Category: Current Affairs

What are the Democrat health care plans?

Dr. Rangel offers a summary:

1. Universal coverage with the Federal government as the single payer. Proponents; Braun, Kunicinch, and Sharpton. Cost; over a Trillion per year at least. Needless to say, none of these candidates are anywhere near the front runners in the polls. Do these people even remember Hillary Clinton and the early ’90s? Under such a system costs would be contained via price controls, restrictions, and rationing and for all this reduced care most Americans will be hit with either higher taxes and/or higher consumer prices (in order to raise most of the trillions needed to pay universal health care many of these plans would target businesses and investments with massive tax increases and these costs would in turn be passed on to the consumer).

2. Universal coverage via employers. Proponent; Gephardt, who would mandate that all employers pay for health insurance for their employees. Employers would be able to deduct 60% of the costs of the insurance premiums (the 60% would also be for the self employed and for government workers). Requiring all employers to provide for some type of health insurance for their employees is a great idea but in it’s current form as proposed by Gephardt it is potentially the most disastrous as far as containing health care costs is concerned.

What he is essentially proposing is that we massively expand the same system that has effectively insulated patients from the real costs of health care, prevented any type of competition or market forces from controlling costs and allowed health care expenses and usage to get out of control in the first place (see my post on this issue)! Without any market forces or direct governmental restrictions to control costs, usage of health care resources would expand ad nauseum and ultimately bankrupt the system. Cost; $215,000,000,000.00 a year assuming that health care costs remain level (likely to be several hundred Billion above these estimates).

3. Expansion of current programs or new government programs. Proponents; Clark, Dean, Edwards, Kerry, Lieberman. Costs; Anywhere from about $50 to $100 billion a year. With minor differences most of these proposals would expand coverage for children, provide for more coverage for people in between jobs, and increase tax relief for employers providing health insurance coverage (though not as much as Gephardt’s plan).

What is the bottom line?

None of these plans would institute any meaningful market reforms that may help to control health care costs. They claim their plans would make health care “more affordable for all Americans” but it all amounts to little more than political slight of hand. Health care wouldn’t be made cheaper nor more affordable. The costs would just be shifted and spread around. Higher costs for employers would be passed off to consumers and the rest would be paid by taxpayers in one form or another.

The danger of many of these plans is that the more money they pour into the system the more they will stimulate health care usage and this will lead yet again to large cost increases. I would be willing to bet that any one of these plans to expand health care coverage will be costing two or three times as much as projected in the next few years alone.

Government, when it simply transfers money (e.g. Medicare), can face lower marketing and administrative costs than does a private insurance company. Or government can save money by simply getting out of the way. These cases aside, the only way government can save real resources on health care is to restrict access, typically through some form of rationing. See also my earlier post on who are the uninsured.

Should we ban HIV-positive immigrants?

Jonathan Rauch says no. He argues that allowing HIV-positive individuals to apply for residence will bring those individuals into mainstream medical institutions. The alternative may bring undocumented HIV-positive individuals who never receive good medical care or perhaps never even discover their HIV status, infecting others in the process. Rauch writes:

The ban on aliens with HIV was first imposed administratively, by the Public Health Service, in 1987, when fear of AIDS was at its peak and the disease was effectively untreatable. As therapies became available, public health authorities soon came to believe that the policy merely drove the disease underground and thus was ineffective, if not counterproductive. The first Bush administration and then the Clinton administration tried to revoke it. To no avail: In 1993, Congress wrote the HIV ban into law. No other disease faces such a statutory ban.

Even in 1993, the ban made little sense. America was the world’s epicenter of AIDS, exporting rather than importing the disease, and so aliens were far more likely to get HIV in America than to bring it in. Anyway, the policy never required an HIV test for entry; only when an alien seeks permanent-resident status, usually after having already been in the country for years, is the blood test routinely required. So the policy, as put into practice, is about kicking people out, not keeping them out.

Congress was worried about the costs of welfare and publicly funded care for immigrants with AIDS. A valid concern, but one addressed by the underlying immigration law, which bars aliens deemed likely to become a “public charge,” whatever their disease. Today, diabetics and cancer patients can visit and live in the United States on showing they have insurance or resources to keep themselves off the welfare rolls; only people with HIV are barred, whether they are sick or not. This is discrimination, pure and simple.

The numbers suggest that much is at stake: for instance about 1 in 12 Africans is HIV-positive, by some estimates. Singapore has faced related issues with foreign prostitutes.

Rauch’s proposal, obviously is not a political winner, even though the Bush administration has been relatively sympathetic on the AIDS issue. I am interested in considering the deportation question more generally. Should we, for instance, deport SARS carriers? SARS is highly contagious to larger groups in a shorter period of time. Unlike HIV-positive status, you can’t (it seems) just walk around with SARS for years. You might argue that if we deport SARS carriers, undocumented immigrants with SARS will be reluctant to report to hospitals. A good point, but I suspect that many of them rather quickly cannot continue on their own without dying. On the other hand, say you have an undocumented SARS patient on your hands. It is crazy to put them on a plane (we cannot over time afford many quarantined flights), best to leave them in a hospital. Nor does it gain you much to deport them once they are better.

So in looking for standards for deportable diseases, we might focus on rapidity of contagiousness, and ability to deport without infecting others in the process. Whether an individual can serve as a “silent carrier” can cut either way. On one hand, silent carriers can infect others for a longer period of time, which suggests a reason to boot them out (though of course they must go somewhere). On the other hand, it is the silent carriers that you want to report to the medical establishment. There is also a question of stock vs. flow. If the potential future flow of HIV-positives is high, that argues for deportation, as an incentive to keep others away. But if the stock is high relative to the flow, that argues for greater tolerance.

Sometimes it puts the world at risk to deport individuals before their treatment is complete, read this story on tuberculosis. And of course some of the deported will simply die without the medical care of the wealthier nation.

The Winners of the MR Challenge

As expected, President Bush’s plan for a moon base and eventual trip to Mars failed to ignite. MR readers have some better ideas.

Honorable mention goes to Roger Meiners for suggesting that a moon base is a good idea so long as Congress and the President must occupy it. Now I am inspired!

Third place goes to Chris Rasch for brain freezing. Chris Rasch writes “I believe that reversible cryopreservation of the human brain could be developed. Remarkable advances have already been made on a shoestring budget. Such a technology would allow people dying today to halt the dying process until technology can advance to the point that we can cure their disease or repair their injuries. I would wager that, for a mere billion dollars, which is far more than has probably been spent on cryobiology during the entire existence of the field, we could have effectively unbounded lifespans. We could then use those extra years to pursue all of the other goals that other submitters may send to you.”

Here is a good, short summary of cryonics and you can sign up to have you brain (or more) frozen here.

I like the cryonics idea and have thought seriously about signing up (believe it or not, one of my colleagues (not Tyler) has already done so). The reason the idea takes third place is that we don’t see a big private demand for cryonics and the public is more likely to think this idea crazy than inspiring.

Second place goes to Nick Shultz for suggesting that we “provide potable water for everyone on the planet.” A number of other ideas were also motivated by the goal of alleviating abject third-world poverty. I think these ideas are inspiring but am unsure whether we can deliver on them given that so many of the problems of the third world have to do with poor governance. My suggestion would be to work on something related but more under our own control. We could do far worse, for example, than following Bill Gates’s lead and put a billion or so into the Malaria Vaccine Initiative.

First place goes to David Wood and Robin Hanson both of whom suggested a space elevator. At first, the space elevator idea seems impossible, even absurd. The idea is to string a cable some 62,000 miles long from a spot on the equator up into outerspace. Wouldn’t it fall down? No, recall that a sateillite some 22,000 miles up is in geosynchronous orbit. The space elevator would extend enough past this point so that gravity at the lower end and centripetal acceleration at the far end would keep the cable under tension. Once the cable is strung, reaching outerspace is as simple as Jack climbing the beanstock.

The most difficult part of the space elevator is finding a material strong enough to carry a load yet light enough not to collapse under its own weight – a short time ago there was no such material but today it’s believed that carbon nanotubes could do the job (nano-technology more generally was another favourite of MR readers and this proposal would advance that cause.)

A space elevator is a game-changer because it dramatically lowers the cost of putting payloads into space. Moreover, once you have one elevator it becomes much easier to get a second. In contrast, rockets are always going to be expensive because you have to carry a lot of fuel just to lift the fuel and sitting on top of 4 million pounds of explosive is always going to be dangerous. The space elevator would provide a permanent access point to the stars and it can be had for less than 100 billion. Going up anyone?

More on the space elevator idea here and here.

Women now outspend men on electronic gadgets

Yes it is true:

Women actually spent more on technology last year than men, according to the Consumer Electronics Association. It says women accounted for $55 billion of the $96 billion spent on electronics gear.

Additionally:

* Women are involved in 89 percent of all consumer electronics purchase decisions.

* Eighty-four (84) percent of women believe that new technologies can help improve their lives.

* Forty-eight (48) percent of women age 18-34 own a digital camera.

On the downside, nearly three-quarters complain that sales personnel ignore, patronize, or offend them while shopping.

Read the full post of Robert Tagorda to learn how retailers and manufacturers are making greater efforts to appeal to this customer segment.

A Challenge to Readers

President Bush reputedly asked his big-think guys to come up with a new vision to unify and motivate the nation and they came up with … a moon base? It’s so been there, done that. Going to the moon was one of the greatest accomplishments of mankind but I am not inspired by imitation. Are you?

Hence, I issue this challenge to the blogosphere. What’s your big-think idea to unify, motivate and inspire the nation? A moon-base will cost on the order of 200 billion so let’s economize and say that the idea should cost 100 billion or less – a better idea and 100 billion to spare! Ideally, the idea should be mostly free of politics and have a strong possibility of success given that the money is spent. Email me and I will post the best ideas with full credit.

China facts

In 1990 bicycles carried 70 percent of travelers in Shanghai. Now it is no more than 15 to 17 percent. Last month the city government of Shanghai banned bicycles on all major roads. Automobile sales in China are growing at a rate of 50 percent yearly. Bus service is considered to be of good quality and a subway network is being built. Upon completion it will have more miles of track than the subways of New York City. China has 7 of the world’s 10 most polluted cities. Here is the full story.

Why Europe is no longer world leader: one illustration

The New York Times writes of:

…a new regulation imposed by the European Union that reduces the allowable sound exposure in the European orchestral workplace from the present 90 decibels to 85. The problem is, a symphony orchestra playing full-out can easily reach 96 to 98 decibels, and certain brass and percussion instruments have registered 130 to 140 at close range.

The directive – issued last February and intended to protect all workers, orchestral musicians included – specifies a daily “upper exposure action value” of 85 decibels, amid a welter of other provisions. It acknowledges “the particular characteristics of the music and entertainment sectors.” It allows discretion to member states to use averaging, specifying a weekly exposure limit of 87 decibels, and to allow a transition period for implementation.

For me this article had a “jaw hits floor” quality. How about legislation saying that no composer can lose blood, sweat, and tears over a masterwork? Bach, after all, wrote the equivalent of twenty pages of music a day. He likely had some form of carpal tunnel syndrome.

Note that private solutions can alleviate the noise problem. Some orchestras increase the spacing between players. Some musicians use earplugs. Sometimes an orchestra will put plexiglass screens in front of the trombones. Or you don’t have to join an orchestra in the first place.

By the way, the trombones are not the only problem. The piccolo also has a negative effect on hearing.

And what about the United States?

In this country, the Occupational Safety and Health Administration takes a more hands-off attitude toward orchestras than the European Union. “We don’t basically get involved with them,” Francis Meilinger, an OSHA spokesman said. Here, too, orchestras fall under the agency’s general guidelines for the workplace, which allow a 90 decibel level over an eight-hour day, and a 97 decibel limit over three hours. Since American orchestras work relatively short days, and the peaks of sound are merely intermittent, they don’t represent a particular concern in this regard.

Imagine that, the EU having less sense than our OSHA. In any case, it remains to be seen how the measure will be implemented and enforced. Many musicians have announced that they plan to continue playing Wagner, Mahler, and Strauss, regardless of regulatory directives.

How many species is global warming destroying?

Gregg Easterbrook debunks some recent doomsaying on this topic. You might have noticed a recent study claiming that more than one million species are being endangered by global warming. Easterbrook points out a calmer yet still environmentalist estimate of 12,259 endangered species, and that is from all causes, not just global warming. Easterbrook writes:

…the study in question is dubious because extinctions don’t seem to be happening at anywhere near the rate called for by other assumptions, mainly concerning habitat loss. Species-extinction theories say habitat loss, development, and logging should lead to rapid declines in species. All these factors are at play in the Pacific Northwest of the United States–and no animal species is known to have fallen extinct there in the last couple decades. (Several salmon species and other species of the area are imperiled.) This is significant because the Pacific Northwest is an elaborately studied area; far more is known about it than the tropical regions about which the Thomas study makes vague computer projections. Graduate students comb over the Pacific Northwest, knowing that tenure and academic renown will go to anyone who documents an animal species loss. And average temperatures are rising in the Pacific Northwest. For anything even remotely close to Thomas’s 1.25 million extinctions to be a hard number, we should already be seeing the bow wave in the form of dozens if not hundreds of extinctions in well-studied areas like the Pacific Northwest. Instead we see, um, zero.

Habitat loss and species extinctions are real problems, but let us not politicize science to scare up support for our favorite proposals.

Addendum: See also this trenchant critique from TechCentralStation.com. Carl Zimmer defends the study, thanks to Chris Mooney for the link.

Arnie’s California budget

Calpundit provides a useful tabular analysis of how California’s new governor will address the state’s fiscal crisis. Here is the entire budget document. Here is another blog analysis.

Where are the cuts coming from?

Overall, the cuts appear to be approximately as follows: $900 million from MediCal, $800 million from CalWorks welfare-to-work programs, $.6 billion in other health and human services programs, $400 million from higher education, $2 billion from primary education, $400 million from prisons, $1 billion from transportation projects, and $.2 billion in miscellaneous.

On top of that we have fee increases of $1.3 billion, much of that coming from casinos, and $4 billion of borrowing. If we can take all the numbers at face value (hardly ever the case with political budgets), a $14 billion budget shortfall will be covered.

The bottom line: Once you push through the smoke and mirrors, spending cuts amount to only a few billion. Still, this is the best political test we are likely to see of whether real spending cuts can be sold to the general electorate. If it sounds like Arnie is cutting too much budget meat for your taste, keep in mind that California state spending rose 44 percent since 1997-8. State bonds are near junk status and possess the lowest credit rating among the states.

Bad news for America but no surprise

The United States has dropped in its standing for the 2004 Index of Economic Freedom. We used to be sixth, now we are tenth.

Here are some of the leaders:

1. Hong Kong, for the tenth consecutive year.
2. Singapore
3. New Zealand
4. Luxembourg
5. Ireland

Moving down in the list, France was #44, North Korea comes in last, and Venezuela, Iran, and Libya were among the ten worst. No polling was possible for Angola, Burundi, and Iraq, among other disaster areas.

The United States was downgraded for poor fiscal policy. Note that the Freedom Index is done by the Heritage Foundation and The Wall Street Journal, hardly left-wing critics of Republican economic policy.

Addendum: The Economic Freedom of the World index offers slightly different rankings. For 2003 America remains in third place. The EFW is considered to rely more heavily on quantitative measurement, the Index of Economic Freedom relies more on observer assessments of economic freedom.

The further decline of the mass audience

Total U.S. movie box office just barely held its own for 2003, as reported by the January 5-11 issue of Variety (not on-line). The number of moviegoers declined by three percent. A few major movies, such as “Finding Nemo” and “Return of the King” did very well, but the overall picture was flat. Elizabeth Guider writes: “…unleashing dozens of $150 million films aimed at the global mainstream audience is an increasingly losing proposition.” Audiences for network TV have been poor as well.

Where is everyone going? Are you all reading blogs instead? That I doubt. The big cultural winner for this year is the DVD:

Check the year-end reports from the various sectors of the entertainment industry, and it’s clear that DVD stands alone as an unqualified sensation. It’s such a success that it might even be eclipsing – and cutting into – other leisure pursuits.

Total DVD revenue last year hit $17.5 billion – $12.1 billion in sales, $5.4 billion in rentals – according to new industry totals from market tracking firm Adams Media Research. That surpasses the most optimistic expectations and overshadows spending on movie tickets, music CDs and video games.

Here are some numbers from the side of the consumers:

Hours spent with home video increased 18% from 1997 to 2002. For the average person that means an increase to 58 hours each year, while time spent listening to music, watching network TV and reading books, magazines and newspapers dropped.

This year, movie fans spent an estimated 67 hours watching discs; that is expected to jump another 46% over the next four years to about 98 hours per person per year…nearly a DVD a week…Meanwhile, total TV watching is expected to rise only 3% (with network TV dropping 3%) and moviegoing 8%. Listening to music is expected to fall 19%.

So what does this mean for culture? People are watching the same movies over and over again. Over time we can expect movies to stand up better on multiple viewings, which is the whole point of the DVD format. Movies should become deeper. It is an open question whether the number of movies issued will rise or fall, but I am an optimist. On one hand repeated viewings mean less time to sample extra titles. On the other hand, the compact and popular DVD format gives filmmakers a new way of reaching audience. It will benefit the blockbusters, such as Nemo, but also will help niche films. For instance many people now order otherwise unavailable foreign movies through netflix.com.

Addendum: Do you resent your loyalties to DVDs? Here is a lengthy and excellent post, from Michael of www.2blowhards.com, on how to think about and revitalize your reading. However his remarks will spur your further interest in cinema as well.