Perspective - November 2014

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Union Accountability Health Care Reform Educational Choice Income-Tax Phaseout Corrections Reform Restoring Federalism Smaller Government


In Case You Missed It Obamacare Medicaid expansion covers health care for inmates over the disabled.

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School choice will raise teacher salaries.

ocpathink.org/articles/2822

The Obama administration’s point man on the Solyndra fraud is now in charge of Ebola.

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More than 214,000 American physicians are declining participation in Obamacare exchange health plans.

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OCPA president Michael Carnuccio says Oklahoma is a hub of the free-market renaissance which is reducing costs and improving quality in health care.

Scholars who prepare the Forbes college rankings say that if Oklahoma professors taught more students, tuition costs could be lowered dramatically.

newsok.com/article/5357537

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In the Edmond Sun, Andrew Spiropoulos and Brandon Dutcher ask: Are education funds for the system, or for your child?

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Why does the University of Oklahoma have a Chinese Communist Party propaganda program on its campus?

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On the website of the Ludwig von Mises Institute, OCPA’s Brandon Dutcher discusses what our political leaders and Bernard Madoff have in common.

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An OCPA research fellow says the rich are already paying their “fair share” — and then some.

ocpathink.org/articles/2778

PERSPECTIVE OCPA Staff

OCPA Trustees

Brandon Dutcher ...........................................Editor

Blake Arnold • Oklahoma City

David McLaughlin • Enid

Robert D. Avery • Pawhuska

Lew Meibergen • Enid

Lee J. Baxter • Lawton

Ronald L. Mercer • Bethany

Lauren Aragon.................................................................Intern

OCPA Researchers

Steve W. Beebe • Duncan

Lloyd Noble II • Tulsa

Brittoni Bobek ..............................Development Coordinator

G.T. Blankenship • Oklahoma City

Mike O’Neal • Edmond

Michael Carnuccio ...................................................President

John A. Brock • Tulsa

Bill Price • Oklahoma City

David R. Brown, M.D. • Oklahoma City

Patrick T. Rooney • Oklahoma City

Clint Colbert ....................................................Office Manager

Paul A. Cox • Oklahoma City

Melissa Sandefer • Norman

Brandon Dutcher .................................Senior Vice President

William Flanagan • Claremore

Thomas Schroedter • Tulsa

Josephine Freede • Oklahoma City

Richard L. Sias • Oklahoma City

Ann Felton Gilliland • Oklahoma City

Greg Slavonic • Oklahoma City

John T. Hanes • Oklahoma City

John F. Snodgrass • Ardmore

Ralph Harvey • Oklahoma City

Charles M. Sublett • Tulsa

John A. Henry III • Oklahoma City

Robert Sullivan • Tulsa

Henry F. Kane • Bartlesville

Lew Ward • Enid

Robert Kane • Tulsa

William E. Warnock, Jr. • Tulsa

Gene Love • Lawton

Daryl Woodard • Tulsa

Tom H. McCasland III • Duncan

Daniel J. Zaloudek • Tulsa

Trent England ..........Vice President for Strategic Initiatives Dacia Harris ..................................Communications Director Rachel Hays .........................................Development Director Alex Jones .....................................................Creative Manager Jonathan Small ................................Executive Vice President Teresa Yoder .................................................Executive Liaison

Steven J. Anderson, MBA, CPA Research Fellow Tina Dzurisin Research Associate Vance Fried, J.D. Research Fellow Jayson Lusk Samuel Roberts Noble Distinguished Fellow Matt Mayer, J.D. Research Fellow J. Scott Moody, M.A. Research Fellow Andrew C. Spiropoulos, J.D. Milton Friedman Distinguished Fellow Wendy P. Warcholik, Ph.D. Research Fellow

Perspective is published monthly by the Oklahoma Council of Public Affairs, Inc., an independent public policy organization. OCPA formulates and promotes public policy research and analysis consistent with the principles of free enterprise and limited government. The views expressed in Perspective are those of the author, and should not be construed as representing any official position of OCPA or its trustees, researchers, or employees.


From the President

Let Freedom Ring

Bold, Innovative Policy Ideas for 2015 Margaret Thatcher, Britain’s greatest prime minister since Churchill, once noted that “you may have to fight a battle more than once to win it.” That’s certainly true in the public policy arena, where it sometimes requires a series of seemingly small, but incremental, steps to reach a goal. The Oklahoma Council of Public Affairs has an annual tradition, set forth in this issue of Perspective: We formulate and publish a yearly “Freedom Agenda,” pulling together ideas on the policy issues we think are most important. Think of it as our road map to expanded liberty—a set of big, bold, daring ideas that in turn become concrete legislative and policy proposals that will help transform our state. In 2015 we’ll focus on union accountability, taking a closer look at things like collective bargaining and the collection of union dues. We’ll stay fully engaged in the Obamacare conversation, while also suggesting pro-patient, pro-taxpayer reforms that work. We’ll look for ways to expand educational choice, assessing

all the various alternatives like vouchers, tax credits, Education Savings Accounts, and more. We will continue to demonstrate the benefits of phasing out the state personal income tax. We’ll keep offering specific proposals for right-sizing state government—gently reminding policymakers that the right size is smaller, not bigger. We will keep examining ways to combine public safety and common sense in prison and criminal justice reforms. And of course we will keep a firm grip on a central theme that runs through all of our agenda items, the proper constitutional relationship among local, state, and the federal government. These are big challenges, but we’ve undertaken them before. And we’ve shown that, as we like to say in the thinktank business, “Ideas have consequences.” Isn’t freedom, above all else, worth fighting for? That’s what our 2015 Freedom Agenda is all about. I hope you’ll read the pages that follow and join us in this important work.

Michael C. Carnuccio (M.A. in political science, Oklahoma State University) is president of the Oklahoma Council of Public Affairs. He has been an adjunct faculty member at OSU, lecturing in courses on American government. His work has been published in the Korean Journal of Policy Studies, The Oklahoman, and Tulsa World. His weekly column, “Free Market Friday,” is published by The Journal Record and syndicated in 27 markets.


Union Reforms Will Protect Workers and Taxpayers

Trent England Trent England (J.D., George Mason University) is vice president for strategic initiatives at OCPA, where he also serves as the David and Ann Brown Distinguished Fellow for the Advancement of Liberty. A former legal policy analyst at The Heritage Foundation, England has contributed to two books, The Heritage Guide to the Constitution and One Nation under Arrest: How Crazy Laws, Rogue Prosecutors, and Activist Judges Threaten Your Liberty. His writings have appeared in The Wall Street Journal, the Christian Science Monitor, and numerous other publications.

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PERSPECTIVE • November 2014

Did you know the state of Oklahoma supports a Washington, D.C.-based political organization that advocates for gun control, opposes home schooling, and supports government-controlled health care beyond even what is in the Affordable Care Act (Obamacare)? State government does this in two ways, and both could be prevented by legislative action to level the playing field. The National Education Association has an innocuous name and a radical agenda. Describing itself as “the nation’s largest professional employee organization,” the NEA is a national union made up of smaller unions representing government education employees. The NEA collects dues from these affiliates, including the Oklahoma Education Association. At its national meeting in July 2014, the NEA adopted 99 pages of resolutions that lay out the group’s agenda. This includes support for

abortion (“reproductive freedom,” Resolution I-17), opposition to programs that allow children to escape failing or dangerous schools (Resolution A-25), advocating “strict prescriptive regulations” on guns (Resolution I-34), and supporting complete government control of healthcare (“single-payer,” Resolution H-7). By choosing to affiliate with and financially contribute to the NEA, the OEA and its local affiliate unions actively support this agenda. Oklahoma is a right-to-work state, which means workers are free to choose whether or not to join a union. Private- or public-sector employees cannot be fired for refusing to participate in or support a union. Nevertheless, the state has granted special power to some government employee unions. This includes unions affiliated with the NEA and OEA. Dues Collection for Political Organizations Collecting dues is one of the


“The process of collective bargaining cannot be transplanted into the public service.” ‘Why Should the State Keep challenges of running a membership organization—unless you are a government union in Oklahoma. In that case, the state has volunteered to collect your dues for you. State government and state taxpayers subsidize the dues collection service that supports both the OEA and NEA. While supporting private organizations generally is outside of the proper role of government, supporting a political agenda is clearly improper. The NEA and OEA are free to lobby for their views and to solicit for members and contributions; the state should neither interfere with nor support those efforts. Oklahoma needs to get out of the business of collecting money from worker paychecks for any outside groups by repealing the law that granted this special privilege. Collective Bargaining President Franklin Roosevelt, an advocate for private-sector unions, nevertheless warned “the process of collective bargaining … cannot be transplanted into the public service.” Requiring “collective bargaining” forces employers to negotiate with union executives over pay, benefits, and conditions for workers. In Oklahoma, just a few government agencies, like school districts, are required to bargain this way with unions. In most of government, elected officials are able to make decisions about how to operate. In a thoughtful letter to a labor leader, President Roosevelt explained that government officials cannot bargain like a private business owner. In government, “the employer is the whole people, who speak by means of laws,” he wrote. A business owner can fully represent his or her interests,

but one or a few government officials cannot really represent the entire public in negotiating contracts. Put more simply, business owners negotiate over their own future profits. Government officials negotiate over other people’s money. And while businesses have a bottom line, that line in government is fuzzy at best. Worst of all, labor unions often invest heavily in influencing who sits at the other side of the bargaining table. In the worst examples—places like Detroit or the state of Illinois—collective bargaining has become a process where union officials and their elected political allies simply divvy up the spoils. The average American private-sector worker is not represented by a union, many by their own choice. Workers at a Volkswagen plant in Tennessee voted earlier this year not to unionize. When Wisconsin and Michigan workers were given more control over whether or not to belong to a union, many got out. All workers should (and do) have the freedom to join political organizations. Yet government should not be used by special interests to artificially increase the power of those political organizations. Government employers should not be required to “bargain” with private special interests over how government workplaces will operate. Voters elect officials to make these decisions. Taking the decisions away from elected representatives and boosting the power of private special interests is not just unnecessary. As President Roosevelt pointed out, it is undemocratic.

Watch a video interview with Trent England at ocpathink.org/videos.

Propping Up the Unions?’ Introducing Wisconsin Gov. Scott Walker at an OCPA dinner in 2012, Oklahoma Gov. Mary Fallin dubbed him “a profile in courage.” She’s right. And with courageous leadership, conservative policy victories are possible. “For years, public employee unions have depended on government to provide automatic payroll deductions for dues,” The Oklahoman has noted. “So what happens when dues payment becomes voluntary? Membership plummets.” When Wisconsin ended automatic deductions, the American Federation of State, County and Municipal Employees lost over half its membership. We hope Oklahoma lawmakers take note and end automatic deductions for all public sector unions. The failure to pay dues indicates government workers don’t see much value in union membership. So why should the state keep propping up the unions? Indeed, why should lawmakers continue to use your tax dollars to prop up a declining labor union (OEA active members are down 18.5 percent in the last four years), a labor union which in 2006 sued those very lawmakers and then spent millions of dollars in the SQ 744 campaign telling their constituents how greedy and deceptive they are? And speaking of profiles in courage, another OCPA dinner speaker—former Indiana Gov. Mitch Daniels—has suggested that public-sector unions should be abolished altogether. —Editor

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Policymakers Must Reform, Not Expand, Medicaid According to health-care researchers Avik Roy and Grace-Marie Turner, Medicaid “has the worst health outcomes of any insurance program in the developed world.” So why do Oklahoma policymakers keep expanding it? It’s time to take a careful look at this medical welfare program—a program which is rapidly crowding out other items in the state budget. According to the state’s fiscal year (FY) 2013 Comprehensive Annual Financial Report, total state spending on health services has grown from $3.14 billion in FY-2005 to $5.44 billion in FY-2013. That’s an increase of 72.9 percent in eight years. According to the FY-2000, FY-2010, and FY-2013 annual reports from the Oklahoma Health Care Authority (OHCA): • A record 1,040,332 people—that’s 27 percent of the population—were enrolled in Medicaid in FY-2013, despite the state having one of the nation’s lowest unemployment rates, a growing GDP, and growing per capita income.

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PERSPECTIVE • November 2014

• The number of children enrolled in Medicaid has increased more than 197 percent since 1997. • In FY-2003 there were 498,031 Medicaid enrollees (14.27 percent of the population) and total (state) Medicaid expenditures of $714.9 million. By FY-2013, the number of Medicaid enrollees had ballooned to 1,040,332 (27 percent of the state’s population) and state expenditures had skyrocketed to $1.9 billion. That’s an increase of 172.71 percent in just 10 years. Inflation over this period was just 28 percent. Total population growth in Oklahoma over that same period was just 9.3 percent. • The unemployment rate for Oklahoma only moderately increased over this period. It was 4.7 percent in 2002, ranking 12th out of the 50 states, and in 2012 it was 5.2 percent, ranking 5th out of the 50 states. • Approximately 63 percent of births in Oklahoma are covered by Medicaid. • Approximately 72 percent of all

Oklahoma children under the age of five were covered by Medicaid at some point during FY-2012. • In Oklahoma, Medicaid historically was geared for the aged, blind, and disabled, yet now this population only comprises 16.1 percent of enrollees and just 46.5 percent of the cost in Oklahoma. • As of FY-2013, of Oklahoma’s 77 counties, 39 counties have 30 percent or more of their population enrolled in Medicaid. Four counties have more than 40 percent of their population on Medicaid. In an article published March 1, 2013, journalist Peter J. Rudy found that the state Medicaid program in Oklahoma has increased in costs and in number of people served for every year of the last 16 years. “The number of individuals served has never decreased—no matter what the state’s economic condition is—more than doubling in that same period,” Rudy reported. The rate at which the federal government matches Oklahoma state funds on Medicaid is decreasing significantly, going from a 70.18


Another Much-Needed Reform: Give State Employees, Teachers More Choices As journalist Patrick McGuigan reported in these pages in April and again in July, free-market medicine is saving taxpayers big bucks in Oklahoma County. Now it’s time for state policymakers to apply the same reforms to their government employees’ health plans as those implemented by Oklahoma County regarding the purchase of surgical procedures.

This will save taxpayers and state employees real money. Oklahoma County Commissioners enacted a provider services agreement between the Surgery Center of Oklahoma and Oklahoma County that established the Surgery Center as an optional benefit for covered employees, retirees, and eligible dependents. Within the first five months, the county

saved more than $500,000, and county employees saved more than $270,000 in deductible costs. Implementing these reforms for the State of Oklahoma would offer a positive expansion of flexibility in options—options that can save the state up to $20 million annually.

percent federal match several years ago all the way down to a 62.30 percent match in FY-2015. The problem is not that there is too little money for Medicaid; the problem is there are too many people on Medicaid. The program has been expanded too far, and enrollees are driving program expenditures beyond sustainable limits. What then shall Oklahoma policymakers do?

expand Medicaid to adults resulted in those new Medicaid enrollees using the emergency room 40 percent more than those without health insurance. This is not surprising, considering that most Medicaid programs do not have robust emergency room diversion programs and the federal government makes it very difficult to encourage co-payments in the Medicaid program, thus making health care services in the Medicaid program virtually free to the recipient. According to the OHCA, they have no emergency room diversion program, and do not have incentivized staff present in emergency rooms to assist Medicaid patients in making better and less costly choices for treatment.

Florida. Louisiana is pursuing similar reforms. In the first year, Louisiana had experienced savings exceeding $135 million from implementing Medicaid reform, only about half-way through the fiscal year. Fundamentally, the reforms refocus Medicaid programs on the patient, and incentivize care coordination, health improvement, patient empowerment, and taxpayer savings.

Don’t Expand Medicaid Special interests in Oklahoma who receive billions of dollars from Medicaid have peddled the notion that expanding Medicaid reduces emergency room use. But this is not true. According to the OHCA, 289,119 Medicaid enrollees (approximately 28 percent of total Medicaid enrollees) visited the emergency room 548,136 times during FY-2013. The cost to taxpayers for these visits was $178 million. This use of emergency rooms by Medicaid patients is not new. According to the OHCA, during FY-2012, 259,030 Medicaid enrollees (approximately 25 percent of total Medicaid enrollees) visited the emergency room 528,264 times. The cost to taxpayers for these visits was $169 million in FY-2012. Medicaid enrollees actually use the emergency room more than other populations. A study conducted by Amy Finkelstein, a Massachusetts Institute of Technology economist, showed that Oregon’s attempt to

Enact Medicaid Reforms It’s not enough simply to oppose the expansion of Medicaid. Policymakers must provide solutions to make Medicaid better. Oklahoma’s political leaders should take advantage of all currently available options to significantly improve Medicaid by implementing the best Medicaid reforms pursued by Florida, Louisiana, Kansas, and other states looking to make Medicaid serve patients first and empower patients toward self-sufficiency. The Foundation for Government Accountability in Florida has provided extensive research regarding Florida’s success with its Medicaid reform and the cumulative hundreds of millions of dollars it has saved the state of

—Editor

Watch a video interview with Jonathan Small at ocpathink.org/videos.

Jonathan Small Jonathan Small, C.P.A., serves as OCPA’s executive vice president. Previously, he served as a budget analyst for the Oklahoma Office of State Finance, as a fiscal policy analyst and research analyst for the Oklahoma House of Representatives, and as director of government affairs for the Oklahoma Insurance Department. He holds a B.A. in Accounting from the University of Central Oklahoma and is a Certified Public Accountant.

www.ocpathink.org

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Parents, Not Government Officials, Should Determine Their Child’s Path

Brandon Dutcher Brandon Dutcher (M.A. in public policy, M.A. in journalism, Regent University) is senior vice president at OCPA. He’s the editor of the book Oklahoma Policy Blueprint, which was praised by Nobel Prize-winning economist Milton Friedman as “thorough, well-informed, and highly sophisticated.” His articles have appeared in Investor’s Business Daily, Forbes.com, WORLD magazine, the Tulsa World, The Oklahoman, and 200 newspapers throughout Oklahoma and the U.S.

In 2007 the U.S. Chamber of Commerce published a report, “Leaders & Laggards,” which gave Oklahoma’s public school system an “F.” The report said “student performance in Oklahoma is very poor—the state ranks among the lowest in the nation.” This sobering news prompted Oklahoma State University regent Burns Hargis to remark, “If this report is not a wake-up call, I don’t know what is.” Fast forward seven years, and Oklahoma received another wake-up call. In the 2014 edition of “Leaders & Laggards,” Oklahoma again earned an “F” for academic achievement. “Student performance in Oklahoma is very weak,” the report said. How then shall we improve student performance? Many continue to call for more government spending on Oklahoma’s monopoly system. But as the nearby chart shows, we’ve tried

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PERSPECTIVE • November 2014

that. It has not been a wise use of scarce resources. There is essentially no link between state education spending and student performance. It makes no sense to continue pouring increasing sums of money into a failed monopoly. Let’s try something different. Let’s try educational choice. Educational choice refers to any policy that allows parents to choose the safest and best schools for their children, whether those schools are government-operated or privately operated. Fortunately, Oklahoma already has many forms of school choice—both public-school choice (charter schools, magnet and specialty schools, online schools, and more) and private-school choice (Lindsey Nicole Henry Scholarships for special-needs students and Equal Opportunity tax-credit scholarships). Now some may say, “School choice is all well and good, but that can’t be our main focus. We need to fix public schools.” True enough. But aside from the fact that it’s difficult to fix schools that don’t want to be fixed (see ocpa.us/FixSchools), the truth is that school choice improves public schools. Dr. Greg Forster, who writes frequently in these pages, recently surveyed the empirical research on school choice. He found that “23 empirical studies have examined school choice’s impact on academic outcomes in public schools. Of these, 22 find that choice improves public schools and one finds no visible impact. No empirical study has found that choice harms public schools.” As convincing as those scientific research findings are, they shouldn’t necessarily have the last word. After all,

“there is no such thing as a ‘scientifically right’ education policy,” Forster says. Science cannot identify what education policy is most fitting to the intrinsic nature of the human person, or most aligned with America’s ideals of freedom and democratic self-rule. To answer those questions, one needs other kinds of knowledge— knowledge about the nature of human life, the meaning of freedom and democracy, and the historic self-understanding of the American people. Professor Jay Greene has perceptively noted that, in a free society, the government rightly defers to parents when it comes to raising their children. And since education is simply a subcategory of parenting, the government should defer to parents when it comes to educating their children. “Do the right and the responsibility to educate children belong primarily to parents, or to the state?” Melissa Moschella asked in a recent essay published by The Witherspoon Institute. Dr. Moschella, an assistant professor of philosophy at the Catholic University of America, writes: Disputes about parental rights are ultimately disputes about authority. Either childrearing authority fundamentally resides in the political community (which partially delegates that authority to parents), or parental authority is natural and pre-political, based on the nature of the


In a March 2014 paper, Cato Institute scholar Andrew J. Coulson uses a timeseries regression approach and “adjusts state SAT score averages for factors such as participation rate and student demographics, which are known to affect outcomes, then validates the results against recent state-level National Assessment of Educational Progress (NAEP) test scores. This produces continuous, state-representative estimated SAT score trends reaching back to 1972. The paper charts these trends against both inflation-adjusted per pupil spending and the raw, unadjusted SAT results, providing an unprecedented perspective on American education inputs and outcomes over the past 40 years.” The results charted here are for Oklahoma.

parent-child relationship. … The personal relationship that parents establish with their child beginning at conception gives them the special, personal obligation to provide for their child’s developmental needs at all levels until that child can take charge of providing for those needs on his own. It also makes them uniquely competent to carry out this task. Now granted, “the state does have a role in education,” she acknowledges. This is because political authority, like all authority, exists to promote the common good, which includes the individual well-being of the community’s members. In the political community, the common good also involves the education of future citizens. However, the state’s role and authority to foster the wellbeing of children is a subsidiary one, meaning that it is secondary to the role of the parents, and serves the function of helping parents in their educational task, not usurping or undermining the

parents’ educational efforts. … Parents should not be forced, for financial reasons, to send their children to schools in which the values taught conflict with those they want to pass on to their children. An effective voucher or scholarship program of some sort is therefore also a requirement of parental rights. And make no mistake, parents are hungry to exercise those rights. As we noted in these pages in February, when asked in a recent scientific survey what type of school they would select in order to obtain the best education for their children, only 33 percent of Oklahoma parents said a traditional public school. Fully 38 percent said they would choose a private school, 14 percent said home school, and 7 percent said charter school. Policy Prescriptions What then shall Oklahoma’s political leaders do to secure the rights of their constituents? • Enact Education Savings Accounts (ESAs). Put parents in charge by allowing them to bank a portion

of their child’s per-pupil funding and use it for private school tuition, tutoring, online classes, educational therapy, college savings, or a customized mix of options. • Enact individual tax credits. Allow parents to receive state income tax relief for private school tuition, online learning, tutoring, and other approved educational expenses. • Expand tax-credit scholarships. Strengthen Oklahoma’s Equal Opportunity Education Scholarship program by expanding eligibility and removing the funding cap. “Public education” is not about propping up a failed monopoly. The goal of public education is an educated public—regardless of where that education takes place. Oklahoma parents should be empowered to choose among various delivery mechanisms. Many Oklahomans will doubtless continue to argue for more education spending. But what matters is not the amount but rather the beneficiary. Policymakers should invest in the child, not in the system.

Watch a video on school choice at ocpathink.org/videos.

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Tax Reduction Will Empower Future Generations Jonathan Small & Dave Bond Jonathan Small, C.P.A., serves as OCPA’s executive vice president. Dave Bond is CEO of OCPA Impact, a nonpartisan 501 (c)(4) organization working to put freemarket, limited-government ideas into action. He previously served as director of government relations at OCPA. Prior to joining OCPA, he served as director of the Republican State House Committee and worked at the Oklahoma House of Representatives in media and communications.

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U.S. history features many crucial moments when leaders made pivotal decisions that changed the trajectory of the future and empowered generations to come. The Founders determined to pledge their lives, fortunes, and sacred honor for the sake of the birth of a nation, declaring that all men are created equal, endowed by their Creator with certain inalienable rights. George Washington refused to serve more than two terms as president, vowing not to establish a new monarchy. John Quincy Adams waged an ideological war against slavery, helping set the stage for its eventual repeal. Ronald Reagan brought back free-market economic principles, ushering in one of the most prosperous periods of growth in America’s history. Story after story from the first and second world wars shows individuals who made heroic decisions that resulted in safety for billions of people today. Such efforts all involved bold leadership, and they changed and empowered generations. Since 1994, Oklahoma has

accomplished much to help grow the state’s economy: Right to Work, death tax repeal, personal income tax reductions, repeal of taxes on intangible property, lawsuit reform, workers’ compensation reform, prioritizing transportation and infrastructure needs, and government employee retirement reform. All these efforts will help empower future generations. The key to any Oklahoman releasing his or her full potential is the ability to work and to lead a productive life. Unfortunately, Oklahoma assesses a penalty on the work and productive activity of most Oklahomans in the form of a personal income tax. Research and human behavior demonstrate that, more than any other type of tax, personal income taxes result in the reduction of output and of a worker’s ability to fully realize the fruits of his or her labor. The superior economic performance, over at least the past 25 years, of states with no personal income taxes compared to states that assess personal income taxes is undeniable. Oklahoma faces a crossroads: Of the


Oklahoma lost a net total of nearly $1 billion in personal income as a result of Oklahoma taxpayers migrating to other states.

six surrounding states, four have lower personal income tax rates, covering Oklahoma’s northern, southern, and western borders. From 1992 to 2011, Oklahoma lost a net total of nearly $1 billion in personal income as a result of Oklahoma taxpayers migrating to other states (see pp. 12-13). It’s no coincidence the two states that gained the most wealth from Oklahoma in that span were no-income-tax Texas and Florida, together receiving $1.6 billion in personal incomes from our state. Oklahoma has demonstrated success with personal income tax reductions. Income tax rate cuts from 2005 through 2012 played a part in significant growth in Oklahoma’s economy and in disposable income. And total state spending and state tax collections are at all-time highs, thus proving tax cuts have not decimated available revenue for government. But it is not just Oklahoma. Creighton University economist Ernest Goss notes: In 2012, Kansas Governor Brownback pushed the Legislature to whack individual tax rates by 25%, to repeal the tax on sole proprietorships, and to increase the standard deduction. In 2013, the Legislature cut taxes again. Since passage in 2012, how has the Kansas economy responded to these dramatic tax cuts? Kansas [following the tax cuts] grew its personal income by 2.92% which was higher than the U.S. gain of 2.85%, and was greater than the growth experienced by each state bordering Kansas, except Colorado. [Colorado has received an influx of Californians fleeing

record-high state income tax increases; Colorado also still has a personal income tax rate below Kansas.] Additionally in terms of average weekly earnings, Kansas experienced an increase of 4.82% which was almost four times that of the U.S., more than four times that of Missouri, approximately seven times that of Nebraska, and nearly four times that of Oklahoma. … Kansas job and income data since the tax cut show that, except for Colorado, the state economy has outperformed, by a wide margin, that of each of its neighbors and the U.S. To remain competitive, expect Kansas’ neighbors to reduce state and local taxes in the years ahead. Consider Hertz and Dollar Thrifty relocating their managers and decision-makers from Oklahoma to no-income-tax Florida. Consider Hilti Corporation relocating its managers and decision-makers to income-tax-free Texas. It is clear Oklahoma’s personal income tax inhibits our state’s ability to make jobs available to those who desperately need them. Now is the time for Oklahoma to fully commit to eliminating the state’s “penalty on work,” the personal income tax. Across Oklahoma, families are faced with rising health insurance deductibles and out-of-control medical costs, rising food prices, out-of-control higher education costs, and numerous other financial pressures. This year there will be Oklahomans who are forced into debt to pay medical bills or cover other necessities. By taxing personal income, state lawmakers are taking away financial freedom from Oklahoma

families—in order to continue growing the size of state government. If Oklahomans don’t act to remove their state’s penalty on work, no-income-tax states will continue to have a competitive advantage over our state. If things remain as they are, when our children and Oklahoma’s future generations are faced with the decision of where to go for opportunity, we will be forced to be honest with them and say that places like Dallas, Houston, Frisco, Lewisville, Abilene, Plano, Orlando, Fort Myers, and elsewhere hold better promise than Oklahoma City, Tulsa, Edmond, Broken Arrow, Enid, or Bartlesville. By gradually phasing out Oklahoma’s penalty on work over an extended period of time, the state can ensure funds are available for core services while transitioning our economy into one that can’t be easily matched. By committing to gradual, steady, quarterpercent reductions in the top personal income tax rate, just as the state has done previously, Oklahoma can provide a new economy, with opportunity in greater abundance for our children and grandchildren. For the sake of future generations, and to unleash the full economic potential of all Oklahomans, our two organizations remain steadfastly committed to ensuring that Oklahoma gradually phases out the state’s penalty on work, the personal income tax.

Watch a video about OCPA Impact at ocpaimpact.com.

www.ocpathink.org

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FACT

MAKING UP GROUND LOSING OPPORTUNITY GAINS AND LOSSES IN THE STATE OF OKLAHOMA

FROM 1992-2011 OKLAHOMA LOST

$954.77 MILLION NET LOSS OF AGI*

OKLAHOMA AND THE NATION

SIX BIG WINNERS & THREE BIG LOSERS

WASHINGTON GAINED $12.65 BILLION 0% INCOME TAX

NEW YORK LOST $71.36 BILLION 8.82% INCOME TAX

CALIFORNIA LOST $46.32 BILLION 13.3% INCOME TAX

ILLINOIS LOST $31.27 BILLION 5% INCOME TAX

SOUTH DAKOTA GAINED $758.12 MILLION 0% INCOME TAX

TENNESSEE GAINED $10.55 BILLION 0% INCOME TAX

WYOMING GAINED $1.49 BILLION 0% INCOME TAX

FLORIDA GAINED $100.53 BILLION 0% INCOME TAX TEXAS GAINED $27.34 BILLION 0% INCOME TAX

OKLAHOMA GAINS AND LOSSES

OKLAHOMA WEALTH MIGRATION FROM 1993-2011 DOLLAR AMOUNTS IN BILLIONS ($)

$-0 $-0.2 $-0.4 $-0.6 $-0.8 $-1 $-1.2 '93

'94

'95

'96

'97

'98

'99

'00

'01

'02

YEARS (1993-2011)

2005

'04

'06

'07

'08

'09

'10

'11

GAIN

STATE

LOSS

CALIFORNIA KANSAS MICHIGAN ILLINOIS NEW MEXICO

$715.38 MILLION $247.38 MILLION $75.54 MILLION $71.40 MILLION $67.40 MILLION

TEXAS FLORIDA ARKANSAS COLORADO MISSOURI

-$1.3 BILLION -$296.93 MILLION -$142.65 MILLION -$132.43 MILLION -$115.10 MILLION

OKLAHOMA GAINED MORE THAN $700 MILLION FROM HIGH-TAX CALIFORNIA, BUT LOST MORE THAN TWICE THAT TO NO-INCOMETAX TEXAS AND FLORIDA

OKLAHOMA BEGINS CLIMBING OUT OF THE HOLE AT THE EXACT TIME THE LARGEST INCOME TAX RATE CUTS IN STATE’S HISTORY ARE PASSED INTO LAW AND TAKE EFFECT, REDUCING STATE’S “PENALTY ON WORK” BY 25% OVER 8 YEARS.

ADJUSTED GROSS INCOME (AGI)

12

'03

STATE

PERSPECTIVE • November 2014

INCOME REPORTED BY INDIVIDUALS TO THE IRS ON THEIR FEDERAL 1040 TAX RETURNS, 1992 - 2011.


FROM 1992-2011 OKLAHOMA LOST $954.77 MILLION IN ANNUAL AGI* OKLAHOMA’S COUNTY GAINS AND LOSSES AT A GLANCE A

H

E G

E GARFIELD A KAY LOST LOST $195.1 MILLION $134.58 MILLION

C

B JACKSON F TULSA LOST LOST $139.74 MILLION $1.14 BILLION C OKLAHOMA G PAYNE LOST LOST $934.52 MILLION $153.79 MILLION

F

B

D

D COMANCHE H WASHINGTON LOST LOST $461.84 MILLION $155.6 MILLION

MORE THAN

LESS THAN

OF COUNTIES ARE LOSING WEALTH

OF COUNTIES SHOW A NET GAIN FROM OUTSIDE OK

60% 20% Every year, the IRS produces a detailed report on the tax migration of Americans. This migration of income raises important questions about state tax policy.

Why did so much wealth walk? Did people vote with their feet?

Those policies profoundly affect growth and development—both in OK and in the other 49 states we compete against for jobs and economic opportunity.

Which states "won," or "lost," and why?

THERE’S A

SIMPLE SOLUTION

ADJUSTED GROSS INCOME (AGI)

Did money walk because the opportunity to keep more personal income talked?

How does penalizing work by taxing personal income affect economic growth?

The key to accumulating working wealth for any state is a pro-growth tax policy. By not penalizing work and not taxing personal income, states can create more jobs and more opportunities.

INCOME REPORTED BY INDIVIDUALS TO THE IRS ON THEIR FEDERAL 1040 TAX RETURNS, 1992 - 2011.

OCPA IMPACT HTTP://WWW.HOWMONEYWALKS.COM/IRS-TAX-MIGRATION/

INFO@OCPAIMPACT.COM | WWW.OCPAIMPACT.COM

www.ocpathink.org

13


Corrections Reforms Will Make Us Smart on Crime Incarceration of non-violent offenders and overcriminalization are both real problems in Oklahoma.

14

PERSPECTIVE • November 2014

Reducing crime and punishing criminals are basic functions of government. Yet Oklahoma’s corrections system is failing. Costs are soaring. The system is badly overcrowded. Oklahoma spends more than $700 million annually on corrections efforts, which largely consist of jailing people convicted of crimes. According to the American Civil Liberties Union, our prison population has grown 446 percent since the 1980s, yet Oklahoma’s population has only grown 26 percent. OCPA believes that in order to unleash the human potential of Oklahomans, we mustn’t merely be tough on crime. We need to become smart on crime. Incarceration of non-violent offenders and over-criminalization at both the state and federal levels are driving up the cost of other government services and robbing homes of mothers and fathers. Oklahoma should move to a system which avoids the incarceration of non-violent offenders, working

instead to help those struggling with substance abuse, mental health challenges, and financial woes to pursue empowerment and improvement through restorative justice and other reforms. A number of states are making great strides in these areas. It’s time for Oklahoma policymakers to do likewise. DOC Reform Lawmakers should work to significantly increase the oversight ability of the governor’s office and the legislature as it relates to the Department of Corrections (DOC) by eliminating the DOC board and requiring the director to be appointed directly by the governor. This will lead to greater accountability and the implementation of reforms in a timelier manner. Lawmakers seeking to be “right on crime” are making the right moves regarding corrections reform. Efforts


should continue to reduce incarceration rates and strengthen families. These and other efforts to significantly reduce the incarceration of non-violent offenders are what’s best for society and also save millions in taxpayer dollars. The Department of Corrections—like the Tourism Department, the Office of Juvenile Affairs, and many other state-operated services—can utilize the private sector to reduce the cost of providing state services. If the DOC would fully utilize the available private prison beds (“halfway” houses) as authorized by law, the state could save approximately $34 million annually (based on state costs per bed in 2009). Sentencing Reform The topic of sentencing reform is a challenging but crucial one. Mandatory minimums and the growth of criminal statutes are the chief reasons for the ballooning growth of the corrections budget and the number of imprisoned offenders. It’s time to implement sentencing reforms which reduce or eliminate required prison time for many non-violent offenses. These reforms have been implemented in both “red” and “blue” states, including Kansas, Kentucky, Mississippi, South Carolina, Texas, and Ohio. Overcriminalization Four of the 10 amendments in the Bill of Rights are protections against government power to investigate, try, and punish criminals. This is where government wields the greatest power against individual citizens, and so there are risks of misuse and abuse. Indeed, criminal law has changed and grown since the Bill of Rights was ratified in 1791. Over the last century, this growth has accelerated. Criminal law has been extended beyond traditional boundaries in ways collectively known as overcriminalization. The traditional definition of a crime required two elements: a harmful act (actus reus) done with bad intent (mens rea). The first element prevents punishment of mere “thought crimes.” The second

element is about culpability—whether a person actually deserves punishment. “Even a dog,” wrote Oliver Wendell Holmes, “distinguishes between being stumbled over and being kicked.” Harmful accidents (torts) are the proper province of civil lawsuits, not criminal prosecutions. This distinction has been blurred in two dangerous ways. First, federal and state legislators have extended criminal punishments to acts done without criminal intent. This is particularly evident in federal environmental law, where people have been imprisoned for violations of the Clean Water Act that even prosecutors acknowledged were unintentional. Again, such a violation would traditionally be a tort, a cause for a civil suit for damages. The other way some lawmakers and prosecutors have blurred this distinction is by increasing the potential damages for certain civil or administrative actions to punitive—that is, punishing—levels. Instead of extending the reach of criminal law, some civil penalties have become just as severe as criminal fines. Administrative courts can shut down businesses or take other actions that deprive people of their livelihoods. This form of overcriminalization is particularly insidious because it strips defendants of some of those protections in the Bill of Rights. Lawmakers are responsible for drafting laws, especially those with criminal penalties, in ways that are clear to the public, prosecutors, and judges. Legislators can prevent some overcriminalization through legislation that makes clear that every criminal prosecution requires proof of intent. In both criminal prosecutions and civil and administrative actions, lawmakers and government officials should follow the traditional, common-sense understanding that only intentionally bad acts are worthy of punishment. Provisional Licenses for Ex-Offenders One of the biggest challenges to corrections reform is the over-regulation of occupational licensing, and specific prohibitions for ex-offenders who are banned from obtaining a license due

to felony or other prior convictions. Non-violent ex-offenders should be allowed to obtain a provisional, or probationary, occupational license if they are otherwise qualified. Research indicates that a person who has been a law-abiding member of society for at least five years is at a low risk of re-offending. Also, according to the Federal Bureau of Prisons, ex-offenders who are employed are three to five times less likely to re-offend. Opportunity for Ex-Offenders, Protection for Employers Due to the litigious nature of our times, many employers are reluctant to hire ex-offenders. Employers rightly fear they will be sued in court for negligence or some other charge if a customer experiences a problem with an employer’s business that involved the ex-offender. To encourage the hiring of non-violent ex-offenders, the state should issue non-violent offenders— either while they are in prison or after a certain amount of time following their release—certificates of rehabilitation that can be presented to employers. If an employer hires a non-violent ex-offender who possesses a certificate of rehabilitation, state civil liability statutes should provide protections for those employers regarding the employment of the ex-offender. Oklahoma policymakers have always been tough on crime. It’s time to be smart on crime.

Jonathan Small & Trent England www.ocpathink.org

15


Federalism

The Objective and the Strategy Restoring the balance between state and federal power will take states standing up against federal overreach. The fight will not be won from within Washington, D.C. This is why the mission of the Liberty Foundation of America is to leverage local resources and partnerships to assert state primacy and personal liberty in national public policy. A massive infrastructure for liberty has emerged within the states over the last two decades. The time has come to leverage those resources in the fight to restore constitutional federalism. Why Federalism? Geography matters. There is something different about a government down the street and one a thousand miles away. Citizens can track down and talk to their city and county officials, and even their state legislators. It is much more difficult to gain an audience with a member of Congress. And just try tracking down an official within a federal bureaucracy. Distant governments are less responsive and accountable to citizens, and thus prone to both inefficiency and hubris. Not only did the American Founders understand this, it has been part of Western political thought since the classical Greeks. They believed only small societies could maintain the kind of virtue that makes freedom and representative government possible. Get too big, with power too distant, and totalitarianism becomes inevitable. The case in point for the Greeks was the contrast between their relatively small (and relatively free) city-states and their bad neighbor to the east: the

16

PERSPECTIVE • November 2014

massive, imperious Persian Empire. Of course, in the end, the Greek city-states fought with each other and then fell to a new imperious neighbor, Rome. History seemed to show that the conditions necessary for freedom were also the causes of weakness and strife; creating a state strong enough to survive meant leaving freedom behind. The Framers of the Constitution faced this challenge and created something new—the structure that is today known as federalism. The states already possessed the complete powers of government, and were left with all that power save what was explicitly handed over to the new federal government or denied the states in the Constitution. Federal powers were limited to those things either inherently or necessarily federal, like foreign policy and defense. The federal government would regulate interstate issues—trade across state lines or in international waters—but all the rest was left to the states themselves. The Constitution begins and the Bill of Rights ends with statements about the limits on federal power. Article I, Section I, says “All legislative Powers herein granted shall be vested in a Congress of the United States…” (emphasis added). The Tenth Amendment reads, The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people. The Constitution is clear on this point. And like all the structures and processes it creates, the ultimate purpose is to establish a government that will “secure the Blessings of Liberty” for generations.

The Progressive Assault Progressives believe human nature is malleable and changes over time. The purpose of government is not just to keep up, but to lead and control this process. This requires a powerful, flexible government. “The trouble with the [American Founders’] theory,” wrote President Woodrow Wilson, “is that government is not a machine, but a living thing.” Structures like federalism, with its limits on federal power and governments competing with other governments, frustrated progressive politicians and their programs. Until the Progressive Era, the Constitution had indeed kept government limited. Except at elections and during wartime, the federal government had very little interaction with ordinary Americans until the New Deal. Federal spending never exceeded 5 percent of the economy, other than in wartime, until 1930. Then it doubled, to 10 percent, in just a decade. Federal spending has represented 15 percent or more of the economy since 1950. The Progressives, in the same year Wilson was inaugurated, amended the Constitution to allow a federal income tax and require direct election of Senators. The first change dramatically increased federal power by creating not merely revenue but also regular interaction with nearly the entire population. The second change, eliminating the power of state legislatures to elect Senators, removed the states’ most potent check on federal legislative power. More importantly, Progressives like Wilson successfully called on the courts “to interpret the Constitution


according to the Darwinian principle.” Rather than focusing on the original meaning of the text, judges would turn it into a “living” document that could grow and change over time. This transformation of the role of judges, from guardians of the Constitution to participants in the Progressive project to remake government and society, set the stage for the New Deal. Wilson was honest about Progressive designs, with limited success. Franklin Roosevelt was a much savvier politician. Instead of disagreeing with the American Founding, Roosevelt simply reimagined the Founding and the Constitution. He claimed the Declaration of Independence was a contract between the people and their rulers, where the people gave power to government, which in turn gave the people certain rights. This

is the breakdown in trust between citizens and government. Less than a third of Americans believe the country is “heading in the right direction.” Polls of citizens’ trust in government are around all-time lows. The Greeks could have warned us; the Framers of the Constitution tried to stop us. The Objective and the Strategy Can we restore federalism and reverse the damage done by the Progressives? We can. In fact, we are better positioned today to push back than at any time since the New Deal. We are at the beginning of the third wave of organized opposition to the Progressives. Or, to put it positively, the third wave in favor of restoring constitutional government to the United States. The first wave came with the founding and growth of national

Until now, these state groups have focused almost exclusively on state governments and policies. Yet these groups are well positioned and motivated to advocate for federalism. Leveraging this infrastructure and these resources is the mission of the Liberty Foundation of America and is the third wave that is now building up so that it can come crashing down on the Progressives. The Liberty Foundation of America is focused on policy issues most subject to federal overreach, starting with agriculture and energy. These are the foundations of a functioning economy. Federal policies have mired farmers and energy producers in red tape, harming the well-being of all Americans. States are competent to make policies and administer the necessary programs in both of these areas. And it is easy to imagine how competition

Can we restore constitutional government and reverse the damage done by the Progressives? Yes. meant government could provide more rights to the people, so long as the people consented to an ever more powerful government. Roosevelt’s New Deal programs were based on these supposed new rights. They were also designed to discredit state governments and change the balance of power in favor of Washington, D.C. New Deal programs intentionally went around the states and either reached down to the people directly or in partnership with local governments. States were made to look impotent as compared to the massive new federal projects and handouts. The expansion of federal power has continued. The most quantifiable results are massive debt, nearing $18 trillion, and even more massive future obligations of $115 trillion. Federal regulations are estimated to cost just over $2 trillion every year. Perhaps even more disturbing

conservative and libertarian organizations. Because the Progressives focused their efforts on Washington, D.C., the opposition did as well. Yet the fight there is inherently defensive. Progressives, with their vision of consolidated, top-down control, can win from the center. Those who believe in freedom and in federalism cannot. Visionary constitutionalists recognized this and began founding state-based groups, with remarkable success. This second wave of opposition to the Progressives has built up an unprecedented statebased infrastructure for freedom. And for these groups, federalism is an existential concern. Either states have authority to make policy choices or else the work of state think tanks and activist groups is an anachronism. Conversely, every exercise of state power is an expression of federalism.

among states would produce policy innovations that make our nation stronger, safer, and more prosperous. Now is the time to bring together national and state-based organizations to push back the Progressives’ unconstitutional federal power grab. The Liberty Foundation of America is proud to be at the leading edge.

Trent England www.ocpathink.org

17


With State Spending at an All-Time High, It’s Time to Right-Size Government` In 2015, it’s time for policymakers to get serious about “right-sizing” government. Consider the following. Total state tax collections have increased by $1.7 billion since their low point in the recent recession. The Oklahoma Tax Commission reports that the state will set another record for tax revenues by the completion of the current fiscal year. Even in the area of education, the state Department of Education reports that total common education available revenues are the largest yet. As I noted in a February editorial in The Oklahoman: “According to the Comprehensive Annual Financial Report (CAFR), the most recent fiscal year (FY 2013) set records for total spending. From FY 2003 to FY 2013, total state spending increased by $6.37 billion, or 59.75 percent. This outpaced, over the same period, inflation (27

percent), state population growth (9 percent), and state personal income growth (39 percent).” Oklahoma policymakers still spend millions of dollars on targeted earmarks (such as rodeos, golf courses, aquariums, and other non-essentials), hundreds of millions on inefficient health care programs (even though bipartisan solutions abound), and hundreds of millions on non-instructional K-12 activities in public schools. Across Oklahoma, families are faced with rising health insurance deductibles and out-of-control medical costs, rising food prices, out-of-control higher education costs, and numerous other financial pressures. This year there will be Oklahomans who are forced into debt to pay medical bills or cover other necessities. Government shouldn’t take from these more than what is absolutely

necessary to perform core functions. OCPA’s proposed annual budget—“a state budget that respects your family budget”—demonstrates how waste and inefficiencies could be eliminated, saving more than $1.7 billion over the next three years. That’s money which can be reallocated to core government functions and to the taxpayers who earned it.

Jonathan Small

Total State Expenditures

R R R

07 $1 6.

13 4. $1

2 2.9

4 $1 7.0 FY-2013

R R R

$1

1.7 3

70 6. $1 FY-2012

D R R

.6 $1 6 FY-2011

D R R

61 $1 6. FY-2010

$1

7 $1

0. 6

$12.00

$1 1.0

8

$14.00

$1 5.0

2

$18.00 $16.00

4

(Billions of $)

$10.00 $8.00 $6.00 $4.00 $2.00 $Party in control when spending approved

18

FY-2003 FY-2004 FY-2005 FY-2006 FY-2007 FY-2008 FY-2009 Governor Senate House

PERSPECTIVE • November 2014

R D D

D D D

D D D

D D R

D D R

D Tie R

D Tie R


2 1

3

4

@OCPAthink 1. Brit Hume, senior political analyst for FOX News Channel, chats with OCPA president Michael Carnuccio at OCPA’s “Liberty Live” event September 24 in Tulsa. 2. State Rep. Chuck Strohm (R-Jenks) and his wife, Angela, are pictured here with Brit Hume. 3. On October 9 in Oklahoma City, OCPA teamed up with The Heritage Foundation to host a panel discussion for lawmakers entitled “School Choice 2.0: Education Savings Accounts.” Pictured here are panelists Andrew Spiropoulos, an Oklahoma City University law professor who also serves as the Milton Friedman Distinguished Fellow at OCPA; Jonathan Butcher, education director at the Goldwater Institute; Matthew Ladner, senior advisor of policy and research for the Foundation for Excellence in Education; and Lindsey Burke, the Will Skillman Fellow in Education Policy at The Heritage Foundation. 4. Work continues on OCPA’s new Advance Center for Free Enterprise, located to the west of OCPA’s main office. The Center will host lawmakers, executive-branch officials, and policy staffers for training sessions on how to apply core principles to difficult public-policy issues. The Center will also be a valuable resource for students, as OCPA partners with schools and nonprofit organizations to host programs teaching students the principles of liberty and the importance of our freeenterprise system.

www.ocpathink.org

19


QUOTE UNQUOTE “Nor should the argument seem strange that taxation may be so high as to defeat its object, and that, given sufficient time to gather the fruits, a reduction of taxation will run a better chance than an increase of balancing the budget.”

John Maynard Keynes

“Monopolies invariably produce bad products at high prices.” The late financier Ted Forstmann, quoted in a September 29 Wall Street Journal piece entitled “What Uber and School Choice Have in Common”

“School choice is probably the greatest threat to the leftist/ progressive agenda.” Heritage Foundation president Jim DeMint, speaking October 9 in Oklahoma City

“Few men have virtue to withstand the highest bidder.” George Washington

“So let me get this straight. ... We are going to be gifted with a healthcare plan that we are forced to purchase, and fined if we don’t, which reportedly covers 10 million more people without adding a single new doctor, but provides for 16,000 new IRS agents, written by a committee whose chairman doesn’t understand it, passed by Congress that didn’t read it but exempted themselves from it, and signed by a president who smokes, with funding administered by a treasury chief who didn’t pay his taxes, for which we will be taxed for four years before any benefits take effect, by a government which has bankrupted Social Security and Medicare, all to be overseen by a surgeon general who is obese and financed by a country that is broke.”

Barbara Bellar, M.D., J.D., a former nun, speaking in 2012


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