Health-Care Smoke and Mirrors

So now the Left-Democrats (Social-Democrats) are focused on somehow ramming the health-care public option through Congress – even though they know that a significant minority opposes it (maybe even a majority). They absolutely refuse to hear the word "No"! Anyone who opposes them is a traitor, a stooge of the Insurance Companies, the Hospitals, or some other interested exploiter – never a sincere objector.

But when pushed about the details of the plan they provide one or more of three unsatisfactory responses.

1. The details have yet to be worked out
   
2. The premiums paid to the public provider will cover the costs
   
3. The private insurance companies are expensive because their profits are high – competition from the public plan will solve that
   

Let's consider these.

Number 1. is a cop out. For such a drastic proposal we need details. How is it going to be paid for? Who is going to pay for it? How much is it going to cost?

Number 2. is smoke and mirrors. Somehow the public provider will be able to cover its costs with premiums way below the private providers'. How can this happen? Which brings us to the number 3.

Number 3.- it's all the fault of the private insurance providers and their high profits. A lot of people believe this. They believe that medical insurance premiums are high because medical insurance companies make large profits. I find this puzzling. If their profits are so high (meaning their RATE of profit, not the absolute numbers) then why are there not more competitors. High rates of profit always attract competitors unless there is some real barrier to entry.

When I point this out I am told there is a barrier – the insurance companies are a cartel (a private monopoly) – they prevent entry by lower cost (premium) competitors. Really? How do they do this? And if this is the case, is not the appropriate response to break this cartel and allow vigorous PRIVATE competition? Why do we need a public, aka government, option. The government never does anything efficiently – why would anyone think the government would be good at producing medical insurance?

So where is this private medical insurance cartel and how do we break it up?

Understand this clearly, the public option, if it charges premiums below the competitive level will have to be subsidized. That means an extension of the model we have now for Medicare. Those who have private insurance will face even higher premiums, maybe much higher, because their medical costs will rise, so that the private plans end up subsidizing the public one. Private medical costs will rise becasue hospitals and doctors will not be able to make money on the public reimbursements (from the public insurer) so they will charge more to their private patients. But price-discrimination ("rich" pay more, "poor" pay less) can only be pushed so far. In addition there will be new heavy taxes – probably on the private insurance companies, which they will partially recoup by raising their premiums. The public option will grow. It will become bloated, inefficient and corrupt, like all the other public health systems - even the French one. And you and I will pay through the nose.

You can't get something out of nothing.

Rosh Hashanah and the Jewish Atheist

In the immortal words of Joan Rivers, let's talk:

I must confess that I enjoy the Rosh Hashanah and Yom Kippur shul services – and also Shabbat. I admit also that I love opera (well at least Italian and French opera). Apart from making me appear weird, what do these two things have in common?

Consider the Jewish religious texts, including the prayer books. It seems to me they comprise the most indigenous Jewish literature that we have. Though composed over many centuries, as we contemplate them today, they constitute an organic network of linked artistic achievement. Take the Machzor for example (Rosh Hashanah-Yom Kippur prayer book). This can be appreciated as an amazing work of art replete with poetry (including ingenious alphabetical acrostics and soaring metaphors), beautiful traditional prose verse and multiple allusions and connections to the Jewish experience throughout the ages. It is a carefully structured script, in numerous acts and sub-acts, for a yearly performance, a playing out of a hypothesized interaction between the Jews and their God, and between the Jews themselves. Every year the text is the same (save for minor insertions or omissions), yet every year we can approach it anew. No matter how many times I see La Boehme, or Madame Butterfly, I enjoy it every time – same music, same libretto, different arrangement, different tempo, different sets, different experience.

The Rosh-Hashanah-Yom-Kippur service is its own art-form. And it too can be enjoyed every time it is repeated. I appreciate the music, mostly in the form of East-European cantoral-choir music, if available, but also in the form of congregational communal singing. The music is evocative of shared memories, the harmonies are pleasing to the ear and the melodies provoke the closest thing to a religious experience I am capable of. Truth be told, it is the same feeling I have when listening to a sublime operatic performance. For me the parallel is exact.

But it is not only the music. The poetry and the text are fascinating and intricate. There are riches to be mined beyond the energy to do so – enough for a lifetime. One can appreciate the confluence of music and text when one listens to a chazzan singing the verses with complete understanding of the significance of each word in its context. But to do so one must have the background knowledge. Jewish education is as much about artistic appreciation as about theology.

I face multiple objections to this viewpoint. Both the Jewish fundamentalists (those who are literal believers) and the modern interpreters (who attach nuances to revelation) object to the "reduction" of a Jewish service to mere artistic expression. Many congregations have banished the art of the chazzan and the choir, feeling that a religious service should not be a "performance" – that, in admiring the virtuosity of the performers, one might be distracted from the overriding religious purpose of the service.

I have never found these objections persuasive – partly because I do not share their religious beliefs, but, also, partly because I believe that they involve a false dichotomy. One need not choose between the admiration of artistic virtuosity and religious fervor and sincerity. One can and should combine them. A very close lifelong friend of mine is a world-class chazzan, choir-master, arranger and song-writer – born to a Chasidic family. During his long and wonderful career as a chazzan, he would often introduce new melodies into the service, from the operatic and Broadway musical world, in addition to the wonderful, but now familiar, Carlebach fare. And he sometimes faced indignant protest and the suggestion that this bordered on blasphemy. His response was emphatic. If the music of the Phantom of the Opera could be used to display the grandeur of God, if it could provoke people to an appreciation of the wonders of this world, how could it be blasphemous to use it in that way? If it were not for him I would never have had much appreciation for the Jewish liturgy.

Still, I will not deny that art and religion are different things. The truly religious, if he appreciates the use of artistic expression in a religious context, sees it as being in the service of religion. I see it as art for its own sake. The appreciative experience of a thing of beauty is, for me, its own justification.

But not so fast! Consider this. Can we not see a connection between artistic expression and the human condition – between art and conscience? What makes us essentially human is our capacity for self-reflection. We do not merely observe. We observe and contemplate, we seek meaning in things. You can probably learn much about the nature of a person by observing what they enjoy, what they appreciate, what they find poignant in a poem, what kind of stories move them to tears. Morality and art are inextricably linked.

Which brings me to an old refrain of mine. We Jews like to claim all manor of morality from our tradition. So, for the fundamentalist Jew, looking to the vengeful and exacting God of Genesis, God is a right wing conservative. For the majority of the rest of the Jews, looking to the prophets and their preoccupation with "social justice," he is a modern "liberal" – the Democratic Party variety. (For me he would obviously be a classical liberal, a libertarian who understood the value of liberty and free markets). Did God create us or did we create him?

In any event, when Keats said, "Truth is beauty, beauty truth, that is all ye know on earth and all ye need to know" I think he was talking about more than aesthetics as simple sensual experience. When challenged on the inconsistency of my secular beliefs with my synagogue attendance, I am tempted to reply: "It's the aesthetics stupid." Yes, it is aesthetics, but its not just aesthetics, where aesthetics is understood as a limitation. I think aesthetics is a big deal. A work of art is something we can all appreciate and enjoy together.

This reminds me of a story that I am fond of repeating.

• Mr. Cohen's son: Dad, how come you go to shul?
• Mr. Cohen: What kind of a question is that?
• Mr. Cohen's son: I know you are a non-believer, an atheist, an agnostic, or whatever; so why would you go to shul?
• Mr. Cohen: Goldberg goes to shul.
• Mr. Cohen's Son: So what? What kind of an answer is that?
• Mr. Cohen: Goldberg goes to shul to talk to God, I go to shul to talk to Goldberg!

Some of my non-Jewish friends have misunderstood this story. They think it means that Cohen cynically talks to Goldberg about business (interesting interpretation!). Of course, what it really means is that Cohen likes to be among friends with whom he has centuries of tradition and much modern experience in common. He is far from cynical. He is affirming the value of friendship, of community and the enjoyment of beautiful things together.

Economics, Politics, Education and Religion.

Representative democracy may be compatible with the existence and maintenance of a free society, but it is neither necessary nor sufficient for it.

Representative democracy gone wrong can be a very dangerous thing. There are numerous examples from history, the most alarming being Nazi Germany – Hitler was elected and used the legislative process to get the laws he wanted. This example, while extreme, is only one of many. In fact it is probably more the rule than the exception, that representative democracies tend, gradually or rapidly, to erode the very freedoms that allowed them to be established in the first place. A dictatorship of a majority (or a plurality) is a dictatorship none-the-less, and it is not surprising that it often gives in to the temptations facing most dictatorships. In representative democracies this erosion comes from the tenacious pursuit by powerful interest coalitions of their economic and ideological self-interest (labor unions, environmentalists, steel producers, farmers of every kind, trial lawyers, you name it) – trying to obtain through the coercive political process what they cannot achieve through the competitive, but non-coercive, marketplace.

Barak Obama is the quintessential messiah of this erosion. It is his mission to use the democratic process to erode the respect shown to the competitive private property system on which our very civilization depends. How does this happen? Why do civilizations like ours flirt with suicide? Too big a question to answer fully in this space. The short answer consists of two elements – the free-riders and the economically-ignorant. Sometimes they overlap. The special interest groups, like the teachers unions who oppose the existence of free choice in education because they know it will threaten their incompetent existence, are free-riders; imposing the costs of their incompetence on the uneducated and mis-educated youth of America and the rest of us. The "liberal" ideologues who think that all the wrongs of the world are the result of the inequality in wealth and circumstance that accompany economic growth, and the evil intentions of those who benefit the most from it, are eco-ignoramuses. Sad to say, the majority of American Jews, who should know better, are part of this group.

Today's Wall Street Journal contains two pieces that address these issues. In a short editorial the editors bemoan the fact that, while the media's radar is fixedly tuned to the nationalization of health-care, the Obama administration has quietly killed a resoundingly successful education voucher program, benefitting 1700 low-income kids in Washington DC. This is a real scandal that deserves to be blasted from the rooftops. It is a sad and cynical example of both free-riding and ideological hubris backed up by economic ignorance.

The other piece is an article by Norman Podhoretz bearing the title of his just-published book, "Why are Jews Liberals?" It is truly astounding the extent to which America Jews evince a basic ignorance of the dangers of allowing government to accumulate too much power. It is astounding because if any group in history should understand that the power for good is also the power for abuse, it is they. It is they moreover who have been amongst the most prominent beneficiaries of the free-market system over the last 150 years. It is they who should understand that without freedom all of their other "progressive" social aims must fail. It is they who should understand that without freedom and secure property rights there can be no escape from poverty, that onerous taxation results in disinvestment and inefficiency and corruption – they should know this from their history if they would take the time to remember it.

As Podhoretz points out, however, the secularization of American Jews has resulted not only in the abandonment of their fundamentalist religious roots, but also in the passionate embrace of a new religion – the secular religion of the Democratic party that they call "liberalism" which should more accurately be called "statism." Having being given the freedom in America to choose to abandon their fundamentalist religious identities they are now leading the charge to have America abandon the essential ingredients of that very freedom itself. Could anything be more frustratingly ironic?

Secularization – the separation of religion and state, or, more importantly, the preventing of any religion from becoming law – is an absolute necessity in a free society. But if the benefits of freedom are to be sustained, the secularized must not be allowed to succeed in harnessing the power of the state for the achievement of their newly adopted secular "religion." This simply puts new, and deceitful clothes, on the same old pretender. The solution, however, is not a return to fundamentalism, as right-wing religious enthusiasts (Jews and Christians) think it is. It is rather an affirmation in concrete terms of the virtues of individual autonomy and the necessity of maintaining a break on the accumulation of power by any branch of government no matter how well-intentioned.

If this be seen as its own "religion," so be it. It is the only one that can save us from ourselves.