Sunday, February 28, 2010

Hsieh Cited in Re:new Magazine

The February 2010 issue of the British magazine Re:new has published a story on the American health care debate and how it relates to ongoing problems with the British National Health Service. They quoted me as a representative of the free-market side.

The story is entitled, "A Bitter Bill".

Although the article is generally supportive of the concept of "universal health care", the author quoted me fairly and she gave me and FIRM a lot of space on the first page. In contrast, the representative for the pro-"single payer" US group, Physicians for a National Health Program, was not named and received less column space.

The online version of the story is not available yet, but you can see the print version here:

http://issuu.com/renewmagazine/docs/renewmagazine1

(Use the navigation controls to go to pages 6-7.)

Here is the relevant excerpt from the article:
Despite living in the only Western country without universal healthcare, millions of Americans are keen to keep things as they are. The current system may not be perfect, but the alternative, or so they believe, is unthinkable.

To them, the idea of paying for others is a socialist one, going against their definitions of rights and freedom. Collective responsibility is an alien concept that means spending your hard-earned money on someone else. To these Americans, Obama's "socialism" is only a short step away from communism, the great fear of the 1950s.

Lobbying groups, such as Freedom and Individual Rights in Medicine (FIRM), argue that universal health care infringes on individual rights. "There is no such thing as a right to healthcare any more than there is to a car or a house," argues FIRM's Dr. Paul Hirsch [sic]. "President Obama's health care plan -- or any other form of universal health care -- is wrong, because attempting to guarantee an alleged right to health care must necessarily violate the actual rights of those forced to provide such care and those forced to pay for it".

The British National Health Service has often been dragged into the American debate, and Dr. Hirsh believes that government provision of healthcare like that in Britain results in unnecessary bureaucracy. "Whenever the government attempts to guarantee health care, it must necessarily also control it," he says. "Hence crucial medical decisions are inevitably made by government bureaucrats, rather than physicians and patients. Healthcare becomes just another privilege to be dispensed at the discretion of bureaucrats."
(The author apologized for misspelling my name and she told me that it would be corrected on their website.)

Overall, I thought she represented my views fairly, and I'm honored to have FIRM's ideas circulated to readers in the UK!

Quick Links: Madianos, Pelosi, Coburn

Dr. Evan Madianos alerted me to a notice that some doctors will be posting in their offices come Monday, following the Medicare cuts.

(The first half of the page is the original posting, ending with "I won't do either!"; the second half is Dr. Madianos' commentary. As long as the Medicare program exists, it will remain a permanent "political football" for patients, doctors, and other interest groups -- yet another reason that Medicare should be phased out and eventually eliminated.)

The February 27, 2010 New York Times notes that, "Pelosi Struggles to Corral Votes for Health Care Bill".

Republican US Senator Tom Coburn (himself a practicing physician), comments on the recent "summit":



(Note: I generally agree with Senator Coburn's critique of the Democrats' proposals. However, the Coburn-Burr-Ryan-Nunes bill appears to be a very mixed bag, with some better elements and some bad statist elements. Hence, this should not be construed as an endorsement of that particular bill.)

Saturday, February 27, 2010

PJTV Health Summit Summary

The February 26, 2010 edition of PJTV includes a good discussion of the health care "summit" by Yaron Brook and Terry Jones:

Summit video

If you missed the full 7-hours of mind-numbing speechifying, Brook and Jones summarize the economic, philosophical and political highlights!

Friday, February 26, 2010

Ryan At The Summit

Yesterday's health care "summit" was of course the big story. Anyone interested in a complete transcript of the proceedings can find a full compilation here by the Washington Post.

For now, I just wanted to highlight this segment by Republican Congressman Paul Ryan, as well as an observation from HotAir.com, which illustrates both the strengths and weaknesses of the Republican approach to the debate.

First, Ryan's segment on costs (transcript and video):



I want to give Ryan credit for an excellent dissection of the financial problems with ObamaCare. The facts he presented should definitely be part of the debate.

And to his credit Ryan also stated, "We don't think the government should be in control of all of this. We want people to be in control. And that, at the end of the day, is the big difference."

But consider this excerpt from the HotAir discussion of Ryan's rebuttal of ObamaCare:
This has always been a core problem of Obama's health-care pitch: He [Obama] knows that the moral argument for the bill -- sure, it'll cost us dearly but it's worth it to insure the uninsured -- is a political loser so he resorts to preposterous assertions about how our giant new federal entitlement will actually save us money in the long run.
And this indirectly highlights the key weakness of the Republican approach.

The GOP needs to more explicitly challenge the moral argument for ObamaCare, rather than concentrating on secondary issues such as costs.

They need to make the argument that government-run "universal health care" is morally wrong and that free-market health care is morally right.

Americans are very moral people and they passionately want to "do the right thing". So if they accept the premise that it's supposedly right for the government to (somehow) make sure that everyone has guaranteed health care, but gosh this particular way just happens to be too expensive, then the statists will eventually win by proposing some plan that doesn't look too costly.

Whatever statist plan is eventually adopted will inevitably either cost more than originally promised or lead to rationing (or likely both). But sooner or later, Americans will buy into such a plan -- if they think that it is "the right thing to do".

But if Americans can be persuaded that government-guaranteed health is fundamentally wrong on moral grounds, then they'll reject all proposed variants regardless of the specific financial details.

With respect to moral and/or philosophical arguments, Republican sometimes say things that sound promising, such as Ryan's "We don't think the government should be in control of all of this. We want people to be in control."

But they never consistently defend the underlying principle of individual rights, the concept that individual rights are essential to human life in a social context, or the morality of a limited government which leaves honest men free to peacefully pursue their lives and their self-interest.

Hence, the Republicans leave themselves constantly vulnerable to statists claiming that there is a "moral imperative" to implement some new entitlement program, whether it be guaranteed health care, a jobs program, or a Medicare drug benefit. The most they can do is object to the costs of a particular program (or to some other specific implementation details) -- but not to the worthiness of the underlying goal.

In other words, the Republicans often argue that socialized medicine is impractical (or the closely related "it's too expensive"), but they rarely if ever argue that it's immoral.

As Leonard Peikoff noted in "Health Care Is Not A Right":
Most people who oppose socialized medicine do so on the grounds that it is moral and well-intentioned, but impractical; i.e., it is a noble idea -- which just somehow does not work. I do not agree that socialized medicine is moral and well-intentioned, but impractical.

Of course, it is impractical -- it does not work -- but I hold that it is impractical because it is immoral.

This is not a case of noble in theory but a failure in practice; it is a case of vicious in theory and therefore a disaster in practice. I want to focus on the moral issue at stake. So long as people believe that socialized medicine is a noble plan, there is no way to fight it.

You cannot stop a noble plan -- not if it really is noble. The only way you can defeat it is to unmask it -- to show that it is the very opposite of noble. Then at least you have a fighting chance.
Without this sort of moral clarity, economic arguments of the type Ryan is offering (as important as they are) will only delay the implementation of government-run medicine, not stop it.

To stop it, one needs to (1) not automatically concede the moral high ground to the statists (i.e., not grant the premise that guaranteed health care is a noble end), and (2) offer the proper moral defense of free market health reforms.

The debate is slowly shifting in this direction. But we still have a long ways to go.

To the extent that the Republicans are able to delay the implementation of ObamaCare, they will at least buy us more precious time to bring these core moral issues to the forefront.

We can't necessarily control how much time we are given, but we can control how we use it. Hence, we must be careful to use it wisely, rather than squander it.

Thursday, February 25, 2010

Hsieh OpEd at PJM: "Republicans: Beware the Trap of 'Limited' Reforms"

PajamasMedia has just published my latest health care OpEd, "Republicans: Beware the Trap of 'Limited' Reforms".

My theme is the seemingly innocuous compromise "reform" of requiring insurers to cover all pre-existing conditions would gradually lead to a full government takeover of health care.

I was very glad to be able to cite John Lewis' excellent TOS article observing that the Democrats' last secret weapon against the American people was the Republicans' willingness to compromise (in the final paragraph).

Here is the opening:
President Obama attempted to revive his faltering health care initiative by releasing a revised version of his plan on Monday. But as Grace-Marie Turner of the Galen Institute noted, the president's basic approach remains to "Tax, Spend, Regulate, Mandate" -- i.e., to impose massive new government controls over health care that Americans have already rejected in tea party protests across the country and in the polling booths of Massachusetts.

GOP leaders have been appropriately skeptical of the president's demand that his plan be the basis for their "summit" negotiations, calling it a "nonstarter." But while they've avoided that obvious trap, the Republicans are still in danger of falling for the subtler trap of agreeing to seemingly benign limited compromise "reforms" that would merely result in a slower government takeover of American health care.

One of the Democrats' favorite limited proposals has been to require insurance companies to accept all customers regardless of pre-existing medical conditions -- an idea supported by many Republicans...
(Read the full text of "Republicans: Beware the Trap of 'Limited' Reforms".)

Dissident Doctors Challenging the AMA

Matt Latimer profiles a group of dissident doctors in his article, "What MSM Won't Tell You: Doctors Are Challenging Government Health Care-and the AMA".

I don't know much about the group Docs4PatientCare.org. But they seem to raising the right issues and asking the right questions. Many of their proposed reforms move us at least partially in the proper direction of a free market.

(I do have questions about their idea of "high risk pools" for patients with pre-existing conditions. If some patients are truly uninsurable, they may need to rely on private charity. The last thing we should do is create yet another government entitlement program. The D4PC statement is vague on whether private parties or the government would ultimately pay for these patients' insurance and/or care. I fully support the former, but would be opposed to the latter.)

One point they raise which bears repeating:
The AMA does NOT represent the majority of 'practicing" US physicians. Only 17% of US physicians belong to the AMA and most of these members are administrators, practice in academic medicine, retired or residents and students. Therefore, the AMA's endorsement of this legislation is meaningless and irrelevant.
Hence, to the extent that D4PC provides doctors who disagree with the AMA endorsement of ObamaCare with a vehicle to express their views and promote free-market reforms, I applaud their work!

Wednesday, February 24, 2010

More Alternatives To ObamaCare

Dr. Bradley Hennenfent has compiled a nice list of proposed alternatives to ObamaCare.

I haven't looked at each one in detail yet. But from my first pass, they contain many excellent free-market reforms that deserve to be on the table.

(I'm sure I would probably disagree with some specific points of some of these proposals as well.)

But the President and Congress should be including these ideas in the debate, rather than merely trying to split the difference between the current bad House and Senate versions of ObamaCare.

Thank you, Dr. Hennefent, for compiling this information!

Reconciliation Roundup

A few quick updates on the proposed "reconciliation" tactic for ramming ObamaCare through the Congress:

Politico reports that "Senate Dems warm to reconciliation".

RedState reports that according to Micheal E. Hammond, former General Counsel of the U.S. Senate Steering Committee (in consultation with Senate parliamentarian Alan Frumin), the reconciliation process is not a legally valid way to pass ObamaCare 2.0 in the Senate. (Via David Catron.)

Keith Hennessey think that is more political theater rather than a real threat -- at least for now.

My own opinion -- I don't know. So much of this depends on details of backroom arm-twisting and deal-making that we in the general public (by definition) won't be privy to.

But we'll all find out soon.

Tuesday, February 23, 2010

Hsieh OpEd at PJM: "Government Grab of Retirement Accounts"

As a slightly off-topic post, PajamasMedia has just published my latest OpEd, "Government Grab of Retirement Accounts a Matter of 'Social Justice'".

Although it's not directly related to health care, it covers many of the same themes of freedom and individual rights vs statism and the entitlement mentality.

In this piece, I criticize the latest Obama Administration proposal to convert some of our private 401(k) retirement money into government annuities in order to help prop up the failing Social Security system. I also attempt to make the moral argument for the phasing out and eventual elimination of Social Security.

Here is the opening of "Government Grab of Retirement Accounts a Matter of 'Social Justice'":
Uncle Sam wants your retirement money.

The Obama administration has just solicited public comment on their proposal to take money from Americans' private 401(k) retirement accounts and convert it into government-backed annuities. In other words, they want to take your money now to purchase U.S. Treasury bonds, then pay you a monthly sum later after you’ve retired.

Although this proposal is being initially portrayed as a voluntary choice, Americans already have the ability to purchase Treasury Bonds with their retirement money. Moreover, the Obama administration is considering making these annuities the default option. And as analyst Karl Denninger noted, "'choices' have a funny way of turning into mandates." Nor is his concern unjustified.

In 2008, Professor Teresa Ghilarducci of the New School of Social Research testified before Congress proposing a similar scheme to convert private 401(k) accounts into government-run "Guaranteed Retirement Accounts" that would pay a 3% return. And in 2008, the Argentinian government attempted to nationalize private retirement funds to help cover its runaway deficit.

As the U.S. Social Security system moves ever closer to bankruptcy, the billions of dollars Americans have saved in their private retirement accounts will become an increasingly tempting target for our politicians...
(Read the full text.)

Presidential Plan Panned

President Obama has just announced his new health care plan based on new price controls on the insurance industry, and it has apparently landed with a "thud".

AP News reports, "Outlook no brighter for Obama's new health plan".

Grace-Marie Turner notes that is just more, "Tax. Spend. Regulate. Mandate."

In other words, he is attempting to address the problems created by prior government controls on insurance with yet more government controls. That's as likely to work as the proverbial "putting out fire with gasoline".

Let's hope the rest of the country sees through this folly.

Monday, February 22, 2010

Permanent Political Football

While reading a seemingly-unrelated story in the New York Times about the Texas State Board of Education, I was struck by the parallels between special-interest lobbying that occurs with a mandatory school curriculum and special-interest lobbying that occurs with mandatory health insurance.

The February 14, 2010 New York Times Magazine published a lengthy article entitled "How Christian Were the Founders?" This article described in detail the ferocious political lobbying in Texas resulting from the fact that Texas has established a statewide curriculum guideline for all its schools. Hence special interest groups have a powerful incentive to have their point of view promulgated in this mandatory curriculum.

The NYT article focused primarily on the Religious Right, and their often-successful attempts to promote the theme that "America is a Christian nation" -- by which they mean that "the United States was founded by devout Christians and according to biblical precepts". This in turn has powerful implications for what they believe children should be taught about American history, the proper relationship between government and religion, and what they considered the dangerously flawed notion of "separation of church and state". And they have been successful in using the power of government to include their views within the textbooks in use throughout the state of Texas.

Regardless of whether one agrees or disagrees with the various Religious Right theories of American history, the kind of lobbying they engage in is a completely predictable consequence of a government-mandated educational curriculum. In other jurisdictions, we might see hardcore environmentalists attempt to require school textbooks adopt a radical "green" perspective or leftists require teaching an anti-West, anti-capitalist curriculum.

Basically, the presence of a mandatory curriculum serves as a giant magnet for special interest groups seeking to have their particular viewpoint represented in the curriculum. It turns the educational curriculum into a permanent political football to fought over by the various interest groups.

Hence, there is a parallel with the lobbying that occurs under a system of mandatory health insurance. If everyone is required to purchase health insurance (as they are in Massachusetts), the government must necessarily determine what constitutes an "acceptable" package. This creates a giant magnet for special interests to have their particular pet benefit included in the mandatory package. In Massachusetts, residents must therefore purchase numerous benefits that they may neither need nor want, including in vitro fertilization, chiropractor services, alcoholism therapy, and hair prostheses -- raising costs for everyone to benefit the few with sufficient political clout.

Nor does the lobbying ever stop. As Michael Cannon noted in the August 27, 2009 Detroit News:
In the three years since Massachusetts enacted its individual mandate, providers successfully lobbied to require 16 specific types of coverage under the mandate: prescription drugs, preventive care, diabetes self-management, drug-abuse treatment, early intervention for autism, hospice care, hormone replacement therapy, non-in-vitro fertility services, orthotics, prosthetics, telemedicine, testicular cancer, lay midwives, nurses, nurse practitioners and pediatric specialists.

The Massachusetts Legislature is considering more than 70 additional requirements.
As with mandatory educational curricula, mandatory health insurance thus becomes a permanent political football for special interests to fight over.

Of course, the solution in both arenas is to eliminate the government mandate. Just as parents should be allowed to decide what kind of education their children should receive, consumers should be allowed to decide what sorts of health insurance they wish to purchase. The government should respect and protect these individuals' rights to make these decisions for themselves, rather than making that decision for them.

However, according to the February 18, 2010 New York Times story, "Obama to Offer Health Bill to Ease Impasse as Bipartisan Meeting Approaches", President Obama is still insisting on his plan of mandatory insurance as the basis for his upcoming health care "summit" with the Republicans.

His plan would thus turn health insurance into an unfair game of permanent political football, where the politically strong perpetually pummel ordinary Americans who lack sufficient lobbying pull. Unless Americans want to become the permanent tackling dummies for the special interest groups, they should remain firm in their current opposition to the President's plan and not let down their guard yet.

Friday, February 19, 2010

Quick Links: Health Care Summit - Trap or Opportunity?

Allahpundit at HotAir thinks it's a trap for the GOP.

In the February 16, 2010 Wall Street Journal, Betsy McCaughey says the GOP should "Just Say No to the Health-Care Summit" until mandatory insurance is taken off the table.

And most Americans want the Congress to start over on health care, rather than taking the Democratic plan as the starting point of the summit.

But some Republicans think they can turn the "summit" into an opportunity.

Unfortunately, I think the Republicans who think it's an opportunity are badly mistaken. Unless they explicitly challenge and repudiate the basic premise of universal health care (i.e., that the government needs to somehow find a way to guarantee health care for all Americans), they'll merely play into the statists' hands.

Duke University professor John Lewis once observed that the Democrats' last secret weapon against the American people was the Republicans' willingness to compromise.

We'll find out soon if the GOP has learned any lessons from the past, or they'll be suckered into offering political life support for the nearly-dead ObamaCare proposal.

Thursday, February 18, 2010

Ralston LTE in NY Times

The February 17, 2010 New York Times has published an LTE by Richard Ralston on health care reform (5th one down):
Although you do not think small ideas will do much, you provide a good list of small ideas that would improve the cost and availability of health care. Some of them would be more helpful than you indicate. (Health savings accounts help middle-income Americans and do not primarily help the wealthy, for whom the few hundred dollars in tax savings are not worth the paperwork.)

Americans have rightly become suspicious of big, bad, expensive ideas that are adopted only because they pay off a laundry list of special political interests. They would not object to small ideas that actually work and that don't need bribes to get votes in Congress.

Richard E. Ralston
Executive Director
Americans for Free Choice in Medicine
Newport Beach, Calif., Feb. 15, 2010
(He was responding to their 2/14/2010 editorial, "Small Ideas Won't Fix It".)

Wednesday, February 17, 2010

The ObamaCare Nuclear Option

I don't know how reliable this sort of procedural analysis is. But I wanted to pass this on to those who might be interested.

According to Brian Darling at RedState, the Congressional Democrats have one last "nuclear option" they could use to pass ObamaCare.

His conclusion:
Conservatives need to be wary that the liberals are not done trying to pass ObamaCare. This may be a desperate last ditch effort to pass President Obama's signature item of his first two year, so be ready for this scenario to play out after the summit, if the summit does not bear any fruit. For those of you that thought ObamaCare had been laid to rest, remember that it is not over.
Again, I can't vouch for the reliability of the analysis, since much of this depends on backroom deals that by their very nature will not be accessible to most of the general public.

Scott Brown: A Mere Speed Bump on the Conservatives' Road to Serfdom

The January 20, 2010 Capitalism Magazine has a terrific essay by Richard Salsman entitled, "Scott Brown: A Mere Speed Bump on the Conservatives' Road to Serfdom".

Here is the opening:
Yesterday's allegedly "surprising" election of Republican populist Scott Brown to the Massachusetts Senate seat occupied by the late Ted Kennedy since 1962 -- a win which removes the 60-seat, filibuster-proof "super-majority" for Democrats in the U.S. Senate -- seems to worry the illiberal-regressive Democrats who've control Washington since 2006, while it heartens the religious-conservative Republicans who are now itching to regain control. Yet neither reaction is justified. America still treads a road to serfdom, with Democrats and Republicans alike paving the way. Brown is a mere speed-bump on this road, which will only slightly decelerate the speed of the journey.

Like Brown, today's religious-conservative Republicans don't in the least oppose socialized medicine -- only the speed, manner and cost by which it's ultimately adopted -- because they share with the illiberal-regressive Democrats a whole-hearted (and irrational) belief in altruism, the notion that it's moral and noble to sacrifice oneself and to serve. Emotional commitment to this virtue' of service necessarily leads -- however long it takes -- to serfdom in politics.
(Read the full text of "Scott Brown: A Mere Speed Bump on the Conservatives' Road to Serfdom")

Salsman is correct. Brown's election has bought supporters of free-market health reforms some valuable time to continue to make our case. But until conservatives embrace the concept that pursuit of rational self-interest is moral (and thus should be legally protected as a right), they will eventually cede the moral high ground to those who would impose serfdom on this country, and eventually lose the political battle.

The good news is that these core issues are being discussed and debated right now.

The question will be whether the right ideas will take hold in our culture.

Tuesday, February 16, 2010

Schwartz Rebuts Carroll

Brian Schwartz does a nice job rebutting Colorado state senator Morgan Carroll's claim that allowing people to purchase insurance across state lines would create a "race to the bottom".

Virginia Legislature Outlaws Mandatory Insurance

From the February 12, 2010 New York Times:
Virginia Legislature Passes Ban on Insurance Mandate

The Virginia House of Delegates on Friday passed legislation intended to shield citizens from any federal requirement that they purchase health insurance. The bill goes to the governor for signing.
Assuming the governor signs this bill, it means that any attempt by the federal government to impose mandatory insurance could create a constitutional issue that might ultimately need to be resolved by the U.S. Supreme Court.

Monday, February 15, 2010

Ten Small-Scale Reforms for Pre-Existing Conditions

John Goodman and the National Center for Policy Analysis have proposed "Ten Small-Scale Reforms for Pre-Existing Conditions". All of these would move us in the right direction of free-market health reforms, without creating a huge new government welfare entitlement.

The ideas include:
* Encourage portable insurance.
* Allow special health savings accounts for the chronically ill.
* Allow special needs health insurance.
* Allow health status insurance.
* Allow self-insurance for changes in health status.
* Give people on their own the same tax break employees get.
* Allow providers to repackage and reprice their services under Medicare and Medicaid.
* Allow access to mandate-free insurance.
* Create a national market for health insurance.
* Encourage post-retirement health insurance.
According to Goodman, "These 10 reforms would encourage insurers to compete to cover patients with chronic illnesses, rather than trying to avoid them. They would give doctors and other health care providers incentives to innovate, and to use technology in order to improve quality and reduce costs".

For further details of each proposal, see the full text of "Ten Small-Scale Reforms for Pre-Existing Conditions". There's also a PDF version.

Update: Trey Givens raised a good point in the comments about point 7 ("Allow providers to repackage and reprice their services under Medicare/Medicaid").

My $0.02: Eventually, the government should get out of all providing health insurance since that's outside of its basic function of protecting individual rights. But point 7 could be a transitional step towards eventual complete privatization of such programs. As Lin Zinser and I discussed in our TOS article on "Universal Health Care", those programs can't be eliminated overnight.

I personally believe that #7 could be an appropriate part of the process of phasing them out. (I'm not necessarily speaking for my co-author Lin on this matter.) Thanks, Trey, for pointing this out!

Taxing MDs in Michigan

Michigan Governor Jennifer Granholm has revived the idea of taxing physicians to help make up the state budget deficit.

It would be like trying to solve the hunger problem by taxing the farmers who grow food.

Between the predicted 21% Medicare cuts and these additional taxes, I expect many Michigan physicians will either stop accepting indigent patients or just leave the state.

With the apparent stalemate at the national level on ObamaCare, we'll see more state-level action such as this. Will states attempt more government controls (as Michigan), or will they adopt genuine free-market reforms?

Friday, February 12, 2010

Ralston OpEd: "Health care fight: What's next?"

The February 10, 2010 Orange County Register has published the latest OpEd by Richard Ralston entitled, "Health care fight: What's next?"

Here's the opening:
The pause seems to be ending in the inept debate in Congress on health care. After a year of struggle, some comfort might be taken from the fact that neither of the monstrosities passed by the House or the Senate has become law.

However, truer than ever is the adage that "no man's life, liberty or property are safe while the legislature is in session." The change of one Senate seat is not a solid foundation to protect us from the threat of massive government intrusion in American medicine. And President Barack Obama's State of the Union address indicated that all the worst features of last year's House and Senate bills are likely to come roaring back.

If the best defense is a good offense, real reforms should be put forward now that permit better and more affordable health care and that expand, rather than restrict, personal choice and freedom.
(Read the full text of "Health care fight: What's next?" for more details on genuine free-market reforms.)

Ralston also offers the following excellent guidelines for our politicians:
The best way to evaluate reform proposals is, first, to determine the direction in which they would take us. More government spending or less? More or fewer taxes? More or fewer government agencies? More freedom and choices, or more obedience to rules, regulations and mandates? More decisions by physicians to best meet the unique condition of each patient, or more government enforcement of "protocols" that physicians must apply to all patients? Privacy for the doctor-patient relationship, or the turning over of all personal medical records to the government so it can monitor and supervise doctors' decisions?
President Obama has asked Americans to give him their own ideas on how to reform health care. Ralston has stepped up nicely. Let's hope the President and Congress decide to listen.

(Ralston is the Executive Director of Americans for Free Choice in Medicine.)

Thursday, February 11, 2010

Reconciliation Trick Back On The Table

This report from the Washington Examiner suggests it is.

Opposite Trends in Health Spending

The Wall Street Journal notes that "government programs next year will account for more than half of all U.S. health-care spending".

Meanwhile, Greg Scandlen cites a report that "medical costs for individuals in account-based consumer-driven health plans (CDHPs) went down 26% over four years".

To the extent that free markets are allowed to operate in the CDHPs, the costs go down without loss of quality.

Meanwhile, government health spending is following a clearly unsustainable upward trend. As we all know, "if something can't go on forever it won't". The only question is how it will end -- in a controlled rational fashion, or a fiery crash.

Wednesday, February 10, 2010

Filibuster For Me But Not For Thee

I've already gotten used to seeing various pro-"universal health care" pundits arguing that we should get rid of the Senate filibuster because it causes "paralysis" and makes America "ungovernable".

Here's one typical example from New York Times columnist Paul Krugman, "America Is Not Yet Lost" (2/7/2010).

However, there's also a new argument being advanced by Ben Eidelsen at Slate, "Why the filibuster is OK for Democrats but not for Republicans" (2/8/2010).

Basically, Eidelsen argues that when Democrats use the filibuster it's for the benefit of the majority of Americans, whereas when Republicans do so it's to thwart the majority.

Leaving aside the issue of whether it would be tenable to allow only one political party to use certain parliamentary tactics but not the other, I want to point out that thwarting the majority (in a controlled fashion) is precisely the idea.

In other words, it's a feature, not a bug.

Our founders did not intend America to be a majority-rule pure democracy. Instead, it was intended to be a constitutionally-limited republic, based on the principle of individual rights.

(I fully acknowledge that this principle has not always been consistently respected and/or adhered to during our history. Government-sanctioned violations of individual rights such as slavery represent some of America's most shameful actions.)

The filibuster helps insure that major legislation doesn't pass without some semblance of a broad consensus. Of course, a "consensus" on any issue does not guarantee that it will be correct. But in a rational (or at least semi-rational) political culture, this constraint will help weed out some of the worst ideas.

Hence to the extent that checks-and-balances like the filibuster slow down ill-considered legislation and help protect our individual rights, then I'm glad for this so-called "paralysis".

Tuesday, February 9, 2010

Does Murtha's Passing Kill ObamaCare In The House?

With the death of Congressman John Murtha (D-PA), some people are thinking that this might be the death knell for ObamaCare in the House as well.

Here are two such analyses:

"Without Murtha, Dems now one vote short of passing ObamaCare in House" (AllahPundit, HotAir)

"Health care rationing bill gets nuked from orbit" (Moe Lane, RedState)

Due to the political stalemate on health care, the President has now decided to invite the Republicans to take part in a bipartisan, televised forum on the issue.

The Republicans now face a crucial choice. Do they stand up for genuine free market reforms? Or do they merely offer a "socialism-lite" proposal that gives the Democrats what they want, just more slowly?

As Duke University professor John Lewis observed in his article, "Obama's Atomic Bomb: The Ideological Clarity of the Democratic Agenda":
The protests and the polls are clear: Americans have, by and large, rejected the radical leftist agenda. But the issue is not yet closed. The Democrats have one last resource -- one secret weapon -- with which they can save their plans while avoiding political suicide in the next election. That weapon is the Republicans.

If the Republicans compromise... they will have once again capitulated to their opponents, abandoned liberty, and ruined the opportunity to redirect this nation toward its founding moral principle: individual rights, protected under a constitution in a free republic.
Will the Republicans give the Democrats an unearned victory? Or will they move this country in the right direction of individual rights?

Stay tuned...

Monday, February 8, 2010

Quick Links: Minnesota, Virginia, Catron

Great story about a Minnesota concierge physician who makes house calls.

Virginia state senate says "no" to mandatory insurance. With bipartisan support.

"Who Killed ObamaCare?" According to David Catron, it wasn't "Sarah Palin, Rush Limbaugh, the Tea Party movement, insurance lobbyists or even Scott Brown." Find out here.

Friday, February 5, 2010

Hsieh OpEd in Boulder Daily Camera: Polis And Public Option

The February 4, 2010 Boulder Daily Camera has published my latest OpEd, "Polis and Health Care Reform".

My theme is that Boulder's congressman Jared Polis (a very liberal Democrat) should drop has latest proposal for a "public option" and instead support free market health care reforms -- because it would be both good policy and good politics.

Here is the introduction:
Boulder's Congressman Jared Polis recently made national headlines when he and fellow first-term Congresswoman Chellie Pingree (D-Maine) teamed up to petition the U.S. Senate to include the so-called "public option" in its next version of health care legislation.

Polis' move was an attempt to break the political stalemate between the House and the Senate following Republican Scott Brown's upset election victory in Massachusetts. After Brown's election deprived Senate Democrats of the 60-vote supermajority necessary to pass the current version of ObamaCare, the House and Senate have struggled to bridge the differences between their respective versions of health legislation. In particular, one key difference has been the government-run "public plan" to compete with private insurance plans, which House liberals (including Polis) supported but which the Senate rejected.

Unfortunately, Polis' "public plan" is both bad policy and bad politics...
(Read the full text of "Polis and Health Care Reform".)

In particular, I mention the fact that Polis' views are out of step with what Americans want. Hence, he could alienate many independent voters here in Colorado.

Could a version of the Massachusetts election upset also happen here in liberal Boulder, Colorado?

Wednesday, February 3, 2010

States Seeking To Ban Mandatory Health Insurance

The Associated Press reports that more states are trying to opt out of any kind of federal mandatory health insurance measures.

From their article, "States seeking to ban mandatory health insurance":
...[C]onservative lawmakers in about half the states are forging ahead with constitutional amendments to ban government health insurance mandates.

The proposals would assert a state-based right for people to pay medical bills from their own pocketbooks and prohibit penalties against those who refuse to carry health insurance.

In many states, the proposals began as a backlash to Democratic health care plans pending in Congress. But instead of backing away after a Massachusetts election gave Senate Republicans the filibuster power to halt the health care legislation, many state lawmakers are ramping up their efforts with new enthusiasm....

Lawmakers in 34 states have filed or proposed amendments to their state constitutions or statutes rejecting health insurance mandates, according to the American Legislative Exchange Council, a nonprofit group that promotes limited government that is helping coordinate the efforts. Many of those proposals are targeted for the November ballot, assuring that health care remains a hot topic as hundreds of federal and state lawmakers face re-election.
I'm very pleased that Colorado is one of those states!

Americans' desire for freedom is still strong.

Tuesday, February 2, 2010

Canadian Premier Comes to the US For Care

CBC News reports that "Danny Williams going to U.S. for heart surgery":
Newfoundland and Labrador Premier Danny Williams is set to undergo heart surgery this week in the United States.

CBC News confirmed Monday that Williams, 59, left the province earlier in the day and will have surgery later in the week.

The premier's office provided few details, beyond confirming that he would have heart surgery and saying that it was not necessarily a routine procedure.

Deputy Premier Kathy Dunderdale is scheduled to hold a news conference Tuesday morning.
Glenn Reynolds quotes one commenter who notes:
Seems to me that when our Premier goes to the US for heart surgery, the analogy that comes to mind would be if the President of General Motors said 'Our GM cars are fantastic, but myself -- I own a Ford.'

ObamaCare Supporters Not Giving Up

According to the January 30, 2010 Los Angeles Times, the Democrats are going to put the health care issue on the back burner for now, then bring it up later once the political heat is off.

Here's an except from "Democrats quietly working to resuscitate healthcare overhaul":
President Obama's campaign to overhaul the nation's healthcare system is officially on the back burner as Democrats turn to the task of stimulating job growth, but behind the scenes party leaders have nearly settled on a strategy to salvage the massive legislation.

They are meeting almost daily to plot legislative moves while gently persuading skittish rank-and-file lawmakers to back a sweeping bill.

This effort is deliberately being undertaken quietly as Democrats work to focus attention on more-popular initiatives to bring down unemployment, which the president said was a priority in his State of the Union address on Wednesday.

Many have concluded that the only hope for resuscitating the healthcare legislation is to push the issue off the front page and give lawmakers time to work out a new compromise and shift public perception of the bill.
(Read the full text of "Democrats quietly working to resuscitate healthcare overhaul".)

And of course, these negotiations will be taking place "behind closed doors" -- precisely the tactics politicians employ when they are afraid of voter disapproval.

Hence, supporters of freedom and individual rights will have to maintain steady vigilance. We may have won this particular skirmish. But the war is a long ways from over...

(Via Hot Air.)

Monday, February 1, 2010

Gorman and Schwartz on Health Choice

The January 29, 2010 Aurora Sentinel published this OpEd from Linda Gorman and Brian Schwartz explaining, "Why we're 'crazy' about health care choice".

Here's an excerpt:
...Along with stopping mandatory insurance purchase, the Right to Health Care Choice allows people to buy more affordable policies sold in other states. Thirty states have less expensive small-group premiums than Colorado. If governments did not shield insurers from interstate competition, “12 million previously uninsured” Americans would have coverage according to University of Minnesota economists.

You have the right to buy the best available insurance policy for you and your family. You also have the right to donate to charities of your choice. The Health Care Choice Initiative would protect you from politicians who want to deprive you of choice and increase your insurance premiums and taxes.
Thank you, Linda and Brian!