Archive for August, 2009

Death Panels

August 19, 2009

There’s been a lot of blathering about this, so I want to throw my two cents in:

Short version:

It is not possible to have a government run / controlled / funded /managed health care system without having death panels. That is one of the many reasons why government health care is a bad idea.

Longer version:

Any and every health care system must have ways of deciding who will get what care. In a totally private system, it’s decided by money: if you’re willing and able to pay, you get the service, if you aren’t / can’t, you don’t. In our current system, if you have health insurance, your insurance company makes decisions about what it’s willing to cover, and may you have to fight with it / jump through its hoops in order to get the treatment you want. Or you can sue it, or you can just pay for it yourself, or you can not get the treatment, and continue to suffer through the problem (or just die).

As someone (who I can’t remember) pointed out: in this system , the government serves as “umpire”, deciding who should win each argument. The other “umpire” is “the market”: if a company’s insurance provider is routinely stiffing its employees, the company is likely to drop that provider, and switch to a different one.

In a government health care system, the government will have to decide what treatments are covered, and what aren’t. Which conditions justify the expensive red pill, which ones only get the cheaper (but less effective) blue pill, and which ones get you a trip to the hospice, or an aspirin and a call back in two weeks (if you’re still alive then). And since our political representatives are chickenshits who do their best to avoid having to make decisions, there will be a “panel” to decide what gets covered, and what doesn’t. In Britain, that panel is called NICE (National Institute for Health and Clinical Excellence: “NICE is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health”) President Obama is pushing for IMAC, (“Yesterday, a group of some of the most distinguished health economists in the country sent a letter to the President and Congress in support of the Administration’s proposal for the establishment of an independent board of doctors and health experts to guide Medicare policy. This Independent Medicare Advisory Council (IMAC) would make recommendations on Medicare reimbursement policy and other reforms – playing a critical role in allowing health care policy to adjust flexibly to a dynamic health care market, thereby helping contain costs and improve quality over time. As the authors note, ‘a properly structured Independent Medicare Advisory Council (IMAC), with a congressional mandate and authority to do so, can reduce the rate of growth of health expenditures substantially.‘”) He already had the Federal Coordinating Council for Comparative Effectiveness Research added to Porkulus. Both of those, by any reasonale definition of the term, are “death panels”. Panels that will decide whether you are worth treating, or if you should be left to die.

Will they decide it for you, personally? No. Will they “send death squads out to round up Trig Palin“? No. Might they decide it’s not worth the effort to fund “extreme” health care for people with Down’s Syndrome? Yes. Might they decide that your grandma doesn’t need that hip replacement, or pacemaker? Oh Hell yes!

Now, if you’re really rich, you can fly someplace else and get treatment, or, if your government allows it, you can pay for it yourself in your country (if, of course, your country has the ability to provide what you want. After all, the main way of government rationing will be to simply not provide the capability, or not provide enough of it, in the first place). But for the rest of us, those government panels will be deciding whether or not we get treated. Not the market, not an insurance company that can be dumped if we don’t like it’s choices, the government.

You know, the same government that has to pay for the care if it decides it’s “appropriate”.

Would you like to play baseball when all the umpires have been hired, and paid, by the other team? If not, then you don’t want those government death panels deciding when it’s not longer “cost effective” to keep you alive.

Too stupid for words

August 19, 2009

Josh Marshall, who was apparently born about 6 months ago, has a moronic post up that ends with the following:

Let’s be honest with ourselves: the American right has a deep-seated problem with political violence. It’s deep-seated; it’s recurrent and it’s real. And it endangers the country. It just makes sense to say something the first time they hit the sauce and not wait for things to get really out of hand.

Wow, and here I thought the Weathermen, and the SDS, were left wingers.  Earth First, the other animal rights wackos (and, Contra Josh’s attempt to minimize their violence, spiking trees, burning down research labs, and destroying researchers work are not minor things), I guess they’re all “True Conservatives.”  Union Thugs?  True Conservatives, on and all, esp. the ones who beat up Ken Galdney.  Anti-globalization protesters?  They, like Andrew Sullivan, are of course the last true conservatives.

Political violence in America has been mainly the domain of The Left since the late 1960s.  You want to see criminality, violence, the destruction of property?  Go to a left wing protest, that’s where you’ll find those things, and that’s most certainly where you’ll find those things glorified.

Josh Marshall can’t possibly be ignorant enough not to know that.

President Obama’s Inability to understand Ethics

August 2, 2009

This bit of news has been making the rounds on the right wing blogs, but as of yet I haven’t seen anyone make the right point about it:

Four of the most powerful business leaders in America arrived at the White House one day last month for lunch with President Barack Obama, sitting down in his private dining room just steps from the Oval Office.

But even for powerful CEOs, there’s no such thing as a free lunch: White House staffers collected credit card numbers for each executive and carefully billed them for the cost of the meal with the president.

The White House defended the unusual move as a way to avoid conflicts of interest.

Excuse me? If the President went to a corporate event, and insisted on reimbursing the company for the cost of his visit, that would be “avoiding a conflict of interest.” That’s why there are rules about lobbyists buying things for Members of Congress. But, to the best of my knowledge, there’s no law preventing a politician from buying things <b>for</b> a lobbyist.

What is mainly on display here is “class”, as in “complete lack of”. But their explanations show something even worse than their complete lack of class:

The fact that no one in the Obama Administration even understand what ethics is. I guess we shouldn’t be too surprised that a Chicago politician backed by the Daley Machine isn’t really clear on the requirements of ethical behavior, but I do find it disappointing.

Jim Geraghty has a near constant refrain (“near constant” because President Obama gives him some many opportunities to use it): “All promises from Obama come with an expiration date.” A fish rots from the head down. So do Administrations. The Obama Administration starts with the liar in chief. Below him we have tax cheats, crooks, political hacks who care about nothing besides winning elections, and inexperienced, clueless losers.

“A” people hire “A” people, “B” people hire “C” people. By the (poor) quality of the people around him, we can judge President Obama.

HT: Slublog posting at Ace’s site, Fausta