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Archives for Market (page 1 / 1)

Florida’s mermaid industry

Florida’s mermaid industry →

Thanks to Craig Pittman, at the Tampa Bay Times, for this very Florida story.

Florida’s best-known industries include citrus, seafood and selling tacky souvenirs to tourists. But there’s one booming Florida industry that hardly ever gets a mention from the Chamber of Commerce folks.


All over the state there are now scores of women — and a few men — who regularly pull on prosthetic tails and pretend to be those mythical creatures made popular by Hans Christian Anderson and Walt Disney. Some do it for fun, but quite a few are diving into it as a business, charging by the hour to appear at everything from birthday parties to political events.

"This mermaid industry has just skyrocketed. It’s crazy," said Eric Ducharme, aka "the Mertailor," whose Crystal River-based business is making high-quality tails. "I don’t know if it’s a fad, or if it’s here to stay."

To judge how crazy the mermaid business is right now, consider this: Ducharme. a Lecanto native, sells his custom-designed tails for up to $5,000 each. He’s working on 80 of them right now, each designed to match the customers’ personal measurements.

This entry was tagged. America Market

Australian Travel Notes from a Policy Wonk

Australian Travel Notes from a Policy Wonk →

From Alex Tabarrok, at Marginal Revolution:

Australia farmers pay for water at market prices. Water rights are traded and government water suppliers have either been privatized or put on a more stand-alone basis so that subsidies are minimized or at least made transparent.

Australia has one of the largest private school sectors in the developed world with some 40% of students in privately-run schools.

Australia has a balanced-budget principle (balanced over the business cycle) which has been effective although perhaps more important has been a widely held aversion to deficits combined with an understanding of sustainability and intergenerational fairness (factors which also played a role in the decision to create private, pre-funded pensions).

If things go badly in the USA, I may have to head for Australia. (The scenery's nice too.)

After the ACA: Freeing the market for health care

After the ACA: Freeing the market for health care →

John Cochrane recently wrote about healthcare reform. This is the direction we need to go in, not Obamacare.

First, he talked about the insurance side of health care.

To summarize briefly, health insurance should and can be individual, portable, life-long, guaranteed-renewable, transferrable, competitive, and lightly regulated, mostly to ensure that companies keep their contractual promises. “Guaranteed renewable” means that your premiums do not increase and you can’t be dropped if you get sick. “Transferable” gives you the right to change insurance companies, increasing competition.

Insurance should be insurance, not a payment plan for routine expenses. It should protect overall wealth from large shocks, leaving as many marginal decisions unaltered as possible.

Preexisting conditions, lack of insurance by the young and healthy, and spiraling insurance costs– the main problems motivating the ACA -- are neatly addressed by this alternative. Why do we not have a system? Because law and regulation prevent it from emerging. Before ACA, the elephant in the room was the tax deduction and regulatory pressure for employer-based group plans. This distortion killed the long-term individual market and thus directly caused the pre-existing conditions mess. Anyone who might get a job in the future will not buy long-term insurance. Mandated coverage, tax deductibility of regular expenses if cloaked as “insurance,” prohibition of full rating, barriers to insurance across state lines – why buy long term insurance if you might move? – and a string of other regulations did the rest. Now, the ACA is the whale in the room: The kind of private health insurance I described is simply and explicitly illegal.

He finished by writing about the supply of health care and why we have expensive, low quality options.

So, where are the Walmarts and Southwest Airlines of health care? They are missing, and for a rather obvious reason: regulation and legal impediments.

A small example: In Illinois as in 35 other states7, every new hospital, or even major purchase, requires a “certificate of need.” This certificate is issued by our “hospital equalization board,” appointed by the governor (insert joke here) and regularly in the newspapers for various scandals. The board has an explicit mandate to defend the profitability of existing hospitals. It holds hearings at which they can complain that a new entrant would hurt their bottom line.

Specialized practices that deliver single kinds of service or targeted groups of customers cheaply face additional hurdles, as they undermine the cross-subsidization provided by “full service” hospitals. For example, the Institute for Justice is bringing a major suit8 by a specialty colonoscopy practice in Virginia, which local “full service” hospitals managed to ban.

... The increasing spread of medical tourism to cash-only offshore hospitals is a revealing trend. Why does this have to occur offshore? What’s different about the hospital location? Answer: the regulatory regime.

So, what’s the biggest thing we could do to “bend the cost curve,” as well as finally tackle the ridiculous inefficiency and consequent low quality of health-care delivery? Look for every limit on supply of health care services, especially entry by new companies, and get rid of it.

Employers Opt for Medical Tourism

Employers Opt for Medical Tourism →

Competition is coming to the healthcare system. It's coming very slowly, but it is coming.

In Priceless, I hazarded a guess that employers could cut the cost of hospital care in half by engaging in medical tourism. It’s a variation on what is sometimes called “value-based purchasing” or “reference pricing.” In its pure form, the employer picks a low-cost, high quality facility and covers all costs there. If the employee chooses another hospital, the employee must pay the full extra cost of the more expensive choice. In Priceless, I argued that to take full advantage of the opportunities available, the patients must be willing to travel.

Several large companies are already trying the idea out. As Jim Landers explains:

Wal-Mart Stores Inc., the nation’s largest employer, will jump into medical tourism next year by offering insured employees no-cost heart and spine surgeries at Scott & White Memorial [in Temple, Texas] and seven other hospitals across the country…By using a hospital in the new narrow network, patients could save as much as $5,000 or more…

The hospitals in Wal-Mart’s network — including the Cleveland Clinic and Geisinger Medical Center in Danville, Pa. — have gained national reputations for both quality and value. Physicians and surgeons work under financial incentives rewarding improved patient outcomes.

“A new market for weddings”

“A new market for weddings” →

Here's a new entry in Tyler Cowen's always interesting "markets in everything" series. This is a fantastic idea.

Here is a new service:

Over 250,000 weddings are called off every year. We purchase cancelled weddings and resell them to new couples.

Sellers recover deposits and upfront costs hassle-free. Venues and providers enjoy uninterrupted business as usual. Buyers find beautiful, pre-planned weddings at a fraction of the price.

Register with us and help us build a new market for weddings.

Don't Blame Obama for High Gas Prices

Don't Blame Obama for High Gas Prices →

There are a couple of things that I really wish the general public would understand. One is that gas prices (and oil prices) aren't, broadly speaking, under the control of any President. No President gets to take credit for prices falling and no President should take the blame for prices rising.

Is President Obama responsible for spiraling price of gasoline? Republicans say yes, but the facts say no.

Why have gasoline prices increased since the start of the year? The simplest explanation is that the price of crude oil has increased. Specifically, the spot price for Brent (North Sea) crude has increased $16 a barrel since January. Given that there are 42 gallons to a barrel, that works out to a 38 cent increase in the price of a gallon of oil. Spot prices for gasoline trade in New York have increased about 41 cents per gallon over the same time frame. So there you go.

Why is the price of North Sea oil relevant to the price of gasoline in the United States? Well, we import gasoline refined in Europe from North Sea crude. Even though these imports constitute less than 10 percent of U.S. gasoline consumption, they are necessary to satisfy domestic demand and their price sets the market price for all gasoline regardless of whether other cheaper crude sources are used to refine most of our gasoline.

You can also listen to the podcast version of this article.

How Doctors Are Trapped, Part II

How Doctors Are Trapped, Part II →

John Goodman returns to a theme of his blog: third-party payment really screws up the healthcare "market". In no sense is the American healthcare system a functioning market. Or, if it is, patients are certainly not true participants in the market.

Of all the people in the health care system, none is more central than the physician. Fundamental reform that lowers costs, raises quality and improves access to care is almost inconceivable without physicians leading and directing the changes. Yet of all the actors in modern health care, none are more trapped than our nation’s doctors. Let’s consider just a few of the ways your doctor is constrained, unlike any other professional you deal with.

No telephone.

No E-mail

Lack of Electronic Medical Records

Inadequate Advice About Drugs and Other Therapies.

Inadequate Patient Education.

What is the common denominator for all of these problems? Unlike other professionals, doctors are not free to repackage and reprice their services in customer pleasing ways. The way their services are packaged is dictated by third-party-payer bureaucracies. The prices they are paid are similarly dictated. Doctors are the least free of any professional we deal with. Yet these un-free actors are directing one-fifth of all consumer spending!

This entry was tagged. Market Prices

Government Is Not Society

If I was going to sum up my political philosophy as succinctly as possible, I think this is how I’d do it.

Perhaps the difference that most fundamentally separates true liberals and libertarians from others is that, to one degree or another, true liberals and libertarians are, unlike non-liberals and non-libertarians, dutiful sons and daughters of the Scottish Enlightenment. And one of the great lessons of that remarkable intellectual movement is the refinement of the understanding that state and society are not the same thing. Society is not created by the state, and the state’s activities not only do not define those of society but often diminish society’s activities.

Professor Don Boudreaux says this in the course of pointing out that FDR did much to destroy the private market for unemployment insurance. Prior to governments providing “free” unemployment insurance, many religious organizations, charities, businesses, and private societies provided it. People helping each other, reaching out, lending a hand to a neighbor in need. All of that was blown away and destroyed once the federal and state governments started providing unemployment insurance.

I found out today that it is possible to buy supplemental unemployment insurance to augment what the government provides. That’s welcome news but it’s a far cry from the vibrant assistance provided by society prior to the government’s take over.

Government has not brought us closer together by providing services that the private sector used to provide. Instead, it has pushed us further apart and made us less reliant on each other. That’s the exact opposite of the brotherly love and caring that President Obama constantly claims to want.

If you want a close knit society of caring people that look out for each other—slash government spending and get government out of the business of replacing society with bureaucracy.

Unions and the "Rights of the Workers"

I took a lot of heat after my last post, Are Teacher's Overpaid?. That's okay. I'm used to it. Let me quickly reiterate my main point from that post: I have no idea idea whether or not teachers are overpaid. Without a functioning marketplace for teachers and employers, it's impossible to know if teachers are overpaid or underpaid. What we really need in education is more information. And only a switch away from a monopoly educational system will give us that. We can start arguing over pay after we get a market.

I was told that, given the hours teachers work and the bureaucracy teachers deal with, it's only common sense that teachers are underpaid. I was told that I didn't need a market to tell me what any teacher could tell me. I was told that teachers take the jobs they do because they don't have any choice and they endure horrific working conditions because they truly believe in education.

Well, most jobs are crappy in some degree or another — just ask the poor sucker actually working the job. By that logic, should everyone get an awesome salary and gold-plated benefits? Who decides whose job is suckier, to merit awesomer pay? This is why you need a market, to settle those questions openly. And, of course teachers will tell you that they're underpaid. How many people really, honestly, say "Nope. I'm well paid. Give my raise to someone else" or "Nope. I'm overpaid. Want 5% back this year? It really wasn't my best effort, you know."

If teachers were as underpaid as they constantly claim, they'd leave for a different job. Period. They do have choices. Every teacher I've ever met has the smarts and skills to succeed in a different field, if they wanted to. They're not trapped in a job that they're being forced to work in. They're not slaves. They can leave anytime they want.

Don't misunderstand me here. I am saying teachers are whiners. I'm not saying that teachers are the only employees that whine about working conditions. I'm saying that every worker in every industry is a whiner. Even in my industry. Especially in my industry. I've been part of after-work bull sessions where we all gripe about how unfair we have it and how we're being worked like Mike Vick's dogs. We whine. And yet we still like our jobs enough to go back and do it with a mostly cheerful heart. Whining proves nothing. Actions prove words.

Actions like quitting. That's serious. If enough teachers leave, schools will have to offer wages sufficiently high enough to entice the teachers back. Salaries and benefits will rise. That's exactly the way it works in any other sector of the economy.

I've been accused of listening to someone cry "Fire!" from a burning building and merely responding with a callous "Move somewhere else!". I've been accused of telling teachers to just "Shut up and teach". But neither accusation is true.

The implication is that if I hear a shout of "Fire!", I should immediately spring into action. I disagree with that. If someone is shouting "Fire!", I'd first look to see if there was, in fact, a fire. If there wasn't, I'd shrug and move on. Performance art, or something, you know? You would too, unless you wanted to join in the art performance.

I also don't think teachers should just "Shut up and teach". I fully believe in the right of any worker to quit any job that he or she thinks is unjust or unfair. I fully support the right of every worker to quit a job and move to another job that has better pay, better benefits, a better work environment, more job satisfaction, or that's just more convenient.

Teachers and other public employees should have exactly the same rights as any other employee in any other sector of the economy. No one is chaining them to their desks, forcing them to work. No once is "forcing them to bend over and take it in the ass". They can leave. The same way I can leave my job, if my benefits and salary get slashed below a level I'm willing to accept.

When 40% of teachers start walking off of the job for good, I'll gladly admit that they're underpaid and start working to figure out what pay and benefit package they do want. But they're not doing that.

Sadly, most teachers have only themselves to blame for the fact that their education work choices are limited to the government or the government. Through the unions, they constantly fight any attempt whatsoever to end government monopoly control of education. They scream to the high heavens whenever someone talks about introducing multiple employers into the education world (through Charter schools, voucher schools, or through increased scholarships to privates schools). Then they scream to the high heavens when that one employer (the local School District or the State) talks about doing something they don't like. It's short sighted.

There are no other employers to compare the government to, to help decide whether or not teachers are being abused. That's why teachers need a market with more than one employer. A market where they would actually have multiple businesses competing to hire them. Then they could have a choice of employers, pay packages, benefits, etc.

I'm perfectly willing to pay teachers more. I'm eager to pay great teachers a lot more. But, before I do, I want proof that the extra money is actually needed. Especially since that money comes out of my property taxes each and every year. If there were more employers, if teachers supported ending the employer monopoly, there would be proof. They could say "Hey, pay me more or I walk across the street to accept a job that pays 10% more and gives me a TA to help with the workload".

And, you bet anything you want, I'll send my kids to the schools that gives teachers a nice pay/benefits package and has happy teachers teaching good classes. Absolutely I would. I'm a Mac user for Pete's sake. I've bought 3 Toyota's in a row. I hardly ever pick the cheapest option when I'm looking to buy something new. I buy quality. I've always bought quality and I'm completely willing to pay for it.

I'm talking favorably about taking away some power from a union — not from teachers themselves — that has tried to block every single major reform proposal set forth over the last 30 years. Charter schools. Voucher schools. Virtual (online) schools. Teacher merit pay. Teacher quality rankings. Alternative routes for teacher certification. Every. Single. One.

The union does not want quality. It wants higher pay for teacher's doing the exact same thing thing that they've always done. It won't allow progress. It won't allow change of any kind. It just wants me to fork over more money for salaries year after year.

Again. Teachers are complaining because the monopoly employer is offering a pay package that they think sucks. And everytime someone proposes ending the monopoly employer and giving teachers a choice of employers with a choice of pay packages, they throw a temper tantrum and demonize the person who suggested doing so.

I've wanted teachers to have a choice of employers for 15 years. I've wanted schools, that have less bureaucracy and better working conditions, to have a chance to thrive. I've wanted schools where parents can have more of say in policies and where parents and teachers can have better working relations.

Who's really being unreasonable here?

Are Teachers Overpaid?

Are teachers underpaid or overpaid? I have absolutely no idea. And, let's face it, you don't really know either. No one can. Without a market to create information, no one can possibly know how much money a teacher is worth.

Markets create information through the process of hundreds or thousands of individuals bidding for jobs. As each individual looks for a job, she or he generates information about what salary they'd love, what they'd like, what they're willing to accept, what they'll grudgingly accept, and what they won't accept under any conditions.

Markets also create information through the process of hundreds or thousands of businesses bidding for employees. As each employer looks for employees, it generates information about what salary they'd love to pay, what they'd like to pay, what they're willing to pay to get the teacher they really want, what they'll reluctantly pay if they have to, and what they won't pay under any circumstances.

This two-way flow of information allows people to quickly see how much a particular job is worth and how much a particular employee is worth. This information can't be created any other way. Only through a market.

Education, for the most part, lacks this market. Somewhere around 85% of all students attend public schools. (10% attend private schools and 5% are homeschooled.) Public schools are a government run, monopoly provider. If you are a teacher, there aren't really a lot of options about which employer you'll work for. You can, to some extent, pick which district you'll work for, but most of the districts tend to have similar benefits and pay packages. So, there's not much (any?) competition among employers, for employees.

School districts face a similar problem. The huge, vast, overwhelming number of teachers in the U.S. are unionized. Every teacher gets the exact same employment package, working under the exact same rules. There is little competition, among teachers, for the best job.

Without competition and choce, there is no information. Without information there is no knowledge. How much is a teacher worth, in salary? No one knows. Teachers have never truly competed for the top jobs and school districts have never really competed for the top teachers.

Teachers today could be vastly overpaid and in need of severe pay cuts. Or teachers today could be vastly underpaid and in need of massive raises. Until there's true competition in the labor market, we'll never know which is true.

Barney Frank Wants to Kill Fannie and Freddie?!?

Be still my beating heart. No, wait. Start beating, my stilled heart. Barney Frank just recommended killing Fannie Mae and Freddie Mac.

"As I believe this committee will be recommending, abolishing Fannie Mae and Freddie Mac in their present form and coming up with a new whole system of housing finance [is in order]," House Financial Services Chairman Barney Frank (D, Mass.) said at a hearing.

This is the same Congressman Frank that previously refused to believe that anything could possibly be wrong with Fannie and Freddie.

"These two entities--Fannie Mae and Freddie Mac--are not facing any kind of financial crisis," said Representative Barney Frank of Massachusetts, the ranking Democrat on the Financial Services Committee. "The more people exaggerate these problems, the more pressure there is on these companies, the less we will see in terms of affordable housing."

And this is the same Fannie and Freddie that the government is bailing out, with no limits whatsoever on the losses to the American taxpayer.

The Obama administration's decision to cover an unlimited amount of losses at the mortgage-finance giants Fannie Mae and Freddie Mac over the next three years stirred controversy over the holiday.

The Treasury announced Thursday it was removing the caps that limited the amount of available capital to the companies to $200 billion each.

Unlimited access to bailout funds through 2012 was "necessary for preserving the continued strength and stability of the mortgage market," the Treasury said. Fannie and Freddie purchase or guarantee most U.S. home mortgages and have run up huge losses stemming from the worst wave of defaults since the 1930s.

Of course, this is Barney Frank we're talking about here. I shudder to think about what he has in mind to replace Fannie and Freddie. Whatever it is, be sure that you'll be paying for it, not him. You'll probably be paying a lot.

Senate Bill Will Increase Healthcare Premiums

At the request of BlueCross BlueShield, Oliver Wyman did a study of the Senate health care bill. Unsurprisingly, this study estimates that the bill will cost consumers quite a bit more than the CBO estimated.

John Goodman summarized the findings this way:

Premiums for individuals and families purchasing coverage on their own will go up 54%. Premiums for small businesses will go up 20%. Both numbers are over 5 years and both numbers exclude the impact of medical inflation.

I skimmed through the study and it looks pretty interesting. The study points out that reform won't work unless everyone is forced to purchase insurance.

The key implication of our analysis is simple: For these types of insurance reforms to be successful and sustainable, it is imperative to get broad participation. Young and healthy people need to be part of the insurance pool, and people cannot defer buying insurance until they are sick or at high risk. This is true no matter who is paying the premiums--individuals, employers, or the government.

The study then goes on to indicate that the current bill likely will allow people to free-ride, with bad results. They're basing their conclusions on several states' experiments with healthcare reform.

  • New York and Vermont: Average premiums in the individual market today are about 60% higher than the national average

  • New Jersey: Reform caused much higher premiums forcing thousands of individuals to drop coverage. The individual market decreased from 157,000 people in 1993 to 88,000 in 2007

  • Maine: Individual market enrollment in Maine dropped from 90,000 to 41,000 between 1993 and 2007 following the state's reforms.

Even in Massachusetts, there is evidence that individuals are selectively jumping in and out of the market when they need healthcare. Data from health insurers in Massachusetts indicate that the number of peopl ein the individual market with coverage of less than 12 months has doubled post reform. These individuals have a significantly higher claims to premium ration when compared to those who had coverage for more than 12 months but let it lapse or those that are active.

Without strong penalties, similar types of behavior are likely to emerge in the reformed individual market--resulting in significantly higher premiums for the insured.

This is one of the reasons why I believe that the "reform" bills will just make American healthcare worse than it already is.

Health care is not a human right

This morning I saw a new Facebook poll: "Is Health Care a Human Right?". I voted no.

Do you have a right to health care? Yes. And no. My answer ultimately depends on what you mean by a "right" to health care.

Rights come in two varieties: negative and positive. A negative right can be thought of as the right to be left alone. It's the right to do something without the fear that someone else will restrain you. A positive right can be thought of as the right to be served. While a negative right requires only that someone leave you in peace, a positive right requires that someone actively do something for you.

I believe you have the right to work with the doctor of your choice -- whether or not that doctor has been credentialed by a government.

I believe you have the right to take the drugs of your choice -- whether or not those drugs have been approved by a government panel of experts. I believe you have the right to take experimental cancer drugs, especially as a last ditch attempt to save your life. I believe you have the right to take marijuana to treat pain, to build appetite, and to relax.

I believe you have the right to buy insurance from any company, located in any state, covering any combination of conditions. I belive you shouldn't be limited to only the health insurance that covers a government approved list of condition from a government approved list of companies.

I believe in a strong negative right to health care. That's something that doesn't really exist in America today. Right now, you are not free to receive health care from anyone you trust, you are not free to take the drugs of your choice, and you are not free to buy whatever health care you desire. I am in favor of more freedom in health care. I believe you have a right to consume health care as you see fit, even if the majority of people around you disagree with your decisions. That's freedom.

I don't believe you have a right to force someone else to pay for treatment, medications, or medical supplies. I don't believe you have a right to force a doctor to work with you. It's one thing if you and the doctor can come to a mutual agreement regarding pay and hours of availability. It's something else entirely to require a doctor to treat you at a price of your choosing (not his) and at a time of your choosing (not his). I don't believe you have a positive right to health care.

To be blunt, I don't believe you have a right to turn doctors into slaves (by requiring them to treat for free or at a steep discount) or a right to turn your fellow citizens into slaves (by requiring them to work in order to pay the bills for your health care).

The current discussion of health care rights revolves almost entirely around positive rights -- getting someone else to pay for our health care. It includes an "exchange" that would strictly limit the options available. It includes subsidies forcibly taken from some people through taxes and used to pay for someone else's health care.

It includes a requirement for insurance companies to charge everyone the same price for health care. This practice, known as community rating, allows sicker people to pay less than the cost of their care and requires healthier people to pay more. In effect, community rating is a subsidy to the sick courtesy of the healthy. Community rated health care is a very bad deal for young, healthy individuals. So the current discussion revolves around a health care mandate. Most of the plans under consideration would require young people to purchase something that's a bad deal. They would be required to do this solely to provide a good deal to sick people and the elderly.

Claiming a positive right to health care is nothing more nor less than the claiming the right to enslave your fellow man. I don't believe you have that right.

Private health care insurance growing world wide

The National Center for Policy Analysis published a press release from the HealthPlanWire today, showing the grow in private insurance world wide.

HPW follows health insurance markets globally, and is projecting that total covered lives will exceed one billion by 2012. Single-payer systems are declining world-wide because they are primarily based in countries which have static or declining populations, while private insurance is growing rapidly in countries with the fastest population growth.

Most of this is coming from developing countries which are for the first time ever building out a health financing system, choosing to encourage private health insurance over single-payer on five continents. Examples include China, Columbia, South Africa, Mexico, India, Australia and most of eastern Europe. Most of these countries considered and rejected a single-payer system in favor of a private insurance system, and more than a dozen more are following suit in the same regions.

Private insurance is the chosen system for several reasons. In developing countries in eastern Europe there is a strong aversion to the former Soviet-style model, and western European global insurers like Allianz and Vienna Insurance Group have actually acquired the entire single payer system from the government and turned it private.


The problem with health insurance "exchanges"

In today's New York Times, David Leonhardt talks about the problem of health care choice. Specifically, the fact that most people don't have any choice. He starts out making a lot of sense.

Health insurers often act like monopolies -- like a cable company or the Department of Motor Vehicles -- because they resemble monopolies. Consumers, instead of being able to choose freely among insurers, are restricted to the plans their employer offers. So insurers are spared the rigors of true competition, and they end up with high costs and spotty service.

But then, discussing the Wyden-Bennett bill, he makes less sense.

In the simplest version, families would receive a voucher worth as much as their employer spends on their health insurance. They would then buy an insurance plan on an "exchange" where insurers would compete for their business. The government would regulate this exchange. Insurers would be required to offer basic benefits, and insurers that attracted a sicker group of patients would be subsidized by those that attracted a healthier group.

The immediate advantage would be that people could choose a plan that fit their own preferences, rather than having to accept a plan chosen by human resources. You would be able to carry your plan from one job to the next -- or hold onto it if you found yourself unemployed. You would never have to switch doctors because your employer switched insurance plans.

The problem with this idea is that it really doesn't offer much choice. Insurance companies are still protected from competition by the friendly confines of a government controlled "exchange". True choice would consist of an open market place where any entrepreneur can offer any product to any interested consumer. The success or failure of the product would depend on one all important criteria: whether or not consumers saw any value in it. Insurers would no longer be able to foist their plans on consumers who don't want them. And entrepreneurs would be free to introduce radical, new products that threaten the current insurance companies.

That kind of free choice wouldn't exist under an insurance "exchange". Each new product would have to be carefully weighed and analyzed by government bureaucrats. Nothing new would be approved unless they determined that it was worthwhile and useful. Existing insurance companies would have a hand in writing the regulations and only products that conform to the current status-quo would be allowed in. Anything that threatens that status-quo would be barred from the "exchange" and never offered to consumers. The end result would be akin to Ford's infamous statement that consumers could buy any color car they wanted -- as long as it was black.

Instead of fostering innovation and creativity in health care, the Wyden-Bennett bill would take the current "insurance" industry and lock it in cement. Consumers would continue to be forced to buy health insurance not health care and bureaucrats would continue to dicatate how, when, and where their health care dollars can be spent.

All of this makes me happy to hear that Wyden-Bennett doesn't have much support in the Senate.

Health care without bureaucrats

Any bureaucracy -- public or private -- is going to make pointless decisions and complicate your life. This applies to health "insurance" as much as it applies to anything else. It's easy to find stories of people who were heartlessly treated by their health bureaucracy. In Britain, the bureaucracy is the government run NHS. In America, it's often a private company. But the end result is often the same.

John Goodman points to a recent story and then offers an alternative.

Is there a better way? Yes. It's called casualty insurance -- similar to the kind of insurance most people have on their homes and automobiles. In the case of a catastrophic illness, the insurer makes a lump sum available -- ideally enough to cover all reasonable care. But when there are differences of opinion, patients can add their own funds to the insurer's payment and buy any type of care from any provider. For Medicaid, additional funds could be provided by private charity (which is what is happening anyway for Dr. Pollard's patients).

This is not a small change from the current system. It is a huge change. It would lead to a real market for catastrophic care in which patients and their families become real, empowered buyers. Providers would compete for patients based on price and, therefore, on quality. Doctors would be free to act as the agents of their patients rather than agents of third-party-payer bureaucracies.

Why would you want to hand control over your health care over to a bureaucracy? And why would you believe that a government bureaucracy would run more smoothly -- and treat you more fairly -- than a private bureaucracy?

The Blessings of Used Book Sellers

It seems that some people get annoyed when used book sellers visit library book sales.

Book dealers armed with handheld ISBN scanners are threatening to take over the used book sales run by volunteer fundraising groups for the Madison Public Library system, Morris said.

The scanners tell them how many copies of a title are in circulation and what it generally sells for -- powerful information to have if your aim is to find cheaply priced books that can be sold online for much more than you paid.

"You see them just literally hunched over ... shelves of books," Morris said, blocking book lovers like him from perusing the titles and maybe picking up a bargain they actually intend to read.

Thomas Boykoff, president of the board of directors for the Central Library Friends group, and Margaret Rentmeesters, who manages the book store at the library, acknowledge that the book dealers have become more common at book sales over the last two or three years.

But profit sometimes motivates unpleasant behavior.

"They sort of claim an area," Boykoff said, "Some of them just don't give a damn."

How horrible! How, how ... profit-driven! How evil! Or is it?

I love reading, but I just don't have time to get out to library book sales. While I wish I could, the timing just never quite works out.

Thankfully, there are people out there willing to trade their time for my money. They'll pore over the stacks, weeding through the books that no one wants, to find the books that someone wants. Then they'll list these books on Amazon.com, Half.com, Alibris, Deal Oz, AbeBooks, Powell's Books or other similiar sites. I can browse the online sites, find what I want, and have it delivered directly to my door.

These book sellers are no nuisance. They're a blessing and I'm grateful for them.