Monday, March 30, 2009

Babies That Go "BOOM"

I'm only now beginning to understand why all Americans aren't running around with their hair on fire and screaming, "The baby boom is coming, the baby boom is coming, hide your money." Most simply don't accurately know what and who the baby boom is. Even the national press corps is somewhat cloudy on the issue. For instance, with the election of BHO, many in the media talked of the "new generation" taking the helm. Sorry press boys and girls but BHO is also (gasp!) a boomer.

BHO was born in 1961, making him three years older than the youngest of the baby boomers, those born in 1964. I am, my-own-wizened-self, very nearly the oldest of boomers, having been born in January of 1946, the first year of the post WW II birth boom (nothing like a defeat of fascism to get the old libido pumped up, eh?). Therefore, starting with "When in doubt, whip it out, Clinton", through "Don't misunderestimate me, Bush" and through "Hope is a strategy, BHO", whatever his tenure turns out to be, the country will experience 20 to 24 years of baby boomer administrative leadership.

When Sarah Palin becomes president in January of 2017 (visible shudder), THEN we will have passed the torch to the next generation. Of course, if the Terminator has successfully changed the Constitutional restrictions by then and becomes president, the baby boom, with a little help from hot Austrian loins, will continue its strangle-hold on the reins of power.

Suffice to say, the baby boom covers more chronological territory than most Americans understand, except demographers (a fun, fun group). A generation covers about 18 years, the time it takes for an infant to become old enough to start producing babies of his or her own. There are some fecund and formerly precocious older boomers who have children who are also boomers. Now that is profoundly weird.

When the concept of the baby boom is discussed today, many people think only of 60's Flower Children, Vietnam vets and Woodstock mud. True, but that is far too narrow a slice of the generation to get a real sense of dread for what the "aging of the baby boom" means to our country and its treasury. You may have noticed that our treasury is already under a bit of stress; it's been in all the papers (for those of you who read papers). As serious as it is, we ain't seen nothin' yet.

In exactly 20 years, the youngest boomers will celebrate their 65th and the oldest boomers will be 83. Even considering that some will have gone to their own Strawberry Fields Forever by then, the actuarial crowd (another fun party group) estimates that America will look like Florida does today, with every fourth person a qualified geezer at the public trough. If I take care, I'll be slopping there my-own-shrunken-self. Currently, it is only every eighth American who is old enough to slop.

The promises made by our elected officials since 1935 (Social Security) and 1965 (Medicare), to all those who have the foresight to reach the age of 65, are far beyond what the national pocketbook can afford, once the tsunami of boomers begins to muscle their way to the trough. The elected officials have known this for a long, long, long time but making more and bigger promises keeps them in office, the future be damned. (W gave us unfunded Medicare prescription drug coverage but McCain lost anyway, so sometimes the strategy fails.)

These entitlement chickens are coming home to roost and they are in a foul mood (I apologize for that one. No really, I do.)

Here's my reality. Only those of us in the baby boom can save America from the baby boom. We can do it through modest shared sacrifice by say, agreeing that some affluent portion of us could get by nicely on 95% of the Social Security that the fiscally irresponsible blowhards in Congress said that we were going to get. Bill Gates, Donald Trump and others of us don't need 100 cents on every dollar promised in order to live a comfortable retirement. If Bill, Don and I all kick and scream and demand our 100 cents on the dollar, then our children and grandchildren will see us for the navel gazing, greedy generation that we promised not to be back in our idealistic days.

Harder will be the changes necessary to shield America from the rampaging financial bull that Medicare/Medicaid are becoming. Make no mistake, these programs have many systemic problems that desperately need correction, fraud and financial abuse being prime examples. However, the programs actually work pretty well as a (sorta) single-payer health system for retirees and the destitute. The poisonous ingredient in the Medicare (and Medicaid) soup is health care cost inflation of 7% each year. If America doesn't finally address and solve our market-driven health care cost inflation challenge, Medicare and Medicaid will sink the ship of state. The solution that Washington has adopted to date is, "Quick, have the orchestra play something perky".

Solving the Medicare/Medicaid challenge means changing, and dramatically so, our health care system. That is what makes it difficult and a problem that all Americans, not just boomers, will have to approach while trying to ignore the screeching coming from the extreme ends of the political bell curve and those of the special interests groups. This is also why, in spite of doubters, BHO is keeping health care reform as part of the agenda in the midst of this financial crisis.

As a voting block of 77 million, baby boomers hold the key. United, we can prove ourselves a great generation, not just a great big generation. Divided, however, our ability to secure the fiscal future of the country vanishes in opposing ideologies. We've already tried it that way and it has brought us to a perilous place.

Have two epiphanies and call me in the morning.


Observoid of the Day: Always keep your fork, there may be pie.

Friday, March 20, 2009

Torches and Pitchforks

It's getting ugly out here. The very mention of A.I.G. or Timothy Geithner can cause normally mellow folk to begin frothing. In fact, some folks remain in a constant state of froth, e.g. Barney Frank and other lesser known bulbs in the House of Representatives. (You would think, Barney being openly gay and all, that he would be a snappier dresser but the constant frothing does go well with the rumpled appearance.)

I recently read an "outraged, outraged, I tell you," essay by no less a financial maven than the ever-popular and ever-present Jesse Jackson. Try this yourself: stand on your front lawn and whisper "social injustice" into the wind and chances are that within 24 hours, Jesse will be at your home with an entire cadre of indignant, placard-bearing and out-of-work protesters eager to shout slogans for your cause. Now, what was your cause, exactly? Can we create a brief chant with hackneyed rhymes?

Anyway, Jesse was predictably railing about the way A.I.G. shoveled taxpayer money out the door to such scumbags as Goldman Sachs, Citibank, Deutsche Bank of Germany, (Germany for chrissakes!) et al. He referred to this process as "injury" to which A.I.G. then added "insult" by paying $165 million in bonuses to its own employees.

The populists and their mob of followers have swooped in and are pulling the guillotine out of storage. Similar to the French experience of the eighteenth century, when heads begin to roll, the crowd gets less and less discriminating about whose heads, as long as the show goes on. If he wasn't currently dead and headless, you could ask Robespierre about the way that these mobs eventually eat their own.

Excuse me while I clean the spittle from my keyboard. All this talk of railing, raging and indignation has created quite a lather. There, I've calmed a bit.

I wasn't sure who Jesse thought that A.I.G. should pay the bailout money to if it wasn't to the firms to whom it owed the money. I soon learned.

Believe me, I am not defending A.I.G.'s business model, wherein they created unfunded insurance products and called them "Credit Default Swaps" so that they could avoid the established rules of insurance regulation. Anyway, they did, sold barrels of them to Goldman Sachs, Citi, Deutsche Bank, et al, all while the regulators shuffled papers for several years. Well, when the credits "defaulted", A.I.G. owed these bank customers barrels of settlement money. Because they hadn't established a fund to pay off claims (as legit insurers are required to do), A.I.G. was in deep doo-doo (a technical financial term, that). And, because the banks had bought these swaps to protect themselves from the eventuality of credits defaulting, they were getting no money from defaulting borrowers nor money from A.I.G. to cover the losses. Deeper doo-doo.

Timothy Geithner to the rescue with $170 billion for A.I.G. Now, A.I.G. may well be run and overrun with avaricious, scheming, soulless jerks but, by law--you remember the law--they were required to use the money to pay their obligations. I hope that they negotiated some cents-on-the-dollar deal but I know nothing about the terms. Their obligations were owed to the banks that bought the credit default swaps.

Jesse apparently thinks that A.I.G. should have taken the $170 billion, ignored the law and used the funds to pay off student loans. Actually, he says, the government should never have given A.I.G. money in the first place and instead, just wipe student loan debt off of the books as an "investment in our future". No doubt, the Rainbow/PUSH Coalition will print up bumper stickers, "Students Don't Pay and Save the Day."

Addressing student loan issues is a worthy endeavor; I know because my oldest is a struggling surgery resident with a whopping student loan debt clouding his future. However, Jesse's solution is the same as pouring money into more firefighter training when the house is ablaze.

Here's a handy tip: If a solution to the current international financial crisis can be put on a bumper sticker it is not the solution. The populist mob may think so, may give a "thumbs up" as they pass by on their way to the next beheading, but they'll be wrong. In this instance, solving the current banking crisis has nothing to do with solving student loan issues.

As for the $165 million in A.I.G. bonus money, which is .001 percent rounding error of the $170 billion in taxpayer money that A.I.G. has sucked up, it's a public relations disaster but it has also created a populists legislative reaction that is way over the stupid line.

There are thousands of bank employees in the tub of TARP bathwater, a very tiny percent of whom had any hand in creating sub-prime loans, derivatives based on securitized debt, credit default swaps, and all the other creative products that built the house of sticks that is now burning brightly. Even so, blustery Barney and a whole posse of do-righters wants legislation to impose a 90% tax on bonuses of employees of any institution that was asked by the government to take TARP money. The populist solution is this: the greedy bastards are in there somewhere, throw out the entire tub.

There will be some game-changing unintended consequences if this legislation passes and unfairly punishes thousands of hard working financial executives whose primary reward for their long hours and honest effort is a lump of coal. These folks vote and so do their families and friends. I have first-hand knowledge of this issue, up close and very personal (by way of full disclosure).

For those readers who have already decided that the only good banking executive is a headless banking executive, I challenge you to a spit-wad duel at ten paces--make that eight paces--and bring your own drinking straw and spit-wads. The first one to lose temporary vision in one eye, loses.


Observoid of the Day: It's really strange that flammable and inflammable mean the same thing.

Wednesday, March 18, 2009

Health Insurance Paradox

After I posted "Free Market Viagra" in early March, a concerned reader commented publicly that I had my "free market" definition wrong. She noted that between government regulation, federal and state spending for Medicare, Medicaid and other discretionary health care outlays that we (Americans) " no way whatsoever, have a free market health care system". We can't both be right.

My understanding is this: who the payers are is immaterial to defining a free market. Neither does regulation necessarily indicate that a market is not operating as a "free" market. Case in point; the government pays for all military hardware, is very specific about what it wants, regulates the process and then spends billions in the free market. This is why Boeing and Northrop Grumman have sales guys who treat generals to golf outings.

In our free market health care system we have providers who decide what to offer, where to offer it, how much to charge and to whom to offer it. This explains why the big drug companies spend more on marketing of erectile dysfunction drugs than they do on Alzheimer Syndrome research. From the drug manufacturers' standpoint, it's better for the stockholders if the manufacturers insure that Grampy can get a woodie than it is to insure that he can remember with whom he is sleeping. Some would argue that this is an odd decision. Not really; it is a free market decision, the gummit doesn't mandate it.

I'll save the rest of my big pharma comments for a subsequent posting. Let's turn our collective attention to the 800 pound turd in the punchbowl, which has cleverly disguised itself as a gorilla, the great American, for profit, private health insurance industry.

Lest you think that I am an unreconstructed insurance scold, let me set the record straight; some of my friends are in the insurance game and they are--with one or two exceptions--reliable, upstanding people. My very own father is still plugging away at making sure that people have the life and property coverage that they need. At nearly 90 years old, we thought that he would have left this challenge to others by now, but, noooooo. Do not let him corner you at a cocktail party.

However, there's insurance and then, there's insurance.

Life insurance is pretty straight forward, either you are or are not dead, except for Jimmy Hoffa, Keith Richards or Senator Robert Byrd. They are considered outliers. Property and casualty insurance is somewhat more subjective, to whit: the water damage was caused by flooding and not a burst pipe so there is (or isn't) coverage.

Health insurance, however, is just chock-full of subjective, market-driven decisions before payment is made.

The first free market decision is whether or not to insure at all. Pre-existing medical conditions usually doom an applicant. After all, insurers want healthy health insurance customers. In a free market system this makes sense. Of course this system creates a pool of uninsured citizens, many of whom could afford the premiums and who are, via poor decisions or bad luck, the most likely to need health care. When these citizens finally show up at the emergency room, society pays for their care one way or another. The insurance companies have no skin in this payment game because providing sick folks with coverage is bad business.

If one has health insurance, the free market subjectivity issue does not go away, however. The insurance company will subjectively decide one or all of the following: which physician(s) can be visited, which treatments are covered, which drugs can be used, how long the treatment will last and what are the "normal and customary charges" on which they will base their eventual payment. You can be sure that each decision is carefully vetted on how it will impact the company's profits.

Unlike death and property damage, the range of subjectivity surrounding health care insurance coverage is the main ingredient in the industry's business model. The less they pay, the more they profit. Therein is the consumer's paradox. The insurance companies have legions of employees whose job it is to review claims and find ways to deny them. They also negotiate with the providers to secure cheaper rates, yet our national health care costs escalate about 7% each year. So much for that cost control strategy.

Besides, the insurance industry simply raises its premiums to match the health care cost increases and concentrates on keeping its percentage of the total payment low. The patients or the taxpayers pick up the rest.

The George W. Bush administration introduced private health care insurance into the Medicare system in order that "...competition among private insurance providers would drive costs down", you know, the free market promise. The Medicare Advantage program, which Prez BHO is now trying to dismantle, costs Medicare 13% MORE than what it pays for retirees who chose to stay with straight Medicare. There are no differences in medical outcomes between those who opted for Medicare Advantage and those who didn't. There was one "advantage", alright; the private health insurers made more money. The downside is that we, via the gummit, spent more for Medicare. Oops, and a tip-o-the-hat to W from the health insurance poobahs.

To conclude today's post--but leaving many threads still dangling to be discussed and trimmed later--it's instructive to note the following: in the entire developed world, it is only in America that the loss of a job often means the loss of medical insurance coverage and only in America does a major medical event, insured or not, often lead to personal bankruptcy.

Neither of these facts is acceptable unless you believe that access to health care is a privilege not a right. If you are in that camp--populated primarily by healthy people who have subsidized health care coverage, are independently wealthy through their own efforts or who won the "lucky sperm contest"--please refrain from trying to convert me.


Observoid of the day: No one ever talks about Custer's next to last stand.

Thursday, March 5, 2009

The American Wet Dream

By the time I bought my first house in 1973, I was a college grad, had just spent three years as an Army officer, had a full-time job, had a growing family and was attending graduate school. Even so, some would say that what I knew about buying a house and getting a mortgage was "diddly". Others might say that I didn't know "squat". So, in an effort to please all, let's just say that I didn't know diddly-squat. The process was quite scary and the real estate agent and mortgage broker led me around, had me sign things, patted me reassuringly and told me that everything was "going to be all right". Three years later I sold house number one and bought house number two. I wasn't much sharper on the mortgage issues the second time around. Terms like "equity", "bridge loan", "mortgage insurance" and "title deed" would bring a slightly dazed look into my incredibly limpid blue eyes.

By the time I moved to the deep south and bought house number three I should have been a real pro. Need I say, "not so", or was the set-up too transparent? The house I bought was brand new. The builder had been sitting on the house for so long that he was preparing to move into it. In spite of that, the real estate agent convinced me that on "new construction it was inappropriate to make an offer lower than the asking price". And so it went.

When it came to buying the American dream, I remained as ignorant as a bag of hammers for quite some time. The real estate professionals and mortgage brokers were the "experts", they had the knowledge and experience. I took their advice because it seemed like the right thing to do. I've since learned somewhat better, regarding mortgages. However, I'd bet that some shark could still talk me into something unwise, unless, of course, my wife was there, in which case she would gut 'em like a carp and throw the chum to the other sharks.

In recent days I have seen the video of the CNBC meat puppet, Rick Santelli, do his outraged riff on "responsible taxpayers forced to subsidize losers' mortgages" and asking, theatrically, a room of Chicago stock traders whether they wanted to "pay their neighbors mortgage" (the answer was a mob-rule, "NO"). I have also received a number of e-mail jokes and comments indicating that the sub-prime mortgage debacle and subsequent world-wide financial meltdown can be blamed almost entirely on the overreaching, conniving, greedy and scheming homeowners, Santelli's "losers".

This viewpoint implies that nearly everyone who received a sub-prime mortgage--and subsequently found themselves underwater on their American dream--completely understood what they were doing. In fact, these messages and jokes imply that these borrowers were at least mildly larcenous or just incredibly stupid and stupid doesn't deserve a break.

With several million homeowners already booted out of homes for non-payment and millions more now facing foreclosure, there's little doubt that some of them were and are larcenous. The great majority, however, were simply ignorant as a box of dirt and, just as I did (three times), took the word of the real estate agent and mortgage broker (probably a former pizza delivery guy who bought two cheap suits at The Men's WearHouse and presto). Those "experts" told the buyers that everything "will be all right; sign here".

Assured by these experts that the American dream was now within their reach because of "new mortgage products", never mind the niggling details of equity, balloon payments, the LIBOR rate tied to adjustable interest rates, flapperschnapple, quirkenblanks, prasquattle, blah, blah, blah and then, "the house can be yours, sign here." Where's my pen?

Before you sit down with venom in your heart and fire in your fingers to write me, let me assure you that I do not hold these homeowners blameless. Most of these homeowners were ignorant and that is a fault that can be cured. I was ignorant about the mysteries of mortgages some time ago, but, and you will have to trust me on this, I wasn' t larcenous. Those of you without faults of ignorance about something in life please report to the Vatican.

Millions of potential homeowners were manipulated; O.K., O.K., let themselves be manipulated. Their desire for owning their home was stronger than their ability to overcome ignorance. My perspective is this: the manipulators shoulder far more of the blame than the manipulated. The manipulators weren't ignorant, they knew what was what.

Frankly--and I'm sure you all remember Frank--the mortgage brokers, the real estate agents, the mortgage companies and most of the the banks with mortgage divisions were themselves ignorant of the risks associated with sub-prime lending. Most of these people did not really understand the complex new derivatives that gave rise to sub-prime mortgage lending. Their collective fault was in not raising a hand, at the risk of embarrassment, and saying, "Wait a second, I don't understand this, please 'splain it to me." There was money to be made, Wall Street's quarterly expectations to be met, the risk was being passed on and the gravy train was leaving the station. All aboard.

There is much blame to parcel out. To conclude, however, that the bulk of it should be given to those least able to sort through the tangle of terms, promises and nuances is a very cheap shot, especially when it was the carrot of the American dream that was dangled before the wide eyes at the bottom end of the mortgage food chain. It's like blaming over-fishing on the fish.

So, who, you ask, should shoulder the bulk of the blame? Wall Street; a place where the moral compass is unusually wobbly thanks to the pull of money being stronger than magnetic north.

Some whiz with a math degree, a computer model and no experience in mortgage lending came up with a way to "securitize" (combine) mortgage debt and, mathematically, "take the risk out of it". Ha! That's like saying that you can mix a bit of fecal matter with a larger amount of clean water and it all magically becomes clean water. Also, the model only worked when housing values climbed INDEFINITELY or at least until the January bonuses were paid, whichever came first. The math whiz's boss knew that the model was shaky, but what the hey, bonus time was just around the corner. With the "no risk" mentality driving the industry, lots of folks who couldn't really afford the American dream were convinced that they could. After all, there was money to be made and the gravy train was constantly leaving the station. So, fog up a mirror, here's your loan. Everything will be "all right"; pat, pat.

Then, to cover their bonus larded butts, the Wall Street bosses sent out linguistically double jointed sales folks and they sold these "safe, mortgage backed, AAA rated securities" to town councils, retirement funds and other entities around the world. The rating agencies were in on the deal. The gravy train had room for them too. "Stringent regulation," said the bright bulbs in Washington, would strangle the economy and besides, everyone is entitled to own their own home. And so, lax regulation was the order of the decade leading up to the bubble pop.

When you assign blame for the current sorry state of the economy, I suggest that you parcel it out with some semblance of fairness. In my opinion, the great bulk of the homeowners who are in trouble and now need help are the least at fault, not blameless, but not the drivers. They had no idea that the American dream was (supposedly) within their reach until somebody, only marginally less ignorant, came along and convinced them so. The town councils also made their investment decisions based on trust. If you can't trust anyone, life is nearly unliveable.

If you have hard data that proves that a majority (or even a plurality; heck, I'd settle for anything above 10%) of the defaulted and defaulting homeowners in America are larcenous and cunningly taking advantage of those civic-minded paragons on the southern tip of Manhattan, please forward it to me. If the data are convincing I'll write a corrective blog. It's the least I could do.


Observoid of the day: A bag of hammers and a box of dirt are equally ignorant. Neither, however, is as ignorant as a carton of sludge.

Tuesday, March 3, 2009

Free Market Viagra

The healthcare reform debate is officially enjoined, now that Prez BHO has unveiled the new budget. Actually, the term "debate" is probably inaccurate because "debate" indicates patiently listening to the opposition and then calmly re-butting those points that seem most vulnerable. In debate, the exchange of facts is mixed with thoughtful opinion in order to reach, if not consensus, at least compromise. Our current cultural and media propensity is to ignore the rules of debate and simply yell at each other in what I call the Jerry Springer model of communication. We're due for a whole boatload of this competitive yelling over healthcare reform.

Already, we are hearing from such experts as Rush Limbaugh that BHO wants our healthcare turned over to "nanny state" bureaucrats and that the relationship between physicians and patients will soon be controlled by the government. Rush is on record as wanting Obama to fail. Oh, Momma! The gasbags on FOX relentlessly talk of "socialized medicine", as if they really knew what that meant, and that if BHO gets his way that we will get healthcare from the same slugs who inhabit the postal service and the IRS. Unless one parses and shines a light on all of this scary rhetoric, the warnings from the extreme right--you know, the kooks who insist that Governor Bobby Jindal's "Republican Reply" speech was a lollapalooza, whizbang homerun instead of an eighth-grade level presentation on "Why I Want to be a Politician" that it was--you could get the wrong impression of where the country is likely headed regarding healthcare. I encourage you not to swallow the extreme left's version either. They may believe it perfectible, but a healthcare system serving over 300 million people and run by humans will never be perfect and there will still be plenty to bitch about at the water cooler.

Speaking of Bobby Jindal, one would think, given his south Asian lineage, that when he changed his name to Bobby, which he did some years ago, that he would have opted for the "Bobbi" version with a tip-o-the-political-hat to Ghandi. But I, as I often do, digress.

America has, by very far, the most expensive healthcare system in the world. If you think that it is also the best and most efficient, you have dipped into the magic kool-aide. Our totally free-market system has brought America to a point where, for every man, woman, boy and girl we spend about $7,200 every year for healthcare. When I say "we" I include, patient out-of-pocket, insurance payments, government payments and borrowed payments. Given that the insurance money, government money and borrowed money originally came out of or will come out of the consumer's pocket, the annual $2.4 trillion bill for healthcare is consumer money.

With all of this spending, however, the World Health Organization (WHO) ranks the U.S. well down the list of countries whose healthcare systems provide the best outcomes. America ranks 37th out of 191 countries measured. Our infant mortality rate is the same as Slovakia and Poland and lags behind Cuba. As for "unneccessary deaths", a category for which the WHO (the organization, not the band) measured 19 countries, the U.S. is, pardon the pun, dead last.

Instead of being outraged by these facts, the Republican base insists that the solution is to let the free markets work without government intervention. There is one glaring error to this logic: America has reached our sorry state of expensive and inefficient healthcare solely through the magic of the free-market system. Why in the world, if the free market caused the problem, would the free market fix it, Bruce asks, rhetorically?

Here's the long answer: it won't.

In the book that I have just written,
The Baby Boom Delusion, a book that still needs a literary agent and a publisher lest it become a 251 page doorstop, I have a section that deals with this very problem. I posit the following: healthcare is a right, not a privilege, in much the same way that our national defense is a right or the use of the national highway system is a right and not based on privilege. If you don't agree with my position then you probably have health insurance and haven't experienced too much friction with the various systems that make up the industry.

Imagine, if you can, what our national highway system--roads, bridges, tunnels, et al--would look like if we let it be planned, delivered and maintained solely by the free-market profit motive. The "empty quandrant" of the great plains and mountain west would have very few highways and the ones that were there would be very expensive to use because a for-profit road system would be pay-as-you-go. On the plus side, no federal gasoline tax. Roads between small towns or far-flung tourist destinations would also be quite pricey. On the other hand, along the northeast corridor, the population centers of California, the industrial north and the Sunbelt, the number of roads, bridges and tunnels would spread, toll plazas would increase to capture revenue every few miles. Price competition and poor planning would mean that some infrastructure would fall into disrepair and be abandoned. "I get my kicks on Route 66....oops, big chunks of that are gone. Never mind." Those without much money couldn't use the road system unless those with money stooped to subsidize the poor, unfortunate traveler, all the while grumbling, "They should have made better choices". Finally, the impact on the nation's economy of a road system organized, run and maintained in a strictly for-profit environment would likely be a disaster.

Of course the national highway system still makes many companies bunches of money in a free-market way. The road designers get paid, the road builders get paid, the asphalt, rock and sand suppliers get paid, the equipment manufacturers get paid, etc. etc. There is plenty of free-market competition. The one area where we eliminate the free-market is in the pooling of taxpayer money to pay for and plan where the roads ought to go for the benefit of all. It ain't perfect but it works pretty well.

Back to healthcare. If the biggest things we do to re-design healthcare are to (1) make sure that everyone takes part and (2) to centralize the planning and payment, there is still a ton of free-market activity remaining in the system. It would certainly be a long-long way from the British model of "socialized medicine" where the whole shebang is owned by the government (even so, the Brits are ahead of us in the WHO rating). U.S. docs would still be for-profit, as would the clinics and hospitals, medical equipment would still be produced in the private sector, big pharma would still be for-profit and so on. The nanny state would then be "running" healthcare in much the same way that it passively "runs" the highway system day-to-day. The government does not decide where you go on the highway system, nor when; you do. I contend that this would be a good thing in healthcare as well and for much the same reasons.

I have much more to cover on this topic but you will have to wait with bated breath until subsequent blogs. Until then, suck on a breath mint.


Observoid of the day: The "young and ignorant" have a shot at becoming the "old and wise". The "young and stupid" merely become the "old and stupid".