Health Policy Scholar Who Said the Public Option Would Lead to Single Payer Now Says You Shouldn’t Worry that the Public Option Will Lead to Single Payer

In an op-ed for The New York Times, Yale political science professor Jacob Hacker argues that Obamacare’s problems can be fixed by the addition of a “public option”—a government-run health insurance plan that would be available in the exchanges alongside private options.

Near the beginning of the piece, Hacker, who has been touting the public option since before Obamacare was signed into law, dismisses one of the major lines of criticism about the creation of a new, government-run health insurance plan, which is that it would lead to fully government-run health insurance system.

“Critics of the public option are convinced it’s a one-way ticket to single payer (the government alone provides coverage),” Hacker writes. “History suggests the opposite: The public option isn’t a threat to a system of broad coverage through competing private plans. Instead, it’s absolutely critical to making such a system work.”

Now, I have argued in the past that Obamacare is unlikely to lead to single payer in the long run, and I still believe that a fully government run system is an unlikely outcome, at least in the forseeable future.

But one could be forgiven for thinking that the inclusion of a public option would eventually lead to a single-payer system, because that is exactly what Jacob Hacker said would happen when he pitched the public option in 2008.

In a 2008 speech to the Tides Foundation, a liberal policy organization, Hacker touted his then relatively new idea for creating a new government-run health care plan available to all Americans. In his remarks, he explicitly addressed the possibility that it might eventually lead to a government takeover. Here’s what he said:

Someone once said to me, ‘Well, this is a Trojan horse for single payer.’ Well, it’s not a Trojan horse, right? It’s just right there!

I’m telling you, we’re going to get there over time, slowly, but we’ll move away from reliance on employment based health insurance as we should. But we’re going to do it in a way that we’re not going to frighten people into thinking that they’re going to lose their private insurance.

These remarks were captured on video. Watch below:

In 2009, after the video aired on Fox News, Hacker backtracked, saying that he did not see his plan as a route to single payer. That appears to be his position still.

But it wasn’t at first, when he was speaking to a liberal audience. And the dynamics he explained in 2008 certainly provide a plausible enough foundation for the idea that a public option would lay the groundwork for more government intervention.

So it is hard to fully trust Hacker’s current assurances that a public option would not eventually lead to single payer given his previous explanation that it would.

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Hillary Clinton or Donald Trump: Who Will Be *Worse*? Is Gary Johnson a “Buffoon”? New Reason Podcast

On the latest Reason podcast, Nick Gillespie and Reason magazine editor in chief Katherine Mangu-Ward are joined by Andrew Ferguson, a staffer at The Weekly Standard and author of a series of best-selling books ranging from Land of Lincoln to Crazy U.

The choice between leading presidential candidates Donald Trump and Hillary Clinton has been likened to having to decide between being shot and being poisoned, contracting different sorts of STDs, or electing a giant douche versus a turd sandwich. So which is it? And how do we feel about Gary Johnson, the Libertarian candidate who is polling at historically high numbers yet still manages to disappoint somehow? (Here’s a clue: One of us calls him a “buffoon,” another is unimpressed but less caustic, and a third says nice things). While Donald Trump has been rising slightly in the poll, does his likely defeat portend a conservative and Republican crackup that will force the right to rethink a process and set of positions that has kept them out of the White House since George W. Bush left with historically high disapproval numbers?

Mangu-Ward discusses her lead piece in the new issue of Reason (currently available only to subscribers), in which she praises American free-speech laws and traditions even as they permit all sorts of crazy talk to flourish:

There’s something heartening, however, to be found in the deep awfulness of [Donald Trump’s] public statements over the years: the fact that he remains a free man despite uttering them. Because in quite a few otherwise civilized countries, a good deal of what leaves the GOP presidential nominee’s mouth on the topic of Muslims, women, and Mexicans could land him in jail.

And Ferguson explains his description of Tom Wolfe as “America’s greatest living essayist” and his new book, The Kingdom of Speech, as doing to uncritical evolutionary scientists what previous tomes did to artists and architects.

It’s a lively, fast-paced, and intermittently nasty conversation. Listen by clicking below. Produced by Ian Keyser.

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When Will Liberals Answer for Obamacare’s Failures?: New at Reason

Will Democrats take responsibility for Obamacare? Don’t hold your breathe.

David Harsanyi writes:

These days, there’s been a lot of discussion about conservative media’s culpability in creating unrealistic expectations and warped priorities among Republican voters. It’s a reasonable critique. My question: When are we going to have this conversation about the other side—you know, the one that enabled the passage of a massive partisan health care reform law that’s failed to deliver on almost all its promises?

No doubt, you’ll remember all those romantic charts and stories from the liberal smart set predicting Obamacare’s affordability and success. Remember the jeering aimed at conservatives who argued that state-run markets inhibiting genuine competition and increasing regulations would only spur costs to rise? “Lies,” liberals said.

In 2014, the Washington Post‘s E.J. Dionne asked a valuable question: “Is there any accountability in American politics for being completely wrong?” The answer: Of course not. Not for conservative talkers—and definitely not for liberal pundits who keep modifying the meaning of success.

View this article.

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Why Big Pharma is Spending so Much Money to Defeat Marijuana Initiatives

Legal marijuana will poison children and cause more Arizonans to die in car crashes, according to scary television and online ads running across the state in advance of Election Day.

Edibles that look like candy, marketed to kids,” warns one ad, with a voiceover meant to sound like a concerned mother. Other spots feature school principals and public officials from Colorado explaining why they believe legal weed has been a bad deal for their state. “Don’t repeat our terrible mistake,” says Wellington Webb, a former mayor of Denver.

The ads were created by Arizonans For Responsible Drug Policy, a group that’s encouraging voters to reject Arizona’s Proposition 205, which would allow people aged 21 and older to possess up to an ounce of marijuana and grow up to six plants in their own homes. Arizona is one of four states—along with California, Massachusetts, Maine and Nevada—that could vote to legalize recreational weed on November 8.

Despite the voices and faces in the ads, though, Arizonans For Responsible Drug Policy and similar groups urging “no” votes on marijuana legalization in other states are not funded by concerned parents and public officials. In large part, these groups are funded by pharmaceutical companies trying to protect their share of the market for painkilling drugs—and in Arizona, the biggest donor to the “No On 205” campaign is a company that’s been investigated for its role in overdose deaths.

That company, Arizona-based Insys Therapeutics Inc., is best known for manufacturing a pain relief spray that contains fentanyl, an opioid that’s been under heightened scrutiny for its role in several overdose deaths, including the high-profile death of Prince in April. As Reason previously covered, Insys Therapeutics in August made a $500,000 contribution to Arizonans For Responsible Drug Policy, the largest donation the group has received from a single source.

It’s not just happening in Arizona. According to a report from The Nation, Purdue Pharma and Abbott Laboratories, makers of the painkiller OxyContin and Vicodin, respectively, are among the largest contributors to the Anti-Drug Coalition of America. Meanwhile, the Pharmaceutical Research and Manufacturers of America, which advocates on behalf of drug companies, spent nearly $19m on lobbying in 2015, according to a report from The Guardian, which called PhaRMA “one of marijuana’s biggest opponents.” Federal lobbying data aggregated by Maplight shows that PhaRMA has spent more than $150 million on lobbying since 2008—a total that only includes federal lobbying efforts, not similar work done in state capitals, where PhaRMA is also active.

These companies and organizations are allowed to spend their money however they want, of course, including trying to influence the outcomes of elections. That’s the beauty of living in a free country. Still, it’s worth asking why they would be so keen to spend millions of dollars fighting marijuana legalization.

One big part of the answer is that states with legal marijuana—medical or recreational—have lower rates of drug prescriptions.

Ashely and W. David Bradford, a daughter-father pair of researchers at the University of Georgia, quantified the relationship between legal pot and prescription drugs in a study published earlier this year. They analyzed state-level prescription drug databases from 2010 through 2013 and found that doctors prescribed significantly fewer pharmaceutical drugs in states with legal medical weed.

The largest drop-off was for prescription pain-killers (with 1,800 fewer doses prescribed annually in states with medical marijuana laws), like the one made by Insys Therapeutics, but the Bradfords found a significant declines in prescriptions to treat depression, anxiety and seizures.

“The availability of medical marijuana has a significant effect on prescribing patterns and spending in Medicare Part D,” the Bradfords wrote. States with medical marijuana laws saved $165.2 million in Medicaid costs during 2013, they said.

Savings to a state is lost revenue to a drug company. No wonder Insys and others are willing to spend so much to keep marijuana illegal in is many places as possible.

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Malheur Occupiers Acquitted, Pence’s Plane Skids Off Runway, Soylent Recalled: A.M. Links

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Bureaucracy, Funding No Cure for Homeless Problem: New at Reason

California politicians are targeting homelessness. Watch out.

Steven Greenhut writes:

The county of Orange recently hired a homeless czar, Susan Price. She just released “An Assessment of Homeless Services in Orange County,” which offers a roadmap of current services. There’s nothing particularly wrong with its assessment or recommendations, as it calls for a more collective, regional approach to the problem. But there’s nothing particularly right about it, either.

The report calls for hiring a manager to “enhance” the Continuum of Care system. It wants to “improve regional coordination” by formalizing “protocols” for responding to homeless encampments. It wants to develop a “systemic navigation of services by diversifying the portfolio of services” and calls for more funding for shelters and housing assistance. It’s self-congratulatory at times.

Homeless activists focused on the funding part of it. “A recent report by the ACLU estimates that it would take $13 million a year to permanently house the chronically homeless population, and a total of $55 million a year to house the entire homeless population,” according to a report in The Voice of OC.

View this article.

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Trump Effect? School Bullying Isn’t Increasing, But Hillary Clinton Wants to Spend $500 Million Fighting It

HillaryMaking use of time-honored federal government logic—we have to do something about X, and this is something, so we must do this—Hillary Clinton has proposed $500 million in federal spending on school anti-bullying initiatives.

Under Clinton’s plan, titled “Better Than Bullying,” the feds would use the money to essentially bribe states into hiring more school counsellors, developing suicide prevention and mental health programs, re-training teachers, and cracking down on cyberbullying. Tax increases would pay for it, according to The Wall Street Journal.

Supporters argue the program is necessary because bullying is on the rise—and it’s all Donald Trump’s fault, the Clinton campaign alleges.

Indeed, this has become a Clinton talking point. “Teachers and parents call it the ‘Trump effect,'” she said during the second presidential debate. “Bullying is up. A lot of people are feeling uneasy, a lot of kids are expressing their concerns.”

The National Education Association—the country’s most powerful teachers’ union, and an important pillar of support for the former secretary of state—has seized upon the idea that Trump’s candidacy has somehow made schoolyard bullying worse. “Amid Trump-inspired spike in school bullying, Clinton announces national initiative,” is how the NEA heralded Clinton’s plan on its website. Another NEA headline: “‘Trump Effect’ elicits ‘disgraceful’ behavior from some students, strikes fear in others, educators say.”

This is a transparently politically useful argument for Team Clinton: my opponent is making your kids less safe! Think of the children! But is it true?

We have no idea.

The NEA has cited the anecdotal evidence of a handful of its members. It also cited a Southern Poverty Law Center survey that found the Trump campaign was producing “an alarming level of fear and anxiety among children of color.” But:

Our survey of approximately 2,000 K-12 teachers was not scientific. Our email subscribers and those who visit our website are not a random sample of teachers nationally, and those who chose to respond to our survey are likely to be those who are most concerned about the impact of the presidential campaign on their students and schools.

So that doesn’t count. But can we do better?

As it so happens, the National Center for Education Statistics collects scientifically sound data on teen bullying rates. Unfortunately, the most recently available data is for the year 2013 (it was published in 2015). Data for 2014 won’t be released for a few more months. Data that takes into account the “Trump effect” won’t be available for years, presumably.

“2013 is the most recent year for which we have published data on student bullying,” NCES’s Lauren Musu-Gillette told me via email.

Still, the 2013 figures were interesting. According to the NCES, 22 percent of kids ages 12-18 were bullied at school in 2013. That was an improvement over previous years: the bullying rate was 28 percent in 2011 and 2009, and 32 percent in 2007. School bullying, it seems, is falling.

Has Trump singlehandedly reversed this trend? There are no data to support such an assertion.

It may even be the case that perceived bullying is rising even as actual bullying continues to fall. That’s because “bullying” is prone to something psychologist Jonathan Haidt calls “concept creep.” For behavior to be considered bullying, it used to have meet certain criteria: a power imbalance between the perpetrator and the victim, intentionality, and repetition. These days, bullying is typically defined more broadly, as virtually any form of unwanted behavior.

In light of evolving definitions, Haidt is concerned that grand efforts to combat bullying—broadly defined—might be ill-advised.

“The concept of bullying has experienced such massive concept creep in psychology and education circles that these new programs are likely to target a great deal of the normal conflict kids have with each other,” he told me via email. “Such a policy focus is likely to intensify the victimhood culture and moral dependency that has been growing so rapidly on college campuses.”

Colleges have fallen victim to administrative bloat: They have hired more and more non-teaching personnel, causing tuition to skyrocket. Clinton’s anti-bullying plan would likely have the same effect, encouraging K-12 schools to employ more counsellors and social workers. What happens when the federal funding runs out? This new anti-bullying bureaucracy won’t just go away.

To recap: We don’t know if bullying is getting worse, let alone whether Trump is the cause. And we don’t really know whether hiring an army of non-teaching staff would lessen the problem. But Clinton wants the federal government to throw another $500 million at it anyway.

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Movie Reviews: Inferno and Gimme Danger: New at Reason

InfernoRon Howard’s Inferno can be recommended for the opportunity it offers to avoid reading the Dan Brown novel on which it’s based. Brown’s bestseller, another exercise in his trademark verbal incontinence and wooden characterizations, would seem to defy cinematic adaptation and, as we see here, actually does. Director Howard, in his third go-round with Brown’s tepid hero, the “Harvard symbologist” Robert Langdon, has attempted to rein in the author’s wandering plot and gushers of babble; but trimming and compressing them has only added to the story’s incoherence.

Langdon (Tom Hanks again) is back in Italy, this time waking up in a Florence hospital with a head wound and no idea where he is—the last thing he remembers is being at home in Cambridge a few days earlier. Attending physician and requisite brainy babe Sienna Brooks (Felicity Jones) sympathizes, but before she can be much help an assassin called Vayentha (Ana Ularu) storms in and starts shooting up the ER. Langdon and Sienna flee, an activity which will consume most of their time for the rest of the movie, writes Kurt Loder.

View this article.

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Obama Commutes Sentences of 98 Drug Offenders, Including 42 Lifers

When he was arrested in 1990 for participating in a cocaine conspiracy, Ignatzio Giuliano was the 55-year-old owner of a dinner cruise boat in Fort Lauderdale. He is now an 81-year-old federal prisoner, suffering from multiple maladies and eager to spend time with his children and grandchildren before he dies. Thanks to President Obama, it looks like Giuliano will get that chance.

Giuliano is one of 98 prisoners whose sentences Obama shortened yesterday and one of 42 who received life sentences for nonviolent drug crimes. In a 2013 interview with the American Civil Liberties Union (ACLU), Giuliano said his defense attorney neglected to tell him prosecutors had offered a plea deal under which he would have received a five-year sentence. Because he went to trial and qualified as a “career offender” based on four prior convictions for nonviolent offenses involving cocaine and marijuana, he received a mandatory sentence of life without parole. The leader of the cocaine conspiracy, who testified against Giuliano and two other defendants, was released after serving three years.

“I am an old man now,” Giuliano told the ACLU in 2013. “I made mistakes in my life, but I am not a threat to society, and I begrudge no one. My co-defendants have been home for years. All I am asking is to be afforded the dignity to spend the last few years of my life with my family, and to die outside of prison.” After spending a quarter of a century behind bars, Giuliano is now scheduled to be released next February.

This latest batch of commutations raises Obama’s total so far to 872, nearly all of them involving nonviolent drug offenders. That is more commutations than were issued by his 11 most recent predecessors combined. According to the White House, the 688 commutations since the beginning of 2016 are “the most ever done by a president in a single year”—not surprising, since Obama’s commutations have been strikingly backloaded, with 79 percent coming during his last year in office and 98 percent in the second half of his second term. He shortened just one sentence during his first term.

Obama clearly is trying hard to make up for lost time. In a speech on Tuesday, Deputy Attorney General Sally Yates said there will be “many more [commutations] to come.” Yesterday White House Counsel Neil Eggleston said Obama is committed to “using his clemency authority through the remainder of his time in office.” If he maintains this month’s rate in November, December, and January, his total will be around 1,500. If he picks up the pace, he could still reach the “thousands” predicted in 2014.

Even 2,000 commutations would represent just 6.9 percent of the 29,000 or so petitions Obama has received, making him slightly more merciful than Richard Nixon by that measure. That nevertheless would represent a huge improvement from where Obama stood just six months ago.

Clemency Project 2014, the consortium of volunteer lawyers that has been helping the Justice Department sort through petitons, reports that it has been contacted by 36,000 federal prisoners and completed reviews for 34,000. Of those, about 2,150—just 6.3 percent—met the DOJ’s picky criteria for special consideration, which include having a minimal prior criminal record and completing at least 10 years of a sentence that would have been shorter under current law.

Even if Obama ends up helping thousands of people who do not belong in prison, thousands more will remain behind bars by the time he leaves office. Congress could do more by passing retroactive sentencing reform, which foundered this year on pre-election anxieties and fearmongering by mindlessly draconian legislators like Tom Cotton. “You can’t fix 30 years of bad policy overnight,” says Kevin Ring, vice president of Families Against Mandatory Minimums. “Every day, people are sentenced in federal court based not on what their judge thinks is appropriate, but on what Tip O’Neill, Strom Thurmond, and a bunch of other deceased lawmakers believed 30 years ago. It’s just ridiculous.”

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