The Radio Free Acton crew is back in the studio! On today’s broadcast, Dr. Donald P. Condit and Dr. Kevin Schmiesing join our host Marc VanderMaas for a discussion of the ins and outs of the US health care system. Dr. Condit gives us some background on how the current system came into being, the problems associated with it, and the pitfalls of the current healthcare reform proposals in Washington.

Next week RFA will be back for part 2, bringing us alternate ideas for reforming the system in ways that will both increase the availability of care for all who need it and make economic sense.

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The argument from federalism: One of the great benefits of federalism is that the states can act as the laboratories of democracy. If a new public policy is tried in the states and works (as happened with welfare reform in Michigan and Wisconsin), then a similar program has a good chance of succeeding at the national level. The welfare reform went national and proved to be one of the most successful public policy initiatives of the last half century. On the other hand, major governmental healthcare initiatives have been tried in Tennessee and Massachusetts. Neither of those have panned out. That should be a cautionary sign to avoid rushing ahead to just get a bill done!

The argument from misery: I cannot think of any encounter with my government that I willingly seek out. I hate going to the DMV. I hate going to the post office. I hate getting my car inspected. I hate getting a passport renewed. All of these things eat up productive time in my day and are filled with useless, inefficient waiting. This basic situation also applies to people who rely on the government for their healthcare. When my wife did indigent care in Houston, her clients did not pay for her services. They paid with their time. LOTS OF WAITING. I don’t need more waiting in my life. And because government employees are typically unionized, I don’t need to be at the mercy of a bunch of unionized employees any more than I already am.

The argument from incentivization: If the government provides the care too cheaply, then there will be a glut of clients who overwhelm the system and create the nightmare of waiting as the price to pay. If the government offers the care too expensively, people will opt out which is exactly what they wanted to avoid. If the government tries to control utilization by deciding what services you can and can’t have, then you are up against a far worse foe than the worst HMO you ever faced. And the government will go where the insurance companies fear to tread. They will decide who should live or die.

The argument from missing the verdammten point: It is exceedingly clear that a huge reason for the skyrocketing costs of medicine is the problem of predatory litigation driven by lawyers looking for 30-40% of a bloody fortune from an industry thought to be able to afford it. Between the cost of malpractice insurance, the payouts, and the defensive medicine that must be practiced to ward off lawsuits, it is easy to see why healthcare is outrageously expensive. Yet, the president very clearly said he would not seek to deal with that problem in the legislation. WHAT? WHY? Because the trial lawyers are very good political donors? Not a compelling reason for the formation of a particular public policy.

The argument from economic theory: Look at two sectors of the healthcare market that are typically paid out of pocket without the influence of insurance providers or the government. I am thinking of plastic surgery and lasik procedures for improving eyesight. Both of those services are becoming less expensive in real dollars rather than skyrocketing out of control. This happens to be the portion of the healthcare industry where actual market conditions apply. Customers pay for and receive value at a price that is becoming more reasonable all the time.

Blog author: hunter.baker
Wednesday, July 29, 2009
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Spurred on by listening to and reading Samuel Gregg, I’ve been making my way through Wilhelm Ropke’s A Humane Economy which is really a special book.

The following passage (on p. 69) really caught my attention with regard to our current situation:

Democracy is, in the long run, compatible with freedom only on condition that all, or at least most, voters are agreed that certain supreme norms and principles of public life and economic order must remain outside the sphere of democratic decisions . . . It is this fundamental agreement which imbues the concept of inviolable law as such with an absolute content, and once it can no longer be taken for granted, we are in the presence of mass democracy of a pretotalitarian kind.

Ropke is making a very important point here. We are naturally quite comfortable with saying that certain rights are not really within the ambit of the democratic process. For example, a simple majority cannot take away my right to stand on a soapbox on a street corner and declaim on American politics. The right of free speech has our fundamental agreement, despite the fact that our mood may change from time to time. The right is firmly enshrined. But shouldn’t that same agreement hold with regard to our economic freedom? What good are our so-called civil rights if we enact a system that continues to eat up giant chunks of our economic prerogatives?

The Supreme Court, for example, has made much of how important it is that we each be able to make our own decisions about the mysteries of sex and reproduction. Are the questions of how we earn our living, how we plan for our financial future, how we choose to protect ourselves against health problems, and the ability to start a business without excessive encumbrance from the government not equally massive in their implications?

[update below] British physician Theodore Dalrymple weighs in on government healthcare and “the right to health care” in a new Wall Street Journal piece. A few choice passages:

Where does the right to health care come from? Did it exist in, say, 250 B.C., or in A.D. 1750? If it did, how was it that our ancestors, who were no less intelligent than we, failed completely to notice it?

When the supposed right to health care is widely recognized, as in the United Kingdom, it tends to reduce moral imagination. Whenever I deny the existence of a right to health care to a Briton who asserts it, he replies, “So you think it is all right for people to be left to die in the street?”

When I then ask my interlocutor whether he can think of any reason why people should not be left to die in the street, other than that they have a right to health care, he is generally reduced to silence. He cannot think of one.

Not coincidentally, the U.K. is by far the most unpleasant country in which to be ill in the Western world. Even Greeks living in Britain return home for medical treatment if they are physically able to do so.

The government-run health-care system—which in the U.K. is believed to be the necessary institutional corollary to an inalienable right to health care—has pauperized the entire population. This is not to say that in every last case the treatment is bad: A pauper may be well or badly treated, according to the inclination, temperament and abilities of those providing the treatment. But a pauper must accept what he is given.

After 60 years of universal health care, free at the point of usage and funded by taxation, inequalities between the richest and poorest sections of the population have not been reduced. But Britain does have the dirtiest, most broken-down hospitals in Europe.

[update] Also, later today we’ll be posting the first part of a conversation our multimedia manager, Marc Vander Maas, had with Kevin Schmiesing and physician Donald Condit on healthcare reform. Schmiesing is an Acton research fellow and has posted regularly on health care topics here on the PowerBlog. Condit is the author of Acton’s new monograph, A Prescription for Health Care Reform.

The Public Discourse recently published my article, Rethinking Economics in the Post-Crisis World. Text follows:

In the wake of the financial crisis, we need an economics with greater humility about its predictive power and an increased understanding of the complicated human beings who, when the discipline is rightly understood, lie at its center.

Apart from bankers and politicians, few groups have received as much blame for the 2008 financial crisis as economists. “Economists are the forgotten guilty men” was how Anatole Kaletsky, former economics editor and current editor-at-large for the London Times, put it earlier this year when explaining why “a bank with just $1 billion of capital [would] borrow an extra $99 billion and then buy $100 billion of speculative investments.”

Greed and sheer imprudence played a role, but so too, Kaletsky argued, did those (unnamed) economists who posited that their models proved that events such as the collapse of Lehmann Brothers in 2008 or Long Term Capital Management in 1998 were mathematically likely to happen once every billion years.

Kaletsky’s broader point was that contemporary mainstream economics had been sufficiently discredited by the financial crisis that the entire discipline required what he called an “intellectual revolution,” or it risked being dismissed as a rather suspect sub-branch of statistical analysis and mathematical modeling.

Kaletsky is hardly alone in arguing that economists need to rethink key aspects of their discipline. Though unwilling to call for a total paradigm shift, the Economist recently opined that the financial crisis has raised profound questions of coherence about two areas of economics: macro-economics and financial economics. “Few financial economists,” the Economist observed, “thought much about illiquidity or counterparty risk, for instance, because their standard models ignore it.” Likewise, the Economist commented, “Macroeconomists also had a blindspot: their standard models assumed that capital markets work perfectly.”

All this is certainly true. But the key expression to note here is “their standard models.” (more…)

Everybody realizes that the current healthcare system in the United States has problems. Unfortunately, much of the discussion about what to do rests on a false premise. The argument goes something like this: Our current free market system is not working: health care costs are astronomically high, and close to 50 million people aren’t insured. Maybe it’s time to let the government try its hand.

But we don’t have a free market health system; we have a highly managed, bureaucratic system that lowers the level of health care and increases costs.

As Acton’s Michael Miller argues in a new video short, the government is already involved in healthcare, and this is part of the problem. Getting the government more involved will only make the situation worse.

Blog author: ken.larson
Monday, July 27, 2009
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In the musical Camelot which first appeared on stage in 1960, Mordred — the antagonist, evil traitor and eventual deliverer of a mortal wound to King Arthur — appropriately lauds the antithesis of what good men are to pursue with his signature song titled “The Seven Deadly Virtues” the first line of which ends “those nasty little traps.”

The lyrics are clever. “Humility,” Mordred tells us, “means to be hurt. It’s not the earth the meek inherit but the dirt.” Hmmm. And the opposite of humility is — come on, all together — pride.

I had never heard of Harvard’s Professor Henry Lewis Gates Jr. until last week, but as with so many academics a quick click or two on an “.edu” web site, first to “Academics” then “Departments” and “Faculty” and voila, you’re opening up their cv online. That’s what I did this past week.

The nature of a resume or as they refer to them in academia and government work “curriculum vitae” — cv — can take lots of different forms. I’m used to seeing resumes from business people where you hope to find succinct goal/results stuff. Budgets are quoted to give the reader a sense of the scale and scope of the experiences; or growth of sales or start up schedules that paint a person who’s a can do, storm the barricades of commerce kind of guy/gal — if they’re there. I suggest resumes not exceed three pages.

Henry Gates’s cv is 27 pages long. While I’m sure there’s a condensed version somewhere you just have to skim through the document to note how he has spent his life. On the surface it’s been charmed and at variance with the titles of his articles. It’s all there, nothing it seems was deemed editable. But I focused on one thing in particular: Gates co-authoring of a book with Cornel West titled The Future of The Race. Who is Cornel West you ask? He’s the professor who left Harvard during the tenure of Larry Summers after having been asked to show up at his classes instead of sending in a grad student. After all Summers argued, Harvard was paying West nearly $400,000 and expected the man to be on site and not at lecture dates or book signings. I wonder what a faculty:student ratio at Harvard really means? In the end, West went to Princeton in a huff.

Now, back to the story.

You Are What You Eat; Play As You Practice; Your Friends Define You. These are phrases that once were needle pointed on course linen. These days they aren’t often repeated anywhere. Also neglected are the virtues they recall. The intellectual virtues are Art and Prudence and are characterized by an ordered approach toward the good. The moral virtues include Justice, Temperance and Fortitude. And the theological virtues are Faith, Hope and Charity. If you’re a math geek you’ve counted eight, not seven in this list. Correct! Mordred was focussing as do a number of us on the “moral” virtues. They include patience, meekness, modesty, piety, gratitude, affability, abstinence, sobriety, chastity, self restraint. He obviously cherry picked his list. Not alone in that, eh?

Now let’s look at the past week of national humiliation on You-Tube. A Maryland Senator blasts a constituent who was arguing that he is able to pay for his own medical expenses by suggesting that if the man gets a bill from a doctor or hospital he’ll ignore it. A junior Senator from California suggests that the President of the National Black Chamber of Commerce get in line with other black organizations and support the Obama energy plan.

Then President Obama in a hour long “news conference” suggests that doctors in the U.S. trump up ways to treat children in order to line their pockets with fees for service; and ends the week by suggesting — some might say profiling — that a police officer’s response to a suspected burglary was done stupidly.

All of this caused some to recall 2007 when the Obama campaign not wanting to be embarrassed, finally paid an assortment of parking tickets which had likely gone to “warrant” and dated back to the Presidential candidate’s student days at Harvard. Hmmm. What did that Maryland Senator accuse the constituent of?

My wife suggests that liberals often target behavior in others that they themselves are most guilty of. I’d say she’s on to something and it certainly includes ignoring the virtues. You pick which ones.

Dr. David Murray of Puritan Reformed Theological Seminary investigates the concept of “biblical fundraising,” reasons to continue to give in the midst of difficult economic times, in the latest edition of his vcast, “puritanPod.” Dr. Murray uses 2 Corinthians 9 as the basis for his brief but valuable message.

Check out the video here.

God is rational, and the universe is governed by unchanging natural laws instituted by Him. The Bible tells us in the Book of Genesis that “God created the heavens and the earth.” God is not arbitrary; the Bible also tells us that He is just and that He keeps promises to His people. The prophet Jeremiah tells us that God has established “ordinances of heaven and earth.” Since they come from a perfect lawgiver, we know that these laws do not change on a whim.

These beliefs were radical, and given historical trends in philosophy, they remain so. Pagans argued that truth exists, but that it is dependent on the will of the gods. Since these gods were capricious rulers of the universe, there were no unchanging laws that could be discovered by humans. In our own day, postmodern constructivist philosophers like Giambattista Vico also argue that objective truth is unknowable. For them, this is because truth is only accessible to humans insofar as we agree with something we have manufactured and labeled as the truth. As Vico put it, “the norm of the truth is to have made it.” If pure naturalism is correct and there is no role for God, then Vico can reasonably argue “the mind does not make itself as it gets to know itself and since it does not make itself, it does not know the genus or mode by which it makes itself.” After all, our ability to understand things as they truly are is difficult to argue in the absence of any reason to think that human reason itself is reliable.

Christianity offers just that reason by asserting two main points: that God has made the universe according to natural laws and that He has given humanity the means to understand them. As God asks Job, “Who endowed the heart with wisdom or gave understanding to the mind? Who has the wisdom to count the clouds? Who can tip over the water jars of the heavens when the dust becomes hard and the clods of earth stick together?” God gives understanding to the mind so that we may know Who has made the world and the universe as it is.

God intends for us to exercise our reason and seek to know reality. Jesus says that He is the Truth, and He promises His followers that “the truth will set you free.” The truth that Jesus speaks of is not, of course, purely scientific and rationalistic. It is the truth of the universe and of humanity. Pope Benedict XVI reiterates this in Caritas in Veritate, where he writes, “Truth, by enabling men and women to let go of their subjective opinions and impressions, allows them to move beyond cultural and historical limitations and to come together in the assessment of the value and substance of things.”

Since truth is objective, reason can discern it. Reason is the universal nature of humans, regardless of our race, culture, language, class, or religion. We all have access to the truth. In a world where subjective truths compete, humanity can no longer find common ground and rise above struggles for power and influence. The truth about humanity and natural reality becomes “Nordic,” “bourgeois,” “imperialist,” or “chauvinist.” The idea that truth is subjective does not set us free. It pits us against each other and fails to let us seek the truth.

Caritas in Veritate points out the dire social consequences: “Without truth, without trust and love for what is true, there is no social conscience and responsibility, and social action ends up serving private interests and the logic of power, resulting in social fragmentation, especially in a globalized society at difficult times like the present.” If we are to seek true solidarity and the creation of a humane world, we must commit ourselves to pursuing the truth. Otherwise, humanity’s divisions will only grow.

By choosing instead to follow constructivism, fundamentalism, fideism, and the consensus view of the truth, we are enslaving ourselves to error and cutting off the truth that unites us. We are also rejecting the duty that God has given us to use the gift of reason to seek Him out. Since this sin only gives us error in place of the truth about us and the universe we inhabit, it results in suffering, tyranny, and conflict.

The truth will set us free in the measure that we are willing to seek it as God commands us to, and in the measure that we reject anything less than the full, universal, reasonable nature that it has.

The Rome Reports news service recently interviewed me about the new social encyclical, Caritas in Veritate. Here’s the segment, and a transcript of the interview.

Rome Reports: Benedict XVI’s encyclical, Charity in Truth is already on the list of best selling books this month. In it, the pope proposes the steps to achieve a sound economy and to avoid another economic crisis in the future.

Kishore Jayabalan: I think he is trying to change our orientation from a moral and ethical perspective, and to address economic and social affairs from a more Catholic moral perspective, sometimes we think catholic morality only has to do with marriage and family issues, or only as something that we hear about on Sundays in church.

RR: Kishore Jayabalan is an economist who directs the Acton Institute in Rome for the study of religion and freedom. He says that one of the most important points the pope stresses in building a new economy is respecting peoples rights to initiative and property.

Jayabalan: What the document refers to as breathing space, you have to let people on the grounds of subsidiarity come up with their our solutions to their own problems, they can’t all be dictated from the top down.

RR: Benedict also says the new economy should entail that globalization be a process that pursues the common good.

Jayabalan: The second thing, is that the rest of us needs to realize that globalization is a process for the good that excluding people from globalization is simply a way of spreading poverty more broadly across the world, which goes against catholic social teaching.

RR: According to Jayabalan, to solve economic problems, the theological aspect must also be included. In his encyclical, the pope explains why a relationship between God and man gives people more freedom.

Jayabalan: It allows for more freedom because it tells us that there is a relationship that the state cannot enter into, and I think this is why the encyclical refers to religious freedom for the first time in a social encyclical.

RR: But Jayabalan says that above all else, the pope seeks to unite two concepts that are often separated, respect for life and social justice. He says the popes gift to President Barack Obama the encyclical Dignitas Personae on Bioethics– clearly shows his agenda.

Jayabalan: The pro-life people tend to be on the right politically and the social justice people tend to be on the left politically and pope Benedict is trying to get us to look beyond those old categories.

RR: In short, according to Jayabalan, “Charity in Truth” is a call to work together for social justice, a goal that cannot be realized without a profound respect for human life in all its stages.