Archives: 06/2009

Understating the Case against a New Government Health Plan

I just caught wind of Rep. Paul Ryan’s (R-WI) quip about President Obama’s proposal to have a new government health insurance program compete against private insurers:

Having the government compete against the private sector is kind of like my seven-year-old daughter’s lemonade stand competing against McDonald’s.

That understates the case.  McDonald’s doesn’t have guns.  It doesn’t use coercion or the threat of coercion against its competitors.  A better analogy is that Obama’s proposal is like having a kid’s lemonade stand compete against Al Capone.

Question Regarding Obama’s Signals Toward Latin America

How come President Obama can find time to call and congratulate Ecuadorian President Rafael Correa on his reelection (someone who has said that he prefers “a thousand times” to be a friend of Fidel Castro and Hugo Chávez than to be an ally of the United States) but can’t find time to meet with, or at least issue a statement supporting, Cuban dissidents at the White House as his predecessors did?

‘The Police Became a Mob’

Chief Judge Frank Easterbrook recounts the horrific police attack on Frank Jude in a ruling this month from the Seventh Circuit Court of Appeals. 

By way of background, Jude tagged along with some young ladies to a house party late one evening.  The party was mostly off-duty cops who immediately made Jude feel unwelcome.  Jude left after just 5 minutes, but several men followed him out to the street and accused him of stealing someone’s police badge.  Then the beating began:

Men punched Jude’s face and torso; when he fell to the ground, they kicked his head and thighs. The partygoers behaved as a mob. Not a single person in the house tried to stop the attack or even to call for aid. Jon Clausing, who had slashed Harris’s face, explained his conduct as “just kind of going along with everybody.” That is the way of the mob. Society has police forces to pose a counterweight to mobs, yet here the police became a mob.

Schabel and Martinez were on duty and had not been drinking, so they should have put a stop to the violence. Instead Schabel joined it, while Martinez watched. On being told that Jude had stolen Spengler’s badge, Schabel called Jude a “motherfucker” and stomped on his face until others could hear bones breaking. After telling Martinez “I’m really sorry you have to see this,” Daniel Masarik picked Jude off the ground and kicked him in the crotch so hard that his body left the ground. Jon Bartlett then took one of Schabel’s pens and pressed it into each of Jude’s ear canals, causing severe injury and excruciating pain. The men also broke two of Jude’s fingers by bending them back until they snapped. Spengler put a gun to Jude’s head and said: “I’m the fucking police. I can do whatever I want to do. I could kill you.” Bartlett used a knife to cut off Jude’s jacket and pants, leaving him naked on the street in a pool of his own blood.

The attack was so violent that it couldn’t be ignored.  Several officers were prosecuted, but the blue wall of silence kicked in and several officers committed perjury to shield their criminal acts.  Judge Easterbrook writes, “The distance between civilization and barbarity, and the time needed to pass from one state to the other, is depressingly short.” 

Read the whole thing (pdf).  Previous coverage here.

HT: Sentencing Law and Policy.

The Ultimate Question: Freedom or Power?

Here I was, sick with worry that the questions I hoped to pose to President Obama about his health reform plan would never be answered.  Thank God, Matthew Holt stepped up to the plate.  Or the wicket.  Whatever.

What follows are some of my questions (addressed to the president) and Holt’s responses (in italics).

Mr. President, in your inaugural address and elsewhere, you said you are not interested in ideology, only what works. Economists Helen Levy of the University of Michigan and David Meltzer of the University of Chicago, where you used to teach, have researched what works. They conclude there is “no evidence” that universal health insurance coverage is the best way to improve public health. Before enacting universal coverage, shouldn’t you spend at least some of the $1 billion you dedicated to comparative-effectiveness research to determine whether universal coverage is comparatively effective? Absent such evidence, isn’t pursuing universal coverage by definition an ideological crusade?

Sadly Michael, universal coverage is not about improving public health. If you want to do that, go teach some kids age 1–5 and build some sewage systems. Universal care is about making sure that the costs of health care are fairly distributed. Under the systems you prefer and the one we now have they’re distributed from the poor and sick to the healthy and wealthy—many of whom we both know work in the health care system. But apparently there was NOT ONE MENTION of the uninsured or sick people bankrupted by the system in the whole hour.

Holt’s categorization of my preferred health care “system” and the un-mentioned uninsured aside, he makes my point for me: universal coverage is about ideology, not health.  In fact, Holt demonstrates that the Church of Universal Coverage would be happy to have people die sooner if that would promote its ideo-religious goals.  I really should send him a fruit basket.

A draft congressional report said that comparative-effectiveness research would “yield significant payoffs” because some treatments “will no longer be prescribed.” Who will decide which treatments will get the axe? Since government pays for half of all treatments, is it plausible to suggest that government will not insert itself into medical decisions? Or is it reasonable for patients to fear that government will deny them care?

Why should patients fear it? We know that less intensive care is better, and cheaper primary care is better than more extensive specialty care.

So the government will insert itself into medical decisions.  Gotcha.  Holt is really clearing a lot of things up.

To answer his question, though, the concern is that one size really doesn’t fit all, and that the government’s rules will, shall we say, break my eggs to make his universal-coverage omelette.

You recently said the United States spends “almost 50 percent more per person than the next most costly nation. And yet … the quality of our care is often lower, and we aren’t any healthier.” Achieving universal coverage could require us to spend an additional $2 trillion over the next 10 years. If America already spends too much on health care, why are you asking Americans to spend even more?

Ah we agree. All the money should come from the current system, even if it means reducing the incomes of pundits, bloggers and those who sponsor them, and a few people in the system. Sadly the politics of the US means that apparently Obama can’t say that.

So nice when we can agree.  Now if only there were some way to deny incumbent producers the power to block more efficient ways of doing things … to block “progress,” if you will … hmmmmm

You found $600 billion worth of inefficiencies that you want to cut from Medicare and Medicaid. If government health programs generate that much waste, why do you want to create another?

You’re saying all government programs are the same? That means the US Marine Corps and the Iraqi volunteer EDF (or whatever it’s called) are the same. I could start a government program that saved $600b very easily in Medicare & Medicaid. I might make a few enemies.

Holt is right.  A new program might waste a lot less.  (Or a lot more.)  But the best part of his answer is that leftist impulse: “I could design a better social order if we could just get rid of that whole constitutional democracy thing.”

You and your advisors argue that Medicare creates misaligned financial incentives that discourage preventive care, comparative-effectiveness research, electronic medical records, and efforts to reduce medical errors. Medicare’s payment system is the product of the political process. What gives you faith that the political process can devise less-perverse financial incentives this time?

See my above answer, oh and abolish the Senate.

I refer my right, honorable friend to the answer I gave some moments ago.

You have said there are “legitimate concerns” that the government might give its new health plan an unfair advantage through taxpayer subsidies or by “printing money.” How do you propose to prevent this Congress and future Congresses from creating any unfair advantages?

I don’t know but I’ll make a deal. I’ll promise my health plan won’t have use an unfair advantage if you promise that AHIP’s members will stop lobbying Congress to rip-off the taxpayer.

Again, so helpful of Holt to acknowledge that the playing field between government and private insurers could never be level.

And to keep the insurance industry from ripping off the taxpayers, it seems we will have to give up either (1) the freedom of speech and to petition the government for a redress of grievances, or (2) the power that government currently wields over our health care sector and that the insurance companies’ lobbyists so often bend to their will.

Which brings me to Holt’s byline:

Matthew Holt is a vicious blogger who wouldn’t mind being President for a day or two but not without the ability to break Congress to his will in the first ten minutes.

Doesn’t sound like he would choose freedom over power.

One Year After Heller

One year ago today, the Supreme Court handed down its decision in District of Columbia et al. v. Heller. The decision affirmed the Second Amendment as protecting an individual right to keep and bear arms and invalidated the District of Columbia’s draconian gun control regime.

The case generated a storm of media attention. The Cato Institute filed an amicus brief, one of nearly four dozen in the case.

The Cato Institute held a forum for Brian Doherty’s book chronicling this victory for liberty, Gun Control on Trial: Inside the Supreme Court Battle Over the Second Amendment. The Heller case also figured prominently in Cato multimedia from Robert A. Levy and Clark Neily.

Heller did not settle all of the questions related to the right to keep and bear arms. The incorporation of the Second Amendment against state bans and regulations is currently being litigated across the country. A three-judge panel in the Court of Appeals for the Ninth Circuit held that the Second Amendment is incorporated against the states. The Seventh Circuit and Second Circuit disagreed. Supreme Court nominee Sonia Sotomayor was on the Second Circuit panel that declined to incorporate the Second Amendment, and Roger Pilon notes that this may play into her confirmation hearings. The circuit split on incorporation sets the stage for a further appeal to the Supreme Court, and Alan Gura and the National Rifle Association have both filed petitions for a writ of certiorari. Robert A. Levy discusses this in his recent Cato podcast.

It will be interesting to see what the next year brings for the Second Amendment.

Setting the Record Straight on Health Care Reform

President Obama took to the airwaves Wednesday in an effort to promote his plan for a national government-run health care system. He answered questions on rising costs, taxing benefits, and many other issues during an ABC News special on health care reform called “Questions for the President: Prescription for America.”

After live-blogging the ABC special, Cato scholars Michael D. Tanner and Michael F. Cannon dissect the president’s health care plan point by point.