I was re-reading this review of a new book on Communism – “Mankind’s Greatest Mistake” – in the July 4th Economist when I ran across a paragraph that made me smile:
The promised communist nirvana brought a mixture of mass murder, lies and latterly the grey reality of self-interested rule by authoritarian bureaucrats. But it was a bit late for second thoughts. Communist regimes proved remarkably durable, partly thanks to the use of privileges for the docile and intimidation of the independent-minded. Another source of strength was tight control of language and information that deemed most criticism unpatriotic.
It’d be almost too easy, I thought, to compare that sentiment to those expressed so recently by the Speaker of the House and her deputy. But that’d be taking the trope too far, I thought. Whatever else their flaws and failures, neither Pelosi nor Hoyer are Communists of the old skull-cracking type, nor even whey-faced apparatchiks of an impersonal and self-interested bureaucracy.
I don’t think.
They’re just cocooned by sycophants, enablers and adorers who don’t know anyone who voted for Nixon. As a result they are quite serenely convinced of their own rectitude, not to mention the evil intentions of their political adversaries. Who are really only racist dupes voting against their own self-interest when they’re not exploitative capitalists, red in tooth and claw.
Maybe both.
Because there’s no principled reason to object to another trillion dollar government program, no reason to fear the inevitable encroachment of a public option whose only fiscal limitations are how many public pockets can be picked or how much of the burden can be passed down to our demographically shrinking successors, and no reason to fear the kind of rationing that would, in any other market system, inevitably result from increasing demand without increasing supply.
No, we are supposed to take the blandishments of our political class at face value: Everyone will be covered. No one will have to join a public option plan who does not want to. Costs will be reduced. Quality will not suffer. You will not have to wait. Just, you know: Shut up.
I wasn’t going to mention it because, you know: This is democracy. It’s occasionally messy, but that’s what you get. The Democratic Party has made no effort to hide their plans to reform the US health care system, and in fact has run aggressively on that plank at least since Hillary presumed to speak for Bill. They’re just trying to keep their promises.
I wasn’t going to mention it until I read Ezra Klein’s latest in the WaPo, entitled “It’s democracy, not health care reform that is sick“:
What we’re seeing here is not merely distrust in the House health-care reform bill. It’s distrust in the political system. A healthy relationship does not require an explicit detailing of the “institutional checks” that will prevent one partner from beating or killing the other. In a healthy relationship, such madness is simply unthinkable. If it was not unthinkable, then no number of institutional checks could repair that relationship. Similarly, the relationship between the protesters and the government is not healthy.
This is revealing language, this definition of the relationship between the electorate and their representatives. Klein seems to believe that we are in some form of marriage relationship with government, that our romantic troth is unalterably plighted. He may even think – although he does not go so far in this essay – that government is in a paternalistic relationship to the people. That daddy knows best. So just shut up.
But we are taxpayers, not children. And congressmen are not our partners, but our employees.
It would be “healthy” for them to keep that in mind: Their contract comes up for renewal in 15 months.
Churchill said of the British people in WWII that they were the Lion, he just gave it the roar.
I’d say you seem a might disturbed by all that is transpiring and have provided a bit a roar for the rest of us so sickened and roused to action of some sort as a result.
I read where the Obama Administration just quietly rescinded some rule that prevented Government Agencies from keeping records through “cookies” and such regarding who is doing what on the government web sites. The question remains: Why?
Its getting time for the pitchforks and cool yet passionate voices will come to the forefront.
I rather enjoy reading your take on the times even if your disdain is hardly hidden at times.
This all kind of reminds me of reading “The Law” by Frederic Bastiat, which is a pretty short book and worth a weekend. To try to distill a major point down to some bare bones, there’s a natural and inexorable link with government size/power and both corruption and partisanship. When the government is small and constitutionally constrained to perform only a few necessary functions like defense, the police, the roads and delivering the mail there’s not much opportunity to use political power for personal gain in a corrupt way and how much do you really care if your crazy nutjob neighbor wants to radically reform the way the post office works. But when government is large, has encroached into legislating every aspect of our lives even as to what lightbulb we can use so that it is de facto unconstrained by a “living” constitution (why bother writing it down if it doesn’t mean anything beyond what you want it to mean in the moment?) and people look towards government to do the above listed plus provide for your retirement, plus pay for your college, plus take care of your medical bills, plus bail out your company if your job looks in trouble, plus nationalize the banks so you never have to fear defaulting on your loan, plus regulate how much anyone can pollute to save the world, plus it’s leader’s wife openly declares that he will “make you change” apparently whether you’re interested in doing so or not, not only does the opportunity to make a quick and shady buck in the byzantine labrynth of garguntuan administration such a government must by necessity become increase exponentially, but all of the sudden your nutjob neighbor’s concept of how you should live every aspect of your life becomes a lot more of a contentious issue too.
ProwlerAMDO/
“….but all of a sudden your nutjob neighbor’s concept of how you should live every aspect of your life becomes a bit of a contentious issue too.”
That’s they way of ALL totalist, utopian
ideologies, be it Communism, Islam, Fascism or the totalist, utopian communal/Socialist experiments like the Israeli Kibbutz or places like New Harmony, Ind. All, all of them attempt(ed) to regulate/control every aspect of one’s waking life right down to what color to paint one’s bedroom walls. Many refugees from the Kibbutz experience who gave it up did so usually using the word “tiring” as all argued/discussed constantly end endlessly over even the slightest of things, i.e., under such regimes EVERYTHING becomes “political,” there IS NO pvt sphere.
Read a good article recently in the NY Post by Adam Brodsky which pointed out that this totalist approach will be the inevitable tendency under Obama’s health-care plan in terms of life-style regulation to hold down costs. Go see@
http://www.nypost.com/seven/0810200/plform_costs_the_health_cops_183774.html
PS to P_AMDO
Sorry the link doesn’t seem to work, although my bookmark works fine to pull it up. It’s a 10 Aug article by Brodsky in the NYPost entitled “Hidden ‘Reform’ costs:The Healthcops.”
Greetings:
Communism: social justice wrapped in social science.
Fascism: social justice wrapped in mythology.
Islam: social justice wrapped in religion.
You are not reading what Klein said correctly. His point is that a good democracy demands a well educated electorate, not one that can be so easily swayed by demagogues.
Gotta chime in with you on this one, Skippy. If all people do is ignore what’s happening around them, and “forget” to show up at the polling place (like about 60+% do), then we really cna’t know what the consensus is on how to operate. Worse yet, those who show up to vote, and have managed to avoid comprehending the issues, and the concepts that underlie that right.
Skippy makes a good point. Democrats have destroyed public education and always vote to kill any possible alternatives such as charter schools since a well educated electorate schooled in the founding documents of this country is antithetical to what the Democratic Party espouses and would have hung progressives and fellow travelers ages ago for adopting the failed doctrines of the National Socialist Party, Communism and the other major Statist tyrannies of the 19th and 20th centuries. Only people utterly ignorant of history would vote to repeat those failed experiments which is why civics and history are no longer required courses in high schools.
Look at the death grip of NEA on the system…and how they mangle/reject those with conservative views….and constantly move away from the 3Rs and head for “self-esteem” and “sex education” as the cornerstones of the process our youth is steeped in daily.
Interesting mention of the NEA…. Here in Michigan, the teacher’s union is fighting a legislative proposal to consolidate teacher’s insurance. Currently each district negotiates it’s own insurance with different insurance firms. Consolidating into one state plan will save an estimated $400M.
Unions are fighting because it’s anti-choice in health care, decisions in health care are their right, etc. etc. etc…. Wait, those are the arguments of the Conservative Right Wing Wackjobs.. no, it’s the unions, no it’s the CRWW… head hurting.. must lay down now.
George V.
So what do you reckon Klein’s recommending, some class of satisfactorily educated elite to lead the hoi-polloi in ways more favorable to their interest than they themselves would choose? Who gets to decide what the syllabus is for a “proper” education? How do we determine the cut-off line for those permitted to engage in the political process?
And is it not a little off-putting to consider that the same people now at least nominally in charge of the public education system will be placed at the helm of the health care system? You expect a better outcome this time?
The president and Ms. Pelosi are trying to deceive us into believing that their program will cover more people for less money while leaving unchanged the availability and quality of the care currently received by the vast majority of the population. Some people are trying to deceive the gullible into believing that “death panels” will adjudicate end of life decisions.
I guess it all depends upon what series of lies you prefer to believe.
While I do find the term “death panels” to be a bit over the top, the bill does call for a federal panel to assign approved treatments for various illnesses. Whether they would make that decision based on the age of the patient is not specified. The bill also calls for doctors to be paid to counsel those over 65 and the severely ill on end of life decisions. I actually did wade through this portion of the bill and think my reading comprehension is pretty good…
Your doctor will be paid to discuss this with you? That is just plain creepy and coersive to a certain degree considering this is the person you have put your trust in to deal with your medical care.
I would much rather a pudgy bureaucrat in a skirt and sweater set walked into the room and asked the patient if they wanted to talk about these things. That way the patient would not have an emotional problem with telling said person to get lost if they so chose.
It seems quite possible from looking at history that there is a certain type of culture that supports and promotes a classically liberal democracy. The traditional Anglo-Saxon culture is usually considered the archetype. The great question after WWII was whether continental European (i.e. German) or Asian (i.e. Japan) cultures could prove fertile grounds for democracy (or, alternatively, whether democracy imposed by an allied occupation would corrode their cultures.) The great question after the fall of the Berlin wall was whether democracy could take root in a slavic or orthodox culture, and the noble experiment, at best, of the second Gulf War has been whether an Arab / Islamic culture (Iraq) could possibly give rise to some form of republican government. The jury still seems out on these latter two examples, and given the demographic death march of the post WWII democracies it’s possible the jury’s still out on the former.
But to go back to the founders, while education is likely a good, Madison harped emphatically on the necessity of a moral society (which he felt only a deeply religious population could provide) as the incontrovertible bedrock of a democracy. Education alone does not seem sufficient. After all in Weimar Germany the Nazis were most popular amongst the youth, particularly the educated, and a good number of the intelligentsia, with Martin Heidegger the most obvious example. And they VOTED in Hitler.
Last, if the mark of education is to sit and nod in silent agreement with the likes of Nancy Pelosi, Chris Dodd, and Barney Frank as they foist, with the “fierce urgency of now,” a 1,000+ page unread/incomprehsible bill to get government’s foot in the door on 1/6th and growing of the American economy sugarcoated with a bunch of illogical and irrational lies like Lex pointed out than lump me in with the unwashed, knuckle dragging masses.
For one, Lex, I’m not believing the president, Ms. Pelosi, the Eastern elite or the fly-over crowd!
As I was wading thru the bill last night, I interpreted the “shall fund end-of-life counseling” as the bill includes plans to pay for discussing the end with the doctor and coming up with a plan for when that moment is reached. Which, while morbid at first glance, is a good idea to be ready for (and funded) – kind of like the military requiring all personnel heading into warzones to have their wills done.
I don’t really care for Pelosi and her brain-dead vocalizations, but the healthcare plan as I read it, funny enough made sense and sounded pretty decent keeping in mind the bigger picture. How to fund it without jacking taxes up is my question.
I’m hoping the idiotic shouting matches at the town halls can be brought under control so level-headed folks can seriously discuss what the bill actually says without resorting to name calling and fear-mongering.
Maybe I’m too optimistic…
…so level-headed folks can seriously discuss what the bill actually says…
Well – since our politicians are far from being level-headed and most concede that they haven’t read the legislation…
Who would these folks be?
I agree that the debate needs to be a bit more reasoned however we aren’t talking about a highway project. We’re talking about the thing that is probably as important to most people as their paychecks. And when there is a provision that will eventually make private insurance illegal, or at the very least drive them out of business (see page 16 of the tome) – then passion becomes the only thing we have to get our point across.
The thing that really gets me is that the opposition to this is so vocal, so very loud – yet these politicians are ignoring it completely. Just pushing forward as if we aren’t speaking at all.
Like Lex says – 2010 is coming.
Speaking of healthy relationships, I have one with my doctor. I see him once every few years, pay the bill, he leaves me alone. Can’t get much better.
I have another with my insurance company — I pay premiums, they pay for portions of the medical bills, anything they refuse I think should be covered I run past the appeals process, then get the lawyer to send a nice letter urging them to reconsider. If that ever fails, I can sue the insurance company. I’ll probably lose, but at least I’ll have my day in court, possibly with a jury of my peers (or 12 folks who can’t get out of jury duty). Those aren’t bad odds for what amounts to upholding a contract.
Quick question: who cannot be sued unless they agree to it? Answer: Da Guv’mint.
We’ve entered the land of No Recourse for we the private individuals, but I’ll betcha lawsuits against doctors won’t be set back at all in a single payer program.
Lex and Prowler reminded me of another book I’d read many years ago. “Unintended Consequences” by John Ross. A short description would be it’s a book about the gun culture, starting at the turn of the century where pigeon shoots actually involve pigeons and young boys releasing them, to the National Firearms Act of 1934 abridging a few more freedoms, to the Gun Control Act of 1968, to Ruby Ridge and Waco, and so on and so forth. In it, a fairly well-off gentleman finds that his boyhood hobby, which he’s never broken the law regarding or harmed another, is slowly and surely placed under more regulation, greater taxation, numerous nuisance laws, until finally the final straw breaks him and others. A revolution starts, a real grass-roots revolution, where the enforcement of these laws becomes hazardous because the protagonist feels he’s nothing left to lose.
It’s a riveting read. Highly recommended.
The other day while helping a neighbor undergoing treatment for colon cancer handle some everyday chores, the topic of single-payer came up. He’s a crotchety not-so-old man and one who makes no bones about what he thinks of things. He opined that without the proper drugs for chemo and radiation treatment, he’s just a dead man walking. With a family. Treatment delayed or denied is a death sentence. So, what’s he got to lose by walking into a government office and having a “compelling conversation” with a beaurocrat regarding health care and the cost/benefit ratio thereof? I opined that if, while imprisoned, society has a duty to keep you alive to complete your sentence, then the proper thing to do is simply maim and cripple the government worker, such that there would be no death penalty case but you’d get your chemo, radiation, and regular follow-up care while in prison, thus costing the taxpayer at least twice the expense. Given good behavior one might even make parole in 5 years, at a considerable cost savings to the family for medical care.
He smiled, the thought had already occurred to him.
Ruby Ridge and Waco galvanized the gun culture, but they were only maybe 10% of the population. Now Congress is taking on health insurance, something almost every voting citizen already has and will be affected by. If this goes to crap the way pretty much everything else the government runs has, it makes me wonder how they anticipate maintaining control when even liberals like my neighbor with the grammatically correct bowels (went from a colon to a semi-colon) make no bones about using force to stay alive and the costs to the coffers be damned.
– Max
AWC N- Your equating military personnel writing a will to the end of life discussions with a doctor, along with appropriate paperwork, is akin to a platoon sargent saying “we are going on patrol now, so every one write their will.” This would not engender faith in the patrol leader. In fact, it would promote fear.
It is down right creepy and counter productive for the patient to be approached by their health care professional in this way. Especially if you knew they were getting paid for it!
OT to Marianne – I thought you would like to read this article about a Houston Congressman:
http://newsbusters.org/blogs/tom-blumer/2009/08/11/cant-make-it-dem-rep-who-opposes-photo-id-vote-requiring-photo-id-town-h
Does he represent you?
Babs
babs/
That sort of end-of-life counseling is ALREADY being done currently on a mandatory basis with either Medicare and/or Medicade patients IIRC. Many ins companies also require it as part of their patient-care planning. I’m fuzzy on details (my wife, the RN, is asleep) but the aim is as I understand it to rationalize the process and get patient to think/take action if desired while still lucid, etc. A logical process in theory, as I know prom personal experience that children are often wary of looking like they are nudging parents toward the grave by even bringing such things up on the one hand, but by not doing so risk huge complications–medical, legal, ethical AND emotional further down the road when many optimum options may be foreclosed. If (and a big “if”) done correctly by Hospital Staff and made a normal, routine, un-threatening more or less seamless part of of the medical experience from the patient’s pov while taking much of the onus for initiating discussion of such things off the backs of family/relatives. And the reimbursement bit comes in as a way of compensating physicians for their time in the same way they bill separately for other services.
Do critiques such as yours and other’s have merit? Certainly, ANY system no matter how well intended, may be abused and/or distorted either by the passage of time and changing social mores, or used purposefully as a a wedge to advance ideological preferences. With the Obama administration I am afraid it is the latter, and the true danger is revealed only by viewing such devices/procedures such as the one here under discussion in conjunction with the interplay of many other provisions of the proffered plan which, in their totality, project/picture a far more ominous mechanism for state control than does each part when viewed/taken separately. And all of this is no mere accident–these people drafting the minutiae are very smart–they know what they are doing and what sort of frame-work they are putting in place to build upon.
Here! here!
I think the key words here are “to build upon.” Once they’ve set the precedent of Government intervention in health care it can quickly grow massive just bureaucratically (i.e. regulations not voted on by the legislature) vice democratically. The statists know they don’t need the whole thing just yet, just their foot in the door, see the Obama YouTube video of him saying he sees a public option as just the first step to single payer. Of course hearing him un-edited, up-front, and frank is officially “out of context,” quick becoming the favorite phrase of liberals in power when confronted with what they truly say and want.
http://energycommerce.house.gov/Press_111/20090619/healthcarereform_discussiondraft.pdf
I respectfully suggest that before we spend too much time we all read the damned thing. When it gets to items like determining your financial ability to pay BEFORE any doctor visit or procedure, you can’t convince me that a national ID card with un-fettered access to bank accts, etc., is not far behind. When a government official will step in and determine that the $40K for a hip replacement will go to this 35 year old and not Miss Marianne Matthews, then we got a real problem, for we are then determining worth of future contribution to society based solely on age. But on the other hand, maybe if it passes then we can eliminate health care for the John Dingells and Barney F’ing Franks.
G-Man – try $65K for a hip replacement. I know because I just had one at age 45 (and may need one on the other side in the next couple of years). Which means I’ll need a revision surgery in my 60s – and under the current proposed plan I may get refused because I’ll be too close to the other side of life.
I agree, judging access to procedures and treatments based on the # of years it is estimated are left in your life is – draconian at best.
I respectfully reply that who the heck here has the time to read the thing? Probably some few of us but it’s hard for a Republic to function practically when the most important legislation the public is supposed to consider is 1,000 pages long and must be voted on with the fierce urgency of now.
I’m also pretty stupid and probably wouldn’t understand it anyway. I’ve made the strategic decision to take on a libertarian paradigm to try to simplify the outside world around me into an operable model that I can actually make decisions on (based on what I perceive as the fact that this is the philosophy behind America’s founding and has produced the freest and most successful human society yet devised) vice the pragmatist approach to consider each piece of legislation on its singular merits, which is clearly the paradigm dominant in any modern American discussion of policy. My problem with this pragmatist strategy is that it tactically yields the high ground to even unintentional government expansion since any program enacted almost never gets de-enacted. It only takes something to sound practically good taken in isolation (vice consideration of all these individual “goods” summed up into a massive whole), or for an inevitable economic downturn due to the necessary process of creative destruction inherent in growth and innovation for people to experiment with more government intervention, that in the long run leads towards a “soft despotism” where we have such a gargantuan and interventionist government that regulates so many aspects of our lives that bureaucratically it can only practically write 1,000+ page bills that inexorably wrench our system away from a Res Publica and hand it to a powerful and unaccountable bureaucracy.
G-Man, that’s funny.
Simply because many years ago we were down in the US visiting my uncle. In Texas, of all places. My aunt unexpectedly got very sick and we took her to the ER. Being a Canuck (even at the tender age of 14 or so), I was shocked to find a Visa (think payment, not alien) sign on the door. How weird was that?!
But what really struck me was how they seemed so much more interested in my uncle’s insurance coverage (being an employee of Greyhound not so much of an issue but still) than in what was causing my aunt’s ongoing excrutiating abdominal pain (which resulted in a week-long hospitallization … once they asscertained she had good coverage, of course). Perhaps they were really checking out my uncle’s bank account.
My other (semi-related) observation – first you are worried about rationing end-of-life care to older parents and then about giving the elderly too much care? I know, I should stay out conversations which are not of my business. But still, sheesh, I don’t envy you guys. Best of luck!
I was sent the following in an E-mail from my Dad.
Page 16: States that if you have insurance at the time of the bill becoming law and change, you will be required to take a similar plan. If that is not available, you will be required to take the gov option!
Page 22: Mandates audits of all employers that self-insure!
Page 29: Admission: your health care will be rationed!
Page 30: A government committee will decide what treatments and benefits you get (and, unlike an insurer, there will be no appeals process)
Page 42: The “Health Choices Commissioner” will decide health benefits for you. You will have no choice. None.
Page 50: All non-US citizens, illegal or not, will be provided with free healthcare services.
Page 58: Ever y person will be issued a National ID Healthcard.
Page 59: The federal government will have direct, real-time access to all individual bank accounts for electronic funds transfer.
Page 65: Taxpayers will subsidize all union retiree and community organizer health plans (example: SEIU, UAW and ACORN)
Page 72: All private healthcare plans must conform to government rules to participate in a Healthcare Exchange.
Page 84: All private healthcare plans must participate in the Healthcare Exchange (i.e., total government control of private plans)
Page 91: Government mandates linguistic infrastructure for services; translation: illegal aliens
Page 95: The Government will pay ACORN and Americorps to sign up individuals for Government-run Health Care plan.
Page 102: Those eligible for Medicaid will be automatically enrolled: you have no choice in the matter.
Page 124: No company can sue the government for pric e-fixing. No “judicial review” is permitted against the government monopoly. Put simply, private insurers will be crushed.
Page 127: The AMA sold doctors out: the government will set wages.
Page 145: An employer MUST auto-enroll employees into the government-run public plan. No alternatives.
Page 126: Employers MUST pay healthcare bills for part-time employees AND their families.
Page 149: Any employer with a payroll of $400K or more, who does not offer the public option, pays an 8% tax on payroll BR Page 150: Any employer with a payroll of $250K-400K or more, who does not offer the public option, pays a 2 to 6% tax on payroll
Page 167: Any individual who doesn’t have acceptable healthcare (according to the government) will be taxed 2.5% of income.
Page 170: Any NON-RESIDENT alien is exempt from individual taxes (Americans will pay for them).
Page 195: Officers and employees of Government Healthcare Bureaucracy will have access to ALL American financial and personal records.
Page 203: “The tax imposed under this section shall not be treated as tax.” Yes, it really says that.
Page 239: Bill will reduce physician services for Medicaid. Seniors and the poor most affected.”
Page 241: Doctors: no matter what speciality you have, you’ll all be paid the same (thanks, AMA!)
Page 253: Government sets value of doctors’ time, their professional judgment, etc.
Page 265: Government mandates and controls productivity for private healthcare industries.
Page 268: Government regulates rental and purchase of power-driven wheelchairs.
Page 272: Cancer patients: welcome to the wonderful world of rationing!
Page 280: Hospitals will be penalized for what the government deems preventable re-admissions.
Page 298: Doctors: if you treat a patient during an initial admission that results in a readmission, you will be penalized by the government.
Page 317: Doctors: you are now prohibited from owning and in vesting in healthcare companies!
Page 318: Prohibition on hospital expansion. Hospitals cannot expand without government approval.
Page 321: Hospital expansion hinges on “community” input: in other words, yet another payoff for ACORN.
Page 335: Government mandates establishment of outcome-based measures: i.e., ration ing.
Page 341: Government has authority to disqualify Medicare Advantage Plans, HMOs, etc.
Page 354: Government will restrict enrollment of SPECIAL NEEDS individuals.
Page 379: More bureaucracy: Telehealth Advisory Committee (healthcare by phone).
Page 425: More bureaucracy: Advance Care Planning Consult: Senior Citizens, assisted suicide, euthanasia?
Page 425: Government will instruct and consult regarding living wills, durable powers of attorney, etc. Mandatory. Appears to lock in estate taxes ahead of time.
Page 425: Goverment provides approved list of end-of-life resources, guiding you in death.
Page 427: Government mandates program that orders end-of-life treatment; government dictates how your life ends.
Page 429: Advance Care Planning Consult will be used to dictate treatment as pa tient’s health deteriorates. This can include an ORDER for end-of-life plans. An ORDER from the GOVERNMENT.
Page 430: Government will decide what level of treatments you may have at end-of-life.
Page 469: Community-based Home Medical Services: more payoffs for ACORN.
Page 472: Payments to Community-based organizations: more payoffs for ACORN.
Page 489: Government will cover marriage and family therapy. Government intervenes in your marriage.
Page 494: Government will cover mental health services: defining, creating and rationing those services
Sorry for the length, but this only covers half of the bill.
When you read this you swear you’re reading something from 1939 Nazi Germany or Stalin’s Russia of 1929. Peasants with Pitchforks, Inc can’t be far behind.
http://www.politifact.com/truth-o-meter/article/2009/jul/30/e-mail-analysis-health-bill-needs-check-/
It’s interesting that in their fact-checking, they claim they work on the first 15 statements in the email. Yet they skip the first one mentioned – Page 16. Because it is true and it’s what scares people the most.
Babs … In answer to your question about Congressman Gene Green, ‘close, but no cigar,’ as the expression goes. He represents the 29th Congressional District, which is contiguous to us, but doesn’t contain us. I live in the southwest quadrant of Houston, and his district includes the southeast quadrant of Houston, as well as Baytown [big refineries]and other areas to the east. Other than that, our political philosophies don’t mesh, as you can imagine.
Marianne
“It would be “healthy” for them to keep that in mind: Their contract comes up for renewal in 15 months.”
Right on target Lex and I have one thing to say to all of those slugs in D.C. : YOU’RE FIRED! Ya gotta vote out those that are in and vote in those that are out. Rotate yer stock, ya know.
(Still waiting to hear from Michael Michaud ,Dem-Maine, on when and where he’ll be holding town meetings.
http://www.denverpost.com/harsanyi/ci_13039228
Very good article in the Denver paper.
It would be “healthy” for them to keep that in mind: Their contract comes up for renewal in 15 months.
IIRC the re-election rate for incumbents in the House is > 90%. Districts are routinely gerrymandered so that they favor one party or another, as well as particular racial or ethnic groups. See this for a particularly egregious example, designed to ensure the election of a Hispanic Congressman. Opposition parties are daemonized such that people will vote for anyone in party “A” regardless of who’s running in party “B”.
A major issue is that no one shows up for primary elections except the true party enthusiasts. So by the time the general election rolls around the only choices are people who have the approval and support of the party elite. People who have enough money, time and inclination to swim upstream against that current are rare – although we did have one here in Illinois for a term. Peter Fitzgerald, the man who gave us some honest U.S. Attorneys who are throwing scores of politicians, libbyists and political functionaries in jail was one. But he bowed out after a term because the elite of his own party (Republican, BTW) refused to support him for re-election and were going to run a party hack against him in the primary. He figured he’d done his bit, I guess, and I can’t blame him.
It’s true that we need a well educated electorate to have a chance to have a functioning Republic. But that education cannot stop the day that they walk out of their high school or college doors, and it has to include the sticky political issues of the day, not just the knowledge they need to make a living. Unfortunately, that interferes with keeping up with popular culture. A test; ask a group of 20 people on the street who are the 3 finalists in American Idol. Now ask them who their Congressman is. Which question do you think they’ll score higher on as a group?
Health care does hit close to home. Maybe this election will be different. We’ll see. I’m not optimistic. The changes in American culture has increased the class of people who are dependent on the government either through direct grants, subsidies or employment to a majority of the electorate. That gives them an impetus to keep voting up more government and more money for it, while shrinking the fraction of people who are actually productive and thus supply money to the government for redistribution. I’m minded of the saying, and I can’t cite the source, that “He who proposes to rob Peter to pay Paul will always have the support of Paul.”
There are 49 House Democrats, from districts that voted for McCain — another 21 who carried their district by less than Obama’s %. These 70 recognize they are vulnerable. They know that there is a voter fatigue over too much, too fast. Take Obama’s turnout off the table, recruit good candidates, tap some of the passion today, and what was unthinkable in November is a real possibility — the house switches by forty seats, and Pelosi is back to minority leader.
I would tie her around all seventy of those necks, like an albatross. With her whopping 35% approval rating, she is the worst nightmare for all seventy. The “un-American” comments this week may play well among the cognoscenti on Nob Hill. But even some of the most unlikely folks see her for the liability she is.
Okay, I’ll say it. All healthcare is rationed. For a heart transplant, the healthcare system does not send out agents around the globe with tissue-testing kits to hang around every single ER department on the planet with the relevant paperwork, translated into the local languages, so that the minute a suitable donor heart became available in a patient who’d had a fatal accident but been brought in in time, have a supersonic jet on standby at every hospital location so that the refrigerated donor heart could be shipped to anyone in time to be of use. Why not?
Last year, I was told my 92 year old grammy needed a mammogram. Hospital doctors try to make 90 year old patients (excuse me, ‘residents’) ingest ‘go lightly’ which almost kills them, to get their yearly colonoscopies. They’re going to die of something for God’s sake. Yet geriatric patients are used..yes, USED in this way, often years beyond when they can feasibly voluntarily refuse treatment. The hospital makes money and charges Medicare, God forbid they don’t do annual preventative care or the hospital is sued. THAT is the problem. And our population is getting older.
Liz … Yes, in a sense all health care is rationed. But the difference between ‘rationing’ because a protocol is too expensive for one’s own pocketbook [a decision you make yourself] and rationing by strangers who know only that you are an old person, and actuarial statistics say that you will only live X numbers of years more, is a profound and disturbing one. Evidently, Obamacare plans to make ‘is it worthwhile to do this’ decisions based on objective criteria which are far too superficial when applied to the complexity which is the human race. Rationing of this type would probably withhold treatment not only from Down syndrome children, but from such distinguished and valuable people like Charles Krauthammer, a paraplegic, and Stephen Hawking [wheelchair-bound with complex health problems]. And even me, since I’m past my pull-date, at 81. Not that I’m a distinguished thinker, but I’ve still got all my buttons and I’d like to keep using them for awhile.
The thing that most disturbs me about this “plan” for me is not just that the ‘civilian panel’ might not consider me worth expensive medical interventions, but that the plan is that I would not be allowed to contract for them, and pay for them myself. This does border on wicked.
Marianne
Marianne, you’re right! I was at a Fredericksburg, Iowa town hall meeting in the early 1990s held because local citizens at that time were enraged that their small town family doctor who refused Medicare was prohibited from seeing elderly patients who still wanted to visit him at their own expense. The Medicare intermediary officials confirmed that any patient over 65 was prohibited from seeing him, even with private payment, and if anyone was caught, the doc would receive a $10,000 fine per occurence. They justified this approach by saying they were “protecting” the elderly from unscrupulous providers. The public furor at that meeting was vociferous, but didn’t put a dent in government policy. One among many reasons I have gone Galt, and left medical practice.
Marianne (and Liz),
It can help clarify the discussion if you use more precise terms. When the government controls something, it is indeed rationing. Think “wartime rationing”. When the private market or private citizens do it, it’s allocation. They’re choosing where to allocate their resources. ie, nobody’s stopping you from getting whatever procedures you want – but you may have to forgo some things to afford it.
There’s a better explanation of the difference here: http://chicagoboyz.net/archives/8601.html
Best,
BKR
I think this gets to the heart on the difference between positive and negative rights. Negative rights are natural and don’t require the fruit of another’s labor whereas positive rights do. The right to free speech is a negative right, no one has to toil in a factory or practice in a hospital for hours on end (after a lenghty and costly education they’re on the hook for) to produce a product named “free speech.” Same as nearly every right in the Constitution. Our founding fathers realized that government was little more and nothing less than the recognized monopoly on the use of force and that freedom thus depended only on government using that force to protect individual’s negative rights. The only positive right I can see in the Bill of Rights is your right to trial by a jury of peers, which introduces the small tyranny we live with called jury service. The founders felt that in our messy world constrained by mankind’s tragic nature (i.e. the will to power, preference for plunder to production, laziness, greed, selfishness, etc.) this small tyranny would serve to block the government from imposing greater ones and was thus worth the tradeoff. Jury service and the principle of innocent until proven guilty actually assume an adversarial relationship between the citizenry and the people in government, something that was fresh in the founder’s minds from the infamous admiratly courts during colonial times.
But imagine now the culture where people think education and health care, if not jobs or homes, are “rights.” These are the same positive rights that the Soviet constitution and every other communist and fascist regime promised. When government deploys its monopoly on force to try to provide positive rights it has no where else to go but to force people into occupations and consumption habits not of their own free choice, either by massive confiscatory taking of the product of your own labor (i.e. taxes) which you are naturally and justly entitled to enjoy at the low end of the force spectrum to, as Virgil Xenophon points out, Kibbutz style / Soviet style government determination of what your job is going to be (hope you like your new shovel), how big a house you will “get,” what your monthly allotment of beets will be (lower obesity is good for us all!), etc.
It’s the classic contest between the fascist’s/statist’s Utopia (more health care for less cost and no waiting lines!) which can sparkle alluringly in people’s imaginations but is ultimately a mirage that the even good natured pursuit of which has paradoxically led to the worst travesties of human suffering in history, and the dirty, messy reality of freedom, which in and of itself is actually a neutral condition but the only one which gives the opportunity of a moral and good society reaching the highest heights of human achievement.
ProwlerAMDO, I reject the new formulation that the left is trying to inject into the discussion of rights. This spin of “negative rights” and “positive rights” is trying to solidify in American thinking the concept that the government exists to take care of you, as opposed to existing so that no one interferes with your ability to take care of yourself. To use the word “negative” to define the rights that are guaranteed to you by the Constitution and the word “positive” to define things that they want the government to do for you makes it sound as though the Founders did something wrong that needs to be corrected, and that they are in the right here. I actually had someone on the left try to tell me that “negative” does not have a negative connotation and “positive” does not have a positive connotation.
Our rights are our rights, and they are not “negative”. What they want to call “positive rights” are more accurately termed “entitlements”, a term that much more and much simply describes what they are asking for; to be entitled to reach into my pocket to take something they have not earned by the sweat of their own brow. But the left hates that term due to it’s clarity and is trying to latch onto “positive” and “negative” rights.
Now, Christian compassion certainly calls for me to give cheerfully so that others more unfortunate have access to certain things like food, shelter and healthcare. But that is my choice and my decision; it is not their entitlement and government’s increasing role in this is nearly an interference in the “separation of church and state”.
Liz, you sound like the President, saying docs would cut your foot off and make $50K, rather than treat your diabetes — or get rich off unnecessary tonsillectomies. First, (had to ask Flight Lead, the hospital administrator for the facts), Medicare won’t pay for a colonoscopy, even for high risk patients, more than once every 23 months — so “yearly” is a stretch. Second, the average Medicare reimbursement for that procedure is right around $300 — while private pay is around $1300. Do you really think a GI doc gets rich doing Medicare colonoscopies at $300 when he can do another one for $1300? To assemble the team (including a CRNA), pay for the facility, and pay for my services, if I were the doc, no way I do that for $300.
Scott, do you seriously believe that any person over 90 should receive a colonoscopy every 23 months? What are they going to do if they find something? Any treatment at that point would be worse than the ailment. The procedure itself is risky for a person that age.
Whether the GI doctor makes it rich or not is an irrelevancy, the hospital will be sued for negligence if they don’t administer that superfluous ‘care’. And it does cost us. Furthermore, and more to the point, existing health insurance companies involve themselves in “purposeful distribution” all the time, by stipulating conditions that they will and won’t cover, etc.
The only way that the healthcare market can REALLY act as a market in any meaningful sense is if you get whatnotitis and then shop around all the possible healthcare providers asking if they’ll treat you or not, and asking the ones that will to quote a price. Most major healthcare costs rather too much for any of us to be choosy, so we all have to use a medical insurance system of some kind, and you don’t get to shop around those in the same way because pre-existing conditions, include and inflamed whatnot, are almost invariably excluded. You have to sign up for insurance when nothing is wrong with you.
Furthermore, irony of all ironies, how many of us posting on Lex’s blogspot receive government paid healthcare? I do.
I think that is a call the attending physician need to make. If someone has a family history of hereditary nonpolyposis colon cancer — yea. If they had numerous polyps on the last scope, yea.
According to the Flight Lead, there is almost ZERO chance of a hospital getting sued for what you outlined, unless it is medically indicated (see above). You can always go AMA — “against medical advice” if you think it advised. The idea that care providers are looking for ways to run up the bill, especially on low reimburement rate Medicare or Medicaid (or Tricare, for that matter) patients may make for good sound bites, but isn’t rooted in reality.
To turn this argument on its ear, why not look for ways to run up the bill if you’re a care provider in the current situation? Next to no one actually directly pays for their own healthcare, they’re either using the emergency room which is legally obligated to provide care, using medicare, or using private insurance. Nowadays private insurance is mandated to cover so many things by government that it is both expensive in premiums (to the point that fewer and fewer people are able to afford it) and ubiquitous in what it covers that using it for nearly anything isn’t much more expensive than what you’re paying already in annual fees. Either way the end result is nearly the same, when you are sick and using medical care you are spending someone else’s money either completely (emergency room) or to a still relatively high degree (private insurance.) And we all know what incentive there is to save money when you’re spending someone else’s. It works both ways for the care providers too. With next to no penalty for frivolous lawsuits the doctors have a huge incentive to practice defensive medicine and run every test and procedure whether it’s helpful or not. This is necessary to try to reduce their liability in a court system designed by trial lawyers (letting the fox into the henhouse) and completely favorable to plantiffs with little to lose and possibly tens of millions to gain.
Insurance is for massive costs that most people would have no ability to pay for themselves and which is not expected to happen to most people, i.e. house fire, or for one time costs (i.e. non-recurring) which are too expensive to fit into people’s annual budgets, i.e. car accidents. Why we pay for every recurring and normal procedure with third party pay is completely beyond me.
I don’t know much about health care so all of the above might be completely retarded, but here’s my dumb three point plan:
1.) Stop regulating insurance so much. Let insurance companies offer cheap and slim policies that will be affordable for the poor and will fight cancer or provide for them after an incredibly rare accident that leads to paralysis, but that doesn’t necessarily cover annual check-ups and a one time dose of penicilin to fight a sinus infection. Don’t require companies to provide health insurance. (I worked for a defense contractor for a few years before the Navy. My take home pay was about $55K but the company sent you a yearly package claiming you got paid the equivalent of $90K with the other $35K being nothing but dental and health insurance “value.” As a young selfish male at the time who made a point of it to work out and eat right I’m pretty sure the occasional excedrin or anti-acid I asked for at the dispensary before a major presentation wasn’t worth $35K. I would much rather have preferred the cash to buy a plan that was better suited for my circumstances, and which I’m sure would’ve cost less than the annual GDP per capita of most of Western Europe.)
2.) Tort reform. For a frivolous lawsuit the plantiff pays all partie’s costs.
3.) Possibly some form of medicare for the types of pre-existing conditions that insurance companies won’t cover. (This one is the tempest in the teapot though, I’m not convinced on it. And by uninsurable pre-existing condition for a possible public option I’m thinking along the lines of boy in the bubble vice obesity.)
SCOTT/
I’ve been derelict in my duties, as I’ve been meaning to warn you about your new, obviously racist, avatar. The PC police may have ALREADY reported you to the proper authorities–best start changing your URL on a daily basis and using anonymizer.com else the PC police will be hot after you. (Of course, most true, dyed-in-the-wool Daily Kos/DU types avoid sites like this as Dracula avoids the cross–so perhaps you still have time to cover your tracks..)
When Bush was President, speaking ill of our Commander-in-Chief during a time of war sent the wrong message to our allies, to our enemies, to our troops in harm’s way and to the American people.”
But now that Obama is President, apparently, calling openly for armed revolution and accusing the President of wanting to destroy his own country and plunge the world into chaos and tyranny is the height of patriotism.
Bush should’ve been impeached after 9/11.
Just as for some people, it’s always the morning after 9/11, so too for others is it always the morning after 20 January 2001. Bush is no longer president, Alos. It’s time to let it go and focus on the issues in front of us.
It might go easier for us all if you ease the tin foil hat off: No one here is calling openly or otherwise for armed revolution. Few, I think, believe the president wants to intentionally “destroy” the country. Many of us question what he means by “change” though, and are concerned that in his haste and passion he will diminish us.
OK, I’ll rise to the single bandit bait and get get butt-shot by someone lurking in the ground clutter. Alos, by your last line I would argue that by those standards, we should have impeached Clinton for 2 embassies, a barracks, and a Navy DDG. I don’t think the discussions are nearly as potent and threatening as you imply. IMHO, of course, as I can’t speak for VX after a coupla drinks.
And yet the name-calling of former President Bush continues – nearly 8 months after he left office.
Let it go. Seriously.
If this is what you really believe, and is not some kind of wierd hyperbole, I’m left stupefied.
I don’t know at what point in this country so many people went completely off the rails, but it’s becoming increasingly disconcerting to me. I don’t know where all this leads, all this increasing disconnect in the thinking and outlook of various people in this country. I can’t imagine it’s anywhere good. It’s like we live in parallel universes.
Allan Bloom wrote a VERY high brow book on this (and other things) called “The Closing of the American Mind.” After still not getting it some months after I read it, blood shot out my eyes. But I got it just enough of the time while reading that it definitely grabbed my attention, and it has actually haunted me ever since for what it implied about where we’re heading due to what you mention.
Re-elect no one. Not even your Mother.
VX – While I am aware that these discussions go on all the time I find it VERY OFF PUTTING that the Federal Gov’t would PAY for this discussion between the primary health professional and their patient.
This amazingly macabe portion of the bill is really beside the point. Page 16 has me a lot more worried.
Marianne- I spent 2 hours reading and re-reading the chapter about residential housing in the cap n’trade legislation several weeks ago.
What John Conyers said, and I paraphrase; why should I spend a weekend reading the bill when it would take me an entire weekend and two lawyers to read it?
This is the problem. Are you aware of the fact that HR3200 calls for funds for street trees and sidewalks?
I actually thought that passing a law that required all bills to be under 200 pages might be a good thing.
As to your neighboring congressman; isn’t it rich that someone that refuses to demand voters present a valid ID at the polls now claims that in order to get to speak to him at a town hall they need a valid ID?
If it weren’t so funny it would be very sad…
The problem isn’t so much that our elected representatives aren’t reading the bills they’re voting on, it’s the professional staffers that are writing these things, turning every bill into a reiteration of War and Peace. So while the electorate may throw the elected bums out of office, the professional scribes remain entrenched and empowered by incoming neophytes.
Ergo — what do we do (what can we do)about the staffers?
- SJS
The United States is currently engaged in a war between freedom and socialism. The political left see this point in history as the time to take over the country. Health care is one battle that they have to win to get the wedge in the door. Any lie that progresses the fight is acceptable. It is not about providing for a few people without health care, it is about controlling the 90% with health care.
The battle is not going well for freedom right now. The recession has been used to subjugate the banking system. The auto industry is under government control and the politicians showed during the bankruptcy proceedings that they could ignore existing laws with impunity. The politicians have created positions of power (called Czars), without public accountability, to control aspects of the government. There is an ongoing quest to control the public census to ensure that future elections maintain the left wing status quo. To top it all off, the news media is acting as the propaganda arm of the left in the fight.
The war cannot be won with violent or armed protest. It will be won with the peaceful exercise of the right of the people to gather, speak and demonstrate as protected by the Constitution. The alternative media will provide the method of getting the news out. Communicate with your representatives and let them know what you want and what you expect of them. Telephone calls, email and snail mail all work. Join the peaceful demonstrations. Let the local main stream media know what you think. If your representatives will not honor your directives, work to replace them.
ProwlerAMDO, I reject the new formulation that the left is trying to inject into the discussion of rights. This spin of “negative rights” and “positive rights” is trying to solidify in American thinking the concept that the government exists to take care of you, as opposed to existing so that no one interferes with your ability to take care of yourself. To use the word “negative” to define the rights that are guaranteed to you by the Constitution and the word “positive” to define things that they want the government to do for you makes it sound as though the Founders did something wrong that needs to be corrected, and that they are in the right here. I actually had someone on the left try to tell me that “negative” does not have a negative connotation and “positive” does not have a positive connotation.
Our rights are our rights, and they are not “negative”. What they want to call “positive rights” are more accurately termed “entitlements”, a term that much more and much simply describes what they are asking for; to be entitled to reach into my pocket to take something they have not earned by the sweat of their own brow. Christian compassion certainly calls for me to do just that, to give cheerfully so that others more unfortunate have access to certain things like food, shelter and healthcare. But that is my choice and my decision; it is not their entitlement.
Steeljaw,
That will be a nice problem to have – but “throwing the bums out” has to happen first. And that is a tall order considering the 85% figure on re-election.
But 2010 is looking a little more optimistic – even for many of us being driven more towards the Libertarian rules rather than either party. I don’t think Libertarians are a useful party but their thinking is causing a lot more independence on just who our reps are and what they stand for. And who we want to replace them with.
RonF … What the Government now terms ‘entitlements’ used to be called ‘benefits’, and that’s where part of the trouble started. Words have power, as the semanticists say. And if you can subtly redefine a word, you can change the grounds of a discussion or a belief. ‘Benefits’, as we used to call them, are gifts, from a healthy company or government which can afford them because of wise and successful actions which have placed the company or the government in a favorable and profitable position. ‘Entitlements’, on the other hand, are a different matter. They are ‘owed’ to the employees of a company or citizens of a government whether or not the company or government is in a stable and successful situation. It could be hanging on the ropes, on its last gasp financially, and still be obligated to pay the employees or the citizens.
And all because the backroom boys in the bowels of the government decided to change the wording. AS I recall, the word change was instituted in the Carter Administration — or maybe it was during the Clinton years. I’m pretty sure it wasn’t during a Republican Administration.
We actually run successful profitable companies. We know better.
Marianne
[...] so vicious that he would allow a world with so much pain and suffering and misery. 5. "Healthy Relationships" Between the people and our supposed representatives.Representative Sample: we are taxpayers, not [...]