Category: Stupidity

Unacceptable Notions

The United Nations is concerned:

More parents are turning to medical clinics to perform genital mutilation, wrongly assuming that it spares girls physical and psychological damage, a U.N. agency warned Monday.

The U.N. is specifically concerned about girls because it’s full of hypocrites. I’ve discussed that before, so no need to rehash it here. Yet, looking into its concern is informative. In this context, the United Nations is worried that parents are making female genital mutilation (FGM) more palatable by turning it into a clinical procedure. What the U.N. now fears for girls sounds painfully similar to the basic history behind the growing acceptance of male circumcision (MGM) in America. Physicians became the new priests. The technique improved, but the logic didn’t.

The practice leaves lasting physical and psychological scars, in addition to the risks it generates during childbirth, the U.N. Population Fund said.

The comparison between each procedure leaving physical scars should be obvious enough, although far too many people believe the circumcision scar(s) that remain on the penis are somehow normal. As for psychological scars, the only difference I can decipher is that female genital mutilation is often performed on girls old enough to understand what’s being done to them, whereas male genital mutilation in “civilized” countries occurs primarily on those too young to consciously remember the surgery. Many tout this aspect as a benefit.

Obaid also warned that in some nations parents were subjecting “younger and younger” girls to the practice to avoid refusals to participate. Girls generally undergo the rite before the age of 10, often without anesthesia.

If children remembering the surgery is what the U.N. is concerned with, it should cheer these parents for sparing their daughters the memory. Instead, the U.N. correctly gasps at such an obscene development. But why the disparity? Why should girls be protected, yet when the same fact pattern occurs in boys, it’s wise medical practice? In some parts of the world, males are not circumcised until they approach puberty. They’re old enough to remember the anticipatory buildup. Even then, when the comparison is particularly direct, the United Nations (and other organizations) never fail in remaining quiet. Why? I’ve argued before that basic human rights require more than a clean operating room and good intentions. Surely gender does not fall into that realm of more.

In related news, the Population Reference Bureau declared today the 4th International Day of Zero Tolerance for Female Genital Cutting (pdf), complete with a symposium. I don’t link this here to indict their work. I’m sure it’s useful and any effort to end medically-unnecessary genital cutting on unconsenting individuals will generally get my support. But the glaring omission that the other half of the population is equally at risk must be highlighted. At the symposium I attended in August, the organizers focused on non-consensual genital cutting. Boys and girls deserve equal protection from unnecessary surgery.

“Soak the rich” is not shared responsibility.

I haven’t had time to work my way through John Edwards’ proposed health plan (pdf), but I’ve read enough to know that it’s a preposterous joke that would end in fully socialized health care. No thanks. But instead of summarizing such a silly idea, I’d rather briefly explore Ezra Klein’s analysis of the plan. (Link courtesy of Balloon Juice.) I suspect it’s a fair representation of a good swath of left-leaning liberals who buy into the economically unsound view sold by most prominent Democrats. Consider:

In other words, the public sector will finally be allowed to compete with the private sector, and consumers will be able to decide which style they prefer. For Democrats, this is a significant step forward. From there, the plan offers the usual mix of sliding subsidies to ensure affordability, individual mandate to universalize coverage, pay-for-performance promises, and public health fixes. You’ve heard those bits before. What’s new, and what’s important, are the community rated health markets that include public insurance. Indeed, the plan satisfied every plank of my progressive health reform test from last week.

The plan will cost between $90 billion and $120 billion a year, and according to Edwards, taxes will have to be raised to pay for it. Readers should remember that this is the first full health reform plan from a major candidate in the 2008 election. As such, it has widened the field of the debate, and unless the other candidates want to explain why they lack the boldness of Edwards’ plan, they’ll have to offer similarly comprehensive proposals. What they will have to match is full community rating, a public insurance option, total universality, scaleability towards more public involvement, and a willingness to propose something comprehensive enough to require revenue increases to fund. In other words: The goalposts have been moved. To the left.

I don’t like this at all. The public sector has no business competing with the private sector. Aside from the centuries of data demonstrating that private markets work better, the public sector isn’t tasked with such endeavors. It must tackle public concerns like national defense. Individual choices of managing personal risk is entirely different. The public sector can’t know what my preference is for medical insurance. Inevitably, I will be forced to pay for something I don’t want or need, or I will be forced to pay for something for someone else that I don’t believe is appropriate. Why should a third-party be involved in that decision?

From what I’ve seen of Mr. Edwards’ tax plans with respect to health coverage, he believes that the rich should pay more and that the IRS can find unpaid taxes to minimize the new burden. Nonsense on both counts. The “rich” have no obligation to the “poor,” just as no man has any specific obligation to another man. That’s what individual, private sector transactions are for. People can create their own network of obligations and commitments. With such a radical shift, and massive increase in the tax burden of a few, those proposing such a change must prove why their new path is justified. If consumers can decide which version they prefer, why will some still get stuck with the bill for those who prefer the other? Using the barrel of a government gun to make me pay for someone else’s choices is wrong, regardless of how much money I make.

Of course, Mr. Klein’s entire premise is absurd, so everything preceding his final point adds little but easy counter-arguments. “Comprehensive enough to require revenue increases” is an ideological assumption, not a practical foundation. It shouldn’t be hard to see the byzantine mess that can evolve if bold vision requires only greater revenue. Too many supporting universal, taxpayer-funded health care seem confused that poor people receiving inadequate care and groups of people lacking health insurance are the same problem. They are not. You can solve one in this debate. Either everyone gets coverage and medical care becomes rationed, or people in need of medical care who can’t pay for it get the specific, immediate care they need, with the question of who pays being a separate discussion. If it’s the latter, this babble about universal health care is a utopian dream. If it’s the former, why do supporters believe that worse health care for most Americans is justifiable to give poor people what they’re generally already getting?

The short version is better. Wishing it so and making it so aren’t the same action.

It makes a great spread for toast, too.

Via Kip comes the disturbing but unsurprising news that Texas Gov. Rick Perry signed¹ an executive order that has no coherent public policy justification:

By issuing an executive order, Perry apparently sidesteps opposition in the Legislature from conservatives and parents’ rights groups who fear such a requirement would condone premarital sex and interfere with the way parents raise their children.

Beginning in September 2008, girls entering the sixth grade — meaning, generally, girls ages 11 and 12 — will have to get Gardasil, Merck & Co.’s new vaccine against strains of the human papillomavirus, or HPV.
…

“The HPV vaccine provides us with an incredible opportunity to effectively target and prevent cervical cancer,” Perry said in announcing the order.

“If there are diseases in our society that are going to cost us large amounts of money, it just makes good economic sense, not to mention the health and well-being of these individuals to have those vaccines available,” he said.

As Kip pointed out, becoming infected with HPV does not guarantee cervical cancer. All this will do for public health is prevent a few cases of HPV infection. His grandiose rhetoric to the contrary, Gov. Perry has done nothing quite as dramatic as he claims. Or rather, the dramatic result is not what he now claims.

Kip also pointed out that the key factor in this debate and whether it makes sense to make vaccination mandatory is that “HPV is not casually contagious.” There is no reason to mandate such an action. Boys are not going to enter the doors of George W. Bush Middle School, sneeze, and infect every any girls with HPV. This is over-reaction with no reasonable basis.

The obvious parallel, of course, is infant male circumcision, which has been justified because it appears to have an impact on HPV transmission. Whether or not that prevention is substantial is irrelevant. The core principle when making a permanent change to someone’s body is medical need. Medical need rarely exists in infant male circumcision; likewise, there is no medical need here to force such an action on young girls. There is no public health basis and a highly subjective personal health basis. Behavior can be taught, and like boys with the behavioral negatives that circumcision supposedly cures, some understanding of the individual affected should influence the decision.

This is naked rent-seeking for Merck poorly disguised as social engineering by Gov. Perry. He delivers millions of customers to Merck. What is he getting in return? Gov. Perry should be ashamed.

¹ Note the wonderful headline to the AP story: Texas Gov. orders anti-cancer vaccine. Gardasil is an anti-HPV vaccine. There is an important difference. Gov. Perry is not mandating an anti-cancer vaccine, no matter how well-intentioned he believes his action to be. It’s being sold with that exaggeration to make it more marketable. Unfortunately, there are individuals involved who can’t consent to such politically warm and fuzzy experimentation on their bodies.

Promoting Ignorance

I seldom watch the evening news because everything it presents can be found in shorter, more productive (i.e., less sensational) formats on The Internets. Last night I stumbled on a segment on NBC where Brian Williams introduced the news that Exxon Mobil produced a record profit of $39.5 billion for 2006. Rather than taking the standard “windfall” profits route, Williams hit a different bit of stupidity. He set up the reporter to address this popular “outrage” by asking what incentive Exxon Mobil now has to find alternate energy sources. Ehhhhhhhhh.

I didn’t listen to the answer because, as he asked it, his implication lacked any notion of understanding or belief that Exxon Mobil might not drive its business into the ground seeking ever greater profits from oil. In the larger context of the economy, Exxon Mobil doesn’t have to perceive any incentive to find alternate energy. Perhaps Exxon Mobil doesn’t want to be in that business and believes that oil (and natural gas) will be around long enough that it can keep generating profits without alternate energy sources. I doubt its executives believe that, but it doesn’t owe anyone beyond its shareholders an obligation to adjust its business to market pressures. If alternate energy is potentially profitable, someone will pursue it. That someone will most likely include Exxon Mobil. This is not complicated.

Of course, the $20 billion or so that Exxon Mobil invested in exploration and research last year suggests that they’re at least working to find more oil, oil that we currently can’t reach or find. While not an alternate energy source, finding more oil delays the need for finding an alternate energy source. The scarcity and political ramifications that Williams probably thought he was asking about are a bit more complicated than one company generating a large¹ profit through its activities. If Williams wanted to make that point, he should’ve offered a monologue on how a $39.5 billion profit is socially irresponsible or some other pontification. He probably figured that Al Gore already has that covered, which left him free to continue his economically simple misunderstanding.

¹ I’ve made this point before, but it probably needs to be said again. In absolute dollars, $39.5 billion is impressive and mind-boggling. In the context of the expenses (and taxes) needed to create such a figure, a great deal of the luster wears off. As a percentage of total revenue, the net profit is only 10.45% (39,500/377,635). Many companies with a smaller absolute dollar profit have significantly higher profit ratios. To illustrate this point relative to Exxon Mobil, its revenue for the fourth quarter of 2006 decreased (pdf link) by more than $9 billion from the same quarter in 2005. Yet, it managed to keep net income mostly stable by lowering its costs. There’s obviously more thorough analysis needed to give that weight, but only politicians with a populist axe to grind would hammer its conservative results. Maybe I should hammer away at the “revenue” brought in by the U.S. government.

A government takeover can’t be far behind.

This is only peripherally about the Major League Baseball Extra Innings package, although I will discuss that angle again. But I can’t let it pass when a politician so bravely steps in to assist in a way that highlights his previous hypocrisy. Consider:

A proposal to make Major League Baseball’s “Extra Innings” exclusive to DirecTV has drawn the ire of Sen. John Kerry.

The Massachusetts Democrat said he plans to raise the matter with the chairman of the Federal Communications Commission at a hearing Thursday.

“I am opposed to anything that deprives people of reasonable choices,” Kerry said in a statement. “In this day and age, consumers should have more choices _ not fewer. I’d like to know how this serves the public _ a deal that will force fans to subscribe to DirecTV in order to tune in to their favorite players. A Red Sox fan ought to be able to watch their team without having to switch to DirecTV.”

So many issues pop up, but it’ll probably make the most sense to first address the MLB decision in the context of Sen. Kerry’s remarks. MLB is stupid if it proceeds with this asinine marketing strategy, but it is free to hurt its business if it so chooses. It is not obligated to “serve the public” any more than Whole Foods is obligated to cater to vegans. That, of course, brings up the notion that consumers should have more choices. I view keeping cable as an Extra Innings choice as desirable because it specifically impacts me. But MLB should have the same range of choice to run its business in whatever way it believes will maximize its profits and its brand, even if that means running both into the ground. Sen. Kerry’s rhetoric will serve well the economic populism that pervades our public discussion, but it’s misguided.

With his statements, Sen. Kerry also managed to make a mockery of his stances on most economic issues and many personal choice issues. If Senator Kerry is in favor of people having reasonable choices, why isn’t he promoting Social Security reform, for example? I contribute, even though I’d prefer to put my money in personal investments controlled by me and backed up by actual assets. But I don’t have that choice. How does that serve the public? I’m sure I could walk through a point-by-point list of Sen. Kerry’s campaign issues and find many more examples where he’s been less than a champion for allowing people to have choices. (I have little doubt I can find multiple examples where Sen. Kerry believes that businesses should be limited, so I won’t challenge him there.)

Greater than all of this, though, is the simple fact that Chairman Kevin Martin and the FCC have no regulatory control over cable that would enable it to take action against Major League Baseball. Sen. Kerry should know this. I assume he does, but that doesn’t sell because then the government¹ isn’t there to come to the rescue.

¹ Major League Baseball should not have anti-trust exemption. There shouldn’t be anti-trust prosecution against MLB if it didn’t have the exemption, but that’s getting further into that issue than I’m interested. Since these are the rules we’re operating under, and MLB is happy to benefit from them, I won’t feel bad if/when Congress goes after the owners for this exclusive deal with DirecTV. Feed the snake enough and you will get bitten.

Maryland will probably try to force Wal-Mart to subsidize this.

Maryland is really stepping into stupidity with its foray into addressing the current politically desirable hot potato health insurance crisis. I’m not sure which is worse, Gov. Martin O’Malley’s plan, or the naked defectiveness of politicians from a plan in the General Assembly. Consider:

Gov. Martin O’Malley (D) will call for expanded coverage of the state’s 780,000 uninsured — one in seven residents — in his State of the State address today, aides said, highlighting a proposal that would bring more of the poorest residents into public programs and require private insurers to allow young adults to remain on their parents’ plans until age 25.

What kind of nonsense is that last new regulation, other than an outright admission that politicians love to coddle people into ignoring reality and the consequences of their own choices. At what point will parents be allowed to kick their children off of their policy? If it’s so desirable for insurers to include young adults on their parents’ insurance, wouldn’t they have already offered such policies? Might current burdensome regulations and perverse incentives be the reason why those under 25 “can’t” purchase affordable health insurance? Making those worse will help? At some point, maybe people can leave the care of their parents and go directly to the care of the state. No one ever has to make any tough choices for himself. Even if he wants to make those choices.

General Assembly leaders are offering more ambitious plans that would add a $1 tax on cigarettes to pay for covering tens of thousands of low-income workers and offer subsidies to small businesses that provide coverage. Many workers who can afford insurance but choose not to pay for it would have to buy it or face penalties.
…

The governor opposes a tobacco tax increase, and even if lawmakers approve it, there is some sentiment to use the revenue to cover other needs. And despite the momentum in the Democrat-controlled legislature, initiatives of this magnitude often take more than a single session to sell.
…

A $1-a-pack increase in the tobacco tax also is the centerpiece of an effort by the Maryland Citizens’ Health Initiative to expand health care access through Medicaid and drug treatment. Although other states have approved tobacco tax increases to pay for health care, Senate President Thomas V. Mike Miller Jr. (D-Calvert) has expressed concern that if the tax acts as a deterrent to smoking, the revenue source could plummet.

If it might not work, why are Maryland’s elected officials so ready to implement it? Because it might work? And even if it works, the outcome might be bad? What? Politicians can’t control themselves, even when they allegedly have good intentions. They will botch the implementation of the noblest of plans. They should not be allowed anywhere near such an important, vital aspect of individual life.

Dude, Where’s My Gas Tax?

Charles Krauthammer starts off with a great premise from his Friday column:

Is there anything more depressing than yet another promise of energy independence in yet another State of the Union address? By my count, 24 of the 34 State of the Union addresses since the oil embargo of 1973 have proposed solutions to our energy problem.

The result? In 1973 we imported 34.8 percent of our oil. Today we import 60.3 percent.

Most everything else in his essay is worth reading. The bit about ethanol, in particular, is useful because we’re not getting the full picture. There are unintended consequences, as the cost to feed livestock increases (not necessarily a bad unintended consequence for vegans). More farmland must go to grow corn. And few in power will acknowledge how government protections irrationally impact decisions regarding ethanol since sugarcane can be used to make ethanol at a significantly more efficient, effective cost in dollars and energy expended. But we must prop up our sugar industry from foreign trade. As Mr. Krauthammer says, we’re not really serious about tackling the issue of oil dependence as much as we’re interested in making the politically correct choices that appear responsible.

As good as it is, I’m still left with questions from Mr. Krauthammer’s essay. Particularly, from this:

First, tax gas. The president ostentatiously rolled out his 20-in-10 plan: reducing gasoline consumption by 20 percent in 10 years. This with Rube Goldberg regulation — fuel-efficiency standards, artificially mandated levels of “renewable and alternative fuels in 2017” and various bribes (er, incentives) for government-favored technologies — of the kind we have been trying for three decades.

Good grief. I can give you 20-in-2: Tax gas to $4 a gallon. With oil prices having fallen to $55 a barrel, now is the time. The effect of a gas-tax hike will be seen in less than two years, and you don’t even have to go back to the 1970s and the subsequent radical reduction in consumption to see how. Just look at last summer. Gas prices spike to $3 — with the premium going to Vladimir Putin, Hugo Chávez and assorted sheiks rather than the U.S. Treasury — and, presto, SUV sales plunge, the Prius is cool and car ads once again begin featuring miles-per-gallon ratings.

No regulator, no fuel-efficiency standards, no presidential exhortations, no grand experiments with switch grass. Raise the price, and people change their habits. It’s the essence of capitalism.

I’d quibble that the essence of price increases mandated by the government is not capitalism, but that’s not really my point. I haven’t refueled my car in several weeks¹, so I can’t really say what the current average is. Also, I’m too lazy to look it up on The Internets. I’m just going to assume $2.50, since it’s an easy number to work with. My assumption means that, to reach Mr. Krauthammer’s suggestion, the government must increase the current gas tax by $1.50 per gallon. Done. And then?

Where does the money go? When the actual, untaxed price of oil fluctuates higher the next time some crisis arises, will the government adjust the extra tax down to keep the price stable at $4? The goal is to reduce consumption, not bankrupt the economy, I assume. So what do we do when capitalism interferes with the essence of capitalism? I don’t trust politicians to be noble with that extra $1.50 per gallon, if nothing else. (Don’t tell me that $1.50 per gallon would go to “energy independence” programs or whatever. Two words: Social Security.)

I agree that this would have at least the effect that Mr. Krauthammer and other supporters suggest. But I’m skeptical. There will be unintended economic consequences, as well as waste by politicians. I don’t like artificially unleashing these demons to make us do what we “should” do.

¹ Public transit is great, except when it leaves me stranded in the cold for an hour, as it did Friday morning.

The rare positive bears the stain of the negative.

More on Major League Baseball’s decision to give its most faithful fans the shaft sell exclusive rights to the Extra Innings package to DirecTV, this time courtesy of Buster Olney’s Insider blog at ESPN (subscription required). Olney has received a multitude of e-mails since writing about this deal several days ago, most of them negative. He has seen the occasional positive spin, even if it’s flawed:

Count me among the minority of baseball fans that’s actually in favor of the DirecTV deal. No one talks about the monopolistic control Comcast has in the cable industry and, as anyone with even a passing familiarity with economics can tell you, the winner goes to the highest bid. Comcast likely gambled on the fact that MLB wouldn’t want to deprive some subset of its fans, but MLB never blinked. Now, I not only finally get the Comcast monkey off my back, but I’m also saving a lot of money every month with the same access to more channels and premium content. What’s not to like?

— Jon Phillips, Seattle, Wash.

I don’t care if some people like the deal, but at least like it for the correct reasons. From Mr. Phillips’ e-mail, every benefit he projects onto this deal is a benefit he could’ve gotten before the deal, while still enjoying Extra Innings. I contend that getting “the Comcast monkey” off his back wasn’t that important to him. The savings from DirecTV didn’t suddenly improve with this deal. I suspect they’ll dissipate, since DirecTV will now have monopoly power over Extra Innings. The access to channels with DirecTV didn’t change. DirecTV had the package every year leading up to this deal. Yet, Mr. Phillips never switched. His hatred of Comcast, however justified, is clearly irrelevant based on his own behavior. The only thing that changed is cable lost the last content it had that Mr. Phillips valued. That is what will send Mr. Phillips to DirecTV. The rest is just feel-good beliefs.

But is that enough to make this a good deal for Major League Baseball? After doing some research into adding DirecTV – I can be outraged and still cave to my addiction – to my house, there are very real costs involved to me. Also, the goodwill that baseball possesses as our national pastime and that it rebuilt after the labor shenanigans in ’94 can’t have a definitive dollar value, but it exists. That extra $30 million DirecTV reportedly offered is not “found money”. Major League Baseball may value it more, but it has a price.

Okay, if your son is Teddy Roosevelt.

Very often, arguments so stupid as to warrant little more than an eye roll and a click to the next article come along to annoy the intelligent reader. Those are easy enough to set aside. Sometimes, though, someone will make an argument so mind-numbingly pointless that highlighting is necessary in an effort to remind others that such drivel will be exposed for what it is. Today, I found such an argument arrived in my rss feed.

Among pediatricians and obstetricians and some insurance companies, there are few topics that generate more controversy than whether newborn boys should undergo circumcision. In this country at this time it is the most common surgical procedure being done. Having done duty with troops in the tropics, the writer has some very strong opinions about the benefits of this operation, whereas most of the physicians (primarily pediatricians) who are opposed to the routine circumcision of boys seem to have escaped the experience of heat, humidity, dirt, and poor opportunities for good personal hygiene that is often the story in the tropics. Circumcising a 20 year old is a far more formidable procedure than taking care of a 20 hour-old baby. And the 20 year-old will be disabled for duty for about 20 days, which is a great loss to the overall effectiveness of the unit, plus misery for the 20 year-old.

The perpetrator of this irrelevant tangent is Dr. Richard S. Buker, Jr., Health Officer for Liberty County, Montana. That scares me. A doctor providing information to the community should provide factual information for use by patients. This is anecdotal hooey aimed at parents with blatant disregard for the child’s medical needs and rights.

Dr. Buker thinks it’s correct to hold every boy to a standard that might – might – be appropriate in a tropical environment with limited access to proper hygiene facilities. I’m fairly certain that Liberty County, Montana does not meet that requirement. (Money should be spent on proper hygiene facilities instead of circumcision, if that’s a problem.) As for any potential decrease in troop effectiveness if soldiers are intact, Dr. Buker posits that forced surgery on infants is a benefit in case he joins our volunteer army. This is not rational. The boy can have himself circumcised before joining the military, if he so chooses.

Or non-facts:

Good evidence keeps increasing to support the argument for routine circumcision, which people should be aware of. The single biggest recent finding is that HIV/AIDS transmission is 80% less when men are circumcised. The big push in Africa and South East Asia is to get all males circumcised to decrease the spread of this horrible scourge. What works in Africa works here as well.

I’m going to be kind to Dr. Kruger and say that he is mistaken instead of lying when he quotes an 80% decrease in HIV transmission. The rate mentioned in the few studies done so far indicate a decreased incidence of between 50 and 60%. That extra 20% or more is huge, aside from the obvious arguments against the other 60%. Dr. Buker is a public health official. He must get his facts correct. The burden is especially important when he’s advocating unnecessary, permanent alteration of a child’s body.

It has long been established that the statistical risks of circumcision are considerably less that the risks of not being circumcised. Cancer of the penis is almost unknown in circumcised men. Sexually transmitted disease is less common in circumcised males. In the experience of the undersigned, who has served as a venereal disease control officer (in the tropics), chancroid was 80 times as common in uncircumcised males as in circumcised men.

Cancer of the penis is almost unknown in intact men. Sexually transmitted disease can be prevented with condoms and responsible sexual behavior. No surgery necessary.

Urinary tract infections in children under 5 years of age are less common in circumcised males. Paraphimosis (the writer hated getting up in the middle of the night to treat this problem), balanitis, and getting foreskin caught in a zipper can all be avoided by routine circumcision plus it is no fun being teased in the locker room, all of which are arguments for circumcision of newborns. What about arguments against the procedure? It is a bit cruel to overpower a helpless baby and do an operation on him, and like all operations there is a small risk. As all readers will readily have concluded by this point, the writer is highly in favor of the procedure.

UTIs are more common in girls than in intact boys. Paraphimosis (the writer should not be a doctor if he doesn’t want to treat patients) and balanitis can be avoided by procedures less invasive than circumcision. Getting the penis caught in a zipper can happen with or without circumcision. Being teased in the locker room is not a medical condition justifying surgery. The only argument against infant circumcision that Dr. Buker can come up with is that it’s a bit cruel, and there are risks. No kidding. That should be enough, since it’s also medically unnecessary at the time it’s performed.

These are the arguments of a man who’s already made up his mind and is looking for excuses in the face of logic and facts.

Coalition of the Willing and Unwilling

From yesterday’s Washington Post, this report on a new “consensus” on healthcare reform:

On the surface, it looked to be just another Washington news conference, part of the white noise of the political and policy process.

But this one was different. There, at the National Press Club, stood the president of the Business Roundtable, representing the country’s largest corporations; the president of the Service Employees International Union, the country’s most vibrant union and one of its fastest-growing; and the president of AARP, the formidable seniors lobby. They put aside their usual differences to deliver a clear, simple message to President Bush and congressional leaders of both parties:

We stand ready to give you the political cover you need for a centrist, bipartisan fix for a broken health-care system.

Or, if you refuse, we stand ready to embarrass you and run you out of office.

That’s interesting enough, if it were actually true. But I reject any claim that those three groups have the authority to speak for the nation as a whole. Only the AARP represents a sizeable portion of the nation, and that’s not enough to provide any claim to policy making. Populist rent-seeking never appeared so obvious.

In my case, I’m a small-business owner. I’m only 33. I’m not in a labor union. Who’s got my voice? Me, of course, and willingly so. But this is no one’s concern. The only outcome that matters is coming up with a solution that represents 20th century forces in the 21st century. This press conference could have just as easily occurred in 1907 as 2007.

What does that consensus look like?

It starts with universal coverage, accomplished either through a mandate on everyone to purchase basic health insurance or a mandate on all employers to offer it.

That much we already know, because we think people just aren’t motivated enough (the former proposal) or that more of what we already have will fix the problem (the latter proposal). There is no need to understand why we got here. Once we have a solution worked out, we’ll find the path backwards to where we are to tell the correct story. It’s insanity.

A few of suggestions warrant consideration, and by consideration, I mean outright dismissal.

Finally, it sets a deadline for physicians and hospitals to switch to computerized health records, along with a program to provide no-interest loans to buy the necessary hardware and software.

I’m sure that physicians and hospitals have delayed computerizing health records because no-interest loans were not available. Or it could be that the economic efficiency created by the process wasn’t supported by the cost. Or maybe it’s that physicians and hospitals are in the business of providing care instead of information technology. Only in a world where universal assumptions pass as analysis for the multitude of scenarios in which physicians provide care can an outcome that a universal solution will work. Of course, it’s a lot easier to say that when you impose a no-interest loan requirement. I’m certain “no-interest” means taxpayers will pick up the cost to subsidize this. It would be important to remember that something economically-justified would pay for itself, despite the cost of interest. It’s silly to let that get in the way, though. PEOPLE ARE DYING IN THE STREET!

Hospitals and insurers would have to agree that 85 percent of their revenue would go to providing direct care, capping profit and administrative expenses at 15 percent.

Wow. Central planning at its most crass. We know what expenses should be, as well as a fair profit. There need not be a direct tie to quality here. Fifteen percent for admin expenses and profit is enough. This will not end well.

Health insurers would have to accept the obligation to sell insurance to everyone, with only modest variation in rates for age and health status.

I guess actuaries should start looking for other work. It hasn’t proven to be useful, anyway, since risk can just be ignored. What could go wrong?