Framing health care reform anew

Via Glenn, I learned of the Investor’s Business Daily editorial today advising the GOP to quickly get its own health care plan.  An excerpt:

If the Supreme Court chucks ObamaCare entirely, which looks increasingly likely, Republicans will finally have a chance to redefine the debate. But only if they get educated and put together reform ideas now. . .

For too long, Democrats have defined the health care issue, depicting the U.S. system as an unfettered market where costs run wild, insurers rip off consumers and deny coverage to tens of millions, and big-government “reforms” are desperately needed. None of it is true.

Not only is it politically expedient for Republicans to do so, if you believe, as I do, that the Supreme Court is a political animal (unfortunately), then having a viable plan makes it more likely that those justices on the fence between amending Obamacare or destroying it, will choose the latter option, knowing that a Plan B is on the way.

So what should such a plan look like?  It should look as much like a free market as possible.  For anything else simply transfers costs and is eventually unsustainable.  Here I think are some general rules:

1.  States should not be allowed to deny out-of-state coverage.  Today a Cincinnatian, for example, is not allowed to drive two miles south to Northern Kentucky to buy cheaper coverage there.  All fifty states have erected insurance moats around their borders in order to protect the insurers who operate within.  Aside from alcohol, the interstate sale of no other product is so highly regulated by the individual states.  Thus, the health insurance market is fragmented, inefficient, and expensive.  Furthermore, there is absolutely nothing anti-constitutional or anti-conservative about denying this power to the states.  In fact, it’s clearly there in the Commerce clause, and is exactly the kind of thing that the Founders specifically wanted to have happen so that the states couldn’t create their own virtual protective tariffs.

2.  There should be no minimum coverage requirements other than for uncapped catastrophic care.  The various states today demand between 13 and 70 specific coverages be included in each of their state-approved policies.  Insurance is for things you can’t afford, you save money for things you can predict.  To make an auto insurance analogy: insurance exists to replace the car, not to replace the tires.  Some people will want to opt for “cadillac” coverage.  Fine.  Let them pay for it.  But by not requiring that everyone carry the same expensive plan, more people who either don’t want or don’t need the gold-plated coverage will be able to afford basic coverage that protects them against the worst case.  But wait:  aren’t there some things that insurers should include because they save money in the long run?  Like birth control, to pick a recent example?  No.  If they are in fact cost savers, then smart insurance companies will include them.  Good companies don’t need a federal mandate to make good business decisions.

3.  The cost of insurance should be borne by the user.  Ideally, people should buy their own coverage, making them more alert shoppers.  If your employer was buying your groceries for you, you wouldn’t care what else they bought as long as they included the things you want and need.  But if you’re buying your own groceries, you’re far more scrutinizing about what goes in your basket.  Additionally, paying for your own insurer incentivizes you to make healthier choices.  Why quit smoking, for example, if I don’t have to pay more for coverage?  Ultimately, the deductability of employer-provided health insurance costs needs to go away.

4.  Health insurance should be portable.  Dovetailing with the last item, if you yourself provide your own insurance, you’re less tethered to a job.  That’s good for the economy too.  Now, if we can just figure out how to get people untethered from their houses . . .

5.  Allow states to cap the amount of mandatory care that medical professionals are required to provide to the uninsured.  This is the most controversial part of my plan, some would say immoral.  But when you think about it, this is no different than the “death panels” that were a feature of Obamacare–and those were for people with insurance!  If the Supreme Court doesn’t allow the health insurance mandate (and they shouldn’t), then there must be an incentive that pushes the uninsured toward buying insurance, as well as protects insurers and the insured from extreme damages by those who still won’t.  Pick a number:  a quarter-million a year, a million dollars a lifetime, something, but cap what insurers and taxpayers have to absorb for those who don’t pay into the system.  Anything else would be immoral.

So there you have it: five easy things to get health care back on the right track.  And it’s less than 2,700 pages, meaning that when it goes up to the Supreme Court for review, reading the legislation doesn’t violate the Eighth Amendment.

Marin Madness

If you are going to use a sports analogy, you better know what you’re talking about. 

Case in point:  Nancy Pelosi, talking about this week’s Supreme Court proceedings to determine the constitutionality of Obamacare.  She was asked, “Have you had any conversations or what have the conversations been between you and the White House or colleagues about what to do about health care if parts–significant parts–the individual mandate, or other parts of the health care law are struck down by the Supreme Court?

Nancy Pelosi:  “This game isn’t over.  In March Madness, what happens when your team doesn’t win one?”

Answer:  You lose.  Season over.  Go home.  And for many of your players, it’s the last time they will ever play the game.

Video

It’s supposed to be their job to be independent, damn it!

Ezra Klein:

“You can mark the point — page 14 — when the liberal justices decide Verrilli is screwing up and step in to make his argument for him.”

When Ezra Klein–Ezra Klein!–makes that observation, I don’t know who that damns more:  Solicitor General Donald Verrilli, whose job it is to make the argument, or the “liberal justices,” whose role is to be independent.

Actually, that question answers itself.  For the approved solution to this quandary, see here.

Instinctively, he’s wrong

I have followed the Trayvor Martin/George Zimmerman issue only slightly, which is to say that I have as little information about the facts of the case as do 99% of other commenters–including, apparently, the President.

After it has been alleged that there may be exculpatory evidence that would support Mr. Zimmerman’s version of the events, Glenn Reynolds voiced concurrence with a reader’s comment regarding the oddity of the President’s willingness to take sides in an ongoing investigation of a local matter.  The reader believes that the President got involved in the case, as well as in other controversial issues, because of bad poll numbers:

IMHO, what’s going in in the WH these days is really, really bad poll numbers. How else can one explain an investment in clearly polarizing issues like picking a fight with both the church and Rush Limbaugh, race-baiting with Trayvon, a flirtation with an advocacy of gay marriage, Stalin-esque striking down of voter ID laws, et. Al. The softness in numbers with the black population must really be stark, otherwise, why bring this stuff up? There’s no upside with independent voters with any of these issues.

Let me suggest another, simpler cause:  the President has bad instincts.

A couple weeks ago I had lunch with a Republican friend who shared with me his contempt for Sarah Palin in 2008.  Let’s discuss Governor Palin another time, but I bring this up because I rebutted with the fact that I like her because I like her instincts.  Instincts are those things that we are programmed by experience to do automatically in the face of incomplete information.  The one quality I absolutely want to see in a leader at any level is good instincts, because often, there just isn’t time to be 100% sure of anything.  As Governmor, Ms. Palin demonstrated a history of trusting indivduals Alaskans over the entrenched interests of big oil and big government.  I happen to share those same biases, so I trust her instincts.

So what do we know of President Obama’s instincts.  In the absence of complete knowledge, apparently he reflexively views typical white people, particularly the police, as bitter clingers to antiquated doctrines.  Meanwhile, he appears to be solicitous towards adversaries and competitors, even at the expense of friends and while giving short shrift to long-time allies.

There is a name for this kind of instinct:  it is called bad judgment.  We see it recently when the Administration supports the spending of hundreds of millions of dollars on projects with little potential for return on investment without government intervention, but who denies approval for projects that cost the taxpayer nothing because investors are glad to bring their own money to the table.  I could go on, but there are numerous other examples of where the President’s choice has been magnificently wrong.  

The President’s acoyltes attribute the shortcomings of his actions to bad luck, incomplete knowledge, and political opposition, but maybe the truth is that he is wrong far more often than he is right and that the President’s frequent miscues are not part of a political plan, but are simply the result of the President’s terrible, horrible, no good, very bad instincts.

UPDATE:  Thanks to Glenn for the link.  While you’re here, take a look around.

We don’t need a new Bill of Rights

Via Glenn, I learned of Frank J. Fleming’s tongue-in-cheek essay claiming that “We need a modern Bill of Rights.”

That’s because the original Bill of Rights was written in a “more primitive time,” of “woolly mammoths” and such.  Or as Ezra Klein infamously pointed out a couple years ago: the Constitution is, like, a hundred years old.  Fleming agrees, noting that the Bill of Rights needs updating since it “doesn’t guarantee anything people need — not food, shelter or even broadband internet.”

Were Fleming merely mocking Occupy-Wall-Streeters and political neophytes, his op-ed wouldn’t merit comment.  However, no less an “authority” than the New York Times’ Supreme Court Corresepondent, Adam Liptak, opined last month that “The U.S. Constitution has seen better days.”  Agreeing with both Klein and Fleming’s doppelgänger, Liptak said that, “The United States Constitution is terse and old, and it guarantees relatively few rights.”

Of course, contained within Liptak’s article were numbers that pointed out that there just might be something good about old.  He noted that the 188 countries analyzed by a team of constitutional scholars had 729 constitutions between 1946 and 2006.  That works out to an average of a new Constitution every 15 years.  Meanwhile America’s outdated guiding document–the oldest in the world–will be 235 this year.  And since 1789 it has been amended only 17 times, or once every 13 years.

It was in the short period between the Constitution’s ratification and the adoption of the Bill of rights that the document saw the most activity:  ten amendments in two years.  To understand why that was, you have to understand that the Constitution and the Bill of Rights are essentially two completely different documents serving opposite purposes, both of which were, and are, important.  The Constitution itself was the instruction manual by which the majority could exercise power.  The Bill of rights was the means by which the minority was safe from overreach of that power.

Two-hundred-plus years later we’ve been instructed to think that minority rights weren’t enshrined in the Constitution until the post-Civil War adoption of the 13th through 15th Amendments ending slavery, granting citizenship, and guaranteeing the right to vote.  In truth, the protection of minority rights was enshrined in the very First Amendment:

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

What does this have to do with minority rights, you ask?  Simple.  Popular speech  requires no protection.  It is unpopular speech, in other words–minority opinion, that needs the first Amendment.  Or as one brilliant writer once opined:

Among the most important of reasons for which we have a Constitution is to protect the unpopular from the torrent of popular opinion.  It, after all, is the heinous derelict who is most in need of a fair trial to protect him from the posse, or the unpopular opinion that most requires the freedom of speech. 

The only quibble I would note with the above is that it is not the Constitution itself that makes explicit such guarantees, but the Bill of Rights.  But you get the point.

I’ll leave you with one final personal observation about why our Bill of Rights is far better than any other “rights” that have been drafted since.  This past summer I visited the Dachau Concentration camp for the first time.  Named for the town of Dachau near Munich, the first Nazi internment camp opened there in 1933, just 51 days after Hitler took power.  

Before my recent visit to Dachau, I didn’t know this fact I’m about to share.  I guess that I had just accepted the conventional wisdom that the victims of concentration camps were primarily Jews, gypsies, and gays.  But it wasn’t true–at least not initially.  That’s because the first prisoners of the Nazi’s first prisoner camp included a large number of communists, Catholics, and constitutionalists.  They were political prisoners who raised objections to the policies of Adolf Hitler’s National Socialist Party–a party enthusiastically supported by a majority of Germans.  Hitler couldn’t silence them, so he sentenced them.  It was only later, after the scourge of minority political opinion had been eliminated, that minorities themselves suffered a similar concentrated fate.  “When there was no one left to speak for me . . . ”

So while you might fret over the fact that the original Bill of Rights–the one written by a bunch of dead white guys, like, over a hundred years ago–says nothing about the right to free contraception and condoms, consider this:  If you ever have a substantive complaint, one that might not yet be a popular opinion, that stupid old Bill of Rights might just keep you out of jail while you try to advance your cause. 

That is, if it hasn’t been replaced by a bill of wrongs.