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http://blog.independent.org/2014/04/14/uninsured-patients-are-36-percent-more-likely-to-get-medical-appointments-than-are-medicaid-patients/

http://blog.independent.org/2014/04/08/medicaid-patients-access-to-specialists-has-dropped-almost-one-fifth-in-five-years/

According to data compiled by the Kaiser Family Foundation, in fiscal year 2010 the average Medicaid payment per enrollee was $5,563. To be sure, there was a wide variance: For aged Medicaid enrollees the average payment was $12,958, and for disabled enrollees it was $16,240. The average for adults was $3,025, and for children it was $2,359.

Medicaid enrollees have terrible access to care, according to a number of studies discussed in John Goodman’s Priceless (chapter 15). New research published in JAMA Internal Medicine suggests that it would be better simply to give Medicaid patients this money and let them spend it directly on medical care.

Posing as patients, researchers made almost 13,000 calls to doctors’ offices in ten states, seeking appointments for a variety of ailments. Those posing as privately insured patients got appointments 85 percent of the time. Those posing as patients on Medicaid got appointments only 58 percent of the time. Researchers also posed as uninsured patients who were willing to pay in full at the time of the appointment.

The result? For appointments costing more than $75, 78 percent of the “uninsured” researchers got a medical appointment — a success rate 36 percent higher than for those posing as Medicaid patients and quite close to those posing as privately insured.

The policy implication? Taking Medicaid money away from Medicaid bureaucracies and giving it to low-income people to pay directly for health care would increase access significantly.

From Dr. Scott Goottlieb For the individual insurance market (plans sold directly to consumers); among the ten states seeing some of the sharpest average increases are: Delaware at 100%, New Hampshire 90%, Indiana 54%, California 53%, Connecticut 45%, Michigan 36%, Florida 37%, Georgia 29%, Kentucky 29%, and Pennsylvania 28%.

Maybe you were focused on the NCAA tournament coming up this week, but if you were, you may have missed a recent editorial in the News Journal writing about Common Core critics like CRI. Rather than engage in the typical bashing of those concerned about Common Core, as even some educators are not happy with the new standards being imposed top-down, one size fits all standards. CRI is supportive of every reasonable effort to bring about education reform that benefits students (read about our reforms at www.caesarrodney.org), but the new standards are a rehash of previously failed standards imposed by the federal government. It does not matter who came up with the standards: what matters is that they function as a top-down, one size fits all approach based more on interpreting texts and following processes than any sense of literacy improvement or real critical thinking skills. Of greater concern is providing parents and students with educational choice and a real means for parents to afford the type of education any good parent would want for his or her child.

Below is the editorial from the News Journal:

Listen carefully to Common Core critics
The counteroffensive launched by Gov. Markell and other governors in defense of the Common Core academic standards underscores the tensions in our polarized politics and the fractured nature of education reform in this country. Gov. Markell, the other governors and several business groups responded to growing criticism of the academic standards that 45 states have adopted for public schools.
The governor said, “It’s not about politics; it’s about raising the bar for our children.”
The Common Core standards began to develop in 2009 with governors from various states as prime movers. The proposal gained popularity, and many states quickly adopted it. But as one observer said, support was a mile wide and an inch deep. However, as the implementation of the program progressed, silent opponents began finding their voices.
The political right attacks the Common Core standards as another intrusion by the federal government on the prerogatives of the states and local school boards.
Some on the political left view the standards as placing too heavy a burden on teachers.
Gov. Markell has promoted the standards as the next logical step in making our schools better. He co-wrote an opinion essay for the Bloomberg news service with the headline “Common Core Isn’t a Government Conspiracy.”
The right’s criticism aligns with its overall political criticism of President Obama and the Democrats, even though some conservative governors back it. Critics lump Common Core in with criticism of the Affordable Care Act. “Obamacore” is teamed with “Obamacare.”
The left’s criticism echoes the growing Democrat-on-Democrat fight over charter schools and their effect on public education.
Common Core may not be a government conspiracy, but its advocates should listen closely to some of these criticisms. Standards, for example, are not new. The 2001 No Child Left Behind Act required every state to put rigorous standards in place. It is worth asking whether those standards did much good. Several observers praised the quality of the Common Core standards, holding them superior to previous ones. But the task of aligning those standards with practices is enormous and difficult. One of the most telling criticisms is about how quickly all this is being implemented. Is it on a political schedule or on a school schedule? Is it a political necessity that it be up and running before President Obama or Gov. Markell leave office in 2017?
“Implementation” is not just a cover for criticism. A poor implementation can be damaging. Just look at Obamacare. Common Core standards could benefit our entire school system. We should take the care, and the time, to get it right.

CRI Turns Six Years Old

The Caesar Rodney Institute celebrates our 6th anniversary today.  All of us at CRI cannot thank you enough for all of your support that has enabled CRI to reach this milestone.

The founders of CRI sought to create a Delaware-focused policy think tank to provide non-partisan, constructive, detailed appraisal of state policies and to provide solutions to Delaware public policy issues, particularly those related to the State’s economy.   CRI was and remains unique in our mission, breadth and quality of research and analysis.  Simply put, no one else does what we do.

From its inception CRI has focused on policies, not personalities; this has allowed CRI to provide independent analysis, sometimes resulting in CRI standing as the only group standing against a wave of conventional “wisdom.”  The Bloom Energy debacle stands as one example of CRI providing prescient analysis to lawmakers, though they did not heed our predictions.  Policy Director David Stevenson explained clearly how the Bloom project would cost you hundreds of millions dollars more in energy bills than was alleged and he has been proven correct. CRI’s John Stapleford correctly predicted the demise of the Fisker project and the loss of over $20 million in taxpayers’ cash based on his objective analysis of the risks and likelihood of success of Fisker.

Just as much as CRI cautions against ill conceived policies, CRI promotes policy solutions that will improve Delaware for all citizens.  CRI has pushed for sound economic growth policies, like eliminating the tax paid by many businesses based on their revenue, regardless of profitability (the gross receipts tax is aptly named in every way).

CRI continues to educate policy makers about the need to make real education reforms, including eliminating paycheck deduction of union dues to free teachers from the state union orthodoxy, and more focus on improving education for Delaware’s students rather than protecting the status quo.  The lack of a high quality public education system remains the biggest drag on economic growth, particularly in New Castle County, as families and businesses move to Chester County for better schools, taking their income tax, spending power, home purchase dollars, etc. along with them.

CRI has accomplished a great deal in six years, starting from a great idea and moving to reality and daily results.  I would like to thank everyone at CRI: the staff, Board, and Advisory Board for all of their time and hard work that keeps CRI moving forward.

CRI has much more to do.  We continue to need your help to continue our work.   Please consider making a tax deductible donation of any size to CRI today by clicking here to donate.  From all of us at CRI, thank you.

Best regards.

Jim Ursomarso

Chairman & CEO

 

From the News Journal and Office of Management and Budget:

These officials were the state’s top-salaried employees in 2013, according to records from the Delaware Office of Management and Budget.

1. Orlando J. George Jr., President, Delaware Technical and Community College: $370,939.92, Total pay=$469,885.84

2. Dr. Vincent F. Carr, Medical Director, Department of Correction: $218,000.12

3. Dr. Gerard Gallucci, Medical Director, Division of Substance Abuse and Mental Health: $211,975.92

4. Tie: Medical Examiner employees: $201,400.42

- Deputy Chief Medical Examiner Adrienne Sekula-Perlman and Assistant Medical Examiners Edward McDonough and Jennie Vershvovsky earned the same salary.

5. Dr. Richard T. Callery, Chief Medical Examiner: $198,521.96

6. Myron T. Steele, Supreme Court, Chief Justice: $192,914.50,*now retired

7. Leo E. Strine Jr., Chancellor, Court of Chancery: $191,360,*now Delaware Chief Justice

8. James T. Vaughn Jr, President Judge, Superior Court: $191,359.73

9. Chandlee Johnson Kuhn, Chief Judge, Family Court: $191,268.45

10. Tie: Supreme Court Justices: $191,202.54

- The Justices are Carolyn Berger, Henry D. Ridgely, Randy J. Holland and Jack B. Jacobs.

73. Jack A. Markell, Governor, State of Delaware: $170,999.92

 

What are your thoughts on this list?

The debate over whether programs such as Head Start are beneficial to young children has been going on for a long time. Some believe universal pre-K programs like Head Start give students an advantage over non pre-K educated children academically. Others maintain that either there is no benefit to universal pre-K, or any advantages gained will eventually be gone within a few short years.

CRI’s Jim Hosley wrote an article this week on this very issue. He changes the focus though from whether pre-K can help children and families (it does, at least to an extent), but on HOW those programs should be run and who should be in control. Delaware and Florida are two states with two different views on pre-K. Delaware has chosen to let the state DOE manage everything; the result has been that since 1994 when the new programs started, Delaware has actually gone backwards in enrolled children, because the state spent too much money improperly on the programs for minimal results, and then in recent years was forced to cut spending for pre-K as the economy worsened. Florida opted to turn over pre-K programs to the county level, and block granted spending to the counties to run a pre-K program based on what the county’s needs were. The results from a study of Florida’s pre-K program showed Florida was #1 nationally in pre-K enrollment, but was 35th in spending on pre-K, due to smarter spending decisions and more local control of programs.

Given Florida’s size, making decisions from Tallahassee would have been a burden to many counties hundreds of miles away. Delaware may be much smaller, but why not try this idea? Why not have New Castle County or the city of Wilmington manage their own pre-K program, and be responsible for it? At least it would be their program and parents and teachers could be more readily involved than with educrats in Dover.

Earlier this week Secretary of State John Kerry took it upon himself to criticize “shoddy scientists” and “extreme ideologues” who are denying the “unequivocal science” and “[T]hose who refuse to believe it are simply burying their heads in the sand. We don’t have time for a meeting anywhere of the Flat Earth Society.”
 
Some of these “shoddy scientists” include the former state climatologist David Legates and Smithsonian astrophysicist Willie Soon (video presentations of there science can be seen HERE and HERE. Both have earned their credentials in the field, yet if they deny the “settled science” in any manner as determined by Secretary Kerry then they are “ideologues” and must be silenced. If groups like CRI say the science is being misused to advance a political agenda, we are “the fringe”. Yet somehow this “fringe” contains nearly half of the US adult population-at least of those registered to vote who do not believe the government needs to expand its power to keep us safe from ourselves.
Click HERE and HERE and HERE and HERE and HERE and HERE to see scientific information from CRI on this issue. In the case of Delaware, we see the same verbal grenades as those lobbed by Senator Kerry, from our own Governor and DNREC Secretary Colin O’Mara. Gov. Markell issued an executive order last year requiring all state agencies to consider Sea Level Rise when planning or developing any projects. DNREC is going further and is prepared to issue its on regulations on SLR, mainly to discourage, or even redo, development along the ocean from Lewes down to Fenwick Island, and even inland past the bays. All three counties will suffer property value loss if/when DNREC goes ahead with the recommendations of its own committee and requires property owners in the “flood zones” to purchase their own flood insurance and label their properties as being in a flood zone, which will drive their value down. This is not a coincidence; in the mind of O’Mara he is merely using “science” to “protect you” from your own bad decision. 
The reality is Delaware IS going to suffer some SLR. This is because the state is sinking into the ocean and Delaware Bay due to natural erosion processes  and someday parts or all of Delaware’s beaches may be underwater, and new beaches in other locations will replaces them . But no government regulations on your behavior or new taxes on your production will “save” you from natural erosion. Dr. Legates, who has studied this issue, recommends the state build sand dunes to prevent erosion of the soil near population areas.
The environment is complex and it is something which matters to all of us. But for  Secretary Kerry, Governor Markell, and Sec. O’mara to denigrate anyone who disagrees with their opinion is foolish, especially since they are misguided on this issue.

This week many people will be snowed in for Valentines Day (stay safe on the roads!), but we at CRI are pleased to announce our new Director of the Center for Economic Policy & Analysis (CEPA), Dr. Stacie Beck.

You can visit our website link at www.caesarrodney.org or click on “our staff” in the “About” section on the top right of the page to view Dr. Beck’s complete bio. Dr. John Stapleford, currently a member of the advisory council, left his position as CEPA director in October. Dr. Beck will be responsible for continuing CRI’s economic policy & analysis work and keeping you up to date on the most recent and relevant studies of Delaware’s economic policies. Dr. Beck will be quite busy: with the potential for a 10 cents per gallon gas tax increase, revenue from the casinos drying up and a new revenue stream needed, and the prevailing wage law still in place, CRI will be busy advocating for policies which benefit Delawareans and keep the size of state government in check.

 

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