THE VIEW FROM CHAOS MANOR
View 583 August 10 - 16, 2009
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August 10, 2009
I posted a lot of mail Sunday, some interesting. I may sleep in late in the morning then spend the day on the column.
Contemporary science fiction:
Installing Windows 7. Column is late. There's interesting mail. I seem to be recovered from what my oncologist called swine flu; a reader tells me that we all got swine flu a decade ago and are probably immune and what I had / sort of have / was the Mexican flu only we don't call it that now. I haven't been following it. Anyway, I'm recovering. I won't fade into the sunset just yet.
For those with an interest in how we got into the Middle East Mess, see the FPRI essay I have posted in mail.
|This week:||Tuesday, August
The health care "debate" has become frantic, which probably means that it will fail just as Hillary-care failed. It's just as well. Whatever one thinks about the obligations of the society to provide "health care" -- and the definition of that term is probably the key issue -- it's pretty clear that it isn't going to be solved by rushing things through. When the Clintons tackled this problem they tried to assemble a brains trust to come up with a comprehensive scheme. That didn't work, but at least there was a unified plan. Handing this problem to the rapacious wolves in Congress and telling everyone to rush along, pass enormous and complex laws with provisions stuck in by anyone who can manage to get into the room, is almost certainly not the proper way to allocate 15% and more of the Gross National Product.
The "debate" will go on, and get even more rancorous; it's not over. It will probably fail this time, but even that's not assured; and the hydra will be back another time. There are too many people who "feel" for those without health care, and who haven't thought a lot about the consequences of the various plans.
One problem is that definition of "health care". There's another problem with the notion of "insurance." The demand for a free good is infinite: you can't just say "everyone is entitled to health care without limit." There is no end to what one can do with enough money. If a study shows that having a private room with 24/7 professional nursing care gives one a better survival chance -- as it almost certainly will -- there will be no lack of lawyers willing to sue on behalf of the poor and homeless demanding that if anyone gets that kind of attention (even if they pay for it themselves) then everyone ought to have it. If a kidney transplant is good for the rich, is not everyone entitled to it? What about pacemakers? What about new procedures? Universal health care without limit is a free good which will generate infinite demand. There have to be limits.
How are those to be set?
Free people are not equal and equal people are not free: if I cannot spend more on health care than you even though I have the money, that is a limit to my freedom and liberty; but if I can, then that is an infringement of equality. If I can't afford it, why should you have it? The pressure is toward equality over freedom in matters of health and life. Without infinite resources this conflict is inevitable.
As to insurance, think about the notion that there is to be no exclusion or increase in premiums for pre-existing conditions (that seems to be common to all the proposed plans). Obviously under that situation the optimum strategy is to keep your money until you get some catastrophic disease, then rush out to buy insurance.
The solution to that, we are told, is to require that everyone buys insurance. That creates the pool from which payments will be made. The pool will be finite: there is sure to be more demand than the pool can cover (at least it has always been that way, and we've been shown no counter-examples). That means limits -- rationing. How will that rationing be accomplished? By whom? Using what criteria? Will we forbid some highly expensive procedures? If not, who gets them and who does not? Those are complex questions, and rushing in to pass a bill that hires a bureaucracy to figure it out is probably not the solution. From all evidence, bureaucrats will work for their own benefit first, then that of their clients -- nearly every bureaucracy that ever existed has worked that way, so why should this one be different?
So there we are. When there's a real plan with real answers and mechanisms (as opposed to a set of goals and hopes) we can consider it. Will most of us be better off under it than we are now? It is certain that SOME will be better off under the various proposals, but who and how many isn't anywhere near obvious until we have an actual proposal in hand. It may be that most of the middle class will be worse off for the benefit of the poor and homeless (and the bureaucracy). We can then decide. But surely it will be better to know just who benefits, and how, and what the costs will be?
August 12, 2009
The column is terribly late due to last week's flu (I'm pretty sure that's what I had; mild but enervating). I am trying to catch up. There is a continued discussion of the health care situation in Mail, and that's where much of the action is today. I found it interesting.
My own view on the healthcare situation is that much of it doesn't seem to be broke: perhaps we should look hard at what we think is broke, decide if it really is broke and what demands public attention (an epidemic of obesity?); and look to fix what really needs attention. Taking over 15% of the economy is s very big deal; it shouldn't be done lightly if at all, and certainly no without better reasons than I have heard.
And of course there is a variety of other mail I found interesting.
Is the Chief Information Officer of the United States a phony?
Since PC Mag went on-line only I haven't read my old friend and colleague John Dvorak as regularly as I used to, and I missed this:
This is the first I have heard of any of this. I would think that Chief Information Officer of the United States would be a fairly important job, and candidates would be vetted thoroughly. I also think that John wouldn't recklessly make such a charge.
On Dvorak's charge: there is this answer.
The whole thing makes me continue to rejoice that I don't do topical news and I don't try to break stories.
August 13, 2009
I have finished the August column. It should be posted in a few hours. I admit near exhaustion: I thought I was recovered from the flu -- Mexican, Swine, whatever they are calling it now -- and went to the Mozart concert at the Hollywood Bowl Tuesday night (we have season tickets) intending to finish when I got home. Instead I had a relapse that ate a good part of yesterday, and it took the rest of the morning to get it finished. This is I think the latest I have been in 30 years -- but it is done.
Meanwhile, the health care debate continues, but it's getting shrill. One problem is that no one knows what to debate: there are several bills, none final, and anyone who thinks that provisions won't be inserted in the dark of night after all the debate is over may be interested in some investments I can offer. It's very easy for health care advocates to say that such and so a provision is not in the bill, that's just what some people have suggested -- but they can't guarantee that because we don't actually have a bill.
A good majority of the American people are already satisfied with their own health care; their concern is mostly for others, and given the economy many of them are having second thoughts. Apparently the President doesn't much care, and continues to campaign. This issue hasn't gone away, and it will be back in spades with big casino next Fall. We're not out of the woods yet.
August 14, 2009
Today's mail opens with Colonel Couvillon, a Marine Reserve Colonel with considerable active duty experience, but also experience with health care insurance management, on the complexities of Medicare. Following Couv's explication there are a number of letters with data and viewpoints. Where relevant I have inserted some comments. There are no obvious conclusions -- at least I have none -- but at least we can get some facts straight.
There probably isn't any obvious conclusion. The US system is said to cost more and provide less, but the evidence for that is thin on the ground. It is asserted that the US system is much worse than the French or British system, but that depends on who is doing the assessment and assertion: it's not obvious to everyone that this is the case.
The most frequent complaint about US health care is transferability. Health care in the US is usually provided by employers, and when one contemplates changing employers there is panic: what if while insured at employer A one discovers a condition that would render one uninsurable?
If you get through today's mail and Cochrane's article that will be enough for today. The key to solving this problem is to understand it, and to examine options. When we see what the options are, and understand the problem, we have a chance.
Note that there is zero chance of "solving the health care problem" to universal satisfaction. Politics is the art of the possible.
There is also mail on wind turbine synchronizing, and a horrible example of the Iron Law at work in climate change models.
The Lars Larson show wants me to comment on the NASA committee and the
Of course we do not expect Obama to consider any such thing.
Piracy fans will appreciate this one from Rod McFadden:
And then there's this from Tracy Walters
August 15, 2009
We will resume the health care debate Monday. There is, however, an important mail on transferability of health care that anyone about to change jobs or in danger of losing a job that provides health care should read. I point out that more people are in danger of losing their job than are aware of that.
We will begin Monday with some fundamentals that perhaps we can all agree to.
August 16, 2009
I took the day off, but there is a large mixed bag of mail, with at least one to interest anyone. I thought them all worth posting.
This is a day book. It's not all that well edited. I try to keep this up daily, but sometimes I can't. I'll keep trying. See also the weekly COMPUTING AT CHAOS MANOR column, 8,000 - 12,000 words, depending. (Older columns here.) For more on what this page is about, please go to the VIEW PAGE. If you have never read the explanatory material on that page, please do so. If you got here through a link that didn't take you to the front page of this site, click here for a better explanation of what we're trying to do here. This site is run on the "public radio" model; see below.
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