Even as the American Medical Association continues their relentless assault against the medical market through restrictions on both provider and consumer, Canadians finally seem to be warming up to the idea that perhaps government doesn’t do things best.

Until recently, it was illegal to pursue private healthcare. Candians feared that if people were allowed to pay for their own care, then doctors would leave for the private sector, and the poor would suffer. Due to government incompetence and poor compensation, Canadian healthcare is instead a quagmire of poor quality, excessively long waiting lists (even for urgently needed procedures), and a doctor shortage. So everyone suffers. Which is of course preferable.

The Canadian physicians were meeting in Charlottetown, Prince Edward Island, which is a wonderful place to vacation. A few years ago, we stayed there at a B&B, and the owner relayed a story of his need for a cardiologist to monitor his heart condition. When he moved from Ottawa to PEI, since he was new to the province, he was told that he was number 609 in the queue to be seen by a cardiologist, which the provincial health authorities estimated meant a wait of about two years. — Arnold Kling, Cato Institute

While the AMA continues their love affair with government, their Canadian counterpart has just elected Dr. Brian Day, head of the largest (technically illegal) private hospital in Canada. I think it’s fairly safe to say that the opinion of Canadian doctors — and many citizens — is starting to turn away from socialized medicine.

They say insanity is doing the same thing over and over again no matter how many times it fails. With every major socialized healthcare system in the world (including Medicaid) in danger of collapse, why do so many on the left continue to champion it?

It’s all rather amusing.

Democrats and even more Republicans are banging the CAFE (Corporate Average Fuel Economy) drum once again, to my intense consternation as both a conservationist and a libertarian.

I’ve talked before about how CAFE will prevent the transition to sustainable and environmenally friendly fuels, but Ronald Bailey of Reason reminded me of something we all have noticed: the curious positive correlation between rising CAFE standards and the sale of SUVs and light trucks. There have been a few theories as to why they were exempted, from their necessity as work vehicles to protection of the Big Three U.S. automakers. Regardless of the intent of the legislators, one thing has become clear: Stringent CAFE standards spelled the demise of more sensible methods of family transport than Expeditions and Yukons.

Before the SUV craze, soccer moms and families on road trips availed themselves of the station wagon. Available with three rows of seating (although those back seats weren’t the most comfortable), V-8 engines, and taking up no more space than a large sedan, these were truly the best of all worlds. With their stout powerplants they could pull a boat for a weekend trip on the lake or in more mundane use haul kids and groceries with ease. The advantages of the SUV in these areas? Next to nil for 95% of the people who drive them. Yet they presented the most economical options thanks to CAFE.

Under CAFE, these relatively efficient and easy to use animals (when compared to SUVs) became unsustainable as fleet mileage was pushed ever higher. This doesn’t even take into consideration the flawed nature of Environmental Protection Agency fuel mileage tests, which by their low speeds compared to the real world, routinely underestimate the thriftiness of large engines at speed while treating small engined cars like hybrids with unwarranted optimism. Small and light is good to a point. But when a car becomes too small to get the job done, people turn to trucks instead of large cars.

Very few of us have not complained about the glut of SUVs on the road, particularly as they are often driven by those who have little respect for the differences between those behemoths and passenger cars. Yet how many of us complained over CAFE? How many thought it was a good idea?

An efficient market depends on the consumer being both informed and rational in his choices. This obviously requires familiarity with the performance of the product (success rate, side effects, etc.) as well as an understanding of how the drug works. This is a bit much to ask of your average consumer, considering all of the education and training required to make a doctor or a pharmacologist. It would be a textbook case of a highly inefficient market with a great degree of misallocation of resources. In other words, patients would go broke as they died while pursuing ineffective treatments.

Is a government agency like the FDA the best solution to this problem? I can’t really say. But I think they’re a valid solution. The problem comes when they move away from that role in improving patient information to actually dictating which medicines a patient can and cannot use and for what they can use them.

FDA Approval

The ridiculously long clinical trial process is designed to determine how effective a given drug is as well as what, if any, the major side effects are. Based on this the FDA then makes a rather arbitrary decision as to whether or not the costs outweigh the benefits. Strangely enough, moneymakers like antidepressants, ADHD drugs and the like are allowed considerably higher thresholds than treatments for things like lupus, multiple sclerorosis, and other debilitating diseases.

The clinical trial itself is a good thing: It improves patient information. FDA approval is not. What the FDA deems “unacceptable risk” might be far different from what an individual patient may think. Tysabri, a treatment to prevent relapse in Multiple Sclerosis, is a perfect example of this. Three of the 1200 clinical trial participants developed a rather rare brain infection and subsequently died. These are not odds that the FDA likes. However, MS is quite a debilitating disease, and a patient might feel completely differently from a bunch of healthy people in white coats sitting far away from the pain, the debility, and the hopelessness.

Off-Label Drug Use

Another peculiarity of the FDA approval process is that a drug isn’t merely approved as “safe”; it’s approved as “safe and effective”. Which is a horse of an entirely different color. The FDA doesn’t approve drugs, but rather approves the use of a given drug in the treatment of certain conditions.

In other words, if your new wonder drug has a second potential use, guess what? Another trial, another 5-10 years before people at large can actually use it. Even though it’s already been deemed safe.

This is particularly problematic given the nature of the human body. Take Viagra for instance. Bob Dole may use it for one thing, but it has great potential in treating pulmonary hypertension and other cardiovascular problems involving constriction of your blood vessels. Although there are other medications out there, they often take a “bigger hammer” approach and in many cases are incompatible with either the patient’s condition or their other drugs. Viagra, on the other hand, is quite a bit more gentle in its effect.

It’s an interesting thing about medicine in that the core of our knowledge hasn’t changed. I use the same textbooks in physiology and pharmacology as my mother did 30 years ago. They’ve been updated in the ensuing decades, but I bet I could get the same letter grade using her ancient version as mine.

A drug is approved for treatment of one illness because it has a certain effect on the body. If this effect is known to be useful in alleviating other maladies, then why must I be hindered in using it in order to treat my patients, simply because of the FDA’s shortsightedness?

Conclusion

The FDA’s biggest sin is micromanagement. As an overarching organization, it can help both patient and doctor make informed treatment decisions by bringing to the fore otherwise unobtainable data on drug performance (and more importantly harmful side effects). As such, it can liberate an imperfect market and allow better allocation of medical and economic resources.

However, when the FDA decides to make the decision for doctor and patient it not only limits their freedom, it compromises the patient’s health and the doctor’s ability to change lives. At least once in my medical career, I will literally hold my patient’s life in my hands. I will stand between him and an untimely death. The idea that some suits in Washington can tell me what I can and cannot do in such a situation is absurd.

Every patient is different; the etiology of their disease, its progression, severity, and how it impacts the patient’s life qualitatively. For one man with a relatively mild case of Multiple Sclerosis, a 1 in 400 chance of dying may not be worth the risk. For a woman who finds herself in a wheelchair, losing sight, losing dexterity, losing her self, she may choose differently. Perhaps to her a year of relative freedom is worth more than five years of increasing debility. Who has the right to take that choice away from her?

Nurse-practitioners apparently shouldn’t be allowed to practice autonomously. The American Medical Association thinks they need to be supervised (read: employed) by a doctor at all times.

This amuses me given that there is a vast and growing shortage of doctors. If you want proof, just count the number of foreign medical graduates in residency positions right at this moment. It’s even more ironic given that clear-thinking individuals have been saying that nurse-practitioners and physician’s assistants are perfectly poised to fill a good chunk of this void.

Nurse-practitioners and PAs alike have a good deal of training. I’ve shadowed and worked with both and have walked away with nothing but the utmost respect for their abilities. No, they’re not doctors, but you don’t need a doctor to do many things they’re currently tasked with in healthcare delivery.

The healthcare market is huge. And even if these NPs and PAs do reduce the demand for family practice doctors somewhat, there is still plenty of opportunity for American medical graduates. Not to mention the fact that since it costs considerably less to produce an NP or PA than it does a doctor, we could be looking at massive savings in labor costs that could be passed on to the consumer.

The American Medical Association has been proposing one protectionist or statist piece of legislation after the next, and while their motives are just as impure as ever when it comes to challenging the growth of retail-store healthcare services, as Dr. Thomas Davis points out, these retail-chain clinics aren’t the free market supporter’s wet dream that some would have us believe.

The exchange by him and Tom Firey over at Cato is interesting, but I’d like to focus on Dr. Davis’s statement on what he (and putatively Mr. Firey) would like to see in a perfect world: “I would prefer a world where a patient can get any medication over the counter without a prescription, where doctors are not licensed, there is no insurance and patients paid cash at the time of service. Health care would be far more efficient and transparent in such a world.”

The problem with “perfect worlds” is that the way we develop our conception of them is flawed. We take observations of the real world, we then develop a model of real world dynamics that works under certain conditions, and then we take the model and try to extrapolate from it a vision of how the real world should be, ignoring those conditions in the process. I’ve dealt with this with market anarchists as well.

We must remember that the free market is a model, a very powerful one, but again dependent on certain conditions that never exist in the real world. To ignore the fact that those conditions do not exist in your “ideal” system is to lie to yourself.

What Dr. Davis’ admittedly appealing utopian view seems to suffer from are the myths of rationality and perfect information, necessary preconditions for a “free market” to operate under. Medicine is a complex and highly specialized subject. At least, that’s why my professors tell me that I won’t be ready to be a full-fledged doctor until I’m 30. And while I hate to come off as elitist, it is simple fact that the consumer — no matter how educated, intelligent, or motivated — would hardly be in a position to understand exactly what a service is, let alone how effective or necessary it may be.

Under such conditions, it’s hard to accept Dr. Davis’ view without a few qualifications:

• “Where a patient can get any medication over the counter without a prescription” — so long as something similar to the Protection of Lawful Commerce in Firearms Act was established. I’m not a big fan of Big Pharma. Not of their predatory business practices, the outright lies they make about cause and effect, their connection with doctors, none of it. But when all is said and done, medicines are a good thing. And it is very costly to research new ones.

• “Where doctors are not licensed” — where they don’t need to be licensed, sure. But I contend that licensing would become an important factor in mitigating the effects of imperfect information in the marketplace. Licensing would become a voluntary and private endeavor, and so become a form of branding. Rather than the patient having to research me with fervor, he could simply turn to my licensing agency, look at how rigorous their standards are, and then be able to make an educated inference about my own abilities.

  In fact, turning to a free marketplace would only make licensing more meaningful. Academies and Board organizations would compete to attract the most competent doctors; organizations like the ever more irrelevant AMA would cease to exist, being more dependent on the consumer rather than the provider.

• “Where there is no insurance” — Insurance has a several thousand year old history. Even if we were to somehow make it magically disappear today, it would reappear tommorrow in some other form. What we should do is decouple health insurance from employment. It was, as usual, well-intentioned legislation that created this juggernaut. If government had never mandated that employers pay health insurance costs, employers would have never tried to buy insurance in bulk. And if that had never happened, the monopolistic systems we see could never have been established.

The key point I’ve tried to make is the importance of freedom of choice. The idea that the American healthcare system is anything resembling a free market is nothing more than a myth. The idea that the American healthcare system can be a completely free market is also a myth. A free market is like a massless string, very useful for theoretical problems and simplifications, but very hard to find in the real world.

Nevertheless, when choice is maximized, individual and organization alike must compete and with competition will come efficiency and quality. Of that I have no doubt.

As to why I — unlike the AMA — am unafraid of the ensuing competition, I’ll have to quote Dr. Davis again: “My point is not that these clinics are ‘bad.’ The competition in the short run is probably a good thing, and I can out-compete Wal-Mart on the delivery of high quality health care any day.”

Radley Balko jokingly refers to them as the American Meddling Association. And he’s completely on point. What’s got him and many others upset is a proposed sin tax on soda to “combat obesity” as well as several other (even more asinine) proposed measures. Where will the revenues go? Government programs, of course.

The initiatives are self-evidently moronic. Disregarding the philosophical reprehensibility of such statist nonsense, as Mr. Balko points out, even the logic of it is dubious: Non-diet soda sales have remained relatively stable over the past 20 years or so. Meaning soda can hardly be considered to blame for the current obesity menace.

This is hardly the first time the AMA has stuck its nose into policymaking. And it likely won’t be the last. And neither are they the only expert organization to do so. I’ve talked about the thinly veiled statist tendencies of the Union of Concerned Scientists before. And I haven’t yet written much about the American Psychological Association for fear of an aneurysm.

Michael Cannon of Cato points out several other statist policy proposals the AMA put forth this week at its annual meeting in Chicago, including prohibitions on prescription drug and alcohol advertising, regulation of clinics run by nurse practitioners (and by that they mean drive out of business since they can offer services much cheaper than their doctor-members’ offices) and much, much more.

It figures that not a week after I publish my magnum opus on why the healthcare market needs to be more free that the American Medical Association would stick their fingers in the statism pot and demand that people carry a certain type of health insurance (Microsoft Word).

I couldn’t decide whether to laugh, cry, or break some skulls when I read the language used in the resolution: Personal responsibility through forced participation. It sounds like an oxymoron. And more than a little like Kos’s retarded pronouncement that he’s a Libertarian Democrat, who of course shows his support for greater freedom by way of increased legislation, regulation, and redistribution. It’s a funny thing about these people that whenever they want to enslave us to the state (or in the AMA’s case, to corporations and themselves), they clothe it in the language of liberty.

It’s particularly ridiculous in the AMA’s case given what they’ve recently called for in just the past week or two: sin taxes, as well as restrictions on advertising and use of common areas, not to mention several propaganda efforts aimed at curtailing behaviors they disapprove of.

It’s a 12 page document composed almost entirely of filth. The remainder consists of outright lies and words twisted so far out of shape that they’ll be in physical therapy for years. The gist of it is that if you make five times the poverty level, you should be forced to purchase not only catastrophic health insurance, but also preventive health insurance (checkups, flu shots, etc). If you don’t, what else? Tax penalties. More money for the state, more money for AMA pet programs. Almost none of which you yourself will see.

Now, as I mentioned previously, I’m actually a big fan of catastrophic/critical care health insurance. As far as I’m concerned the only people it doesn’t make sense for are those with younger-than-school-age children, the infirm, and the elderly. But part of a free market is choice. Just as freedom of religion includes the choice to be free of religion, freedom of choice in the marketplace includes the freedom not to consume goods of a given type. At any rate, the AMA not only wants to make that mandatory, they also want to make conventional health insurance mandatory. And conventional insurance is just a bad deal all around for many people. In the past year I’ve had physical therapy bills, two primary care visits, a specialist consult, and 3 prescriptions (don’t take em, just have em around). A good deal more expense than most. And out of pocket expenses would’ve been half the cost of my conventional insurance for the year. So not only does the AMA want to eliminate choice, they also want to force you to make an economically unsound purchase.

Sure, car insurance is mandatory even though many never or rarely use theirs (haven’t used mine yet, knock on wood), and ideologically while I feel it shouldn’t be, there’s no denying that that particular mandate at least makes sense on some level. In the almost 7 years I’ve been of driving age (1 of which was spent in a foreign country, and three of which were spent without a car), I’ve been hit 5 times. I wouldn’t have relished the prospect of going to small claims court five separate times and dealing with the headache of collection 5 separate times. I certainly wouldn’t have enjoyed paying the ER, MRI, and surgical consult bills that came after the first one. If you don’t have car insurance, you can screw up other people’s lives. Which is why while liability insurance is mandatory, but comprehensive isn’t. If you ball up your own car and can’t afford to replace it, tough. You chose not to pony up the extra cash.

If, on the other hand, you don’t have health insurance, the only life you can screw up is your own. Meaning, generally, being up to your eyeballs in debt (a debt that would be considerably lower if the healthcare market were more free). Someone will have to explain to me exactly why the government can tell me what I can do to myself. After reading the eloquent words of Paine and Jefferson, the fiery words of Freneau and Henry, I can fairly confidently say that the founding fathers would not have approved.

But the worst part of the whole thing was their use of the word responsibility. Especially paired with “individual” and “personal.” Now, if you haven’t figured out yet, I’ve got a little bit of a libertian streak. Meaning that “personal responsibility” is more or less my mantra. And the whole reason us minarchists worship at that altar is because those two simple words characterize not only how we view ourselves, but how we judge others. Personal responsibility is about choice. It’s about having the ability to waste your money on useless frippery, or invest it in education. It’s about clawing your way out of a ditch instead of waiting for some guy with a ladder to come strolling by. It’s about doing everything in your power not to fall in to the ditch in the first place.

But let’s see how the AMA uses it:

In considering an individual requirement for health insurance, the Council believes that at some point incomes rise to a threshold where personal responsibility should be required. . . .

Personal Responsibility should be required? As I’ve already said, the entire point of personal responsibility is that you do it yourself. If you’re forced to do it by laws and penalties imposed by the state, it’s simple obedience. My dog is obedient. She pees outside, doesn’t pull food off the table, and stays off the couch. Because I trained her that way.

Maybe I’m missing something though. Responsibility means obligation or duty. Personal means of or pertaining to the self. Well, that gets personal responsibility coming and going. Responsibility to the self, responsibility from the self. Either way if an external force (i.e. government) is the one enforcing the obligation or duty, it’s not personal. Nope, my logic is solid.

Kos and the AMA both know how to talk a good game. They know how to lie through their teeth claiming to defend liberty, personal responsibility, and the American way while doing nothing of the sort. A word out of context is just a word. And personal responsibility as the AMA would have you think means being told what to do and being punished for not doing it.

Hat tip: Cato

[This is part 2 of a two-part series. Part 1 was published Friday.]

The so-called “Citizens’ Health Care Working Group,” created by the Medicare Prescription Drug, Improvement and Modernization Act of 2003, which Michael F. Cannon of the Cato Institute accurately labeled as a more or less leftist front group, is soliciting comments on its interim recommendations on how to fix American healthcare. They of course, don’t mention any of the obvious solutions which should come to a red-blooded American capitalist. Nope, taxes, taxes, taxes. Not to mention behavioral restriction and income redistribution. In the interest of public health of course. But let’s take a gander at their own words:

It should be public policy, established in law, that all Americans have affordable health care coverage. . . .

This and other of the recommendations contained here call for actions that will require new revenues. . . .

We recommend adopting financing strategies for these recommendations that are based on principles of [socialism, bureaucracy and wealth redistribution]. These strategies should draw on dedicated revenue streams such as enrollee contributions, income taxes or surcharges, “sin taxes,” business or payroll taxes, or value-added taxes that are targeted at supporting these new health care initiatives.

So let’s go through these one by one:

Enrollee contributions: So you’re still going to have to pay a premium of sorts.

Income taxes: If the middle class was pissed about how hard it is to pay for healthcare, they’re going to be even more upset now that they’re paying even more of other peoples’ insurance costs. Paying more for the same health insurance just because you have more money. The very essence of “from each according to his ability, to each according to his need.”

Payroll taxes: Because we all know how well Social Security works. Not to mention that even if it’s a flat rate, those with a higher income will again be paying more for the same coverage. The other thing I don’t like about payroll taxes is that they’re a form of hidden taxes. You never think about how high your payroll taxes are because the money never touched your hand (the same reason I don’t withhold for income tax). You don’t realize the level of taxation because you have no mental framework to do so.

Sin taxes: As a 22 year old ex-athlete who eats like he still is one, what do you think I’d say about this? Here the government is going to make the assumption that junk food inevitably leads to bad health. It doesn’t. Not in moderation. And those who responsibly consume such victuals as Taco Bell at 2 a.m. will be punished for the transgressions of a few lardly individuals.

Value-added taxes: Basically a combination of a sin tax and a hidden tax. The thing about the VAT is that, like the payroll tax, you don’t fully mentalize how much these cost. I lived in Britain for a year. I can’t even tell you what the VAT was — and I paid it every day. All I can tell you is that everything in Britain was bloody expensive. Here, at least I can scream about my income tax because come April 15th I know exactly how much the government stole from me.

I’ve given their recommendations a once over, and they seem to be a once again perfect example of Hayek’s Road to Serfdom. First, they take our money through enrollment fees, income tax (doubly progressive), and payroll tax (progressive). And then, in order to reduce costs, they control the way we can act through “sin” taxes and value added taxes. Now how does this encourage freedom? By taking yet more property (income) away from the masses, controlling how its redistributed, and then yet further restricting their behavior in the interest of “the public good.”

Not to mention the fact that their entire premise, that “it should be a matter of public policy that all Americans have affordable health care” is on shaky ground when it comes to American political philosophy. Now, I’m a big fan of affordable healthcare, don’t get me wrong. But at what cost? Of being told I must pay into and use the government (substandard) system (as in Canada)? Or that I must pay into it even if I don’t use it (as in England)? Or that the food I can eat and the ways I can behave be proscribed because it would cost the government more to pay for my care should something happen to me? No thank you.

To repeat the words Thomas Jefferson famously penned in a letter to Archibald Stuart: “I would rather be exposed to the inconveniences attending too much liberty than those attending too small a degree of it.”

[You can comment on the proposed health care policy until August 31. Tell them to take their socialism and shove it.]

The basic problem of government healthcare is that no one feels the costs of their actions. Government isn’t held accountable for lack of access. Consumers aren’t held accountable for abuse of medical resources. And healthcare providers have no incentive either to enter the field or to maintain a high level of quality of care. This is your classic commons situation.

What to do about it? Surely the free market is an abysmal failure in this regard; just look at how much we’re spending for coverage, which half the time we can’t use anyway, right?

No, not really. Michael F. Cannon writes for Cato: “One need not be an advocate of socialized medicine to see that America wastes gobs and gobs of money on health care, which is one of the reasons that health care is so unaffordable.”

And as any good economist knows, waste simply ceases to exist in a truly competitive environment. People often assume industry operates in a free market just because we’re in the good old U.S. of A. The truth is, in this time of regulation, taxation, and tariffs, markets are usually anything but. This is particularly true of the health insurance industry.

One glaring absence necessary to fulfill the conditions of a free market is perfect information. This means that the consumer has to know about the cost, quality, and other aspects of the product he’s purchasing. When was the last time a surgeon told you his success rate during consultation? Complication rate? What about actual price for a doctor’s visit or a run-of-the-mill procedure? (How often does he actually catch life-threatening problems?) No clue, right?

Some of the new ways in which various companies (including coverage providers) are starting to provide this information are already showing dividends.

But perfect information is only one of the conditions necessary for a free market. Dr. T discusses another major problem, namely the coupling of HMO/PPOs to your employer. If your employer only offers to help pay costs if you go with their provider, you have what is in essence a miniature monopoly, due to the high opportunity costs. Another thing that both of he and I talk about in our posts is critical care insurance and health savings accounts. These make a lot of sense to a lot of people (more or less anyone without a kid who’s younger than 35-45).

The take home message is simply that the health market is anything but free. We don’t have enough information as consumers of medical care or medical coverage. Furthermore, our choices in the market are bounded severely by constraints both practical and absolute. You can’t say the free market failed. The free market hasn’t been tried yet.

[This is part 1 of a two-part series. Part 2 will be published Saturday.]

I nearly choked to death when I saw that the Union of Concerned Scientists was advocating higher Corporate Average Fuel Economy (CAFE) standards in order to lower our dependence on foreign oil. I’ve seen a lot of garbage come out of this socialist front organization over the years, but this really takes the cake. You’d think as part of the “intellectual elite,” they would recognize the role that market forces can play in shaping behavior. I’m pretty sure Adam Smith first mentioned something about an invisible hand around 230 years ago.

What makes it so sad is that they’re simultaneously advocating the development of alternative technologies. The two initiatives are mutually exclusive; the consumer will choose whichever is more economical. You can’t make gas cheaper while shifting people to alternative fuels. This is beautifully illustrated by the fact that our ever higher oil prices are accompanied by record sales in hybrid vehicles.

It’s a simple fact that alternative technologies will likely carry a hefty premium for the foreseeable future. Internal combustion engines are a very mature and efficient technology; very little has changed in the past 120 or so years. Oil distribution, too, enjoys the high level of coordination and infrastructure that can only come with decades of growth and capital expenditure.

Why should you pay several thousand dollars more for a hybrid that in the long run, will actually cost you money compared to a conventional car? Why should you bother with the hassle of ethanol given that there are only three fillup stations in your entire metro area? Why should you bother spending a couple thousand dollars to install a Straight Vegetable Oil kit in your diesel truck if the savings won’t be that great?

You won’t. It’s that simple.

What does CAFE have to do with this? It would have a two-pronged effect on fuel consumption as a percentage of household budget. First, if average fuel economy for passenger cars was increased while mileage stayed the same, the demand for oil would go down, along with the price of a gallon of gas. Second, because your car is likely to be more fuel efficient, you’d be using less gas to do the same amount of travelling. Less fuel consumption at a lower unit price means a substantial reduction in how much you’re spending.

Why is this a bad thing? Surely if you’re spending less and using less gas, that means you’re reducing your dependence on foreign oil? Not exactly. You’re reducing the degree of dependence, but not the nature of the dependence itself. All you’re doing is drawing it into a longer, more protracted affair. It’s a bit like a heavy smoker compared to a more moderate one. Paradoxically, the guy with the two pack a day habit would actually be more likely to quit. Why? Because he feels the costs more. It’s much easier to make the decision to stop smoking when you spend $10 a day on the habit, cough up a liter of black gunk every morning, and can no longer get to your mailbox without feeling winded.

It’s the same thing for oil. The higher the price of oil, the more incentive there is for companies to invest in alternative technology. The more interest consumers will show in it. And the higher premiums everyone from the distributors to the drivers are willing to pay in order to move to the new tech. And as more and more money flows into research and design, the technology will mature. If not ever as economical as gasoline was, certainly much more so than now.

I think we can all agree that no matter whether we’re talking international politics, economics, or conservation, our dependence on oil is a bad thing. It’s not enough to simply cut back on the habit. We’ve got to quit. And that’s something we’ll never do as long as we aren’t pushed to. The more the price of oil affects the consumer, the faster we’ll move away from it.