Up and at ‘em! Big Brother needs you to work!
George Will refuses to let go of the argument that health-care reform legislation needs to overcome a serious hurdle: the Constitution.
Supporters of the mandate say Congress can impose the legislation under the enumerated power to regulate interstate commerce. Since the New Deal, courts have made this power capacious enough to include regulating intrastate activity that “substantially affects” interstate commerce. Hence Congress could constitutionally ban racial discrimination in “public accommodations” — restaurants, motels, etc. — as an impediment to interstate commercial activity.
Opponents of the mandate say: Unless the commerce clause is infinitely elastic — in which case, Congress can do anything — it does not authorize Congress to forbid the inactivity of not making a commercial transaction, of not purchasing a product (health insurance) from a private provider.
“Congress can regulate commercial activities in which people choose to engage, but cannot require that they engage in those commercial activities.” So says Sen. Orrin Hatch, who also notes that if Congress can mandate particular purchases to help the economy, there was no need forCash for Clunkers: Congress could have ordered people to buy cars (with subsidies, if necessary). Why not the Anti-Couch Potato Act to Make Calisthenics Mandatory and to Impose a $50 Excise Tax on Cheeseburgers Because Unhealthy Lifestyles Affect Interstate Commerce?
Will didn’t take it this far, but if you grant Congress that power, here is the logical progression:
IF it is legal for Congress to ban specific forms of inactivity because there would be an economic consequence, THEN it would be legal for the government to force you to work, even at a job not of your choosing. Oh, did you retire? Too bad! Get your ass to the office, pronto!
(Which is a good thing, because once people start dropping out of medical professions, they’ll need a way to conscript doctors, nurses and therapists.)
The Most Public of Options
For the many Americans who simply can’t afford health insurance…
No American should have to choose between health insurance and getting drunk.
Do it for the children.
ObamaCare loses heart
You can read the Bloomberg article for yourself:
Cardiologists Crying Foul Over Obama Medicare Cuts
I want to draw your attention to these excerpts:
Obama and his allies in Congress are pushing to extend coverage to the 46 million Americans without health insurance, at a potential cost of $1 trillion over a decade. The separate Medicare proposal, announced July 1, slashes projected spending for care by cardiologists and oncologists by more than 10 percent each, while paying family doctors 8 percent more and nurses an additional 7 percent.
The cuts would be “impossible” for some small-town cardiologists who rely on Medicare patients, said Zia Roshandel, a heart doctor in Culpeper, Virginia. The town of 10,000 people is about 60 miles southwest of Washington.
Roshandel and two partners see perhaps 50 patients a day at his practice, the local hospital and a community clinic for the indigent, the 40-year-old said in a telephone interview. Medicare accounts for two-thirds of their clientele, he said.
Already squeezed by government and private insurers, Roshandel said he has cut office hours, forgone paychecks and shifted his 12 workers to a high-deductible insurance plan over the past two years. The latest proposal would push him out of private practice altogether, most likely to a hospital in a larger community less reliant on Medicare, he said.
And here’s the rub of single-government-payer. One-size-fits-all is doomed to fail, because there is no universal intelligence or bureaucrat that can properly allocate resources with the same efficiencies as a free market. In this case, the doctor will have to pick up and leave his patients behind, because the system rewards his being part of a larger collective practice in a bigger community.
That also ignores the other conundrum of the healthcare debate: if you do succeed in shifting resources to preventative care, you simply create a larger population of people who will eventually succumb to heart disease and cancer. Unless you decide to ration, restricting access to only the young…
No more Enemies List (wink wink)
Whitehouse.gov has “pulled” its effort to get neighbors to snitch on each other for sharing “misinformation” about healthcare reform. From a post called “An Update on Reality Check“:
Since the White House’s Reality Check site launched, we’ve seen incredible response from individuals eager to get the facts about health insurance reform and pass them along to family and friends.
An ironic development is that the launch of an online program meant to provide facts about health insurance reform has itself become the target of fear-mongering and online rumors that are the tactics of choice for the defenders of the status quo.
So let’s clear up two issues that have come to our attention.
I would hope that those two issues might include the notion of asking people to turn in American citizens who have done nothing but exercise their freedom of speech. I would pray that complaining about the collection of data that could be construed as an “enemies list” (and certainly would be if the previous administration was still in place) would be called something other than fear-mongering.
I was wrong. The apologies are for:
- Inadvertently adding people to the President’s e-mail blast list, and
- .
Oh, wait. There was no second issue!
Seriously, read the post in its entirety, and tell me what the two issues were. It seems to be clear that one had to do with the integrity and security of the e-mail blast list. But was there an apology for making it “appear” as though they were asking for “dirt” on others? Nada.
In fact, the first apology also shifts blame! Look at this:
It has come to our attention that some people may have been subscribed to our email lists without their knowledge –- likely as a result of efforts by outside groups of all political stripes
What the hell? Apparently, it was the Astroturf lobbyists for the insurance industry who are to blame, for putting themselves on the list and being too dumb to realize they might get emails from the White House Reality Check Team!
Instead, here are some self-serving back-slaps about just how awesome this whole administration-led community organizing effort truly is:
- we’ve seen incredible response from individuals eager to get the facts about health insurance reform
- However, it’s clear that a lot of Americans appreciate getting updates from the White House and that number continues to grow.
- Despite reports by some bloggers and others in the media that have invoked a variety of sinister conspiracy theories, more people signed up for updates last week than during the entire month of July.
- we’ve seen incredible response from website visitors who are using the tools provided on the site to share videos and other content with friends and family.
- The Reality Check website exists to inform public debate about health insurance reform – not stifle it.
The last one is rather funny, because the site is not about hosting or fostering a debate. Those running the site made up their minds a long time ago, and have no interest in other opinions.
The one about “more people signed up for updates last week than in the month of July” is hilarious, because the infamous flag@whitehouse.gov email address was launched August 4.
Hey… what about that email address? If you send anything to it now, it will bounce back to you. However, there is now this nifty contact form on the page, which is the same sort of webform that one would use to create a back-end email, but legally it is not an email.
So, what was missing?
- An acknowledgment that it was an abuse of power to ask citizens to report each others’ activities to the Oval Office
- An apology for same
- A pledge to find some means of discarding that data, within the law
- Any culpability whatsoever.
Arrogance?
Why Journalists Should Never Teach Logic
This piece ran in The Independent from London:
They came in their thousands, queuing through the night to secure one of the coveted wristbands offering entry into a strange parallel universe where medical care is a free and basic right and not an expensive luxury. Some of these Americans had walked miles simply to have their blood pressure checked, some had slept in their cars in the hope of getting an eye-test or a mammogram, others had brought their children for immunisations that could end up saving their life.
In the week that Britain’s National Health Service was held aloft by Republicans as an “evil and Orwellian” example of everything that is wrong with free healthcare, these extraordinary scenes in Inglewood, California yesterday provided a sobering reminder of exactly why President Barack Obama is trying to reform the US system.
The LA Forum, the arena that once hosted sell-out Madonna concerts, has been transformed – for eight days only – into a vast field hospital. In America, the offer of free healthcare is so rare, that news of the magical medical kingdom spread rapidly and long lines of prospective patients snaked around the venue for the chance of getting everyday treatments that many British people take for granted.
So, the mere fact that people will line up for something that is free is somehow proof that it ought to be publicly paid for?
Let’s think about this for a second.
If I set up shop in the LA Forum for a week offering free automobiles, how many people would come from hours away? Would the teeming throngs constitute “proof” that we should socialize transportation?
If I set up in the LA Forum for a week offering free steaks and beer, how many people would show up? Would the numbers arriving be prima facie evidence that the government ought to pay for everyone’s lunch?
If there were a gun show in the LA Forum sometime in the near future, and vendors started offering free ammunition, I wonder what Guy Adams would write…
It’s the Market, Stupid
From Reason:
The New York Times calls it “possibly the most complex legislation in modern history.” The health care “reform” currently being hammered out by the Democratic leadership of the House of Representatives already clocks in at $1 trillion and 1,000 pages—and it’s nowhere near done. But one thing is clear: the legislation attempts to substitute top-down mandates from a centralized bureaucracy for the distributed decisions made by millions of consumers, physicians, and insurers acting in a marketplace. This will fail.
While I agree that the legislation will fail — in the sense that it will ultimately produce worse health outcomes at higher cost than our current system — I am quite concerned that the legislation will not fail to pass.
It’s embarrassing — and should be offensive to anyone who has ever taken a civics or US History class — that a piece of legislation this big and complex, that affects a huge portion of our economy, could be rushed through without being read, in an attempt to create yet another “entitlement” that will be nearly impossible to take away.
Read the article for a great summary of what a true market in healthcare might look like…
Prophets or Profits?
There’s been a phrase bubbling forth that really bothers me.
“Healthcare is too important to leave in the private sector; it is immoral to make a profit on someone else’s health.”
So, now it’s immoral to make a profit where a life is concerned? Let’s examine that statement a little further, because it’s one thing to make a case for government spending on something like national security or even efficiency. But morality?
This thinking comes as a result of a pair of faulty premises, that when taken together become very dangerous to liberty. They are “Profits are immoral” and “Zero-sum wealth.” The first is an appeal to what we think is the better side of human nature, the latter an empirical observation that is misses the entire nature of trade or pricing.
For that matter, shouldn’t it also be immoral to make a profit on food? Is it now time to initiate a takeover of farms, on the basis we should ensure there is enough food for the hungry? The proponent of government-run healthcare either has to accept this as a newly-christened potential government power, or has to supply a Constitutional rationale as to why food would be any different than healthcare. If I were boxed in such a corner, I’d likely argue for scarcity: there is no need to nationalize the farms, because there is more than enough food in America. It’s that so many Americans go without health coverage that we must address the scarcity.
This line of thinking presumes there’s no relationship between the supply of a commodity and the incentive to produce it. We must ask ourselves, why is there an abundance of produce? Might it have something to do with a free market for those goods? The prices are set by the constant flux of hundreds of millions of individual consumers, who signal what they want in relation to everything else by the act of selecting their groceries. No one individual or entity sets those prices – yet the optimum amount of what was wanted gets produced.
On the flip side, we have another profession (medicine) that comes with a significant barrier to entry in the form of up-front investment. Just like a farmer can’t throw seed on someone else’s property and start reaping, the health professional must spend time and money before earning the first real paycheck. Unlike agriculture, though, there is a large insulating barrier between the consumer and the price information.
Because of the manner in which insurance (and government-paid insurance) is administered, you will very rarely find a patient who knows as much about the cost of healthcare as he knows about the price of carrots or bananas. The “shortage” isn’t in availability of care, it is in the convenience of health coverage. Most have it. A few don’t. But even that system is broken, because the price signal is dampened beyond recognition.
The only way to have “enough” of something is to let people put a value on it for you. This is the genius of eBay, that an item is worth exactly what it is worth because the price is set in comparison to all of the identical items also being sold at that time, and against the opportunity cost of what you might have done with those dollars in another auction.
Taking health to single-payer dissolves any notion of a market. One buyer means one price set – and no data about wants and needs that might inform a course correction. Do we have enough trauma doctors in this city? In this neighborhood? How many podiatrists does this county need, and how many orthodontists? You could try to allocate them based on census data, but how well would that work? The Prophet must divine an answer from a single set of data; Profits are the continuous stream of data that tell us when there is an imbalance to be addressed.
Let’s put it another way. If you want to make something disappear, put it in a basket marked “Free.” People will always avail themselves of something they think they aren’t paying for. The danger in single-payer is that in reality you aren’t paying for your MRI – just 1/300,000,000th of it. That’s a sweet deal, until you end up paying 1/300,000,000th of my hormone replacement therapy, 1/300,000,000th of her surgery, 1/300,000,000th of the kids’ braces…
Essentially, single-payer brings to final fruition the illusion that others will pay for my healthcare. Instead, we’ve created the incentive for more people to use the system than really need to do so. With a greater demand for care and no budget increase (or signal) to allocate for it, we do indeed have shortages and rationing. The profit motive – no matter how immoral you think it might seem – is the only moral means of ensuring the proper amount of care is created.
So, would you rather trust your abundance to Prophets? or Profits.
Spokes Model
Paris had a wonderful experiment with public bicycles.
A popular bicycle rental scheme in Paris that has transformed travel in the city has run into problems just 18 months after its successful launch.
Over half the original fleet of 15,000 specially made bicycles have disappeared, presumed stolen.
People take care of private property. They don’t take care of public property.
And in a national health system, your body is indeed public property.
No joke.
Were you aware that soliders who are lax in avoiding sunburns can be written up for “damaging government property?”
Once HHS is writing the rules for what treatments will and won’t get payment, watch for the behavioral rules and mandated diets, because your health is now of financial interest to the state.
Sorta like having NutriSystem in the Stimulus package, but rather a bland and flavorless version that costs three times what an ordinary meal might, and is designed to be culturally offensive to no one.