Mandating and Incentivizing Health Care

(((The logic of mandates and penalties in health insurance; it's really hilarious to be lectured on how the penalties actually have to mean something by industry representatives with actuaries who probably do those very calculations for every move these companies make.)))

Blue Cross/Blue Shield representative on Morning Edition this morning sounding all sternly maternal, pointing out that a mandate has to be a mandate, and if there's no penalty for not buying into the health care system, people will find it much more reasonable to pay some small fine than to pay what it takes to buy insurance.

Wait, you're saying small fines for breaking the laws, not abiding by guidelines, missing certain kinds of targets, and so on, those fines can be worth paying when you stand to pay less overall -- or even, let's say, make lots more money -- by going ahead and doing what you're not supposed to do?

Shocking. It's as if the private sector has thought about this before. And, well, it's like they've all become . . . socialists! Obama wins!

Aliens Are Not Running the NHS

(((Health care; UK's "orwellian" National Health Service, which is pretty good and which people generally like pretty well; Obama's plan not really comparable to the NHS, in the first place; the debate is not a rational one, anyway; the paranoid style in American politics.)))

Maybe this is why I've tuned out of politics for so long, now. Because it's just so inane. When Sarah Palin can get away with calling the NHS "evil," as if people in the UK wouldn't raise their hands and say, "hey, we can hear you over here." What was she thinking, that the oppressed sick of the UK would rise up and overthrow their Orwellian NHS overlords? "Mr. Brown, tear down these hospitals!" Now we know that everyone in the UK has been to Room 101, because it's clear that they have been brainwashed to think the NHS is good for them.

Unless they're actually right, of course.

But there is a nice collection of articles and op-eds in the Financial Times (that liberal rag) about the current debate in the US and in particular about the comparison of Obamacare (TM) to the NHS. In the latter, they note right off the bat that, on the one hand, Obama's plan is less "socialized" than the NHS (the government insurer won't run the hospitals), and on the other, that US health care is already more "socialized" than people seem to notice (Medicare and Medicaid). It's a very reasonable article.

Alas, as Edward Luce notes in his op-ed, "reasonable people might as well be living on Venus." Noting the conspiracy-prone nature of American politics, on vivid display at the town hall meetings and related protests, Luce concludes:

Their issues are diverse. But their sentiment is common: America’s constitution is being trashed by un-American values. Which brings us to another important strain in US politics that Mr Obama, along with other educated liberals, shares with the Clintons: the belief that the fight is won or lost over the quality of reason.

No amount of contrary evidence will puncture the view that Mr Obama plans to establish “death panels” that will decide which grannies get to live or die. Nor will reason counter the view that countries such as Canada and the UK push their weakest to the back of the queue. “Who will suffer the most when they ration care?” asked Sarah Palin, the former governor of Alaska on Thursday. “The sick, the elderly and the disabled, of course.”

Mr Obama’s proposals have many flaws. Reasonable people can disagree on whether the reforms would bring down the cost of healthcare, an overriding priority, or sufficiently expand coverage to include the uninsured, a twin, but not always compatible, goal. For all their impact, reasonable people may as well be living on Venus.

The multi-generation battle to reform healthcare will be won or lost over faith rather than reason. The more nuanced Mr Obama appears, the more frenzy it will provoke in his critics. The more he mentions his mother, denied healthcare by the insurance companies when she was dying of cancer, the more progress he will make. What happened to her was un-American, Mr Obama should say. Forget the details of healthcare reform. The side that identifies with American values will get the upper hand.

We can wish as much as we like that reason would win out in such things, but we ignore the fact that it won't at great peril. There is a price to pay for such naiveté, which is naive with respect to both the nature and the efficacy of rationality. Myself, I have not decided whether or not I am willing to pay it, or even whether it is my decision to make. But let's at least be honest about it (which may or may not be the "rational" thing to do).

Activist Judges Threaten CEO Compensation

(((Richard Posner as "activist judge;" the market is structurally incapable of setting CEO compensation and mutual fund fees; and this according to none other than Posner.)))

Eliot Spitzer (srsly?) has a piece in Slate examining Chicago School free-marketeer Richard Posner's comments in a recent decision:

In an opinion dissenting from the "denial of rehearing en banc"—a sequence of words only a lawyer could love—Posner wrote that there are growing indications that CEO compensation "is excessive because of the feeble incentives of board of directors to police compensation. … Directors are often CEOs of other companies and naturally think that CEOs should be well paid. And often they are picked by the CEO." He then examined the conflicts inherent in the process of CEO compensation determination, concluding that "[c]ompetition ... can't be counted on to solve the problem because the same structure of incentives operates on all large corporations and similar entities, including mutual funds" [emphasis added]. [ . . . ]

In other words, there is precisely no check within the market, because the people deciding how much the CEO should make are the same people who stand to gain if CEOs are highly valued, or -- dare I say it? -- overvalued.

Spitzer continues:

Posner concluded that while judges shouldn't directly review corporate salaries, evidence of unreasonable compensation could be evidence of a breach of fiduciary duty. Yes, these are legal words, but they reveal a remarkable conclusion—courts should take a hard look at private-compensation issues—and demonstrate how far, and rapidly, the world has shifted.

So in other words, the solution is for courts to keep an eye on the situation and to consider compensation and fees in the context of, or as aspects of, the fiduciary duties of governing boards. So here come the activist judges once again threatening the American way of life, at least, if that's understood as the right to marry only someone of the opposite sex, or the right to make as much money as you can legally convince someone to pay you.

Isn't it ironic, though, that the activist judge in this case is Judge Posner? It sounds so Adam Smith, so old school capitalist, so . . . moral. So much of the socialist objection to capitalism is the tendency to socialize costs while privatizing profits (see the bailout), but here's Posner acknowledging that it's not all about how much money you can make.

The Wikipedia page on the Chicago School quotes this interesting little snippet from Posner: "[the central] meaning of justice, perhaps the most common is – efficiency… [because] in a world of scarce resources waste should be regarded as immoral." We don't have to agree with this conception of justice to see that, in its terms, CEO compensation and mutual fund fees have become essentially wasteful and, hence, immoral. And that the inability of the market to account for this means that the market is, to that extent, inefficient and, well, yeah: immoral.

The Red(coat)s are Coming!

(((More accusations of "socialism;" if you don't actually say who you mean, you don't have to explain why your use of the term is accurate or appropriate, or maybe not even what you mean by it.)))

Politico.com has a note on Spencer Bachus' ominous hinting that the Soviet Union left behind plants in the US Congress to turn us commie long after the Old Girl bit the dust. They were so clever that way.

Unfortunately, Politico actually takes this somewhat seriously.

“Socialism” is one of the more elastic nouns in the political lexicon. In the broadest sense, it defines a system that provides for state ownership of some private industries and governmental commitments to providing direct housing, health care, education and income supports.

To many on the left, it’s a relatively benign — if outdated — term, representing an activist, interventionist government that prioritizes economic security over the unfettered freedom of the marketplace.

To many on the right, it’s practically an epithet — suggesting a return to Soviet-style Communism or a leap toward a hyper-regulated European brand of capitalism that stifles innovation and hikes taxes.

But this is already to cede too much ground to Bachus's rationality and integrity. It's not "practically an epithet;" it is an epithet. Calling someone a socialist in the US is roughly equivalent to standing up in church and saying that some people sitting in nearby pews worship the devil; or in this case, like someone in the choir saying there are some unnamed choir members who worship the devil. Everyone agrees devil worship is bad, or at least no one is going to go standing up for the devil, so instead of defending devil worship, everyone trips over themselves to prove they don't worship the devil. The accusation is already the damning evidence, so the burden of proof is on the accused.

Enter the godless [sic] commie.

But socialism is not devil worship. Unless maybe poverty, unemployment, illness, and the desire for a meaningful life outside of wage slavery are sins. In that case, sign me up with whoever calls bullshit.

Anyway, I don't think Bachus pulled that number out of his behind. I expect him to name his names. That's why he came out with a number. He knows who he's prepared to make some kind of case about. So let's have 'em.

Orkut and Facebook: Social Networking Sites Allergic to Socialism and Communism

(((Attention Conservation: Google, Orkut, Facebook, Censoring political self-identification, Why can't users self-identify as socialist, communist, or anarchist?)))

Looking at the available options for "political view" on Orkut, I find it quite striking that someone is allowed to call themselves "authoritarian" or "very authoritarian" (who would seriously claim such a label, I wonder--surely it could only be neo-Nazis?), but that I can't identify myself as socialist or as communist (or anarchist, for that matter).

Your options at Orkut are these:

no answer
right-conservative
very right-conservative
centrist
left-liberal
very left-liberal
libertarian
very libertarian
authoritarian
very authoritarian
depends
not political

I had already noticed this about Facebook: there is no option for self-identifying as socialist or communist, but it at least lets me pick "other." MySpace, incidentally, has no profile field dedicated to political views or opinions. At least, not that I could find.

Is the issue that Google, like so much of the Western capitalist world, equates socialism, communism, and authoritarianism? It sure looks like the idea is that "authoritarian" and "very authoritarian" are meant to indicate both socialism/communism, on the one hand, and Nazism/fascism, on the other, because according to what most of us learned in high school, fascism and communism are the extremes of right and left that actually come together in a circle (rather than a line) as totalitarian systems opposed to freedom. But this is a facile pseudo-theory barely suitable for pre-teens, and the Google people seem smarter than that, and certainly not inclined to tell me I'm an authoritarian despite my own understanding of my politics, so let's say that's not it.

So, then, am I supposed to identify as "very left-liberal"? Well, my left-liberal comrades would balk at being called socialists or communists, since many Americans think socialists are ipso facto "dirty rotten scoundrels," so why force us onto them? And why make me lump myself in with people who actually probably believe more in the state than I do, despite the fact that they are less "radical" than I am? It strikes me that this would really be a political maneuver to conflate the left wing of the Democratic party with communists and socialists (e.g., Hillary Clinton, who, like Howard Dean before her, is far from communist, but is nevertheless painted with that brush as a means of discrediting her). Whereas neo-Nazis can comfortably call themselves authoritarians and not be confused with conservative right-wing evangelical protestants who vote Republican, for example.

In the end, I suppose I think the most disturbing answer is the correct one: that it is somehow more acceptable in a Western liberal (in the technical sense) democracy to self-identify as "very authoritarian" than to identify as socialist or communist (or as anarchist, by the way). This is deeply distressing, if true, although perhaps Jeanne Kirkpatrick is smiling in her grave.

So I suppose I am stuck with "very left-liberal" as the closest to my position. Likewise, my in-many-respects-mistaken anarchist brothers and sisters are left with "libertarian" if they choose to participate at all.

I suppose I should also acknowledge progress in the apparent fact that, some twenty years after Bush père turned "liberal" into an epithet by calling Michael Dukakis a "card-carrying liberal" (whatever that was actually supposed to mean) in a presidential debate, it's now at least ok to be a "liberal."

tags technorati : socialism, communism, facebook, orkut, liberalism, authoritarianism, fascism, politics, google