Healthcare Tomfoolery

There is a very important issue in court where the forces of bureaucratic interests are overpowering the public good and attempting to undermine an excellent model of how to reduce the cost of healthcare while maintaining its quality and universality:  Healthcare Resource Centre (HRC) vs. Alberta Health Services (AHS)

The HRC is a privately run and managed, publicly funded, hip, knee and ankle surgery centre which is currently in receivership because… they can perform surgeries too efficiently.  How is that possible?

So here is the scoop.  HRC had a commitment with the Calgary Health Region to expand their surgeries from 1,000 / year to 3,500 / year.  Based on that commitment, HRC made an agreement with Cambridge Group, a construction company, to build a $65 million facility which would provide enough space for the increased surgery load.   However, when Alberta Health Services took control over from the Calgary Health Region, they reneged on the agreement with HRC which forced HRC into receivership vis-a-vis the agreement with Cambridge Group which, in the absence of the 3,500 / year surgeries agreement, could no longer be honoured.

Why would AHS want to renege on their agreement and shut down HRC?  How would they have any motivation to do this when the HRC is able to deliver cheaper, faster and better hip and knee replacement services?  The HRC represents a threat to the AHS bureaucracy as the increase in efficiency that public funded, private delivery offers would reduce the size of AHS meaning a smaller and less potent bureaucracy.

I encourage concerned citizens to write to newspapers and speak with their public representatives and ask how can pressure be put on the AHS to do the right thing by not sabotaging the HRC. Bureaucratic interests should not run rough shod over the public interest of increasing efficiency and reducing cost of delivery.

Enterpreneur or Advocate – who really fights poverty?

Here is a 10/10 page: http://www.gapminder.org/

I’ve found myself lost several times in this place. During one such playful meander, I looked at % of people earning below $2 per day income (one measure of extreme poverty) against GDP per person. Two interesting facts emerge:

1) The world is improving. Enormous populations are moving out of extreme poverty.

2) % below is negatively correlated with GDP per person ie. More wealth in a society means fewer people who live in extreme poverty.

The interpretation of these facts is pretty simple – wealth is the single most powerful destroyer of poverty. Nations which increase absolute wealth, reduce absolute poverty. Period.

One other interesting point is also clear – Africa is one of the few places which sees no reduction in poverty levels over time. Contrasting the policies of foreign aid which dominate the global response to that continent’s plight with the intense free trade that China and India, once as impoverished as Africa, should leave one with the obvious conclusion that economic freedom and trade are the most potent weapons we have to reduce poverty while socialism and dependence are the surest way to ensure continued human suffering on a mass scale.

If you want to really help the poor, stop dreaming about that high status trip to Africa to hand out food and start building wealth. As an example of the real fighters of poverty, check out what these guys are doing: http://www.kiva.org/.

Peace.

Motivations of Anti Oil Sands Sentiments

It is rare to see a politician taking a stand on a polarizing issue on principle.  Like most rare things, it is also rewarding to witness.  While at the Wildrose AGM held in Red Deer this past June, Albertans witnessed something that they hasn’t seen for some time – a political leader having the courage to defend a key engine of our province – the development of Alberta’s oil sands.

Much fodder is hurled at the oil sands development for environmental trespasses.  The attacks may be summarized by the motivations of the attackers: some are motivated by politics, others by sincere feeling that the development is hurting the environment.

Political Environmentalism.

Environmentalism is an important concept in so much as it is an expression of our desire for conservation, protection of animal and plant species, clean air and other such noble purposes.  As people gain wealth, their ability to spend money and time improving the environment increases – try telling someone who is starving that they should buy carbon offsets!  Thus, when society grows, it is natural, expected and right that we pass laws which will protect the environment in an effort to combat externalities.  Some environmentalists scorn China for their dirty air, water, etc.  However, the underlying cause of this pollution is the fact that China is much poorer than those places which are so critical.  Once well developed, China will certainly clean up their environment in the same manner that North America has on real pollutants.  You want to clean up China – advocate for free markets and watch the environmental miracle that follows.

Since the fall of socialism, however, a new breed of environmentalism has emerged – politically motivated environmentalism.  With the failing of socialism, many in that movement perceptive of the growing power of environmentalism saw the latter as an opportunity to keep their war against the free market fuelled.  Much of the rhetoric against the oil sands is from people who know nothing about them and who are motivated by an anti-growth / anti-development agenda rather than an anti-oil sands agenda.  While I disagree deeply with anti-growth sentiments (growth is the number one antidote of poverty), it is, however, a separate discussion for a separate stage.

The other kind of motivation is by people sincerely interested in the environment.  I appreciate this motivation because it is interested in facts rather than conclusions.

The Environmental Impact of the Oil Sands

I will save a more rigorous analysis of the environmental impacts for another posting – I wanted to outline motivations in this post.  However, the key points to summarize include:

  • Surface mining is the only activity with non-negligible environmental impact since it hosts both the tailings ponds (processed water) and the largest surface footprint.
    • Tailings ponds, which are pools of water with suspended fine particles have been getting progressively cleaner due to improvements in technology.
      • Coarse ponds, where the sand is larger, are no issue since the sand settles quickly.
      • Fine ponds are the real environmental issue since the sand does not settle quickly and takes a longer time to reclaim.
      • Dry tailings technology will likely eliminate the need for the ponds in the future.
    • Damage on wildlife is minimal and the companies should, and do, contribute to funds like Ducks Unlimited to more than offset any damage done.
    • The footprint of the surface mining is actually very small compared to industrial / urban centers.
      • For comparison, the entire mineable area is less than half of the Greater Toronto Area (3,450 square kilometers vs. 7,125 square kilometers).  Why aren’t people boycotting Toronto for its mass environmental impact?  Oh yea, see political motivations.
  • Surface mining represents only 20% of the oil sands recoverable resource.  In Situ mining, operations that have negligible environmental impact, make up the other 80%.
  • The companies are legally liable to reclaim the area they mine when they are finish.  This includes planting trees, re-landscaping, etc.

I see the oil sands development as actually an overall gain for the environment.  The key points are: (1) Developers of the resource pay far more to the environment through environmental funds than they do in damage (2) The surface footprint is less than half of Toronto’s and (3) The companies are legally bound to put everything back (and even better) than the way they found it.

If aliens were watching they’d see the BP Gulf spill as a massive environmental tragedy – then they’d see us taking the oil out of the dirt, sending it away and then planting trees – they’d say “it must be a massive environmental reclamation project”.

It is time to be proud of the oil sands development – an engine of growth, jobs and wealth which has a reasonable and manageable impact on the environment – at least not politically.

For more facts, see this:

http://www.capp.ca/getdoc.aspx?DocID=135721

While motivated to alarm, I find Pembina to be the most reliable of the anti-oil sands sources if you’d like another perspective:

http://pubs.pembina.org/reports/mining-vs-in-situ.pdf

Markets reward Value not Merit

There are few moments in our lives when we read or hear something, ponder the content, and feel overwhelmed by the impact of the expressed concept.  I experienced such a moment reading the following article:

http://www.forbes.com/2010/02/10/markets-finance-sarkozy-economics-opinions-columnists-shikha-dalmia.html

So why is this so compelling?

“Give me Liberty or Give me Death!” was uttered by Patrick Henry in arousing his fellow Virginian statespeople to take up the revolutionary cause against Great Britian.  The line summarizes my own emotional feeling for liberty.

Unfortunately history is full of gangs, militias, crusades and governments which do not hesitate to trample on individual liberty through warfare, repression, extortion and theft.  While fighting for liberty would require the uptake of arms in the past, present day liberty is best defended through the battle of ideas.  This is where Shikha’s article comes in.  Her article is a bombshell for retiring old arguments defending the morality of liberty.

The Power of Liberty

Liberty’s proponents, myself included, argue that encouraging as much liberty as possible is both moral and effective.  We have won the “effective” argument.  Even the NDP will argue for markets, albeit saddled with all sorts of governmental meddling.  Somehow they feel that enterpreneurs will continue to provide society with jobs and wealth if you steal their effort and rail against their honor.  They don’t want to kill the golden goose and their mission is to find out just how much they can grab without making a fatal blow.  The Europeans are getting close to that fatal blow as their sovereign debt burdens teeter after decades of funding a bulging welfare state.  Japan is also at the brink for the same reasons.  All that said, many well-meaning centrist / leftists want simply to balance the “effectiveness” of liberty with what they perceived to be the immorality of allowing liberty to create disparity.

To counter the concept that liberty is immoral, some libertarian and conservative thinkers employ the heroic man theory to defend the moral argument for liberty.  The heroic man basically states that individuals get what they deserve – the poor person is such because he/she doesn’t work hard or smart and a rich person is such because they do (work hard or smart).  While this view may correlate with reality, it certainly is not a perfect fit – there are many examples of people getting rich from sheer luck and losing their shirt for the same reason.  Given that luck, together with hard work and ability, are factors of (financial) success, isn’t forced redistribution (or forcing one group to give to another) morally justified to counterbalance the forces of chance?  Sounds reasonable.

This is the key big idea taken on by Shikha’s article:

Point 1: Many factors can drive success: luck, hard work, intelligence, pragmatism, “divine” birth, appointment, arbitrary government choices, etc.  Let’s not pretend that intrinsic merit (honesty, hard work, intelligence, etc) are the only drivers of success.

Point 2: Liberty (ie. free markets) do not reward intrinsic merit (heroic man argument) – they reward social “value” (what you can offer others).

Take comedy as an example.  Assume one culture enjoys Bill Cosby style comedy while another culture enjoys Jerry Seinfeld comedy.  Under the “intrinsic method” view of rewarding success, who decides how to compensate Seinfeld and Cosby in either culture?  Only the market, or individuals voting with their feet and their wallets, can morally decide the value of either comedian’s work to themselves individually.  Their individual successes are not a statement of their intrinsic worth – only a statement of the combination of factors that made them successful.  The success of Paris Hilton says far more about American youth than it does about Paris Hilton.  Free markets reward value, not merit, in a way that is social, not elitist.  The self-designated plethora of Philosopher Kings really don’t like that last point – it takes away from their important status of deciding what is best for society.

Is seinfeld unlucky to be in a Cosby-style culture?  Yes.  Should we therefore impose his humor and equalize it with Cosby’s?  I’d prefer the congress of society’s individuals decide what humor they like and reward the provider accordingly.  That will send the right signals to future comedians and lead to greater satisfaction of the community’s preferences.

Let me be clear – I am not against social welfare nor am I advocating that we turn off state welfare.  I am advocating that we understand that forced redistribution is not optimal and that we strive as a society to shift policies involved in forced redistribution to community volitional redistribution as possible.  We need to ask how we can encourage community groups, churches and businesses to take on more of the welfare duties which the government now undertakes.  Doing so would increase the effectiveness of the care as well as make the compassionate act moral.