It certainly doesn’t strike me that universal coverage for basic medical needs should have much impact on the degree to which medical technology and techniques remain “innovative”. Relatively few of the dollars swallowed up by the U.S. health “system” are going to those who develop such technologies/techniques.

Incidentally, I don’t believe that the current American system is especially good, just that I strongly doubt that a single-payer system will save any great amount of money. Overall, perhaps unsuprisingly, I see healthcare as generally a stultified, over-protected and crappy industry not much better than aviation.

So not a surprise that my personal favorite is medical tourism, which I see as the most exciting (and promising) trade frontier at the moment. There are staggering potential cost savings from that.

Personally I’d be happy to argue in favour of a single-payer system on various other grounds, but from an economically conservative POV it seems a no brainer.

And ok, I’m sorry, it might be only a few hundred billions for now.

Noting that the Krugman piece suggests $124bn a year for Obama, which is trillions in less than ten years, and given the track record of large government entitlement programs (or indeed any other kind of program), I might stick with trillions, actually.

However, it is likely on the polls that Obama would control a Democratic Congress (and in any case the Republicans don’t have a lot of obvious Gringrich’s). Clinton’s example tells us very little about what would happen then, except to the extent that things like Hillarycare probably would have gone ahead, and cost trillions up till now. Oh wait, in fact, Obama is publicly committed to Obamacare – oops,

there seems to be minimal massive grounds for assuming that another Democrat President would preside over significant increase of government programs

.

“It was Gorbachev’s efforts to reverse the decline and to modernize his country that knocked the props out from under the system. The revolution was in essence a series of decisions made by one man, and it came as a surprise precisely because it did not follow from a systemic breakdown.”

Now, it would be nice if it went into more detail about what “knocked the props out” meant, and why it was that Gorbachev’s efforts backfired, but it’s pretty clear Gorbachev never intended the result he ultimately got.

Reagan may or may not have had a role to play in ending the Cold War, but there seems tenuous grounds for suggesting that it was the U.S.’s huge military spending during the 80′s that did it.

Either way, given the tiny spending increase recorded during Clinton’s reign, there seems to be minimal grounds for assuming that another Democrat President would preside over significant increase of government programs, which appears to be Patrick’s concern.

Reagan killed the Soviet Union.

Simple as that.

Clinton significantly reduced the size of the US military and, thus, gained the ‘peace dividend’. It was also a time of much reduced international conflict as the proxies of the Soviet Union found themselves without a source of funds.

Simple as that.

Arguments that the Soviet Union came down due to Gorbachev are fallacious. I spent 18 months in Moscow and followed the politics of the place for 30 years. The last thing he wanted was for the Soviet Union to end but as the economy collapsed he was backed into a corner. At least he took the least bloody way out at the end, which is to his credit.

http://www.j-bradford-delong.net/Politics/fitzgerald.html

I actually feel somewhat foolish for repeating the idea unquestioningly.

At any rate, I fully agree that “small government” is just a completely unworkable goal, no matter how admirable it might be. So what’s the advantage in a presidential candidate that claims to believe in something that’s never going to happen? Most of central planks of Obama’s platform are at least things that have already succeeded (to varying degrees) elsewhere in the world.

But more significant must be that Clinton almost never controlled Congress. I suspect that Hillarycare might have cost a little motza, for example.

So if you are making a statistical argument in favour of a divided government, I would be tempted to support you. Unfortunately recent evidence suggests that neither hell nor high water can come between politicians and our money, and certainly nothing as trivial as partisan differences.

What was Clinton’s result after the peace dividend as a consequence of the Cold War’s end?

has some interesting data on how much government spending increased under various Presidents. Clinton comes in as by the lowest at +0.81% per capita. Reagan was almost 3 times as profligate.

Even Reagan, the only president in recent history with a strong “less government” stance implemented all sorts of “big government” type programs.

In fact, the only Western government in modern times that seems to have achieved any genuinely noticeable reduction in government scope and spending was the ALP under Hawke and Keating.

As far as Obama’s “deep-seated conviction” – name one leader that didn’t improve his or her nation without some sort of conviction to do so? And the idea that “most” government-initiated programs are inefficient and counter-productive really is hogwash. What I care about is whether Obama or McCain is more likely to initiate inefficient and counter-productive policies. On that front, I’m pretty sure I could name more McCain policies likely to be so than Obama ones (including his recent announcement of buying up bad mortgages at full value).

Whereas I expect both McCain and, even more so, Palin, to prefer at almost any given junction, less government to more. Which I firmly believe is likely to make us all much better off.

The US presidency is much too big a job for any man or woman, certainly while America sees itself as “the exceptional nation”, ordained to lead others out of error and protect all freedom loving peoples. I don’t see this changing anytime soon; there’s just too much inertia, and pride, at stake. That’s why the degree of disqualification of their candidates is so critical.

If Palin (as Ron Paul actually does) dreamt of returning America to its modest Republican roots and dismantling the excesses of empire, temperament might well be the most important qualification. Unfortunately, both parties are locked into continued projection of American power; the Republicans in their Jacobin crusade and the Democrats in their slightly more cuddly version. Knowledge of the world is therefore critical for whoever takes the hot seat; bad could so easily go to worse.

If Palin knew her limitations, and had sufficient intelligence and commonsense, there might be some hope. She so clearly doesn’t, though; saying yes to the job offer without blinking confirmed that and nothing we’ve seen since gives any cause to reconsider. Rather the opposite.

But FWIW, I don’t think there’s any reason to think either Obama and McCain wouldn’t make competent presidents, as would Joe Biden. How how anyone could think that of Palin, especially after four years of Bush (and Palin is almost a caricature of Bush), would make a competent president is beyond me.

I am not so upset over Palin. I am coming to believe that there is no such thing as a qualified politician. Seriously, what would you in Arcadia (which obviously wouldn’t have a President) designate as qualifications for a President?

Who can you think of that has met them recently?

I sometimes (less often) think temperament is about the only real issue left on which to vote on.

Does this mean I think McCain is unfit to be president? No – plenty of past presidents had arguably more serious health issues. But they were backed up by essentially competent VPs that, as far as I know, weren’t religious fundies that believed in rapture and creationism.

BTW, does anyone have any statistics on how many VPs have been required to take over presidential duties in, say, the last 50 years?

I can understand you being comfortable with McCain, but you can’t seriously tell me you’re comfortable with Palin? And given his age and purported health issues, the chance of Palin needing to take the reigns, temporarily or otherwise, can’t be dismissed out of hand. The thought Palin as the arguably the most powerful individual in the world scares the bejesus out of me. I’d take another 4 years of Bush over that possibility any day.