David Stokes
David Stokes, a Saint Louis native, is a graduate of Saint Louis University High School and Fairfield (CT) University. He spent five years as assistant to Saint Louis County Councilman Kurt S. Odenwald, where he was closely involved with legislation including MetroLink expansion, property assessments, HVAC licensing codes, the new Cardinals ballpark, pharmacy privatization, and much more. He is currently the president of the University City Library Board. He has served on boards and committees for several area organizations: the University City Centennial, the Saint Louis County Pachyderm Club, and the Downtown Saint Louis Residents Association. He lives in University City with his wife, Jennifer, and son, Nathaniel.
Wednesday, September 24, 2008Interesting Questions About Health InsuranceBy David StokesCategories: Insurance Regulation, MissouriThere is nothing more enjoyable when researching issues than coming across an article you think you are going to hate, and then discovering you’re completely wrong. I really don’t know why I assumed I’d dislike this column by Mary Jo Feldstein in the Post-Dispatch. Perhaps the opening line led me to make the wrong assumptions about it. But, anyway, it is an excellent article, and sort of a counter to the terrible piece by Bob Herbert that I blogged about the other day. This is not to say that Feldstein’s column is in full agreement with the health savings account approach favored here at the Show-Me Institute. In fact, she raises some very interesting questions about them:
There is simply no magic potion to take our health care system and make it perfect. Last night we cosponsored the Steven Levitt (coauthor of Freakonomics) lecture along with St. Louis University, where the event was held. Levitt, in response to a question from a lottery-winning audience member who regularly runs for office, talked about health care. He believes that market pricing has to be put back into the system, and consumers and insurers are going to have to make tough choices about what people can and can not afford. As Feldstein writes:
I see her point perfectly. It is one thing for parents not to take their teenager, who only has a simple cold, to the doctor. That choice allows for more important uses of limited resources. To go further, it is unfortunate — but probably necessary — that dying elderly people do not receive every single expensive treatment possible. Remember when Mickey Mantle got a liver transplant and died soon anyway, after potentially taking away a precious resource (a functioning liver) that someone else may have used to live much longer? (Note: there is no proven evidence that someone other than Mantle died because of that transplant, but the decision to give the liver to him was still very controversial.) It is another issue entirely for people with treatable conditions not to take their medicine because they are responsible for the first $2,000 of their costs before insurance kicks in, and they can’t afford it. I am not saying HSAs don’t work because of this issue, just that it is a reasonable possibility to consider. The great thing about Feldstein’s column is that it is a well-researched piece about a complicated issue, as opposed to Herbert’s uninformed broadside.
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Wednesday, September 24, 2008Bob Herbert’s Weak Attempt on Health CareBy David StokesCategories: MissouriIf Bob Herbert of the New York Times had read the Show-Me Institute’s primer on health savings accounts, perhaps he would not have written such a pathetic piece about health care, carried in today’s Post-Dispatch. Some of the problems Herbert decries — such as employees losing their health care, and young, healthy people choosing to go without — are already happening now. Increasing the options available for private insurance is an answer to those problems, not a way to make our health care system worse. As for the tax implications, we absolutely should level the playing field between the tax code’s treatment of employer-based plans and individual plans. Why should health care provided by a company be tax exempt as pretax income and individual insurance be classified as after-tax? Reducing the cost of individual plans via a tax credit will encourage insurance plan purchases by more healthy, young people — not fewer. I guess in the end, though, it comes down to a difference of outlook:
Herbert, and others like him, think that average people are too stupid to take care of themselves. Needless to say, I disagree.
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Thursday, June 12, 2008Missouri Court ReportingBy David StokesCategories: MissouriThere are several recent articles in Missouri media that touch on the courts, which is particularly appropriate given the recent arguments I have had with some trial lawyer friends about the success (or failure) or tort reform in Missouri. (Here's a hint, it's been a success.) First of all, Missourinet has an audio story about our recently released study of judicial selection (link via Mr. Combest). Check it out if you can. Next, the Washington Examiner has an article about tort reform success across America that mentions Missouri as an example. According to the article:
This dovetails nicely with last month's Missouri articles discussing insurance premium reductions for doctors, which we blogged about here at SMI. I think the facts are pretty clear. Our judicial selection system is a good one for our state, although I believe small improvements can still be made to it (our study focused on the big picture and admitted minor changes could be either helpful or harmful). I discussed some of those minor changes last year. Even more importantly though, the tort system had gotten out of whack, however we pick our judges with the "Missouri Plan." Our tort system -particularly the venue laws — needed some major changes, and they got them. Those changes have benefited our economy and our health care system. Now, unless some Law & Order twist happens in the next few seconds (like St. Luke's Hospital announcing they are moving to St. Clair County, Ill.), I declare this post closed.
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Thursday, November 8, 2007Interesting Story in St. Louis Post-Dispatch About Outsourcing Mental Health CareBy David StokesThe St. Louis Post-Dispatch has a very interesting story (link via johncombest.com) on the state's plan to send the casework on developmentally disabled citizens to local and county boards, and outside groups. I don't yet know enough about this plan to talk with certainty about it, although it sounds good to me in theory. I think that some of the cost savings that would be realized by outsourcing should be put back into very solid oversight of the program. The Legislature has yet to approve this plan, and I look forward to hearing more about it. I hope both its pluses and minuses get a fair examination. The real point of this post, though, is yet more examples of how the welfare state has become a permanent part of some people's mindsets, and the belief many have — which I will never comprehend — that government bureaucrats are somehow more kindly and fair than employees in the private sector. Trust me on this, people — there is nobody more cold than a bureaucrat following orders and a budget. Here is a quote from one state rep whose worldview never fails to astound me:
How about including the family in this issue, first and foremost? Isn't it the responsibility of the families, rather than the state, to look after their own family members? Here is another quote demonstrating welfare-state creep:
Of course it is not about the money when everybody else is paying for it. I really don't mean to sound cruel, but the assumption so many people have that other people should pay for their needs is something that always amazes me. As I said, I don't know whether this proposal is a good one or not, but it sounds promising as a way to both improve service and make sure more of the money goes to the people who need it, rather than to the layers of bureaucracy that oversee it.
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