PBMs

In April, 2015 Citizens Against Government Waste examined Consumer Operated and Oriented Plans (CO-OPs), created under the Affordable Care Act (ACA) or Obamacare.  They were established as an alternative or compromise to placate several Democratic Senators who wanted to adopt a government-run, or single payer, option for healthcare reform.  The theory was that the nonprofit and member-owned CO-OPs would provide real competition to big healthcare insurance companies.  But like most provisions of Obamacare, they have not worked as intended.

While “irreconcilable differences” is a term often used in divorce proceedings, it might also describe the vast policy chasm on legislative proceedings between an extremely liberal President and an increasingly conservative Congress.  In that light, where all but the least controversial policies (think naming of post offices) face a veto threat, it is no wonder that the Republican majorities in both chambers have resigned themselves to getting few of their legislative priorities to the President’s desk, with little hope that he will agree to sing the bills into law.

The great umbrage against government waste, fraud, abuse, and mismanagement expressed by politicians during election cycles give taxpayers hope that something will be done when they get to the nation’s capital.  And there is no shortage of targets once they arrive on Capitol Hill.

Soon after the Massachusetts Bay Colony was created in 1629, its leaders attempted to institute a “just price” for goods and labor.  Economist Gary North wrote in a May 1, 1974 article, “The Puritan Experiment with Price Controls,” that in 1630 “a law was passed which established wage ceilings for carpenters, joiners, bricklayers, sawyers, and thatchers.  Common laborers were limited to twelve shillings a day, or six if meat and drink were provided by the employer.  Any artisan violating this statute was to be assessed a ten shilling fine.  The effect of these wage ceilings must have presented itself almost immediately: an excess of demand for the services of artisans over the available supply.  Under such conditions, it is always difficult to recruit labor.  Within six months, these wage ceilings were repealed, leaving wages ‘free and at liberty as men shall reasonably agree.’”