What is wrong with asking Congress for authorization to go to war?

What, indeed, is wrong with asking Congress for authorization to go to war? The power of the imperial presidency and the irrelevance of the Constitution has been so much taken for granted that most politicians and pundits have been thrown into a state of shock and confusion over this unexpected turn and have manifest difficulty in answering the question. The most popular objection seems to be that it shows weakness of US leadership. This follows from the Louis XIV theory of leadership, ("L'etat, c'est moi"), that the president is the state -- nevermind that Congress allowing itself to be shut out of its constitutional duty would certainly be weakness by any reasonable measure. If Congress is counted as a co-equal branch of government, as it properly should be, then US leadership has been weak for many years. Congress has, in particular, been Israel's shameless poodle in all matters relating to the Middle East. It would be wonderful, however unexpected, if Congress would take this occasion to play a leadership role on behalf of the American people for a change.

Snowden right to seek asylum

There is absolutely no logic to the notion that a whistleblower should surrender himself to the mercies of the unrepentant and angry government that he has exposed. Mr. Snowden is entirely justified in accepting asylum in whatever place circumstances permit. Suppose a German citizen, upset upon learning of the Holocaust, had attempted to assassinate Adolf Hitler and then fled to France or Russia for protection. Should he have then been condemned for not submitting to the justice of the democratically elected Third Reich or for instead seeking the protection of foreign regimes? While one may properly object that the NSA abuses are not comparable to the Holocaust the logic of the situation would be nevertheless precisely parallel.

Financialization of the economy

When financial markets have more liquidity than can be invested in the real economy then it goes into speculation. The speculators, which includes banks, other financial institutions such as hedge funds and some wealthy individuals, are plainly getting rich so if it isn't coming from producing valuable products and services for consumers then it is necessarily extractive; i.e., it comes from claiming a bigger share of the pie. Better regulation is a fine idea but by itself it will be largely defeated because ways to speculate will always be found as long as liquidity is excessive.

Why is liquidity excessive? It has been at least since the 70s when the last link between the US Dollar and gold was severed allowing the Fed freedom to manage the money supply mainly for the purpose of avoiding recessions. The strategy for accomplishing this was to aim for a steady, moderate rate of price inflation. In an economy without a fiat money supply a certain amount of price deflation is natural due to technological advance and accumulation of capital resulting in rising productivity. I believe persistent excess liquidity resulting in speculation, excessive debt and the financialization of the economy is due precisely to the anti-recessionary strategy of the Fed, (also adopted by other central bankers). Unless we find a better way to either avoid or live with recessions, speculation and anti-productive financialization of the economy is sure to continue regulatory reforms notwithstanding.

A radically financialized economy

It didn't happen overnight. The introduction of credit cards was a part of it. So too were NOW accounts. Then there were credit default swaps and collateralized mortgage obligations the repeal of Glass-Steagall and hedge funds and much more. Today nobody actually knows the difference, if any, between money and credit. At the website of the New York Federal Reserve Bank one reads: "In July 2000, the Federal Reserve announced that it was no longer setting target ranges for money supply growth. In March 2006, the Board of Governors ceased publishing the M3 monetary aggregate." What monetary aggregates mean anymore is a mystery. There seems to be a theory of sorts that it doesn't matter so long as the economy can be regulated through managing interest rates -- raising them to cool down price inflation and lowering them to combat unemployment. But to me, that is whistling in the dark. We have radically financialized the economy, domestically and globally, and nobody really understands it anymore.

Read more here: http://www.mcclatchydc.com/2013/07/23/197469/obamas-major-economy-talk-comes.html#storylink=cpy

 From Today's WaPo:

The financial market freakout, in five charts

The strong reactions of the financial markets to mere suggestions that the Fed may begin to taper off its "quantitative easing" program sometime later this year show how tricky the eventual withdraw of this form of monetary stimulus will be. Perhaps it is fortunate that the real economy has not actually benefited much from the Fed's stimulus. You can't fall off the floor. It is the financial sector mainly at risk as a bubble in financial assets once again threatens the solvency of the banking system. We are seeing the early signs of panic as the more worried holders of those assets seek to avoid being the last to get out.

U.S. says Syria has used chemical weapons

It is very strange that Assad would risk greater Western intervention by approving a few small scale chemical weapons attacks. It would be easier to understand, as an act of desperation, a decision to resort to such weapons openly in a major way. I know it sounds like the intelligence community is being very careful about this but I still have to wonder if somehow, perhaps with aid of a defector, the rebels have managed to stage attacks for which the Assad government will get the blame.

Read more here: http://blogs.mcclatchydc.com/washington/2013/06/us-says-syria-has-used-chemical-weapons.html#storylink=cpy

The cold spot in the cosmic microwave background (CMB).

There is a hole in the cosmic microwave background, (CMB).

It's the blue blotch near the center of this map of the CMB made using the Planck satellite. It represents microwaves, (light), that is of longer wavelenght than that of the warmer colors on the map. It is relatively cold radiation.

The popular theory, never actually proven I believe, is that there is no origin point for the Big Bang -- the universe simply expands out in the same way from every point. That could be wrong. I think the cold spot may be the an empty bubble formed around the origin point of the Big Bang as matter expanded away from it in a shell. Light crossing from the far side of this gap will have been traveling longer than other parts of the CMB which would make it more stretched out and colder than the rest, hence the cold spot.

Radical reform of capitaism

There is speculation that capitalism is in need of radical reform. That may be so. It would not be the first time. Capitalism is a system which has adapted and evolved as technology and changing political structures have altered its environment.

One area for possible reform that has attracted attention is the unusual skewing of income and wealth caused by a diminishing share of economic returns to labor and a rising share to capital -- especially financial capital. Aside from the direct damage to the living standards of the working class this has the undesirable effect of reducing consumer demand to levels inadequate to maintain full employment. This produces a classic perverse feedback loop in which rising unemployment further reduces demand which further reduces employment.

If it is truly necessary for the common good to distribute the returns to capital more broadly to the general population by radical means then the way I would do it would be to (1) eliminate taxes on dividends paid by individuals who receive them from from non-financial corporations, (2) allow those corporations to charge dividend payouts against income but (3) tax them separately at a flat rate and dedicate the revenue to a trust fund for the general public with monthly payouts to be made tax free to every adult citizen that files to receive it.

Growth companies which normally would not pay dividends anyhow would be unaffected except that there would likely be more consumer demand for their products. Mature companies would be distributing their income more broadly although share holders would still benefit more than others as they would collect twice, tax free both times. The financial sector would have to adapt and probably shrink but that would be a good thing. It would have to find its proper niche investing, (i.e., lending), productively where retained earnings and equity offerings are, for whatever reason, inadequate.

I shall elaborate a bit on this last point:

There is an inherent instability in the use of corporate and household debt. Most of it has to be underwritten by collateral; i.e., assets owned by the borrower. But assets of all kinds are subject to speculative bubbles. Asset price volatility, via collateral, translates into financial markets instability. While some debt financing is certainly healthy and necessary, too much reliance of debt puts the entire economy in jeopardy.

By far, the safest form of capital investment is retained earnings. It is the means by which successful companies build on their success and branch out into related products and services. Next safest is equity as the risk of failure is mainly limited to those best able, or at least most willing, to bear it. Debt is comparatively more hazardous for the reasons already mentioned and also because the risks of failure are communicated to the broad economy through the potential and actual failures of lending institutions. Otherwise healthy enterprises can fail when their institutional creditors are unable to sustain continued financing.

Limiting the new treatment of dividends in my proposal to non-financial corporations is an important feature and should not be omitted even if there are technical difficulties in implementation.

Saddam the secularist unbound by the rule of law

I was thinking last night, for no particular reason, about Saddam Hussein and decided to save some of these thoughts in my blog. Please excuse me if I ramble. It reflects the way I was thinking.

What occurred to me is that the favoritism shown to Sunnis in Saddam's regime was likely not intentional. That doesn't square with the secularism of his Baath Party. Moreover, he did not favor the Kurds who, though Sunnis, were also disposed to separatism. Sunnis from the central and western regions of Iraq likely came to be favored because Saddam favored members of his own Tikriti tribe who incidentally happened to be Sunnis. Saddam was almost certainly a firm secularist himself intent upon making Iraq into a modern, technologically up to date, country -- probably encouraged in this by his associations with the USSR.

It is a mistake to suppose that if someone is a brutal despot that anything and everything he believes or attempts to do must be purely evil. Such tyrants normally have some commendable intentions. Where they uniformly go wrong is in accepting the very common moral error that the ends justify the means. It should be observed that, in the context of politics, this is directly contrary to the rule of law -- which is the principle that those who govern, no less than the governed, are required to obey the law. Under that principle it doesn't matter as much as it does in a dictatorship what brutal means a leader thinks are justified by his ends because the public, and the world, has some protection from the law -- perhaps a great deal of protection if the laws are based on protection of individual rights and the institutions of law are strong.

In a democracy, war is the principle means by which the rule of law and its institutions are subverted and weakened. It is not just coincidental that Saddam made war upon two of his neighbors, Iran and Kuwait.

The new regime in Iraq is much more sectarian than Saddam's was. This is very unfortunate. Shia, in particular, feel that they have been discriminated against in fact even if it was not in intent and now are repealing secularism in fact even if the intent is just to abolish Sunni favoritism. Iraq lacks adequate legal institutions for protecting the Sunnis from Shia vengeance. Majorities can be despots too. They too are prone to believe that the ends justify the means and they too need to be restrained by the rule of law.

Ten years ago I, for one, had the distinct impression that those Democrats agreeing with the Bush-Cheney Administration that Saddam was hiding WMDs were going out of their way to avoid noticing that they were only being given claims, not actual evidence, supporting the charges. This was manifestly the case with Secretary of State Colin Powell's now infamous UN presentation. There was no real evidence presented at all. It was like the Emperor's New Clothes story come to life with politicians and much of the public raving how Powell had "nailed" Saddam dead to rights. The sad truth is that most politicians and many citizens, regardless of party, wanted the war on Iraq and were prepared to believe almost any charge that could justify it. The evidence of WMDs was not really there and the contrary evidence was ignored:

A special BBC Panorama programme aired on Monday night details how British and US intelligence agencies were informed by top sources months before the invasion that Iraq had no active WMD programme, and that the information was not passed to subsequent inquiries.
It describes how Naji Sabri, Saddam's foreign minister, told the CIA's station chief in Paris at the time, Bill Murray, through an intermediary that Iraq had "virtually nothing" in terms of WMD.
Sabri said in a statement that the Panorama story was "totally fabricated".
However, Panorama confirms that three months before the war an MI6 officer met Iraq's head of intelligence, Tahir Habbush al-Tikriti, who also said that Saddam had no active WMD. The meeting in the Jordanian capital, Amman, took place days before the British government published its now widely discredited Iraqi weapons dossier in September 2002.

The negative findings of the UNMOVIC inspectors, although being publicly reported were being dismissed:

The Bush administration certainly wanted to go to war, and it advanced eradication of weapons of mass destruction as the main reason. As Deputy Secretary of Defense Paul Wolfowitz has since explained, it was the only rationale that was acceptable to all parts of the U.S. administration.

The WMDs argument also carried weight with the public and with the U.S. Congress. Indeed, in the autumn of 2002 the threat seemed credible. While I never believed Saddam could have concealed a continued nuclear program, I too thought there could still be some biological and chemical weapons left from Iraq's war with Iran. If not, why had Iraq stopped U.N. inspections at many places around the country throughout the 1990s?

However, suspicions are one thing and reality is quite another. U.N. inspectors were asked to search for, report and destroy real weapons. As we found no weapons and no evidence supporting the suspicions, we reported this. But U.S. Defense Secretary Donald Rumsfield dismissed our reports with one of his wittier retorts: "The absence of evidence is not evidence of absence." -- Hans Blix head of U.N. weapons inspections in Iraq (UNMOVIC) in the lead-up to the 2003 invasion.

Please ignore the claims made by some advocates of the war that they are not to blame because "everybody" believed Saddam was hiding WMDs. True, many did believe but on a matter as serious as going to war they were inexcusably negligent and gullible.

It's the 10th anniversary of the invasion of Iraq

 by the US and its "coalition of the willing". There hasn't been as much retrospective in the media as I thought there would be or should be about this chapter of recent history. The Gallup public opinion poll says the majority view is that the war was a mistake but the margin of difference between those who believe that and those who deny it is only 11 percentage points: 53% that it was a mistake, 42% that it was not. Those in the 42% really worry me. What can they be thinking?

I feel very sorry for the Iraqi people. I know that there are some Iraqis who feel that the removal of Saddam Hussein was worth the death, the suffering, the fear and the destruction of the war. I must assume that for them this is true but I find it hard to imagine how it can be. Perhaps these are individuals who by chance were among the most to suffer from Saddam's rule but among the least to suffer from the war and the occupation.

Remember Riverbend, author of the Baghdad Burning blog? She and much of her family fled to Syria in September of 2007 and her last blog post is dated October 22, 2007. No one seems to know what became of her since. Now a terrible war rages in Syria. Riverbend, it seems, can't get a break.

UPDATE: Riverbend is back with a new post to her blog dated Tuesday, April 09, 2013.

Adapting to rising competition to labor from technology

There has been a rash of media reports lately of economic analyses demonstrating that competition to labor from technology has changed: It is much more intense than in the past and it is not going to stop but only intensify more going forward.

What can't be cured must be endured. In other words, the strategy for aiding labor must be for adaptation. This is similar to the situation with climate change where the consensus now is that it is too late to stop it and that while it might still be slowed a bit the main challenge will be to adapt.

Wages are notoriously "sticky" and this helps to produce unemployment as demand for labor slackens. Two adaptations that help would be falling consumer prices and lower taxes on employment, income taxes and payroll taxes, especially at the low end. This will make it easier for workers to find work at lower wages while still maintaining a reasonable standard of living. Lowering the cost of medical care and getting away from employer provided health insurance fits particularly well with this strategy as would lowering consumption taxes generally. Tolerating some deflation, while contrary to accepted monetary policy of the past, may be a good idea under our new circumstances.

Natural law

A natural law, as opposed to a social law, is simply one derived from an observation, or at least a belief, about the nature of something. A good example was the argument made by Thomas Jefferson in his 1813 letter Isaac McPherson that ideas are not by nature property:

If nature has made any one thing less susceptible than all others of exclusive property, it is the action of the thinking power called an idea, which an individual may exclusively possess as long as he keeps it to himself; but the moment it is divulged, it forces itself into the possession of every one, and the receiver cannot dispossess himself of it. Its peculiar character, too, is that no one possesses the less, because every other possesses the whole of it. He who receives an idea from me, receives instruction himself without lessening mine; as he who lights his taper at mine, receives light without darkening me. That ideas should freely spread from one to another over the globe, for the moral and mutual instruction of man, and improvement of his condition, seems to have been peculiarly and benevolently designed by nature, when she made them, like fire, expansible over all space, without lessening their density in any point, and like the air in which we breathe, move, and have our physical being, incapable of confinement or exclusive appropriation. Inventions then cannot, in nature, be a subject of property.

Jefferson recognized, however, that a right in social law to what we now call "intellectual property" might be justified on utilitarian grounds. Nevertheless, the natural law regarding ideas is that they may not be owned.


To the extent that the law tries to be realistic and take the nature of things into account, all laws are more or less "natural" even if not purely so. What makes pure natural law so problematic in practice is that in most cases the argument is derived from nothing so simple as the nature of ideas but from human nature -- which is complex, not well understood and varies a bit from one human individual to the next making generalization difficult. Social law, derived from politics, fills the gaps in our understandings although it sometimes also represents unwise attempts to deny the nature of things.

The advantage of natural law, where it can be correctly determined, is that it is by definition realistic insofar as not being in conflict with nature. It is less prone than social law to fail due to unanticipated problems when tested against reality. Patent and copyright law is a mess -- full of arbitrary distinctions and determinations and endless disputes and controversies. This is the natural result of being so artificial.

Quantum weirdness looks less so in four dimensions

I was reading this article in ScienceDaily and was gratified, because it fits so well with my personal view, to read this closing line:

"In a certain sense, quantum events are independent from space and time," says [physicist] Anton Zeilinger.

In thinking about quantum weirdness, it seems to me, that something fundamental in Einstein's theory of relativity tends to get lost -- that nature is four dimensional with time as the forth dimension. The past and future parts of four dimensional reality objectively exist with equal reality separated only by slices of time subjectively experienced as the "present". This understanding tends to be unpopular, even among scientists, because under some interpretations it seems to deny free will.

If we imagine space and time as a solid four dimensional block with events permanently embedded in it we can see that classical events are connected by strands of causality but deduce from evidence that quantum events across space and time are not. (Causality, without which observation would not be possible, is what produces our subjective sense of the present). Importantly, quantum events remain connected by conservation principles. These principles, of course, apply across time but we never thought of this as being "caused" by anything. They are simply fundamental. With classical conservation laws as the precedent we should have been less surprised than we have been by non-causal quantum correlations, "entanglements", that similarly reach across time and space. That we were surprised, I believe, is because we largely failed to think of conservation principles in the four dimensional context.

Let me just add that the "many worlds" interpretation of quantum mechanics effectively adds a fifth dimension to this picture. It solves the mystery of "wave function collapse", which is otherwise inexplicable, by suggesting that there is no collapse, just continuation along multiple fifth dimensional paths of which we can never observe more than one. This is actually quite similar to the way a subjective "present" is singled out for us as unique.

UPDATE: I recently came across mention of a book,  A World Without Time: The Forgotten Legacy of Godel and Einstein by Palle Yourgrau, that corroborates what I said about the unpopularity of the four dimensional space-time of relativity.

In 1942, the logician Kurt Godel and Albert Einstein became close friends; they walked to and from their offices every day, exchanging ideas about science, philosophy, politics, and the lost world of German science. By 1949, Godel had produced a remarkable proof: In any universe described by the Theory of Relativity, time cannot exist. Einstein endorsed this result reluctantly but he could find no way to refute it, since then, neither has anyone else. Yet cosmologists and philosophers alike have proceeded as if this discovery was never made.

I object, however, to use of the ridiculously misleading phrase "time does not exist" in describing the four dimensional space-time view. Obviously, time very much exists as the fourth dimension. The intent must have been to explain that time as commonly understood as a real present but annihilated past and unborn future does not exist.

Obama's Legacy

Upon the occasion of his second term inauguration, there has been much talk of Obama's likely legacy, the theory being that he is now better able to decide what it will be than he was in his first term. It leads to the question of what his legacy is shaping up to be so far.

One item frequently mentioned is not really of Obama's own doing. Being elected while black is not to Obama's credit but that of the electorate. Moreover, this particular racial barrier fell for the Whitehouse much later than it was broken in Congress or the Supreme Court. As an "Obama legacy" I expect it to amount to no more than a footnote in the end.

Obamacare? Setting aside that its actual content is much more a product of Congress than of Obama's authorship it comes after Medicare, Medicaid and the Bush Administration's drug benefit. Much will undoubtedly also follow if only in correction of Obamacare's flaws and deficiencies. In context it will not seem that big a step -- not necessarily even a step forward.

No, as of this moment the central feature of Obama's legacy as it will be seen in the long view taken by history is, in my opinion, his "look forward, not back" policy regarding torture and other likely war crimes. By this will he join the Bush Administration in the annals of infamy.

A common error regarding recurrences in an infinite multiverse

The Life of Pi, and Other Infinities By Natalie Angierm (Published: December 31, 2012) contains a statement by Anthony Aguirre, an associate professor of physics, with which I must take exception. (NYT did not provide for comments to this article on its site).

If you take a finite physical system and a finite set of states, and you have an infinite universe in which to sample them, to randomly explore all the possibilities, you will get duplicates.

This is well and fine but after this I think Professor Aguirre gets a bit sloppy:

If I ask, will there be a planet like Earth with a person in Santa Cruz sitting at this colored desk, with every atom, every wave function exactly the same, if the universe is infinite the answer has to be yes.

No it does not. That there will be duplicates, indeed infinitely many duplicates, does not mean that any particular duplicate must occur.

Consider this infinitely long sequence of digits:

12 122 1222 12222 122222 ... etc.

This can represent a universe of infinite possibilities, (it goes on forever yet there is always further out a sequence you have not seen before) and it is built from finite set of states, (each digit is limited to being either '1' or '2').

Any finite number of '2's in a row will appear infinitely often, as will the single digit '1' - those are the inevitable duplicates. Yet you will never find the sequence '121212' anywhere and '1212' occurs just once at the beginning. To suppose that any particular duplicate should have to occur requires more than just an assumption of infinity. There would have be a particular structure in the infinity to guarantee it.

(Reuters) - The international mediator touting a peace plan for Syria warned on Saturday of "hell" if the warring sides shun talks, and Moscow blamed the foes of President Bashar al-Assad for refusing to negotiate.

The mediator and Moscow are correct. US policy is apparently strong backing of the rebels, including their demand that Assad depart before negotiations can begin. This is not sensible and comes from the obsession with Iran and the desire to deprive Iran of an ally. It has nothing to do with the stability of the Syrian government, the region or the welfare of its people. Our real interest lies in discouraging Sunni Moslem radicalism generally by encouraging political-religious pluralism and tolerance. Our politicians, however, are practically immune to constructive criticism from a public or media that is not very concerned with foreign and they use the occasion to act stupidly and they will freely sacrifice that goal to cause Iran even a minor inconvenience.

Also: Do not believe the propaganda that harsh sanctions on Iran are an alternative to war. They are provocations leading to war. This is shaping up as Iraq all over again, except worse. Suppose we implement the harshest sanction we possibly can and Iran still refuses our main demand, which is to stop enriching uranium even if it is used only for electrical power. What then? Do we simply wait for the pain inflicted upon the Iranian people, (in many cases fatal), to cause Iran to eventually give in -- or do we, (while Israel will be undoubtedly egging us on), commit to war as a "humanitarian" sanctions ending policy -- (a variation on "we had to destroy the village in order to save it")? We will, of course, put the blame on Iran for refusing to knuckle under.

Gun control

I read an interesting article yesterday at the Time mag website, "3 Approaches to Curbing Gun Violence — Using Economics" By Christopher Matthews. I like the middle proposal, "Require Gun Owners to Purchase Liability Insurance":

[An] idea is to have the government treat guns much like it does cars: Require owners to purchase liability insurance. Such an idea was proposed in Illinois in 2009 but never passed into law. The first step to requiring this type of insurance would be to set up national or state-by-state gun registries and licensing mechanisms -- a step Second Amendment absolutists oppose because they believe such measures would compromise their Constitutional rights. This step alone, were it to gain enough support, would probably do a lot to curb gun violence, as any gun in the country could be tracked by law enforcement to the person who should be responsible for it. But the next step of requiring gun owners to purchase liability insurance would create the incentive for insurers to determine which individuals are fit for gun ownership. It would also incentivize those insurers to require gun owners to store their property in a safe way, and to take other steps like undergoing gun safety training.

Perhaps the courts don't agree, (yet), but the part about "well regulated militia" in the Second Amendment, it seems to me, can reasonably be interpreted as authorizing the registration/liability proposal. This is  not going as far as some who would have it that this phrase in today's context means only law enforcement and the military, including the National Guard, have a constitutional right to bear arms. The registration/liability proposal, in my opinion, does not infringe a right to "well regulated", meaning responsible, gun ownership for the purposes of home protection and sport or even for effective deterrence of potential government tyranny. I am not on the bench, I am not even a lawyer, but I believe the Constitution was written not for judges and lawyers but TO judges and lawyers as the demands of "We the People" and this is my citizen's say in the matter.

The real Bengazi scandal

Based on officials interviewed by the Wall Street Journal:

The officials said the first draft of the talking points had a reference to al Qaeda but it was removed by the Central Intelligence Agency, to protect sources and protect investigations, before the talking points were shared with the White House. No evidence has so far emerged that the White House interfered to tone down the public intelligence assessment, despite the attention the charge has received. [My emphasis added]

Protection of sources and protecting investigations would be the natural bias of an intelligence agency but should not have been the only consideration. There is also a need for the public, not to mention the president and his advisers, to know what their government's foreign policy is or isn't accomplishing. The evidence that has so far emerged is that the Whitehouse was preemptively cut out by the CIA from participating in the account to be given for the Bengazi attack. The real scandal is that the Petraeus CIA decided on its own how the incident should be perceived and reported -- and that the Obama administration is not having a fit over it.

On radical reform

A lot depends on how radical we are willing to be. I believe we can go far beyond "sensibly trim defense and run less of a global empire" and fundamentally do without empire and its expense altogether. The savings that would result from radical rethinking of our place in the world are potentially enormous. It is interesting that we seem to be on a path for energy independence that seemed unimaginable as recently as a decade ago -- which removes a major excuse for aggressive foreign policy. Actually, we have been at least from the early 20th century a very large and resource rich country which always had the option to be very self-sufficient if that is what we really wanted.

Medical care is begging for fundamental reform that addresses its cost structure, not merely availability of insurance. When it was discovered in the 80s that the frequency of certain medical treatments varied more by geography than outcomes there developed a growing interest in outcomes research -- basically cost-benefit analysis. However, the results are basically advisory and using it effectively has been politically difficult. "Death panels" anyone? I was reminded how in the legal profession practitioners sometimes charged contingency fees where payment was due only in the case of delivering a promised outcome. Why doesn't this occur in medicine? Probably there are some laws or regulations that stand in the way. If it were the practice, however, it would powerfully direct medical providers, individuals and organizations, to make best use of outcomes research and empower patients to bargain intelligently without giving up control of their care. The role of patents in the cost structure of medical care also needs radical review.

Perhaps our main problem is that we have been a comfortable and prosperous nation too long and institutional sclerosis has set in. We have many special interests that don't want to have their boats rocked and radical solutions, like political third parties, are rejected out of hand in favor of thoroughly inside-the-box thinking.