Our view

President Obama must be feeling somewhat relieved, thanks to Putin, Crimea and Malaysia Flight 370. Fox News has moved off of Obamacare.

In fact, we all have. Including Obama. The way we’ve been reading things, the president has whisked his I’m-above-the-law pen and waived or delayed just about every mandate in the law. So no one really knows what is law and what isn’t.

To be sure, Obamacare will remain top of mind in the 2014 election campaigns, as demonstrated a few weeks ago by the election of Republican David Jolly in Pinellas County. What’s more, you can expect Democrats in Florida to target their Republican opponents with negative campaigns focusing on how Republicans have refused health care for Florida’s poor by not expanding Medicaid.

If you’ve tuned in to the current legislative session, the word from Tallahassee is neither the Republican House nor Senate will take up any legislation proposing to expand the free medical care system for the poor.

If you remember, in 2013, the Florida House said “no way” to expanding Medicaid. Speaker Will Weatherford and his leadership team did extensive research prior to the session and determined expanding Medicaid was the wrong way to go for seven reasons. Two of the most prominent reasons: It provides the lousiest kind of health care for its recipients, and the cost will be prohibitive for taxpayers.

One of the theories of enrolling more people in Medicaid is that the recipients, knowing they can obtain medical care from doctors, would dramatically decrease their visits to hospital emergency rooms, the most expensive care available.

No such thing occurs. The journal “Science” recently reported that in Portland, Ore., in a comparison of low-income people enrolled in Medicaid and those not, those in Medicaid made 40% more visits to the emergency room than their uninsured counterparts during their first 18 months in the Medicaid system.
In 2013, the Florida House leadership showed in an extensive Medicaid study, entitled “Florida Health Choices Plus,” how the cost of charity care at Maine hospitals skyrocketed after the Maine Legislature expanded Medicaid coverage in 2001 (Click here and here see tables in PDF format).

And look at the history of Florida’s own Medicaid costs even without the Obamacare expansion. For three decades now, state lawmakers have often referred to Medicaid as the Pac-man that is devouring the Florida budget. The above table shows a 160% increase in 12 years in state Medicaid costs — 43% of which Floridians pay, 57% of which federal taxpayers pay.

Even without expanding Medicaid under Obamacare, Florida Medicaid is expected to consume about $27 billion a year for the next 10 years. If Florida expanded Medicaid under Obamacare, that amount would grow to about $34 billion a year.

Just for context, Florida’s total budget this coming fiscal year is expected to be $75 billion.

So think about that $27 billion a year covering the medical costs of uninsured Floridians. From where does that money come? It is transferred from one group to another.

Obamacare advocates argue that transfer is moral and right. By providing free medical care to low- and moderate-income Floridians, the Obamacare advocates say this will lower medical costs for all in the future. They say expanded Medicaid will reduce hospitals’ unpaid, charity-care costs and lead to healthier low-income people who will need less medical care in the future.

The table on charity care above debunks the one claim. What’s more, no one can say with any certainty that just because more people will have their medical care covered for free by Medicaid today that they will be healthier and need less medical care in the future.

If Obama had any inkling of human behavior and how it relates to economics, he might realize that his hope is simply that. As Americans will soon find out, expanding Medicaid and providing subsidized medical care to all Americans cannot do anything but make the nation’s health care costs rise. And here’s why:

1) When anything is free, it is abused, overused and over-consumed. The more people who receive free medical care under Medicaid, the more they will use it — driving up the cost.

2) The Milton Friedman law of spending. When you spend your own money on yourself, you are careful about what you buy. When you spend your own money on someone else (e.g. a gift), you have the same incentive to economize as you do when you spend on yourself; but not the same incentive to get full value for your money.

And when you spend other people’s money on yourself, you have an incentive to get your money’s worth but no incentive to hold down the cost. This is Medicaid.

There is certainly a better way. It’s definitely not Obamacare.

+ Brenner: Agitator for good
It has become customary in this space each March to extend gratitude to Longboat Key’s outgoing town commissioners who have served multiple terms and contributed to the good of the town.

In that vein, Vice Mayor David Brenner, whose second term was to end at Wednesday’s Town Commission meeting, is aptly deserving.

To be sure, Brenner had detractors (all politicians do) who liked to grumble about his modus operandi (e.g. frequently behind the scenes). But it’s accurate to say Brenner was a catalyst and leader in changing the direction of the town and Town Commission for the better.

He wasn’t alone in bringing about this positive change; other commissioners have been involved. But it’s also accurate to say were it not for Brenner’s persistence and a passion for Longboat’s future, the atmosphere on the Key could still be one of stagnation and staunch opposition to change.

Brenner has never liked to stand still. It’s his nature to be an agitator. Not in the negative sense of a noodge, but in the positive sense of leading a cause for the better.

After his successful professional life as managing partner at Arthur Young & Co. in Philadelphia, Brenner served as the city’s director of commerce in the mid-1980s and then took on the challenge of helping rescue the city of Brotherly Love from its fiscal disasters as director of finance.

After Brenner and his wife, Maggie, moved to Longboat Key full time in 1999, he stayed on the sidelines of public affairs for six years. And then he couldn’t resist. The Town Commission appointed him to the town’s planning and zoning board in 2006.

And rather than just grumble about the town’s declining economic base; the shuttering of retail stores at Avenue of the Flowers and Whitney Beach Plaza; the loss of tourism; and the Key’s “anti-everything” atmosphere, Brenner began agitating.

While serving on the planning board, he started an economic development committee. As its spearhead and ringleader, Brenner took it upon himself to create discussions between the leaders of Publix and town officials about redeveloping the supermarket and Avenue of the Flowers.

Brenner was also a leading organizer and force for important changes to the town charter in 2008 — two measures voters overwhelmingly approved. One allowed all existing, non-conforming developments to be rebuilt to existing density in the event of destruction. The other allowed for the permitting of 250 tourism units beyond those provided in the town’s 1984 comprehensive plan.

To an extent, these two charter amendments were turning points. The dialogue and sentiments began to change on Longboat Key: Residents recognized the Key needed to be more welcoming and open to tourism and business. The anti-growth atmosphere that pervaded for 20 years was threatening the Key’s future. Brenner was at the core of this change.

In 2010, he was elected to the Town Commission, then again in 2012. For the past four years, Brenner’s fingerprints can be found on the town’s vision plan; the change in town managers; creation of a citizen-led town finance committee; reforming the town’s disastrous pension plans; the redevelopment of Publix and CVS; and now the discussions about creating a town center, thanks to the Urban Land Institute study.

We know Brenner would have liked to have left office with an expanded and redeveloped Longboat Key Club and Resort, a re-opened Colony Beach & Tennis Resort; and redeveloped Whitney Beach Plaza.

But hey, he can leave office with the satisfaction that 30 years from now he will be in Longboat Key history as a leading agitator who changed the course of the town — from stagnation and decline to moving, once again, onward and upward.