Thursday, February 25, 2010

Why the Republicans are Wrong on Healthcare

Just a brief note on the president's health care care summit that is taking place today. First of all, I agree with David Gergen on CNN this afternoon that this represents everything good about our country and our way of government. Sure, nothing will come directly from the interaction today, but it shows the American people that beyond all the electioneering rhetoric and silliness of "death panels" and "socialism", our elected officials are thinking about health care and that solutions exists. Very few nations in human history could have such a substantive discussion.

A couple days ago, Sen Orrin Hatch was on CNBC and said that requiring people to acquire health insurance is unconstitutional-- and it may be. Sen John Kyl, another Republican, re-iterated the meme against universal coverage with the argument that it would increase the average premium by 10-15%. President Obama retorted with the fact that this is a comparison between apples and oranges, since the Democratic bill requires a more comprehensive insurance coverage as opposed to the cheaper catastrophic policies that a lot of marginally insured folks have now. Obama made the point that such catastrophic policies are not health insurance but rather home insurance since it only protects someone from losing their home in the event that a major health issue drains their finances. It does not insure health since it covers no preventive care or regular visits.

Sure, some wealthier folks do not need anything more than a catastrophic policy and could pay out of pocket for most expenses, but that is the exception and not the norm. Even so, I see no problem with individuals doing their own analysis as to how much coverage they need or desire... but remember the consequences if their analysis is wrong.

Rep. Clyburn, a South Carolina Democrat, gave an example of a local hospital telling him that their Emergency visits increased by 31% over the past 3 years and that most of those people were uninsured or under-insured. The reason that folks are using the ER is because physicians offices do not accept their (under)insurance-- such as Medicaid-- and the people do not have cash to pay upfront. Clyburn never mentioned why these folks end up in the ER-- the reason is because acute care hospitals are required by law to see them. Clyburn never mentions that the hospitals and the doctors on staff do not get paid for seeing these people. Even if someone has cheap insurance-- a catastrophic policy-- the deductible may be $1500 or $2000, and these people have no intention of paying anything, that is why they go to the Emergency room.

This goes back to my same old thesis: if you believe in the free market and people making their own decisions, then repeal the Emergency Medical Treatment and Active Labor Act (EMTALA) that compels hospitals and affiliated physicians to treat everyone regardless of their willingness to pay. This will revolutionize medical care finances. The Republicans keep saying we should allow individuals to make their own choices, but yet they do not have any intention of allowing individual physicians or individual hospitals to choose not to see Medicaid patients or nonpaying patients. At least the Democrats realize that the mandate should be funded somehow.

Without EMTALA laws individuals-- doctors and patients-- can have all the choice they want. If their kid has a fever of 105 degrees and all they have is Medicaid... oh well, they can try to convince someone to get up at 3:00 AM and see him for $25. Senator Kyl is from a big square state (Arizona) and they have this fetish about people being in charge of their own destiny. Great. But if he wants to live in a world red in tooth and claw, then he should stop telling doctors and hospitals that they must see people for free.

Some conservative thinkers do not feel that EMTALA is a driver of increased costs. John Graham says that "uncompensated care" is a small fraction of the ER load. Sure, but what about "under" compensated care? Medicaid pays only 18 cents on the dollar. Furthermore, Graham concentrates on hospitals reimbursement and argues that non-profit hospitals should shut up and absorb the costs. Okay, but "hospitals" don't treat patients, doctors do. EMTALA compels physicians affiliated with acute care hospitals to take turns seeing patients regardless of the payment.

EMTALA was signed in 1986 by Ronald Reagan, and both Democrats and Republicans have strengthened this mandate over the last 20 years. My belief is that this is a primary driver of health costs since the loss of funds from under-insured ER visits is simply passed onto private paying customers. And the ER is the most costly department in the hospital. Furthermore, poor folks without insurance will wait for a small problem to become a big problem before going to the ER for "free" care. Not only are we all paying, but we are paying for a bigger problem that it would have been otherwise. Pay doctors a fair wage and that poor family's kid would have been seen in the office last week and the fever never would have been 105.

Also, the Republicans authored, championed and passed the Medicare Part D prescription drug benefit in 2003 which President George W. Bush signed into law. This is a huge entitlement, funded with borrowed capital, that did three wonderful things for the Republican party: 1) it gave a large entitlement to their primary voting block, seniors, whether those seniors needed it or not, 2) it promised to pay drug companies 100% of the retail cost of all drugs for seniors with no negotiating, thus paying off their industry overlords, and 3) pretty much required any senior on medication to sign up for a privately administered Medicare Advantage plan, thus paying off their other block of industry overlords. Cost of Medicare Part D is projected to be $727.3 billion over 10 years.

So the Republicans are hypocrites. Yes, one could argue for a free market health care system. Consumer information is available and perhaps we should open up health care to all the vagaries and vicissitudes of the free market. If that's preferred, then why didn't the GOP do that with Medicare Part D? If we are to do this with health care in general, then let's engage is full disclosure: people will die from preventable illness. If they try to game the system or are hoodwinked into a crappy policy by a slimy insurance agent, then their care may not be covered. Physicians should be able to demand payment upfront-- just like grocery stores and gas stations-- and all of a sudden the lack of financial acumen can lead to some one's death. One morning you wake up with the world by the tail, and by evening you're dead from acute appendicitis-- all because you didn't read the fine print on your insurance policy.

Another thought I had was when Kyl or someone said that our nation is too diverse for a comprehensive health care policy. Maybe so. It occurs to me that other western nations have populations of between 40 and 80 million folks. Perhaps we should split the nation into 5 regions-- Northeast, Southeast, North, Midwest, West-- since each share various political leanings and each region can decide how comprehensive their health care should be. Again, be warned, if you have crappy insurance from South Carolina or Oklahoma, and you end up in my Emergency Room, then you better have cash my friend.

I'll have Senator Kyl's office number handy to give to patients.

Wednesday, February 24, 2010

Greeks are not like Chinese

Greece is seeing civil unrest in response to austerity measures:

Addressing a sea of protesters from a lectern bedecked with a banner reading, “People and their needs above the markets,” the head of main labor union encouraged public resistance to the government’s austerity measures. “We refuse to pay the price for a crisis that we didn’t create,” the leader, Yiannis Panagopoulos, said.

In China:

The global financial crisis left 20 million Chinese migrant laborers unemployed and more than 7 million college graduates seeking work by March last year. In February 2009, a clash between police and about 1,000 protesting workers from a textile factory in Sichuan province injured six demonstrators, rights group Chinese Human Rights Defenders reported.

Hardly a ripple... so far. We know how China historically handles these things, but the question remains how Germany and the EU will manage Greece.

Sunday, February 21, 2010

Weekend Links: From Orwell to Palin to the Grateful Dead

Having died in 1949, George Orwell avoided the choice that many leftists faced during the Cold War. As a young man, he had fought as a pro-Marxist in the Spanish Civil War, but was not faced with the dilemma of defending the totalitarian scourge that Marxism brought to Asia.

(h/t TV)


Is Germany just a nation of 80 million Tea Partiers?

Fifty-three percent of Germans want Greece thrown out of the Eurozone, and two-thirds were against any bailout of the troubled country. What would Germany do about cost-effective solutions to the impending civil unrest in Greece?

Or, is Greece predictive of the West's 60-year failed experiment with the welfare state?


Do engineers make good public officials? I found one candidate who stands opposite to me on every single issue-- except maybe gun rights: but does it really need to be the #1 issue? Is the government really ready to take away your .22? (One side note: nearly every single housemate I had in college was an engineering major; I will maintain that they tended to be very disciplined and regimented in their studies and lifestyles.)


Is Medicare Advantage (MA) a cost-benefit disaster? The 20% who have MA plans are healthier and wealthier, yet their care is relatively more costly to the taxpayers.


Glenn Beck: national savior or just another humorous dry-drunk?


Your retirement portfolio is still all about asset allocation and, yes, cash is a valid category.


Most dangerous opinion piece I read this week... and the rational response.


Gallup says that Sarah Palin is the #2 choice for Republican Presidential candidate, and the generic Republican candidate trails Obama by a mere 44-42% margin. Yikes.

Future President (?!) Sarah Palin on the Daytona 500: "Haven’t thought a darn thing about the politics of this. I’m thinking about this good, active, speed-loving event that a lot of Alaskans, too, are really into. We’ve got our snow-machine races up there, and this is, of course, on a much greater scale, same type of sport though, same type of breath-taking, speed-loving, All-American event that we like to see up north.”


And then we have "her public" relishing in her ignorance. It's not so much that Future President Palin wrote on her hand... it's that she had to write tax cuts, as if that were new and a novel Republican talking point! And she didn't even get it right and had to cross off budget first. WTF?

One more on Palin: Why is she even concerned about a cartoon? Why is she (again) using her family to run interference for her? Or is she feeling maligned because the disabled have jobs? Note to Future President Palin: they were making fun of you, not your son.


Management secrets of the Grateful Dead. With apologies to Oscar Wilde: "Once they’re not dangerous anymore, it’s okay to discuss them in serious ways."

Friday, February 19, 2010

Medicaid Enrollment Rises Dramatically

... while revenue available to the program decreases.

The recession has fueled the greatest influx of Americans onto Medicaid since the earliest days of the public insurance program for the poor, according to new findings that show caseloads have surged in every state.

More than 3 million people joined Medicaid in the year that ended in June, the data released Thursday show. That pushed enrollment to a record 46.8 million, exacerbating the financial strains on already burdened states and complicating the federal politics of health care...


In the past year or two, many states have responded by reducing the medical services available to Medicaid patients or payments to doctors, hospitals and other providers of health care...

Now, 29 states are considering further reductions or have made them since their current fiscal year began, Thursday's report said.

More under-insured patients, less money available.

It's not so good to be a physician.

Medicare Advantage Premiums Rise Dramatically

Elderly and disabled Americans who choose Medicare Advantage Programs will be transferring 14% more of their wealth to private insurance companies in the form of premiums.

"Medicare Advantage plans continue to be paid about 13 percent more than original Medicare," said Medicare spokesman Peter Ashkenaz. "The plans need to explain why these increases are necessary."

Or not.

It's good to be an insurance executive.

Tuesday, February 16, 2010

The evolution of Evolution

Most scientists are well-versed in the principles of Darwinian evolution, marked by the vertical transmission of beneficially mutated genes from one generation to the next. Now,
a microbiologist and physicist at the University of Illinois-Urbana have hypothesized that horizontal transmission of genetic material may have played an even larger role than previously thought.

Woese believes that along the way biologists were seduced by their own success into thinking they had found the final truth about all evolution. "Biology built up a facade of mathematics around the juxtaposition of Mendelian genetics with Darwinism," he says. "And as a result it neglected to study the most important problem in science - the nature of the evolutionary process."

In particular, he argues, nothing in the modern synthesis explains the most fundamental steps in early life: how evolution could have produced the genetic code and the basic genetic machinery used by all organisms, especially the enzymes and structures involved in translating genetic information into proteins. Most biologists, following Francis Crick, simply supposed that these were uninformative "accidents of history". That was a big mistake, says Woese, who has made his academic reputation proving the point.

In 1977, Woese stunned biologists when his analysis of the genetic machinery involved in gene expression revealed an entirely new limb of the tree of life. Biologists knew of two major domains: eukaryotes - organisms with cell nuclei, such as animals and plants - and bacteria, which lack cell nuclei. Woese documented a third major domain, the Archaea. These are microbes too, but as distinct from bacteria genetically as both Archaea and bacteria are from eukaryotes. "This was a enormous discovery," says biologist Norman Pace of the University of Colorado in Boulder. Woese himself sees it as a first step in getting evolutionary biology back on track. Coming to terms with horizontal gene transfer is the next big step.


Evidence for this lies in the genetic code, say Woese and Goldenfeld. Though it was discovered in the 1960s, no one had been able to explain how evolution could have made it so exquisitely tuned to resisting errors. Mutations happen in DNA coding all the time, and yet the proteins it produces often remain unaffected by these glitches. Darwinian evolution simply cannot explain how such a code could arise. But horizontal gene transfer can, say Woese and Goldenfeld.

This relatively new thesis helps to better explain the diversity of life on earth. Read the entire article for a fuller explanation.

Class Warfare Closer Every Day [Updated below]

The United States Congress and Senate will see remarkable turnover in this fall's elections. Unprecedented "retirements" and primary challenges will ensure that the Congress we have next year will look quite different than today's.

Such tumult is due to the general dissatisfaction the voters have for their elected representatives. You don't have to be a Tea Partier to feel angst toward the behemothic machine of greed and corruption that defines our corporations and government. Personally, I am always amazed at the acquiescence the general public exhibit.

The largest single expenditure of public wealth in my lifetime-- which was the waging of war in Iraq-- was surpassed in 2008 with a $780 billion bailout facility for banks. Never mind the sweetheart deal signed into law in 2003 under the name Medicare Part D, an entitlement that will cost taxpayers a trillion dollars over ten years.

My guess is that this massive wealth transfer was a large part of the rationale behind electing Barack Obama in 2008. Now after 12 months at the helm, girded by solid majorities in both Houses of Congress, we have no financial reform legislation, no health care reform, increased war expenditure in Afghanistan, and the world credit crisis is entering the second phase. The 2008 election was the closest thing to a revolution we could have had within the United States, giving the new leader broad latitude and high approval ratings to change the status quo, and yet we still have the same gridlock and pay-offs, filibusters and logjams, that we have always had.

The public is restless, and the politicians know it. Senator Evan Bayh (D-IN) announced his surprise retirement yesterday and FireDogLake asks if this is because the PhARMA leadership is available, and the light bulb sparked to brightness. These folks are retiring from Congress because they know that change is afoot. The next change we see will be a complete collapse of the known political influence system; perhaps with much-need lobbyist reform, or better, publicly-financed elections. And guys like Bayh need to cash in NOW before the hammer comes down.

Nicolas Taleb, author of the Black Swan, warns us that the largest cataclysms are those that are unforeseeable, and they occur out of a clear blue sky. As the stock market makes it's recovery, job losses are pared and people start spending again, we could blind-sided by the next leg down in the global economic crisis. I'm not naive enough to believe I can predict what will occur, but there are plenty of oily rags laying about the garage that a spark from any of several sources-- Greece, Spain, CRE-- could ignite a conflagration.

Our ability to manage the next crisis will be limited since the world's central banks have already shot their wad of liquidity at the last crisis, and now they must weigh the risks of social unrest against the devaluing of their respective fiat currencies even more. Greece can cut public pensions only so much before the riots break out. Evan Bayh probably figures he's got about 24 months, at a million dollars per month as head of PhARMA or some other lobbying concern, before the class war hits Indianapolis. By then he'll have his stash secured.

UPDATE at 1337hrs

Aproximately 6 hours after the post, the news services are reporting a bomb has exploded in the JP Morgan branch in Athens. The civil unrest may be closer than we thought, Mr. Taleb notwithstanding.

Sunday, February 14, 2010

Dan Quayle = George W. Bush 1.0

Yes, before we had Shrub, we had the Potatoe Man.

And now, as if our country didn't have enough problems, we have another chapter in the Legacy of Stupid:

Underwater Astonishments

Saturday, February 06, 2010

Paul Ryan (R-WI) for President?

The rising star of the Republican party could be Wisconsin congressman Paul Ryan who is hailed as a budget hawk who can be bipartisan. He has come up with a bold plan to balance the budget and, according to CBO estimates, erase our national debt in the coming decades, which is winning accolades from liberals and conservatives alike. But will it work?

The bottom line is that he proposes to throw seniors into the free market for their health care by using Medicare funds to provide each senior with a voucher to purchase a private health insurance policy. The thought is that the federal government will pass the risk of health insurance onto the individual and by doing so fix the costs that the government pays for providing health care for the elderly and disabled.

The National Review hails the plan as paradigm changing, and even left-leaners like Ezra Klein give it kudos. There, of course, are two questions: 1) will it work?, and 2) is it politically viable? Short answers: 1) sort of, 2) probably not yet.

Will it work? The stated goal is to reduce the federal budget outlays for health care, so yes it will work because the federal government will have complete control on how much each voucher will be. Of course, it will not provide any more access to medical care and will likely reduce access for some who choose to go without insurance.

The Economist explains that, by design, Ryan's plan forces seniors to pay on average $2900 out of pocket for a private plan that will be no more comprehensive than the current Medicare plan. This puts market economics into the system which free marketers say will reduce costs. Opponents will argue that some seniors will either choose or be forced to go without coverage because of this marginal cost. I suppose we could impose low income subsidies, but that changes the CBO estimates for the Ryan proposal.

Is it politically viable? Even the stalwart tea-partiers will cry that they love socialism when it comes to Medicare. Seniors vote-- and they will never support anything that is going to take money out of their fixed income paycheck. Only as part of a more comprehensive budget reconciliation could this pass and only an imminent federal budget default would trigger such a draconian discussion.

Is Paul Ryan conservative? While he claims to be a fiscal hawk, I would note that he voted in favor of Medicare Part D which is the largest expansion of government entitlement in his lifetime. It seems odd that he would favor expanding an entitlement program that he now wants to eliminate. Furthermore, he voted against Medicare drug price negotiations for seniors which, in effect, forces the federal government to pay full price for medications. I wouldn't call this fiscally conservative.

Economist Howard Gleckman points out that some of Ryan's assumptions about tax revenue are unrealistic. Rep. Ryan expects to eliminate the entire national debt in 70 years-- a dauntingly impressive feat- but, as Gleckman says, "[the] CBO assumed this wonderful outcome would occur only if the revenue portion of Ryan’s plan generated 19 percent of GDP in taxes. And there is not the slightest evidence that would happen."

But just because Ryan's plan would not fulfill it's most bold prediction does not negate it's potential value in reducing Medicare costs to the federal government. If it reduces costs, great. The problem is that such a plan would effectively change the mandate of Medicare to care for all seniors regardless of their ability to pay, and essentially make Medicare a type of non-guaranteed pension plan since there would be no guarantee that an individual could ever be covered with the determined voucher.

Of course, I'll take this opportunity to climb atop my soapbox again about EMTALA (Emergency Medical Transfer and Active Labor Act) laws that require emergency management of all patients. Under Ryan's ideologically pure free market reform I would argue that EMTALA would need to be repealed, and I find it disingenuous that Paul Ryan never broaches this topic. The CATO Institute calls EMTALA the single largest driver of health care inflation since it acts as an "accidental safety net" and tends to remove the moral hazard of remaining uninsured. When a senior with pre-existing illness chooses to forgo expensive coverage, or gets turned down, will hospitals and physicians be required to care for them without payment?

Another issue is the relative cost of private insurance versus public care. Many studies have shown that the administrative costs of Medicare are dwarfed by those of private carriers and Ryan's plan would put every Medicare recipient on a private plan, so by deduction the administrative costs of providing medical care will rise- a lot. Even Ryan himself admits in this interview (below; fast forward to the 5:00 mark) that public option coverage would be cheaper when he was arguing against it as anti-competitive during the health care debate last summer.


In conclusion, I give Rep. Ryan marks for creatively attempting to tackle an as yet insoluble problem. I don't think his plan would be politically viable because it changes the entire purpose of Medicare. Before 1965 many seniors and disabled simply went without insurance and I'm sure we won't accept this scenario in the future. He is effectively rationing care using market economics and I think is a cop-out and will only lead to more misery for seniors and the infirm. Rationing is necessary but should be done upfront, out in the open and should not be based on an individual's ability to pay. Not only would they need to deal with being sick and old, but now they would be left to navigate the treacherous health care "free market" with their lives at stake. I have argued previously that health care does not follow market principles in the classic sense and it screams for central regulation just like any other utility.

From the Economist article:

Mr Ryan has put forward a serious proposal for shrinking medical-cost inflation and hence shrinking the long-term federal budget deficit. It does so by ending America's provision of first-rate health care to all seniors. Rich seniors will still be able to afford high-quality medical care. Poor seniors won't. They will suffer more and die younger. A different approach to solving America's health-care cost problem might involve letting Medicare use its vast bargaining power to negotiate lower rates with the providers of pharmaceuticals; establishing a commission of experts (MedPAC) to rate the effectiveness of medical procedures, to avoid wasteful incentives in the current fee-for-services medical model; and establishing bundled payments for disease management, to achieve Mayo-Clinic-like efficiencies in care while improving quality. Those are the models proposed in the Democratic bills currently in Congress. But they're really complicated and hard to understand—they make for a bill that's 2,000 pages long. And everybody knows the American people hate that. Mr Ryan proposes to simply slash Medicare spending and balance the budget on the backs of poor seniors. That'll work too.

Wednesday, February 03, 2010

Pitchers & catchers report Feb 20

The only good thing about February is that it's time to start pricing my Ozzie Plan.

Tuesday, February 02, 2010

What Journalism Isn't

James O'Keefe, the right-wing poster child for felonious criminal trespass, engaged in his brand of so-called gonzo journalism for an apparent long time. Here's an old video of O'Keefe and a male friend trashing the institution of marriage:

Would this little charade have been less meaningful if a man and a woman had entered the clerks' offices with a similar deception? Are the protagonists trying to make a statement about the validity of gay marriage, or marriage in general? I can't tell. In effect, what O'Keefe and Wetmore are doing are agreeing with the libertarian idea that the government should have no role in approving relationships at all since the characterization of a "loving" relationship should not be tied to employer-based benefits or state-based rights. I'm sure that was not their intent.

As an aside, "journalism" does not include purposely deceiving the interrogatee or inserting yourself as the primary focus of the issue being covered. This is prankish behavior that tells the reader nothing of the nature of the operation in question. At best it is a distraction, at worst it is a crime.

Try not to be cynical, the gangsters dare ya

Volcker Rule Dead on Arrival.

If we have learned one thing in the Global Economic Downturn (TM) it is that leverage kills. For all the venial sins of securitization, credit default swaps, sub-prime lending and the myriad creative financial products, but for the the mortal sin of Leverage would our economy have survived.

The lesson we should have learned is that all things are forgivable if done without leverage, or at least 30:1 leverage. This is the sage advice of Paul Volcker, the only guy who had the cojones to remove the punch bowl in the 1970's and subsequently triggered the 20 year economic boom.

But now we have Chris Dodd (D-CT), Chairman of the Senate Banking Committee, desiring "bipartisanship" on any regulation of the industry. Huh? The second largest majority in 150 years and now Dodd is bending to the gangster* Republicans? Since he's not running for another term, methinks Dodd's acquiescing to his future employers on Wall Street.

Money quote: “Chris is retiring so he wants to end his career with an important regulatory reform bill and he wants to make the bill bipartisan,” the staffer said. “He is not going to risk bipartisan support to make the White House happy.”

Ya, right. Bipartisanship.

*The previous chairman: a wonderful vignette about Richard Shelby (R-AL) from journalist Patrick Byrne (from the Columbia Journalism Review):

There had also been some victories. Like that time that Patrick called Senator Richard Shelby (R – Alabama) a “gangster.” It was in October 2006, and Shelby, the chairman of the Senate banking committee, was spending a lot of time on television defending hedge funds accused of selling phantom stock. When the Senate held hearings on hedge funds, Shelby stacked the panel with friends of David Rocker.

So Patrick went on a radio program and called Shelby a “gangster.”

Shelby invited Patrick to meet him on Capitol Hill. Patrick made the trip. He waited in an ornate conference room for an hour. Then Shelby entered. The Senator referred to himself in the third person: “The Chairman of this Committee believes that you are trespassing on matters that are under hisjurisdiction.” Then he just sat there and stared Patrick down. It was as if…well, it was as if Shelby were a gangster.

If Shelby is Capone, then Dodd is Bugsy Siegel.

Better explanation of EMTALA

Previously I talked about instituting truly free market reforms in health care and the fundamental change would be to repeal EMTALA laws. The CATO Institute has an excellent explanation of EMTALA (Emergency Medical Transfer and Active Labor Act) and how it impacts physician and hospital economics.

The discussion on EMTALA begins on page 31 with David Hyman*, MD JD, and although this particular piece is from 2001, the explanation of the law is relevant, and if anything, the impact of EMTALA on health finances is even more pronounced today with more people uninsured and underinsured with each passing year.

Alternatively, one could argue that free markets have no place in the allocation of medical care, in which case we should enact Medicare-for-all and move on.

[Disclosure: David and I lived in the same dorm in college although we have not kept in touch. I remember he was an excellent student... as were we all. Ha.]

Keynes vs Hayek

Government control versus free market.


There is a similar debate in control of the health care market as well.

(h/t Brian at at Teresa Lo's site.)

Monday, February 01, 2010

Conservative reading list

I'm putting this on-line just to maybe start a discussion. Eric asked about a conservative reading list (apparently he's hanging around a better crowd these days) and wanted my input. Off the top of my head I came up with this:

On-line (NRO), are the usual suspects. There's a lot of shrill stuff out there (, but NRO and Weekly Standard , Bill Kristol's rag, present the conservative views without screaming. My favorite conservative think tanks are Cato Institute and Heritage Foundation, although I don't really agree with their conclusions from a practical standpoint.

There's a ton of shrill "pundits" who should be avoided at all cost-- they are out there just to stoke anger, juice the limbic system and add nothing substantive: Beck, Coulter, O'Reilly (while he does have some good points, he is platitudinous without conclusions or remedies.)

The only modern author worth reading is Mona Charen who makes excellent points: Do-Gooders: How liberals hurt the ones they claim to help" presents the classic argument against the welfare state, and much of it is relevant. She discusses these unwashed masses who go to Walmart in their pajamas and play video games all day and how they are a creation of the welfare state, and it's somewhat planned that way by the liberal power elite. I would add that these images of the recalcitrant and ungrateful welfare recipient resonate with working class folks, and this imagery is used by the wealthy capitalist elite to turn the working class against the poor. Complex interactions.

Classical conservatives:

1. Bill Buckley (past editor of National Review)

2. Edmund Burke (Reflections on the Revolution in France) is considered the father of modern political conservatism and his wikipedia entry is excellent. Although he was an ardent republican, he expressed disdain for the French revolution. Favorite quote: The people never give up their liberties but under some delusion.

3. Leo Strauss is an interesting character. Schooled in existentialism, he came up with the idea of the Noble Lie as a necessity for leaders to govern. He gets a bad rap about being the so-called father of neo-conservatism probably because of his Zionist views and he was a mentor of Irving Kristol (Bill's father) and Paul Wolfowitz. Strauss harkened back to the classic philosophers (Plato) and viewed the acceptance of revealed religion in the Middle Ages as a negative. Very complex, but interesting.

Those are my snapshot thoughts.