What Is Seen and What Is Not Seen

“Suppose you were an idiot, and suppose you were a member of Congress; but I repeat myself.” — Mark Twain

The great French economist Frederic Bastiat observed that “In the economic sphere an act, a habit, an institution, a law produces not only one effect, but a series of effects. Of these effects, the first alone is immediate; it appears simultaneously with its cause; it is seen. The other effects emerge only subsequently; they are not seen; we are fortunate if we foresee them.

“There is only one difference between a bad economist and a good one: the bad economist confines himself to the visible effect; the good economist takes into account both the effect that can be seen and those effects that must be foreseen.”

The same is true in the sphere of public policy. The bad economist or the thoughtless politician (but I repeat myself) sees only the direct effect of a law; he doesn’t foresee the indirect effects. In many cases the politician may consider only the short-term effects that might help him win the next election; he may not consider at all the long-term effects.

Bastiat noted that “it almost always happens that when the immediate consequence is favorable, the later consequences are disastrous, and vice versa.” So when a politician urges a great new solution to some problem – or typically, the same old ineffective solution to a problem – the long-term result very often is more harm than good.

One such example was alcohol Prohibition almost 100 years ago. The problem of alcohol may have been bad, but Prohibition made the problem much worse, to the point that Prohibition was later repealed. Another example was a luxury tax on yachts to “soak the rich”. Even a mediocre economist or a slightly thoughtful politician could have foreseen the disaster it turned out to be. The tax collected virtually nothing from the rich but did send many blue collar boat builders to the unemployment line. Two years later Congress repealed the law.

With the greatest intentions of reducing poverty, politicians have enacted policies that, in the short-term, help people survive one month until the next government check, but the unseen long-term effect is to trap people in poverty, sometimes for generations. If we truly care about helping people – and I think most of us do – then wouldn’t it be better to find long-term solutions that help people escape poverty?

As long ago as the 1980s, better economists and more thoughtful politicians saw the indirect effects of the welfare system – it “fostered a permanent underclass dependent on government handouts.” In 1996, a Republican Congress and Democrat President Clinton passed welfare reform with the goal of reducing the dependency trap and helping people escape poverty. Ten years later, The New Republic, a liberal magazine, looked back and editorialized that the reform “worked much as its designers had hoped [foreseen].” Since then, less thoughtful politicians seeing only the easily visible effects of welfare, and not seeing the long-term consequences, have undone most of the successful reform.

Our disability system likewise helps disabled people survive month-to-month but traps them in poverty. Wouldn’t it be better to find long-term solutions, using some amazing modern technology to help them overcome their disabilities, become productive, and no longer trapped in poverty?

Some short-sighted politicians want to extend the length of unemployment benefits beyond 26 months, but the long-term effect can be permanent unemployment. Studies have found that someone unemployed for more than six months has very little chance of ever getting a job.

Other bad economists and thoughtless politicians suggest raising the minimum wage. The immediate effect would be to slightly raise the pay for a small number of people – but cause others to lose their jobs. The long-term consequence would be to destroy many more entry-level jobs, making it harder and harder for teenagers to enter the work force.

When was the last time you saw a full-service gas station? That used to be a good first job for many young kids. Washing dishes was another good first job. Kids learned the self-discipline of showing up on time every time. While on the job they often picked up skills from the auto mechanics or cooks around them. But as the minimum wage rose, machines replaced those jobs. If it continues to rise, we will see machines taking orders for fast food, flipping burgers, and delivering the goods. The long-term effect of raising the minimum wage is disastrous for millions of young people.

Some politicians saw ObamaCare as a good idea; they did not foresee the terrible consequences. Today, some people think we will see good effects if we adopt the ObamaCare expansion of Medicaid. Not only do they fail to see the indirect, long-term terrible effects, they don’t even see the bad effects that have already occurred elsewhere. To put it simply, Medicaid is an inefficient, incredibly expensive program that provides even worse health outcomes than for people who are uninsured. Expanding it would cost even more than now predicted and would lead to much higher taxes.

To achieve better results – better economy, more good jobs, higher pay, less poverty, lower cost health care – we need to see not just the immediate effects of a policy, but to foresee the long-term effects.

Medicaid is a cruel program

“If we wish to be compassionate with our fellow man, we must learn to engage in dispassionate analysis. In other Walter E. Williams

Would you believe that many politicians over-promise and under-deliver? They promise you that a new law will fix some terrible problem, but usually it does not fix the problem, and often it makes the problem worse.

Too many politicians look only at the stated goals of a program. They believe so much in the goals that they refuse to believe any harm could result. They don’t look beneath the surface for possible unintended consequences. Even when other people do find bad side-effects in the bill, the true believers ignore the potential problems.

Thus is the case with expanded Medicaid. The same politicians who thought ObamaCare was a good idea and promised us that “If you like your health insurance, you can keep your health insurance”, those same politicians now tell us that expanding Medicaid is a good idea.

Sadly, Medicaid is a cruel program that hurts the very people it’s meant to serve. One commentator wrote: “Imagine a government-run health care program in which medical access is severely limited, that is racked by uncontrollably rising costs, and that in many instances results in demonstrably worse health outcomes than having no insurance at all. Such a program isn’t a mere hypothetical; it already exists, and it’s called Medicaid.”

More and more doctors are refusing to accept Medicaid because the system doesn’t pay enough to cover their expenses. Would-be patients spend hours on the phone trying to find someone willing to treat them. If they do succeed in finding a doctor, the appointment is, on average, three weeks later than someone with private insurance.

And it gets worse…, multiple studies have shown that Medicaid patients are more likely to die from surgery than privately insured patients and sometimes even more likely to die than uninsured patients. A Univ. of Pennsylvania study of colon cancer found that the mortality rate for Medicaid patients was 27% higher than for uninsured patients. A Florida study found that Medicaid patients were more likely than uninsured patients to have late-stage prostate cancer, breast cancer, or melanoma.

On broader measures of health, the Oregon Medicaid health experiment found no significant difference between Medicaid patients and uninsured patients in objectively measured physical health outcomes. Put simply, Medicaid did not make patients any healthier, though it did make them feel more financially secure.

Expanded Medicaid has been tried and has failed. The state of Maine expanded their Medicaid program ten years ago. Every predicted benefit failed. Politicians said it would reduce the number of uninsured. Wrong. Politicians said it would reduce emergency room visits. Wrong. Politicians said it would relieve uncompensated care. Wrong. The only significant change was that thousands of Mainers switched from private insurance to Medicaid.

There was one absurd result from Maine’s Medicaid expansion: Since the eligibility rules differ for expanded Medicaid and regular Medicaid, 10,000 able-bodied, childless adults received benefits while 3,000 elderly and disabled were put on a waiting list.

A pernicious aspect of Medicaid is that it traps people on the edge of poverty. The eligibility rules make it very difficult for someone to escape poverty and move up the ladder of success. A young person entering the workforce, earning $14,856 gets free health care. But if he or she earns just one dollar more, then that same young person not only loses the free coverage, but becomes obligated to purchase coverage or else face a penalty. This is a terrible incentive that encourages people to stay poor.

Isn’t it a good thing to learn more skills, get a better job, work more overtime, earn more money, save toward the future? Medicaid and similar entitlement programs punish people who try to better themselves and become self-sufficient, not dependent on government. Why should we encourage people to be involved in such a terrible system?

Proponents of expanded Medicaid rarely, if ever, discuss the adverse health outcomes for people on Medicaid. They never talk about the perverse incentives that can keep someone trapped in near-poverty forever.

What proponents mostly talk about is getting “free” money from the federal government. It is as if the poor are mere pawns for collecting more money. But does anyone really believe that the money is “free”? The federal government is running gigantic deficits. It has borrowed trillions and trillions of dollars. Our children, grandchildren, and their grandchildren will be stuck paying off this debt.

And the money isn’t free even in the short term. The feds talk about paying 100% of the cost for two years, but can we really believe that promise? And the federal budget negotiators are already talking about reducing the 100% promise because the costs keep going higher and higher and higher.

Many opponents of expanding Medicaid worry that the ever-increasing costs to NH taxpayers will lead us inevitably toward a sales or income tax.

The ObamaCare Medicaid expansion is bad for the people it claims to help, bad for the taxpayers, and bad for the future of New Hampshire. We should fix the broken system, not expand it.

Extending unemployment benefits can hurt the unemployed

A strange thing happened when North Carolina slashed unemployment benefits. People got jobs. Unemployment fell to its lowest level in five years. 

Economists have observed this behavior for decades. The unemployed are most likely to find a job when their unemployment benefits are about to run out. 

Their new job may not be as good as they want but any job is better than staying unemployed. Someone who is unemployed for more than six months is at risk of never finding a job again. 

When “compassionate” politicians extend unemployment benefits beyond 26 weeks, the unintended consequence is often to condemn recipients to permanent unemployment.

Who should make decisions for you?

“Politics is the art of looking for trouble, finding it whether it exists or not, diagnosing it incorrectly, and applying the wrong remedy.” — Ernest Benn

There was a time when there were “company towns”. The company owned all the land, all the buildings. The company provided food and housing; the company doctor provided health care; the bar and general store were company-owned. The employer made all decisions about food, housing, clothing, liquor, etc. Employees had no other choices because the nearest town might be a day’s ride away.

With one major exception, employers no longer decide for us what we will consume. Our employers pay us cash then we go out and buy food, clothing, housing, cars, entertainment, vacations, college educations, etc. We each make our own decisions, not our employers. The one exception is health insurance. In most businesses, the employer chooses our health insurance and we have very little, if any, say about the insurance.

But why? Why should our employer decide what health insurance is best for each of us? Our employers don’t choose the best auto insurance, fire insurance, or life insurance for us. Why should they choose the best health insurance for us? Wouldn’t it be simpler just to take the cash they are sending to an insurance company, give it to each employee, and let each of us decide what is better for us?

If you think it is a good idea for your employer to buy health insurance for you, would you also like your company to buy your food, clothing, housing, and automobile for you? After all, by buying in bulk the company should be able to get a better price on all of your family’s clothes. Isn’t that a good reason for the company to make decisions for you? No, I didn’t think so.

But, you say, it’s “always” been that way; most people get their insurance from their employer. If it ain’t broke why fix it? Well, it is broke. Employer-paid insurance is a major cause of problems with our health care payment system. (Our health care system is excellent; our payment system is terrible.)

Employer-paid insurance is not portable from one job to another job. If you switch jobs, you lose your old insurance and have to get new insurance, probably with a whole different set of conditions. Same problem if you are laid off or the company goes out of business. Contrast this with your home, auto, or life insurance. You pay for those. It doesn’t matter if you switch jobs or lose your job. You don’t lose your insurance.

The problem of pre-existing conditions largely disappears when you own your own health insurance policy. With self-paid policies you might keep the same insurance for years no matter how many times you switch jobs. With employer-paid policies you get a new policy every time you have a change of jobs. If you develop a medical condition after you have had a policy for just a few months, the insurance company can say, “That condition existed before you signed up for this policy, so it is not covered.” But if you have had the policy for years, then the condition started on their watch and they must cover it.

Employer-based insurance suffers from the one-size-fits-all problem. What is right for one employee might be not at all right for another employee, but at most companies they both get the same insurance. If employers simply paid the employees directly whatever amount they were paying the insurance companies, then each employee could choose the kind of policy that is best for him and his family.

Now consider the not uncommon case of both spouses working and both receiving employee-paid health insurance. One of those insurance policies is useless, a waste of money. If something happens they can’t file claims under both policies. If instead, their employers paid them cash, they would buy just one policy; they might take the extra cash and put it into an HSA account.

If you have employer-paid insurance, you probably have no idea what the cost of that insurance is. Your employer pays the cost and doesn’t tell you what it was. When you don’t know the price of something, it is hard to be a smart consumer. It is even harder when you won’t benefit from any cost savings that you undertake.

If you buy your own insurance using money that your employer would have paid to buy his choice of insurance, then you can often greatly reduce total health care costs by shopping around. The Wall Street Journal reported on one surgeon who managed to reduce his patient’s out-of-pocket cost from $20,000 down to $3,000 with a few simple phone calls to an anesthesiologist and nearby hospitals.

So with all of its disadvantages, why do so many of us have employer-paid insurance? It is due to ill-thought out tax policy that gives an incentive for employers to buy insurance instead of paying that same money to employees and letting them buy insurance. (Did you think that politicians and bureaucrats never made bad decisions?) ObamaCare only exacerbates that same bad policy.

Real health care payment reform would give to individuals the same incentive given to businesses to buy health insurance.

We are a caring and generous society

“The history of recent decades has involved replacing what worked with what sounded good.” — Thomas Sowell

According to an old story, a small town in Italy was having a problem with vipers. So the town council established a “viper bounty” to pay people for bringing in dead vipers. The result was that people started breeding vipers in their basements.

This illustrates one of the basic laws of economics: People respond to incentives. They do more of something when the reward increases; they do less of something when the penalty or cost increases.

Much of our public policy suffers from a failure to understand the basics of human behavior. Politicians perceive a problem, rush to pass a law that sounds good, pat themselves on the back, then go on to the next problem. They rarely look back to examine whether their “solution” actually fixed the problem or made it worse. If the program doesn’t work, their answer always is that it needs more money. They never admit that they were wrong.

Consider our many programs to help the poor and vulnerable. We are a caring and generous society. We donate hundreds of billions of dollars and countless millions of hours of our time to helping others. Caring for the vulnerable attracts almost universal support. But good intentions don’t automatically produce good policies.

Shouldn’t the goal of our anti-poverty programs be to help people move up out of poverty? Most if not all of the programs don’t even try to reduce poverty. Instead, they simply hand out money so the poor will be a little less destitute. Those unfortunate people remain in or near poverty, dependent on government sometimes for their entire lives – and their children’s lives.

To paraphrase Winston Churchill: “They want to give you a line where you can wait for a handout… I want to offer you a ladder so you can reach for your dreams.” Democrats measure success by how many people receive assistance. Republicans measure success by how many people no longer need assistance.

The myriad of welfare programs reward people for being poor and penalize those who try to move out of poverty and up the income ladder. Someone who works harder, takes a second job, learns more skills, might earn $10,000 more but lose $15,000 of benefits. Hence, many say “I can’t afford to take that job. I’d lose my benefits!” With perverse incentives like these it is no wonder that we have more people in poverty and fewer people making the effort to better themselves.

New York Times columnist Nicholas Kristof recognized the problem: “This is painful for a liberal to admit, but conservatives have a point when they suggest that America’s safety net can sometimes entangle people in a soul-crushing dependency. Our poverty programs do rescue many people, but other times they backfire.”

Democrats like to claim that they are for the poor, that Republicans are for the rich. The truth is that we Republicans are for all people to have the opportunity to become rich. The Democrats are for policies that keep people poor. If they really cared for the poor, they would fix a system that traps people in poverty. They would reward, not penalize, people who try to better themselves and escape poverty.

Bad policies are condemning people to lifelong poverty, trapping them there, and killing all hope of a better life.

Three simple rules will keep most people out of poverty: “finish high school, get a full-time job, and wait until age 21 to get married and have children.” Follow all three rules and you have just a 2% chance of falling into poverty. Break all three rules and your chance of winding up in poverty is 76%. Tragically, government policies create incentives to break all three rules.

Welfare programs pay more to a teenage girl who has children, and pay less if she gets married, thus violating the third rule. ObamaCare provides a terrible incentive for businesses to limit employees to part-time work. This year 96% of all new jobs are part-time jobs, making it very hard to follow the second rule.

But the worst incentive of all is the government school system in too many parts of the country. In the inner cities the school systems are so bad that half the children drop out before they graduate and half those who do graduate are functionally illiterate. They will never get a decent job or a shot at the American dream.

The politicians and even the teachers know that the schools are terrible. That is why they send their own kids to private or parochial schools. Parents cry out for voucher programs that would let them send their kids to the same good schools that the politicians and teachers use for their kids. But the politicians and teachers care more about teachers’ jobs than they care about the kids whose lives they are destroying.

Did I mention which party runs all of these cities, has held the mayoralties, the city councils, the school boards for more than fifty years? Democrats run the welfare and school systems; they have created the policies that ruin the lives of the recipients of their handouts. And these are the people who say they care for the poor. They like the poor so much that they want more of them.

Gun control myths demolished

This video does a good job of demolishing some gun control myths, e.g. “gun control prevents gun crime”. To those of us who remember that “The road to hell is paved with good intentions”, there is no surprise in the video itself. The only surprise is that it was broadcast prime time by ABC News (20/20).

  • Since Washington’s gun ban passed, the murder rate actually increased, even while in the rest of the country it went down.
  • Guns can also save lives.
  • Just pulling out the gun was enough to stop [the bad guys].
  • In the 40 states that allow concealed carry, there is no more violent crime than in states where guns are restricted.
  • After Kennesaw, GA required every home to have a gun, violent crime decreased.
  • Felons said they feared an armed victim much more than the police.
  • Felons said they didn’t worry about gun laws, they would carry a gun anyway.
  • We don’t know how often guns stopped criminals because who reports a crime that didn’t happen?
  • People use guns in self-defense every day. Often, just showing the gun is enough to stop the crime.
  • The National Academy of Sciences reviewed hundreds of studies and could not document a single gun regulation that reduced violent crime.
  • If some [bad guy] gets in your house, which would you rather have: a handgun or a telephone?

The timing of this story is a bit strange. The blogosphere has had at least a dozen posts on this video in the last month. But it was originally broadcast in December 2010. Every few months since then another post appears as if the story is new. I don’t know why there was a flurry of activity this past October.

Government solutions often have disastrous consequences

The problems of Obamacare’s healthcare.gov or the negative consequences of the law should come as no surprise. … Government-program incentives tend to favor interest groups instead of rewarding success or punishing failure. … The health care law was designed to expand health care insurance coverage rather than to improve health outcomes — a choice that benefits the insurance industry without necessarily producing better and more affordable health care.

Those are just a few observations in a recent column by Veronique de Rugy. You probably haven’t heard of her but she is a brilliant scholar at the Mercatus Center. Here’s more:

Obamacare, like Medicare and Medicare Part D, is yet another law that concentrates benefits on older Americans (who are often active voters) at the expense of young and healthy ones (who aren’t as active voters). … government institutions themselves are inherently prone to bad decision-making, often choosing the interest of politically favored groups. … The institutions of government themselves are inherently incapable of performing certain tasks well even when the people in power are smart, compassionate and well-intentioned.

Read the whole thing. It’s short and very readable.