The latest data on fatal drug overdoses just released by the Centers for Disease Control and Prevention (CDC) show record numbers. Nearly 108,000 Americans died of drug overdoses in 2021. This is far more than in 2017, when President Trump declared drug deaths a public-health emergency. Among blacks, the drug mortality rate has quadrupled in less than eight years.

What accounts for this increase?

Joseph Grogan and Casey B. Mulligan, writing in The Wall Street Journal, say the Covid pandemic is one reason. The Trump administration acted aggressively and directed agencies to implement several recommendations from the Commission on Combatting Drug Addiction and the Opioid Crisis. These included changes to prescribing patterns, treatment paradigms and law-enforcement procedures. The rate of deaths from drug overdoses slowed and then dipped. But then Covid hit, bringing with it numerous mental health consequences, aggravated by lockdowns, school closures, and job losses. These authors now say the addiction and overdose crisis is the most important public-health issue facing the country.

But a more important reason is the unchecked flow of illegal drugs coming across our southern border. It seems the Biden administration has no intention of changing this. President Biden’s most recent budget pays little attention to it, while his National Drug Control Strategy provides resources, such as clean syringe programs, that aren’t coupled with strategies to help patients beat addictions or stem the flow of illegal drugs.

The main problem drug is fentanyl. Fentanyl is 100 times more potent than morphine. When I was hospitalized with a kidney stone, I was given fentanyl in the emergency room and then transported to the floor. When I later asked for more fentanyl, I was told fentanyl was only available in the emergency room and the operating room, where there was equipment and personnel immediately available for resuscitation, if needed. Imagine such a drug being casually taken by drug addicts on the street! It’s no wonder the number of fatal overdoses is rising rapidly.

Fentanyl is not a new drug. Until 2013, it was only available in hospitals under strictly controlled conditions. But these authors share that in 2013, President Obama and Attorney General Eric Holder decided to end the war on drugs, and illicit fentanyl flooded into the country. In the past decade, many blue states and localities have opted to accommodate the public use of previously illicit drugs. Progressive prosecutors and movements to defund the police have contributed to this wholesale surrender by civic leaders to drug abuse.

Fentanyl is so lethal, a single backpack of this drug could kill a million people. Yet Biden eliminated controls on illegal immigration instituted by his predecessor. The Trump administration’s Drug Enforcement Agency temporarily placed all of its analogs – such as carfentanyl, acetylfentanyl, butyrfentanyl, and others yet to be invented – into Schedule I of the Controlled Substances Act. That prevented drug cartels from tweaking the chemical composition of the drugs to get around prosecution.

While Congress is supposed to be working to update this temporary order into a permanent change, over 100 civil rights groups have pressured the White House to stop this move, asserting that using law enforcement to stop fentanyl is racist! The rate of drug overdose of whites exceeded the rate of blacks before 2019, but has since surged past it during the pandemic to reach 43 annually per 100,000 of the black population since last September. In other words, those who claim to be looking out for the interests of minorities are in fact doing just the opposite – they’re looking out for the interests of drug dealers and cartels.

Stopping the flow of illegal drugs across our borders and putting an end to the widespread use of fatal drugs like fentanyl are two things needed for all Americans, no matter what the color of their skin. Anyone getting in the way of these goals are the real racists.

Getting old isn’t for cowards. That’s an old cliché, but why does the government have to pile on? It’s tough enough to deal with the challenges of getting old without the government making it even harder.

John C. Goodman, healthcare economist writing in Forbes, says the federal government spends an enormous amount of money on the elderly – far more than it spends on children. But at the same time, rules, regulations, taxes, and penalties create enormous burdens for senior citizens when they do such ordinary things as work for wages, withdraw funds from an IRA or even try to insure for medical expenses.

Social Security

Social security was set up by the Roosevelt Administration to protect the elderly. But seniors who claim early retirement under Social Security face the highest tax rates in the nation when they earn more than a modest amount of wage income. These taxes can exceed 90 percent, and they are far higher than the rates faced by Warren Buffet or Jeff Bezos, two of the richest men in the world. Some seniors face higher tax rates on capital gains and pension fund income than younger people at the same income level. Some are even taxed on their tax-exempt income!

You probably believe your accountant is aware of these issues and takes the necessary steps to minimize the damage. But Goodman says even well-trained CPAs tend to be unaware of the problems seniors encounter when they try to insure against unexpected medical expenses – not to mention those seniors who file their own taxes.

Health Savings Accounts

A good example is Health Savings Accounts (HSAs). Goodman is the founder of this extremely popular program which allows nonseniors to self-insure for medical expenses not paid for by third-party health insurance. People can put pre-tax dollars in their HSA and employers can contribute as well. Funds can be invested at the owner’s discretion and the accounts are completely portable – you can change jobs and take your HSA with you. About 30 million Americans have an HSA with an accumulated $82 billion in these plans. Some financial experts have called these plans the most attractive way there is to save – even better than an IRA or a 401(k) plan.

But seniors can’t have an HSA. I had one until I reached age 65 and then I had to give it up. Once you become eligible for Medicare, you can no longer open and contribute to an HSA. You can use the existent funds, but when they’re gone, they’re gone.

Prescription Drug Costs

This is especially bad for seniors who face all kinds of out-of-pocket expenses when it comes to healthcare. Prescription drugs is a good example. A senior who enrolls in Medicare Part A (hospital services), Medicare Part B (doctor services) and Medicare Part D (drugs) can face considerable costs for drugs, even after paying premiums. I take 12 pills a day and my wife takes even more. You can almost bet that the older you get the more pills you’ll be taking! You’d think that Medigap insurance would pick up the slack for these expenses, but it doesn’t. For some strange reason, the law doesn’t allow Medigap to pay for the patient’s share of drug costs.

A study of 28 expensive specialty drugs found that among Medicare enrollees covered by Part D drug insurance, the out-of-pocket spending by patients ranged from $2,622 to $16,551 annually! No wonder the drug discount coupons (GoodRx, SingleCare) are so popular.

Here is how Medicare drug coverage is working in 2022. After a deductible of $445, Medicare pays 75 cents of the next dollar of cost. And it pays 75 cents of the dollar after that. It keeps on doing this until the patient’s out-of-pocket expenses reach a limit of $6,550. Above that amount, in the “catastrophic phase,” the patient is responsible for 5 percent of any additional costs. For the 28 drugs mentioned above, more than half (61 percent) would require an average cost of $5,444 a year in out-of-pocket costs in the catastrophic phase alone.

What can be done about this?

Congress could change the laws governing Medicare. There are also market-based alternatives. Goodman mentions a Houston-based firm called Health Matching Account Services (HMA) which has been offering young people a way of insuring out-of-pocket medical costs that is intriguing. In recent years it has been expanding to the senior market as well.

Under a standard plan, seniors make a monthly contribution of $140 to an HMA. After 12 months, they will have paid $1,680. For that amount, they will have coverage for the first $1,980 of medical expenses. That means they are getting $1.17 of coverage for every dollar they contribute in the first year. But it gets better. In year two you get $2 of coverage for every dollar contributed. In year three it goes up to almost $3 per dollar. After 35 months of payments, people who have had no medical bills will have $10,000 of coverage in return for monthly payments of less than half that amount. When you draw down your account, you can replenish it by resuming the $140 monthly payments.

Goodman says what’s needed even more is deregulation. He says, “Seniors deserve real catastrophic coverage and they deserve the opportunity to save and manage their own health care dollars for noncatastrophic expenses.” The market is capable of providing these needs if the government would just get out of the way.

 

(Author’s note: The following blog was posted on 2/11/15, just five years after the passage of the new healthcare bill called the Affordable Care Act, which we now know as ObamaCare. In the last post, I reviewed the current status of ObamaCare. Today I let you review what I said about it seven years ago. You can see that things have gone from bad to worse.)

 

The Republican-controlled House of Representatives recently passed a bill to repeal ObamaCare. President Obama responded in his usual way – he doubled-down on his failed healthcare legislation. He said, “This is working not just as intended, but better than intended.”

There is a theory about prevarication that asserts that if you tell a lie often enough, many people will begin to believe it. Therefore it’s worth remembering all of the previous promises of President Obama concerning his signature healthcare law.

Broken Promises Review

Chris Conover, healthcare analyst for Forbes, recently reviewed the five most significant promises made by President Obama:

Promise #1: Universal Coverage

Obama: (6/23/07) – “I will sign a universal health care bill into law by the end of my first term as president that will cover every American.”

Excluding the illegal aliens never intended to be covered by ObamaCare, the latest Congressional Budget Office (CBO) projections (April 2014) expect that by 2017, ObamaCare will cover 92% of the nonelderly population. (Nearly everyone over 65 is already covered by Medicare.) Sounds good – until you realize that 84.7% were already covered in March 2009 before the law was passed.

Therefore, even if the CBO projections are accurate (and they usually overestimate), ObamaCare will only increase the rolls of the insured by 48% of the deficit. In other words, ObamaCare will insure less than half of those it was intended to insure. How can Obama claim the law is working “better than intended?”

Promise #2: No New Taxes on the Middle Class

Obama: (9/12/08) – “I can make a firm pledge under my plan, no family making less than $250,000 a year will see any form of tax increase. Not your income tax, not your payroll tax, not your capital gains taxes, not any of your taxes.”

The CBO and the Joint Committee on Taxation projects ObamaCare will increase federal revenues by $1.058 Trillion between 2013 and 2022. Only 30% of that will be raised from taxes exclusively targeting households earning more than $200,000 (individuals) or $250,000 (married).

That leaves 70% of the taxes to be imposed on all income levels. Many of these taxes will be levied directly upon health insurers, medical device manufacturers, drug companies, etc. – and later passed on to consumers. Even if you assume that such households will only bear a similar share of the burden as they do to all federal taxes, this still leaves at least 35% to be borne by families at or below middle-class incomes. That’s not what Obama promised.

Promise #3: Annual Premium Savings of $2,500

Obama: (6/5/08) – “We’ll lower premiums by up to $2,500 for a typical family per year. . . . We’ll do it by the end of my first term.”

This promise was repeated many times, the most recent on 7/16/12 (after the law was passed). Some have argued this was actually meant to convey that total health spending would decline by that amount. Conover suggests allowing the president this adjusted promise – and also allowing him 12 years rather than four to accomplish his goal.

Even by these relaxed standards, his promise doesn’t hold up. According to figures from the left-leaning Kaiser Family Foundation/Health Research & Educational Trust annual Employer Health Benefits surveys, there has been no evidence of declining growth in health insurance premiums. The graph below makes this clear.

Once again, ObamaCare’s outcomes fall short of Obama’s intentions.

Promise #4: No Increase in the Deficit

Obama: (9/9/09) – “I will not sign a plan that adds one dime to our deficits.”

Rep. Paul Ryan pointed out in February 2010 that Obama’s claims used “gimmicks and smoke-and-mirrors” economics to make this claim. The CBO was forced by the White House to use 10 years of revenues but only 6 years of spending to achieve the desired projections.

Since then, several other more accurate assessments have drawn similar conclusions as Ryan. In June 2010, former CBO director Douglas Holtz-Eakin concluded, “the new reform law will raise the deficit by more than $500 Billion during the first 10 years and by nearly $1.5 Trillion in the following decade.”

In April 2012, Medicare public trustee Charles Blahous concluded ObamaCare would add at least $340 Billion to the deficit between 2012 and 2021 but possibly as high as $530 Billion. In February 2013, the Government Accountability Office (GAO) projected that ObamaCare could add $6.2 Trillion (2011 dollars) to the deficit over the next 75 years. That’s a lot of dimes added to the deficit, Mr. President.

Promise #5: You Can Keep Your Plan If You Like It

Obama: (6/15/09) – “If you like your health care plan, you’ll be able to keep your healthcare plan, period. No one will take it away, no matter what.”

This promise was originally made in a speech to the American Medical Association in an effort to reassure doctors and patients that little would change for them. Nothing could have been farther from the truth. In fact, this promise earned President Obama the Politifact “Lie of the Year” award for 2013.

In 2013, after the opening of the ObamaCare exchanges in October, over 6 million Americans received cancellation notices from their healthcare insurers because their old policies were non-compliant with the new law. The RAND Corporation projects that of 17.7 million who would have had non-group coverage in 2016 absent ObamaCare, only 0.2 million will retain that coverage.

Delays in enforcement of the Employer Mandate have delayed the pain of more cancelled insurance policies. Estimates of how many will lose their employer-provided insurance are widespread. The CBO estimates 11 million, the Medicare actuary estimates 14 million, the Lewin Group says 17.2 million, and the American Action Forum estimates as high as 35 million.

Reality

Much like his view of the problem of Islamic extremism, President Obama’s view of his healthcare law seems delusional. In the face of all these failed promises, it is inconceivable that he would argue, “This is working not just as intended, but better than intended.” The American people deserve a better healthcare system – and a president who sees the world as it really exists.