I see this at work all the time – the “Idea” people just love to talk. Most of them are the first ones to get fired when times get tight. The best companies I have worked for have balanced the talkers with the geeks, marketing in tandem with engineering.   The failures did not.   You know politicians are lying if they are talking, yet somehow we felt 25% of our GDP could be master-planned by politicians?

The health care bill is a terrible idea, for no other reason than the debate has ceased to be about economics and has become about philosophy.     Our country combining the ideals of freedom and welfare\charity\opportunity\fairness are what makes it unique and wonderful.   But i dont think dwelling on it, as all the pundits are doing, will be all that revealing or all that interesting after a few days – the issue is as old as philosophy itself, and at least to this grad-school dropout, irresolvable.   I think the only rational thing to do in that situation is stand back and let individuals make decisions.     Several facts are undeniable:   economies are more efficient when they are primarily driven by individual choices and incentives at a micro level, and correspondingly, master planning an economy will always fail in the long run.   I just can’t believe that everyone has gotten so wrapped up in the ideology that they’ve lost sight of the economics.

I think a health care system can work in several different models, the articles and studies paraded around 6 months and a year ago convinced me of that.   But no analysis or plan has been able to fully operate with the consistency that either a free market model or a social justice model requires to not be broken, including our current one.   I personally do not find the current system broken as much as bent, and am furious that its been destroyed for an unproven plan. I won’t even paint the exterior of my house because its too big a job for someone with no experience, yet we want to master plan 25% of our GDP?   Its complete political conceit to think we are capable of that.   I thought Obama was more moderate and more grounded, and I am regretting trusting him with my vote; I always knew Pelosi was an evil political backroomer.   At least the Republicans who represent me in Scottsdale all seem more centrist than the far-righters in Mesa, cause I guess I will be voting for them again. I’m sure I’m not alone. Once again the Democrats have handed the Republican fringes the ammunition they need to become empowered, by acting like the crazy pinko fringe everyone dreads.

The Roman empire collapsed because it was built on slavery and expansion, and when there was no one left to conquer and fuel the machine, upward mobility became equated with comforts and lavish non-essentials rather than actually moving up.   Citizens became content to let 3rd parties do their fighting.   The country was no longer hungry, it did not defend itself, and it collapsed.   I don’t know if that is a fair parallel – its certainly a great goal to provide everyone health care, but 25% of your GDP managed by politicians?!?!?   Its unprecedented in history that we have the technology and means to invest that much in our health, that a life can cost so much, and is worth so much.   If you view that as a lavish non-essential, we are en route to being another tired European economy.

Why did the system need to be overhauled, and not just fixed?   My approach would have been cost standardization within each provider, greater cost bearing by the patient to remove the obscurity of a 3rd party payer and incentivize different choices, and a designation of a “welfare” level of universal service but not even attempting to make it the same as a private level.   Less cost shifting, better incentives, more transparency, but no re-architecting.   Its easy to say a family should not have its savings wiped out because of 1 illness, but what costs does that impose on every other family?   If you make $30k a year, and have 5 kids and the last one has some half-million dollar condition…how can you impose your need on your neighbors?   If we didn’t have such amazing technology developed in the past few decades, this would not even be an option for the 30k family…how did it get to be an entitlement?     Inexpensive and vastly effective prenatal care or immunizations for everyone makes sense as we are a wealthy nation, but the 1% and the corner cases and all the money invested in the last 6 months of life is the giant SUV or 60 inch TV that no one needs.   Its hubris to think we can address these catastrophes, its hubris to think we can scheme around a way to pay for them.   People die, resources are finite, why did this issue become about philosophy and not about economics?   We make these tradeoffs with everything else in the world.   Will the person who does not buy insurance or the 19 illegal immigrant crammed into a van be denied service now in the ER?   If they are not, then all arguments about fairness in the new system go out the door, and it proves itself to be just another bullshit Democrat big government powergrab.

One democratic pundit suggested that we are heading for a consumption tax to make up for the revenue gap this plan will cause.     Oddly, opponents of consumption taxes are often the same people who champion the poor, since the poor often have the least choice in using discretionary income.

Time to starting hiding my income in Switzerland.