Supreme Court Upholds Constitutionality of ObamaCare – Not its Efficacy

“The U.S. Supreme Court’s ruling that most of the Patient Protection and Affordable Care Act (ObamaCare) is constitutional means that Congress now has power to do virtually whatever it wants,” says Steve Buckstein, Senior Policy Analyst and founder of Cascade Policy Institute, Oregon’s free-market think tank. “But having the power to write health care rules and actually improving our health care system are two very different things.”

“By finding that the individual mandate cannot stand under the Commerce Clause, but can stand when looked at as a tax, the Court essentially seems to be telling Americans that while Congress cannot control every aspect of our behavior, it has virtually unlimited powers to tax us and spend the money as it sees fit.”

“Moving more control over health care to Washington, D.C. means that Oregonians, and citizens of every state, will have even less control over our own health care decisions. Big, centralized government systems mean higher costs, less access and less innovation in one of the most important areas of our lives,” Buckstein added.

Buckstein concluded that, “Now that the Court has failed to limit the role of the federal government in health care, it is up to Congress and the states to try to do so. The better chance for a lasting health care system fix involves empowering patients rather than marginalizing them. It involves giving them choices, and letting them do the inevitable rationing themselves, even if part of the money comes from public sources.

“Today’s Court decision was a step in the wrong direction, but Cascade Policy Institute will continue working to reaffirm that in America personal liberty is a cornerstone, not an afterthought, of our way of life.”

Press Release: Requiring a Prescription for Cold Medicine Has Not Reduced Meth Use in Oregon

Media Release
FOR IMMEDIATE RELEASE

Contact:

Steve Buckstein

Senior Policy Analyst
Cascade Policy Institute
Phone: (503) 242-0900

steven@cascadepolicy.org

February 21, 2012

Requiring a Prescription for Cold Medicine Has Not Reduced Meth Use in Oregon

Cascade Study Raises Questions about Real Impact of Oregon’s
Prescription-Only Requirement

PORTLAND, OR — Cascade Policy Institute released a study today which found the 2005 Oregon law which restricts access to medicines containing pseudoephedrine (PSE) has not made the illegal drug methamphetamine harder to get or reduced the number of people using it. The Oregon law makes any medication containing PSE available only via prescription (“Rx-only”).

“This study affirms what we predicted over six years ago: The law would not significantly curb meth use or production, but it would impose a considerable burden on legitimate users of cold and allergy medicines like Claritin-D and Sudafed,” said Steve Buckstein, Cascade’s founder and Senior Policy Analyst. “With other state and federal lawmakers considering following Oregon’s lead on this issue, we thought it was critical to find out what has actually happened here since the law went into effect.”

“The prescription requirement for cold and allergy medicines containing pseudoephedrine had no more of an impact on the reduction of meth lab incidents than other measures adopted in neighboring states. In fact, the rate of mobile meth lab reductions in Oregon is nearly identical to that of six neighboring and nearby states that do not have a prescription requirement. Moreover, meth addicts in Oregon can still get access to their drug of choice,” added Buckstein. “Overall, our study raises fundamental questions about the effectiveness of Oregon’s law and whether such a prescription mandate—which impacts all consumers in the state—is warranted.”

Key findings of the study:

  • Law enforcement in Oregon report that methamphetamine remains the state’s greatest drug threat, despite the reduction in in-state meth production, and contributes the most towards drug-related crime.
  • Methamphetamine lab incidents in Oregon declined more than 90 percent between 2004 and 2010. Most of this decline occurred before the prescription-only law went into effect in 2006.
  • Six neighboring states including Washington and California experienced similar declines in meth lab reductions without imposing a prescription requirement during the same time frame.
  • The number of methamphetamine admissions to substance abuse centers in Oregon declined about 23 percent from 2006 to 2009, the exact same rate as the rest of the United States. Usage was slightly higher in California at 29 percent and slightly lower in Washington at 20 percent.
  • Legitimate users of pseudoephedrine in Oregon incur additional costs as a result of this law, because it requires a doctor visit to get Sudafed and similar products that are available over-the-counter in 48 other states. Some of these additional costs are also borne by all taxpayers who fund government health care programs.

The first part of the study examines whether the manufacture and availability of methamphetamine in Oregon is substantially different from similar states and similar regions of the country. Part two examines trends in indicators that track methamphetamine production, such as Oregon’s lab incidents compared to other states. Part three examines trends in indicators of methamphetamine use, such as substance abuse-related admissions in Oregon compared to other geographies. And finally, part four explores the costs, financial and otherwise, to consumers.

The report’s findings are consistent with studies conducted by other independent groups, such as Oregon’s High Intensity Drug Area (HIDTA), which reported: Methamphetamine continues to be highly available and widely used throughout the HIDTA region and remains the most serious drug threat to Oregon” (“Threat Assessment & Counter-Drug Strategy,” 2011 Oregon High Intensity Drug Trafficking Areas (HIDTA) Report, Accessed 9/26/11).

Please visit the Cascade Policy Institute website to read the entire study, entitled

Making Cold Medicine Rx-Only Did Not Reduce Meth Use
Analyzing the Impact of Oregon’s Prescription-Only Pseudoephedrine Requirement

The study was conducted by Chris Stomberg, Ph.D., a Partner, and Arun Sharma, a Principal, in the Antitrust and Competition, and Healthcare practices at Bates White, LLC, an economic consulting firm based in Washington, D.C. Primary report author Chris Stomberg can be contacted at chris.stomberg@bateswhite.com or (202) 747-1421.

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“We Have a Year to Figure out How to Violate Our Consciences”

“Never before has the federal government forced individuals and organizations to go out into the marketplace and buy a product that violates their conscience,” stated Cardinal-designate Timothy Dolan, archbishop of New York and the president of the United States Conference of Catholic Bishops. “This shouldn’t happen in a land where free exercise of religion ranks first in the Bill of Rights.”

Serious constitutional concerns have been consistently raised about the Patient Protection and Affordable Care Act (PPACA, known popularly as “ObamaCare”), passed by Congress in 2010. Twenty-seven states have sued the federal government on the grounds that Congress does not have authority to require their citizens to purchase a specific product or service, in this case, health insurance. The Supreme Court has agreed to hear some of these cases in March and presumably will rule on the constitutionality of the PPACA’s so-called individual mandate by the end of June.

Beyond this fundamental constitutional objection, another aspect of the PPACA recently took a disturbing turn. In August 2011, the Department of Health and Human Services (HHS) directed virtually all employers to include coverage of contraceptives, sterilization procedures, and abortion-inducing pharmaceuticals without copayment in their employee insurance policies. The HHS mandate has an extremely narrow conscience exemption that will not include the vast majority of religiously affiliated employers and institutions, including hospitals, colleges, schools, and social service organizations which may object to these services on moral grounds.

So, not only does the PPACA require all Americans to purchase health coverage, but Americans can be forced to pay for―or to provide as employers and insurers―things their faith may teach are wrong.

The Catholic Church, along with faithful of other religious communities, protested. The Administration has not backed down. In fact, on January 20, 2012 President Obama called Archbishop Dolan to inform him that the conscience exemption will not be broadened. Enforcement of the mandate simply will be delayed until August 2013, at which time insurance coverage of “preventive services” must include all FDA-approved forms of contraception, including sterilization and some abortion-inducing drugs.

“In effect,” Dolan said publicly in response, “the president is saying we have a year to figure out how to violate our consciences.”

Opponents of the HHS mandate stress that it is very troubling for the government to attempt to force members of one of the largest religions in the world, the Catholic Church, to directly participate in what their Church considers grave moral evils. If Catholic institutions can be forced to behave in contradiction to their moral beliefs, pay massive fines to the government, or close their doors, no other group can expect to have its “free exercise” of religion protected, either.

The last two weeks have seen a firestorm of protest, from the Catholic Church and from others seriously concerned about First Amendment rights. The Catholic bishops released statements denouncing the HHS decision, read from pulpits nationwide. Orthodox, Protestant, Evangelical, Jewish, and Muslim leaders have spoken out against the mandate, noting that if “free exercise” is not respected in this case, other abuses of religious liberty and freedom of conscience surely will follow. As chancellor and CEO-elect of Reformed Theological Seminary (one of the largest Protestant seminaries in the country) Michael Milton wrote, “This is not a Catholic issue only. It is not a contraception issue. It is a religious liberty issue. It is an American issue.”

Members of the current Administration, including Secretary of State Hillary Clinton, have begun referring to the First Amendment right to “free exercise” of religion as “freedom of worship.” This is dangerously incomplete. “Free exercise” of religion is more than the ability to choose the house of worship one frequents on weekends. Free exercise is the ability to live your faith and morals seven days a week.

Members of Congress have introduced legislation intended to prohibit the federal government from requiring a provider to provide, participate in, or refer for a specific health care service contrary to the provider’s religious beliefs or moral convictions (the “Respect for the Rights of Conscience Act,” or House Resolution 1179/Senate Bill 1467). But while Congressional leaders work to defend the rights of religiously affiliated organizations, they must not forget the rights of individual Americans, either.

Americans must send the federal government a clear message: Government must not abrogate the conscience rights of employers and insurance providers, and neither should it abridge the First Amendment rights of individual Americans by forcing them to participate in something to which they morally object. It was a small step from government forcing Americans to “go out into the marketplace” and buy health care to, as Archbishop Dolan said, “go out into the marketplace and buy a product that violates their conscience.”

 

Health Care’s Newest Epidemic: Red Tape

By Douglas A. Perednia, M.D.

Here’s a riddle: What costs Americans over $12 billion per year, generates more work than the nation’s thirteenth largest employer, drives millions of doctors and patients crazy, and is growing so fast it makes kudzu look stunted? The answer: the over half-billion hours of health care paperwork mandated last year by the Department of Health and Human Services (HHS). Even before ObamaCare the burden of HHS paperwork had been doubling every six years. The sheer complexity of the health care reform law guarantees a massive increase between now and 2020.

Combined with the red tape generated by insurance companies, state governments, and a proliferation of other organizations, this administrative overhead is a major reason why the cost of health care continues to grow at a rate that dwarfs increases in the nation’s gross domestic product. Our marginal health care dollars are generating less health than ever.

These insights come to us courtesy of the Information Collection Budget of the United States, an annual report that documents the amount of time Americans must spend filling out forms at the behest of Washington bureaucrats. By far the biggest paperwork offender is the tax-levying U.S. Treasury, which accounts for 84% of the 8.8 billion hours consumed. But while Treasury paperwork has grown 25% since 1999, the amount mandated by HHS has risen by 331% – far outstripping the growth rate of any other federal agency. Unchecked, HHS will generate more paperwork than all other non-Treasury federal agencies combined by 2015.

Figure 1 shows the amount of private sector paperwork demanded by HHS, compared to the total amount required by all other non-Treasury departments. The recent drop in non-HHS paperwork is purely the result of agencies lowering their estimates of how long their paperwork takes to complete. Nevertheless, last year HHS bucked even this trend with an increase of nearly 50 million hours. Only 15 million of those were attributed to ObamaCare.

Figure 1.

Another way of looking at HHS paperwork is to express it as a proportion of all non-Treasury paperwork Americans must complete in the course of each year. This is shown in the Figure 2.

Figure 2.


The burden of paperwork required by HHS is growing so fast that it now accounts for almost 40% of all non-Treasury paperwork, dwarfing the individual contributions of agencies like the EPA, the SEC, Homeland Security, and the Department of Labor. And it seems willing to demand more information at any price. HHS is now the nation’s foremost offender with respect to the Federal Paperwork Reduction Act, with sixty-five violations in FY 2010. This is nearly 60% of the violations generated by the entire federal government.

Just how much is 542 million hours of paperwork? Imagine 271,000 people employed doing absolutely nothing other than filling out forms at the behest of HHS. If these people were all in a single private company, it would have more employees than Albertsons. At the current rate of increase, over 540,000 full-time employees would be needed by 2015. That would make HHS paperwork the second largest employer in the country, right behind Walmart. The cost to the private sector for supplying the government with all that information? Nearly $26 billion.

Most of the people doing this work are doctors, patients, and armies of administrative personnel hired by hospitals, clinics, nursing homes, and private offices to help handle the load. All of these documents are in addition to those they have to complete for literally thousands of private health insurers, disability insurers, state governments, licensing boards, and accreditation organizations. If you want to know why your insurance premiums are rising at 9% per year, this is a big part of the answer.

Why does HHS need all of this information? Quite simply, federal regulators are now struggling to control nearly every aspect of health care – from the price and distribution of hundreds of thousands of health care-related goods and services, to the benefits to be included in private health insurance policies, to exactly what procedures doctors must follow when dealing with patients who smoke. It is an impossible task. No central authority can possibly gather and process enough information fast enough to reconcile the needs of hundreds of millions of patients, providers, and medical suppliers. Free markets are efficient precisely because such information is passed along automatically, instantly, and for free in the form of prices, inventories, and demand.

HHS’s information budget should warn us that the only way to truly reduce health care costs in the long term is by dumping government controls and returning to something that looks far more like a free market in health care goods and services. The entire system needs to be drastically simplified, and fast.

To borrow a phrase from the President, we can’t wait.


Douglas A. Perednia, M.D. is a physician and senior research associate at the Cascade Policy Institute. He is author of the book Overhauling America’s Healthcare Machine: Stop the Bleeding and Save Trillions, published by Financial Times Press, and writes for the blog The Road to Hellth. Dr. Perednia is a guest writer for Cascade Policy Institute, Oregon’s free market public policy research organization.

Health Care Reform: Then and Now

Steve BucksteinQuickPoint!

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by Steve Buckstein

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In 1993, syndicated columnist Mike Royko had some choice words about Hillary Clinton’s national health care reform. Seventeen years later his words seem just as appropriate for Barack Obama’s plan. Here’s an extended quote:

“I listened to much of her testimony about how and why the health care program would be terrific for all of us. And I couldn’t figure out what the heck she was talking about. It was a deadly combination of bureaucratic jargon and legal jargon. And if any congressman claims to have understood it, he has been in Washington too long.

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Will America Go the Way of Greece?

Steve Buckstein
QuickPoint!

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by Steve Buckstein

 
Will America Go the Way of Greece?

How many times have you heard that America is the only industrialized country without a national health care system? Now, just as America seems to be jumping into that pond, another country may be required to jump out.

The country of Greece is so deeply in debt, and has made so many promises to its citizens that it can’t keep, that it needs a massive bailout from other nations and organizations. America is a part of the IMF, European Union and European Central Bank consortium putting up funds to help Greece weather its financial crisis.

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Government Health Care “Reform:” The Culmination of Incrementalism

Cascade Commentary

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The opening words of HR 3200, the initial solution to the health care “crisis” in the United States, read: “A Bill to provide affordable, quality health care for all Americans and reduce the growth in health care spending, and for other purposes.” I haven’t yet heard President Obama or Congressional leaders comment on those “other purposes.” However, let us be completely honest here. The only words in that opening statement that have real meaning are those last four words.

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