Patterico's Pontifications

1/25/2013

We Don’t Know As Much As We Think We Do About the Economy, Part 1

Filed under: General — Patterico @ 11:08 pm

We all make the error of confidently saying that this or that governmental policy is certain to have this or that effect. But while studying history and economics is important, perhaps a little humility is in order.

I have told you that I am a fan of Russ Roberts’s Econ Talk podcast. Today I listened to one in which the guest questioned whether people can confidently use economic (and other social science) theory to confidently predict the effects on human behavior of changing certain variables. Do we truly know that a stimulus is going to increase GDP . . . or that it is not?

The hour-long podcast summarizes concepts in a denser and more complex book. I’m going to dumb it down even further and summarize three or four of the points the guest made that stuck in my head. I’ll do so over a series of posts, so let’s start with a single observation that is central to the guest’s thesis.

Essentially, the guest distinguished social sciences from hard sciences that give one the ability to make consistent non-obvious predictions about the future. One example he gave to make the point:

[I]magine you are the President of the United States and you are receiving, you are considering an Iranian nuclear weapons program, what to do about it.

And into the room walks your science advisor and she says: Look, if the Iranians take the following amount of physical material and combine it in this size and using this method, it will create an explosion big enough to blow up the city.

And next into the room comes an historian. And the historian says: Well, you know, if an attempt to subvert the Iranian nuclear weapons programs, my reading of the history of Iran is that the people will want this enough they will continue to replace, one way or another, the government until this happens. So it really is not a good idea to try and stop this.

And what I say is, no, even if this happens to be President Carter, trained as a nuclear engineer, even if you know nuclear physics, for the President to sit there and begin debating the empirically validated laws of physics with his physics advisor is kind of foolish. On the other hand, not debating the historian, not bringing in different historians of different points of view, talking to people who have lived in Iran, personal introspection about human motivations, would be equally foolish.

And so really you ought to treat the prediction made by the physicist very different from the one made by the historian. Both are very valuable. I would never advise taking action without listening to both those. People make lots of use of historian experts and non-historians make lots of useful predictions about this situation.

And then imagine, third, his economic advisor walks into the room. And she says: Well, you know, the CIA has a program to counterfeit currency in Iran. And this amount of currency will create this amount of inflation and unemployment. The question I pose is: Should you as the President treat the economist’s prediction more like the historian’s prediction or more like the physicist’s prediction? And what I say is: A lot more like the historian’s prediction.

Economics is not hard science like physics. It’s more like history. There are too many complex variables to make consistent predictions about exactly how changing one variable will affect the economy.

This, by the way, is why I tend to oppose any government intervention in the economy. There are so many documented examples of unintended side effects that I think it’s best to leave a complex system to the distributed intelligence of the nation and indeed the world, rather than trust a group of supposedly smart guys in a room with their hands on the financial levers. The more humility you have, the less apt you are to opt for the government solution.

The big government guys are the arrogant ones. We free marketeers believe in the market precisely because we don’t think we know everything.

UPDATE: It’s also worth noting, as I have noted many times, that capitalism is the only economic system fully compatible with freedom. My comments about supporting capitalism in this post are made in the context of discussing what economic system is most likely to work. But freedom is an independent reason for supporting capitalism. Everyone who regularly reads my blog understands this.

451 Responses to “We Don’t Know As Much As We Think We Do About the Economy, Part 1”

  1. Ding.

    Patterico (8b3905)

  2. We all make the error of confidently saying that this or that governmental policy is certain to have this or that effect.

    ok I’ll start being that I’m up and all

    food stamp’s giant tax increases – the just done ones and the obamacare ones and the ones the EPA is putting on energy – to say nothing of the fica one and the ones I’m forgetting

    they will slow the economy relative to where it would be without the huge punitive redistributive taxings

    and real people will get hurt

    and who’s gonna take the blame for that?

    All I know is it won’t be food stamp.

    happyfeet (ce327d)

  3. Patterico – In your example, the president needed to talk to a global warming expert as well. Otherwise he was not getting the complete picture. Plus he needed to weight the global warming experts opinion as much as the physicist’s.

    daleyrocks (bf33e9)

  4. By the way: this is not the same as saying that we can’t get a good sense of whether borrowing at astronomical rates with no plan to pay it off is a good or bad idea. Just like, even though history is not science, we can get a good sense of whether nationalizing the media and arresting dissenters is a good or bad idea. But history doesn’t necessarily tell you whether aggressive behavior or conciliatory behavior is a better foreign policy move in any given situation, any more than you can KNOW whether raising taxes to level x will gain or cost revenue.

    Patterico (8b3905)

  5. The beginning of wisdom is to recognize how little we truly know.

    I’ve never met anyone who I thought wise who thought himself so.

    Beldar (6875c0)

  6. Sort of like an administration composed of policy wonks with no private sector experience predicting how the private sector will react to various policy initiatives.

    daleyrocks (bf33e9)

  7. Patterico:

    We free marketeers believe in the market precisely because we don’t think we know everything.

    [Thinks...]

    This, by the way, is why I tend to oppose any government intervention in the economy. There are so many documented examples of unintended side effects that I think it’s best to leave a complex system to the distributed intelligence of the nation and indeed the world, rather than trust a group of supposedly smart guys in a room with their hands on the financial levers.

    [Thinks again...]

    Ah, but if you admit you don’t know, and you don’t even know what you don’t know (as Rumsfeld puts it), then how can you believe you know enough to choose non-meddling over meddling?

    Dafydd

    Dafydd the Pensive (763797)

  8. “Ah, but if you admit you don’t know, and you don’t even know what you don’t know (as Rumsfeld puts it), then how can you believe you know enough to choose non-meddling over meddling?”

    Dafydd – Ah, because I was always told if you keep playing with that thing you’ll go blind. Makes non-meddling an easy choice.

    daleyrocks (bf33e9)

  9. Ah, but if you admit you don’t know, and you don’t even know what you don’t know (as Rumsfeld puts it), then how can you believe you know enough to choose non-meddling over meddling?

    I’ll answer your perhaps slightly tongue in cheek question seriously. I don’t claim we can’t try to reach our best judgments on issues. This is a blog and if I weren’t constantly giving my opinions, I wouldn’t be a blogger. But the same way that a juror might choose to believe one expert over another while possessing the expertise of neither, I choose to put my faith in the wisdom of the people as a whole rather than Barack Obama’s economic team or the guys at the Fed — even though I might possess the collective economic wisdom of neither.

    (Then again, I might possess more economic wisdom in my left big toenail than the latter two groups. I really couldn’t say.)

    Make sense?

    Patterico (8b3905)

  10. Russ has a weatlh of interesting articles at the Library of Economics & Liberty website: http://www.econlib.org

    Dirty Old Man (0c7e45)

  11. They predict with the same confidence as the weather man. If these factors combine this outcome will likely result. Unfortunately, Keynesian economics–a pet theory that really ought to carry the para prefix with it–works on a small scale but fails in the long-term global scale we are dealing with today.

    If you look at the market you’d assume things are going okay. But when you look at the labor statistics, you’ll realize something’s wrong. People are buying gold like there’s no tomorrow. Investments in stock are similarly attempts to buy something that will hold value better than our ever dwindling wiemer dollar. Therefore you have to question, is it stimulus that’s heated up the economy or is it people looking for anything of value to replace their suspect currency?

    You want a weather prediction? I’ll give you one. It’s going to be cold and gray. And it’s going to last for the rest of your life.

    jack (fafc9f)

  12. Economics was once called the “Dismal Science” because it was better at telling you what you ought not to do than at telling you what you ought to do. The “science” of economics has not changed but those who call themselves “economists” have changed. Wonder where those used-car salesmen who cound not sell cars went . . . back to school to get an economic degree. Yes, I have an MBA in Economics but I observed some of my teachers and most of my classmates!

    Michael M. Keohane (ff6ddb)

  13. Markets are impersonal in how they deal with lots of information. State direction of an economy or society is inherently subject to corruption apart from all the relevant info that never gets to the decision makers. Bureaucrats with no real stake in the downside.

    This Administration has explicitly adopted an Industrial Policy in numerous National Research Council reports it has put out. We are officially dirigiste now with Climate Change being used as the foundation. Plus the poorly understood Common Core education initiatives coupled with a determination to squelch climate skepticism through education mean that the social sciences like economics, sociology, psychology, and pedagogy are actually being used to create false beliefs and values. False beliefs and perceptions and changed values are still drivers of behavior.

    And that recognition is precisely what federal report after federal report shows. http://www.invisibleserfscollar.com/if-reality-is-ignored-or-disregarded-when-do-we-become-a-state-against-its-people/ is a story I did after reading the USGCRP 2012-2021 report this summer.

    Lots of people major in economics at prestigious schools these days and never learn that economies do not actually behave like the models in their courses. Reading through the aspirations involving climate change and the social sciences from the UN to the NRC and National Science Foundation to systems thinking in K-12 classrooms, they all seek to create a belief that real life will correspond to computer modelling.

    Then modelling becomes just another excuse for central planning. Pretending that this time it will work because we have Big Data and Supercomputers and widely held false beliefs among the masses at a deep emotional level.

    It does alter human behavior but cause and effect and adverse and unforeseen consequences still lurk. But too few are looking or are trained to look. As Von Mises said economics does not vary with whether it is understood.

    Robin (801f44)

  14. Probably dates to Adam Smith, but some authority posited Free Markets are the most efficient and lead to the lowest costs to society. But for markets to operate efficiently there has to be open access to reliable economic information, e.g., prices.

    We no longer have the latter information, therefore the former market is overthrown.

    gary gulrud (dd7d4e)

  15. We do know that every government that has borrowed and squandered on this kind of scale-the Romans, the Soviets, the Brits, French and Weimar Germany after WWI, Gatlieri’s Argentina, Greece right now-has seen it’s collapse. Nobody can borrow 40 cents of every dollar forever. And as to borrowing, if we were suddenly confronted with a US bond-buying amrket that wanted a higher interest rate ion order to buy our bonds, say something approaching Carter Error rates, we would be in very deep…stuff

    http://www.nationalreview.com/articles/338621/regressive-spending-kevin-d-williamson

    Bugg (ba4ca9)

  16. When our debt level has passed 100% of current GDP we have a problem, of course they don’t see it as such, for their goal is to take us down a peg.

    narciso (3fec35)

  17. The big government guys are the arrogant ones. We free marketeers believe in the market precisely because we don’t think we know everything.

    I think this helps explain the inconsistency we see in how the electorate votes. Most of us want to be independent (free market/conservative) but we understandably worry whether we can successfully handle our affairs in difficult economic times. With the advent of liberal secularism and the resulting decline in church and family, that leaves Americans even more dependent on liberal big government.

    DRJ (a83b8b)

  18. This, by the way, is why I tend to oppose any government intervention in the economy. …

    The problem with this as a political program is that some government intervention in the economy is inevitable (and in fact desirable) and so a blind opposition to intervention (like a blind opposition to taxes) can start to look silly and as unrealistic as the notion that government can solve all our problems.

    This is not to claim that a bias against intervention is the same thing as blind opposition to all intervention just that it can end up looking like it and at some point that becomes politically problematic.

    James B. Shearer (e64877)

  19. Gatlieri’s Argentina

    That nation fascinates me because it’s a South American society that, unlike a Mexico or Peru, is predominantly of European extraction (ie, Argentina’s percentage of people of indigenous background is quite small), yet it has a history of over 70 years that is reminiscent of that of a stereotypical Third-World, tin-horn-dictator nation. For instance, it’s currently illegal for anyone who is not authorized by that country’s government to report the actual rate of inflation, which is alarmingly high.

    Moreover, the current crime rate in Argentina also is very high. I read an article about the plight of a young woman living in Buenos Aires who has been robbed 12 times over the recent past.

    The only thing — the only theory — that I tend to believe just about any researcher or expert can point to as a likely predictor of the economy (and culture) of a country becoming noticeably mediocre is when its politics are very much imbued with lazy, self-entitlement-crazed liberalism.

    In that regard, we (meaning much of the industrialized world, mainly US and Europe) all are becoming variations or shades of Argentina.

    Mark (43380c)

  20. And while the President is listening to the “Experts” the Iranians complete 4 bombs, smuggle one into the US, use the other 3 to destroy Tel Aviv, Haifa, and Jerusalem, 40% or so of the Israeli airforce gets into the air and nukes every major Muslim population center within one way flying distance. Half a billion, maybe a billion people are incinerated, die of radiation sickness, or starve. And the “Experts” all look at each other and say “At this point what difference does it make?” Because they are down in the bunker advising the President.

    f1guyus (647d76)

  21. Here’s some “expert” support for Patterico’s belief that markets make better decisions than experts: A January 2013 (preliminary) research paper examines why economic experts’ opinions differ from those of ordinary Americans on the most relevant economic policy questions. It concludes that average Americans may make better decisions than economic experts:

    When faced with policy questions, economic experts seem to provide answers very different than those of average Americans, the more so the more agreement among economists there is and the more technical the questions are. This difference does not seem to be justified by a superior knowledge of economists, but by a different way average Americans interpret the questions. Economists answer them literally and take for granted that all the embedded assumptions are true, average Americans do not.

    Our analysis cautions against using these economic expert opinions as a policy tool. The questions are framed more as exam questions rather than as policy questions: eliciting in economists the desire to be right, rather than to be relevant. Hopefully, the same economists, when they do policy advice, would answer the same questions very differently. Otherwise, we would have to conclude with William F. Buckley, Jr. that “I’d rather entrust the government of the United States to the first 400 people listed in the Boston telephone directory than to the faculty of Harvard University.”

    DRJ (a83b8b)

  22. PS — My link is to a PDF.

    DRJ (a83b8b)

  23. … The more humility you have, the less apt you are to opt for the government solution.

    Well humility also implies not making drastic changes to existing institutions that are more or less working even if not perfect. Like converting Social Security to private accounts, or returning to the gold standard or abolishing the Fedreral Reserve.

    James B. Shearer (e64877)

  24. I think the key portion is that experts take for granted that their assumptions are true, while most Americans realize many of those assumptions are flawed or will never come to pass.

    DRJ (a83b8b)

  25. James B. Shearer,

    How is Social Security “more or less working” when it is already paying out more than it is taking in?

    DRJ (a83b8b)

  26. With the advent of liberal secularism and the resulting decline in church and family, that leaves Americans even more dependent on liberal big government.

    There are a fair number of people who consider themselves economic conservatives but who also gladly identify themselves as being social liberals. I see that as a form of cognitive dissonance, since it’s tougher to have one (ie, a stable economy) when the other aspect of a society (ie, stable families nurturing stable children, who represent the next generation) is loaded down with dysfunction, including nihilism and narcissism.

    Bright, talented, resourceful people (including children) will tend to do well no matter what is placed before them. That’s probably why a place like London (or closer to home, San Francisco or New York City) does well even though the country that surrounds it (a far cry from the British Empire) has become increasingly marginal through the decades. But when it comes to the millions of people who are less than that (and who also are the epitome of “sheeple”), the politics of their society will have quite a bit of impact.

    Mark (43380c)

  27. This, by the way, is why I tend to oppose any government intervention in the economy…

    So do I, but for a different reason.

    For all of their PHDs, most economists fail to acknowledge that the most important component of a growing economy is confidence… and most critically, confidence among those who have money and are willing to invest it in hopes of making more.

    Therefore, I am all in favor of government doing things to increase the confidence of those able and willing to take risks.

    Unfortunately, government (certainly the liberal variety and, sadly, too often the conservative version as well) does things that sap the ability and willingness of those with money to invest and grow. The old adage that Democrats love the worker but don’t understand that hating the employer doesn’t result in more or better paid workers is as true today than it ever has been.

    Since I can’t trust government to make things better, I would settle for them just not doing anything to make things worse.

    steve (e7e6c7)

  28. What we do know is socialism doesn’t work. Never has. Never will.

    Colonel Haiku (7073fd)

  29. 26

    Your link claims:

    … For the first time in its history the Social Security program will pay out more money than it takes in. This watershed event will occur this year, to the tune of $41 Billion dollars. Under any rational accounting standards this makes the Social Security program bankrupt. …

    I am unaware of any rational accounting standards that say a single deficit year after many years of surplus means you are bankrupt. At some point some modest changes (tax increases or benefit cuts) will be required but there is no necessity for drastic changes. And a lot of the privatization proposals seem reckless to me.

    I am not talking about the disability portion of Social Security here which is in trouble because of millions of bogus claims which something should be done about.

    James B. Shearer (e64877)

  30. not making drastic changes to existing institutions that are more or less working even if not perfect. Like converting Social Security to private accounts

    Okay, that was just funny.

    JD (b63a52)

  31. Now. I’m going to take a wild leap here, but I imagine drawing down the trust fund, through the payroll tax cut, wasn’t the best way to keep it solvent,

    narciso (3fec35)

  32. 2% into a private account is drastic!

    41,000,000,000 in deficit this year and every subsequent year and it can be fixed by just confiscating a little more from everyone.

    JD (b63a52)

  33. just kickin’ that can
    on down that dusty ol’ road
    that’s true leadership!

    Colonel Haiku (7073fd)

  34. The US government’s reporting of inflation specifically exlcudes food and fuel, supposedly because they are prone to fluctuations. In fairness this has been so under presidents of both parties. So the 2 things which exactly drive up the cost of living for everyone are not part of their calculation. Kind of like going to a barbeque that served only hot dog and hamburger buns but no weenies nor burgers. We are more like Argentina than I thought.

    Bugg (ba4ca9)

  35. now doan cry for us
    Argentina we beg you
    just change our Pampas

    Colonel Haiku (7073fd)

  36. Gary Gulrud : The quote “Free Markets are the most efficient and lead to the lowest costs to society. But for markets to operate efficiently there has to be open access to reliable economic information, e.g., prices” is completely untrue. Ricardo, Bastiat and others in the Eighteenth Century proved that the “Free Market” did not need “reliable economic information.” However, every “Command Economy” must start with “reliable economic information.” Ricardo put it best when he stated that, over time, the market reduces price, wage & profit differences to a minimum.

    Michael M. Keohane (ff6ddb)

  37. we know that food stamps are the best form of economic stimulus

    nancy pelosi said it on cnn

    and we all sing wheeee wheeee wheeee like the geico pig

    we in high cotton now booba

    happyfeet (ce327d)

  38. ==There are a fair number of people who consider themselves economic conservatives but who also gladly identify themselves as being social liberals. I see that as a form of cognitive dissonance, since it’s tougher to have one (ie, a stable economy) when the other aspect of a society (ie, stable families nurturing stable children, who represent the next generation) is loaded down with dysfunction, including nihilism and narcissism.==

    Mark-
    I don’t think your accusation of “gladly identify as social liberals” is fair at all. Many many people agree with you about the value and role and benefits of traditional families–and in more than just the economic sense. But pining for a past way of life that ain’t coming back gets us exactly nowhere in our current fiscal mess. Most economic conservatives who are also realists question that we as a nation can ever go back to Norman Rockwell images of a religion-based America and big intact nuclear families, when in fact a couple generations of Americans have now already lived without those influences, expectations and mores. Further, there are few to no role models left of “real” families (as you would probably describe them) in many communities both large and small.

    Let us know when you figure out a way to reinvent and reconstitute the miracle of stable mom and dad headed families which nurture stable healthy children, who represent the next generation– instead of the dysfunctional ones which you describe as loaded down with nihhilism and narcissism that you describe.

    In he meantime, yeah it’s tougher to have and shepherd a stable healty economy under these terms. But it’s 2013 and it is what it is. We as economic conservatives and libertarians have to deal with it and fight the battles we might actually be capable of winning.

    elissa (567694)

  39. hispanics are a very family oriented people

    some of them even have a special name for the family they call it “la familia”

    and conservatives say you got to the count of ten to self-deport that la familia right over la rio grande

    and I tell them no no no don’t listen to the stupid conservatives they just don’t know any better

    they mama didn’t raise them right is all

    happyfeet (ce327d)

  40. Yet they vote for Betamax Brown, and Transom Newsom, even when immigration is not on the ballot,
    the genius of Mike ‘Iceberg’ murphy.

    narciso (3fec35)

  41. 26 30

    The claim that this is the first deficit year is also wrong. For example the combined (OASI and DI) trust funds decreased from 1976 to 1981 with the balance decreasing from $46 billion to $25 billion. Trust fund balance data can be found here .

    James B. Shearer (e64877)

  42. Transom Newsom is so handsome he could be a model for lotions what have exotic ingredients like cucumber and aloe in them

    yup he’s leaving a lot of money on the table, that one

    happyfeet (ce327d)

  43. When is the next reasonably projected surplus, James?

    JD (b63a52)

  44. at the rate people are dropping out of the work force in barack obama’s food stamp economy social security will NEVER have a surplus again

    unless…

    those death panels really need to get on the stick

    happyfeet (ce327d)

  45. 40.hispanics are a very family oriented people

    In general, hispanics in America are not voting heavily in favor of the Democrats because they lack family values. They do it for the goodies the Democrats bestow upon them, including affirmative action, easy immigration for friends and relatives, and the usual redistribution like food stamps, medicaid, the EITC and so on.

    We aren’t going to be able to out bid the Democrats on those kinds of things. Identity group politics is the Democrat thing. Always has been. Always will be.

    When Republicans start talking about going down that road we know we are in deep trouble.

    Roland (c4ee0b)

  46. This, by the way, is why I tend to oppose any government intervention in the economy

    Our founders and Mr. Hayek would agree with you. And any hand but an invisible one ends up has a heavy hand. Next, a boot on the neck.

    Patricia (be0117)

  47. 2% into privately controlled accounts is reckless!

    JD (b63a52)

  48. who cares who hispanics vote for the point is they honor and value the traditional family

    which is a nice thing they contribute to america

    which, that doesn’t mean they should get goodies in return

    but nevertheless to them I say hola mi amigos

    happyfeet (ce327d)

  49. But you see, that is exactly the point, they want the spendings,

    narciso (3fec35)

  50. of course they do they’re americans

    americans are a trough-feeding people

    just ask porky porky chris christie

    it’s cute to see their little tails wag when the chinesers come round with the slop buckets

    happyfeet (ce327d)

  51. It does take humility, which is a virtue, to admit one’s limitations.

    It also takes some courage, another virtue, because it can be comforting to think “somebody knows the answer” as long as you can.

    And one has to make a choice as to where they will place their faith, their “basic trust” about the future. Either that people will figure it out, or it gets worked out regardless, be it a personal God or an optimistic view of “destiny” or whatever.

    MD in Philly (3d3f72)

  52. “Well humility also implies not making drastic changes to existing institutions that are more or less working even if not perfect.”

    James B. Shearer – It took a lot of humility to impose Obamacare on all Americans to solve a problem of less than 15% of Americans.

    daleyrocks (bf33e9)

  53. In Pat’s example in the post, the President consults a bevy of advisors on science, history, etc.
    but doesn’t consult a moral-advisor to ascertain not what he should do, but if he should do anything.
    All too many politicians neglect this step for they feel they must be seen doing something, and all we can hope for is that their choice is the least-bad one.

    askeptic (2bb434)

  54. The one who started this is Keynes. Ironically, in some letters he wrote in his last years, he seemed to be having second thoughts about his own theories.

    Gerald A (f26857)

  55. Well humility also implies not making drastic changes to existing institutions that are more or less working even if not perfect. Like converting Social Security to private accounts, or returning to the gold standard or abolishing the Fedreral Reserve.

    Wrong. Humility doesn’t mean you refuse to recognize an existing problem, such as a program that takes in less than it pays out and that is moving towards taking in FAR less than it pays out. And abolishing the Fed would mean that we are leaving decisions to be made by the distributed knowledge and intelligence of society rather than a few guys in a room.

    Humility does, in my opinion, mean that while I might surmise that returning to the gold standard would help save the dollar from losing value, I could be wrong. And while you might surmise that passing an $820 billion stimulus or keeping interest rates artificially low or quantitatively easing a trillion dollars per year into the economy are good for the economy, you could be wrong.

    By the way, I’m not saying this is all junk, any more than all history is junk. The more times that we can observe that altering a particular variable has a predictable impact on the economy in a particular way, the more the observed results are useful, because the repetition of observed results allows one to make repeated predictions about the future that hold true.

    Thus, for example, economists’ certainty about the gold standard being problematic has a lot to do with one view of the Great Depression: that the gold standard got us into it, and that abolishing it got us out of it. But that’s one instance, and drawing grand policy lessons from a single instance can be problematic.

    I think precepts that are more proven include Friedman’s observations about the effect of money supply on inflation, or works of history that show that governments implode once they pass 90% of GDP. So in the example given in the post, the inflation of monetary supply in Iran is actually likely to have a fairly reliable effect.

    But it still ain’t physics.

    Patterico (8b3905)

  56. James B. Shearer:

    My link shows Social Security payments exceeding revenues in 2010. Apparently you view that as an anomaly — one year of payments exceeding revenues — but I view it as a pattern of declining revenues and increasing payments. FactCheck.org agrees with me:

    The federal government for the first time in its history had to borrow money in 2010 to cover Social Security benefits to retired and disabled workers — a trend that worsened in 2011 and will not change at any point in the future unless changes are made.

    DRJ (a83b8b)

  57. That was not nice, DRJ ;-). If only we could increase taxes just a little bit all would be well.

    JD (b63a52)

  58. now who the hell is gonna pay these bills one’s drinkin one’s smokin one’s takin pills

    happyfeet (ce327d)

  59. Mark:

    Yes but I don’t see it as cognitive dissonance. I see it as believing flawed assumptions, i.e., that you can’t be a caring, compassionate, good person unless you’re socially liberal.

    DRJ (a83b8b)

  60. I wish you were my doctor, MD in Philly.

    DRJ (a83b8b)

  61. And a lot of the privatization proposals seem reckless to me.

    Comment by James B. Shearer (e64877) — 1/26/2013 @ 8:22 am

    Why?

    Also I’m only aware of one concrete proposal (Bush) that’s been put out. What other ones are you referring to? Or are you just making stuff up?

    Gerald A (f26857)

  62. Comment by Patterico (8b3905) — 1/26/2013 @ 11:12 am

    After countless “Stimulus” failures, I just want to know when the Econ-guru’s (at least the Keynesian ones the Progs listen to) will start to realize that such government spending has a negative multiplier on the economy, not a positive one?
    They keep doing the same thing over and over, always saying “well, this time we’ll get it right”, but the result is always the same.
    Our Keynesians are in terrible need of Freudians.

    askeptic (2bb434)

  63. James B. Shearer #43,

    From your link, notice the need for general fund reimbursements in 2010 and 2011. The only prior time that happened was in the 1980s and, according to the Social Security Online History regarding revenues, that was due to accounting adjustments in 1983 amendments to the SS Act.

    DRJ (a83b8b)

  64. Let us know when you figure out a way to reinvent and reconstitute the miracle of stable mom and dad headed families which nurture stable healthy children, who represent the next generation

    Time and experience may bring us closer to that because it works. I think it would also help to strengthen the requirements for welfare-to-work, encourage faith-based initiatives, consider limits on no-fault divorce, and implement tax breaks for married couples/families.

    DRJ (a83b8b)

  65. The comparison of social “sciences” with real science is an interesting one. Richard Feynman of Caltech made some very telling observations about the folly of social sciences as they existed in his days in his book “Surely You’re Joking, Mr. Feyman!”. I see that this book can be downloaded as a pdf from FSU if you aren’t interested in using the Amazon link to buy the real thing. In any event, I recommend it highly. The book will also debunk conscientous Democrats (both of them) of any lingering affection for state-directed public education as practiced in California. My read on the utiility of economic analysis, particularly on the macro side of the field, is that it was largely rendered useless once the “Theory of Games and Economic Behavior” was published in 1944. As Hayek has pointed out, humans are pretty clever, and a lot of people are quite happy finding little vacuums in the regulatory environment that can be milked for a safe and contented existence. I would think that the opportunities for finding such rent seeking sinecures grows combinatorially with the number of rules and regulations. Our world is far better off when these individuals, let’s just call them lawyers, spend their time looking for opportunties in a free- and lightly regulated market to produce something that someone else values.

    And daleyrocks’ suggestion that the “global warming” experts be given the same weight as the physicists before squashing the Iranian bomb (#3) is, I hope, an attempt at sarcasm. Physics has advanced by rigorous testing of theories using experimental data. Theories are discarded if they are inconsistent with observation. Global warming is little more than a poorly thought-out religion that relies on computer models. It is true that CO2 levels are rising but to say this confirms global warming is nonsensense. It is like political “scientists” saying that their scientific polls confirm their conclusions. The only thing “scientific” about a poll is that if the same poll is adiministered to a similar population by a third party in the same time frame, then the results will be statistically similar. But if you change the wording just slightly, or order of the questions, the results will not be comparable. The science comes in the design of the target population. The rest is all artwork.

    The debasement of currency has a long and dishonorable history. Spain didn’t do so well when it pillaged the new world for gold despite thinking that they would be able to buy control of Europe. And the history of coinage over the last two millenia is that failing empires resort to debasing their coins early in their plunge into oblivion.

    Right now the productive portion of economy is in a position that for every five dollars of earnings, they are required to give two dollars to the government. Their productivity will not survive this parasitic attachment. And when they cease to be productive, little will be left.

    bobathome (c0c2b5)

  66. This, by the way, is why I tend to oppose any government intervention in the economy. There are so many documented examples of unintended side effects that I think it’s best to leave a complex system to the distributed intelligence of the nation and indeed the world, rather than trust a group of supposedly smart guys in a room with their hands on the financial levers. The more humility you have, the less apt you are to opt for the government solution.

    The big government guys are the arrogant ones. We free marketeers believe in the market precisely because we don’t think we know everything.

    As with most conservatives, you miss the fundamentals at issue here. You [Patterico] make the point that because of the sheer number of variables involved, one can’t make precise predictions, economically, but you can make broad enough characterizations about an economic system to reliably determine the inevitable outcome of that system. This is true, but if I can point to capitalism and say that it is more efficient and that leads to greater prosperity then why are we growing ever socialist? Isn’t it self-evident — economically and historically — that capitalism is preferable to any alternative, if for no other reason than simple practicality?

    No, it’s not self-evident. Do you hear any of the socialists claiming that our present socialism is more efficient or practical than capitalism? No, what they beat you over the head with is that capitalism is the economic system of greed and is therefore immoral. Socialism, on the other hand, is the system of “social justice” and who could be against “social justice”? Hell, they even have “free marketers” on board: “I tend to oppose any government intervention in the economy”. You “tend” to oppose it? Indeed, what does that mean?

    If it means what other “conservatives” that I know mean, it means that you support “less” government regulation of the economy, which (ostensibly) is good. But you don’t really mean “free markets”; you don’t mean leaving large (and therefore, greedy) corporations unregulated (you know, for the “public good”, whatever the hell that means) and free to make contracts with whomever they choose; you don’t mean an end to subsidies to agriculture, certain “key” industries, and concerns relating to “national security” and “energy independence”; you don’t mean outlawing government action to prevent “monopolies” or the regulation of mergers, financial transactions or stock exchanges; you don’t mean eliminating protective tariffs for domestic industries, etc. In short, you aren’t seeking to outlaw all or even most government manipulation of the economy. Thus, all that you are actually “for” is a roll-back of government interference to a level the you’re comfortable with, but you’re not against it in principle.

    Here’s the problem with agreeing with that principle: if you are not against government “regulation” of the economy, then you are for it — to some degree. And unless you can be ruthlessly strict in your definition of that regulation — and can justify it philosophically — it will be simply a matter of time before it is all restored to the economic chaos that we have at present because it’s the slippery slope argument writ large, i.e., if a little regulation is good, then more regulation is better. And like Santa Claus and his “magic dust”, a “little bit” of regulation inevitably begets a “little bit” more, which begets a “little bit” more, etc.

    Our present Constitution comes to us as a result of the failure of the Articles of Confederation. One of the major failings of that compact was that the Federal government, such as it was, was powerless to prevent the economic calamity that erupted as a result of 13 sovereign states trying to protect their own economic interests via interstate tariffs. As such, the power to regulate commerce that Congress presently enjoys was not intended to encompass any regulation of business under the sun (as it does now) but was intended primarily to prevent trade wars between the states! Thus, the role of the federal government was to objectively facilitate trade by removing barriers to trade — that is, to facilitate free markets — and not to act to limit trade in any way and certainly not to pick the winners and losers in the national economy.

    That we still are on the road to socialism is testament to the fact that the superiority of capitalism is not obvious, let alone self-evident. But it isn’t because the evidence isn’t right in everyone’s face. Rather, it is the fact (again) that it is the moral argument against capitalism that is being prosecuted by the socialists and it is their moral denigration of capitalism that is winning. Face it, the MSM and the school system indoctrinate the people on the virtues of socialism and essentially by default, they thus choose to believe that capitalism is evil and that the morality behind socialism is the good. Trying to convince them that capitalism is the good because it is practical defeats the purpose of exposing the immorality of socialism. Yes, capitalism is practical but in order to defeat socialism, its opponents must make the case that capitalism is both moral and practical.

    What you’ve failed to take into account in your economic analysis here is that “free markets”, i.e., capitalism is moral because it is the only system compatible with man’s individual rights — the right to his life, the right to his property and the right to trade with whom he chooses. Every regulation of the economy is a regulation on man’s individual rights. The Founders understood this and, as such, created a government with minimal and (if you actually study the history) objective limits on the State’s power to regulate economic issues because that maximizes individual liberties.

    Your task is to determine what you think is the maximal amount of regulatory authority that the government should have on the lives of individuals and then try to justify that regulation in the context of infringing on individual liberties (which also means that you will have to develop a thorough understanding of what constitutes individual rights.) Then you will be able to say with confidence “this far [is the legitimate regulatory powers of the government vis-a-vis the economy] and no further.” To the extent that you promulgate freedom and the protection of individual rights, you will be able to justify your stance morally.

    One last point to illustrate the crucial importance of making morality the centerpiece of the fight against socialism. You all have heard of the Dalai Lama, the head of Tibet’s “government in exile”. Here he’s been living in exile since 1959, trying (somehow) to return to rule in his home nation of Tibet that is occupied and ruled by the same Chinese communists (i.e., socialists) that effectively exiled him in the first place. If it is not obvious to him how evil communism is, then I don’t think that you could get it through to anyone.

    And to that extent (commenting on China today), one might think that he understands that idea: ” ‘The Chinese government’, he said, seeks harmony, ‘but harmony must come out of the heart, not out of fear. So far, methods to bring harmony mostly rely on use of force.’ ” But then he turns around and makes this bold and puzzling statement: [Marxism has] “moral ethics, whereas capitalism is only how to make profits.”

    You have to understand the enormous significance of what this world leader on “spiritualism” (i.e., morality) just said. Here is a man, the ruler of his own country, and has been exiled by force for over 50 years by a nation that occupies and rule Tibet through force for its own ends. And yet, communism (i.e., “Marxism”, that is, socialism) is the only system of “moral ethics“, whereas capitalism (the only nations of which who recognize his exile as illegitimate) is caught up solely in the self-interested desire to make greedy profits and to selfishly enjoy your life at the expense of others. That is, capitalism — the only economic system that recognizes your inalienable individual rights — the right to your life, the right to property — is not moral. More to the point, he believes that it is practical but it is not moral. It is not to be emulated, the free market is not an example of justice or fairness in action and most importantly, it is not to be seen as good.

    If what you fight for is not the good, then tell me: how do you expect to win?

    J.P. (bd0246)

  67. One of the things I find most arrogant about Democratic politicians is the idea that, without big government, we wouldn’t be free to take risks and innovate. Pelosi said it was entrepreneurial to free people from routine jobs so they could be creative during the ObamaCare debate, and Obama echoed this theme in his recent Inaugural Address.
    There may be reasons to advocate a social safety net, but calling it the path to innovation isn’t one of them.

    DRJ (a83b8b)

  68. Are you a libertarian, J.P.?

    DRJ (a83b8b)

  69. hey no labels

    happyfeet (ce327d)

  70. ==Time and experience may bring us closer to that because it works==

    I hope so, I really do, DRJ, but unfortunately I’m not as optimistic as you. Your ideas are very good ones– but the poor public education system, our politicians who thrive on helping “victims”, and our celebrity and sports cultures that seem to glorify and legitimize having kids without the benefit marriage all are big rocks on that highway.

    elissa (a981fa)

  71. J.P.,

    Welcome to the blog. I can tell you’re new here because you just confidently told me a lot of things about my alleged opinions on various matters, and you are utterly and completely wrong about what I think.

    Capitalism is the only system compatible with freedom. I have said that many times on this blog. That’s not the topic of this post, but just because I don’t repeat that in every post I write about capitalism doesn’t mean I don’t understand it.

    The context of the post is discussing what works, which is a different question. My contention is that if one is less arrogant about one’s knowledge of the likely effects of government regulation, one will tend to trust distributed decision making over centralized decision making. Which is a separate issue from the fact that freedom demands capitalism and does not exist without it.

    Patterico (5f5b8b)

  72. Added an update:

    UPDATE: It’s also worth noting, as I have noted many times, that capitalism is the only economic system fully compatible with freedom. My comments about supporting capitalism in this post are made in the context of discussing what economic system is most likely to work. But freedom is an independent reason for supporting capitalism. Everyone who regularly reads my blog understands this.

    Patterico (5f5b8b)

  73. one will tend to trust distributed decision making over centralized decision making

    In the case of Egan-Jones, the SEC brought administrative action against the agency within two weeks of their second downgrade. And a few days ago, the case was settled.

    I’m sure you have already guessed the ending: Egan-Jones is banned from for the next 18 months from rating US government debt. They’ve effectively been silenced from telling the truth.

    I don’t know about you I’m about ready to foller a yodeling nun over yonder mountains

    happyfeet (ce327d)

  74. Awesome post J.P. (#69.) Perhaps it would be helpful to begin a systematic policy of characterizing socialism as the conjunction of greed and envy, and be a little more aggressive in pointing out the lust for power that characterizes it’s leaders. Along these lines, I do enjoy Drudge’s use of hte one’s photos with flies crawling around his face. Open contempt with a touch of humor will help bring him back to earth.

    The tea party with Hillary on Wednesday pointed out that our representatives in D. C. aren’t up to such a task. Peggy Noonan of all people makes some very good points in today’s WSJ about the need for concerted action by the Rs. Instead of her usual blather about the need to get along and act like nice neighbors who would be welcome to come and play bridge at her house (I’m extemporizing a bit,) she actually nails the problem with the need for Repubicans to stop acting out of mindless personal entrepreneurialism. In her words, the Rs look like ants on a sugar cube. The ceaseless requests for additional donations by all our politicians coupled with their embarassing incompetence confirms her analysis, in addition to making me very uncomfortable.

    bobathome (c0c2b5)

  75. 54

    James B. Shearer – It took a lot of humility to impose Obamacare on all Americans to solve a problem of less than 15% of Americans.

    I did not favor Obamacare. There are two main problems with medical care in this country, it costs too much and it is overutilized. Obamacare doesn’t help with either of these and will likely make them worse.

    James B. Shearer (e64877)

  76. 65

    From your link, notice the need for general fund reimbursements in 2010 and 2011 …

    This was because of the temporary payroll tax cuts which have now expired. When these cuts were passed it was agreed that Social Security would receive equivalent funding from general tax revenues.

    James B. Shearer (e64877)

  77. Yet it will be in deficit from now until the end of time, this program that is essentially working, just needs a few more tax dollars.

    JD (b63a52)

  78. As one of those left wingers previously laboring under the (seeming) illusion that the problems of Medicare and Social Security could be solved by slight across-the-board tax increases, the message of a thread like this is not lost on me – and is fact appreciated.

    The question (as implicated by this post) is what to do in light of the realization. I’m amenable to a historicist approach, but that could mean a lot of different things.

    Leviticus (17b7a5)

  79. historically countries this bad eat up with debt inflate inflate inflate

    happyfeet (ce327d)

  80. 57

    Wrong. Humility doesn’t mean you refuse to recognize an existing problem, such as a program that takes in less than it pays out and that is moving towards taking in FAR less than it pays out. …

    I am not refusing to recognize a problem. Demographic changes (very likely) mean the current level of Social Security taxes will not in the future be able to support current benefit levels. This will require some combination of benefit cuts and tax increases (as has occurred when this situation has arisen in the past). It doesn’t require drastic changes. Drastic changes are a risky bet that the new system will be better than the current system.

    … And abolishing the Fed would mean that we are leaving decisions to be made by the distributed knowledge and intelligence of society rather than a few guys in a room.

    Maybe a new system would work better. Maybe it wouldn’t. Maybe we should let some other country try it first.

    James B. Shearer (e64877)

  81. Demographic changes (very likely) mean the current level of Social Security taxes will not in the future be able to support current benefit levels

    You say this like we are not already past this point.

    JD (4fbbe6)

  82. Just a little more in taxes and it will all be fine.

    JD (4fbbe6)

  83. 80

    80.As one of those left wingers previously laboring under the (seeming) illusion that the problems of Medicare and Social Security could be solved by slight across-the-board tax increases, the message of a thread like this is not lost on me – and is fact appreciated.

    Medicare and Social Security are not equivalent situations. Medicare’s problems are much more serious and might well need drastic changes to fix. But these changes (letting some people die to save money) are hard to sell politically.

    James B. Shearer (e64877)

  84. this “America,” it does not have my best interests at heart

    happyfeet (ce327d)

  85. Medicare’s problems are much more serious and might well need drastic changes to fix. But these changes (letting some people die to save money) are hard to sell politically.

    Luckily, your implication notwithstanding, letting people die is not the only possible solution. Ever hear of a thing called the free market? Does a great job of allocating resources when given a chance, which is rarely.

    Patterico (4a878d)

  86. Managing 2% of your own contributions is drastic and reckless.

    JD (4fbbe6)

  87. “Medicare’s problems are much more serious and might well need drastic changes to fix. But these changes (letting some people die to save money) are hard to sell politically.”

    - James B. Shearer

    And, echoing Patterico’s sentiment that letting people die is not the only possible solution, one easy answer to fixing the Medicare problem is “raise a lot more tax revenue.”

    Or “transfer funds previously allocated to discretionary programs to Medicare” (i.e. cut spending elsewhere).

    Or, most likely, some combination of the two.

    Leviticus (17b7a5)

  88. let’s not dismiss the letting codgers die thing out of hand

    happyfeet (ce327d)

  89. Or let a freer market address it. Or let people make purchasing decisions with skin in the game.

    JD (4fbbe6)

  90. JD: letting people make their own decisions is drastic and reckless.

    And, echoing Patterico’s sentiment that letting people die is not the only possible solution, one easy answer to fixing the Medicare problem is “raise a lot more tax revenue.”

    Or “transfer funds previously allocated to discretionary programs to Medicare” (i.e. cut spending elsewhere).

    Or, most likely, some combination of the two.

    Economic theory tells us increased demand causes higher prices. This is not controversial as the theory produces repeatable results. The question is whether a system that divorces choices from cost creates increased demand and this higher prices. My best judgment is that it does. I would be interested to hear a logical argument to the contrary.

    Patterico (db4096)

  91. If you go into a store and no prices are listed and everything is covered by “insurance,” is that more or less likely to make demand insensitive to price, causing prices to skyrocket?

    I think the clear answer is “more” but would be interested to hear how someone could argue to the contrary — or how that example does not fit health care.

    Patterico (db4096)

  92. “I did not favor Obamacare.”

    James B. Shearer – Well, good to know I guess, but it was curious you left it out of your examples of government intervention in the economy and instead focused on things that had not actually happened like the partial privatization of Social Security accounts, return to the gold standard and the abolition of the Fed.

    daleyrocks (bf33e9)

  93. ==Medicare and Social Security are not equivalent situations. Medicare’s problems are much more serious==

    Oh Rilly? You might want to double check the funding and looming insolvency of SSDI (Social Security Disability). Much of the hoopla and focus in Washington has been on fixing Social Security’s retirement system with proposals ranging from raising the retirement age to means-testing benefits for wealthy retirees. But the disability system is in much worse shape and its problems defy easy solutions since applications for disability have skyrocketed in the last decade.

    From Yahoo News:The trustees who oversee Social Security are urging Congress to again shore up the disability system by reallocating money from the retirement program, as was done in 1994. If Congress does nothing, and relies only on payroll taxes, the trust fund will be exhausted in 2017.
    Last year about 3.3 million people applied for federal disability benefits. That’s 700,000 more than in 2008 and 1 million more than a decade ago.
    “It’s primarily economic desperation,” Social Security Commissioner Michael Astrue said in an interview. “People who get bad news in terms of a layoff and have no other place to go take a shot at disability,”

    elissa (567694)

  94. 87

    … Ever hear of a thing called the free market? …

    My understanding of free markets is if you can’t afford something (like medical care) you do without.

    James B. Shearer (e64877)

  95. I think we have to know what our ultimate goals are before we can talk about the best means of achieving them.

    Providing unlimited healthcare for everyone?
    Providing unlimited healthcare for everyone over a certain age?
    Providing limited healthcare for everyone?
    Providing limited healthcare for everyone over a certain age?
    Ensuring the long-term sustainability of Medicare in its current form?
    Lowering the costs of healthcare?
    Decreasing the deficit?

    There are obviously more, but I think we need to figure out what our objective is.

    Leviticus (17b7a5)

  96. bobathome – FYI, my point about consulting a global warming scientist last night was entirely sarcastic because while Democrats are fond of accusing conservatives of being anti-science, they refuse to look in the mirror and review their own agenda driven “science” proudly utilized to support policy decisions in the Obama Administration at the EPA, Department of the Interior, Energy Department and elsewhere that can’t pass the pink face test.

    daleyrocks (bf33e9)

  97. “If you go into a store and no prices are listed and everything is covered by “insurance,” is that more or less likely to make demand insensitive to price, causing prices to skyrocket?”

    - Patterico

    Isn’t that what a co-pay system is for? A deductible system?

    Leviticus (17b7a5)

  98. My understanding of free markets is if you can’t afford something (like medical care) you do without.

    Then you have a poor understanding of markets. There is a long history of charity care going back hundreds of years.

    The fact that something is necessary does not compel a conclusion that government will do it best.

    Patterico (833791)

  99. Isn’t that what a co-pay system is for? A deductible system?

    I don’t think so. A $15 co-pay does not make someone think twice about the cost of the MRI.

    Patterico (833791)

  100. How does a market system model altruism? Serious question, I’m curious.

    Leviticus (17b7a5)

  101. “I don’t think so. A $15 co-pay does not make someone think twice about the cost of the MRI.”

    - Patterico

    What about a $200 co-pay? $300?

    Leviticus (17b7a5)

  102. “There are obviously more, but I think we need to figure out what our objective is.”

    Leviticus – Who is “we”?

    daleyrocks (bf33e9)

  103. It’s fine if we take “decreasing the deficit” as our objective, by the way, but we should be explicit about it so as not to confuse the issue.

    Leviticus (17b7a5)

  104. 95

    Oh Rilly? You might want to double check the funding and looming insolvency of SSDI (Social Security Disability). Much of the hoopla and focus in Washington has been on fixing Social Security’s retirement system with proposals ranging from raising the retirement age to means-testing benefits for wealthy retirees. But the disability system is in much worse shape and its problems defy easy solutions since applications for disability have skyrocketed in the last decade.

    I said in 30

    I am not talking about the disability portion of Social Security here which is in trouble because of millions of bogus claims which something should be done about.

    The reason applications have skyrocketed is because of all the bogus claims. Its finances would be much improved if payments were limited to people who are actually disabled.

    James B. Shearer (e64877)

  105. daleyrocks,

    The people discussing this issue, here and elsewhere.

    Leviticus (17b7a5)

  106. I’m not sure what you mean by “model.” Again, history provides some guidance; there has been charity health care longer than there has been modern medicine. And wealthy people are quite generous, generally, with charitable contributions. I doubt Bill Gates would stand by and do nothing while people died in the streets from hunger and lack of basic health care.

    Patterico (a08a41)

  107. Leviticus–it seems like the goal of lowering the cost of healthcare services to individuals would be something most normal people of any age or econmic strata could get behind. Maybe that’s where we should have started rather than insurance.

    elissa (567694)

  108. Maybe Mr Shearer can point out where government intervention has led to increased freedom, decreased prices, increased access and a more viable market.

    JD (4fbbe6)

  109. “My understanding of free markets is if you can’t afford something (like medical care) you do without.”

    James B. Shearer – How did people survive before employer provided health insurance and Medicare and Medicaid? It is a true mystery.

    daleyrocks (bf33e9)

  110. My immediate goal is to get our fiscal house in order so the dollar does not collapse causing a worldwide depression making the 30s look like the 90s.

    Patterico (a08a41)

  111. Maybe Mr Shearer can point out where government intervention has led to increased freedom, decreased prices, increased access and a more viable market.

    Maybe not.

    Anyone want to try? Bueller?

    Patterico (a08a41)

  112. it makes little difference what the optimal thing to do is

    what will happen is boomers will vote themselves ever-increasingly large redistributey chunks of the wages of young healthy people who have jobs, and they’ll borrow the rest from the chinesers

    that’s just how America rolls anymore

    it’s very sad, but all the evidence says that’s how these americans like it

    happyfeet (ce327d)

  113. Patterico,

    That’s fair enough, but I have some doubts as to whether or not the institutions that provided charity-care infrastructure in the past – religious institutions, most often – continue to possess the means (and/or will) to provide healthcare on the scale that would be required of them. What size gap do you think they would have to fill, and do you think they would be able to do so?

    Leviticus (17b7a5)

  114. Another goal, which goes hand in hand, is controlling skyrocketing health care costs. Which brings me back to my grocery store example that I would like people to address.

    Patterico (a08a41)

  115. “My immediate goal is to get our fiscal house in order so the dollar does not collapse causing a worldwide depression making the 30s look like the 90s.”

    - Patterico

    Cool. Good goal.

    Could I stipulate as a secondary goal “providing [necessary] healthcare to people over [age] and/or under [income],” leaving the proper inputs for those three variables open for discussion?

    Leviticus (17b7a5)

  116. “The people discussing this issue, here and elsewhere.”

    Leviticus – Good luck on finding agreement on the objective.

    daleyrocks (bf33e9)

  117. The reason applications have skyrocketed is because of all the bogus claims. Its finances would be much improved if payments were limited to people who are actually disabled.

    Can you support this? Because if so, it should be damn easy to fix.

    JD (4fbbe6)

  118. daleyrocks,

    My faith in productive discourse burns bright, despite the best efforts of American political society to kill it in the cradle.

    I believe in us!

    Leviticus (17b7a5)

  119. Claimed objectives are meaningless.

    JD (4fbbe6)

  120. How bout negotiated ones?

    Leviticus (17b7a5)

  121. I mean, we’re just talking here.

    Leviticus (17b7a5)

  122. i believe in math

    happyfeet (ce327d)

  123. Well reducing the charitable contribution limit, won’t improve that circumstance,

    narciso (3fec35)

  124. That’s fair enough, but I have some doubts as to whether or not the institutions that provided charity-care infrastructure in the past – religious institutions, most often – continue to possess the means (and/or will) to provide healthcare on the scale that would be required of them. What size gap do you think they would have to fill, and do you think they would be able to do so?

    I think it would be hubris to try to guess. But at the store orange juice costs maybe $4 to $7. In a hospital it might cost you $400, no joke. It would be a mistake to assume that the cost of health care under a free market system would necessarily be the same astronomical cost that it is under a system rife with government subsidies and payers divorced from consumers. Prices fall in most areas of the economy not subject to those distortions.

    Patterico (8b3905)

  125. ==Its finances would be much improved if payments were limited to people who are actually disabled.==

    No argument fom me there. But the state and federal government bureaucracies do seem to have a bit of trouble doing that, don’t they? At least if you read the exposes of disability fraud that are regularly noticed and written up in the newspapers.

    elissa (567694)

  126. a package of bacon costs like 9 bucks at albertsons

    happyfeet (ce327d)

  127. Could I stipulate as a secondary goal “providing [necessary] healthcare to people over [age] and/or under [income],” leaving the proper inputs for those three variables open for discussion?

    No. First, what does age have to do with it? Second, why provide something to people who can afford it? What does “provide” mean? Through the government?

    Patterico (8b3905)

  128. I don’t want people of any age dying unnecessarily because they lack health care. That does not mean we need the government involved. I believe it means we should NOT have the government involved.

    Patterico (8b3905)

  129. Assume our objectives were:

    1. Get our fiscal house in order so the dollar does not collapse causing a worldwide depression making the 30s look like the 90s.

    2. Control skyrocketing health care costs.

    3. Provide [necessary] healthcare to people over [age] and/or under [income], leaving the proper inputs for those three variables open for discussion.

    Leviticus (17b7a5)

  130. “My faith in productive discourse burns bright, despite the best efforts of American political society to kill it in the cradle.”

    Leviticus – I don’t question your faith in productive dialog, more Washington’s as you indicate, although when you start questioning the future of entitlement programs with comments along the lines of “how can you consider cutting programs my parents have paid into their entire lives,” I sense a certain wobbliness in your spirituality.

    daleyrocks (bf33e9)

  131. I don’t want people of any age dying unnecessarily because they lack health care.

    of course not

    but we need them to be concerned that it’s a very real possibility if something is not done soon to change the status quo

    and by soon the math says yesterday

    happyfeet (ce327d)

  132. What it has to do with it is that no good negotiated settlement rests on a unilateral stipulation of objectives. “Provide” does not necessarily mean “provide through the government.” What does “afford it” mean?

    Leviticus (17b7a5)

  133. “although when you start questioning the future of entitlement programs with comments along the lines of “how can you consider cutting programs my parents have paid into their entire lives,” I sense a certain wobbliness in your spirituality.”

    - daleyrocks

    Imagine, if you will, that I’ve seen the error of my ways. Then we can have a productive discussion on this thread.

    Leviticus (17b7a5)

  134. “how can you consider cutting programs my parents have paid into their entire lives”

    Not that it matters, since I’ve seen the error of my ways and all, but that sentiment is as free-market as it gets. By the way.

    Leviticus (17b7a5)

  135. 100

    Then you have a poor understanding of markets. There is a long history of charity care going back hundreds of years

    Charity is nice but it is a stretch to say it is part of free markets (rather than say compatible with them). In any case charity can no more provide unlimited funds than taxes can. Which means some people will have to do without some increasingly expensive medical treatments that are providing increasingly marginal benefits.

    James B. Shearer (e64877)

  136. ==How did people survive before employer provided health insurance and Medicare and Medicaid? It is a true mystery.==

    heh, Mr. daley–my great gramps the farmer raised a family of 8 and lived to be 89. My great aunt Lulu the self employed seamstress reached 102. They were of average income for the time, probably some years way less than average. But the cost to go see a doctor or to go to the pharmacy was the same as buying a chicken or a couple dozen eggs or a new pair of gloves. The proportion has gotten way skewed in our day. Gramps and Aunt Lulu were living in more free market times.

    elissa (567694)

  137. Medicare:
    Thirty years ago, when the true costs of Medicare were becoming apparent, political observers started to examine and discuss what was driving the cost explosion in LBJ’s Crown Jewel.
    It was as simple then as it is simple now:
    Increased utilization of the system, absent any cost restraint, was driving the number of patients up, and also the resultant costs.
    The classic example was of the senior going to the doctor’s office for the sniffles to get a check-up, when prior to Medicare, he/she would have gone to the drug-store and bought an over-the-counter decongestant. That doctor’s visit required piles of paperwork to be initiated, and multiple billings to be made, driving up the costs of medical practice; plus, the doctor had to divide his time among an increased number of patients, resulting in less time per patient, and less personalized care.
    At the time, calls were being made to require a per-visit fee (to have the Medicare recipient have skin in the game), but I don’t recall what the eventual outcome was.
    All I do know is that, as a person who throughout his working life only briefly had “medical insurance”, I got used to paying for my care out-of-pocket, and only used same when absolutely necessary – the same as now when I am not covered by Medicare, even though I’m eligible.

    The Congress had the opportunity to change all this, starting with the divorce of “health-care insurance” from employment, but they fell to the sway of the demigogues and passed O-Care instead, which has, and will continue to, made the problem worse, until the truly sick will be unable to find practitioners willing to serve them (isn’t that true MikeK?).

    In almost any sector of the economy, and society, that you care to look at, as government intervenes, the situation gets worse.
    Can anyone debate without a smirk on their face that since the creation of the Department of Health, Education, and Welfare; any of those areas have gotten better for average Americans?
    Has HUD made the housing sector better?
    A Department of Agriculture is tasked with preserving the “family farm”, which has – due mostly to technology – disappeared, yet it devises program after program to forestall that disappearance that is fore-ordained. Then, because it has subsidized farmers to such an extent that many cannot afford their products, it devises subsidies for consumers in the form of Food Stamps.
    Madness!
    And that one word sums up much of what passes for business-as-usual within the Beltway, and other corridors of power from Sea-to-Shining-Sea.
    Madness!

    askeptic (2bb434)

  138. “The classic example was of the senior going to the doctor’s office for the sniffles to get a check-up, when prior to Medicare, he/she would have gone to the drug-store and bought an over-the-counter decongestant.”

    - askeptic

    Make the co-pay for a checkup higher than the cost of OTC decongestant.

    Leviticus (17b7a5)

  139. Comment by happyfeet (ce327d) — 1/26/2013 @ 2:16 pm

    You’re going to the wrong Albertson’s.

    askeptic (2bb434)

  140. Assume our objectives were:

    1. Get our fiscal house in order so the dollar does not collapse causing a worldwide depression making the 30s look like the 90s.

    2. Control skyrocketing health care costs.

    3. Provide [necessary] healthcare to people over [age] and/or under [income], leaving the proper inputs for those three variables open for discussion.

    If “provide” does not necessarily mean “through the government” them I am OK with this. I prefer “ensure the availability of” and take out references to age and maybe income. Those who can afford it — meaning they might have to make sacrifices — pay on their own. Those who can’t get a very minimal charity health care package: reasonable efforts to keep people alive, nothing extraordinary.

    Patterico (8b3905)

  141. “Provide” does not necessarily mean “through the government” to my mind. I’m fine with charity care bearing as heavy a burden as it can.

    Leviticus (17b7a5)

  142. Make the co-pay for a checkup higher than the cost of OTC decongestant.

    But, LBJ promised the Great Depression era generation that he was going to take care of all of the health-care needs –
    that Medicare was the logical extension of Social Security.
    You wouldn’t want his heirs to break his word, would you?

    askeptic (2bb434)

  143. Okay: then raise enough tax revenue to cover the costs of the entitlement programs we voted for back in the 60s.

    Or would you rather discuss the co-pays?

    Leviticus (17b7a5)

  144. Charity is nice but it is a stretch to say it is part of free markets (rather than say compatible with them). In any case charity can no more provide unlimited funds than taxes can. Which means some people will have to do without some increasingly expensive medical treatments that are providing increasingly marginal benefits.

    Thank goodness I didn’t say charity is a part of free markets. I took issue with your historically ignorant and false claim that free markets = you do without if you can’t afford it. BECAUSE charity is compatible with free markets, and historically is available in free markets, that statement of yours is wrong. That’s all I am saying.

    You seem to be assuming all treatments would remain equally expensive under a free market. If so, I think it’s hubris on your part and my best judgment is you are incorrect.

    Ultimately your grand observation is that resources are scarce, and must be allocated. Welcome to basic economics 101.

    The next question is how those resources should best be allocated. I believe in people making their own decisions. Apparently you trust the government and believe that freedom and independent decision making is drastic and risky.

    Patterico (8b3905)

  145. “I believe in people making their own decisions.”

    - Patterico

    I believe in the rule of law. We passed these programs; until we can agree on a solution to their deficiencies, don’t we have a duty to implement them?

    Leviticus (17b7a5)

  146. What happend to “provide for the General Welfare“?
    Are some on the Left rethinking the way they have used that clause in the Preamble to drive government costs ever higher with the creation of the Entitlement State?

    BTW, in a discussion elsewhere on the cost of the Federal Gov’t, it was noted that Entitlement Spending (SS, Med, etc) is – or shortly will be – fully 2/3 of all Federal expenditures, making the Federal Government a Welfare mechanism that also, as a sideline, does minor things like regulate drug effectiveness, provide for the common defense, prosecute lawbreakers, etc.
    Sort of like the realization that General Motors went from a car manufacturer who offered its employees health-care insurance, to a Health-care Insurer, who just happened to make cars.

    askeptic (2bb434)

  147. Copays and deductibles require documentation, record keeping, reporting, verification billing and auditing at various points all along the way. I call that busy work –and doctors and clinics call it a pain in the a*s.

    elissa (567694)

  148. I have to step out for a couple of hours, Patterico – meeting a friend. I’ll jump back in when I get home.

    Leviticus (17b7a5)

  149. Okay: then raise enough tax revenue to cover the costs of the entitlement programs we voted for back in the 60s.

    Or would you rather discuss the co-pays?

    I would rather discuss the free market. My lonely grocery store example is wondering why everyone is studiously ignoring her. She wonders if her logic is too compelling to merit response, because response would be sophistry or concessions, and one is obvious and the other unpleasant.

    I keep telling her there must be some other reason she is being overlooked.

    Patterico (8b3905)

  150. 119

    Can you support this? Because if so, it should be damn easy to fix.

    This is well known to people familiar with the program. Here is a column by liberal budget wonk Peter Orszag.

    The spike in disability insurance applications (and awards) does not reflect a less healthy population. The fraction of working-age adults who report a disability, about one in 10, has remained roughly constant for the past 20 years. (Indeed, it would be surprising if the number of workers with disabilities had risen by 50 percent over the past four years.) Rather, the weak labor market has driven more people to apply for disability benefits that they qualify for but wouldn’t need if they could find work.

    Orszag is reluctant to call out fraud but many of the applications are fraudulent (in ways that are difficult to disprove like claiming crippling back pain). And in any case if you could work you aren’t really disabled even if you do qualify under current rules.

    It would be easy to fix if you are willing to cut off a few genuinely disabled people amid all the bogus claims. Otherwise it is difficult.

    James B. Shearer (e64877)

  151. Or would you rather discuss the co-pays?

    No, I want the entire system changed.
    First, by divorcing health-care insurance from employment.
    Make everyone buy their own insurance, but give them a tax deduction for doing so.
    It would have a lot of down-stream changes that are currently drags on the economy.

    askeptic (2bb434)

  152. See here’s an example of another poorly thought out policy;

    ttp://www.bloomberg.com/news/2013-01-25/epa-cellulosic-biofuel-regulation-rejected-by-court.html

    narciso (3fec35)

  153. I believe in the rule of law. We passed these programs; until we can agree on a solution to their deficiencies, don’t we have a duty to implement them?

    Thank you for that strawman. My never-made argument that we should refuse to implement these programs without taking legal steps to change the law has been utterly demolished.

    Now can we move on to what I *have* argued?

    Patterico (8b3905)

  154. Comment by James B. Shearer (e64877) — 1/26/2013 @ 2:48 pm

    When the “99 weeks” runs out, you apply for SSDI, and officially drop out of the employment pool.

    askeptic (2bb434)

  155. First, by divorcing health-care insurance from employment.
    Make everyone buy their own insurance, but give them a tax deduction for doing so.
    It would have a lot of down-stream changes that are currently drags on the economy.

    Yes on divorcing health-care insurance from employment.

    No on a mandate to buy insurance.

    No on a tax deduction.

    Patterico (8b3905)

  156. I guess I didn’t call it “grocery” store. Let me repeat the example that everyone sailed past. It is important, I believe.

    If you go into a store and no prices are listed and everything is covered by “insurance,” is that more or less likely to make demand insensitive to price, causing prices to skyrocket?

    I think the clear answer is “more” but would be interested to hear how someone could argue to the contrary — or how that example does not fit health care.

    Patterico (8b3905)

  157. It would be easy to fix if you are willing to cut off a few genuinely disabled people amid all the bogus claims. Otherwise it is difficult.

    I am willing to say the government should not pay for ANY of these people. Charity should take care of the ones who need it.

    Patterico (8b3905)

  158. Comment by narciso (3fec35) — 1/26/2013 @ 2:49 pm

    That’s great news, as the EPA has been penalizing refiners for not buying a product that is not commercially available.

    Like many distortions in our current economy, this is based on a pipe-dream sold to, and advanced by, GWB, our Compassionate Conservative President, and it deserves to die with a wooden-stake through its heart, never to rise again.

    askeptic (2bb434)

  159. 111

    James B. Shearer – How did people survive before employer provided health insurance and Medicare and Medicaid? It is a true mystery.

    No big mystery, in most cases they made do with less. And on the whole they didn’t live as long.

    James B. Shearer (e64877)

  160. Would the solution to that demand problem be to have “co pays” at the grocery store and monkey around with the size of the co pay?

    Or just have the market set prices?

    WHY must every health care purchase be pursuant to insurance? Insurance should be for catastrophic unforeseen events, not day to day routine needs.

    Patterico (8b3905)

  161. When I say make, I mean that if you want insurance, you have to buy it. Father Christmas is not available.
    But, tax deductability would be a fair extension of the current system, in that employers are using pre-tax dollars to buy that insurance in your name.

    askeptic (2bb434)

  162. “but that sentiment is as free-market as it gets. By the way.”

    Leviticus – I disagree since it deliberately takes solutions off the table up front.

    daleyrocks (bf33e9)

  163. No big mystery, in most cases they made do with less. And on the whole they didn’t live as long.

    Also we had Jim Crow laws. Social Security was passed and before too many decades were out, those laws were gone. If we eliminate Social Security, old people will die and we’ll have separate drinking fountains again to boot.

    Patterico (8b3905)

  164. ==If you go into a store and no prices are listed and everything is covered by “insurance,” is that more or less likely to make demand insensitive to price, causing prices to skyrocket?==

    I think your point is so obvious and so truthful and so clear as the nose on one’s face is why no one is arguing with you or challenging you on it, Patterico.

    elissa (567694)

  165. “And on the whole they didn’t live as long.”

    James B. Shearer – Interesting, the steady increase in American longevity before and after Medicare and Medicaid was due to Medicare and Medicaid? Is that your theory?

    daleyrocks (bf33e9)

  166. Comment by James B. Shearer (e64877) — 1/26/2013 @ 2:56 pm

    Longevity….
    I believe the most influential factor of increased longevity in the 19th & 20th Centuries has been improved sanitation,
    followed by a more wide-spread access to health-care –
    which has a lot to do with advances in communication and transportation;
    but not so much by the utilization of same, particularly its more exotic sectors.

    askeptic (2bb434)

  167. Comment by Patterico (8b3905) — 1/26/2013 @ 3:00 pm

    Somebody has turned up the sarcasm.

    askeptic (2bb434)

  168. 159

    I am willing to say the government should not pay for ANY of these people. Charity should take care of the ones who need it.

    Charities don’t have some magical ability to distinguish genuine claims from bogus claims.

    James B. Shearer (e64877)

  169. I find that concerned volunteers have very highly-tuned antennae.

    askeptic (2bb434)

  170. Everyone lived less time back then.

    And poor people live less time today than rich people do.

    Shearer implies Medicare is why we have longevity now without considering these factors.

    Hence the absurd Jim Crow correlation does not equal causation example.

    I always have to explain my jokes.

    Patterico (c80820)

  171. “If we eliminate Social Security, old people will die and we’ll have separate drinking fountains again to boot.”

    Patterico – But when Social Security was passed the retirement age was beyond the average black life expectancy anyway, so it was structured as a racist program from the beginning.

    daleyrocks (bf33e9)

  172. “Charities don’t have some magical ability to distinguish genuine claims from bogus claims.”

    James B. Shearer – I was not aware this required magic. Do insurance companies which write disability policies possess such magic?

    daleyrocks (bf33e9)

  173. 167

    James B. Shearer – Interesting, the steady increase in American longevity before and after Medicare and Medicaid was due to Medicare and Medicaid? Is that your theory?

    No it was mostly due to other factors. Better medicine and increased wealth in general. But I expect a small portion is from the government providing care to people who could not otherwise have afforded it.

    James B. Shearer (e64877)

  174. Charities don’t have some magical ability to distinguish genuine claims from bogus claims.

    You are the acknowledged master of these strawman arguments which is why having discussions with you is such a frustrating exercise. I never said that charities have some kind of magical ability to distinguish fraudulent claims from non-fraudulent claims. What I do say is that government has a very poor ability to make those kinds of distinctions, and that private charity has a much better ability to make those kinds of distinctions because charity is more likely to involve face-to-face transactions. Charity, unlike the government, is not required to help people — and if somebody walks through the door clearly does not need help, a charity will tell them to go pound sand. The question is not whether the charity is perfect — it’s whether it’s better than government. Try addressing that argument, James B. Shearer.

    Patterico (f80c5e)

  175. Any one remember Dr.’s making house calls?
    They would receive payment in eggs, milk, beef, pork, and sometimes cash.

    mg (31009b)

  176. Pretty sure longevity is up because fewer infants and their mothers die in first months.

    gary gulrud (dd7d4e)

  177. other factors. Better medicine and increased wealth in general. But I expect a small portion is from the government providing care to people who could not otherwise have afforded it.

    You can’t know that. And you can’t know charity would not do it equally well.

    Patterico (f80c5e)

  178. I always have to explain my jokes.

    There’s a msg there.

    askeptic (2bb434)

  179. 174

    James B. Shearer – I was not aware this required magic. Do insurance companies which write disability policies possess such magic?

    No they don’t so they have to cope with a lot of fraud and attempted fraud. Their employees probably have more incentive to eliminate bogus claims than your typical government bureaucrat but I imagine a lot still get through. Fraud is a general problem with insurance and makes many forms of insurance more expensive than they would otherwise be. Life insurance is a relatively good buy because it is less subject to fraud.

    James B. Shearer (e64877)

  180. How does the EDD (unemployment office) week out fraud?

    askeptic (2bb434)

  181. 176

    Charities may or may not be better at distinguishing genuinely disabled people from fakes than the government but unless they are perfect they will still be denying aid to some genuine cases. I don’t have a big problem with this whether it is a charity or the government but some people do. If they have trouble with the government cutting off 1 genuine case and 99 fakes they are also going to have trouble with the government cutting off 100 genuine cases in the belief that private charity will take over.

    James B. Shearer (e64877)

  182. James Shearer- after reading a dozen or so of your posts– several of which seem to contradict each other especially as relates to the government– I have no clue what it is you are arguing for or against on this thread, or what you propose.

    elissa (567694)

  183. Patterico:

    If you go into a store and no prices are listed and everything is covered by “insurance,” is that more or less likely to make demand insensitive to price, causing prices to skyrocket?

    I think the clear answer is “more” but would be interested to hear how someone could argue to the contrary — or how that example does not fit health care.

    Here’s the only contrary argument I can think of: It’s a really, really crappy grocery store with really, really crappy products, so it’s less likely to to make demand insensitive to price because no one wants to shop there.

    DRJ (a83b8b)

  184. elissa,

    I’m not trying to speak for James B. Shearer and I’m sure he can speak for himself, but I think his initial premise is that we should be leery of changing programs because the cure may be worse than the disease. If so, my response is that the “disease” is so advanced, we need to consider aggressive changes.

    DRJ (a83b8b)

  185. 182.How does the EDD (unemployment office) week out fraud?

    They check with your claimed previous employer that you were actually employed there (and were laid off). If you are working on the books while collecting unemployment this is likely to be caught at some point and get you in trouble. There is theoretically a requirement that you be actively working for work while on unemployment but in my experience no attempt is made to enforce this.

    James B. Shearer (e64877)

  186. Patterico:

    WHY must every health care purchase be pursuant to insurance? Insurance should be for catastrophic unforeseen events, not day to day routine needs.

    Amen. And not only would this be good for the market, it would be good for doctors and health care in general, which makes it good for patients.

    DRJ (a83b8b)

  187. Comment by DRJ (a83b8b) — 1/26/2013 @ 3:34 pm

    Ah, you’ve been shopping in the old Soviet Union?
    Heh!

    The point is, if everything in the meat-case was the same price, people would overwhelmingly be buying Rig-Eye and Porterhouse, instead of Ground-beef.
    And, with low co-pays, and third-party payers, that is what you have in medical care.

    askeptic (2bb434)

  188. 188- And that is what they should have done with Medicare, but it was antithetical to the Socialist/Progressive Mantra.

    askeptic (2bb434)

  189. askeptic@3:43- a friend traveled to Moscow just before Christmas. She said the town was all duded up and the women rather fashionable despite the frigid cold. The GUM department store was decorated and downright festive not to mention stocked with goods.

    It’s hard for me to shake the images of the dreary all-gray old soviet union, the babushkas, and GUM’s nearly barren shelves.

    elissa (567694)

  190. Okay: then raise enough tax revenue to cover the costs of the entitlement programs we voted for back in the 60s.

    My calculation is that’s about a 50 percent hike on everyone.

    That’s assuming that nobody changes their behavior with a 50 percent hike. No black markets; no Phil Mickelsons leaving the country.

    Good luck with that assumption.

    Patterico (c80820)

  191. I don’t have a big problem with this whether it is a charity or the government but some people do.

    There always be “some people” against any sensible proposal. Why spend time worrying about them?

    Patterico (22f0a7)

  192. Comment by elissa (567694) — 1/26/2013 @ 3:53 pm

    Yeah, ain’t capitalism – even Putin’s crony capitalism, in comparison – wonderful!

    askeptic (2bb434)

  193. Lister and Fleming gave us a big boost but advances adding a half-dozen years at the margin have not done all that much for the average life span.

    Hard work and interest in life separate the extreme geriatric set from the rest of us.

    Entitlements, making sure we have phones and TVs is mostly irrelevant. Families used to take that burden.

    gary gulrud (dd7d4e)

  194. Good genes help, too.

    DRJ (a83b8b)

  195. “Okay: then raise enough tax revenue to cover the costs of the entitlement programs we voted for back in the 60s.”

    I did not realize the public was given the opportunity to vote on them.

    daleyrocks (bf33e9)

  196. Flawed assumptions doom utopian ideas.

    DRJ (a83b8b)

  197. It must be that amorphous “we” that Leviticus keeps using.

    daleyrocks (bf33e9)

  198. Of course, flawed assumptions doom a lot of ideas, but it seems to happen more to utopian ideas … and Democratic legislation.

    DRJ (a83b8b)

  199. “We” all vote for Democratic ideas, daleyrocks. Republican ideas are there for protests and to prove the First Amendment still matters.

    DRJ (a83b8b)

  200. “Fraud is a general problem with insurance and makes many forms of insurance more expensive than they would otherwise be. Life insurance is a relatively good buy because it is less subject to fraud.”

    James B. Shearer – Yes, fraud is a problem with virtually every line of insurance as it is with government entitlement programs. And I thought life insurance prices were low because of competition and the ability to actuarialy predict life expectancies, not the absence of fraud in the application process, which is not uncommon.

    daleyrocks (bf33e9)

  201. ““We” all vote for Democratic ideas, daleyrocks. Republican ideas are there for protests and to prove the First Amendment still matters.”

    DRJ – Thank you for the reminder. Liberal tolerance is the only thing separating people with Republican ideas from the pitchforks.

    daleyrocks (bf33e9)

  202. 193

    There always be “some people” against any sensible proposal. Why spend time worrying about them?

    Because they often have the power to block the proposal. It doesn’t matter how sensible the proposal is if you can’t get it enacted. Which means you have to worry about how to sell it.

    In the particular case of Social Security disability insurance I personally would eliminate coverage for “disabilities” that aren’t easy to independently verify. However this would be a fairly drastic change from current practice and would not be easy to enact. Nevertheless as I said in my first comment on the subject something needs to be done about the flood of bogus claims.

    James B. Shearer (e64877)

  203. 202

    James B. Shearer – Yes, fraud is a problem with virtually every line of insurance as it is with government entitlement programs. And I thought life insurance prices were low because of competition and the ability to actuarialy predict life expectancies, not the absence of fraud in the application process, which is not uncommon.

    Yes people lie about their medical history which is a problem. However determining whether the insured has died or not is usually pretty straightforward. As oppposed to say determining whether someone is or isn’t disabled.

    James B. Shearer (e64877)

  204. 184.James Shearer- after reading a dozen or so of your posts– several of which seem to contradict each other especially as relates to the government– I have no clue what it is you are arguing for or against on this thread, or what you propose.

    I am agreeing with Patterico’s point that economics is not an exact science and that economic predictions are often quite uncertain but am drawing somewhat different conclusions.

    In particular I am wary of discarding existing institutions with which we have a lot of experience for wildly different institutions which might not work out as hoped. Especially when incremental improvements seem feasible.

    Also while I generally favor a large role for markets in the organization of society I don’t have Patterico’s faith in completely unregulated markets. Among other things I think history shows that market economies are prone to dangerous instabilities (boom bust cycles) and I believe measures to dampen these are desirable.

    As for what I propose, I propose not abolishing the Federal Reserve, not returning to the gold standard and not privatizing Social Security. Eligibility for Social Security disability needs to be tightened up. I believe the current US medical system has severe problems but I don’t really see how to fix them (in a way that is also politically feasible).

    James B. Shearer (e64877)

  205. Why the Fed was set up to prevent an action like Morgan took in 1907, surprising in the last hundred years, it has not done so, either preventing the Great Depression, and every other major crisis, including the current financial crisis, despite it had the tools to do so,

    Now, the gold standard, really does go to the issue of what is backing for our money, right now it’s ‘full faith and credit’ don’t laugh so loud.

    narciso (3fec35)

  206. elissa,

    Speaking of social liberalism and social conservatism, several top Republican leaders in Texas have announced they want new limits on abortion. Maybe this is ‘all cattle and no hat’ or maybe they’re simply ‘pining for a past way of life that ain’t coming back.’ At some point, though, we should find out whether Texans agree with them.

    I don’t know whether this topic will resonate with Texans, turn them off, or bore them. But after the announcement of Battleground Texas — the Democrats’ big effort to turn Texas blue — I suspect these Texas Republican leaders decided the best defense is a good offense. Apparently they’ve decided abortion and gun control are parts of their offense.

    DRJ (a83b8b)

  207. James B. Shearer–thank you for the clarification. If you believe the current U.S. medical system has severe problems then perhaps you’d be willing consider the proposition (or at least the possibility) that if we took politics and “political feasability” out of the equation and left it to the actual medical profession and patients, that we’d have more options and better opportunities to improve/personalize care plus reduce adminstrative costs. Just a thought.

    elissa (567694)

  208. Of course, obama made it quite clear in 2007, and Schakowsky and Hacker, have reinforced the message, their goal is single payer, because this plan cannot work,

    narciso (3fec35)

  209. “Yes people lie about their medical history which is a problem. However determining whether the insured has died or not is usually pretty straightforward.”

    James B. Shearer – I thought it was too obvious a point to bring up the difficulty of faking death claims and deliberately avoided insulting the intelligence of the audience here by including it in my comment. Thank you for addressing my omission.

    daleyrocks (bf33e9)

  210. DRJ–Thanks for the Texas update. Keep us informed on that. My state’s mention in the news this week was that Standard and Poors downgraded the bond rating again and we’re now the lowest rated state in the union (tied with California). However IL got a negative outlook which means a further downgrade is likely. Cali has recently at least gotten a positive rating. Apparently IL now has the second highest per capita debt of any state. Our pension problems are insurmountable.

    elissa (567694)

  211. Well let’s take each piece at a time, Dodd/Frank doesn’t do much to actually prevent the time of crisis that irrupted in 2008-2009, just like Sarbanes/Oxley didn’t prevent the next one, TARP did not sequester the toxic assets, the Affordable Care Act, does no such thing,

    narciso (3fec35)

  212. I don’t get how California could improve it’s rating with such a precipitous collapse in sales tax revenue, likely because any rational business, is abandoning it like the Titanic and the Andrea
    Doria combined,

    narciso (3fec35)

  213. 214. They got credit for raising taxes and flopping for Federal matching money, e.g., the railroad to nowhere.

    They will be revisited.

    gary gulrud (dd7d4e)

  214. Much like Enron got credit for transactions, when they were booked.

    narciso (3fec35)

  215. I don’t think your accusation of “gladly identify as social liberals” is fair at all.

    Elissa, when I describe various people as “gladly” labeling themselves social-cultural liberals, I meant that in purely descriptive and not necessarily pejorative terms.

    I think much of that gladness can be explained by the dynamics evident in a typical household—one that at least isn’t broken down in a modern, hipster sort of way. That’s where “daddy” sets the rules, cracks the whip and is more likely to say “no.” Meanwhile, “mommy” is the big pushover, the soft touch, the enabler who often says “yes.” This description is admittedly based on stereotypes, and sometimes the roles are reversed, but overall, it’s applicable in more cases than not.

    So in various folks’ eyes, conservatives/Republicans are “daddy,” liberals/Democrats are “mommy.” So such people conjure up the word “liberal” and then envision “mom” tending to them in their sick bed. They sigh and smile, because “mom” proclaims: “My love is unconditional.”

    Then such people think “conservative” and envision “stick in the mud,” “party pooper,” and someone who doesn’t suffer fools lightly. Booring.

    Yes but I don’t see it as cognitive dissonance. I see it as believing flawed assumptions, i.e., that you can’t be a caring, compassionate, good person unless you’re socially liberal.

    DRJ, to me it is cognitive dissonance because such people tend to believe money, money, money (ie, a good economy, and all its benefits) is at the core of what makes a society happy and whole. They’ll dreamily think that if unemployment rates are low, and their income is good — and the social safety net is wide and strong — everything else good will fall into place.

    But switch your gaze to wealthy celebs in Hollywood — super, smugly, gloriously liberal Hollywood — who live large yet suffer from plenty of dysfunction. They illustrate that money, by itself, isn’t necessarily the answer to one’s salvation.

    Somewhat related to this, I recall reading a few years ago about a liberal woman who was observing the current “slutty” behavior that’s become more and more common among young females. The liberal shook her head and in so many words sighed, “women’s liberation and progressive values have come down to this?!”

    Mark (1c1145)

  216. who cares who hispanics vote for the point is they honor and value the traditional family

    I’m not sure if much of what you describe as “traditional” is any more firmly rooted in the Latino community than it is in other communities. Even more so when it’s also inundated with the modern-day liberalism that infuses America, along with the beguiling mirage offered by feel-good “progressives,” be they here or in countries like Mexico—whose own version of the US’s Democrat Party has enjoyed almost non-stop one-party rule for over 80-plus years.

    And whether traditional or not, or liberal or not, Latino America has floating over too much of it the specter of persistent academic mediocrity or outright failure. So if this nation is becoming increasingly dependent on that demographic, then, oh-oh, Houston, we have a problem.

    Mar (1c1145)

  217. elissa,

    I apologize for talking about Texas so much, but recently I haven’t seen many Republican politicians speak about conservative social issues and be successful. In fact, not many talk about social issues anymore, unless they are adopting liberal positions.

    Maybe red states are different and social issues are still important or persuasive, but this strikes me as Republicans deciding not to apologize for, waffle on, or hide their socially conservative positions. In other words, it’s the opposite of what we’ve seen in the last two Presidential elections. It may not be successful but I think it’s a worthwhile experiment. I’m especially interested in whether it appeals to our Hispanic population.

    DRJ (a83b8b)

  218. The left is very in your face, about their social issues they put a MAMBLA supporter as head of ‘safe schools’ they mandate that Church affiliated institutions provide contraception,

    narciso (3fec35)

  219. “My calculation is that’s about a 50 percent hike on everyone.”

    - Patterico

    Ok.

    “My lonely grocery store example is wondering why everyone is studiously ignoring her. She wonders if her logic is too compelling to merit response, because response would be sophistry or concessions, and one is obvious and the other unpleasant.”

    - Patterico

    Your lonely grocery store example was so compelling that I addressed it by reminding the discussion of co-pays – those things implemented to give the “skin in the game” that you and I acknowledge is so crucial to keeping “users” tied to “payers.” You want to talk about the “free market.” I want to talk about co-pays (of negotiable level) as a step to middle ground – a compromise that drives down demand and thus drives down cost. I’m not ignoring your point. If you could buy everything on “insurance” then you would completely detach cost from utilization, and that would lead to a profligacy which would drive up price. So, attach cost to utilization via co-pays. Is that not a step in the right direction?

    Leviticus (17b7a5)

  220. social cons should frolic and play and indulge themselves to their heart’s content at the state level

    pretty sure that was god’s original plan

    happyfeet (ce327d)

  221. omg with the wonky wonk Mr. Levi

    it’s a feelin alright saturday night and that’s how we do it round here

    happyfeet (ce327d)

  222. My goodness, DRJ, don’t apologize. You have every reason to be proud of living in Texas. As I’ve said here many times over the years it is a pleasure and a real learning experience to see people talk about their states and describe the unique characteristics of both the population and the politics–not to mention the terrain.

    I very much hope the Republicans don’t blow it on gun control. It’s an emotional issue right now, but I do not believe responsible gun ownership or protecting the second amendment is, or should be, a party centric or a conservative social issue. We cannot allow the big city gun grabber pols to reframe the gun issue as just another extreme right wing position with themselves as the rational stewards of civility. Many Democrats own guns and plan to keep them. Those Democrats need to be included in the fold and added to the narrative. It makes me nervous to see the words “abortion” and “gun control” in the same paragraph.

    elissa (567694)

  223. dammit happy… you right. its no time for wonk – that substance what drives obstacles betwixt us.

    i’ll pick this wonk up tomorrow.

    Leviticus (17b7a5)

  224. cheers Mr. Levi

    happyfeet (ce327d)

  225. cheers, tovarish.

    To shrimp & grits & imperial reds.

    Leviticus (17b7a5)

  226. You understand they want to take every right away from us, right, this is why Obama and Ayers, spent all those years funding studies from the Joyce foundation, that’s where the 40% factoid comes from, every thing stat they spout is a lie or an omission, yet to cite two examples Mark Kirk and Manchin are willing to sell us out, for a little
    recognition,

    narciso (3fec35)

  227. Everytime there’s a negative jobs report or a jihadist bombing or another shooting in allegedly “gun-free” Chicago or the discovery that “those shovel-ready jobs just weren’t as shovel-ready as we thought!,” Obama Incorporated and the sychphant lamestream media characterize it all as having happened….”unexpectedly.”

    As often as things happen contrary to what President Alinsky & Co. “expect” to happen, you’d think they’d finally back off from all of their holier-than-thou insistence about predicting the future, particularly when it comes to assessing future job growth, GDP numbers, and the fruits of Arab ‘democracy.’

    But that would probably require a conscience.

    Elephant Stone (3a3598)

  228. DRJ,

    Texas is pretty awesome.
    If I weren’t a Hollywood guy, I’d be a north Texas guy.

    Elephant Stone (3a3598)

  229. count me in for west texas

    or austin

    but wemberley is too too twee

    but I’m a go see the boot whisperer this summer

    but just for s-kickers nuffin dressy

    i’d never wear em and when i did it would be at night when it’s dark anyway

    happyfeet (ce327d)

  230. sorry *wimberley*

    happyfeet (ce327d)

  231. Narciso– Improved background check procedures, especially at gunshows or to try to ferret out crazy disturbed people who want to buy/own more guns seems rather benign to me. I think it would be popular and comforting to the public. Other than the “give ‘em an inch and they’ll take a mile” concern do you have specific objections about tightening background checks? (Obviously we’d need to see the actual wording)

    I guess this is an example of what I mean when I say I hope the Republicans don’t blow it. I think a minor, reasonable, public accommodation to the debate would not be all that bad. What am I missing?

    elissa (567694)

  232. i think it’s messed up to make any accommodation what would have had no bearing whatsoever on the fate of the doomed newtown babywazzles

    this idea that we always have to have dramatic legislative flourishes to events featured on cable news is how we got porky porky chris christie’s hideously bloated porky porky welfare bill

    happyfeet (ce327d)

  233. Have all these laws worked in Chicago, or NY or DC, four years after Heller, three after McDonald, except to disarm the citizenry.

    narciso (3fec35)

  234. *in response* to events featured on cable news I mean

    happyfeet (ce327d)

  235. Your lonely grocery store example was so compelling that I addressed it by reminding the discussion of co-pays – those things implemented to give the “skin in the game” that you and I acknowledge is so crucial to keeping “users” tied to “payers.” You want to talk about the “free market.” I want to talk about co-pays (of negotiable level) as a step to middle ground – a compromise that drives down demand and thus drives down cost. I’m not ignoring your point. If you could buy everything on “insurance” then you would completely detach cost from utilization, and that would lead to a profligacy which would drive up price. So, attach cost to utilization via co-pays. Is that not a step in the right direction?

    Not enough of one. If you buy grocery items through food insurance, increasing the “co pay” is not going to stop rampant overspending beyond what is needed. If you want to tie the co pay to the price, so it’s half of the actual bill, as opposed to a flat rate (which is what a co pay usually is — it has NOTHING to do with the final bill), then you’re just establishing a market, but one not as effective at controlling costs as one where the full price is charged.

    What is so wrong with just having a market and insurance for catastrophes??

    Patterico (8b3905)

  236. So what Loughner was protected by the local sheriff, Holmes wan’t flagged by the university,
    Lanza, stole his guns, how does this a farthing’s worth of difference, and Dylan and Klebold wanted to blow up the school.

    narciso (3fec35)

  237. narc and happy–I’m lookin’ at it more through a PR lens. I dunno. I just think the other side always gauges the public and plays it way better than we do. Lily Ledbetter Fair Pay act was a total nothingburger but they sure made political hay with it with the public –as if it was a major accomplishment for womens’ rights. What have we done like that lately to make headlines? I mean other than Mourdock and Todd Akin.

    elissa (567694)

  238. elissa, gun-control is not really a partisan issue, it is just that the 2nd-A is supported more on the conservative side than on the liberal side.
    The NRA will oppose any politician, either Dem, GOP, or Hairy Python, if they advocate gun-control.

    I’m the NRA, and I Vote!

    BTW, that “gun show loophole” that the Left likes to talk about, only applies to one private (non-commercial) individual selling to another private (non-commercial) individual, except in states like CA that require all private-party transactions to be conducted through a licensed dealer (FFL). Any transaction of an FFL must have a back-ground check attached, no matter where the transaction is conducted.

    askeptic (2bb434)

  239. ==how does this (make) a farthing’s worth of difference==

    I guess that’s kind of my point. It seems like by beefing up background checks nothing much is gained and likewise nothing much is lost in terms of rights. But it would sure look nice on PBS and on the mommy blogs and on the cover of USA Today. Does having background checks on sales such as askeptic describes feel like gun “control” to you? Does it feel like an egregious violation of the second amendment when background checks are already customary on other types of sales?

    elissa (567694)

  240. In attempt to mosey back to Patterico’s thread topic, here’s a final thought before I sign off. From the justoneminute blog, a bumper sticker in a popular double entendre genre:

    Liberals Do It With Government Assistance

    elissa (567694)

  241. “My lonely grocery store example is wondering why everyone is studiously ignoring her. She wonders if her logic is too compelling to merit response, because response would be sophistry or concessions, and one is obvious and the other unpleasant.”

    Patterico – It’s kind of like when I go to the Chicago Auto Show with my boys and we play around and say if you ignored all the price tags, which car would you get. Guess what, it’s not a big surprise to figure out that none of choose toasters on wheels from Scion, NTTAWWT. I’m sure removing price constraints leads others to behave in a similar fashion.

    daleyrocks (bf33e9)

  242. “a bumper sticker in a popular double entendre genre:”

    elissa – What’s the double entendre part of that bumper sticker?

    daleyrocks (bf33e9)

  243. “If you want to tie the co pay to the price, so it’s half of the actual bill, as opposed to a flat rate (which is what a co pay usually is — it has NOTHING to do with the final bill), then you’re just establishing a market, but one not as effective at controlling costs as one where the full price is charged.”

    - Patterico

    One not as effective at controlling costs, but one more effective at providing healthcare access to the poor. But less effective than it was before. So, a half measure.

    “What is so wrong with just having a market and insurance for catastrophes??”

    - Patterico

    What is wrong with “just having a market for catastrophes” is an unwillingness to acknowledge that a “catastrophe” is relative to income level.

    Leviticus (17b7a5)

  244. 209

    209.James B. Shearer–thank you for the clarification. If you believe the current U.S. medical system has severe problems then perhaps you’d be willing consider the proposition (or at least the possibility) that if we took politics and “political feasability” out of the equation and left it to the actual medical profession and patients, that we’d have more options and better opportunities to improve/personalize care plus reduce adminstrative costs. Just a thought.

    I don’t think administrative costs are the main problem. Medical services cost more in the United States than in other countries because doctors and other medical professionals are paid more. Costs are rising rapidly because expensive new treatments are constantly being devised. These procedures are often of dubious value but people are reluctant to apply normal cost benefit calculations to medical decisions. And patients are often insulated from the cost in any case. But I don’t see an easy way of fixing all this.

    James B. Shearer (e64877)

  245. Well that’s just weird – I have a Scion.

    Leviticus (17b7a5)

  246. It’s a riff on ‘you didn’t build that’

    narciso (3fec35)

  247. “Well that’s just weird – I have a Scion.”

    Leviticus – Would you prefer a BMW Alpina for the same copay?

    daleyrocks (bf33e9)

  248. elissa,

    I think Republicans should agree to gun control measures that make sense and are likely to produce meaningful results, but I don’t agree they should agree to changes just because the changes make them look good. It makes Republicans look like Democrats-lite, plus they run the risk of turning off GOP voters who care about the gun control issue for no real gain.

    Obviously, I could be wrong but I think standing firm on basic principles ultimately produces more support than relying on PR or trying to appeal to moderates. Republicans may lose single-issue voters who only care about gun control, but they gain the support of people who know they mean it when they say they stand for something.

    It’s the same reason forcing Republicans to agree to tax increases was so important to Obama — not because the extra taxes mean anything, but because they undermine an important GOP principle.

    DRJ (a83b8b)

  249. 238

    What is so wrong with just having a market and insurance for catastrophes??

    Medical insurance currently has two functions. It ensures against catastrophe (large unexpected medical expenses) which is the normal function of insurance. But it also obtains better prices than an individual can by buying in bulk. I had a minor operation a few years ago and my insurance company obtained extreme discounts from the list prices (like 95% in some cases IIRC). I doubt I would have been able to get anything like those prices on my own. So the market is currently pretty dysfunctional for the uninsured. Perhaps this would change if nobody was insured (for non-catastrophic expenses) but there are problems with expecting sick people to shop around.

    James B. Shearer (e64877)

  250. No, this is the bug hanging around from the HMO bill of ’71, uncorrected by ERISA, complicated by EMTALA and Kennedy Kassebaum, just one more law will solve the problem, right.

    narciso (3fec35)

  251. Nevertheless as I said in my first comment on the subject something needs to be done about the flood of bogus claims.

    Maybe Obama could take his feet off the economy’s throat. Or his Admin could quit approving this flood of new applicants.

    JD (b63a52)

  252. that a “catastrophe” is relative to income level

    Are you talking about medical catastrophies?

    JD (b63a52)

  253. “Medical services cost more in the United States than in other countries because doctors and other medical professionals are paid more.”

    James B. Shearer – Don’t go forgetting about the expensive liability insurance our medical professionals have to buy because of our screwed up tort system, mkay?

    daleyrocks (bf33e9)

  254. 251

    It’s the same reason forcing Republicans to agree to tax increases was so important to Obama — not because the extra taxes mean anything, but because they undermine an important GOP principle.

    If the principle is opposition to any tax increase ever no matter what the circumstances in my view the party is better off without it. Obama does have an interest in pushing issues that divide the Republican party (in this case between purists and pragmatists who like to win elections now and then) but that is normal political manuvering.

    James B. Shearer (e64877)

  255. These procedures are often of dubious value but people are reluctant to apply normal cost benefit calculations to medical decisions.

    Essentially it is everyone EXCEPT government’s fault.

    JD (b63a52)

  256. 256

    James B. Shearer – Don’t go forgetting about the expensive liability insurance our medical professionals have to buy because of our screwed up tort system, mkay?

    That is also a factor of course. The cost of liability insurance may not be the worst part. There is also pressure to adopt expensive new technologies of dubious value since if you don’t and something goes wrong a lawyer can always claim the new technology would have prevented it.

    James B. Shearer (e64877)

  257. Patterico – he has a way of being obtuse, and like nailing jello to a wall. He generally will pick a tiny mainly irrelevant point and nitpick that to avoid talking about the actual point. As an example, see his full privatization of SS strawman and the comment above where he quibbles about admin cists ignoring the actual point of the comment.

    JD (b63a52)

  258. There is also pressure to adopt expensive new technologies of dubious value

    It seems like you understand about 10% of this topic. And that doctors forcing dubious value treatment on people is common.

    JD (b63a52)

  259. “Are you talking about medical catastrophies?”

    JD – We are all one catastrophe away from a catastrophe.

    daleyrocks (bf33e9)

  260. “The cost of liability insurance may not be the worst part.”

    James B. Shearer – Well, I’m glad I did not contend it was. Is your theory that doctors are overpaid in the U.S. or are you just making an observation? Can you name any credentialed professions in which people are compensated more highly overseas than in the U.S., e.g., is your observation just par for the course.

    daleyrocks (bf33e9)

  261. 258

    Essentially it is everyone EXCEPT government’s fault.

    In this case (as in many others) the government’s actions (faulty as they may be) reflect the desires of the people (not all of them of course). People in general don’t want the government deciding for example to let extremely premature infants die without treatment although that is what a cost benefit analysis might suggest.

    James B. Shearer (e64877)

  262. Agreeing to background checks….
    That can be done, if there is someway to insist that the States, who have the option of conducting the check outside of the NICS system, adequately fund their systems to prevent the backlogs that CO and CA (for instance) have seen over the last 6-weeks. Particularly, when you have a legislature such as in CO that refuses to pony up the money needed to deal with that backlog.
    By slowing down the system (and in CA the 10-day waiting period has stretched out to over 6-weeks for some purchasers) through a lack of resources to conduct the checks, you are in-effect imposing a form of gun-control denying people the opportunity to acquire firearms (shall not be infringed).

    askeptic (2bb434)

  263. “In this case (as in many others) the government’s actions (faulty as they may be) reflect the desires of the people (not all of them of course).”

    James B. Shearer – What the heck are you talking about? Except for Medicaid and Medicare, the government was not imposing treatment options on people prior to Obamacare. After Obamacare it will. The people did not vote on Obamacare. It was unpopular when it passed and it remains unpopular.

    daleyrocks (bf33e9)

  264. James B. Shearer,

    One of the GOP’s core principles has always been avoiding tax increases. Apparently even the Speaker thinks how he handled the fiscal cliff negotiations, which included a tax increase, was a mistake.

    DRJ (a83b8b)

  265. Medical insurance currently has two functions. It ensures against catastrophe (large unexpected medical expenses) which is the normal function of insurance. But it also obtains better prices than an individual can by buying in bulk. I had a minor operation a few years ago and my insurance company obtained extreme discounts from the list prices (like 95% in some cases IIRC). I doubt I would have been able to get anything like those prices on my own. So the market is currently pretty dysfunctional for the uninsured. Perhaps this would change if nobody was insured (for non-catastrophic expenses) but there are problems with expecting sick people to shop around.

    I thought I said this before, but in case I wasn’t clear or it was missed: you can’t discuss what a truly free market would do by reference to the “market” that exists now.

    there are problems with expecting sick people to shop around

    Tell us about them, and how they are different from other situations where people have to shop around.

    Remembering that I recommend having insurance for catastrophes.

    Patterico (8b3905)

  266. One not as effective at controlling costs, but one more effective at providing healthcare access to the poor. But less effective than it was before. So, a half measure.

    I don’t agree. Higher prices make it more difficult for everyone including the poor. If a true market creates incentives to create efficiencies, driving down costs, that benefits the poor. Your mistake lies in your apparent assumption that instituting free market reforms will not drive down prices. Maybe it won’t, but you can’t know that.

    What is wrong with “just having a market for catastrophes” is an unwillingness to acknowledge that a “catastrophe” is relative to income level.

    It can be, yes, and I’m not sure who is unwilling to acknowledge that. Could you tell me?

    But: so?

    There are many areas of life where occurrences that would be a minor or perhaps semi-major irritant for one household are a catastrophe for another. Having to replace the roof or air conditioning. A car crash totaling the car. A death in the family necessitating extraordinarily high-cost plane tickets for several family members. I could go on.

    Health care is another situation like that, and households would have to calibrate what constitutes a catastrophe for *them* and insure against *that*.

    So? Does that mean we suddenly need the helping hand of government?

    For someone who hates political parties as much as you do, I’m surprised at your faith in other areas of government. You consistently seem to assume that if there is a need, why then government must be the best way to meet it. I tend to assume the precise opposite.

    That’s because if the market fails to meet a need, incentives are created for entrepreneurs to meet that need. (As long as government gets out of the way and lets them meet it without too much burdensome taxation and regulation).

    Patterico (8b3905)

  267. My general impression is that James B. Shearer thinks everything is hunky dory and needs no change — except for the areas that do, but hey, can’t be done because unpopular.

    The latter part may be true but I am more worried about it than he seems to be.

    Patterico (8b3905)

  268. James B. Shearer or George A. Custer, really, at this point, what difference does it make?

    gary gulrud (dd7d4e)

  269. hillarud?

    happyfeet (ce327d)

  270. 272. Ad Hoc West Point erudition flying in the face of superior warriors, superior logistics, superior position, superior motivation, superior command and control,…

    http://www.zerohedge.com/news/2013-01-26/end-era

    Money quote: “The critical distortion here is clearly inflation, which feeds through into computations showing “growth” even when it is intuitively apparent (and evident on many other benchmarks) that, for a decade or more, the economy has, at best, stagnated, not just in the United States but across much of the Western world. Distorted inflation also tells wage-earners that they have become better off even though such statistics do not accord with their own perceptions. It is arguable, too, that real (inflation-free) interest rates were negative from as long ago as the mid-1990s, a trend which undoubtedly exacerbated an escalating tendency to live on debt.”

    Consumer credit has collapsed. Small wonder we are overrun. Today 10% of GDP is created from nothing by the Federal Reserve. We are literally still collapsing, our runaway foreign exchange deflation computes as GDP ‘growth’ of 2%.

    There is no money and increasing tax rates will not result in increased revenue.

    gary gulrud (dd7d4e)

  271. 197.“Okay: then raise enough tax revenue to cover the costs of the entitlement programs we voted for back in the 60s.”

    I did not realize the public was given the opportunity to vote on them.

    Comment by daleyrocks (bf33e9) — 1/26/2013 @ 4:47 pm

    The public had a chance to repudiate them at the polls. Many, many, many times. The People love them some welfare as long as we pretend they are ‘entitled’ to it. They love it even when it is ripping them off. Observe how the young are voting. Their ….. let us call it ‘naivete,’ is mindboggling.

    Roland (c4ee0b)

  272. “The public had a chance to repudiate them at the polls. Many, many, many times.”

    Roland – What years were they on the ballot?

    daleyrocks (bf33e9)

  273. James B. Shearer – What the heck are you talking about? Except for Medicaid and Medicare, the government was not imposing treatment options on people prior to Obamacare. …

    That’s the point, the government (and private insurers) was paying for medical treatments with little regard for their cost benefit ratio. The natural result was steadily rising medical expenditures. As long has people have little personal incentive to choose less expensive treatment options this rise in costs is likely to continue. But people on the whole don’t want to have to look for cheap doctors.

    James B. Shearer (e64877)

  274. Yes, we’ve seen the result of this method in the UK, where the Hippocratic oath is a dead letter, under QALY and NICE, in Holland, where euthenasia has become a viable option,

    narciso (3fec35)

  275. Imposing treatment options on people is a GOOD thing. A government solution to a government created problem.

    JD (b63a52)

  276. 270.My general impression is that James B. Shearer thinks everything is hunky dory and needs no change — except for the areas that do, but hey, can’t be done because unpopular.

    The latter part may be true but I am more worried about it than he seems to be.

    I am not saying needed changes are impossible just that political feasibility is a constraint that needs to be taken into account. Something that the Republican party has had trouble with lately.

    I am worried about the future but more because of peak oil and immigration than deficits. The deficit hawks would be more credible (with me at least) if they had worried about it as much when GWB was President.

    James B. Shearer (e64877)

  277. Maybe this is what you’re saying, James, but the current health care system discourages people from cost-shopping when it comes to medical care. However, we’re generally a nation of consumers, so most people would know (or quickly learn how) to shop for medical care in a market-based system.

    DRJ (a83b8b)

  278. Thank you for that nugget of idiocy. How does 450B compare to 1.4T?

    JD (b63a52)

  279. 267

    One of the GOP’s core principles has always been avoiding tax increases. Apparently even the Speaker thinks how he handled the fiscal cliff negotiations, which included a tax increase, was a mistake.

    Under the circumstances I thought the deal was reasonably good from a Republican point of view. You can’t expect your negotiators to perform miracles, the environment was unfavorable and the Republican caucus was badly divided.

    James B. Shearer (e64877)

  280. The deficit hawks would be more credible (with me at least) if they had worried about it as much when GWB was President.

    The people that spleen vented about Bush’s deficits would be more credible if they did the same about Obama’s much worse deficits. Problem is that what was once reckless, irresponsible, and evil now gets a deep throated cheer and support, and apologia from the likes of Shearer.

    JD (b63a52)

  281. James,

    Many conservatives worried about spending during Bush’s Presidency. Reagan’s, too. But surely you aren’t suggesting that all debt is equal?

    DRJ (a83b8b)

  282. 281.Thank you for that nugget of idiocy. How does 450B compare to 1.4T?

    Running a big deficit in good times makes a huge deficit in bad times inevitable.

    James B. Shearer (e64877)

  283. James B. Shearer #282,

    I’m sure many people agree with you that the GOP did the best it could during the fiscal cliff negotiations, but isn’t it particularly important that the Speaker thinks he didn’t handle it well? Isn’t his hindsight more informed, and thus more valuable, than other’s?

    DRJ (a83b8b)

  284. Running a big deficit in good times makes a huge deficit in bad times inevitable.

    Comment by James B. Shearer (e64877) — 1/27/2013

    For the record, there were tons of conservatives saying this in the early to mid 2000s.

    It’s worth noting that the deficit really exploded in 2006, then exploded again in 2009. Democrats gaining negotiating power was the real reason.

    I do not believe that the deficits when the GOP held congress and the White House made our current situation inevitable at all. I do think the GOP should have balanced the budget, which would have given them credibility going forward. It was completely doable back then.

    Dustin (73fead)

  285. 286

    I’m sure many people agree with you that the GOP did the best it could during the fiscal cliff negotiations, but isn’t it particularly important that the Speaker thinks he didn’t handle it well? Isn’t his hindsight more informed, and thus more valuable, than other’s?

    Sure the Speaker’s opinion matters but taking what he (or any top level politician) says at face value is problematic (particulary when reported third hand). In any case the Speaker seems to be saying that his approach caused problems with his caucus during the process and not necessarily that a substantially better deal was obtainable.

    “You have no idea the suspicions and the undercurrents that it caused, frankly, a lot of my members,” Boehner said of his negotiations with Obama. “It really has, in fact, caused somewhat of a breach that I’ve been in the middle of trying to repair.”

    James B. Shearer (e64877)

  286. 287

    It’s worth noting that the deficit really exploded in 2006, then exploded again in 2009. Democrats gaining negotiating power was the real reason.

    The bad economy was a big part of the reason from 2009 on. Falling tax receipts in bad times naturally blow up the deficit.

    James B. Shearer (e64877)

  287. 286. Boehner comes off, as very disingenous, he purged Amash and Jones, off the committees precisely because they wouldn’t go off the cliff, like good lemmings,

    narciso (3fec35)

  288. “I don’t agree. Higher prices make it more difficult for everyone including the poor. If a true market creates incentives to create efficiencies, driving down costs, that benefits the poor. Your mistake lies in your apparent assumption that instituting free market reforms will not drive down prices. Maybe it won’t, but you can’t know that.”

    - Patterico

    I’ve also suggested a measure for decreasing costs. We haven’t discussed it. And what are the free market reforms that you have in mind, by the way – I haven’t clarified that yet.

    “There are many areas of life where occurrences that would be a minor or perhaps semi-major irritant for one household are a catastrophe for another. Having to replace the roof or air conditioning. A car crash totaling the car. A death in the family necessitating extraordinarily high-cost plane tickets for several family members. I could go on.”

    - Patterico

    I’m reluctant to add medical issues to that list. Some things are more important than others.

    “For someone who hates political parties as much as you do, I’m surprised at your faith in other areas of government. You consistently seem to assume that if there is a need, why then government must be the best way to meet it. I tend to assume the precise opposite.”

    - Patterico

    I’m a left-wing republican. My problem with the two political parties is that they keep people from having the say in government that is (theoretically) their birthright. Do you view trust-busting as a legitimate role of government, by the way?

    Leviticus (17b7a5)

  289. Note how Shearer ignores 2006 and forward spending by his leftist brethren.

    JD (b63a52)

  290. Trust-busting?

    JD (b63a52)

  291. Or the way, Obama opposed the raising of the debt ceiling that year, much like he voted against Stafford Act funding, and demagogued it, like he made that big speech against Iraq, in 2002, but voted for funding the first two years in the Senate, because his patron had interests in the area.

    narciso (3fec35)

  292. Leviticus and others : Have you even noticed that we have two medical systems operating. One system deals with medical services covered by insurance and the other with those medical service not covered by insurance. The costs of medical services covered by insurance keep increasing but the cost of the medical services not covered by insurance keep falling. Check it out, people. The unregulated free market in uninsured medical services means lower prices over time just as Ricardo stated in the Eighteenth Century.

    Michael M. Keohane (354329)

  293. Roland – What years were they on the ballot?

    Comment by daleyrocks (bf33e9) — 1/27/2013 @ 5:43 am

    Every year there has been an election. You can choose to vote for the people who ‘want to take away your medicare,’ or you can choose to vote against them.

    Everyone knows this. You know perfectly well which people I am talking about without me having to explain it further. Everyone knows who is on the side of those who want to do something to restrain entitlement spending and who is on the side of those who want to destroy us with profligate spending. Everyone who doesn’t have a serious mental dysfunction, that is, wherein they are unable to distinguish between different degrees of a thing.

    Politics is not about positions. Politics is about direction. It is not about where you think we ought to be. It is about which direction you think we ought to be going.

    Everyone who could vote in 1968 and could still vote in 2012 has had at least 23 chances to vote against them. Yet the Democrats dominate Washington. That is the way it is. Those are the voters. That is what they want.

    Pretending they have not chosen it is ridiculous.

    Roland (c4ee0b)

  294. “As long has people have little personal incentive to choose less expensive treatment options this rise in costs is likely to continue. But people on the whole don’t want to have to look for cheap doctors.”

    James B. Shearer – Congratulations for finally recognizing Patterico’s point in your first sentence above. As for the assertion in your second sentence, you have provided no evidence to support it. Seeking lower cost doctors is a lower cost treatment option and many people I know without health insurance actively shop around. The problem arises when the incentives to shop around are removed or minimized through low copays or annual individual or family deductibles because somebody else is paying rather than the consumer of the health care.

    daleyrocks (bf33e9)

  295. I am worried about the future but more because of peak oil and immigration than deficits. The deficit hawks would be more credible (with me at least) if they had worried about it as much when GWB was President.

    In regards to “peak oil,” who would have thought this was in our future?:

    Time.com, November 2012:

    Thanks to a burst of new shale oil production in states like North Dakota and Texas — as well as conservation measures like increased auto fuel efficiency — U.S. oil imports have been falling, with the country now bringing in just 20% of its energy from beyond its borders. And if the International Energy Agency’s (IEA) new World Energy Outlook is to be believed, the U.S. may be on its way to becoming the single biggest player in the global oil market. By around 2020, the IEA projects, the U.S. will be the world’s largest global oil producer, overtaking both Russia and Saudi Arabia. U.S. oil imports will keep falling, and by around 2030 North America as a whole will become a net oil exporter. From being the world’s biggest customer for oil, the U.S. could become the world’s biggest salesman.

    ^ Things like that is one reason why people, regardless of their politics, should be humble when predicting the future. I aim that comment squarely at myself too, because it wasn’t that long ago I was quite pessimistic about the US and oil vis a vie the Middle East. The non-linear nature of the future certainly needs to be kept in mind by those praying at the altar of Global Warming in particular and Do-Gooder Environmentalism in general.

    As for immigration, I’m not sure if I’m being overly pessimistic about the US’s future when it comes to the shape and role of our demographics–focusing on the impact of the “undocumented” from nations like Mexico. However, I come across information like the following and I can’t help but go “oh-oh.” After all, if more of the US becomes increasingly reminiscent of societies of Central or South America, will we end up with all the dysfunction and mediocrity associated with those places?

    scholarworks.umb.edu, April 2012: The academic achievement of Latino students has been a national concern for decades and the gap between White and Latino student achievement has not narrowed. Latino students now represent the largest and fastest-growing minority group in our nation’s schools. More than one in five students in K-12 are Latino (Hemphill & Vanneman, 2011).

    Nationally, scores on the National Assessment of Educational Progress (NAEP) math and reading tests have increased over the past two decades for both White and Latino students but the gap has stayed the same, even when scores are disaggregated by gender and, for the most part, by income (Hemphill & Vanneman, 2011). Research indicates that this achievement gap begins as early as pre-school, where Latinos are the least likely to be enrolled in preschool and to exhibit school readiness skills.

    This gap continues throughout the educational pipeline. In high school, Latino students are 2.5 times as likely as White students to drop out of school and twice as likely as Black students. An educational attainment gap is also apparent in the adult population, where Latinos have the highest proportion of adults who have earned less than a high school diploma and the lowest proportion who have attained a bachelor’s degree or higher.

    Over the past decade, while total student enrollment in both Boston Public Schools (BPS) — Massachusetts’ largest public school district — and the state as a whole has declined, the number of Latino students and proportion of Latino student enrollment have increased. In BPS, Latino students now constitute 43.0% student enrollment, representing the largest racial/ethnic group in the district.

    As for George W Bush and deficits, I’ve noted in the past that just about any big blunder of a Republican president has been when he has leaned left, when he’s allowed his inner-liberalism to get the better of him. That was true of Herbert Hoover in the 1930s, with his tax-and-spend policies that exacerbated the Great Stock Market crash of 1929, Richard Nixon from A to Z, Ronald Reagan and Iran-Contra, George Bush Sr and “read my lips…,” and, of course, his son, George W Bush and his “compassionate conservatism.”

    Now we have loony liberalism pouring out of every crevice imaginable, including from the big ears and other orifices of Barry Obama. So we’re drunk with the notion that health insurance should be full of self-entitled perks and features, or pretty much the opposite of catastrophic insurance.

    To be a happy, wonderful society, we need to demand that ObamaCare also provide us with free Internet service (because we must have every way possible of obtaining health-related information), free membership to 24-Hour Fitness, and free healthy items from Whole Foods. And maybe also free chocolate bars from Hershey, to lighten our mood as we worry about deductibles not being low enough ($50.00 is still too much!!) for healthcare.

    Mark (1c1145)

  296. “Every year there has been an election. You can choose to vote for the people who ‘want to take away your medicare,’ or you can choose to vote against them…………….

    Pretending they have not chosen it is ridiculous.”

    Roland – The only people saying they want to take away Medicare is Democrats making that claim about Republican plans for the future. Any other claim is ridiculous.

    If you view the Republican landslide in the 2010 mid-term elections as a referendum on Obamacare, why do we still have it?

    daleyrocks (bf33e9)

  297. Pretending they have not chosen it is ridiculous.

    I fully agree with that. After all, there is a REASON why Greece is Greece, France is France, Mexico is Mexico, Argentina is Argentina, Venezuela is Venezuela, Egypt is Egypt, South Africa is South Africa, and, closer to home, Detroit is Detroit (ie, urban America is urban America), and, in general, Obama’s America is Obama’s America.

    “The fault lies in our selves, dear Brutus, not in our stars…,”

    Mark (1c1145)

  298. Problem exists in a market (largely caused by govt interference)
    Govt campaigns against problem they created
    Govt creates new laws, regulations, and programs to fix problems previously created
    New laws, regulations, and programs caused new foreseeable and unforseeable problems.
    Wash, rinse, repeat.

    JD (b63a52)

  299. Well it’s a little more conplicated then Mark, Greece has vacilated between the regime of Metaxas on the far right and Papandreou on the left, the former as with the Colonels a generation later, focused on those traditional values, although they were more autarchic economically,

    narciso (3fec35)

  300. 299

    If you view the Republican landslide in the 2010 mid-term elections as a referendum on Obamacare, why do we still have it?

    Because it takes more than the House to get things done in DC. The Republicans didn’t do all that well in the Senate in 2010 and then did poorly overall in 2012.

    Of course Romney wasn’t well positioned to make the case against Obamacare but the Republican Presidential field was weak in general.

    James B. Shearer (e64877)

  301. Also France’s leading party, the Radicals were much more freemarket although more socially liberal, the Depression ushered in the Popular front, and also seeded the roots of the Petain counterrevolution,

    narciso (3fec35)

  302. Roland – The only people saying they want to take away Medicare is Democrats making that claim about Republican plans for the future. Any other claim is ridiculous.

    Yes, and the only people saying the other side wants to destroy us with profligate spending are Republicans. I was giving the hyperbole from both sides, hyperbole with which every voter is familiar.

    If you view the Republican landslide in the 2010 mid-term elections as a referendum on Obamacare, why do we still have it?

    Comment by daleyrocks (bf33e9) — 1/27/2013 @ 8:41 am

    Every election is a referendum regarding how our government has governed. Obamacare passed before the 2010 election. The people voted against it. Then they turned around and voted for it in 2012.

    Of course they are voting for and against a great many things in any particular election, but 23 different major votes since Medicare is way beyond definitive.

    Roland (c4ee0b)

  303. “I fully agree with that.”

    Mark – Of course, because the asinine point Roland is trying to make is that every election is a single issue election about entitlements, whereas the original point made was rebutting Leviticus’s claim that the American people as opposed to Congress voted for the entitlement programs in the 1960s. Completely different points.

    If Roland would like to point out candidates who ran exclusively on a platform of eliminating entitlement programs, he might have a point. Otherwise, he is comparing apples with oranges.

    daleyrocks (bf33e9)

  304. “Every election is a referendum regarding how our government has governed. Obamacare passed before the 2010 election. The people voted against it. Then they turned around and voted for it in 2012.”

    Roland – Obamacare was as unpopular in 2012 as it was in 2010 I believe. That’s why your approach of pulling a single issue out of the pile from year to year and saying voters were for or against it falls down. There is general agreement that Democrats favor bigger government than Republicans, but my original point to Leviticus stands, that the entitlement programs he referenced were not put to a yea or nay vote of the American people and since that time I am unaware of national candidates running on a platform of completely eliminating them. My objections were to Leviticus using the “royal we.”

    daleyrocks (bf33e9)

  305. Roland – Obamacare was as unpopular in 2012 as it was in 2010 I believe. That’s why your approach of pulling a single issue out of the pile from year to year and saying voters were for or against it falls down.

    I did not say from year to year. I was speaking of a long series of votes.

    We could have cancelled Obamacare. We chose not to do so. You can say it was not the overriding issue in the election, but that does not change the fact the People had a chance to vote it down by defeating Democrats. They still can.

    Again, as I said at the start, pretending they have not chosen Medicare is ridiculous.

    Roland (c4ee0b)

  306. Again, as I said at the start, pretending they have not chosen Medicare is ridiculous.

    Comment by Roland (c4ee0b) — 1/27/2013 @ 9:29 am

    BTW, I despise Medicare. I despised it even when I was a young leftwing Democrat who had not yet figured out the Republicans were not greedy rich people of ill will. Medicare is a grossly obvious society destroyer.

    Roland (c4ee0b)

  307. Has Shearer pointed to a govt solution that has decreased prices, increased access, and increased efficiencies?

    JD (134f7b)

  308. Leviticus and others : Have you even noticed that we have two medical systems operating. One system deals with medical services covered by insurance and the other with those medical service not covered by insurance. The costs of medical services covered by insurance keep increasing but the cost of the medical services not covered by insurance keep falling. Check it out, people. The unregulated free market in uninsured medical services means lower prices over time just as Ricardo stated in the Eighteenth Century.

    Comment by Michael M. Keohane (354329) — 1/27/2013 @ 8:30 am

    Yes!!! I’ve been saying since 1994 that we should go with a catastrophic care only insurance system. The price of uninsured services keep going down. If we had to pay for the first big chunk of health services out of pocket we’d be much more careful about healthcare spending and it would create competition which would drive down costs just as it has i medical services not covered by insurance.

    Tanny O'Haley (12193c)

  309. 310.Has Shearer pointed to a govt solution that has decreased prices, increased access, and increased efficiencies?

    Comment by JD (134f7b) — 1/27/2013 @ 9:35 am

    Or anyone?????????????

    Also can anyone look to a program other than a tax cut that enthused a non-recipient?

    EPWJ (e83e82)

  310. One of the main things I learned in my economics classes is that the economy and the “market” is complex beyond comprehension.

    Statement were always qualified with “all other things being equal” but of course, my professors always let us know that “all other things weren’t equal very long” because every change rippled through the system causing enormous changes that is simply too complex to model.

    But arrogant progressives believe they can figure out the market. Obama and his pals are really like Cnut the Great standing in the surf and ordering the tide not to rise. Obama already told us he could do this 5 years ago and yet people still voted for the arrogant clown…

    WarEagle82 (97b777)

  311. Are people really still talking about “peak oil?” Seriously?

    Sure, we have tapped out some fields. But we keep finding enormous new fields all over the world. And we know about enormous fields all over the world that we cant exploit largely because of politics and government regulation.

    “Peak oil” is a political condition and not a scientific or economic one…

    WarEagle82 (97b777)

  312. “Every election is a referendum regarding how our government has governed. Obamacare passed before the 2010 election. The people voted against it. Then they turned around and voted for it in 2012.

    Nonsense Roland. Your assertion is silly. Almost no Democrats ran on Obamacare during 2012.

    SPQR (768505)

  313. Nonsense Roland. Your assertion is silly. Almost no Democrats ran on Obamacare during 2012.

    Comment by SPQR (768505) — 1/27/2013 @ 10:43 am

    Of course they did. They voted for it, and they failed to repent their votes and promise to undo the damage.

    The People got their chance to register their displeasure with it. They will get dozens of more chances over the coming decades, just as they’ve had with Medicare.

    If the People are so incredibly thick they fail to understand what they are voting for, that would be an entirely different issue.

    Roland (c4ee0b)

  314. It’s not my intent to re-engage anybody on a brief turn that a few of us on this thread took last night (away from economics and into gun registration issues).

    But for those who say PR and optics are not important, and that we must keep the public focused on a debate about core principle and the second amendment, here is the headline on page three of this morning’s Trib:

    ******THE LANGUAGE OF GUNS******

    The reporter, Mark Jacob, tells us that the phrase “gun control” is rapidly disappearing from the debate– being forcibly jettisoned by the very people who have been loudly pushing gun control for years. Here from the article:

    “Initiatives are now described as attempts to promote ‘gun safety’ or prevent ‘criminal access to guns’ or to pass ‘gun violence legislation’.

    “…Mayor Rahm Emanuel who has a master’s degree in communication from Northwestern University urged gun reform activists to make sure their pitch empahasizes the war on crime. ‘It’s all about criminal access,’ Emanuel said, ‘It’s not about gun control. It’s about criminal access. That changes the debate.”

    Jacob goes on to point out that last week when VP Biden was asked a question about gun control he demurred by saying he doesn’t consider it gun control but rather as “gun safety”.

    Final important excerpt: “Jonathan Schuldt, assistant professor….Cornell University noted that most all Americans care deeply for personal freedom, making ‘gun control’ a word that evokes government regulation and may have negative connotations to many. ‘It’s really easy to justify why one is against ‘control’, he`said, ‘But it’s way harder to to be against ‘safety’.”

    It’s a battle of semantics and rhetoric. It’s why I believe we’ve got to play smarter and adapt our language and tactics in order to save our core principles. Jacob ends the article by saying that the new language of the left leans closer to, and at least to the casual observer doesn’t sound much different from the right’s old bumnper sticker, “Guns don’t kill people–people do”.

    elissa (f1f945)

  315. “I did not say from year to year. I was speaking of a long series of votes.”

    Roland – Unless you are a psychic, you had no idea of the intended meaning of my words. You are flailing around and attempting to give them a completely different meaning than intended while making an impossible to defend point.

    Please explain how Lyndon Johnson chose not to run for reelection based upon Medicare and Medicaid and how Nixon defeated Humphrey because of the same programs. I’ll wait.

    daleyrocks (bf33e9)

  316. Greece has vacilated between the regime of Metaxas on the far right and Papandreou on the left

    Narcisco, I know that history goes in cycles, and that many people can be ideologically schizophrenic. But my impression is that the idiocy of feel-good liberalism is so pervasive in just about all of us (eg, conservatives/Republicans who have a soft spot in their heart for the idea of same-sex marriage), that unless a conservative regime is truly long-lasting and fully represented, it’s influence in the long run will be negligible.

    I believe you’ve also cited that Mexico’s presidency over the past several years has been in the hands of that country’s version of the US Republican Party, and therefore isn’t necessarily tilted way to the left. But that’s similar to saying California also isn’t tilted in a loony-liberal way because Arnold Schwarzenegger was the governor a short while ago, and before him, Republicans George Deukmejian and then Pete Wilson occupied the governor’s office.

    BTW, I was surprised to learn that Sacramento was not much less one-party berserk in Deukmejian’s time (1983 to 1991) than it is today. Deukmejian had to deal with a legislature whose voting majority was of the left. For some reason, I originally believed the state’s House and Assembly over 20 years ago were at least split between the two parties. I guess I wasn’t quite as alarmed and sickened by just how corrupt (philosophically and otherwise) the left was back then.

    the asinine point Roland is trying to make is that every election is a single issue election about entitlements, whereas the original point made was rebutting Leviticus’s claim that the American people as opposed to Congress voted for the entitlement programs in the 1960s. Completely different points.

    daleyrocks, I certainly don’t think a good number of voters, in any year, are single-issue devotees, and a large portion of the electorate in general is only vaguely aware of what their representatives — at the local, state and federal levels — are doing in specific, detailed terms. But I do think foolish liberal impulses in most humans do make them intrinsically more likely to give greater benefit of the doubt to liberals, no matter how foolish and scroungy they are, compared with a variety of conservatives. That’s why Hillary “Sniper-Fire” Clinton (of “what difference does it make!” notoriety) is able to generate higher poll ratings than, for example, a woman like Sarah Palin.

    From this, you end up with, as another example, an ultra-liberal analogous to the woman currently in charge of Argentina, and who’s running it straight into the ground.

    Mark (1c1145)

  317. You cannot forget how Menem’s successors really botched the privatization efforts, particularly that of Dela Rua and Duhalde, in how the Kirchners have held on to power,

    narciso (3fec35)

  318. Please explain how Lyndon Johnson chose not to run for reelection based upon Medicare and Medicaid and how Nixon defeated Humphrey because of the same programs. I’ll wait.

    Comment by daleyrocks (bf33e9) — 1/27/2013 @ 10:58 am

    I fail to see how you cannot understand that when People reelect the people and party who gave them a major, society altering policy, and then the People do that over and over and over while the people who voted for the policy trumpet their policy year after year after year, that somehow the People have not voted ‘for’ the policy.

    Roland (c4ee0b)

  319. “They will get dozens of more chances over the coming decades, just as they’ve had with Medicare.”

    Roland – I’ll ask again. When have the American people had the opportunity to vote on a platform of eliminating entitlement programs? Your premise is false. The choices presented have been between big and bigger.

    daleyrocks (bf33e9)

  320. “I fail to see how you cannot understand that when People reelect the people and party who gave them a major, society altering policy”

    Roland – Maybe you or your theory are stupid?

    daleyrocks (bf33e9)

  321. The larger point is they seem to reward that faction, that is more irresponsible with said programs,

    narciso (3fec35)

  322. Roland – I’ll ask again. When have the American people had the opportunity to vote on a platform of eliminating entitlement programs? Your premise is false. The choices presented have been between big and bigger.

    Comment by daleyrocks (bf33e9) — 1/27/2013 @ 11:10 am

    As I have said, they have had the choice in every single election where they got to choose between a Democrat and a Republican. Again, every voter knows which party is which on this issue.

    Roland (c4ee0b)

  323. Roland – Maybe you or your theory are stupid?

    Comment by daleyrocks (bf33e9) — 1/27/2013 @ 11:12 am

    Or perhaps you suffer from the kind of mental dysfunction that keeps so many people from understanding evolution.

    Roland (c4ee0b)

  324. ==Again, every voter knows which party is which on this issue==

    I’m afraid I might have to challenge you on that one, Roland. First, it’s not clear from election to election what “this issue” is. Candidates from both parties shy away from putting specifics about real or controversial proposals in writing. Bills are regularly passed in congress without having been read. Plus-have you ever listened to any of the “man on the street” interviews where clueless people who say they vote, often don’t know who’s running, who their critter is, or what their positions are?

    elissa (f1f945)

  325. I’m afraid I might have to challenge you on that one, Roland.

    If you want to float the theory that the People are dumber than rocks and have no idea what they are doing, well, sure.

    However, that would be an argument that if the People understood a bit better, then they would be even more Democrat and more anti-Republican, since the idiot element tends to be more easily demagogued.

    Roland (c4ee0b)

  326. Thank you for straightening me out by responding to all my specific points, Roland.

    elissa (f1f945)

  327. 310.Has Shearer pointed to a govt solution that has decreased prices, increased access, and increased efficiencies?

    How about the interstate highway system?

    James B. Shearer (e64877)

  328. Comment by elissa (f1f945) — 1/27/2013 @ 10:56 am

    And there is this from the President…..
    http://www.foxnews.com/politics/2013/01/27/obama-gun-control-advocates-should-listen-more/?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+foxnews%2Fpolitics+%28Internal+-+Politics+-+Text%29

    …except, when he (and the headline) say “gun-control advocates” he’s talking about 2nd-A defenders.
    Summary: It is the Republicans’ fault for not listening to the sentiments of the vast-majority, as framed by the media.

    askeptic (2bb434)

  329. 312

    Also can anyone look to a program other than a tax cut that enthused a non-recipient?

    Happens all the time. Lots of people favor things like the space program without directly benefiting.

    Of course part of this is that lots of people think the government has unlimited funds.

    James B. Shearer (e64877)

  330. Comment by Mark (1c1145) — 1/27/2013 @ 10:58 am

    CA’s legislature has been controlled by The Left since Big Daddy got it changed to a full-time legislature. That gave the apparatchiks a career path, while the mostly conservative Republicans still had their businesses to tend to, and we lost our first-tier of politicians to their economic concerns, opening the GOP ranks to a lessor quality of candidate (Dem-lite).

    askeptic (2bb434)

  331. We know his record at the Joyce Foundation, his bill banning a gun store, anywhere within the Chicago city limits, we hear you, we just know you speak with ‘forked tongue’

    narciso (3fec35)

  332. 329.Thank you for straightening me out by responding to all my specific points, Roland.

    Elissa, I thought my general response covered all of your specific points, but if you’re going to snark ….

    I’m afraid I might have to challenge you on that one, Roland. First, it’s not clear from election to election what “this issue” is.

    From election to election it is not about one specific issue. As narciso pointed out, it is about who gets rewarded with more votes and who gets punished with fewer.

    Candidates from both parties shy away from putting specifics about real or controversial proposals in writing.

    This is the way our political system has always worked. Both sides play to the middle. You have to pay attention to what each candidate says and does in terms of the direction they favor in comparison to their opponent. Both extremes should always be outraged at being sold out by their candidates. That is what is supposed to happen.

    Bills are regularly passed in congress without having been read.

    And that is outrageous. I wonder which party has been the biggest offender at doing that?

    Plus-have you ever listened to any of the “man on the street” interviews where clueless people who say they vote, often don’t know who’s running, who their critter is, or what their positions are?

    That’s the part I already addressed.

    Roland (c4ee0b)

  333. However, that would be an argument that if the People understood a bit better, then they would be even more Democrat and more anti-Republican, since the idiot element tends to be more easily demagogued.

    Based on that, you’re making a point that I agree with. Liberal sentiment in humans is quite ingrained, quite far reaching, and easily very, very idiotic.

    I can think of so many issues and situations where the concept of “you reap what you sow” should be directed at liberals and liberalism (perhaps clinically devoid of common sense), far fewer issues and situations where the same thing applies to conservatives and conservatism.

    Mark (1c1145)

  334. Comment by Roland (c4ee0b) — 1/27/2013 @ 11:18 am

    The only national GOP candidate that ran on repealing parts of The New Deal (and subsequently, The Great Society) since Ike, was Barry Goldwater in ’64. That did not turn out well, and allowed LBJ to pass all of his GS programs, and the GOP has been snake-bit ever since.

    askeptic (2bb434)

  335. How about the interstate highway system?

    Really? The government builds roads cheaper and more efficiently than the private sector? You didn’t build that!

    JD (b63a52)

  336. 310.Has Shearer pointed to a govt solution that has decreased prices, increased access, and increased efficiencies?

    How about the interstate highway system?

    Comment by James B. Shearer (e64877) — 1/27/2013 @ 11:43 am

    In 1994 when we had a large earthquake in So Cal. A private company rebuilt the 10 in record time and below cost. The government took years to rebuild the interstate and came in above cost. So no.

    Tanny O'Haley (9599bd)

  337. CA’s legislature has been controlled by The Left since Big Daddy got it changed to a full-time legislature.

    The “Golden State” is so beautifully, wonderfully progressive — politically and culturally — that a peaceful, happy, heavenly aura hovers over it. Public school textbooks now are mandated to talk about GLBT people throughout history, so tolerance and diversity in general truly are settling over the land like a magic rainbow. That’s why it’s puzzling that both California’s and Los Angeles’s population growth rate is lower now than at any time in over 100 years.

    How can that be? After all, we’re nirvana, baby, a slice of progressive heaven in a world that has experienced decades of feel-good liberalism.

    latimes.com via drudgereport.com:

    The attacks on the family are the latest in a series of violent incidents in which Latino gangs targeted blacks in parts of greater Los Angeles over the last decade. Compton, with a population of about 97,000, was predominantly black for many years. It is now 65% Latino and 33% black, according to the 2010 U.S. census. But it’s not only historically black areas that have been targeted.

    Federal authorities have alleged in several indictments in the last decade that the Mexican Mafia prison gang has ordered street gangs under its control to attack African Americans. Federal authorities have alleged in several indictments in the last decade that the Mexican Mafia prison gang has ordered street gangs under its control to attack African Americans. Leaders of the Azusa 13 gang were sentenced to lengthy prison terms earlier this month for leading a policy of attacking African American residents and expelling them from the town.

    Similar attacks have taken place in Harbor Gateway, Highland Park, Pacoima, San Bernardino, Canoga Park and Wilmington, among other places.

    ^ The comment section to that article at latimes.com are full of postings that have a Twilight-Zoneish-quality in this era of Obama-liberalism gone berserk. That’s because California right now to me has glints of Egypt after the fall of Hosni Mubarak in 2011 or Iran after the fall of the Shah in the 1970s. So while many liberals (then and now) cheer and joyfully believe “happy days are here again!,” another concept needs to be directed their way: “Be careful what you wish for, because you just might get it.”

    Mark (1c1145)

  338. The people in charge in chicago like to make The Criminal the center of public policy as opposed to worrying about how normal real people are supposed to get safely through their day.

    Rahm thinks piggy piggy union thug corrupt chicago cops are the people his heavily-victimized citizens should look to for safety.

    How’s that working for you, citizens?

    Me I still think that passing laws in reaction to hysteria whipped up by cable news propaganda whores is not something we want to be in the habit of doing. Why because it empowers the propaganda sluts like the Erin Burnett and Carol the morning news crone and the Piers Morgan at the expense of empowering the real people in chicago who are the daily victims of violent criminals.

    So I think we can hold off on more stupid background checkings and what have you. Even if that means a squishy enfeebled loser like Mark Kirk has to get a new job somewhere.

    happyfeet (ce327d)

  339. ==As I have said, they have had the choice in every single election where they got to choose between a Democrat and a Republican. Again, every voter knows which party is which on this issue.==

    ==From election to election it is not about one specific issue. As narciso pointed out, it is about who gets rewarded with more votes and who gets punished with fewer.==

    Roland, If you look closely and think about it very deeply you may find an inherent flaw of logic in these two contradictory statements which you made on this very thread this morning.

    elissa (f1f945)

  340. it’s a tough issue cause it’s not as if a Team R decision to come out in support for propaganda slut gun laws could make me more disgusted with Team R

    I would still mostly just be waiting for their next porky porky chris christie spending orgy or their next eruption of weirdo lifeydoodle rape baby philosophizings or their next compulsive and ritual bout of anti-gay bigotry before I were moved to get super-excited I think.

    You have to pick your battles with these losers.

    happyfeet (ce327d)

  341. They are not contradictory at all, elissa. One refers to what every voter knows, while the other refers to what the election is about.

    All elections are about multiple issues. However, a major issue that is popular with the voters will have a huge effect over time, garnering large numbers of votes for its proponents every election. Unpopular positions will be punished with fewer votes over and over and over until the victims of the punishment will be reluctant to embrace the unpopular position at all ….. as in the way Republicans are so skittish about addressing entitlement reform.

    Roland (c4ee0b)

  342. How many republican senators you got in Cali, Mr. Feets? If its all the same to you I think we’ll prolly try to hang on to “squishy” Republican Sen. Kirk in blue IL. instead of enabling and enduring another Sen. Obama like senator. Thanks

    elissa (f1f945)

  343. it’s your call I just would note that your squish has fallen in with a very disreputable crowd of fascist mikey bloomberg types

    happyfeet (ce327d)

  344. Part of the problem is that humans are susceptible to hubris.
    Every economist is smarter than the ones before him/her.
    Spending ones way out of recession has failed before but saying: “I know a better way. I’ve studied their mistakes and my plan will make this work” in a charismatic and persuasive presentation can carry the day.

    But we need a little of that even in the hard sciences. It is how breakthroughs happen; it is how current climate science absolutes will be tomorrows disgrace.

    The problem comes when a very unwise young king surrounds himself with the people he was taught were the smartest. The unwise young king has taken their advise and filled his court with persons of extensive academic pedigree who are indulging themselves in a socioeconomic experiment. The unwise king has no experience that would warn him if this all is wise or unwise… he has lived the life of a prince and couldn’t figure out how to make money selling ammo at a gun show.

    SteveG (831214)

  345. Roland–Your “everybody knows what the parties stand for”, “every election’s a policy referendum” BS positions do not hold up, at least partly because it does not account for a candidate’s personality and many other extraneous factors which often influence an electorate to a greater degree than “punishing” or “rewarding” policy. (Just for example, the numbers of people of normally left persuasion who voted for Bush because he seemed normal and decent and a leader– instead of Kerry whom they saw as elitist, vacuous traitorous. Or the right leaning folks who voted for Obama in 2008 because he was half black and it seemed like a way to particpate in an historic “healing” election.)

    elissa (f1f945)

  346. California is lost lost lost to middle earth btw elissa it’s like mordor with boob jobs

    happyfeet (ce327d)

  347. you know who could make a valuable contribution to this discussion elissa?

    Mr. Karl.

    He knows politics like cookie monster knows cookies plus he has a lot of insight into Chicago specifically.

    I hope he’s ok he’s been very much in absence.

    happyfeet (ce327d)

  348. 348.Roland–Your “everybody knows what the parties stand for”, “every election’s a policy referendum” BS positions do not hold up….

    Sure they do. There is this thing called “representative democracy” that is based on the process I have been talking about.

    Roland (c4ee0b)

  349. “From election to election it is not about one specific issue.”

    Roland – Then how can you say there have been 23 chances since Medicare and Medicaid were enacted for the American people to vote on it?

    You cannot even point to one election when there was a platform to eliminate the programs. All you keep doing is doubling down on stupid.

    If you want to make a different and unprovable or disprovable point than I was making with Leviticus, that’s fine. I don’t give a crap. Just don’t keep pretending it’s the same.

    daleyrocks (bf33e9)

  350. Roland – Then how can you say there have been 23 chances since Medicare and Medicaid were enacted for the American people to vote on it?

    You obviously don’t understand representative democracy. The People could have punished the supporters of Medicare 23 times. They have had 23 chances to do it. Many did try to punish them. Most did not. So we still have Medicare, and we still have it in its stunningly destructive form.

    That is how representative democracy works. The failure of so many of you here to understand something so incredibly basic is truly bizarre.

    Roland (c4ee0b)

  351. Roland, your argument gets only more comical the more you repeat it. Not least when you intentionally ignore the fact that the Democrats worked hard to make 2012 not be about Obamacare.

    SPQR (4a49a0)

  352. daley–I hope Roland is a football fan. It will give him a somewhat graceful way to exit this discussion.

    elissa (f1f945)

  353. 354.Roland, your argument gets only more comical the more you repeat it. Not least when you intentionally ignore the fact that the Democrats worked hard to make 2012 not be about Obamacare.

    Comment by SPQR (4a49a0) — 1/27/2013 @ 1:31 pm

    And now you guys swing back to the “they didn’t claim it” argument, even though everyone knows they did it.

    Okay, elissa et al. I’m not a football fan, but I know I’m arguing with people who are not actually listening to what I am saying, so have a nice day.

    Roland (c4ee0b)

  354. Roland, “everyone knows” …

    as I said, more comedic by the comment.

    SPQR (4a49a0)

  355. They couldn’t defend O-care, which is why they set out from the get-go to destroy Mitt, because they knew with R-care in his background, he wouldn’t dare attack O on the PPACA.

    askeptic (2bb434)

  356. I cannot recall the last time any candidate ran on a platform of repealing MediCare. In the generic were Roland making the case that Team R is generally more likely to wish to attempt to reform the system, and Team D more likely to spend and demagogue, then I would agree with him.

    JD (b63a52)

  357. I’ve also suggested a measure for decreasing costs. We haven’t discussed it. And what are the free market reforms that you have in mind, by the way – I haven’t clarified that yet.

    Co pays? We have discussed it a little bit. Making people bear the financial consequences of their choices drives down cost. You want to do that a little, with co pays. I want to do it all the way, with free market reforms. What free market reforms? Ideally, get the government out of health care entirely. Less ambitiously, gradually means test Medicare until it is folded into Medicaid and is a tiny program. Repeal ObamaCare.

    I’m reluctant to add medical issues to that list. Some things are more important than others.

    Now we’re getting to the meat of it.

    I was giving a list of situations where occurrences are catastrophic for one household and non-catastrophic for another. I am going to make a stab at interpreting your Delphic comment. You’re not disagreeing that these occurrences are catastrophic for one household and not for another. You’re just making the well-worn argument that “health care is different.”

    Which I think means: we can do without a car or air conditioning or plane flights. But if we don’t have our health we have nothing. It is far more important than other things we can pay money for.

    Meaning, apparently, we can’t leave it to the free market.

    That’s not true, of course — as the example of food shows. More on that below. But for now let’s pretend, counterfactually, that health care is the single thing in the world more important than anything else we pay money for.

    The laws of supply and demand apply to health care just like they do with any other economic area. Why do we think we need government involvement in health care just because it’s “important” or “different”?

    James B. Shearer implies that before Medicare people died at a younger age, as if Medicare is responsible for our longevity. He might want to consult the history books and see when the polio vaccine and penicillin began to radically improve our heath. Hint: Medicare is not responsible. Before Medicare, we were steadily getting healthier all the time.

    Remember my food example? Food insurance at a grocery store would cause food prices to skyrocket. Co pays would minimize that but they are simply a less effective substitute for a free market. WE WILL DIE WITHOUT FOOD!!!! Why, then, do we not have a system of food insurance? Where all your purchases at the market are covered by your food insurance plan?

    If we had such a system, I am confident the increased demand would cause food prices to rise. Basic supply and demand, which is a concept that is provable through repeated observation in various contexts.

    Do rich people get better health care? They probably do. They get better everything. If Bill Gates could buy a $50 million dollar solution to a serious health care problem — say his leg is chopped off and he wants a bionic leg — does that mean every citizen has a consitutional right to a bionic leg? Because equality! If you say yes, let’s stop talking now because you are totally unrealistic.

    If you agree the answer is no, then you are agreeing that, like every resource in the world, health care resources are scarce. They must be allocated in the most efficient manner possible, like all other resources. And in general, markets and prices allocate resources more efficiently than Platonic wise men.

    This does leave poor people in a bind. Society has a responsibility to ensure that its citizens are not dying unnecessarily when basic nonextraordinary health care could save them. The questions are : 1) is government the best entity to handle that responsibility, or is charity? and 2) what are the parameters of that responsibility?

    These things could be debated. But instead, we have a society that answers: 1) government will handle everything, 2) government will handle everything, and 3) you didn’t ask, but we’re not restricting that to poor people. We’ll make everyone pay into Medicare so they feel they have a right to have the government handle it — even if they’re rich.

    And then prices skyrocket for EVERYBODY. And, as government always does, it rushes in with MORE regulation to solve a problem it caused.

    Leviticus, the central point of the book I have sent you is that 1) economics is the study of allocating scarce resources, 2) all resources are scarce, and 3) markets and prices are generally the best way to allocate scarce resources, because individuals making choices for themselves is a) the only economic system compatible with freedom and b) the more efficient system, because it allows the collective knowledge of all market participants to affect the allocation of resources through the magic of prices.

    Patterico (8b3905)

  358. I can’t even recall an election where MediCare was the top priority for voters, much less candidates. Top 3?

    JD (b63a52)

  359. kelsie was an energy voter I remember

    for sure she didn’t even mention medicare

    happyfeet (ce327d)

  360. “Why, then, do we not have a system of food insurance? Where all your purchases at the market are covered by your food insurance plan? If we had such a system, I am confident the increased demand would cause food prices to rise.”

    - Patterico

    We do have such a system. It’s called SNAP. It functions as a food insurance system for the very poor. (I know it’s not exactly the same, but the difference is ultimately one of scale. The principle is the same.).

    You’re saying we should be focusing on maximizing one value: efficiency. There are certain lines I’m not willing to cross in the pursuit of efficiency. There are other values that have to counterbalance efficiency from time to time. One of those values is mercy.

    Leviticus (17b7a5)

  361. it’s really called food stamps they just changed the name to SNAP cause of the stigma attached to food stamps, but it’s the same thing

    happyfeet (ce327d)

  362. The scale difference is but one of many gigantic differences.

    JD (b63a52)

  363. I think it’s a huuuuge stretch to put food stamps in the category of “insurance” as insurance is historically known and understood in commerce. No, I don’t think the principle is even remotely the same. But Leviticus’ comment helps clarify one thing. I see why we can’t seem to have rational discussion about this right here if clearly we are not all on the same page about what insurance is, is not, how it is actuarially funded and rated, and what it is structually set up to do.

    elissa (f1f945)

  364. Food stamps allow people to pay a flat premium and them select whatever quantity they like of any food they like regardless of price??

    Come on, Leviticus. I am on a phone right now and really don’t want to waste my time. If that is how food stamps work, I am shocked. If it’s not, you’re wasting my time by bringing it up.

    Patterico (879b60)

  365. The scale difference is but one of many gigantic differences.

    No kidding.

    Do I really have to re-explain that I am talking about price sensitivity caused by reaction of the payer to price signals?

    Really?

    Patterico (6b7e88)

  366. In other words I am completely agreeing with your point, JD, and wondering how many times we have to make it.

    Patterico (6b7e88)

  367. elissa,

    Citing food stamps as insurance of the type I described in my example suggests that the point I was trying to make with that example did not get across, at all.

    Patterico (6b7e88)

  368. You’re saying we should be focusing on maximizing one value: efficiency. There are certain lines I’m not willing to cross in the pursuit of efficiency. There are other values that have to counterbalance efficiency from time to time. One of those values is mercy.

    If the economy collapses, the demand for mercy will far exceed the supply.

    I’m throwing my hands up now. What is your proposed solution? Raising taxes 50 percent on everyone? What do you propose that would make the numbers work???

    Patterico (1a103d)

  369. L. –Just curious. Are any of your college buddies getting food stamp assistance that you know of? Are they “very poor”? Do they need mercy? Are any of their parents well off and/or helping with tuition and housing? Do any of them already have meal plans in dorms or college apartments? Are the kids “very poor” only because they are in school right now instead of working and can prove they earn no W2 income or a very small income? When and why did colleges start encouraging and “helping” students to sign up for food stamps? It sure wasn’t done in “my day.” This student SNAP scam has been big news in Cali and elsewhere and it’s easy to google articles about the abuses. I remember the WSJ had a particularly well researched one. As Mr. Feets regularly points out, SNAP signups have skyrocketed under the Obama admin which changed some eligibility rules. Even if you don’t personally know any student food stamp users do you think it is generally what the program was set up to do and is a worthy use of taxpayer money?

    That’s all my questions for now. :)

    elissa (f1f945)

  370. I don get why we would means test. The rest seems to be self evident.

    You all have bad intentions and want people to die or starve.

    JD (134f7b)

  371. Please ignore my grumpiness, Leviticus.

    JD: I don’t want government to di any of this, but if it does I want it to do less, hence the means testing as a stopgap.

    Patterico (1a103d)

  372. One of the pernicious evils that has infected our society and causes a large amount of destruction to the financial wellbeing of young people is the idea that college students are entitled to a middle class lifestyle while attending college.

    SPQR (768505)

  373. means testing is the most depressing concept since checked bag fees

    happyfeet (ce327d)

  374. “If that is how food stamps work, I am shocked. If it’s not, you’re wasting my time by bringing it up.”

    - Patterico

    What I meant by “the principle is the same” is that SNAP is a market-inefficient program implemented as a concession to other values. It’s obviously not “insurance” the way health insurance is “insurance.” Food stamps obviously don’t allow people to pay a flat premium and them select whatever quantity they like of any food they like regardless of price. But they serve as a buffer between the poorest members of society and the free market that tells them TS. In that sense, I don’t think it’s ridiculous to think of them as insurance – particularly when I slap a fat disclaimer on the claim.

    I only mean for the parallel to suggest (another) possible middle-ground solution. What if we handled healthcare for the poor the way we handle food for the poor? Health Stamps, essentially. It would cap use of healthcare services and prevent the sort of no-skin-in-the-game abuses of access that drive up healthcare costs. Abolish Medicare/Medicaid and fund Supplemental Healthcare Assistance Program.

    Lastly, I have repeatedly put forth co-pays as a response to your concerns about “price sensitivity caused by reaction of the payer to price signals.” I don’t think it’s fair to suggest that I’m not arguing in good faith when my most straight-forward suggestion directly addresses your most immediate concern.

    Leviticus (17b7a5)

  375. Doctor Shortage Could Cause Health Care Crash

    hey lookit i found one of them price signal thingies

    happyfeet (ce327d)

  376. Means testing is institutionalized progressivism and redistribution all wrapped up in a bow of good intentions.

    JD (134f7b)

  377. Well they can’t means test, pikachu, because they need the monies from the 1% for the spendings.

    narciso (3fec35)

  378. so so many of the people what will get their greedy codger asses means tested after age 60 scrimped and saved and invested slowly slowly to get to that point

    these are the people food stamp wants to punish

    he’s a right dick I think

    happyfeet (ce327d)

  379. The idea that the quality of care and access to care isn’t going to decline is nonsensical. It is already terribly difficult to get to see many specialists. I frequently have to wait a month to see a GP. Getting seen in an ER is now a nightmare!

    There are already doctor and nurse shortages in the nation. And many health care professionals are considering leaving the field because of Obamacare.

    Adding tens of millions of people to health care roles is not going to improve any of these facts. But Obama and his ilk truly believe they can legislate away the facts of supply and demand. They are ideologues and idiots.

    Do you best not to get sick for the next four years…

    WarEagle82 (97b777)

  380. if there ever comes a time guns n gates no longer hold me in

    I’m moving to georgia

    happyfeet (ce327d)

  381. 330. The Minneapolis I-35 bridge that collapsed was MN-DOT designed. Two others were hastily replaced.

    A German outfit handled the Mpls replacement.

    Things go better for us when the government stays out of the nitty gritty in details.

    gary gulrud (dd7d4e)

  382. 276. “Cheap doctors”

    Actually, Medicare patients are already finding a dearth of doctors who will see them. Cheap, I don’t mind so much, crappy, way.

    287. Federal government spending is known to generate 42 cents of economic activity for our dollar. It is malinvestment of a scarce free market resource.

    Seriously don’t you have a garage to clean, or toenails in need of a trim?

    gary gulrud (dd7d4e)

  383. And what I say is, no, even if this happens to be President Carter, trained as a nuclear engineer, even if you know nuclear physics, for the President to sit there and begin debating the empirically validated laws of physics with his physics advisor is kind of foolish. On the other hand, not debating the historian, not bringing in different historians of different points of view, talking to people who have lived in Iran, personal introspection about human motivations, would be equally foolish.

    I’ll drink with Navy nukes. I wouldn’t vote for one as President though.

    People should listen to me more.

    Steve57 (a17907)

  384. 287 was the comment responded to by 289.

    gary gulrud (dd7d4e)

  385. 303. “it takes more than the House to get things done in DC.”

    Amerikkka has established a preference for gridlock in order that Federal government be thwarted in its ill will of “getting things done”.

    Funny you hadn’t noticed.

    gary gulrud (dd7d4e)

  386. Amerikkka has established a preference for gridlock in order that Federal government be thwarted in its ill will of “getting things done”.

    Gridlock? Thwarted?

    Somebody fill me in cuz I’ve been missing out.

    Steve57 (a17907)

  387. 385.330. The Minneapolis I-35 bridge that collapsed was MN-DOT designed. Two others were hastily replaced

    Not that it matters but the bridge was actually designed by Sverdrup & Parcel an Amercian civil engineering company.

    James B. Shearer (e64877)

  388. Actually it was the insistence on building a stadium for the Vikings, the one who’s roof collapsed some years ago, that prevented proper
    maintenance of the bridge,

    narciso (3fec35)

  389. 391. I can spend a day tomorrow digging up the details, but the DOT is covering its butt saying that outfit did the design. The reason the plates were inadequate was because MN-DOT specified them. The same design was adapted for perhaps a half-dozen bridges, one across the Mississippi in St. Cloud.

    Another “user beware” with the Wiki.

    The young lady working on the other side of my cubical wall facing me, stopped a few car lengths from the maw on her way to pick up her husband at the U.

    gary gulrud (dd7d4e)

  390. Well you would know the details more then I, gary, but it struck me more like the case of the levy funds diverted to studies and port, rather then reinforcing the levies

    narciso (3fec35)

  391. 393. Although I often used the bridge during my commute, particularly on the way home, the maintenance had made the route unattractive to me.

    gary gulrud (dd7d4e)

  392. 394. Oh, no doubt, a maintenance milestone was missed. Pawlenty skated again.

    But the St. Cloud bridge was found to have the same stress fractures, it just was never under that sort of load.

    gary gulrud (dd7d4e)

  393. A chart graphing quanta relevant to the discussion:

    http://www.zerohedge.com/sites/default/files/images/user3303/imageroot/2013/01/20130125_fed2.png

    Note however, that GDP and the Fed’s assets are both overstated for interrelated cause over a period in which Federal revenue nonetheless ballooned from 19% of GDP to 24%.

    gary gulrud (dd7d4e)

  394. 393.391. I can spend a day tomorrow digging up the details, but the DOT is covering its butt saying that outfit did the design. The reason the plates were inadequate was because MN-DOT specified them. The same design was adapted for perhaps a half-dozen bridges, one across the Mississippi in St. Cloud.

    The NTSB report cited in the wiki entry found otherwise:

    Although design details of various gusset plates were changed from the time
    the computation sheets for the preliminary design were prepared until the final design,
    the thickness and material of the U4(′), U10(′), and L11(′) node gusset plates did not
    change—which resulted in the gusset plates at these three nodes being substantially
    underdesigned. An evaluation of the final design showed that the gusset plates at
    multiple other nodes also were underdesigned, though not to the extent of those at
    the U4(′), U10(′), and L11(′) nodes. The fact that the U4(′), U10(′), and L11(′) nodes had
    gusset plates with a basic and very serious design error—and that additional nodes
    had gusset plates with inappropriate thicknesses—suggests that the design error was
    not the result of a single calculation error associated with a specific node. Furthermore,
    the shear calculations that were done for the floor trusses of the I-35W bridge and the
    main truss calculations done for the Orinoco bridge demonstrated that Sverdrup &
    Parcel knew how to properly apply these calculations. These facts, coupled with the
    lack of any documentation for main truss gusset plate calculations, indicate that none
    of these plates were designed correctly because the appropriate calculations were
    simply not made for these design elements. Therefore, the Safety Board concludes
    that, even though the bridge design firm knew how to correctly calculate the effects
    of stress in gusset plates, it failed to perform all necessary calculations for the main
    truss gusset plates of the I-35W bridge, resulting in some of the gusset plates having
    inadequate capacity, most significantly at the U4(′), U10(′), and L11(′) nodes.

    James B. Shearer (e64877)

  395. What I meant by “the principle is the same” is that SNAP is a market-inefficient program implemented as a concession to other values. It’s obviously not “insurance” the way health insurance is “insurance.” Food stamps obviously don’t allow people to pay a flat premium and them select whatever quantity they like of any food they like regardless of price. But they serve as a buffer between the poorest members of society and the free market that tells them TS. In that sense, I don’t think it’s ridiculous to think of them as insurance – particularly when I slap a fat disclaimer on the claim.

    I only mean for the parallel to suggest (another) possible middle-ground solution. What if we handled healthcare for the poor the way we handle food for the poor? Health Stamps, essentially. It would cap use of healthcare services and prevent the sort of no-skin-in-the-game abuses of access that drive up healthcare costs. Abolish Medicare/Medicaid and fund Supplemental Healthcare Assistance Program.

    Lastly, I have repeatedly put forth co-pays as a response to your concerns about “price sensitivity caused by reaction of the payer to price signals.” I don’t think it’s fair to suggest that I’m not arguing in good faith when my most straight-forward suggestion directly addresses your most immediate concern.

    I don’t intend to suggest you’re not arguing in good faith. Forgive my grumpiness. The point of my food example is that a flat premium, and even a flat co-pay, pretty much eliminates price sensitivity. If your suggestion of a co-pay is not a suggestion of a flat co-pay, but rather having the patient pay a percentage of the final bill, I think that would be better than nothing. The patient would start asking what prices were, and providers would start having to know the answer. That’s a start.

    I’m not a fan of food stamps because I think they create disincentives to work, and I doubt I will ever be a fan of any sort of government subsidy for health care. But if I am making you question the notion that we can continue to divorce price from decisionmaking on what options to pursue, then I consider that success. My goal here is modest: to get you to question whether, just maybe, it could be the case that market forces and prices could help bring costs down.

    Which would benefit everyone. I can see you’re concerned about the poor getting care, and that’s admirable. I am too. Just consider the possibility that maybe the market is the best way for the poor to get the best care, in general, because when prices come down, that benefits everyone.

    Patterico (8b3905)

  396. And again: I don’t think you’re arguing in bad faith, Leviticus. The best evidence of that is the time I am spending talking to you. I consider you to be open-minded. That is the only kind of person worth talking to — unless you use the person you’re talking to as a foil to reach the open-minded.

    There is no point in convincing the already convinced or the unconvincable. Only the open-minded are worth the time.

    Patterico (8b3905)

  397. A neighbor of mine in Oakdale was a DOT engineer. I don’t remember whether, in fact, the I-35 was the model or a replicant.

    http://www.constructionlawtoday.com/2009/08/minnesoata-i35-bridge-collapse-engineers-request-to-get-out-of-lawsuit-denied/

    Part of the reason the engineer skated was a statute of limitations.

    http://en.wikipedia.org/wiki/Leif_J._Sverdrup

    They were Minnesotans.

    http://en.wikibooks.org/wiki/Professionalism/URS_and_the_I-35_Bridge

    A more thorough writeup. But my contention is still to be validated, that MN-DOT owned and substantially contributed to the design as a progressive, cost saving effort.

    Just as a sidelight, the morning the Milwaukee Harbor bridge failed I drove the wife over it on our way to respective workplaces. A county sheriff’s deputy was manning barricades closing off the right lane. She displayed the widest eyes I think I’ve ever seen.

    gary gulrud (dd7d4e)

  398. 400. And, I would say, our majority opinion. Well said.

    gary gulrud (dd7d4e)

  399. 401. From the last link, the “calculations for the gusset plates” have gone missing.

    No, I don’t think Sandy Berger’s been busy. I just think its par for the course.

    gary gulrud (dd7d4e)

  400. Pat

    The point of my food example is that a flat premium, and even a flat co-pay, pretty much eliminates price sensitivity. If your suggestion of a co-pay is not a suggestion of a flat co-pay, but rather having the patient pay a percentage of the final bill, I think that would be better than nothing

    The insurance companies tried this – this formula fell apart in the late 70′s early 80′s for the profit models insurance companies and hospitals were expecting.

    Its the incredibly expensive cancer treatments that are great but cost into the millions.

    Much of the health care problem is the burden this places on the medical institutions financially.

    EPWJ (d84fb0)

  401. …In the generic were Roland making the case that Team R is generally more likely to wish to attempt to reform the system, and Team D more likely to spend and demagogue, then I would agree with him.

    Comment by JD (b63a52) — 1/27/2013 @ 1:53 pm

    That was the case I was making, and I was saying that when the People have had 23 solid chances to repudiate Team D’s position on it, yet have failed to do so, that constituted having had a “chance to vote on it.” 23 times.

    No, it wasn’t a clean, up or down one time vote on the one issue. Of course it wasn’t. I never said it was.

    That is how representative Democracy works. If Medicare was something the People did not want, supporters of it would have been getting weeded out over those 23 elections. Instead, the opposite has happened. From the elections. That the American Voter got to vote in.

    So the Voters have gotten to “vote on it.” 23 times, so far, with some candidates cautioning us regarding the costs and others demagoguing against those saying anything negative about it at all. The Voters will get to vote on it every single election until it is no longer an issue at all, which means it will be being voted on in every single election as long as America and its elections continue to exist.

    That is how representative democracy works. It astounds me that this argument is even taking place here. It’s like they do not understand why politicians pay so much attention to issue polls.

    Roland (c4ee0b)

  402. The actual facts, is the Medicare fund is hemorrhaging funds, so consequently let’s take 700 billion out of it, and dump 20 million more people into it, very logical.

    narciso (3fec35)

  403. “If your suggestion of a co-pay is not a suggestion of a flat co-pay, but rather having the patient pay a percentage of the final bill, I think that would be better than nothing. The patient would start asking what prices were, and providers would start having to know the answer. That’s a start.”

    - Patterico

    1. That would be my suggestion, more or less (I thought co-pays were always assessed on some kind of graduated scale). It would be a rough couple of years in transition, though – where people were suddenly forced to pay a flat percentage for procedures with grossly inflated price tags. But who knows? Maybe that would be the best sort of wake-up call.

    2. Whether or not creating a “Health Stamp” system might create a disincentive to work, do you think it might have some success in driving down costs by capping access to services for people who might otherwise over-utilize for lack of price signals to the contrary?

    3. If you’re worried that divorcing utilization from cost, isn’t your problem with insurance generally, beyond Medicare/Medicaid? Private insurance divorces utilization from cost as surely as public insurance, and inflates costs to the same degree and in the same market. If people can still purchase private health insurance, and over-utilize services via private health insurance, won’t healthcare costs continue to be inflated by private health insurance even in the absence of public health insurance?

    4. Are healthcare services really the sort of services that a sane person will over-utilize just because he can? Many (if not most) healthcare services are distinctly unpleasant, and most people avoid utilizing them if at all possible? I have medical insurance through my parents. I pay nothing for it. I have access to services entirely divorced from cost. I actively avoid utilization, because utilization of these particular services is a pain in the ass. I don’t wanna take pills with nasty side effects, I don’t wanna have needles (or worse) jammed in me, I don’t wanna have an NG tube run down my throat (through my nose), I don’t wanna be immobilized for six weeks because a doc put a pin in my foot, etc. These are the food items on display on your grocery store – all kinda the equivalent of canned brussel sprouts. There are only so many canned brussel sprouts that any sane person is going to eat, regardless of how little it costs him.

    Leviticus (17b7a5)

  404. The problem is partly in calling it insurance. Insurance is generally understood to be for unforeseen circumstances, unexpected events. Health “insurance” is nothing of the sort. It is the equivalent of auto insurance covering the costs of filling your gas tank, changing your oil, changing tires, and routine maintenance.

    JD (b63a52)

  405. *brussels* sprouts

    they’re a favorite but i always get the frozen ones except for i bookmarked a brussels sprouts salad to where I think I wanna try fresh next time

    doesn’t that look awesome and different? Yes it does. But I won’t get the fancy fancy cheese I’ll get the pecorino probably unless I’m a make it for company and even then it depends on who they are

    happyfeet (ce327d)

  406. Brussel sprouts braised in beef stock are tolerable

    JD (b63a52)

  407. A fair point – and a good argument for restricting “insurance” to catastrophic events, of course.

    But it applies to private insurance, too. Is a prohibition on selling private comprehensive health insurance compatible with free market values?

    Leviticus (17b7a5)

  408. i always have to google “braised”

    like since google was invented I been googling that word

    happyfeet (ce327d)

  409. Feets and JD and Leviticus

    Ooh, Now we’re talking! Brussel sprouts cut in half and roasted on a thin layer of bacon fat –then low simmered in a little heavy cream that’s been flavored with dijon, seasalt, and fresh thyme are much more than tolerable. They’re absolutely yummy. They’re not buried in cream sauce either, –just a tad of the flavor infused cream sticks to the sprouts. They’re yummy. Low carbish even. Mariano’s has fresh Cali sprouts for 88 cents a pound this week. Ima go get some tomorrow. That’s even way cheaper than canned or frozen.

    People need to learn to be open minded about brussel sprouts, (and a lot of things) I think.

    elissa (ea9191)

  410. ok that one’s bookmarked now too

    this is day 5 in a row without any meaningful carbs … I have to go through wednesday maybe i can try this one before then

    if not I start back next monday

    happyfeet (ce327d)

  411. I-35 working summary.

    Apart from the Judge involved, Ms. Hedlund, the government is effectively a gang of thugs.

    The original design was purchased from an Engineering firm headed by a local hero. It was de-engineered to fit a shorter span.

    The government had a routine for maintenance. The fault they had created was never discovered and was not being addressed by the delayed maintenance.

    Following the disaster, instead of going after their inspection contractor, doubtless without deep pockets, but mainly because that had only potential to increase the government’s culpability in a state full of deficient bridges, they repealed a law protecting the original designer and went after them for their 10 or 20% liability for selling them the rope and gallows.

    Inorder that they make that case they slur the legacy of a war hero.

    Any resemblance to our Federal government or the several states headed by Blue politicos(CA, IL, NJ, MI,…) is merely in kind, not extent.

    gary gulrud (dd7d4e)

  412. 413. Thanks, the Mrs. loves brussels sprouts. I’ll have to use veggie bacon bits tho.

    gary gulrud (dd7d4e)

  413. Oh, feets,

    So sorry. I notice I left out an important flavor and texture ingredient– a little minced shallot– in the recipe above. You can use the bacon fat or a bit of butter to heat and soften them up before you add to the cream.

    elissa (ea9191)

  414. They are like the cavemen before the monolith came, gary. and this was Tpaw the magnificent’s gig in part,

    narciso (3fec35)

  415. ok that’s kinda cool cause I can use my stupid food processor on the mincings

    that thing just hasn’t been earning its keep

    happyfeet (ce327d)

  416. gg–the point of the bacon fat is both the oil to roast the sprouts on and to keep them from burning while they’re slowly browning, as well as the slight bacony flavor it imparts. If you need to go the vegetarian route and use another oil instead, it may substantially alter the yumminess and I don’t want to be held responsible! Give it a shot, though and let us know.

    elissa (ea9191)

  417. Brussel Sprouts over wood coals until tender, then toss with olive oil, salt and pepper.

    mg (31009b)

  418. Too bad “capitalism” as it’s currently practiced in the Western world is anything but “free”.

    Powder Dry (3d5492)

  419. Brussels sprouts, suitable for vegetarians:

    Cut off the stems and halve them. If they’re big, maybe quarter them.

    Drown them in buckets of olive oil. Include as much salt, pepper, garlic powder, and garlic cloves as you can stand. Sprinkle lemon juice all over it if you can stand it.

    Roast them on a tray in the oven for 20 minutes. Toss them halfway.

    The leaves are the best part.

    I always hated Brussels sprouts. My mom dumped them in boiling water and gave us this stinking mess. Mom, I love you and you’re a great cook in many ways, but you have a lot to learn about how to prepare Brussels sprouts.

    Patterico (8b3905)

  420. The key is the olive oil. Buckets.

    Patterico (8b3905)

  421. 2. Whether or not creating a “Health Stamp” system might create a disincentive to work, do you think it might have some success in driving down costs by capping access to services for people who might otherwise over-utilize for lack of price signals to the contrary?

    I doubt doctors will cap services for people who are dying because they run out of health stamps. I say: let everyone pay their own way, and if you can’t pay, you get what charitable care is willing to provide. I believe most doctors are dedicated enough to do what’s necessary and if it’s truly necessary and not extraordinarily expensive, charity will cover it. But the very poor will lose choice. That’s the cost.

    3. If you’re worried that divorcing utilization from cost, isn’t your problem with insurance generally, beyond Medicare/Medicaid? Private insurance divorces utilization from cost as surely as public insurance, and inflates costs to the same degree and in the same market. If people can still purchase private health insurance, and over-utilize services via private health insurance, won’t healthcare costs continue to be inflated by private health insurance even in the absence of public health insurance?

    This is an important question.

    First you need to realize the depth of government subsidization and involvement.

    We subsidize employer plans with a tax deduction.

    States force insurance plans to cover a basket of services whether the consumer wants them or not. We’re done having children; I don’t need a health insurance plan that covers IVF. But that and many other items are probably mandated by my state.

    Medicare basically sets hospital prices, and as the 800-pound gorilla, overshadows any price signals set by the market.

    Take all that government involvement out of the market, and am I cool with people being free to have comprehensive plans that cover every aspirin pill and every doctor visit for the sniffles? Sure! Just like I would be fine with a comprehensive auto insurance policy that covers oil changes as many times as you want them (every 500 miles? no problem!), tire rotation/replacement/inflation, etc.

    But without government subsidies and interference, plans like that might cost a lot. At the very least, people considering a plan like that would take a look at what they are likely to need or want on the open market, and weigh that cost against the convenience and security of not having to worry about whether to get new tires every x thousand miles.

    But the free market can handle these issues any way it chooses, as far as I am concerned.

    4. Are healthcare services really the sort of services that a sane person will over-utilize just because he can? Many (if not most) healthcare services are distinctly unpleasant, and most people avoid utilizing them if at all possible? I have medical insurance through my parents. I pay nothing for it. I have access to services entirely divorced from cost. I actively avoid utilization, because utilization of these particular services is a pain in the ass. I don’t wanna take pills with nasty side effects, I don’t wanna have needles (or worse) jammed in me, I don’t wanna have an NG tube run down my throat (through my nose), I don’t wanna be immobilized for six weeks because a doc put a pin in my foot, etc. These are the food items on display on your grocery store – all kinda the equivalent of canned brussel sprouts. There are only so many canned brussel sprouts that any sane person is going to eat, regardless of how little it costs him.

    Yeah. I hear and understand that argument. Going to the doctor is a pain to begin with. Nobody wants to undergo procedures they know are unnecessary.

    But:

    First of all, you can make the Brussels sprouts the way I suggest above and they are delicious. OK, that has nothing to do with health care, but still, they’re really good.

    Second: here’s this can of Brussels sprouts. I’m gonna heat it up the way mom did, and the product will be mushy and will smell and taste like garbage.

    There is an 1 in 100,000 chance it will save your life if you eat it.

    Now, imagine your favorite food. One of my favorite dishes is shrimp brochette from Pappadeaux in Texas. Imagine they can make my Brussels sprouts taste like that. I’ll eat it all day no matter whether it helps or not.

    OK, the analogy is getting a little off track again, but let’s put it in real world terms. This 30-minute MRI just might save your life, because there’s a 1 in 100,000 chance you have the disease that it will catch. Want to do the MRI?

    Scenario 1: your co-pay is $10.

    Scenario 2: the MRI will cost you $5000.

    If you’re not inclined to take the MRI even if it cost only $10, then make the chance more likely: say you have a 1 in 1000 chance of having the disease, or even 1 in 100.

    If you are inclined to do the MRI even if it’s $5000 out of your own pocket, make the chance less likely: it’s only 1 in a million chance, or 1 in a billion.

    Objectively, in the scenarios where your chances of having the disease in question are only 1 in 100,000 (or less), the test should not be run if the MRI itself costs $5000 or $10,000 to run. But you might well do it if it costs you $10. After all, someone is that 1 in 100,000.

    Chances are you’ll find several situations where bearing the cost, or something close to it, makes a big difference to one’s decisions in whether to undergo certain procedures.

    In a free market, the machine is more likely to be used by the people who would be more likely to benefit from it — and, admittedly, by the rich, who may not want to take chances. To the extent the rich overpay, that can help subsidize charity care for the poor. Otherwise, the market efficiently allocates the scarce resource where it’s most necessary: in those situations where the $5000 seems like a good tradeoff because you are far more likely to catch a deadly disease.

    Patterico (8b3905)

  422. That reads like gibberish. I must be tired.

    Patterico (8b3905)

  423. The darker the olive oil, the better. It’s more flavorful.

    DRJ (a83b8b)

  424. I am having brussell sprouts tomorrow.

    JD (b63a52)

  425. Not all are as med-averse as Leviticus. One of my neighbors is a doctor (a very good doctor by reputation and by the ratings) and a hoot. Once, during the Obamacare/congress battle we were discussing healthcare and the idiotic malpractice insurance rates, and why so many expensive tests get run. Bill said, “well, a lot of tests that people hear about and want are not really necessary– but if you do enough tests, sooner or later you’re bound to find something to treat”.

    elissa (ea9191)

  426. It’s not an easy discussion. I am familiar with people who demanded tests the gatekeepers didn’t want to do and found out about serious problems as a result.

    Also: I know people who swear by putting maple syrup on Brussels sprouts. Haven’t tried it myself but I might. Only problem is, sounds like too much sugar.

    Patterico (8b3905)

  427. 415

    Inorder that they make that case they slur the legacy of a war hero.

    This is silly, the local hero’s firm made a serious design error. (Probably because some important computations were not performed). As a result the gusset plates that failed were half the thickness they should have been. This eliminated all the safety margin and when construction put a minor additional load on the plates they failed bringing down the bridge. For anyone interested this is discussed in great detail in the NTSB report .

    James B. Shearer (e64877)

  428. 431. This is silly Hedlund’s court agreed that the engineering firm well knew their business. NTSB or the Judge, who to believe?

    Your problem Sir is the simplisme.

    gary gulrud (dd7d4e)

  429. You can count on the likes of Shearer to focus on tangential issues.

    JD (134f7b)

  430. Brussel sprouts are great as a vehicle for melted margarine/butter and salt.

    Speaking of medicine (after only skimming the thread), it is hard to decide on the correct treatment until one has made a proper diagnosis. This is true not only of individuals with an illness but the medical system as well.

    There are a few things about medical care that make it different from all other segments of the economy, and without taking those things into account any attempted solution is totally inadequate.

    Medical care in theory is a matter of the physical and emotional well being of an individual and a family in a way most other consumer goods are not-
    Many things in no specific order:
    - Buying a Ford instead of a Mercedes is rarely of serious importance. Paying 50% on cancer chemotherapy to get what you can afford instead of what is recommended.
    - Nutrition can be provided by growing vegetables, grains, and raising vegetables that have been around for hundreds of years or more. Basic food produced by newer methods typically is also cost effective. There are exceptions such as more expensive new fruit hybrids, etc., but it would not be often that paying twice as much for an apple buys you a significantly more healthy-for-you apple.
    - A third party payment system, especially when the individual doesn’t even pay the third party premium directly takes away incentive not only for what one expects of the “system”, but affects the individuals general choices in life.
    In other words, I can spend money on my wide screen TV and cable feed instead of worrying about how much I pay for my medical care.
    - The conflict between rights and responsibilities. Everybody wants to claim their rights and only want other people to live up to their responsibilities.
    Groups of people do not successfully get along that way, be it a family or society. Society works when people are focused on maintaining their own responsibilities and protecting the rights of others.
    I always saw my responsibility as a physician (and in life) to follow the (true) Golden Rule and treat patients as I would want to be treated or want my family to be treated, and I never thought anyone had a “right” to be treated except by the establishment of an individual patient-doctor relationship.

    The consequences of many of those things add up to what Dr. Schilling (of Schilling Test fame) said to our class 30 years ago, “Why do people think that medical advances should make medicine less expensive”?
    The medical care for a person with healthy kidneys is zero as far as the kidneys go; the medical care of someone with kidney failure once was minimal, they had minimal nursing care until the died; the medical care of someone with kidney failure since the 1960′s has been quite expensive providing the use of artifical kidneys (dialysis) or kidney transplants.[Now, it is true that a successful kidney transplant is both a medical advance and less expensive in the long run than lifelong dialysis, but that still does not make it cheap].

    Now, my last point will overlap what many people will say, but I will say it in a way that will agitate folk (not my intention, just the reality).
    In large part people want medicine to act like witchcraft, they want to figure out a way to manipulate life that gets around the “natural”, the typical consequences of our actions. We like to eat what we want, drink what we want, have sex as often and with whoever we want, exercise as little or as much as we want, smoke what we want, drive bikes, motorcycles, or cars as dangerously or as carefully as we want etc., etc., and when it’s time to “pay the piper” we don’t want to, we want a way around it, even better if we can tell someone else it is their job to get us a way around it.
    The more acceptible way to have said that is we need to take responsibility for promoting health, not treating illness.

    Now, I think the way the medical system has developed in the US has been a hodgepodge of little segments trying to “make the best”/”take advantage of” their little slice of the pie at the expense of other parts of the pie. Often one part of the system forces other parts to do poorly, including because of govt. attempts to incentivize some things over others.

    The idea of putting govt in charge of health care only makes sense if you think there are people in the government who are smarter, wiser, and more noble than any one else in the country. Since this is not true, putting government in charge is just replacing people who can be held accountable to people who can’t be (like State Dept. officials responsible for the disaster/fiasco that was Benghazi).

    MD in Philly (3d3f72)

  431. 433.You can count on the likes of Shearer to focus on tangential issues.

    This could be avoided by sticking to examples of government incompetence that are actually true. There must be zillions.

    James B. Shearer (e64877)

  432. Have you pointed out a single instance of government improving efficiencies, and/or decreasing costs?

    JD (448fa8)

  433. Well humility also implies not making drastic changes to existing institutions that are more or less working even if not perfect. Like converting Social Security to private accounts, or returning to the gold standard or abolishing the Fedreral Reserve.

    SS is not more or less working. Ditto MediCare. Both are currently fiscally unsustainable. Allowing people to put 2% into private accounts was not drastic.

    JD (448fa8)

  434. The local PBS station is running the program about Henry Ford tonight. The beginning the show focuses on the hundreds of inventors and engineers who were all simultaneously and independently working on their prototype horseless carriages (dozens in Detroit alone) and competing for investors.

    The excitement of that time (1899-1905-ish), the contests and races, the successes and disappointments amidst the players in that nascent industry–the pride in development of the cars– comes flying out through the TV screen. It was a more pure time when the government did not create winners and losers. It was a time when the public decided what worked, what designs and features and prices appealed to them and which auto brands seemed reliable and safe. It was a time when business savvy and efficiency mattered. Most companies failed. A few like Ford survived.

    elissa (82092a)

  435. Elissa – now, the competitors that lost would make donations to the Dems, get State and Fed subsidies and guaranteed loans, and have the EPA cripple those that beat them.

    JD (448fa8)

  436. 436.Have you pointed out a single instance of government improving efficiencies, and/or decreasing costs?

    I cited the interstate highway system which has decreased shipping costs.

    James B. Shearer (e64877)

  437. I believe that the major reduction in shipping costs was the shutting down of the ICC.

    askeptic (2bb434)

  438. i think in a better world it would’ve been the media post what got the 442 comments or what have you

    happyfeet (ce327d)

  439. I’m not judging

    happyfeet (ce327d)

  440. James – all the govt did was take tax dollars from so e and give to others. They didnt build that.

    JD (b63a52)

  441. “I cited the interstate highway system which has decreased shipping costs.”

    James B. Shearer – How is that similar to lowering costs through government regulation, the topic of this thread?

    daleyrocks (bf33e9)

  442. “I believe that the major reduction in shipping costs was the shutting down of the ICC.”

    askeptic – Trucking deregulation did materially lower costs for shippers in the early 1980s.

    daleyrocks (bf33e9)

  443. 440. On the whole I’ll buy that, especially in fly-over Amerikkka.

    There are some utterly wretched corners, e.g., Chicago, San Francisco, but LBJ had a winner in the Interstate.

    gary gulrud (dd7d4e)

  444. 445. It’s also worth noting that government mainly just lets out bids, picks a design, disburses the checks, and notifies the inmates.

    gary gulrud (dd7d4e)

  445. 447- The Interstate System was proposed by Ike to allow the efficient transport of troops and war material, so that the gov’t, in a future major conflict, would not be so dependent upon the major railroads, as they were in both WW-1 and WW-2.

    askeptic (2bb434)

  446. 445

    James B. Shearer – How is that similar to lowering costs through government regulation, the topic of this thread?

    I answered the question asked. In general evaluating government depends on what you are comparing to. Compared to no government at all lots of what government does (like maintaining law and order) looks pretty good. Compared to some hypothetical ideal government actual governments (not surprisingly) are less impressive.

    In my view the role of government is to provide an environment in which private enterprise can flourish. Some regulation is inevitable (and in fact desirable). Conservatives should (in my opinion at least) try to avoid blind opposition to all regulation and instead try to make regulation more consistent with conservative principles. Otherwise you just end up letting liberals write the rules.

    The changes in trucking regulation cited above are an example of this. Trucking is of course still heavily regulated.

    James B. Shearer (e64877)

  447. “Conservatives should (in my opinion at least) try to avoid blind opposition to all regulation and instead try to make regulation more consistent with conservative principles. Otherwise you just end up letting liberals write the rules.”

    James B. Shearer – Or you wind up with liberals arguing against conservative positions nobody is advocating or constructing fields of blazing straw men.

    daleyrocks (bf33e9)


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