 LTC Bullet: The LTC Anointed Friday, September 17, 2021 Seattle— LTC Comment: Thomas Sowell’s books, A Conflict of Visions, The Vision of the Anointed and Intellectuals and Society, offer insights into why the long-term care intelligentsia think and act the way they do. We explain after the ***news.*** *** LTC CLIPPINGS are daily emails the Center for LTC Reform sends to premium members ($250 per year or $21 per month) apprising them of critical information they need to know before they’re blindsided by clients or prospects. They average two per day and include the date, title, author, a representative quote, a link to the source and Steve Moses’s brief interpretation. The Clippings cover popular and scholarly articles, studies and reports, newly published data, etc. Our goal is to free others from time-consuming research that takes them away from their normal sales or administrative work. The LTC Clippings are compiled each Monday in an LTC E-Alert sent to all Center regular members ($150 per year or $12.50 per month). Check out all the membership levels and benefits here and join the Center here. These are two LTC Clippings from earlier this week: 9/16/2021,
“Facing
Medicare’s fiscal challenges: The 2021 Medicare trustees’ report,”
American Enterprise Institute 9/13/2021,
“Will
Medicaid take life insurance proceeds after I die?,” by Karin Price
Mueller, NJ.com LTC BULLET: THE LTC ANOINTED LTC Comment: In A Conflict of Visions, Thomas Sowell identifies and distinguishes two principal ways of viewing the world and human potential. He calls them the unconstrained and the constrained visions. The “unconstrained vision” is The Vision of The Anointed. People with that view of the world imagine that anything is possible, human nature is improvable, and the better sort, especially intellectuals, should guide and direct the rest of humanity. Those with Sowell’s “constrained” or “tragic” vision, in contrast, see human potential as delimited by unavoidable obstacles that must be systematically confronted and overcome. For them, human nature is already mostly established and must be worked around with ingenuity and effort. Intellectuals, according to the constrained vision, are self-satisfied prima donnas who arrogate authority to themselves while ignoring or demeaning the public’s cumulative knowledge and preferences, often called “common sense,” gained from centuries of experience and tradition. Which of these two visions of the world would you associate with the academics and advocates who tell us so confidently what’s wrong with and what to do about long-term care? To my mind, Sowell’s unconstrained vision clearly prevails among “The InLTCgentsia.” These experts, the “LTC anointed,” believe they know best what ails America’s long-term care system and how to fix it. They ignore the long history of government interference in the long-term care market. They persist in promoting government “solutions” for problems created by government funding and regulation. They brush off arguments to the contrary while refusing to engage on specific objections to their collectivist dogmas. They insist on addressing only symptoms, never identifying or analyzing the causes of long-term care’s dysfunctions. They seduce politicians with ideas and proposals based on the fantasy that government, following their advice, can provide better long-term care than a free market in which people vote with their own money for the kind, amount and quality of care they prefer. The LTC anointed persist in offering the same analysis and proposals rejected by voters decade after decade while expecting a different result. To expand and elucidate, here are some quotes from Thomas Sowell about the unconstrained vision of the anointed followed by our examples based on observation of the “LTC anointed.” Sowell:
“The question for the anointed is not knowledge but compassion,
commitment, and other such subjective factors which supposedly
differentiate themselves from other people. The refrain of the anointed is
we already know the answers, there’s no need for more studies, and the
kinds of questions raised by those with other views are just stalling and
obstructing progress. ‘Solutions’ are out there waiting to be found, like
eggs at an Easter egg hunt. Intractable problems with painful trade-offs
are simply not part of the vision of the anointed. Problems exist only
because other people are not as wise or as caring, or not as imaginative
and bold, as the anointed.” LTC Comment: The LTC anointed have dreamed up “solutions” for long-term care in studies, commissions and legislative proposals over many decades. Somehow they can never figure out how to force the public, who are more self-interested, and supposedly less wise and caring, to pay for their illusive dreams. Sowell:
“While those with the vision of the anointed emphasize the knowledge and
resources available to promote the various policy programs they favor,
those with the tragic vision of the human condition emphasize that these
resources are taken from other uses (‘there is no free lunch’) and that
the knowledge and wisdom required to run ambitious social programs far
exceed what any human being has ever possessed, as the unintended negative
consequences of such programs repeatedly demonstrate.” LTC Comment: All we need to do is raise the marginal tax rate, bump up the Social Security tax, or nail the rich. Never mind that every dollar removed from the supply of private capital to fund social welfare schemes is a dollar that will not go to invest in producing products and services people actually want, as proved by the fact they’re willing to pay for them and do not have to be compelled by the threat of government force to spend for them. Sowell:
“To suggest that ‘society’ can simply ‘arrange’ better outcomes somehow,
without specifying the processes, the costs or the risks, is to ignore the
tragic history of the twentieth century, written in the blood of millions,
killed in peacetime by their own governments that were given extraordinary
powers in the name of lofty goals.” LTC Comment: The LTC anointed insist, without specifying the “processes, the costs or the risks,” that if we would just turn over to government the power to compel everyone to pay more taxes to support their recommendations, we could somehow get a better long-term care result than the dysfunctional system we have now that is grounded in many decades of government funding and control. Sowell:
“The vision of the anointed is one in which ills as poverty, irresponsible
sex, and crime derive primarily from ‘society,’ rather than from
individual choices and behavior. To believe in personal responsibility
would be to destroy the whole special role of the anointed, whose vision
casts them in the role of rescuers of people treated unfairly by
‘society.” LTC Comment: The LTC anointed assume it is society’s responsibility to fix long-term care as other followers of the anointed vision “fixed” retirement security and elderly health care with Social Security and Medicare. It feels good to proclaim solutions from on high. But greater and greater dependency on government has depleted individuals’ sense of personal responsibility leaving real life people unprotected if and when government lets them down. Sowell:
“Systemic processes tend to reward people for making decisions that turn
out to be right—creating great resentment among the anointed, who feel
themselves entitled to rewards for being articulate, politically active,
and morally fervent.” LTC Comment: That shoe fits the LTC anointed like a glove. They bask in the warm, unchallenged shibboleths of the “unconstrained” vision while evading the market’s school of hard knocks. Entrepreneurs, on the other hand, risk their own capital in search of profits earned by giving consumers what they actually need and want. Which should we appreciate more? Sowell:
“The hallmark of the vision of the anointed is that what the anointed
consider lacking for the kind of social progress they envision is will and
power, not knowledge. But to those with the tragic vision, what is
dangerous are will and power without knowledge—and for many expansive
purposes, knowledge is inherently insufficient” LTC Comment: The LTC anointed seek to force people into one-size-fits-all compulsory social programs that eliminate the power of personal agency leaving people dependent on politicians and bureaucrats. What has our increasing dependency on politicians and bureaucrats given us so far? Sowell:
“One of the first things taught in introductory statistics textbooks is
that correlation is not causation. It is also one of the first things
forgotten.” LTC Comment: The LTC anointed often confuse correlation and causation. Two examples: (1) They assume elderly asset decumulation late in life must have been caused by catastrophic long-term care spend down. They never consider the possibility that older people and their families may learn of Medicaid’s generous and elastic income and asset eligibility rules and hide, jettison or reconfigure their wealth to qualify, with or without the assistance of omnipresent lawyers eager to help them artificially self-impoverish in exchange for a generous fee. (2) Trying to make their case for catastrophic Medicaid spend down, the LTC anointed over-estimate its incidence by pretending that every transition to Medicaid LTC eligibility occurs because of spending on long-term care. People can and often do transition to Medicaid eligibility without spending down significantly. The correlation between spending and transition often hides the true causation, i.e., that Medicaid rules allow people with substantial income and assets to qualify for LTC benefits. Even greater wealth than the basic eligibility rules allow is protected by means of techniques explained in the formal legal literature on Medicaid planning which the LTC anointed almost entirely ignore. Sowell:
“What is seldom part of the vision of the anointed is a concept of
ordinary people as autonomous decision makers free to reject any vision
and to seek their own well-being through whatever social processes they
choose. Thus, when those with the prevailing vision speak of the family—if
only to defuse their adversaries’ emphasis on family values—they tend to
conceive of the family as a recipient institution for government largess
or guidance, rather than as a decision-making institution determining for
itself how children shall be raised and with what values.” LTC Comment: The LTC anointed treat ordinary people like chess pieces to be moved around on political and economic game boards. They seek to replace personal responsibility and planning with government compulsion through mandatory social insurance for long-term care. They know best; the rest of us are too ignorant or irresponsible to do the right thing. But do they ever ask why the public has become so ignorant and irresponsible when it comes to retirement, health care and long-term care planning? Do they question whether government promises from Social Security, Medicare and Medicaid may have undercut private concern for economic risks? Does the concept of moral hazard, so fundamental to private insurance theory, ever enter their minds? The answers are no, no and no. Sowell:
“Among the many other questions raised by the nebulous concept of ‘greed’
is why it is a term applied almost exclusively to those who want to earn
more money or to keep what they have already earned—never to those wanting
to take other people’s money in taxes or to those wishing to live on the
largesse dispensed from such taxation. No amount of taxation is ever
described as ‘greed’ on the part of government or the clientele of
government.” “[W]hen people choose their
occupations according to what the public wants and is willing to pay for,
that is ‘greed,’ but when the public is forced to pay for what the
anointed want done, that is ‘public service’.” LTC Comment: The LTC anointed routinely ask hard-working people to pay just a little more in taxes to fund their elaborate schemes. Two examples are the WA Cares Fund and the WISH Act. These programs and their ilk add long-term care to the mountain of moral hazard already inflicted on the economy by Social Security and Medicare. Yet the LTC anointed will characterize the opponents of their programs as uncaring and stingy. Sowell:
“Another way of verbally masking elite preemption of other people’s
decisions is to use the word ‘ask’—as in ‘We are just asking everyone to
pay their fair share.’ But of course governments do not ask, they tell.
The Internal Revenue Service does not ‘ask’ for contributions. It takes.” LTC Comment: Usually the LTC anointed don’t even bother to ask nicely. They presume they’re right and the rest of us should fall into step with their mandates. Sowell:
“…the very commonness of common sense makes it unlikely to have any appeal
to the anointed. How can they be wiser and nobler than everyone else while
agreeing with everyone else?” LTC Comment: The LTC anointed bristle at arguments grounded in common sense. They display contempt for people who just want to keep what they’ve earned, take responsibility for themselves and their families, and give charity as and when they can afford it and deem it justified. Sowell:
“In short, numbers are accepted as evidence when they agree with
preconceptions, but not when they don’t.” “Today, despite free speech and the
mass media, the prevailing social vision is dangerously close to sealing
itself off from any discordant feedback from reality.” “Reality does not go away when it is
ignored.” LTC Comment: Confirmation bias is commonplace among the LTC anointed. They do not consider, much less attempt to refute, evidence that conflicts with their predispositions. Examples are rife. The LTC anointed cling to the myth that Medicaid requires impoverishment while they ignore the ubiquitous popular and scholarly published evidence to the contrary. They insist wide swaths of the American public are being wiped out financially by long-term care expenditures, when there is no evidence this is so and they cite none. They rely slavishly on Health and Retirement Study (HRS) longitudinal data on asset decumulation assuming it’s proof of LTC spenddown without acknowledging or addressing the data’s many flaws. Moreover, nothing in that data demonstrates that spend down occurs because of long-term care expenses. Sowell:
“Many intellectuals are so preoccupied with the notion that their own
special knowledge exceeds the average special knowledge of millions of
other people that they overlook the often far more consequential fact that
their mundane knowledge is not even one-tenth of the total mundane
knowledge of those millions. However, to many among the intelligentsia,
transferring decisions from the masses to people like themselves is
transferring decisions from where there is less knowledge to where there
is more knowledge. That is the fatal fallacy behind much that is said and
done by intellectuals, including the repeated failures of central planning
and other forms of social engineering which concentrate power in the hands
of people with less total knowledge but more presumptions, based on their
greater average knowledge of a special kind.” LTC Comment: That quote pretty much sums it up. |