Good Entropy

Meet the Regulations – TCS Daily

Thorium is a radioactive metal that isn’t used for very much any more, precisely because of its light radioactivity. The US Geological Survey (having absorbed the Bureau of Mines) estimates annual usage in the US at about $30,000 worth a year. One of the people who does use it is one of our customers and a few years back they asked us to provide some for them. About 12 or 13 lbs was needed to keep their process going for 5 years or so in the manufacturing of a particular type of light bulb, a fairly trivial enterprise you might think and certainly one that you would think would be easy to supply. Especially if like us you were on the inside of the metals business and knew that there were (and are) warehouses full of this metal in the US. The material is left over from the US Navy’s nuclear reactor program and at current rates of usage there are centuries of supply simply sitting there. Should be the easiest thing in the world really, shouldn’t it? Buy a piece, slap a decent profit margin on to it and send it off to the customer and, as is said in certain English circles, Bob’s your parent of choice’s male sibling. Then we met the regulations.

The Covert Rationing Blog – Sage

From the ominously-titled book, “New Rules,” by Donald Berwick MD and Troyen Brennan MD:

“Today, this isolated relationship [between doctor and patient] is no longer tenable or possible. . . Traditional medical ethics, based on the doctor-patient dyad, must be reformulated to fit the new mold of the delivery of health care. . . The primary function of regulation in health care…is to constrain decentralized individualized decision making.”

The Volokh Conspiracy » “Constitutional Tinkering”

Justice Scalia notes (in a Matter of Interpretation if I recall correctly) that what is striking about the 19th Amendment is how quaint it seems that in order to give women the right to vote it was thought that you actually had to amend the Constitution in order to bring that result about. Today, of course, someone would just file a lawsuit and have the judges order that result.

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.