Grassroot Perspective – March 5, 2003-Healthy Aging v. Chronic Illness: Preparing Medicare for the New Health-Care Challenge; An 'ABC' Proposal to Modernize Medicare; The NGA Should Pay its Own Way

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”Shoots (News, Views and Quotes)”


– Healthy Aging v. Chronic Illness: Preparing Medicare for the New Health-Care Challenge; An “ABC” Proposal to Modernize Medicare

Source: Progressive Policy Institute, 2/14/03

Two papers from the Progressive Policy Institute offer a new organizing theme for the Medicare debate: improving care for people with chronic illness.

Lead author David Kendall makes a convincing case that Medicare must replace its system of paying for acute procedures one by one and move to a more integrated system of long-term treatment of chronic illness, with a focus on accountability, prevention, quality, and patient involvement. He says that it would be a mistake for Congress to focus simply on adding a drug benefit to Medicare without integrating the benefit into a new system of care.

In an accompanying paper, lead author Jeff Lemieux explains an “ABC proposal” for A-ccountability and performance-based management, a modern drug B-enefit, and widespread C-hoices of coverage. He also proposes decentralizing the Centers for Medicare and Medicaid Services to allow local decision-making in 150 sub-regions. Kendall, Lemieux, and colleagues offer a plan to make Medicare’s administrators more accountable for both the quality and cost of health care to wean Congress from its micromanagement of the program.

Lemieux outlines a “universal, zero-premium, high deductible drug benefit.” Unfortunately, it is based upon the same model that some members of Congress have proposed in which Medicare would pick up the tab for beneficiaries’ drug expenses above $4,000 to $5,000, with subsidies and lower thresholds for lower-income beneficiaries.

At the Galen Institute, we fear that government will insist on level prices from the first dollar to make sure everyone reaches the catastrophic level on an even playing field — an open invitation to the price controls that the authors’ other policy recommendations are designed to avoid. Lemieux counters that “the extreme pluralism of our approach — with hundreds or even thousands of Medigap plans, employers, etc. contracting with CMS to provide the catastrophic benefit — will mitigate against price controls.” Let the debate begin.

The links to the reports are:

Above article is quote from

Lucky Numbers

A hacker has evidently gained access to more than 5 million Visa and MasterCard credit card numbers. So far, none of the numbers have been ripped off. It remains a mystery why any server, anywhere, would have 5 million unencrypted credit card numbers on it.

Searching for Answers

Seattle-Tacoma International Airport, alone among airports it seems, has resisted the Transportation Security Administration’s call to conduct random searches of vehicles entering airport terminals. Sea-Tac officials say they need some sort of probable cause to search vehicles outside the airport. The TSA says the Code Orange terrorism alert is all the reason you need.

Better Safe than Free

Nevada Senate Majority Leader Bill Raggio (R-Reno) actually argues that because it is impossible to tell what terrorists might do next, the state must adopt an anti-terror bill that defines a wide selection of activities as terrorism, including “indtimidataion.” Just in case.

Above quotes are from Reason Express

”Roots (Food for Thought)”

– The NGA Should Pay its Own Way

By Peter J. Ferrara

EXTRA: What Conservatives & Free Market Leaders Say About the NGA

The National Governor’s Association (NGA) is a national lobbying organization for the states. Its members are the incumbent state governors from across the country. It lobbies Congress and the president for legislation favorable to state governments.

You may not know much about the NGA, but you should. You’re paying for it.

This year, taxpayers across the country will be required to pay at least $8.1 million to fund the NGA. That figure includes $4.2 million paid by the state governments as “dues” and $3.9 million from federal grants and contracts. The total budget of the NGA is $13.2 million. So taxpayers finance about two-thirds of the organization.

What do taxpayers get for this money? Another liberal lobbying group. The chairmanship of the NGA rotates every year between a Republican and a Democrat governor, regardless of which party has the most governors. As a result, no chairman is in control long enough to really change the organization.

That leaves daily control in the hands of the NGA staff, which is composed primarily of typical Washington liberals. They tend to be former congressional staffers, mostly from Democrat offices. Their view of what is good for the states is a bigger federal government.

The staff pushes higher government spending for the states and state-administered entitlement programs, including welfare programs. It fights against federal tax cuts, because it wants more money for the states. In the past, it opposed the federal balanced budget amendment out of fear that federal funding to the states might be cut to balance the budget. Recently, to justify its existence, it bragged that it lobbied successfully for higher federal highway spending and to stop restrictions on the runaway growth of Medicaid.

During the early 1980s the NGA was used as a base to fight against President Reagan’s welfare reforms. Robert Carleson, Reagan’s senior welfare advisor in the White House and before that in California, says “the NGA used the liberal Republican heading it at the time, Richard Snelling of Vermont, to sabotage Reagan’s efforts to devolve welfare to the states.”

More recently, the NGA and its liberal staff have sought to undermine the welfare legislation passed last year. The staff developed a resolution calling on Congress to restore food stamps and Supplemental Security Income (SSI) benefits to legal immigrants. Yet, those benefits have been drawing immigrants from around the world, particularly those who are elderly and retired, to live off the U.S. taxpayers. About 350,000 elderly immigrants receive SSI, accounting for about 15 percent of the entire SSI caseload.

This resolution was defeated by the majority of Republican governors in the NGA. But a final resolution called for new benefits for these groups. Another staff-developed resolution sought to weaken the work requirements in the reform bill, by counting as work “job readiness” activities, high school equivalency courses and even drug and alcohol treatment.

Liberal foundations think the work of the NGA is highly valuable to their cause, because most of the rest of the NGA’s budget is financed by them. The Joyce, Casey, Kaiser, Mott and Carnegie foundations have all given money to the NGA.

Finally, at least one governor has stood up and said, enough. Last week, Gov. Fob James of Alabama announced that he was pulling out of the NGA.

The governor’s decision was quite practical. Alabama’s taxpayers have to pay $100,000 each year in dues to the NGA. Yet, the governor says, the state gets nothing for it. The NGA sends the states policy papers and briefs that nobody reads, and that included the same information the states get elsewhere. To represent Alabama’s interests in Congress the state already has a full congressional delegation, the governor notes. If the governor wants information from another state, he or his staff can simply call the state directly.

So, the governor decided to save his taxpayers $100,000 per year. “In taking the lead on this issue” says Grover Norquist, president of Americans for Tax Reform, “Gov. James has established himself as a first-rate taxpayers’ hero.” Norquist urges other governors to follow James’ lead, and others may do so.

Taxpayer funding for the NGA is indefensible. Taxpayers should not be forced to finance liberals fighting for more big government. Most states, in fact, already keep an office in Washington to look out for their interests, in addition to the state’s congressional delegation. Governors should stop taking their taxpayers’ money as well to finance the NGA and its liberal staff. The federal government also must stop financing numerous liberal lobbying groups like the NGA with the money of hard-working taxpayers who often oppose what these liberal groups do. The NGA and other liberal groups must raise their money voluntarily just as organizations that support conservative causes do.

What Conservative and Free Market Leaders Say About the NGA

“The NGA should have to raise its own money voluntarily from the general public, like we do. As Jefferson said, forcing people to pay for the advancement of views they do not agree with is tyrannical.”

Ed Crane
President, Cato Institute

“Lobbying groups and think tanks should not be financed through taxpayer funds. It is unfair for me to have to raise money voluntarily to counter the views of others who are taking their money form the public by force.”

David G. Tuerck
Beacon Hill Institute, Boston, Mass.

“At a time when states are aggressively cutting taxes and downsizing their state governments, it certainly seems to make sense to save money by withholding payments to the National Governor’s Association. Most of the truly important tasks of the NGA can be handled well by the Republican Governor’s Association.”

Stephen Moore
Director of Fiscal Policy Studies, Cato Institute

“It’s time to end federal taxpayer support for a trade association that has long been a tired, predictable voice for an expanded government.”

Mike Horowitz
Hudson Institute
General Counsel, Office of Management and Budget (1981-85)

“The NGA operates outside any standards of accountability and openness. Taxpayers’ funds paid by the states in dues to the NGA become akin to private funds, exempt from the requirements of open government statutes in the various states.”

Peter Flaherty
President, National Legal and Policy Center

“The NGA has every constitutional right to politic, but it doesn’t have a right, constitutional or otherwise, to do so on the taxpayers’ dime.”

Jim Martin
President, 60 Plus Association

Above articles are quoted from The Americans for Tax Reform

”Evergreen (Today’s Quote)”

“The politics of greed always comes wrapped in the language of love.” — Dick Armey

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