Pay gap between men and women does not need further regulation or legislation.

According to an article in the Des Moines Register, The American Association of University Women (AAUW) issued their annual report on the “pay gap” between women and men.  According to the report, women in Iowa earn about $10,000 less per year than men. This article, and the related report, are excellent examples of misuse of meaningless statistics.  (See link below.)   Comparing the median pay for all women with the median pay for all men tells us nothing about whether or not sex discrimination is taking place. A valid analysis would compare the pay of women and men who do the same work for the same employer.  The report by the AAUW did not do that.
This report tells us more about the bias of the AAUW than it does about bias in the workplace.  As you reported, Kim Churches, chief executive officer of AAUW, said, “It’s unacceptable. There is no gender differentiation when it comes to quality, skills, and talent.  It’s time to close this gap and give every woman in Iowa and across the country the salaries they deserve.”  She advocated for more regulation.
Based on the facts given in the article, and assuming that women and men can and do perform equally, then it is fair to presume that the AAUW would agree that if any woman wants to earn the same pay as a man, then they should go for the same jobs that men go for.   When the relevant qualifications, working conditions, and job duties are accounted for, the difference in pay between women and men reduces dramatically.  The pay gap has been reducing for years.  Our current laws are working.  We don’t need to add more regulations.

Link to AAUW report: https://www.aauw.org/aauw_check/pdf_download/show_pdf.php?file=The_Simple_Truth

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How to slow the growth of health care costs.

Thanks to Susan Voss for her thoughtful essay about the complexities of our health care system, and how difficult it is to reduce costs. (See link to Register essay below.)   I don’t claim to have “the answer”, but I do suggest that the following cost saving ideas be given serious consideration.

  • Medicare, Medicaid and private insurance should not be required to cover every new drug, product, or procedure that is approved by the FDA. Some are very high cost but provide only marginal improvement over alternatives that cost much less.  Also, at least some covered products and procedures would likely be considered not medically necessary by most people.
  • Consider shortening the amount of time that government grants a monopoly for patents.  Patents are not natural property: humans have copied one another since the beginning of time.  Our U.S. Constitution allows patents to be granted to encourage inventiveness, but there is no objective reason why a patent must be granted for 20 years. Why won’t five or ten years work?  Maybe the length of the patent should be based on the cost to develop the patented item and whether or not government funds were used to help develop the item.
  • Don’t require limits on out-of-pocket payments such as co-payments, especially for very high cost items.  A person should have “skin-in-the-game” if they expect their insurance to cover very high cost items.  Today, we see the opposite: drug companies offer to help pay people’s out-of-pocket costs so there won’t be so much political pressure on them to lower their prices.
  • Allow both pharmacies and individuals to purchase drugs from sellers in other countries that are “deemed” to have sufficient safety procedures in place.  If drug companies are free to charge lower prices in other countries, then pharmacies and individuals should be free to purchase the drugs from those other countries.
  • Allow Medicare and Medicaid to negotiate with drug companies on prices they pay for the drugs that are covered by the programs.  Right along with that, Medicare and Medicaid should be allowed to develop formularies (lists of drugs that are preferred over other therapeutically similar drugs), that give beneficiaries a financial incentive to use the preferred drugs and a penalty for using higher cost drugs.

Our health care wants are unlimited.  Our ability to pay is not.  We, as citizens, should not expect private insurance or our government health care programs to cover everything, regardless of cost.  We should expect our government to NOT do things that increase costs, or reduce our choices.

Link to Register essay:  https://www.desmoinesregister.com/story/opinion/columnists/iowa-view/2018/09/19/dont-fooled-when-someone-claims-have-answer-soaring-health-care-costs/1355890002/

 

Free Iowa Car Dealers!

 

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.

Link ro Register article:  https://www.desmoinesregister.com/story/money/business/2018/02/07/its-illegal-buy-car-rv-sunday-iowa-new-law-might-change/315016002/

Is our government responsible for the opioid crisis?

The Des Moines Register recently reported that 36 Iowa counties have joined in a law suit against opioid makers.  (See link to Register article below.)  Two law firms are enlisting counties across the country to go after drug manufacturers and others for the costs of the opioid crisis.  There is no cost to the counties.  If successful, the “Lawyers will  be awarded a portion of the settlement, …”  (Interesting that the word “settlement” is used instead of “judgment”.)

What is often missing in much of the opioid crisis discussion is how our government’s policy of prohibition has made a bad situation even worse.  When a person becomes physically addicted to opioids, they will do almost anything to get the drugs they want.  If the drugs are not available legally, or if legal drugs cost too much, addicts will find illegal alternatives. According to the CDC, 60% of opioid deaths do not involve prescription opioids.  That is, in 60% of opioid deaths the person who died was using illegal opioids.  (See CDC reference below.)  A significant problem with illegal drugs is that is no way to assure the quality and potency of the drugs.  In the case of opioids, that leads to inadvertent over-doses because the illegal drug was much more powerful than thought.

If opioid addicts were able to readily get prescription methadone or other FDA approved opioids at reasonable costs, many deaths would be prevented.  That would also take the profit out of the illegal opioid drug trade.  If opioid addicts were treated under a medical model rather than a criminal model, it is likely that more opioid addicts would seek help to solve their addiction problem.  But as it is, under our drug war, prohibition policy, addicts have good reason to not seek help.

CDC reference: https://www.cdc.gov/drugoverdose/data/overdose.html

Link to Register article: https://www.desmoinesregister.com/story/news/crime-and-courts/2018/01/05/iowa-counties-file-lawsuits-against-opioid-manufacturers/1008522001/

Many Iowa licenses protect existing businesses more than public safety

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.

Some of the rich are getting poorer, and some of the poor are getting richer.

The Des Moines Sunday Register published a lead article (Page 1) titled, “The rich keep getting richer”.  (See link below.)  Included were a number of misleading statistics or misleading conclusions based on the statistics.  For example, according the think tank, Iowa Policy Project, the median hourly wage in 2016 was $16.04 per hour.  37 years ago, the average wage, adjusted for inflation, which is fair, was $15.91.  The Register concluded, “This means a typical wage earner  working 40 hours per week for a full year would have seen a real increase of $270.40 over a 37 year span.”  While the statistics are technically true, you cannot logically conclude and that any specific person or group of people did not move themselves from a lower wage to a significantly higher wage.  I’m sure it is true some people moved down while some people moved up.  An interesting study would be to see how wages correlate to the number of years in the employment market.  It would be interesting to know the median starting hourly rate for a young inexperienced worker versus and an experienced worker who has been in the labor market to 30 years.  The fact that the average stays about the same my be a problem, but almost no one stays at the average wage for 37 years.

Another statistic was that the number of people who earned $1 million or more during specific years increased from 5,031 in 2010 to 8,325 in 2015.  Their “slice” of the state’s total adjusted gross income grew 37%.  Meanwhile, the number of Iowans claiming gross incomes of $40,000 to $99,999 climbed by 23%  while their slice of the state’s total adjusted gross income fell 2%.  First, I would venture to guess that a significant majority of the $1 million+ earners are people who sold their businesses or had other one-time income.  So, again,there is no logical reason to presume that the $1 million+ club is made up of the same people year-after-year.  At the same time, from 2010 to 2015 the Iowa economy was generally continuing to improve, so values and prices of businesses likely climbed.  Also, in the case of an “expanding pie”, the fact that any group gets a smaller percentage of the total does not mean that their real income is not increasing.

Finally, the Register reported that their analysis of U.S. Census data showed that the bottom fifth of earners saw practically no growth in household income – going from $13,798 in 2006 to $13,848 in 2016, again adjusted for inflation.  Here again, there is no logical reason to believe that the specific group of people who were in the bottom 20% in 2006 are the same people who were in the bottom 20% 10 years later.  It would be interesting to know what percent of the people in the bottom 20% in 2006 were still in the bottom 20% 10 years later.   My guess is there would be some, but not a majority.

As a society we need to make sure we don’t put hurdles in front of people who are trying to improve their lot in life.  In many cases this means removing government created regulatory barriers to entry into certain jobs.  The Register has done very good work exposing job licensing regulations that are in place more to protect existing businesses from competition and to protect the profits of licensing education businesses, than to protect the public.  Yet, the Iowa Legislature has done precious little to address this real problem for low income workers who are trying to work their way up in our economy.

Link to Register article:  https://www.desmoinesregister.com/story/money/business/2017/11/25/most-iowa-wages-have-stagnated-but-rich-keep-getting-richer/818770001/

 

Wellmark right to disclose cost of anonymous patient

The Des Moines Register recently reported that Wellmark Blue Cross Blue Shield has been accused of violating federal HIPAA privacy regulations in the case of a patient with severe hemophilia.  (See link to Register article below.)  As reported, a representative of Wellmark was discussing the high cost of health insurance at a Rotary Club meeting last March.  She gave an example of an extreme case that was costing $1 million per month.  (ACA – Obamacare – prohibits insurance companies from placing any limit on the amount it will pay for patients.)  She did not identify the patient by name, but described him as a 17 year old male with hemophilia.  Maybe she should not have mentioned the age or sex of the patient, but that information alone did not identify who the specific patient was, and should not be considered a violation of federal privacy regulations.

Wellmark and other insurance companies must be able to cite specific high cost cases that are causing health insurance premiums to rise to unaffordable amounts.  How can we openly debate ways to contain health care costs if we don’t know what is causing the high costs?  Can we really afford to require insurance companies to pay out unlimited amounts for any patient?  I recently heard that the last remaining company to offer individual health insurance policies in Iowa may charge more than $30,000 per year next year for a couple who are 55 years old.  Health care wants are unlimited.  Our ability to pay is not.  We need to debate whether or not government should prohibit health insurance policies from having limits on how much they pay out for individual patients.

Link to Register article: http://www.desmoinesregister.com/story/news/health/2017/08/21/wellmark-accused-violating-privacy-iowa-teen-severe-hemophilia-reportedly-costing-1-million-month/586702001/