Wednesday, September 16, 2009

Jimmy Carter, the sage of Plains

This one is great. Now, I'm no defender of Rep. Joe Wilson (R-SC), for two reasons: first, what he did during Obama's speech was rude, boorish, and silly; second, he's from South Carolina, which contains the most annoying stretch of interstate highway in all the land -- and it's annoying not because of the road, but because the SC drivers make it so intolerably miserable.

Anyhow, here's Jimmy Carter, adding his own folksy wisdom to the debate over health care:
ATLANTA (AP) - Former President Jimmy Carter said Tuesday that U.S. Rep. Joe Wilson's outburst to President Barack Obama during a speech to Congress last week was an act "based on racism" and rooted in fears of a black president.

"I think it's based on racism," Carter said in response to an audience question at a town hall held at his presidential center in Atlanta. "There is an inherent feeling among many in this country that an African-American should not be president."


I'm unclear how Jimmy has determined that the "inherent feeling" that "many in this country" believe Obama shouldn't be president exists....is this based upon evidence? Is this based upon the statements of people in power? How many people are the "many" to which he refers? Is it the 60 million or so who didn't vote for Obama? Is it six dudes in south Georgia sitting on a porch drinking Dixie Beer? Or is it based in Jimmy's wisdom of the ages (i.e. he's just making shit up)?

The point, dear reader, is this: saying that people, including elected representatives, who oppose the policies of the Obama administration are doing so because they are racist is, essentially, and invocation of Godwin's Law on racial terms. If you can assign racist motives to the speaker, you don't have to engage the substance of his argument. Joe Wilson's point, poorly made as it was, was that the administration's proposed health care plan likely would cover illegal/undocumented aliens. There is considerable debate over this issue -- the plan says it won't cover anyone other than Americans, but apparently does not require proof of citizenship, nor is there any discernable enforcement mechanism. I'm sure that will change as the bill winds its way through the House and the Senate -- it may have already.

Now, whether it's kosher to shout "You Lie!!" during the President's address is one question (Wilson has received an official rebuke for it). Whether the health care bill in its current form would end up with taxpayer funded coverage for illegal aliens is another question, and one that clearly deserves a fair debate -- and there is a debate going on, so let's have it.

But for a former president to come out and say your opposition to Obama's health care plan is due to your being a racist, based upon nothing other than an "inherent feeling" and your opposition to the policies being debated is nothing short of astonishing. Set aside the supposed dignity of the office of ex-president--Carter just called those of us who disagree with Obama's policies racists!! And the best part -- because these "racist" outbursts are an "aftershock" of America's racist past, you may not even know you're being racist when you speak! And who gets to decide if you're racist? Jimmy Carter, that's who!

Are there racists out there? Sure there are. However, there are waaaaay more of us non-racists out here, struggling with notions of freedom vs. the concentration of power in the federal government, struggling with how best to remedy the problems of our health care system, struggling to determine how best to vindicate the rights we have under our constitution, and much more. So before you call people "racist" for opposing Obama's policies, you better be prepared to debate on the substance of the issue.

Friday, September 04, 2009

The Great Health Care Debate goes to kindergarten

So I'm on Facebook, and I've noticed a number of my friends have updated their status to say the following:
[Name] believes that no one should die because they cannot afford health care, and no one should go broke because they get sick.
Another friend of mine posted this most excellent question:
[Name] understands why libs are dumbing down their message of healthcare reform, but I don't agree with it. It's not that simple.


I'll be the first to admit our health care system, as it is currently operating, is fraught with problems. I will also state that all those who opposed the administration's efforts to create a "public option" by screaming "it's socialism!" need to wake up and see that the system is already largely socialized. Medicare, Medicaid, S-Chip, etc., are government-run health care programs, and they cover a significant percentage of the population.

The problem with making the debate about emotionalism/sentimentalism, which is what the "no one should die" statement is all about, completely misses the point of why there is a debate in the first place. This form of argument is juvenile -- nobody involved in the debate would disagree with the sentiment of the statement. However, it certainly does not follow automatically that to agree with that sentiment means you are evil and bad if you don't support the health care reform efforts of the administration or congress.

For example, we can all agree that "no one should die because of domestic violence." That is an obvious truth. However, because that sentiment is an obvious truth, do we completely dismantle the criminal justice system to handle this subset of cases? Do we start giving wife-beaters life in prison? Do we change the burden of proof?

It seems to me that, if you support a public option, single payer system, complete free market approach, whatever, you should be able to back up why with something other than sentimental arguments a 5 year old could make. Take a listen to John Hunt, a doctor at UVA, who has some interesting thoughts on the matter (scroll down to the podcasts, look for John Hunt). You may disagree with him, but he at least makes sense.

So to get back to the facebook status updates, the point is that argument, when taken down to the level of sentimentality, becomes completely meaningless. "What do you mean, you don't support health care reform? That means you want people to die because they don't have health insurance! Meanie!" Think about it this way...how many people have you heard about who have died in the last 20 years from not having insurance? Apparently, folks are arguing that something like 60 people per day are dying from not having health insurance. They apparently get this information from this article. Of course, actually reading the article would help, so I did so.
"Health insurance really matters in how people make their health care decisions," said Ron Pollack, executive director of Families USA. "We know that people without insurance often forgo checkups, screenings and other preventive care."

But one can't conclude that being uninsured alone killed people, said Kim Bailey, Families USA senior health policy analyst. Instead, not having health insurance is associated with mortality-increasing behavior. "We can't actually attribute any individual deaths," Bailey said.
....snip....
After hearing several minutes of background on the patient, Dr. Nielsen eventually asked when the woman's last Pap smear was. The answer: 10 years ago. The woman had developed uterine cancer, a curable disease if caught early. She died a few months after the initial diagnosis.

"You can dance around it all you want, but people who do not have health insurance delay the kinds of preventive care that everybody acknowledges are critical," Dr. Nielsen said. "That woman had a preventable, curable disease, and as a society we failed her because we have not made affordable health care available to all Americans."


So what can we divine from studies and articles like these? That folks who are uninsured (a) engage in riskier behavior, or (b) are more likely to delay preventative care that could prolong their lives. Is there a direct link between the lack of health insurance and these behaviors? Maybe so, because the common factor in folks like this is, of course, poverty. I represent folks in this cohort in court all the time. They engage in risky behavior not because they don't have health insurance, but because that's just how they roll. I'm pretty sure most of my 19-25 year old criminal clients, which demographic makes up a sizable chunk of people, are eligible for Medicare already. They don't have insurance because they never signed up. They don't get preventative care not because they don't have insurance, but because they just don't give a shit about it. Why is that? There are hundreds of reasons, no doubt, but I'm pretty sure "because I don't have insurance" is not high on the list.

Discuss...

UPDATE: and astute commenter reminds me that I meant to say "Medicaid" instead of Medicare for my young clients. Sorry about the error.

Wednesday, July 29, 2009

I know it's been a long time.....

I've been on a blogging hiatus for some time, and for all 3 of my regular readers, permit me to apologize. I just haven't been all that inspired.

However, that is changing with the new and changey political climate. I have really wanted to give President Obama a chance to do some of the things he promised during the campaign, and I have refrained from forming any sort of concrete judgment of him and his policies until he's had a chance to get settled into office. Now that he's settled, I've come to a conclusion--he just ain't all that smart. He doesn't appear to have a handle on basic economic concepts, and yet one pillar of his presidency is his proposal to have a huge chunk of the economy federalized.

Sure, the man can give a great speech -- but what else has he actually accomplished thus far? Back in the 90's, I thought Clinton gave an awful lot of speeches and press conference...but Obama is taking that to a whole new level. Frankly, that is not much to worry with, since the President is a figurehead, and to expect any President to grasp the intricacies of each and every decision that gets made in government is entirely unreasonable. However, it is reasonable to expect the President to be familiar with the big-ticket items on which he campaigned -- and for Obama, that was, as I recall, closing Guantanamo (and other issues relating to Iraq), "health-care" reform, and economic recovery.

So how is Obama doing so far? Well, as for Guantanamo, he appears to be continuing the same policies as the previous administration. As for the wider war, with Iraq, he appears to be continuing the same policy as the previous administration, although I gather there is now a deadline (the end of 2011, I believe) for the complete withdrawal of American forces from Iraq. That is well and good, but longer than the 18 months or so he campaigned on -- however, we can forgive him for that, because no candidate (other than a sitting President running for re-election) can really know or understand such a complicated military situation until he's actually in office.

As for the economic recovery, neither the stimulus package Bush got through nor the efforts of this administration have done much good. As for the "most transparent adminsitration evah," well, even on the stimulus money Obama has fallen way short. And why are taxpayers buying sprial-sliced ham at an inflated price? Has the recession caused a huge decrease in demand for ham? Aren't we supposed to get a volume discount, as opposed to an almost 100% markup over the grocery store price for ham? I like ham as much as the next guy, maybe even more so, but c'mon, Prez...if these are the same negotiating skills you'll bring to bear on "big pharma", I'll expect the cost of medication to skyrocket.

My point on the economy is this -- the notion that government has to "do something, anything" has, once again, been shown to be misguided at best, and destructive of a quicker recovery at worst. Increasing government debt increases uncertainty in markets, and that's not a good for the investor class (which comprises something like 50% of the population now). This is the same investor class that (a) pays virtually all the taxes the government collects, (b) provides most of the jobs in the private sector, and (c) produces nearly every single innovation in nearly every single thing innovated. And now, to pay for all this "stimulus", that same investor class is going to have more of its hard-earned dollars taken from it in the form of taxation to fund the government, and the newest experiment in government interference in private affairs, "health care reform."

Even the words "health care" bother me. "Health care" has become a catch-all, and it's treated as a right that everyone has. Why is it a right? Because somebody said so -- there's no Constitutional right to "health care." That means that "health care" is a positive right, as opposed to negative rights like free speech and the like. Positive rights are essentially legal rights -- we have these rights because the government (local, state, or federal) says we have them. As a result, some good things have happened in the field of medical care -- hospitals can't turn away patients who lack the ability to pay, for example.

As an aside, I've often wondered who the "46 million" uninsured are. There are those that cannot qualify for Medicaid for whatever reason that comprise one slice of the pie. There are those that can afford health insurance but, due to reasons all their own, do not purchase insurance and pay out of pocket, which might very well be the most economically efficient thing for them to do (I myself went to the doctor a total of about 6 times between the age of 22 and 37, and it would have made more sense for me not to have insurance for me...but I also had two kids, and my ex had a number of complicated medical issues that required surgery, so I was quite glad that BC/BS was there to cover the vast majority of those costs). This is another significant (and, from what I understand, larger group than the chronically uninsured) slice of the overall pie. Another large chunk is a group that may or may not be covered by any "public option" -- illegal immigrants. Again, it may very well be that this group is larger than the chronically uninsured. The last sizable group are folks that qualify for Medicaid but never sign up, for whatever reason -- and it's more than you think. In any event, the numbers have been bandied about are difficult to discern, and those that strongly favor a "public option" often use the 46 million figure without knowing or caring what the reality behind that number is. This includes the President, unfortunately, and it appears that, like Avon Barksdale in The Wire, sometimes you have to fight on a lie.

My general problem with the government getting in the health insurance business is that it already is in the health insurance business, and does it poorly. Medicaid is going bankrupt as we speak. As for the government "negotiating" prices with doctors and institutions for procedures and tests and the like? Well, the government says "you have to treat folks on Medicaid, and this is what you will charge them" -- which is neither negotiation nor a rational market solution to the problem of access to medical care.

Why do I dislike the term "health care" in this debate? Because, in my opinion, it moves the goalposts from what I consider the government's proper role in medical care -- ensuring access to medical treatment for those who cannot afford it on their own. Again, this system is already in place in the form of Medicaid. Perhaps I'm not privy to sufficient information, but I'm unclear where ability of access medical care has been anything other than increased for poor folks over the years. The question isn't obtaining medical treatment -- it's who pays for that treatment.

Furthermore, what treatment is reasonable under the circumstances? Persons making private contracts with private insurers can pick and choose which plan suits them, which coverages they need, and then they pay the premium for that in a voluntary transaction. With a public option, it's difficult to see that same principle applying.

Also, the public option appears to create some perverse incentives. Apparently, part of the proposal is to penalize private businesses of a certain size to the tune of 8% of their payroll if they don't provide insurance to employees. What that means is that employers whose present insurance costs exceed 8% of payroll will stop insuring their employees and pay the penalty -- perfectly rational economic behavior. What that also means is that those employees would then be shuttled into the government's insurance pool -- and the government, depending on its whim, can change the penalty to whatever it wants, and further manipulate the supply of and demand for the government's insurance plan.

These are just a few of the problems I have with it. Now, reasonable people can disagree about the policy itself and the implementation of the policy into practical solutions to our health care "crisis". I for one will not welcome our new bureaucratic health care overlords. Others that I know think that it is absolutely imperative that there be a public option, and others still who think that a Canadian-style single-payer system is the only way to go. The questions I ask are "how much do you want the government deciding your medical issues for you?" and "how much will this increase the deficit, and how will that affect the economic opportunities of my kids?"

Increasingly, I am aware of the pervasiveness of government in all our lives, and the effect that pervasiveness has on us. I've grown over the years to despise the federal government, due mainly to the politicians that control it. The democrats appears to want to increase government's presence in my life in matters as intimate as medical decisions I make for me and my family. The republicans apparently want to do somewhat the same on a slightly smaller scale, with a lot of Jesus stuff thrown in. I can't stand either party, and to cede yet more control over our lives to those in power, whose interests do not align with our own ("I want to see my doctor" vs. "I want to get reelected") is not a solution to problems the politicians made in the first instance.

These are merely my opinions on this, based on what I understand the situation to be. Feel free to correct me where I'm wrong on the facts, or debate the points made.

Thursday, March 05, 2009

First, they came for the smokers

Here we go again. It's for our own good, after all:
“The dangers of second-hand smoke are undeniable — that’s why I made a restaurant smoking ban one of my legislative priorities. This legislation will make Virginia’s restaurants safer for both patrons and employees,” the governor said in a statement. “I’m proud to have been able to work with leaders in both parties of the General Assembly to find common ground on this reasonable and necessary public health measure.”
Of course, Virginia's bars and restaurants were already safe for patrons and employees -- you don't like secondhand smoke? You're free not to go to places that permit smoking. It's that easy. I've ranted about this before, and will likely rant about it in the future. But here's my rant today.

Legislation like this makes non-smokers, who represent a majority of folks in the Commonwealth, happy. It does so because they can now enjoy any restaurant without someone smoking near them. And, as our esteemed Governor points out, "[t]he dangers of secondhand smoke are undeniable."

Of course, the dangers of crossing the street are undeniable, also. As are the dangers of eating potato chips, staying up too late, drinking too much, playing music at loud volumes. The list of things about which the dangers are undeniable is endless. As the government increasingly invades our lives, and criminalizes or otherwise bans what were until very recently simply personal choices that one was free to make, we are all less free to do what we like.

Increasingly, we are becoming a society of positive rights -- we have only those rights that the government chooses to let us exercise. This is happening on a federal level, state level, and local level, without regard to party or political affiliation. This is a creeping shift from the notion behind the negative rights philosophy of the founding of our country -- that the government has only those powers that we, the people, grant to it. That which is not forbidden is permitted, and the government cannot interfere in our private affairs without good reason and the consent of the governed. The law exists to protect the least of us, after all -- it's the baseline for our common morality.

Now, perhaps you're of the opinion that, because the dangers of secondhand smoke are "undeniable", that this is appropriate legislation with a good and necessary goal relating to public health. That's fine, but I want those of you who think that to consider what this type of mission creep by government does, and what its logical end point is. Taking away unpopular freedoms in the name of public health can only lead to more intrusion by government into our personal choices. Is that really desirable?

Wednesday, March 04, 2009

Savings? Taking money from me is savings??

Apparently so:
In his speech to Congress last week, President Obama promised to "go line by line through the federal budget in order to eliminate wasteful and ineffective programs." Although the process was not completed yet, he said, "we have already identified $2 trillion in savings over the next decade."

But it turns out that tax increases account for half of those "savings." From Obama's perspective, it seems, letting people keep their own money qualifies as a "wasteful and ineffective program." That makes sense if you believe all resources are the government's to distribute as it sees fit, which is the premise underlying the multitrillion-dollar spending binge that Obama calls "A New Era of Responsibility."

and more!
In response to nonprofit organizations worried that limiting the deduction for charitable contributions will reduce donations, The Washington Times reports, Orszag "said Mr. Obama took care of that by giving charities government money to make up part of the difference." Orszag noted that "in the recovery act, there's $100 million to support nonprofits and charities." In essence, then, Obama plans to take money people otherwise would have given to the charities of their choice and give it to the charities of his choice.

Positive vs. negative rights, in action!

Is this kind of thing the Hope and Change folks voted for? If so, then I need to find a deserted island....here's why:
Even the name of Obama's tax credit is insulting: "Making Work Pay." What makes work pay is the willingness of other people to pay for it. Taxes subtract value from this arrangement; they do not add to it. Obama not only wants to take his cut; he wants to take credit for taking less than he could have—indeed, for letting you keep anything at all. As far as he's concerned, the fruits of your labor are yours only by the grace of government.

Tuesday, March 03, 2009

Hold tight....ride's getting bumpier

How does a government spend money to "solve" a recession? Poorly, very very poorly.
Americans have welcomed the Obama era in the same spirit of hope the President campaigned on. But after five weeks in office, it's become clear that Mr. Obama's policies are slowing, if not stopping, what would otherwise be the normal process of economic recovery. From punishing business to squandering scarce national public resources, Team Obama is creating more uncertainty and less confidence -- and thus a longer period of recession or subpar growth.

The Democrats who now run Washington don't want to hear this, because they benefit from blaming all bad economic news on President Bush. And Mr. Obama has inherited an unusual recession deepened by credit problems, both of which will take time to climb out of. But it's also true that the economy has fallen far enough, and long enough, that much of the excess that led to recession is being worked off. Already 15 months old, the current recession will soon match the average length -- and average job loss -- of the last three postwar downturns. What goes down will come up -- unless destructive policies interfere with the sources of potential recovery.

......snip.......

What is new is the unveiling of Mr. Obama's agenda and his approach to governance. Every new President has a finite stock of capital -- financial and political -- to deploy, and amid recession Mr. Obama has more than most. But one negative revelation has been the way he has chosen to spend his scarce resources on income transfers rather than growth promotion. Most of his "stimulus" spending was devoted to social programs, rather than public works, and nearly all of the tax cuts were devoted to income maintenance rather than to improving incentives to work or invest.

Monday, March 02, 2009

Excellent!

Go here, you won't regret it. At all.

A taste?
Today, I found out my mother has another new boyfriend. She told me she wanted me to meet him, and I reluctantly agreed. When I walked out to meet him in the living room, to my surprise, I knew him. He's 18, my mother is 44. He also happens to be in my second period high school math class. FML.


Special thanks to the Kimzilla.