November 27, 2006 12:20PM

What Is Health Insurance?

Over at the Health Affairs Blog, Mark Smith, president of the California HealthCare Foundation, offers the following assessment of that which we call “health insurance”:

When you ask people why they want health insurance, they will give you one of four answers.… (1) “What if I’m hit by a bus?”; (2) “I need to be covered for my preventive services”; (3) “I can’t afford to go to the doctor, or to get my medicine”; and (4) “I’ve got a chronic disease, for which I can’t afford to pay over time.” …


Please note: Only the first of those is insurance, in the sense in which anyone would understand that term — that is to say, protection of financial assets against the rare, unpredictable, catastrophic event …


Some component of what we call health insurance is that “what if I’m hit by a bus” concept. But the difficulty, we think, in trying to find a method of coverage which is acceptable to the various constituencies who are involved in health insurance … is that this thing we call health insurance is actually four different market items put together in one financial instrument which is increasingly unaffordable.…


To the extent that insurers and providers both see the problem of the uninsured as a revenue problem — which is to say, there are all these people out there who aren’t part of our system, and we need to find a way to buy them into our system at more or less our system’s price, at more or less our system’s configuration, and more or less maintain the incomes of everybody in our system — that is a very different question from how can we make the underlying asset more affordable.…


My point, therefore, is not [we] shouldn’t continue with the quest for expanded insurance coverage but that in so doing, we try to understand what it is we mean by insurance in the first place, and the extent to which combining these functions in one financial package creates a package which is simultaneously attractive for some people and unattractive for others. And in a voluntary market you create this mismatch, because for instance, how many people would pay money to protect their assets if they don’t have assets to protect? Most of the uninsured are low income; most low‐​income people don’t have huge amounts of assets to protect. They know that the hospital won’t come after them in quite the same way as the department store will, even for the same bill, and so asking them to pay money every week or every month, to protect assets that they don’t have, in case of an experience which will probably not occur to them, strikes us as not a very likely way to expand coverage among that population.

November 27, 2006 9:50AM

Hagel Makes the Case for an Exit Strategy

Sen. Chuck Hagel (R-NE) penned an important op ed in Sunday’s Washington Post Outlook section calling on President Bush to fashion an exit strategy from Iraq.


Hagel’s candor is refreshing, but I have come to expect this from Hagel. Equally impressive is his brevity. He manages to say in a short 739 words what so few of his fellow senators have been willing or able to articulate in twice or three times as many: “The United States must begin planning for a phased troop withdrawal from Iraq.”


The gist of the editorial explains that we must exit Iraq because it is in our interest to do so. He notes the “devastating” costs “in terms of American lives, dollars and world standing.” He points out that “We are destroying our force structure, which took 30 years to build.” This cost to our military — and therefore to our national security — cannot be quantified. Neither can the cost in lives. But this much we do know: in dollar terms alone, war costs now exceed $300 billion, and are accumulating at a rate of $8 billion per month.


As to Hagel’s pragmatic understanding of the limitations of military force to achieve noble ends, the following passages are instructive:

Militaries are built to fight and win wars, not bind together failing nations. We are once again learning a very hard lesson in foreign affairs: America cannot impose a democracy on any nation — regardless of our noble purpose.

We have misunderstood, misread, misplanned and mismanaged our honorable intentions in Iraq with an arrogant self‐​delusion reminiscent of Vietnam. Honorable intentions are not policies and plans.

Well said, Senator Hagel. Here’s hoping that some of your fellow senators took time off from leftover turkey and stuffing to read the newspaper.

November 24, 2006 8:25AM

The Results of Defending Freedom of Religion and Referring to “This Man” in Turkey?

Dr. Atilla Yayla

A respected political scientist, Dr. Atilla Yayla of the Gazi University of Ankara, Turkey, has been dismissed from his teaching position and pilloried in the press in Turkey for daring publicly to make critical remarks about the legacy of Mustafa Kemal Atatürk, whose version of “secularism” has meant state control of and suppression of religion.


Kemalist secularism is not well understood by Americans and Europeans. As Dr. Yayla put it some years ago (about 10, I think) at a seminar on Islam and civil society I organized for him at the Cato Institute, “People say that you have separation of church and state in America and we have separation of mosque‐​and‐​church and state in Turkey. In America, that means freedom of religion. In Turkey, it means freedom from religion. There is a great difference between the two.” Private property, contract, and limited government, he argued, should create the framework for people to decide on their own, through voluntary cooperation, whether and how to build a mosque, a church, a synagogue, or anything else. Such decisions should not be made by state officials.


Atilla was calm during the hot discussion that followed and offered a voice of reason and true liberalism, as passionate secularists and Islamists around the seminar table argued against each other, the former for suppressing and controlling religion by force and the latter for imposing it by force. One secularist even showed a calculation of how many square meters a Muslim needs to pray, multiplied it by the Muslim population of Turkey, calculated the number of square meters of Mosque space in Turkey, and concluded that Turkey had a 50 percent surplus capacity of Mosque space, and therefore that no more should be allowed to be built. Dr. Yayla suggested that that decision should be left to the religious devotion of the faithful, whether Christian, Jewish, Muslim, or otherwise, and calmly appealed for peace by promoting freedom of religion: religion should be neither suppressed nor supported by the state.

Read the rest of this post »
November 23, 2006 12:07AM

Janet Reno’s Late‐​Blooming Concern for Justice

Noted civil libertarian Janet Reno has signed an amicus curiae brief objecting to indefinite detention of alleged enemy combatants.


Maybe Reno would have a more positive attitude if the Bush administration sentenced the detainees to live under Castro’s tyranny, sent them to jail for decades on bogus charges, or simply launched a military assault on the Guantanamo prison and killed everyone inside.

November 22, 2006 2:52PM

If Thanksgiving Travel Woes Get You Down …

… you might want to mark your calendar for December 13th.


The Cato Institute is having a book forum on Overblown: How Politicians and the Terrorism Industry Inflate National Security Threats, and Why We Believe Them (Free Press, 2006). In the book, Ohio State University national security expert John Mueller puts terrorism in the context of other national security threats our country has faced in the past, and challenges us to assess the threat of terrorism rationally.


Yesterday, security expert Bruce Schneier published a TSA Security Round‐​Up that might make you thankful just to get to and from your family home this holiday. Our country and government can do better.

November 22, 2006 1:54PM

Strange Justice

Today’s Washington Post has a report on how the U.S. military is punishing war crimes in Iraq. Prosecutors initially charged a Marine with murder. Later, prosecutors dropped that charge when the Marine agreed to plead guilty to engaging in a cover‐​up of the crime.

In return for Lance Cpl. Jerry E. Shumate Jr.‘s guilty pleas to charges of aggravated assault and conspiracy to obstruct justice, the government dropped other charges, including murder, kidnapping, assault and conspiracy.


Shumate is one of seven Marines and a sailor charged with kidnapping Hashim Ibrahim Awad, 52, in the rural town of Hamdaniyah, dragging him to a roadside hole and shooting him, and then trying to cover it up.

The Marine will serve less than 2 years in jail. That’s a strange notion of justice. But the state has strange notions of how to apply the law–sometimes it is incredibly harsh and sometimes it is incredibly lenient. The less we pay attention, the worse it gets.

November 22, 2006 1:52PM

Judging Kyoto

Next Wednesday, the Supreme Court will hear oral argument in Massachusetts v. EPA, the blockbuster environmental case of the term. The issue: Does the Clean Air Act, a 1970s‐​vintage anti‐​smog statute, require the EPA to regulate greenhouse gas (CO2) emissions from new American cars? A number of states and enviro groups say “yes!” The EPA–in an exceedingly rare example of administrative self-restraint–says “no.” The stakes? Big: If the petitioners win, American carmakers may face the equivalent of Kyoto global warming standards, imposed by judicial fiat, despite Congress’s umpteen rejections of the Kyoto regime.


Cato filed an amicus brief on the EPA’s behalf, written by environmental law whiz Jonathan Adler and joined by lawprofs James Huffman and Andrew Morriss. Read it here. We argue that the petitioners lack standing to sue the EPA and also argue, for good measure, that nondelegation principles should counsel against creatively translating the Clean Air Act into a template for federal global warming regulation.


Cato’s intrepid Pat Michaels also filed a brief, joined by a number of other prominent climatologists, which tackles the dubious scientific claims of the environmental petitioners.


For more on the case, and its implications, Professor Adler recently participated in a panel discussion of the case at the American Enterprise Institute, which will be replayed on C‐​Span 2 tonight at 6 p.m. However, you can watch the archived video anytime here.