Couldn't see this one coming

I was listening to Rush Limbaugh the other day and he made a great point. In the health care debate, the talk is never of creating more health care, never of increasing the supply, only of controlling costs, rationing care, sacrifice. One of the differences between the market and government, is that the market incentivizes creation, government doesn't. Here is a yet another New York Times letter from a disenchanted liberal lamenting the distribution of the H1N1 vaccine.

To the Editor:

Re “Officials Defend Distribution of Flu Vaccine to Companies” (news article, Nov. 6):

The defense by officials at the New York City Department of Health and Mental Hygiene of the distribution of thousands of doses of H1N1 vaccine to Wall Street firms is outrageous.

As an attending physician in pulmonary and critical care medicine, I find it disheartening that health care officials in New York City are not properly prioritizing those who require vaccination. The Centers for Disease Control and Prevention has clearly deemed that pregnant women, children, health care workers and people with underlying chronic medical conditions be vaccinated first.

As someone who cares for hundreds of patients with chronic respiratory disease, including young asthmatics on disability, I am deeply disturbed by the fact that my patients have no access to the vaccine.

It is difficult to fathom that physicians and nurses who work for large corporations have been empowered to distribute the vaccine and decide who meets the criteria for receiving it, whereas those of us who care for chronically ill patients, who are most at risk from H1N1 infection, have no access.

Although corporations that have access to the vaccine should, in theory, be following the guidelines set out by the C.D.C., the greatest need for the vaccine is clearly in our city’s hospitals and clinics.

Gail E. Schattner
New York, Nov. 6, 2009

Surprisingly I agree that the system ought to triage the use of a scarce medical resource. But why Mr. Schattner is surprised by the politization of this is beyond me. When will we learn that our governers are not saints?

Nevertheless, it's ironic that it never occurs to Mr. Shattner or the New York Times that reducing triage, aka rationing, ought to be the ultimate goal. Let prices reflect demand and encourage more supply from greedy capitalists. Fighting over who gets what and why will not provide everyone with more.

Fiduciary Failings

Very good article from Ben Stein on Yahoo Finance:

2. By the same token, the investment advisors who guided billions into Madoff's phony accounts have to be held to account. They are required to behave according to fiduciary standards. That means they have to put the client's interest ahead of their own, do stringent investigation, and avoid even the appearance of conflict of interest. Clearly, in many, many cases, none of these requirements were met.

I am going to start collecting references to failures of regulators and others entrusted with doing the right thing. Perhaps, one day we will realize that people are severely flawed and will see that "fiduciary responsibility" is as meaningless in practice as "next time we will try harder" or "this time it will be different".