Principles for public provision of health care.

Divide health expenditures into three categories:

1. "public good" health care (mostly prevention of infectious disease, provision of clean water, and so forth)

2. care whose benefit to the patient is very large compared to its cost (fixing broken legs, antibiotics, or any potentially curative treatment of children and working-age people).

3. care whose benefits to the patient are not large compared to its cost (fill in your favorite draconian examples here).


Categories 1 and 2 can in fact be taken care of by publicly subsidized care at modest cost -- if you don't want to believe me, read Amartya Sen's piece from 1993 in Scientific American on Kerala (India) vs. Harlem.

But on the whole single payer schemes for doing this simply cost too much in terms of foregone medical progress due to the difficulties of central planning.

In the US, public health (category 1 expenditures) is mainly a state and municipal responsibility, and they do it well enough.

The US is rich enough that it can afford to subsidize category 2 health care, and if governments concentrate on that more thoroughly they will do the job better and at less cost. But it would be best if actual provision was handled by competing HMO's, each offering a modest basket of high benefit to cost services, with membership in these funds subsidized for low earners out of taxes, and mostly out of state taxes. People who wanted fancier surroundings or more rapid access to specialists than the basket requires would pay out of pocket or buy supplemental health insurance coverage. This would be an American version of the Israeli system, and that, too, works well enough.

But no scheme can pay for all the care that has a reasonable prospect of providing health benefit to the patient. And it is most reasonable (and equitable) if paying for care that neither (a) improves the health of the public (as opposed to the patient), nor (b) provides a benefit much larger than its cost, is the responsibility of the patient and his or her family.

Letter to an American Gentile Friend

Once, there was a great King, the King of Kings, Ahasverosh, who ruled over a mighty Empire: from India to Ethiopia, from the islands of the Aegean to the great plains of central Asia (Esther 1:1). And yet this King was afraid: even his Queen had failed to obey him (Esther 1:10-13). Even his doorkeepers, his most trusted bodyguards, had plotted against his life (Esther 2:21-23).

So the Great King of Kings elevated a new man, whose origins lay in a foreign land. He put him over all his other ministers and servants (Esther 3:1). The King gave to this man, this Haman the son of Hamedatha the Aggagite, the ring that was the instrument of royal power. The King also gave him the license to do as he saw fit unto the Jews (Esther 3:10-12).

In the fall of 2008 the American people were afraid. They were weary of war, and facing economic crisis the likes of which few had seen in their lives.

Out of these fears, the American people have put their trust in a new man, with new ideas different from those that brought America to greatness.

Unlike Haman, this new man bows before others instead of demanding they bow before him. But like Haman, this new man is determined to destroy the Jews, for they will not bow to him (see Esther 3:2-7). Like Haman his plan is to disarm the Jews and so leave them naked in the face of their enemies

Though I am a Jew, I do not write for the sake of the Jews. God will preserve us Jews from our enemies when and to the extent that we turn to him (Psalms 106:44-46, 107:19-20, etc.). As Mordecai vouchsafed to Esther: "Prosperity and salvation will come to the Jews from another Place" (Esther 4:14). I cannot prophesy whether we Jews will do our part, but I can see with certainty what will happen to you if you fail to do yours.

The question that concerns me in this letter is what will happen to you. What will the judgment of God be upon an America that abandons her principles and her allies?

You ask yourself, "What can I do?" Perhaps you even say to yourself: "I didn't even vote for this man. Why is it up to me?"
But in truth it is not too late to do what you can to check this new Haman in his evil schemes. Men and women dedicated to stopping these schemes exist in every town and county. They have already put themselves forward, whether they call themselves "Tea Partiers," "Republicans," or even "Democrats." God has no concern with these names, but only with their deeds -- and yours!

What have you done to help these brave men and women? Have you given your time to join their rallies, to distribute their pamphlets? Have you even taken thirty seconds to forward their emails to your friends, colleagues and neighbors?

Ask yourself: Have I done enough? And if not, take some time every day to reflect on the events of the day. Reflect on what you see on the news, read on the web or in the newspaper. Remind yourself that a great day of judgment is coming, a day when you will be judged by which side you have chosen: the side of God's chosen people, or, God forbid, the side of their enemies. The future of God's people is in God's hands: it is your future and that of your family and community that depends on your choosing correctly.

But be strong and of good courage! It is true that this new Haman has many friends, many of them rich or powerful. You ask yourself: "If I act against him and his friends will I offend my boss, my colleagues, my teacher, even my pastor?" Perhaps you even supported this man, unknowing or inattentive to who he was and what he stood for. Perhaps you too were afraid in November of 2008, and sought salvation from this man.

But will you serve God or man? In your heart, you know that nothing this man has done since he received your trust, whether at home or abroad, has benefited you. How could it, when everything he has done has contradicted the principles that you have cherished for so long, and under which you have gained a prosperity and power that God has heretofore given to no nation upon this earth?

Know that it not too late to take a stand to do what you can to bring this man and his wicked friends down. It is not too late to witness this truth before those who may be swayed by it.

Remember, this man is doomed to fail in his evil schemes against the Jews. The only question is: will his failure drag America and the American people down too?

If this letter speaks to you, please send it to anyone you know whom you think might be open to its message

Only if the hearts of millions are open to God's truth in time will God give to the American people the benefit of the blessing he gave to Abraham: "I will bless them that bless thee, and curse him that curseth thee: and in thee shall all families of the earth be blessed" (Genesis 12:3).

Haman, too, was humbled before his fall, when by the order of the King he was made to honor Mordecai the Jew, whom he had sought to destroy (Esther 6:10-14). God has given the American people, from now until November of 2010, the opportunity to be the instruments of the humiliation of this Haman.

Fear God and do your part, and He who gives strength to His People will give strength to you as well.

{And feel free to write to me with your thoughts and suggestions,
mskochin@gmail.com}

Boomers

The Boomers will leave the future a twofold legacy: Obamacare and Microsoft Windows.

Hilllary channels her inner neo-con!

Remarks on Internet Freedom -- Hillary Clinton
"On their own, new technologies do not take sides in the struggle for freedom and progress, but the United States does."
Speak for America, Hillary!
But after Obama's fiascos on Honduras and Iran, we have to wonder if she is speaking for the administration.

The Moral Case for Torturing Terrorists

The moral case for torturing terrorists.
Copyright 2009 Michael S. Kochin all rights reserved

Assumptions:
A1. Terrorism is a crime.
A2. It is the obligation of everyone with knowledge of a potential crime to share that knowledge with those that can prevent the crime.
A3. If someone is obliged to do something, there is a prima facie case that they ought to be coerced to carry out their duty.
A4. Torture is an effective means of extracting information
--
It follows:
C1. There is a prima facie case that those with relevant knowledge that can prevent terrorist actions ought to be tortured into revealing that information.

Discussion: Obviously, the required means of coercion depends on a whole host of factors. We must do things to prevent a murder that we must not do to prevent a shoplifting.
Also, this argument assumes that we know that somebody has relevant knowledge which they are refusing to share. Since in the real world we are are uncertain about this in any given case, we need to concerned about torturing innocent people. But in the real world we also need to worry about arresting innocent people, jailing innocent people, and executing innocent people. The answer to all these problems is the same as the answer to the surgeon: "try real hard not to make mistakes."

Don't Confuse Diversity with Bias

I am reposting my op-ed on academic bias at Tel Aviv University, in response to the piece in Haaretz -- MSK.

Don't Confuse Diversity with Bias (originally published in the Jerusalem Post, January 2004)

I am a recently tenured member of the Department of Political Science at Tel Aviv University, the department that is the focus of Caroline Glick's "Academic Gulags." I am also a conservative, an opponent of a Palestinian state, a supporter of Jewish settlement in Judea, Samaria, and Gaza -- and I have not hesitated to air my political views since joining the department in 1995. I have written for the neo-conservative Weekly Standard, and have received funding from such well-known conservative institutions as the John M. Olin Foundation and the Heritage Foundation.

Nor am I the token conservative in an otherwise solidly far-left department. One colleague, a strong cultural Zionist, participates in a seminar at the conservative Shalem Institute in Jerusalem. Another, while dovish politically, works on the politically incorrect topic of sociobiological explanations for warfare. Yet another has, in her scholarly publications, defended the Israeli right to retain the settlements. Nor are we monolithic in our political affiliations and political activities: members of the department have been linked to political parties from the right, the center, as well as the left, advising figures from former IDF Chief of Staff Raful Eitan to Likud's David Levy to former Labor Party foreign minister Shlomo Ben-Ami.

We Tel Aviv political science professors are active in presenting Israeli affairs from diverse points of view both at home and abroad. My colleague Gideon Doron defended Israel and the Sharon Government in an internationally publicized debate with Palestinian spokeswoman Hanan Ashrawi last year at the University of Colorado. Another colleague, Yossi Shain, has defended Israeli policy on ABC's Nightline and other major media outlets.

Ms. Glick found that some of our students echoed back to her the teachings of Yoav Peled. I am not surprised: Professor Peled is, without a doubt, the most influential teacher in our department  not because his views are echoed by other members of the faculty, but because he does the best job in his lectures of marshaling arguments and evidence in support of them. To the rest of us, who disagree with him about everything from the virtues of capitalism to the Palestinian right of return, Professor Peled's influence is only a spur to us to do a better job in researching, writing, and presenting alternative understandings that we find more plausible. Professor Peled is also the strongest voice in the department for the maintenance of unimpeachable academic standards and the place of the liberal arts in our curriculum, to an extent that even I, a former student of the late Allan Bloom's, am sometimes hesitant to echo.

Yoav Peled is indeed a Marxist, a supporter of concessions to the Palestinians, and has even spoken out for "regime change" in George W. Bush's United States. Professor Peled is also a captain in the Israel Defense Forces reserves, a former El Al air marshal, and the son of one of the most prominent generals in IDF history, Motti Peled. Somehow I doubt that many such figures can be found in America's academic left.

Are alternative views to Yoav Peled's welcome at Israeli universities? My experience of the past decade, a tumultuous decade for Israel, as we all know, indicates that such views are more than welcomed; such views are rewarded by Tel Aviv's Department of Political Science. My department values diversity of viewpoint and excellence in research and presentation above criteria of political correctness whether leftist or conservative. By following that policy, we have become the leading political science department in Israel.

Three questions on the war in Afghanistan

Have Afghanis learned their lesson not to permit attacks on the US
homeland to be run from their country?
If they haven't, what does the US need to do to "learn 'em"?
if they have learned, WTF is the US still doing there after eight years?