Yglesias argues for raising the Medicare eligibility age to 70

I truly wish more people thought this way.

Terrorism suspects arrested in Norway and Germany

Matt Yglesias:

As ever with these things it’ll take several days to figure out what, if anything, was really going on here but the Norwegian Police Security Service says it’s busted a terrorist cell in cooperation with American, British, and German agencies and arrested three men, two in Norway one in Germany:

She added, “‘We believe this group has had links to people abroad who can be linked to Al Qaeda, and to people who are involved in investigations in other countries, among others the United States and Britain.”

One of the men arrested was a 39-year-old Norwegian citizen of Chinese origin who belonged to the Muslim Uighur group, she said. Another was a 37-year-old Iraqi citizen who came to Norway in 1999 and has permanent residency.

The third man was a 31-year-old Uzbek citizen who also has permanent residency in Norway.

I think this once again underscores a couple of important points. One is that for all the disparagement of the “law enforcement and intelligence” approach to counterterrorism from the right, this is all we’ve got. International terrorists aren’t the same as average criminals, but the basic methods involved in apprehending them are similar. An aircraft carrier doesn’t help, and soldiers don’t have the right training. The other is that the most dangerous “safe havens” are inside western cities and not in remote areas of Pakistan and Afghanistan. There’s no way to perpetrate a terrorist attack on a western target if you’re in Peshawar, still less if you’re in the mountains somewhere. If you’re in Oslo with a Norwegian passport, you can hop on a plane and go anywhere. And yet somehow we’re debating a $37 billion supplemental appropriation for a war in Afghanistan while the total FBI budget is around $7 billion. I’m not saying we should necessarily go out and triple the FBI’s counterterrorism budget, but if you want to think about spending lots of money on catching terrorists that seems like the smart place to do it.

A real solution to polarization

Multiple-member districts with single transferable vote

Taxation and migration

A.S. at The Economist explains that people move to Texas because the taxes are low:

IN THE ten years I’ve lived in New York I forgot how to drive. Lately I’ve been spending lots of time in Austin, Texas. Enough so that I’ve had to start driving again. When you go many years without driving, it becomes terrifying. So to refresh my skills I took lessons with a wonderfully patient and brave woman who has taught driving in Austin for nearly thirty years. I expected to be one of her few adult students, but no. My instructor claimed in the past few years the number of adult students increased exponentially, not quite rivalling the number of teenagers. Most are tech workers who come from all over the world, drawn by the vigorous labour market. Adult driving students struck me as a rather interesting economic indicator. It doesn’t tell us anything we didn’t already know. Migration statistics reveal that people are moving in droves to Texas. Why? Jobs and no state income taxes. High earning New Yorkers and Californians can take home between 9% and 11% more of their income by moving to Texas. Every trip down I speak to at least one bitter New Yorker/Californian fed up with high taxes and cost of living.

Yglesias responds:

Well . . . maybe. Texas certainly is growing rapidly, and it does have a relatively healthy labor market. But even though a lot of people are moving to Texas, it seems to me that California’s population is also growing at an impressive clip:




I suspect A.S. is being somewhat misled by this fascinating interactive tool which charts domestic migration only and thus gives the impression that certain places are experiencing massive net population flight when in fact they’re just attracting a lot of immigrants.

So successful citizens are moving to low tax states while less well off immigrants head to high welfare states. Is anyone surprised?

I'm all for open immigration, but I'd much rather live with a red state's economy. As should anyone who's interested in a healthy labor market with low taxes and welfare. Among people who feel the same, the Economist's point stands.

Alas, the problems with Texas are certainly not economic—rather, they are called Texans.

Immigration restrictions are stopping us from preventing illegal immigration

Yglesias makes the apparently not-as-obvious-as-it-should-be point.

Quote of the day

Mr Yglesias might not be too pessimistic about the crisis of overproduction in journalism because, to put it bluntly, he is the crisis of overproduction in journalism.

—DiA, Does the left need bigger ideas?

Wonks in conservative politics

Matt Yglesias:

Whenever liberals point out that the entire conservative case against climate change legislation consists of the ravings of cranks, liars, and know-nothings someone eventually trots out Jim Manzi. Indeed, National Review tapped Manzi to write its big feature-length denunciation of the American Clean Energy and Security Act. Manzi, you see, isn’t a crank, a liar, or a know-nothing—he’s cooked up some wonky reason for agreeing with the cranks, liars, and know-nothings on the question of climate legislation.

Then Jim Manzi read Mark Levin’s book, focused his attention on its climate section, and discovered that Levin is a crank, liar, and/or know-nothing. The result? Manzi is savagely and hypocritically attacked by the staff of National Review. Because, after all, the crankery and the know-nothingness is the essence of conservative politics. The wonks are useful just insofar as they can be used to support the crank agenda—when they take the cranks on, they get trashed, even by publications that were happy to cite them as experts on the very issue at hand just a few months ago.

Touché.

Well, the rest of the right can throw him under the bus, but I say one of Manzi's posts or articles is worth a hundred of regular National Review fare.

What if Republicans proposed a revenue-neutral carbon tax?

Yglesias considers.

Preserving freedom in the long run

Conor Friedersdorf rebutts Yglesias.

Taxes per person

Greg Mankiw compares the U.S. to other countries.

Yglesias is not impressed.

Why are Scandanavian welfare states so successful?

Reason protests:

For those of us who place more trust in free markets than state-directed economies, we must inevitably (and repeatedly) confront the skeptical interlocutor who details the "successes" of Swedish social democracy. "If state intervention into the economy is so bad, high taxes so destructive, then why is Sweden such a success?" It's an irritatingly simple question with a incredibly complicated answer, though I do recommend pointing out, when the conversation turns to health care and secondary education, that nothing, in a state the confiscates a massive portion of your income, is "free." But as many have pointed out, during its boom years, Sweden was a pretty free market place; from the 1970s through the 1990s—when taxes and regulation dramatically increased—the economy slowed until it spun out in the early 1990s.

There isn't enough time in the day to respond to the ceaseless stream of Sweden hagiographers, though I took a crack at it a few years back, when a liberal blogger at The American Prospect, in an error-laden piece of Google scholarship, told readers that "everything they knew about Sweden was wrong."

[..] My favorite Sweden-know-it-all, incidentally, is lefty blogger Matthew Yglesias, who never misses an opportunity to correct American "misconceptions" about the land of Ace of Base and early retirement (you see, he went on a junket to Stockholm last year). "Americans often find this a bit confusing but Scandinavia," he recently wrote, "strictly speaking, only refers to Denmark, Sweden, and Norway." Or this classic bit of pompous pedantry, correcting the Swedish Foreign Minister Carl Bildt on whether, when he served as prime minister, he was technically the "head of state": "I don’t necessarily expect Americans to grasp the distinction, since our President is both head of state and head of government, but Sweden’s prime minister is not a head of state."

Elsewhere, Yglesias claims that former conservative party leader Bo Lundgren is the "architect" of the Swedish model. As Lundgren, author of the 1989 book Sänk skatten för alla (Lower Taxes for All), recently explained to the Telegraph, "I am a market liberal. I was even called the nearest Sweden had every (sic) come to having a party one could call libertarian." Picayune details, I suppose.

But the nitpicky often segues into the bizarre generalization: "My bottom line: Visit the Nordic countries and you’ll be impressed that their civilian public agencies are much more effective than ours." Well. How one determines that Sweden's "civilian public agencies" are better functioning than those in the United States during a few days in Stockholm (Did he try to post a letter? Start a business?), is left unsaid. But I have dealt with all manner of public agencies in Sweden and the results were, at best, mixed (try changing doctors in Stockholm).

So here is my bottom line: When some American pundit, with expertise is everything, explains why some European welfare state "works," or how everything you know is wrong about taxing income at 75 percent, do a little digging, make use of Google Translate, and don't trust that, because Swedes and Danes tell researchers that they are happy, the United States should introduce "daddy leave" and provide subsidies to syndicalist newspapers.

The best English-language explication of the Swedish model comes from my pal Johan Norberg, who wrote this brilliant piece for The National Interest a few years back. And watch my interview with Norberg on Swedish welfare politics here and on Naomi Klein here.

One commenter:

My sample size is relatively small, but all of the Norwegians and Swedes I ever met:

1. Had a fanatical work ethic.
2. Believed that the state ought to ensure a minimum standard of living.
3. Were honest to the point of annoyance.
4. Had no desire for wealth.
5. Believed ostentatious displays of wealth were either seriously tacky or outright immoral.

Mix this culture with nearly immeasurably low crime and easy access to world markets for import and export, and you've probably got a successful society, 66% tax rate or no.

But for the love of God, don't let them cook for you.

Another:

Well myself am a Norwegian, and i must say that the so called welfare states are a joke. The only ones who earn on it is the immigrants who refuses to work and still get enough to live and more. Its pure exploitation of the welfare system where everyone who actully needs help dont get any and those who exploit the system get all they want. Try to send a letter to the public services and you will most likely never hear anything from them because they "didnt get it" or such. Many Norwegians are now asking our government "What will we live with after the oil dissapears?". And we dont get any answers. Where is the Norwegian Industri? Its not there at all, they have been chased out of the country because Sosialistisk Venstreparti(Socialist Left Party) have declared a open war against those who are rich. Today UN and other will write Norway is "World greatest country" in 40 years we will not even get mentioned because we wont have anything more to live with. Because of our Welfare system and because we are a socialist anti cooperation country.

Im sorry if my English isnt to good but i am a Norwegian so bare with me.

More:

The economic system is not the whole culture, only part of it. If we didn't have [formerly enslaved] racial minorities, huge immigration issues, lots of crime, etc. we would be as well off or better than the Swedes. The question is whether less welfare state and more free markets will make Sweden even better, and the answer is yes.

Compared to Sweden, we bare many more evils.

Matt Yglesias himself (my favorite progressive blogger) engages in comments here. I enjoyed the thread.

The second time as farce

From Yglesias' comments:

Is there a word for the process whereby a political party gets so emotionally invested in defending a past mistake that they start to celebrate the mistake, and eventually transform it, willy-nilly, into a central plank of their philosophy?

R: What do you think about waterboarding a prisoner?
D: Waterboarding is torture.
R: Is not. We never torture.
D: Is so.
R: Is not, and anyway, torture might be morally justified in some cases.
D: What?! are you crazy?
R: I'm just saying, in some cases, it might be actually be necessary.
D: This is crazy. I'm taking over.
R: sulks for a year, then finally says: I’m starting to get really nervous. We can't be safe, because you refuse to torture.
D: Jesus, we're just re-establishing the Reagan standard.
R: Torture! Torture! Torture! Freedom has never been safe without torture! Torture is the centerpiece and fulcrum of all our Constitutional liberties! Give me torture, or give me death.

Personally, I think it's a losing proposition to make “torture” the centerpiece of your brand identity. But Cheney clearly disagrees.

Terrorists and the right are co-dependent

Yglesias goes there. He's right, though.

The shape of things to come

Old prejudices die hard.

(via Yglesias)

USPS, Inc.

Yglesias explains why we should privatize the postal service. Hear, hear.

Climate change denialism and alarmism

Kevin Drum wrote:

I mean, suppose you accepted that climate change was both real and catastrophic. What options would you have if you insisted on sticking solely to free market principles? Beats me. Hell, it’s hard enough to address even if you don’t. But that’s where we are these days: an awful lot of our most pressing problems simply can’t be solved unless you accept that the government has to be involved. So conservatives are stuck.

Yglesias responds:

I think this is far too kind to the behavior of right-of-center institutions—Heritage, AEI, Cato, National Review, Weekly Standard, the Chamber of Commerce, Rush Limbaugh, etc.—on the issue of climate change. It implies that there’s some genuine ideological dilemma that makes it impossible for a committed free marketer to propose constructive policies to avert catastrophic climate change. But how about reductions in subsidies for fossil fuel production and consumption? The free market credentials seem impeccable. Or how about a “green tax shift” in which carbon is taxes or carbon emission permits are auctioned and the revenue is used to finance deficit-neutral reductions in other taxes? Again, it surely can’t be that free market principles commit people to the precise series of revenue streams currently used in the United States.

Now of course in the real world it’s going to be impossible to legislate a pure free market “tax shift” policy just as it’s going to be impossible to legislate a pure “tax polluters to subsidize clean energy” approach or a pure “cap and rebate” or a pure anything. But if people started from the premise that emissions need to be reduced, and then debated the extent to which this needs to be done in a free market way versus some other kind of way, then compromise would be easy to reach and a solution could be within reach. But that’s not what we have. Not because market-oriented approaches are inadequate to the challenge but because too many of the key institutions that espouse market-oriented approaches are run by people who are too corrupt, incompetent, immoral, stupid, or cowardly to get their side to take the problem seriously.

It doesn’t have to be this way. The German Federation of Industry had a bunch to say, not all of it sensible on the merits, about making German climate policy friendly to export-oriented manufacturers, but none of it involved ranting about “cap and tax” or denouncing “socialism” or pretending that the whole problem was made up by Al Gore.

I agree: the many climate change deniers on the right are awful.

However, alarmists from the left are also contemptible. Al Gore, Barack Obama, Matt Yglesias, et. al. did not make up the problem. But they sure do exaggerate, peddling end-of-the-world-as-we-know-it scenarios and distorting our extremely limited ability to mitigate the more moderate warming that's actually likely to happen.

Jim Manzi's non-denialist, non-alarmist cost-benefit analysis looks correct to me. You can read his many detailed posts on the subject at The American Scene.

Fear of trusts

Andrew is concerned:

It seems to me that a public option which allows the government to use its huge buying power to achieve cost cuts that no private company could manage would be a Trojan horse.

A Dish reader replies:

You call the public option a "Trojan horse." I take it that you do not mean that allowing a public plan in which the government could generate savings by using its collective buying power will not, in fact, result in lots of Greeks with swords jumping out and killing us in our sleep. I am at a loss, however, as to what exactly you imagine the danger to be -- your sentence follows with no explanation. This is one of those things that I just do not understand at all when public option opponents gesture in this direction: what is the perceived worst case scenario here and why do you find it objectionable?

Let's say that such a government public plan would prove so effective at negotiating low rates that it would price private plans out of the majority of the health care insurance market. Is this a problem in some way? Anyone who had enough money could assuredly buy whatever high-end services or plans they would wish--you can't seriously believe that such a government plan would result in the absolute legal preclusion of private payment for medical insurance or services, can you? Or is this just a generalized fear that people will overwhelmingly prefer the public option, and the portion of our collective income going to the government in taxes (rather than private insurance policies) will increase? Really wondering what your fear is.

Andrew doesn't respond further, but I'll bite: I would have the same kind of fear if the government or a large private entity got a similar near-monopsony over any market. Monopsonies and monopolies are bad for well-understood reasons, which is why we have antitrust law. I elaborated on this several months ago in "Public health insurance, antitrust, and price controls".

For instance, today Medicare has a near-monopsony on care for the elderly. You might think that, per liberal health-care theories, this would make geriatrics a thriving field!

Alas:

KINGMAN - As baby boomers reach retirement age, the need for geriatric physicians in America will increase.

However, slow or less-than-adequate reimbursement to them by Medicare and/or Medicaid is discouraging doctors from getting into or staying in that field of medicine. Jane Potter, president of the American Geriatrics Society, responded to several questions last week.

[..] "The best indication that physicians are leaving the field is the fact that the number of practicing geriatricians is declining," Potter said. "There are more physicians leaving than entering the field.

"In September 2006, a group of leading educators who operate the nation's top geriatrics fellowship programs told us that finances are a major disincentive for physicians in training to enter geriatric medicine.

[..] "Geriatricians have the lowest expected salary of all medical specialties.

Those shamelessly evil, profit-mongering doctors! Oh, wait...

Meanwhile, progressives like Matt Yglesias and Ezra Klein often ridicule more conservative Democrats who both:

(a) Wish to reduce the cost of health-care reform.
(b) Simultaneously oppose a public option, which the CBO scores as lowering the deficit.

But as I've explained in the past, economic conservatism is not limited to reducing the cost of government.. Some of us actually want a healthy market in which the government does trust busting instead of, you know, creating and running one.

It is on these grounds that we consider a "robust" public option--one that uses outsized bargaining power to reimburse at Medicare's below-market rates--to be a trojan horse.

If I could be assured that a public option would compete on a level playing field (not take taxpayer funds, not pay below-market rates) I would still oppose it. But for different reasons, because I would think it as doomed to failure as, say, the government launching a new department store. Governments suck at running things competitively (see: Union of Soviet Socialist Republics, economic history of).

This is why progressives are so adamant that the public option be "robust" and allowed to leverage its large size to create a "real alternative" to private health-care providers. It's the only way their idea has any merit.  Alas, it's merit of the trojan horse, we-play-by-different-rules variety.

The first congressional website

(via Yglesias)

Radley and Yglesias

Two of my favorite bloggers have at it:



When the MSM steals scoops from bloggers (06:09) 
Radley bemoans liberals’ rightward shift on crime (07:37) 
Fixing health care by eliminating health insurance (09:37) 
Why the most important reforms are least likely to happen (05:28) 
Employer-based insurance will always be with us (04:46) 
Are low-cost clinics the answer? (04:00) 

Mentioned: David Goldhill: “How American Health Care Killed My Father”

Why I oppose government programs

As a contemporary example, Cato argues Cash for Clunkers is among the dumbest ever:

• A few billion dollars worth of wealth was destroyed. About 750,000 cars, many of which could have provided consumer value for many years, were thrown in the trash. Suppose each clunker was worth $3,000 at a guess, that would mean that the government destroyed $2.25 billion of value.
• Low-income families, who tend to buy used cars, were harmed because the clunkers program will push up used car prices.
• Taxpayers were ripped off $3 billion. The government took my money to give to people who will buy new cars that are much nicer than mine! 
• The federal bureaucracy has added 1,100 people to handle all the clunker administration. Again, taxpayers are the losers.
• The environment was not helped. See here and here.
• The auto industry received a short-term “sugar high” at the expense of lower future sales when the program is over. The program apparently boosted sales by about 750,000 cars this year, but that probably means that sales over the next few years will be about 750,000 lower. The program probably further damaged the longer-term prospects of auto dealers and automakers by diverting their attention from market fundamentals in the scramble for federal cash.   

Sane folks should agree these outcomes are outrageously dumb.  B-b-but, Obama bragged the program was popular!  And truly, it was.

Offering everyone $100 towards burning an old set of ugly clothes and buying a sleek new replacement might also prove popular, both to consumers and the clothing industry.  Huzzah, let's do it!  Regrettably, such popularity does not make it a good idea nor mean that implementing it would make any kind of economic or environmental sense—which it clearly wouldn't.

This basic problem of economic inefficiency, generalized, is why the majority of other government programs and economic interventions are also really bad ideas. What is politically popular seldom implies economic efficiency.  Often, quite the contrary. Political popularity foments fiscal insanity.  First you get your Democrats, who want to give every person on Earth a free cake, dog, and pony—plus the choice of a prepaid subscription to either People or The Washington Monthly.  This proves popular.  Then as a reaction you get your Republicans, who don't want to pay half a cent toward anything.  This also proves popular.  Unsurprisingly, voters want to have their cake and not have to pay for it, too.  Politicians are happy to pander to both sides.  The emerging compromise?  Massive deficits—a.k.a. having our children and grandchildren deal with it somewhere down the line.

Yes, Virginia—I don't mean to scare you with technical phrasing, but politics and government really do suck.

A sufficiently free market, by contrast, implements a method that almost always results in superior efficiency to either political popularity or technocratic fiat.  It's called price signals.

Unfortunately, due to a history of misguided (but politically popular!) government interventions and regulation, the U.S. health-care system does not have price signals.  This works out very poorly.

Allow me to paint you an analogy.  It would be as if credit cards were issued by "insurance card" companies who agree to provide their customers with "consumption coverage".  You would pay them a pre-arranged monthly "consumption premium", and in exchange they would "cover"—with just a small co-pay!—any shopping you do with their card, provided it was clear that you "needed" it.  Ramen noodles would probably be covered—eat more than you can puke.  So would most canned goods.  Even many of the cheaper fruits and veggies.  But the fine entrée you wanted to serve at your next dinner party?  Sorry, your insurance card company doesn't think you "need" it.  Oh, and there would also be limits on things like how much gas you can buy per week or how many drinks you're allowed at the bar per night.  Sound good?  Meanwhile, more and better ways would be developed to game and profit off the convoluted system.  Retailers would overcharge whatever they could get away with making the "insurance card" companies pay, and consumer demand for more and better purchase coverage would rapidly increase. Thus the monthly cost of these "consumption premiums" would also soar.

The above scenario is basically the status quo of U.S. health-care.  Obviously, it sucks.   In lieu of price signals, people always want more and better health-care to be provided, just like in the above they always want more "consumption coverage".    When the consumer doesn't pay for services, markets become dysfunctional. (Also true of some marriages >_>)

So how to reform the system?  Apart from those unfortunate Brits—who tragically got the idea during WWII that it would be good for their state to stay in the business of directly providing care—the left's favored solution tends to be single-payer: a government takeover of health insurance companies, analogous to taking over the odd "insurance card" ones above.

Insurance companies make great villains, but as we saw with Cash for Clunkers and can observe by looking at many other programs—particularly socialized health plans in other countries—they all have their own kinds of problems.   These problems are different from the US status quo: better in some ways, worse in others.

For example, one thing other countries' socialized systems are better at is cost control (.pdf).  They use their monopsony power to negotiate lower prices, and they can often be better at saying no to consumers.  They say no in more equitable ways, such as long waiting times, and some Canadian towns run regular lotteries to decide which families get a doctor.

Controlling costs would be nice, especially compared to an expensive system like the US status quo.  But one thing centralized bureaucratic cost controls also do is reduce the incentive for future private innovation.  Why spend your time experimenting with and further developing a new health product if you can't know whether the health bureau will decide it's a cheap and effective enough treatment to get it off the ground?

In short, the choice between the U.S. status quo and a single-payer system offers trade-offs.  I won't spill more ink trying to formally pin them all down: it's a big topic, kind of like going on about the difference between Republicans and Democrats.

At this point someone usually pipes up and wails about the plight of the uninsured poor.  But that is not a health-care system problem, it is an income problem.  And one of the few ways to directly mitigate an income problem is to provide subsidies to low-income families (some ways are more economically sound than others).  Point is, you could implement subsidies and attain universal health insurance coverage in the U.S. without directly changing anything about our health-care delivery system or the insurance companies themselves.  It would just be really expensive and balloon either the deficit or tax rates, which is why it shouldn't be done in isolation.

Happily there's a reform that would lower costs for everyone while actually increasing innovation:  bring back the price signals that are so essential to market efficiency.  Here's how this might be accomplished:

Firstly, repeal any state-level regulation—often called "patients bill of rights"—that require insurance companies to fully cover particular procedures or put an artificial ceiling on deductibles.  This would clear the regulatory barriers for health plans that sport low premiums and high deductibles, suitable for catastrophic coverage only.  This is how real insurance is supposed to work, like the kind we have for our cars and homes.  By contrast, the sort of thing we call "health insurance" today is actually "pre-paid health care".  Just imagine how high your car insurance payments would be if it were required to cover 80% of the cost of oil changes, tire rotation, wiper blades, new tires, regular service, etc.

Secondly, implement something like Health Savings Accounts (HSAs) for all the routine, preventative, non-catastrophic care.  Apart from trimming administrative jobs in our bloated health insurance industry, this would free consumers to shop for their own health care (Enter price signals, mission accomplished).

Of course, esteemed Nobel laureates like Paul Krugman shall protest:  "Health care is not a bowl of cherries...or a carton of milk, or a loaf of bread."

Indeed, shopping for health-care probably sounds like an odd idea to most.  But HSAs have been tried right here in America, and the data suggest they work well:

Consumer-driven health (CDH) products [i.e., high-deductible health plans relying on HSAs or Health Reimbursement Arrangements to reimburse for qualified expenses] have been marketed in various forms since the early 2000s. While emerging data is [sic] not entirely conclusive, general directional conclusions can be drawn from the studies published to date. […]

With regard to first-year cost savings, all studies showed a favorable effect on cost in the first year of a CDH plan. CDHplan trends ranged from -4 percent to -15 percent. Coupled with a control population on traditional plans that experienced trends of +8 percent to +9 percent, the total savings generated could be as much as 12 percent to 20 percent in the first year. All studies used some variation of normalization or control groups to account for selection bias.

For savings after the first year, at least two of the studies indicate trend rates lower than traditional PPO plans by approximately 3 percent to 5 percent. If these lower trends can be further validated, it will represent a substantial cost-reduction strategy for employers and employees.

Generally, all of the studies indicated that cost savings did not result from avoidance of appropriate care and that necessary care was received in equal or greater degrees relative to traditional plans. All of the studies reviewed reported a significant increase in preventive services for CDH participants. Three of the studies found that CDH plan participants received recommended care for chronic conditions at the same or higher level than traditional (non-CDH) plan participants. Two studies reported a higher incidence of physicians following evidence-based care protocols.

Bottom lines: the status quo puts health care rationing in the hands of insurance companies.  Single-payer puts rationing in the hands of bureaucrats.  A free, CDH market places it in the hands of consumers.

Which of the three do you prefer?

Contrary to popular belief, those of us on the economic right do not advocate market solutions because we have some arcane faith in mythical powers of the market.  We do so because they actually work better—even when they're politically unpopular.

(At this point someone usually pipes up to rail about how the financial crisis, like, totally discredits the idea of markets being better. Let's try not to be distracted by this different, macroeconomic topic that has more to do with a combination of poor regulation and lack of understanding the business cycle.)

The mean socially conservative Republican voter is our useful idiot. They don't understand free market economics any better than the left does, and are liable to show up at your local town halls spouting all sorts of nonsense about government conspiracies to kill more babies.  But the socons are willing to vote with us, so we often have to hold our nose and work with them.  It's called fusionism, and it's been the price to pay for an economic way of doing business that—while superior on the merits—would otherwise be too politically unpopular.  See for example the situation in contemporary Europe, which unlike the US has managed to purge socon fervor the old-fashioned way: through a long, tragic history of disastrous war.

I deplore social conservative attacks on personal freedom as much as the next freethinker, and I aim to counter them.  But I also deplore the left's attacks on economic freedom.  And I'm aware of the uncomfortable truth: unless I can convince a lot more of my fellow social liberals to cut back on their leftism and support freer markets, a chronic Faustian bargain with socons is necessary to preserve what economic freedoms we have.  Without this bargain, the U.S. economy would become more like Europe's, with the lower efficiency and lowered growth that over the long term is worse for everyone—rich and poor alike. Unless, of course, one is lucky enough to become a politician, bureaucrat, or have a personal connection to the business. Then the European political-economic landscape looks pretty rosy, and one can seek out all sorts of creative ways to gloss over the underlying economic inefficiency.

(Cross posted)