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The Lighthouse is the weekly email newsletter of the Independent Institute.
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Volume 16, Issue 37: September 16, 2014

  1. Your Doctor’s Unhappiness May Be Hazardous to Your Health
  2. Why Obama’s Strategy to Defeat Islamic State Won’t Work
  3. When Cigarette Taxes Kill
  4. The Independent Review—Fall 2014 Issue Now Available
  5. New Blog Posts
  6. Selected News Alerts


1) Your Doctor’s Unhappiness May Be Hazardous to Your Health

When you arrive at a medical appointment, is your physician happy to see you—or are the hassles that now plague the practice of medicine so burdensome that he or she secretly wishes that you had just stayed home? Sadly, for many the correct answer may be the latter. In his new book Doctored, Long Island cardiologist Sandeep Jauhar reports that only 6 percent of physicians are happy with their jobs. But, according to Independent Institute Senior Fellow John C. Goodman, you would get a much different statistic if you were to survey only doctors who manage to stay clear of the third-party payment system.

By its nature, the medical profession is highly stressful. But in recent years, the third-party payment system has compounded the pressures that trouble the medical professionals. One reason is that it has greatly reduced physician autonomy and discouraged providers from offering treatment options they believe are in their patients’ best interests. In contrast, a doctor writing a Letter to the Editor in the Wall Street Journal reports that when he worked at a clinic in Macau, where patients paid every medical expense out of pocket, he was better able engage with his patients, and ultimately provided them with better care.

Some doctors have sought relief from the red tape of an overly bureaucratized medical profession by changing their medical practice to one of “concierge medicine,” enabling them to give more attention to a smaller number of total patients. This trend is not something that should benefit only elite patients, however. “We all could have a concierge doctor if we freed doctors and patients to relate the way other professionals and their clients relate,” Goodman concludes.

Why Are Doctors So Unhappy?, by John C. Goodman (Forbes, 9/11/14)

Priceless: Curing the Healthcare Crisis, by John C. Goodman

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2) Why Obama’s Strategy to Defeat Islamic State Won’t Work

President Obama has promised the American people that the United States will help defeat the Sunni Islamist insurgency in Iraq (and Syria) without resorting to U.S. ground troops. In his televised speech last Wednesday evening, the president said U.S. forces had already conducted more than 150 successful airstrikes against the insurgents. Writing in the Huffington Post, Independent Institute Senior Fellow Ivan Eland argues that in waging a counterinsurgency, airstrikes alone are insufficient and “may quickly become counterproductive as civilian casualties mount.”

What should the United States do? Eland argues that although the Sunni insurgents—who call themselves the Islamic State—pose a regional threat, they pose no direct threat to the U.S. homeland. Indeed, their stated aim is limited to establishing a caliphate in Sunni parts of Iraq and Syria. Thus, the U.S. government should leave the fighting to locals with intimate knowledge of the terrain and culture—i.e., the Iraqi military, Iranian-backed Shi-ite militias, or the Kurdish peshmerga—and leave the training and equipping of them to “Iran, Turkey, Jordan, Saudi Arabia, and the other conservative Gulf Sunni monarchies.”

The U.S. role, according to Eland, should be limited to monitoring and neutralizing any future training camps that would teach terrorists who plan to attack the American homeland. “Only if such terrorist training camps are discovered should the U.S. launch low-key, but congressionally approved, drone attacks to wipe them out,” Eland writes.

Locals Leading the Fight Against the Islamic State Will Be More Effective, by Ivan Eland (The Huffington Post, 9/8/14)

Video: Eland on HuffPost Live

No War for Oil: U.S. Dependency and the Middle East, by Ivan Eland

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3) When Cigarette Taxes Kill

Before a police officer placed Eric Garner in a fatal chokehold in July, the asthmatic Staten Island resident had been arrested eight times for selling cigarettes illegally to smokers eager to avoid having to pay city and state cigarette taxes. Days before Garner died, New York City Police Chief Philip Banks ordered his department to crack down on illegal cigarette sales—arguably the coffin nail that sealed Garner’s fate. Perhaps someone should issue a new warning: Cigarette taxes—when enforced with violence—can kill.

It’s not surprising that Eric Garner and others would find it worthwhile to risk a run-in with law enforcement by selling untaxed cigarettes. “In the name of cutting smoking rates, New York has the highest state cigarette tax at $4.35 per pack,” Lawrence J. McQuillan, a senior fellow at the Independent Institute, writes in the Washington Times. “New York City piles on an additional local cigarette tax of $1.50 per pack. Since 2006, the cigarette tax in New York state has been raised 190 percent.”

John Hancock and other Founding Fathers made a living by smuggling untaxed goods, but McQuillan suggests that the excise-tax burden in our own day is worse, in part because the taxes are imposed not by a colonial power, but by our own government. “From black markets in cigarettes to black markets in drugs,” McQuillan continues, “today police ride herd over voluntary exchanges between individuals in American communities and kill smugglers on the streets. Garner was another victim of this immoral system—‘collateral damage’ in New York’s war on tobacco.”

Lessons from Eric Garner’s Death and Cigarette Taxes, by Lawrence J. McQuillan (The Washington Times, 9/12/14)

Taxing Choice: The Predatory Politics of Fiscal Discrimination, edited by William F. Shughart II

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4) The Independent Review—Fall 2014 Issue Now Available

With school bells ringing once again, it’s time to broaden your intellectual horizons—by immersing yourself in the Fall 2014 issue of The Independent Review. If you’re not already a subscriber, begin enjoying the feast by signing up now and receiving a FREE book!

Here are some of the questions contributors to our new issue address:

  • Why is it that coercive U.S. policies targeting other countries have contributed to the rise of surveillance and the militarization of police in the United States? (Read Christopher J. Coyne and Abigail R. Hall’s insightful analysis.)
  • Why was the State of Mississippi able to get away with stiffing its creditors when it repudiated its debts? (Read a summary.)
  • Why would the American legal system need to implement full-scale privatization if the goal were to emphasize victims’ rights to restitution? (Read a summary.)
  • Why have efforts to deregulate the electricity industry failed to spark significant improvements in retail competition and innovation? (Read a summary.)
  • Why would critics of an activist global-warming policy be better off focusing on claims made about the costs, benefits, and implementation of fossil-fuel restrictions, rather than critiquing predictions of climate change? (Read a summary.)
  • Why should academic economists consider following the example set by a Nobel laureate who avoided using higher mathematics in his publications? (Read Robert Higgs’s latest contribution to The Independent Review.)

Our Fall issue also includes several reviews of new books:

Please don’t miss our on our SPECIAL OFFER!

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5) New Blog Posts

From The Beacon:

From MyGovCost News & Blog:

Low Morale at the Department of Labor
Craig Eyermann (9/12/14)

CashForGovSnoops.Con
K. Lloyd Billingsley (9/10/14)

You can find the Independent Institute’s Spanish-language website here and blog here.

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6) Selected News Alerts

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