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Archive for the ‘Health Care’ Category

This is it for me, at least for this chapter.  I am off to join some people who don’t much appreciate voices singing out of key, and while they might be able to get over my public disdain for coaches who punt in opposing territory, it would be rather awkward to continue to point out the incompetence of the administration.  So for now, it’s probably best to hang it up.

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For years we have been subjected to odd debates about whether the government should permit, encourage, or attempt to prevent the reimportation of prescription drugs from Canada.  Seniors love it; they want to be able to drive across the border and save money.  The drug companies hate it; they want to charge American prices.

That the entire debate happens offends good sense.  Drugs that are researched, tested, trialed, and manufactured in central New Jersey do not magically become cheaper from a round-trip drive along the New York Thruway.  If we are to discuss prescription drugs, the only policy question should be whether the US should do something to use the purchasing power of its 300mm person market to drive down the cost of drugs, not whether scattered northern seniors should be left to try to free ride on the purchasing power of 30mm Canadians. (more…)

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Nick Kristof hits on one of the most bizarre aspects of the health care debate: the inability even to agree that there is a problem in the first place:

We have the greatest health care system in the world. Sure, it has flaws, but it saves lives in ways that other countries can only dream of. Abroad, people sit on waiting lists for months, so why should we squander billions of dollars to mess with a system that is the envy of the world? As Senator Richard Shelby of Alabama puts it, President Obama’s plans amount to “the first step in destroying the best health care system the world has ever known.”

That self-aggrandizing delusion may be the single greatest myth in the health care debate.

I don’t think the delusion has much to do with health care.  I think it has everything to do with how we speak about America. (more…)

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I find it awfully difficult to care about county elections.  Luckily, Ben Adler seems willing to look at them, and he picked up something interesting:

Unlike the New York City mayoral, or the Virginia governor’s race, there is a really bad sign for Democrats out of the East Coast:… Republicans made inroads in New York’s suburbs.

Why does this matter so much? Because the New York suburbs epitomize the new Blue America. Twenty-some-odd years ago, the economically diverse, but generally affluent, suburbs in Westchester and Long Island represented the success of the Reagan Revolution…But the New York suburbs led the way back to Democratic dominance, arguably presaging the Obama coalition.

I have written often about the strange alliance of very high and very low incomes that defines the modern Democratic party – the working class and the intellectual property class.  It’s my version of “flat earth,” I suppose.  So I’m a bit jealous that someone else spotted this. (more…)

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Even by off-cycle election standards, this was an odd one.  Perhaps it’s just payback for such a good election last year.  I’ll trade watching Chris Christie do his Sopranos impression for never having had to listen to this:

It’s been just 68 days since that afternoon in Dayton, Ohio, when Senator McCain introduced me as his running mate. He is truly the maverick. He took a chance on me. I will always be grateful for that. It will be the honor of a lifetime to work him as vice president of the United States. And I pledge to govern with integrity, and goodwill, and clear conviction, and a servant’s heart.

When the Democratic Party finishes licking its wounds, I hope it learns at least one lesson: when you win an election, you are expected to do something.  Asking the genie for three more wishes is not something. (more…)

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MFN for Patients

Gregg Easterbrook asks about community rating and then goes on a very intelligent tangent: what would happen if medical service providers were required to offer their services to everyone at the same cost?

health care proposals now in the Senate are so utterly fixated on handouts and giveaways that they don’t even address a core problem — the inability of individuals to buy at insurer’s prices. This is the PPO problem, and is serious. Most health insurance now operates through some variation on the Preferred Provider Organization. Physicians and clinics sign up with some insurers but not others; they agree to discount their list prices; if the patient goes to someone within the PPO, the provider gets business while the patient and insurer pay less…The distinction between list prices and “adjusted” prices prevents health care services from functioning as a rational marketplace.

Would this simple change make a difference in bringing down health care costs? (more…)

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I doubt Joe Lieberman needed any outside encouragement to demonstrate his particular brand of weasel on health care reform.

However, Harry Reid might need some help seeing the golden opportunity staring him in the face, so here is some free advice for Harry: slap Lieberman in the face.  Publicly.

I think most people can understand that some political negotiation is best carried out behind closed doors.  There is a necessary element of accommodating vanities and concerns in any coalition-building, and so long as humans value a foolish consistency over the ability to compromise, leaders who compromise will want some cover.  I get it.

That said, it is a blessing to have incompetent adversaries, and right now Harry has one.  All he has to do is let Joe keep running his mouth and then go on TV and announce “Joe will vote to end debate or he will no longer vote as Chairman of the Homeland Security Committee; your guess is as good as mine which he will choose.”

By making a public threat, Reid backs himself into a corner – now he has to go through with it if Lieberman calls him on it.  But it’s an easy threat to deliver.  A Lieberman who will not vote with the Democrats on health care – and who has already defected on war – is useless.  There is no other bill that will come close to a filibuster; carbon and immigration have much bigger problems than one guy, a Senator from Connecticut will always endorse finance companies in any financial services regulation review, and nothing else is of much excitement between now and 2010.

By announcing that Lieberman is useless, Reid gives Lieberman two choices:

  • Admit the hollowness of his position and back down to preserve a chairmanship.  If this happens, Reid looks strong to the voters back in Nevada and can claim that his profile allows him to do things in DC.
  • Join in a filibuster and get stripped of his chairmanship.  This is the hidden gem of the big threat.  If Lieberman calls, Reid gets the muscle-flexing opportunity to pull the chairmanship in the middle of the term.  Hard to demonstrate more raw power than this.  Not only does it look cool for the voters back home, it scares the hell out of Nelson and Landrieu and Lincoln and Pryor; all of a sudden they will be quite a bit more circumspect about going against the leadership.

There is no third option.  Once Reid goes public, Lieberman does not have the muscle to pull himself out.  In fact, as an independent, he is at risk of losing all his committee seats, since there are no seats that are not allocated to one of the two parties.  He could join the Republicans and try to get one of their seats, but that means both begging for scarce seats from people trying to cling to what they have and forced retirement in 2012.  In a vote of the Democratic caucus as a whole, Lieberman would be easy to push aside, if for no other reason than that Carl Levin would like the Homeland Security gig.

Last summer, not dissuaded by the dismal record of invaders of Russia, the Georgian military decided to take a crack and pushing Russian troops who were supporting Georgian separatists off of Georgian soil.  The Russians could scarcely believe their luck.

Joe has gone to battle from equally poor strategic position.  Slap him, not only because he has a face to slap but also to keep the rest of the fractious troops in line.  It’s rarely this easy, Harry – enjoy it.

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Luis Gutierrez is leading a rally in DC to argue for comprehensive immigration reform.

We simply cannot wait any longer for a bill that keeps our families together, protects our workers and allows a pathway to legalization for those who have earned it…We need a bill that says if you come here to hurt our communities, we will not support you; but if you are here to work hard and to make a better life for your family, you will have the opportunity to earn your citizenship. We need a law that says it is un-American for a mother to be torn from her child, and it is unacceptable to undermine our workforce by driving the most vulnerable among us further into the shadows.

“Comprehensive” sounds good.  But “comprehensive” is not what Gutierrez really wants. (more…)

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David Brooks’ silly season seems to have found an Indian Summer, as he goes on about his imaginary friends Mr. Bentham and Mr. Hume:

If you put Mr. Bentham in charge of the government, he’d proceed with confidence. If you told him to solve a complicated issue like the global-warming problem, he’d gather the smartest people in the country and he’d figure out how to expand wind, biomass, solar and geothermal sources to reduce CO2 emissions.

“I don’t know the best way to generate clean energy,” [Hume]’d whine, “and I don’t know how technology will advance in the next 20 years. Why don’t we just raise the price on carbon and let everybody else figure out how to innovate our way toward a solution?

Brilliant…except the mechanism to achieve Bentham’s goal is Hume’s tax.  Way to find a distinction without a difference. (more…)

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The basic story is tragic if common: person eats food, person gets sick from food.  In this case, the person was a young Minnesota dance instructor named Stephanie Smith, and the food was ground beef processed by Cargill in Wisconsin from sources in Nebraska, Texas, South Dakota, and Uraguay and contaminated with the E.coli bacteria, and sold at the local Sam’s Club.

People have been getting sick from food for all of human history; no doubt we were getting sick from food before we could fairly be said to be a species.  Even with the best intentions, it will probably continue.  But the diseases of the modern food supply – E.coli, salmonella, etc – are not inevitable.  They wouldn’t exist at all – and Stephanie Smith wouldn’t be in a wheelchair – if our government functioned properly.  These microbes are the canaries in the coal mine of a dysfunctional bureaucracy. (more…)

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