Philip Contos: at least he died in his freedom

"The care of every man's soul belongs to himself. But what if he neglect the care of it? Well what if he neglect the care of his health or his estate, which would more nearly relate to the state. Will the magistrate make a law that he not be poor or sick? Laws provide against injury from others; but not from ourselves. God himself will not save men against their wills." - Thomas Jefferson

Contos was riding his motorcycle, without a helmet specifically to protest laws requiring one, and died in an accident. He accepted the risk and harmed no one but himself. If he had plowed into a crowd of schoolchildren, or flipped through a car's windshield, a helmet would have made no difference.

There are many who deserve a Darwin Award, and many who I wish would hurry up and earn theirs before they kill someone else. Contos isn't one of them, though. It is irony that a helmet might have saved his life, but he wasn't doing anything egregiously stupid. There are many who don't wear helmets and yet survive, and enough who wear helmets yet die. Accidents happen. Did T.E. Lawrence or George Patton deserve Darwin Awards? Certainly not -- people have died in vehicular accidents for thousands of years, ever since we learned how to tame animals.

Darwin Awards go to real jackasses like this goddamn idiot, especially because he took someone else with him.

Anything government can do, the free market can do better, part II

Over at QandO, McQ blogged about New York City forcing a tobacco shop owner to remove its $9000 coffee machine, because the shop doesn't have a food license.

Skorj left a comment, "I think it’s totally reasonable that the government can impose safety regulations, including requiring food handlers’ certs, whenever food would pass between you and a stranger – even in a soup kitchen."

No. Not even that much, as I pointed out in my reply: "Skorj, if you don’t like how someone prepares your food, then you have the freedom not to go there. However, someone else may not mind, so don’t infringe on their freedom to do business with whom they want."

Regular commenters Steverino and looker, for all their talk against big government, don't see that they still don't mind feeding the beast. Being state-worshippers, they advocate standards: government-enforced standards. As I said a few nights ago, you don't have to be Paul Krugman to worship the state. You need only believe the falsehood that we need government to accomplish certain (good) things. Their argument is that the private sector can't enforce standards, which in and of itself is true. The private sector has no power to force a business to close. Private citizens cannot legitimately make a shopkeeper cease business, or imprison and/or fine him if he does anyway.

But their fallacy is that since the private sector cannot do something, then government must. This is not true in the least. They also don't understand my point about not forcing standards on anyone. The private sector's powers are to let competition and consumer choice work unhindered so that standards can come into existence on their own. It would mostly be a matter of trust: sellers would have earned reputations, good or bad. Also, within the private sector, it's perfectly possible for a trusted entity be relied on for judging others, even though it doesn't have the force of government. McQ kindly reminded us of Underwriters Laboratories, and I pointed out McAfee's website certification.

My key rebuttals:

Most establishments are clean enough, but not because of law. It’s because our wealth, courtesy of capitalism, allows us to be clean without much cost, and it’s to a restaurant’s best interest to maintain a reputation — or at least not develop a bad one. Most everyone in New York heard about that KFC with the rat problems. The government didn’t need to shut them down, because they’d have shut down from a lack of business.

...

Cleanliness is a good thing. A government that tries to enforce “cleanliness” via arbitrarily standards is not a good thing. But I already knew you worship at the feet of the state. You might talk a good line on this and that, but in the end you rely on what law provides you.

...

It’s [government] not enforcing standards. It’s the myth that the standards can be enforced all the time. So people grow reliant, and they presume that any place they walk into will be ok. More often than not, they’ll be fine. It’s that occasional occurrence, however, that proves the state’s inability to protect us.

The problem with your reliance on government-set standards is a form of the so-called “market of lemons.” Akerlof’s basic argument applies here in the sense that government enforces — or pretends to enforce — a minimum standard of quality. You’re now expected to assume that any given food handler is clean, however, you don’t really know that. Government has said, “Any used car sold must be in certified good mechanical condition,” but buyers can no longer properly judge what’s worthwhile and what is not. They can’t tell if a seller is pulling a fast one, unless they inspect for themselves.

Look at the outbreaks the FDA failed to prevent. Do you understand now why they occurred? Because people gave trust that was not truly earned, and some died because of it. “The government wouldn’t allow this to be sold if it weren’t safe.” Instead of checking how and where a toy was made, parents bought all the toys with lead-containing paint. The plain fact is that government cannot enforce the “standards” you cling to, which creates (in food, transporation and a host of other things) a false sense of security.

...

In a free market, sellers of goods and services would be too scared to give anything but their best. They wouldn’t dare let anything slide. They would compete not on the basis of meeting some standard set arbitrarily by a government official, but on the basis of reputation: which one is setting the highest standard (service, trustworthiness, etc.) becomes the standard by which everyone else is measured.

My employer is one of the most respected firms in the financial industry, and we exceed every “standard” the government sets for transparency and accountability. That’s because we want to compete so effectively that we’ll be considered THE standard.

But as I said, when you have government supposedly enforcing standards, it can never do so as effectively as the free market. Government’s “standards” are set by politics and ignorance, by the bureaucrats who make arbitrary decisions and/or don’t know the industry. The “standards” are met without too much difficulty by many participants (this truism is proven by modern history), thus making “standard” a very low bar to clear. It might put enough fear into food handlers, but fear of government punishment is never as great as fear of losing your customers. If you really were in the restaurant industry, you’d know that a place needs a helluva track record to be shut down. Otherwise, well, fines may be issued but are rarely publicized more than obscurely.

The Old West is popularly imagined as a violent society, but it was actually a very polite one. If you shoed someone’s horse poorly, no one would trust you anymore unless you redeemed your name, or unless you charged so little that a customer knew he would get what he was paying for. Even then, you might get shot by someone’s friends if your customer got thrown after his horse lost a shoe. There were no “standards” enforced, so every seller of goods and services was extremely careful to do a good job.

There was a lot of dancing around the fundamental issue of freedom, which I brought us back to:

How is it YOUR right, or anyone else’s, to prevent that transaction? You’re being nothing more than a busy-body, trying to save the buyer from himself. It’s his right to be stupid: you can try to persuade him from something that harms himself and no one else, but you have no right to force him.

Looker asked, "who has the authority to tell you to cease and desist in a completely government free market." It's easy to figure that one out. My reply:

The individual has the authority, either by not returning or not going there in the first place.

As an individual, you have the power to shut down any business — to the extent of your own business with it, and that should be the extent of the “authority.” Do you see that what you and Steverino are advocating is that one person or a few individuals can act on behalf of “society,” forcing a business to shut down just because some people don’t think it’s good enough? Neither of you have yet addressed the fundamental question: by what right can you to force people to do business only by your standards and not their own? If they agree to a peaceful, private transaction that harms no one else, what is it to you?

You argue, in essence, that people might not know a place is dirty. What, though, if someone fully knows what he’s buying and wants it anyway? Whether he’s ignorant or deliberate, you can try to persuade him, but do not force him. If he refuses, then what is it to you? It’s not harming you or anyone else. Let him go his own way and don’t lose any sleep.

There are people who can’t sell particular kinds of meat, or even butcher it for their own use, because of “health codes.” Unfortunately it’s been argued on the basis of “religious freedom,” instead of on the basis of freedom, period.

...

Without health codes, people would scrutinize establishments more carefully. They’d rely on newspaper reviews and Zagat ratings, perhaps late night news segments about the latest dirty restaurant.

Do you see the paradox that Michael and I have been trying to tell you? When government enforces standards, it in fact does not make anyone implicitly trustworthy, but rather makes it dubious that any given entity is truthfully adhering to the standards. Government can never be effective in making sure everyone follows the rules. There are health code violators no matter what government tries, just like it can never rid the road of bad (let alone drunk) drivers.

Looker also asked, "Can we really go back, especially in the case where many people can be, for want of a better term, poisoned, to Caveat Emptor?" I replied affirmatively:

We not only can, but we must. It’s the only way for a free people to live. And it won’t be some Stone Age world; you’re just not giving capitalists enough credit. It would be an opportunity for the smart ones to bill themselves as the cleanest operations.

I’ve seen signs in Third World fast food joints touting their “Clean restrooms,” and they were. In fact, they were in better condition than most in the States. We take such things in the U.S. for granted, not because of laws, but because our greater wealth already made possible what laws later mandated.

Now, “caveat emptor” is half inaccurate because it implies that sellers may suffer no consequences. Buyers should beware, but as I’ve been pointing out, a free market has solutions for people who harm others. If you sell me a pie that you advertised as “cherry” but it contains small stones, then regardless of what “warrant of merchantibility” laws are on the books, I regard it as implicit that the pie won’t break my teeth.

I will again quote Bastiat:

Do those worshippers of government believe that free persons will cease to act? Does it follow that if we receive no energy from the law, we shall receive no energy at all? Does it follow that if the law is restricted to the function of protecting the free use of our faculties, we will be unable to use our faculties? Suppose that the law does not force us to follow certain forms of religion, or systems of association, or methods of education, or regulations of labor, or regulations of trade, or plans for charity; does it then follow that we shall eagerly plunge into atheism, hermitary, ignorance, misery, and greed? If we are free, does it follow that we shall no longer recognize the power and goodness of God? Does it follow that we shall then cease to associate with each other, to help each other, to love and succor our unfortunate brothers, to study the secrets of nature, and to strive to improve ourselves to the best of our abilities?

So now Mike "Fuhrer" Bloomberg is crusading against salt

I've previously wished ill upon Bloomberg for pushing the trans fat ban, and now he's going after excessive salt in food. Here's my comment at my friend Karol's blog, replying to someone who said, "But obviously no one else is going to fix it."

Tanya, you're perfectly capable of fixing "it" for yourself. You're evidently capable of discovering that certain foods are not as healthy as they seem.

Instead of you and Bloomberg using government to force people to be healthy, then why don't you write a plan for Bloomberg to teach people about excessive salt, and he can fund it with $1 billion of his own money?

Should government protect people from their own stupidity?

"They may wonder about the proper course. But I am convinced that here, as in all other areas of public policy, the just and efficacious solution is liberty." - Rep. Ron Paul (R-Tx), MD.

This BusinessWeek Online article talks about the alleged danger of the increasingly popular Adjustable Rate Mortgage. It cites several anecdotes of people who didn't realize what they were getting into and, frankly, should have known better: always read the fine print.

"Those who took the bait" -- as if we were dealing with instinct-driven fish, instead of living, breathing capable of intelligent thought. There's the old caveat that "if something seems too good to be true, it probably is," but that doesn't apply here. The lenders aren't scamming anyone, and people should realize almost instinctively that if their mortgage payments are reduced, there will likely be a catch sometime in the future. Didn't Gordon, the Sacramento police officer, stop to question what was happening when his monthly payment went from $2443 (assuming a $500K house, 10% down, 30-year fixed-rate mortage at 5.1%) to $1697? What about Harold, who refinanced his home and seems to be quite aware of the future payments he can't afford? What was he doing?

"But others, caught up in real estate mania, ignored or failed to appreciate the risk [of ARMs]." Why must the rest of us be condemned when we were smart enough to pay attention to the Federal Reserve's actions, and to seek clarification from anyone possible so we would know exactly what we were getting into?

"There was plenty more going on behind the scenes they didn't know about, either: that their broker was paid more to sell option ARMs than other mortgages; that their lender is allowed to claim the full monthly payment as revenue on its books even when borrowers choose to pay much less; that the loan's interest rates and up-front fees might not have been set by their bank but rather by a hedge fund; and that they'll soon be confronted with the choice of coughing up higher payments or coughing up their home." However, these are irrelevant, as are the allegations of deceptive accounting practices, to the real issue: the borrowers were never forced into the deal, nor were they denied opportunities to understand every ramification. Do you buy a car from a dealership based on how much the salesman will make in commission, or based on how good a deal it is for you? Do you worry about the particulars of the relationship between the dealership and its loan financing company, or do you only care about the interest rate?

The article tries to imply that the financial sector's usage of ARMs is shady or improper, but it's no different than someone selling a bond for ready cash to a buyer who's willing to assume the risk that the borrower may not repay the full balance. Mortgages, primarily fixed-rate ones, are often used as assets in mortgage-backed securities for certain investors to buy. Such transference of risk has happened for a long time, and the investors, like mortgage borrowers should be, are well aware of the risk. Similarly, certain hedge funds may be snapping up ARMs, but buying heavy-risk investments is what they do. They'll pay banks a certain percentage of the loan's total value, counting on enough borrowers to pay back the loans successfully so the hedge funds will make an overall profit. What they're not counting on is people defaulting: they're not in the real estate business, so mortgage holders will auction a seized house as quickly as possible for whatever they'll get. Rarely will they break even, let alone exceed the balance still owed, and some states also don't permit banks (or whoever the mortgage is payable to) from making a profit on foreclosures.

Some people feel that government should regulate ARMs more strictly, although not what financial firms do with them afterward. These people, as the article describes, want government to regulate ARMs' availability to the borrowers. I ask, are people unable to read through a legal document and understand it thoroughly? Are they too cheap or lazy to pay an accountant a few hundred dollars to give them an amortization table and explain every implication? Shouldn't they be intelligent enough to realize that this isn't something they can just return to the store when they find it doesn't work for them?

Some, like Paul Krugman, believe that government must insulate people from life's risks. Libertarians and true conservatives oppose that primarily from a moral, freedom-based perspective, but we also note that such protection doesn't make economic sense. Government has no true ability to protect people: it can only force people to protect themselves, at higher costs to themselves, though some people perfectly accept the risks and don't want to assume those costs. Sometimes a higher cost is not getting the product or service you wanted, not because of availability in a free market, but because government policies have made it so expensive that they priced it out of your reach. Perfect examples are live-saving medicines and medical procedures that are illegal in the U.S. without the FDA's say-so: FDA approval involves delays, which kill people who could have used the medical breakthroughs, and higher prices because of all the jumping through bureaucrats' hoops, which kills people who can't afford the increase to the drugs' prices.

"[The lenders] know they're selling crap, and they're doing it in a way that's very deceiving," said the Sacramento policeman. Well, one of my friends and his wife have an ARM, and it's been great for them. They were smart enough to make much higher payments when interest rates were low, so when interest rates rose, they already had paid off a lot of principal and weren't hit as hard. But how would they be affected if government decided to start "protecting" people from ARMs? Let's consider some scenarios.

1. Mandatory disclosure of all details before closing, so that people know what they're getting into. But that already happens, and in black and white too: borrowers aren't prohibited from reading the contract, which lays out every detail.

2. A mandatory sit-down with a bank official, who will explain the risks involved. Most people, however, would go through this like they're back in school: with glazed eyes and short attention spans.

3. Mandatory consultation with an accountant. But my friends clearly didn't need this, so it would only make them waste money. Even if the law required banks to pay the fee, who's stupid enough to think the bank wouldn't somehow pass it on to the borrower? Perhaps there could be an option to waive this, but then what's the point of a law requiring it? Moreover, people would sign a waiver indicating they understand all the risks, yadda yadda, only to claim later that they weren't fully informed.

4. Legislation restricting the number of ARMs (perhaps as a percentage of all mortgages issued), or restricting them to to people who meet a certain debt-income ratio. But what of people who don't happen to win the inevitable "lottery" for ARMs, or who can't meet the arbitrary requirements, notwithstanding that they know what they're doing?

It's a nice thought that government policies can reduce the risks of life, but protecting a few people denies the rest their freedom to assume risk, and it's economically inefficient anyway. Without exception, government's "protection" makes it more expensive for everyone: the stupidity of some becomes unnecessarily higher costs for everyone else. Think about this the next time your car passes a safety and emissions inspection with flying colors, the next time you buy agricultural products that had to be inspected before you could buy them, or the next time you're stopped at a "sobriety checkpoint." Each of these, and countless other examples where government interferes in our lives, involves a pound of prevention to get an ounce of cure.

The freedom to assume risk

In its benevolence, government at all levels has uncountable regulations and statutes just for what we ingest. It's the tip of the iceberg that the FDA's legions must approve pharmaceuticals and inspect and/or supervise food production. New York City, for example, has decided that milk's usual expiration dates are too long. Once fluid milk is pasteurized, it's legal to sell it only within 96 hours of 6 a.m. on the next day (which is about three days earlier than what most dairy producers stamp on the containers). I have never heard an explanation for this that satisfied me. This New York Times article quotes an "Assistant Commissioner of the Department of Health" as saying, "There are too many variables, and we have no guarantee that proper care has been taken." In other words, just like Ronald Reagan warned, that guy is from the government, and he's here to help you.

Do delis not keep their refrigerators cool enough, in an effort to save money, making their milk riskier? (The doors are also opened and closed so frequently that a constant temperature is virtually impossible to maintain.) Does the city government not trust the trucks' refrigeration systems? Who knows. What I do know is that I'm intelligent enough, and my olfactory senses are of sufficient acuity, that when I open the bottle or carton, I can usually tell if it's spoiled. If there are curdles when I pour it out, yeah, most anyone would know it's gone bad.

Moreover, businesses build success upon gaining consumers' trust. Thus I generally will trust an established dairy's expiration date, and more so if I buy it in a reputable store, until I'm given reason to avoid it. If I keep my refrigerator on the coolest setting, but a certain brand still consistently sours very soon, then I'll simply stop buying it. A&P's milk is fine, but I don't like the Byrne Dairy milk that I occasionally picked up at Rite Aid. It could be the milk, the transportation, or Rite Aid's refrigerators. I don't know, nor do I care to find out: for me, it would be a very heavy cost in time to determine why. Since I rarely bought milk at Rite Aid anyway, it's cheaper that I buy only other brands at other stores.

Let's talk some more about trust. People apparently trust Arlie Stutzman, an Amish dairy farmer, to the extent that they buy his raw milk in unlabeled containers. Some participate in his "herd share," receiving milk in return for paying for cows' upkeep. The fact that this commerce is completely voluntary and harms no one is not good enough for the Ohio Department of Agriculture, who entrapped Stutzman in a sting operation. According to Jeffrey Quick, Stutzman got his milk license (a license is when the state gives you permission for something you already have a God-given right to do) back in April, but his latest court appearance is for running a herd share.

That's irrelevant, though, and with all respect to Stutzman, so is his defense based on "freedom of religion." The freedom to "share" (actually a better word is sell or trade) is not grounded in religion. Indeed, it's a dangerous precedent to base a basic right on freedom of religion. It's almost like Stutzman and his lawyer are grasping for straws, when they should argue something more fundamental. Then again, maybe they fall back on religion because the proper argument would be lost on most Americans, who have grown up believing government must protect us from ourselves and our mistakes. The real issue is the right of the individual to choose to engage in voluntary commerce that harms no one, free from others (especially government) hindering him. Hindering ranges from outright prevention to regulation, though bureaucrats and their lackeys like to claim that regulation allows you to do the same thing, only under government's direction.

Government tells us that only it can properly educate our children. Government tells us that only it can properly plan (via zoning laws and permits) where we can live and how we may build our houses. Apparently the necessity of state supervision extends to buying milk, too. I always thought it was a simple process, but according to government, only it can protect us from unsafe or fraudulent products -- on the one hand "persuading" us from childhood through public schools' indoctrination, and on the other, coercing merchants through criminal penalties. It does not matter that people buy Stutzman's milk in purely voluntary, peaceful transactions. Nor does it matter that Stutzman does not misrepresent his milk, like selling week-old milk that he claims was milked that morning, or telling them that it's pasteurized. Yet Stutzman isn't promoting his raw milk as anything but an unpasteurized product straight from his own cows. There's his herd, there's his machinery, so what you see is what you get.

Since there is no coercion or fraud, then beyond whatever marketing Stutzman may do, it becomes the consumer's responsibility to discover raw milk's properties and then determine its suitability. Stutzman is not forcing anyone to buy his milk; in fact, he was initially reluctant to sell to the Ohio undercover agent. However, government is ever populated by the socialist busybodies whom Bastiat described in The Law:

Moreover, even where they have consented to recognize a principle of action in the heart of man—and a principle of discernment in man's intellect—they have considered these gifts from God to be fatal gifts. They have thought that persons, under the impulse of these two gifts, would fatally tend to ruin themselves. They assume that if the legislators left persons free to follow their own inclinations, they would arrive at atheism instead of religion, ignorance instead of knowledge, poverty instead of production and exchange.

According to these writers, it is indeed fortunate that Heaven has bestowed upon certain men—governors and legislators—the exact opposite inclinations, not only for their own sake but also for the sake of the rest of the world! While mankind tends toward evil, the legislators yearn for good; while mankind advances toward darkness, the legislators aspire for enlightenment; while mankind is drawn toward vice, the legislators are attracted toward virtue. Since they have decided that this is the true state of affairs, they then demand the use of force in order to substitute their own inclinations for those of the human race.

Instead of Patrick Henry's exhortation that "liberty ought to be the direct end of your government," the members of government establish themselves as a worse nightmare than any micromanaging supervisor or nagging babysitter. It's really time we stopped calling them "leaders," because that only reinforces their fallacious belief that they are They Who Know Better Than Us.

Bastiat would no doubt sigh and shake his head over what our federal government, states and local municipalities do, all in the name of "public health" and "good government," which are euphemisms for "saving the people from themselves." He would remind us of the conclusion of The Law that our Creator hardly left us helpless:

God has given to men all that is necessary for them to accomplish their destinies. He has provided a social form as well as a human form. And these social organs of persons are so constituted that they will develop themselves harmoniously in the clean air of liberty. Away, then, with quacks and organizers! A way with their rings, chains, hooks, and pincers! Away with their artificial systems! Away with the whims of governmental administrators, their socialized projects, their centralization, their tariffs, their government schools, their state religions, their free credit, their bank monopolies, their regulations, their restrictions, their equalization by taxation, and their pious moralizations!

And now that the legislators and do-gooders have so futilely inflicted so many systems upon society, may they finally end where they should have begun: May they reject all systems, and try liberty; for liberty is an acknowledgment of faith in God and His works.

God created man and endowed him with certain unalienable rights, also endowing him with the requisite abilities to acknowledge, use and enjoy those rights. So ask yourself: are you going to deny God's gifts of reason and faculties, or leave the direction of your life to a select few?

Why should you need the government's permission?

Previous:
When government kills people

The FDA has now approved inhalable insulin. It sounds really cool -- I'm talking about the new form of insulin, not the government's approval. There's a great potential to save many lives, because so many patients (I was shocked) didn't want to inject themselves. If anything, I'm sure inhalable insulin will be of great comfort to children who, as I can attest from personal experience (running in terror out of a doctor's office at 5 years old), are often afraid of needles.

Why should any government agency have the power to forbid people to take medicine that could save their lives? Don Ho had to travel to Thailand to undergo a "risky" procedure that strengthened his heart muscle with his own stem cells. The FDA has yet to approve it, and Ho could have well died before government bureaucrats did. As I said before, the state essentiall tells people, "You'll just have to die. We won't let you take this stuff, because it could kill you."

Update: conversely, as I wrote last Tuesday, eleven federal bureaucrats at the FDA are using their power to effectively ban propellant-based inhalers, like Primatene Mist. This affects millions of asthma patients, who must now pay more money (and go through greater inconvenience) to get prescription inhalers. Doctors, of course, love the extra business.

The people who oppose the personal choice to accept risk are the state-worshippers who fallaciously believe government can (not just should) eliminate risk from our lives, like Paul Krugman, who recently said:

...it's neither fair not realistic to expect ordinary citizens to have enough medical expertise to make life-or-death decisions about their own treatment. A well-known experiment with alternative health schemes, carried out by the RAND Corporation, found that when individuals pay a higher share of medical costs out of pocket, they cut back on necessary as well as unnecessary health spending.

(Quote courtesy of Don Luskin.)

The underlying issue isn't whether people have medical expertise: it's whether they have the right to choose. People do tend to make rational decisions. Not always correctly, granted, but that is not mutually exclusive with rational decision-making. If it weren't for the nanny state's bureaucratic mazes to "protect" us, people would revert back to their natural tendency of being careful about a new product. As a medicine's potential health hazards increase, people will more closely scrutinize whether it's worthwhile. The proper role of government is not to approve or ban these substances, but to provide remedies for families who were defrauded or injured. The latter includes criminal negligence.

Isn't government's approval better, though, so that one person doesn't die from dangerous medicine or a risky procedure? Hardly, because more people might suffer and die because their access to the medicine was delayed, not even denied. As I recounted in my entry about Ho, my father chose to use some possibly deadly "clot-buster" drugs after his stroke. They saved his life, but how many more lives could have been saved if previous patients had had my father's choice? Furthermore, the free market provides incentives and remedies. People will tend to avoid risky new medicines that were not carefully tested, and they will judge the risk based on their personal perception of how much they have to lose. On the other hand, it's in companies' interest to test medicines thoroughly, and not just because of product liability suits, but because testing makes the product more attractive.

And by the way, Paul, do you think that "when individuals pay a higher share...they cut back" is a novel economic principle? Perhaps that's something that originated only after the mean Republicans supposedly started trying to take away health care from people. I thought it was elementary microeconomics, and of course Milton Friedman's great principle, that when people can no longer spend other people's money on themselves, they'll naturally spend less. And as a matter of consumer preference, "necessary" is purely a matter of personal choice. By definition, the people made the decision that the treatment is less necessary than the money they could have spent on it.

I really can't bring myself to believe Krugman ignores such basic micro, so we can only presume it's part of his old game: tax "the rich" to give social services to everyone else. He forgets that the wealth of "rich people" does spread throughout the economy. I cannot say often enough that Bastiat was so right, that government spending means depriving the private sector of that same spending, so there is no net economic benefit. If government spends $100 so someone has health care, that's $100 less that would have been spent on landscapers' salaries, waiters' tips, etc. -- now that is a zero-sum game, unlike Krugman's myth that people get rich at the expense of others. Worse, higher taxes (like the 1990 luxury tax) tend to backfire and discourage the wealthy from earning and spending as much, so there is less revenue for the welfare state, encouraging it to raise taxes even more.

When government kills people

Since the dawn of human civilization, big government has killed people via outright massacres and deliberate starvation. In modern times, big government very much kills people by denying them the freedom to choose experimental medical treatments that might be successful.

Don Ho (link is to an AP article at Yahoo! News) underwent a highly experimental procedure for his failing heart. It was successful, and as he said, "It was my last hope."

Are government bureaucrats God, or agents of the Almighty, that they can approve or deny this procedure, though the patient fully accepts any and all risks involved? These were Ho's own stem cells. The procedure involves no embryos, so neither side of the "culture of life" debate applies here. Ah, but government steps in to save us from ourselves, because like Paul Krugman and big government's other proponents say, government should reduce the risk in our lives. Even if we accept those risks, and even if we believe we have much to gain?

As Jefferson said, and this is worth quoting as often as needed, "The care of every man's soul belongs to himself. But what if he neglect the care of it? Well what if he neglect the care of his health or his estate, which would more nearly relate to the state. Will the magistrate make a law that he not be poor or sick? Laws provide against injury from others; but not from ourselves. God himself will not save men against their wills."

When my father had a stroke at 80 years old, there was at least one clot that immediately threatened his life. With standard treatment, he had very poor odds of survival, let alone recovery. The then-new "clot-buster" drugs were the only treatment capable of clearing the blockage. These particular substances had recently been approved by the Food & Drug Administration for use on stroke patients outside of tests.

I was 22 at the time and still living at home, but I was out when my father suddenly fell down in the kitchen that night. He later told me that he knew instantly that it was a stroke. What he didn't tell me was that he begged my mother, the only other person home, to help him to bed so he could die in peace. Thankfully she refused to give up and instead called 911. She was too distraught to go to the hospital with him, however. By the time I got home, learned what happened and rushed to the hospital, I found that my father was lucid enough that he had chosen and had already taken the new drugs.

The doctors had explained to him very carefully that the "clot-busters" had but a 10% chance of success; there was a 90% chance they would work too well, causing an uncontrollable brain hemorrhage and subsequent death. Aware that standard treatment, at best, meant he'd spend the rest of his life as an invalid, my father figured he had nothing to lose. He chose to take the new drugs, which succeeded without causing a hemorrhage. They succeeded well enough that, true to his style, he was busy charming all the night shift nurses. He still lost a lot of strength and his sense of taste, but he did hold up pretty well -- until about 18 months later when he started dying of cancer.

Now consider this: when the drugs were still experimental but not yet approved, how many stroke victims could have been saved? How many would have gladly accepted the high risk of dying if it meant a solid chance at recovery? Isn't that their choice? It's one thing if the doctors simply give potentially deadly medicine, but if the risks are completely, properly and sincerely presented to the patient, who is government to decide? Had my father suffered a stroke just a year or two prior to the "clot-busters" approval by the FDA, government would have told him, "You'll just have to die. We won't let you take this stuff, because it could kill you."

Should this be permitted?

Doctor Pushes for First Face Transplant

Sep. 17, 2005 - In the next few weeks, five men and seven women will secretly visit the Cleveland Clinic to interview for the chance to have a radical operation that's never been tried anywhere in the world....

They will smile, raise their eyebrows, close their eyes, open their mouths. Dr. Maria Siemionow will study their cheekbones, lips and noses. She will ask what they hope to gain and what they most fear.

Then she will ask, "Are you afraid that you will look like another person?"

Because whoever she chooses will endure the ultimate identity crisis.

Siemionow wants to attempt a face transplant....

The "consent form" says that this surgery is so novel and its risks so unknown that doctors don't think informed consent is even possible.

Here is what it tells potential patients:

Your face will be removed and replaced with one donated from a cadaver, matched for tissue type, age, sex and skin color. Surgery should last 8 to 10 hours; the hospital stay, 10 to 14 days.

Complications could include infections that turn your new face black and require a second transplant or reconstruction with skin grafts. Drugs to prevent rejection will be needed lifelong, and they raise the risk of kidney damage and cancer.

After the transplant you might feel remorse, disappointment, or grief or guilt toward the donor. The clinic will try to shield your identity, but the press likely will discover it.

The clinic will cover costs for the first patient; nothing about others has been decided.

Another form tells donor families that the person receiving the face will not resemble their dead loved one. The recipient should look similar to how he or she did before the injury because the new skin goes on existing bone and muscle, which give a face its shape....

It took more than a year to win approval from the 13-member Institutional Review Board, the clinic's gatekeeper of research. Siemionow assembled surgeons, psychiatrists, social workers, therapists, nurses and patient advocates, and worked with LifeBanc, the organ procurement agency she expects will help obtain a face....

Despite its shock factor, it involves routine microsurgery. One or two pairs of veins and arteries on either side of the face would be connected from the donor tissue to the recipient. About 20 nerve endings would be stitched together to try to restore sensation and movement. Tiny sutures would anchor the new tissue to the recipient's scalp and neck, and areas around the eyes, nose and mouth.

"For 10 years now, it could have been done," said Dr. John Barker, director of plastic surgery research at the University of Louisville, where the first hand transplant in the United States was performed in 1999.

Several years ago, these doctors announced their intent to do face transplants, but no hospital has yet agreed. They also are working with doctors in the Netherlands; nothing is imminent.

The article is a bit longer than what I quoted here, and very interesting, especially considering doctors have been able to do this for a decade now. This is nothing like "Face-Off" with Nicholas Cage and John Travolta, with its implausible (insofar as our current medical technology) premise that requires reshaping facial muscle and altering the underlying bones, not just the entire facial skin graft that Dr. Siemionow plans to do.

I cannot find any reason that a medical body or government can or should prevent the doctor from performing such surgery on a consenting patient, using facial skin obtained from a cadaver with the deceased's survivors' consent. The consent form should be extremely frightening because of its sheer uncertainty: "We don't even know what could happen to you," in essence. That should make a potential patient very wary, and Dr. Siemionow's personal interviews will weed out those she believes harbor secret doubts.

The care of every man's soul belongs to himself. But what if he neglect the care of it? Well, what if he neglect the care of his health or estate, which more nearly relate to the State? Will the magistrate make a law that he shall not be poor or sick? Laws provide against injury from others, but not from ourselves. God Himself will not save men against their wills.

What Thomas Jefferson said applies more to my immediately preceding entry on the market solution to obesity, but the last two sentences do apply here. No one is being coerced into this highly experimental procedure, and to some it may well be worth the risk (and any medical costs once Dr. Siemionow starts charging for it). Any medical boards and governments that deny a voluntary procedure to patients are simply deny people the freedom to assume risks for themselves, in a perfectly voluntary transactions that harm no one else.