In the face of widespread public demand for changes in the U.S. health care system, both Barack Obama and John McCain have offered detailed proposals for reform. In the new study, “A Fork in the Road: Obama, McCain, and Health Care,” Cato scholar Michael D. Tanner examines the candidates’ plans, and concludes that, while Senator McCain’s proposal is far from perfect, from a free-market perspective, it appears superior to Senator Obama’s plan.

At the Cato Institute’s Health Policy Studies department we’re not sure which is riskier – being the leading advocate for free market healthcare or this Cavalcade. Nonetheless, we’re glad to present CoR #56. Enjoy at your own risk.

Health Risks

• David Williams knows that air ambulance services are risky but wonders why. While the New York Times blames the hospitals for outsourcing to for-profit industry, Williams questions whether they could do better given their own poor safety record.
• Paul Levy sends the message he never hoped to send after his Harvard-affiliated teaching hospital is responsible for a wrong-site surgery.
• Bob Vineyard becomes a medical astrologist for one day. Tell him your birthday and he’ll tell you your chance of developing schizophrenia, heart disease or cancer.
• Jason Shafrin floats the idea of a new currency for premiums. He thinks you would trade your life for less risk.
• Jim Harper shows us how the risks we take reveal how much we value life.
• Jolyon Patten says there’s a chance that genetically modified (GM) foods are dangerous to your health.
• John Leppard shines a light on the other health insurance problem: physician liability insurance.
• Guest blogger Brian Poncelet at Million Dollar Journey gives a well-researched analysis of critical illness insurance.
• Raag Vamdatt dissects the anatomy of an accident and personal injury policy from Tata AIG General Insurance Company of
  India.
• Vera Lang asks us to look starboard and play it safe on the water.
• Jonathan Pleztke breaks down the Medicare puzzle piece-by-piece.
• Yours truly discusses the risks of letting religion guide health care reform.

Corporate Risks

• Nancy Germond provides managers with a list of strategies to mitigate the risk of “brain drain” at your company.
• Stephanie Balaouras points out that companies often overlook the risk of power outages, which cause more downtime that hurricanes, tornados or earthquakes.
• Leon Gettler cannot understand why companies are ignoring environmental risk.
• Joe Kristan gives a technical explanation of a new IRS ruling on how life insurance premiums and proceeds affect the ability of S corporations to make non-taxable distributions.

Personal Financial Risks

• The Silicon Valley Bogger is worried about the risks of money market funds. Is your $$ safe in one? Read and see.

Ethical Risks

• Jon Coppelman has a gnawing case study in political corruption: Zimbabwe, where the danger of running a legitimate risk management business is more real than the risks you manage.

The Risk of Progress

• SocProf argues that modern progress is making ours a “risk society.”

This might be bad news for the world. But it’s good news for the Cavalcade. There is nowhere to go but up as we progress toward CoR #57 at the Sentinel Effect in two weeks. Until then, happy risk-taking.

The new Wash​ing​ton​Watch​.com blog (a project of yours truly, which, along with C@L, recently ignited a firestorm of controversy over federal bed bug legislation) has inaugurated a new category of post, called “… and a Pony”.

It’s for bills in Congress promising what you’d ask Santa Claus for after you finished with the stuff you thought you might actually get.

The inaugural recipient of this categorization is H.R. 6444, To provide affordable, guaranteed private health coverage that will make Americans healthier and can never be taken away.

Uh-huh. Yeah.

Yesterday, I blogged about Ezra Klein’s claim that universal coverage would help contain health care spending. Klein writes:

This is, at least in the abstract, the political logic of focusing on access first: Expanding access creates pressures that force the system to figure out how to control costs.

That’s what I quoted yesterday. Here are Klein’s next two sentences, about how his theory is unfolding in Massachusetts, which has implemented what the Boston Globe calls a “near-universal health insurance law”:

There’s evidence this is beginning to happen in Massachusetts. The legislature is beginning to consider cost-control measures.

Oh, are they?

Today, the Boston Globe reports that the Commonwealth of Massachusetts requires consumers to buy so many different types of insurance benefits that it increases premiums by about 6 percent. So how is the legislature grappling with the problem of already expensive premiums that are growing faster than inflation? According to the Globe:

State lawmakers are now considering proposals that could require employers to add more benefits, including expanded mental healthcare coverage.

Wow. I don’t think we can afford much more of this cost containment.

HT: David Hogberg.

My friend Ezra Klein puts some more meat on the goofiness for which I recently dinged my friend Jonathan Cohn. The Left’s approach to health-care cost containment is to give more health coverage to more people with more ailments, all the while making everyone pay less. (What do you mean it doesn’t make sense? Don’t you believe??)

Cohn expressed that strategy like so:

The better way to control costs is with a variety of approaches that starts with a guarantee of coverage to everybody.

Klein adds:

This is, at least in the abstract, the political logic of focusing on access first: Expanding access creates pressures that force the system to figure out how to control costs.

So if you have an alcoholic friend, Klein suggests you keep buying him drinks until he hits rock bottom. Or maybe he means that we should keep buying “olive oil” until Don Corleone is so flush with cash that … no, wait. That won’t work. Maybe I just don’t understand abstract thinking.

Of course, the Church of Universal Coverage can always point to the health gains we’d see from covering the uninsured. And I can’t dispute those gains. It’s just a pity that they’re so obsessed with their holy grail that they don’t see other ways of improving health, maybe at a lower cost, and that wouldn’t feed the very beast that’s going to fight their future cost-containment efforts.

In case my last post didn’t convince you that universal coverage is a religion, here is its apostle’s creed:

To believe in universal health care is to believe that we can do more and do better, all at once — that it is possible to have hospitals full of high technology and emergency departments with room for all comers; that it is possible for people to choose their doctors and have a say in their treatments; that it is possible to make the economy more free and more efficient; and that it is possible to do all of this for everybody, not just an economically or medically privileged few, in a way we can all find affordable. [Emphasis added.]

(As delivered by Church of Universal Coverage high priest Jonathan Cohn and chronicled in the book Sick, chapter 9, p. 231.)

I may think that government often serves the few at the expense of the many, that people respond to incentives, that tradeoffs are unavoidable, that there may be better ways to promote health, and that introducing coercion into human affairs creates more problems than it solves. 

But just try telling that to someone who believes.

I have blogged before about the “Church of Universal Coverage,” my affectionate term for those whose support for universal health insurance coverage is impervious to reason — or would be, were they to subject it to reason. I read something today that has me wondering whether the Church might be waking up to the fact that it is indeed a religion.

The July/​August 2008 issue of the journal Health Affairs contains a letter from Mitch Roob, the Indiana official who oversees Gov. Mitch Daniels’ (R) health care agenda. Roob writes:

Like other advocates for children’s health, I have an almost religious conviction that the State Children’s Health Insurance Program (SCHIP) is effective public policy … Although I have no empirical evidence to support the assertion that SCHIP is a beneficial and effective way to invest in children’s health, I worked to expand the program … I was not able to base this expansion on empirical evidence because there is none … The lack of actual evidence of the benefits for children is simply damning to the program … Public policymakers need more than just a conviction that SCHIP works and is worthy of public investment. We need facts. [Emphasis added.]

Wow. I mean, wow. 

I see three possible outcomes. One, all that cognitive dissonance causes Roob’s head to explode. Two, the Church hierarchy dispatches its goons to burn this heretic at the stake for noticing that their god has no clothes. Three, the Left decides “to hell with it,” admits that it has a religion, and files for tax-exempt status.