Posts tagged ‘Holy Grail’

The Looming Failure of Obamacare, Part 3: Rent-Seeking

The third installment of my series on Obamacare is now up at Forbes.  An excerpt:

In the health care field, the Holy Grail of rent-seeking is to get one’s medical device, drug, or procedure added to state health insurance mandates.  Before Obamacare, health care insurance regulation had been a state function, and each state had written laws mandating that all health insurance policies written in the state must cover certain services.   By getting one’s particular service added to such a mandate, the service essentially becomes “free” to consumers in that state  (of course it’s not free — everyone pays in the form of higher premiums, but the marginal price for the service goes to zero).

Imagine you have a procedure — let’s use laser elimination of birthmarks as an example.   This procedures requires a series of treatments using a fairly expensive piece of equipment to produce results that are of enormous value to a few people with extensive birthmarks, and of smaller value to many other people with smaller birthmarks.  Business growth in such a field is typically good at first as those who most value the procedure pay for it.  But it can be hard to grow outside of a relatively small niche, as most potential customers may consider it to be an expensive elective cosmetic procedure that, given other uses for their money, they can do without.  What can an aspiring dermatologic surgeon do?  Run to the government!

In 1997, the University of Indiana conducted a study of the laser treatment of these birthmarks.  I don’t know who funded the study, but tellingly the study findings did not really touch on the efficacy of the treatment or its risks.  The study surveyed a number of dermatologic surgeons.  What was its primary finding?  ”Based on current health care policy guidelines, laser treatment of port-wine stains should be regarded, and covered, as a medical necessity by all insurance providers.”  In other words, the sole purpose of this research was to convince legislators to add this procedure to their state’s  insurance mandates.   To date, this procedure has been added to the must-carry list in only two states, but in those two states doctors no longer have to convince price-sensitive patients that this elective procedure is worth the cost – after all, its free!

As you can imagine, the cost of these mandates are staggering for those of us who pay the premiums.  State governments are requiring us to pay higher insurance rates in order to cover procedures we might never consider.   Four states have mandated coverage for naturopaths;  three for athletic trainers; one for oriental medicine; eleven for hair prosthesis; four for massage therapists; and three for pastoral counselors.  The state with the most such mandates is Rhode Island, with 70, a state which not coincidently also has the third highest insurance premiums in the country.

On a quasi-related note, John Goodman has thoughts on "government failure" (an analog to market failure) as it applied to health care.  It is a point that cannot be made too often.  Merely pointing out supposed imperfect outcomes from private action does not immediately justify government action -- too often people take the default position that if an improved outcome can be imagined, the government can achieve it.  But does this ever happen?  In health care, the irony is that many of the supposed market failures we are "fixing" with Obamacare are in fact results of past ham-handed government action.

We're Sorry, Larry

Larry Summers caught a lot of grief for a statement that has been oft-misreported:

"It does appear that on many, many different human attributes- height, weight, propensity for criminality, overall IQ, mathematical ability, scientific ability - there is relatively clear evidence that whatever the difference in means - which can be debated - there is a difference in the standard deviation, and variability of a male and a female population."

Carpe Diem brings this chart, visit the link for more explanation.

Personally, I don't have a lot of problems with the gender hypothesis, but I am skeptical of our ability to test intelligence.  I think most of us in the real world have enough experience to understand that the people we meet have a range of cognitive abilities, but I am not sure it is even possible to put a number on this, particularly since my experience is that there are many categories of intelligence and intelligence in one area is not intelligence in another.  Besides, I think most IQ tests are dominated by logic problems where one's ability to solve them improves with practice and training -- but this is counter to the idea we are somehow testing some property separate from education or training.

Update: As to the idea of different intelligences, I will offer myself as an example.  In my prime, I was pretty freaking good at advanced math, and later in life I got pretty good at deconstructing business problems that were pretty complex.  But I can't spell my way out of a paper bag, and I have a horrendous proof-reading ability (as all my readers will know by now).  I can stare at text over and over and still miss obvious errors.  I have a fabulous memory for concepts and problem-solving approaches, and I can recite the entirety of Monty Python and the Holy Grail from memory, but have almost no ability to retain a name, date, or phone number.

Sanction of the Victim

This has been an incredible week in the ongoing culture clash between the western democracies and radical Islam.  In a series of events right out of the Onion or Monty Python, radical Muslims around the world protested the Pope calling them violent with ... waves of violence.  Once his remarks were proven right in such an obvious and public way the Pope reacted by ... apologizing for his remarks.**   

I am tired of apologizing to radical Islam (for some silly, bland cartoons, for god sakes!)  I am tired of bending over backwards into pretzels to give them the benefit of the doubt.  I am extremely tired of being told these folks are just aggrieved and in reality they share my values, because it is very very clear that they don't share my values.  I am tired of being told most Muslims are peaceful --  when these peaceful folks give their sanction and support to the violent ones and accept the most radical as their leaders. 

Radical Islam is, with the downfall of soviet communism and the painfully gradual opening up of China, the most illiberal force in the modern world. By a long shot.  It treats individual life with contempt, has no concept of rights, and in particular treats women far worse than apartheid South Africa ever treated blacks.  The theocracy we fear from certain Republican 700 Club folks is like 3.2 beer compared to full 200 proof Islamic theocratic fascism. 

I don't know why the left in this country has been hesitant to call out illiberal practices in the Middle East as vociferously as they have in other circumstances.  A part of this hesitation is probably opposition to the Iraq war, and fear that denouncing radical Islam for its faults might somehow give the administration a stronger mandate for more military adventures.  A less charitable explanation is that the hesitation is an extension of political correctness and cultural relativism run wild).

Well, I opposed the Iraq war:  The Augean stables are just too dirty to clean up by sending the military from dictator to dictator. I will go further and say I actually think the terrorist threat is exaggerated (and yes I do remember 9/11) in order to keep giving the FBI more powers and help politicians get elected.  Get tough on terrorism is sort of the new get tough on crime election speak.

But I don't think the threat to liberal values posed by Islamic fundamentalism is exaggerated.  And the first step in fighting it is to not give it, as Ayn Rand would say, the sanction of the victim.  People sometimes email me and say "who are we to talk -- America is not clean."  I will agree we have our warts - and much of this blog is taken up with pointing some of them out.  But what I always tell people, and still believe, is the following:

The US does harm when we fail to live up to our values.  Radical Islam does harm when they successfully pursue what they value.

**Postscript:   I don't pretend to understand all the 13th century quotations in the Pope's speech.  I don't think it matters.  If he had simply said "radical Islam preaches too much violence and it has to stop" he would have gotten the same reaction.  By the way, every person in the world seems to say bad things about the US, many of these comments are untrue or apply only to a minority of our leaders and not to myself. I can't remember anyone ever apologizing to me.   This story  that Muslims will do more violence unless the Pope apologizes some more reminds me of Sir Robin in the Monty Python and the Holy Grail.  "Perhaps if we run away more..."

And here is my message to the right -- I acknowledge that radical Islamic leaders treat apologies, backing-down, etc. as weakness to be exploited rather than preludes to reasonable compromise.   For this reason, I thought the invasion of Afghanistan was a necessity.  However, this general fact does NOT automatically justify the Iraq war.  If it did, it would also justify invading any Islamic country we want.  I still don't understand the strategic sense of Iraq and now we are stuck there, because I agree that once in, backing off will only embolden the radicals in the area to further hi-jinx.

I have seen 43

This is a pretty good list of the 50 best "guy" films of all time.

Films I would add:

  • Where Eagles Dare
  • Kelley's Heroes
  • Deliverance
  • Patton


And True Lies, how could I leave that off?  Also, I might tend to add Monty Python and the Holy Grail.  Not a classic guy movie in the action sense, but there are sure dang few women who seem to get into it like guys do.  Nee.