I was impressed with the New York Times editorial The High Cost of Health Care. I don’t really have time to review it here right now (it’s quite long) but it is well worth the read and I would like to come back to it later to review it. They talk about some of the approaches to lowering our health care costs, but they don’t attempt to endorse any particular approach. I hope, and believe, that this was an attempt to paint a broad picture in advance of future articles which will explore the issue in more depth.
Tag: issues
There are a variety of ideas for how we can fix our primary election process. They range from a lottery system proposed in comments and a post earlier on my site to more authoritative proposals such as rotating regional primaries as outlined by Trey Grason (go to page 25 of the PDF – hat tip the Senate Site)
Unfortunately, it is too late to fix the process for 2008, but steps can be taken for 2012. The National Association of Secretaries of State (NASS) is hoping to generate support for rotating regional primaries as a step toward that goal. The association’s bipartisan proposal, created by the nation’s chief state election officials, divides the country into four regions and establishes primary windows in March, April, May and June.
I was also interested in the proposal published in the New York Times by Jonathan Soros suggesting a national primary day where individual voters could opt to vote early.
There is, however, a simple way to establish a national primary and yet still allow retail politicking to meaningfully affect the course of the campaign over several months: allow early voting, with regular reporting of the tally.
Here’s one way it could work. Set a national primary date of June 30 and create a window for early voting that opens on Jan. 1. The early votes would be counted and reported at the end of each month from January through May. . .
If we began counting and reporting the interim results in advance of a national primary, the voters who cast early ballots would play the same role as voters in Iowa and New Hampshire do now: they could signal viability or create momentum for their favored candidates. These early voters would be self-selecting, trading the opportunity to watch the campaign unfold for the ability to demonstrate early conviction.Most important, every voter, no matter where he or she lived, would have the freedom to make this choice. Right now, when one votes is determined by where one lives.
The national primary day has drawbacks, but I’m sure there are detractors to the rotating regional primaries as well and I know there are those who gripe about the lottery idea. I’m not ready to advocate for one idea over another, and I’m sure that all of them would offer an overall improvement over the current mess. What I would really like to see is an widespread, active, and public conversation now – not sometime after 2009 – to decide how we would like this system to operate because the current setup is going to lead to perpetual campaigning (like having candidates declaring six months into the four year cycle) unless we take steps to rein it in.
First I would like to thank Steve Urquhart for his comments. And in case anyone got the wrong impression, I had no intention to spar with Steve over this issue or single him out. I respect Rep. Urquhart for his openness on this and many other issues. He has convincingly demonstrated his honest belief that “sunlight [is] the best disinfectant.” The major reason that I singled him out is that I know that he is one member of the legislature that understands the value of blogging discussions.
All that being said, this post is mainly some of my further findings after his comments to my previous post. He said that term limits came in a wave in 1994, but it would be more accurate to say that 1994 was the tail end of the wave. 15 states enacted term limits before 1994, 3 more (including Utah) did so in 1994, and 3 have enacted term limits since 1994. Of the 6 states that have repealed their term limit laws (that’s 28% of states that had such laws), it appears that none of those laws ever lasted long enough to limit the term of any legislator. No state where term limits actually started limiting terms has gone back. My assessment would be that Utah retreated from that legislation prematurely.
The second part of Steve’s response was quite enlightening:
Of course, I realize that people can, and will, argue that we just want to hold the offices for life. That’s their right, and for some legislators it might be true. But people should consider the average lifespan of a legislator. In the House (largely through self-selection), it is right around 4 years. (I heard that number and have never independently verified it; but, it seems accurate. I’ve been there 7 years, and there aren’t many Reps who’ve been there longer than I have).
Since he had not verified the 4 year average I went to the website for the Utah Legislature (a very good site, by the way) and did some quick checking on the 75 members of the house and all 29 senators. In the Senate the mean term length is 7 years with an average of 6.93 so by the time we next have elections the average term will be sitting at 8 years (the longest current term being 18). 14 of the 29 have served between 3 and 7 years, most of the other 15 have served more than 7 years.
In the House, where Steve serves, the mean length of current consecutive service is 5 years with an average of about 5.2 so the average will be 6 years before we next vote. The are a number of representatives who have served 3 years or less consecutively who have previously served in the House, sometimes for more than a decade. If we factor in lifetime service for these representatives the average goes up to nearly 5.5 years. About 70% of the members of the house have served no longer than Steve, although there are many who have served 7 years like he has.
It is comforting to see that we have a pretty good rate of turnover in our state and I hope that it stays that way. So long as we have consistent turnover I think we need to focus more on correcting the imbalance of power between the major parties – as Obi wan had suggested – at least here in Utah.
I asked what people were interested in and the interest seemed to be term limits. I decided to do some initial research and found a good resource on term limits. The states that currently have term limits are:
- ARIZONA
- ARKANSAS
- CALIFORNIA
- COLORADO
- FLORIDA
- LOUISIANA
- MAINE
- MICHIGAN
- MISSOURI
- MONTANA
- NEBRASKA
- NEVADA
- OHIO
- OKLAHOMA
- SOUTH DAKOTA
In addition I was surprised to find that Utah was on a short list of states where term limits had been enacted and later repealed.
- IDAHO
- MASSACHUSETTS
- OREGON
- UTAH
- WASHINGTON
- WYOMING
A little more digging and I learned that Utah enacted term limits by statute in 1994 (just before I was paying close attention to politics) and repealed them in 2003 before they ever affected any legislators (the limit was 12 years and the statute only lasted for 9). So now we know that our Utah legislature is not anxious to limit themselves.
Now I would love to hear from anyone who has experience in the states with term limits. Jason has voiced his unqualified support of the limits in his state. Does anyone else want to share? Are there any opinions on lifetime bans versus limits of consecutive years of service? I am not ready to choose sides on that yet.
I would also be interested to know more about the decision to end limits before they began in Utah. Perhaps Steve Urqhart might have some insights there that he would share (hint – information from 2003, or hints on where to get some would be nice because my short search led to a bunch of dead links).
There has been lots of talk since November 6th about moving on to improve education after the defeat of vouchers. People on both sides of that debate have talked about working together towards a common goal. I have been happy with the tone of talk, but I have wondered what is the next concrete step that we can approach to demonstrate our genuine interest in improving education. After reading The People Have Spoken, and Fans and Foes Vow to Work for Change I have had an idea of where to take a next step.
I’ve never heard a credible argument against merit-pay or performance-based pay for teachers. Does this mean that I have not heard enough discussion on the subject or is it evidence that this might be an area where people who want to improve education can agree? I think that an effort to bring performance-based pay for our teachers would make a great demonstration of our commitment to making changes to improve our education system.
While casting about for something to write today I began thinking about what issues are important to me. There are many political subjects I am interested in, but not always new material to write about. Sometimes there is discussion worth following that I don’t feel I have anything to add (like the current warm-fuzzies coming from the “let’s move on from referendum 1” discussion). Other times the news is truly dead or full of things I have no interest in. At those times I have subjects that I am interested in, but I am looking to discuss the issues and not just pontificate in a vacuum. The question is, what should I discuss that other people are interested in?
The answer seemed obvious – ask.
If I were talking about what modifications to our primary election system who would be interested? What if I were talking about the value of term limits for elected officials?
Based on past experience there seems to be some interest in those subjects, but I would like to hear whether others think those are worth discussing and would be interested in participating in such a discussion. Please let me know which of these would interest you – “both” and “neither”
are perfectly valid answers.
I’ve already admitted that Health Savings Accounts are not the full solution to our health care system, but they are among the most powerful tools that we have today. The example of Whole Foods grocery really illustrates the point.
Five years ago, the Whole Foods grocery chain switched to a high-deductible plan. If an employee has a sore throat or a sprained ankle, he pays. But if he gets cancer or heart disease, his insurance covers it.
Whole Foods puts around $1,500 a year into an account for each employee. It’s not charity but part of the employee’s compensation. It’s money Whole Foods would have otherwise spent on more-expensive insurance. Here’s the good part for employees: If they don’t spend the money on medical care this year, they keep it, and the company adds more next year.
It’s called a health savings account, or HSA.
CEO John Mackey told me that when he went to the new system, “Our costs went way down.”
Yet today, some workers have $8,000 in their accounts.
The same articles states that:
If people paid their own bills, they would likely buy high-deductible insurance (roughly $1,000 for individuals, $2,100 for families) because on average, the premium is $1,300 cheaper. But people are so conditioned to expect others to pay their medical bills that they hate high deductibles: They feel ripped off if they must pay a thousand dollars before the insurance company starts paying.
From my own experience when people really understand the program they like it. Here are the numbers that our company found as we have been shopping for insurance lately. We chose one high deductible plan and one standard plan that each employee could choose from. The high deductible plan was $2500 a year cheaper in premiums. We calculated that the worst case scenario for the high deductible plans – paying every penny of the deductible without receiving a cent from the insurance company – would cost $884 more than the same medical care under the standard plan (this assumes that much of the deductible is used in preventive care where the standard insurance charges a copay for each visit, if it were some accident that cost the whole deductible for the HD plan the difference is no more than $700). On the other side – the person on the HD plan has to spend a minimum of $3900 (okay it came out to $3899.99) before they have spent as much – including premiums – as the person on the standard plan.
When we started discussing the plans as employees there were 2 of us who were already planning on getting HD plans. By the time we made the decision on what plans to offer 70% of the company had decided to switch to HD plans.
Michael Cannon, a self-described conservative turned libertarian at the Cato Institute has some very good ideas on what health care reform should look like. (Hat tip Scott) Some of his suggestions seem like they would appeal to most reasonable people (“think freedom, not universal coverage” and “health-savings accounts are not enough”) while others look like they are ripe targets for those who have been working to “reform” our health care system for 15 years already (most notably “don’t ‘improve’ welfare programs — cut them”). It is important to dig deeper into such suggestions before dismissing such libertarian ideas as heartless. In this case, digging deeper means nothing more than reading the rest of the paragraph:
At the behest of conservatives, Jeb Bush and other governors have made Medicaid more consumer-friendly. The only problem is that Medicaid and SCHIP are welfare programs, and making welfare more attractive leads to…more welfare.
After all what is more heartless, finding ways to help people become more self-sufficient, or teaching them to be dependent on the contributions of people they don’t even know? (The second one sounds like a very precarious position to be in.)
Mr. Cannon also throws in gems like “The lefties aren’t always wrong.” Only a libertarian would say that to a conservative – and the conservatives need to hear it. My personal favorite thought (because it’s to easy to forget sometimes) is this – “private markets are not necessarily free markets.” That’s the thing that has worried me about so many of the plans proposed by many leading conservatives. They pat themselves on the back for turning to private markets but they do nothing to ensure that the market is actually free. That difference is why “the health-care industry does not want free markets.” They are all for private markets where they can make their private fortunes, but those who are thriving in a market that is not free have little incentive to make the market free.
Some people will argue that the rising cost of health care is driven by the rising costs of running health care related businesses, but rising costs are easy to accept when you know that nothing short of releasing a drug that leads to fatal consequences is going to put you out of business. Health care is probably more stable than real-estate – and almost as stable as alcohol, tobacco, and pornography.
I’ve strayed from my original point – go read the article by Michael Cannon.
We took the kids to Timpanogos Cave a couple of weeks ago. One of the people on our tour with us was a soldier who we learned was recently back from a tour in Iraq. At the end of our cave tour Laura took a moment to point him out to our girls and told them “He’s a soldier, he has been fighting for our country.”
He overheard her saying this and commented “Right, fighting for oil.”
This obviously stuck with Laura more than me because she brought it up again recently with this insightful observation, “What is he willing to do about it?”
This is not an indictment against this soldier, or any who feel as he does. This is a legitimate question for all of us, especially those who complain about our war for oil. Al Gore won a Nobel Prize for his crusade about the environment. He has obviously determined that he is willing to give speeches, make movies, and organize concerts to raise public awareness. So far he has not been willing to reduce his own consumption. (Purchasing carbon offsets is nice, but it does not actually reduce consumption – it’s like buying indulgences.)
It’s fun and easy to participate in publicity stunts like Live Earth or Lights Off Utah but beyond their potential for raising awareness, these events are insignificant unless we change our lifestyles to match our rhetoric. We may want to see the state go dark, or attend a popular concert, but are we willing to drive less, use public transit, bike more, walk more, turn off unused lights at home, and use CF light bulbs or other energy efficient alternatives where we do consume natural resources.
I’m not saying that everyone has to do all those things. We have done many of them in our lives, but the real point is that there is no reason to believe someone is serious about the environment so long as they continue to consume as if they are not part of the solution.
I have been a vocal supporter of vouchers previously, but I have been less than pleased with some of the tactics of those behind vouchers. My support was wavering because of my displeasure but then as I stared at the conclusion of the Legislative Fiscal Analyst’s Report that vouchers would be draining more than 40 million dollars per year once all students have become eligible for them I realized the magnitude of the flaws in our current voucher laws. In my opinion, that’s too much of a drain for an experiment. I also firmly believe that it’s much harder to change a law once it is implemented than it is to just let 40 million dollars get siphoned off from our state budget each year.
Between that financial drain and the gutter-politics associated with voucher support I can not support Referendum 1 in good conscience. I still support the idea of vouchers, and would be supportive of future efforts to implement a better implementation later. Good suggestions include using tax credits or requiring that students attend a minimum amount of time in public school before accepting vouchers. I certainly don’t have all the answers, but I have one answer – I have to vote “no” on Referendum 1 in November.