The Daily Gouge, Monday, August 6th, 2012

On August 5, 2012, in Uncategorized, by magoo1310

It’s Monday, August 6th, 2012….and here’s The Gouge!

First up in today’s Enola Gay commemorative edition, the WSJ details why Obamacare is doomed to validate Einstein’s definition of insanity:

RomneyCare 2.0

With costs rising fast, Massachusetts moves to dictate medical care.

ObamaCare’s illusions are starting to fall like autumn leaves, even among some liberals, and what they’re discovering are things that have happened over and over again in Massachusetts. Beacon Hill “reformed” health care four years before Capitol Hill, and ever since it has reliably predicted the national trend—on surging costs, price controls, physician shortages and so much else.

So Boston’s latest adventure deserves particular scrutiny, since odds are its methods are coming soon to a hospital near you. After more than a year and a half of debate, last week the legislature passed a far-reaching “cost containment” bill that Democratic Governor Deval Patrick is about to sign. It is the inevitable postscript to the model that Mitt Romney introduced in 2006. (An legislative disaster, not to mention political heresy Mr. Romney refuses to recant.)

The claim then, as with the Affordable Care Act, was that health care would be less expensive if everyone had insurance. Soon Massachusetts Democrats leaked that their political strategy all along was to expand coverage only, because had RomneyCare seriously squeezed providers it never would have overcome industry opposition. “Bending the curve” on costs could be saved for another day, once a vast new government liability was locked in.

Sure enough, 79% of the newly insured are on public programs. Health costs—Medicaid, RomneyCare’s subsidies, public-employee compensation—will consume some 54% of the state budget in 2012, up from about 24% in 2001. Over the same period state health spending in real terms has jumped by 59%, while education has fallen 15%, police and firemen by 11% and roads and bridges by 23%.

Meanwhile, Massachusetts spends more per capita on health care than any other state and therefore more than anywhere else in the industrialized world. Costs are 27% higher than the U.S. average, 15% higher when adjusted for the state’s higher wages and its concentration of academic medical centers and specialists.

The health-care postman always rings twice, and now medicine itself is the target, instead of unsympathetic insurance companies. Under the plan, all Massachusetts doctors, hospitals and other providers must register with a new state bureaucracy as a condition of licensure—that is, permission to practice. They’ll be required to track and report their financial performance, price and cost trends, state-sanctioned quality measures, market share and other metrics.

The best that can be said is that in principle such transparency could increase useful information about cost and quality. Today’s lack of comparative tools makes it hard for consumers to search for value in health care, even when they have the incentive to do so.

But Massachusetts takes 360-degree surveillance and converts it into a panopticon prison. An 11-member board known as the Health Policy Commission will use the data to set and enforce rules to ensure that total Massachusetts health spending, public and private, grows no more than projected gross state product through 2017, and 0.5 percentage points lower thereafter. (And Paul Ryan’s Medicare projections are unrealistic?)

No registered provider is allowed to make “any material change to its operations or governance structure,” the bill says, without the commission’s approval. The commission can also rewrite the terms of provider contracts with insurers and payment levels and methods if they are “deemed to be excessive.”

As the commission polices the market, it can decide to supervise the behavior of any provider that exceeds some to-be-specified individual benchmark—that is, doctors and hospitals that are spending too much on patient care. These delinquents must submit a “performance improvement plan” that the commission must endorse.

In other words, the commission is empowered to control the practice and organization of medicine. The Massachusetts left complains that this government control is too weak because the delinquents can only be fined $500,000 for disobeying the commission’s dictates. But more teeth can always come in round three when this plan fails, as it will.

The main reason is that the enlightened planners never allow for the complexity of medicine in the real world. For example, Medicare has for years been trying to lower hospital readmissions using the strategies across the health policy universe—generate performance and quality measures, then pay “good” hospitals more and the “bad” less.

But it turns out that many of the supposedly bad hospitals also have much lower mortality rates than the ones Medicare is rewarding in its readmission programs monitoring heart attack, heart failure and pneumonia. The reason is that patients who die can never be discharged and then readmitted if something later goes wrong. The alleged underachievers that Medicare punishes are often much better at treating sick people and saving lives, less good at crunching the numbers.

Despite these Medicare failures, Washington has never gone as far as Boston is now going, installing itself as the arbiter of care in order to redesign care, though under ObamaCare it’s only a matter of time. Everyone agrees that the health system needs to deliver medicine more efficiently and be more accountable, but accountable to whom? The answer for the political rulers of medicine, if not patients, is always: government.

This, more than anything else, gives us pause when considering Romney’s candidacy. Okay, this….and his lack of preparedness for the Bain attacks….and the failure to be ready to release his tax returns….and idiotic jet ski ride….and….ad infinitum.

Seriously, anyone can make a mistake; nothing says more about a man’s character than a willingness to acknowledge his errors, and, more importantly, how he handles the consequences.

Still….we’d prefer four more years of Jimmy Carter to four more hours of….

Meanwhile, as Richard Landes notes in the WSJ, the MSM’s prejudiced reporting notwithstanding,….

Romney Is Right on Culture and the Wealth of Nations

A 2002 United Nations report written by Arab intellectuals acknowledges the problems the Republican candidate pointed out.

Mitt Romney caused a firestorm last week in Jerusalem by commenting on the cultural dimensions of Israeli economic growth. Palestinian spokesman Saeb Erekat, correctly seeing an implied criticism of Palestinian culture, called Mr. Romney a “racist” and complained that Palestinian economic woes are really caused by the Israeli occupation. Analysts said Mr. Erekat’s reaction was a sign that Mr. Romney has disqualified himself as a broker for peace. The episode reveals as much about the dynamics of the Middle East conflict as about presidential politics.

In making his brief case, Mr. Romney cited two books: “Guns, Germs and Steel,” by geographer Jared Diamond, and “The Wealth and Poverty of Nations,” by economist David Landes (my father). As in other fields of social “science,” economists argue about whether development derives from cultural advantages or from natural ones such as resistance to disease and access to primary resources. Prof. Diamond, whose book focuses on societies’ natural advantages, last week wrote an op-ed in the New York Times emphasizing both culture and nature and trying to draw Prof. Landes in with him.

But Israel (which neither book examined) and the Arab world (which only the Landes book examined) illustrate the primacy of culture as both necessary and sufficient for economic development. Israel, a country with no natural resources, an economic backwater even in the Ottoman Empire, rose to the top of the developed world in a century on culture alone. The Arab nations, on the other hand, illustrate the necessity of a certain kind of culture: Even those with vast petrodollars still have among the least productive economies in the world.

Americans tend to assume that everyone shares their cultural attitudes—that everyone strives to get to “yes,” to positive-sum, win-win, voluntary relations; that everyone holds productive work in high respect and prizes the principles of fairness embodied in the meritocratic principle of “equality before the law”; that everyone encourages criticism, treasures intellectual capital, promotes risk-taking, prizes transparency and fosters innovation. With institutions built on such values—with a culture dedicated to making, not taking, money—a society can make use of whatever primary products a land offers.

But there are cultures whose favored mode is not voluntary but coerced and zero-sum relations, where the principle of “rule or be ruled” dominates political and economic life. The elites in such cultures hold hard work in contempt, and they distrust intellectual openness and uncontrolled innovation as subversive. They emphasize rote learning and unquestioning respect for those in authority. Protection rackets rather than law enforcement assure the public order and bleed the economy. Public criticism brings sharp retaliation. Powerful actors acquire wealth by taking, rather than making.

Few cultures on the planet better illustrate the latter traits than the Arab world, a fact outlined in painful detail by a 2002 United Nations report written by Arab intellectuals. As “The Wealth and Poverty of Nations” points out, Arab culture intensifies these problems with its attitude of hyper-jealousy and misogyny toward women, which turns out entitled sons and cloistered daughters.

Even the huge influx of petrodollars did not change the basic contours of Arab economies: Rather than fueling economic development that benefited all, it bloated corrupt and opaque elites. Oil-rich countries like Libya and Iraq have social structures akin to those of oil-bereft Egypt and Syria. Change may occur, but it is hindered by an authoritarian culture that fears it. Such societies impoverish the masses, while elites thrive on their debasement.

Strikingly, Palestinian culture compares favorably with that of other Arabs. Palestinians have higher education, a strong work ethic and successful entrepreneurs. Much of that comes from their close association with the Zionists, who (unlike Western imperialists) settled the land without conquest, by dint of making everyone more prosperous.

From the late 19th century, Arab populations grew and prospered where Jews settled (Tel Aviv, Hebron, Jerusalem) and remained stagnant and poor where they didn’t (Gaza, Nablus, Nazareth). Many Arabs found the presence of Jews a great advantage. Thus the Palestinian diaspora is among the best-educated and most competent in the Arab world—and under Israeli rule (the notorious “occupation”) the West Bank was one of the 10 fastest-growing economies in the world in the 1980s.

Other Palestinians, however, found Jewish economic leadership an unbearable blow to their pride. Said one to the British Peel Commission in 1936: “You say we are better off: you say my house has been enriched by the strangers who have entered it. But it is my house, and I did not invite the strangers in, or ask them to enrich it, and I do not care how poor it is if I am only master of it.”

Sooner rule in hell than share in heaven. These actors have dominated Palestinian political culture, and terrorized Israeli and Palestinian alike, for generations.

In calling Mr. Romney’s remarks “racist” and blaming Palestinian economic difficulties on Israel’s “occupation,” Mr. Erekat illustrated one of David Landes’s major points: Blaming others for one’s own failures prolongs failure. Even though his own government daily chooses a culture of death, not life, Mr. Erekat wants to blame Israel for Palestine’s woes; no admission here that he and his colleagues might have some role in the suffering of their own people.

So when Westerners denounce Mr. Romney for his “gaffe,” they actually do a great disservice to the Palestinians. Palestinian entrepreneurs and administrators—the ones who wept when Yasser Arafat rejected Israel’s peace offer at Camp David in 2000—know well the costs to their people’s well-being engendered by their political leaders.

Had Western observers criticized Mr. Erekat for his silly and dishonest response, they might have strengthened those Palestinians who could lead their people to the promised land of independence and prosperity. Instead, they threw the real progressives, the ones who could put an end to the occupation by good faith negotiations, under the bus.

Threw him under the bus? This is what comes when the world, looking to America for leadership, emulates the example of our….

Can you shine my shoes while you’re down there?

….Bower-and-Scraper-in-Chief.

Next up, Tales From the Darkside, and a story you have to read to believe:

‘It’s a historical sign’: ‘White Only’ pool owner tries to defend sign that defies civil rights commission by claiming it was antique

http://www.dailymail.co.uk/news/article-2183752/Jamie-Hein-Outraged-father-moves-apartment-landlord-posts-poolside-White-Only-sign.html

Evidently the landlord believed a young Black girl’s hair treatments were clouding the pool at a duplex she owned. So rather than hanging a sign stating swimmers must shower prior to entering the water, she felt a “Whites Only” warning would better convey her message.

Amazing….simply amazing….until you consider a sizable portion of America still believes The Dear Misleader deserves another four years in office.

In a related item, here’s today’s “Timing Is Everything” segment, courtesy of NBC and what can fairly be described as an unfortunate confluence of events….or, if one believes what goes around comes around….just desserts!

NBC forced to apologise after ill-timed ad features a monkey doing gymnastics – right after showing Gabby Douglas’ gold medal victory

NBC has become the centre of a race storm after airing an ad featuring a monkey performing gymnastics, right after showing the performance of Gabby Douglas, the first African-American to win Olympic gold. The network has since apologised for the advert’s poor timing, explaining: ‘No offense was intended.’

The controversy ignited as sportscaster Bob Costas wrapped his analysis of her incredible routine during the all-around competition last night. Costas said: ‘There are some African American girls out there who tonight are saying to themselves: “Hey, I’d like to try that too.” More from London in a moment.’

The broadcast then went to a commercial break, showing an advertisement featuring a monkey wearing a gymnastics uniform and performing a rings gymnastics event. The unintentional, but poorly-timed ad was for Animal Practice, an upcoming NBC sitcom.

Specific commercial slots are scheduled well in advance of the outcomes of individual Olympic events; still, NBC is broadcasting the London games on a tape delay….and their network news affiliates, particularly MSDNC, have been rather intolerant of similar examples of simple oversight but those with whose politics they didn’t agree.

Which is a long-winded way of saying it couldn’t have happened to a nicer network….excepting of course CBS!

And in today’s Money Quote, the Opinion Journal host asks James Freeman precisely what this inquiring mind wants to know:

“Why can President Obama cite Scripture to justify higher taxes, but Dan Cathy cannot cite Scripture to explain his view on gay marriage?“

We won’t hold our breath waiting for Team Tick-Tock’s response, let alone for anyone in the MSM to ask what should have been an obvious interrogatory.

Turning now to the Environmental Moment, the green agenda once again places Liberals between a rock and a hard place:

Dam could be removed to restore Yosemite’s lost Hetch Hetchy valley

This fall San Franciscans will vote on a local measure with national implications: It could return to the American people a flooded gorge described as the twin of breathtaking Yosemite Valley. Voters will decide whether they want a plan for draining the 117-billion-gallon Hetch Hetchy reservoir in Yosemite National Park, exposing for the first time in 80 years a glacially carved, granite-ringed valley of towering waterfalls 17 miles north of its more famous geologic sibling.

The November ballot measure asks: Should city officials devise a modern water plan that incorporates recycling and study expansion of other storage reservoirs to make up the loss? The measure could eventually undo a controversial century-old decision by Congress that created the only reservoir in a national park and slaked the thirst of a city 190 miles away.

The battle over Hetch Hetchy, first waged unsuccessfully by naturalist John Muir, had turned the Sierra Club from an outdoors group into an environmental powerhouse. The fight gained momentum in recent years when unlikely allies joined forces.

On one side are Republican lawmakers and environmentalists, including Ronald Reagan’s former interior secretary, who want the dam removed and valley restored. On the other are Democratic San Franciscans, led by Sen. Dianne Feinstein and Rep. Nancy Pelosi, fighting to hold onto the city’s famously pure drinking water in a drought-prone state.

“Eventually it will be broadly understood what an abomination a reservoir in a valley like Yosemite Valley really is,” Donald Hodel, the former interior chief, told The Associated Press. “I think it will be hard to quell this idea (of restoration). It is like ideas of freedom in a totalitarian regime. Once planted they are impossible to repress forever.” (“….like ideas of freedom in a totalitarian regime.” REALLY?!?)

Over the past decade, studies by the state and others have shown it’s possible for San Francisco to continue collecting water from the Tuolumne River further downstream. But the city never seriously has considered giving up its claim to the valley. “This is a ridiculous idea,” Mayor Ed Lee said. “It’s a Trojan Horse for those that wish to have our public tricked into believing we have an adequate substitute for the Hetch Hetchy reservoir. We do not. There isn’t any.”

Yet they’ll dry up half of the best agricultural area in America for a three-inch fish which is of no use, practical or otherwise, to anyone or anything….and let their fellow citizens pay more at the market so they can feel better about themselves.

Then again, what can one expect from the city that brought us….