Federalist No. 8

Posted on 2008-04-22 by David

I found Federalist No. 8 to be simply prophetic about the dangers a country faces when subjected to the intersection of human nature and the constant perception of external threat.

Safety from external danger is the most powerful director of national conduct. Even the ardent love of liberty will, after a time, give way to its dictates. . . . the continual effort and alarm attendant on a state of continual danger, will compel nations the most attached to liberty to resort for repose and security to institutions which have a tendency to destroy their civil and political rights. To be more safe, they at length become willing to run the risk of being less free.

This is exactly the danger that libertarian minded pundits have been vocally warning against since September 12, 2001. Though Alexander Hamilton is speaking about real external dangers the truth is that the public perception of external danger can be used to these ends with equal effect.

. . . weaker States or confederacies (or even nations) would first have recourse to [standing armies] . . . They would, at the same time, be necessitated to strengthen the executive arm of government, in doing which their constitutions would acquire a progressive direction toward monarchy. It is of the nature of war to increase the executive at the expense of the legislative authority.

This is precisely the effect that we have seen throughout the Bush administration with the constant harping on the dangers posed by terrorists from around the world. To be sure, the technological advances of the last century have reduced the geographic cushion that had contributed to our national safety for the earlier part of our history. Despite the greater range available to anyone who would threaten us, we must stand vigilant against attempts to reduce our freedom in the name of safety when the safety being offered is against a threat more imaginary than real.

I don’t mean to say that the events of 9/11 were imaginary but those events, devastating as they were, did not constitute a real threat to our national survival except insofar as we respond to them by changing our society so that we become a different nation than the one which has been a beacon of liberty to the world. That idea cannot be killed by terrorist acts, and that idea is the American that is enshrined in our constitution.

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A Novel Approach

Posted on 2008-04-21 by David

As the clock starts in our efforts to reform out Utah health care system I was encouraged by this Op-Ed in the Salt Lake Tribune.

Making health insurance affordable – forcing carriers to offer so-called “affordable plans” – will not result in affordable health care. . . . our priority must be to restore the health-care provider/patient relationship by providing the patient with cost and performance information and making him responsible for his own care. The government does not tell its citizens what house, car or flat screen to buy, but there is an assumption that when it comes to choosing a health-care service, we are incapable of intelligent decision-making and need intermediaries.

Only when the patient is armed with relevant information regarding cost and a providers performance will that patient be able to make informed decisions. Armed with such information, a patient will shop quality and price, which will drive down costs. (emphasis added)

What I really love about this is that it comes from a completely unexpected source – this article was written by the executive director of the Utah Association of Health Underwriters. Along with her valuable diagnosis, Ms. Smith also offers this idea as a possible approach to explore:

For example, an insurance company might give the patient a benefit credit equivalent to the average price of a knee replacement surgery and the patient would shop around with the information given. Based on this data, he might choose a surgeon with a long record of solid outcomes and a lower price than the benefit credit his insurance has given him.

The insurance company could allow him to keep the change in his Health Savings Account for future health-care needs. This practice is already happening on a small scale in several areas where a hospital lists a global price for a heart bypass and gives a 90-day warranty. No extra charges for pain medication, Band Aids or physical therapy – all are included.

This does not require a mandate for our citizens, and might serve as an incentive to bring some people into the insurance pool. It also allows for comprehensive health insurance plans that keep the patient as the one making decisions about how the insurance money gets spent.

As if that was not enough, Cameron drew my attention to an Editorial in the Deseret News written by a doctor talking about how he improved his practice by dropping insurance plans. Though the article is not explicit on the point, it sounds like he eventually dropped all insurance plans and now only deals directly with patients.

{Many physicians} feel that it’s their mission to serve as many patients as possible rather than to provide the best care possible. Most significant, today’s doctors are preoccupied with the bureaucracy of insurance companies. . .

To be sure, physicians are not entirely to blame. With insurance companies dictating how much doctors can charge for services as diverse as a routine checkup or an appendectomy, a doctor has only one route to more income: increase volume.

Does anyone else want to help ensure that these perspectives do not go unnoticed by our illustrious task force?

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Repeat After Me

Posted on 2008-04-19 by David

If there was one thing that I would like to accomplish related to the health care issue it would be to highlight the fact that having health insurance does not equal having decent, or even basic, health care. The Deseret News perpetuates the falsehood of equating the two:

The task force will begin the design phase of rebuilding a health care system that will ultimately ensure all Utahns have access to basic health care — nearly 300,000 Utahns don’t have insurance now.

Not having insurance is not the same as not having access to basic health care. The dangers of buying into this false association are illustrated later in these words:

Top on the list of priorities is getting everyone into the insurance pool, i.e., the chronically healthy to the chronically ill.

Is there anyone who has not heard the adage “if it ain’t broke, don’t fix it?” Forcing the chronically healthy to get into the insurance pool is a case of fixing what “ain’t broke.”

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Federalist No. 7

Posted on 2008-04-19 by David

My first reaction to Federalist No. 7 was that it was applicable to the nation at the time it was written, but had little insights to offer us at present. Later it occurred to me that the issues being addressed would be applicable at any time we might consider the possibility of dissolving the nation into smaller sovereign entities. For example, the problem of how to discharge the national debt should be daunting enough to convince the majority of our citizens and states to preserve the union at any cost.

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Myth Perpetuation

Posted on 2008-04-18 by David

Just as our Task Force is getting started, NPR has a story on John McCain’s perspective on the issue. They outline his preferred approach – which seems generally right, and then they perpetuate one of the myths that might sink any meaningful reform.

“The problem is not that most Americans lack adequate health insurance — the vast majority of Americans have private insurance, and our government spends billions each year to provide even more,” McCain has said. “The biggest problem with the American health care system is that it costs too much.”

McCain wants to get people to buy their own insurance, rather than get it through their jobs. NPR’s Julie Rovner reports that McCain would accomplish this in a variety of ways: giving people tax credits, encouraging more people to set up tax-advantaged health savings accounts, and letting them buy insurance policies across state lines.

And no mandates for McCain. If you don’t want health insurance, you don’t have to get it.

What do you think of this plan? Would tax breaks encourage you to buy your own insurance? Is a mandate to have health care a good or bad idea? (emphasis added)

A mandate that everyone be insured is not a mandate that they have good health care (it would be impossible to mandate that everyone have good health care). Health Insurance ≠ Health Care. So long as we confuse the two the insurance industry will sway the debate in their own favor. Giving everyone insurance, no matter what method you use, will not guarantee that they have good health care.

As our Utah task force held their first meeting (which I could not attend) I was worried that they would not actively try to include consumers among their stakeholders, leaving the influence to industry professionals and lobbyists. I was very encouraged as I listened to the audio of the meeting when Senator Killpack listed consumers among the five major stakeholders for the task they are tackling.

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The Dread Disease Called Ease

Posted on 2008-04-17 by David

With the news that WordPress.com is banned in Brazil because of some inappropriate blogging by someone, Lorelle makes this observation:

I think bloggers around the world have become apathetic. Lazy. Uninspired. Dumbed down. Honestly. When the term echo chamber was coined, it was a good label for all the regurgitation of content spread all over the web, drowning individual voices. Self-interest blogging is pervasive. What happened to altruism and using the blog publishing platform to support freedom of speech and bloggers around the world?

What happened to us? Why am I not seeing protests and opinions on this issue all over the web? Why isn’t the banning of three million WordPress.com blogs a big deal? Why aren’t we talking about this instead of the latest iPhone gizmo and useless SEO techniques? Why didn’t people get angry and protest loudly when WordPress.com blogs were banned in Turkey, China, and other countries? WordPress.com continues to be banned in places – why aren’t we talking about this?

. . . I’m asking bloggers around the world to take a stand and let their voices be heard when others can’t.Let not millions of bloggers be blocked and banned for the sake of a couple of idiots. You don’t send an entire city’s population to jail because two people break the law. (Note to Lorelle – in Texas you can do exactly that.)

What really struck me about this observation is that it is not limited to blogging in any way. Because it is so easy to shout out your frustration – using blogs, YouTube, letters to the editor, or any other easy way to blow off steam – many people have settled into inaction when it comes to actually doing thing to make a change about those things that they don’t like.

Inaction on the part of most people to the minor inconveniences of a .05% tax hike are the reason that a few people who stand to gain millions of dollars from that tax hike are able to get the tax raised over the muted objections of  the vast majority of people who have nothing to gain from the hike. (I’m not talking about any specific tax hike here, I’m talking about principles of politics and human behavior.)

It’s time to do more than what is easy, blowing off steam in a blog or a letter to the editor, and start doing what is hard but important, attending public hearings and caucus meetings , actually reading the text of bills being considered by our government. Then we have to do more than write a letter to our representatives – we have to talk with our fellow citizens and urge them to action as well. We have to inspire them to action on issues of importance to us – otherwise we deserve whatever government give to us – or takes from us.

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Messed Up and Out of Touch

Posted on 2008-04-16 by David

Okay, so the “messed up” and “out of touch” refer to two different things, but I think they both point to the kind of systemic problems that exist in our political system. In response to a post about the Bush tax cuts an anonymous comment reveals this:

I made about $47,000 and I paid $1700 in taxes so I effectively made $45,300. If I had made $45,000 in your scenario I would have effectively made $47,400. So if I had made $2000 less I would have come out with $2100 more money in my pocket for the year.

I can vouch for the fact that this is true because last tax year I did make $45,000 and I got a huge return (everything I had paid in plus about $2400).

That’s what I call messed up.

Not long after I ran into that post I saw one from Kip Meacham that five days after sending in his perspective as a party delegate on the delegate email list policy of the Utah Republican Party he still has not received so much as an acknowledgment. This just reinforces the image that party leaders don’t feel the need to respond to regular citizens -or even grass-roots party members.

I can’t imagine a more effective way to be viewed as out of touch.

A messed up system is easy to find at many levels of both parties as well as the current party system as a whole. It is also too easy to find counter-intuitive (sometimes even destructive) practices being perpetrated at all levels of our government. The perception that the leaders of our parties and our elected representatives are out of touch with all but the most short-sighted needs of our nation is easy to maintain when everything they do is either because the party said so, or because the latest poll said so. We are almost devoid of principled leadership in the political arena.

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Federalist No. 6

Posted on 2008-04-14 by David

With the subject of the dangers of dissension between the states, I was very interested in Federalist No. 6. My interest stems from the fact that we have seen, and continue to see, the results of such dissensions – not as much between the states as between powerful parties and organizations within the nation.

. . . it has from long observation of the progress of society become a sort of axiom in politics, that vicinity or nearness of situation, constitutes nations natural enemies. An intelligent writer expresses himself on this subject to this effect: “NEIGHBORING NATIONS (says he) are naturally enemies of each other unless their common weakness forces them to league in a CONFEDERATE REPUBLIC, and their constitution prevents the differences that neighborhood occasions, extinguishing that secret jealousy which disposes all states to aggrandize themselves at the expense of their neighbors.”(Vide “Principes des Negociations” par 1’Abbe de Mably.) This passage, at the same time, points out the EVIL and suggests the REMEDY. (emphasis original)

There is enough strife, and enough of regional differences to make me question if the system we have has enough force in the built-in mechanisms of self-correction (separation of powers, competitions between overlapping interests different groups and competing interests between various groups of individuals and states) to regain the unity that has previously brought our nation together when we most needed it.

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Wandering

Posted on 2008-04-13 by David

I thought about the value of wandering as one of our neighbors walked past our house this afternoon. He was just out for a walk with his daughter and their dog. There are many possible reasons that might have prompted the walk, but arriving at a specific destination or in a specific time was obviously not a major concern.

I was reminded of similar walks that our family has taken over the years – like our first Christmas soon after we moved into this house when the girls wanted to go for a walk and we met a bunch of our neighbors for the first time after their Christmas mornings. There is so much that we can gain from having times when you do not have a specific goal to strive for and you are free to follow a whim or prompting that you could not plan in advance.

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House Members on the Task Force

Posted on 2008-04-12 by David

I wrote to the co-chairs of the HB133 Task Force asking for a full list of the task force members. David Clark responded with a list of all the task force members from the House. My current list of task force members is now:

Now if Senator Killback would respond with the last two senators I would have a full list.

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