A persistent headache is a symptom, but the underlying cause can be anything from a migraine to a brain tumor. Good medicine means identifying and treating the cause as well as the symptom. The same is true in health care reform.

via Journal of Clinical Investigation — Health care reform: without a correct diagnosis, there is no cure.

Good article from the Dean of Harvard Medical School.

Certainly investment in certain areas can cost now and save later, but a 900 billion dollar tax outlay over the next 10 years doesn’t scream net savings to me. Not to mention that there is no analysis of alternatives. If I was to put forward such a convoluted system with so many assumptions and projections at work I’d be tossed out the room and probably lose my job.

• What happens when the savings don’t show up?

So, we’re going to save a bunch of money supposedly. What if we don’t? Are we going to scrap the whole thing? Close down certain systems? Or, just like other social outlays, are we just going to keep them running and dump money into them? There are thousands of assumptions in these projections, when reality hits (like, say, with all that stimulus funding to fix everything) what is the plan? Will we say “WHO COULD’VE SEEN IT COMING?”, shrug our sholders, and allocate another couple billion dollars to all the new programs created by this ‘reform’?

• How are you going to define affordable? What happens if the government ideal isn’t affordable?
  

I keep hearing that the various government ideals (co-op, government, etc.) will only enter the market if the market isn’t affordable. What does that mean? 10% of my income? 20% of my income? 10% of a median income? Who gets to define what is a correct amount to spend on health care? Second, what happens when the government option isn’t ‘affordable’? I mean, supposedly it won’t take ANY government support, so certainly we’ll just adjust our thinking to the market price for ‘affordable’. …..Or, we’ll shrug our shoulders, say “WHO COULD’VE SEEN IT COMING?”, and allocate money to the government run program to support it. I mean, no one saw the current flu issue, if that pushed insurance prices up would the government step in to help out, you know, just this once?

• Why do you have to be laid-off or fired to get access to a portable health care market?

So, the free market solution, advocated by many, many academics and politicians is that you purchase your own health insurance from an open market which has to compete for your business. Apparently that IS an option in the new system, but only if you get laid off. If you’re employed you’re stuck with whatever bullshit your company has selected for you. Since when does the left think that companies are looking out for their employees? Or is this only to protect your union buddies from having to give up their awesome company provided health insurance?

• How is a government organization going to be more efficient than a profit making company?

All research and evidence is that people function best when they’re aligned with an appropriate incentive for their task. For employees productivity is tied with your wage, for companies your profitability (and how much owners make) is tied with your efficiency, which allows you to under price or over compete with competitors, and make more money. How is a government run option, with no profit motive (and supposedly no government subsidy) going to be more efficient than other insurance companies? Couldn’t you just go start that insurance company today, be cheaper than other providers, and make a boatload of money? Is the idea to give indirect subsidies to this government option such as freedom from certain regulations, restrictions on other, non-governemnt insurance companies, and tax exemptions?

• How are you going to planning to take bureaucrats out of my health decisions?

I have a nifty system for keeping most bureaucrats out of my health care decisions. Its called an HSA. I save my money for health spending, then use it as I see fit. Mandating insurance for every individual, creating a government insurance company, and increasing the regulations around other health care companies is going to create a larger incentive to monitor, coordinate, and control my health spending. How does THAT minimize the amount of people involved in my private medical decisions?

• Why are you mandating “free” (0$ out of pocket) health screening?

Isn’t the idea that certain health care expenditures are ‘free’ at the point of purchase the economic bullshit that helped get us into this mess? Requiring certain types of screenings to be free isn’t going to help contain health care spending at all. In fact, it will drive up insurance costs as I will now be required to take a certain amount of money (the $ for screening), send it to my insurance company (as part of my plan costs), let them skim a bit off the top for ‘administration’, then send it to my doctor on my behalf. Horah, I’m still paying the money out of my own pocket, but someone else gets a cut too!

• Why are you limiting deductibles? What happens to my HSA?

If you’re happy with your existing insurance you’re allowed to keep it, unless you have an HSA account. Why limit deductibles on plans? Is this an ‘affordable’ concept again? If I make plenty of money am I not allowed to reduce my insurance payments by having higher deductibles? I’m allowed to do that for my car (and drive safer as appropriate as well) but not my health insurance? Am I going to lose my nice HSA account which marries a savings account to a high deductible insurance plan for truely catastrophic health issues as opposed to routine things like the stomach flu and broken limbs?

• Are you not worried that Republicans might eventually run your government health care system?

You spent considerable time the last 8 years telling me how horrible the Republicans were at everything. I mean, really, really bad people. Hell, they even fucked up Katrina and FEMA right? And those assholes tend to govern roughly half the time! Are you not the least bit worried you’re going to put those exact some people you really, really hate in charge of your health insurance?

• Do you think we’re going to fall for the ‘no-government-money-ever’ scam?

I keep seeing proposals to create entities in the health insurance market that are initially funded by the government but, we’re promised, will never ever take another federal dime. Right. Just like Fannie Mae. How dumb do you expect the American people to be? We KNOW that it is much easier to create the entity politically than it will be to fund it later. Funding can be a nice little rider on a bigger bill with little political risk. We don’t have to create a central government insurance now, we can just slowly turn our ‘independent’ one into it over time. A boil the frog approach if you will.

It will only take a little emergency, or some akward definition of ‘affordable’ to get the government to sign a little bill, just for a few billion till the program gets back on its feet. Then another. Oh, then a real emergency, here is some extra money. Pretty soon they’ll be able to “compete” with private insurance because they’ll have federal billions in the back pocket. Once those pesky independt companies are gone (or you know, protected via lobbying as a “independent” cabal) we can finally have that government run health care that certain people dream of.

But to an independent voter or moderate Democrat, President Everyman is starting to look like a salesman for the superstate.

via Daniel Henninger: Will They Still Love Him Tomorrow? – WSJ.com.

Check it out.

The list of 77 spending cuts, which the White House is calling “the $100 million savings challenge,” reflects the vastness of government — and its vast inefficiency. Hundreds of millions of dollars in savings were found simply by casting around for areas to trim.

Still, the reductions barely scratch the surface. “Some of these cuts are so small they would be a rounding error of a rounding error in the federal budget,” said Brian Riedl, a federal budget expert at the conservative Heritage Foundation. They also show how “unbelievably outdated” the government is, he said.

via WSJ.

Our national conversation about curbing the cost of health care is crippled by the vocabulary in which we conduct it. We must stop talking about “health care” as if it were some kind of collective public service, like fire protection, provided equally to everyone who needs it. No government can provide the same high quality body repair services to everyone. Not all doctors are equally good physicians, and not all sick persons are equally good patients.

Universal Health Care Isn’t Worth Our Freedom – WSJ.com.

Sorry about the lack of updates lately. I’ll be back on the horse shortly.

With budget deficits soaring and President Obama pushing a trillion-dollar-plus expansion of health coverage, some Washington policymakers are taking a fresh look at a money-making idea long considered politically taboo: a national sales tax.

Common around the world, including in Europe, such a tax — called a value-added tax, or VAT — has not been seriously considered in the United States. But advocates say few other options can generate the kind of money the nation will need to avert fiscal calamity.

At a White House conference earlier this year on the governments budget problems, a roomful of tax experts pleaded with Treasury Secretary Timothy F. Geithner to consider a VAT. A recent flurry of books and papers on the subject is attracting genuine, if furtive, interest in Congress. And last month, after wrestling with the White House over the massive deficits projected under Obamas policies, the chairman of the Senate Budget Committee declared that a VAT should be part of the debate.

via The Washington Post.

Horah, more taxes! Here I was worried that 30+ % of my income going to government programs just didn’t feel like enough. Here is another few smart solutions to our fiscal problems

1. Stop paying & treating government workers like their jobs are sacrosanct. Fire people when they screw up.
2. Cut programs who soley exist to throw away money to a select few
3. Privatise expensive government pension and drug benefits

I mean these kinds of reforms work perfectly well in Chile. Are we not smart enough to make them work here?!

As the savings swelled above $20 billion — more than 15% of Chile’s economic output — Mr. Velasco faced growing pressure to break open the piggy bank. In September, protesters barged into a presentation by Mr. Velasco, carrying an effigy of him and shouting, “The copper money is for the poor people.”

The 48-year-old Mr. Velasco, wary that a flood of copper income could generate lending and consumption bubbles, stood his ground, even as the popularity of the center-left government withered. Latin American history, he cautioned, was full of “booms that had been mismanaged and ended badly.”

via Prudent Chile Thrives Amid Downturn – WSJ.com.

Great story about how the finance minister did the right thing and saved for a rainy day, saving his country from the fate of many developing countries in these hard times.

President Obama revealed Monday that he’s half a supply-sider. If only someone could explain to him the other half. We have a tax code, the President said, “that says you should pay lower taxes if you create a job in Bangalore, India, than if you create one in Buffalo, New York.” That sounds like a great argument for lowering taxes on the guy creating jobs in Buffalo. Alas, that’s not what he has in mind.

Great article over at the WSJ explaining why the proposed tax changes of Obama are going to hurt American companies big time if imposed.

Capital Ideas Evolving

Nudge: Improving Decisions About Health, Wealth, and Happiness

Sway: The Irresistible Pull of Irrational Behavior

Bryan Caplan explains that in voting most actors are rationally ignorant and rationally irrational. Without going through all the analysis most people are rationally ignorant because they make a rational decision to forgo the effort required to fix their ignorance since voting has such a small expected payoff. People are rationally irrational for much the same reason, taking an easy or socially accepted position rather than figuring out the correct solution out of a rational lazyness. Basically, since we understand that our vote counts so little we make little effort to make vote in an intelligent way.

I highly recommend picking this one up, it will give you a whole new set of tools in understanding politics and participating in debate and it is an incredibly interesting read.