Tag Archives: Mike Pence

What Am I Missing?

I have to admit I frequently listen to a political or policy discussion, and have what might be called a “duh” moment–wondering why I see a rather obvious approach that everyone  else is ignoring.

This week, Governor Pence announced that state revenues have fallen below budget estimates for the past few months, and the only remedy is to cut funds to education and state agencies and sell the state airplane. Leaving aside the airplane gesture (a one-time, largely symbolic “sacrifice”) why is the administration focusing on cutting services rather than delaying or foregoing its beloved tax cuts?

There are two ways to handle revenue shortfalls, after all–cut expenses or raise revenue.

Despite the fervent belief that lower taxes stimulate the economy and foster job growth, there isn’t an iota of evidence supporting that belief. Indiana is already one of the lowest-tax states in the Midwest, our economic indicators still lag those of our higher-tax neighbors, and the case for continued tax cuts is thin, to put it mildly. (Indeed, research indicates that quality of life drives economic development; continued service cuts that diminish quality of life indicators–far from stimulating the economy– are probably counterproductive.)

Then there was the research report presented at a recent meeting of the Advisory Board of the Institute for Working Families. The subject was paid sick leave, which relatively few Indiana employers offer. When researchers talked to those who opposed a law requiring a sick-leave benefit, they found that the major objection wasn’t to paid sick leave, it was to the idea of a government mandate. (Don’t tell me how to run my business!!)

If the objection is to the use of a stick, why not offer a carrot? Why not give a tax deduction or other incentive to employers who voluntarily decide to offer paid sick leave? Avoid the mandate, but reward the desired behavior.  Evidently, such an approach hasn’t been considered.

My grandmother used to say there’s more than one way to skin a cat.

What am I missing?

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Our Own Desert Island

Later today–between I:00 and 2:00 pm– there will be a rally at the Indiana Statehouse on behalf of the nearly 400,000 Hoosiers who find themselves marooned on Indiana–the island of the uninsured.

States surrounding us, Republican and Democrat, have opted to take advantage of the new federal incentives and expand Medicaid. Not Indiana. Our Governor has decided that political posturing trumps the health needs of Indiana citizens who work in retail, education, home health, child care and other low-wage jobs without benefits. These are the people who are caught in the middle, who are too poor to use the new exchanges but  too “rich” to qualify for Indiana’s existing medical programs.

It’s pretty obvious that refusing to expand Medicaid effectively screws over these  400,000 Hoosiers. What is less obvious–and even more maddening–is how that refusal screws over the rest of us.

  • If a state expands its Medicaid coverage, the federal government will pay 100% of the costs for the first three years and 90% thereafter. Indiana is forgoing approximately twenty-six billion dollars between now and 2020–dollars that would create an estimated 30,000 sorely needed new jobs in our state.
  • The American Academy of Actuaries says that private insurance costs will rise in non-expansion states like Indiana. Local media has reported that Hoosiers are already seeing rates higher than the rates in states that surround our “island.”
  • The federal money we are turning down would offset expenses for indigent care and prison health care that are currently being covered by Indiana taxpayers.

Medicaid expansion would save money while saving lives and improving the health of our citizens. It would provide access to preventative care to those who are currently uninsured, reducing the tab for healthcare costs overall, including those that we taxpayers are now paying.

I know you’ll all be shocked to discover that Indiana currently ranks near the bottom of all states for most health indicators. In a sane world, we would jump at the opportunity to improve Indiana’s health and its economy.

Governor Pence’s refusal to expand Medicaid has already forced significant layoffs by Indiana hospitals, which have argued forcefully–but thus far unsuccessfully–for expansion. Other states with Republican governors have done the math and decided that the good of their citizens should trump their hatred of the President.

This should be a no-brainer.

I’ll forego the obvious pun.

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When Elected Officials Don’t Get It, We All Pay the Price

Indiana Governor Mike Pence is adamantly opposed to the expansion of Medicaid in Indiana, despite the fact that his opposition will cost Hoosiers a lot of money–not to mention lives.

I have previously explained why our stubborn refusal to participate in this particular aspect of the Affordable Care Act is irresponsible, inhumane and costly.

When Pence announced his negotiated one-year “deal” with the federal government to continue “Healthy Indiana” in lieu of expanding Medicare (a “deal” that leaves some 400,000 Hoosiers without healthcare), he insisted that “Consumer driven healthcare is the path to the future.”

Sorry, Mike–but if that’s the case,  the future is pretty damn bleak.

Here’s the problem: markets work incredibly well when buyers and sellers operate on a level playing field. They work especially well when consumers are looking for widely-available goods and services, and can compare prices and quality and shop around for the best deal. Economists define a market transaction as one involving a willing buyer and willing seller, both of whom are in possession of all relevant information.

That description does not remotely apply to medical care.

The “consumer” who needs a hernia operation is highly unlikely to be in a position to shop around. He’s much more likely to need immediate care, and be locked into using a particular provider by his insurance company. And he is highly unlikely to know as much about the procedure as his doctor.

For that matter, this “consumer transaction” isn’t going to be negotiated by the patient and his doctor. The real parties to this transaction are the doctor and the health insurance company–and as recent news reports have reminded us, the needs of the patient are rarely front and center. (The Star recently reported on a lawsuit brought by the widow of a man who needed a pacemaker–despite the urging of his own doctor and another doctor who was consulted for a required “second opinion,” the insurer delayed its approval, and the man died. The doctor insists that, had his patient had a timely procedure, he’d be alive today.)

There is no market in health care. There never will be. Hernias and heart attacks aren’t widgets and mousetraps; there is not and cannot be a level playing field where consumers have as much information and power as their providers–or where their providers have as much power as the insurers. Other countries have figured that out. And in those other countries, amazing as it may seem, big bad evil government has turned out to be more protective of patient needs than for-profit insurance companies beholden to their shareholders.

To suggest that “consumer-driven” healthcare is the future is to display profound ignorance of market economics.

I think it’s interesting how many “free market” ideologues like our governor have no idea how markets really work.

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Pissing on Democracy

Democratic theory is actually pretty simple; voting is a substitute for physical struggles for power, but it only works when the fight is fair. The loser in any election abides by the decision because the winner abides by the rules.

What we are seeing now is a situation where the losers refuse to play by the rules.

In Washington, the GOP’s antics have been the equivalent of a big “screw you.” The party has said, in effect, “we don’t care that the people voted for this President, despite our best efforts to keep his supporters from the polls. We are taking our ball and bat and going home–we are refusing to play the game.” In this case, of course, the “game” is governing the nation, and their childish behavior has made that nearly impossible.

In Indiana, where the Republicans won almost every office, they are determined to strip the one Democrat who did manage to win office of the authority to do her job.

Most recently, in yet another in a series of power grabs, the State Board of Education voted (8 to 1, with Glenda Ritz being the 1) to authorize Dan Elsener to spend money from the Board’s budget and work with the Governor’s office to hire the Board’s staff. According to several people, despite the fact that the Superintendent has often come from a different political party than the Governor, this is the first time in Indiana history that money budgeted for the State Board will not be controlled by the Department of Education.

As one observer wrote, “Obviously, a State Board with its own staff using a budget of $3,010,716 each year could become a power center independent of the State Superintendent and the Department of Education. Apparently, the Governor has quietly put this seismic shift into motion.”
Ever since the voters elected Glenda Ritz (by a margin exceeding that of Governor Pence, it might be noted), the administration and the Republicans have worked to overturn the results by reducing the powers of the office.

Like the current Superintendent or not, this is most definitely not the way the system is supposed to work. The message being sent is clear: we’ll respect election results and the democratic process when we win.

When we lose, we’ll play dirty.

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Poor Fiscal Management. Again.

Government isn’t a business, but it does have an obligation to conduct its operations in a business-like way.

According to recent news reports, three state agencies — the Department of Natural Resources, the Department of Health and the State Budget Agency — paid more than $130,500 in late fees in fiscal years 2011 and 2012. The payments were uncovered in recently released audits by the Indiana State Board of Accounts.

The penalties were assessed because the agencies failed to pay claims on time. The audit reports say the delays resulted, in “an unnecessary use of state funds.” The reports are just one more bit of embarrassing evidence of this administration’s tenuous grasp on fiscal competence. (Remember that 300 million dollars they “found” awhile back? Or the payments “inadvertently” withheld from local government agencies?)

The report is not just a reminder that our Governor’s much-touted business acumen is mostly hype. It is also a reminder to those of us who vote that the positions politicians are spending millions of dollars to win require not-so-glamorous skills. Running state government requires an understanding of a whole range of management practices, many of which go beyond the skills required by private-sector enterprises: building bridges with fractious legislators, demanding accountability from those you’ve appointed to run departments, an acquaintance with the intricacies of policy formation, and an ability to communicate with citizens.

Campaigns test the ability to connect with enough voters to get elected, but otherwise, require no evidence that a candidate possesses any of these skills, and most have not held previous positions that demanded them. So we get rigid ideologues who–despite their pro-business rhetoric–never met a payroll, never had to build a team from competing factions, never had to be accountable to anyone who didn’t agree with them.

I’ve had my differences with the Daniels Administration, and I’ve aired many of those differences here. But the Governor is pragmatic and intelligent, and has done many things well (been to the BMV lately?? Much improved.)

Mike Pence is a different matter entirely. Pence is running a strategically brilliant campaign for Governor–a campaign intended to “upgrade” the Pence 1.0 version to a kinder, gentler, and infinitely more competent Pence 2.0. His 30-second spots portray someone very different from the culture warrior whose entire focus while in Congress has been on de-funding Planned Parenthood, working with Todd Akin to define “legitimate” rape and outlaw most existing birth control methods, and ensure that GLBT folks remain second-class citizens. Fortunately for women and gays, Pence has been a much more effective Tea Party spokesman than legislator: in his eleven years in Congress, he’s sponsored 63 bills and has been successful in getting exactly none of them passed. Only three ever made it out of committee.

Unfortunately for Pence and the other “true believers” who have come to dominate the GOP, governing involves a lot of non-glamorous, practical tasks where conciliation, an open mind and sound information are required.  Self-righteousness, ostentatious piety and intransigence don’t contribute much to transportation policy or parks maintenance–or to fiscal accountability.