Friday, November 15, 2002

Medical Experiment

Over the last two months, I've had occasion to make and keep seven appointments with five physicians in Manhattan. The specialties represented were Internal Medicine, Radiology, Gastroenterology, Urology, and Dermatology. Manhattan physicians are usually very good but their office staffs often leave a little something to be desired. Four of the five offices worked about the same. There were the usual communications difficulties and waits that one becomes used to here. The paperwork and such. Once I was admitted to the presence of the physician, the appointments went well.

One of the five offices however worked much more efficiently than the others. I secured an appointment as a new patient without much phone delay. Staff was unusually articulate. I arrived 15 minutes late and finished my medical history, arranged payment, saw the PA and physician, received a prescription and was out the door a half hour after I arrived. Now it happened that my problem was a simple one but the ease of the transaction owed more to the office than to me. Some of my appointments with the other physicians involved as little MD interaction but the total process was much more involved.

Play a little game. Guess which of the specialists listed above had the most efficient office and why.

Answer -- the dermatologist. Why? Because most of his practice involves patients paying their own money for cosmetic procedures such as laser zapping for veins and wrinkles, botox, peels, liposuction, etc. Not covered by third party payors. Lots of competition on Manhattan's Upper East Side. Office efficiency. Amazing correlation.
Non-Citizens Voting
Professor Volokh on voting by aliens:

I would probably be somewhat more opposed than my friend to letting noncitizens vote in state and federal elections, especially since in many jurisdictions noncitizens are a huge group, and I do think that swearing allegiance to your new nation is an important step in making people feel like they have a long-term stake in the nation's health. But it is important to realize that the proposals to allow noncitizen voting are not some departures from an unbroken American tradition.

For obvious reasons, we are at a peak in anti-alien feelings.

In fact immigration itself was unrestricted throughout much of our history. Immigration controls were non existent for the first 100 years of the Republic, reflecting the pro immigration stance of the Founders. Note that immigration is not mentioned in the Constitution. There is only a reference to naturalization and the requirement that the President be native born. Arguably, Congress lacks the power to restrict immigration since they are not given that power in the Constitution. It could be argued that immigration control is part of the inherent "police power" that all governments possess but that then leads to the question of whether or not the Feds have "police power" (outside of the Federal District) or if that is the sole province of the States.

Both advocates and opponents of immigration should keep in mind that two of the leading documents in the history of liberty include immigration among the rights that governments should respect:

The Magna Carta

[30] All Merchants (if they were not openly prohibited before) shall have their safe and sure Conduct to depart out of England, to come into England, to tarry in, and go through England, as well by Land as by Water, to buy and sell without any manner of evil Tolts, by the old and rightful Customs, except in Time of War.

The Declaration of Independence

He has endeavoured to prevent the population of these States; for that purpose obstructing the Laws for Naturalization of Foreigners; refusing to pass others to encourage their migrations hither, and raising the conditions of new Appropriations of Lands.

War & Liberty

Libertarians should know what libertarian theory actually has to say about War -- but they don't. Here are some "Believe it or Nots" from libertarian war theory.

1) War is permitted.
2) Military forces are permitted.
3) Government Armies in peacetime are less of a problem for libertarians than government teachers or social workers anytime.
4) Both the Income and Social Security tax systems under which Americans now suffer, were introduced in peacetime and collectively have caused far more loss of liberty for Americans than all our wars combined.
5) Libertarian principles permit one to "invade" another country and kill its government practically at will.
6) Almost all of the growth of the spending, taxation, and power of OECD governments over the last 50 years can be blamed on non-military spending and non-security-related regulation.