Friday, April 29, 2011

LOL at Dr. Berwick and Obamacare

LOL is the only way that I can respond to Dr. Berwick’s recent editorial in the WSJ “The Right Way to Reform Medicare.” After observing that Medicare costs are growing, he summarily dismisses the Republican plan to have customers pay for their own insurance, eliminate guaranteed Medicare benefits and limit choices. He says the right way to bring down costs is to make care better and improve our healthcare system. This observation begs the very basic question he asks. He observes that we should use the automobile, computer, television and telephone industries as examples to follow in making health care better. What follows is a long list of unsupported promises, vacuous claims and socialist utopian platitudes as reasons why the Patient Protection and Affordable Care Act (“Obamacare”) is the solution to our health care problems. This vacant reasoning is the same reasoning supporting Obamacare in the first place, “we must pass the bill to find out what is in it.”

I will agree with one statement in Dr. Berwick’s analysis. We should look to private industry to find our solution to our health care problems. If Dr. Berwick had initiated a reasoned analysis on this proposition, he would have come to a completely different conclusion. What is it about these industries that has made them successful in making their products better and more efficient? It is the very thing that Obamacare is removing from the healthcare industry: freedom, competition and market forces.

When someone goes to buy a car, a television or a computer, he has a multitude of choices. Technology is changing dramatically in each of these industries. The technology is changing dramatically because the many competitors are motivated to make a better and cheaper product that is attractive to customers. This is particularly true in the telephone industry. It was only after the deregulation of AT&T decades ago, when companies were able to compete for customers, that the technology advanced to give us the technologies we have today.

Market forces impacting costs and prices drive producers and consumers to make commercial choices which they deem to be the most beneficial and efficient. Removing market forces and price signals removes the incentive to be efficient. One example should suffice. Anyone who has been the beneficiary of a good health insurance plan at work should recognize that when there is no cost to visiting an emergency room, there is no incentive to minimize the use of that valuable service. When emergency room treatment of a cold or flu or a splinter has no cost, there is no incentive to seek an appropriate alternative yet less costly form of treatment, such as chicken soup or a tweezers. Price causes customers to make efficient and cost effective decisions.

Obamacare, by removing market forces and price signals from the market place, will cause the healthcare system to operate in an increasingly inefficient manner. Dr. Berwick is correct to observe that Medicare costs continue to grow. However, a reasoned analysis would cause him to conclude that that very fact contradicts his conclusion that Obamacare will improve the health care system. Medicare is a federal program that has removed market forces from the health care industry. What Medicare does in a small way, Obamacare does in a big way. If Medicare costs are increasing, Obamacare costs will increase much more. Obamacare is a big problem designed to solve a small problem. The actual solution should be to eliminate the small problem. Government is the problem. Therefore, government should be removed from the system.

Dr. Berwick’s reasoning is also internally inconsistent. Consider the following paragraph:

Under President Obama's framework, we will hold down Medicare cost growth, improve the quality of care for seniors, and save an additional $340 billion for taxpayers in the next decade. These policies don't shift costs to seniors or deny care to people in nursing homes or people with disabilities. Instead, they focus on improving the quality of care and lowering costs by putting patients first.
Who is “we?” One can only conclude it is Dr. Berwick and the Obama framework. They will “hold down” Medicare cost growth compared to what? One can only conclude that these central planners will hold down Medicare costs compared to actual costs. However, artificially holding down costs compared to actual costs does shift cost. It also makes a service more attractive than it actually is, causing an increased demand on the service. If the demand exceeds the supply in a centrally planned system, care will be denied because there will be no market forces—due to the actual cost being artificially held down—to incent the expansion of the service. If you artificially hold down the price of a television that costs $1,000 to make to $500, there will be cost shifts, there will be a reduction in service, or there will be no service, i.e. bankruptcy.

Obamacare scared me in its inception and its final passage. I am even more frightened by this kind of reasoning behind its implementation. With this kind of reasoning, we have a government that will bankrupt us all if they don't kill us first.

Taken From Bubbles and Money, One of the Blogs I Follow

How awesome is that day to me-
O day of hallowed history!
Set time in God’s determined plan
To sacrifice the Son of Man.
What famous work that day was done
By Jesus Christ, His Perfect Son!
The Second Adam, sent to save,
Humbly obeying to the grave!

How savage is that day to me-
O day of pure brutality!
When Christ, the Son of God Most High,
Was fiercely whipped and hung to die.
And O the horror of my sin,
Seen there in His appalling skin!
For God struck down- as meant for me-
The sinless One, at Calvary.

How precious is that day to me-
O day of purchased liberty!
In Him, a freeman now I live;
My sins, through death, did God forgive.
No wrath at length looms o’er my head,
But lovingkindness there instead.
His righteousness, my guilt replaced,
And Love, this ransomed soul embraced!

O awesome, savage, precious day-
‘Tis God the Savior on display!
What peerless, holy, gracious Mind
Would fashion such a Grand Design?

Kevin Hartnett works for NASA at the Goddard Space Flight Center in Greenbelt, Maryland, overseeing the science operations activities of the mission. He was selected in 2003 from a thousand candidates as the “Poet of the Year” by the Fellowship of Christian Poets.

Doctors the New Cops on the Beat

So what is the conservative reaction to HB 658, the so called Meth Lab Elimination Act? What the bill would do is require a doctor’s prescription for ephedrine, phenylpropanolamine, or pseudoephedrine. The rationale is that this would make it harder for meth labs to get the raw material for their product. It would make doctors the gate keepers (or cops) for the flow of the raw material for the illegal substance.

While I understand the motive for this act, it is going about finding a solution the wrong way. I find it ironic that when government is taking over so many areas of life for which it has no authority, it is forcing doctors to take on its responsibility and private citizens to give up liberty because it is failing in one of its primary responsibilities, to punish the evil doer. Government wants to take responsibility for my health, for my employment security, for how I view the arts, and how I raise my children. But it does not want to engage its primary responsibility to get the bad guy who makes the meth. Rather it wants to regulate the manufacture and commerce of a good product. Get the government out of all of those things it has no responsibility for and it will have the where-with-all to accomplish those things for which it has responsibility.

Saturday, April 2, 2011

Time to Change Our Attitude

There were two stories that emerged last week that portray the stark contrast in views of governmental power. One story told of state Senators Lembke, Nieves, Schaaf and Kraus filibustering the Missouri Senate so as to prevent Missouri from receiving federal funds to extend unemployment benefits from 79 to 99 weeks. The story continued that Senator Lembke wants to accomplish the same goal for federal funds earmarked for education. The other story told was of Governor Jay Nixon seeking one billion dollars of federal money to build a light rail line from St. Louis to Kansas City. Not only would the system improve transportation in the state, it would bring higher paying jobs to the state.

There are arguments pro and con for each issue. It is always “good” to help those in need. It is “good” to bring new jobs to the state. However, at what point should a culture stop facilitating unemployment and create a real felt incentive to get a job? And is a centrally planned transportation system better than one designed by the free market? I do not wish to get into any of these issues. My goal is to look beyond these to bigger arguments, arguments of attitude. My goal is to highlight how the trajectory of time has shown that our welfare state mentality will actually destroy us.

In his work The Law, Frederic Bastiat observes that,

But how is this legal plunder to be identified? Quite simply. See if the law takes from some persons what belongs to them, and gives it to other persons to whom it does not belong. See if the law benefits one citizen at the expense of another by doing what the citizen himself cannot do without committing a crime.

Then abolish this law without delay, for it is not only an evil itself, but also it is a fertile source for further evils because it invites reprisals. If such a law—which may be an isolated case—is not abolished immediately, it will spread, multiply, and develop into a system.
In another place, he observes,

The law perverted! And the police powers of the state perverted along with it! The law, I say, not only turned from its proper purpose but made to follow an entirely contrary purpose! The law becomes the weapon of every kind of greed! Instead of checking crime, the law itself guilty of the evils it is supposed to punish!

If this is true, it is a serious fact, and moral duty requires me to call the attention of my fellow-citizens to it.
Are Bastiat’s observations borne out in our government today? Consider, as Congressman Akin is often known to do, that the income of the federal government is roughly equivalent to the cost of the growing entitlement system and the interest on the debt. That leaves all other functions of our national government unfunded except through borrowing. The federal behemoth has now grown to such a state that the interest on the debt, which is not paid, continually adds to the national debt. Many have rightly commented that this is unsustainable. What this situation indicates is that the continued spending by the federal government, whether directly, or by bribes to the states, is putting the nation in deeper and deeper debt. This debt will be paid back in one form or another. If it does not bring the nation to a financial collapse, it will burden our children’s children for their repayment. We are enslaving our children with this debt. Indeed, Bastiat’s observations are borne out in our government. We are not satisfied with taking from some in this generation to satisfy our greed. We are willing to saddle the next generation with slavery for our greed.

The happy argument for those who want to take the money is that the federal government will spend it anyway. We might as well benefit from it rather than letting others use it to their advantage. This argument has some validity, but only in a culture in which greed has been institutionalized. Only by assuming that everyone else is as greedy as you are can such an argument work. Unfortunately, that assumption is valid in the United States of America at this time, at least among many in the ruling class.

What Senators Lembke, Nieves, Schaaf and Kraus are trying to do is change attitudes. Attitudes are hard to change, but changing attitudes has to start somewhere. Changing attitudes is also painful, particularly when you are invested in your attitude as we are today in the United States of America. Again, we are so invested in our attitude that we burden our children’s children for our convenience. Let us remember that the preamble of the U. S. Constitution declares that the purpose of the Union is to secures the “Blessings of Liberty to ourselves and our Posterity,” not just to ourselves. If for no other reason, we must listen to the good Senators because it is the purpose of government to protect our children.

Bastiat once more has a helpful insight: “When, then, does plunder stop? It stops when it becomes more painful and more dangerous than labor. It is evident, then, that the proper purpose of law is to use the power of its collective force to stop this fatal tendency to plunder instead of to work. All the measures of the law should protect property and punish plunder.” Yes, stopping the plunder will be painful. But not to stop the plunder will be even more painful for the next generation. Thank you, Senators Lembke, Nieves, Schaaf and Kraus for your courage.