October 18, 2010

Not Moderate; Far Left

Justin Katz

Long-time readers will know that I'm a skeptic of "moderates," although I've actually been surprised at just how liberal Moderate Party founder and gubernatorial candidate Ken Block actually is. Here's the latest indication:

[Republican John] Robitaille said that, if elected, he would seek to have the attorney general challenge the legality of the federal law, calling it unconstitutional because of its requirement that citizens purchase coverage.

"I'm very much against that," responded Kenneth J. Block, Moderate Party candidate for governor. "We want everyone in this state to have health insurance." He said Robitaille's stance is "one of ideology, and has nothing to do with the provision of health care."

At least as of April, a majority of Rhode Islanders actually supported repealing Obamacare. How is it "moderate" to be "very much against" a majority? More important, though, is Block's elision of wanting everyone to have health insurance and believing that strong government control is the answer.

Block is smarter and more independent than the typical left-wing Democrat, but his worldviews are entirely those of the ruling class, and his governing philosophy appears to be technocratic. In other words, it is built on the principle that he and his fellow go-getters know better how our society should be ordered, and our lives lived, than the rest of us.

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It's looking more and more like AG candidate Chris Little will have to be the one to save the Moderate party by getting the 5%. I'm not so sure Mr. Block will be able to achieve that.

Posted by: Patrick at October 18, 2010 2:01 PM

You are easily fooled if you thought Block was anything but a liberal masquerading as a moderate.

Posted by: Mike Cappelli at October 18, 2010 2:08 PM

I think challenging the law is a wild goose-chase, it's flat-out just not going to succeed.

As for heath care... I just don't understand why we aren't doing a 'hybrid system' that cuts costs, encourages personal responsibility -and- allows everyone access:

1. Baseline government insurance to cover a checkup and a tooth cleaning every year.
2. Patients who take care of themselves have a flat 10% co-pay for everything else (maybe more for prescriptions and long-term stuff).
3. Hospitals operate finance departments that are required to issue loans to people who want treatment. Loans would -not- be forgivable.

In this case, the person who has a headache wouldn't go to the ER and rack up a $3,000 bill because it would cost them $300 (three payments of $101?). I would gladly take a $20K loan to cover a $200K cancer treatment, but grandma might want to call it quits if it means not passing down her Nest Egg to get a few more months.

Right now all insurance options ('cadillac private', 'crappy private', and 'government') all conspire to have patients spend the most. Once you hit that deductible, the sky's the limit!

Virtually all of those 'ambulance as taxi' and 'ER for a headache' calls that Michael talks about would disappear if taking an ambulance cost $50 instead of $0.

Posted by: mangeek at October 18, 2010 2:16 PM

"We want everyone in this state to have health insurance."

ARGH! Ken, who pays for it??

Posted by: Monique at October 18, 2010 2:19 PM

Also, Ken Block makes no bones about being socially liberal. He'll tell you himself. He's the most fiscally responsible candidate up there though, and who cares if he's a 'technocrat' if he has the tools to do the stuff that virtually everyone wants done (cut waste, reduce spending, direct investments towards fruit-bearing industries). I wish we had more 'technocrats' here in RI, we all know how difficult it is for our current legislators to make sense of charts and graphs, or handle cost/benefit analyses.

Also, I think you'll find that the Moderates are just as welcoming to folks who lean right as they are to those who lean left. That's kind of the whole point.

I describe myself as 'social liberal/fiscal conservative' and I feel much more comfortable with Moderate Party folks than I do at a Tea Party rally.

Posted by: mangeek at October 18, 2010 2:29 PM

mangeek, with your system in place, let's try this...You're the finance administrator, or VP of finance for a hospital. Someone comes in with many outstanding bills due, but has never paid a cent. Now they're wheeled in with a sprained ankle or a broken arm. What does triage do? Accept them and add to the financial burden of the hospital that we know isn't going to get paid, or turn them away?

Posted by: Patrick at October 18, 2010 2:40 PM

What happens now to the uninsured? Exactly the scenario you describe. Except that the critical piece of making individuals responsible for the costs they incur is missing from both the insured and the uninsured sides of the equation.

My little sister (a hard working twenty-something with two jobs) broke her hand a few months ago. She couldn't work. She also couldn't afford medical care, and didn't have insurance. The hospital fixed her up with a cast, but the surgery she needed to go back to work was going to be $3,500, an amount far out-of-reach to most young people. In the end, she was only on welfare and food stamps for a month or so, far faster than if she had to secretly stash cash up over the months to pay for surgery (you can't have savings on welfare). She can afford to pay me $200/month, she just had no way to pay for $3,000 upfront, and that was the only way 'the system' would have it.

If she didn't lean on me for a $3k loan, she would still be out of the workforce, collecting food stamps and disability. The -hospital- should be making these loans, and right-sizing them for the people they're serving.

What happens when the average uninsured person gets a $3,600 bill in the mail? They toss it and we all take the hit. What happens when they get a bill for $100.50 every month for three years? They'll probably pay it. Will there be a fair portion of people willing to sacrifice their credit over $101.50 a month? Sure, but far fewer than those who would do it over a $3,600 one-time bill.

We do have a -lot- of people who are collecting from social safety-net programs because they didn't have access to proper healthcare (mostly mental). Getting baseline bare-bones healthcare to everyone would likely be a boon to the economy, especially if the programs don't creep too far into the private system we have. Imagine how much cheaper it would be for locals with toothaches to walk to a local Urgent Care instead of calling 911 for a ride to the ER. Right now, they -have- to go to the ER, it's the only place that's obligated to care for them. That's dumb.

Posted by: mangeek at October 18, 2010 3:17 PM

Block is absolutely a big-government technocrat. He just thinks that he can run it better than the Democrat marionettes and their union puppet-masters. But he is still a Wilsonian totalitarian who believes that "experts" are entitled to run our lives at our expense. He doesn't understand that under the American system, government power is limited to a few clearly defined functions.

Block's advocacy of a state venture capital fund is of the same stripe. Ken, you do realize that we tried that over the past ten years (the Slater Fund and Slater Center) and it didn't produce squat?

Posted by: BobN at October 18, 2010 4:21 PM

"The latest poll also showed 48 percent of Rhode Islanders approve of federal health-care reform, with 46 percent opposing it. Support was stronger last month, with 54 percent in favor and 41 percent opposed."

That was Justin in April.

"At least as of April, a majority of Rhode Islanders actually supported repealing Obamacare."

And this is Justin today. Please explain.

Posted by: Phil at October 18, 2010 4:58 PM


The same poll found that 51% favored repeal and 48% (vs. 46%) favored reform. The wording is critical; I favor reform, but this particular reform is dreadful.

Posted by: Justin Katz at October 18, 2010 5:35 PM

Rules clarification: Little does not count under the 5% rule, only the Gubernatorial candidate (or presidential candidate) getting 5% confers party status automatically. That is why the Cool Moose is no longer a party (although he is allowed to have that listed under his name on the ballot.)

Ken Block is my second choice for Governor. Integrity does matter to me!

Posted by: Bob Walsh at October 18, 2010 6:29 PM

As long as John Robitaille comes in first for Governor, I don't care who is second.

Posted by: BobN at October 18, 2010 8:16 PM

Recent Bloomberg poll has 47% favoring repeal v. 42% saying it should not be. Same respondents are in favor of: eliminating lifetime caps, setting up exchanges, allowing kids to stay on their parents' insurance 'til 26, high risk pools, and an increased Medicare drug benefit, with an astonishing 75% in favor of prohibiting pre-existing condition denials. Same respondants also oppose requiring everyone to have health insurance, and taxing cadillac plans.

So we as Americans like all the stuff the plan does, but we don't want to be forced to pay the bill. Perhaps we should just fund it through the deficit Part D style? Makes sense to me. I'm calling Geico tomorrow and telling them to cancel my car insurance until I have an accident.

This is some classic American have-our-cake-and-eat-it-tooism. And for all the polls showing a majority favoring repeal (and by all I mean one, the Rasmussen poll, the only major poll showing even a slim majority in favor), it'll never happen. The pres has a veto for one, and the public hasn't the stomach for any more of anything having to do with "health care" coming out of Washington.

Posted by: Scott at October 18, 2010 8:17 PM

I think Mangeek has the answer. Problem is, the money generated by the # 1 "industry" as it stands reaches the pockets of nearly every demographic group. Doctors profit. Nurses profit. X-ray techs, phlebotomists, EMT's pharmaceutical sales reps, groundskeepers, unions, independent contractors and on and on. Try to get into the pockets of all those people, it's a long uphill climb.

Posted by: michael at October 18, 2010 8:43 PM

Two problems with that, Michael:

1. Who is doing the "getting into the pockets of all those people"? Some altruistic, infallible bureaucrat? Any chance the interested parties (e.g., the unions) would find ways to influence those bureaucrats to shift the balance in their favor?
2. What's wrong with those folks all profiting from their work and talent? Isn't it actually ideal to ensure that everybody in the supply chain makes money?

Posted by: Justin Katz at October 18, 2010 8:55 PM

It was very helpful, by the way, of mangeek to declare himself in favor of technocrats in a conversation thread in which he'd already illustrated how foolish the notion is. His perfectly contrived solution for the healthcare system ignores messy realities, such as politicians' tendency to define "baselines" in ways beneficial to them and the ability of our society to determine who "takes care of themselves" and put down the heavy boot to let those who don't do so suffer. (Note how even mangeek, in a subsequent comment, slips mental health into the baseline.)

Meanwhile, he is aghast that he had to lend his own sister money for assistance, insisting that that responsibility should have fallen to a hospital... funded by whom, I wonder. With what lending expertise? (I should note, however, that I've managed in the past to work out payment schedules with hospitals.)

With the family anecdote, I'd say we're on the cusp of a tangent challenging his social liberalism.

Posted by: Justin Katz at October 18, 2010 9:04 PM

There is nothing wrong with people profiting from their talents. Problem is, we're profiting by contributing to the greed perpetrated by a for profit health care system. A simple car accident that should have been waved off becomes a machine making tens of thousands of dollars for lawyers, plaintiffs, the people who treat the bogus claimants, ie. physical therapists, MD's, EMT's, x-ray techs...I think you get the idea.

Fear of lawsuits keeps x-ray, cat scan, MRI and countless other people involved in the healthcare "system." The waste is simply immense, and the money generated, which originates in our pockets, then goes to insurance companies or the government programs, if taken away from the economy would send this country into a downward spiral I doubt we would recover from.

Posted by: michael at October 18, 2010 9:52 PM

Walsh-if integrity really mattered to you,then I imagine you'd support either Robitaille or Block.
Instead you are supporting a feckless nitwit who wants to make us economically well on the backs of those least able to afford more taxes.
All because he kisses NEA ass-all because he plays lapdog for teachers who don't want to give up a cent.
Federal retirees are now being denied a COLA for the second year in a row.Not to mention Social Security recipients and disabled veterans.
Do you hear a lot of whining from us?
The NEA is a greedy organization which has also contributed to the deterioration of education in this country.
As long as you got yours,screw everyone-right Walsh?

Posted by: joe bernstein at October 19, 2010 7:39 AM

So Michael, you have just provided good evidence in support of tort reform. I take it that you support it, then?

There is much cognitive dissonance in saying that you are in favor of people profiting from their work and then saying that the problem is "the greed perpetrated by a for profit health care system." Are you similarly opposed to a for-profit automobile industry, for-profit airlines, for-profit computer makers, for-profit farms, for-profit restaurants, or for-profit ambulance services? What makes the health care industry any different from these?

Posted by: BobN at October 19, 2010 8:17 AM

Block's definitely the smartest one of the gubernatorial bunch. Unfortunately, his smarts seem to be a threat to those who fall back on the "too liberal" naysaying of any candidate who is not beholden to either the GOP and/or the Tea Party.

Posted by: hellas at October 19, 2010 10:11 AM

Bob Walsh's second choice for Governor:
Proof Block is the second most liberal.

Posted by: George at October 19, 2010 4:58 PM

Not sure if "for profit" is the right term here. Someone profits off just about every health care system in the world (even the bright red socialist ones so reviled 'round here): Doctors, nurses, administrators, secretarys, etc... all make livings off these systems.

We can say our American system is a bit more purely capitalist than the others out there, in that it - as presently constituted - has far less overt state control. It's American-style capitalism though, Government subsidised at just about every level.

So, call it "for-profit", "capitalist", or "American-style". By any name its inefficiencies are evident. We spend more per capita than any other developed nation. Our costs are rising at a rate nearly three times the rate of inflation. And our outcomes are middle of the pack (talk about American-style!)

Argue about the reform, but what we've were doing wasn't working... not for the people it should work best for anyway: patients and doctors.

Posted by: Scott at October 19, 2010 9:01 PM

Scott, it is illogical to say that the dysfunction in our health care system is due to it's being relatively unburdened by government. Just throwing up your hands and saying "it isn't working" is not constructive either.

You are right that it isn't working for the essential people at the core of the system: patients and doctors. They are the customers and suppliers. And yet these two have the least control over their destiny in the entire system. All of the other apparatus in the system is controlled by government.

My contention, proven in every free industry, is that deregulating and privatizing the healthcare system will remove many layers of cost, bureaucracy and corruption. It will also spur innovation in healthcare delivery systems and restore to consumers control over their purchasing choices. All of these effects will dramatically reduce the overall cost of the system, making healthcare genuinely affordable for a much larger proportion of the population.

Posted by: BobN at October 20, 2010 6:04 AM


"it is illogical to say that the dysfunction in our health care system is due to it's being relatively unburdened by government."

No moreso than saying privatization will cure all its woes.

The parts of the health care system that are most dysfunctional (and most hated by consumers) are the parts that have been "deregulated and privatized".

People love Medicare. Doctors hate the paperwork (three forms to every two from a private payer), but they love the generous reimbursements (so long as Congress keeps passing the doc fix), and they know Medicare will always pay what they bill, v. private pay which often tries to worm its way out. Patients love Medicare too. We all recall the senior citizens at the August '09 town halls screaming for Government to keeping its damn hands off their Medicare (how could we such delicious hypocracy?) The cost structure was out of wack, but Reform's most meaningful accomplishment is to try and fix that (mainly by rolling back the ridiculously bloated Advantage Plans subsidies put in place by Part D [which, I'll remind you, was a 50 billion dollar entitlement expansion, funded by the deficit, passed through reconciliation by a Republican Congress - damn you, totalitarian Gov't!]) VA patients love the VA (except for the rats at Walter Reed), and Meicaid patients aren't really in a position to complain.

Everyone hates private payers. Patients, doctors, everyone. That's why Obama ran so effectively on Reform. No more recision! No lifetime caps! These concepts are still incredibly popular. So your fix for health care is to make the parts that function work more like the parts that don't.

PS: Anyone notice UnitedHealthCare's massive 23% Q3 profit increases? They outpaced the Street! All in the first quarter under health care reform. Clearly they'll have to keep demanding massive rate hikes just to survive under these socialist reforms! They're barely scraping by! CEO Steve Hemsley only made 3.5 million in '09 for God's sake!

Posted by: scott at October 20, 2010 10:16 AM

Scott, you are clearly operating at a far distance from the facts.

For one, senior citizens did not protest Obamacare by yelling "keep your hands off my Medicare." That is a canard spread by the leftist press.

You have not offered a single fact in refutation of my contention.

Government is the problem. And so are you.

Posted by: BobN at October 20, 2010 2:06 PM

Scott, a word of advice from someone who has been through it. BobN will cherry-pick any commentary you make that he doesn't agree with and ignore things that make perfect sense, even to him, then insult your opinions. It gets old.

Posted by: michael at October 20, 2010 2:56 PM

"For one, senior citizens did not protest Obamacare by yelling "keep your hands off my Medicare." That is a canard spread by the leftist press."

Only if by "the leftist press" you mean "my own two eyes".

Posted by: Scott at October 20, 2010 5:57 PM

Since there has been published no video of such events anywhere in the country, you'd better have more evidence than your own two eyes and one mouth.

Posted by: BobN at October 20, 2010 9:45 PM

Scott-do your homework.I'm a VA patient,and it's good medical care provided by really excellent practitioners in decent facilities.I've been an inpatient six times in the last three years at VAMC Providence,and once at West Roxbury,so I oughta know.
You didn't even bother to find out that Walter Reed is a DOD facility,NOT a VA hospital.
The Secretary of Defense is holding the bag on that horror story.

Posted by: joe bernstein at October 21, 2010 7:34 AM

The problem with my 'perfectly contrived' system isn't that it's not awesome: It would increase coverage, reduce waste, and probably cost less overall than our current system does while extending coverage to every citizen.

The problem is that the lefties hate the 'personal responsibility' part, they want all insurance to be totally free for everyone. The righties hate it because it -is- an expansion of government, even if it's the kind that would ultimately boost capitalism by unburdening a huge load off its back.

I'd rather not have any 'national' health care system, I want to see states take up the issue, and that way, different states can model off of the ones that have the most successful systems.

Would politicians muddle with the system? Absolutely. They do now, too. But if we keep the core idea in place, that users pay a portion of the costs they incur, we'd have a much-improved system. Democrats would probably want to lower or make progressive the reimbursement rate, Republicans would want to slim-down on services that might be self-inflicted. It's still better than what we have today. Nobody in their right mind would attach health insurance to employment if they could redesign the system today. Nobody would incentivize everyone to spend the most they could if they could redesign the system today.

I -do- believe that government has a role in making sure people don't go hungry or freeze on the street. I'd argue that we do a damn-fine job of that already, and even that we can scale-back or limit those programs quite a bit and still cover the bases. I'd also say that if it costs $4,000 to get a broken finger set, the government should step in and make sure everyone can get access to healthcare, if only to keep people with broken fingers from costing $20,000 in disability benefits. Making everyone accountable for a small portion of their costs and issuing fairly-scheduled loans to cover that portion would seriously cut down on superfluous spending that costs us -all- so much int he end.

Posted by: mangeek at October 21, 2010 11:48 AM


My line was "VA patients love the VA", which is I think just what you're saying. The Walter Reed thing was a joke of course, and a pretty funny one I must say, though I guess not one based in fact (thanks for pointing that out). I was trying to point out that most people with Gov't administrated health care like it just fine, a point you backed up for me quite nicely.


Though tangential to our discussion, here's what you get when you enter "senior citizens protest medicare" into that notioriously collectivist liberal web instrument, Youtube.


Now the first guy who speaks seems like a pretty pure libertarian (though one imagines he doesn't mail back his SS checks, but that's fine-he's a taxpayer after all.) But the lady near the end with the sign that says "WE DON'T WANT GOV'T HEALTH CARE" with the "GOV'T HEALTH CARE" crossed out (which makes the sign a sort of double negative, right?), would be an example of the "sublime hypocrisy" mentioned above.

Now maybe she'd verbalize a more nuanced argument against reform, but the optics, as they say, are bad.

Posted by: Scott at October 21, 2010 5:15 PM

Scott-here's why the VA works well:They have a limited patient population,no dependents are treated or covered.They don't treat children,which is much more complicted and costly then treating adults-most adults can describe symptoms-small children can't and therefore require more diagnostic effort.
They don't have any language barrier because all veterans speak and understand English.The armed forces don't have bilingual instruction.
There are no illegal aliens accessing the system.
So,sometimes a framework that works well in a relatively limited situation isn't readily applicable to a much larger one.
There were parts of the health care bill that were indisputably good,but far too much that wasn't-the tax on owner occupied house sales,which was a backdoor nullification of the $500,000 exemption on capital gains for those very same sales;the 1099 avalanche which will cripple small businesses;the creation of multiple layers of bureaucracy having nothing to do with direct health care;and other hidden taxes.
Only since the Patriot Act have we taken to passing omnibus bills that the legislators don't really read.
That is a completely irresponsible way to run government.No wonder people are sick of incumbents

Posted by: joe bernstein at October 22, 2010 5:47 AM

Good points all, Joe, though the real estate tax doesn't confront me much. In this market, who's seeing those kind of capitol gains anyway? And even in the best of times it's a pretty modest tithe and well... you gotta pay for the thing somehow right?

I don't wanna come off as arguing in favor of the Reform. It has big problems even beyond the ones you mention. It does nothing substantive to bends costs, just funds think tanks to solve the problem down the road. The breastfeeding thing is a joke, etc...

But some sort of reform was clearly needed (and wanted; Obama got elected on it for God's sake), and there's some useful stuff in the bill (it is a Republican concept after all, right candidate Romney?), is my point.

Posted by: Scott at October 22, 2010 6:03 PM
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