There has been much attention
given recently to the problems of drug addiction and the release of criminals
convicted for drug related crimes as the sentences they received are now deemed
too harsh for these ‘non-violent’ crimes.
It has becomes an issue in the primaries with Jeb Bush, Chris Christy,
and Carly Fiorina all giving personal testimonies on the matter. In addition it is one of the main election
concerns in New Hampshire. So far the
focus in the media has been on factors such as:
The legalization of drugs, such as marijuana
The prescription practices for legal drugs
Drug use as a factor in other crimes
Drug crime’s impact on communities
While all of these things are
important, they all have at least two things in common. One, they are all effects and not causes. They address the supply side, but not the
demand. Two, there is a call at some
level for more government intervention to ‘fix things’. However, when you try to fix the effects, and
not the cause, you generally end up spending large amounts of money without
having a significant impact on the underlying problem – witness the trillions
spent in the war on poverty. And what
have we to show for that? More people in
poverty than before the war began – by whatever measure you want to choose. Also, there are often unintended consequences
from legislative actions that prove to be worse than the problems that they
were initially intended to address. This
too stems from trying to treat an effect, especially when the intervention is
performed by parties who have no experience in the subject at hand. Would you go to your plumber with an
electrical question? If not, then why
would you go to a group of lawyers for answers concerning addiction?
The above factors being
presented all speak to emotions. They
are satisfying to discuss, but they do not address the source, they do not involve
intellect, and therefore do not move the ball forward in terms of actually
trying to resolve the issue itself. I
would like to propose two simple things that I believe are the underlying cause
of this problem. Now these are only
hypotheses, and need to be vetted and tested – but that is okay. That is exactly the type of discussion that
is needed, and maybe this will be a start.
The first issue is the changes made
to the healthcare environment, specifically the regulatory changes that have
occurred over the last ten years or so. These
include the use of pain scales for treatments that suggest it is possible for someone
to not experience pain. The scale
usually goes from 1 – 10 with the end points indicating no pain and extreme
pain. This misconception is supplemented
by the inference that many medical procedures are either pain free, or that the
pain can be controlled to such an extent that no pain should be
experienced. This is simply setting false
expectations and leads to bad outcomes. Underlying
these regulatory changes is the shift from looking at the quality of medical
outcomes to simply looking at payment reimbursements based patient satisfaction
– based in large part on the amount of pain one experiences. When you couple that with a legal environment
where overtreatment is common in order to lessen the risk of legal liability,
you have a recipe for disaster – and that is exactly what is occurring.
Just last evening there was a
story on the local news about a local high school cheerleader who was by all
accounts a good student and well-rounded individual. She was prescribed opiates after a medical
procedure. She became addicted and moved
from the opiates to heroine that was both cheaper and available without a
prescription. Of course the story ended with
her losing her life. What has happened
to enduring hardship when it occurs, instead of believing it can and should be
avoided at all costs? Do we think we can
live without there ever being any adversity?
What does that say about our character?
That is the first issue.
I believe the second issue is
simply the loss of hope, and has its roots in an economic environment where for
about the last eight years there have been few job prospects, and what jobs have
been created are generally part-time and/or in low wage areas. One report I remember from earlier this year said
that the top three industries in terms of job growth were the hospitality,
sanitation, and retail sectors. There is
nothing wrong with any of those jobs; they are just not high-paying. The increase in the number of those types of
jobs serves to lower the average wage and not raise it. The labor participation rate is also at the
lowest level that it has been since the dysfunctional days of the Carter administration
– forty years ago. Real wages have
stagnated or declined. There presently
does not appear to be an end in sight, and people see and know that is so.
Add to that the false news that
things are getting better when people see that they are not. The unemployment rate keeps going down. There is little inflation. Unfortunately, these measures simply do not
reflect reality any more. We have a
government that has decided what the outcomes need to be, and if those outcomes
do not materialize then it needs to create measures that support its story. This criticism is not aimed at any particular
party. Both are guilty. The numbers reported in the two measures just
mentioned are simply no longer reliable.
A change to the way the unemployed population is being measured results
in that segment being under reported.
All one has to do is to give up looking for work to be removed from the
roll of the unemployed. It doesn’t
matter if you want to work or not. What
kind of measure is that? Substitutions are
used in measuring the cost of living figures, and is the practice of influencing
that measure by simply changing the basket of goods that go into it. While the use of substitution has its place,
it is no longer legitimately used to just replace items that are superseded by innovation,
but instead are simply a means to achieve an end – a specific narrative.
So how do people know that
things are not getting better? They see
their friends, neighbors, family; maybe even their own family struggling
financially. They see the cost for the
same things that they buy at the grocery store each week; meat, milk, bread,
produce, all going up 30 – 40% over the last several years. These are not simply speculations, they are
facts – and facts simply don’t go away when a measure conflicts with reality. Both of these issues are being exacerbated by
a third cause, the escapism that is available from today’s technology. This allows someone to create an artificial
world into which they can escape for a while, but in the end the real world is
also a fact – and cannot be eluded from forever.
There is one simple solution
that I think will solve the first two problems.
That that is to lessen government intervention. In terms of healthcare, remove the regulations
preventing the patient/doctor relationship from again being the primary driver
of a strictly outcome oriented medical delivery process. Using satisfaction as an outcome measure for
this service could only come from a bureaucrat that has no idea what the real
drivers of healthcare delivery are.
Also, allow healthcare consumers to decide whether they need to purchase
insurance or not. These are areas where
there is no constitutional basis for government intervention in the first place. It is when government starts to have skin in
the game, through payments such as Medicaid, Medicare and other assistance
programs that it becomes more involved in the process and outcomes. The simple answer is removing it from the
process, and letting people make choices that are in their own best
interest. However, the people making
those choices must have a moral basis that is used in caring for those in need, so that
charity becomes a responsibility they individual acts upon – and not the government.
The same is true with the second
issue, the loss of hope. Regulatory
requirements cost us billions of dollars each year. Do they provide billions of dollars in
benefits to society? That is hard to
believe as compliance has a cost that must be paid for, that must eventually result
in either passing those costs on or finding ways to reduce other costs –
through methods such as automation or moving businesses to locations that are
less expensive to operation in (which may not be in the US). Man is intended to work. He has been given skills, abilities, and
talents to use, and their proper use is how we fulfill our purpose. So what is the purpose of a government that
prevents one from fulfilling their purpose?
How can that be justified, when the main purpose of government is to
I must admit that this solution
will not address the third issue mentioned in this article. That is a different animal altogether. But I believe in that area the answer will
likely lie in restoring virtue and character to us as a people. To both set our expectations and provide us
with the tools and insights to make better decisions for ourselves. And if we choose to make bad decisions, then
there should be consequences for that and those should be borne by the individual
making the bad choice. No one else.
We need to once again look at
people as individuals, and not simply as groups. To do that we need to put government in its
proper place so that we can care for ourselves, our families, and our