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- Seth Roberts on top and bottom versus middle.
I predict that someday someone in the American government (top) will realize that a way to greatly improve health care is to empower patients (bottom) against doctors (middle).
To avoid confusion, let me point out that in this terminology the middle class are the ‘bottom’. The problem we face right now is that our government sides with the ‘middle’ (doctors, bureaucrats) against the ‘bottom’.
To be fair, most leftists probably think they are siding with the ‘bottom’ when they support things like government-regulated health care. But it’s also fair to point out that the fact that the end result is to empower and enrich leftists on the ‘top’ is not mere coincidence. You will notice that there are no leftist ideas that crucially involve disempowering powerful leftists in government and bureaucracy and devolving power to regular people.
- Old (~2 weeks is old in blogging terms) but still great, the generic movie trailer via Jim Emerson:
- Geekiest thing I’ve seen in a while, these are the voyages of the microscopic Enterprise.
- You need to read this post from (again) Seth Roberts. If I’m reading correctly, he (a blogger) basically cured a 5 year old girl of coughing fits that were ruining her childhood. By blogging.
- Russ Roberts has the most optimistic or at least, least pessimistic take on the health care bill that I find credible. It starts by pointing out (if not in so many words) that the setup we currently have is basically already socialized:
It is a nominally “private” system but the hand of government is the dog, not even the tail that wags the dog. Given the role of medicare reimbursment, and the tax-advantaging of generous private plans, there is very little room left for the invisible hand. The simple way to say it is that too little health care is currently paid for out of pocket. The patient is not the customer.
- David Mamet tells his TV-show writers how to write drama, in a memo. As I started reading the memo, it struck me that Mamet sounded just like my boss (a small, windy blowhard trying too hard to ‘talk tough’). By the end (“LOVE, DAVE MAMET”) he had won me over though. Even though it’s not at all obvious that Mamet follows his own advice.
- M. Simon cites an example of science being a crime: innocent people went to jail on the say-so of ‘science’. At root here seems to be a belief that nothing said by ‘scientists’ can possibly be wrong or questioned, indeed that people who are ‘scientists’ are not subject to the same biases and errors as other humans. Parallels to certain other topics in current debate are obvious.
- Arnold Kling is going a little nuts lately, and I kinda like it. Where do you land on the (skilled, unskilled) x (not college educated, college educated) spectrum? Kling’s new theory is that the current ruling class is dominated by the (unskilled, college educated).
My theory is that the ruling class gets its strongest support from people in the lower-right quadrant. They identify strongly with the ruling class. Placing an artificially high value on educational credentials is in the interest of the ruling class and everyone else in the lower-right quadrant. If it were not for the protection provided by credentialism and government employment, my guess is that many of those in the lower-right quadrant would have incomes no higher than those of people who are not college educated.
To try to retain support among the highly-educated who are skilled, the ruling class tries to blur the distinction between the upper-right quadrant and the lower-right quadrant.
This is actually not far off from the first Seth Roberts link above (‘top and bottom versus middle’), because Kling’s critique is precisely the same as Roberts’s: that the ‘top’ (governnment/ruling clas’s) is on the side of the ‘middle’ (unskilled wealth extractors/credential inflators) versus the ‘bottom’ (skilled/non-rent-seeking middle class).
Not to toot my own horn here but as far as I can see this is all basically the same as my Smart People theory. Kling, Roberts and I all share, if little else, a distaste for the ‘Smart People’ and their claims to power. I guess it’s no wonder that they are probably 1-2 on my list of favorite bloggers (not counting myself).
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Seems pretty clear that one major effect (whether intent or not) of this “healthcare” “reform” will be to eliminate health insurance companies from the market. It takes a true economic retard to sincerely believe in most of the claimed good effects of the bill. And it doesn’t take an economic genius to discern that companies cannot long survive (unaided) if they are forced by the government to sign money-losing contracts with anyone who asks them to.
Now as far as I’m concerned, the jury’s still out on exactly how insurance companies will be eliminated from the market. Will they just go bankrupt and fold? Some of them perhaps. More likely though I think is that they will just become de facto if not literal arms of the government (thus, the “market” as such will just disappear as everyone ends up under the government umbrella).
The trajectory is pretty clear: a couple years down the road, when insurance companies have been abiding by these “reform” diktats, and losing money, and ratcheting up premiums as much as they can, but it’s not enough, and people paying the higher premiums complain (to politicians), and politicians grandstand, and hearings are held, and pressure is put back on the insurance companies….sooner or later the insurance companies will go to the government hat in hand. Government (“to preserve our historic health reform and patients’ health rights”) gives them a “bailout”, which is another term for buying them out. Of course now government can tell them what to do directly. Now every insurance company is Fannie Mae. Part of the government. Hence: not a private market actor. One way or another this all leads to one destination only: the federal government controlling health care distribution – single-payer, completely socialized medicine. What we used to term “insurance companies” end up just being the quasi-government agencies which the government uses to administer/oversee/ration its socialist health system.
So the obvious question is what can be done by people opposed to all this. Step 1, I think, involves rediscovering the concept of “insurance”, and resurrecting it – but with a new name. As my most devoted reader(s) know, the thing we have today that we call “insurance” is not insurance. Like the term “liberal”, the word “insurance” has by now been so misused and abused that it is unrecognizable as its former self. But insurance, real insurance, is still a valuable risk-management tool. It’s still something people would need and want, which has natural buyers and sellers. So, like any such thing, I would look to companies – entrepeneurs, private actors – to deliver it.
The service ‘if you give me a fixed payment stream now, I’ll give you payouts if certain extreme events happen’ is a valid one. Companies should be free to offer it. People should be free to buy it. Obviously those involved can’t call it “insurance” (although that’s exactly what it would be) but this can be gotten around. As everyone who’s read a two-minute Time Magazine-level summary of The Financial Crisis(tm/2007) knows by now, banks and other financial institutions buy and sell insurance on bonds and company debt all the time, they just don’t call it insurance (which would bring the contracts under the purview of state insurance commissioners): they call them credit-default swaps (CDS).
What the health care market needs now is just for some daring, innovative company to come out with health-downturn swaps (HDS). Buyer (a person) pays a fixed running coupon (the premium) and in return receives ‘protection payments’ if such-and-such health downturn events (HDE’s) occur. Since HDS-selling companies would not be ‘Insurance Companies’ ™ they would not be subject to any of the provisions of the current “healthcare” “reform” (i.e. requirements to cover birth control, to ignore ‘pre-existing conditions’ (i.e. bad health), etc.) They could (gasp) actually charge market rates; just as a CDS seller charges more to insure against an Ambac or MBIA default than against an IBM or a Berkshire Hathaway default, HDS sellers would charge more to sell an HDS contract to a 400-pound person smoker with diabetes and cancer than to a 22-year-old nonsmoker. Obviously this would require some legal acrobatics, as well as some objective way (that couldn’t easily be gamed by either side) to determine when/whether HDE’s have actually occurred, but as this was all accomplished for the CDS market, I don’t see why it would be impossible.
The benefit of a buyer of an HDS would be: the cash payout he’d receive in the event of a HDE (disease, injury, etc). He would presumably want and need that cash payout, of course, in order to compensate various professionals for treating/remedying his health issue, outside of/independent from the federal “healthcare” system. Now, obviously this is just the service we call “health care” (or “healthcare” if you’re Smart). But as all “healthcare” under the sun now seems to come under the purview of the watchful eye of the Federal Government, I think we’d have to rename and set up a parallel system for that too.
But that would be step 2…let’s not get ahead of ourselves.
Filed under: Uncategorized | Tags: health care, health care reform, healthcare, healthcare reform, obama, obamacare, smart people
Hey, Smart People:
You totally support the health care bill. And you have no f**king idea what’s in it. That’s how smart you are. You are so f**king smart aren’t you?
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Wait – who did you think I was talking about?
I can’t get a license
to drive in my car
but I don’t really need it
if I’m a big star.
With the new season of Breaking Bad coming up, I dug up and read what I had written about it before. As usual, my first reaction was pure awe – awe, at how fricking great this blog is. I’ve said it before and I’ll say it again: I would totally be reading this thing every day if it weren’t mine.
Anyways, rewatching the previous two seasons (currently being rerun, I guess as a lead-up to the new one) I noticed a strong angle I had left out before. Indeed Breaking Bad is about a guy who is like us, but becomes a criminal. I should have added that he’s not quite like all of us, however.
Walter White is a smart guy, a talented guy. He’s also a guy for whom success has passed him by. He has missed opportunities. He has sat on sidelines. He has seen more well-connected, more brazen, more bold, more ruthless, more hip/cool, more yuppie, more privileged, more lazy, more lucky people pass him by. And he is f**king pissed off about it. Walter White is an angry white male. He’s a Joe the Plumber. He’s a ‘Tea Partier’, if only metaphorically.
I hadn’t actually seen most of the first season before so I had missed how strong this angle is set up. But the contrast is there near the beginning with the characters of the Schwarzes, two fabulously wealthy fabulous people whom Walter knew from grad school and who bootstrapped off his ideas to form a megamillions tech company. The Schwarzes have it all, a giant house, and they are oh so suave, and hip, and nice, and PBS, and down to earth, and rich, and privileged, and cultured, and cushy. White is none of these things (or very few). He doesn’t work in a university or a high tech lab, he’s just a gritty high school teacher who knows how to make homemade batteries. He doesn’t wear flowing, beige casual expensive designer clothes, he wears cheapo plaid button-downs and dockers. He doesn’t appear on the cover of magazines, he’s not part of the biotech age, he’s not into new-age stuff, he doesn’t have a million famous friends.
He’s just a guy who knows his s**t, works hard, and tries to feed his family. He has a modest house, a kid with cerebral palsy, a second job at a fricking car wash, and bills up the wazoo. And then he gets cancer.
His reaction is one of rage. The brilliance of the show is that the rage is 99% pent-up and only let out once in a blue moon. So the actor’s performance is that of a walking bottle of rage, stuffed to the brim, close to bursting, but rarely doing so. He just wakes up and lives every day, seething with rage inside that he must hide. But the viewer can see it. His is a great, great performance.
I’m not sure this is the intent but the show is a big ‘f**k you’ (as Walter tells Gretchen Schwartz, in an amazing scene) to the pretty people, the lucky people, the rich people, the privileged people. They don’t deserve their comfort, they didn’t get where they are honestly, and they probably just don’t know their s**t the way Walter White does. Or so believes Walter White, quite apparently. And if you watch Breaking Bad, you’ll probably come to agree with him.
Breaking Bad is an indulgent fantasy based on the recognition that meritocracy is a lie, that in-group tribalism (or as I call it, high school politics) is the norm, that everyone uses the system to their advantage, and that the fiction of meritocracy means society’s winners are all that much more insufferable to society’s losers. This may seem a stretch for a show that’s ostensibly about a dude who decides to cook meth.
But let’s be more precise then: it’s about why he decides to cook meth.
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This is a really great blog. I’m finding I really can’t emphasize that enough.
My Oscar-picking rule is really pretty simple actually. Say it’s ten years from now and you’re forced at gunpoint by your evil nemesis to watch one single movie from 2009. Which one do you pick, The Hurt Locker or Inglourious Basterds? The answer of course is Basterds. So there’s your Best Picture. By similar methods you can deduce that, say, Jack Black deserved the Best Actor Oscar for his performance in School of Rock that year (would you really rather be forced to watch Sean Penn in Mystic River?). You’d give Amelie lots of awards in 2001, Sixth Sense would sweep 1999. Less awards for the Hilary Swanks of the world, more for the Catherine Zeta-Joneses; less period pieces, more comedies. As you can see, the method is surprisingly powerful. But it’s also logical, because it’s rooted in actual enjoyment of the movie.
Unfortunately this is not how Oscars are actually chosen in practice; they seem to be chosen by self-conscious considerations of whose ‘turn’ it is to get an Oscar and who the Academy wants to be seen as having voted for to get an Oscar. Typically the Academy is essentially answering these questions: “When I look in the record books ten years from now, which films/actors/directors do I want to see there as this year’s Oscar winners, and who do I want to be able to claim at cocktail parties I voted for?” Sometimes this logic allows for needed catch-up: it was Scorsese’s ‘turn’ to get an Oscar because the Academy was obviously embarrassed he hadn’t gotten one yet (e.g. for Goodfellas), so they gave it to him for The Departed (which is absurd). It was Jeff Bridges’s turn to finally get an Oscar this year, so he got one (in reality he should have gotten one over ten years ago for Big Lebowski but perhaps also for Fearless, Tucker, even Thunderbolt and Lightfoot). And The Hurt Locker/Kathryn Bigelow got Oscars b/c it was time to give a woman director an Oscar and this was a way to award the single Iraq-war movie that hadn’t been a failure. On that note, quite often the Oscars allow the Academy to preen about how PC they are: giving it to Halle Berry for something-or-other, for instance (seriously, does anyone remember what movie she won it for? would anyone ever watch that movie again if they weren’t forced to?), so that she can make a teary speech about being the first black winner of whatever-it-was she won (by my method, either Renee Zellwegger in Bridget Jones or Nicole Kidman in Moulin Rouge were obviously superior picks that year).
The overall issue here is are the Oscars about the actual movies, or are they about the ‘Academy’? Every year we see the answer to that from the choices they make.
I’ve tried to follow some of the debate surrounding the trial-ballooned ‘Slaughter Rule’ method of passing “healthcare” “reform”, wherein some sort of rules-vote is taken containing language that “deems” the Senate version to have been passed by the House. For some, the issue is whether it shows contempt for the constitution (see Volokh) or otherwise shocking/extreme in one way or another. I certainly find the idea repellent, but I don’t feel overly qualified to weigh in on its Constitutionality and all that.
Unfortunately, such debate seems to miss the main issue, which is that the logic behind the ‘Slaughter Rule’ hinges crucially on the idea that the people are morons. This rule may or may not show contempt for the Constitution, but it undeniably shows contempt for the people.
The entire intent of the ‘Slaughter Rule’ is to allow certain key congressmen to vote for the Senate’s version of “healthcare” “reform” while pretending they didn’t vote for it. That’s all it is, pure and simple. So they will vote on this ‘rules change’, and “healthcare” “reform” will (therefore) be signed into law, but somehow (I guess the idea is) they will go back to their home districts and tell their people they didn’t vote for “healthcare” “reform”. Thus leaving them a ‘safe’ middle way out of the political bind they’re supposedly in while remaining party-loyal. That seems to be about the extent of the political calculation here.
But that only makes sense if you think people are morons. Idiots. Stupid. Anyone who suggests the ‘Slaughter Rule’ as a method of passing laws is implicitly saying they think the people are stupid. Any congressman who (a) wouldn’t vote for law X but (b) would consider voting for law X via a ‘Slaughter Rule’ is admitting they think their own constituents are dupes. The entire ‘strategy’ is premised on one and one idea only, which is that there’s a way for congressman to vote for a law – undeniably, incontrovertibly vote for a law – but in such a way that they can still trick their own constituents into thinking they didn’t vote for it. The premise here is that voting for a law via the ‘Slaughter Rule’ is somehow different, not the same as, voting for the law itself. But (if the ‘Slaughter Rule’ works at all!) that is obviously blatantly false.
The best answer to this proposed ‘Slaughter Rule’ is not to get bogged down in attacking it through thickets of Constitutional law and precedent, but rather, to deny its first (indeed only) principle, which is that lawmakers who vote for a law via this ‘Rule’ somehow haven’t voted for the law. They have! I don’t care what arcane parliamentary rules we’re talking about, I’m sorry to have to break this to the ‘Blue Dogs’ but if a vote occurs, and you vote ‘yes’, and a bill becomes law as a result, and it wouldn’t have if you hadn’t voted ‘yes’, then you voted for that damn law.
Those opposed to this maneuver’s success need to try to deny the ‘Blue Dogs’ this supposed safe-haven middle-way of voting for a law while pretending they didn’t. If opponents don’t do that, I’m afraid this maneuver, rooted in a sheer and utter contempt for the people, will succeed.
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Some more cherished beliefs of Smart People:
- Congress should pass the health care bill, whatever the hell is in it. Which they, in all their Smartness, have virtually no idea. (Think this one is a joke? Pelosi: “We have to pass the health care bill so that you can find out what is in it.”)
- “Global warming” is occurring, and anthropogenic, and going to be disastrous unless we reshape our society, and no conceivable evidence could possibly prove otherwise. Smart Peoples’ primary reason for believing this is that they heard some folks somewhere with PhD’s (i.e., other Smart People) – they don’t know who – made some computer models and that’s what the models showed. So that’s good enough for them! Smart People know nothing whatsoever about these models and wouldn’t know how to evaluate them if they tried. They just assume the models have been checked out by other Smart People (“peer review”) and the suggestion that this may not be sufficient offends Smart People to the core.
- “Stimulus” works and no conceivable evidence could possibly prove otherwise. The primary reason for believing this (as far as I can tell) is that “stimulus” is a word that impressively sounds like it comes from Latin. Smart People would totally use it in a school paper and everything. So, the whole theory of “stimulus” must make sense. You almost just can’t argue with it. How can you argue with a Latin term for crying out loud? You must be dumb.
- Health folklore such as, eat less fat, eat ‘organic’ (i.e. smaller/less plump) fruits/vegetables, and don’t eat salt is all totally incontrovertibly correct and proven 100%, and to whatever extent possible should be enforced by government. Ultimately this sort of health knowledge often tends to come from some phony nutritionist who came out with a health book and that Oprah Winfrey once had on her show in the late ’80s/early ’90s. But Smart People don’t even actually know that much. In actuality, Smart People tend to have no idea whatsoever where their views on healthy eating ultimately come from (and certainly haven’t lifted a single finger to actually check them out). For most of their nutrition beliefs, they heard something about a “study” on the news once, or from another Smart Person at a cocktail party, and that’s good enough for them, and should be (forcibly!) good enough for everyone else.
Oh yes, Smart People are oh so very smart.
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My Oscar pick is, of course, Inglourious Basterds. This could be because I’ve seen literally none of the other nominees. But I doubt any of them are any better.
- Cobb seemed to like it too, though like me, had difficulty articulating why:
Every once in a while I come across a creative work that defies my attempts to critique it, and I feel that there is something useless about describing it. IB is such a work primarily because it doesn’t inspire me towards any particular unspoken notion.
- Elliot Temple on Force and Charity, at the newish blog Critical Rationalism.
- I feel oh so sorry for the Person Who Defaulted On Debt Kept Up At Night By Not Being Able To Take On More Debt. Don’t you?
- Read about “The Ancestral Territorial Imperatives of the Trumpeter Swan” in the wacky, wonderful Franklin Ace computer manual.
- “In every downturn, unions cannibalize their junior membership, throwing them to the dogs.”
- Everyone loves the beautiful melody of Paco Bell’s Cannon.
- Must-read: Sheila O’Malley trains her opus, near-perfect movie reviewing skills on the (indeed) underappreciated About A Boy.
- I must be reading the following post wrong, because in it Mencius Moldbug almost seems to think that Climategate will have some effects on the scientific community. Me, I say never underestimate the power of the Meritocratic Elites to cover their own asses and assert their own correctness in all things.
- Tea Party sentiment summed up in one sentence: I saw the window closing for my own kids.
- Michael Totten on Obama and the Falklands. I chimed in there somewhere. I get bored sometimes.