Before We have Government do More to Help the Poor We Need to examine what Government is Doing to the Poor.

I just read the following on Marginal Revolution and it reinforced my thinking that

before we get government to do more to help the poor we need to examine what Government is doing to the poor and stop some of it.

This is only one data point, but it supports hypotheses that higher levels of New World violence stem from relatively recent population shifts, drug trafficking, and arms trafficking. When Old World cities have that blend, they too become quite violent.

 It played into my priors:

Abstract

The effect of requiring consumers to obtain prescriptions for pharmaceuticals on mortality is examined for a sample of middle‐income countries. In countries enforcing the requirement, infectious disease mortality is no lower and poisoning mortality is higher than in those not enforcing the requirement. A broader measure of government intervention—public expenditures on health relative to GDP—is shown to have moderately adverse effects on overall life expectancy.

We should at least take a sober and serious look at legalizing all drugs but antibiotics without a prescription

The Green New Deal

A funny thing about the green new deal. It includes:
 
1. “a job with family-sustaining wages, family and medical leave, vacations, and retirement security”
2. “high-quality education, including higher education and trade schools”
3. “high-quality health care”
4. “safe, affordable, adequate housing”
5. “economic security to all who are unable or unwilling to work”

I read those and I say they are technically easy to do with less Government spending than today (Of course they are politically impossible until and if the t-bond market goes south dramatically.)

To do it:

• Replace Social Security, minimum wage SNAP and TANF with a negative income tax. 
• Force state and local gov to allow any residential building increases density.
• Replace medicare and medicaid with a plan with a very high deducible based on income that only cover care that has strong evidence of dollar efficacy.
• Cut defense spending in half.
• Quality education can be done for 30% (at least) less than is spent now and many go to school longer than they should. And USA schooling is already good. We could make it even better by using some existing money to pay for low cost tutors.
• Cut enrollment at state schools in half and we'll be fine. 
• Cut university spending per student in half and we'll be fine. We spend a lot.
• People can live well on less than many think see.

The Democrats and AARP will not lat any of that happen except defense spending cut and the republicans will not let that happen.

So do they really think AGW in an existential danger. I think not. Nor do they think much of the above are really important.

My Problem with Bernie Sanders

My problem with Bernie Sanders.

Judging from the communists that I spoke to back in the 1970's, Bernie's language seems to me to be colored by his communist past.

 
He doesn't say not we should be more charitable to our poor people, which I can buy, rather he sounds like the old communists who liked to say, you made it you deserve it, the capitalists stole what was yours.

He doesn't say that Healthcare is not something we should provide for everyone, he says it's should be a right.

He likes to talk about millionaires and billionaires rigging the system. He talks like millionaires and billionaires getting a tax cut is stealing from you.

High Deductible and Delays in Getting Care

I've been confronted about my very high deductible healthcare plan with a challenge that people with high deductibles delay care after diagnosis costing more for the insurer, be it Government or Insurance companies.

Here is the research:

And once diagnosed, women in high-deductible plans waited longer to start chemotherapy: an average of almost nine months among lower-income women, and nearly six months among higher-income women.

Diagnosis of breast cancer at early stages is associated with better clinical and survival outcomes. How the costs of care vary depending on the stage at which breast cancer was diagnosed has not been thoroughly examined.

Here is some research that goes the other way on screening and preventive care:

Sweeping statements about the cost-saving potential of prevention, however, are overreaching. Studies have concluded that preventing illness can in some cases save money but in other cases can add to health care costs

But the question is, can and will people learn if we were to implement a plan with very high deductibles? 

One data point that I go to is the Peltzman effect, how does the Peltzman effect work with safer cars? It may be by people hearing about someone being in an accident. Another is to consider the that the salience of terrorism has caused a huge overreaction in the USA. 
These lead me to believe that people can and will learn such things and that may tend move toward about or above the optimal reaction to a diagnosis healthcare regardless of the higher deductibles.

On a personal note I have paid a deductible of $10,000 in one case and of $30,000 in another and in neither case did we delay treatment. 

Also if the problem does persist, one way to combat delays might be to have health saving accounts. And there are many other potential ways to address the problem at low cost.

The USA Needs a More Positive Message on Immigration

The USA Needs a More Message on Immigration here is my attempt:

Americans descended from a bunch of rejects. Religious rejects including the puritans, baptists, Quakers, Anabaptist, English Catholics, Russian and Polish etc. Jews. The bottom of Irish society from during the potato famine, a little latter economic migrants from the bottom of Italian society and blacks from the bottom of African society, mostly war captives which tend to skew low stats, brought here in chains. More lately Mexicans and Central Americans .

They have all given us great things and made the USA great.

The religious rejects gave us our moral and governmental foundations.

Blacks brought here in chains, gave us and the whole world great music; gospel, jazz, blues, rock and roll. The world would be a poorer place without such and they added great grace, skill and style to athletics.

Italians and Mexicans improved our food. (Food in the UK is bland and bad.)

The Jews have excelled in science giving the world great things.

The Irish built up our police and fire forces.

Even those who just work blue collar increase the division of labor and help us cover our national defense.

Education and PISA

If this is accurate it is quite an indictment. 

But, the kind of classes they set up, they were like 30 people signing up for a job retreat[?] to teach you have to be a lineman for one of the utilities. Well, okay, so they go through the training and they get certified; and it turns out maybe there's maybe 2 jobs available for the 30 linemen, that all these people have put in the time, the money, the effort--

I'm a believer in Arnold Kling's null hypotheses on schooling, we have been trying to teach students more and largely failing. I think we should rather try to teach students more valuable stuff. In the above example had they taught the students plumbing, electrical, auto-mechanics. carpentry, cooking, home design, etc. at least the students would have been better able to maintain there own stuff and live on less money.

If what is taught  is more important than how much is taught, how do we measure success?
If the USA performs best in schooling which it might, maybe we have room to maneuver?

What does this say about charter schools and private schools, home schools and school vouchers? They seem to not produce better scores on the PISA and other standardized tests.

I Almost Cannot Believe How Bad the Questioning was in this Interview of Bernie Sanders by Joe Rogan

Here's what I object to.

Let's start with the drug stuff:

First, I am a patent skeptic. It seems me that the patent system might not be worth the costs and especially now in pharmaceuticals, but I found the discussions of pharmaceuticals to be one sided.

The people who invested in developing pharmaceuticals (and that includes those who invested in stock of pharmaceutical companies and pharmaceutical companies in research and marketing) with the understanding that they would be allowed to charge what the market would bear, get no mention. And it real does not matter how much or how little they I put into development, the agreement was what it was. But no questions in that direction form Rogan.

Now I believe that we should discuss ending patents, that would be no more giving of patents after some date but no questions about that either.

Sanders says that the new drugs are mostly me too drugs. If the new drugs are mostly me too drugs, as he says, then people should buy the generics that are off patent, and the current system is fine. That's somewhat contradictory, you'd think an interviewer would ask about that.

BTW Drug prices usually fall when drugs go off patent. Over 84% of drugs that Americans buy today are off patent.The prices often fall 80% or 90% when the drug goes off patent.

Deaths of Despair

Sanders talks about deaths of despair due to low earning opportunities.

New Hampshire was the highest earning state in 2016 AND number 2 in opioid OD deaths. Dear Angus Deaton with all due respect you might consider reassessing your deaths of despair theory. It never made much sense to me, there is in fact some evidence that people drink and drug more when they have more income and therefore access to booze and drugs, which is BTW a problem for my advocacy of legalization but I think the positives would out weigh the negatives.  

New Hampshire is one of the wealthiest sates and low in inequality too, if it's deaths of despair, how is New Hampshire is number two. You would think an interviewer would ask about that gaping hole in Sanders' story.

College Debt

Sanders goes on about college debt.

College debt is federal Government created problem. As far as college debt if you treated college loans like other, loans dischargeable in bankruptcy, have the Government stop guaranteeing them:

• Then no one will lend eighteen year olds so much money
• Then colleges will reduce spending and lower tuition
• Then fewer marginal students will go to college
• Then culture will change and students will live four to a room. 

But none of that in the line of questioning. 

US Schools

Because the selection effect is so powerful in education we don't see it but a stron rational argument could made that the USA has best education in the world (See: The Amazing Truth About PISA Scores: USA Beats Western Europe, Ties with Asia) and BTW Florida has the best education among the USA states (Florida Number One in School Measure).

Rogan let's Sanders say just clearly wrong stuff through the interview almost everything else Bernie says is wrong and no follow up. Rogan kisses up to Sanders like he wants to the next Barbara Walters, who got interview powerful people because she would not ask though question except those that the powerful people knew that they needed to answer.

Bernie used to be a communist, now he is just a guy trying to get elected. He is one of the few national level politicians who are worse than Trump. 

Student Debt

To address student debt we need to move toward a point where we treat college loans like other loans. That is make them dischargeable in bankruptcy and stop Government from guaranteeing them. Then no one will lend students so much money, then colleges would reduce spending and lower tuition, then fewer marginal students would go to college, then culture will change and students would live 4 to a room (oh the horror).


Colleges could spend much less per student , some already do, and would if the money was not there.

In 2015–16, total expenses per full-time-equivalent (FTE) student were higher at private nonprofit 4-year postsecondary institutions ($56,401) than at public 4-year institutions ($44,009) and private for-profit 4-year institutions ($16,208).

They Have Always Lived Longer than Us

Advocates of single payer heath insurance for the USA often tell us that life expectancy is greater in the Scandinavian countries where they have universal health insurance but some of those countries had higher life expectancy that the USA before they had universal health insurance. The evidence that I've seen indicate that non-medical factors contribute much more to life expectancy that do medical care above the cheap basics of vaccinations and antibiotics and trauma care.

The global average life expectancy today is 71 years. In 1950 the global life expectancy was 46 years. And only two countries had a life expectancy higher than today’s average (Iceland and Norway with 72). My post:

Life Expectancy Globally

Link to tweet
https://twitter.com/MaxCRoser/status/1072974251051896832
https://twitter.com/MaxCRoser/status/1072974251051896832
https://twitter.com/MaxCRoser/status/1072974251051896832https://twitter.com/MaxCRoser/status/1072974251051896832

Could Salt Spray Prove Feasible Geoengineering

Salt Spray May Prove Most Feasible Geoengineering 

There are many ways to try and climate engineer the planet, but many of them are so far-fetched that scientists aren't sure if they would even be physically possible, let alone physically successful. Sea-salt climate engineering (SSCE) might be the most low-tech, and plausible, possibility.
In such a situation, specially designed unmanned boats would plow the seas, spraying salt water into the air. The water would evaporate and leave behind sea-salt particles, which may be lifted into the clouds, increasing their albedo, or reflecting power.

 Maybe it would work.

More Baumol Effect in Schooling and Healthcare

Alex by  Alex Tabarrok answers his critics: 

SlateStarCodex and Caplan on ‘Why Are the Prices So D*mn High?’

I think that the Baumol effect is big but you also need an increase in demand to make it explain the gerat majority (95%+) of the increase in spending on healthcare and schooling.  That is were Governments subsidizing demand contributes. Government does not subsidize demand for cars nearly as much as for schooling and healthcare.

If 95% of spending rise is dues to all the Baumol effect, we should ask what percent of the healthcare cost is direct labor? To look at a non the Baumol effect part of healthcare, drugs, drugs use very little direct labor, are drug prices are falling but very slowly.

So, I think it takes both rising demand and the Baumol effect to explain the increase in spedning.

BUT:

If it is 95%+ Baumol effect, since a lot of schooling healthcare seems to have such low bang for the buck. how do we lower demand AND increase efficiency.

Direct instruction and tutoring seems to work in schooling but there is little move in that direction AND is it totally irrational for a person to increase his life time consumption of non- healthcare stuff by say 12% and only use the most effective healthcare? I don't think that is irrational at all, the UK provides something like that though the NHS, though it provides much more than the one third that would save use 12% of spending. 

BTW there have also been a sharp rise in costs of road/subway construction which is mechanizing fast.

Am I Reading This Right?

Am I reading this right?

 In 2015–16, total expenses per full-time-equivalent (FTE) student were higher at private nonprofit 4-year postsecondary institutions ($56,401) than at public 4-year institutions ($44,009) and private for-profit 4-year institutions ($16,208).

Is the average expenditure per student in US state universities  $44,009/year? That seems so high.

The Baumol Effect on Schooling and Medicine

Alex Tabarrok with colleagues has done some research on the rising costs of healthcare and schooling and written a book available free online. Why Are the Prices so D*mn High.

He also did a blog post on the The Baumol Effect on Schooling and Medicine.

My comments:

What he says and seems correct to me is that the marginal cost of healthcare and schooling has gone up, and yes Government subsidies have made it worse. I think he is saying is that we are buying more healthcare beyond the growth in productivity. Some people assume that there is no productivity growth but there is, but we are spending more because we have more to spend and we desire to spend more so total spending is rising.

This hypothesis merges nicely with Robin Hanson's idea that we buy more healthcare in part to show how much we care, so we are now buying healthcare beyond the point where it even improves health, just because we want to spend more to show how much we care.

So in schooling, today we have youtube and easily available educational videos with great teachers available for free, which is great productivity growth, but if a live teacher helps even a tiny bit over an online lecture we are willing to pay for it and so spending is rising.

A few examples of this in action is:

The great economist Alan Bennett Krueger's research showed no benefit of Ivy league schools over state schools but parents are willing to pay big bucks to get there child in and through Ivy league schools. (I think so they can get a little more to brag about.)

Even in k-12 people spend more to get a home in a good school district even though it seems to make little difference in measurable educational attainment. 

In healthcare we'll pay a lot to get the MD we want, and if a live MD is perceived as giving any benefit at all over telemedicine we will pay for it.

Also they will screen fragile 85 year old women for breast cancer etc. even though any treatment is likely to kill the patient.

If you wanted to improve poor people's health there are much better places to do that more and better police, safer cars, than access to healthcare yet there is a big push for more healthcare.

Venezuela, Crime and Poverty

I don't know whether to believe the story or not (It is an AP story) but if it is true does it say anything about poverty and crime and causality?

The feared street gangster El Negrito sleeps with a pistol under his pillow and says he’s lost track of his murder count. But despite his hardened demeanor, he’s quick to gripe about how Venezuela’s failing economy is cutting into his profits.
Firing a gun has become a luxury. Bullets are expensive at $1 each. And with less cash circulating on the street, he says robberies just don’t pay like they used to.
For the 24-year-old, that has all given way to a simple fact: Even for Venezuelan criminals it’s become harder to get by.
“If you empty your clip, you’re shooting off $15,” said El Negrito, who spoke to The Associated Press on the condition he be identified only by his street name and photographed wearing a hoodie and face mask to avoid attracting unwelcomed attention. “You lose your pistol or the police take it and you’re throwing away $800.”
In something of an unexpected silver lining to the country’s all-consuming economic crunch, experts say armed assaults and killings are plummeting in one of the world’s most violent nations. At the Venezuelan Observatory of Violence, a Caracas-based nonprofit group, researchers estimate homicides have plunged up to 20% over the last three years based on tallies from media clippings and sources at local morgues.
Officials of President Nicolás Maduro’s socialist administration have drawn criticism for not releasing robust crime statistics, but the government on Tuesday gave the AP figures showing a 39 percent drop in homicides over the same three-year period, with 10,598 killings in 2018. Officials also report a fall in kidnappings.
The decline has a direct link to the economic tailspin that has helped spark a political battle for control of the once-wealthy oil nation.

I once read a UK police official who said crime goes up when the economy is good because people drink more.

Some democrats used to contend that the way to reduce violence directed at the USA from the middle east was to stop buying petroleum, presumably so they would be so poor that they could not buy tickets to fly to the USA. BTW I never believed that idea and still do not.

The News Media's Main Goal to to Attract Eyes for Advertisers

Always keep in mind that the News media's main goal to to attract eyes for advertisers. Better to read the academics who actually study the subject. BTW If you think the academics are all far leftists nuts it is because of the reporting of News media, most of the academics are down to earth in their area.

My guess is that you’ve heard that famous result from a recent Federal Reserve survey of Americans: Four in 10 adults in 2017 would either borrow, sell something, or not be able pay if faced with a $400 emergency expense. That’s the exact wording of the Federal Reserve Board’s report of the results of its survey.

...

Question EF3. Suppose that you have an emergency expense that costs $400. Based on your current financial situation, how would you pay for this expense? If you would use more than one method to cover this expense, please select all that apply.

Check the results as reported in the Appendix or as reported by Reynolds. (He reproduces their table.) 36 percent of people answered “Pay it on my credit card and pay it off in full at the next statement.” That would be my option: I want the air miles. 50 percent of people answered “With the money currently in my checking/savings account or with cash.” We can’t simply add these two numbers to get 86 percent because the survey, as noted, gave people the option of using more than one method.

So here are some headlines reporting on this:

CBS:

Nearly 40% of Americans can't cover a surprise $400 expense

CNN:

40% of Americans can't cover a $400 emergency expense

CNBC:

Millions of Americans are only $400 away from financial hardship.

Fox Business:

Shocking number of Americans can't cover $400 surprise expense

Bloomberg:

Almost 40% of Americans Would Struggle to Cover a $400 Emergency

NY Times:

Many Adults Would Struggle to Find $400, the Fed Finds

 

Better to read the academics who actually study the subject. If you think the academics are all far left nuts it is because of the reporting of News media, most of the academics are down to earth in their area of expertise though outside their area they tend to be a little leftist nuts because they read the media above.

 

We Can Get More Poverty Reduction for Less Taxes.

Areas where we help the poor more and spend less tax money:

1. Replace TANF, SNAP, Social Security, housing subsidies etc. with an NIT
2. Replace Medicare and Medicaid with High deductible health insurance with deductible based on income.
3. Even if we do not do number 1 above, change our largest welfare program, Social Security to stop giving more to high life time earners and give everyone the same like they do in Australia.
4. We should force local Government to allow sufficient building so people can move to were the jobs are. It is an infringement of rights for local voters to limit the rights land of owners to subdivide and build housing. The default should be to allow all residential building. Note there are a very few occasions were it is justified but you need very good reasons.

Which of these are Republicans or Democrats for?

On a Negative Income Tax

I'm updating this because Ed Dolan convinced me that what I describe is really not a Basic Income Guarantee (BIG) but Negative Income Tax (NIT).

People are contending that the Negative Income Tax (NIT) would cost more than the current system but if you design it as outlined below it would save money.

Each  adult US citizen would get $200/week. To lower the cost you would:

• Raise the tax rate on lower income people to consume the BIG more rapidly, low earners currently pay no income taxes. Income up to $26,000/year tax rate would be taxed at a 40% rate. So at $26,000/year of earnings the net effect of the BIG on their income would be zero. The tax rates on income above $26,000/year would then drop to the current rate and rise as the current rate does from there. 
• With the BIG you eliminate SS.There is Absolutely no need for SS with a BIG! Also you would eliminate the minimum wage.
• And you replace Medicaid and Medicare with something like this:

The state would provide insurance to all Americans but the annual deductible would be equal to the family’s trailing year adjusted income minus the poverty line income (say $25,000 for a family of 4) + $300. So a family of 4 with a trailing year adjusted income of $30,000 would have a deductible of $5,300. A family of 4 with a trailing year adjusted income of $80,000 would have a deductible of $55,300. Middle class and rich people could fill the gap with private supplemental insurance but this should be full taxed. This would encourage the middle class and rich, who are generally capable people, to demand prices from medical providers and might force down costs. They could opt to pay for most health-care out of pocket while the poor often less capable would be protected.
It is not a perfect plan but it might help. Some deregulation of health-care would also help the poor gain access. The gauntlet that Doctors have to run these days to get to practice seems like an anachronism in today’s world. Let smart people get to practice medicine after on the job training. Let the medical businesses decide who is qualified to practice medicine. 12 years of training to tell if my child has an ear infection is overkill and reduces access to health-care for the poor.
Another benefit of my plan is that it would encourage capable Americans (the rich and middle class) to be a counter weight politically against the providers.

Of course our politicians are too corrupt to set up such a program but any discussion of a NIT is pure theory anyway.

All of our debt and inefficiency problems come from rationally ignorant voters and corrupt politicians. With rationally ignorant voters, politicians almost have to be corrupt of ignorant to get elected.

NOTE: You would still need programs for the very disabled. but they are few enough that the problem is manageable.

NOTE: US Democrats seem to think the Europeans have a better welfare system than we do, and that may be true, but ours and theirs seem unnecessarily inefficient. An NIT might give the USA the world's best welfare system.

My Updated Healthcare Compromise

This is my new compromise between advocates of government provided health insurance and those against. My earlier version may have had a flaw incentive wise so I am changing it. This version moves close to that put out by the Niskanen Center see here.

The state would provide insurance to all Americans but the annual deductible would be equal to 60% of each family’s trailing year adjusted income minus the poverty line income (say $25,000 for a family of 4) + $300. 

Why 60%, because some research by the Democrats has shown tax revenues are maximized at 70%, meaning most people will not hugely cut back at working at up to a 70% marginal tax and the current top rate in some states is about 50% already. I took the mid point between the two at 60%. 

So a family of 4 with a trailing year adjusted income of $30,000 would have a deductible of $5,300 * .6 or $3,180. 

A family of 4 with a trailing year adjusted income of $80,000 would have a deductible of $33,180. 

Middle class and rich people could fill the gap with private supplemental insurance but this should be full taxed. This would encourage the middle class and rich, who are generally capable people, to demand prices from medical providers and might force down costs. They could opt to pay for most health-care out of pocket while the poor often less capable would be protected. 

 

It is not a perfect plan but it might help. Some deregulation of health-care would also help the poor gain access. The gauntlet that Doctors have to run these days to get to practice seems like an anachronism in today’s world. Let smart people get to practice medicine after on the job training. Let the medical businesses decide who is qualified to practice medicine. 12 years of training to tell if my child has an ear infection is overkill and reduces access to health-care for the poor. It appears that medical care could much cheaper than it is, see here.

Another benefit of my plan is that it would encourage capable Americans (the rich and middle class) to be a counter weight politically against the providers.

Also it seems worthwhile to me to maintain flexibility in the system. Our slightly more freedom oriented medical  systen looks not so great right now because we spend more than the other developed countries but things are still changing and our more flexibility may start to pay off at some point. 

Here are some possible avenues for that flexibility to pay off:

• Direct Primary Care (DPC) also called Concierge Medical Care. I've been reading good things about this recently.
• Medical Tourism groups like the Amish already do some of this already, and maybe surprisingly so do people from countries like the UK with Universal health insurance coverage. 
• Dean Baker's idea of allowing foreign providers to come into the USA market.

One, all or none of these things might workout and others not mentioned but it is worth maintaining some level flexibility and freedom.   

Here is an article that makes a strong case for a system similar to the one that I propose.  His plan suggests a  insurance for catastrophic events that cost more than, $50,000 combined with a large health savings account.

In addition since Government provided health insurance is paternalism it should provide insurance that experts would recommend and that means among other things insurance that only pays for care that shows a significant margin of cost benefit. So it should not cover procedures that the UK's NHS does not cover. There would be huge savings there.

Government Provition of Daycare

Government provision of daycare seems an oddity to me

I once asked a few single mothers I worked with, if they would rather have $x/week or free daycare. I varied x from $10 to $100.  Some said that the would not use the daycare even if it was freely available without receiving any money at all. The average preferred about $20 cash per week to free daycare. There is no way a government could provide daycare for $20/week. I've seen estimated costs as high as $400/week and I don't think I've ever seen numbers below $200/week. On top of that 56% of women with children under 18 say they would prefer to stay home and care for their children.

So why do some countries provide it rather than giving cash? Below are some possible reasons, some of which people might not want to admit:

• They believe low income people are such bad parents that government provided daycare will help the children become better adults.
• They are afraid that if given cash the parents would spend the money on themselves.
• They don't want to give cash because they do not want to be seen to be paying people to have children.
• People don't understand that government paid for things have costs. 

There may be other reasons but these are what come to mind. 

A Rational Argument Could Made that the USA has Best Education in the World and Florida has the Best Education in the USA

Because the selection effect is so powerful in education we do not see it but a rational argument could made that the USA has best education in the world (The Amazing Truth About PISA Scores: USA Beats Western Europe, Ties with Asia) and Florida has the best education among the USA states (Florida Number One in School Measure).

But if you ask me, I will tell you that there are not significant differences in overall schooling quality in the developed world.


In fact I think a slight modification of of Arnold Kling's null hypothesis in schooling is accurate.

Playing off Arnold Kling's Clarifying his Null Hypotheses on Schooling

Note, this does not mean that we cannot improve education education over time as techniques improve that can be applied that do improve education but they spread very fast in the developed world and we see no significant differences.

Of course there are some good techniques that do not spread. One technique that works but has not spread is direct instruction, it has not spread because teachers and students hat it. Also a singular focus on the three R's might work but is not tried for the same reason.

It is not bad that those techniques do not spread, childhood should not be all about education.

Could Sending the Money to State Governments Push Healthcare Spending Down?

I think it is possible to lower healthcare spending dramatically without loss in health (see here: Article Contends Healthcare could be 80 to 90% Cheaper Based on Direct labor Costs And here Cut Medicine in Half

But what incremental steps could get us moving in that direction? One Idea I had was for the Federal Government to send all the money they would have spent on healthcare to the states and require that the state Government's cover the elderly and poor. The money would be sent on an age adjusted per capita basis.The state Governments would be allowed to spend the money as long as they choose cover those over 65 years old and the poor, as Medicare and Medicaid do today

Arizona and Utah have much lower medical spending than do Massachusetts, New York and California so they might be able to cover everyone in the state without adding money.  There is a lot of bad regulation of medical care at the state level. The states that spend the most would have to augment the federal money with their own tax money and the states that spend the least could use the excess wherever they choose.

The states do most of the healthcare regulation  and a lot of regulation is bad. This would motivate the high spending states to regulate with more of an eye toward keep spending down.

What Anthropogenic Global Warming Alarmists Should Acknowledge

The Anthropogenic Global Warming alarmists should at least acknowledge how wrong popularly seen and read environmentalist were in the 1970's, and distance themselves from such.

Paul Ehlich was  a regular on the Tonight show and though the real scientists specialized in the area of environmental studies (Ehlich is a butterfly scientist) at the time were not so alarmist, it was the alarmist who got the publicity.

Considering that it is quite understandable that people be skeptical of alarming claims. Even today it seems to me that there is a huge gap between what the real scientist on the IPCC and the likes of Al Gore are saying.

It is dangerous to try to scare the voters into action with projections that are very likely to be undershot by a huge margin.

I believe that co2 is causing AGW and that at some point we will better of addressing it, but it seems to me that there is still plenty of time.

Let's stop demonizing the deniers and work on educating them.