2nd Term Priorities

Obama's prioritization
In his 2nd-term administration
Should be making some dents
In the rising expense
Of medicine and education.

This priority shouldn't give pause
To government skeptics because
There's much to be gained
By undoing the pain
From ongoing federal laws.

President Barack Obama kicked off his second inauguration yesterday with a rousing speech of liberal policy prescriptions that he intends to pursue in his new term.  Underlying much of the rhetoric was the goal of using the social fabric and safety net to support and strengthen the American middle class.  Among the many factors that have led to the hollowing-out of the middle are the rapidly rising costs of education and healthcare.  It is education that is increasingly necessary to enter the world of steady, well-paid work, while affordable healthcare would prevent much of the undoing of employer-provided benefits that we have seen in the last generation, as well as the great number of personal bankruptcies.

To those who ask: what could the federal government possibly do to arrest these cost increases, I would say: what is it currently doing to contribute to them?  Two examples come to mind.  In education, the federal government contributes to the price spiral by providing a seemingly limitless supply of student loan funding for it.  A more discriminating, less misguidedly generous posture might be in order.  In medicine, the Medicare and Medicaid programs are the biggest contributors to the "fee for service" model that is one of the roots of healthcare inflation identified by the President.  These are just two thoughts off the top of my head; I'm sure that thoughtful policymakers could find more.

Supreme Court ACA Ruling

When the Chief Justice made a majority
To uphold the Prez' priority,
It wasn't because
Of the old commerce clause,
But the Congress' taxing authority.

In a landmark decision that delighted liberals, enraged conservatives and gave everybody something to ponder, the Supreme Court upheld President Obama's Affordable Care Act 5-4, with Chief Justice John Roberts siding with the majority - sort of. The rejectionists, led by usual swing voter Justice Kennedy, found the ACA "invalid in its entirety." The more liberal justices, led by Ruth Bader Ginsburg, sided with the President and his Solicitor General on the basis of Congress' ability to regulate interstate commerce. The Chief Justice, perhaps splitting hairs, would not validate the "commerce clause" argument, but did reason that the individual mandate in the ACA amounts to a tax, which the Congress has broad powers to impose. Part of the Court's ruling may be read as enabling the states to opt out of funding the expanded Medicaid coverage mandated by the ACA, which means that - even assuming the President is re-elected in the fall - we're not done fighting over Obamacare.

Cause of Death

Said the mayor of a municipality
Whose failure was filed with finality:
"The medical fees
Of our retirees
Were the cause of our fiscal mortality."

The city of Stockton, California is the latest US locality to conclude that the cure is worse than the disease. The city declared bankruptcy with $700 million in debt overwhelming the resources of its 300,000 residents. Among the insurmountable costs were Stockton's pension and healthcare outlays for its retired workers, along with falling property values and an expensive downtown-revitalization project. The Wall Street Journal reports that healthcare costs are expected to rise for all of the US states, regardless of the outcome of the Supreme Court decision on the Affordable Care Act, indicating much work to do to bring health care costs on a sustainable path.

Bloomberg vs the Big Gulp

Mayor Bloomberg despaired of obesity:
"What's fattening up NYC," said he,
"Is the public presumption
That soda consumption
Is better in servings of three," said he.

In a city known for swelled skylines and clogged vehicular arteries, Mayor Michael Bloomberg aims to slim waist lines and clear cardiac arteries. The mayor announced that New York would soon ban extra-large servings of sweet soft drinks in public places, having found that their consumption is linked to the city's growing obesity problem. Brushing aside criticism of the "nanny city", Mayor Bloomberg declared that New York City would not "wring its hands" over the obesity epidemic, but rather "do something."

New Year's Resolution

A researcher of deep comprehending
Said: "To hold down medicinal spending,
One would certainly fare well
To take to the stairwell,
And spend 30 minutes ascending."

This past weekend, The New York Times asked its economics columnists to think deeply on the issues and solutions that may have an impact in 2012. Professor Richard Thaler, who teaches economics and behavioral science to business students at the University of Chicago, suggests that our national health care spending crisis can be ameliorated with a few "nudges" from employers. The thesis of “Nudge,” by Dr. Thaler and Cass R. Sunstein, is

that “choice architects” can often help people achieve their goals simply by making the necessary steps easier.

According to Dr. Thaler, employers can nudge their employees in the right direction by, among other things, subsidizing healthy foods in the cafeteria, enticing workers to use the stairs instead of elevators, and tweaking insurance plans to make life-saving prescriptions free, thereby encouraging patients to keep up with their medications.