I put the Trump Rx and MFN ideas in different categories.

Trump Rx is a garden-variety, within-normal-parameters bad idea. If it provides value, the private sector will do it. If it doesn’t provide value, the government should not subsidize it. If it would provide value but there are policy obstacles preventing the private sector from doing it, the government should remove those obstacles. Under no circumstances should the government do the thing itself.

Let’s be honest. Republicans aren’t cutting Medicaid − but they should.

If Republicans were to reduce future #Medicaid spending $880B, Medicaid would keep growing.

Its rate of growth would merely fall from 4.5% to 3%.

(My latest in @USATODAY.)

1/19 @USATODAY Trump promises to balance the budget without touching Medicaid. But keeping both promises is impossible.

Unless Congress significantly cuts federal health care subsidies, it could trigger a debt crisis with wrenching cuts that hit Medicaid enrollees hardest.

2/19

A measles outbreak in Gaines County, Texas—24 cases so far in a county that voted 91% for Trump—illustrates a grim irony.

Senate Republicans plan to vote today on RFK Jr.'s nomination to be HHS Secretary. If they seat him, it will be Republican families that suffer. 🧵 In the 1960s, measles struck 3–4m U.S. residents annually, leading to nearly 500k diagnoses, 48k hospitalizations, and 400–500 deaths.

By 2000, cases had fallen to <100 per year, striking only when travelers—mostly, unvaccinated U.S. citizens—brought it home from abroad.

Insurers abandoned parts of LA that are now on fire for the same reason choice & coverage are narrowing in #Obamacare.

Politicians, activists & even some economists see insurance as a piggy bank, raid it until it doesn’t work anymore, and then blame insurance company greed.

1/5
California imposed binding price ceilings on homeowners insurance. It probably seemed like a nice thing to do for customers—keep the greedy companies from raising rates too much.

They were so binding, @StateFarm had to abandon 72,000 customers.



2/5 latimes.com/california/sto…

Whether you're conservative, centrist, lefty, libertarian, pro-life, pro-choice, vegetarian, whig, or know-nothing, the correct approach to #mifepristone or #misoprostol is this:

Government should not limit access to these drugs.

🧵 #Mifepristone and #misoprostol are *medicines*.

Like most medicines, they have multiple effects, and a single effect can have multiple uses.

For 8 months in 2003, I worked for a now-defunct free-market think tank in Texas, @DrJohnCGoodman’s National Center for Policy Analysis. On its board sat Harlan Crow. I may have met him, I don’t recall.

It was then that Goodman told me about what I call Crow’s “tyrants garden.” JCG explained Crow wanted to use the wealth he & family amassed through voluntary exchange to scour the globe, preserving monuments to tyrants & their failed ideologies, to show equality & freedom triumph in the end. To say freedom wins, evil loses.

@DavidAFrench @JonahDispatch

Tremendous respect for @TomasPhilipson; lots of issues with his latest in @WSJopinion.

🧵...

wsj.com/articles/medic… #CatoHealth First, some background.

Congress has complete control over the prices Medicare pays for drugs.

By most accounts, it sets drug prices too high. It agrees to pay drug makers whatever they charge for 6 categories of Part D drugs, encourages excessive drug prices in Part B, etc.

Congressional Rs defeated a proposal by Ds to mandate that private insurance companies cap out-of-pocket spending on insulin by their enrollees at $35/mo. They were right to do so. Govt is already driving insulin prices sky-high. Further intervention would make matters worse. 1/

https://twitter.com/TeamPelosi/status/1556362038384934912

Diabetics need insulin to live. Insulin prices should be falling yet they have more than doubled over the last 10yrs (healthcostinstitute.org/hcci-research/…). Many diabetics struggle (pbssocal.org/shows/newshour…) with those rising prices, often with deadly consequences (nymag.com/intelligencer/…). 2/

A few issues with the @EnergyCommerce "Build Back Better Act" provisions relating to states that rejected #ObamaCare's #MedicaidExpansion.

Based on a summary by @CenterOnBudget's @JudyCBPP: cbpp.org/research/healt….

🧵 1. Rewards Republican states for rejecting #ObamaCare.

It would authorize Exchange subsidies for people below the poverty line--but only in states that rejected the #ACA's #Medicaid expansion.

That gives GOP states a better deal than Democratic states that embraced #ObamaCare.

1/ SCOTUS agrees 7-2 with #ObamaCare critics like @jadler1969 & me (nypost.com/2019/03/28/oba…) that the plaintiffs in #CAvTX lacked standing to challenge #ObamaCare's individual mandate: supremecourt.gov/opinions/20pdf…. GOP appointees Roberts, Thomas, Kavanaugh, Barrett joined majority. 2/ #CAvTX arose after Roberts in #NFIBvSebelius saved the #ACA by interpreting the mandate as a tax. NFIB "gutted the Constitution's political-accountability constraint, which had prevented Congress from creating the mandate via Congress' taxing power." forbes.com/sites/michaelc…

#DCCircuit affirms district court, rules against private insurers seeking to crush their competitors by stripping coverage from patients with #PreexistingConditions.

cadc.uscourts.gov/internet/opini… #STLDI #ACAPvTreasury #CatoHealth @CatoInstitute @TheBuckeyeInst @jrovner @StephArmour1 Appellants are @safetynetplans -- i.e., #ACA-participating private insurance companies.

They complain competition from short-term, limited duration health plans--#STLDI, which Congress exempts from #ObamaCare's costly regulations--are hurting their revenues.

“If health economists were in charge of the health system, not a lot would change,” which tells you just about all you need to know about most health economists in the United States. @afrakt ow.ly/bJO030qj6KX @afrakt More constructively...the responses to this survey's normative questions confirm something that I’ve observed anecdatally: there is a mountainous structural ideological-bias problem in #HealthPolicy.

cc: @KosaliSimon, @cawley_john

Thread...

The more of our lives and decisions government controls, the more tolerant everyone becomes of corruption, at least among their own tribe. Big government encourages corruption by increasing the cost of integrity. Think about it. If we had a night watchman state, where the government controlled <10 percent of the economy, there would be much less riding on each election. The spoils of each election would be much smaller. There would be less of the economy to divvy up.

As a #libertarian who watched congressional Republicans attempt to remove a Democratic president (1998-99) and congressional Democrats try to remove a Republican president (2019-20), what strikes me the most about these two episodes is how similar they are. #TrumpImpeachment I witnessed Clinton’s trial up close, as a staffer for the leadership of the US Senate. Clinton clearly committed perjury, suborned perjury, and merited removal. @jacobsullum made the best case, though I can’t now locate the column. Similar column: unz.com/print/Reason-1….

A comment I posted on Facebook…

Let’s assume the @NHS’s troubles are due to inadequate funding and that one political party is to blame — i.e., other political parties would set spending at the “right” level. 1/ @NHS If you support giving government control over the health care sector of the economy, then, by definition, that means you support occasionally letting that power fall into the hands of the “wrong” political party. 2/

1. Judge Brett #Kavanaugh is on @realDonaldTrump's short list to replace Anthony Kennedy on #SCOTUS. In #HallvSebelius (2012), he issued a bizarre ruling that allowed exec agencies to usurp Congress' legislative powers & delayed desperately needed #Medicare reform. @CatoInstitute @realDonaldTrump @CatoInstitute 2. I have a history with #HallvSebelius (en.wikipedia.org/wiki/Hall_v._S…). I published the @CatoInstitute study (object.cato.org/pubs/pas/pa601…) that caught Hall’s eye. I introduced him to the author, who became his attorney. I may have referred another plaintiff (a Cato board member), etc.

1. Today’s @washingtonpost. 2. The @washingtonpost two weeks ago (washingtonpost.com/outlook/school…).