The Ayatollah of Health Care

I know health care is a hideously complicated subject, and it is more than likely I am talking doggy doodoo, but here is what I think I know.

There was never any chance, whatever, that Obamacare was going to reduce costs, and everybody knew it at the time.  Except, possibly, Barack, who does not care about cost.  Cost was never an issue for him.

Barack wants to lead a revolution, nationalized health care is a means to an end, and he channels the late Ruhollah Khomeini, master of the 1979 Muslim revolution in Iran.  It was once explained to Khomeini that certain of his plans would have adverse economic consequences, to which he famously replied, "This revolution is not about the price of watermelon."  As with Khomeini, so with Barack.

Oh, the old American health care system certainly could have benefited with some tweaking, here and there.  Maybe a lot of tweaking.  But nothing more than tweaking.  Certainly, there were some inefficiencies and some fraud, but there never were massive inefficiencies, or massive frauds, and rising costs were not due to the rising costs of established medicines and procedures.

It is not as if we are paying more for aspirin, for example.  To the contrary, we are paying much less.  Consider aspirin prices in Morris County, NJ.  In 1932, aspirin cost 1¢ per pill.  Prices varied over time, and in 2012 aspirin cost 3¢ per pill.  Nominal prices.  In real dollars (2011), aspirin cost 16¢ per pill in 1932 and just under 6¢ per pill in 2012.  A 62.5% drop in the cost of aspirin in the 80 yr span.

And that's how it is with all old, established medicines.  The "problem", especially over the last 30 years or so, is that pharmaceutical companies have developed a wide range of miracle drugs, real life savers.  It may well be true that Big Pharma extorts obscene profits, but it is also true that it can cost half a billion dollars to bring a new drug to market.  There is no way around the evident fact that, these days, we are buying aspirin and a whole lot of, very expensive, new life saving medications.  In other words, we are buying more health care and we have to pay for it.

The same with medical procedures.  Before 1967, nobody was buying a heart transplant because no such thing existed.  The first heart was transplanted in December, 1967, it then took a while for the expertise to spread, and these days there are about 2,000 transplants a year, in the U.S. alone.  Should I mention this is an expensive procedure?  Well, the more heart transplants (and other daring, new, and very expensive procedures) we buy, the more we have to pay.  It's really that simple.

There is also a well known allocation problem in health care.  It is a strange but true fact that fully 30% of all Medicare expenditures are made in the last year of life.  As the population ages, this will get worse.  Does this enormous expense really make sense?  Almost certainly not.  Now, you explain to your neighbor that he cannot spend money on his beloved, dying mother.  See the problem?  The problem is that we have to pay for what we want.

In other words, unless Obama was going to withhold new medicines, or withhold new procedures, or withhold some significant amount of care from the elderly, there was no chance he was going to reduce costs.  To the contrary, as he put more people on the health insurance rolls, costs had to go up.

And so they have.

African Levels of Corruption

Many years ago, maybe 25 or so, I read an article in "The Economist" newspaper about public corruption in Africa.  "The Economist" tried to convey the staggering level of corruption with a joke.  I have not been able to find this joke anywhere on the internet, so I write it down here, from memory.

First, you have to know that the London School of Economics is an astonishingly influential institution.  Many young people, who go on to positions of power and influence in their home countries, are educated at the LSE and develop personal friendships there with young people from other countries.  Indeed, the LSE has educated more than a few prime ministers and dictators.  The story:

Two young students at the LSE, an African and an Asian, became fast friends and stayed in touch after they returned to their home countries.  Both developed influential careers in the service of their respective governments.

It came to pass, after some years, that the African had an opportunity to travel to East Asia.  His Asian friend from the LSE was delighted to receive him into is large and beautiful home, where they ate an elegant dinner.

Enjoying their after-dinner cigars and cocktails, on the balcony with a lovely view, the African could not help asking, "I am delighted at your success, but how can you afford all this on a government salary?"

The Asian pointed out into the distance and asked, "Do you see all that development?"  The African looked out and saw earth moving equipment, construction cranes, and all the obvious signs of a great deal of work happening.  He nodded.  The Asian then proudly tapped himself on the chest and explained, "10%".  Meaning, of course, that in bribes and kick-backs, he had skimmed into his own pocket 10% of the expenditures on the development.

The African nodded in understanding.

A couple of years later, the Asian had the opportunity to travel in Africa.  His African friend from the LSE was delighted to receive him.  Upon arriving, the Asian drove up to a palatial estate where he was received by liveried servants and they enjoyed a sumptious meal.

Enjoying their after-dinner cigars and cocktails, on a balcoy with a spectacular view, the Asian could not help asking, "I am delighted at your success, but how can you possibly afford all this on a government salary?"

The African pointed out into the distance and asked, "Do you see all that development?"  The Asian looked and looked and could see nothing but virgin wilderness.  He turned to his friend with a curious look on his face.  The African then proudly tapped himself on the chest and explained, "100%".

And that, ladies and gentlemen, is African levels of corruption.

The Most Qualified Something-or-other

For the Nth time, recently, I have heard that Hillary Rodham Clinton is the most qualified presidential candidate in history.  And I'm wondering, what on earth can that mean.

So far as I know, there are exactly three qualifications for the presidency.  The candidate must:

1. Be a natural born citizen,
2. Be at least 35 yrs of age, and
3. Have won the election.

The brother-in-law who has been sleeping on your couch for the last six months would be qualified for the presidency, if he won the election.  Of course, we tend to look for some more qualities in our presidents and that, I think, is the key to making sense of the Left's assertion.

Keep in mind, the Left are saying Hillary is the most qualified candidate "In History"!  More qualified than George Washington?  More qualified than Abraham Lincoln, Franklin Roosevelt, Dwight David Eisenhower?  Really?!  Obviously, their meaning of "qualified" is rather different from what you and I mean by it.

The presidency is an executive office.  More, the president is the Commander-in-Chief of the armed forces.  Historically, we looked to men with a track record of getting things done, and we have had a strong bias towards men with military experience.  Two thirds of all presidents have had some kind of military experience.

Dwight David Eisenhower, 34th President of the U.S., General of The Army, was Supreme Commander of Allied Forces in Europe during the greatest war in human history.  George Washington created the U.S. by leading men in battle under desperate circumstances, and then declined the crown that was offered him (I still can't get over that).

But, Washington did not lie about a non-existent rape culture.  Eisenhower did not lie about gender pay equity.  Evidently, in the minds of the Leftists, lying about gender pay equity makes Hillary Rodham Clinton more qualified than Dwight David Eisenhower.

You should come to your own conclusions about that.

Political Anaphylaxis

Is it worth saying that Trump and Clinton are not, themselves, the problem?  They are mere symptoms of the problem.  It's not as if everything has been peachy all along with American politics and then, all of a sudden, two monsters appear out of nowhere.  Rather, American politics have been corrupt, and getting more corrupt, certainly since the first Clinton administration, if not before.  I would say the rot started in 1942 (under a Democratic administration, unsurprisingly) with the Wickard v Filburn decision of the SCOTUS.

Roscoe Filburn, an Ohio farmer, grew wheat entirely for his own use, to feed his animals, selling none of it on the open market.  And yet, the SCOTUS decided that Filburn, by minding his own business on his own property, was violating the **Interstate** Commerce Clause.  So, the federal government wanted to regulate the actions of a private citizen on his own property, and the Supreme Court agreed, using a legal argument indistinguishable from Jabberwocky.

With the Wickard decision in mind, how can you be surprised with the 2005 SCOTUS decision, Kelo v City of New London?  In that decision, the state expropriated one private citizen's private property to give it to another private citizen.  From Wickard to Kelo, the Constitution had come to mean nothing.  So, in 2010 when then Speaker of The House, Nancy Pelosi was asked by what Constitutional authority did Congress enact the Affordable Care Act, she responded, "Are you serious?"  It was perfectly clear that Pelosi could not give an answer because she did not care about the question.  The Constitution had become irrelevant to the the most powerful member of the People's House, the person third in line to the presidency of the U.S.

As Angelo Codevilla has observed, as Mark Levin has observed, as has been observed by more than a few people who pay the least attention, we have been living in a lawless society for more than a while, already.  No wonder Hillary Clinton feels she can do whatever she likes.  If the Constitution does not mean what it says it means then, in the notorious words of Al Gore (March, 1997), "There is no controlling legal authority."

How has it come to this?  How do we get two of the most despised people in the country contending for the presidency?  I think the answer is self-evident.  As our politics have become more and more corrupt, good people have declined to dive into the political cesspool.  Criminals and weirdos are all we have left.  Or, as Edmund Burke would have it, “All that is necessary for the triumph of evil is that good men do nothing.”

I can say only this in defense of the repugnant Donald Trump (I have thought him repugnant long before he entered politics).  A vote for Hillary Clinton is a vote for the status quo, for continuing and worsening public corruption.  Donald Trump, however distasteful, however inadequate, is a reaction to the corruption.  Donald Trump is the incarnation of "Throw the bums out."  He is the anaphylactic shock in the body politic. And that, friends, is as good a reason as any to reject Hillary Clinton and vote for Donald Trump.

Oh, do *I* sound like a crackpot?  Then let me remind you that come Jan 20, 2017 one of Hillary Clinton or Donald Trump will be our next president.  And if you have not yet absorbed that kick in the nuts, then you are the crackpot.

After the Republic

Marxists make much of the "contradictions" in capitalism.  Turns out their notion of contradiction is trivial, if not vacuous.  However, in his long-ish but fascinating, and depressing article, After the Republic, Professor Angelo Codevilla makes me think of the real contradiction in American democracy.

The foundational idea of the American experiment is that individuals should mind their own business and government should mainly stay out of the way.  If this idea was ever valid, it was valid for only a fairly narrow slice of the population that existed at the time of the American Revolution.

Please remember that the American Revolution was really the first American civil war.  Fully half the population remained loyal to the English crown, there was considerable internecine fighting, and a significant portion of the population decamped to Canada, mainly southern Ontario, where the Loyalist heritage is still remembered.

In other words, lots of people, maybe most people, want to be slaves.  For example, there is an entire civilization, of some 1 1/2 billion people, predicated on the notion of abject submission.  Now, it is one thing to be born into Islam, quite another to see Westerners voluntarily converting to a religion in which they are promised slavery, most especially women.

The will to slavery reveals itself in many other ways.  Socialism is nothing but a cri de coeur of the large mass of the people who want somebody else, the government, to run their lives for them.

Conversely, there are a few people with a "will to power", which brings up the other part of the American contradiction.  One can imagine a government of limited power, but it is harder to think of individuals who voluntarily decline power.  George Washington, the towering figure of the American Revolution, did something that, if not unique, most certainly is very rare in the human experience.

After the victory over the British, Washington was offered the crown.  He was, actually, invited to become king of the United States.  A lesser man would have accepted.  Washington replied something like, "Thanks, but I'd rather go fishing."  And for nearly 100 years, the U.S. was true to its ideal of private property, limited government, and rule of law.

But George Washington was exceptional in almost every way imaginable.  What you have to imagine now is a POTUS who wants less power not more, senators who want less power not more, congressmen and judges who want less power not more, etc.  Friends, this is not the way of the world.  And that is the American contradiction:  the powerful few want power and most people want to be slaves.  The mystery is that the American Experiment lasted as long as it did.

I am glad to have lived in it for a time.  I am very sorry to see it wither away.  And I am very sorry for the America our children will inherit.  If Donald Trump is elected president, it may wither slower;  if Hillary Clinton, then faster.  But the withering seems inevitable.  I suspected this in 2008 with the election of the fatuous and vacuous Barack Obama.  President Hillary Clinton would bring certainty.

Your Move, FIDE

The WaPo, coming late to the party, reports on the boycott, led by the unfortunately named Nazi Paikidze, of the Women's World Chess Championship because it is to be held in apartheid Iran.  Since the WaPo article is all I know about her, I cannot tell if Nazi is a political moron or a political genius.  She may well be a political genius.

Of course, I approve her move wholeheartedly.  But, listen to her explanation,

A message to the people of Iran: I am not anti-Islam or any other religion. I stand for freedom of religion and choice. I'm protesting FIDE's decision not because of Iran's religion or people, but for the government's laws that are restricting my rights as a woman.

She is distinguishing between the government of Iran and the religion of Islam.  But, Iran is a theocracy and nobody there is confused on this point.  Any attack on the government is, per force, an attack on Islam and that is how Iranians see it.  Some, probably many, Iranians may even welcome such an attack, but an attack it surely is, in their eyes.

On the other hand, Westerners are deaf, dumb, and blind to any religious motivation.  The writer Sam Harris makes much of this point.  For example, Westerners have no trouble understanding that Europeans enslaved Africans out of economic self-interest, but they are wholly incapable of believing that Muslims were murdering Yazidis in anticipation of the eternal pleasures of a heavenly whorehouse.

Nazi Paikidze is not, strictly speaking, a Westerner.  An ethnic Georgian, she may be far more alert to Islam than most of us.  Having spent some years in the U.S., studying at the university of Maryland, she may also be fully aware of Western deafness to religion.  Therefore, on the one hand, her explanation may be just another sad manifestation of the suicidal Western ignorance of Islam.

On the other hand, Nazi's statement, gibberish on its face, may be a brilliant exercise in political double-entendre, worthy of a chess grand master.  Her attack on the government of Iran can be understood by shallow, naive Westerners as a political statement while, at the same time, the Iranians will hear it as the attack on Islam that it should be.  If this is, in fact, what she intends, then

Well played, Nazi Paikidze.

Two Peas In A Pod

Too many people subscribe to the erroneous idea that fascism and socialism exist at opposite ends of a long political spectrum.  How this false idea gained widespread currency is a question explored by Stéphane Courtois in his essay introducing "The Black Book of Communism," a must read (book and essay), if you want to understand anything about the 20th century.

In short, the idea that fascism and socialism are far apart ideologically, therefore politically inimical, was a central element of a decades long and highly vigorous propaganda campaign waged by Cold War era Moscow.

As a matter of fact, the founders of fascism, Adolph Hitler and Benito Mussolini, were dyed-in-the-wool communists who broke with the communist movements in their respective countries over one narrow element of ideology (nationalism vs internationalism), and over tactics.  They remained faithful socialists to their dying days.

Are you surprised?  You should not be.  As with people so with ideologies, blood feuds are the bitterest the closer they are and the better they know each other.

Consider the blood feud between Sunni and Shia Islam.  The ideological differences between them are so trivial as to be essentially imperceptible to an outsider.  And yet, exactly this meaningless difference between them is a central element in the horror we are now watching (in this year of the Common Era, 2016) in the internecine and genocidal war in Syria, Iraq, and The Yemen.

Not to let Christianity off the hook, as a Jewish man I see the Thirty Years War (1618 to 1648) in exactly the same way.  Until WW I, the Thirty Years War was the single greatest Man-made catastrophe on the European continent.  While it may have evolved somewhat over its three decades, that terrible war began as a religious war between Protestants and Catholics.  There is no explanation you can give me, about the doctrinal differences between Protestantism and Catholicism, that would make me conclude, "Oh, now I understand why they were butchering each other's children."

Therefore, you should not conclude, from the insensate violence perpetrated by fascism and communism on each other, that they are very different ideologies.  Quite to the contrary.

Stéphane Courtois explains this from a socialist point of view.  From a fascist point of view, now let Adolph Hitler tell you, himself.  I have started reading "Hitler's Second Book," edited by Gerhard L. Weinberg, the same German-Jewish historian who wrote the masterful, "A World At Arms."

In the opening paragraph ("Hitler's Second Book") of Chapter V, page 46, Hitler writes,

"I am a German nationalist.  That means I am openly committed to my Volkstum [ethnic community].  All of my thoughts and actions belong to it.  I am a socialist.  I see before me no class or rank, but rather a community of people who are connected by blood, united by language, and subject to the same collective fate.  I love the people and hate the current majorities only because I do not see them representing either the greatness or the happiness of my people."

If Hitler had stopped with, "I see before me no class or rank, but rather a community of people," he would have been indistinguishable from garden variety marxists.  Only the nationalist element of "National Socialism" (aka, Nazism) sets him apart.  Other than that,

Socialism is Fascism and Fascism is Socialism.