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President Donald J. Trump holds a meeting with manufacturing leaders on Thursday Feb. 23, 2017. (Photo: Reuters)

President Donald J. Trump holds a meeting with manufacturing leaders on Thursday Feb. 23, 2017. (Photo: Reuters)

President Donald J. Trump paid more in taxes and a higher effective federal tax rate than his predecessor Barack Obama, socialist icon Bernie Sanders and Mitt Romney. According to leaked tax returns from 2005, which leftwing opinion anchor Rachel Maddow on MSNBC bombed in revealing, President Trump paid roughly $38 million in taxes on $150 million in income.

That’s an effective federal tax rate of roughly 25%.

In 2015, Mr. Obama released his federal income tax returns showing he and the First Lady filed jointly and reported an adjusted gross income (AGI) of $436,065. The Obamas paid $81,472 in total tax, giving them an effective federal income tax rate of 18.7%.

In 2014, Sen. Sanders and his wife took $60,208 in deductions from their taxable joint income of $205,271. Of course, they are all perfectly entitled to do so because these oft-assailed deductions are legal under and permitted by the U.S. tax code. They paid a total $27,653 in federal income taxes, giving them an effective federal tax rate of just 13.5%. According to the Tax Foundation, the average federal income-tax rate for a couple making $200,000 to $500,000 in 2014 was 15.2%, meaning the class warfare warrior paid a lower-than-average tax rate.

Meanwhile, on average, millionaires and billionaires–the same group of people Sen. Sanders hammered as greedy on the campaign trail last cycle–paid nearly double the federal tax rate that he and his wife did. According to the Tax Foundation, those greedy evil people paid an average effective federal tax rate of 27.4%, slightly higher than the percentage President Trump paid in 2005.

Lastly, Mitt Romney, the 2012 Republican nominee, paid $1.9 million in taxes on $13.69 million in income in 2011, most of it from his investments. That’s an effective tax rate of 14.1%.

(UPDATE: A previous version of this article reversed average years for 2005 and 2015.)

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President Donald J. Trump paid a more

House Speaker Paul Ryan, R-Wis., explains the American Health Care Act, the ObamaCare replacement bill introduced by House Republicans, during a town hall-like press conference on March 9, 2017. (Photo: Courtesy of the Speaker)

House Speaker Paul Ryan, R-Wis., explains the American Health Care Act, the ObamaCare replacement bill introduced by House Republicans, during a town hall-like press conference on March 9, 2017. (Photo: Courtesy of the Speaker)

The National Federation of Independent Business (NFIB) in a statement on Tuesday announced their support of the American Health Care Act (AHCA). President and CEO Juanita Duggan urged lawmakers to come together and support the AHCA: the ObamaCare repeal and replace bill introduced by House Republicans.

“Small business optimism has soared since November because small business owners anticipate a change in policies,” President Duggan said in the statement. “Driving that optimism is the expectation that Congress will repeal ObamaCare, which has been devastating to small businesses. The American Health Care Act would repeal the most punishing elements of Obamacare, including the massive tax increases and mandates that have increased costs, limited choices, and smothered job creation.”

The NFIB was the plaintiff in the landmark case in which the Supreme Court in a 5-4 decision upheld the individual mandate. Chief Justice John Roberts essentially rewrote the law to treat the mandate as a tax, which the Obama administration repeatedly argued was not the case.

U.S. Secretary of Health and Human Services (HHS) Tom Price (2nd R), Office of Management and Budget (OMB) Director Mick Mulvaney (R) and White House Press Secretary Sean Spicer (L) speak to reporters after the Congressional Budget Office (CBO) released its score. (Photo: Reuters)

U.S. Secretary of Health and Human Services (HHS) Tom Price (2nd R), Office of Management and Budget (OMB) Director Mick Mulvaney (R) and White House Press Secretary Sean Spicer (L) speak to reporters after the Congressional Budget Office (CBO) released its score. (Photo: Reuters)

According to NFIB research, the high cost of health care has been identified by small business owners as their top concern for the past 30 years. Representing their members, the group has significant influence in Congress and openly announced they will use it to throw their weight around to get at least some version of the AHCA through both houses and onto President Donald J. Trump’s desk. The NFIB announcement comes a day after the group sent a letter to members of Congress yesterday informing them that the American Health Care Act will be a key vote.

“This will be a key vote for NFIB. Our members will pay very close attention. Every member of Congress who cares about small business should vote for this measure. There’s a lot more work to be done in order to make the health care system affordable, flexible, and predictable, but the American Health Care Act is a necessary first step.”

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The National Federation of Independent Business (NFIB)

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Rep. Steve King, R-Iowa, a favorite punching bag for the left, came under political attack this week after tweeting about immigration’s impact on “culture and demographics.” Backpedaler-in-chief House Speaker Paul Ryan, R-Wis., said he hoped Rep. King misspoke, while others immediately called him a racist.

The tweet was in response to reports of Muslim migrants screaming “Allahu Akbar” in the streets of the Netherlands as tension continues to build ahead of their insurgent election. Geert Wilders, a populist nationalist leader of the Party for Freedom (PVV), has overcome nearly all established parties in the polls. Now, with one day before voters choose a new government, he and the PVV are surging against the People’s Party for Freedom and Democracy (VVD), led by Prime Minister Mark Rutte.

Rep. King tweeted Mr. Wilders “understands that culture and demographics are our destiny.”

Rep. King defended his tweet on “Tucker Carlson Tonight,” stating flat-out that he did not misspeak.

“All of western civilization has gone down below the replacement rate [of population]… with the exception of Israel,” he said, adding that the “vacuum” created would “be filled by people who don’t believe in our values here in Western civilization.”

“A nation-state needs to have a sense of a common history and common culture,” he said, pointing to recent public demonstrations “pushing back against American civilization.”

Here’s the bottom line. Nothing Rep. King tweeted or subsequently said in the interview with Tucker was racist and, indeed, both the premise and conclusion of his argument are widely accepted within the academic community.

In the 20th century, the demand for assimilation was considered common sense. Even progressive heroes understood the basic need to assimilate immigrants, including Teddy Roosevelt.

While “it is an outrage to discriminate against any such man because of creed, or birthplace, or origin,” President Roosevelt said in 1907, “this is predicated upon the person’s becoming in every facet an American. There can be no divided allegiance here. Any man who says he is an American, but something else also, isn’t an American at all.”

Iowa Rep. Steven King, a Republican, speaks about immigration.

Iowa Rep. Steven King, a Republican, speaks about immigration.

Yet, the globalist left first vehemently challenged the definition of nationalism and even its very existence. Let’s take a look at why before coming back to Rep. King.

The untold casualty of the great wars of the 20th century, particularly World War I, was socialist theory as a sound intellectual school of thought. European socialists in Germany and France prior to the war believed in a “spontaneous harmony of interests” among the various proletariat parties in each country, which in their view, would put the common aspirations of all socialists above individual nationalism.

They were wrong. Kenneth Waltz, an international relations scholar and father of defensive realism, correctly argued in Man, the State and War, the harmony of interests and common aspirations “quickly broke down” as “each socialist party found itself bound to its national state by ties of emotional and material interest.”

In other words, nationalism is more powerful than ideology.

“The theory of nationalism represents Marxism’s great historical failure,” Tom Nairn, the heir to the Marxist school of social science painfully admitted in The Break-up of Britain. Nairn’s admission is important because most globalists who demonize nationalists understand this is true. They understand they will continue to lose the argument at the ballot box and in academia until they change the very national identities of western cultures.

Nationalism, or the concept of nation, has proven difficult to define–yet, much to the chagrin of statists–exists nonetheless. For the Left, it has proven far more difficult to defeat. As someone who has researched extensively and help define it, perhaps with and in more detail than any other before me, I think that’s has been particularly true of their effort to change the American national identity.

In What is a Nation?, British-born philologist and historian Ernest Renan added religion, economy and geography to a list already including language to define a nation. If these sound familiar it is because the preservation of these things are central tenets in President Donald Trump’s platform and, subsequently, the justification for the candidacy of Mr. Wilders.

The left’s academic response to the traditional definition of “nation” was to simply argue that it does not exist. That is, until Benedict Anderson wrote Imagined Communities, which without challenge determined nations–even if “imagined”–are still very, very real. Anderson is now considered the academic authority on the concept of nation.

But equally real is the danger of a nation “forgetting” what binds them, losing the “memory” of their shared sense of glory and/or suffering. In America, that danger comes from the left’s insistence we stop thinking of ourselves as a “melting pot” and replace our identity with a “mosaic,” despite all the chaotic cultural and political internal contradictions that follow.

With that being understood, it’s easy to see how all of this is relevant to what Rep. King was trying to convey.

The U.S., nor any other western civilization nation, cannot hope to preserve what makes western civilization prosperous and great if immigration by those who do not share our values outpaces the domestic fertility rate.

In most developed countries, such as the U.S., a fertility rate below approximately 2.1 children per woman cannot sustain a nation’s cultural identity. Currently, the U.S. fertility rate is around 1.88. The replacement rate is as high as 3.4 in third-world and developing nations due to higher mortality rates.

What President Trump, Mr. Wilders and Rep. King are pointing out is that it is a mathematical certainty for citizens’ cultures, values, political and economic systems to be “forgotten” and replaced with a new national “memory” that doesn’t at all resemble what it is now. This stand has earned them their political successes simply because most citizens in America and other nations in western Europe want to preserve their identities. That’s not because they’re bad people. It’s because they love and cherish them.

That doesn’t make them racist, nativist, Islamophobic or xenophobic. Hell, it doesn’t even make them wrong. Ultimately, whether or not citizens of any nation want to willingly replace their own identities with another–particularly with one that isn’t conducive to freedom and hasn’t produced prosperity–is their right, and a debate worth having.

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Iowa Rep. Steve King came under political

[brid video=”121323″ player=”2077″ title=”Dennis Kucinich Government Wiretapped My Congressional Office”]

Former Ohio Congressman Dennis Kucinich on “The O’Reilly Factor” Monday night claimed that the government wiretapped his office. In 2011, then-Rep. Kucinich was talking to the son of former Libyan dictator Muammar Gaddafi about a resolution he had introduced aiming to prevent foreign intervention, which he believed–ultimately correctly–would lead to radical Islamists taking control of the Middle East country.

It was not a criminal case, which would have been the only instance in which they could have legally listened to his conversation.

Former Ohio Congressman Dennis Kucinich on "The

President Donald Trump signs an executive order to withdraw the U.S. from the 12-nation Trans-Pacific Partnership trade pact agreed to under the Obama administration, Monday, Jan. 23, 2017, in the Oval Office of the White House in Washington. (AP Photo/Evan Vucci)

President Donald Trump signs an executive order to withdraw the U.S. from the 12-nation Trans-Pacific Partnership trade pact agreed to under the Obama administration, Monday, Jan. 23, 2017, in the Oval Office of the White House in Washington. (AP Photo/Evan Vucci)

President Donald J. Trump signed an executive order directing the Office of Management and Budget to submit a plan to reorganize and streamline the executive branch. The Presidential Executive Order on a Comprehensive Plan for Reorganizing the Executive Branch gives OMB Director Mick Mulvaney 180 days to look at ways “to improve the efficiency, effectiveness, and accountability of federal agencies, and even to eliminate or reorganize unnecessary or redundant federal agencies.”

“Our moral duty to the taxpayer requires us to make our Government leaner and more accountable,” President Trump said in a statement after signing the order.

The Trump Administration cited a April 2016 report by the Government Accountability Office (GAO) that concluded the Executive Branch under former President Barack Obama and Congress failed to fully address a majority of the Government fragmentation, overlap, and duplication identified by the GAO. The White House also said the order instructs Director Mulvaney to publish a notice in the Federal Register inviting the American public to suggest their own improvements.

“Implementing this executive order would have a de minimis impact on costs and revenues to the Federal Government,” Director Mulvaney said in a statement. “The benefits of this executive order include the development of a detailed plan to modernize the Federal Government and make it leaner, more effective, and more accountable by reorganizing, consolidating, and eliminating unnecessary components.”

EXECUTIVE ORDER

– – – – – – –

COMPREHENSIVE PLAN FOR REORGANIZING THE EXECUTIVE BRANCH

By the authority vested in me as President by the Constitution and the laws of the United States of America, it is hereby ordered as follows:

Section 1.  Purpose.  This order is intended to improve the efficiency, effectiveness, and accountability of the executive branch by directing the Director of the Office of Management and Budget (Director) to propose a plan to reorganize governmental functions and eliminate unnecessary agencies (as defined in section 551(1) of title 5, United States Code), components of agencies, and agency programs.

Sec. 2.  Proposed Plan to Improve the Efficiency, Effectiveness, and Accountability of Federal Agencies, Including, as Appropriate, to Eliminate or Reorganize Unnecessary or Redundant Federal Agencies.  (a)  Within 180 days of the date of this order, the head of each agency shall submit to the Director a proposed plan to reorganize the agency, if appropriate, in order to improve the efficiency, effectiveness, and accountability of that agency.

(b)  The Director shall publish a notice in the Federal Register inviting the public to suggest improvements in the organization and functioning of the executive branch and shall consider the suggestions when formulating the proposed plan described in subsection (c) of this section.

(c)  Within 180 days after the closing date for the submission of suggestions pursuant to subsection (b) of this section, the Director shall submit to the President a proposed plan to reorganize the executive branch in order to improve the efficiency, effectiveness, and accountability of agencies.  The proposed plan shall include, as appropriate, recommendations to eliminate unnecessary agencies, components of agencies, and agency programs, and to merge functions.  The proposed plan shall include recommendations for any legislation or administrative measures necessary to achieve the proposed reorganization.

(d)  In developing the proposed plan described in subsection (c) of this section, the Director shall consider, in addition to any other relevant factors:

(i)    whether some or all of the functions of an agency, a component, or a program are appropriate for the Federal Government or would be better left to State or local governments or to the private sector through free enterprise;

(ii)   whether some or all of the functions of an agency, a component, or a program are redundant, including with those of another agency, component, or program;

(iii)  whether certain administrative capabilities necessary for operating an agency, a component, or a program are redundant with those of another agency, component, or program;

(iv)   whether the costs of continuing to operate an agency, a component, or a program are justified by the public benefits it provides; and

(v)    the costs of shutting down or merging agencies, components, or programs, including the costs of addressing the equities of affected agency staff.

(e) In developing the proposed plan described in subsection (c) of this section, the Director shall consult with the head of each agency and, consistent with applicable law, with persons or entities outside the Federal Government with relevant expertise in organizational structure and management.

Sec. 3.  General Provisions.  (a)  Nothing in this order shall be construed to impair or otherwise affect:

(i) the authority granted by law to an executive department or agency, or the head thereof; or

(ii) the functions of the Director relating to budgetary, administrative, or legislative proposals.

(b) This order shall be implemented consistent with applicable law and subject to the availability of appropriations.

(c) This order is not intended to, and does not, create any right or benefit, substantive or procedural, enforceable at law or in equity by any party against the United States, its departments, agencies, or entities, its officers, employees, or agents, or any other person.

DONALD J. TRUMP

THE WHITE HOUSE,
March 13, 2017.

President Donald J. Trump signed an executive

[brid video=”121305″ player=”2077″ title=”Newt Gingrich ‘Corrupt’ CBO Scoring ‘Totally Dishonest Disgustingly Wrong'”]

Former House Speaker Newt Gingrich slammed the “corrupt” Congressional Budget Office (CBO) after it released its “disgustingly wrong” score for the American Health Care Act. During an interview on The First 100 Days on Fox News, the former Republican House speaker

“They should abolish the Congressional Budget Office (CBO). It is corrupt it is dishonest,” Mr. Gingrich said. “It was I totally wrong on ObamaCare by huge, huge margins. I don’t trust a single word they published and I don’t believe them.”

The former House speaker under former President Bill Clinton said Republicans fought the CBO during budget battles, which resulted in a balanced budget.

“Let me be very clear.” he said. “I help balance the budget four straight years, the only time in your lifetime, and we fought the Congressional Budget Office at every turn.”

“It is totally dishonest, disgustingly wrong.”

CBO) released their highly-anticipated scoring of the ObamaCare repeal bill, the American Health Care Act (AHCA), which found it would reduce federal deficits by $337 billion over the 2017-2026 period. However, the CBO also predicted up to 24 million could lose coverage by 2026, which is being touted by Democrats. Health and Human Services Secretary Tom Price disputed the claim, noting it would require those who are on Medicaid to choose not to keep a free product, something that is highly unlikely given historic trends.

“CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law,” the report says. “Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.”

Newt Gingrich slammed the "corrupt" Congressional Budget

President Donald J. Trump, left, shakes hands with House Speaker Paul Ryan, R-Wis., right, before his address to a joint session of Congress.

President Donald J. Trump, left, shakes hands with House Speaker Paul Ryan, R-Wis., right, before his address to a joint session of Congress.

The Congressional Budget Office (CBO) released their highly-anticipated scoring of the ObamaCare repeal bill, the American Health Care Act (AHCA),  and its favorable. The report, which was anticipated to be a political hammer for Democrats, is a huge boon to President Donald J. Trump and House Speaker Paul Ryan, R-Wis., against more conservative opposition in the House and Senate.

“CBO and JCT estimate that enacting the legislation would reduce federal deficits by $337 billion over the 2017-2026 period,” the CBO said. “That total consists of $323 billion in on-budget savings and $13 billion in off-budget savings. Outlays would be reduced by $1.2 trillion over the period, and revenues would be reduced by $0.9 trillion.”

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The loss of coverage is due by and large to the repeal of the mandate. Put bluntly, Americans receiving Medicaid are not those initially impacted by the repeal of ObamaCare. Rather those who lose coverage are Americans who were previously forced to purchase coverage under ObamaCare and are likely to choose not to after repeal.

“CBO and JCT estimate that, in 2018, 14 million more people would be uninsured under the legislation than under current law,” the report says. “Most of that increase would stem from repealing the penalties associated with the individual mandate. Some of those people would choose not to have insurance because they chose to be covered by insurance under current law only to avoid paying the penalties, and some people would forgo insurance in response to higher premiums.”

Health and Human Services Secretary Tom Price disputed the claim that up to 24 million could lose coverage by 2026, which is being touted by Democrats. As Secretary Price noted, it would require those who are on Medicaid to choose not to keep a free product, something that is highly unlikely given historic trends.

Worth noting, the CBO when scoring ObamaCare overestimated the amount of people who would gain coverage by the exact same number—24 million.

It’s a shocking report considering the nature of CBO scoring methodologies. They use static scoring methods, not dynamic. Thus, it is entirely possible they are overestimated the rise in premiums and, therefore, overestimating the number of Americans who would choose not to purchase insurance coverage. House Republicans and the Trump Administration argue further amendments to the bill allow more competition by permitting the purchase of insurance across state lines, which is prohibited now.

More competition leads to lower costs as insurers compete for more business. As it stands under ObamaCare, they aren’t just not competing but also not participating.

United HealthGroup Inc. (NYSE:UNH), the nation’s largest insurer, announced in April 2016 that the company would bail on all but a “handful” of ObamaCare exchanges in 2017. Regulators confirmed they are completely abandoning exchanges in Missouri, North Carolina, Pennsylvania, Tennessee and Washington state, while partially withdrawing from Georgia.

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In August, Aetna (NYSE:AET), the nation’s third largest insurer, announced the most significant withdrawal from the federal marketplaces set up by ObamaCare to date. Citing heavy losses, Chairman and CEO Mark T. Bertolini said Aetna would severely reduce its participation from 15 states to just 4 in 2017.

Now, nearly 33% of all U.S. counties have only one insurer offering plans on their state’s exchange and 34% fewer doctors and other health care providers accept ObamaCare insurance compared to private insurance. In October last year, the Obama administration itself confirmed insurance premiums for a midlevel benchmark plan will increase an average of 25% across the 39 states served by the federally run online market before taxpayer-provided subsidies.

Still, the CBO estimates that the 15 percent to 20 percent higher premium increases will be temporary and the American Health Care Act would actually reduce premiums after 2020.

“The legislation would tend to increase average premiums in the nongroup market prior to 2020 and lower average premiums thereafter, relative to projections under current law,” the report adds. From the report:

Starting in 2020, the increase in average premiums from repealing the individual mandate penalties would be more than offset by the combination of several factors that would decrease those premiums: grants to states from the Patient and State Stability Fund (which CBO and JCT expect to largely be used by states to limit the costs to insurers of enrollees with very high claims); the elimination of the requirement for insurers to offer plans covering certain percentages of the cost of covered benefits; and a younger mix of enrollees. By 2026, average premiums for single policyholders in the nongroup market under the legislation would be roughly 10 percent lower than under current law, CBO and JCT estimate.

Speaker Ryan took a victory lap following the release of the CBO report.

“This report confirms that the American Health Care Act will lower premiums and improve access to quality, affordable care. CBO also finds that this legislation will provide massive tax relief, dramatically reduce the deficit, and make the most fundamental entitlement reform in more than a generation,” the speaker said in a statement. “These are things we are achieving in just the first of a three-pronged approach. It’s important to note that this report does not take into consideration additional steps Congress and the Trump administration are taking that will further lower costs and increase choices.”

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[pdfviewer width=”740px” height=”849px” beta=”true/false”]https://www.peoplespunditdaily.com/wp-content/uploads/2017/03/CBO-Report-American-Health-Care-Act.pdf[/pdfviewer]

The Congressional Budget Office (CBO) released their

U.S. President Donald Trump listens during a meeting about healthcare at the White House in Washington, U.S., March 13, 2017. (Photo: Reuters)

U.S. President Donald Trump listens during a meeting about healthcare at the White House in Washington, U.S., March 13, 2017. (Photo: Reuters)

President Donald J. Trump met with ObamaCare “victims” at the White House Monday before heading out to the campaign trail next week to sell the House repeal bill. The meeting comes ahead of the scoring released by the Congressional Budget Office (CBO), which is expected to show modest costs with several millions losing their Medicaid insurance.

But the president wanted to tell the other side of the story, which is certain to get less coverage in the mainstream media.

Joel Brown, a resident of Tennessee, said not only have his rate increases been astronomical because there’s not competition, but his plan now has a $7,000 deductible. His county has only one insurance option. Kim Sertich, of Arizona, which is one of the worst states for premium increases under ObamaCare, said she was forced to go into a faith-based cost-sharing program after having losing her coverage.

“More competition and less regulation will finally bring down the cost of care,” President Trump said. “The press is making it look so wonderful. It’s a little bit like President Obama. When he left, people liked him. When he was here, people didn’t like him so much.”

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He predicted the current law will collapse, saying, “Whether we do it or not, it’ll be imploded off the map.”

United HealthGroup Inc. (NYSE:UNH), the nation’s largest insurer, announced in April 2016 that the company would bail on all but a “handful” of ObamaCare exchanges in 2017. Regulators confirmed they are completely abandoning exchanges in Missouri, North Carolina, Pennsylvania, Tennessee and Washington state, while partially withdrawing from Georgia.

In August, Aetna (NYSE:AET), the nation’s third largest insurer, announced the most significant withdrawal from the federal marketplaces set up by ObamaCare to date. Citing heavy losses, Chairman and CEO Mark T. Bertolini said Aetna would severely reduce its participation from 15 states to just 4 in 2017.

Now, nearly 33% of all U.S. counties have only one insurer offering plans on their state’s exchange and 34% fewer doctors and other health care providers accept ObamaCare insurance compared to private insurance. In October last year, the Obama administration itself confirmed insurance premiums for a midlevel benchmark plan will increase an average of 25% across the 39 states served by the federally run online market before taxpayer-provided subsidies.

“We’re not going to have one-size-fits-all,” Mr. Trump told the group, which also included the vice president and HHS Secretary Tom Price. “Instead, we’re going to be working to unleash the power of the private marketplace to let insurers come in and compete for your business. And you’ll see rates go down, down, down, and you’ll see plans go up, up, up. You’ll have a lot of choices. You’ll have plans that no one’s even thinking of today.”

Regarding the score, House Speaker Paul Ryan, R-Wis., told CBS News’ “Face the Nation” on Sunday he expected that CBO would predict some Americans would lose coverage.

“The one thing I’m certain will happen is CBO will say, ‘Well, gosh. Not as many people will get coverage,’” Ryan said. “You know why? Because this isn’t a government mandate. This is not the government that makes you buy what we say you should buy and therefore the government thinks you’re all going to buy it.”

Meanwhile, President Trump will head to Kentucky to hold a campaign-style event next Monday in Louisville to rally support for repeal and replace. Vice President Mike Pence appeared in the Bluegrass State last Saturday to put the pressure on legislatures to support the plan. Worth noting, Kentucky Sen. Rand Paul has been one of the most vocal conservative opponents to the American Health Care Act, the ObamaCare repeal bill put forward by House Republican leadership.

“The House leadership Obamacare Lite plan has many problems. It will not pass,” Sen. Paul tweeted. “Conservatives are not going to take it.”

Still, the president remains optimistic about the bill’s chances of passing both houses of Congress. He tweeted early Monday, “Republicans will come together and save the day.”

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President Donald J. Trump met with ObamaCare

healthcare-capitol-hill

Capitol Hill and healthcare emblem.

I shared last year a matrix to illustrate Milton Friedman’s great insight about the superior results achieved by markets compared to government.

Incentives explain why markets work best. When you spend your own money on yourself (box 1), you try to maximize quality while minimizing cost. And that drives the businesses that are competing for your money to constantly seek more efficient ways of producing better products at better prices.

This system generates creative destruction, which sometimes can be painful, but the long-term result is that we are vastly richer.

Governments, by contrast, don’t worry about efficiency or cost (box 4).

Today, though, let’s  use Friedman’s matrix to understand the shortcomings of the US healthcare system. Way back in 2009, I opined that the most important chart in healthcare was the one showing that American consumers directly paid for less than 12 percent of health expenditures.

Rise of the Third-Party Payer: Consumers Directly Pay for Less than 12 Percent of Healthcare Costs

For all intents and purposes, instead of buying healthcare with their own money, they use other people’s money (box 2), a phenomenon known as third-party payer. And because most of their health expenses are financed by either government (thanks to Medicare, Medicaid, Obamacare, etc) or insurance companies (thanks to the tax code’s healthcare exclusion), consumers focus only on quality and don’t care much about cost.

That 2009 column was written before Obamacare’s enactment, so let’s see if anything has changed.

Well, we know healthcare has become more expensive. But do we know why?

The answer, at least in part, is that consumers are directly financing an even smaller percentage of their healthcare expenses. In other words, the distortions caused by third-party payer have become worse.

Here’s the most-recent data from the federal government’s Centers for Medicare and Medicaid Services (specifically the National Health Expenditures by type of service and source of funds, CY 1960-2015). Consumers are now paying only 10.5 percent of healthcare costs.

Now let’s consider the issue of efficiency.

Are we getting better healthcare for all the money that’s being spent?

That doesn’t seem to be the case. Here’s another chart from the archives. It compares per-capita health spending in various nations with average life expectancy.

As you can see, the United States is not getting more bang for the buck. And I very much doubt an updated version of those numbers would show anything different.

Heck, we even have more government spending on healthcare, per capita, than many nations with fully nationalized systems.

So if we’re not buying better health outcomes with all this money, what are we getting?

The blunt answer is bureaucracy and inefficiency. Here are some excerpts I shared years ago from a column by Robert Samuelson.

There are 9 times more clerical workers in health care than there are physicians, and twice as many clerical workers as registered nurses. This investment has not paid off in superior outcomes or better customer service, however. …Every analysis of medical care that has been done highlights the significant waste of resources in providing care. Consider a few examples: one study found that physicians spent on average of 142 hours annually interacting with health plans, at an estimated cost to practices of $68,274 per physician (Casalino et al., 2009). Another study found that 35 percent of nurses’ time in medical/surgical units of hospitals was spent on documentation (Hendrich et al., 2008).

Let’s close with a chart from a left-wing group that wants a single-payer system.

And this chart clearly makes a compelling case that the current approach in the United States is very wasteful.

And this chart clearly makes a compelling case that the current approach in the United States is very wasteful.

For what it’s worth, I’m slightly skeptical about the veracity of the numbers. Why, for instance, would there be a sudden explosion of administrators starting about 1990?

But even if the data is overstated, I’m sure the numbers are still bad. We see the same thing in other areas of our economy where government-instigated third-party payer enables waste and featherbedding. Higher education is an especially shocking example.

The real issue is how to solve the problem. Our leftist friends think a single-payer healthcare system would solve the problem, but that would be akin to nationalizing grocery stores to deal with the inefficiencies created by food stampsand agriculture subsidies.

The real answer, as Julie Borowski explains in this video, is unraveling all the government interventions that caused the problem in the first place.

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Healthcare costs have increased as consumers directly

Hungarian Prime Minister Viktor Orban (Photo: Reuters)

Hungarian Prime Minister Viktor Orban (Photo: Reuters)

Since being overrun with economic migrants from the Middle East in 2016, Hungary has installed multiple measures to combat the problem. A primary border fence was erected, followed by a secondary barrier still under construction. Hungarian Prime Minister Viktor Orban has called the migrants ‘the trojan horse of terrorism.’

The Eastern European nation is now training a new border law enforcement force called the ‘Border Hunters.’ This thousand man strong unit will undergo a six month training course and assist the border guards and regular police in keeping the migrants from breaking the law and entering Hungary.

“The migrant flow has ebbed greatly since Hungary erected a fence along the southern boundary and the EU struck a deal with Turkey 18 months ago that curbed migration from that country into neighbouring Europe,” reports Reuters.

Hungary’s border wall has been extremely effective, with the borders now practically quiet as the migrant flow heads to easier crossings. Reports from the crossing station at Barcs, on the Croatian border, describe the zone as eerily calm, with only spot checks on a few trucks passing into Hungary.

The EU has routinely decried Hungary’s actions, calling the border security measures ‘devastating’ for migrants. But isn’t that the point?

Brussels has even gone as far as threatening legal action against Hungary and other Eastern European nations that have a different view of Muslim migration than the globalists in the EU capital. The lesson to take away from Hungary’s experience, stuck in the middle of the migration route from the Middle East to Western Europe, is that a wall, if done right, really works.

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Since being overrun by Middle East migrants

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