sábado, 1 de junho de 2013

Rep. Paul Ryan's Irving Kristol Award address: Conservatism and community - Society and Culture - AEI

Rep. Paul Ryan's Irving Kristol Award address: Conservatism and community - Society and Culture - AEI

Rep. Paul Ryan's Irving Kristol Award address: Conservatism and community - Society and Culture - AEI

Rep. Paul Ryan's Irving Kristol Award address: Conservatism and community - Society and Culture - AEI
Obama Care

The Obamacare Election

The Romney-Ryan plan is maddeningly vague, but at least it reduces the role of government in health care.
As the fractious 2012 presidential campaign careens down to a photo finish, no issue presents a starker contrast between the two candidates than health-care reform. President Obama is committed to implementing his elaborate reform of health-care markets by creating state exchanges, extending Medicaid coverage to some 25 million new enrollees, retaining the current reimbursement system for Medicare, and implementing an individual mandate.
Former Governor Romney seeks to repeal and replace Obamacare. On Medicare, Romney proposes a “premium support” or voucher system that would offer an alternative method of financial support to senior citizens and is calibrated to offer the largest subsidies to the most needy persons.
  epstein  
  Illustration by Barbara Kelley
In assessing these two programs, a recent New York Times editorial minces no words in its denunciation of Romney’s proposals. The Times argues that Romney’s undeveloped proposals will not grant sufficient coverage both to those who are currently uninsured and current Medicare recipients.
But the Times does nothing to protect its own flanks. The Times assumes, for example, that so long as Obamacare announces its intention to expand coverage and control costs that the techniques that it proposes will necessarily achieve that result. In fact, my greatest fear about the law is that it will topple on all fronts because its reach exceeds its grasp.
The law is, at best, a work in progress. It is not a complete program. Many of its features have already proved themselves to be economically unviable. The problem is the law’s key assumption that competition among private insurers will not bring down the cost of health care or reduce the ranks of the uninsured.
This same flawed reasoning led to disaster in real estate markets, where rent controls caused a reduction in the quality of housing and a reluctance of firms to remain in the field. Similar results are already happening with respect to health care under Obamacare. Its “medical loss ratio” (MLR) imposes a maximum amount of revenues that can be spent by insurers on “administrative” cost—a term of art that has yet to be fully defined.
The consequences of this one regulatory initiative have not been trivial. Many extant insurance plans, especially those targeted to low-income workers with high turnover rates, have applied for and received administrative waivers from the MLR requirements because their actual costs are far higher than the allowable MLR.
On this issue, the Department of Health and Human Services really had no choice, because the alternative would have been the wholesale withdrawal of insurance coverage to a vulnerable portion of the market given that the so-called insurance exchanges are not yet up and running. We are not talking about a small breakdown in the system: Over 3,000 employers have received waivers to keep their plans in operation for over 3 million workers.
The Messy State-Run Exchanges
The health-care law fares no better with its state-run exchanges, directed at those who are unable to procure health-care insurance through the voluntary market. Right now, there is a conscious equivocation on the part of the states to sign up, let alone invest, in a program that may well not be around after the November election. Even so, the law is unstable when taken on its own terms. As an economic matter, it may well be in the interest of employers to “dump” their employees—especially their high-risk employees—onto the exchanges that may not be up and running by the highly ambitious January 2014 date for their implementation, leaving many employees (whose income is too high for Medicaid) with no place to go.
It is unclear whether it is rational for employers to pay the required, but smaller, fee to the exchanges in order to avoid the direct costs of the new programs. One possibility is that they will retain coverage because they are able to pass much of these health-care costs down to their employees. But what if employees prefer higher wages and exchange coverage to lower wages and ostensibly better coverage?
The uncertainties here are great because it is not clear if either employers or the exchanges can afford to pay for the rich set of minimum coverage benefits that could prove unaffordable even for individuals eligible for generous government subsidies. The law presumes Cadillac plans as its default.
The Revenge of the Law of Unintended Consequences
The New York Times is heedless of the institutional risks of the law. For instance, it lauds the program for its decision to “require insurers to accept all applicants and charge them without regard to health status” starting in January 2014. That program was in effect as of September 2010 with respect to children, and it led to a contraction in the number of health-insurance suppliers in the market.
The larger initiative promises more of the same. Why? Individuals will likely load up on insurance when they need it, only to drop it, as they are allowed under the law, when their personal medical emergency has passed.
There is of course no way in which any market-based system of insurance will provide cross-subsidies to high-risk patients, which is what Obamacare tries to do. But in the concern for health-care access, it is easy to overlook one major advantage of market-based insurance, which is that people will retain their coverage no matter who else is admitted into the plan. Once cross subsidies are mandated, however, many people will find it cheaper to drop out of their plans than to pay insurance premiums for other people. The individual and employer mandates are intended to block that alternative, but, ironically, the law may well have set the penalties—or “taxes”—too low to achieve that particular end. Yet once these plans unravel, it could well increase the number of uninsured.
In an effort to respond to these concerns, the defenders of the law have claimed that it includes various efficiencies that are intended to keep the program from spiraling out of control. Really? The provisions already cited do no such thing, and the most careful analysis of the cost structure that I have read, The Fiscal Consequences of the Affordable Care Act, by Charles Blahous of the Mercatus Center at George Mason University, projects the exact opposite result by concluding that between 2012 and 2021, “The ACA is expected to add at least $340 and as much as $530 billion to federal deficits while increasing federal spending by more than $1.15 trillion over the same period and increasing amounts thereafter.”
As Blahous notes, these numbers are necessarily spongy because of the now inveterate tendency for everyone to regard new benefits as fixed in stone, but to treat new cost constraints as unfortunate nuisances rightly subject to constant erosion by future Congressional action.
The Times also falters in its claim that a government advisory board can make good on its promise to “propose cuts in payments to providers and insurers if necessary to meet budget targets.” That task requires the heroic assumption that the physicians and insurers will never exit the market if the payment cuts make it impossible for them to cover their costs, including those needed to comply with the law. Indeed, the real fear here is that the supply of health-care professionals will fail to meet the added demand generated both by the exchanges and the Medicaid extension.
Time For a Fresh Start
Plainly, there is need for a fresh start on this program. David Hyman and I have proposed that the only way in which it is possible to reduce costs and increase access is by a systematic program of deregulation that allows new entry into the market by parties such as out-of-state medical groups, corporate providers of basic health-care services, or out-of-state insurers now blocked from doing business within the state.
The Times itself pays a backhanded compliment to this proposal when it chides Romney for consigning the uninsured to emergency room care. But the entry of these new market players would reduce that grim prospect by allowing the entry of private health-care businesses into the market that specialize in providing walk-in care to all individuals at lower costs. Once those costs are reduced, individuals will filter back into the health insurance market without government compulsion.
The same can happen to employer health-care programs. Over the past 30 years, employers have dropped about 15 million workers from such plans because they cannot afford to pay for the government mandates that force them to offer expensive coverages for benefits that employees do not want.
In short, it is not possible to cure the present dangers of current regulation by more regulation.
The same can be said here of Medicare’s perilous situation, where the current program is not sustainable so long as it provides all individuals with expensive care at zero margin costs. It is difficult, of course, to figure out how to work a premium support plan, but at least the Romney-Ryan plan offers the promise of forcing individuals to internalize some of their own costs in an effort to prevent the system from going bankrupt, which it easily can do. The difficulties here stem in part from the delicate problem of transition, as it is not possible to cut current Medicare recipients from the program without massive and unacceptable dislocation.
The Romney-Ryan programs seek to introduce a ten-year transition period, after which those individuals who do not like the current Medicare program can opt into the voucher-like support plan that gives them greater control over their own health care expenditures. It would be rash to predict that any system like this could work, given the political risks that are sure to crop up during a long transition period. But it is foolish to think that yet another round of payment controls can bring the Medicare budget into balance, when all such efforts have had, at most, limited success during the 47 years of Medicare’s existence.
There is no easy path to health-care reform and there is no way in which market mechanisms, going forward, can undo all of the damage done to the system. But doubling down on government control of the market will not make matters better, as President Obama would have us believe. The Romney proposals are maddeningly vague in many respects, but at least they hold out the prospect of unraveling many of our past regulatory mistakes by shrinking the size of the government role in health care.

Richard A. Epstein, the Peter and Kirsten Bedford Senior Fellow at the Hoover Institution, is the Laurence A. Tisch Professor of Law, New York University Law School, and a senior lecturer at the University of Chicago. His areas of expertise include constitutional law, intellectual property, and property rights. His most recent books are Design for Liberty: Private Property, Public Administration, and the Rule of Law (2011), The Case against the Employee Free Choice Act (Hoover Press, 2009) and Supreme Neglect: How to Revive the Constitutional Protection for Private Property (Oxford Press, 2008).
Capitalism.
Mitt Romney's résumé at Bain should be a slam dunk. He has been a successful capitalist, and capitalism is the best thing that has ever happened to the material condition of the human race. From the dawn of history until the 18th century, every society in the world was impoverished, with only the thinnest film of wealth on top. Then came capitalism and the Industrial Revolution. Everywhere that capitalism subsequently took hold, national wealth began to increase and poverty began to fall. Everywhere that capitalism didn't take hold, people remained impoverished. Everywhere that capitalism has been rejected since then, poverty has increased. 

Capitalism has lifted the world out of poverty because it gives people a chance to get rich by creating value and reaping the rewards. Who better to be president of the greatest of all capitalist nations than a man who got rich by being a brilliant capitalist?
"Capitalism has lifted the world out of poverty because it gives people a chance to get rich by creating value and reaping the rewards."-Charles Murray
Yet it hasn't worked out that way for Mr. Romney. "Capitalist" has become an accusation. The creative destruction that is at the heart of a growing economy is now seen as evil. Americans increasingly appear to accept the mind-set that kept the world in poverty for millennia: If you've gotten rich, it is because you made someone else poorer.

What happened to turn the mood of the country so far from our historic celebration of economic success?

Two important changes in objective conditions have contributed to this change in mood. One is the rise of collusive capitalism. Part of that phenomenon involves crony capitalism, whereby the people on top take care of each other at shareholder expense (search on "golden parachutes").

But the problem of crony capitalism is trivial compared with the collusion engendered by government. In today's world, every business's operations and bottom line are affected by rules set by legislators and bureaucrats. The result has been corruption on a massive scale. Sometimes the corruption is retail, whereby a single corporation creates a competitive advantage through the cooperation of regulators or politicians (search on "earmarks"). Sometimes the corruption is wholesale, creating an industrywide potential for profit that would not exist in the absence of government subsidies or regulations (like ethanol used to fuel cars and low-interest mortgages for people who are unlikely to pay them back). Collusive capitalism has become visible to the public and increasingly defines capitalism in the public mind.

Another change in objective conditions has been the emergence of great fortunes made quickly in the financial markets. It has always been easy for Americans to applaud people who get rich by creating products and services that people want to buy. That is why Thomas Edison and Henry Ford were American heroes a century ago, and Steve Jobs was one when he died last year.

When great wealth is generated instead by making smart buy and sell decisions in the markets, it smacks of inside knowledge, arcane financial instruments, opportunities that aren't accessible to ordinary people, and hocus-pocus. The good that these rich people have done in the process of getting rich is obscure. The benefits of more efficient allocation of capital are huge, but they are really, really hard to explain simply and persuasively. It looks to a large proportion of the public as if we've got some fabulously wealthy people who haven't done anything to deserve their wealth.

The objective changes in capitalism as it is practiced plausibly account for much of the hostility toward capitalism. But they don't account for the unwillingness of capitalists who are getting rich the old-fashioned way—earning it—to defend themselves.

I assign that timidity to two other causes. First, large numbers of today's successful capitalists are people of the political left who may think their own work is legitimate but feel no allegiance to capitalism as a system or kinship with capitalists on the other side of the political fence. Furthermore, these capitalists of the left are concentrated where it counts most. The most visible entrepreneurs of the high-tech industry are predominantly liberal. So are most of the people who run the entertainment and news industries. Even leaders of the financial industry increasingly share the politics of George Soros. Whether measured by fundraising data or by the members of Congress elected from the zip codes where they live, the elite centers with the most clout in the culture are filled with people who are embarrassed to identify themselves as capitalists, and it shows in the cultural effect of their work.

Another factor is the segregation of capitalism from virtue. Historically, the merits of free enterprise and the obligations of success were intertwined in the national catechism. McGuffey's Readers, the books on which generations of American children were raised, have plenty of stories treating initiative, hard work and entrepreneurialism as virtues, but just as many stories praising the virtues of self-restraint, personal integrity and concern for those who depend on you. The freedom to act and a stern moral obligation to act in certain ways were seen as two sides of the same American coin. Little of that has survived.

To accept the concept of virtue requires that you believe some ways of behaving are right and others are wrong always and everywhere. That openly judgmental stand is no longer acceptable in America's schools nor in many American homes. Correspondingly, we have watched the deterioration of the sense of stewardship that once was so widespread among the most successful Americans and the near disappearance of the sense of seemliness that led successful capitalists to be obedient to unenforceable standards of propriety. Many senior figures in the financial world were appalled by what was going on during the run-up to the financial meltdown of 2008. Why were they so silent before and after the catastrophe? Capitalists who behave honorably and with restraint no longer have either the platform or the vocabulary to preach their own standards and to condemn capitalists who behave dishonorably and recklessly.
"Historically, the merits of free enterprise and the obligations of success were intertwined in the national catechism."-Charles MurrayAnd so capitalism's reputation has fallen on hard times and the principled case for capitalism must be made anew. That case has been made brilliantly and often in the past, with Milton Friedman's "Capitalism and Freedom" being my own favorite. But in today's political climate, updating the case for capitalism requires a restatement of old truths in ways that Americans from across the political spectrum can accept. Here is my best effort:

The U.S. was created to foster human flourishing. The means to that end was the exercise of liberty in the pursuit of happiness. Capitalism is the economic expression of liberty. The pursuit of happiness, with happiness defined in the classic sense of justified and lasting satisfaction with life as a whole, depends on economic liberty every bit as much as it depends on other kinds of freedom.

"Lasting and justified satisfaction with life as a whole" is produced by a relatively small set of important achievements that we can rightly attribute to our own actions. Arthur Brooks, my colleague at the American Enterprise Institute, has usefully labeled such achievements "earned success." Earned success can arise from a successful marriage, children raised well, a valued place as a member of a community, or devotion to a faith. Earned success also arises from achievement in the economic realm, which is where capitalism comes in.

Earning a living for yourself and your family through your own efforts is the most elemental form of earned success. Successfully starting a business, no matter how small, is an act of creating something out of nothing that carries satisfactions far beyond those of the money it brings in. Finding work that not only pays the bills but that you enjoy is a crucially important resource for earned success.

Making a living, starting a business and finding work that you enjoy all depend on freedom to act in the economic realm. What government can do to help is establish the rule of law so that informed and voluntary trades can take place. More formally, government can vigorously enforce laws against the use of force, fraud and criminal collusion, and use tort law to hold people liable for harm they cause others.

Everything else the government does inherently restricts economic freedom to act in pursuit of earned success. I am a libertarian and think that almost none of those restrictions are justified. But accepting the case for capitalism doesn't require you to be a libertarian. You are free to argue that certain government interventions are justified. You just need to acknowledge this truth: Every intervention that erects barriers to starting a business, makes it expensive to hire or fire employees, restricts entry into vocations, prescribes work conditions and facilities, or confiscates profits interferes with economic liberty and usually makes it more difficult for both employers and employees to earn success. You also don't need to be a libertarian to demand that any new intervention meet this burden of proof: It will accomplish something that tort law and enforcement of basic laws against force, fraud and collusion do not accomplish.

People with a wide range of political views can also acknowledge that these interventions do the most harm to individuals and small enterprises. Huge banks can, albeit at great expense, cope with the Dodd-Frank law's absurd regulatory burdens; many small banks cannot. Huge corporations can cope with the myriad rules issued by the Occupational Safety and Health Administration, the Environmental Protection Agency, the Equal Employment Opportunity Commission and their state-level counterparts. The same rules can crush small businesses and individuals trying to start small businesses.

Finally, people with a wide range of political views can acknowledge that what has happened incrementally over the past half-century has led to a labyrinthine regulatory system, irrational liability law and a corrupt tax code. Sweeping simplifications and rationalizations of all these systems are possible in ways that even moderate Democrats could accept in a less polarized political environment.

To put it another way, it should be possible to revive a national consensus affirming that capitalism embraces the best and most essential things about American life; that freeing capitalism to do what it does best won't just create national wealth and reduce poverty, but expand the ability of Americans to achieve earned success—to pursue happiness.

Reviving that consensus also requires us to return to the vocabulary of virtue when we talk about capitalism. Personal integrity, a sense of seemliness and concern for those who depend on us are not "values" that are no better or worse than other values. Historically, they have been deeply embedded in the American version of capitalism. If it is necessary to remind the middle class and working class that the rich are not their enemies, it is equally necessary to remind the most successful among us that their obligations are not to be measured in terms of their tax bills. Their principled stewardship can nurture and restore our heritage of liberty. Their indifference to that heritage can destroy it.

—Mr. Murray is the author of "Coming Apart: The State of White America, 1960-2010" and the W.H. Brady Scholar at the American Enterprise Institute.

Why capitalism has an image problem - Economics - AEI

Why capitalism has an image problem - Economics - AEI

A Fiscal Proposal Both Keynes and Reagan Could Support — The American Magazine

A Fiscal Proposal Both Keynes and Reagan Could Support — The American Magazine

A Fiscal Proposal Both Keynes and Reagan Could Support — The American Magazine

A Fiscal Proposal Both Keynes and Reagan Could Support — The American Magazine