KWBaker

“So dig this everyone. We can spend as much money as we want on anything that we want. We’ll just get our kids to pay it off man. Far out!”*

Greenpeace and the Tea Party on the same side of this one.

These guys were good “liberals” who knew how to stand up for what was right.

Among the many maddening things about the American health care market, few are so exasperating as its baroque and opaque pricing. The typical hospital bill makes the untranslatable Voynich manuscript seem like a child’s grade-school reader by comparison.

Such complexity is partly owing to a simple fact: Much of the market is managed by huge, bureaucratic organizations that employ thousands of people to do nothing all day but grind through minutiae. This leads to things like the ICD-10, a diagnostic coding system that governs the classification and reporting of diseases and injuries.

With 16,000 different codes, the ICD-10 gets rather specific. Was the patient struck by a turtle? Enter code W5922XA. Was she struck by a sea lion? That’s a separate code—W5612XA. Code S30867A covers nonvenemous insect bites to the anus. There’s one code for assault with a hockey stick, another for assault with a baseball bat. And then there is V91.07XA, for patients who have been burned by flaming water skis. (Burned by flaming water skis a second time? That’s V91.06XD.)

American health care providers must update from ICD-9 to ICD-10 this year. It says so right in the Federal Register, under a rule titled “Administrative Simplification.”

Drug pricing represents another area that seems to have been designed by a circus clown on quaaludes. Most products drop in price over time as new and better ones come on the market. Not so for some drugs. Take Avonex, a prescription drug for multiple sclerosis. According to a piece in Bloomberg Businessweek, prescriptions for Avonex have been declining—while its price has more than doubled. The price for Gleevex, a drug used to treat leukemia, has risen from about $118 per pill seven years ago to more than $300 now.

Indeed, prices for numerous drugs have shot up in recent years by twofold, fourfold and even more. And that doesn’t even count new wonder drugs such as Sovaldi, the life-saving hepatitis drug that costs $84,000 for a 12-week course, or Kalydeco, a treatment for cystic fibrosis that costs more than $300,000 per year.

There are various explanations for such eye-popping charges. Pharmaceutical companies spend billions of dollars a year on research, and they need to recoup that money. If they don’t, then the stream of new wonder drugs eventually will dry up. But R&D is not the sole explanation, especially regarding those drugs whose prices suddenly jump after they’ve been on the market for years.

Other factors include pharmaceutical industry consolidation, which leads to larger companies with more bargaining clout, and a federal law, much in need of repeal, that prevents one of the largest market participants—Medicare—from haggling. Confronted with a useful drug that carries an outlandish price, Medicare has two choices: take it or leave it.

Then there’s the patent-and-exclusivity system, which allows drug companies to recoup the costs of developing a drug by granting them exclusive sales rights for only a limited time. The exclusivity period for orphan drugs—those created to address rare conditions—lasts only 7 years, for example.

In 2013, drug companies lost more than $19 billion when patents expired and competitors started replicating various treatments. By a remarkable coincidence, the industry collected $20 billion by marking up other prescription drugs.

Sky-high prices present a serious dilemma: How much should people pay, or be forced to pay, for life-saving and life-changing treatments?

Insurance spreads the cost around. For run-of-the-mill prescriptions, co-payments usually constitute a fixed dollar amount, such as $25. For some advanced and expensive drugs, insurers have been asking policyholders to pay a percentage, such as 25 percent. For a drug that costs thousands of dollars, that can put a big dent in the patient’s bank account.

According to some, there oughtta be a law against that. And in a few states, such as New York and Vermont, there is. Del. Jennifer McClellan would like Virginia to have one, too. The Richmond Democrat has introduced a bill that would forbid insurance companies to charge more than a $100-per-month co-payment for such specialty drugs.

This seems an odd way to go about addressing the problem of high drug prices, which is not caused by insurance companies. In fact, the legislation is likely to make the problem worse, not better, by hiding the true prices of the drugs instead of bringing them down.

Like the flat rate at an all-you-can-eat buffet, flat co-payments are an invitation to overconsume. A patient asked to pay 10 percent of a drug’s price will object if the price doubles. But a patient who pays no more than $100 regardless of the price won’t care.

What’s more, pharmaceutical companies often know they can jack up prices without fear that insurers will drop coverage for a particular drug—because Obamacare requires prescription-drug coverage, and each state sets the formulary determining which drugs must be included. That robs insurance companies of bargaining leverage against drug companies. Allowing insurers to choose what they cover would help solve the drug-price problem.

Proponents of McClellan’s bill say people shouldn’t have to choose between paying for medicine and paying for food. That’s like saying people shouldn’t have to choose between paying for clothes and paying for shelter. It sounds high-minded, but it ignores economic reality.

Capping co-payments doesn’t lower prices one cent—it simply forces some people to pay more so others don’t have to. In the process, it renders the health-care market even more opaque and obscure.

They should have an ICD-10 code for that, too.

The idea that the American left is engaged in a war against the family has always struck me as an exaggeration.

The claim might be good for direct-mail fundraising and talk-radio ratings. But I have enough friends with left-wing politics and lovely families to find the accusation of a war on family to be, frankly, at least a touch paranoid.

Alas, the events of the past week have caused me to reconsider.

First came President Obama’s State of the Union address. Four times, at the start of the speech and at its conclusion, Obama repeated the phrase, “We are a strong, tight-knit family who has made it through some very, very hard times.” He said, “My fellow Americans, we, too, are a strong, tight-knit family.  We, too, have made it through some hard times.”

Second came Andrew Cuomo’s State of the State address, in which the governor, a Democrat, quoted his father, Mario Cuomo, who recently died. Governor Mario Cuomo had said, “those who made our history taught us, above all things, the idea of family; the idea of mutuality. The sharing, the benefits and burden, fairly for the good of all, it is an idea essential to our success and no state or nation that chooses to ignore its troubled regions and people while watching others thrive can call itself justified. We must be the family of New York feeling one another’s pain, sharing one another’s blessings, reasonably, equitably, honestly, fairly, without regard to geography or race or political affiliation.”

Andrew Cuomo commented, “My father was right then and he is right now. That is the New York spirit. That is the New York essence.”

So the president is trying to tell us that all America is not just an extended metaphorical family, but “a strong, tight-knit one.” And the governor of the Empire State is claiming that New York, too, is a family—not even one full of nasty divorces or bitter sibling rivalries, but one characterized by sharing “fairly for the good of all.”

The problem with both these claims is that, not to put too fine a point on it, they are total nonsense.

Perhaps some of our smaller mediating institutions or voluntary associations—family businesses, labor union locals, churches and synagogues, softball leagues—can at their best fill some of the roles a family does. They can feel or function like family, even if they aren’t family.

And a person may still feel responsible and want to help those who are not family, whether those people are neighbors, genocide victims in Africa, or poor youth or frail elderly or victims of terrorist attacks or school shootings here in America.

But Americans aren’t family, and New Yorkers are not family, either, and anyone who claims they are is trying to confuse you. That confusion makes it easier for the politicians to take away the money that you’d actually prefer to keep and spend on your own family. The politicians tell you that the money is going to help out your “family” members. But what the politicians are actually doing is taking the money away from you and your real family and giving it away to other people who aren’t your family at all.

Social conservatives may view this as a consequence of the breakdown of the “traditional” family, and the need for politicians to find something to replace it with. The more conspiracy-minded will see the attack on the traditional definition of the family as part of scheme intended to replace the traditional family with allegiance, instead, to the governmental unit, either the state or the nation-state.

But one doesn’t need to go that far and make either of those moves to see the effort to describe New York or America as one big “family” as an attack on the concept of family, an effort to change the definition of a family into something else.

The economist Friedrich Hayek saw this coming, as he did so much else. In his book The Fatal Conceit: The Errors of Socialism, he warned, “If we were to apply the unmodified, uncurbed rules of the micro-cosmos (i.e., of the small band or troop, or of, say, our families) to the macro-cosmos (our wider civilisation), as our instincts and sentimental yearnings often make us wish to do, we would destroy it.”

In other words, a society in which we try to treat everyone the way we’d treat our parents or our children just wouldn’t work. It would break down. Acknowledging this doesn’t make us unpatriotic or callous or somehow disloyal to the “New York spirit.” It just makes us realistic.

Plenty of us like the family members we have just fine, thank you; the last thing we need is tens or hundreds of millions more family members by virtue of presidential or gubernatorial edicts.

In the early 1990s, Gloria Bonilla-Santiago hatched a plan to create an alternative school for families in the impoverished city of Camden, New Jersey, who were desperate to avoid sending their kids to the city's abysmal public system.

She became deeply involved in building political support to pass the state's first charter school authorization bill. In 1996, the charter school bill passed, and the following year she opened a new school called LEAP in a vacant lot on the Camden waterfront.

Today, the school occupies 5 buildings on Cooper Street, offering its students a cradle to college education, and it's the most successful school in the city. While the four-year graduation rate in Camden's traditional public schools is 61 percent, LEAP has a graduation rate of 98 percent, and every member of its 2014 graduating class got into college.

This profile of LEAP is the second in a three-part video series on Camden public schools. Click here to watch part one, which looks at a failed effort to fix Camden's schools by dramatically boosting spending. Click here watch part three, which looks at the recent initiative to remake public education in Camden by creating a hybrid model of traditional and charter schools.

Reason Foundation is a partner in National School Week, an annual event that draws attention to increasing educational options for K-12 students and their parents. For more information on resources and activities, including more than 10,000 events taking place nationwide between January 25-31, go here now.

About 5:30 minutes.

Shot, edited, produced and narrated by Jim Epstein. Production assistance from Brett Crudgington.

Scroll down for downloadable versions and subscribe to Reason TV's YouTube Channel to get automatic notifications when new stories go live.

Despite what some people think, hero is not a synonym for competent government-hired killer.

If Clint Eastwood's record-breaking movie, American Sniper, launches a frank public conversation about war and heroism, the great director will have performed a badly needed service for the country and the world.

This is neither a movie review nor a review of the late Chris Kyle's autobiographical book on which the movie is based. My interest is in the popular evaluation of Kyle, America's most prolific sniper, a title he earned through four tours in Iraq.

Let's recall some facts, which perhaps Eastwood thought were too obvious to need mention: Kyle was part of an invasion force: Americans went to Iraq. Iraq did not invade America or attack Americans. Dictator Saddam Hussein never even threatened to attack Americans. Contrary to what the George W. Bush administration suggested, Iraq had nothing to do with the attacks on Sept. 11, 2001. Before Americans invaded Iraq, al-Qaeda was not there. Nor was it in Syria, Yemen, and Libya.

The only reason Kyle went to Iraq was that Bush/Cheney & Co. launched a war of aggression against the Iraqi people. Wars of aggression, let's remember, are illegal under international law. Nazis were executed at Nuremberg for waging wars of aggression. With this perspective, we can ask if Kyle was a hero.

Defenders of Kyle and the Bush foreign policy will say, "Of course, he was a hero. He saved American lives."

What American lives? The lives of American military personnel who invaded other people's country, one that was no threat to them or their fellow Americans back home. If an invader kills someone who is trying to resist the invasion, that does not count as heroic self-defense. The invader is the aggressor. The "invadee" is the defender. If anyone's a hero, it's the latter.

In his book Kyle wrote he was fighting "savage, despicable evil" — and having "fun" doing it. Why did he think that about the Iraqis? Because Iraqi men — and women; his first kill was a woman — resisted the invasion and occupation he took part in.

That makes no sense. As I've established, resisting an invasion and occupation — yes, even when Arabs are resisting Americans — is simply not evil. If America had been invaded by Iraq (an Iraq with a powerful military, that is) would Iraqi snipers picking off American resisters be considered heroes by all those people who idolize Kyle? I don't think so, and I don't believe Americans would think so either. Rather, American resisters would be the heroes.

Eastwood's movie also features an Iraqi sniper. Why isn't he regarded as a hero for resisting an invasion of his homeland, like the Americans in my hypothetical example? (Eastwood should make a movie about the invasion from the Iraqis' point of view, just as he made a movie about Iwo Jima from the Japanese point of view to go with his earlier movie from the American side.)

No matter how often Kyle and his admirers referred to Iraqis as "the enemy," the basic facts did not change. They were "the enemy" — that is, they meant to do harm to Americans — only because American forces waged an unprovoked war against them. Kyle, like other Americans, never had to fear that an Iraqi sniper would kill him at home in the United States. He made the Iraqis his enemy by entering their country uninvited, armed with a sniper's rifle. No Iraqi asked to be killed by Kyle, but it sure looks as though Kyle was asking to be killed by an Iraqi. (Instead, another American vet did the job.)

Of course, Kyle's admirers would disagree with this analysis. Jeanine Pirro, a Fox News commentator, said, "Chris Kyle was clear as to who the enemy was. They were the ones his government sent him to kill."

Appalling! Kyle was a hero because he eagerly and expertly killed whomever the government told him to kill? Conservatives, supposed advocates of limited government, sure have an odd notion of heroism.

Excuse me, but I have trouble seeing an essential difference between what Kyle did in Iraq and what Adam Lanza did at Sandy Hook Elementary School. It certainly was not heroism.

This article originally appeared at the Future of Freedom Foundation

The Jack Paar Program. March 8, 1963. The premiere of Richard Nixon's first piano concerto, performed by the composer:

The sound cuts out at 2:07; I'm not sure why. If you feel like you've been cheated out of an extra minute of musical Nixon, I'll try to sate you with this bonus footage of Nixon and Jack Benny playing a duet. Alternately, here is the opening scene of Nixon in China.

(For past editions of the Friday A/V club, go here.)