A Bridge Too Far

by Don Boudreaux on December 23, 2009

in Health, Man of System

Here’s my latest column in the Pittsburgh Tribune-Review.

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  • vidyohs
    In his fondest dream Senator Muirduck is speaking to you.

    "A human economy is very different. Each person -- as producer and as consumer -- has his own unique abilities and wants."

    We will fix that during next year's session, you damn people are just not following the plan! And, you have no right to unique abilities and wants!

    You will want what we tell you that you want. This fucking freedom shit has just gone too far.
  • vidyohs
    Why Don, you rascal, are you saying my health care is like a snowflake, unique? Well yes it is, thank you for saying so.
  • txslr
    Here's the question that is plaguing me today. Let's say I am willing to stipulate that, in some areas, government-planned healthcare outperforms our current system by some measurable amount, but that in others in falls short. Note that I have seen no convincing evidence that this is true, but it seems to me to be the most generous position I can hold with respect to government healthcare. The question is, what standard do we (or muirgeo, for example) use to decide that this set of outcomes is better? How much of a decrease in infant mortality equals a set improvement in cancer survivability? There must be a way of figuring this out, because that is what the government is promising to do, isn't it? Unless you take the position that once the government gets involved absolutely everything will be better for everyone all the time. And you couldn't possibly take that position because it is mind-bogglingly stupid.
  • muirgeo
    As far as standards and outcomes. Let doctors and nurses decide. We do that know. We advocate for our patients all the time. And when are patients are asking for things they don't need we make a case for that as well. But none of our Medicare patients have gone bankrupt paying health care bills.. that only happens to people with no insurance or private health insurance plans.
  • LowcountryJoe
    Maybe I'm mistaken about this but when I lived in California and had Kaiser as an HMO, it was either me or the company I worked for who bought the coverage for me and my family. It was (and is) a private insurer, was (is) it not?
  • muirgeo
    It's a private non-profit health plan.
  • LowcountryJoe
    So, it is a private insurer. The premiums that Kaiser charges have nothing to do with income and so-called fairness: instead the company charges premiums based on discriminating factors such as, number of members on the plan, ages, and health histories, right? Let me never hear of you bad-mouthing private insurers again, Doctor; you work for one that has vertical intergration.
  • muirgeo
  • Randy
    You've just been made a civil servant, and yet you think you will be allowed to "decide"? Good one :)
  • txslr
    You really don't understand my question at all, do you? Try reading it again and see if it doesn't start to make sense.

    And by the way, bankruptcy is a benefit to the person who declares it. It allows them to use the power of the courts to work out an acceptable way of settling debts. So not getting any insurance and relying on bankruptcy in extreme circumstances may be a perfectly reasonable strategy, particularly if the cost of insurance is above your probability-weighted chance of needing it because the premium is being used to subsidize some politically favored group.
  • Gil
    Why do you presume there's has to be a trade-off between infant mortality and cancer survivabiltiy? Are you arguing a poor person who can't afford medical treatment shouldn't be getting that treatment? Or if everyone is magically insured for health then no one has any real incentive to take care of their health? Or what?
  • txslr
    Seriously?! Is it your belief that, once the government is in control, there will be an unlimited amount of healthcare available for everyone at all times? No waiting and unlimited resources? Will all scarcity be banished? No tradeoffs?

    Will Congress next take up the issue of the perpetual motion machine so we can also have unlimited free energy?
  • Randy
    Its about progress, Gil. Not your hokey political idea of progress, but real progress. The kind of progress that comes from people with an incentive to satisfy customer's demands. Once the industry becomes a civil service industry, the only incentive will be to comply with regulations. Incentives. So what incentive does a civil servant have to keep a cancer patient alive? A live cancer patient is just one more asshole in the waiting room to keep him from going home on time.
  • Metre
    Being an engineer, I can tell you that no engineer understands everything about a jet airliner; yet collectively, engineers as a group are able to build them. And these jets safely transport millions of people day after day. So the analogy of a trans-Atlantic bridge is not a good one. Engineers know how to deal with complexity; congress may not, but engineers do.
  • JohnK
    A mathematician, physicist and engineer are given a red rubber ball and asked to determine the volume.
    The mathematician performs some measurements, does a few complex integrals, and gives his result.
    The physicist immerses the ball in water, measures the displacement, and gives his result.
    The engineer carefully examines the ball, finds a serial number, looks it up on a table, and gives his result.

    Complexity? Ha!
  • Randy
    Good one. Reminds me of this one.

    A systems engineer, mechanical engineer, and a software engineer are in a car careening down a mountainous road without brakes. The driver is furiously pumping the pedal while he steers the speeding car around the treacherous turns - stones flying and passengers gasping. Finally, he finds an incline and the car coasts to a stop. All three get out and, thanking their lucky stars, begin to assess the situation.

    "Oh," says the mechanical engineer, "the brake lines are leaking - lets patch the hole, bleed the brakes and be on our way!"

    The systems engineer said "maybe we should consult with the manufacturer and the dealer to ensure that is really the problem."

    The software engineer said "why don't we get back in and see if it happens again?"
  • Randy
    "Engineers know how to deal with complexity."

    Yes and no. I work with engineers. They often deal with complex requirements with a design that requires the least possible effort from them. They want to play with the stuff they want to play with, and not necessarily to produce what the customers actually want. So we often get half-baked solutions, unsellable products, and bugs, instead of quality products as defined by the customers. So yes, engineers can deal with complexity, if they put their minds to it, but it can take some serious effort to make that happen.
  • mark
    "Engineers know how to deal with complexity; congress may not, but engineers do."

    Oooh, wow. What an impressive oversimplification.
  • Metre
    Mark, so your point is what exactly? Engineers routinely deal with systems that are too complex for any one engineer to understand, yet we build such systems anyway, and with great success. Implying that one person needs to understand everything is simply wrong; hence Professor Boudreaux's analogy was simply off the mark (pun intended). Economists could learn much from engineers.
  • mark
    " Economists could learn much from engineers."

    Narcissist.
  • Gil
    Who the Gaian worshipper now?
  • muirgeo
    "Health care will be severely damaged if it is designed and restricted by a few hundred arrogant political operatives."

    Don Boudreaux


    What's so frustrating about this claim is that I can point to no less then 30 countries who HAVE had their government design universal access to health care and they spend far far less then us, their outcomes are just as good and their citizen are generally very happy with it. THE REAL WORLD CONTRADICTS YOUR CLAIM ABOVE (not shouting ... just emphasis that I am stating a fact).

    Then you make this claim..."Health care will be improved only by unleashing the creativity of millions of people and by market competition. ".... completely anti-thetical to your argument that mere mortals can predict complicated systems. How do you know this will be the case??? But in your case there IS NOT ONE SINGLE REAL WORLD EXAMPLE for you to point to as proof of your claim. NOT ONE!!!

    You haven't proved anything. You haven't made a good point. You've only one-upmanshipped (maybe two or three-upmanshipped) the typical congressman who claims he knows how to make things better in a complicated system.
  • carlsoane
    You make a good point. If you cannot predict the future state of a complex system, you cannot predict it, whether the system be free or government designed. Your other claim is also reasonable: we have many examples of government designed systems that seem to be functioning well. I assume that you're measuring the success of these systems by general health factors, coverage and cost. I would argue that the US system is the most successful in the world if you measure success by technological and process innovation.

    The key questions then are why are other systems successful at covering more people at reasonable cost and why are we successful at innovating. Nobody can know enough about any of these complex systems to say for certain. What I can do is look at an individual actor operating within a system and try to discern how the incentive structure affects him. It makes intuitive sense to me that an individual would have a lot of incentive to innovate if the system provides a great deal of opportunity for profit and does not have much central control. It also makes intuitive sense to me that individuals will spend their money more frugally than other people's money. And, it makes sense that health care providers are more likely to provide services to poor people if the services are subsidized.

    And, that seems to match well with the results we see for different systems. The US system is the most innovative; the Singapore system in which people pay a great deal more out of pocket than in the United States and Europe does the best job of controlling costs; and a number of systems (France, the Netherlands...) that subsidize care directly for the poor do a good job of providing basic care to the poor.

    What I don't understand is why Congress is choosing the path it is choosing. They are continuing to obscure pricing and expecting to control cost. They are expanding coverage and expecting to control cost. They are creating more central control and expecting more innovation. They are obfuscating subsidies for the poor and expecting better management of health care for the poor.
  • muirgeo
    Thanks for a reasoned response.

    The innovation issue is a good point but I'd argue its overdone. Much of our innovation comes from publicly funded research.

    But indeed the profit motive is critical. But its a two edged sword. The profit motive creates innovative diagnostic and treatment technologies. It also creates innovative ways to make profits by finagling the system, rescinding coverage, making lots of contractual fine print and rent seeking from the government. Having the government option or even single payor for health insurance won't stymie the profit motive on new technologies only on profiting from NOT providing care.
  • txslr
    Then why do government programs, including Medicare, reject more claims than private insurance? In fact, the only way in which government can lower overall expenditures on healthcare is by forcing a lowering of consumption - that is, by refusing to provide care.
  • muirgeo
    First I'd like to see evidence that supports your claim. But assuming you have that evidence you need to understand what Medicare does. It takes care of EVERYONE over 65. They are the sickest Americans, none are denied coverage. These are Americans who are the most expensive to care for.

    The insurance companies basically cherry pick the healthiest Americans and then drop them when they get really sick.

    The way to decrease the cost of Medicare is to get the private insurance companies grubby hands off of it. Medicare supplement programs add nothing but cost an additional 11%.
  • txslr
    That would be the AMA's 2008 National Health Insurer Report Card. Look under Metric 12, Percentages of claim lines denied. Medicare leads the pack. So when you say that none are denied coverage, can you explain the benefit of having coverage that won't pay your claims?

    And by the way, I'd like to see the evidence that supports your claim that insurance companies cherry pick the healthiest Americans and then drop them when they get really sick.
  • LowcountryJoe
    Shit...evidence from muirgeo? He cannot even come up with his claimed list of thirty countries that provide universal healthcare; sure he posted two links but neither of them had a breakout of who supplied universal healthcare. And you think that he'll be able to prove another claim of his -- one that would seemigly have more difficult to find links that prove absolutely nothing about his claims?


    Doesn't Medicare have lists of proceedures that they will cover and at what compensation to the physicians that will provide the service? And didn't the supplements come about because patients over 65 were tired of the restrictions on those lists: so, they paid additional premiums, voluntarily, to have more coverage options should the need for the coverage arise?


  • Methinks1776
    we have many examples of government designed systems that seem to be functioning well.

    You know why they "function well"? Because they are so inadequate that a private system arose in EVERY European country to give people the health care they really desire rather than the crap foisted on them by the state. So, they get pretty good outcomes when you ignore chronic conditions caused by wait lists like lameness, the cost of the public system and the fact that to get anything resembling health care, you actually have to go to the parallel private system.

    Europe does the best job of controlling costs.

    This is wrong. With very few exceptions (maybe one or two), every European country spends more than 10% of GDP on health care. In contrast, Singapore less than half of any European health system - only 4.5% of GDP on healthcare and gets better health care outcomes (and I'm not talking dodgy infant mortality and life expectancy numbers, but outcomes from the point of diagnosis) and has no queues.

    I was "fortunate" enough to sample the public system in Europe for years in two different countries and no American would recognize it as health care. It's substandard compared to U.S. healthcare.

    Incidentally, Singapore doesn't control costs. Prices are lower because people pay a large portion of medical expenses out of pocket and health care providers compete for those dollars. Even so, they still have basic coverage for everyone. It's just that the Singapore government isn't weaving the fiction of some poncy universal egalitarian coverage. The government charges everyone a very small tax and pays for extremely basic, no frills treatment. Everyone pays the tax. If you want something better, you have to make up the difference in price out of pocket. Singapore forces mandatory contributions to an HSA, but everyone spends their HSA on their desired level of treatment - the consumer retains right to choose the level and quality of health care consumption.

    ...do a good job of providing basic care to the poor.

    Only because the standard of care in Europe is lower than in the U.S. and because the less poor all opt for the private system, leaving the crude government system to the poor. BTW, what Americans consider "basic care" and what the Europeans consider "basic care" are miles apart. Ever been to a free clinic in the U.S.? Voila. Basic care in France.

    And, it makes sense that health care providers are more likely to provide services to poor people if the services are subsidized.

    That makes no sense. Why do you think that makes sense?


    What I don't understand is why Congress is choosing the path it is choosing. They are continuing to obscure pricing and expecting to control cost.....

    This bill has nothing AT ALL to do with reforming health care. Once you accept that, you'll stop being confused. They are expanding coverage and mandating the details of health insurance, centralizing control and obfuscating and expecting none of the things you think they expect. They expect more power and control. Full stop. And that's exactly what they're getting. This legislation has feck all to do with healthcare. It's a purely a naked power grab.
  • carlsoane
    You misread my comment about controlling costs. I said the Singapore system does the best job of controlling costs because people pay the largest share out of pocket. Also, why doesn't it make sense to you that people are more likely to provide services to the poor when those services are subsidized? That's how charities work; that's how public education works.

    I'd be interested in learning more about your experience in Europe. I hear such a mixed bag of stories; in fact I hear completely different stories from different members of my own family who live in Europe. Some say their systems are fantastic, others awful.

    I disagree with your assessment of the politicians' motives. I believe that the Democrats honestly believe that a more centrally planned healthcare system works better than one that relies on a freer market. And, as Muirgeo points out, they have a number of more centrally planned systems to point to that by many objective measures are successful. Personally, I lean towards Milton Friedman's position, which to me seems somewhat like the Singapore system minus a number of the controls.
  • Methinks1776
    I certainly don't wish to attribute to you a position you don't hold. I thought you said Singapore AND Europe as if they did a comparable job. In fact, the rate of increase in health care costs in most of the OECD countries is higher than the rate of increase in the United States. Singapore's is way lower.

    I don't think it's a small nitpick to say that neither can control costs. European countries control state spending and Europeans control how much they spend because they earn less and get to keep less of what they earn (for now, we'll surpass most European countries in taxation soon). They simply live with more chronic ailments, but they are used to it. They've never known another way. It amounts to a lower standard of living. Since, as you point out, health care providers in Singapore compete for health care dollars, prices are naturally driven down by competition.

    Subsidies are not what encourage service providers to provide a service and charities work entirely differently from government subsidy. Services will only be provided if the doctor is adequately paid with or without subsidy. Further, government subsidies come with a myriad of restrictions and obligations for the service provider and good doctors who can attract private patients avoid government subsidized patients entirely. Charities typically can't and don't compel doctors. That's pretty much the goal of government subsidy. For example, a doctor who accepts you as a medicaid patient cannot charge you for procedures medicaid does not cover. Those are the rules of medicaid. The doctor and patient are trapped. A charity will just come up with the required funds to have the procedure done. That's pretty much how Singapore's public system works too (to their credit).

    If the politicians honestly believe what you think they believe, then they are bigger morons than I had originally thought. There are no "successful" centrally controlled systems. Anything that resembles success derives from the parallel private systems that arose to meet the demand public systems could not meet. And you're also wrong that the combined system is as successful. The metrics you mentioned are worthless when comparing medical systems in developed countries. You have to compare from the point of diagnosis. Why? Because all first world countries have good basic sanitation and a high standard of living - all of which impact life expectancy. Infant mortality is a persistent canard because Americans count even a 500 gram preemie as a live birth and then an infant death (50% mortality rate among 500g preemies), while all other developed countries count that as a fetal death. Multiple fetuses increase the probability (almost ensure it) of a premature birth. We indulge ourselves with infertility treatments at a much higher rate in the United States because we can afford it and infertility treatments greatly increase the probability of multiple fetuses. So, not only are our infant mortality stats skewed by preemies that Europe and Cuba count as fetal deaths, but we give birth to more preemies. In fact, most of the "objective measures" you refer aren't aren't measures of the health care system at all (beyond some basic comparison to third world systems).

    A comparison at the point of diagnosis more accurately compares advanced treatments in first world systems. When comparing from the point of diagnosis for diseases that are truly scary, like cancer, the United States stands head an shoulders above European systems. I think that you will agree that this down to innovation and I will note that until Europe adopted its current egalitarian single payer systems and their necessary price controls, most medical innovation came from Europe.

    I was very sick for years, necessitating extensive use of the medical system in the Soviet Union and Italy. I also have a lot of doctors in my family who practiced in the Soviet, European, and American systems as well as third world countries while working for the WHO. I can tell you lots and lots of things. I know a lot of people disregard the Soviet system in the same manner as they disregard the political system. "It can't happen here". However, one must remember that the Soviet system is the ONLY government run system (let's not engage in the fiction that this bill is anything but) that covered 150MM ethnically diverse people over a large landmass. We're trying to control a system for over 300MM ethnically diverse people. NO European country has a population challenge as large as this and the problems of extending centrally controlled coverage to such a population are exponential. And, remember, even for tiny populations like Sweden's the public system has been inadequate.

    If politicians don't understand this, they truly are too stupid to make any decisions and should all be run out of this country with torches. I don't think they are that stupid. I think it's patently obvious that they don't give a damn about anything but control.

    As for your family members' differing opinions, this is unsurprising. Results vary in all systems. If they've never been that sick, they will have a favourable opinion. If they got sick and happened to live in an area without wait lists, then they'll have a favourable opinion. If they were able to buy and make use of private supplemental insurance, they'll be happy. But, I put little value on those opinions because few of them have been treated in multiple countries and been able to compare health care systems. So, they like it relative to what? Since they have no experience with another system, they can't say which is better. It's difficult to find a person who has been forced to extensively use both a European system and the American system. I can't tell you how much fun it was to wake up in the middle of surgery only to be told that there is no more rationed anesthesia and the surgery will be have to be finished without it. I've had two surgeries here and I can assure you the experience from start to finish was different. However, we can get a clue beyond my own anecdotes when we consider the fact that those who can afford to go anywhere in the world for health care when they are gravely ill, come here.
  • And we have to costantly point out to people that we are not comparing a free market in medicine to universal health care.

    In the U.S, governments are heavily involved in all aspects of medicine.

    Of course TFI will suggest that the lack of universal government involvement is a sign of libertarian policies, but the reality is that government has been affecting the medical market ever since the AMA persuaded government to control the supply of physicians.
  • Methinks1776
    I'm just glad you're willing to repeat yourself so often because your posts are always so eloquent.

    TFI? I love it. I see you are making full use of the military acronym generator.
  • carlsoane
    This is a great response. Thank you.

    You make a great point about scale. Comparing a small culturally homogeneous European country (or Singapore) to the United States is fraught with problems and should be done cautiously.

    Regarding charities: I agree that charities are different from government in that they do not have the power to coerce. But, I do not change my central point: when you subsidize services for the poor you will get more services for the poor. The more that can be done through private charity the better, but even Friedrich Hayek believed in government's involvement in creating a social safety net.

    Regarding my relatives: I neglected to mention my Japanese friends with whom I also argue about healthcare. And, the people I argue with have used the Japanese and American and European and American systems respectively. And, they're not convinced the American system is better. Interesting footnote: many of the European relatives who side with me are doctors.

    Your point of diagnosis argument is a good one. I often find myself trying to get people to parse the argument more carefully. An argument about healthcare shouldn't include how many people died on the highways or were killed in gang fights or, as you point out, it shouldn't include preemies in one country and not in another. If you have some good statistics on point of diagnosis numbers I'd love to see them. The information I've read on the subject is not very comprehensive.

    Regarding your last point: I agree that we shouldn't take lightly the fact that the wealthy come here for treatment. That's a good indicator that we are the most innovative. It is that innovation which I am afraid of losing.

    Regarding my opinion of people who argue for government run healthcare: I came to my opinion after many years of arguing with people on this subject. Some on the lunatic fringe simply want more control, but most just don't believe the slippery slope arguments about government power and think that market economics is not a good model for understanding the requirements of healthcare.
  • Methinks1776
    I actually think the Singapore system is so reliant on the market that it can work in a larger, more ethnically diverse population. That's an unqualified opinion, of course. Also, for a small country, Singapore has a pretty ethnically diverse population. Despite much better results, congress never so much as glanced at that system when concocting "reform". That's telling.

    I'm not challenging your conclusion that the majority of people with whom you have debated the issue do see it as a control issue. I'm asserting that politicians don't care about health care. Theirs is not changing, after all, and they refused all calls to subject themselves to the system they impose on those they perceive as unwashed masses. That's telling. Politicians understand how much more power and control this legislation shifts to them and that is the point of this legislation. Support for it was in the 30's. They jammed it down our throats. How is this not about power and control?

    There are few if any comprehensive studies at the point of diagnosis. However, there are plenty of comparative cancer studies. Cancer studies are the easiest to compare because they have the least reporting variation.

    I am not at all surprised that doctors in socialist system have a dim view of socialized medicine. They do know more about the system than any single patient. We would have to control for the seriousness of the conditions your Japanese friends were treated for. Socialized medicine is incredibly good at handing out anti-depressants, aspirin and band-aids.

    "...but most just don't believe the slippery slope arguments about government power and think that market economics is not a good model for understanding the requirements of healthcare."

    How remarkably ignorant. Once again I point so Singapore and it's reliance on the market resulting in lower costs, better access and better health care outcomes.

    I don't know about you, but I'm incredibly frustrated by all this. If my uncle were not a high ranking military surgeon in the Soviet Union, I would have died. Yesterday, my cousin, a surgeon in the U.S., told me not to worry because if I need anything, she'll just make a call and I'll get whatever I need. No wait, no hassle. I feel like I'm back in the USSR.
  • carlsoane
    I am frustrated. I'm worried that we are going to bankrupt ourselves while at the same time retarding innovation.

    I now think, however, that the debate has to switch from trying to prevent a mandate to reforming that mandate so that it emphasizes HSA's and transforms insurance from a means of paying for routine care to a means of insuring against catastrophe. And I think we need to figure out how to provide care to the poor without adding red tape to the rest of the system (perhaps vouchers, but if vouchers with education are any indication, vouchers are not an easy sell and they are not immune to red tape).

    Unfortunately, if I am right and the current bill proves untenable both because of increases in cost and decreases in quality, there will probably be as many people calling for single payer and increased rationing to cure the shortcomings as there will be people calling for a more market based approach. As Sam Grove points out below, most people mistakenly believe that we have a market based system today and attribute its high costs to market failure.
  • Methinks1776
    I am in complete agreement with your last point.

    I've always liked the voucher idea. That idea doesn't appeal to politicians and statists because it leaves too much control in the hands of individuals. BTW, I think most if not all the red tape in vouchers can be traced directly to the teachers unions.

    The debate could have been about things that actually improve health care if the bill were about health care. It's not.

    The bill is just a tax increase masquerading as health care legislation. Premiums and taxes will rise, but there is no practical way to restrict denial of treatment. We will pay more for much worse medical care and government will attempt to plug the deficit with the difference. I have no doubt this will lead to the scenario you describe in your last paragraph.
  • Randy
    "How do you know this will be the case?"

    For me, experience.

    I've worked in government. Its all about the authority structure. Do what you're told, follow the rules, even when doing so is obviously and blatently stupid. And then everything is okay. Not great. Not even good. Just okay. In government, okay is as good as it gets.

    And now I work for a private tech company. We are driven, always driven, by customer demands. So we are driven to make things better, because if we don't meet those customer demands then someone else will. Every single day, working to do what we do better.

    And that is how I know.
  • JohnK
    I work closely with the government and I marvel at the waste. Everything is about power. If there are ten tasks that ten people want done, they'll spend more time arguing over how to prioritize the tasks than it would take to get everything done. It's pathetic.
    And to imagine these people arguing over health care decisions?
    People will die waiting for the decision makers to come to a consensus.
  • mark
    " can point to no less then 30 countries who HAVE had their government design universal access to health care and they spend far far less then us, their outcomes are just as good and their citizen are generally very happy with it."

    Like Cuba, right muirscab?
  • muirgeo
    Yep, I believe everyone in Cuba gets free health... oh but wait they are a communist country. Oh so I see your point. Since Cuba provides free health care and since Cuba is a communist country those other 29 countries that provide universal health care MUST BE COMMUNIST TOO... OH....MY......GODDDDD!!!! I never thought of this your way Mark. I was going to go to New Zealand for vacation but now that I realize its a communist country I'm canceling those plans. Frickin Kiwi Commies!!! Your brilliance has shown me the light. I'm calling my Senators NOW to NOT sign the bill so we don't turn communist tomorrow.



    Actually I am calling them because I DON'T want them to sign it... it stinks of lobbyist slime.
  • MWG
    According to the Cuban govt., right?
  • Methinks1776
    Moron, unless you among the party elite, you can't get so much as an aspirin in Cuba. That's the "free" health care "provided" in Cuba.
  • Mark
    Well, you and stinky slime go together pretty well.
  • mark
    "THE REAL WORLD CONTRADICTS YOUR CLAIM ABOVE (not shouting ... just emphasis that I am stating a fact)."

    Actually, it's your dream world, and your jack-booted president is dragging us all into it.

    thanks a lot, muirpoo!
  • muirgeo
    Yeah right Mark because those 30 other countries that provide health care for all their citizens have on Jackboots and our oppressing their citizens. But the funny thing is their citizens take 6 weeks of vacation a year often in our National parks. You would think they'd defect when they arrive here but funny enough they all go home to get Jack-booted health care again and to live in their oppressive societies.
  • Mark
    Lets see the list, dreamer! Thirty countries. Nice. Thirty countries who do a better job than the sucky one you do, huh muirgroin?
  • muirgeo
  • miltonsnephew
    Wonderful.
  • mark
    "It's as if a committee of engineers trying to design, say, a bridge to connect New York and London draft a blueprint that is so huge and complex that none of the engineers can possibly comprehend its details. No engineer knows, or can know, exactly what it is he or she is helping to engineer."

    This is exactly the kind of pride that Daniel-wonk and muir-anus display. Daniel thinks he can design the bridge (i.e., policy) and muir trusts the Donkeys to do it.
  • JohnK
    I really can't figure out how people can be so brazen in their lies, even when the lies are pointed out over and over. It is as if the liars only need one person to believe them, and that gives them the confidence to stick to their untruths as if they were true.
    They will never back down, even when their face is rubbed in it over and over and over.

    I don't get it.
  • Randy
    They've studied politics. Or they take their messages from people who have studied politics. Think about that. Political Science is the art of exploiting human beings... and they've studied it. So the question is not, how can they be so brazen in their lies, but rather, why would we expect anything but lies. Okay, I'll be charitable... make that anything but manipulation.
  • mark
    Oh I wish this Tool song were directed against the state:

    Ticks and Leeches

    Suck and suuuuuuuck.
    Suckin up all you can suckin up all you can suck and suck.
    Workin up under my patience like a little tick.
    Fat little parasite.

    Suuuuuck me dry.
    My blood is bruised and borrowed. You thieving bastards.
    You have turned my blood cold and bitter,
    Beat my compassion black and blue!

    Hope this is what you wanted.
    Hope this is what you had in mind.
    'cause this is what you're getting.

    I hope you're choking. I hope you choke on this.
    I hope you're choking. I hope you choke on thiiiiiiiiiiiis.

    Taken all I can taken all I can, we can take. Taken all you can taken all you can, we can take.
    Got nothing left to give to you.
    Blood suckin parasitic little blood suckin parasitic little blood suckin parasitic little tick!
    Take what you want and then go.
    Hope this is what you wanted.
    Hope this is what you had in mind.
    'cause this is what you're getting.
  • Methinks1776
    Ah, but their faces aren't really rubbed in it. It's usually someone else's face that's meant to be rubbed into the dirt. Therefore, if they can't support their ideas on logic, they turn to social justice and other tools of social engineering for justification. Only when they realize it is actually their faces that are being rubbed in the muck do they suddenly come to some belated realization. Of course, the smart ones go into politics early on where they become capos in the great mafia political machine. I think we call them "bureaucrats".
  • mark
    Liars keep lying because they have apologists like the hairsplitting count danku. Oh, and fanatics like muirgoo.
  • Methinks1776
    LOL!
  • Great column. Good analogy. Seems I remember another marvel of engineering that made Trans Atlantic travel possible and failed miserably, in fact, it was a Titanic failure.

    I think we are witnessing a colossal failure of education, Scheiffer is a prime example. When he himself can recognize and then excuse inexcusable behavior, I think something went terribly wrong with our teaching of critical thinking.

    When I say something so ignorant, I at least try to figure out why I said it.
  • This column had similarities to an earlier post. I see you left out the part about engineering "summer hurricanes away from the Gulf Coast". Good idea!
  • muirgeo
    R=There are things we can d to minimize the impact of hurricanes on the gulf coast. Katrina pointed out the problems of NOT doing them.
  • mark
    Oh, right muiranus. We should build a steel reinforced wall to keep those pesky hurricanes out.

    Way to beat a dead horse, muiranus!
  • Methinks1776
    Don't you love it, Mark? They guy barely has enough grey matter between his ears to figure out how to wipe his own azz, but he's now going to stop hurricanes.

    Tomorrow, I'm going to make the earth spin the other way as a Christmas present to the Goracle. Tralala.
  • The reason I made the comment above is that Bill Gates (of Microsoft fame) has filed a patent regarding a way to stop (weaken) gulf hurricanes and I wouldn't be surprised if the government tries it one day.
  • muirgeo
    No there really are things we could have done and not done. Experts and the facts are on my side and you're all too ignorant to know that and I will thus leave you in your ignorance because it's obvious that is where you find comfort.
  • Methinks1776
    Reality not withstanding, experts, facts and logic are always on your side in that lush fantasy land concocted by the three grey cells in your otherwise empty skull.
  • sandre
    Like? illuminate us, muir. We are looking forward to your pearls of wisdom

    Love you. mmmwwwwaaaahhhh
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