You finally get your dream and are selected to be a contestant on Wheel of Fortune. You get to see Pat Sajak and Vanna White! You win a vacation to some country that you don’t really want to see. You cannot get the cash equivalent. You have to take 10 days off of work to take the free vacation you did not want. You discover that you have to pay the tax on the free vacation.

Or you win a free car. You have a perfectly functioning 3-year-old car. The free car was not really the car you would have selected. You accepted it because it was free. Then you see that you have to pay tax on the list price of the free car. You also discover that the collision insurance and Department of Motor Vehicles registration for the free car are significantly higher than for the car you currently own.

These are examples of why nothing is “free.” This applies to medical care as well. You may have to see the “health care provider” the government program or private insurer makes available to you. You don’t particularly want to see a nurse, but that’s the way the cookie crumbles with free health care. Oh well, you convince yourself that it’s okay because, just like that car on the game show, it was free.

Here’s a new spin on “free.” Yes, your medical care should be free – free from the restraints of government control. Free from the government rules that have raised the price of insurance premiums. The Affordable Care Act mandated ten essential benefits that all insurance plans must include free of out-of-pocket charges to patients. Of course, this does not include the initial out-of-pocket charge: the insurance premium. Insurance premiums shot up over the post-ACA year because the insurance plan has to cover conditions that the insured persons may not even encounter in their own lives. A glaring example is obstetrics coverage in a menopausal female. Preventive and wellness visits are also labelled as free.

Moreover, a recent AMA study revealed that over the last four years the competition in the commercial insurance market has decreased. In over 50 percent of metropolitan areas, representing about 73 million persons, one insurer has half of the market. The more concentrated the market, the higher the premiums.

Remember that free car? We all know and readily accept that car insurance does not pay for the gas and basic maintenance. So why should maintenance medical care be covered by insurance? Car insurance would be unaffordable for most car owners if it paid for gas, oil changes, new mufflers, radios, and batteries. Most states require drivers to have car insurance. If people can’t afford the insurance, they lose the benefit of owning a car.

Similarly, if you lose your health due to long waits or delayed diagnosis because the CT scan was not authorized or poor medication response because you had to take the formulary drug that was not the doctor’s first drug choice for you, the care is not free, but very costly.

The underlying message of free “health care” is disempowering. The message is that we are incapable of taking care of ourselves. Empowerment is having control over our own lives. First, we take charge of our own health by thinking about the choices we make. We choose to not smoke, overindulge in food or drink, or engage in foolhardy behaviors. Second, we decide what is important for our own health. If you do not want insurance coverage for obstetrics or fertility treatment because you are 50 years old and do not want children, there should be a less expensive insurance product available to you. Third, we need to be free to choose our own doctor as well as the treatment the doctor—not the invisible third-party payer—recommends.

The promised free health care would increase the payroll taxes on all workers, even if that worker does not want that particular brand of free medical care. The next time you hear that medical care is free, just think about that “free” car that is the wrong color, is too small, has uncomfortable seats, inadequate headroom, and overall is not what you really want.

Dr. Singleton is a board-certified anesthesiologist. She is Immediate Past President of the Association of American Physicians and Surgeons (AAPS). Her opinions are her own. This is an edited column that originally appeared at www.pennypressnv.com, reprinted with permission. 

When I was Nevada controller, my deputy James Smack had an inspired idea.

On the Transparent Nevada web site of the Nevada Policy Research Institute, he searched pay levels of state employees with “controller” in their job titles.  After eliminating air traffic controllers, he found he was ninth and I was tenth.

We knew his pay was higher than mine because our salaries were dictated by statute.  What was surprising was that eight state employees with a controller job title made more than us.  They were all employed in the colleges, universities and Desert Research Institute.

This illustrated that non-academic pay in Nevada higher education is above market levels, as we already knew.  Full-time academic pay is also high because it competes with only the bloated levels at other colleges.  Throughout academe, full-time faculty and administrative compensation is very high, while that for part-time (adjunct) faculty is very low.

I don’t raise this matter to complain that our pay was too low.  Even if it should be higher, no one forced me to run or James to take his job.

However, Nevada local government pay, especially in the two large counties and in public safety, is unduly high due to very powerful unions.  In higher education, the problem is the board of regents is as weak as local governments.  Thus, costs – and taxes – continue to rise due to ever-increasing staffing, especially in administrative areas, and very high compensation.

Total compensation for Nevada state employees is closer to private market levels and in the mid-range for state employees around the country.

Now, however, state employees can bargain collectively for compensation.  So, we can expect their compensation and staffing levels to soar too – unless governor Steve Sisolak and his successors make good use of their statutory power to restrain the results of collective bargaining.  I commend my former regent colleague the Governor for insisting that a gubernatorial veto be included in the legislation allowing state employee collective bargaining.

I also commend his two other recent thoughtful actions on related fronts.  First, reining in the excesses, overreach and illegal actions of state boards and commissions, especially those regulating occupations.  Second, taking on the use by such agencies and others of outside lobbyists to get more funding from the legislature, often contrary to the governor’s proposed budget and usually at very high fees.  (They also spend too much staff time lobbying an d on public relations.)

All these costs contribute to raising our taxes.

And to making state government ever more opaque and less accountable.

Government at state and local levels, just as much as the federal government, has shifted from limited and enumerated powers, spending restraint, and resulting accountability to unlimited powers, wanton spending and tax increases, and an uncontrollable administrative state.

While state and local governments may not yet have developed the really sinister Deep State “intelligence,” spying and police powers now being exposed in Washington, they are working on creating such a nationwide swamp with extensive police powers.

None of this should be surprising, because it’s all in the nature of government and public employee unions.

The people who run and staff public agencies, just like those in the private sector, want more pay, power, perks and prestige.  And less work for each of them to do, less accountability and fewer restraints on their actions and prerogatives.  They’re only human.

This leads them to seek ever higher pay rates and benefits, more people to work with and for them, and higher expenses and capital budgets.  And especially less accountability to voters, taxpayers, governors and legislatures.

People in the private sector have the same instincts.  This isn’t a matter of better or lesser folks in either sector.

The difference is that in the private sector there are inherent restraints, especially on spending, pay and staffing levels.  Businesses can’t just raise their prices willy-nilly, as governments do taxes, because they’ll lose sales, customers and revenues.  And their powers are restrained by law and government.

That’s why, in general, the private sector works better than government, which keeps metastasizing and burdening us further.  Government and public employee unions are, by their very natures, predatory upon the public, interest and taxpayers.  And little restrained.

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Ron Knecht is a contributing editor to the Penny Press - the conservative weekly "voice of Nevada." You can subscribe at www.pennypressnv.com. This is an edited version of his column which has been reprinted with permission. 

Whenever I hear some left-wing wacko spewing moronic hatred for President Trump, I think, Wow!  If this President can make a whack-job like that hate him, he must be doing a pretty good job.

Think about it.

Adam Schiff, Eric Swalwell, Jerrold Nadler, Nancy Pelosi, Maxine Waters, Alexandria-Ocasio Cortez, Ilhan Omar, Rashida Tlaib, Juan Williams, Chris Matthews, Joe Scarboro, Mike Brezinski, Rachel Maddow, Chris Cuomo, Peggy Noonan, George Conway, Peter Strozk, Lisa Page, James Comey, Andrew McCabe, Hillary Clinton, Max Boot, Jennifer Rubin, Michael Gerson, Bill Kristol, Peter Wehner, Trevor Noah, Tom Hanks, Shakira, Russell Simmons, Rosie O’Donnell, Ricky Martin, Miley Cyrus, Mac Miller, Louis CK, John Oliver, John Legend, JK Rowling, George Clooney, Eva Longoria, Demi Lovato, Chrissy Teigen, Chris Brown, Joe Walsh (not the Eagles’ Joe Walsh, the phony politician Joe Walsh.)

Whew!  And that’s mostly the rookie league. (Maybe Pelosi is AA.)

We haven’t yet gotten to the Democrat politicos running for the Democrat nomination. (Triple A)

There, you have one billionaire (Tom Steyer) who called Trump a “failure” in a TV spot he’s paying for himself, hopefully to get past 1 percent.

Then you have another billionaire, a former New York Mayor who just “apologized” for the stop and frisk policy he inherited from his predecessor—Trump’s personal lawyer—but cannot otherwise explain the dramatic drop in violent crime during his term.

If you look at just the list above, there are some common threads.

First are the overstuffed Hollywood types—some of whom I’ve only briefly heard of—who just know so much about politics that we should be overwhelmed by their intelligence quotients.  Then we have the writers and TV personalities who fall into the category of “pundits”.  They are trying to make a living by badmouthing the President.  And, finally, we have the politicians who are green with envy.  They should have his political skills.

Why do they hate this guy so much?

Well, he stands for the concept that this is the United States of America, as my father used to say, and any little boy or girl can grow up to be President or accomplish anything they want to accomplish by simply putting one foot in front of the other and moving forward.

Contrary to what the clowns on the list above would have you believe, Donald Trump is not successful because his father was rich.  In fact, he went against the wishes of his father when he went into Manhattan real estate.

He’s successful because he took some giant risks.

Not everything he did worked.

His experience in Atlantic City as an example.  Hillary Clinton famously asked in a debate, “I mean, ask yourself, how can anybody lose money running a casino? Really.”

Of course, she demonstrated her ignorance of that business because she asked that question without knowing that one of the two largest casino companies in the nation, Harrahs, was almost two years into Chapter 11 of the United States Bankruptcy Code.  That’s right, the company now known as Caesars Entertainment because, yes, it happened to own Caesars Palace in both Las Vegas AND Atlantic City.

Caesars today operates approximately 47 casinos in 13 U.S. states and five countries, including the Caesars, Harrah’s, Horseshoe and Bally’s brands.  When stupid people ask stupid rhetorical questions, they often get they asses handed to them.

I mean, ask yourself, how can you take any of the clowns I have listed above seriously?

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Fred Weinberg is a guest columnist and the CEO of USA Radio Network. His views and opinions are his own and do not necessarily reflect the opinions of GCN. Fred's weekly column can be read all over the internet. You can subscribe at www.pennypressnv.com. This is an edited version of his column, reprinted with permission. 

The fastest growing addiction in the US is online shopping. Ads pop up on our social media, news feeds and email. Boxes pile up in your closet of unopened packages. And then one day you notice you purchased the same item twice! Are you addicted to online shopping or any shopping for that matter? Let’s break down this latest epidemic.

What is Compulsive Spending Disorder?

A “Compulsive Buying Disorder (CBD)” was first described in the early 20th century as a compulsive disorder that left the patient with debt.  Later in the century its classification was debated and eventually included with the personality disorders.

Compulsive buying is known as “oniomania” where one buys impulsively and excessively to the point that it leaves them in financial hardship.  And despite their financial issues they continue to make purchases.  We’ve used the term “shopaholics” to describe those addicted to shopping but compulsive buying connotes the lack sense of financial ruin that can ensue. The spending is an attempt to satisfy a need that never gets fulfilled.

Compulsive buying disorder may be seen in those who suffer from mania and bipolar disorder.  During manic episodes excessive spending may occur.  Additionally we may see CBD co-morbidly in those who suffer from eating, gambling, substance use, and mood disorders.

What is Compulsive Online Shopping?

Compulsive online shopping occurs when purchases are made online, without much thought or planning, and at a frequency where it may interfere with one’s life.  People who might have never become a compulsive shopper in a traditional store may become easily addicted to online shopping.  Those who are compulsive online shoppers may exhibit any of the following:

• Preoccupation with when they can go online to search items
• Anxiety when one cannot go online
• Purchasing items they don’t necessarily need
• Spending beyond their budget
• Hiding their shopping behavior
• Feeling guilt after shopping
• Struggling at work or at home because of the time devoted to online shopping
• Other addictive or impulsive behaviors such as binge eating, drinking, or substance abuse

So compulsive online shopping, as well as compulsive buying disorder, can affect relationships, employment, finances and health.

How many people suffer from Compulsive Online Shopping Disorder?

Various sources have put the range at 5-8% of the US population.

Why are people becoming addicted?

When one is able to shop from the comfort of one’s desk or work station, the “ease” factor drives more shopping.  Avoiding the need to leave work or home to battle traffic and weather and long lines, is one of the biggest draws.  Moreover, those who hate going into a store or dressing room, concerned others will see the sizes of clothes they are trying on, can now shop in the privacy in their own home.  Additionally shopping allows one to fight the boredom they have at work or home and give one a sense of accomplishment.  And once one has a successful and satisfying purchase, the reward centers of the brain are activated making one want to shop more.

Hence, shrewd marketing will appeal to the human psyche by any of the following:

• Displaying or popping up attractive ads on your browser or social media
• Disrupting your feed, reading material or game with above ads
• Following your likes, searches or prior purchases and suggesting related products
• Offering deals and coupons that can be used immediately
• “Rewarding” the buyer with positive feedback after the purchase such as, “You SAVED 15%!”
• Allowing the purchase to be done so quickly and easily that one has less of an opportunity to ponder the purchase
• Sending reminders of a reorder

So how can one avoid becoming a compulsive online shopper?

Don’t give in to the ads.  People must realize they are being bombarded with some of the most creative marketing manipulation known to mankind.  We can’t fall for it.  Why are we letting our smart devices dictate to us what we need in our closets, pantries or garages?

But to fight the urge to shop online excessively, we must:

• Budget expenditures and stick to it
• Have hobbies
• Avoid boredom, or going to the internet when bored
• Limit internet time
• Stop ads and unsubscribe on out tablet or smart phone
• Deputize a family member to be our go-to when we want authorization to purchase something online.
• Ask ourselves prior to purchasing:  Do I really need this item?
• Seek counseling if unable to stop

If needed, compulsive shopping can be treated with therapy as well as medications including SSRI’s, selective serotonin reuptake inhibitors, which are efficacious in those with impulsive personalities or obsessive-compulsive disorder.