Filed under: Bureaucracy — Christian Schneider @ 4:17 pm
Have you been looking to join the high-pressure world of counting things? Are you interested in the fast-moving job of reading pieces of paper and entering numbers on those papers into a computer?
According to this promotional video, you may be just enough of a thrill-seeker to work at… the Wisconsin Department of Revenue! Get ready for the nonstop action of poring over tax forms and entering that data into a computer. Sense of adventure (and willingness to take short lunch breaks) required.
In the video, intended to get people fired up about the bean-counting over at DOR, it mentions that the agency is reponsible for “providing property tax relief for the taxpayers of Wisconsin.” Actually, the Legislature does that via changes in the law – DOR just cuts the checks. In fact, there’d be a little more “property tax relief” available had DOR not spent money on this ridiculous video. DOR taking credit for property tax relief shows they’re trying to fool prospective employees into thinking that all the calls they get from taxpayers are going to be friendly calls thanking them for all the wonderful tax relief they provide.
Oh, and did I mention that the DOR workforce is diverse? They only point it out three times in the video. As if some guy sitting at home in his underwear watching “The View” is going to turn down a job offer because DOR doesn’t employ enough Eskimos.
Of course, DOR is a vital department to the well-being of the state. The more truant taxpayers they can track down, the less you will have to pay. But it’s not exactly like they’re picking from a pool of recruits whose only options are to either join the Navy SEALS or enter data from tax forms into a computer.
Filed under: Budget — Christian Schneider @ 10:35 am
There are plenty of arguments to make in urging increased funding for the University of Wisconsin System. You can say the system is the economic engine of the state, or that it is vital to an educated workforce, etc. Yet last Thursday during budget conference committee deliberations, Senator Judy Robson made an unbelievable argument for funding the UW that truly is beneath the dignity of any thinking person. Her argument to send more money to the UW System shows the depths to which she will go to get her hands on taxpayer money.
Robson argued that the UW System couldn’t provide campus safety under the Assembly Republican version of the budget, and tied that issue to the April shootings at Virginia Tech. Clearly, she was making the case that by only increasing the UW Budget $63 million, a Virginia Tech situation was much more likely, and the campus police would have trouble dealing with the situation.
Here’s her exact quote: (at the 28:04 point of the video clip)
After Virginia Tech, we all were astonished, grieving, upset, and wondered if the campuses at the University of Wisconsin, all the college campuses, whether private or public, would be safe.
We had the UW System President Kevin Reilly, who after the shootings at Virginia Tech, covened a school safety task force, and they came up with their recommendations, and he said today that there is no way they can implement the recommendations to make the campuses safe because of the significant cuts to the University of Wisconsin:
You can bet that if something happens on those campuses and there is a student that is harmed, after these recommendations are going to come out, who is going to get blamed? It’s not going to be the Republican – they should be – you know, because you’re going to cut the university, but they’re going to blame Kevin Reilly.
Let me be up front – as a Virginia Tech alum, I am probably oversensitive to people using the tragedy to further their own causes. But to say that somehow a violent act like we saw at Tech could be averted if taxpayers just gave the UW more money is insulting.
The fact that the UW reviewed their security policies in the wake of the Virginia Tech shootings is actually commendable. Certainly, if there could be something they could do differently to make campuses safer, it would be worth investigating. But a review of their final report (a report ignored by noted campus safety expert Judy Robson until it became politically advantageous) shows that most of their recommendations are policy changes, not fiscal ones. Furthermore, it is unclear how any of these changes could stop a random shooter that has their mind set on mass murder. One of the areas they emphasize is hiring more mental health counselors, but it is unclear as to whether this would actually stop someone with no known mental health problems.
UW leadership, to their credit, has not tied any of these changes to the proposed budget. There is some merit to their contention that much of the new money granted by the Assembly will be tied up in operational cost-to-continue funding. However, after several expensive high-profile budget missteps, there seems to be a feeling in the Legislature that they could get by with more focused budgeting priorities (Democrats often forget that it was Governor Doyle who cut $250 million from the UW System just two budgets ago).
In politics, people say stupid things all the time. Often times, they are excused as just being “hyperbole” or “in the heat of the moment.” In the technological age in which we live, it is sometimes unfair to hold people to things they say, as their words will now live on forever. Yet this Virginia Tech fearmongering by the Democrats is particularly galling. It was a calculated, planned talking point meant to appeal to the lowest common denominator, and managed to even go lower than its target.
UPDATE: Nick Schweitzer wonders what the UW could possibly spend more money on that would lower the risk of violence on campus. As I commented on his post, the state could double the budget of the UW System and it wouldn’t stop any homicidal maniac with his mind set on taking out some students. And the rarity of such events makes invoking them in a plea for more funding, as if such an event is imminent, is even more galling.
Filed under: Health Care — Christian Schneider @ 9:47 am
David Leonhardt has written a fantastic article in the New York Times that addresses the contention that government-run universal health care somehow “saves” money. Although Leonhart is open to the idea of cost savings in some circumstances, he says:
The theory goes like this: By practicing preventive medicine, doctors can keep many people from getting sick in the first place. Those who do end up with a chronic illness will be closely tracked so that fewer of them develop complications. These steps will result in less illness, which in turn will require less health care. With the savings, the country can then lower its medical bills or provide health insurance for the 40-odd million people who lack it – or maybe even both.
[...]
No one really knows whether preventive medicine will save money in the long run, let alone free up the billions of dollars a year needed to help pay for universal health insurance. In fact, studies have shown that preventive care – be it cancer screening, smoking cessation or plain old checkups – usually ends up costing money. It makes people healthier, but it’s not free.
“It’s a nice thing to think, and it seems like it should be true, but I don’t know of any evidence that preventive care actually saves money,” said Jonathan Gruber, an M.I.T. economist who helped design the universal-coverage plan in Massachusetts.
This is a tough idea to swallow because better health really does seem as if it should lead to lower medical bills. Indeed, if it were somehow possible to wave a wand and turn people into thin nonsmokers who remembered to take their statins, this country’s health care expenses would fall.
[...]
Jay Bhattacharya, a doctor and economist at Stanford’s School of Medicine, estimates that to prevent one new case of diabetes, an antiobesity program must treat five people -not cheaply, he says. Along the same lines, Mr. Gruber found that when retirees in California began visiting their doctor less often and filling fewer prescriptions, overall medical spending fell. People did get sick more often, but treating their illnesses was still less costly than widespread basic care – in the form of doctors visits and drugs. Louise Russell, an economist at Rutgers, points out that programs that focus on at-risk patients cost the least, but even they are rarely free.
The idea that savings can be realized with a government takeover of health care is a central component of the “Healthy Wisconsin” plan currently before the Legislature. The notion that somehow all these cost savings are going to materialize once government takes over health care is far-fetched, as they rely on people fundamentally changing their behavior to reduce hospital visits in the future. In fact, providing government health care for everyone may have the exact opposite effect, since individuals may begin to over-utilize the system for minor health problems.
Filed under: Health Care — Christian Schneider @ 3:44 pm
In the United Kingdom, the National Health Service has dropped Alzheimer’s medication from the list of drugs covered by their universal health care system, citing the high cost of providing the drugs. In a recent court ruling, the High Court found the move to be legal, citing the diminished benefits of Alzheimer’s drugs in later stages of the disease.
In essence, it was up to the courts to make a determination of how effective the drugs were – and not health professionals. Some very interesting points are made in the comments section of this Scottish news account of the court ruling. Among them:
My wife’s mother here in Madrid has been using Aricept for about 3 years now to treat Alzheimer’s, and we have certainly seen a massive improvement since she started using it. It is free for all pensioners over 65 in Spain, although those under 65 have to pay 40% of the cost.
I find it perplexing that the UK constantly appears to lag behind countries such as Spain in so many health related issues like this.
This may sound familiar:
This is the same NHS that wastes huge amount of money to offer free treatment to immigrant and asylum seekers as well as paying for translation costs and bankrolling a lot of useless manager.
While supporters of Wisconsin’s proposed government-run health care system continue to speculate as to how the program will work, they forget that similar programs already exist. And they have the same problems we will inevitably see in Wisconsin. “Healthy Wisconsin” is a mystery to which we already know the answer – it’s just a matter of who is willing to listen.
Filed under: Health Care — Christian Schneider @ 2:02 pm
Watching the legislative budget conference committee debate the proposed government-run health care plan for three hours had me thinking about a lot of things. Most notably, I wondered how much liquid drano I would actually have to ingest to make sure I didn’t have to watch any more.
However, there’s one point the committee Democrats keep reciting that deserves a little more scrutiny than it has gotten. Senate Democrats keep pointing to the fact that their plan “saves money,” since the amount of revenue their newly imposed tax brings in falls a couple billion short of what health care currently costs. According to the Lewin Group powerpoint presentation prepared for AARP Wisconsin, current health care spending for the Healthy Wisconsin (HW) Plan population is $18.5 billion. The HW plan is expected to bring in $15.2 billion in tax revenue to pay for universal health care. Thus, $3.3 billion in health care spending will be eliminated from the market.
Let’s back up for a moment. That $18.5 billion is what health care currently costs, as determined by the market. Health care costs what it costs. It factors in what doctors charge, what equipment they need, what insurance companies charge for premiums, and so on. In setting all these costs, it is the people actually in the health care arena determining what to charge – due to competition within the system, many of these costs are controlled as much as possible, as a company has to meet some price level to attract and retain customers.
Senate Democrats, however, believe they can actually do a better job of setting these prices than can the people actually performing the heart surgeries and building the CAT scan monitors. In fact, they think they can pull $3.3 billion out of the health care system without any adverse effects on consumers, while at the same time greatly expanding the number of health care users in the system.
This brings up an interesting contradiction within the Democratic ranks in the State Legislature. Think about the University of Wisconsin System and the nearly $1 billion the state provides to the system annually. Now imagine the state cutting $300 million from the UW System and freezing tuition, while doubling the number of students the state’s campuses had to accept. Is there any Democrat in the Legislature that wouldn’t say the quality of education those students receive would be drastically harmed by such a scenario?
Yet this is similar to what the Healthy Wisconsin plan proposes doing. Democrats are proposing pulling $3.3 billion in “savings” out of the health care system, while drastically increasing the scope of individuals and procedures covered. And this isn’t supposed to affect our quality of health care?
Plan supporters argue that numerous insurance companies operating within a market creates inefficiencies within the market. They believe having the state being the sole insurance provider can save bureaucratic costs and negotiate better drug prices through bulk purchasing. They argue that more of an emphasis on preventative care will lower health spending in the long run, since people will be healthier.
It’s adorable that Democrats have suddenly embraced the idea of streamlining bureaucracy. They seem to be all for streamlining the bureaucracies of private companies, yet defend state government administration as apparently too valuable to face even modest cuts.
Furthermore, is there anyone in the state that believes once government takes over paying for health care that costs will actually be reduced? The Wisconsin Taxpayers Alliance has demonstrated that the more rapid increases in health care costs versus personal income could push the tax rate for the program to 20% in 10 years. Either the tax will continue to rise, or benefits will have to be cut. Given the lack of political will that spawned this plan, you can guess which is more likely to happen – workers will be picking up more of the tab, so legislators can avoid kicking people off of certain procedures covered by the plan.
Finally, who is more likely to know what procedures cost and are actually necessary – doctors and insurance companies or the newly created Healthy Wisconsin Board of Trustees? This Board, incidentally, is made up almost entirely of labor, farm, and business interests, with no representation from insurance or doctors’ groups. There are a couple slots for health care administrators, but they are non-voting members. When the Board implements “cost containment strategies” (i.e., rationing and price controls) it will do so without the input of a single appointed doctor or insurance representative. Apparently representatives of the AFL-CIO will know what types of procedures are more medically necessary than actual doctors. In fact, if they added Doctor McDreamy to the Board, it would have more medical credentials than it has now.
There’s no doubt that insurance companies can institute more effective cost-saving measures. In fact, many of them haven’t had to slim down administration due to the healthy profits they have been collecting. Sadly, when many insurance companies look to trim costs, it generally means dropping coverage for their sickest patients.
But to think that somehow government is going to tell insurance companies how to cut bureaucracy is laughable. I’d rather my dog got obedience training from Michael Vick. The only thing that will get insurance companies to cut costs is more competition. This is where tax-free health savings accounts can be effective. As more people get comfortable with the notion that they can pay for quality health care without insurance, it will force insurance companies to become more consumer-friendly. Think of it as getting a birthday card from Saddam Hussein.
The instances where government takes over a program and costs explode are too numerous to mention. The idea that the Healthy Wisconsin plan is going to somehow save everyone money without affecting the quality of care is simply a chimera. Ultimately, the Healthy Wisconsin plan, as all government plans are, is going to be judged by how quickly it grows, not by how effectively it can hold down costs.
Filed under: Health Care — Christian Schneider @ 9:26 am
Yesterday, State Senator Jon Erpenbach held a press conference on his “Healthy Wisconsin” universal health care plan to say – well, to say pretty much the same thing he’s been saying all along. His main talking point is that people should have health care as good as their state legislators. He calls legislators who oppose the plan “hypocrites” for accepting almost-free health care themselves, while “denying” it to their constituents.
Without a doubt, it is an effective talking point, given the low approval ratings of state elected officials. Erpenbach could have picked any number of state employees who take part in the state insurance plan as an example (UW Professors, DNR wardens, that guy sitting in a cubicle at the Department of Revenue), but he chose elected officials because they give him the most political bang for his buck.The calculus is pretty easy to work out: “Boo, elected officials! – Yay, me!”
This line of thinking is intended to build public support for the proposal based on sheer envy. How is it rational to completely overhaul the state’s health care system because we’re jealous of something a few people have? Regardless of whether you think state legislators should have health care, is it really worth bankrupting the state to pull 5 million people in the state closer to those 132 legislators?
As long as we’re making public policy based on things a handful of legislators have, let’s go all the way. Can’t we guarantee that everyone in the state makes $45,000 a year, like they do? Can we make sure all Wisconsin residents get 32 cents per mile travel reimbursement to drive to work? I propose everyone in the state get a free parking spot on the Capitol square.
Unfortunately, if the Senate Democrats’ government-run health care plan passed, everyone would have similar health care. Unfortunately, both you and your state legislator would have similarly crappy health care. As has been discussed at length in other venues, universal health care means waiting lists, rationed care, and migration of sick people to Wisconsin to take advantage of the plan. So congratulations on having the same health care as your state representative – now go home and wait for three months for a doctor to see you about that cough.
Another aspect of Erpenbach’s rhetoric is interesting, as well. He claims that legislators who oppose his plan are “hypocrites.” Regardless of what you think of the plan or of legislators, I don’t at all see what’s “hypocritical” about wanting to keep the same system that provides the best health care in the nation to you and your constituents. That seems entirely consistent. In fact, the state teachers’ union (WEAC) spends a great deal of time lobbying to keep their system of health insurance intact, since it is run by the union itself. Are they hypocrites, too?
In fact, Erpenbach’s plan carves teachers out of the universal pool altogether – meaning, he thinks government-run health care should be mandatory for all Wisconsin residents – except for teachers, who happen to be his biggest supporters. Certainly no hypocrisy there.
So which is more hypocritical – a legislator defending the free market health insurance system, or a legislator using the lucrative health insurance benefit for 9 years, then deciding it’s evil when it’s politically expedient? Somehow, I don’t recall legislators complaining about their health benefits before this universal plan became an issue – and I wouldn’t hold my breath waiting for Jon Erpenbach to reimburse the state for covering him and his family since 1998.
So far, I’ve probably heard 20 different people use the “you deserve health care as good as your state legislators” line. It’s cheap and easy, and plays on people’s dislike of elected officials. But jealousy is probably the worst way to formulate public policy – any time you need to fall back on one of the seven deadly sins to push your plan, you may want to reconsider your public relations strategy.