Few policy reforms have been as popular as welfare-to-work. Why, then, is the U.S. Senate trying to kill state efforts at encouraging able-bodied adults to get a job?

Welfare-to-work was one of the signature policy wins of the 1990s, resulting in the 1996 Personal Responsibility and Work Opportunity Reconciliation Act.

The legislation was signed by President Bill Clinton, after being shepherded through Congress by House Speaker Newt Gingrich and Senate Majority Leader Trent Lott, who recognized welfare had become a trap for many Americans.

The two most important features of the federal law were time limits on how long recipients could remain on welfare and work requirements for those on welfare. Both of these reforms were targeted at able-bodied, working-age adults on cash assistance (TANF) and food stamps (SNAP).

The positive impact of federal welfare reform is well documented. A 2004 report by the left-of-center Brookings Institution states: “The welfare-to-work objective was predicated on a simple proposition: poor families are better off employed than on welfare.

Jobs are the best antidote to poverty. The work requirements have helped increase the employment rate of single mothers, lowering welfare dependency and child poverty.”

In particular, poverty rates for black children reached an all-time low.

In spite of its immense success and popularity, the temptation to reverse federal welfare-to-work and related reforms has been unrelenting. Even though he signed PRWORA, Clinton crafted an expansive waiver process that had already started to undo some of PRWORA’s gains by the time he left office.

President George W. Bush not only failed to reign in the waiver process, he oversaw passage of the 2002 Farm Bill (in his defense, he vetoed the 2008 Farm Bill), which loosened food stamp requirements even more, including opening up the program to noncitizens.

Then, beginning in 2009, the Obama administration used the Great Recession in an attempt to unilaterally–and thus illegally–dismantle TANF work requirements.

To say the least, the waiver process under the Obama administration was not transparent.

As late as 2013, no state had even formally applied for a TANF work waiver. Instead, regional offices pressured state welfare agencies to accept various waivers, allowing longstanding policies to be overturned with a single email. Most state lawmakers, and some governors, were unaware that their human services departments had even requested such waivers.

The results soon became evident. Whereas only 12 states had obtained statewide permission to waive food stamp work requirements before Obama took office in 2009, two years later 47 states were waiving food stamp work requirements.

This stampede was aided by the American Recovery and Reinvestment Act, which also suspended the work requirement nationwide for two years (2009 and 2010). Food stamp participation rates–and food stamp spending–skyrocketed, with spending doubling under the Obama administration, even as it had already doubled under Bush.

With food stamp spending hitting $80 billion in 2013, lawmakers in conservative states started ringing the alarm bell.

Kansas was one of the first states not to renew its waiver. In doing so, Kansas merely reverted to what the 1996 welfare reform law actually says–that able-bodied adults without children are only eligible for food stamps for three months every three years.

After three months, these adults have to find work, volunteer, or obtain job training in order to remain on welfare. Kansas tracked what happened to those able-bodied adults who cycled off their state rolls. Almost two-thirds obtained employment within a year, many finding permanent well-paying jobs in a variety of industries. Other quality-of-life measures, like marriage rates, also increased.

Here in Mississippi, the poorest state in America, lawmakers first started pressuring for change in 2015. In 2016, Gov. Phil Bryant declined to renew Mississippi’s waiver. And in 2017, the legislature codified that Mississippi could not waive federal work requirements for SNAP.

The $867 billion Farm Bill (H.R.2) just passed by the U.S. Senate threatens to undo this reform for Mississippi, as well as Arkansas, Florida, Kentucky, Missouri, and West Virginia. The subterfuge was accomplished by deleting 7 U.S.C. 2015(o) and moving the work requirement to 7 U.S.C. 2015(d). This occurs on p. 295 and pp. 326-327 of the 1,242-page Senate bill and is a textbook illustration of why it is bad practice to amend laws by reference without indicating what is being changed.

At best, the substitution creates unnecessary confusion. At worst, the result for Mississippi and the aforementioned states is to invalidate their state laws that specifically cite subsection 2015(o) in eliminating the work requirement waiver.

It is tempting to believe the Senate didn’t realize that in the back and forth of crafting the Farm Bill it might be gutting state efforts at helping able-bodied adults find work. Given the tendency of past Farm Bills to expand welfare eligibility, the artful deletion seems intentional.

This assumption is buttressed by the Senate’s tabling of a floor amendment aimed at reforming the food stamp waiver process altogether. In any event, the offending language needs to be fixed now that the Farm Bill is headed to conference.

As demonstrated in a new study by the Employment Policies Institute, more generous welfare entitlements lead to more poverty and more people on welfare.

Whatever the benefits of a targeted and limited safety net for families in crisis, able-bodied adults should be expected to work. Allowing these folks to remain on food stamps indefinitely is personally and socially destructive.

It is immoral that the U.S. Senate is not only doing nothing to free people from the welfare trap, it is also trying to stop states from doing so themselves.

This column appeared in the Daily Signal on July 6, 2018. 

Conservatism is a word I’ve heard a lot since moving here to take the position as CEO of Mississippi’s conservative think tank, the Mississippi Center for Public Policy. It seems almost everyone considers himself a conservative. I’m discovering the word has lost some of its meaning, though. It has become interchangeable with the GOP or with one’s views on the Second Amendment or on being pro-life. But those definitions of conservative are not wholly accurate. More importantly, they’re not enough. A conservative is also willing to stand up to encroaching power of all forms of government, to the growing corporatism that seeks to govern us from the boardroom, and to the menace to our society that is a progressive culture.

To make Mississippi a leader in economic growth, entrepreneurship, job creation, and prosperity, we have to make progress on the issue of our long-standing dependence on government. We have to change our public policy. We need to value work, remove barriers to risk-taking, free parents to choose the education path that works for their own children, and leverage the power of the private enterprises of faith, family, non-profits, and private organizations. The faith-based and philanthropic generosity of Mississippians is amazing. It can create so much good, but we have to prevent government from competing with this philanthropy. The best solutions in civil society come from local, efficient, effective, temporary actions where a personal relationship ensures mutual accountability. This is how we used to solve the problems in our civil society.

There are far too many Mississippians who seek to petition government to do this work. Worse, too many individuals and companies are looking to the government for a contract, a job, a partner, or protection from competition. When we allow government to become the Holy Grail in this way, we weaken the free market. We create a disincentive to the formation and deployment of capital. We thwart the opportunity for all Mississippians to prosper. What’s more, such reliance on government ensures only those with power have significant influence on Mississippi, including determining who represents us in the legislative and executive branches of our government.

What makes a “conservative” is not a party or allegiance to a particular leader or political campaign, but the power of ideas. As conservatives, our ideas are based on bedrock values and fundamental truths. Freedom is a policy that works. A limited and restrained government is the essence of our system. And the principle of ordered liberty holds it all together. Our goal at the Mississippi Center for Public Policy is to play a leadership role in building a Mississippi where individual liberty, opportunity, and responsibility reign because government is limited. We believe this is the only way nations, states, and cities have ever enjoyed durable prosperity.

If we remain committed to these ideas and work hard to convince others of their value, we can all experience a Magnolia renaissance. And we can say conservatism made it possible. Real conservatism. The kind of which Bill Buckley, Ronald Reagan, and Milton Friedman spoke. The kind where we are free to pursue our individual liberty and speak our minds. The kind where we encourage people to take action and take risks in pursuit of their happiness. The kind where we take personal responsibility for our futures and stop looking for government to solve all of our problems.

There is an important role for government but it must be limited. Government functions best when it is closest to the people and when it is open and transparent. And the states are the best avenue for getting things done. Although our national government continues to grow into an unwieldy and bureaucratic swamp, our country is still federalist. We are a collection of semi-sovereign states. Federalism is a conservative idea. As Reagan stated in his first inaugural address, “The federal government did not create the states; the states created the federal government.” Thanks to our founding fathers, the real political and policy power is supposed to belong to the states.

Though I’ve lived in Mississippi for only a few months now, I’ve come to learn that y’all are not very fond of people telling you what to do, especially not people in Washington, D.C. I admire that. That’s a conservative thing, too. That independence goes to the heart of the conservative movement. It was present at our founding. It was what compelled Bill Buckley to start National Review. It was what gave us Ronald Reagan and Donald Trump. And if we harness it, conservatism will lead us to a prosperous Mississippi—a Mississippi where individual liberty, opportunity, and responsibility reign because government is limited.

The remaining Toys-R-Us stores closed last week ending an era of retail shopping in America. Many were saddened to see the large retailer collapse, but as long as we have had stores in this country, we have had stores that go out of business.

Before Toys-R-Us entered our malls and shopping centers, we had independent toy stores. They couldn’t compete with the large chain and today you see very few independent toy stores, outside of specialized stores in specific locations.

But the reaction to Toys-R-Us closing was a little different than we usually see for these types of announcements. Driven by nostalgia, we saw people shed tears- either real or virtual- about the news. We even saw someone set up a GoFundMe campaign to raise $1 billion.

GoFundMe and nostalgia simply weren’t enough to save the giraffe.

If people were that concerned about Toys-R-Us, there is one very important thing they should have been doing for a long time: shopping there. As happens in a free market economy, the markets change. Toys-R-Us did not adapt and they failed. No different than any other number of businesses.

But we always have to blame someone. That use to be Wal Mart. Today it is Amazon. They are the reason small towns are dying. Why shops downtown are boarded up. Why local governments aren’t receiving enough tax revenue to pave their roads or fund schools. The list could go on for days.

Blaming someone else is the easy thing to do. But the market always chooses the winners. American consumers are, and should be, free to shop for the best options available. In the end, Toys-R-Us missed on a number of key business trends in consumer shopping behavior.

They weren’t competitive with competitors, brick and mortar or online

A very basic rule to retail: you need to be competitive to survive. Toys-R-Us simply did not match their brick-and-mortar competitors like Wal Mart or Target on pricing. Add in the fact that you can also get groceries or household items at those stores and there was no real reason to visit multiple stores when you could complete your shopping in one location. Something that is especially appealing to mom’s with young children.

But Toys-R-Us, as well as Babies-R-Us, had a larger selection than their competitors in the store some might say. That was a bonus if you needed an item at that very moment. However, you can find those same items online either from Wal Mart and Target, or an online retailer like Amazon. And you can receive them in a day or two, with free shipping. Toys-R-Us didn’t seem to grasp the digital trend until it was too late. Again, they just weren’t competitive.

To truly understand how uncompetitive they were on pricing, you needed only to visit a Toys-R-Us or Babies-R-Us during their liquidation sales before closing. At 30 or 40 percent off, they were about on par with their competition.

They didn’t set themselves apart from their competition

The brick-and-mortar advantage is that people can touch and feel items before they buy. We certainly purchase tablets and computers online, but we also like to be able to go to a Best Buy and put our hands on a keyboard or our fingers on a screen- and maybe seek a sales adviser for some expert guidance.

Save for the joy of riding bikes down the aisles, there was nothing that set Toys-R-Us apart. The stores were often cluttered, the experience wasn’t enjoyable, and they certainly were not known for their customer service.

You need to be competitive in pricing, but you also need a niche. Simply selling toys is no longer a niche. Toys-R-Us didn’t do anything to set themselves apart. A joyful customer experience was not part a customer’s average visit to Toys-R-Us.

Kids are seeking digital options, rather than traditional toys

The other part of this story is that the market for toys has changed. As much as we may or may not like to hear it, kids today prefer digital options such as tablets or video games. If you are in the business of selling products for children, you need to adapt. Especially in an environment that is becoming more and more competitive each day.

Some might feel sad that Toys-R-Us closed. Some of us might think back to our childhood. But consumers voted with their feet. They chose convenience. They chose lower prices. They chose independent, niche toy stores. Unfortunately for Toys-R-Us, that means the market chose someone else.

When all is said and done, nostalgia or a catch phrase will only get you so far. The market always determines the winner…and the loser.

Mississippi has a recidivism problem that’s jeopardizing public safety and burdening taxpayers. As of 2013, the Magnolia State had the nation’s third-highest incarceration rate per capita. What’s more, research suggests that around 95 percent of Mississippi’s enormous prison population will eventually be freed. And, unfortunately, around three quarters of those released will likely reoffend within five years.

There are policies, however, that can be implemented to help reverse this trend. Researchers have demonstrated that the formerly incarcerated are more likely to return to crime if they cannot find stable employment upon release. But many employers will not hire or even interview someone with a criminal record regardless of their crime, which often leads to long-term unemployment for these individuals. In fact, surveys suggest that 60-75 percent of the formerly incarcerated are jobless up to a year after their release.

Consequently, several states have enacted “second chance” legislation to better these individuals’ odds of landing decent jobs. “Second chance” measures aim to address the unemployment issue by enabling the formerly incarcerated to expunge their records of petty, first-time offenses. Mississippi should similarly strive to remove barriers to employment for these individuals.

Mississippi already has a program that allows certain first-time offenders to petition the court to seal their criminal records. However, these individuals aren’t permitted to have their records expunged under this program if they have been convicted of a misdemeanor traffic offense, such as a DUI. Considering that at least 1 percent of drivers are arrested for DUIs each year, an inordinate number of people are struggling to find gainful employment due to a one-time DUI offense.

DUIs and similar low-level traffic offenses ought to be treated the same as other misdemeanors for the purposes of the first-offender program. Mississippi could follow Texas’ lead in this regard by allowing first-time DUI offenders who registered a 0.14 blood alcohol content or lower to petition for expungement.

Individuals are also ineligible for first-time offender-status — and therefore cannot have their criminal records sealed — if they have been convicted of specific, nonviolent felonies, including many drug crimes. Nationally, 16 percent of inmates are imprisoned due to drug-related crimes. While it isn’t entirely clear how many of these are first-time-offenders, this statistic shows that a large number of individuals could benefit from a fresh start. Mississippi should therefore append more non-violent drug crimes to the list of expungement-eligible offenses.

Also, in many cases, Mississippians who were over 21 years old at the time of their offense are precluded from having their records sealed. Like juveniles, adults over the age of 21 make mistakes and deserve a second chance after their first violation. As a result, Mississippi ought to include more of those who were over 21 years old at the time of their crime into its first-time-offender program.

Even when offenders actually qualify to have their records sealed, they can’t request an expungement until five years after they have completed their sentence. By that point, many of the formerly incarcerated have already been dealing with criminal background-related joblessness. Like Texas, Mississippi ought to avail the first-time-offender program to individuals immediately upon their completion of court requirements to enable them to quickly obtain work.

Mississippi’s occupational licensing system also impacts formerly-incarcerated individuals’ ability to find employment. Like most states, Mississippi requires state licenses for myriad jobs. While most licenses don’t have strict criminal background requirements, many boards can reject applications based on prior convictions, thereby preventing people from working. Rather than allowing this, the state ought to permit boards to only consider convictions directly related to their industry and allow prospective employers to decide whether they wish to hire someone with a record.

Finally, each of these reforms should be applied retroactively in order to provide past offenders the same second chance as present ones.

Mississippi’s current law is clearly fraught with limitations and desperately needs updating. These proposed measures should not be misinterpreted as being soft on crime. Rather, they are about giving first-time offenders an opportunity to become productive citizens after they’ve been prosecuted and punished for their crimes. These reforms are simply smart public policies. They can decrease the number of formerly-incarcerated people whom Mississippians financially support through various entitlement programs. Further, these reforms would reduce recidivism rates, benefiting the general public with a safer society and reduced tax burden.

Work gives people purpose and contributes to a stronger economy and civil society.

A prospering Mississippi requires putting as many individuals to work as possible. Let’s give the formerly incarcerated the chance to become employed, productive members of society.

This column appeared in the Clarion Ledger on June 24, 2018.

Much has been written lately about how sports gambling is going to lead to the downfall of man, the decay of society, and the loss of the integrity of sports. As the late Lewis Grizzard would say, “That’s a bunch of hogwash.”

What the Supreme Court did in voting 6-3 to overturn the federal ban on sports gambling was to give back to the states their constitutional powers.

In affirming federalism, they also gave people back their rights to choose how they want to live and whether they want to spend their own after-tax money on a sports bet, a municipal bond, or a ham sandwich. No matter how you personally feel about gambling on sports, it’s a mistake to take away a person’s individual liberty just because some people will be irresponsible.

Now that power to regulate gambling has been returned to all the states, there are more than a few organizations making spurious arguments about the need for all sorts of remedies to potential harms. The sports leagues have started to campaign for a “content fee” from each state. The argument is that their team and league intellectual property will be used by various sports gambling sites, apps, media, and other related entities. Ironically, such increased use of the “content” of the leagues’ and teams’ logos and trademarks is actually going to make the the leagues and teams more valuable, along with the rights to distribute their live programming. The states shouldn’t agree to pay a penny to a sports league.

The other specious claim is that sports gambling will seriously threaten the integrity of the games. You’ll hear this especially from the NFL and the NCAA. But rather than seeing legal sports betting as the enemy of sports competition, we should see it as an ally to protect sports. Using powerful algorithms, sports leagues (the NCAA included) can use sports wagering technology as an “early warning system” to uncover potential signs of corruption. Major data companies, including Google and Microsoft, have been developing technologies to aid in the operation of legal sports betting for years. Thanks to the free market, sophisticated software and innovative competitors will harness technology to improve the integrity of all the games.

The repeal of the federal prohibition on sports wagering is bringing a massive industry out of the shadows and into the sunlight. Despite the ban, which began with the passing Professional and Amateur Sports Protection Act in 1992, annual sports betting activity in the U.S. is estimated to be as high as $400 billion. Since the enactment of PASPA, which was largely driven by the NCAA as a way to prevent gambling on sports, the industry has grown by a factor of 10. Like most federal intrusions into state matters or consumer protection, the results of PAPSA were far different from the original intent.

Most of that betting was happening offshore or through the dark net — without transparency or consumer protection. According to the estimates from the American Gaming Association, 80 percent of the $10 billion bet on the NCAA tournament this past March and April was done illegally, essentially making anyone who participated in the bracket office pool a criminal.

For 26 years, we’ve been living under a dubious set of claims about sports wagering while Nevada and a few other states enjoyed a federal monopoly. In Mississippi, where I now live and work, the Mississippi Band of Choctaw Indians is planning to have the first casino in the Magnolia State to offer sports betting. What’s more, they expect to be the first Native American tribe in the U.S. to offer sports wagering. Because the Choctaw tribe is not subject to state regulation, they are free to offer sports betting to customers immediately.

In Mississippi, and in other states in need of new revenue streams, the regulated casinos will not be far behind. That’s because Mississippi lawmakers had the foresight to approve new rules from the state’s Gaming Commission in anticipation of a repeal of PAPSA.

Why should Nevada and a few other states have all the fun (and all the tax revenue) associated with letting people legally pursue their interests and hobbies? The games will be fine, and individuals will have the personal liberty (and responsibility) that comes along with it.

This column appeared in the Washington Examiner on June 22, 2018. 

Telemedicine: High-Quality, Affordable Care for Mississippi Families
Hearing on Telemedicine
Testimony before the Miss. State Senate, Public Health & Welfare Committee
October 18, 2016
(Unabridged version)

I am Dr. Jameson Taylor, vice president for policy with the Mississippi Center for Public Policy.

This is what we believe about telemedicine: Telemed needs to be allowed to flourish and grow and respond to consumer needs. Burdensome regulations will hinder this growth and reduce access to high-quality care. To repeat: We believe telemedicine needs to be allowed to flourish and grow and respond to consumer needs. Burdensome regulations will hinder this growth and reduce access to high-quality care.

You might say we believe in a free market for healthcare. What this really means is that we believe that a light regulatory touch will promote the supply side of healthcare and solve the problem of access by increasing quality and lowering cost. In other words, if government stays out of the way, healthcare innovation will massively increase the supply of affordable, high-quality care. This strategy has worked for computers and cell phones. Why not healthcare?

But I am here today, not as a healthcare policy analyst, but to share my own telemed story with you.

I am married and have two children. Over the past few years, our family has paired telemed with a High Deductible Health Plan. Our family deductible is typically $5,000 a year. What this means is that my insurance company does not cover a dime of my healthcare until I spend $5,000 out of pocket. In this respect, my family is not different from many others in Mississippi. For instance, if we look at the health insurance policies on the ACA exchange, we see deductibles ranging from $4,000 to $13,000.

Just yesterday, I pulled up a plan for a family of four in Hinds County. One option was a bronze plan from Magnolia Health at a cost of $800 a month and a deductible of $13,600 a year.

I guarantee that if you have a deductible of $13,000 a year, you are going to act like an informed consumer for healthcare because you are going to be paying cash, almost exclusively, for your care. That, at least is how my family and I shop for healthcare. We approach healthcare as consumers and believe that a free market for healthcare is the best way to attain high-quality care at a fair price.

When we consider taking our kids to the doctor for the usual problems: sniffles, an ear infection, a stomach ache, we have a choice between using telemed at $40 a visit or going to our pediatric specialist for $165 or going to MEA for around $120. Depending on the situation, we choose the option we think is best for our family. Sometimes it is telemed, sometimes it is an in-office visit, sometimes it is MEA.

Let me walk you through a typical telemed visit for us. Our usual provider, by the way, is connected with Blue Cross Blue Shield and is called Doctor on Demand.

Last year, our daughter had the typical crud that turned into a fever. We had a family event coming up, and my wife wanted to make sure we did all we could to get our daughter feeling better. That said, it wasn't a very serious illness. At $40 a visit, we chose to use telemed. The alternative would have been an in-office visit at $165. Under those circumstances, we would not have gone to the doctor.

I want to make this point very clear: This is not an apples to apples scenario. If you hinder access to telemed, you are not necessarily generating new business for brick-and-mortar doctors. You are, for some people - the single mom with no cash to spare, a family on vacation down in Biloxi, a truck driver on the road -eliminating that doctor's visit altogether.

Money and time are not infinite resources - at least not in my world and not for the hardworking people of Mississippi. If we did not have the option of using telemed in this case, we would not have gone to the doctor at all. We would have waited things out and hoped our daughter recovered.

Again, our situation is not unusual. We all know access to healthcare is a problem in Mississippi. One-third of our population is underserved because we do not have enough primary care physicians and rural doctors.

This problem will not be resolved by giving everyone an insurance card - whether it be private insurance or government-sponsored insurance, like Medicaid.

According to a recent study by researchers at the Social Science Research Center at Miss. State:

• "32% of adults covered by private insurance (ages 50-64) reported difficulties in obtaining an appointment when seeking an initial appointment with a primary care physician";

• "35% of Medicare-insured adults (ages 65 and older) reported problems when seeking a new appointment"; and

• "Up to half of primary care physicians' offices in Mississippi are not accepting new Medicaid patients."

All of these people have insurance, but they are having trouble obtaining primary care.

I believe we are making a fatal mistake in approaching healthcare in Mississippi from an attitude of scarcity and protectionism. We have an abundance of healthcare needs. We have so much need we can't handle it all. Why regulate a telemed market that is clearly working to address some of these needs?

The study from Mississippi State also notes the following:

"Even with health insurance, access to care may be limited by several factors, including whether one can contact doctors' offices by telephone during office hours, whether one can receive a scheduled appointment within a reasonable amount of time, lengthy waits in doctors' waiting rooms, restrictive clinic hours, and patient access to transportation."

Telemed can help with all of these access problems.

In our case, we usually use telemed early in the morning or late at night, when we are trying to figure out just how sick we are and whether we need to take a sick day from school or work.

Likewise, the wait for a telemed appointment is usually 10 minutes or less. In our case, we are able to pull up a screen full of doctors - all of them licensed in Mississippi - and choose the doctor we want. Usually, we choose the same doctor. Her primary practice is in California.

As far as waiting rooms go, I also want to add that, frankly, as a parent, the last thing you want to do is expose your child and yourself to other sick patients in the waiting room. The last time my wife took our kids in for a routine checkup, our doctor informed her that she was seeing a lot of children with hand-foot-and-mouth disease. That is not a comforting thought when you are in a crowded waiting room trying to keep your toddler from chewing on and handling everything he can reach.

Indeed, in my research on this issue, I found several medical sources that suggested simply avoiding the waiting room altogether. Advises Dr. Hansa Bhargava, medical editor for WebMD:

"As a doctor, here are some guidelines I use for myself:

"Stay home if you can. Ask yourself: are you sick enough to need to go in? Granted, this can be a hard decision. ...

"If you are not sure whether you need to come in, try calling your doctor's office. This way, you may be able to save yourself a visit."

Telemed delivers the best of both worlds. It allows you to stay home and see your doctor. My family and I value the convenience and, if you will, additional safety, telemedicine provides. For me, a quick telemed visit may mean the difference between missing a morning of work or not. For my kids, it means the same when it comes to school. For my wife, it means access to high-quality care at the touch of a button. Imagine that, at the touch of a button. ... But isn't that the kind of service we expect today?

You can order all manner of life-saving products online - for instance, that last-minute wedding anniversary gift ... at the touch of a button.

You can book a dream vacation - instead of going to a travel agent - at the touch of a button.

You can sit in on courses at MIT and radically change the direction of your entire life - at the touch of a button.

Why is healthcare so radically different that we are going to deny consumers this same choice?

To get back to our routine telemed visit, during the last three visits, we have been offered a prescription twice. In my limited research, this is on par with the national average for in-office visits.

And, let me be honest, if you are going to pay $165 for a doctor's visit, you kind of expect to walk out of the office with some kind of vindication that you were right to go to the doctor - a prescription. Many patients want that antibiotic, even if it's just for a bad cold. When you pay $40 for a visit and you hear that all you really need is some sleep and orange juice, you feel a lot better about the hit to your pocketbook.

Before I end, one thing I want to mention is that we prefer to connect with our telemed doctor over the phone, as opposed to video feed. I live in Jackson. I have a decent internet connection. Many Mississippians do not. Just like any technology, you want multiple options: both phone only and video.

I suspect, too, that my wife prefers the phone consult because, then, she doesn't feel like she has to do her hair and make the kids picture perfect before seeing our doctor.

In any event, the phone consult has worked well for us. Indeed, I imagine nearly every person here has been on one end or another of a phone-only consult with their brick-and-mortar doctor.

Of course, most doctors doing telemed ARE brick-and-mortar doctors. As I mentioned, they are also licensed by the state of Mississippi.

And that is, really, what all this comes down to. If the state is going to license doctors, it needs to trust these doctors to serve their patients in whatever setting they choose.

Whether it's in a telemed setting or an office setting, we have to trust the doctors to make the best decisions for their patients. Otherwise, the state shouldn't license doctors to begin with. We also have to trust families like mine to make the best healthcare decisions we can for our children. ... Because I guarantee that I care a lot more about my kid's safety and health and my own health than any other person in this room.

Finally, I want to end with a quick story about Billy Durant. Durant co-founded General Motors. But before he founded GM, he worked for a carriage maker. As a carriage maker, he vehemently spoke out about how dangerous automobiles were. He called the new technology "smelly, noisy, and dangerous." He even refused to let his daughter ride in a car. Less than four years later, Durant co-founded GM.

Like the automobile revolution during Durant's day, the healthcare revolution has already begun. We can use our smartphones to monitor blood sugar levels and measure heart rates. Patients increasingly want to text and web chat their doctors. Soon, we are going to see nanotechnologies that can be implanted in patients, perhaps making routine doctor visits a thing of the past. Government cannot regulate all of these innovations. And Mississippi shouldn't let bureaucracy be the reason we don't share in this progress. Take a cue from Billy Durant and join the winning side - the side that promises to expand the supply of high-quality, low-cost care for the people of Mississippi.

Thank you.

Seven years after his death, a friend of mine is drawing national attention because of a simple but profound observation he made about the process of how ideas move from being politically impossible to becoming law. His observation helps explain, in part, why the work of think tanks like ours is so important. (more…)

I have some great news, and some bad news.

First, the bad news. Charter school legislation is dead for this legislative session. Thousands of children will go another year without being able to escape the schools that are failing to meet their needs. (more…)

Attn: PERS Study Commission

Written Statement of Dr. Jameson Taylor
V.P. for Policy at the Mississippi Center for Public Policy
September 14, 2011 (more…)