President Gore?

I'm skeptical, but John Derbyshire is sticking to his guns.

Cutting Down on Wait Times Government Style

Waiting too long in the hospital for a bed in Britain (more than four hours)? The government has a solution: You can wait in the ambulance. The average in the United States is closer to thirty minutes for critical care, though average treatment time is closer to four hours when non-serious injuries and illnesses are taken into account. Why is this the case? Well, part of it is certainly due to the fact that trips to the ER won't necessarily cost you anything. Because ER's treat regardless of ability to pay, they are an attractive alternative to visits to the doctor's office to deal with minor bumps and bruises or minor illnesses for those who don't have health insurance. Those without health insurance have to pay for trips to the doctor at the same rate HMO's pay, and HMO's pay a rate much higher than what the market would normally bear because removing the responsibility of paying for doctor's visits from the hands of those who would normally pay them (i.e. the patients) and places them in the hands of the HMO's, and ultimately the employers who offered health benefits to their employees. The cost of health care being thus dramatically reduced for the insured, they consume health care at a rate far higher than they otherwise would, increasing the price of health care and causing a shortage of health care, leading to the increased wait times in both ER's and doctors' offices.

The fact that ER's are required to treat regardless of the ability of their patients to pay means that a further segment of the population is receiving, in effect, free health care, and this further increases the size of the health care shortage, as well as its price, as hospitals pass these unmet increased costs on to patients in more long-term situations who either can pay or have to pay. Illegal immigration only compounds this as illegal immigrants, who are generally not the wealthiest folks in the world, are taking full advantage of this, in some areas becoming the majority of hospital patients, straining resources to the point where some of these hospitals are little better than the ones in Mexico, even causing many of them to close.

On top of this, Medicare and Medicaid, though well-intentioned, further subsidize the demand for medical care, exacerbating its costs and shortages. What makes these increases particularly pernicious is that the federal government pays for health care these programs no matter the cost, causing increasing in both the net and proportional share of the federal budget taken up by health care spending, inhibiting its ability to fulfill its other obligations, never mind the effects of an aging population and the additional costs of an increasingly bloated and sclerotic bureaucracy rife with increasing inefficiency. Furthermore, the fact the government's payment for treatments through programs like Medicare once again shields the consumer from the incentive to mitigate cost, driving demand up further and increasing costs and shortages further still.

Litigation drives costs higher still, as litigation insurance drives the cost of doing business higher than it would otherwise be. Doctors also tend to perform more and more unnecessary procedures to reduce the likelihood of being sued for malpractice because they somehow managed to miss some obscure condition that only three people have had in the past hundred years. Now, it is certainly true that doctors who, say, amputate the wrong leg or leave surgical instruments inside of patients or maltreat their patients in some way should be subject to legal action, but doctors should be protected from litigation and criminal proceedings when they have made a decision in good faith, and the burden should be on the litigants to prove maliciousness or negligence on the part of the doctor, not for the doctor to prove he wasn't. Also, in cases where the litigants lose, they should be required to pay they attorney's fees of the defendants. Attorneys are expensive, and many times even the prospect of a lawsuit is enough to prevent a doctor doing what he believes is in the best interest of his patient if he is not sure of its prospects for success.

With the possible exception of an aging population, the federal government bears a large portion of the responsibility for creating the conditions which have precipitated today's health care problems, from increased costs to shortages of care. And what is the solution to this problem? Allowing the market to function effectively to reduce costs and alleviate the health care shortage, while relying upon the good will of the American people to see that those in need get the help they need? Remove the government imposed barriers to a functioning market for health care? Well, if you're a Democrat running for president, your solution is more of the same: increased government interference in the market that will inevitably increase costs, cause shortages, curtail innovation, and reduce overall quality of care. We don't need more health insurance, we need less of it. We don't need more government regulation, we need less of it. We don't need more employer-provided benefits, we need less of them, which will free up the resources of corporations for increased investment, wages/salaries, and whatever else corporations feel the need spend money on to operate more effectively. We don't need more litigation, we need less.

There are certainly problems in the health care system not caused by the government, but getting the government mostly out of the health care business will go a long way to creating an environment where solutions to the health care shortage can be found. If you get the government more involved the only way to reduce your wait-time in the hospital will be to wait in the ambulance.

Who's Right?

The CIA or Mossad. Given the CIA's recent track record on things like 9/11 and Saddam Hussein's WMD program, I think I'll trust Mossad, thank you very much.

Pigs Do Fly

And an anti-Communist article has appeared in The Nation.

A Riposte to Sen. McCain (sort of)

Senator John McCain has said he's willing to follow Osama bin Laden to the gates of Hell. Based on his preferred global warming policy, he seems to want to bring the economy with him.

The Great Conservative Crack-Up Continues Apace

Deacon Keith Fournier has an article at Catholic Online on the current state of the Republican Party. Particularly, he is interested in Sean Hannity's dressing down of Sen. John McCain and Gov. Mike Huckabee as not being true conservatives. He then contrasts this, quite effectively, with Hannity's much more sympathetic treatment of Mayor Rudy Giuliani. Deacon Fournier takes from this that modern conservatism "does not operate from a foundational philosophy which positions the dignity of every human person as the polestar of every public policy analysis. It then fails to order and prioritize issues based upon a hierarchy of values and importance." I don't disagree that this is the philosophical implication of an endorsement of Mayor Giuliani, but I suspect Hannity's willingness to give the mayor a pass on social issues stems more from feelings of personal loyalty to the mayor than from an inadequate philosophical devotion to the dignity of every human person (i.e. he let his feelings obscure his beliefs).

Still, Mayor Giuliani, before he left the race, had picked up significant support from conservatives who knew full well that Rudy was pro-choice, pro-gay marriage, etc. Even so, I don't think it is correct to view these endorsements as an explicit rejection of the primacy of the dignity of every human person. The reason for this is the nature of the abortion issue and what many conservatives want to see happen, namely the return of the issue to the political sphere. While it is enshrined as a Constitutional right by Supreme Court precedent, it is impossible for to advance the cause of defending the life of the unborn through the political institutions of American society. Thus, in order for any substantial progress to be made in enshrining protection of the unborn in law, Roe has to be overturned, at which point a correct ruling would hand responsibility for abortion regulation to the states. Mayor Giuliani's pledge to appoint "strict constructionist" or "originalist" justices to the Supreme Court, had it been honored in a Giuliani administration, would have advanced the pro-life cause as surely as had, say, Governor Huckabee nominated the justice. Similarly, these conservatives reasoned that an originalist justice would hold the lines on the expansion of rights discovered by the Supreme Court, among them a right to gay marriage. In both of these cases, these conservatives feel that the proper venue for dealing with issues like abortion and gay marriage are properly dealt with at the state level,* rendering Giuliani's political positions on these issues irrelevant. Indeed, some even believe, plausibly, that a pro-choice Giuliani supporting a return of the issue to the states grants the position a certain degree of political credibility it cannot attain if only those who are pro-life argue for it. I don't buy the argument, but it's not an unreasonable one to make (and might have become more persuasive had Giuliani won the nomination, making the election a choice between him and Clinton or Obama).

I also suspect that the apologetics voiced on Mayor Giuliani's behalf reflect are the result of of the perceived trend on the right and in American politics in general. Deacon Fournier makes this point himself when he says

Most people agree on the importance of economic freedom. Certainly, most Republicans, and Democrats for that matter, want to see the dynamism of the market economy flourish and open up participation to more and more of our people.

Simply put, the trend among voters, swing voters in particular, was thought to be economically conservative, socially liberal (ECSL). The 2004 and 2006 elections have basically amounted to a reverse of this apparent trend, so that the trend now seems to be socially conservative, economically liberal (SCEL). The upshot of this is that on the one hand many on the right had been preparing for a situation where electoral circumstances would have to come to terms with a presidential candidate who held positions that were ECSL and what concessions such a candidate would have to make in order to make him palatable to social conservatives. Now, someone like Governor Huckabee comes along with positions on economic issues that seem closer to those of the Democrats, from "Fair Trade," to support for increased federal funding for arts education, to his embrace of Keynesian "pump-priming," and while his views may be more in line with public sentiment, those on the right have not had time to determine what concessions are necessary to prevent the undermining of conservative economic principles. This becomes an especially thorny issue when you consider the influence the federal government holds over the economy. It was relatively easy for social liberals on the right to say to social conservatives "I don't agree with you, but I won't get in your way," as appeared to happen with Mayor Giuliani because many social issues either can or should be dealt with on the local level. Unfortunately, a live-and-let-live approach becomes much harder when the two sides are advocating contradictory positions as is happening on trade with Gov. Huckabee and Free-Traders.

Then there is the issue of Gov. Huckabee's populism (For a very good take-down of populism, go here.). Deacon Fournier avers that populism is a good thing. If by populism, you mean simply grass-roots democracy or working-class activism, then populism can very well be a good thing, depending on what is being advocated. But there are other senses in which this word is used that are unquestionably bad and which Governor Huckabee has evinced in his rhetoric. The first definition of populism that is undeniably bad is

any of various, often antiestablishment or anti-intellectual political movements or philosophies that offer unorthodox solutions or policies and appeal to the common person rather than according with traditional party or partisan ideologies.

The second is

A political philosophy supporting the rights and power of the people in their struggle against the privileged elite.

These definitions point to a political style and philosophy that relies on emotional appeals offering simplistic solutions to problems (real or perceived) that are long on sentiment, ill-defined principles, grandiose promises and short on effective analysis of the problems. Governor Huckabee's rhetoric about social conservatives being neglected by the Republican Party also smacks of this darker side of populism. From the ban on partial-birth abortion, the Born Alive Infants Protection Act, to attempts to enact a Federal Marriage Amendment, to appointing Justices Roberts and Alito to the Supreme Court, to President Bush holding the line on federal funding for embryonic stem cell research and human cloning, social conservatives have fared as well as, if not better than any other faction of the conservative coalition. The Republican record on social issues may not be perfect over the past seven years, but it has been a far sight better than its record on, say, fiscal issues. There is also the issue of demagoguery, as Jay Nordlinger explains here and here (see second item).

From all I can tell, Governor Huckabee is a good man, and if he were to get the Republican nomination (unlikely at this point), I would vote for him. But his views on economics and national security, as well as his populism have persuaded me that, among the major contenders for the Republican nomination, the only one less likely to get my support would have been Rudy Giuliani.

*They're right on abortion and wrong on gay marriage.

The Market Responds

With many places instituting bans on smoking indoors in public places, cigarette companies are developing shorter cigarettes with more punch.

Subsidising Illegality

If a man has more than one wife, he can claim additional welfare benefits for his additional for each of his additional wives. Is this happening in some enlightened Muslim country with a generous welfare state? Nope. It's happening in Great Britain, where polygamy is illegal. Why in the world would a country supposedly governed by the rule of law not only allow such behavior to continue but pay additional benefits to those who violate the law in such a brazen manner?

At bottom, this seems to be a problem of multiculturalism. Muslims are considered an alien culture in Britain, and the doctrines of multiculturalism dictate that host societies make attempts to accommodate the alien cultures in their midst. This is a reasonable thing to do, but only up to a point. From a political point of view, the purpose of accommodating other cultures is to ease the transition of people from alien cultures into the host culture, making assimilation easier and reducing tensions between the host culture and its strange guests. To the extent that these objectives are attained, accommodation makes sense, but when accommodation is demanded in matters that go to the fundamental organizing principles of a society, it ceases to be a means of assimilation and social cohesion and instead walls off the host culture from the culture of the newcomers and increases tensions between host and guest.

In this case, the principles at issue are the rule of law and the nature of the institution of marriage. The issue of the rule of law is fairly obvious: Polygamy is illegal in Britain. Muslims in Britain are receiving additional welfare payments for having multiple wives. Therefore, the British government is rewarding British Muslims for violating British law, QED. Much more interesting is the question of why. Why is the British government paying Muslim men to violate British law? Certainly it is consistent with the principles of multiculturalism, but I suspect the decision has as much if not more to do with the nature of the institution if marriage. In what could be described as Christendom (traditionally Christian Europe and places where Christianity came to be the primary religion through European colonization), marriage was the union between one man and one woman for the purposes of uniting them (and, importantly for reasons of politics, their families), as well as for the procreation of the subsequent generation. On the left, of which Gordon Brown's Labour Party is a part, undermining this traditional understanding of marriage has been a central goal in their attempts to remake society as they see fit. The gay marriage movement has been essential to undermining the heterosexual nature of marriage, and it is more than likely that in Muslim polygamy Labour sees an opportunity to undermine the monogamous nature of marriage in Britain. By granting tacit approval to polygamy among Muslims, the British government has rejected the idea that marriage in Britain is a monogamous institution, clearing the way for future attempts to enshrine polygamous marriage in British law.

Ken Green Misses the Correlation

Over at Planet Gore, Ken Green wonders why Vice President and Nobel Peace Prize recipient Al Gore is suddenly questioning the scientific consensus on global warming. The answer is, of course, obvious. The magnitude of the threat to humanity and the global ecosystem in general posed by global warming is inversely proportional to the amount of hot air being spewed by Gore on the issue. Thus, as the magnitude of the threat decreases, the amount of hot air spewed by Gore increases, apparently to the point where predictions he once regarded as legitimate are no longer dire enough to inspire action.

Does Capitalism Lead to Democracy?

That's the question Hilton Root asks in this piece reviewing two books on the subject. Root's conclusion is that it is not necessarily the case:

At least at the global level, the correlation between free markets and plural politics breaks down, and it seems to do so from both ends. Democratic politics often do not support open markets, and open markets do not always reinforce the tendency to democratic government.

And:

Young, still-developing democracies lack the resources and the institutions to counteract the enormous lobbying power of global business. Young democracies have few mechanisms to prevent large corporate contributions from influencing political outcomes. Even mature democracies, after all, often fail to meet this challenge.

Yet it is also clearly the case that under the correct circumstances, capitalism is a major pillar of democracy, as has been the case in the United States. Under what conditions then does capitalism foster democracy. It seems to me that three conditions need to be present in order for capitalism to foster democracy: the rule of law, limited government, and an economy with its foundations in entrepreneurial activity.

American political philosophy begins with the premise that government governs with the consent of the governed and that its powers and duties are established by the Constitution, which is held to be the supreme law of the land. No man is held to be above the law or beneath it, and the legitimate actions of government, groups and individuals are bounded by the law, not by the whims of a king or potentate.

Closely linked to the rule of law, though not necessarily following from it (see the European Constitution), is the notion of limited government. The Constitution of the United States limits the power of the United States' government to regulate the economic activity of the people of the United States. This limitation on government power reduces the incentive of players in the marketplace to use the government to advance their business ends through regulation of the market, seizure of the assets of competing firms, etc.

The third major component of the equation, an economy grounded in entrepreneurial ventures, is also essential because it limits the ability of larger corporations to drive competitors out of the market. It also reduces the political power of individual corporations and increases the incentive of individuals to fight for limited market regulation to give them freedom to carry on their businesses as they see fit.

Though the power of government has waxed, especially since the 1930's; living constitutionalism has somewhat undermined the rule of law; and large corporations play a larger role in American life than they had in the early history of the United States, and many of them pressure the government to pass regulations designed to benefit them to the hindrance of their competition, especially small businesses, the foundations of American society, built on the rule of law, limited government and the entrepreneurial spirit continue to drive American vitality and preserve its democratic society.

What does this tell us about, say, Iraq. There is no history of the rule of law in Iraq; many people look to the government for jobs; the nation's largest portion GDP comes from oil revenue, and the Iraqi oil industry is state-run. None of the three elements that contribute to a flourishing of capitalism and democracy are present, though there is a significant entrepreneurial element in Iraqi society. As long as the United States remains in Iraq, something like democracy and capitalism will survive in Iraq because that is the system the United States is promoting, and they are the dominant power in the country. If the United States leaves too soon, it is likely that the cycle of tribalism and nationalism that dominated Iraqi society in the post-Ottoman era will come to dominate Iraq again with spikes of Saudi Wahabbism and radical Iranian Shi'ism further enflaming the situation. If the United States is willing to remain the dominant player in Iraq for the foreseeable future, a stable, democratic, capitalist Iraq may yet emerge, but it will take awhile.