‘Health Care Mythology’ Meets Reality

Just read an excellent breakdown of the flawed thinking behind many of the justifications for the radical restructuring of the US health care system being pushed by the Obama Administration.  It’s somewhat long (though not a dry read), so I won’t rehash the arguments here.  But I did want to highlight something that I think was expressed beautifully, and does a better job of getting across a point I tried to make, in a previous post, about access to health care not being a right:

Listing rights generally involves enumerating things you may do without interference (the right to free speech) or may not be done to you without your permission (illegal search and seizure, loud boy-band music in public spaces). They are protections, not gifts of material goods. Material goods and services must be taken from others, or provided by their labor, so if you believe you have an absolute right to them, and others don’t choose to provide it to you, you then have a “right” to steal from them.

Exactly.

Come On, Krugman, Aren’t You Smarter Than That?

Paul Krugman gets a lot of respect, and perhaps deservedly so.  In 2008, he won the Nobel Prize in Economics (a fact used to sell papers, I guess, like “Academy Award Winner” is used to sell movies).  So, he’s “influential,” as they say, and, one would guess, intelligent.  His Nobel was given for his work regarding international trade — but, apparently, that means he’s an expert on “economics.”  However, I happen to think he’s wrong about economic policy, pretty much all of the time.  I read his work because, being an influential lefty economist, he lends intellectual heft to the left’s economic policy agenda.  But I often find myself shaking my head at many of the things he says as they seem unbelievable, coming from someone who’s supposed to “get” economics.  Normally, I just let it go, but I couldn’t, this time.

In an op-ed in the NY Times about how the “Blue Dogs” aren’t making sense, Krugman drops these gems:

This would stop insurers from gaming the system by covering only healthy people.

On the other side, individuals would also be prevented from gaming the system: Americans would be required to buy insurance even if they’re currently healthy, rather than signing up only when they need care.

“Gaming the system?”  It’s “gaming the system” to not want to insure people against the chance of illness when they already have it?  It’s “gaming the system” to not want to buy something you do not want or need until you decide that you want or may need it?  So, is it “gaming the system” to not buy shoes every time you go shopping, and to only buy them when yours are wearing out?  Is that “gaming the system?”  Spending your money in the way you see fit is somehow cheating?  Providing a service in a way that allows you to sustain a business is somehow unethical?

Apply this “thinking” to housing and mortgages.  Are lenders “gaming the system” by lending in such a way that they can profit from the money they lend?  Should they not be allowed to consider risk?  Should everyone, regardless of whether they plan to buy a home this year or in 10 years (or never), be required to take out and start paying for a mortgage now, so that they’ll have it, should they ever need it, or so that lenders will make enough money to overcome losses from risky lending?  Or is it “gaming the system” to wait and take out a loan when they need one?

Come on, Mr. Krugman.  You’re smart, right?  How about applying some of your understanding of scale and consumer behavior toward making the economics of the free market health care system work?  Describe some models under which insurers can leverage scale and the power of open competition to continue to make money while expanding access to care.  Show consumers how they can pool their resources and use scale, choice, and competition to their advantage.  That’s what you should be doing, instead of criticizing people for not wanting to be forced to provide services to support a system that will destroy their incentive to continue to do so, or to hand over money to support a system that will likely wind up limiting their freedom.

Well, Something Sure Was ‘Ill Chosen’

“I could’ve calibrated those words differently.”

This is how President Obama hopes to defuse the the controversy he created, when he decided to basically tag some cops in Massachusetts as at least stupid, if not racist.  Yes, I know he didn’t exactly call the cops racist, but he did link their “stupid” behavior with the “long history in this country of African-Americans and Latinos being stopped by law enforcement disproportionately.”  How did brilliant Mr. Obama expect people to take his statement?  He was saying that either the cops were stupid for arresting Gates knowing how it would look, or that the arrest itself was stupid (i.e., wrong) and they only did it because they must be racist.  Either way, it was a ridiculous thing for him to say without (as he admitted) having all the facts.

Obama conceded his words had been ill-chosen, but he stopped short of a public apology.

In typical spin-it-as-somebody-else’s-problem form, the White House has said the president “would regret distracting [the media] with obsessions,” when asked about his comments.  Right, that’s the problem with what he said, that it’s going to cause the obsessive media to be distracted.  It’s not that he unjustifiably labeled some cops as racist (whether intentionally or not) and stupid.  It’s not that he stoked racial tensions, without even knowing what the heck he was talking about.  It’s not that he, the leader of our government, reactively called into question the integrity of law enforcement in America.  No.  It’s that he drew some attention away from the disaster that his health care reform proposal is becoming.  I’m sure he really regrets that.

“Could’ve calibrated those words differently,” comes up way short of what is required here to make this right.  How about that fresh candidness that you were supposed to be bringing to politics, Mr. President?  “I’m the one who acted stupidly, by stoking racial tensions unnecessarily.”  That would be more like it.

One by one, this president is destroying every reason that a large number of moderate Democrats, independents, and even some Republicans were able to support him, or at least hope that he would be something different.  Great work.

Good for the Goose…?

The other day, I saw an article about how President Obama is opposed to the move by congress to restore some of the dealerships cut in the restructuring plans of GM and Chrysler.  While I happen to agree with the president, 100%, that the dealers should not be reinstated, it still struck me as funny that the president is essentially telling congress not to do what the president himself has done:  intervene in what should be a matter handled by the bankruptcy courts and the parties involved in the business relationships impacted by the bankruptcy.  Just as the president stepped in to “save” the automakers, with “saving jobs” as the stated rationale and rewarding political supporters as the practical effect, the various representatives simply want to do the same thing.  This is yet another example of why it is stupid to get the government involved in running businesses.  Congress has just as much of a legitimate claim — as representatives of the taxpayer owners of these companies — as the administration does for making business decisions (good, bad or terrible).

Meanwhile, I heard President Obama on the radio today, dismissing critics of the ridiculous monstrosity of a health care reform bill working its way through congress as simply trying to “score political points.”  Right.  Couldn’t be that anyone who doesn’t like the bill might have any legitimate concerns about handing over so much more power and responsibility to the federal government, or about the price tag, or the possible effects on the quality of care.  No.  They just want to stop these thousand plus pages of complex legislation from flying through congress, before anyone can even truly understand what they say, for political gain.  I see.  So, when your were on the campaign trail, Mr. President, and you criticized anything your opponent said, or the previous administration did, or when you were a Senator (all those long 3+ years) and you spoke out against or voted to block legislation you did not agree with, was that simply to “score political points?”  How absurd.  Oh yeah, I forgot — change, right?

Sotomayor Should Be Approved – That’s How It Works

I have no idea how “liberal” or “moderate” or “activist” or “restrained” Judge Sotomayor really is.  But it doesn’t really matter.  The people of the United States elected a liberal Democrat as president, and gave him a large, sympathetic majority in the US Senate.  That means that, barring the discovery of any truly disqualifying behavior (abuse of her position on the bench, illegal activity), the president should get his choice.  Every Republican in the Senate should vote to approve the appointment.  Their job is “advice and consent” — that’s all.  While I’m sure the president didn’t seek much advice from Republicans, and probably disregarded any he received, it is still not the responsibility of the Senate to make the appointment.  That is the sole responsibility of the president, whether a Republican or Democrat.  The Senate’s role is basically to guard against an outrageous appointment.   So, approver her, Republicans, and don’t make a silly show of the hearings. And next election cycle, try making a better case for your point of view about the role of government, the importance of the Constitution, and how the Supreme Court fits into that picture.

This Health Care Bill Must Be Stopped

Look, I admit there are issues with the health care system in the United States.  The entire industry could do with some reform to help bring costs down and make access to care easier for more people.  But having the government basically take over the entire system is simply not the way to do it.  This is true for a number or reasons:

1) The federal government does almost nothing right.  Waste, fraud and corruption are almost inevitable in any large government enterprise.  It is impossible for a massive federal bureaucracy to be responsive to the needs of individuals.  Politics will invariably play a role in the administration of the system, and will most certainly lead to inefficiency and ineffectiveness.

2) It is beyond ridiculous to believe that putting the government, with its propensity to spend money it does not have, in charge of health care will lead to anything but higher overall costs and lower quality.  In an effort to control costs, the government will likely impose some form of price controls on services and drugs, and some form of rationing.  These things will be necessary, because otherwise doctors will charge as much as they want, and people will take much more than they need.  Clamping down on such overindulgence will involve some amount of arbitrary decision making (and some based on politics and lobbying), meaning doctors will have an incentive to seek out procedures that maximize what they can earn, and people will not necessarily get the care appropriate for their needs.  Price controls will also provide an incentive for health service providers to try to make up in volume what they lose in margin.

3) Most importantly, it is an absolutely improper role for the federal government, and is a threat to the very idea of liberty upon which this country was built.  The federal government will wind up with an unbelievable amount of control over the health of every individual.  Even granting that it is not the intention of the plan’s backers to wield such influence in any harmful way, the power will nonetheless have been given to the government, with its passage.  Think about it, the current private health insurers already (rightly) try to influence how we live, by providing incentives for healthier living (no smoking, exercise, preventative care, etc).  They do so in their own self-interest, which generally happens to mesh with the interest of better health.  They also each have their own rules for what is covered, which drugs patients have access to, which doctors patients can see.  But at least right now, if you don’t like what your insurance company offers, there is at least a possibility for you to go elsewhere.  There is competition (though it is distorted, and could use some opening up).  But with only one massive insurer in the picture, and that is what a federal system would almost certainly become, there would be no alternatives for anyone.  They could tell you what kind of care you could get, and that would be that.  They could tell you how to live, using the threat of withholding care or higher taxation, and you would have no possible recourse.  They could — and would — tell drug companies which drugs to develop, based on their idea (subject to lobbying and political pressure) of what is most needed, as opposed to the free market’s.

The federal government of the United States was created with one idea in mind: maximizing the liberty of all US citizens.  To achieve that goal, the founders placed limits on the role of the central government, with the purpose of keeping power as close to the people as possible.  The federal government exists essentially to facilitate cooperation between the states, allowing for the pooling of resources, where necessary, such as in the area of defense, and in most areas providing rules under which the states must operate, when dealing with one another.  Its other essential responsibility is to insure that none of the individual rights, enumerated in the Bill of Rights and subsequent amendments, are denied to any citizen.  Access to health care is only a right insofar as no government should have the power to deny such access to any citizen.  This does not mean the government must or should provide that care, just like it is not the business of the government to provide you with a religion, just because it guarantees your freedom to access the religion of your choice.  Nor should the government provide you with a gun, even though it is supposed to protect your right to have access to one.  It would be foolish beyond imagination to grant so much more power to a government so unresponsive to the people whose freedom it is supposed to protect.  This bill must be stopped.