Freedom and Liberty
Ezra Klein discusses what has commonly become known as the “public plan” in the emerging “health care reform” legislation. Put simply it is “public insurance” which is supposed to compete with the private insurance industry and, as Paul Krugman claims, keep them “honest”.
Klein lays out the various flavors being floated out there concerning this option:
• The “Trigger” Plan: Olympia Snowe is pushing this compromise, as are some conservative Democrats. The basic idea is that the public plan would act as an invisible threat: It would be “triggered” into existence if the private insurance market was unable to offer, say, enough options in a particular region, or enough cost control. In addition, the public plan would only come into existence in this or that region, or this or that state. It would be effectively useless as an insurer. It could potentially have some competitive effect in that private insurers would still work to avoid its existence. Some have argued, however, that the conditions being mentioned in the “trigger” proposals have already been met.
• The Weak Public Plan: This is what people are talking about when they refer to a “level-playing field.” This incarnation of the public plan — first proposed by Len Nichols at the New America Foundation and later echoed by Peter Harbage and Karen Davenport at the Center for American Progress — would have no special advantages over private insurers. It couldn’t use the low rates that Medicare sets or access taxpayer subsidies. It couldn’t force its way into networks. It would simply be another insurer, albeit with different incentives than traditional insurers.
• The Strong Public Plan: This would be like Medicare for the rest of us. It could throw the federal government’s weight around. It could negotiate deep discounts with providers. It could muscle its way into networks. Outside groups like the Commonwealth Fund estimate that it would save the average consumer 20 percent to 30 percent. That would give it a massive competitive advantage over private insurers, and would probably result in tens of millions of Americans dropping their current coverage and entering the public plan to save money. A variant of this was in the draft of Ted Kennedy’s bill that was leaked last week.
While Blue Dog Democrats have come out in favor of the “trigger” option, liberals such as Klein and Krugman prefer the “Strong Public Plan” for the reasons stated (massive dropping of private insurance for “public” (i.e. government) insurance). And there’s a reason they both prefer that – they see it as a backdoor way to move health insurance to a single payer system.
And that is a distinct possibility with both the “strong public plan”. In fact it is a design feature. The “competition” touted would most likely be in name only as Greg Mankiw explains (quoting Krugman to set up his explanation):
What’s still not settled, however, is whether regulation will be supplemented by competition, in the form of a public plan that Americans can buy into as an alternative to private insurance.Now nobody is proposing that Americans be forced to get their insurance from the government. The “public option,” if it materializes, will be just that — an option Americans can choose. And the reason for providing this option was clearly laid out in Mr. Obama’s letter: It will give Americans “a better range of choices, make the health care market more competitive, and keep the insurance companies honest.”
It seems to me that this passage, like most discussion of the issue, leaves out the answer to the key question: Would the public plan have access to taxpayer funds unavailable to private plans?
If the answer is yes, then the public plan would not offer honest competition to private plans. The taxpayer subsidies would tilt the playing field in favor of the public plan. In this case, the whole idea of a public option seems to be a disingenuous route toward a single-payer system, which many on the left favor but recognize is a political nonstarter.
If the answer is no, then the public plan would need to stand on its own financially and, in essence, would be a private nonprofit plan. But then what’s the point? If advocates of a public plan want to start a nonprofit company offering health insurance on better terms than existing insurance companies, nothing is stopping them from doing so right now. There is free entry into the market for health insurance. If a public plan without taxpayer support would succeed, so would a nonprofit insurance company. The fundamental viability of the enterprise does not depend on whether the employees are called “nonprofit administrators” or “civil servants.”
The bottom line: If the goal is honest competition in the provision of health insurance, the public option cannot do much good but can potentially do much harm.
That is a critical point in this debate – there isn’t an insurer out there that has as deep pockets as the US Treasury. If there is public money backing the public option, then the talk of “competition” is a sham. It is being used to placate and fool those who oppose a government takeover of insurance, the result which would surely happen if what Mankiw’s concerns are true. And if you follow the reasoning process that Mankiw has laid out above, it should be pretty darn obvious what the intent of this “public plan” really is, all the happy talk Klein and Krugman throw out there notwithstanding.
Last, but not least, while the “strong public plan” is an obvious short-cut to single-payer government run health care, the other two plans simply delay that same eventual outcome for a while. While there are certainly reforms that could be made in the insurance industry and health care generally, anyone who believes that government can do it a) better and b) more efficiently has simply not been paying attention to the shape government finances are in right now or how large the deficit has grown as it has mismanaged its entitlement empire to this point.
I enjoy analyzing arguments. Not two people shouting at each other mind you, but arguments people make to support their positions.
Yesterday I posted about Ed Whelan of NRO outing Publius of Obsidian Wings (no, I’m not going to use Publius’s name). I found it to be a very juvenile reaction to what appeared to me a fairly typical blog war – someone wrote something, another disagreed, and they went back and forth hammering each other’s arguments. But in terms of provocation that might warrant what Whelan did, I found nothing.
Simon Owens, at Bloggasm, contacted each of the parties involved and talked to them about what had happened. If you’ve read each of their blog posts, the reasons given are mostly a recapitulation of those. However there were some other interesting arguments used, one of which I found very wanting.
Whelan even objected to the term “outed,” which has been used by many (including me) to describe what he had done to Blevins. “I think the word ‘outed’ confuses understanding here. I think people are drawing on the ugliness of identifying that someone is homosexual. In this context, to say I outed publius, well publius doesn’t exist. I identified who’s hiding behind publius. I think to identify someone who is blogging behind a pseudonym is very different than exposing some private aspect of a person’s life. I think that the term outing confuses things.”
I don’t think it confuses anyone but Ed Whelan. He claims that publius didn’t exist. But neither did the person pretending to be straight. In the case of the homosexual, both personalities may have had the same name, but one of them certainly doesn’t exist in reality. It is a pseudo-personality. Outing is a completely apropos description of what Whelan did and nonsense such as this argument is just epic rationalization in an attempt to justify the unjustifiable.
Publius makes the argument that he’s not really anonymous, but is instead an established personality with a reputation. And the reputation, achieved while writing under that name and on that blog is of value to him and something he doesn’t take lightly.
“It’s one thing for an anonymous commenter to come in and just be a flame thrower, but what I do is I write pseudonymously, and I have a reputation of my own. It’s an online reputation. It’s a reputation that I care about, that I’ve invested a lot in, and I don’t want to be embarrassed in the blogosphere. I try to think through my arguments. To say there’s no real world effect, I don’t agree with that, because if I write something stupid, I’m going to get called out for that. In fact, I have written stupid things and I got called out and it affected my reputation. So I do have some reputational incentives to be honest, to be respectful in all these things.”
Given that, the arguments on both sides should have been dealt with on their merits and nothing else.
“A law professor should especially be held to minimal standards, and I was surprised that this guy was a law professor given the poor legal understanding of his posts. Let me be clear, I have no objection to bloggers who want to hide behind pseudonyms, but if someone is hiding behind a pseudonym to take cheap shots at me, I don’t think I owe him any favors.”
And outing him did what to enhance Whelan’s arguments or counter those of Publius?
Zip. Zero. Nada. Nothing.
The fact that Whelan’s outing of Publius added nothing of weight to his arguments nor took away from those of Publius smacks of petty vindictiveness. He knew he could hurt Publius by doing something to him that Publius had carefully avoided over the years. In a word it was petty. Juvenile. Something a 10 year old would do.
The more I read Whelan the less I care for him. He may be a heck of a bright guy intellectually, but socially and ethically he’s still in grade school.
One of the things we talked about on the podcast this week is how, in the broadest sense, socialism is a growing phenomenon in our country. As I mentioned, while government may not actually own the means of production, if its regulations are such that they dictate how a company must operate, then government exercises de facto ownership.
What is happening in the financial sector right now serves as a perfect example.
The Obama administration plans to require banks and corporations that have received two rounds of federal bailouts to submit any major executive pay changes for approval by a new federal official who will monitor pay, according to two government officials.
Others, which are being described as broad principles, would set standards that the government would like the entire financial industry to observe as they compensate their highest-paid executives, though it is not clear how regulators will enforce them.
So regulators will have the final say on compensation. That, of course, is an ownership function. The de facto owner then is who?
In a sign of how eager corporations are to escape government diktats on pay, nine of the nation’s biggest banks are likely to repay bailout money as quickly as by the end of this month. The administration is expected to grant its approval this week.
Goldman Sachs, JPMorgan Chase and a handful of others have worked to rid themselves of their ties to government in order to shed restrictions on pay that they say put them at a competitive disadvantage.
But under the administration’s new plans, even companies that repay the taxpayer money will not escape some form of oversight on their compensation structure.
The set of broad pay principles being drafted by the Treasury Department would authorize regulators to tell a bank to alter its compensation arrangements if they are found to encourage too much risk-taking. It is not clear how the government will define too much risk.
Part two – no matter whether you pay the money back in full with whatever interest is owed, the government retains the right to dictate your compensation structure based in some arbitrary metric of “too much risk”, to be determined only by them.
They will apply to a broad swath of financial companies, even the United States operations of foreign banks, as well as private companies like hedge funds and private equity firms.
“This is the government trying to tell the TARP banks not to worry, because everyone else’s compensation will be monitored too,” said Gustavo Dolfino, president of the WhiteRock Group, a financial recruiter, of the industrywide principles. “We’re in a world of TARP and non-TARP.”
Clear enough? For those that like to quibble about the meaning of socialism and parse words, I’m eager to hear your spin on this. But, in light of the plan above you’d better be damned good at deploying the rhetorical smoke and mirrors if you plan to call this anything but a manifestation of the “s” word.
Yesterday evening I thought about what was occurring at the same time 65 years before in Europe. Young paratroopers of the 82nd and 101st Airborne Divisions as well as the British 6th Airborne Divison and 1st Canadian Parachute Battalion were headed in for night combat jumps with the mission of securing key bridges and road junctions and setting up blocking positions to prevent German reinforcements from reaching the beaches of Normandy. Of the 17,000 US airborne troops engaged in operation Overlord, 1,003 were KIA, 2,657 were WIA and 4,490 were declared MIA.
At the same time, off that coast, the largest amphibious assault fleet the world had ever seen, drawn from 8 allied navies (6,939 vessels: 1,213 warships, 4,126 transport vessels (landing ships and landing craft), and 736 ancillary craft and 864 merchant vessels), began gathering. 19 and 20 year old young men, who to that point had never seen a shot fired in anger nor fired one themselves, would get their baptism in war on Omaha, Gold, Utah, Swordand Juno beaches. In all 160,000 allied troops would land that day.
At Pointe du Hoc, the US 2nd Ranger Battalion assaulted the massive concrete gun emplacements that commanded the beach landing sites. They had to scale 100 foot cliffs under enemy automatic gunfire to reach them. When they did, the found out the guns had been moved further inland. They pressed their assault, found them and destroyed them and then defended the location for two days until relieved. The operation cost them 60% casualties. Of the 225 rangers who began the operation, only 90 were still able to fight at its end.
On Omaha beach, the US 1st and 29th Infantry Divisions landed opposite the veteran German 352nd Infantry Division. They had sited their defensive positions well and built concrete emplacements which were all but immune from bombardment. The initial assault waves of tanks, infantry and engineers took heavy casualties. Of the 16 tanks that landed upon the shores of Omaha Beach only 2 survived the landing. The official record stated that “within 10 minutes of the ramps being lowered, [the leading] company had become inert, leaderless and almost incapable of action. Every officer and sergeant had been killed or wounded […] It had become a struggle for survival and rescue”. Only a few gaps were blown in the beach obstacles, resulting in problems for subsequent landings.
Leaders considered abandoning Omaha, but the troops that had landed refused to stay trapped in a killing zone. In many cases, led by members of the 5th Ranger Battalion which had been mistakenly landed there, they formed ad hoc groups and infantrymen infiltrated the beach defenses and destroyed them, eventually opening the way for all. Of the 50,000 soldiers that landed, 5,000 became casualties of bloody Omaha.
Canadian forces landed at Juno. The first wave suffered 50% casualties in the ferocious fighting. The Canadians had to fight their way over a sea wall which they successfully did. The 6th Canadian Armoured Regiment (1st Hussars) and The Queen’s Own Rifles of Canada achieved their 6 June objectives, when they drove over 15 kilometres (9 mi) inland. In fact, they were the only group to reach their D-Day objectives.
By the end of D-Day, 15,000 Canadians had been successfully landed, and the 3rd Canadian Infantry Division had penetrated further into France than any other Allied force, despite having faced strong resistance at the water’s edge and later counterattacks on the beachhead by elements of the German 21st and 12th SS Hitlerjugend Panzer divisions on June 7 and June 8.
The Brits landed at Sword and Gold beaches. At Gold the 50th (Northumbrian) Infantry Division landed with heavy casualties, but overcame the obstacles and drove about 10 kilometers off the beach.
Led by amphibious tanks of the 13th and 18th Hussars, the landings on Sword went rather well with elements of the 8th Infantry Brigade driving 8 kilometers off the beach.
And the final beach, Utah, saw the 23,000 troops of the US 4th Infantry Division land. Through a navigation error they landed on the western most part of the beach. That happened to be the most lightly defended as well. Taking full advantage of the situation, the division fought their way off the beach and through the German defenses linking up with the 502nd and 506th Parachute Infantry Regiments of the 101st Airborne Division which had dropped in the night before and secured the inland side of the beach exits.
The liberation of Europe had begun. But it was costly. Of the total 10,000 casualties suffered that day on the beaches by the allies, the US had 6,603 of which 1,465 were killed in action. The Canadians suffered 1,074 casualties (359 KIA) and the British had 2,700.
Men who had never set foot on the continent of Europe before died trying to liberate it that day. Today most of them lie in quiet graveyards near where they fell, the only piece of land ever claimed, as Colin Powell said, was enough to lay them to rest. 65 years ago, as the guns boomed, the shells exploded and desperate and courageous men made life and death decisions on the bloody sands of Normandy beaches, the fate of the world literally hinged on their success.
I think it is important, on this day to remember that. It is also just as important to remember that had the rest of the world taken the threat posed by the evil of Nazi Germany seriously earlier than they did, the possibility exists that such a fateful landing would never have been necessary.
But it was. And to those who made it, liberated Europe and destroyed the evil that was Nazi Germany, they have my undying respect and deserve to have what they did -and why they did it – remembered by all for eternity.
Barack Obama recounted the contributions of Islam yesterday during his speech in Cairo. This may not have been what he was talking about:
German media outlets reported last week that a Saudi inventor’s application to patent a “killer chip,” as the Swiss tabloids put it, had been denied.
The basic model would consist of a tiny GPS transceiver placed in a capsule and inserted under a person’s skin, so that authorities could track him easily.
Model B would have an extra function — a dose of cyanide to remotely kill the wearer without muss or fuss if authorities deemed he’d become a public threat.
The inventor said the chip could be used to track terrorists, criminals, fugitives, illegal immigrants, political dissidents, domestic servants and foreigners overstaying their visas.
Another wonderful tool for the state. My guess is it will be beta tested in NoKo.
That’s what John McCain has said about the Obama tendency to appoint “czars” to oversee various issues. As McCain points out, these czars operate outside of any real oversight.
And apparently there’s going to be another new “czar” in town. A – are you ready for this? – “pay czar”.
The Obama administration plans to appoint a “Special Master for Compensation” to ensure that companies receiving federal bailout funds are abiding by executive-pay guidelines, according to people familiar with the matter.
The administration is expected to name Kenneth Feinberg, who oversaw the federal government’s compensation fund for victims of the Sept. 11, 2001, terrorist attacks, to act as a pay czar for the Treasury Department, these people said.
A tendency toward fascism?
I’d have to say yes. There’s no question that this is a very deep intrusion into the management of a company which will have negative consequences on down the road (the companies still compete for talent in the same pool as companies not under these restrictions). But apparently their competitive health is less important than enforcing some arbitrary and political level of “fair” compensation.
Perhaps the time has come to be perfectly frank. We Americans live in a socialist country. In point of fact, we have for quite some time, even though private property has a long, continuing and still revered position in our society. To be sure, we aren’t an entirely socialist country, but instead a mixed one that teeters between the two extremes of collectivism and freedom (i.e. socialism and capitalism). In the past century or so, however, the scale tipped noticeably toward the socialism side, and we are now at the point where capitalism is not the dominant force. Of course, there are many who will disagree with my assessment.
Conor Clarke, for example, offers the following to dispel notions that we have become a socialist country:
Have you heard that the United States is headed toward socialism? Jonah Goldberg says it is. Alabama Senator Richard Shelby says it is. Phyllis Schlafly says it is. Richard Viguerie says it is. The Republican National Committee says it is. We must be getting pretty close.
The hot-pink portion of this pie chart is the percentage of listed American business assets that have recently been nationalized by the American government (ie, General Motors). Obama’s version of socialism is so sneaky you can hardly see it!
(And there is some reason to think this actually overstates the portion of the corporate landscape that’s been nationalized, but more on that at the end of the post.*)
While the chart above would appear at first glance to be pretty dispositive of the issue (if the federal government owns so little, can we really be socialist?), it actually begs a huge question. If the segment of the economy effectively nationalized in the past several months is so vanishingly small, why is it necessary for taxpayers to fund trillions of dollars to save it? We’ll come back to that.
Next, Jon Henke observes:
NOTE: The fact is, American has always had a mixed economy, as do all modern, developed economies. The question is not one of category – capitalism or socialism? – but of degree.
Obama is not socialist. But he is more comfortable with centralizing economic power. As that centralization proceeds, the focus of public interest will shift from “how do we fix the immediate economic problems?” to “how do we fix the problems we created when we tried to fix that temporary problem?” That is when the pendulum can swing back towards decentralization and individual empowerment.
Jon takes a more organic view of the subject. That is, he posits the governing structure of the US as subject to the tolerance of the polity for centralized control of the economy. In his view, just because Obama “is more comfortable with centralizing economic power” that does not mean that we have become a socialist nation. Instead, we are merely experiencing a swing of the political pendulum towards socialism that will inevitably swing back towards the capitalism node. Left unsaid is how often that pendulum has swung away from socialism in the past 100+ years. More importantly, Jon’s assertions beg their own question — i.e. how “comfortable” must a politician and/or the populace be with centralized power before we can safely label it socialism?
In addition to the above, another line of argument is sure to be made (if it hasn’t been already) that we cannot possibly be a socialist country because private property has not been outlawed and the people as a whole do not own and control the means of production. Truly, this is the argument that Conor attempts to support with his graph (not that Conor necessarily agrees with that argument, just that he is holding up evidence that would tend to suggest socialism is not at hand). Essentially, although socialism comes in many forms, a primary ingredient is that the state (on behalf of the people) have dominance over the means of production instead of private concerns. The most extreme form, of course, is where all private property is abolished and the state decides what will be produced, by who, when and how much. Much milder versions such as social democracy exist today that, while they allow private property and much more freedom than, say, Stalinist North Korea, maintain a firm grip over the economy as a whole. Is there any doubt that Germany is a socialist country for example? The question then is, where does America fit when it this spectrum of socialist possibilities, if it fits at all?
At bottom, the problem with these sorts of arguments is almost always definitional. If I start arguing that communism never works and use the Soviet Union as an example, someone is sure to pipe up “that wasn’t real communism” followed by a neat explanation how Lenin and Stalin perverted what the true communists wanted in order to seize power for their own means. In order to avoid that annoyance, let’s at least agree on the dictionary definition of socialism:
An economic system in which the production and distribution of goods are [owned and] controlled substantially by the government rather than by private enterprise, and in which cooperation rather than competition guides economic activity. There are many varieties of socialism. Some socialists tolerate capitalism, as long as the government maintains the dominant influence over the economy; others insist on an abolition of private enterprise. All communists are socialists, but not all socialists are communists.
The definition above comes from the The American Heritage® New Dictionary of Cultural Literacy, Third Edition, and I think sums up the idea nicely. The one thing missing is the word “ownership” which, I expect, someone will insist upon, so I’ve inserted the words “owned and” into the definition. As luck would have it, this is the very concept that I think is missed by almost everyone who discusses whether or not we are a socialist country.
Specifically, what is the difference between ownership and control? Looking again to the dictionary, here is a good legal definition of “ownership”:
“one’s exclusive right of possessing, enjoying, and disposing of a thing.” 72 So. 891. The term has been given a wide range of meanings, but is often said to comprehend both the concept of possession and, further, that of title and thus to be broader than either. See 139 N.W. 101. See fee simple.
The primary concept behind ownership is that of exclusivity, such that if I own real property, for example, I can by right exclude all others. Without the ability to exclude, my “ownership” is something less than complete and the use, enjoyment and alienation (a fancy word for selling, trading or giving away) of property is limited.
To illustrate the idea, consider that you own a piece of real property (Blackacre) which is rich with gold and silver mines, oil, and an abundance of flora and fauna. In short, it is a little slice of heaven and it is all yours. Or at least it would be if were not for the fact that the flora are mostly designated as protected, the fauna are all listed as endangered, and the mineral deposits are tightly regulated, all to the extent that you cannot make any real use of your land except to look at it from a neighbor’s yard in humble admiration for its splendor. Not only are you prevented from drilling or mining on your property, you cannot even build a house or structure of any kind because that might disturb the protected species. The rules and regulations governing Blackacre are so ominous, that you can’t even sell it without first offering it to the government for a price it will set in its own arbitrary discretion. Furthermore, just on the other side of Blackacre is the Pacific Ocean fronted by a lovely beach, to which the law declares access must be allowed for the public, and there is nothing you can do to prevent them from traipsing across your wonderland. In short, you may own Blackacre in title, but you have very little, if any, control.
Of course, at least here in America, the laws and regulations aren’t quite that strict. And the vast majority of people would agree to at least some controls over private property to prevent the owners from harming other property or people (e.g. pollution, building setbacks to prevent fire, etc.)[ed. – let’s ignore Coasean bargaining for now, shall we?]. At some point, however, those restrictions on the owner’s use become so burdensome as to effectively deprive the owner of any real control. The same can be said for the ownership of capital, which can be anything from money to a large factory for building tractors. When the government sets up enough rules and regulations affecting the use and enjoyment of that capital, the fact that ownership is nominally in private hands does not somehow render that government as something other than socialist.
Now, getting back to our definition of socialism, which is more important, “ownership” or “control”? To my mind, this isn’t even a close call. Without control, ownership is next to meaningless. Therefore, if the state has the ability to control the means of production (a.k.a. capital), whether directly through ownership, or indirectly through law and regulation, I contend that such state should be deemed socialist.
Think of a scale that measures the owner’s rights in her own property and how, with each new government missive, that ownership indication drops a little more. Where the state’s intervention becomes intolerable will be different for each person, but from a definitional standpoint, that intervention represents socialism. When the scale registers a significant enough intervention into the owner’s rights, socialism becomes the prevalent factor in the control of property, and private, capitalist “ownership” is either dulled or altogether neutered. Again, without the ability to control that capital, ownership is a meaningless concept that should be left out of the conversation.
Accordingly, when Conor suggests that we are not a socialist nation because the government only owns an almost immeasurable portion of the corporate assets of this country, I suggest that he use a new measurement. Specifically, one that measures the amount of control that “owners” have over their property/capital/etc. That graph would look significantly different in my estimation.
Furthermore, when Jon states that Obama is not a socialist, he’s just comfortable with centralizing economic power, I ask that he consider what ways centralizing power (i.e. control over the means of production) is not socialist, and that he provide a few examples for clarification. Also, if the pendulum is going to swing back towards more decentralization (i.e. less control over capital), how far back would it have to go before most people could be reasonably certain that we are not, in fact, a socialist nation? How far back does he think it would have to go, or is his contention that the pendulum simply hasn’t swung into socialist territory? In considering those questions, I’d ask that the concept of control, rather than titular ownership, be the dominant factor in deciding where the state stands vis-à-vis socialism.
As I see it, we’ve been living with socialism in this country for a very long time. The only difference has been one of degree and magnitude. Its pervasiveness has ebbed and flowed over the decades, but American’s tolerance for it has grown substantially, even if many of us don’t like to call the governance we desire “socialism.” Unfortunately, that’s exactly what it is, and it’s only going to become more prevalent and intrusive. After all, why would anyone who is comfortable with centralizing economic power stop it? They’ll just call it something else and move on with asserting they’re control until one day you’ll be gazing longingly at Blackacre from the public beach, because that’s the only place where you can legally see it.
A few new developments, none of them good.
One – Obama has indicated his willingness to entertain legislation that would tax your private health care benefits. What that means is you’ll be taxed on the money your employer spends on your health care insurance. Of course the obvious immediate effect would be to raise revenue to pay for the public portion of his health care plan.
Two – Obama has decided that making insurance mandatory may not be such a bad idea. This is 180 degree change from candidate Obama who attempted to hide his statist tendencies by pretending that he wouldn’t require mandatory insurance for Americans.
He told Democratic Sens. Edward Kennedy (Mass.) and Max Baucus (Mont.) that their legislation must include a government-run insurance option that would compete against the private sector. He also reaffirmed his support for a Massachusetts-style insurance exchange.
What do you suppose will happen if government-run insurance is an option for all? Depending on how it is structured (if, for instance, if it is a universal pool), we could see massive dumping of private insurance by businesses pointing their employees to the government option.
[I]mbuing a federal panel with the power to make Medicare payment recommendations that Congress must either accept or reject in their entirety.
Obama likens this proposal, based on the current Medicare Payment Advisory Commission, to the way military base closure decisions are made. To Republicans, however, the notion smacks of the kind of “rationing” dictated by government-run healthcare programs in Europe and Canada.
Ezra Klein explains the “federal panel’s” proposed role:
The health system changes too quickly for Congress to address through massive, infrequent, efforts at total reform. New technologies and new care structures create new problems. A health care reform package signed in 2009 might miss some real deficiencies, or real opportunities, that present themselves in 2012. A health reform process that recognizes that fact is a health reform process that is continual, rather than episodic.
But the reason health reform is so infrequent is that it’s structurally difficult. Small tweaks are too technically complex for Congress to easily conduct and so are dominated by lobbyists. Large reforms attract broad interest but are impeded by polarization and the threat of the filibuster. The MedPAC changes under discussion are, in other words, nothing less than a new process for health care cost reforms. They empower experts who won’t be intimidated by the intricacy of the issues and sidestep the filibuster’s ability to halt change in its tracks.
In other words health care decisions that will directly effect you will be in the hands of an unelected and unaccountable panel of bureaucrats just as all the critics of this sort have program have been claiming since the beginning of the debate.
MedPAC, of course, is restricted to Medicare. But there’s little doubt that where Medicare leads, the health care industry follows. Private insurers frequently set their prices in relation to Medicare’s payment rates. Hospitals are sufficiently dependent on Medicare that a reform instituted by the entitlement program becomes a de facto change for the whole institution, and thus all patients. A process that empowers Medicare to aggressively and fluidly reform itself would end up dramatically changing the face of American health care in general.
Klein is exactly right, but most likely not for the reasons he thinks he is. The level of care, innovation and incentive will follow the decline in prices driven by MedPAC. What the nation needs is insurance reform, not “health care reform”. And while that is how the proponents of this try to spin the issue as just that, MedPAC’s existence and proposed expanded role argues persuasively against that spin.
Watch carefully – the Democrats are going to try to move this quickly and with little debate.
UPDATE: Apparently the letter from Obama I spoke about above also had another effect:
President Obama’s letter to Senate lawmakers yesterday saying a healthcare package must include a public option may have stalled progress on a bipartisan deal, Sen. Judd Gregg (R-N.H.) said Thursday.
Gregg said that the president’s letter, which said a public option should be included in the legislation, stalled “significant progress” in negotiations.
“We were making great progress up until yesterday, in my opinion,” Gregg said during an interview on CNBC. “There’s a working group under Sen. Baucus that involves senior Republican and Senate senior members who are involved in the healthcare debate, and we were, I thought, making some fairly significant progress.”
The most discouraging thing about this update is the fact that Republicans, who are claiming government is too big and we’re spending too much are knee deep in negotiating more government and more spending (i.e. selling out – again) having apparently swallowed the Democratic premise that this is necessary whole.
China, despite its economic progress, remains a rigidly totalitarian state that certainly doesn’t wish to be reminded of the pro-democracy rallies 20 years ago, or the bloody government crackdown that ended them:
China blanketed Tiananmen Square with police officers Thursday, determined to prevent any commemoration of the 20th anniversary of a military crackdown on pro-democracy protesters that left hundreds dead.
The government reacted angrily to a mention of the anniversary by Sec. State Hillary Clinton:
“The U.S. action makes groundless accusations against the Chinese government. We express strong dissatisfaction,” a Foreign Ministry spokesman, Qin Gang, told reporters at a regular briefing.
“The party and government have already come to a conclusion on the relevant issue,” he said. “History has shown that the party and government have put China on the proper socialist path that serves the fundamental interests of the Chinese people.”
And to ensure that the people of China have few venues in which to discuss this anniversary, the “fundmental interests of the Chinese people” are being “served” by blocking various internet sites:
Access was blocked to popular Internet services like Twitter, as well as to many university message boards. The home pages of a mini-blogging site and a video-sharing site warned users they would be closed through Saturday for “technical maintenance.
Known activists and dissidents are under close supervision:
One government notice about the need to seek out potential troublemakers apparently slipped onto the Internet by mistake, remaining just long enough to be reported by Agence France-Presse. “Village cadres must visit main persons of interest and place them under thought supervision and control,” read the order to Guishan township, about 870 miles from Beijing.
In a report released Thursday, the rights group Chinese Human Rights Defenders said 65 activists in nine provinces have been subjected to official harassment to keep them from commemorating the anniversary.
Ten have been taken into police custody since late May, the group said. Dozens of others, mostly from Beijing, are either under police guard or have been forced to leave their homes, according to the report.
The mass media has, as expected, cooperated with the state as well:
There was no mention of the day’s significance in Thursday’s Beijing newspapers. The state-run mass-circulation China Daily led with a story about job growth signaling China’s economic recovery.
An interesting counterpoint to the claims that China has become more democratic over the years, and is actually doing a much better job with human rights than it has in the past. The fear of a simple remembrance of government brutality 20 years ago says that’s not at all true. And the government’s concerted effort to wipe that memory away prove it.
It certainly seems like it. Reason magazine finds the current way the US is addressing the economic crises to be pretty familiar:
The scenario was eerily familiar. A long real estate bubble that had expanded extra rapidly for the previous five years suddenly burst, and asset prices came crashing back down to earth. Banks and financial institutions were left holding piles of worthless paper, and the economy soon headed south. The national government responded to the crisis by encouraging more lending and spending previously unfathomable amounts of money on public works projects in an effort to stimulate consumer spending and restart growth.
Of course that’s where we are now and what that led too in Japan has come to be known as the “lost decade” (now three decades old).
One of the things we’ve pointed out is there is an element within this model that both Japan and now the US has used that is focused on “pain avoidance” (GM and Chrysler are prefect examples of that). Part of that is driven by the belief by those in power that the government can address problems within markets and lessen the impact. The second part of that, of course, is by convincing the public that’s the case, they then have to try to do what they claim they can do. But the law of unintended consequences has a bad habit of pushing its way into such situations and turning them sour:
The Japanese experience shows that when the government is an active participant in the market, many firms would rather accept state support than initiate the inevitable financial reckoning. Such a status quo does not provide a sustainable foundation for the economy. Instead, it restricts economic growth and creates a cycle of stagnation.
A friend, talking about the recession and eventual recovery, said that we’ll come out of it “okay” because “Americans are neurotically productive”. True. But so are the Japanese. While we have a fantastic workforce which is among the most productive in the world, even they won’t be able to overcome restricted economic growth caused by the government’s deep intrusion into various markets.
Comparing Japan’s reaction to the US reaction in similar circumstances is instructive:
When a recession began to set in after the 1990 stock market crash, Japan responded by reversing its tight money policy, cutting rates to 4.5 percent in 1991, 3.25 percent in 1992, 1.75 percent from 1993 to 1994, 0.5 percent from 1995 to 2000, and as low as 0.1 percent in September 2001.
A similar pattern took place in the United States. From 2000 to 2002, the Federal Reserve slashed the target discount rate from 6 percent to 0.75 percent. Fearing irrational exuberance, to borrow Alan Greenspan’s famous phrase, the Fed then raised the rate as high as 6.25 percent in June 2006. But now that the bubble has burst and the economy contracted, the Fed has cut the discount rate 12 times, lowering it to the current 0.5 percent. Federal Reserve Chairman Ben Bernanke has repeatedly stated that he sees interest rate cuts as a way to “support growth and to provide adequate insurance against downside risks.”
In both the Japanese and the American cases, post-bubble policy makers believed that lowering interest rates would make credit easier to obtain, thus recreating the environment that had spurred economic growth to begin with. But this meant that the supposed cure for a bubble created by easy credit was to extend even more easy credit.
These rate cuts only perpetuated the distortion of economic decisions and prevented savings, investment, and consumption from realigning with true preferences, as opposed to the illusory ones created by easy credit and artificially low interest rates. The lesson is that when monetary policy is used to “smooth” or “tweak” the market, it inevitably causes unintended consequences that in some cases can be very damaging to long-term economic growth.
Of course it is hard to say what future growth might be had the US government not done what it has done. But again, using Japan of that era vs. the US of that era, the difference is between 1.3% growth on average vs. 3.5% growth here. In economic terms that is a huge difference.
Reason also does a nice job of dismantling the “failure of regulation” argument. As they point out, what must be examined is how the regulatory environment then in place spawned the crisis vs. the claim that not enough regulation was in place.
For instance, government housing policy of the era:
The push to expand homeownership had two big effects. First, it greatly increased the number of buyers, driving up housing prices. Second, it provided mortgages to a large number of people who had a high risk of default.
That policy was further enabled by the capital reserve requirements which, in effect, encouraged heavy lending and an insensitivity to risk. Instead of admitting that and understanding that such policies are dangerous, the reaction has mostly been to ignore that and shift the blame to the private sector with calls for “more regulation”.
And then, going back to the “pain avoidance” point (justified as “too big to fail” by the government), what has happened is, as in the case of GM and Chrysler before the bankruptcies, government propping up failed businesses:
The Bank of Japan tried to ease economic pain by loaning large amounts to businesses. But the attempts to recapitalize the market ignored underlying management problems in the dying firms. It was a costly mistake. Intense lobbying from special-interest groups representing various sectors of the Japanese economy perpetuated the ill-fated loans and funneled government money to zombie businesses.
The United States has already begun to copy this policy, lending billions of dollars to financial institutions and auto companies and buying up billions more in bank equity in an effort to recapitalize the marketplace. The effect has been to keep poorly managed firms alive with taxpayer money.
Had they been allowed to fail and go through the reorganization process, those problems would have at least been addressed. They haven’t, at this point, in most of the financial sector and in the auto sector, it remains to be seen.
Of course the government’s deep involvement in these sectors and businesses sets up a natural conflict of interests. While a business is market oriented, and takes signals from consumers, governments are agenda driven and politically oriented. And it then comes down to a matter of incentives. In the first case the incentive of a business is to serve its consumer base. But that’s not the case with politicians necessarily, is it?
Lawmakers’ incentives are to serve their constituencies or their own political careers. This can put them at odds with the businesses they are suddenly attempting to manage. The more the government is involved in directing business activity, the less likely those firms will succeed in maintaining long-term growth, and the more likely they will turn into Japanese-style zombies.
While we’d like to believe that lawmaker’s constituencies consist of the people in their state or district, in reality they consist of special interests who help keep them in office. The ability to deliver to those special interests and keep their support and dollars flowing is just to much to resist for most.
Studies from Okimoto’s center and the Bank of Japan concluded that data revealing the scope of the economic malaise were suppressed and that regulations were developed with governmental interests in mind.
Given how the discussion has been driven here by the likes of Barney Frank and Chris Dodd, there’s little doubt that regulations will be “developed with governmental interests in mind”.
In reality it all comes down to power, or the illusion of power, and politics. Short-term politics with no real eye on the future impact of actions taken today. And these actions are based in a false premise that the market is not self-correcting and that it must be both controlled and tweaked by government.
Japan bought into that premise, and so has the US:
The principle of creative destruction—the economic mutation that continuously breaks down old forms and creates newer, more productive and efficient ones—was ignored in the hope that legacy corporations could somehow save Japan. From Wall Street to Detroit, under both George W. Bush and Barack Obama, the American government has been equally unwilling to let once-formidable companies fail.
And that, in my opinion, will see us repeat the Japanese experience, despite the small glimmers of hope we’ve been seeing in the reports in recent days. This isn’t about short term increases in home sales and construction spending. This is about the long term economic health of our economy.
Unsurprisingly, I’m not seeing moves by the government that work toward the most positive outcome in that regard.