Link to AAUW report: https://www.aauw.org/aauw_check/pdf_download/show_pdf.php?file=The_Simple_Truth
I appreciate the good intentions of farm owners Maggie McQuown and Steve Turman who are making good effort to conserve their farmland and our environment. In their Iowa View essay published in the Des Moines Register they wrote, “… transitioning farm practices takes time to understand and accept, and requires resources to implement. ” They urged Congress to renew and increase funding for the Conservation Stewardship Program (CSP) as part of the Farm Bill. CSP pays farmers to implement conservation practices. They implied that their farm operator might not continue conservation practices if he loses his CSP payments. (See link to Iowa View essay below.)
The problem with CSP, which started in 2004, is that it is not a transitional program. It doesn’t create any permanent solution. It creates dependency. Conservation efforts continue only so long as payments continue. If we stop paying the subsidies the conservation stops. We need to use both “the carrot and the stick.” Maybe now is the time to start penalizing farmers who pollute our water and air – just like we do to every other business.
Recently, candidates for office in Iowa have been asked to promise future Iowa public employees that they will make no changes to the Iowa Public Employment Retirement System (IPERS) retirement plan. Instead, politicians need to state clearly that they make no promises to future employees about their retirement benefits. The fact that IPERS is currently underfunded by about $7 billion shows clearly that we already have over-promised benefits when compared to what we expected taxpayers and public employees to pay.
(When government has a defined benefit plan, the participants seem to think that any over-funding is their asset, but any under-funding is a liability of the taxpayers. In the past, when IPERS was over-funded, benefits were increased!)
The way to make sure that we don’t make retirement benefit promises that turn out to be more expensive than we expect to pay is to put new government employees on a defined contribution retirement plan – just like most employees in the private sector. This will cause the unfunded liability to come due over the next 50+ years, but at least it won’t get worse.
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.
Joel Kurtinitis had an opinion printed in the Des Moines Register on 3/25/18 (see link below) wherein he wrote that a fetus should be protected against abortion as soon as a heartbeat can be detected (around 6 weeks into pregnancy). He and other millennials may not have been exposed to the philosophical argument in favor of a woman’s right to choose abortion up to the time that a fetus is viable. A fetus is viable when it is able to live outside of the mother’s womb, either with or without assistance (usually around 24 week into pregnancy). A classical libertarian philosophical position is that every person has the right to use and control his or her own body as they wish as long as they don’t infringe on other people’s right to do the same. In the case of abortion, this means that neither the fetus nor anyone else, has the right to force the mother to carry the fetus inside her body. If the fetus is not viable, then the mother should be free to abort it. If the fetus is viable, then the mother should take reasonable care to not harm the fetus during delivery.
Link to Kurtinitis’ opinion in The Des Moines Register: https://www.desmoinesregister.com/story/opinion/columnists/iowa-view/2018/03/22/heartbeat-bill-abortion-millennials-iowa-legislature/449965002/