Saturday, May 29, 2004

Promotion of Buggery Intimately Connected to Obesity

According to Lord Tebbit of Britain's House of Lords:

A high ranking Conservative member of the House of Lords says that the push for civil rights by gays is leading to a nation of obese people. Lord Tebbit then compared same-sex marriage to the promotion of buggery.
Tebbit, the former chair of the Tory party and its current Whip in the Lords, was debating the growing problem of obesity with a member of the governing Labor party on a British radio program.
He suggested Labor's ''promotion of buggery'' was ''intimately connected'' to the increasing number of overweight people.
''Families now so seldom eat together. They don't prepare meals properly. Wives are pressurized into thinking they ought to go out to work instead of looking after their children. And it is the breakdown of family that is at the root of it.

Mindboggling. It's almost admirable in its idiocy. I especially like the pressurized women. It's a model specimen of how so much of the extreme right propaganda starts with the conclusions: "the gays did it" "the uppity working women did it", and then rearranges the landscape between this and the problem at hand to lead to where they want to go. That's why crime is caused by feminism, by the way, and why our national defence is weak. In fact, everything is the fault of those people who are demanding their rights, yet shouldn't have any. In a hierarchical right-wing society large numbers of people are needed standing and just holding up the ladders so that others can climb, and horror of horrors if some of the supporters go and get their own ladders! Imagine the teetering on one leg of the ladder! Hmmm. I wonder if Lord Tebbit is at all overweight?

Thanks to frog for the link.

Friday, May 28, 2004

Friday Night Dog Blogging

Or blog dogging. Hello, this is Henrietta the Hound, the smarter of the two dogs at the Snakepit Inc.. All the others are asleep right now, having gorged on strawberries (the goddess) and kibble (Hank the Rethug Labrador). (The snakes are always asleep.) I'm in charge. Finally!

The first thing I wanted to do is to activate picture blogging so that you can see how handsome and soulful I really am, but I may not have enough time; I hear them moving in the other room. But I am handsome and soulful and should be the president of the United States.

For one thing, I would never have let Chalabi's nephew pretend to be the new prime minister of Iraq. Everybody knows the dangers of in-breeding, except the idiotarians in Washington, D.C.. Just look at Hank to see what I mean! Ok, he may not be a real nephew, but he sure sounds like a brother-in-arms to Chalabi.

For another, I would never have stooped to torturing. A good butt bite is all that's needed for anybody who wants to show domination. It works for me, and it would have worked for George Bush if he possessed any real canines.

Here's my proposal: Let me in charge of the world for one year, and then judge if things are better. During that time, humans are limited to only the necessary roles like opening cans and driving cars to dogparks, but in return I promise a democracy in Iraq (I know a lot of good dogs there), an American revival and unlimited Parmesan cheese to all dogs. And a world at peace. What do you say? What can you lose by this arrangement anyway?

Yours, in solidarity
Henrietta the Hound

Puritan Thoughts

People are too fat. They cost the health care system far too much. Smokers are evil. Their health care shouldn't be covered. Pregnant women should not run, take hot baths, go to work, get angry or sad. If they do, they're sinners and deserve chastizing, maybe ultimately even prison sentences.

This is my summary of many health issues I read or hear about. There is a fire-and-brimstone tinge to these stories, an air of moral putrification and its purification, and the experts are sometimes not easily separable from enthusiastic preachers and judges. A sort of a Puritan carneval.

Now we're all eagerly out there condemning overweight people. Overweight causes more preventable deaths than smoking, we're told. And then we go for the artery: Who's to blame? Maybe McDonald's is. But no, every overeater is responsible for her or his own extra pounds. And here's what you do: cut out everything that brings you some psychological relief during your long and stressful day, replace these things with raw slices of cabbage and jog home with a backpack full of stones. Or if you're very poor, just take seven buses with poorly overlapping connections to the nearest organic food store and spend your month's income on expensive fresh produce. Then take seven buses back and cook for the next four hours. And the children in ghettoes? Well, they should ride their bikes to school or walk. And the children in the suburbs? Well, they can't take bikes or walk, they might be kidnapped, you know, so parents should drive them to martial arts classes and to gym classes and to baseball clubs. Of course, then the parents will get fat from all that sitting in the cars.

Then we'd all be really healthy and deserving of others' respect. Until the next purification carneval comes along, and some other deep weakness in our personalities, nay, in our very souls will become the object of public condemnation and scrutiny.

I'm not a Puritan goddess. I'm slender and healthy due to my divine genes, so it would not be fair of me to join this raving and ranting. But let me point out a few corrective facts: Fact 1: The most expensive patients for the health care system are ultimately the "healthy lifestyle" people, as they'll end up in nursing homes until they are 102. Nursing homes are very expensive to run. The average beer-and-hamburgers guzzler will keel over quickly of a heart attack at sixty and save us both the retirement payments and the nursing home costs, especially if he or she is one of those people who don't bother with checkups and stuff so that there is no forewarning of the attack.

Fact 2: People usually try to live their lives as best they can. Parents don't usually try to make their children fat slobs with diabetes. Pregnant mothers don't usually try to choose lifestyles as bad as possible for their fetuses. Sometimes people eat too much or smoke because this life can be almost unbearable at times without such crutches.
Yes, by all means, give people better information, give them healthy, quick and cheap recipes. Make the streets safe for kids to ride their bikes, encourage walking and playing outside. Give workers some relief from stress, and have grocery stores offer good healthy food at a reasonable cost. Give everybody the know-how they need to negotiate life successfully. But don't blame those who falter. You have not walked in their shoes. Maybe they're better people than you, Mr. or Ms. Expert. Maybe they take care of orphaned children, maybe they spend hours working in the soup kitchens, maybe they rescue abandoned animals. Maybe they're just ordinary people in a world that sometimes seems to go crazy around us, and we have no control over those events. And you're going to tell them how bad that chocolate bar is going to be to their arteries in ten years' time?

Fact 3: People will ultimately die. Even if their mothers never smoked and drank while pregnant, even if they exercized every day of their lives and never ate anything but bran and flax oil (or especially then). We can't control this, and we can't control all the diverse causes of disease and accidents. We can try our best, but there comes a time when we must say that this is how life is. It ends. What should matter more, perhaps, is how that life is lived, what it has brought to the world, how we share the trip together. What could matter more is some compassion, some humility, some love towards others. And who knows, this might make us all healthier, too.

Thursday, May 27, 2004

Something Fun and Relaxing

I need to laugh a little. I think we all do. So what good jokes have you heard recently?
Use the comments to tell us.

Here are a few I found today, to get you started:

God and the Village Idiot
One day God was hanging out at the Pearly Gates with St. Paul.

"I need to find someone to run for president," he said after a while.

Attentive to his boss' needs, St. Paul started naming off a few qualified candidates.

"Nah, I want that guy," he said pointing to a drunken Texas governor pissing off a balcony.

"You've got to be kidding," said St. Paul, "Not only is he dumber than a box of rocks, he's got drinking and drug problems."

"I don't care," said God, "This is the guy."

Perplexed, St. Paul asked: "What is the problem, Lord, art thou angry with the Americans?"

"No," said God, "I made a bet with the Devil that I could get a village idiot to run for president."

"But won't that work in the Devil's favor, oh Lord?" Paul asked.

"That's all right," said God, "he'll never take Florida"

How the Bushies Change a Light Bulb
How many members of the Bush administration are required to replace the proverbial light bulb?
Are you ready for this?
The Answer is SEVEN:
(1) one to deny that a light bulb needs to be replaced;
(2) one to attack and question the patriotism of anyone who has questions about the light bulb;
(3) one to blame the previous administration for the need of a new light bulb;
(4) one to arrange the invasion of a country rumored to have a secret stockpile of light bulbs;
(5) one to get together with Vice President Cheney and figure out how to pay Halliburton Industries one million dollars for a light bulb;
(6) one to arrange a photo-op session showing Bush changing the light bulb while dressed in a flight suit and wrapped in an American flag;
(7) and finally one to explain to Bush the difference between screwing a light bulb and screwing the country.

Smith Barney Advertizing

This one is in Vanity Fair, the current number, page 105. The picture shows a very early morning scene, the sun is just reaching its first rays up from the horizon and world is beginning to show the first faint signs of color. A man carrying a heavy attache case is leaving a building, walking towards the only car still parked in the lot under a solitary street light. No other life anywhere. The man's back is permanently bent forward, and he looks ready to stumble.

The text in large letters says: "Your financial consultant may share your goals, but does he share your work ethic?" The rest of the text reinforces the same idea: Smith Barney only hires workaholics who hate their children and spouses. They all work twenty hour days, then take a quick four hours off to shower, eat, and change to a new pinstriped suit. Then back to the treadmill.

The ad ends with: "This is who we are. This is how we earn it."

And someone actually regarded this as a clever form of advertizing! My money doesn't go to an institution that selects people based on their own self-destructive work habits, and then sucks them dry before throwing them into the garbage (even if well padded with bank notes). My money doesn't go to an instution that is so niggardly that it won't hire enough people to work ordinary working days, or to an institution who employs workers so inept that they have to stay redoing it all night long. And one of these must be the explanation for the sad-looking bent-over shape dragging itself to the cold car at about four a.m..

Some Coleslaw

This coleslaw is not edible, which is probably a good thing as I am a very bad cook. Rather, it is bits and pieces from various articles, mixed together and seasoned with my comments. The idea behind this is one well-known to us lazy cooks: when you don't feel like slaving over the hot stove, serve people a salad of everything you find in the fridge.

The first thing I unearthed is the news that the National Public Radio is, alas, not liberal as we have all been taught to believe:

Despite a perception that National Public Radio is politically liberal, the majority of its sources are actually Republicans and conservatives, according to FAIR, a left-leaning media watchdog.
"Republicans not only had a substantial partisan edge," according to a report accompanying the survey, "individual Republicans were NPR's most popular sources overall, taking the top seven spots in frequency of appearance." In addition, representatives of right-of-center think tanks outnumbered their leftist counterparts by more than four to one, FAIR reported

This isn't news to anybody who has recently listened to the NPR, which just may be short for Nice, Polite and Republican. Though they do broadcast the BBC World News. But the widespread assumption that NPR is left-wing tells us something about how the public conversation has been hijacked by the right, and how they now define all the terms, including the term 'liberal'.

The second snippet is on a topic that scares me, and I include it here for its scare value, not because I necessarily believe that it is true:

If religious conservatives win their fight to define marriage as between a man and a woman, Ferree warns, they might not stop there.
We find ourselves now in a strange period of what might be called attempted Christian Fascism. Our president believes God has called him to the White House (it certainly wasn't the popular vote). Empowered by Bush, evangelical Christians are pushing for a rollback of Darwin, the end of scientific experimentation, and the coming of Armageddon. The hallowed American separation of church and state has never been more under attack. The goal is the creation of a Christian nation - and later a Christian world - under Biblical law.
So after a constitutional amendment, the next logical step would be defining the roles of men and women in heterosexual marriages according to Biblical standards. Can you hear the patriarchy calling

I stopped my ears with wax a long time ago, and also had myself tied to the mast of my ship. So I don't hear the patriarchy calling, but there are lots of people, with names such as Ann and Rush and George and Midge and so on, who not only hear this calling but hum along as loud as they can. A Christian world doesn't appeal to me that much, either; what would happen to my snakes in such an environment? They would probably all be hunted down and turned into Bible covers or whips for self-flagellators.

Finally, something about animals:

"Human beings," says an American novelist, "are chimpanzees who get crazy drunk on power." The novelist is selling the chimpanzees short. Ever see a chimpanzee force another chimp into acts of sexual degradation - for tourist photos? Or cut the head off another chimp - for God? Or unleash the forces of "smart bomb" hell on other chimps - for freedom, for imaginary weapons of mass destruction, for oil?


Wednesday, May 26, 2004

The "Election Threat"

As we have all heard from our dearly beloved John Ashcroft, the terrorists are already here, among our midst, plotting to cause widespread death and havoc. The information is very credible, he says, but, as always, it does not include what, where and when. Just that something really horrible is in the planning stages, perhaps a plague or radiation sickness or a smallish nuclear war. Be very, very afraid. You are powerless, a fly trapped in the spider's web just waiting for the moment when the poison strikes you. But do not worry: all is in the good hands of the administration.

I am doing my utmost to pray to all powers, whether real or not, that nothing of the sort will happen. I don't want people to die for any reason at all, and especially not for someone's delirious nightmare views of a war between what some misguided people call civilizations. Or for someone's desires to have unlimited power. We really need to put adults in charge of this world, and that goes for both sides of this so-called war.

Just consider this interpretation of the terrorists' plans:

That information dovetails with other intelligence "chatter" suggesting that al-Qaida operatives are pleased with the change in government resulting from the March 11 terrorist bombings in Spain and may want to affect elections in the United States and other countries.
"They saw that an attack of that nature can have economic and political consequences and have some impact on the electoral process," said one federal official with access to counterterrorism intelligence.

That's why the purportedly planned attack has been coined the "election threat": we are to view it as an attempt to change how we vote: If there is a terrorist attack this summer, then the terrorists have won if Americans vote for Kerry. On the other hand, if there isn't one, then Americans should vote for Bush as he kept the country safe. Get it? There's only one acceptable conclusion: Americans must vote for Bush.

But that's what Al Qaeida wants, too, of course. They can have no more suitable enemy in their desire to set all of Islam against all of Christianity than George W. Bush. He's reacting exactly as they wish him to do, and no way would anybody in Al Qaeida want an adult in control on the other side. That would ruin their games completely.

If we had adults in power, Al Qaeida would be regarded as the criminal gang they are. They would not be given the kind of status they get today. Instead, they would be hunted down by the police forces, arrested and punished as their crimes deserve. Ordinary innocent people on both sides of the religious divide would be allowed to live their lives peacefully and with dignity. But then adults are not in power, and I am only a minor goddess not all interested in world domination.


I knew someone who went to work one day and never came home. That day was September 11, 2001. He is still dead. Countless others know someone who went out or went to sleep and is now also prematurely dead, either on that date or on other dates before and after, and all these loved ones and missed ones are still dead. These senseless deaths are not to please any God. The very earth cries when such things happen, and the only creatures who receive sustenance from violent death, fear and suffering are very sick souls who never grew up. They should not have the power to kill, and that they do have this power is to the eternal shame of all of us.

Tuesday, May 25, 2004

On Aprons and Sin

An interesting snippet of news:

Women legislators in California staged a protest on Monday over remarks that it was "sinful" for them to leave their children at home while they served in the state legislature. The sexist remark came from Pastor Ralph Drollinger, president of the evangelical Capitol Ministries, who leads a weekly Bible study session with lawmakers and staff members. According to the Tri-Valley Herald, he wrote in a Bible lesson that "It is one thing for a mother to work out of her home while her children are in school. It is quite another matter to have children in the home and live away in Sacramento four days a week … [T]he latter is sinful." The Bible lesson was about the different roles of women and men in parenting – "Man's is, primarily, to be a breadwinner, and woman's is to be at home nurturing their children," said Drollinger, according to the Herald.

A dozen women legislators protested the remarks by arriving to the Capitol on Monday wearing 1950s-style dresses and aprons, and the state Senate Majority Leader, John Burton, showed his support by tying on a floral apron over his suit, the Contra Costa Times reports. The women's caucus later asked the Rules Committee to clarify which groups should be allowed to meet in the Capitol, saying that groups that encourage sexist beliefs should not be allowed, the Times reports.

Actually, the Bible doesn't say anything about men being the breadwinners or about women having to stay at home nurturing their children. That is something Pastor Ralph Drollinger says. It's just more convenient for him to insert the same message into God's mouth, or maybe he thinks that he has full diplomatic powers of representation.

That Damned Liberal Media

Here we go again. Instapundit notes the following in his blog:

Those convinced that liberals make up a disproportionate share of newsroom workers have long relied on Pew Research Center surveys to confirm this view, and they will not be disappointed by the results of Pew's latest study released today. . . .
At national organizations (which includes print, TV and radio), the numbers break down like this: 34% liberal, 7% conservative. At local outlets: 23% liberal, 12% conservative. At Web sites: 27% call themselves liberals, 13% conservatives.
This contrasts with the self-assessment of the general public: 20% liberal, 33% conservative. . . .
While it's important to remember that most journalists in this survey continue to call themselves moderate, the ranks of self-described liberals have grown in recent years, according to Pew. For example, since 1995, Pew found at national outlets that the liberal segment has climbed from 22% to 34% while conservatives have only inched up from 5% to 7%.
The survey also notes a dramatic "values gap" on issues like gay marriage and belief in God. But : "Of course, no one would ever expect this to impact the way news is covered."
Though, the war and the Second Amendment aside, my views are probably closer to those of the press than the general public, I have to agree with those who find this troubling. If despite aspirations toward objectivity, reporters' gender and ethnicity is as influential on the news as newsroom diversity advocates tell us, then surely reporters' views are even more significant. So where's the move toward greater diversity there?

You tell me, instapundit. How come do we have a hundred Rush Limbaugh wannabees on every radio station? How come are nine out of ten political commentators so right wing that I often find myself muttering Molly Ivins' unforgettable words: It was better in the original German.

So instapundit finds the number of liberal journalists troubling. I wonder if he finds the number of conservative media owners troubling, or if he loses any sleep over the fact that Rupert Murdoch, a well-known arch-conservative, will soon own most of the news sources in this country. It is very odd that a capitalist would simply assume that the workers in a firm make the decisions and that the owners just meekly stand by. Yet this is what right-wing commentators always assume about the media.

They also conveniently forget that the number of pundits who are right-wingers completely swamps the very few and almost invisible left-wing pundits (can you mention any?) in mainstream media, and it hardly ever occurs to them to point out that the whole Fox News is explicitly and extremely conservative in its coverage. So is much of the rest of the so-called liberal media. In fact, the conservative assault on the presumed liberal dominance of the media has been so successful that many media outlets bend over backwards to not seem too lefty. The result is that the observable bias in the media is considerably more conservative than liberal. Read Eric Alterman's book What Liberal Media? to get the facts, or at least some countervailing bias. Even the New York Times, which was mentioned by twenty per cent of the surveyed journalists as liberal, has David Brooks as its columnist. Where do such great writers as Molly Ivins find employment? In the left fringes of the media, that's where.

In fact, my reading of the various pundits has convinced me that there is affirmative action of an unusual sort going on in the media world: if you're a rabid conservative, you'll be snapped up in no time by some major newspaper or tv station, and you'll be given your very own column or show, even if your writing is on the fourth grade level or if your screen presence is that of a vulture who never cleans its teeth.

There! Now that I have gotten all that off my chest I wish to return to my austere goddess-of-scientific-argument role and point out that the journalists interviewed in the Pew study differ from the general population much more in one yet unmentioned characteristic than in their political views. That is their education level. Only five per cent of those surveyed lacked a college degree. Now, if you made me guess I'd surmise that the political views of these journalists look a lot like those of other people who have college degrees. Sadly, I was unable to unearth any clear statistical data on political views of the college educated, but I'm willing to go out on a limb here and propose that the media professionals are not that different from most educated people. Instapundit might agree with me here, but would probably argue that this just shows the horrible results of our lefty university professors having brainwashed people over the last three decades. An alternative, and saner view, is that college education does make one think differently about some issues, even without any foaming-in-the-mouth liberal professors. Education is supposed to open the student's mind to new ways of thinking, after all.

The 'value gap' in beliefs in God that instapundit refers to might be a good example of this effect. According to the Pew study, sixty per cent of the general public surveyed stated that people who don't believe in God can't be truly moral. In contrast, the vast majority of the surveyed media workers believed that atheists can be moral. I would argue that the media views are the correct ones here, and I have considerable evidence on that. Sometimes not reflecting the views of the general public is like being the one lemming who doesn't think that a nice suicide would be just the thing on a lovely spring day. Sometimes the one lemming is right.

So what determines how liberal or conservative the news presentation of the media will be? This is the real question in the debate, and the conservatives argue that it is determined by the political affiliation of the workers in the system. Most liberals argue that the ownership of the media outlets should be of at least equal, if not greater concern, just as the owners of the firm have the final say in how they operate. Liberals also point out to studies which demonstrate a preponderance of dependence on right-wing think tanks in the expert opinions sought by the media, the visibility of right-wing talk show hosts and the large hordes of loud conservative pundits everywhere in the mainstream media. Where would you go to read or view or listen to a left-wing pundit? How often is Noam Chomsky on the Fox News? Who owns the system?

A related question is whether media professionals can do their work in a neutral manner, despite any political views of their own that might conflict with such an approach. My belief is that this is possible to some extent, but that no human being is a completely neutral observer of this planet. Some bias is unavoidable, and this means that it is indeed a good thing to have all the different biases represented in the media. The right-wingers ignore all but one possible cause of bias, and wish that this one and only bias against them be removed. This would not make the media objective; it would make it thoroughly conservative: a world full of Rupert Murdoch clones.

Bush Spoke, They Listened

These are the reactions of people from various parts of the U.S. to Bush's Monday night speech.

From a suburb of Boston, Massachusetts:

For Goldberg, 66, an investment manager, the sadness stems from what he believes is the failure of a war he once reluctantly supported, hoping it would make the world safer from terrorism.
"I don't see how we can pull off a smooth transition," Goldberg said, shaking his head.
He is particularly wary of Islamic fundamentalism, but he was not hopeful about the president's assurances on Iraq's future, and believes the U.S. will hand authority to the U.N. as quickly as possible and pull out.
"Should we leave the country, it will be a colossal victory for the jihadist movement," said Goldberg, who voted for Bush in 2000 but said he's likely to vote against him this year.
McElaney, 38, a medical salesman, said the speech did nothing to ease his anger. "I don't feel we should have been there in the first place," he said.
As for the handover, "I don't really see it happening by the end of June," he said. "I think Spain made the right decision getting out when they did."
A third man at the counter, who wouldn't give his name, said America must accept that the Sept. 11 terror attacks were a declaration of war against the country, and America must be prepared to respond forcefully.
"I'm confused, but not so confused that I'm ready to leave Iraq," he said. "When they flew those planes into the buildings, they started a war."

From Dearborn, Michigan, a major center of Iraqis in the U.S.:

"I believe that the country will get the elections," 24-year-old Nasser Nasser said while watching Bush's speech broadcast and translated over an Arabic television station.
"He says he's going to give this and that, but I'm worried that this is all for votes," Nasser couldn't help but add, as he munched on a kabob wrapped in pita. Even so, he said the United States should remain after a new government is in place because he believes an early exit could lead to civil war.
At the Karbalaa Islamic Center, many were happy with Bush's pledges. But not all.
As the day's final call to prayer echoed in the mosque, Hadi Hadi pounded his chest in disgust, too distrustful to even watch the speech.
"Anything he says is a lie," said Hadi Hadi, 43, who had just arrived back from a visit to Baghdad. "The Americans are using means that don't rely on Iraqis. They're beginning to use the Ba'athists, those criminals, and this is a big mistake."

And from Wadesville, Indiana, the mother of a soldier stationed in Iraq:

"The ordinary Iraqi citizens will maybe in time say no to these factions or help us in a way," Arnold said. "It's not going to be an instant thing. I don't think any of this is instant. It's going to take time."
She wonders if the troops really will be out of Iraq by 2005. Still, she was pleased to hear that President Bush was talking about training more Iraqi troops.
"I think that's the only way they're going to learn to take care of themselves," Arnold said.
Arnold was Bush supporter before, and that hasn't changed.
He is "making a statement we're not there to take over the country, to replace Saddam," Arnold said. "We're there to help the people. That's what America is about, the freedoms."

These are not meant to be representative views, of course, but they're interesting nevertheless. For example, people seem to hear what they are already convinced about.
It's all sort of depressing, especially that one comment above which bears repeating:

"I'm confused, but not so confused that I'm ready to leave Iraq," he said. "When they flew those planes into the buildings, they started a war."

Yep. He sure is confused. Sigh.

Sunday, May 23, 2004

What Ails the Health Care Markets?

Many on the political right believe that the U.S. health care system should be operated as an unregulated market system, without government intervention. (If this sounds alien to you, replace the word 'unregulated' with the word 'free'. The term 'free markets' has gained such religious overtones among some pro-market groups that it no longer has a clear economic meaning. I prefer to call such markets unregulated.)

Totally unregulated markets in health care will not work for reasons that have to do with the basic characteristics of medical care. For simplicity, compare some medical care commodity, say, the provision of an appendectomy to that of some more ordinary consumption good, say, bread. Then consider the differences between the two commodities:

1. Feeling hungry is an adequate reason for a person to decide to buy bread. In contrast, all a patient who will end up having appendectomy knows is that something hurts a lot. Thus, we know our own needs when buying bread, but we are unsure about whether we even need an appendectomy. The level of information is very different in the two cases; in the latter case we as consumers lack most of the necessary information.

There are no such people as specialists who tell us when we should buy bread. But we do have exactly such specialists in health care, usually physicians, who diagnose and inform us about our condition and the best products and services to buy for it. This creates an unusual situation, as the person advising us about these needs is also in most cases the person who is going to sell us the products and services, and is therefore directly going to benefit from our purchases. Just think what would happen if bakers were allowed to decide how much bread we 'need'.

This dependency on professional advice leaves patients quite vulnerable. An unregulated health care market would not stop ruthless providers from exploiting the most desperate and/or wealthiest consumers. One reason why physicians traditionally did not advertize lies in this very fact: such advertizing can never be guaranteed to be objective, given the self-interests of providers and the lack of information most consumers possess.

2. Hunger is quite predictable, and if a person likes bread she or he can plan its purchases long in advance. Much of health care use is very unpredictable. With the exception of routine checkups and preventive care, health care consumption can't be planned in advance. Illness and accidents are uncertain events, and this fact makes health care use also an event which we can't predict with certainty. This is the basis for health care insurance. Insurance solves the problem of unpredictability and the need to keep large sums of money at hand for any major expenses. Instead, insured consumers can pay a fixed smaller sum every month (or have their employers pay it on their behalf).

While having insurance is a good thing, on the whole, insured patients behave differently from those who have no insurance. Just think what you would do if you had insurance for bread eating with no cash down needed. You would probably buy more expensive types of bread and more bread in general. This is what happens in health care markets, too. As a consequence, prices don't have their usual ability to affect consumer purchases. What most people take into account in their calculations is the actual amount of money needed (for example any deductibles and copayments), not the total bill of the treatment. Yet it is this total which is counted in the overall costs of medical care.

3. Quality assessment by patients is extremely difficult. In contrast, most of us can tell when bread is stale, and it usually takes just a small sample to find if we like the taste. Taking small samples of health care services may not be practical. It can even be extremely dangerous. That's one of the reasons why patients employ providers as advisers on the type and quantity of care needed. It's also the reason why pharmaceuticals and hospitals are so rigorously regulated, and why the system of malpractice suits exists.

Quality or effectiveness of health care is not completely known even to its providers. Many treatments are routinely carried out that might have only minor impact on the disease they aim to treat. New technologies are sometimes developed on the basis of nothing much more than a hunch, and they often spread widely before any research can be carried out about their appropriateness.

4. Whether I consume bread or not should have no direct impact on others' welfare (though it may affect others indirectly if I'm very poor and others would like me to have more bread). Whether I get treated for an infectious disease or not is of obvious direct interest to others: If I don't get treated, I am going to be a risk in the community. This means that the society as a whole, usually seen as reflected in the government, has an interest in assuring that infectious diseases and other general health problems are tackled. Markets tend to underprovide such services. Why? Because firms don't have the ability to charge other people for the benefits they receive when someone else's infectious disease is treated. These benefits are not then taken into account in market decisions; only the private demand of those infected will be satisfied by the market forces.

All these differences between bread and various types of medical care explain why markets perform poorly in health care and well in the bakery industry. Competitive behavior in most markets drives prices down, keeps quality up and offers variety to the consumers. But in health care prices may not go down with competition because consumers can't always judge what they are getting in quality, which makes per unit prices meaningless, and because insured patients are not taking the whole price into account in making decisions. Quality may not increase through competition if consumers are truly unable to judge quality, or if they use wrong signals to measure the inherently unknown quality. As an example, think about hospitals offering intricate technological services. Competition between hospitals might make them all acquire the latest gadgets, and consumers might think that a well equipped hospital is a high-quality one. But in reality, such competition may mean that none of the hospitals gets enough patients that actually need these services. The personnel operating the technology may not then get enough practice to remain skilled. And, as noted above, markets will underprovide those medical care services which have strong effects on the well-being of others than the patient under treatment.

For these reasons health care costs keep on rising year after year, despite our best attempts to control them, competition seems to have no real impact on keeping prices low, malpractice suits remain common and government regulation an important aspect of health care. The markets for bread, on the other hand, are doing pretty well with minimal intervention.

Those who advocate unregulated health care markets seem to assume that medical care is no different from bread, and that just getting rid of the government role in health care markets would make an appendectomy as affordable, bland and safe as sliced bread. I hope that this post shows why they are wrong.

A Deep Thought for the Day

By Justice Antonin Scalia, U.S. Supreme Court:

"I think all Americans would love their country if they had to live abroad for a while," Scalia said.

Are foreign ducks trickier to catch?

My apologies for having the word 'deep' in two consecutive headlines. 'Profound' doesn't quite work here. I bet you never thought how bloggers have to fret over minor details like that one!