Good luck on that.*** Purely politically, you would think the ground has shifted since 1993--and that it's shifted against attempts at cost control, at least through government regulation. Why? Boomers! They're the demographic bulge in the voter rolls, right? Well, they're 15 years older now than they were when Hillary first tried health care reform. They naturally spend more time with their doctors, they typically like their doctors, and are naturally more likely in their older age to value the services their doctors provide. This means, I think, they will be more resistant than ever to regulatory cost controls--fee schedules, bureaucratic impediments, restrictions on ability to practice outside the government-subsidized system, etc.--that might be opposed by the medical professionals who are, after all, saving their lives. The doctors will certainly have expanded opportunities to lobby their aging boomer patients on these points. ... More fundamentally, fifteen-year-older boomers will feel more intensely the need for unimpeded access to expensive new life-enhancing technologies (and the doctors who can employ them) as soon as they read about them in the papers--which, in turn, are more likely to report them to their boomer readers.
**Sorry, her husband's plan! Hillary had practically nothing to do with it! It was all Bill's fault, Paul Starr now tells us, in one of the most informative and least convincing articles I've read recently.
***--I'm intuitively skeptical of the ability to wring vast efficiency gains from the health care sector a) because when I go to the doctor or a hospital it doesn't seem like a wasteful sector; b) because I assume technology will continue to provide more complex and expensive cures that people will rightfully want, and c) because I don't understand why it's so terrible if health care expenses keep rising, as a percent of GDP, as our society gets richer--and I assume others will come to the same conclusion rather than sacrifice what they regard as services that could improve and prolong their lives. 4:13 P.M.
Thursday, October 4, 2007
Remission of Burma: Bob Wright says he does not argue in his book Nonzero that history is moving ineluctably toward democracy and political liberty because prosperity requires freedom of thought and speech and inquiry. Rather, he argues that history is moving ineluctably toward democracy and political liberty because prosperity requires access to information technology which in turn empowers aggrieved groups to press their interests against the state--and these empowered aggrieved groups are most easily satisfied in democratic, or at least pluralist, systems. You could have fooled me. ... 10:15 P.M.
It looks like the only Republican who's not quitting the Senate is Larry Craig. ... 9:53 P.M.
Yahoo vs. Yahoo: This audio link doesn't work for me, but maybe it will work for you--and if it does, you can hear an intra-yahoo panel discussion on immigration in which 1) Mark Krikorian smartly tries to make a move I didn't think he'd make, sketching out how he thinks the anti-legalization movement could project a more pro-immigrant attitude; and 2) I try to argue against Krikorian--the powerful Numbers USA organization--when they seek to reduce the number of legal immigrants. ... 9:43 P.M.