Under the heading “Managed Care: Get Used to It,” he writes:

The question is not managed care versus the status quo, but which opportunities — and the restrictions that go with them — we are prepared to accept. When will we acknowledge that our government — or, for that matter, our insurance companies — can’t pay every bill? We’re in denial, and the longer we wait, the more painful the solution will be.

Professor Paul Starr, of Princeton University, is the author of The Social Transformation of American Medicine (Basic Books, 1984), a must-read for anyone interested in health policy.

In The New York Times, Starr proposed an interesting twist to the question of mandating that people buy health insurance. As he correctly notes, passing a law preventing health insurers from demanding actuarially fair premiums (a.k.a. “banning exclusions for pre-existing conditions), makes it possible for people to wait until they fall ill to buy health insurance. That’s why current state and federal laws only offer this protection to those who have had continuous coverage.

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I am one of very few capitalists you know (probably the only one, actually) who is intensely interested in understanding who gets what under socialism. At the other end of the spectrum, almost every socialist I know is focused only on the idea of socialism and has very little interest in discovering how socialist systems actually function.

So, what you are about to read, I am afraid, is something you are unlikely to find in any other place.

Suppose the government nationalizes the school system and makes schooling available for free. Without knowing any institutional details, could you predict in advance which students will end up in the classroom of the best teacher? How about the worst teacher? And how will the other students be sorted in between?

I certainly could not predict with any accuracy. But I can almost guarantee you the students will not be distributed randomly. I can also almost guarantee you that the distribution will not be independent of the parents’ income, wealth and social status.

Similarly, suppose the government nationalizes the health care system and makes medical services available for free. Without knowing any institutional details, could you predict in advance which patients will be seeing the best doctors and entering the best facilities? How about the worst doctors and the worst facilities?

Again, I can virtually guarantee you that the patients will not be distributed randomly and that the distribution will not be independent of income and social status.

Brother Can You Spare a Dime

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Malarial mosquitoes like beer drinkers.

Never forget a face? Thank your parents because facial recognition is inherited.

Oxygenated booze won’t give you a hangover.

The human gut can harbor more than 1000 different species of bacteria. But the average person only has 160.

This is Jim Capretta at National Review Online:

The big Medicare cuts in the president’s plan come from across-the-board payment-rate reductions. In particular, the president wants to cut the inflation update for hospitals, nursing homes, and others by half a percentage point every year, in perpetuity. On paper, this change produces huge long-run savings. But it does nothing to control the underlying cost of treating patients. It just pays everyone less, without regard to patient need or quality of care. The chief actuary of the program has said repeatedly that these cuts are completely unrealistic for these very reasons. If implemented, he expects they would drive one in five facilities into serious financial distress. And yet [Peter] Orszag and [Nancy-Ann] DeParle want us to believe these savings can be counted to finance the president’s massive entitlement promises.

And this is backed by the AMA?

American men have a 16 percent lifetime chance of receiving a diagnosis of prostate cancer, but only a 3 percent chance of dying from it. That’s because the majority of prostate cancers grow slowly. In other words, men lucky enough to reach old age are much more likely to die with prostate cancer than to die of it. Even then, the test is hardly more effective than a coin toss…

The results from the American study show that over a period of 7 to 10 years, screening did not reduce the death rate in men 55 and over.

The European study showed a small decline in death rates, but also found that 48 men would need to be treated to save one life. That’s 47 men who, in all likelihood, can no longer function sexually or stay out of the bathroom for long.

Full editorial on the inappropriate use of P.S.A. screening.

As Washington debates health care, this small hospital in a dusty desert town on an Indian reservation, showing its age and struggling to make ends meet, somehow manages to outperform richer, more prestigious institutions when it comes to keeping Caesarean rates down, which saves money and is better for many mothers and infants.

Full story of the hospital run by the Navajo Nation.

Overall, federal workers earned an average salary of $67,691…the average pay for the same mix of jobs in the private sector was $60,046 in 2008… These salary figures do not include the value of health, pension and other benefits, which averaged $40,785 per federal employee in 2008 vs. $9,882 per private worker.

Source: Bureau of Labor Statistics, USA Today analysis.

This is Robert E. Litan, writing in The Wall Street Journal:

Google was founded by Sergey Brin, a Russian immigrant, and American Larry Page by borrowing funds from their own credit cards. Why on earth would we want to create an entrepreneurs’ visa that couldn’t let in the future Sergey Brin?

He’s criticizing a bill by Sens. John Kerry (D-MA) and Richard Lugar (R-IN) that would:

Create a new, two-year visa for immigrant entrepreneurs whose firms attract at least $250,000 in financing from American angel investors or venture capital firms…

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In 2008, 28 percent of sales from the pharmaceutical industry’s top 100 products came from biologics; by 2014, that share is expected to rise to 50 percent.

Biologic drugs can be more expensive to manufacture; they are grown inside living cells rather than put together chemically, as conventional drugs are. But this does not fully account for their high prices. Another important factor is that they very rarely face competition from generic copies.

Congress is about to change that.