Monthly Archives: March 2010

Great expectations

Barack Obama won a dramatic, unexpected political victory on health care this week. Even in partisan terms it might be wise to withhold congratulations until November 2. But here’s the question I want to ask: When’s the last time a major government program did what it was supposed to do, or cost what it was supposed to cost?

I concede that it’s a political triumph. The president got a bill passed that looked doomed and emerged looking more like a leader. And I won’t quibble that his vaunted non-partisanship came down to a House of Representatives vote in which not one single Republican supported his health-care bill. We have political parties because people disagree on fundamental issues, and it is as undesirable for politicians to deprive voters of important choices by ganging up on us as it is unlikely, given their propensity to squabble. But it doesn’t much matter.

What matters is the policy question: Why do we think this bill will work the way it’s meant to? I am constantly amazed at the way the American and Canadian chattering classes plow ahead with one government initiative after another on the assumption that it will, if enacted, perform as advertised. Why do we think that? Continue reading

Madely in the morning, March 19

An impressive ability to mess up

It seems the Obama administration has finally found itself the sort of mishandled foreign policy problem without which no agonizing political tailspin is complete, a dispute with Israel over housing in East Jerusalem that comforts their enemies, alarms their friends and annoys voters. Now it only remains to be seen how cluelessly they will thrash their way through it.

You can’t get into a crisis like the one that erupted during Vice-President Joe Biden’s visit last Tuesday without some preparatory blunders, particularly intellectual. And President Obama and his advisers started with a howler that, being tiresomely familiar, offered no hope of a creative exit when it failed again.

They assumed everyone in the Middle East wants peace except, perhaps, their own beleaguered democratic ally, and everyone but their ally is behaving suitably. So they pressured Israel for concessions that could only be read on the other side as feeble-minded weakness, an approach the Israelis have sensibly long since discarded. Continue reading

Madely in the morning, March 12

Health care rhetoric making me sick

Dalton McGuinty has solved our health care problems again. How many times is that?

This time the idea is to replace global budgets for hospitals with a “Health Based Allocation Model” (H-BAM) that will apparently send money to hospitals serving growing and aging populations and also, as the Globe and Mail reports, give hospitals “additional money based on how cost-effectively they treat patients.” Hey, efficiency. Why didn’t I think of that?

This is a definite case of “If I could walk like that, I wouldn’t have to work for a living.” If the Ontario government knew how to direct funds to hospitals that treat patients cost-effectively, do you not think they would have done it before now? Continue reading