The debate over health care

The current health care debate is a real mess. I suspect that whatever plan the Democrats end up pushing through will cost much more than they claim. Moreover, it won't likely do much to solve many of the real problems in this nation with health care such as rising cost and lack of real choice for individuals. The Democrats may end up covering more people and eliminating some of the insurance industries more dubious use of things such as pre-existing conditions. However, their plans will likely raise premiums and reduce coverage for those who already have insurance. Worse yet, once they commit the federal government to what is in effect an entitlement expansion, there is little chance it will be cut back as entitlements rarely if ever are cut back. This means bigger government and a larger budget deficit-a very dangerous proposition for a government that already spends nearly 10% of its budget on the INTEREST of its debt.

As usual, the Republicans don't seem to have any genuine alternatives to this, though at least almost all Republicans in Congress won't support the Democrats. If I was in charge, here are some of the changes I would make:

1) Employment needs to be disconnected from health insurance. This is one of the biggest problems today and neither side seems to want to discuss it. Employers should stop offer health insurance and should simply pay workers more so they can go buy it for themselves on the free market. At the moment, one of the biggest problems is that health insurance companies can be jerks. But the insurance companies know good and well that people can't drop their health insurance as they could their auto insurance because they get it through their employer. If they dropped their employers' insurance, they would in affect be turning down hundreds of dollars each month in pay from their employer and would be forced to buy insurance at a higher rate on their own, something most people simply can't afford to do. The system we have now isn't capitalism. It is a quasi-monopolistic system. Real competition, which along with disconnecting employment with insurance coverage would also including allowing people to buy health insurance across state lines, would go a long way to changing things.

2) The federal government should allow everyone to have a tax-free health savings account as some companies currently have. Individuals should be allowed to contribute as much as they want each year and deduct it from their taxes. They should also be allowed to roll over what they don't use one year to their account for the next year (though for taxes they should only be allowed to deduct contributions made for each year). Individuals could use their savings accounts to purchase health insurance and pay for out of pocket expenses. This would give people a great deal of freedom to manage their own affairs.

3) Everyone should be required to purchase some form of "emergency" health insurance that covers things such as cancer or terrible accidents. It is outrageous that people go bankrupt in this country because of medical bills. There really should be insurance to prevent this. Those who are too poor to pay for this should be given a subside to buy their own insurance or receive it through Medicare or Medcaid.

4) The way we pay doctors needs to change. At the moment, they are paid for all the tests and procedures they do. This needs to be changed to how things work in other countries such as Britain where doctors are paid (and even given bonuses) for results, i.e. getting patients well instead of for procedures. Doctors should be well compensated. But they need to be paid for results, not simply having expensive tests and procedures done.

5) We need to stress wellness and prevention more. Is it any wonder that we have such high health care expenses in this country with our obesity rates and the poor diet and exercise that causes obesity, heart disease, diabetes, etc.?

Much of the above is similar to the system in Switzerland, which is cheaper, has universal coverage and gives individuals more choice over their health decisions than is currently the case in America with health insurance companies and their quasi-monopolistic practices or if the government took more control over the health care system, especially if we went to a single payer system. Americans don't like answering to a health insurance bureaucrat. But answering to a government bureaucrat wouldn't be any better. The choices we have in America between the left and right today are false choices.

I believe many of the above ideas make sense. Which of course is why they probably won't be adopted.

Why the global warning debate doesn't matter

In recent years the media has discussed global warming quite a bit. It has become an important issue for the left, which holds that the “carbon footprint” that humans are leaving on this planet could well melt the icecaps, cause the oceans to rise, and totally disrupt life on earth as we know it. Many on the right on the other hand sees this as fear-mongering and believes that global warning is a hoax concocted by blowhards such as Al Gore. Further, the right views government efforts to reduce greenhouse gases will cost businesses billions and hamstring the American economy. Obviously, both sides have ideological reasons for their positions and those on the extreme left and the extreme right can be pretty dogmatic about this issue.

It appears that many scientists do believe that global warming is caused by human activity. But it also seems that a substantial and perhaps even growing number of scientists dispute this claim. The global warming debate seems important. Certainly the potential consequences of getting this issue wrong either way are pretty bad. In the end, however, I just don’t think this debate is all that important. Why not? Mainly because I don’t think people are going to change their ways all that much, especially Americans. I heard not too long ago on NPR that as individuals liberals don’t act any differently than conservatives when it comes to the environment. That seems about right from my personal experiences. I’ve definitely known liberal colleagues who drive more and drive less fuel efficient vehicles than do I.

As a nation, we may well adopt lifestyles that consume less fossil fuels in general and oil specifically. But this will be due to market forces, namely the rising cost of oil and other fuel. Of course, it would also improve our long-term national security if we moved away from oil as well. One thing is for sure, we aren’t about to give up our cars, electricity, and other modern conveniences, especially for something as abstract to the average person as global warming.
Industry and agriculture, which is also heavily dependent on fuel isn’t about to do this either. The vast majority of Americans aren’t remotely interested in living more like the Amish. We prize the conveniences of our live above almost everything else. This attitude isn't a good thing and is also why things such as abortion are so difficult to fight. Abortion is the taking of innocent human life and is a monstrous evil. Sadly, for many Americans it is a convenience that helps give them the “freedom” to live materialistic and sexually unethical lifestyles.

Americans aren’t about to give up their cars and other gadgets. If the government tries to reduce carbon emissions in a manner that hinders access to these modern conveniences, it will face an outcry from the public. I’m not a scientist, so I can’t say much about the science of climate change one way or the other. But I hope anthropomorphic global warming is a hoax. If it isn’t, we’re screwed because there is no way that Americans, much less the rest of the world will every change their lives in a way that would stop it. That in the end is why the debate over global warming just doesn’t matter. It’s a lot of talk on an issue where apart from market forces and technological innovation we just aren’t going to make in substantial changes.

So what should the Republicans propose? Some suggestions

So if the Republicans weren’t nearly worthless and had any credibility, and if they had any ideas worthy of offering the public, what might they propose as an alternative to what the Democrats are currently doing? The Republicans should actually propose real conservative ideas, though tough economic times do require some ideological flexibility. It’s easy to be negative and sit back and criticize the Democrats. The Democrats did this for years with Bush. It didn’t help them any and made them appear as simply a bunch of nay-sayers. Some of their criticism of Bush were correct. But they didn’t go anywhere because they went over the top at times, came off as bitter and hateful, and above all didn’t have any new ideas or alternatives to offer. The Republicans need to avoid this and while in the opposition should offer a real alternative instead of just complaints. I would offer the following general suggestions:

1. Cut the size of the federal government, especially unnecessary programs.
2. Cut back our defense budget by reigning in our commitments abroad. We have no need of an Empire and it will bankrupt us in the long run.
3. We need to avoid too much government debt and inflation via printing money. There is a real possibility that some of the policies currently being pursued could weaken or even destroy the value of the dollar, which would be a disaster.
4. We need to do something about illegal immigration, the loss of industry, and our dependence on foreign imports. While there is nothing wrong with a service based economy per se, our fundamentals do not seem solid for the long term.
5. Something needs to be done to prevent entitlement programs from eating the federal government’s budget alive in the future. Some real entitlement reform needs to be discussed.
6. Some temporary government spending on infrastructure (roads, bridges, the power grid) might not be such a bad thing. Investments in alternative energy that would help free our dependence on oil would be especially worthy of government spending. After all, in the long run our current energy situation is both an economic and security problem that needs to be addressed.
7. We should have across the board tax cuts, but especially on the middle class and small businesses. These would stimulate spending and create jobs.
8. The public loathes the idea of government bailouts because they seem to reward greed and reckless incompetence. Bailouts should only be a last resort to prevent a recession from turning into another Depression. When at all possible, the market should be allowed to take care of itself. Some people who bought too much house should have their homes foreclosed on. Some banks that made reckless loans should go under. But we shouldn’t stick to free market principals to the point that it plunges us into a Depression.
9. What about companies who took bailouts? If a bank or company takes government money, there should be some serious strings attached. For example, the CEOs who made the poor decisions that put them in such dire straits should have to forfeit all the big bonuses they were awarded for the bogus “profits” they made their company in the form of back taxes and penalties. Bailouts should mean their golden parachutes get turned into lead. If said corporate leaders get fired, go bankrupt, lose everything they own, or even go to jail, too bad. This would send a clear message to the corporate world about what happens to people who take such reckless actions. It would also play well with the public who hates the idea of those responsible for this mess being rewarded i.e. “bailed out” for their stupidity.
10. It is clear that the banking industry needs to be regulated more. The government especially needs to zero in on preventing fraudulent lending the future.
11. Finally, we don’t need to lose focus that many individuals, banks, and corporations in America did not act recklessly. Regulations and taxes should not be allowed to hurt those who did not act foolishly. They already have to pick up the tab as taxpayers, so why should they be hurt twice for things they are not responsible for? Truth be told, the government should try and ensure conditions in which responsible people, banks, and corporations can take advantage of the stupidity of others in the market.

I don’t pretend to have all of the answers. And I freely admit that some of these ideas are vague at even possibly at cross-purposes. But I do think that in general if the Republicans sought to return to a more authentic form of conservatism and offered alternate proposals that were based on a mix of fiscal conservatism, pragmatism, and basic fairness that they might get a hearing with the public. They might actually contribute to what the government does and help us recovery as a nation and the Republican party as a credible party. With the party’s current group of leaders and commentators, however, I’m not holding my breath.

Republicans and the stimulus package: A lack of credibility

Daniel Larison has an interest post over at his blog "Eunomia" on the current Republican party and the economy. It is worth reading, so I've posted it below:

http://www.amconmag.com/larison/2009/03/07/look-on-the-bright-side

"It seems to me that implicit in a lot of conservative criticism of the stimulus bill, the mortgage plan, and Obama’s cap-and-trade scheme, among other things, must be the odd notion that things would have been very different had McCain won the election. While we can be sure that McCain the crazed earmark-hunter would still be with us (no doubt keeping us safe from volcano monitoring and gang tatoo removal), let us recall that McCain supported cap-and-trade (even if he didn’t necessarily understand what he was talking about when he said so), proposed an insane mortgage bailout plan that pretty much everyone hated, backed TARP and differed from Obama on taxes largely in that he refused to raise any rates. In the end, the main difference turns out to be a disagreement about whether to return the top rate to its Clinton-era level or not. I guess that is a bit more than a dime’s worth of difference, but it isn’t much. Of course, this is why so many Republicans were relieved that McCain lost, because had he won they would have ended up backing a whole host of policies that they are currently denouncing as disastrous. At the same time, we would have had an old, irritable President prone to fits of bellicosity in international affairs and moral grandstanding about any issue he doesn’t understand, and behind him would have been an unqualified VP. However bad things are, remember that they could have been far, far worse."

As Larison notes, as much as the Republicans (rightly in many cases) complain about the stimulus package, it is doubtful that a president McCain would do things much differently if he were in office instead of Obama. Perhaps more importantly, the Republicans don't really have a lot of room to talk after all the problems of the Bush years. Bush and the Republicans in Congress wastefully spent money on pork barrel projects. They spent money like drunken sailors and increased both the size of government and the national debt. Moreover, they got us into the war in Iraq, which has turned out to be an unnecessary disaster that has cost tens of thousands of American and Iraqi lives and hundreds of billions of dollars. Congressional Republicans were also involved in a number of scandals. And last but not least, the Bush administration played fast and loose with civil liberties in the name of fighting terrorism.

In short, the Republicans did not act as real conservatives in the first place and certainly were not responsibly with power and money. Unfortunately, so far they don't seem to have learned much from their mistakes during the Bush years. Granted, it hasn't been all that long since the November election. But there has been no indication that "mainstream" Republicans have even began to question the disastrous and fundamentally unconservative radicalism of the neocons. Rush Limbaugh and Sean Hannity are still widely seen as authentic spokesmen of conservatism. The rank and file of the Republican party haven't exactly turned to Ron Paul for leadership or to paleoconservative publications such as "The American Conservative" or "Chronicles" for new ideas. I wish I could say there is a chance of this happening in the coming years, but I doubt it.

I suspect that the stimulus package may do more harm than good. It appears to have some good aspects, but will certainly increase the size of the national debt and government all while quite possibly doing little to kick start the economy. Politically, the problem is that the Republicans don't have any new ideas and consequently aren't able to present much of an alternative to what Obama and the Democrats in Congress are doing. Not only are the Republicans intellectually exhausted, but they have very little credibility in the eyes of the public. As skeptical as I am about the stimulus package, Republican (and I include talking heads such as Limbaugh and Hannity here) attacks on the stimulus package look a lot like the pot calling the kettle black. I'm sure the same is the case with much of the public as well. The Republicans are going to have to wander in the wilderness for several years. After the follies of the Bush years, they deserve it, though unfortunately in the meantime Obama and especially Congressional Democrats may do damage of their own to our country and economy.