The Nanny State is Here to Help You

It was the Clinton operation in 1992 that brought us the permanent campaign. Then the financial crisis of 2008 provided the all-purpose excuse for more expansion of federal power. It was during this time that Rahm Emmanuel famously said never allow a crisis go to waste. Now the sentiment among the nation’s control freaks, otherwise known as progressives, seems to be never let a pandemic go to waste. For instance, Bloomberg Magazine, a kind of bible for Nanny Staters,  recently published an article by Andreas Kluth entitled “We Must Start Planning For a Permanent Pandemic”. It is a reaction more than vaguely reminiscent of HL Mencken’s observation that Puritans were haunted by the fear that somebody, somewhere, might be happy.

And so the rise the Dead Enders proceeds apace. Consider, a little over a year ago in January of 2020, Dr. Anthony Fauci was busy reassuring Americans that there was no need to wear masks. Now he recommends wearing double masks for what seems to be the foreseeable future, vaccination progress notwithstanding. And speaking of vaccinations, back in April of 2020 Dr. Fauci said the earliest the U.S. would get a vaccine would be 12 to 18 months. Other “experts” noted that it typically would take up to 10 years to get the FDA to approve a vaccine. 

As of today, 11 months later, about 90 million U.S. citizens have received vaccination shots. The U.S. is third in line behind Israel and the U.K. for shots-in-arms per capita. As a result, we could be on the cusp of herd immunity. We will almost certainly achieve herd immunity over the summer months. 

Europe, on the other hand, is a mess. Its vaccination programs are stalled; Italy is locked down once again, and Germany and Spain, along with Italy, are facing another wave of infections. In the meantime, Sweden, which faced intense mainstream criticism for its relatively laissez-faire policy for dealing with the virus, has fared relatively well. More about later. 

There has been considerable controversy among scholars about the effectiveness of lockdowns for protecting public health. You could be forgiven for being unaware of this by relying exclusively on the mainstream press. They have proceeded under the assumption that lockdowns are not only effective, but crucial to public health, irrespective of circumstances and implementation. 

Empirical questions remain however. For example, how has Sweden fared relative to other countries? Data collected by the EU statistics agency Eurostat suggests that, comparatively speaking,  Sweden has done rather well. In an article published by the Foundation for Economic Education (FEE), John Miltimore uses these data to take a hard look at the costs benefits at lockdowns. 

He writes: 

“Preliminary data from EU statistics agency Eurostat compiled by Reuters showed Sweden had 7.7% more deaths in 2020 than its average for the preceding four years. Countries that opted for several periods of strict lockdowns, such as Spain and Belgium, had so-called excess mortality of 18.1% and 16.2% respectively.

Twenty-one of the 30 countries with available statistics had higher excess mortality than Sweden. However, Sweden did much worse than its Nordic neighbours, with Denmark registering just 1.5% excess mortality and Finland 1.0%. Norway had no excess mortality at all in 2020.”

However, in a separate article published by FEE, Miltimore demonstrates that, for most of the pandemic, Finland and Norway adopted policies that were even less restrictive than Sweden’s

 John Carlson, Director of Sweden’s Public Health Agency sums up. “Some believed that it was possible to eliminate disease transmission by shutting down society. We did not believe that and we have been proven right.” (See the entire article here.)

It is true that U.S. cases have recently experienced an uptick after almost 3 months of rapid decline. Whether the uptick is lasting, or the result of loosening restrictions remains to be seen. So far, a causal link between restrictions and infections has been difficult to pin down. 

For example, New York and New Jersey have had some of the most stringent restrictions while Florida has been far less so, earning it lots of Bronx cheers from…New York. But look at the outcomes. New Jersey has had 274 deaths per 100K. Excluding New York City, New York State has had 169 per 100K. New York City, the epicenter of infection for a good part of 2020, had a staggering 369 deaths per 100K. The wide variation between New York City and the rest of the state strongly suggests that statewide mandates are not particularly useful.

Then there is Florida. Statewide, Florida had 154 deaths per 100K. That’s 44% less than NJ and 58% less than New York City. 

At the very least these data suggest that the severely restrictive policies many governments have adopted have not been very effective if the goal is to protect public health. Add to that the policy induced economic crash, the shutdown of schools, the rise in suicides and the deepening sense of isolation felt by many, and the policy response is now starting to look catastrophic. 

So why, given their obvious and material harms, have general lockdowns persisted as a prime policy tool despite a lack of evidence proving their efficacy?

Control. 

In fact, the entire progressive project is about control. The goal is control over the everyday lives of citizens through the centralization of power and the tools of command-and-control. Hence the assault on free speech, the hysteria over school choice and the rules, regulations and guidelines about masking, business hours, family gatherings, having people over for dinner and all the rest of it. 

The idea of a virtuous and educated citizenry is tossed out the window like so many campaign promises.  So shut up and eat you spinach.  Your betters are here to take control. 

Never let a pandemic go to waste. 

JFB

A Sign of Hope in the Midst of Idiocy

It is unquestionably the case that we live in an era in which abject stupidity has risen to a high art form. However amid all the nonsense a sign of hope has emerged. That sign is in the recent surge in the sale of Dr. Seuss books. The #1 seller on Amazon is “The Cat in the Hat.” In fact the top 6 slots in the Amazon Best Sellers list are occupied by Dr. Seuss books.  

Why is this a cause for hope? It is because the American people en masse decided to go out and buy these books, currently under siege from the Social Justice Warriors, precisely because they are under siege. These buyers are not racist troglodytes celebrating white supremacy. They simply do not buy the argument that childrens’ books published decades ago that expressed then common sentiment should be cancelled for not measuring up to the tender sensibilities of today’s lefty activists. 

No, people want to buy Dr. Seuss books for their children. They refuse to be intimidated and they are not about to let the book burners get their way. That represents a glimmer of hope, however slim. But there remains a long, long way to go. 

Consider for instance the behavior of the bureaucrats in in ever-so-woke Loudon County in Northern Virginia.  County school administrators “… have instructed employees to disassociate Read Across America Day from Dr. Seuss’ birthday.” During “… the past couple of years… LCPS Public Information Officer Wayde Byard added that teachers dressing in Seussian garb for Read Across America Day — for instance, the Cat in the Hat’s iconic headpiece — is discouraged but “not prohibited.”

How encouraging. 

Then there is the National Education Association (NEA). The NEA partnered with Dr. Seuss Enterprises for over 20 years as part of a program to get kids to read. But then the Social Justice Warriors made an appearance and published a “study” entitled  “The Cat is Out of the Bag: Orientalism, Anti-Blackness, and White Supremacy in Dr. Seuss’s Children’s Books.” 

And guess what? Dr. Seuss is now off the reading list. And not surprisingly, President Joe Biden, whose literary history includes several instances of plagiarism, one of which got him suspended from law school, conspicuously left Dr. Seuss books out of the White House message for Read Across America Day. 

But—and here is the good news—the campaign against Dr. Seuss seems to be failing, mostly because everyday people are revolting against the high-handed stupidity (there is no other word for it) of the Social Justice keyboard warriors. 

Unfortunately, the insanity of the era is not restricted to the juvenile behavior of affluent university students who want to be protected from the world of ideas. It also includes the bureaucrats who run various public agencies. For an example, let’s turn our attention to the World Health Organization (WHO) for a moment.  

The Director-General of WHO, Tedros Adhanom Ghebreyesus, actually said that the Covid-19 pandemic has caused more “mass trauma” than World War II. When you think about it for a moment you realize it would take a great deal of effort to come up with something to match that for idiocy. 

World War II was the deadliest military conflict in history. Estimates are that as many as 70 to 85 million people died as a result of that conflict. That amounts to about 3% of the population of the world at that time. About 50 – 55 million of the deaths were directly caused by the war. Another 20 or 30 million were the result of disease or famine. 

Six million Jews were murdered in places like Auschwitz as part of the Nazi war effort, which had as one of its goals the extermination of Jews. Some would consider that a bit traumatizing. Which is not to omit the Polish Officer brigade murdered by the Soviets in Katyn Forest. Or the surprise attack on Pearl Harbor. Or the nuclear bombings at Hiroshima and Nagasaki. Or the siege of Leningrad (now St. Petersburg) where  millions of Russian civilians were systematically starved to death by the German  Army. 

It takes a special kind of stupidity to claim that Covid -19 is more traumatic than World War II was. Just as it takes a special type of idiocy to try to cancel Dr. Seuss, or to rename Mr. Potato Head to just Potato Head in order to deny the existence of sex differences. 

Fortunately, the American people have responded by buying lots of Dr. Seuss books. And Hasbro has backed down and restored Mr. Potato Head’s rightful name. Perhaps this is the beginning of a return to sanity. There is always hope. 

JFB

Malarkey Man

It is a mere 3 days since President Joe Biden took the oath of office and he is already furiously backtracking on his Covid campaign promises. Back on October 29, 2020 at a campaign rally in Coconut Creek FL, Biden tore into President Trump’s handling of the virus—a task that didn’t really require much effort. Anyway, candidate Biden pledged “I’m not going to shut down the economy, I’m not going to shut down the country, but I am going to shut down the virus.”

President Joe Biden

Sometime after January 20, Biden discovered that his desk in the Oval Office did not have a red button labeled “Virus Killer”. And so the reset began. At his Friday press conference Biden proceeded to announce “there’s nothing we can do to change the trajectory of the pandemic in the next several months.” He went on to project that Coronavirus deaths would rise by another 50% to reach “well over 600,000.” 

In the meantime he did say that he is sticking to his target of 100 million vaccinations delivered in his first hundred days in office. Left unmentioned is that we are already vaccinating about 960,000 people daily. Which means that Biden means to raise the vaccination rate all of 4% over the next several months. Pretty impressive for a guy who promised to make the coronavirus his #1 priority. 

But he has been busy on other fronts. Like gender identity. The executive order he just signed reads as follows: “Children should be able to learn without worrying about whether they will be denied access to the rest room, the locker room, or school sports. . . . All persons should receive equal treatment under the law, no matter their gender identity or sexual orientation.” 

Note that the executive order references gender identity, not sex. Meaning that you don’t have to be a girl to play on a girl’s sports team; you merely have to self-identify as female. Which, among other things, means that girl’s sports are essentially over. They will be dominated by boys claiming to be girls. 

The Biden team is busy pretending that the President is merely enforcing the Supreme Court’s Bostock  v. Clayton County decision handed down in 2020. But in that 6-3 decision, the majority opinion for which was authored by Justice Gorsuch, the Justices took pains to say that it was limited to employment status  and had no bearing on “sex-segregated bathrooms, locker rooms, and dress codes”. 

The Court went further to note that their decision was limited to the language of Title VII of the 1964 Civil Rights Act. The majority specifically noted that under Title IX of the 1972 amendments “we do not purport to address bathrooms, locker rooms, or anything else of the kind.” (See Abigail Shrier in the Wall Street Journal here.)

As bad as this is, it’s actually even worse than it appears at first glance. On the matter of gender identity Mr Biden has gone so far as to say that “in prison, your sexual identity is defined by what you say, not what the prison says.” Which effectively means that sex (or gender) is simply a social construct; biology is not determinative.

This conceit denies the profound difference between men and women. Not only that, it is part of a much grander project; namely the utopian transformation of society into one without differences, and therefore without hierarchies. 

It is a vision of human beings as undifferentiated cogs in a machine, the equivalent of ants living in an ant colony. There is no room for individualism, for decency, for joy, for love; only for the dream which inevitably leads to marching orders. It is a vision as old as the hills and has always and everywhere led to authoritarianism and human misery. 

But of course there will always be hierarchies. There can be hierarchies of competence that are freely chosen and held to account. Or there can be unaccountable hierarchies that are aristocracies of power not subject to the rules designed for mere mortals. The difference is that one is beholden to the idea of truth; the other denies there is any such thing. For them all that matters  is power. 

Around 490 BC, it was Protagarus, who laid the foundation for today’s postmodernism by arguing that “Man is the measure of all things”.  Plato understood Protagurus to mean that there was no objective truth. Things are either true or not true based on how an individual perceives them. 

There is a great irony here. Joe Biden, who endlessly goes on about “following the science” apparently doesn’t realize that if there is no truth there is no science. And all his talk is nothing more than what he likes to call “Malarkey”. 

JFB

Post Election Absurdities

It would seem that “the most important election of your life” was a tie. 

It is hard not to laugh when political partisans make impassioned arguments about the cause du jour. And not just because the arguments are typically awful.  When Democrats launch their next grandiose scheme for whatever it is they’ve just hatched up, they seem to have convinced themselves that it will actually work as advertised. For their part, Republicans will be in fierce opposition, haunted by the fear that somehow it might work. 

As a result we have endless arguments that are mostly pointless about stuff that doesn’t matter much. On the other hand, things that actually do matter are studiously avoided because often they do not easily fit into a neat ideological box.  So the combatants spend their afternoons dreaming up slogans that substitute for thought, after which they adopt and implement policies that are riotously out of kilter with reality. 

Consider some recent examples. In Manhattan, police recebroke up an orgy attended by some 80 people. The event was sponsored by an operation named Caligula. The firm advertises itself as a private on premise swinger club. Among the reasons the event was raided was that—I am not making this up—the patrons apparently did not properly observe social distancing regulations. 

And then we have the Governor of Oregon to consider. A side note: for the last 50 years radio stations have played Arlo Guthrie’s “Alices Restaurant” on Thanksgiving Day.  All 18 minutes of it. Alice’s Restaurant is the talking blues song about…well here are some of the lyrics below.

“I was drafted and when I went to my induction physical they handed out papers and said , “Have you ever been arrested?” I raised my hand and told the Sergeant , “Yes” and he said, “What for?” and I told him, “Litterin” the Sergeant said,” I’ve seen that movie, ain’t gonna work here.” So I got sent into the Army.”

And in the true spirit of Alice’s Restaurant, the Governor has encouraged people to call the police on their neighbors if they see a possible violation. The violations carry a maximum sentence of 30 days in jail, $1,250 in fines or both. 

So, back to Governor Kate Brown of Oregon. Last week the Governor instituted a new round of Covid restrictions that included a freeze on both indoor and outdoors gatherings, just in time for Thanksgiving. The indoor gatherings permit no more than 6 people from a maximum of 2 families. Thanksgiving Day dinners are no exception. 

The Marion County Sheriff’s office is apparently hesitant to enforce the edict, noting that we cannot arrest our way out of the pandemic. It seems that the heel-clickers are the politicians, not the police. Defund the Politicos has a nice ring to it.  

Finally. Perhaps one of the most absurd remarks made in recent days comes from…Donald J Trump. No surprise there. Any way, Mr. Trump who never takes responsibility for anything even mildly negative actually complained that it is his lawyers who are making him look bad. 

Happy Thanksgiving

JFB

The Great Barrington Declaration, COVID-19 and Herd Immunity

One of the problems with DIY Science is that an awful lot of people use terms of art incorrectly. The term “herd immunity” is one such term. It refers to a point of steady state equilibrium. In essence, a sufficient proportion of the population has been infected and retains sufficient immunity such that it shields most of the rest of the population from infection. 

This does not mean that the virus is eradicated. Nor does it imply stasis. People who got infected can and probably will be infected again. That is the pattern of other corona viruses, for instance, the flu. But the body’s defenses build up and the virus weakens over time, consequently reducing the severity of subsequent infections, until such time as the immune system weakens with age. That is why the sensible course of action is to take steps to develop effective therapeutics and protect vulnerable populations, particularly the elderly. 

That said, there should be no illusion that COVID-19 is going to be eradicated. The only virus in the world that has been successfully eradicated is smallpox. All the rest are still with us and contained by the use of vaccines, proper sanitation (like clean water) and other public health measures. Parenthetically, it should be noted that vaccines, which are often only 50% effective, are but one tool in the arsenal whose function is to contain the virus and treat patients. Eradication is not likely to be in the cards. 

It is important to consider another factor, namely that the infection estimates that are published daily in the U.S. are very likely incorrect, perhaps by an order of magnitude. Various studies have shown that actual infections far outnumber confirmed infections, possibly by as much as 6 to 24 times the amount. See for instance, this article in Reason Magazine and this column by Holman W. Jenkins in the Wall Street Journal

It is unfortunate that coverage of the Coronavirus pandemic has verged on the hysterical. Why is an interesting question. It is clear that many journalists writing about the virus have no understanding of science. They do not understand the distinction between a data point and a sample; nor do they understand the basics of research design or statistical methodology. Nor have many read, much less understood, the research papers they cite.  

But it is vitally important to understand the nature of the virus and the policy implications for dealing with it. That means understanding the costs, benefits and trade-offs needed to contain and treat it. The authors of the Great Barrington Declaration have provided a framework for doing just that. Below is an interview with Oxford Professor Sunetra Gupta, one of the authors of the Declaration. It is well worth watching. 

Professor Sunetra Gupta

JFB

A Conversation with Dr. Jay Bhattacharya

Dr. Jay Bhattacharya is a Professor of Medicine at Stanford University. He is also a PhD economist and research associate at at the National Bureau of Economic Research and a senior fellow at the Stanford Institute for Economic Policy Research. In the video below he is interviewed by Peter Robinson of the Hoover Institution at Stanford. 

JFB

Joe Biden: Super Hero

It is hard to imagine that anyone could figure out a way to be more juvenile and petty than Donald J. Trump. But the Democrats have managed to do it. They are going to blame the COVID19 crisis on Donald Trump. And Joe Biden is slated to be the messenger. His job is to read the teleprompter and avoid extemporizing. 

I can hear the wail of protest now. The Democrats will argue that they are not blaming the virus on Trump; only that his belated response caused the virus to get out of hand. And we are meant to believe that the Democratic Party’s standard bearer would have done much, much better. 

If, for some reason, you ignore (1) who the standard bearer is actually likely to be, and (2) the time line of what actually happened, the argument has surface plausibility. But then reality sets in. The Party is poised nominate Joe Biden, a 78 year old with mental faculties obviously in decline. Not that they were anything to write home about to begin with.

So let’s look at the time line.

January 14, 2020—The World Health Organization (WHO) voiced the Chinese government’s party line. WHO said “Preliminary investigations conducted by the Chinese authorities have found no clear evidence of human-to-human transmission of the novel coronavirus (2019-nCoV) identified in Wuhan, China.” (See the Federalist). 

January 30, 2020—WHO declares a public health emergency of international concern and confirms person-to-person spread of the virus. 

January 31, 2020—President Trump declares a U.S. public health emergency and issues a ban on travel between the U.S. and China. That decision was endorsed by Dr. Anthony Fauci who later in an interview with Lester Holt, said “One of the things we did right was very early cut off travel from China to the United States…outside of China, where it originated, the countries in the world who have it are through travel.”

What was Joe Biden’s reaction?  Joe Biden reacted that day on the campaign trail in Iowa by saying “This is no time for Donald Trump’s record of hysteria and xenophobia.” 

And what has Joe Biden proposed to handle the crisis? Well, he has called for “a decisive public-health response.” This is a pretty typical Biden non-response, on par with his penchant for referring to working with “the international community” whenever a foreign policy dilemma makes an appearance. And believe it or not, on the campaign trail he promised that if he is elected President, “Were gonna cure cancer.”

Really. He actually said that. 

And we are supposed to take Joe Biden seriously?   Why?

JFB

Why is there a Shortage of Medical Equipment to Fight COVID-19?

Gary Becker, a Nobel Prize winning economist from the University of Chicago was once asked what government’s mainly produces. “Lines” he replied.

So here we are in March 2020 with the economy screeching to a halt and citizens staying in their homes largely as a result of government decree. The reason? There is not enough equipment available to test to see who has COVID-19 so that they might be isolated and treated, and the spread of the disease stopped.

Why did we lack adequate supplies of diagnostic kits, hospital beds and other treatment facilities and equipment? Routine bureaucratic incompetence. See the video below. Then think again about a “single payer” system.

JFB

The Narrative

One of the more disheartening developments in what we laughingly call public debate has been the extraordinary emphasis placed on “the narrative”. The whole point of “the narrative” is issue framing. Instead of facts like who, what, where, why and when, the narrative seeks to define the contours of a story, and therefore the way the story is understood. In this manner, a story becomes part of a larger picture, woven into a tapestry of stories, pointing in the same direction, supposedly revealing a larger truth. 

But there is a problem with this. It is reasonably easy for unscrupulous players to get away with deliberately mischaracterizing issues by slippery uses of language and symbols, especially when they are not called out by the press. To be clear, it is not just deliberate mischaracterization that is a problem; it is also results from intellectual laziness and sloppy thinking that comfortably fits into the accepted “narrative”. 

Consider recent developments. The Corona virus is now charting a devastating path across the globe. With few exceptions, Taiwan being one, governments have been caught flat-footed. In part this is due to the dishonestly of the Chinese government which tried to cover up the outbreak at its epicenter in the Wuhan province. But other governments and international agencies like the World Health Organization (WHO) chose to believe them or pretend to believe them, giving the virus time to metastasize around the globe before effective containment efforts could begin. 

Let’s acknowledge that there are reasonable people (most politicians excluded) on all sides of the discussion considering the likely path and severity of the virus. In part this is due to a lack of data. As the Wall Street Journal reports, CDC officials botched the initial development of a test kit; resisted calls from state officials and medical providers to broaden testing, and health officials failed to coordinate with outside companies to ensure needed test-kit supplies. As a result, largely due to lack of information, U.S. efforts to contain the virus were hamstrung from the very beginning. 

Add to that the magical thinking of President Donald J Trump. The irony is that Trump, a germaphobe, apparently decided that the whole exercise was nothing more than a publicity problem. And so he embarked on a regimen of happy talk in the hope that it would all go away, thus displaying for the umpteenth time how utterly unsuited he is for the office he holds. 

Which gets us back to the narrative. 

There is little question that Trump put on a breathtaking display of incompetence in his initial response to the threat posed by the virus. That said, it is also the case that we have a systemic failure on our hands. The failure has been years in the making. It is the result of bureaucratic ineptitude and policies adopted across many levels of government over a long period of time. It is not the singular fault of Trump as the developing narrative has it. Nor is the solution to simply hand out buckets full of cash, which is the usual progressive solution to just about everything. 

Consider, for example, the latest policy initiative which is to “flatten the curve”. When epidemiologists talk about flattening the curve, they mean to spread out over time, rather than reduce, the incidence of contagion. The rationale for this is to avoid a concentrated case load that would overcome the treatment capacity of the health care system. Note that this approach, designed to save the system rather than individual patients, may very well result in more rather than fewer people becoming infected. On the other hand, if the system did become overwhelmed, it is quite possible, if not probable, that more people would die. 

Why Are We in This Mess?

At this stage of the game it is worth asking why the wealthiest, most powerful nation on earth finds itself with a potential shortage of hospital beds, other relevant medical equipment, doctors, nurses and other health care professionals. One important reason, although not the only one, is the collection of perverse incentives embedded in the health care system. 

Consider the question of hospital bed capacity. The limited number of available hospital beds is not an accident; it is there by design. Hospitals are subject to state as well as federal regulations.  Among those are requirements for hospitals to acquire a “certificate of need” or CON from state regulatory authorities before adding hospital beds and some other types of equipment, e.g.,— MRI machines. Partially as a result, the U.S. has only 2.8 beds per 1,000 people—less than the 3.2 beds Italy has. By way of contrast, South Korea heads the list with 12.3 beds per 1,000 people. (For an in depth discussion, please see this article in Reason Magazine.)

Anti-competitive restrictions on hospital beds and other capital equipment are not the only problem. The system is driven by price controls that discourage innovation. The biggest spender for health care is the federal government, which decrees what it will pay for certain services through Medicare and Medicaid. In turn, these pricing policies affect what insurance companies will pay providers. Which in turn affects premiums that customers pay. Which, of course, our modern central planners want to eliminate by making private insurance illegal, thus locking in all the market distortions the current system has embedded in it. A single payer system would rely on mandates and allow no competition, and would guaranty that supply and demand would remain out of alignment. 

But rational discussion of supply, demand and market pricing is to be avoided at all costs. The all important and phony narrative must be maintained. The problem is really the result of waste, fraud, abuse and corporate greed. Couple that with the fact that Donald Trump is president. Add the fantasy that he is illegitimate because Vladimir Putin put him there, and all the ingredients are there to believe anything. Anything but the truth of the matter, which is that a combination of incompetent leadership and the command and control system put in place over the years failed us. As usual.

Not surprisingly, because it fits the narrative, the solution being crafted in Washington is to throw money at favored constituencies, which may or may not have anything to do with the virus. Consider the argument for sending out checks to citizens in order to stimulate the economy. Does anybody seriously believe that sending citizens checks and then telling them to stay home is even remotely stimulative?

It is certainly the case that many citizens will experience significant hardship over the months ahead as the unemployment rate rapidly heads north. In this emergency situation it is proper for the government to act as a backstop, especially since it is a response to a situation utterly beyond the control of the citizenry. But it is important to note that the rescue is not free; the bill will have to be paid later. In addition, it should serve as a wake up call for reform that moves in the opposite direction we have been headed. The health care system should move toward decentralization, market pricing and local decision making rather than more centralization, price controls, and top down bureaucracy.  

But I’m not holding my breath. 

JFB