Stupid Texas: Yes, I Live Here

I'm not making this up

To be fair, though, we aren't talking about a Bush policy speech, but one promoting the Super Bowl, a matter of universal social and cultural significance far surpassing the importance of Obama's "stay in school so you don't grow up to be an imbecile" speech.

Here's How It's Done: James D. Cox

For a while, it looked as though uncouth haters might scare the proud innovators of Wall Street away from the innovations that have made the U.S. economy the current envy of the world.

Fear not. No one will tell Wall Street that there is anything irrational in creating transferrable financial assets out of the mortality probabilities of Americans. There is, understandably, some anxiety about this. But there is a polite way to express this and an impolite way. First, the polite:

“It’s bittersweet,” said James D. Cox, a professor of corporate and securities law at Duke University. “The sweet part is there are investors interested in exotic products created by underwriters who make large fees and rating agencies who then get paid to confer ratings. The bitter part is it’s a return to the good old days.”

That's how you make it into the venerable Gray Lady. Polite concern revolves around the prospect that such securities might not create gigantic, never-ending flows of cash. Other polite concerns revolve around the prospect that the root asset behind the security might be unpredictable:

In addition to fraud, there is another potential risk for investors: that some people could live far longer than expected.

And:

The challenge for Wall Street is to make securitized life insurance policies more predictable — and, ideally, safer — investments.

It's a fine line from polite to impolite, though, and while it's OK to point out the lamentable fact that people might screw up this great idea for everyone by living longer lives, it is not OK to point out that the entire scheme is a lottery of human death. I hate to even link to anyone who could be this uncouth:

But even beyond that… what the fuck??? This feels like financial innovation as practiced by Josef Mengele meets the Zucker Brothers; not just evil, but wacky evil. I don’t even want to think about what happens when Goldman Sachs suddenly has a large financial stake in the premature deaths of a bunch of old people. Where are the crazy police? Where is the crack federal crazy squad with the big butterfly net?

I've dealt with you before, Matt. Please keep your uncouth tirades to yourself.

More Stupid Texas

A humble proposal: If Newt Gingrich is to be treated as one of the giants of American history, make sure to cover his life and work in the complete detail that it deserves.

Also, incorporate Gingrich's description of Gettysburg as part of the state history curriculum. If it's desirable to teach children that Gingrich was a stalwart for human liberty then it should be desirable to teach them that the Confederacy won, a delusion that is evidently well-established in these parts and consistent with the contemporary state of the union.

That's Uncouth: Pointing Out Reagan's Proselytizing to School Children

Pointing out when right-wing activists engage in blatant hypocrisy is uncouth. Please don't do it.

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True Gentlemen: David Brooks

Brooks is an admirable gentleman, and never fails to find a way to describe complex and politically fraught situations in terms that allow everyone to feel good about themselves and require nothing so uncouth as affixing blame to individuals or groups. Well, unless those individuals happen to be liberals. But no one's perfect.

Brooks shows his gentlemanliness in his opening line:

If I were magically given an hour to help Barack Obama prepare for his health care speech next week

Yes, if only. Rare is the pundit today motivated not by self-aggrandizement but by the desire to assist a politician with whom he disagrees vigorously. Brooks's advice? Quite reasonable. Peruse an article in the estimable Atlantic Monthly with the perfectly non-inflammatory title "How American Health Care Killed My Father." But wait, you say. Such an article by name alone suggests the impertinence of populist anger against The System, a social plague thought eradicated in the 1960s. Fear not, for both Brooks and author David Goldhill seek not to rouse pitchforks against The System, an entity guided and driven by recognizable and identifiable human hands. Rather, perverse incentives are to blame for costs. As Brooks summarizes:

Goldhill’s main message is that the American health care system is dysfunctional at the core. He vividly describes how the system hides information, muddies choices, encourages more treatment instead of better care, neglects cheap innovation, inflates costs and unintentionally increases suffering.

As Brooks is an upstanding gentleman, I trust the reader will feel no need to pursue a full reading of Goldhill's piece to judge the veracity of Brooks's summary. Clearly, once Barack Obama declares war on the Malefactors of Perverse Incentive this reform is as good as done. I also trust that the reader, like Brooks, sees no possible obstacle to a government initiative to regulate the health delivery system to avoid unnecessary expenses, encourage economies, and streamline information. No one has any problem with suggestions so reasonable.

Kudos, David Brooks, for solving one of our most intractable problems, without asking us to bicker and argue about who's gouging/overcharging/dropping/denying/defrauding whom. You are a gentleman and a scholar.

It is unfortunate, however, that David Goldhill's dad had such strong perverse incentive to die.

Update: An uncouth person might point out that Goldhill's article, which deals with a fatal infection contracted in a hospital as a result of systemic failure to practice good hygiene, describes an important issue but one that is nonetheless irrelevant to the issues being debated now, which largely involve the financial end of the health system rather than the health delivery end.

Update 2: An even more uncouth person might point out that Goldhill's aversion to blame-fixing is perhaps insincere since it allows him to proceed to a standard glibertarian argument for market-oriented reforms:

To achieve maximum coverage at acceptable cost with acceptable quality, health care will need to become subject to the same forces that have boosted efficiency and value throughout the economy. We will need to reduce, rather than expand, the role of insurance; focus the government’s role exclusively on things that only government can do (protect the poor, cover us against true catastrophe, enforce safety standards, and ensure provider competition); overcome our addiction to Ponzi-scheme financing, hidden subsidies, manipulated prices, and undisclosed results; and rely more on ourselves, the consumers, as the ultimate guarantors of good service, reasonable prices, and sensible trade-offs between health-care spending and spending on all the other good things money can buy.

A truly uncouth person might point out that, while Goldhill's proposed remedy of eliminating "moral hazard" by ceasing the funding of routine care through insurance would, indeed eliminate much bureaucratic overhead for administering preventive care, it would also discourage anyone from seeking care until their illness was debilitating.

Society’s excess cost from health insurance’s administrative expense pales next to the damage caused by “moral hazard”—the tendency we all have to change our behavior, becoming spendthrifts and otherwise taking less care with our decisions, when someone else is covering the costs.

Evidence? hold on to your hats. How spendthrifty are we when a generous insurance company is footing the bill?

Want further evidence of moral hazard? The average insured American and the average uninsured American spend very similar amounts of their own money on health care each year—$654 and $583, respectively. But they spend wildly different amounts of other people’s money—$3,809 and $1,103, respectively. Sometimes the uninsured do not get highly beneficial treatments because they cannot afford them at today’s prices—something any reform must address. But likewise, insured patients often get only marginally beneficial (or even outright unnecessary) care at mind-boggling cost.

An super-duper uncouth reader might say: Where exactly is this "other people's money" that the uninsured are spending coming from? Doesn't such a ridiculous statistic undermine Goldhill's whole point? Such a clod might argue, "I've racked up more than $10,000 in charges in three hours. For an ambulance ride, an X-ray, six stitches, and an antibiotic IV. I guess I should have explained to the 19-year old who hit me with his car while I was cycling that we were engaging in moral hazard. I guess I could have texted him 'OMG: mrl hzrd plz dnt rn me ovr11111'."

A yet-more uncouth reader still might read Goldhill's proposal for paying for medical expenses -Health Savings Accounts--and exclaim "Dear God, this horseshit again?" After spending a few moments swearing and stomping around the room, this person might wonder how they might be expected to save enough to pay for treatments whose costs might exceed by a factor between 1 and 100 the amount they spend on food in a year:

What about care that falls through the cracks—major expenses (an appendectomy, sports injury, or birth) that might exceed the current balance of someone’s HSA but are not catastrophic? These should be funded the same way we pay for most expensive purchases that confer long-term benefits: with credit.

Here, our reader, by now approaching asymptotal uncouthness, might wonder if all of the health savings accounts in America could cover the cost of extracting David Goldhill's head from his anus (if this reader were either a glutton for punishment or a snarky smartass, this piece would truly be a gift that kept on giving).

But such crudeness has no place in polite debate. David Goldhill is a "media executive", and therefore has numerous great ideas for managing risk and incentive in high-stakes contexts. His opinions are to be respected and his demands obeyed.

Final update: Others noted Goldhill's piece when it was first published last month, and good manners dictate that I credit or scold them accordingly. Consumer Watchdog had a particularly uncouth response. The Economist more politely glossed over the logistical, logical, moral, and sociological merits of the article and contented itself with pointing out that Goldhill was being a bit hasty in demanding the immediate implementation of his ideas, as sudden change is unpleasantly disruptive to all parties involved.

Okay There Guy: Curt Schilling

Far be it from me to point out that Curt Schilling would have an uphill fight in seeking a U.S. Senate Seat in Massachusetts, given the state's recent electoral showing.

I would also certainly not be so crude as to torpedo this statement with an ironic barrage of links:

While Schilling has never run for or held political office, he said it’s an asset because he’s unencumbered by special interest connections.

“My credentials are that I have no baggage,” he said.

While I myself will of course take a gentleman at his word until given reason to doubt it, others might not observe a code of proper conduct so rigorously. "No baggage, indeed. Nothing between the Bloody Sock Game and this morning," an ignorant, uncouth oaf might remark between bites of his hamburger sandwich and immoderate swigs of beer. "Okay guy, whatever."

That clod might continue to read a statement like this one

“The person that works 9-to-5 for crap dollars gets spat on, and it’s becoming a state that’s next to impossible to live and prosper in, and I think it was anything but when it was founded,” he said at one point. At another, he proclaimed, “The status quo sucks. The status quo is not working.”

and opine that Curt Schilling Professional Baseballer's knowledge of said subject has been gained from his extensive study of the Boston Herald opinion page while seated in stall 3 of the home clubhouse in Fenway Park. This person might bray that, considering only thirty percent of state voters supported repealing the income tax in November 2008, there might not be a big enough "eeeeeevil gubmint is taking my money and giving it to bums and darkies" vote to put Schilling over the top. Said person might note the high rankings of the Commonwealth on most measures of quality of life, and also might declare that if Curt Schilling could name the century in which either Massachusetts Bay Colony or the Commonwealth were founded he would eat his hat.

And finally, our hypothetical man-of-low-breeding might question whether there is any causal connection between Schilling's well-thought-out analysis of public rectitude in the Bay State and his choice of comparison:

“This state, next to Illinois, is probably looked on as one of the most corrupt, laughable political scenes in the nation, and it should be just the opposite,” he said during one of his regular appearances on WEEI-AM, a sports radio station. “I think there’s so much broke here, that the fixing piece, I don’t think you’d have to look very hard to pick up the pieces of debris and start to reform and fix it.”

And, finally, our hypothetical Joe-Twelve-Pack might rudely and impolitely note a proclivity on the part of Mr. Schilling to run his mouth and then issue half-assed apologies and backtrack when when criticized. This person might opine that if Schilling could only master the art of blaming the media for his ill-advised comments, an art that he's begun to practice--

And he expressed surprise at the reaction after he told a cable television reporter he was considering a campaign.

“The chances of it happening are slim to none, but they ran with I’ve been thinking about it, so it’s gone nuts,” he said.

then he might make the leap to running for Vice President.



Bearing in mind, of course, that to actually speak these things would be terribly uncouth.

In conclusion, our imaginary interlocutor, were he a native-born Masshole, might thank Schilling for the memories and suggest that Schilling pursue his political interests in the Granite State, where the Northabamans are more receptive to this stuff.

Okay There Guy: Michelle Bachmann

It would probably be uncouth to point out that there is very little chance that this tactic will derail the modest reforms that the insurance industry will countenance from the O-Rahm-a administration. Hey, if you insist, by all means, go to town. It worked for the Judean People's Front I guess.

Also uncouth to argue that suicide pacts have a bad name, or that, much like the Rapture, this particular suicide pact will be a win-win for those leaving this earthly realm and those left behind.