This Day in History

Fifty years ago today at 1:30 PM eastern standard time, a minor tragedy took the life of President John F. Kennedy. A little over an hour later, a major tragedy ensued, as Lyndon B. Johnson was sworn in to replace him.

If there is such a thing as evil, it lived in Lyndon Johnson, whose life was one long obsession with the accumulation and exercise of power. His biographer Robert Caro relates how, in college, Johnson engineered, by intimidation and deceit, a takeover of the Student Council partly so that he could, apparently for sport, force the removal of talented and hardworking students from the editorships of campus publications, replacing them with non-entities and reveling in the tragic aftermath as ousted incumbents (who had received small but urgently needed stipends for their work) were forced through financial hardship to drop out of school.

It was downhill from there. As President, Johnson presided over a misbegotten war in Southeast Asia — a whirlpool of destruction fed with lives and treasure — and an equally misbegotten “War on Poverty” that too often became a war on economic freedom, the only effective antidote to poverty the world has ever known.

The War on Poverty might have been more accurately termed a war to consolidate Johnson’s influence. Poor rural families got grants and loans to expand their farms — provided they stayed on the farms, where Johnson needed their votes. Job training, educational programs, small business loans — all were available as long as you lived your life in a way that suited Lyndon Johnson’s purposes.

It was Johnson who launched the National Endowments for the Arts and Humanities and the Corporation for Public Broadcasting, to ensure that the agendas of the arts, the humanities and the airwaves could be guided by the tastes of officials appointed by Lyndon Johnson. It was Johnson who arrogated unto himself and his cronies the power to veto private rental and employment contracts.

The depredations did not end with Johnson’s departure from office at the end of 1968. In many ways, the Nixon administration that followed was a seamless continuation of the Johnson regime, the only change being the identity of the sociopath-in-charge. Under Nixon, the carnage continued in Southeast Asia. Under Nixon, the Great Society grew larger and more entrenched. It was Nixon who launched the eerily Johnsonian power-grab of wage/price conrols, injected his tentacles into the workplace with the odious Occupational Safety and Health Administration Act, and insured the incarceration of millions by launching the War on Drugs.

For nearly ten years, the United States and the world suffered under the yoke of what can fairly be called the Johnson/Nixon administration. The administrations and policies that followed have often been dreadful, but never quite so intensely and relentlessly dreadful as in the Johnson/Nixon years. Today is the anniversary of the onset of our long national nightmare. Only eternal vigilance can spare us another.

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54 Responses to “This Day in History”


  1. 1 1 Ted Levy

    I don’t understand the part at the beginning about “minor tragedy”…

  2. 2 2 Brandon Berg

    He means that one man’s death was a minor tragedy in comparison to the disaster that was the Johnson administration.

  3. 3 3 Harold

    I guess the premature loss of any life is a minor tragedy.

  4. 4 4 suckmydictum

    I would argue it was Kennedy’s election itself which first portended the influence of organized crime on 20th century politics. It seems pretty ridiculous to believe he didn’t understand what sort of scum bag he selected as a running mate.

  5. 5 5 Harold

    What about the Civil Rights Act of 1964? Injecting himself into the private transactions of individuals, or a much needed stepping stone to a curb the hateful and wasteful discrimination against millions?

  6. 6 6 Brad Calder

    One good thing that happened during Johnson’s first term was the invention of the Buffalo Wing.

  7. 7 7 Daniel

    @Harold,

    I was thinking much the same thing when I read this post. LBJ was probably not that great of a guy, but he still did some good things. Whether the good things he did out-way the bad is impossible for me to know given my lack of historical expertise. I would say that Medicare has worked reasonably well. Obviously it needs some overhaul given our current budget constraints, but our lack of updating can hardly be blamed on LBJ can it?

  8. 8 8 jefe

    Did he not also found the public university system, a bulbous, publicly-funded teat upon which libertarian intellectuals could feast?

    Joking aside, seems a little hypocritical.

  9. 9 9 Manfred

    Daniel @7,
    Medicare “has worked reasonably well”???
    Daniel, please, stop that Kool-Aid you are drinking.

    Medicare is one of the most expensive programs of the federal government, with no end in sight of its cost. It created an entitlement and moral hazardous mindset and mentality in the old folks that is now pretty much impossible to shake. It is a top down, soviet style run, hyperbureaucratic government program, that ossifies and stifles innovation. It is a program (which together with Social Security) which is politically impossible to reform. Politicians do not get near this thing, and stay away hundreds and hundreds of miles from talking of reforming. Waste, fraud and abuse of Medicare is rampant.
    And with all this, you say, while drinking Kool-Aid, that this thing “worked reasonably well”?

  10. 10 10 Daniel

    @ Manfred,

    No I say these things based on actual evidence showing Medicare costs increasing at about the same rate or slower rate than the private sector. I also say this knowing that Medicaid, which has negotiating power, has done a much better job at controlling costs than either of them. I also say these things knowing that before Medicare poverty rates among seniors were much higher than they are today. I also say these things knowing the main reason Medicare is on an unsustainable fiscal path at the moment is because we have an aging population and high health care inflation (health inflation led by the private sector, btw), neither of which are directly the fault of the program. I also say these things based on the fact that other countries with a much more controlling health system have lower costs relative to GDP and about the same outcomes.

    Also Kool-Aid has no effects on cognitive ability last time I checked, so I’ll drink all the Kool-Aid I feel like knowing that it will not affect my judgement.

  11. 11 11 Don Boudreaux

    The presumption against the proposition Medicare works well is strong given that that system created a tragedy of the commons for older Americans to graze free of monetary charge on the health-care resources of others.

    Of course, we have no historically concurrent counterfactual to see what health-care markets – and expenses, access, and quality – would have been like had not LBJ and Congress created a system in which older Americans get to free-ride on each other and, mostly, on younger Americans for their medical care.

  12. 12 12 Steve Landsburg

    Harold: What about the Civil Rights Act of 1964? Injecting himself into the private transactions of individuals, or a much needed stepping stone to a curb the hateful and wasteful discrimination against millions?

    Why can’t it be both?

  13. 13 13 Ken B

    @Steve 12:
    If it’s both then this “It was Johnson who arrogated unto himself and his cronies the power to veto private rental and employment contracts” is reduced to a procedural objection, and it reads like something more substantial. If the interference was “a needed step[]” then you aren’t really objecting to the interference, just how Johnson effected it.

  14. 14 14 Daniel

    @ Don Boudreaux,

    Your proposition that older American “Free Graze” when in actuality they still pay a significant amount of their healthcare costs, is simply misinformed. Also while there’s no direct counterfactual, cross-country evidence points to our relatively “free” system being the mostly costly possible way to deliver healthcare.

  15. 15 15 Patrick R. Sullivan

    ‘What about the Civil Rights Act of 1964?’

    Take the Civil Rights Act…please!

    I’ve heard a lot of people, from Tom Sowell to Diahann Carroll thank their lucky stars they grew up in Harlem BEFORE the Civil Rights Act. When it was a civilized place to live.

    For a decade and a half, most measures of welfare for Blacks in America were improving. Within 5 years of the ’64 law that all ended.

  16. 16 16 David

    @ Daniel

    You seem to be using “relatively free” and “private sector” synonymously. While the U.S. system is free relative to other countries, it is hardly a system run by the private sector.

    Cosmetic surgery is an industry run by the privates sector. The real (inflation-adjusted) price of cosmetic surgery fell over the past two decades – despite a huge increase in demand and considerable innovation.

  17. 17 17 Daniel

    @ David,

    Okay, do you agree that there’s considerably more choice from the consumers point of view when services are needed in cosmetic surgery? Also I agree that if we made everyone pay out of pocket for medical care we’d have a much less costly system. We’d also have a much less healthy population, so there’s considerable tradeoff to what you’re proposing.

  18. 18 18 Daniel

    @ Patrick R. Sullivan,

    Whatever could you possibly be referring to? Homicide rates are essentially the lowest they’ve been on record, and poverty rates are also near all time lows especially for African Americans in comparison to 1964 (although exacerbated by recession), so I literally have no clue what you’re talking about.

  19. 19 19 Mark

    Harold (#5), the Civil Rights Act was orchestrated by Kennedy before Johnson even took office. Yes, Johnson signed it into law, but he could not very well ignore this, especially given that his attorney general was Robert Kennedy, who had been instrumental in bringing this legislation about.

  20. 20 20 David

    @ Daniel 17

    Yes, I agree that consumers have considerably more choice in the private sector.
    I did not “propose” anything, I merely questioned your assertion that high health care inflation was “led by the private sector,” a point you now appear to have conceded.

    @ Daniel 18

    Patrick clearly compared 1964 to 1969 and concluded that those indicators got worse over that time period. Not sure why you are commenting on a completely different time period…

  21. 21 21 Daniel

    @ David,

    “Yes, I agree that consumers have considerably more choice in the private sector.
    I did not “propose” anything, I merely questioned your assertion that high health care inflation was “led by the private sector,” a point you now appear to have conceded.”

    First, it’s not the fact that you have more choice in the private sector, it’s the fact that you get to choose when and where and with whom your procedure for plastic surgery occurs. How much “choice” do I have when I have a heart attack? Can I shop around for the best price, or am I pretty much limited to the hospital in my nearest vicinity. So one reason plastic surgery is handled by the private sector is because I have more choice, rather than me having more choice because it’s handled by the private sector. I wouldn’t have any more choice about where I receive care for my heart attack, if it was handled by the private sector.

    So the point is that one way we could substantially reduce costs in the healthcare sector would be to switch to a more closed system (I’m guessing I don’t need to cite the numerous examples of the cases where these closed systems have lower costs than our own and provide about the same level of care). So I’m offering a proposal that will shrink costs and provide about the same level of care. If you don’t have a viable alternative to our current system, than I’m not really sure what your point is?

    “Patrick clearly compared 1964 to 1969 and concluded that those indicators got worse over that time period. Not sure why you are commenting on a completely different time period…”

    Well than I’d just say that Patrick’s point is completely irrelevant. Why would we pick such a short time period to judge the Civil Rights Act of 1964 on, is it because we’re trying to cherry pick the evidence?

  22. 22 22 Ted Levy

    Brandon Berg at #2: You seem to focus, in responding to me at #1, on the word “minor”. I was confused by the word “tragedy.”

    Harold at #3: Isn’t your claim clearly false by over-statement? I can think of any number of historical figures that would have made the world a better place by dying earlier.

  23. 23 23 Ted Levy

    Daniel @14: I believe recent figures indicate that even today Medicare recipients pay in about $1 for every $3 they take out. You may feel it wrong to call that “free grazing” but it certainly highly subsidized grazing.

  24. 24 24 Ken

    Harold,

    What about the Civil Rights Act of 1964?

    Yes, what about it? Do you think this is a good example of good legislation? Please explain.

  25. 25 25 Roger

    LBJ = worst USA president since Wilson.

  26. 26 26 Daniel

    @Ted Levy,

    I’d like to actually see the analysis for which you refer. Are they accounting for the taxes they paid in for medicare adjusted for inflation? Even so it’s highly biased even if that is the case due medical care inflation (originating in my opinion from the private sector). And what exactly is your proposed alternative again?

  27. 27 27 David

    @ Daniel
    Yes, in a life-or-death emergency scenario where time is of the essence, consumer choice is limited by necessity. This obviously doesn’t apply to the majority of health-care transactions, where there’s no reason the same degree of choice couldn’t exist.

    Not sure what this fact has to do with my original point about your conflation of “relatively free” and “private sector” and your assertion that high health care inflation was “led by the private sector.” Nor do I think my comment requires a health-care overhaul proposal in order to have a point.

    Patrick’s point is that after decades of a steady downward trend of those indicators, the trend reversed after passage of the CRA, which is contrary to what you’d expect. One could certainly dispute whether or not there’s a causal relationship there, whether the time period is relevant, and whether or not the benefits outweighed the cost, all of which would be preferable to feigned density.

  28. 28 28 Daniel

    @David,

    All I’m saying is that using plastic surgery as a good example for the rest of healthcare is just false equivalency run amok. There are so many other things which are different about the dynamics in cosmetic surgery that it’s hard to name all of them. Take the fact that people are willing to pay virtually anything possible for themselves or their family to stay alive or improve their chances of staying alive. Couple this with the fact that there’s information asymmetry on quality of healthcare received and you’re pretty limited in how you can effectively choose the right treatment at the right price if the decision is left up to you alone. So how does your point that prices for cosmetic surgery have fallen, for which people are not willing to pay anything they can to become marginally more attractive relate to changes in prices in HC in the least.

    What your saying is essentially equivalent to saying that the price of computers, made by the private sector have fallen so much, so obviously the private sector is more efficient. Meanwhile Medicaid prices have remained stable, Medicare has rise, less per enrollee in percentage terms than private insurance, so. I’m just not at all sure why your point was at all relevant.

    You’re exactly right on the Patrick point that correlation does not equal causation, but Patrick had made no sophisticated analysis, and seemed to be simply cherry picking a 4 year period in which things got worse before they started getting much, much better. I agree that a more sophisticated analysis than the one I gave is required, but please don’t try to tell me that we can determine the effectiveness of a law based on a four year trend.

  29. 29 29 Daniel

    And for those who seem to think that the civil rights law of 1964 was so harmful, can you please explain to me which part of the law was supposed to be so harmful? I’m really having trouble figuring this one out.

  30. 30 30 Ken B

    Do 24 and 29 cancel each other out?

    I’m not going to undertake either task. But supporters of the law usually point to things like voting rights and the abuse of literacy tests, and critics usually point the creation of destructive incentives.

  31. 31 31 Floccina

    @Daniel but the least effective medical spending that spent on seniors. Much of it does not help at all. See the work of Robin Hanson and others.

  32. 32 32 Daniel

    @Floccina,

    I know this, but how would switching to private insurance fix this? Some of the most effective treatments are also given at the end of life, who should determine which is which? I think the government does a better job at balancing the cost of treatment with the benenifits of treatment, whereas purely profit seeking companies have an incentive to cut services that on net might be beneficial, but is not beneficial to their profit margins.

  33. 33 33 David

    @ Daniel

    I’ll try this once more.

    Estimates of overall government expenditures on healthcare range from 40 – 60% of the total, depending on whether healthcare-related tax subsidies are counted as expenditures. The vast majority (88%) of the costs for healthcare services are paid for by third parties rather than out-of-pocket by individuals, and historically, as the proportion of the costs paid for by third parties has increased, overall spending on healthcare has increased.

    In the comments above you repeatedly blame healthcare inflation on the fact that our healthcare system is rum by the private sector. Here’s my point: The healthcare system described in the paragraph above is *not* a private sector system. In private sector systems like cosmetic surgery and yes, computers, quality and innovation have increased dramatically while costs have decreased. In #17, you acknowledge that costs would indeed be lower if our system was more of a private sector system, which seems to contradict your repeated assertions that healthcare inflation was caused by the private sector.

    Your arguments that healthcare could not work as a private sector system (which undermine your initial point and are unrelated to my point)are unconvincing. Your information asymmetry argument is especially puzzling. I researched orthopedic surgeons as well as the failure rate of cadaver grafts vs hamstring and patellar tendon grafts prior to my ACL surgery just as I would research cosmetic surgeons and procedures if I were ever considering cosmetic surgery. And let me concede, before you point it out yet again, that if I was dying of a heart attack I would not have this option.

    If people are willing to pay more for health-related costs than for cosmetic-related costs, why not let them? You’re arguing that despite being willing to pay more, they should pay less. How do you think paying less will affect consumption?

    If these are the strongest of your arguments about the many differences in the dynamics of private sector cosmetic surgery vs the current system, I don’t need to hear the rest.

    This is much further into the weeds than I intended to go to simply point out to you that our current system is not a private sector system, especially on a post that has little to do with healthcare.

  34. 34 34 Ted Levy

    I’ll simply add, as a physician, to David’s excellent comment #33, that the VAST, VAST percentage of what occupy the day of the healthcare professional, and the VAST, VAST percentage of complaints that bring any given patient into the healthcare system, are NOT emergencies of the type one cannot bargain for ahead of time.

  35. 35 35 Daniel

    @David & Ted Levy,
    It’s relevant because Medicare is considered by many to be Johnson’s most important achievement. Would you disagree with this?
    What I’m saying is that healthcare inflation in our current system is higher than it would be in a closed system. In other words government’s are more efficient at running *health insurance* than the private sector. Direct oop in healthcare has obvious flaws and I don’t think it’s a viable alternative. Since healthcare is an expensive venture, we’d see massive flows of healthcare from those in most need to those that have the highest budget constraint since those in most need are often those least able to pay. We see vast corruption in medical care in countries where oop is the way of the land. To your point about researching “the best surgeon” for ACL, how exactly did you conduct the research? How do you know that the measures you were using were the correct measures? This is not an easy decision to make because failure rates are not always the best indication of the quality of the surgeon unless you can somehow control for the difficulty of the surgeries they perform. Do you expect the average person to be able to collect data for this in every healthcare service provided?

  36. 36 36 Daniel

    @Ted Levy,

    Which visits are more expensive, the emergency or the routine visits? Both of you are also talking as if the average healthcare patient has the abilities or emotional strength to sort through these very complicated quality measures when their health is jeopardized in some way, which is to me a naiive assumption.

  37. 37 37 Ted Levy

    Well, you’re quite a sophisticated young man, Daniel to appreciate the naïve assumptions of someone who’s practiced medicine for over 20 years about the nature of his patients. Quite sophisticated, though your spelling could still use a little work.

    You seem to enjoy practicing a priori economics. Get back to me when you’ve had time to go to actual databases and compare the costs of chronic routine care with emergency medicine.

  38. 38 38 Daniel

    I was asking you for your expertise, and I don’t really feel the need to spell check in the comments of a blog. Notice how you didn’t actually answer my question.

  39. 39 39 Michael Moran

    I disagree with the core of your post. I think the Johnson was in all ways a continuation of Kennedy, and all of the evils that you site as committed by Johnson would have been done by Kennedy. The thought that Kennedy would not have continued in Vietnam seem very unlikely. So the real tragedy was the election of Kennedy.
    Nixon was not a continuation of Kennedy/Johnson, though one can reasonably argue just as bad in his own way (I would argue he was bad, but not as bad).
    With respect to the evils done by both Kennedy/Johnson and Nixon, much of it was done more as a result of ignorance as malice. The prevailing economic wisdom was toward Keynesian economics and centralized planning. Many of the stupid things they did they thought would work, and they had PHDs from Harvard telling them they would work (just like Obamacare).

  40. 40 40 Daniel

    @Ted Levy,

    And I’m not really sure what qualifies a doctor to speak to the average knowledge about comparative quality of healthcare, even among his own patients. Sorry but the whole, trust me I’m a doctor thing only works for Doctor Who.

  41. 41 41 Ted Levy

    Daniel, you’re having trouble with simple reading comprehension. Nowhere did I comment on “comparative quality of healthcare.” YOU asked ME to provide YOU with “Which visits are more expensive, the emergency or the routine visits”. I responded, in essence, that I’m not being paid to Google things for you. If you truly think physicians have no knowledge of whether more of one’s health care dollar goes to the former vs. the latter, you’re simply misinformed. But I’ve told you what I think the answer is. It’s not an a priori answer. Spend a few minutes Googling it and show me if you can find any data supporting your position that emergency visits, for which you find the free market “bargaining” position wanting, is where most of the nation’s health care dollar is spent.

    You seem amazingly sure of yourself for one who provides no data to support his claims.

  42. 42 42 Harold

    Ted Levy 22: Even a tyrant’s death is probably a minor tragedy to their mother, even if rejoiced by the masses.

    #12 and subsequent. Of course the Civil Rights act is both, but one could choose to focus on one over the other.

    #15 “Within 5 years of the ’64 law that [improvement] all ended” implies a cessation of improvement, not just a snapshot comparing two different dates.

    One factor that is difficult to asses is the impact of the legislation on how people think. Racism is more effectively dealt with by change in attitudes than compulsion, but I believe the legislation actually results in change in attitude, and this could be the biggest impact. Racism is essentially irrational, like phobias. Legislation acts like de-sensitisation. To treat a spider phobia you slowly and gradually introduce spiders to the sufferer. Eventually, the sufferer realises that there are no dire consequences and the fear reduces. Similarly with racism. Legislation forces people to experience people of different races. Individuals eventually come to realise that there are no dire consequences when people of different races share a space, and the fear lessens.

    I am no expert on USA healthcare, but it seems to me that the bastard chimera of the USA system fails to achieve the good points of either a public or a private system. I have no idea if Obamacare will make this worse or better.

  43. 43 43 Daniel

    @Ted Levy,

    The problem is that this is somewhat of a difficult question to answer. There direct expenditures on emergency room care that come in around 2%, but because of cost shifting the costs are probably more like 4-6%.

    http://www.politifact.com/truth-o-meter/statements/2013/oct/28/nick-gillespie/does-emergency-care-account-just-2-percent-all-hea/

    http://news.brown.edu/pressreleases/2013/04/emergency

    My larger point though is that even if it’s a chronic care issue, the average person does not have access to data or the ability that would allow them to comparison shop, which is the more important issue. I don’t have time to look for data now, but given my experience working with students as a TA, I’m not encouraged by the thought of them needing to do complicated analysis at a time when their life or health threatened. Emergency room care visits were more of just a side point that we’ve now spent time harping on.

  44. 44 44 Michael Stack

    Whatever you may think about Johnson’s programs, the man himself was a pure psychopath. Read Caro’s “The Path To Power” to see what I mean. The stories Landsburg alludes to above are just the tip of the iceberg. I think God I’ve never had to work around anyone like that.

  45. 45 45 RJ

    @ Michael Stack

    I think God I’ve never had to work around anyone like that.

    You might have, psychopaths and/or sociopaths are disproportionately represented in the business world as bosses or other leaders. Maybe yours weren’t as ‘overt’ as LBJ was?

    I’m pretty sure a couple of mine have been.

  46. 46 46 iceman

    So taking dictation from someone on the crapper isn’t your dream job?

    I don’t get the argument that Medicare would be just fine if it weren’t for the ageing of the population…sounds like saying the Titanic would’ve been fine if not for the icebergs. Unless the baby boom came as a surprise to the social engineers of the ’60s & beyond, it’s just another example of an irresponsibly designed program, unfortunately this time on a massive scale. But that shouldn’t be a surprise either since politicians’ incentive is always to buy votes in the ST and defer the LT ramifications. (Btw if one is not going define the services covered, cost inflation isn’t a big shocker either.)

  47. 47 47 Daniel

    @iceman,

    The aging of the population is an independent problem from the problems in Medicare. What we should be looking at are increases in costs per person, not increases in cost overall, that’s the only point I was making when I mentioned the aging of the population. Private insurance has done a less good job at controlling costs per person over the past decade than Medicare. That’s why if you want to criticize Medicare you should at least offer an alternative proposal to weigh Medicare against. If your idea is to switch to oop for seniors, then you must accept roughly 30% of the elderly population living in poverty. If you want to switch to a subsidized marketplace, Paul Ryan’s plan, then it’s not really clear that this would be a more efficient system then traditional Medicare, and may still leave some people in destitution that would not otherwise be (depending on the particulars).

  48. 48 48 Seth

    @Daniel: “Take the fact that people are willing to pay virtually anything possible for themselves or their family to stay alive or improve their chances of staying alive.”

    What % of health care spending is to stay alive?
    Isn’t that what catastrophic insurance should cover?

    “Couple this with the fact that there’s information asymmetry on quality of healthcare received”…

    Yet, private sectors have innovated ways to solve this in other industries. Used cars is an example where several things have been innovated like Carfax, branded used car dealerships and certified/warrantied used cars.

    “you’re pretty limited in how you can effectively choose the right treatment at the right price if the decision is left up to you alone.”

    In the legacy structure that is dominated by 3rd party intervention, true. But, that thinking lacks imagination to assume it would stay that way in a more private, 1st party pay system. Very few people know much about computers, but the market has still evolved ways for people to buy them with reasonable assurances of quality and ease of use.

  49. 49 49 Daniel

    @Seth,

    “Yet, private sectors have innovated ways to solve this in other industries. Used cars is an example where several things have been innovated like Carfax, branded used car dealerships and certified/warrantied used cars. ”

    “Very few people know much about computers, but the market has still evolved ways for people to buy them with reasonable assurances of quality and ease of use.”

    I’d be happy to hear how these types of innovations could be applied to the medical sector. There’s are several complications to medical care, mostly having to do with the fact that there are so many variables you have absolutely no control over, that limit the ability to measure quality in healthcare.

    So for both computers and cars the average consumer can at least observe, is it working or is it not working, how long will it work for, how fast is the speed, how long does it last without needing repair, without having to know the particular in and outs of how a computer or a car work. Both can be tested by equal measures to compare across items and the same tests are performed on each model so a consumer looking at these statistics can be reasonably well assured that there were no other variables at play affecting the differences.

    In medical care each service performed has it’s own set of variables that affect the end result. Like I mentioned earlier in the example of non-emergency surgery, you can’t just look at failure rates without controlling for the difficulty of the surgery, and how exactly would you create a trusted metric for difficulty of surgery? Can you think of a private *service* industry as complicated as medical care that has innovated to create information symmetry equal to computers and cars?

  50. 50 50 Daniel

    @Seth

    “What % of health care spending is to stay alive?Isn’t that what catastrophic insurance should cover?”

    According to the below, most of the most costly illnesses are potentially life threatening. The consumer only needs to believe that they are life threatening when in actuality they might not be. And the problem with catastrophic coverage is thay it encourages people to wait as long as possible before seeking medical attention, which can increase costs.

    https://www.google.com/url?sa=t&source=web&cd=1&ved=0CCgQFjAA&url=http%3A%2F%2Fwww.nationalhealthcouncil.org%2FNHC_Files%2FPdf_Files%2FAboutChronicDisease.pdf&ei=SpuUUs3BMpS_sQS_1IDYAQ&usg=AFQjCNETN7eUQdQmoXE8PpsVOZPgnoROgQ

  51. 51 51 iceman

    47 – fair enough. I would just note that public sector HC costs *must* grow more slowly than private, if we want any scope for innovation. That’s my alternative – a public option for those who need it for which the basic services available are responsibly defined. I think almost everyone can agree on that.

  52. 52 52 Daniel

    @iceman,

    Right, the devil as always are in the details though.

  53. 53 53 Michael Stack

    @RJ

    Good point. I probably have worked with a few psychopaths; I’ve just been lucky enough that circumstances prohibited them from fully expressing their psychopathy (unlike Johnson).

    Michael

  54. 54 54 ConnGator

    @Roger

    Going to fix this for you:

    LBJ = worst USA president since Hoover/FDR.

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