Dr. Rand Paul Unveils Obamacare Replacement Act

WASHINGTON, D.C. – U.S. Senator and physician Rand Paul introduced S. 222, the Obamacare Replacement Act, to provide Congress with a health care plan grounded in broadly supported conservative reforms that is ready for an immediate vote after Obamacare is repealed. Dr. Paul’s proposal would expand access to higher-quality, lower-cost health care for more Americans, regardless of medical history.   

“Getting government out of the American people’s way and putting them back in charge of their own health care decisions will deliver a strong, efficient system that doesn’t force them to empty out their pockets to cover their medical bills,” said Dr. Paul. “There is no excuse for waiting to craft an alternative until after we repeal Obamacare, and the Obamacare Replacement Act charts a new path forward that will insure the most people possible at the lowest price.”  

The Obamacare Replacement Act empowers the American people to: 1.) Choose inexpensive insurance free of government dictates; 2.) Save unlimited amounts in a health savings account (HSA) and have wider options for using those funds; 3.) Buy insurance across state lines; and 4.) Join together in voluntary associations to gain the leverage of being part of a large insurance pool. 

Dr. Paul has led the charge to replace Obamacare at the same time it is repealed, and he has been joined in calling for simultaneous action by fellow Republicans including President Trump and Speaker of the House Paul Ryan. 

You can see Dr. Paul’s entire plan laid out section by section HERE, and you can find summary information below. 

Dr. Rand Paul’s Obamacare Replacement Act, S. 222:

Legalizes Inexpensive Insurance Plans:

• Ensures that Americans can purchase the health insurance coverage that best fits their needs.
• Eliminates Obamacare’s essential health benefits requirement, along with other restrictive coverage and plan requirements, to once again make low-cost insurance options available to American consumers.

Protects Individuals with Pre-Existing Conditions:

• Provides a two-year open-enrollment period under which individuals with pre-existing conditions can obtain coverage.
• Restores HIPAA pre-existing conditions protections. Prior to Obamacare, HIPAA guaranteed that those in the group market could obtain continuous health coverage regardless of preexisting conditions. 

Helps More People Save To Buy Health Insurance and Cover Medical Costs:

• Incentivizes savings by authorizing a tax credit (up to $5,000 per taxpayer) for individuals and families that contribute to HSAs.
• Removes the annual cap on HSAs so individuals can make unlimited contributions.
• Allows HSA funds to be used to purchase insurance, cover premiums, and more easily afford a broader range of health-related expenses, including prescription and OTC drugs, dietary supplements, nutrition and physical exercise expenses, and direct primary care, among others. 

Guarantees Fair Tax Treatment of Health Insurance:

• Equalizes the tax treatment of the purchase of health insurance for individuals and employers by allowing individuals to deduct the cost of their health insurance from their income and payroll taxes.
• Frees more Americans to purchase and maintain insurance apart from their work status.
• Does not interfere with employer-provided coverage for Americans who prefer those plans.

Helps Individuals Join Together to Purchase Insurance:

• Expands Association Health Plans (AHPs) to allow small business owners and individuals to band together across state lines through their membership in a trade or professional association to purchase health coverage for their families and employees at a lower cost.
• Also allows individuals to pool together through any organization to purchase insurance.
• Widens access to the group market and spreads out the risk, enhancing the ability of individuals and small businesses to decrease costs, increase administrative efficiencies, and further protect those with pre-existing conditions.

Allows the Purchase of Insurance Across State Lines:

• Creates an interstate market that allows insurers who are licensed to sell policies in one state to offer them to residents of any other state.

Increases State Medicaid Flexibility:

• Enables states to fully exercise current flexibilities afforded to them through Medicaid waivers for creating innovative state plan designs. 

Empowers Physicians:

• Allows non-economically aligned physicians to negotiate for higher quality health care for their patients.
• Amends the Internal Revenue Code to allow a physician a tax deduction equal to the amount such physician would otherwise charge for charity medical care or uncompensated care due to bad debt, limited to 10% of a physician’s gross income for the taxable year.

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5 Smarter Ways to Keep Your Home Warm

(Family Features) When cool winds are blowing and the temperatures outside take a dive, even a well-insulated house may feel the chill. Simply kicking up the thermostat can be expensive and depending on your home’s circulation, you may still have areas that need an extra blast of warmth. Cozy up with these tips for heating up your living space.

Check for gaps and cracks. Poorly sealed windows and doors are among the biggest sources of heat loss in a home. Not only do those imperfections let heat escape, they also let in the cold. If you can see daylight, there’s definitely a problem, but even less visible gaps and cracks can be problematic. Clear plastic sheeting is one temporary DIY solution for windows. It’s also easy to replace the weather stripping around doors.

Rely on supplemental heat. When it’s impractical to completely eliminate drafts, or other measures aren’t fully correcting the problem, you might consider a home upgrade to your cooling and heating system. One of the most efficient products on the market is a floor-mounted indoor heating system from Mitsubishi Electric Cooling & Heating. The M-Series KJ model has built-in heating technology, which is designed to ensure the whole room warms up evenly and quickly. The cooler months are notorious for a spike in energy bills because of heating needs, but the KJ model is more efficient than its competitors, can help you stay comfortable and save money too. The flexible system also allows homeowners to adjust up to five fan speeds and set a weekly timer.

Layer up. Especially when cooler weather first appears or makes a comeback, many homeowners forget to dress for the weather, even indoors. Trading in your t-shirt and shorts for long sleeves and pants can help push your comfort several degrees warmer, and even a couple of degrees can result in big savings on your heating bill. If extra clothes aren’t enough, invest in a few plush throw blankets and a cozy robe and slippers for more comfortable lounging.


Enjoy a crackling fire. If your home has a fireplace, use it. These features are often treated as ornamental, but they serve a true function. When paired with blowers, the heat from a fireplace can warm a significant portion of the house, well beyond the room where the fireplace is located. Before your first fire, take proper safety precautions, including checking that the flue is clean and open. Also be sure you have protective features such as glass or mesh covering to prevent popping embers, and be sure to create a barrier that keeps small children safely out of reach.

Decorate your way to warmth. Subtle changes to your decor can make a big impact on a room’s climate and comfort level. Two areas that can make a big impact: the floor and windows. An area rug is an addition that not only takes the physical chill out of a wood or tile floor, but adds visual warmth, as well. Although windows can be a major source of energy loss and drafts, they can also let in a natural heat source: sunlight. Use heavy draperies at night to block the chill and provide privacy, but during daylight hours, throw those curtains open and let the warm light shine.

Find more ideas to help warm your home at mitsubishicomfort.com.

SOURCE:
Mitsubishi Electric

Lower Costs, Not Regulations, Will Save the Environment

I have a long bus commute to work in Washington DC. Most mornings I am engrossed in reading the latest news or a scholarly article, but the other morning I was thinking about a knotty problem and found myself looking out of the window. The answer to the problem became apparent as I realized how many commercial vehicles there were out there, and that each one was engaged in an economic transaction of one kind or another. It’s all about transaction costs.

Nobel laureate Ronald Coase first brought transaction costs to our attention in the 1930s. His article, The Nature of the Firm, examined the role of what was then called “marketing costs” in allowing an economic transaction to take place, and the particular nature of the employment contract in reducing these costs.

A transaction cost is, at its simplest, a cost incurred in making an economic transaction such as buying a new phone, getting legal advice, or flying to Maui for a holiday. If the transaction costs are too high, the transaction doesn’t happen. Yet it is these transactions that are the basis of wealth creation. As David R. Henderson says, “The only way to create wealth is to move resources from a lower-valued to a higher-valued use. Corollary: Both sides gain from exchange.”

So if transaction costs are too high, resources remain at their lower-valued usage. I keep my money in my pocket rather than getting a new phone, the lawyer’s investment in his skills goes without a return, and planes fly with empty inventory. It is in all our interests to get transaction costs down. Technology has been a great enabler of this in the decades since Coase wrote that first paper. Yet there are other aspects to reducing transaction costs – such as the institution of the rule of law reducing the transaction costs of corruption.

Indeed, the vast wealth of America can be explained by how we have lowered transaction costs. The invention and adoption of the automobile, for example, lowered the transaction cost of distance. All those commercial vehicles flying by my bus were engaged in economic transactions that would not have been possible a hundred years ago.

Keeping Costs Low

That’s not all lowering transaction costs can do. In his second great article, Coase looked at “The Problem of Social Cost.” Coase’s insight here was that so-called economic “externalities” were not just a question of one party inflicting harm on another, but a conflict of interests that could be resolved by an economic transaction if transaction costs were low enough. 

We now live in a world where Venmo makes settling debts for shared pizza purchases easy. Is it too hard to believe that environmental nuisance problems cannot be solved quickly and easily by appropriate cost-sharing mechanisms? While we may not be there yet, we are much closer than we were just a few years ago. As I have written about at length here, homesharing and ridesharing technologies have created new markets simply by lowering the transaction costs of putting people in touch with one another. It is plausible that new environmental markets could be created in similar ways.

Want to save the spotted owl? Using a crowdfunding platform, you could contribute to compensating the owner of the woodland who won’t be able to harvest lumber.

Unfortunately, while many transaction costs are trending down, some are veering up. That’s often because of regulation. Payment regulations could make apps like Venmo too expensive to use. Occupational licensing regulations could make trading your skills illegal unless you gain licenses requiring thousands of hours of study – and costing hundreds of dollars. Environmental regulations crowd out the possibility of running a crowdfunding campaign to save the spotted owl (the money goes instead to environmental pressure groups who simply lobby for more regulation).

That’s a problem because all that regulation is getting in the way of yet more wealth creation. It’s no coincidence that the much-ballyhooed income stagnation in America began at about the same time as regulation started to take off. Technology has kept us a few steps in front of some of the regulation, but we’d still benefit from much of that $1.9 trillion annual burden being lifted.

If we lift that burden, transaction costs will go down, and there will be even more commercial vehicles speeding down the highway. If you’re worried about the cost of congestion, well, autonomous vehicle technology and ridesharing could take care of that, as long as the transaction costs are low enough. Because, in the end, it’s all about transaction costs.

Iain Murray

Iain Murray is the Competitive Enterprise Institute's vice president of strategy. For the past decade with the Institute, he has concentrated on financial regulation, employment and immigration regulation and free market environmentalism.

Murray has published several acclaimed books, including Stealing You Blind: How Government Fatcats Are Getting Rich Off of You and The Really Inconvenient Truths: Seven Environmental Catastrophes Liberals Won’t Tell You About – Because They Helped Cause Them. His op-eds have appeared in The National Review, The Providence Journal and Fox News. He has appeared on Fox News, CNN Headline News, the BBC and Al-Jazeera, among other broadcast networks.

In addition to his work at CEI, Murray is the visiting fellow at the Adam Smith Institute and board members of the Cherish Freedom Trust and American Friends of the Taxpayers Alliance and advisory board members of Global Britain and Young Britons Foundation.

Prior to coming to CEI in 2003, Murray was the Director of Research for the Statistical Assessment Service and an Executive Officer in HM Department of Transport. He received his MBA from the University of London and his MA from the University of Oxford.

This article was originally published on FEE.org. Read the original article.

We're Poorer Because the Government Plays "World Cop"

Thanassis Cambanis argues in Politico that, contrary to what we may think, America’s role as global policeman, defender of more than 50 different countries, buyer of more than a third of worldwide military spending, etc. is not a costly burden compared to the benefits it yields. All this talk about how allies free ride off our security commitments and how the promiscuous use of U.S. military power imposes significant economic and geopolitical costs on the homeland are off base, according to Cambanis. Being the policeman of the world makes us richer, he says.

Since the United States is so extravagantly rich in relative international terms but also historically speaking, identifying even major costs can be difficult. But Cambanis misses the mark with some selective accounting. He makes his case with three main points. First:

[M]ost of America’s defense spending functions as a massive, job creating subsidy for the U.S. defense industry. According to a Deloitte study, the aerospace and defense sector directly employed 1.2 million workers in 2014, and another 3.2 million indirectly. Obama’s 2017 budget calls for $619 billion in defense spending, which is a direct giveback to the American economy…

Of course, a “giveback” to the American economy implies the real truth: that in order to create jobs by massively subsidizing the military industrial complex, the government has to first extract resources from the more productive sectors of the private economy. If the U.S. pared back its global role and initiated serious restraint-oriented cuts to the defense budget, it could produce something on the order of $150 billion in annual savings. That could serve as quite a stimulus if left in taxpayers’ pockets.

Second:

America’s steering role in numerous regions – NATO, Latin America, and the Arabian peninsula – gives it leverage to call the shots on matters of great important to American security and the bottom line. For all the friction with Saudi Arabia, for instance, the Gulf monarchy has propped up the American economy with massive Treasury bill purchases, and by adjusting oil production at America’s request to cushion the effect of policy priorities like the U.S. invasion of Iraq in 2003.

Active international engagement certainly gives a peerless superpower like the United States more leverage to secure its interests more efficiently, but Cambanis inadvertently draws attention to the benefit-outweighing costs of that “steering role” we’ve played in the world. The Iraq War is not synonymous with Liberal Hegemony, but if America had not been playing the role of global policeman, it’s hard to imagine the invasion of Iraq having happened in the first place. It served mostly as an achievable item on a pre-existing laundry list of errands that the Bush administration thought would serve as a useful show of force following the 9/11 attacks. It cost trillions of dollars and hundreds of thousands of lives and it destabilized the region in a way that continues to eat up lives and resources to this very day. And the U.S. relationship with the Saudi regime has hardly been a net positive for U.S. interests.

Third:

America’s “global cop” role means that shipping lanes, free trade agreements, oil exploration deals, ad hoc military coalitions, and so on are maintained to the benefit of the U.S. government or U.S. corporations. The truth is that America puts its thumb on the scale to tilt the world’s not-entirely free markets to America’s benefit. Nobody would be more thrilled for America to pull back than its economic rivals, like China.

It’s not clear to me that America secures better oil exploration deals as a result of its expansive grand strategy. Nor am I convinced that the ability to organize ad hoc military coalitions always serves U.S. interests; too often they have been used as a veneer of international legitimacy for reckless interventions. It seems a good thing, for example, that the U.K. parliament refused to go along with Obama’s plan to bomb the Assad regime in 2013. According to Secretary of State John Kerry, that was the pivotal moment in derailing a war that was deeply unpopular with the American public and that Congress wouldn’t even formally approve.

More interesting is Cambanis’s argument that America’s “global cop” role keeps shipping lanes open and facilitates free trade agreements. I think America’s post-war and early Cold War role in setting up international institutions that liberalized economies and encouraged the lowering of trade barriers was important, but the notion that global free trade today depends on U.S. hegemony is dubious. Most countries have learned the lesson that freer trade and globalization is a net economic benefit; they don’t need U.S. military bases to continue to be convinced. And certainly America’s frequent “global cop” military interventions don’t help. Moreover, as Joshua Shifrinson and Sameer Lalwani write in a chapter for a Cato Institute book on threat perception and U.S. national security, “Although more actors are increasingly capable of disrupting American command [of the seas], none are capable of systematically undermining the maritime status quo.” Indeed, any state interested in gaining global power and influence will strive to keep shipping lanes open and engage in free trade. Just ask China.

And as for the argument that China would be “thrilled for America to pull back,” I seriously doubt it. China certainly prefers an American withdrawal from the South and East China Seas, but, as a recent RAND Corporation study found, China is all too eager to let the U.S. carry the burden for Middle East energy security, believing (erroneously) that American military presence there helps secure the free flow of oil out of the Persian Gulf, incidentally a region that China relies on for oil imports far more than the U.S. does.

Much of this debate boils down to whether or not U.S. primacy deserves credit for the decline of interstate war, and thus for the increase in global economic productivity, since 1945. Many argue that it does, but there are competing arguments. Nuclear weapons and the destructive power of modern conventional militaries have created an environment of “defense dominance” in which war and conquest are either prohibitively costly or just plain infeasible. Economic interdependence, which developed long before America’s rise to superpower status, also creates incentives to keep the peace and get rich instead – so the cause-effect variable could very well be the reverse of what Cambanis and others claim. Cato’s own John Mueller has long argued that a normative shift in the way most societies see war, from a glorified practice to an abhorrent last resort, is the real reason for the decline of international conflict.

Cambanis predicts that, contrary to the prognostications of some fearful commentators, Trump will not reduce America’s role in the world because he will soon realize that it is a net benefit to the country’s interests and its bottom line. I agree Trump is unlikely to pare back U.S. predominance, but I think it will have more to do with his predilection for exercising immense power than anything else.

Republished from The Cato Institute.

John Glaser

John Glaser is associate director of foreign policy studies at the Cato Institute. His research interests include grand strategy, basing posture, U.S. foreign policy in the Middle East, the rise of China, and the role of status and prestige motivations in international politics.

This article was originally published on FEE.org. Read the original article.

At the Heart of Protectionism is a Fear of Prosperity

Reality is always vastly more complex than is any mental model that we humans might use to make sense of it and to navigate it.  The best mental models are ones that highlight and clarify those aspects of reality that are most likely to enable us to muster appropriate means for the achievement of our ends.

Our World of Scarcity

One important aspect of reality that sound economics highlights and clarifies is the unavoidability and ubiquity of scarcity.  “The economic problem” (as it is commonly called) exists only because not all human wants can be satisfied with the means – resources, tools, time, knowledge  – available to us.  Some – indeed, most – of our desires will forever go unsatisfied in order that we might use the scarce resources, tools, time, and knowledge that we have to satisfy those relatively few desires that we judge to be the most important.

We – as individuals and as society – never act perfectly.  We make lots of mistakes.  But if we keep our mistakes to some achievable minimum, we’ll prosper.  So we must beware – again, both as individuals and as society – of our proneness to error.  The successful amongst us learn from our mistakes; those amongst us who do not learn from mistakes fail.

One of the gravest economic mistakes that humans can make is to forget that ours is unavoidably a world of scarcity.  In a world of superabundance – an almost-unimaginable world of no scarcity – human beings who mistake their world as being one of scarcity will pay no price.  It would be a costless error.  But in the real world – in our world of scarcity – human beings who mistake their world as being one of superabundance will pay a high price.  It is a very costly error.

If you think me here to be stating what is not only obvious, but so obvious as to be irrelevant, because no one would dare to suppose otherwise, think again.  A great deal of government policies are premised on the supposition that the biggest ‘problem’ humanity faces isn’t scarcity, but superabundance.

Protectionism and the Fear of Prosperity

A stellar example of such a policy – a policy premised on the fear of superabundance – is protectionism.

By far, the single most powerful ideological force buoying and promoting protectionism is the fear that, with free trade, there will be too few jobs for workers in the domestic economy.  Yet what is this fear if not, at bottom, a fear that free trade will create superabundance?  What is this fear if not one that is premised on the notion that, with free trade, the desires of humanity (or at least of fellow citizens) will be so fully satisfied that there will be too few opportunities for us to be of useful service to each other?

The primal man-in-the-street fear of free trade – and fear of other labor-saving innovations – is a fear rooted in a completely mistaken understanding of reality.  It is a fear that we humans (or at least we in our country) are on the verge of conquering scarcity and of transforming the world (or at least our country) into one of superabundance.  This fear is truly irrational.

This fear is irrational not only because no matter how materially prosperous we become, scarcity will always exist.  The ‘economic problem’ ain’t going away, ever.  This fear is irrational also because its expression is invariably internally inconsistent.  Those many people who fear that free(r) trade or labor-saving innovations will lead to ever-higher and everlasting involuntary unemployment fail to understand that such remarkable success in overcoming scarcity would mean that being without a job would not mean destitution.  In a world of superabundance, no one needs to work in order to survive or even to live lavishly.  In contrast, a world in which people need to work in order to survive, and certainly to live lavishly, is a world of scarcity – which means that it is a world filled with opportunities for all who wish to do so to serve each other productively and profitably (that is, to work gainfully).

Policies based upon an error so gigantic as the one that mistakes our world of unremitting scarcity as being a world of – or a world on the verge of -superabundance are destructive.  And the more fully these policies are pursued, the more destructive they become.  Protectionism is a policy based upon the calamitously mistaken fear that among the main problem that we humans face isn’t scarcity but, rather, superabundance.

Government Limits the Flexibility of Human Capital

It’s true that more sophisticated defenses of protectionism exist.  Resources, although scarce, are often specific to certain tasks.  If the demand for resource L to perform the task to which it is specific falls, the owner of that particular resource does indeed suffer.   Making trade freer – as with any change in the pattern of consumer spending – often reduces the demand for resources to be used in specific ways.  The problem here is scarcity: scarcity of human ability to learn quickly how to perform new tasks productively.  (Remember: the problem is not unique in any way to international trade, for this problem is triggered with any change in the pattern of consumer spending.)

Often, this problem with resources being unable to move quickly into other, no-less-attractive uses is amplified by artificial restrictions on the abilities of workers and other resource owners to switch occupations.  Government policies that dampen entrepreneurs’ abilities to employ currently un- or underemployed resources by launching new firms or by expanding existing firms ensure that changes in patterns of consumer spending will create more, and longer-lasting, unemployment than would exist in the absence of such policies.  (Ironically, among such damaging policies are those that artificially make the firing or laying-off of workers more difficult.  Workers who are more costly to stop employing are workers who are more costly to start employing.)

So, yes, while there are some (weak) justifications for trade restrictions that are not ultimately rooted in a failure to recognize that our world is one of unavoidable scarcity, the primal justification – the justification believed by the man-in-the-street – for trade restrictions is premised on the strange belief that humanity is on the verge of superabundance.  It’s premised on the mistaken notion that we are inconceivably wealthier than we really are or could ever be.

Republished from Cafe Hayek.

Donald J. Boudreaux

Donald Boudreaux is a senior fellow with the F.A. Hayek Program for Advanced Study in Philosophy, Politics, and Economics at the Mercatus Center at George Mason University, a Mercatus Center Board Member, a professor of economics and former economics-department chair at George Mason University, and a former FEE president.

This article was originally published on FEE.org. Read the original article.

Trump’s OMB Pick Shares Vision on Social Security, Regulation

Rep. Mick Mulvaney, R-S.C., appeared before the United States Senate Committee on the Budget Tuesday to share how he will reform entitlement programs and regulations, should he be confirmed by the Senate as the next director of the Office of Management and Budget.

In his opening statement, Mulvaney said that the Office of Management and Budget has likely been falling short on its duties to oversee entitlements and regulations.

“I think the law currently requires OMB to do a retrospective analysis of regulations, and it’s probably been falling short on that,” Mulvaney said.

During the hearing, Mulvaney stressed the importance of reforming entitlement programs in order to save them for future generations.

Sen. Lindsey Graham, R-S.C., asked Mulvaney about his intentions to “save” the Social Security program.

“Would you agree with me that for younger workers, they may have to work longer when they enter the program to save the program?” Graham asked.

Mulvaney said that he has told his children to “prepare for exactly that.”

Graham also questioned Mulvaney about his vision for other entitlement programs such as Medicare and Medicaid.

Mulvaney said that failing to take action on these programs is not an option.

“If we do nothing, then by the time I retire, there will be an across-the-board 22 percent cut to Social Security benefits,” Mulvaney said.

Mulvaney said that he would not be advocating cuts to Social Security benefits for the elderly.

“I don’t think that any proposal … that I would take to the president, should I be confirmed, would suggest that we touch folks anywhere who are already—I’m not making my parents go back to work, they’re 74 years old,” Mulvaney said.

If the Social Security program is not reformed, Mulvaney said that individuals will not receive the full benefits of the program.

“Without changing the current Social Security program, a 40-year-old today will receive roughly 77 percent of what they have been promised for their adult life,” Mulvaney said.

Sen. Pat Toomey, R-Pa., questioned Mulvaney about the future of Social Security and its implications on being available to young people.

“To continue to suggest that we do not have to do anything here is just being dishonest to the young people … Is that fair?” Toomey asked.

Mulvaney said that Toomey’s estimation was “correct” and stressed that in order to fix the program, people will have to work more hours in order to close the budget gap in Social Security.

“It would require, I think, one of the proposals would require a need to work an extra couple of months before I retire … ” Mulvaney said.

Mulvaney also stressed the importance of reforming government regulations.

He said that Trump is committed to significantly reign in regulatory programs.

“My very distinct impression, from working with the transition team, is that regulatory reform is going to be an absolute priority for this president,” Mulvaney said. “In fact, I think you saw him mention yesterday that he wants to cut 75 percent of the regulations. He is absolutely dead serious about this.”

Mulvaney expressed confidence in the dedication to reforming regulation, stating that he believes Trump to be “the first person to campaign for president on regulatory reform since Ronald Reagan.”

“I have some plans or ideas of how we could help to [reform regulation], but I absolutely believe that you will see this be a priority for President Trump,” Mulvaney said.

In mid-December, Trump, then-President-elect, announced Mulvaney as his choice to lead the Office of Management and Budget.

Republican leaders have expressed confidence in Mulvaney to lead the Office of Management and Budget.

Sen. James Lankford, R-Okla., said that Mulvaney would do a “great” job in the leadership role.

Sen. Mike Enzi, R-Wyo., chairman of the United States Senate Committee on the Budget, said in a statement released Tuesday that he is “pleased that President Trump has nominated a fiscal conservative for this key post” and expressed faith in Mulvaney’s ability to “reform the broken budget process.”

Report by The Daily Signal's Rachel del Guidice.  Originally published at The Daily Signal.

Nativists Refuse to Learn from History

Proponents of more restrictions on immigration—legal and illegal—talk a big game, suggesting more penalties for lawbreakers, more assets for the border, and more surveillance for the workforce. These, restrictionists say, will restore the rule of law. Yet while occupying the White House is new for them, the fact is that restrictionists largely dictated U.S. policy until recently. Not only have their ideas failed on their terms, they have backfired, creating more lawlessness than before.

Creating the Problem

Under the Bracero guest worker program, illegal immigration almost vanished.

Before the 1920s, America had no numerical restriction on the number of immigrants, so legal immigrants poured in. As a share of the population, total annual immigration flows were four times as great then as they are today. Restrictionists—members of the progressive wings of both parties—won the election of 1920 and immediately imposed a numerical cap. This reduced legal immigration by 80 percent, barring immigrants regardless of their health, wealth, or skills.

This fateful decision spawned all of the problems that restrictionists have blamed on their opponents ever since. “While legal immigration has been curbed to the extent that advocates of the new policy expected, that of the illegal—the ‘bootlegging’—kind has probably increased greatly,” the New York Times reported in 1925. “Some officials estimate that immigrants have been coming in clandestinely at a rate of at least 100 a day.”
Border patrols and deportations were increased to stop the flow of unauthorized immigrants, but they had little effect. “I’ve no doubt whatever that the man finally deported is back here,” the Assistant Secretary of Labor told the Times. “Easily 50 per cent of them return.” In July 1929, Congress gave in and provided “amnesty” or citizenship to the undocumented immigrants. Then, the Great Depression dried up demand for workers, temporarily resolving the issue.
When the economy finally picked up again following World War II, illegal immigration returned. This time, Congress opted for a different approach: admit more workers legally. Under the Bracero guest worker program, illegal immigration almost vanished as the number of Braceros soared to almost a half a million in the early 1960s (Figure 1). Apprehended Mexicans were directed to border stations to receive cards to enter legally.

Figure 1: Aliens Apprehended at the Border and Low-Skilled Guest Workers (Braceros & H-2s)

Sources: Border Patrol; INS

But the restrictionists wouldn’t allow the fix to last. Over the vigorous objections from the Border Patrol, they cancelled the program under the guise of protecting U.S. workers. Over the next decade, the entire legal flow (and then some) was replaced with immigrants entering illegally. By the 1980s, over a million people were crossing the border each year. 

A Parade of Phony Solutions 

If enforcement efforts had remained at pre-1986 levels, there would have been 5.3 million fewer net undocumented entries.”

Restrictionists refused to accept responsibility for this chaos and demanded a new law to restrict the flow and fine employers who failed to check workers’ IDs. In 1986, President Ronald Reagan, who believed in more open legal immigration, signed the law, while extracting a legalization concession for unauthorized immigrants.

But the law backfired. Before 1986, workers—first as legal guests or later as illegal migrants—would return home at the end of each harvest, and as Figure 2 shows, the total illegal population in the country grew only very slowly throughout the decade. (The drop after 1986 occurred due to the legalization.) But with more border guards, it became too risky and costly to circulate each year. Instead of not coming at all, immigrants came and built their lives here. “If enforcement efforts had remained at pre-1986 levels,” concluded Princeton University’s Douglas Massey, “there would have been 5.3 million fewer net undocumented entries.”

Figure 2: Unauthorized Immigrant Population and Number of Border Patrol Agents

Sources: Warren and Passel (1980); Census Bureau (14 and up only, 1983); Congerssional Research Service (1986-1988); Pew Research Center (1990-2006); Border Patrol

The illegal population rose as fast as the number of border agents—both tripled between 1986 and 2000 (Figure 2). Not acknowledging their failure, restrictionists tried again, doubling the border agents over the next decade, which brought the level to ten times the amount in 1985. Immigrants continued to enter by the millions and the shadow population hit 12.2 million in 2007. As the cost of each crossing rose, cartels swooped in to capture the smuggling profits.

At the same time, the requirement that employers check IDs only created another black market in fake documents. Ignoring past failure, restrictionists doubled down in 2008, demanding a border fence and pressuring employers to use E-Verify, an employment verification system that checks Social Security numbers against federal databases. Rather than expunging the black market in jobs and documents, E-Verify has only ballooned yet another black market in identities.

Restrictionists have never admitted that their core policy—restricting legal immigration—was the cause of all the others.
Illegal immigration finally nosedived after the housing bubble burst, and the illegal population shrunk from 2007 to 2014. Meanwhile, ignoring the restrictionists, the Bush and Obama administration quietly resumed issuing many more work visas to Mexican workers. The result has been that just as many people were entering from Mexico in 2016 as in 2006, but most of them were doing so legally.
The Trump administration might want to undo this progress. With each new failure, restrictionists have never admitted that their core policy—restricting legal immigration—was the cause of all the others. Never mind that the Obama administration set records for deportations, it was never enough. Enforcement is the only tool in the restrictionist shed. Their many botched attempts to clean up their own mistakes is proof that they simply cannot fix the problem today.

Republished from The Cato Institute.

David J. Bier

David J. Bier is an immigration policy analyst at the Cato Institute’s Center for Global Liberty and Prosperity.

This article was originally published on FEE.org. Read the original article.

The DEA Is to Blame for America’s Opioid Overdose Epidemic

Heroin overdose rates doubled in 28 states between 2010 and 2012, according to the Centers for Disease Control and Prevention. A record-breaking 28,000 Americans died of opioid overdoses in 2014. In 2000, the age-adjusted drug overdose death rate was 6.2 per 100,000 persons. By 2014, it had increased to 9, according to the CDC.

What happened?

The truth is that many of those deaths are completely preventable and result not from painkillers, but from the Drug Enforcement Administration’s war on painkillers.

This week, the Senate is likely to pass the 21st Century Cures Act. Among other things, it allocates $1 billion to help states “combat heroin and painkiller addiction and recovery.” Policymakers would be wise to make sure that states don’t use that $1 billion to make the problem worse.

Who’s Taking Opioids?

Marine corporal Craig Schroeder served in Iraq. In the so-called “Triangle of Death” region, south of Baghdad, a makeshift-bomb explosion left him with traumatic brain injury. Schroeder returned home with a broken foot and ankle and a herniated disc in his back. He suffers from chronic pain in addition to hearing and memory loss.

And the regulations keep coming.

A study in the Journal of the American Medical Association showed that half of all troops who return from Iraq and Afghanistan suffer from chronic pain.

This isn’t a new phenomenon. During maneuvers in Germany in 1979, retired Army corporal Mike Davis shattered his left arm from the elbow to the fingertips when he fell from a Pershing missile. He’s needed painkillers ever since.  


Accidents, failed surgery, degenerative conditions, or all of the above can cause chronic pain. It can hit anyone at any time. In an unpublished paper, Dr. Harvey L. Rose told the story of a 28-year-old man with persistent leg pain caused by a work accident that lumbar disc surgery couldn’t fix. Rose also treated a 78-year-old woman left with chronic back pain after surgery for degenerative cervical disk disease didn’t work.


Forcing Users into the Black Market


The Drug Enforcement Administration actively prevents patients from getting the prescription painkillers they need. It started in the 1970s, when the DEA’s reporting requirements made many doctors decide to stop prescribing painkillers altogether. Why go through the hassle of ordering triplicate forms and turning them over to the government? Many others stopped out of fear. The DEA sent armed men to arrest Ronald Blum, associate director of New York University's Kaplan Comprehensive Cancer Center. It turned out he’d done nothing wrong, other than accidentally filling out his forms incorrectly. That mistake cost him $10,000 in legal fees.


Even in 1973, pain undertreatment was endemic, according to Psychiatrists Richard M. Marks and Edward J. Sachar, writing in the February Annals of Internal Medicine.


And the regulations keep coming. In 2015, the DEA decided to require patients to see their doctor, in person, every month in order to get refills for hydrocodone-based medicine. Earlier this year the CDC released guidelines that discourage clinicians from prescribing opioids. The agency recommended doctors prescribe the “lowest effective dose” and “no greater quantity than needed.”


The Black Market Solution


Opioids work by mimicking chemicals our brains produce naturally. The problem for long-term users is that the brain stops producing them if it doesn’t have to. Stopping medication leaves  sufferers “constantly sore, sensitive to pain, depressed, fatigued but unable to sleep,” according to Siegel.


Thanks to the DEA, men and women who lost limbs serving in Iraq and Afghanistan are needlessly entering withdrawal.


Chronic pain sufferers who can’t get their medication experience withdrawal symptoms that “feel like a panic attack and the flu at the same time,” according to the Washington Post.


Going without painkillers isn’t an option for many people who need them. Dr. Rose’s 28-year-old patient turned to alcohol and street drugs after his doctor prescribed an antidepressant instead of a painkiller.


He later hanged himself in his garage.


The 78-year-old woman Rose got into her bathtub with an electric mixer after a series of physicians refused to prescribe an effective dose of painkillers. In all she tried to kill herself four times, slashing her wrists and overdosing on Valium and heart medication.


Thanks to the DEA, men and women who lost limbs serving in Iraq and Afghanistan are needlessly entering withdrawal. After the DEA rules change, Schroeder’s VA doctor couldn’t see him for nearly five months. This isn’t unusual. Schroeder spent those months bedridden in crippling pain and opioid withdrawal. Another Iraq vet can’t drive due to shrapnel in his femur and pelvis. Getting his medications requires a monthly two-hour bus ride for “a one-minute consult.”


Patients who can’t find legal opioids because of the DEA turn to heroin and other black market opioids. With legal prescription opioid medication, chronic pain sufferers know their dose. Without accurate labeling, they must estimate their drugs’ purity, which varies according to source. When they guess wrong, they overdose. Even worse, heroin has a smaller margin of error than prescription opioids. Meaning if you guess wrong with heroin, you’re more likely to die.


The CDC suspects that many, if not most, of the people who died of opioid overdoses in 2014 were taking black-market fentanyl. Many drug dealers add fentanyl to heroin without letting users know.
When the CDC reports on opioid deaths, that includes street drugs like heroin and synthetic opioids. Toxicology tests used by coroners and medical examiners can’t distinguish black-market fentanyl and prescription fentanyl. But we do know that there was more of the illegally-manufactured, synthetic opioid-derived fentanyl available in 2014 than in previous years, according to law enforcement reports. This coincided with the 2014 jump in deaths from opioid overdoses.


Yet the DEA keeps patients from getting methadone and buprenorphine treatment.


In addition, we know that patients combine drugs when they can’t get enough painkiller. Combinations of opioids and drugs like alcohol make up 60% of deaths ruled opioid overdoses by the CDC. New York City government data shows that more than 90% of opioid overdose deaths involve mixtures of opioids with other drugs.

The toxicology tests did reveal that almost none of the opioid deaths involved methadone. Methadone and buprenorphine are synthetic and semi-synthetic opioids that are proven to divert patients away from the black market. Whether a person is no longer in chronic pain, doesn’t like the side effects of opioids, or is caught in a lifestyle they don’t enjoy, these drugs safely keep withdrawal symptoms at bay.


The key, again, is dosing. Under close medical supervision, methadone activates your brain’s opioid receptors just enough to prevent withdrawal, but not enough to get the user high.


Zachary Siegel is a MA candidate at the University of Southern California’s Annenberg School for Communication and Journalism and has been treated for opioid addiction.


“This gives the brain, and most importantly, one’s connection with the world, a chance to rebuild,” Siegel wrote of his experience with the drugs. “Simply put, these medications hydrate a thirsty system. Synthetic and semi-synthetic opioids help stabilize users and stanch these side effects while giving the brain a chance to heal. On these drugs we can work, drive, and behave virtually indistinguishably from ordinary Janes and Joes.”


Yet the DEA keeps patients from getting methadone and buprenorphine treatment. The DEA forbids doctors outside of highly regulated clinics to prescribe these drugs. The DEA meddles in buprenorphine prescriptions to an unprecedented degree. Even in those clinics, only doctors who’ve completed an eight-hour course and applied for a special license from the DEA are legally allowed to prescribe buprenorphine. And even those doctors can only prescribe it to 275 patients. This is all part of why three-quarters of U.S. opioid-use disorder patients don’t get these medicines.


Dependence Isn’t Addiction


Jacob Sullum pointed out that bureaucrats accept “dependence” on heart or cholesterol medicine. Nobody talks about being addicted to Lipitor. But the government is willing to make criminals of people who depend on certain types of painkillers.


This moralizing and dearth of empathy fuels policies that spend tax dollars to make our lives more difficult and painful.


This is nothing new. In 1973, Drs. Marks and Sachar looked at why patients were complaining about pain after doctors gave them medication. They found that, in “virtually every case.” doctors and nurses were under-prescribing pain medication. Further surveys of patients and doctors found "a general pattern of undertreatment of pain with narcotic analgesics, leading to widespread and significant distress." The problem was, and is, that doctors don’t understand the difference between tolerance and physical dependence, causing "excessive and unrealistic concern about the danger of addiction."


An article in a 1993 National Institute on Drug Abuse newsletter said narcotics “are rarely abused when used for medical purposes" and lamented that "thousands of patients suffer needlessly."
“It’s just insulting to the veteran to assume they are abusing these drugs,” Linda Davis said of her husband Mike Davis. “I’m fully aware that people doctor-shop, some docs overprescribe. But I think they need to realize that there’s a real difference between addiction and dependence.” VA patients suffer nearly double the overdoses of the national average, according to a 2011 American Public Health Association study.


This moralizing and dearth of empathy fuels policies that spend tax dollars to “make our lives more difficult and painful,” Sullum wrote.


We Know How to Cure Addiction and Save Lives


If the goal is to prevent overdoses, we already know how to do that.


The data is clear. By making methadone or buprenorphine harder to get, the DEA has caused death, disease, and crime.


A 2015 U.K.-based study found that opioid-dependent patients treated with medication like methadone and buprenorphine were half as likely to die of an overdose within four years as counseling-only patients. Australia found similar results in their 2014 study of opioid-dependent patients leaving prison. Methadone or buprenorphine treatment reduced their risk of overdose death by 75 percent.


The World Health Organization calls methadone or buprenorphine “essential” for keeping people out of the black market for opioids, which besides saving lives, also reduces crime and the spread of infectious diseases. France allowed doctors to prescribe methadone and buprenorphine when they deemed it necessary during the 1995 HIV outbreak. In the years since, France reduced their overdose deaths by 80 percent. Baltimore cut overdose deaths by 66% by 2008 after making methadone or buprenorphine move available in 1995.


The data is clear. By making methadone or buprenorphine harder to get, the DEA has caused death, disease, and crime.


Will this Money Fund More of the Same?


The DEA wants you to think that overprescribing opioids leads to addiction. Even Huffington Post reporters are buying the story, reporting that the pharmaceutical industry has spent billions of dollars over the last decade encouraging doctors to prescribe OxyContin and other opioids. True as that may be, that’s not the reason opioid pain reliever deaths are up.


This causes overdoses. Not only is it intuitively obvious to anyone who bothers to think about it, it’s even backed up by CDC data.


The irony of blaming prescriptions of OxyContin for opioid deaths is twofold. First, opioids are still underprescribed. Jacob Sullum reports that prescription painkiller has declined recently.
Second, opioids are actually safer than most other pharmaceuticals. The most serious common side effect of long-term opioid use? Constipation.


Aggressive DEA enforcement causes opioid underprescribing. This means patients can’t access safe pain medicine. Facing chronic pain and withdrawal, patients take black-market opioids. The reduction in prescription painkiller use has been accompanied by an increase in heroin use.


A 2014 JAMA Psychiatry study found that most young heroin addicts entering treatment had previously been on prescription painkillers, and more than 90% of them switched to heroin because it was cheaper and easier to get.


This causes overdoses. Not only is it intuitively obvious to anyone who bothers to think about it, it’s even backed up by CDC data.


People simply don’t overdose on prescription painkillers under medical supervision. They overdose when they can’t get the medicine they need and turn to the black market for help. The DEA’s efforts to keep chronic pain sufferers from accessing prescription painkillers and methadone is literally  killing them.

And yet lawmakers and reporters keep buying the DEA’s lies that prescription opioids cause overdose deaths. New Hampshire Senator Jeanne Shaheen said of the 21st Century Cures Act, “My goal has been trying to get funding to address the heroin and opioid epidemic. And there is significant funding in this bill.” She also supports increasing federal funding “for all aspects of Drug War.”


The 21st Century Cures Act looks likely to pass, with bipartisan support and the Obama administration’s blessing. But if we want to end the opioid overdose epidemic, we don’t actually need to spend $1 billion. We could just abolish the DEA, which would also free up $28 billion.


Think that sounds crazy? Portugal decriminalized heroin, along with every other drug, in 2001.


Check out what happened to their overdose deaths:




In Portugal, three out of a million people die each year by overdosing on any drug. Just as a reminder, each year in America 9 out of every 100,000 people die of an opioid overdose. Sure, decriminalization demonstrably and unambiguously saves lives. But won’t it lead to more drug use?
No. In Portugal after 2001, fewer people reported doing drugs in the past year and the past month. 

New HIV infections are also significantly down.


The other key to preventing overdose deaths is legalizing over-the-counter sales of naloxone nationwide. In the same way that you use an EpiPen to reverse anaphylactic shock, naloxone reverses opioid overdoses. It still requires a prescription in most states and is outright banned in three. We should also make sure people who call the ambulance when their friend overdoses won’t face criminal charges.

Since most opioid-related deaths involve alcohol or other drugs, awareness campaigns about the dangers of combining opioids could help. But more important than teaching people not to combine is giving them access to enough safe drugs that they aren’t tempted to.


The best thing the Trump administration could do to end the overdose epidemic is to stop the war on painkillers. Psychiatrist Jerome H. Jaffe, Richard Nixon's drug czar, himself said, “No patient should ever wish for death because of his physician's reluctance to use adequate amounts of potent narcotics."

Cathy Reisenwitz

Cathy Reisenwitz is a D.C.-based writer. She is Editor-in-Chief of Sex and the State and her writing has appeared in The Week, Forbes, the Chicago Tribune, The Daily Beast, VICE Motherboard, Reason magazine, Talking Points Memo and other publications.

This article was originally published on FEE.org. Read the original article.