Warning: Medicaid is hazardous to your health

So says the headline of my article in the Boulder Daily Camera today. A scan of the print version is here. The first half of the article is pretty much the same as the one that appeared in the Denver Post a few weeks ago. The second half goes into more detail on how Medicaid could work on the food stamps model:

Medicaid should not compete with insurance companies. After all, the government doesn’t try to emulate Soviet Russia by operating its own grocery stores. Instead, it taxes us to provide food stamps. Similarly, Medicaid could provide vouchers for private insurance, which some states are already considering.

This would be an improvement over the current system, but it’s still a coercive charity. To remedy that, I propose a tax credit for those who donate money to Colorado charities that compete with Medicaid. Of course, this isn’t “perfect,” either, as surely the government would have a role in determining who qualifies as such a charity, and hence exert influence on how they run. This argument comes up with school vouchers, too. But it’s a good way to get people to start thinking about Medicaid as competing with both insurance companies and charities.

I also have a better definition of consumer-driven health care. I’d made the error of identifying it as a Health Savings Account with a high-deductible insurance plan. But this is only an example. Most generally, it results from not having a tax code that neither (a) favors employer-provided insurance over buying it on your own, and (b) favors paying for medical expenses with insurance vs. directly with one’s own money.
So regardless of what kind of insurance you have, you should be able to have an HSA. That way, if you have a choice between spending an extra dollar on an (employer-provided) insurance policy, or insuring yourself by saving that dollar, it’s a true dollar-per-dollar decision. As it is, if you choose not to spend the extra dollar on the insurance, then you are taxed on it, and have much less to spend on out-of-pocket medical expenses.

government run medicine treats doctors like vending machines & adult patients like dependent children

So says my letter to the editor in the Denver Post this past Monday:

“Universal” health care

Re: “Patient, take care of thyself,” June 14 Pius Kamau column.

Surgeon Pius Kamau admirably explains that “each man and woman should be responsible for their own health.” Yet, the “universal health care” he advocates as “ideal” erodes this responsibility.

“Universal” health care is a deceptive euphemism for government- controlled medicine. By forcing providers and patients to abide by its prices and rules, government treats doctors like vending machines and adult patients like dependent children. The only thing “universal” about government-run health care is poor quality, low access, and long waiting times. By restricting choice and freedom, authority-driven health care makes government the parent responsible for the health of infantilized adults.

Contrast this with consumer-directed health care, which combines a low-premium, high-deductible insurance policy with a tax-deductible Health Savings Account. Patients self-insure with money invested in HSAs until reaching the deductible, after which the policy’s coverage applies.

Free-market medicine and voluntary charities promote personal responsibility and accessible quality care.

Brian T. Schwartz, Boulder

Will Pirkey of Evergreen responded the next day, claiming that “Our society does not need more personal responsibility, but rather social responsibility.” I wonder where this “social responsibility” comes from, and what actions does it entail. Who determines that, and by what right?

Pirkey continues: “We have the moral and social obligation to ensure every American, rich or poor, gets the care they need without the threat of lifelong debt.” For sake of argument, say this is true. This does not provide an argument for government controlled healthcare. Since it’s had such a poor record, the “moral and social obligation” (or the personal chosen obligation, which is how I see it) compels us to consider that free-markets can provide quality at a good price, just as it does other products and services.

Pirkey also writes: “The personal responsibility argument here is just another sad example of the blame-the-victim public policy and discourse in the United States.” Surely there are victims here – those who cannot afford health care because government policies have driven up the cost.

Government is still hazardous to our health care

Indeed, I am on a roll. Two more letters just today:

1. Rocky Mountain News
Kudos to the Rocky Mountain News editorial board for explaining how “community rating” regulations on health insurance plans drive up premiums and discourage small companies from offering insurance (“Too quick off the mark,” April 10).

I found similar effects when researching my proposal to the Blue Ribbon Commission on Health Care Reform entitled FAIR: Free-markets, Affordability and Individual Rights. Online at the commission’s Web site, it also shows that other state-level mandates such as guaranteed- issue and benefits mandates also increase premium costs and leave many unable to purchase medical insurance.

As does all legislation that violates our rights to freely associate, such as voluntarily contracting with insurance companies, these prohibitive rules are hazardous to our health.

2. Boulder Daily Camera

The government would worsen it

Clay Evans (Insight, April 29) argues that a monopolistic government-run “single-payer” health care system “would almost certainly lower costs.” Government lowers costs? That’s an oxymoron. Like any monopoly, a government-run program lacks incentive to lower costs and provide quality products because its customers cannot leave. Government-run health care lowers costs by rationing, where bureaucrats decide whether you’re important enough to legally receive treatment.

Consider Medicaid. My proposal to Colorado’s Blue Ribbon Commission on Health Care Reform, Free markets, Affordability and Individual Rights (at the commission’s Web site), documents that Medicaid fails to meet the commission’s criteria for accessible, affordable, and quality health care. And Medicare? The Medicare Payment Advisory Commission reports that Medicare is “largely neutral or negative toward quality …. At times providers are paid even more when quality is worse.” If government can’t provide quality low-cost health care to Medicare and Medicaid enrollees, how can it provide it to the rest of us?

Government meddling in the free market has distorted real health insurance into prepaid health care. This encourages thoughtless over-consumption, increases costs and limits access. It also erodes the doctor-patient relationship by wedging either a government or insurance bureaucracy between them. My proposal outlines how effective health-care reform requires repealing unjust policies that prevent a free market from delivering quality, low-cost health care — just as free markets provide other essential goods and services.

Madcap Theater – Improv Comedy in Westminster, CO

Today my improv comedy class from Madcap Theater performed a couple of shows to demonstrate what we had learned in the six week “Level 1″ class. As with the first performance, it went great. What is even more satisfying that what I’ve learned through the classes is the story of Madcap Theater as a successful family-owned entrepreneurial venture.

I’ve been taking the classes since September, and gradually realized the extent to which this is a family-owned and run business – from the actors, bar tenders, servers, to the behind-the-scenes marketing and other business aspects. Check out this televised feature on Metrobeat TV. I don’t know how long this like will be valid – I appear briefly in the part about classes – at 3:11 into the segment. Also, the Boulder Daily Camera has a nice article on it.

Government-run auto repair? Yes!

Today The Daily Camera published the following as a Guest Opinion (good choice of headline!) Here is one-line version, & here’s a scan of the print version.

Modeled in health-care debacle, some could clean up

By Brian Schwartz

Sunday, February 11, 2007

“Government-run health care, that’s the model for how to monopolize the auto repair industry.” The men in fedoras looked doubtful. “Continue,” said the driver through cigar smoke. I had no choice, but, now safely in hiding, I divulge this diabolical plan.

The federal and state governments are intent on monopolizing health care. Emulate their path. First, pass legislation to satiate voting blocks dissatisfied with their auto-repair costs and service. Since such disruptions of free trade inevitably exacerbate existing problems and create new ones, they provide a rationale to push more legislation marketed to “fix” them. Repeating this cycle will insidiously cripple a once-competitive market; voters will demand a complete government take-over, even though government created the crisis in the first place. Here`s the scheme:

Make employer-paid auto insurance premiums tax-deductible — just like health insurance. Consider an employee paying an annual $1,000 premium. His federal, state, and local income taxes exceed 45 percent. With employer-paid premiums, he gets the same coverage — while saving $450 on taxes. Such a discount will be popular, and drivers will start demanding legislation to fix problems arising from changing jobs. For you, boss, that means more jobs for your cronies.

Today, auto-insurance premiums are low, while claims are large but rare. Not for long. Why pay car-related expenses out-of-pocket when they can save 45 percent if their insurance covers it? Drivers will demand low-deductible, high-premium policies covering everything from scheduled inspections, oil changes and tire rotations. Insulated from true costs, they will splurge on seemingly “free” services, which will make repair and insurance costs skyrocket.

Consider health care, Godfather. The National Center for Policy Analysis reports that patients pay only 14 percent of costs out-of-pocket. Paraphrasing economist Arnold Kling, this is cost-insulation, not insurance. Between 1992 and 2005, medical-service prices increased by 77 percent while the Consumer Price Index rose only 39 percent. The cost of cosmetic surgery, an uninsured medical procedure, increased only 22 percent despite booming demand. And yet, the RAND Health Insurance Experiment concluded that low deductibles increases consumers` spending, but not their health.

Increased costs will leave many drivers unable to afford automobile insurance. To “alleviate” this crisis, introduce two new government products: Autocare for older car owners and Autocaid for low-income drivers. This will also draw more customers.

Consider medicine. The USA Today reports that “many workers choose Medicaid over insurance offered by their employers because it is less expensive.” Why wouldn’t they? The National Bureau for Economic Research found that Medicaid increases prescription-drug prices for non-customers by 13 percent. Autocare and Autocaid will surely advance government`s hijacking of the auto-repair industry.

On the state level, be sure to have your boys mandate that all insurance policies cover routine maintenance and that all cars are as safe as a Lexus. Sure, costs will explode and thousands will lack transportation, but it satisfies special interest groups, gets votes and jobs for your gang, and allows you to demonize the opposition as “anti-safety.”

Also remember the wonderful combination of “guaranteed issue” and community rating. The first guarantees that a teen driving a muscle car can buy insurance — from the scene of his accident! Community rating ensures that he`ll pay the same premium as a soccer mom for her minivan. This will come at a price of course — no more “futile” repairs for those selfish sentimental drivers who want to keep their grandparents` old car alive.

To see the potential of this, again consider health care. The Council for Affordable Health Insurance estimates that “mandated benefits currently increase the cost of basic health coverage from a little less than 20 percent to more than 50 percent.” Chris Conover of Duke University estimates that health-care industry mandates costs each household $1,500 — with dubious benefits — and is responsible for one-sixth of the daily uninsured. More customers for the government!

Now that government is paying the piper, you can force “car doctors” to play your tune. Red tape will strangle their exercise of car-healing wisdom and expertise; draining joy from their careers and driving them to other professions. Look at Canada`s allegedly ideal system. According to Dr. Sunil V. Patel, former president of the Canadian Medical Association, “physicians across Canada are in an advanced stage of burnout due to work conditions” which “causes them to retire early or pull away from certain kinds of work or simply leave.” The New York Times reported that Patel “attributed much of the problem to technological shortages and the powerlessness doctors feel when patients complain about long waits for treatment.” Long waits indeed.

The Fraser Institute found that Canadians wait over 17 weeks for treatment after a general practitioner’s referral. Brian Day, CMA’s current president, says that “dogs can get a hip replacement in under a week,” while “humans can wait two to three years.” Aim high, boss. Aim high.

That’s it, fellas. Tax exceptions, compulsory charities, and crippling rules — new ones pitched as solutions to problems caused by previous ones. Each increases government’s market share at the expense of individual freedom.

Standing on the sidewalk, I saw the unmarked car speed toward the Capitol building.

Brian Schwartz is an optical engineer in Boulder, where he also studies free-market economics and enjoys improv comedy and softball.

© 2006 Daily Camera and Boulder Publishing, LLC.

Who Really Cares?

This week’s Boulder Weekly published my letter to the editor about the book Who Really Cares and an article a columnist had written about it. Here’s a link to the print version and the text of the letter:

Wayne’s wasted chance

I was quite disappointed in Wayne Laugesen’s recent article (“Jesusland,” Wayne’s Word, Dec. 28) about the book Who Really Cares: America’s Charity Divide, by Professor Arthur Brooks of Syracuse University. The author’s website summarizes: “Approximately three-quarters of Americans give their time and money to various charities, churches, and causes…Why has America split into two nations: givers and non-givers? Arthur Brooks, a top scholar of economics and public policy…demonstrates conclusively that conservatives really are compassionate—far more compassionate than their liberal foes. Strong families, church attendance, earned income (as opposed to state-subsidized income), and the belief that individuals, not government, offer the best solution to social ills.”

Wayne has often defended individual freedom and free-market policies, and exposed government folly and abuse of power. His explanation of Brooks’s findings could have continued this. Wayne could have mentioned the obvious: that “progressives” worship at the altar of compulsory government charities, and then exposed their moral bankruptcy, hypocrisy and destructiveness. He could have shown how government charities unfairly crowd out voluntarily-funded ones, how they are unaccountable because tax laws compel us to donate and how spending other people’s money is not compassionate, but intolerant and arrogant. He could have mentioned relevant scholarship such as David Beito’s From Mutual Aid to the Welfare State or Marvin Olasky’s The Tragedy of American Compassion. That is, he could have explained how compulsory charity is neither a moral nor effective way to solve social problems. Yet, Wayne chose not to do this.

He had ethics, economics and history on his side—not to mention several column-inches to showcase his writing talents—to influence public opinion and be a force for positive change. Instead, his “explanation” employed blatantly fallacious non sequiturs to insult secular non-believers, a good part of his audience. (For an elegant refutation, see Kent Northcote’s letter in the Jan. 4 issue.) A left-wing secular friend of mine regularly reads Andrew Sullivan, a conservative Roman Catholic who refrains from such inflammatory ad hominem attacks. After reading Wayne’s Ann Coulter-like rant, I doubt my friend would give Wayne a second chance.

Wayne: What is the purpose of your writing? Is it to persuade people that more individual freedom—not Big Government—will promote peace, wealth and justice? Or is it to insult your readers, court angry letters, turn people off to your ideas and consequently become an enemy to the values you profess to advocate?

Brian Schwartz/Boulder

I’m glad they printed it, but the four letters supporting a minimum wage are so poorly argued, I suspect that this newspaper will print anything. This reminds me of research on how biased and irrational people are when advocating public policy. Arnold Kling (Yes, that Swarthmore guy, what’s that I feel “school pride”??) has a good article on it, though TCSDaily is down as I write this.

Flemming Rose fights for freedom

As his Wikipedia entry states, he is cultural editor at the Danish newspaper Jyllands-Posten. He was principally responsible for the publishing of the cartoons that initiated the Jyllands-Posten Muhammad cartoons controversy. The Boulder Objectivist Club sponsored his talk at the University of Colorado, and I was quite impressed by it. In short, Rose said did not anticipate a controversy when he published the cartoons, as they were not intended to offend. He was countering what he perceived as self-censorship in response to intimidation by what many call religious extremists (or what others might call consistent with scripture.)

What follows are some ideas Rose related. Since I am not too familiar with this issue, I may not be as precise and accurate as I’d like in paraphrasing them. One of his main points was the notion of “peaceful coexistence” of secular and religious states, proposed by some Muslims is disingenuous, as if some had their way, everyone would live under a theocracy. He also stressed the distinction between tolerance and respect for other people’s ideas and values: the former is essential to a free society, while requiring the latter, well, intolerant to say the least. Rose compares the situation of Muslims in Europe, that is, those who portray themselves as weak victims, to the play Mr. Biedermann and the Arsonists, where criminals use the trust and guilt of their victims against them.

Ari Armstrong has posted a good summary of the talk, as well as its complete audio. Rose’s article in the Washington Post, Why I Published Those Cartoons, is also worth reading. I admire Mr. Rose for his using his position as a journalist to further the the cause of individual freedom.

suspicion(less)* driver, helmetless biking, topless basketball,

Late Saturday morning I road my new snazzy bike around Boulder and observed a few notable items. (1) I leaving a store where a man was asking for directions. He’d left his car running with the door open just outside the store. Sure he’d be in there for about 15 seconds, but I’m too much of a control freak to do that.

(2) For the second time during that week, I saw someone biking with, but not wearing, a helmet. What!? I mean, if I was not aware of the idea of biking with a helmet for safety purposes, and for some reason needed to bring a light-weight helmet with many vents, made for other purposes of course, with me on a bike trip, it might occur to me that wearing it would be easier than having it swing from my handlebars or my back pack. But hey, that’s just me.
(3) Speaking of alternative universes, I saw a man and a woman playing one-on-one basketball on a school yard court. It was quite hot outside by this point, and neither wore shirts. On a cooler day, I can imagine, given her cup side, that a sports bra would have added comfort, but it was hot. The funny thing was how ordinary it seemed, as I almost had to remind myself that it was not ordinary.

* My plethora of readers, feel free to suggest a replacement for “suspicion(less)” above that ends in “less.” Fearless is close, but not quite right.

Blowin’ in the wind

On Saturday I went to the credit union on the north-west corner of 55th and Arapahoe to deposit a couple of paychecks. Only the drive-in tellers were open, and I hadn’t endorsed the checks, so I started to do so on a ledge near the tellers. Soon after a gust of wind came along and, yes, took one of the checks with it. I scanned the area to the west, where the wind was blowing, had no luck, and realized that my search space was growing rapidly with every second. Since I’m currently reading (Nobel-prize-winning physicist – how do people not know this?) Richard Feymnan’s What Do You Care What Other People Think?, I found some deposit slips in the bushes and placed them on the ledge to see how they would respond to the wind. To my surprise, they blew around the wall and east. So I searched in the drive-in area, certainly to the amusement of the tellers working that shift, to whom I’d mentioned my predicament. After a few minutes I gave up and was resigned to call to have the check reissued, and did not expect much of a problem with that. The next day, to my delight, I received an e-mail from the Flatirons Golf Club, at 57th and Arapahoe (south side) [map] saying that someone had found a check with my name on it and, if it were mine, I could pick it up at the Pro Shop. I go to pick it up, and it turns out a guy working there Googled my name and found my e-mail address from one of my web pages. Nice.

Picked up where I left off.

Late last August I completed yet another season of the University of Colorado faculty/grad student/staff softball league, defended my PhD dissertation, and left Boulder for Washington, D.C. for a technology & science policy fellowship at the National Academies. In short, that didn’t work out, so I began looking for jobs in Boulder. Two weeks ago I had an interview at a local company, after which I had softball practice. Since I planned to drive out the next week, I left most of my clothes, including my “interview suit” in my old office at CU, which remained as I’d left it, down to the content of the dry erase boards and trash cans. Last night I even had a frozen dinner that I’d left behind.

It was as if I’d never left, for the above reasons, and that I had not participated in a graduation ceremony of any kind. This week I’ve been on campus a fair amount doing research for a grant proposal, and on Thursday saw my professors and former classmates donning their robes and funny hats for the Engineering graduation ceremony at 7 PM. At first I thought nothing of it, but then realized that participating in it would be nice, as it would commemorate an accomplishment and be quite literally a commencement of a new chapter in my life, which has been more-or-less in limbo for the past eight months. (“Life’s what goes on when you’re busing making other plans.” — John Lennon)

I arrived at the event center around 15 minutes before the ceremony was to begin, and casually inquired as to whether I could participate. They had no extra robes, I had not signed up to be on the list, and my advisor, who was supposed to “hood me” was not there. Resigned to be a spectator, I found the optics professors and my former classmates who were graduating and chatted with them, joking about how I could scrounge up a cap and gown, and that Adam, the department’s excellent graduate program assistant, could once again (for old times’ sake) save the day. I approach him at 7:00 PM, and jokingly state my case. He outlines a plan and says “Hey, you have to crash your own graduation.” I was weary, and figured I’d just watch it with him. Listening to the speeches, I realized that the only thing stopping me was that my attire was too casual, and it would be disrespectful to the occasion. Then I turned to Adam and said “Wait, I have a suit in my office!” So off I went, put on the suit, tied the tie, opted to go beltless than wear a brown belt with a gray suit and black shoes, and returned. Adam spoke to the right person, I joined my professors and classmates, borrowed a hat (jester-like, very nice), tassel, and hood from a professor (who has been very helpful for years, and continues to be) and walked across the stage with a few students in “my” cohort in the CU optics program since the autumn 1999. And to top if all off, I had my picture taken with an (empty) diploma case (mine was mailed to be months ago) and Colorado flags behind me. My final school photo! I even rested my chin on my fist.