In today’s (10-30-07) Washington Post, K street columnist Jeffrey Birnbaum discusses former NRA lobbyist Richard Feldman’s new book, Ricochet: Confessions of a Gun Lobbyist. The gist of Ricochet is that the guys who run the NRA care more about bringing in cash than protecting gun owner rights. Oh, what a surprise!!
The NRA is no different from NARAL or any other interest group that works issues where opinions are strong and polarized. There is nothing like an ad horrorem "emergency" newsletter to whip up its true believers and get them scratching checks.
Special interest groups perform services similar to the character McBean in the Dr. Seuss story "Sneetches." In the story, McBean fleeces all the Sneetches by charging them to get stars put on their bellies, or removed, and repeats the process until all the Sneetches are broke.
Similarly, we are being bankrupted by special interest groups that push for a state of permanent war and a health care system that itself appears to have been designed by Dr. Seuss.
Groups like the NRA, NARAL, and the rest are peripheral characters forming alliances with special interest groups that milk the biggest issues facing the country: the consequences of military intervention and a fundamentally flawed health care system.
The Sneetches finally wised up when all their money was gone. Based upon how the presidential race is going to this point, I doubt the U.S. populace in general will show any more foresight than the Sneetches.
W.J. Malan
Author, The Audacity of Truth
www.anarcorp.com
Tuesday, October 30, 2007
Saturday, October 27, 2007
Pundidiots: who has the dopiest fans?
Opinions molders are on television, radio, and in newspapers. They write books, bellow from the pulpit, or lead marches. In general, they opine on matters of public policy. Some are liberal, some conservative, some centrist.
But of all the opinion molders, which one has the most intellectually challenged fans? I don't know, and you can help fill this knowledge gap by nominating an opinion molder for study. This is non-partisan, and all nominations will be considered.
To be nominated, an opinion molder:
1. should have a national reputation or following
2. have an internet presence where his or her fans can post comments.
That's it. Provide your nominations via a post on this blog. Vox populi, vox boum (the voice of the people is the voice of cattle)
But of all the opinion molders, which one has the most intellectually challenged fans? I don't know, and you can help fill this knowledge gap by nominating an opinion molder for study. This is non-partisan, and all nominations will be considered.
To be nominated, an opinion molder:
1. should have a national reputation or following
2. have an internet presence where his or her fans can post comments.
That's it. Provide your nominations via a post on this blog. Vox populi, vox boum (the voice of the people is the voice of cattle)
Tuesday, October 23, 2007
Unity08 and a health care debate?
A recent CBS survey of Democratic and Republican voters is not encouraging. Over half the Democratic voters say their candidates are addressing issues important to them, but what does this mean? Apart from Dennis Kucinich, the Democrats are not going to end U.S. presence in Iraq and the region, and want to continuing the saber rattling towards Iran. A recent CNN poll indicated most Americans are tired of the war and want us out of the area. If that assumption is correct, most Democratic candidates oppose the majority view regarding military intervention.
On health care—the other key issue—the Democratic candidates are all proposing various flavors of reform plans, but that is anything but re-assuring.
For their part, the Republican candidates (according to the same CBS News poll) are avoiding issues of concern to Republican votes. Like the Democrats, they overwhelmingly support ongoing military intervention in the Middle East; the notable exception is Congressman Ron Paul, who wants to bring the U.S troops home.
On health care, the Republicans propose some modest steps such as reducing mandates and making insurance more affordable and portable. They tend to support high-deductible insurance and more consumer choice and price transparency. These aspects of “consumer directed health care” are, I believe, a step in the right direction, but do not address one of the root problems of our health care system: the lack of MEANINGFUL competition.
How do we get REAL competition in health care? In addition to the modest steps proposed by some Republicans and the consumer directed health movement, it would require three measures:
1. Allow patients, providers, and insurers to contract out of the medical malpractice tort system. Doctors would love this, costs would be lower, and patients would benefit. Of course the ATTORNEY GUILD would oppose this tooth and nail. Plaintiff and defense lawyers make hundreds of millions of dollars per year playing the med-mal gambit.
2. Allow patients to receive medical services from any willing provider. This means ending the PHYSICIAN GUILD’S monopoly control over the delivery (and billing for) health services. For example, I should be allowed to purchase insurance that states non-emergency cardiac surgery would be performed at say, Escorts Heart Institute in India. Escorts, a for-profit hospital, performs thousands of surgeries per year at a fraction of the cost and with better outcomes than most U.S. so-called “non-profit” hospitals. Many British subjects who can afford to do so go to hospitals in Asia because they do not wish to wait in the queue (and perhaps die waiting) for services to be available under their National Health System. Of course, cardiac surgeons licensed to practice in New York will not welcome competition (whether foreign or interstate) and would oppose insurance companies contracting with New Yorkers to send patients to Singapore or India, or Indiana.
3. The third fundamental measure needed to spur real competition is to restore the right of competent adults to self-medicate. Under current law, if you start coughing up blood and remain conscious, you can call a doctor or stuff a rag in your mouth or call a faith healer. You can refuse a life-saving transfusion for any reason. Similarly, if you have type I diabetes, you can stop taking your insulin on the advice of a faith healer. (This happens more than most people realize). We have a right to accept or refuse treatment; to be prudent, stubborn, or stupid. What you CANNOT do today if you want a sleeping pill or effective painkiller is purchase them in a pharmacy. What you must do if you want these medications is to go to a doctor and be examined and get a prescription. Hundreds of millions of physician office visits are solely for the purpose of getting medications you cannot purchase “over the counter” at a pharmacy. The savings from restoring the traditional right to self medicate that existed in the U.S. until the 20th century would be huge.
Special interest groups have undue influence in both the Democratic and Republican parties. This is true in domestic (i.e. health care) as well as foreign policy.
Defense contractors want more military spending going into their pockets. The pro-Israel lobby wants the U.S. to continue its presence in the Middle East, and to forcibly prevent Iran from getting a nuclear weapon—despite the fact that Israel has several hundred nukes, as well as chemical and biological weapons, and can defend itself quite adequately.
The physician guild wants to maintain its monopoly control of health services and the prescription pad. The lawyer guild opposes tort reform, from which both plaintiff and defendant attorneys earn hundreds of millions per year. The special interest groups will filter any “problem” candidates out during the Democratic and Republican party nominating processes in the 2008 cycle. As Tammany Hall grafter “Boss” Tweed said, “I don’t care who does the electing, as long as I get to do the nominating.”
Third parties have traditionally not done well in the U.S. Perhaps this year it just might be different. Maybe. The “Unity08” movement www.unity08.org is circumventing special interests and leveraging the internet by allowing direct participation in the nominating process online. Their goal is to put a ticket together of one Democrat and one Republican for president and VP.
Who Unity08 will nominate remains to be seen, but a ticket of Ron Paul and Dennis Kucinich would be interesting. If Paul and Kucinich were elected, U.S. military adventures abroad would come to a screeching halt. We could then engage in a national debate about two very different visions for health care.
W.J. Malan
Author, The Audacity of Truth
www.anarcorp.com
On health care—the other key issue—the Democratic candidates are all proposing various flavors of reform plans, but that is anything but re-assuring.
For their part, the Republican candidates (according to the same CBS News poll) are avoiding issues of concern to Republican votes. Like the Democrats, they overwhelmingly support ongoing military intervention in the Middle East; the notable exception is Congressman Ron Paul, who wants to bring the U.S troops home.
On health care, the Republicans propose some modest steps such as reducing mandates and making insurance more affordable and portable. They tend to support high-deductible insurance and more consumer choice and price transparency. These aspects of “consumer directed health care” are, I believe, a step in the right direction, but do not address one of the root problems of our health care system: the lack of MEANINGFUL competition.
How do we get REAL competition in health care? In addition to the modest steps proposed by some Republicans and the consumer directed health movement, it would require three measures:
1. Allow patients, providers, and insurers to contract out of the medical malpractice tort system. Doctors would love this, costs would be lower, and patients would benefit. Of course the ATTORNEY GUILD would oppose this tooth and nail. Plaintiff and defense lawyers make hundreds of millions of dollars per year playing the med-mal gambit.
2. Allow patients to receive medical services from any willing provider. This means ending the PHYSICIAN GUILD’S monopoly control over the delivery (and billing for) health services. For example, I should be allowed to purchase insurance that states non-emergency cardiac surgery would be performed at say, Escorts Heart Institute in India. Escorts, a for-profit hospital, performs thousands of surgeries per year at a fraction of the cost and with better outcomes than most U.S. so-called “non-profit” hospitals. Many British subjects who can afford to do so go to hospitals in Asia because they do not wish to wait in the queue (and perhaps die waiting) for services to be available under their National Health System. Of course, cardiac surgeons licensed to practice in New York will not welcome competition (whether foreign or interstate) and would oppose insurance companies contracting with New Yorkers to send patients to Singapore or India, or Indiana.
3. The third fundamental measure needed to spur real competition is to restore the right of competent adults to self-medicate. Under current law, if you start coughing up blood and remain conscious, you can call a doctor or stuff a rag in your mouth or call a faith healer. You can refuse a life-saving transfusion for any reason. Similarly, if you have type I diabetes, you can stop taking your insulin on the advice of a faith healer. (This happens more than most people realize). We have a right to accept or refuse treatment; to be prudent, stubborn, or stupid. What you CANNOT do today if you want a sleeping pill or effective painkiller is purchase them in a pharmacy. What you must do if you want these medications is to go to a doctor and be examined and get a prescription. Hundreds of millions of physician office visits are solely for the purpose of getting medications you cannot purchase “over the counter” at a pharmacy. The savings from restoring the traditional right to self medicate that existed in the U.S. until the 20th century would be huge.
Special interest groups have undue influence in both the Democratic and Republican parties. This is true in domestic (i.e. health care) as well as foreign policy.
Defense contractors want more military spending going into their pockets. The pro-Israel lobby wants the U.S. to continue its presence in the Middle East, and to forcibly prevent Iran from getting a nuclear weapon—despite the fact that Israel has several hundred nukes, as well as chemical and biological weapons, and can defend itself quite adequately.
The physician guild wants to maintain its monopoly control of health services and the prescription pad. The lawyer guild opposes tort reform, from which both plaintiff and defendant attorneys earn hundreds of millions per year. The special interest groups will filter any “problem” candidates out during the Democratic and Republican party nominating processes in the 2008 cycle. As Tammany Hall grafter “Boss” Tweed said, “I don’t care who does the electing, as long as I get to do the nominating.”
Third parties have traditionally not done well in the U.S. Perhaps this year it just might be different. Maybe. The “Unity08” movement www.unity08.org is circumventing special interests and leveraging the internet by allowing direct participation in the nominating process online. Their goal is to put a ticket together of one Democrat and one Republican for president and VP.
Who Unity08 will nominate remains to be seen, but a ticket of Ron Paul and Dennis Kucinich would be interesting. If Paul and Kucinich were elected, U.S. military adventures abroad would come to a screeching halt. We could then engage in a national debate about two very different visions for health care.
W.J. Malan
Author, The Audacity of Truth
www.anarcorp.com
Friday, September 14, 2007
Dick Morris on competition in health care
In his best-selling book OUTRAGE, Dick Morris notes the benefits of free trade. Morris says the "sectors where costs have soared--such as health care and higher education--are ones where there is no foreign competition." (p.294)
Morris is correct that the lack of competition in health care is a key factor in higher prices. He does not mention that quality of health care services is also a casualty of the lack of competition.
The modern physician guild (like the attorney guild) is protectionism in its most restrictive and odious form. Through state legislation the medical guild restricts who can provide health services, ostensibly "to protect the public"--regardless of how the "public" feels about this paternalistic and self-serving position of the guild. The physician guild also has monopoly control of the prescription pad, increasing demand for guild services.
What to do? As described more fully in my book The Audacity of Truth: what Rudy and Barack won't tell you, the answer is allowing more market alternatives: far more than Rudy or the rest of the Republican fake-markters would allow.
Here are a couple quick thoughts:
1. allow insurance companies to contract with low cost and high quality providers--whether they are in state, out of state, or out of country. Costs for major surgery in a U.S. hospital can be 20 times higher than in other countries. For example, the Escorts Heart Institute in India, a for-profit organization, performs heart-valve replacement surgery for $10,000; the same surgery in the U.S. runs about $200,000. And Escorts, which performs about 15,000 heart surgeries a year, has a mortality rate about half that of major U.S. hospitals. Hip replacement and other costly, non-emergency surgeries can be performed out of the country--or better yet--by "local branches" of these foreign competitors.
2. pass legislation to allow insurance providers to provide policies allowing individuals to "opt out" of the tort system. In return for limiting their remedies to arbitration or caps on damages, insurance purchasers would get additional coverage or a lower price. Lawyers of course would hate this.
Increased competition and enhancing the right to contract for insurance are two significant steps to reign in health care costs and improve quality. For more information, see www.anarcorp.com
Morris is correct that the lack of competition in health care is a key factor in higher prices. He does not mention that quality of health care services is also a casualty of the lack of competition.
The modern physician guild (like the attorney guild) is protectionism in its most restrictive and odious form. Through state legislation the medical guild restricts who can provide health services, ostensibly "to protect the public"--regardless of how the "public" feels about this paternalistic and self-serving position of the guild. The physician guild also has monopoly control of the prescription pad, increasing demand for guild services.
What to do? As described more fully in my book The Audacity of Truth: what Rudy and Barack won't tell you, the answer is allowing more market alternatives: far more than Rudy or the rest of the Republican fake-markters would allow.
Here are a couple quick thoughts:
1. allow insurance companies to contract with low cost and high quality providers--whether they are in state, out of state, or out of country. Costs for major surgery in a U.S. hospital can be 20 times higher than in other countries. For example, the Escorts Heart Institute in India, a for-profit organization, performs heart-valve replacement surgery for $10,000; the same surgery in the U.S. runs about $200,000. And Escorts, which performs about 15,000 heart surgeries a year, has a mortality rate about half that of major U.S. hospitals. Hip replacement and other costly, non-emergency surgeries can be performed out of the country--or better yet--by "local branches" of these foreign competitors.
2. pass legislation to allow insurance providers to provide policies allowing individuals to "opt out" of the tort system. In return for limiting their remedies to arbitration or caps on damages, insurance purchasers would get additional coverage or a lower price. Lawyers of course would hate this.
Increased competition and enhancing the right to contract for insurance are two significant steps to reign in health care costs and improve quality. For more information, see www.anarcorp.com
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