Mark & Milton Fix Health Care

If Americans weren't averse to creating a two-tier health care system, this national uninsured crisis could be solved in a snap. We don’t change the whole damn system ( at least not yet ) to insure that everyone lives in a nice house, has a nice car, can afford to shop at Sacks, or eat at Ruth's Chris. Why do it for health care? Does everyone deserve to go to the Mayo Clinic? Does everyone need an MRI if their knee hurts? My nose has always been too big. Federally funded Viagra, anyone? If we just created a voucher for poor or selectively qualified uninsured people to go and purchase whatever health care plan they wished and we deregulated health care insurance* so insurance companies could create in their coverages what the market dictated, presto – crisis la morte . The real free society-threatening problem is that those ‘universal advocates’ can’t live with well-to-do people having better health care than less-to-do people. The central issue isn’t whether the unfortunate have a decent, basic health care package, but whether it covers birth control pills, abortion, cell-phone elbow and sex change operations; it‘s not whether they have a roof over their head but whether they have a respectable condo near the public transit line; it’s not whether they get enough food, it’s whether the food stamps are good for t-bone steak and the delivery system doesn’t embarrass them ( we make them look like credit cards now ); it’s not whether everyone gets an adequate education, it’s whether the not-so-quick are interred with the smart kids so they don’t develop low self esteem. But I digress. If we gave every poor person a voucher** for $3000/yr to buy whatever health care they could buy it would cost a fraction of what a national health care system would cost and, not only that, the price of health care for everyone would come down as it would create an honest to God new market necessitating insurance companies to compete for those new customers.

The bitter irony is that the same Cadillac benefits that our benign dictocrats have added to state minimum insurance package requirements which has relentlessly driven up the cost of health insurance will be the same ones that will be rationed or cut when national health care is implemented. It’s been all too easy for the guv to mandate what’s covered in private carriers' packages when they didn’t have to pay. When it's on the taxpayers dime Americans might be surprised what Big Brother deems a necessary test or procedure for poor, old Aunt Tillie.

There are few ways the world has discovered to lower costs. The only sure-fire ways I know are price controls/rationing and free market competition/ increased productivity. If you don’t understand why prices for health care would plummet if fee for service were the only option, go back and retake ‘Real World 101’ at your local community college. In a free market every individual does their own cost benefit analysis before purchasing anything. What doesn’t work is ferreted out because over time no one is willing to pay for it with their own money. And what does get ferreted out will have private doctors and institutions competing for that business. Not to mention that when uncle is deciding what gets covered and what doesn’t, it inevitably becomes politicized. He/she that makes the most noise gets coverage; like breast cancer research getting tons more funding even though diabetes affects and kills multitudes more people. Spending decisions become dictated by the ‘cause de jour’; in other words what makes the politicians look good. Taking health politicization to its’ illogical extremes, the end result will be a society with the most caring, concerned, selfless and sadly beloved politicians the world has ever seen and a populace waiting agonizingly in line for hip surgeries and bypasses. ( So what did Obama actually mean when he said this week, ‘You ain’t seen nothing yet?’ I’m afraid to guess! )

All I can say is, if the fundamental requirement for dealing with all human ills is that the solution must be applied equally and unilaterally, we’re doomed before we start because need is endless. The good becomes the enemy of the perfect. Sort of like ‘save everybody or save nobody’. Well, my teacher, Professor Hardnoks, told me in ‘Real World 101’ that if the boat’s sinking, it’s women and children first; not let’s tinker and talk till we figure out how to keep everyone from drowning.

*Deregulation would require competitive bidding across state lines. What idiot(s) decided limiting access by state was a good idea? Eee Gad!

** One would hope that even the left and right could agree that if people get the best health care available for nothing that would leave no incentive to work hard in life and contribute to an upgrade in benefits. Where are Milton Friedman’s public policy heirs? If we ever needed them, we need them now.

M.D.T.

Carry That Weight

One of the central problems of having a professional political class is that we have life-long public servants voting on and controlling the compensation of all the other life-long public employees; in effect people who produce no tax revenue voting on how much those that do need to pay to adequately compensate themselves.* Is it any wonder they overlook their collective failings in reforming our troubled institutions? Is it any wonder that they believe in higher taxes? When you have a group of people whose individual financial futures depends on increasing every person in their group's compensation, how can the group evolve into anything but a mutual admiration society. After all, if Susie's chance of getting a raise is just as likely if Joe does a great job as if she does, why not commend Joe's performance? Plus, by commending Joe instead of yourself ( you're Susie ), you have the added benefit of appearing selfless and caring. 'You do such a great job! No you do such a great job! No you ....' In the twisted psychology of the collective, 'I am he as you are he as you are me and we are all together. Koo Koo Kachoo'. ( But how does that make us walruses? Although they do 'Carry that Weight.' )

It took me years to figure out why school teachers never speak ill of one another's abilities; at least to outside parties. With them, everybody's always doing a great job. After all, the better 'we' do, the easier it is for me to justify 'my' raise this year. And what good is it to criticize substandard performance if you can't get rid of them anyway?** Why take the risk of unnecessarily creating an enemy? Just where are those bad teachers flunking half their classes? Obviously, in somebody else's school. Not just to pick on teachers, the same would hold true for any and all union dominated professions. Isn't it entirely possible, if not likely, that the impossibility of truly standing out and being rewarded individually within public service psychologically discourages those with more intelligence and ambition, aka 'the best and the brightest', from entering those fields? What's sadder is that when mediocrity surrounds itself with mediocrity - the incompetent don't know they're incompetent.

When almost everybody's doing a great job, almost nobody's doing a great job.

*It makes no sense to say people pay taxes when their compensation, benefits and retirement packages far exceeds any realistic return on their withholdings. Similarly it makes no sense to say a federal employee pays federal taxes as the withholdings are simply returned to the payer. I suppose it could be argued that higher earners who work for state government pay some federal taxes.

** In the private sector the incentive is just the opposite. A peer's underperformance lessens the probability that a higher performer will get a raise. The more money the business makes the more likely the top producers will do well.

M.D.T.

Pay Your Tithing

So if President Obama made a public announcement tomorrow that he had a plan to end world hunger within his term would you believe him? How about if he proposed to have a plan to end war? Or a plan to eradicate world poverty? Would you believe that? So why do the majority of Americans believe that this administration can provide quality, accessible, affordable health care to everyone in America? Where does such faith in our government spring from? What evidence do we have for the success of such an undertaking from real life experience? Pray tell. History would indicate you might make it affordable at the expense of quality or preserve quality but not lower costs without limiting access -but not both. Maybe some things just aren’t fixable. Is capitalism a failure because not everyone in the country has free 21st century health care? Why isn’t the measure of our success that fewer die of cancer now than at any other time in human history? That life expectancy continues to rise? That miraculous new treatments and drugs appear every year?

The Obama administration, like the Clinton administration before it, believes itself to be able to succeed in delivering the big health enchilada where all else have failed. What’s even more bedazzling is that the voters saw fit to endorse this ‘reform’ without even having heard the plan. That’s what I call the ‘Audacity of Hope’! Even now, as this epic piece of legislation looms forbiddingly on our horizon, a seemingly unarrestable act of nature, there are no details whatsoever about how universal health care can be affordably provided; just some vague rumblings about a parallel public system to compete with the private. ( Maybe they could publish this new plan on the internet and let us read it before they vote on it like they did with the trillion dollar plus stimulus bill? ) They have endeavored to lead us to believe that all that is necessary to pay for this mother of all leviathans is to raise taxes on the top 3% of wage earners, cut compensation to a bunch of rich doctors and break the backs of those evil, rich drug companies, insurers and HMOs. But now the train’s about to leave the station they’re suddenly about $600,000,000,000 short of what they had hoped by their own estimates. And just try to remember the last time that the government’s own estimates didn’t end up at half or less off actual cost. This thing could easily cost double that. You think health care's expensive now, just wait til it's free! It’s appears to be an article of faith with the left that there’s always unlimited money out there. ‘It’s such a rich country…this. In such a rich country … that.'

But maybe it just can’t be done. Maybe it's impossible to provide unlimited, 21st century universal health care to all Americans. Maybe the doctors will choose not to treat the patients in the new public system because the remuneration is too low. Maybe the government’s driving down costs with ultimately a one payer solution will drive all the talent out of the sector, causing doctor shortages making your low cost health care not even worth the lower price you pay for it. Maybe government plans to pay for a secure retirement, quality health care, universal pre-school through college education and a greener environment for every person in the country will bankrupt us. Maybe private investment in new medicines and technologies will plummet when the government’s controlling prices and life expectancy will go down instead of up. Maybe the plan will result in rationing and more suffering as millions wait to be treated. Maybe Kennedy was baying at the moon when he said, "Many look at the world and say why, but I look at the world and say why not".

But I say, why are we all required to take part in this dreamy, idealistic and utopian faith by the would be reformers of this world? This latest but always predictable, historical incarnation of the ‘vanguard of the proletariat’? Why can’t we just opt out of this mega-scheme? Why can’t we just pick up our chips, cash in and go home? But no, President Obama and his ilk insist that everyone has to play but not everyone has to pay. Yep. Kennedy said ‘why not’. Clinton was the ‘man from hope’, Obama dares us to have the ‘courage to change’. Excuse me but I thought we had the freedom to worship in the church of our choice in this county? The tithing to bring heaven to earth in this latest mandate from the Church of Big Government is just too damn high for this infidel and, more than likely, for the rest of you as well.

M.D.T.