Here’s a link to an audio interview I did on Healthy Competition for a Tampa-based newspaper called — I love this — Creative Loafing.
Cato at Liberty
Cato at Liberty
Email Signup
Sign up to have blog posts delivered straight to your inbox!
Topics
General
Announcing the Anti-Universal Coverage Club
Inspired by National Review’s recent editorial and Andrew Sullivan’s embrace of same (as well as by Greg Mankiw), I have decided it would be fun and educational to keep tally of those who reject the idea that federal or state governments should strive to provide every American with health insurance. Call it the Anti-Universal Coverage Club.
Here are the guiding principles of the Anti-Universal Coverage Club:
- Health policy should focus on making health care of ever-increasing quality available to an ever-increasing number of people.
- To achieve “universal coverage” would require either having the government provide health insurance to everyone or forcing everyone to buy it. Government provision is undesirable, because government does a poor job of improving quality or efficiency. Forcing people to get insurance would lead to a worse health-care system for everyone, because it would necessitate so much more government intervention.
- In a free country, people should have the right to refuse health insurance.
- If governments must subsidize those who cannot afford medical care, they should be free to experiment with different types of subsidies (cash, vouchers, insurance, public clinics & hospitals, uncompensated care payments, etc.) and tax exemptions, rather than be forced by a policy of “universal coverage” to subsidize people via “insurance.”
If you’d like to join the Anti-Universal Coverage Club, let me know by posting something to your own blog, or by emailing me here. Feel free to forward items from other like-minded individuals.
I predict that neither the American Medical Association, nor the Federation of American Hospitals, nor America’s Health Insurance Plans will join the Anti-Universal Coverage Club.
Related Tags
Lazy Leftists
A certain segment of the political left is, shall we say, lazy in its critique of letting consumers control their health care dollars and decisions.
For example, I recently wrote about my experience using my health savings account (HSA) to pay for medical care after I tore my anterior cruciate ligament. When my orthopedist learned that I faced a high deductible, he helped me weed out unncessary expenses that would provide little benefit. In particular, we skipped an X‑ray because I didn’t hear or feel any bones break, and he agreed there (probably) would be no harm in doing so. The only reason I shared that information about my injury, indeed the only reason we gave the X‑ray a second thought, was because I had a financial incentive to do so: I was paying for the X‑ray.
Big deal, says Ezra Klein:
That’s all for the good, when it’s all for the good. On the other hand, that’s just a hop, skip, and a jump away from “She had shortness of breath, but no radiating arm pain, so she decided to wait through the weekend because she couldn’t afford the ambulance ride. She died.”
Here’s why that’s lazy.
Klein knows that when people face additional cost-sharing, some patients will forgo some medical care and some of those patients will end up less healthy. But he also knows that when people have HSA-like coverage, on balance, people do not end up less healthy.
Related Tags
Cheney’s Secret Failure
The Washington Post has been running a huge series on the power and influence of Vice President Cheney. The first two parts examined his immense influence on the administration’s response to 9/11, “pushing the envelope” of presidential power (not to mention vice-presidential power) and crafting the administration’s position on the use of torture — or rather “cruel, inhuman or degrading” methods of questioning.
But the third part, although written with the same sinister soundtrack, tells a very different story. The Post reporters seem to want us to be alarmed by Cheney’s power over fiscal policy and by his relentless push to reduce the burdens of taxes and spending on the American people. But there’s a problem with that story: not only is fiscal conservatism a good thing — unlike, say, secret authorization for domestic surveillance — but if Cheney’s goal was to constrain spending, he failed utterly.
Jo Becker and Barton Gellman report on Cheney’s power over the budget:
Read the rest of this post →Cheney has changed history more than once, earning his reputation as the nation’s most powerful vice president. His impact has been on public display in the arenas of foreign policy and homeland security, and in a long-running battle to broaden presidential authority. But he has also been the unseen hand behind some of the president’s major domestic initiatives.…
And it was Cheney who served as the guardian of conservative orthodoxy on budget and tax matters.…
The vice president chairs a budget review board, a panel the Bush administration created to set spending priorities and serve as arbiter when Cabinet members appeal decisions by White House budget officials. The White House has portrayed the board as a device to keep Bush from wasting time on petty disagreements, but previous administrations have seldom seen Cabinet-level disputes in that light. Cheney’s leadership of the panel gives him direct and indirect power over the federal budget — and over those who must live within it.…
Related Tags
Government Makes Things Worse, Not Better
In this column, John Stossel eviscerates David Brooks, the ostensibly conservative columnist for the New York Times. Brooks has argued for big new government initiatives to boost human capital. Stossel correctly explains, though, that Brooks wants to expand failed government programs when the right approach is to move in the other direction:
David Brooks is a bright guy, so I wonder how he can blame the free market for failing in this way. He continues, “Despite all the incentives, 30 percent of kids drop out of high school and the college graduation rate has been flat for a generation.” Excuse me, but why is that the market’s fault? Government dominates education in America. K‑12 education is a coercive, often rigidly unionized government virtual monopoly that fights every attempt to experiment with free-market competition. Brooks writes that Hamiltonians like him “think government should help people get the tools they need to compete.” But when has government ever been good at that? He claims the state can “increase the quality of human capital” by, for example, providing “Quality preschool [to] help young children from … disorganized homes. … ” Really? What is the chance that it would be “quality” preschool if government runs it? Even the acclaimed Head Start has not been shown to have any lasting effect on academic performance. …When I asked Brooks why a government that performed as ineptly as FEMA did after Hurricane Katrina will be better at running preschools, he said, “Some lives are so screwed up, it’s hard to make them worse.” Government coercion almost always makes things worse. It discourages individual effort, and sucks capital away from more productive uses. …America became an economic power despite, not because of, Hamiltonian intervention. Hong Kong and much of East Asia went from abject poverty to affluence in a few decades not because their governments gave people “tools they need to compete” — they didn’t — but because they exercised limited powers.
Related Tags
Jurisdictional Competition is the Only Hope for Europe’s Taxpayers
A new report from the European Commission shows that the tax burden continues to climb. The only silver lining to this dark cloud is that tax competition is forcing politicians to lower corporate rates and to consider lowering tax rates on labor. A Dow Jones report notes that Eastern European nations are having a good effect since their low-rate tax systems are forcing reforms elsewhere in Europe:
Eurostat said the E.U.‘s tax burden remained below the high of 41.0% reached in 1999. The tax burden last increased in 2003. Taxes on work rose to 35.2% from 35.1% in the E.U., and to 36.8% from 36.2% in the euro zone. Eurostat said the decline in labor taxes that began at the turn of the century had come to a halt “despite a wide consensus on the desirability of reducing labor taxes.” E.U. governments have agreed that persuading more Europeans to work is essential if the bloc is to remain economically competitive with the U.S. and Asia. Cutting taxes on work is seen as a vital step in that direction. Eurostat said that although taxes on work remained below the 2000 high of 36.5%, they are “much higher…than in the other main industrialized economies.” …there is growing evidence of tax competition between E.U. members that is pushing tax rates down. In general, new E.U. members from eastern Europe have lower top rates of income and corporation tax. Fearing that companies may move production to the new members, some older members of the E.U. have begun to cut corporation tax rates, including Germany and the U.K..
Related Tags
Is Efficient Government A Good Thing?
One of the behind-the-scenes initiatives of President Bush’s budget staff the past six years has been something called the Program Assessment Ratings Tool (PART) analysis. It’s an effort to measure the “effectiveness” and “efficiency” of nearly 1,000 federal programs. Each program is graded on how well it achieves its “goals,” with marks ranging from “effective” (the equivalent of an A grade) to “ineffective” (the equivalent of an F grade).
In Tuesday’s Investor’s Business Daily op-ed section, Ernest Christian and Gary Robbins take a look at the results to date of the effort:
Congress is about to wave its wand over nearly $1 trillion of additional “discretionary” spending that will, among other things, perpetuate or increase funding for nearly 500 expenditure programs that are not even “moderately effective,” according to the Office of Management and Budget. This includes more than 200 expenditure programs that have failing grades of D or F.
By our calculations, the OMB study, called Program Assessment Ratings Tool (PART), further reveals that on average more than half of all federal expenditure programs are falling about 50% short of their stated goals.
This means that out of every dollar spent, 50 cents may possibly be accomplishing something worthwhile, but the remaining 50 cents might as well have been poured down a rat hole. In these cases alone, the cost of government incompetence is over $250 billion per year.
The list of programs with the lowest grades might make any supporter of limited government point wildly and say, “Told you so!” This rogue’s gallery includes the Department of Housing and Urban Development’s pork-filled Community Development Block Grants, the Department of Education’s Even Start literacy program, and Amtrak.
Read the rest of this post →