**Written by Doug Powers
Ever since the gleam in the eye of American progressives/socialists — Venezuela — started going disastrously wrong, it was perhaps inevitable that they would find other inspiration to peddle. Bernie Sanders’ wife Jane might have found one:
Iran as a beacon for voting rights? Great idea:
Neither Sanders nor Nichols mentioned that the Iranian regime has been accused of rigging elections, most famously in 2009, when then-Iranian President Mahmoud Ahmadinejad won reelection under suspect circumstances. The election results sparked massive protests and demonstrations throughout Iran that the regime violently suppressed.
The Guardian Council, the powerful body that vets candidates for Iranian elections, controls who can run for president. This year over 1,600 hopefuls registered to run, but the council narrowed the field down to six finalists who were only allowed to campaign for about a month. The country’s supreme leader, Ayatollah Ali Khamenei, directly or indirectly appoints all 12 members of the Guardian Council, giving him significant influence over who is allowed to campaign. The supreme leader appoints six clerics to the body, and the Iranian Parliament elects the other six from a pool of jurists nominated by the chief of the judiciary, who is appointed by the supreme leader.
No woman has ever been allowed to run for Iran’s presidency.
Learn more about how awesome Iran is for freedom when Jane Sanders manages to reboot Burlington College with a satellite campus in Teheran.
Oh, and also nobody tell Sanders that Iran has a voter ID law:
**Written by Doug Powers
It is official: Puerto Rico has entered into the “Title III” bankruptcy that many feared would be the ultimate outcome of the Puerto Rico Oversight, Management, and Economic Stability Act passed by Congress last summer. This includes the island’s largest public pension plan, the Employee Retirement System, for which the Commonwealth commenced bankruptcy proceedings this week.
Some conservatives initially rejoiced upon the passage of PROMESA, believing that it could prove to be a formula to fix the pension problems that plague many of the states, especially my home state of Illinois. That seemed to have been the intent, at least: When Congress passed PROMESA the House leadership made it clear that it hoped to facilitate serious reforms across the Puerto Rican government, including its underfunded pension systems.
PROMESA opens the door to significant pension reform through three provisions. First, the legislation contemplates that the board would engage an independent actuary to analyze funding and the sustainability of existing benefits for any territorial pension plan that is materially underfunded (as are every one of Puerto Rico’s pension plans).
Congress passed legislation that sought to help the commonwealth and establish a formula for other states, but the resulting plan won’t fix much.
Second, PROMESA requires that a fiscal plan only provide “adequate” funding to pensions during the restructuring process (that is, it does not specify that the board achieve “full” funding at or near current benefit levels in perpetuity).
Third, it specifies that the Commonwealth and other covered entities (such as its myriad public corporations) that are participating employers are afforded the authority to restructure their pension obligations as well under Title III.
However, it is important to note that the House Natural Resources Committee responsible for drafting PROMESA clearly indicated in its section-by-section summary of the bill that the bill does not “reprioritize pension liabilities ahead of the lawful priorities or liens of bondholders as established under the territory’s constitution, laws, or other agreements.”
This provision was included to avoid a repeat of the costly mistakes made in Detroit, where pension reform was shunted aside and the city simply got out of its financial morass by forcing bondholders to take a disproportionate share of the losses, often out of line with the city’s legal debt hierarchy. To this day, Detroit cannot access the municipal lending market on traditional terms.
In spite of these explicit provisions, the oversight board approved a fiscal plan that does just the opposite while doing little to reform Puerto Rico’s retirement systems.
The oversight board retained Pension Trustee Advisors, a Colorado-based firm, to undertake the required review of funding and the sustainability of the pension system, but this has yet to be done. Given the alacrity by which the island’s government embraced bankruptcy, PTA seems to have been retained instead to merely validate a pre-wired, aggregate 10 percent reduction in pension obligations. This matches an arbitrary number publicly proposed by the board in a January letter to the commonwealth.
This is a missed opportunity and is a manifestation of the oversight board’s apparent ambivalence toward PROMESA.
The ostensibly independent actuary should have been permitted to analyze the financial situation and offer creative solutions to Puerto Rico’s pension problems, where—admittedly—one size does not necessarily fit all. For example, contractually based “basic” benefits earned through years of service should be treated differently than legislatively based “system administered benefits” (which include assorted bonuses and cost-of-living adjustments) that might be taken away by the same legislative pen with which they were bestowed. Likewise, existing retirees should be treated differently than active employees, whose accumulated contributions might be returned and invested in a 401(k) style system in lieu of further accruing pension benefits.
At a minimum, the oversight board could greenlight a reform for the Puerto Rico Teachers Retirement System—struck down in 2014 on a technicality—that would have provided an estimated $3.7 billion of savings. There are myriad other ideas that an engaged actuary and a motivated oversight board could explore to achieve meaningful and sustainable reform for Puerto Rico.
The lack of serious reform is made all the more glaring by a recent government move that served to exacerbate the pension issue. Governor Ricardo Rossello signed into law a single employer legislation, which creates the risk that all employee retirement systems liabilities—including those of the commonwealth’s municipalities and public corporations—could be shifted to the commonwealth’s general fund. It’s problematic because the commonwealth and its central government agencies were responsible for only 60 percent of the unfunded actuarial liability, as just one of many participating employers.
This faux reform will prove a costly mistake for many stakeholders. Unfortunately, it seems that both Judge Laura Taylor Swain, who is overseeing the bankruptcy proceeding, and Governor Rossello may nonetheless support it. The governor has adopted an increasingly populist tone toward protecting the pensions in full since being elected on a platform of working with bondholders. Meanwhile, Judge Swain recently made a point of stating that her vision strived to “safeguard pensions.”
If “safeguard” means moving forward without serious reform, then Puerto Rico is on the path to wasting this golden opportunity presented by PROMESA to make significant changes to the government’s various retirement systems that would make them solvent over the long term. Any short-run political gain of the sort that seems to preoccupy the current government will only entail a far larger degree of long-run economic and financial pain, as a post-Rossello and post-oversight-board Puerto Rico would be left to grapple with the same spiraling problem down the road with far less leeway to enact unilateral fixes. The unstated purpose of the board—as it has been whenever it’s been used—is to take the political heat off of the government and allow it to do economically beneficial but politically unpopular reforms. Puerto Rico’s government seems to not recognize this.Ike Brannon is president of Capital Policy Analytics and a visiting fellow at the Cato Institute.
Jeffrey A. Singer
Earlier this month, in an effort to help stem the nation’s rise in opioid addiction and overdose, Sen. Joe Manchin (D-WV) introduced a bill that purports to solve that problem. The bill would require the Food and Drug Administration to revoke the approval of one opioid pain medication for each new opioid pain medication the FDA approves for health care practitioners to prescribe.
As a practicing surgeon who prescribes pain medication for my postoperative patients, I think the senator’s proposal will not only make the opioid problem worse, but also create new problems as well.
This proposal essentially caps the number of arrows I may have in my quiver. Every patient is unique. It is not unusual for a patient in pain to have a poor response — or even an adverse reaction — to a pain medication that works well in most other patients. On many occasions, I need to try on my patient several different types of opioids, sometimes in combination with other types of analgesics, until I get my patient relief from pain. I need as many options as possible. Demanding the removal of one existing option for every new option that arises hampers and intrudes on my ability to complete my primary mission: the relief of suffering.
Sen. Manchin’s proposal is another example of a well-intended but inappropriate intrusion into the practice of medicine and the patient-doctor relationship by people who presume the ability to engineer human behavior.
It also invites unintended consequences. Suppose a new opioid is approved that is found to be faster acting and more effective in relieving pain, yet has a higher potential for addiction and respiratory depression than those already approved. Is it really a good idea to remove from doctors’ armamentarium a less potent and less dangerous opioid to make room for the new one?
It is not rare for a newly approved drug, several months after its introduction into the marketplace, to be found to have serious adverse effects not previously demonstrated during FDA clinical trials, and then be pulled from the market by the manufacturer or the FDA.
Suppose this happens with a new opioid that replaced an older one under Sen. Manchin’s bill? Does the old one get re-approved? Or is the practitioner left with even fewer options?
Finally, if Sen. Manchin thinks that limiting the number of opioids legally available will prevent addicts from obtaining their opioid of choice, then maybe he hasn’t heard about the Heroin epidemic. Heroin was banned in the US in 1924, but remains readily available and in fact has become a popular substitute for opioid addicts who are cut off by their prescribers and turn to the black market for relief. In 1924, morphine was the most common intravenous drug to which people were addicted. When heroin was totally banned, it became much more attractive than morphine for drug dealers to promote, because they had no competition from the legitimate market, and soon heroin overtook morphine in sales.
Removing popular opioids from the legal market merely transfers drug options from health care practitioners to black market drug dealers.
Sen. Manchin’s proposal is another example of a well-intended but inappropriate intrusion into the practice of medicine and the patient-doctor relationship by people who presume the ability to engineer human behavior. I appreciate the senator’s concern, but if he is looking for an answer to the opioid abuse problem the answer lies in “harm reduction.” Let doctors be doctors. Let them exercise their professional judgment and work with patients who have opioid dependency, confidentially and compassionately.
If a doctor decides it is less harmful for the patient to get a refill of the opioid prescription than to send the patient to the street, the doctor should be able to do so.
Naloxone is an effective antidote to the respiratory depression that arises from an opioid overdose. It is available in intravenous, subcutaneous (like an insulin injection), and nasal spray form. Pharmacists should be allowed to dispense naloxone without a prescription, and naloxone should be made more readily available to first responders. This is already happening in some states, such as New Mexico.
If Senator Manchin really wants to help solve the problem, he should stop doubling down on the same strategy that has failed us since the 1920s and try something new.Jeffrey A. Singer practices general surgery in Phoenix, AZ and is an adjunct scholar at the Cato Institute.
Michael D. Tanner
Our annual budget theater has now begun: President Trump has released his proposed FY 2018 budget, and Congress has pronounced it “dead on arrival.” This yearly ritual has become such a part of Washington life that presidential budgets should probably be delivered to Capitol Hill in a crepe-draped carriage drawn by six black horses. Still, even if Trump’s budget is not going to become law, it offers an important opportunity to reshape the fiscal landscape.
Let’s start by giving credit where credit is due: Trump’s proposal would reduce the growth in federal spending by $3.6 trillion over ten years, resulting in a balanced budget by 2027. Yes, this projection relies on unrealistic levels of economic growth and cuts that are never going to happen, but it still makes Donald Trump the only president even to aspire to balancing the budget since Bill Clinton in 2001.
In many ways, Trump’s plan shows that, like presidents before him, he has discovered he can’t actually balance the budget simply by eliminating “waste, fraud, and abuse.” The only way to truly reduce federal spending is to reduce federal spending. And that means cutting programs that are popular, supported by powerful special interests, or both. Hence the screams of pain and outrage.
For all its flaws, the president’s plan could prompt a sorely needed conversation about fiscal reform.
Trump’s budget challenges the Washington notion that, once enacted, every program — no matter how unnecessary, ill conceived, or unsuccessful — is forever sacrosanct. Trump would eliminate such sacred cows as the Corporation for Public Broadcasting, the National Endowment for the Arts, and the Legal Services Corporation. He would significantly slash funding for the Departments of Commerce and Energy. And he would shift education funds to charter schools and school-choice efforts.
It’s not just Democratic or liberal oxen that would be gored by this budget, either. Trump would also cut agricultural subsidies near and dear to the hearts of red-state congressmen, and corporate-welfare programs such as the Overseas Private Investment Corporation (OPIC).
Much of the early criticism of Trump’s proposal has been focused on its cuts to what is euphemistically called the “social safety net.” Those cuts have generally been described as “savage” or “devastating.” But we should recall but that they are just a sliver of a welfare system that extends to more than 100 programs and costs nearly $1 trillion in both federal and state funds each year.
In particular, Trump would reduce Medicaid spending by roughly $610 billion over ten years (on top of some $800 billion in cuts that were part of the Obamacare-replacement bill that recently passed the House) and $193 billion in reductions to the food-stamp program.
It is important to understand that the Medicaid cuts are reductions from the projected baseline, not from current spending levels. That means that, even if Trump’s budget were to become law, Medicaid would still spend more in ten years than it does today, albeit less than was previously planned. Moreover, most of the projected reductions wouldn’t take place until after 2020, meaning they are less than solid. Still, the Medicaid cuts would undoubtedly force states to make some tough decisions about whom to cover and how. This is especially true of those states that have expanded Medicaid under Obamacare, though states would also be given more flexibility to experiment with better and more efficient ways to deliver program services under the House’s health-care bill.
As for food stamps, the cuts would be real, but spending on the program has expanded exponentially in recent years. It essentially doubled under President George W. Bush, and doubled again under President Obama. Trump’s budget would basically return the program to roughly the level of funding it received in the first year of the Obama administration, not a year generally known as the Great American Famine. With the Great Recession now in the rear-view mirror and unemployment once again approaching pre-recession levels, it is not unreasonable to reduce spending on such counter-cyclical welfare programs.
If the Trump administration is making a mistake here, it is in treating welfare cuts as a budgetary matter rather than attempting wholesale reforms of a system that has failed to help poor people escape poverty or become self-sufficient. It is hard to see how Trump’s cuts to Medicaid and SNAP, or what are likely to be ineffectual work requirements, will substantially change the dynamics of a dysfunctional welfare system.
Moreover, the cuts to social programs might not have to be as deep if the budget didn’t include some unnecessary spending increases, including a $19 billion program for paid family leave. In addition, Trump is seeking some $200 billion in new infrastructure spending. That’s better than his campaign promise of $1 trillion or more, but it still amounts to a wasteful pretext for yet more legislative pork. Trump would also hike defense spending by a hefty 4.6 percent, without any clear justification beyond “more is better.” Spending restraint needs to apply to programs Republicans like as much as it does to programs they hate.
Perhaps the biggest problem with Trump’s budget is its continued failure to deal with the biggest drivers of our long-term debt: Social Security and Medicare. Without a willingness to reform these two programs, which together account for 38 percent of federal spending, it will be impossible to stem the future tide of red ink.
Trump’s budget will inevitably provoke a great deal of sound and fury, most of it signifying nothing. There is about as much chance of Congress’s passing his proposal as there is of his deleting his Twitter account. But, if it sets a new baseline of discussion in which we finally commit to restraining the size, scope, and cost of government, it will prove invaluable nevertheless.Michael Tanner is a senior fellow at the Cato Institute and the author of Going for Broke: Deficits, Debt, and the Entitlement Crisis.