American Elephants


The Trump Administration is Reforming Medicare with Competition and Common Sense. by The Elephant's Child

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President Trump has approved a new medicare rule to reduce prescription drug prices through competition. U.S. Health and Human Services Secretary Alex Azar explained to reporters on Saturday. Few people know that America leads the world in encouraging doctors and patients to use low-cost, high-value generic drugs. More than four-fifths of all prescriptions in the U.S. are for unbranded, off-patent generic drugs that cost less than a typical bottle of mineral water. A tremendous help for people with ordinary medical issues like high blood pressure, early-stage diabetes, and high cholesterol.

The cost problem is the high cost of branded, on-patent prescription drugs. Pharmaceutical companies take advantage of their market power to charge unreasonably high prices unrelated to the true clinical and economic value of the underlying medicine. The way Medicare — with four different insurance programs with different premiums and copays—covers different kinds of prescription drugs. Medicare Part A covers hospital stays, including the drugs administered there. Medicare Part B, covers drugs administers in doctors” offices such as intravenous infusion. Medicare C, “Medicare Advantage”, is a new, popular, privately-administered Medicare program that covers the same services and Parts A and B. The Bush administration created a 4th Medicare program to cover retail prescription drugs from your pharmacy.

Part D has done a great job of helping competition among private insurers and drug companies to bring lower prices, and the program has come in way under budget. A novelty in U.S. history. However Medicare’s design puts a ceiling on competition because it prevents competition among retail drugs and those administered in doctors offices and hospitals.

A number of expensive drugs for rheumatoid arthritis are administered in doctors offices under Medicare Part B. Doctors get a 6% commission on the average selling price of prescription drugs they administer in their offices, which means a big incentive for doctors to steer patients to these drugs. A new generation of treatments for rheumatoid arthritis are oral drugs financed through Medicare Part D. Because the different Medicare programs operate separately, seniors don’t get the benefit from competition between the new oral drugs and the older drugs covered by Part B.

The new rule allows Medicare Advantage plans to use “step therapy” under which seniors might start with an oral drug paid for by Part D, if it’s of equal clinical value but lower cost, and then step to a more expensive injectable drug if the first medicine fails to work. Insurers would be required to return at least half of the savings to seniors, possibly in the form of those Visa gift cards often sold in grocery stores and pharmacies.

This gives Medicare Advantage plans the tools to get a better deal for patients. Competition works. This is free market capitalism at its best.

There are two short books that I recommend highly, by Philip K. Howard: The Death of Common Sense and The Lost Art of Drawing the Line. He explains how government rule books (law) dictate results that never make sense. Government, with the best of intentions, hands out new legal rights that screw up something else. Intending to be fair, in the name of individual rights, Americans end up losing much of their freedom. Brilliant books that help in understanding why free market capitalism brings prosperity that simply eludes the control freaks of the world.

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More Good News Is Coming Our Way! Maybe. by The Elephant's Child

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Fabulous news, maybe. The Daily Caller reports that “the Trump administration is preparing to repeal an Obama-era rule effectively outlawing a wide swath of popular lightbulbs, the Washington Post reported Wednesday”

The Department of Energy is ready to scrap a rule broadening the number of lightbulbs that must meet strict energy efficiency standards set to take effect in 2020, according to a document the agency published on its website. The document was later removed from the site, WaPo noted.

Former President Barack Obama’s DOE expanded the class of bulbs covered by a 2007 lightbulb ban to include bug lights, three-way bulbs, “rough service lamps,” and some decorative bulbs, such as globe-shaped bulbs. Obama’s decision came in January 2017 and roped in bulbs that had previously been exempt from the ban.

Obama officials argued the expansion was needed because consumers might use the unregulated bulbs to replace regulated ones. “DOE expects these sales will likely increase since these lamps could be used as replacements for other regulated lamp types,” the law notes. The Trump administration is clamming up about the change.

The administration is clamming up because they don’t discuss rule-making while they are in the middle of making rules, they’ve got enough arguments as it is, and they don’t need the public involved at this stage.

I don’t know about you, but I want my 100-watt incandescent lightbulbs back. The worst current shopping experience of all time is standing in front of the display of lightbulbs at Home Depot and trying to figure out what to buy that will not prove unsatisfactory. Everything seems to take a different kind of lightbulb because everyone is trying to save energy because? They had some nutty idea (actually the big lighting companies wanted to buy cheaper bulbs from China I think) about decreasing carbon emissions. The emissions are carbon dioxide (not carbon which is a solid) which is a benign gas that we exhale every time we breathe. Plants take in the CO² which they use as fertilizer, which is greening the world and releasing oxygen which we breathe. So they had force us to use twisty lightbulbs because global warming, although the science is quite clear.

During 2017, there were 150 graphs from 122 scientific papers published in peer-reviewed journals indicating modern temperatures are not unprecedented, unusual, or hockey-stick-shaped — nor do they fall outside the range of natural variability.  We are a little over halfway through 2018 and already  108 graphs from 89 scientific papers undermine claims that modern era warming is climatically unusual.

The belief in unprecedented global warming is important to Democrats, because it is their chosen weapon to destroy capitalism, which they don’t like, though it provides them with all the life enhancements they depend on. They refer to conservatives as “Deniers” meaning that we deny that the climate is changing, which is nonsense. The climate is always changing. Europe is currently sweltering under “unprecedented” hot weather, which we normally call “summer” and which will end sometime in late September or early October, which we call “fall.”

The Daily Caller added:”Advocates of the phase-out bans believe the regulations will increase efficiency, reduce carbon emissions, and lead to greater technological innovation.” That summarizes the problem at the lighting aisle in Home Depot fairly well.



It Was Last Week, But I Thought This Was Funny and Accurate by The Elephant's Child

I don’t know where this came from, I copied it down because it made me laugh. Apologies to the author, and appreciation.



Things Are Just Getting Better and Better by The Elephant's Child

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It wasn’t too long ago that President Obama was saying that manufacturing wasn’t coming back, and there was little hope of getting the economy above 2% growth, times were just different. now. At least that’s how I remember it.

The second quarter GDP came in last Friday at 4.1%, evidence of a steady revitalized economy. The manufacturing sector added 37,000 jobs and has added 327,000 over the last 12 months. That was the highest total 12 month record since April 1995. President Trump said during the campaign that he would “restore manufacturing in the United States.” The number of manufacturing jobs is not yet up to the sectors peak in the late 1970s, but it’s unclear if automation is reducing the numbers needed.

The Labor Department’s Bureau of Labor Statistics says a record 155,965,000 people were employed in July, the 11th record-breaker since Trump took office 19 months ago. Over the year, average hourly earnings have increased by 2,7 percent.

That’s a lot of numbers that don’t mean much to most people, but when you have a new higher-paying job, or a raise, and it starts appearing in your paycheck, it’s very nice. Democrats complain bitterly about tax cuts, Nancy Pelosi announced that the first thing the Democrats would do when they get back in power, would be to do away with Trump’s “tax cuts for the rich.” Which is the usual party line for them, but someone who pays a huge amount in taxes gets a bigger amount of money back than does the person who pays only modest taxes. It’s based on percentages. When a business gets a tax cut and keeps more of their own money, they can hire, add facilities, start new divisions and do more to earn more—which ends up in workers’ paychecks.

Lefties are hung up on the idea of making everybody equal, except for themselves, of course, because you need somebody to run things. The Right wants to give everybody the opportunity to make the best of themselves that they are able to do.

“The left objects to “things as they are”and wants things to be “as they might be. That was the Obama’s way of putting it. But what they mean  is the perennial Left’s concept . They don’t like human beings as they are  and want to “fix” them—humanity needs to be fixed so they are more egalitarian, nice, and don’t disagree with the Left.” A quotation I copied down, but forgot to note who I was quoting.



An “Oldie” Worth Remembering by The Elephant's Child

As long as I’m doing Constitutions and what people believe, here is an oldie but goodie, with the late Milton Friedman explaining the most basic facts of Capitalism to Phil Donahue, who, of course, doesn’t get it at all. Always worth a refresher on what is important.

I particularly like John Steele Gordon’s  An Empire of Wealth: The Epic History of American Economic Power, which beautifully describes how Capitalism and a free people who can act on their ideas and dreams have brought forth a powerful and wealthy nation that is the envy of the world.



What Rights Does the First Amendment Protect? by The Elephant's Child

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According to Campus Reform, the Freedom Forum Institute’s annual “State of the First Amendment” survey has found that while 74 percent of Americans say they support the First Amendment, nearly half could not identify a single one of the rights that it protects.

Meanwhile, roughly half of those surveyed said public universities should be able to disinvite “controversial” speakers, such as those who are likely to provoke protests or cause offense to certain groups or individuals.

According to the report, 56 percent of respondents recalled that the First Amendment guarantees freedom of speech, 15 percent mentioned freedom of religion, 13 percent remembered freedom of the press, 12 percent noted the right to assembly, and just 2 percent cited the right to petition.

Meanwhile, nine percent erroneously asserted that the First Amendment protects the right to bear arms, a freedom that is actually guaranteed by the Second Amendment.

In the interests of making sure you all have the facts and if you have kids, making sure they do too, Here is the First Amendment:

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press, or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

The amendment is about what the government may not do, not about what you may or may not do. Doesn’t mean that people cannot insult you or criticize what you say or cast aspersions on your religion. It’s there to protect you from an overreaching government.  Though if the country gets so far gone that Congress is completely ignoring the Constitution, all bets are off.

You might try to memorize it, and have your kids memorize it. It is our greatest protection from tyranny and as long as people know what it says and what it is about, we’ll probably be all right. But the numbers of people without a clue is discouraging.

If you are interested, you can get nice little bound copies of the Constitution, about 3½” x 5″, from the Cato Institute by calling 800-767-1241 (8:30am to 4;30 pm EST) They are inexpensive, but my copy is years old, and prices have probably gone up.  (It also includes the Declaration and a preface about the history)

Nice little gift for new grads or kids leaving for college. The way things are going they probably would not encounter it there.



Democracy Is Government by Amateurs by The Elephant's Child

From Daniel Boorstin’s Hidden History: Exploring our Secret Past

Aristocracies are governed by people born to govern, totalitarian societies by people who make ruling their profession. But our representative government must be led by people never born to govern, temporarily drawn from the community, and sooner or later sent back home. Democracy is government by amateurs. The progress—perhaps even the survival—of our society depends on the vitality of the amateur spirit in the United States today and tomorrow.

The two new breeds whose power and prestige menace the amateur spirit are the professionals and the bureaucrats, Both ae by-products of American wealth, American progress. But they can stifle the amateur spirit on which the special quality and vision of our American leaders must depend.

First, the professionals. Professions, as we know them, are a modern phenomenon. The word “profession,” when it first came into the English language, meant the vows taken by members of the clergy. By the  sixteenth century professions included other vocations in which “a professed knowledge of some department of learning or science is used in its application to the affairs of others.

He goes on to write about the modern expansion of professions to an endless list. He adds that business has become a profession. In the 18th century, a man who was engaged in public affairs was described as a “man of business.” And today the increasing vogue of the M.B.A. suggests the end of the amateur spirit. Today in the professional organization there is an unspoken article of faith: The profession really exists for the benefit of the professionals. The law exists for the sake of lawyers, medicine for the convenience, maintenance and enlightenment of doctors, and universities for the sake of professors. That’s true enough. There are houses designed to provide plans and photographs for architectural journals.  And his theme would suggest further that the reportage of politics today is designed to win the accolades of their fellow journalists, which sounds about right.

The increasing size and reach of government has meant the rise of the bureaucrat. The professional government worker. The theory of the founders was surely that our senators and congressmen were supposed to be amateurspeople who came from the people and returns and lets someone else have a turn. Today our congresspeople become professional bureaucrats and look for the approval of their major financial supporters rather than to the concerns of the folks back home. That’s partly our fault. We are reluctant to choose an amateur, and prefer someone who has experience in government preferably as a governor, or a doctor—we trust doctors. But once elected, they become professional congresspeople. It’s helpful when they know their way around and can become effective, but sometimes they just settle in and become bureaucrats, more interested in maintaining the bureaucracy.

It would be easy to think of Donald Trump as an amateur, but he is a man of vast experience with business and with government, just not in government. On the Left, most potential candidates are old, tired politicians, and some very political businessmen are toying with the idea of running. Can we really return to the idea of a representative government run by amateurs?




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