October 2, 2006
From the desk of Jane Galt:In which I apologise to Ezra Klein, and urge us all to stop dwelling on the past so much
In response to my post on the Marxist Fallacy, Ezra Klein emails:
It's certainly true, btw, that I have some pro-statist ideas you'd be relatively horrified by. But that post wasn't one of them, and I'm surprised to see you characterize it as a "horrified" reaction, or group it anywhere near folks calling you a bitch. I thought it was a pretty honest and good-faith addition to the discussion, and I'm unsettled that you took it so differently.
Which indicates that we've gone off the rails somewhere. I like Ezra Klein . . . I read him daily. He's a very good blogger, who you should also read daily, because ideas you disagree with are healthy for you. Go on, get that heart-rate up!
His post was very sensible . . . in fact, let me excerpt it for you:
Since 1993, the number of native-born Americans with coverage has ranged between 86.3% and 88.1%, with 2005 seeing 86.6%. As for the number of foreign-born Americans, their coverage numbers have remained between 65.5 percent and 67.7 percent, with 2005 ending at 66.4%. Which is to say the percentage covered among both groups has remained relative stable.What did happen is that the foreign-born population increased from 22 million to 35 million over that period: a far more rapid expansion than the native population saw during the same timespan. Indeed, while in 1993, 32 million native-born Americans were uninsured and 7 million foreign-born Americans lacked coverage, in 2005, 35 million native-born Americans were uninsured while 12 million foreign-born Americans went without protection. While the uninsured of each population remained approximately the same, the foreign-born population exhibited a great absolute increase. None of which really changes the basic narrative: 35 million uninsured natives, 12 million uninsured foreigners, 47 million uninsured total. Nothing to be proud of.
Now, I might quarrel with this on several grounds: first, that if we had more health care for immigrants, we'd almost certainly get fewer immigrants, since cost pressures would force politicians to set stricter limits on legal immigration. That's a big cost, to us and especially to the immigrants, who tend to be much poorer than even uninsured Americans, and probably get worse health care back in their own countries than whatever they get here. So perhaps it is something to be proud of. And I could drag out my arguments about a relatively free market being the genesis of both uninsurance, and innovation, and how I see no reason to privilege those who currently have diseases we can cure, over the much larger group who now have, or will in the future have, diseases for which we currently have no treatment, but one day will. And Ezra could retort, and we could go round and round, and it would be hours of fun for the entire family.
But that's a good argument to be having. Should things be the way they are, or should they be different?
What it is not good to be doing is arguing about things that really aren't disputable: on almost anything we can measure, things have gotten better for average and poor Americans over the last thirty years, as well as rich ones. We could argue about whether intangible social values like cohesiveness and civility have eroded, but the tangible things that we can count and quantify have indisputably improved. The question is "how much" not "whether". And unless you are an economist who needs to learn how to correctly measure things in the past, so that he can better measure things in the future, the correct answer to "how much" is "who cares?" It is a waste of time to quibble about fine technical distinctions in measuring the past, when what you really care about is shaping the future.
No one is seriously proposing a return to the economy of 1973: heavy industry (and heavy pollution), women at home, wage and price controls, strong unions, low immigration, trade restrictions, and all the rest of it. Lots of people want some piece of fit, but no one wants the whole shebang . . . and the whole shebang is what created the economy of 1973. Strong unions, for example, were strongly aided by keeping women, immigrants, and foreign workers (through trade) out of the workforce; even if you magically increased unionisation levels, the sheer size of the modern labour supply would defeat many of your plans for boosting labour's bargaining power.
Since we are not planning on trading in the Nissan Altima for a Chrysler Cordoba and cruising back to The Good Old Days, it is futile to spend emotional energy on discussing how much better (or worse) everything was back then. It kinda reminds me of one of my favourite lines from "The Dilbert Principle", in which Scott Adams points out how salesmen whose products suck often fall back on ridiculous comparisons:
"Sure, 48 mph isn't a very good top speed for a sports car, but you have to compare that to hopping!"
Libertarian policies are no more vindicated by the fact that growth has occurred than liberal policies would be if they had not; the important question is whether our lives are as good as they could be. Mr Klein has very sensibly opted to debate whether an 86% insurance rate for native-born Americans constitutes a job well done, or a terrible failure, rather than how it compares to 1820's Birmingham, or the the modern-day Ibo of Nigeria.
A couple of his commenters, however, thought that the truth was better served by making fun of me:
Why do bloggers, yourself included, even give "Galt" the time of day? Her comments section reads like LGF with tweed elbow patches.She is a perfect emblem of cheap-shot Republicans masquerading under the banner of Libertarianism. No solutions, only wise cracks, and the annoying tendancy to use facts in the same way whores use lampposts: not for illumination, but for support.
They were the ones I was referring to, not Mr Klein, whose post was a shining example to us all of the joys of reasoned debate.
"No solutions, only wise cracks, and the annoying tendancy to use facts in the same way whores use lampposts: not for illumination, but for support."
Good thing you aren't asian, or the left would be making cracks about ping pong balls as well.
Hey - I was convinced.
Oh - I'm an art historian. I'm easily swayed.
I basically agree with Ms. McArdle, but I don't think we are totally limited to discussing intangibles if we want to consider things that may have declined since 1973. Illegitimacy rates, for instance, though they have declined lately, are higher than they were in 1973, and I think divorce rates are too. Other things I don't know, but they may have declined: SAT scores? Voter participation rates?
Of course, the left/liberal types who want to abuse Ms. McArdle would in a bit of a tricky position if they focused on divorce and illegitimacy, so I expect them to rely on continued personal invective.
JG says: Now, I might quarrel with this on several grounds: first, that if we had more health care for immigrants, we'd almost certainly get fewer immigrants, since cost pressures would force politicians to set stricter limits on legal immigration.
I happen to have this quote from the late CA Assmblmn MarcoAntonioFirebaugh handy, which he said on a trip to Mexico: "[Arnie] is the one who has the ability to make [CA DLs for illegal_aliens] law, to give this right to Mexicans, whether they have settled in California or not... We want the Mexican people to know that the measure is on his desk... However it is now September and he has not responded whatsoever, although we will insist on approval of the bill, basically so that illegal migrants can have access to education and health services in the U.S..."
Libertarianism, liberalism, meet the real world.
That's a big cost, to us and especially to the immigrants, who tend to be much poorer than even uninsured Americans, and probably get worse health care back in their own countries than whatever they get here. So perhaps it is something to be proud of. And I could drag out my arguments about a relatively free market being the genesis of both uninsurance, and innovation, and how I see no reason to privilege those who currently have diseases we can cure, over the much larger group who now have, or will in the future have, diseases for which we currently have no treatment, but one day will. And Ezra could retort, and we could go round and round, and it would be hours of fun for the entire family.
It isn't clear that we can compare SAT scores between now and 1973. A smaller percentage of the eligible cohort took the SAT then, than now, and the SAT has been changed ("dumbed down" critics say) at least once since 1973. Removing the analogies from the SAT was, IMO, a bad thing.
The truly interesting thing is this: many adults in 1973 felt that society had come quite a bit unzipped, and were debating whether things were better in 1953 or not than in 1973...
Oops, didn't mean to include the last paragraph of that comment.
In the 1950's very few people had health insurance and even fewer needed it. Hospital costs were low. I spent a week in the hospital at the Mayo Clinic and got a bill for $103.46. I had no insurance and I was charged normal rates. Today that bill would be $103,460.
There were no malpractice lawsuits in those days. Now there are and every one pays the cost so that some unlucky bastard and his team of lawyers can go home $100,000,000 richer. If there were no malpractice health costs would be so low no one would need health insurance.
There is no question that medical service providers of the 1950s were more dedicated and more careful than people are today. But these people, most of whom worked for nothing more than their love of God, were forced out by the lawyers and replaced by strike happy union members.
How to restore love, compassion, excellence, and caring - and above all low costs - to medical care? 'The first thing we do, let's kill all the lawyers'. ...to quote Henry VI, Part 2 W.Shakespeare.
Wow...even when Jane Galt excerpts insults, she still manages to find all the good ones. "LGF with tweed elbow patches"? I nearly choked on my soft drink!
and the annoying tendancy to use facts in the same way whores use lampposts: not for illumination, but for support.
I thought that was how drunks use lampposts. Whores usually swing around on them and do all that dancing. I saw it at a friend's bachelor's party.
You hit on the welfare and immigration problem, European states have now for quite some time. You can't have a welfare state and a high level of immigration. It would ruin your state finances and thus the taxpayers, who have to pay for all the scoundrel immigrants flowing over the border. So, you either have to be protectionist and all "national identity" (like, f.e. Mussolini) and cut off most immigration (which also leaves some of the big science brains out), or you cut your welfare state, which then encourages only the productive to come to your country.
But you can't have both things, which is something we in Europe are now learning the hard way. I make a modest prediction and say that it will cause riots in about 20 years or so.
Max: It already caused riots in France - by the immigrants, who apparently find being stuffed into welfare ghettos and ignored less than fulfilling. But if you were referring to riots by the native Europeans, I expect that and worse are coming...
"It already caused riots in France - by the immigrants, who apparently find being stuffed into welfare ghettos and ignored less than fulfilling."
Well said!
I am a conservative, but the Paris Riots cannot really be blamed on the welfare state. The Muslim immigrants to France generally have a work ethic. A better cause of blame is the $9.00 / hour and the lifetime job protection laws that make gambling on hiring an unskilled immigrant a risky proposition. I suspect they are the true cause of the nearly 40% unemployment rate for young muslims in some parts of France.
But your general point is taken. My wife teaches in an inner city middle school with a large immigrant population, and there is a sizeable subset in which single moms illegally immigrate to America for welfare benefits, medicaid, and food stamps.
sol vason: "There is no question that medical service providers of the 1950s were more dedicated and more careful than people are today."
What is the basis for this insulting assertion? I know many health care professionals - including my wife - and I am certain they are far more dedicated to their craft than just about any other professional group.
How can anyone compare professionalism of medical personnel over that fifty year span? The job is now much more demanding. Sophisiticated equipment and drugs require far greater skills and knowledge, and far more after hours study. The constant threat of lawsuits pressures all practitioners. Information tracking systems - which didn't even exist 50 years ago - allow for heightened awareness of any mistakes. It's just not the same world at all. There is just no objective way to compare qualities such as "professionalism" or "dedication".
Since we are not planning on trading in the Nissan Altima for a Chrysler Cordoba
Your loss ... now you won't get to experience the joys of "rich Corrrrrrinthian leather"
Justin,
What is $9.00/hour and lifetime job protection laws except another manifestation of the welfare state? While not a direct transfer payment, it's clearly a governmental intervention to insulate people from misfortune in their private lives. The government has outsourced the burden onto private business, but the government is clearly responsible for the burden, and the burden was added in an effort to improve the public welfare.
"There were no malpractice lawsuits in those days. Now there are and every one pays the cost so that some unlucky bastard and his team of lawyers can go home $100,000,000 richer. If there were no malpractice health costs would be so low no one would need health insurance."
Tell that to people living in some of the states that have tort-reformed lawyers out of business.
Like in Michigan, where getting FDA approval of a drug immunizes you from liability for injuries caused by the drug, and the widow of a man who committed suicide after taking a psychoactive prescription drug for three days and losing his mind is thrown out of court, not because the drug wasn't risky, but because the drug manufacturer enjoys immunity from lawsuits.
Or in Indiana, where a doctor making $1 million a year can negligently leave a patient permanently disabled (say, by giving the patient the wrong anesthetic), and still have damages owed that patient capped at $250,000. The doctors' malpractice insurance coverage liability limits in Indiana are lower than their car insurance coverage liability limits.
Has health care gotten cheaper in those states? No, it's just become the primary growth industry, as doctors flocked there to practice low-risk medicine (for the doctor, that is).
"Her comments section reads like LGF with tweed elbow patches."
I don't want to get all nit-picky, but actually it is micro-suede, not tweed. Tweed has always given me the willies.
Jane,
Thank you for the always-needed "see how well things have improved and don't take it for granted" perspective. When I hear some "health care for all" advocate whining on I actually think that health care in the US has actually worked too well -- at least in the respect that we've been able to shunt all our seniors off to The Home (or Del Webb nightmares) and can't hear them tell us often enough how things used to be.
For example to hear my grandfather tell it, they used to suck. He was born in the Ozarks in 1903 and didn't have shoes until he went to school -- at 13. About half the babies born in the area died at birth; a whole plethora of diseases we don't bother with now were horribly common. The idea of "health care" would have made him howl with laughter; most of the time he was trying to find enough to eat.
Two generations later his grandson lives a Very Good Life ... but gosh, is he covered? I work for myself and have HMO coverage with a massive deductible; most everything (dentists, eye docs) short of catastrophes comes out-of-pocket. Am I in the blessed 86.6%? I'm with you, Jame: who the hell cares?!?
Oh, and as for the tawdry lamppost: isn't one supposed to use facts for support?
Actually, socialized medicine a la Europe caps costs by rationing. So, instead of surgery, you get on the waiting list for surgery.
johnDewey - I said they were more dedicated and caring in the 50's than today. Which is a statement based on averages, not on outliers. In the 50's almost all hospitals were staffed and operated by religious orders who were called by God to tend the sick and infirm. That is the derivation of the word "Vocation".
Today we describe that rare person who is thoroughly meticulous and careful in his/her work and who performs it lovingly as a person who does his work religiously. Today this type of person is rare; in the 50s she/he was the norm in health care.
I have lived in that era and in this current one. Medicine has advancedErrors happened in the 50s in spite of heroic efforts to make things go right. Today knowledge has advanced to the point that a whole set of errors are now possible and there are a whole new set of people making hero efforts to avoid these errors.
Lawyers do not inspire this type of heroism. They do not inspire devotion to duty, self sacrifice or love.
Lawyers inspire a form of medicine where the first goal is to avoid a lawsuit and the secondary goal is the health and welfare of the patient.
Health insurance is an income redistribution plan which takes money from all of us and gives it to obscenely wealthy lawyers.
In spite of the fact that malpractice suits have increased exponentially hospitals are no safer than in the 50s; mistakes are no less prevalent than they were in the 50's. By every measure, malpractice suits have not improved the quality of medicine but have actually slowed the development of new drugs and therapies and have closed off completely some valuable avenues of development; and in doing so have made both the practice of medicine and the cost of health care obscenely expensive.
Marge: "Homer, it's leather patches on a tweed jacket not tweed patches on a leather jacket."
"Now you have ruined a perfectly good jacket."
Homer: "Wrong Marge. Two perfectly good jackets."
It was drunks, not whores:
http://reluctantnomad.blogspot.com/2006/09/insults-they-just-dont-make-them-as.html
With regard to lampposts - in the case of argumentation, support *is* illumination.
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