Category: Leftism – Statism – Democracy

Libertarian-Conservatives Are from the Earth, Liberals Are from the Moon

A post by Tyler Cowen of Marginal Revolution points to George Lakoff’s book, Moral Politics. Lakoff thinks he has an explanation for the difference between conservatives (who hew to a “Strict Father” model) and liberals (a “Nurturant Parent” model):

What we have here are two different forms of family-based morality. What links them to politics is a common understanding of the nation as a family, with the government as parent. Thus, it is natural for liberals to see it as the function of the government to help people in need and hence to support social programs, while it is equally natural for conservatives to see the function of the government as requiring citizens to be self-disciplined and self-reliant and, therefore, to help themselves.

Lakoff is probably wrong about liberals, and he’s certainly wrong about most conservatives — and about libertarians, whom he doesn’t seem to acknowledge.

Liberals, in my observation, don’t think of the nation as a family. They think of it as a playground full of unruly children, needing someone (government) to enforce the rules (liberal rules, of course). A liberal’s candid thoughts would run something like this:

Well, here we are all on the same playground. Well, if we’re going to be here, we might as well get along together. I’m sure we’ll do just fine, and you’ll all be happy, if you do as I say. Now, if we all share, there won’t be any fights. Johnny, you have more toys than Billy, you have to give him some of your toys. Susie, no fair hanging around with your friends, you have to hang around with people you’ve never met; it’ll be good for you.

In other words, the liberal mindset is more like that of a bossy child trying to control her playmates than that of a “nuturant parent.”

Conservatives (those who think about such things, anyway) and libertarians don’t see “the nation as a family, with government as parent.” They see the nation as parent whose role is to guarantee a form of government that exists not to require citizens to be self-disciplined and self-reliant but to allow citizens to realize the fruits of whatever self-discipline and self-reliance they can muster.

It is not surprising, therefore, to find that conservatives and libertarians are generally more patriotic than liberals. Conservatives and libertarians put nationhood above government, realizing that without the nation our enemies (without and within) would rob us of our ability to enjoy the fruits of our self-discipline and self-reliance. Liberals, on the other hand, put government first and seem embarrassed by patriotism.

Thomas Sowell, in A Conflict of Visions, has a much better explanation of the dichotomy between the liberal and conservative-libertarian perspectives. He posits two opposing visions: the unconstrained vision (I would call it the idealistic vision) and the constrained vision (which I would call the realistic vision). As Sowell explains, at the end of chapter 2:

The dichotomy between constrained and unconstrained visions is based on whether or not inherent limitations of man are among the key elements included in each vision….These different ways of conceiving man and the world lead not merely to different conclusions but to sharply divergent, often diametrically opposed, conclusions on issues ranging from justice to war.

Thus, in chapter 5, Sowell writes:

The enormous importance of evolved systemic interactions in the constrained vision does not make it a vision of collective choice, for the end results are not chosen at all — the prices, output, employment, and interest rates emerging from competition under laissez-faire economics being the classic example. Judges adhering closely to the written law — avoiding the choosing of results per se — would be the analogue in law. Laissez-faire economics and “black letter” law are essentially frameworks, with the locus of substantive discretion being innumerable individuals.

By contrast,

those in the tradition of the unconstrained vision almost invariably assume that some intellectual and moral pioneers advance far beyond their contemporaries, and in one way or another lead them toward ever-higher levels of understanding and practice. These intellectual and moral pioneers become the surrogate decision-makers, pending the eventual progress of mankind to the point where all can make moral decisions.

Sowell has nailed it. Equality is a state that we will reach when liberals tell us we’ve reached it. Until then, we must do as they say — or else.

Things Have Gone Too Far

From AP via Yahoo News:

‘Ladies Night’ Discount Axed in N.J. Bars

TRENTON, N.J. – The state’s top civil rights official has ruled that taverns cannot offer discounts to women on “ladies nights,” agreeing with a man who claimed such gender-based promotions discriminated against men.

David R. Gillespie said it was not fair for women to get into the Coastline nightclub for free and receive discounted drinks while men paid a $5 cover charge and full price for drinks.

In his ruling Tuesday, J. Frank Vespa-Papaleo, director of the state Division on Civil Rights, rejected arguments by the nightclub that ladies nights were a legitimate promotion.

Later in the story we find that some States have the right idea:

[C]ourts in Illinois and Washington state have said that ladies nights are permissible because they do not discriminate against men but rather encourage women to attend.

James E. McGreevey, the governor of New Jersey, is quoted as saying that the ruling “is an overreaction that reflects a complete lack of common sense and good judgment.”

Not bad for a Democrat.

The Cost of Affirmative Action

La Griffe du Lion, in “Affirmative Action: The Robin Hood Effect”, assesses the redistributive effects of affirmative action:

[O]n average a black worker between the ages of 25 and 64 earns an extra $9,400 a year because of affirmative action. Hispanics also benefit to the tune of almost $4,000 a year. However, being a zero-sum game, white workers pay an average of about $1,900 annually to foot the bill.

Working from data for 1999, La Griffe estimates that affirmative action cost white workers a total of $192 billion. But there’s more to it than that.

Because of affirmative action — and legal actions brought and threatened under its rubric — employers do not always fill every job with the person best qualified for the job. The result is that the economy produces less than it would in the absence of affirmative action.

GDP in 1999 was $9.3 trillion. Taking $192 billion as an approximation of the economic cost of affirmative action in that year, it’s reasonable to say that affirmative action reduces GDP by about 2 percent. That’s not a trivial amount. In fact, it’s just about what the federal government spends on all civilian agencies and their activities — including affirmative action, among many other things.

Favorite Posts: Affirmative Action and Race

Priorities Revealed

Courtesy of Yahoo News:


Group: Terror War Has Hurt Human Rights

Wed May 26,10:10 AM ET

By JANE WARDELL, Associated Press Writer

LONDON – The U.S.-led war on terror has produced the most sustained attack on human rights and international law in 50 years, Amnesty International said in its annual report Wednesday.

Irene Khan, secretary general of the human rights group, condemned terrorist assaults by groups such as al-Qaida, saying they posed a threat to security around the world.

Well, groups such as al-Qaida also pose a threat to the basic human right: the right to life.

Where’s the headline that reads “Terror Has Hurt Human Rights”? I’m still waiting for that one.

Social Injustice

From Economic Theories of Social Justice: Risk, Value, and Externality, by Anthony de Jasay:

Stripped of rhetoric, an act of social justice (a) deliberately increases the relative share…of the worse-off in total income, and (b) in achieving (a) it redresses part or all of an injustice….This implies that some people being worse off than others is an injustice and that it must be redressed. However, redress can only be effected at the expense of the better-off; but it is not evident that they have committed the injustice in the first place. Consequently, nor is it clear why the better-off should be under an obligation to redress it….

There is the view, acknowledged by de Jasay, that the better-off are better off merely because of luck. But as he points out:

Since Nature never stops throwing good luck at some and bad luck at others, no sooner are [social] injustices redressed than some people are again better off than others. An economy of voluntary exchanges is inherently inegalitarian….Striving for social justice, then, turns out to be a ceaseless combat against luck, a striving for the unattainable, sterilized economy that has built-in mechanisms…for offsetting the misdeeds of Nature.

The Roots of Statism in the United States

Government — measured by its real cost — has never been larger. The regulatory state thrives and its hidden costs grow apace. Future generations are faced with huge tax bills for compulsory charity in the form of Social Security, Medicare, and Medicaid. Why, why, why?

First, we have become locked into a cycle of dependency on government, which began in earnest in the 1930s. The government way of life has acquired powerful and vocal constituencies, which few politicians dare to offend.

Second, we think we can afford gargantuan government. Thanks in large part to three eras of rapid technological progress (in the early 1800s, the late 1800s, and the late 1900s), real per capita GDP has grown more than 30-fold since 1789. Thus most Americans don’t know (or don’t care) how much better off they would be if, for example, Social Security were privatized or the mountain of economic regulations were reduced to a molehill.

Third, the onset of the Cold War — followed closely by the Korean War and then by the apparent threat of nuclear war — led us to a state of permanent and costly mobilization. Our reluctance to demobilize — and our willingness to use armed force in some parts of the world — stems, in part, from increasing dependence on foreign trade as a source of our growing affluence.

Fourth, with greater affluence we have become worldlier and less wedded to traditional sources of moral authority, namely, family and church. The family has dwindled in size, split with greater frequency, and drifted apart geographically. The church — with the notable exception of counter-cultural fundamentalism — has become more secular and less prone to the teaching of behavioral absolutes. Family and church have been displaced, in large part, by an increasingly paternalistic government, one that compels charity through taxation, one that enforces “right” behavior (e.g., bestowing special treatment on “disadvantaged” classes of people, banning smoking in most public and many private places, dictating the design of our automobiles in the name of safety and environmentalism), and one that fosters the redress of grievances through legislatures and courts rather than directly or the good offices of friends, family, and clergy.

Like teen-age cultists, we have renounced our faith in voluntary (and relatively costless) institutions. We have become addicted, instead, to the adoration of the state, which compels our obeisance and demands a high price for the privilege.

The Inevitability of the Communitarian State, or, What’s a Libertarian to Do?

What kind of state? Bear with me. To get there (inevitably) we have to reject some useless terminology.

It’s obvious that “left” and “right” inadequately capture the subtleties in political ideology. (Calling Stalin and Mao leftists while putting Hitler and Pinochet on the right is as descriptive as parsing shades of white.) “Liberal” and “conservative” are somewhat more meaningful labels, but libertarians always object (rightly) to being lumped with conservatives, who object (rightly) to being lumped with neo-fascists.

The left-right, liberal-conservative taxonomies of the political spectrum fail because they are linear and lacking in subtlety. My alternative is a somewhat more subtle taxonomy with these four major points arrayed on a circular continuum:

• Anarchy — “might makes right” without an effective state to referee the fight

• Libertarianism — the minimal state for the protection of life, property, and liberty

• Communitiarianism — the regulation of private institutions to produce “desirable” outcomes in such realms as income distribution, health, safety, education, and the environment

• Statism — outright state control of most institutions, reached either as an extension of communitarianism or via post-statist anarchy or near-anarchy, as in Stalin’s Russia, Hitler’s Germany, and Mao’s China.

Think of anarchy, libertarianism, communitarianism, and statism as the North, East, South, and West of a compass. The needle swings mostly from anarchy to statism to communitarianism, and occasionally from communitarianism toward libertarianism, but never very far in that direction.

The tide of communitarianism rose inexorably to engulf the federal government in the aftermath of the Great Depression and World War II. The tide continues to rise, threatening to engulf us in statism. Libertarians, like the sorcerer’s apprentice, have been trying futilely to turn the tide with a broom.

Consider the ambitious Free State Project,

a plan in which 20,000 or more liberty-oriented people will move to New Hampshire, where they may work within the political system to reduce the size and scope of government. The success of the Free State Project would likely entail reductions in burdensome taxation and regulation, reforms in state and local law, an end to federal mandates, and a restoration of constitutional federalism, demonstrating the benefits of liberty to the rest of the nation and the world.

The movement has attracted fewer than 6,000 adherents since it began almost three years ago.

The communitarian state is simply too seductive. It co-opts its citizens through progressive corruption: higher spending to curry favor with voting blocs, higher taxes to fund higher spending and to perpetuate the mechanisms of the state, still higher spending, and so on. Each voting bloc insists on sustaining its benefits — and increasing them at every opportunity — for one of two reasons. Many voters actually believe that largesse of the communitarian state is free to them, and some of them are right. Other voters know better, but they grab what they can get because others will grab it if they don’t.

Communitarianism leads inevitably to statism because the appetite for largesse is insatiable. The resultant statism may be relatively benign, like the statism of pre-Thatcher Britain or today’s France and Germany, but it is statism nevertheless.

The good news is that statism is an easier target for reform than communitarianism. The high price of statism becomes obvious to more voters as more facets of economic and personal behavior are controlled by the state. In other words, statism’s inherent weakness is that it creates more enemies than communitarianism.

That weakness becomes libertarians’ opportunity. Persistent, reasoned eloquence in the cause of liberty may, at last, slow the rise of statism and hasten its rollback. And who knows, perhaps libertarianism will gain adherents as the rollback gains momentum.

If we reach for the stars we may at least rise above the Earth.

Fear of the Free Market — Part III

If it’s unnecessary to regulate health care — as I’ve argued in Part I (April 8) and Part II (April 11) of this series — can we take the next step and denationalize it? Can we forgo other forms of nationalization (particularly Social Security) and the regulation of other industries (e.g., telecommunications, banking, and securities)?

The prospect of deregulating health care; giving up Medicare, Medicaid, or Social Security; and leaving consumers generally “at the mercy of the market” may seem unthinkable. So let us think about it.

Regulation and nationalization (an extreme form of regulation) restrict competition and therefore reduce the supply and quality of regulated products and services. Many have argued, rather persuasively, that individuals would be far better off with the privatization of Social Security. (See, for example, my posts of March 5.) Moreover, there is ample evidence that proper deregulation leads to higher quality and lower prices. Phone service, for example, is not only cheaper (in real terms) but indisputably better, given the range of options available to consumers. Air travel, to take another example, is also cheaper (in real terms) and certainly better for the great majority of travelers who prefer more legroom to the so-called meals that airlines used to serve in coach class.

Why, despite sound arguments and concrete evidence, do most Americans tend to resist denationalization and deregulation? Their resistance arises from two things: risk aversion (both personal and paternalistic) and economic illiteracy.

Risk aversion is revealed in questions like these: Will I choose the right doctor? Will he choose the right medicine? Will that over-the-counter drug poison me? Will I save enough for retirement? What about my parents, my children, my friends, and the elderly poor? The answers are:

• Licensing of doctors doesn’t ensure your doctor’s competence or help you choose the right doctor.

• The FDA’s approval of drugs doesn’t ensure that your doctor will choose the right drug for you or a drug that’s safe for you.

• That over-the-counter drug is unlikely to poison you, especially if the one you choose has been on the market for at least a few years.

• Your parents, children, and all the rest (even you) would have plenty of money for retirement living (including private medical insurance) if the government didn’t collect taxes for Social Security, Medicare, and other welfare programs. The elderly poor would be taken care of by greater charitable donations (afforded by lower taxes) and relatively small, strictly means-tested, welfare programs.

I could go on and on about other components of our over-regulated economy, but I think you get the idea. There is little risk of coming to harm in a free-market economy, where individuals learn to look out for themselves, especially if they are backed by strict enforcement of tough laws against deception and fraud. Conversely, the rewards of a free-market economy are great: more competition, higher quality, lower prices, greater output, higher employment, and higher incomes (from which to fund minimal welfare programs for those who are truly dependent on society because no one else can meet their needs).

Economic illiteracy blinds people to the benefits that flow from a truly free-market economy. The illiterates (that’s most of us) therefore become easy prey for the real beneficiaries of nationalization and regulation, what Bruce Yandle aptly calls “Bootleggers and Baptists”:

• The “bootleggers” are market incumbents (as represented by the American Medical Association and the American Bar Association, for example) who benefit from the suppression of competition (as bootleggers did during Prohibition).

• The “Baptists” are self-appointed guardians of our health and well-being (the sum of all our risk-averse fears, you might say).

Economics can be as abstruse as the physics of special relativity. But it rests on two things that are easily remembered:

• Incentives matter.

• There’s no such thing as a free lunch.

Nationalization and regulation suppress incentives and therefore weaken the economy. The benefits of nationalization and regulation come at a high cost, but we tend to focus on our own benefits (the “free lunch”) and forget the cost (the taxes we pay for benefits that go to others).

Fear of the Free Market — Part II

In Part I of this series (second post under April 8, 2004), I pointed out that

[i]t is easier to list those markets in which the government doesn’t intervene (namely, “black markets”) than it is to list those markets in which the government does intervene. There simply isn’t a lawful business activity that isn’t affected by government regulation….[G]overnment intervention in the market for any product or service tends to reduce the supply of that product or service.

Health care, being something almost everyone needs (like electricity and phone service), has been regulated to the point of being nationalized (see Part I). Yet it is unclear that the regulation of health care does anything but restrict our access to doctors and drugs. Licensing exams have no meaningful effect on our ability to choose competent doctors (see Part I).

What about FDA approval of drugs? The FDA doesn’t test drugs, it prescribes testing procedures for drugs. The responsibility for testing falls to the maker of the drug. According to a statistics published on the FDA web site, The FDA ultimately approves about 20% of applications for new drugs. The three phases of the FDA’s prescribed testing process last at least one year and sometimes six years and longer. What does the FDA hope to accomplish through its approval process? Here’s some of what the FDA’s Ken Flieger has to say:

Most of us understand that drugs intended to treat people have to be tested in people. These tests, called clinical trials, determine if a drug is safe and effective, at what doses it works best, and what side effects it causes–information that guides health professionals and, for nonprescription drugs, consumers in the proper use of medicines.

Clinical testing isn’t the only way to discover what effects drugs have on people. Unplanned but alert observation and careful scrutiny of experience can often suggest drug effects and lead to more formal study. But such observations are usually not reliable enough to serve as the basis for important, scientifically valid conclusions. Controlled clinical trials, in which results observed in patients getting the drug are compared to the results in similar patients receiving a different treatment, are the best way science has come up with to determine what a new drug really does. That’s why controlled clinical trials are the only legal basis for FDA to conclude that a new drug has shown “substantial evidence of effectiveness.”

It boils down to safety and effectiveness. But safety and effectiveness are also your doctor’s concern. Do you suppose that your doctor would prescribe a drug that its manufacturer hadn’t thoroughly tested for safety and effectiveness? Of course, your doctor might well flub his diagnosis (something that happens a lot, despite the medical licensing exam) and prescribe the wrong medication. Or your doctor might diagnose you correctly but prescribe a medication that produces an unpleasant side effect. In summary, the safety and effectiveness of the drugs your doctor prescribes depends mainly on your doctor’s competence.

Misadventure is more likely with non-prescription (over-the-counter) drugs. As the FDA acknowledges, “Most OTC drug products have been marketed for many years, prior to the laws that require proof of safety and effectiveness before marketing.” Very interesting. As with prescription drugs, OTC drugs, used to be available without the FDA’s imprimatur. That is, individuals used to be trusted to buy and use OTC drugs wisely, but then the FDA got into the act. Why? According to the FDA:

Languishing in Congress for five years, the bill that would replace the 1906 [Food and Drugs Act] was ultimately enhanced and passed in the wake of a therapeutic disaster in 1937. A Tennessee drug company marketed a form of the new sulfa wonder drug that would appeal to pediatric patients, Elixir Sulfanilamide. However, the solvent in this untested product was a highly toxic chemical analogue of antifreeze; over 100 people died, many of whom were children. The public outcry not only reshaped the drug provisions of the new law to prevent such an event from happening again, it propelled the bill itself through Congress. This was neither the first nor the last time Congress presented a public health bill to a president only after a therapeutic disaster. FDR (pictured at left) signed the Food, Drug, and Cosmetic Act on 25 June 1938.

The new law brought cosmetics and medical devices under control, and it required that drugs be labeled with adequate directions for safe use. Moreover, it mandated pre-market approval of all new drugs, such that a manufacturer would have to prove to FDA that a drug were safe before it could be sold. It irrefutably prohibited false therapeutic claims for drugs, although a separate law granted the Federal Trade Commission jurisdiction over drug advertising. The act also corrected abuses in food packaging and quality, and it mandated legally enforceable food standards. Tolerances for certain poisonous substances were addressed. The law formally authorized factory inspections, and it added injunctions to the enforcement tools at the agency’s disposal.

And on it went:

Enforcement of the new law came swiftly. Within two months of the passage of the act, the FDA began to identify drugs such as the sulfas that simply could not be labeled for safe use directly by the patient–they would require a prescription from a physician. The ensuing debate by the FDA, industry, and health practitioners over what constituted a prescription and an over-the-counter drug was resolved in the Durham-Humphrey Amendment of 1951. From the 1940s to the 1960s, the abuse of amphetamines and barbiturates required more regulatory effort by FDA than all other drug problems combined.

Notice that the focus is always on abuses and never on successes. Here’s what The Cato Institute’s Handbook for Congress has to say about the FDA::

As an agency, the FDA has a strong incentive to delay allowing products to reach the market. After all, if a product that helps millions of individuals causes adverse reactions or even death for a few, the FDA will be subject to adverse publicity with critics asking why more tests were not conducted. Certainly, it is desirable to make all pharmaceutical products as safe as possible. But every day that the FDA delays approving a product for market, many patients who might be helped suffer or die needlessly.

For example, Dr. Louis Lasagna, director of Tufts University’s Center for the Study of Drug Development, estimates that the seven-year delay in the approval of beta-blockers as heart medication cost the lives of as many as 119,000 Americans. During the three and half years it took the FDA to approve the drug Interleukin-2, 25,000 Americans died of kidney cancer even though the drug had already been approved for use in nine other countries. Eugene Schoenfeld, a cancer survivor and president of the National Kidney Cancer Association, maintains that ‘‘IL-2 is one of the worst examples of FDA regulation known to man.’’

In the past two decades patients’ groups have become more vocal in demanding timely access to new medication. AIDS sufferers led the way. After all, if an individual is expected to live for only two more years, three more years spent testing the efficacy of a prospective treatment does that person no good. The advent of the Internet has allowed individuals suffering from specific ailments and patient groups to use websites and chat rooms to exchange information and to give them an opportunity to take more control of their own treatment. They now can track the progress of possible treatments as they are tested for safety and efficacy and are quite conscious of how FDA-imposed delays can stand in the way of their good health and even their lives….

[I]n a free society individuals should be free to take care of their physical well-being as they see fit. The advent of the Internet gives individuals even more access to information about medical products and treatments. Individuals should be allowed to choose the treatments they think best. Such liberty does not open the door for fraud or abuse any more than does a free market in other products. In fact, informed consent by patients probably will become more sophisticated as the market for information about medical treatments becomes more free and open.

Government regulation of health-care products and services makes them harder to get and more expensive than the products and services that would be delivered in the absence of regulation. Would quality suffer in a free-market health-care system? It might in some cases, but competition among producers and providers would lead to an overall increase in quality, in response to consumers’ demands for competent medical practitioners and effective drugs.

If it’s unnecessary to regulate health care, can we take the next step and de-nationalize it? What about other industries and types of economic activity? Stay tuned for Part III of this series.

Fear of the Free Market — Part I

In So When Are We Going to Get That Free-Market Health Care Everyone’s Complaining About?, Trent McBride guesstimates that with the addition of the prescription drug benefit to Medicare “our health care system will be paid for by explicit or implicit public funds at a rate of 65-70%.” By “explicit or implicit public funds” he means direct payments (e.g., Medicare, Medicaid, and the VA) plus the sundry regulatory activities (e.g., FDA approval of new drugs) that are funded by taxes. McBride therefore characterizes the health-care system as “marginally nationalized.” He asks, “if we have a nationalized health-care system now, and that system is [considered] broken, is more nationalization the way to go?”

Sasha Volokh objects to McBride’s characterization of the health-care system as “nationalized” because what matters is not only “who pays but also…who controls.” Apparently, in Sasha Volokh’s view, Medicare doesn’t count as a form of nationalization because beneficiaries get to choose their doctors. In this regard, it’s important to recall the old variation on the Golden Rule: “Them what has the gold makes the rules.” I might get to choose my doctor from a government-approved list, but all good doctors won’t be on that list, nor will all the treatments I might like to have. It would cost me more to go to doctors who aren’t on the list and to receive non-approved treatments, but I may not be able to afford either because my wealth has been depleted by many years of paying into Medicare. Bottom line: Medicare is most certainly a form of nationalization.

Government’s effective control of the health-care system is only a notorious example of government’s distortion of free-market mechanisms. It is easier to list those markets in which the government doesn’t intervene (namely, “black markets”) than it is to list those markets in which the government does intervene. There simply isn’t a lawful business activity that isn’t affected by government regulation.

If, for example, I wished to turn this blog into a business by selling advertising space on it, I would (or should) get a business license from the city, pay property tax on my computer (as a piece of business equipment), keep a set of business books for tax purposes, file a special income tax return (Schedule C, at a minimum), and pay additional Social Security taxes at the rate for self-employed persons. If business thrived and I hired someone to help me produce the blog (or handle the paperwork), that would compound my compliance problem and the cost of dealing with it.

Alternatively, I could ignore the law and run the risk of being caught and fined or even imprisoned. That’s a risk that I might take for the sake of a low-profile blog. It’s not a risk that I would take for the sake of making big bucks as an untrained, unlicensed M.D., though it is a risk that others (sometimes trained but unlicensed doctors) have been willing to take.

In summary, government intervention in the market for any product or service tends to reduce the supply of that product or service.

But, but, but…the proponents of regulation say…if government didn’t require doctors to pass licensing exams people wouldn’t know if they were being served by “good” or “bad” docs (not to mention lawyers, electricians, plumbers, and beauticians). Similarly, if the FDA didn’t approve drugs, people wouldn’t know if they were buying efficacious drugs or snake oil. And so on and so forth.

Are all medical school graduates equally competent? Are all medical school graduates who pass licensing exams equally competent? Is the doctor who barely passes the exam significantly better than the doctor who barely flunks it? The correct answer in every instance is “no.”

Do medical licensing exams weed out a large percentage of incompetent doctors? It’s not obvious that they do. Statistics for takers of the <a href="

http:// http://www.usmle.org/news/2002perf.htm”>U.S. Medical Licensing Examination in 2002 indicate that about 85% of first-time takers of the exam from allopathic (conventional) medical schools in the U.S. and Canada successfully complete all three steps of the exam. With re-takes, the percentage successfully completing all three steps is expected to be 97%. Osteopaths have a lower success rate — 60% for first-takers — but they represent only 2% of the first-takers from U.S. and Canadian medical schools.

The only real weeding-out takes place among graduates of medical schools outside the U.S. and Canada. First-takers from those medical schools have only a 34% success rate. This weeding-out may reflect incompetence in English — even though applicants had to pass an English-language proficiency exam — as much as it does incompetence in medicine. These results suggest a simple strategy of avoiding doctors who weren’t trained in the U.S. or Canada — a strategy that many Americans follow instinctively.

As for graduates of medical schools in the U.S. and Canada, you’re on your own. When you go to a licensed doctor for the first time you will probably have no clue about that doctor’s competence. You can avoid the relatively few doctors who have been disciplined because most States now make such information available online. You can get recommendations from family, friends, and acquaintances, but those recommendations may tell you more about a doctor’s “bedside manner” than about his or her competence. And in some large cities you can find lists in local magazines for the “best” doctors, by specialty, though you will have no idea of the criteria underlying such lists. In the end, you’ll simply hope that your doctor is competent, if not warm and fuzzy.

You’ll learn from experience whether your doctor seems competent, just as you’ll learn from experience whether your auto mechanic is competent (and honest) or merely a smiling face. So much for licensing as a boon to consumer choice.

Ten-Plus Commandments of Liberalism, er, Progressivism

I. Free speech is for everyone but those whose views I don’t like.

II. There should be no restraints on personal behavior, except for smoking. (Corollary: People should be forced to save energy, but you can’t take away my SUV.)

III. Death to tyrants, unless they tyrannize in the Middle East or Cuba.

IV. Terrorism is bad, defending against terrorism is worse. Someone might get hurt.

V. Corporations and profits are bad, but I love the things I can buy because corporations are motivated to make profits. (Corollary: Let’s stop “exporting” jobs, but let’s keep importing Guccis and Manolo Blahnicks.)

VI. Health care in the U.S. is terrible, but I can’t name another country where it’s better.

VII. People shouldn’t be forced to act against their own interests, but they should be forced to make bad investments, like participating in Social Security and Medicare.

VIII. The U.S. stinks, that’s why so many people freely choose to move here. (Corollary: And that’s why I live here even though I said I’d leave the country if Bush were elected.)

IX. Sexual harassment and lying under oath are bad, except when the lying harasser is a Democrat president. (Corollary: Jefferson was bad because he owned slaves and was therefore a hypocrite about freedom; Clinton wasn’t bad even though he was a hypocrite about seeing to the faithful execution of the laws.)

X. War is bad, although I have nothing against the Revolutionary War, Civil War, and World War II. (Corollary: Iraq is just like Vietnam, except that we won the war, deposed the tyrant, and are rebuilding the vanquished nation — having lost 99% fewer American lives in the process.)

XI. Libertarians and conservatives are mean-spirited because, unlike me, they don’t want to use the coercive power of the state to subsidize my favorite social programs. (General rule: Recourse to the coercive power of the state is good when it’s for “progressive” values, bad when it’s for conservative values.)

XII. It’s wrong to tell people how to live their lives, but urban sprawl is so ugly that we really ought to make people live closer to urban centers (where they can afford one one-fourth as much housing). (Corollary: See Commandment II.)

XIII. Christian conservatives want to impose their values on the rest of us. (Ha. Unlike fascists, communists, socialists, and “progressives.”)

XIV. Capital punishment is bad; abortion is good. (Conservative version: Capital punishment is good; abortion is bad.)

XV. Taxes are the price we pay for (my “progressive” version of) civilization.

Left-Wingers Dominate the Blogosphere

A significant sample of bloggers (411 to date) has taken the “Political Compass Test” and posted the results here. Despite complaints voiced there about the ambiguity of the test questions, the results are probably a good approximation of the political views of the test-takers (my result seemed right to me).

The chart near the top of the page tells the tale. Most bloggers who posted their results are in the lower left quadrant: strong on personal liberty and strong on government intervention in the economy. The authors of the test characterize that quadrant as “libertarian left” — the ultimate oxymoron. But down the page they more accurately label adherence to the economic left as “Communism (Collectivism)”.

Thus, it seems that the blogosphere is dominated by the self-indulgent and irresponsible (social “libertarian” collectivists). Just like the real world.

Diversity

Segregation thrives, but it is voluntary segregation based on income and culture. Nothing wrong with that.

Diversity — a code word for forced integration — is a liberal pipe dream. How many well-off, well-educated liberals (including members of Congress and academe) choose to live in “diverse” neighborhoods?

Favorite Posts: Affirmative Action and Race

Rich Liberal Hypocrites

What do Senators Clinton, Corzine, Edwards, Kennedy, Kerry, Lautenberg, and Rockefeller have in common, other than their membership in the Democrat Party? They, like most of their fellow Democrats in Congress, want the rest of us to pay higher taxes to fund their favorite giveaway programs. They also possess great wealth. A little tax hike wouldn’t bother them, so why should it bother the rest of us?

The Erosion of the Constitutional Contract

Contracts come in many forms and serve many purposes. They may be as informal and ephemeral as the understanding between barber and customer that the barber will cut the customer’s hair and the customer will pay the barber a certain amount of money for the haircut. They may be as solemn and hopefully eternal as marriage vows.

In the public realm there is no more solemn contract than the Constitution of the United States. But the great national crises of the Twentieth Century — especially the Depression and World War II — fostered the habit of giving illegitimate power to the federal government. Thus the constitutional contract and the pillars of the Constitution — the States and citizenry — have been undermined.

The immense, illegitimate power that has accrued to the federal government cannot be found in the Constitution. It arises from the cumulative effect of generations of laws, regulations, and court rulings — each ostensibly well-meant by its perpetrators.

The habit of recourse to the federal government has become a destructive cycle of dependency. Elected representatives and non-elected elites have vested unwarranted power in the federal government to deal with problems “we” face — problems the federal government cannot, for the most part, begin to solve and which it demonstrably fails to solve many more times than not. The conditioned response to failure has been to cede more power (and money) to the federal government in the false hope that the next increment will get the job done.

There has been much bold talk in recent times about making the federal government smaller and devolving federal power to the States. The bottom line is that the executive branch still regulates beyond its constitutional license, Congress still passes laws that give unwarranted power to the federal government, and federal spending still consumes about the same fraction of economic output that it did two decades ago.

To break out of this cycle of addiction, we must restore the constitutional contract and thus enable the States and citizens — especially citizens — to realize their economic, social, and spiritual potential.

The Constitutional Contract, Its Reach, and Its Principles

The Constitution is a contract between the States. In it, the States cede certain powers to a government of the united States, created by the States on behalf of the States and their citizens. Thus, for example, in Section 10 of Article I, the States voluntarily deny themselves certain powers that in Section 9 they vest in Congress — creation of money, regulation of trade among the States and between the States and other nations, conduct of foreign relations, and conduct of war.

The Preamble lists the States’ reasons for entering into the constitutional contract, which are “…to form a more perfect union, establish justice, insure domestic tranquillity, provide for the common defence, promote the general welfare, and secure the blessings of liberty to ourselves and our posterity….” These are ends desired, not outcomes promised.

To further these ends, the Constitution establishes a government of the united States, and authorizes it to enact, execute, and adjudicate laws within a delimited sphere of authority. The Constitution not only delimits the federal government’s authority but also diffuses it by dividing it among the federal government’s legislative, executive, and judicial branches.

The Framers knew what we are now only re-learning: A government is a power-hungry beast — even a representative government. More power in the hands of government means less power for individuals. Individuals are better off when they control their own lives than when government, directly or indirectly, controls their lives for them.

Thus the limited scope of the constitutional contract provides for:

• primacy of the federal Constitution and of constitutional laws over those of the States (This primacy applies only within the limited sphere of authority that the Constitution grants to the federal government. The federal government is not, and was not intended to be, a national government that supersedes the States.)

• collective obligations of the States, as the united States, and individual obligations of the States to each other

• structure of the federal government — the three branches, elections and appointments to their offices, and basic legislative procedures

• powers of the three branches

• division of powers between the States and federal government

• rights and privileges of citizens

• a process for amending the Constitution.

The principles embodied in the details of the contract are few and simple:

• The Constitution and constitutional laws are the supreme law of the land, within the clearly delimited scope of the Constitution.

• The federal government has no powers other than those provided by the Constitution.

• The rights of citizens include not only those rights specified in the Constitution but also any unspecified rights that do not conflict with powers expressly granted the federal government or reserved by the States in the creation of the federal government.

The Limits of Federal Power

The Constitution may be the “supreme law of the land” (Article VI), but as the ardent federalist Alexander Hamilton explained, the Constitution “expressly confines this supremacy to laws made pursuant to the Constitution…[Federalist number 33].”

Thus the authority of the federal government — the government formed by the united States — enables the States to pursue common objectives. But that authority is limited so that it does not usurp the authority of States or the rights of citizens.

Moreover, the “checks and balances” in the Constitution limit the federal government’s ability to act, even within its sphere of authority. In the legislative branch neither the House of Representatives nor the Senate can pass a law unilaterally. In his sole constitutional role — as head of the executive branch — the President of the United States must, with specified exceptions, sign acts of Congress before they become law, and may veto acts of Congress — which may, in turn, override his vetoes. From its position atop the judicial branch, the Supreme Court is supposed to decide cases “arising under” (within the scope of) the Constitution, not to change the Constitution without benefit of convention or amendment.

The Constitution itself defines the sphere of authority of the federal government and balances that authority against the authority of the States and the rights of citizens. Although the Constitution specifies certain powers of the federal executive and judiciary (e.g., commanding the armed forces and judging cases arising under the Constitution), federal power rests squarely and solely upon the legislative authority of Congress, as defined in Article I, Sections 8, 9, and 10. The intentionally limited scope of federal authority is underscored by Amendments IX and X; to repeat:


The rights of citizens include not only those rights specified in the Constitution but also any unspecified rights that do not conflict with powers expressly granted the federal government or reserved by the States in the creation of the federal government.

The Rise of Unconstitutional Laws and Regulations

The generations of laws and regulations that have seized the powers and rights of States and citizens are, to put it plainly, unconstitutional. Most such laws and regulations seem to rest on these foundations:

• the phrase “promote the general welfare” in the Preamble. This was a desired result of the adoption of the Constitution, not an edict to redistribute income and wealth.

• the power of Congress “to regulate commerce…among the several states [Article I, Section 8].” This power was meant to prevent the States from restricting or distorting the terms of trade across their borders, not to enable the federal government to dictate what is traded, how it is made, or how businesses operate.

• the authority of Congress “[t]o make all Laws which shall be necessary and proper for carrying into execution the foregoing powers, and all other powers vested by this Constitution in the Government of the United States, or in any department or officer thereof [Article I, Section 8].” The words “necessary and proper” have been wrenched out of their context and used to turn the meaning of this clause upside down. It was meant to limit Congress to the enactment of constitutional legislation, not to give it unlimited legislative authority.

• the “equal protection” clause of Amendment XIV: “…nor shall any State…deny to any person within its jurisdiction the equal protection of the laws.” Amendment XIV was meant to secure the legal equality of those former slaves whose freedom had been secured by Amendment XIII. Amendment XIV became, instead, the basis for Supreme Court decisions and federal laws and regulations that have given special “rights” to specific, “protected” groups by curtailing the constitutional rights of the many who cannot claim affiliation with one or another of the “protected” groups. As the proponents of such groups might ask, is it fair?

Restoring the Constitutional Contract

The constitutional contract charges the federal government with keeping peace among the States, ensuring uniformity in the rules of inter-State and international commerce, facing the world with a single foreign policy and a national armed force, and assuring the even-handed application of the Constitution and of constitutional laws. That is all.

It is clear that the contract has been breached. Only by restoring it and reversing generations of federal encroachment on the rights and powers of the States and people can we “secure the Blessings of Liberty to ourselves and our posterity.”

In a future post I will link to a restored constitutional contract, one that would undo the damage that has been done to the Framers’ great work.

Labor Unions

Labor unions are “legal monopolies in restraint of trade.” (Students of anti-trust law will recognize the allusion to the Sherman Anti-Trust Act of 1890.) The acts of Congress that enabled labor unions were intended to improve the lot of laboring people. The result — owing to the inviolable law of unintended consequences — has been the opposite: Laboring people who belong to unions have steadily lost employment over the decades. Their jobs have been “taken” by other laboring people who are willing to work at the prevailing wage. Only one group has benefited from the legalization of labor unions: union bosses who thrive on the mandatory dues paid by union members.

What Liberals and Conservatives Have in Common

So-called liberals (or “progressives” as many of them now prefer) and conservatives (as distinguished from libertarians or libertarian conservatives) have this in common: a penchant for using the coercive power of the state to enforce their views of proper economic and social arrangements.

Because the courts have in the past 70 years allowed the Executive and Legislative Branches to assume unconstitutionally broad power, and because that broad power has been mainly at the service of liberals, we now live under a highly regulated economic and social regime.

Would the courts restrain non-libertarian conservatives if they were to hold a strong majority in both houses of Congress for a considerable time, while the presidency was also held by a non-libertarian conservative?

Don’t bet on it. Sooner or later the courts “follow the election returns.”