- The "doctor fix" to permanently get rid of cuts to doctors' Medicare payments has been removed, shunted off to another bill. This is crafty accounting; the Democrats have decided that if they don't want the cost of paying doctors to "count" toward the national deficit, it won't. This is sheer evasion, and no matter how much lawmakers pretend that a measure isn't costing the country anything, it will cost us.
- There's a public option. The government has no place telling private insurers how to run their businesses, much less try to run an insurance business itself.
- The bill is supposed to generate surpluses...but the projected cost savings diminish toward the end of the bill. Even if things go just as projected (they can't, because all the new taxes and regulations will drive all kinds of tax- and regulation-avoiding behavior that politicians will later claim could never have been foreseen), that's a red flag that "cost savings" gained from starting spending cuts a few years before spending increases begin, will turn into huge deficits once we don't have a few years' worth of stockpiled money to burn through.
- Medicaid's going to get bigger. This means straining already cash-strapped state governments...and assumes that healthcare providers, pharmaceutical companies, and medical device makers are going to be happy to accept millions of new patients covered at Medicaid's low reimbursement rates. Gee, I wonder how that's going to go.
- Huge taxes on people making $500K or more, just because being rich is grounds for cannibalization. Disgusting...and of course it will encourage the wealthy to shrug (whether by cutting back on working or fleeing the country), which makes us all poorer.
- Huge fines for businesses that don't insure their employees, violating their rights and making it harder and harder for businesses to get started or expand. Let's think about what this will do to unemployment rates.
Friday, October 30, 2009
1900 pages of evil
So the House version of healthcare "reform" is out, and it's a 1900-page monster. I think I'll stick with the Wall Street Journal's summary, which indicates so many things wrong:
Thursday, October 29, 2009
Daddy Bloomberg says tobacco can't taste good.
Mayor Bloomberg just signed a bill that will make it illegal to sell flavored cigars or chewing tobacco in NYC. This is supposed to discourage children from using tobacco.
For the love of all that is good! Like I said, it's thoroughly wrong to ban a product because it's possible to misuse that product -- or even because that product has no objectively good use. Individuals have rights -- the individuals who make tobacco products have the right to offer flavored goods if they wish, and consumers have the right to buy such products. What right has the government to intercede in the transaction? None. If adults are worried that their children might try tobacco just because it has a flavoring agent, it's their responsibility to teach their kids not to smoke -- not the responsibility of the state to make it harder for them to do so.
For the love of all that is good! Like I said, it's thoroughly wrong to ban a product because it's possible to misuse that product -- or even because that product has no objectively good use. Individuals have rights -- the individuals who make tobacco products have the right to offer flavored goods if they wish, and consumers have the right to buy such products. What right has the government to intercede in the transaction? None. If adults are worried that their children might try tobacco just because it has a flavoring agent, it's their responsibility to teach their kids not to smoke -- not the responsibility of the state to make it harder for them to do so.
Tuesday, October 27, 2009
A lesson in statistics
When I was in eleventh grade, my American history teacher was full of pithy sayings, one of which was, "Statistics don't lie, but liars can use statistics."
It's true: Facts are facts. But based on the lens of the interpreter, facts can seem to support a fallacious argument. I'm paraphrasing, but I think in a Q&A segment Ayn Rand once mentioned that there appeared to be a correlation with the printing of the word "bread" (or some similarly irrelevant word) in New York Times headlines and deaths in India. So when you see correlation, it doesn't necessarily imply causality. Similarly, statistics can be used to "support" altruism: "76% of Sudanese children go hungry! That means we have to feed them!" This argument ignores that the second statement does not follow from the first.
The Wall Street Journal presents, without comment, an "annual checkup" of how the US performs relative to other countries on various measures of health care. In the hands of altruists, this list of statistics could be dangerous. I'll point out just a few of the bad arguments that an altruist might use this list of statistics to "support":
It's true: Facts are facts. But based on the lens of the interpreter, facts can seem to support a fallacious argument. I'm paraphrasing, but I think in a Q&A segment Ayn Rand once mentioned that there appeared to be a correlation with the printing of the word "bread" (or some similarly irrelevant word) in New York Times headlines and deaths in India. So when you see correlation, it doesn't necessarily imply causality. Similarly, statistics can be used to "support" altruism: "76% of Sudanese children go hungry! That means we have to feed them!" This argument ignores that the second statement does not follow from the first.
The Wall Street Journal presents, without comment, an "annual checkup" of how the US performs relative to other countries on various measures of health care. In the hands of altruists, this list of statistics could be dangerous. I'll point out just a few of the bad arguments that an altruist might use this list of statistics to "support":
- The US has more MRI scanners per capita than any other nation in the analysis. An altruist who wants healthcare "reform" might argue that there are "too many" scanners, that doctors are inclined to prescribe "too many" expensive scans when more basic care would do, and that basic care could be given to more people. Well, when it's your health that's at stake, you would probably want to know what's wrong -- perhaps you'd want to know badly enough to pay for the extra scan, and it's your right to do that, not your responsibility to provide health services to anybody else.
- Americans spend more money on pharmaceuticals than any other country does. This fact can be used as "evidence" that Big Pharma is evil, and that it needs to be subjected to price controls here as it is in other countries. In fact, drugs cost an enormous amount of money to develop -- hundreds of millions of dollars each -- and until we get rid of onerous regulatory agencies like the FDA and Europe's EMEA, that cost has to be distributed among those who purchase them. But because socialized medicine in Europe has led to price controls, pharmaceutical companies accept lower rates there -- rates that cover their marginal cost of producing a drug, but not the huge amount of overhead from developing it -- and distribute the cost of the overhead in markets where there aren't price controls (read: the US.) That's why we pay so damn much for drugs. No, price controls will not solve the problem. They will merely ensure that no pharmaceutical company can stay in business, and you can kiss innovation goodbye.
- The US has the lowest percentage of tobacco smokers of any country surveyed. "Great!" altruists will say. "The campaign against Big Tobacco is working!" But everyone's rights have been trampled in that effort -- the right of tobacco makers to sell their products without interference from the government (not to mention their property rights, which are routinely violated any time lawmakers want to raise money by fining somebody), the right of smokers to light up wherever a property owner says they may, the right of restaurant and bar owners to allow smoking on their property, etc., etc., etc. And that is too high a price to pay.
- We're the fattest country of the bunch, with more than a third of the population obese. I've already ranted and raved about how laws to prevent obesity are morally wrong, but that won't stop a determined altruist from claiming that we all have to "sacrifice" a little to keep Americans healthier.
Thursday, October 22, 2009
The danger of the sob story
As healthcare "reform" draws closer to a vote, those who want universal health care are bringing out the small guns -- small children, that is, and stories about those of them who can't get health insurance, as Yahoo! News reports. A four-month-old baby was denied coverage for being too heavy. A 2-year-old girl was denied for not being heavy enough. We are supposed to feel outrage on behalf of these children -- our system must be wrong if innocent babies can't get insurance, right? And we've got to force the insurance companies to do the right thing and cover them (and everybody else), right?
WRONG!
First of all, it's not at all clear that being denied health insurance is a tragedy for a kid. What kind of health services do most children consume? Immunizations, trips to the pediatrician for a cold, broken bones -- none of which is pleasant, but none of which is a family-devastating expense if properly planned for. (Yes, I know you can't plan when a broken bone happens, but you can keep an emergency fund around, knowing that it can be tapped for that kind of thing.) For the most part, kids don't get cancer, heart disease, or other diseases that would bankrupt all but millionaires without insurance. Nobody should be buying insurance for routine stuff like scraped knees and runny noses, any more than we should be buying insurance for oil changes and gas tank fillups, as I've described previously.
Second, even if it were a tragedy, insurers still have the right to say no. You can write letters to the CEO and tell him you think it's a disgrace, you can give a television interview, you can urge everyone in your town to boycott the insurer -- but you have no right to force that insurer to cover that kid by getting a law passed. If an insurer looks at all the facts and decides that the financial risk of insuring that child is greater than the benefits of collecting his premiums, it has the right to take action according to that decision -- to decline to offer coverage. Let's say you're a carpenter and your neighbor wants you to fix the hole in his roof for $500. Not only would you need to charge $1,000 to make it worth your while, but you'd really prefer to spend your time teaching your son to play baseball. Does your neighbor have a right to force you to fix the hole for $500, just because you can? Absolutely not -- and neither do we have the right to force insurers to go against their judgment and make them cover people, even children, whom they have deemed poor risks.
And third, let's not forget what Economics in One Lesson teaches: It's easy to point to a crying baby and say, "We need universal health care!" But we cannot forget that forcing the insurer to cover a million babies at a loss might mean it cuts its workforce by 10%, throwing people out of work; forcing a young couple with no health problems to buy high-priced comprehensive coverage (so that their premiums can subsidize the old and the sick) might mean they can't afford their first home; forcing a small business to pay even more taxes than it does already might mean it shuts its doors, and we are all poorer by the goods it will no longer produce. It's easy to point to sob stories like the underweight toddler and the overweight baby, but implementing universal health care will simply create more sad cases that are invisible to those in power -- and it will violate rights on a massive scale.
WRONG!
First of all, it's not at all clear that being denied health insurance is a tragedy for a kid. What kind of health services do most children consume? Immunizations, trips to the pediatrician for a cold, broken bones -- none of which is pleasant, but none of which is a family-devastating expense if properly planned for. (Yes, I know you can't plan when a broken bone happens, but you can keep an emergency fund around, knowing that it can be tapped for that kind of thing.) For the most part, kids don't get cancer, heart disease, or other diseases that would bankrupt all but millionaires without insurance. Nobody should be buying insurance for routine stuff like scraped knees and runny noses, any more than we should be buying insurance for oil changes and gas tank fillups, as I've described previously.
Second, even if it were a tragedy, insurers still have the right to say no. You can write letters to the CEO and tell him you think it's a disgrace, you can give a television interview, you can urge everyone in your town to boycott the insurer -- but you have no right to force that insurer to cover that kid by getting a law passed. If an insurer looks at all the facts and decides that the financial risk of insuring that child is greater than the benefits of collecting his premiums, it has the right to take action according to that decision -- to decline to offer coverage. Let's say you're a carpenter and your neighbor wants you to fix the hole in his roof for $500. Not only would you need to charge $1,000 to make it worth your while, but you'd really prefer to spend your time teaching your son to play baseball. Does your neighbor have a right to force you to fix the hole for $500, just because you can? Absolutely not -- and neither do we have the right to force insurers to go against their judgment and make them cover people, even children, whom they have deemed poor risks.
And third, let's not forget what Economics in One Lesson teaches: It's easy to point to a crying baby and say, "We need universal health care!" But we cannot forget that forcing the insurer to cover a million babies at a loss might mean it cuts its workforce by 10%, throwing people out of work; forcing a young couple with no health problems to buy high-priced comprehensive coverage (so that their premiums can subsidize the old and the sick) might mean they can't afford their first home; forcing a small business to pay even more taxes than it does already might mean it shuts its doors, and we are all poorer by the goods it will no longer produce. It's easy to point to sob stories like the underweight toddler and the overweight baby, but implementing universal health care will simply create more sad cases that are invisible to those in power -- and it will violate rights on a massive scale.
Wednesday, October 21, 2009
Once you pop, you can't stop
As the New York Times reports, Democrats took a blow yesterday when their proposal to make permanent a previously temporary "fix" in Medicare doctor fees that had to be reapproved each year didn't make it through the Senate. Doctor payments are supposed to be cut by a certain percentage each year, and every year Congress, realizing that doctors will shun Medicare patients if the cuts are instituted, steps in to nullify the fee cut, an action known as the "doc fix." If the "doc fix" isn't implemented this year, fees are due to be cut by more than 20 percent in 2010 -- which would surely cause many doctors to stop accepting Medicare.
The "doc fix" shows one reason government entitlements are so pernicious: They're nearly impossible to get rid of, or even to reduce, once they're around. Doctors are used to charging X amount, not X minus 20 percent. So they scream when the cuts loom, and their patients scream too, which makes Congress edgy about losing the votes of doctors and seniors, so the rates stay. That means a bigger deficit for you and me to pay off, but Congress pulls a Scarlett O'Hara ("I'll think about that tomorrow") every time because they're only interested in saving their own hides in the short term.
What do you think is going to happen if a health insurance mandate passes? Costs are going to go up, not down, and Congress will talk about, say, cutting services to make premiums go down. Except that whatever pressure group wants the particular services that are going to be cut will squeal, forcing Congress to decide whether they want to cut costs at the expense of cutting votes. And that's how status quo stays status quo -- even when it's completely untenable.
Now, I'm not saying that Medicare payments to doctors are too high; from what I hear, fees often don't cover the full cost of treatment, forcing doctors to shift costs onto privately insured patients. What I am saying is that the free market needs to find the solution, because the government obviously can't. In fact, a free market would likely find multiple solutions: bare-bones clinics or treatment by supervised medical students for those who can't or won't pay the market rate for middle-of-the-road care; top-of-the-line facilities with the best equipment and the most prestigious doctors for those willing to pay top dollar; and everything in between. But the status quo -- paying the same fee to a doctor whether he's a 20-year veteran with a degree from Harvard or someone who's just finished his residency, whether he spends five minutes doing a patient consultation or two hours answering detailed questions -- is certainly not going to encourage the development of a range of services that suit customers' varying needs.
So, not only is the status quo highly limiting, but as we've seen, it has inertia on its side. That's why we need to argue for a free market instead of health care "reform" that would create an even worse status quo.
The "doc fix" shows one reason government entitlements are so pernicious: They're nearly impossible to get rid of, or even to reduce, once they're around. Doctors are used to charging X amount, not X minus 20 percent. So they scream when the cuts loom, and their patients scream too, which makes Congress edgy about losing the votes of doctors and seniors, so the rates stay. That means a bigger deficit for you and me to pay off, but Congress pulls a Scarlett O'Hara ("I'll think about that tomorrow") every time because they're only interested in saving their own hides in the short term.
What do you think is going to happen if a health insurance mandate passes? Costs are going to go up, not down, and Congress will talk about, say, cutting services to make premiums go down. Except that whatever pressure group wants the particular services that are going to be cut will squeal, forcing Congress to decide whether they want to cut costs at the expense of cutting votes. And that's how status quo stays status quo -- even when it's completely untenable.
Now, I'm not saying that Medicare payments to doctors are too high; from what I hear, fees often don't cover the full cost of treatment, forcing doctors to shift costs onto privately insured patients. What I am saying is that the free market needs to find the solution, because the government obviously can't. In fact, a free market would likely find multiple solutions: bare-bones clinics or treatment by supervised medical students for those who can't or won't pay the market rate for middle-of-the-road care; top-of-the-line facilities with the best equipment and the most prestigious doctors for those willing to pay top dollar; and everything in between. But the status quo -- paying the same fee to a doctor whether he's a 20-year veteran with a degree from Harvard or someone who's just finished his residency, whether he spends five minutes doing a patient consultation or two hours answering detailed questions -- is certainly not going to encourage the development of a range of services that suit customers' varying needs.
So, not only is the status quo highly limiting, but as we've seen, it has inertia on its side. That's why we need to argue for a free market instead of health care "reform" that would create an even worse status quo.
Tuesday, October 20, 2009
Marathon training and personal health
Okay, really this post is just an excuse to brag about my husband.
He's not the one training for the marathon -- I am. It's gone extremely well this year, far better than the two previous years. I ran both of my 20-milers as smoothly as I could have hoped for, and finished them with a smile on my face. (Hubby says last year I looked like a zombie after every run longer than 16 miles.) I haven't had any injuries except for a bout of ankle pain a few weeks ago, which went away with only a day or two of enforced rest. I've been able to run all of my training mileage at a significantly faster pace than I did last year, with no increase in effort. In short, I've been feeling great.
Now I'm in the "taper" period, the three weeks before the race when I cut back substantially on weekly mileage. I wouldn't have expected that it would be during taper, of all times, that I would start to exhibit signs of overtraining. This past Saturday, after I came in from a 12-mile run, I was wrecked. I don't think it's possible to exaggerate how much. As I later put it, I felt like I lost about 75 IQ points -- and all of my emotional maturity. I ordered pizza for lunch -- it took an hour and fifteen minutes, not the promised half hour, and I was in tears by the time it showed up. I took a nap after eating the pizza, and woke up feeling just as tired as before. Hubby and I went to a tango show, which I couldn't fully enjoy because I was feeling so irritable (didn't help that latecomers were allowed to take their seats up to an HOUR after the show started, which meant that those of us who showed up on time had our views of the stage blocked every few minutes), and when we got home, I sat down on the sofa...and hit my head on the wall. Well, then the tears really came out.
My husband, bless him, knows what overtraining is. He knows I've been beating up my body by running more and more miles each week for the past 16 weeks, and he knows what kind of effects that can have. A man who isn't athletic might have thought, "Oh my god, my wife's going crazy, she's crying over nothing, what the HELL?" But my husband knew what was going on. He held me until I stopped crying, made me sit with a pillow behind my head (so I wouldn't hit it on the wall again), made me drink some Gatorade, made sure I got to bed early, and has been checking on me periodically for the past couple of days to make sure I'm not ready to fall over.
So, clearly, the cumulative effect of all that mileage has been more than I expected, and my body needs time to recover before I put it to the test in the marathon on November 1. I feel unbelievably fortunate to be married to a man who understands that, and who supports me in my athletic endeavors, even if sometimes that means having a shrieking harpy for a wife when the pizza doesn't show up on time! :D
He's not the one training for the marathon -- I am. It's gone extremely well this year, far better than the two previous years. I ran both of my 20-milers as smoothly as I could have hoped for, and finished them with a smile on my face. (Hubby says last year I looked like a zombie after every run longer than 16 miles.) I haven't had any injuries except for a bout of ankle pain a few weeks ago, which went away with only a day or two of enforced rest. I've been able to run all of my training mileage at a significantly faster pace than I did last year, with no increase in effort. In short, I've been feeling great.
Now I'm in the "taper" period, the three weeks before the race when I cut back substantially on weekly mileage. I wouldn't have expected that it would be during taper, of all times, that I would start to exhibit signs of overtraining. This past Saturday, after I came in from a 12-mile run, I was wrecked. I don't think it's possible to exaggerate how much. As I later put it, I felt like I lost about 75 IQ points -- and all of my emotional maturity. I ordered pizza for lunch -- it took an hour and fifteen minutes, not the promised half hour, and I was in tears by the time it showed up. I took a nap after eating the pizza, and woke up feeling just as tired as before. Hubby and I went to a tango show, which I couldn't fully enjoy because I was feeling so irritable (didn't help that latecomers were allowed to take their seats up to an HOUR after the show started, which meant that those of us who showed up on time had our views of the stage blocked every few minutes), and when we got home, I sat down on the sofa...and hit my head on the wall. Well, then the tears really came out.
My husband, bless him, knows what overtraining is. He knows I've been beating up my body by running more and more miles each week for the past 16 weeks, and he knows what kind of effects that can have. A man who isn't athletic might have thought, "Oh my god, my wife's going crazy, she's crying over nothing, what the HELL?" But my husband knew what was going on. He held me until I stopped crying, made me sit with a pillow behind my head (so I wouldn't hit it on the wall again), made me drink some Gatorade, made sure I got to bed early, and has been checking on me periodically for the past couple of days to make sure I'm not ready to fall over.
So, clearly, the cumulative effect of all that mileage has been more than I expected, and my body needs time to recover before I put it to the test in the marathon on November 1. I feel unbelievably fortunate to be married to a man who understands that, and who supports me in my athletic endeavors, even if sometimes that means having a shrieking harpy for a wife when the pizza doesn't show up on time! :D
Monday, October 19, 2009
"That doesn't count"
The New York Times reports that the AMA, once an ardent opponent of Medicare, now wants to make sure that Medicare doesn't get cut in whatever health care "reform" happens to be. They want a law that would make permanent the temporary "fix" that happens every year when Congress staves off cuts to doctors' Medicare payments that an earlier law demands -- but removing the cuts permanently would threaten Democrats' (already empty) promises that health care "reform" would be budget neutral.
The Democrats are arguing that spending more on Medicare shouldn't "count" against the budget total because it's a problem they inherited, and not really part of health insurance reform.
Are you kidding me? It shouldn't count?
That's like a man who plans to remodel his kitchen, finds termites in the garage, and doesn't have the money to fix both the garage and the kitchen -- so he says, "The money for the garage shouldn't count against my annual budget! It's not my fault, so it doesn't count!" Um, duh? It still costs money. Even a five-year-old who wants to spend more than his allowance will not get far arguing that the price of a pack of gum doesn't "count" against his allowance, but a new G.I. Joe doll does. When he gets to the checkout counter, he is only going to have enough money for one or the other, and all his protestations of "it doesn't count" will not change the situation one iota.
All money spent by the government "counts" toward ballooning the deficit. Some of it (not much of it, these days) is money properly spent by the government (judges' salaries, combat equipment); most of it is not (entitlement programs). But it all counts -- and that's why we need to get rid of those expenses that don't relate to the government's proper function of protecting individual rights.
The Democrats are arguing that spending more on Medicare shouldn't "count" against the budget total because it's a problem they inherited, and not really part of health insurance reform.
Are you kidding me? It shouldn't count?
That's like a man who plans to remodel his kitchen, finds termites in the garage, and doesn't have the money to fix both the garage and the kitchen -- so he says, "The money for the garage shouldn't count against my annual budget! It's not my fault, so it doesn't count!" Um, duh? It still costs money. Even a five-year-old who wants to spend more than his allowance will not get far arguing that the price of a pack of gum doesn't "count" against his allowance, but a new G.I. Joe doll does. When he gets to the checkout counter, he is only going to have enough money for one or the other, and all his protestations of "it doesn't count" will not change the situation one iota.
All money spent by the government "counts" toward ballooning the deficit. Some of it (not much of it, these days) is money properly spent by the government (judges' salaries, combat equipment); most of it is not (entitlement programs). But it all counts -- and that's why we need to get rid of those expenses that don't relate to the government's proper function of protecting individual rights.
Sunday, October 18, 2009
Another belated LTE announcement...
I have a LTE in the New York Times! It's heavily edited -- I included a bit about how I would be happy to say "live and let live" to Francis Collins if it weren't for the fact that I pay his salary, and at the end of the last sentence I also had "particularly not one run on taxpayer dollars." It was hard enough to squeeze in an allusion to the fact that the government shouldn't be funding scientific research in 150 words or less -- when the Times cut my letter to less than 100 words, even that allusion went away.
I've decided that I'm not going to concentrate any more letter-writing efforts toward the Times. I've sent many a letter that was at least as well written as this one arguing against government interference in health care, but none of them has been printed. I don't think it's a mistake that this one did and the others didn't -- because my anti-religion viewpoint is in keeping with the liberal editorship of the paper. Free-market advocacy is antithetical to what the Times advocates -- so I have about as much chance of getting a letter printed about a subject I find far more important as I have of finding a fifty-dollar bill on the sidewalk.
Now I know -- I will continue to write to the Post, and probably give amNewYork and Metro New York, two free papers that get distributed to NYC commuters every morning, a try.
I've decided that I'm not going to concentrate any more letter-writing efforts toward the Times. I've sent many a letter that was at least as well written as this one arguing against government interference in health care, but none of them has been printed. I don't think it's a mistake that this one did and the others didn't -- because my anti-religion viewpoint is in keeping with the liberal editorship of the paper. Free-market advocacy is antithetical to what the Times advocates -- so I have about as much chance of getting a letter printed about a subject I find far more important as I have of finding a fifty-dollar bill on the sidewalk.
Now I know -- I will continue to write to the Post, and probably give amNewYork and Metro New York, two free papers that get distributed to NYC commuters every morning, a try.
Friday, October 16, 2009
Can we get one thing straight about the "public option"?
Please?
The New York Times writes, "The public option would presumably be cheaper than the private plans, because it would not have to pay private-sector executive salaries or generate profit for shareholders."
Hello? If the government doesn't pay high salaries, who is it going to get to run its plan? Not, presumably, the best and most ambitious minds out there. So we'll all end up paying for those non-executive salaries because the not-so-best-and-brightest aren't going to run the government option as efficiently as someone who's worth more money can do.
And the fact that the "public option" need not generate a profit is bad, not good. Businesses that don't at least break even go bust. When government employees generate a surplus, they see their budgets reduced for the next year. When they don't break even, they get subsidies. It's like Ronald Reagan said -- "if it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Having the government in charge means inefficient behavior gets rewarded, not punished.
Even without the "public option," healthcare "reform" as it is being proposed is a moral crime. Adding the public option would simply make it a moral crime with an even BIGGER money pit associated with it.
The New York Times writes, "The public option would presumably be cheaper than the private plans, because it would not have to pay private-sector executive salaries or generate profit for shareholders."
Hello? If the government doesn't pay high salaries, who is it going to get to run its plan? Not, presumably, the best and most ambitious minds out there. So we'll all end up paying for those non-executive salaries because the not-so-best-and-brightest aren't going to run the government option as efficiently as someone who's worth more money can do.
And the fact that the "public option" need not generate a profit is bad, not good. Businesses that don't at least break even go bust. When government employees generate a surplus, they see their budgets reduced for the next year. When they don't break even, they get subsidies. It's like Ronald Reagan said -- "if it moves, tax it. If it keeps moving, regulate it. And if it stops moving, subsidize it." Having the government in charge means inefficient behavior gets rewarded, not punished.
Even without the "public option," healthcare "reform" as it is being proposed is a moral crime. Adding the public option would simply make it a moral crime with an even BIGGER money pit associated with it.
Thursday, October 15, 2009
Karl Rove explains the funny math
Today's Wall Street Journal contains an op-ed by Karl Rove that exposes the many tricks of math being used to hornswoggle Americans into believing that the Baucus bill won't lead to budget deficit increases:
- Raising taxes and cutting Medicare spending right away -- but not starting the new bill's benefits until years later, thus using many years of taxes to pay for a few years of benefits.
- Pretending that employers who choose to drop coverage for their employees will increase salaries by a corresponding amount (so that the government can then tax that salary increase).
- Taxing "insurers" -- meaning, making the cost of being an insurer higher, meaning higher prices for policies for all of us.
- Pretending that revenue from taxing "luxury" insurance policies will increase from year to year. As Mr. Rove says, "That's nonsense. If you tax something heavily you'll get less of it." Duh.
- As I've previously mentioned, the federal government is going to pretend its deficit isn't getting any bigger by forcing states to make theirs bigger through an expansion of Medicaid. Whether we're paying it to Uncle Sam or to the governor, we're still paying.
Tuesday, October 13, 2009
Forget anything good I said about the insurance industry.
Yesterday I said it was good that the insurance industry is criticizing the healthcare "reform" effort, but bad that it was doing so with purely pragmatic, not moral, arguments.
But, of course, I should have realized that the industry has no moral leg to stand on. Earlier this year, it was an ardent supporter of coverage for anybody, regardless of prior health status, gender, or age -- if the government mandated that all Americans get coverage (as I blogged back in March). In other words, the insurance industry was perfectly willing to embrace statism in medicine if it brought the industry millions of new customers, the healthy outnumbering the sick.
Why is the industry screaming now? It's not because insurance executives suddenly understand the Objectivist ethics and recognize that the government needs to get out of health care altogether. It's because, as the healthcare bills make their way through the legislative process, they are losing their teeth. Congressmen who previously wanted to slap their constituents with heavy fines if they didn't buy health insurance are now afraid to make the fines as drastic as they were in previous drafts of legislation, lest they lose their seats in midterm elections.
What that means, of course, is that many young and healthy people will find it less onerous to pay fines than to pay for health insurance, especially when that health insurance has to be priced the same regardless of health status or age (read: to be required to subsidize the old and the chronically ill). And young and healthy people are exactly the kind of customers insurers need in order to profit from this statist intervention. They're the kind who pay in lots of money in premiums and don't collect much in terms of benefits -- thus subsidizing other patients who pay the same premiums but consume far more health-related goods and services.
Notice that UnitedHealth Group continues to say, "We have proposed market reforms that will guarantee quality, affordable and portable coverage for all Americans, regardless of gender, health status or pre-existing conditions. These changes must be accompanied by a personal coverage requirement that brings everyone into the system..." What the insurers want is not for healthcare "reform" to go away. They want it brought back to the form in which they get to be looters.
But, of course, I should have realized that the industry has no moral leg to stand on. Earlier this year, it was an ardent supporter of coverage for anybody, regardless of prior health status, gender, or age -- if the government mandated that all Americans get coverage (as I blogged back in March). In other words, the insurance industry was perfectly willing to embrace statism in medicine if it brought the industry millions of new customers, the healthy outnumbering the sick.
Why is the industry screaming now? It's not because insurance executives suddenly understand the Objectivist ethics and recognize that the government needs to get out of health care altogether. It's because, as the healthcare bills make their way through the legislative process, they are losing their teeth. Congressmen who previously wanted to slap their constituents with heavy fines if they didn't buy health insurance are now afraid to make the fines as drastic as they were in previous drafts of legislation, lest they lose their seats in midterm elections.
What that means, of course, is that many young and healthy people will find it less onerous to pay fines than to pay for health insurance, especially when that health insurance has to be priced the same regardless of health status or age (read: to be required to subsidize the old and the chronically ill). And young and healthy people are exactly the kind of customers insurers need in order to profit from this statist intervention. They're the kind who pay in lots of money in premiums and don't collect much in terms of benefits -- thus subsidizing other patients who pay the same premiums but consume far more health-related goods and services.
Notice that UnitedHealth Group continues to say, "We have proposed market reforms that will guarantee quality, affordable and portable coverage for all Americans, regardless of gender, health status or pre-existing conditions. These changes must be accompanied by a personal coverage requirement that brings everyone into the system..." What the insurers want is not for healthcare "reform" to go away. They want it brought back to the form in which they get to be looters.
Monday, October 12, 2009
The good news and the bad news
The good news is that insurance companies have decided they're not going to roll over and let Democrats impose more rules on them without a fight. Where the insurance industry had previously been quietly cooperative so as to "gain a place at the bargaining table," it seems to finally have realized that its "place" will be in the center of the table, as the main dinner entree, and it has issued a report attacking the proposed healthcare "reform" legislation.
The bad news is that insurers are defending themselves in the wrong way. They're arguing that the legislation is bad because it will push up the price of insurance for all Americans. That's true -- but it's not the argument that most needs to be made.
A pragmatic argument against insurance "reform" is vulnerable to attack, as the Democrats have already shown. It can be shouted down with charges of inaccuracy in calculations ("your numbers are wrong; look at ours, they're better") and deliberate bias ("your numbers are wrong because you've deliberately engineered them to look bad" -- after all, Democrats ought to know that funny math can be used to manipulate data into any sort of projection one wishes). And even if it's accepted, it doesn't lead to any conclusions other than "this legislation shouldn't pass."
The moral argument, on the other hand, does not suffer from these problems. Insurers should proudly assert their right to enter into whatever voluntary agreements they choose with their customers, unfettered by government intervention. No matter what the projected costs are or who calculates them, the moral argument shows that a free market is the only proper system. And it leads us to a conclusion beyond "this legislation is bad" -- it leads us to the conclusion that all the government intervention we already put up with in health care is bad. The moral argument doesn't just say "defeat the Baucus bill"; it says, "Americans have the right to purchase insurance across state lines"; it says "Insurers have the right to offer policies that don't cover in vitro fertilization, methadone clinics, or whatever the special interest du jour happens to be"; it says, "self-employed individuals have the right to buy insurance without a tax penalty"; and so on and so forth.
I'm encouraged by the fact that the insurance companies finally realize that they shouldn't cooperate meekly with the government that wants to cannibalize them. Now it's time they took a moral stand, not just a practical one.
The bad news is that insurers are defending themselves in the wrong way. They're arguing that the legislation is bad because it will push up the price of insurance for all Americans. That's true -- but it's not the argument that most needs to be made.
A pragmatic argument against insurance "reform" is vulnerable to attack, as the Democrats have already shown. It can be shouted down with charges of inaccuracy in calculations ("your numbers are wrong; look at ours, they're better") and deliberate bias ("your numbers are wrong because you've deliberately engineered them to look bad" -- after all, Democrats ought to know that funny math can be used to manipulate data into any sort of projection one wishes). And even if it's accepted, it doesn't lead to any conclusions other than "this legislation shouldn't pass."
The moral argument, on the other hand, does not suffer from these problems. Insurers should proudly assert their right to enter into whatever voluntary agreements they choose with their customers, unfettered by government intervention. No matter what the projected costs are or who calculates them, the moral argument shows that a free market is the only proper system. And it leads us to a conclusion beyond "this legislation is bad" -- it leads us to the conclusion that all the government intervention we already put up with in health care is bad. The moral argument doesn't just say "defeat the Baucus bill"; it says, "Americans have the right to purchase insurance across state lines"; it says "Insurers have the right to offer policies that don't cover in vitro fertilization, methadone clinics, or whatever the special interest du jour happens to be"; it says, "self-employed individuals have the right to buy insurance without a tax penalty"; and so on and so forth.
I'm encouraged by the fact that the insurance companies finally realize that they shouldn't cooperate meekly with the government that wants to cannibalize them. Now it's time they took a moral stand, not just a practical one.
Thursday, October 8, 2009
Don't quit!
According to the New York Times, the Baucus bill will go to the Senate Finance Committee on Tuesday. Through new math, the drafters of the bill have convinced themselves that it won't cost us anything -- ignoring the facts that it would tax insurers and those whose policies are deemed "luxury," fine Americans who don't consider the available health insurance options to be a good deal, and shift costs to the states (read: us taxpayers) through an expansion of Medicaid.
Keep writing to your senators and representatives! They must be told that a vote for increased government intervention in health care is a vote that could put them out of office. I just wrote to my senator yesterday, and will be sending another such letter to my congresswoman today.
I'd like to ask for advice, though: I live in a very "blue" area of the country, and the politicians who get elected here reflect that. My senator, Kristen Gillibrand, for example, is listed by a prominent liberal website as having one of the top 20 "progressive" voting records in the country. I've already discussed how my congresswoman, Carolyn Maloney, is a flaming government-interventionist as well.
So my question is, what's the best strategy to write to such people? I have a feeling any arguments, however well-reasoned, in favor of a free market are going to be lost on them. Should I get straight to the point and say "a vote for the Baucus bill means I'll vote against you"? Should I write to congressmen in other states who are more likely to be swing votes to give them moral support to say no, even though the fact that I'm not one of their constituents means my voice will carry little if any weight?
Keep writing to your senators and representatives! They must be told that a vote for increased government intervention in health care is a vote that could put them out of office. I just wrote to my senator yesterday, and will be sending another such letter to my congresswoman today.
I'd like to ask for advice, though: I live in a very "blue" area of the country, and the politicians who get elected here reflect that. My senator, Kristen Gillibrand, for example, is listed by a prominent liberal website as having one of the top 20 "progressive" voting records in the country. I've already discussed how my congresswoman, Carolyn Maloney, is a flaming government-interventionist as well.
So my question is, what's the best strategy to write to such people? I have a feeling any arguments, however well-reasoned, in favor of a free market are going to be lost on them. Should I get straight to the point and say "a vote for the Baucus bill means I'll vote against you"? Should I write to congressmen in other states who are more likely to be swing votes to give them moral support to say no, even though the fact that I'm not one of their constituents means my voice will carry little if any weight?
Tuesday, October 6, 2009
Why we don't just point and laugh...
If your teenager, working an after-school job at the mall, were to exclaim, "I should be able to afford a brand-new Range Rover, fully loaded, with what I make!" you'd laugh, wouldn't you?
If an actor who hasn't made it beyond Off-Off Broadway yet thought that he should be able to have a ten-course meal at Per Se every night for dinner, you'd consider him ridiculous, no?
If your fresh-out-of-college administrative assistant tells you, "On my salary, I should be able to have a new Versace gown every day of the week!"...well, that would inspire laughter, too, right?
So why is it that when politicians insist that health care reform should provide Americans with the best of every possible type of care they could want, and insist that it be affordable to everyone, do we not point and snicker? We shouldn't have to take these clowns seriously.
If an actor who hasn't made it beyond Off-Off Broadway yet thought that he should be able to have a ten-course meal at Per Se every night for dinner, you'd consider him ridiculous, no?
If your fresh-out-of-college administrative assistant tells you, "On my salary, I should be able to have a new Versace gown every day of the week!"...well, that would inspire laughter, too, right?
So why is it that when politicians insist that health care reform should provide Americans with the best of every possible type of care they could want, and insist that it be affordable to everyone, do we not point and snicker? We shouldn't have to take these clowns seriously.
Boy, am I late.
I wrote a letter to the editor of the New York Post back in July, in response to its coverage of the healthcare debate. I checked for a couple of days after that to see whether or not my letter got published, but apparently I lost patience too soon! Here, quite belatedly, is my published LTE. Note that it's been edited -- and I certainly hope it's a typo and not deliberate editing that the word "neither" is prominently missing from the beginning of the last sentence.
I've just sent another LTE to the Post, since its coverage is far less left-leaning than that of any other NYC newspaper I can think of. I'd been discouraged about "upping my game" in activism by getting my views visible in non-Objectivist outlets when I live in a hotbed of leftism, but this is a nice surprise to spur me on!
I've just sent another LTE to the Post, since its coverage is far less left-leaning than that of any other NYC newspaper I can think of. I'd been discouraged about "upping my game" in activism by getting my views visible in non-Objectivist outlets when I live in a hotbed of leftism, but this is a nice surprise to spur me on!
Monday, October 5, 2009
If you saw the Will Ferrell healthcare "reform" video...
...you gotta watch this. Thanks to Robert Begley for pointing it out!
Brownies are the devil!
I wish this were a joke, but it isn't: New York City has banned, with few exceptions, bake sales as fundraisers in schools.
Are you kidding me? So the basketball team can't sell banana bread to get new uniforms? The orchestra can't sell Oreos? The debate team can't sell Ding Dongs? In the name of ending obesity, we really have to ban as innocent and fun an activity as making treats and selling them to classmates?
Squashing the bake sale isn't going to make NYC's kids any thinner. The ones who want to eat junk will find it. They'll hide cookies in their backpacks, head to Mickey D's for fries after school, yada yada yada.
What getting rid of bake sales will do is hurt extracurricular groups. As the Times article points out, clubs can turn to selling nonfood items like T-shirts and key chains, but those are much more expensive to produce than a batch of brownies. So kids will end up doing their extracurricular activities without the equipment they need, or else the schools will come begging to the city for more money. I'd much rather school extras were funded with money earned through voluntary transactions at bake sales than with tax money out of my wallet.
The government has no business regulating the size of our waistlines. Bring back the bake sale, NYC!
Are you kidding me? So the basketball team can't sell banana bread to get new uniforms? The orchestra can't sell Oreos? The debate team can't sell Ding Dongs? In the name of ending obesity, we really have to ban as innocent and fun an activity as making treats and selling them to classmates?
Squashing the bake sale isn't going to make NYC's kids any thinner. The ones who want to eat junk will find it. They'll hide cookies in their backpacks, head to Mickey D's for fries after school, yada yada yada.
What getting rid of bake sales will do is hurt extracurricular groups. As the Times article points out, clubs can turn to selling nonfood items like T-shirts and key chains, but those are much more expensive to produce than a batch of brownies. So kids will end up doing their extracurricular activities without the equipment they need, or else the schools will come begging to the city for more money. I'd much rather school extras were funded with money earned through voluntary transactions at bake sales than with tax money out of my wallet.
The government has no business regulating the size of our waistlines. Bring back the bake sale, NYC!
Friday, October 2, 2009
Someone's going to have to tell this girl that words have an exact meaning
A few days ago, a mini-mob of healthcare "reform" advocates gathered in Oakland, CA to protest at a Whole Foods store in reaction to John Mackey's August editorial on his stores' approach to keeping insurance affordable. The group, which bastardized Toni Basil's famous "Mickey" into "Hey Mackey, you're a swine, you're a swine you blow my mind," insists that health care is a right. It isn't, of course, and I'm not going to make those arguments again. I'm simply going to point out a little bit of idiocy coming from one of the protesters, Sarah Noll.
Ms. Noll says: "Mackey is being pretty hypocritical to sell expensive, organic, healthy foods that is [sic] inaccessible to poor people and then say that poor people don't have a right to treatment."
Huh?
Let's turn to the dictionary definition of "hypocrisy" (since "hypocritical" is defined in terms of "hypocrisy"). Per the American Heritage Dictionary, "hypocrisy" is defined as "The practice of professing beliefs, feelings, or virtues that one does not hold or possess; falseness." It means saying one thing and doing the opposite.
Let's leave aside whether Mr. Mackey's actual behavior is hypocritical or not. (It isn't.) By her own assessment, Ms. Noll is anything but calling Mr. Mackey a hypocrite -- all she's doing is showing that she doesn't know what the word "hypocritical" means. If John Mackey were claiming that poor people don't have a right to treatment, but was also advocating for a government-run insurance plan, that would be hypocrisy. If his stores were charging the high prices that they do, and Mackey were going around saying that eating organic should be as cheap as eating at McDonald's, that too would be hypocrisy. But how is "sell[ing] expensive, organic, healthy foods" the opposite of saying that "poor people don't have a right to treatment"?
It's like that Alanis Morissette song, "Ironic," where Morissette sings about a bunch of crappy situations ("rain on your wedding day," "a traffic jam when you're already late"), not one of which actually represents irony, and then whines, "Isn't it ironic, don't ya think?" (Maybe that song is just a supremely ironic joke on all of us; perhaps we are supposed to have a huge guffaw and think, "Nothing in this song is an example of irony! Now THAT'S ironic!")
I digress. But this person -- who has no idea of the actual meanings of words, who is simply carrying around a mishmash of ideas in her head that are unconnected with reality -- is the kind of person we're up against. It would make me laugh if there weren't so many of them.
Ms. Noll says: "Mackey is being pretty hypocritical to sell expensive, organic, healthy foods that is [sic] inaccessible to poor people and then say that poor people don't have a right to treatment."
Huh?
Let's turn to the dictionary definition of "hypocrisy" (since "hypocritical" is defined in terms of "hypocrisy"). Per the American Heritage Dictionary, "hypocrisy" is defined as "The practice of professing beliefs, feelings, or virtues that one does not hold or possess; falseness." It means saying one thing and doing the opposite.
Let's leave aside whether Mr. Mackey's actual behavior is hypocritical or not. (It isn't.) By her own assessment, Ms. Noll is anything but calling Mr. Mackey a hypocrite -- all she's doing is showing that she doesn't know what the word "hypocritical" means. If John Mackey were claiming that poor people don't have a right to treatment, but was also advocating for a government-run insurance plan, that would be hypocrisy. If his stores were charging the high prices that they do, and Mackey were going around saying that eating organic should be as cheap as eating at McDonald's, that too would be hypocrisy. But how is "sell[ing] expensive, organic, healthy foods" the opposite of saying that "poor people don't have a right to treatment"?
It's like that Alanis Morissette song, "Ironic," where Morissette sings about a bunch of crappy situations ("rain on your wedding day," "a traffic jam when you're already late"), not one of which actually represents irony, and then whines, "Isn't it ironic, don't ya think?" (Maybe that song is just a supremely ironic joke on all of us; perhaps we are supposed to have a huge guffaw and think, "Nothing in this song is an example of irony! Now THAT'S ironic!")
I digress. But this person -- who has no idea of the actual meanings of words, who is simply carrying around a mishmash of ideas in her head that are unconnected with reality -- is the kind of person we're up against. It would make me laugh if there weren't so many of them.
Thursday, October 1, 2009
The same government that hates monopolies hates competition
Antitrust law gets hauled out every time a hardware or software maker gets too successful and ends up with a huge share of the market. That's unfair, the government argues, and we need competition (defined by the government as "more competitors," never mind that one competitor can be all that's needed if it delivers more value to its consumers than anyone else is capable of doing). You would think, based on such lawsuits, that the government would favor having as many competitors as possible -- trying to mimic the Platonic ideal of "perfect" competition from college Econ 101.
Not so, as it turns out, for the beleaguered pharmaceutical industry. GlaxoSmithKline is the latest victim of laws that allow the FDA to change the playing field any time it wants -- because, apparently, there's already too much competition.
GSK's kidney cancer drug, pazopanib, is in the preapproval stages of development: The drug cannot be marketed or sold because it has not yet received FDA approval. In order to secure FDA approval, a company must conduct extensive clinical trials of its drug, comparing it to the best available alternatives. Four years ago, when GSK was initiating trials of its drugs, the best available alternative in kidney cancer was nothing. Nada. Squat.
The last five years have seen milestone developments in treatments for kidney cancer. Several new treatments, including Pfizer's Sutent, Genentech's Avastin, and Bayer's Nexavar, have been approved for the disease. They can extend life, if by months and not years, in this difficult-to-treat disease.
So now that patients have options, the FDA is looking at pazopanib with a more critical eye than it would have otherwise -- and it implies that approval is no longer likely. The drug, say FDA officials, is too unsafe to warrant approval -- especially when patients have other approved options.
In other words, the playing field has changed -- and because it has, pazopanib is not to be allowed to enter the game.
No company is immune from competition. I certainly would not argue that Glaxo is entitled to sell X number of pills regardless of whether pazopanib is the only drug on the market or the seventeenth in its class. But it has the right to try! It has the right to put its product out there and try to convince consumers why it should take a chance on pazopanib. Maybe, in a free market, Glaxo could price its product lower than its competitors, so that those who cannot afford Sutent might be tempted to give pazopanib a try. Maybe the drug has an easier-to-use formulation that would make it an attractive choice. Or maybe the drug really is nothing but a me-too -- in which case, it should still be allowed to compete with those earlier to market, where patients can decide for themselves what combination of features and price are the most appropriate to their own situations.
Since when are more choices bad for us?
Not so, as it turns out, for the beleaguered pharmaceutical industry. GlaxoSmithKline is the latest victim of laws that allow the FDA to change the playing field any time it wants -- because, apparently, there's already too much competition.
GSK's kidney cancer drug, pazopanib, is in the preapproval stages of development: The drug cannot be marketed or sold because it has not yet received FDA approval. In order to secure FDA approval, a company must conduct extensive clinical trials of its drug, comparing it to the best available alternatives. Four years ago, when GSK was initiating trials of its drugs, the best available alternative in kidney cancer was nothing. Nada. Squat.
The last five years have seen milestone developments in treatments for kidney cancer. Several new treatments, including Pfizer's Sutent, Genentech's Avastin, and Bayer's Nexavar, have been approved for the disease. They can extend life, if by months and not years, in this difficult-to-treat disease.
So now that patients have options, the FDA is looking at pazopanib with a more critical eye than it would have otherwise -- and it implies that approval is no longer likely. The drug, say FDA officials, is too unsafe to warrant approval -- especially when patients have other approved options.
In other words, the playing field has changed -- and because it has, pazopanib is not to be allowed to enter the game.
No company is immune from competition. I certainly would not argue that Glaxo is entitled to sell X number of pills regardless of whether pazopanib is the only drug on the market or the seventeenth in its class. But it has the right to try! It has the right to put its product out there and try to convince consumers why it should take a chance on pazopanib. Maybe, in a free market, Glaxo could price its product lower than its competitors, so that those who cannot afford Sutent might be tempted to give pazopanib a try. Maybe the drug has an easier-to-use formulation that would make it an attractive choice. Or maybe the drug really is nothing but a me-too -- in which case, it should still be allowed to compete with those earlier to market, where patients can decide for themselves what combination of features and price are the most appropriate to their own situations.
Since when are more choices bad for us?
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