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Virginia Postrel: How to Reform Health Care Without Killing Innovation

Wed, 10 Mar 2010 07:54:00 EST

Former Reason magazine Editor in Chief Virginia Postrel has seen the strengths and the shortcomings of the American health care system both as a kidney donor and a breast cancer survivor.

She argues that individuals should be free to sell their organs, and that encouraging organ markets may be the best way to save the lives of the more than 100,000 Americans currently awaiting transplants. A 2009 article Postrel wrote for the Atlantic Monthly highlights her experience with the ultra-expensive wonder drug, Herceptin, and the perils of centrally controlling health care costs.

Reason.tv's Ted Balaker sat down with Postrel to discuss organ markets, wonder drugs, and how to reform health care without squashing innovation.

Interview by Ted Balaker. Shot by Hawk Jensen and Paul Detrick. Edited by Paul Detrick. Music: "Something New" by Very Large Array (Magnatune Records).

Approximately nine-and-a-half minutes. Scroll down for embed code and downloadable versions.

To see Reason.tv's health care play-list, go here.

Postrel, the editor in chief of the blog Deep Glamour, talks to Reason.tv about politics, style, and voter expectations here.

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And come back to Reason.tv March 15 through March 19 for the debut of Reason Saves Cleveland With Drew Carey: How to fix the "Mistake on The Lake" and other once-great American cities, an original six-part documentary series.

Treat Me Like a Dog

Thu, 25 Feb 2010 00:00:00 EST

When it comes to health care, who gets treated better—man or man's best friend? Of course, it's hard to make an apples-to-apples comparison when you're comparing four-legged patients to people, and there are many ways in which human care tops pet care. But pet owners told Reason.tv there are some ways where it would be a step up to be treated like a dog.

Pet owners like the convenience of animal care; they also like the client-focused atmosphere. "I think one of the things that human health care can learn from veterinary medicine is the client service side of things, the relationship side of things," says Dr. Peter Weinstein, executive director of the Southern California Veterinary Medical Association. Various reasons explain why people often find animal care so pleasant, says Weinstein. One reason—animal care workers love what they do. Another reason—competition.

Weinstein notes that vets work hard to differentiate themselves from their competitors because "there are a large number of vet hospitals, many located very closely to one another." And vets know even more competitors could emerge because less red tape makes it easier to open an animal hospital. Weinstein recalls opening his clinic, which offered everything from X-rays to operations: "I believe it was 12 weeks from the time I signed the lease to the time I saw my first client. Try doing that with human health care."

It would take at least 20 times as long to open a comparable human hospital in California. It can take even longer in the 34 states with "certificate of need" (CON) laws, where state agencies—not consumers—decide how many hospitals there should be. These laws even allow existing hospitals to hold up plans for new hospitals. "The existing hospitals go in front of these government agencies and say, 'we don't need any competitors; we're taking fine care of the people,'" explains Reason magazine's Ronald Bailey. Recently, certificate of need—often called CON law—provoked a showdown in Tennessee where frustrated residents resorted to protests and petition drives to pressure the state to green-light a new hospital.

Weinstein is happy veterinarians don't have to deal with anti-competitive CON laws, "In veterinary medicine we could have two practices right next to each other and then it's the consumer deciding to whom they want to go." Consumer choice and competition—maybe we could use more of that in human health care.

"Treat Me Like a Dog" is written and produced by Ted Balaker, who also hosts. The director of photography is Alex Manning, the field producer is Paul Detrick and the animations were done by Hawk Jensen.

Approximately six minutes. Scroll down for embed code and downloadable versions.

To see Reason.tv's health care play-list, go here.

To sign up for Reason.tv's YouTube page, go here.

Net Neutrality for Dummies

Mon, 22 Feb 2010 07:00:00 EST

Al Gore says that legislation ensuring "net neutrality" is "needed for the revitalization of American democracy." Techno-vegan Moby says without it, the "egalitarian" Internet would disappear. Even Mallory from Family Ties, Justine Bateman, thinks "the freedom to access the site of any organization from Planned Parenthood to the Christian Coalition is going to end."

But just what the hell is net neutrality—and is all that is good and holy about the Internet really imperiled if legislation guaranteeing it isn't passed? Network neutrality is necessary, say its supporters, to make certain that all data on the Internet is treated equally and to protect users from information discrimination on the part of Internet service providers who will slow down or even block access to certain sites.

Reason.tv's Michael C. Moynihan takes a skeptical look at the growing push for net neutrality legislation and asks Peter Suderman, a Reason associate editor who is closely following proposals on the topic, why Moby and Mallory want the Federal Communication Commission, of all agencies, to regulate the Internet.

Approximalely 4 minutes. Written by Moynihan. Shot and edited by Dan Hayes and Meredith Bragg.

John Mackey's Conscious Capitalism: Abridged Version

Wed, 14 Oct 2009 11:00:00 EDT

When he started his first organic food store in Austin, Texas in 1978, Whole Foods Market CEO and co-founder John Mackey had no idea that he would eventually usher in not just a revolution in how we shop but what we buy. If you dig being able to buy dozens of types of once-exotic apples, or cheese, or wine, or soaps, or countless other items, you can thank Mackey in part for helping to create cathedrals of commerce that have vastly enriched our day-to-day lives and vastly expanded our palates. (Full disclosure: Mackey has contributed to Reason Foundation, the nonprofit that publishes this website.)

In August, Mackey became one of the most controversial businessmen in America when he penned an op-ed for The Wall Street Journal outlining his company's free-market-oriented health care system and offering eight concrete reforms that would reduce costs and improve access. Noting that health care is not "a right" as that term is properly understood, Mackey forcefully argued that increasing government intervention into health care is precisely the wrong thing to do: "The last thing our country needs is a massive new health-care entitlement that will create hundreds of billions of dollars of new unfunded deficits and move us much closer to a government takeover of our health-care system. Instead, we should be trying to achieve reforms by moving in the opposite direction—toward less government control and more individual empowerment."

The response from the left to Mackey's op-ed was swift: Advocates of single-payer health care, union activists, and others called for protests at and boycotts of Whole Foods, despite the fact that the company provides affordable and well-regarded coverage to its employees.

As a cutting-edge entrepreneur who is comfortable quoting astrological signs and Ludwig von Mises, who practices veganism and sells some of the best meat in America, and who chases profits and is an outspoken advocate of charitable giving, Mackey confounds conventional political categories. As an advocate of what he calls "conscious capitalism," Mackey is that rarest of businessman: an articulate and passionate defender of free enterprise and free individuals.

In late September, Mackey sat down with Reason's Matt Welch and Nick Gillespie to talk about health care reform, corporate social responsibility (on which Mackey has written for Reason), why government interventions rarely achieve their goals, and how Mackey came to his unstinting belief in free markets.

Approximately five minutes. Shot by Dan Hayes and Meredith Bragg. Edited by Meredith Bragg.

This is an abridged version of an hour-long conversation with Mackey. For the full interview and downloadable versions, go here or click below.

The Next Great Leap Backwards For Consumer "Rights"

Tue, 01 Sep 2009 13:30:00 EDT

Is your mortgage confusing to you? Are you bewildered by credit card offers? Do you crave the simplicity of "plain-vanilla" financial vehicles whose complete terms can be read in less than four minutes?

Be careful what you wish for: The Obama administration and members of Congress are pushing legislation that will create a new agency, The Consumer Financial Protection Agency, whose job would be to simplify and police all manner of financial transactions, from what sorts of mortgages could be offered to what sort of credit cards would be in your wallet to whether Wall Street could create new ways of buying and selling stocks. In the name of making your life easier and avoiding the next financial meltdown, the CFPA might just harshly limit how you spend your hard-earned (and dwindling!) dollars.

Would the CFPA do anything other than add another layer of bureaucracy and regulation on top of what already exists? Are consumers too bewildered by competing credit cards to make a rational choice? Reason.tv's Nick Gillespie recently sat down with George Mason University law professor, Volokh Conspiracy blogger, and Mercatus Center scholar Todd Zywicki to get answers.

"The agency is one of the centerpieces of the Obama regulatory reform act[s]," says Zywicki, "It goes far beyond how we've thought about consumer credit regulation for the past 30 or 40 years." More importantly, it will do nothing to address pernicious incentives that encouraged banks and consumers to take on more debt than was prudent.

Approximately 9.44 minutes. Scroll down for embed code and downloadable versions. Shot by Dan Hayes and Meredith Bragg and edited by Dan Hayes.

Throw-Pillow Fight

Wed, 01 Apr 2009 07:00:00 EDT

Should moving a throw pillow get you fined or jailed?

With all the artistry and attitude, it's no wonder design shows are so much fun. But are the people on those shows putting your life, and even the president's life, at risk?

Natasha Lima-Younts can't see how she's putting anyone's life at risk. She's been an interior designer for more than 20 years. She started her own business, and hired dozens of employees. She has an extensive portfolio and magazine features about her work. What she doesn't have is a state license. That doesn't bother Yount's client Angie Stoeker, who loves what Younts has done with her home, but it does bother those who push for licensing laws.

Alabama politicians once threatened unlicensed designers with jail time—moving a throw pillow could get you a year behind bars—and 22 states plus the District of Columbia regulate interior designers. Industry groups lobby for such laws because they say unlicensed designers put lives at risk. "Every decision an interior designer makes affects the health, safety, and, welfare of the public," says the the American Society of Interior Designers. Another group implies that "confusing floor patterns" and other items installed by unlicensed interior designers cause 11,000 deaths per year.

Reason.tv's Nick Gillespie went looking for dead bodies, and for an explanation for why the state of Florida launched a legal case against Younts. State regulators demand that she obtain a license, a license she says she doesn't need, a license that could cost her six years and hundreds of thousands of dollars.

Do licensing laws protect consumers from death and destruction or, as the Interior Design Protection Council argues, do they protect licensed designers from competition? Should Younts be stripped of the career it took her decades to build? Should President Obama be worried about his interior designer, the unlicensed Michael Smith? Jump into the throw-pillow fight and decide for yourself.

"Throw-Pillow Fight" is written and produced by Ted Balaker. Director of photography is Roger Richards.

Slumdog Thousandaire

Fri, 20 Feb 2009 07:00:00 EST

Perhaps the only people who don't like the hit movie Slumdog Millionaire are those who compete against it at awards shows. After all, it's already cleaned up at the Golden Globes, and the BAFTAs, and it's poised to repeat these feats at the Oscars.

The film follows an Indian orphan named Jamal who grows up and hits it big on the famous game show Who Wants to be a Millionaire? In important ways, Slumdog tells the story of India itself—a poverty-stricken underdog with its own rags-to-riches tales. British rule ended in 1947, and the economic woes America faces now are nothing compared to the widespread malnutrition and starvation India faced then.

Indians were enthusiastic about self-rule, but "the problem was that the Indian political leaders had this very Fabian Socialist idea," says Shikha Dalmia, a senior analyst at Reason Foundation and native of India. "And that completely thwarted the entrepreneurship of the country."

For decades would-be entrepreneurs staggered under the weight of corruption and bureaucracy. Want to import a computer for your business? You'd have to get permission from a bureaucrat. Want to sell food from a small cart? You'd need all kinds of licenses.

But in the 1990s, India emerged as a high-tech powerhouse. What changed?

"In the 1990s India started liberalizing its economy," says Dalmia, "and it did three things: cut taxes, liberalized trade, and deregulated business." Although they failed to cut the kind of red tape that entangled Slumdog's orphans, the reforms did make it easier for more Indians to start businesses and hire employees.

"One IT company doesn't just employ computer professionals," says Dalmia. "It also needs landscaping services, cleaning services, and restaurants. There was this tremendous spillover effect that allowed people to lift themselves out of poverty."

Since the early 1990s, India has cut its poverty rate in half. About 300 million Indians—equivalent to the population of the entire United States—escaped the hunger and deprivation of extreme poverty thanks to pro-market reforms that increased economic activity.

Yet here in America we're turning away from market reform. Says Dalmia, "It's just this great conundrum that at the same time that deregulation and markets have produced such dramatic results in India, they are falling into suspicion in America." Dalmia's prescription for India is at odds with what politicians have chosen to "stimulate" the United States. "What India needs to do is continue apace with its liberalization effort, but expand it to include the poor. Release them from the shackles of government corruption and government bureaucracy."

"Slumdog Thousandaire" is written and produced by Ted Balaker. The director of photography is Alex Manning.

Go here for an audio podcast version.

Grover Norquist: Leave Us Alone Already!

Fri, 02 May 2008 00:00:00 EDT

Americans for Tax Reform honcho Grover Norquist recently sat down with reason.tv's Nick Gillespie for a 45-minute conversation about Norquist's new book Leave Us Alone: Getting the Government's Hands of Our Guns, Our Money, Our Lives.

From the book's description at Amazon:

The modern Republican party is a coalition of groups and tendencies created during the political life of Ronald Reagan, based on principle rather than region and history. The new political movement that now controls much of the Republican party is one of Americans who simply wish to be left alone by the government. They are not asking the government for others' money, time, or attention. Rather, they want to be free to own a gun, homeschool their children, pray, invest their money, and control their own destiny.
They are the Leave Us Alone coalition, at the heart of the center-right, and Grover Norquist argues that it will grow in power and size during the next generation. Directly opposed to this coalition is the descriptively titled Takings Coalition, which is at the heart of the tax-and-spend left, and they will battle for control of America's future over the next fifty years. It is increasingly important to better understand these coalitions than it is the Republican or Democratic parties themselves.
In a compelling and powerful narrative, Norquist describes the two competing coalitions in American politics, how they are organized, what makes them stronger or weaker. What each can achieve and what they cannot do. And how you may fit into the contest as well as gain a deeper understanding of American politics—where it's been, where it is and particularly where it will go—through a series of eye-opening economic, demographic, and political trends that will shape these coalitions in the years to come.

In this wide-ranging, in-depth discussion, Norquist talks about splits among libertarians and conservatives, the many failures of the Bush administration and the GOP Congress, his trouble with Sens. Barack Obama and Hillary Clinton, the urgent need for reform in Social Security, health care, and education, and much, much more.