Investor’s Business Daily (IBD) has an editorial asking one of the stupidest questions you are likely to hear this year, Why Is There No Uber For Health Care? It is based on a paper by pretend wonk Avik Roy, Health Care 2.0: Ushering in Medicine’s Digital Revolution (pdf). Before I get to the specifics of the stupid question, let’s go over a few issues that the editorial raises.

First, IBD thinks healthcare costs are all about technology. This isn’t even close to being true. For one thing, in Japan, they have a lot more healthcare technology than we do, yet their healthcare spending is much lower. People who make these kinds of arguments are all free marketeers who are just looking for some reason to claim that the free market will save us if we just let it.

Well, a free market in healthcare might be just fine. But the people at IBD aren’t interested in that. And Avik Roy certainly isn’t interested in that. They aren’t calling for an end to licensing of doctors. In fact, they aren’t even calling for an end to restrictions in doctors immigrating to the US. Because that’s the reason healthcare costs so much: doctors get paid two to three times as much in the United States as they do in other advanced countries. Do we have better doctors than they do in Canada and Japan and Germany? I don’t think so.

Then IBD asks a question about all this technology, not understanding its wider ramifications, “Why would any consumer demand a more expensive product if they had no idea whether it would work?” Well, the truth is that most people do not demand a more expensive product. But generally speaking, healthcare customers are not knowledgeable enough to make good healthcare buying decisions. This is why the neoliberal approach (Not to mention the free market approach!) is not a good way to provide healthcare.

But the editors — based upon Avik Roy — go in the opposite direction. The real solution is to get rid of insurance! It’s the conservatives’ great solution to everything: health savings accounts so that people can count every penny and not go in for expensive procedures! Of course, they started with the understanding that people don’t know what they are doing when it comes to healthcare.

But there’s another issue here. Ultimately, conservatives all think we should save money on healthcare by getting less of it. They don’t want to deal with the issue that the healthcare itself is too expensive. And let’s face it: it’s a false saving. Because if you get people to count their pennies, many of them will decide they can save a buck by not getting preventative care or taking drugs that will lead to much more expensive care later on.

Big on Avik Roy’s radar is that the insurance that people get, they don’t pay for directly. Thus the “direct consumer is largely indifferent to the price.” But surely the businesses and government agencies that are paying for the insurance care about price and are in a much better position to negotiate it. Again we are back to the idea that the more the individual has to pay for care, the better. But the truth is that increasing co-pays and similar devices have not been shown to cut down on unnecessary care.

The great Avik Roy trick in all this is that technology will save us. This is the answer that conservatives have for every problem. And there is no doubt that technology can help. But the kind of technology that Roy and Carly Fiorina and the editors at IBD want is market innovation. They want a way to make it easier for customers to compare prices. They want a little app that will allow people to get the best price on a colonoscopy. Okay. I’m not saying that might not save a few pennies.

But it wouldn’t be like Uber. Uber saves money because it is a low-skill service. It has thrived because there are a bunch of out of work, desperate people. And it effectively placed all the burden on these powerless people. In as much as it has changed the market, it has taken a pretty bad job and made it worse. Yet in the entire IBD editorial, the word “doctor” is used only once — and then in a quote that they attack. Do they really think that doctors are going to allow themselves to be Uberred?

No. What it all comes down to is that the people at IBD and Avik Roy (who I’ve been following for years), don’t give a damn about providing healthcare. They just want to keep taxes down and salaries high for the already rich. So they will nibble around the edges. Medical technology! Skin the game! Malpractice insurance! In fact, the article even talks about the high price of drug entrepreneurship, without discussing all the billions of dollars that the government does in drug research that makes the drug companies rich.

A couple years ago, Avik Roy went through a cycle. He kept writing articles about this or that country that had a supposed free market healthcare system that worked. And then, an actual healthcare wonk would point out why he was wrong. So Roy would move onto another country. Because there just isn’t a country that provides reasonably priced high quality healthcare without having the government very much involved.

The problem is as it always is with conservatives on any issue. They are constrained by conclusions. Yes, they would like everyone to have good paying jobs, but only if the solution is that we lower taxes on the rich and get rid of regulation. And they would like everyone to have good affordable healthcare — but only if it involves the government only helping the rich stakeholders in the process. If it involves subsidizing individuals, forget it.

For more on this, see my article from three years ago: Avik Roy: Healthcare Apologist.

I devised The Paul Krugman Bernie Sanders Giving Game just three days ago. If I were actually playing it, I would now be broke. Three days! Krugman doesn’t seem to be interested in much of anything but how wrong it would be to vote for Bernie Sanders and how Hillary Clinton is the only sane choice.

He also has taken to complaining about Sanders’ supporters not being nice to his friends and him. In fact, last week, he wrote, Health Wonks and Bernie Bros. Now I don’t know the etymology of the term “Bernie Bros”; it probably started with Sanders supporters, but among the liberal punditocracy, it has become a pejorative. The implication has long been that Sanders appeals to young men and that being a Sanders supporter is somehow sexist (despite the fact that the people supporting Sanders first wanted Elizabeth Warren). And note: young women now support Sanders far more than Clinton.

But Krugman’s column yesterday was truly over the top, Plutocrats and Prejudice. It’s a straw man, as so many arguments against Sanders are: Sanders is an idealist who can’t get his big ideas accomplished and Clinton is a pragmatist who will make incremental improvements. The implication is always and forever that Sanders is some ossified old sixties socialist who can’t adjust to political reality. Listening to Krugman, you would think that when the public option was off the table, Sanders had voted against Obamacare. What actually happened was that he got the Senate to roughly double funding for community clinics in exchange for his support. Sounds like a guy who is capable of making incremental change.

So Krugman argues that since Sanders talks insistently about economics, he must think that is the only (or almost the only) issue. It’s funny. Just a few days before, Jonathan Chait wrote pretty much the same thing, What Bernie Sanders Doesn’t Understand About American Politics. I’m not suggesting that these guys are on the Clinton payroll, but they both have the same ax to grind, and they grind it the same way.

But it is worse than that. Because Krugman starts off by going over territory that I’ve gone over before: the plutocrats were able to get their lower taxes and decreased regulation by supporting politicians who got votes by demagoguing against minorities. But that isn’t entirely true. We got the Taft–Hartley Act in 1947 — long before the Silent Majority, Welfare Queens, and Willy Horton. But does Krugman really believe that Sanders doesn’t understand the role that bigotry has played in helping the plutocrats since the 1960s? I don’t think so.

If you look at the other things that Krugman has been writing, you’ll see a certain level of hysteria. He’s been looking for anything he can hammer away at Sanders on. There’s never a kind word. And there is never a negative word for Clinton. No, in Krugman’s world, Clinton is right and perfect and Sanders is wrong about everything that matters. As one commenter (PN) put it, “Prof Krugman seems to dream of ways to disagree with Sanders and to support Hillary.” It’s true.

So we have a Republican Party that is bigoted. One of their great bigotries is against powerful women. And one of their greatest bigotries is Hillary Clinton herself. And she’s the one who is going to be able to make incremental progress? Krugman ended the article with a question, “Isn’t there something noble, even inspiring, about fighting the good fight, year after year, and gradually making things better?” Yes! Yes! Again, I say, yes! But isn’t there also something incredibly suspicious about a candidate who campaigns in that way?

Everyone (and certainly Krugman) knows the Mario Cuomo quote, “You campaign in poetry. You govern in prose.” And Bernie Sanders’ entire career has demonstrated that. The only place that isn’t true is in the fever dreams of people like Krugman. It could be that Krugman either doesn’t really like Sanders’ positions, but this seems unlikely given that they really aren’t that different from Clinton’s. I think it is that Krugman doesn’t think Sanders can win the general election. That’s a fair argument. Make it! Don’t give us this garbage about how Sanders is too high minded and naive to be president.

You all know that I like rats — a lot. And I’ve certainly told you the story about the study that showed rats exhibiting altruism. In particular, if given a bunch of chocolate chips (which rats love), they will generally save some of them for another rat that is in another cage. But then I found out something unfortunate. All the females rats did this. But only 30% of the male rats did it. The other 70% of the male rats ate all the chocolate chips. I mean, rats don’t have to be altruistic. Having a selfish rat as a pet is perfectly fine because rats are awesome regardless.

But ever since learning that, I think about it every time a man does a horrible thing. It’s really not hard to conclude that 70% of men are selfish jerks. This does go along with my general sampling of male behavior. The one place that it breaks down is in that I also think about 30% of women are jerks. But I should be clear, because I’m implying that there are certain people who are just jerks. Well, sure: some are. But mostly, I think it is that 70% of the time, any given man is a jerk. Certainly I am not perfect. But the point is that because of the mix of chemicals swimming around in our bodies, women really are better then men.

Well, I was over on We Hunted the Mammoth. Why do I do that? It just upsets me. When I say that men tend to be jerks, I’m talking on the small scale. I’m talking about them doing things that I can see myself doing — in many case have done. But it’s nothing too bad. A trip to We Hunted the Mammoth is the gender politics equivalent of putting on NAZI Death concentration camps Germany August 28 1945. It’s really upsetting. But given that Nazis are mostly gone and MRAs are still around, very vocal, and I think, dangerous, it is necessary.

So yesterday, David Futrelle offerred up, Richard Dawkins, Lindy West, and the Cartoon Video of Great Hatefulness. It is about Richard Dawkins, because Dawkins was recently in a fight that is just like so many others that he’s been in. And that means in many ways it hardly is worth writing about. It’s more the backstory that bothers me. But before I get to that, allow me one sort parenthetical paragraph.

(What’s with the MRAs? Do they think people mistake them for “real men” or something? My direct experience with them is that they are a bunch of man-boys who are mostly just upset because they can’t get dates. It really is all about scapegoating women. I suppose for the older ones, it is about all the other things in their lives that suck. But the younger ones clearly need girlfriends — which they won’t get because they are such misogynists. I would be willing to provide training for the young ones, though. I’m no Don Juan, but it really isn’t that hard to get women to like you. Hint: don’t be an MRA.)

There is a woman named Chanty Binx who made the mistake of yelling at some MRAs on video. This went viral, at least through the Mammoth community. Which led to the usual rape and other violence threats. And then came a video that equated fundamentalist Islamists with feminists. The feminist in the video was a caricature of Binx. Richard Dawkins then tweeted out a link to the video saying that he didn’t think all feminists were like this but some where.

Ultimately, Dawkins backed down. But his back-down position I find truly repugnant. If you haven’t read it, I highly recommend you read Jon Ronson’s So You’ve Been Publicly Shamed. What Richard Dawkins is pushing as a good thing in fact destroys lives. So apparently, as a society, we should allow absolutely anything so long as it doesn’t threaten violence. This is beyond absurd. Has Dawkins never heard of bullying? It very often has nothing to do with violence or threats thereof.

But what’s sad is Richard Dawkins is — relative to the MRAs — reasonable. He even calls himself a “feminist,” even though he seems to think that as long as women somewhere are having forced clitorectomies, women elsewhere can’t complain about anything. And this is, remember, one of our greatest scientists. I guess we can just place him next to William Shockley. But it does remind me of all the New Atheist nonsense of, “I only believe things I have evidence for!” I’m sure that Dawkins and Shockley would claim the same thing.

Regardless: rats. Love ’em or hate ’em, they are not very different from us. I’m not against men. My rat was a male and he was wonderful. But we men tend to be worse than women. And at our very worst, we are terrible.

My friend Kristen McHenry recently wrote about, That Oddly Existential Bernie Sanders Ad. It reminded me that I had wanted to write about the spot. When I first saw it, I cried. Now that’s not terribly surprising, given that I’ve written before, On Sobbing and Being a Blubbering Fool. But the ad is amazingly effective.

The song, Simon & Garfunkel’s “America,” is the perfect choice. And the spot gets 15 seconds in before we see a Bernie Sanders sign, and then the man himself is incidental. But it turns suddenly different at the line, “Counting the cars on the New Jersey Turnpike. They’ve all come to look for America…” Part of this is because they cut from the early quiet portion of the song, right to the end when it is most energetic. Then we see Sanders and his wife walking into an event and the sound of crowd rises. I’m not much for joining things, but it’s hard not to stand up and shout, “I want to be part of that!”

The commercial was designed for the Iowa caucus. And I assume most of the footage is from that state. And I have to say: it is really white. The state is 91% white and less than 3% black. It really is a hell of state to start our only national election. But I would assume that the Bernie Sanders campaign will continue to use the ad outside Iowa, and I assume they will cut a little diversity into it. I understand Ta-Nehisi Coates’ argument against Bernie Sanders, but what I think Coates fails to understand is that Sanders might be interested in shaking things up, but he’s also interested in winning. Sanders’ not being more radical on racial issues and having a pretty white commercial for Iowa are pretty much the same thing.

But the question is, “What is the meaning of the Bernie Sanders spot?” I’m with Kristen, it isn’t about nostalgia. She thinks it is about “our growing sense of alienation and loss of identity.” I think she’s definitely onto something there. But it’s clear that the identity to be found is not some sense of conformity. Looking for America is an odd kind of thing because we are all different. What binds us together must be something more nebulous. America is not a people but an idea. This is how I put it in my comment to Kristen’s article:

I am tired of — angry about, even — this idea that the sum total of my civilization can be quantified by the GDP — or even worse, the wars we’ve “won.” To me, the ultimate symbol of America is YouTube where people of great talent and little post their videos. They express themselves in all their idiosyncrasies. Yet we live in an economic system that not only doesn’t provide proper compensation, but also no sense of security. It’s as if our greatest cultural desire is to make the lives of ordinary Americans the same as the natural world where the strong thrive and the weak die.

I like Hillary Clinton. But I’m with Robert Reich:

That’s as good a textual description of that video as anyone could make.

I think that certainty can be an extremely dangerous thing. Having a healthy dose of doubt is really important. Personally, I work on having a constant background thought that I might be totally wrong — that I am not the keeper of The Truth. I try on things like “tax cuts for the rich help the economy” and “same sex marriage harms society.” In almost all cases, I don’t just find the fit bad, I can’t even fully squeeze into their absurdity before ripping them off. But it is good to try because there are little things you can learn and you can evolve on questions. Some issues I do find vague and difficult to take absolute stands on.

But I wonder about conservatives on this issue. I’m not talking David Brooks here. He’s an idiot and a hack, but some intellectual sunlight really does make it to his brain. But you have to wonder about the conservative truth believers — and that is most of them. And then you really have to take a look at people like David Daleiden and Sandra Merritt. They were two of the people behind the Center for Medical Progress (CMP) — the group that staged a “sting” against Planned Parenthood, using the usual tactics of highly edited footage made to look like something that wasn’t going on was — in this case that Planned Parenthood was selling fetal tissue.

I read a really good Dahlia Lithwick article about it, The Anti-Abortion Activists Targeting Planned Parenthood Have a Slew of Legal Troubles. Thus far, there have been 11 investigations of Planned Parenthood and all of them found that the group was (as expected) squeaky clean. But the most recent out of Texas turned the whole thing on its head, “The Harris County district attorney, announced the surprise indictments against the Center for Medical Progress’ David Daleiden and Sandra Merritt for the felony of tampering with a governmental record; Daleiden received a second indictment for the misdemeanor prohibition on the purchase of human body parts.”

Not that it matters. In the end, this will be just like it has been with James O’Keefe. These two will get a slap on the wrist. Maybe they will even go to jail for a while. But the money will continue to flow in and they will continue to be stars in the conservative movement. But this whole movement of young “sting” operatives has yet to result in a single actual discovery. In the case of the CMP, an enormous amount of time and energy was put into the effort. And like always, they found nothing. This is normally the case when one investigates an outrageous claim. When you shoot for the moon, you almost always miss.

But conservatives don’t seem to care about the truth. The nicest way you can put it is that they think they already know the truth. So it really doesn’t matter that they take dozens of hours of video, cut it up to make it look like something bad is going on, and then release it. The ends justify the means because they just “know” that Planned Parenthood is selling fetal tissue. But I suspect I’m being far too charitable. Knowing conservatives it is just a matter of their side winning. (What continues to amaze me is that the mainstream press takes these adolescent pranksters seriously; have journalists no pride?)

Lithwick goes over in exhaustive detail all the legal problems that David Daleiden and CMP are having. At every turn they lose. As she put it, “The law is — we forget — different from politics, and even as politics becomes ever more a fact-free enterprise, the law is not.” This, of course, hasn’t stopped Congress and various state legislatures from acting as though CMP were on the level. But then, they are just looking for any excuse to end reproductive rights.

What it does all mean is that American conservatism is a kind of cult. Everyone in it just “knows” the truth and they will believe everything that confirms their beliefs. In fact, things that push against their beliefs make them believe it all the more strongly. It’s a very dangerous situation, given that these people will eventually be in control of this country and along with it by far the biggest military in the world.