When I visited the House of Lords’ minister, Lord Marland, at the Climate Change Department a couple of years ago, I asked him and the Department’s chief number-cruncher, Professor David Mackay (neither a climate scientist nor an economist, of course) to show me the Department’s calculations detailing just how much “global warming” that might otherwise occur this century would be prevented by the $30 billion per year that the Department was committed to spend between 2011 and 2050 -– $1.2 trillion in all.
There was a horrified silence. The birds stopped singing. The Minister adjusted his tie. The Permanent Secretary looked at his watch. Professor Mackay looked as though he wished the plush sofa into which he was disappearing would swallow him up entirely.
Eventually, in a very small voice, the Professor said, “Er, ah, mphm, that is, oof, arghh, we’ve never done any such calculation.” The biggest tax increase in human history had been based not upon a mature scientific assessment followed by a careful economic appraisal, but solely upon blind faith. I said as much. “Well,” said the Professor, “maybe we’ll get around to doing the calculations next October.” They still haven’t done the calculations -– or, rather, I suspect they have done them but have kept the results very quiet
Sugar and other sweeteners are, in fact, so toxic to the human body that they should be regulated as strictly as alcohol by governments worldwide, according to a commentary in the current issue of the journal Nature by researchers at the University of California, San Francisco (UCSF). The researchers propose regulations such as taxing all foods and drinks that include added sugar, banning sales in or near schools and placing age limits on purchases…
In the United States, more than two-thirds of the population is overweight, and half of them are obese. About 80 percent of those who are obese will have diabetes or metabolic disorders and will have shortened lives, according to the UCSF authors of the commentary, led by Robert Lustig. And about 75 percent of U.S. health-care dollars are spent on diet-related diseases, the authors said. Worldwide, the obese now greatly outnumber the undernourished…
Lustig, a medical doctor in UCSF’s Department of Pediatrics, compares added sugar to tobacco and alcohol (coincidentally made from sugar) in that it is addictive, toxic and has a negative impact on society, thus meeting established public health criteria for regulation. Lustig advocates a consumer tax on any product with added sugar…ban the sale of sugary drinks to children under age 17 and to tighten zoning laws for the sale of sugary beverages and snacks around schools and in low-income areas
In a country where the EPA has issued an endangerment finding about a gas that is necessary for life to exist on earth, it is possible to imagine the government requiring a photo ID and a prescription to buy a bag of sugar. How life has changed in the last half century, and in many ways not for the better.
NPR reports about a contract among Chinese farmers in 1978:
There was no incentive to work hard — to go out to the fields early, to put in extra effort, Yen Jingchang says. “Work hard, don’t work hard — everyone gets the same,” he says. “So people don’t want to work.” In Xiaogang there was never enough food, and the farmers often had to go to other villages to beg. Their children were going hungry. They were desperate. So, in the winter of 1978, after another terrible harvest, they came up with an idea: Rather than farm as a collective, each family would get to farm its own plot of land. If a family grew a lot of food, that family could keep some of the harvest…
Despite the risks, they decided they had to try this experiment — and to write it down as a formal contract, so everyone would be bound to it. By the light of an oil lamp, Yen Hongchang wrote out the contract. The farmers agreed to divide up the land among the families. Each family agreed to turn over some of what they grew to the government, and to the collective. And, crucially, the farmers agreed that families that grew enough food would get to keep some for themselves. The contract also recognized the risks the farmers were taking. If any of the farmers were sent to prison or executed, it said, the others in the group would care for their children until age 18…
by changing the economic rules — by saying, you get to keep some of what you grow — everything changed. At the end of the season, they had an enormous harvest: more, Yen Hongchang says, than in the previous five years combined. That huge harvest gave them away…
fortunately for Mr. Yen and the other farmers, at this moment in history, there were powerful people in the Communist Party who wanted to change China’s economy. Deng Xiaoping, the Chinese leader who would go on to create China’s modern economy, was just coming to power. So instead of executing the Xiaogang farmers, the Chinese leaders ultimately decided to hold them up as a model. Within a few years, farms all over China adopted the principles in that secret document. People could own what they grew. The government launched other economic reforms, and China’s economy started to grow like crazy. Since 1978, something like 500 million people have risen out of poverty in China.
In 1623 William Bradford figured out the same thing after the Pilgrims spent two years on their communal farms: “they began to think how they might raise as much corn as they could…so assigned to every family a parcel of land, according to the proportion of their number…and ranged all boys and youth under some family. This had very good success, for it made all hands very industrious…The women now went willingly into the field, and took their little ones with them to set corn; which before would allege weakness and inability.”
the number of scientific “heretics” is growing with each passing year. The reason is a collection of stubborn scientific facts. Perhaps the most inconvenient fact is the lack of global warming for well over 10 years now. This is known to the warming establishment, as one can see from the 2009 “Climategate” email of climate scientist Kevin Trenberth: “The fact is that we can’t account for the lack of warming at the moment and it is a travesty that we can’t.” But the warming is only missing if one believes computer models where so-called feedbacks involving water vapor and clouds greatly amplify the small effect of CO2.
The lack of warming for more than a decade — indeed, the smaller-than-predicted warming over the 22 years since the U.N.’s Intergovernmental Panel on Climate Change (IPCC) began issuing projections — suggests that computer models have greatly exaggerated how much warming additional CO2 can cause. Faced with this embarrassment, those promoting alarm have shifted their drumbeat from warming to weather extremes, to enable anything unusual that happens in our chaotic climate to be ascribed to CO2.
The fact is that CO2 is not a pollutant. CO2 is a colorless and odorless gas, exhaled at high concentrations by each of us, and a key component of the biosphere’s life cycle. Plants do so much better with more CO2 that greenhouse operators often increase the CO2 concentrations by factors of three or four to get better growth. This is no surprise since plants and animals evolved when CO2 concentrations were about 10 times larger than they are today. Better plant varieties, chemical fertilizers and agricultural management contributed to the great increase in agricultural yields of the past century, but part of the increase almost certainly came from additional CO2 in the atmosphere.
Although the number of publicly dissenting scientists is growing, many young scientists furtively say that while they also have serious doubts about the global-warming message, they are afraid to speak up for fear of not being promoted — or worse. They have good reason to worry. In 2003, Dr. Chris de Freitas, the editor of the journal Climate Research, dared to publish a peer-reviewed article with the politically incorrect (but factually correct) conclusion that the recent warming is not unusual in the context of climate changes over the past thousand years. The international warming establishment quickly mounted a determined campaign to have Dr. de Freitas removed from his editorial job and fired from his university position. Fortunately, Dr. de Freitas was able to keep his university job.
This is not the way science is supposed to work, but we have seen it before — for example, in the frightening period when Trofim Lysenko hijacked biology in the Soviet Union. Soviet biologists who revealed that they believed in genes, which Lysenko maintained were a bourgeois fiction, were fired
The lesbian parents of an 11-year-old boy who is undergoing the process of becoming a girl last night defended the decision, claiming it was better for a child to have a sex change when young. Thomas Lobel, who now calls himself Tammy, is undergoing controversial hormone blocking treatment in Berkeley, California to stop him going through puberty as a boy…The mothers say that one of the first things Thomas told them when he learned sign language aged three — because of a speech impediment — was, ‘I am a girl’. At age seven, after threatening genital mutilation on himself, psychiatrists diagnosed Thomas with gender identity disorder…This summer, he started taking hormone-blocking drugs…Tammy Lobel’s hormones are being blocked by an implant on the inside of the 11-year-old’s upper left arm, which must be replaced once a year. Ms Moreno explained: ‘In other words, she will stay as a pre-pubescent boy until she decides and we feel that she can make this decision about surgery.’
As VDH noted recently, civilizations often devolve. Exhibit A above. Unlike 50 years ago, we now live in a world where smoking a cigarette can get you in trouble, but this abusive freak show doesn’t.
millions of Americans remain unaware that this nation is broke –- broker than any nation has ever been. A few days before Christmas, we sailed across the psychological Rubicon and joined the club of nations whose government debt now exceeds their total GDP. It barely raised a murmur -– and those who took the trouble to address the issue noted complacently that our 100 percent debt-to-GDP ratio is a mere two-thirds of Greece’s. That’s true, but at a certain point per capita comparisons are less relevant than the sheer hard dollar sums: Greece owes a few rinky-dink billions; America owes more money than anyone has ever owed anybody ever.
Public debt has increased by 67 percent over the past three years, and too many Americans refuse even to see it as a problem. For most of us, “$16.4 trillion” has no real meaning, any more than “$17.9 trillion” or “$28.3 trillion” or “$147.8 bazillion.” It doesn’t even have much meaning…there is no politically plausible scenario under which the 16.4 trillion is reduced to 13.7 trillion, and then 7.9 trillion and, eventually, 173 dollars and 48 cents…
Our most enlightened citizens think it’s rather vulgar and boorish to obsess about debt. The urbane, educated, Western progressive would rather “save the planet,” a cause which offers the grandiose narcissism that, say, reforming Medicare lacks. So, for example, a pipeline delivering Canadian energy from Alberta to Texas is blocked by the president on no grounds whatsoever except that the very thought of it is an aesthetic affront to the moneyed Sierra Club types who infest his fundraisers. The offending energy, of course, does not simply get mothballed in the Canadian attic: The Dominion’s Prime Minister has already pointed out that they’ll sell it to the Chinese, whose Politburo lacks our exquisitely refined revulsion at economic dynamism and, indeed, seems increasingly amused by it…
Last January, the BBC’s Brian Milligan inaugurated the New Year by driving an electric Mini from London to Edinburgh, taking advantage of the many government-subsidized charge posts en route. It took him four days, which works out to an average speed of 6 miles per hour – or longer than it would have taken on a stagecoach in the mid-19th century. This was hailed as a great triumph by the environmentalists.
Steyn goes on to talk about the regulatory sclerosis that afflicts the country and is so evident over the march of decades. Of course it’s not all bleak. Some companies in the tech sector continue to show impressive growth. But the heavy lifting of massive job creation can’t occur unless government stops its spending binge and gets out of the way of business. 2013 can’t arrive fast enough.
1968 was a tumultuous year, really awful in some ways, hardly what you’d call the good old days. Yet it had its moments, including the first human spaceflight to leave the earth’s orbit. Merry Christmas from the three astronauts of the Apollo 8 mission.
When the EPA announced its new air pollution rules this week — designed to reduce power plant emissions of mercury and other to gases — Administrator Lisa Jackson blogged that: “Mercury is a neurotoxin that is particularly harmful to children, and emissions of mercury and other air toxics have been linked to damage to developing nervous systems, respiratory illnesses and other diseases.” At $10 billion a year, complying with the new rules won’t come cheap, and that assumes the EPA’s low-ball estimate comes true. According to the coal industry, this is the most expensive rule the EPA’s ever imposed.
For our part, we get our mercury from swordfish, about which the EPA also screams trouble. On the other hand, the EPA says that with mercury CFL’s “there is no evidence that the brief exposure to the mercury in a broken bulb presents a health risk to you.” Go figure. (The state of Maine begs to differ.)
BTW, both left and right, AEI and Brookings say that the $10 billion annual boondoggle by the EPA is totally unnecessary. Surprised?
Coca-Cola’s traditional Christmas cans disappeared this year. Wes Pruden:
Coca-Cola…withdrew the red cans and replaced them with snow-white cans as antiseptic as a bedpan. The white cans are decorated with shadowy images of polar bears, commemorating Coke’s contribution of $3 million to the World Wildlife Fund’s campaign to “save the polar bears.”
Maybe next year Coke will have cans illustrated with a hockey stick and no Medieval Warm Period. That’ll wow ‘em. (In our view, doctoring the data to remove the MWP was necessary in the minds of the global warming fraudsters so that they could claim that recent warming was “unprecedented” and would require spending vast unnecessary sums, which BTW would benefit them economically and professionally.)
Bret Stephens in the WSJ sounds as dismissive as his opponents:
Consider the case of global warming, another system of doomsaying prophecy and faith in things unseen. As with religion, it is presided over by a caste of spectacularly unattractive people pretending to an obscure form of knowledge that promises to make the seas retreat and the winds abate. As with religion, it comes with an elaborate list of virtues, vices and indulgences. As with religion, its claims are often non-falsifiable, hence the convenience of the term “climate change” when thermometers don’t oblige the expected trend lines. As with religion, it is harsh toward skeptics, heretics and other “deniers.” And as with religion, it is susceptible to the earthly temptations of money, power, politics, arrogance and deceit.
You know where we are on the issue. Our question is this: in 5 years and in 10 years, will AGW still be the conventional wisdom in the media and the academy?
The other day we were talking about 1961. Not a bad year. We still hear snippets playing from time to time. “Crest has been shown to be an effective decay preventive dentifrice that can be of significant value when used in a conscientiously applied program of oral hygiene and regular professional care.” That of course is a statement from the Council on Dental Therapeutics of the American Dental Association, and a marketing coup for P&G. But what 9 year old remembers things like this?
We know the themes from obscure TV shows like Destry, which aired for less than 3 months, as well as famous themes like that of 77 Sunset Strip (“you meet the highbrow and the hipster, the starlet and the phony tipster). When we took the math SAT in high school the album version of the Doors’ Light my Fire played in the background. We often hear Tommy Dorsey and his orchestra, like this war ditty and other songs from the 40′s and also some tunes from quite a bit earlier as well. And of course there’s a lot of classical music in the mix. We used to hear a lot of Brahms, but lately Beethoven’s 6th symphony has been playing.
Memory is certainly cheaper than buying on iTunes. But our question is this: does everyone have a soundtrack? We know Bob Dylan does.
EU bans claim that water can prevent dehydration…EU officials concluded that, following a three-year investigation, there was no evidence to prove the previously undisputed fact. Producers of bottled water are now forbidden by law from making the claim and will face a two-year jail sentence if they defy the edict…
professors Dr Andreas Hahn and Dr Moritz Hagenmeyer…compiled what they assumed was an uncontroversial statement in order to test new laws which allow products to claim they can reduce the risk of disease, subject to EU approval. They applied for the right to state that “regular consumption of significant amounts of water can reduce the risk of development of dehydration” as well as preventing a decrease in performance.
However, last February, the European Food Standards Authority (EFSA) refused to approve the statement. A meeting of 21 scientists in Parma, Italy, concluded that reduced water content in the body was a symptom of dehydration and not something that drinking water could subsequently control.
Just how many millions of euros were spent on conferences in Parma and other things for a “three-year investigation” of whether water is wet? Niall Ferguson may well be right.
According to the IPCC, who produce the original numbers, humans produce approximately 9 gigatons of CO2 per year. This is within the error factor for the amount of CO2 from at least two natural sources. Estimates of CO2 from natural sources are very crude as evidenced by the large error factors…In 2010 humans produced 9 gigatons, but ocean output was between 90 and 100 gigatons and ground bacteria and rotting vegetation was between 50 and 60 gigatons
Maybe we’ll have to get rid of all the bacteria, rotting plants and those darned oceans if we’re going to make the five-year window to avoid doom.
The US has enough smallpox vaccine to inoculate the entire population for three bucks a pop. But that’s not good enough. LAT:
the Obama administration has aggressively pushed a $433-million plan to buy an experimental smallpox drug, despite uncertainty over whether it is needed or will work. Senior officials have taken unusual steps to secure the contract for New York-based Siga Technologies Inc., whose controlling shareholder is billionaire Ronald O. Perelman, one of the world’s richest men and a longtime Democratic Party donor. When Siga complained that contracting specialists at the Department of Health and Human Services were resisting the company’s financial demands, senior officials replaced the government’s lead negotiator for the deal, interviews and documents show. When Siga was in danger of losing its grip on the contract a year ago, the officials blocked other firms from competing…
the government could draw on $1 billion worth of smallpox vaccine it already owns to inoculate the entire U.S. population and quickly treat people exposed to the virus. The vaccine, which costs the government $3 per dose, can reliably prevent death when given within four days of exposure. Siga’s drug, an antiviral pill called ST-246, would be used to treat people who were diagnosed with smallpox too late for the vaccine to help. Yet the new drug cannot be tested for effectiveness in people because of ethical constraints — and no one knows whether animal testing could prove it would work in humans.
Smallpox is lethal and nasty. When Edward Jenner created the smallpox vaccine by using cowpox, he arguably contributed to saving more lives than any single man in history, yet we have found no record of him receiving a $433 million contract.
You will recall that some years ago, people worried about a smallpox terrorist attack. The US government created a plan to deal with it, and an idiotic plan it was. A group a bad guys flying on Southwest for a week before they keeled over would render the government’s plan useless. They’d also render ST-246 useless. So this is another big waste of money. Far better and cheaper to encourage voluntary vaccinations, but apparently this is not being done. We are given to understand, however, that the government officials in charge of smallpox response have all been vaccinated. How nice for them.
The NYT has a piece about the billions of dollars in subsidies being given to companies for solar and wind power. (Spending taxpayer money on these things apparently continues to be more popular than we would have thought.) The Times story is interesting, but it never gets to a central point — the cost at the consumer level. With natural gas reserves increasing so dramatically (up 35% in a single year) and generations worth of untapped reserves, it’s hard to believe that the subsidized power sources are ever going to be cost-competitive. If that’s true, giving another dime to some large company to feed a fantasy is even more wasteful and outrageous.
World headed for irreversible climate change in five years…If the world is to stay below 2C of warming, which scientists regard as the limit of safety, then emissions must be held to no more than 450 parts per million (ppm) of carbon dioxide in the atmosphere; the level is currently around 390ppm. But the world’s existing infrastructure is already producing 80% of that “carbon budget”, according to the IEA’s analysis, published on Wednesday. This gives an ever-narrowing gap in which to reform the global economy on to a low-carbon footing. If current trends continue, and we go on building high-carbon energy generation, then by 2015 at least 90% of the available “carbon budget” will be swallowed up by our energy and industrial infrastructure. By 2017, there will be no room for manoeuvre at all – the whole of the carbon budget will be spoken for, according to the IEA’s calculations.
Think of this: the difference between Have a Nice Day! and We’re Doomed! depends on 60 parts per million of the gas that plants breathe. That’s less than 1 out of 10,000 bits of air, as we tirelessly point out. If you think the earth is that fragile, well, good luck. Or maybe we’re just among the Gomers and Goobers of the world, as the WaPo reported: “It is not surprising that support for federal funding for clean energy drops among Republicans when their major source of information is a ‘news’ network that is pushing an anti-environment, anti-science, anti-government agenda 24/7.”
what Canada and Australia are paying to fulfill their entirely voluntary Copenhagen Accord climate change commitments. Australia committed $599 million and Canada $1.2 billion between 2010 and 2012. Both nations have already donated the first third of this commitment, an amount that is almost exactly the current shortfall in the international Horn of Africa Drought fund, a deficit that may lead to the deaths of hundreds of thousands of people if it is not rectified.
The Copenhagen Accord specified that contributions should be split 50-50 between helping people adapt to climate change and stopping (or “mitigating”) climate change. Australia is generally following this formula, but 90% of Canada’s first $400 million donation is dedicated entirely to mitigation.
This undue focus on mitigation of a hypothetical human-caused dangerous warming that has yet even to be measured comes at the expense of the urgent needs of the world’s most vulnerable peoples. For example, ClimateWorks Foundation — an American climate activist group that has donated millions to Al Gore’s Alliance for Climate Protection — received over $500 million from charitable foundations when they launched in 2008. This was twice as much as foundations contributed to the World Health Organization, and over seven times as much as they donated to UNICEF in that year.
Over the last two decades ending in 2009, the U.S. government spent a total of $68 billion for climate science research and climate-related technology development. Worldwide, it is estimated that Western countries alone are pouring at least $10 billion annually (2009) into global warming related research and policy formulation.
A million people die of malaria every year. It is easily and cheaply prevented by using DDT, for a fraction of the dollars spent on the fantasy of global warming. But DDT has been banned in many countries, and no doubt many of the same scientists who prattle on about the menace of global warming decades from now endorse the ban of a substance that can save human lives today. Al Gore has saved exactly zero human lives by scaremongering about the UFO that is global warming — in the years since he won the Nobel Prize he could have contributed to saving 4-5 million humans, mostly kids. Bad science, bad economics, opportunity to make a real contribution lost.
Eugene Robinson seemed awfully sure of himself in the WaPo:
The scientific finding that settles the climate-change debate…For the clueless or cynical diehards who deny global warming, it’s getting awfully cold out there.
The latest icy blast of reality comes from an eminent scientist whom the climate-change skeptics once lauded as one of their own. Richard Muller, a respected physicist at the University of California, Berkeley, used to dismiss alarmist climate research as being “polluted by political and activist frenzy.” Frustrated at what he considered shoddy science, Muller launched his own comprehensive study to set the record straight. Instead, the record set him straight.
“Global warming is real,” Muller wrote last week in The Wall Street Journal. Rick Perry, Herman Cain, Michele Bachmann and the rest of the neo-Luddites who are turning the GOP into the anti-science party should pay attention…
Muller’s plain-spoken admonition that “you should not be a skeptic, at least not any longer” has reduced many deniers to incoherent grumbling or stunned silence. Not so, I predict, with the blowhards such as Perry, Cain and Bachmann, who, out of ignorance or perceived self-interest, are willing to play politics with the Earth’s future…
The Berkeley group’s research even confirms the infamous “hockey stick” graph — showing a sharp recent temperature rise
There’s only one little problem with all this. Here’s the actual data from Best’s archives, without the ten-year “smoothing” and other features created to produce the graph above. As you can see, it shows cooling over the last decade:
However, Mr. Muller was already on the record: “Richard Muller, leader of the initiative, said that the global temperature standstill of the past decade was not present in their data.” Oops!
James Delingpole of the Telegraph is in high dudgeon: “I had my doubts about Muller’s findings from the start. I thought it was at best disingenuous of him to pose as a ‘sceptic’ when there is little evidence of him ever having been one….I really didn’t want my first blog post in a week to be yet another one about global bloody warming. Problem is, if those lying, cheating climate scientists will insist on going on lying and cheating what else can I do other than expose their lying and cheating?”
Of course, much of this is becoming irrelevant, since the US and the West can’t afford the expensive fantasies like cap-and-trade and so forth. But it’s nice for candidates for cutting government spending to stand up and draw attention to themselves as Muller has done.
On Oct. 22, 1844, thousand of Millerites, having sold all their possessions, climbed to the top of hills in Upstate New York to await the return of Jesus and the end of the world. They suffered “the great disappointment” when it didn’t happen. In 1212, or so the legends go, thousands of Children’s Crusaders set off from France and Germany expecting the sea to part so they could march peaceably and convert Muslims in the Holy Land. It didn’t, and many were shipwrecked or sold into slavery. In 1898 the cavalrymen of the Madhi, ruler of Sudan for 13 years, went into the Battle of Omdurman armed with swords believing that they were impervious to bullets. They weren’t, and they were mowed down by British Maxim guns.
A similar but more peaceable fate is befalling believers in what I think can be called the religion of the global warming alarmists. They have an unshakable faith that man-made carbon emissions will produce a hotter climate causing multiple natural disasters. Their insistence that we can be absolutely certain this will come to pass is based not on science — which is never fully settled, witness the recent experiments that may undermine Einstein’s theory of relativity — but on something very much like religious faith. All the trappings of religion are there.
– Original sin: Mankind is responsible for these prophesied disasters, especially those slobs who live on suburban cul-de-sacs and drive their SUVs to strip malls and tacky chain restaurants.
– The need for atonement and repentance: We must impose a carbon tax or cap-and-trade system that will increase the cost of everything and stunt economic growth.
– Ritual, from the annual Earth Day to weekly recycling.
– Indulgences, like those Martin Luther railed against: private jet fliers like Al Gore and sitcom heiress Laurie David can buy carbon offsets to compensate for their carbon-emitting sins.
– Corporate elitists, like General Electric’s Jeff Immelt, profess to share this faith, just as cynical Venetian merchants and prim Victorian bankers gave lip service to the religious enthusiasms of their days. Bad for business not too. And if you’re clever, you can figure out how to make money off it.
– Believers in this religion have flocked to conferences in Rio de Janeiro, Kyoto and Copenhagen, just as Catholic bishops flocked to councils in Constance, Ferrara and Trent, to codify dogma and set new rules.
But like the Millerites, the global warming clergy has preached apocalyptic doom — and is now facing an increasingly skeptical public. The idea that we can be so completely certain of climate change 70 to 90 years hence that we must inflict serious economic damage on ourselves in the meantime seems increasingly absurd.
Take a fishbowl and place 10,000 blue marbles in it. Take out just one little blue marble and replace it with a green marble. You have now illustrated to yourself how much additional CO2 has increased in the atmosphere in the last several hundred years. Predicating doom on such a truly trivial event is not science. Barone has explained it very well indeed.
it’s called the Affordable Care Act, and boosters argue that it will subdue runaway spending. It almost certainly won’t. One prominent skeptic is Arnold Relman, the former editor of The New England Journal of Medicine.
Writing in The New York Review of Books, Relman says that “the law does very little or nothing to address some of the most important causes of the high cost of care and its rapid inflation.” Note: Relman isn’t a conservative crank. He’s a critic of insurance companies and advocates a single-payer, government-run health-care system.
The ACA, Relman writes, doesn’t alter fee-for-service reimbursement that gives “all physicians strong financial incentives to provide more services than needed.” The resulting “fragmentation of medical care … allows specialists to practice in isolation without restraints on cost, causes duplication and disorganization of services, and discourages the use of primary care physicians.”
Relman is unimpressed with the ACA provisions intended to control costs: for example, the Independent Payment Advisory Board (IPAB). It’s a group of 15 experts who would recommend changes if government health spending rose too rapidly.
“However, the law stipulates that the IPAB cannot reduce Medicare benefits or increase Medicare premiums, and it defers any proposed reductions in payments to hospitals for a few years,” Relman writes. The IPAB would mainly cut physicians’ Medicare reimbursement rates, he says. But doctors could “easily” offset these cuts “by providing more services, such as performing more diagnostic tests.”
Relman also dismisses “accountable care organizations” (ACOs) that supposedly save money through coordinated care by doctors and hospitals. The regulations governing ACOs will be so complicated that there won’t be many of them
This was obvious more than two years ago, and yet so many people played along at that time. Pity that more people on the left weren’t writing things like this in the NY Review back in 2009.
