Washington Policy Blog

Wal-Mart Endorses Employer Based Health Care

In somewhat of a surprise move, Wal-Mart on Tuesday announced an endorsementof employer-based funding for health insurance. Wal-Mart is the largest private employer in the country and has been criticized in the past by labor groups for its modest employee health insurance plans.

In an interview with the Wall Street Journal, the senior manager for health policy for the U.S.Chamber of Commerce reiterated the fact that the vast majority of the Chamber's members continued to oppose a forced mandate on employer funded health care.

So what's Wal-Mart's motivation.

Their stated purposes are to decrease the number of uninsured and to bring down the cost of health care. In the middle of a recession, however, forcing small employers to purchase health insurance is a guaranteed way of driving more employers out of business. Could this decrease competition and benefit Wal-Mart? Probably.

Often the best defense is a good offense. Could it be that Wal-Mart wants to appear as an ally in the Administration's push for health care reform, enjoy potentially good public relations, and at the same time ease its strained labor relations? Very possibly.

The driver for increasing health care costs in this country is that some third party (either employers or the government) pays for almost 90% of our health care. If someone else pays for our health care (or food, or clothes, or shelter), demand will far out pace supply and costs will rise. By mandating that employers must pay for employee health care, this model of third-party payer will be more firmly entrenched and will lead to further increases in costs.

Sneak peak at supplemental budget

Although the new fiscal year and biennium are only 1 day old, it's not too early to start thinking about next year's supplemental budget. Based on yesterday's caseload forecast, the Governor is already hinting at what agencies can expect to be proposed.

Here are details on the caseload forecast as reported in The Olympian:

"More Washington residents will receive Medicaid and children’s health assistance in the next two years than earlier forecast, creating a $250 million shortfall in the state’s already-strained budget.

The new forecast was released Wednesday by the Caseload Forecast Council, and Gov. Chris Gregoire’s budget office released an analysis showing that $113.4 million of the expected increase is in aid to needy families that qualify for Medicaid.

An additional $69.6 million is for children’s health care, including some children whose families qualify for Medicaid and others whose citizenship has not been verified. General Assistance Unemployed costs also are up $12 million, and nursing-home costs are up by $6 million."

Coupled with last month's poor revenue forecast, the state's new budget is already projected to be in the red. In response, the Governor's budget office (OFM) sent a memo to agency directors yesterday detailing her strategy:

"On June 18, the Governor directed the following administrative actions by cabinet agencies:

• Full Time Equivalent (FTE) reductions equivalent to a 2 percent reduction in 2009-11 budgeted GFS FTEs.

• Continuation of specific GFS savings in out-of-state travel and training, personal services contracts, and equipment purchases.

• Spending restricted to only critically necessary activities.

She also has encouraged non-Cabinet agencies to impose similar measures.

The Governor’s reductions are intended to create savings that mitigate the effect of the June revenue drop. OFM will continue to watch revenue collections and caseload/enrollment projections as we approach the September and November forecast updates for GFS revenues. Ongoing expenditure and revenue pressures will very likely require further action, including revisions in a 2010 supplemental budget. The reductions in this memo represent the first steps toward supplemental budget changes for expenditures funded by the GFS."

Included in the memo are two tables showing the projected FTE and spending reductions. These figures are a good first look at what the Governor may propose in a supplemental budget.

If enacted by agencies, the Governor's proposal would reduce FTEs below budgeted numbers by approximately 642 and spending by $374 million.

While this is a good first step, additional spending corrections by the Legislature next session will be necessary to rebuild the state's rainy day account. Otherwise we may not be able to respond effectively to any future curve balls the struggling economy may throw our way.

The convergence of technology and democracy

There's no doubt that 2008 was an evolutionary leap forward in the use, and focus on, technology as a main driver of civic involvement in the democratic process. Then-candidate-Obama's masterful use of social networking for both messaging and fundraising took the nation, and the electorate, by storm. By comparison, the Republicans ramped up their focus on technology trends as well, but let's face it, the Democrats fired on all cylinders in this area.

But now that the Obama administration, whose messengers campaigned on "accountable" and "transparent" government, are now in the seat of power, how will they follow through with their campaign promises?

I recently attended the Personal Democracy Forum in New York and one of the guest speakers was Vivek Kundra, the U.S. Chief Information Officer. Vivek unveiled a new website aimed at opening up U.S. federal I.T. spending -- it.usaspending.gov. The website takes a dashboard approach to outlining major U.S. "investments" (aka spending). And while the site is still in a beta mode, the early results look good.

Eventually, anyone will be able to drill down into specific government projects (non-classified of course) and look at spending patters, contracts with private companies, link to GAO and other evaluative reports, and more.

We are seeing this here in Washington state as well. Last year the legislature passed a WPC recommendation for a fiscal transparency website, fiscal.wa.gov. It has been in operation for about a year now and is helping to make Washington state government more transparent and therefore accountable.

Efforts on both state and federal levels are to be applauded. But more needs to be done. More suggestions and ideas on government transparency.

Medicare Administrative Costs Are Higher, Not Lower, Than Private Insurance

Since rising health care costs are the number one issue in the health care reform debate, it is essential that any reform addresses this problem. The Heritage Foundation published an interesting study that found administrative costs to be higher, not lower as frequently cited by proponents of a public plan, than private insurance.

"On a per-person basis Medicare's administrative costs are actually higher than those of private insurance--this despite the fact that private insurance companies do incur several categories of costs that do not apply to Medicare."

You can read about it here , from June 25th.

Planetary treason – Krugman has lost his head!

In his latest writings, syndicated Op-Ed Columnist Paul Krugman takes aim at more than two-hundred members of Congress for their no vote on federal legislation promoting a national cap-and-trade policy.  Krugman opines:

“…most rejected the bill because they rejected the whole notion that we have to do something about greenhouse gases.  And as I watched the deniers make their arguments, I couldn’t help thinking that I was watching a form of treason – treason against the planet."

Krugamn’s accusation of planetary treason, though laughable, shows how far alarmists are willing to go in order to pervert the global warming debate.

The assignment of treason attempts to delegitimize all other positions within the climate debate, except the position which Krugman himself holds as an alarmist.  Krugman believes, “we’re facing a clear and present danger to our way of life, perhaps even to civilization itself.”  His message: Anyone who disagrees with me is a traitor.

So, if members of Congress are guilty of treason, what does Krugman have to say about the 56% of Americans who, according to the latest Rasmussen poll, don’t want to pay for the costs to fight climate change or the 63% of people who believe creating jobs is more important that fighting global warming?

The extreme position taken by Paul Krugman makes me believe that he is the only one losing his head!

Read My Lips, Obama Style

 In June of 1990, then President George H.W. Bush famously reneged on his campaign promise not to raise taxes. Now fast forward to the most recent campaign promises of last Fall. If you were around a television set anytime late in 2008, chances are you heard Barack Obama promise you that if you make less than $250,000 a year, he would not raise your taxes by one penny.

That is why it is troubling to hear White House Press Secretary Robert Gibbs announce Monday that he cannot "reaffirm" this promise.  With the Obama Administration leaving the option of taxing employee health benefits to pay for the cost of health care reform on the table, the road to reform for the President might entail not following through on one of his biggest campaign promises only months into his presidency.

CPR, Conservatives for Patients' Rights, mentions this potential reality in their Daily Dose segment today, June 30th.

Massachusetts' Health Care Plan for the Nation?

Many of the national health care reform measures currently under debate in Congress have been in place since 2006 in the state of Massachusetts. Major reform was implemented that year in a bipartisan fashion with a Republican governor and a Democratic legislature.

Those reforms include:

   *  Individual mandates - all residents must purchase health insurance.

   *  Employer mandates - each employer must purchase health insurance for his employees or pay a fine.

   *  An insurance "connector" to offer a "market place" for insurance plans. The state then dictates benefit mandates and pricing of the plans within the "connector".

   *  State subsidies for the poor.

   *  A goal of universal coverage.

Since these same reforms are now being debated in Washington, D.C., it is reasonable to see how they have worked in Massachusetts? A recent Rasmussen Report found that only 26% of the state's residents view the program as a success, with 37% convinced it is a failure and 37% unsure. Only 10% feel that the quality of their health care is better, while 29% believe it is worse and 53% see no change.

Michael Tanner at the CATO Institute has found that although the number of uninsured has decreased in MA, this decrease is mainly the result of the generous state subsidies and not the individual mandate. Costs have spiraled out of control and the state is currently lobbying the federal government for upwards of $1 billion dollars to cover cost over-runs. Access is also an issue, especially in the area of primary care.

Congress has to look no further than Massachusetts to see that more government control of our health care will not lead to more access and patient satisfaction, better care, and cost containment. Instead, the  Massachusetts experience should be used as a model of what not to do to reform our health care system.

Passenger Rail: not so good for the envrionment

A new study by two professors at the University of California, Berkeley argues that when assessing the environmental impacts of a transportation system, one should include life cycle costs of infrastructure, fuel production and supply chains, not just the simple measure of tail pipe emissions.

In doing so, the researchers conclude:

We find that total life-cycle energy inputs and greenhouse gas emissions contribute an additional 63% for onroad, 155% for rail, and 31% for air systems over vehicle tailpipe operation.

Why is rail so much more harmful to the environment than other modes?

          Ranges in passenger occupancy can easily change the relative performance of modes.

This means transit modes that don't carry a lot of people are more harmful to the environment when compared to other transportation modes that are more efficient, like air travel or private vehicles. This is the point we try to make in our analysis of Sound Transit's Light Rail system and High Speed Rail.

Yet rail advocates continue to push for greater public spending under this false premise of environmental stewardship. Consider this statement from the campaign folks supporting the 2008 ballot measure to expand light rail in the Puget Sound:

"One thing that really struck me is, when people get a sense of the greenhouse gas levels that will be reduced, that will be a compelling argument," said Alex Fryer of the group Mass Transit Now.

Yet our analysis shows ST2's poor ridership would only reduce CO2 emissions by 1.11%. Randal O'Toole made similar findings in his remarks about High Speed Rail. And these don't even include the life cycle costs of infrastructure or supply chains that the Berkeley researchers count.

You can find the full U.C. Berkeley study here.

 

Train collides with car

Sound Transit train and car collide in Seattle

According to local transportation policy expert, John Niles, Sound Transit's EIS,,,

...forecast a collision with a vehicle, bike, or pedestrian averaging every 12 days. Most are expected to be minor, but serious injuries and fatalities are not unheard of in other light rail cities, at a rate per passenger mile that exceeds urban car and bus driving/riding.

John has portions of the EIS showing Sound Transit's analysis posted on his website here.

Interestingly, yesterday's collision was caused by a driver crossing the tracks after turning left against a red light. According to the EIS:

A review of the experience of other light rail transit systems indicates that motor vehicles turning left in front of light rail vehicles account for the largest percentage of collisions.

Yet, despite this latest collision and according to the EIS, the light rail line will reduce overall accidents along the MLK corridor by about 37%. This is because an at-grade line will separate oncoming traffic and require more signalization. Only time will tell if Sound Transit's estimate is correct....

Update: originally I questioned whether Sound Transit should have installed some sort of audible or visual warning device at each intersection on MLK Way and apparantly, they have. Who knew I had that much influence...now if I can get them to reconsider placing light rail across I-90.

Will lawmakers pledge to read healthcare bill before voting?

2009 may go down in history as one of the most ambitious policy years in history. First there was the 1,073 page federal "stimulus" bill passed by Congress in February. Then last Friday the House passed the 1,200 page cap-and-trade bill. Next up is the restructuring of the nation's health care sector with current proposals totaling hundreds of pages.

Congress is considering these massive proposals under the direction of House Speaker Nancy Pelosi who promised in 2006 to "create the most open and honest government in history," if given power. In fact, she went a step further and said, "Lawmakers must have the opportunity to read every bill before they vote on it. It’s common sense."

With Pelosi running the House, it's safe to assume lawmakers were provided time to read these policy tomes line-by-line before adoption, right?

Wrong.

Both bills were voted on within hours of the final versions being made available. 

Hoping to change this, one citizen group is asking lawmakers to sign a pledge to read and post online for 72 hours the health care bill before voting. As reported by Politico:

. . . Let Freedom Ring, a group that promotes constitutional government and traditional values, has launched a campaign to get all 535 lawmakers in the House and Senate to pledge to not vote on the health care bill (likely to top 1,000 pages) until they have personally read it and the bill has been posted on the Internet for 72 hours.

“People were shaken into a new state of awareness when people talked about the size of the stimulus bill and the fact that, in all probability, no member of Congress or senator had read the bill,” said Colin A. Hanna, president of Let Freedom Ring. “That struck people as inherently absurd, almost in the existential, theater-of-the-absurd sense. We all know lots of bills are not read, but sometimes the scope and nature of a bill rises to a different level than everyday legislation.”

The full text of the pledge reads:

I pledge to my constituents and to the American people that I will not vote to enact any healthcare reform package that:

1) I have not read, personally, in its entirety; and,

2) Has not been available, in its entirety, to the American people on the Internet for at least 72 hours, so that they can read it too.

Simple enough. Read the law you are proposing and allow voters the time to read it as well. Seeing how this is supposed to be the most transparent Congress in history, no doubt Pelosi is encouraging lawmakers to sign this pledge, right?

Additional Information
Lawmakers to arm wrestle Speaker to see copy of cap-and-trade bill before vote