Single-Payer And Pies-In-The-Sky

Vermont can’t keep moving towards single-payer, as even the folks in charge of Vermont have determined it’s not economically feasible.

The ACA isn’t single-payer, of course, but I’m guessing much support for Obamacare comes from similar pools of sentiment:  Those sympathetic to activist models of governance and the progressive coalitions held together for a time by this President, as well as those who stand to gain the most from the law: Some lawmakers, like-minds in California’s health-care system, many health-care bureaucrats with dogs in the hunt, direct recipients and the few ‘winning’ companies and contractors who will receive the money, prestige, and political power required to implement the law.

Megan McArdle foresaw the likely outcome Vermont back in April:

‘So this is going to be expensive. So expensive that I doubt Vermont is actually going to go forward with it.

This should be instructive for those who hope — or fear — that Obamacare has all been an elaborate preliminary to a nationwide single-payer system. It isn’t. The politics are impossible, and even if they weren’t, the financing would be unthinkable.’

From another piece of hers:

‘The problem is that Obamacare promised too much:  universal coverage, and no rationing, and lower costs.’

The problem as this blog sees it, is that you can end-up harming everyone more than helping in the long-run; over-promising and under-delivering ultimately to those you’re claiming to help and through taking away a lot of liberty, wealth and public trust in the process.

The moral case has never been sufficiently made to me that health care is a right.  Of course, there were serious cost problems with the jerry-rigged system we had going (where our health-care delivery system was used to dispense care inefficiently to save lives), but the solution we’ve legislated will now require much more government oversight of a limited resource, potentially increased politicization of the issues at stake, and the likely growth of a vast bureaucracy with its own inefficiencies, self-interested politics and inertia.  It’s as if we’ve backed into a forest of potentially unnecessary hazards without necessarily having the potential rewards to show for it.

Related On This Site:  Avik Roy At Forbes: ‘Democrats’ New Argument: It’s A Good Thing That Obamacare Doubles Individual Health Insurance Premiums’Megan McArdle At Bloomberg: ‘Health-Care Costs Are Driven By Technology, Not Presidents’

Richard Epstein At The Hoover Institution: ‘The Obamacare Quaqmire’

Richard Epstein At The Hoover Institution: ‘Watching Obamacare Unravel’

From The New England Journal Of Medicine Via CATO: ‘The Constitutionality of the Individual Mandate’From If-Then Knots: Health Care Is Not A Right…But Then Neither Is Property?… From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”Sally Pipes At Forbes: ‘A Plan That Leads Health Care To Nowhere’

The Conventional Wisdom Machine May Be Broken-Some Sunday Culture War Links

Via Pejman Yousefzadeh via Dylan Byers:-From The AP Press: ‘8 Ways The Obama Administration Is Blocking Information:’

Those czars have to report back to central command, I imagine, and it’s worthy of note that this is the AP making a specific list of charges:

6) One of the media — and public’s — most important legal tools, the Freedom of Information Act, is under siege. Requests for information under FOIA have become slow and expensive. Many federal agencies simply don’t respond at all in a timely manner, forcing news organizations to sue each time to force action.

7) The administration uses FOIAs as a tip service to uncover what news organizations are pursuing. Requests are now routinely forwarded to political appointees. At the agency that oversees the new health care law, for example, political appointees now handle the FOIA requests.

The modern Presidency is full of ‘optics,’ but the current White House is very invested in how the President is seen, spurning media outlets for its own carefully planned PR photos and branding.  When all that PR meets reality….well:

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Behold a trailer for an episode of the original Star Trek. Catspaw’:

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Moving along, Amity Shlaes offers a critique of Ken Burns’ new documentary on the Roosevelts, and the political philosophy that often leaks through:

‘On the surface, the series’ penchant for grandees might seem benign, like the breathless coverage of Princess Kate’s third trimester in People magazine. In this country, elevating presidential families is a common habit of television producers; the Kennedys as dynasty have enjoyed their share of airtime. Still, Burns does go further than the others…’

More substance at the link. The Roosevelts earn a special place in the modern pantheon, greater than that of the Kennedys, much more intellectual than the John Lennon pathos, more old-timey than the righteousness of 60’s coalitions and Woodstock nostalgia, and more native and local than the obsessive Royal Baby Watching.

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In the above video Burns discusses how he is primarily an artist, not an historian. He does, believe, however, that his work has other goals besides art. He sees himself as:

“…rooted in a humanist tradition of American History..that includes not just the old top down version, but the bottom up version that acknowledges women and labor and minorities….”

I’m guessing such a vision of the public good acts as a beacon for many at PBS, NPR, and other people interested in speaking for all of the public. Usually they end up, like all of us, presuming their ideals are universal and forming coalitions of self-interest, money, sentiment, political influence etc.  Their ideals have clear limitations and consequences.

Who among us can speak for all the public, or design some rational framework upon epistemological foundations that could ever do so?

To my ears, it’s pretty clear Burns’ ideals lead him to his own top-down version of things.  It would seem Big Labor, Left-liberal Woody Guthrie-like populism, coalitions of 60’s activists, feminists, environmentalists etc. tend to prosper under such a vision.

At what cost to me, to you, to those who might not share in the ideals?

Addition:  Shlaes’ suggestion seems correct.  Burns has done a lot of work to put this piece together, to tell a story and to also try and get many facts right.  It may also focus on some issues and not others, may be biased and examining history through an ideological lens. In a competitive marketplace of ideas, it’s incumbent on opposing points of view to offer their own films that do the same.

Get busy.

Related On This Site:  What about black people held in bondage by the laws..the liberation theology of Rev Wright…the progressive vision and the folks over at the Nation gathered piously around John Brown’s body?: Milton Friedman Via Youtube: ‘Responsibility To The Poor’……Robert George And Cornel West At Bloggingheads: “The Scandal Of The Cross”

I’m drafting on Charles Murray: The Hoover Institution Via Youtube: Charles Murray On ‘Coming Apart’

Free speech and Muslimst From Kenanmalik.com: ‘Introduction: How Salman Rushdie Changed My Life’… Via YouTube: ‘Christopher Hitchens Vs. Ahmed Younis On CNN (2005)’…  Mohammad Cartoonist Lars Vilks HeadbuttedDuring Lecture’From The OC Jewish Experience: ‘UC Irvine Muslim Student Union Suspended’From Volokh: ‘”South Park” Creators Warned (Threatened) Over Mohammed’… More From Spiegel Online After The Westergaard Attacks Via A & L Daily: ‘The West Is Choked By Fear’

A Few Thoughts On NPR And Current Liberal Establishment Thinking Under Obama

From FIRE.org-’Federal Government Mandates Unconstitutional Speech Codes At Colleges And Universities Nationwide’

Greg Lukianoff At FIRE.Org: ‘Emily Bazelon And The Danger Of Bringing “Anti-Bullying” Laws To Campus’

Via The Future Of Capitalism: ‘Nurse Union Chief’s Communist Past’

Future of Capitalism here.

Original article here.

The head of NY biggest nurse’s union:

“I’ve absolutely been an activist since high school,” said Ms. Furillo. “It helped make me who I am.”

When Ms. Furillo was 25, she was an active member of the Young Workers Liberation League, a youth arm affiliate of the Communist Party USA, and an editor of its Young Worker publication. She wrote in 1975: “It is clear that for youth today, there is no real and meaningful future under capitalism. Capitalism means joblessness, racism and degeneracy.”

And from the NY Times on current NYC mayor Bill de Blasio’s past:

‘His activism did not stop. In the cramped Lower Manhattan headquarters of the Nicaragua Solidarity Network of Greater New York, where he volunteered, Mr. de Blasio learned to cause a stir. He and a ragtag team of peace activists, Democrats, Marxists and anarchists attempted to bring attention to a Central American cause that, after the Sandinistas lost power in a 1990 election, was fading from public view. “The Nicaraguan struggle is our struggle,” said a poster designed by the group’

Let’s call the activism of our current President more tame, less radical and more ‘progressive:’

A WaPo piece looked at Organizing For Action, the President’s bid to to make a non-profit fundraising machine out of his coalitions and activist supporters around the time of his second election.

An OFA spokeswoman’s defense of the group’s mission:

“We are confident as we have always been in our abilities to programatically and financially fulfill the mission we have laid out, working on issues like raising the minimum wage for Americans and continuing the fight for action on climate change. It is because of OFA’s strength of having 4.6 million action takers, an average contribution under $40 and more than 420,000 contributors that we are able to choose not to solicit new large donations now through November as we expect some of our supporters will also choose to shift their focus during the midterm season.”

If by ‘grassroots’ you mean organized from the top-down…and if by ‘individuals’ you mean they call you ‘an individual’…for now…then I see a lot of laws that interfere with individual liberty, overpromise money and benefits in poorly-designed systems that favor certain coalitions (unions, activists), and also a governance model that feeds on emotions and outrage often over facts and statistics, encouraging membership on political and ideological grounds.

Addition: Or as a friend points out, OFA is a more sanitized version of activism, made to adapt to a national audience, a breach into which the other radicals run.

A national leader with such commitments needs to use the budget to reward friends and fellow activists, and find the broadest policies possible that keep him in touch with his base (climate change, labor unions, immigration policy tapped into La Raza and Wall street backers), so if the gap can’t be breached, it’s the other party’s fault.

Catholics, Punditry, Progressives & Rubes-Ross Douthat At The NY Times

Full piece here.

Douthat responds to E.J. Dionne’s ‘The Reformicons‘ and Andrew Sullivan’s ‘Reform Conservatism.’ It’s interesting to note that Dionne is a liberal Catholic progressive Democrat (concern-trolling at its finest), and Sullivan a gay, Catholic British emigre, aligning with progressives on many social and political issues (Obama is the ‘true conservative‘), and Douthat a more conservative Catholic columnist for the NY Times, who’s written a book on the subject ‘Grand New Party.’

This seems a pretty BosWash and Catholic affair.

Perhaps Dionne and Sullivan are gazing with warier eyes upon religious and social conservatives now that the progressive coalition in power may be running out of steam, and Obama’s approval numbers are running lower lately.

Douthat:

‘The reality is that, except in truly exceptional cases, our politics is better off in the long run when views held by large proportions of the public are represented in some form by one of our two parties. Right now (to run down a partial list of divisive cultural issues), a plurality of Americans want the immigration rate decreased; about half the country opposes affirmative action; more than half supports the death penalty; about half of Americans call themselves pro-life. Support for gay marriage and marijuana legalization has skyrocketed, but in both cases about 40 percent of the country is still opposed. Even independent of my own (yes, populist and socially conservative) views, I think these people, these opinions, deserve democratic representation: Representation that leads and channels and restrains, representation that recognizes trends and trajectories and political realities, but also representation that makes them feel well-served, spoken for, and (in the case of issues where they’re probably on the losing side) respected even in defeat’

The wheels are turning, and like politicians, many a pundit’s limp body has been pulled from the gears of electoral politics and predictions about the future.

Predictions are hard, especially about the future.

Two Monday Links On Nudging-No, You’re Going To Do What We Say

NPR via Althouse ‘It Takes More Than A Produce Aisle To Refresh A Food Desert

How can you be against the ‘community?’

‘Alex Ortega, a public health researcher at the University of California, Los Angeles, agrees that providing access to nutritious food is only the first step.

“The next part of the intervention is to create demand,” he says, “so the community wants to come to the store and buy healthy fruits and vegetables and go home and prepare those foods in a healthy way, without lots of fat, salt or sugar.”

Dear Reader, I invite you to please indulge my fancy.  Below is an excerpted scene from my hit play Quinoa, Community, Cancer & You-How To Be Good & Healthy For the 21st Century:

Intern–Mr. Ortega, sir, the numbers aren’t…the numbers aren’t what we were hoping for.

AO–It’s ok, Andrea, let’s have a look.  This happens every month (rustling of papers…the audible ticking of the clock on the wall…a door closes sharply down the hall)

AO–I see then. I see. Who did the research here?  Who put this report together? (Ortega brings a heavy laborer’s hand to his brow and stares at his desk)

Intern–An independent firm, sir, but I did some research on HealthWebPlusNet.Gov and it says they’re affiliated with Community Interests & The General Will, same as us.  I don’t recognize no names on there.

AO-Do I know any of them?

Intern–I don’t think so, sir.  I haven’t seen them ever.

AO-Well, I’m not understanding then.  We’re getting great feedback on that quinoa recipe drop over Food Desert 2 last week.  I did a walkthrough over there on Tuesday. People seemed happy.

Intern-I know sir, I know. I hear those recipes are really good.  My auntie collects them all. They’re really great.

AO-And all the price-allocation dials are still turned to 11?

Intern-Of course, Mr. Ortega, of course.

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That’s just a teaser, folks.  There’s more where that came from.  But now onto the People’s Green Front, somewhere between science and ideology: Maria Konnikova At The New Yorker: ‘Hot Heads In Cold Weather

Capstick & Pidgeon?:

‘A slight change in presentation, however, may shift attitudes in the direction of climate science and away from the vicissitudes of local weather. A study out this month, from the Cardiff University psychologists Stuart Capstick and Nicholas Pidgeon, found that periods of exceptionally cold weather in the United Kingdom had the opposite effect as they did in the United States: more people believed in the truth of climate change. The reason for the difference? The media had framed the weather within the context of climate change, emphasizing that it was unnatural, rather than simply cold. Perhaps if people here were told that it’s not just brutal out there, it’s unnaturally brutal, they, too, might jump to a different conclusion.’

If you can’t think for yourself, there are plenty of people to do it for you.

The right people, of course, with all the right ideas, policies, and knowledge.

Related On This Site:  Sunstein’s got to create some space between the Bloomberg backlash and the totalitarians on the Left: Daddy’s Gonna Make You Do ItCass Sunstein At The New Republic: ‘Why Paternalism Is Your Friend’

Kant is a major influence on libertarians, from Ayn Rand’s Objectivism to Robert Nozick’s ‘night-watchman’ state:  A Few Thoughts On Robert Nozick’s “Anarchy, State and Utopia”…Link To An Ayn Rand Paper: The Objectivist Attack On KantRepost-Youtube Via Libertarianism.Org-David Friedman: ‘The Machinery Of Freedom’…Anarcho-capitalism:  Pro-market, anti-state, anti-war…paleo-libertarian: Link To Lew Rockwell Via A Reader

Anarcho-syndicalist, libertarian socialist and sometime blind supporter of lefty causes:  Via Youtube: (1 of 3) Kant, Chomsky and the Problem of Knowledge

New liberty away from Hobbes…toward Hayek…but can you see Locke from there?: Repost-From Public Reason: A Discussion Of Gerald Gaus’s Book ‘The Order of Public Reason: A Theory of Freedom And Morality In A Diverse And Bounded World’

Richard Rorty tried to tie postmodernism and trendy leftist solidarity to liberalism:  Repost: Another Take On J.S. Mill From “Liberal England”

Catholic libertarianism: Youtube Via Reason TV-Judge Napolitano ‘Why Taxation is Theft, Abortion is Murder, & Government is Dangerous’

The classical liberal tradition…looking for classical liberals in the postmodern wilderness: Isaiah Berlin’s negative liberty: A Few Thoughts On Isaiah Berlin’s “Two Concepts Of Liberty”… From George Monbiot: ‘How Freedom Became Tyranny’…Looking to supplant religion as moral source for the laws: From The Reason Archives: ‘Discussing Disgust’ Julian Sanchez Interviews Martha Nussbaum.New liberty away from Hobbes?: From Public Reason: A Discussion Of Gerald Gaus’s Book ‘The Order of Public Reason: A Theory of Freedom And Morality In A Diverse And Bounded World’…Richard Rorty tried to tie postmodernism and leftist solidarity to liberalism, but wasn’t exactly classically liberal:  Repost: Another Take On J.S. Mill From “Liberal England”

From Erica.Biz: ‘Dear California: I’m Leaving You. Here’s Why…’

Full post here.

It made the rounds a while back, but still worth a read.

‘California just isn’t worth it. My priorities have changed. I value income freedom and flexibility more than I value living near the beach. I value having a paid-off house I can call “home” more than I value having a half-million-dollar noose around my neck that declines in value by the day.’

The coast controls the legislature, and the public sector unions, greens, progressives and various lobbyists and activist groups have made living in California prohibitively expensive for many businesses, families, and the private sector.  In short, they’re hollowing out the tax base, and many people have chosen to leave.

Culturally, California has often been ahead of the curve, which would translate poorly for our nation’s fiscal health:  Environmentalism, multiculturalism and diversity, and the folks whom I call fiscally irresponsible egalitarians have been making cultural inroads across America.   They tend to define the public in Left-Of-Center fashion, heavy on the equality side of the equality/freedom equation for the sake of this discussion.

Thus, beneath such a definition of the public, public goods such as utilities, basic services, and education end up being controlled by those who can often end up free riding on the public good: public sector unions, a host of questionably important environmental regulators choking out businesses and jobs, and the worst kind of educrat who determines budgets and hiring.

The ideals guiding this definition of the public and public good clearly place impossible demands upon our institutions, which our institutions can’t practically live up to given the realities of human nature and economic scarcity.  Ironically, those who wanted more equality often end up with less equality.  Getting ahead for many people who end up in charge is still about who they know, luck, making political connections, and money, but now there are fewer people to know, more politicians and interest groups controlling the money supply while aiming for reelection, and less money all around because you’ve driven the productive people out.

More liberty isn’t a bad first step to remedy the situation, but don’t expect too much of California politics in the near future.

So goes California, so goes the nation?

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-A link for Michael Lewis’ article about California politics, public pensions and Schwarzenegger’s time in office.

-A map from Immodest Proposals on how to divide California.  Topographic crime map of San Francisco. 

-California’s anti-immigration, anti-union Democrat: Full video and background on Mickey Kaus here.

Related On This Site: Neo-conservatism partially came out of the increasingly liberal trends in our society, as folks get ‘mugged by reality,” and the response to those liberal trends.  There is always a sharp edge to people, their affairs, and the groups they form:  Victor Davis Hanson Via Youtube Via Uncommon Knowledge: ‘The New Old World Order’Victor Davis Hanson At The City Journal: ‘California, Here We Stay’

Dream big: Via Reason: ‘California’s Public Transportation Sinkhole’ A great city deserves great art extravaganzas…: L.A.’s New Public Art Piece ‘The Levitated Mass,’ Or As The American Interest Puts It: ‘A Moving Rock’

Richard Epstein At The Hoover Institution’s Defining Ideas: ‘California’s Kafkaesque Rent Control Laws’

California Dreamers From The Atlantic-A Brief Review Of Kevin Starr’s History Of California

The people who promise solutions to poverty and homlessness seem to be engaged in a utopian cost-shifting exercise which favors their interests and overlooks crime, violence and personal responsbility…hardly a way to balance the budget: Repost-Heather MacDonald At The City Journal: ‘The Sidewalks Of San Francisco’

Some concentrated wealth on top, a stalled legislature with members who know how to play the game…and a service sector beneath…that probably can’t go on forever: …From The WSJ: ‘Joel Kotkin: The Great California Exodus’

From AEI: ‘Study: ‘Obama Healthcare Reform Raising Costs, Forcing Workers Out Of Existing Plans’

Full post here.

Well, some people behind the Affordable Care Act want to get to single payer, that’s no doubt true.

You also need young, usually healthy people (usually without much money) to pay into the system to subsidize the old, the sick and the poor.  Right now, 2.5 million of those young people have been added to their parents’ plans for a longer period of time, but eventually they will be siphoned in.  I believe one of the primary goals of the Affordable Care Act is to fundamentally change the relationship between nearly every American and their government, bending it more toward the progressive political and moral vision of “shared sacrifice” and collectivist principles of organization which require another entitlement program which won’t ever pay for itself.  This is nothing new.

Some will get access to health care who didn’t have access before, and others will pay for them.  Some insurance companies will gain a lot of new customers (but they must play the game right and tithe the overseers and check the political winds more than they do now).  Some reasons for rising healthcare costs will be addressed (longer life spans, technology and prescription drugs) and many other won’t, and new ones will pop up.

The people who make decisions though, and where the money comes from, and where it goes, and what principles govern our politics and lives, our health, health care, and health insurance will change drastically.

Here are a few quotes posted before on this site:

Pournelle’s Iron Law of Bureaucracy:

‘Pournelle’s Iron Law of Bureaucracy states that in any bureaucratic organization there will be two kinds of people”:

 First, there will be those who are devoted to the goals of the organization. Examples are dedicated classroom teachers in an educational bureaucracy, many of the engineers and launch technicians and scientists at NASA, even some agricultural scientists and advisors in the former Soviet Union collective farming administration.

Secondly, there will be those dedicated to the organization itself. Examples are many of the administrators in the education system, many professors of education, many teachers union officials, much of the NASA headquarters staff, etc.

The Iron Law states that in every case the second group will gain and keep control of the organization. It will write the rules, and control promotions within the organization’

and two quotes from Henry Hazlitt:

“The art of economics consists in looking not merely at the immediate but at the longer effects of any act or policy; it consists in tracing the consequences of that policy not merely for one group but for all groups.

and

“The first requisite of a sound monetary system is that it put the least possible power over the quantity or quality of money in the hands of the politicians.”

My two cents.

Related On This Site:  From The New England Journal Of Medicine Via CATO: ‘The Constitutionality of the Individual Mandate’From If-Then Knots: Health Care Is Not A Right…But Then Neither Is Property?… From The New Yorker: Atul Gawande On Health Care-”The Cost Conundrum”Sally Pipes At Forbes: ‘A Plan That Leads Health Care To Nowhere’Peter Suderman At The WSJ: ‘Obamacare And The Medicaid Mess’

Reason Via Youtube: ‘A True Tale of Canadian Health Care: ‘Why Some Patients Need To Go To The U.S. For Surgery

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Caitlin Flanagan At The Atlantic: ‘Cultivating Failure’

Full piece here.

About the Chez Panisse, Alice Waters, grow-your-own garden-progressive education movement, Flanagan asks:

‘What evidence do we have that participation in one of these programs—so enthusiastically supported, so uncritically championed—improves a child’s chances of doing well on the state tests that will determine his or her future (especially the all-important high-school exit exam) and passing Algebra I, which is becoming the make-or-break class for California high-school students?”

Perhaps very little.  And as for California’s budget mess and bogged down, aimless legislature…is this the way out?

Also On This Site: How do you square progressive policies that grow government with J.S. Mill’s protection of individual rights against the tyranny of government or of the majority?    A Few Thoughts-Another Take On J.S. Mill From “Liberal England”

The Five New States of California…and Seattle?

California Dreamers From The Atlantic-A Brief Review Of Kevin Starr’s History Of California

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