Economics

In Praise of Doing Nothing

Why saying "no" does not equal saying "yes" to the status quo

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No. Normally used to express the negative of an alternative choice or possibility.

No. A super way to convey negation, dissent, denial, or refusal.

No. Republicans—the "Party of No"—should embrace the glory of the word.

It is always curious to hear irascible members of one political party accuse members of the opposing political party of "playing politics" as if it were a bad thing. Can you imagine? Politics. In Washington, no less.

As you know, Democrats claim to be above such petty, divisive and lowbrow behavior, especially on those days they are running both houses of Congress and the White House. What this country really needs, we are reminded incessantly, are more mavericks. Well, Republican mavericks. Folks who say "yes."

How starved is the White House to unearth some imaginary bipartisanship on the health care front?

Consider that for possibly the first time in American history, a vote in a Senate committee was the lead story for news organizations across the country, simply because the ideologically bewildered Sen. Olympia Snowe (R-Maine), used her inconsequential vote to move forward a government-run health care bill.

Judging from the coverage, you might have been under the impression that Snowe had nailed her 95 Theses to the door of the Republican National Committee's headquarters. In reality, she sits in a safe seat and habitually votes with Democrats.

"Forget Sarah Palin," remarked The Associated Press. "The female maverick of the Republican Party is Sen. Olympia Snowe." CNN's resident rational, reasonable, moderate Democrat, Paul Begala, called Snowe the "last rational, reasonable, moderate Republican."

Snowe even unleashed her own cringingly absurd self-congratulatory missive, claiming, "When history calls, history calls."

You know what? History always calls. You're in the United States Senate, for goodness' sake.

"The status quo approach has produced one glaring common denominator; that is that we have a problem that is growing worse, not better," Snowe added, in a glaringly obvious false dilemma. However ghastly the status quo might be, the alternative has the potential to be far worse. Saying "no" does not equate to a "yes" vote on the status quo.

In 2006, Snowe was listed by Time magazine as one of America's 10 best senators, in part for her ability to set aside partisanship. Which is funny because this year, Time magazine ran a hyper-adulatory story about the late Ted Kennedy, perhaps the most partisan force the Senate ever has known. Praise of bipartisanship, you see, is doled out selectively.

Now, as unlikely as it is, history also offers Republicans an unexpected opportunity to remake their party, to find an ideological center, to use politics to thwart a movement that is antithetical to every tenet they've been rhetorically peddling since Ronald Reagan.

Of course, Republicans will increasingly be accused of being ideologues. If only.

Is ideology something to be dismissed as a barrier to progress? Isn't ideology a framework of ideas that politicians should be using to inform their decisions?

Mavericks, well, they dismiss ideology because it would bind them to consistent and principled votes. John McCain often displays the muddled and mercurial thinking of a person with no political, intellectual, or economic philosophy guiding him.

There is plenty of room for dissent in political parties. But when it comes to health care reform, Republicans—powerless to stop meatloaf from being served in the Senate mess hall, much less a bill—do have a chance to embrace the ideals they've been pretending to champion for a decade with one straightforward, graceful and honorable word: "no."

They have no moral or civic or political obligation to embrace bipartisanship. History might even be telling them not to.

David Harsanyi is a columnist at The Denver Post and the author of Nanny State. Visit his Web site at www.DavidHarsanyi.com.

COPYRIGHT 2009 THE DENVER POST
DISTRIBUTED BY CREATORS.COM

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  1. Why say “no” on principle when you can just say “no” on unadulerated blind hatred of your opponent. Republicans are much better at that.

    1. A politician should never say “yes” unless its on principle, especially when have a huge transformative piece of legislation like the healthcare takeover. What principles is Senator Snowe operating under?

      1. The principle of ‘join the winning team, even if they are wrong’.

      2. Whatever principles come with having a bizarre and slightly stupid name like Olympia Snowe, I’d guess.

    2. Saying “yes” to one’s political and ideological opponents is suicidal. We don’t have a two-party system so everyone can get along. “Progressives” seem to have forgotten this. They whine and stamp their feet and complain that the other boys are being mean. Tough titties.

  2. “In 2006, Snowe was listed by Time magazine as one of America’s 10 best senators, in part for her ability to set aside partisanship. Which is funny because this year, Time magazine ran a hyper-adulatory story about the late Ted Kennedy, perhaps the most partisan force the Senate ever has known. Praise of bipartisanship, you see, is doled out selectively.”

    Well of course, conservatives pols are partisan, liberals idealistic, moderates siding with liberals are rational, moderates siding with conservatives are caving in or selling out. You should know this double standard by now.

  3. Republicans?powerless to stop meatloaf from being served in the Senate mess hall

    Isn’t that freedomloaf now?

    1. I believe it’s called “shit loaf.”

      1. It’s euphemistically called Shepard(‘s) pie.

        1. Are you sure its not Shepard and Byrd’s pie now?

  4. If the Republicans don’t eventually drop their objections and jump on the healthcare reform train in an effort to secure a their pieces of that very large, taxpayer funded pie, my faith in the system will have been shaken.

    (Mixaphorically speaking.)

  5. Saying no isn’t so easy when you know that your constituents will be told that you are a status quo loving obstructionist. That’s why Republicans are holding record numbers of town hall meetings. Yet the meetings don’t even scratch the surface of changing the minds of the purposefully misinformed masses.

  6. You know what? History always calls. You’re in the United States Senate, for goodness’ sake.

    FTFY.

  7. Sorry for the threadjack.

    *channeling Whackalone*

    Concerning a story I have written about several times here since it happened, the decision to send armed MPs from Fort Rucker to Samson Alabama to help local law enforcement after a mass murder on March 10, 2009 violated federal law.

    story here

  8. The Dems seem to think that “no” means “we hate America”. I’ll have to bring that up at the next Take Back the Night event.

    1. It’s beyond a “Dem” thing, it’s political bullshit from both sides. Let us not forget those who opposed the Iraq war, and were subsequently considered “anti-American.”

  9. A politician should never say “yes” unless its on principle, especially when have a huge transformative piece of legislation like the healthcare takeover. What principles is Senator Snowe operating under?

    The Peter Principle

    Preview button has gone poof, Your Most Exhalted Squirrelship!

    1. It’s back. Must have been a browser fail.

  10. I wouldn’t worry excessively about being the “party of no”.

    As I stated on another thread, I am rather a fan of gridlock and opposing parties in the legislative and executive branches. Keeps Congress and The POTUS in check and reduces (in theory and largely in practice) the amount of mischief government can enact.

    I still believe “bi-partisanship” ranks right up there with Nessie,Tin Foil Hattery Conspiracies, The Jersey Devil and La Cupacabra.

    I used to phooey the notion of sasquatch, but the existence of the systemically hirsutic, acromegalic lecher and rapist, Steve Smith, I now believe.

    1. You may not believe in the Cupacabra, but the Cupacabra still believes in you.

      1. Spare me your feeble attempts at disquieting my calm, Saccharin Man.

        Now Warty OTOH…..

        1. Yes, he is all too real.

  11. If the Republicans were smart they would have tackled the health care issue when they were in power. Saying no, is really not an option. A quick look at the OECD stats and one realizes that this is not a political issue, but an economic issue. The cost of health care in this country is beginning to stifle the economy. 16% of GDP is on health care. That’s double what it was 20 years ago. By 2025 it’s predicted to jump to 31%. The $7,290 per capita expenditures are more more than 2.5 times the average of other OECD countries. If that isn’t a hindrance to economic development, I don’t know what is. All the arguments about gubmit run health care pale in comparison to the fact that every other OECD country spends half of what we do, and gets better quality of care. But, I know, nobody wants to pay for someone else’s health care, right?

    http://www.oecd.org/dataoecd/46/2/38980580.pdf

    1. “better quality of care”? What? Why do all the heads of state come here when they need a medical procedure done? Why do Canadians wait weeks and months for MRIs, when Americans can get them done the same day or next day? What is the level of PRIVATE spending on medical research in the US vs. PUBLIC spending in the other countries? (Hint, the private sector in the US spends more on research). The only reason the other OECD nations have decent health care at all is because they ride on the back of our research.

      1. Really, I didn’t see that in the report. Is that your opinion, or can you cite a source? This isn’t about research, it’s about delivery. Read through the quick stats again. Pay attention to the number of doctors per capita, life expectancy and infant mortality rates. We pay more and get less. The only way we can continue to compete in the World markets with costs like these is to artificially weaken the dollar. The Federal Reserve is very good at doing that.

        Why must you single out Canada? Canada is just as fucked up as we are, but in different ways. Perhaps, you should look at Norway or Japan.

        1. Not quite, they are in much better fiscal shape than we are. IIRC, their courts are starting, slowly but surely, ruling against the Universal Care. They are figuring out it doesn’t work, even with a strong Canadian Dollar and a much smaller population than the US.

          1. Quebec is not Canada.

            The court in Quebec did not rule against Universal Care, they ruled that putting a patient on a waiting list and not allowing them to use a private alternative was the equivalent of denying care and contrary to the Quebec Charter of Rights. That strikes me as a ruling in favor of universal care.

            The other provinces that have similar rules have made no changes to their policies.

            1. Thank you for clarifying IB.

              However, semantics and definitions have now muddled this up a bit.

              With Universal Care, rationing ensues and waiting lists are par for the course. By allowing for private care at any time as opposed to governemnt care would serve to weaken the efficacy of a “universal system”, depending on how one defines it.

          2. Canada has a pseudo universal care system. All of the hospitals are privately owned and doctors are privately employed. I’ve noticed, in my area, some of the hospitals are going non-profit. The problem with that, is they can’t get any doctors to practice there.

            My point is, however, that the Republicans are supposed to be pro-business, and pro-economic development. I think that their own ideologies about free markets have gotten in the way. I’m beginning to see some supply-siders recognize this. However, they stop short of offering any real solutions. That’s why I feel this needs to be addressed as an economic issue, not a political ideology issue. If, of course, it is possible to separate the two.

            1. Handing a large portion of the economy over to the feds, is not pro-business, or pro-economic development.

              1. And anything governemnt get its mitts on, without the benefit of enumerated power under the Constitution, is invariably going the way of political ideology and subsequent bastardization (see “entitlements).

        2. Oh? Do you have a cite telling us how much better the health of Norwegian-Norwegians and Japanese-Japanese is than the health of Norwegian-Americans and Japanese-Americans?

            1. Apologies if that wasn’t clear enough…

              What are the life expectancies and infant mortality rates of Norwegians and Japanese in the US?

              1. Hmm, proving difficult to find that specific a statistic, even going to CDC and JAMA.

                But you have piqued my curiosity; I watched a special aired on PBS sun regarding the health of illegal immigrants before and after they enter and live in the US. The data showed a marked increase in the DX of diabetes, heart disease and depressive/psychiatric disorders after arriving and living here fore a few years. Many explanations were given, such as change in diet and constant economic stress, but nothing conclusive.

                I am curious if the data to answer your query would be congruent (given the Standard American Diet adopted after acculturation in the US, I would be inclined to think yes).

                1. “The data showed a marked increase in the DX of diabetes, heart disease and depressive/psychiatric disorders after arriving and living here fore a few years.”

                  This doesn’t necessarily mean that Mexicans are suffering more health problems under our system than back home. What this does demonstrate, however, is how great healthcare is in the US, especially for the poor. The average lower-middle class Mexican national is typically not born in a hospital or even under medical supervision, goes without pediatric care, doesn’t get all of the standard vaccinations (if any at all), and will likely never receive any preventative medical care or have a “well” checkup.
                  In the US, there are numerous, inexpensive options to access services such as a basic checkup or blood work, which can reveal conditions such as diabetes or heart disease. In contrast, in Mexico it is common for people die from undetected and untreated ailments that wouldn’t even be regarded as a serious threat to a patient’s health in the US (such as conditions that are routinely treated by a nurse practitioner).

                  The disparity in disease diagnosis before and after immigration is a testament to the US system, and not an indication of poorer health post-immigration. It shows that immigrants have access to care that they did not have before, so contrary to what PBS suggested, it can be reasonably argued that they are probably in better health post-immigration.

        3. Pay attention to the number of doctors per capita,…

          No question: The US should get rid of medical licensing laws that are enforced through AMA certification of medical schools and an extremely throttled residency program.

          …life expectancy…

          After correcting for deaths due to violent causes — e.g., homicides and car accidents — the US has the highest life expectancy in the world.

          …and infant mortality rates.

          And this is mostly measuring teenage maternity rates that are several times higher than those of other OECD countries.

          Read through the quick stats again.

          Quick stats are astonishingly useless in health care debates. Unfortunately, quick stats are all most of the health care nationalizers know.

        4. “life expectancy and infant mortality rates.”

          1.Life expectancy is effected byt hings outside of the healthcare system. We are not as dense of a populated country as most OCED so we drive more and therefore have mroe car accidents. Plus for whatever reaosn we have mroe homocides. If you adjust for car accidents and homicides, the US has the highest life expectency in the world

          2. child mortality rates here are higher because we measure it differently. In this country we tryt o save far higher amounts of children drurring pregnacy complicatios via c-section. Though we save a lot, obviously this sample has a high mortality rate than average. In other coutires these children just die pre birth and are not added into the stats. We deliver via c-section and then a higher percent die. Thats why ours is inflated.

          3. costs… we subsidize the entire worlds R&D… other countries systems deny use of the most recent drugs and procedures and only after prices have come down when the US market has absorbed the fixed cost do they adopt them. If we had a similar system, there would be virtually no new medical advances.

          4. % of GDP – why is having a percent of GDP higher on healthcare necessarily a hinderance to growth? Is the fact that we spend a higher % of GDP on cars, baseball games, vacations, and pizza than most countries do a hinderance to growth? Yes we use more of our production for health than other things, but consuming more healthcare does not necessarily mean its “hindering the economy”

        5. Infant mortality rate. ahahaha!

          Once someone cites that easily misread, and misleading, stat, I know they aren’t arguing with full weaponery.

          Come on. The U.S. keeps more premies alive, thus, when some end up dying anyway, they go under the heading of infant mortality. That won’t change (except we’ll keep less premeies alive) under the new system.

          Doubt what I said above? Then explain how universal health care promises to keep babies alive in a way that our current system doesn’t. Surely your argument won’t be that under our system the poor and uninsured are chronically having children they neglect to get care for, right?

        6. HAHAHA. Japan? Really? Funny, considering they’re having trouble with funding, and have 50% of their hospitals facing possible shut down.

          Yes, let us look at Japan, please.

    2. 1) The US has the best outcomes in the world. That has a cost.

      2) That said, the costs are still much higher than they would be in a free market.

      3) The dem proposal does nothing at all to fix the problem, and expands all the factors that cause the problem.

      It’s true the GOP should have done something.

      That doesn’t mean making things much worse makes sense.

  12. TP, if you want universal health care, move to MA, or work to pass it in your state. Why do you feel the need to inflict the rest of us with more of the federal governments inefficient, controlling solutions? What in the history of the US government leads you to believe that they could successfully take over such a large portion of our economy, and make it better? What makes you actually believe that they won’t ration care in an increasingly restrictive manor? What makes you believe that they won’t try to have more and more control of your daily decisions, if they can be construed to impact your health?

    You might be able to manage all of that belief, but I’m a skeptic. I happen to like no. At least in response to the pathetic excuse for a solution that is being presented by democrats. However, that isn’t really what republicans are presenting. They want to addresses the real issues; tort-reform, tax inequity, and removing restrictions on out of state insurance.

    You see, if the feds weren’t already so involved, we wouldn’t have this “crisis”. Get them out of the medical business, and we can all be richer, healthier, and happier.

    1. That’s a nice sentiment. But, we’ll never get the government out of health care because of the large number of uninsurable people in this county. The elderly.

      Those are not real issues. Out of state insurance is just a way to bypass state regulations. Tort reform is a way to bypass trial lawyers. Has anyone done any research on how these would reduce our per capita expenditures?

      Look, it’s bad enough we have to compete with the low labor costs of China and Singapore. Now, we also have to compete with the low health care costs of the European countries.

      We need to face the simple fact that we are already paying for other people’s health care. Where it comes from is not the issue. The issue is, whether or not we can do it cheaper, and raise the quality of care. Every other OECD country has done just that. So why can’t we?

      1. I’m just suggesting that we handle the problems at the lowest common denominator, while trying to maintain as much freedom and choice as possible. Making it a federal issue, automatically injects pretty much the maximum inefficiency, while eliminating or reducing choice.

        Your dismissive responses to my suggestions on the economic front are completely uninformed. Tort-reform doesn’t mean we’re bypassing lawyers. It’s a variable solution. It could be implemented to simply reduce or limit financial awards. It could rationalize the system to take responsibility away from doctors that didn’t clearly make mistakes. There are a lot of variables there. The idea of buying across state lines is simply a way to increase consumer choice, and increase competition. right now, the left is using this situation to argue for “the only solution, a single payer option” disingenuously. The best solution to the problem of the lack of in state competition, is to remove the barriers to competition. Make sure consumers are properly informed, but stop trying to protect us from ourselves. Allow us to choose what option we think is best.

        You didn’t even address the tax inequity.

        1. The idea of buying across state lines is simply a way to increase consumer choice, and increase competition.

          Health care was being debated on my local NPR station the other day. When someone asked whether the public option could be per state, the response was that that wouldn’t be competitive enough: it’s got to be nationwide.

          And, yes, at another time during the program someone mentioned that 75% of Montana’s residents were covered by one company. This was evidence that we need a public option to provide competition.

          The mentality of these reformers truly boggles the mind.

      2. A key point the Democrats fail to mention is that this health insurance overhaul/takeover is not “Health Care Reform” per se. Health Care Reform itself would entail looking at the other factors that drive up the cost of care, such as the outrageous salaries commandeered by health care and pharmaceutical professionals.

        If you want to take a good, hard look at the factors driving up care, look toward the heavy-handed tactics of the AMA, which created and perpetually maintain a doctor shortage in this country, and then zealously prosecute non-members of their “guild” (such as Chiropractors) for what they view as encroachment on “their turf”.

        If collision repair specialists suddenly unionized, raising the rates of car repair 5x over the course of a decade and the cost of car insurance suddenly went up 5x, is that the fault of “evil, greedy insurance companies who only care about profit”?

        Obamacare is smoke and mirrors that deflects blame away from the true factors that raise the cost of health care in the US.

      3. How come all of these countries with low healthcare costs that we are “competing” against have smaller economies, or slower growing ones? France has the #1 healthcare system according to the WHO and they only spend 11% of their GDP on healthcare vs. 16% for the US. Meanwhile France’s PPP adjusted per capita income is 33,000 vs the US 46,000, and Japan’s is 34,000.
        http://en.wikipedia.org/wiki/L…..es_by_GDP_(PPP)_per_capita

        Also, real GDP growth in France is much slower. The US’s real per capita income PPP adjusted grows at a rate of about 1.1% vs. France’s 0.3% growth or Japan’s -0.7%. http://en.wikipedia.org/wiki/L…..es_by_GDP_(real)_growth_rate Yes these numbers are based on slightly older estimates, but I consider that a good thing considering all of the recent economic upheaval.

        Now i know that you might be thinking, “The US has a higher per capita income, but their society is less equal with a large proportion of that money going to the upper classes,” but this isn’t the argument here. The argument taking place is that the US is falling behind countries that have nationalized medicine, however we clearly aren’t. How the income is distributed is an entirely different matter. I could not find the statistics for the median household incomes of france or Japan, because they only put out numbers for their average household income. And we beat them there too. France and Germany are ranked highly for their healthcare systems, but I sure don’t see their economies outperforming ours any time soon. The only European countries that are “competitive” with us right now are small countries with populations smaller than some of the richest cities in the US.

        1. How many of these countries have a doctor-to-patient ratio higher than that in the US? In how many of these countries is physician one of the highest paid professions? In how many of these countries are pharmaceutical companies bribing legislators and colluding with health care professionals to get every suggested procedure and treatment reimbursed?

          If we’re going to have an honest talk about the true cost of health care, why stop at the health insurance level?

          ObamaCare is smoke and mirrors, man, smoke and mirrors…

      4. Out of state insurance is just a way to bypass state regulations. Tort reform is a way to bypass trial lawyers. Has anyone done any research on how these would reduce our per capita expenditures?

        Well before government interfered in the health care market (at the behest of, in order, doctors, employers, insurance companies, then trial lawyers, everyone could afford health care and physicians made no more than any other skilled worker. So we do have data.

        Look, it’s bad enough we have to compete with the low labor costs of China and Singapore. Now, we also have to compete with the low health care costs of the European countries.

        You act like the money spent on U.S. health care leaves the economy. It’s part of the economy. And all the foreigners that come to the U.S. are contributing to that economy.

        Every other OECD country has done just that.

        No they have not. There is no place in the world that has better outcomes than the U.S. If you get sick you come to America. Where will Americans go once they finish demolishing the health care economy?

  13. Two cites for thought.

    Statistics for costs and life expectancy in US and other countries

    Looking for the genetic specific v. different country cite(s)

    More on Japanese healthcare

  14. @aelhues: Ah yes, Massachusetts and our “universal” health care! If by “universal” you mean that 20% of the population is still uninsured (with the program billions over-budget trying to subsidize their coverage), and the insured pay the highest premiums in the country. More of your government at work.

    1. 🙂 I wasn’t suggesting it was a good solution!!

      1. that’s a good idea.

  15. Massachusetts tried and failed miserably.

    But the only good arguments I’ve heard, is the quality of care. Perhaps I’d be willing to concede that the quality is equal or better. Life expectancy and infant mortality rates do have their limitations. But using teen pregnancy and homicides can appear disingenuous. We all know what we’re talking about. Inner city poverty.

    But still, no one has offered any real solutions to the fact that we spend much more per capita. That’s exactly why it is an economic issue. I would be so bold as to suggest we spend far too much in administrative costs. This, I feel, is due to the fact that health care dollars come from so many different sources. Taxes, private insurance, charity, out of pocket, etc. Any business person will tell you it is desirable to consolidate expenditures. Is single payer the answer? Probably not with the current state of government. There’s already far too much corruption. The current plans in Congress are a shining example of this. I’ve heard some talk of non-profit regional co-ops.

    I see no way to defend the current system and just say no. Like I said, the Republicans blew a good chance to do something and only gave us health care savings counts.

    1. Way to ignore the debate and call yourself the winner.

      1. What debate would that be? I’m just trying to have an open, honest conversation with as little political rhetoric and Dogmatic idealism as possible. I never once supported Obama’s plan, or supported a single payer. I merely suggested it. If you are that insecure in your position that you feel you must debate and “win”, perhaps you should re-examine your position.

    2. Here are 5 ways to improve health care and lower costs:

      1. Allow purchase of insurance across state — and national, for that matter — borders.

      2. Give all health expenditures the same tax treatment. If that equal treatment is pre-tax — as employer-based insurance is today — require employers to give the benefit to employees as a voucher that the employer can take elsewhere with the balance going into an HSA.

      3. Phase out Medicare. Make the richest age cohort in the country buy their own damn health care. Give vouchers to those who can’t afford it based on poverty or preexisting condition.

      4. Make medical licensing advisory only. Open the borders to immigrant doctors.

      5. Make FDA drug approval advisory only. Allow sales of all drugs over the counter except those with actual public health consequences, such as last-line antibiotics.

      1. …require employers to give the benefits to employees as a voucher that the employees can take elsewhere with the balance going into an HSA.

        1. What about the small business employers that can’t afford to give their employees health care in the first place. I sure as shit can’t. And yes, that bothers me. I wish I could. I said many years ago that small businesses need a pool of buying power.

          1. Then at least under my proposal you’ll be on the same playing field as the employer who can afford health care benefits.

            And, please… Pools of buying power pale in comparison to the tax advantages of giving someone a $12,000 benefit instead of $7,000 in after-tax wages.

      2. 1. I guess you mean eliminate a state’s right to regulate insurance. The reason this is popular is because of large companies that operate in several different states. It would be much easier for them to “centralize” their health insurance purchasing than having to buy policies in each individual state that their employees live. It has nothing to do with choice for the consumer. This actually does make good business sense and would cut administrative costs, but which states regs would take precedence. Federal regs?

        2. It’s not taxes, it’s the large pools of buying power that make the real difference.

        3.You still run into the problem of getting companies to provide insurance, at any cost, to uninsurable people.

        4 and 5 You lost me on those. We can’t even get drug companies to properly market their products in the current system. Are you actually suggesting that people be allowed to “self medicate” with OTC drugs. People can barely be trusted with Tylenol, let alone blood thinners and such. I know I can’t understand everything in a PDR book.

        1. 1. Regulations of the state where you bought the health insurance from. Look at your Windows license some day. It’s not rocket science.

          Most importantly, it breaks the monopoly of governance held by the state insurance commissions and the legislatures who feed them.

          2. It’s taxes. Since World War II when wages were frozen, companies have been giving health insurance benefits as a way to get past wage caps and taxes — and the result is the horrendous incentive that leads most of us to get our insurance from our employer. Amazingly stupid!

          3. If vouchers don’t work, then use outright welfare. The important thing here is not to destroy the health care market for the 75% of people who can afford health care in order to coddle the people who can’t into thinking they are not on welfare.

          As for 4 and 5, I am curious why you think you can’t go to a doctor or pharmacist unless you are forced to. Do you really take so little responsibility for yourself and your lack of knowledge?

        2. You still run into the problem of getting companies to provide insurance, at any cost, to uninsurable people.

          You’re confusing a service contract and insurance.

          Are you actually suggesting that people be allowed to “self medicate” with OTC drugs.

          Are you actually asking this question on a libertarian site?;)

          Anyway you should try to understand his suggestions, they are economically sound.

          Basically they amount to reversing the interventionist influences that have caused the problem while retaining some of a safety net, which safety net will basically pay for itself by the price reduction.

          The reason why nothing like this is on the table is because it doesn’t give any of the key players an artificial market advantage and in fact undoes all of the ones they have spent a century securing.

      3. Good ideas all, very close to what I would suggest. You clearly have a grasp on the real causes of health care inflation decoupling.

        I would also suggest however it would be better to break the link between employers and tax breaks.

        1. In the long run, I’d want to see all employee benefits taxed as wages to avoid just these kinds of market distortions.

          But there are three problems with instantaneously going there:

          1. It would be a huge dislocation to individuals’ health insurance and the market in toto.

          2. Sticky wages mean it will take time for employees to see the benefit as cash in their paychecks.

          3. Taxing health insurance benefits would mean something like $340 billion dollars added to the general revenue. I fear what government would do with such a windfall…

          1. Oh I understand the benefit of slow transitions to free markets.

            I would first shuttle the tax break to the individual instead of the employer, then I would slowly remove it.

    3. We have a limited single payor already. Its called Medicare. Everyone, and I mean EVERYONE, including Obama, the Dems, the Repubs, thinks its wasteful by the billions, overbudget, poorly run, and a big reason for our current deficiet.

      But the answer is to expand it to 100% of the population?

      That makes so little sense that I’m almost to the point where I want single payor to pass, just so you MFers can get your system and watch it burn to the ground.

      It would suck, but at least I’ll be prepared and know what it coming and be able to laugh while it all falls down.

    4. But still, no one has offered any real solutions to the fact that we spend much more per capita.

      Everyone knows the solution. You can act like it’s
      not
      been
      offered
      all you like, but it’s not flying here.

      Even the GOP has a better plan.

      In any case ‘just say no’ is much better than what they are trying to do, which will make things much worse.

  16. You know, the Republicans do have someone who says “no” all the time. It’s part of his nickname, in fact.

  17. So, if there was a DINO, suppose a Democrat who voted only for limited government, would TIME magazine name them one of the best Senators, b/c of his/her bi-partisanship?

    1. No because he wouldn’t get elected

    2. No, it’s only bipartisanship when it’s a republican voting with democrats.

      1. Note: Repubs vote with Dems – bipartisan goodness.

        Dems vote with Bush on Iraq & 100 other things – bipartisanship largely ignored.

  18. How would buying insurance rom out of state providers work? Would it require for federal regulations and/or less state regs? Would it lead to a few companies running the national market? What possible downsides are there for individual liberty might there be?

    1. Have you ever noticed that almost all corporations in the country are incorporated in Delaware? And all credit cards come from South Dakota?

    2. The downside would be that the federal government would feel that it had the right to regulate health care nationally.

      If someone can divine the difference between that fear from what is happening today, be my guest.

  19. But still, no one has offered any real solutions to the fact that we spend much more per capita.

    Because of two things. One, because of the perverse incentives governing health care spending no one has an incentive to economize on health care spending. We’ve beat that to death already, I think.

    Two, because there is an amazing variety of shit we spend money on because we can. Fake tits are a medical cost. So are botox, orthodontia, teeth whitening and liposuction. We spend money on things you will never get in a European country because the state won’t pay for it. That can’t help but drive up our per capita costs.

    1. I’ll agree with your first point. It costs an individual the same out of pocket expense whether he goes to Dr. Joe Shmoe, or the University of Penn.

      The second, I’m not so sure of. I’d like to see some numbers on that. You may be right.

    2. 2) is not true and really confused.

      Cosmetic surgery is covered by almost no insurance, and hence not directly subsidized by the government (although it still is indirectly via the LCME/AMA monopoly).

      As such it’s a much more free market and in general cosmetic surgery is much cheaper, because many more competitive forces apply to the market.

  20. How come all of these countries with low healthcare costs that we are “competing” against have smaller economies, or slower growing ones? France has the #1 healthcare system according to the WHO and they only spend 11% of their GDP on healthcare vs. 16% for the US. Meanwhile France’s PPP adjusted per capita income is 33,000 vs the US 46,000, and Japan’s is 34,000.
    http://en.wikipedia.org/wiki/L…..es_by_GDP_(PPP)_per_capita

    Also, real GDP growth in France is much slower. The US’s real per capita income PPP adjusted grows at a rate of about 1.1% vs. France’s 0.3% growth or Japan’s -0.7%. http://en.wikipedia.org/wiki/L…..es_by_GDP_(real)_growth_rate Yes these numbers are based on slightly older estimates, but I consider that a good thing considering all of the recent economic upheaval.

    Now i know that you might be thinking, “The US has a higher per capita income, but their society is less equal with a large proportion of that money going to the upper classes,” but this isn’t the argument here. The argument taking place is that the US is falling behind countries that have nationalized medicine, however we clearly aren’t. How the income is distributed is an entirely different matter. I could not find the statistics for the median household incomes of france or Japan, because they only put out numbers for their average household income. And we beat them there too. France and Germany are ranked highly for their healthcare systems, but I sure don’t see their economies outperforming ours any time soon. The only European countries that are “competitive” with us right now are small countries with populations smaller than some of the richest cities in the US.

  21. How come all of these countries with low healthcare costs that we are “competing” against have smaller economies, or slower growing ones? France has the #1 healthcare system according to the WHO and they only spend 11% of their GDP on healthcare vs. 16% for the US. Meanwhile France’s PPP adjusted per capita income is 33,000 vs the US 46,000, and Japan’s is 34,000.
    http://en.wikipedia.org/wiki/L…..es_by_GDP_(PPP)_per_capita

    Also, real GDP growth in France is much slower. The US’s real per capita income PPP adjusted grows at a rate of about 1.1% vs. France’s 0.3% growth or Japan’s -0.7%. http://en.wikipedia.org/wiki/L…..es_by_GDP_(real)_growth_rate Yes these numbers are based on slightly older estimates, but I consider that a good thing considering all of the recent economic upheaval.

    Now i know that you might be thinking, “The US has a higher per capita income, but their society is less equal with a large proportion of that money going to the upper classes,” but this isn’t the argument here. The argument taking place is that the US is falling behind countries that have nationalized medicine, however we clearly aren’t. How the income is distributed is an entirely different matter. I could not find the statistics for the median household incomes of france or Japan, because they only put out numbers for their average household income. And we beat them there too. France and Germany are ranked highly for their healthcare systems, but I sure don’t see their economies outperforming ours any time soon. The only European countries that are “competitive” with us right now are small countries with populations smaller than some of the richest cities in the US.

    1. Look at it this way. There are many foreign companies that operate in this country. That’s basically a good thing. Sony’s been here for years. Toyota, Mercedes, there’s even a British company in Michigan.

      But, when a foreign company is considering opening up a plant here, say like the French company that owns Airbus, one of the factors that must be considered is the fact that it costs twice as much to provide health benefits than in France. This must be carefully weighed with and against other important economic factors. Labor costs, tax liabilities, energy costs, construction etc. At what point does the cost of health care become the breaking point and Airbus says “we may as well just stay in France”.

      1. I understand! But you’re not considering the other costs. Those companies will have to pay higher taxes to cover the cost of that government provided healthcare. Higher taxes scare businesses away. In the US many employers benefit from NOT having to provide healthcare benefits. Maybe a lot of people who would rather pay for their own insurance (employer provided health insurance is just another form of compensation like direct salary; it’s just salary that is already spent for you), or maybe they have a spouse or family member who already has insurance benefits that also cover them. Why shouldn’t these people be able to agree to work for less compensation? That’s the employment market process. I agree that we need to do something about healthcare to improve our lives, but how come you can’t tell me why all of these countries that should be beating our asses, according to your logic, lag so far behind? Are we about to lose our place in the world because of our crummy healthcare system? Nope. Not even close. It sucks that we have a crummy healthcare system, but it’s not like we face any real “competition” from the people who do have, what you would consider, a “better” healthcare system. Maybe economically, the healthcare system doesn’t make a tremendous difference. Even in the countries with “bad” healthcare, new life expectancy records are set every few years and mortality rates are in decline. Saying that our healthcare system is going to ruin our economy is just chicken little antics. Not real economics.

        Obviously, those foreign investors seem to value american workers enough to pay them better than workers in other countries. Obviously there are other, much more relevant, factors. Even if healthcare is a factor, it couldn’t be more than a tiny one. I have yet to see any mathematical trends linking economies and healthcare together.

        Unless you are arguing that the US is super productive compared to European and Asian countries, and that if ONLY we had a “good” healthcare system, we would experience explosive boost of savings that all of those other countries aren’t experiencing due to their inexplicably slow groing economies for some unexplainable reason.

  22. sorry for the double post!

  23. Interesting thought; what if the Dem’s health care plan is pushed through, and care is somehow mandated for every citizen. Imagine, then, when the Republicans inevitably gain power. Assuming they stay the same way, won’t that make it very easy for them to ban abortion in all public health care offers? Just a thought.

  24. “Airbus says “we may as well just stay in France”. ”

    Except the lower taxes, and more friendly pro business environment in the US more than makes up for the difference in cost. Foreigners don’t seem to mind investing their money here. Having a market based healthcare policy is probably integral to that. Plus you’re ignoring the fact that Airbus wouldn’t have to pay for the healthcare of the US workers.

  25. …one of the factors that must be considered is the fact that it costs twice as much to provide health benefits than in France.

    As the wiki says [citation needed].

    I’m not sure where you’re looking but someone here cited an article (FT IIANM) with some numbers on the levels of payroll taxes levied in France to provide there workers with various benefits like healthcare and pensions and they make FICA look like a pittance. Frankly, it’s a wonder anyone gets hired in France at all.

    I will reseach further if I get the time but my main point is that for the moment I doubt if your contention has any better basis in fact than mine.

    This and the fact that France’s system runs a perpetual deficit that is funded from general revenues means that their system is faced with the constant reality that they must either continue to have the system bleed money, raise taxes or cut services. When the impact of the last choice starts to be felt by enough people (ie it’s your own granny that’s on a waiting list instead of someone else across the country) governments in those places fall, and fall hard.

    1. edit:

      …they make [my] FICA [plus my healthcare premiums] look like a pittance…

  26. But still, no one has offered any real solutions to the fact that we spend much more per capita.

    (1) Why is this a problem? This seems to assume there is some Right and Correct amount of money that should be spent on health care for 300MM + people. What is that number, and where did it come from?

    (2) Assuming it is a problem, what are the causes? If the cause is the decoupling of the decision to obtain health care from the obligation to pay for it, then we are well on our way to a solution.

  27. Dear David Harsanyi,

    How about just saying no to the settlements in the Occupied Territories, you right-wing Zionist prick.

  28. I like the side of the article, and very like your blog, to write well and hope to continue their efforts, we can see more of your articles.

  29. Saying “No” to a reform proposal and offering no alternatives of your own logically equals to saying “Yes” to status quo. But it’s not illogical to “Yes” to status quo. But it’s illogical to say they are not equal.

    1. Saying “No” to a reform proposal and offering no alternatives

      Wrong twice in less than a sentence.

      Saying no to ‘a’ reform proposal is not equal, logically, or otherwise to saying yes to the status quo. It’s saying no to ‘a’ proposal.

      Also there are many alternatives being offered that are clearly beneficial and stand on their own.

      L2 logic before you consider yourself qualified to be a logic critic.

  30. When you look at a trade agreement like NAFTA, it’s about that thick (holds his hands about?

  31. My only point is that if you take the Bible straight, as I’m sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won’t get the full deal by just doing regular skill english reading for those books. In other words, there’s more to the books of the Bible than most will ever grasp.

  32. My only point is that if you take the Bible straight, as I’m sure many of Reasons readers do, you will see a lot of the Old Testament stuff as absolutely insane. Even some cursory knowledge of Hebrew and doing some mathematics and logic will tell you that you really won’t get the full deal by just doing regular skill english reading for those books. In other words, there’s more to the books of the Bible than most will ever grasp. I’m not concerned that Mr. Crumb will go to hell or anything crazy like that! It’s just that he, like many types of religionists, seems to take it literally, take it straight…the Bible’s books were not written by straight laced divinity students in 3 piece suits who white wash religious beliefs as if God made them with clothes on…the Bible’s books were written by people with very different mindsets

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