The title of this post says it all. I’ve been meaning to mention this for a long time.

The picture on the left is of Jewish refugees from Europe in the 1930s. The picture on the right is of people in the “caravan” from Guatemala today.

The key passage in the post at RealClearHealth by Marshall S. Runge, “The Wonders of Modern Medicine Come at a Cost” is this one:

Medicine is not like other aspects of our technological age, where everything from cell phones to PCs inevitably get better and cheaper. One reason is that therapies like CAR-T represent the trend in medical innovation toward targeting smaller groups of patients with relatively rare conditions. This is the exact opposite of the newest gadget aimed at a mass market. And in most cases, expensive, novel therapies are adopted earlier and to a greater extent in the United States than in many countries. In essence, we are taking the economic risk to implement medical breakthroughs when costs are highest.

That caused me to think of a couple of other articles I’d read recently, the first predicting that by 2040 life expectancies in the U. S. will have increased less than 1% from now, the other than by 2040 real health care spending in the U. S. will have doubled.

The greatest wonder of modern medicine is that we continue to be so complacent with paying so much for such meager results.

There is a story that goes back a millennium about how King Canute commanded that his throne be brought to the seashore where the king commanded the tide to halt so as not to wet his feet and robes, knowing full well commanding the elements was beyond his power:

“Might I stay the sun above us, good sir Bishop?” Canute cried;
“Could I bid the silver moon to pause upon her heavenly ride?
If the moon obeys my orders, sure I can command the tide.

“Will the advancing waves obey me, Bishop, if I make the sign?”
Said the Bishop, bowing lowly, “Land and sea, my lord, are thine.”
Canute turned towards the ocean–“Back!” he said, “thou foaming brine.

“From the sacred shore I stand on, I command thee to retreat;
Venture not, thou stormy rebel, to approach thy master’s seat:
Ocean, be thou still! I bid thee come not nearer to my feet!”

But the sullen ocean answered with a louder, deeper roar,
And the rapid waves drew nearer, falling sounding on the shore;
Back the Keeper and the Bishop, back the king and courtiers bore.

And he sternly bade them never more to kneel to human clay,
But alone to praise and worship That which earth and seas obey:
And his golden crown of empire never wore he from that day.
King Canute is dead and gone: Parasites exist alway.

I am frequently baffled that people don’t understand how limited government is. Wouldn’t it be great if everyone earned at least $30,000 per year? Sure it would but you can’t mandate it. If you did here’s what would happen:

• Some people would be better off
• Some people would lose their jobs
• Some businesses would go out of business and all of their erstwhile employees would lose their jobs
• Other businesses would invest in equipment to make it possible for them to get rid of more of their employees

or, as Amazon has recently learned, it would not only ensure that its employees earning less than $30,000 per year got that but it would make its employees who are already earning $30,000 per year unhappy that they were being paid at the same rate as people who used to earn less.

Or it might have the results that Jim Epstein points out at Reason.com—it might produce a black market:

“We used to do the same thing with 25 people, and now I’m doing it with two,” says Belinsky.

By making cheap labor illegal, the $15 minimum wage made it possible for Belinsky to downgrade his service. “Before if I go exterior, my competition would say, ‘ah, he went exterior and I’m still full-service so I’ll take all his customers,'” Belinsky says. “That never gave me a chance to go exterior. Now everybody is forced to go exterior because of this crazy law and the minimum wage $15 per hour. It evened out the field.”

“These workers have few options and little power, RWDSU President Stuart Applebaum said in his December 2014 speech. “They live in the shadows.”

The irony is that progressives have pushed the car wash workers further into the shadows.

The $15 minimum wage amounts to government prohibition of low-wage work. And yet just making something illegal won’t stop able-bodied men with few alternatives from meeting a market demand for their services.

Since many legitimate car washes can no longer hire them, workers are going to the streets, where it’s all cash, no tax, no unions, no workers comp, no insurance, and certainly no wage floors.

“The economy has led us to this situation to have to work washing cars in the street,” says Fausto, an illegal car wash worker who asked that we only use his first name. He’s part of a three-man operation washing cars on the curb out of a van for about $15 a pop.

We don’t need a $15 per hour minimum wage. We need more jobs that pay more than minimum wage and more workers who are capable of filling jobs that pay more than minimum wage. Some of that can be accomplished with training if the workers are trained in the right skills. But some of it means that we need to control immigration.

What I think Mark Penn is missing in his piece at The Hill tut-tutting over how illiberal the Democrats are becoming is the role he played in the process. He was instrumental in maintaining Bill Clinton’s popularity and ensuring that Hillary Clinton was some sort of feminist icon when the reality was that she was anything but and remained a viable presidential contender herself.

You don’t get to be cynical in your 30s and then suddenly discover the value of our institutions in your 60s. They had value 25 years ago, too, Mark. If you don’t like having a low character as president you should have thought of it then.

Has anyone else noted how carefully the major media outlets are treading the line between expressing their outrage over the presumed murder of Jamal Khashoggi and recognizing that both Democratic and Republican presidents have cozied up to the Saudis? The problem is that the Saudis didn’t suddenly become reprehensible a week ago. They’ve always been reprehensible.

Rick Klein, Maryalice Parks, and John Verhovek take note of the issues that are cropping up most in the midterm elections at ABC News. The issues they single out are:

Trump

That’s obvious enough. Trump has dominated the opinion pages of most major media outlets for much of the last two and a half years, largely in a negative light.

Firsts

So important they mention it twice. Women are likely to be elected in these midterms at the highest rate ever. Gender, race, sexual preference, and age are all hot topics. Unmentioned in the article is that if she is re-elected, Dianne Feinstein will become the oldest woman ever elected to the Senate. She’d need to run two more times to get a shot at being the oldest serving senator, though.

Health Care

That’s certainly the case here in Illinois. We’re being deluged with political advertising and just about every spot for a Democratic candidate castigates the Republican opponent for wanting to take people’s health care away. No word though on how they’d reconcile health care as an absolute right, a right to earn a living as a physician, and the right to property. If health care is not an absolute right, it means they want to take somebody’s health care away, too, and the whole thing is sophistry. If health care is an absolute right, either wages in health care must be driven to an arbitrarily low point or there is no limit to how high takes must be raised to pay for all of that health care. Claiming that your’re going to balance those rights somehow calls for more acumen and mental acuity than appears to be possible.

Border control

Most of the related complaints I hear are about illegal immigration rather than the broader topic of immigration.

What’s remarkable to me are the issues that aren’t important to people. We are still fighting a war in Afghanistan. We’re spending billions there which can’t be spent on anything else. Americans are dying. I can only conclude that Americans have accepted that we’ll be fighting there forever.

Despite its evergreen presence in the country’s opinion pages, global warming/climate change don’t seem to be much of a topic.

I’m not seeing as much outrage over the tax reforms that took effect earlier this year as all of the complaints about “tax cuts for the rich” might have led you to believe. It’s darned hard to cut taxes for anybody but the rich when most of the people who aren’t rich aren’t paying income taxes, either, and you can’t talk about cutting payroll taxes without being accused of attacking Social Security. That sort of defuses taxes as an issue.

I haven’t heard much about now-Justice Kavanaugh, either. I guess that caravan has moved on.

What other issues are surprising in not being major topics of discussion in the midterms?

My wife and I were evaluating our alternatives in voting for state and county offices (poor) and we noticed something. Among county-wide offices all of the offices are uncontested except County Assessor for which both a Republican and a Democrat are vying for the office. No Republicans are running for any other county-wide office.

Complaining about Democrats is fine. Complaining about Democratic hegemony is fine.

Complaining about Democrats or Democratic hegemony while not even attempting to do anything about it is not fine. It is lazy, cowardly, cynical, or some combination.

Yes, you have to spend money to win elections. That’s true of all offices at every level in every state and nationwide. “He either fears his fate too much or his deserts are small, etc.” You can’t expect to win any election without competing for it. Kwicherbellyakin.

Boy, did these things need saying. In his Wall Street Journal column Holman Jenkins remarks on Trump as a phenomenon:

Bruno Maçães, a Portuguese political scientist, recently pointed out that European thinkers have become obsessed with U.S. domestic politics. “They’re not watching German politics. So again, tell me why this is so bad.”

His point is subtle and best illuminated by new work from liberal scholar Cass Sunstein on how true voter preferences can stay unrevealed in a democracy and then emerge spontaneously. Mr. Trump made new things sayable. The U.S. relies on a military alliance with countries that no longer spend money on having militaries. Our China trade openness has been rewarded by the rise of a neo-Maoist totalitarianism in China. We engage in costly climate policies that have no effect on climate.

We might also remind ourselves of a general principle: It’s not Donald Trump who is a threat to a democracy; it’s politicians generally. Democracy is a system for curbing their quest for power. Of the two candidates in 2016, which was the protégée of the president in office? Which was backed by longstanding and highly organized support networks? Mr. Trump is accused of violating norms, but which party concocted evidence that its opponent was a Russian agent? Which now questions the legitimacy of basic institutions like the Electoral College and the Supreme Court? Which encourages the mobbing of partisan opponents in restaurants?

In 2008, Barack Obama’s campaign was a snow job about bipartisanship. Political misdirection clearly has its uses, but this hasn’t been the Trumpian approach. Mr. Renshon rightly describes him as a president who does “much better in keeping his promises than in speaking accurately about them.”

I do not like Trump for any number of reasons, not the least of which is that my assessment is that he sees people, women in particular, solely in instrumental terms. But I don’t think that’s why so many Democrats hate him with a white hot hatred.

Besides his not being Hillary Clinton, I think they hate him because he doesn’t give lip service to the prevailing wisdom and most particularly their prevailing wisdom. That isn’t a vice. It’s a virtue.