Saturday, August 29, 2009
Friday, August 28, 2009
Wednesday, August 26, 2009
Hopefully, somewhere there is justice. You'll prefer mercy.
Friday, August 21, 2009
President Obama and other advocates of nationalized health insurance have tried a variety of sales pitches, which indicates their difficulty in getting traction with the public. The latest is”competition and choice.” Who could be against those things? Barack Obama for one.
The rest of TGIF is here.
Thursday, August 20, 2009
Tuesday, August 18, 2009
Here are some facts that champions of Medicare are either ignorant of or hope you remain ignorant of. They leave the impression that before Medicare (pre-1965), life for "seniors" (hate that term) was unenviable because of lack of access to medical care. Since then, thanks to a government program that really "works," things have turned around.
Leaving aside whether a program with a $37 trillion unfunded liability can be said to be working, look at this:
In 1930 average life expectancy for Americans at age 60 was 74.5 years. (Infant mortality pulls down average life expectancy, hence the measure "at age 60.") In 1960 -- five years before Medicare began -- the average jumped 2.6 years, to 77.1. By 1990 -- 25 years after Medicare began -- it had jumped to 79.7 -- again 2.6 years.
Medicare did not make the upward-sloping life-expectancy curve any steeper!
For historical context, from 1900 to 1960, overall life-expectancy increased 22.4 years, from 47. 3 to 69.7.
I hasten to add that the medical system may be the least important factor in life expectancy, and one must never judge a country's health care by that measure. (Too many other factors -- lifestyle, genetics, culture -- play more important roles.) Nevertheless, it is interesting to know that Medicare did not improve the rate of progress in life expectancy that was occurring before the program started.
(Source: Derived from data presented in Sue A. Blevins, Medicare's Midlife Crisis, Cato Institute, 2001.)
Monday, August 17, 2009
I exaggerate only slightly -- and I mean slightly -- when I say that all you really need to read on the healthcare debate is Steve Horwitz's Freeman article "Profit: Not Just a Motive."
No one who is ignorant of these arguments can be counted as a serious participant in the debate.
Saturday, August 15, 2009
So did Olbermann praise Mackey for putting conviction before (short-term) profit? (He often criticizes business for putting profit first.)
Of course not. He implied that Mackey must be an idiot who doesn't know his own interests.
That's the sign of a demagogue.
The company refused to issue the policy.
When will we finally get homeowner's insurance reform so that companies will stop this cruel practice of refusing to cover preexisting conditions?
After that we should move against the life insurance companies' vicious discrimination against dead people.
Friday, August 14, 2009
But this is a general problem that plagues any government intervention in health care, and the advocates of increased government intervention have no answer. Worse, most of them do not even acknowledge that the agent-principal problem exists.
For whom does the doctor work? The patient, whom medical ethics would seem to designate as the principal, or the State, which pays the bills?
I can't blame anyone for finding the end-of-life issue ominous in the context of healthcare "reform." Still, we must get our facts straight.
Thursday, August 13, 2009
Correction: It's the Senate Finance Committee that has removed the provision from its bill.
Here's why I almost believe the right-wing critics are moles: By raising the phony "death panel" claim, Palin, Gingrich, Limbaugh, Beck and the others have taken everyone's eye on the ball. Defenders of Obama's scheme had an easy time demolishing the inventions of the right-wing simpletons, enabling Obama defenders to evade the real problem with"reform," which continues to fly under the radar.
The problem is not that the bill calls for death panels--it doesn't. The problem is that the expansion of medical coverage by government decree and taxpayer subsidy, along with a determination to keep prices from rising, logically requires rationing of medical services. How else can you expand demand without raising costs? Through government efficiency? Get real. (Price controls would lead to shortages and then rationing.)
With rationing the government would decide how medical resources would be distributed. Bureaucrats would have to make choices, and they'd have to have standards by which to make those choices. Is it outlandish to suggest that they would want to divert scarce resources from people who are near the end of life and with little chance of recovery to those who are not? This wouldn't be euthanasia; but it might well be a refusal to pay for some medical procedures for older people. It might even include a prohibition on paying for services privately. (The alternative to rationing is bankruptcy, to which Medicare has already put us on the path.)
Obama has already said he wants Medicare to pay for the value not volume of services. Value to whom?
Instead of conjuring up phantom death panels and compulsory counseling, the right wing should have been demanding that the defenders of "reform" explain how they can avoid rationing if they are serious about pumping up demand without pumping up prices. They should have been using their access to the media to point out that rationing in an inevitable implication of a government limit on total healthcare spending.
Maybe some advocates of "reform" really haven't thought about this. Maybe they believe that somehow costs can be controlled without rationing and bureaucratic triage. (This can't be said about others, such as Peter Singer.) But their premises logically commit them to rationing whether they know it or not and whether they like it or not.
By the way, do not accept the glib comeback that the market rations too, only by price. As I point out here, the market does not ration. The market is not a conscious, decision-making entity. It's a process in which people exchange money for goods and services, and vice versa. That is not rationing. Economists talk about markets rationing, but that is only a metaphor. Our choice is between rationing by bureaucrats (including insurance clerks empowered by government tax policy) and individual self-determination through free exchange.
Barack Obama and many others want the government to get into the health-insurance business. Very good. Is the government in any other kind of insurance? As a matter of fact, it is: flood insurance. It essentially has a monopoly. Here's a Reuters story about the House last month extending the "troubled [i.e., broke] program" for six months while postponing a comprehensive overhaul. Why does it need an overhaul?
The program has been deep in debt ever since the costly hurricane seasons of 2004 and 2005. Repeated rescue efforts have failed....
[T]he administration said it favors forgiving the 40-year-old program's $19 billion debt.
This would not be the first time the program was bailed out by Congress or had its huge debt forgiven. This trouble did not begin with Katrina. See this article I wrote 16 years ago. (Scroll down.)
About the postponement of comprehensive reform, Reuters reports that Financial Services Chairman Barney Frank "said discussion on repairing the program needed to be put off due to other pressing matters, including healthcare and financial regulation reforms."
Translation: Government can't fix what it's already screwed up right now because it's too busy screwing up some other things.
Wednesday, August 12, 2009
Many of the people attending congressional district meetings to protest the emerging healthcare reform harm the cause of freedom when they are unruly and, more importantly, when they repeat unfounded rumors they’ve heard on the radio or read on the Internet. My advice is to get your facts straight and act in a dignified way. Reason should be in for forefront. Passion too prominently displayed looks like blind emotion and alienates those who might be persuaded by calm argument. Don’t call people names. Coolly state the moral and economic reasons against government control. Remember: Statism did not begin with Obama.
That said, I must point out that the critics of the protesters — those who want to continue the status quo of government-dominated health care but even more so — are off base in their sneering dismissal of the people who are worried about the so-called reform. Why would anyone have confidence in an 1,000-page-plus piece of legislation, obscurely written, that would give not-fully-defined powers to the secretary of Health and Human Services? Because Barack Obama, Ted Kennedy, Henry Waxman, Barney Frank, and Chris Dodd say so? Excuse me, but that’s not good enough.
Anyone who doesn’t have an instinctual revulsion at such a bill needs to read some history.
Tuesday, August 11, 2009
Random thoughts on healthcare reform:
- The core of "healthcare reform" is the principle that what one takes out of the system should have no necessary relationship to what one pays in. Aside from the injustice of the inevitable coercive subsidies, this principle is economically nonviable.
- Healthcare reformers must think they've repealed the law of unintended consequences. Can't be done.
- Healthcare reform rests on a pretense of knowledge (Hayek): viz., that bureaucrats know the just price of medical services, drugs, and insurance coverage.
Friday, August 07, 2009
Best quote I've seen today:
Law and commerce were indelibly linked in the thought of David Hume, who argued that it is commerce itself that gives rise to notions of justice between people and peoples. Although commerce is today typically seen as something which is proactively enabled by law, it is much more accurate historically to see law as something which emerges because of its vital importance in commerce – and particularly commerce involving foreigners. Within the Roman Empire, it was the ius gentium, the “law of nations,” derived from custom rather than legislation, and applying specifically to noncitizens, that governed most types of commercial transactions.
The modern notion that law is inseparable from the will of a ruler or ruling body, antithetical to the idea of a universal natural law or a ius gentium, has, in parts of the world and during epochs where it has actually been applied, been devastating to economic development.
--Benn Steil and Manuel Hinds, Money Markets, and Sovereignty
Hat tip: Don Boudreaux, Cafe Hayek
Healthcare reformers say they have two objectives: to enable the uninsured and under-insured to consume more medical services than they consume now, and to keep the price of those services from rising, as they have been, faster than the prices of other goods and services. Unfortunately, Economics 101 tells us that to accomplish those two things directly — increased consumption by one group and lower prices — the government would have to take a third step: rationing. The reformers are disingenuous about this last step, and for good reason. People don’t like rationing, especially of medical care.
The rest of TGIF is here.
Thursday, August 06, 2009
Today is the 64th anniversary of the U.S. atomic bombing of Hiroshima, one of President Harry Truman's two acts of butchery against Japan in August 1945. There isn't much to be said about those unspeakable atrocities that hasn't been said many times before. The U.S. government never needed atomic bombs to commit mass murder. It's "conventional" weapons have been potent enough. But considering how the "leaders" saw The Bomb, its two uses against Japan stand out as especially heinous acts. The U.S. government may not have used atomic weapons since 1945, but it has not yet given up mass murder as a political/military tactic. Presidential candidates are still expected to say that, with respect to nuclear weapons, that "no options are off the table."
The anniversary of the Nagaski bombing is Sunday.
Rad Geek People's Daily has a poignant post here. Rad says: "As far as I am aware, the atomic bombing of the Hiroshima city center, which deliberately targeted a civilian center and killed over half of the people living in the city, remains the deadliest act of terrorism in the history of the world."
[This post appeared previously.]
Saturday, August 01, 2009
Why do economists, even those who favor the free market, call what the market process does "rationing." When you choose, because of the price, to buy four pounds of hamburger rather than eight, that is not rationing. Rationing is when an authority says you can only buy four. It indicates a conscious process of allocation of other people's property. The market is not a conscious process. Rather it's a bunch of people engaging in conscious exchanges involving their own property to improve their situations. That's very different.
I think it does the case for the market harm to call what it does rationing. The other side can say: "I agree. But the market is a cold, impersonal rationer. We need a kinder, gentler rationer: the State."
I don't think we should want those to be the terms of the debate.
Later thought: When I enter a store and spend $50 rather than all I have, would we say I rationed my money to the store owner? Who would talk like that?
The other night she and state-socialist congressmen Anthony Weiner had a good laugh because all the Republicans on a congressional committee voted against his trick amendment to end Medicare. What hypocrites, they sneered. Republicans say they are against socialized medicine, but when their political careers are at stake, they won't vote to end the socialized medicine we already have for retirees. (Clip here.)
I am the last person to want to defend the Republicans. The charge of hypocrisy is easy to make, and no doubt Maddow and Weiner are right about many or most of them in this case. But they were engaging in demagoguery, and they must have known it. The principle of charitable interpretation is worth applying not only because it's decent but also because it forces oneself argue against your opponent's strongest possible case. Going for the weakest case is a wimpy thing to do--a confession you lack confidence in your own.
Someone can nonhypocritically and coherently say, "I'd vote against creating Medicare today. But since after 44 years people on fixed incomes have come to rely on it, I would not just kill it in one shot now. I favor some kind of gradual transition to a private system."
Agree or disagree with that position, it shows that voting no on an up-or-down vote to kill Medicare is not necessarily hypocrisy for one who opposes government-controlled medical care.
Maddow's schlocky program is little more than a series of conversations with guests who agree with her so she can distort the positions of those she diagarees with. She might have brought on a someone to argue the point I make above, but she wouldn't know what to do with someone who intelligently disagrees with her. That speaks volumes about her intellectual heft or confidence, or something.
My friend Shikha Dalmia at the Reason Foundation nails the healthcare issue here. No, we don't have a free market here, and see what's happening in Germany and France.
The point is that there is no health care model, whether privately or publicly financed, that can offer unlimited access to medical services while containing costs. Ultimately, such a model arrives at a cross roads where it has to either limit access in an arbitrary way, or face uncontrolled cost increases.