Category: Weird thoughts about civilization

Watching lots of history documentaries lately, and I had a sudden realization.

If you took an ancient Egyptian from, say, 3000 BC, and a Roman from 100 BC, and a German from 1500 AD, and you popped them all down in Kentucky in 1815, they would do fine. Using axes to clear the land and build a cabin, using animals to plow the fields, farming, raising livestock. Everything. Nothing had changed enough to discomfit any of them.

But from 1815 to 1915, the world changed. The steam engine, then the internal combustion engine. Railroads, cars, planes. Electric lights and streetcars and subways. Telegram and telephone and radio. From muzzle-loading muskets to rifles to cartridge guns to machine guns. Everything changed.

And if you follow it back, it was James Watt’s improved steam engine of 1775 that really started it all off.

But did you know that Watt had a real problem with making his steam engine efficient? He couldn’t make a smooth enough bore and piston set to seal against the steam, to get the full potential of the engine. He enlisted the help of Henry Maudslay.

Maudslay revolutionized industry by inventing the screw-cutting lathe, which allowed the pitch of threads to be accurately reproduced. Before Maudslay, every nut and bolt were a matched set. After Maudslay, you could take any bolt out of the box and screw it into any nut from the box.

He also invented standardized measuring techniques, which allowed interchangeable parts on machinery. Prior to that, parts had to be fitted to the machine. After Maudslay, you could swap one part for another. This was a really big deal in gunsmithing as well as with Mr. Watt’s steam engine and all the rest of the machinery introduced in the nineteenth and early twentieth century.

Yes, the whole world changed between 1815 and 1915, and Henry Maudslay was the biggest reason.

And you never heard of him before.

Henry Maudslay bio.

In Search of Doc Holliday

I saw a documentary on Doc Holliday last night. They didn’t mention what sort of guns he used, but they got several things right in a critical way.

The guns used in the West were almost exclusively single-action revolvers. You had to manually cock them before shooting them. The Colt Lightning of 1877 (and the later Model 1878) were not. They were self-cockers, which rotated the cylinder, cocked the hammer, and fired when you pulled the trigger.

By October of 1881, Doc Holliday carried a self-cocker in a holster on his chest on the right side, and a single-action revolver on the left side. As a gambler, this was important. If you wore your revolver in the typical holster we think of most often when we think of the West, down on your thigh, you couldn’t draw the weapon when seated in a chair with arms. You had to stand first, which is why all those bar shoot-outs have the belligerents stand first.

But Doc Holliday could draw and fire while seated, and he didn’t have to cock the weapon first. Stand up at the card table to clear your holsters and Doc Holliday would shoot you while still seated, before you could even get your gun out of the holster. Holliday had a reputation of being “good with a gun” (a quote about him from Wyatt Earp, no less), and the Colt self-cocker was likely part of the reason why.

When the documentary showed a recreation of Holliday seated at the table playing cards, he had a Colt self-cocker in a chest holster on his right side, and a Colt .45 revolver on his left side, both accessible while seated. The self-cocker is easily identifiable by it’s “birds’ head” (rounded) grip. The Colt .45 had a ‘standard’ grip. Both of Holliday’s guns in the documentary had white grips — an extra-cost option — which would have been Holliday’s choice. Having people know he had them while playing cards was better than having to use them.

The documentary also got the gunfight at the OK Corral right. The scenes showing people firing pistols all showed them manually cocking the hammer with their right thumb between rounds. Doc had a shotgun at the OK Corral, and also was the only person there with a self-cocker.
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Contrast the grip of the self-cocker to the grip of the Colt .45 Peacemaker.

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The movie Tombstone, in which Val Kilmer gave the definitive portrayal of Doc Holliday, also got it right. Spot the self-cocker and the single-action revolvers, both with white (very visible — ‘Don’t screw with me’ — grips), both worn in a position to be accessible while seated. Doc was known to be quick with a gun, and to be able to switch from an amiable Southern manner to a brutal temper in seconds. In the movie Tombstone, John Ringo is portrayed as being afraid of him, and not without reason.

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The documentary had one difference to the movie Tombstone. In the documentary, the two guns were also at different heights on Doc’s torso, but the heights were reversed, with the self-cocker higher on his right side than the Peacemaker on his left side. The documentary was likely right. The Peacemaker — which was a very simple mechanism with only four moving parts — was an extremely reliable back-up gun, while the self-cocker would have been much faster, but could be more finicky. Both guns were in a cross-draw position — grips oriented for the hand on the other side — which is faster, especially with your hands already in front of you on the card table. Reporting of the gunfight at the OK Corral is that Doc was grazed on his left hip, which had a pistol ‘scabbard’ (not a hanging holster), which also argues for the Peacemaker being lower on that side.

I grabbed this screen shot from the documentary’s trailer, of Holliday seated at the card table. Spot the self-cocker and the Peacemaker, both guns accessible while seated. It was a quick scene, only a couple of seconds in the documentary, but I was looking for it. I like it when people get the details right.

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By the way, if you wonder whether an 1877 or 1878 model pistol would be available in the West by 1881, don’t kid yourself. Tombstone had a gun store that kept current with new models. Founded in 1877, by 1879 Tombstone had a bowling alley, four churches, an ice house, a school, two banks, three newspapers, and an ice cream parlor, alongside 110 saloons, 14 gambling halls, and numerous dance halls and brothels.

The documentary is “In Search of Doc Holliday” and is available on Amazon.

Watch it here.

 

Category: Weird thoughts about hats

A prediction, and a story

Story first. Up through 1960, any adult male going out wore a hat. All classes. You just did. Other than at the beach, say, men wore hats. The shelf behind the rear seat in a car, under the rear window, was a hat shelf.

From 1961 onward, men didn’t wear hats. Oh, some ball caps and the occasional geezer wearing a cowboy hat (ahem), but generally no hat. The hat shelf in most cars is gone.

Why? Because JFK never wore a hat. And men still don’t wear a hat now, sixty years later. You can tell whether a movie was made before January 1961 or after, based on whether the men wear hats when going out

Now a prediction. You will be able to tell, decades from now, whether a movie or TV show was made before COVID-19 or after by whether people shake hands.

Category: Weird thoughts about Game Theory

In Game Theory, a Nash equilibrium exists when, for each player, no change in strategy will result in a positive outcome as long as all other players continue to play their current strategy. It is a form of non-optimal equilibrium — a local optimum.

In US foreign policy, NATO, NAFTA, and relations with China, N. Korea, and Iran had settled into long-standing Nash equilibria. No US politicians changed our strategies for decades, despite the non-optimal state, because there was no path to a positive outcome for the US if the other side continued playing their current strategy.

However, you can disrupt a Nash equilibrium by making moves that make their position substantially worse, which forces them to change their strategy to seek a better outcome.

This is what Trump has done in all five of these scenarios. It is also the reason that the Washington establishment screams bloody murder when he does it. The potential negative outcome for the US is apparent. But the other players change their strategies, because the disruption is planned to make their situations much worse.

With China, Trump imposed tariffs. “He’s going to start a trade war that will be disastrous for the US!” Well, it would be even more disastrous for China. So China is having to modify their policies to avoid it.

Same with Canada and Mexico, Trump threatened or imposed tariffs. He actually threatened to close the Mexican border to imports. The DC crowd was screaming about trade wars again, but Canada and Mexico changed their strategies because the situation would have gotten much worse for them. And we got the USMCA trade deal to replace the stupid NAFTA.

With NATO, Trump threatened to withdraw. The DC crowd was in hysterics. But the US withdrawing from NATO would be much worse for our European allies, so they are modifying their strategy by increasing their defense spending as the treaty requires.

With North Korea, Trump agreed to meet with Kim Jung Un without any concessions. The foreign policy crowd complained that Trump was giving Kim a big propaganda coup without anything in return. But Kim changed his strategy, and some positive things are happening there.

Again and again, Trump disrupts Nash equilibria in a specific way, forcing others to change their strategies and finding a more optimum solution than the impasse of the equilibrium. And every time, the know-it-alls see disaster ahead.

What about Iran? On January 13, 2020, Iranian President Hassan Rouhani said “In the current conditions, we must all cooperate with each other to establish peace and stability and ease tensions.”

“The current conditions” being the disruption of the Nash equilibrium that’s existed for forty years.

Category: Weird thoughts about high crimes and misdemeanors

Sir William Blackstone, the authority on the English law on which the Constitution is based, defines “crimes and misdemeanors” (“Commentaries on the Laws of England”) Book IV Chapter 1, as follows:

“A CRIME, or misdemeanor, is an act committed, or omitted, in violation of a public law, either forbidding or commanding it. This general definition comprehends both crimes and misdemeanors; which, properly speaking, are mere synonymous terms: though, in common usage, the word, “crimes,” is made to denote such offences as are of a deeper and more atrocious dye; while smaller faults, and omissions of less consequence, are comprised under the gentler name of “misdemeanors” only.”

Those who argue for a broader meaning usually point to Blackstone at Book IV, Chapter 9:

“II. MISPRISIONS, which are merely positive, are generally denominated contempts or high misdemeanors; of which

“1. THE first and principal is the mal-administration of such high officers, as are in public trust and employment. This is usually punished by the method of parliamentary impeachment: wherein such penalties, short of death, are inflicted, as to the wisdom of the house of peers shall seem proper….”

So how is Blackstone to be squared with itself? The first thing to realize is that the laws of England are not the laws of the United States. Further, the laws of England at the time included a large body of Common Law. Federal law in the United States is (almost) exclusively statutory law. Thus the idea that Blackstone apparently considers mal-administration a violation of law need not be surprising. The law in Parliament is whatever Parliament says it is, including — at the time, at least — ex post facto laws and bills of attainder, which the US Constitution strictly disallows.

We need to look further to make sure we have reconciled these passages properly. Consider Blackstone once more, at Book IV, Chapter 19:

“But an impeachment before the lords by the commons of Great Britain, in parliament, is a prosecution of the already known and established law, and has been frequently put in practice; being a presentment to the most high and supreme court of criminal jurisdiction by the most solemn grand inquest of the whole kingdom.”

And so Blackstone circles around again and makes the point clear: “impeachment … is a prosecution of the already known and established law….” In the United States, at the federal level, that means statutory law.

This is an important point. Fundamental to the law is that it can be understood, that an offender have the means to know an act is unlawful before it is committed. The idea that the President can be impeached — and an election overturned — for some offense which he cannot know ahead of time is wrongful, is ludicrous and contrary to the basic principles of law, fairness, and democracy.

Arguers against this position often bring up Alexander Hamilton’s Federalist Paper No. 65, and quote it, but only in part, and out of context:

“those offenses which proceed from the misconduct of public men, or, in other words, from the abuse or violation of some public trust. They are of a nature which may with peculiar propriety be denominated political, as they relate chiefly to injuries done immediately to the society itself.”

In the greater context, however, one can see that Hamilton was complaining about the inherent political nature of impeachment, and that was why he argued that the Senate, a more deliberative body, was the proper place for neutral consideration of the charges:

“A well-constituted court for the trial of impeachments is an object not more to be desired than difficult to be obtained in a government wholly elective. The subjects of its jurisdiction are those offenses which proceed from the misconduct of public men, or, in other words, from the abuse or violation of some public trust. They are of a nature which may with peculiar propriety be denominated POLITICAL, as they relate chiefly to injuries done immediately to the society itself. The prosecution of them, for this reason, will seldom fail to agitate the passions of the whole community, and to divide it into parties more or less friendly or inimical to the accused. In many cases it will connect itself with the pre-existing factions, and will enlist all their animosities, partialities, influence, and interest on one side or on the other; and in such cases there will always be the greatest danger that the decision will be regulated more by the comparative strength of parties, than by the real demonstrations of innocence or guilt.

“The delicacy and magnitude of a trust which so deeply concerns the political reputation and existence of every man engaged in the administration of public affairs, speak for themselves. The difficulty of placing it rightly, in a government resting entirely on the basis of periodical elections, will as readily be perceived, when it is considered that the most conspicuous characters in it will, from that circumstance, be too often the leaders or the tools of the most cunning or the most numerous faction, and on this account, can hardly be expected to possess the requisite neutrality towards those whose conduct may be the subject of scrutiny.

“The convention, it appears, thought the Senate the most fit depositary of this important trust. Those who can best discern the intrinsic difficulty of the thing, will be least hasty in condemning that opinion, and will be most inclined to allow due weight to the arguments which may be supposed to have produced it.”

So impeachment requires a violation of law, and not the political decision Hamilton declaimed against. In the US, that means a violation of statute, and a failure to cite the statute violated in any charge of a bill of impeachment renders that charge meritless.

Category: Weird thoughts about fairness

Marguis of Queensbury rules and similar concepts of fairness apply when two people decide to fight each other. For boxing, and WWE, and martial arts, there are rules.

A fight that results from one person attacking another is a different matter altogether. No rules of fairness apply. One person is minding their own business when the other attacks him. Fairness went out the window when one party decided to unilaterally initiate violence.

Three teenaged toughs armed with knives and brass knuckles broke into a man’s home, and he killed all three of them with an AR-15. The uncle of one of the deceased complained that, “It wasn’t fair. He had an AR-15.” No, moron. It wasn’t fair that they initiated violence against someone minding their own business.

If somebody walks into a bar and sucker punches some guy, and it turns out that guy is Chuck Norris and he breaks every bone in the attacker’s body, that’s just tough shit. The attacker threw fairness out the window when he initiated violence.

That’s why, when people get all upset about August 6th or August 9th, I just say, “December 7th.”

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Category: Weird thoughts about impeachment

OK, so the Dems want to impeach Trump because he beat Hillary and is dismantling a lot of their pet programs, many of which are on shaky legal ground. Understood. But what is going on with the CIA, the FBI and the State Department? Why are George Kent, Bill Taylor, John Brennan, James Comey, Marie Yovanovich, Susan Rice, and so many others opposing the president, whose job it is to set foreign policy? What is it with the FISA warrants and the unmaskings and the whistleblower and all that?

Simple. It’s all about Russia and China.

Russia has been treated as an enemy of the Unites States since the Truman Doctrine in 1947. The CIA was founded by Truman to keep an eye on the Soviets. The FBI made many of its most famous busts (after Al Capone) of Russian spies. The State Department has coordinated US policy against the Russians for over seventy years. Every senior diplomat in the US cut their teeth on opposition to the Soviets and Russia. It’s what they know. It’s ALL they know.

China, in contrast, has been a friend of the United States since 1972, when Henry Kissinger negotiated a trip by Richard Nixon to visit Mao Tse-Dong. China had been an ally of the United States against Japan in the Second Word War, but there was tension — and the Korean War — from the rise of the communists in China. The theory was that, if we were friends with China, and they become more capitalist, then surely political freedom would follow. We let them into the WTO, and they ate our lunch. Former State Department officials like Henry Kissinger and Madeline Albright have made millions consulting for US companies relocating manufacturing to China. Meanwhile, China is actually cracking down on freedoms, with the Uighurs, with Falun Gong, with Hong Kong.

When the Soviet Union broke up in 1991, there was an opportunity to be friends with Russia. We had been friends before, in allying against the Nazis, and that was with Stalin. We certainly don’t have problems being friendly with people who aren’t exactly saints. The big fly in the ointment? George H. W. Bush, who had been head of the CIA and ambassador to China. Do you see it now?

So what’s the current kerfuffle all about? What the hell is it with Ukraine, anyway? And Syria, too, for that matter? Simple. Naval bases.

Russia has six major naval bases. St. Petersburg, Kaliningrad, Murmansk, Vladivostok, Tartus, and Sebastopol. St. Petersburg is iced in over the winter. Kaliningrad isn’t iced in, but it isn’t contiguous to Russia. Poland and the Baltics are in between, much as Canada is between the main part of the US and Alaska. Murmansk is iced in much of the year, and it is primarily a submarine base. Vladivostok is north of Korea, and the Russians actually have to heat the harbor to keep it open all winter.

Which leaves Tartus and Sebastopol. Tartus is in Syria, a base Bashar al Assad leases to the Russians. Do you see now why Russia will support the Assad regime against all comers? Tartus is a warm-water base on the Mediterranean, where Russian ships can be serviced without transitting the Dardanelles and the Bosporus Strait through Turkey.

As for Sebastopol, in the Crimea, the naval base there was founded by the Russians in 1783, before the US even had the Constitution. The city of Sebastopol was actually founded to support the naval base, because if you’re going to have a naval base, you need a place for all the hookers and bartenders to live, as well as a railhead for supplies.

So how the hell did the Crimea end up with Ukraine?

In the 1930s, there was a movement in Ukraine to break off from the USSR. Stalin starved Ukraine, and millions died. When Stalin died in 1953, Khrushchev took over. Whereas Stalin had been from Georgia, a neighbor and rival of Ukraine, Khrushchev had been born near the Russian-Ukraine border. He made nice with the Ukrainians, transferring Crimea and the Donbass to the Ukrainian SSR. This was all still within the USSR, so, no problem.

When the Soviet Union broke up, however, the Ukraine split off, and took Crimea and the Donbass — which are completely ethnically Russian; no Ukrainians there at all — with them, including the naval base at Sebastopol. This was still not a problem, because the Ukrainian government was pro-Russian.

Enter our heroes, the CIA and the State Department. Yes, that’s sarcasm. US stated policy was “regime change” in Syria. What does that mean to Russia? No more Tartus naval base. Oops. And we actively worked to support pro-Western politicians in Ukraine, and pushed for Ukraine membership in the EU and NATO. This would put the Russians’ naval base in Sebastopol — which has been theirs for 236 years — in NATO, an organization formed to oppose the Russians. Oops.

Why the hell would we do that? These aren’t in our national interest. No, but they are directly opposed to the Russians’ national interest in a major way. We’ll show those guys. So Putin continues to support Bashar al Assad, and he took the Crimea and the Donbass back from the Ukraine in 2014, after the election of a pro-Western government. We’ve made Putin out to be the huge big bad guy over this, but ANY Russian leader, even the most enlightened, would have done the exact same thing.

Meanwhile, we continue to be friends with China, while they steal our technology, round up the Uighurs into concentration camps, practice religious oppression against the Falun Gong, welch on their treaty obligations over Hong Kong, and cheat on WTO rules.

WTF?

So Trump, when campaigning, said China was the problem, and wondered aloud why we couldn’t be friends with Russia. This was a huge threat to the established order in the CIA, FBI, and the State Department. All these people have been fighting the Russians for decades. It’s all they know. If Trump made friends with the Russians, all their Russia-fighting credentials — and funding — are gone. Can you imagine the interview questions? “So, uh, what else do you know? Anything?” All their clout, all their experience, all their influence depends on the US being enemies with Russia.

The reason we’re on the side of the Ukraine, which is the most corrupt country in Europe, is because they’re fighting with the Russians. Ukraine should just give Crimea and the Donbass back to Russia. Problem solved. But you heard George Kent testify on Wednesday that the cornerstone of US policy on Ukraine is the “security of an intact Ukraine.” Notice that key phrase, “intact Ukraine.” Meaning, taking Crimea and the naval base from the Russians.

The reason we’re in favor of regime change in Syria is because that would deny the Russians the naval base in Tartus. It has nothing to do with Bashar al Assad being a bad ruler. There’s a ton of those guys around. Why is this guy so important? Because we can cost the Russians another naval base. Bwahahahaha.

We continue to have troubles with Russia — expensive troubles, over issues important enough to Russia to go to war over — because we have a bunch of career people in Washington whose whole career is worthless without troubles with Russia.

And that’s why the foreign policy establishment hates Trump. He would remake US foreign policy to reflect current realities, which would make them irrelevant.

Category: Weird thoughts about systemic racism

Oh, I’ll probably get in trouble for this one. What the hell, here goes.

There’s a lot of talk about systemic racism among the Democratic presidential candidates lately. America is a racist country, etc. I want to agree in part and disagree in part.

First, let’s face it, most of the wealth, power, and cool shit in this country is in the possession and control of white people. That is, I think, not realistically contestable.

But there are a lot of black people and Asian people who have also made a lot of money, wield a lot of power, or have a lot of cool shit. And there are a lot — the vast majority — of white people who don’t have any of it. So it’s clearly not race, or not just race, that determines those outcomes.

I’ve also heard about young black people being excoriated by their friends for “acting white” when they study, speak proper English, or eschew drugs and dressing like a gangbanger.

The confluence of those facts led me to a stunning realization. The people with money and power and cool shit in this country don’t have it because they *are* white, they have it because they *act* white.

So what is “acting white”? How does one do that? I think it’s pretty simple.

– Be well-spoken. Lose the ghetto slang.

– Be well-read, especially about history and economics.

– Don’t commit crime. No shoplifting or theft or breaking into cars or running stop signs or driving like a nut case.

– Don’t do drugs, and use alcohol moderately if at all.

– Don’t get pregnant — or get somebody else pregnant — until you finish school.

– Work at school. Graduate. Go to college. Graduate.

– Don’t hang out with, or dress like, gangbangers.

– Unless you have a carry permit, leave the guns at home.

And realize that people who tell young blacks that they’re acting white don’t want those young blacks to have money, wield power, or have cool shit, because so-called “acting white,” whether you’re white or not, is the way to get them.

There are a ton of examples. Clarence Thomas, Condoleeza Rice, Ben Carson, Tim Scott, Larry Elder, Walter Williams, Thomas Sowell, Mia Love, Barack Obama, Michelle Obama, Kamala Harris, Cory Booker, Herman Cain, Robert Johnson, John Johnson, Charles Payne, Bob Woodson — and that’s just off the top of my head as I write this.

It doesn’t depend on your starting circumstances. Ben Carson, for example, was raised in the projects by a single mother who could not read, and he became a brain surgeon and head of pediatric neurosurgery at Johns Hopkins before becoming HUD secretary.

That’s just blacks. Asians are better at “acting white” than white people are. In fact, it might better be called “acting Asian.” And there are a lot of whites who don’t “act white.” They also end up without money, power, or cool shit. Southern cracker culture in particular is antithetical to “acting white.”

I bounced this idea off a black friend the other night. “It’s not because they are white, but because they act white. Wow.” They thought about it, then slowly nodded their head and said it was a powerful insight.

It does explain a lot. And it means that, in this country at least, people’s futures are largely in their own hands.

It also means that no attempts to ‘correct injustice’ that don’t address personal behaviors can ever succeed.

My Slides From LibertyCon XXXII

CyberSecurity for Writers and Scientists
Rich Weyand moderates this panel on cybersecurity for Writers and Scientists and other professionals including new threats and new countermeasures.
With Scott Bragg, Doug Loss, Gerald Martin, Jessica Schlenker, and Rich Weyand
https://www.dropbox.com/s/ntbd4xdcs6xir2j/CyberSecurity.pdf?dl=1

The Challenges of Cyberwarfare
Rich Weyand moderates this panel on the challenges of waging and surviving cyberwarfare.
With Scott Bragg, Doug Loss, Jessica Schlenker, and Rich Weyand
https://www.dropbox.com/s/jqqylg9j8f7nwvd/CyberWarfare.pdf?dl=1

Cryptocurrency
Rich Weyand will do a presentation on the technology of cryptocurrency and what you need to know.
https://www.dropbox.com/s/ydowqc2bk8sgym2/CryptoCurrency.pdf?dl=1

Pantsing For Beginners
Authors Rob Howell and Rich Weyand and Stephanie Osborn — all write without an outline — will teach their process for beginners who just can’t seem to get that first novel done.
https://www.dropbox.com/s/7v18pfhad53efw3/Pantsing.pdf?dl=1

Fixing Healthcare

Neither the ACA nor the AHCA address the real problem in health care.  The real problem is that healthcare costs too much.  Neither bill solves that, they just rearrange where the money comes from.

What is the real problem? A system that has no price transparency and no competition, so the marketplace can’t work.

You want to fix healthcare?  How to do it in a few simple steps:

1) Providers can charge whatever they want, but they must charge the same price for everybody. No PPO prices. No negotiated prices. One price for everyone, insured or not.

No more $10,000 hospital bills that they will chase the uninsured for with collection agencies, when the insured get a PPO price negotiated down to $3,000 or less. Every provider must offer services at the same price for the same procedure to everyone.

“You have money to buy insurance, so we’ll charge you less.”  What?

2) All prices for healthcare providers have to be posted on their websites by Medicare procedure number.

If it isn’t on their website, then it’s free. And if you prove it wasn’t on their website when you had the procedure done, and they charged you for it anyway, it’s triple damages plus costs.

3) Allow flat-rate pricing for major procedures, such as a price-per-stent-installed or per-knee-replaced, rather than a la carte for each Medicare procedure number.  Flat-rate pricing can eliminate guesswork for the patient.  The provider can spread the costs of complications across all procedures.  Simplifies billing.

4) Allow charity pro bono medical work.  Currently Medicare must be the lowest price, so doctors cannot charge the legitimately indigent lower prices.

5) Provide some broader method to cover indigent visits to emergency rooms.  Right now it is on a per-facility basis.  Combined with the “must treat” policy, this is driving hospitals out of poorer areas.  Either state-wide or federal sharing of these costs across all facilties, or outright federal reimbursement to facilities.

One solution would be to account these at the state level, and then reimburse them as part of Medicaid, or under the Medicaid organization.  Without some relief, hospitals will move out of poor areas.  Further, hospitals will have a hard time competing in an open market against providers who do not have emergency rooms, such as imaging centers, surgery centers, etc, since they must spread the indigent emergency room costs across other services.  So get rid of the unfunded part of the mandate and its hidden costs and get the costs out in the open.  Let the entire market share these costs.  One way would be federal funding.

The other things that’s strange about the current unfunded mandate is that emergency care for the poor is funded by other people who are sick and facing big hospital bills.  The healthy take no part in funding this care for the poor, which is of general benefit to society.  Right now it’s a tax on the sick.  Some broader funding mechanism seems appropriate.

6) Enable private healthcare fraud investigators with 10% or 20% bounties on finding Medicare and insurance fraud.  Let the private sector provide a more adaptive and more effective enforcement against fraud.

7) No 100% insurance coverage for anything.

The patient has to pay 10% or 15% or 20% of everything out of pocket, up to a maximum of $2000-$3000 per year. We can figure out which numbers work best later.  This incentivizes the patient to shop prices.

8) No deductibles on which insurance pays nothing.

The insurance company should have some exposure up until the deductible is met, to incentivize insurance companies to assist the patient in controlling costs.

7 and 8 could be combined into something like 50-50 insurance and patient payment up to $4000 (so insurance pays $2000 and patient pays $2000) before insurance kicks in at 100%.

9) Allow health insurance purchase across state lines.

Get rid of the exemption, granted by Congress to the states, that sidesteps the Commerce Clause.  No state insurance boards selecting which insurance companies can and cannot sell in their state.

10) Eliminate state and federal coverage mandates that force people to buy coverage they don’t want, and substitute a simple federal basic catastrophic coverage plan as the minimum health insurance plan nationwide.

11) Tort reform, to make costly defensive medicine unnecessary.

Limitation on pain and suffering damages.  Actual economic damages, wrongful death, etc. are not limited.  Perhaps the actual limit should be 150% of actual economic damages, so the plaintiff is 100% restored after the lawyers take their one-third contingency payment.

12) Insurance companies not allowed to drop you when you get sick.

13) No pre-existing conditions if you have been continuously insured.  No refusal of insurance to anyone.  One-year maximum exclusion of any pre-existing condition for someone who has not been insured.

14) An initial grace period with no pre-existing conditions and guaranteed acceptance even if you haven’t been previously insured, to get the system started.

15) Some sort of HSA system, where people can set aside tax-free dollars for the patient portion, and roll that into their IRA if they don’t use it. Can be inherited tax-free if it is rolled over into another HSA.

16) Tax deductions for all medical expenses, both for insurance premiums and the patient portion of expenses.

17) Get the AMA — the doctor’s union — out of the business of certifying medical schools, and using that to limit the supply of doctors.

How much would truck drivers earn if the Teamsters ran the DMV?  Would we have a shortage of truckers?  What would be the education requirements for truckers?  Would they be reasonable?

One solution is to split the AMA into a minimum of three associations — the BMA, CMA, and DMA — none of which can have more than 40% of the membership of all three taken together.  Any of the three could certify a medical school or a hospital.

18) Get rid of the residency requirement for doctors from other countries coming to the U.S. to be certified.

This could be on a country-by-country basis, but OECD countries should probably be specified right off the bat.

19) Get rid of certificate of need requirements for medical facilities.

The cheapest groceries are when Kroger and Marsh are across the street from each other, not when there is only one grocery in town.

20) If a medication has been approved and in use in another OECD country for five years, it gets approved here automatically.  No FDA requirements for approval.

21) Allow the free import of approved medications.

No more milking the American public in a closed market while selling wholesale overseas.

22) Change the dietary recommendations away from the discredited low-fat diet to a low-carb diet.

Obesity and Type 2 diabetes are being driven by the low-fat diet nonsense.  Jelly beans brag “Zero Fat!” on the package.  Order the FDA to abandon the existing food pyramid and dietary recommendations, and revise them in the light of current research.

23) At the end of every year, the government determines what the median Medicare spending per senior is for every age: 65, 66, 67, 68,….  Anyone of that age who had more Medicare spending than that, well, that’s OK.  That’s what it’s there for.  But if someone had Medicare spending below the median for their age, they get a check from the government for, say, 20% or 25% of the difference.

Example: Someone who is 65 had $4000 of Medicare spending last year, while the median spending in the age 65 group that year was $10,000.  In January, the Medicare system sends him a tax-free check for $1200, 20% of the difference of $6000.

What this does is encourage people to go to less expensive providers, and to not go to the doctor for every little thing just because it’s free.  It also encourages providers to charge less than the Medicare maximums if they can, in the hope of attracting more patients trying to save Medicare money. That is to say, it would restore market incentives even though the costs were reimbursed, which is the really tough problem to making Medicare pricing competitive.