Over the last decade, the United States has routinely, even frivolously, attacked countries, overthrown regimes, and intervened in civil strife where few or no American security interests were at stake. Particularly striking is that two successive administrations that were filled with people who avoided the draft in Vietnam or chose not to volunteer in succeeding years were so enthusiastic in making war.

Equally striking has been the overseas cheerleading. Other countries long have urged America to defend them even if they don’t do much for themselves. Now comes foreign enthusiasm for American empire. The United States has the wealth and power. Why don’t its citizens want to fight endless wars and patrol endless hellholes around the world?

British historian Niall Ferguson is the latest foreign intellectual to generously suggest squandering American money and lives to advance his vision of global social engineering. Americans, he writes, “should try to do a better rather than a worse job of policing an unruly world than their British predecessors.”

Still, Ferguson’s book is as interesting as it is irritating. He begins by asking: Is America an empire? Yes, he responds. Indeed,“it always has been an empire.”

U.S. power is extraordinary. Ferguson details America’s stunning military dominance, economic strength, and other forms of “soft power.” The first Americans believed in limited government, but had grand ambitions for the nation. Notes Ferguson: “there were no more self-confident imperialists than the Founding Fathers themselves.”

America expanded through a combination of brutal warfare and generous expenditure. Domestic expansion was later supplemented with overseas imperialism. But in contrast to European colonialism, Ferguson writes, the United States “could instead use its economic and military power to foster the emergence of ‘good government’ in strategically important countries,” such as the Philippines. Alas, good government seldom showed up in practice. Today, more than a century later, the Philippines exhibits little “good government.”

But it was the world wars that turned America into a global power. Coming out of World War II, the United States manifested what Ferguson terms “the imperialism of anti-imperialism.” The result, ironically, was an empire. He writes: “even as Americans pledged themselves to make war against the empires of their allies and enemies alike, all unacknowledged, their own empire grew apace.” Since Washington was not consciously attempting to rule the world, its efforts were more inadvertent than planned.

The refusal to consciously do more irritates Furguson. Cold War was always expensive and sometimes bloody, but Washington was cautious. For instance, the Truman administration refused to attack China after it intervened in the Korean War.

In just two paragraphs—a surprisingly superficial discussion in a generally enlightening book—Ferguson suggests that the United States should have deployed tactical nuclear weapons against China. He attributes the war’s two-year bloody stalemate to the failure to go nuclear.

Ferguson’s blithe willingness to have Washington inaugurate global war then matches his belief that the United States should patrol the planet now. He advocates that America do so even though he recognizes that intervention helps spawn terrorism. After all, the latter “is the continuation of war by other means—by those who are too weak to wage proper war in pursuit of their political goals.”

That’s not the only cost that he suggests America bear. Although the price of military empire is lower than today’s wildly irresponsible domestic spending, the combined total is formidable. And for some reason, Americans “like Social Security more than national security,” he fusses.

Unfortunately, in his view, the biggest problem is an “attention deficit.” Most Americans just don’t want to be imperialists. There is in the United States “the absence of a will to power.”

How true and how wonderful.

The world is filled with tragedy. The temptation to try to reach out and manipulate other societies is great. But while a British academic might be willing to treat U.S. soldiers as gambit pawns on a global chessboard, the American government is responsible for and to its servicemen and women, just as it is to its other citizens.

Equally important, most Americans don’t want to remake the world, engage in global social engineering, or create an empire. Instead, they want to spend time with their families and friends. They want to earn money, enjoy the bounty of the world’s most creative and productive society, and leave the problems of the world behind. And they want the patriots who join the military to be able to do the same at any time other than during a genuine emergency.

Americans do lack “a will to power”. That is a testament to their greatness.

The columnist naturally said no. Accepting the rebate doesn’t mean endorsement of the tax code, any more than paying one’s taxes does so: “Obeying the tax laws is simply a civic obligation.”

The columnist does suggest giving away the cash as a protest. It could help the poor or fund “political candidates who would unseat those who backed the tax bill.” Naturally, one should also write political leaders to protest. But The Ethicist’s bottom line was simple — “it is not dishonorable to keep your rebate.”

How . . . liberal. Why should anyone have to live with the consequences of his opinions? It’s fine to be against tax cuts—and to cash your rebate check or, presumably, collect your refund.

In fact, people who don’t believe in tax cuts should give back the money. Just write a check or send a money order to Uncle Sam. If tax hikers want to be a bit fancier, they could help pay off the national debt by following the lead of Senator Robert Byrd, the big-spending porker who does so much to create the pressure for high taxes, and tag it for Gifts to Reduce the Public Debt. Anyone doing so, of course, should not take a deduction on his taxes the next year.

But tax enthusiasts should do more. They should lead by hiking their own taxes. If you think taxes are too low, then prove it by raising your own.

It’s really quite simple. Pick up the standard 1040 form. Although it might seem a little strange to declare more income than appears on the W-2, that should pose little obstacle to doing what is right.

Add some extra interest. Make up some sums from a couple of banks. Create names for nonexistent ones. Do the same for ordinary dividends. The IRS won’t mind.

Add some alimony. Toss in some pension payments, if you’re retired. Put down a little unemployment compensation. There’s even a line for other income. This includes prizes and awards (imagine being honored for being an insufferable social engineer and friend of overbearing government), gambling winnings (don’t worry—the IRS isn’t going to work to disprove that you won), jury duty fees (be reasonable, since you don’t get much for such service), state tuition benefits (so what if you have no kids?), and reimbursements for expenses previously deducted (who will know any better?).

Create some business income. Indeed, a would-be tax-hiker should get malicious pleasure out of posing as a greedy capitalist.

File a schedule C or C-EZ, and toss in some imagined revenue. Keep the expenses to a minimum, since you wouldn’t want to reduce too much the taxes due.

But inflating income is only the start. It’s also important to cut the adjustments to income. Forget the IRA deduction—why should the government subsidize people who want to save for their own retirements? Same thing with the self-employed SEP, SIMPLE, and other retirement programs.

Forget the interest deduction for student loans—obviously a subsidy primarily for middle-income and wealthy students. No self-respecting “liberal” would take a deduction for a medical savings account: after all, the government should be providing all health care!

Ignore other deductions and credits. After all, people’s earnings really belong to the government, so why cut its take?

Itemized Deductions

Most important, forget all of those ridiculous itemized deductions. Spend a lot on health care? Just grin and bear it. Are your state and local taxes high? They should be. Why should that reduce your federal obligation?

Same with real estate taxes, which are usually financing the failing government school system. Then there’s mortgage interest. But why should you get to deduct more money if you have a bigger, fancier, more expensive house?

No reason to take off charitable gifts, since that is obviously government’s job. Casualty and theft losses don’t warrant a deduction, since the perpetrator was probably a victim. Unreimbursed business expenses should go undeducted, since they helped you make money, a dishonorable act. Tax preparation fees—heck, the more you spend, the less you deserve to take anything off. And forget the other miscellaneous deductions. Actually, it would be simplest to take the standard deduction. Why should your misfortune or generosity be used as an excuse to starve poor old Uncle Sam? We know he needs the money more. There are also a host of credits that every good tax hiker should forgo. Drop the foreign tax credit and credits for child care and the elderly. Forget education, child, and adoption credits.

Now we come to figuring your tax. If your total isn’t up to snuff—come on, don’t be greedy!—add some other taxes. You might have to file an extra schedule or two, but go for it: self-employment, Social Security and Medicare taxes on tips, taxes on retirement plans and other accounts, advance earned income credit payments, and, one that should thrill every good “liberal,” household employment taxes. For the latter, double the number of servants that you actually have.

If all of this doesn’t increase your taxes enough, go back and inflate your income numbers a bit more. Or simply write Uncle Sam a check and say it’s to pay off the national debt. In fact, Governor Mike Huckabee of Arkansas has established the “Tax Me More” Fund for any residents who want to pay more. Alas, so far it has had only minimal success: apparently people prefer to tax other people rather than themselves.

Anyone who thinks taxes are too low, objected to the minuscule Bush tax cut, or voted for Al Gore should hike his own taxes. The Ethicist to the contrary, people who want the rest of us to pay more should voluntarily pay more themselves.

The Food and Drug Administration has approved a drug to combat non-Hodgkin’s lymphoma. That’s good news for cancer patients in America and around the world. But you wouldn’t know it, given the vicious political campaign being directed against the pharmaceutical industry.

America’s drug makers are under attack. Congressmen would like to cut prices, and the expansion of Medicare will encourage Uncle Sam to regulate drug access and prices directly.

State legislators are debating their own draconian price-control schemes. The media, such as the PBS show “Frontline,” have targeted the drug makers. Trial attorneys, left-wing activists, and state attorneys general are filing lawsuits charging pharmaceutical firms with everything from racketeering to fraud.

This assault is not new. Drug companies have been under pressure for a decade. When the Clinton administration attempted to nationalize American health care, it sought to demonize the drug makers, as well as most doctors and hospitals.

Unfortunately, years of demagoguery advanced for political profit are having an impact. Public opinion of the industry has been falling sharply.

While the American people have yet to agree with Al Gore’s grotesque comparison of the drug makers to the tobacco companies and “big polluters”—there is little that he would not say to win a vote—they are increasingly turning on an industry that has done so much to improve their lives. Harris Interactive reports that those who believe the drug makers are doing a good job of serving consumers fell from 79 percent to 57 percent from just 1997 to 2001.

Yet new pharmaceuticals are responsible for almost half the reduced mortality from different diseases between 1970 and 1991. Columbia University’s Frank Lichtenberg figures that every new drug approved during that time saves over 11,000 life-years annually. And the benefits continue. He estimates that fully 40 percent of the increase in average life span between 1986 and 2000 is due to new drugs.

Three decades ago medical technology was rather primitive by today’s standards,” says Dr. E. M. Kolassa of the University of Mississippi School of Pharmacy. “Today, physicians have at their disposal medications and technologies that provide for the immediate diagnosis and treatment of most of the disorders that affect modern man.”

Hundreds of new drugs are in development for cancer, heart disease, strokes, Alzheimer’s, infectious diseases, and AIDS. Consider the last: Two decades ago there was no treatment for AIDS. By 1987 there was one drug, AZT. Now there are 74 anti-AIDS drugs available and another 100 in development.

Similarly, pharmaceuticals offer the best hope of combating any future outbreak of SARS, which has killed over 700 people. In fact, the quickest solution is to find an existing medicine that works. Laboratories are currently screening some 2,000 approved and experimental drugs to see if they are useful in fighting SARS. Gurinder Shahi, a doctor in Singapore, explains: “Given how little we know about SARS and the reality that it is killing people, it is justified for us to be daring and innovative in coming up with solutions.”

Daring innovation is most likely to come in a competitive, profit-driven market. After all, today’s medicines exist only because there is a bevy of sophisticated pharmaceutical companies devoted to finding drugs to heal the sick.

Isn’t this serving consumers well?

Ah, but prices are high. Too high, in the view of myopic, vote-seeking politicians. “There’s no question that prescription drugs cost too much in this nation,” claims Senator Jim Jeffords of Vermont.

Why, yes. They only save lives. Extend our life spans. Moderate our pain. Control our nausea. Eliminate our need for surgery. Treat our allergies.

Why should we have to pay for such products? The outrage. The horror. Drugs should be free. Or at least a lot cheaper.

If Life Were Different

It would be nice if they were, of course, but people who believe prices can be lowered legislatively are living in the world as it ought to be. Everyone ought to be rich and beautiful. Everyone ought to be paid a million dollars a year for working ten hours a week. Everyone ought to have a Mercedes at a Yugo price. Everyone ought to have a mansion for the price of a shack. And everyone ought to have all of the pharmaceuticals now available, but for less money.

Unfortunately, pharmaceuticals do not appear outside company doors every morning as manna from heaven appeared in the Promised Land for the ancient Israelites. Instead, firms review numerous plausible substances: of every 5,000 to 10,000 checked, 250 make it to animal testing. About five reach human trials.

Only one gets past the Food and Drug Administration (FDA) onto the market. That one has to pay for the research costs of the other 5,000 to 10,000. It isn’t easy.

Thus the real cost of pharmaceuticals is not making the pill that patients swallow. It’s the research that goes into developing the pill—as well as the other 9,999 substances that never made it to market. The pill’s price also has to cover the cost of running the company and complying with burdensome FDA requirements.

The Tufts Center for the Study of Drug Development estimates that companies spend nearly $900 million over a ten- or 15-year period to develop each drug. America’s major research firms alone spent $32 billion on R&D last year.

Nevertheless, some politicians would control prices directly. For instance, legislators in Maine want to impose prices they think are fair, and are threatening retaliation if any company tries to pull out of the market in response. Washington State already demands superdiscounts for some of its programs.

But government can only confiscate the drug makers’ existing inventory. It can’t force them to keep making drugs to be confiscated in the future.

Adopting Canadian- or European-style controls will result in a Canadian- or European-style drug industry and patient access. These countries do their best to free ride on America, but their pharmaceutical industries are weak and getting weaker.

Moreover, their ill citizens have far less access to important medicines. A group called Europe Economics points out that patients often wait years for life-saving products.

Still, America’s political air is filled with other alleged panaceas, such as reimportation of drugs from Canada. Yet prices are lower there because the government imposes price controls and litigation costs are less. (The country is not full of profit-minded tort attorneys.) Imposing Canadian (or Mexican, or Afghan) prices in the United States would mean the drugs would not be developed in the first place.

Politicians also are pushing a range of use restrictions—formularies, reference pricing, and more. Yet every attempt to stop people from using new medicines endangers their health and threatens to increase health costs elsewhere. For instance, Frank Lichtenberg estimates that replacing 1,000 older prescriptions with newer drugs raises pharmaceutical costs by $18,000, but cuts hospital costs by $44,000.

Everyone in America has a stake in lowering health-care costs. But they also have a stake in maintaining quality health care. If the pharmaceutical industry succumbs to the demagogic campaign against it, we will all suffer the painful consequences.

Chemicals are one of the wonders of human creation. They help heal and feed us; they help fuel our autos and heat our homes; they help produce toys and computers. Yet some chemicals can hurt, making them a perfect target for alarmists who detest most anything modern.

There’s no doubt that chemicals have become an integral part of our lives. The Centers for Disease Control (CDC) has released its latest “National Report on Human Exposure to Environmental Chemicals,” which reviewed Americans’ exposure to 116 different substances. The study confirms that most people have contact with a plethora of chemicals.

Yet this conclusion reflects the dramatic advances in bio-monitoring: scientists are now capable of detecting the minutest trace of different substances in human beings. Researchers measure concentrations of a thousandth, millionth, and billionth parts.

This enables us to better understand our environment, assess chemical exposure, and understand risks. But it also provides a tool for alarmists, who conveniently ignore actual contact levels when claiming an epidemic of chemical exposure.

At a time when many people fear for their lives, the CDC found much good news. Exposure to lead, which is particularly harmful to the development of children, and cotinine, a tobacco residue, is down.

Moreover, exposure levels to some of the most toxic chemicals were extraordinarily low. Reported the CDC: “For dioxin, furans and coplanar PCBs, most people in the Second Report had levels that were below what the analytic method could detect.”

Even the bad news was bad mainly relative to overall successes. For instance, during the 1990s cotinine exposure dropped 55 percent for teens, 58 percent for kids, and 75 percent for adults; yet today the exposure of black children remains disproportionately high.

Alas, good news does not dampen the alarmist impulse in some people. The Environmental Working Group (EWG) conducted its own study and found an average of “91 industrial compounds, pollutants, and other chemicals” in the nine volunteers studied. All told, the EWG reported 167 different chemicals, many of which, it claimed, caused cancer, birth defects, or other harms. The result was a significant “body burden,” as the group put it.

But this is fear-mongering at its misleading worst. Simple exposure demonstrates nothing. As the CDC explained: “Just because people have an environmental chemical in their blood or urine does not mean that the chemical causes disease.”

This is the case even for substances known to be capable of causing harm. Observes Elizabeth Whelan, president of the American Council on Science and Health (ASCH), people “should remember the basic tenet of toxicology—the dose makes the poison.” Almost anything can prove toxic if ingested in a high-enough concentration, one vastly above the levels faced by even the most at-risk person.

Yet animal tests not only rely on huge dosage levels, but also can fall afoul of the substantial differences between rodents and primates. In many cases absorption rates and hormonal reactions, which vary among creatures, matter far more than exposure levels.

Todd Seavey of ACSH argues, “Thanks to the CDC report, we’re now more certain than ever that the synthetic chemical amounts we are routinely subjected to are trivial. We ought to feel safer than ever.”

Another argument has been advanced by groups like the Collaborative on Health and the Environment (CHE), an umbrella group for the most active alarmists. It claims that multiple chemical exposure can be harmful—indeed, that chemicals are currently hurting one-third of the population. CHE is aided by the PR firm Fenton Communications, which specializes in turning junk science into newspaper headlines.

It’s an attractive argument for the scientifically uninformed, but it fails the basic test of evidence. As Steven Milloy, publisher of JunkScience.Com, points out: “Despite more than 40 years and countless billions of dollars of research, no credible scientific evidence exists to link typical exposures to chemicals in the environment with disease.”

Indeed, though our theoretical exposure to chemicals has increased dramatically over the last half century, actual chemical contamination of the environment has been falling. And we are living longer and healthier lives than ever. Apparently the human body is able to bear the alleged chemical burden.

Children at Risk?

What of children? People naturally worry about the impact on youthful development, but ACSH warns, “We are at a juncture where emotion, fear, and uncertainty compete with scientific data, toxicological principles, and principles of risk analysis.” In fact, ACSH reports in a new book, Are Children More Vulnerable to Environmental Chemicals?, “There is little toxicological evidence to support the premise that children are consistently more susceptible to environmental chemicals than adults.”

Where there is a problem, as with lead and PCBs, kids need to be protected. But parents need not live in fear of a world that is actually getting safer and healthier day by day. And they need to be aware of what ACSH warns as a “disturbing pattern in which activists with a nonscience agenda manipulate the public’s legitimate and appropriate concern for children’s health in an effort to promote legislation, litigation, and regulation.”

This is the fundamental problem. Alarmist groups with radical political agendas are ever-ready to manipulate science to promote their own ends. A particularly apt example is the case of acrylamide, a chemical coagulant used in drinking water, wastewater treatment, and tunnel construction. In April 2002 the Swedish National Food Administration and researchers at Stockholm University held a press conference announcing that disturbingly high levels of acrylamide had been found in food.

The revelation set off a media sensation around the world. French fries and potato chips cause cancer! California environmental activists sued snack-food makers and fast-food restaurants to warn customers that their products included a chemical “known to the State of California to cause cancer.”

Acrylamide is formed naturally in the cooking of many foods. It appears to cause cancer in rodents fed exceptionally high doses. In fact, in this case the doses not only well-exceeded human consumption, but they also may have exceeded medically tolerable levels for mice, since more died from other causes than from cancer.

Moreover, extrapolating such results to humans is always problematic: genetic differences between rodents and primates often result in different metabolic reactions to chemicals. Dr. Joseph Rosen of Rutgers University observes: “There is substantial evidence that the rodent studies may not be accurately predicting relevance to human health.”

Last January the British Journal of Cancer published a study announcing that there was no apparent link between acrylamide in food and cancer. One British newspaper headline trumpeted: “Crisps Do Not Cause Cancer!” A Swedish paper went onto suggest that acrylamide in food might actually reduce cancer risks.

Obviously, some substances do cause cancer, and evidence of carcinogenic properties requires investigation. But as Waldemar Ingdahl puts it, “Publication by press conference is not good scientific publishing,” especially when there is a transparent political agenda. Constantly crying wolf will make it harder to deal with the few cases where there is a legitimate health issue.

When Robert Johnson, founder of Black Entertainment Television, wanted a $190,000 Ferrari 360 Spider, he went to a German dealer, since it would have taken two to three years to obtain one from a domestic dealer. But it had to be modified to meet U.S. environmental and safety standards. That took 15 months.

If this were the only inefficient, silly, wasteful regulation, there’d be little cause for concern. But Washington is a regulatory behemoth, supplemented by state monsters of various sizes.

Last year Clyde Wayne Crews of the Cato Institute published his annual “Ten Thousand Commandments.” For the first time in years there was modest good news. For instance, the Federal Register in 2001 ran 64,431 pages, down 13.2 percent over the last full year of the Clinton administration. Also in 2001, 4,509 new regulations were working their way through the system, a reduction of 4 percent over the year before.

Still, the news is good only relative to how bad it has routinely become. The regulatory burden remains staggering. Perhaps the best estimate, from analysts W. Mark Crain and Thomas D. Hopkins, is that federal regulations cost the American people $854 billion, roughly 46 percent of the total $2 trillion in federal outlays this year. That’s about 8.4 percent of GDP.

It’s almost as much as collected by both the corporate income tax and the personal income tax. Per family it comes to $7,410. That means government is basically taking another fifth of the median two-earner income after direct taxes have been paid.

Moreover, the claimed advantages are often impossible to verify. For instance, the American Enterprise Institute and Brookings Institution’s Joint Center for Regulatory Studies estimates that roughly half of environmental regulations saves lives, but often at costs far disproportionate to the likely benefits achieved. And, incredibly, in about half the cases “regulations specifically aimed at saving lives actually resulted in a net increase in deaths,” according to the Center’s Robert Hahn and Patrick Dudley.

In another Center publication, Hahn and Cass Sunstein of the University of Chicago Law School, review some of the most perverse rules. The Environmental Protection Agency’s municipal solid-waste regulations generate costs of $100 million annually with no benefits. Pulp and effluent guidelines start at a net zero benefit at best and range up to a $150 million annual loss. The EPA’s ozone standards are already wracking up annual net losses in the hundreds of millions, with the potential of exceeding $9 trillion in a few years.

Some regulations are completely irrational. Consider Corporate Average Fuel Economy (CAFE) standards, by which the federal government mandates that auto manufacturers achieve an arbitrary level of fuel economy. It’s not clear that CAFE even saves energy. After all, raising fuel economy lowers the marginal cost of driving. Moreover, by forcing people into smaller autos, which lose in accidents with bigger ones (as well as vans, SUVs, and trucks), CAFE kills.

John Graham, formerly of Harvard University and now head of the Office of Management and Budget’s Office of Information and Regulatory Affairs (OIRA), and Robert Crandall of Brookings have estimated CAFE’s annual death toll at between 2,200 and 3,900. In the mid-1990s the Competitive Enterprise Institute figured that between 2,700 and 4,700 people were dying because of CAFE.

Even when some benefits might occur, there remains the problem of opportunity costs. Where an existing life is at stake it is tempting to say that every life is priceless. But when we are dealing with risks, no life is priceless. Every expenditure involves a tradeoff. The true cost of any activity is its opportunity cost, the value of forgoing some other activity. To spend $40 billion to save one potential life means that $40 billion is not available to improve roads and traffic signals or to do something else

Americans desperately need a wide-ranging program of regulatory reform. The executive branch can help. Graham has emphasized the importance of weighing costs as well as benefits and of considering “nonquantifiable factors such as fairness, privacy and personal freedom.” As part of its budget, the administration proposed additional changes in how benefits and costs are balanced. Agencies would have to compare different strategies for achieving the same ends, better address the issue of risk, and offer several estimates of benefits and costs for expensive rules based on “uncertain science.”

Crews, Hahn, and others propose a variety of other steps that would pare and improve regulatory policy. They start with reducing congressional delegation of power to regulatory agencies, further streamlining legislative procedures to overrule regulations, creating a congressional office of regulatory assessment (as an analog to the Congressional Budget Office), and setting statutory standards for regulatory disclosure, assessment, and oversight.

Just Say No

However, the most important “reform” would be the willingness to say no. Not every problem is worth regulating. Some cannot be solved by regulating. And many are not worth the expense of doing so. Besides, the free market is the most powerful “regulator” of all.

Reform in Washington isn’t enough. States have taken on an increasingly aggressive, and counterproductive, role. Particularly problematic is the increasing tendency of state attorneys general, almost all governor wannabes, to try to set policy independent of the federal government, such as their jihad against Microsoft.

People routinely refer to America as a free country. And compared to Europe, it is. There a frustrated European Commission recently declared that only through more economic reform could the continent catch up with America. Yet in 2002 the Washington-based Americans for Tax Reform pegged July 1 as “Cost of Government Day”—when we finally stopped paying to fund and comply with government. Of the 181 days spent working for the government, 38 went to cover the cost of federal regulation and 23 for state rules.

Then there’s the loss of simple personal freedom. For instance, Americans are not allowed to buy Kinder Surprise Eggs, chocolate eggs with tiny toys inside, which are available in Europe and elsewhere. Fanciers have to import them illegally through the Internet since both the Consumer Product Safety Commission (the toys pose a choking danger) and the Food and Drug Administration (the toys are an “embedded” non-food item) ban them here.

America, though it possesses the world’s leading economy, nevertheless faces some daunting problems. In such a world, it makes no sense to waste so many resources on trivial concerns.

The Bush administration seems ready to push Medicare reform, and Republican legislators are committed to creating a pharmaceutical benefit. The congressional hopper is sure to fill with bills attacking the pharmaceutical industry and probably even a few proposing to nationalize the entire medical system.

Some states aren’t waiting for Washington to act. Maine and Vermont are trying to control drug prices. Florida is restricting the pharmaceuticals that Medicaid will cover.

In Oregon political activists unsuccessfully pushed an initiative for a Canadian-style, single-payer system last November. California State Senator Sheila Kuehl has proposed that her state adopt the same sort of plan.

West Virginia Governor Bob Wise and others score political points by using Canada to attack the drug makers. Pharmaceutical costs are “outrageous,” he says. People are “being taken advantage of” since they pay more than residents of Canada.

It’s an emotional litany worthy of the finest demagogue. Critics routinely heap abuse on the pharmaceutical industry, but only it makes new, life-saving medicines available to all Americans.

Of course, we face real health-care problems. In Governor Wise’s state surgeons went on strike to protest rising malpractice premiums. But rates are rising because of an abusive tort system, not high drug prices.

Despite Governor Wise’s obvious misconceptions, Canadian health care is no model for the United States.

Adjust for the two nations’ differences—the United States has more war veterans and inner-city residents and spends far more on medical research, for instance—and medicine doesn’t look so cheap up north. Indeed, a commission headed by former provincial premier Roy Romanow, appointed last year by the Prime Minister to review Canada’s health-care system, has just published a report advocating a doubling of the national government’s subsidies.

No wonder, given the fact that Canadians routinely stand in long lines for care. In fact, the Vancouver-based Fraser Institute estimates that Canadians are waiting longer than ever before for medical services. The average delay between general-practitioner referral and specialty consultation is 16.5 weeks; the time between the latter and actual treatment is another 9.2 weeks.

Delays for cancer patients run a month or two. The wait is almost seven months for eye care and eight months for orthopedic surgery.

Canadians have only limited access to new technologies. In August, reported Nadeem Esmail and Michael Walker of the Fraser Institute, “While ranking number one as a health care spender [compared to 26 largely European states], Canada ranks eighteenth in access to MRIs, seventeenth in access to CT scanners, eighth in access to radiation machines, and thirteenth in access to lithotripters.”

Total health-care outlays are determined by a “global budget” rather than medical needs. The province of Ontario closed its hospitals around Christmas 1993 because it was out of money. Explained Theodore Freedman, president of Toronto’s Mount Sinai, which was shuttered for two weeks, “This is not about health care. This is about the deficit.”

Patients flee abroad, particularly to America. Provinces contract out treatment, such as for cancer, to U.S. hospitals.

The story is much the same for pharmaceuticals. U.S. politicians have organized well-publicized bus trips to Canada to help constituents purchase pharmaceuticals at lower prices. “There’s no question that prescription drugs cost too much in this nation,” claims Senator Jim Jeffords.

But international cost comparisons must be viewed with skepticism, since there is no “correct” price. Prices overseas generally reflect the lower incomes of many nations and the highly politicized nature of most foreign health-care systems. Exchange rate variations also matter: America’s relatively strong dollar make drugs priced in weaker local currencies seem particularly cheap.

Canada’s economy too, has suffered, with its dollar losing nearly a quarter of its value over the last decade. As a result, many goods are cheaper there than here.

Less Litigation

Canadians also benefit from less, and less expensive, product-liability litigation. Economist Richard Manning estimates that one-third to one-half of the drug price differential between the two countries is due to the higher cost of liability litigation in America. Moreover, the national and provincial governments restrict prices, free-riding on American research and development.

Patricia Danzon of the Wharton School also points to issues involving patent protection, limited use of generics, and continuing availability of prescription drugs without prescriptions. After adjusting for such factors, she and Jeong Kim found, using 1992 data, “that the average U.S. consumer would have paid 3 percent more in Canada.”

More recently, Dr. John Graham, director of the Fraser Institute’s Pharmaceutical Policy Research Center, and Tanya Tabler, a student at the Faculty of Pharmacy at the University of Alberta, surveyed prices on both sides of the border. Although they found costs to be lower in Canada, Graham and Tabler observed that “a shopper can save almost as much money by bargain hunting within his own area as by crossing the border.” Indeed, reliance on U.S. list prices is itself misleading since actual transaction prices are often lower.

Pharmaceutical controls also have sharply reduced Canadians’ access to needed drugs. Even when the national government approves a medicine, provinces often do not cover its use.

For instance, Ottawa added only 24 of 400 drugs considered for reimbursement between 1994 and 1998. Provinces sometimes wait months or years before including pharmaceuticals in their formularies, or use such techniques as “reference pricing,” covering only the cheapest drug within a therapeutic category, irrespective of relative effectiveness.

The consequences are predictable. Canadian physician William McArthur reports that more than a quarter of doctors in the province of British Columbia have had to treat and even hospitalize patients because of government substitutions of medicine; six of ten have seen their patients’ conditions deteriorate.

American health care is a mess. But nationalizing the system will only exacerbate the problems. Drugs, which often cut costs by eliminating the need for other treatments, are part of the solution.

If Governor Wise and his allies nevertheless impose Canadian-style prices on drugs here, Americans will suffer Canadian-style access to drugs. In fact, the impact will be even worse, because Canadian-style pharmaceutical regulation means a Canadian-style pharmaceutical industry—with few new drugs and even fewer new breakthrough medicines.

As Washington, D.C., prepared for the descent of thousands of anti-globalization protesters last fall, George Washington University law professor John Banzhaf proposed deploying the ultimate weapon: trial lawyers.

Hit the demonstrators with a class-action lawsuit! Luckily, the city survived the protests without resorting to such extreme measures.

But the proposal was par for Banzhaf, who believes that just about every decision in life should be decided by judges. No rhapsodic commitment to liberty. Just send in the lawyers.

Unfortunately, there are few people Banzhaf would not like to sue. He apparently will not be satisfied as long as anyone is making a personal decision that has not been cleared by him in court.

He cites among his accomplishments sex-discrimination lawsuits against the Washington Cosmos Club and South Carolina’s military-oriented university, The Citadel; hair stylists who charged more to cut women’s hair and dry cleaners who charged more for women’s clothes; and bars that discriminated against men with “ladies’ nights.”

Long known as the “Father of Potty Parity,” last year he joined in a federal complaint against the University of Michigan for having only a third more restroom facilities for women. In his view, this constituted illegal “sexual harassment.”

He really hates the tobacco companies. Consenting adults have no right to make what he thinks is a bad decision. He was involved in the campaign to ban cigarette advertising on TV. He naturally backed the legal avalanche of state Medicaid lawsuits against cigarette makers, and last fall put out a press release lauding a judge for banning parental smoking around a child in a custody case.

Banzhaf also has suggested legislative action, such as a tax proportional to the medical costs created by consumption of particular foods. Banzhaf contends: “If there are products the use of which cause large costs, grave costs, it is better that the burden of those costs fall on people who use and make the products.”

He says that some of the revenues should go “to fund healthy eating messages to compete against the $30 billion that the food industry spends.” And government should “put more health foods in vending machines, install bike racks and showers at public buildings to encourage more exercise, and so on.”

Should his fellow citizens and their elected representatives be too stupid to go along with his plans, however, there is always the class-action lawsuit. Sadly, though, while helping to pioneer the basic theory of fat litigation, Banzhaf was slow in finding actual plaintiffs. An overweight 56-year-old, Caesar Barber, used another lawyer to file the first suit, charging McDonald’s, Burger King, KFC, and Wendy’s with making him fat.

But now Banzhaf is trying to catch up. He has complained that fast-food companies “aim in particular [at] young people,” and kids thereby “fall into the trap and become obese at youth.” He’s threatening to sue schools and school boards “for entering into contracts whereby they get paid for every fat burger and sugary soft drink they sell to kids.”

Moreover, Banzhaf has filed a class-action case against McDonald’s for selling to children. Suing on behalf of kids “avoids the major argument that plaintiffs are supposedly responsible for their own actions, since one can hardly blame youngsters who are lured into McDonald’s by playgrounds, gotta-have toys in Happy Meals, birthday parties, etc.”

Elsewhere Banzhaf has admitted that consumers have some responsibility, but “to exercise their personal responsibility, consumers need the same clear and conspicuous disclosure of calories and fat content in fast foods that we enjoy and use regarding food purchased in stores.” As if most people don’t know that a Big Mac has more calories than a tub of Tofu.

We Know Better

The basic point is that people know better, but still choose “bad” stuff. And most people still eat most meals at home. Grocery stores, diet doctors, and packaging companies could be next on the legal hit list. Even people who give out candy on Halloween. Sue ‘em all!

Seem unlikely? Observes Banzhaf with delight: “Never underestimate the tenacity of a lawyer working on a contingency fee.” Indeed.

Nor are private suits the only option. Banzhaf says we could see “similar state lawsuits against fast food companies for the public costs of obesity, just as states were so successful in suing tobacco companies for the public costs of smoking.”

The argument that we are all paying for the costs of fat people and that instead such expenses should be “confined to those who use the products or produce them” is superficially attractive. But in the case of smoking, government actually benefited: though smoking-related diseases are expensive, they are not as expensive as decades more of age-related diseases.

Moreover, that government tries to socialize the cost of everything—health care, for instance—doesn’t entitle it to control our lives. Should people be allowed to hang-glide? Should people be forced to exercise? Why let individuals assess the relative benefits and risks of any activity when the rest of us pay?

Banzhaf is a dedicated social engineer. He told one critic, “the problem is, the remedies that you proposed—exercise, moderation in eating—and what some others propose—parental responsibilities, individual responsibility, education—aren’t working.”

He’d prefer that government legislate. But even here there are limits. Banzhaf allowed in an interview with a French publication: “one can change the behavior of the companies much more easily than that of the consumers. . . . I can’t think of any way we can legislate that people go out and jog a mile a day.” We should be thankful for small favors.

“But we can change how fast foods are advertised, promoted, sold. We can adopt taxes on fast foods so the losses are borne much more by people who eat them,” he exults. Who cares if people like fast food? He doesn’t want them to eat it, and he will do whatever is necessary to stop them. If government won’t do his bidding, then “as in the tobacco area, where the legislatures did not act, we were forced to litigate.” Lawsuits pushed their way out of his pen in the same way that hamburgers forced their way into Caesar Barber’s mouth.

When will all this end? Never, if Banzhaf has his way. He told Insight magazine: “I’m not sure anybody at this time can say. I would suggest that we have to work it out the way we always have. Which is . . . in the great laboratories of law that are our courts.”

Freedom requires responsibility, a willingness to bear the cost of one’s actions. Increasingly, however, Americans want someone else to bear the consequences.

Why that royal family, which has been spending ten times as much as Iraq on its military, wasn’t expected to defend itself was never explained. The problem, presumably, was the lack of internal support for a monarchy both rapacious and useless. Thus enter Washington.

Yet contrary to popular wisdom, the Saudis’ trump hand is surprisingly weak. True, with 262 billion barrels in proven reserves, Saudi Arabia has about one-quarter of the world’s oil resources and 8.7 times America’s supplies. Riyadh is not only the world’s leading supplier, but as a low-cost producer can easily augment its daily exports, eight million barrels a day last year.

However, the reserves figure vastly overstates the importance of Middle Eastern oil to the U.S. (and Western) economy. Saudi Arabia accounted for about 10 percent of production last year; it plus Kuwait and the various sheikdoms came to one-quarter; OPEC produced 40 percent of the world’s supplies. Were Saudi Arabia to fall, prices would rise substantially only if the conqueror, whether internal or external, held the oil off the market, especially if the other Gulf states also collapsed. The result then would be severe economic pain in the short term, though the Strategic Petroleum Reserve would help moderate prices.

Such a policy would, however, defeat the very purpose of conquest, even for a fundamentalist regime. After all, the Iranian revolution did not cause that nation to stop exporting oil; in fact, Iranian production increased steadily throughout the 1990s. If a new regime did halt sales, the primary beneficiaries would be other oil producers, who would likely increase exports in response to the higher prices. A targeted boycott against only the United States would be ineffective, since oil is fungible and available around the world. In fact, the embargo of 1973-74 had little impact on production; the global recession of 1975 caused a far more noticeable drop.

A new regime might decide to pump less oil in order to raise prices. Such a strategy would require international cooperation, yet the oil producers have long found it difficult to coordinate price hikes and to limit cheating on agreed-on quotas. Even if effective, restricting sales would have only a limited impact.

A decade ago, when oil was selling for about $20 a barrel, energy economist David R. Henderson, a professor at the Naval Postgraduate School, figured that the worst case of an Iraqi seizure of the Saudi oil fields would be about a 50 percent price increase, costing the U.S. economy about one half of one percent of GDP. Prices are today running close to $30 a barrel, but that includes an uncertainty premium over war with Iraq. Thus, the real price hike today of a Saudi collapse probably would be similar to that of a decade ago. Moreover, it would fall on an economy more than one-quarter larger.

In any case, the economic impact would diminish over time. Countries like Kuwait, Iran, Nigeria, Russia, the United Arab Emirates, and others have the ability to pump significantly more oil. A resolution of Iraq’s status would bring substantial new supplies on line; Baghdad pumped 2.2 million barrels a day in 1990, before becoming subject to sanctions after the Gulf War. As economist Susan Lee puts it, should Riyadh turn off the pumps, “the U.S. would find itself plenty of new best friends.”

Sharply higher prices would bring forth new energy supplies elsewhere. Total proven world oil reserves were 660 billion barrels in 1980, 1,009 billion in 1990, and 1,046 billion at the end of 2000. Yet in the last decade alone, the world consumed 250 billion barrels of oil. How could this be? A combination of new discoveries and technological advances increased the amount of economically recoverable oil.

Reserves rose even as oil prices dropped. Between 1980 and 1990, proven oil reserves jumped by 62 percent while prices for Middle Eastern petroleum were falling 43 percent. Prices eventually hit a dramatic low in 1998, down another 41 percent, before rising over the next two years.

Plugged Wells

America is dotted with high-cost wells that could be unplugged. The nation’s outer continental shelf (OCS) alone is thought to contain more than 30 billion barrels of oil, greater than our current proven reserves; since barely 6 percent of the OCS has been leased, those resources have not been proved. Barely 15,000 acres of the 19.6 million-acre Arctic National Wildlife Reserve could contain a similar amount of oil. Even the modest estimate of five billion barrels of recoverable reserves at current prices would be a significant addition to current supplies. However, we won’t know how much is there without drilling, which could be conducted in an environmentally sensitive manner.

Further, some 300 billion barrels of unrecovered oil, ten times our proven reserves and more than known Saudi resources, lie in beds of shale under the United States. They are not counted, however, because they are not currently worth developing. But as prices rise and new techniques are developed, they may become economically recoverable. Moreover, energy companies are looking for new oil deposits around the world, including in the Caspian Basin, Russia, South China Sea, and West Africa. Estimates of as-yet undiscovered potential recoverable oil range from one trillion to six trillion barrels.

At current consumption rates the Energy Information Administration estimates that we have enough oil for another 230 years and “unconventional” sources, such as shale, that could last 580 years. And even these figures are based on existing prices and technologies. Higher prices would stimulate exploration, as well as production of alternative fuels and conservation, reducing oil consumption.

In short, while an unfriendly Saudi Arabia might hurt America’s pocketbook, it would not threaten America’s survival. Thus there is no need to go out of our way to protect the Saudi dictatorship, let alone keep the royal family happy. Moreover, the withdrawal of U.S. forces would remove a prime source of potential instability.

Anyway, Riyadh isn’t likely to turn hostile. It needs the money from selling oil as much as we need the oil.

A cynic might ask “so what?” if people are frustrated with government. They shouldn’t be putting their faith in it to fulfill their aspirations. Instead, they should expect it to protect their rights, establishing the minimal framework for a free society. That, however, is far from Bok’s mind. He assumes government is the creator, not the protector, of rights and should actively manage “society.”

Bok admits that the state often manages badly and worries that “persistent disappointment over the government’s performance could deepen and solidify the public’s loss of trust and confidence in its officials and in their capacity to help people achieve their goals.” Of course, that warrants concern only if the business of government is helping people achieve their goals.

Bok thinks it is. Perhaps most shockingly, he argues: “Amid the welter of separate interest groups, religious denominations, advocacy organizations, and associations of all kinds, government is the one authoritative agency that can define, enunciate, and validate a set of common moral standards and obligations for all the people.” Distrust in government will naturally “weaken the moral authority of the State.” To expect that of government, however, is to ensure failure and disappointment, not because of constitutional structure, interest-group pressure, or citizen apathy, but because of the nature of political institutions, where coercion is applied by human beings responding to perverse political incentives.

There is another, more practical problem, Bok argues. When government promises to do something, and doesn’t perform, people are hurt. He explains: “a shoddy performance by public officials today can mean inadequate schooling for children, hunger for needy families, sluggish growth or even a recession for the economy, useless training for workers seeking job skills, substandard health care, polluted air, and a host of other misfortunes.”

That is quite true, but the analysis should not start with how can the government better educate children?, but should the government be in the business of educating children? Government failure is not so much a result of its not working as intended, but of its working exactly as intended. Why would one expect a centralized educational monopoly run by political officials accountable primarily to vested professional elites to be the best method of helping children learn?

Bok’s basic thesis, “the trouble with government,” makes the most sense when it comes to the essential, core roles of government. How does one efficiently and effectively defend the nation? How does one prevent and prosecute crime? Etc. Here, Bok’s analysis is generally thoughtful, sometimes provocative. He criticizes politicians and the media, but doesn’t strongly indict either group, writing that “the charges against them are not linked convincingly to the failures of the federal government to achieve the goals most Americans affirm.”

So Bok goes on to review the specifics of governing, asking why legislation is so badly designed and regulations so inefficient. Much of his analysis is correct, but he undermines it by assuming that government must be responsible and we must keep looking for better ways to legislate and regulate. For instance, he contends that government should be “protecting all Americans against the major hazards of life” and that poor people don’t have enough political power to demand that government create the right programs.

Bok dismisses many of the usual panaceas, such as direct democracy, citizen panels, and campaign-finance reform, but offers none himself. Some of his ideas would undoubtedly make Americans worse off, especially expanding the political power of unions.

He closes by calling for civic involvement, but simply convincing more people who want to use government to live at everyone else’s expense to vote is no answer to anything. Indeed, that reflects the fundamental flaw in Bok’s book. Making government more efficient and responsive would be an important goal if government were limited, doing only what it needs do. But when government is the most imperialistic of institutions, determined to take over not only the functions of most other social institutions, but decision-making by individuals as well, efficiency and responsiveness are not major concerns. Returning government to its proper role is.

Washington, D.C., is filled with professions of good intentions by politicians and bureaucrats as they steadily strip away Americans’ liberty and money. The political class uses even the most serious social problem to cement its control.

Elections, which H. L. Mencken called advance auctions of stolen goods, bring out the worst in politicians. But it’s better to have elections than not, even though the political world usually looks about the same whether the Democrats or Republicans win.

Nevertheless, America, in contrast to its government, remains special. The uniqueness is most evident when traveling abroad.

Not so much when visiting other industrialized nations—what I call “real countries”: Great Britain, Germany, Japan, Australia, and the like. Places that have advanced health care, modern telecommunications, democratic polities, respect for human rights, and abundant consumer goods. The United States remains freer and the opportunities remain better than in most of these states. But any American could live a prosperous and reasonably free life in them.

That’s not the case with much of the globe, however. The bulk of the world’s population lives in poverty and oppression. People spend their entire lives without opportunity or hope. The need for real reform—that is, freedom—is so much greater there.

For instance, journey to the border between Thailand and Burma (Myanmar). I’ve gone several times with a group called Christian Freedom International (CFI; www.christianfreedom.org), which works on humanitarian and religious liberty issues. In this case, it assists ethnic Karen refugees displaced by the Burmese military.

Roughly 100,000 Karen live in refugee camps near the city of Maesot in western Thailand. Wooden huts cover undulating hills as far as the eye can see. The physical facilities are primitive, but people have organized themselves, especially around several churches (the Karen were converted by Christian missionaries in the mid-1800s). They are fed, housed, and clothed. Yet many people have been there for years; children have been born in the camps. None see any prospect of going back to their ancestral homes anytime soon.

Even worse are conditions in eastern Burma. Up to three million people have been displaced by decades of war. The junta’s forces move in, rape the women, conscript men as porters, kill the villagers’ livestock, destroy the buildings, and sow landmines to prevent people from returning. Two years ago government forces eradicated one small village just over the Moie river inside Burma six weeks after I visited.

Last summer I went to a larger, semi-permanent camp, protected by guerrillas with the Karen National Union (KNU). At least they have formal privies, in contrast to other villages deeper in the hills. And the meeting building and “freedom hospital” supported by CFI have electricity, which is absent elsewhere.

Still, it is impossible to escape not just dirt, but mud during the rainy season. Jungle green encroaches a few yards away. Only the careless would wander into hills covered with landmines and vulnerable to Burmese military attack.

Moreover, there is no hope for peace or prosperity. I met soldiers as young as 13, teenagers whose parents had been murdered by government troops. I met KNU soldiers in their 30s or 40s who have fought and killed for their entire adult lives. I met Burmese defectors who prefer uncertain exile to forced service under government thugs in Rangoon.

Life in Pakistan

Or journey to Pakistan. I went there last year as well. It is a military dictatorship, where General-President Pervez Musharaff has rigged the electoral process to create a democratic facade for his authoritarian rule. As in most of the Third World, state mismanagement of the economy has resulted in mass poverty.

On top of that is state-supported discrimination against minority faiths. Converts from Islam are often murdered. Non-Muslims find themselves prosecuted for blasphemy. No one even bothers to mouth the principle of equal rights under the law.

Worse, far worse, is North Korea. There are executions, mass starvation, and labor camps. And a stifling personality cult. Never, ever, speak ill of the Great Leader and Dear Leader. Commemorate them by photos in every room and buttons on every breast.

It’s been a decade since I traveled to the so-called Democratic People’s Republic of Korea, but what I most remember is the lack of life on the streets. Masses of people walking, but never a group leaving a restaurant laughing. Never anyone having an animated conversation. Just silent souls streaming by, crushed by a system dedicated to squeezing out the slightest spark of creativity and individuality.

Obviously, many Americans face serious challenges, some of them life-threatening. But most problems here pale in comparison to those burdening the average Burmese Karen, Pakistani, and North Korean. In the United States hardship is real, but an exception. For so many other people elsewhere it is a way of life, for one’s entire life.

Seeing so many people in such straits highlights our responsibility for others, the obligation of those to whom much has been given to help those in great need. Moreover, such situations illustrate how the best way to help others is through private voluntary organizations that show up in isolated lands to feed and train people, create orphanages and schools, and maintain medical facilities. U.N. humanitarian agencies operate in Maesot, but none of them will work against the wishes of Burma’s brutal junta to help save Karen children who have stepped on land mines or been infected with malaria on the other side of the river. CFI will, even in the most primitive and distant village and at significant risk to its own personnel.

In Pakistan Christians routinely are denied access to basic services, such as electricity, available to Muslim neighbors across a street or field. And aid workers complained that the government manipulated foreign assistance for its own ends, rewarding its supporters and denying funds to disfavored groups. Looking to government for help is the path to starvation. Only private aid really turns out to be aid.

Not that this is always a good answer. Private groups can’t do much in North Korea. Some provide food, but their activities are constrained by Pyongyang’s dictates. Still, every little bit of private engagement helps, though often only a little bit.

Although I’ve always disliked jingoistic nationalism, even when applied to the United States, going to places like these causes me to grasp my American passport a little—actually, a lot—tighter. There is much wrong here. We desperately need to free our people, while addressing the sometimes desperate human needs that rightly unsettle our consciences. Even so, America remains a beacon of liberty for the world.