Wednesday, July 29, 2009

I know it's been a long time.....

I've been on a blogging hiatus for some time, and for all 3 of my regular readers, permit me to apologize. I just haven't been all that inspired.

However, that is changing with the new and changey political climate. I have really wanted to give President Obama a chance to do some of the things he promised during the campaign, and I have refrained from forming any sort of concrete judgment of him and his policies until he's had a chance to get settled into office. Now that he's settled, I've come to a conclusion--he just ain't all that smart. He doesn't appear to have a handle on basic economic concepts, and yet one pillar of his presidency is his proposal to have a huge chunk of the economy federalized.

Sure, the man can give a great speech -- but what else has he actually accomplished thus far? Back in the 90's, I thought Clinton gave an awful lot of speeches and press conference...but Obama is taking that to a whole new level. Frankly, that is not much to worry with, since the President is a figurehead, and to expect any President to grasp the intricacies of each and every decision that gets made in government is entirely unreasonable. However, it is reasonable to expect the President to be familiar with the big-ticket items on which he campaigned -- and for Obama, that was, as I recall, closing Guantanamo (and other issues relating to Iraq), "health-care" reform, and economic recovery.

So how is Obama doing so far? Well, as for Guantanamo, he appears to be continuing the same policies as the previous administration. As for the wider war, with Iraq, he appears to be continuing the same policy as the previous administration, although I gather there is now a deadline (the end of 2011, I believe) for the complete withdrawal of American forces from Iraq. That is well and good, but longer than the 18 months or so he campaigned on -- however, we can forgive him for that, because no candidate (other than a sitting President running for re-election) can really know or understand such a complicated military situation until he's actually in office.

As for the economic recovery, neither the stimulus package Bush got through nor the efforts of this administration have done much good. As for the "most transparent adminsitration evah," well, even on the stimulus money Obama has fallen way short. And why are taxpayers buying sprial-sliced ham at an inflated price? Has the recession caused a huge decrease in demand for ham? Aren't we supposed to get a volume discount, as opposed to an almost 100% markup over the grocery store price for ham? I like ham as much as the next guy, maybe even more so, but c'mon, Prez...if these are the same negotiating skills you'll bring to bear on "big pharma", I'll expect the cost of medication to skyrocket.

My point on the economy is this -- the notion that government has to "do something, anything" has, once again, been shown to be misguided at best, and destructive of a quicker recovery at worst. Increasing government debt increases uncertainty in markets, and that's not a good for the investor class (which comprises something like 50% of the population now). This is the same investor class that (a) pays virtually all the taxes the government collects, (b) provides most of the jobs in the private sector, and (c) produces nearly every single innovation in nearly every single thing innovated. And now, to pay for all this "stimulus", that same investor class is going to have more of its hard-earned dollars taken from it in the form of taxation to fund the government, and the newest experiment in government interference in private affairs, "health care reform."

Even the words "health care" bother me. "Health care" has become a catch-all, and it's treated as a right that everyone has. Why is it a right? Because somebody said so -- there's no Constitutional right to "health care." That means that "health care" is a positive right, as opposed to negative rights like free speech and the like. Positive rights are essentially legal rights -- we have these rights because the government (local, state, or federal) says we have them. As a result, some good things have happened in the field of medical care -- hospitals can't turn away patients who lack the ability to pay, for example.

As an aside, I've often wondered who the "46 million" uninsured are. There are those that cannot qualify for Medicaid for whatever reason that comprise one slice of the pie. There are those that can afford health insurance but, due to reasons all their own, do not purchase insurance and pay out of pocket, which might very well be the most economically efficient thing for them to do (I myself went to the doctor a total of about 6 times between the age of 22 and 37, and it would have made more sense for me not to have insurance for me...but I also had two kids, and my ex had a number of complicated medical issues that required surgery, so I was quite glad that BC/BS was there to cover the vast majority of those costs). This is another significant (and, from what I understand, larger group than the chronically uninsured) slice of the overall pie. Another large chunk is a group that may or may not be covered by any "public option" -- illegal immigrants. Again, it may very well be that this group is larger than the chronically uninsured. The last sizable group are folks that qualify for Medicaid but never sign up, for whatever reason -- and it's more than you think. In any event, the numbers have been bandied about are difficult to discern, and those that strongly favor a "public option" often use the 46 million figure without knowing or caring what the reality behind that number is. This includes the President, unfortunately, and it appears that, like Avon Barksdale in The Wire, sometimes you have to fight on a lie.

My general problem with the government getting in the health insurance business is that it already is in the health insurance business, and does it poorly. Medicaid is going bankrupt as we speak. As for the government "negotiating" prices with doctors and institutions for procedures and tests and the like? Well, the government says "you have to treat folks on Medicaid, and this is what you will charge them" -- which is neither negotiation nor a rational market solution to the problem of access to medical care.

Why do I dislike the term "health care" in this debate? Because, in my opinion, it moves the goalposts from what I consider the government's proper role in medical care -- ensuring access to medical treatment for those who cannot afford it on their own. Again, this system is already in place in the form of Medicaid. Perhaps I'm not privy to sufficient information, but I'm unclear where ability of access medical care has been anything other than increased for poor folks over the years. The question isn't obtaining medical treatment -- it's who pays for that treatment.

Furthermore, what treatment is reasonable under the circumstances? Persons making private contracts with private insurers can pick and choose which plan suits them, which coverages they need, and then they pay the premium for that in a voluntary transaction. With a public option, it's difficult to see that same principle applying.

Also, the public option appears to create some perverse incentives. Apparently, part of the proposal is to penalize private businesses of a certain size to the tune of 8% of their payroll if they don't provide insurance to employees. What that means is that employers whose present insurance costs exceed 8% of payroll will stop insuring their employees and pay the penalty -- perfectly rational economic behavior. What that also means is that those employees would then be shuttled into the government's insurance pool -- and the government, depending on its whim, can change the penalty to whatever it wants, and further manipulate the supply of and demand for the government's insurance plan.

These are just a few of the problems I have with it. Now, reasonable people can disagree about the policy itself and the implementation of the policy into practical solutions to our health care "crisis". I for one will not welcome our new bureaucratic health care overlords. Others that I know think that it is absolutely imperative that there be a public option, and others still who think that a Canadian-style single-payer system is the only way to go. The questions I ask are "how much do you want the government deciding your medical issues for you?" and "how much will this increase the deficit, and how will that affect the economic opportunities of my kids?"

Increasingly, I am aware of the pervasiveness of government in all our lives, and the effect that pervasiveness has on us. I've grown over the years to despise the federal government, due mainly to the politicians that control it. The democrats appears to want to increase government's presence in my life in matters as intimate as medical decisions I make for me and my family. The republicans apparently want to do somewhat the same on a slightly smaller scale, with a lot of Jesus stuff thrown in. I can't stand either party, and to cede yet more control over our lives to those in power, whose interests do not align with our own ("I want to see my doctor" vs. "I want to get reelected") is not a solution to problems the politicians made in the first instance.

These are merely my opinions on this, based on what I understand the situation to be. Feel free to correct me where I'm wrong on the facts, or debate the points made.