jims musings

Here in Amer­ica, we have cer­tain rights. Most of our rights are indi­vid­ual rights, as opposed to group rights, where the right is mean­ing­less or non-existent with­out the group.
Anti-discrimination laws, for exam­ple, are an exam­ple of group rights. So is the con­sti­tu­tional right to a jury trial. The Pres­i­dent believes in a right to health care, which would also fall into the domain of group rights. In the case of a jury trial or health care, you have the right to call upon the time and resources of your fel­low cit­i­zens and require some­thing of them– which cer­tainly inter­feres with their indi­vid­ual rights. How­ever, we feel jury tri­als are so impor­tant that par­tic­i­pa­tion and ser­vice on a jury is seen as a duty of cit­i­zen­ship.
There is a story float­ing around on the inter­web about a Ver­mont state rep­re­sen­ta­tive who has a unique alter­na­tive for gun con­trol. (The ear­li­est ver­sion of this story dates from 2000, and I can­not find any infor­ma­tion about Rep. Fred Maslack.)
As the story goes, if a cer­tain piece of leg­is­la­tion passes, Ver­mont cit­i­zens who choose not to own a firearm would be charged a tax of $500. The foun­da­tion of this idea rests on the 2nd Amend­ment and Arti­cle 9 from the Ver­mont con­sti­tu­tion:

That every mem­ber of soci­ety hath a right to be pro­tected in the enjoy­ment of life, lib­erty, and prop­erty, and there­fore is bound to con­tribute the member’s pro­por­tion towards the expense of that pro­tec­tion, and yield per­sonal ser­vice, when nec­es­sary, or an equiv­a­lent thereto, but no part of any person’s prop­erty can be justly taken, or applied to pub­lic uses, with­out the person’s own con­sent, or that of the Rep­re­sen­ta­tive Body, nor can any per­son who is con­sci­en­tiously scrupu­lous of bear­ing arms, be justly com­pelled thereto, if such per­son will pay such equiv­a­lent; nor are the peo­ple bound by any law but such as they have in like man­ner assented to, for their com­mon good: and pre­vi­ous to any law being made to raise a tax, the pur­pose for which it is to be raised ought to appear evi­dent to the Leg­is­la­ture to be of more ser­vice to com­mu­nity than the money would be if not collected.

Cer­tainly, a bill requir­ing a tax, fee, fine or other pun­ish­ment for those who choose not to par­tic­i­pate wouldn’t stand a chance of pas­sage, despite the con­sti­tu­tional man­date to “pay such equiv­a­lent.” A lien of that sort runs counter to our sense of lib­erty and free­dom.
So why does the health care bill, cur­rently before the sen­ate, have such a pro­vi­sion for those who do not main­tain ‘accept­able health insur­ance cov­er­age… as deter­mined by the Sec­re­tary of the Trea­sury”? (See “TITLE V–AMENDMENTS TO INTERNAL REVENUE CODE OF 1986″ in H.R. 3962)

The push towards ‘Fix­ing’ health care has noth­ing to do with health care, improv­ing it or even help­ing the poor. There is only one rea­son why lib­eral politi­cians are pur­su­ing this goal: polit­i­cal power.
Think: there is no good rea­son to rush into chang­ing some large frac­tion of the US econ­omy. There is no good rea­son to extend health care cov­er­age to ille­gal aliens while at the same time reduc­ing bor­der patrols. There is no good rea­son impose a new Fed­eral bureau­cracy and threaten jail time for those who do not have health insur­ance.
Surely, if The Plan was so great, there wouldn’t be any need to threaten jail?
The only rea­son to pur­sue expen­sive, poorly-reasoned leg­is­la­tion as con­gress is cur­rently doing is to fur­ther expand the num­ber of vot­ers (we’re not even peo­ple, just ‘vot­ers’) who are depen­dent upon a gov­ern­ment pro­gram, and thus a polit­i­cal phi­los­o­phy.
There are ways to pro­vide pay­ment for health care for the poor with­out cost­ing tril­lions and with­out con­strain­ing eco­nomic free­dom. Amer­ica can­not afford a mis­take of this mag­ni­tude, and cer­tainly not for a “Health Insur­ance Plan For The Re-Election Of Congress”.

Solu­tions. We all want them. Here are some broad strokes to some prob­lems we face.

Health Care
I reject the idea of a “Health Care Cri­sis.” A cri­sis as such sim­ply doesn’t exist. Go to any hos­pi­tal, urgent care cen­ter or what have you, and you will receive the care you need. Nobody is turned away.
What we do have is a prob­lem of pay­ment, which is tied to our insur­ance, which is tied to our employ­ment. Note the two-step link­age; this is also a prob­lem.
Solu­tion:
1) Revoke, amend or repeal the fed­eral leg­is­la­tion which encour­ages receiv­ing health care through an employer. HIPAA only went a small way towards portable health insur­ance; we need to com­pletely decou­ple health care from employ­ers alto­gether. (Doing so would also reduce the over­head of run­ning a com­pany.) This prob­a­bly means los­ing the pre-tax excep­tion on health care pre­mi­ums, and it means peo­ple begin pay­ing the true cost of their health cov­er­age. This would be painful, but with a tran­si­tory period (say, 24 months) it would be doable.
2) Now that insur­ance is truly portable– like auto insur­ance– and costs are more trans­par­ent to the con­sumer, we can work on what insur­ance is for. Namely, health insur­ance is for emer­gen­cies. Heart attacks, can­cer, bro­ken bones and that sort of thing. Insur­ance com­pa­nies can also offer addi­tional plans for those will­ing to pay more. The point is, for the mil­lions of healthy peo­ple and fam­i­lies out there (whose demand is cur­rently hid­den by the ‘pools’ of employ­ees in com­pany insur­ance plans), plans with low pre­mi­ums and high deductibles will be offered. This is true insur­ance and dif­fers greatly from cur­rent plans, which are more akin to pre-paid med­ical care. Inter­est­ingly, plans like HSAs would prob­a­bly tran­si­tion quite well.
3) In no case is addi­tional fed­eral involve­ment needed, except per­haps to allow (under the Com­merce clause) insur­ance com­pa­nies to oper­a­tion across states. This leg­is­la­tion shouldn’t vary much from the fun­da­men­tal rules which gov­ern inter­state bank­ing.
4) Medicare and Med­ic­aid can be mod­estly expanded to cover basic pre­mi­ums for cit­i­zens who do not work, sim­i­lar to other gov­ern­ment plans which cover auto insur­ance.
There. We end up with a health care sys­tem which is avail­able to all with­out gov­ern­ment man­aged care (so-called ‘Death Panels’).

The Mid­dle East
If I were sud­denly made King of the United States, I would adopt a sim­ple plan for the mid­dle east. The plan is sim­ple, and one that we west­ern­ers are good at: igno­rance.
The prob­lem with the mid­dle east, you see, is oil. They have lots of it, and cur­rently we need it. We pay through the nose for it, too– not only at the gas pump, but in mil­i­tary involve­ment in silly places. These con­di­tions need to change, and the only way to do that is for the United States to become sov­er­eign in its energy needs.
Con­ser­va­tion is good, but doesn’t solve the fun­da­men­tal prob­lem: we sim­ply require unholy amounts of energy. There­fore, we must pro­duce more. More oil (gasp!) for the near-term (1–7 years). For the medium-term (7–30 years), we need nuclear power. We have about 100 nuke plants today. We should have 500. This would pro­duce cheap, clean energy for our entire nation– not to men­tion the con­struc­tion, engi­neer­ing and other ancil­lary jobs. You want an effec­tive ‘stim­u­lus’ bill? Take half that $787 Bil­lion and build nuclear plants.
Now, that we’re inde­pen­dent of the mid­dle east, we have a free hand to act in a man­ner that is mean­ing­ful to us and clear to the rest of the world. If we then choose to con­tinue sup­port­ing Israel, we can do so with­out fear of the oil weapon.
They can drink their oil. And, if they hap­pen to develop nuclear weapons, we can deal with that threat as a sov­er­eign nation, instead of as a depen­dent client state.
For the long term, we need to develop tech­nolo­gies which allow us to pre­serve our hydro­car­bon sup­plies, rather than burn­ing them. Oil is far too use­ful as a chem­i­cal feed­stock for us to be burn­ing it.
Per­haps one of these future tech­nolo­gies would be space-based solar power, but we need cheaper access to space for that to work.

The Envi­ron­ment
We’ve made some silly moves recently with regard to the envi­ron­ment, the most note­wor­thy of which is the politi­ciza­tion of ‘cli­mate change.’ This is not a venue for me to dis­cuss my views on this mat­ter, but I will say that changes such as this have occurred and will con­tinue to occur regard­less of what we do– I’m sure the Polar Bears will sur­vive.
I do fully agree that dump­ing bil­lions of tons of CO2 in our atmos­phere is a bad idea. Since much of this CO2 comes from burn­ing hydro­car­bons, shift­ing to a nuclear-centric power grid could only have good effects for our envi­ron­men­tal impact.
We should also con­sider National Oceanic Pre­serves– places where fish­ing is not allowed, and where marine life can find refuge for breed­ing and migra­tion. Ulti­mately, these areas will also help sup­port exist­ing fish­eries and species diversity.

Edu­ca­tion
The fed­eral gov­ern­ment should not be involved at all in pri­mary edu­ca­tion. Uni­ver­si­ties, as research insti­tu­tions, can very much use fed­eral dol­lars. Edu­ca­tional assis­tance pro­grams– Pell Grants, Stu­dent Loans and such, should be elim­i­nated. Yes, I know all about the costs of col­lege– and the pri­mary rea­son for these increas­ing costs is the avail­abil­ity of gov­ern­ment money. Think of the hous­ing bub­ble, but applied to class­room seats. The myth that every­one needs or deserves a world-class edu­ca­tion is a fan­tasy. At some point, if we con­tinue on our cur­rent course, the eco­nomic ben­e­fit of a col­lege degree will be out­weighed by the debt of acquir­ing such. What will hap­pen then?
Best to get out now and let the bub­ble deflate.

National Debt
This is the Mother of All Prob­lems. Our debt load lim­its our flex­i­bil­ity and saps future capa­bil­ity. My per­sonal incli­na­tion, if I were King, would be to fol­low the path of cut­ting busi­ness reg­u­la­tion (see the Health Care com­ments above) and elim­i­nat­ing most cor­po­rate income taxes. For cit­i­zens below a cer­tain income level, mort­gage pay­ments and per­haps even rent pay­ments would be entirely tax deducible.
Cor­po­ra­tions which pro­vide funds to sup­port National Parks, Pre­serves and other such spaces would be allowed cer­tain exemp­tions in their oper­a­tions. (This would be extended to cor­po­ra­tions like Google, which uses tremen­dous amounts of elec­tric­ity.) In short, I would do every­thing pos­si­ble to encour­age long-term eco­nomic growth. Short term ‘solu­tions’, like rais­ing taxes, only dam­age long-term growth trends and make the debt more dif­fi­cult to pay off.
Pay­ing off the debt would increase the strength and buy­ing power of the dol­lar. As this occurs, I would require a gen­eral import tar­iff– per­haps 5–10%- to hold ultra-cheap goods at bay. My goal is not pro­tec­tion­ism, but to level the play­ing field so US man­u­fac­tur­ers have a com­pet­i­tive chance.

That’s the short story, ladies and gentlemen.

A would direct you to this fan­tas­tic arti­cle in The Atlantic. It is the best sum­ma­tion of the health care sit­u­a­tion in the United States and an appro­pri­ate primer before any seri­ous dis­cus­sion of how and what to ‘fix’ can really begin.
Again: I don’t sub­scribe to all the con­clu­sions reached by the author, but it seems silly to me to even begin think­ing about change with­out hav­ing read this arti­cle and con­sid­er­ing what is said.

Jeep­ers, are we seri­ously think­ing of giv­ing gov­ern­ment con­trol of 15% of GDP?

Remem­ber, this is the same group that allowed Enron, invented McCain-Feingold Cam­paign Reform, brought us the Real Estate Mort­gage Melt­down, runs Amtrak and the Wash­ing­ton D.C. school sys­tem, res­cued New Ore­lans after Hur­ri­cane Kat­rina, voted over­whelm­ingly to sup­port war in Iraq, and annu­ally spends more than a tril­lion dol­lars beyond its means.

In case I’m unclear, Con­gress’ track record isn’t so good. Crys­tal Clear: they have a bad track record. Look at it this way: can you imag­ine your health in the hands of the TSA?

The national debate of the day is ‘fix­ing health care’. The Clin­tons tried this back in 1993, and failed. That attempt used a panel of experts– peo­ple who under­stood health care and were more or less qual­i­fied to weigh in on some sort of fix. Now we’re leav­ing it up to… politi­cians and lawyers. If the effects of the cur­rent pro­pos­als were weather on the hori­zon, it would prob­a­bly look like this.

Side­step­ping all the issues of social­ism, end-of-life com­mit­tees, death pan­els, increased taxes, rationing, and trillion-dollar bud­get increases, I’ve got one question:

Why isn’t health insur­ance more like auto insur­ance?

Sure, I’m prob­a­bly miss­ing some­thing here. But here are my points:

• Auto insur­ance is portable. Noth­ing changes if a get a new job– or have no job at all, for that matter.
• Many states man­date that I carry auto insurance.
• If I want more cov­er­age, or a lower deductible, I pay more.
• In many ways, auto insur­ance groups com­pete for my business.
• My rates go up if I’m acci­dent prone or have areas of risk.
• States which man­date auto insur­ance have pro­grams to assist dri­vers with poor risk profiles.

I think health insur­ance jumped the rails when employ­ers began pro­vid­ing group insur­ance cov­er­age. Back in the day, when most employ­ees worked an entire life­time for one com­pany, this may have been fine. Nowa­days, most employ­ees will have sev­eral employ­ers, and the non-portability of health insur­ance has become a problem.

If we switch to the auto insur­ance model, insur­ance com­pa­nies will com­pete for the healthy, states will assist the less healthy and needy*, and we get insur­ance that is portable and prob­a­bly cus­tomized to each indi­vid­ual or family.

Per­son­ally, I’d like cov­er­age with a fairly high deductible, but with great cov­er­age for cat­a­strophic injury or health prob­lems, more or less like I keep on my cars. Why is this so hard to do?

*We already have a prod­uct for that: Med­ic­aid. It’s been around since 1965.