RoR: Forum

Ed, your faith in the Republican Party leaves me puzzled.

Conservative commentator Pat Buchanan said Romney’s debate performance was excellent and that he couldn’t imagine Romney doing any better.

But let me suggest several areas where improvement might help both his electability and the prospects for liberty.
... He could have started with ...
Romney might have made these points and... Romney missed concerned teachers. ... Romney might have pointed out that since 1970 real inflation-adjusted per-pupil ...

Granted that Pat Buchanan has limited imagination, you apparently are going to vote for the candidate you wish that Romney was.

... he and the GOP will need more consistent policies in favor of the free market and limited government.

Yes, but that would depend on something more fundamental, would it not?

I watched some of both the RNC and DNC shows. The Democrats talk about opportunity and achievement. Costco president, Jim Sinegal, and CarMax's Austin Ligon are not alone among business people who are also Democrats. It is just that the Democrats have this little problem, which maybe we could fix if we invited them to speak at Cato dinners. If President Obama had stressed his lines about individual achievement - which were made in the same moment - instead of "you didn't build that" he would be more acceptable to Objectivists. The DNC visibly reached out to the LGBT community, while the RNC said nothing about the "Log Cabin Republicans" who are in the big tent. If only the Democrats would extend that same openness to all business actions, they would be a better party. Would you like me to write the debate points that I wish President Obama had made, but did not? "Existence exists," said the President. "And that axiom leads directly to a free society with an open marketplace where achievement is welcomed."

I will pretend that he said that while I vote for him, and you pretend that Romney said your points, and we will see whose wishes have come true in 2016. Maybe yours will: sometimes our prayers are answered.

"... a more radical reversal of current statist policies."

How radical a reversal do you actually expect that "more" would be an option?

Post 1

Friday, October 5, 2012 - 9:44am

A coma patient would make a better president than Obama, that way you would have 4 yrs of nothing...which would be a much better alternative than 4 more years of commyObamarx

Post 2

Friday, October 5, 2012 - 9:52am

Meanwhile, the debates are being followed up with the announcement today of the latest job numbers.

The beaches were softened with spin articles from the WaPost et. al. 'expecting unemployment to rise slightly.'

Lo and behold, the unemployment rate in America apparently dropped by 0.3% in one month to 7.8%! Remarkably...the same number as January 2009, when Obama took office...

How does this jive with recent uptick in first time unemployment? Got me by the sneaks.

Never mind population growth alone requires 250,000 jobs/month to stay even. With less than half that reported number, our little unbiased public number crunchers came up with a 0.3% drop in the unemployment rate the month before the elections.

How, one might ask, after they stop laughing?

Apparently, they conducted a new telephone poll of private households and discovered a flood of people 'working for themselves' and previously 'uncounted.'

So, lets get this straight; when you leave the workforce, and are so disheartened that you are scraping by doing odd jobs for relatives and neighbors under the table, instead of being counted as 'no longer actively looking for work,' we can count these Obamaville scrappers as 'employed.'

Does any of this fun with public numbers do anything to America except raise our cynicism to the boiling point?

What is the participation rate today? How many people are working? How many people could be working?

What is the actual unemployment rate?

We pay for the generation of these numbers; it is clear that they are self-serving and total nonsense, an extension of the campaign.

What actions can we take to not tolerate this complete nonsense?

regards,
Fred

Post 3

Friday, October 5, 2012 - 9:56am

The Chicago machine got to Census the same way they got to Roberts.

Post 4

Friday, October 5, 2012 - 2:27pm

Michael,

I can't believe that you think any Objectivist could ever find Obama more acceptable than Romney. Yes, it is a case of the lessor of two evils, but there is such a massive difference in the level of evil here that it should be a no-brainer.

And you are going to vote for him? I'm astonished!

Post 5

Friday, October 5, 2012 - 5:15pm

Fred, I posted my own reservations over on MSK's OL where you also visit.

You know, famously, in 1932, a poll claimed that Hoover would win because they sampled via telephone. Here, too, who has landlines? They must be many of those 25,000 new government jobs since August.

Steve, you missed the rhetorical flourish. I am not voting for President Obama again. I made that mistake in 2008.

You think that the Republicans are pro-business but anti-abortion.

Tallied against the business ledger, Mitt Romney might be Paul Larkin, the well-meaning mid-level guy who eventually (inevitably) sides with the looters. You can only betray your friends --- your enemies already do not trust you. Republican administrations are bad for business; and Democrats are bad for labor. Look at the actual record. Rudolph Giuliani prosecuted Michael Milken. (Look at Rahm Emanuel versus the Teacher's Union.) If big business is America's persecuted minority, then whom do we serve by excoriating Goldman-Sachs for "crony capitalism"? Hank Rearden employed Wesley Mouch as his lobbyist. Should Rearden not have a lobbyist? Should Goldman-Sachs not influence the Treasury, considering that the Treasury holds them by the throat? I only ask to get past the easy rhetoric.

In Atlas, Cuffy Meigs was the conservative. He was a muscle-mystic. He wanted to conquer Mexico. He dismissed Dagny out of hand because she was a woman. No one is favor of abortion. It is not something to advocate for. The ultimate question is who controls a woman's body. Note that the conservatives do not ask who controls a man's body.

Among the looters, the leftists were often women: Ivy Starnes, of course, but also the sob sister "with the heart of a policewoman" who tried to do her best for Cheryl Brooks. Kip's Ma, Laura Bradford, and Betty Pope are other looter women we meet in addition to Lillian and Mother, of course. Compared to them, we have Gwen Ives, who is technically efficient, but non-political. The point is that conservatives dismiss women as lower creatures, not up to a man's standards. Does that not bother you?

(Edited by Michael E. Marotta on 10/05, 5:32pm)

Post 6

Friday, October 5, 2012 - 7:16pm

I had lunch with a left leaning friend of mine today. (He's not really that left leaning, but relative to me, he's a commie. He's more like a lovable left leaning libertarian/eastern european/mobster from Brooklyn.)

And yet, we find many areas of agreement.

He made an interesting observation today; we both agreed that Medicare, never mind the justification of the program or its popularity, has severely distorted the marketplace. In terms of bang for the buck, few of us could actually explain exactly where or why that original $3B/yr in funding has exploded. He expressed a kind of stunning wish; he pointed out that of all the 'socialist' leaning things that our government has ever done, the creation of the land-grant teachers college system in America was at least something that had a tangible impact as a national asset. His modern point was, he expressed the idea that he wished that Medicare money was better spent-- by creating the equivalent as a university medical school system that would become the vehicle for Medicare services -and- the engine of providing an affordable national resource, a greased skid for human capital, that pumped out educated health care providers (and by so doing, put competive drag in the marketplace to put downward pressure on costs.)

Land-grant/teacher's college affordable medical school system, primarily aimed at providing MEDICARE services as part of the teaching university hospital process. It kind of works as an idea on both ends of the generational divide; the present system simply takes from the young and gives to the old; why not a delivery system that provides benefit to all generations?

I was actually stunned by the idea, because in a lessor of two evils analysis, his idea was clearly superior to what is going on today with all that money. It is being siphoned off by Medicare rehab mills(basically, factories where the elderly and infirm go to get a final billable bout of C-Diff before the big dirt nap), by can't hide it opulence at 'for profit' but non-competitive and removed from normal commerce hospital centers, by insurance companies enjoying their part of the broken commerce ring-around-the-rosy.

So, like existing medical schools with teaching hospitals, these land grant university/medical schools would provide services as part of the medical school education process, but would be similar to public land grant teachers colleges, with similar tuition and structure. They would not replace for profit medical schools, but they would put downward pressure on costs and broaden the availability of health care providers in the coming years, as well as be platforms of delivery for MEDICARE services.

Taxpayers could actually visbly -see- the tangible evidence of the government's Medicare program-- something nearly impossible to do today.

As long as we are spending a crapload of money on Medicare, I had to admit, with that as a political given, this was a more appealing way to spend all that money.

I think few regard the national land-grant college program as anything but a huge success for America. Had that literal investment not been made in the mid 1800s, America would have been a much different nation. It was a success of common government, with such broad benefits to the nation that it is hard to argue against it. As an element of policy to address the coming realities in this nation, I have to admit it has a certain real-politik appeal to it.

On a purely libertarian basis, I'm not sure it passes the sniff test. But where is that world?

It's clearly not this nation.

Post 7

Saturday, October 6, 2012 - 5:58am

Fred,

Meanwhile, the debates are being followed up with the announcement today of the latest job numbers.

That didn't surprise Limbaugh, who predicted this very thing last December. It speaks to the temporary refusal by the Obama administration to nominate someone to head the BLS. A refusal to nominate along with other details -- such as a refusal to pass a budget -- that indicates skullduggery. It's like we are living through a new era of Soviet-style propaganda (as in Orwell's 1984), where party leaders assure the public that things are really very rosie. Even our wars in the Middle East follow the Orwellian storyline of intentional confusion.

Ed

(Edited by Ed Thompson on 10/06, 6:00am)

Post 8

Saturday, October 6, 2012 - 11:50am

Fred,

Stick with sound economic principles, old friend. When government funding and regulation intrudes into an area that would otherwise be filled by voluntary associations of private individuals, then the results will be, net-net, worse - always.

Land grant medicals colleges tied to Medicare hospitals would not be an exception. Sometimes it is just hard to see what would otherwise have been - to see the outcomes we would be denied when government intervenes. Sometimes the government effects are multi-layered and less than obvious. For example, in the case of medicine, there is no way that the system escapes the effects of licensing. The AMA has, in conjunction with government, sets up an artificial shortage of seats in the current medical schools which drives up the cost of that education, and then the cost of doctors. Even without the AMA, and even outside of the field of medicine the certification of a graduate degree program is a nightmare.

I have no doubt that without government there would be many more medical schools, far better medical schools, and that most would be working with teaching hospitals and that they would take in patients for fees that are massively lower than we see today (because of Medicare, Medicade, FDA, AMA/Govt-licensing, irrational tort law, HIPPA, etc.) I think that the symmetry of the young doctors taking care of the aging population would arise naturally, out of the economics - always better than with government's forced associations.

We won't ever get near that perfect Libertarian world if even its sharpest and most stalwart supporters goes astray :-)

Post 9

Sunday, October 7, 2012 - 12:31pm

Steve:

I basically agree with you; my assessment of his idea was purely in comparison with only one alternative-- the way we spend that same Tsunami of public money now as a nation.

A lesser of two evils. Not ideal. But better or worse?

The current program is purely intergenerational wealth transfer in only one direction. It is compassion for our elderly and contempt for our youth.

I don't think it has a prayer of happening. (For example, the Dems would negotiate it into an 'in addition to', not 'instead of.' It would just bloat government even more. We couldn't afford that; we can't afford what's already in place.)

And yet, the nation in the 1800s not only easily afforded it, but grew to afford much more from the national land grant teachers college system. Those were actual 'investments' in national strategic infrastructure that broadly benefited the nation, directly and indirectly.

regards,
Fred

Post 10

Tuesday, October 9, 2012 - 5:31am

Steve:

It is the Medicare equivalent of choosing Romney over Obama; realpolitik.

regards,
Fred

Post 11

Tuesday, October 9, 2012 - 11:34am

Fred,

I understand what you're saying, and I agree that we have to approach the changes we want with RealPolitik - that is, we have to judge realistically how large a step can be taken at one time.

I think that moving towards the ultimate goal of getting government totally out of Medicare would be better served by making changes something like this:

1. Move towards bringing in more private enterprise (reducing the number of government employee and introducing some competition) and,

2. Means testing for any payments in excess of the person's lifetime contributions and,

3. Going to a voucher-like, health savings account system to reestablish the connection between the person who pays and the people being paid, and,

4. Then, after those changes are up and running, shifting it to the states where they get the program and the money, but decrease the federally supplied money each year and the states can raise their taxes or reduce the program, and

5. Hopefully, over the years, it will be killed totally with people taking care of their own medical needs.

6. In the end, the constitution needs amending to make clear that the federal government may not collect money for, or spend money on, anything not specifically named in the constitution (and that "the general Welfare" is not to be understood as justification for providing money or services to people, whether in need or not). And the states should follow suit, amending their constitutions so that they are not in the health care business.

Post 12

Tuesday, October 9, 2012 - 7:17pm

Fred,
What you are describing sounds a lot like the Medical Center of Louisiana at New Orleans pre-Katrina. (aka LSU hospital, aka University hospital) Hurricane Katrina, that is. Prior to that devastation, public state funds were diverted to the university medical center, as were most indigent patients. Private organizations (including not-for-profits) didn't get to claim state funds, but they also didn't have the same responsibilities to indigent or uninsured patients. It wasn't ideal and I know I'm over-simplifying the way the system actually worked, but that's the gist of it and it seemed to work at least better than it does now post-Katrina. The change occurred because Katrina shut down that medical center for a good long while. The city's remaining healthcare organizations had to start taking those patients. Unfortunately, the state funds didn't follow them, at least not right away. And now 7 years out, private medical centers are still having to treat the patients, but not getting the funds even though the university medical center is fully operational again.

In any case, my point is that your friend's idea has been put to the test in a fashion, and seemed to work while it was in place.

Post 13

Wednesday, October 10, 2012 - 10:26am

Steve/Deanna:

In the vein of RealPolitik changes to MEDICARE, what do you think of the following purely hypothetical -babystep-?

(I think MEDICARE should have always been this way from Day 1, as long as we were going to have it at all.)

1] The marketplace before MEDICARE: some had private insurance, some did not. All were handed bills by their doctors/hospitals. Those with insurance carried those bills home, sat at a desk, filled out a claim form which they submitted to their insurer, who reimbursed them directly. Patients, even insured patients, stared at their bills, were invested in two acts of commerce. Doctors and hospitals were still involved with face to face commerce, as were insurers, who dealt with their insured. (Patients were involved with an act of commerce with their doctor, and also with their insurer.)

2] When MEDICARE was introduced, why not continue the exact same model? Those covered by MEDICARE get a bill, carry it home, sit at a desk, submit a claim form to their insurer....which is now a state run MEDICARE program. (Putting aside the bigger argument for a moment; I am just talking about the form of implementing the program.)

Instead, this is -exactly- when the health care marketplace was perverted by the current non-commerce, when 'third party payer' was introduced. Ring a round the rosy.

And when doctors/hospitals modified their back-offices to accomodate Medicare third party payer(and companies like Perot's EDS made its billions during the salad days of automating government MEDICARE programs), private insurance was swept into the growing insanity.

A gets services from B. B bills C. C charges premiums/taxes to D, who might not even be A. Not a single act of face to face commerce to be seen in that marketplace; it is a game ripe for gaming, for endlessly struggling to shed costs onto the next weak link in the non-commerce food chain.

What could go wrong?

By maintaining the patient/doctor relationship as face to face commerce, patients remained active drag on costs.

Today, speaking of realpolitik, it would be impossible to go back to that model of direct commerce(that once widely was with those who had/did not have insurance.) We view it as a 'convenience' that we walk around with some form of magic plastic card, often provided for us by either the government or our employers, and we have no clue when it comes to commerce what our THIS IS NOT A BILL statements are all about. We are several generations into the 'health care is beyond commerce' belief system.

And, that shit won't ever float, but we as a nation will cling to our plastic cards all the way to ruin, dumbfounded the entire way.

regards,
Fred

PS: Steve-- the above 'babystep' is akin to your Step 3. Why wasn't it always like that? We might never have even noticed the program if it was still run like that...

Begs the question; why wasn't it? (The answer to that brings to mind JFK mob conspiracy theories, because it does seem like the mob took over our government with the express goal of bleeding the nation dry...)

Instead, it grew from $3B/yr in a nation of 180M to ... Jesus. Are we really that sickly? That $3B inflation and population adjusts to maybe $45B today. We are nowhere NEAR $45B. By over a factor of ten... (10!)

(Edited by Fred Bartlett on 10/10, 10:37am)

Post 14

Wednesday, October 10, 2012 - 2:45pm

Fred,
Your proposed solution assumes the 3rd party payor system is desirable only to the patient (or at least more desirable to the patient than to the healthcare provider). Yes, the patient has the convenience of not having to file claims and doesn't have to figure out how to come up with half a million dollars when involved in a level 1 trauma and then wait to get reimbursed. I agree that we, as patients, would be more mindful if we had to deal directly with the payors. However, the arrangement is at least as desirable (if not more so) to the healthcare provider.

That's my only thought for now. In a hurry. ;-)

Post 15

Wednesday, October 10, 2012 - 4:59pm

Fred,

I agree with both you and with Deanna. That is, people would be more aware of health care costs if they were billed and had to fill out and send in the forms to their insurance company - but I don't think it would change much. It would force people to learn more about the insurance: what was covered and under what conditions.

As Deanna mentioned, it is a problem for the providers and I think that would result in slightly higher costs. When you have to count on billing that goes to the patient who then has to effectively send it on to the insurance company, the providers will see higher average accounts receivable balances and experience greater collection costs. It also gives the insurance company a 'softer' target to fire denials at since the patient is more easily snowed and frustrated in fighting with an insurance company than a provider is.

These are minor objections, but I just don't think there would be great gains either.
------------------

If we get a new senate and a new president, I'm hoping they go after tort reform - that will lower costs everywhere (medicare, medicaid, privately insured, or uninsured). It will lower costs of drugs, labs and doctors charges. And while they are at it they should eliminate class-action suits which have proven a failure to do anything but enrich lawyers.

If they prohibit states from restricting the kind of insurance that their citizens can buy, then the costs of private insurance will drop a lot. (What the states are doing is a violation of what the founders thought of 'regulating commerce' - making it possible for citizens to engage in commerce across state lines.)

But I'm afraid that Romney may want to create a national health care reform that includes things like forcing insurance companies to accept pre-existing conditions, and mandating some other 'consumer oriented' goodies.

Post 16

Thursday, October 11, 2012 - 6:36am

Deana:

"However, the arrangement is at least as desirable (if not more so) to the healthcare provider."

I totally agree, which is a primary reason the present model has persisted; the appeal of the carrot "commerce without commerce" has been enough to overwhelm the stick of "at the cost of ever increasing command and control from on high."

I think, because they think they can persevere in that steel cage death match struggle to finesse Congress and wrestle enough legislative favor. They are relying on 'their man in Washington' Mr, Wesley Mouch, to tip the steel cage death match struggle in their favor.

As do all the other special interest groups, including, those pandering promises of 'Affordable Health Care Acts' to patients drowning in a broken marketplace...

How did previous generations deal with these exact same issues? There was not a broad health care crisis in the 50s. We can't blame it on 'but there is so much more expensive technology today.' We can only blame it on our faulty models of non-commerce in what is still commerce, no matter how we try to finesse it.

Ultimately, when we try to constructively finesse the commerce, someone, somewhere is either being tied to a desk or operating table or far away chained to an enabling pump, and pull on that pump handle they will refuse to do while wearing someone's chains...

The current system is all about shedding costs onto others via political wrestling. It is ... unsightly.

The self employed used to be able to go out into the private marketplace and obtain group rates via 'aggregators.' I paid about $250/mo for a family plan back in the 80s.

The law was changed by Congress, prohibiting this. Why? Because Congress is for sale, period. There is no economic, moral, or ethical reason. Up until recently, I was paying about $2400/mo for that same family plan(and my oldest son had moved out of the house, got a job, and had his own HI, but that didn't lower my premiums by even $1...)

I converted to a high deductible catastrophic coverage only, self insure all our routine health care, and now 'only' pay $1100/mo for HI that covers almost nothing.

A few years back, I dropped our dental coverage and self-insured that. It wasn't expensive -- but it had a $1000/yr family cap. Our yearly dental bill for the three of us is about $600/yr, which made it a wash, but I noticed something; as soon as I 'self-insured,' the charges from my dentist dropped by about 30%. Apparently, he makes up what he can by ... overcharging his patients who have insurance.

Now, if that is what voluntary face-face commerce does to my dentist, then imagine me taking that bill home, filing a claim with my insurer, and getting re-imbursed. Cost savings. Drag on costs. That is the power of commerce, and that is indeed why providers are not entirely averse to the present marketplace... until the government inserts ever more heavy handed 'controls' on what they can charge.

I don't know, but I don't want some guy giving me a root canal with a gun to his head. I can, however, live with his need to, like everyone else making a living in the world, deal with the drag of commerce. Previous generations of doctors and dentists did exactly that, it is not immediately clear to me why the current generation believes itself to be exempt from commerce, other than, they've been encouraged to believe that by politicos/state plumbers intent on taking over yet more of the economies in a command and control manner.

Bad move.

regards,
Fred

Post 17

Thursday, October 11, 2012 - 7:56am