Alex Garlick
@garlicksauce.bsky.social
UVM prof. Author of "Pre-Existing Conditions: How Lobbying Makes American Health Care More Expensive." I research lobbying, legislatures and health policy. www.alexgarlick.com
If a more free market approach really helps patients/consumers, why do states where citizens spend the most of their expenditures on health care controlled by Republicans?
(figure from my book PRE-EXISTING CONDITIONS: academic.oup.com/book/60804)
(figure from my book PRE-EXISTING CONDITIONS: academic.oup.com/book/60804)
November 20, 2025 at 3:30 PM
If a more free market approach really helps patients/consumers, why do states where citizens spend the most of their expenditures on health care controlled by Republicans?
(figure from my book PRE-EXISTING CONDITIONS: academic.oup.com/book/60804)
(figure from my book PRE-EXISTING CONDITIONS: academic.oup.com/book/60804)
and now this could sail through the Senate. What a world.
November 18, 2025 at 9:30 PM
and now this could sail through the Senate. What a world.
This is gonna be "High Deductible Health Care Plans for All" if this money is delivered as HSAs which require a HDHP to access.
November 18, 2025 at 4:08 PM
This is gonna be "High Deductible Health Care Plans for All" if this money is delivered as HSAs which require a HDHP to access.
that paper writes itself
November 14, 2025 at 4:25 PM
that paper writes itself
Public policy folks: What should we call policies in the (?) space? Chuck Cameron's policy tool kit names policies that pencil out and actually work (but aren't popular) WALLFLOWERS. Policies that work and are politically okay, but costs outweigh the benefits for society STINKERS.
November 12, 2025 at 6:44 PM
Public policy folks: What should we call policies in the (?) space? Chuck Cameron's policy tool kit names policies that pencil out and actually work (but aren't popular) WALLFLOWERS. Policies that work and are politically okay, but costs outweigh the benefits for society STINKERS.
It's very academia coded to have a meeting scheduled when you're about to be fired, or in academia speak "denied tenure."
November 11, 2025 at 3:37 PM
It's very academia coded to have a meeting scheduled when you're about to be fired, or in academia speak "denied tenure."
This is why I teach Skowronek's "The Politics Presidents Make." It gets at this motivation presidents have to "be great" and then helps explain whether they achieve that (rarely) or not.
November 11, 2025 at 3:27 PM
This is why I teach Skowronek's "The Politics Presidents Make." It gets at this motivation presidents have to "be great" and then helps explain whether they achieve that (rarely) or not.
“Concepts of a plan” forever.
November 9, 2025 at 12:57 AM
“Concepts of a plan” forever.
Encouraging thaw in the Senate, but this would only kick the responsibility for ending the shutdown over to the House.
November 6, 2025 at 8:04 PM
Encouraging thaw in the Senate, but this would only kick the responsibility for ending the shutdown over to the House.
X is lamenting that Republicans are getting blamed, but I wonder why that is?
November 6, 2025 at 4:10 PM
X is lamenting that Republicans are getting blamed, but I wonder why that is?
This is looking like 18/18.
November 5, 2025 at 11:42 AM
This is looking like 18/18.
Sadly I can also report that Needham High School will be without an elected Governor alumnus for the first time since 2014.
November 5, 2025 at 11:18 AM
Sadly I can also report that Needham High School will be without an elected Governor alumnus for the first time since 2014.
I'm teaching Skowronek tomorrow, whose belief that "the presidency is a battering ram" has held up. Although, his statement should probably be updated that the POTUS is a "foreign-made excavator" to keep up with the times.
November 3, 2025 at 9:37 PM
I'm teaching Skowronek tomorrow, whose belief that "the presidency is a battering ram" has held up. Although, his statement should probably be updated that the POTUS is a "foreign-made excavator" to keep up with the times.
This shows how lobbying works in a polarized age. The hotel trade association just hired Scalise's chief, and from his mind, the need to build coalitions only includes Republicans.
via POLITICO Influence
via POLITICO Influence
October 30, 2025 at 1:49 PM
This shows how lobbying works in a polarized age. The hotel trade association just hired Scalise's chief, and from his mind, the need to build coalitions only includes Republicans.
via POLITICO Influence
via POLITICO Influence
Why is this dragging on with no end in sight?
1) The House being out is simply not building political pressure on House Dems
2) Trump was eager for shut down. They dressed up Vought like grim reaper!
3) Many Dems are okay with Senate Repubs nuking filibuster, so that consequence is not foreboding.
1) The House being out is simply not building political pressure on House Dems
2) Trump was eager for shut down. They dressed up Vought like grim reaper!
3) Many Dems are okay with Senate Repubs nuking filibuster, so that consequence is not foreboding.
October 29, 2025 at 2:18 PM
Why is this dragging on with no end in sight?
1) The House being out is simply not building political pressure on House Dems
2) Trump was eager for shut down. They dressed up Vought like grim reaper!
3) Many Dems are okay with Senate Repubs nuking filibuster, so that consequence is not foreboding.
1) The House being out is simply not building political pressure on House Dems
2) Trump was eager for shut down. They dressed up Vought like grim reaper!
3) Many Dems are okay with Senate Repubs nuking filibuster, so that consequence is not foreboding.
This week the #GarlickBLT makes it to @usnews.com, where I drop some important new economic insights. www.usnews.com/news/best-st...
October 28, 2025 at 5:48 PM
This week the #GarlickBLT makes it to @usnews.com, where I drop some important new economic insights. www.usnews.com/news/best-st...
The @Newsweek.com reviewed my book highlighting how negative lobbying is a key driver of health care inflation.
www.newsweek.com/study-finds-...
www.newsweek.com/study-finds-...
October 22, 2025 at 1:52 AM
The @Newsweek.com reviewed my book highlighting how negative lobbying is a key driver of health care inflation.
www.newsweek.com/study-finds-...
www.newsweek.com/study-finds-...
My book does not advocate for a single "silver bullet" to make health care more affordable. But Vermont needs to think more holistically about increasing the supply of providers to ease costs, either with the federal rural health care dollars or by building more housing. #YIMBY
October 20, 2025 at 1:18 PM
My book does not advocate for a single "silver bullet" to make health care more affordable. But Vermont needs to think more holistically about increasing the supply of providers to ease costs, either with the federal rural health care dollars or by building more housing. #YIMBY
If you pull out one year of those state-by-state expenditures, you see 1) It's not liberal/blue states where health care is most expensive for residents. 2) There's a positive relationship with the size of the health care lobby driving the trend.
October 13, 2025 at 1:48 PM
If you pull out one year of those state-by-state expenditures, you see 1) It's not liberal/blue states where health care is most expensive for residents. 2) There's a positive relationship with the size of the health care lobby driving the trend.
My book shows that while the ACA did not "bend the cost curve down" like Obama hoped, it has plateaued a bit. But the bigger issue for Lawler and Republicans is that the states where health care is the biggest crisis for its residents are red states, like WV where 24%! of expend went to healthcare.
October 13, 2025 at 1:46 PM
My book shows that while the ACA did not "bend the cost curve down" like Obama hoped, it has plateaued a bit. But the bigger issue for Lawler and Republicans is that the states where health care is the biggest crisis for its residents are red states, like WV where 24%! of expend went to healthcare.
Rick Scott joins team "Concepts of a Plan." Where is the secret plan that lowers the cost of care without (1) kicking people off health insurance? (2) Gutting what health insurance covers (pre-existing conditions)?
www.wsj.com/opinion/demo...
www.wsj.com/opinion/demo...
October 10, 2025 at 4:50 PM
Rick Scott joins team "Concepts of a Plan." Where is the secret plan that lowers the cost of care without (1) kicking people off health insurance? (2) Gutting what health insurance covers (pre-existing conditions)?
www.wsj.com/opinion/demo...
www.wsj.com/opinion/demo...
Republicans just cannot resist leaking the contents of a conference call while they're on the call. But yeah, this tactic seems like it's losing steam.
October 9, 2025 at 6:21 PM
Republicans just cannot resist leaking the contents of a conference call while they're on the call. But yeah, this tactic seems like it's losing steam.
Keeping the House out has been an interesting tactic. On the one hand, Johnson and leadership struggle to keep their conference's messaging together. But it's taken energy out of shaming Dems for shutting things down, which usually is the best argument of the ruling party.
October 9, 2025 at 1:12 PM
Keeping the House out has been an interesting tactic. On the one hand, Johnson and leadership struggle to keep their conference's messaging together. But it's taken energy out of shaming Dems for shutting things down, which usually is the best argument of the ruling party.
This is a rich text from Rep. MTG for understanding the health care plank of the "populist economics" wing of MAGA.
October 7, 2025 at 1:28 PM
This is a rich text from Rep. MTG for understanding the health care plank of the "populist economics" wing of MAGA.
To the extent the Democrats shutdown tactics over ACA subsidies makes sense, this is it. It could bring a looming wedge issue in the GOP conference to light.
October 1, 2025 at 8:52 PM
To the extent the Democrats shutdown tactics over ACA subsidies makes sense, this is it. It could bring a looming wedge issue in the GOP conference to light.