Obamacare and Intelligent Design

We have previously posted about the similarity of free market economics and biological natural selection. For a few examples, see Adam Smith’s Invisible Hand and Charles Darwin’s Natural Selection and also Evolution, Intelligent Design, and Barack Obama, and also Creationism, Socialism, and Intelligent Design (we love the graphic at the top of that one!), and about six months ago Evolution: the Biosphere and the Shopping Mall.

Today we won’t rant about Obamacare — the Patient Protection and Affordable Care Act, as it’s officially known. All we’re doing is mentioning that it strikes us as another example that illustrates an old theme around here, so merely raising the subject should be sufficient to stir things up.

Please bear in mind that we’re not blasting away at Obamacare. We could, but that’s not what this blog is all about. Nor are we advocating some kind of lawless regime where Bernie Madoff sucks your blood, or a jungle-like society where the sick are tossed out in the street and left to die. It’s a flamingly false dichotomy to contrast those scenarios with centralized controls. We favor laws against fraud, and we favor charity too.

The only thing we’re doing is pointing out — once again — the analogy of centralized controls to intelligent design. If the biosphere didn’t need a plan imposed from above, then … you know the rest.

We don’t think the other science blogs are going to touch this subject. We understand. But it needs to be raised, and because this is a slow news weekend, the time is right. You already know what your Curmudgeon thinks, and you don’t need to hear that again. But we’d like to hear from you.

Copyright © 2013. The Sensuous Curmudgeon. All rights reserved.

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27 responses to “Obamacare and Intelligent Design

  1. We don’t have a free market. There wasn’t a free market for health care before Obamacare.

    In a truly free market, we would not have the DMCA, which is anti-free market welfare-for-wealthy-corporations legislation.

    Oh, biology has lots of regularitory aspects, too.

  2. Another gauntlet (really must be a slow news weekend!):

    You already know what your Curmudgeon thinks, and you don’t need to hear that again. But we’d like to hear from you.

    I generally try (not always successfully) to recuse myself from discussions on American politics, if only on the grounds my long, long residency in Europe has distorted and tainted me horribly. But I’ll chip into this topic with a link to a relevant article by Mark Mardell, BBC North America Editor–not with my full personal agreement with his views, but as an intelligent exemplar of European perception of the USA: Why America doesn’t work

    In Europe, for good or ill, the parties of left or right came to a grand bargain that the rougher edges of capitalism would be sanded off by a dose of big government and the welfare state.

    The US has never made that accommodation. The US is not just changing, it is still becoming.

    Although calling Obama a “socialist” sounds daft to our ears (he’s a pretty right wing social democrat), it is exactly how many conservatives see him.

    The two parties have a very different vision of what America means, and what it should be.

    In most democratic systems, that would make for a very fractious, very angry opposition. But here it’s another thing, perhaps the main factor, in America’s apparent dysfunction.

    The Republicans in the House are not some angry faction of the opposition. They are automatically part of the government

  3. Richard Olson

    A pretty significantly large portion of US conservatives are convinced utopia once existed: pre-1820 America. And if we just undo most federal policy enacted since, those halcyon days of yore will once again benefit one and all.

  4. Richard Olson claims: “A pretty significantly large portion of US conservatives are convinced utopia once existed: pre-1820 America.”

    I haven’t run into that. Most would settle for a legislative roll-back to the 1950s. There might be a few earlier things I’d abolish — like civil service — and some that I’d restore — like NASA — but I wouldn’t want to restore things to a time when there was slavery.

  5. ” If the biosphere didn’t need a plan imposed from above, then …”

    1. SC is guilty of the natural fallacy: because biology doesn’t need an Intelligent Designer – blessed be he/she/it – Homo Sapiens shouldn’t organize it’s economies.
    2. SC is contradicting himself. One of the arguments against an Intelligent Designer is that he/she/it – blessed or not – has done such a lousy job. Analogous logic requires to expect a non-regulated economy to be as lousy as the biosphere. As the Intelligent Designer obviously won’t Homo Sapiens – certainly not blessed – has to do the job.
    Of course this second argument – oh irony – is a form of the natural fallacy itself. The real question is: do we want to get something better than a non-regulated economy which relies on Smith’ Invisible Hand like relying on natural selection?
    In the end SC doesn’t really want that either: “It’s a flamingly false dichotomy ….”
    Yup. But that means SC shouldn’t accuse those who favour some more regulation, like the vast majority of western Europeans, of thinking like creacrappers either. I grant you the false dichotomy but you will have to grant socialist me the false analogy.
    Perhaps, very perhaps, then you will get at the question that really matters: how will we organize things in such a way that as many citizens will benefit as possible? Clearly Smith’ Invisible Hand is not enough. Now will Obamacare be helpfull in this respect?
    Let’s look at some numbers. The far less regulated US health system is a lot more expensive than the European health systems (France, The Netherlands, Sweden) subject to centralized control.
    I’ll leave it to you to draw the logical conclusion. Mine is that another anti-socialist bias of you is busted.

  6. MNb claims: “Clearly Smith’ Invisible Hand is not enough.”

    As it is clear to the Discoveroids that the Darwinian mechanism of mutation and natural selection isn’t enough. It’s clear to them, but not to us.

  7. We forget that the ACA was written and implemented to address huge and ongoing problems in our national heath care system involving both high cost, limited access, and in some cases quality of care. As I recall, Republicans complained about those issues as well as Democrats.

    While I think the Democrats took undue advantage of being in the majority when they pushed the bill through congress, they at least made a solid effort to correct the existing system’s weaknesses. More needs to be done. But where are Republican’s on this issue? If you listen to them, it sounds like they are against health care, period. When did they have their change of heart, and decide that the old system was wonderful? I suspect their newfound love of the creaky, expensive, health system in the U.S. is directly due to the fact that fixing the system might accrue to the credit of a democratic president, whom they seem to hate beyond any rational explanation.

    When the Republicans propose a bill to fix the weaknesses they perceive in the ACA, while preserving the strengths of the bill, then they will have a credible position – and, who knows, they may even get more than a few democrat votes.

  8. I’m not one to philosophize over whether a program is an example of “free-market Darwinian economy” or some “left-wing plot to overthrow the American Way”, but there is no denying that health care prices in the US are unreasonably high. I say “prices” rather than “costs”, because in so many examples, the price charged has no relationship to the actual cost. A prime example would be lab charges for simple blood work — a $570 bill is charged by the lab, but the lab accepts full payment of $24.75 under its contract with my health insurance company. Pity the poor (very poor!) soul who doesn’t have health insurance!

    So, what causes this dichotomy between price and cost? My opinion is that health care prices are so high because the users of the services have no reason to shop around for the best price. After all, the bill will be paid by my health insurance, so what do I care if the hospital bill for two days, with an MRI thrown in for good measure, amounts to $20,000 or so. (Admittedly, I’m pulling that figure out of the air, but it’s just to illustrate the point.)

    What’s the answer? Perhaps introducing some competition into the system, so we users do care what the charges are, to get us to do some shopping. Everyone having high deductibles on our insurance policies might do it, but not for preventive care. It makes tons of sense to have regular check-ups and other preventive medical care paid 100% by our insurance policies (regardless of who’s paying for those policies — ourselves, our employer, or all taxpayers through our government).

    Frankly, I don’t see health care costs coming down without introducing competition into the system, unless it’s by government mandate — and I don’t see that working out very well at all.

  9. retiredsciguy asks: “What’s the answer?”

    I like the answers that I gave in this post, four years ago: The Curmudgeon’s Health Care Reform Plan.

  10. Curmudgeon, I don’t think your 2009 post addresses the price/cost issue. Government bureaucrats don’t add to the cost of routine blood work (as in the example given above) and other insane costs which can only be attributed to creating profit. In my current job, I pay less than $100 a month for my health insurance. My employer pays almost $1000. Wouldn’t that money be better off being given to me in salary, and my taxes going up by some fraction of that to go to universal health care? Don’t you think that society as a whole would suffer less bureaucracy?

  11. eryops asks, if we had universal health care: “Don’t you think that society as a whole would suffer less bureaucracy?”

    That’s not the British experience with their National Health Service.

  12. Megalonyx
    · … he’s (President Obama) a pretty right wing social democrat…
    · … a very fractious, very angry opposition.
    · The Republicans in the House are not some angry faction of the opposition. They are automatically part of the government

    Indeed, Megalonyx.
    Perhaps divisiveness is inherent (divide and conquer) so that a plutocracy is less threatened?
    ———

    Curmudgeon
    · … settle for a legislative roll-back to the 1950s.

    Would that include the top marginal tax rates?
    ——–

    Would point our re our inappropriately named Affordable Health Care Act that it was sold out to corporate interests in the name of “the art of the possible” and that in doing so the true issues of cost was never addressed. See Dr. Marcia Angell’s erudite written statement to Congress (U.S. HOUSE COMMITTEE, 10 June 2009; http://www.gpo.gov/fdsys/pkg/CHRG-111hhrg50116/html/CHRG-111hhrg50116.htm)

    BTW (re Curmudgeon’s Health Care Reform Plan) Single Payer addresses Tort reform as it becomes a non issue. If competition worked why has there been so much consolidation (hint: money influences; power corrupts). See other nations (e.g. France) for mechanisms re medical personnel/education. A relevant question might revolve around why does the rest of world’s industrialized nations provide for all their inhabitants at half our cost? As noted by Dr. Angell, for other nations the issue is amount of money spent (more would correct for their weaknesses) – for this nation the issue is the system.

    Perhaps we the people need a government stronger than our oligarchic plutocratic opponents?

  13. While I don’t like this use of analogies, I think that it is appropriate to point out that the standard argument that eugenics (or so-called “Social Darwinism”) has some connection with evolutionary biology is a seriously failed analogy, because of this point. If one were to make an analogy to eugenics, it would be rather to “intelligent design”. The eugenicist says allowing nature to take its course must lead to “deterioration”. The eugenicist says that there must be goal-directed actions taken in order for there to be “improvement”. The eugenicist believes in teleology.

    I’d also note that those evolution-deniers who insist that they accept “micro-evolution” within a “kind” have another problem with eugenics, for eugenics is solely concerned with changes within “man kind”.

  14. TomS says:

    If one were to make an analogy to eugenics, it would be rather to “intelligent design”.

    That’s good! I don’t recall seeing that point made before, although (now that you’ve mentioned it) it seems so obvious — along with racism, segregation laws and such — that I can’t believe I haven’t run across it before.

  15. Cogito Sum responds to my proposed legislative roll-back to the 1950s by asking: “Would that include the top marginal tax rates?”

    The income tax is one of the pre-1950s things I’d eliminate. I’m sure you saw that coming.

  16. With reference to eryops’ point re: bureaucracy, our Curmudgeon claims

    That’s not the British experience with their National Health Service.

    This needs some elaboration, I’m not sure what you mean here. I am wary, however, because I have seen some pretty wildly misleading reportage in the US on the UK system (remember Sarah Palin’s ‘NHS Death Panels’?)–which, in fairness, is about as unreliable as plenty of European reportage on US 2nd Amendment issues.

    Overall, NHS has been a remarkable success, and that is pretty general consensus. There are, of course, many problems in the system, but many of those have arisen in recent years (under both Labour & Tory govts). Ironically, some the biggest current problems arise from attempts to introduce ‘internal markets’ to ‘foster competition’ within NHS: that, more than anything else, resulted in unnecessary and expensive bureaucracy.

  17. A few items to supplement my previous post re: UK NHS

    [1] From the Conservative Party website: Conservative Party Policy on Health

    The NHS is our country’s most precious asset. Over the last two years, because of the dedication of staff across the country, the NHS has maintained or improved quality across the board – reducing waiting times to record lows, reducing hospital infections to their lowest levels ever, increasing access to dentistry, delivering more doctors and fewer administrators, and giving thousands of patients the cancer drugs they need.

    Though there is much still to do, it is clear that the NHS is achieving outcomes which are among the best in the world. We are determined to make sure this continues.

    [2] From The Independent:
    Margaret Thatcher’s impact on the NHS

    [Under provisions of Thatcher’s 1990 reforms, ]Health authorities ceased to run hospitals but instead “purchased” care from hospitals who had to compete with others to provide it and became independent, self-governing trusts. The aim was to increase efficiency and eliminate waste through competition.

    Every development since has been a refinement of this market structure. Has it improved the NHS? The service is better today than it has ever been, with shorter waiting lists, better access and higher standards of care than at any point in the last 60 years. But many would say that has been achieved in spite of, not because of, constant reform.

    I could very easily google up a host of articles in the US press that paint a very different picture of the NHS–one that is, frankly, unrecognisable. If the NHS were even 10% as ghastly as some American reportage would have us believe, then there would surely be a political party here that would be hugely popular for campaigning for its abolition and the introduction of the American pre-Obama medical market model. No such party, or even fringe of a party, has any such policy (and on the good grounds that such a policy would have no resonance with the British electorate).

  18. Megalonyx speculates: “If the NHS were even 10% as ghastly as some American reportage would have us believe, then there would surely be a political party here that would be hugely popular for campaigning for its abolition …”

    Yes, one would think so. I don’t pretend to know anything about the NHS, but I recall press accounts (in the US, not the UK) saying that because there are so many people employed by the system (I don’t recall the number), they form one of the largest voting blocks in the UK, and thus it’s political suicide to oppose them. Do you have any information about this?

  19. Our Curmudgeon recalls

    press accounts (in the US, not the UK) saying that because there are so many people employed by the system (I don’t recall the number), they form one of the largest voting blocks in the UK, and thus it’s political suicide to oppose them. Do you have any information about this?

    Not really plausible IMHO. True, NHS is very large, with 1.4m employees (sources: Staff census shows NHS workforce hits 1.4 million, and of particular interest, see also Key statistics on the NHS for wealth of info on NHS size, costs, and productivity). Total British electorate (2011 census) is 46.1m (total UK population 63.2m).

    Even if all 1.4m NHS employees were eligible to vote in UK (but many are not UK citizens and thus not eligible), that would barely be 3% of the electorate–hardly a decisive block. And in any event, it’s wildly fanciful to suppose that those 1.4m employees (from neurosurgeons through to cooks and cleaners) would hold homogenous political views, or indeed–as medical professionals–would if anything favour a replacement for the NHS if anyone were able to propose a superior alternative, as after all these are the folks who would make up the workforce for that alternative.

  20. ” If the biosphere didn’t need a plan imposed from above, then … you know the rest.”

    The rest is that the biosphere works by extinction, but I don’t think you can decide policy at so high a level of abstraction anyway. The reality is that the US spends more and gets less than any other industrialised nation. And the money goes, not on providing care, but on the paperwork of paying.

    I spent 18 years in the US with excellent insurance for myself and family. Give me single provider, as in the UK NHS as it still survives in Scotland, any day.

  21. Richard Olson

    “I could very easily google up a host of articles in the US press that paint a very different picture of the NHS–one that is, frankly, unrecognisable.”

    The same press that fabricates porky’s about single-payer health care is the one responsible for climate change denial; evolution denial; Free Market is right there next to the deity, public goods are always Wrong and privatization of all things is always Right; Labor is evil/Capital is Divine; regulation is an effrontery to the Divine, and on and on and …

    Same as the it is in the UK, the EU, and many other places. I think the unspoken goal must be to achieve Greece everywhere!

  22. Paul Braterman says: “The rest is that the biosphere works by extinction”

    And a free market economy works by companies failing, leaving behind their competitors who are better attuned to the needs of the market. As with the biosphere, it may appear that the outcome was prearranged, but that’s illusory. Look at Wikepedia’s Historical components of the Dow Jones Industrial Average.

  23. @Megalonyx “many are not UK citizens and thus not eligible”
    Is that how it now works in the UK? Traditionally, IIRR, voting rights were dependent not on nationality, but on residence.

  24. @ jimroberts: Yes, I simplifed; in fact, for the UK it’s a combination of nationality + residence. See Who can register to vote?. Basically, nationals of European Union or the Commonwealth, if resident in UK, can vote in some local elections–but not UK parliamentary elections.

  25. Why do American’s always want to talk about the UK when it comes to healthcare.

    There are literally 20+ other countries and systems that more closely resemble what they want for and from there system. Each and everyone of them has lower costs and better results than the US has.

    Instead of looking at those other countries they compare results from countries that are the polar opposite of the system they want to create.

    For insistent the Japanese system.
    http://en.wikipedia.org/wiki/Japanese_healthcare_system

    Or Germany
    http://en.wikipedia.org/wiki/Germany_healthcare_system

  26. Richard Olson

    Paul – The US single payer system, Medicare, costs about 3.5% for administrative overhead, including salaries. Overhead in private insurance sector delivery, on the other hand, is never below 20% of aggregate cost, not least of which is attributable to the fact that insurance companies are businesses, and the primary goal of business is to generate profit for investors; salaries for top insurance company officials may be 50x or more than civil servant salaries; there is bloat in pharmaceutical expenses and hospital/doctor fees for a long list of reasons. I have read many opinions by physicians about how this abuse proliferates in our present system, and outlining how the abuse is far more amenable to control were a single payer system for all implemented.

    But the issue in America is not a matter of viewing alternatives and choosing the one that is best. No, it is a matter of guaranteeing that private enterprise does not have to compete with public “socialized” services.

    Private health insurance simply is not as efficient as single payer public health service, although it is hellish good at generating profit. Profit is plenty high enough to not only own congresspersons to ensure favorable policy outcome — guess who writes most of the legislation introduced in the US Congress — but also to fund expensive propaganda machines dedicated to maintaining the status quo.

    Actual health delivery outcomes in US health care leave a great deal to be desired though, as any comparison of US health statistics with countries with socialized medicine demonstrates. But we’re still (just) ahead of banana republics!

  27. Richard Olson

    The bloat I refer to is universally present in non-overhead expenses common to both public and private delivery.