Map of life expectancy at birth from Global Education Project.

Friday, October 30, 2020

A new category of lie

 Krugthulu brings to my attention some really weird shit I didn't know about, and some that I did. If you can't read it because of the paywall, don't worry, I'll give you the bonbons

We were all agog when a White House press release -- actually from the White House Science Office! -- claimed among the Resident's many great achievements "ending the Covid-19 pandemic." Uh, whaaat? 

Then he said in a rally, "New York is a ghost town." There are about 8 million people living in New York right now who are walking around seeing that it is not. Campaigning in Pennsylvania, he repeatedly said that Pennsylvanians "can't go to church," whereas the people he was saying this to had probably mostly been to church last Sunday. The it got, if that is possible, even weirder:


On Wednesday, campaigning in Arizona, Trump went on a rant about California, where “you have a special mask. You cannot under any circumstances take it off. You have to eat through the mask. Right, right, Charlie? It’s a very complex mechanism.” As 39 million California residents can tell you, nothing remotely like that exists.


So what is going on here? These obviously aren't lies in the normal sense, that anyone is expected to believe them. Oh I don't know, maybe there are some chawbacons out in Wisconsin who think the bit about New York is just an exaggeration, but they know their hospital is filling up and their friend's grandmother died. And the California mask thing is just ridiculous on the face of it. Do people really believe that if Biden is elected their won't be any windows in their house? I have to doubt it.


That's the whole point. Membership in the cult isn't about any tangible relationship to observable reality, it's about abandoning the constraints of truth and reason. If you have read 1984, you may remember the climactic scene in which Winston literally sees that 2+2=5. Then he is freed and allowed to rejoin society. To establish your belonging, to become one of us, you must share the delusions.


Resistance is futile. You will be assimilated.

Wednesday, October 28, 2020

Freeze Peach

Many people seem confused about the concept of freedom of speech. The First Amendment literally constrains only congress. Here it is:

Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

The courts generally understand that this also constrains the executive, since there cannot in principle be a law that gives the executive (i.e. the president) the power to violate these prohibitions. Subsequently, the 14th Amendment extended these constraints to the states. 


The courts have also concluded that this should not be taken too literally. Many crimes are committed by means of speech. Frauds and cons are not legal, nor are coercive threats and dangerous deceptions. (The classic "yelling 'Fire' in a crowded theater.") Although the amendment was obviously intended to protect political speech, the courts have, in my view unfortunately, extended it to commercial speech which is why it is so difficult to regulate deceptive advertising. Individuals who are defamed can sue, although the courts have made it difficult to sue "public figures," as probably it should be. People will make mistakes, but only willful or recklessly negligent defamation of public figures is actionable.

So what's the current brouhaha about "cancel culture" or claims that "the Left" wants to suppress speech? First of all, let's be clear that this has nothing to do with the First Amendment or anybody's constitutional or legal rights. The First Amendment constrains government, not any private entity. You have a First Amendment right to say what you want to say, within the above specified constraints, but you don't have a First Amendment right to have your op-ed published in the New York Times. Publications, broadcasts, web sites -- editors and publishers decide what they want to present to readers and viewers. Many have an overt political point of view, others protect some version of what they consider to be truthful or important enough to publish, and that's their choice. I don't expect to get published in Breitbart News or the Wall Street Journal op-ed page and I don't claim I'm being censored, although I suppose in a sense I am. But that's their right.

So if people complain about an editorial decision by, say, the Times, and the editor-in-chief fires the editorial page editor because of it, that's their perfect right. Objecting to what somebody says or writes is not censorship. Saying that I'm not allowed to object, on the contrary, is to call for censorship.

Then there is the question of academic freedom. There is no academic freedom at Liberty University, and I don't hear people on the right complaining about that because they don't think there should be. Liberty University exists to promote an ideology. But what about a hypothetical Ivy League university, let's call it Fuchsia U? The biology department does not grant its professors the freedom to teach creationism because that lies outside their definition of biology. The medical school does not allow teaching of homeopathy, and the sociology department does not teach racist theories, for the straightforward reason that they do not believe these theories to be true.

What about a professor of any subject who espouses racist or misogynistic theories? This professor is disqualified because she or he cannot provide a supportive educational experience to many students, or fairly evaluate any of them. Non-discrimination, equity and inclusion are core values at Fuchsia, and it is the right of the trustees, the deans, and the faculty to promulgate and protect those values. However, the speech of these hypothetical racists is not suppressed. They are free to say whatever they want, they just aren't free to say it while they are professors at Fuchsia U. And any and all employers have the same right to protect their employees and customers from discriminatory or harassing behavior by employees, in fact they are obligated to do so under federal law.

What about a student group that wants to invite a racist speaker? Again, as with the New York Times, the university is under no obligation to provide university sponsorship, or even a venue, to a speaker it finds objectionable. These are finite resources to be deployed as the institution sees fit. 


So no, people on "The Left" do not want to censor or suppress speech. They just don't want to be forced to promote speech they disagree with, which is everybody's right and which, in fact, the courts have found also to be inherent in the First Amendment. So go whine someplace else. 

The Proud Boys don't shout people down, they threaten to kill them with semiautomatic weapons. But that's their Second Amendment right.

Wednesday Bible Study: Shoah

I was originally going to title this post res ipsa loquitur because I didn't think I really needed to comment. You are commanded to read the whole thing. I do however want to make a few points about this.

1) Moses is married to a Midianite woman. There is evidently nothing wrong with that. She has several sisters. Her father was Moses's confidante and counselor. I wonder how she felt about all this.

2) The incident which precipitated this, described in Chapter 25, made no mention of Balaam. All of a sudden he gets the blame, which seems strange since he was totally respectful of Yahweh and predicted that the Israelites would be invincible. Puzzling. Also, it takes two to tango, as they say. In Ch. 25 the Israelite man gets murdered along with the Midianite woman, but now the entire blame falls on the Midianites.

3) Moses is angry that the soldiers didn't murder all their noncombatant prisoners, so he order them to kill all the men, women and children except for virgin girls, which they are to keep as slaves. Given that marriage in those days typically occurred shortly after puberty, they are presumably mostly prepubescent. The text is silent on the age at which it is okay to start raping them.

4) A large share of animals, sex slaves and precious metal is allocated to God. Since the Big Y presumably has no particular use for any of this personally, it actually goes to the priests.

5) As always, the Bible totally affirms the Right to Life. All those boy babies and children, pregnant women with their unborn babies, get murdered on God's orders along with the other adult women and all the men. That's because human life is infinitely precious and God commands you shall not kill.

6) Everybody who is committed to living biblically, knowing that all morality derives from God, needs to read this carefully and follow all of the moral precepts presented here.

31 The Lord said to Moses, “Take vengeance on the Midianites for the Israelites. After that, you will be gathered to your people.”

So Moses said to the people, “Arm some of your men to go to war against the Midianites so that they may carry out the Lord’s vengeance on them. Send into battle a thousand men from each of the tribes of Israel.” So twelve thousand men armed for battle, a thousand from each tribe, were supplied from the clans of Israel. Moses sent them into battle, a thousand from each tribe, along with Phinehas son of Eleazar, the priest, who took with him articles from the sanctuary and the trumpets for signaling.

They fought against Midian, as the Lord commanded Moses, and killed every man. Among their victims were Evi, Rekem, Zur, Hur and Reba—the five kings of Midian. They also killed Balaam son of Beor with the sword. The Israelites captured the Midianite women and children and took all the Midianite herds, flocks and goods as plunder. 10 They burned all the towns where the Midianites had settled, as well as all their camps. 11 They took all the plunder and spoils, including the people and animals, 12 and brought the captives, spoils and plunder to Moses and Eleazar the priest and the Israelite assembly at their camp on the plains of Moab, by the Jordan across from Jericho.

13 Moses, Eleazar the priest and all the leaders of the community went to meet them outside the camp. 14 Moses was angry with the officers of the army—the commanders of thousands and commanders of hundreds—who returned from the battle.

15 “Have you allowed all the women to live?” he asked them. 16 “They were the ones who followed Balaam’s advice and enticed the Israelites to be unfaithful to the Lord in the Peor incident, so that a plague struck the Lord’s people. 17 Now kill all the boys. And kill every woman who has slept with a man, 18 but save for yourselves every girl who has never slept with a man.

19 “Anyone who has killed someone or touched someone who was killed must stay outside the camp seven days. On the third and seventh days you must purify yourselves and your captives. 20 Purify every garment as well as everything made of leather, goat hair or wood.”

21 Then Eleazar the priest said to the soldiers who had gone into battle, “This is what is required by the law that the Lord gave Moses: 22 Gold, silver, bronze, iron, tin, lead 23 and anything else that can withstand fire must be put through the fire, and then it will be clean. But it must also be purified with the water of cleansing. And whatever cannot withstand fire must be put through that water. 24 On the seventh day wash your clothes and you will be clean. Then you may come into the camp.”

Dividing the Spoils

25 The Lord said to Moses, 26 “You and Eleazar the priest and the family heads of the community are to count all the people and animals that were captured. 27 Divide the spoils equally between the soldiers who took part in the battle and the rest of the community. 28 From the soldiers who fought in the battle, set apart as tribute for the Lord one out of every five hundred, whether people, cattle, donkeys or sheep. 29 Take this tribute from their half share and give it to Eleazar the priest as the Lord’s part. 30 From the Israelites’ half, select one out of every fifty, whether people, cattle, donkeys, sheep or other animals. Give them to the Levites, who are responsible for the care of the Lord’s tabernacle.” 31 So Moses and Eleazar the priest did as the Lord commanded Moses.

32 The plunder remaining from the spoils that the soldiers took was 675,000 sheep, 33 72,000 cattle, 34 61,000 donkeys 35 and 32,000 women who had never slept with a man.

36 The half share of those who fought in the battle was:

337,500 sheep, 37 of which the tribute for the Lord was 675;

38 36,000 cattle, of which the tribute for the Lord was 72;

39 30,500 donkeys, of which the tribute for the Lord was 61;

40 16,000 people, of whom the tribute for the Lord was 32.

41 Moses gave the tribute to Eleazar the priest as the Lord’s part, as the Lord commanded Moses.

42 The half belonging to the Israelites, which Moses set apart from that of the fighting men— 43 the community’s half—was 337,500 sheep, 44 36,000 cattle, 45 30,500 donkeys 46 and 16,000 people. 47 From the Israelites’ half, Moses selected one out of every fifty people and animals, as the Lord commanded him, and gave them to the Levites, who were responsible for the care of the Lord’s tabernacle.

48 Then the officers who were over the units of the army—the commanders of thousands and commanders of hundreds—went to Moses 49 and said to him, “Your servants have counted the soldiers under our command, and not one is missing. 50 So we have brought as an offering to the Lord the gold articles each of us acquired—armlets, bracelets, signet rings, earrings and necklaces—to make atonement for ourselves before the Lord.”

51 Moses and Eleazar the priest accepted from them the gold—all the crafted articles. 52 All the gold from the commanders of thousands and commanders of hundreds that Moses and Eleazar presented as a gift to the Lord weighed 16,750 shekels.[a] 53 Each soldier had taken plunder for himself. 54 Moses and Eleazar the priest accepted the gold from the commanders of thousands and commanders of hundreds and brought it into the tent of meeting as a memorial for the Israelites before the Lord.


  1. Numbers 31:52 That is, about 420 pounds or about 190 kilograms

Tuesday, October 27, 2020

The matrix

I first started this blog maybe 15 years ago. I have never gotten a huge number of comments, but for the first 11 years they were always constructive and thoughtful. Then something happened. I had to start moderating comments because I got so many that were offensively racist, or consisted of disinformation and wild illogic. I even tried doing a series of posts on logical fallacies and verification to try to educate some of these commenters on critical thinking. Obviously that didn't work. What happened, obviously, is that we entered the Trumpian post-truth era. 

What is left of the journalistic profession is finally recognizing that new "reality show" unreality. Here are Linda Qiu and Michael D. Shear of the NYT. It's paywalled but if you have a free read left this month this is probably the one you should take. But if you can't read it I'll give you the headline and lede.

Rallies Are the Core of Trump’s Campaign, and a Font of Lies and Misinformation

A recent rally in Wisconsin was typical. In 90 minutes, President Trump made 131 false or inaccurate statements.

Two minutes and 28 seconds into a campaign rally on a recent Saturday night in Janesville, Wis., President Trump delivered his first lie.

“When you look at our numbers compared to what’s going on in Europe and other places,” Mr. Trump said about the coronavirus raging across the United States, “we’re doing well.”

The truth? America has more cases and deaths per capita than any major country in Europe but Spain and Belgium. The United States has just 4 percent of the world’s population but accounts for almost a quarter of the global deaths from Covid-19. On Oct. 17, the day of Mr. Trump’s rally in Janesville, cases were rising to record levels across much of the country.

Over the course of the next 87 minutes, the president made another 130 false or inaccurate statements. Many were entirely made up. Others were casual misstatements of simple facts, some clearly intended to mislead. He lied about his own record and that of his opponent. He made wild exaggerations that violate even the pliable limits of standard political hyperbole. . . .

A detailed examination of his statements in Janesville by The New York Times found that more than three-quarters of the president’s assertions were either false, misleading, exaggerated, disputed or lacked evidence. Less than a quarter were true.

Yet his besotted crowds cheer and scream and chant their approval. I get commenters telling me that people vote for him because he has kept his promises. Really? There are fewer manufacturing and coal mining jobs in the U.S. today than when he took office. There is no border wall, only repairs to existing structures and no, Mexico has not and will not pay one cent for it. Taxes on low and middle income people are nearly unchanged, while the wealthiest have gotten a huge tax cut, and the federal budget deficit has exploded. There has been no infrastructure investment program, and no new and better health care plan. Zip, zilch, nada.  I won't bother with further discussion of the pandemic, but you can read the basic facts above. 

All he has done is spew a non-stop torrent of lies and racist invective, along with whining about how badly treated he is. He's a cry baby who cares about nobody but himself, and he is an ignorant idiot. Bleach injections, anyone?

The problem is there doesn't seem to be anything we can do about this. The cultists have gone over to an alternate reality where facts and logic don't apply. It's just a world of raging id and resentment, with no practical direction or plan. All we can do is vote and put sane people in charge of government at every level. The insane cultists will still be out there but maybe they'll get bored with the game once it's no longer on TV every night, although I suppose it will be on Faux News. That's the best we can hope for.

And this is exactly what I mean:  In 1987, in his first run for president, Joe Biden's standard stump speech included some quotations from British politicians Neil Kinnock, which he always credited. Then, on one occasion, while using the same quotations he had always credited before, he forgot to credit Kinnock. That is the exact equivalent of the current resident spewing a continual stream of outrageous lies throughout his candidacy and presidency. Obviously no difference at all.



Sunday, October 25, 2020

Sunday Sermonette: Sexist piggery

When I first read this I was a bit puzzled that there was so much interest in pledges and vows, and why women wouldn't be allowed to make them without the permission of father or husband. But then I realized that this is an illiterate society. They weren't any leases or contracts or debt instruments or salary letters. If you wanted someone to farm one of your fields in exchange for 10% of the produce, or rent out a house, or employ someone, each party had to make a vow to the other. If you wanted to give somebody 5 shekels to buy the material needed to sew some tunics, and pay them another 5 on delivery, you would each have to make a vow. (I don't know what a shekel was worth so I don't know if this is realistic.) Same if you wanted to lend or borrow money, or by on credit, or take an apprenticeship, or any other transaction.

In other words, we are talking about everyday commerce. What this says is that women can't do any sort of business without permission from their owner, who is their father until they get married, and is then their husband. And note that if the obligation is allowed, it actually falls on the man, who is responsible for his female property. Just so we're clear. 

Brace yourself. Wednesday it's going to get very, very ugly.

30 [a]Moses said to the heads of the tribes of Israel: “This is what the Lord commands: When a man makes a vow to the Lord or takes an oath to obligate himself by a pledge, he must not break his word but must do everything he said.

“When a young woman still living in her father’s household makes a vow to the Lord or obligates herself by a pledge and her father hears about her vow or pledge but says nothing to her, then all her vows and every pledge by which she obligated herself will stand. But if her father forbids her when he hears about it, none of her vows or the pledges by which she obligated herself will stand; the Lord will release her because her father has forbidden her.

“If she marries after she makes a vow or after her lips utter a rash promise by which she obligates herself and her husband hears about it but says nothing to her, then her vows or the pledges by which she obligated herself will stand. But if her husband forbids her when he hears about it, he nullifies the vow that obligates her or the rash promise by which she obligates herself, and the Lord will release her.

“Any vow or obligation taken by a widow or divorced woman will be binding on her.

10 “If a woman living with her husband makes a vow or obligates herself by a pledge under oath 11 and her husband hears about it but says nothing to her and does not forbid her, then all her vows or the pledges by which she obligated herself will stand. 12 But if her husband nullifies them when he hears about them, then none of the vows or pledges that came from her lips will stand. Her husband has nullified them, and the Lord will release her. 13 Her husband may confirm or nullify any vow she makes or any sworn pledge to deny herself.[b] 14 But if her husband says nothing to her about it from day to day, then he confirms all her vows or the pledges binding on her. He confirms them by saying nothing to her when he hears about them. 15 If, however, he nullifies them some time after he hears about them, then he must bear the consequences of her wrongdoing.”

16 These are the regulations the Lord gave Moses concerning relationships between a man and his wife, and between a father and his young daughter still living at home.


  1. Numbers 30:1 In Hebrew texts 30:1-16 is numbered 30:2-17.
  2. Numbers 30:13 Or to fast

Friday, October 23, 2020

As I have said before . . .

. . . and some people didn't want to believe, much of the violence associated with BLM protests was initiated by far right, racist provocateurs. Just so we're clear.

Update: Here's a clear-eyed look at the issue from USA today.

Since I expect that the people who actually need to read this can't be bothered, here are the main points:

Black Lives Matter protests have been overwhelmingly peaceful.

There was looting and arson late at night during the early days of protest in some cities, but this quickly  died down. These were opportunistic acts by people not associated with the protests.

The cities where this happened are now calm and ongoing protests are not disruptive to everyday life.

Much of the violence was initiated by police.

People arrested in connection with the protests have not been members of extremist groups, and they have mostly been arrested for minor offenses.

Kevin Shay at Medium rounds up innumerable instances of right wing provocateurs initiating violence at BLM protests. He also notes:

Studies show that right-wing extremist groups are much more violent than left-wing ones. For instance, 90 percent of the extremist-related murders in the US in 2019 were linked to right-wing extremists, according to an Anti-Defamation League study. Between 2010 and 2016, about 35 percent of terrorist attacks in the United States were carried out by right-wing extremists ,compared with 12 percent by left-wing or environmentalist extremists, according to a University of Maryland-led consortium.

And here's more on the subject from Just Security.

Health Care 101 Continued: The allocation problem

We often hear sentiments to the effect that human life is infinitely precious, that you can't put a price on human life. While most people probably think this instinctively, it is conservatives, and particularly religious conservatives, who are most likely to try to apply the concept in reality. Do you remember the ravings about "death panels" when the Affordable Care Act passed? Of course there's nothing in the ACA that could conceivably be construed that way, but the scary meme was imported from arguments about single payer or, as in the UK, socialized medicine schemes.

To put this in the simplest and starkest terms, let's consider Britain, that totalitarian dungeon. In the UK, the government owns and operates an entire health care system that serves the entire population, called the National Health Service. Physicians, nurses, technicians, hospital staff, everybody who works in the system, are government employees. If you want to, you are free to pay for services from private providers, but obviously you have to be able to afford it.

This means that every year, Parliament has to put up the money to fund the NHS, and that sum is necessarily finite. Under Tory rule, it's been less than enough for the NHS to provide generally satisfactory services, but even under a more liberal government it would obviously have to be a specific number. Necessarily, therefore, there is a body called the National Institute for Health and Care Excellence (abbreviated NICE because of its former name) which among other functions decides what treatments the NHS will cover based in part on their price.

The way it works is that they estimate the benefits of a given treatment using a metric called Quality Adjusted Life Years (QALYs), which takes into account both the additional years of life that will be gained across the whole population if the treatment is authorized, and the associated quality of life. How they do the quality adjustment is controversial and can legitimately be questioned, but it is necessary. Some treatments don't extend life at all, they just make life better. They still need to be scored. Others might extend life but only in a vegetative state, or in terrible suffering such that most people would prefer death. So you need some common metric. We won't worry about the specifics of that just yet.

Then, yes, they put a price on it. As a first order decision rule, the price is 20-30,000 pounds per QALY, which comes to about $40,000. Note that contrary to a common misrepresentation, this does not take into account the present health or quality of life state of any given individual. Approval applies to the treatment, not to individual recipients. Also, they do make exceptions to the general rule and approve some treatments that cost more under some circumstances. But they are not a "death panel" that decides that Sarah Palin's child with Down Syndrome doesn't deserve health care. 

Weirdly, some Republican politicians tried to claim that under a system of rationing such as would be required by a universal health care system, Stephen Hawking would have been allowed to die. Hawking of course received free health care from the NHS for his entire life. The stupidity of conservatives is breathtaking.

Anyway, nevertheless, many Americans find this offensive. However, what we do is far worse. We deny people who can't afford it any health care whatsoever, at least in those Republican led states that refused the Medicaid expansion. And absent the ACA, private insurers denied insurance to people who actually needed it. That was apparently perfectly okay. Note that in the UK, NICE doesn't take anything away from anybody. If you can pay out of pocket, go for it, just as in the U.S. They just try to allocate the finite budget of the NHS in the most equitable and effective manner.

So consider a cancer treatment that costs $250,000, that extends life a median of a few months, and they definitely do exist. Does it really make sense to give that to every possible candidate, while providing no health care at all to low income young adults? While letting uninsured or underinsured people die of readily preventable causes? How is that a moral imperative?

In fact every one of us puts a price on our own lives every day, every time we ride in a motor vehicle or cross the street. There has to be a price on human life because our resources are finite. The only question is how we set it, and why we set it differently for different people. The problem is indeed very complicated and I have not even tried to fully analyze it. I'm just making it clear that it exists and pretending it doesn't is not a rational argument.

Wednesday, October 21, 2020

Rudy, Rudy, Rudy

I have read all sorts of bizarre byzantine discussions about this situation but I'll just say:

If I were in a situation where I thought I might have the unexpected opportunity to enjoy sexual congress with a previously unknown but desirable individual, my move would not be to stick my hands down my pants and fondle my own parts. This is irrespective of any additional context.

Note: It seems there are varying accounts of what the clip actually shows. We'll wait for the reveal. Meanwhile, I'll just say it's amazing that SBC discovered a young Bulgarian film school graduate with no film credits who apparently nails it. Does he know  people in Bulgaria?

Wednesday Bible Study: Redundant and repetitive

And it's deja vu all over again. Numbers 29 promulgates the observances which are today called Rosh hashanah, Yom Kippur, and Sukkkot. But these have already been established in Exodus and Leviticus. I don't remember for sure and I don't feel like looking it up, but I believe the elaborate schedule of sacrifices, especially for Sukkot, is an embellishment, which is in keeping with the tendency in Numbers to pile on the sacrifices.

As a clarification, seventh month here refers to the liturgical calendar. Rosh hashana is the first day of the new year in the civil calendar, and that is the meaning of the celebration today. Numbers 29 does not ascribe any particular spiritual or secular meaning to these observances, although they have been given more substantive meaning earlier in the Torah and their meaning has deepened over time. Rosh hashanah is the date from which jubilees are measured, and Yom Kippur is the holiest day of the Jewish liturgical calendar, set aside for repentance and atonement. The 10 days from Rosh hashanah to Yom Kippur are known as the high holy days. Sukkot is the harvest festival. However, you don't really see any of that here, just a boring recitation of sacrifices. 

29 “‘On the first day of the seventh month hold a sacred assembly and do no regular work. It is a day for you to sound the trumpets. As an aroma pleasing to the Lord, offer a burnt offering of one young bull, one ram and seven male lambs a year old, all without defect. With the bull offer a grain offering of three-tenths of an ephah[a] of the finest flour mixed with olive oil; with the ram, two-tenths[b]; and with each of the seven lambs, one-tenth.[c] Include one male goat as a sin offering[d] to make atonement for you. These are in addition to the monthly and daily burnt offerings with their grain offerings and drink offerings as specified. They are food offerings presented to the Lord, a pleasing aroma.

The Day of Atonement

“‘On the tenth day of this seventh month hold a sacred assembly. You must deny yourselves[e] and do no work. Present as an aroma pleasing to the Lord a burnt offering of one young bull, one ram and seven male lambs a year old, all without defect. With the bull offer a grain offering of three-tenths of an ephah of the finest flour mixed with oil; with the ram, two-tenths; 10 and with each of the seven lambs, one-tenth. 11 Include one male goat as a sin offering, in addition to the sin offering for atonement and the regular burnt offering with its grain offering, and their drink offerings.

The Festival of Tabernacles

12 “‘On the fifteenth day of the seventh month, hold a sacred assembly and do no regular work. Celebrate a festival to the Lord for seven days. 13 Present as an aroma pleasing to the Lord a food offering consisting of a burnt offering of thirteen young bulls, two rams and fourteen male lambs a year old, all without defect. 14 With each of the thirteen bulls offer a grain offering of three-tenths of an ephah of the finest flour mixed with oil; with each of the two rams, two-tenths; 15 and with each of the fourteen lambs, one-tenth. 16 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering and drink offering.

17 “‘On the second day offer twelve young bulls, two rams and fourteen male lambs a year old, all without defect. 18 With the bulls, rams and lambs, offer their grain offerings and drink offerings according to the number specified. 19 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering, and their drink offerings.

20 “‘On the third day offer eleven bulls, two rams and fourteen male lambs a year old, all without defect. 21 With the bulls, rams and lambs, offer their grain offerings and drink offerings according to the number specified. 22 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering and drink offering.

23 “‘On the fourth day offer ten bulls, two rams and fourteen male lambs a year old, all without defect. 24 With the bulls, rams and lambs, offer their grain offerings and drink offerings according to the number specified. 25 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering and drink offering.

26 “‘On the fifth day offer nine bulls, two rams and fourteen male lambs a year old, all without defect. 27 With the bulls, rams and lambs, offer their grain offerings and drink offerings according to the number specified. 28 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering and drink offering.

29 “‘On the sixth day offer eight bulls, two rams and fourteen male lambs a year old, all without defect. 30 With the bulls, rams and lambs, offer their grain offerings and drink offerings according to the number specified. 31 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering and drink offering.

32 “‘On the seventh day offer seven bulls, two rams and fourteen male lambs a year old, all without defect. 33 With the bulls, rams and lambs, offer their grain offerings and drink offerings according to the number specified. 34 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering and drink offering.

35 “‘On the eighth day hold a closing special assembly and do no regular work. 36 Present as an aroma pleasing to the Lord a food offering consisting of a burnt offering of one bull, one ram and seven male lambs a year old, all without defect. 37 With the bull, the ram and the lambs, offer their grain offerings and drink offerings according to the number specified. 38 Include one male goat as a sin offering, in addition to the regular burnt offering with its grain offering and drink offering.

39 “‘In addition to what you vow and your freewill offerings, offer these to the Lord at your appointed festivals: your burnt offerings, grain offerings, drink offerings and fellowship offerings.’”

40 Moses told the Israelites all that the Lord commanded him.[f]


  1. Numbers 29:3 That is, probably about 11 pounds or about 5 kilograms; also in verses 9 and 14
  2. Numbers 29:3 That is, probably about 7 pounds or about 3.2 kilograms; also in verses 9 and 14
  3. Numbers 29:4 That is, probably about 3 1/2 pounds or about 1.6 kilograms; also in verses 10 and 15
  4. Numbers 29:5 Or purification offering; also elsewhere in this chapter
  5. Numbers 29:7 Or must fast
  6. Numbers 29:40 In Hebrew texts this verse (29:40) is numbered 30:1.

Tuesday, October 20, 2020

Now this is embarrassing . . .

. . . to say the least.  No doubt you have heard  about the misfortune of Jeffrey Toobin but most reports have been somewhat circumspect. The original story broken by Vice is explicit. It seems he was on a Zoom call with fellow New Yorker contributors in which they were somehow simulating election night. (Bizarrely, Masha Gessen was playing Orange Julius.) Anyhooo, as they were going into break rooms Toobin apparently transferred his attention to a video sex service and jerked off (to quote the Vice story directly), thinking he could not be seen by the other participants, but sadly no. 

I bring this up for the sake of a few reflections on human nature and morality, and the digital age, in no particular order.

1. Toobin is a rich, famous married guy. This happened in the middle of the workday while he was in fact working, yet he felt compelled to get in a quick wonk. This reminds us that: a) Humans are capable of obtaining sexual gratification from an essentially imaginary experience, although the imagination sometimes benefits from a boost such as feelthy peectures or, in the brave new world, an on-line interlocutor. That tells us something about how the big brains bequeathed to us by evolution work, which is not always very functional for survival and reproduction: b) We really don't know very much about people who may have all sorts of odd shit going on when you aren't looking. In this case presumably his wife didn't know about this habit. It's reminiscent of Anthony Weiner, actually, who was under some inexplicable compulsion to tweet his junk. 

2. This was evidently a complete accident, and the vast majority of people don't think there's anything morally wrong with yanking the crank in private. So we need to reflect on exactly why he's in big trouble, has been suspended from his job, and is so profoundly shamed. He could have committed some other fuck up such as burning the roast or accidentally deleting some computer files, in which case his wife or his employer would have been annoyed with him but he wouldn't end up divorced or fired. The reason this is big news and he's in such disgrace is because we are squeamish about sex. By accidentally reminding the world that all sorts of shit happens in private that we're supposed to keep secret, he disrupted the social order. 

3. Let's face it, it's also comical and entertaining. We tend to laugh at transgressions or failures that are absurd or surprising. Think of schlemiel comics like Jerry Lewis or Jim Carrey. And while we're squeamish about sex we also like to talk about it and be entertained by it, so this is doubly entertaining and doubly funny. It's something absolutely ridiculous which could only happen because of strange new world in which we find ourselves, so it serves to make fun of our predicament. 

Can Toobin live this down? I would say I hope so because it's absurd, not intentionally offensive. But who knows?

Sunday, October 18, 2020

On Freedom

Much attention is being paid to this essay in the NYT by Michael Tomasky, and I endorse it. So read it. Now I will offer my own thoughts on this subject.

The words "freedom" and "liberty" resonate powerfully in American political discourse. The so-called American Revolution (it wasn't actually a revolution in technical political science terms, but a war of secession) was animated by rhetoric of liberty. The underground resistance leading up to the Declaration of Independence was called the Sons of Liberty. The Declaration of Independence asserts three rights which purportedly belong to "all men":  Life, Liberty and the Pursuit of Happiness. So liberty is the second most important right after existence. The preamble to the Constitution, after proclaiming practical ends such as domestic tranquility and national defense, proclaims the purpose of the document to be to"secure the Blessings of Liberty to ourselves and our Posterity."

The word freedom does not come up prominently until later, in the First Amendment:

First Amendment: Congress shall make no law respecting an establishment of religion, or prohibiting the free exercise thereof; or abridging the freedom of speech, or of the press; or the right of the people peaceably to assemble, and to petition the Government for a redress of grievances.

Freedom was also central to the rhetoric of abolition, and of the Civil Rights Movement of the 1950 and 1960s, which also came to be known as the Freedom Movement. Which reminds us of the obvious points that slaves had none of the liberties or freedoms asserted by the founding documents, and their descendants have been winning them only gradually and grudgingly, against horrific violence, in the century and a half after the Emancipation Proclamation and the 13th and 14th Amendments. 

This should remind us also that the slaveholders argued that abolition would be a violation of their rights, as were attempts by non-slave states to shield fugitives from the slavecatchers. Specifically, these were violations of their property rights. To libertarians, property rights are the most essential. Liberty means the right to do as you wish with your own property, and property is itself a kind of "natural right," which precedes law and custom.

Perhaps you begin to see the problem. Granting unencumbered liberty to one person or group of people inevitably means depriving others of liberty. If there is a right to own slaves, then the right not to be a slave cannot pertain to "all men." And yes, I haven't specifically mentioned gender so far but that's another glaring deficiency in the concept of liberty as inscribed in the Constitution, although the First Amendment is good enough to use the term "people." 

And this is true of all property rights. If you dump your toxic waste in the river, I can't drink the water. If you own a monopoly over a good or service, I can't buy it from anybody else and I can't seek employment in the industry from anyone but you, which means you can overcharge me and underpay me. 

More generally, people with a lot of money have a lot more liberty than people without much money, but contrary to mythology, having a lot of money is mostly a matter of luck. Not only who you were born to but also just plain, dumb luck. There seems to me no way to justify inheritance of vast wealth -- the Koch brothers don't deserve to be rich, or even mildly privileged. But even success in business for the self-made is contingent on good luck at least as much as it is on hard work. 

But the rhetoric of liberty is useful to plutocrats who want to keep their privilege and prevent a real revolution. The American war of independence was not a revolution in the technical sense because it did not expand political rights and participation. The same class of white men of property who ran things before continued to run it afterwards, and the Constitution was written to make sure of that. The ruling class just didn't have to put up with the King of England any more. And still today, if the Koch brothers and their plutocratic friends can convince working people that making the rich pay taxes, and not allowing them to dump their toxic waste in the river, and not letting them underpay their employees or put their lives and health at risk, are violations of the sacred rights to liberty and property, then they can get people to vote against their own interests and fail to demand what should be their own rights.

When this utterly warped ideology makes people refuse to wear a face covering because they have a sacred right to spew a deadly pathogen on their neighbors, then it ought to be pretty damn obvious that it makes no sense at all. Libertarianism is internally inconsistent, and inconsistent with observable reality. That is all.

Sunday Sermonette: My eyes glaze over

Numbers 28 is basically a repetition of previous instructions to make temple offerings. I haven't gone back to compare everything, but it does seem to be very interested in adding substantial quantities of wine and olive oil to the formulas. It also emphasizes how much God loves the smell of burning meat. Remember, however, that it is only the abdominal fat and offal that is burned. The priests get to keep the meat and hides, along with the other swag. In the first reference to wine it is to be "poured out" in the sanctuary but I strongly suspect it wound up being poured down the throats of the priests. 

The priesthood is kind of like Jim and Tammy Fae Baker, Jimmy Swaggart, Jerry Falwell and that crowd: your first and foremost religious duty is to give them money.

28 The Lord said to Moses, “Give this command to the Israelites and say to them: ‘Make sure that you present to me at the appointed time my food offerings, as an aroma pleasing to me.’ Say to them: ‘This is the food offering you are to present to the Lord: two lambs a year old without defect, as a regular burnt offering each day. Offer one lamb in the morning and the other at twilight, together with a grain offering of a tenth of an ephah[a] of the finest flour mixed with a quarter of a hin[b] of oil from pressed olives. This is the regular burnt offering instituted at Mount Sinai as a pleasing aroma, a food offering presented to the Lord. The accompanying drink offering is to be a quarter of a hin of fermented drink with each lamb. Pour out the drink offering to the Lord at the sanctuary. Offer the second lamb at twilight, along with the same kind of grain offering and drink offering that you offer in the morning. This is a food offering, an aroma pleasing to the Lord.

Sabbath Offerings

“‘On the Sabbath day, make an offering of two lambs a year old without defect, together with its drink offering and a grain offering of two-tenths of an ephah[c] of the finest flour mixed with olive oil. 10 This is the burnt offering for every Sabbath, in addition to the regular burnt offering and its drink offering.

Monthly Offerings

11 “‘On the first of every month, present to the Lord a burnt offering of two young bulls, one ram and seven male lambs a year old, all without defect. 12 With each bull there is to be a grain offering of three-tenths of an ephah[d] of the finest flour mixed with oil; with the ram, a grain offering of two-tenths of an ephah of the finest flour mixed with oil; 13 and with each lamb, a grain offering of a tenth of an ephah of the finest flour mixed with oil. This is for a burnt offering, a pleasing aroma, a food offering presented to the Lord. 14 With each bull there is to be a drink offering of half a hin[e] of wine; with the ram, a third of a hin[f]; and with each lamb, a quarter of a hin. This is the monthly burnt offering to be made at each new moon during the year. 15 Besides the regular burnt offering with its drink offering, one male goat is to be presented to the Lord as a sin offering.[g]

The Passover

16 “‘On the fourteenth day of the first month the Lord’s Passover is to be held. 17 On the fifteenth day of this month there is to be a festival; for seven days eat bread made without yeast. 18 On the first day hold a sacred assembly and do no regular work. 19 Present to the Lord a food offering consisting of a burnt offering of two young bulls, one ram and seven male lambs a year old, all without defect. 20 With each bull offer a grain offering of three-tenths of an ephah of the finest flour mixed with oil; with the ram, two-tenths; 21 and with each of the seven lambs, one-tenth. 22 Include one male goat as a sin offering to make atonement for you. 23 Offer these in addition to the regular morning burnt offering. 24 In this way present the food offering every day for seven days as an aroma pleasing to the Lord; it is to be offered in addition to the regular burnt offering and its drink offering. 25 On the seventh day hold a sacred assembly and do no regular work.

The Festival of Weeks

26 “‘On the day of firstfruits, when you present to the Lord an offering of new grain during the Festival of Weeks, hold a sacred assembly and do no regular work. 27 Present a burnt offering of two young bulls, one ram and seven male lambs a year old as an aroma pleasing to the Lord. 28 With each bull there is to be a grain offering of three-tenths of an ephah of the finest flour mixed with oil; with the ram, two-tenths; 29 and with each of the seven lambs, one-tenth. 30 Include one male goat to make atonement for you. 31 Offer these together with their drink offerings, in addition to the regular burnt offering and its grain offering. Be sure the animals are without defect.


  1. Numbers 28:5 That is, probably about 3 1/2 pounds or about 1.6 kilograms; also in verses 13, 21 and 29
  2. Numbers 28:5 That is, about 1 quart or about 1 liter; also in verses 7 and 14
  3. Numbers 28:9 That is, probably about 7 pounds or about 3.2 kilograms; also in verses 12, 20 and 28
  4. Numbers 28:12 That is, probably about 11 pounds or about 5 kilograms; also in verses 20 and 28
  5. Numbers 28:14 That is, about 2 quarts or about 1.9 liters
  6. Numbers 28:14 That is, about 1 1/3 quarts or about 1.3 liters
  7. Numbers 28:15 Or purification offering; also in verse 22



Saturday, October 17, 2020

Economics 101, the third

One of the many always false assumptions of the pseudo-science called economics, as embraced by libertarians, is the assumption that all of the costs and benefits of a transaction are captured between the transacting parties. Since this is obviously false, economists pretend that it's only false in certain anomalous circumstances they call "market failure," that may require some form of intervention. But in fact it is always false, perhaps with trivial exceptions that one can invent, but it is false in every standard commercial transaction.

I won't go into that in general right now, but in the case of health care it is especially, glaringly obviously and egregiously wrong. One obvious reason why it is false is the case of infectious disease. People who are contagious are a danger to others. If infectious disease can be prevented by vaccination, or cured by antibiotics, then innumerable other people benefit. In the case of HIV, although it cannot be cured and there's no vaccine, people who receive and adhere to appropriate antiretroviral treatment are no longer contagious. These are very good reasons to make sure that contagious diseases are prevented or treated, regardless of whether people want to pay for it, or can afford it.

A second reason is that people's health is strongly determinative of their economic and household productivity. Sick people can't work, can't provide for themselves or their dependents, and can't properly care for children or others who may need caregiving. They may well even become dependent on others. This is why prior to the ACA at least Medicaid was made available to families with dependent children. Better that the children get health care to enhance their future prospects, and that the parents get health care so they are better able to work and provide for their children and themselves -- and indeed, wise guy, most families that receive Medicaid do have at least one working member. The fact is that some jobs don't pay enough to lift people out of poverty. Now, in those states whose governments are sufficiently non-insane to have accepted the Medicaid expansion, all low-income adults can receive it. Again, that makes them better able to work and perhaps not even need Medicaid next year.

In other words, health care isn't just a service that is consumed. It is also an investment that creates both social and economic capital. Making sure that everybody has access to quality, affordable health care isn't a handout, and it isn't stealing from Peter to pay Paul. It's to affluent Peter's benefit to contribute something to make it happen, because it will help Peter's business be more profitable.

There are many other externalities I haven't mentioned because libertarians don't care about them. Most people are distressed to see mentally ill homeless people, or children who live in poverty, and would certainly be distressed to see people dying in hospital parking lots because they didn't have insurance cards. I understand that you might not be. So just read the preceding paragraphs.

Wednesday, October 14, 2020

More health care basics

There are several more very important ways in which health care does not conform to the assumptions necessary for the idealized "free market." (This is actually true of just about every kind of good or service but more glaringly so for health care.) One important way is imperfect information. I know what kind of cheese I like or what kind of clothes I want to wear. But we don't actually know what health care services we need. The first thing we pay the doctor for is to figure that out. Physicians tell us what's wrong with us and what to do about it. Sure, there's a big movement going on for shared decision making, but before I can share in the decision I need the physician to tell me my diagnosis, the prognosis -- what the likely consequences are -- and my treatment options.  

The result is that consumers don't create demand for health care, except maybe for cosmetic surgery. Providers do. And if they are paid to do certain procedures they are likely to decide you need them. This is called provider induced demand. And no, they aren't being unethical greedy bastards -- well maybe some are -- but it's just human nature to be unconsciously biased toward deciding that something needs to happen that will make you money. This can happen to some extent with auto mechanics and roofers and other professions of course, but a) the stakes aren't as high and b) more of us have some capacity to judge whether the advice is really sound. In health care, it's pretty much 100%, very few people know enough to second guess their doctors.

This is part of what makes health care in the U.S. so expensive. In other countries the way it's paid for is different and incentives outcomes rather than doing more stuff. Experiments with that are underway here, but it's difficult to make it work when there are multiple payers and multiple payment systems going on at once. This is a very complicated subject, unfortunately, and I can't really do it justice with blog posts, but I'll try to unpack it a little bit next time.

Wednesday Bible Study: More social anthropology (also onomastics)

No, onomastics doesn't mean what you think it does, it's the study of the etymology of proper names. I would venture to say that at least half of the popular given names in English speaking countries are Biblical in origin. What's hard to figure, however, is which ones make the cut. Some fairly obscure characters have had a vogue. For example, Lemuel, who is mentioned once in a psalm and otherwise unknown, was the given name of Swift's Gulliver and was popular in 19th Century New England. Now it's out of vogue. Moses's sister Miriam is popular, but his wife Zipporah I have never encountered. Bezalel, the multi-talented artisan in Exodus you might think would be popular, but he isn't. Aaron is popular, but Eleazar is not. Maybe having a "Z" is bad? Anyway, something to think about. 

Numbers 27 should really be two chapters. The first part is interesting because it clarifies the nature of the Israelite patriarchy. It supplies a whole lot of names, none of which are popular baby names today. The point is that a man has died without male heirs, which means his clan will vanish. So God decides that  in that event, daughters can inherit. Presumably their sons will thereafter take over the estate and restore the line. What's important to understand here is that the daughters are not asserting personal rights as women (they really don't have any), they are asserting the interest of the clan. If there is a male heir, the women will get nothing, although presumably they will become wards of their brother until they are married.  The requirement that if a man dies childless, his brother must impregnate the wife, is of a similar intent. (Note that Onan's failure to do so was his actual sin.) Anyway . . .

27 The daughters of Zelophehad son of Hepher, the son of Gilead, the son of Makir, the son of Manasseh, belonged to the clans of Manasseh son of Joseph. The names of the daughters were Mahlah, Noah, Hoglah, Milkah and Tirzah. They came forward and stood before Moses, Eleazar the priest, the leaders and the whole assembly at the entrance to the tent of meeting and said, “Our father died in the wilderness. He was not among Korah’s followers, who banded together against the Lord, but he died for his own sin and left no sons. Why should our father’s name disappear from his clan because he had no son? Give us property among our father’s relatives.”

So Moses brought their case before the Lord, and the Lord said to him, “What Zelophehad’s daughters are saying is right. You must certainly give them property as an inheritance among their father’s relatives and give their father’s inheritance to them.

“Say to the Israelites, ‘If a man dies and leaves no son, give his inheritance to his daughter. If he has no daughter, give his inheritance to his brothers. 10 If he has no brothers, give his inheritance to his father’s brothers. 11 If his father had no brothers, give his inheritance to the nearest relative in his clan, that he may possess it. This is to have the force of law for the Israelites, as the Lord commanded Moses.’”

Note that all of this is designed to preserve the patriarchal line. It is similar to the typical rules for inheritance of a kingship. Only because Henry VIII had no male heir did Elizabeth take the throne.

12 Then the Lord said to Moses, “Go up this mountain in the Abarim Range and see the land I have given the Israelites. 13 After you have seen it, you too will be gathered to your people, as your brother Aaron was, 14 for when the community rebelled at the waters in the Desert of Zin, both of you disobeyed my command to honor me as holy before their eyes.” (These were the waters of Meribah Kadesh, in the Desert of Zin.)

 Remember that all Moses did was strike the rock with his staff rather than speak to it. God can really hold a grudge!

15 Moses said to the Lord, 16 “May the Lord, the God who gives breath to all living things, appoint someone over this community 17 to go out and come in before them, one who will lead them out and bring them in, so the Lord’s people will not be like sheep without a shepherd.”

18 So the Lord said to Moses, “Take Joshua son of Nun, a man in whom is the spirit of leadership,[a] and lay your hand on him. 19 Have him stand before Eleazar the priest and the entire assembly and commission him in their presence. 20 Give him some of your authority so the whole Israelite community will obey him. 21 He is to stand before Eleazar the priest, who will obtain decisions for him by inquiring of the Urim before the Lord. At his command he and the entire community of the Israelites will go out, and at his command they will come in.”

The Urim is one of the two divining stones attached to the priestly vestment, in case you have forgotten.

22 Moses did as the Lord commanded him. He took Joshua and had him stand before Eleazar the priest and the whole assembly. 23 Then he laid his hands on him and commissioned him, as the Lord instructed through Moses.


  1. Numbers 27:18 Or the Spirit

Tuesday, October 13, 2020

Health Care 101, continued

Okay, back to where we were before I was so rudely interrupted. As we have established, insurance is about risk pools. Sure, you can offer a cheap policy if you only sell it to people who are young and healthy, and that's what would happen in a non-regulated ("free") market; but that would be largely pointless. As soon as somebody actually needed the insurance, they would not be able to renew it. 

People who are fortunate enough to have employer-provided insurance (which is an oddity largely specific to the United States, for historical reasons we won't go into there) don't generally have this problem. Employers are only willing to buy policies that cover all their employees, so the insurer views the company as constituting a single "risk pool" and prices the policy for that employer in accordance with the overall composition of the workforce. But you must understand that the younger and healthier employees of the company are subsidizing the insurance of older and sicker people. There's nothing wrong with that because we're all going to get old and sick some day, so if you're providing the subsidy now you should be grateful, because you'll eventually be on the other end.

Prior to the Affordable Care Act, people who didn't have employer provided insurance and didn't qualify for government-sponsored insurance were in the situation of the first paragraph: if they actually needed insurance, they couldn't get it. And insurers would kick people off who got cancer. It's those people who the whole pre-existing condition kerfuffle is about. 

Then there is Medicaid, which is for people who are too poor to afford any kind of insurance. Note that many people in that category have jobs. Others are disabled, and of course many are children and elderly people. Yes, disabled and elderly people also get Medicare but it has cost sharing and premium requirements that poor people can't meet, so Medicaid fills in the gaps for them. Prior to the ACA, however, it wasn't enough to be poor to qualify for Medicaid. You had to either also be Medicare eligible -- i.e. over 65 or disabled -- or you had to be caring for minor children. That meant childless adults couldn't get it, and you'd lose it if your youngest kid turned 18 or your marriage broke up. But with Medicaid expansion, in states that accepted it, all people below a certain income threshold (which varies somewhat by state) became eligible for Medicaid. People with incomes too high for Medicaid but too low to afford private insurance get subsidies under the ACA to buy insurance on the state exchanges, so that's how the ACA gets every citizen and legal permanent resident access to health insurance.

So there are three requirements for universal coverage to work. The first is called guaranteed issue and community rating. Insurers have to sell insurance to everybody, for the same price. (The ACA allows adjustment for age.) The second is some form of subsidy for people who can't afford a basic product. The third is that everybody gets in the pool. That's what the individual mandate was intended to assure, but as it turns out it wasn't absolutely necessary because insurance under the ACA is a good enough deal that most people go for it even if they aren't at high risk. Actually the same is true with Medicare. You have to pay a premium for outpatient care insurance under Medicare but almost everybody does because it's a good deal.

There is no way around this. The reason Republicans keep making empty noises about better and cheaper, but never actually come up with a plan to do so, is because they can't. The logic is inescapable, there's no way around it, there's no other way to do it.

However, as I proclaim at the very top of this blog, health care in the U.S. is too expensive. It costs more than it does anywhere else on the planet, and we get less for our money. I'll talk about why next.

Both parties have pledged . . .

I got a comment to the effect that both parties have pledged to protect people with pre-existing conditions so that's off the table. Here's the Republican plan, as tweeted by Cheeto Benito:


Republicans must state loudly and clearly that WE are going to provide much better Healthcare at a much lower cost. Get the word out! Will always protect pre-existing conditions!!!

Also, the Great Pumpkin is going to visit every home on October 30 and leave $2,000 under the pillow of every sleeping child.

The fact is that in order to protect people with pre-existing conditions, you have to put them in the same risk pool as everybody else. That's the purpose of insurance, to spread risk. If you do that, it will not be cheaper. The Republicans, and Cheeto, have absolutely no plan to do this because it is impossible

I was going to get to the problem that the U.S. spends more on health care than any other country, pretty much no matter how you measure it -- per capita, percent of GDP, cost to manage a given condition. But guess what insurance plans get better value? Medicare and Medicaid pay less than private insurance for everything. Medicaid pays the least. So if Cheeto's plan is Medicare for all, he might be right. He should hook up with Bernie Sanders.

Monday, October 12, 2020

My periodic health care 101 post

One of the most important issues in the upcoming election -- as it has been now really for decades, to some degree -- is of course health care. (I prefer to say "medical services," for a couple of good reasons, but I'll have that fight another day.) Conservative politicians like to extol the so-called free market™, and tout "market solutions" to health care. The libertarian fantasy free market™ does not in fact exist, never has existed, and never can exist.

It is true that markets of one kind or another are effective ways of organizing production and distribution of goods and services, and allocating resources, in many instances. But markets are always regulated, and structured by law, policy, and government intervention. They are not forces of nature, they are socio-political constructions, and in complex modern societies that construction is and must be done by government. I won't go into this at greater length here, but if you want to argue with it as a general assertion you'll be in trouble. 

It is also true that we learned in the 20th Century that societies that have substantial sectors in which private enterprises operate within these structured and regulated markets, have been more prosperous and sustainable that societies in which state-owned industries dominate the economy. Whether someone might be able to come up with a model for state dominance that works better than actually existing communism is imponderable, but it hasn't happened. However, every successful society with a large private economic sector also has a large public sector. Road and bridges, ports, most of education, law enforcement, fire protection, national defense (and offense), and more, are government enterprises. Where they are absent, you have Somalia, the libertarian paradise.

But in the case of health care, the model of a structured and regulated private market does not work at all. This is because of fundamental, immutable properties of the service in question. The first, which is largely decisive in itself, is that any individual's need for it is unpredictable. You need a certain amount of groceries every month, you need housing, you need clothing. Rich people will have bigger and fancier stuff, but we can determine what a basic minimum income is that will provide enough calories and shelter for people, and allocate all that in markets.

That doesn't work for health care, because you might need none at all this year and $100,000 worth next year. That's largely out of your control. Sure, don't smoke, don't drink too much, wear your seat belt, don't have a gun in the house -- but even if you do all those smart behaviors you still might just be unlucky. 

So okay, maybe it's like homeowner's insurance. Your house might burn down so you pay the premium, and we can tell people to do that and if they don't, tough luck. But there are a couple of problems here. If the house burns down, the insurance company pays off, you build a new house, and you can still get insurance. It might cost you a bit more but the assumption in most cases is that it wasn't your fault and your risk is not that much higher than anybody else's. On the other hand you can't get insurance in a flood zone, for obvious reasons, unless the government subsidizes it, which (unfortunately) they do.

However, if you develop a chronic illness it won't just cost money once, it will be costly year after year after year. That's what we call the dread "pre-existing condition." Insurance companies compete with each other on price so if they want to be able to sell insurance cheaply, they will kick you off. If they knew your house was going to burn down every year, they wouldn't sell you homeowner's insurance either, but that situation does not occur.

To be continued . . .