Are you worried that you may face a medical emergency and be hit with a big surprise bill from an out-of-network provider? Maybe you shouldn’t be concerned. If Presidential contender and self-avowed Socialist Bernie Sanders has his way, bills will soon disappear.
The Democrat, who nearly became the party’s nominee in 2016 and is a top choice among liberals for next year, has already unveiled plans to spend more than $48 trillion to eliminate student debt and battle against climate change. Now Sanders aims to “release a new proposal to cancel $81 billion worth of medical debt Americans are struggling to pay off,” according to the Washington Post.
Great, if your country happens to have a spare $80 billion or so sitting around.
I jest, because of course the United States didn’t have that kind of money available when I was Treasurer in the 1980s and tax revenues were pouring in. These days, money is tighter. Congress is already spending $1 trillion per year more than the country takes, and the federal budget deficit is already more than $20 trillion. There simply isn’t any money to spend on big government programs.
To be fair, it’s easy to mock Sanders and his big government approach to every social ill. This is the man, after all, who once told CNBC: “You don’t necessarily need a choice of 23 underarm spray deodorants or of 18 different pairs of sneakers.” He would presumably use Washington’s power to reduce consumer choices in health care as well as deodorants.
However, it’s less funny when Republicans want to use the power of the federal government in an ill-fated attempt to eliminate big medical bills.
When it returns from a month-long break, Congress may take up S.1895, a bill called the “Lower Health Care Costs Act.” It’s sponsored by Republican Lamar Alexander of Tennessee, himself a former presidential aspirant. Lower health care costs would be a great goal. But the bill goes about things the wrong way, by empowering government and insurance companies instead of people.
Alexander’s proposal would mandate that health-care providers set a “median in-network rate” for services. That rate would be based on the comparable Medicare (another big government attempt to solve health care costs) rates. It wouldn’t matter whether the recipients are in-network or out-of-network; the price would be controlled.
The problem is that price controls never work. Instead, they always lead to shortages. In this case, the price controls would cap the amount that doctors could be paid. Some providers would leave medicine, leading to a shortage. Patients would face longer wait times and have fewer skilled providers available. That’s not exactly what Americans are clamoring for in the 2020 presidential race.
Meanwhile, insurance companies love this idea. They would start with the new median price, and then start squeezing doctors and hospitals from there. They would offer lower and lower payments as they kept raised premiums for patients. They’d stand to make more money and face less competition as hospitals disappear.
The correct way to deal with the problem of surprise health care bills is by encouraging competition, which tends to drive down prices.
For example, a bipartisan bill sponsored by Sen. Bill Cassidy of Louisiana and Sen. Maggie Hassan of New Hampshire would be a much better option. Their bill, the “Stopping The Outrageous Practice of Surprise Medical Bills Act,” would, among other steps, apply price arbitration to settle health care bills.
Arbitration means that when there’s a price dispute, for example over the cost of out-of-network care, the hospital would submit a number that it considers fair and the insurance company would submit a number that it considers fair. An independent arbiter would choose one number or the other. Both sides would have an incentive to be reasonable, and the patient would benefit. The process is already working in New York state, and deserves a trial nationwide.
Americans need more health care choices, not fewer. Sen. Sanders wants to hobble our successful medical system by imposing price controls and eliminating price discipline. Mitch McConnell and the rest of Congress should refuse to go along. Instead, lawmakers should take sensible actions that can lower costs in the long term and improve the system for everyone.
Bay Buchanan is a former U.S. Treasurer under President Ronald Reagan.
Not all Shi’a-Majority Nations are the Same
The recent alleged arson attack on the Tomb of Esther and Mordechai, a Jewish holy site in Iran, was indicative of the ever-rising rate of anti-Semitism and broader religious intolerance in the Islamic Republic. The recently released United States Commission on International Religious Freedom (USCIRF) annual report had highlighted Iran’s anti-Semitic targeting of its small Jewish population as well as other minorities including followers of the Baha’i faith; the most persecuted faith in Iran.
The USCIRF described that it documented “a particular uptick in the persecution of Baha’is and local government officials who supported them in 2019. Iran’s government blamed Baha’is —without evidence — for widespread popular protests, accusing the community of collaboration with Israel, where the Baha’i World Centre is located. Iran’s government also continued to promote hatred against Baha’is and other religious minorities on traditional and social media channels.”
U.S. Special Envoy to Monitor and Combat Anti-Semitism Elan Carr has said that “anti-Semitism isn’t ancillary to the ideology of the Islamic Republic of Iran. It is a central foundational component of the ideology of that regime, and we have to be clear about it, and we have to confront it and call it out for what it is.” After the Tomb of Esther and Mordechai was set ablaze last weekend, Carr reiterated these statements and called Iran the “world’s chief state sponsor of anti-Semitism.”
In 2016 I wrote, “According to Articles 12 and 13 of the Iranian Constitution, all branches of Islam and Christianity have the right to worship, as do Jews and Zoroastrians, within the limits of the law there. However, converting away from Islam to any other religion is considered haram, or forbidden, and in many cases, could result in execution.”
Anti-Semitism is a historical reality in Iran’s strict brand of Shi’a Islam, which emphasizes the separation between believers and non-believers, expressed in terms of purity versus impurity. The Jewish People Policy Planning Institute explains that in Iran, “under the influence of Zoroastrian traditions, the Jews were considered physically impure and untouchable (najasa). Jews were also prohibited from inheriting from Shiites, whereas the opposite was allowed. A Jew who converted to Islam was entitled to the entire inheritance. Shiites were not allowed to marry Jewish women, except for in temporary marriage (mut’a), which is an inferior and exploitative type of concubinage.”
It is also a little-known fact that the country name of Iran is derived from the ancient Persian word Arya, a linguistic predecessor of the modern European term Aryan. Further, Armenian Nazi collaborator Garegin Nzhdeh (1886-1955) is the founder of the racist Tseghakronism movement, whose ideology is reminiscent of the Aryan supremacy espoused by Nzhdeh’s Nazi comrades. Today, Nzhdeh’s brand of Aryan and anti-Semitic ideology is palpable in both Armenia and Iran, neighboring countries where the Anti-Defamation League has documented that more than half of the populations hold a series of anti-Semitic views — at even higher rate in Armenia (58 percent) than in Iran (56 percent).
At the same time, it is important to note that the majority of Iranians are secular and the regime does not necessarily represent them, or their values. In fact, the Iranian government persecutes its Azerbaijani, Arab, and other citizens from minority populations.
Yet a stark contrast with Iran is found in its Shi’a-majority neighbor, Azerbaijan, which has strong relations with Israel and protects its Jewish citizens as well as other religious and ethnic minorities.
Southern California-based evangelical pastor Johnnie Moore has elaborated on the telling differences in the realm of religious tolerance between Azerbaijan and Iran, noting that Azerbaijan is “a country where Sunni and Shi’a clerics pray together, where Evangelical and Russian Orthodox Christians serve together, and where thriving Jewish communities enjoy freedom and total security in their almost entirely Islamic country.” He has also called Azerbaijan “a model for peaceful coexistence between religions.”
During my own visit to Azerbaijan, I observed and documented this first-hand. I believe that Azerbaijan is a nation that bears the torch, and burden, of bringing religious freedom to its less tolerant neighbors in the region, like Iran.
Perhaps the most dramatic indicator of Azerbaijani tolerance is the post-Soviet state’s special relationship with its Jewish community and with Israel. Last November, Azerbaijan unveiled a statue in honor of the nation’s Jewish war hero Albert Agarunov (1969-1992). Although Agarunov was killed in battle, his legacy remains a powerful symbol of Jewish integration and pride for his Muslim-majority country.
Israel and Azerbaijan have closely cooperated for more than a decade in the realms of security, energy, and tourism. Most recently, Azerbaijan sent its Finance Minister Samir Sharifov to this year’s American Israel Public Affairs Committee (AIPAC) policy conference, where Sharifov said that the country’s “cooperation with Israel is not limited to oil supply; we are interested in widening cooperation in defense and the transfer of technology.”
Sharifov also read remarks from a letter to AIPAC by Mehriban Aliyeva, the first vice president of Azerbaijan, who wrote, “It is gratifying that our former compatriots of Jewish origin, living nowadays in the United States and Israel, have maintained close ties with Azerbaijan and contribute to the strengthening of our relations with these countries. We are grateful to them.”
How can Azerbaijan govern and act so differently from its Shi’a neighbor? Iran is a theocracy that mixes religion and state more thoroughly than any other country in the world. In contrast, Azerbaijan’s constitution affirms the country as a secular state and ensures religious freedom for its citizens. Azerbaijan is also facing its own human rights issues and working on progressing as a nation. However, the fact of the matter remains, though Iran and Azerbaijan share a border, the similarities between their governments largely end there. Not all Shi’a-majority nations are the same.
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