Is Denial a Good Basis for Abortion Policy?

17 Weeks

17 Weeks

Once again, a political sideshow is likely to be the sole outcome from the revelations in the recent Planned Parenthood videos, drowning out what could have been an important conversation around another perennially politicized issue.

As could have been a good starting point, the videos show definitely that abortion involves far more than the suctioning of a formless glob of cells. The procedure discussed in detail throughout the videos is the forceable, fatal extraction of human bodies from their protective environment.

Bodies with lungs, livers, hearts, heads, and “lower extremities”—all clearly identifiable, differentiable—with abortions performed systematically to avoid crushing the body parts to be “supplied.”

The “17 weeker” whose body parts are at the center of part of the conversation is a baby who “can move her joints, and her sweat glands are starting to develop.” At 18 weeks, a girl’s uterus and fallopian tubes are formed and in place, and boys’ genitals have been formed, “but he may hide them from you during an ultrasound.”

At 24 weeks—the upper limit at which the doctor in the video performs abortions—the baby is fully formed: “his brain is also growing quickly now, and his taste buds are continuing to develop.”

This of course is simply the latest “in our face” evidence of what abortion actually entails. A similar sound and fury followed the revelation of Gosnell’s grisly late-term abortion clinics, at which the active killing of aborted babies was standard operating procedure—quickly swept under the rug as “exceptional.”

With today’s technologies—ultrasounds that clearly show the humanness of babies in the womb at very early stages; advances in medical care providing high survival rates to “preemies” born at the same age that unwanted babies are being aborted—and with now decades of evidence that universal access to birth control and sex education has failed to produce any reduction in the number of abortions being performed, it is surely time to revisit this issue that Roe v. Wade did nothing to resolve.

Yes, such a conversation will surely be “complicated.” But let’s not follow Gov’s advice that “when things get that complicated, it’s probably best to just let other people worry about it.”

This is clearly not a conversation we can leave to politicians. Asked about the ethics of late-term abortion in light of Gosnell, Nancy Pelosi responded with typical hyperbole: abortion is “sacred ground,” with any question on late-term abortion being the equivalent of declaring “there’s no abortion, it would make it a federal law that there would be no abortion in America.”

So can we who claim to uphold the principles of rights, liberty, and responsibility establish a starting point for agreement?

Is the decision over life or death any woman’s, under any circumstance?

In ancient Rome, a husband could order his wife to have an abortion—almost certainly a death sentence for her as well. Selective and forced abortions are accepted public policy in India and China. Are we more enlightened in supporting domestic abortion rates running above a million annually, but “chosen” by a woman by a procedure that (usually) doesn’t kill her?

Do we care how a cavalier attitude towards women and children may undermine our foundational principles of rights to life and liberty?

Are we concerned with what trading in body parts—from bodies that have no say in the matter—may portend for ownership of our own bodies?

The majority of women cite not being able to afford a baby as being the driver of her decision to abort. Can not we—the richest and most generous people in history, the beneficiaries of a tradition, practice, and canon in voluntary society—not produce a rich array of alternative choices better serving our sisters and their babies in need?

A starting point could be supporting counseling centers that help women facing an unintended pregnancy chart a plan that allows her to carry to term; supporting voluntary organizations that help women find employment, housing, job and life skills.

And step up the assault against barriers to educational and economic opportunities: further alternatives to the failed government school system, end licensing, zoning, minimum wage, and other regulations that protect established interests against new entrants.

None of us has to act—but let’s at least stop denying what abortion really looks like.

Harassment Ruled a Protected Union Activity

What do you mean you don't want to join the union?

What do you mean you don’t want to join the union?

In an advisory to employers, the California Chamber of Commerce provides this not-very-useful recap of a recent National Labor Relations Board decision:

Employers have an obligation to investigate and take appropriate corrective action for employee misconduct; at the same time, employees have a protected right to discuss union activities. In a 2012 decision, the National Labor Relations Board (NLRB) put employers between a rock and a hard place when these two issues intersected: If one employee harassed another in the course of discussing union activities, the employer could not discipline the harasser. However, the employer was then open to a lawsuit from the harassment victim for failing to act.

Recently, the NLRB issued a new decision opening the door slightly for employers to take corrective action against this type of harassment. An employer may terminate an employee for lying about misconduct, even if the underlying behavior constituted a protected union activity (Fresenius USA Manufacturing, Inc. and International Brotherhood of Teamsters, Local 445. Case 02– CA–039518 June 24, 2015).

So, in other words, the employer remains in a Catch-22: subject to a lawsuit for failing to protect an employee from the harassment of another who can work “discussing union activities” into his or her harassment.

Apparently the only possible protection the employer has is to ask the harasser if he or she in fact harassed another employee, and if Harasser says “No,” then the employer can discipline the harasser for lying.

Of course, these He said/She said cases are themselves a bag of worms no employer can hope to win.

Bottom line: Harassment is legal when practised by union sympathizers; employers and employees who aren’t interested in unionization can lump it.

Will 11 Million Pay Obamacare’s Mandate Penalty?

a_better_choice_1800x2700I recently took issue with lack of clarity in media coverage of a report by the IRS Taxpayer Advocate, which claimed that 6.6 million people paid Obamacare’s individual-mandate penalty last year. I figured the total must be significantly higher, because each tax return would cover more than one individual.

In an e-mail to me dated July 21, 2015, Doug Badger, a longtime veteran of Republican administrations, pointed out that there can be more than one person in a household applying for Obamacare coverage:

..... a more accurate measure of household size could be obtained by dividing the number of people included in a completed applications by the number of applications. That yields a factor of around 1.35, as opposed to 2.35. I admit that is a rough approximation and there may be better ways of calculating the number of people affected by the tax on the uninsured. In any event, your central point is exactly right: the number of people living in households that paid the tax is much greater than 6.6 million.

This brings us a little closer to reconciling the IRS report with the U.S. Department of Health & Human Services’ report (although the latter does not appear to have consistency used the word “individual” accurately).

Last Friday, another officer of the U.S. Treasury issued a different estimate: 7.5 million “taxpayers” paid Obamacare’s individual mandate penalty. (Again, it is unclear whether a taxpayer is an individual or a household.) The report also notes that only 135 million of 150 million estimated 2014 tax returns have been submitted and processed. That suggests that once all the tax returns are finalized, the 7.5 million who have paid the penalty will have increased to 8.3 million.

The report anticipates 4.8 million “taxpayers” will have to claim or reconcile Obamacare’s premium tax credits. As discussed in one of my previous blog posts, this group should represent around 6.14 million individuals, or 1.28 individuals per tax return (and broadly in line with Mr. Badger’s estimate).

However, the report also suggests that one-half of those who claimed Obamacare premium, tax credits received too much money, and have or will have to pay it back. That would be 2.4 million returns representing about 3 million people.

Also, if we assume there are also 1.28 individuals per tax return among those liable for 2014 Obamacare individual mandate penalties, that would turn 8.3 million “taxpayers” into just under 11 million individuals.

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For the pivotal alternative to Obamacare, please see the Independent Institute’s new book, A Better Choice: Healthcare Solutions for America, by John C. Goodman.

Standing with Rand? Maybe Take a Seat.

rand paulOn April 7, Senator Rand Paul declared he is officially running for President in 2016. Since this time, there has been a lot of buzz surrounding his candidacy. In particular, many are pointing to Rand as a champion of liberty. I recently heard a talk in which the speaker was encouraged by Paul and several of his Congressional colleagues. He looked forward to more libertarian candidates making their way into Congress, arguing they would push for more limited government.

Certainly, this speaker is not the only one to hold these hopes. Many libertarians, or generally liberty-minded people, are pushing for more libertarianish (there is certainly a spectrum which most libertarians readily acknowledge) individuals to enter into the political process. In doing so, they claim “freedom-friendly policies” will be enacted and predatory policies will be blocked. If enough libertarian candidates get into Congress, it is thought, perhaps they can tip the scales away from Leviathan and toward liberty.

The question then comes—are we headed toward a “libertarian revolution?” Will politicians who value freedom take office and work to constrain the ever-expanding powers of the government? Will freedoms lost in the name of combating the war on drugs and war on terror be restored? Will such political figures repeal or drastically alter a variety of policies detrimental to individual liberty?

While I sympathize with the desire for such an event, I think my libertarian friends would be disappointed with Rand Paul as President, or any other “libertarianish” politician.


First, it seems to me that many people are hitching their wagons to Paul without really looking at his record. While I can appreciate Senator Paul’s filibuster regarding the use of drones abroad and his opposition to the USA PATRIOT Act and the FREEDOM Act, he’s hardly the pinnacle of the classical liberal ideal. He’s still a politician.

Let me repeat that. He’s a politician.

Look at Paul’s voting record. Far from breaking away from partisan politics, Paul votes align with the Republican Party some 84 percent of the time. This includes affirmative votes for the annual National Defense Authorization Acts. These bills work to sustain and expand the arguably most nefarious crusher of liberties domestically and around the globe—the U.S. military.

As opposed to cutting out government waste and superfluous government activity, he’s sponsored some 50 bills and co-sponsored another 120.

He supports bills that positively reek of special interest and do anything but offer individual liberties. He sponsored a bill that would outlaw all abortions in the United States. He opposes same-sex marriage, the legalization of drugs like marijuana, and even suggested in an interview in 2011 that he was supportive of profiling and even imprisoning people who listened to “radical political speeches.”

There are further reasons for those who value liberty to be skeptical of Paul or any other politician claiming to champion liberty. Put simply, there’s a problem with the political game. Moreover, there is a problem with the people who choose to play. Certainly, I’m not the first to point this out. In fact, don’t take my word for it at all. Instead, let’s look at two Nobel laureates, F. A. Hayek and James M. Buchanan.

Almost a year ago, I wrote a post on an idea presented in F. A. Hayek’s most famous work, The Road to Serfdom. Specifically, I discussed the chapter, “Why the Worst Get on Top.” As I explained in the post, people often claim that government would function better “if only we could get the right people in office.” In his work, Hayek explains why this is not the case. That is, the very institutional structure of government draws particular people into its fold. As he explains, these are not going to be the harbingers of freedom.

Furthermore, James Buchanan, the father of public choice economics, explained that government is not some benevolent homogeneous mass working for the betterment of the people. Instead, political actors are like any other people interacting with one another. They respond to the incentives they face. These incentives are determined by the institutional context in which they operate. The incentives facing politicians do not necessarily align with those of the population as a whole. As a result, we wind up with pork barrel spending and policies that benefit special interests at the expense of the average American taxpayer.

Paul is no exception to this critique. For example, he voted to kill legislation that would have done away with some federal subsidies for tobacco farmers. But why? Why would Paul, a supposed beacon of free market ideals, shoot down legislation that would not only eliminate some government activity, but help to end a practice that nearly all economists agree is a bad idea (see here, here, here and here for examples)? He would because it’s in his interest. Tobacco is a major cash crop in his home state of Kentucky. Voting to end the subsidies would cut against the interests of his constituents and harm his chances of reelection. As such, Paul voted with his own interests and not those of the broader populace.

Many individuals who claim to value liberty, who have read and claim to appreciate the work of both Hayek and Buchanan seem to put on blinders when it comes to Rand Paul. Although they would never claim to trust the broader system of government, that is precisely what they are doing! Arguing that “more libertarians” or “the right people” in office will bring the changes they desire is like asking the fox to guard the henhouse. It’s placing trust in the broken and backward bureaucratic system they claim to despise and magically expecting it to achieve a different result.

Maybe I’m wrong. Some may accuse me of letting the perfect be the enemy of the good. But I don’t think so. When pressed, I’ll put my money on Buchanan and Hayek every time. While many claim to #StandwithRand, forgive me if I take a seat.

Obamacare Exchange Plans Have 34 Percent Fewer Providers than Non-Exchange Plans

Avalere Health has quantified how narrow networks are in Obamacare exchange plans, as shown in the figure below.

According to Avalere CEO President Dan Mendelson: “Plans continue to test new benefit designs in the exchange market. Given the new requirements put in place by the ACA, network design is one way plans can drive value-based care and keep premiums low.”

Well, that is one way to look at it, and I hope Mr. Mendelson is right.

On the other hand, there are other indications that insurers are designing plans to attract healthy applicants and shun sick ones. I fear that this research builds on that case, because the networks of specialists (oncologists, cardiologists) are much narrower than the networks of general practitioners.

That is what you would do if you were designing a network for the healthy—ensure adequate access for those who need only their annual preventive visit (free under Obamacare) but reduce access for patients who need specialty treatment.

I don’t want to go overboard here. It may well be that there are greater differences in quality among specialists than general practitioners, in which case it would be quite reasonable to characterize a very narrow network of specialists as high value.


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For the pivotal alternative to Obamacare, please see the Independent Institute’s new book, A Better Choice: Healthcare Solutions for America, by John C. Goodman.

Did 15 Million—Not 6.6 Million—Pay Obamacare’s Mandate Penalty?

a_better_choice_180x270The media have reported that 6.6 million “taxpayers” paid the Obamacare penalty (tax) for not obeying the individual mandate to buy federally qualified health insurance in 2014. However, the actual figure must be much larger.

The report by the Taxpayer Advocate discusses “returns,” although not individual taxpayers. It reports that 2.6 million 2014 returns claimed Obamacare’s premium tax credits, totaling $7.7 billion paid out, and an average pay out of $3,000 (page 39, figure 3.3.1).

We know from other sources that about 6.14 million individuals claimed tax credits for Obamacare coverage last year (87 percent of 7.06 million individuals). (And that is only if we count people who signed up during open enrollment, which ended in March 2014. Because special enrollment continued throughout the year, most of those who signed up later would also have claimed tax credits.)

So it looks like we have at least 2.36 Obamacare-enrolled individuals per household filing a tax return claiming a premium tax credit. Although, the U.S. Department of Health and Human Services reports an average tax credit of $264 per individual per month, which would add up to $3,168 per year – about the same as the Taxpayer Advocate reports for the average return. Of course, only about half of Obamacare enrollees stay enrolled for the whole year, so maybe these dollar figures are not as confusing as they initially appear.

Anyway, if we flip around the number of individuals per return, we would guesstimate that those 6.6 million returns that paid penalties for not obeying Obamacare represent about 18 million individuals.

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For the pivotal alternative to Obamacare, please see the Independent Institute’s new book, A Better Choice: Healthcare Solutions for America, by John C. Goodman.

The CSA and Symbols: Learning from History

CivilWarSince a crazed, hate-filled and cowardly gunman killed nine black Christians in Charleston, South Carolina, the PC police have been in attack mode on anything associated with the Confederate States of America. The South Carolina General Assembly quickly voted to removed the Battle Flag from a Confederate Soldiers’ Memorial on the State House grounds. Now, critics want to destroy a massive carving on Stone Mountain outside of Atlanta featuring Confederate heroes Jefferson Davis, Robert E. Lee and Thomas “Stonewall” Jackson. Some are even demanding the rethinking of events associated with Thomas Jefferson, Andrew Jackson, and others because they were slave owners.

Ben Hallman at the Huffington Post tells us how we are supposed to think: “The Confederacy was the most vile and harmful political invention in United States history. It was founded on the explicit principle that slavery is the ‘natural and normal condition’ of black people, and that they should be ruthlessly exploited to the benefit of their white masters.” Hallman and others see Confederacy as synonymous with slavery and racism, and tell us to despise all things Confederate. His is a very simplistic view of history.

Slavery was a horrible institution that most of us, thankfully, cannot begin understand. But if we are going to remove symbols and emblems associated with it, we better look at the Stars and Stripes before hunting down anything with the initials CSA. Slavery, of course, existed in the United States from colonial times until ratification of the 13th Amendment. Twelve presidents owned slaves at one time or another, including George Washington and U.S. Grant. Actually, slavery existed longer in the Union than the CSA, since the Emancipation Proclamation did not apply to slaveholding states remaining loyal to the Union. For a good study on the war, causes, and effects, see Robert Higgs, “The Bloody Hinge of American History.” For anyone interested in the growth of the federal government under Lincoln and the Republicans, see Joseph R. Stromberg, “Civil War and the American Political Economy.” For a scholarly argument that war was not necessary to gain emancipation, see Jeffrey Rogers Hummel, Emancipating the Slaves, Enslaving Free Men. A review of the book can be found here.

Of course, the Stars and Stripes has also presided over many horrific acts and policies dealing with removal of American Indians, imprisonment of Japanese Americans in WWII, and the torturing of prisoners at Gitmo. Such examples are abundant.

If we want to hold the USA and CSA to our modern standards and sensibilities, both will be found lacking. But in both the CSA and the USA we can find men and ideas worth studying and considering. Libertarians have long realized this. For example, Professor Randall Holcombe points to many provisions of the Confederate Constitution that limited government power and that would serve us well today. Robert E. Lee rightly remains internationally respected as a brilliant tactician, a gentleman, and man of honor. The Independent Institute has long championed William Lloyd Garrison, his demands for the abolition of slavery, and his contributions to liberty.

Bottom line: We need to pause before we banish all symbols of our past that don’t comport with modern thinking. Our history has rough edges and embarrassments we don’t want to repeat. But there’s plenty to learn from great men of the North and the South, the Blue and the Gray.

Love, Marriage, and Green Cards


For most of human history, love and marriage had positively nothing to do with each other. Marriages were arranged in order to strengthen alliances, end family feuds, and secure political power. You were lucky if you liked your spouse, let alone loved them!

In the United States today, we don’t see marriages for political power (though it’s an interesting thought experiment to think about what would happen if one of President Obama’s daughters married one of Mitt Romney’s sons). But we do see marriages that, more than likely, aren’t for love. The late Anna Nicole Smith, for example, made headlines when she married the 89-year-old oil tycoon J. Howard Marshall. She was 26 at the time. Needless to say, the union of a former Playboy model to a man 63 years her senior raised some questions—until people found out Marshall’s net worth was a cool $1.6 billion.

According to the CDC, approximately 2.1 million marriages occurred in the United States in 2011. My guess is that some of these did not happen for love.

One interesting instance of such a transaction involves a special type of immigration visa—and highlights how government policy induces people to take desperate measures to improve their lives.

A K-1 visa is issued to individuals living outside the United States and allows him or her to immigrate in order to marry a U.S. citizen. I’ve written elsewhere about the complexities of the immigration process and how for many people in developing countries, their chances to obtaining entry for work or asylum are slim to none. Even those who can obtain work visas may spend years waiting in line. This has led people to undertake dangerous journeys and send even their children thousands of miles away alone–all in hopes of a better life.

As such, it should come as no surprise that more than one person has figured out they can get to the States by marrying a U.S. citizen. This issue received some attention recently with the release of the second season of the TLC reality show, “90 Day Fiance.” As the title of the show implies, the K-1 visa allows for a foreign fiancé to enter the country, but requires he or she to marry their betrothed within three months. In nearly every case, the family members of the American were skeptical, some asking point blank if their fiancé was “just in it for the green card.”

This is not to say that everyone who is issued a K-1 visa is solely seeking citizenship, but without a doubt, some people who enter the U.S. on K-1 visas are just in it for the green card. Understandably, there isn’t data on how many marriages take place every year just so a foreigner can obtain citizenship.

This got me thinking, why would someone marry a U.S. citizen if they were just looking to enter the U.S.? Is it easier than the alternatives?

Let’s look at the process for a K-1 visa. Assume the foreign partner is just trying to get a green card.

Timeline (approx) Step Information
Varies 1.
U.S. Petitioner gathers various documents
U.S. Petitioner gathers various documents (birth certificate etc) to send with I-129F
N/A 2.
I-129f Package sent
U.S. Petitioner sends compiled I-129F package to theUSCIS Dallas Lockbox which will forward the package for processing.
2-3 Weeks 3.
1st Notice of Action (NOA)
U.S. Petitioner Receives first Notice of Action (NOA) acknowledging K-1 petition has been opened
See Processing Times 4.
2nd Notice of Action (NOA)
U.S. Petitioner Receives second Notice of Action (NOA) acknowledging K-1 petition has been approved
2 Weeks 5.
Case Forwarded by your Service Center to the National Visa Center (NVC)
Case Forwarded by your Service Center to the National Visa Center
1-4 Weeks 6.
Case Forwarded by NVC to U.S. Embassy in your fiance(e)’s country
Case Forwarded to U.S. Embassy as specified in the I-129F.
1 week 7.
Case received by Embassy from NVC
Embassy receives package and processes it. They will then prepare a letter to be sent to the foreign fiance(e).
1 week 8.
Forms and Checklist sent to Beneficiary
Forms and Checklist sent to foreign Beneficiary (Fiance/e).
Varies 9.
Foreign Beneficiary compiles required forms
Beneficiary fills in Forms and assembles various documents
N/A 10.
Completed Forms sent to Consulate
Beneficiary sends completed Forms to U.S. Embassy
N/A 11.
Fiance(e) must attend medical interview prior to interview
Attend medical appointment.
1 week to issue date 12.
U.S. Embassy issues Beneficiary with Interview date
U.S. Embassy issues Beneficiary with Interview date
1 Month to interview 13.
Beneficiary has Interview at U.S. Embassy
Beneficiary has interview at U.S. Embassy for K-1 visa. All being well case is approved.
N/A 14.
Beneficiary travels to and enters the U.S.
Beneficiary travels from their country to be with the U.S. Petitioner (Fiance(e)) in the US.
5-20 minutes 15.
Point of Entry (POE) in U.S.
Beneficiary arrives at Point of Entry (POE) in U.S. and shows K-1 to the immigration officer.
1 hour (early morning) 16.
Apply for Social Security Number
Apply for Social Security Number (SSN)
1 hour 17.
Apply for marriage certificate
Apply for marriage certificate. Must marry within 90 days of entering the U.S. on a K-1 visa.
Get married
Get married. and give each other a pat on the back. You’ve both earned it!
1 hour (early morning) 19.
Change name on SSN
Go back to the SSA office and bring your SSN Card and marriage certificate. Change your name.
Varies! 20.
Complete I-693
Complete I-693 per the K1/K3 AOS Guide. This is required so that your vaccinations can be documented properly on the I-693 as part of your completed AOS package.
(File as soon as possible once you marry)
Apply for Adjustment of Status (AOS), EAD, AP
Apply for Adjustment of Status (AOS). You should file as soon as possible. If you have not filed for AOS and your K-1 expires, you will be considered out-of-status until you file. Make all attempts to file before you become out-of-status. You may also file for your EAD and AP at this time.
See Processing Times 22.
Receive EAD / AP
Receive your EAD and AP via US Mail. You will have a biometrics appointment prior to being issued the EAD.
See Processing Times 23.
Interview for AOS (I-485 approval)
Interview appointment for AOS. When approved you will receive an I-551 stamp in your passport indicating you have been approved for AOS and will also receive your green card in the mail later.


Add to this process the following. If you are just in it for the green card, you need to find someone to marry you. You can A.) manipulate another person and trick him or her into marrying you. This takes time, effort, and spending copious amounts of time without someone for whom you have no feelings. B.) You can find someone who will agree to marry you if you pay him (The amount of money this takes varies. I’ve seen estimates from less than $10,000 to $25,000+). This requires additional time and effort, though perhaps less time on the back end with someone you don’t really care about (though you have to fake it well enough to fool immigration). C.) You can find someone who is particularly sympathetic to your plight and get him to agree to marry you. You forgo paying them, perhaps, but still incur the costs noted above.

This process should seem insane–because it is! It requires time, money, and fraud. Yet, as economics tells us, individuals would not undertake these transactions if the benefits were not greater than the cost.

This means that the above process, all of it, is more appealing than going through the other U.S. immigration processes. If that doesn’t indicate a need to reform the current immigration system, I don’t know what does!

Let’s Hope Arizona’s New Health Law Is Contagious

a_better_choice_180x270Last April, Arizona governor Doug Ducey signed a law that allows patients to order lab tests directly from a lab, without physician intermediation. The tests will be self-paid: No government nor private health plan has to pay for them.

The legislation was backed by one of the most exciting diagnostic companies in the market: Theranos, founded by an incredibly entrepreneurial young billionaire, Elizabeth Holmes. The firm’s technology allows a battery of tests to be run on a single drop of blood, instead of the long draws we are used to undergoing.

Ms. Holmes’ business strategy necessitates disrupting the very staid world of clinical laboratories, which has been protected from innovation by the government-driven payment model. Instead of lobbying to get inside the model, Ms. Holmes lobbied to be exempt from the model. We need more people like that in health care.

This brings us to an interesting dispute between another billionaire, Mark Cuban, and the journalistic and medical establishment. Mr. Cuban advises everyone who can afford it to have his or her blood tested quarterly. His opponents say that’s overkill. Arizona’s new law makes their opposition obsolete.

(Recall that the Obama Administration has issued a rule allowing anyone direct access to lab results. I was not quite comfortable with it because of a concern for federalism. I have no such concerns with Arizona’s new law.)

Fellow Forbes contributor and health care entrepreneur Dan Munro has taken advantage of the new law. It was a positive experience:

The Theranos process really has removed much of the friction I associate with blood tests I have taken in the past. Access is through a familiar retail facility with pharmacy hours. Billing is a typical retail transaction with credit, debit and HSA cards (or cash/check). The lowest price blood test is $2.70 (Glucose) and Theranos advertises that their pricing is at least 50% below Medicare reimbursement rates for all tests.

The highest price test on the Theranos order form was $59.95 ‒ a comprehensive test for Sexual Health. For comparison purposes, RequestATest (which appears to be an online, front-end for using LabCorp locations around the country), charges $199 for a comprehensive STD test and AnyLabTest Now (with 3 locations in the Phoenix metro) charges $229 for a comprehensive STD test.

The Obama administration is a fan of getting clinical data in the hands of patients. Here is a great opportunity for it to do something I’ve advocated forever: Tell Medicare beneficiaries in Arizona that if they can find a blood test for half the cost of the fee Medicare pays, Medicare will split the savings between the patient and taxpayers, adding some share of the savings to the patient’s Social Security deposit. (Note: Medicare would not recommend or endorse Theranos specifically. Theranos and Walgreens would take care of promoting the option.)

I’d bet that if Medicare adopted such a policy, and beneficiaries in Arizona told their friends on Medicare around the country, other state legislatures would pass laws mimicking Arizona’s pretty quickly.

Government’s Burden on Young Americans

LoveGov2_416x358The Independent Institute’s Love Gov videos offer an amusing look at the raw deal government policies give to America’s youth. In the videos, sometimes government tempts young people into bad deals, such as student loans, and other times it offers them little choice but to take bad deals, as with health insurance. But the videos understate the magnitude of forced transfers from younger Americans to elders.

Social Security, Medicare, and Medicaid make up 60% of the federal budget, and those programs are transfers from the taxpayers who fund them to recipients. Social Security and Medicare are only for older Americans, and a major share of Medicaid also goes to older Americans. Younger Americans pay the taxes; older Americans get the benefits.

Things are getting worse for young Americans. As Jonathan Gruber noted, it is because of “the stupidity of the American voter” that Obamacare charges artificially higher premiums to younger people so that older people can have lower premiums.

So sure, government tempts young people to take out excessive student loans, to take on home mortgages beyond their abilities to afford them, and do other irresponsible things, but government also forces even the most responsible American youth to sacrifice some of their own well-being to support older Americans.

Government does many things. One is: it systematically plunders American youth for the benefit of older Americans. Is this fair? Ironically, programs that support the old at the expense of the young are more politically popular among the young than the old.