Hypothetical grocery store illustrates health care “marketplace”

In his new book, The Righteous Mind: Why good People are Divided by Politics and Religion, Jonathan Haidt compares the American marketplace for health care to a hypothetical grocery store run the same way:

The next time you go to the supermarket, look closely at a can of peas. Think about all the work that went into it—the farmers, truckers, and supermarket employees, the miners and metalworkers who made the can—and think how miraculous it is that you can buy this can for under a dollar. At every step of the way, competition among suppliers rewarded those whose innovations shaved a penny off the cost of getting that can to you. If God is commonly thought to have created the world and then arranged it for our benefit, then the free market (and its invisible hand) is a pretty good candidate for being a god. You can begin to understand why libertarians sometimes have a quasi-religious faith in free markets. Now let’s do the devil’s work and spread chaos throughout the marketplace. Suppose that one day all prices are removed from all products in the supermarket. All labels too, beyond a simple description of the contents, so you can’t compare products from different companies. You just take whatever you want, as much as you want, and you bring it up to the register. The checkout clerk scans in your food insurance card and helps you fill out your itemized claim. You pay a flat fee of $10 and go home with your groceries. A month later you get a bill informing you that your food insurance company will pay the supermarket for most of the remaining cost, but you’ll have to send in a check for an additional $15. It might sound like a bargain to get a cartload of food for $25, but you’re really paying your grocery bill every month when you fork over $2,000 for your food insurance premium. Under such a system, there is little incentive for anyone to find innovative ways to reduce the cost of food or increase its quality. The supermarkets get paid by the insurers, and the insurers get their premiums from you. The cost of food insurance begins to rise as supermarkets stock only the foods that net them the highest insurance payments, not the foods that deliver value to you. As the cost of food insurance rises, many people can no longer afford it. Liberals (motivated by Care) push for a new government program to buy food insurance for the poor and the elderly. But once the government becomes the major purchaser of food, then success in the supermarket and food insurance industries depends primarily on maximizing yield from government payouts. Before you know it, that can of peas costs the government $30, and all of us are paying 25 percent of our paychecks in taxes just to cover the cost of buying groceries for each other at hugely inflated costs. That, says [David] Goldhill, is what we’ve done to ourselves. As long as consumers are spared from taking price into account—that is, as long as someone else is always paying for your choices—things will get worse. We can’t fix the problem by convening panels of experts to set the maximum allowable price for a can of peas. Only a working market can bring supply, demand, and ingenuity together to provide health care at the lowest possible price.
Haidt then compares the "market" for most health care products for the market for uninsured health care products, such as LASIK surgery, which highly competitive. More food for thought: Think of any other type of insurance that we buy to cover ordinary and expected costs (I admit that most health care policies also cover unexpected high cost occurrences). Health care insurance is thus a rather strange creature compared to most other kinds of insurance. Imagine homeowners insurance that covered the cost of cutting the grass, or the cost of a carpet wearing out. I suspect that health insurance is treated differently because many of us sacralize health. We treat it as sacred, meaning that we refuse to negotiate it as though it were a commodity, even in some instances where we might be better off subjecting some health services to the open market (such as we already do with many over the counter medications and devices).

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Bonus clawbacks and fair play

Businessweek is reporting that JP Morgan is considering moving to "clawback" bonuses which had been awarded to executives and others responsible for Morgan's recent $2 BILLION dollar loss.:

The lender can cancel stock awards or demand they be repaid if an employee “engages in conduct that causes material financial or reputational harm,” JPMorgan said in its annual proxy statement. The company will claw back pay if it’s appropriate, said one of the executives, who asked not to be identified because no decisions have been made.
But wait! These big Wall Street firms told us that bonuses were untouchable after they blew up the economy in 2008. Am I the only one that remembers that? There was all sorts of bullshit about how these employees were simply too valuable, that if they didn't get their massive bonuses they would leave to seek other employment, that contracts and bonus structures were sacrosanct and untouchable (untouchability does not extend to unions and teachers, by the way). Oh, but I guess that was when taxpayers were paying the bonuses. Now that JP Morgan took a big hit in their own shorts, they want their money back. Funny how things change.

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Amory Lovins offers his recipe for Reinventing Fire

Our energy system is inefficient, disconnected, aging, dirty and insecure. In this TED talk, Lovins argues that we can become frugal with our energy, eliminating our addiction to oil and coal by 2050, in addition to using 1/3 less natural gas. This talk is based on ideas presented by his book, Reinventing Fire, and his website. This could cost $5 trillion less than business as usual, assuming external costs of business as usual is zero (which he wryly terms a "conservative" estimate). His approach requires no new inventions, no act of Congress and no subsidies, and it will increase the U.S. economy to 158% of the present. Our addiction to oil costs us $2B per day in direct costs and $4B in indirect costs, such as the U.S. military. This amounts to 1/6 of GDP. Lovins opened his talk by noting that 80% of the energy we use every year comes from burning four cubic miles of primordial swamp goo. How can we reduce the use of oil? Make cars "oil free." Cars use 3/5 of this amount. 2/3 of the energy caused to move a car is attributed to its weight, but over the past 25 years, our cars have become "obese." We have the ability to make lighter and "more slippery" autos, which makes electricity an excellent way to move cars. Lovins asserts that we have the technologies to make the cars much lighter. America could lead this revolution, though Germany is currently in the lead. If this technology were prevalent, it would be the equivalent of finding 1 1/2 Saudi Arabias worth of oil. He proposes that we save electricity and make it differently. Most electricity now is wasted. Buildings now use 3/4 of our electricity. That offers a tremendous opportunity for savings through "integrative design." (min 14). One way of doing this is via "2010 retrofit." Industry still has $1/2 trillion of saving to reap. Pumps can be made much more efficient by using larger straighter pipes instead of narrower winding pipes. (Min 16). Needing less electricity means we can make it more easily. China is leading the way currently. Solar panels are an excellent way to make the shift. Wind and solar constitute half of the new capacity of electricity. (19). How can we replace coal-fired electricity? Natural gas is one option. A grid using wind and solar can be a substantial part of the grid, much like it is in Europe. (21) The U.S. grid is old, over-centralized and vulnerable, and it will need to be replaced by 2050. In 34 states, utilities are rewarded for selling us more electricity. Where they are rewarded for cutting our bills, investments are shifting to renewables. (22). Lovins' approach to "reinventing fire" asserts that our energy future is a matter of choice, not fate. He recognizes that these facts and numbers seem incredible, but they are true. A bonus would be an 86% reduction in greenhouse gases, in addition to a much more secure energy supply. He describes his approach as a "once-in-a-civilization business opportunity."

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More politics of peak oil

One can be forgiven for not understanding the state of our world today in terms of oil and its availability. A new article in Forbes assures us that peak oil is off, that the world is awash in oil. Meanwhile, an article from the current issue of The Economist claims the opposite: that oil supply is insufficient to keep up with demand. Meanwhile, the president is blaming high prices on those nasty speculators. So which of these competing claims is a person to believe? For the uninitiated, peak oil is the point in time when maximum extraction of the world's oil endowment is reached. Since oil is a finite resource, we can exploit it in increasing amounts until we can't any longer, and flows begin to decline.

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The Fate of the Volker Rule

Bill Moyers opened a recent show featuring Paul Volker with the following:

Well here we go again. The old game of congressional creep. After months of haggling and debate, Congress finally passes reform legislation to fix a serious rupture in the body politic. The president signs it into law, but then we discover the fight’s just begun, because the special interests immediately set out to win back what they lost when the reform became law. They spread money like manure on the campaign trails of key members of Congress. They unleash hordes of lobbyists on Capitol Hill, cozy up to columnists and editorial writers, spend millions on lawyers who try to rewrite or water down the regulations required for enforcement. And before you know it, what once was an attempt at genuine reform creeps back towards business as usual.
Following this introduction, Moyers interviewed Mr. Volker, who discussed the Rule named after him:

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