Slouching Towards Single Payer

At the Wall Street Journal Chris Jacobs of Juniper Research has an op-ed in which he notes that Democrats are moving towards endorsing a single payer healthcare system:

Conventional wisdom in Washington holds that so-called moderate Democrats who haven’t endorsed Sen. Bernie Sanders’s single-payer healthcare plan support many coverage options.

But a white paper on healthcare reform from Oregon’s Ron Wyden, ranking Democrat on the Senate Finance Committee, shows that this is false. The report, released July 30, mentions the word “profit” or derivations thereof 185 times in an 86-page document, echoing New York Mayor Zohran Mamdani’s rhetoric demonizing wealth. The outlined policies also resemble those of Mr. Mamdani and Mr. Sanders—proposals that Democrats previously rejected as too costly and disruptive, and that would move the country toward a fully government-run system.

The Wyden document begins with a discussion of “consumer-friendly enrollment.” It proposes “a more standardized or centralized platform that creates a consistent enrollment experience across coverage programs,” suggests that “existing enrollment processes in the employer market can be burdensome for workers,” and raises the idea of including employer coverage in this “more standardized employer platform.” The apparent attempt to integrate businesses and employer coverage into a government-run enrollment architecture resembles the purchasing alliances that defined Hillary Clinton’s failed healthcare proposal in the 1990s.

That raises a more fundamental question: what mechanism prevents the amount being paid from continuing to grow faster than the resources available to pay it? I don’t object to a single-payer healthcare system with one proviso: healthcare costs must be controlled.

Some do it better than others but there are no single-payer systems that do not at least attempt to constrain costs. The biggest problem with single-payer in the United States is that the Congress has abandoned attempting to control healthcare spending on the programs it subsidizes.

Our problem is that the incentives of patients, healthcare providers, and those who pay for healthcare are not properly aligned. My own preference would be for a system that resembles Italy’s, a capitation system in which primary care physicians are compensated based on the number and demographics of their patient base. I would go farther, however, and have specialists compensated through primary care physicians. That would align the incentives of patients, primary care physicians, specialists, and those who pay for care.

A system in which the government merely foots more of the bill without increasing taxation to pay for it may be appealing but is impractical.

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Mister, We Could Use a Man Like Count Binface Here

Read this article at Associated Press by Brian Melley. It will make your day. Here’s a snippet:

LONDON (AP) — Timing is everything in comedy and, so it seems, in British politics for a perennial joke candidate who wears a garbage can on his head.

Count Binface, a self-described intergalactic space warrior, has landed in the center of the U.K.’s political universe ahead of a special election Thursday that was derided as a farce long before the ballot was packed with nearly three dozen candidates — many from the silly end of the spectrum.

Binface, who has run against prime ministers past and present, was the first to throw his bucket in the ring when Reform UK leader Nigel Farage abruptly quit Parliament and said he would seek reelection to clear his name over financial allegations.

“Game on, Nige,” Binface declared soon after Farage, portraying himself as the victim of a witch hunt, said he would represent the people against the establishment.

and then seek out some of the many videos in which he is featured.

I even have a campaign slogan for him: “Put a lid on it!”

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Changing of the Guard

There aren’t too many television series that are around long enough to face the challenges that NCIS has. NCIS began as a series anchored by Silent Generation and Baby Boomer authority figures with a predominantly Gen X supporting cast. Today it is anchored by a Baby Boomer and a largely Gen X/Millennial ensemble. These were its early cast members:

Actor Part Age Cohort
Mark Harmon Leroy Jethro Gibbs Baby Boomer
Sasha Alexander Caitlin Todd Gen X
Michael Weatherly  Anthony DiNozzo Gen X
Pauley Perrette Abby Sciuto Gen X
Sean Murray Timothy McGee Gen X
David McCallum Dr. Donald “Ducky” Mallard  Silent

and these are its most recent cast members:

Actor Part Age Cohort
Gary Cole Alden Parker Baby Boomer
Sean Murray Timothy McGee Gen X
Wilmer Valderrama  Nick Torres Gen X
Katrina Law Jessica Knight Millennial
Brian Dietzen Dr. Jimmy Palmer  Gen X
Diona Reasonover Kasie Hines Millennial

The recurring cast once reinforced the show’s multigenerational feel. Characters played by Ralph Waite, Muse Watson, and Joe Spano represented parents, mentors, and longtime colleagues rather than peers. Those kinds of recurring older characters have largely disappeared.

I presume that most of its audience are Baby Boomers. Will the transition in the cast enable it to capture viewers of a younger cohort? Frankly, I doubt it. No scripted broadcast network show has a scripted series that skews towards younger viewers. Even the streaming audience for scripted shows skews older.

I suspect CBS is just trying to hold onto the audience it has.

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Those Were the Days

I just heard Louisiana Sen. Bill Cassidy outline his plan to “rescue” Social Security on Face the Nation. Here’s the relevant snippet:

SEN. CASSIDY: Yes, but I have a plan, and we don’t raise the retirement age in my plan. But that said–

MARGARET BRENNAN: This is the sovereign wealth fund–

SEN. CASSIDY: –somebody else may have a plan that does it- what’s that?

MARGARET BRENNAN: This is the sovereign wealth fund plan you had with Senator Kaine?

SEN. CASSIDY: This is the one where you do a investment fund and you put $1.5 trillion in it and you allow it to grow with the economy. It’s what the Canadians do, the Norwegians do, the Japanese do. It’s what the U.S. government does with the Federal railroad retirement system. When you do that, the growth in the economy takes care of a lot of the problem with the debt.

IMO that would have been a fine idea in the 1980s when Congress reformed Social Security by raising FICA and the retirement age but it has several serious problems now.

The first is where do you get the $1.5 trillion? Not only do Social Security expenditures exceed receipts but general spending is running at a deficit. We could:

  • borrow another $1.5 trillion which would increase pressure to monetize the debt and thereby contribute to inflation and reduced affordability
  • raise taxes which Sen. Cassidy opposes
  • reduce or reallocate other federal spending

all of which are difficult or impossible in the present political climate.

The second is that such a fund would inevitably be politicized unless clear lines are drawn. The federal government should not be picking winners and losers. Congress would inevitably face pressure to favor politically desirable industries, avoid investments in unpopular sectors, or use shareholder voting power to pursue policy goals.

The third is that a large government purchase of equities would initially transfer wealth to existing shareholders by bidding up asset prices. According to the Federal Reserve the top .1% of wealth owners own 30% to 35% of of equities and mutual fund shares. That the richest are not rich enough is not presently a major problem in the United States.

The conceptual problem is do you really want the federal government to own a large portion of the economy? It’s unclear to me how one can philosophically oppose socialism and support government ownership of the economy. Even if one rejects the label “socialism”, a government investment fund of this scale raises legitimate questions about the appropriate role of the federal government as a major shareholder in private enterprise.

First restore actuarial balance through taxes and benefits; only after the program again generates surpluses should those surpluses be invested. My alternative plan would be to raise the Social Security retirement age to 70, raise the maximum income subject to FICA so that 99% of wage income is subject to it (that’s about $560,000 at present) indexed to inflation, invest some portion of Social Security surpluses up to 100% in one or more privately administered mutual funds, and cap the administrators’ earnings for the fund.

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Summer Reruns

The editors of the Washington Post consider the dire plight of Afghanistan:

The situation there is dire: Aid agencies say 3.7 million children and 1.2 million pregnant and breastfeeding women are suffering from malnutrition. Children are experiencing “wasting” — slowly dying from hunger — because of a lack of therapeutic feeding.

concluding:

Donor fatigue with seemingly endless conflicts is undeniable. The U.N. badly needs reforms to streamline burdensome bureaucracy and wasteful spending.

Americans don’t want their tax dollars feeding terrorists. Careful controls must be imposed to ensure that food aid goes to women and children, not military-age males. But Americans are generous, and the crisis calls for compassion.

The world’s richest nation should not let the poorest people on earth die of hunger.

The editors are correct that these humanitarian disasters demand a response. The more important question is who should bear the burden? Responsibility should fall first on those governments whose policies have materially contributed to the crises. That responsibility includes the United States but it does not end there.

Between 2002 and 2021 the U. S. provided considerable humanitarian aid to Afghanistan—at least $7 billion. When military aid, reconstruction aid, and humanitarian aid are combined the U. S. provided a substantial portion of the country’s GDP during that period. When the Taliban reassumed control in 2021 the GDP fell correspondingly.

During the twenty years in which Western governments financed much of Afghanistan’s economy, widespread famine was largely averted. Once the Taliban regained power, foreign assistance collapsed, the economy contracted sharply, and predictable humanitarian disaster followed.

In the editorial the editors also note 13 other “hot spots” around the world with serious humanitarian calamities. Of the thirteen, the overwhelming majority involve armed Islamist movements, governments that have supported them, or conflicts in which such movements play a major role. The remaining countries are Myanmar, Haiti, and Madagascar.

I have a modest proposal. The U. S. should provide humanitarian assistance to Madagascar. Haiti presents a specific problem. Humanitarian aid cannot be delivered effectively while heavily armed criminal gangs dominate large portions of the country. The first humanitarian imperative is restoring sufficient security that food and medical assistance can actually reach civilians. If the United States chooses to assist Haiti, helping the Haitian government reestablish order should come before large-scale relief efforts.

China already supports Myanmar. The Chinese government should provide additional humanitarian aid to Myanmar to counter the bad results the government they have supported has produced.

Saudi Arabia has long provided ideological and financial support for radical madrassas and, at times, insurgent movements throughout the region that is the area primarily in crisis including Afghanistan. The Saudis should provide humanitarian assistance for the people in the countries presently roiled by the activities of radicals and insurgents.

Americans have demonstrated extraordinary generosity for decades. The question is not whether humanitarian aid should be provided. It is whether the burden should continue to fall primarily on the American taxpayer while governments whose policies have contributed to these crises escape comparable responsibility.

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Puzzled

I’ve encountered a number of pieces in which the authors wrote that LLM AI never disagreed with them. That puzzles me.

I occasionally use ChatGPT, Claude, Grok, and Gemini. They’ve all disagreed with me at one time or another. When I have remonstrated with them they occasionally back down, particularly when I point out the logical flaws in their statements. Even more occasionally they’ve been flatly wrong. When I point that out, they’ve acknowledged that.

One of the great things about contradicting an LLM AI model is that I can do so harshly without worrying about its feelings.

I don’t think the proper lesson from this is that the models aren’t useful. It’s that they are easy to misuse.

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Cut the Cord

The first successful municipal water treatment plant in the United States was built in 1872 in Poughkeepsie, New York. It was not connected to the public Internet.

The largest municipal water treatment plant in the United States was the Jardine Water Treatment Plant built in the 1960s in Chicago, Illinois. It was not connected to the public Internet. It is still operational and remains the large municipal water treatment plant in the U. S.

There are probably around 150,000 municipal water treatment plants in the U. S. nationwide according to the Environmental Protection Agency.

Cyberattacks on municipal water treatment facilities have been much in the news lately. U. S. officials suspect Iran-backed hackers are responsible. For example, at CBS Nicole Sganga reports that such cyberattacks have been reported in at least 12 states:

Cyberattacks on U.S. water systems that officials suspect may be linked to Iran-backed hackers have been reported in at least a dozen states, sources familiar with the matter told CBS News on Wednesday.

Those states include Michigan, Minnesota, Georgia, New Jersey and South Dakota. In Minnesota specifically, more than 30 community water systems were impacted, CBS News previously learned.

In Georgia, the Clayton County Water Authority, which serves 300,000 customers in the Atlanta area, said cyber activity last month caused a water pressure drop and forced the agency to issue a boil water advisory. Service was restored within hours, however.

Some utilities have lost critical remote-control capabilities, forcing operators to switch to manual mode. In several cases, the hackers gained remote access to pumps, valves and water pressure.

So far, according to officials, the cyberattacks have had no impact on drinking water, which has remained safe.

Connection to the public Internet is not an operational necessity. It is merely one possible engineering choice, not an inherent requirement of modern water treatment.

Direct connections between operational control systems and the public Internet should be prohibited by law. Where remote access is genuinely necessary, it should occur through dedicated, authenticated, cryptographically protected communications over private networks designed so that a compromise of the public Internet cannot directly compromise plant operations. Security should be achieved primarily through system architecture, not through perfect human behavior.

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How?

President Trump’s threat to “decapitate” Iran if no agreement is reached raised a question for me: How do you decapitate an organization that has no single head?

One lesson of the conflict so far is that Iran’s military and political structure appears decentralized enough to continue functioning despite heavy losses among senior leaders. Leadership strikes may disrupt operations but they have not produced collapse.

A prolonged war of attrition could eventually deplete Iran’s missiles and drones. Whether it would similarly deplete the willingness of people to continue resisting is a much more difficult question.

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Rats Desert Sinking Ship

Another major officer in Mayor Brandon Johnson’s administration has resigned. That makes three in less than a month. Jasmine Minor and Sarah Schulte report at ABC 7 Chicago:

CHICAGO (WLS) — Chicago Budget Director Annette Guzman is resigning from Mayor Brandon Johnson’s administration as the city prepares for another challenging budget season.

Johnson said Guzman, who has been with his administration since he took office, is leaving City Hall to care for her ailing mother.

“She has certainly helped us navigate some of the most significant fiscal challenges that our city has faced,” Johnson said.

Both the Chief Financial Officer and the Budget Director have resigned in the last several weeks. I have little doubt that both intend to spend more time with their families.

In addition the field of candidates to replace Mayor Johnson is substantial. It includes the Illinois Secretary of State, the Cook County Treasurer, the Illinois Comptroller, and my Congressman, Mike Quigley, just to name a few. My greatest concern is that in such a large field the “anybody but Johnson” votes will divide the vote and Johnson will be re-elected.

His present approval rating in Chicago is 23% and only 13% of Chicagoans want him to run again.

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TCM’s “Summer Under the Stars” 2026

During the month of August Turner Classic Movies (TCM) typically devotes its programming on each day to a different Hollywood star. The first half dozen stars for this month are Doris Day, Humphrey Bogart, June Allyson, Glenn Ford, Joan Bennett, and Diane Keaton. Today’s “Star of the Day” is June Allyson. If you get TCM in general they’re a good opportunity to see the movies of individual stars, some rarely broadcast. For the whole list see here.

There are some good Doris Day pictures, as documents if nothing else. For example, The Pajama Game captured the performances of much of the Broadway cast of the show. Except that Doris Day replaced Janis Paige as Babe. I would rather have seen Janis Paige but you can’t have everything.

At the risk of being unkind is there such a thing as a good June Allyson picture? They just finished showing a movie I’ve never seen: The Secret Heart. In it June Allyson portrayed a 14 year old. When it was made she was 29 years old. Watching it required a certain suspension of disbelief. I’ve never seen the movie from beginning to end and I suspect I never will.

On the other hand yesterday they showed Casablanca, The Maltese Falcon, The Big Sleep and others of Bogart’s best.

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