An Infuriating Feature of the Healthcare "Debate"

I just read this:

Parents care more about their children than do the members of the bureaucracy. But parents are being gradually curbed in their authority by precisely those bureaucrats across the West.

On Tuesday, a British court condemned a not-yet-2-year-old child to die. Now, make no mistake: The child, Alfie Evans, is expected to die in the near future anyway; he suffers from an undiagnosed brain condition that has robbed him of much of his function. But his parents simply wanted to be able to transfer him from a British hospital to an Italian hospital to seek experimental care.

And the British court system refused.

Citing the expertise of Evans' doctors, the courts declared that Evans' best interests are not served by his parents' attempts to save his life. Instead, the little boy would be deprived of life support, left to die without oxygen or water. The ruling, the judge said, "represents the final chapter in the life of this extraordinary little boy." But that chapter was written by the British bureaucracy, not by his parents -- the ones who will have to engrave his epitaph and visit his grave.

This appalling result isn't the first of its kind; just last year, a little boy named Charlie Gard was taken off life support thanks to the British court system, which presented his parents from sending him to the United States for further treatment. Again, the courts made the argument that the best interest of the child lay in his death.

All of this is the final result of a system of thought that places parental control of children below the expertise of bureaucrats on the scale of priorities.

This argument is, I suppose, valid on its face. However, what it fails to recognize is that we currently have a system that "places parental control of children below the" unquestioned infallibility of the free market, i.e. "If you can pay, you get the treatment. If you can't, your children die."

So, Ben Shapiro (author of the linked article) is making a great case for not letting government bureaucrats control the health outcomes of citizens while utterly ignoring the fact that market forces are controlling such outcomes. Is it better that my 3-year-old die because I can't afford her treatment as opposed to because some government bureaucrat decided that the treatment options available were not worth pursuing? I don't know, but I think that any argument that merely focuses on the injustice of a bureaucrat making decisions for my family without at least acknowledging the alternative is problematic on its face.

For example, what if I argued that here in Indiana, you can only get to places where the government bureaucrats have decided that we should have public roads? Is the logical conclusion of that argument that we should not have public roads? After all, the reason I can't get certain places is because government bureaucrats have determined that the route that I care about isn't important enough to get built (according to the argument, which utterly ignores that any one person can't possibly be expected to finance each and every road upon which he may someday want, or need, to travel).

Policy Positive - Healthcare

I have spent a lot of time in the past year writing about how bad the since-defeated crop of Republican healthcare policy proposals were. However, I appreciate that the Republican party took seriously, if only for a few weeks, the idea that American healthcare needs to be reformed.

It does.

I don't think anyone disagrees with that.

Nonetheless, I have noted that Republican efforts to reform American healthcare have dwindled to essentially "nothing." Now, as a member of the public, I am generally inclined to believe that any policy proposals put forth by this crew in Congress is bound to be terrible, but I still want them to try to advance policies. Show me what you believe in people!

I write this in context of something interesting I read today in Slate. Here is an excerpt (I highly recommend clicking through):

Having lots of different health care plans already formulated won’t make those debates any easier. But by drawing legislation up now, Democrats are showing that this is a priority for the party, and that they are thinking through the policy questions seriously, not just as a political show. In my view, they might as well keep tossing more bills on the pile.

Amen. I would ask that anyone who passes laws ostensibly in my name to, at the very least, think through the details.

Trends of an Era

Short post today; I saw this column in the New York Times and wanted to share a great quote:

the late 1960s and the 1970s should have moved a reasonable person to the right on economic policy, in response to rampant inflation, rising crime, sky-high top tax rates and breakdowns in Europe. The last 15 years — with “widening inequality, financial crisis, zero interest rates, rising gaps in life expectancy and opportunity,” as Summers notes — should move that same person to the left. Different eras require different solutions.

On Todd Rokita . . . the worst kind of "lawyer" there is

The kind that likes to call himself a "small-government conservative" yet has been on the government gravy train for essentially his entire career. From his own web site:

ROKITA, Todd, a Representative from Indiana; born in Chicago, Cook County, Ill., February 9, 1970; graduated from Munster High School, Munster, Ind., 1988; B.A., Wabash College, Crawfordsville, Ind., 1992; J.D., Robert H. McKinney School of Law, Indiana University, Indianapolis, Ind., 1995; lawyer, private practice; general counsel, Indiana state secretary of state’s office, 1997-2000; Indiana state deputy secretary of state, 2000-2002; Indiana state secretary of state, 2002-2010; elected as a Republican to the One Hundred Twelfth and to the three succeeding Congresses (January 3, 2011-present).

So, to be clear, he went straight through from Kindergarten through Law School, graduating in 1995 (I wonder what kind of grades he had? I note he doesn't brag about them . . .). He claims he was in private practice, but his first job appears to have been for the State of Indiana. He then went to work for the federal government.

I'm confused. How stupid does Todd Rokita think we are? He hates government, but has worked in government his entire career? Huh.

I also note that, even though he says he was a "lawyer, private practice," I can't find a single case in which he has appeared. Now, of course, it is possible that he did practice but didn't do litigation. However, I get the feeling that the more accurate story about him is that he clerked for the Secretary of State until a position opened up for him there, so that he could pursue political ambitions.

In other words, Mr. Rokita is a professional politician. One might even say he is a "swamp creature," if one were inclined to use such terms.

What an a$$hat. And don't even get me going on this, a bush-league stunt that any first-month law student should know better than to try, let alone someone who actually bears the moniker "Lawyer."

Foreign Policy Question

On October 7, 2001, the United States launched its war in Afghanistan.

Today, April 17, 2018, we are still there. That was 6,036 days ago.

Starting in October 2019 (presuming we are still there, and I have no good faith reason to believe we won't be) the United States military will be sending soldiers to fight a war for which they weren't even alive when it started; they will never have known a world where we (I use that term loosely, to reference the United States as a whole) were not fighting a war in Afghanistan.

I want the war to end. Yesterday.

I have no moral qualms with the effort itself, but I believe that all we reasonably can accomplish in Afghanistan has been accomplished.

My question, for those who support a continuing presence there, is this: What objective, measurable "thing" could convince you that we have won the War in Afghanistan and the troops can now come home?

Answers along the lines of "make it so that terrorists can't have a safe haven there" or "when they have freedom and liberty" by the way don't count unless the proponent of such answer can provide the objective and measurable metrics associated with "freedom," "liberty," or "non-safe haven."

My son is 5 years old. The war was more than a decade old when he was born in 2012. I don't want him or his cohorts to still be fighting that war when they become adults, though I could be convinced if the proponents of the war can explain to me what it is that they want. What objective fact would make this hypothetical foreign policy hawk (i.e. John Bolton) satisfied?

I generally tend to avoid writing about foreign policy because, aside from living outside of Toronto for a few years when I was young, I have scarcely even been outside of America; I certainly do not have the kind of expertise that one would expect to consider someone knowledgeable on foreign affairs. However, after speaking of the seemingly neverending Afghan War with my neighbor, I felt the need to speak up on the blog as well.

QOTD

Sometimes, all you can do is just tip your cap:

Due to his closeness with President Donald Trump, there is a lot of talk about the recently raided Michael Cohen being the key to unraveling all of the president’s alleged and supposed crimes. We want answers and it appears Cohen has some. It’s natural to project the desire that Donald Trump be held accountable for something onto the decisions of Robert Mueller, the U.S. Attorney, or the Department of Justice.

It may well be that the raid of Cohen’s office is the beginning of the end of Donald Trump, but let’s not lose sight of the fact that Michael Cohen is a terrible attorney, the Wreck-It-Ralph of fixers. 

Ha! 

Anecdotes, not Data

I am the first to concede that the plural of "anecdote" is not "data." However, often times anecdotal evidence is more powerful as it puts a "human face" on the reams of data at issue in an argument. 

There is a lot of discussion, here and elsewhere, about the cost of healthcare. I feel as though those in the healthcare industry believe that when someone such as myself mentions frustration with the high cost of healthcare, the reflexive response is to either (a) claim that American healthcare is the greatest in the world; (b) argue that everyone gets healthcare in America, regardless of whether they can pay for it; (c) argue that the cost is so high because of uniquely American problems; or (d) deflect on the high cost and argue that because their healthcare costs are covered by good employer-provided insurance, anyone complaining must be a loser, or lazy, or not want to work, or something.

I make no response to any of those arguments here. I believe I have addressed them before and will likely address them again. However, I just want to share this anecdote about the crushing burden of high healthcare costs:

Last October, Bradley Sroka took his 1-year-old daughter, Margot, to the local emergency room. The little girl had managed to tie a piece of her own blonde hair around her toe, causing it to swell and turn purple.

The hair had left a clean circular cut around Margot’s toe, which spurted blood each time her parents tried to inspect it.

“We had no idea how deep the cut was, whether we could just wrap a Band-Aid around it,” Sroka says. “It was like nothing we’d ever encountered.”

Margot turned out to be fine — a physician assistant inspected her toe, made sure the hair was gone, and applied an antibacterial ointment.

A month later, the Sroka family got the bill: $937.25 for the 29-minute visit. They are responsible for the entire bill, which was within their deductible.

Now, I don't know about either reader of this blog, but I can tell you that $937.25 for 29 minutes would destroy my family's monthly budget. Imagine if this was a "real" problem that required more than a PA inspecting an extremity and applying an antibacterial ointment. 

These cases fit what experts describe as one of the defining features of the American health care system: exceptionally high prices for routine medical services

USA! USA! USA! 

Talking Past Each Other . . . Still

For 8 years, I watched self-styled "conservatives" rail against deficit spending, even at the height of the Great Recession. Beginning in mid-January 2017, all of these voices seemed to go silent and proceeded to pass a party-line tax bill that drastically cut taxes on corporations and did not even pretend to pay for itself.

Now, people are back to bemoaning the national debt. Case in point:

As is well-known, our deficit and debt problems stem from sharply rising entitlement spending. Without congressional action, the combination of the automatic spending increase per beneficiary provisions of these programs and the growth in entitlement program recipients as the population ages will cause entitlement spending to continue to rise far faster than U.S. national income and tax revenue.

This article, as confirmed by the link, was published in the Washington Post within the past two weeks. What is notably missing from this analysis of the failure of our nation's tax receipts to fully fund our expenditures? Any guesses?

Never interested in disappointing, the authors of this crap-sandwich column give us this:

 To address the debt problem, Congress must reform and restrain the growth of entitlement programs and adopt further pro-growth tax and regulatory policies. The recently enacted corporate-tax-reform plan is a good first step, as it sharply increases the incentive to invest and grow businesses, which will increase incomes. The revenue loss, which amounts to about 0.4 percent of gross-domestic product in 2025, is not by itself a budget buster, considering both the offsetting revenue reflow from higher incomes and the far larger long-run entitlement explosion. Moreover, over the next decade, the tax plan maintains or increases the federal tax claim on GDP compared with recent levels.

I am a lawyer, and I know sophistry when I see it.  

First off, where is the evidence that cutting taxes on high earners is "pro-growth?" Objective, verifiable evidence on this point is utterly lacking. Rest assured, the advocates of upper-income tax cuts would cite it ceaselessly if it were there. Alas . . .

Second, where is the evidence that this particular tax cut "sharply increases the incentive to invest and grow businesses?" Again, if the evidence exists, cite it and win the argument. Failure to do so implies lack of such evidence.

"The revenue loss, which amounts to about 0.4% of GDP in 2025, is not by itself a budget buster." The House of Representatives, the very entity that wrote the most recent tax cut and the one entity with the most incentive to polish that turd stated that this would decrease federal revenues by $1.5T over a decade. That's $150,000,000,000/year, every year. Further, that 0.4% of GDP is misleading, as federal policy currently will have 2025 tax rates being approximately 15.7% of GDP. Thus, the most recent tax cut bill will reduce rates by approximately 1/31 as opposed to 1/200. A fine piece of sophistry.

Third, what exactly is "revenue reflow?" 

Fourth, and back to the proof problem, where is the effect that this tax bill will boost anyone's income or boost tax receipts? We've been through this. If the proponents had the proof, they would cite it ad nauseum. They don't cite it because they don't have it.

Finally, "the tax plan maintains or increases the federal tax claim on GDP compared with recent levels." I'm confused. I thought this was a tax cut? I noticed the explicit cut to corporate taxes, so where is the rest of this "maintain[ed] or increase[d] claim on GDP" coming from?

All of this is to say that the so-called deficit scolds don't take deficits seriously. When did you see any plan, whatsoever, to pay for the enormous tax cut that just happened, or the massive increase in military spending?

Nowhere.

The only times I have seen any national politicians attempt to explain how things get paid for in recent years is when a liberal is attempting to do something, whether that liberal is Barack Obama explicitly and painstakingly requiring "pay fors" in the Affordable Care Act or Bernie Sanders meticulously explaining how he would pay for "Medicare for All."

This is why we can't have adult conversations. When one side acknowledges a problem and the other side doesn't, we simply talk past each other.

UPDATE: People with qualifications that far exceed mine in every way imaginable (i.e. Janet Yellen, former Fed Chair, among others) have written a fairly comprehensive rebuttal. You can see it here.

Cal Thomas - dial "O" for "Oblivious"

The right-wing victimization party is at it again. Recall, these are the people who advocate "personal responsibility" and constantly characterize themselves as "constitutional conservatives." Nonetheless, we get this from Cal Thomas in today's Indianapolis Star (note, I was only able to see it in the print edition and the link goes to Mr. Thomas' personal site):

This is the wrong approach. Instead of boycotts and threats, how about celebrating the First Amendment by encouraging people to say what they think? Then viewers can decide whether to “buy” what a program is selling or change channels. That was what the left said to do in the 1980s when conservatives were upset by some TV programming. “If you don’t like it, change the channel,” they said. If that was an option then, why isn’t it an option now?

By way of background, the "wrong approach" referenced is the campaign by various groups to get advertisers to stop paying to advertise on Laura Ingraham's show.

It seems that Mr. Thomas believes that this is somehow an infringement on Ingraham's First Amendment right. Accordingly, let's have another lesson in the constitution, for the benefit of Mr. Thomas and his adherents:

1. The constitution does not confer on Laura Ingraham or anyone else the right to have a cabal of advertisers willing to pay money for the right to advertise on one's show.
2. The constitution does not confer on Ingraham (or Hogg for that matter) any immunity from criticism.
3. Advertisers are free to determine for themselves, based on their own self interest, the party with whom they choose to place their advertisements.
4. Individuals are entitled to make their feelings known to advertisers, and advertisers are entitled to judge their own self interest (and act accordingly) based on the feedback they get.
5. Finally, and perhaps most importantly, the First Amendment reads, in full, as follows:

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

Mr. Thomas, neither David Hogg nor Ms. Ingraham's advertisers qualify as "Congress," and there has been no law passed that prohibits the free exercise of Ms. Ingraham. Accordingly, Mr. Thomas, criticizing right-wing provocateurs is no more a First Amendment issue than criticizing wrong-headed newspaper columnists.

I have found that reading the constitution is helpful prior to making claims as to what the constitution does and does not prohibit. That's just me.

UPDATE: Upon further review, I've got a theory as to why Mr. Thomas decided to make this an argument about the constitution, albeit an utterly wrongheaded argument that any first-year law student would smack away.

If this issue is not about the constitution, then what is it naturally about? I guess, the question, absent any constitutional question, has everything to do with who the bully/jerk is. If that's the question, we're left with, on the one hand, a teenager who recently bore witness (whether personally or by proximity) to the brutal murder of his classmates; and on the other hand, an Ivy league educated, nationally known, media personality. 

Stated another way, on the one hand we have a teenager (I'm pretty sure he's under 18, but I can't represent that as a confirmed fact) and on the other hand we have a wealthy adult with a large media platform.

Who's the bully again?

Todd Rokita - Indiana's Resident Jackass

Another day, another reason to think poorly of Representative Todd Rokita.

First, this, from Rep. Rokita's web site:

Representative Rokita is pro-life and believes that life begins at conception.  He strongly believes that to encourage a culture of life rather than one of death, tax dollars should not be spent on abortions or to fund organizations that encourage it. 

And this:

In 2017, he voted to pass the Pain-Capable Unborn Child Protection Act.  He was a cosponsor of this bill to prohibit abortions after 20 weeks of fetal age.  

He lists numerous "pro-life bona fides" on his web site. If you have a strong stomach, check it out for yourself. Of course, that is Rep. Rokita's public side. Today, the Ft. Wayne Journal Gazette provides us a glimpse behind the curtain:

a political action committee affiliated with Rokita has given $9,000 to the campaigns of a fellow Republican lawmaker who, years before his election, had approved of abortions for his future wife and a woman with whom he had an affair.

The Fund for American Exceptionalism has made four financial contributions since 2014 to the re-election campaigns of Tennessee Rep. Scott DesJarlais, according to campaign finance reports filed with the Federal Election Commission. 

Who is this Scott DeJarlais? Well, it's a good thing we have "the internet" so we can look him up:

 The anti-abortion, pro-family Tennessee congressman who pushed his patient and mistress to get an abortion also agreed that his wife should have two, according to court transcripts released Thursday.

Those documents, from GOP Rep. Scott DesJarlais’ 2000 divorce proceedings, paint a lurid picture of a doctor who had multiple affairs with coworkers and patients — at least one of whom he prescribed pain pills for — while he was chief of staff at a local hospital.

Or we could maybe find this out about Rokita's buddy:

A Tennessee congressman who supported his ex-wife’s decision to have two abortions, voted this week for a bill that would ban late-term abortions, according to news reports. 

We could go on and on about DeJarlais just as we could go on and on about Rokita.

Bottom line: everything I've heard about Rep. Rokita makes me a bit sick to my stomach. My parents used to tell me that I should be careful about who I hang out with, because "you're judged by the company you keep." Perhaps Rep. Rokita should think about that long and hard, though I suspect Rep. Rokita relies on his constituents not knowing or caring about his ongoing hypocrisy; I also suspect he is well aware that, short of hell freezing over, there is nothing he could ever do to get my vote.

School Comparisons

For the first time, the Indiana State Board of Education has released a study comparing the effectiveness of charter schools versus traditional public schools.

Before getting to the real meat of this post, I note that the Indy Star has precisely zero mention of this report on its home page (the main page right now discusses how the Indiana Lottery often ends high-prized scratch-off games before awarding all prizes . . . an issue of importance I'm sure, but I value a quality education for my children (and the rest of the children in this state) over getting something for nothing via the lottery, but that's just me).

I had to go to the Ft. Wayne Journal Gazette for some actual (what do they call that?) reporting. Some highlights:

As of the 2016-17 school year, there were 93 public charter schools serving 44,444 students. That is about 4 percent of total enrollment in the state.

Good to know that baseline number.

On enrollment, it found charter schools enrolled more free-and-reduced-price-lunch students but fewer special education students and English-language learners.

On performance, it found charter students are doing better in improvement on state tests but worse when it comes to passing the test. 

OK. That seems like fair reporting. I've always believed that charter schools cherry pick their students, but perhaps it's a bit more complicated than that. Similarly, the school choice advocates I know maintain that charter schools perform better, but you can see that too is a bit more complicated than a bumper sticker slogan.

In accountability grades, charter schools received more A's and fewer F's than similar traditional public schools.

I question that statistic. It would seem that given the disparities in numbers, traditional public schools would have both more A's and more F's. After all, charters only account for 4% of total enrollment in the state.

All four virtual charters received an F grade in 2016-17.

And, above, we have the award for the most predictable outcome.

Superintendent of Public Instruction Jennifer McCormick said other states focus a lot of quality and not “choice for the sake of choice” and asked about charter school closures.

Twenty-three charters closed between 2011 and 2017. 

23 huh? There are currently 93 operating, and 23 more have closed in the past 6 years? If we have a total of 116 charter schools opening since 2011 and 23 have closed, that is a closure rate of nearly 20%. That is pretty distressing. What happens to that 20% of charter students? Are they then dumped back into public schools after missing a year or more of instruction in their destined-for-closure charter school?

Over all, I think that charter schools can be a positive force for good; it all depends on how they are implemented. A former teacher myself, I was always concerned that charter schools would take what was the figurative equivalent of working at a GM factory in the 1970s and turn it into the figurative equivalent of working at Wal-Mart. Conversely, a charter school could be the figurative equivalent of a small law firm . . . it does one or two things really well and is owned by the teachers (as law firms are owned by the lawyers).

Food for thought. I'm hungry.

 

For What It's Worth - Part II

Recall that yesterday's post dealt with the anti-Joe Donnelly ad populated by an alleged local businesswoman who just couldn't understand why Joe Donnelly would vote against the wonderful, glorious, and absolutely necessary tax "reform" plan. The point of that post was that we should be aware when someone is trying to play us.

Enter today's contestant for dishonesty - Sinclair Broadcast Group. For those who don't realize, Sinclair Broadcasting Group owns more than 100 local news stations and has required those local anchors to read certain scripted editorial content during the local news.

Watch for yourself:

One of the first lessons I learned in litigation: "If you look around the table and can't tell who the sucker is, it's probably you."

For What it's Worth

Has anyone seen the latest hit job on Joe Donnelly? The one that purports to feature a local "small businesswoman" who really needs those tax cuts to "invest in her business" because she really wants to "help people."

Pardon me, I just barfed in my trash can.

For starters, if your business needs tax cuts to survive, you have a business model problem, not a taxation problem.

Further, what business person started a business primarily to help people? NOBODY! You start a business so that you can make money and support yourself and your family. Helping people is an added bonus and is only the goal if it is accompanied with the business person getting paid. Ken Nunn wants to help his clients, but that's presumably because he collects between 33% and 40% of the "help" that he provides. Do you think he gives a damn about his clients?

Finally, I can't help but notice that this small businesswoman, who so desperately needs those tax cuts in order for her business to thrive, is never identified. Who is she? What is this business of hers? Methinks that perhaps she's an actress paid by some outside advocacy group?

Here is the ad:

Who is "Cathy"? Anyone know? I can't help but notice that they don't use the name of her business or her last name. Methinks she is a "fictional character."