Joe Flower has a good post explaining why free market competition fails in health care. Go read the whole thing, but the short version:

Medical demand is wildly random but tends to be absolute. There is little way to predict who, specifically, will need most kinds of medical care. But, when you do need it, you have to have it or you’ll die.

Medicine is usually beyond the layman’s understanding. Consequently, the buyer has to rely on the doctor’s (who is also the seller) representation of what the buyer needs. “So the seller is agent for the buyer, the seller is rewarded for doing more and punished for doing less, and neither the buyer nor the seller can easily tell the difference between what is really necessary and what is optional.”

Rick Yencer of the Muncie Star Press has an article about the Muncie City Council’s efforts to impose a $6 traffic ticket surcharge to help pay for police salaries.

For the record, I think it’s a bad idea to inject a profit motive into the machinery of the criminal justice system. People already think traffic tickets are a scam – rumors abound about how officers have ticket quotas and will issue more tickets at the end of the month and so forth. This diminishes our respect for the rule of law. Adding a surcharge may not be as serious as having a private prison industry that profits from greater levels of incarceration, but it’s still not good.

Disclaimer: I don’t have any expertise in the subject matter. Further disclaimer: I’ve never let that stop me before.

Eric Bradner has an article about state secretary of public instruction, Tony Bennett’s, proposal to reduce instructional education for teacher licensure in favor of substantive education requirements. In other words, as I understand it, place less emphasis in making sure teachers know how to teach and more emphasis on teachers knowing the subject matter they teach. Unsurprisingly, teachers — and particularly teachers of teachers — object.

I’m torn here. I have little patience for Bennett. What I’ve seen so far is a guy intent on busting teacher’s unions and willing to rub shoulders with folks who insist Genesis (and, in particular, not evolution) is the only viable explanation for the creation of humans.

On the other hand, my exposure to education theory suggests a discipline built on jargon and unprovable theories. For me, the “tell” was that in legislative hearings, educators would spend about half their available testimony time going on about their credentials. This was a sharp distinction to, say, engineers who were more likely to tell you who they were in a sentence or two and get straight to the point of what they wanted to do and why they thought it would work. My beef here isn’t with teachers on the front line; rather it’s with the education professors. (I had the same sorts of issues with political scientists when I was in college.)

I think it’s important that teachers know how to communicate with kids; particularly at the younger ages. The world is full of smart people, excellent in their field, who couldn’t begin to explain what they do to beginners. We don’t need these people teaching.

The Associated Press has a story about a study with an eye-popping statistic:

Nearly half of all U.S. children and 90 percent of black youngsters will be on food stamps at some point during childhood.
. . .
For a family of four to be eligible, their annual take-home pay can’t exceed about $22,000.

Either we’re too generous with these sorts of benefits or (more likely, I suspect) there is a tremendous amount of economic instability for a lot of Americans. It’s not enough to get a job, work diligently, and expect that’s the end of the story. You have to have a Plan B and Plan C and do your best to build up a nest egg to weather the storm.

Rep. Ed Delaney was attacked last night and is currently recovering at the hospital. The person accused of the attack is an attorney about my age named Augustus Mendenhall. Delaney was apparently lured to a meeting with Mendenhall in Carmel at Catherine Dr. near 131st Street under false pretenses; something having to do with a land deal. The motives are unclear.

Ann DeLaney, Edward DeLaney’s wife, said her husband never had met his attacker before Saturday. Her husband thought Mendenhall was interested in buying land in the area and wanted legal advice, she said.

This reminds me a little of the kidnapping and murder of former Benton County prosecutor, John Barce, by Lloyd Lichti. Lichti was apparently made at Barce for matters related to the will of Lichti’s father. He lured Barce out to meet him under the guise of being a new client, and then kidnapped him.

I’m hoping for a swift recovery for Rep. DeLaney.

I’ve been hearing a lot from Todd Rokita on the radio lately. Clearly these aren’t campaign ads because they are airing with public money. And that would be wrong. Ergo, they aren’t campaign ads. iPOPA flags one of the ads that really made my ear perk up. I forgot to blog about it, and I’m glad iPOPA did.

Rokita came over the top this week with a clever, new public service announcement warning people of the dangers of “faith-based affinity fraud.” . . . What struck me was when Rokita says it’s hard to detect fraud “especially when it’s done in the name of the Lord.” Notice how Rokita doesn’t say “in the name of religion” or “in the name of faith” or “even in the name of God.” He specifically refers to “the Lord,” an undeniable, not-so-subliminal statement of his Christian faith.

The reference to faith-based fraud struck me as gratuitous and injected into the concerns of the commercial so that Secretary Rokita could identify with Christians in this matter.

That’s not to say that faith-based fraud is non-existent. The commercials also remind me of a line in Jon Krakauer’s “Under the Banner of Heaven.” He is discussing how one county in Utah with particularly fervent Mormons also had the highest incidence of white collar fraud in the country. The grifter would close the deal with his mark by suggesting that the person “pray on it.” The voice of God, apparently, would often tell the person to participate in the fabulous new investment opportunity. Krakauer quoted one law enforcement official as telling people in his jurisdiction that God was not a very good investment adviser.

I wonder if, later on down the line, Secretary Rokita will suggest that voters “pray on it” when they have a new voting opportunity down the line.

A little religion humor for your Friday afternoon:

The Lafayette Journal & Courier has an editorial which ties into a conversation I was having a couple days ago about an eagerness I see in some quarters to attribute health problems to moral failings such as gluttony and sloth. I was thinking about that conversation yesterday after a Legal Aid meeting where the discussion turned to how stunningly poor decision making got families embroiled in the legal system.

One thing I have concluded is that I believe in the value of personal responsibility but I am suspicious when the need for personal responsibility is cited in policy discussions. When “personal responsibility” comes up in policy discussions, all too often it’s a sort of code for “let’s do nothing, ignore the structural problems, and maybe yell at people to work harder.” Among other problems, this approach simply doesn’t fix what’s broken.

The Journal & Courier editorial is entitled “Diet, exercise are solutions for obesity.” It isn’t wrong. It even gives a nod of the head to the need for pedestrian friendly infrastructure and parks and the like, but primarily it chalks up obesity to personal lifestyle choices to eat too much, smoke, and be sedentary. I agree that the fat person in the grocery line — or any person in the grocery line — should choose something other than the Cheetos and the soda.

But, blaming the individual gives you an excuse not to really think about the ways in which structural issues stack the deck against healthy choices and in favor of unhealthy choices. It seems to amplify this sense that every generation is in decline from the one that came before it back to some Golden Age. (I’m never really sure whether that Golden Age was Eden, the WWII generation, sometime before FDR, prior to the prohibition of child labor laws, or maybe sometime before the War of Northern Aggression. I’m pretty sure there hasn’t been a generation since the dawn of time where parents thought their kids were smarter, worked harder, and listened to better music.) If you can cast blame, you don’t have to address subsidies to corn producers and the resulting abundance of products with high fructose corn syrup. You don’t have to address the number of hours parents need to work sedentary jobs to keep a mortgage paid. You don’t have to address the lack of sidewalks or places to exercise. You don’t have to address the fact that messages encouraging people to eat and drink unhealthy crap far exceed the messages encouraging people to eat healthy. Instead, you can just feel superior to those stupid, lazy people; comfortable in the knowledge that they are getting what they deserve, perhaps while you wait for the Rapture to come and reward you for your righteousness and punish the wicked.

And, still, I raise an eyebrow when I see someone obviously suffering from their poor health lighting up a cigarette, eating the Twinkies, or sucking down the soda. I know they should be making different choices. They probably do too. But, in terms of public policy, knowing that and judging them for that doesn’t help the problem. The Journal & Courier editorial doesn’t make any effort to explain why Hoosiers are fatter, exercise less, and smoke more than other Americans. Is it because we are made of lesser moral fiber than our brothers and sisters in Colorado or other healthier states? Probably not. There are other variables that we should probably be working on.

The Urbanophile has a good post up as one part of his series on privatization. The Toll Road lease is one of the case studies he uses. The general observations are probably more important than the specific ones (my way of suggesting that you go over and read the whole thing), but on the subject of the Toll Road deal, he concludes that the state profited:

So let’s put it all together and look at how the Indiana Toll Road and Chicago Skyway leases generated almost $6 billion in value. It’s a combination of several factors:

* Tolls went up. That is, prices were raised significantly
* The hedge paid off – big time. I mentioned in the previous installment that by paying a fixed price up front for 75 years, the toll road concessionaire took on a huge amount of risk about future revenues and costs that the government used to have. In turned out that they are getting far less traffic than predicted and they are taking a bath on the deal. In short, they vastly over paid. You can’t hang your hat on this happening every time, but it is nice when it does.
* Some cost savings, but probably not a major amount
* Some customer improvements such as electronic toll collection

Principally, it was about raising prices and then getting lucky when the vendors radically overpaid. Indiana had one additional lever. Chicago had already leased the Skyway. The only way to get to the Skyway is via the Indiana Toll Road. Indiana could have jacked tolls through the roof and cut off the supply to traffic to the Skyway whenever it wanted. As a result, the same consortium that leased the Skyway almost had to pay whatever it took to win the Indiana Toll Road. Mitch Daniels had them over a barrel.

TPM Muckraker has two stories about how the health care industry benefits Hoosiers — two families anyway.

Yesterday, the site had an article about the Buyer family entitled PhRMA Gave Big To GOP Rep’s Iffy Foundation, Hired His Son, Kept On Giving (h/t Blue Indiana).

Drug industry umbrella group PhRMA, which has given $200,000 to given Rep. Steve Buyer’s Frontier Foundation, in June 2008 hired a director of the foundation as its federal affairs manager, TPMmuckraker has confirmed.

The name of that director? Ryan Buyer, son of the Indiana congressman.
. . .
With the revelation that Ryan Buyer was hired by PhRMA in what appears to be a lobbying position, the web of connections between the Indiana congressman, his foundation, and the drug industry grows still thicker.

Today, it has an article about the Bayh family entitled Report: Bayh’s Wife Made Millions As Board Member for Health Insurer.

Susan Bayh’s affiliation with Indianapolis-based WellPoint isn’t news. But a new report on TheStreet digs into the details. It also finds that last year, Susan Bayh sat on four other corporate boards, in addition to WellPoint’s. She received over $656,0000 in cash and stock for all her board work, around half of which came from WellPoint.

For his part, Sen. Bayh denies that Mrs. Bayh’s board memberships influence his judgment. But, at the least, the appearance is pretty bad.

In any case, I guess it’s wrong to vilify the health insurance and pharmaceutical industries when they are providing good jobs to ordinary Hoosiers like the Bayhs and the Buyers.