O-Care Replacement Watch

This article from the New York Times suggests that following repeal of Obamacare, House Republicans will look for a replacement that substitutes liberty for compulsion -- a big improvement:

In defending the Affordable Care Act, the Obama administration, congressional Democrats and advocacy groups have focused on the 20 million people covered by the law, which has pushed the percentage of Americans without health insurance to record lows. The American Medical Association recently said that “any new reform proposal should not cause individuals currently covered to become uninsured.”

But House Republicans, preparing for a rapid legislative strike on the law next month, emphasize a different measure of success.

“Our goal here is to make sure that everybody can buy coverage or find coverage if they choose to,” a House leadership aide told journalists on the condition of anonymity at a health care briefing organized by Republican leaders.

. . . 

Republicans have an “ironclad commitment” to repeal the law, the aide said, as lawmakers moved to discredit predictions that many people would lose coverage.

“There’s a lot of scare tactics out there on this,” said Representative Kevin Brady, Republican of Texas and chairman of the Ways and Means Committee. “We can reassure the American public that the plan they are in right now, the Obamacare plans, will not end on Jan. 20,” the day Donald J. Trump will be inaugurated.

The suggestion that 20 million people will lose coverage is a “big lie,” Mr. Brady said, after meeting here with Republican members of his committee.

“Republicans,” he said, “will provide an adequate transition period to give people peace of mind that they will have those options available to them as we work through this solution.”

Alvarado Punches Back Twice as Hard

Good for Sen. Ralph Alvarado (R-Winchester). He just won a defamation and false light suit -- and $200,000 in damages -- from former Sen. R.J. Palmer

As Pure Politics reports, Alvarado (who is a doctor) sued his former election opponent for essentially portraying him as a drug dealer.

It took Alvarado two years to get the victory; it went all the way to a jury trial, where the jury awarded $125,000 in compensatory damages and $75,000 in punitive damages.

The point of punitive damages is to deter. Hopefully, the verdict in this case will indeed deter slimy politicians from lying about an opponent just to advance their chance of winning.

This suit has important ramifications not just for defamation law but also for candidate recruitment.  Honorable people who would make terrific public servants often refuse to run because they don't want to be subjected to lies of the sort Palmer spread about Alvarado.

It's good to see that there is recourse, even despite the difficulty of proving actual malice when the victim is a public figure (which candidates are).

Parents Should Watch This JCPS Issue

Reprinted with permission of the Courier-Journal:

As the most recent National Geographic illustrates —its cover story features a nine-year-old transgender girl— parents are facing challenges and choices that would have been unimaginable a generation ago. That calls for vigilance about what images and messages bombard our children, and clear communication about what we believe, and why.

Take, for example, the Jefferson County Public School sex education curriculum.

For more than a year, an organization called Louisville Sex Ed Now has been advocating changes to that curriculum. LSEN is a coalition of Planned Parenthood, the ACLU, the Fairness Campaign and others. It maintains that due to vague state standards, there is too much variation among JCPS schools and teachers in how sex ed is taught.

Given Kentucky’s Republican governor and legislature, there is no possibility that the state standards on sex ed will be modified to please organizations like Planned Parenthood and the ACLU. So they are taking the fight to the local level. LSEN wants JCPS to enact new standards to specify what must be taught to middle school and high school students. That is, LSEN wants to reduce the discretion that Site Based Decision Making Councils at schools within JCPS have to choose sex ed curricula.

In addition to this reduction of local control, LSEN advocates “comprehensive sexuality education.”

“Comprehensive” appears to be a term of art, or perhaps code, for sex ed that goes way beyond the “birds and the bees” of reproduction. The United Nations defines comprehensive sexuality education as “rights-based and gender-focused.”

Typically, “comprehensive” sex ed gives a passing nod to abstinence and therefore is sometimes misleadingly called “abstinence-plus” sex ed.

The goal of comprehensive sex ed is to reduce the risk of pregnancy and sexually transmitted infections. That sounds reasonable, at first glance. The underlying premise, however, is that teenagers are brimming with hormones and will have sex, whether we like it or not, so best show them how to use a condom.

To that end, the Obama administration took away $100 million from abstinence programs and spent nearly a billion dollars on comprehensive sex ed known as the Teen Pregnancy Program (TPP). A recent Health and Human Services report foundthat teens in some TPP programs were more likely to begin having sex, more likely to begin having oral sex, and more likely to get pregnant than teens who did not take the class; 80 percent fared no better than or actually did worse than non-TPP students.

Many parents who addressed the JCPS board on Nov. 29 similarly argued that sex ed should teach students risk avoidance, not risk reduction. The best way for a teenager to avoid the risks of unwanted pregnancy and sexual infections altogether is to not have sex.

That entails more than preaching abstinence. It requires empowering students to defer gratification, master their passions, remain focused on long term goals —  to learn self control and patience. A curriculum that teaches risk avoidance, therefore, has broader applications than just deferring when a child becomes sexually active.

A curriculum based on abstinence need not (and should not) evoke fear or guilt or teach that sex is bad. Nor should an emphasis on abstinence omit the lesson of treating all people with dignity and respect. Rather, the point should be to elevate sex to its proper context.

Risk avoidance recognizes that teenagers are more than the sum of their hormones. Risk reduction, in contrast, takes a cynical view of what is attainable for a teenager — similar to what former President George W. Bush called the “soft bigotry of low expectations.”

At the very least, parents must ask to review what is being taught to their children to make sure it doesn’t undermine the values they are trying to instill; if it does, opt out.

Regardless of one’s opinion, it is unrealistic to expect that JCPS will teach everything that parents want their child to know about sex. Parents will have to supplement and perhaps enlist the help of their church, on the one hand, or Planned Parenthood on the other.

There is no reason to believe that JCPS’s success rate at sex ed will exceed what it has, or has not, achieved with other more traditional academic subjects. Some would advance the “radical” view that a school district should focus on those other subjects rather than advance a more “comprehensive” sex ed agenda.

Obamacare Repeal and Replace Update

A good read from the Wall Street Journal on the critical issue of what the replacement for Obamacare should look like. President-Elect Trump's nomination of Rep. Tom Price (R-Ga.) actually encourages me that this might happen:

. . .

The new system should be fully consumer driven, empowering individuals to be the surveyors and purchasers of their care. Past reforms in this direction became stilted and ultimately incomplete, but the current moment offers a chance to truly rebuild from the ground up. If Messrs. Trump and Price want to make the most of this short window, they should keep four central reforms in mind.

1. Provide a path to catastrophic health insurance for all Americans. There’s ample evidence that enrollment in insurance doesn’t always lead to improvements in health—but access to health insurance is important nonetheless. A 2012 study from the National Bureau of Economic Research found higher insurance enrollment from reforms in Massachusetts led to better results in several measures of physical and mental health.

Health insurance is also important for financial security. The ObamaCare replacement should make it possible for all people to get health insurance that provides coverage for basic prevention, like vaccines, and expensive medical care that exceeds, perhaps, $5,000 for individuals.

Those Americans who don’t get health insurance through employers, or Medicare and Medicaid, should be eligible for a refundable tax credit that can be used to enroll in a health-insurance plan. The credit would be set at a level comparable to the tax benefits available to individuals with employer-sponsored insurance plans. The subsidy would be enough to make a basic level of catastrophic coverage easily affordable for all Americans. 

2. Accommodate people with pre-existing health conditions. The price of insurance naturally reflects added risk. That’s why beach houses cost more to insure than a typical suburban home. Yet there is a reasonable social consensus that people should not be penalized financially for health problems that are largely outside of their control.

So as long as someone remains insured, he should be allowed to move from employer coverage to the individual market without facing exclusions or higher premiums based on his health status. If someone chooses voluntarily not to get coverage, state regulation could allow for an assessment of the risk when the person returns to the market. 

This would prevent healthy people from waiting until they get sick to buy insurance, which is one reason ObamaCare’s insurance markets are unstable. The refundable tax credit ensures that everyone, including the unemployed, can get access to at least catastrophic insurance and maintain continuous coverage. Well-run and properly funded high-risk pools can help address the inevitable cases of expensive claims for the remaining uninsured.

3. Allow broad access to health-savings accounts. ObamaCare pushed millions of Americans into high-deductible insurance without giving them the opportunity to save and pay for care before insurance kicks in. There should be a one-time federal tax credit to encourage all Americans to open an HSA and begin using it to pay for routine medical bills. And HSAs combined with high-deductible insurance should be incorporated directly into the Medicare and Medicaid programs.

An NBER study from 2015 concluded that families spent between 7% and 22% less on health care in the three years after switching to an HSA. Spending was also lower for outpatient services and pharmaceuticals, without any increase in emergency-room spending.

As millions of consumers begin using HSAs, the medical-care market will begin to transform and deliver services that are convenient and affordable for patients.

4. Deregulate the market for medical services. HSAs will empower the demand side of the market, but suppliers need freedom from regulation to provide packages of services better tailored to people’s needs. For example, those consumers who maintain HSA balances should be allowed to use their resources to purchase direct care—basic services that keep people healthy and treat illnesses and chronic conditions—from physician groups. This might take the form of a monthly fee, a practice sometimes referred to as direct primary care. Today, this could be considered an insurance premium that’s barred by law.

Hospitals and physicians should also be allowed to sell access to their networks of clinics, oncology services, and inpatient facilities as an option to be used in the event a patient is diagnosed with an expensive illness. Medicare patients should be allowed to purchase the option to consult with their caregivers by phone, videoconferencing, or email. These are only some of the needed reforms. Regulation shouldn’t be an obstacle to entrepreneurs crafting more consumer-oriented services, many of which can’t be countenanced under current rules.

American health care is teetering because it relies too much on governmental coercion. A functioning marketplace can deliver high-quality care at lower cost. Now is the time to secure a system that empowers consumers to take command of their health care.

Welcome the Pegasus Institute to KY!

I just met with the founders of the Pegasus Institute, Jordan Harris and Josh Crawford and was most impressed. As the C-J recently reported, the Pegasus Institute is the first center-right think tank founded by Millennials.

Harris and Crawford are committed to tackling problems that have held Kentucky back for decades. Look to them to present market-based policy solutions backed with data and peer-reviewed research from leading conservative academics across the country.

The formation of this think tank comes at a perfect time, with the Republican majority in the Kentucky House for the first time in 92 years. Pegasus Institute can equip Republicans with solid policy proposals that have been proven to work in other states.

They are poised to fill an important niche: research and policy formation -- the true role of a think tank -- as distinct from issue advocacy.

The Pegasus Institute is organized as a 501(c)(3). Donations to it are therefore deductible, and from what I've seen, this will be a good place for conservatives and libertarians to donate.