“No Man’s life liberty or property is safe while the legislature is in session”.

- attributed to NY State Judge Gideon Tucker

Thursday, November 11, 2010

Wonderboy Abroad

Much was made by conservatives over Wonderboy's nearly-immediate post-election trip to India, Indonesia, et. al. Rather like running away from the distasteful, though misunderstood results of last Tuesday's Democrat drubbing.

Unfortunately, Fox News' Glenn Beck reported an outlandish figure of $2B for the trip, citing stories that 34 US naval vessels would be standing by off India.

Many aspects of Beck's contended trip details were debunked by others in the media. I'm a little surprised, but more disappointed, that he didn't take more time to check some of the more obvious factual errors. The US Navy spokesperson sounded like he nearly doubled over with laughter at the idea that more than 10% of available fleet vessels would be detailed to a diplomatic visit.

But Beck did point up something notable and troubling. He reported that the First Rookie was meeting with an Indian Chamber of Commerce group. Which is odd, as Beck noted that Wonderboy won't meet with any American Chamber people and, instead, accused them, without proof, of accepting and using foreign donations in the recent Congressional election campaigns.

Watching some of the footage from the Anointed One's risky town hall formatted meetings with apparently-ordinary Indians, you couldn't help but notice his inability to answer tough questions directly there, either. One young woman asked him about Jihads, and he rambled off into an incomprehensible muck of a reply. The poor girl must have been quite disappointed. There was a similar incident a few days later regarding some other social policy issue.

Meanwhile, global leaders are heaping opprobrium on Wonderboy for the US' fiscal policies of huge deficits and excessive spending, coupled with the Fed's currency devaluations via QE2. It seems most of the rest of the world, including Southeast Asia, holds stronger beliefs in free market capitalism than the sitting president of the US.

Truly a sad state of affairs.

Wednesday, November 10, 2010

Senate Control Through 2012

Several conservative pundits, most notably Fred Barnes, in a recent Wall Street Journal, post-election editorial, have opined that control of the Senate won't necessarily be in Harry Reid's hands for the next two years.

With this month's election already in the rear view mirror, these pundits are already looking forward to November, 2012, when something like twice as many Democratic Senators are up for election, relative to only about 12 Republicans.

With so many Democrats at risk, and the potential for the Tea Party-inspired conservative pressure on spending and reversing liberal social legislation and regulation, these observers contend that perhaps as many as half of these Democrats in the Senate will want to appear more moderate, if not conservative. This could mean surprising majorities for Republican Senate Minority Leader Mitch McConnell.

Even if a few Northeast liberal Republicans (Snowe, Collins) defect, they could be more than replaced by ten Democratic Senators suddenly allying themselves with McConnell's agenda, at least in some cases.

Should make for an interesting next two years, as House GOP control could occasionally be joined by occasional Senate GOP control, as well.

Tuesday, November 9, 2010

A Detailed View of Medicare's Destruction of US Medical Care

Yesterday's Wall Street Journal included an eye-opening editorial by Richard Hannon, a Blue Cross Blue Shield (of Arizona) SVP, concerning how Medicare contributed to the destruction of US medical care.

Hannon's father-in-law was a doctor. The type of doctor whom Hannon describes as 'a Marcus Welby, M.D.' type who made house calls and treated the poor sick either for free, or for payment in kind. He writes,

"I remember my father-in-law, a real-life Dr. Welby, telling me the exciting news that the federal government was going to start paying him to see seniors- patients who before he had seen for the proverbial chicken (or nothing at all). That fabulous deal was Medicare."

Right at this point, I thought about prior posts I've written on this or my other blog concerning how Medicare was a rather stupidly-designed knock-off, for medicine, of the 1930s Social Security program. They both share direct federal government intrusion into otherwise-private behaviors, and a 'common pot' approach to social services provision. That is, social security has a single general fund out of which payments are made, without any limits on individual payments or an ability to assign individual ownership of assets.

In the case of Medicare, just from Hannon's example, it's easy to see how wrong things went from the very start. Rather than have government, as a third party, pay the doctor, why didn't Washington's political hacks simply means-test Americans for vouchers to be used either to buy health insurance or to fund a health savings account, out of which to pay for medical care?

Hannon continues by describing how Medicare's costs ballooned so exorbitantly that, in 1966, Congress estimated the program's 1990 cost would be $12B, which was laughably under the actual 1990 cost of $107B!

Then came cost controls. But Hannon provides details that simply defy reason and logic,

"To fix the cost problem, Medicare in 1992 began using the "resource based relative value system" (RBRVS), a way of evaluating doctors based on factors such as education, effort and specialized training. But the system didn't consider factors such as outcomes, quality of service, severity or demand.

Today most insurance companies use the Medicare RBRVS because it is perceived as objective. As a result of RBRVS, specialists- especially those who perform a lot of procedures- do extremely well. Primary-care doctors do not."

It makes you want to cry, doesn't it? Most sensible people wouldn't design such a stupid system. And they'd certainly include outcomes and relative demand or incidence of condition and disease when creating algorithms to price medical care.

Hannon goes on to trace the decline of the GP, or, as they are now called, primary-care doctor, under this pricing system. And to lay the demise of good, preventative primary care at the feet of Medicare's centrally planned system, replete with formulas, data, and abstracted views of medicine.

His editorial is engaging for its combination of a personal anecdote which captures so well the innocent hopes even doctors initially held for the centrally-operated federal government medical juggernaut which would ultimately warp, then destroy the simpler, less-expensive world of medical care that I knew in my youth.

Monday, November 8, 2010

Frisco Nan Aims To Be Next House Minority Leader

You cannot make this story up. After having led House Democrats to a 60+ seat loss last Tuesday, California's Nancy Pelosi is demanding to be returned to the leadership of her party's House members.

Of course, most sensible people would have exited the scene, the better to facilitate independent voters forgetting why they swept so many Democrats out of the House last week.

It must be near the height of arrogance for Frisco Nan to insist on staying at the helm for House Democrats, albeit now in the minority. Not to mention stupidity on the part of the remaining Democratic House members who don't think it matters that Nan's antics led them to defeat. Can you get more clueless than that? I don't think so.

Given that the GOP is similarly mistaken in keeping Boehner in their leadership team, they are truly lucky that Nan is eager to remain in the public eye for the next two years. Otherwise, voters might forget why they chose to give control over to the Republicans for a couple of years.