Stromata Blog

Tom Friedman on Presidential Legitimacy

New York Times columnist Thomas Friedman showed his impatience with democracy a few weeks ago by praising communist China’s superior ability to adopt what he regards as the correct environmental policies – none of that messy constitutionalism, consensus and rule of law. Now he packages what is essentially the same complaint in different garb: Opponents of President Obama’s policies object too long and loudly; they might even prevail. The implication is that they should just shut up.

The garb is the claim that “the far right has begun tipping over into delegitimation and creating the same kind of climate here that existed in Israel on the eve of the Rabin assassination”. Now, if Mr. Friedman had made that statement about the far left and George W. Bush, he could have clothed it substantially: Liberals routinely asserted that Mr. Bush was “selected, not elected” in 2000; leading MSNBC pundit Keith Olbermann and others pushed the fantasy that his reelection in 2004 was the product of a 100,000-plus vote fraud in Ohio; a large proportion of Democrats (35% according to polls) believed that the White House was complicit in the 9/11 attacks; leading liberals talked of a “secret executive order” altering the Presidential succession to bypass Congress, among other nefarious plots; and we were constantly warned that the Bush Administration posed an immediate threat to civil liberties. There was “tipping over into delegitimation”, loud and clear. Thomas Friedman was unalarmed.

What comparable evidence can he cite for a parallel climate in the Obama Administration? Well, somebody posted a Facebook poll asking whether the President should be murdered. (The Secret Service is, of course, investigating.) Beyond that,

And Mr. Obama is now having his legitimacy attacked by a concerted campaign from the right fringe. They are using everything from smears that he is a closet “socialist” to calling him a “liar” in the middle of a joint session of Congress to fabricating doubts about his birth in America and whether he is even a citizen. And these attacks are not just coming from the fringe. Now they come from Lou Dobbs on CNN and from members of the House of Representatives.

The birthers, who try to prove that Barack Obama was born in Kenya, are ridiculous, and – aside from the ideologically unclassifiable Lou Dobbs – no one with the least influence has taken up their cause. Note, too, that, while birtherism can aptly be termed an attempt to delegitimize the President, it is emotionally feeble. Being born outside the United States doesn’t involve moral turpitude, and, if any fraud had been committed, Barack Obama could not have been the culprit: He was a few days old when announcements of his birth appeared in the Honolulu newspapers. If there were actual evidence of their falsity, one might conclude that Americans elected an ineligible candidate in 2008, but there would be no cause to hate him for his parents’ or grandparents’ fib.

As for the rest of Friedman’s case, shouting during a Presidential speech is rude, but the now infamous Rep. Joe Wilson was correct on his substantive point, as the White House quietly conceded, and alleging that the President’s policies are “socialist”, whether right or wrong, is surely within the bounds of rational debate, not an incitement to assassination.

And that’s it. From those paltry facts, a New York Times pundit purports to fear that “people [are] crossing the line between criticizing the president and tacitly encouraging the unthinkable and the unforgivable”. That makes sense only if what is truly “unthinkable and unforgivable” is the failure of the pundit’s favorite political causes. That wouldn’t be a problem in enlightened Beijing.

Further reading: Victor Davis Hanson and Jay Nordlinger recall, with quotes, the grand old days of Bush Derangement Syndrome, which Tom Friedman never saw as much of a threat to the Republic. Mr. Nordlinger adds the interesting point that the handful of examples of outrageous anti-Obama rhetoric are mostly cherry picked from unreflective rank-and-filers (or less – the Facebook poll that is so significant to Friedman was posted by a teenager, and the Secret Service has dismissed it as juvenile bad taste); the deranged anti-Bush screeds emanated from the elite of the Global Left. Turning to more recent times, Peter Wehner cites examples of Democratic civility in the debate on health care reform.

Arthur Laffer as a Leading Indicator

Today’s Wall Street Journal praises the California Tax Commission’s forthcoming proposal to revise the state’s tax system dramatically, replacing the current personal income, corporate income and state sales taxes with a semi-flat personal income tax and a VAT-like “business net receipts tax”.

A point that struck me was how closely this structure resembles the one proposed for the country by Arthur Laffer, Stephen Moore and Peter J. Tanous in their recent book, The End of Prosperity. They advocate a 12% flat income tax rate, with a large personal exemption and deductions only for mortgage interest, charitable contributions and rent, plus a 12% value added tax. All but a handful of other federal taxes would disappear. The upshot, according to their calculations, would be just as much government revenue as the present system produces and improved prospects for future economic growth.

Compare that to the California proposal:

The commission would replace the current, hugely complex system with one that has no sales tax (currently 5 percent) and no corporate income tax (currently 8.85 percent). Instead, it would have a Business Net Receipts Tax of 4 percent, which would tax what a business sells minus the cost of what they purchase from other firms. It is, therefore, very similar to the Value Added Tax widely used in Europe. . . .

The personal income tax would move sharply towards the flat-tax model. There would be a personal deduction of $22,500 for individuals and $45,000 for joint filers, and only three tax rates: 2.75 percent on taxable income up to $56,000 for a couple, 6.5 percent on income above $56,000, and 7.5 percent on income above $1 million. The current tax has seven tax rates and reaches as high as 10.55 percent. There would be deductions only for mortgages, property taxes, and charitable contributions. A family could fill out its state income-tax form in five minutes.

When I read The End of Prosperity, my reaction to the tax ideas was that they were pipe dreams. On the national level, where a fundamental alteration of the tax code would create huge transitional problems, that may be the case, but California’s choice is between bankruptcy and fundamental reform, not between a not-very-good tax system and a better one. Today California’s tax burden drives away the producers who pay taxes and thus leaves the state poorer in every sense, a perfect illustration of the Laffer Curve. (Dr. Laffer himself has relocated his prosperous consulting business from California to income tax-free Tennessee.) As the prospect draws nearer of California as a Third World polity, with entrepreneurs chased out and rent seekers in the ascendant, perhaps the legislators, or at least the voters, will concentrate their minds.

Degeneracy Prime

At the moment, I happen to be in Las Vegas, which is supposed to be the epicenter of Western decadence. A future Laclos will, however, portray it as a place of simple, straightforward morality compared to what one might call “Global Hollywood”.

In Vegas, drunken couples contract insincere “marriages” in fake chapels, hawkers thrust prostitutes’ calling cards at passing tourists, and “comedians” think George Carlin’s “seven words” are the only funny ones in the English language. But nobody promotes sex-with-drugged-13-year-olds as a harmless amusement verging on a civil right. To reach that level of degeneracy, one must turn to Whoopi Goldberg and other film dignitaries defending fugitive from justice Roman Polanski.

An enterprising reporter might want to ask the celebrities who pledged allegiance to Obama last January what they think of their leader’s indirect complicity in the apprehension of roamin’ Roman. Which is more important to them: bowing down to their “sort of god” or upholding the modern version of droit de seigneur?

I hope, BTW, that the Justice Department underlings who took note of Polanski’s stepping outside of sanctuary and acted swiftly to take advantage of it will receive bonuses and promotions, though I realize that, if publicly identified, they may never be able to rent a DVD again.

Addendum: Not being someone who follows Roman Polanski’s movements – until a couple of days ago, I couldn’t have told you whether he was dead or alive – I was unaware that he “has been traveling between his main residence in Paris and his chalet in Gstaad[, Switzerland] for years” and could have been nabbed several Administrations ago. Cheers, then, to the Obama Justice Department for doing the deed. I hope that the President will stand behind his subordinates in the face of the wrath of Woody Allen et al.

Correction: I’ve been informed that it was California rather than federal authorities who arranged for the Swiss to nab felon-on-the-run Polanski. I’m sorry to have to withdraw my praise of the Obama Justice Department but hope that I’ll have an occasion to say something nice about it in the near future, perhaps when the attorney general stops stiff-arming inquiries by the Civil Rights Commission.

The President of Chicago

I’ve seen four theories about why President Obama has decided that the most important task he can undertake this week is to fly to Copenhagen to lobby in behalf of the Chicago bid to host the 2016 Olympic Games.

The one that I would like to believe is Bill Kristol’s: that the sports junket is a cover for a surprise visit to our troops in Afghanistan. The trip could be the start of a White House effort – conspicuously absent to date – to rally public support behind the Af-Pak campaign and contradict the hints (such as his delay in authorizing new force commitments and nearly complete absence of communications with the commander in the field, not to mention Joe Biden’s vaporous “fight terrorism from 35,000 feet” proposal) that Kabul is about to go under the spacious Obama bus.

A second theory is that the International Olympic Committee has covertly made the decision to pick Chicago and that the President wants to bask in the “glory” of putting an American city over the top. If that’s the motive, it will be yet another example of our chief executive’s childish vanity. Hundreds of rank-and-file Chicagoans have devoted thousands of hours to pushing the bid. The One swoops down to claim the credit. Appalling.

For the true cynics, Jim Geraghty notes that the trip “just happens to take him out of the country the day the unemployment numbers for September will be announced”. How handy to have a big foreign story to overshadow what’s likely to be an unhappy domestic one.

Finally, and most plausibly, there’s the view of John Fund, writing in the WSJ.com Political Diary (subscription-only, and the best use of $7.95 you have this month):

Some even in Chicago question the wisdom of his lobbying trip. “To let himself be distracted by a parochial concern like this does not speak well for Obama’s judgment,” wrote Chicago Tribune columnist Steven Chapman. Not every Chicagoan shares Mr. Obama’s enthusiasm for hosting the games. The latest Tribune poll shows only 47% of residents backing the city’s bid in the wake of Mayor Richard Daley’s decision to put taxpayers on the hook for any cost overruns.

But in reality President Obama’s decision makes perfect sense. Chicago’s bid for the Olympics is in jeopardy, and even though the president will have perhaps five minutes before the microphones of the International Olympic Committee, his star presence could make the difference. What’s on the line in Copenhagen is much bigger than the Olympics, at least to the parochial players who run Chicago. Mayor Daley has staked his legacy on snagging the games. The 67-year-old mayor has dominated the city for the past two decades, but recent scandals and financial strains have dented his prestige. “The mayor’s ability to continue to run the city as he sees fit could hinge in great part on whether the Olympics bid succeeds,” reports the Chicago Tribune.

That’s why Chicago sources tell me Mayor Daley pulled out all the stops to mobilize the White House to save the city’s bid. He was aided in his appeals by the fact that the White House is now stuffed with top aides who are Daley loyalists, ranging from Valerie Jarrett to David Axelrod to Rahm Emanuel.

In their heyday, the big city political machines wielded massive influence. The bosses had governors, senators and congressmen in their pockets – but never quite managed to dominate a Presidency. Richard M. Daley is generally regarded as a pale shadow of his father, Richard J. In this respect, at least, he has surpassed the old man.

Further reading: The American Spectator, “Obama’s Olympic Spirit”

A Fact a Day About Obamacare – Day Seven: Insurance Company Profits

Okay, so I missed a few days. As Glenn Reynolds often says, blogs aren’t public utilities. Anyway, resuming the series, let me call attention to a post by Andrew Biggs of the American Enterprise Institute, discussing the allegedly outrageous profits that health insurers gobble up at the expense of the rest of us:

Despite all the hype, the health-insurance industry’s profit margins remain modest. On average, health insurers deliver a profit of less than 4 cents for each dollar of sales.

Health insurance’s profit margin is lower than that of the soft-drink industry, which competes ferociously through advertising. It is lower than that of the fast-food industry, which lures customers with dollar menus and supersized meals. It is far lower than that of the beer industry, with its profit margin of 18 percent. And it’s not just foodstuffs that earn higher profits than health insurance: Some 85 industries have higher profit margins. . . .

Assuming that the only difference between the public option and private insurance is the need to deliver a profit, the public option would cost only about 4 percent less than private-sector coverage. And even this is an overstatement. Private health insurers produce a profit to pay the return demanded by their investors. The public option, instead of having investors, would receive its capital from the government. Those funds will be borrowed, of course, and the taxpayer must pay interest. When interest costs are included, the total costs of the public option are about the same as those of private insurance.

While demonizing health-insurance profits is a central part of the Democratic leadership’s strategy, it is a red herring: health insurance is no more profitable than dozens of other industry sectors. And it’s the free market that keeps it so. That’s something to be remembered as the health debate progresses.

The same reasoning applies to the nonprofit cooperatives that the Baucus bill would set up to compete with profit-making insurers. A nonprofit organization requires capital in order to continue to exist. If the government doesn’t subsidize it and private equity investment is by definition impossible, it must rely on either borrowing or retained earnings. In either case, it will have to charge prices comparable to those of its for-profit competitors.

The President may believe that a four percent profit margin is exorbitant and that, in any case, profits are just a dispensable element of overhead. Meanwhile, he misses the true structural problem with the insurance industry: that the ban on competition across state lines has split what should be a huge national market into 50 little fragments, each subject to the whims of state regulators.

Clunk, Clunk, Clunk

Anybody who has read Bastiat could have told you that destroying old but functional automobiles is not a path to wealth, and some did. The geniuses in Washington were sure, however, that the lure of “cash for clunkers” would produce a bonanza for car makers and help invigorate the economy. The government spent $3 billion. Predictably, the bribe brought out lots of buyers in August. It turns out, though, that the net effect was merely to shift sales from one month to another. Henry Payne reports what happened after the golden shower came to an end:

Edmunds.com [the link is behind a subscription wall] reports that “September’s light-vehicle sales rate will fall to 8.8 million units . . . the lowest rate in nearly 28 years, tying the worst demand on record. After the cash-for-clunkers program boosted August sales to their first year-over-year increase since October 2007, demand has plunged. In at least the last 33 years, the U.S. seasonally adjusted annual rate has only dropped as low as 8.8 million units once — in December 1981 — with records stretching back to January 1976.”

“Many people regard February as the darkest month of the recession, but even then (sales were) higher, at 9.1 million units,” adds Edmunds.com statistician Zhenwei Zhou.

The price of this maneuver was the destruction of a couple of hundred thousand vehicles that could have served the needs of less affluent purchasers who can’t afford new cars. Now the poor will pay higher prices for transportation. Rarely does the government come up with so brilliant a reverse-Robin Hood scheme.

P. S.: Other matters have distracted me from my “fact a day about Obamacare” endeavor, but I’ll make the banal observation that the same folks who can’t figure out the most obvious facts about the market for cars think they can reshape the market for health care without adverse side effects.

A Fact a Day About Obamacare – Day Six: Why Medical Costs Rise

Thanks to The Belmont Club, I came across a fascinating article by Richard Fogel, dean of the cliometricians. In “Forecasting the Cost of U.S. Health Care”, Professor Fogel looks at the trends affecting the major factor in aggregate medical expenses: the illnesses of the elderly. At age 85, the average person is consuming about six times the health care resources that he used at age 50. Trying to look forward to what the care of the oldest cohorts will cost later in this century requires weighing a number of contradictory factors.

On the positive side, people are getting sicker later in life, and pharmaceutical and technological advances have reduced the cost of treatment. But there are now many more old people. The latter is, of course, a good thing from every point of view but that of the most blinkered cost-cutter. Professor Fogel glances at a few facts demonstrating just how spectacular – and unexpected – the medical advances of the last century have been.

Whereas more than a third of all deaths at the turn of the 20th century were of children under 5, today infant and childhood deaths are less than 2 percent of the annual total. By contrast, deaths among persons age 65 and over, which accounted for just 18 percent of the total in 1900, have grown to three-quarters of all deaths today [meaning that you are four times more likely to reach age 65 now than you were then]. . . .

[T]he record life expectancy at birth in 1840 was found among Swedish women, who lived on average a little more than 45 years. In the year 2000, Japanese women achieved a record life expectancy of nearly 85 years. . . .

In the late 1920s, L. I. Dublin, the chief actuary of the Metropolitan Life Insurance Company, put a cap of 64.75 years on life expectancy for both men and women. In 1936 he collaborated with the leading mathematical demographer of the first half of the 20th century to publish a revised upper limit of 69.93 years. [Except in Africa, even very poor countries, such as Albania, now exceed that prediction.] . . .

At the beginning of the 20th century the burden of chronic diseases among elderly Americans was not only of greater severity but began more than ten years earlier in the life cycle than it does today. Moreover, the number of comorbidities at each age between 50 and 70 is well below levels that prevailed a century ago. . . . Studies of changes in functional limitations among persons who have reached age 65 since the early 1980s indicate that such limitations declined at an accelerating rate during the balance of the 1980s and the 1990s. . . .

For those who reached age 65 during the first decade of the 20th century, the average age of onset of chronic disabilities was about 51. By the 1990s, however, the average age of onset of chronic conditions was more than ten years later. Moreover, these disabilities are now generally milder, and many effective interventions to reduce the impact of chronic conditions are available.

All of this good news has led, however, to a conundrum that our President labels a national emergency, deserving of far more of his time and energy than minor matters like the possibility of a nuclear armed nest of anti-Western fanatics in Iran: “Why is it that although the average age of onset of disabilities has been delayed by ten years, and that these disabilities have become milder than they used to be, the share of GDP spent on health is rising?”

Professor Fogel suggests that the fault lies not in insurance companies or greedy doctors but in ourselves – and that it’s not a fault at all:

The main factor is that the long-term income elasticity of the demand for healthcare is 1.6 – for every 1 percent increase in a family’s income, the family wants to increase its expenditures on healthcare by 1.6 percent. This is not a new trend. Between 1875 and 1995, the share of family income spent on food, clothing, and shelter declined from 87 percent to just 30 percent, despite the fact that we eat more food, own more clothes, and have better and larger homes today than we had in 1875. All of this has been made possible by the growth in the productivity of traditional commodities. . . .

Consequently, there is no need to suppress the demand for healthcare. Expenditures on healthcare are driven by demand, which is spurred by income and by advances in biotechnology that make health interventions increasingly effective. Just as electricity and manufacturing were the industries that stimulated the growth of the rest of the economy at the beginning of the 20th century, healthcare is the growth industry of the 21st century. It is a leading sector, which means that expenditures on healthcare will pull forward a wide array of other industries including manufacturing, education, financial services, communications, and construction.

In other words, as we get richer, we voluntarily buy more health care. The growing proportion of the GDP expended on doctors, hospitals and drugs is no more ominous than the growing proportion that went to automobiles and televison sets in the 1950’s or to personal computers and cell phones today.

This is not to say that the medical cost trend is wholly benign. Rising expenditures on other goods and services reflected market forces. A portion of what we spend of health care stems from the dead weight of government intervention. No other sector of our economy is so heavily regulated and subsidized. Perhaps it is time to give freedom a chance.

A Fact a Day About Obamacare – Day Five: The Individual Mandate

As the “public option” fades from view, the “individual mandate” – a requirement that everybody purchase health insurance meeting a government standard or pay a substantial fine – has come to the fore. It is a centerpiece of Senator Baucus’s new legislative proposal, the “bipartisan compromise” backed only by Democrats.

During the Democratic Presidential primaries, candidate Obama opposed Hillary Clinton’s plan to “force every American to buy health care”. That stance may have been a response to the fact that the mandate is highly unpopular. One of the Krazy Kos Kidz, after scrutinizing the polls, remarks wryly, “It seems that the individual mandate gets broad support, until a fine for non-compliance is mentioned.”

The main objections to the individual mandate were well summarized by Ramesh Ponnuru back when Mitt Romney first floated the idea in Massachusetts:

First of all, the problem he’s addressing doesn’t seem to be a major factor in pushing health-care costs up. Greg Scandlen of the Galen Institute writes: “There may remain some free-riders who refuse to pay their fair share, and remain uninsured, confident that society will take care of their needs eventually. But, so what? Even today with 41 million uninsured, the cost of uncompensated care is a mere 3.5% of total health spending. . . .

Second, the analogy the governor makes [and that President Obama repeated in his speech to Congress this week] to mandated car insurance doesn’t hold up. Michael Cannon of the Cato Institute puts it this way: “First, mandated auto insurance leaves you free to take the bus. You can’t exactly decline to own your body. Second, mandated auto insurance is supposed to insure that victims are made whole after they are hit by a tortfeasor” – which germs aren’t. . . .

Third, if you’re going to mandate health insurance, you’ve got to define what counts as health insurance. Every provider group will be lobbying for inclusion in the government’s definition of a standard benefits package. . . . And it will be hard to resist demands for price controls over a product that you are required to purchase. So we are talking about a reasonably direct path to a much greater expansion of governmental involvement in health care. . . .

Finally, we should face the fact that health insurance is not an attractive deal for many young, healthy people. Getting rid of some mandates – for example, the state-level mandates that make it harder for people to buy a cheaper catastrophic policy – to make it a better deal for them would make more sense than forcing them to buy a product they don’t want.

Today’s Washington Post explains quite candidly why liberal “health care reformers” like this kind of compulsion:

Drafting young adults into any health-care reform package is crucial to paying for it. As low-cost additions to insurance pools, young adults would help dilute the expense of covering older, sicker people. Depending on how Congress requires insurers to price their policies, this group could even wind up paying disproportionately hefty premiums – effectively subsidizing coverage for their parents.

It will be interesting to see whether the generation of young Obamalators cheers for economic conscription.

Massachusetts, by the way, enacted Governor Romney’s mandate proposal (with a number of additions by the Democratic legislature). The Boston Globe, no foe of government-run medicine, today reported the results so far, calling attention to a problem that Ramesh didn’t mention – the tendency of conscripted buyers to try to recoup their premiums by overutilizing medical services:

The state’s major health insurers plan to raise premiums by about 10 percent next year, prompting many employers to reduce benefits and shift additional costs to workers.

Increases will range from 7 to 12 percent, capping a decade of consecutive double-digit premium increases, according to a Globe survey of the state’s top health insurers. Actual rates for 2010 will depend on the size of the employer and the type of coverage, with small businesses and individuals expected to be hit hardest. Overall, premiums are more than twice as high as they were 10 years ago. . . .

Some insurers say the Massachusetts law mandating coverage has added to the cost burdens on the health system. At least initially, they said, it encouraged newly enrolled members to flood the offices of primary care physicians and specialists to receive physicals and other exams. . . .

Despite being dominated by not-for-profit health plans, Massachusetts had the highest family coverage premiums in the nation – an average of $13,788 – in 2008, the most recent year for which figures were available, according to the Kaiser foundation. That included employer contributions of $10,425 and $3,363 from employees.

A large portion of those costs can be traced to the Boston area, where world-class medical centers perform expensive operations that elsewhere are handled for less money at community hospitals.

Raise the demand curve. Leave the supply curve constant. Prices go up. President Obama may be able to lower the oceans and heal the planet, but he can’t repeal the laws of economics.

A Fact a Day About Obamacare – Day Four: The “Lump of Health Care” Fallacy

Writing in today’s Wall Street Journal, Rupert Darwell asks why Britain’s National Health Service “is institutionally ageist”. The NHS doesn’t exactly have “death panels”, but its concern for the lives of the elderly is limited.

In a report, the [Patients Association, an independent charity] presented a catalogue of end-of-life cases that demonstrated, in its words, “a consistent pattern of shocking standards of care.” It provided details of what it described as “appalling treatment,” which could be found across the NHS.

A few days later, a group of senior doctors and health-care experts wrote to a national newspaper expressing their concern about the Liverpool Care Pathway, a palliative program being rolled out across the NHS involving the withdrawal of fluids and nourishment for patients thought to be dying. Noting that in 2007-08, 16.5% of deaths in the U.K. came after “terminal sedation,” their letter concluded with the chilling observation that experienced doctors know that sometimes “when all but essential drugs are stopped, ‘dying’ patients get better” if they are allowed to.

In other words, you don’t have to be all that close to death for the NHS to regard you as “life unworthy of life” (as the Germans used to call it). The starvation death of Terri Schiavo a few years ago was tremendously controversial in this country. Everyone agreed, though, that her circumstances were extraordinary. In Britain, she would have been just one among thousands. The practice is so routine that, according to another report, doctors often don’t bother discussing it with patients’ families.

In the U.S., health care spending rises sharply for older patients. In Britain, it doesn’t. “The U.K.’s pattern of health-care spending by age [has] more in common with the former Soviet bloc.” Since age brings increased illness and infirmity, holding down spending for the elderly can only mean that fewer of their medical problems are treated. Mr. Darwall identifies the key premise behind this policy, what he labels “the lump of health care fallacy”:

Because health-care resources are assumed to be fixed, those resources should be prioritized for those who can benefit most from medical treatment. Thus the NHS acts as Britain's national triage service, deciding who is most likely to respond best to treatment and allocating health care accordingly. . . .

The elderly have fewer years left to them; why then should they get health-care resources that would benefit a younger person more? . . .

A scarcity assumption similar to the British mentality underlies President Barack Obama’s proposed health-care overhaul. “We spend one-and-a-half times more per person on health care than any other country, but we aren’t any healthier for it,” Mr. Obama claimed in his address to Congress last Wednesday, a situation that, he said, threatened America’s economic competitiveness.

But, Mr. Darwall asks, is what “we” spend the important metric? Only if health care is a zero-sum game, in which A’s treatment comes at the expense of B.

But in a market-based system triggering one person’s contractual rights to health care does not invalidate someone else’s health policy. Instead, increased demand for health care incentivizes new drugs, new therapies and better ways of delivering health care. Government-administered systems are so slow and clumsy that they turn the lump of health-care fallacy into a reality.

According to the 2002 Wanless report, used by Tony Blair’s government to justify a large tax hike to fund the higher spending, the NHS is late to adopt and slow to diffuse new technology. . . .

The Wanless report found that of the five countries it looked at, the U.S. was the only one to be both an early adopter and rapid diffuser of new medical techniques. It is the world’s principal engine driving medical advance. If the U.S. gets health-care reform wrong, the rest of the world will suffer too.

A Fact a Day About Obamacare – Day Three: The Good Side of the Status Quo

One of the President’s core assertions, oft repeated, about health care is that the status quo is unacceptable. He regularly assails opponents of his (nebulous) plan for lacking one of their own, coming very near to that fine old line of reasoning:

Something must be done!
This is something.
Therefore. . . .

Fred Barnes has penned an excellent column assembling the case for the health care system we have now. It’s worth pondering before we rush to make massive fixes to something that isn’t all that badly broken.

One major reason for satisfaction is that American medicine has been astoundingly successful in lessening mortality from the two most feared killers, cancer and heart disease.

Two major studies (EUROCARE-4 and a study by the National Center for Epidemiology, Health Surveillance, and Promotion, in Rome, both published in the September 2007 issue of Lancet Oncology) [compared] five-year survival rates for Americans and Europeans diagnosed with cancer.

For all cancers, 66.3 percent of American men and 63.9 percent of women survived [for five at least five years]. In Europe, 47.3 percent of men and 55.8 percent of women survived five years. Those are statistically important gaps.

And the survival rates were higher in the United States for the most common cancers as well. More than 99 percent of men with prostate cancer had survived in the United States after five years, 77.5 percent in Europe. Those with colon or rectal cancer survived at a 65.5 percent rate here and 56.2 percent in Europe. The rates for breast cancer showed a similar difference, 90.1 percent for Americans, 79 percent for Europeans.

The U.S. does more than other countries to prevent heart disease. Barnes quotes Dr. Scott Atlas, chief of neuroradiology at Stanford University Medical School:

“Some 56 percent of Americans who could benefit from statin drugs . . . are taking them,” Dr. Atlas wrote. “By comparison . . . only 36 percent of the Dutch, 29 percent of the Swiss, 26 percent of Germans, 23 percent of Britons, and 17 percent of Italians receive them.”

When Americans do suffer heart attacks, their prospects for survival have improved vastly compared to just a few years ago.

“Wildly successful” is the way David Brown of the Washington Post has characterized the transformation of heart treatment. “Today, someone having a heart attack who gets to a hospital in time is likely to get cardiac catheterization, angioplasty, the placement of a medicated stent, therapy with four anticoagulant drugs and, on discharge, a handful of lifetime prescriptions,” he wrote. These are innovations over the past half-century.

The results are in. “In the 1960s, the chance of dying in the days immediately after a heart attack was 30 to 40 percent,” Brown wrote. “In 1975, it was 27 percent. In 1984, it was 19 percent. In 1994, it was about 10 percent. Today, it’s about 6 percent.”

These results are matched by the success in dealing with all heart disease. “In 1970, the death rate from coronary heart disease was 448 per 100,000 people,” according to Brown. “In 1980, it was 345. In 1990, it was 250. In 2000, it was 187. In 2006, it was 135.”

In other, less life-and-death areas, the United States leads the world by a large margin. For example,

The two most significant innovations for patient care in the past decade are magnetic resonance imaging (MRI) and computerized tomography (CT) . . . . The United States has 27 MRI machines per million Americans. Canada and Britain have 6 per million. The United States has 34 CT scanners per million. Canada has 12 per million, Britain 8.

Surprisingly (at least if one has listened only to lamentations about excessive costs), Americans pay less directly for this care than people in other countries.

Out-of-pocket expenses by American patients amounted to 12.6 percent of total national health spending ($2.24 trillion) in 2007.

That’s one of the lowest percentages of private out-of-pocket spending among the world's advanced countries – lower than Germany, Japan, Canada, and most countries in Europe, including those with government-run health care systems. Why do Americans get more and pay less? Because their insurance policies provide broader coverage than most government plans, says Tom Miller of the American Enterprise Institute.

That breadth of coverage is, in fact, a major cause of one of our system’s perceived problems: “[B]reakthroughs and discoveries are enormously expensive, so much so that America spends far more on health care (now 17 percent of GDP) than any other country.”

That statistic is, however, the aggregate product of individual decisions. Someone who wants to minimize his own personal medical expenditures can do so by purchasing only catastrophic coverage, forgoing tests and treatments that are not strictly necessary to deal with current health problems, and accepting the risk of a shorter life span. Is it, for instance, cost-effective to take statins in order to reduce a one-in-five chance of developing heart disease during the next ten years to a one-in-ten chance? The figures quoted above indicate that Americans making their own choices think so, while central medical planners in other countries are more skeptical. Ultimately, the debate about health care reform is a debate about who should decide.

Overall, the status quo gives Americans high quality medical care, for which they pay a great deal, albeit through insurance company conduits. It isn’t the only possible trade-off, but many worse ones are imaginable.

Eighty-nine percent of Americans in a June 2008 ABC News/USA Today/Kaiser Family Foundation survey said they were satisfied with their health care. Put another way, more than 270 million Americans (I’m including kids) are reasonably happy with the system of medical care in this country. Other polls have found the same level of satisfaction.

President Obama and other liberals are sure that their countrymen are the victims of false consciousness and that only massive government intrusion can remedy the status quo’s intolerable defects. Maybe the difficulties that they’re facing in selling hope-and-change are evidence that their certainties are at fault.

Bill Buckley and “the Dark People”

Rick Brookhiser (whom I knew when he was an undergraduate but haven’t been in touch with since) knew Bill Buckley very well. I met WFB only twice. He is, then, far more expert than I on the father of modern conservatism. Nonetheless, I’m certain that he is dead wrong in his explanation of Buckley’s skepticism about the Iraqi campaign:

Two points: 1) Bill spent much of 2005 and 2006 writing that the Iraq War was lost, over, a bad job. I give instances on p. 232 of Right Time, Right Place, and I could easily have given more. The fact is indisputable. What do we make of it? What I make of it is that it was a major failure of Bill’s judgment, as great as his support for segregation in the 1950s (see pp. 12, 33). I believe the two failures are linked by an indifference, inherited in the first instance, atavistic in the second, to the rights and well being of dark people. 1950s Bill did not care that white people oppressed black people, 2000s Bill did not care that brown people tormented brown people.

I haven’t read Rick’s book (and paragraphs like that don’t encourage me to pick it up), but there’s no doubt that, if it presented solid evidence that Bill Buckley was a racist, the elite media would have been trumpeting it in their headlines, and excerpts from Right Time, Right Place would litter the pages of the New York Times. The inference that Buckley opposed federal civil rights legislation (which is what “support for segregation” must mean – at least, that’s all that I find in Up from Liberalism and the early National Review) and persistence in Iraq because he didn’t care what happened to non-whites is pulled out of the air.

Isn’t it far more likely that Buckley said in 2005 and 2006 that the war in Iraq was hopeless, because that was a reasonable view of the facts on the ground (not the only reasonable view – I didn’t believe it – but believable regardless of what one might think about “brown people torment[ing] brown people”)? Rick himself supplies the proof that Buckley wasn’t indifferent to the fate of the people of Iraq:

By the end of his life, Bill snapped out of it, supporting the surge and telling the last directors’ meeting he attended that the struggle against jihadists was our world war (p. 241).

As for civil rights in the 1950’s, there are two clear themes in Buckley’s writings from that period: that the government should not try to rectify individuals’ attitudes toward other people and that trying to impose non-bigotry from Washington, D.C. would spark massive resistance that would threaten the fabric of the nation. Those are non-racist arguments. They were, however, founded on false beliefs about the real situation of the South. Segregation was the perfervid cause of an intimidating minority, who kept everyone else in line through the threat of violence. The region’s accommodating reaction to the Civil Rights Act of 1964 showed that most whites had no real desire to perpetuate Jim Crow and welcomed an excuse to send him out to pasture.

Conservative politicians understood more about real popular attitudes than conservative intellectuals. Except for a handful of Goldwater libertarians, every conservative Republican in Congress in 1964 voted in favor of the Civil Rights Act, including, for instance, Rep. John Ashbrook, than whom no right-wing legislator was ever more sans peur et sans reproche.

As a Parthian shot (suggested to me by another ancient Brookhiser acquaintance), let me note that Rick became Bill Buckley’s protegé, a position with which he showed no discomfort, at a time when he could have read all that his mentor had written about civil rights. He doesn’t seem to have found any of it objectionable until he was passed over for the editorship of National Review.

A Fact a Day About Obamacare – Day Two: The Public Plan We Have

The federal government runs a very large health insurance program, Medicare, and President Obama says that its success – it is so popular with its beneficiaries that no non-suicidal politician proposes its abolition – demonstrates that “there should be a little more confidence that maybe the government can have a role” in the rest of the health care sector.

Our experience with Medicare is indeed instructive. An essay in last Friday’s Wall Street Journal by health care economists Grace-Marie Turner and Joseph R. Antos reviews the lessons to be learned.

Prefatorily, let’s look a bit more closely at Medicare’s popular support. I’ve never heard anyone who’s actually had to deal with the Medicare bureaucracy say a positive word about the program’s design or administration. The reason why senior citizens support it is because they fear that changes would make it worse. Given that the reforms most often mooted involve cutting reimbursements to providers (thus reducing the number willing to take Medicare patients) and restricting patient choices, it isn’t surprising that beneficiaries prefer the devil they know. Benign reforms – like Medicare Advantage, which the President wants to kill, and the private-sector-based prescription drug program – have been well received. In short, it isn’t the government’s role that accounts for Medicare’s popularity.

Miss Turner and Mr. Antos lay out the dark side of Medicare, faults that hint at how disastrous it would be to extend the same concepts to the rest of the population. Their first point is well-known:

Medicare is going bankrupt. The Medicare Trustees estimate that the program will run short of money starting in 2017. Medicare will drown in a sea of red ink, with spending over the next 75 years outpacing dedicated revenues by nearly $38 trillion. . . .

Medicare has undeniably guaranteed that all seniors have health coverage, even if that coverage is not as good as advertised. But the program is in trouble. Even though it has a blank check funded by federal revenues, Medicare will not be able to pay all the hospital bills that come in eight years from now. If you think that's bad, just wait until 70 million baby boomers turn 65 and drive federal budget deficits into the stratosphere.

That fact alone does not increase one confidence that Congress and the Administration will be able to devise a universal scheme that will comport with the President’s promise not to sign a bill that adds even a dime to the federal deficit. Especially not when the details will be improvised in the dark of the night by a Congressional conference committee.

A couple of other bits from the Turner-Antos piece, to encourage you to read the whole thing:

Providers could not keep their doors open without the higher payments from private insurers [that make up for shortfalls in Medicare reimbursements]. A recent letter to Congress from 13 leading health-care delivery organizations, including the Mayo Clinic, said “many providers suffer great financial losses associated with treating Medicare patients.” They said that if these rates were expanded to patients who currently have private insurance, the result “will be unsustainable for even the nation’s most efficient, high quality providers, eventually driving them out of the market.” That means we would say goodbye to some of the best health-care systems in the country. . . .

Washington decides how much doctors, hospitals and other providers will be paid down to the smallest detail, with mountains of regulation and paperwork to track the politically driven process. Medical professionals are in a perpetual battle with Congress over their payment rates, and many physicians refuse to accept new Medicare patients because payment rates are so low. With few exceptions, Medicare’s solution to cost containment is the club of price-controls, not innovation and efficiency.

The part of health care that the President has consistently ignored is supply. It does no good to give everyone insurance coverage if all the doctors have retired and all the hospitals have gone broke.

Medical decisions are made in Washington. Patients and their doctors are slowly losing the ability to decide what course of treatment is best. Medicare’s decisions to cut funding for the cancer drug EPO, implantable cardiac defibrillators and virtual colonoscopies, for example, have led to epic battles between providers and politicians, while patients and their doctors watch from the sidelines. Medical decisions, which should be made by doctors and patients, are being made by politicians.

This is the prosaic basis for the “death panel” rhetoric. As Washington assumes a larger and larger portion of the cost of medical care, it will inevitably want a greater say in how that money buys, with the reasonable objective of minimizing waste, fraud and abuse. It’s an impossible dilemma: Leave doctors and patients free, and the blank check on federal resources will lead to waste. Control their decisions from the top, and patients will suffer or die under a one-cure-fits-all regime. Only a panel of angels can furnish a solution.

Medicare may well be the most efficient and successful government-run insurance program in history. That doesn’t mean that we should extend its management principles further.

A Fact a Day About Obamacare – Day 1: Illegal Aliens

Well, maybe it will be more than one fact, and betimes it might be less. I’ll be interested to see how long I can keep the series up.

Let’s begin with the fact (or fiction) that made Rep. Joe Wilson (R[ude]–S.C.) a national figure overnight. Who was lying about whether the reformed health care system would provide benefits to illegal aliens? The White House waited till Friday afternoon (its standard time for releasing news it would rather no one hear) to announce that it would support requiring applicants for subsidized insurance to present proof of citizenship or legal residency.

Democrats on the Ways and Means Committee had unanimously voted against verification requirements, without which it meant nothing to say that benefits were available only to persons legally present in the United States. That’s why Rep. Wilson was moved to call the President’s blanket statement that illegals would be excluded a “lie”. The White House now agrees, though it presumably would prefer “inexactitude” to “lie”. The congressman’s outburst of truth speaking to power was impolite, but Mr. Obama is himself a one-time rabble rouser community organizer, and he was not famous for obeying Miss Manners’ precepts.

That leaves a question that hasn’t gotten much attention. Should illegals be excluded? Philip Terzian, a conservative who, like me, doesn’t support immigration restrictionism puts forward an argument for covering them:

Rep. Joseph Wilson of South Carolina shouted ‘You lie!’ from the floor when President Obama told Congress that his health care ‘reform’ proposals would not insure illegal aliens. As it happens, it was Joseph Wilson, and not Barack Obama who spoke the truth in that exchange, and I leave it to others to sort out the etiquette of presidential harangues to joint sessions of Congress.

But what struck me was the substance of Obama’s assertion: What sort of humane national health-insurance program would pointedly exclude illegal aliens? There is no national debate, so far as I know, about the fact that we offer free, competent, taxpayer-subsidized health care to convicted felons, pedophiles, rapists, and murderers of the cruelest variety – that is to say, to the millions of Americans currently in prison – but a Democratic president is eager to deny health care to people who live here peaceably, pay taxes, and make a vital contribution to the American economy? Barack Obama would subsidize health care for Charles Manson, but not the man who fills your potholes or the woman who scrubs your toilet.

The flaw in this analogy is that prisoners have, as part of their punishment, been deprived of the means of making money to pay for goods like health care. (If they do happen upon sources of income, most states will levy upon it to reimburse the costs of incarceration, including medical care.) Illegal aliens have entered the U.S. voluntarily in the hope of economic betterment. One of the factors that they should have to weigh is whether the income they gain by working unlawfully will suffice to cover their expenses, one which is the cost of medical treatment. That doesn’t strike me as an unfair trade-off. I agree with Mr. Terzian that it would be better to establish a rational guest worker program, so that willing workers could enter the country freely, but that’s a separate debate.

The drawback to letting anybody who can slip across the border take advantage of government-subsidized health benefits has been summed up by Mark Steyn:

The minute a first-world country has “free” health care, it becomes the provider of choice to anyone who can get there, particularly for any long-term ailments requiring state-of-the-art medications. In 2004, Britain’s Health Protection Agency revealed that 44 percent of HIV patients being treated by the National Health Service were not residents of the United Kingdom at all, but from southern Africa. In essence, a huge number of AIDS patients in South Africa, Zimbabwe, Zambia, Malawi, Swaziland, and Lesotho have decided to outsource their health-care needs to British taxpayers. Similar trends will manifest themselves here in nothing flat.

It seems, then, that the President agrees with Joe Wilson on substance – health care reform shouldn’t be an open-ended foreign aid program – and ought to be grateful for the warning against legislative tomfoolery. Well and good, but let’s keep in mind that there’s no guarantee that Mr. Obama will get his way with his fellow Democrats. Remember how he was going to rein in earmarks and how much attention the Reid-Pelosi cabal paid to that effort? I’d be willing to bet a moderate chunk of my life savings that verification falls into a black hole before the bill is ready to be signed into law. Will a Joe Wilson be around to alert the President then?

Quote of the Day

Senator (and Medal of Honor recipient) Daniel Inouye (D–Haw.), chairman of the Appropriations Committee:

As we go forward today killing the F-22, the presidential helicopter, the Combat Search and Rescue helicopter, the Kinetic Energy Interceptor, we do so with the hope that today’s military and civilian leaders are more prescient than their predecessors in predicting our future needs.

Half of all military spending is wasted. When a war breaks out, we learn which half.

Obamacare for Dogs

The big news today is that a Republican congresscritter called President Obama a “liar” last night. Obviously, no Democrat has ever said anything of that sort about Republicans. The outburst took place at some event or another, where the President talked for the first time since last time about how the nation urgently needs to provide more health care to more people without devoting any more resources to the task.

Anyway, the errant lie-labeler quickly apologized. He’s from South Carolina, whose Representatives have been known to express disapproval in more ferocious ways than name-calling.

(I suppose that I need to add, for the sake of any hypersensitive liberal readers, that I thoroughly disapprove of heckling Presidents when they speak to Congress and think that Rep. Wilson should be subjected to the same official censure as the Democrats who booed and jeered President Bush’s State of the Union address in 2005. Each branch of the government should display respect toward the other two. Heckling is the province of their bosses, namely, the people of the United States of America.)

But I don’t want to write about South Carolina, which has been entirely too much in the news lately. My real topic is dogs. Via James Taranto (very last item), I came across a column contrasting the state of health care for two species:

Over the weekend, we rushed our dog Hamlet to an emergency clinic in Riverhead, New York, where the vets who saw him said he had suffered a “G.I. episode” – an upset stomach – caused by a “dietary indiscretion.” (The precise source of the indiscretion is still unknown.)

But within 48 hours, our four-year old cockapoo was treated at two New York hospitals – the East End Veterinary Emergency and Specialty Center, in Riverhead, which admitted him at 3:30 am, and then at the Animal Medical Center, in Manhattan, which was fully staffed despite the holiday. At both centers, he was seen immediately by skilled, caring doctors, and in New York City, by a specialist.

Hamlet is presumably satisfied with the health care available to canine-Americans. Less so the writer’s husband, who was compelled –

. . . to wait for over two hours in a crowded emergency room . . . after cutting his hand on a martini glass. The E.R. was overflowing that night with people who, because they had no insurance, could not possibly afford to get the kind of treatment that Hamlet was getting.

The column then drifts into generalities about how much Americans spend on medical care and the writer’s hopes that the President will figure out a way to get things up to veterinary standards. She misses the moral of her story. If we want her husband to be treated more like her dog (hmm, perhaps not precisely what she wants), a good starting point is the ways in which dog care differs from human care. Two leap immediately to mind:

• Almost all veterinary bills are paid out of pocket by the consumer (or the consumer’s human companion). Pet insurance exists – some companies even offer it as a fringe benefit – but it is rare and unregulated: no community rating, no mandated benefits, no guaranteed issue, et non cetera.

• The government plays almost no role. States license veterinarians, and that’s about it. To the best of my knowledge, no level of government expends a dime of tax money to maintain the health of dogs, cats, horses, parakeets or tropical fish.

Is it conceivable that these features have something to do with the speedy, friendly service that Hamlet received and the long wait that Mr. Miller had to endure? (Bonus preventive care tip: Don’t handle martini glasses while drinking alcohol.) Well, let’s imagine that canine care were more like the regulated, subsidized, bureaucratized regime that humans endure.

The great majority of pets’ medical bills would be covered by insurance. Veterinarians would have a lot more business, and prices would rise to attract practitioners and other resources to the field. Uninsured pets wouldn’t be able to afford these boosted costs and so would congregate in emergency rooms, where poor Hamlet might have to wait and wait, behind pooches who were there as much to socialize free of charge as to receive medical attention, before his “G.I. episode” was diagnosed and treated.

The government would address the problem of affordability by subsidizing the expenses of the neediest pets. As more dollars poured in and demand steadily outstripped supply, costs would rise “uncontrollably”. The response would be a complex reimbursement process replete with arbitrary caps and a high incidence of fraud.

Eventually would come the “pet care crisis” and the cries for “pet care reform”. Judging by the human parallel, hardly anybody would think to scrap the causes of the discontent and look to marketplace economics for a remedy.

Obama Expects

Now we can read the speech that President Obama will deliver tomorrow to the country’s schoolchildren. It of course is not an exercise in political indoctrination. In fact, it contains many fine sentiments about the importance of hard work, personal responsibility and forethought, plus admonitions on the unlikelihood of effortless success. True, these are the same sentiments that students hear, often in about the same words, from parents, teachers, principals and commencement speakers, but reiterating them does no harm.

No doubt the President intends to do good by adding his voice to the chorus of conventional (and correct) opinion. Yet his addition embodies a couple of the annoying and counterproductive elements of his Presidential persona.

First there is the relentless focus on the unparalleled and unprecedented life of Barack Obama, which he presumes is an inspiration to everyone. He seems to take it for granted that youngsters will automatically want to emulate his own route to success. The flaw in that self-regard is that 43 men have served as President of the United States, and almost every one of them accomplished more than the current incumbent has to date. Maybe he will someday be ranked among the great and admirable holders of the office, but we don’t have any way to be confident of that. Let the orators of the future single out President Obama as a role model. But while his place in history is still being formed, might not figures like Abraham Lincoln and George Washington Carver be better exemplars for his lesson?

Self-regard reaches its heights in the peroration:

Your families, your teachers, and I are doing everything we can to make sure you have the education you need to answer these questions. I’m working hard to fix up your classrooms and get you the books, equipment and computers you need to learn. But you’ve got to do your part too. So I expect you to get serious this year. I expect you to put your best effort into everything you do. I expect great things from each of you. So don’t let us down – don’t let your family or your country or yourself down. Make us all proud. I know you can do it.

Exactly why should American children – excepting the Obama daughters – care what this middle-aged government official expects of them? The President is not our king, father or spiritual counselor. He is an elected magistrate, who holds his position because experience has shown that republics cannot remain free, safe and prosperous without what Alexander Hamilton called “energy in the executive” and that there is no better way to obtain that energy than to vest executive power for a limited time in a single individual.

If citizens of the United States educate themselves, or otherwise improve their condition, it is not because their lord and master expects that of them. It is because our constitutional system leaves them free to do so. The expectations that matter are those of their families, friends, neighbors and fellow countrymen.

To be fair, the President does include the country among those to whose expectations students are exhorted to rise. They’re not asked to do it only for Obama. On the other hand, his young listeners may wonder why they should respond enthusiastically to what America wants. By the President’s account, our land is not the freest, most civilized, most generous nation in the history of the world, whose virtues should be defended and conserved. No, it’s just a place that may, if the next generation works hard enough, rectify its historical vices of racism, inequality, poverty and so on.

You’ll need the knowledge and problem-solving skills you learn in science and math to cure diseases like cancer and AIDS, and to develop new energy technologies and protect our environment. You’ll need the insights and critical thinking skills you gain in history and social studies to fight poverty and homelessness, crime and discrimination, and make our nation more fair and more free.

John F. Kennedy’s “Ask what you can do for your country” is an ambiguous entreaty. It may mean either, “Ask what you can do to continue the great tradition of America” or “Ask what you can do to clean up the rotten mess your far from admirable forebears left behind”. The President echoes Kennedy. Unfortunately, he also has fairly clearly resolved the ambiguity.

Addendum: Okay, Lincoln and Carver may be too old and dead to inspire the iPod generation, but what if the President were to put aside self-adulation and choose a figure other than himself as an ideal for student aspirations? How about a black man who, like Barack Obama, was abandoned by his father at a young age and raised by his grandparents – but who also, unlike Barack Obama, is a descendant of slaves, grew up in poverty, in a part of the country where anti-black bigotry still flourished, attended segregated schools, and didn’t even have English as his first language? Despite these grave handicaps, he persevered, educated himself, earned an Ivy League law degree, and is now a Justice of the Supreme Court. That sounds pretty inspirational to me.

The Midnight Bus

Jen Rubin asked, at 10:23 p.m. EDT on Saturday, “Van Jones: What Are They Waiting For?” What they were waiting for, it turned out, was the wee hours of Sunday morning, when the terse announcement appeared that Mr. Jones, avowed communist, 9/11 truther and Obama Administration “green jobs czar”, had resigned the last post.

The obvious reason for picking this moment for the bus under-throw was to make sure that readers of the elite media never learn that the President appointed a full-fledged nutcase to what was supposed to be an important economic role. It was rather like putting a segregationist in charge of civil rights enforcement. Interestingly, lots of left-wing organizations (Jonah Goldberg collects the links) praised and defended the czar even as the bus roared nearer. And PowerLine has summarized the insight that this appointment offers into the reigning ideology at the White House:

The key point about the Van Jones affair is what it tells us about Barack Obama. Jones isn’t someone who slipped through the cracks of the vetting process. We know this because, as Scott pointed out earlier today, top Obama aide Valerie Jarrett has said, “So, Van Jones, we were so delighted to be able to recruit him into the White House; we were watching him. . .for as long as he’s been active out in Oakland.”

Having watched the rise of Van Jones, why did Team Obama nonetheless “recruit” him into the White house? Because what Jones says and believes is well within the range of what Obama believes, and thus not jarrring to him and his crew.

If Jones is now beyond the pale, it is only because the Obama crowd finally hears him through the filter of a controversy. When Obama and company heard him only through the filter of what they believe, there was no controversy because his statements – e. g., his attack on Israeli “occupation” dating back to 1948 and his claim that “U.S. tax dollars are funding violence against people of color inside the U.S. borders and outside the US borders” – are not particularly controversial to Team Obama.

The hope in the White House is that, Van Jones have vanished in the middle of the night, nobody except a few right-wing crazies will think about what his brief tenure of office really meant.

What Hugo Wants, Hugo Gets

Hillary Rodham Clinton – remember her? – announced today that the United States is cutting off all non-humanitarian aid to Honduras and will not recognize the results of the next election, scheduled for November, unless the country restores Manuel Zelaya to the presidency.

The announcement offers no rationale. It admits that “both the legislative and judicial branches of the government” were “participants” in the so-call coup that sent Zelaya into exile. Stated more fully, the Supreme Court ruled unanimously that Zelaya had violated Article 239 of the Honduran constitution, which forbids the president to seek a second term and automatically removes him from office if he does. The court ordered the military authorities to enforce its decision. They did, and the Congress, controlled by the president’s own political party, also voted to remove him. If that constitutes a coup d’état, could Zelaya have been deposed by any means that the State Department would accept? Have Barack Obama and Hillary Clinton amended the Honduran constitution to make presidents irremovable?

Rick Richman aptly labels the American action “Chicago democracy”. The open question is, cui bono? There’s no visible U.S. interest served by interfering in the internal affairs of a small friendly Central American nation, but someone else, as Mary Anastasia O’Grady observes, cares greatly about what happens there:

By insisting that Mr. Zelaya be returned to power, the U.S. is trying to force Honduras to violate its own constitution.

It is also asking Hondurans to risk the fate of Venezuela. They know how Venezuela’s Hugo Chávez went from being democratically elected the first time, in 1998, to making himself dictator for life. He did it by destroying his country’s institutional checks and balances. When Mr. Zelaya moved to do the same in Honduras, the nation cut him off at the pass.

For Mr. Chávez, Mr. Zelaya’s return to power is crucial. The Venezuelan is actively spreading his Marxist gospel around the region and Mr. Zelaya was his man in Tegucigalpa.

The Honduran push-back is a major setback for Caracas. That’s why Mr. Chávez has mobilized the Latin left to demand Mr. Zelaya’s return.

And the Latin left now has new members: the yanqui President and Secretary of State. The United States is still dictating to Latin America, just as in the bad old days, and displaying contempt for democratic and constitutional processes. The difference is that we used to bully in behalf of banana growers; now we’re providing the muscle for the region’s foremost despot.

Update (9/4/09): We learn more from Assistant Secretary of State Philip J. Crowley. The gist of Crowley’s explanation of the reasons for the aid cut-off to Honduras is that there was no military coup. The Administration simply didn’t like the outcome of Honduras’s constitutional process and has ordered the “de facto government” to reverse it. With Iran and North Korea, we negotiate. To Honduras, we issue unappealable commands.

Maybe the President should appoint Hugo Chávez to Mr. Crowley’s position and cut out the middleman.