Friday, January 29, 2010


Most Americans know that the cost of health insurance has far outpaced the rate of inflation for many years. Indeed the cost and availability of health insurance lies at the root of the Congressional impasse which has so enraged so many people.

But despite all the finger pointing from both ends of the political spectrum, no one seems to understand the rather obvious reason for increasing health care costs.

It’s basic, fundamental economics.

If you separate the duty to pay for a benefit from the right to receive the benefit, the demand for the benefit will go up. And if the demand goes up, the price goes up.

In short, health care costs go up because most people have health insurance!

Years ago at Cooley Law School, we introduced a modest $5.00 co-pay for office visits, and the cost savings were astounding.

Let me say it again: what makes health care so expensive is the proliferation of health insurance. It doesn’t make any difference if the health insurance is private enterprise or a public option; if you separate the right to receive health care from the duty to pay for it, the cost will rise.

The solution to the health care dilemma is simple: Let everyone pay for their own health care. If they want to buy insurance and can afford it, they will buy insurance. If they don’t want insurance or can’t afford it, they won’t buy it.

Wait a minute, you say. What if the people who can’t afford health insurance get sick?

Good question. I’m not one to say let them suffer or let them die. I strongly believe that one of the fundamental duties of organized society is to care for the needy.

It is the role not only of private charity, but also of public institutions to foster and protect human life. The homeless, the hungry, the infirm, the injured; they are all our brothers and sisters. It is the proper duty of government at every level to provide for their needs.

The outpouring of public and private help to the people of Haiti is proof enough that organized society comes to the aid of every human being on the planet.

But the duty to help the needy does not presuppose a level of largess beyond the reasonable capacity of the donor.

Providing a home for the homeless doesn’t require guaranteeing everyone a three bedroom house in the suburbs. Feeding the hungry doesn’t mean serving a Thanksgiving turkey dinner every night on every street corner. And attending to the sick and injured doesn’t demand that every patient have a private hospital room and nurses around the clock.

The first rule of helping people is to encourage them to help themselves. During the Clinton years, we opted for workfare over welfare. It is time for the Obama administration to stress selfcare over healthcare.

I’m not talking about a nanny state in which a ubiquitous federal government dictates everyone’s diet and exercise routine. But I am suggesting that folks without a lot of money have always found inexpensive ways to take care of themselves, and the best way to encourage them to do that is stop talking about giving everyone free health insurance.

I wrote a blog some time back about a plan I called Medi-Fex. It is a simple way to guarantee adequate health care for everyone without mandating universal health insurance. It puts the first duty to pay the doctor on the patient. That’s about as fundamental as economics can get.

Friday, January 22, 2010


In 1899, English poet Rudyard Kipling penned a poetic commentary on American occupation of the Philippines. Entitled, “The White Man’s Burden,” its sardonic message has been debated in literature classes for generations.

A New York newspaperman, John L. O’Sullivan, arguing for the annexation of Texas in 1845, insisted that the people of the United States were commissioned by the Almighty to migrate west. It was, in his view, our ‘Manifest Destiny’ to populate the continent.

Throughout the nineteenth and twentieth centuries the white man moved west under the protection of the United States army, which literally waged war against indigenous native tribes. Indians who were not killed or assimilated into the majority white population were moved to reservations.

Teddy Roosevelt personified the American spirit of ‘Manifest Destiny.’ He envisioned American expansion even more grandiose than stretching from sea to shining sea.

First Hawaii, then the Philippines. Roosevelt wanted a presence in the Pacific. He saw the native Filipinos as savages, primitive and uncivilized.

As President, he had 1,200 Filipinos brought to the 1904 World’s Fair in Saint Louis where they were put on display. James Bradley, author of The Imperial Cruise, quotes one fairgoer this way, “I went up to the Philippine village today and I saw the wild, barbaric Igorots, who eat dogs, and are so vicious that they are fenced in and guarded by a special constabulary…”

Further on, Bradley says, fair visitors would come upon the reassuring scene of freshly scrubbed Filipino children reciting their lessons in an American school, and finally they would see a troop of Filipino soldiers, dressed in U.S. army uniforms, and performing snapping military drills.

It was all part of what Roosevelt, and McKinley before him, had lauded as a policy of ‘benevolent assimilation.’ Benevolent indeed. In fact, the American occupation of the Philippines, after purchasing the islands from Spain for 20 million dollars, was a long, bloody, and brutal war. Natives were tortured and murdered by the tens and hundreds of thousands. Returning veterans were quoted in newspapers as saying, “The country won’t be pacified until the niggers are killed off like Indians.”

The water cure, a crude and violent precursor of waterboarding, inspired a popular U.S. army marching song,

Get the old syringe boys and fill it to the brim
We’ve caught another nigger and we’ll operate on him
Let someone take the handle who can work it with a vim
Shouting the battle cry of freedom

We Americans have always been confident of our own rectitude. And we have every right to be proud of our tradition of generosity and compassion. This evening, we saw film clips of U.S. soldiers and marines ministering to the suffering people of Haiti. Last Sunday, our priest told us that the entire weekly collection would go to help the earthquake victims. At the Publix market, the check out lady asked if I wanted something added to my bill for Haitian relief.

We give, and we pray. And some of us get up and go to wherever we may be needed. Wherever we can help.

And when we see the squalor and the poverty and the anarchy; when we hear of the looting, the fighting, the random violence; the frantic grabbing and clutching that frustrates attempts to organize distribution of food and water, we wonder why there is no order, nobody in charge, no system in place for relief and survival.

Today there are echoes of Teddy Roosevelt’s benevolent assimilation. How many years will it take to rebuild the infrastructure in Haiti? How much will it cost? How can we be assured that our largess is not wasted by corruption and incompetence?
How long should our troops stay to help the people?

Perhaps we should ask ourselves whether it is really our manifest destiny to

Take Up The White Man’s Burden.
Send forth the best ye breed
Go bind your sons to exile
To serve your captives’ need
To wait in heavy harness
On fluttered folk and wild
Your new caught, sullen peoples,
Half-devil and half-child

Saturday, January 9, 2010


My son the law professor said it. Life is messy.

Like the view out the window of a speeding train, the landscape changes minute to minute. What was isn’t. What is wasn’t.

On Christmas Eve, 1979, the Soviet Union, led by the implacable Leonid Brezhnev, invaded the neighboring country of Afghanistan. It was a David and Goliath scenario. The mighty Soviet Union, with its nuclear arsenal, its sputniks in space and its powerful modern army against a primitive, tribal, disorganized country.

The Berlin Wall was still standing. Planet Earth shivered in a Cold War that divided humanity between East and West.

For the next eight and a half years, the Soviets tried to subjugate the Afgan people. But the locals refused to stop fighting. Student gangs, known as the Taliban, and other rebels and freedom fighters, called Mujahideen, fled to the mountains and kept up a continuous disruption of the Soviet occupation.

And, of course, the people of the United States cheered them. We had learned in World War II that the enemy of our enemy is our friend. In Afghanistan, the Taliban were the good guys.

And we helped them. The movie, “Charlie Wilson’s War” tells the story of how we did it. Our CIA sent guns. And missiles. And copies of the Koran, because we wanted to encourage the Mujahideen to see their struggle as divinely inspired.

In February of 1989, a new Soviet leader, Mikhail Gorbachev, called his soldiers home. Afghanistan had been his Viet Nam. On June 12, 1987, Ronald Reagan demanded, “Mr. Gorbachev, tear down this wall.” Five months later, it came tumbling down.

Like a sudden change of scenery, September 11, 2001 opened the curtain on a new world view. The President of the United States, with the acquiescence of the Congress, ordered the invasion of Iraq. Nine years later, we are still there.

A new President, elected on a wave of anti war sentiment, now tells us that we are at war with Al-Qaeda. His army is in Afghanistan killing and being killed by the Taliban.

“Since 9-11 there has been an unfortunate confusion between the Taliban and Al-Qaeda in the minds of people who were previously unfamiliar with this region -- to the point where a U.S. member of Congress once expressed great surprise when I said the Taliban were not the people who [attacked] the World Trade Center," So says Barnett Rubin, Director of the Center on International Cooperation at New York University.

Of course the Congressman doesn’t know the difference between the Taliban and Al-Qaeda. Nobody in the streets of America does. To most of us, they are all Muslims. Fanatic Islamic Jihadists who grow their beards, subjugate and mistreat their women and regard Hugh Hefner’s America as an infidel nation.

Life is messy and war is the messiest part of it. Give a man a gun and he wants to know who he is supposed to shoot. In the good old days when Christian nations used to do battle with each other all the soldiers worn uniforms. You knew who the other guys were.

In Korea and Viet Nam, our people called all the natives “gooks.” The good gooks and the bad gooks all looked alike, but you were only supposed to kill the bad ones.

In World War II, we knew what we were trying to do. Winston Churchill and Franklin Delano Roosevelt agreed that the goal was to achieve the unconditional surrender of the Axis powers.

President Obama says we are at war with Al-Qaeda. O.K., then what is our goal?

Are we trying to get Osama Ben Laden and his followers to surrender, so we can bring them all to New York and put them on trial for 9/11? That’s not war. That’s law enforcement. That’s criminal justice.

Or are we just trying to kill them? Kill Ben Laden. Kill all the members of Al-Qaeda. Kill all the fanatical Muslim Jihadists who want us dead.

That’s not war either. That’s genocide.