NCPA - National Center for Policy Analysis
NCPA - National Center for Policy Analysis
Barry is a Senior Economist with the National Center for Policy Analysis, one of the most influential think tanks in America today.

The National Center for Policy Analysis (NCPA) is a nonprofit, nonpartisan public policy research organization, established in 1983. The NCPA's goal is to develop and promote private alternatives to government regulation and control, solving problems by relying on the strength of the competitive, entrepreneurial private sector. Topics include reforms in health care, taxes, Social Security, welfare, criminal justice, education and environmental regulation.

NCPA Motto - Making Ideas Change the World - reflects the belief that ideas have enormous power to change the course of human events. The NCPA seeks to unleash the power of ideas for positive change by identifying, encouraging, and aggressively marketing the best scholarly research.

Daily Policy Digest

Provided courtesy of: NCPA

Daily Policy Digest

American Patients Have Much, Much Better Access to Cancer Drugs Than Others Do
22 Feb 2017 07:00:58 CDT -

Senior Fellow John R. Graham writes at NCPA's Health blog:

New research by scholars at the University of Pittsburgh shows how much better access American patients have to new cancer medicines than their peers in other developed countries:

Of 45 anticancer drug indications approved in the United States between January 1, 2009, and December 31, 2013, 64% (29) were approved by the European Medicines Agency; 76% (34) were approved in Canada; and 71% (32) were approved in Australia between January 1, 2009, and June 30, 2014. The U.S. Medicare program covered all 45 drug indications; the United Kingdom covered 72% (21) of those approved in Europe -- only 47% (21) of the drug indications covered by Medicare. Canada and France covered 33% (15) and 42% (19) of the drug indications covered by Medicare, respectively, and Australia was the most restrictive country, covering only 31% (14).

(Y. Zhang, et al., "Comparing the Approval and Coverage Decisions of New Oncology Drugs in the United States and Other Selected Countries," Journal of Managed Care and Specialty Pharmacy, 2017 Feb;23(2):247-254.)

I am no fan of the U.S. Food and Drug Administration, but it is a less restrictive bureaucracy than its counterparts in other developed countries. Allowing patients to use new medicines without the interference of a government bureaucracy should be pretty straightforward, as long as they are aware of the risks.

Coverage is more ambiguous. Both Medicare and other countries' single-payers systems are socialized. So, we should not always jump to the conclusion that every approved drug should be covered 100 percent. As long as patients are free to pay out-of-pocket, we might not want taxpayers to pay the entire cost of each drug. However, cancer is the textbook diagnosis of a catastrophically expensive diagnosis, when we expect insurance to kick in. If insurance does not cover a wide portfolio of therapeutic options, it is not good coverage.

When we look at approval and coverage combined, the results are appalling. Of 45 drugs covered by Medicare, the British National Health System was the best of the other countries measured, and it covered only 21 -- less than half. We are not talking about North Korea, here. Nevertheless, it is shocking how much citizens of otherwise free countries give up when they allow their governments to control their access to health care.


For more on Health Issues:

It's Time to Rethink How We Manage, Pay for Care for The Sickest 10%
21 Feb 2017 07:00:57 CDT -

Senior Fellow Devon Herrick writes for Managed Healthcare Executive:

Health insurance has served different purposes over the years. Congress established the U.S. Marine Hospital in 1798 as a way to care for U.S. seamen, who were required to contribute a portion of their wages in return for access to services. However, most health insurance policies developed over the next century were designed to protect against income loss due to accidents rather than covering medical services.

It wasn't until near the end of the 19th century that companies from selected industries began providing coverage for medical services.

In the early part of the 20th century, progressive social reformers began advocating for a compulsory health insurance system. Reformers wanted to redistribute sick peoples' medical costs and wage losses among the rest of society through social insurance. 

Until the 1950s, most health insurance plans were mini-med plans, by today's standards. Benefits were limited to specific circumstances, such as a specific number of days, hospital stays or episodes of care, etc.

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For more on Health Issues:

Repealing Obamacare Is Good For California Jobs
20 Feb 2017 07:00:56 CDT -

Senior Fellow John R. Graham writes at NCPA's Health blog.  (A version of this Health Alert was published by the Orange County Register.)

Obamacare was a cash cow for providers, which now argue it was a program for jobs and economic growth. They now say that repealing Obamacare will kill California jobs. That grabs any politician's attention, but it is not true.

According to a study by the UC Berkeley Labor Center, which is promoted by the California Hospital Association:

"The majority (135,000) of these lost jobs would be in the health care industry, including at hospitals, doctor offices, labs, outpatient and ambulatory care centers, nursing homes, dentist offices, other health care settings and insurers. But jobs would also be lost in other industries. Suppliers of the health care industry, such as food service, janitorial and accounting firms, would experience reduced demand, leading to job loss. The lost jobs also include those lost due to the 'induced effect' of health care workers spending less at restaurants, retail stores and other local businesses."

Such research relies on the so-called "multiplier effect," a politically seductive but misleading type of voodoo economics.

It goes like this: Obamacare throws money at hospitals, doctors' offices and other health services. Those recipients build new facilities and hire more workers, who spend their paychecks in their communities.

Okay, but if Congress just sent a fleet of helicopters to scatter banknotes from the sky, the same "multiplier effect" would take place: People would pick the money up and spend it. Businesses located near the drop zones would profit, hire and expand. However, jobs and the economy would not grow because the effect would be a mix of inflation and reduced spending in areas away from the drop zones.

Worse, because this type of spending is politically motivated, it is usually demanded by industries that resist productivity improvements. Last July, Dr. Bob Kocher, a venture capitalist who served as a special assistant to President Obama when Obamacare was crafted, lamented that just over half of health services workers are administrators, up from just over one third before Obamacare.

Indeed, the evidence suggests Obamacare has had the perverse effect of driving too many workers into health services, depriving other, more productive sectors of labor.

During Obamacare's "incubation" until December 2013 (before Covered California's insurance policies became effective and Medi-Cal expanded), health services jobs increased by 2.5 percent annually while non-health jobs increased by 2.0 percent annually. From the start of Obamacare coverage through last December, health services jobs grew by 3.4 percent annually, while non-health jobs grew by 2.6 percent annually.

The change in composition of employment in California during this period, just short of a decade, is astonishing.

At the end of July 2007, health and social services employed 1,692,000 people and added 517,000 jobs by the end of last year, never having suffered a recession. Just 587,000 nonfarm civilian jobs outside health and social services jobs were added during that same period. Health and social services jobs grew over 30 percent while other jobs grew by less than 5 percent over 113 months! Although comprising just 11 percent of jobs in California in July 2007, health and social services accounted for almost half the job growth since then.

This is the result of a politically driven reallocation of resources toward health services spending that is still characterized by waste and inefficiency. Obamacare has proven a poor deal for patients. It is also a poor deal for jobs and economic growth in California. It has to stop before more workers' valuable labor is consumed pushing paper in the government-health care complex.


For more on Health Issues:

Employers Beware, NLRB Shows Grit in Protecting Walkouts and Informal Strikes by Non-union Workers
17 Feb 2017 07:00:55 CDT -

Research Associate Coulter Young writes at NCPA's Tax and Retirement blog:

Employers are finding themselves on thin ice in their response to employees' walkouts, informal strikes and other activities that include demands for higher wages and improved working conditions. However, employees who participate in "general strikes" unrelated to work, such as the "general strike against Trump" planned for February 17, may not be protected by federal labor law.

The National Labor Relations Board (NLRB) has taken an expansive view of Section 7 of the National Labor Relations Act (NLRA), which protects workers who "engage in other concerted activities for the purpose of collective bargaining or other mutual aid or protection" and is applicable to union and non-union workers alike. Generally a "concerted activity" involves at least two employees acting together, but even a single employee acting on behalf of others  may be protected. Though the NLRB has long been thought of as an organization protecting union workers, it is applying Section 7 protections with increasing frequency to non-union workers.

A recent ruling by an NLRB administrative law judge involving Walmart employees who engaged in protests for higher wages and improved working conditions, known as the "Ride for Respect," invoked Section 7 protections. The strike in May and June of 2013 was centered around Walmart's annual shareholder's meeting in Bentonville, Arkansas. In response to the strikes, Walmart disciplined employees who participated by counting the missed days as absences, resulting in the dismissal of some employees.

An administrative law judge held that Walmart threatened, disciplined and fired 16 workers at stores in 13 states for engaging in legally protected strikes and protests. In addition, the NLRB found the corporation used two national television news broadcasts to threaten retaliation against workers who took part in strikes or protests, which violated Section 8 of the NLRA. The judge ordered Walmart to allow the 16 workers to return to their jobs, and the company has filed to appeal parts of the ruling. According to law experts, this decision has broad implications for employers confronting non-union protests.

This isn't the only case in which the NLRB has cracked down on Walmart. Six employees in a California store, most who were temporary associates, were disciplined for engaging in a work stoppage to protest mistreatment by their supervisor and to secure permanent jobs. The board often uses a 10-factor test to determine if the stoppage is peaceful or interferes with the employer's production. In this decision, the board determined the protest passed the 10-factor test, however, Walmart has filed an appeal with the D.C Circuit Court.

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For more on Economic Issues:

Social Security Disability Insurance Program is "High Risk," Says GAO
16 Feb 2017 07:00:54 CDT -

Senior Fellow Pam Villarreal writes at NCPA's Retirement and Taxes blog:

Every two years the Government Accountability Office (GAO) identifies and reports on government operations that are "high risk" -- meaning vulnerable to fraud, waste, abuse, mismanagement and inefficiency.  I know, I know…the entire government could be considered "high risk," but for the sake of keeping this blog post short, let's focus on one program identified in the GAO's most recent report:  the Social Security Disability Insurance (SSDI) program.  SSDI has been identified by the GAO as high risk since 2003.  According to their 2017 report, some recommended goals have been "partially met," but more needs to be done:

  • SSA needs to better manage their disability claims workloads.  As I mentioned in a recent NCPA report, some 900,000 claims are awaiting approval (this does not even include disability claims from the VA).
  • The GAO reports that SSA updated their criteria for disability benefits by partnering with the Bureau of Labor Statistics to collect and update occupational information.  This saved the SSA $27 million in 2015.  They are currently working on a study to be released in July 2017 on how current technologies that assist workers can affect disability determination decisions.  The GAO reports it will remove this goal once the SSA determines a course of action in finalizing medical criteria for disability.  This is long overdue.  With all of the technology available now for people with disabilities, there is no reason that the SSA should rely on outdated criteria from decades ago.
  • Also, the GAO noted that the SSA fell short of improving coordination across federal programs.  The reason?  The proposed council assigned to this task has not yet been funded.

Social Security Disability Insurance is a $147 billion a year program and is growing at a faster rate than Social Security retirement benefits.  We need to consider major reforms that change the incentives to work and reduce the inefficiency of the appeals process.

For more on Tax and Spending Issues:

The Failure of a Dam in California Is Warning About the Grid
15 Feb 2017 07:00:53 CDT -

NCPA Senior Fellow David Grantham writes for Townhall:

What in the world does the frightening news about the Oroville Dam in California have to do with America's electric grid? Answer: the Federal Energy Regulatory Commission (FERC).

The California state government is scrambling to address the failing dam after heavy rains have damaged the main concrete spillway and water is now pouring over the emergency spillway for the first time in history.  The erosion of the natural barrier -- the last line of defense between Californians and the emergency spillway -- has prompted the evacuation of some 185,000 residents. Some outlets are even reporting that the dam might very well break, a mini-doomsday scenario for those in the immediate vicinity of the deteriorating infrastructure.

This brewing catastrophe might have been avoided had FERC acted some years ago to upgrade the capabilities of the dam, according to early reports. A motion was filed with the federal government on Oct. 17, 2005, "urging federal officials to require that the dam's emergency spillway be armored with concrete, rather than remain as an earthen hillside," Mercury News writes. FERC officials, however, rejected the fix, arguing that the upgrades were "unnecessary" when compared to the costs; and they called "overblown" the scenario that enough water could accumulate to overwhelm the emergency spillway. FERC concluded the assessment with its age-old mantra that dam's safety measures met "engineering guidelines."

These are the same phrases FERC uses to explain why they have not required greater protection of the electric grid. When industry leaders and FERC officials are faced with questions about the fragility of America's grid system, the potential for damage to the grid from high impact threats and the possibility for prolonged blackouts, both groups routinely call the threats overblown, suggest that recommended upgrades are unnecessary and fall back on the mediocre conclusion that the grid "meets required guidelines."  

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For more on Government Issues:

Health Policy Digest

Provided courtesy of: NCPA

Consumer Driven Health Care

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Does Health Insurance and Seeing the Doctor Keep You Out of the Hospital?
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The Case for Competition in Medicare
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Potential Effect of Health Care Reform on Emergency Department Utilization Not Clear
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