A Conservative View of Health Care

A thoughtful reader sent along a Progressive view. I respond interactively. His piece is indented, my responses are in italics. My bottom line is this:

Whatever happens in Washington after the machinations, rich people like Michael Jackson will try to buy doctors to help them live against impossible odds, and they will die. Poor people will try to afford doctors to help them live against impossible odds, and they will die. And everybody that lives will take life for granted and try to tell the sick to live like the well, and Death will not be impressed at all.

http://www.nytimes.com/2009/09/03/health/policy/03care.html

Makes sense, but the left (correctly I believe) is getting suspicious of the gov supplements to lower HC costs for the poor.  They will amount, in the end, to cash payments to those who are driving costs up in the first place, namely the health insurers and drug companies, in exchange for promises to provide “savings” based on their own estimates of what the costs would normally be. 

This reminds me of saving the banking industry, driven over a cliff by greed, by giving them cash on the hope that they will perform so well and responsibly that they will pay the money back with a profit.  That was followed by an urgent need to reign in executive compensation in light of the awful political realities around bailout cash going to crazy executive bonuses.  And of course we “saved” the auto industry, driven over a cliff by incompetent leadership (whoever signed off on job banks was an idiot), by giving that same leadership tons of money on the hope that they will perform so well and make such great decisions that they will pay the money back.  Gm responded by shedding 4 brands (including some profitable ones), and then “reducing” their number of models from 48 to 34.  And of course Fannie Mae and Freddie Mac, whose function in the economy was risk management, failed to see the concentration of risks around mortgage backed securities and associated derivatives, and required a government bailout that is counting on them to make enough great decisions to turn the housing market around so we can get the money back.  So far, no good.

This is called throwing good money after bad. But it is the inevitable consequence of industrial policy. Once you decide to bailout an industry, you bail it out unselectively. You cannot enforce any law or priority that will ever be more thorough, exacting and fair than the law of supply and demand. You merely stimulate artificial supply or artificial demand, then sit back and admire your ability to juice the system. It doesn't change the people involved - it doesn't make them better businessmen, it only proves that they respond to incentives. In other words, you substitute one sort of greed for another. And in this case it is the greed for money provided by politics instead of the money provided by private enterprise. It's Obama money and those that get, get.

What is troubling about all of this, when looked at in aggregate, is that it smacks of Reaganism.  I hated Ronald Reagan.  Sure, he offered some entertainment value, but I thought his ideas were whack.  He delivered them so well, that he emboldened an army of whack thinkers who still threaten our political stability with their stubborn refusal to use reason to navigate our way through tough issues.  It is very hard for Sarah Palin to use reason.  Sarah Palin is, by choice, unreasonable.  Faced with a series of nation-threatening scenarios, her and her band of angry Appalachian dwellers have united with Rush Limbaugh to fight for the right to do nothing.  As much as I hate Ronald Reagan, at least he had the decency to surround himself with smart people.  Jim Baker earned my respect, as did Frank Carlucci and a number of other Reaganites.  But his ideological legacy is Sarah Palin, and that alone is grounds for an ass whoopin.  His political/economic legacy is the trickledown theory.  And that is what we are practicing right now, in spades.

Sarah Palin is what people used to call a useful idiot, but more importantly, she is the most successful ruse imaginable. Palin doesn't have to lead, just like Jesse Jackson and Al Sharpton don't have to lead. She merely needs to keep all eyez on her and speak an occasional obvious truth. Nobody who discusses Sarah Palin is serious. Nobody.
 

I don’t think progressives sit around dreaming of ever increasing government influence over the economy and our lives.  Shoot, we pay taxes too.  It was the actions of George Bush (Ronald Reagan with no vision, no charisma and a much tougher opponent than Grenada or Daniel Ortega), that lead directly to where we are now, with no choice but government intervention on a major scale.  Progressives do dream of better living conditions for everyone.  We do sit around and dream of reducing the disparities between the rich and the poor, not by necessarily bringing down rich folks, but rather bringing up poor ones.  We recognize that we need a bit more of rich folks money to do so.  But up until recently, we tried to find ways to directly impact the communities that were suffering.  Those days appear to be over.

Progressive dreams are dreams deferred. There is a reason for that, which is that they defy the order of things for the conceit of any temporary ability to make the weak strong, the poor rich, the foolish wise, the uneducated brilliant, the common extraordinary. Progressives revel in achieving social inversions, to afflict the comfortable and to comfort the afflicted, and they do so from a perverted sense of obligation to achieve through politics what their souls are too thin and selfish to accomplish through Christian charity. It is not enough for the Progressive to take his own money to feed the hungry, he must take mine too, and it is only through this sort of unity that the Progressive achieves satisfaction. This is why Progressives are never silent and have nothing to be proud of. Their struggle is endless. It is the struggle to politically steamroll everyone into their perverse universe where the poor are always noble and deserving and the rich are always suspect and corrupted. I for one hope that Progressive dreams shrivel up like a raisin in the sun. Progressives always hope that it explodes.

One of the most successful government programs is Medicare, which directly impacts the lives of poor people.  One of the least successful was welfare, which was implemented wrongly and then decimated too suddenly.  The democratic party seems so shaken by the reality of the failure of welfare, that we have caved in to Reagan’s point of view.  Indeed, Obama the candidate upset the party with some almost nostalgic references to Reagan’s impact.   Perhaps that explains why every major solution to date has smacked of trickledownism.  While the administration is trumpeting the success of the stimulus plan (which admittedly included a few bucks directly to citizens), unemployment continues to increase right alongside corporate profits.  The tax rebates are spent, the cash for clunkers program (a whopping $2.4 billion…less than 1% of what we gave to B of A) is over, foreclosures are still skyrocketing, yet we still have billions set aside in case any other executives fall upon hard times.

Medicare will not defeat death. Every major solution must smack of trickledownism because that is the nature of hubris. Those that seek to achieve the impossible are always selling their plans to people dumb enough to believe. There are no solutions to be had from the top down. There is only what you do from the bottom up. The very act of asking for a solution makes you a sucker.

With that as a backdrop, we are engaged in a bitter struggle over absolutely necessary health care reform, and progressives are being asked to give up on a government run alternative to the ridiculously expensive private solutions.  The reason the status quo fears a government run health care alternative is that it will most certainly lower costs (and profits) by its very existence.  Managed Health Care is a commodity now.  There are no more important innovations outside of electronic records (drug, equipment, and treatment innovations are being developed in academia and in laboratories, not corporate suites).  You don’t need armies of overpriced executives to make awesome business decisions on how to give Johnny an immunity booster.  Managed Health Care executives are spending all of their time trying to figure out how to increase the size of their yachts.  Trust me, I know a few of these people.  They are mostly older men with a penchant for good drink.  They don’t deserve to profit so handsomely from the suffering of poor and middle class folks (the rich don’t need health insurance, they pay directly).  A government run option is the best way to fundamentally rein in costs, which is the most important component that needs to be reformed.  Trickle down won’t work in this instance.  All these other gimmicks, which fill a few thousand pages of dense legislation, amount to compromises that progressives are not impressed by.

Don't take Viagra. Don't buy Anacin. Deal with your headache. Study anatomy. Birth your baby at home. Whose fault is it that people who own human bodies understand more about how their cars and their iPods work than how their knees and their lungs work? You don't have a right to be stupid about your body. But just like crime funds a prison industrial complex, such stupidity funds a hospital industrial complex. What else could you possibly expect from the clever people who spend maybe five more years in their lives studying the human body except for them to exploit the fools who do not?

I still support Obama.  His health care sticker is on my business website because he asked me to put it there.  I cringe at the thought of a McCain/Palin administration.  But I hate the compromises Obama is making.  I am beginning to wonder if it even makes sense to reach across the aisle when you know that the folks on the other side enjoy playing with venomous snakes.  I am beginning to think that a strident, ideological left is just what the doctor ordered in these crazy times.  If you like Reagan’s impact, don’t copy his whack ideas, copy his swagger, his command of the stage, his conviction.  It will get the drama-addicted media back on our side, and with that, who knows what we can do.  Right now, we look like suckers.

Washington is the wrong direction to look. So long as your orientation is "I need Washington to do X for me to lead a happy life", then all you'll ever do is compete with people who want Y, and Z, and R, and D, and Q, and P. In the end you'll only get F'd.

Handle your own business.