How Medicaid and Obamacare Hurt the Poor

By Jim Epstein, ReasonTV

"Most physicians can't afford to accept Medicaid" patients, says Dr. Alieta Eck, a primary-care physician based in Piscataway, New Jersey. "If you're getting paid about $17 per visit, it won't be long before you can't pay your staff or pay your rent."

Medicaid is the nation's health care system for the poor. It's funded jointly by the federal government and the states. Medicaid is either the first- or second-largest budget item in all 50 states and the program is slated for a massive expansion under President Obama's health-care reform law. Despite the program's huge and growing overall cost, reimbursements to medical providers are so low that many practices refuse to accept Medicaid patients, causing long waiting periods for treatment.

Eck and her husband, Dr. John Eck, are the founders of Zarephath Health Center, a free health care clinic in Somerset, New Jersey, where they each volunteers six hours per week taking care of poor patients. While the Ecks don't accept Medicaid in their private practice, some of the patients that show up at their free clinic are Medicaid recipients who can't find a regular doctor.

"The hardest thing for a Medicaid patient to do is get a doctor's appointment," says Avik Roy, who writes a health care blog at Forbes.com and is a senior fellow at the Manhattan Institute. One consequence is that Medicaid recipients show up at emergency rooms at nearly double the rate of the privately insured, often with accute problems that could have been addressed earlier in a doctor's office. They're also more likely than both the privately insured and the uninsured to have late-stage cancer at first diagnosis.

Subsidizing Bad Habits: How SC Pays for Other States

On a share-by-share basis, some donor states such as Texas, Florida, and South Carolina get less than an 85 percent share of the highway money they pay in [to the Federal Highway Trust Fund], while New York, Connecticut, and Massachusetts get more than 100 percent. As bad as this disparity is, the allocation of federal transit spending is even more inequitable. Many highway donor states are also transit donor states, receiving much less for transit projects than they paid into the transit account, while many of the highway done states are also transit donees…

While the diversions focused initially on non-road, transportation-related investments such as urban transit programs, non-transportation projects such as nature trails, museums, flower plantings, metropolitan planning organizations, bicycles, Appalachian regional development programs, parking lots, university research, thousands of earmarks, and historic renovation became eligible over time for financial support from the highway trust fund. As a consequence of this growing number of diversions, as much as 35 percent of federal fuel tax revenues paid by the motorists is spent on projects unrelated to general-purpose roads. ...

It goes without saying that Texans and South Carolinians shouldn't be forced to subsidize bad decision-making in New York and Massachusetts.  Under today's system, those state do.  It is time for that system to end.

Read more in PPF’s report on unleashing the power of

Competitive Federalism.

OpEd: Thatcher was a true leader

The Greenville NewsBy Ellen Weaver
Guest Columnist

A post-Vietnam America adrift in self-doubt; a hostage crisis in Iran; gas lines; stagflation biting at family budgets: This was the weary reality of 1979, the year I was born.

But it also marked the rise of Ronald Reagan, Pope John Paul II and Margaret Thatcher, a generation of world leaders who in the famous words of William F. Buckley dared to “stand athwart history yelling ‘Stop!’”.

And this week, as we commemorate the life and passing of the last of these transformational figures, I stop to consider the personal impact of this lady I never met.

Can Poor Kids Learn?

The answer, based on the evidence garnered from Florida’s transformative education reforms is a resounding “Yes!”   Demographics are not destiny.

No one would deny that there are critical factors of home life – parental education, family structure, poor nutrition and other variables that directly impact the educational readiness of children who enter school.  But far too often, these external factors become an excuse for adults in the education system to dismiss lackluster performance and reinforce what has been correctly called “the soft bigotry of low expectations.”

Empower Education Summit: The Path to Transforming SC's Future

Education transformation is a topic we are incredibly passionate about.  In fact, in 2012, The Palmetto Fort Foundation (the Forum’s precursor) and U.S. Senator Jim DeMint’s office teamed up to host the “Empower Education Reform Summit.”

This event, which was keynoted by former Florida Governor Jeb Bush, attracted elected, education, business and community leaders – and most importantly, parents – from all over the state.  It has played a vital role in expanding the dialogue about how we best serve the diverse educational needs of South Carolina children and prepare them for the workforce of the future.

"Why are Florida schools moving forward and ours falling behind?"

By Tara Servatius
Charleston City Paper

They pack their families like lemmings into 1,400 square-foot houses situated on postage stamps in Mt. Pleasant and tell themselves they are doing it for their kids' education. They pay $150 a month for flood insurance on those homes to attend the highest scoring schools in the region.

Other parents choose the soul-crushing commute route. They move out to the nether regions of Dorchester County and then drive an hour each way to work through rush hour. All this to put their kids in the small handful of Dorchester Two public schools with test scores as high as those at the best public schools in Mt. Pleasant. Day in and day out they grind away, telling themselves they're doing it for their kids' education.

I know, because I am one of those parents.

"The Intellectual Case for Competitive Federalism"

By Veronique de Rugy
The Corner - National Review Online

I have argued for several years that fiscal federalism is bad shape. Economist tend to like federalism because it promotes interstate competition. When states can differentiate themselves on the basis of taxes, spending and regulation, or even social policies,

Americans get more leeway in deciding the rules under which they want to live. If you don’t like the level of taxes or the policies in your state, you can vote with your feet and move to another jurisdiction. In theory, this competition for residents helps keep lawmakers in check, giving them an incentive to keep taxes and other intrusions modest. 

Obamacare's 3rd Anniversary

A new report shows that by 2014, under the Affordable Care Act, unsubsidized individual premiums in South Carolina will skyrocket by 61%!  Thank you @NikkiHaley and South Carolina legislators who are standing strong for state flexibility and innovation by fighting against the legislation’s full implementation.

"Medicaid expansion wrong for SC "

The State
OpEd by Jim DeMint

‘For every problem,” H.L. Mencken wrote, “there is a solution which is simple, clean and wrong.”  Enter Obamacare and one of the main ways that it purports to reduce the number of uninsured: putting more people on Medicaid.

S.C. legislators are being pressured to do just that. The House has rejected the idea, and Gov. Nikki Haley has vowed to veto it, but it’s not dead. And if they ultimately sign on to the idea, they’ll find they’ve made a costly mistake and created a long-term fiscal problem.

"We can learn a lot from Florida"

South Carolina Radio Network
Interview with Superintendent of Education Mick Zais

South Carolina’s education superintendent says he wants this state to be more like Florida when it comes to education.

During an interview on Charleston affiliate WTMA, Superintendent Mick Zais referenced a recent study by the new South Carolina conservative think tank Palmetto Policy Forum, founded by former U.S. Senator Jim DeMint, who is now president of the Heritage Foundation.

“The difference between high poverty kids who are learning and being successful and high poverty schools where kids are not learning anything is not the demographics of the students or the education level of the parents, it’s the competence of the adults in the system,” says Zais.

Press Release: PPF Unveils Groundbreaking K-12 Education Report

Columbia, SC – Today, the newly formed Palmetto Policy Forum announced the release of its inaugural policy paper, Transformation: What South Carolina Can Learn from Florida’s K-12 Reforms.

In 1998, South Carolina students led Florida students in performance on a number of national tests, including the National Assessment of Educational Progress (NAEP), known as “The Nation’s Report Card.”  But over the last decade, Florida far surpassed South Carolina in K-12 education outcomes, most notably among traditionally disadvantaged student populations:

Cheers! The Forum has commenced.

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