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Bruce
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Andrew, take a look at this. http://www.washingtonpost.com/wp-dyn/content/article/2008/06/12/AR2008061203915.html
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Andrew, I agree with the first part of your analysis, but I disagree with you for extolling the virtues of Medicare, and therefore your advocating of the public option. It seems to result from a forest/trees problem. Administrative costs should not be the controlling variable for measuring efficacy of health care. It should be outlays relative to results. To that end, Medicare has never been judged honestly. First, it benefits from an explicit tax on workers to pay for the care of the elderly. So, it suffers from the problem that someone else is paying for a person's health care as well as not being measured honestly. Second, while differing greatly by procedure and type of medical specialty, the private health sector subsidizes Medicare through higher reimbursement rates from private plans than from Medicare to service providers. Assuming that those service providers strive for a blended rate that adequately compensates them for their time and capital, this subsidization should be charged to Medicare. Third, part of your insurance overhead goes to ferreting out fraud and waste. If an insurance company doesn't do that successfully it goes out of business. If the government doesn't do that properly, well who notices? Guess who does a better job managing fraud and waste? I would argue that is a very important function in any system, but you seem to lump it in there with marketing expenses. So I don't think we have a clue how well Medicare delivers a unit of health care for a dollar, relative to private insurance companies. Looking at administrative costs only totally misses the picture. Finally, have you ever looked at the historical analysis of Medicare's projected costs relative to actual results. Even when adjusting for population growth and medical care inflation Medicare is now much more expensive than originally projected (and more expensive than updated projections). How can that be considered a model that should be adopted more broadly? But look at the public option more holistically. What, in your experience, does the government do well when providing a good or a service that the private sector can also offer? And even if you can cite one, why does health care qualify as something that the government should involve itself in? As Mike has pointed out, food is arguably more important to a human's existence than health care, yet the government doesn't start a chain of grocery stores. Instead it provides vouchers (food stamps) for people to buy the food they need in the private market. Believe me, I am not one of those saying that everything is fine and dandy as is. I would tear up the whole system and start from scratch. I would adopt many of your reforms, but I would simplify things as much as possible. If I were king, I would do the following: 1. Mandate that every individual have catastrophic health insurance so that insurance goes back to its core function of insuring against financial disaster. This is about the only place where I agree with Obama. Of course, he wants to mandate first-dollar insurance so that the young and healthy can subsidize the older and sicker. There should be no mandate for first-dollar insurance. 2. Service providers would have to post their prices and charge everyone the same amount for the same procedure. 3. Eliminate all tax preferences for health care expenditures. 4. Provide each citizen with a voucher for a physical every two years (this should have a cap so prevent abuse). 5. Provide refundable tax credits or vouchers for people of modest means to purchase health care services. These last two items could be optional, but are an acknowledgment that government likely will want to encourage proper health management on the part of the citizenry. Then let the free market do its magic, which by the way it has done for basically the entire time of human existence. I think it can do it again.
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Ironically, the way "reform" is headed now it will screw Obama's biggest supporters, the young. The young already help pay for the cost of elderly care through Medicare taxes. Now they will get to pay a second time by being mandated to purchase insurance. Young people should have catastrophic insurance (as everyone should), but the mandates require that they buy typical "first-dollar" type insurance so that they can subsidize the less-healthy's first-dollar insurance. I doubt the young thought this was the hope and change they signed up for. The Republicans should point this out forcefully. I agree that not a single Republican should sign on to any compromise. Let the Democrats wear this one by themselves. They will ultimately be despised for it.
Toggle Commented Sep 16, 2009 on School's Back From Summer at Law of the Bad Premise
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I am actually more optimistic that this will not be enacted than I was in 1994 with HillaryCare. In 1994 the Republicans put forward an alternative proposal that could only be described as HillaryCare Lite. I thought at that moment that it was inevitable that something would be enacted, but somehow it died. Now the Republicans seem to be hanging tough and the Democrats who care about re-election really don't seem to have the stomach to do this on their own. I never thought I would say this but thank God for the Congressional Budget Office. What I have never understood is how any clear-thinking liberal could ever think that universal coverage provided by the government would actually improve very many people's lives. It just runs counter to history and common sense to think that government could fulfill this function at all competently.
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I consider myself to be a reasonably intelligent person, but am certainly well short of being a genius. In college and grad school if I worked really hard I got very good grades. When I didn't work hard I got B's and a very occassionnl and painful C. I remember really envying the guys who could nail exams without working hard. To me they were the "geniuses". And when those people found subjects which motivated them to work hard, they could be scary smart. Projecting this personal experience means one thing to me. Obama is far from a genius. If he were, he would have pulled great grades at Occidental and Columbia, regardless of his poor work habits. The fact that he couldn't means he is like me, a person with a pedestrian intellect. I'm sorry to rain on the parade of those who want to bestow magical powers on Obama, but he is rather ordinary.
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If she were indeed seeking the Republican nomination in 2012, she would have 4 major and immediate claims on her time. 1. Governor of Alaska 2. Travel all over the US, but from a home base that is incredibly remote 3. Really get up to speed from a policy standpoint so she doesn't have another Couric interview 4. Be a Mom to 5 children, one of whom is a special needs child. There is no earthly way she could do all that. I think she has more energy than almost anyone I have ever seen in politics, but even she couldn't handle the load. So I think this move was designed to give her flexibility, even though she may not yet have decided what she will do with that flexibility. As you say, she might try to make some money for awhile and see if that lifestyle suits her. I think she has great political instincts and she knows that 11 or 15 years from now she will be old news. She knows she has to strike while the iron is hot, which means for her it is 2012 if Bambi looks vulnerable (or 2016 if he doesn't) or never. I hope she stays in the game, if for no other reason, she exposes the meanness and hypocrisy of the left. Ultimately, that will rebound to the left's detriment. Even if she never becomes the nominee I want her to be a threat to be for a long time so that the left can continue its mean-spirited ways.
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I am merely focusing on his response to the ham-handed electioneering on the part of the current regime in Iran, not his overall approach leading up to this moment, which I agree has been dangerous. The point is, a tremendous opportunity has fallen into his lap, in spite of his actions and words. Some times it is better to be lucky than good. And, frankly, what the US says and does may be irrelevant to how things evolve in Iran. These things have a way of taking on a life of their own. If Iran progresses to something much more palatable to the US, then Obama will get the credit, and to a certain degree, I say who cares. If, on the other hand, Iran becomes even more dangerous, then Obama should rightly shoulder the blame. Because the stakes are so high I hope it works out, regardless of whether Obama gets undeserved credit.
Toggle Commented Jun 17, 2009 on Obama-dinejad? at Law of the Bad Premise
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There are two plausible explanations. The first is that his advisers think that the Iranians in the street will have a greater chance of success if the the US is low-key in its support of them. The other explanation is that he is blowing it. I am reserving judgment for awhile until we see how this plays out. One thing is for sure, though. This is a once-in-a-generation opportunity in Iran. While I am not a fan of Obama, I truly hope that Iran changes significantly for the better as a result of this. If so, I won't even begrudge him the universal adolation that he will receive as a result.
Toggle Commented Jun 16, 2009 on Obama-dinejad? at Law of the Bad Premise
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I believe that if my 8th grade son wrote in the same manner that Obama writes, he would fail language arts. The fact that Obama is not called out for his juvenile constructs is laughable.
Toggle Commented Jun 15, 2009 on Seven Easy Pieces at Law of the Bad Premise
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It is a strange world we live in. Somehow it is ok that we have become the contract killers for Pakistan, but we waterboard 3 guys and we become the very definition of evil. Very strange.
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Andrew, I would make the following points in response to your post. First, from a legal perspective one has to know whether the UN Convention Against Torture binds a country and its citizens in all cases or only in those cases where it is dealing with a counterpart who is also a signatory to the Convention. I suspect it is the former, rather than the latter, but I don't know for sure. If it is indeed the former, then the issue becomes whether a particular technique or approach causes severe pain or suffering of a physical or mental nature. I haven't read the "torture memos" but I assume that the memos addressed this specific issue in detail. I assume that one of the justifications of waterboarding is that it didn't cause severe pain or suffering because otherwise we wouldn't subject our own citizens to it in their training. I don't know if that is a strong argument or not. But I would argue that the language in the UN Convention is vague enough to call detention itself torture. I mean if I were picked up in a safe house in Afghanistan, taken to Gitmo and told I would be spending the rest of my life there, well I might consider that threat to cause me severe mental suffering. So by that definition we could not even detain these people. My point is that the legal issues are not cut and dried. If they were, Nancy Peolosi would have exposed the practice to the world in 2002 when she first learned of it. I also assume that you favor Clinton officials being investigated for their practice of rendition. I suspect that a few detainees suffered far worse torture than waterboarding under that practice. In fact, my guess is that our partners in rendition would laugh at the notion of calling waterboarding torture. They wouldn't even consider it foreplay. It would probably be more akin to kissing, and kissing your sister at that. So let's make sure we investigage the Clinton folks who were instrumental in implementing such a policy, which happens to include our current CIA director. Per my earlier post I agree that in the end the only issue that matters is the legal issue. Each person has his or her own definition of morality in this case and while I might want the US to adhere to my definition of morality I don't think it ought to, no more than I think it should adhere to yours. So debating the moral issue, in the end, becomes only a slightly more serious debate than what is the greatest football team of all time. I have not read the "torture memos" so in almost any respect I have no reasonable authority to write about the legality of those who wrote them. I perhaps should. But, my two cents, for what it is worth, is that as long as the lawyers were doing a lawyer's classic job of trying to guide their client to engage in legal behavior then they have behaved in an appropriate manner regardless of whether you like the opinion they produced.
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I agree that MSR's post points out the logical inconsistency of those who decry waterboarding as torture, and therefore, believe that techniques such as those are inconsistent with our moral beliefs. I want to make a different point. That is, does a country even have a "moral framework", and, even if it does, should it matter when thinking about an issue like this? A person has a moral framework. He/she decides whether an act or thought is moral or immoral. I'm not sure a nation does. How would a national moral framework be determined? If even one citizen finds an act immoral does it make it so? That doesn't seem to either be right or very workable. Should it be based on a simple majority or a super-majority? Is it determined by plebiscite? A nation is made up of many individuals, each with his own moral framework. So when someone says that such and such an act is against our nation's morals I'm not really sure what that statement means, given that that person may have a totally different moral framework than his neighbor. Where I am going with this is that in the end we have laws and that is all that matters. Over time the law has evolved in such a way that it tends not to deal with moral issues but the practical issues that, once addressed, hopefully foster a smoothly functioning civil society. For instance, though both are part of the Ten Commandments, as a society we don't have or enforce laws related to adultery or coveting thy neighbor's wife or property but we do have laws that enforce restrictions against theft or murder. This trend in legal theory is to the good I think. I think that there are some people that beleive our laws should be written and enforced in such a way as to make us live as God would want us to, but I am not one of those people. It is hard enough to design a good legal system to begin with, let alone have it carry that burden. In the end then, the individual is the organic entity that is subject to laws that make it optimal for that individual to interact with other individuals. I think it is appropriate to extend that framework to the international arena. In this instance the organic entity is a nation. Nations form treaties to create an environment for a smoothly functioning society at the global level. And the US as a nation decides to live up to its obligations and expects its counterparts to live up to theirs. If a counterpart does not live up to its obligation the US enforces its interest in the ways made permissible under the treaty. This is all straight-forward, though admittedly unwieldy at times. What about its dealings with "others", those entities that choose not to participate at the level of a civilized society, or are not nations to begin with? I'm not sure what the answer is but I don't think a nation should be bound by the same standards it applies to the nations it does have treaties with. Those entities have chosen to stay outside the system that our nation has determined is important to foster a civil global society. While we wish that they would behave in a certain manner, wishing does not make it so. So the US has to pursue its interests with an entity that has already chosen not to "behave by the rules". How the US does so would seem to me to be a function of the circumstances and the entity involved. In short, the US should pursue its interests forcefully, but with some sense of "proportionality". In the end I think that what the Bush administration did in the case of waterboarding was entirely acceptable relative to this last standard. Waterboarding was used extremely infrequently. It was not used to coerce confessions, but to gather intelligence of a high-value nature to prevent future loss of life. It was done under physician supervision. Finally, it worked. It ultimately was very "proportional", by any reasonable reading of that standard. And with what we have learned from this experience we should amend our laws, and enter into new treaties, if we feel that is needed to correct some perceived wrongdoing on our part. But let's not continue this nonsense that somehow we violated our morals.
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JS, I suspect the internal security agents in Egypt, Syria and Zimbabwe would laugh in your face if you characterized waterboarding as torture. It wouldn't even merit being called foreplay in their playbook. They would probably characterize it as equivalent to kissing, and kissing your sister at that. As to your other points, ask Dennis Blair (Obama appointee) if waterboarding yielded valuable intelligence. Ask Bill Clinton about the rendition policy he started (an inconvenient truth for you lefties) and whether it yielded worthwhile intelligence. The left believes that if you keep making an assertion often enough, and you can get the pliant media to repeat it often enough (that is the easy part for sure), it then becomes the truth. Thankfully there are still independent thinkers out there such as the person who writes this blog.
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