Tuesday, November 30, 2010

Al Gore's Ethanol Epiphany - WSJ.com



Anyone who opposes ethanol subsidies, as these columns have for decades, comes to appreciate the wisdom of St. Jude. But now that a modern-day patron saint—St. Al of Green—has come out against the fuel made from corn and your tax dollars, maybe this isn't such a lost cause.

Welcome to the college of converts, Mr. Vice President. "It is not a good policy to have these massive subsidies for first-generation ethanol," Al Gore told a gathering of clean energy financiers in Greece this week. The benefits of ethanol are "trivial," he added, but "It's hard once such a program is put in place to deal with the lobbies that keep it going."

At least on corn subsidies, we now have the makings of a left-right anti-boondoggle coalition. Major corn energy subsidies such as the 54-cent-per-gallon blenders credit expire at the end of the year, and Republican Senators Jim DeMint and Tom Coburn are encouraging the new Congress to prove its fiscal bona fides by letting them die.






Friday, November 19, 2010

This Lame Duck Session Should Be the Last - WSJ.com

Betsy McCaughey: This Lame Duck Session Should Be the Last - WSJ.com

Americans ought to make this lame duck session of Congress the last in history. Members who lose re-election have no moral authority to continue governing: They were fired by the voters, who should demand that they clean out their desks and go home.


On Nov. 2, the voters replaced the Democratic majority in the House of Representatives with at least 61 new Republican members who campaigned on lower spending and less government power. Allowing members who were not re-elected to legislate national policy or set the 2011 federal budget is like allowing a fired employee to run the office another two months, or letting your ex-spouse continue managing your checkbook.


Lame duck sessions were unavoidable before jet planes. The framers of the U.S. Constitution provided 17 weeks for newly elected members to travel to the capital and take their seats on March 3. That was the 18th century.


In 1933, Americans ratified the 20th Amendment to eliminate lame duck sessions. It set Jan. 3 as the day newly elected members would take their seats. That still left seven weeks after the election, but no one imagined that the old Congress would return to the capital during that time.


For a half-century, the 20th amendment worked. Except during World War II and the Korean War, Congress did not reconvene after November elections. But for the last two decades, lawmakers have hurried back to the capital after Election Day to deal with spending bills and controversial legislation they deliberately had avoided before the election.


The unrepresentative lame duck Congress should do as little as possible.

Wednesday, November 10, 2010

How Medicare Killed the Family Doctor - WSJ.com

Richard Hannon: How Medicare Killed the Family Doctor - WSJ.com

Remember Marcus Welby, M.D.? He defined the family doctor on TV in the 1970s, exemplifying the four Cs: caring, competent, confidant and counselor. In the mid-'60s, I remember my father-in-law, a real-life Dr. Welby, telling me the exciting news that the federal government was going to start paying him to see seniors—patients who before he had seen for the proverbial chicken (or nothing at all). That fabulous deal was Medicare.

Medicare introduced a whole new dynamic in the delivery of health care. Gone were the days when physicians were paid based on the value of their services. With payment coming directly from Medicare and the federal government, patients who used to pay the bill themselves no longer cared about the cost of services.

Eventually, that disconnect (and subsequent program expansions) resulted in significant strain on the federal budget. In 1966, the House Ways and Means Committee estimated that by 1990 the Medicare budget would quadruple to $12 billion from $3 billion. In fact, by 1990 it was $107 billion.

To fix the cost problem, Medicare in 1992 began using the "resource based relative value system" (RBRVS), a way of evaluating doctors based on factors such as education, effort and specialized training. But the system didn't consider factors such as outcomes, quality of service, severity or demand.

Today most insurance companies use the Medicare RBRVS because it is perceived as objective. As a result of RBRVS, specialists—especially those who perform a lot of procedures—do extremely well. Primary-care doctors do not.

The primary-care doctor has become a piece-rate worker focused on the volume of patients seen every day. As Medicare and insurers focused on trimming the costs of the most common procedures, the income and job satisfaction of primary-care doctors eroded. So these doctors left, sold or changed their practices.

So who really killed primary care? The idea that a centrally planned system with the right formulas and lots of data could replace the art of practicing medicine; that the human dynamics of market demand and the patient-physician relationship could be ignored. Politicians and mathematicians in ivory towers have placed primary care last in line for respect, resources and prestige—and we all paid an enormous price.

Monday, November 1, 2010

A Vote Against Dems, Not for the GOP - WSJ.com

Even though I’d personally love it if the majority of Americans were on board with a true limited government philosophy, I recognize that many of tomorrow’s GOP voters are not, but are instead reacting to over-reach by the liberals who misread their 2008 electoral success.  I worry the GOP may make a similar mistake and over-reach on conservative policy issues not related to spending reductions, which could hurt the GOP in 2 years.




Democrats face massive losses in tomorrow's midterm election. Based upon our generic ballot polling and an analysis of individual races, we project that Nancy Pelosi's party will likely lose 55 or more seats in the House, putting the GOP firmly in the majority. Republicans will also win at least 25 of the 37 Senate elections. While the most likely outcome is that Republicans end up with 48 or 49 Senate seats…


But none of this means that Republicans are winning. The reality is that voters in 2010 are doing the same thing they did in 2006 and 2008: They are voting against the party in power.


More precisely, it is a rejection of a bipartisan political elite that's lost touch with the people they are supposed to serve. Based on our polling, 51% now see Democrats as the party of big government and nearly as many see Republicans as the party of big business. That leaves no party left to represent the American people.


Voters today want hope and change every bit as much as in 2008. But most have come to recognize that if we have to rely on politicians for the change, there is no hope. At the same time, Americans instinctively understand that if we can unleash the collective wisdom and entrepreneurial spirit of the American people, there are no limits to what we can accomplish.


In this environment, it would be wise for all Republicans to remember that their team didn't win, the other team lost. Heading into 2012, voters will remain ready to vote against the party in power unless they are given a reason not to do so.


Elected politicians also should leave their ideological baggage behind because voters don't want to be governed from the left, the right, or even the center. They want someone in Washington who understands that the American people want to govern themselves.