Stand Up and Deliver

Dennis Prager says we're in a civil war in America. They say the pen is mightier than the sword. And a well-tuned wit is much sharper. Stand Ups for America: Fight the Power With Ridicule

So I decided to fight back with the one weapon I do own: ridicule. If there is one thing that the Left cherishes more than power, it is stature. They can’t stand being laughed at. They want to be seen as noble intellectual public servants, the same thing they see when they look in their mirrors every morning. They buttress those delusions with awards and other recognitions of achievement in the world of group-think, It is why they hate Breitbart.com, talk radio, and Fox News; because in this world we refuse to take them seriously.
....
We decided to exact our revenge by doing what the Left hates most: being laughed at.

It’s something they’re not used to. Most comics and comedy shows are quite kind to the people in power right now. Other than the fabulous Red Eye show and Newsbusted, most political comedy today is centered against Glenn Beck and Sarah Palin, with the occasional vintage George Bush joke still sprinkled in for good effect.

Yes, they can dish it out, but they can't take it.

Federalist Papers

For the online reference library: Federalist Papers

Targeting Democrats and Republicans

John at Verum Serum has taken up the challenge raised by Paul Krugman in Memo to Paul Krugman and Rep. Van Hollen: My Search Was Not in Vain (Updated)

Each of the cross-hairs represents a Democrat from a conservative district who voted in favor of health reform. Immediately after highlighting the map, Krugman wrote:

All of this goes far beyond politics as usual…you’ll search in vain for anything comparably menacing, anything that even hinted at an appeal to violence, from members of Congress, let alone senior party officials….to find anything like what we’re seeing now you have to go back to the last time a Democrat was president.

Here's the offending map:

And there's this map from the Democratic Leadership Committee website:

And another map showing "targeted Republicans", just for good measure.

Read the whole thing.

Geese, ganders, and sauce

Victor Davis Hanson looks at how attitudes about dissent have changed. Why All the Wounded Fawns? - Victor Davis Hanson - The Corner on National Review Online

Like it or not, throughout much of the Bush administration, the public was conditioned to believe the following:

• Filibusters were a key traditional Senate protection designed to thwart the tyranny of the majority as embodied by the Bush-Cheney steamroller (Republicans, to be fair, often damned them as obstructionist).

• Recess appointments were the desperate acts of an executive without confidence in either popular or legislative support. Popular protests were grass-roots democracy at its finest.

• Occasional fringe groups that frequented anti-war, anti-Bush rallies, and called their president horrific epithets or threatened violence, were either irrelevant or forced into such understandable extremism by their own government's excesses.

• The once-abhorrent expression of hatred in popular culture for the president (cf. e.g., Knopf's Nicholson Baker novel Checkpoint, about killing Bush, or the Toronto Film Festival award winning a docudrama about assassinating George Bush, or Jonathan Chait's New Republic essay "The Case for Bush Hatred," or Michael Moore's abhorrent talk after 9/11 about blue/red state deaths and his empathy for terrorists in Iraq ("Minutemen" . . . "and they will win")) were not merely not abhorrent, but often creative expressions that captured the mood of popular dislike, and certainly no grounds for ostracism (cf. Moore's attendance at film openings and conventions with top Democratic politicians).

In other words, apparently few on the Left realized that in their dislike for Bush, and in their tolerance for those who hated Bush, they more or less changed attitudes toward acceptable and unacceptable public expressions of dissent. So now the public sees their sudden call for polite discourse as abject hypocrisy.
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I think ultimately many "progressives," adherents to relativism, feel that the past furor over Bush in all its creepy manifestations was justified because of who Bush was; but that a similar methodology (or, in fact, far softer manifestations) of dissent toward Obama is unacceptable because of who Obama is (i.e. one can act rudely toward clearly bad people, but not rudely toward unquestionably "good" people). It is that simple.

Didn't dissent used to be patriotic?

Jonah Goldberg looks at how the Democratic response to dissent has changed along with administrations in The Hostility Follies at National Review Online.

...the Democrats and their media transmission belt, who largely turned a blind eye to partisan vandalism and extremist rhetoric against Republicans for eight years but now express horror at what they claim to hear from the right.

Columnist Paul Krugman, who encouraged liberals to hang Sen. Joe Lieberman (I., Conn.) in effigy, is concerned about right-wing “eliminationist rhetoric.” The Washington Post’s Courtland Milloy can’t stand the incivility of the tea partiers, which is why he wants to “knock every racist and homophobic tooth out of their Cro-Magnon heads.” Frank Rich says the mantra “take our country back” is now code for a white racist backlash — though it was an apparently fine Democratic applause line when George W. Bush was president.

And also...

As for the epithet aimed at Lewis, if it happened, it’s disgusting. But going by the video, there’s nothing to back it up, and the claim by Rep. Andre Carson (D., Ind.) that the N-word was chanted 15 times is pure dishonesty.

Let’s assume it is true. I thought liberals rejected guilt by association as McCarthyism. Or are we to believe that every opponent of Obamacare is a racist?

Hatari!

Hatari!

My colleague Brian Doherty mentioned yesterday that the mainline Michigan militia groups don't seem to have much respect or fondness for the Hutaree, the Michigan-based Christian militants hauled in last weekend for allegedly plotting to kill as many cops as they could. For more on the differences between the two varieties of militia -- and on the general ideological ecology of the militia milieu -- I recommend this interview with Amy Cooter, a doctoral candidate in sociology at the University of Michigan who has been writing her dissertation on the militia subculture:

The divide between the Hutaree and the other Michigan militiamen reflects the split between the "millenarian" and "constitutionalist" wings of the militia movement, a rough distinction outlined in the University of Hartford historian Robert Churchill's book To Shake Their Guns in the Tyrant's Face. The constitutionalists organize in public, they emphasize gun rights and other civil liberties, and they see themselves as a deterrent to repression and abuse. The millenarians are more likely to organize in secret cells, they emphasize elaborate conspiracy theories, and they see themselves as survivors in the face of a coming apocalypse.

Bonus Michigan militia link: Militia members lend a hand with search and rescue; militia watchdogs hit the roof.

Paying For Health Care the Hard Way

Paying For Health Care the Hard Way

Here's the opening to a misguided but not-altogether-bad New York Times piece on why ObamaCare is unlikely to bring down health care costs:

Dr. Robert Colton, an internist in Boca Raton, Fla., has a problem, and he knows it. His patients come in wanting, sometimes demanding, tests and treatments that are unnecessary, just adding to the nation's huge health care bill. He even has patients, he says, who come in and report that their chief complaint is, "I need an M.R.I."

And what does Dr. Colton do?

"I do the damn test," he said. "There is no incentive for me, Rob Colton, to reduce overutilization. If the person wants it, what are you going to do, say no?"

And the new health care legislation, he says, is not going to make a bit of difference.

The piece goes on, making some reasonably good points about problems with the way care is doled out and paid for. But I think the author gives away the game in the second sentence, which ends with words "adding to the nation's huge health care bill." The nation's. Not the patient's. There's a huge difference between the two, and therein lies the problem.

Third-party payment systems, whether they work through private insurers or the government, result in massive overutilization of care because consumers aren't price conscious. When somebody else is paying, there's no incentive to find out what a procedure costs, or if it's really necessary. And the more the third party pays for, the bigger the problem. The result is that consumers end up thinking of health insurance as medical prepayment rather than as a hedge against major expenses. 

That makes medical care a collective expense, and thus a collective problem. ObamaCare, by reinforcing our clunky third-party payment system, only locks the country further into that problem. And that's why we have health wonks mulling the virtues of government-managed rationing:

One way to make those links is to do what some other countries do — say that there will be no payments for care that is not deemed the most cost-effective. But politicians shy away from such measures, Dr. Luce said. "That is not likely to happen soon, particularly at a national level," he said.

It would mean rationing, said Dr. Robert D. Truog a professor of medical ethics, anesthesia, and pediatrics at Harvard Medical School. "That's the word nobody wants to use. It's just a firecracker. Nobody wants to touch it."

The result is a crazy system in which, he points out, a government-appointed task force on screening mammography was explicitly forbidden to consider the costs of offering mammograms to women for whom the benefit is very small.

"The point is that as long as a health care system has anything less than an infinite budget, there is a need to decide which types of health care will be funded and which will not," Dr. Truog said.

Truog is right that limited resources inevitably place limits on care. But aside from the basic technocratic appeal of centralized efficiency rules, why should those limits be set centrally, by bureaucrats rather than by individuals and their doctors? 

As former Reason editor Virginia Postrel recently pointed out in The Atlantic, when government sets out rules determining which treatments are cost-effective and which aren't, the result is a politicized medical system that frequently ignores the varied responses individuals have to care. I'm all for deciding "which types of health care will be funded and which will not"; I'm just skeptical that the government is the entity best positioned to make those decisions. 

The Hutaree Arrest and Getting Tough on Terror From Left and Right

The Hutaree Arrest and Getting Tough on Terror From Left and Right

The indictment on the Hutaree "militia arrests" is out. From my read, even taking every word in it as gospel, it sounds like these guys were angry loudmouths who fantasized too much to someone who turned out to be a federal informant or agent, but who they thought was a potential comrade who might help them obtain some explosives.

I may be wrong on this, the government will have its opportunity to prove its case in court, and the defendents will have their opportunity to, well, defend themselves. (I have written and blogged in the past on the generally weak nature of the government's past highly publicized "domestic terror" busts.) It is way too early to decide exactly how much of a real threat to other people's lives and property these guys were.

Not if you are bloggers at DailyKos who are thrilled to see "sedition" being called by its true name, and appearing to presume that, well, the government wouldn't charge someone with something if they weren't guilty.

At Balloon Juice, they play a particularly dumb version of the "my opponents are hypocrites" game while lumping together everyone they think of as "on the right":

The indictment sounds pretty clear: we captured a bunch of religious fundamentalist extremists planning mass casualty attacks against America. Unlike, say, Jose Padilla or any of the clown car gangs whom Bush rounded up this team had the gear and the training to go operational (and kill a lot of people) within a month.

Rightwing antiterror doctrine clearly states that we must strip these "terrorists" (no such thing as alleged in the war on terror) naked and hang them in cold cages by the wrists with their arms tied behind their backs so that the tendons tear and the shoulder joint dislocates. We should waterboard them until they confess and give up their co-conspirators (the Inquisition found waterboarding almost 100% effective!). Without question these people should be held without any trial or access to habeas corpus petitions until the "war" against violent fundamentalist groups is over. At the very least we should shunt these guys into military tribunals where the rules have been rigged to ensure a conviction.

Of course Jonah Goldberg and Glenn Reynolds and Crittenden and Erickson and any other credentialed rightblogger will agree with what I just said. They have to.

I guess Balloon Juice is saying that, well, since these terrorists are on Goldberg and Reynolds' team, that they will defend them? Frankly, from their website's concerns and the general sense of their intellectual and cultural milieu I got from it, it would surprise the hell out of me if the Hutaree gave much of a damn about the vital importance of keeping Gitmo open, nor do the Jonah Goldberg/Glenn Reynolds right generally make much common cause with Christian apocalyptic warriors in the woods. But I am glad to see Balloon Juice is setting themselves up to be strong watchdogs for the Hutaree's procedural rights as this proceeds.

The Detroit News article (filled with good details on the specifics of the many raids that led to the arrests) has an interesting story spelling out that, whatever the Hutaree's crimes turn out to be, it would be wrong to smear the entire "militia movement" so-called with them:

Mike Lackomar, of Michiganmilitia.com, said...he heard from other militia members that the FBI targeted the Hutaree after its members made threats of violence against Islamic organizations.

"Last night and into today the FBI conducted a raid against homes belonging to the Hutaree. They are a religious cult. They are not part of our militia community," he said.....

One of the Hutaree members called a Michigan militia leader for assistance Saturday after federal agents had already began their raid, Lackomar said, but the militia member -- who is of Islamic decent and had heard about the threats -- declined to offer help. That Michigan militia leader is now working with federal officials to provide information on the Hutaree member for the investigation, Lackomar said Sunday.

"They are more of survivalist group and in an emergency they withdraw and stand their ground. They are actively training to be alongside Jesus," he said.

Anyone writing or thinking about how this is all going to play out as a cultural and political story should have under their belt Jesse Walker's excellent October 2009 Reason magazine feature on "The Paranoid Center."

Poll about Republicans is garbage

Not according to me. Not according to right-wing bloggers. According to Columbia Journalism Review. Out on a Limb

In the course of surfing the Web last week, you may have come across some polling data showing that large numbers of Republicans believe some pretty scary things about the president. The figures, provided by Harris Interactive, seem to have been first reported by Daily Beast contributor John Avlon in an item posted at midnight Tuesday. The story, titled “Scary New GOP Poll,” cited details including:

• 45 percent of Republicans (25 percent overall) agree with the Birthers in their belief that Obama was “not born in the United States and so is not eligible to be president”
• 38 percent of Republicans (20 percent overall) say that Obama is “doing many of the things that Hitler did”
• Scariest of all, 24 percent of Republicans (14 percent overall) say that Obama “may be the Antichrist.”

It's going to be interesting to see who finds these results "too good to check."

Look what just got cited as a reference?

The Southern Poverty Law Center!

From Discover The Networks:

  •   Monitors the activities of what it calls “hate groups” in the United States
  •   Exaggerates the prevalence of white racism directed against American minorities
....
As part of the Intelligence Project, the SPLC website currently features a map of "Active U.S. Hate Groups." Deeming racism the the nearly exclusive province of the "radical right," Intelligence Project reports mostly ignore groups on the left. And although SPLC denounces extremist religious organizations like the Jewish Defense League and Westboro Baptist Church, no mention is made of any extremist Muslim groups. (In 2007, SPLC identified 888 separate "active hate groups" in the United States.)

To be sure, the link I was handed as evidence of the growth of hate groups was extremely sparse with respect to methodology.

Norman Podhoretz: In Defense of Sarah Palin - WSJ.com

From the Wall Street Journal: In Defense of Sarah Palin

Nothing annoys certain of my fellow conservative intellectuals more than when I remind them, as on occasion I mischievously do, that the derogatory things they say about Sarah Palin are uncannily similar to what many of their forebears once said about Ronald Reagan.
....
But how do we explain the hostility to Mrs. Palin felt by so many conservative intellectuals? It cannot be differences over policy. For as has been pointed out by Bill Kristol—one of the few conservative intellectuals who has been willing to say a good word about Mrs. Palin—her views are much closer to those of her conservative opponents than they are to the isolationists and protectionists on the "paleoconservative" right or to the unrealistic "realism" of the "moderate" Republicans who inhabit the establishment center.

Much as I would like to believe that the answer lies in some elevated consideration, I have reluctantly come to the conclusion that the same species of class bias that Mrs. Palin provokes in her enemies and her admirers is at work among the conservative intellectuals who are so embarrassed by her. When William F. Buckley Jr., then the editor of National Review, famously quipped that he would rather be ruled by the first 2,000 names in the Boston phone book than by the combined faculties of Harvard and MIT, most conservative intellectuals responded with a gleeful amen. But put to the test by the advent of Sarah Palin, along with the populist upsurge represented by the Tea Party movement, they have demonstrated that they never really meant it.

Amen.

Obamacare -- Week 1

CleanGovernmentNow.org has a piece on the effect ObamaCare is having right out of the gate:O-Care - A Good Government Advocate's Nightmare

The essence of O-Care is quite simple: Health insurance is now an arm of the federal government by virtue of extensive federal regulation of the terms, conditions and comparative rates health insurers can offer. The law tells insurers how to run their business and then offers to pick up the cost where conditions prove uneconomic. Hmmmm. If this all sounds a little dodgy, your instincts are correct. We tried this kind of experiment in housing with Fannie Mae and Freddie Mac, which were pressed to buy non-economic sub-prime loans dressed up to look respectable via bundling and shaky insurance.

This secondary market "nudge" by the government was a major reason for the bubble and subsequent collapse of the financial system under the weight of $2T of bogus AAA securities. Expect similar results from health insurers who will look a lot like the housing Government Sponsored Entities (GSEs) going forward. Fannie Mae and Freddie Mac started with a modest mission of helping first time home buyers and morphed into near monopolies in the residential home market ... which then collapsed.

It gets even worse with O-Care. Housing is real property with an underlying intrinsic value. Medical expenses are consumer expenditures with no floors or ceilings. Extensive regulation will mean only a few "too big to fail" mega-insurers are likely to survive -- and for how long who knows. With fewer competitors, the prices go only one direction: UP. Americans will not put up with rationing, and they have come to expect the best care in the world, so any pretense of cost controls is just that: pretense. O-Care only expands the cancerous dynamics of the third party payer and creates more of a sense of entitlement to be paid for by the ever diminishing "other guy".

A GOP Plot

That's how the Democrats describe the response corporate America is taking to the passage of ObamaCare: The American Spectator – Obama in Rude Denial

The White House political and legislative operations were said to be livid with the announcement by several large U.S. companies that they were taking multi-million or as much as a billion dollar charges because of the new health-care law, the issue was front-and-center with key lawmakers. By last Friday, AT&T, Caterpillar, Deere & Co., and AK Steel Holding Corp. had all announced that they were taking the one-time charges on their first-quarter balance sheets. More companies were expected to make similar announcements this week.

"These are Republican CEOs who are trying to embarrass the President and Democrats in general," says a White House legislative affairs staffer. "Where do you hear about this stuff? The Wall Street Journal editorial page and conservative websites. No one else picked up on this but you guys. It's BS."

Absolutely. These companies are going to broadcast negative earnings reports in order to embarrass Obama.

The companies are taking the charges because in 2013 they will lose a tax deduction on tax-free government subsidies they have had when they give retirees a Medicare Part D prescription-drug reimbursement. Many of these companies have more than 100,000 retirees each. AT&T may have more than three-quarters of a million retirees to cover.

Pols are demanding an explanation, but when they get one, they don't like it.

"Most of these people [in the Administration] have never had a real job in their lives. They don't understand a thing about business, and that includes the President," says a senior lobbyist for one of the companies that announced the charge. "My CEO sat with the President over lunch with two other CEOs, and each of them tried to explain to the President what this bill would do to our companies and the economy in general. First the President didn't understand what they were talking about. Then he basically told my boss he was lying. Frankly my boss was embarrassed for him; he clearly had not been briefed and didn't know what was in the bill."

It isn't just the President who didn't understand his own proposal. Late Friday, House Energy and Commerce Committee Chairman Henry Waxman and Rep. Bart Stupak, chairman of the Oversight and Investigations panel, announced that they would hold hearings in late April to investigate "claims by Caterpillar, Verizon, and Deere that provisions in the new health care reform law could adversely affect their company's ability to provide health insurance to their employees."

Neither Waxman or Stupak -- who betrayed the pro-life community by negotiating for more than a week with the White House to ensure his vote on the health care bill -- had anything more than a cursory understanding of how the many sections of the bill would impact business or even individual citizens before they voted on the bill, says House Energy Democrat staff. "We had memos on these issues, but none of our people, we think, looked at them," says a staffer. "When they saw the stories last week about the charges some of the companies were taking, they were genuinely surprised and assumed that the companies were just doing this to embarrass them. They really believed this bill would immediately lower costs. They just didn't understand what they were voting on."

Pharaoh, the Ten Plagues, and Iran

The owner of Bookworm Room comments on the ten plagues of Egypt, and the relevance today: Pharaoh, the Ten Plagues, and Iran

An antisemitic Jew I know, rather than seeing the Passover ceremony as the celebration of freedom (the world’s first and for a long time only successful slave revolt), and of justice and morality (the Ten Commandments), derides the whole ceremony as the unconscionable and immoral celebration of the genocide of the Egyptian people. What troubles him so much is the fact that, after each plague, when Pharaoh seems about to soften and let the Jews go, God hardens Pharaoh’s heart, leading to the necessity of yet another plague, culminating in the death of the first born.

There’s a much more profound purpose behind the ten plagues, and that is to remind us of the tyrant’s capacity for tolerating others’ suffering, as long as his power remains in place.

What Pharaoh discovered with the first nine plagues is that life can go on, at least for the ruler, despite an increase in the burdens placed upon his people. A blood filled Nile River may, at first, have seemed appalling, but the red receded and life went on. Pharaoh still held together his government. The same held true for each subsequent plague, whether lice or boils or wild animals or frogs, or whatever: As long as Pharaoh could maintain his power base, he was okay with the incremental decimation visited upon those he ruled.

Sheltered in his lavish palace, Pharaoh might worry about a populace starving and frightened, but that was irrelevant as long as that same populace continued to fear and worship him. The people’s suffering, ultimately, was irrelevant to his goals. It was only when the price became too high — when Pharaoh’s power base was destroyed because his citizens were destroyed — that Pharaoh was convinced, even temporarily, to alter his evil ways.

Human nature hasn’t changed much in 3,000 years. Think, for example, of both the Nazis and the Japanese at the end of WWII. For the Nazis, it was apparent by December 1944 (the Battle of the Bulge) that the war was over. Hitler, however, was a megalomaniac in the pharaonic mold, and his high command, either from fear or insanity, would not gainsay him. Rather than surrendering, the Nazi high command was willing to see its country overrun and its citizens killed. Only when the death toll became too high, and it was apparent that nothing could be salvaged from the ashes, did the war on the continent finally end.
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But what about the innocent lives lost as a result of Pharaoh’s, the Nazi’s, and the Japanese high command’s intransigence? As the Japanese tale shows only too well, the innocents were always going to die, with the only question being whether they would die quickly or slowly. The same holds true for the Germans, whom the Nazis had long ago designated as cannon fodder to support their intensely evil regime. That’s the problem with an evil regime. If you’re unlucky enough to live under that regime, whether or not you support it, you’re going to be cannon fodder. Pharaoh will let you die of plagues, and the Nazi and Japanese leadership will let you be bombed and burned — as long as they can retain their power.
....
Liberals believe that it is immoral to impose serious consequences against the Iranian regime because there are innocents who will suffer from those consequences. What these liberals fail to understand is that, when power doesn’t reside in the people, but resides, instead, in a single group that is insulated from all but the most terrible strikes, imposing small plagues against the country (freezing a few bank accounts, public reprimands, vague threats) is utterly useless. These small plagues, no matter how much they affect the ordinary citizen, do not affect the decision-making process in which a tyrant engages. The only thing that will move the tyrant is to destroy his power base. Everything else is theater.

RNC '08 Report: Text: Protests Turn Violent at GOP Convention

Reports of violence by non-conservatives. RNC '08 Report: Text: Protests Turn Violent at GOP Convention

Protesting the GOP in St. Paul

It's only the conservatives who are violent? Someone forgot to tell Time magazine: Protesting the GOP in St. Paul

For a few radical demonstrators, the simple presence of GOP delegates was enough to justify throwing bricks through storefronts and a delegate-bus window, lighting a Dumpster on fire, and damaging police cars.

Stratfor looks at the security precautions taken for the convention.

This could easily have killed someone – or several someones. Man accused of tossing sandbag on I-94 pleads guilty to assault

Obamacare and Rationing

From Hugh Hewitt's blog, Rich Stowell on Obamacare and rationing:

I know a thing or two about rationing from my military service. In the Army, everything is rationed. We all get a prescribed number of the same uniform items, meals are not unlimited, and every Soldier receives the same equipment, whether he uses it or not.

On deployments, Soldiers are even given “ration cards,” to track the purchase of certain items. As a non-smoker, my tobacco rations went unused by anybody.

For supporters of Obamacare, it is utter ignorance to entertain any illusion that the government won't ration what it has dominion over.

The Congress, for example, appropriates tax dollars. With every spending bill, the public monies are rationed out to various agencies and projects. Rationing is such a basic fact of life that we take it for granted.
....
As a commuter, I ration my mileage and fuel. If gasoline were unlimited, we may not think twice about driving all over creation when it suits us. Except that we don’t have unlimited time. Each of us rations his/her time every day, choosing how it would be best spent.

So when the Democrats say that the government, now ultimately in charge of the health care system, won’t somehow try to apportion at least some of those dollars or services, they are either lying or stupid.

We are now shackled by a system that, at the direction of various government agencies, will force everybody to buy a health plan, make businesses supply insurance to their workers, and cut benefits from previously-enacted entitlements.

The president himself has touted that a crack down on waste, fraud, and abuse will save billions. Nobody defends waste, but what is wasteful to Mr. Jones might be needful from Mrs. Smith’s point of view. Who cares if the Joneses and Smiths are using their own dollars? Now they are Uncle Sam’s dollars, so he gets to decide what is needful. It may not be a death panel, but few could argue that cutting back on services isn’t a form of rationing.

An Alternative Proposal for Health Care Reform

Guest Poster David JP offers this at Air Vent: An Alternative Proposal for Health Care Reform

This may be way too late given the recent events at our nation’s capital, but I hope not. As I mentioned in my post on the People Dependent thread, I had already sent these ideas to a main-stream media outfit. They have not responded to date, which does not surprise me. But even if they do, I realize now that it would be best if these important topics are debated in public.
....
Here are my ideas for health care reform:

The health care reform ideas are broken down into three main categories:

-Insurance company reforms

-Doctors, health care providers, and malpractice insurance/lawsuits reforms

-Intellectual property reforms

For each category I’ve made the following sub-sections in an attempt to organize things better:

-What society needs

-What society can give in exchange

-What the government can do

-Sticky left over details

Insurance company reforms (modified slightly thanks to feedback in the other thread)

-What society needs:

1. Open coverage to all at a fixed price with no preconditions (only one group). People enroll during the designated open enrollment period. Contract is for one year at a time.

2. Limits on company pay ratio as determined by a vote of the investors/shareholders. If bonuses are to be given out, they must apply to all at the same ratio and include sub-contracted workers.

3. Stock that pays profit dividends to investors.

4. Excellent service as judged by the survey results of customers (patients and doctors)

-What society can give in exchange:

1. No corporate taxes so long as the above conditions are met.

2. No income tax on the dividends for the companies that deliver excellent service to it’s customers (determined from the survey results).

-What the government can do:

1. Administer/manage the surveys to doctor and patients.

2. Provide income tax deductions to help people purchase the insurance based upon income levels/need (this replaces the benefit that large companies give their employees to purchase group insurance, my company currently pays about half of my luxury insurance costs).

-Sticky left over details:

What to do with the healthy folks that could afford to, but won’t purchase the insurance? First let me boldly say based upon extensive personal experience: if you aren’t rich enough to be self insured, it’s pure stupidity to not purchase health insurance if you can afford to do so. You stand to loose everything you have along with garnished future wages if something catastrophic happens to you and you don’t have health insurance.

The government and the insurance lobby seems to favor mandatory enrollment for those who don’t buy. I’m more in favor of the penalty for those caught sick without the coverage they could have afforded. The penalty could be the lesser of:

-paying for the costs outright (with a payment plan negotiated through the collection agency if you’re not rich)

OR,

-paying a penalty of 10 years worth of past insurance premiums (on a payment plan) with a further commitment to buy health insurance coverage for future needs.

Since the open enrollment will only occur for two weeks out of the year, and if it’s in November for selecting coverage the following year, then there isn’t much of an opportunity to game the system by waiting to buy the insurance the day you get sick.

There's lots more – this is a very long post.

Anything can be a serious threat...

...with enough imagination.

John Hinderaker at PowerLine looks at the "threats" Paul Krugman is seeing: Sun Rises In East; Krugman Makes Fool Of Himself

After referring to "the wave of vandalism and threats aimed at Democratic lawmakers"--no mention of Eric Cantor's office being shot at, death threats against Sarah Palin, etc.--he continues:

What has been really striking has been the eliminationist rhetoric of the G.O.P., coming not from some radical fringe but from the party's leaders. John Boehner, the House minority leader, declared that the passage of health reform was "Armageddon."

Is that scary, or what? An "Armageddon" is "any great and crucial conflict." I think the debate over health care qualifies, and, judging by their own statements, so do the Democrats. Krugman continues:

The Republican National Committee put out a fund-raising appeal that included a picture of Nancy Pelosi, the speaker of the House, surrounded by flames, while the committee's chairman declared that it was time to put Ms. Pelosi on "the firing line."

This is downright funny. Krugman, in his usual dishonest-but-ineffective way, forgets to mention the whole point of the RNC fund-raising appeal, i.e., "Fire Pelosi."

And the Weekly Standard recalls another threat that seemed perfectly OK with Krugman in the past:

This is the same Paul Krugman who wrote in December:

"A message to progressives: By all means, hang Senator Joe Lieberman in effigy."

Update: A friend of TWS reminds us that effigies were actually burned at Krugman's 2008 election party:

...We had two or three TVs set up and we had a little portable outside fire pit and we let people throw in an effigy or whatever they wanted to get rid of for the past eight years.”

“One of our Italian colleagues threw in an effigy of Berlusconi.”...

The costs of Obamacare

It's what's known as an "announcement effect". People don't only change their behavior in response to incentives, they pay attention to incentives that are announced as coming up, and change behavior to prepare for them. This piece in the Wall Street Journal gives examples of: The ObamaCare Writedowns

ObamaCare passed Congress in its final form on Thursday night, and the returns are already rolling in. Yesterday AT&T announced that it will be forced to make a $1 billion writedown due solely to the health bill, in what has become a wave of such corporate losses.

This wholesale destruction of wealth and capital came with more than ample warning. Turning over every couch cushion to make their new entitlement look affordable under Beltway accounting rules, Democrats decided to raise taxes on companies that do the public service of offering prescription drug benefits to their retirees instead of dumping them into Medicare. We and others warned this would lead to AT&T-like results, but like so many other ObamaCare objections Democrats waved them off as self-serving or "political."
....
On top of AT&T's $1 billion, the writedown wave so far includes Deere & Co., $150 million; Caterpillar, $100 million; AK Steel, $31 million; 3M, $90 million; and Valero Energy, up to $20 million. Verizon has also warned its employees about its new higher health-care costs, and there will be many more in the coming days and weeks.

As Joe Biden might put it, this is a big, er, deal for shareholders and the economy. The consulting firm Towers Watson estimates that the total hit this year will reach nearly $14 billion, unless corporations cut retiree drug benefits when their labor contracts let them.

The political response: Blame the victims.

Meanwhile, Henry Waxman and House Democrats announced yesterday that they will haul these companies in for an April 21 hearing because their judgment "appears to conflict with independent analyses, which show that the new law will expand coverage and bring down costs."

Because of course, politicians know a corporations' costs so much better than they do themselves.

Investment Advice

From Cafe Hayak: Investment Advice

Rep. Henry Waxman is angry that corporations are now writing down the losses they anticipate they’ll incur as a result of Obamacare. So he’s demanding that many of these firms’ executives testify before Congress to explain this practice that he says “appears to conflict with independent analyses, which show that the new law will expand coverage and bring down costs” (“The ObamaCare Writedowns,” March 27).

Overlook Mr. Waxman’s arrogant heavy-handedness and ask: if Mr. Waxman is correct, why aren’t he and those who trust his judgment now buying shares of these companies? By making these companies appear to be less valuable than Mr. Waxman believes them really to be, the writedowns will lower these companies’ share prices. If Mr. Waxman buys now, when Obamacare’s promised cost-reductions materialize these writedowns will prove to have been mistaken, the companies’ share prices will rise, and Mr. Waxman – having put his money where his brilliant mouth is – will be rich.

Sincerely,
Donald J. Boudreaux

On the other hand, I've just started buying shares of Toyota. I got 330,000 miles out of my last van, and right now they're a victim of bad publicity.

Democrats' deafness reaps hate mail

Nolan Finley writes in the Detroit News: Democrats' deafness reaps hate mail

People get loud and angry when they feel as if they're being ignored.

Unfortunately, they sometimes also get ugly.

Democrats stubbornly refused to listen to the tremendous public outcry against their health care package. They attempted to minimize the protests and marginalize the protesters. But now that they've shoved the bill down America's throat, they're feigning shock -- and even fear -- at the vehemence of the backlash.

They say they're being terrorized by potentially violent opponents of the health care bill, and produce stacks of letters, e-mails and phone messages they claim make them fearful of their lives.

Sprinkled among them are what may be a few legitimate threats. This is a wholly unacceptable way to react to losing a political fight, and should be dealt with seriously by law enforcement agencies.

But most of what is being passed off as menacing is nothing more than old-fashioned hate mail. Much of it is crude and offensive, a lot of it is inappropriate, but it doesn't rise to the level of a threat.
....
Rep. Mark Schauer, D-Battle Creek, takes as a threat a message expressing the wish that he die a slow and painful death from cancer. That's nasty business. But it's no worse than the e-mails that pop into my inbox.

For a long stretch, I heard from a detractor who wanted me separated from body parts that I'm rather fond of. I felt intensely unloved, but never in danger of losing my vitals.

There's nothing new here. Hatred has been part of politics for some time. Ask former President George W. Bush about his mail. Bush loathers even made a movie fantasizing about his assassination.

The real threat presented by the hate mail is to the Democratic pretense that they've passed a bill demanded and welcomed by the American people. Neither Stupak nor Schauer can say with any credibility that their votes represented the will of their right-of-center Michigan districts.

Let’s Take a Look At the Record

Penny Nance at Big Journalism looks at the record on violence and rumors of violence: » As Accusations of ‘Violence’ Flow, Let’s Take a Look At the Record - Big Journalism

...are the threats of violence just a charade to distract Americans from learning about what the massive healthcare bill really does? I think so.

Could you imagine what would happen if someone set fire to, say, Nancy Pelosi’s church? (Does she even go to church?)

Or what if a Congressman who supported healthcare reform was beaten up so badly that he had to have stitches on his eye? How about if a Congressman’s car window was shot out because he opposed healthcare reform?

The same media so excited to rush to protect the “defenseless” Congressmen barely mentioned that someone set Sarah Palin’s church on fire or that private citizens in California were personally harassed and targeted for simply suggesting that there should be a ballot initiative on marriage, or for donating to it.

That’s right, Sarah Palin’s church was damaged by arson after the 2008 election. One man in Modesto, CA was beaten to a pulp because he was handing out “Yes on Prop 8” stickers and a pastor’s car was shot up because he also supported a ban on gay marriage.

On the Road to Serfdom

Linked from Patterico's blog:

"...This is also an income shift. it's a shift -- a leveling to help lower income middle income americans . Too often of late, the last couple -- three years, maldistribution of income in america's gone up way too much. The wealthy are getting way, way too wealthy. And the middle income class is left behind. Wages have not kept up with the increased income of the highest income americans. This legislation will have the effect of addressing that maldistribution of income in America, because health care is now a right for all americans, and because health care is now affordable for all americans."

And here's Howard Dean:

Doctor shortage could worsen as more people become insured and demand care, experts say

Linked from Patterico, A first look at Obamacare's Impact: Doctor shortage could worsen as more people become insured and demand care, experts say

As I interviewed everyone from hospital executives to insurance industry leaders for a story slated to run Sunday about the health care law President Obama signed this week, I heard a common refrain: Coverage does not equal access.

In plain English: Insuring a bunch of people in a few years is no guarantee they will actually get access to medical care. Why? Because Texas, along with the rest of the country, has a shortage of doctors. It’s especially acute in primary care. And it is expected to worsen as more uninsured people get coverage.

How did this shortage happen?

A lot of studies, including some cited in this space, list various reasons: Primary care doctors don’t get paid as much as other doctors, and they don’t get reimbursed for talking to their patients about how to stay healthy. The average doctor graduates from medical school with $150,000 in debts, according to Dr. James Rohack, president of the American Medical Association. With that kind of debt, many of them can’t afford to get into primary care.

What did Republicans do to the economy?

PowerLine links to a post at A Goy and his Blog, with lots of data on the Republican economy. A Goy and his Blog » Blog Archive » Every picture tells a story. Don’t it.

More Thoughts On Liberal Political Violence

Threats go both directions. The left whines about them a lot more. Power Line - More Thoughts On Liberal Political Violence.

The Democrats have tried to change the subject away from their health care debacle by claiming that conservatives are threatening violence against them. Their complaints are pathetic where they are not out-and-out lies (e.g., Clyburn and Lewis), and they have taken a lot of well-deserved criticism. It is liberals, not conservatives, who rely on ad hominem attacks, outrageous allegations and violent imagery. We talked about this on our radio show today, and several callers reminded us of a particularly sorry episode of liberal violence that, for some reason, has not gotten much attention: the 2008 Republican convention in St. Paul.

I attended the convention and remember the terrorist acts that were carried out by anti-Republican protesters very well. They threw bricks through the windows of buses, sending elderly convention delegates to the hospital. They dropped bags of sand off highway overpasses onto vehicles below. Fortunately, no one was killed.

These were anti-Bush and anti-Republican protesters. Is it a stretch to think that some of them, at least, may have been inspired by over-the-top, hateful attacks on the Bush administration by Democratic Congressmen, DNC Chairman Howard Dean, Michael Moore, who was a guest of honor at the Democrats' own convention, various show business personalities, and many other leading liberal figures? I don't think so. We haven't seen that sort of hate campaign since the Democrats went after Abraham Lincoln. It seems unlikely that none of the "protesters" who tried to commit murder were inspired by those liberal voices.

Yet, hardly anyone seems to be aware of the violence that took place in 2008. At most, the story was treated with a ho-hum attitude in the press. For some reason, political violence was not a concern less than two years ago. Yet today, we can hardly imagine what would happen if a group of tea partiers were to drop sandbags off a highway overpass, trying to kill motorists below. Liberal reporters' heads would explode. Yet this is exactly what anti-Republican Party protesters did in 2008, and no one cared. To my knowledge, not a single Democratic politician condemned this anti-Republican violence or attempted in any way to distance the Democratic Party from it.

Wehner vs. Corn on Bush and the Iraq War

Peter Wehner takes on David Corn on the charge that Bush Lied. Round 4: Wehner vs. Corn on Bush and the Iraq War -- Politics Daily

Round three appears to be this piece: Iraq War Debate: Surge Success, Intelligence Mistakes, Civilian Casualties.

Round one: The Iraq War: Suddenly, It's Not So Bad After All.

Responses by David Corn: Iraq War Triumphalism Ignores a Key Matter: Dead Civilians, Can the 'Bush Lied' Deniers Handle the Truth?

Trying to save costs on health care

In the wake of the passage of ObamaCare, businesses are cutting programs and laying off employees. businesses react to rising cost of obamacare they're cutting benefits: Tech Ticker, Yahoo! Finance

In Great Britain, the NHS is preparing to make cuts as well: Hospital wards to shut in secret NHS cuts. Those beans weren't supposed to be spilled until after the elections.

Double standards on hate

From the Bookworm Room:  The quivering, whining cowards on the Left

Pitchfork brigades

When Barack Obama decided to launch his political career in the living room of unrepentant domestic terrorist Bill Ayers, he tacitly endorsed using violence as a political tactic.

....

Later that day, at an anti-ObamaCare rally in St. Louis, a black man named Kenneth Gladney was handing out "Don't Tread on Me" flags when he was approached by pro-ObamaCare SEIU union members. One of the men asked Gladney, "What kind of n*%%er are you to be giving out this kind of stuff?"

The union thugs then beat him so badly he required overnight hospitalization.

Obama's supporters got the message. They were getting in people's faces, and they were punching. And kicking. Repeatedly.

Megan McArdle on predicting the future of health care

Prediction is Hard, Especially About the Future

She offers predictions anyway.

About that hate...

http://townhall.com/columnists/MichelleMalkin/2010/03/26/how_the_left_fakes_the_hate_a_primer?page=full&comments=true

 

 

About death threats

From Victor Davis Hanson at NRO:

This week's talking point is the sudden danger of new right-wing violence, and the inflammatory push-back against health care. I'm sorry, but all this concern is a day late and a dollar short. The subtext is really one of class — right-wing radio talk-show hosts, Glenn Beck idiots, and crass tea-party yokels are foaming at the mouth and dangerous to progressives. In contrast, write a book in which you muse about killing George Bush, and its Knopf imprint proves it is merely sophisticated literary speculation; do a docudrama about killing George Bush, and it will win a Toronto film prize for its artistic value rather than shock from the liberal community about over-the-top discourse.

Hate and threats

In the wake of news reports of threats made against Democrats who voted for ObamaCare, some additional stories:

 

From GatewayPundit: Racist NH Dem Rep on Japanese: "2 Nukes Just Wasn't Enough"

 

Stunner. Politico Changes Their Bogus Coffin Story But Won't Admit It

 

GOP Whip Eric Cantor's Campaign Office Is Shot At

Republican Jean Schmidt Receives Threats Over Health Care Stance

 

From HotAir: Cantor: Democrats "dangerously fanning the flames" by screeching about security threats

And I wonder how many threats wound up on Sarah Palin's answering machine.

Rasmussen: 55% Favor Repeal of Obamacare

Rasmussen: 55% Favor Repeal of Obamacare

Rasmussen:

The latest Rasmussen Reports national telephone survey, conducted on the first two nights after the president signed the bill, shows that 55% favor repealing the legislation. Forty-two percent (42%) oppose repeal. Those figures include 46% who Strongly Favor repeal and 35% who Strongly Oppose it. ...

Most senior citizens (59%) also favor repeal. Earlier, voters over 65 had been more opposed to the health care plan than younger adults. Seniors use the health care system more than anyone else. But 58% of those 18 to 29 also support repeal of the plan which requires all Americans to have health insurance.

Coward Russ Carnahan Pushes Bogus Tea Party Lie to Media– Claims Prayer Serv...

Coward Russ Carnahan Pushes Bogus Tea Party Lie to Media– Claims Prayer Service With Coffin Was a Violent Threat

Remember as you read this: There is nothing the democratic-media complex will not do to lie about the tea party patriots or to prop up these horrid leftists who are transforming our country into some kind of quasi-socialist state.

On Sunday night several members of the St. Louis Tea Party Coalition held a prayer vigil at Russ Carnahan's office for the millions of babies that will be slaughtered under the democrat's pro-abortion health care bill. We also prayed for the handicapped and the elderly who will be turned away as they face the death panels created by this bill. And, as we stood outside his office in the rain, we prayed for our country and for the democrats in Washington DC who were stealing away our freedom at that very moment.

We brought a coffin with us to represent the millions of Americans who will suffer from inadequate treatment and perish under Obamacare.

(KSDK Photo)

Local reporters from KSDK News Channel 5 showed up to interview myself and others after our prayer service.

KSDK put together this report on our peaceful protest:

In St. Louis, people on both sides of the issue gathered to watch the vote. Those in favor of healthcare reform came to celebrate, those opposed came to mourn.

For the Tea Party protesters, it was a somber night. Jim Hoft says, "We're sad about what's going on tonight in Washington D.C."

And so complete with candles and casket, they held a funeral, grieving over the heathcare changes to come.

Hoft says, "We believe they're taking away our freedom and this represents death to part of what we've grown up with."

And the tears here were very real. Cynthia Rice says, "It'll change everything for us."

After our prayer service we took our coffin and went and prayed on the sidewalk outside of Russ Carnahan's home.

We prayed for Russ Carnahan. We prayed that God would forgive him for taking away our freedom. We prayed for the babies who will never feel the warmth of the sun or a gentle spring rain. We prayed for the elderly who will die waiting for care because they couldn't make it past the Obama death panels.

We prayed for Russ Carnahan.

So obviously it came as quite a shock tonight to see that the Carnahan people and the Democratic-media complex had twisted this innocent prayer vigil into some kind of threat against Russ Carnahan.
The Politico reported:

A coffin was placed on a Missouri Democrat's lawn, another in a string of incidents against lawmakers after their vote Sunday on a health care overhaul.

Rep. Russ Carnahan (D-Mo.) had a coffin placed "near his home," a spokesman said Wednesday evening.

"Carnahan appreciates thoughtful feedback received both in favor and opposition of health insurance reform," Carnahan spokesman Jim Hubbard told POLITICO Wednesday evening "We can disagree on important issues facing our country without resorting to this kind of thing. Russ Carnahan isn't going to shy away from the importance of reform when 45,000 fellow Americans died last year due to a lack of health insurance."

Of course, this is a complete lie.

Russ Carnahan is so frightened to meet with his constituents after his very unpopular vote that he is now lying about a prayer service. This is despicable. Russ Carnahan never said anything when his SEIU supporters beat, kicked and stomped on Kenneth Gladney in a parking lot outside one of his events. These were the same supporters he was sneaking into one of his staged town halls. Instead of apologizing for his supporter's violence, he is making up stories about peaceful tea party protesters at a prayer service.

This won't stand. There was a time Russ Carnahan and the Politico could get away with this awful lie. Those days are over. We demand that the liberal cranks at Politico and Russ Carnahan retract their dishonest tea party hit piece.

See also… Russ Carnahan fears the reaper.

UPDATE: The Carnahans told reporters that the coffin was left on their lawn. This is an absolute lie. We had a prayer service and then left. The state-run media didn't bother to follow up on this outrageous lie before they published their hit piece. The coffin is currently in a member's garage…. Oh, and the protest was on SUNDAY not Wednesday.

Rights and Health Care

Steven Horowitz at The Freeman draws a distinction between positive and negative rights:

In debates over entitlements many on the left frequently invoke the idea that whichever one happens to be at issue — health care, education, pensions — is a "right," and therefore we should not worry about costs.  After all, they say, did the authors of the Bill of Rights worry about "costs" when they passed the First Amendment?

As seductive as that analogy might be, it's utterly misguided because it ignores the important distinction between negative and positive rights.  Negative rights, such as the right to free speech, limit the State's power to interfere with choices citizens might make. The First Amendment begins, "Congress shall make no law…."  Negative rights do not require other people or entities to provide human or material resources to make that right a reality.  Others are simply required to refrain from doing things that interfere; hence, the term "negative right."

Positive rights, by contrast, require others to provide such resources.   For a "right" to health care or education to have real meaning, it must entail the ability to coerce others into providing health care or educational services as needed.  As philosophers say, rights are trumps.  A right to free speech overrides the utilitarian calculations of particular circumstances.  If you have a right to your property, it doesn't matter how good the thief's reason for stealing it is.

....

I suspect that when leftists say people have a right to health care and education, they mean something different and that they are confusing means and ends.  They seem to think that declaring something a right is an end in itself — simply doing so assures that the object of that right is secured.  As I recently noted, this is the equivalent of the magical thinking of South Park's "Underpants Gnomes," whose business plan was:  "Phase 1:  collect underpants;  Phase 2:   ?????;  Phase 3:  Profit."

Here's the upshot: Declaring things like health care and education rights is an empty gesture unless one specifies what sorts of institutions would actually deliver those things and how those institutions would muster the knowledge and incentives to get the job done.  Phase 2 has to have content to explain how the promised results of Phase 3 will be delivered!  Merely declaring something a (positive) right does nothing to ensure that people will actually get what they allegedly have a right to.

The issue looks different if we think instead about positive rights as means rather than ends.  If those who defend such rights were actually saying, "I think we should declare health care a right so that the largest number of people possible get the best health care possible," at least they would be raising the right question.  In response, libertarians might say, "Is declaring health care a 'right' really the best way to accomplish that goal?"

Here, as is often the case, libertarians might generally agree with leftists on the end: a society in which the largest number of people possible have the best health care possible.  The question is how to make that happen.  In responding to the claim that we need to declare health care a right, we must insist on knowing what particular institutional arrangement will be put in place to make that right real and then we must critically assess whether those institutions would do the job.

The decline of medicine

From The Freeman:

 

There has been much talk of people leaving the medical profession if government further bureaucratizes health care. But the odds are great that there won't be any dramatic job stoppage. No medical "Galt's Gulch" will form where masses of physicians on strike will live in peace and solitude, some building cars and others mining copper, all vowing never to return to medicine until their demands are met. Such is the stuff of fiction. But the reality is much worse.

What will happen is more insidious, though over time no less damaging. There will be an increase in early retirement, as more physicians tire of their jobs. More physicians will take time off and let their practices suffer at the margin. Patients will have slightly more difficulty making appointments . . . each year . . . year after year, though never so quickly as to lead to mass complaints or a recognition that things are obviously worse.

....

The filter of who gets into medical school will change. Fewer will enter the field due to intellectual curiosity. More and more people who cannot tolerate bureaucracy will be weeded out. Questioning authority will become as dangerous in medicine as it is in policing or the military. The 40-hour physician work week, on the other hand, will become commonplace, and the type of person attracted to medicine will not be the type who is willing to work any longer, or any harder.

Health care will be less a service than a commodity. All your complaints will have answers, if not always the right answers. Workups will be standardized by "expert panels" allegedly educating physicians as to "best practices." And if the "best practice" is to not treat you because it is not cost-effective to society, the fact that you want and are willing to pay for the treatment will be seen as a problem rather than a solution.

These panels are designed to save money by making workups more efficient and uniform, but the reality is different. More expensive imaging tests routinely substitute for less expensive physical exams because the quality of physical exams varies and doctors have little incentive to improve their own abilities at examination. Not only is it becoming something of a lost art ("Why use a stethoscope to listen for a heart murmur when we can just see it on a cardiac ultrasound exam?"), but it takes time. And since doctors are paid by third parties more concerned about efficiency than quality, taking time with patients—improving one's diagnostic exam skills—is a luxury fewer and fewer physicians can afford.

Does this sound unbelievable? It is happening already. In the 1990s the Office of Inspector General investigated major teaching hospitals in America. Taxpayers are billed by such institutions for training new generations of physicians. PATH (Physicians at Teaching Hospitals) audits found patients in these hospitals were commonly evaluated by medical students or interns only. Attending senior physicians were fraudulently simply "signing off," saying, "I agree," without ever seeing the patient. The University of Pennsylvania Hospital settled a PATH dispute for $30 million, and Thomas Jefferson University Hospital did so for $12 million. Anecdotes describing such problems abound, including hospital charts saying, "Physical exam shows both pupils equally reactive to light," when the patient had actually been blind in one eye for decades, a mistake much more easily attributable to the exam's never having been done than to error.

....

Pharmaceutical innovation, produced by those evil for-profit companies that even doctors love to denounce, will drop off. Not precipitously, but eventually. And people will die, as they have died since time immemorial, without anyone ever knowing what drugs might have improved or extended their lives, if only there had been greater incentives to produce them.

Where Have All The Werewolves Gone?

Long time passing...

This article from the Fortean Times looks at why werewolves have faded from the list of things to be afraid of. (source).

For most of recorded history, the half-man, half-wolf lycanthrope reigned supreme as the creature travellers most feared encountering in the woods and along dark roads at night. Numerous legends concerned werewolves – the awful deeds they committed, how to protect against them, how to kill them – and belief in their reality can be found in many cultures from ancient times to the present. But while the werewolf still holds a place in fiction and films, few people today actually fear meeting one in reality. Many individuals and groups actively search for cryptids, but there are no werewolf-hunting organisations. So – where have all the werewolves gone?

It's Darwin's fault.

...In 1843, some years before the publication of the Origin, he wrote to fellow naturalist GR Waterhouse (1810–1888), who had just published an article on biological links. “I never understood,” Darwin wrote, “a half-way link, but merely one in a long series. I think you have done good service in pointing out how rare half-way-links are, if indeed they exist… one cannot have a simple species intermediate between two great families.” [4] In general, such attitudes, along with the view that dogs and primates followed two very different lines of descent, suggested they could in no way join together or one turn into the other. Natural historians had also shown that while various living organisms could change their shape or colour temporarily, when threatening or being threatened, for example, none could shape-shift in the manner attributed to werewolves.

The scientific method and evolutionary theory put such a stain on monsters that by the end of the century any attempt by naturalists to engage with them could be seen as an intellectual step backward – a problem which still haunts crypto­zoology today. In 1886, Cornell University physio­logist Simon Henry Gage believed monsters and mythical creatures had finally been put down. “Fairies are fled,” he wrote, “the genii banished the mermaid and the remora are captured.”

Health Care in 2020

Reason Magazine's Ronald Bailey powers up the TARDIS and offers his view of health care from the year 2020.

 

With 2020 hindsight, things have gotten a bit better for everyone, but some major benefits have gone by the wayside:

 

Thanks to the health care reform legislation, a higher percentage of Americans are now covered by health insurance than ever before—up from 83 percent in 2010 to nearly 95 percent of the legal population now. About half of the newly insured are covered by Medicaid and Children's Health Insurance Program. Most of the remainder purchased subsidized coverage through the new state insurance exchanges. There have been some improvements in the overall health of Americans. Cardiovascular disease continued its decline because cholesterol lowering statins, which are no longer under patent protection, are more widely prescribed under new federally set treatment guidelines. Over the past 10 years, cancer mortality rates have also continued to decline, at least in part because people now covered by government programs or subsidized insurance now receive earlier cancer screening. Nevertheless, in 2020, cardiovascular disease and cancer remain the leading causes of death among Americans.

It seems like 2020 is a good time for American health care. But these benefits are what 19th century economist Frederic Bastiat would call the visible, or "seen" effects of health care reform. Bastiat pointed out that the favorable "seen" effects of any policy often produce many disastrous "unseen" later consequences. Bastiat urges us "not to judge things solely by what is seen, but rather by what is not seen." A bad economist looks only at seen effects, according to Bastiat, while a good economist tries to foresee the unseen effects of a policy. So trying to play the role of a good economist, what were some of the deleterious unseen effects of health care reform enacted back in 2010?

Since 2010, insurance companies had been turned essentially into public utilities with the feds setting strict minimum benefits requirements. The health reform bill also limited the administrative costs of insurers, which has ended up basically guaranteeing their profits. With competition all but outlawed, the increasingly consolidated insurance industry has had very little incentive to pay for new treatment regimens outside those specified by government standard-setting agencies. Federal government health agencies have been reluctant to authorize newer treatments because they often lead to higher insurance premiums that then must be subsidized by higher taxes.

Then there is the doctor dearth. The signs of the impending shortage were already clear back in 2010. For example, as reimbursement rates from government health care schemes tightened, more and more doctors were refusing to accept Medicaid and Medicare patients. After health care reform passed, the physician shortage was exacerbated when many doctors faced with declining incomes simply chose to retire early. Already bad in many areas back in 2010, waiting times for a doctor's appointment 10 years later have nearly quadrupled, reaching the Canadian and British average of about 110 days.

The hardest unseen effect of health care reform to evaluate is what it did to biomedical innovation. Innovation is a trial-and-error process, and making predictions about what might have been is speculative at best. But let's take a look back at where budding biomedical technologies to treat cancer, replace damaged organs, and develop new vaccines stood back in 2010.

Big pharmaceutical companies initially did fairly well under health care reform, but as the cost of health care rose partly as a result of covering more Americans, Congress enacted legislation allowing government health care schemes to "negotiate" pharmaceutical prices. The negotiation requirement quickly devolved into price controls that have ultimately turned the big drugmakers into little more than cost-plus government contractors. In addition, the feds have established a comparative effectiveness evaluation commission similar to the British National Institute for Health and Clinical Excellence which limits patient access to treatments based on their overall cost-effectiveness. The result of these restrictions is that investments in pharmaceutical and biotech research and development have fallen off sharply.

....

The seen aspect of health care reform is that it has had some success in providing more Americans with access to vintage 2010 medical therapies. The unseen aspect is that more people are suffering from and dying of diseases that might well have been cured had the Obama version of health care reform never been enacted. As a result of health care reform, Americans forfeited 2020 medicine in favor of more equal access to 2010 treatments.

 

Rationed health care?

http://corner.nationalreview.com/post/?q=ODlkNmVkYmVjMDUxODRjYmUxZjA5ZGVlZGU0NGM4MmQ=

A View from Britain

[Ramesh Ponnuru]

A British friend who has been following the health-care debate writes in:

....

Rationing is implicit in both Obamacare and the NHS. But the customers of both systems are very different. Most modern Americans get good health care. They have learned to expect it. They will complain if they don't get it. And they have their present care as a method of comparison to any new system. Brits in 1948 had just survived a terrible war. Rationing was part of their everyday lives. They were a deferential people to begin with in a much more hierarchical society. Brits of today would be much much harder to convince—if they had not got used to getting free but inadequate health care.

....

Predictions for Obamacare

From NRO.

The bill will cost more than advertised. It won’t be long before Congress is shocked — shocked! — to discover that health-care reform is going to cost a lot more than expected.

Insurance premiums will keep rising. The president has tried to convince people that health-care reform will cut their insurance costs. They are in for a surprise. According to the Congressional Budget Office, insurance premiums will double in the next few years.

The quality of care will be worse. Doctors’ reimbursements for providing care will be squeezed, making it harder to find a doctor.

The Left will keep pushing for more. Speaker Nancy Pelosi’s inner censor was clearly on the fritz this week when she said, “Once we kick through this door, there’ll be more legislation to follow.” Faced with rising costs and higher premiums, not to mention millions still uninsured, Democrats will blame the “evil” insurance companies and demand further reform. They will argue that we tried “moderate” reform and failed.

Republicans won’t really try to repeal it. Republicans will run this fall on a promise to repeal this deeply unpopular bill, and will likely reap the political advantages of that promise. But in reality there is little chance of their following through. Even if Republicans were to take both houses of Congress, they would still face a presidential veto and a Democratic filibuster.

Democrats Must Take Responsibility for What Comes Next in Health Care

The Doctors of the House: Democrats Must Take Responsibility for What Comes Next in Health Care - WSJ.com

Mr. Obama and the Democrats have sold this takeover by promising that multiple benefits will follow: huge new subsidies for the middle class; lower insurance premiums for consumers, especially those in the individual market; vast reductions in the federal budget deficit and in overall health-care spending; a more competitive U.S. economy as business health-care costs decline; no reductions in Medicare benefits; and above all, in Mr. Obama's words, that "if you like your health-care plan, you keep your health-care plan."

We think all of this except the subsidies will turn out to be illusory, as most of the American public seems intuitively to understand. As recently as Friday, Caterpillar Inc. announced that ObamaCare will increase its health-care costs by $100 million in the first year alone, due to a stray provision about the tax treatment of retiree benefits. This will not be the only such unhappy surprise.

8 Predictions for Health Care

At The Atlantic, Megan McArdle offers eight predictions for health care, now that ObamaCare has passed the house: 8 Predictions for Health Care.

My predictions:

1) Conservatively, Ezra's arithmetic implies a reduction in the death rate of people between 18-64 of at 20,000-45,000 a year. Let's take the low bound--20,000 deaths a year--and assume that we should see that, or something close to it, by 2020. That's about 3% of deaths in the relevant age group, which would show up as a very noticeably kink in the death rate. For comparison purposes, the entire fall in mortality between 1980 and 2000 was about 2.7%.

Contra Ezra, I am predicting that this will not happen. I'm about 75% confident that you will not be able to discern any effect from the health care reform among the statistical noise. But I am 95+% confident that the effect will not be as large as 3%.

2) I'm pretty sure that Kristof read the table he was drawing from wrong--he was looking at life-expectancy at birth, but he interpreted the data as if it was about adults in the 1940s. Still, age-adjusted mortality fell about 15% in just 10 years, an achievement that hasn't been matched since. If Kristof is right, and this had more to do with health care access than antibiotics, we should be able to get a similar improvement this time around--especially since we're already seeing terrific reductions, with a 10% decline in age-related mortality just between 2001-6. Hell, both Ezra's numbers and Kristoff's imply that we should be able to knock down the death rate by at least 20% between 2014 and 2024, when we add their improvements to the existing trend.

I do not think that there will be a noticeable kink in the trend line around 2014. The death rate jumps around quite a lot, so there may be a big drop (or increase) in 2014, neither of which would be meaningful. By 2025, however, I'm skeptical that we'll see a major inflection in the trend.

3) David Himmelstein claims to believe that the majority of all bankruptcies are related to medical issues, and that this is a strong argument for national health care . . . i.e., he claims to believe that medical bills rather than income loss are the main causal driver here. That's the data Michael Moore is citing. I will make a bold counterclaim: the bankruptcy rate after 2014 will not fall by half. It won't even fall by a quarter. This is among the easiest effects to measure, as if the people citing these statistics are right, we should see a sharp and immediate reduction in bankruptcy rates in the first year, with the full effects evident by 2018.

4) Infant mortality should be no greater than that of the Netherlands by 2018. Again, I predict that this will not happen, and indeed, that infant mortality rates may not fall at all.

5) I predict at least one of the major funding sources, and possibly all of them, will be substantively repealed: the Medicare cuts (except Medicare Advantage), the excise tax, and so forth.

6) This program will not reduce the rate of growth in medical costs by anything like 1.5% a year.

7) A fiscal crisis of some sort is quite likely by 2030, though not just because of this program. But this program will make it worse, either by increasing the deficit directly, or by using up the low-hanging fruit that should have funded Medicare reform.

8) By 2030, there's an 80% chance that the government will have imposed substantial price controls on pharma and other medical technology--and this will noticeably slow the rate of innovation.

I feel like any reasonable proponent of health care reform should be willing to take the other side of most of these bets, without weaseling that this isn't the health care reform that you wanted. If you aren't confident that we can get at least some of these results, than we shouldn't have committed to spend $200 billion a year . . . and you shouldn't have deployed these arguments in the run-up to health care.

Obama’s Pseudo-Achievement

Obama's Pseudo-Achievement

Give him this: Barack Obama did not lay down. He and his advisers surveyed the political field after the election of Scott Brown and they saw their own potential epitaph — not in the rejection of his ideas but in the potential exposure of his weakness. A president cannot seem politically weak; much if not most of his ability to act is predicated on the notion that he is the strongest public official in the country. They determined that they had to push health care or die, and they worked their will relentlessly, and they got what they wanted. These are tough and resourceful political players, and they played this one very well.

And yet one must not get carried away. The story here is not that he succeeded against all odds and with the winds against him to push through historic legislation, even though that is what the media would have you believe. The story is that a party holding a 75-seat margin in the House of Representatives was barely able to squeak by with its greatest legislative priority and most devoutly desired policy. That is the salient fact here. What Obama pulled off was a textbook example of raw intra-party discipline; the unpopularity of the measure and its political consequences remain exactly as they were before the vote.

They passed it.

From the Wall Street Journal: Democrats Expect to Have Health Votes.

And later on, it seems they did indeed have them. 219 to 212.

The biggest transformation of the U.S. health system in decades won approval on Capitol Hill late Sunday, the culmination of efforts by generations of Democrats to achieve near-universal health coverage.

Facing voters' judgment in the fall, Democrats bet they could overcome public misgivings on a bill that reshapes one-sixth of the U.S. economy. The final battle on the House floor exposed again the divisions that have riven Congress and the nation over the past year.
....
Still to be voted on late Sunday night was a companion bill making changes to the Senate bill, a measure necessary to attract support in the House. After House approval, those changes still need to go before the Senate.

I wonder what incentive the Senate will have to pass those changes. They have the House's votes. What will the House do if the Senate reneges? Can they mount a recall vote?

I'm sure it won't be a problem, because the Senators will do the honorable thing and keep their promises.

The legislation will extend health coverage to 32 million Americans now without insurance, according to the Congressional Budget Office. It will mandate that almost every American carry health insurance...

I thought the insurance companies were the bad guys. So we force more people to do business with them? That'll sure show 'em!

Democrats are highlighting popular provisions, such as one that requires insurance companies to accept all comers, even people who are already sick.

In that case, why buy insurance? If the fine for not having insurance is low enough, just pay that until you get sick. I can see insurance companies bleeding money over this, or raising their rates. But they'd have to raise rates on everyone, otherwise it's discrimination against people with pre-existing conditions.

The bulk of the legislation wouldn't take effect until 2014. Once the tax credits and Medicaid expansion are in place, most Americans will be required to carry health insurance or pay a fee, topping out at either $695 a year or 2.5% of income.

Employers would have to provide affordable insurance or pay a penalty of up to $3,000 per worker.

So an individual whose health insurance costs more than about $58/month is better off just paying the fine. (Well, if he makes no more than $27,800/year, that is – about $13.90 per hour.)

An employer whose employee costs more than $250/month to insure is better off paying the penalty.

I think my employer pays a little under $500/month for my insurance.

One of the rabid proponents I've been crossing swords pointed me at this piece: If the Senate bill passes, here’s what happens immediately.

1. Adult children may remain as dependents on their parents’ policy until age 26

Heretofore, insurance policies have assumed they need carry children only until 18, 21, or maybe older if the kid's in college. This is bound to increase the expense to the company. Probably not a whole lot, as people that age are usually pretty healthy, unless they do something stupid.

Children under age 19 may not be excluded for pre-existing conditions

So why bother getting them insured? Unless the fine is more than the premiums would be, that is.

No more lifetime or annual caps on coverage

Again, insurance companies base their projected costs, and set their premiums, on the assumption that these caps are valid. Either insurance companies have to raise rates to cover increased costs, or start losing money.

Free preventative care for all

Really? How much preventative care? Monthly MRI scans for anything they might spot? Weekly biopsies? All free?

Adults with pre-existing conditions may buy into a national high-risk pool until the exchanges come online. While these will not be cheap, they’re still better than total exclusion and get some benefit from a wider pool of insureds.

At last, something I can agree with.

Small businesses will be entitled to a tax credit for 2009 and 2010, which could be as much as 50% of what they pay for employees’ health insurance.

Room to quibble, but tax credits are usually a good thing.

The “donut hole” closes for Medicare patients, making prescription medications more affordable for seniors.

I guess Medicare has to pay for these prescription medications? Too bad they're losing half a trillion dollars over the next decade.

Requirement that all insurers must post their balance sheets on the Internet and fully disclose administrative costs, executive compensation packages, and benefit payments.

Since I work for the government, my salary is an open record. It was even published in a newspaper database recently. I guess this is how the Obama Administration meant by "transparancy".

Authorizes early funding of community health centers in all 50 states

Frankly, I don't know from this. A way to get more community health centers built faster? No idea.