Monday, April 24, 2017
The map is not the thing mapped.
Eric Temple Bell
The map is not the territory.
Between 1965 and 2011, the official poverty rate was essentially flat, while the government spending per person on poverty programs rose by more than 900% after inflation.
If a foreign government had imposed this system of education on the United States, we would rightfully consider it an act of war.
Glenn T. Seaborg, National Commission on Education, 1983
Last week started well. I got the taxes off Monday, walking down the to post office perhaps a half mile away, figuring that the walk would do me good. It even seemed to. But from the moment I got back to the house, things started going downhill. My cold got worse. My get up and go got up and went. I had little to no interest in anything, my balance got worse, and the best description of my mood was malaise. It got progressively worse. I managed enough energy to get through a couple of chapters of Godson and Starborn or whatever — the book Steve Barnes, Larry Niven, and I are writing – and I think I made decent improvements, but after our story conference and lunch Wednesday I settled back into malaise, and didn’t some out until this morning. I still don’t have a lot of energy, but at least I feel like doing something.
I’m typing worse than usual. But at least I’m typing. And I’ve got up the energy to arrange to see my primary physician next Thursday, and arrange for Mike Galloway to drive me in my car, and I’ll get bank work done and we’ll have a decent lunch I’m actually looking forward to. So I can hope this was just an episode that’s now over. With luck and the grace of God I’m through the worst of this and I won’t slip back into the fit of malaise. Wish me luck. Just noticed I wrote wish me muck; I’ve corrected it, but I hope it wasn’t a portent…
When Mr. Obama famously said “If you like your health care plan, you can keep your health care plan”, he clearly made a false statement. Since it is unlikely he had any idea of the details of the scheme that eventually became law under the name “Obamacare”, he may well have believed it, but that is not what happened.
The usual Republican statement is that “millions of Americans have lost their health care.” Pro Obamacare organizations, including some that claim to be “fact checking”. Say
It’s true that insurance companies discontinued health plans that had covered millions of people who had bought them directly rather than through an employer. That’s because those plans didn’t meet the coverage standards of the new law.
But those policyholders didn’t lose the ability to have insurance. In most cases, insurers offered them an alternative plan, though there were some instances of companies exiting the individual market altogether.
Note what was said here: they lost their health care plan, because it did not meet the standards of the new law, not because they were not satisfied with their plan. Obamacare does not care about your satisfaction, or needs: it sets standards witch your health insurance must meet or you are not permitted to purchase it. Whether this was known to Mr. Obama at the time of his statement may be questioned, but the fact that Obamacare would set standards surely was. It would not take a great deal of intelligence to infer that if you set standards in law – such as that your health care plan must offer abortion and contraceptive services, no matter your sex or age – some people would not be allowed to keep their plans and would not want to pay for those “standards” – but in the rush to get Obamacare passed before the Democrats lost control of the Senate to an incoming new Senate, perhaps that can be excused.
The problem with repealing Obamacare is that “millions now have healthcare insurance who never had it before.” Not only do they have “insurance” but it meets the standards of Obamacare, offering services that many never had before.
Of course most of these newcomers do not have insurance under any same definition of the word. They have assured medical care, not insurance; and they can afford it because they are given massive subsidies. This is not insurance, it is free stuff; and if you try to take it away they will make a big fuss.
Insurance is simple: a group of people get together and agree to pay each other’s medical bills. They pay premiums, which, collectively add up to more than they are going to spend on medical services; in other words, it’s a money losing proposition for most of them. But among the insured will be some who will suffer catastrophes, medical emergencies costing more than they could possibly have saved up for and which would have left them destitute. Proper insurance deals with those unforeseen matters; you have paid out more in premiums (or membership dues) than you would have spent if you merely took care of those yourself, but you are spared the catastrophes. Most of the others in your association have paid for your problems, so you don’t have to. On the other hand, you have contributed to paying off other people’s debts.
This is how insurance works, and it has proved effective over the years. The primary assumption is that you re responsible for paying your medical bills, but you have ganged up with others who will help you pay if they get too big for you.
And there’s the rub: you and your associates are responsible for your medical expenses. The rest of us are not. If you get sick, I have no obligation to pay your doctor for you, nor you to pay mine. But under Obamacare, many, who thanks to the subsidies, have no obligation to pay for any medical expenses, their own or mine or anyone else’s. They will not easily give up the right to “insurance” with obligations: to subsidies that allow someone else to be obliged to pay for their medical expenses.
For an enormously detailed and mostly correct exposition on all this, see
The point is that it is not easy to repeal Obamacare, because there are a very many people who get free stuff from it, and they will not willingly give it up.
One “solution” is to do what Obama and Nancy Pelosi obviously wanted to do: socialize medicine as it is socialized in many other countries. The government pays your medical expenses. We all insure each other. Each of us pay something more than we would have paid under the old “pay your own” system many of us grew up under, and the obligation to pay for medical service no longer rests with the individual or family: your medical expenses are my obligation, as mine are yours.
Of course this leads to questions: who determines what will be paid? Will all doctors be paid the same amount? What of those who say you’re not paying enough and want to opt out? Do we enslave them? Do we allow them to make private deals with those who can pay? Perhaps we say “You are compelled to put a certain percentage of your time into general service, but you may sell the rest.” Now do we pay Inspectors – presumably physicians themselves – to determine whether our part time general service physicians are giving their best services to the general public, or are they holding something in reserve for those who pay? We’ll have to fix that! Or perhaps when you graduate from medical school you must spend a certain number of years in general service. That would work, wouldn’t it?
This is not likely in the minds of any of the Republicans who are planning schemes to replace Obamacare. On the other hand, simply repealing Obamacare and going back to what we had before leaves some number of “insured” who never had “Insurance” before now without “insurance”, and a media to tell their painful stories with maximum pathos.
Former Speaker Newt Gingrich has much to say on this:
Governing Majorities and Health Reform: Part One
April 21, 2017
To receive Newt’s weekly newsletters, click here.
Republicans are struggling with the repeal and replacement of Obamacare.
They should be.
Health is a matter of life and death. People pay very personal attention to it. In the end, regular people skip past the macro policies that shape the nation and ask, “what about me?”
In our immediate network of family and friends, Callista and I know an older woman with a history of breast cancer who has had both hips replaced, a middle-aged woman taking anti-rejection medicine for a recent liver transplant, a young woman (30) diagnosed with breast cancer, a dear friend suffering from a rare disease in which his red blood cells no longer carry oxygen, and the list goes on.
In every case, the individuals and their family and friends will ask: How does this health care bill affect me? Will I be better or worse off? Their natural bias is against change, because they have adjusted to the current system and know how they are getting care today.
I am not arguing against repealing and replacing Obamacare. It is a failing system that will ultimately cripple the country and leave millions without insurance coverage. I am suggesting that its replacement must be carefully thought out. Every House and Senate Republican who deals with this issue, along with the leaders in the Executive Branch, will be asked a lot more questions about this bill than they would about other legislation. They must be able to answer those questions. [snip]
The entire essay is worth your consideration.
I recently came across two numbers about AIDS and HIV. First, the annual cost of treatment for HIV is $20,000 a year. This is required: skimp on it, and the HIV will blossom into full fledged AIDS, and your annual treatment cost will rise greatly until you are dead. The 20 grand a year will keep you functioning for decades.
I presume but do not know that the $20,000 a year goes mostly for the drug “cocktail” that mitigates the HIV effects, and it is paid for by “insurance”, or in some cases by the government; I doubt that few individuals pay or are expected to pay for their expensive cocktails. This will last for at least twenty years.
The second number I learned is that there are about 50,000 new cases of HIV per year. If you multiply that by 20,000, the cost becomes $1Billion for each succeeding year. This will last for decades.
MSM means men who have sex with men.
It is not politically correct to draw any conclusions about such statistics, and probably racist, sexist, and homophobic as well.
A long time ago I said, in Galaxy, that I thought the federal money invested in the National Science Foundation to make grants was about the best tax money ever spent. The was true under Kennedy, Nixon, Carter, Reagan, and possibly under Johnson, but after Reagan it became politicized, and I cannot make that statement any longer. Still, my lifetime career has been in favor of science, and I have always encouraged investment in the national labs, both civilian and military, and most of the universities. It is now no longer true at all, and those who favor science – as opposed to political machinations need to stop and start over.
As to the March for Science, held last “Earth day”, I’m not always fond of this source, but for this it will do:
‘March for Science’ invokes God, Hitler, Gay Marriage, Racism, Sexism – Blames GOP for making climate worse
Climate Depot’s Round Up of Coverage of the alleged ‘March For Science’
Climate Depot’s Marc Morano: “Having spent the day in DC on April 22 interviewing the marchers, it struck me about how this is first and foremost a march for endless government funding, ideology and in support of a no dissent policy. (Another new study gives plenty of reason to dissent: New Climate Study Calls EPA’s Labeling Of CO2 A Pollutant ‘Totally False’) The Trump administration can help make science great again by resisting these pay up and shut up demands for taxpayer research money.” See: Bloomberg News: Obama ‘stashed’ $77 billion in ‘climate money’ across agencies to elude budget cuts
Watch: Princeton Physicist Dr. Will Happer criticizes ‘March for Science’: ‘It is sort of a religious belief for them’ – Dr. Will Happer on Fox News: Asked about more government funded science? Happer: “We’ve had 8 years of very highly politicized so-called research on climate. It’s not what most of us would recognize as real scientific research. Something where the outcome was demanded before the funding was provided. We should tend to real environmental problems and fix them and stop chasing these phantom problems that are really just religious dogma.”
You can no longer be in favor of science; those causes have been politicized, supporting them is evil. I make no doubt that there are still dedicated true scientists remaining in the universities, but they keep a low profile now; the noise is all made by those who claim to speak in the name of science, just as many other academic organizations are dominated by political agents who claim to advocate scholarship, but seem to favor much that has no scholarly purpose at all. I wish that were no longer true; but academia has become a political fighting ground, and true science is neglected or even despised.
Positive News about Donald Trump
President Trump has some good points that nobody speaks of and I find these points worth considering:
President Trump has saved taxpayers more than $86 billion in regulatory costs during his first three months in the White House, according to a new study from a conservative group.
The American Action Forum (AAF) points to several Obama-era regulations that Trump has either rolled back on his own or with the help of Republican lawmakers using the Congressional Review Act (CRA).
This includes the Education Department’s school accountability standards, the Environmental Protection Agency’s waters of the United States rule and the so-called “blacklisting” rule for government contractors.
$86B is a success this president can take most of the credit for; the next is harder to associate with him but I’m sure he’ll take credit for it and most will believe it:
The number of out-of-work people collecting unemployment checks fell to a 17-year low in April, underscoring the strongest U.S. labor market in years.
Unemployment is not infinite; this could simply mean people are no longer eligible. Further, unemployment rates are cooked numbers and anyone who knows the meaning of “U3” and “U6” knows this. Neither number is accurate since people stop being counted at a certain point.
Labor force participation rate remains at 63% despite the cooked numbers and the rosy picture the media tries to create.
Even if President Trump governs over real improvement, we would need to consider the realities of the business cycle and place much of that credit with the previous president since this cycle lasts 7-11 years before any changes actually manifest in the economy. It seems the media assumes most people slept or were absent when the teacher mentioned this in their high school civics or American government courses.
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Joshua Jordan, KSC
Climate Science/Religion needs it’s Martin Luther to guide it away from Religion and back to Science.
There seem to be many parallels between today’s Climate Modelers and Luther’s Catholic Church. One of the more obvious is the Modelers selling of indulgences (models that produce the results desired by the worshipers of Global Warming/Climate Change.) in return for Government Grants that allow a continuing rush away from Scientific Enquiry.
If we are to return to a rational view of our challenges and adopt solutions that minimize economic damage, we must STOP shouting down those whose views do not agree with ours and engage in free and open debate.
Scott Adams: ‘Climate scientists probably believe they have convinced about half of the public to their side using their graphs and logic and facts. That’s not the case. They convinced half the public by using fear persuasion disguised as facts and logic.’
Middle East Countries Venturing Into Space
Space May Be the Next Frontier for Crude Oil Giants:
Countries like the United Arab Emirates and Saudi Arabia are developing space programs and investing in nascent private space commodity initiatives, said Tom James, a partner at energy consultant Navitas Resources. “Water is the new oil of space,” said James.
If the United States doesn’t establish a strong space presence, other nations will — and they might be unfriendly to the United States. It’s a shame that instead of spending money on a good space program ourselves, we spent money on buying oil, and now that money will be used so other countries can get into space.
Take the high ground, boy, or they’ll kick hell out of you in the valley.
Bloomberg on Aspen Pharmacare
Dear Mr. Pournelle,
I would like to discuss health care courteously; and outside any liberal echo chamber, in hopes that we might learn something from each other. I am beginning to think that at present people who care about our country are so polarized this may not be possible.
However, I’ve been continuing to search for reports which could indicate whether Aspen Pharmacare’s increases in the price of cancer medications were in support of new, improved medications. I have found no such indications. The most complete report I’ve found so far is in Bloomberg: https://www.bloomberg.com/news/articles/2017-01-30/old-cancer-drug-gets-1-000-plus-price-hike-in-frugal-u-k
“The chemotherapy known as busulfan is more than six decades old, and part of doctors’ standard arsenal against leukemia. It’s not scarce, and by all accounts, it should be dirt cheap. Instead, its price has soared like that of a prized antique.”
Aspen Pharmacare does not have the reputation of a villain. It seems to have been instrumental in providing anti-HIV medications in Africa. However, as best I can tell, Aspen purchased the rights to five existing anti-cancer medications from GlaxoSmithKline (GSK), and then raised the prices. No new or improved medications have been mentioned. Apparently, existing British and European laws attempting to control drug prices do not apply reliably to generics, on the assumption that market competition would handle this. However, it is also apparently possible to gain monopolistic control of a generic medication, especially if the market for it is small. In those circumstances no real market competition exists.
To my mind, this is interesting because it offers a real-world test of the hypothesis that markets will suffice to produce an optimal allocation of medical resources. But that, as I understand, assumes active competition and a rough parity between buyer and seller.
I do *NOT* maintain that government management will solve this problem. I don’t think there is any easy solution: as Mr. Trump has observed, health care is complicated. Beyond that, as I’ve said before, I don’t believe we humans are much good at producing stable solutions. To anything.
But I do think honest discussion might help us find better partial and temporary solutions. And in human societies that’s usually the best we can do. As I think it was Poul Anderson observed, buying time is always a good investment.
Allan E. Johnson
What am I to say? I defend free markets as being, generally much more efficient than directed economies. Freedom implies being free to do the “wrong” thing. The remedy is generally not simply to force the “right” thing, and the motives whop do the compelling are often no more clear or pure than those of the compelled. I do suspect that FDA regulations often aid the monopolist, since for small markets there simply is no incentive to invest in certifying a generic which can then be sold by others as well as you. Medical trials are expensive and often boring. I understand the revulsion people have toward those who grind the faces of the helpless; but unless they actually break laws, compulsion to force “the right thing” often has even worse consequences. The Almighty can rely on His angels to have the purest of motives, but He is fully aware that humans are able to defy His will. Alas, that often applies to those sent to remedy things.
I do not know enough to contribute much to an honest discussion. In particular I have heard nothing I remember Aspen has said in their own defense. I do understand that their monopoly is created by government regulations which are said to be needless.
Small business exemptions
“If you want more people working, make it simpler to hire them. Exempt more small businesses from regulations.”
The first sentence was perfect, the second was truly horrible.
Why would a small business get an exemption denied a large one?
I’m a small businessman and I survive by being more efficient in my niche than large businesses. But if a large business could better my efficiency why in the Jesus H. Christ would you want to subsidize an inefficient me?
I print this, but since I do not seem to understand you, I cannot reply. I know there are regulations that apply to large businesses, but not to small ones; and I know that there are businesses that would expand were it not for those regulations. It seems reasonable to me to make the exemptions larger; if not double, then perhaps half again.
I do not understand your reference to subsidies. I certainly would neither compel nor forbid you to expand your business.
Oh this is rich, kinda reminds me of the “manhunt” for the recent “Facebook killer”. A fast food worker identified him before he shot himself. Now CIA and FBI are on a “manhunt”‘ problem is they don’t know who they’re hunting for:
CBS News has learned that a manhunt is underway for a traitor inside the Central Intelligence Agency.
The CIA and FBI are conducting a joint investigation into one of the worst security breaches in CIA history, which exposed thousands of top-secret documents that described CIA tools used to penetrate smartphones, smart televisions and computer systems.
Sources familiar with the investigation say it is looking for an insider — either a CIA employee or contractor — who had physical access to the material. The agency has not said publicly when the material was taken or how it was stolen.
Much of the material was classified and stored in a highly secure section of the intelligence agency, but sources say hundreds of people would have had access to the material. Investigators are going through those names.
They do not even know what classification of worker they seek and they’re going through “hundreds” of names? Something this important didn’t require signatures, logs, etc? Who is in charge of security over at CIA and where did they go to school to learn how to do it?
If something like this happened in the military, a chain of custody, logs, etc. would quickly identify the person. You notice PFC Manning remains incarcerated in a US Army disciplinary barracks while Edward Snowden drinks vodka and harasses the United States government as he continues to remain out of their grasp. Can we expect any less in this instance?
I have more comments, but what’s the point? Clearly security protocols at CIA remain in desperate need of review and restructuring.
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Joshua Jordan, KSC
Ancient Stone Carvings Confirm How Comet Struck Earth in 10,950BC, Sparking the Rise of Civilizations.
Freedom is not free. Free men are not equal. Equal men are not free.