When you seem to have no good options, opt for the least-bad.

Reformer, temper thy optimism!

Health care reformers predicting enormous potential savings should keep in mind that whenever something--anything--is free, or perceived as free, its consumption tends to increase.

To a Friend

In response to a health-care reform proposal that would allow all Americans to buy into Medicare:

OK. But Medicare "works" partly because it underpays providers, who then charge more (price shifting) to private-insureds (and the private insurers, not the providers or Medicare, take the heat). And Medicare administrative costs appear extremely "low" because Medicare doesn't pay claims (the biggest administrative expense), it contracts with "third-party payors" (some of the same insurance carriers everyone rails against for administrative inefficiencies). Besides, this proposal still doesn't address the MAJOR determinant of health care costs--physician behavior!

To the Editor

Today's editorial pointed out that Philly is a tough sports town and that Michael Vick will "get no slack" from Eagles fans. Not quite true. If Vick scores touchdowns, he'll get lots of slack--many fans will embrace him; as long as he performs on the field, those fickle fans couldn't care less about Michael Vick's character or his crimes.

What do YOU think?

My friend, himself quite a player in "the day," asked what I thought of the Eagles signing Mike Vick:

Only someone amoral--a sociopath--could have committed acts (electrocutions, eviscerations, et al) as despicable and sadistic as Michael Vick did. He gets only scorn, no sympathy, from me. I thought he should have been locked up for about 20 years--then if he wanted to try to play football again, I'd have had no objection! I find it offensive hearing the Eagles' coach say, and "fans" mindlessly parrot, "This is America...everyone deserves a second chance"--including murders, rapists, pedophiles?? Vick's acts were just as heinous; his remorse, I believe, is primarily over being caught, losing his multimillion-dollar contract and the misplaced adulation of the masses. There must be scores of talented players who actually DESERVE an opportunity to compete and prove themselves--Vick does not. Surely, as a society, especially one that often lauds its own compassion and humanity, we must aspire to higher values than how fast someone can run or how accurately he can throw a ball!

Lunacy comes in many flavors!

A group of fifty orthodox rabbis and Jewish "mystics" boarded a plane and conducted an airborne prayer meeting while flying over Israel--to prevent the spread of swine flu. Oy vey!

Health Care Reform

To all you Free-Marketers out there who want to rely on unfettered capitalism to reform the U.S. health care system: IT WON"T WORK! Why? Because heath care is relatively immune to the usual marketplace forces of competition/supply-and-demand. Why? Because in health care, the provider (doctor), not the consumer (patient), actually creates much of the demand for his own services and even initiates the purchase orders. Only physicians admit to hospitals, order tests, perform surgeries, prescribe drugs, even determine return-visit frequency and intensity. That's one reason why, counterintuitively, areas with the highest physician densities (the most "competitive") often also have the highest physician incomes. Until this fundamental reality of health care economics is recognized and addressed, heath care costs will continue to soar.

In the special case of health care economics, Adam Smith's Invisible Hand is the same hand that writes the scrip and weilds the scalpel.