Okay to allow insurance companies to require drug switch.

Today, 3/30/23, the Des Moines Register published an opinion essay by Lynn Rankin. She advocated for a proposed law to restrict insurance companies from requiring patients taking high-cost drugs to try switching to lower-cost drugs that are considered therapeutically equivalent.

 It is very reasonable for both private and government-sponsored healthcare plans to require you to try a lower-cost drug that meets your needs before going to a higher-cost drug.  If you start on a high-cost medication, it seems reasonable to ask you to try a lower-cost drug that has been determined to be therapeutically equivalent.  If you and your doctor don’t want to try a lower-cost drug first, it again is very reasonable to require a prior authorization request that shows evidence why the lower-cost drug should not be tried first. It is also reasonable to charge higher co-pays for higher-cost drugs as an incentive to encourage the use lower cost alternatives.

 It is very easy for doctors to prescribe the newest and most costly drug to treat any illness, especially since patients typically pay out of pocket only very a very small portion of the total cost of the drugs they take.  That is part of the reason why our health insurance costs are so high. If people had to pay the full amount for the drugs they take, they would look for lower cost alternatives on their own.

Time for Iowa to decriminalize marijuana.

Iowa Democrats have introduced a bill in the Iowa Legislature to legalize the sale and possession of marijuana for recreational purposes. The Republican majority says they are not interested in doing this.

Republicans used to be the party of individual liberty. Today, they seem to be the party of religious morality enforcement, wanting to control the peaceful, voluntary activities of adults.

No one is opposed to reasonable regulations to protect the public, such as prohibiting driving while intoxicated and licensing sellers in order to prevent sales to minors and to prevent the sale of adulterated products.

As we saw in the case of alcohol in the 1920s and early 1930s, prohibition creates violence and corruption. The same is true in the case of drug prohibition today. To the extent that the possession and sale of drugs are decriminalized, related violence and corruption will be reduced. Yes, just as with alcohol, some people will be negatively affected by abuse and addiction. But the vast majority of people will be responsible, and their peaceful, voluntary activities should not be criminalized.

It is time for Republicans to help create responsible legislation to legalize the possession and sale of marijuana in Iowa.

Iowa Employers should not get immunity for negligent acts.

Iowa Senate File 167 would expand the ability to work for young Iowans between the ages of 14 and 18. Part of the bill pertains to school work-study programs. One provision reads:

“A business that accepts a secondary student in a work-based learning program shall not be subject to civil liability for any claim for bodily injury to the student or sickness or death by accident of the student arising from the business’s negligent act or omission during the student’s participation in the work-based learning program at the business or worksite.”

I don’t see any good reason to grant this immunity to businesses for their own negligence. Of course, businesses would like this immunity, but what they would like does not make it the right thing to do. This provision should be taken out of the bill.

State of Iowa going too far with school book bans.

In Iowa,  Senate Study Bill 1145 would require the Department of Education to keep a list of all books banned by each and every school district in the State. Then, every school district in the State would be required to get a parent’s permission before granting any student access to any book on that State-wide list. That means any one school district could restrict access to books at every other school district in the State! That is just wrong.

Most Republicans used to be in favor of keeping governance as close to the people as reasonably possible. I guess not anymore. I agree that there are very good and proper reasons for keeping certain books out of schools, but local district school boards are best left to make those decisions, not the State and not some other district school board! In addition to being a bad policy, it would be quite costly for both individual school districts and the State of Iowa to comply with such a law.

Balance needed between religious and civil rights.

The Supreme Court of the U.S. recently heard arguments in a case that weighs anti-discrimination rights against religious rights. The specific question is: Should a Christian web designer who is morally opposed to gay marriage be forced to design a website that celebrates the marriage of a gay couple? Colorado law prohibits discrimination based on sexual orientation by any business that offers its products or services to the public.  The web designer argues that she is not discriminating against the couple, she is discriminating against the website content being proposed.

Even though I am an atheist and support equal rights for all, I look at this as a case where the web designer is in the minority and the gay couple has the vast majority on their side.  I would guess that 90+% of web designers would be very willing and able to design the website for the gay couple.  Additionally, this is not about purchasing a standard product or service – like renting a room, buying something off of a shelf at a store, hiring a taxi,  or buying food in a restaurant.  It is asking a person to use their creative talent to create something that promotes an act that they are morally opposed to.

If we force relatively small minorities of people to act in opposition to their sincerely held religious beliefs, especially when the person who feels discriminated against has many completely voluntary, peaceful alternatives, then we will be putting ourselves in an unnecessary situation where the minority will feel aggrieved and will fight without end.  In a pluralistic society, which is what we have in the U.S.  we should look first to find voluntary, peaceful solutions to our differences.  The force of government should be used only as a last resort when no other reasonable alternatives exist – which is not the case here.

Democracy or Republic?

The title of this blog is also the title of an essay by Walter E. Williams that was published in the June 2007 edition of magazine The Freeman: Ideas on Liberty.

I am about a third of the way through a book by Walter Williams entitled American Contempt for Liberty. It is a compilation of many of his essays. Each essay is only about a couple of pages long. The book is hard to put down. I find myself underlining something on almost every page.

Separately, while organizing my office today I found about 10 photocopies of the essay referred to in the first paragraph. I just reread the essay and understand why I made copies to give out to people who I thought might be interested. It is a concise essay that explains the difference between a democracy and a republic and how clearly our founding fathers wanted to establish a republic and not a democracy. So, below is a link to the relatively short essay. I expect that you will enjoy reading it.

https://fee.org/articles/democracy-or-republic/

Can’t our federal government spend money on anything that promotes the general welfare of citizens?

Here is what one of our founding fathers, James Madison, said about our Constitution and the ‘general welfare’ clause:

“With respect to the two words ‘general welfare’, I have always regarded them as qualified by the detail of powers connected to them. To take them in a literal and unlimited sense would be a metamorphosis of the Constitution into a character which there is a host of proofs was not contemplated by its creators.”

We have gone far outside the Constitution with respect to both corporate/business welfare and social welfare.

As Walter Williams might say, most Americans and politicians have contempt for our Constitution. They very much have violated its clearly written provisions and think that is best. They think we should have a pure democracy where the majority gets whatever they want. (We have a republic with a constitution that protects the rights of minorities.)

If they really think the Constitution is wrong, the proper way to amend it is by getting three-fourths of the State Legislatures to agree. That may be hard. It is intended to limit the power of the federal government and leave other powers to the states or the people. As it should be.

The president has no authority to forgive student loan debt.

By what authority does the President have the power to forgive student loan debt?  Our Constitution grants Congress the power to tax and spend, not the President, and surely the forgiveness of student debt is spending money.  In addition to the President’s action being unconstitutional, forgiving student debt, even for those with incomes below $125,000 per year, will mostly benefit people with above average incomes.  It’s also a slap in the face to those who have already paid off their debt or who saved and never went into debt.  It also sets a terrible precedent.  Students who go into debt in the future will be encouraged to not pay their debt in hopes that it will be forgiven.  Democrats should not feel good about this. At some point in the future there will be a Republican President  who will have the same power. 

Living in a pluralistic country.

The United States of America is a pluralistic, heterogeneous country. Liberals, conservatives, libertarians. Muslims, Christians, atheists. Asians, Blacks, Latinos, Whites. And on and on. It seems that we are getting more tribal – my tribe is good and other tribes are bad. Many media outlets reinforce the idea that those who disagree with us are evil and have bad intentions. We are righteous and our intentions are honorable. We want to save our Country and our opponents want to destroy it. There doesn’t appear to be a path to peace and agreement about how to go forward.

Every group seems to go to our government to lobby for laws and regulations that support their position and/or outlaw contrary positions. Very few seem to care about fundamental, first principles. They just want their side to win. It would be nice if we could agree on fundamental principles and then go forward with laws and regulations that are consistent with those principles.

Living in a free country doesn’t just mean that others should tolerate the things you do that they don’t like. If you truly believe in individual liberty and want to support diversity, equity, and inclusion, then you need to tolerate people who do things you don’t like.

Governor and Legislature wrong to force E15 ethanol-blended gas on Iowans.

The Iowa Legislature has passed, and Governor Reynolds is expected to sign, a bill that will force most gas stations in Iowa to sell E15 – 15% ethanol-blended gasoline. Both Republicans and Democrats should be ashamed of this bill, especially Republicans. Republicans have traditionally said that they support free-market capitalism where consumers and business owners decide what to buy and sell. In addition to being unprincipled, supporters of this bill are wrong on the facts. The Governor said, “It’s a lower cost of fuel.” We know that the price at the pump is lower, but that does not factor in the various subsidies paid by taxpayers to farmers, ethanol producers, and fuel blenders. It also does not factor in the lower miles per gallon that a car gets when ethanol is blended into the gasoline. Taxpayers will also pay for most of the costs to upgrade pumps and other infrastructure needed by the gas stations. I did not read where there is any phase-out of the mandate. The good news is that those who supported the bill can rest assured that they will continue to get financial support from corn farmers and ethanol producers.