My favorite TV shows

I haven't written in a while, and I don't have the stomach now to address my two front-burner issues: the invasion of Iraq and the Hydrogen Myth. Given that sage thrasher has misconstrued my exasperation with Commander in Chief as endorsement of that awful program, I thought I would take some time to discuss the shows I actually like.

I should mention that I was a big fan of Buffy, the Vampire Slayer: I own all five seasons on DVD, plus the two seasons of that crappy spinoff on UPN. I also enjoyed Angel, and own all those DVDs as well. But those shows are off the air, and it's time to move on.

I record four shows during the week: Desperate Housewives, Bones, House, and Veronica Mars. The first is out of habit: my wife likes it, but I don't care much about it now. I started out recording Kitchen Confidential and watching How I Met Your Mother -- out of a sense of loyalty to the Buffy alumni on those shows, but I lost interest. I also recorded Nightstalker, because I never got to stay up late enough to watch the original series, but since it was basically a regurgitation of X-files, without the fun banter, I stopped.

So the remaining three shows all have the following in common: they are plot-driven, but have sufficient characterization and are sufficiently well-written to have interesting and amusing interplay among the characters, and resolution of the plot comes through reasoned analysis by the principal characters. Plus, Veronica Mars has a cute blonde chick, which is something I've missed since since Buffy went off the air.

I hate reality shows, because, frankly, I have a life. Lost, and the whole brood of shows that one spawned, is too much driven by characterization and character development: the plots are too situational, too vague and ephemeral. Alias, with the cute but somewhat horse-faced Jennifer Garner, just got too weird.

The other shows I watch, obizatel'no, are Nightly Business Report (my son used to like it a lot, too, because of the music and the little up and down arrows for the stocks; also, because Paul Kangas is like a big muppet), The News Hour with Jim Lehrer, and, when the wife lets me, The MacLaughlin Group, or Five Heads Shouting.

We don't have cable anymore, otherwise I'd be watching Nip/Tuck and Carnivale -- which between them are probably as weird as Alias, and as vague and ephemeral as Lost et al. So what do I know?

Abusive lawsuits?

Okay, speaking of high medical costs, I have to say something about caps on medical liability lawsuits. I don't like 'em.

I am highly suspicious of any attempt to put limits on the ability of individuals to seek and obtain redress of wrong resulting from another's action. The civil court is the last resort for non-violent resolution of conflict among citizens, and if a citizen cannot receive full compensation for deliberate or negligent harm to him, can we blame him for seeking extra-legal means to do so?

The main complaint is that damages awarded by juries are too high, and that, therefore, damages must be limited. But to what level? Santorum's proposal, as reported by Nightline, is $250,000. But look at the costs for organ transplants. If the patient doesn't have to pay, insurance companies still do. The averages may fall under a quarter million, but what about the high end for liver transplants ($367,000)? UnitedHealthcare, in its policies that cover heart transplants, cover up to $1,000,000, so there must be costs relating to the average $148,000 for that procedure. What about missed work for somebody in the $40/hour range? What about the legal costs of a trial to secure that amount? What about inflation between the time the cap was set and the time the trial occurs?

In terms of other liability, here's an illustration. Suppose a developer builds 300 $200K houses on a plot of land that has unreported toxic waste on it -- or builds the homes such that they cannot be lived in. Would $60 million to fully reimburse all those homebuyers be considered excessive? Suppose a global company knowingly sells a product sufficiently flawed to, say blind or maim folks who use it: what are the lifetime costs of such injuries, and how many individuals might be supposed to have to pay them? If a thirty-year-old person goes blind, how many years of assistance, training, material aids shall such individual require over the course of the life remaining to him? Is $1 million ($25,000/year for the next 40 years) unreasonable? Suppose 50,000 individuals are so injured; or 100,000; or 500,000 -- would it be unfair to required the corporation to pay $50 billion dollars in settlement?

There is a sort of self-devouring serpent aspect to medical liability, of course, as damages are likely to be used to pay somebody else to repair whatever harm stimulated the suit. Surgeons or doctors who perform such services have to pay malpractice insurance, which rises a certain amount for all to cover large awards. I mention that to demonstrate my cognizance of it. It doesn't change the reality that, if somebody gets broken by a negligent doctor, there's still a certain amount that fixing the damage is going to cost. Capping awards may bring certain doctors to drop their rates for plaintiffs, but more than likely nobody will do anything for the amount of money left over after legal fees.

What all of this really represents is the complexity of our society. The illustrations above are all too possible -- imagine if Union Carbide's plant had been in Hoboken instead of Bhopal: what would the actual calculable damages have been? -- and I here add more. If you walk down the street, or even if you ride a bike, allowing your mind to wander may cause you to bump into somebody, but is unlikely to cause more than a broken bone to the object of the impact. Allowing your mind to wander while driving can kill somebody. Defective products can be produced one at a time by an artisan, or hundreds a day by a factory, or hundreds of thousands a day by a thousand factories -- scaling up the number of persons affected. A defective hammer causes less actual damage than a defective gas line on your furnace -- or battery in your pacemaker. A doctor who lances a boil is less likely to threaten your quality of life than a doctor who opens up your skull to remove an operable tumor. It is now possible for one person to do harm completely out of proportion to his own action, because an individual can control machinery that can exert . . . lots and lots of force or very little force in an extremely vulnerable area.

This does not mean that we should limit just compensation to those wronged by an individual's actions just because those harmed are so numerous and that individual is at the top of a large multinational corporation. What it means is that some activities, some systems, may be inherently too risky to be sustained. A CEO who claims not to know what his underlings are doing isn't mitigating his liability, but illustrating his foolishness. Sure, he can't know what everyone in his company is doing -- but a CEO must bear responsibility for it. That's what a CEO is. Corporations incapable of regulating their actions sufficiently to prevent harm to individuals MUST BE DESTROYED, NOT CODDLED. The sudden disappearance of such a corporation represents opportunity to competitors, who, in expanding, shall probably hire all those who lose their jobs when the company folds -- smaller competitors, each capable of doing less harm on its own. Or, perhaps, whatever the corporation was doing shouldn't be done.

It's not my intention to be a neo-Luddite, here, but the same idea applies to medicine. If a procedure is too fraught with risk, perhaps it shouldn't be performed unless the alternative is more risky. If a doctor botches a non-risky procedure, well, the doctor probably shouldn't practice anymore. Babies can be born without doctors, nurses, or anybody 'ceptin' the momma, and although complications in such a case are fatal to baby and mother, well, some births aren't viable.

Or, more reasonably, patients and juries must be properly educated to recognize that risks can only be managed, not eliminated -- for example, in the risky procedures from the previous paragraphs. It's interesting, therefore, that the folks I've heard pushing for medical tort reform are the kinds of folks who advocate policies that can only lower the level of science education: ignorance-based sex education, intelligent design, etc. The individual's right to be fully compensated for harm to him must not be impaired simply because of the ignorance of his fellow citizens.

Are some lawsuits frivolous? Of course. Are some awards ridiculous? Undoubtedly. But the resolution is found in a case-by-case manner, not with a blanket limit on awards. The most I'll accept is the requirement of unanimity in civil juries with regard to the binary question of culpability of the defendent, and even the scale of money to be awarded -- only so high as all jurors present approve. A judge and jury must be deemed capable of determining the validity and value of the case that it adjudicates. The juror is the ultimate guardian of individual liberties: randomly selected, unbeholden to any constituency save his conscience, deciding on only one case. Unanimity among a group of such individuals is the closest we can get to objective validation of a given interpretation of a specific case. Abstract, I know, but a unanimous juror is much less corruptible than a legislator, a judge, or a president. The Libertarian Party calls for full liability for individual actions, and where such liability is decided must not be the legislature, but the courtroom, because each individual is unique, and each action or case, a confluence of unique individuals and events, is best judged by a body formed specifically and only to decide it. Limiting liability by statute can only license individuals to harm others by rendering such individuals immune to full responsiblity for their actions.

But only if those individuals are wealthy enough, right?

Government Health Insurance as slavery

On some talking heads program on NBC today, various strangers were talking about the effects and validity of employers charging employees more for health insurance or firing outright employees for smoking or engaging in other risky behaviors. As I watched, I concluded that it was within the employer's right to hire or fire on any basis he or she chose, and that either employer action above was justifiable as a reasoned response to the expense of such employees to the company's health insurance premiums. Then I was left with the unshakeable suspicion that some level of government had caused this problem.

When taxpayers pay for everyone else's medical expennses, it is inevitable that personal behavior shall constitute a cost to taxpayers. That is, smoking, which is an exercise of individual foolishness, now raises costs for all citizens by requiring an additional expenses: a cessation program, respiratory treatments, cancer treatments, and even transplants. This becomes not a consequence to the individual, but what amounts to misuse of government funds. The logical extension, then, if all citizens should receive medical services for free, is that all citizens must be subjected to scrutiny and even penalty for engaging in activities that require more medical service.

Let me note at this point that health care is a myth: it doesn't exist. There are medical services and medical products, and then there are the choices that individuals make about diet, exercise, sleep habits, employment and nonemployment activites, etc. As above, universal health care requires subsidization of food, mandated exercise, a government nanny to put one to bed and get one up, and a government coach to keep one from taking unnecessary risks. Medical services and medical products are commodities, not rights or gifts, and should be treated as such, just as food, posturepedic mattresses, and Thighmasters are.

Think of taking your car to the mechanic. He looks it over, gives you an itemized estimate for the cost of repair, and you decide whether or not to have the repair performed at that time or place. Auto insurance companies actually require competitive estimates when they have to pay. Contrast this with a doctor's visit: you walk in, pay the check-up fee (or copay) and are billed separately for any tests that are run or any additional services provided. Doctor's overcharge, insurance companies underpay, each anticipating the other's intention. Wouldn't you rather get a reasonable diagnosis, be apprised of costs for further tests, and be given an estimate to fix what's wrong with you? Wouldn't it encourage lower medical costs if insurance companies required competing estimates for costly procedures? Granted, like the tow truck fee, you're stuck with a certain expense in emergencies. But once the car's off the road, and your condition is stable, economics can kick in. Take a look at this discussion on the evolution of health care costs.

But back to the government. State government requires all health insurance companies to cover specific medical services, varying by state. The federal government mandates other health insurance provisions for companies. This raises the cost of health insurance, which creates the alleged crisis in health care: many persons cannot afford healthcare unless it is subsidized by the employer and the government (one should point out that the pre-tax status of company health insurance premiums means that Americans who cannnot afford insurance are still paying part of the cost of those who have it provided by their employers). This reduces the ability of individuals to shop around for health insurance, or be comfortable not having any. It is analagous to the situation now of realtors trying to impose state regulation on all real estate transaction assistance, requiring them all to provide full-service, essentially forcing all realtors to charge more -- all to eliminate competition. Medical providers, including pharmaceutical companies are under no obligation to reduce prices on their products when government subsidizes those prices, either through elimination of competition, or through guaranteeing that those prices shall be paid by picking up the costs of, say, senior citizens, or other Medicaid recipients.

So, to come full circle, employers have to find a way to reduce the expense of group insurance policies. The most obvious way is to exclude or require extra funds from individuals engaging in behaviors that insurance companies identify as higher risks. If employees don't want to pay out of pocket, they have to put up with the drug tests and other measures the employers may enact. I'll note here that the International Workers of the World and other labor groups opposed the creation of company-based healthcare, for fear that the worker would become a slave of the all-providing company. That they failed to see the same danger in government-provided healthcare doesn't make them wrong about company-based healthcare.

As to the harshness of the title, I conclude that this situation constrains individual options to such a degree, by artificially increasing the consequences of certain choices, as a form of slavery. I view tax laws regarding 401k and other IRA plans, as well as Flexible Spending Accounts, Healthcare Spending Accounts, etc. as enslavement as well, and I'll talk about that in another post. The bottom line is that state regulation becomes a tool of sectors of the economy -- whether medical specialists or full-service realtors -- to restrict choice and increase cost for the consumer. Regulation also costs all tax-payers more, of course, because of the universally-borne cost of enforcement. The first step to rationalizing the cost of any product or service is to enable the consumer to choose among multiple providers of that product or service. See the Libertarian Party position on all this here.

Undoubtedly, some of you reading will ask what would happen to those who need medical services and can't afford them. As with all charity, my response is this: if you care enough about it, give your own money and try to persuade others to give theirs: don't enable the state to use its force to take property from everybody, or, worse yet, to distort the entire economy to ensure that only those within specific niches, can pay for the services in the first place. That's not generosity: that's tyranny.