I wish I’d seen this on St. Patrick’s Day. I’d have posted it then. Enjoy.

I’ve been asked to give my ideas on what real health care reform would look like and I’m a bit nonplussed. Here are a few facts about our present health care system:

• We spend more on health care per capita than any other OECD country by a substantial margin.
• Other OECD countries adopted their own systems when health care was much, much less expensive than it is now.
• Health care presently comprises about 17% of the U. S. economy, more than any other OECD country, and prices in health care are growing at a multiple of the prices in most other sectors with the exception of education which has much the same problems as the health care system.
• Government at one level or another provides between 50% and 70% of all of the funds spent on health care.
• The incentives for government to increase health care spending have outweighed its incentives to restrain spending to date.
• Prices in other sectors of the economy have been kept low through mass production.
• In health care we have mass consumption and artisanal production—an obvious mismatch.
• Physicians produce much of the demand for health care.
• We haven’t had a free market in health care for more than a century. I don’t believe we want one.
• Health care insurance prices are proportion to health care prices.
• The evidence that increasing health care insurance coverage in the absence of a commitment to control costs will reduce costs is weak.
• At present prices and the present rate of increase a single-payer system will solve nothing.

Somewhere in all of that there may be a solution but I’m damned if I see it. At least not a solution that we want.

Should the federal government provide funding for the arts or National Public Radio?

My own view is that both the National Endowment for the Arts and National Public Radio are largely subsidies for the upper middle class, they can well afford to fund both themselves (and largely do), that public radio in particular is an idea whose time has past, and I would rather see the federal government spend money on evidence-based programs that help inner city black kids than on the NEA or NPR.

I recognize there’s a fallacy in my response: even if funding for the NEA or NPR were zeroed out it’s unlikely that additional money will be spent on programs that help inner city black kids. How about the program most likely to help inner city black kids: jobs for their parents?

This discussion is an excellent example of the main advantage conveyed by holding the White House and majorities in both houses of the Congress—the power to set the agenda. Why are we talking about this? Because the budget submitted by President Trump cuts funding for the NEA and NPR and increases military spending.

My agenda would be drastically different from either Democrats or Republicans in that not only would I defund the NEA and NPR, I’d cut military spending commensurate with a reduction in a reduction in the missions we’re asking our military to perform.

Maybe it’s my own blockheadedness but I fail to see why we should be deploying special forces to two-thirds of the countries in the world. I also recognize that there are others who think we should be spending a lot more money on the NEA and NPR and spending more on our military. I wonder where they expect to get the money to do it? Especially since we’re already extracting about as much money from the private sector as at any time in our history with the exception of the depths of World War II.

I’ve just realized that The Glittering Eye turned 13 this year. In looking over my old posts I’ve noticed that I wrote many more long form research pieces years ago but that my volume of writing has increased substantially.

Speaking of obituaries, one of my siblings happened upon something interesting. My grandfather had an obituary published in Billboard:

I wonder who placed it? I can only suspect that it was one of his vaudeville associates. One interesting aspect of the obit is that it only mentions two daughters, presumably Vera and Helen, his first two daughters by his wife, Vera Luce, who died, presumably giving birth to her second daughter, Vera. Vera was raised by their uncle, Charlie, and his wife, Belle, and never knew that Owen was her father. Helen’s daughter told me that she did, indeed, know.

Unmentioned are Owen’s son, Eugene, who died in boyhood, and my mom who was his only child who actually knew him.

The possibility that my grandfather played with Primrose and Dockstader’s Minstrel Men, suggested in the obit, is interesting and provides some new avenues for research for me. It also conflicts with my mom’s claim that her father had never done blackface.

Having only a casual relationship, an acquaintanceship shall we say, with the truth, was not unusual in my mom’s family but I can’t help but wonder if it hadn’t been a sensitive subject for my grandfather.

The foundational rock musician Chuck Berry has died. Variety reports:

Singer-songwriter-guitarist Chuck Berry, the rock ‘n’ roll pioneer who established the form and the themes of the music with his slyly funny, rhythmically propulsive ’50s hits, such as “Maybellene,” “Roll Over Beethoven” and “Johnny B. Goode,” has died in Missouri. He was 90.

St. Charles County police responded to a call placed at around 12:40 p.m. local time on Saturday. They arrived on the scene where Berry was found unresponsive. He was pronounced dead at 1:26 p.m., according to the police department.

Berry hammered out the then-nascent sound’s groundwork in a series of self-penned singles for the Chicago R&B label Chess Records that successfully crossed over into the pop mainstream.

The tunes showcased Berry’s droll singing, inventive guitar licks and acute eye and ear for the nuances of teenage life. In a matter of years, his repertoire would be adopted by such British acolytes as the Beatles and the Rolling Stones; California band the Beach Boys surrendered some of the copyright for its 1963 hit “Surfin’ U.S.A.,” which shamelessly copped the melody of Berry’s “Sweet Little Sixteen” without credit.

“One of my big lights has gone out,” Rolling Stones guitarist Keith Richards said via Twitter on Saturday. Richards befriended Berry in the 1960s and was the architect of the 60th birthday tribute concert featured in Taylor Hackford’s 1987 Berry documentary “Hail! Hail! Rock ‘n’ Roll.”

Although we usually think of Chicago, Memphis, Nashville, or Detroit as the sources for the popular music of the second half of the 20th century, St. Louis played a role, too. I attribute that to the highly developed music programs in its early 20th century public schools and the large number of music clubs, particularly in East St. Louis.

I hail and welcome California’s attempting to institute a single-payer health care insurance system in the Golden State. US News reports:

This week the Trump administration encouraged governors to use the framework of President Barack Obama’s health care law to craft plans that meet their residents’ unique needs, stressing that the federal government is set to usher in a new era of flexibility in health care.

In California, lawmakers are going to see how far they can push these calls to action: They plan to put forth a health care bill that would offer a single-payer system to guarantee coverage for all Californians, regardless of their immigration status.

The proposal is still being fleshed out, but it likely would require significant funding from the Golden State, and previous efforts to implement a single-payer measure have failed there and in other states. The move comes at a time when fierce opposition to the Trump administration has escalated following the president’s executive actions on illegal immigration and a battle on Capitol Hill to overhaul the health care system.

Canada’s health care system was not imposed by its federal government; it rose from the provinces and continues to be administered by the provinces. Could it be that state-based health care reform has more potential than a federal program?

Success in California could also lead to other states adopting their own reform plans. It will be an interesting experiment.

I have a question. When did Germany’s policy objectives become American policy objectives? It wasn’t always that way. I have a vague recollection of Americans intervening twice to prevent Germany from realizing its policy objectives.

Has a Europe dominated and led by Germany become more acceptable? If so, why?

The Dutch people have spoken but what the heck have they said? Parliamentary elections in the Netherlands took place on Wednesday. The anti-EU anti-immigrant anti-Muslim candidate Geert Wilders’s party came in second with 13% of the vote (compared with the 21% showing of the center-right party that garnered the largest number of seats). That party will now need to cobble together a ruling coalition from political parties that have little in common other than an aversion for Geert Wilders. The editors of the Wall Street Journal observe:

Center-right Prime Minister Mark Rutte’s victory over euroskeptic, anti-immigrant firebrand Geert Wilders had looked likely in the final polling before the vote. In the event, Mr. Rutte’s Party for Freedom and Democracy won 33 out of 150 seats in Parliament with a little above 21% support. That’s a fall from his 27% vote share and 41 seats five years ago, but a respectable showing compared to Mr. Wilders’s 13% and 20 seats, despite the latter’s improved results compared to 2012.

Holland’s complex proportional-voting system, which saw 13 parties elected to Parliament, will now descend into the usual coalition building. Mr. Rutte is widely expected to emerge as the Prime Minister, although he’ll need to work hard to assemble a majority. The only thing uniting most parties is their refusal to form a coalition with Mr. Wilders even though his party came second.

Most observers won’t think any of that matters. This vote was billed by the media as 2017’s first test of euroskepticism after 2016’s Brexit and Italian referendum, and this time the vote seemed to suggest the anti-European tide might be waxing at last.

Yet this result means less than advertized, for both the Netherlands and Europe. Domestically, Mr. Rutte won in part by co-opting the sensible elements of Mr. Wilders’s platform, especially the need to better assimilate immigrants.

Some, like the editors of the New York Times, rather desperately tried to take solace from the results to which Anne Applebaum, writing at the Washington Post, replied:

Because we were looking at the Netherlands with populist-colored glasses, we missed the bigger story: the implosion of the unified center-left — the Dutch Labor Party — which is a story that really does have pan-European significance, affecting electorates in almost every country. Though temporarily halted in some places by centrists such as Tony Blair, this slow-motion collapse has been going on for two decades, ever since the end of communism removed the dream of the state-run economy and economic change undermined the trade unions, as well as the working-class solidarity they created.

Across the continent, disillusioned ex-left-wingers have often drifted into the arms of xenophobes, particularly since many of them — most notably France’s Marine Le Pen, but also the Austrian Freedom Party and the Polish Law and Justice Party — now advocate what one might call Marxism Lite or, less politely, national socialism: Elements include the re-nationalization of industry, curbs on trade and bigger social-welfare states. But others who have left the Left have taken a different route. Some support liberals such as Emmanuel Macron in France, or Greens such as Alexander Van der Bellen, the president of Austria. In the Dutch elections, support for social and economic liberals, as well as for the Green party, went up dramatically.

In other words the results in the Dutch election were a sign of increased polarization which may sound familiar to you. Moderates have lost ground to the more radical.

At RealClearWorld George Friedman remarks:

The affluent do not live with poor immigrants, and if they know them at all, it is as servants. The well-off can afford a generous immigration system because they do not pay the price. The poor, who live in neighborhoods where immigrants live, experience economic, linguistic and political dislocation associated with immigration, because it is the national values they were brought up with that are being battled over. It is not simply jobs at stakes. It is also their own identities as Dutchmen, Americans or Poles that are at stake. They are who they are, and they battle to resist loss or weakening of this identity. For the well-to-do, those who resist the immigrants are dismissed in two ways. First, they are the poorer citizens, and therefore lack the sophistication of the wealthy. Second, because they are poor, they are racists, and nationalism is simply a cover for racism.

Thus, nationalism turns into a class struggle. The wealthy are indifferent to it because their identity derives from their wealth, their mobility and a network of friends that go beyond borders. The poor live where they were born, and their network of friends and beliefs are those that they were born into. In many cases, they have lost their jobs. If they also lose their identity, they have lost everything.

A number of questions arise from all of this. First, what does Mr. Rutte mean when he says that immigrants “should act normal”? I think it’s almost certain that he means that they should speak Dutch with reasonable facility, that they should dress like ordinary Dutchmen, and that they should accept convention Dutch mores. A rejection of multiculturalism, that may prove to be as anti-immigrant as Mr. Wilders’s pledge to shutter mosques.

Second, what does it mean for the Netherlands? I think it means that the Dutch people have rejected Mr. Wilders’s strident nativism but are also trying to stand up for their own language, culture, and ways. This continues a process which, as Ms. Applebaum pointed out, has been going on for years.

Finally, what does it mean for Europe? While I think that the Netherlands may be a bellwether for other small countries with languages spoken nowhere else and distinctive cultures and histories, e.g. Hungary, Greece, Holland’s economy with a growth rate of around 2%, unemployment rate of 6%, and family income about what it is here but with income inequality much lower, suggests that the reaction in the Netherlands to the strains that mass immigration have produced may be less extreme than we will see elsewhere in Europe.