September 17, 2009

Are We Punishing the Immobile Among Us?

There are those who favor nationalized health care.  There are those who favor national standard testing for students in the realm of education.  These are but two examples in the drive towards nationalization that are often espoused by liberals, and in some instances even conservatives.  Those who promote a levelling of the playing field across the country (nationalization) argue that by not doing so, we are punishing the immobile among us. In other words, they argue that those unable to move to where better health care exists (for example), are stuck with the ersatz local health care they can reach.  They argue that nationalizing things ensures that everyone will have access to the best. But they are wrong. Indeed they are not just wrong but catastrophically wrong, for three reasons.
  1. The 50 experiments theorem (or as the President prefers, the 57 experiments theorem)
  2. The modern day mobility paradigm
  3. Lost time and treasure.
50 Experiments Theorem

Don't bother to look it up, I just created the name this morning. Here's what it means.  This logic can apply to health care, it can apply to capital punishment, it can apply to absolutely anything the government is involved in or wants to be involved in.  For the sake of explanation, education will serve as an example.  If the federal government were in charge of all education for every student in the country, there would be some synergy involved.  There would be uniform testing and it would quickly become evident if teachers in a certain region or state were outperforming or under-performing the rest of the nation.  In theory at least, costs would be streamlined.  Additionally, a point conservatives rightfully trumpet, a level playing field would ensure a more levelled equality of opportunity, as opposed to the liberal doctrine of an equality of outcome.  More on that in another post.

Given those benefits, why wouldn't America want a standardized educational environment?  After all if Japan, Korea, India, China or any other country is pumping out a better educated class of students shouldn't the United States do everything within it's power to compete?  Absolutely!  But by nationalizing the industry you are ensuring that is exactly what you are NOT doing.  Why?  It's simple.

The United States, given the intelligence of the 10th Amendment to the Constitution has the ability to leverage a crucible that most other countries can only dream about.

10th Amendment refresher:
The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.
That's a simple but powerful statement that allows an almost free market approach to government.  The 50 State Experiment amounts to this;

Every state can attempt to govern in the way it deems best fit for its own particular circumstance.  In most every legislative endeavor, that means 50 different approaches to a given matter. Some of these approaches will work very effectively, others are likely to fail miserably.  But by having 50 different shots at getting the answer right, you have dramatically improved your odds over one single, all-encompassing approach getting it right.

What if the national approach is 180 degrees wrong?  We're not talking about some minor tweak any longer.  We are talking about a legislative re-write on a national scale.  We are talking about missed opportunities.

Alternatively, 50 different approaches is likely to yield more than one success.  The free market of ideas then kicks in at a state level. Any state that has taken a bad approach will have at least one but likely more models to work from to correct its bad choice.  In other words, states learn from the right decisions of others and adapt.  Just like the free market does in any competitive environment.  The added benefit is that the corrections will likely come a lot faster than they would out of a monopolistic bureaucracy with a vested interest in protecting jobs, agendas, and personal reputations of that guy who decided teaching needlepoint instead of Math was a good idea. Left alone, things progress faster, and smarter, because of the Invisible Hand. Simple. 

And to push the idea down one level further, if private industry were allowed to compete on that platform, that 50 experiments could become thousands.  Imagine the improved probability of finding a successful model in that scenario.

Critics of this theory would argue that the United States could do the same by looking at 170+ other countries and choose the best among them to emulate.  That's a flawed premise though.  The United States has been a leader or the leader in so many aspects of innovation, technology, ideas, etc., that to start emulating other nations is not only a step backwards, its an abdication of the mantle of leadership that the country earned by it's robust pursuit of experimentation in every sector - both private and public. Why would you want to emulate India because they are beating you in education?  If you emulate them now you emulate something they will have moved beyond by the time you get there.  You have to look inward if you are leading the pack.  If you aren't leading the pack, you have to look beyond the leader and try to leapfrog them - not catch up.  That's the thinking of the second place finisher.


The Modern Day Mobility Paradigm


Don't look it up, I just coined that one too.  The argument against allowing the states to try their own "home-brewed" solutions to challenges is that by doing so you are harming individuals in states that are not getting it right. Firstly, it's arguable that they are harming themselves by not electing a different state government that is more responsive to the need to fix the problem.  More importantly though is the modern day mobility paradigm.
It is becoming increasingly ever more easy to become intellectually, if not physically mobile beyond the artificial borders of a state, a country, or the physical imposition of geography.
With the advent of faster and faster transportation, and more importantly, faster and faster communication, the world has become a much smaller place.  While someone might be stuck in a remote outpost in Alaska, it doesn't mean they don't necessarily have access to the Internet. Likely they do.  And that access means that they have access to knowledge resources beyond their own state borders. Intellectual mobility is not what it was 10 or 20 years ago.  If you twin in our education example, that mobility, with school vouchers, you given parents and students the ability to attend a school anywhere in the country, perhaps even eventually, beyond.

That type of virtual commute is ideally suited to education and ensures that no one is captive to a bad system.  Obviously the same is not equally true for health care.  But don't think about now, think about beyond tomorrow.  The possibility exists for virtual operating rooms.  If we can remote pilot a Predator drone across the globe, could we not, through the use of remote sensing and remote robotics eventually operate across the country?  That would ensure more equality of access to skilled surgeons.  The other point that would help is an agenda item the GOP keeps trying to push into the health care debate - opening up competition so that health care insurance providers can compete across state lines.  The competition will see to it that the most consumer-responsive models become the market norm.  There it is at work again - the Invisible Hand.

What the modern mobility paradigm does for America is return an untapped competitive advantage in competing to be the greatest country in the world.  The 50 experiments theorem allows someone with virtual mobility to select from the broadest range of options to find the one that best suits their needs.  Someone could be a resident of California and have engaged their entire education as supplied by Ohio.  They could be in a position someday in the not too distant future to have gotten virtual knee surgery from a surgeon in New York City.

That's real change.  Change doesn't come just because somebody promised it to you.  Change is inevitable.  Good change is what matters.  Good change requires meaningful and actionable vision and a way to navigate circumstances and developments to guide the outcome towards a better one.  The current liberal agenda is driven by a goal - nationalized health care service.  It's being driven by a predetermined solution, not an embracing of an "anything is possible" and a "let's brainstorm" style solution.  In that sense, there's a practical application of the 50 experiments theorem in effect.  The decision has been made and the objective is based on looking at running one experiment only.  You will never be able to quantify it against other options.  And perhaps that's been part of the agenda all along.

Which brings us to the last reason nationalization proponents have got it wrong.


Lost Time and Treasure

Let's face it, esoteric arguments aside, the 12 trillion pound dollar gorilla in the room is cost and to a lesser extent, missed opportunities.  This is an easy argument and countless others have already made it, comprehensively, emphatically and passionately.  The country cannot afford more cost.  No solution that has yet been proposed passes muster on the CBO calculation of deficit neutrality.  And none will. At least not honestly.  Reform comes in many guises.  Some of the easy reforms mentioned above like opening insurance competition across state lines are clearly deficit neutral.  Not to mention there is immediate expansion of consumer choice.  It does not address availability of health care to those who are uninsured.  But what exactly were Medicare and Medicaid designed for again?  Oh yeah.

The reality is that by requiring government to be a provider you are doing a couple of things.  You are creating a new bureaucracy. That bureaucracy will grow, and expand and become involved in an eternal struggle to promote it's own survival. Non-medical jobs are added to the equation and they will be fiercely protected just like in any other bureaucracy.  It means automatic debt expansion.

Another thing you are doing is creating a national provider that the President is saying won't crowd out the private providers, who co-incidentally, are still only allowed to compete within their own state.  The government sets the rules, the government has the biggest provider, it has the biggest available marketplace and is a provider of zero cost (on the surface of it) for many.  It doesn't matter how competitive the private providers are and how inefficient the government option is.  All the cards have been dealt to the big player (the government health care option), so it will win.

Lastly, the country is being promised the solution in progress raises the bar for all concerned.  That's also a canard, because what it is really doing is lowering the bar to the lowest common denominator.  More demand without more doctors means a supply shortage.  It means people will get short changed on their health car as medical staff get spread thinner.  It doesn't raise the bar on quality.  It means more people will have access to a lower quality product, and at a higher national cost.

Wouldn't you want to run a challenge of a few ideas for a couple of years and see which solution really does work the best?  If you are afraid of the answer, then I suppose not - you'd rather just ram your idea through before anyone can stop to ask any meaningful questions.  I urge you as Americans, to at least ask for a pause and an honest comparison and a real debate and a real experiment before you go down this path with no easy way back.

To not do so is to cast aside that greatest competitive advantage you have as a country, known as the 50 experiment theorem (to me at least) away.  To pass that up is either blind, foolish, naive, or all three.

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