When Don Rickles got on a roll, he was very, very funny.
Following on this post from earlier in the week on the adverse impact that the third party payer system of health care finance has had on controlling health care costs, check out this Catherine Rampell post that passes along the graph on the left and the following startling observation:
ìFor every doctor, there are five people performing health care administrative support.î
And we are about to implement changes in the health care finance system that increases the third party payer element that requires much of this administrative support? While dramatically increasing the number of people covered under such a third party payment scheme with no provision for increased supply of medical services to meet that additonal demand?
What possibly could go wrong?
What is the most efficient way to pay for health care?
Proponents of a single-payer governmental system content that patients should not have to pay the cost of their health care decisions and that the government can effectively control costs through top-down mandates.
On the other hand, opponents of such a system maintain that the most effective way to curb costs is to have patients bear a portion of their health care costs — such as routine expenses — and that the government canít efficiently control costs without rationing care.
In a recent JAMA op-ed, Dr. John Ford provided this graph (H/T Jeff Miron) to reflect the increase in third-party payment of health care expenses over the past half-century and the decrease in patient payment of expenses over the same span. Health care costs have skyrocketed over the same period.
Why should anyone believe that reform that continues the trend toward more third party payment of health care expenditures is going to result in meaningful reduction of health care costs?
It takes awhile, but Adam Scott gets an eagle:
Good thing that Phil Mickelson won and didnít have to endure losing by a stroke. He might have never recovered from this:
I just finished Ken Gormleyís The Death of American Virtue: Clinton v. Starr (Crown 2010) and recommend it highly to anyone who is interested in a thorough examination of the dynamics and circumstances that lead to the abuse of the governmentís enormous prosecutorial power.
What started out as an investigation into Bill and Hillary Clintonís small investment in a failed real estate deal (Whitewater) turned into a tsunami of litigation that practically paralyzed the executive and legislative branches of the federal government for months. Essentially, when the attorneys involved in the investigation couldnít pin anything of substance on the Clintons in regard to Whitewater, they jumped at the opportunity to set President Clinton up to lie in a civil deposition and before a grand jury in regard to his relationship with former White House intern, Monica Lewinsky.
Although few of the attorneys involved in either side of this battle come out looking good, this scrupulously even-handed book places most of the blame at the hands of Ken Starr and his Office of Independent Council prosecutorial team. The fact that Starr and his team thought they could get away with intimidating Lewinsky in a hotel room for over 12 hours without allowing her to contact her counsel speaks volumes of how out of touch they were with the pursuit of justice, not to mention legal ethics. That type of reasoning is why, on balance, Starr and his prosecutorial team come out looking worse than President Clinton and his defenders despite the fact that Clinton lied about his relationship with Lewinsky under oath on two occasions.
One of the most interesting of the dozens of fascinating anecdotes in the book involves Starrís dubious decision to de-emphasize the Whitewater investigation in favor of the Clinton-Lewinsky investigation. Hickman Ewing, who was Starrís deputy running the Whitewater investigation in Little Rock at the time the Lewinsky investigation exploded in Washington, had concluded that Hillary Clinton had committed crimes in regard to her involvement in Whitewater. Iím not as sure as Ewing that she did commit any crime ñ most of what Hillary did appeared to me to be the actions of a lawyer who was simply over her head in dealing with a faltering real estate development and a failing S&L.
At any rate, "[i]n Ewing’s eyes, Mrs. Clinton had lied to the [Office of Independent Council], had lied to the grand jury, and would keep lying until the cows came home if she was not brought to justice," writes Gormley. Ewing went so far as to draft an indictment of Hillary for conspiracy to conceal her true relationship with the Madison Guaranty S&L in order to ìavoid and evade political, criminal and civil liability, fraudulently secure additional income for the Rose Law Firm and safeguard the political campaigns of William Jefferson Clinton.î But because the focus of the investigation had turned toward President Clintonís relationship with Lewinsky, Starr and the other prosecutors outvoted Ewing and elected not to dilute their investigation with a prosecution of Hillary.
Thus, with more than a touch of irony, Ewing observed, "Monica saved Hillary."
It all seems so clear, doesnít it?
As this Laurie Goodstein/Michael Luo/NY Times article presents, Pope Benedict XVI and a chronically corrupt Roman Catholic Church have been complicit in the protection of child-abusing priests.
But as this William McGurn/WSJ op-ed notes, the Timesí reporters undisclosed feeding of information from plaintiffís lawyers who have made a cottage industry out of suing the Catholic Church raises as many questions as the ones the Times raises about the churchís handling of the sex-abuse cases. As McGurn notes:
The man who is now pope reopened cases that had been closed; did more than anyone to process cases and hold abusers accountable; and became the first pope to meet with victims. Isn’t the more reasonable interpretation of all these events that Cardinal Ratzinger’s experience with cases like Murphy’s helped lead him to promote reforms that gave the church more effective tools for handling priestly abuse?
Yeah, but reporting that would not sell as many newspapers. And also not comply with the objectives of undisclosed agendas.
Morality plays are comforting because they make it easy to identify and demonize the villains. The truth is usually more nuanced and complicated, but ultimately more fulfilling to understand and less likely to generate witch hunts.
Update: Father Raymond J. De Souza provides more insight into the Kiesle case.
How much wasteful spending on security theater is enough?
Bruce Schneier links to U.S. Representative John Duncanís Congressional observation about the Federal Air Marshals Service:
Actually, there have been many more arrests of Federal air marshals than that story reported, quite a few for felony offenses. In fact, more air marshals have been arrested than the number of people arrested by air marshals.
We now have approximately 4,000 in the Federal Air Marshals Service, yet they have made an average of just 4.2 arrests a year since 2001. This comes out to an average of about one arrest a year per 1,000 employees.
Now, let me make that clear. Their thousands of employees are not making one arrest per year each. They are averaging slightly over four arrests each year by the entire agency.
In other words, we are spending approximately $200 million per arrest.
Let me repeat that: we are spending approximately $200 million per arrest.
One could quibble that spending per arrest is not an entirely fair measure of effectiveness. A good deterrent effect means fewer arrests, right?
Nevertheless, itís a pretty good indication of misdirected resources if a law enforcement agencyís officers are more likely to be arrested than to make arrests.
Do New York Times reporters even bother to research the subject of their articles at all?
Take this A.G Sulzberger/NY Times puff piece on the departure of current U.S. Attorney for the Southern District of New York, Benton J. Campbell.
You may remember Campbell. He was the lead prosecutor on the Enron-related criminal trial known in these parts as the first Enron Broadband trial, which ended in an embarrassing loss for Enron Task Force after the prosecution was caught threatening defense witnesses (see also here) and propounding false testimony from one of its key witnesses. Sort of what you would expect from a trial in which the Task Force advocated an unwarranted expansion of a criminal law intended to punish kickbacks and bribes against business executives who didnít take any.
Then, as if that wasnít enough, Campbell proceeded to lead the prosecution (unsuccessfully, thank goodness) that attempted to make refusing to throw in the towel a crime. Given that he decided to become a prosecutor while watching Rudolph W. Guiliani, who could be surprised by such appalling lack of judgment?
Sort of makes one wonder just how much unwarranted destruction of lives one has to be involved in before the Times notices?
