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All articles with the "Deregulation" tag.

Published: Mon, 19 Mar 2018 00:00:00 -0400

Last Build Date: Mon, 19 Mar 2018 19:01:43 -0400


Trump Is 'Destroying' Regulations

Mon, 12 Mar 2018 15:40:00 -0400

With his tariffs on aluminum and steel, his family-separating crackdowns on nonviolent illegal immigrants, and his authoritarian musings about executing drug dealers, President Donald Trump is a libertarian's nightmare.

Except when it comes to regulatory reform.

The Competitive Enterprise Institute (CEI), a D.C.-based free-market think tank that focuses on the administrative state, tallied up the number of regulations in Trump's first year in office and found "the lowest count since records began being kept in the mid-1970s." CEI's Clyde Wayne Crews told Reason, "I haven't seen personally anything like the regulatory reductions that have taken place."

What's producing these results? Part is the president's early executive orders mandating that for every new regulation two old ones get killed, and that the net imposed regulatory cost of each agency and department be zero. Trump has also appointed some genuine reformers: Scott Gottlieb at the Food and Drug Administration (FDA), Ajit Pai at the Federal Communications Commission, and Betsy DeVos at the Department of Education.

Chief among the anti-bureaucratic bureaucrats is Neomi Rao, administrator of the obscure but important Office for Regulatory Affairs, which applies cost-benefit analyses to proposed regulations while making sure they still align with legislative intent. Rao, who came to the administration after founding the Center for the Study of the Administrative State at George Mason University, tells Reason, "We have done more in our first year than any president since we've been keeping records, which is back to Reagan."

President Trump appears genuinely enthusiastic about this push, talking up FDA reforms in both of his State of the Union addresses and crowing at a December red-tape-cutting ceremony that the "never-ending growth of red tape in America has come to a sudden screeching and beautiful halt."

But Crews warns that a midterm will be much harder for Trump to navigate than the comparative honeymoon of 2017. "I think in 2018, he's going to have a much tougher time meeting the goal," Crews said. "When you're acting alone as president and you can't make law on your own, the barrier that you run into is you run out of low-hanging fruit."

Produced by Matt Welch and Alexis Garcia. Camera by Todd Krainin, Ian Keyser, Mark McDaniel, and Jim Epstein.

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Indiana Allows Sunday Alcohol Sales, Keeps Cold Beer Laws on Books

Wed, 07 Mar 2018 11:10:00 -0500


Indiana has repealed its ban on Sunday carry-out alcohol sales, allowing people to buy beer, wine, and liquor on the Lord's Day for the first time since 1816. From now on, Indiana residents won't be forced to shuttle across the Ohio border when they need to pick up some last-minute booze for a party, nor will anyone be reminded mid-checkout that she must forgo that bottle of Merlot until Monday.

While 10 states still prohibit the sale of liquor on Sundays, Indiana had been the only one with a statewide ban on all alcoholic beverages.

"We couldn't unlock the doors until noon," Joel Massoth, owner of Decatur Package Liquors, told WANE on Sunday. "I got here at about ten 'til, and the whole parking lot was packed. Everyone was waiting at the door wanting to be the first one to walk in. Kind of a day in history. It's pretty cool seeing all the customers excited."

But Hoosier State drinkers have many battles left to fight. For instance, Indiana remains the only state to regulate beer based on temperature. Yes, temperature: Gas stations and convenience stores aren't allowed to sell carry-out alcohol that is "iced or cooled." If you want to take some beer home that's already been chilled, you need to get it at a restaurant or a liquor store.

In 2017, the state Senate voted against the repeal of cold beer laws. Public support for repeal was high—around 61 percent, according to a Ball State study—but the Indiana Association of Beverage Retailers lobbied successfully to retain the restrictions. Worse yet, the legislature made the laws more restrictive: A convenience-store chain had added seating and fast-food service to a few of its stores, so they could obtain restaurant status and sell carry-out beer, so Indiana mandated that 60 percent of all alcohol sales must be for on-site consumption if you want that restaurant classification. Republican Gov. Eric Holcomb called that "common sense."

Yet the fight is far from settled. Shortly after he signed the bill, Gov. Holcomb was asked whether Hoosiers could expect a change in cold beer laws.

"We will cross that bridge when we come to it," the governor said.

The U.S. Cattlemen's Association Has a Beef with Lab-Grown Meat

Fri, 02 Mar 2018 14:15:00 -0500


The U.S. Cattlemen's Association (USCA) wants the government to hobble the coming competition from "clean meat" startups—companies that specialize in creating lab-grown meat products that don't involve animal slaughter. The association has petitioned the United States Department of Agriculture (USDA), claiming that the words "beef" and "meat" should not be used to describe lab-grown and alternative meat products, since they are not derived from the flesh of animals.

The USCA insists that such labels confuse or mislead the customer. In a press release—headlined "Meat is Meat, Not a Science Project"—USCA President Kenny Graner said:

Consumers depend upon the USDA Food and Safety Inspection Service to ensure the products they purchase at the grocery store match their label descriptions. We look forward to working with the agency to rectify the misleading labeling of "beef" products that are made with plant or insect protein or grown in a petri dish. U.S. cattle producers take pride in developing the highest quality, and safest beef in the world, and labels must clearly distinguish that difference.

While lab-grown meats are not yet commercially available, clean meat startups have garnered considerable investment in recent years. Lab-grown meat may hit the market as early as 2020, the petition suggests.

Tyson, Bill Gates, and Richard Branson have all invested in Memphis Meats, a company that specializes in the creation of cultured meats. Other startups—Impossible Foods, Beyond Meat, Just Meat—have also attracted attention. Ethan Brown, the founder of Beyond Meat, thinks lab-grown meat is an innovation on par with the automobile or the iPhone.

Why is the USCA, a major player in the traditional beef industry, interested in this semantic distinction? Food policy expert Baylen Linnekin offers some clarity.

"I think the USCA is worried about competition and is trying to make sure lab-grown foods are distinguished from those that come from a living animal," Linnekin tells Reason. "I don't think use of the terms 'meat' or 'beef' is anything the government generally or the USDA in particular should regulate. If the USCA has a problem with its competitors trying to use those words, they should sue. The Supreme Court has already held, in POM Wonderful v. Coca-Cola, that beef producers or, perhaps, an industry group such as the USCA can sue competitors over misleading statements. Hence, this is properly a legal rather than a regulatory matter."

It's too early to say whether consumers would be mislead by using the word "meat" to describe lab-grown beef. Indeed, removing the label could be more confusing.

"When government defines terms like 'meat' or 'beef' or 'natural' or 'organic,' it can stifle innovation and, consequently, harm consumers and innovators," said Linnekin. "Here, there's no reason for lawmakers or regulators to get involved. The courts are perfectly capable of protecting consumers from being misled."

But perhaps that's not the sort of protection the beef producers really want.

Cancer Survivor Fined $2,260 for Providing Rides to Hospital Patients

Wed, 28 Feb 2018 15:06:00 -0500


In London, Ontario,* city bylaw officers fined a cancer survivor $2,260 for providing discounted rides to hospital patients—a service hospital staff said was invaluable.

For more than three years, the cancer survivor—an unnamed woman—served outpatients at St. Joseph's Hospital, offering round-trip rides for those in need. Despite years of successful work and those in the hospital calling her a "critical volunteer," her charitable operation was shut down after being a target of a police sting operation.

"I'm devastated," she said, according to The Ottawa Citizen. "I had cancer and I just wanted to give back to the community."

After her own health struggles, she saw the hospital's need for drivers. Many patients were unable to arrange rides, and other alternatives were expensive. She charged the smallest fee manageable, $12 for round-trip rides, and refused tips. She drove her patients to and from appointments. She would offer her customers water and would walk them to their doors before departing. Having been a patient herself, she sought to be reassuring.

"I treat them well, the way I want to be treated," she said.

On February 15th, her client—a cop—did not return the hospitality:

An enforcement officer called her for a ride, saying he was a patient getting a colonoscopy; she even providing words of reassurance on the ride to the hospital. But after he paid her, another enforcement officer ran over and issued her two tickets for owning and operating a vehicle for hire without a licence.

Chris Vinden, a doctor who performs endoscopies and colonoscopies at St. Johns, was upset by the news.

"From my point of view, she is providing a service to the hospital ... It makes the hospital run more efficiently," he said. "(She) solved a lot of problems for us."

In addition to the $2,260 fine, the woman needs $450 to cover the cost of legal representation.

This post has been updated to clarify that the incident took place in London, Ontario.

When Governments Suspend Their Own Rules

Sun, 18 Feb 2018 06:00:00 -0500

The Political Economy of Special Economic Zones: Concentrating Economic Development, by Lotta Moberg, Routledge, 192 pages, $140 All over the world, in carefully delimited areas, governments have carved out exceptions to their own rules. These special economic zones, better known as SEZs, come in many sizes and types, ranging from simple duty-free warehouses to jurisdictions the size and complexity of entire cities. Host governments typically roll back taxes, customs, and similar barriers to trade in their zones, but sometimes offer special labor, environmental, or financial regulations, too. You probably live within a short drive of an SEZ: The United States has more than 400 of them, in the form of Foreign Trade Zones. Today most countries—about 75 percent—host SEZs of some sort. Worldwide, they number well over 4,000, and if you count micro-zones, some of them no bigger than parts of buildings, over 10,000. Though the core idea runs back to ancient times (including the colonial proto-SEZs that gave rise to the United States), modern special economic zones started to emerge in 1948, when Operation Bootstrap made Puerto Rico a special trade and processing zone. A more popular model emerged in 1959, when the international airport in Shannon, Ireland, opened a special zone to accommodate transshipping and value-added processing. More recently, as with the zones that already fill China and that are planned in Saudi Arabia and Honduras, SEZs have grown to cover whole cities and areas of law. The Political Economy of Special Economic Zones casts a coolly objective eye on this latest institutional mutation to issue from the roiling competition of global trade. Its author, Lotta Moberg, a recent graduate of George Mason University's economics doctoral program and now an analyst at the investment bank William Blair & Co., finds both opportunities and challenges in their rise. As Moberg explains, politicians often have self-interested reasons to promote special economic zones. Sometimes they're merely seeking a new venue for graft. More honorably, they often hope the zones will attract investment, create jobs, and increase exports—and that voters will reward them for it. Can SEZs work such wonders? Moberg voices doubt. Her book lays out the reasons, deeply informed by public choice reasoning, why SEZs too often distort economies rather than help them grow. Politicians lack the information and incentives required to plan and run the zones well. Many become burdens to their hosts, and they can distract policy makers from broader and more essential reforms. Yet Moberg also reveals an underappreciated benefit of SEZs: Under proper conditions, they can help free an economy from pervasive rent-seeking and transition it to a more open system of market exchange. Her book concludes with insightful suggestions for how reformers can ensure zones fulfill this, their greatest potential. Among them: Make SEZs big, make them diversified, and let private parties rather than government agents choose the sites and run them. Intellectuals have been theorizing about how to run governments for almost as long as governments have been running. But SEZs offer a unique opportunity for empirical study, an opportunity that Moberg seizes. Special economic zones allow a single country to test different policies within its own borders. The popularity of America's Foreign Trade Zones, for instance, has scattered small, custom-free areas all across the country. SEZs also allow different countries to test the same policies across borders, as when Dubai imported the common law of England and Wales to its International Financial Centre. Social scientists could hardly ask for a better experimental framework for testing the real-world impact of varying rules. Moberg's book draws on the author's field work, primarily in the Dominican Republic, and on other SEZ research, much of it conducted by the World Bank. From this rich collection of data, she prod[...]

Tennessee Bill Would Make It Easier for Ex-Convicts to Get Jobs

Thu, 15 Feb 2018 14:45:00 -0500

In Tennessee, a new bill would make it easier for ex-convicts to find work by easing the burden occupational licensing boards place on people released from prison. If the bill became law, boards could only deny licenses based on past crimes that are directly related to the sought-after occupation, preventing arbitrary discrimination against people with criminal histories. "When the prison doors open and it is time for those who have served their time to be returned to our communities, one of the most critical factors to keep them from re-offending is an opportunity to make a living," said Republican Senator Kerry Roberts. "This bill helps remove barriers that exist in licensing so that they have access to employment as long as the offense does not directly relate to the occupation or profession." "Last year there were over 13,000 felons released out of our jails and prisons in Tennessee with over 2,200 released from Shelby County," said Democratic Senate Minority Leader Lee Harris. "The most important thing we can do to ensure these folks don't return is to provide them with a path to employment." Occupational licensing boards remain a significant problem for those seeking employment after prison. As Reason's Eric Boehm reported: In 29 states, occupational licensing boards are allowed to reject applications from anyone with a felony conviction. In Illinois, for example, a criminal record automatically disqualifies people from obtaining 118 different state licenses, preventing them from pursuing work as barbers, massage therapists, roofers, cosmetologists, and dozens of other professions. Around a quarter of persons in the U.S. had to acquire an occupational license in order to practice their current profession, up from only 5 percent of persons in 1950. And in many states, no matter how unnecessary the license my seem (be it a florist license, horseshoeing license, or a milk testing license), ex-offenders can be prevented from obtaining permission to work if they have a criminal record. Tennessee is one of the of harsher regulatory states with respect to occupational licensing. The Institute for Justice ranks the state as the 13th most "broadly and onerously licensed state." According a press release relating to the bill, Tennessee requires a license for 110 jobs and nearly every licensing board can deny a license due to past crimes, including misdemeanors. This bill marks a potential step in the right direction, and measures like these may even slow the current rate of incarceration. With fewer options to earn a living, formerly incarcerated persons are more likely to be drawn to a life of crime.[...]

What Jimmy Carter and Jerry Brown Can Teach Us About Deregulation

Fri, 09 Feb 2018 07:05:00 -0500

When President Trump bragged in his first State of the Union address that "we have eliminated more regulations in our first year than any administration in the history of our country," the response from Democrats was not surprising. "Deregulation," warned Center for American Progress senior adviser Sam Berger in Fortune, "is simply a code word for letting big businesses cut corners at everyone else's expense." Such a jaundiced definition of the term, routine though it may be on the contemporary left, would be unrecognizable to leading Democratic politicians of the late 1970s, including the president who jump-started the modern notion of deregulation: Jimmy Carter. Reclaiming that lost history may soon prove crucial in an era marked by unsustainable public sector spending obligations. "We really need to realize that there is a limit to the role and the function of government," Carter said in his first State of the Union address, in 1978. "Bit by bit we are chopping down the thicket of unnecessary federal regulations by which government too often interferes in our personal lives and our personal business." If that sounds more like your conception of Ronald Reagan than the peanut farmer from Plains, it may be time to check your premises. After televised hearings chaired by Democratic Sen. Ted Kennedy, based on academic spade-work by the liberal economist Alfred Kahn, featuring testimony from consumer advocate Ralph Nader, Carter in 1978 signed the death warrant for the Civil Aeronautics Board, thus breaking up the regulatory cartel that had kept the same four national airlines virtually unchallenged the previous four decades. Thus began a federal assault on "price and entry" regulations, or rules that determine which companies can compete in a given industry and what they're allowed to charge. Carter also lifted individual prohibitions, most notably (thanks to an amendment by California Democratic Sen. Alan Cranston) on brewing beer at home. Result? You're drinking it. There were fewer than 50 breweries in the United States when Carter deregulated basement beer-making; now there are more than 5,000. In two generations, America went from world laughingstock to leader in the production of tasty lagers and ales. Such was Carter's conviction about deconstructing chunks of the administrative state that he dwelled on it at length in his only presidential debate with Reagan. "I'm a Southerner, and I share the basic beliefs of my region [against] an excessive government intrusion into the private affairs of American citizens and also into the private affairs of the free enterprise system," he said. "We've been remarkably successful, with the help of a Democratic Congress. We have deregulated the air industry, the rail industry, the trucking industry, financial institutions. We're now working on the communications industry." Here in California, then fresh off its Proposition 13 tax revolt, Jerry Brown, in his first stretch as governor, was sounding similar themes. Government must "strip away the roadblocks and the regulatory underbrush that it often mindlessly puts in the path of private citizens," Brown said during his bracingly anti-statist second inaugural address in 1979. "Unneeded licenses and proliferating rules can stifle initiative, especially for small business….[M]any regulations primarily protect the past, prop up privilege or prevent sensible economic choices." These insights from the Disco Era are sorely needed today, particularly on the state and local level, where much of the price-and-entry regulatory action takes place. In the '70s, around one job in every 10 required a government-enforced occupational license; now the ratio is closer to one in three. As Kahn and other liberal economists could have told you, those licensing boards tend to be shaped by industry incumbents, who are incentivized to protect their turf. So you have such insane regulations as[...]

What Jimmy Carter Can Teach Us About Deregulation: New at Reason

Fri, 09 Feb 2018 07:05:00 -0500

A Republican Congress is jacking the federal deficit back over the $1 trillion threshold, just as the cost of borrowing is spiking upward. Democratic mayors and governors are grappling with annual public-sector pension outlays that will increase by 50 percent over the next seven years. It won't take much more folly to send us careening into a new "era of limits," argues Matt Welch, in which case we should start asking ourselves a very '70s question: What would Jimmy Carter do?

Trump is no Deregulator on Immigration

Thu, 25 Jan 2018 16:51:00 -0500

The University of Pennsylvania Regulatory Review has just published my article on how the widespread belief that Trump is a deregulator is contradicted by his immigration policy. The article is part of the Regulatory Review's symposium on "Regulation in the Trump Administration's First Year," which also includes contributions by Hawaii Attorney General Douglas Chin, Texas AG Ken Paxton, and law professors Dan Farber (UC Berkeley), Cary Coglianese (University of Pennsylvania), Richard Pierce (George Washington) and Mark Nevitt (Penn). Here is an excerpt: If there is one thing that most commentators agree on about President Donald J. Trump's economic policies, it is that he promotes deregulation. American Enterprise Institute President Chris DeMuth lauds him for being a "full-spectrum deregulator." Susan Dudley, a leading academic expert on regulation, similarly concludes that Trump has made "undeniable" progress on the deregulation front. Most liberal commentators agree that Trump has been a deregulator, even if they differ from DeMuth and Dudley in their normative evaluation of his actions. But the near-universal belief that Trump is a deregulator is in need of serious revision. His Administration's immigration policies are nothing of the kind. Not only do they increase regulation, but they likely do so far more than Trump's other policies decrease it... The impact is by no means limited to immigrants. American citizens also face substantial costs, both narrowly "economic" and otherwise. American businesses and consumers obviously suffer from losing the productivity of those excluded or deported by the Administration. American citizens also obviously suffer from being cut off from family members who are deported or banned from entering the United States. In addition, expanded efforts to deport undocumented migrants also harm American citizens. Shockingly, the federal government probably detains or deports several thousand American citizens every year, on the assumption that they must be illegal aliens. Once arrested by immigration authorities, these people are "swept into the Kafkaesque nightmare of the immigration system, [where] they are effectively assumed illegal until proven otherwise," as immigration expert Shikha Dalmia puts it.... The article also addresses claims that Trump's immigration policies are just a matter of "enforcing the law" by reducing illegal immigration, an interpretation further belied by his support for legislation that would massively cut legal immigration. There is an interesting synergy between my article and Cary Coglianese's forthcoming contribution to the same symposium, which argues that Trump's deregulatory record elsewhere is not nearly as extensive as it is cracked up to be (I did not have an opportunity to see his essay before completing my own).[...]

The Feds Are Willing to Let More Medical Workers Treat Opioid Addicts. Now the States Need to Step Up and Allow It.

Tue, 23 Jan 2018 15:30:00 -0500

The Drug Enforcement Administration (DEA) announced today that it will begin granting waivers making it easier for nurse practitioners and physician assistants to administer a drug designed to wean people off prescription painkillers and heroin without inducing withdrawal. Under the new rule, they'll be able to give patients the drug—buprenorphine—in outpatient settings without requiring that care providers register as narcotics treatment programs. If the state where they practice allows it, nurse practitioners will also be allowed to administer the drug without a physician on the premises. The Food and Drug Administration approved buprenorphine in 2002. That same year, the Department of Health and Human Services created a waiver program that would allow physicians to administer the drug in a primary care setting. The waiver system was designed to provide an alternative to the regulatory obstacles physicians must navigate to set up a treatment center. Establishing a federally approved treatment program requires you to submit an application to both the DEA and the Food and Drug Administration, plus a state regulatory agency. Applicants must then be interviewed and have their facilities inspected by all three agencies. The waiver provision—which also involves a fair amount of paperwork—was intended to expand treatment access to Americans in rural areas. But nurse practitioners and physician assistants weren't allowed to apply for the waivers. In 2016, the Comprehensive Addiction and Recovery Act changed the waiver eligibility language from "qualifying physician" to "qualifying practitioner." The DEA's notice states that the definition of "qualifying practitioner" will include physicians, physician assistants, and nurse practitioners until October 2021, at which point the language will have to be reauthorized. Under the new regulations, any nurse practitioner or physicians assistant who is licensed to administer a schedule III drug can now apply for a waiver. (Schedule III drugs have moderate potential for abuse and can be mildly habit forming.) They will be required to undergo 24 hours of training, and they will need a physician's authorization if their state requires them to work under a doctor's supervision. All physician assistants require such supervision, but 22* states and the District of Columbia allow nurse practitioners "full practice" status, meaning they can prescribe drugs independently of a medical doctor. Unfortunately, many of the states hit hardest by opioids do not allow nurse practitioners this independence. Pennsylvania, New Hampshire, Kentucky, West Virginia, and Ohio had the highest overdose death rates in 2016. Of those five, only New Hampshire allows nurse practitioners to prescribe independently. That blunts the impact of today's announcement. According to the DEA, "rural providers of buprenorphine report a demand far beyond their capacity and say they lack the resources to adequately support themselves and patients in treatment." A 2017 report from the National Rural Health Association revealed that only 39 percent of rural counties have a waivered physician. Meanwhile, a 2016 survey found that 36 percent of waivered physicians who are not treating the maximum number of patients allowed by Health and Human Services say it's because they lack the time to treat additional patients. A 2015 research review by the Kaiser Family Foundation found that nurse practitioners "can manage 80–90% of care provided by primary care physicians" and that primary care outcomes between nurse practitioners and physicians are roughly identical. The DEA took a step in the right direction today. Now states need to make it easier for non-physicians to keep their patients alive. *Correction: This post erroneously stated that nurse practitioners have full practice authority [...]

Trump Turns One

Thu, 18 Jan 2018 09:30:00 -0500

The 45th president does not tend to elicit measured evaluations. Since even before his formal entry into national politics in 2015, Trump has acted as a powerful magnet on the body politic—attracting and repelling onlookers with equal force. A year ago, as we prepared to see a former reality television star sworn into the highest office on Earth, predictions abounded regarding the effects he was about to have on the country and the world. On one side were confident assertions that he would repeal the Affordable Care Act, bring back manufacturing jobs, and end political correctness once and for all. On the other were fears that he was a racist and a dimwit who would certainly abuse the powers of his station and might well start a nuclear war. On the Trump presidency's first birthday, the reality is less extreme than either set of prognosticators envisioned. The Republican Party under his leadership managed one major legislative accomplishment—tax reform that cut the corporate rate and is projected to add nearly $1.5 trillion to the debt—and failed after months of wrangling to enact an Obamacare replacement. Tensions with foreign governments from Iran to Russia to North Korea continue to simmer. The stock market has followed a dramatic upward trajectory, yet anger continues to grow over perceived wealth and income inequality. With the midterm elections now 10 months away, political polarization seems to hit new highs daily, but in many ways the checks and balances of our federalist system are working to keep even the current unscrupulous White House occupant from actualizing his most ambitious plans. As the 365-day mark approaches, have we reached a milestone worth celebrating or taken just another step in our national descent to unthinkable places? Reason asked 11 experts to weigh in on Trump's record so far. From positive signs on transportation policy and regulatory rollback to a worrying rise in nationalist sentiments and redoubled efforts to cleanse the United States of undocumented immigrants, the answers were a mixed bag, highlighting just how much uncertainty awaits the country in the year to come. —Stephanie Slade TAXES AND HEALTH CARE: Victory, Sort of, Maybe Peter Suderman At the beginning of 2017, Speaker of the House Paul Ryan told GOP lawmakers that the new Congress would repeal Obamacare and pass deficit-neutral tax reform by August. At summer's end, Republicans, despite holding majorities in both chambers, had accomplished neither. But eventually they would accomplish parts of each. In March, the House was set to hold a vote on legislation that would have repealed much of the Affordable Care Act while setting up a new system of related federal tax credits. Ryan was initially forced to pull the bill from the floor due to lack of support, but after making a series of tweaks intended to provide states with more flexibility, the body passed a health care bill in May. GOP leaders congratulated themselves for making progress on the issue, but the plaudits were premature. The bill stalled out in the Senate. By September, the Obamacare repeal effort was dead and Republicans had moved on to more comfortable territory: rewriting the tax code. At the center of the new effort was a significant cut to America's corporate tax rate, which at 35 percent was the highest in the developed world. Donald Trump had campaigned on slashing it to 15 percent. The GOP aimed for 20. At first, the tax effort went much like the health care effort. There were disagreements between the House, which hoped to partially offset any revenue losses with spending cuts, and the Senate, which gave itself permission to increase the deficit by $1.5 trillion. Republican senators also disagreed among themselves: Jeff Flake (R–Ariz.) and Bob Corker (R–Tenn.) worried abou[...]

How To Make Health Care More Affordable

Wed, 17 Jan 2018 12:00:00 -0500

Virginia's new Democratic governor, and its new class of Democratic lawmakers, have an opportunity to improve access to health care in Virginia. But to do so, they might have to go against their partisan instincts. Gov. Ralph Northam already has made Medicaid expansion one of his top priorities. Republicans don't like the idea. But their recent abandonment of divisive social causes such as abortion and anti-LGBT issues suggests they might be more receptive to compromise on Medicaid as well. Then again, maybe not. Regardless, Democrats and Republicans should be able to find common ground on two other approaches to expanding health care. The first is a bill from Republican Del. Roxann Robinson. HB 793 would let nurse practitioners practice medicine independently, rather than under the thumb of a supervising physician, after a probationary period of supervision. At present, nurse practitioners in Virginia must have a contract to work under a doctor's watchful eye. If a nurse can't find a doctor to agree to such an agreement, the nurse is out of luck. If a doctor retires or dies, the nurse is out of luck. If a doctor joins a group practice with restrictive rules, the nurse is out of luck again. Roughly half the states in the U.S. already permit advanced-practice nurses to operate independently. A huge body of research has validated the approach. The Institute of Medicine recommends it because the rules limiting nurse practitioners "are related not to their ability, education or training, or safety concerns, but to the political decisions of the state in which they work," and because "most studies showed that NP-provided care is comparable to physician-provided care on several process and outcome measures. Moreover, the studies suggest that NPs may provide improved access to care." The Department of Veterans Affairs adopted the reform last year. The Kaiser Family Foundation endorses it. The Federal Trade Commission also supports expanding the ability of nurse practitioners to perform medicine independently, which would provide "safe, lower-cost competition" to physicians. Likewise, it would increase the supply of medicine in underserved areas, such as rural areas, where there is a serious shortage of doctors, as well as statewide. (By one estimate, Virginia will need 29 percent more doctors by 2030 to maintain the status quo.) Other research has shown that giving nurses a greater scope of practice helps bring costs down by as much as 35 percent, with higher levels of patient satisfaction. That's the first reform. The second? Repeal the state's Certificate of Public Need (COPN) requirements. Virginia's COPN regime requires health care providers to get the state's permission to spend their own money on investments such as new hospital wings or major medical devices such as MRIs and CT scanners. The process is hugely expensive and time-consuming — in large part because market incumbents, such as large hospital chains, are allowed to weigh in on whether the state should permit new entrants to compete with them. Congress originally imposed the system to deal with a problem caused by federal reimbursement rates for Medicare and Medicaid. Washington eventually changed the reimbursement formulas and lifted the COPN requirement, but many states (including Virginia) kept it in place. In theory, COPN is supposed to control health care spending through central planning. In practice, it doesn't. Washington state found, for instance, that "CON has not controlled overall health care spending or hospital costs." A commissioner for the Federal Trade Commission has written: "Ironically, a government program originally aimed at reducing health care prices is likely inflating them, at least in some situations." The FTC and the Antitrust Division of[...]

Will Deregulation Kill Workers?

Thu, 11 Jan 2018 11:15:00 -0500

A temporary federal hiring freeze last year saw staffing numbers at the Occupational Safety and Health Administration (OSHA) fall by about 4 percent. Forty of the agency's approximately 1,000 inspectors departed without replacements filling their vacated positions. Some observers see this as an example of deregulatory fervor running amuck and costing lives. "The bottom line," wrote former OSHA official Jordan Barab, "is that shrinking government is not just about reducing employees and 'bureaucrats,' or combating 'waste, fraud and abuse,' it means limbs severed and lives lost." "While Trump might say we need smaller budget, smaller government, at the end of the day I think workers would rather their health and safety thought of," says Marni Von Wilpert of the Economic Policy Institute. A declining number of OSHA inspectors, managers, and other staff, she tells Reason, are putting lives at risk. In fact, as with most critiques of the Trump administration's rather marginal regulatory rollbacks, these worries about a small decline in the number of safety snoops are overwrought. They carry an implicit assumption that only federal regulation can keep workers safe, but the evidence suggests the opposite: While the number of OSHA inspectors per capita has declined, American workplaces have only gotten safer. Since agency's founding in 1971, the number of OSHA inspectors has stayed pretty consistent, never going above 1,500; it has hovered around 1,000 since the early 1980s. During that same time, the number of workplaces in the United States has expanded rapidly. So the ratio of inspectors to workers has fallen from roughly 15 inspectors for every million employees in 1980 to 6.8 per million in 2016. "The economy has been growing and jobs have been growing. OSHA's ability to keep up with workplace safety has been shrinking," von Wilpert says. Yet workers are safer on the job now than at almost anytime before. In 1980, 13,800 people died at work—a workplace fatality rate of 13 deaths per 100,000 workers. By 2015, worker deaths were down to 4,836, making for a workplace fatality rate of 3.4 deaths per 100,000 workers. Workplace fatalities were also falling at a continous rate in the decades prior to OSHA's creation, dropping from 37 deaths per 100,000 workers in 1933 to 17 per 100,000 workers the year OSHA was created. None of that surprises John Leeth, a Bentley University economist who has researched workplace safety. A marginal decline in the number of OSHA inspectors in nothing to be concerned about, he says. "It's hard to say that increasing the number of inspectors for OSHA or reducing them by small amounts is going to have much of an impact one way or another," Leeth tells Reason. Employers have much stronger incentives than OSHA to provide a safe workplace. Each state, for example, requires employers to purchase workers compensation insurance for their employees. Those policies cost employers $91.8 billion in 2014, according to a study conducted by the National Academy of Social Insurance. Total OSHA penalties in that same year totaled only $143.5 million. Like other forms of insurance, workers comp grows more expensive with new injuries and accidents. Leeth estimates that this incentive to improve workplace safety is responsible for up to a 22 percent reduction in workplace fatalities. Labor markets themselves provide another major incentive for employers to provide safer working conditions. "Workers don't like risk," says Leeth. "There is nothing to be gained by taking a risky job other than the employer giving you something in return." A 2012 working paper co-authored by Leeth found that employers paid an additional $100 billion a year in this kind of danger pay, easily dwarfing the costs of OSH[...]

D.C. Deregulates Birth Control...and Dooms It With Obamacare Add-Ons

Wed, 10 Jan 2018 12:45:00 -0500


The District of Columbia Council gave the green light Tuesday to a bill allowing birth control pills to be purchased with a pharmacist's prescription.

The measure stops short of allowing over-the-counter contraceptive sales, which would run afoul of Food and Drug Administration policy. But it would allow for women to obtain birth control pills without regular visits to a doctor. The D.C. Board of Pharmacy would figure out how to implement the change.

The change would put D.C. in line with a rapidly increasing number of states allowing pharmacist-prescribed oral contraceptives. Following Oregon and California's lead, Colorado, Hawaii, Maryland, Missouri, New Mexico and Ohio passed similar legislation last year. Several others (including Iowa, Illinois, Massachusetts, Maine, South Carolina, Texas, and Tennessee) considered it.

The D.C. bill isn't all deregulatory goodness: it would also enshrine parts of the Affordable Care Act (ACA) into local law, including the requirement that insurance companies cover contraception and other preventative health services at no out-of-pocket cost to the insured. The idea is to ensure their continued "free" coverage even if all or part of the ACA is repealed.

The bill now heads to D.C. Mayor Muriel Browser. If she signs it, the measure will then (like all D.C. legislation) be subject to congressional review—which could be tricky considering the current climate with regard to contraception mandates and Obamacare in general.

"No other state or local jurisdiction in the country has to worry that a random congressman is going to try and meddle with a locally-passed law," lamented D.C. council member and author of the bill, Charles Allen, in a statement.

True—but decreasing the barriers to accessing contraception might have a better chance if not yoked to a currently pointless policy backing up an already existing (and controversial) federal law.

Deregulatory Successes Point to Direction for Trump Administration

Tue, 09 Jan 2018 00:15:00 -0500

Even as CNN talking heads remain in shock that Donald Trump is actually president, and the man himself apparently sees social media as a means to go full drunk-uncle on an international scale, millions of Americans continue to support the current resident of the White House. FiveThirtyEight has Trump's approval ratings at 38.8 percent as I write, and an insight into why many Americans continue to put their faith in this president landed last week in the form of a Washington Post article on the relief felt by Iowa farmers over the Trump administration's push to roll back much-resented regulatory red tape. "Obama set aside millions of acres of undeveloped land as national monuments—more than any other president—preventing huge areas from being mined, logged or farmed. Obama also implemented more regulations with a significant economic impact than any president in three decades, according to the George Washington University Regulatory Studies Center. Those actions were cheered by many Americans but widely viewed in rural areas as killing jobs." Iowa, a farming state, notably went overwhelmingly for Trump in 2016 after supporting Barack Obama in both 2008 and 2012. The Obama administration's controversial Waters of the United States rule received particular criticism for extending federal jurisdiction over unlikely wet patches of ground in ways that burdened the use of private property. The U.S. Court of Appeals for the 6th Circuit issued a nationwide stay against the rule in 2015, but memories linger. And so does resentment of politicians and regulators who seem clueless or even actively hostile to whole ranges of economic activity. "The overwhelming number of proposed regulations on the nation's food system is unprecedented and promises profound effects on both the structure and competitiveness of all agriculture," Carl Shaffer of the American Farm Bureau Federation noted in congressional testimony during 2011 hearings. "EPA proposals are overwhelming to farmers and ranchers and are creating a cascade of costly requirements that are likely to drive individual farmers to the tipping point." Business people who never touch a plow have similar concerns about regulation. "The average small-business owner is spending at least $12,000 every year dealing with regulations," National Small Business Association President and CEO Todd McCracken commented upon the release of a survey of small business owners last year. "This has real-world implications: more than half of small businesses have held off on hiring a new employee due to regulatory burdens." In that survey, 58 percent of small business owners said federal rules were the most burdensome to their business, with a specific emphasis on the tax code and the Affordable Care Act. Unsurprisingly, USA Today reported as Trump took office that "small businesses are hoping to see some high-profile Obama administration regulations scrapped." The federal government was equally tough on the energy industry, issuing rules regarding hydraulic fracturing that were sufficiently overreaching that they were quickly blocked by the courts as being "in excess of its statutory authority and contrary to law." Those rules were officially rescinded at the end of December, prompting the market-friendly Las Vegas Review-Journal to exult, "President Donald Trump's deregulation agenda has perhaps been the defining accomplishment of his first year in office. " Which is an interesting point. Largely lost in headlines about Russians, campaign dirty tricks, and Trump's alleged shock at his own victory is his administration's follow-through on deregulatory promises. Soon after taking office in January 2017, Trump ordered federal [...]