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August 21, 2009

Collected Thoughts on Health Care Reform

Let's start with Steven Malanga on How Free Health Care Got So Expensive:

State government mandates and favorable tax treatment in Washington have so distorted the market for health insurance that a generation of Americans now look on medical coverage as something very different from other kinds of insurance that we buy. While we will pay several hundred bucks out of our own pockets to have a plumber come repair a leaky pipe, we'll balk at deductibles and a $50 co-pay for a doctor's visit. We've been schooled in this attitude by politicians who have mandated that health insurance do things that we'd never expect from other kinds of insurance, and by consumer advocates who will demand our legislators do something about a health insurance company that doesn't cover some optional procedure that has nothing to do with life and death.

Next, Charles Krauthammer on the promise of savings through universal preventative medicine:

The idea that prevention is somehow intrinsically economically different from treatment -- that treatment increases costs and prevention lowers them -- is simply nonsense.

If you instinctively think he's wrong, please read his article, and follow his links to the CBO.

Also, Robert Samuelson asks readers to "Just imagine what the health care debate would be like if it truly focused on controlling spending."

Incidentally, Samuelson's proposal to use vouchers to cut costs--"Medicare recipients would receive a fixed amount and shop for networks with the lowest cost and highest quality,"--steps directly into the larger conversation about the problem conservatives and libertarians have in fighting the expansion of government programs. A lot of people are afraid of being ripped off in the free market. They don't want to hear that they paid more than their friends for a plumber or auto mechanic or cell phone service. They don't want to compare plans, when they could just demand a "fair" plan that would apply to everybody. To some voters, the thought of a health care voucher is just a nightmare. They want to be able to go to a doctor when they are sick, without having to think about the cost. They want a mom, as noted on NPR's Morning Edition today.

Free market advocates just don't have a nuanced answer to that. We can keep telling people to grow up and take responsibility for themselves, but while we do that they'll keep voting for politicians who offer to take care of them. It is possible that there is no way out.

August 17, 2009

Could have been worse--Bob Dylan in America

How many roads must a man walk down before he is considered suspicious? Well, I guess it depends on whether it is raining.

A few weeks ago, Bob Dylan--yes that Bob Dylan--was taking a walk in the rain while on tour in Long Beach, NJ. According to reports, he entered the yard of a house that had a For Sale sign out front. This very alarming behavior prompted the occupants of the house to call the police, apparently without interacting with ol' Bob one bit. I confess I don't understand that. But what I really don't understand is the behavior of the officer who responded to the phone call for help. It seems she (politely) asked Bob Dylan who he was and what he was doing, and made the determination that he was indeed suspicious lookin'.

Says the officer, "You know, it was pouring rain and everything."

Based on the suspicious act of walking in the rain, the officer put Bob Dylan in the back of her cruiser. The articles I've read make it sound very amicable and voluntary, but I have to wonder how this would have played out of Bob had tipped his hat, thanked her for her concern, and walked away. And maybe it wasn't so voluntary after all, given what else the officer had to say:

"He was really nice, though, and he said he understood why I had to verify his identity and why I couldn't let him go," Buble said. "He asked me if I could drive him back to the neighborhood when I verified who he was, which made me even more suspicious."

Officer Buble, I don't understand why you had to verify his identity. I don't understand why you couldn't let him go. I bet most Americans would be outraged if this had happened to them, but of course most Americans don't think it could happen to them, so the outrage does not take hold. What's the big deal? He looked like a homeless man, and it's not like they tased him or arrested him (this time).

For a variety of reasons, Americans have developed a relationship with their police departments that is best categorized as "It could be worse". It's not the Gestapo, or frontier justice, and yes this situation probably would have been worse for Jay-Z than for Bob Dylan. But I have the feeling that George Washington would have run you through with a sword if you tried to take him into custody for walking in the rain without identity papers. If that doesn't give you pause for thought, then I think you've missed the point of what this nation was supposed to be about.

To quote Bob Dylan, "A man is a success if he gets up in the morning and goes to bed at night and in between does what he wants to do." May you someday find that kind of success, Bob.