Here in Tennessee we are dealing with the death of TennCare. Actually it is not dead, but it is certainly not going to be the same program. Gone is unlimited state-paid health insurance coverage for over 300,000 people. The plan will still cover over 600,000 children and certain other segments of the population. But basically the free ride for people who don’t seem to think that paying for health insurance is their responsibility is over. We got to this juncture because back in 1994 the state decided to become a pilot program for what would have been Hillary-care. What ended up happening was what you would have excepted to happen. People flocked to the program because it meant using someone else’s money for their own expenses. It is a natural law of economics. What we had was a quarter of the state’s population on TennCare, higher than any other state’s Medicaid enrollees. The result of that is also what you have expected when people get stuff for free. They use a lot more of it. You can figure out what happened next. The program began to eat more and more of the state budget. Lawmakers had to figure out a way to work through the problem. There was the typical liberal answer of higher taxes. But the citizens of Tennessee, God love ‘em, roundly reject that. So the other option is to cut benefits. Have you ever given something to someone and the tried to take it back? It’s pretty difficult, especially if they become dependant on it. Throw into the mix a lot of lawyers and mandates from the courts requiring expanded coverage and limiting the state’s ability to deny benefits and cut costs. So in comes Governor Phil Bredesen, a Democrat with a history in the health care industry, with a promise to fix the TennCare problem. His reform efforts are obstructed at every turn by folks like Gordon Bonnyman’s Tennessee Justice Center and other advocate groups. The governor basically told them that it is either reform or the end of the program and a return to Medicaid. The TJC and their allies insisted on the continuation of Cadillac coverage. The governor wanted to scale it back to Chevrolet. Neither side blinked. Bredesen did not go as far as to end it completely, but he did make good on the threat to eliminated a whole lot of people on the enrollment list. So now hundreds of thousands of people are off of TennCare. The natural reaction from the press and certain corners of society about the end of TennCare as we know it was outrage and cries of how heartless we are to take this away from those poor people. The coming storm will be predictable. We’ll see heart-wrenching news stories about some people who depended on TennCare and now do not know how they will cope. And there will be big deals made about former TennCare enrollees who died, with the blame being placed squarely on the bastards in government that took away their health care coverage. Modern-day compassion is defined as helping people using other people's money.
The end of TennCare does not upset me much. I’m not a fan of government involvement in health care. But there was an interesting discussion on a local radio program this morning that featured a prominent local physician. This man is fairly conservative for the most part, but he is in favor of a single-payer governmental health insurance program. I’m sure he has his reasons. Maybe he just thinks it would be easier for those in his profession. But there was one thing he said that also explains his stance. He believes that health care is a right rather than a privilege. I beg to differ. Health care is not a right. It cannot be. If there is anything I’ve learned from libertarians it is that we have a right to life, liberty and the pursuit of happiness as long as it does not infringe on the rights of others. Anything that requires the life, liberty or property of another is not your right. Going to the doctor requires the participation of the doctor, therefore part of his life. If it is paid for by the state, it requires the property, the tax money, of others. Because it requires work to acquire property, it is by extension part of someone’s life. It is that simple. That’s part of the problem in the whole abortion debate. I don’t think most people disagree that a woman has the right to do with her body what she wishes. The question revolves around the point at which life begins and therefore rights are bestowed upon the life within. But that’s another discussion I’m not going to revisit. There are people who want to solve every problem by throwing money at it. In fact on that same radio program this week it has been a compassionate spendfest. The way to improve Tennessee schools is to spend more money. The way to help people pay for health care is to spend more money. More tax money that is. Never mind the fraud and abuse that might be going on. Never mind the waste and redundancy involved in various government programs. There are European countries trying to figure a way out of the same mess that we are just bound and determined to get ourselves into. So much for learning from the mistakes of others.
And another thing...
The president has put forth his budget and the Democrats are spinning so fast they are screwing themselves into the ground. They are trying to have it both ways yet again. I've never been particularly happy with Bush the Younger and his penchant for "compassionate" spending programs. Republican always seem to think that they need to dismiss their principles and spend lots of money to buy votes and be liked. That Medicare prescription drug plan is a fiscal disaster waiting to happen. During his first term Bush seemed to not even try to reduce spending. Of course the good people on the other side of the aisle routinely criticized him for not spending or not funding initiatives enough. They do love to spend our money after all. Now here we stand with a budget deficit, not a first in American history by any stretch, but after the few alleged surpluses at the end of the Clinton Administration it doesn't look good. The whole budget process is something of smoke and mirrors anyway. There are projections and estimates and just flat-out hopeful guesses about revenue and economic growth. It is hard to get a grip on actual numbers until the die has already been cast. Then there is the whole issue of deficit in whole dollars vs. as a percentage of GDP. But the funny thing is that Democrats are actually trying to convince people that they are the party of fiscal responsibility. I was recently at a professional conference in which one speaker, who could just not contain his partisanship, pointed out what the deficits and surpluses have been over the past couple of decades have been. We were supposed to have been shocked that the largest deficits have been under G.H.W. Bush and G.W. Bush. Did he think he was actually going to fool me? Bush the First never had the backbone to stand up to the Democrat-controlled Congress. Remember "Read my lips"? Then miraculously in 1994 the Republicans gained majorities in the House and Senate with one of their goals being to balance the budget. And amazingly enough they beat the Clinton Administration's opposition and got it done. You will remember that Bill himself said it wasn't a priority and that we could balance the budget in any number of years depending on which speech you were listening to. Then let's get to the current deficits. When did they really start? Well, after 2001 of course. Anyone want to tell us what happened in that year that would have caused a spike in spending? Anyone? Yes, of course we all can. When you realize that the military and intelligence budgets had been pared down for years, of course there would have to be dramatic increased spending for important things like national defense. Certainly more important than a lot of federal social programs. Who cares if a kid is getting a free school lunch if he is dead from a terrorist attack? Couple that with the "please like me" Bush spending on the domestic side and you get some big deficits. Of course the Democrats want to solve the problem in all the wrong ways. Raise taxes and cut defense spending. Fortunately they keep losing elections and they haven't figured out why. Shh, don't tell them.
Anyway, all of this puts me in a bit of a quandary. Bush's 2005 $2,400,000,000,000 budget (that's 2.4 trillion) calls for the elimination of a lot of federal spending programs and the reduction of growth for others. This is a good thing. There are redundant and ineffective federal spending programs. There is government waste to be found and dropped. If it were me, I'd freeze spending levels for a few years and find out where the severe belt tightening can be done. But there is a problem, you see. One of those programs on the chopping block is the Federal Perkins Student Loan program. Since I am in the profession, let me explain how it works. The feds kicked in money into a revolving loan fund with the institution matching funds. The current contributions are 75% federal and 25% institutional. The loan fund is revolving in nature, meaning that funds that are lent and repaid by former students are then lent again to current students. One option the feds have would be to simply stop making contributions to the fund and to allow schools to lend what they have in the fund. The trouble is that the Perkins Loan has loan cancellation benefits for borrowers who are employed in certain jobs that the government thinks we need more of. This would be things like teachers in low-income schools or of special education, nurses, etc. They are currently not funding the cancellations fully thereby shorting the schools loan funds. If they eliminated funding the cancellations, the available funds would dwindle away. But the plan is for the Department of Education to completely recall all of its contributions and increase the Pell Grant by a few hundred dollars. As I mentioned before, I am all for cutting spending wherever it can be found, but this doesn't make a lot of sense to me. Eliminate funds from a revolving loan fund that can be lent over and over again and put them into a one-time giveaway grant. So you can see my dilemma. As a fiscally conservative libertarian, I see no reason the government should even be involved in funding people's education. (Or any of a great number of things they spend money on.) But a fair portion of my job depends on one of these government programs. And besides, it is being eliminated under false pretense. So I'll do my duty to my employer and to the students who depend on the money to afford an expensive Vanderbilt education, but I don't have to like it.
And another thing...