-payer insurance, which isn’t market-oriented, and we didn’t think was a good idea,” Pauly told me last year. In the 1990s, the individual mandate was also the Republican counterproposal to President Bill Clinton’s health-care bill, and in 2005, it was the centerpiece of Massachusetts Gov. Mitt Romney’s health-care reforms.

The Medicare Part D model doesn’t really work as an alternative to the individual mandate because it requires the federal government to set the cost of premiums. That’s possible with the over-65 set, because the government controls the market. To import that idea to the under-65 market, however, would require vastly more governmental intrusion into the health-care space.

The tax credit, meanwhile, is essentially indistinguishable from the mandate. Ryan’s plan offers a $2,300 refundable tax credit to individuals and a $5,700 credit to families who purchase private health insurance. Of course, tax credits aren’t free. In effect, what Ryan’s plan does is raise taxes and/or cut services by the cost of his credit and then rebate the difference to everyone who signs up for health insurance. It’s essentially a roundabout version of the individual mandate, which directly taxes people who don’t buy health insurance in the first place.

“It’s the same,” says William Gale, director of the Tax Policy Center. “The economics of saying you get a credit if you buy insurance and you don’t if you don’t are not different than the economics of saying you pay a penalty if you don’t buy insurance and you don’t if you do.”

Interestingly, Ryan’s plan imposes, if anything, a harsher penalty on those who don’t purchase health insurance. Ryan’s tax credit is far larger than the individual mandate’s penalty, and much easier to enforce. Under Ryan’s plan, if you don’t purchase insurance, you don’t get the credit. End of story. Conversely, the Affordable Care Act doesn’t include an actual enforcement mechanism for the individual mandate. If you refuse to pay it, the IRS can’t throw you in jail, dock your wages or really do anything at all.

This leads to one of the secrets of Obamacare: Perhaps the best deal in the bill is to pay the mandate penalty year after year and only purchase insurance once you get sick. To knowingly free ride, in other words. In that scenario, the mandate acts as an option for purchasing insurance at a low price when you need it. For that reason, when health-policy experts worry about the mandate, they don’t worry that it is too coercive. They worry that it isn’t coercive enough.

The mandate is considered more effective than tax credits because people seem more inclined to take action to avoid penalties than to receive benefits. That’s worked extremely well in Massachusetts, for instance, where there’s been almost no free-rider problem at all. So while it’s not different as a matter of economics, it’s a bit different as a matter of behavioral economics. In that way, the mandate does a little more to solve the free-rider problem with a little less action from the government.

Randy Barnett, a conservative law professor at Georgetown University, agrees that there’s some similarity between the two approaches. But he warns that that doesn’t make them legally equivalent. “Just because the government does have the power to do X, doesn’t mean they have the power to do Y, even if Y has the same effect as X,” he says. “There’s no constitutional principle like that.”

Although that’s true, it also leaves us in a peculiar spot. The constitutional argument over Obamacare is a dispute over a technicality. We agree that it’s constitutional for the government to intervene far more aggressively in the market. We agree that it’s constitutional for it to intervene in an almost identical, albeit slightly more roundabout, manner. We’re just not sure if the government needs to call the individual mandate a “tax” rather than “a penalty,” or perhaps structure it as a tax credit. As Pauly puts it, “This seems to me to be angelic pinhead density arguments about whether it’s a payment to do something or not to do something.”

Of course, this battle isn’t really about the constitutionality of the individual mandate. Members of the Republican Party didn’t express concerns that the individual mandate might be an unconstitutional assault on liberty when they devised the idea in the late 1980s, or when they wielded it against the Clinton White House in the 1990s, or when it was passed into law in Massachusetts in the mid-2000s. Indeed, Sen. Jim DeMint (S.C.), arguably the most conservative Republican in the Senate, touted Romney’s reforms as a model for the nation. Only after the mandate became the centerpiece of the Democrats’ health-care bill did its constitutionality suddenly become an issue.

The real fight is over whether the Affordable Care Act should exist at all. Republicans lost that battle in Congress, where they lacked a majority in 2010. Now they hope to win it in the Supreme Court, where they hold a one-vote advantage. The argument against the individual mandate is a pretext for overturning Obamacare. But it’s a pretext that could set a very peculiar precedent.

If the mandate falls, future politicians, who will still need to fix the health-care system and address the free-rider problem, will be left with the option of either moving toward a single-payer system or offering incredibly large, expensive tax credits in order to persuade people to do things they don’t otherwise want to do. That is to say, in the name of liberty, Republicans and their allies on the Supreme Court will have guaranteed a future with much more government intrusion in the health-care marketplace.


By: Ezra Klein, The Washington Post, March 31, 2012

April 1, 2012 Posted by | Constitution, Health Reform | , , , , , , , | 2 Comments

“Bringing Back The Grease”: House Republicans Discuss Reviving Earmarks

The huge federal transportation bill was in tatters in early March when Representative Mike Rogers of Alabama posed a heretical idea for breaking through gridlock in the House.

In a closed-door meeting with fellow Republicans, Rogers recommended reviving a proven legislative sweetener that became politically toxic a year ago.

Bring back earmarks, Rogers, who was first elected to Congress in 2002, told his colleagues.

Few members of Congress have been bold enough to use the “e” word since both the House and Senate temporarily banned the practice last year after public outcries about Alaska’s “Bridge to Nowhere” and other pork barrel projects.

But as lawmakers wrestle with legislative paralysis, there are signs that earmarks – special interest projects that used to be tacked onto major bills – could make a comeback.

“I just got up … and did it because I was mad because they were talking about how we can’t get 218 votes,” Rogers told Reuters, referring to the minimum of 218 votes needed to pass legislation in the 435-member House.

“There was a lot of applause when I made my comments. I had a few freshmen boo me, but that’s okay. By and large it was very well embraced,” he added.

New Republican members backed by the Tea Party movement have railed against earmarks as a symbol of out-of-control government spending and unaccountable lawmakers.

Congress has another nine months to operate under an earmark ban, so discussions on lifting the ban are in their early stages, members and aides say.

But on the House side, where a splintered Republican majority is struggling to muster enough votes to pass bills, second thoughts about the earmark ban are “pretty pervasive,” said a senior aide.

Rogers’ remarks in the closed caucus meeting in early March were echoed by two other Republican lawmakers, Representatives Louie Gohmert and Kay Granger, according to some at the meeting.

House Speaker John Boehner, who pushed for the earmark ban, is considering forming a committee to study earmarks reforms, according to Rogers. Other sources also said that during the closed meeting, the speaker said he would consider reforms, and other leading Republicans did not shoot down the idea.

Boehner has acknowledged that the ban makes his job more difficult. In past years, one reason the sprawling transportation bill could move through Congress with bipartisan support was because thousands of lawmakers’ pet projects were tacked onto the bill, he has said.

But reviving earmarks is still so controversial that Boehner and other leaders are unlikely to publicly discuss it in an election year in which pork barrel spending is still under attack. The discussions so far appear to be among Republicans.

“The House did the right thing in instituting an earmark ban, and the American people strongly support it,” a Boehner spokesman said in response to questions.

In the Senate, Thad Cochran, the senior Republican on the Appropriations Committee – an earmark gateway in the old days – told Reuters: “At some point there will surely be conversations about alternatives” to the earmark ban. He was quick to add that he has not tried to initiate the conversation.

Democrats agreed to banning earmarks after suffering big defeats in 2010 congressional elections and after President Barack Obama warned he would veto bills containing them.

But like Republicans, Democrats have differing views on keeping the ban. Senate Majority Leader Harry Reid is on record defending earmarks, saying elected representatives are more in touch with local needs than executive branch bureaucrats.

Steve Ellis, vice president of Taxpayers for Common Sense, a non-partisan budget watchdog group, said discussions about reviving earmarks suggest the desperation of a Congress in which stalled legislation is now routine.

The difficulties in passing bills are leading lawmakers to conclude the only answer is to “bring the political grease back into the system,” Ellis said.


Political analysts have long referred to earmarks, or “member-directed funding” as it is sometimes known, as the grease enabling legislation to move through Congress.

Republican Representative Steven LaTourette, an 18-year House veteran, said the earmark ban “has affected discipline” within the party. “You can’t get 218 votes (out of 242 Republican House members) and part of that has to be if you can’t give people anything (earmarks), you can’t take anything away from them.”

If a member of Congress agrees with 90 percent of a pending bill but is “uncomfortable” with the other 10 percent, “Sometimes taking care of your district (with earmarks) made up for that 10 percent,” he said.

Some believe earmarks got a bad rap.

Public outrage focused on projects like the notorious “Bridge to Nowhere” connecting the Alaskan mainland with an isolated island, or a teapot museum in North Carolina.

Other earmarks have funded crucial projects, proponents say. One example is the “Predator” drone, the unmanned military aircraft used in Afghanistan and other hot-spots to target militants without jeopardizing U.S. soldiers’ lives, that came from a lawmaker’s request.

Both sides in the debate agree that before earmarks resurface, reforms are essential.

Earmarking was long controversial because many of the projects showed up in the fine print of legislation without warning and with little or no public debate.

Congressman Gohmert believes the solution is rules to keep spending on specific companies and projects from being “air dropped” into bills without oversight.

“We can be specific without having it be crony capitalism, monuments to me, bridges to nowhere,” Gohmert said.

Others propose limiting earmarks so that they only go to local or state government-backed projects or universities. And reforms should also break the links between campaign contributions and earmarked projects, members say.

In pitching earmarks, Gohmert and other Republican lawmakers and aides lament that the ban has been a boon to Democratic President Barack Obama, whose administration can still dole out projects as it sees fit.

“I think there’s a way that it can be done that we take back the purse strings that the Constitution gives us without just handing sacks of money to the president,” Gohmert said.

But even if momentum grows for an earmark revival, some members are unlikely to join in.

Representative Jim Jordan, who heads a conservative coalition in the House, told Reuters: “My read is that the ban on earmarks is where it needs to be.”

And Senator Tom Coburn, a conservative Republican who wants a permanent ban, said earmarks should not be a tool for buying votes on important bills.

Pork barrel spending was “the bane of the American taxpayers’ existence.” he said.


By: Richard Cowan, Reuters, March 30, 2012

April 1, 2012 Posted by | Congress | , , , , , , , | Leave a comment

“No Liberals Allowed”: Catholic College Cans Vicki Kennedy Speech At Bishop’s Request

A small Massachusetts Roman Catholic college rescinded its invitation to Vicki Kennedy to speak at its graduation ceremony this spring, saying the local bishop objected to honoring the widow of the liberal lion Senator Edward M. Kennedy.

A spokesman for Worcester Bishop Robert McManus declined to say why exactly he objected to the choice of Kennedy, a member of the most prominent U.S. Catholic family in politics.

“Bishop McManus is acting, he feels, consistently with what all of the U.S. bishops asked colleges or higher institutions to do going back to 2004, that they not honor … Catholics who take a public stance or position on issues contrary to things that the Church is trying to teach,” said Raymond Delisle, a spokesman for the diocese.

Kennedy said she was “disheartened” by the public rebuke.

“I am a lifelong Catholic and my faith is very important to me,” she said in a statement. “I have not met Bishop McManus nor has he been willing to meet with me to discuss his objections.”

She said that by opposing her appearance at the college, the bishop “has made a judgment about my worthiness as a Catholic.”

Senator Kennedy, a Democrat, was a liberal standard-bearer during his nearly 47 years in office and an advocate for abortion rights — a stance that ran afoul of church teachings. His brother John F. Kennedy, the first Catholic president of the United States, was assassinated in 1963.

The school, Anna Maria College of Paxton, Massachusetts, apologized to Kennedy.

“As a small, Catholic college that relies heavily on the good will of its relationship with the Bishop and the larger Catholic community, its options are limited,” it said in a statement.

The Catholic church has been increasingly vocal on political issues over the past year, particularly regarding the use of contraception, which the church opposes.

In February, clergy around the United States were asked to read statements at the pulpit calling on the administration of President Barack Obama to exempt religious employers from paying for insurance coverage of contraceptives.

Following Edward Kennedy’s death in 2009, the clan has slowly faded from the political spotlight, though Joseph Kennedy III — grandson of Edward’s brother Robert, who also served in the Senate — has announced plans to run for Congress.


By: Scott Malone, Reuters, March 30, 2012

April 1, 2012 Posted by | Catholic Church | , , , , , , , | 2 Comments

“No Shortage Of Stupid Ideas”: Romney Vows No Tax Returns Unless Meeting Transcripts With Foreign Leaders Released

In the wake of a report raising questions about whether Mitt Romney exploited a tax shelter in the 1980s, the Obama campaign is calling for the release ofRomney’s tax returns during those years.

Instead of simply saying no, Romneyland attempted to sidestep the issue with what might just be the dumbest deflection ever:

“The Obama campaign is playing politics, just as he’s doing in his conduct of foreign policy,” Romney spokesperson Andrea Saul wrote. “Obama should release the notes and transcripts of all his meetings with world leaders so the American people can be satisfied that he’s not promising to sell out the country’s interests after the election is over.”

I cannot even begin to comprehend the delusions that Romneyland must be under to think that this is a reasonable response. Never mind the false equivalency—President Obama has already released his own tax returns despite Mitt Romney’s refusal to do so—it’s absurd to think that any president would be wise to publicly release the transcripts of every conversation he ever has with any foreign leader. If that were the policy, it wouldn’t result in more transparency, it would simply mean that presidents would no longer have meaningful conversations with foreign leaders, because no foreign leader in their right mind would agree to such terms. And can you imagine the diplomatic fallout from retroactively and unilaterally breaking confidentiality across the board for past conversations?

There’s been no shortage of stupid ideas to come out of Romneyland, but this is one of the stupidest. But even if we cut them some slack and say that it’s so stupid that they couldn’t possibly really mean it, it still doesn’t change this fact: Unlike President Obama, and unlike his father, Mitt Romney is unwilling to release his tax returns. So, what’s he hiding?


By: Jed Lewison, The Jed Report, Daily Kos, March 30, 201

April 1, 2012 Posted by | Election 2012, National Security | , , , , , | Leave a comment

Mitt’s “Hunger Games”: The GOP’s “Career Tribute” Seeks His Inner Katniss

Mitt Romney’s outing last weekend to watch The Hunger Games with his grandkids spurred snickering among the political media. In a Tuesday interview, Wolf Blitzer ribbed the governor about whether the violent flick was appropriate for such young children. Wednesday, Morning Joe’s Mika Brzezinski proclaimed Romney a “nerd,” while Scarborough flatly refused to believe the candidate had either seen the flick or read the book (“He did not!”), likening Mitt’s claims to his previously professed love of varmint hunting.

I get where Joe’s coming from, but come on: how could Romney not love the wildly popular tale of teens fighting to the death for the amusement of a blood-thirsty public? That’s basically been his life for the past several months. And at this point, the governor must be wondering whether it’s time to break out his bow and go all Katniss Everdeen on Newt and Rick.

Everyone knows the HG basics, right? In a post-apocalyptic society, a despotic central government forces teen “tributes” from 12 outlying districts to do battle in a sprawling, nightmarish biosphere of sorts. Twenty-four go in. One comes out—but only after the rest are slaughtered either by fellow combatants or by the lethal traps sprinkled about by Gamemakers to keep things interesting: mutated beasts, fireballs, poison vegetation, blizzards … There are no rules, and the carnage is, of course, televised.

You can see why the story naturally brings to mind the primary. Multiple combatants enter. Only one can emerge the victor. Along the way, candidates face hazards that include gaffes (Perry, Bachmann), scandal (Cain), staff upheaval (Bachmann, Gingrich), money shortages (Santorum, Gingrich), congenital blandness (Pawlenty), perceived nuttiness (Bachmann, Paul), and a complete inability to get anyone to notice they are in the game at all (Roemer, McCotter, Karger).

Once the battle proper begins (Cue Iowa!), most players don’t last long. But there are generally one or two scrappers who, no matter how badly wounded, refuse to die. This cycle, Santorum and, even more so, Gingrich have made clear their intent to limp along, inflicting as much damage as possible on what they see as an unworthy tribute.

How exactly to end this spectacle has proved a thorny question not just for Team Romney but also for a Republican leadership that’s grown weary of the public bloodbath.

The recent flood of pro-Romney endorsements by party elders hasn’t worked. Nor has high-minded talk about the need for unity. Various carrots and sticks are presumably being brandished behind the scenes (for instance, at Newt and Mitten’s secret sit-down Saturday), thus far to no avail. Unless you count Gingrich’s announcement Tuesday that he is shifting to a “big-choice convention” strategy. Tell me that doesn’t have trouble written all over it.

Some candidates might be able to pull off an above-the-fray statesman’s repose while their final opponents expire. Romney isn’t one of them. His position is too weak, his support too tenuous. Nobody liked him much to begin with, and all this slap-fighting has made him look even more unctuous and ineffectual. At this point, the Tribute from Massachusetts needs to take a breath, aim well, and—zing—put one through the enemy’s brainpan.

Not literally, of course. (Although, how awesome would it be to see Mittens decked out in leather hunting gear, shimmying up trees with a quiver of arrows strapped to his back?) But a figurative kill is in the party’s best interest as well as Mitt’s. Besting Santorum in Pennsylvania might take care of Rick, but Newt is beyond shaming and will need to be hit where he lives. You know the kind of thinly veiled brutality I’m talking about: nice little consulting business you’ve got there, shame if anything happened to it.

Of course, any Hunger Games fantasies Romney may harbor contain a fatal flaw: no way he’s Katniss. More than any of the combatants this cycle, the governor has “career tribute” written all over him—one of the privileged killing machines that hail from the rich, well-connected districts and train for battle their whole lives. Think Cato from District 2, only with more money and better hair.

Indeed, if anyone had a shot at the Katniss role, it would be Santorum: the scrappy underdog who entered the arena heavily outgunned and wound up charming the audience with his passion, ingenuity, and fierce will to survive. This is precisely the sort of inspirational, irresistible against-all-odds victory from which blockbuster fiction is made.

Republican nominees, not so much.


By: Michelle Cottle, The Daily Beast, March 30. 2012

April 1, 2012 Posted by | Election 2012, GOP Presidential Candidates | , , , , , | Leave a comment


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