Showing posts with label insurance. Show all posts
Showing posts with label insurance. Show all posts

04 April 2012

Distinction without difference

I've seen a lot of commentary over the last few days about the so-called "individual mandate" in the Affordable Care Act (ACA) that discusses how the mandate is beyond the power(s) of the U.S. federal government and that the Supreme Court would be right to strike it down. Those same commentaries, however, then concede that the same federal government does have the authority to raise taxes and then use that money to provide health care, a la Social Security.

Two thoughts immediately come to mind:
  1. If the commentary, as described above, is correct, why is there such an uproar about the mandate? If the federal government really does have the authority--assuming it does so via the "proper" means--to force health care on every person within its jurisdiction, wouldn't it be far less injurious to individual liberty to allow people to choose from which provider they will get their insurance and the terms of that insurance? Furthermore, wouldn't it be far more economically efficient if individuals purchased insurance for themselves, saving the cost--both monetary and bureaucratic--of the government having to hire more IRS agents to collect the money and more functionaries to manage it?

  2. Isn't the real problem that the U.S. Constitution is all but worthless at this point? That is, if the mandate is such an affront to individual liberty, but the constitution allows the government to achieve the same ends via different means, what good is it as a protector of that liberty?

13 January 2012

Bruce Schneier <3's TSA

Yesterday, Bruce Schneier wrote a blog post about abolishing the Department of Homeland Security. It was based, in large part, on a CATO report calling for the same citing that
DHS has too many subdivisions in too many disparate fields to operate effectively. Agencies with responsibilities for counterfeiting investigations, border security, disaster preparedness, federal law enforcement training, biological warfare defense, and computer incident response find themselves under the same cabinet official. This arrangement has not enhanced the government's competence. Americans are not safer because the head of DHS is simultaneously responsible for airport security and governmental efforts to counter potential flu epidemics.
Schneier agrees, citing his own writing from 2003:
Our nation may actually be less secure if the Department of Homeland Security eventually takes over the responsibilities of existing agencies. [...] Security is the responsibility of everyone in government. We won't defeat terrorism by finding a single thing that works all the time. We'll defeat terrorism when every little thing works in its own way, and together provides an immune system for our society. Unless the DHS distributes security responsibility even as it centralizes coordination, it won't improve our nation's security.
But Schneier takes issue with CATO's suggestion, later in the above linked report, that the TSA should abolished. Instead, he believes
abolishing the TSA isn't a good idea. Airport security should be rolled back to pre-9/11 levels, but someone is going to have to be in charge of it. Putting the airlines in charge of it doesn't make sense; their incentives are going to be passenger service rather than security. Some government agency either has to hire the screeners and staff the checkpoints, or make and enforce rules for contractor-staffed checkpoints to follow.
It would be very easy, at this point, to attack Schneier on the basis that the TSA is a colossal failure. However, that TSA is not a failure of epic proportions is not what he is arguing. In fact, Schneier himself is the progenitor of the idea that exactly "two things have made flying safer: the reinforcement of cockpit doors, and the fact that passengers know now to resist hijackers". Furthermore, just this week, he penned an article calling the TSA irrelevant. So, let's look at exactly what he did say: that airline security should return to pre-9/11 levels with the government being in charge of it, either directly (government-hired goons staffing the checkpoints) or indirectly (private contractors acting under government regulation). If we hearken back to the pre-9/11 days, we find that his statement is redundant. Prior to 9/11, the government via the FAA was in charge of airline security, and what Schneier is suggesting is exactly how we arrived -- ignoring the reason(s) for the attacks themselves -- at 9/11 in the first place.

Before addressing Schneier's claim that putting the airlines in charge of airport security doesn't make sense, let's start with why his own solution doesn't make sense. First, there is the empirical evidence. As I just pointed out, 9/11 happened on the government's watch. While I agree that airline security should be rolled back to pre-9/11 levels, putting/leaving the government in charge of it is ludicrous, and the reason for that is that the government's interests do not align with that of the traveling public. Ostensibly, both care about flight safety. But in reality, as Schneier himself points out relentlessly, the TSA fails to provide this on any level. Just last month, a Vanity Fair writer explained how Schneier helped him circumvent TSA security to meet Schneier at the gate when his flight arrived. Then there's my own personal experience: after leaving the screening area (without being screened), the TSA demanded that I return because they feared that I may have an explosive device on my person. Why would they usher me back to the most crowed area of the airport if they feared that I had explosives? In reality, the government's interest(s) lie in an ever increasing role in security. This provides, not an actual increase in security, but an ever increasing ability to funnel money to favored contractors and further ratchet up the police state apparatus for the same reason.

The other reason that having the government in charge of airline security doesn't make sense is the same reason that letting the airlines manage their own security does: the profit and loss test. The basic idea is that when a business produces a product that consumers want at a cost that is less than what consumers are willing to pay, then the business profits. If any of these conditions are not met, the business suffers a loss. If the business does not change, then it goes out of business, government intervention notwithstanding.

Let's apply this test to the government's handling of airline security. It is producing a product that consumers want, namely, security. It is producing it at a cost of approximately $8.8 billion per year according to the federal government's 2011 budget. But this is where the profit and loss test ends for the TSA or any government entity. The profit and loss test requires that consumers of a product voluntarily pay or not pay for it. The government is funded via compulsory taxation. Therefore, the government need not concern itself with whether or not it is producing a product that people want or, more importantly, in a way that they want. That the government acts in exactly this way is borne out by reality. The TSA's budget during its first full year of funding in 2003 was $4.8 billion. It's current budget, only 8 years on, is a near 100% increase from that initial budget. This comes despite repeated TSA bungles including sleeping on the job, physically harassing passengers, allowing criminal activity to bypass security, stealing from passengers... the list goes on and on. If the TSA was a private corporation, consumers would have put it out of business almost 10 years ago. Instead, its costs are higher than ever and rising with no end in sight. In fact, the TSA's only measurable goal is total security, something that requires an absolute police state. Despite the desire on the part of the traveling public for total security, I'd wager that none would actually want to pay for it in terms of money or liberty required to implement said police state.

Now we can return to Schneier's claim that putting airline security in the hands of the airlines makes no sense. He believes this because he thinks that the airlines' focus will be on passenger service instead of security. Somebody didn't think through his rationale, completely. Tsk, tsk. Security is part and parcel of the service provided by the airlines. No passenger is going to be concerned about a glass of soda and a bag of peanuts or that he didn't get a blanket and a fluffy pillow if his plane is commandeered or blown up by a terrorist. Not only that, but the loss of a plane costs an airline hugely. There is of course the capital loss of the plane and the fuel, but more than that, if the airline wants to stay in business it's not only going to have to beef up its security, but it is going to have to figure out how to prove to passengers that it had changed its ways so that they'd be willing to fly again. We see then, that the airlines' interests, unlike the government's, align perfectly with the traveling public. In addition, airlines carry insurance for their operations. This means that airlines want their operations to be safe and secure because they don't want their premiums to rise in the event of an accident, and the airlines' insurance companies have every incentive to pressure the airlines to keep their operations safe and secure lest the insurance company have to pay out a multi-million, possibly billion, dollar claim.

"We can't trust the airlines", I hear you scream. "They're greedy capitalists!" Indeed they are, and that's exactly why the system would work. The airlines, unlike the government, cannot just take consumers' money to fund their operations. They must induce consumers to voluntarily give money to them. Thus, the airlines are subject to the profit and loss test described earlier. If the airlines provide too little security, passengers won't be willing to fly. The airlines will have saved some money by skimping on security, but the lack of income will ultimately result in losses. If they provide too much security, either the costs will drive ticket prices to a level that consumers are unwilling to pay, or consumers will find alternate means of travel because they find the security required by the airlines too onerous. In either event, the airlines will again find themselves losing money. In order to make money, the airlines will have to provide enough security to satisfy their passengers' desire for safety and their insurance companies' risk tolerance while not imposing so much security that passengers seek other airlines or other modes of travel entirely to avoid the costs and hassles.

Astonishingly, a self-correcting and self-policing system like this hasn't taken hold. Part of the reason for this is human nature. Humans have demonstrated a surprising inability to correlate events with the likelihood of their occurrence. For example, very few people are concerned about choking to death on their own vomit. However, it turns out that one is 9 times more likely to die by this method than via an act of terrorism. This is a topic that Bruce Schneier has also written about repeatedly. Because of this, people always demand ever more security in the event of some kind of accident or attack. Normally, the costs of these demands would temper them somewhat, but this doesn't happen because of government involvement. This is the other reason that a free market system has not taken hold: the government provides moral hazard. The airlines prefer that the government be involved because by using government provided security and/or standards, responsibility for security failures falls on the government, not the airlines. When something tragic occurs, the airlines can point to the government as the failure. Insurance companies are likewise not terribly worried about having to pay airline claims because the government has proven willing to bail them out. Even consumers are unwitting accomplices in this system because the costs of security have been separated from the cost of a ticket. Instead, these costs are (or would normally be) imposed as taxes, but even if one went looking for them, they would be difficult to find as the government has taken to inflating the currency in order to finance its operations. The increased costs of security are found in the rising prices of everyday items like milk, rent, electricity, and gasoline.

The government's involvement in airline security is not only an abject failure but an impediment to allowing a free(d) market to discover what the people really want when it comes to airline security. Bruce Schneier is a smart guy, and he's one of the TSA's harshest critics. He's written extensively about security and the trade-offs made in its name; he's no stranger to economics, especially when it comes to security. In light of this, I can only conclude from his desire to keep the government involved in airline security that he secretly loves the TSA.

08 October 2010

The arrival of the total state will not be televised

Yesterday, a federal judge in Michigan handed down a ruling upholding the new health care law. Here is an excerpt:
There is a rational basis to conclude that, in the aggregate, decisions to forego insurance coverage in preference to attempting to pay for health care out of pocket drive up the cost of insurance. The costs of caring for the uninsured who prove unable to pay are shifted to health care providers, to the insured population in the form of higher premiums, to governments, and to taxpayers. The decision whether to purchase insurance or to attempt to pay for health care out of pocket, is plainly economic. These decisions, viewed in the aggregate, have clear and direct impacts on health care providers, taxpayers, and the insured population who ultimately pay for the care provided to those who go without insurance. These are the economic effects addressed by Congress in enacting the Act and the minimum coverage provision.

The health care market is unlike other markets. No one can guarantee his or her health, or ensure that he or she will never participate in the health care market. Indeed, the opposite is nearly always true. [...]

The plaintiffs have not opted out of the health care services market because, as living, breathing beings, who do not oppose medical services on religious grounds, they cannot opt out of this market. [...]
The decision, in simpler terms, is this. Unless a person opposes the medical establishment on religious grounds, that person will at some point avail himself of services provided by the health care market. That person, at the time of service, may not be able to pay for the service. Therefore, that person's original refusal to participate in the market by purchasing insurance constitutes economic activity (because if he can't pay, his costs will be shifted to other participants) which the congress may regulate under the commerce clause. In even more simple terms, refusal to participate in an economic activity constitutes an economic activity that congress may regulate.

I want to address the mental gymnastics undertaken by the judge in arriving at this decision, e.g. that a person can't not get sick; that a person, once sick, can't avoid the health care market; and the fact that that person may not be able to pay means that he can be forced to buy insurance. I'm not going to, though. At least, I'm not going to any more than I just did.

Instead, I'll focus solely at the situation in which a person does get sick, does avail himself of the health care market, and can't pay for the service(s) since that is the situation on which the judge's upholding of the PPACA is based. So, what happens when an uninsured person arrives at a hospital emergency room? Under the EMTALA, that person must be treated. Nobody [explicitly] pays for this treatment, though. The federal government has mandated that hospitals treat such patients but does not reimburse them for these costs. Instead, hospitals can write this cost off as charity or bad debt on their taxes. They can also shift these costs to paying customers in the form of higher charges for service. (Note, too, that there is nothing preventing a hospital from doing both.)

So, the judge is correct that caring for uninsured patients creates additional costs for taxpayers (in the form of tax deductions taken by hospitals) and for paying participants in the health care market (in the form of increased costs for service). Here's the rub, though. The government created that additional cost in the first place by passing the EMTALA! The absurdity of trying to fix the problems created by government interference in the market by further interfering in the market should be obvious to everyone. The problem is more insidious than that, however.

The government has dropped all pretense of "legally" taking people's money via taxation. It is now explicitly assuming the ability to force people to spend money in the ways that it directs and is using its own policy as an excuse for the authority. By this logic, there is nothing that the government cannot regulate. The total state has arrived.

Unintended consequences revisited

Last week I wrote about how some people were actually going to lose their health insurance coverage as a result of the new health care law. USA Today reports today via Bloomberg that the government has reversed course and issued waivers to McDonald's and 29 other companies exempting them from the conditions imposed by the new law. Those employees will now get to keep their insurance, but they won't be afforded the "protections" of the new law. Look at it this way, though: the government actually helped these people more by doing nothing at all.

The whole debacle is a perfect example of the failure of central planning:
The most notable critique of economic planning came from Austrian economists Friedrich Hayek and Ludwig von Mises. Hayek argued that central planners could not possibly accrue the necessary information to formulate an effective plan for production because they are not exposed to the rapid changes in the particular time and place that take place in an economy, and are unfamiliar with these circumstances. Transmitting all the necessary information to planners to accumulate and form a comprehensive plan is therefore inefficient.[13]

Centralized economic planning has also been criticized by proponents of de-centralized economic planning. For example, Leon Trotsky believed that central planners, regardless of their intellectual capacity, operated without the input and participation of the millions of people who participate in the economy and understand/respond to local conditions and changes in the economy would be unable to effectively coordinate all economic activity.[14]
Ultimately, though, as reported in the USA Today article, it's highly unlikely that the government set out to help these people at all.
"The big political issue here is the president promised no one would lose the coverage they've got," says Robert Laszewski, chief executive officer of consulting company Health Policy and Strategy Associates. "Here we are a month before the election, and these companies represent 1 million people who would lose the coverage they've got."
Those in office need to stay in office so that the can keep "helping" the people.

06 October 2010

Fire protection and the free market

Earlier this week, fire fighters in Obion County, Tennessee let a man's house burn to the ground because he hadn't paid his annual $75 fee to the nearby city of South Fulton for fire protection. Here is the short version:
In rural Obion County, homeowners must pay $75 annually for fire protection services from the nearby city of South Fulton. If they don't pay the fee and their home catches fire, tough luck -- even if firefighters are positioned just outside the home with hoses at the ready.

Gene Cranick found this out the hard way.

When Cranick's house caught fire last week, and he couldn't contain the blaze with garden hoses, he called 911. During the emergency call, he offered to pay all expenses related to the Fire Department's defense of his home, but the South Fulton firefighters refused to do anything

They did, however, come out when Cranick's neighbor -- who'd already paid the fee -- called 911 because he worried that the fire might spread to his property. Once they arrived, members of the South Fulton department stood by and watched Cranick's home burn; they sprang into action only when the fire reached the neighbor's property.
I was planning on writing about this, but smarter people have already done the heavy lifting:
I don’t get this debate at all. It is not even a real debate. The fire-protection services were government services. The fee in question was a government-mandated fee. The county lines in which the fee was applicable is a government-drawn line that is completely arbitrary. The policy of not putting out the fire was a government policy enforced by the mayor. As he said, in the words of a good bureaucrat, “Anybody that’s not in the city of South Fulton, it’s a service we offer, either they accept it or they don’t.”

So why is the market being criticized here? This was not a real market. Instead, this is precisely what we would expect from government. In a real market, there is no way that a free-enterprise fire service would have refused to provide the homeowner service. They would be in business to provide that service. The fire would have been put out and he would have been charged for the service. It is as simple as that.