Instapun*** Archive Listing

Archive Listing
August 23, 2009 - August 16, 2009

Friday, August 21, 2009

The Problem Nobody's Talking About

WE NEED HEART AND BRAINS. Now that everyone's focused on health care, it might finally be time to think about it a little bit. Thinking isn't a usual by-product of political debate, but it could be helpful if somebody actually tried it.

The political question is, Do we want the government to be in charge of health care for everybody? Most of us, as we ponder the government's record, are coming down on the "no" side, because whatever government gets involved in typically becomes more expensive, not less, and poorer in quality than what free markets can manage. Additionally, when it comes to health, issues of personal liberty come into play more than on almost any other issue about which the government might want to legislate.

All the fears of a government-run system are justified. Even the darkest and most apparently unmentionable ones, like the suddenly proscribed term "death panels." If the government is responsible for healthcare, there will be death panels. Maybe not tomorrow or next year, but eventually, and they'll be as bureaucratically ruthless as the craziest protester imagines they will. The U.S. Veterans' Administration already has something pretty darn close in full operation.

BUT. And here's where the thinking comes into play. This worst of all possible outcomes will not be prevented by defeating Obama's drive toward universal health care. There is a unique problem with the topic of health care that makes it unlike most of the free market commodities conservatives keep comparing it with. And it's a problem that will be extremely difficult to solve in the long run, whether the chosen instrument is the government or the market or, as the case presently stands, a combination of both.

For much if not most of the services it entails, health care is a commodity. People will make their decisions at the margin based on a rational tradeoff between cost and benefit, similar to the way they buy a car, a house, a college education for their children, and other significant quality of life investments. But the analogy breaks down completely in matters of life and death. At the limit, health care becomes a "Cost No Object" requirement for individuals if not for institutions. Which is simply not true of other commodities. At the limit, people can pass up their dream house, dream car, and dream university as too expensive. Not so when the dream treatment is necessary to prolong life itself. This is the precise point at which the conservative "personal responsibility" argument breaks down. If your child needed an impossibly expensive operation or drug regimen to live, you would probably say anything, sign anything, promise anything, and tell every conceivable lie to procure it, which makes your word as an economic trading partner worthless. There's no such thing as a valid contract with such a person. Life and death is the choice that trumps all other values and codes. People do not regard death as a legitimate trading chip in free market bargaining.

There are multiple reasons why health care costs are rising faster than the rate of inflation. The government is already involved in subsidizing health care for a huge chunk of the population, and whatever the government subsidizes, it produces more of. I believe the record indicates that Canadians go to the doctor more often than Americans do. Americans on Medicare probably go to the doctor more than they would otherwise. Why wouldn't they? It costs them less cash than if they were paying for it out of their own wallets. Frivolous malpractice suits are another big contributor. Suing the doctor is a viable income alternative in this country. This drives up costs in a host of ways -- doctors pass on their malpractice insurance costs to all their patients, they perform tests and procedures they wouldn't otherwise regard as necessary, and they generate expensive additional paper trails that are purely defensive in nature. (No one, to my knowledge, has quantified the cost in quality of doctors practicing medicine with an eye constantly on the lookout for "cops" in the rearview mirror.)

Yet the biggest, deepest driver of increasing medical costs is the expansion of medical technology. There are more things that can be done to treat, cure, and prolong the lives of patients. Stuff the good old family doctor who once made housecalls could never do. (His pro bono kindliness, even if restored, could never make up the difference.) And all those things, especially the newest and greatest things, add huge increments of cost to the entire system. This phenomenon is entirely consistent with free market principles. The first VCR, the first microwave oven, the first iPhone, the first HD television cost a small fortune. As more competitors enter the market, the price falls. But consumer behavior does not follow the normal pattern in medical situations. No one says, "This new set of innovative cancer drugs is too expensive; I'll wait till the price comes down in a year or two." The definition of rational behavior in this circumstance is different. A rational economic decisionmaker could be dead when the price drops to reasonable levels. They have to have it now or it's no good to them at all.

This is not a political problem. It's a major economic problem, a fundamental disconnect between what represents rational behavior to the providers of medical innovations and rational behavior to the consumers of their products. All the ways of arbitrating that disconnect involve unacceptable costs. If we remove the economic incentive for being first to market with a breakthrough product, we will cease to get breakthrough medical products and our health care system will become essentially static. If we enforce sound economic principles on consumers -- pay the freight or don't get the product -- we will be condemning people to death for economic reasons; i.e., free-market "Death Panels."

What's interesting about the present system, the one that's supposedly so "broken," is that it has naturally evolved to handle the disconnect in a way that's actually pretty efficient given the scale of the problem, though still too expensive when we look at the long term. We treat most of health care as the commodity it mostly is. People pay for health insurance and are indemnified against the expenses they regard as most unacceptable. This part of the system works so well that most people are pretty satisfied with it, apart from all the normal grumping and complaining they also spout (if we're being honest) about the phone company, car dealers, their electrician, and their daughter's wedding consultant.

At the same time, everybody in the whole country is also walking around with a get-out-of-jail free card they can play the moment health care ceases to be a commodity and becomes a Cost-No-Object requirement. People with no insurance can go to the emergency room and receive in life-and-death situations the same care anyone else would receive. People who have insurance that can't cover a truly dire and expensive crisis can, when the bills for which they are personally responsible come due, declare bankruptcy. Of course, these additional, unanticipated costs are subsidized in the insurance premiums paid by the people who carry health insurance and by individual creditors, which means that they are already the "brother's keeper" Obama insists they still have to become. That's how the market is bridging the unique and hugely expensive divide between two vastly different definitions of rational behavior.

Overall, the personal costs entailed by the market's ad hoc approach are both rational and acceptable, however much individuals may complain. It may be rough to have to declare bankruptcy because of a life-threatening illness, but what were the stakes? Life and death. If you escape with your life, or with the knowledge that everything possible was done, it's worth the price, now isn't it? All the rest is kvetching. For those who never thought to invest in insurance, or couldn't afford it, there is still an excellent possibility of escaping with their lives. That's not a bad bargain. Is it?

It's the long-term institutional and economic costs that aren't addressed by the current system and probably can't be by a government system that heaps the additional costs of waste, inefficiency, human casualties and economic disincentives for innovation on top of the structural problem of evolving, increasingly expensive medical technology.

The dilemma is this. Doing nothing right now is clearly superior to what's on the table. But doing nothing will also not solve the real problem, which is that the disconnect between economic rationality and human survival rationality will eventually make medical care as we presently conceive it too expensive for both indviduals and society as a whole. Somewhere out there, something's going to break; either 1) people will be denied available care and trapped into early death choices for economic reasons, or 2) medical technology will adjust by ceasing to innovate.

This is the area in which people who are still capable of thinking should start thinking. Hard.

Warnings Ignored

NOT the Messiah.

INSTAPUNK IS (MOSTLY) ALWAYS RIGHT. Just a reminder that we tried to tell you, long before this crisis descended like a ton of bricks. We were right about everything in the last election except the act of insanity that caused the Republicans to nominate John McCain. (Yes, we endorsed him, but what else could we do? The alternative was incomprehensibly worse.) And we've been right all along about Barack Obama.

We warned the press:

Start nitpicking his cabinet appointments, legislative agenda or policy decisions, and you will perish in a wave of hurt euphemisms which will make it clear to the most extreme sycophants and true believers that you are, ahem, probably a resentful racist. Watch as, one by one, the most illustrious and invulnerable of your number are disgraced into retirement for having dared to use their verbal talents against the new pharaoh. If it can happen to Geraldine Ferraro, it can happen to you, too.

Continue being the same adoring cheerleaders you've been so far -- through the inevitable crises and missteps and blunders and failures -- and the already tottering structure of the MSM will collapse in cataclysmic ruin. You will bore your dwindling audience absolutely to death, and they will begin seeking honest news reporting elsewhere. (As they have been, btw, for some time now; how's NYT stock doing these days, kemo sabe?)

The nature of your bet thus far is idiotic -- that Obama really is the absolute answer to everyone's prayers you so want him to be. He isn't. He's a flesh-and-blood man who will stumble and err and make some truly awful decisions. When that happens, your extravagantly uncritical support for his rise to power will make you accountable to many Americans before you cover the first act of his administration. And when he does take office, the fact that you have let him rewrite all the rules of what is and is not fair coverage in political reporting will do you in no matter what course you choose. Criticize him and be branded with some of the worst labels available in these United States... Suck up to him and go rapidly out of business -- not to mention lose all the power you have so jealously acquired and used so self-righteously in the last hundred years.

Take your pick.

We warned the irrationally smitten voters and pundits:

Do you believe the lie that the government really cares about your health, your healthcare, and your lifespan? Then you don't understand the circle of power at all. Have they outlawed tobacco and cigarette smoking? No. Because then they'd lose the incredibly onerous and regressive taxes they impose on cigarettes. They care about your healthcare only if it enables them to make more businesses -- insurance, hospitals, medical practices, pharmaceutical giants -- dependent on them for profit, permission, existence. That's what it means to be "liberal." Inside the circle, that is.

Your side is dedicated to only one constituency: power. If you don't understand that, you're outside the circle. Any good they do you is the sheerest accident, an unintended consequence of a strategy whose prime purpose is to maintain your pitiful dependence on their breathtakingly humongous lies.

Enjoy the next four years. Obama's inside the circle now. Where the hell are you? And more importantly, what the hell are you? You're the meat that baits the trap.

We even warned the libs who wanted a black president principally to expiate their own guilty consciences:

[I]t's the absolute worst time to elect a first black president. Nothing he does, or can do, will be analyzed in nonracial terms. He will be handcuffed by his race, criticized for every act of compassion and restraint, and there's absolutely no chance in the current circumstances that he will be able to govern as a "trans-racial" pioneer of some new age.

I won't labor the point. If times are going to be genuinely hard, there's no rationale for compelling a black American to be identified with hard times in perpetuity. If Obama really were as talented as a Lincoln, there would be some reason for taking the risk. But he isn't. And there isn't.

The presidency right now is a sour apple. Hand it to McCain. He's used to sour apples. Hold your fire. Elect Obama when the time is propitious for success rather than years of darkness and failure.

I know you won't listen. But there's nothing ironic about the advice offered.

Of course, we didn't specifically predict that he would compound the mess by having his Chicago foot soldiers brand all his opponents as racists. We sorta thought he would, but we were too afraid of being called racists to predict that. But you're all smarter than we are. We know. Live with that.

Thursday, August 20, 2009

Rants Are Cool.

It's not the stone that makes it all possible; it's the water.

MAGGIE SOUNDS OFF. The subject of rants came up in our Comments section a few days ago, and we sort of agreed with JS, who said:

Ranting feels good, and also has many positive physiological benefits...

And we liked Maggie's fiery response to this IP post. But it's not the whole story. Rants are, in reality, like the skipping of the stone across the water, sustained by an enormous body of deeper thought rarely referenced in the performance itself. So, when we saw Maggie's rant, we thought maybe this was a good opportunity to show that 1) Rants aren't purely the emotional pyrotechnics they're usually dismissed as, and 2) This rant's not really telling us anything we didn't know already, in pretty excruciating detail. No offense, Maggie. Honestly. Loved the vibe. But we've been all over this, under it, around it, inside it, and completely on top of it for years. What did we do? We hyperlinked her comment. The first link isn't to InstaPunk. All but one of the rest of them are. We're the ocean of rage under your angry skipping stone. Just so you know.

O.M.G.!!!! That poor eagle is stranded on that drifting chunk of melting polar ice shelf! Damn you selfish humans! If only the United States Congress would take charge of every aspect of our very personal lives and restrict, forbid, and regulate our very breaths with a bill that makes things right ...

Our capitalist system has the natural means to flush and correct itself ... if allowed to. But the government over the last several decades has not permitted the natural course of such things. Worse, said government blob is about to cripple and stifle any proper and just failure, lessons learned, and innovations resulting from the process. They are putting us in straightjackets in securely locked padded cells with themselves and unelected lobbyists and czars as the nasty abusive staff of this putrid asylum. Soon we'll all be mercilessly slapped about, abused in our beds, starved, left in our own excrement, and loudly chided to just hurry-up and fucking die already.

We are experiencing a new generation produced from the previous generation that arrived from their parental generation that watched and lived through horrific economic strife and the threat of world fascism. Our generation and that of our offspring's are lazy from lack of want and the need to be useful beyond the limited materials at hand. We knew when we were leaving high school our next paths were either to continue on to college or trade school, find a nepotism placed position with a standing factory in our area, or look for a job we could climb the proverbial ladder in.

Today's generation expects, for some reason, that if they don't go immediately into either the MTV video line-up (NSFW) of music or an insanely ignorant reality show, the NBA/NFL/MLB, or pointless modeling on billboards while posing scantly clad, androgynous sexual partners ... well, then, there's just nowhere else for them to go so the government must assume the job of parent and provider for them and however many offspring they carelessly plant and bring into this society. They suffer from "Day Care" syndrome. All the country is a day care for them ... and all day day care.

Several years ago I saw an evening network news show (I'm thinking it was Diane Sawyer on 20/20 ABC) and she was sitting at a long table with teen girls who were either pregnant or had given birth out of wedlock. She asked them why they would do such an irresponsible thing so carelessly and willingly, and then expect the taxpayers via the government to provide for them and their babies/children (a girl or two/three had more than one child) ... One of the girls made an indignant snit back at her and frankly stated, "Because it's the government's job to take care of me and my baby ... I'll have as many babies as I want. They have to help me."

You have an inner city 'class' in this country where the parents of, say, a 15 yr old kid is roughly on average no more than twice that kid's age ... meaning THEY were parents at 15 yrs old. In most cases their own home situation was one of a single parent who more than not was the mother who also had more children from other 'encounters' outside that kid's sperm donor. For all Planned Parenthood's intended struggle to eradicate the "undesirable" lower class segment of our society (See; Margaret Sanger) their self-righteous goal not only fell flat on its face, but now exists only to justify itself by providing their butcher services to the middle and upper class wenches who are better educated and should be smart enough to use preventative birth control in their careless sex drives ... but have this 'safety net' of dehumanizing someone else's life in order to use abortion as 'birth control'.

This is just a sample of the mentality we are dealing with in this generation after ours, and the one they are currently producing. The 'power' has been lazily given over by the more capable, but distracted and complacent, members of society to the powerless who have no more of an idea of what to do with that power than a 3 yr old does with a space shuttle. The liquor cabinet was left unlocked and the drunkards are driving the damn bus. Unaccountability is an art form and personal responsibility has become obsolete, much like the way our body's appendix has, so it's "all good" we're told. They no longer need to think and discover for themselves. All they need are the golden celebrities to guide their politics through Che T-shirts, Chi-Com red stars, and bullshit blurry-eyed warnings of republicans making rape and slavery legal. They are blind to their own chains of ignorance while being raped by the self-important people who lead their very lives ... and the bigger movement behind those 'useful idiots' who would see our society/nation sacrificed for the cause of the collective hive of totalitarian Marxism. They walk joyfully into the fire ... and drag the rest of us with them.

Ashes leave no legacy behind for archeologists and historians to read, define and emulate ... or avoid.

Well, as I said, we don't always rant. But we are the waterfront.

Wednesday, August 19, 2009

Oh Please...

JOURNALISM IS ALL ABOUT HONESTY. Damn, the mass media love to praise themselves, especially by proxy. I'm sure Don Hewitt loved his family and knew how to get 44 minutes of 60 Minutes on the air every week (Hmmm, how's that for ironclad journalistic integrity?), but as a journalist he was a propagandist worthy of Goebbels. Even otherwise glowing depictions of the man were forced to concede that his work had its less than shining moments:

Inevitably the program has also been charged with bias. "You get the feeling they sometimes shape a story to fit their preconceptions," says Los Angeles Times TV critic Howard Rosenberg. "I remember a 1991 piece on animal rights where the activists were depicted as screaming zealots while scientists against animal rights were calm distinguished figures in suits. It was incredibly slanted." But Hewitt stands by his record—and his staff. "We have an editor," he says, "whose sole job is to compare the cut segment to the uncut transcript and answer the question 'Have we been fair?' "

uh, frequently the "fair" answer has to be no. The faked Audi story, the Alar fiasco, and so many corporate ambush hackjobs that leading PR executives counseled companies in this particular instance not to appear on 60 Minutes even while standard advice called for maximum openness and cooperation on controversial stories. Insiders knew Hewitt and his crew were not to be trusted.

That's all I'll say about Hewitt. But I will remind you there's something significant about the speed with which 20th century dinosaurs are dying off. Something big is going to happen. Something the citizens of the last age don't want to be part of.
P.S.  An interesting and baffling question has been posed at the Metalkort. Everyone's encouraged to weigh in. You don't need to be an approved poster to comment.


WHAT MATTERS NOW. I'm an impatient sort by nature. Metalkort hasn't had much time to respond to the question asked: How do you prove the obvious and should you even try? There's been one answer so far. Apotheosis said:

The vast majority of voting-age adults will already have had more than enough exposure to [the] post office, the DMV, and various other government-run agencies to form their own opinions.

If those experiences weren't enough to make that necessarily negative impression, there's nothing you or I or anyone else can say that's going to convince them. Whatever proof we could provide is going to fly directly in the face of what they've already resigned themselves to accepting.

Which is pretty much what I thought. The so-called health care debate isn't really a debate. It's a gut check. Who are we as Americans, how do we conceive of our social contract with the government, and just how strong are we in the face of gray-suited bureaucrats who claim they know what's better for us than we do ourselves?

Let me rephrase that. Not a gut check. It's a life check. What's the point of being here at all? Is it to cower in fear of all the bad things that might happen to us and our own? And to expect continuous protection from all those things?

Or is it to, well, live? Live with the uniquely American risk of doing more for ourselves than any other people has expected of themselves and bask in both the fear and joy that accompanies the experience no other people has ever had. Human flight.

Buffalo Bill and Lindbergh and Mark Twain and Sam Houston and Neil Armstrong and, yes, Amelia Earhart, too, who did not come safely home. Sometimes we don't. Lincoln and King could tell you that if we could only ask them. But would they, if we asked, bleat for safety and circumscribed security above all other principles? I don't think so. I still think they'd trade everything for the chance to spread their wings and fly the American flight.

That's the only question Americans across the country have to ask themselves about this new drive toward government control of everything in their lives. Do they still want to be Americans? Or have they grown tired and anxious for succor in place of the chance for success?

The question goes double for the kids. Do you want to be a gradually expiring appendage to an i-Phone? Or do you want to live?

Your choice.

Tuesday, August 18, 2009

Hot Air at HotAir.

"I think the NFL did the right thing..."

MODERATION IS THE SOUL OF MODERATION. Sometimes you get a perfect definition of a moderate. Lots of principled feelings but no actual principles. Ed Morrissey today:

I think the NFL did the right thing by lifting the ban after Vick’s release. I’m not especially supportive of the Eagles’ decision to pay Vick to play football per se, but I definitely believe they should not have been blocked from doing so.


btw. Loved the poll results. 55 percent think Vick should be allowed to play for some NFL team. What would the result be if you asked whether they want him to play for their team? Moderates.

The Greatest Sci-Fi/Horror
Movie Ever Made

THE UNDERVERSE. Thought that would get your attention. No, it's not Alien. It's Cat People. True, it has no spaceships. What does it have? Absolutely superlative setting, cinematography, score, and most of all, casting. This movie couldn't be made today because there is no way to replace Malcolm McDowell and Nastassia Kinski in the lead roles. McDowell is brilliant because he isn't playing a leopard; he simply is one. Kinski is brilliant because for all the promotion and puffery of supposed screen sirens we get these days, this is the only woman in the last quarter century who is not only completely uninhibited about being naked, she also looks like she's naked even when she's wearing clothes, which is nearly half the picture. On top of that, amazingly, the beautiful Kinski and the historically, epically ugly McDowell also look like brother and sister. (Try to cast it with any of today's stars; just try.) The score is so good it could tempt one to think that the whole film is simply a teaser for the song played during the closing credits -- Bowie at his best. Except that the movie is genuinely horrifying, a perverse Cajun gumbo of bayous, eros, incest, suspense, and hideous violence. Is there science fiction? Yes indeedy? The autopsy scene might not be as chest-bursting as Alien's biggest moment, but that's because it's a different kind of moment, yet definitely fictitious in its scientific details.

Wanna fight about it? Take it to the Underverse.

Monday, August 17, 2009

Our Story Thus Far...


LOVE IS A MANY SPLINTERED THING:  Just to put everything in its proper perspective. The world's most mature government, a beacon of judgment and altruism to every nation on earth, decides to elect as its leader a man without record, political experience, or verifiable personal history because he knows how to combine cliches in speeches any third rate TV writer could trump in a Law & Order episode, and the smartest people in the country -- professors, media stars, and social scientists of global reknown -- are so swept away that they suspend all their faculties of logical criticism in an orgy of adoration that gives the man carte blanche to remake the most successful country in human history as he sees fit.

When individual citizens resist and object, the same brilliant "leaders" denounce them as mobs and describe them as "anti" the principles of the nation their chosen savior has written two books deploring. Why can't they see that he wants to feed us all from the bosom of government he has dreamed of since his grandmother rescued him from starvation in Indonesia? (And since his grandmother was a "typical white woman" who reminded him of American imperialism, he preferred to think of that rescue as destiny preparing him to use America to save the world?) Ali ali akbar. Think about it. If he'd ever seen the First Princetonian naked, he wouldn't be a baritone anymore; he'd be the kind of Soprano who does in his enemies Chicago style.

Beauty Redefined. It's an A-Line thing. With flinty eyes.

He certainly wouldn't be the kind of impotent freak who does in his enemies Chicago style calling for everybody else to share the wealth while his wife wears $2,000 shoes and a $5,000 handbag as she troops through the best and worst neighborhoods in the world, including the middle east. I mean, Oops. Shouldn't Michelle be wearing a burkha and obeying husbandly orders? With that cow spraddle? Please. She's far more Egyptian Hathor than Saudi queen. Does she even know why her husband says Pah-kee-stahn in the same sentence with Afghanistan? She doesn't care. They don't talk. She glares. He's not an African-American. He does what she declares. She's bigger than he is. It still matters.

I have only one question for the pussy-whipped One. Where's the milk?


Well, where is it? I just can't wait to suck out the dollars his minions don't want want me to have from 80 to 90. That's some precious fluid indeed...

And people are having a hard time making fun of this androgyne? Give me a break.

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