There are two types of people in this world, good and bad.
The good sleep better,
but the bad seem to enjoy the waking hours much more.
Woody Allen
Chart of the Day
Exhibit 1
National Health Expenditures (NHE), Amounts And Annual Growth From Previous Year Shown, By Spending Category, Selected Calendar
Years 2008–23
| Spending category | 2008a | 2012 | 2013 | 2014 | 2015 | 2019 | 2023 |
| Expenditure, billions | |||||||
| NHE | $2,411.7 | $2,793.4 | $2,894.7 | $3,056.6 | $3,207.3 | $4,042.5 | $5,158.8 |
| Health consumption expenditures | 2,257.3 | 2,633.4 | 2,735.1 | 2,893.3 | 3,040.8 | 3,834.0 | 4,891.3 |
| Personal health care | 2,017.1 | 2,360.4 | 2,448.3 | 2,579.3 | 2,706.0 | 3,413.1 | 4,359.7 |
| Hospital care | 729.0 | 882.3 | 918.8 | 959.9 | 1,008.5 | 1,276.1 | 1,637.7 |
| Professional services | 652.8 | 752.3 | 776.7 | 822.7 | 856.8 | 1,077.4 | 1,369.1 |
| Physician and clinical services | 486.5 | 565.0 | 583.9 | 618.5 | 641.9 | 805.2 | 1,023.8 |
| Other professional services | 64.0 | 76.4 | 79.8 | 87.6 | 92.3 | 119.3 | 153.4 |
| Dental services | 102.4 | 110.9 | 113.0 | 116.6 | 122.7 | 153.0 | 191.8 |
| Other health, residential, and personal care | 113.5 | 138.2 | 145.6 | 153.1 | 161.5 | 206.9 | 267.1 |
| Home health care | 62.3 | 77.8 | 81.5 | 86.2 | 91.7 | 121.5 | 162.3 |
| Nursing care facilities and continuing care retirement communities | 132.6 | 151.5 | 156.4 | 162.3 | 170.2 | 215.6 | 271.4 |
| Retail outlet sales of medical products | 326.9 | 358.3 | 369.2 | 395.2 | 417.3 | 515.6 | 652.3 |
| Prescription drugs | 242.6 | 263.3 | 272.1 | 290.7 | 309.3 | 381.8 | 482.8 |
| Durable medical equipment | 34.9 | 41.3 | 42.3 | 44.0 | 45.8 | 56.0 | 71.3 |
| Other nondurable medical products | 49.5 | 53.7 | 54.8 | 60.5 | 62.2 | 77.8 | 98.2 |
| Government administration | 29.4 | 33.6 | 35.1 | 36.3 | 37.8 | 50.1 | 66.7 |
| Net cost of health insurance | 139.2 | 164.3 | 174.5 | 196.7 | 212.5 | 268.7 | 341.0 |
| Government public health activities | 71.5 | 75.0 | 77.2 | 81.1 | 84.5 | 102.1 | 123.9 |
| Investment | 154.4 | 160.0 | 159.7 | 163.3 | 166.5 | 208.5 | 267.4 |
| Noncommercial research | 44.0 | 48.1 | 47.1 | 47.2 | 46.4 | 55.8 | 69.5 |
| Structures and equipment | 110.4 | 111.9 | 112.6 | 116.2 | 120.1 | 152.7 | 197.9 |
| Annual growth | |||||||
| NHE | 7.1% | 3.7% | 3.6% | 5.6% | 4.9% | 6.0% | 6.3% |
| Health consumption expenditures | 7.0 | 3.9 | 3.9 | 5.8 | 5.1 | 6.0 | 6.3 |
| Personal health care | 6.9 | 4.0 | 3.7 | 5.3 | 4.9 | 6.0 | 6.3 |
| Hospital care | 7.2 | 4.9 | 4.1 | 4.5 | 5.1 | 6.1 | 6.4 |
| Professional services | 6.4 | 3.6 | 3.2 | 5.9 | 4.2 | 5.9 | 6.2 |
| Physician and clinical services | 6.4 | 3.8 | 3.3 | 5.9 | 3.8 | 5.8 | 6.2 |
| Other professional services | 6.7 | 4.5 | 4.5 | 9.8 | 5.3 | 6.6 | 6.5 |
| Dental services | 6.1 | 2.0 | 1.9 | 3.1 | 5.3 | 5.7 | 5.8 |
| Other health, residential, and personal care | 7.0 | 5.0 | 5.3 | 5.1 | 5.5 | 6.4 | 6.6 |
| Home health care | 8.8 | 5.7 | 4.8 | 5.7 | 6.4 | 7.3 | 7.5 |
| Nursing care facilities and continuing care retirement communities | 5.6 | 3.4 | 3.2 | 3.7 | 4.9 | 6.1 | 5.9 |
| Retail outlet sales of medical products | 7.6 | 2.3 | 3.1 | 7.0 | 5.6 | 5.4 | 6.1 |
| Prescription drugs | 8.3 | 2.1 | 3.3 | 6.8 | 6.4 | 5.4 | 6.0 |
| Durable medical equipment | 4.8 | 4.3 | 2.5 | 4.0 | 4.1 | 5.2 | 6.2 |
| Other nondurable medical products | 6.3 | 2.1 | 2.1 | 10.4 | 2.7 | 5.8 | 6.0 |
| Government administration | 6.4 | 3.4 | 4.3 | 3.4 | 4.3 | 7.3 | 7.4 |
| Net cost of health insurance | 10.1 | 4.2 | 6.2 | 12.7 | 8.1 | 6.0 | 6.1 |
| Government public health activities | 6.2 | 1.2 | 2.9 | 5.1 | 4.2 | 4.8 | 5.0 |
| Investment | 7.8 | 0.9 | −0.2 | 2.3 | 1.9 | 5.8 | 6.4 |
| Noncommercial research | 6.4 | 2.2 | −2.1 | 0.1 | −1.7 | 4.7 | 5.7 |
| Structures and equipment | 8.4 | 0.3 | 0.6 | 3.2 | 3.4 | 6.2 | 6.7 |
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SOURCE Centers for Medicare and Medicaid Services, Office of the Actuary, National Health Statistics Group. NOTES Definitions, sources, and methods for NHE categories can be found at CMS.gov. National Health Expenditures Accounts: methodology paper, 2012: definitions, sources, and methods [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; 2014 [cited 2014 Jan 6]. Available from: http://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/Downloads/dsm-12.pdf. Numbers may not sum to totals because of rounding. Percent changes are calculated from unrounded data.
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↵a Annual growth, 2002–08.
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| Via LFC |
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| Via Libertarian Republic |
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| Via Joseph Dunlap |
This group is perhaps 20,000 fighters possessing some artillery and armor but no air force. It is an island of tenuously occupied territory in a sea of hostile regimes — those of Saudi Arabia, Jordan, Syria, Iran, Iraq, and Iraq’s Kurdish region, which has its own regime. These command approximately 2 million troops who, with ample air power, can pulverize the Islamic State whenever the regimes summon the will to do so. - George WillRemy Goes Live From Freedom Fest
Examples of Public Pension Exploitation at Taxpayer Expense
- From the Florida Times-Union (my edits):
No other large municipal pension fund in the state is in such dire financial shape as the Jacksonville Police and Fire Pension Fund, which is $1.65 billion in debt and is so underfunded that the city’s bond ratings have suffered. Today, the average soon-to-be retiree is 48 and has put in 21 years; they are signing up younger and after fewer years worked. Out-of-control pension costs [are] currently costing taxpayers $153 million this year with an anticipated pledge of another $40 million a year for more than a decade A guaranteed 3 percent cost-of-living increase annually and the ability to bankroll a separate pension — funds from his Deferred Retirement Option Plan account potentially paid by taxpayers — will allow Deal [Sheriff's office recent retiree; Deal’s top income earned when working was $109,221] one day to bring home twice as much money per year as a retiree as he did when he worked. A retiree’s DROP account is guaranteed to earn 8.4 percent interest each year [with the taxpayers making up any downside market offset: during the worst of the recession between late 2007 and late 2008, when taxpayers saw their 401(k) funds and stock portfolios obliterated, the Jacksonville Police and Fire Pension Fund had market returns of negative 16.12 percent.]. The DROP program allows police officers and firefighters with just 20 years of service the chance to put five years of future pension checks into what amounts to a secondary, high-interest retirement account while they continue to work and draw their regular pay. Deal is among a group of 16 July retirees who are guaranteed to turn $4 million in DROP benefits into $11 million in additional pension benefits. On top of his regular pension, Deal will draw more than $52,000 a year from his DROP account. As a senior-level employee, Deal was entitled to a pension of 80 percent of his average monthly salary of the previous two years. For 2015, Deal will have earned $153,045 in pension benefits between his regular $100,701 pension and $52,344 from his DROP account.
- From the NY Post:
Ray Dean, police chief of the 2.9-square-mile village of Westhampton Beach, is getting $403,714 for 15 years’ worth — or 531 days — of unused sick, vacation and personal time. Dean, who is only 53, will collect an estimated pension of $142,000 a year. Dean was already a millionaire. He bought a house in Quogue for $1.3 million in 2005, owns a 32-foot boat, and his pay last year came to $226,236 — more than NYPD Commissioner Bill Bratton makes. But while Bratton oversees a force of 34,500 uniformed officers, Dean presided over 11 in a resort town of 1,700 permanent residents.Some Healthcare Notes
Because health spending is projected to grow 1.1 percentage points faster than the average economic growth during 2013–23, the health share of the gross domestic product is expected to rise from 17.2 percent in 2012 to 19.3 percent in 2023... Supporters of centralized federal control of health care tout its supposed efficiencies. For that to happen, the costs of administration would have to grow at a slower rate than spending on actual health care. The opposite is happening. Government control of health care has grown well beyond its optimal span and scope.
Goodman points out that while one anti-competitive restriction on economic freedom, i.e., unions, has lessened to just under 7% today, a fraction from the 1950's, another obstacle, occupational licensing, has expanded, correspondingly from 5% to about 30%. He notes that the stagnation in today's job market largely reflects 2 factors: the adverse effect of government tax/regulatory burden on small businesses and occupational licensing. Goodman traces how the AMA since its birth in the mid-nineteenth century has promoted public policies creating artificial shortages in physicians, including closure of for-profit medical schools and licensing. He points out workarounds to these constraints, including for-profit medical schools in the Caribbean countries, with highly qualified graduates who are accepted for rotations and residencies in the states. He argues instead of licensing, we should consider the alternative of certifications and let the market decide their relevance and importance.
(Being Classically Liberal).It seems as though most libertarians on social media adhere to Austrian economics, they're favorite economists are von Mises and Rothbard, their living hero is Ron Paul, and they consider themselves anarcho-capitalists based on their adherence to the non-aggression principle. Am I wrong, or do you think this is an accurate assessment?
Some subtle differences. I thinks most libertarians, including minarchists, accept the NAP. I think only Rothbard is in the AnCap category; many have put Friedman, Hayek and Mises in the fusion libertarian conservative category, including Ron Paul. I do think Ron Paul is seen as the most likewise principled libertarian politician, although a few active ones also enjoy a following, like Justin Amash, Mike Lee and Rand Paul. Tom Woods is probably the closest to what you describe; the historian, an AnCap, recently hosted "Ron Paul week" on his daily podcast.
(Independent Institute). This summer, twenty graduate students at the University of Virginia who participated in a cross-disciplinary course on the national debt created a 10-minute YouTube video to help their fellow Millennials better understand where it comes from and also the consequences of the national debt. Check out the video!
The video has a define "progressive" edge, particularly in the later aspects. It doesn't really discuss where to cut spending, it buys into "progressive" talking points on healthcare (e.g., administrative costs and international cost comparisons) and after pointing out nearly 60% of the budget is mandated individual benefits, argues there's not enough spending in certain areas because those nefarious corporations "buy" votes and youths don't get their fair share of the loot because they don't turn out to vote enough. Almost no discussion of rampant government waste, redundancy, and failed programs, that government spending and regulation is a drag on the rest of the economy, etc.
(We the Individuals). Never did I think I'd live to see the day where even "libertarians" were using the ol' "We gotta attack [enter terrorist group X ] over there so we don't have to fight [enter terrorist group X] over here" line as a justification for further war.
Rand Paul had a junior moment: he forgot what his dad taught him.
More Proposals
Musical Interlude: My Favorite Vocalists
Petula Clark, "Happy Heart". This is the end of my Petula Clark series; I'll start my Barry Manilow retrospective with my next post.
