Month: November 2009

If you're as bleary-eyed as I am by the minutiae of health insurance reform, and somewhat discouraged by the developments of late, take a look at David Leonhardt's brush-clearing column today. The House bill does a decent job of expanding access to coverage, but fails to tackle the deeper problems of costs. David has six criteria to determine whether the final bill will be better. They all make sense to me – although they all face the usual entrenched opposition. Read the whole thing. But here's one eye-opener:

Each year, about 100,000 people die from preventable infections they contract in a hospital. When 108 hospitals in Michigan instituted a simple process to prevent some of these infections, it nearly eliminated them. If Medicare reduced payments for the treatment of such infections, it would give hospitals a huge financial incentive to prevent them. The Senate bill takes a small step in this direction by cutting payments to hospitals with high infection rates by 1 percent. The House bill merely requires hospitals to report their rates publicly.

Think of it this way: America's hospitals are responsible for avoidable casualties thirty times that of 9/11 every year. Preventing that could save tax-payers' money. But the Congress seems unable to do anything about it. For me, finding a way to allow individuals to opt out of their employer health plan for a cheaper one in the insurance exchange seems to me a vital foot in the door for more competition and consumer choice. 

The benefit of Obama allowing the legislature to legislate and letting this arduous process take its time is that it maximizes chances for evolution, correction, evaluation … and improvement. Let's improve this thing as well as pass it.

Glenn Beck loses a lawsuit against a satirical site.

Umdiddlediddlediddleumdiddleye. Umdiddlediddlediddleumdiddleye:

That's Michelle Malkin's broad brush. And that kind of rhetoric can have consequences:

Marine reservist Jasen Bruce was getting clothes out of the trunk of his car Monday evening when a bearded man in a robe approached him.

That man, a Greek Orthodox priest named Father Alexios Marakis, speaks little English and was lost, police said. He wanted directions.

What the priest got instead, police say, was a tire iron to the head. Then he was chased for three blocks and pinned to the ground — as the Marine kept a 911 operator on the phone, saying he had captured a terrorist.

And here's a classic moment:

When officers arrived, police say, Bruce told them he heard the man say “Allahu Akbar” – Arabic for “God is great.” “That’s what they say before they blow you up,” Bruce said, according to police.

But this too is worth noting:

McElroy said Bruce "teared up when we told him that (Marakis) was a Greek Orthodox priest and not a terrorist."

A reader writes:

Your reader wrote:

"The biggest upshot of the self-publishing revolution is the greater likelihood of people finding the crap that means something to them rather than having experts tell them what crap should mean something to them."

I agree with most of what he or she wrote, but I think the statement above is partially wrong. With more people publishing, there is more "noise" out there. That means that even though there is now a greater likelihood that some crap out there means something to me, there is also a smaller likelihood I'll be able to cut through the noise and find it.

In a Long Tail economy, the role of the gatekeeper becomes extremely important. The gatekeeper can be a traditional one, like the NY Review of Books, or a more modern one like the reviews on Amazon, or it can be some unknown blogger who I happen to find has interesting taste. But I need someone or something to help me find the crap that means something to me. That's why Netflix felt the need to have a competition to improve its recommendation engine by a very small amount. The gatekeepers own the future.

al-Khobar, Saudi Arabia, 4.21 pm

Sonny Bunch follows up on the death penalty debate:

I’m not entirely sure I understand the difference between revenge and justice, especially in a case as personal as this one. What does justice mean for the husband and father whose wife was raped, one of his two daughters was raped, and all three were burned alive by a sadistic pair of monsters? The first definition of justice in Merriman-Websters is thus:

The maintenance or administration of what is just especially by the impartial adjustment of conflicting claims or the assignment of merited rewards or punishments.

I guess that definition hinges on what we decide is a “merited” punishment. But you will never convince me that those two’s actions do not merit death.

Will at Ordinary Gentlemen also goes another round.

Will Saletan joins the abortion debate:

Pro-lifers say the health insurance abortion restriction, known as the Stupak amendment, is just an extension of the Medicaid abortion restriction, known as the Hyde amendment. Pro-choicers say the Stupak amendment is much more invasive. The pro-choicers are right. But pro-lifers didn't create that difference. Democrats did. By mixing public and private health care, they complicated the separation of taxation from abortion. If pro-lifers can't keep their money out of the insurance exchanges, they'll fight to keep the insurance exchanges out of abortion.

Granted, there are less onerous ways to interpret the no-taxes-for-abortion principle. Pelosi tried to sell these alternatives to the pro-life Democrats. They weren't buying.

There's something poignant about the last-minute outrage of the pro-choice groups. The complaints they're leveling—that people had more choices in the private market, that the House bill radically upsets this market, and that it violates Obama's promise not to deprive anyone of their existing coverage—are hardly novel. Republicans have issued such warnings all year. But liberals didn't pay attention until the coverage in jeopardy was abortion.

I'm not saying we shouldn't socialize health insurance. I'm pretty comfortable with the House and Senate bills. But let's give up the two lies we tell ourselves about such legislation. One is that it won't cost us much money. The other is that it won't cost us much choice. When you throw in your lot with other people and agree to play by the same rules, you surrender some of your freedom and risk losing some of your options. Sometimes it's coverage of an MRI or a hip replacement. Sometimes it's coverage of abortion. If that's the price of health care reform, are you willing to pay it?

Friedersdorf makes the same point:

The bigger role the federal government takes in funding health care, the more you’re going to see politicians interfering in matters that would otherwise be left to doctors and patients, and the more controversial these battles are going to become among the public. This seems obvious to me, but I never see progressive writers worrying about it.

This story speaks, rather movingly, for itself. And yes, the “pearly gates” comment is priceless:

Even Fox News is fact-checking her now.