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Who’d’a thought we’d see two shout-outs to King Canute in as many days in the health care arena? Yet there he is, popping up again in Business Week in the service of opposing more government intervention in health care.
According to legend, King Canute of Denmark facetiously tried to stop the rising tide by simply raising his hand and commanding the waters to roll back. The tide, of course, kept rising. Yet policymakers throughout history have followed Canute’s lead. From Hillary Clinton and John Edwards to Mitt Romney and Arnold Schwarzenegger, politicians across the spectrum have tried or vowed to solve America’s health-care woes by enacting an individual mandate – a law requiring every adult to purchase health insurance. Despite its bipartisan support, the individual mandate is bad policy, a vain attempt to command a better result while doing nothing to achieve it.
An excellent discussion of the folly of individual mandates follows. Of some interest is the way the estimate of the size of the problem meshes with that made below.
According to an Urban Institute study released in 2003, uncompensated care for the uninsured constitutes less than 3% of all health expenditures. Even if the individual mandate works exactly as planned, that’s the effective upper boundary on the mandate’s impact.
If you do the math, I think you will find that Mark Steyn’s number of the poor uninsured comes out to about 3% of the population.
More importantly, Whitman points out the major flaws in the individual mandate proposal – it would not work (people will still refuse to buy health insurance), and it will make the problem worse by driving costs even higher.
Even now, every state has a list of benefits that any health-insurance policy must cover – from contraception to psychotherapy to chiropractic to hair transplants. All states together have created nearly 1,900 mandated benefits. Of course, more generous benefits make insurance more expensive. A 2007 study estimates existing mandates boost premiums by more than 20%.
If interest groups have found it worthwhile to lobby 50 state legislatures for laws affecting only voluntarily purchased insurance policies, they will surely redouble their efforts to affect the contents of a federally mandated insurance plan. Consequently, even more people will find themselves unable to afford insurance. Others will buy insurance, but only via public subsidies. Isn’t that just what the doctor didn’t order?
His prescription for incremental policy reform strikes me as being pretty sound, as the fundamental shift that needs to be made in health care insurance is away from first dollar coverage, low deductibles and copays, etc. and toward catastrophic insurance. First dollar coverage has proven to distort if not destroy any semblance of financial responsibility on both sides of the health care transaction, and is one of the primary drivers of high costs. Catastrophic coverage fulfils the true function of insurance – protection against risks you can not afford – without creating the disastrously misaligned incentives that our current system has.
First: raising a particular tax rate or lowering a particular tax rate, even quite substantially, makes extremely little difference to the amount of actual money that the government ends up collecting. This is because Britain is now at the top of the Laffer Curve. Raising a particular tax rate increases what the government gets from that particular tax, but spreads a ripple of disappointed indolence and enforced inactivity throughout the economy, which lowers the yields from all the other taxes. Lower a particular tax rate, and the yield from that tax falls, but a ripple of enthusiasm and activity spreads through the economy, and the yield from all the other taxes rises.
British politics arrived at this state in the late 1970s and has been in this state ever since.
Labourites are now saying that the sums associated with Conservative promise to cut inheritance tax do not add up. Yes they do. How will this cut be paid for? By the increased yield from all the other taxes. (By the way, I know that this “cut” would not be “real” in the sense that it has already been preceded by a massive increase due to house price rises. In other words, it would be real, just as the previous but slightly less obvious increase was real.)
Insofar as Chancellor Gordon Brown has already pushed Britain beyond the top of the Laffer Curve, a cut in a particular tax rate may even increase government revenue.
Other Labourites (i.e. The Government) are also now revealing that they semi-understand all this. The Conservative cut in inheritance tax would be evil, would not work, etc., but they will now do their own (this reminds me of the Soviet response to Star Wars. It is mad. It will not work. We will do it too.)
Second: When pollsters ask voters whether they would like better public services in exchange for a tax increase, they quite often say:yes. The voters imagine only a small tax increase to themselves, and a definite increase in the services that they themselves will get. Okay? Okay. (A lot depends on the exact wording of the question.)
But, when a politician running for office says that he will put up taxes and supply better public services, only the first process is certain and the voters know it. The question in the previous paragraph about increased taxes and better services is not the question that the voters will actually be asked. The question they will actually be asked is: do you want a definite tax increase, and the almost certainly empty promise of better services which are unlikely to benefit you in particular anyway even if by some magical process such improvements do occur? Okay? Not okay.
By the same token, tax cuts are very popular with those who are paying the tax in question. These persons will definitely benefit, if only a little, and provided only that the tax cut occurs as promised. Will the particular public services that these persons get deteriorate? Probably, but only because these services will probably deteriorate anyway.
I agree that there is nothing iDave could say that could convince me to vote Tory apart from “I resign”.
– commenter Nick M
I have just come across this interview with Bjorn Lomborg, the Danish statistician who has rained on the parade of eco-gloomsters to memorable effect, but it is worth a read despite this rather sniffy sign-off:
Lomborg looks startled when I put the charge of utopianism to him. He sees himself as a pragmatist. He believes in progress, but sees where it can go wrong. But the deep green and antihumanist intuition – most beautifully expressed by the American biologist EO Wilson – that we are utterly dependent on the earth and must, therefore, approach nature with reverence and humility, means nothing to him. He cycles only in the city, not in the forests. And if, in spite of your own hypocrisy, you feel uneasy about that then you are right to do so.
I imagine he looked “startled” because the suggestion is such utter crud, to be blunt about it. Lomborg does not, as far as I can tell from his writings, contest the idea of man-made global warming as an issue, nor does he dismiss concerns about such things as some pro-capitalists are wont to do (although I can see why they do so). What Lomborg keeps banging on about is that if we use or sacrifice resources to combat such threats, then those resources cannot be used on other things, which might be just as important from the point of view of human wellbeing, such as clean drinking water, sanitation, health care, etc. Lomborg has had the temerity to remind people that resources are scarce and they have alternate uses. Nothing remotely utopian about that.
Appleyard also refers to the late Julian Simon, the economics writer, as a “right-wing” thinker. Oh please. So to be a broad optimist about technology and Man’s ability to deal with supposed terrors like population growth is now “right wing”, is it? It shows how one almost misses those old-fashioned socialists of the Eastern bloc with their posters of smiling factory workers standing in front of a building belching out smoke. What Appleyard and others don’t seem to quite grasp – or perhaps they do and are not letting on – is quite how reactionary a lot of the Green agenda is.
Here’s Lomborg’s latest book, Cool It. I like the title and have ordered a copy.
Our theme for today comes from George W Bush: “Freedom is the desire of every human heart.”
Whether or not freedom is the desire of every heart, I think it is abundantly clear that most people are indifferent or hostile to their neighbor’s freedom, which is why a mere democracy, unencumbered by principles of limited government, is assured of devolving into some sort of Total State in short order. But the inimitable Mr. Steyn is not content with observing that most people think of freedom as “fine for me, but not for thee.” No, he has in mind the apparent eagerness of so many to give up their own freedom.
A year ago, I wrote that, “The story of the western world since 1945 is that, invited to choose between freedom and government ‘security,’ large numbers of people vote to dump freedom — the freedom to make your own decisions about health care, education, property rights, seat belts and a ton of other stuff.”
This is what makes being a small-government libertarian so frustrating. Our patron saint should be King Canute, for it often seems like we are standing on the shore, trying to stop the tide. The reply to Mr. Steyn, if it is not couched in shallow democratism (“we are just giving the people what they want”) is usually couched in terms that imply that freedom is not possible, or at least can not be enjoyed, without material security provided by the State. This inversion of real freedom (the freedom of self-ownership) was perhaps best catechized by FDR, the man most responsible for freeing demagogic democracy from the strictures of the constitutional republic, as “freedom from want.”
FDR’s heir is Hillary Clinton, and she is pushing (again) for nationalized health care in America. The battlecry this time is that there are “45 million uninsured” (or whatever spurious number is trotted out).
My first response is “so what?” Anyone in America can get health care simply by walking into the nearest hospital, as all hospitals are required to give an exam and emergency treatment regardless of ability to pay.
But, as always, one should not let the factual assertions of the advocates of the Total State go unexamined. Mr. Steyn continues:
So, out of 45 million uninsured Americans, nine million aren’t American, nine million are insured, 18 million are young and healthy. And the rest of these poor helpless waifs trapped in Uninsured Hell waiting for Hillary to rescue them are, in fact, wealthier than the general population. According to the Census Bureau’s August 2006 report on “Income, Poverty and Health Insurance Coverage,” 37% of those without health insurance – that’s 17 million people – come from households earning more than $50,000. Nineteen percent – 8.7 million people – of those downtrodden paupers crushed by the brutal inequities of capitalism come from households earning more than $75,000.
In other words, if they fall off the roof, they can write a check. Indeed, the so-called “explosion” of the uninsured has been driven almost entirely by wealthy households opting out of health insurance. In the decade after 1995 — i.e., since the last round of coercive health reform — the proportion of the uninsured earning less than 25,000 has fallen by 20% and the proportion earning more than 75 grand has increased by 155%. The story of the last decade is that the poor are getting sucked into the maw of “coverage” and the rich are fleeing it.
At a conference on health law last week, I predicted (only half in jest) that Hillary would be signing the bill nationalizing health care at the beginning of her second term. The more I think about it, the more likely it seems. The tide of the Total State never sleeps.
Richard Dawkins is someone whom I generally admire in the field of science. He is on the right side of the argument, in my view, in excoriating attempts to portray ‘intelligent design’ (creationism) as science; much of what he says about religion is true and he is a sharp, lucid commenter about scientific issues. But alas, that does not mean his grip on reality is particularly strong when it comes to other matters. Take his recent comments about the supposedly enormous influence of Jews on US foreign policy, which have already provoked a lot of comment.
My own take on all this is as follows: Dawkins is not anti-semitic and it would be pretty outrageous to suggest as such; I don’t think he is trying to say that Jews totally control the foreign policy of the world’s most powerful nation, only that they have a lot of influence in proportion to their numbers. But what Dawkins plainly does not consider – assuming his remarks have been reported accurately – is how the ‘Jewish lobby’ is not some sort of undifferentiated mass. Also, consider some of the main policymakers in Washington: Dick Cheney and Condi Rice. They are not Jews; neither, as far as I know, is Don Rumsfeld, George W. Bush, etc. Nor do I think that the policy of the US/other major nations has necessarily favoured Israel vs other Middle East countries. Arguably, if the Jewish lobby was as powerful as some say, then the US would have sanctioned the ability of Israel – which certainly has the means – to reduce its foes to radioactive dust. Anyway, a desire to protect the state of Israel from annihilation – a threat that is all too real if one takes the ravings of Iran’s leadership seriously – is a noble one. Israel is, with all its faults, one of the few functioning liberal democracies in the Middle East (that is partly what drives its Islamic foes nuts, of course). Even if one subtracts the beneficent impact of foreign aid, Israel’s domestic economic success is a standing rebuke to the theocracies that surround it.
If Dawkins wants to press the claims of atheists, fine (as an atheist myself, I count myself an admirer of what Dawkins has done to challenge religious superstition). But he does himself no favours by repeating the tired mantras about the vast influence of the Jewish lobby.
With infuriating credulousness, the BBC has taken as its top story (on radio as well as the web) the launch of a report from the ‘All-Party Committee on Identity Fraud’:
The All Party Group on Identity Fraud said a tsar was needed to co-ordinate the work being done by the government, police and private sector. The MPs also called for the government to make the public and businesses more aware of identity fraud and how they can avoid becoming victims. […] In their report the MPs also recommended police are given the resources to employ dedicated identity fraud officers. They said tougher sanctions should be placed on organisations that put people’s personal information in danger.
(Such as the Identity and Passport Service, local planning authorities, the Department of Health, ContactPoint, DVLA…and all the other branches of the caring data-sharing state? Just asking.)
So far so hopeless. The usual call for for more officials and more powers rather than any attempt to analyse the problem. The committee itself is not quite that stupid, even if it has not taken a particularly fresh look. It rightly blames the indifference of institutions and the foolishness of the public for much of it.
What is really damaging to the BBC’s credibility and to the honesty of public debate is what is next.
The crime costs the economy about £1.7bn a year, according to government estimates, with 171,488 cases coming to light in the UK during 2006. Recent surveys suggest as many as one in four people may have been affected by identity theft.
“Surveys” by whom? I wonder if the reporter knows. I can guess: Experian. But I can not readily find where this headline comes from. It appears in a more nuanced version on the National Identity Fraud Prevention Week site as…
“A quarter of the UK population has been affected by identity fraud or knows somebody who has.”
My emphasis. Not remotely the same thing. I know several Catholics quite well. My catechumenacy is a distant unlikelihood.
YouGov did a proper poll a year ago on behalf of NPower and found one in ten claimed to have been a victim in some way – without themselves providing a rigorous definition or checklist. The difference ought to indicate to anyone with the remotest curiosity that something is screwy about all these figures. You have to be suspicious of anything described as a “survey” – do BBC reporters not learn that in training?
And worse, they persist in quoting the entirely spurious “government figure” for identity fraud of £1.7bn a year. Anyone working in this field ought not just to ask, “What is the source for this figure?” and then check it. They should know that the Home Office report has been utterly discredited…
See here, or, in more detail, here.
… but it keeps coming back time and time again, as if you can make a fact by repeating a lie often enough.
There is no agreed definition of ‘identity fraud’. There are few useful figures, and in the circumstances there can hardly be. Meanwhile several interested parties – Experian, the only organisation linked to from the story on the BBC site, being one, and the Home Office being another – are engaged in a sustained campaign of hype for their own benefit. That is a scandal in which you would expect the news media to take an interest.
It is (at least) disappointing that the BBC apparently uses no critical judgement or background knowledge – or even Google – in reporting these things, but sees fit to reprint the gush of press-releases, as if it were a cheap fashion magazine handling a cosmetic company’s announcement of the latest face-cream. For all its admitted corporate culture problem in editorial matters, this is one of the world’s most widely trusted news sources (which, unless you take Fox or Xinhua to be gospel, you may say only shows how appallingly untrustworthy the others are). But it is starting to give the impression of not caring about the integrity of basic, readily-checkable, facts.
It’s a pretty good piece, though author Bara Vaida calls me a “conservative,” which is only true if “conservative” is a synonym for “supports the war.” But then, that’s common usage these days.
– Glenn Reynolds
The postal strike in Britain would seem like the perfect opportunity to not privatise the Royal Mail but to acknowledge that in an era of competing global courier companies and e-mail, there is no long any need for the state to have a ‘national’ postal service at all.
As Dave Cameron never misses the opportunity to miss an opportunity, I do not suppose we will be hearing this from the Conservative Party any time soon then, eh?
I like to read paperback thrillers as well as the supposed more “serious stuff” out there. Authors that I willingly take to the beach or read on a train, the Tube or for that matter, while curling up on the sofa in my flat are ones that many people will recognise: Frederick Forsyth, Ian Fleming, Alastair Maclean, Eric Ambler (a much under-appreciated writer), Mickey Spillane, Roger Simon, John D. McDonald (Travis Magee stories, etc), and many more. And I am never more grateful than when I stumble upon a new author who has the ability to keep the pages turning. One such example is Lee Child, a TV journalist from the West Midlands who has emigrated to the States and become an accomplished thriller writer via his superb Jack Reacher stories. If you haven’t read them, start now. There’s no excuse. Reacher is simply one of the most engaging characters I have come across in years. Reacher embodies the sort of “loner hero” one gets in the best Westerns (think of the great movie Shane or Clint Eastwood’s terrific Outlaw Josey Wales) and the very modern up-to-date know-how of a criminal investigator. He has a manly, no-nonsense attitude towards dealing with the bad guys with a very smart understanding of women but does not fall into fake sentimentality or over-the-top macho posturing one gets in certain kinds of movies. Reacher has his demons – he cannot deal with being tied down in any sort of relationship – but he is blessedly free from the “flawed hero” syndrome of much popular culture. He is a hero, full stop. If ever there is a series of novels crying to be made into movies, this series is it, although part of me hopes that it does not happen, given how Hollywood often royally buggers up fine material.
Now, gentle reader, you are wondering why I referred to the “power of blogs” in the headline. Well, I wrote that because I owe Robert Bidinotto, a blogger, academic and magazine editor a large ‘thank you’ (if we ever meet, the beer’s on me, Bob) for praising Lee Child’s writings to the skies. Bob’s literary judgement is normally laser accurate, so almost as soon as I read his interesting interview with Child, I made sure that the next time I passed a bookshop, I got one of Child’s novels (Bob’s blog can be found here).
For spending a week on the seaside in Malta and Gozo, as I have been this week, there is not a better writer to stick in the rucksack for the trip to the beach than Lee Child.
Of course, there are some who would argue that the greatest thriller ever written, certainly in terms of its sweep and scope, is the Count of Monte Cristo. I am not going to contest that.
I like to figure out the appropriate term for collections of things (a disorganisation of libertarians?), and upon reading the bizarre responses to Dave Cameron’s speech at the Tory Party conference, a ‘credulousness of Conservatives’ came to mind.
The Times writes of the speech, remarkably describing the entire exercise in dissembling as ‘refreshingly spin-free’:
By the time David Cameron got up to give his conference speech yesterday, it had become an awful lot easier to present him as a man of integrity in a world of spin. That was not the main theme of his speech, but it was a clear subtext. The Old Politics is failing, he said. And he explained why: top-down statism has not wrought the improvements that everyone seeks. This was an argument for limited government, not merely another shopping list.
Clearly there must be someone else in the party who just happens to share a name with party leader Dave Cameron, as obviously no one who writes for an august publication like The Times could have mistaken Dave “greener-than-thou we will match Labour’s spending on public services” Cameron for an honest advocate of limited government in any way, shape or form (or in fact a honest advocate of anything other than the notion “Dave Cameron should be Prime Minister”).
Now, if it was in fact the same Dave Cameron who runs the party who said things to indicate he is a supporter of limited government, do you think that maybe, just maybe, he is saying those things not because he believes it but because he is at a conference attended by activists for whom the term “limited government” is not a dirty word? And if so, could he just possibly be saying those things so these activists do not defect to UKIP in disgust or, more likely, spend next election day gardening or playing Halo 3 or just about anything else to deaden the pain rather than vote for someone who has lied and lied and lied to them and who is not in fact a conservative at all? Could he just possibly be saying what they want to hear in the hope they will pretend they never heard him advocate more ‘green’ taxes, sumptuary laws in the form of de facto rationing of air travel for the plebs, more public spending and more regulation, allowing those things to vanish down the ‘memory hole’ because they want to believe their woeful party still stands for limited government regardless of all the evidence to the contrary?
Just askin’.
I hardly know whether to laugh, or cry, at this one.
First, the tears:
Democratic presidential candidate Hillary Rodham Clinton said Friday that every child born in the United States should get a $5,000 “baby bond” from the government to help pay for future costs of college or buying a home.
A more grotesque pander is hard to imagine. Naturally, the more rational among us are puzzled:
How might this be funded? There are only three groups that could be asked to pay for the new entitlement with higher taxes (or lower benefits): the current elderly, those currently of working age, or the same future generations who are getting the new benefit and are slated to pay for existing unfunded entitlements. Which group do you think Senator Clinton has in mind?:
As with all arbitrary handouts, it also raises the question (and you can be sure it will be asked if this goes anywhere) of “why not more”? If $5,000 of free money is good thing, why isn’t $10,000 twice as good?
Now, the laughter:
Sixty percent (60%) of America’s Likely Voters oppose giving every child born in the United States a $5,000 savings bond, or “baby bond.” A Rasmussen Reports national telephone survey found that just 27% support the concept suggested on Friday by Senator Hillary Clinton.
Unlike socialized medicine, which I believe is a genuine Cause to the otherwise calculating Hillary, the baby bond is most likely just a trial balloon, thrown out there to see if it would strike any sparks. Having drawn derision and virtually no support from anyone who wouldn’t vote for her anyway, I suspect we have seen the last of it. Still, it is a little chilling to contemplate the leading contender for President of the United States already toying with naked wealth transfers such as this.
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Who Are We? The Samizdata people are a bunch of sinister and heavily armed globalist illuminati who seek to infect the entire world with the values of personal liberty and several property. Amongst our many crimes is a sense of humour and the intermittent use of British spelling.
We are also a varied group made up of social individualists, classical liberals, whigs, libertarians, extropians, futurists, ‘Porcupines’, Karl Popper fetishists, recovering neo-conservatives, crazed Ayn Rand worshipers, over-caffeinated Virginia Postrel devotees, witty Frédéric Bastiat wannabes, cypherpunks, minarchists, kritarchists and wild-eyed anarcho-capitalists from Britain, North America, Australia and Europe.
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