That's how Garrison Keillor feels about those of us who think the present healthcare reform schemes are not the best course of action:

[O]ne starts to wonder if the country wouldn’t be better off without them and if Republicans should be cut out of the health-care system entirely and simply provided with aspirin and hand sanitizer. Thirty-two percent of the population identifies with the Republicans, and if we cut off health care to them, we could probably pay off the deficit in short order.

Garrison Keillor: healthcare nazi.

"When I use a word," Humpty Dumpty said..., "it means just what I choose it to mean -- neither more nor less."

"The question is," said Alice, "whether you can make words mean so many different things."

"The question is," said Humpty Dumpty, "which is to be master -- that's all." -- Lewis Carroll, Through the Looking Glass (Ch. 6)

I didn't know this (neither would I ever have guessed), but, apparently, use of a dictionary is evidence of impropriety. Well, that's what His Beatitude thinks, anyway – at least when one is using a dictionary in opposition to Him. During his Sunday morning talk show tour, Our Leader appeared with George Stephanopoulos, who asked,

STEPHANOPOULOS: Under this mandate, the government is forcing people to spend money [by requiring them to purchase health insurance] and fining you if you don't. How is that not a tax increase?

OBAMA: No, that's not true, George. The -- For us to say that you've gotta take a responsibility to get health insurance is absolutely not a tax increase. What it's saying is that we're not going to have other people carrying your burdens for you any more than the fact that right now everybody in America just about has to get auto insurance. Nobody considers that a tax increase. People say to themselves that is a fair way to make sure that if you hit my car, that I'm not covering all the costs.

Actually, that isn't how auto insurance works at all. But its very instructive, and not surprising, that he thinks it works that way, though -- very, very instructive. (In case you don't know: Auto insurance is not required so you can pay your bills if the other guy hits you. The requirement is that you be able to cover your liabilities if you hit the other guy. I don't know whether consulting a dictionary would have helped the president on this.)

But I digress.

[...]

OBAMA: ...George, you can't just make up that language and decide that that's called a tax increase.

STEPHANOPOULOS: I don't think I'm making it up. Merriam-Webster's dictionary, tax: a charge, usually of money imposed by authority on persons or property for public purposes.

OBAMA: George, the fact that you looked up Merriam's dictionary, the definition of tax increase, indicates to me that you're stretching a little bit right now, otherwise you wouldn't have gone to the dictionary to check on the definition.

There you have it. Using a dictionary to check on the definition of a key term (something most of us were taught to do in school) indicates that one is stretching. Trying to resolve a difficulty which relies upon the correct meaning of a term must, in His Beatitude's incredible opinion, be done without consulting a dictionary. That's incredible. What's even more incredible is that His Beatitude went to law school, which means he was required to know definitions of key terms, the definitions of these key terms being found in many cases in legal dictionaries.

Since His Humptiness specifically singled out Stephanopoulos's use of Webster's as improper, here is a discussion from a source other than Webster's:

John Bouvier defined a tax as:

A pecuniary burden imposed for the support of the government. The enforced proportional contribution of persons and property levied by the authority of the state for the support of the government and for all public needs.

In Lower Mainland, the Privy Council, Justice Thankerton for the Court, wrote that taxes:

... are compulsorily imposed by a statutory (authority)....They are enforceable by law...(and) compulsion is an essential feature of taxation.

In Australia, Justice Dwyer wrote, in Leake:

A compulsory contribution, or an impost, may be nonetheless a tax, though not so called.

The distinguishing feature of a tax ... is that it is a compulsory contribution imposed by a sovereign authority on, and required from, the general body of subjects or citizens, as distinguished from isolated levies on individuals.

In Canada, an oft-cited definition is that of Justice Duff of the Supreme Court in Lawson:

[Taxes]are enforceable by law .... Then they are imposed under the authority of the legislature. They are imposed by a public body.... The levy is also made for a public purpose.

In Ontario Private Campground, Justice Howden wrote:

A tax is defined as an impost or levy by the legislature or other public body for a public purpose, enforced by law.

At common law, the terms fee and charge do not exclude a tax and have been used interchangeably; therefore it was held in British Columbia that a fee imposed by provincial statute on operators of mobile home parks ... was considered to be a tax on land. Similar fees or taxes on mobile home parks have been upheld as land taxes.

But in Westbank, at ¶4, Justice Gonthier of the Canadian Supreme Court distinguished a tax from a user fee:

[User fees] bear all of the traditional hallmarks of a tax. They are enforceable by law, imposed pursuant to the authority of Parliament, levied by a public body, and are imposed for a public purpose. There is no nexus between the revenues raised and the cost of any services provided. As such, they do not resemble a user fee, nor any other form of a regulatory charge.

Granted, that discussion is in terms of Canadian law, but we belong to the same legal tradition. Here's how my Black's, 5th Abridged Edition, in relevant part, defines tax:

A pecuniary burden laid upon individuals, business entities, or property to support and carry on the legitimate functions of the government. Essential characteristics of a tax are that it is not a voluntary payment or donation, but an enforced contribution, exacted pursuant to legislative authority.

His opponents assert that this insurance requirement, including perhaps especially the fines, constitutes a tax because it accords with the definition -- even the legal definition -- of a tax. His Humptiness, a trained lawyer, rather than offering even an attempt at distinguishing meanings, summarily declares it improper to employ a dictionary in fixing the meaning of a key term. It's not a tax because when His Humptiness uses a word it means only what His Humptiness wants it to mean, and nothing else.

It's not a tax, you see, because His Humptiness says it is not a tax. So, if it's a question of which is master, then His Humptiness is master – that’s all.

Did the President of the United States knowingly utter a falsehood when he said that his healthcare plans would not cover those in the country illegally? Joe Wilson thought so, and said so. (If it was not so, then...uh...why did the loophole have to be removed? And why is Luis Gutierrez, of the Congressional Hispanic Caucus, only now angry with the president? He wasn't angry before the president's disavowal. Why is he now?)

It could be that His Beatitude was simply mistaken. That is always a possibility. It's also a possibility that Bush was mistaken about the presence of WMD in Iraq. But when no such weapons were found, we did not hear a hue and cry over the fact that Bush was mistaken (which would have been bad enough); we heard he lied. No wonder, then, that if the current president makes a statement of fact which is false, someone might just get the idea that he knowingly did so.

Former president, James Carter, must think such fine distinctions are a waste of his dwindling time. He knows something more important. He knows that the truth of the matter is not that Joe Wilson, and others, thought the president made a statement of fact which was untrue -- and did so knowingly -- but that inherent opposition to a black president is the real issue.

Poppycock! It could very well be true that every single opponent to the president's silly insurance scheme is a card-carrying member of the KKK. It could also -- at the same time, I mean -- be true that the President of the United States, in an address to Congress, knowingly made a statement of fact which was not true. Someone's race issues -- or putative race issues -- have no bearing on whether someone has lied, or whether adding yet another insurer to the insurer pool counts as healthcare system reform.

If saying, "You lie!" to a man one thinks is lying to you makes one a racist, then how are we ever to call liars on the carpet?

In other news, the New York Times informs us that it isn't all bad, that very little hiring is being done. Only during a Democratic regime.

As I've mentioned before, I vividly recall the day I took my first step toward embracing capitalism (well, capitalism lite, anyway, not laissez-faire):

I was in Germany on a military exercise. During the course of this exercise, my tank platoon were just outside a small German village. As frequently happened, some of the local boys (in the 12-14 year range) came out to check out my tank. While we were all standing on our tank talking, I pulled a soda out and started drinking. One of the boys offered me some money for one of my sodas (actually, the crew’s sodas; this is an important fact). Wanting to live up to the reputation of Americans as generous people, I let the kid have the soda for free. Suddenly, the demand for soda went from one-fifth of the German population present on that tank to one hundred percent of that population. What was I to do? Give one away for free and then start charging money? So I gave away five of our remaining sodas, leaving us with three.

[...]

Note the effect of price on both the supply of, and demand for, the sodas. When there was actually a price for the soda the...demand for soda amounted to...one.... This changed—drastically—when there was no price for the soda. This then led to a sharp drop in the supply of soda. If I were to have charged that single German child more than he was willing to pay, there would have been a change in the demand for soda, but no change in the supply. If I had simply accepted his price, the supply of soda would have gone down only by one soda; plus, we’d have a contribution to the next soda purchase. (It staggers the imagination: that German child knew more about free enterprise than I did.)

What if the kids who couldn't afford a can of Coke at my price had another option. What if they had soft drink insurance, allowing them to purchase a soft drink at 25% of the price I was charging (say, a dollar), with their soft drink insurance paying the rest? Sounds good, doesn't it? In actuality it's one of the worst possible things which can happen. Since these consumers can now -- sort of -- afford a good they could not afford before, and (at 25% of the price) a lot of it, their demand for the product will necessarily increase.

This is a law of nature, an economic law. To them, the price of a soda is no longer $1.00; it is $.25. Recall, before they could not afford a soda because it cost $1.00; now they can because it costs only $.25. They may not ever have had a spare dollar for a soda, but they did occasionally have a spare quarter. That spare quarter can now be used for a good like soda. But there were always others, who could occasionally afford, say, one soda per week at $1.00. Now, thanks to their soda insurance, they can afford four per week.

Still others, who could afford eight sodas per week, now can afford thirty-two. This artificially lower price has increased demand, which will soon begin to have a negative effect on supply. The (artificially) lower price to the consumer (but not to the insurer!) will lead to a spike in demand. The normal response to increased demand is to ensure against stock depletion by increasing the price of the good. But in our scheme the increased price is born not by the consumer of the good but by the insurer. If the soda-lover's co-pay does not increase, remains at 25% percent of the original price (i.e., $1.00) but the actual price goes up to, say, $2.00, in an effort to decrease demand (protecting supply), then the insurer is no longer paying 75% of the cost of soda; he's paying 87.5% (i.e., $1.75), while the consumer is now paying only 12.5%.

The price increase, intended to protect supply by decreasing demand, actually has no such effect, because the price paid by the consumer (the one actually wanting the soda) has not changed, while the price paid by the insurer has done. The soda producer, still trying to curb demand in order to ensure supply, raises the price yet again, to $2.50, a point at which the insurer pays $2.25, 90% of the price of a soda and the consumer still pays $.25, a mere 10%. Clearly, this can't go on, so the insurance company now raises the co-pay. And on and on it will go until the consumers, who clearly know next to nothing about how insurance works, begin to think they are the ones being abused.

I know what you're thinking. There is an important difference between soda and healthcare; one is an important need and the other is an unimportant want. Perhaps, but it is immaterial to economics whether a good (and healthcare and soda are both goods) is a "need" or a "want". To tell someone that some good he wants is not a need and then to legislate on the basis of that assertion is dictatorial. A good is a good and someone who wants it ought to decide for himself the reasons he wants it; it isn't for anyone to divide objects of his desire into needs and wants -- even if we are tempted to do so. Healthcare and soda are both goods; it is, therefore, legitimate to compare them in terms of each other simply as goods.

After all if we are really going to limit ourselves to needs, we could argue that no one really needs healthcare; they simply want it. They want it because they want to live, either for just another day (but they may not need, or deserve, to live another day) or at a certain standard of living (but they may not need, or deserve, that standard of living).

The woman, Florence Owens Thompson, and her children, below, probably have everything they need: clothing, just enough food, just enough water, and a roof (such as it is) over their heads:


You may be thinking that, no, they don't have everything they need. But that is only because you are thinking not in terms of life, but in terms of quality of life. You are thinking that they do not have everything they need to have a certain quality of life, a quality of life like mine, for example:


Dry wall in my garage -- I bet Florence Owens Thompson and her family would have loved to call my dry-walled garage home. Heck, I bet she'd have loved my garage even before the dry wall, possibly even before I insulated it.

So healthcare, like soda, is not something we need for life. It is something we want for a certain quality of life.

But the point really is that insurance is a silly way to pay for soda, especially since, like healthcare, it is uninsurable. And if it is a silly way to pay for soda, it is an even sillier way to pay our medical bills. This is especially the case since, like my present comparison, we still have not asked the most important question: Why did the cost get so high as to give someone the idea that insurance would be the best way to pay those bills? It is true that insurance itself is to blame for some of the rising costs by artificially increasing demand, which always results in price increase. But this is not the only thing that causes price increases.

It is no reform of the healthcare system simply to continue the practice of using "insurance" to pay the bills. One more insurance company -- even a public one -- isn't a solution. It's a variation on a theme.

Frankly, if anyone were really serious -- and I do mean really serious, not about "reforming" the "system", but in reducing costs, they should follow Hans Hoppe's advice, advice going all the way back to 1993, and summarized as follows:

1. Eliminate all licensing requirements for medical schools, hospitals, pharmacies, and medical doctors and other health care personnel. Their supply would almost instantly increase, prices would fall, and a greater variety of health care services would appear on the market.

[...]

2. Eliminate all government restrictions on the production and sale of pharmaceutical products and medical devices. This means no more Food and Drug Administration, which presently hinders innovation and increases costs.

[...]

3. Deregulate the health insurance industry. Private enterprise can offer insurance against events over whose outcome the insured possesses no control. One cannot insure oneself against suicide or bankruptcy, for example, because it is in one's own hands to bring these events about.

[...]

4. Eliminate all subsidies to the sick or unhealthy. Subsidies create more of whatever is being subsidized. Subsidies for the ill and diseased breed illness and disease, and promote carelessness, indigence, and dependency. If we eliminate them, we would strengthen the will to live healthy lives and to work for a living. In the first instance, that means abolishing Medicare and Medicaid....

There's a simple answer to the question why they don't follow this advice: Doing so means not being able to take credit (and assign blame) for our quality of life; it means surrendering control of something they enjoy controlling. I mean, the next thing they want is our food system.

Parenthetically, Glenn Beck doesn't think we should really be talking about healthcare reform when the real issue is corruption, at all levels and in both major parties, such as that captured by James O'Keefe. Frankly, I think we can multitask. Well, I know I can.

P.S.

The reason I posted nothing about 9/11, is that my state of mind is much like that once expressed by Abraham Lincoln regarding some other casualties of war, which I paraphrase thusly:

I can not dedicate, nor consecrate, nor hallow this day. I cannot adequately commemorate this day. The victims of the attacks have done so, and far above my own powers of expression, and none more so than those aboard United Flight 93, who gave the last full measure of devotion to their country. No one can care what I think or feel; no one can care where I was when I first heard the news -- but everyone should care and long remember what happened to them.

One of the few things our first constitutional dictator ever said with which I whole-heartedly agree. Mark it.

Of course, my favorite Lincoln quote of all time might just be this one, from a 4 July 1848 speech: "Any people whatsoever have the right to abolish the existing government, and form a new one that suits them better. This is a most valuable, a most sacred right."

Edited 15 September 2009 to correct local grammatical errors. -- JFS