It’s comforting to think that most healthcare problems in the U.S. could be solved by letting the power of an unregulated free market do its work.
It’s also wishful thinking and overly simplistic, according to Peter Ubel, MD, a general internist, behavioral scientist, and Duke University public policy professor who blogs for Forbes and The Atlantic.
That’s a sentiment that many of his fellow physicians would dismiss out-of-hand, so don’t let it be said that Ubel shies away from controversy.
In his writing, Ubel has explored whether physicians should pray with their patients. He’s asked whether the primary care shortage is a myth and asserted that physician pay is too high in the United States. He’s theorized that more transparency in healthcare could actually increase prices… (Read more at Medical Economics)
A Smattering of Quotes from: Last Call – the Rise and Fall of Prohibition
I have written a couple blog posts recently based on reflections inspired by Daniel Okrent’s wonderful book, Last Call. But there are so many wonderful tidbits from this book, I thought I’d share a few of my favorite quotes.
First there is William Jennings Bryan, a prominent force in the Democratic Party at the end of the 19th century, who colorfully described his opposition to the theory of evolution:
“It is better to trust in the Rock of Ages than to know the age of rocks.”
Of course he is completely wrong. But at least he is wrong eloquently.
Then there is the Kentucky Distillers and Distribution Company, which sought out a local alcohol treatment center and offered to sell them names of their frequent customers for $400. They bragged to the treatment center that:
“Our customers are your prospective patients.”
So much for business ethics!
I particularly enjoyed the song title by songwriter Albert Von Tilzer. He cleverly captured one of the unforeseen benefits of Prohibition, with his
“I Never Knew I Had a Wonderful Wife until the Time Went Dry.”
A newspaper reporter mocked the inability of Prohibition law to prevent people from drinking:
“It was absolutely impossible to get a drink in Detroit unless you walked at least 10 feet and told the busy bartender what you wanted in a voice loud enough for him to hear you above the uproar.”
Another person commented on the impossibility of stopping liquor smuggling across the US/Canadian border by saying:
“You cannot keep liquor from dripping through a dotted line.”
A man who made his business selling Scotch gave colorful advice:
“Of two evils, choose the more interesting.”
That is an aphorism that Oscar Wilde would be proud of.
And then, of course, there was Ernest Hemingway boldly claiming that
“a man does not exist until he is drunk.”
Ernest, Ernest, Ernest…
Another Review of Critical Decisions
Here’s a link to a review of Critical Decisions published in a journal called Theoretical Medicine and Bioethics. The reviewer had some nice things to say, but felt it wasn’t theoretical enough for his liking. Not surprising given that I wrote the book for a general audience, and not for an academic one. But this kind of review does motivate me to try to write some more spin-off articles, aimed at academic audiences, to go into some of the theoretical issues I raise in Critical Decisions in a more thorough, and academic manner. Good to remember in the meantime: writers have to know their audience. And my goal in writing Critical Decisions was to reach a broad one, not just an academic one.
Is the Penalty for Not Getting Health Insurance Too Small to Work?
As part of Obamacare, people are required to get health insurance or pay a penalty. That’s what’s known infamously as the individual mandate. But is the penalty too small to matter? For some people, the penalty might be as low as $95. Would anyone in their right mind, who is not otherwise inclined to buy health insurance, buy it just to avoid such a small penalty? Here is an interesting Marketplace report that looks at this topic, quoting me and a several others who argue that the size of the penalty isn’t the only thing that matters.
How Anti-Alcohol Regulations Promoted…Prostitution?!
John “Eagle-faced” Raines had a simple goal in mind: put a big hurt into the evil saloon industry that was threatening the moral fabric of late 19th century New York State. Low wage workers were spending huge chunks of their Sundays (for many, the only day of their weekend) tipping pints at dingy saloons, when they would have been better off spending that money on food and clothing for their families.
Raines could have pushed for New York to ban all alcohol sales on Sundays. But that would have gone too far. Many proper men of ample means were known to enjoy a drink or two on Sundays. So Raines and his legislative pals came up with a clever solution: they banned Sunday alcohol sales at saloons but not at hotels. (Technically, they allowed establishments to serve alcohol on Sundays if the establishment also served meals and had at least ten bedrooms.) Well-to-do men, after all, primarily gathered in New York’s fancy hotels for their libations. Daniel Okrent summarizes Raines’ intentions (in his marvelous book: Last Call) as “prohibition for the other guy, not for me.” (See here for another post inspired by the book.)
But like so many government regulations, this one had unintended consequences. Saloon owners were not going to lose their best day of business without looking for a way around the legislation. So they adapted. They began serving meals, or at least pretending to serve them. Some saloons even mocked the Raines law by placing a brick between two pieces of bread “sat out on the counter, in derision of the state law”…(Read more and view comments at Forbes)