WASHINGTON, Jan. 21 (UPI) -- The UPI think tank wrap-up is a daily digest covering opinion pieces, reactions to recent news events and position statements released by various think tanks.
The Institute for Public Accuracy
(The IPA is a nationwide consortium of policy researchers that seeks to broaden public discourse by gaining media access for experts whose perspectives are often overshadowed by major think tanks and other influential institutions.)
WASHINGTON -- U.S. pressure on Turkey
-- Sanar Yurdatapan, who was recently awarded the Global Rights Defenders award by Human Rights Watch.
"An overwhelming majority of the people in Turkey are opposed to a U.S. war on Iraq; a recent Pew Research Foundation poll shows that a full 83 percent of the population is against the use of Turkey's bases to strike Iraq. In spite of such strong popular opposition, the current government is inclined to allow Turkey to be used in this war. The Turkish government is obviously being pressured -- as many others are -- by the U.S. government. Turkey is particularly vulnerable to pressure because of its dependence on IMF (International Monetary Fund) loans: its external debt is now more than $115 billion."
The Ludwig von Mises Institute
(The LVMI is a research and educational center devoted to classical liberalism -- often known as libertarianism -- and the Austrian School of economics. Grounded in the work of economists Ludwig von Mises and Murray N. Rothbard, LVMI seeks a radical shift in the intellectual climate by promoting the market economy, private property, sound money and peaceful international relations, while opposing government intervention.)
AUBURN, Ala.--Healthcare interventionism: A case study
By Christopher Westley
We are often told that 40 million Americans lack health insurance, and that this is a scandal caused by greedy healthcare providers in the private sector constantly raising healthcare costs. This simply must be true because it is told to us by Those Who Care.
Of course, there is much more to this story than the storytellers let on. Many of the uninsured are uninsured by choice, and not by necessity. Healthcare costs rise in response to providers trying to recover losses emanating from government interventions into an alarmingly socialized medical industry. (That prices tend to fall in industries marked by scant intervention leads one to the conclusion that if "public servants" really cared about helping the poor and sick, they would simply go away.)
The truth is that this story is largely a myth promoted by those who stand to benefit in some way by a bigger government. This explains why events such as those that recently happened in my own state of Alabama rarely receive media coverage.
Several years ago in Birmingham, a private initiative to stem the flow of the uninsured to area emergency room facilities resulted in a program known as HealthPlus. In this program, doctors would volunteer their time and facilities to provide frequent emergency room visitors primary medical care.
The care would be less expensive than trips to the ER, and unlike the ER, payments could be made on a sliding scale. Besides reducing the burdens placed on local health institutions, HealthPlus would provide the working poor an avenue through which they could receive the preventative care necessary to reduce their future use of them.
It sounded like a great program, reflecting the efforts of private individuals to try to deal with problems made worse by government regulations, such as those governing the use of private ERs. It suggested some of the ways that the working poor might be served by a free market in medicine if one were ever allowed to come about. Its army of doctor-volunteers underscored the notion that factors other than greed were causing healthcare costs to spiral.
What's more, HealthPlus was geared to the segment of the 40 million uninsured that is most often invoked by medical socialists to justify the U.S. government's adoption of a Canadian or British healthcare system. As a result, HealthPlus attracted funding from the Robert Wood Johnson Foundation for a three-year test.
However, one problem became obvious two years into the program: Very few people wanted to use it. To effect a genuine reduction in ER crowding, HealthPlus had to attract 3,000 patients. After two years, it succeeded in attracting only 500 individuals to sign up for the program, and of these, far fewer kept their follow-up appointments at participating clinics. Recently, the program was declared a failure and officials withdrew their last year of funding totaling $150,000.
What happened? While focus groups showed that patients perceived emergency room care to be of higher quality, they also showed that patients considered the convenience of using the ER option more important than the financial and health benefits that would result from utilizing alternatives provided through HealthPlus.
Since programs such as HealthPlus have been successful in other states in getting patients out of emergency rooms and into primary care by offering medicine and doctor's visits free of charge to recipients, there will most likely be an effort to resurrect the program with these benefits.
In truth, the demise of HealthPlus illustrates the unintended consequences that accompany any government intervention of market forces. In this case, federal regulations require private owners of hospitals to provide healthcare to all comers. The intent is to create a medical safety net to uninsured individuals in need of healthcare and unable to otherwise pay for it.
Hospitals provide this service, but at higher prices than they charge patients utilizing non-ER-using customers. Efforts to force hospitals to reduce this price results in an overuse of these facilities by the uninsured and a general increase of prices for all other consumers of healthcare.
This result is completely congruent with economic theory in general, and Austrian theory in particular. As Mises argued over seven decades ago in his "Critique of Interventionism," such solutions inevitably lead to more interventions in the future. By creating unforeseen problems, they lead to more government programs to deal with problems that would not otherwise exist prior to the initial intervention.
As this process repeats itself, whole industries can become effectively socialized. No one is happy with the results save for the government bureaucrats charged with overseeing it.
This point is important to remember when policymakers discuss providing free medical care to repeat-ER users in an effort to make HealthPlus-like programs work as designed. Such efforts actually harm the very people they are intended to help. While reducing crowding problems in the ERs, other problems would arise, such as the creation of perverse incentives to those receiving the aid to remain both uninsured and dependent on the fruits of other's labor.
Moral hazard problems abound, as those receiving the entitlement have little incentive to avoid unhealthy behavior. This solution also further legitimizes the seizure of wealth and giving it to others -- in this case, of tax dollars going to doctors so as to allow recipients of medical care to continue to pay a zero-price for it.
In the process, both doctors and patients become dependent on the expansion of medical welfare programs, thus making such programs ends in themselves and providing reliable voting blocs for the politicians that make them possible.
These are parts of the healthcare story that do not make it into much of the mainstream press and they should be remembered the next time you hear of the 40 million Americans who lack health insurance. One wishes they were merely fairy tales. They can, however, have happier endings once enough people stand athwart the system, and yell stop.
(Christopher Westley is an assistant professor of economics at Jacksonville State University.)
The Cato Institute
Beware of Total Information Awareness
by Gene Healy
John Poindexter, head of the Pentagon's Office of Information Awareness, is developing a vast surveillance database to track terror suspects. The Total Information Awareness system, or TIA, will, according to Poindexter, "break down the stovepipes" that separate commercial and government databases, allowing OIA access to citizens' credit card purchases, travel itineraries, telephone calling records, e-mail, medical histories and financial information. It would give government the power to generate a comprehensive data profile on any U.S. citizen.
Adm. Poindexter assures us that TIA will be designed to respect constitutional guarantees of privacy and shield law-abiding citizens from the Pentagon's all-seeing eye. But if the history of military surveillance of civilians is any indication, accepting that assurance amounts to the triumph of hope over experience.
Opponents of new government surveillance measures such as TIA or Operation TIPS, the Justice Department's aborted plan to utilize citizen informants, often invoke the specter of the East German secret police and communist Cuba's block watch system. But we don't have to look to totalitarian states for cautionary tales. There's a long and troubling history of military surveillance in this country. That history suggests that we should loathe allowing the Pentagon access to our personal information.
During World War I, concerns about German saboteurs led to unrestrained domestic spying by U.S. Army intelligence operatives. Army spies were given free reign to gather information on potential subversives, and were often empowered to make arrests as special police officers. Occasionally, they carried false identification as employees of public utilities to allow them, as the chief intelligence officer for the Western Department put it, "to enter offices or residences of suspects gracefully, and thereby obtain data."
In her book "Army Surveillance in America," historian Joan M. Jensen notes, "What began as a system to protect the government from enemy agents became a vast surveillance system to watch civilians who violated no law but who objected to wartime policies or to the war itself."
The War Department relied heavily on a quasi-private volunteer organization, the American Protective League, composed of self-styled patriots who agreed to inform on their fellow citizens. America's experience with the APL makes clear that civil libertarian concerns about Operation TIPS are, if anything, understated. APL volunteers carried identification cards and tin badges and responded to requests from the War Department for investigation of civilians. By the end of the war the APL had close to a quarter of a million members and had carried out some 6 million investigations.
At the War Department's request, APL volunteers harassed labor organizers, intimidated and arrested opponents of the draft, and investigated such potential subversives as Mexican-American leaders in Los Angeles, pacifist groups, and antiwar religious sects. Through it all, the army caught exactly one German spy, a naval officer who tried to enter the United States via Nogales, Ariz.
The Army's domestic surveillance activities were substantially curtailed after the end of World War I. But throughout the 20th century, in periods of domestic unrest and foreign conflict, army surveillance ratcheted up again, most notably in the 1960s. During that tumultuous decade, President Johnson repeatedly called on federal troops to quell riots and restore order. To better perform that task, Army intelligence operatives began compiling thousands of dossiers on citizens, many of whom had committed no offense beyond protesting government policy.
Reviewing the files, the Senate Judiciary Committee noted that "comments about the financial affairs, sex lives and psychiatric histories of persons unaffiliated with the armed forces appear throughout the various records systems." Justice William O. Douglas called army surveillance "a cancer in our body politic."
Poindexter seeks to bring Pentagon surveillance into the 21st century, replacing the low-tech, labor intensive system relied on in the past with high-tech data-mining techniques. He maintains that "we can achieve the necessary security we need and still have privacy." But given the military's legacy of privacy abuses, such vague assurances are cold comfort.
Some have suggested that Poindexter's record as a former Iran-Contra defendant convicted of five felony counts of lying to Congress disqualify him from his position. But the question isn't whether Poindexter's the right man for the job; it's whether that job should exist in the first place
(Gene Healy is senior editor at the Cato Institute.)
