Good Entropy

Megan McArdle :: The Atlantic – Sage

Harold Meyerson makes an argument that will be familiar to readers of this blog: stimulus doesn’t work the way it used to. Workers have more skills, which makes it harder to create jobs to soak up an untapped labor pool–even if we did create large numbers of jobs swinging pickaxes, many unemployed Americans wouldn’t take them.

Meyerson identifies a lot of the procedural barriers that I frequently talk about–the bidding and environmental safeguards that make federal projects very slow to get off the ground. But perhaps unsurprisingly, he doesn’t really explore a huge barrier to a WPA-type jobs program: public sector unions. They are not going to let you hire a bunch of cheap workers and run crews without civil service protections.

There’s something ironic in the fact that the legacy of the New Deal is the inability to reproduce it. On the other hand, it’s not so necessary, either. People are richer now, and though it isn’t perfect, our financial regulation is better. We’re not at much risk of people starving to death. So there’s no urgent need to create low-skilled jobs for them to fill.

Patrick’s Price Controls – WSJ.com

On Thursday, Democratic Governor Deval Patrick’s insurance regulators announced that they had rejected 235 of 274 insurer requests for premium increases for individuals and small businesses over the coming year. This power has been on the books since 1977 but never used, and Mr. Patrick announced in February that he was dusting it off as an opening bid for rate-setting for hospitals, doctors and all other providers as well. The state’s health costs have risen to the nation’s highest since Beacon Hill passed the ObamaCare prototype that was supposed to reduce health costs.

The premium increases were “excessive and unreasonable,” Mr. Patrick said in a statement, though his insurance division issued no actuarial analysis to justify its decision. “Now, the big insurance companies will criticize this action,” he said. “But the fact is that for three years now, both they and health-care providers have sat around the table talking the issue of excessive cost to death and coming up with no solutions.” In other words, price controls are supposedly the only option.

Yet campaigns against the insurance industry are always the first political resort, as Mr. Obama’s assault on Anthem Blue Cross of California showed. In Massachusetts, however, the major insurers—Blue Cross Blue Shield, Harvard Pilgrim, Tufts Health Plan—are all nonprofits. The state itself calculates that they spend at least 88 cents of every premium dollar on the underlying costs of medical care, often more.

Over at The Covert Rationing Blog

He quotes a journal piece:

It is untenable for the medical profession to coninue asserting an idealistic ethic that is contradicted so openly in clinical practice. . .We propose that devotion to the best medical interests of each individual patient be replaced with an ethic of devotion to the best medical interests of the group [of patients] for which the physician is personally responsible.

from:Hall MA, Berenson RA. Ethical practice in managed care: a dose of realism. Ann Intern Med. 1998; 128:395-402.

This is a good example of how not having the patient paying for care allows ne forces the doctor to serve two masters in terms of ‘best medical interests’. Individuals are treated by physicians not groups.

The whole post is very worthwhile. He goes onto cite pioneering work by progressives to extend medical ethics to include

…a third ethcial precept: The Principle of Social Justice.

Fresh From the Farm

Joel Salatin is a self-proclaimed “Christian-conservative-libertarian-environmentalist-lunatic” and the proprietor of Polyface Farms in Charlottesville, Virginia, where he practices the kind of small-scale agriculture that baffles (and sometimes infuriates) regulators.