ER Crisis
Emergency rooms are somewhere from 67 to 80 percent over capacity. In part, this is because it's the health care provider of last resort, a place where someone who doesn't have health insurance can get care. A spokesman for the Wisconsin Hospital Association says that "There is an ever-worsening problem with inappropriate use of emergency departments."

St. Joseph Regional Medical Center is planning to impose some fiscal discipline on the situation; people who come in will be asked to have a $150 deposit on hand. Those who don't have the money "will be referred by financial counselors to community programs that help with medical costs." Roughly 60 percent of all ER visits could have been taken care of in cheaper settings.

Other hospitals are looking at instituting this plan.
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No Further Comment Necessary
From the Detroit News and wire reports: Most U.S. public school teachers ... are qualified to do their jobs, according to information that all states submitted to the federal government.

But each state defined teacher qualifications differently. And experts say some state definitions are so broad that virtually all classroom teachers would meet the requirements. That has the potential to mask one of the most troubling problems in American schooling: assigning students to educators who don't fully grasp the subjects they teach, education experts say.
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Here's a Test: Can You Not Lose the Test?
Choice works to advance the quality and cost-effectiveness of everything from vision-correcting laser surgery to groceries. Yet when it comes to K-12 schooling, the establishment reform of choice is not choice, but testing.

You've got to wonder about how effective the test-and-reward approach (embodied by the federal "No Child Left Behind" act) really is. How, for example, can you make use of test results that you don't have? Michigan officials are trying to account for 3,400 student tests believed to be missing.
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No Michigan Money for Kiddie Laptops, But Program Lingers On
Gov. Jennifer Granholm says that Michigan won't be using $22 million to buy laptops for sixth graders. But she hasn't killed the program entirely, saying that it will simply proceed on a slower pace, with only federal money. The proposed cutback is one way to deal with a $900 million budget deficit. The leading proponent of this boondoggle is House Speaker Rick Johnson, a Republican.
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How Effective are Tax Rate Increases? Not as much as you'd think
As one of their advisors, I'm proud to announce that the Illinois Policy Institute has released a new study that offers a dynamic scoring model of the Illinois economy.

What that fancy language means is this: government imposes a tax rate increase. What happens? The tax hike doesn't generate as much money as projected.

The current fiscal year budget was built with the expectation that tax and fee increases would raise another $541 million. Does the state get that much more? No, it collects only $443.91 million more -- or 18 percent less than projected.

Why does this happen? Raising taxes and fees destroys jobs and reduces investment. In other words, tax revenues depend on a strong economy, but tax increases destroy economic life.
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Hell Freezes Over. Or does it? Union concessions in Michigan.
It looks like state workers in Michigan will agree to contract concessions, designed to save the state some money in its current fiscal year. For example, members of the UAW would work 40 hours but get paid for only 38. It's not a total loss, though, for the employees--they get to stash those hours towards vacation or retirement benefits. Think of it as a long-term loan at below-market rates rather than an outright gift.

Give credit to the president of the UAW local, who defended the agreement this way: "You look around the world, and you see very few companies that have not had to do concessions."
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Should I buy from you? Do you live here?
Kwame Kilpatrick, mayor of Detroit, has revised the rules for who gets preference and who doesn't when it comes to city contracts. Tom Walsh applauds Kilpatrick for simplifying the rules. But then he says "If Detroit were widely perceived as a good place to locate corporate headquarters, we wouldn't need to bribe companies with goodies like this."
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Here's One Good Thing About the Budget Crunch in Michigan
The ill-suited fascination with technology may have to wait; a plan to distribute laptop computers to government-school students "is running into trouble because of the state's money woes and emerging opposition from voters and educators."

The Mackinac Center (based in Michigan) argues that the plan, if it goes through, won't improve education.
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Conceal Carry Measure Still Twisting in Wisconsin
Negotiations still continuing over where conceal carry permits in Wisconsin would be able to pack heat. One state senator says "What's terrifying to me is, this could become law. I live in a city where there are thousands and thousands of shots fired every year."

With all due respect ... those shots aren't launched on their own, but by criminals (in most cases). The proposal merely gives law-abiding citizens the right to carry a gun, which they may eventually find useful for self-defense. The rest of the law-abiding population would benefit, too.
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Rx Roulette?
The Washington Post is running a series of articles on the safety of the prescription drug supply chain. Part one discusses the "diverters," or "armies of little-known brokers who illegally gain control of discounted medicines intended for nursing homes, hospices and AIDS clinics." Part 2 explores the lucrative world of (legal) narcotics. Part 3 profiles "rogue Internet pharmacies" and physicians who staff them.

There's more to come. The series shows the futility of government regulation (even as it calls for more). It also (indirectly) is a cautionary tale of proposals to import prescription drugs from price-controlling countries. Just how safe is that going to be, when there's trouble ensuring the safety and efficacy of what's already in-country?
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Rich Dems Subsidize Poor Republicans
That's the argument of Daniel Gross. The northeast U.S is generally Democratic, and sends more money to the U.S. treasury than it gets back. This is due in part to military bases (scattered more in the Sunbelt than in the Northeast) than the giant subsidies given to the agricultural industry (on the Great Plains, and elsewhere). What Gross doesn't note, however, is that the Northeast's higher taxes come largely from progressive tax rates at the federal level, reflecting a philosophy most at home in the Democratic party. In other words, if there's any complaining in the Northeast about "unfair" tax and spending policies, the damage is at least partly self-inflicted.

Gross points out that "11 of the 13 wealthiest states voted for Gore while 15 of the poorest 17 states voted for Bush." So much for the Republicans as the party of the wealthy?
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State Workers Get the Ax in Wisconsin
Corporate America has shed hundreds of thousands of jobs in recent years. Wisconsin state government makes cuts ... a few dozen permanent employees and it makes the Milwaukee Journal-Sentinel.

Wisconsin has been trying to address a $3.2 billion budget deficit, and may need to cut more. Jim Doyle, the state's governor, suggests that 10,000 jobs may be cut over the next 8 years. But nobody knows for sure what the final number will be, because it depends both on negotiations with the union (will they take lower pay raises, or fewer workers?) and on the number of current employees who retire. (Historically, "job cuts" in government mean eliminating vacant positions.)

From 1986 through the 2002-03 fiscal year, the number of state employees has increased from 56,433 to 68,091, or 21 percent.

A human interest angle makes any policy discussion more interesting, so the paper runs this article through the prism of a 46-year old woman who used to teach in the state's prison system. Too bad for her that she lost her job--a blow that makes the job cuts look worse than they really are. (The story doesn't, by contrast, feature any, say, machinists who are out of work because rising taxes caused their employers to leave the state or go out of business.) Don't feel too sorry for the teacher, though; she quickly found work elsewhere.
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Canadian Health Care: No Model for U.S.
On the subject of Canada, Brian Lee Crowley, president of the Atlantic Institute for Market Studies (Halifax, Nova Scotia) tells an audience in Michigan about the Top Ten Things Americans Believe About Canadian Health Care, But Shouldn't.
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Want Drugs? Go to Canada
Maybe it's because Minnesota has Canada on its northern border. Maybe it's because "Minnesota Nice" mixes so well with the mythical vision of Canada as just like the U.S., but only more polite. Maybe it's simply wrong-headed thinking (which it is), but the Pawlenty administration is planning to combine two public policy blunders into one program: negotiate a contract by which state residents may purchase pharmaceutical drugs (error one: get government involved as a "purchasing club" for the public) from Canadian pharmacies (error two: encourage violations of federal law), who sell drugs at discounted prices (error three: depend on price controls, which the Canadian government uses to bring about those attractive prices.)

Today the St. Paul Pioneer Press endorses this trifecta of error.

The paper notes "A poll done this month for the Washington Post and ABC News indicates people want to get out from under the bills for prescription drugs, higher in the United States than elsewhere in the developed world."

True enough, people do "want to get out from under the bills." That doesn't require government action, though. I would like to state help to help me get out from my mortgage bill. By golly, that's just too high, you know? And how about my telephone bill? And while we're at it, my greens fees, too.

Ain't gonna happen--nor should it.

Ah, but prescription drugs, that's different. At least in the political calculus. Why? One, senior citizens use prescription drugs more than other age groups; more importantly, they vote more often, too. Two, health care policy has long been based on the perverse notion that somebody else pays the bills. Through government programs (Medicare, Medicaid) and employer-provided insurance, we've become accustomed to health care as a system by which somebody else pays--actually, pre-pays, for our medical care. So the thought of the consumer actually being involved in a retail transaction involving prescription drugs is just too much for some to take.

But back to the Pioneer-Press. They have one thing right: prescription drug prices are indeed higher in the US than elsewhere. Just so that truth is repeated for the thousandth (or more) time, there's one reason for this: other countries are freeriding off the U.S. It's only because the Americans pays full freight of development that drug companies earn the profits required to engage in the expensive research required to bring a drug to market ($800 million for one drug is a number I commonly read).

(Oh yes, another reason for discontent over drug prices: it's easy to see that the marginal cost of producing another pill is next to nothing, and focus on that. It's harder to remember the upfront costs of developing the chemical combination in that pill.)
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I Hate Spam--and Here's Another Reason
I post a comment about blogger Chip Taylor. Ten minutes later I get what is obviously a piece of spam with the name "C. Taylor" in the column listing the (phony) sender. Someone's busy today.
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Non-Profit Doesn't Mean Starvation Wages
No surprise, I guess, but it bears repeating: just because someone works at a non-profit group doesn't (necessarily) mean that they work for little money. The Philadelphia Enquirer reports that top on-air talent at National Public Radio pull in $100,000 or more a year, and more. Getting into a "I'm more underpaid than thou" debate is silly, of course, but this is something to think about the next time you read about "corporate greed."
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Medicare is a Bunch of Hot Air
Just when you think a government office can't possibly spend more, it does--to encourage more people to sign up for this or that entitlement. You know there's a blimp for Goodyear, Budweiser, and so forth? Now there's even a blimp for Medicare. As Dave Barry would say, I am not making this up. Here is the news. (Thanks to National Review's corner for the tip.)
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You Can't Be Trusted With Your Money, but We Can
Chip Taylor notes two items that affirm (again) the danger of relying on public financing to achieve social goals.

First, opponents of Social Security privatization argue that Joe SixPack can't be trusted to manage his own money; better leave that to the professionals in the public service. Well, various state and local governments have recently taken on a lot of risks in managing retirement accounts for their employees.

Second, tobacco settlement funds were supposed to be a boon to state coffers, or at least a way to recoup (allegedly) lost revenue due to smoking. Guess what? Supply and demand strike again. Smokers are going to the less-taxed cigarettes, meaning that everywhere there are shortfalls in projected tobacco tax money.

And speaking of Social Security, David Hogberg announces his new study on Social Security and union households in Iowa. (Here's a hint: they would come out much better with private investments rather than political promises, which are the foundation of Social Security.)
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Economics 101: Supply, Demand, Parking Lots and Football Games
Few things illustrate the laws of supply and demand than the parking fees of lots near popular stadiums and arenas. Park all day in the Chicago loop, and you may be looking at $25. Park all day in Lincoln, Nebraska, and you may pay $5. Last Friday evening, I paid $10 to park 5 blocks away from an arena for a concert, even though during the week the same amount of time may have set me back $4. Did it bother me? No. It's just economics.

Apparently, Econ 101 has not made it to the officials of Detroit, (yeah, no kidding--look at the decline of that once-great city). Members of the political and football going class alike are shocked, shocked that parking rates increase during Detroit Lions football games. And they think that city government ought to do something about it.

This desire to impose at price controls, of course, is not limited to urban parking lots. We see it in health care delivery, telecom regulation, and any number of policy areas. Most famously, of course, we saw it in the long queues for gas during the 1970s. Supply and demand have got to be respected, one way or the other.
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States Want Guaranteed Money, not Flexibility
No great surprises here, but Stateline.org reports that proposals from the Bush Administration to give states block grants--fixed sums in exchange for increased flexibility--aren't being warmly received by the nation's governors.

Robert Rector, policy expert with The Heritage Foundation, endorses some kind of control, saying "The worst possible situation you could have is one group of politicians spending money raised by another group of politicians. It's a recipe for non-accountability."

Perhaps the best example of how inter-government funds can lead to trouble is the Medicaid. This federal-state program medical program for the poor is a mess for everyone concerned--patients, medical professionals, and state budgets. Thanks to matching funds from Washington, states have an incentive to expand Medicaid in flush times (earning political points from activist groups). But when states need to cut back in hard times, they get hammered by the federal match: cutting $1 in state funds eliminates another $1 (in federal funds), making the total cuts $2. The result? Twice the political opposition for the same fiscal discipline.

Overall, the Bush proposal is a sound one (though the better way would be simply to eliminate many of these programs altogether). But if there's one thing state officials want more than flexibility, it's guaranteed money. And the block grant proposal all but guarantees no new money.
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