ShrinkWrapped

The Open Mind I: Call Me Irresponsible.

Jay has provided his first post in this endeavor and he has taken an interesting route, apparently in response to comments from my readers.  I am putting up his post in full and will try to put together a cogent response in the next day or two.  I am putting up a link to his post, as well, and will not have comments on this blog to his posts, so anyone wishing to comment should go there.  In your comments, please attempt to be clear, polite, and to the point.  This experiment is designed to see if it is possible to have dialogue between people who have some fundamental political disagreements.

The Open Mind I: Call Me Irresponsible.

Dear Shrink,

By this point I’ve enjoyed my long draft of Alka Seltzer (extra strength – and lemon-lime, to obscure that particular bitter taste), and brought up the deep grepts that expells the heavy load of indigestion.

I confess, I had hoped for a different beginning. But then I, according to some, am a liberal who, by definition, lives in a world of foolish hopefulness (and that is putting the best face on it). You, it appears, have some similar, non-defining impulse, too. You should check that in yourself.

The response of your commenters has changed the game.

The Israel Test: Prelude

I am in the middle of George Gilder's The Israel Test, and plan on offering a review when finished.  In the meantime, Gagdad Bob has already done a superb job capturing Gilder's thesis.

He first posits that Israel Has No Right to Exist, but don't be alarmed, he is just setting his readers up:

Now that all of the anti-Semites have eagerly googled their way here, let me repeat that Israel has no "right" to exist. Rather, it has an obligation to do so.

Someone once said -- can't think of who at the moment -- that the purpose of culture was to produce a few great men. That being the case, perhaps the purpose of man is to produce a few great cultures.

First of all, this has nothing to do with the infinite worth of the individual. Rather, it has more to do with how one culture -- say, the Palestinians -- produces monsters by the truckbombload, whereas another -- oh, say, Israel -- produces more human greatness on a per-keppellah basis than any other.

For a bonus, Bob offers a decent definition of Projective Identification, which is a useful concept for understanding how the world operates, including the blogosphere viz its trolls.  Bob continues: 

For Gilder, Israel -- or the Jewish people -- is like an ax that conveniently cuts straight through the center of mankind. On one side you will have people who believe in freedom, achievement, and especially creative excellence. On the other side you will have people who believe in "fairness," in zero-sum economics, and in collectivism, but the practical effect is an envious attack on excellence -- and the cultural means to excellence.

Again, we are speaking in truisms, given the staggering amount of human excellence produced by the Jewish people. All decent people should be supporters of Israel -- indeed, even all indecent people, if only for reasons of pure self-interest, given the staggeringly disproportionate contribution they make to advances in science, including, of course medicine. In all likelihood a Jew will save your life many times over if he hasn't already (cf. nuclear physics).

In fact, if I were president, you know what I'd say to Ahmadinejad? I'd say how pathetic that you must rely upon Jewish physics to defend yourself! If this isn't a stark admission of the utter failure of Islamic science, I don't know what is. But anyway, thank you for admitting the superiority of the Jewish people, you frightful pig.

[Now might be a good time to read, or re-read, Pity the Poor Anti-Semite, which explains why Ahmadinejad ends up unconsciously idealizing the Jews who he hates so much.]

In the second part of his review, Israel and the Defense of Civilization, Bob illuminates how Game Theory explains why the Peace Movement is the greatest danger we face:

In The Israel Test, Gilder discusses how game theory explains why even (or especially) good people end up encouraging evil. This is especially true of the left, since in implementing policies, they only consult their good intentions, never the system of incentives -- the rules of the game -- they are putting in place. This is why they can never see that the long term results of those incentives usually aggravate the problem the policy was designed to address.

This is also true of the moral simpletons who imagine that wanting peace is the only barrier to having it. In reality, the more one communicates the desire to have peace with evildoers, the more power one gives them.

In the case of Israel, "by relentlessly seeking Peace Now," they have "predictably communicated to the Arabs that terror and aggression work. By repeatedly informing the Arabs that it wants peace more than victory, Israel evinces a short-term strategy that powerfully and consistently rewards bad behavior. As a result, Israel gets neither peace nor victory, and the Palestinians get neither economic growth nor political progress" (Gilder). By appeasing evil, only the good suffer, both in Israel and in the Palestinian territories (which, due to their proximity to Israel, had by far the highest standard of living in the Arab world before declaring the most recent intifada in 2000).

According to game theory, a long-term player will be penalized for doing business with a short-term player. Imagine if every business transaction were with someone you were never going to do business with again. This would encourage predatory and dishonest behavior on the part of the seller. We would live under the economic law of the jungle.

Note that this is not a result of anyone's intentions, just the rules of the game: "In a single exchange, the rational policy is predatory. If predatory action brings success, a player is never induced to extend the time horizon. By accommodating aggression, a nation invites it. Peace requires the imposition of penalties on aggression."

Oddly, the left understands how this principle applies to illegal and predatory activity on Wall Street, but does not apply that lesson to the world.

As Gilder explains, "the single greatest domestic threat to the United States is not the jihad but the peace movement." Just last week, Obama voiced his desire to rid the world of nuclear weapons, which makes him the most powerful ally and abettor of evil in the world. Again, his intention is "peace," but the result would be an unprecedented escalation of violence and aggression.

The Israel Test is an important book.  It offers a frame for understanding the conflict in the Middle East and in the larger world between those forces that aim to enhance and extend civilization and those that aim to destroy.  Our increasingly complex society depends on technology.  Like the pelagic shark that must keep moving in order to survive, our technology cannot become stagnant if we aim to survive as a civilization.  It is always hard for people to imagine that our way of life could change yet we are always merely two weeks away from chaos.  There are powerful forces in array against the future, including large parts of the left that wittingly or unwittingly support the barbarians, and a new dark ages is never far out of the question.  When I write my review of Gilder's book, I will expand upon this thesis.

Denial of Service

One important issue used to support single payer, government healthcare is that the insurance companies deny payments far too often.  One reason I stopped accepting insurance coverage many years ago was that I would often find claims denied because my paperwork was late or had minor errors. 

Interestingly, private insurers actually appear to deny claims less often than government insurers: [HT: the Lumberjack, who you should be checking out everyday, since we all need a good laugh once in a while.]

AMA Endorses Largest Denier of Health Care Claims 

Beverly Gossage, Research Fellow for Show-Me Institute and founder of HSA Benefits Consulting wondered which insurance companies rejected the most claims.  She found her answer in the AMA’s own 2008 National Health Insurer Report Card.  The chart below appears on page 5 of the 16-page report.

 
Of the eight insurers listed, Medicare is most likely to reject a claim, sending away 6.85% of requests.  This is more than any private insurer and double that of the private insurers’ average!

Who would have thought it?

Progressive Myopia*

Progressive Myopia is a degenerative condition of the eye leading to blindness.  Our partisan myopia is a degenerative condition leading to political blindness and is on display today.

Roger Cohen writes today on the healthcare debate, affirming The Public Imperative:

Whatever may be right, something is rotten in American medicine. It should be fixed. But fixing it requires the acknowledgment that, when it comes to health, we’re all in this together. Pooling the risk between everybody is the most efficient way to forge a healthier society.

Europeans have no problem with this moral commitment. But Americans hear “pooled risk” and think, “Hey, somebody’s freeloading on my hard work.”

To imagine that the debate about healthcare simply factors down to concerns over someone else "freeloading" is trite and inane.  Are there aspects of such an argument in the debate?  Of course, yet the debate has seen some fairly sophisticated analysis of the dangers that some of the proposed changes will engender.  My particular concerns have been for the threat to innovation (see here for a current example) and the disincentives for our smartest young people to go into Medicine, but there have been a great many other particulars discussed by many other very smart commentators.  For Cohen to base his entire article on this idea is not only lazy but smacks of someone trying to find a way to discredit "the other side" rather than someone willing and able to engage in an open and honest good faith debate.

Paul Krugman, in his inimitable style, goes Roger Cohen one better (or would that be one worse?)

The Politics of Spite

There was what President Obama likes to call a teachable moment last week, when the International Olympic Committee rejected Chicago’s bid to be host of the 2016 Summer Games.

“Cheers erupted” at the headquarters of the conservative Weekly Standard, according to a blog post by a member of the magazine’s staff, with the headline “Obama loses! Obama loses!” Rush Limbaugh declared himself “gleeful.” “World Rejects Obama,” gloated the Drudge Report. And so on.

So what did we learn from this moment? For one thing, we learned that the modern conservative movement, which dominates the modern Republican Party, has the emotional maturity of a bratty 13-year-old.

But more important, the episode illustrated an essential truth about the state of American politics: at this point, the guiding principle of one of our nation’s two great political parties is spite pure and simple. If Republicans think something might be good for the president, they’re against it — whether or not it’s good for America.

Lets immediately note that Krugman conspicuously fails to mention the noxious rhetoric that came from his side of the divide, including barely disguised wishes for the United States to lose in Iraq (see Michale Moore's "Minutemen" quote, et al) all through the Bush administration.  For Krugman to fail to appreciate that the Right found some Schadenfreude in Obama's Olympian humiliation for a host of reasons, the least likely being any pleasure at America failing, is disingenuous at best, an example of Progressive Myopia at its most overt.  Krugman is a bright man so when he misses the point by such a large margin, it suggests that he is looking through a progressive lens that damages his perceptions.

There are some genuine reasons brewing that should be cause for disquiet on the Progressive side of the partisan divide, but their appearance in the Progressive sphere is minimal.  Honest Progressives should be horrified by the Obama administration's efforts to support the UN in its attempts to limit Freedom of Speech, a right generally accepted as a fundamental in America.  As per Anne Bayefsky: [All emphases mine-SW]

You Can't Say That
At the UN, the Obama administration backs limits on free speech.

The Obama administration has marked its first foray into the UN human rights establishment by backing calls for limits on freedom of expression. The newly-minted American policy was rolled out at the latest session of the UN Human Rights Council, which ended in Geneva on Friday. American diplomats were there for the first time as full Council members and intent on making friends.

President Obama chose to join the Council despite the fact that the Organization of the Islamic Conference holds the balance of power and human rights abusers are among its lead actors, including China, Cuba, and Saudi Arabia. Islamic states quickly interpreted the president's penchant for "engagement" as meaning fundamental rights were now up for grabs. Few would have predicted, however, that the shift would begin with America's most treasured freedom.

For more than a decade, a UN resolution on the freedom of expression was shepherded through the Council, and the now defunct Commission on Human Rights which it replaced, by Canada. Over the years, Canada tried mightily to garner consensus on certain minimum standards, but the "reformed" Council changed the distribution of seats on the UN's lead human rights body. In 2008, against the backdrop of the publication of images of Mohammed in a Danish newspaper, Cuba and various Islamic countries destroyed the consensus and rammed through an amendment which introduced a limit on any speech they claimed was an "abuse . . . [that] constitutes an act of racial or religious discrimination."

The Obama administration decided that a revamped freedom of expression resolution, extracted from Canadian hands, would be an ideal emblem for its new engagement policy. So it cosponsored a resolution on the subject with none other than Egypt--a country characterized by an absence of freedom of expression.

...

The new resolution, championed by the Obama administration, has a number of disturbing elements. It emphasizes that "the exercise of the right to freedom of expression carries with it special duties and responsibilities . . ." which include taking action against anything meeting the description of "negative racial and religious stereotyping." It also purports to "recognize . . . the moral and social responsibilities of the media" and supports "the media's elaboration of voluntary codes of professional ethical conduct" in relation to "combating racism, racial discrimination, xenophobia and related intolerance."

This should disturb Progressives.  After all, the modern left received a major infusion of credibility and youthful energy from the Berkeley Free Speech Movement of the early 1960s.  Yet they are now willing to sell their birthright for warm feelings from the world's worst despots.  Where are the Progressives warning the Obama administration of the danger to our most cherished rights?

[I am not naive.  I know that the left has been trying to shut down debate for years, but there should be some who actually believe in their professed beliefs.]

Ross Douthat notes an even more problematic issue for the Progressives. 

Not long ago, liberals were insisting that income inequality was America’s most serious economic problem.

The latest census figures show the gap between the wealthiest Americans and everybody else widening — rather than shrinking, as some economists expected — during the crash of 2008. An August report from Bank of America/Merrill Lynch suggested that middle-income Americans, buried in real-estate debt, will have to wait much longer than the rich to see their finances rebound.

This landscape will put liberalism to the test. Since Ronald Reagan was elected nearly 30 years ago, Democratic politicians have promised that their program could reverse the steady post-1970s growth of income inequality without sacrificing America’s economic dynamism.

But having promised win-win, they may deliver lose-lose. In the short run, Barack Obama could preside over an America that’s more economically stagnant and more stratified.

There’s only so much that politicians can do about broad socioeconomic trends. The rise of a more unequal America is a vexingly complicated issue, whose roots may wind too deep for public policy to reach.

Liberals, though, have spent decades telling a more simplistic story, in which conservatives bear all the blame for stagnating middle-class wages and skyrocketing upper-class wealth. So it’s fair to say that if a period of Democratic dominance doesn’t close the gap between the rich and the rest of us, it will represent a significant policy failure for contemporary liberalism.

Progressives have long declared they were the repository of societal fairness.  Barack Obama, when out of reach of his teleprompter, on more than one occasion declared that fairness was more important than efficacy when it came to economic and taxation policy.  If the Progressives fail to deliver greater fairness, they will have nothing to offer their supporters,  yet it apparently required the lone Conservative voice at the New York Times to mention this inconvenient truth.

I could go on.  The hoax at the core of the Anthropogenic Global Warming scam (the now shown to be non-existent "hockey stick") has not yet found its way into print, and is worth a post of its own, yet the resounding silence from the Progressives suggests a blindness that is worsening.  The Progressives clearly have a debilitating case of Progressive Myopia. 

*A more appropriate title for this post would be Partisan Myopia; although my focus is on the Myopia of the Progressive side of the political divide, there is plenty of Myopia on the right as well.  The irresistible pun and my tendency to more clearly see the Myopia on the left made the title unavoidable.

The Open Mind is Delayed

Jay has run into some stumbling blocks (it sounds like his work is interfering with his obviously more important blogging) and will be posting his first effort in the next few days.

The Open Mind: Introduction

Two of the most common problems that blogs can fall into involve a descent into monotony and partisanship.  When you blog on a daily basis, your repertoire can easily become predictable and boring.  As well, there is a powerful temptation to write to your audience, which can all too easily lead to a confusion of partisanship with political philosophy.  I try to avoid both temptations but occasionally catch myself resorting to the "easy" path of either echoing writers whose work I admire or "fisking" writers whose work I find shoddy, rather than coming up with original thoughts of my own. 

[When I find myself at a loss for a topic the easiest thing in the world is to read Thomas Friedman and point out his inconsistencies and inanities.  When I am really stuck, there is always Roger Cohen and Bob Herbert; fish in a barrel comes to mind.]

In an effort to avoid predictability and increase the level  of discourse, I have tried over the last few years to engage in productive and constructive discussions with liberals on numerous occasions; it has been difficult.  Blogs tend to elicit tendentious arguments and invective and all too often disagreement is taken as evidence that those holding opposing opinions are not only wrong, but evil or mad. 

Recently I have been involved in an interesting exchange of e-mails and opinions with Jay Adler, the proprietor of The Sad Red Earth.  Our exchanges led to the suggestion that we do a blog experiment, to see if we could speak to each other and to our readers in an open minded manner.  Here is Jay's description of the endeavor:

Announcing “The Open Mind”: Shrink vs. Scribe

As a recurring feature of both of our blogs, we are going to take on the issues that bedevil relations between right and left, maybe even toss some wild cards on the table for the pleasure of it. We agree on very close to nothing. But we intend – we hope – to avoid the usual debate. We already know we think the other is wrong. You can seek the shouting and the name calling all day long on web and tube. What we hope to make the sharper focus of our effort is the attempt to understand, as SW so well put it, “how two reasonably bright, reasonably decent people can disagree so significantly in their perception of reality.” We have agreed to try mightily not to descend to the usual incredulous insult. We will, if necessary, discover the other to be regrettably mentally impaired rather than a sorry ignoramus.

The plan is that on an alternating basis, one of us will post on a topic, and the other will respond after about twenty-four hours or so. We will cross-post on each other’s blog so that post and response are viewable at both sites. Our valued readers are independent agents (and don’t we love it!) so you will, of course, do as you please, but it probably makes the most sense for comments to my posts to be made at the sad red earth and comments to SW’s posts to be made at ShrinkWrapped. Sometimes, if the spirit or argument moves us, we will follow up on our post and response – maybe, in part, because of your comments.

I have suggested to Jay that when we cross post his posts on my blog I will close comments and direct my readers to make their comments on his blog.  My hope is that our commenters will avoid the easy routes to what  passes for discourse these days and actually try to engage in substantive argumentation.  That implies that people will be polite, there will be a minimum of ad hominem arguments and, hopefully, no name calling.  Jay, again:

We hope for some intellectual pleasure, and even – dare I say it – some opened minds. Regardless, it’s worth considering, amid the differences that roil us now, that at the very founding of the nation, Americans, all, argued about – would you believe it – how much power should be granted the federal government, whether there should be a national bank, and (contemplate this one) whether human beings should be trafficked and owned as slaves. Of course, they agreed about much more: democracy, the rule of law, the Bill of Rights, the freedom to pursue our individual destinies, and, you know, it is time to remember, and never forget – that all this land should be taken, through innumerable wars and countless deceits and abuses, from the people who first lived on it.

I think there is a great deal to gain from making a good faith effort to understand each other and am looking forward to watching how this evolves.  The best way to hone one's arguments and one's thinking is to have someone critique what you say and force you to defend it.  We often fail to recognize our own assumptions.  It is possible that we will find, and enlarge upon, some areas of agreement.  It is more likely that Jay and I will end up most of the time "agreeing to disagree"  but more likely that we won't; if we can become clear about why we disagree, that will be an important achievement.  If we are both forced to clarify our thinking and the assumptions that motivate our thinking, we will both end up wiser for the effort.

Jay has volunteered to go first.  His post will be on his site and here on  Monday.

In the meantime, by all means visit The Sad Red Earth and poke around a bit.  Especially take note of his post announcing The Open Mind.  He has a picture of himself (OK, a cartoon) and a picture of Kevin Spacey playing me that doesn't do me justice; both are worth checking out.

The Healthcare Debate Premises: Addendum

There is an excellent article in reason magazine which considers the costs and benefits of medical innovation.  Here are the key memes:

Does High-Tech Medicine Mean Higher Health Care Costs?

... in June, Columbia University economist Frank Lichtenberg published a new study that suggests advanced medical technologies are not contributing all that much toward rising U.S. health care expenditures.

Lichtenberg's key finding is that life expectancy increased faster in states that more rapidly adopted advanced diagnostic imaging techniques, newer drugs, and attracted an increasing proportion of doctors from top medical schools.

...

It's not too surprising that high-tech medicine and better physician training boost life expectancy, but what about their costs? To answer that question, Lichtenberg looked at per capita medical spending by state. The top six states used advanced imaging diagnostics roughly 30 percent more often than the bottom six, for instance, making them ripe for comparison. He found that the states with larger increases in high-tech diagnostic procedures, newer drugs, and higher quality physicians did not have larger increases in per capita medical spending.

Read the whole thing and keep in mind that every government run healthcare system treats innovations as expenses to be minimized rather than as opportunities to enhance life.  This is inevitable and one of my major reasons for opposing the current plans for fundamental reform in how we finance our healthcare.

The Healthcare Debate Premises

Recently I sent an e-mail to a number of friends describing one person's experience with the overly bureaucratic healthcare system in Canada.  Recently, in response to intractable problems in the public sector, Canadians decided to allow a private option.  One response in particular stood out; it was brief but contained the core of the Democratic argument for Obamacare:

This is not the experience of the many associates I have in Ontario.   If this claim is legitimate I feel for this fellow.  No system is perfect.  Our system is discriminatory and not available to all.  The quality of our care is also not necessarily world class overall either.  

First of all, the comment that "our care is also not necessarily world class overall either" is simply incorrect.  There are reasons people form around the world come to America for care that they cannot receive at home.  But leaving such notions aside, there is much to agree with in mu friend's brief note.  It is a banal truth that "No system is perfect."  If that were the end of it, there would be nothing t o discuss.  However, the idea that "Our system is discriminatory and not available to all" is worth parsing.

I do not know what my friend means by claiming our system is discriminatory.  If by discriminatory he means that not every person can have access to any Doctor, I suppose there is some obvious truth to that.  Otherwise I am at a loss.  No one can be turned away from an Emergency Room.  No one is denied Medical care because they lack the means to pay.  Certainly, if someone has enough money they can afford to go to the best institutions and the most renowned Doctors (who often do not accept most insurance.)  People routinely go "out of network" for care when they are dissatisfied with their treatments.  Because their insurance premiums have been held down by using only approved in-network Physicians who accept lower fees for the privilege, the patients are expected to pay a premium to go out of network.  This, however, is hardly discriminatory except in the most literal meaning of the word.  Again, I am at a loss to understand what is discriminatory about American Medicine.

It seems to me that the issues we should be addressing when examining our healthcare system are two fold. 

1)  How do we allocate scarce Medical resources?

2) How do we expand most rapidly the pool of scarce resources?

Those who propose wholesale reform of the healthcare financing system are making a systematic error.  Obamacare treats the healthcare pie as a zero sum system; they assume that the healthcare pie can only expand very slowly and that resources will remain limited forever.  For that reason none of the proposals in Congress address the supply side of medical care but only the demand side.  In fact, by attempting to expand the pool of patients for whom healthcare will be divorced from the actual cost of their care, the current plans will make the scarcity far worse, and permanent.

Were we to address Problem 2 and work on ways to increase the size of the pie, we could ultimately make healthcare more affordable and more available.

For example, there are a great many very bright young people who would at one time have been planning careers in the financial industry who are now faced with the necessity of changing career paths.  Many of them are quite talented in math and science (Physics PhDs have had an affinity for jobs as Wall Street "Quants") and could become Doctors, Nurses, and other healthcare professionals.  The problem for the brightest, best students, is that going to Medical School means facing up to a $200,000 debt as an entry fee to a field where the compensation is being pared away year by year.  Obamacare will make this worse; fees to Doctors will have to either continue to decrease of fail to keep pace with expenses all the while the Doctors are expected to see more and more patients.  This is a formula for less Doctors, not more.   

Beyond the supply of Doctors, there is the fact that healthcare is becoming an Information Science with all the implications that that has for the price curve.  When any technology become an Information technology, the price of new developments always starts out very high, available only tot he wealthy, early adopters, and soon makes its way down the socioeconomic ladder.  The first cell phones were prohibitively expensive and barely functional devices.  Now they can be made so cheaply that you can buy a disposable phone for a dollar.  New medications start off very expensive (much of the expense caused by our overly conservative regulatory regimen) and rapidly descend in price.  When Lipitor was first developed, it was available to a limited number of patients; now Statins are available to anyone who might need or benefit from one.

Where the proponents of Obamacare make their error is to assume that fairness requires that we upend a system that works for most people and provides innovation that makes the lives of everyone better.  There are many tweaks we should entertain before deciding on wholesale changes that will make the system function less efficiently and, as a bonus, damage the prospects of innovation.  If I were convinced Obamacare would be efficient, fair, and increase innovation, I would be fully supportive; if anyone can tell me a government program that has increased efficiency, fairness, and innovation, I'd be delighted to hear of it.  It would be a first.