Recently, Gloria Mazza wrote, (and other Iowa Republicans signed), an essay in The Des Moines Register that urged President Trump and Iowa’s Republican Senators to oppose recent proposals by the Centers for Medicare and Medicaid Serivces (CMS) that would have taken reasonable steps to reign in increasing drug cost under Medicare Part D. It has now been reported that CMS and the Trump administration have backed off of important parts of the proposed changes.
Currently, Medicare Part D regulations require patient access to “all or substantially all” medications within “six protected classes” of drugs regardless of price. (Protected classes include drugs for HIV, mental illness, cancer, epilepsy, and organ transplants.)
Among other things, the proposed new rule would have allowed Medicare Part D plans to exclude a drug from coverage, 1) for an existing drug if the price increased more than the rate of inflation, or 2) for a new drug if it was simply a reformulation of an existing drug. Apparently, lobbying efforts were successful in getting these two provisions removed from the final new rule.
We don’t have a free market for prescription drugs under Medicare Part D. We should not allow drug makers to set their own price and still require coverage. It is unfortunate that the Trump administration caved-in to the lobbying pressure.
As reported in the Des Moines Register, a jury recently found the State of Iowa guilty of illegal discrimination against a transgender man. He had not been allowed to use the men’s bathroom or locker room, and he had been denied health insurance coverage for gender re-assignment surgery. (See link below to Register article.)
It is morally correct and good public policy that our government not discriminate against a people based on their gender identity. But refusal by government or private employers to cover gender reassignment surgery under their health insurance plans should not be considered wrongful discrimination, unless the plans cover other types of cosmetic procedures for people who feel similar dysphoria. People may feel mental distress over their teeth being crooked, or their nose being too big, or many other aspects of their body, but that does not mean health insurance plans should be required to cover procedures to make people feel better about their appearance. We have already seen that requiring health insurance plans to cover almost everything makes the premiums unaffordable for many people. There is nothing inherently wrong with expecting people to pay their own way for cosmetic procedures.
The Des Moines Register recently published an editorial that showed how out-of control Iowa and other states are in giving incentives to businesses to locate in their state. To help reverse this situation, Congress should exercise its Constitutional power to “…regulate commerce… among the several states…” and should limit states’ ability to bribe companies to locate in their state. States should be prohibited from giving custom incentives to specific businesses to locate in their state. They should only be allowed to use schemes that provide uniform incentives to all companies that locate their business or otherwise create new jobs in that state.
It is not surprising that the Iowa Automobile Dealers Association has registered its opposition to Iowa Senate Study Bill 3139 which would allow RV dealers to sell RVs on Sundays. (See Register link below.) I’m sure they think if RV sales are allowed Sundays, then car sales might be next. It would be nice if that were true. The only reason that it remains a crime to sell RVs or cars on Sundays in Iowa is because of the lobbying power of the dealers. If RV and car sales were allowed on Sundays in Iowa, it would not require any dealer to be open for business on Sundays. The decision would be left up to the owner, just like every other business. I urge Iowans to let there elected representatives know that Iowa should stop making it a crime for RV and auto dealers to be open for business on Sundays.
The Des Moines Register recently published a nice essay by a gay couple who got married in Iowa without any discrimination issues to deal with. (See link to Register essay below.) It is fair and reasonable for government to prohibit discrimination against gay couples and others in the selling of standard goods and services that are offered to the public, like most products retail stores, rooms at hotels and motels, and meals at restaurants. But when the product or services needs to be customized or personalized by the seller, then discrimination by the seller should be allowed, and the buyer should not be able to enlist the force of government to require the seller to provide the product or service. So, for example, cake bakers should required to sell what is what is on their shelves and available for sale without discrimination, but they should not be required to create custom cakes against their will. At the same time buyers are free to choose other sellers and to organize peaceful protests and boycotts against such discriminating sellers. This way, everyone’s liberty is preserved, and no force needs to be used, by government or anyone else.
As readers of this blog may know, I am and atheist libertarian and support gay marriage.
In today’s Des Moines Register, the guest opinion by Kollan Kolthoff was very vague in his call for “common sense reform” of the licensing of cosmetologists. (See link below.) He wrote, “…leaders from within the industry are uniquely aware that there are problems that need to be addressed.” I presume the industry leaders he refers to are existing licensed cosmetologists and licensed schools of cosmetology. After a person has completed the 2,100 required hours of education and paid as much as $20,000, it is very understandable that they would not want to see license requirements significantly lowered – thereby indirectly lowering the value of what they have already paid for. Similarly, licensed schools of cosmetology have a very strong financial incentive to maximize the number or hours of schooling required for a license.
He also wrote Iowa needs reform that, “…protects consumers against the deregulation of licensed beauty professionals.” Deregulation does not and should not mean a lessening of regulation to keep consumers safe. Deregulation should focus on removing regulations that have the primary purpose of protecting the income of existing cosmetologists and schools of cosmetology.
The same issues apply to a large number of occupations that require a license from the state. Most calls for licensing, and opposition to deregulation, come from existing businesses and licensees, not from the general public. Our elective representatives should establish a process to review and reduce licensing requirements in Iowa so that only public safety is is taken into account when requiring Iowans to get a license from the state before being able to work in any particular job.
If President Trump wants Mexico to pay for The Wall, he can not do it by putting a tariff on imports from Mexico to the U.S. A tariff on imports is a tax paid for by U.S. consumers in the form of higher prices. If the tariff stops the imports, it will allow the higher prices to be charged for U.S. made products. It will be a “win” for the company and its workers who get the protection, but it will be paid for by U.S. citizens, not Mexico.
The Des Moines Register recently recently ran an editorial advising us to not buy into the idea that Iowa farmers “feed the world”. As the Register documented, “Only half of one percent of U.S. agricultural exports went to a group of 19 undernourished countries that includes Haiti, Yemen and Ethiopia.” Some farmers and their supporters have a vested interest in making sure that fellow citizens hold them in a special position because they produce the food we eat. They perpetuate that meme in order to get special treatment by our government, for example by not having to either stop or pay for polluting our waters, and by receiving a 60% subsidy on their crop/revenue insurance premiums, among many others.
Every week, most of us buy food from all over the world at our local grocery stores. It may be wonderful to be able to buy local fresh food, but it is not a necessity. International voluntary free trade is what has allowed us, and much of the rest of the world, to avoid starvation when local producers fail for any reason. Farmers should be given no more credit than other producers of all kinds of products. As Adam Smith wrote in 1776 in his book, The Wealth of Nations, “It is not from the benevolence of the butcher, the brewer, or the baker that we expect our dinner, but from their regard to their own interest.”
Link to Register editorial: http://www.desmoinesregister.com/story/opinion/editorials/2016/10/09/editorial-dont-expect-iowa-farmers-feed-world/91735242/
Craig Hill’s editorial explaining the importance of crop insurance to farmers made a lot of sense. (“This much is certain – For farmers, crop insurance is essential” 10/5/2016) Most business and individuals buy insurance to reduce risk, and, as Mr. Hill explained, farmers have plenty of risk. What he did not explain is why taxpayers need to subsidize about 60% of the premium. Contrary to his opinion, it definitely is a handout. Farmers, on average, have much more wealth than the average person. It doesn’t matter that much of the wealth is tied up in land values. Land can be sold for cash just like any other asset. Crop insurance is a good idea, it just should not be subsidized by taxpayers. In the next farm bill, a couple of years from now, we need to eliminate the taxpayer subsidy for crop insurance.
Link to Register article: http://www.desmoinesregister.com/story/opinion/columnists/iowa-view/2016/10/04/much-certain-farmers-crop-insurance-essential/91551614/
Our government, not free market capitalism, is to blame for this situation which has allowed Mylan Pharmaceutical company to jack-up prices for its EpiPen. The FDA is has created a huge delay in approving generic epipens. This has effectively given Mylan a monopoly. Established drug companies should have some type of fast-track authority to manufacture generic products without having to get advance approval from the FDA. Don’t blame private enterprise for problems created by government.