<$BlogRSDUrl$>

27 September 2010

Real Healthcare Reform

The Patient Protection and Affordable Care Act that is popularly known as “ObamaCare” is the product of liberal Democratic impatience and medical industry determination that only accomplishes some improvements in the equity of healthcare delivery at the risk that the cost of healthcare will rise until that issue is faced head-on. As pointed out by observers like Atul Gawande in his article in the August 2, 2010 New Yorker, “Letting Go,” the real problem of the American health care system is the expectation of patients that they can ultimately evade death and not have to settle for making their short life spans as pleasant as possible. In effect, we value time more than gratification—the ultimate in future preference.

The filibuster-proof majority that passed the bill through Congress could only be assembled by sacrificing any reform of our healthcare system that would reduce its cost while improving its outcomes. This trade-off was needed in order to obtain the consent of the insurance companies and health care providers to suspend their reluctance to change certain discriminatory rules that they believed were necessary to preserve their competitiveness. They further insisted on being able to raise the price of their services to cover the additional expenses caused by more equitable service. In other words, all that was achieved was to force change in the user-friendliness of the health care system at the expense of the patients.

The irony of ObamaCare is that it relies on the market to solve the nation’s potentially disastrous failure to face that fact that people do not live forever. Leadership is needed to draw the public to a realistic notion of what medical science can actually accomplish in the relief of the inevitable emotional and physical pain of death. Any nation that tries to buy its way out of the human condition will only be bankrupted by the effort.

10 September 2010

Unanticipated Consequence

Hendrik Hertzberg bemoans the lack of sacrifice that has been asked of those of us who have not fought in the two long wars since 9/11 in his comment in the September 13, 2010, New Yorker, “Iraq’s Cost.” Unfortunately, without a draft our nation is likely to get involved in another such “military adventure” and others. That is, as long as the rest of the world is willing to finance them—even the U.S. isn’t able to foot the trillion-dollar bill of such martial tasks out of its own treasury.

The Bush Administration did a pretty good job of convincing not only Americans, but the Europeans and China, as well, that our use of force and the contingent human suffering were needed in order to prevent deterioration in our collective living conditions. But without standing armed forces, our leaders could not have undertaken such an escapade. We must have thought it a worthwhile investment to pay the cost of avoiding having to draft an army in order to defend ourselves; perhaps we did that because we realized that there would not always be agreement on the necessity of fighting overseas. However, we and our financiers abroad have become very pliable when experts manipulate information in order to justify warfare for non-transparent reasons or even for its own sake.

Maybe the “new American moment” that Secretary of State Hillary Clinton was talking about at the Council on Foreign Relations on September 8, 2010, comes with the admission that the U.S. will only perform the world’s policeman role in the future responsibly and still on its own terms.

09 September 2010

Unseen Restitution

The purported failure of the Obama Administration’s economic recovery program was analyzed by James K. Glassman in Commentary Magazine (September 2010) as in part the result of the realization that it would ultimately have to be paid for with higher taxes. Well, you don’t say! The entire community deceived itself into an inevitable crisis—the banks fooled themselves into believing that the mirage of immediate returns from greater risk-taking would never disappear; the Congress fooled itself that deficit-spending on pork-barrel projects would be continuously supported by overseas lenders; lower middle-class families fooled themselves that home prices would rise forever.

The current strategy of the Obama Administration is to let the Bush income tax reductions for upper middle-class citizens expire in order to pay for the recovery program. That will probably affect 5% of the population. The trick is to combat the public relations strength of that sliver of the public, which has been successful in convincing the rest of the country that a rise in income taxes on those making more than $250K/year will have a devastating impact on everyone’s economic welfare. Yes, it will sting those higher-income groups; but they were the primary beneficiaries of the economic boom over the last ten to fifteen years. A return to more disciplined behavior forced by the state, in French president Sarkozy’s conception, is needed in order to guarantee prosperity in the long run.

This page is powered by Blogger. Isn't yours?