Nathan Benefield

Nathan BenefieldNathan Benefield is the Director of Policy Research with the Commonwealth Foundation, an independent, non-profit public policy research and educational institute located in Harrisburg, Pennsylvania.

Nathan has researched and written on public policy issues including taxation, government spending, education reform, transportation funding, health care policy, and economic development.  Nathan has had editorials featured in the Philadelphia Inquirer, the Pittsburgh Tribune Review, the Allentown Morning Call, and dozen of other papers across Pennsylvania.  Nathan has provided testimony to Pennsylvania House and Senate Committees related to the state budget and transportation funding. 
 
Nathan is a graduate of DePaul University in Chicago, Illinois, also earning a masters degree in public service management from DePaul.  He is currently working to complete his doctoral dissertation in political science from Loyola University of Chicago.
 
Nathan is a resident of Camp Hill, Pennsylvania.


Tuesday, November 11, 2008

Government Health Care Kills 

Pennsylvania Governor's demagoguery masks problems with government health coverage

By Nathan Benefield

Categories:  Pennsylvania

Pennsylvania Governor Ed Rendell is calling on the Pennsylvania Senate leadership to break their pledge not to hold a lame duck session. Among Rendell's rhetorical arguments is that "nearly two people a day die in Pennsylvania because of a lack of health insurance."

The Commonwealth Foundation's response, tongue-in-cheek, is that 10 Pennsylvanians die every day because of government involvement in health care.

Of course, no one really dies because they lack insurance or because they enroll in Medicaid, but the point (besides exposing Rendell's demagoguery) is that government health insurance—which Governor Rendell sees as the solution—is worse than the disease.

Instead, we should look to options that allow more individuals to enroll in private coverage.

Thursday, October 16, 2008

Health Care at a Crossroads 

By Nathan Benefield

Categories:  How Many Uninsured?

Bob Moffit of Heritage writes that we are at a crossroads in health care in term of the difference between McCain and Obama's proposals. The Commonwealth Foundation has said much the same thing about the divergent paths we face in health care reforms at the state level. Moffit also seems to be one of few who have noted Obama's "pay or play mandate," though I'm not sure why he doesn't compare Obama's plan to the failure of RomneyCare:
The Obama plan is comprehensive in scope, but sparse in detail. ...
Independent analysts expect that Obama’s creation of a new national health plan within a federally run “health insurance exchange” would lead to a rapid erosion of private coverage in general and employer-based coverage in particular. ...
Independent analysts generally see McCain’s proposal as a bold and innovative change in health care financing. Powered by a universal health care tax credit, the tax policy change would result in a rapid expansion in private health insurance coverage and a decrease in dependency on government programs. While some critics imply that McCain’s proposal to tax health benefits to finance the tax credit amounts to a tax increase, the indisputable truth is that it is a major tax cut, particularly for the middle class.
David Gratzer also has a piece detailing why Obama's attack on McCain's plan is unfair, noting (among other things), that there is no reason why employers would stop providing health care plans:
But it’s difficult to understand why employers would run for the exits. Under the McCain plan, they would still be allowed to take tax deductions on payroll, as they do now (no raising of costs here). By one estimate, the total number of insured Americans would increase under the McCain plan as Americans—including many currently uninsured—opt to buy insurance directly, armed with a tax credit. That estimate may be quite conservative, since the McCain plan would also let people purchase health coverage across state lines, allowing them to shop around for better deals and making coverage more affordable for all. A recent study suggests that even without the tax credit, 12 million uninsured would get insurance through such a reform alone.
Finally, there is the "Gillespie plan" - this video from the Reason Foundation in which Nick Gillespie details his plan: "If you want health insurance, get some."

Friday, October 3, 2008

New Report Compares US and Canadian Health Care 

By Nathan Benefield

Categories:  Single-Payer Follies

I doubt this will surprise regular readers of this blog, but Canada's single payer health system isn't all that Michael Moore makes it out to be. From a new report of the Fraser Institute.

On a comparable basis, Canadians have fewer doctors and less high-tech equipment than Americans. Canadians also have older hospitals and have access to fewer advanced medicines than Americans. Health care appears to cost less in Canada than in the United States partly because Canadian government health insurance does not cover many advanced medical treatments and technologies that are commonly available to Americans. If Canadians had access to the same quality and quantity of health care resources that American patients enjoy, the government health insurance monopoly in Canada would cost a lot more than it currently does.

Not only do Canadians have fewer health care resources than Americans, experience also shows that the Canadian health system is not financially sustainable in the long run. Ever since the single-payer system was established in Canada in the early 1970s, government spending on health care has grown faster than the ability of governments to pay for it. In Ontario, Canada’s largest and most populated province, health spending will soon consume close to half of all government revenues.

Another false economy of the Canadian health system is the money saved by delaying access to necessary medical care. Canadian patients wait much longer than Americans for access to medical care. In fact, Canadian patients wait much longer than what their own doctors say is clinically reasonable (Esmail and Walker, 2007b). Many Canadian patients wait so long for treatment that, in practical terms, they are no better off than uninsured Americans. In Canada, the government promises everyone that they have health insurance coverage for all medically necessary goods and services; but, in reality, access to treatment is often severely limited or restricted altogether.

 

Thursday, October 2, 2008

Matthews in WSJ on Interstate Health Insurance 

By Nathan Benefield

Writing in the Wall Street Journal, Merrill Matthews says that John McCain's plan to allow individuals and small businesses to buy insurance across state lines - a policy championed in Congress by John Shadegg and in the Pennsylvania Senate by Mike Folmer - would be a positive change for millions of Americans seeking lower priced health insurance.

He also notes that Barack Obama, though opposing such change, isn't subject to the restriction himself, as the program for federal employees is, obviously, a national market.

Thursday, October 2, 2008

Rendell continues push for "Cover All Pennsylvanians" 

By Nathan Benefield

Categories:  Pennsylvania

Pennsylvania Governor Ed Rendell has revised his proposal to increase government spending and eligibility for health insurance yet again. The latest edition has lowered the cost of the program by reducing the number of expected enrollees.

The latest edition responds to criticisms that the original proposal cost too much, but not to the analysis that it doesn't "cover all Pennsylvanians,” it doesn't benefit those currently struggling with the rising cost of insurance, it will result in "crowd out,” and won't actually reduce the number without insurance.

His compromise includes restoring the MCare abatement fund (which expired earlier this year, and he was using as leverage) – a funding source which subsidizes medical malpractice insurance by taxing smokers – and perhaps the Senate Republicans plan to offer tax credits for donations to free clinics.

Giving the looming budget deficit, it is hard to see how this minor scale back will be affordable.

While there has been a push for some real health care reform in both the PA House and Senate, those proposals have been largely ignored.

Tuesday, September 30, 2008

Bailing out Massachusetts 

By Nathan Benefield

Categories:  Massachusetts, Medicaid

The Foundry Blog of the Heritage Foundation has discovered that the federal government will "bail out" Massachusetts troubled health care plan (e.g. RomneyCare) with a $4.2 billion increase (to $21 billion) in Medicaid funding for Massachusetts.

The program had dramatically exceeded its projected costs and is not delivering the effect of universal coverage proponents had hoped for (even though that is an ill-conceived goal).

Oh, and remember how proponents of extended government insurance claim it will actually save money by reducing uncompensated care passed on to taxpayers (i.e. through Medicaid). Yeah, that didn't happen either.

Wednesday, September 24, 2008

PA Senate passes "slacker mandate" 

By Nathan Benefield

Categories:  Pennsylvania

The Pennsylvania Senate today passed by a 50-0 vote a "slacker mandate," (SB 1453) requiring insurance companies to cover single, childless children of policy holders (at the policy holders discretion)up to age 30.

Study after study show that health care mandatesdrive up the cost of insurance - and this cost is why many go without insurance. But instead of addressing the cost drivers in health care, proponents of the "slacker mandate" look to more regulation to try and force insurance companies to cover more people - even though slacker mandates fail to do so.

Friday, September 5, 2008

McCain and Obama on Health Care 

By Nathan Benefield

While health care policy won't getthe level ofmedia coverage as Sarah Palin's teenage daughter or Barack Obama's crazy pastor, some people might be interested in looking at the candidates proposals on that.

The NCPA has put together a brief analysis of both the McCain plan and the Obama plan.

- The John McCain Health Plan
- The Barack Obama Health Plan

The Cato Institute also released a policy brief a few weeks ago describing the McCain and Obama plans on health care.

[Editor's note: The focus here is on state rather than national politics, but there are a few rare exceptions. With the national conventions over, it may be worthwhile to take a glance at what's going on with the presidential candidates. We now resume our look at state issues.]

Monday, August 4, 2008

Fixing Medicaid in PA 

By Nathan Benefield

Categories:  Medicaid, Pennsylvania

The Commonwealth Foundation released a report by Michael Bond on reforming Medicaid in the Keystone state in May (I am tardy in blogging on the subject).  Bond writes:

Over the last 25 years, Pennsylvania’s Medicaid spending increased approximately 8% annually, versus approximately 6% for overall medical spending.  In 1980, Medicaid represented around 12% of the state budget. As of 2007, that total had increased to almost 26%. At this rate of growth, Medicaid will consume 94% of the Pennsylvania budget in the year 2075.
 
Unfortunately, the enormous fiscal problems facing Medicaid often overshadow its other major flaw: a well deserved reputation as a low-quality provider of health care. The program delivers episodic treatment, provides poor preventive care, and offers low-quality services to many beneficiaries. The plan produces some tragic health outcomes for America’s most vulnerable populations. It is routinely abused by both providers and beneficiaries. This ranges from Medicaid “mills” to outright theft. There have been estimates that as much of 40% (over $100 billion) of Medicaid spending involves abuse and fraud.
 
States should create insurance and provider exchanges for the provision of services to beneficiaries. Unlike the current price control system, those eligible for Medicaid will receive risk-adjusted credits to purchase services from competing plans. This would turn Medicaid into a real market in which buyers act in their own interest and providers compete to enroll beneficiaries and would also produce gains in efficiency that would make Medicaid sustainable in federal and state budgets and, just as importantly, improve the quality of health care that beneficiaries receive.

Click here for the full report (PDF file).

Wednesday, July 9, 2008

The Church of SCHIP 

By Nathan Benefield

Categories:  SCHIP

Michael Cannon pulls a troubling quote from an advocate of SCHIP expansion, who admits his support is based on faith, not evidence.

Of course Cannon is a well-known heathen.

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