Alaskan Researchers Say “Leave Us Out”

A new report from the Institute for Social and Economic Research, at the University of Alaska, says the Senate and House “health reform” bills would hurt Alaskans. JuneauEmpire.com has a short story on the report, which you can download in a PDF.

The reform legislation (either House or Senate edition) will drive up costs and make it harder for seniors to visit a physician. Already, fewer than one in five physicians in the state is open to seeing new Medicare patients, a figure that’s less than a third of the figure for the lower 48. (Curiously, Alaska is one of only two states–Wyoming is the other–in which Medicare pays less than Medicaid.)

Mark Foster and Rosyland Frazier also say that an employer mandate would cause difficulty for the state’s small-business owners. They conclude that it would be better for Alaska to have the option of designing programs and plans that fit its own situation.

U.S. Index of Health Ownership 2nd Edition Is Here

Pacific Research Institute has published the 2nd edition of the U.S. Index of Health Ownership, the only ranking of health care in the states that uses criteria of individual choice.

Americans lack the basic freedom to make their own health care decisions. The Index measures the degree to which individuals, be they patients, health professionals, entrepreneurs, or taxpayers, “own” the health care in their states.

The lack of health ownership is a real problem. Almost half of the country’s health care spending is in the hands of the government, instead of patients themselves. The other half is governed by regulations inflicted upon doctors, health plans and patients.

The Index uses 24 variables to quantify how state laws and regulations affect the liberty of citizens involved in state government health plans (primarily Medicaid), the private health-insurance market, and the provision of medical services. It also assesses the effect of medical tort on people’s freedom to engage health services.

Alabama, Montana, Nebraska, North Dakota, and New Hampshire finished in the top five, as the states that allow their citizens the highest degree of health ownership. Alabama leads the pack primarily because of a lightly regulated private insurance market, and good control of state government programs. Also, the state performs well on medical tort indicators. Alabama’s regulatory environment for providers favors competition, and government health programs run more effectively than in most states.

New York, Massachusetts, Rhode Island, Vermont, and North Carolina rounded out the bottom five, as the states in which the government has taken the most undue control of health care from its citizens. This is the second year that New York was in last place. The state suffers from government health-care programs that are out of control, a grossly overregulated private-insurance market, and almost completely uncompetitive provider markets.

A full listing of all 50 states and their rankings is contained in the Index.

The Index will give concerned citizens a good basis to demand reforms from their state politicians that will put American families in charge of American health care, instead of government and special interests.

No Quarter

This 4/20 ought to have been a real heartbreaker for opponents of cannabis prohibition who’ve bought into the ocean of hype surrounding Obama’s assurances of change.

Or perhaps there was just a communication breakdown, because despite promising a whole lotta love for states’ rights regarding medical marijuana during the campaign, real reform is over the hills and far away.

Obama’s DOJ said over the weekend that after considering a California federal judge’s request for an explanation from the feds regarding their alleged new policy on the persecution of state-approved medical marijuana dispensaries and users, government attorneys have determined it’s basically not much different than the old policy. Furthermore, the Bush administration’s “investigation, prosecution, and conviction of (California medical marijuana distributer Charles Lynch) are entirely consistent with the policies of DOJ and with public statements made by the Attorney General with respect to marijuana prosecutions,” according to the DOJ brief (pdf).

But even if the government’s actions don’t appear now to be exactly jiving with the political smoke blown by Obama and his attorney general, said Justice Department attorneys, it hardly matters. You see, the “enforcement policies of the Department of Justice, including those expressed by the United States Attorney’s Office, or by Attorney General Holder on this topic, do not confer any rights or defenses on any person.”

In other words, the song remains the same: Going to California, or any other state that’s legalized medical marijuana, provides no legal protection whatsoever against an individual’s rights getting trampled under foot by the federal government so long as the criminally incompetent drug war rambles on and the dogs of doom are howling “More.”

Judge on Feds’ New State-Friendly Medi-Pot Policy: Can I Get That in Writing?

A California federal judge has requested that U.S. Attorney General Eric Holder’s justice department explain, on paper and in black and white, just precisely what in blazes the administration has in mind regarding its much buzzed-about shift in medical marijuana policies.

Pot law reform advocates have been flying high on rumors that Obama’s kinder, gentler Drug Enforcement Administration – in a 180-degree reversal of Bush- and Clinton-era policies – is set to turn over a new leaf and start respecting the democratic wishes of state voters regarding cannabis laws.

However, the sentencing judge in a high-profile California medical marijuana case seems a tad skeptical – or maybe just a little confused. U.S. District Judge George H. Wu wants to know if Obama’s federal law enforcement braintrust has actually devised a legitimate, coherent new states’ rights-respecting prosecutorial policy.

Wu on Monday postponed sentencing the owner of a Morro Bay medical marijuana dispensary convicted of five federal counts, including distributing drugs.

(Wu) said he will hold off sentencing Charles Lynch, 47, until prosecutors provide a written clarification from the Justice Department on the Obama administration’s newly revised position that federal agents target marijuana distributors only if they violate state and federal law.

Judge Wu may suspect the administration is just blowing some capricious smoke into the air, hoping it’ll narcotize the medical marijuana activist constituency, most of whom no doubt Voted for Change, without actually doing or indeed changing anything of substance (or in writing) at all.

But if indeed there’s been a true and documentable shift in federal medical marijuana policy, then there are likely a whole lot of federal prosecutors around the country who aren’t even close to being on the same page as the newly minted higher-ups on the issue. For example, Thom Mrozek, a spokesman for the U.S. attorney in Los Angeles, was quoted just Monday after Wu issued his request saying that the Lynch case “involves a violation of federal law, and that’s really all that matters.”

Lynch’s attorney, Reuven Cohen, reminded reporters on Monday that throughout his client’s trial, the federal government did all it could to keep any discussion whatsoever of medical marijuana’s legality under California law entirely out of jury earshot.

“At least the statements that we have from Attorney General Holder thus far indicate that somehow state law is now relevant to these prosecutions,” said Cohen. “Well, the government, as everyone here who covered the trial knows, argued for days to keep state law out of it. And the reason they did that is that Charlie was in complete compliance with state law.”

Raid Numbers Don’t Lie; Does the President?

The Obama administration's declaration last week that it might someday start thinking about calling the federal drug-war dogs off state-approved medical marijuana dispensaries was certainly welcome news.

White House flack Nick Shapiro assured Americans the changer-in-chief "believes that federal resources should not be used to circumvent state laws, and as he continues to appoint senior leadership to fill out the ranks of the federal government, he expects them to review their policies with that in mind."

Again, good for him. Because as it stands now, just 23 days into the Obama years (I know, I know – it seems like so much longer), the Drug Enforcement Administration under the former Illinois Senator is on an early but unmistakable trajectory to surpass George W. Bush's two-term raid total, and do it in just two years.

DEA agents have committed at least five medical-marijuana facility burglaries since Inauguration Day. In the entirety of Bush's eight years in office (I know, I know – it seemed like so much longer), the DEA conducted 148 raids, said a spokesman from Americans for Safe Access.

By contrast, President Clinton's DEA looted voter-endorsed pot dispensaries on fewer than 20 occasions, according to the spokesman. (A bit misleading, that lower number by no means indicates some higher appreciation for individual rights or grassroots democracy on Clinton's part: States didn't even start legalizing medical marijuana until his second term. And, of course, it'd be difficult to conceive of a more fanatical living opponent of patient freedom and physician autonomy than Clinton's odious drug czar, Barry McCaffrey.)

End of the Gravy Train for Vaccines

In 2000, the state of Alaska offered to spend $219 per child to get vaccinated against measles, mumps and other ailments. Presumably, it was justified on public health grounds: If one child in a school has mumps, for example, he's likely to spread it around.

But now the cost of recommend battery of vaccines has soared to over $1,000 per child. In response, the state has said that it will not offer free vaccines for the human papillomavirus (HPV) or one for meningitis to all comers. The freebies will be limited to low-income families.

The only person to leave a comment (so far) on the story sums it up well: "Sounds like a reasonable solution. People who can pay and/or have insurance should use it. If people start expecting the government to pay for everything regardless of ones ability to pay we'll quickly be bankrupt." As an addition, I'd say perhaps it's not necessary to expect that insurance will pay for vaccines, either. This sounds like the kind of thing for which cash payments would work well for many people: Save money on premiums by not wrapping up an expected cost into what amounts to a prepaid service plan.

The CON Game: Palin v. Hospitals

In a commentary published earlier this year, Gov. Sarah Palin (R-Alaska) describes her state's proposal to repeal its Certificate of Need (CON) program.

After more than 30 years of such programs, the National Conference of State Legislatures has found there is no solid proof that the state-sponsored CON programs have actually controlled health care costs. In 2004, the Federal Trade Commission and the Department of Justice both asserted that these programs actually contribute to rising prices because they inhibit competitive markets.

Repealing Alaska's current CON program will not only reduce the cost of health care, it will also improve access to health care, allow more competition and improve quality of care for patients, Palin wrote back in February.

Not surprisingly, the health care providers that benefit from the absence of competition are much more enamored of the status quo than the governor, writes The American Spectator. And, for the time being, they have successfully thwarted the governor's reform effort. An aggressive lobbying campaign by the Alaska Hospital and Nursing Home Association prevented Palin's legislative allies from garnering enough votes to pass the measure during this year's session.

More on Alaskan Health Care Reform

More insight into health care reforms proposed in Alaska comes from David Catron, writing in the American Spectator.

Patients need more governors like Gov. Sarah Palin (R-Alaska). Speaking of a health care commission she appointed, Catron says:

The recommendations of the HCSPC were decidedly pro-market and emphasized the power of the health care consumer: "With respect to lowering costs, insurance that is portable and consumer-owned plays a central role… consumerism is an essential component of bringing rationality to the health insurance structure in Alaska." Such a consumer-driven approach assumes, of course, that the patient possesses useful data about hospitals and physicians. Thus, the HCSPC also advocated providing patients with "cost and quality information about health care providers and services."

Hospital fat cats (who benefit from CON laws), professional advocates for government health care and many other voices would restrict the ability of consumers to enjoy the benefits of competition. But patients will benefit if more governors and other public officials pursue some of the ideas on health care articulated by Gov. Palin. 

The Palin Record in Alaska

To take off on Joe's notice of the Washington Post article about the Gov. Palin administration, I notice that she was not successful in taking out the CON law.

Matthew Mosk characterized her approach as an "aggressive, uncompromising and, to date, unsuccessful push to promote competition." He also called it "one of her signature efforts."

A business executive on the other side of the struggle from her said "There are times when a leader has to take a stand, and that's what she did."

Doing away with certificates of need–14 states have done so–is not the only answer to improving the state of health care, certainly. But it's a step that others should follow.

For more on Alaska, see Legislative Non-Action is Half a Loaf.

Palin vs. CON in Alaska

A Washington Post story examines Gov. Palin's efforts to end Certificate of Need (CON) laws in Alaska. Nice to know a governor somewhere gets it.