Planners Versus Markets

David Brooks summarizes the Medicare reform debate as a clash of faith-based visions:

Democrats tend to be skeptical that dispersed consumers can get enough information to make smart decisions. Health care is phenomenally complicated. Providers have much more information than consumers. Insurance companies are rapacious and are not in the business of optimizing care.

Given these limitations, Democrats generally seek to concentrate decision-making and cost-control power in the hands of centralized experts. Under the Obama health care law, a team of 15 officials will be created to discover best practices and come up with cost-cutting measures. There will also be a Center for Medicare and Medicaid Innovation in Washington to organize medical innovation. Centralized officials will decide how to set national reimbursement rates.

Well, since roughly 20% of adults still smoke, one third of adults are overweight, and another third are obese, I would say there is superficial evidence that people do not choose wisely on matters of personal health.  On to the right:

Republicans at their best are skeptical about top-down decision-making. They are skeptical that centralized experts can accurately predict costs. In 1967, the House Ways and Means Committee projected that Medicare would cost $12 billion by 1990. It actually cost $110 billion. They are skeptical that centralized experts can predict human behavior accurately enough to socially engineer new programs. Medicare’s chief actuary predicted that 400,000 people would sign up for the new health care law’s high-risk pools. In fact, only 18,000 have.

They are skeptical that political authorities can, in the long run, resist pressure to hand out free goodies. They are also skeptical that planners can control the unintended effects of their decisions.

Republicans point out that Medicare has tried to control costs centrally for decades with terrible results. They argue that a decentralized process of trial and error will work better, as long as the underlying incentives are right. They suggest replacing the fee-for-service with a premium support system. Seniors would select from a menu of insurance plans. Their consumer choices would drive a continual, bottom-up process of innovation. Providers could use local knowledge to meet specific circumstances.

 

 

Comments

[Why didn't I ever think of this before? How much more easy life becomes.]

Yes, I need a committee of wise persons to decide what's best for me.
=========

[Clarice]

Yeah--smarties like those people who put us on high carb diets; sold us hormone replacements promising(falsely) to reduce heart attacks; high estrogen birth control pills which caused who knows how many strokes.
Brainiacs like Geithner and Spitzer and Weiner. Give me smart sommittees or leave me alone to bumble thru on my own.

[Clarice]

**Committees***

[bgates]

Throw in a lot of skepticism about having scumbags running our lives.

[jimmyk]

I would say there is superficial evidence that people do not choose wisely on matters of personal health.

Hey, government bureaucrats are people too. And while I'd love to have people like Anthony Weiner helping me out with personal decisions, I think I'll choose for myself, thank you very much.

[Danube of Thought]

Weiner will not be in the House much longer.

[Rick Ballard]

"Medicare’s chief actuary predicted that 400,000 people would sign up for the new health care law’s high-risk pools. In fact, only 18,000 have."

If we could get that guy to post his stock picks we could make a fortune taking the other side.

[Jim,MtnViewCA,USA]

I'll stand with the "wingers" on this one.
As a local radio ad summarizes "This is greatest no-brainer of ALL TIME."

More Paul Revere in LUN

[MayBee]

Yeah--smarties like those people who put us on high carb diets; sold us hormone replacements promising(falsely) to reduce heart attacks; high estrogen birth control pills which caused who knows how many strokes.
Brainiacs like Geithner and Spitzer and Weiner. Give me smart sommittees or leave me alone to bumble thru on my own.

The end.

[Danube of Thought]

Why is Anthony Weiner clinging to his House seat? Because he really, really thinks he knows how to run people's lives better than the people themselves do. They all think that way. No amount of contrary evidence affects their thinking in any way.

[jimmyk]

You don't think it's because he still thinks it makes him a chick magnet? What else does he have going for him?

[Clarice]

You don't suppose they confuse their drive for power with competence, do you?

Years ago while in law school I had a foundation grant to study the probation and parole system in Wisconsin. Among the things I came away with was the abiding notion that those in the helping professions quickly grew to hate their clients.

I expect the same phenomenon occurs with political leaders==they grow to dislike and minimize the capabilities of those dumb enough to keep electing them to office.

[Jim,MtnViewCA,USA]

"Why is Anthony Weiner clinging to his House seat?"
Could he get a job outside of gov't? Maybe he is just wondering how to pay the bills racked up by his lovely Huma.

[Clarice]

What I could never understand was how Huma, essentially Hil's "body person", the chid of Saudi academics, could afford all her expensive designer clothing.

[Danube of Thought]

I don't like to say this, but I really don't see Huma as particularly pretty. I take it on faith that she's a remarkable woman. I hope she leaves this sick creep.

[Clarice]

I don't think she's especially attractive either, but she has the kind of starved, sexless body fashionistas adore.(Probably because it's easier to make clothes look good on a hanger-human or man made--than it is on a real person.

[MayBee]

I am amused by the number of reporters covering the Weiner story who insert into the story how they know Huma and think so highly of her. It's as if they don't see that colors their reporting.

[Clarice]

Reporters on political affairs are far too close generally with the Dems they cover IMO.

Everyone seems to be practicing access journalism with the predictable result.

[MayBee]

Among the things I came away with was the abiding notion that those in the helping professions quickly grew to hate their clients.

Clarice, that makes sense. A lot of people go into the helping professions believing they can change peoples' lives, and those people want to change and will do so with the right guidance.
Then they come smack up against people who either do not want to change, or are simply incapable of thinking through the consequences of whatever their current impulse is.

[bgates]

It's as if they don't see that colors their reporting.

I'd think that would bias them against Weiner. It's one thing to stick up for a typical Democratic scumbag, but if you know and adore his wife, don't you want to make the guy suffer? Or do they figure the best thing for her is to protect the power of her scumbag husband, since that's why she was interested in him to begin with?

[Rob Crawford]

I would say there is superficial evidence that people do not choose wisely on matters of personal health.

Or they value other things more than their health.

[Sara (Pal2Pal)]

Then they come smack up against people who either do not want to change, or are simply incapable of thinking through the consequences of whatever their current impulse is

Or that do-gooders are just nosy busybodies who are repressed hall monitors who like to run other people's lives, when most of them can't even run their own.

[Clarice]

And they are always needy and rarely grateful etc etc.

Now--Imagine working hard all week in Congress, going home to your constituents and mostly all they are doing is nagging you for one favor or another or bitching--often about stuff you have nothing to do with. After a while, you really detest them and are contemptuous of their intelligence. So like the social worker who stops caring, you withdraw into a DC cocoon where the electorate is largely viewed as dumb oxen to be manipulated for their own good (and/or your personal benefit).

[narciso]

Rush had some segment where Roger Simon and others, said the intelligence of Spitzer and
Wiener, drove them to do this.

[MayBee]

Or do they figure the best thing for her is to protect the power of her scumbag husband, since that's why she was interested in him to begin with?

This. But also a strong desire to just not let the unpleasantness be publicly visited upon them.

[Ignatz]

--Among the things I came away with was the abiding notion that those in the helping professions quickly grew to hate their clients.--

At least half the people that go into "helping professions" are seriously disturbed or emotional basket cases to begin with and are there in an unwitting quest to exorcise their own demons, not others.

[Captain Hate]

I take it on faith that she's a remarkable woman.

What does "remarkable woman" really mean? She's Muffer's assistant; how hard can that be? I think she's a somewhat attractive mediocrity that the MFM dotes on.

[centralcal]

narciso: Rush played a clip of Mark Halperin and Roger Simon on the Charley Rose show saying how absolutely "brilliant" Spitzer and Weiner were as politicians, etc. etc. And, of course, inferred that it was that "brilliance" that led them to make mistakes or some such nonsense that made no sense. Who can keep track anymore of the left's insanity.

[Janet]

Rush played a clip of Halperin on the Charlie Rose PBS show saying how Spitzer & Weiner were so bright! Good Lord.

I guess the guy I saw on COPS the other evening soliciting a prostitute is really a brainiac!...just should have gone into politics.

[narciso]

That's the one, CC, I only listened to the Simon part, you know once upon a time, he was a decent reporter for the Baltimore Sun.

[Janet]

To funny centralcal! I was laying out in the sun in the Redneck Beauty Salon listening to Rush.

[Extraneus]

The Schlitz earrings, I'm guessing?

[Jane (sit on the couch or save your country)]

I don't like to say this, but I really don't see Huma as particularly pretty.

Me neither, but I'm a girl. She looks like a toothy waif to me.

[Ignatz]

--David Brooks summarizes the Medicare reform debate as a clash of faith-based visions:--

He's half right. The Dems have faith that somehow the catastrophe that always follows central planning will somehow be avoided this time and they place great faith that the laws of mathematics do not apply to their schemes.

Everything Brooks wrote about the Dem idea is equally true of almost every economic decision people make and yet freedom somehow works better than central planning. But they argue this time, with health care, it'll be different. That's blind faith.

In contrast, nothing Brooks wrote about what Republicans believe is faith based; it's a hard headed look at the actual facts and history of central planning especially relating to health care.

[Danube of Thought]

Anthony Weiner, doo-bop-sidoo
Anthony Weiner, booga-looga-loo

Woot!

[Danube of Thought]

There are two Mark Halperins and two Roger Simos. There's one of each on the good side, and one of each on the bad.

[Janet]

The Schlitz earrings, I'm guessing?

Pabst Blue Ribbon

[jimmyk]

she has the kind of starved, sexless body fashionistas adore.

I think Tom Wolfe called them "boys with boobs" in A Man in Full.

Here's a not-so-flattering image:

Why do I keep thinking of Mick Jagger?

As far as how remarkable she is, didn't we hear that a lot about someone else who likes to keep his past mysterious?

[narciso]

Right, the Pollster and the Pajama Media honcho, that's why I threw in the Baltimore
part.

[Janet]

Here is the Charlie Rose vid.

[Danube of Thought]

In Bonfire of the Vanities Wolfe called them Social X-rays.

[Danube of Thought]

Beutiful, Iggy. Just beautiful.

[jimmyk]

Speaking of Tom Wolfe, I'd love to hear his take on recent events.

An early notable moment on the Charlie Rose video is when Halperin mentions all the "right-wing bloggers" at Weiner's presser and empathizes that poor Anthony "had no choice but to engage with people who were not objective journalists." Like who? Katie Couric?

[jimmyk]

Dittos, Iggy. That's another danger of letting the Dems shift the goalposts. For every policy that is predicted to achieve a specific end, when it fails, all previous claims are flushed down the memory hole. That gets harder with the internet (think of the famous unemployment rate picture with and without the stimulus). But they do it anyway.

[centralcal]

ha ha ha ha ha

hee hee hee hee

ho ho ho ho ho

snort!

From Mediaite:

Olbermann also confirms he has hired David Shuster as his primary substitute anchor for the Current show.

Cannot stop laughing! When will he hire on Rick Sanchez for some latin flavor? Talk about a trifecta!

[Danube of Thought]

Remember when Weiner said the photo was "taken out of context?" i finally figured it out: he meant to send it to his doctor and tell him it had been four hours.

[Janet]

about 15:30 is where the clip Rush played starts....whole thing is good though in a sickening kind of way.
Noted how Halperin & Rose said Weiner was a friend (like Barbara Walters said also). The MFM & Dems are inbred. Kids, cousins, spouse, friends...they look out for one another.

[Ignatz]

--For every policy that is predicted to achieve a specific end, when it fails, all previous claims are flushed down the memory hole.--

Or worse, they claim they just didn't do enough of whatever didn't work.
Like Barry and Krugman lamenting being restricted to throwing away a mere $800 billion on the "stimulus", or the annual cries for just a few hundred billion more to finally get our gold-plated "education" system out of the gutter.

[Danube of Thought]

Joan Walsh:

"If it turns out that Rep. Anthony Weiner sent dirty pictures to a college student via Twitter, I will be surprised. However, there is one lesson I won’t learn: I will never, ever take the word of Andrew Breitbart or anyone in his army of political sewer workers, over the word of someone who denies his claims, without independent proof.”

[narciso]

In other news, 'We'll always have Wisconsin"

http://althouse.blogspot.com/2011/06/state-supreme-court-justices-expressed.html

[Janet]

I don't understand that quote DoT. She won't learn?...will she trust Breitbart now? I can't understand it.

[Clarice]

Great explanation for the snap, DoT. Four hours, indeed.

[narciso]

There is no understanding Walsh, Clarice, her words have a scant relationship to reality.
It confirms my view that she's running a SCAM
for Soros

[Extraneus]

Yes, I bet Weiner's sorry he didn't think of that first.

[narciso]

A bit of irony, at the end of this,

http://jammiewearingfool.blogspot.com/2011/06/aww-matt-damon-hasnt-given-up-on-weiner.html?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+blogspot%2FCnSK+%28JammieWearingFool%29

[Appalled]

DoT:

You might want to mention that Walsh posted that comment you quoted on June 1 -- well before the parade of pictures from yesterday. So the remark is somewhat short-sighted, in retrospect, but not as droolingly stupid as if she had posted it during the day yesterday.

My guess is that the most painful thing for the left in all this is not that a promising politician was caught with his pants down, but that Breitbart claimed another scalp.

By the way, aren't Pelosi's actions in all this interesting? Is she acting from principle? Or is she keeping her toga clean for the time when a GOP politician gets caught in the inevitable sex scandal, and tries to tough it out? Speculation is invited.

[Captain Hate]

MATT DAMON and Ben Affleck; the real life Dumb and Dumber

[Captain Hate]

My guess is that the most painful thing for the left in all this is not that a promising politician was caught with his pants down, but that Breitbart claimed another scalp.

This plus Breitbart seems to be gaining respect from the members of the MFM not myopic enough to see the edge of the cliff their fellow lemmings are marching heedlessly toward.

[MayBee]

I will never, ever take the word of Andrew Breitbart or anyone in his army of political sewer workers, over the word of someone who denies his claims, without independent proof.”

It would be awesome if she held every journalist and politician to this burden of proof.

[narciso]

What's been Tammy's read on this, Captain,

[Extraneus]

Is she acting from principle?

Good one.

[Captain Hate]

She hasn't addressed it yet, narc; maybe she wasn't aware of it. She's taken a few shots at Mitt (Obama's second term) and is now talking about the non-receipt by the dumb bastard in the White House of the daily economic briefings which means he can stop pretending to care about it.

Now her broadcast cut out dammit; still a few bugs in her system.

[narciso]

No wonder he's not 'concerned about a double
dip recession,' the Buck never got here, as
Rush used to say of Clinton.

[Sara (Pal2Pal)]

By the way, aren't Pelosi's actions in all this interesting? Is she acting from principle? Or is she keeping her toga clean for the time when a GOP politician gets caught in the inevitable sex scandal, and tries to tough it out? Speculation is invited.

She want to bury it in the ethics cmte. a la Maxine Waters. Keeps her boy Tony in Congress, at least until the next election.

[narciso]

Right, just like the little slap they gave Rangel, the c hairman of the ax writing committee, that didn't pay tax on a million
dollars worth of property.

[Porchlight]

Under the Obama health care law, a team of 15 officials will be created to discover best practices and come up with cost-cutting measures. There will also be a Center for Medicare and Medicaid Innovation in Washington to organize medical innovation.

Is Brooks aware that he just described the death panels?

[Janet]

Center for Medicare and Medicaid Innovation in Washington to organize medical innovation.

Can you imagine. :(
Meetings about having meetings about new rules & regulations for innovations.

[daddy]

As I'm frantically catching up on the many JOM threads this morning, would someone please advise me whether it's worth my time to actually read the linked David Brook's column or should I just blow it off like normal and go walk the dogs?

[Danube of Thought]

"You might want to mention that Walsh posted that comment you quoted on June 1"

Couldn't find the date for it, but I assumed it was self-evident that it was written before the confession.

[daddy]

Concerning Weiner remaining in office:

Dennis Miller just made an interesting point worth thinking about.

He sez he thinks the Dem Leadership are concerned that they have to handle Weiner now with kid gloves. Dennis thinks Weiner was such a rabid valuable attack dog-bombthrower for the Dem's, that he was allowed in on all the top meetings and strategy sessions and therefore he knows where all the Dem dirty secrets and laundry are buried, and so they are worried that this obviously wacko creep might loudly go off the reservation if they completely abandon him.

Have no idea if that's true but thought I'd throw it out there for your consideration.

[Frau Ratgeber-Weisenheimer]

A panel of smarties has been suggested:
Calling Jimmy Carter and his Council of Elders! There's work to be done right here in the US&A. LUN

(Naughty Porch to remind us all of the death panels. Will Sarah Palin be the Paul Revere to sound the alarm about them?)

[Frau Ratgeber-Weisenheimer]

LUN for the Death Panel Council of Elders.

[Melinda Romanoff]

Frau-

I can hear the first question, now.

"Where y'all from? Zion?"

[Sara (Pal2Pal)]

Porch: At the Romney town hall the other day, one of the questioners from the audience told how he had cancer treatment that was billed to Medicare/Medicare Advantage for $120,000. He moved to a different state, had the same treatment and the cost was $5000. It was in response to Romney talking about giving consumers more choice: crossing state lines, selecting coverage to meet your own needs rather than one size fits all, malpractice reform, etc.

[narciso]

Now that group is not totally useless, Aung Sang Su Kyi as a notable exception, that proves the rule, Annan, Aarhtisari, Robinson,
Tutu, 'good god, it's full of fail'

[Pofarmer]

Double the number of Dr's and you'll control the cost of healthcare. Everything else is rearranging the deck chairs.

[Jim]

The dems don't give the populace credit for being able to make a decision that is in their own best interest. But, I think the welfare system has proven them wrong. The leaches of society have learned how to milk the system to get the best for themselves without exerting much effort.

Only in the US can the dregs of society have cell phones, flat screen tv's, two cars, multi-bedroom houses, smoke, drink and take drugs, all on the tax payers' dime. So, that proves that they are not stupid, just lazy.

[bgates]

whether it's worth my time to actually read the linked David Brook's column

Good one.