Sept. 6, 2019
Permission to republish original opeds and cartoons granted.
Congress should reject Lamar Alexander’s plan to federalize health data
Senator Lamar
Alexander (R-Tenn.) who once vociferously opposed federalized health care plans
like Obamacare, is now embracing a federal government role in health insurance
markets as an offset to the Democrat’s Medicare for All push. Republicans used
to agree that the federal government needs stay out of the details of health
care leaving governance to the states.
But now, thanks to soon to retire erstwhile Senator Lamar Alexander,
they are looking to leap into creating the largest invasion of health care
privacy in history. The Senate needs to just say no to Lamar Alexander’s
federalization of your health care data, after all, what could go wrong besides
everything.
Cartoon: Free Falling
Is the hard left
about to jump off a cliff in 2020?
John York: Union sues to allow government employees to promote #resistance at work
“The largest
federal employee union in the country is suing the Office of Special Counsel
(OSC) over a seemingly mild exhortation to career bureaucrats: Please do not
promote the #resistance or impeachment movements during your working hours. The
American Federation of Government Employees (AFGE), the largest and most power
federal employees’ union in the country, has challenged this directive. They
claim that the OSC’s guidance memo violates its members’ right to free speech.
If the AFGE wins its legal challenge, the career bureaucracy will become even
more intractable and insulated from accountability.”
Congress should reject Lamar Alexander’s plan to federalize health data
By Rick Manning
Terrible ideas come in all partisan packages and this seems to be particularly true when it comes to federalizing your health care.
One Republican, Senator Lamar Alexander (R-Tenn.) who once vociferously opposed federalized health care plans like Obamacare, is now embracing a federal government role in health insurance markets as an offset to the Democrat’s Medicare for All push.
Lamar Alexander’s really bad idea stems from his quest to make Obamacare work better and be more affordable genre is called the All Payers Claims Database.
It is hard to imagine a more obtuse idea in this era where our federal government has been weaponized against our individual liberties, but here is how the United States Department of Health and Human Services’ Agency for Healthcare Research and Quality defines state All Payers Claims Databases:
“All-payer claims databases (APCDs) are large State databases that include medical claims, pharmacy claims, dental claims, and eligibility and provider files collected from private and public payers.
“APCD data are reported directly by insurers to States, usually as part of a State mandate.”
Eighteen states currently have implemented the APCD, and the federal government website cited above claims that one of the major advantages of this federalization of your health care information is that it is much more comprehensive including, “information on care for patients across care sites, rather than just hospitalizations and emergency department visits reported as part of discharge data systems maintained by most States through State governments or hospital associations. They also include large sample sizes, geographic representation, and capture of longitudinal information on a wide range of individual patients.”
What could go wrong when every person in America’s doctor visits, prescriptions, and health concerns are tracked in a federal database? Obamacare already required doctors to switch over to a computerized system to check boxes on your health care, with a patient portal for you to access whatever is in there, so this is a simple compelled click of the button away.
It is not hard to imagine the mischief hackers could do in opening up millions of health care files for public view. Ever been tested for AIDS or contracted a Sexually Transmitted Disease, a few clicks from a clever hacker will reveal all. Have you talked to a mental health counselor? Do you trust the results of that conversation to be on a federal government website?
With every prescription in capable federal government hands, you can be “confident” that your neighbors or kids won’t find out using the dark web that you used a prescription morning after abortion pill in the past? After all, we never read about massive data breeches from federal government agencies like the Veteran’s Administration.
And don’t even think of being a Republican nominee for the Supreme Court, as the same kind people who used the IRS to abuse tea party activists and turned high school yearbooks and video store rental records into tools of political destruction, will crack a federal health care database faster than Cleveland Brown quarterback Baker Mayfield chugs a beer.
Of course we can “trust” the federal government with our personal health care information, after all those who turned the nation’s intelligence services into partisan operatives intent on bringing down a duly elected President, surely won’t abuse the information in this system for political purposes.
The last thing our nation needs at this time of unparalleled attack on individual privacy and rights is to federally weaponize our doctor’s visits.
And I’m not even going to go down the inevitable pathway of artificial intelligence bots that will crawl all over the data to determine the most cost effective means of treatment without regard for individual personal history and your doctor’s judgment. You won’t even know it when your doctor changes your coagulant medication that they were directed to for cost purposes when they opened your chart from the helpful federal database monitor. You just know that the medication that didn’t quite work right before is now the one you are filling at your local drug store.
Republicans used to agree that the federal government needs stay out of the details of health care leaving governance to the states. But now, thanks to soon to retire erstwhile Senator Lamar Alexander, they are looking to leap into creating the largest invasion of health care privacy in history.
The Senate needs to just say no to Lamar Alexander’s federalization of your health care data, after all, what could go wrong besides everything.
Rick Manning is the President of Americans for Limited Government.
Cartoon: Free Falling
By A.F. Branco
Click here for a higher level resolution version.
ALG Editor’s Note: In the following featured oped from the Washington Times, Heritage Foundation policy analyst John York reports on the American Federation of Government Employees that is suing the federal government so that #resistance and impeachment movements can be discussed at work:
Union sues to allow government employees to promote #resistance at work
By John York
The largest federal employee union in the country is suing the Office of Special Counsel (OSC) over a seemingly mild exhortation to career bureaucrats: Please do not promote the #resistance or impeachment movements during your working hours.
The American Federation of Government Employees (AFGE), the largest and most power federal employees’ union in the country, has challenged this directive. They claim that the OSC’s guidance memo violates its members’ right to free speech. If the AFGE wins its legal challenge, the career bureaucracy will become even more intractable and insulated from accountability.
In its November 2018 guidance to federal employees, the OSC points out that federal employees are barred from engaging in overtly political activity under the Hatch Act, at least while they are at work. This limitation has ordinarily been applied only to electioneering activities, not issue advocacy. In concrete terms, while bureaucrats cannot tack up campaign flyers in their cubicle, they are free to display a “Save the Whales” poster.
While AFGE contends that promoting the #resistance or impeachment is more like the latter than the former, the OSC disagrees. In its guidance memo, the OSC argues that terms like “resistance” are “inextricably linked with the electoral success (or failure) of the president.” Insofar as impeachment “would bar an individual from serving as president,” such statements are also “clearly directed at the failure of that candidate’s campaign for federal office,” according to the OSC.
Whether the OSC has correctly interpreted the Hatch Act is, in a sense, beside the point. The fact that our laws, on any plausible interpretation, would allow career bureaucrats to openly promote resistance to the president and remain at their post, is troubling. Unelected bureaucrats who vocally support impeachment of and resistance to a sitting president cannot be trusted to faithfully execute the law under that president’s direction.
AFGE’s lawsuit is just the tip of the iceberg. Other recent incidents illustrate just how insulated career bureaucrats are from political leadership and, as a consequence, how free they are to stymie elected officials.
Last month, the State Department inspector general chastised two political appointees in that department for “retaliating” against career bureaucrats that they judged to be undermining the president’s agenda. What draconian reprisals did these political appointees mete out? According to the IG, the career bureaucrats in question were excluded from “sensitive discussions” and relieved of some job responsibilities. They even had the nerve to “berate employees with raised voices.”
Knowing how far the scales are tipped in favor of careerists, even Peter Strzok has decided to contest his removal from the civil service. As a reminder: Mr. Strzok was fired from the FBI for using a government cellphone to text his then-girlfriend incendiary criticism of President Trump (whom he was actively investigating as a member of Robert Mueller’s team) and seemingly alluding to a conspiracy to stop his ascension to the White House.
Consider what all of this means when taken as a whole. A federal employee could pin up a poster announcing his resistance to President Trump and his agenda. Then, that employee could spend his working hours maligning the president and slow-rolling and subverting directives from his political appointees. But if a political appointee bars that employee from sensitive, high-level meetings or shifts that employee’s workload to someone who has not vowed to #resist, it is the political appointee who is in the wrong.
One need not be a devotee of the unitary executive theory to see the problem here. Since the president and his appointees cannot discipline, nor even side-step, actively oppositional career bureaucrats, there is very little reason for those bureaucrats to make a good-faith effort to fulfill an agenda they disagree with. A resident who does not meaningfully control executive branch personnel does not truly direct the execution of the law.
Completely divorcing those who execute the law from the president and, by extension, the American people was never the intent of the Progressive reformers who replaced the spoils system with a career bureaucracy. They wanted to eliminate pay-to-play arrangements and partisan bias in the enforcement of the law. They did not aim to create a cloistered, permanent and unelected cadre of policymakers free to act on biases of their own.
Nonetheless, many of the merit-system protections they initiated have had exactly this effect. While no one wants to return to the spoils system of the 19th century, a presidential administration — whether Republican or Democratic — should be able to count on the good-faith efforts of civil servants.
