Michigan Governor Says “Go Vegan”

First they came for cigarettes. Then it was soda pop in school vending machines. And then foods with trans fats, salts and now, meat.

Gov. Jennifer Granholm (D-Mich.) is calling for residents of Michigan to forgo eating meat in observance of “Michigan Meatout Day.”

Am I the only one who finds this slightly creepy? Sure, go ahead and eat a vegetarian or a vegan diet if you’d like. Try to sell me on the virtue of a soy burger as a replacement for ground beef. I wouldn’t even mind a lecture from the governor if the two of us were sitting down over a couple of beers (is that still allowed?) , if she were talking as a private individual.

An official proclamation, as meaningless as that is, crosses over the line and gets government in the business of deciding what goes in my body and what doesn’t.  But expect more of the same nanny-state nagging when governments take on an ever-larger role in paying for health care services.

Michigan Legislator Calls for “Civil Disobedience” on Health Care

Three Michigan lawmakers have introduced legislation aimed at protected their state’s residents from being forced into a health care system, either by the state of Michigan or the national government. The publication Michigan Capitol Confidential has a review. One state senator says “Where this is going, I don’t know. You don’t know until the states try to do it.”

While the supremacy of the national government over the states is widely cited as an objection to such measures, states have successfully repelled other initiatives, such as the REAL ID act.

Mortgaging Taxpayers for Government Employee Retirement Benefits

The Lansing State Journal calls for ending health bennies for all current state retirees! Welcome to the resistance movement,  LSJ. Now if we can also get on board the Senate Republicans who are trying to pile more debt onto taxpayers to give these bennies to age 50-something local government retirees.

Previous posts have described legislation passed by the Michigan House (House Bill 4075) and pending on the Senate floor (Senate Bill 927) to let local governments borrow to pay for retirement health insurance benefits that current and past officials have offered to local government employees.

The bills are different in one respect: The House version says, “The funding of postemployment health care benefits … shall constitute a contract to pay the postemployment health care benefits.” (Emphasis added.) The Senate bill contains just the opposite: “The funding of postemployment health care benefits … shall not constitute a contract.” (Emphasis added.)

Implicit in both versions is recognition that under current law there is no contractual obligation to pay, and as explained in a previous post, that “shall not constitute a contract” phrase is essentially weasel words, intended in part to obscure what’s really going on here, which is both Republicans and Democrats cooperating to transfer even more wealth from the people to the government class.

The phrase is just for show, because the local politicians doing the actual borrowing will almost certainly adopt other provisions to ensure that this money goes only to retired government workers’ health care benefits. (Many of those local pols will also continue to cut services and pursue tax hikes to provide ever more money to pour into this black hole, all the while crying a river of tears about ongoing “budget crises.”)

Nevertheless, this particular “not a contract” language is likely to become the theme of a legislative Kabuki dance, starring Senate Republicans and House Democrats, in which the former pound their chests and proclaim sanctimoniously that they will not support the measure without the provision, while the latter pretend just the opposite.

To the extent they get the chance to cover this issue, reporters will probably be drawn to the “controversy” over this detail, which seems meaningful on the surface. Unfortunately, they may miss the real import of the bills, which is more debt loaded onto taxpayers to pay for government employee benefits that appear not to be contractual, and that far exceed anything received by most private-sector workers.

In the end a bill may well pass with the Senate language, giving Republican politicians the “cover” they need to stick it to taxpayers once again, while both parties make another installment on paying off the most politically powerful special interest in the state: government employees and their unions.

They all may even get away with it, for one simple reason: No one will tell the folks back home.

(Psssst – folks back home: Are you listening?)

Doctor Shortages and Socialized Medicine

Writing for the Michigan State University Capital News Service, Chenqi Guo reports the following:

Several thousand physicians have left the state after their residency programs or during their practices, according to Gregory Forzley, board chair of the Michigan State Medical Society (MSMS). The situation could be worse since an 8 percent cut in Medicaid and Medicare reimbursement rates was approved on Sept. 30, 2009. The total number of physicians licensed in Michigan is 42,960 and about 27 percent of them work outside Michigan, according to the state’s 2009 physician licensure report.

One of the realities driving the push for a government takeover of the American health care market is the unsustainability of current government health care programs, including Medicaid, which provides coverage for low-income persons. (In Michigan, spending on this and related health programs for the poor has skyrocketed from $8.2 billion in 2000 to nearly $13 billion this year.)

Medicaid is a good example of how “coverage” does not equal “care.” In addition to a declining number of doctors, the number of those who report that they accept Medicaid patients is also down, according to the annual survey cited above, from 89 percent in 2006 to 85 percent in the 2009 report. And that was before the last year’s compensation cuts kicked in. Also, many of these doctors report that their practice is “full” or “nearly full,” and the number of Medicaid patients they actually accept is not reported, so challenges for a person seeking care under this government program (even though he or she has “coverage”) are greater than even these figures suggest.

Medicare (the government health program for the elderly) also pays below-market compensation rates to providers, but not as low as Medicaid. The government health care takeover pending in Congress would essentially convert the entire system into a version of Medicare/Medicaid, subject to all the same perverse incentives and dysfunctions.

Single-payer fans always seem to ignore what happens when the forgotten man of socialized medicine – the doctor – just “shrugs” and walks off the job.

(Last fall the Mackinac Center for Public Policy documented the painful consequences suffered by some individuals currently living under such system.)

Medicare & Medicaid Melt Down in Michigan

Another day, another report in the local newspaper about the shortage of doctors, driven by the policies and pay under which government programs expect physicians to labor.

The latest is from the South Bend Tribune, which reports that several thousand physicians have stopped practicing in the Michigan. The Michigan State Medical Society assigns primary blame to a recent 8 percent cut in Medicare and Medicaid fees.

These government programs are nothing short of miraculous: Per capita spending on both Medicare and Medicaid have increased one third more than private health spending, from 1970 through 2008. Nevertheless, their dependents are rapidly losing access to medical services, because reimbursements are too low. Only government could have a track record like that, and keep proposing their expansion.

Instead of fixing these broken programs, the health “reform” proposes to decimate Medicare Advantage, a program which reduces Medicare’s hidden tax on private plans, and provides better care to beneficiaries than the traditional Medicare monopoly.

If the government succeeds, the flow of patients escaping government-rationed care across the Ambassador Bridge between Windsor (Ontario) and Detroit might well reverse itself.

HSAs Save Money for Taxpayers, Civil Servants

The Mackinac Center for Public Policy explains that by moving state employees to a high-deductible/health savings account combination Michigan taxpayers could save over $100 million a year in reduced premium costs. That’s even after the state would contribute 75% of the maximum annual deposits to each worker’s HSA.

Employees benefit, too: “the maximum out-of-pocket expense with HSA/CDHPs is an absolute, hard number, while with traditional insurance, there is no limit to some of the co-pay amounts.”

Move State Employees into New Health Plans

With states grappling with deficits that won’t go away even when the economy picks up, what can they do? To start with, move public employees into high-deductible health plans that are matched with contributions to health savings accounts.

That combination would save taxpayer money, and potentially save government employees money as well.

Michael D. LaFaive and James Porterfield explain how it would work in Michigan. Moving state employees would save taxpayers $106 million in its first year; making the same change for public school teachers would  save even more, or $451 million.

An Honest Advocate for Socialism

While some advocates of GovernmentCare spout words such as “choice” and “competition,” others are more upfront about their desire to see government-run health care. One of them is Rep. John Dingell (D-Mich.), a man who has been advocating a single-payer approach for two generations. (Hey, isn’t it about time for term limits?) Henry Payne gives us a short review of Dingell’s perspective.

Michigan Senate Votes Down Doc Tax

Remember Michigan’s doctor tax, which was approved by the House as a way to (a) play the Medicaid matching game, (b) reduce pressure to find economies in the state budget by bring in more tax money, and (c) boost government-paid health care over private-pay care?

Well, it’s not going anywhere. The Michigan Senate voted it down by a stunning vote of 32-4, with all 20 Republicans and 12 out of 16 Democrats voting no.

Michigan House Imposes New Doctor Tax

The Michigan House has voted to impose yet another tax (a gross receipts tax) on doctors in the state. There are two obvious reasons for the move. One is to get more money into the state’s treasury. Another is to play the matching-fund game with the Federal government. It’s also supposed to take from doctors who don’t see a lot of Medicaid patients (more on that later) and increase reimbursement rates for those who do.

The Detroit Free Press notes that the major physicians’ groups in the state oppose the tax, though some individuals support it. One surgeon, however, said the tax is “like taxing teachers to pay for schools.”

The Detroit News editorialized against the tax, calling it unhealthy. It points out that only one other state currently imposes such a tax–and that is set to expire soon. The state is already paying doctors so little that only 55% of Michigan physicians see Medicaid patients. It concludes, “Could there be a bigger incentive to leave the state? Could there be a bigger disincentive for newly licensed physicians to set up practice here?”

The unmentioned elephant in the room is the option that Michigan has to increase payments to doctors by finding economies elsewhere in the state budget.