Archive for October 22nd, 2009

“Run for your life from any man who tells you that money is evil. That sentence is the leper’s bell of an approaching looter.” – Ayn Rand

“Do not muzzle an ox while it is treading out the grain.”Deut 25:4

Part I: Laying the Groundwork
Part II: Principles and Strategic Choices
Part III: A Laffer Matter

[NOTE: This will likely be the most contentious article in this series, as there are no "good"/"painless" answers. Whether we suffer a gradual descent into madness via incremental socialism or whether we're able to accelerate the its catastrophic failure, people will be hurt - regardless. My contention is that fewer will be hurt by a catastrophic failure - if the recovery is to learn from the failure and to ditch socialist and semi-socialist policies - than by the steady decline inevitable in the existing and proposed Ponzi schemes of government-provided health-care. Most, if not all of my 'Galt-ish' suggestions are simply pushing trends faster in the direction they will already be going, for optimum "failure-potential".]

ObamaCareAssumptions

While no health-care “reform” bill has yet passed out of the House or Senate this year, it is probably a safe assumption that one will – in some form, popular opinion be damned – ultimately pass. I’ve already written on the topic at least three times this year.

Within that plan, for the sake of this article, I will assume that there will be provisions that:

  • Prevent health insurance companies from policy denial for pre-existing conditions (”Guaranteed Issue”) and from charging different rates to different customers, based on their risk potential (”Community Rating”). What this means, if this were auto insurance, is that ACME Insurance would have to insure Lindsay Lohan, and they would have to insure her at the same rates as my father-in-law, who I’m not sure has received a ticket or been in an accident that was his fault in 50+ years of driving.
  • Require individuals to carry health insurance or pay a fine (for which the fine would be significantly less money than the cost of insurance). What this means, using the above example, is that Ms. Lohan is better off paying the fine for not having insurance until after she’s been in an accident.
  • Pay doctors on a scale tied to the same scale as Medicare (which most often pays doctors less than their actual costs of providing care).

By the time the government system fails, the goal of “going Galt” should be making it obvious that the road to hell is truly paved with good intentions.

The Looming Tsunami

Currently, there are 267 doctors (without regard to specialty) per 100,000 residents in the USA – a downward trend since the high-water mark of 279/100K in 2000. Even that mark was below the optimal mark – thought to be in the range of 325-350/100K – to support the medical system as it is used in America. Even worse is the huge shortfall in Primary Care Physicians (PCP’s) – where the majority of PCP’s are within 10 years of retirement (right when the wave of Baby Boom retirements hit) and the supply of graduates is less than 50% the number of retirements.

To make matters worse, the trend-line in graduates is headed downward – dropping 50% between 1997 and 2006, and is only kept afloat by the increasing number of immigrant students, willing to help fill the ranks. And it’s not just “about the money” (PCP’s earn 50+% less than most specialists), but also the work, itself – which has longer hours, a more demanding customer base, and lower reimbursement rates from payers. With med-school bills of $300K+ and an ever-increasing risk/reward ratio, along with an explosion in defensive medicine, malpractice insurance and burdensome paperwork that consumes 10 minutes of work for every 1 minute with a patient, it’s no wonder medicine is not an attractive field to enter.

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I’m not sure yet why I’m still reading Jesus for President, but I am. There are parts of it that intrigue me, and other parts that anger me. There are parts that are naive, and other parts that are profound. There are parts that are accurate, and there are parts that are (despite what some have said here) revisionist. There are parts where I’m jumping up and shouting, ‘Amen,’ and there are parts where I’m asking, ‘how could anyone write this stuff.’ I’m still reading, waiting on the other shoe to drop.

I almost put it down after I read his two pages on Hitler (202-203; which I think are incomprehensible and utterly naive). It’s hard to buy into a lot of what he says about the military (but I may be too close to the situation to see clearly since I come from a military family and my brother is currently in the military.) It was hard to read their justification of Tim McVeigh on page 214 (if it was not a justification, it was at least sympathy) and quote from him as if he were a saint to be adored.

I think sometimes Claiborne confuses the ‘body of Christ’ with the ‘united states.’ That is, I think he expect the united states government to act like the church and that the government is wrong when the government acts like, well, the government. I don’t think it can be both ways.

But I’m not sure sometimes. It’s hard to read their words that the government is bad, that the united states is (nearly) criminal in most of its actions, that the church shouldn’t hold hands with the state and then read that ‘We can provide universal health care and keep folks breathing longer (another nice move)…’ (228). I wonder how ‘we’ are supposed to fund this universal health care without rendering more unto the very Caesar that he is advocating we despise?

It’s probably easy to do so when one doesn’t have to worry about all those things like family, going to work every day, and doing things other than protesting the things you think are wrong with the world. I know. That is a broad, terrific, generalization. I repent. As Claiborne points out in the book, it’s easy to pontificate.

It’s hard to read about how criminal technology is and then read of the ’struggle’ they had to even publish this book (193, footnote 37). In order to assuage their conscience’s, they gave back ‘to the earth’ 10% of their book’s earnings. How generous.

OK. So on to the part about ‘whaddya think.’ (I didn’t ask permission to contribute to this series, so I hope it is alright to do so.)

I would like to know what you think about the following paragraph from Jesus for President:

Besides, the contradictions in evangelicalism are clear. Take divorce, for example, a sin Jesus spoke clearly about [as if Jesus didn't speak 'clearly' about any other sins]. The divorce rate of evangelical Christians now surpasses that of the rest of the population of the United States. Evangelicals are getting divorced, and gay folks are wanting to get married, and religionists keep accusing homosexuals of destroying the family. Yikes. If we truly had a church in which people could love and be loved, we would transcend so many divisive issues and be free to become the people God has created us to be. (233)

Try not to get too caught up in my complaints about the book. I’m not finished with it yet and I read every book the same way–like it is a deep mine and every now and again I might find a gem. But seriously, what do you think about this quote?

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