Monthly Archives: November 2009
Hidden within the murky depths of the 1990 page health care insurance reform bill is a bonanza of new government bureaucracies among the numerous agencies, programs, funds and “corps”.
Among some off the new agencies, the list cites a Health Insurance Exchange; the Center for Medicare and Medicaid Innovation; the Public Health Investment Fund; the Public Health Workforce Corps; an Assistant Secretary for Health Information; the Food and Drug Administration Office of Women’s Health; grant programs for alternative medical liability laws, infant mortality programs and other issues; and about 100 other government-sponsored creations.
If smaller and less intrusive government is one of the GOP’s guiding principles, then being the party of “no” on this particular monstrosity is the most principled stand they can make.
Bill Quick has been pondering why the GOP establishment can look so lost:
I’ve been wondering why the suicidal wing of the GOP – the elites and others who want to turn the party into an echo of the Democrats – think that way. I finally believe I may have a glimmer.
He then summarizes the state of the disconnect between the establishment GOP and the wider world, and finished with:
It’s easy to say they don’t get it because they’re stupid, but the truth is much worse: They don’t get it because they don’t want to get it.
Your quiz for today, then, is to answer the question: Why don’t they want to get it?
The quiz answer has got to be some variation of “They’re getting what they want right now, so why change?” If it were not in their self-interest to try and perpetuate the status quo, then they wouldn’t do it, at least not again and again the way they have.
Here’s my own mental model: they are members of a separate society from the rest of America. That society consists of politicians, lobbyists, top-tier media people, A-list celebrities, and top-level bureaucrats. The GOP establishment politicians are far more loyal to the society they belong to (including the most liberal members of it) than they are the wider American society.
So they regularly and consistently do what their own tribe expects and demands, rather than what the rest of us want. They grow to see us as simplistic rubes who don’t know any better, and they talk themselves into believing that the ways of their tribe are the right ways. Anyone who thinks otherwise is just ignorant or confused.
Being chauferred around in limos and having 95% of the people you run into pay obeisance to you smooths their assimilation into the tribe and and serves to remind them every hour of ever day of their special status and the vast gulf separating them from the rest of us. They also get security in the form of big pensions, various perks from those who want to get their attention, and respect far beyond what their abilities would otherwise command.
When someone comes in who was not formerly a member of the tribe, they take special effort to initiate that person into the tribe and ensure that they know the unwritten rules of membership. This is how a Bill Frist goes from being a campaigner for limited government in his first campaign in 1994 to being a senator who helped pass a bunch of Bush welfare state programs – in only about six or eight years.
The tribe ostracizes anyone who does not take to the assimilation process, but that’s seldom necessary. The immense craving for acceptance that is a part of the typical politician’s personality profile is almost always enough to eventually suck them in.
This is perhaps an inevitable result of having a professional political class and ever-growing government.
Spending all their time in the tribe, and accustomed to being buffered and covered by the media wing of the tribe, it’s hard for them to assess when a level of dissatisfaction is reached that will seriously threaten very many members of the tribe. The tribe was caught flat-footed in 1994 and they saw several members forced into new roles or even retirement. As a whole, though, they recovered quite well. In two or three years things were back to normal. They assimilated the new members, ramped up the media control, and prepared to ride out the next such wave.
They passed a bunch of new rules to keep the outsiders in line: Campaign Finance Reform, Sarbanes-Oxley, and others. Since the nominal process they thought they controlled got a little beyond their control, they simply passed rules to give themselves more control.
That gave them the confidence that they can ride out any such episodes in the future; nothing the barbarians outside the tribe have attempted has worked to cause any real change in decades. So they’re paying lip service to the principles of the Tea Parties, but they don’t really think those barbaric outsiders can do anything that really threatens them.
Maybe they’re right. It’s up to us to prove them wrong.
Or at least they seem to have astonished Klein. Here’s one as an example:
My goodness. As Klein says:
There is a simple explanation for why American health care costs so much more than health care in any other country: because we pay so much more for each unit of care.
Anyone – what’s missing from this rather simplistic explanation?
What is the real cost of delivering the expected/desired/demanded health care during a doctor’s visit? What is the cost per “unit delivered”. And if it is higher, why is it higher? Is it higher simply because we’re being gouged as is implied by Klein? Or is more being delivered per unit and thus justifying the higher cost? The chart tells us none of that.
What will these various countries pay for during a visit? And given that, which country’s patients get the most (and best) care for the money? Again, the chart tells us none of that.
As has been pointed out any number of times, when you remove non-health care related deaths from this country’s life expectancy statistics, we are in better shape than anyone. In fact, when you get into the later years, survival rates among our elderly are unsurpassed by any system. That to me would say that we must be delivering something during those visits that the mere “price” doesn’t reflect.
But all folks like Klein ever seem to want to talk about is “price”. This may comes as a surprise to some, but price is determined by cost and competition. It’s not an arbitrary number. In fact, competition keeps both cost and price (and thus profit) at a reasonable level. That’s how a market works, even one as distorted by government intrusion as our health care system.
There’s also another 800 pound gorilla in the room. Actually the gorilla is the bar on the graph disguised as a $72 fee from Medicare. How do you think the difference between those paltry fees and the real cost of the visit are recovered? Look left, young man, look left. That big bar of private insurance subsidizes Medicare by absorbing the cost shifting which goes on from Medicare payments which don’t cover cost. Without the ability to do that fewer and fewer doctors would accept or treat Medicare patients. In fact, why do you think they limit them now? That reality, of course, isn’t reflected at all in the chart.
Additionally, there is the quality of care – what does a $30 doctor’s visit buy in Canada or the UK in comparison with a $72 Medicare visit in the US? We really have no idea. So how then is such a comparison relevant to anything? I can buy a KIA or I can buy a BMW. Few would argue they have the same cost and certainly not the same value. The quality is entirely different. Yet they’re both cars. The chart assumes all care is equal. But we know that isn’t true.
In fact, these sorts of apples and road apples comparisons aren’t useful for much more than gulling the masses when pushing an agenda. Surely, common sense tells us, we can get more for less, right? Of course not. Most people discover during their lifetime that you do indeed get what you pay for. And in the field of health care, the differences can be vast.
In terms of a serious argument for government run health care in a free country, the astonishing charts leave a lot more unsaid than said. Or put another way, they and the argument Klein tries to make with them aren’t worth the powder to blow them to hell.
If you were wondering what it would take in terms of tax rates, to “erase the deficit”, the Tax Foundation [pdf] provides a couple of handy, dandy charts for you:
Note – this only “erases the deficit” – it does not even make a small dent in the debt which stands somewhere in the 11 trillion dollar area.
So when you hear that all this new spending, which will indeed raise the deficit, won’t raise your taxes by a single “dime”, you can believe it if you wish. But that doesn’t mean it is true. And it certainly doesn’t mean Democrats can keep that promise. Because if they do, they’re simply kicking the same can down the road that Republicans have for years (and no, I’m not advocating massive tax increases, I’m just providing a little reality check to counter the nonsense the politicians continue to spout). The alternative to the tax rates above is to cut spending – drastically. If you see that on the horizon you’re the only one because Congress just raised the debt ceiling – again.
[HT: Tax Prof]
Right now, if you believe the final Public Policy Polling surveys in New Jersey and New York’s 23rd Congressional district, it looks like wins for the right side of the ideological curve.
In NY-23, PPP has Hoffman at 51%, Owens at 34% and Scozzafava – the GOP’s favored nominee – at 11%. So the insurgent conservative candidate who the GOP is now quite happy to claim, is pulling a majority in the district. Head to head, PPP has Hoffman at 51% and Owens at 38%. The former GOP candidate has chosen to act as conservatives thought she would – she’s endorsed the candidate which most closely matches her politics – the Democrat. Joe Biden will be in the district today to try and push Owen’s numbers up.
“Polling the race was a little haphazard in a weekend with many twists and turns but Hoffman showed a similar lead at all junctures… The bottom line though is that Hoffman led by double digits during every segment of the poll, an indication that he may have been headed for a definitive victory regardless of Scozzafava’s actions over the course of the weekend.”
In the NJ governor’s race, PPP has Christie at 47%, Corzine at 41% and Daggett at 11%.
PPP points out that in NJ, the difference is independents going over to Christie’s side in a big way:
“Christie’s advantage is due largely to his support from independents and because he has Republicans more unified around him than the Democrats are around Corzine. Christie leads Corzine 52-29 with indies, as Daggett’s support with that group has declined to 16%. Christie is getting 82% of Republicans to Corzine’s 72% of Democrats.”
Of course this is NJ we’re talking about and 6% would seem to be a pretty significant lead, but there are factions at work which will most likely do whatever is necessary to overcome that. But the defection of independents to the Republican candidate has to worry Democrats.
And I’d guess that what is happening in the VA Governor’s race is much the same as what is being seen in NJ – McDonald leads Deeds mostly because of a more unified Republican base and the defection of Independents.
Should all 3 go to the Republicans, it will be very interesting to see the spin – from both sides. Democrats will most likely downplay the significance while privately being very concerned with 2010 right around the corner. And Republicans will most likely misread the results as some sort of mandate for them and their “big tent” compromising ways.
Suffice it to say these are 3 specials that I’ll actually be interested in following tomorrow, if for no other reason than to hear the establishment party types on both sides explain what happened.
I‘m not kidding. So says none other than the New York Times:
A Week Mapping Radioactive Rabbit Feces With Detectors Mounted On A Helicopter Flying 50 Feet Over The Desert Scrub. … $300,000 In Federal Stimulus Money.” … “A government contractor at Hanford, in south-central Washington State, just spent a week mapping radioactive rabbit feces with detectors mounted on a helicopter flying 50 feet over the desert scrub. … the helicopter flights, which covered 13.7 square miles and were paid for with $300,000 in federal stimulus money, took place in an area that had never been used by the bomb makers. … Marylia Kelley, the executive director of a California group called Tri-Valley Communities Against a Radioactive Environment, said the rabbit cleanup was ‘kind of funny, in a sick way.”
A great way to stimulate the economy, no?
Well how about this:
“President Obama’s Stimulus Plan… Is Now Paying Americans To Buy That Great Necessity Of Modern Life, The Golf Cart.”…“Thanks to the federal tax credit to buy high-mileage cars that was part of President Obama’s stimulus plan, Uncle Sam is now paying Americans to buy that great necessity of modern life, the golf cart. The federal credit provides from $4,200 to $5,500 for the purchase of an electric vehicle, and when it is combined with similar incentive plans in many states the tax credits can pay for nearly the entire cost of a golf cart.”
Let’s not forget that our president is a great fan of golf afterall. What better way can you think to stimulate the economy?
Oh, how about this?
“The other third of the stimulus, government infrastructure spending, has been the most controversial from the start. Some proposals have been criticized as wasteful, Such as a $6 million snowmaking facility in Duluth, Minn.”
A snowmaking facility in Duluth, MN – the 15th “snowiest” city in America. Why that’s a perfect way to stimulate the economy.
But if that doesn’t resonate, there’s this:
“A big chunk of the money that will pay for a new spring-training baseball complex on Ttribal land in the East Valley will be delivered via a financing program that’s part of the Federal Economic-Stimulus Plan. The Salt River Pima-Maricopa Indian Community says it may borrow as much as $30 million of the estimated cost of the $100 million complex near Scottsdale that will become the spring home of the Arizona Diamondbacks and the Colorado Rockies.”
Because, of course, MLB is going broke.
You can read the whole disgusting list here.
Wasn’t Joe Biden going to police this?
Oh wait, I forgot – he and John Kerry are preoccupied deciding our new strategy in Afghanistan.
Yeah, nothing can go wrong with that, can it?
Dede Scozzafava, who suspended her House campaign earlier this week, in the face of rising discontent from Republican rank and file voters over her candidacy in the conservative NY-23 district, made the following statement this afternoon:
I want to thank you for your support and friendship. Over the past 24 hours, I have had encouraging words sent to my family and me. Many of you have asked me whom you should support on Tuesday.
Since announcing the suspension of my campaign, I have thought long and hard about what is best for the people of this District, and how to answer your questions. This is not a decision that I have made lightly.
You know me, and throughout my career, I have been always been an independent voice for the people I represent. I have stood for our honest principles, and a truthful discussion of the issues, even when it cost me personally and politically. Since beginning my campaign, I have told you that this election is not about me; it’s about the people of this District.
It is in this spirit that I am writing to let you know I am supporting Bill Owens for Congress and urge you to do the same.
So much for being a “lifelong Republican”.
Call in number: (718) 664-9614
Yes, friends, it is a call-in show, so do call in.
Subject(s):Economy (is the recession over?), health care math, NY-23 (what does it mean if anything?), California (no interest loans to the state from worker’s paychecks), Afghanistan (is the decision again delayed?), Honduras, etc.]
From a short post about The Wire by Jonah Goldberg at The Corner:
A lot of conservatives today are too quick to think that because liberals have some affinity for Marxist sentiments that they are actual Marxists. Liberals often make the same mistakes as Marxists, but they’re not Marxists.
I suppose this is true, but it got me to wondering. So I have a question for QandO readers.
Suppose, completely hypothetically, that Obama were a hard-core Marxist who wanted to go in the direction of Marxist programs as quickly as the system in place in this country allowed him to move.
Looking at his history in office so far, do you think there are any decisions that the hypothetical Obama-the-Marxist would obviously have made differently than the real Obama? If so, which ones?