House Passes Health Care Bill

Submitted by ka1igu1a on Sun, 2009-11-08 07:17.

Near the stroke of midnight on a Saturday night, the house passed H.R. 3962, the Affordable Health Care for America Act by a final tally of 220 to 215. The Stupak Amendment, which would prohibit the use of any federal funding of abortion under the "public option" and subsidies to purchase a health insurance policy that covers abortion, also passed. Too bad no one was awake to experience this "great moment in history." Of course, from my perspective, I only reminded of Anthony De Jasay's Against Politics.

While the US health care system is fundamentally flawed, it is precisely flawed because there is such a thing a "US health Care system" to begin with. Implementing central planning boards, mandates, and public insurance as a "solution" to the current government-sponsored/enforced system isn't going to address the real issue, which is "affordability of health insurance or health care." The real title of this health Care bill should have been, "Statistically Increasing the Universality of Health Insurance Coverage at the Expense of Increasing Prices for Everyone." This was the exact outcome of MittCare, and will be the exact same outcome of this bill, which is largely just MittCare redux. The idea that Nancy Pelosi's political interest group wheeling and dealing to forge a 2000 page central planning/public choice masterpiece is going to overcome bedrock libertarian principles such as the "Knowledge Problem" is an obscene joke.

Frankly, watching progressives "cave in" on the Stupak Amendment only portends what is to come if this thing actually becomes law and passes a challenge to the Supreme court. Washington isn't Boston. Be careful what you wish for...

Still trying to dig through all of this...

#7688 On Sun, 2009 11 08 16:59 Paba said,
It's me again. I decided to try to parse this site again after my initial view confused the hell out of me as I tried to figure out how Hayek, someone who I'd viewed with as much suspicion as I view Ayn Rand (or, with regards to other tribe's political villains, Irving Kristol), can be a model for egalitarian minded persons.
 
I agree that what we have is a morass of corporate handouts, unfunded mandates, and confusing junk, but what do you do when the other options are the "free market" plan which has at its cornerstone buying plans over state lines (thus turning health insurance cos. into credit card companies vis a vis their inevitable move to credit industry friendly South Dakota or...the Norther Marianas) and savings accounts (nice if you have the money to put in, but can those who have the most health problems be expected to make more money?) and the "egalitarian" plan which has the politically unviable utopian single payer plan?
 
I really hope the solution isn't the Ron Paul "well get government out and things will be like they were in the model era of the 19th century, oh and don't forget to let people arrange to pay with pelts or oil" plan. There has to be a way forward that takes the egalitarian interest in "not wanting people to go bankrupt or die due to lack of coverage" into account without just putting up a new bureaucracy, or trusting the invisible (but blind) hand to fix everything with the help of some think tanks funded by right wing "libertarians" and businesses".

Welcome Back...

#7690 On Mon, 2009 11 09 07:33 ka1igu1a said,

There were quite a few comments generated by your last comments last time; do you see them?

In any event, just to reiterate, Rand and Hayek are dichotomically exclusive in their approach to things; I can't emphasize that enough. Hayek inherited from and extended the Scottish liberal tradition, and in the end, was really more of a sociologist than anything; Rand's Objectivism was something new, representing her particular strain of normative, virtue Aristolelian ethics, which in the end, makes a her more of a pop psychologist than anything. Neither were "libertarians."

I'm not going to write a novel expounding on this. I'll point out a few helpful posts(although I don't agree with everything in them)

Herbert Gintis(who writes amazon reviews in lieu of blogging), a noted evolutionary game theorist, experimental economist, and former Marxist, on Hayek and his legacy

Was Hayek an Egalitarian?

Hayek and Rand on Reason.

Back to to the original question, can libertarianism serve as a model for "egalitarianism?" It depends on how you define "egalitarianism." If egalitarianism is something that must achieved at the hands of an administrative State, then, obviously, no. Historically, libertarianism more or less intellectually derives from the blowback against the Post-Napoleonic French Administrative State. If egalitarianism means a social order producing institutions that are by and large devoid of special privilege(or granting such) and monopoly(or granting monopoly privileges) and allowing efficient redress of grievances and injustices, emergent collective action that is actually addressing a problem and not benefiting a special interest(under the guise of "the general welfare"), and where 'collective action' doesn't actually create 2 new problems for every problem it is supposed to address, and where there is legitimate equality of opportunity, then, yes, libertarianism can serve as the basis such a model. Unfortunately, this precludes the Administrative state from serving as such a model.

For example, in terms of "Health Care," here's a good article how government solved an original problem, namely that prices were too low and how spontaneous order social institutions and competition threatened the medical establishment, which eventually successfully "lobbied " the State to put an end to those social institutions.

Kenneth Arrow's famous paper, "Uncertainty and the Welfare Economics of Medical Care," which is the bible of market failure in health Care, argued that the institutional deviations from a "Free market" in health care in post WW II America were the result of socially organic processes naturally arising as a result of such things as "uncertainty" and "information asymmetry." Arrow's paper, however, discounted or dismissed Public choice counter-arguments(explaining the institutional framework that had arisen), which, in academia, were only in their infancy at that time. Since the time of Arrows paper(early 1960s), as government has become more involved in the health Care system, the rise of spontaneous medical tourism markets makes the case that the evolution of the current system is built more around Public Choice and not, actually, market failure. Although Arrow was correct that that the market for health care was not a classic "xyz widget" model of neoclassical perfect competition, the idea of spontaneous social institutions arising to solve 'collective action problems' seemed absurd to him. Indeed, an argument not worth considering, which was the common attitude at that time.

My contention is that problems originating in Public Choice is not an argument for doubling-down on "public choice," or tolerating this insanity of politics that tries to use doubling-down on government failure as some sort of self-masturbation to some "great moment in history,' all for some political gain, which only benefits the very few at the expense of the many. And that if this bill passes constitutional muster, then you will see our quasi-nationalized health care system being a new battleground for the culture wars. Count on it...

You'll have to bear with me

#7692 On Mon, 2009 11 09 17:13 Paba said,
I don't have a strong background in this sort of academic approach to these philosophies. My understanding comes primarily through their political and economic influences. That said, as someone who errs on the side of:
 
"If egalitarianism means a social order producing institutions that are by and large devoid of special privilege(or granting such) and monopoly(or granting monopoly privileges) and allowing efficient redress of grievances and injustices, emergent collective action that is actually addressing a problem and not benefiting a special interest(under the guise of "the general welfare"), and where 'collective action' doesn't actually create 2 new problems for every problem it is supposed to address, and where there is legitimate equality of opportunity, then, yes, libertarianism can serve as the basis such a model."
 
This seems to be the radical model which comes from the French Revolution, no?
 
On to the health care issue: what you're talking about here is far beyond anything I've really looked at (I like studying this stuff, but I'm no academic in this field, I'm an academic in the Information field). I'm not so sure that my belief in the irrationaly of markets might preclude any possible belief that "things will just be sorted out" for the most vulnerable populations.
 
Once again, I hope you'll bear with me because I'm trying to find a way forward for my belief in liberty somehow reconcilied with a belief in irrational markets (due to lack of information). Maybe I'm missing something about spontaneous order...

RE: Academic Approach

#7694 On Tue, 2009 11 10 08:01 ka1igu1a said,

I don't have any formal training in economics, political science,philosophy either(my "formal training" would be math,physics and practical is IT/programming), but I've read enough "informally" to have a working knowledge; but the primary reason i may use "academic terms" or 'academic language' on occasion is so that terms of a given discussion can be well-defined and any debate or further discussion that may ensue doesn't end up degenerating into pointless straw-man diversions. Quite a bit of internet forum or blog commentary debates is just that, strawman attacks/noise, which is just a pointless time-waster.

This seems to be the radical model which comes from the French Revolution, no?

I would argue that "libertarianism" does indeed derive more from the French tradition, as opposed to "liberalism," which derives more from the English/Scottish tradition. Historically, american libertarianism was "individualist anarchism," which more or less was the fusion of radical liberalism("laissez faire") with anti-authoritarian socialism. Nonetheless, "individualist anarchism" was viewed, however, as the logical extension of "Jeffersonian Liberalism" in the United States. But this mode of thought originated, largely, out of the french intellectual movement that arose as a protest against the privilege and bureaucracy of the post-revolution french administrative State. Indeed, the very terms "laissez faire" and "bureaucracy" originate from france(as well as "entrepreneur").

One of the great myths is that the likes of "Adam Smith" were advocates of "laissez faire;" that's inaccurate, that term post-dates him and if you actually read his stuff, that's not what he was advocating. Truth be told, if you actually read Hayek, he wasn't actually a staunch advocate of "laissez faire" either. Laissez faire is a dialaectical counter-argument originating from the pernicious effects of "administrative statism," while "classical liberalism" deriving from the english/scottish side had more faith in "constitutionally limited governments."

Another myth is that the 19th century was "laissez faire" run amuck. That's a historical perversion. Laissez faire was actually a counter-argument against the Administrative State, and it was State Capitalism monopoly which was the source of the great libertarian/anarchist/socialist social movements of the latter part of the 19th century. One of the great historical white-washes of the 20th century is the progressive movement's revisionist success in historically portraying itself as the "great tamer" of "laissez faire." And in the end, World War I killed the original libertarian movement.

But enough of history. Back to your post. Your contention that "markets are irrational" is exhibit A why I think "defining terms" is often necessary when debating. i have no idea what you mean by that statement. if you mean that markets don't follow neoclassical equilibrium behavior, that's one thing--indeed, "libertarian economics' for the most part doesn't subscribe to neoclassical equilibrium modeling--but if you mean prices convey no real information, then I think you are dead wrong, and the burden of proof is on you to justify that statement, because there is a vast scholarly archive of literature that argues to the contrary.

I would argue that markets are far more rational than politics or voting. If your argument is rooted in the experience of the recent financial markets bailout, it should be pointed out these are markets largely rooted in public choice. This was a failure in political capitalism and the admnistrative state, not "laissez faire." Don't conflate irrational behavior in public choice, when you don't actually have to bear the burden of your mistakes, with behavior in markets where you actually do have to bear the burdens of irrational behavior.

"if you mean that markets

#7699 On Tue, 2009 11 10 21:33 Paba said,
"if you mean that markets don't follow neoclassical equilibrium behavior, that's one thing--indeed, "libertarian economics' for the most part doesn't subscribe to neoclassical equilibrium modeling--but if you mean prices convey no real information, then I think you are dead wrong"
 
Prices are generally the best information we have. My cynicism comes from how speculation creates havoc. Look at housing markets, and the dot com bubble (and the coming green boom).
 
So yes, I'd say its the former. Don't most right-wing conservative libertarians subscribe to that, though?
 
If I had to throw my lot in with anyone, I'd probably fall somewhere in between the radical laizzes faire of the FR and constitutional liberalism. I won't give up on the limited state with its essential but minimal safety net, at least until we rediscover civic engagement of the kind we saw before the depression (or in some isolated cases during and after). I wonder where that puts me? As one of those "liberaltarian" wierdos that everyone knows one of but noone cares to define?

furthermore

#7700 On Tue, 2009 11 10 21:35 Paba said,
I think there have been more than enough elections that have proven the irrationality of the electorate, increasingly so as you move up the ladder of federalism.

Arrow's theorem

#7703 On Tue, 2009 11 10 22:20 adam ricketson said,

In addition to Arrow's work on health care, he also made a big contribution describing the irrationality of electorates--even assuming that each individual was completely rational.

Then there's the whole issue of why voters should even bother to be informed when their vote basically can't change anything.

social safety net; radical yet realistic reform

#7705 On Tue, 2009 11 10 22:39 adam ricketson said,

I won't give up on the limited state with its essential but minimal safety net,

I think most of us here agree, in large part because the social safety net isn't really the source of the problem. The safety net clearly developed after many other state institutions (aggressive war, anti-labor policies, cultural crimes, growth-at-any-cost policies), and there's a good argument to be made that the safety net is just a fail-safe to discourage rebellion against a fundamentally exploitative system.

The other reason to leave the safety net alone is that it addresses real, immediate problems in peoples lives. Dismantling them is an administratively complicated task, if were going to make a transition to a freer society without a lot of suffering on the way.

However, there are a number of state policies that create hardships for people, all in the name of rather abstract and hard-to-prove benefits. Administratively, they could be dismantled rather easily, with the only immediate hardship being that some rich people have less money. However, politically they can be very difficult targets because they are so ingrained in our society, and the ruling class uses their propaganda system to support useful ideologies.

So here are a few:

  1. Bankruptcy should be easier.
  2. Non-compete contracts should be unenforceable.
  3. Intellectual property should be much more limited 
  4. No government license should be property--all rental value arising from such licenses should be public revenue.
Aside from this, we should make all attempts to prevent government officials from using their power to line their pockets of otherwise economically benefit their allies.

Crumbs to the peasants

#7706 On Wed, 2009 11 11 00:28 b psycho said,

there's a good argument to be made that the safety net is just a fail-safe to discourage rebellion against a fundamentally exploitative system.

@Paba: the way I've come to see it, what Adam refers to here is pretty much fact, with the difference between staunch liberals & radical libertarians being a matter of response to that fact. The state-administered safety net as revolt prevention -- and the seeming inability of the Right to consider long-term consequences to undermining the net while strengthening the system that makes such a net necessary -- has been a discussion point here previously.

RE: Economics and libertarianism

#7707 On Wed, 2009 11 11 07:32 ka1igu1a said,

most(but certainly not all) of the american "libertarian movement" subscribes in some form or other to "austrian economics." But it is not a uniform school, by any means. There is the "historical school," which was responsible for the development of marginalism(and subjective value), which was incorporated into standard neoclassical theory. There is the "praxeological school," best represented by Mises.org, and which is considered hetereodoxical(praxeology simply means the logical deduction of "human action" from an axiomatic basis). There is another school which takes a non-praxeological approach to economics, and can loosely be called the Hayekian wing of the School. This school is currently best represented by the economics faculty at george mason University with a number of them actively blogging; e.g, EconLog.

There are 2 main online repositories of libertarian/classical liberal political and economic thought.

Mises.org
The Online Library of Liberty

In the 80s and 90s, the Chicago School, originating out of the work of the likes of Milton Friedman and Robert Lucas, which represented a consequentialist/utilitarian academic approach, actually had the most influence on "public policy." But i think this "school" is on the marked decline, both in terms influence on public policy and acceptance within the "libertarian movement." Ostensibly, Obama was supposed to represent thinking from the "4th generational" iteration of the chicago School, which was "libertarian paternalism;" however, his pushing of mandated health insurance(contrary to what he campaigned on) ends that notion; and in the end, "libertarian paternalism' just ends being plain ole paternalism.

Technically, the distinction between "left-libertarian' and 'right-libertarian" has to do with "treatment" of land, with "left-libertarianism' rejecting lockean homesteading in favor of a Georgist or Mutualist treatment of land. The second distinction usually deals with the "use of dialectical methods" in social analysis, usually as means to go beyond a simple 'atomistic" libertarian approach in determining/assessing the "justice" of contractual arrangements. Left-Libertarianism per se doesn't have the same type of institutional money backing that the more "right-libertarian" perspective does; in other words, it's doesn't have patronaged intellectual/academic class to churn out papers and studies to compete with the more rightward perspective that typically is more sympathetic to "conservatism." Left-Libertarianism relies more on historical criticism and the modern work of amateurs(by amateur, I mean a non-subsidized, non-patronaged intellectual class that produces intellectual work in spare time).

The two academics most associated with "left-libertarianism" in the US are Roderick Long and Chris Sciabarra. Interestingly, both are actually quite sympathetic to Ayn Rand and sit on the editorial board of the Journal of Ayn Rand Studies(however, neither subscribe to what one typically thinks of being "Objectivism"). Left-Libertarianism doesn't really have online repository that can compete with Mises.org or The liberty fund; There's Alliance of the Libertarian Left. Roderick Long hosts Molinari Institute, which is a repository for historical market anarchism that derives from the French laizzes faire tradition. There is also the recent, Center for a Stateless Society, which publishes essays by influential left-libertarian amateur scholars.

My own approach doesn't really fall into typical categories. I take a Hayekian approach to sociology, but in terms of economics, I link the Hayekian approach more toward Complexity Economics than traditional neoclassical economics. I'm a left-libertarian because I reject the lockean homesteading principle and i have deep abiding aversion to social conservatism and the mixing of religion and politics, and reject, outright, that liberty has anything to do with sectarian religion. However, I'm also skeptical of some aspects of left-libertarianism's overreliance on "dialectical methods" to harmonize with some aspects of the political left.

My two most contentious posts on this site were:

Kinsella on the Chicago Sit-in: "Shoot 'em", where I criticized "paleolibertarian" opinion about apparently approving the shooting of "United Electrical, Radio and Machine Workers union workers' in their labor dispute with "Republic Windows & Doors."

The second post was Libertarian Thickness, where I criticized "left-libertarian' attempts to align with certain feminist opinion that porn and the 'sex industry,' all of it, were indefensible.

I actually found stephan kinsella to be a more cordial foe than some of the vitriolic private correspondence i received from "left-libertarians" as a result of that latter post.

I find myself to be a bit of "wierdo" as well; I don't fit in politically with much of anything. I think 'constitutional conservatism,' or this recent expropriation of libertarianism by the political right is a joke. I'm pretty much, however, opposed as well to the political left because i don't think it is all that liberal, or is willing to sacrifice whatever liberal principles it has on the alter of political partisanship. I think right-libertarianism is much too tied into reigniting libertarian-conservative fusionism and left-libertarianism simply cannot fuse with left-wing communitarianism at all.

Equality

#7702 On Tue, 2009 11 10 22:05 adam ricketson said,

Just to spell out my views on equality, I typically aim for social equality -- a situation where no person is the superior of another (except in specific aspects of relationships, such as teacher/student or one person being more skillful than another at a given task).

This is separate from absolutist economic equality (where each person has equal income and wealth), though economic and social equality definitely interact. I think that the key to maintaining social equality in the face of economic equality is for people to be rather independent economically -- and to the extent that interdependence is necessary, a person should be able survive in an association with equals. I am not satisfied with simply increasing the level of consumption for the poor (as some liberals/libertarians are), because I believe that much of what humans value is inherently social and can't be replaced by material goods--though I don't want to dictate social relations either. I am very suspicious of any social or economic policy that increases inequality in the name of expanding total GDP--and there ore plenty of these policies.

This vision is not compatible with the mainstream social roles of "worker/capitalist" or "civilian/governor". 

While I would not expect a libertarian legal system to have perfect economic equality (it can't be if people are allowed to make economic choices), I suspect that it would be more equal than most modern societies. This is because I think that political power is inherently unequal, and those with more power use their power to dominate and exploit the rest of society -- thereby expanding their wealth, some of which gets reinvested in the political process.

Hmmm...I see what Long is saying

#7693 On Tue, 2009 11 10 00:21 Paba said,
And in all seriousness, it makes a great deal of sense. I'm still in the dark as to whether or not doctors would have still been sufficiently recruited to the profession w/o an increase in price, but like the single payer crowd, I'd like to think that most doctors are in it for the service aspect and not the money.
 
Civil societarians are probably the most predominant silent voice out there today. You're more likely to trust your most local governance than a high level of governance. Likewise, as you reach higher levels or governance, it has to be more coercive by its very nature (it's much much harder to reach anything close to consensus, but I think the rule of law vis a vis constitutional republics can work on a greater scale than little communities dotting the map).
 
Now as long as this civil societarianism squares with my belief in irrational markets (which are corrected at best through transparency and increased information on speculative forces), then we might be in business... 

Ron Paul uses Medicare

#7691 On Mon, 2009 11 09 10:14 missliberties said,

as does Virginia Foxx, a board certified member of the government will kill you crowd.

The market failure in health care is intentional. The reason is the profit motive. It's that simple.

All of the collusion, corruption, culture wars, and inequity in our uniquely American health care system, has been driven by the desire for and the power of wealth in the hands of the few. Any change that brings cost into the realm of reality will be nigh impossible. I see any shift towards reducing costs as a small victory.

Medicare is compulsory...

#7695 On Tue, 2009 11 10 08:21 ka1igu1a said,

You are forced to participate...

The market failure in health care is intentional. The reason is the profit motive. It's that simple.

Well profit motive in public choice politics does result in welfare minimizing outcomes. However, i don't think that's what you mean are referencing; based on my experience with you at swords Crossed, you are stating that "profit motive' in general results in 'market failure." Well, that's equivalent to stating that trade is intentionally done to make everyone worse off. Quite a boneheaded, indefensible statement...

Re: Medicare is compulsory....

#7696 On Tue, 2009 11 10 14:09 missliberties said,

No it isn't. You are free to use private insurance, if you so chose.

I meant what I said in my original statement. The market failure in 'health care' is by design.

If what you are marketing is actually health care, there would be incentives to increase the over all health of the general population.

Your interpretation of my statement is incorrect.

What is particularly aggravating is those who advocate for market based solutions, yet then chose to go with a solution for their own care, that is subsidized by the tax payer by giving outside contractors a piece of the federal pie. Many of the AARP plans, like Medicare Plus, and Medicare Advantage reimburse doctors, and privately contracted companies, with Federal dollars at a higher rate of pay than just regular medicare.

Making up an equivalency, by first reversing what I said, then inserting an assumptions on trade, then deciding this is boneheaded, then ascribing this to me, is quite a reach.

Re: Medicare is compulsory...

#7708 On Wed, 2009 11 11 07:56 ka1igu1a said,

yes it is; you can't opt-out of medicare payroll taxes and if you opt-out of Medicare Part A coverage when you reach the eligible age, you forfeit you Social Security benefits as well that you have been forced to pay into...

"An offer you can't refuse' is compulsory...When the mafia does this, it's grounds for life imprisonment; but put on a badge and wear a uniform, and all of a sudden it's "voluntary."

Your argument is exactly the same type of crap that any libertarian who drives on a 'public highway' is thusly a hypocrite. Well, there is no other alternative. "progressives" have their own hypocrisy to deal with, simultaneously claiming that the free market can't produce "roads" and then complaining that the likes of Walmart, whose distribution system benefits from and is dependent on public road subsidies, is thusly inevitable monopoly outcome of "the free market."

That's interesting

#7715 On Wed, 2009 11 11 22:19 missliberties said,

So is this:

Companies Discontinue Retiree Health Benefits
Friday November 4, 2005
J.C. Penney and Jostens have elected to discontinue their retiree health benefit programs once the new Medicare Part D Prescription Drug Benefit begins on January 1, 2006. Although most companies have not chosen to follow J.C. Penney's and Josten's example, this is not an isolated phenomenon.

http://healthinsurance.about.com/b/2005/11/04/companies-discontinue-retiree-health-benefits.htm

Medicare Part D in Action or how businesses rid themselves of the costly expense of providing retiree health care benefits.

You're point?

#7717 On Thu, 2009 11 12 09:02 ka1igu1a said,

i have no idea what point you are trying to make, other than apparently pointing out that large scale government action crowds out private action, and thus concluding that large scale government action thusly proves the hypocrisy of private action. this is fallacious reasoning, and frankly, I'm finished trying to argue against obvious logical fallacies with you...

I don't belong here

#7721 On Thu, 2009 11 12 22:41 missliberties said,

Good luck on your crusade.

No crusade

#7723 On Sun, 2009 11 15 09:53 ka1igu1a said,

being able to logically argue/defend your position is a feature not a bug...

As was the case on Swords Crossed, i have no idea half the time what point you are trying to argue...