Tag: Bastiat

The Decision Is Whether We Will Reform Health Care with Our Eyes Open

Donald Berwick may have mastered the science of health care management and delivery. (I for one would jump at the chance to enroll my family in the Berwick Health Plan.) But his recent oped in the Washington Post shows he has yet to absorb the lessons that economics teaches about government planning of the economy, such as through ObamaCare.

Berwick, whom President Obama recess-appointed to be administrator of the Centers for Medicare & Medicaid Services (CMS), sets out to defend ObamaCare from a fairly devastating critique by Robert Samuelson a few days earlier. Berwick responds, in essence, nuh-uh:

I saw how this law is helping tens of millions of families and is finally putting our health-care system on the right track…I have seen how improving care can reduce costs dramatically.

Berwick fails to see the world of difference between those two statements. Yes, in his private-sector work, Berwick has helped hospitals save more lives, kill fewer people, and save money in the process. I’m pretty sure he has saved more lives than I ever will.

But all he saw from his perch at Medicare’s helm was people happy to receive checks from the government, and a bunch of well-meaning bureaucrats setting goals. He did not see the costs imposed by those subsidies. As for goal-setting, this one sentence captures it all:

The CMS, for example, has set ambitious goals to reduce complications that, if met, would save 60,000 lives and $35 billion in just three years.

If. Met. A recent Congressional Budget Office review of Medicare pilot programs showed that Medicare bureaucrats set goals all the time. They never achieve them.

Berwick’s claim that ObamaCare “cracks down hard on waste and fraud” because “Last year the government recaptured a record $4 billion” is even more ridiculous. The official (read: low-ball) estimates are that CMS loses $70 billion per year to fraud and improper payments. The best evidence suggests that wasteful spending approaches $200 billion per year in Medicare alone. All that money that comes from you, John Q. Taxpayer. Berwick knows all these things. Yet he thinks you should be impressed that recovering a measly $4 billion is the best the government has ever done.

Berwick would never tolerate such willful blindness, shoddy reasoning, and (surprise!) poor results if it were his own money on the line. Which is exactly the point. In a free market, people spend their own money. At Medicare, Berwick spent, and ObamaCare continues to spend, other people’s money.

That is the main reason why markets are smart and government is stupid. And why otherwise smart people like Berwick can afford to keep their eyes shut.

Should the Government Ban ATMs and Create “Spoon-ready” Projects?

At the Britannica Blog today I note President Obama’s concern over ATMs, Hillary Clinton’s support for the candlemakers’ petition, John Maynard Keynes’s simple solution to the problem of unemployment—and how Bastiat refuted all their arguments more than 150 years ago:

And there’s your question for President Obama: Do you really think the United States would be better off if we didn’t have ATMs and check-in kiosks? …  And do you think we’d be better off if we mandated that all these “shovel-ready projects” be performed with spoons?

In his 1988 book The American Job Machine, the economist Richard B. McKenzie pointed out an easy way to create 60 million jobs: “Outlaw farm machinery.” The goal of economic policy should not be job creation per se; it should be a growing economy that continually satisfies more consumer demand. And such an economy will be marked by creative destruction. Some businesses will be created, others will fail. Some jobs will no longer be needed, but in a growing economy more will be created… .

Finding new and more efficient ways to deliver goods and services to consumers is called economic progress. We should not seek to impede that process, whether through protectionism, breaking windows, throwing towels on the floor, or fretting about automation.

More here.

Broken Windows All Over

It reminds us of the need to repeat, and repeat, and repeat the same messages.  Tornadoes, diseases, and wars are not good for “the economy.”  They may be good for hardware stores, doctors, and military contractors, but not for the rest of us.  Still, the New York Times couldn’t help but tell us on the front page that “Reconstruction Lifts Economy After Disasters.”

Frederic Bastiat exploded the fallacy long ago.  Here’s a modern (and shorter) retelling:

The GM ‘Turnaround’ in Bastiat’s View

GM’s long-rumored initial public stock offering will take place Thursday and self-anointed savior of the U.S. auto industry, Steven Rattner, is pretty bullish about the prospect of investors turning out in droves. 

I’ve been saying for a while that I thought the government’s exposure [euphemism for taxpayer losses] in the auto bailout was in the $10-billion to $20-billion range.

But since investor interest has pushed the initial price up from the $26-to-$29 per share range to the $32-$33 range, Rattner now believes:

[T]his exposure is in the single-digit billion range, and arguably potentially better.

I won’t argue with Rattner’s numbers.  After all, they affirm one of my many criticisms of the bailout: that taxpayers would never recoup the value of their “investment.”  My bigger problem is with Rattner’s cavalier disregard for the other enduring—and arguably more significant—costs of the auto bailouts.

Rattner is like the foil in Frederic Bastiat’s excellent, but not-famous-enough, 1850 parable, That Which is Seen and That Which is Unseen.    Rattner touts what is seen, namely that GM and Chrysler still exist.  And they exist because of his and his colleagues’ commitment to a plan to ensure their survival, along with the hundreds of thousands (if not millions, as some “estimates” had it) of jobs that were imperiled had those companies vanished.  (For starters, I very much question even what is seen here. I am skeptical of the counterfactual that GM and Chrysler would have disappeared and that there would have been significantly more job loss in the industry than there actually was during the recession and restructuring.  But I’ll grant his view of what is seen because, frankly, the specifics are irrelevant in the final analysis).

For what is seen, Rattner admirably admits of a cost.  And that cost is not insignificant.  It is anywhere from $65 billion to $82 billion (the range of the cost of the bailout) minus what is being paid back and what investors are willing to pay for GM shares—in the “single-digit billion range,” as Rattner says.  But Rattner is willing to stand by that trade-off, claiming his efforts and the billions in “government exposure” were a small price to pay for saving the U.S. auto industry, as it were.  It’s merely a difference in philosophy or compassion that animates bailout critics, according to this position.

No.  Not so fast.  All along (quite contemptuously in this op-ed, which I criticized here) Rattner has been unwilling to acknowledge the costs that are unseen.  Those unseen costs include:

  • the added uncertainty that pervades the private sector and assigns higher risks and thus higher costs to investing and hiring (whom might government favor or punish next?);
  • the diversion of resources from productive to political purposes in the business community (instead of buying that machinery to churn out better or more lawn mower engines, better to hire lobbyists to keep Washington apprised of how important we are or how this or that policy might be beneficial to the national employment picture!);
  • excessive risk-taking and other uneconomic behavior that falls under the rubric of moral hazard from entities that might consider themselves too-big-to-fail (perhaps, even, the New GM!);
  • growing aversion to—and rising cost of—corporate debt (don’t forget what happened to Chrysler’s “preferred” bondholders in the bankruptcy process!);
  • the sales and market share that should have gone to Ford or Honda or VW as part of the evolutionary market process;
  • the fruitful R&D expenditures of those more disciplined companies;
  • the expansion of job opportunities at those companies and their suppliers;
  • productivity gains passed on to workers in the form of higher wages or to consumers as lower prices;
  • the diminution of the credibility needed to discourage foreign governments from meddling in markets, often to the detriment of U.S. enterprises.

 The list goes on.

 Yet, Rattner, seemingly oblivious to the fact that the economy remains stuck in the mire, speaks triumphantly of the successful auto bailout.  But nobody ever doubted that taxpayer resources in the hands of policymakers willing to push the bounds of legality could “rescue” GM from a fate it deserved.  The concern was that policymakers would do just that, leaving behind wreckage to our institutions not immediately discernible.  But anemic economic activity, 9.6 percent unemployment, and a private sector unwilling to invest is pretty darn discernible at this point.

Rattner should take off the tails, put down the champagne flute, and acknowledge what was originally unseen.

Excellent Video Channeling Bastiat

Tom Palmer of the Atlas Network has a very concise – yet quite devastating – video exposing the Keynesian fallacy that the destruction of wealth by calamities such as earthquakes or terrorism is good for economic growth. Tom cites the work of Bastiat, who sagely observed that, “There is only one difference between a bad economist and a good one: the bad economist confines himself to the visible effect; the good economist takes into account both the effect that can be seen and those effects that must be foreseen.” As you can see from the video, many who pontificate about economic matters today miss this essential insight.

I can’t resist the opportunity to also plug a couple of my own videos that touch on the same issues. Here’s one on Keynesian economics, one on the failure of Obama’s faux stimulus, and another on the policies that actually promote prosperity.

What Is Seen and What Is Not Seen

Two items in Tuesday’s newspapers remind us of the often unseen costs of regulation and also of the often unseen benefits of market processes. In the Wall Street Journal, Prof. Todd Zywicki examines the likely consequences of a law to limit credit card interest rates and the fees they charge to merchants:

Card issuers might also reduce the quantity and quality of credit cards by restricting credit availability and cutting back on product innovation or ancillary card benefits. This is exactly what happened when Australian regulators imposed price controls on interchange fees in 2003: Annual fees increased an average of 22% on standard credit cards and annual fees for rewards cards increased by 47%-77%. Card issuers also reduced the generosity of their reward programs by 23%. Innovation, especially in terms of improved security and identity-theft protection, was stalled. Card issuers also increased their efforts to attract higher-risk customers who generate interest and penalty fees to offset lower interchange revenues from lower-risk transactional users.

Those are the kinds of unseen costs that most of us wouldn’t anticipate (that’s why economists talk about “unanticipated [or unintended] consequences” of action). Only after the fact were economists able to identify the specific costs of the regulation. It seemed like a good idea – limit the cost of something that consumers (voters) want. Did anyone predict the consequences? People probably predicted that annual fees would rise to compensate for the lost revenue from interchange fees. But did they anticipate a slowdown in innovation in security and identity-theft protection? Did they anticipate that card issuers would work harder to get higher-risk customers? Such regulation always impedes the optimal working of market processes, and thus inevitably delivers sub-optimal results. 

Meanwhile, we often observe conditions in the marketplace that don’t seem to make sense to us. So we assume something is wrong, maybe even corrupt. An article in the Washington Post written in a sober yet hysterical style raised the problem of “medical salesmen in the operating room.” Then, in a letter to the Post, Dr. Mark Domanski explains why it makes sense to have medical salesmen in the operating room. A Post article on the topic had been full of anecdotes about a salesman who “began his career selling hot dogs” hanging out in operating rooms and doctors who expressed outrage. If only they had thought to ask a surgeon in distant Arlington, Virginia:

I found David S. Hilzenrath’s Dec. 27 Business article, “The salesman in the operating room,” to be one-sided.

Of course, medical sales representatives work along doctors in operating rooms. As a surgeon, I always want a company rep in the operating room.

So, if you were having surgery that involved a complicated piece of equipment, wouldn’t you like somebody from the manufacturer to be there? I know I would.

Here’s why:

Remember when you tried to assemble that desk you bought from a furniture store? We all know how to use a screwdriver, but when something is off, it’s nice to know there is a number to call. What if you needed to put that desk together quickly because you needed it for something important? It would be nice if the company sent someone to make sure all the parts were there and in good order. That’s what a good rep does.

As the surgeon, I make the diagnosis and decide the treatment. No company representative tells me how to use a knife. But many products in the operating room are complex and change almost every year; they are getting better that fast.

When I am using a complex product, such as a plating system for fixing a jaw fracture, having the rep in the room ensures that the system is functional. I know all the parts will be there. I know that the right screw and plate will be handed to me at the right time.

Sometimes we call in the rep for an operation, and it turns out that the fracture does not need to be plated. No rep has ever suggested that I plate a fracture that didn’t need to be plated.

Members of Congress and activists are constantly reading articles about apparent problems and rushing off to propose legislation. These examples and countless more should remind us to think carefully before we coercively interfere in the decisions that millions, billions, of people make every day.

Week in Review: A Health Care Summit, School Choice and Ayn Rand

Obama Holds White House Health Care Summit

President Obama hosted almost 150 elected officials, doctors, patients, business owners, and insurers on Thursday for a White House forum on health care reform. The Washington Post reports Obama “reiterated his intention to press for legislation this year that dramatically expands insurance coverage, improves health care quality and reins in skyrocketing medical costs.”

Cato senior fellow Michael D. Tanner responds:

The Obama administration and its allies mainly seek greater government control over one-seventh of the U.S. economy and some of our most important, personal, and private decisions. They favor individual and employer mandates, increased insurance regulation, middle-class subsidies, and a government-run system in competition with private insurance. On the other side are those who seek free market reforms and more consumer-centered health care.

These differences are profound and important. They cannot and should not be papered over by easy talk of bipartisanship.

In a new article, Tanner explains why universal health care is not the best option for Americans seeking a better system:

If there is a lesson which U.S. policymakers can take from national health care systems around the world, it is not to follow the road to government-run national health care, but to increase consumer incentives and control.

To find out how the free market system can increase health care security, read University of Chicago professor John H. Cochrane’s new policy analysis, which explains how markets can “provide life-long, portable health security, while enhancing consumer choice and competition.”

Battle Over Washington DC School Choice Program Continues

Congressional Democrats are considering cutting the funding for a pilot education program that sends low-income children in Washington, D.C., to private schools through vouchers. The program serves as an example of how helpful school choice programs can be to children who are born into families that cannot afford to send them to good schools.

Adam Schaeffer, policy analyst at Cato’s Center for Educational Freedom, says even the mainstream media is on the side of school choice this time.

In a recent study, Andrew J. Coulson, director of Cato’s Center for Educational Freedom, demonstrates the superiority of market-based education over monopolies.

For comprehensive research on the effectiveness of charter schools, private schools, and voucher programs, read Herbert J. Walberg’s book, School Choice: The Findings.

Cato Celebrates Women’s History Month

The Cato Institute pays homage to three women during Women’s History Month who unabashedly defended individualism and free-market capitalism early in the 1940s — an age that widely considered American capitalism dead and socialism the future.

In 1943, Isabel Paterson, Rose Wilder Lane and Ayn Rand published three groundbreaking books, The God of the Machine, The Discovery of Freedom and The Fountainhead, that laid the foundations of the modern libertarian movement.

On Rand’s centennial, Cato executive vice president David Boaz highlighted the many contributions she made to liberty:

Although she did not like to acknowledge debts to other thinkers, Rand’s work rests squarely within the libertarian tradition, with roots going back to Aristotle, Aquinas, Locke, Jefferson, Paine, Bastiat, Spencer, Mill, and Mises. She infused her novels with the ideas of individualism, liberty, and limited government in ways that often changed the lives of her readers. The cultural values she championed — reason, science, individualism, achievement, and happiness — are spreading across the world.