Monthly Archives: June 2011

Kevin Drum’s Guest Bloggers Upholding The [ahem] Fine Standards He Has Created There

Kevin Drum is on vacation this week. While I thought that might leave me without boneheaded material to criticize, I’m afraid he’s found guest bloggers as credible and clueless as himself. Today we have Andy Kroll, who wants to delve into meta-debates about rights and entitlements with Wisconsin Gov. Scott Walker:

But the statement that really jumped out from Walker’s interview is his own perception of the bargaining fight:

“They defined it as a rights issue. It’s not a rights issue. It’s an expensive entitlement.”

What’s his first step to show how wrong Walker is? Well, he skips right to the United Nations, a body whose Declaration of Human Rights clearly states that you can use your rights as long as you don’t do so in a way “contrary to the purposes and principles of the United Nations” (Art. 29, Sec 3). He starts there and follows on with a lot of other legally-created privileges that he calls rights:

Hmm. I’m pretty sure the Universal Declaration of Human Rights, passed by the UN after World War II (and drafted and adopted by the US), says that collective bargaining is in fact a human right. Oh, yes, there it is, in Article 23 of the Universal Declaration:

4. Everyone has the right to form and to join trade unions for the protection of his interests.

Then there’s the National Labor Relations Act (NLRA) here in the US, which “explicitly grants employees the right to collectively bargain and join trade unions,” according to the scholars at Cornell University Law School. Or as the National Labor Relations Board’s website puts it, the NLRA “protects employees’ rights to act together, with or without a union, to improve working terms and conditions, including wages and benefits.”

All of this analysis has one critical flaw: it doesn’t properly recognize that there are multiple kinds of rights, and that a right which the government shall not deny is, well, slightly different than one that it grants. I left the below in a comment to that Kroll’s post at the original site:

Are you even familiar with the distinction between “negative rights” and “positive rights”?

Negative rights are rights that you have unless someone else infringes upon them. You have a right to life, but not to force others to produce the food and shelter you need to live. You have the right to freedom of speech, but not the right to force anyone to listen (or, in the case of blogging, to force a blog to print your comments to a post). A right to healthcare or education — if you define it as me not being stopped by government or highway robbers from freely purchasing health or education services on an open market from a willing seller — is a negative right.

Positive rights are rights that require someone else to procure them to you. A right to healthcare — if you assume that those who can’t afford care should be covered by “society” — is a positive right. A right to an education — if you assume it should be paid for by government taxes — is a positive right. A right to food — if you define it as foodstamps for the indigent — is a positive right. *ALL* positive rights can be described as “entitlements”, as they’re what we as a society might define all people are entitled to be provided to them if they cannot do it themselves.

A “right” to organizing a union is a positive right (inasmuch as it restricts and employer’s ability to fire people for trying to exercise it). If we so choose, in our democratic society, that people should be allowed to unionize to counterbalance what may be perceived as in unfair labor advantage to the employer, we can call it a “right” all we want, but it’s a positive right, not a negative right. As such, calling it an “expensive entitlement” doesn’t seem all that out of the ordinary. I don’t see any real disconnect in what Walker said.

Now, I was a bit unclear in that final paragraph. What I intended to say was this: The right to form a union is a negative right. It is inherent in the right to freedom of association. The right to collective bargaining is a negative right. It is inherent in the right to freedom of speech. As you point out (and as I intended to), it becomes a positive right when we write laws or regulations forcing businesses to the other side of the table. Forcing an employer to actually deal with them on those collective terms is the “entitlement” of that positive right.

Andy Kroll waded into deep water here, and it’s clear he didn’t want to recognize that. It’s also potentially true that Gov. Walker did the same — the original linked article doesn’t make clear whether Walker’s statement about entitlement had deeper context. Kroll is trying to use one line from an already snipped interview to make Gov. Walker sound like a simpleton who doesn’t understand the nature of rights. In doing so, Kroll only proves that to be the case about himself.

Will Individualized Medicine Increase Health Inequality?

Ezra Klein has a rather thought-provoking post today about human genome sequencing and its ability to allow doctors to better-tailor treatment to the specific needs of an individual patient. It presents a phenomenal opportunity to both make medicine more effective, and IMHO to make it cheaper by spending less time and energy on substandard treatments. Ezra raised a different point, though, and I think makes a logical error that warrants further discussion:

If that’s the path that medical advances ultimately take, one byproduct will be an immense explosion in health inequality. Right now, health inequality, though significant, is moderated by the fact that the marginal treatments that someone with unlimited resources can access simply don’t work that much better than the treatments someone with more modest means can access. In some cases, they’re significantly worse. In most cases, they’re pretty similar, and often literally the same.

But as those treatments begin to work better, and as we develop the ability to tailor treatments to individuals, we should expect that someone who can pay for the best treatments for their particular DNA sequences to achieve far better health-care outcomes than someone who can’t afford the best treatments and has to settle for general therapies rather than individualized medicine.

I believe Ezra makes assumes the premise that the “best” treatments are also the most expensive treatments. I believe this to be unsupported by evidence.

Suppose 10 different people all happen to have the same malady. To use a common one, let’s say that the malady is hypertension. Multiple drugs today exist for the treatment of hypertension. Some of them may be specific variants (branded or generic) of medications all within a specific class, but often multiple classes of drugs may be used to treat hypertension. Those multiple classes will affect different people in different ways, but my guess is that a typical doctor will offer a “standard” treatment regimen for hypertension and only deviate from that standard if something doesn’t appear to be effective. What’s further important to note is that different doctors may have different “standard” regimen, based on their own experience rather than exact current medical literature.

What the idea of genome sequencing may bring to the table is that medical research can form stronger predictions of a particular person’s response to certain medicines based upon their specific genes, and it is easier to tailor the treatment to the patient. This doesn’t mean that the rich person’s treatment will be more expensive than a poor person’s, but it does mean that someone who has genome sequencing will likely have more effective treatment than someone who does not. What it also means is that someone who has genome sequencing may actually have less expensive medical treatment than someone without, as less effort and dollars can be used adding treatments that are statistically likely to be ineffective.

And herein lies the rub. Will a rich person have better access to genome sequencing than a poor person? Not if we have Ezra’s wet dream: government socialized health care. Once effectiveness at reducing costs is shown, government in its awesome authoritarian-ness will undoubtedly use the desire for cost-cutting in medical treatment to demand genome sequencing of anyone participating in Obamacare. Sure, we civil libertarians will soundly object to government getting access to everyone’s DNA, but I’m sure they’ll tell us, much like they do with the TSA pornoscanners and told us with our social security numbers, that there’s NO CHANCE the genome information will ever be used for anything other than our medical care, and will be completely confidential. And since nobody listens to us civil libertarians today, they’ll get it done.

If Ezra looks at the potential from this angle, I think he’d change his tune. If he sees genome sequencing as a potential cost-cutting measure, rather than an inequality-increasing measure, I’m sure he’d actually push for wider adoption of it. And like any government authoritarian impulse, if something is good [and if we’re paying for it with tax dollars], we might as well make it mandatory, right?

Wrangling Long-Term Costs

Ezra Klein, on education & health care costs:

I’m not going to end this post with some wan paragraph explaining how to transform these two industries into something closer to their potential. My ideas on health-care reform are available elsewhere on the blog and I don’t know enough about education to say anything worthwhile. But if you asked me to paint an optimistic picture of the American economy over the next three or four decades, the story I’d tell you would mainly be about how we finally figured out how to drag health care and education into the 21st century. And if you asked me to paint you a pessimistic story of the next three or four decades, it’d be about how we failed to do that, and the two sectors continued eating up more and more of our money while delivering less and less value.

Well, good news, Ezra! Those two sectors are increasingly coming under bureaucratic government control, so I’m just sure we’ll figure out the answers to these hard problems! It’s not like Washington has any history of eating up more and more of our money while delivering less and less value

Quote Of The Day

Who joined whom?

Gay marriage has always been an ideal niche for liberaltarians. After all, it’s the states, not the feds, that are the ones deciding whether it should be legal, a question that feeds into libertarians’ federalist affinities. And when you strip away the cultural and identity politics, gay marriage is really just a fight about whether the government should be allowed to regulate personal liberty. On that, again, libertarians side with liberals.

(emphasis added)

Yeah, because liberals are so consistent on those questions of government regulating personal liberty!

Liberty Rock: “No Knock Raid” by Lindy

It had to happen sooner or later – a song about no knock raids. Be warned, this music video contains disturbing footage from actual no knock raids. But you know what? This is an issue that we should be disturbed about.

What disturbs me the most is the double standard concerning shootings in these raids. The police routinely kill innocent individuals in the course of a raid while unsuspecting home owners who kill who they believe to be criminal intruders who turn out to be cops do time. Recent examples: An Albuquerque, New Mexico man shot a cop in the groin; he will do three years. In the neighboring State of Arizona, 5 SWAT officers have been cleared of any wrong doing when they shot honorably discharged Iraq war veteran who served two tours as a Marine Jose Guerena, 22 times and didn’t allow paramedics access to him for more than an hour which resulted in his death.

Some of the footage from the Guerena raid appears near the very end of the video.

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