Kennedy Op-ed in Star-Tribune

My latest Future of Freedom Foundation op-ed, on Ted Kennedy, was published by the Minneapolis Star-Tribune here.

TGIF: Proposers versus Producers

Why do people who really make us better off get nowhere near the attention when they die that prominent national politicians get?

The rest of TGIF is here.

Bye, Teddy

We knew ye all too well and liked little of what we saw. You stayed around far too long, spending our money and finding ways to run our lives. For this you were dubbed the compassionate "lion of liberalism." You disgraced a noble word.

Hopefully, somewhere there is justice. You'll prefer mercy.

Obama's Health-Insurance Cartel

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.

Now at TheFreemanOnline.org

"Now I Am Finally Scared of a White House Administration."

Nat Hentoff, who has valiantly defended civil liberties against all threats, declares, "Now I am finally scared of a White House administration," in his analysis of the Obama healthcare-takeover plan here. It is well worth reading.

Has Medicare Extended Life?

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.)

Must-Read on Health Care

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.

Keith Olbermann, Demagogue

John Mackey, head of Whole Foods, favors a free market in health care and thus opposes Obama's nationalization. He wrote this in a Wall Street Journal article. Keith Olbermann of MSNBC reported this and pointed out that since Whole Foods specializes in organic products, many of its customers probably favor Obama's plan. (Let that dubious leap pass.) In fact some advocates are calling for a boycott of Whole Foods.

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.

Oh the Injustice!

The house of a friend caught on fire. While his home was aflame he called an insurance company to buy fire insurance. Honest fellow that he is, he told the company rep that his house was on fire as they spoke.

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.

Don't MissThis

Keith Hennessey answers President Obama’s case for health-care nationalization point by point here. You won’t want to miss this.

Rigging the Debate

Calling something"reform" biases the discussion from the start. It's question-begging. Whether the proposed changes actually amount to reform -- that is, improvement -- is precisely what is in dispute.

Health-Care Interview on Antiwar Radio

Scott Horton interviewed me about health care on Antiwar Radio. The audio is here.

The End-of-Life Rigmarole II

I'd like to take this matter a step further and to make explicit what was only implicit in the original post. It should be a matter of concern that people paid by the State -- doctors treating Medicare patients -- would be authorized under the House legislation to venture into end-of-life issues when the government's priority is to control medical costs. One need not be an alarmist to connect those dots and wonder how the source of the paycheck might influence the advice given. Whom exactly is the doctor working for?

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.

The End-of-Life Rigmarole

Sometimes I almost believe that the right-wing critics of Obama healthcare "reform" are moles working for Obama. Take the end-of-life controversy. There is nothing in the House bill that would require Medicare recipients to have end-of-life counseling, much less submit to some kind of euthanasia process. All I can find is a requirement that Medicare pay for end-of-life counseling if requested. Not that I like this; I don't want government anywhere near medical care or end-of-life decisionmaking. But nothing is imposed on the elderly. (By the way NBC reported tonight that this provision has been dropped from the House bill.)

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.

Government Logic

1. Outlaw full interstate health-insurance competition.
2. Denounce the lack of competition.
3. Propose ersatz competition (exchanges) with a government option.
4. Live happily ever after.

Government's Track Record in the Insurance Business

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.

The Healthcare-Reform Protests

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.

Healthcare Thoughts

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.

Law Did Not Predate Commerce

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