Quotulatiousness

May 23, 2014

He was for the Veterans Health Administration before he was against it

Filed under: Bureaucracy, Government, Health, Military, USA — Tags: , , , , — Nicholas @ 08:33

The Wall Street Journal‘s James Taranto rounds up some amusing-in-hindsight bloviations by Paul Krugman about the efficiencies of the Veterans Health Administration:

There was no ObamaCare in January 2006, when former Enron adviser Paul Krugman wrote this:

    I know about a health care system that has been highly successful in containing costs, yet provides excellent care. And the story of this system’s success provides a helpful corrective to anti-government ideology. For the government doesn’t just pay the bills in this system — it runs the hospitals and clinics.

    No, I’m not talking about some faraway country. The system in question is our very own Veterans Health Administration, whose success story is one of the best-kept secrets in the American policy debate.

The “secret” of the VA’s “success,” Krugman argued, “is the fact that it’s a universal, integrated system.” That saves on administrative costs and allows for efficient record-keeping. Krugman acknowledged that the VA had a history of mismanagement and mediocre care, until “reforms beginning in the mid-1990’s transformed the system.” But wait. Hasn’t it been a universal, integrated system all along? Maybe the secret is something else. At any rate, the Phoenix revelations suggest it’s the system’s failures that are being kept secret.

Krugman lamented that his argument “runs completely counter to the pro-privatization, anti-government conventional wisdom that dominates today’s Washington.” That was 2006, remember, when Republicans had the White House and both houses of Congress. If Krugman is to be believed — a big “if,” to be sure — the Bush administration did a far better job running the VA than the Obama administration is doing now. Which reminds us of something Waldman wrote: “There’s an old saying that when they’re out of office, Republicans argue that government is inefficient and incompetent, and when they get in office, they set about to prove it.”

Krugman concluded that 2006 column as follows:

    Ideology can’t hold out against reality forever. Cries of “socialized medicine” didn’t, in the end, succeed in blocking the creation of Medicare. And farsighted thinkers are already suggesting that the Veterans Health Administration, not President Bush’s unrealistic vision of a system in which people go “comparative shopping” for medical care the way they do when buying tile (his example, not mine), represents the true future of American health care.

“Good Glitches,” anyone?

Krugman managed to get two more columns out of the glorious VA. One, in September 2006, also damned Medicare Advantage and complained that the administration opposed the idea of letting elderly vets use Medicare benefits at VA hospitals:

    “Conservatives,” writes Time, “fear such an arrangement would be a Trojan horse, setting up an even larger national health-care program and taking more business from the private sector.”

    Think about that: they won’t let vets on Medicare buy into the V.A. system, not because they believe this policy initiative would fail, but because they’re afraid it would succeed.

OK, but think about this: According to The-Military-Guide.com, “if you’re eligible for any level of VA care, whether it’s high-priority or low-priority, you’re no longer eligible for ACA exchange subsidies.” (ACA is an abbreviation for PPACA, in turn an abbreviation for the Patient Protection and Affordable Care Act, ObamaCare’s official title.) There are worse things than being excluded from ObamaCare, of course — but the VA may be one of them.

April 6, 2014

Obamacare, viewed from a distance

Filed under: Government, Health, Politics, USA — Tags: , , , — Nicholas @ 09:16

Peggy Noonan attempts to look at Obamacare apart from the daily battles over details:

As I say, put aside the argument, step back and view the thing at a distance. Support it or not, you cannot look at ObamaCare and call it anything but a huge, historic mess. It is also utterly unique in the annals of American lawmaking and government administration.

Its biggest proponent in Congress, the Democratic speaker of the House, literally said — blithely, mindlessly, but in a way forthcomingly — that we have to pass the bill to find out what’s in it. It is a cliché to note this. But really, Nancy Pelosi’s statement was a historic admission that she was fighting hard for something she herself didn’t understand, but she had every confidence regulators and bureaucratic interpreters would tell her in time what she’d done. This is how we make laws now.

Her comments alarmed congressional Republicans but inspired Democrats, who for the next three years would carry on like blithering idiots making believe they’d read the bill and understood its implications. They were later taken aback by complaints from their constituents. The White House, on the other hand, seems to have understood what the bill would do, and lied in a way so specific it showed they knew exactly what to spin and how. “If you like your health-care plan, you can keep your health-care plan, period.” “If you like your doctor, you can keep your doctor, period.” That of course was the president, misrepresenting the facts of his signature legislative effort. That was historic, too. If you liked your doctor, your plan, your network, your coverage, your deductible you could not keep it. Your existing policy had to pass muster with the administration, which would fight to the death to ensure that 60-year-old women have pediatric dental coverage.

[…]

The program is unique in that the bill that was signed four years ago, on March 23, 2010, is not the law, or rather program, that now exists. Parts of it have been changed or delayed 30 times. It is telling that the president rebuffed Congress when it asked to work with him on alterations, but had no qualms about doing them by executive fiat. The program today, which affects a sixth of the U.S. economy, is not what was passed by the U.S. Congress. On Wednesday Robert Gibbs, who helped elect the president in 2008 and served as his first press secretary, predicted more changes to come. He told a business group in Colorado that the employer mandate would likely be scrapped entirely. He added that the program needed an “additional layer” or “cheaper” coverage and admitted he wasn’t sure the individual mandate had been the right way to go.

Finally, the program’s supporters have gone on quite a rhetorical journey, from “This is an excellent bill, and opponents hate the needy” to “People will love it once they have it” to “We may need some changes” to “I’ve co-sponsored a bill to make needed alternations” to “This will be seen by posterity as an advance in human freedom.”

February 21, 2014

QotD: The unexpected benefit of government incompetence

Filed under: Bureaucracy, Government, Quotations, USA — Tags: , , — Nicholas @ 14:56

As Eugene McCarthy, of all people, observed: “The only thing that saves us from the bureaucracy is inefficiency. An efficient bureaucracy is the greatest threat to liberty.”

Luckily the United States is blessed with one of the most incompetent governments in the developed world. It isn’t simply that the Americans have a bloated government, it’s that they have a bloated government that accomplishes far less dollar for dollar than the bloated governments of other leading nations.

This is why Americans should have no fear of Canadian style socialized health care being imposed on them, their government isn’t smart enough to run it. That said Obamacare is turning out to be something that makes Canadian Medicare look like the Swiss Army. I grimly await the flood of American health care refugees trickling north of the 49th. That’s bad news for them and worse news for us. What kept the Canadian system semi-functional was the American escape hatch. If upper middle class Canadians can no longer sneak across to Buffalo, Burlington or Seattle for treatment, that puts more pressure on our system.

From time to time I’m asked why government is so incompetent. It’s such a truism among conservatives, libertarians and classical liberals that it’s rarely reflected upon. February is cold in Winnipeg, governments are generally incompetent. We accept these things perhaps too readily. The truism is true, but in assuming it so blithely we fail to communicate its importance to reasonable people who are uncommitted.

Richard Anderson, “The Incompetence of Evil Government”, The Gods of the Copybook Headings, 2014-02-20

February 5, 2014

NYT – reducing full-time employment by 2.5 million is a good thing

Filed under: Business, Economics, USA — Tags: , , — Nicholas @ 09:33

This New York Times editorial tries valiantly to make the case that the recent prediction by the Congressional Budget Office of 2.5 million full-time job losses is a good thing for the affected workers and the economy as a whole:

The Congressional Budget Office estimated on Tuesday that the Affordable Care Act will reduce the number of full-time workers by 2.5 million over the next decade. That is mostly a good thing, a liberating result of the law. Of course, Republicans immediately tried to brand the findings as “devastating” and stark evidence of President Obama’s health care reform as a failure and a job killer. It is no such thing.

The report estimated that — thanks to an increase in insurance coverage under the act and the availability of subsidies to help pay the premiums — many workers who felt obliged to stay in a job that provided health benefits would now be able to leave those jobs or choose to work fewer hours than they otherwise would have. In other words, the report is about the choices workers can make when they are no longer tethered to an employer because of health benefits. The cumulative effect on the labor supply is the equivalent of 2.5 million fewer full-time workers by 2024.

[…]

The new law will free people, young and old, to pursue careers or retirement without having to worry about health coverage. Workers can seek positions they are most qualified for and will no longer need to feel locked into a job they don’t like because they need insurance for themselves or their families. It is hard to view this as any kind of disaster.

Despite all the whistling as we stroll along the cemetery fence, the editorial does correctly point out that insurance benefits that are tied to particular employers do limit choices for many workers. I’ve made the argument a few times that this is something that unions should be pushing very hard for: to make benefits more portable for both unionized and non-unionized workers. The rest of the editorial isn’t quite as helpful … two and a half million current workers no longer working (and not through a voluntary switch to self-employment or retirement) isn’t the wonderful thing they claim it is. Those people and their families will still need income to provide themselves with food, shelter, and all the other necessities of modern life. Tough to do that without visible means of support.

Update: At the National Journal, James Oliphant rallies to the White House’s defence during what he calls “the worst day that Obamacare has had in weeks — and that’s saying something.”

To debate that point, the White House supplied as its first responder Jason Furman, the chairman of the Council of Economic Advisers, an academic and policymaker schooled in the intricacies of the labor market. Furman disputed any reading of the report that said the ACA was a net drag on the economy — but often doing so in head-scratching language of a Washington insider.

At one point, a reporter at Tuesday’s briefing asked Furman in frustration, “What the heck do you mean?”

Furman’s presence, however, outlined in neon the problem the Obama administration has been having since the ACA became law: a persistent inability to detail its benefits in language that resonates with the public. And in its defense, the ACA’s multiple mechanisms are not the easiest to explain. To that end, its critics, who often have relied upon hyperbole and scare tactics, have always held the political advantage.

But sometimes you just have to punch the bully in the nose — and Furman wasn’t the person for the job. That was the case Tuesday. The first takeaway from a complex CBO report was that the office had concluded that Obamacare is going to be a job-killer. Period. Full stop. It fell upon Furman — along with liberal bloggers — to attempt to explain that, no, it’s more complicated than that.

Follow along: The report doesn’t say that the ACA will result in 2 million jobs lost by 2017, but projects there will be 2 million fewer workers in the workforce, the White House says (a number it doesn’t necessarily agree with). It’s the difference, Furman underscored, between labor supply and labor demand. And they aren’t “jobs,” he reiterated, they are “FTEs.” (Full-time equivalents, if you are scoring at home.)

In other words, he explained, businesses will still want as many workers as ever, but the ACA will result in an increasing number of workers deciding to take themselves either entirely out of the job market or working fewer hours. Why? Because they may decide to keep their income below a certain level in order to qualify for government help to buy health insurance on the exchanges.

This is a good thing, Furman said, because the ACA will give workers more flexibility, whether they want to become entrepreneurs or take another, lower-paying job. And again, the press corps had some trouble with this concept. It’s good for someone to take a lower-paying job? And it’s good that the law encourages them to take it?

January 19, 2014

Obamacare opponents ruthlessly parody the efforts of supporters

Filed under: Humour, Media, Politics — Tags: , , , , — Nicholas @ 10:51

Those who are still opposed to President Obama’s healthcare program will go to any lengths to ridicule and belittle both the program itself and the people who support it. Here, for example is one of the nastiest attempts to drag Obamacare into the public eye in as negative and mocking a fashion as possible.

I’m either on drugs, or the administration is this helplessly stupid. The Tell a Friend — Get Covered campaign, better described as “a tourist trap off Route 66,” began a six-hour live-streamed event Thursday afternoon that was advertised to “include stories, tips, helpful information and other details related to national health care options.” Really, it was as if the audio-visual club got wasted on malt liquor and hijacked public access television.

Get Covered, a partnership among state healthcare exchanges and the Obamacare missionary Enroll America, expertly fails to cater to young people. Its circus began Thursday with a dance-off between Richard Simmons and the contortionist Nathan Barnatt, overseen by the star of an Internet show whose premise is “drunk cooking.” How this is supposed to entice a 27 year old to pay $200 a month for health insurance, or even talk about it, is a question for the gods.

“What’s he doing?” Simmons exclaimed as Barnatt began to shake his body wildly.

“He’s extending his livelihood! That’s what he’s doing!” Hannah Hart, your host and creator of My Drunk Kitchen, responded in an endorsement of cardio.

Oh, c’mon. Is this seriously going to be one of those D-grade infomercials in which the participants force every line back to the bottom one?

“His moves are telling us something,” Barnatt whispered as Simmons took his turn.

“They are, and I think they’re saying, ‘Be flexible about your health insurance options,’” Hart responded.

Yes. Yes, it is.

Oh. Sorry. Apparently this isn’t a sleazy disinformation scheme by opponents. It’s a “good faith” advertising effort by supporters. Carry on, then.

December 26, 2013

The limits of redistributive politics

Filed under: Economics, Government, Politics, USA — Tags: , , , , — Nicholas @ 09:19

Wendy McElroy on the economic redistribution problem in politics:

A friend is celebrating the season by visiting her children in the States. Like many millennials, her 20-something son is working brutal hours for minimum wage at an unfulfilling job. After visiting with him and his girlfriend, my friend emailed, “These kids are SO stuck in not being able to even pay their rent that they have no energy left to dream anything.”

A similar story is playing out in family after family across America. Twenty-somethings are holding down two minimum wage jobs because no one wants to hire full-time people for whom they might have to provide health insurance. In a stagnant economy, their unemployment tops the chart. Meanwhile, they are saddled with debt and taxes for entitlements they will probably never receive, like social security.

As I moved through the day, my friend’s words haunted me. They perched at the back of my mind as I read a New York Times article that was an odd combination of proclaiming the obvious and writhing to avoid it. One quote captures the dance: “These days the word [“redistribution”] is particularly toxic at the White House, where it has been hidden away to make the Affordable Care Act more palatable to the public and less a target for Republicans…. But the redistribution of wealth has always been a central feature of the law and lies at the heart of the insurance market disruptions driving political attacks this fall.” The obvious: The core goal of Obamacare is the redistribution of wealth. The writhing: Obama lied, only he had to lie because of those wretched Republicans.

And, then, it occurred to me. It wasn’t just wealth. The dreams and future of my friend’s son have been systematically redistributed away over the last five years. As a white, male, 20-something, he is in a particularly hard-hit category of people. He is likely to work unfulfilling, low-paid jobs for as far in the future as he can see. And, as diligent as he may be, it is far from clear that he will be able to rise through merit.

From the onset of his presidency in 2009, Obama’s domestic policies have revolved around distributive justice. That is, he uses the force of law to forcibly wrench wealth, political pull, opportunity and dreams themselves from those in so-called ‘privileged’ classes and transfer them to so-called ‘disadvantaged’ ones. As his popularity sinks, Obama is returning to the theme of redistributing wealth, which has been a vote winner among his constituents. On December 4, he delivered a speech that foreshadowed policy in 2014. The White House called it a speech on “economic mobility”; the press called it his “inequality speech.” It was a call for egalitarianism, especially in terms of income and opportunities. In other words, a greater redistribution of wealth and further regulation to guarantee that everyone has access to money and upward mobility.

December 21, 2013

I’m starting to think that Megan McArdle is a bit jaundiced about Obamacare

Filed under: Government, Health, USA — Tags: , , — Nicholas @ 11:27

Otherwise, how can you account for running a column titled like this?

Obamacare Initiates Self-Destruction Sequence

On Wednesday, Politico’s Carrie Budoff Brown reported that the administration was saying fewer than 500,000 people had actually lost insurance due to Obamacare-induced cancellations. This struck me as a strange leak: Half a million is a lot less than many people (including me) have been estimating, but it is still not a small number, and the administration has tended to sit on negative information until the last possible moment.

Yesterday, we had a more official announcement from the administration: Anyone who has had their policies cancelled will be exempt from the individual mandate next year. The administration is also allowing those people to buy catastrophic plans, even if they’re over 30.

What to make of these two statements? On the one hand, the administration is trying to minimize the number of people who have been affected by cancellations, and on the other hand, it is unveiling a fix to the problem of cancellations. And these are not minor changes.

[…]

The White House is focused on winning the news cycle, day by day, not the kind of detached technocratic policymaking that they, and the law’s other supporters, hoped this law would embody. Does your fix create problems later, cause costs to spiral or people to drop out of the insurance market, or lead to political pressure to expand the fixes in ways that critically undermine the law? Well, that’s preferable to sudden death right now.

However incoherent these fixes may seem, they send two messages, loud and clear. The first is that although liberal pundits may think that the law is a done deal, impossible to repeal, the administration does not believe that. The willingness to take large risks with the program’s stability indicates that the administration thinks it has a huge amount to lose — that the White House is in a battle for the program’s very existence, not a few marginal House and Senate seats.

And the second is that enrollment probably isn’t what the administration was hoping. I don’t know that we’ll start Jan. 1 with fewer people insured than we had a year ago, but this certainly shouldn’t make us optimistic. It’s not like people who lost their insurance due to Obamacare, and now can’t afford to replace their policy, are going to be happy that they’re exempted from the mandate; they’re still going to be pretty mad. This is at best, damage control. Which suggests that the administration is expecting a fair amount of damage.

December 7, 2013

Hitchcock’s MacGuffin in US politics

Filed under: Media, Politics, USA — Tags: , , , — Nicholas @ 13:16

At Ace of Spades HQ, Ace explains what the MacGuffin is and why American media outlets don’t care about it and think you shouldn’t care about it either:

In a movie or book, “The MacGuffin” is the thing the hero wants.

Usually the villain wants it too, and their conflict over who will end up with The MacGuffin forms the basic spine of the story.

In Raiders of the Lost Ark, the MacGuffin is, of course, the Lost Ark. Indy wants it; the Nazis have it. This basic conflict over simple possession animates a two hour long movie.

Alfred Hitchcock noted — counterintuitively, when you first hear this — that the specifics of the MacGuffin don’t really matter at all to a movie. He pointed out that the audience doesn’t care at all about the MacGuffin. The hero in the movie itself cares, but the audience doesn’t.

In one Hitchcock film, the MacGuffin was some smuggled uranium hidden in vintage wine bottles. But Hitchcock noted it didn’t matter if it was uranium in wine bottles, or a fragment of a diplomatic dispatch from the Nazi high command, or a hidden murder weapon, or photographs proving a Senator’s affair.

Okay, we’ve got the movie notion down … what’s the US political MacGuffin?

For Obama’s fanbois, this is not politics. This isn’t even America, not really, not anymore.

This is a movie. And Barack Obama is the Hero. And the Republicans are the Villains. And policy questions — and Obama’s myriad failures as an executive — are simply incidental. They are MacGuffins only, of no importance whatsoever, except to the extent they provide opportunities for Drama as the Hero fights in favor of them.

Watching Chris Matthews interview Obama, I was struck by just how uninterested in policy questions Matthews (and his panel) were, and how almost every question seemed to be, at heart, about Obama’s emotional response to difficulties — not about policy itself, but about Obama’s Hero’s Journey in navigating the plot of President Barack Obama: The Movie.

As with a MacGuffin in the movie, only the Hero’s emotional response to the MacGuffin matters.

Again and again, Matthews and his panel focused not on weighty questions of state, but on what toll these important-sounding MacGuffins took upon the Star of the Picture, Barack Obama.

Matthews was not terribly interested in hearing about the problems with Obamacare, or how Obama planned to address them.

But he was very interested in learning how Obama was coping with the challenges.

Matthews didn’t care all that much about disputes over the budget. But he was keenly interested in Obama’s thoughts on his opponents in such struggles.

Chris Matthews’ called Obama’s last answer the most important in the interview, and his entire panel agreed it was simply amazing.

[…]

Note what they’re not talking about: America. Policy. The economy. Obamacare. Actual live political controversies and possible programmatic responses to the difficulties we face (many of which Obama has caused himself, or made worse).

No, American politics is now merely a MacGuffin, an important-sounding but ultimately inconsequential and disposable plot device for holding interest in the Hero’s Journey.

Ultimately the only thing that matters is the Hero itself. It doesn’t matter why the Hero Barack Obama wants the Lost Ark of Sensible Gun Control, or the Shankara Stones of Comprehensive Immigration Reform, or the Democratic Holy Grail of Affordable Health Care. These are very minor details and only matter to the extent the Hero exerts himself to achieve them.

The viewers of this film don’t really care about these things, but only Obama’s frustration at being denied them, or his joy in attaining them.

December 6, 2013

The devil’s-in-the-details department: Obamacare and volunteer firefighters

Filed under: Bureaucracy, Law, USA — Tags: , , — Nicholas @ 13:38

Talk about unintended consequences! Jim Geraghty linked to a disturbing issue for many Americans, but especially for Pennsylvanians: the risk of losing some of their volunteer firefighters due to an Obamacare rule. Ninety-seven percent of Pennsylvania fire departments are at least partially staffed by volunteers … this could be a very serious thing indeed.

Great. Now Obamacare Is Going to Louse Up Your Local Firehouse…

They had to pass the law so you could see what’s in it. Kind of like Pandora’s Box.

With any luck, Obamacare won’t close down your local firehouse, just curtail emergency response activities:

    The International Association of Fire Chiefs has asked the Internal Revenue Service, which has partial oversight of the law, to clarify if current IRS treatment of volunteer firefighters as employees means their hose companies or towns must offer health insurance coverage or pay a penalty if they don’t.

    The organization representing the fire chiefs has been working on the issue with the IRS and White House for months.

    “It could be a huge deal,” said U.S. Rep. Lou Barletta, R-11, Hazleton, who is seeking clarification from the IRS. “In Pennsylvania, 97 percent of fire departments are fully or mostly volunteer firefighters. It’s the fourth highest amount in the country.”

    So far, the IRS hasn’t decided what to do.

    Efforts to reach spokesmen for the IRS were unsuccessful.

    Under the fire chiefs’ organization’s interpretation, the concern goes like this:

    The health care reform law, known officially as the Patient Protection and Affordable Care Act and derisively by Republicans as Obamacare, requires employers with 50 or more full-time employees to offer health insurance. Companies with fewer than 50 employees do not have to offer insurance. Full-time employees are defined as an employee who works 30 or more hours a week.

    Such employers who don’t offer health insurance must pay fines.

    The requirement is complicated by differing interpretations about the status of volunteer firefighters within the federal government. The Department of Labor, according to the fire chiefs group, classifies most volunteers as non-employees, but the IRS considers all volunteer firefighters and emergency medical personnel to be employees of their departments.

    “If the IRS classifies volunteer firefighters and emergency medical personnel as employees in their final rule, fire departments may be unintentionally forced to comply with requirements that could force them to curtail their emergency response activities or close entirely,” the chiefs’ group says on its website.

November 28, 2013

Colby Cosh on Obamacare’s international ripples

Filed under: Cancon, Government, Health, USA — Tags: , , — Nicholas @ 11:12

You’ll have guessed from the tone of my Obamacare links and comments that I didn’t think it was a good idea from the start and it’s been a great example of how not to implement a major government initiative. That said, it’s a sure bet that Obamacare will have influence on other countries as they consider their own health programs. Colby Cosh is surprised that the scandal-addled Canadian media hasn’t been paying more attention to the Obamacare train wreck as the wheels fall off in all directions:

Obamacare isn’t going to make major systemic change in either direction look more appetizing to Canadians. That’s an important Canadian angle right there. Not long ago it looked as though national pharmacare was likely to become an election issue here, quarterbacked by the NDP and perhaps the Liberals, too. The concept has plenty of support among economists and other health policy experts—the same class of kindly boffins that, in the U.S., lined up almost unanimously behind the Affordable Care Act.

For better or worse, nationalizing prescription-drug insurance seems likely to be a much tougher sell here in the immediate future. Any large, complex health care experiment will be. The more wise heads support it, the easier it will be for supporters of the status quo to shout, “Unintended consequences! Ivory-tower tomfoolery!” Indeed, political strategists may already be saying it to themselves.

American commentators are already starting to wonder if Obamacare’s difficult start and increasingly troubled prospects may end up as a victory for small-government conservatism. The problems for the program do not end with the calamitous state of the federal insurance-exchange website, or even with the nasty surprises handed to the self-employed and freelancers in the “individual market” who were falsely promised: “If you like your plan you can keep your plan.” Some Obamacare buyers are finding themselves shut out from their preferred doctors and hospitals; employers are junking non-compliant health plans; and many in the middle class who liked the Obamacare concept are facing sticker shock.

[…]

The redistributive aspects of Obamacare were undersold, and possible pitfalls obviously not foreseen. The neoliberal Democrat Walter Russell Mead put it neatly the other day: “President Obama may be the Democrat who ends up convincing millions of American millennials that Ronald Reagan was right, and that the progressive administrative state is neither honest nor competent enough to solve the problems of the American people.” If that is the case, the effects cannot be confined to the U.S.

November 21, 2013

How Obama lost young voters

Filed under: Media, Politics, USA — Tags: , , , , — Nicholas @ 13:46

Nick Gillespie looks at the remarkable way Barack Obama transitioned from cool to square for one of his key supporting demographic groups:

Back in 2008, Barack Obama seemed like the coolest cat to hit the national scene in a long time, almost scientifically engineered to appeal to idealistic young Americans. He was the perfect combination of a dream dad and an older brother who could run you ragged up and down the basketball court, wink and nod about smoking dope, and hip you to some older but still cool music, you know? In 2008, the Pravda of youth culture, Rolling Stone, slathered the future president with praise for being so with it that he even knew how to use…an iPod. We were all pretty sure that his eventual Republican challenger, John McCain, had stopped listening to music when Rudy Vallee went electric or Stephen Foster released his Chris Gaines record or something, but there Obama was, listening to Bob Dylan, Yo-Yo Ma, Sheryl Crow, and even Jay-Z. “I have pretty eclectic tastes,” Obama told Rolling Stone. He even went on to invoke “Maggie’s Farm,” Dylan’s classic song of generational defiance and opting out. “It speaks to me as I listen to some of the political rhetoric,” explained.

Yeah, well, it’s all over now baby blue. Like Bush before him — and in many wars, even worse than Bush before him — Obama has personified the failure of leaders to speak plainly, honestly and directly and to enact simple, effective, financially responsible policies that speak to Americans’ hopes and dreams. The great political continuity in the 21st century is one of transpartisan failure and the continuing flight from party affiliation by more and more Americans.

Beinart and others like him are right to note that Obama’s and the Democrats’ decline in popularity is not automatically the Republicans’ gain (though get a load of this: Ken Cuccinelli won the 18-24 year-old vote against Terry McAuliffe in the Virginia governor’s race). But just as there’s no reason to expect the problems with Obamacare to be fixed anytime soon, there’s no reason to think that youth disaffection with the president is going to get better over the remainder of his second term. He’s failed with younger voters not in spite of his policies but because of them. Along the way, he transmogrified from a hipster dad into a near-total drag whose control is as absolute as his inability to get anything right.

In terms of basic demographics, the future belongs to Millennials because they are young. For good and ill, they will inherit the world their elders made for them. In terms of politics, the future belongs to leaders and parties who not only agree with the record-high percentage of Americans who think the government has too much power but actually propose to give some of it away.

November 16, 2013

US apparently trying out new quasi-monarchical form of government

Filed under: Government, Wine — Tags: , , , , — Nicholas @ 10:18

As a British-born Canadian I’m used to the occasional ill-informed jab from American commentators about our form of government being a barbaric remnant of the dark ages, what with still having a monarch and all. If I respond at all, it’s usually to point out that we owe a lot for the longevity of our slowly evolving political system to the “Baronial brute squad of 1215” and the fact that we’ve (for the most part) steadily moved the monarch away from the levers of power. 798 years of political evolution is not to be sneered at. In the United States, the evolution has apparently gone in the other direction: moving those levers of power toward the monarch and away from the soi-disant “legislative branch” of government.

I haven’t seen as much fun-poking about the monarchy from my American friends lately, as they seem to have introduced a new form of non-crown-wearing, non-ermine-trimmed monarchy:

It is a condition of my admission to this great land that I am not allowed to foment the overthrow of the United States government. Oh, I signed it airily enough, but you’d be surprised, as the years go by, how often the urge to foment starts to rise in one’s gullet. Fortunately, at least as far as constitutional government goes, the president of the United States is doing a grand job of overthrowing it all by himself.

On Thursday, he passed a new law at a press conference. George III never did that. But, having ordered America’s insurance companies to comply with Obamacare, the president announced that he is now ordering them not to comply with Obamacare. The legislative branch (as it’s still quaintly known) passed a law purporting to grandfather your existing health plan. The regulatory bureaucracy then interpreted the law so as to un-grandfather your health plan. So His Most Excellent Majesty has commanded that your health plan be de-un-grandfathered. That seems likely to work. The insurance industry had three years to prepare for the introduction of Obamacare. Now the King has given them six weeks to de-introduce Obamacare.

“I wonder if he has the legal authority to do this,” mused former Vermont governor Howard Dean. But he’s obviously some kind of right-wing wacko. Later that day, anxious to help him out, Congress offered to “pass” a “law” allowing people to keep their health plans. The same president who had unilaterally commanded that people be allowed to keep their health plans indignantly threatened to veto any such law to that effect: It only counts if he does it — geddit? As his court eunuchs at the Associated Press obligingly put it: “Obama Will Allow Old Plans.” It’s Barry’s world; we just live in it.

The reason for the benign Sovereign’s exercise of the Royal Prerogative is that millions of his subjects — or “folks,” as he prefers to call us, no fewer than 27 times during his press conference — have had their lives upended by Obamacare. Your traditional hard-core statist, surveying the mountain of human wreckage he has wrought, usually says, “Well, you can’t make an omelet without breaking a few eggs.” But Obama is the first to order that his omelet be unscrambled and the eggs put back in their original shells. Is this even doable? No. That’s the point. When it doesn’t work, he’ll be able to give another press conference blaming the insurance companies, or the state commissioners, or George W. Bush . . .

November 15, 2013

Misunderstanding the purpose of health insurance

Filed under: Business, Economics, Health — Tags: , , , , — Nicholas @ 00:01

One of the big problems facing everyone in the US is the cost of healthcare: it’s expensive and getting more so. Obamacare is supposed to be an attempt to lower the overall cost of healthcare, but by approaching it from the “insurance” angle, it’s likely to make the situation worse rather than better. The Anti-Gnostic reposted an extended comment from Steve Sailer’s blog explaining why misunderstanding the purpose of insurance is a big problem:

1) Most people lose money on insurance, because most of the time insurance doesn’t pay out more than it takes in.

2) Thus, a “good” policy is a catastrophic-coverage-only, high-deductible policy, where most payments are out of pocket. This is a policy that protects you against the downside risk, but where you lose a lot less on average.

3) This is because the purpose of insurance is to protect yourself from *catastrophe*, not to make routine purchases.

4) For example, if you went to Best Buy and whipped out your home insurance card to get a new flat screen TV, everyone would look at you as a crazy man. “Don’t you know that home insurance is only for fires and floods, and not for routine purchases?”

5) And so it should be with health insurance, because you’ll actually — *provably* — pay less with a high deductible plan for all but catastrophic conditions.

6) Indeed, the most innovative and technologically advanced areas of medicine are ambulatory areas in which people feel that markets are “ok”. These are paradoxically the most trivial areas: lasik, plastic surgery, dermatology, dentistry, even veterinary medicine.

7) Why are these areas so advanced? Because people pay cash money, because they choose based on quality, and because they are *able* to choose — i.e. they aren’t being wheeled up to the hospital in a gurney in a no choice scenario.

8) Moreover, with every technology ever, from cars to cell phones to air travel to computers, things that start out expensive become cheaper when enough people demand them. With medicine it seems to bite more that money means differences in care. But at the end of the day doctors, patients, nurses, drugs, ambulances…all that stuff means real resources, and a refusal to do explicit computations just results in massive waste as costs are shunted to a place where no one looks at them.

At the Independent Institute blog, John Graham points out that — in the few places that government allows free markets to operate — prices tend to drop over time even while services or features improve:

It has taken a long time, but the price of hearing aids is in the process of falling dramatically. How has this happened? Technological innovation, of course, but there is more. There’s no shortage of technological innovation in U.S. health care. However, because third-party payers, that is, health insurers and governments, determine prices, there is no mechanism for customers to signal value to providers.

This is not the case for hearing aids: Although some states have mandated insurance coverage for hearing aids, this is usually limited to disabled children. The big market for hearing aids is seniors, and Medicare does not cover hearing aids.

This is another case of a phenomenon observed elsewhere by Devon Herrick of the National Center for Policy Analysis [PDF]: Where patients pay directly for medical care, prices fall like they do in every other market.

Seniors who want highly personalized service from an audiologist in his own practice can get it, and they will pay for it. Those who want to order online can save money by doing that. Those who want to get their old hearing aids repaired can make that choice. And the most adventurous seniors, who don’t mind running an earpiece into an iPhone, can get a functional hearing aid almost for free.

We are on the verge of enjoying universal access to hearing aids — but only because the government restrained itself from interfering, and let the market operate.

November 9, 2013

Barack Obama on the difference between private enterprise and government

Filed under: Bureaucracy, Business, Government, Technology, USA — Tags: , , , — Nicholas @ 11:43

Ann Althouse finds it amazing that President Obama clearly understands why his campaign website was so effective and why the Obamacare website fails on so many levels, but can’t generalize that knowledge to the whole public/private sphere:

In yesterday’s interview with Chuck Todd, Obama said:

    You know, one of the lessons — learned from this whole process on the website — is that probably the biggest gap between the private sector and the federal government is when it comes to I.T. …

    Well, the reason is is that when it comes to my campaign, I’m not constrained by a bunch of federal procurement rules, right?

That is, many have pointed out that his campaign website was really good, so why didn’t that mean that he’d be good at setting up a health insurance website? The answer is that the government is bad because the government is hampered by… government!

    And how we write — specifications and — and how the — the whole things gets built out. So part of what I’m gonna be looking at is how do we across the board, across the federal government, leap into the 21st century.

I love the combination of: 1. Barely able to articulate what the hell happens inside these computer systems, and 2. Wanting to leap!

    Because when it comes to medical records for veterans, it’s still done in paper. Medicaid is still largely done on paper.

    When we buy I.T. services generally, it is so bureaucratic and so cumbersome that a whole bunch of it doesn’t work or it ends up being way over cost.

This should have made him sympathetic to the way government burdens private enterprise, but he’s focused on liberating government to take over more of what has been done privately. And yet there’s no plan, no idea about what would suddenly enable government to displace private businesses competing to offer a product people want to buy.

November 5, 2013

QotD: Accumulated bureaucratic turkeys

Filed under: Bureaucracy, Government, Quotations — Tags: , — Nicholas @ 00:01

Anyone with family or friends in the civil service hears about the hours wasted on bureaucratic wrestling with the guy who spends his energy crafting strategies to get you to do his work. My favorite came from a doctor in a prestigious department at a state hospital whose secretary threw out most of his mail, including all of the invitations, because answering it was too much work. He ended up getting his wife to come into the office and act as his unpaid secretary, because firing or replacing the secretary was way too much trouble.

I am not slamming all civil servants as lazy lackwits; these stories come from good civil servants who are endlessly frustrated by the obstructive and destructive minority. Turkeys in government are like prizes on Wheel of Fortune: Once you win one, it’s yours to keep. They can’t be fired, and they rarely quit; the best you can do is wait for a chance to transfer them somewhere else.

Because of the Universal Law of Turkey Accretion, the quality and effectiveness of a government agency’s personnel are likely to peak very shortly after that agency is established. HHS has been around for a long time, and so has its IT staff. Which means it has more than a few turkeys. Or, as David Cutler put it in a 2010 memo to Larry Summers, “The agency is demoralized, the best people have left, IT services are antiquated, and there are fewer employees than in 1981, despite a much larger burden.”

Megan McArdle, “Get Rid of Obamacare’s Turkeys”, Bloomberg.com, 2013-11-04

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