195 Comments

1. buckets:

There’s obviously no good answer, and the Good Doctor’s dexterous verbiage doesn’t change that fact.

Some of the commentators on this blog are prone to exaggeration, but I think on this one it’s safe to call it “tyranny.” As Mark Steyn has remarked, national health care irrevocably changes the relationship between citizen and State. Let’s hope that Obama can’t muster the votes.

Jul 6, 2009 - 6:40 pm 2. Eric J:

Remember all those academic papers equating Conservatism with various mental illnesses and impairments? Trying to show that Republicans have less empathy, lower mental functioning, etc.? Combine those ideas with this framework for rationing, and we’ll start seeing political beliefs being used as a criterion for care.

Jul 6, 2009 - 6:43 pm 3. DWB:

No one seems to appreciate this, but we have thousands of rules and regulations passed by many governmental agencies for the good of the people. The people in these agencies who do this are ordinary people. One hundred years ago they would have been called the proletariat. For the United States, the Dictatorship of the Proletariat is functioning and in place. Currently it is a mostly soft dictatorship. It can become hard soon enough. Governmental control of our health care system is just one more nail in our collective coffin.

Jul 6, 2009 - 6:50 pm 4. JMH:

…youngest-first, prognosis, save the most lives, lottery, and instrumental value.

Interesting, that last one. Instrumental value. Is that the one that says Rahm and Ezekiel Emmanuel, along with other “good liberals” get more care? Is that the one that says people who vote too often for the wrong candidates get less care?

Here’s my prediction. You’ve heard of dynamic scoring, right? On tax policy, it says that as you change tax policy, you change behavior which changes the underlying numbers driving revenue. Well, I think there’s something similar here. Attempt to implement this policy and the need for treating traumatic injuries will skyrocket. This will cause open violence on the streets. Jackass bureaucrats telling people that their mom can’t get treatment cause she’s too old, or that their little baby can’t get treatment cause she’s too young, well, I can see lots of busted jaws follewed by worse later.

Jul 6, 2009 - 6:55 pm 5. Walt:

Well now says Rahmie’s brother
We’ll fix this thing up right
And soon we’ll have another
Little bitty health care fight
We want to make things even
We want to make things fair
That’s why we shall be heavin’
Out that nasty old health care
We know right now we have the best
Health system in the world
But we progressives cannot rest
And so the gauntlet’s hurled
You’ve seen the charts you’ve seen the graphs
You know now what’s in store
The young and old get epitaphs
The rest of us will score
Of course we know that some will say
The rich will get the share
That rightfully belongs to they
Who qualify for care
And politics will surely play
A roll in who gets what
The well connected have their way
The rest of you get squat
But best of all we at the top
Already know what gives
We get to say whose life will stop
And get to say who lives

Jul 6, 2009 - 7:01 pm 6. Kinuachdrach:

Rahm Emmanuel’s brother? What? Was Barrack Obama’s half-brother from Kenya not interested in the gig? Maybe nepotism is the salt of good government.

Putting my snittiness aside, this kind of discussion is what is really needed in health care. Along with a few others, such as how much of an individual’s earnings should be permitted to be spent on health care?

Of course, we all understand that a place is being prepared for Ezekiel under the bus right now. Those rock-solid old Democrat voters may become somewhat less reliable Obama supporters when they see where they fit on the priority scheme.

Jul 6, 2009 - 7:02 pm 7. Whitehall:

I wonder if they factor in the voting behavior of your precinct. Voting for the wrong candidates lower your instrumentality rating.

One might also notice that this curve looks a bit like the age distribution of Obama voters, weighted as it is towards the young and stupid.

Jul 6, 2009 - 7:04 pm 8. wretchard:

Now Walt, that is great stuff. BTW, registration for the Lancet article is free. Fill in the registration form and read the whole article.

Jul 6, 2009 - 7:04 pm 9. E. Nigma:

Supply and demand, basic laws of economics, tell us that at a high enough price, there is an ample supply of anything.
Set the price too low, and supply will disappear.

Dr. Emmanuel obviously believes that such basic economics are passe’, and should not apply to a modern health care delivery system. That is the tacit implication of the word ’scarcity’. When the Obama medical care system is passed and made into law (and yes, it will pass an be made into law), the US will be the largest and wealthiest country to ever have implemented such a system. And to contain costs, the ’supply’ of medical care will have to be limited, hence there will be a scarcity, due to the ‘global annual budget’ that such systems demand.

I’m sure it will work perfectly, just as any large bureacracy does. Or any large piece of machinery turned on for the first time. Of course when machinery doesn’t quite work, a mechanic has to bang on it a little. And when this doesn’t work very well, the government will have to bang on the social machinery to make this work.

There’s a very precise word that describes what is about to happen to us, but it loses its impact if it is tossed about carelessly.

Jul 6, 2009 - 7:07 pm 10. will:

http://bastardobama.blogspot.com

Jul 6, 2009 - 7:12 pm 11. PA Cat:

I suppose Ezekiel Emmanuel thinks M.D. is an abbreviation for M. Deity. Fair to ask where he went to med school and what his specialty is? If it’s psychiatry . . . hoo boy.

Jul 6, 2009 - 7:14 pm 12. joe buzz:

Nice title. How will the privileged view their “attenuated chances”. Could one of you double math/psyc majors explain that y axis to me?

Jul 6, 2009 - 7:19 pm 13. Tollhouse:

If you read this, http://www.bioethics.nih.gov/people/cv/emanuel.pdf

He has YEARS AND YEARS of experience in the politics of medicine. Not much medicine practice from what I can see.

Jul 6, 2009 - 7:22 pm 14. PA Cat:

13 Tollhouse

In other words, he’d rather preach than practice.

Jul 6, 2009 - 7:25 pm 15. NullificationNow:

Blood letting and leaches for all. Will the lottery be a scratch off or pick 5?

Jul 6, 2009 - 7:25 pm 16. Rurik:

Extra points for living the gummint-approved lifestyle. Trade in your SUV for a new car from Gettlefinger Motors. Forsake flesk for a stylish vegan diet. Get out in the community street every morning for calisthenics supervised by the local block warden. Smoke hemp but not tobacco. Are your sexual practices “inclusive”? Lose points for bringing too many offspring into the world, or not enough? Extra points for devoting extra social service hours in excess of the required. And of course, mental health is factored in as revealed by your attitude.

Jul 6, 2009 - 7:31 pm 17. RicardoVerde:

That is a very interesting graph. Who is to say that the function cannot return negative values for “Y” at some point?

Jul 6, 2009 - 7:32 pm 18. Leo Linbeck III:

Obama margin over McCain by age group:

18-29: 36%
30-44: 6%
45-59: Tie
60+: -4%

I’m not that cynical. Really.

What is also very interesting is this quote from the paper:

Accepting the complete lives system for health care as a whole would be premature. We must first reduce waste and increase spending.

So the authors place a priority on increasing spending. Huh? We’re already spending our way to oblivion in the current system: the unfunded Medicare/Medicaid liability is over $80 trillion by some estimates.

The paper is a scary look into the thinking of one of the President’s top healthcare advisors, and how he would ration care. I guess once we give up the idea of individuals being responsible for their own decisions, and turn them over to “experts,” it’s only a matter of time until we get into the health equivalent of a FICO score.

I’m sorry Mr. Linbeck. Your HIFYL score is 400. I’m afraid we can’t treat your broken leg. However, I am delighted to offer you this commemorative “Yes We Can” Obama plate. We hope you’ll find this comforting during your self-recovery. If anything changes, we’ll let you know.

More hope, more change.

L3

Jul 6, 2009 - 7:34 pm 19. wretchard:

That is a very interesting graph. Who is to say that the function cannot return negative values for “Y” at some point?

My first reaction on seeing the graph was that it was fancy dress for a very blunt model based on subjective weights. It’s actually a consensus or opinion-driven function which be can be made to do anything at all, if you want to. At least, so it seems to me. That reminds me of a story.

When I was starting out as a developer, I was onsite at a client’s developing an application. One particularly difficult procedure took me a long time to develop. When I finished it my supervisor said, “there’s no way to make the client understand why so much time was spent to do that because all the machinery works behind the scenes.” So he told me to put in a control which blinked and spun around with a delay built into it so that the user thought it was “doing something”. Instead of dumping the output into a window or something it sang and danced for a while for purely cosmetic reasons. I objected on the grounds that it was useless and chewed up computing cycles. He told me to trust him. Well the clients were as pleased as punch and were happier than clams in muck to pay up. Never underestimate the power of graphs; never underestimate the influence of flashing lights; never underestimate the power of salesmanship.

Jul 6, 2009 - 7:39 pm 20. Charles:

Here’s an easier graphic. This one shows oil imports over the last 20 years. Imports rose constantly until rising oil prices in 2005 capped imports. they have been falling and are now falling fast. We’re down 20% and headed to 30% from the top by years end.

Jul 6, 2009 - 7:41 pm 21. Rurik:

13. Tollhouse:

Did you notice he contributed to a volume titled “Regulating How We Die”.
Sorry, but that does not inspire political confidence any more than medical confidence.

Makes me think of Old Boxer the plowhorse in Animal Farm.

Jul 6, 2009 - 7:51 pm 22. Juliet:

I got an idea. Congress or hell, even the Executive branch should voulnteer to go first on a government run universial health plan. The public can see how well it works. But remember no private pay, the congress ( both dem & rep) will have to go to who ever is in the system with no perks. No lines, no rationing & no choice then after 4 or better yet 8 years the public can see how well the Congress & Executive branch is doing then we can vote on universial health care.

Jul 6, 2009 - 8:03 pm 23. tzanchan:

Wretchard,

I agree that the absence of addressing “who is the “we’ ” is quite glaring in the article, but there is also another notable missing theme, namely – what is the definition of scarce? Are we talking vaccines for the H1N1 virus, or aortic valve replacements? Antibiotics for a 2 year-old’s ear infection or anti-retroviral drug cocktails? I guess the “we” get to decide that.

Great topic and paper thanks.

Jul 6, 2009 - 8:05 pm 24. Marcus Aurelius:

I wonder what AARP will say about this, such scheme would really do a number on their membership levels. Boy, did they scream when it came to imaginary fairies taking their money away, now we are looking at proposals for fairies to take their lives away.

Jul 6, 2009 - 8:10 pm 25. trangbang68:

A blue collar aging boomer like me is screwed, but I’ve been using the VA for years. The one saving grace of the VA is even non-service connected vets are given love because they served. That won’t count for much in Obama’s brave new world.
Does a fat,twenty five year old addicted single mom with six bastards get priority over a sixty year old concert pianist?

Jul 6, 2009 - 8:10 pm 26. Joshua:

“Electing God”? I thought we already did that, back in November.

Jul 6, 2009 - 8:19 pm 27. lynndh:

I guess my wife and I are just SOL. We are 63, with a few age related issues, nothing serious if we take the meds. Good by world.

Jul 6, 2009 - 8:20 pm 28. Leo Linbeck III:

Another juicy bit from the paper:

In a public health emergency, instrumental value could also be included to enable more people to live complete lives.

The definition of instrumental value, for those of you scoring at home, is:

Instrumental value allocation prioritises specific individuals to enable or encourage future usefulness.

For instance:

where a specific person is genuinely indispensable in promoting morally relevant principles, instrumental value allocation can be appropriate.

So, in a public health emergency, “genuinely indispensable” people will get treated first. Like, say, elected officials, government staff, and (of course) medical ethicists.

I guess that means we’ll be living in a state of perpetual emergency.

In more ways that one…

L3

Jul 6, 2009 - 8:28 pm 29. Laird Lochenlode:

So, no more medical treatment in prisons, because felons have negative social utility.

Jul 6, 2009 - 8:31 pm 30. PA Cat:

Like, say, elected officials, government staff, and (of course) medical ethicists.

L3– Don’t forget the folks from ACORN, union leaders, and Rahm Emmanuel’s ballet instructor.

Jul 6, 2009 - 8:33 pm 31. peterike:

Wretchard at 19: Instead of dumping the output into a window or something it sang and danced for a while for purely cosmetic reasons… Never underestimate the power of graphs; never underestimate the influence of flashing lights; never underestimate the power of salesmanship.

Apropos of nothing, but I think our host (and perhaps Programmer) may find this amusing. Some years back I worked in marketing for a company selling network management software, monitoring bandwidth and throughput and CPU cycles and what all. The software put out lots of graphs and such. I once asked, “How do we know they’re accurate?”

The response was that we don’t really know for sure, but it didn’t matter. The design philosophy was thus: “Draw some colored lines and declare victory.”

The Obama team must have been listening.

Jul 6, 2009 - 8:43 pm 32. Leo Linbeck III:

OT -

Here’s the update on the Twitter experiment.

I’ve set up a Twitter account, BCinHouston, for all those who are interested in attending some kind of get-together in the “hometown” of this splendid blog. Here’s what you do:

Go to the URL http://www.twitter.com/BCinHouston

Click on the “Follow” button.

That’s it. Pretty simple.

Note that, as of right now, this name does NOT come up in a Twitter search, so you have to link to it directly. Hopefully, Twitter’s indexing engine will eventually get to this account.

Anyway, after a week or so, I’ll see who has signed up to Follow. Depending on how many people express an interest, I’ll make arrangements for venue. I’ll tweet the time and location once the details are set. I’ll also report back to the BC blog on the level of interest.

(W – I’ve never really gotten your OK on using Belmont Club name. If this is not kosher, lemme know and I’ll find a different moniker. And if you are so moved, feel free to post this information in a BC blog entry for those who don’t read comments.)

Cheers,
L3

Jul 6, 2009 - 8:43 pm 33. Robohobo:

PA Cat @ 11: “…Emmanuel thinks M.D. is an abbreviation for M. Deity.”

An RN friend of mine says that THEY think it stands for Major Deity. It fits it seems.

As to the graph, you just saw the shape of the ice floe the society will put you on once you reach ‘a certain age’. Sweet.

“the complete lives system is least vulnerable to corruption”.

I LOL’ed at that one! Least vulnerable? As compared to WHAT?

Sorry, but down this path lie death camps. But now we couch the language as “health care choices”.

Molon labe.

Jul 6, 2009 - 8:46 pm 34. Marcus Aurelius:

Joe Buzz,

The Y axis (vertical axis) is the probability of receiving treatment, no scale is given but the min is zero and the max is 1 (or think 0 to 100%). No negatives on this one, probability can not be negative (however, a few of things I was “taught” were: for subtraction you can not subtract larger numbers from smaller ones, you can not take the square root of a negative number, etc. I wonder if anyone has studied what happens when that restriction on probability is relaxed?)

This one does not have to normalize (i.e. the area between the line and the X axis must be one) as such graphs usually have to do. This chart is not communicating the notion that you have people in a office waiting for their lottery number to come up and there will be one winner. Still, I think that would be a great advert hitting back on such proposals. “I’m sorry Mr. Jones, you will have to bleed to death, Mr. Stinle’s number came up. Now Mr. Stinle what about that hangnail?”

Apparently, giving Grandma a razor and a bottle of whiskey is going to come back.

Jul 6, 2009 - 8:50 pm 35. Leo Linbeck III:

Robohobo,

More like Logan’s Run…

Cheers,
L3

Jul 6, 2009 - 8:50 pm 36. Leo Linbeck III:

Marcus Aurelius,

I don’t think many Grandmas will have to worry about healthcare after 2010. After all, the Bush tax cuts expire at midnight 31 December 2010, so the estate tax rate goes from 0% to 50%. That’s quite an incentive to make sure she doesn’t make it to 2011…

Cheers,
L3

Jul 6, 2009 - 8:55 pm 37. peterike:

Nice graph. I guess you damn well better hope you never get sick before the age of about 10 or so. Pretty grim odds there. So much for women and children first.

Well women maybe. We haven’t seen how gender impacts your status as one of the “socially useful.”

Huh. “Socially useful.” Interesting phrase, that.

Now is it me, or is this, ummm, pretty much Nazi territory? I know, I know, Nazi comparisons are the acknowledged death of any thread (that’s somebody’s law). But… but…. but… there’s no other comparison to this. It’s demonic.

Better make sure you’re wearing your Obama button any time you have to go to the Emergency Room. Oh wait, I mean the Social Utility Room.

Jul 6, 2009 - 8:55 pm 38. Tcobb:

I have a modest proposal that will solve ALL of the economical problems associated with health care. Just make the practice of medicine illegal. Let it all go black market. Society would be better off for it.

And any government employee who is found to be buying services, stick them in prison for 20 years.

Jul 6, 2009 - 8:56 pm 39. Marcus Aurelius:

As far as the animation while background processing is going on, I LIKE those. If a large amount of background processing has to occur I like to see that thing spinning so I know the system is working and not locked up.

I recently bought a laptop and put a new OS over the store default system. One package took a long time to unpack and while that was going on no other aspect of the computer appeared alive, all was stuck & quiet – it was disturbing.

Most of my work has been in true batch applications, no one watching.

Jul 6, 2009 - 8:57 pm 40. Marcus Aurelius:

One has to wonder how abortion will fare under all of this?

http://liberalfascism.nationalreview.com/post/?q=ODk4MjUzZTZiY2JmMjQ4OTMwOTVkOTBlZDdkMWY1NjY=

Jul 6, 2009 - 9:00 pm 41. rickl:

Dr. Emmanuel forgot:

5. Reciprocity (paying back people who have ‘contributed’, such as political donors)

In our new politicized health care system, your priority will depend on who you know. Someone influential makes a phone call or two, and presto! You go to the head of the line.

Jul 6, 2009 - 9:06 pm 42. JTR:

Leo #35:

Renew!

Jul 6, 2009 - 9:18 pm 43. Robohobo:

Marcus Aurelius: “…you can not take the square root of a negative number, etc.”

Um, yes you can, IFF (if and only if) you define SQRT(-1) = i
It is called complex mathematics. When you apply the theory to geometry you get interesting results. Long story short, out of this comes chaotic systems/geometry. And that stuff is fun to play with.

peterike @ 37: Not so much Nazi as Fascistic I think is the better way to put it. BTW, it is Godwin’s Law: “As a Usenet discussion grows longer, the probability of a comparison involving Nazis or Hitler approaches 1.”

The 0bamanation is actively pursuing the end of the American Republic as we know it. The funny part is that he is getting so far.

Jul 6, 2009 - 9:19 pm 44. Marcus Aurelius:

Robohobo,

When I first learned about square roots (like in third or fourth grade) I was taught you couldn’t take the square roots of negative numbers. However, I once took a course (and that was in like 15 grade or so) called “complex variables” and learned how the CRC math manuals came up with the solutions to all of those fiendish looking integrals.

What I was saying, is when I was first taught a lot of these things there were assumptions and rules we were saddled with. Eventually, I came to discover that most of those rules and assumptions were not necessary and one could do lots of intriguing things when those assumptions are relaxed.

Sure enough, google “negative probability” and the #1 result is a wiki page noting negative probability (and probability greater than one) has utility in finance & quantum mechanics.

The link I put up before takes the reader to Jonah Goldberg’s Liberal Fascisim blog and he wonders about the idea of how when it comes to abortion people want govt to stay out of the patient doctor interaction, but now, the govt is looking at a huge intrusion in that relationship. He also highlights a speech by Obama and links to a Wiki page on Lebensunwertes Leben

Jul 6, 2009 - 9:28 pm 45. rascalfair:

Folks, this is MUCH too complicated. It’s been done before…simply assign a jackbooted Dr. Joseph Mengele to decide. He points his swagger stick either left or right, and bingo…it’s decided. Simple. And as just as having a Chicago thug decide.

Jul 6, 2009 - 9:32 pm 46. Promethea:

I’m truly disgusted that “liberalism” has come to this. Killing old people and “useless” people?

Feh!

Rahm Emmanual and your brother Ezekiel should go directly to Hell.

The government must not play God.

Jul 6, 2009 - 9:49 pm 47. Mad Fiddler:

To my fellow BC readers,

It’s useful to examine how euthanasia legislation has been used in the European countries that enacted it.

Death with Dignity?

Bullshit.

Legalized murder of the inconvenient.

Why Not?

We already have been doing that to the unborn for 4 decades.

Jul 6, 2009 - 9:49 pm 48. Robohobo:

Marcus Aurelius -

BTW, I am a trained in mathematics. Yup. One of THOSE! I wanted to do grad work in chaos theory but there wasn’t anyone at the university who could teach me. So, I did it myself. Fun stuff.

From the Wiki page on Lebensunwertes Leben:

“Those considered to be “deviant” or a “source of social turmoil” in Nazi Germany and the occupied Europe fell under this designation. The “deviant” category included the mentally ill, people with disabilities, political dissidents, homosexuals, intermarriage partners, and criminals. The “social turmoil” category included the clergy, Communists, Jews, Roma, Jehovah’s Witnesses, “non-white” or non-Caucasian peoples, and a variety of other groups in society. More than any other of these groups, the Jews soon became the primary focus of this genocidal policy.”

Like I said up-thread, the course that The 0bamanation wants to pursue on health care leads to death camps:

“The concept culminated in Nazi extermination camps, instituted to systematically murder those who were unworthy to live, according to Nazi ideologists. It also justified various human experimentation, and eugenics programs, as well as Nazi racial policies.”

The issue that I see is that there were those of us who saw The 0bamanation for what he was and were SCREAMING about what we saw. No one seemed to be aware. We were called nut cases and worse. So, here we are. What are we to do? Do you really believe that we will be allowed elections in 2012? I don’t. (Cloward-Piven)

Jul 6, 2009 - 9:57 pm 49. Blindman:

Designed by a committee of supreme beings. Arrogance is not reflected in their mirrors or if it is it cannot be seen through the smoke. These people are the same characters who one hour after publishing their opus would chat about the lack of good Samaritans.

Complete lives you say. I say to them that if an American stood outside the door of his local congressman with his suffering family the committee of the self anointed would melt away faster than the wicked witch of the East. Any public official who truly understood what is being proposed by the complete lives theory should expose those policy makers for the sophomoric social engineers that they really are. They are not here to help us but rather to help protect our neighbors from us when we are in need. Word truly cannot capture the arrogance of their class.

Laudato si, mi Signore, per quelli ke perdonano per lo Tuo amore
et sostengono infirmitate et tribulatione.

St Francis- Canticle of the Sun

Translation
[Be praised, my Lord, through those who forgive for love of you;
through those who endure sickness and trial.]

Jul 6, 2009 - 9:58 pm 50. Mad Fiddler:

Promethea has put the finger on the problem.

Obama’s precious legislative and extra-legislative programs have blatantly and unashamedly singled out the unions for special favors and rewards.

1) United Auto Workers given enormous advantages and ILLEGAL preferences in the takeover and re-casting of General Motors.
That was the whole point of intimidating the secured creditors who under all historical bankruptcy law should have been first in line to be paid. The great irony, of course, is that the secured creditors were the institutional lenders that represented many tens of millions of teachers, firefighters, hotel & entertainment workers, masons & bricklayers, electricians, pipefitters, carpenters, beauticians, et cetera. Lotta folks who may have voted for O, but got screwed ROYALLY anyway.

2) The pending CAP&TRADE hemmhorrage specifically grants exemption to the taxes in the bill to various unions, for NO REASON OTHER THAN THAT THEY ARE UNIONS. The Union leaderships have been taking union dues and giving them to the Democratic Party since the time of FDR. OVER the objections of many of the rank and file.

Great system, eh?

———-

Robohobo, we really need several groups that keep track of the people associated with a certain “community group” that assisted O with collecting signatures of alleged voters, then helped lots of people cast ballots without really stringent examination of their legal status.

Jul 6, 2009 - 9:59 pm 51. Tcobb:

I find it very amusing. As a group, women tend to be those most in favor of the right to abortion and the idea of nationalized health care. How ironic is it that they get their wish as to both issues but, as a consequence, will face the prospect of being put on a ten month waiting list to get an abortion?

The Great God Murphy must be laughing his a** off.

Jul 6, 2009 - 10:02 pm 52. RCM:

24. Marcus Aurelius:

The AARP will work out a tit-for-tat plan to ensure no loss of revenue from their membership. Who will pay it? Why…the Health Czar, of course.

They, just like Walmart, will be on board in a heartbeat…no pun intended.

Jul 6, 2009 - 10:03 pm 53. RCM:

What’s wrong with death camps?

We kill unwanted babies trying to get in; we’ll just start killing us worthless, unwanted old-timers on the way out.

In fact, if you think about it, the first only paves the way, for the second.

Once the culture is dispassionate about the first, the second only makes sense.

I hope that makes everyone feel just a little bit better. Now that I think about it, it’s darn logical, in a manner of speaking.

I think the Pope called it “the culture of death;” right here in River City.

Jul 6, 2009 - 10:13 pm 54. JMH:

Like I said up-thread, the course that The 0bamanation wants to pursue on health care leads to death camps:

That’s where liberalism always leads. Sometimes it’s a shorter road, sometimes a longer one, but the destination is always the same.

So, given that, would it be morally wrong to steal a march on the Leftists?

Jul 6, 2009 - 10:22 pm 55. RDS:

A market-driven system is amoral. But that’s better than an immoral one. Sure, they intend their system to be moral, but it will end up being evil, through their very attempts to enforce their vision of morality.

Funny how it’s the left who always screamed “you can’t legislate morality!” when they’re really the only ones who do exactly that, with healthcare and green living etc.

Jul 6, 2009 - 10:23 pm 56. Ned:

It was only a few years ago that lawyers became the highest paid professionels over doctors and the nursing profession has been hurting for years for want of people because of better opportunities elswhere. To what kind of people will we leave our healthcare to in the future with the lowest common denominator?

Ned

Jul 6, 2009 - 10:25 pm 57. Pascal:

Many here know I warned that this was building for some time. This is no trial balloon, though the outcry over this news may cause some backtracking.

I was not clairvoyant. Due to my reading a great deal about Blaise Pascal I stumbled on the 1988 philosophy book, “The Abuse of Casuistry”, by Albert Jonsen and Stephen Toulmin that worked hard to rehabilitate a 17th Century thought process that had given, to kings and indulgence selling clerics (casuists), license to bend moral precepts to their liking — and profit.

There are obscure terms revealed in the book that would put most people to sleep. One of these, very similar to one of Pascal’s math discoveries, was called Probabilism. It was this that casuists relied on extensively. Try saying intrinsic or extrinsic probabilist let alone find an audience to discuss the differences.

Yet it is such a concept that has been adopted by the CDC that has led to this story. Those obscure words laid the groundwork that has made the words “useful individuals” speakable in the open for the first time since the Third Reich.

I hate to write so I didn’t for years. I only spoke of my concern for innocent human life that was aroused by that book.

I, a lifelong agnostic, came to understand that many clerics today have abandoned the Judeo-Christian Ethic at its core when their faith in a just God fell to the fears driving population control. Many think this way, but former Episcopal Bishop Sponge is one of the few willing to say it:

“God is about love. The God of the Bible commands us to be fruitful and multiply. This is not a loving God because his commandment is absurd. Following that command would have people overpopulate the earth leading to its destruction and theirs. Thus the commandment discredits the compiler of that text. The commandment is hopelessly outdated. This proves all Bible text needs to be seen from modern viewpoints and adapted to modern mores.”

Sponge has been shunned for saying things like that, but terribly few contradict him. To borrow form Sherlock Holmes, there are way too many dogs who have not barked.

I wrote a few things over the years on the threat to humanity, but not until 2006 did I write my first essay about the threat posed to the faithful: “At The Core of the Judeo-Christian Ethos: What Animates Its Critics.”

I have entered the link to this essay in my URL that appears with my name (I hope it isn’t too long) so as not to overload the post screener’s work (two links slows the publishing of a post significantly). That essay was updated to include a link that discusses the importance of Gen22 to all of this.

Anyway, those essays will add a deeper appreciation for the threat that may be inferred from the title of this thread: “Electing God.”

I may write a new essay now that this story has finally broken the illusion that radical human population control is nothing more than the fears of a fevered imagination.

Jul 6, 2009 - 10:25 pm 58. Pascal:

I posted a comment with only one link that is not appearing so that I may see if the formatting worked and so I can review it. (The link was to a book at Amazon dot com. Could that be the problem?)

Jul 6, 2009 - 10:34 pm 59. RCM:

Here is the reason you must also steal the guns. Some old codgers might not “go quietly into the night” after they see their wife ignored to death…especially knowing he is next and his time short for “justice.”

How old was that guy who stormed the Holocaust Museum?

Jul 6, 2009 - 10:34 pm 60. RCM:

Why do all the quotes from this document have “s” where Americans are used to seeing “z”?

Wow. An American Health Care Plan proposed by a non-American?

Jul 6, 2009 - 10:36 pm 61. Karen Yvonne:

Electing God, huh yeah. When the Real Thing’s unavailable, we’ll demand that somebody take on the role. It’s either the real God who already provided the one sacrifice once for all, or false gods who always require human sacrifices.

Hope the hue and cry over this brings everyone to their senses but I’m not feeling too sanguine about it.

Jul 6, 2009 - 10:42 pm 62. RCM:

Gosh, seems we lost Dr. Tiller just at the time we may need him the most. Hell, he could have really “spread his wings” and “branched out,” as it were, under the Obama plan.

Just think of the dis-assembly line he could have organized…and what are we going to do with all the “clean” organs we can harvest in the “mill?”

Maybe we can sell those overseas – certainly a way to address our “balance of payments” issues. Wouldn’t want to sell them here what with all our carbon footprint issues.

Jul 6, 2009 - 10:44 pm 63. dwall:

Obama is a temp talking head 4 or 8.

soros, Ayers/SDS/acorn will be around for years and now will be well funded.

I understand obama being a communist, with his past. But the congress??? WTH?

this is not over. But they must be slowed down in 2010.

Jul 6, 2009 - 10:47 pm 64. Marcus Aurelius:

This stuff put out by Emmanuel sounds like the kind of thing Robert Strange McNamara relished.

Jul 6, 2009 - 10:48 pm 65. PA Cat:

Why do all the quotes from this document have “s” where Americans are used to seeing “z”?

Because it was published in the Lancet, which is a British medical journal and imposes British spelling on all the articles it publishes, including those written by Americans.

Jul 6, 2009 - 10:53 pm 66. RCM:

In an ethics class I attended quite some time ago, the professor posed a very real test of character that he said we ought to think about.

“There’s an old man in China (or Madagascar; no matter)and you can earn $1 million by pressing this button and killing him, quickly, quietly, and painlessly. He probably will die in 2 to 5 years anyway, and you will never know who he is, nor he you, nor will any other person on the planet know that it was you who pressed this button.

“What is your decision? – I have the check right here.”

Of course, he didn’t ask us to answer the question, just to ponder it over night and and we would talk about that decision’s impact tomorrow.

I was naive then; couldn’t imagine that anyone actually would. I know much better just whom would press it today.

Jul 6, 2009 - 10:55 pm 67. wretchard:

The British spelling is innocent (”s” for “z”) because the article came out in the Lancet, which is a British journal.

The points Dr. Emmanuel makes about rationing are simply the standard ways in which that process is carried out. Access to goods are always limited by some constraint, either by supply and demand (in which case the price level determines how much is consumed) or by “rationing”, which comes from the Latin root word ratio implying computation, reason. In today’s world resources are mostly distributed according to market forces because we learned, or were said to have learned form the experience of Communism, that rationing by the bureaucrats is less efficient than allocation by the market. But rationing is still a respectable strategy when the market fails.

This I think, is what the debate should be about. Whether the market has failed so badly that we have no option but to ration health care. Notice that rationing is not necessarily a global solution. When parts of the market fail, one can intervene in that market segment alone. Suppose for example, there were a biological war, or suppose there were some part of the population who could not be served by the market? Thus rationing might still be valuable as the exception to the rule. One of things that is still unclear is to what extent Obamacare actually replaces the rule, that is, replaces the market with government regulation.

Right now it is being spun as supplementary, but as I said, health care is political, not just clinical. In the wrong hands, the control of the health care system can be an enormous lever for acquiring power. The Left is always very suspicious of The Corporations and maybe they should be. For equally valid reasons, conservatives may also be wary of The Government. The issue in both cases is the same: the fear of ceding too much power to a small group of people.

Jul 6, 2009 - 11:02 pm 68. whiskey:

I look at that graph, and I see first, that most people are screwed, since most are over 40 years in this country. Second, the weighting is to young Mexican illegals, at the expense of elderly seniors. Grandma and Grandpa and maybe the parents. It’s a death sentence for everyone who is White and is old or will become old.

That’s an easy sell in Congress. I would hope that Sarah Palin leads that fight, as a private citizen, against Obama. It’s a two-fer. It establishes what Obama wants to do: kill older White people, along with the Dems, and saves the day. It also hopefully fatally weakens Obama politically.

Obama and Company are also filled with hubris. He could politically, extend coverage merely to the uninsured, guaranteeing a patronage/vote advantage, with minimal risk. He’s now into rationing, as his pal Rahm Emmanual and brother describe in detail. He thinks he’s God. That he can do no wrong. That everyone will always love him. My guess is he will never see how quickly it turns south for him (and all his cronies). Just like Louis XVI.

Jul 6, 2009 - 11:07 pm 69. RCM:

O/T, but visit the Drudgereport and look at the picture of Obama and Medeved shaking hands.

Which one looks bored and which “needy?”

http://www.drudgereport.com/

Also on Drudge is a link to an article of Roger Stone explaining Palin’s “decision,” but I cannot get to it. Perhaps that might be because all the Democrats are clogging up the site…

Jul 6, 2009 - 11:08 pm 70. RCM:

…make that Medvedev…

Jul 6, 2009 - 11:22 pm 71. Fletcher Christian:

Of course, the apparent ideas behind that graph are reprehensible. However, it appears to me that it’s better than the American system, which can be summed up in two words: “Richest first”.

Jul 6, 2009 - 11:24 pm 72. PA Cat:

It’s a death sentence for everyone who is White and is old or will become old.

Well, that includes Pelosi (no more Botox for Grandma!), Byrd, Reid, Biden, and Murtha (Ted Kennedy probably won’t have to worry). The Dems have a real gerontocracy.

Jul 6, 2009 - 11:25 pm 73. Leo Linbeck III:

The fundamental argument against market-driven healthcare is that it is unfair: the rich get more and better access and care than the poor.

But that is true of all goods and services in a market economy. I might prefer to eat at Tavern on the Green, but my pocketbook only allows Gray’s Papaya. Isn’t food as (or more) important than healthcare? Yet food prices are largely market-based; government intervention comes in the form of subsidies to the supply side (farmers, etc.). Generally, supply-side subsidies are less distorting that pricing controls. But I digress.

Why should we use a queue as the default mechanism for matching supply and demand in healthcare? Sure, there may be situations where a queue is called for (e.g. pandemics), but should the default position be that a government bureaucrat, under the thumb of a politician, will make the determination of who gets what?

If you’re part of the political class, of course the answer is yes. At the end of the day, the politically powerful and connected will get better care. The rich will still find a way to get what they want, but the political class will be able to extract a toll since they are running the booth.

I hate to be repetitive, but there are only two ways to match supply and demand: a market and a queue. The President’s plan is a move toward a single payor system, which necessarily results in a queue (aka rationing). If we end up there, the line will eventually look like the old Studio 54 lines: the rich, powerful, and famous get in, and everyone else is stuck on the outside looking in.

And you can be sure that the bouncer who ends up working the front door will be not be thinking about maximizing social justice.

L3

Jul 6, 2009 - 11:26 pm 74. Leo Linbeck III:

Fletcher Christian,

the American system, which can be summed up in two words: “Richest first”.

As opposed to where else? Name a single country in the world where the rich do not have preferential access to healthcare. Just one.

You can’t because no such place exists.

Besides which, what is the argument against the rich getting first dibs? I understand the emotional sentiment (envy, jealousy, etc.), but what is the philosophical argument? After all, the rich get first dibs on a whole bunch of stuff; why treat healthcare differently than, say, housing or transportation or food or water or anything else?

I would like to hear the argument, and am willing to be convinced. Seriously. Cheers,

L3

Jul 6, 2009 - 11:41 pm 75. Fletcher Christian:

Leo, it’s really quite simple. To use your example, if you eat at Gray’s Papaya (or even a soup kitchen) rather than Tavern on the Green, you still get food. If you buy clothes from a charity shop rather than from Chanel, you still get clothes. If you take the bus rather than a business jet, you still get where you’re going.

You don’t have the money for medical treatment, in a purely market-driven system? You don’t still get medicine. You get dead.

Jul 7, 2009 - 12:01 am 76. Lou C Fur:

The state of the poor,
left at your door,
bare witness to me.

What Grace comes to thee?

Jul 7, 2009 - 12:12 am 77. Pascal:

The spam filter delayed my post from appearing for over two hours. Thank you for clearing it RF.

It is currently number 57, but the time, 10:25 pm, won’t change.

I make some points that may answer some of the questions that have been raised before and since.

Jul 7, 2009 - 12:36 am 78. buddy larsen:

FC, we have Medicaid for the poor. Hospitals do not turn people away. Everyone has access. Access and insurance are two different things. People with more resources have more choices. That is one reason for a young person to decide to make something of his/her self.

That education, work, virtue and dedication bring rewards, is, in societies that do well enough to care for the people, considered a ‘feature’ rather than a ‘bug’.

Societies that ignore human nature are hard to study –usually you just get a Potemkin tour. People do not try to escape the USA and get into Cuba, the land of ‘great medical care’. Wonder why –could there possibly be something more to life than making sure that everyone one will ever encounter will be just as poor and ignorant as one is oneself?

Jul 7, 2009 - 1:13 am 79. bob:

Actually, at the rate we’re going, some of us might start to consider escaping to Russia.

Putin has warned us about much of this, recall. But, having elected God, we’re deaf to worldly advice.

Jul 7, 2009 - 1:37 am 80. buddy larsen:

or china –jeez, those business people are go-getters. like we were in the recent past –

Jul 7, 2009 - 1:46 am 81. Doug:

In restaurants, there are very few instances of businesses lowering their prices, or giving food away, because someone is too poor to afford their fare.

Likewise for hardware stores, groceries, and etc.

This happens far more frequently in medicine where services are often given away to the poor in emergency rooms and clinics.

Doctors often make choices for “health care allocation” on the basis of hundreds of factors having nothing to do with Emanuel’s Immaculate Allocation Graph tm.

The only efficient way to control costs without seriously compromising quality is patient choice/patient pays, just as it used to be, and just as it is for other goods and services. (reimbursed by insurance, when applicable)

Jul 7, 2009 - 2:03 am 82. cubanbob:

“71. Fletcher Christian:
Of course, the apparent ideas behind that graph are reprehensible. However, it appears to me that it’s better than the American system, which can be summed up in two words: “Richest first”.

Jul 6, 2009 – 11:24 pm”

As opposed to to the well connected getting first dibs? Thats the socialist way. Ask any Canadian who gets first in line, the ordinary guy or the well connected guy? The richest paying first is at least more honest and egalitarian since rich encompasses poor boys who made it good to trust fund babies. Besides whats the point of having money if you can’t use when you really need it?

Jul 7, 2009 - 2:08 am 83. cubanbob:

“

Jul 7, 2009 - 2:08 am 84. no mo uro:

Looking at the graph, I can see:

1. that the people who receive the most healthcare are the ones in the age demographic that are most likely to vote left (adolescents)

2. that infants are not well regarded, bringing in the idea (voiced by Singer and others) that life of the newborn is as unimportant as life of the unborn

3. that as people age and attain wisdom (and therefore become more conservative) they will be “thinned out” by the system proposed

The problem with these is that young and healthy people are the ones least likely to need “scarce” care, so allocating it there means that it will in all likelihood never be disbursed. Who gets to keep the allocated funds?

Jul 7, 2009 - 3:53 am 85. ledger:

Good gallstones, Ezekiel Johnathan Emanuel’s CV indicates he has been feeding at the Government’s trough for a long time.

“Work Address: National Institutes of Health, Bethesda, MD”

“Home Address: “1*37 Michigan Ave., Evanston, IL.”

“Education: PhD Political Philosophy Harvard University.”

“Administrative Experience: First Chair, National Institutes of Health”

“Chair, ASCO Task Force on Conflict of Interest, Developed and authored revision of conflict of interest rules…” (yet he posts partisan comments on HuffPo)

“Chair, Committee of Develop Ethical Guidelines, Society of Health Services”

“Member, President Clinton’s Health Care Task Force”

“Associate Professor of Social Medicine, Harvard Medical School”

[On and on]

The man is a political hack.

He should adopt the slogan:
“Dam it Barack! I am a political hack not a doctor!”

Jul 7, 2009 - 4:34 am 86. Herb:

How will this work? WSJ today has a discussion of the Brit’s NICE system :http://online.wsj.com/article/SB124692973435303415.html#mod=djemEditorialPage

Jul 7, 2009 - 5:45 am 87. Leo Linbeck III:

Fletcher,

Your argument is not convincing. First of all, I can assure you that if you don’t have money, they won’t serve you at Gray’s Papaya. Same with a bus ticket. Same at a charity shop (although there is probably something there that they’ll give to you). But you seem to be arguing that healthcare is somehow different, and that there is no market-clearing price that poor people can afford, and therefore will end up dead. Of course, this is not true; there have been charity hospitals and public hospitals for decades who serve the poor. They have been supported, for the most part, by the rich, either through philanthropy or taxes. And they don’t turn people away.

But, more to the point, the question is not whether the poor get access to healthcare. They do, and the pretty much always have. The question is whether they should get access to the same healthcare on the same basis and equal priority as the rich, at little or no cost (presumably, since they’re poor). Your claim was that the American system is “Richest first.” You appeared to make that claim as if that were somehow inherently evil; an argument-ender, QED. But I’m not satisfied. I am asking for an argument.

“Richest first” is how markets always function. In fact, people who purchase goods and services first – early adopters – pay a premium that subsidizes innovation for all of us. The first iPod was more expensive than the latest version. Most of us couldn’t afford it. But the profits were used to invest in future versions, and over time costs came down so that almost anyone can afford one.

So, I’ll ask it again: why is “Richest first” – that is, a market – a bad way for matching supply and demand in healthcare?

Cheers,
L3

Jul 7, 2009 - 5:47 am 88. Lifeofthemind:

This plan of Rahm’s brother should cross the line to meeting standards of prohibited hate speech in that it advocates discrimination and violence against protected classes. As a Federal employee he should be subject to EEO sanctions that could be brought by any effected party. State legislators should push through laws at the State level, where physicians are licensed in America, specifically stating that allocating care under any such formula, with an exception for military combat triage, would constitute malpractice. Also making clear that any person who advocates any such degradation or assault on human life may be held civilly liable. Are there no lawyers in America who can take this fight on?

Jul 7, 2009 - 5:55 am 89. Mongoose:

Sure there is a good answer: Get government out of it. Do away with medicare and medicaid. Stop letting the AMA act as a union for doctors. In short, allow competition into the sector.

And in general, reduce the size of the state, redulation and taxation.

Then there will be plenty of enterprise, plenty of money, and plenty of firms which can compete with their own insurance plans. Plenty of affulent people that can have their own plans will quickly crop up. Plentiful amounts Private Charity, such as hospitals owned by confessions of faith will reemerge.

Go the direction it was going before LBJ screwed up the system.

Once we assume that there are “positive rights” and that these rights must be footed by the taxpayer, there is no end to this nonsense.

When you have a State that rejects the dignity of a human soul, and holds to economic determinism, positivism, atheism, collectivism, scientism and materialism (in the philosophic sense of the word), you will get euthanasia.

You will get political abuse of the system, right down to denying opponents care, right down to forcing diagnoses of mental illness on those that do not agree with the state.

Sooner or later it is inevitable.

To impoverish the nation so “poor people” have “equal access” to medical care, is not only insane and immoral. It is treason.

Hiding behind the suffering of the “poor” in order to sneak i na Leftist ideology is the worst sort of indecency. It is not noble. it is not about concern for the poor. It is pure evil.

Jul 7, 2009 - 6:04 am 90. ftl1087:

“In pandemic situations, it also allocates scarce interventions to people instrumental in realising these four principles.”

Now take away the phrase, “In pandemic situations…”, and read the rest of the sentence. That is what we’ll be left with: those that are instrumental in realising the principles of the system will always be high on the list to receive care. Gee, who will that be? Democrat party donors, voters, and politicians.

There is one other point that should be made about government healthcare, too. What about racial or gender bean-counting? You can bet that care will be allocated by race/gender/socio-economic status. Need to have your knee replaced? Too bad, we’ve already had too many white males get knee replacements this year, so here’s a crutch, instead. Besides, we don’t want you living too long anyway…

Jul 7, 2009 - 6:32 am 91. Mongoose:

redulation=regulation

Jul 7, 2009 - 6:35 am 92. The Wobbly Guy:

Feel free to come to Singapore for all your healthcare needs! We’re trying to establish ourselves as a medical hub and encourage medical tourism, we’re cheaper than the Swiss, and almost as good!

Thank you Obama!

Jul 7, 2009 - 6:36 am 93. bob:

What about the right to privacy that has been found in the Constitution? If we have a right to abortion because of some privacy right in the Constitution, and worries about the ‘health’ of the mother, I’d think we’d have a Constitutional right to a by-pass operation or a hip replacement under the same sort of logic. But it may depend on the wisdom of some Latina woman.

Jul 7, 2009 - 6:37 am 94. Peter Boston:

Obama’s health care administration is a restart of Progressive eugenics, which was very popular and almost universally accepted by the intellectual class until Uncle Adolph put the kibosh on the acceptability of using the power of government to “improve” humanity by going too far. Awarding or withholding medical care based on some concept of social utility is no different in principle than what Uncle Adolph was up to.

The Progressive/liberal mantra about unrestricted abortion at government expense is easier to understand when you consider whose babies are being destructed. The less underclass DNA in the pool the better the society.

The problem for those of us who espouse Judeo-Christian values and want to see them lived through our social and political institutions is not a dearth of leadership in the Republican Party. It goes much deeper than that.

Survey an online modern American history class at iTunes U. It will be about the ebb and flow of Progressivism and the evil Republicans who occasionally get in the way.

Progressivism is not the dominant political philosophy of our time – it’s the only political philosophy. Until another great idea comes to the fore that convinces us we that we will all be better off with a different, and less intrusive, relationship of citizen and state then the only available arguments are about how much is too much.

Jul 7, 2009 - 6:39 am 95. Joe Doakes:

I’d love to see that graph overlaid on a graph showing maximized lifetime taxes paid. I bet they’d be identical.

We’ll fix up young people because they’ll pay taxes for a long time. Old people don’t pay taxes, they cost us money. The ideal situation from the government’s point of view would be a person who dropped dead the day after retirement.

Looks as if the health care system will be redesigned to help achieve that goal.

.

Jul 7, 2009 - 6:42 am 96. pel:

> Feel free to come to Singapore for all your healthcare needs!

I also hear that crime is quite low in Singapore, because y’all know what to do with bad guys.

Hmm…

Jul 7, 2009 - 6:53 am 97. steeple:

not that I’m complaining, but it’s interesting to me that the trolls have seemingly slunk away recently. seems to be a good barometer of their reaction to priceless gems like this development.

Jul 7, 2009 - 6:57 am 98. Eric Hines:

Beyond the question of “Who is the we”, also is the of “who decides the moral imperatives that underlie all of this” question.

And Mr Hernandez doesn’t mention, except peripherally, the tacit assumption of the brothers Emmanuel that the government knows best of all the players how to make all these choices. The patient is, ipso facto, singularly unqualified, not being a gentleman, after all; the doctor is merely the government’s instrument, and so not qualified to make judgments differing from Those Who Know Better; and the government knows best, having been appointed by God–oops, I mean elected by the people to be their rulers, vice their employees.

And I don’t see the capitalist method of selection at all in the Emmanuel article, as cited. Interesting elision.

Jul 7, 2009 - 7:01 am 99. starling:

@ JMH (#4): “I can see lots of busted jaws followed by worse later.”

I thought something similar, something of out the movie JohnQ to be more precise. Only one or two lines in the synopsis below needs to be changed to turn the “Special Advisor for Health Policy” the heavy instead of an exec at John Q Public’s HMO.

http://www.rottentomatoes.com/m/john_q/ (released Feb 2002)

“Synopsis: John Q. Archibald (Denzel Washington) is struggling through a recession trying to provide for his son Mikey (Daniel E. Smith) and his waitress wife (Kimberly Elise). Mikey collapses at a Little League game and is rushed to a hospital. The situation is bleak. Only a heart transplant will save Mikey’s life. John’s HMO refuses to cover the expensive surgery. With the hospital and his insurance provider unwilling to help and his wife pleading with John to act, he takes matters into his own hands, holding the hospital’s renowned heart surgeon (James Woods) and several others hostage in an emergency care wing until the surgery will be performed. Nick Cassavetes directed this attack on the American health care system. Like his previous feature, SHE’S SO LOVELY, Cassavetes proves adept at mining the political ramifications out of human drama. The film criticizes hospitals and health care providers for working in collusion against the working class. This moving drama is propelled by the intense lead performance by Washington as one man against an unjust system.”

Jul 7, 2009 - 7:01 am 100. programmer:

Peterike@31 says:

I once asked, “How do we know they’re accurate?”
The response was that we don’t really know for sure, but it didn’t matter. The design philosophy was thus: “Draw some colored lines and declare victory.”

Programmer sighs and asks, “Were you working for a major airline at the time, which shall remain nameless, but had a large scale computer system named after a large, sharp sword?”

Jul 7, 2009 - 7:05 am 101. Steve:

I’m glad I’m not the first to think of Lebensunwertes Leben. Here’s the other way LuL works into this.

The hard left has invested heavily in Obama. They now get to benefit by having their guiding concepts enacted into law. One of those is the idea we need to drastically reduce the human population. The easiest way is to assign a low social utility to replacements. If we can raise the mortality rate for the first ten years to 50% or so, we can effect a drastic drop in population in a generation or so.

If you’re so heavily over educated that you have no morals, then social engineering that would seem repellent in a video game becomes just a means to an end.

Welcome to the future; we hope you enjoy what we allow as your stay.

Jul 7, 2009 - 7:08 am 102. Mongoose:

steeple: The trolls have just gone elsewhere on PJM.

Lately, the very high quality of Wretchard’s postings and the ensuing discussions have pushed out the ignorant and the silly. I imagine that they cannot quite understand the discussions even enough find a chink to cram with snark. At least that is my take. I am not, however, getting my hopes up for the national debate.

Jul 7, 2009 - 7:13 am 103. Eric Hines:

L3 sums things up nicely: The fundamental argument against market-driven healthcare is that it is unfair: the rich get more and better access and care than the poor.

So, the current situation is that we have a health care system where some people don’t pay, and some people (not necessarily the same group, but there is overlap) don’t get access. And under the Social Democrats’ socialized medicine received wisdom, everyone pays, and nobody gets access. Problem solved.

Sorry. I’m one of those who’s uninsured, by choice (e.g., my wife’s bilateral mastectomy, and preceding biopsy, were cheaper to pay for out of our pocket than the accumulated insurance premiums, and the 20% we’d still have been invited to pay), and yet, first lie of Obama, this is exactly the insurance plan that I will not be allowed to keep under His Plan.

I know where my choice lies.

Jul 7, 2009 - 7:13 am 104. Buzz K:

I’ve heard the argument that insurance companies already ration health care made many times as justification for allowing the gov’t to do so. Given his prolific writing on tyranny, there are numerous G.K. Chesterton quotes that would fit the bill. This is my favorite (from The Outline of Sanity):

“…[I]t is our whole point that the central power needs lesser powers to balance and check it, and that these must be of many kinds: some individual, some communal, some official, and so on. Some of them will probably abuse their privilege; but we prefer the risk to that of the State or of the Trust, which abuses its omnipotence.”

Jul 7, 2009 - 7:19 am 105. Pascal:

Would you care to see a video preview of how your concerns and complaints will be received club members?

This video is of a panel discussion where Ezekiel Emanuel briefly hears a response from historian Anton Chaitkin similar to those we all have stated on this thread. Dr. Chaitkin was clearly a bit more prepared to respond to the news than we have been.

Emanuel then denies the implications that we all can see.

The thing of most importance? He summarizes: “My reputation has been besmirched here.”

He thanks the panel and commentators, and then storms out.

How’s that for a giving you a good sense of things to come?

Jul 7, 2009 - 7:25 am 106. HV:

Any thoughts on the possibility that market-based health care will simply move offshore?

Jul 7, 2009 - 7:30 am 107. Whitehall:

I have to admit that there is a germ of reason behind this curve. What is the number? Half of all health care costs come in the last 6 months of life. But that is a statistic and also includes those big expenditures that add decades of healthy, happy life to individual retirees. We also need to recognize that the current system has incentives to over-treat, especially for expensive “procedures.”

Maybe we’d be better off buying motorcycles and skydiving lessions for every retiree with their first Social Security check.

Jul 7, 2009 - 7:33 am 108. Sorry, Mom and Dad « Sidemeat:

[...] Mom and Dad Jump to Comments But you’re screwed.

Jul 7, 2009 - 7:36 am 109. Mongoose:

P. Boston: you keep making this assertion:

Progressivism is not the dominant political philosophy of our time – it’s the only political philosophy

Even a shallow reading of the history of the last 200 years shows definitively that this is not the case. And you seem to be saying that “Progressivism”, which is essentially Communism and not Classical Liberalism in any of its forms, has been a success. Where? When? It has taken directly hundreds of millions of lives directly, and blighted many more indirectly. It is a truely bizarre opinion.

What possible proof can you give for this? It is a preposterous argument, so preposterous that almost everyone here is ignoring you. Did you miss WW2 or the Cold War. Have you been to an inner city lately? Go have a peek at Venezuela. Are you aware of the hstory of India since partition?

And I must say, you seem to be taking every bourgeois social or political movement of the last 200 years and cloaking it in the mantle of “Progressivism”. This will not do. Progressivism today as a term is merely a cover for Communism of various stripes. However misguided T. Roosevelt was, he was hardly a Collectivist, and his “movement” was really just a minor heretical wing of Classical Liberalism. Soon after he was out of the way, the Bolshevicks co-opted that “movement” and preverted it into a cover for a radically different ideology. Moreover, the pragmatic regard for material progress that was (and is) a major part of Classical Liberalism has little to do with “Progressivism”.
You seem to be engaging in parlor tricks in your definition of “Progressivism”.
These words all have historical meaning, if you want to come up wth your own notions and put that label on them you should say so.

You do not seem to be a Liberal, Socialist or a Collectivist. This does not seem like you are a troll. What is up with this panic? Why do you make such weird assertions? You need to man up. History and morality are on our side.

Jul 7, 2009 - 7:40 am 110. Lifeofthemind:

Mongoose,
Let me defend Peter Boston. In the first half of the 20th century collectivism was widely seen as ascendant. Labeled Progressivism in the United States (The Wisconsin Experiment) or Fascism in Italy (The trains ran on time) or Leninism in Russia (George B. Shaw saw the future) there was a common vision. The right versus left dispute within collectivism, as opposed to the conflict between tradition and modernism (seen as Progressive) was not dominant outside of narrow intellectual circles. Later the cataclysm of WW-II discredited right wing collectivism and revived the American concepts of Individualism and Liberty. The left spent the next 40 years creating a distinction between right and left totalitarianism to rescue the legacy of communism. They succeeded among the intellectuals and in the media just at the time that the market confirmed the failure of system they advocated.

Obamaism is a profoundly reactionary movement. It is a hodgepodge of discredited collectivist nostrums from earlier decades.

Jul 7, 2009 - 7:59 am 111. RCM:

Buddy @ 80:

A friend of mine is on a medical mission to China for the summer. I just got an email that describes conditions as shocking; conditions that are not going to be discussed until my friend returns home. How shocking? Dunno. But this person is not willing to put them in an email. No kidding, huh?

It will be an interesting debrief.

The more things change, the more they stay the same…and people are still willing to throw away the miracle of the American system.

Jul 7, 2009 - 8:01 am 112. RCM:

Ledger @ 85″

Perhaps instead of:

“Dam it Barack! I am a political hack not a doctor!”

What Walt might say:

“Dam it Barack, do you need a proctor?
I am a pol hack – not a doctor!”

Jul 7, 2009 - 8:09 am 113. Marcus Aurelius:

#66 RCM,

That thought experiment forms the basis of a Twilight Zone episode and is a good way to think about what is going on here. In that episode the woman pushed the button and got her check. As the man came to deliver the check and reclaim the box she asked what was to become of the box. His answer was he would reset and deliver the button to someone SHE did not know.

I can not recall who or where it was noted, but the observation was that the healthy in other nations LOVE their socialize health care system, it is only sick, dying, and dead that come to detest socialized medicine, but unless one is dead in Chicago the dead don’t vote.

Jul 7, 2009 - 8:11 am 114. Hutsul:

As a provider of health care, this is appalling! This graph and Obama’s desire represent our rapid ascent down the mountainside of euthanasia or as he will call it planned death (you no longer meet our criteria). Combining this with his radical approach to killing infants and we have nothing short than a modern day Hitler/Mengele dressed up in hopey change. Remember, as we exclude God something has to replace the pain associated with the difficulties of life – the 24 – 40 crowd really don’t want to deal with mom dying – can’t we just give her the Obama Juice, burn her body and pretend life is without pain – welcome to the World of Obama where the One is everpresent and merciful. Sometimes I think this AntiChrist stuff might be real – ah no can’t be.

Jul 7, 2009 - 8:13 am 115. Blindman:

“This I think, is what the debate should be about. Whether the market has failed so badly that we have no option but to ration health care. Notice that rationing is not necessarily a global solution. When parts of the market fail, one can intervene in that market segment alone.”-Wretched #67

For the sake of a discourse one might posit that the market has actually succeeded all to well in health care. The issue now is that those with fewer resources simply want to buy value added goods that are beyond their income. One might say the culture that prescribes the more costly treatment as the only acceptable treatment is further preventing the market from selling alternative and less expensive choices.

The choice does not have to be about medical care, it could be about the difference between catastrophic coverage versus complete coverage. Covering every dollar is infinite in cost whereas catastrophic coverage with deductibles, and excluding unproven or derivative therapies would provide drastically lower premiums.

That being said the basic issue is still the the amazing amount of money that is spent on the health services. People spend what they spend. There is an assumption that they are spending only what they have to spend. No more and no less. If that is true then they are already rationing their purchases. If they are thought to be spending too much then they either don’t understand what they are buying or they are not really paying for what they are buying. Someone else then is buying too much for them.

Certain tiers of medical care have become commodities, other tiers do exist and always will. Rationing health care in America is like rationing gasoline in Saudi Arabia. If you had to ration gasoline in Saudi Arabia you would have to suspect that the price of gasoline is being used to prop up other non gasoline commodities. It is not that health care has failed but rather the economy that does not provide an income for individuals adequate to purchase SUFFICIENT health care.

Beyond the notion of sufficiency there will always be exceptions where none other but government assistance will be needed. It should be on a limited basis if at all possible.

Jul 7, 2009 - 8:31 am 116. dennis:

One doesn’t have to go to the Nazi’s to discuss choosing who is “fit” for care. The Progressives of the early 20th century, the progenitors of the current “intellectual elite” were very enthused about eugenics. This, hidden behind the fancy metrics of Emmanuel’s thesis is exactly the same thing.

The very first thing in the article that struck me was the idea of “allocation”. Wretchard is right: Who? and whom?

Jul 7, 2009 - 8:36 am 117. RWE:

Rationing by personal exasperation – the result of a complex bureaucracy that people get disgusted with – already exists for almost everyone, especially those dependent on some form of government provided health care. It even exists for people who have to rely on private insurance.

However, the Exasperation Factor also exists on the other side of the counter, and actual health care professionals, not just the admin types, have to spend an inordinate amount of time dealing with the bureaucracy. This also increases costs significantly.

The rise of the Government Health Care Apparachnik will simply make this worse, much much, worse.

I know where to invest my money now – into firms that will provide health care on the same basis as successful retailers: the ones outside the Apparachnik Apparatus.

Jul 7, 2009 - 8:43 am 118. JMH:

…rationing by the bureaucrats is less efficient than allocation by the market. But rationing is still a respectable strategy when the market fails…This I think, is what the debate should be about. Whether the market has failed so badly that we have no option but to ration health care

Well, I might question whether “market failure” really exists, outside of the occasional – and temporary – catastrophe (e.g. hurricane aftermath). Long-term problems that are blamed on “market failure” would generally be better called “regulatory ossification.” Most “market failures” are really the result of rent-seeking crony capitalists and socialist thugs using government to exclude competition, extract fees, or otherwise distort true markets for their own benefit. The regulations prevent the market from reacting to signals. It’s like complaining to GM that the steering failed on your Suburban after you lashed the steering wheel to the door post.

Because that’s what Markets do, they react and adjust to signals. If long lines are forming and prices are going up, it draws more providers in, and rewards existing providers for becoming more efficient. Notice that the opposite is happening in the US. As health care prices rise, we are getting fewer doctors, fewer nurses, and more administrators, lawyers, bureaucrats, and non-practicing MDs like Doctor, or should I say Doktor, Emmanuel. In fact, as health care costs are rising, more doctors are deciding to get out of their profession. The most efficient level of care – GP’s – is suffering the worst attrition (or maybe second-worst behind OBGYNs).

This tells me that there is not a market at work in health care. What we have is regulatory failure. Obamacare will only create worse regulatory failure.

But, for sake of argument, let’s say we do have market failure in health care. Rationing might distribute scarce resource differently than the current market system, but I think it’s perposterous to claim it would distrubte them “more fairly.” In theory, rationing could be more fair, but in practice it almost always just substitutes one type of unfairness for another. Instead of “the Rich” getting treatment, it will be the politically connected. And that’s not just substituting one type of unfairness for another, it’s substituting a worse and more corrosive type. Say what you will about wealth, it’s not as corrupting as power. Wealth in a capitalist society is a lot more fluid than influence in a cronyist society.

Plus, even if rationing was able to distribute the scarce resources fairly, it doesn’t do anything to alleviate the scarcity. Market systems encourage increased supply when demand goes up – rationing doesn’t (in fact, usually does the exact opposite as we’re seeing with nurses and doctors today). The one and only redeeming trait of Herr Doktor Emmanuel’s paper is that it’s up front about this. It doesn’t claim to provide care for all. It doesn’t promise a solution to the real problem. It’s unapologetic about screweing large segments of the population. “Sorry, can’t help you. Now please go #*@&-off and die. Quietly.”

Jul 7, 2009 - 8:51 am 119. Lifeofthemind:

Remember a few years ago when the French went on vacation and left thousands of old people to cook to death in the attics? Thanks to Obama we will all be European sophisticates now.

Jul 7, 2009 - 8:52 am 120. Jrod:

Pro rata medical allocation based on the premise, from each according to his ability (to pay patronage) to each according to his needs (subject to interpretation by your block health offical).

My wife who has visited Cuba a number of times once told me that one of the reasons there is a doctor on every block is so that they can extract blood for nutritional testing easily and frequently. The idea being that if anybody is more nourished than anybody else, they must be cheating, calorically speaking. Maybe diving for lobsters at night, for example.

Jul 7, 2009 - 8:56 am 121. Jim Nicholas:

Several thoughts about Dr Emanuel:

I think that someone who has become certified in internal medicine and oncology has had enough experience with pain, suffering, and death to get over the bar of experience as a clinician. Also, as someone who served on a medical staff committee 35 to 40 years ago to determine who would get the kidney transplant, I can say that it would have been good to have been able to consider the thinking of persons like Dr Emanuel.

Having said that, I am seriously troubled by two a priori assumptions Dr Emanuel makes:

“We do not regard ability to pay as a plausible option for the scarce life-saving interventions we discuss.” Whatever dollars I have to spend on my or my children’s or grandchildren’s health care represents what is left from 40 years of working never less than 70 hours a week, except for a two-week annual vacation. Dollars are not an accidental and unjust consideration. They represent hours and years of deferred gratification, of life not spent in ways others might have spent theirs. Is it unjust that I spend this deferred life on myself now, or on my children or grandchildren?

Dr Emanuel states “social value allocation must not legislate socially conventional mainstream values”. It seems to me that, on the whole, mainstream values represent the values arising out of generations of human experience. And so, it seems to me that it takes more audacity than is warranted to believe that the wisdom of one generation (or the elite of one generation) is greater than and should necessarily replace the accumulated wisdom of the past.

Best wishes,

Jim Nicholas

Jul 7, 2009 - 9:00 am 122. Insufficiently Sensitive:

People do not try to escape the USA and get into Cuba, the land of ‘great medical care’.

But Americans do hop over the border to Mexico and enjoy medical services there at Mexican prices – a fraction of the inflated bill they’d receive here, if they paid it themselves.

Our system is already rigged to punish financially those who have not enlisted in some ‘insurance’ scheme, and the medics use opportunistic rates when billing the non-insured. Or perhaps it’s an attempt by the medics to recover from the mandatory limits on their billings by various insurance and HMO organizations, under influence of the benevolent Government.

Jul 7, 2009 - 9:02 am 123. Doug:

Maybe you’re better off to tell your mother to take a pill, take a painkiller.

A question for the President of the United States from the audience:

Next question.
Member of the audience.

Jane Sturm:

“My mother is now over 105.
But at 100, the doctors said to her, ‘I can’t do anything more unless you have a pacemaker.’
I said, ‘Go for it.’ She said, ‘Go for it.’

But the specialist said,
‘No, she’s too old.’
But when the other specialist saw her and saw her joy of life, he said, ‘I’m going for it.’
That was over five years ago.

My question to you is:
Outside the medical criteria for prolonging life for somebody who is elderly, is there any consideration that can be given for a certain spirit, a certain joy of living, a quality of life, or is it just a medical cutoff at a certain age?”

Obama:

“I don’t think that we can make judgments based on people’s ’spirit.’
Uh, that would be, uh, a pretty subjective decision to be making.

I think we have to have rules that, uh, say that, uh, we are going to provide good quality care for all people.

End-of-life care is one of the most difficult sets of decisions that we’re going to have to make.

But understand that those decisions are already being made in one way or another. If they’re not being made under Medicare and Medicaid, they’re being made by private insurers.

“At least we can let doctors know — and your mom know — that you know what, maybe this isn’t going to help.
Maybe you’re better off, uhh, not having the surgery, but, uhh, taking the painkiller.” ”

Do you realize how cold and heartless that answer is?
This woman is asking about her mother.

So they found a specialist:
“Maybe this woman really loves living. I’ll put it in.”

She’s lived five years with the pacemaker, and still Obama:
“Maybe you’re better off to tell your mother to take a pill, take a painkiller.”

We have to have rules!

“We have to have rules. Your mother should have died five years ago, lady.
She would have been better off taking that painkiller.”

Who says we have to have his rules?
The President of the United States is not a king.
He’s not an autocrat.
He’s not a ruler.

– Limbaugh

Jul 7, 2009 - 9:05 am 124. Doug:

“But Americans do hop over the border to Mexico and enjoy medical services there at Mexican prices ”

Sensitive:
And they often die after paying for a cure that wasn’t.

Jul 7, 2009 - 9:08 am 125. Mongoose:

JMH is right. I can also point out that the energy sector is prone to the exact same “ossification” (not to mention osbcruifications). And, no, the enegery sector was not “deregulated”, not really.

The solution is to get government out of there. Just get it out of the markets. When it is gone, things will improve.

(of course, you have to get government out of everything else too so there will be enough money in people’s pockets to make the market work.)

Health, Energy, Education–even manufacturing–are all failing sectors. What do they all have in common?

I am sure that none of this is new to JHM.

Jul 7, 2009 - 9:16 am 126. raven:

When mom can’t get her care because of “rationing”, it will put a severe focus on the Gov. who denied her. All of Gov., not just the sector that provides for health care. This thing is filled with unanticipated consequences.

Jul 7, 2009 - 9:22 am 127. peterike:

Programmer @ 100: Programmer sighs and asks, “Were you working for a major airline at the time, which shall remain nameless, but had a large scale computer system named after a large, sharp sword?”

Hah. No, not them. It was a very large company with a logo semi-affectionately referred to as “the flaming asshole” by employees. Said company was once upon a time one of best, if not THE best, exemplars of American technical know-how and innovation. Sadly, as years went on they were taken over by a gang of corporate criminals much like the Sopranos. Indeed, they were even New Jersey based. And much like the historical arc of organized crime in the US, the corporate bust-out was started by a guy with an Irish name and finished off by a couple of broads with Eye-talian names. Just a curious historical coincidence that. Though the end result was basically the same result you got when the Sopranos busted out that hardware store. Only in this case it resulted in hundreds of thousands of jobs lost, and a pre-eminent American tech icon being sold off to…. god help us… the French.

It was an arc of ruin. Much the same thing is happening now across many segments of the economy, courtesy of Mr. Obama and his gang of bust-out artists. But I digress.

Jul 7, 2009 - 9:24 am 128. peterike:

I also hear that crime is quite low in Singapore, because y’all know what to do with bad guys.

You’ve also got great restaurants, a terrific promenade along the river, everybody speaks English, and there are numerous roaming gangs of super-hot Japanese girls in very, very short skirts and very, very high heels.

I mean, I’m just saying.

Jul 7, 2009 - 9:27 am 129. Doug:

That’s why he’s the Wobbly Guy.
—
Gore likens fight against ‘climate change’ to battle with Nazis…

Jul 7, 2009 - 9:41 am 130. Peter Boston:

Mongoose

As they say, the facts are out there. Make your own decision.

Here are two modern (Post Civil War) American political history courses. If you identify an enduring political philosophy other than Progressivism that runs through this entire period then please tell me what it is.

Political Science 114B – United States Political Thinking from 1865 (syllabus)

Dr. Dominic Capeci, Jr. HST 122: History of U.S. Since 1877 (no link – available at iTunes U)

By any rational, objective standard the candidacy of Barack Obama was an absurdity. That he actually won the election with the overwhelming support of the media and academia was a bell ringer that something more significant was going on. The public display of unmitigated, genuine, visceral hatred of Sarah Palin is not explainable except as part of a zeitgeist.

I say that Progressivism is the only current political philosophy because the only political debate that takes place is about the degree of federal government intrusion into individual liberties for the common good.

If I’m wrong point me to a recent book or lecture series that seriously debunks Progressivism as a desirable way to order society.

Jul 7, 2009 - 10:12 am 131. Jonathan Rubinstein:

I do not doubt the sincerity and honor of Dr. Emmanuel but he is embarked on a fool’s errand. First of all, anyone with money will get whatever medical treatment it can afford. Currently only the rich, the poor and those who have Medicare get real treatment. The government’s agriculture and tax policies have created a food system that has contributed mightily to the ill-health of the country. Ending subsidies for sugar and corn are the first step toward a public health policy that encourages well-being. Putting a new health care system on top of this ill-fed people has to fail. We need preventive medicine not rationing as a first step. We need neighborhood health clinics that take people out of emergency rooms and provide the foundation for preventive medicine and care. We need to reform Medicare and Medicaid before anything is added. But we will have a fiasco instead.

Jul 7, 2009 - 10:18 am 132. Oh, bother:

L3 at 36 re: Offing Grandma before 11:59pm 12/31/10. That’s the first thing I thought of, with this difference: My first though was that elders might kill themselves in order to better their children (I am sure my mother would think of this). Of course, back in early Bush 43 I doubt if anyone imagined an administration that might become proactive.

Jul 7, 2009 - 10:22 am 133. Doug:

“Currently only the rich, the poor and those who have Medicare get real treatment.”
—
Untrue.

Jul 7, 2009 - 10:25 am 134. Professor Guvinoff:

Elect God? Too late! That was already done last year!

Numbers, graphs and statistics cannot really hide the main point: What happens to choice? I know, my mother used to choose for me, (and kept fighting for the priviledge longer than I could have reasonably allowed it), but should I surrender my choice to some numbers-graphs-and-statistics unionized government bureaucrat dude?

Jul 7, 2009 - 10:26 am 135. Charles:

This national review satire of the O admin is not really a satire.

Whereas Wretchard has been pointed from time to time at the ends of his pieces–the article linked to above has paragraph after paragraph of bullet points.

The piece answers the question: Why are the dems so over the top in their opposition to sarah palin and how can the pubblies return fire.

Jul 7, 2009 - 10:26 am 136. aaron:

Maybe we can “promote” this newfangled healthcare approach with a new slogan:

Eugenics, Euthnasia, And YOU.

Jul 7, 2009 - 10:26 am 137. Thomas:

I leave aside the question of what portion of the total medical care costs should properly be borne by the government and what portion should be left to the free market. Currently, the federal government does arrange payment for some medical care.

Rather, I think we should take the opportunity to address the question of how much medical care is necessary? We have assumed that more medical care is always better and that fancy expensive care is best. Very fancy, very expensive care is now possible because of recent advances in technology and the availability of electricity. But is more care always a good idea?

Must a person exhaust all possible treatments (assuming the finances)?

I find it useful to particularize an argument. Thus, for example, my cousin died recently at the age of 90. He served in the U.S. Navy in WWII, saw most of the battles in the Pacific, married a lovely lady (who died several years ago), had two children, several grandchildren, and lots of great-grandchildren, and worked as an accountant for many years. The last family gathering was Easter at his house. In the last year, he got older, more frail, and had trouble getting around. He finally got sick and spent one month in hospital, where he died. Assume that the medical staff performed the usual heroic procedures at great expense.

Let’s take several scenarios. Scenario one: He was poor. In this case, does society have an obligation to pay for the last month of heroic, ultimately futile, hospital care? I think Dr. Emmanuel’s framework allows us to think about triage and allocating scarce resources. Some things was can afford and some things we can’t. We could choose to merely undertake payment for palliative care.

Scenario two: My cousin was always prudent with his money, could afford to pay for anything he wanted, and he wants fancy treatments. In Canada, we say tough luck, you may only pay for those things we approve of.

Scenario three. My cousin was always prudent with his money, and wants to go live at home. Should we allow him to refuse medical treatment? I know that in his position, I would refuse even to go to the hospital out of fear that they wouldn’t let me leave until I was dead.

Jul 7, 2009 - 10:51 am 138. Gerald P. Hanner:

I’m sure that Dr. Emmanuel knows the oldest in the population require the most medical care. That’s one of the reasons why Medicare has seen such a cost runup (not to mention advancing medical technology and that if something is seen to be free people will take more or it). His system sounds so egalitarian, but I’ll guarantee you that anyone in a position of power will see to it that their loved ones are given the care they need/demand rather that meekly following the diktats of “we.”

Jul 7, 2009 - 10:52 am 139. Papabear:

Fletcher: The advantage of the market-based solution is that if there is an increase in demand for medical services which bids up prices, the medical providers get the money. This provides an incentive for an increase in capacity (docs and nurses working longer hours, and people returning from retirement).

In a “connections”-based solution, where you have to pay money under the table to a politician or bureaucrat to get prompt treatment, the incentive to the political class is to REDUCE medical capacity, since doing so increases the bribes to get to the head of the line.

Jul 7, 2009 - 10:52 am 140. buddy larsen:

L3, would you happen to have a website where you might have maintained a compendium of your Belmont comments re the topic here?

Jul 7, 2009 - 11:03 am 141. Roderick Reilly:

Wow, how creepy are the Emanuel brothers? Antiseptic, insectoid uber-geeks. Toss in the likes of Peter Singer the “Bioethicist” (Orwellian overkill there) and that montrous, officious old lady in the UK who suggested that Alzheimer patients commit suicide for the good of us all, and we’ve got quite a ghoulish collection, haven’t we?

Jul 7, 2009 - 11:18 am 142. Pascal:

Update and warning.

In the video I provided at post 105, the man who made the charges against Dr. Emanual an his health care plan is, according to Wiki:
“Anton ‘Tony’ Chaitkin is an author, historian and political activist with the LaRouche movement. He serves as History Editor for Executive Intelligence Review.”

Because of this I bet that health care proponents are considering ways of connecting all opponents to LaRouche. That includes us skeptics here at Belmont Club.

MSM, even without an excuse, is ready to treat all opposition as loony.

Jul 7, 2009 - 11:25 am 143. Marty:

Ignoring the question we often posed in my youth, “Who made you God?”, this all begs the larger question of how big is the overall budget, ion competition with everything else the govt funds? Or, even if one accepts the scheme and the curve in the figure that wretchard reproduces, what are the actual values on the Y-axis, and what is the REAL as opposed to conceptual height of the line at each point?

This is all a bunch of highfalutin’ balderdash, the reality will be in the details of what procedures are allowed under what conditions.

I see nothing to recommend this over the free market where one’s income is a product of the value of services one provides to others, and one’s wealth is a function of the value of services provided in the past (also, by one’s ancestors) moderated by frugality and successful investments. And, where one can use those resources as one wishes including for an elderly parent or a newborn who would rate low on the proposed schema.

What makes this proposal any better than that? Arguably, what I am posing is better because wealth or resources is a good surrogate for the person’s social value and the overall well-being of society.

Not that I am suggesting something that extreme, I do believe we owe some care to everyone including those who have no other resources, but I object to teh idea that what is put forth in this article is particularly moral or well-conceived.

And you can’t get away from teh fact that it is from a not very distinguished relative of an insider—how very Chicago.

Jul 7, 2009 - 11:25 am 144. Lifeofthemind:

John McCain just released a statement on Twitter that condemned the Honduran Zelaya for violating his countries Constitution.

This is something.

Jul 7, 2009 - 11:39 am 145. Charles:

ANCHORAGE, Alaska – Sarah Palin says she’s not a quitter, she’s a fighter — but adds that, politically speaking, “if I die, I die. So be it.”

–Sarah is bible literate

Esther 4:16
Go, gather together all the Jews who are in Susa, and fast for me. Do not eat or drink for three days, night or day. I and my maids will fast as you do. When this is done, I will go to the king, even though it is against the law. And if I perish, I perish.”

Jul 7, 2009 - 11:45 am 146. Joe-Margate, FL.:

Healthcare is man-made. The only one with a right to the man-made is the man who made it. If the preamble to the Declaration of Independence and the preamble to the US Constitution are to mean anything at all, it must be left to the healthcare provider how he wishes to put his skill to use.

The first poster on this comments thread hopes that there are enough votes to stop Obamacare. It is sad that our society has succum to the idea that one’s personal skills/profession and how they’re put to use can become the subject of a vote in the land of the free. This, of course, means we really aren’t free are we?

Jul 7, 2009 - 11:47 am 147. JMH:

What makes this proposal any better than that? Arguably, what I am posing is better because wealth or resources is a good surrogate for the person’s social value and the overall well-being of society.

Ever since craftsmen and merchants broke the feudal stranglehold on absolute power and made a middle class of prosperous freeholders possible, the Aristocracy (including the wannabe aristocrats) have been bitching and moaning about the evils of money. But every single “evil” associated with weath and the pursuit of it is also found, often to a worse degree, in every single system proposed to replace one that allocates resources based on wealth. And most of the other systems add their own unique evils that money doesn’t have (e.g. money may be heartless, but it isn’t intentionally cruel. Nazism proved to be both).

Funny, because money is in reality the very things so many Leftists claim to aspire to. It is absolutely colorblind, tolerant and egalitarian. Money doesn’t care who you are, where you were born, or what religious beliefs you have. It is a profoundly neutral arbitor of resources. It is democratic in that it always tries to flow towards those people providing the most good as judged in multiple continuous resolutions by their fellow members of society. It is, of course, subject to manipulation by unscupulous people, but unlike physical force or physical real estate, it tends to escape their grasp, avoids being horded, and is not a zero-sum game.

But Leftists hate it, hate it because in reality they are not egalitarian, tolerant or democratic. Leftists of all stripes are authoritarians at heart. Control freaks. They hate money because it refuses to acknowledge them as inherently superior beings. As Nobles. It doesn’t defer to them.

Jul 7, 2009 - 12:01 pm 148. Mongoose:

P. Boston: Did you read what i wrote? Please address those points.

I am not really interested in what some academic (at UCLA no less) “thinks” about this for I already know. I am talking about the actual history, not revisionist “progressive” cant. You can rest assured that these people want to pull the wool over your eyes. Think for yourself. As you say, the evidence is out there, and in copious (and bloody) amounts. Go ask Twobyfour about it.

I think that this is your problem: You imagine that a course like this will tell you the truth. This course is designed to obscure the truth. And BWT, A course syllabus is not “evidence”. Don’t be silly. This is just someone’s opinions. You repeating them does not make them true either. You have academic tunnel vision.

Please answer my points, do not steer me of to someone at UCLA, for Pete’s sake.
If you expect a UCLA professor to put forth any notion other than American has always been “progressive” then you are exceedingly naive. If he would have taught a course like that in 1948 he most likely would have been under investigation. How could “progressivsim” be the dominant ideology of modern times when this could occur?

This is is a misuse of language. This is the Rhetorical Parlor game of which I referred to above. This is a retroactive redefinition of “Progressive”. These progressive (i.e., Communist,) villains of today would have been thrown out of the country as subversives at most times in our history. They are a part of the Communist tradition and in fact their ideology was surreptitiously implanted in their forebears by KGB operatives in the 1920’s and the 1930’s.

I do not know what to say, if you think that this is an argument, then we cannot proceed. It is just silly. It is not argumentation all. It is not evidence, or, if it is, it is only evidence of the Leftist cant they teach in academia, and little more.

As for Obamas election, I will note that concurency or sequence are not proof of causality. Furthermore, I can use your argment against you: In the post-war years three American Presidents who were not progressive, Ike, Reagan and GWB, held two terms, and and another GOP president, Nixon, also was elected twice. Now Nixon is problematic given his price control support, but I will posit that this fault was due more to polticial exigencies rather than anything remotely resembling progressivsim, and assuredly he was not one in the modern sense. He was a righteous Cold Warrior and was reviled by “progressives” from the moment he first appeared on the political stage. I am not really sure that we can call Trumann a progressive either, and we most certainly cannot call him one in the current sense of the term.

Against this we have Wallace being beaten out by Truman, JFK, LBJ, McGovern roundly defeated, Carter and Clinton, and only one of which served out more than one terms after elected. Now JFK is problematic, but that was an extremely close election, and it is pretty much accepted that the Daly machine stole it for him. We can throw out Clinton, for the simple fact that during his term the GOP took over congress for the first time since Ike. On top of that, Perot, a decidedly non-progressive character if there ever was one, split the vote. Clinton campaigned as a New Democrat, which we were told was a sort of Conservative Democrat, though nobody with half a brain could ever figure out just what a New Democrat was. Turns out that they were just Old Democrats but they had to pretend otherwise. Carter, well we all know about how reviled he was and how he was soundly thrashed. And let us not bring up Dukakis, Boy did that hurt.
Obama himself had to pose as a centrist. I rather doubt that if the election were held today that Obama would win.

I will also point out the T. Roosevelt did not have a lot of luck with his third party.

So presidential elections surely do not prove your point. In fact, up until recently, the direction was going the other way.

They show an electorate that can be duped for a while by progressives, but when they get a gander of them close up, they vote conservative.

Again you have this amorphous definition of “progressiveness” that really is a bit intellectually dishonest. It is so broad as to be meaningless. Let me repeat myself.

And I must say, you seem to be taking every bourgeois social or political movement of the last 200 years and cloaking it in the mantle of “Progressivism”. This will not do. Progressivism today as a term is merely a cover for Communism of various stripes. However misguided T. Roosevelt was, he was hardly a Collectivist, and his “movement” was really just a minor heretical wing of Classical Liberalism. Soon after he was out of the way, the Bolsheviks co-opted that “movement” and preverted it into a cover for a radically different ideology. Moreover, the pragmatic regard for material progress that was (and is) a major part of Classical Liberalism has little to do with “Progressivism”.
You seem to be engaging in parlor tricks in your definition of “Progressivism”.
These words all have historical meaning, if you want to come up wth your own notions and put that label on them you should say so.

It simply will not do to unite Hitler, Stalin, Tojo, Pol Pot or a third world Marxist like Obama with T. Roosevelt or McKinley under the banner of progressivism. And, no, there is not such thing as right wing collectivism; Fascism is of the left, the notion that it was not was just a lie pushed by Stalin’s propganda machine. There is certainly no tradition in the USA of this, no matter what you call it.

Your thesis, and it is nothing more than that, is just revisionist nonsense coming out of some academics, and it certainly seem to have had its desired effects on you.

The dominant political force in the 19th and 20th century has been good old pragmatic Liberal Capitalism, supported by the political, moral, intellectual and religious culture of Western Civilization. It was this force that tamed the West, built the industrial might of the USA, defeated Hitler, won the cold war, liberated E. Europe and that is responsible for the great wealth creation of the 19th and 20th century.

It was so powerful a force that it could tolerate the idiotic parasite of “progressivism” within it and still prosper. It is the decision to move towards it that has moved nations like India and China into what prosperity they now enjoy today. The historical plight we are in now is due to many forces, only one of them being the emergence of an elite steeped in progressivism (again, read Communism). That is just the point, they are now introducing this as the dominant force, not reasserting it as the dominant force. It is Collectivism that is the “innovation” in American political life not Liberal Capitalism.

Nothing could be clearer. I challenge you to prove otherwise.

Teachers like this want you to think otherwise. You should ask why they want you to do this.

Jul 7, 2009 - 12:02 pm 149. buddy larsen:

The best short explanation of the issue that I have yet saw!

Jul 7, 2009 - 12:04 pm 150. LFMayor:

We can be free again, just have to read the playbook that they left from the first time.
See to your necessities. If you’ve already seen to them, see to some more.
It doesn’t sound quite so crazy as it did a few months ago, just like RoboHobo mentioned earlier, now does it?

Jul 7, 2009 - 12:05 pm 151. NateTheGrate:

The graph is already very negative for small values of age in the negative 1 to 9 month range.

Jul 7, 2009 - 12:34 pm 152. Roderick Reilly:

Pardon my simplistic naivetee for even bringing up the Declaration of Independence, but it does say that we have a right to life, plain and simple. Any system that mandates that some innocents must die at the behest of the government has violated our founding document.

Jul 7, 2009 - 12:44 pm 153. joe buzz:

Is it my monitor or does the red line not originate on the Y axis?
So a 25yo has roughly twice the probability of “receiving an intervention” than a 6 or 8 year old. How wonderful.

Jul 7, 2009 - 1:00 pm 154. Mongoose:

P Boston:

If I’m wrong point me to a recent book or lecture series that seriously debunks Progressivism as a desirable way to order society.

Go the the Heritage foundation. Go to thousands of Conservative Web sites.

If you really need to read a book go read Hayek, or Burke or any of the thousands of writers of the political, moral and economic philosophies of our traditions. How you get the notion that either Liberal Capitalism or Conservatism as not spoken about itself all these centuries is beyond me.

But I have to ask, did you miss the last 30 years of the culture wars in this country? Did you miss the Cold war?
The conservative movement has set forth one of the most articulate and comprehensive expressions of their point of view, complete with historical grounding, that this nation has ever seen. They have had too, given the assaults the left makes upon the truth. And their work is not filled with revisionist nonsense and pseudo-intellectual deconstructionist cant either. Did you miss all the brouhaha surrounding the creation of all those Conservative think thanks in the 1970’s and the 1980’s. The Progs were livid. Even though they had every other Liberal Arts department in the country captive, they still thought it unfair and set up their own.

In fact Obama’s backer’s successes has been in part from imitating the institutions of the Reagan Revolution and applying them to the internet.

I find this extremely odd:

If I’m wrong point me to a recent book or lecture series that seriously debunks Progressivism as a desirable way to order society.

You require these matters in order to debunk “Progressivism”? Why?
And why “a recent one”?

But it is beside the point, your point was that it was the dominant political force in American history, or at least the last 100 years. What does debunking it as an ideology have to do with that assertion?

But since progressivism has, as I pointed out, murdered hundreds of millions of people, and blighted many more hundreds of millions of lives, why do you need a “lecture series” to understand that it is a wholly “undesirable way to order society”. Just pick up a history book–try one not written by a progressive.

I must say your very construct though is troubling. It is not the governments business to “order society”. Individuals order society through their interactions with other people, including elections. It is governments business to see that the individual’s rights are protected in the process. Government is a product of society and not the other way around, or at least it is in the Classical Liberal tradition. This is, famously, just what is wrong with “progressivism”, or, to use a clearer term, “Collectivism”, and it is why it has been rejected for most of American history.

Your problem is that you are thinking along ideological lines. Capitalism is not a ideology, it is a resource management technique.

The West is a confluence of thought and practice, most particularly in the Anglosphere. It is the meeting of these matters that constitutes Liberal capitalism’s success. It is not a totalitarian ideology in either the historical political sense, or in the philosophical sense. It does not attempt to explain or order all things. It is not an “ideology” in the same sense as socialism. It is a collection of principles and practices, and in our case, they are encoded into law.

Jul 7, 2009 - 1:13 pm 155. RWE:

Does this remind ya’ll of THX1138, where the guy is chased for not taking his medications and then let go when the “pursuit funds allocated depleted” light goes on in the chase car?

Why would not this same mentality apply it to everything? A kid falls down a well – too bad it’s gonna cost too much to rescue him. Troops are under enemy fire – too bad, it will cost too much to rescue them. “Never leave a man behind” becomes “Unless it costs more than $63.48″. And why, if you have withheld health care for the elderly would you keep paying for their food?

Food is more important than health care to staying alive, so why don’t we have a Medifood program, too? And how would this same logic apply to it?

They can’t ever explain where they are going to stop – that is why it is collectively called “progressive” thinking – because they are not.

Jul 7, 2009 - 1:21 pm 156. buddy larsen:

RWE is right –”progress” means what? “Progress” toward what? What is “progress” leaving behind?

Also, RWE, if MediFood is good, so is MediShelter. Some places are healthier than others. What right do the people who live there have to more health than the people who don’t live there?

Many union bosses, for example, are in need of beachfront or mountaintop villas, due to having done all that time in the smog on the picket lines (even if they didn’t, they did). The state should take care of this, as it did in Stalin’s time over in the Worker’s Paradise.

Jul 7, 2009 - 1:32 pm 157. peterike:

Food is more important than health care to staying alive, so why don’t we have a Medifood program, too?

Because even Obama can’t do everything at once. Almost, but not quite. And the Left has softened the battlefield around health care for decades, to the point where loads of people will parrot “healthcare is a right.” They haven’t done so for food.

They will though. Low hanging fruit first. Then the branches. Then the tree. Then the orchard.

Jul 7, 2009 - 1:41 pm 158. Brooks:

Buddy @ 149:

Want to bet that these benighted creatures are graduates of unionized public schools?

Jul 7, 2009 - 1:44 pm 159. Jamie Irons:

RWE (#155);

With your permission I am going to memorize and use that comment in discussions with friends.

Brilliant. Concise, grounded in plain speech, and supremely forceful.

Jamie Irons

Jul 7, 2009 - 1:52 pm 160. JMH:

Buddy @ 149:

Want to bet that these benighted creatures are graduates of unionized public schools?

Grumpy (on the left, as opposed to Ditzy on the right) probably teaches at one.

Jul 7, 2009 - 1:54 pm 161. buddy larsen:

If you turn around and go back in the other direction, aren’t you still making progress? If you don’t turn around, but just start walking backwards, aren’t you still making progress? So really, what it means in “the movement” is not the true meaning of closing the distance between you and your destination, but rather, closing the distance between you and *their* destination. As usual with them, the word is used to complicate, not clarify.

Keep twisting words long enough, and the Word itself –humankind’s signal accomplishment –becomes “questionable”.

Does the destination matter? What if a Progressive of 1914 had no intention of progressing to a Stalinist of 1937? If he didn’t, then all that a ‘progressive’ can be is reduced to ‘one who is moving through time’. Or, simply, ‘time passes’. And as we all know, time flies Like an arrow, but fruit flies like a banana.

((JMH, whatcha wanna bet as soon as the camera moved off, Grumpy started chasing Ditzy around that tree, flailing away at her “You Idiot, Do Not Talk to Capitalist Running Dogs!”))

Jul 7, 2009 - 2:02 pm 162. Norm:

#147, JMH: Ayn Rand condensed.

Jul 7, 2009 - 2:03 pm 163. buddy larsen:

i swear to goodness, i just saw, on the Fox Business channel, an ad — a high production-value ad that appears to’ve purchased a Disney license (voice-over a Cinderella clip, i think, was only half registering until the close), touting booster seats for the tykes. The close, which got my eye, was ” For more information, visit us at boosterseat.gov ”

I ain’t kiddin’

soon we’ll be hearing –voiceover expensive television productions –stirring speeches about spoon safety

Jul 7, 2009 - 2:23 pm 164. James:

As a previous poster said, this is a somewhat typical approach to rationing of healthcare which is needed in a government run system and to a certain extent used by HMO’s as well. There are certainly worse systems in place.

There is no doubt here that someone is playing God disguising himself as rational and objective. Is it better to have an amoral system or an immoral system where someone is making the choice, and where the choice is clearly being made on who pays taxes.

What I continually find frustrating in these discussions is the lack of basic economics. If we talk about “who pays” and leave the whole system unchanged, then costs will never go down and choice will continue to diminish.

The laws of economics say that price goes up if demand increases and supply remains the same or is controlled. We know that in an advanced society the demand for better health care will increase.

The answer is to increase supply; and that means to destroy the health care monopolies and tort reform. Why for instance do we need a doctor for most now prescription drugs? Why can’t a second tier health worker tell us we have a cold. Why aren’t there more doctors available. Why aren’t doctors protected from tort lawyers?

Jul 7, 2009 - 2:24 pm 165. RWE:

Jamie #159:

Sure, glad you liked it.

But you don’t need my permission. The Medifood part is not original to me. Rush Limbaugh asks that question all the time. And John Stossell even did a piece of health care where he went into a grocery store and said “Hey! Suppose everythig here was paid for by the government? What would you put in your basket?”

They have had food stamp programs for decades. But the new health care plan is like putting EVERYONE on food stamps to make sure that NO ONE eats better than the rest of the people.

Reducto ad absurdum is sometimes the best way to respond to Progresso ad absurdum.

Jul 7, 2009 - 2:26 pm 166. RWE:

Buddy #163:

A product of Obama’s Booster Seat Czar, perhaps?

Jul 7, 2009 - 2:28 pm 167. Leo Linbeck III:

Buddy,

Sorry, no website. I just don’t have the time to try to maintain one. Years ago had a blogger site, but it was too much trouble.

The great thing about BC is that W churns out great stuff on a regular basis, and I can contribute when I have a spare moment. No pressure to do regular updates to keep the audience engaged. Even if I had nothing else to do, I doubt I could do better than our esteemed host. I’m a big believer in using what works, and building on it. I guess that’s why I like business, as opposed to more contemplative or academic pursuits. I respect those vocations, they’re just not why God plopped me down here, methinks.

I do wish that the PJM site had search tools that could search comments. Sometimes I wish I could remember what I wrote, so that I can argue with myself. In my spare time.

Oh, and while we’re at it, what about MediGuinness? That’s what we need from our government, lads.

Cheers,
L3

Jul 7, 2009 - 2:46 pm 168. Artofnoise:

Google will return searches in PJM comments.
Give it a day or two and they are all there.

Jul 7, 2009 - 3:42 pm 169. buddy larsen:

…and MediLullaby, for those restless nights when we feel we need a change. I wouldn’t need it of course –i already sleep like a baby –wake up crying every two hours.

Jul 7, 2009 - 3:44 pm 170. RWE:

Hey! Don’t get me wrong. Medifood is a bad idea, they are not all bad!

MediShoelaces, for example. I need some new ones bad.

Then there is MediSex and its associated national agency, AmPorn. There would have to be National female draft for that, of course.

And Leo, I think that the MediGuiness program could best be adminstered by MediHooters. Come to think of it, MediSex could be adminstered by MediHooters as well.

And don’t forget the basis for all our freedoms, Medigun and AmAmmo.

Did you hear that they have invented a way to stop AIDS from spreading? A new Federal Goverment agency will be created to distribute it on an equitable basis.

Jul 7, 2009 - 4:15 pm 171. Leo Linbeck III:

RWE,

MediHooters – excellent idea. They have great MediWings.

So, would government-provided transcendental meditation be MediUm?

Would all house paint be provided free by Washington? If so, it would have to be one color: MediOcre. [Ed: isn't the color spelled "ochre"? Yes, but a Belmont Club poster should be allowed a little poetic license, right?]

And let’s not forget that most important organ of the state, the MediA.

The possibilities are so exciting!!!

Cheers,
L3

Jul 7, 2009 - 4:44 pm 172. MarkJ:

Dr. Emanuel’s rationing article shows all the sensitivity and nuanced thought of the “Selektion” process at Auschwitz.

Jul 7, 2009 - 5:48 pm 173. bogie wheel:

Maybe we can “promote” this newfangled healthcare approach with a new slogan:

Eugenics, Euthnasia, And YOU.

Slogans are good. I have found
a poster for the occasion, too.

Jul 7, 2009 - 6:42 pm 174. MTL:

Is our society fighting a pyrrhic war with all the resources we put towards medicine?

One overarching theme within medicine is its progress and the increased cost of that progress. As opposed to other areas of our society where the costs have not exploded as much. For example, the cost of a nice dinner back in the 70s probably wasn’t all that different from a nice dinner now when adjusted for inflation. But the cost of taking care of a heart attack now vs the 70s is orders of magnitude more. Undeniably, there have been huge improvements, however we are starting to reach the limits of diminishing returns with medical technology (unless something comes along and completely changes the way we do things). The biggest bang for our buck came when we figured out to give people with heart disease aspirin. Now, we spend tons of money on cardiac stents which for all their whizbang effects are often placed for reasons that don’t actually increase lifespan.

The problem with medicine is that you’re fighting a losing battle- we all die in the end, and one of the questions that our society hasn’t answered is how much money are we willing to spend to fight that battle.

Jul 7, 2009 - 6:45 pm 175. bogie wheel:

i swear to goodness, i just saw, on the Fox Business channel, an ad — a high production-value ad that appears to’ve purchased a Disney license (voice-over a Cinderella clip, i think,

Are you sure it wasn’t Mary Poppins?

We are talking NANNY state, after all! (*rim shot*)

Jul 7, 2009 - 6:45 pm 176. Occam's Taser:

I say we vote to accept any system that requires Congress and all government employees to be treated exactly as the rest of us.

Jul 7, 2009 - 7:46 pm 177. Bob Smith:

You don’t have the money for medical treatment, in a purely market-driven system? You don’t still get medicine. You get dead.

That assumes an absence of charity. I know why the left assumes that: they are notoriously stingy at giving to charity, so they assume everybody else is too.

Dr Emanuel states “social value allocation must not legislate socially conventional mainstream values”.

When did “mainstream values” become pariah? One wonders what values Dr Emanual thinks should be promoted by “social value allocation”.

Jul 7, 2009 - 8:43 pm 178. buddy larsen:

well bogie i’m sure i half-saw hosses and carriage with a princess inside –i wasn’t really watching until that BOOSTER SEATS DOT GOV bolted me upright.

Bob, the reason they so suck at charity is they’e giving all their donations to 527 groups. Really –no joke.

Jul 7, 2009 - 8:58 pm 179. Fat Man:

This sort of theorizing is the sort of thing that liberals love to do. They love to sit down with a clean sheet of paper and say: “If I ran the zoo … “.

In fact it is completely pointless. Our existing health care institutions are well rooted. They occupy a huge chunk of social, physical, economic, and intellectual space. They (i.e. the people who are the institutions) will not dry and blow away. They will fight any attempt to change their ways, and they are likely to succeed.

“Annals of Public Policy: Getting There from Here: How should Obama reform health care?” by Atul Gawande in New Yorker on January 26, 2009 is a worthwhile read. He points out that other countries have not in fact gotten to their health care systems by clean sheet design. The British system arose out of the nationalization of health care during WWII.

When we realize this and we set out to identify, and solve, one problem at a time, we may have some success. Before that, not so much.

Jul 7, 2009 - 9:27 pm 180. buddy larsen:

there’s only 8 million who need help –the other of that 47 mm number are just baggage off a CBO gross number. This is well-known. ok, one problem at a time, tweak the tax system to make it level for self-insured people, make policies portable across state lines, and do something about the some 2000 mandates that insurance premiums must pay for. Cut down the junk, it’s expensive as hell and three quarters of it is just idiocy.

Three tweaks are we’re done. without any Gestapo clinics.

Jul 7, 2009 - 9:50 pm 181. RCM:

#113 Marcus Aurelius

Thank you, I missed that episode. And in the “perfect world” of your story’s ending, payback is cynically sweet!

It is amazing the bits ‘n’ pieces we are able to assemble here, and improve greatly the (my) calculated sting of “the rest of the story.” Yours is the cherry, on top!

Jul 7, 2009 - 10:29 pm 182. Mad Fiddler:

Mongoose sez: “Lately, the very high quality of Wretchard’s postings and the ensuing discussions have pushed out the ignorant and the silly.”

Not so. I’m just reading and thinking.

Jul 7, 2009 - 10:33 pm 183. JMH:

Three tweaks are we’re done. without any Gestapo clinics

Buddy, my dear fellow. Have you learned nothing from Herr Doktor’s brother Rahm? We must not let a good crisis go to waste. ja? What problem do your dri little tweaks solve if they do not create any Gestapo clinics? Surely no problems that concern The One.

Jul 7, 2009 - 10:36 pm 184. buddy larsen:

Jawohl, herr Obersturmbannfuhrer! I…I…do not know…what came over me. It will not happen again, mein Obersturmbannfuhrer!

Jul 8, 2009 - 4:38 am 185. Roderick Reilly:

“”"”“Lately, the very high quality of Wretchard’s postings and the ensuing discussions have pushed out the ignorant and the silly.””"”"

Mongoose: I’m doing like Mad Fiddler. I have not been pushed out.

Jul 8, 2009 - 8:22 am 186. Roderick Reilly:

“”"”I swear to goodness, i just saw, on the Fox Business channel, an ad — a high production-value ad that appears to’ve purchased a Disney license (voice-over a Cinderella clip, i think, was only half registering until the close), touting booster seats for the tykes.”"”"”"

Buddy: I see that ad all the time. The most obnoxious aspect of it is the new “4 ft. 9 in” tall mandate for the upper height limit of who should be in a child seat. Shawn Johnson, the 17 year-old Olympic gold medal gymnast, would have to be in a child seat if she’s a car passenger. Many slow-growing 12 and 13 year-olds would have to be in kiddie seats. It’s so stupid and so contrary to the proper way to bring up a child as to make steam come out of my ears.

Jul 8, 2009 - 8:32 am 187. Pascal:

Reilly.

Let’s not forget that this halfast mandate was made necessary by the halfasity of the air bag mandate which preceded it. It was the logical consequence; deemed needed to protect air bag thinking. It was implemented because the bureaucrat’s plea of “amend it, don’t end it” near always succeeds. And so here we are.

This should be seen to be typical of Progressive incremental-ism in that it demonstrates the Rube Goldberg route to total statism, where everybody must be constrained in order to protect everybody else from any consequence of leaving them free.

Jul 8, 2009 - 9:13 am 188. Barry 0351:

when some minor bureacrat in the local system tells your suffering mom to go home and take a painkiller then you will understand what National Healthcare means, Deny, delay till you die.

Jul 8, 2009 - 9:31 am 189. tomw:

Well, I guess the old “It is for the children..” will no longer work, no?

I see a possibility of a negative Y-axis value: You get to donate your kidneys, liver, and arteries/veins for grafts before they give you that last shot of Morphine to ’stop the pain’ (and also the breathing..). Heart and lungs, corneas, etc left for post-mortem harvest. And profit. How many bars of goldLatinum …

All men are equal, it is just that some are more equal than others…
tom

Jul 8, 2009 - 9:53 am 190. Pascal:

Ok, I have now followed through on Wretchard’s request in a comment on another thread. Spread the news on our own threads.

I reduced this story down to a subsequent question and a few words of expansion on the consequences of this story. If you would do me the honor of reading And So, What’s the Consequence of Being Deemed Unuseful? it will encourage me.

Perhaps you might pose a similar question to those you know. I think it could spur a grassroots movement that can’t be beat.

Jul 8, 2009 - 10:06 am 191. Artofnoise:

Soylent Green seems apropos for some reason.
Even the name is apropos.
The ultimate recycling event.
I would guess 15% of Americans and Europeans would endorse it.

Jul 9, 2009 - 7:35 am 192. Pascal:

Art, Organ harvesting made it passé.

“Progressive” thought has moved on from “Soylent Green” to “Coma” to “Death Becomes Her.” All that advanced under the influence of “Night of the Living Dead.”

As to 15% of Americans and Europeans endorsing it, I pray it is that small, but there’s cause to doubt it. Recipients of “donated” organs may be too ready to accept a conscience numbing story as to the origin of their new body part. A scraping of the organ and DNA test could verify the story’s veracity. Could their life extension be the product of far Eastern notoriety? Uh, STFU.

Bottom line: “Soylent Green seems apropos for some reason” because cannibalism is not strictly a gastronomic experience any more.

Jul 9, 2009 - 8:49 am 193. buddy larsen:

…because cannibalism is not strictly a gastronomic experience any more.

True, because God –or gods, or religion –forbade it (or was made to forbid it, perhaps by elders eyeing the sharp-toothed young around the clan campfire). But now that God and all that is banished from so many precincts, how long before our half-million years of barbarism swallow up our last few thousand of civilization?

Take a look at this essay on stone age genocide.

Jul 9, 2009 - 1:52 pm 194. buddy larsen:

That is, if we let it.

Jul 9, 2009 - 9:27 pm 195. keaner:

Whatever form nationalized healthcare implementation in the US will take, it certainly won’t be the opportunity for the gov’t to ‘control our lives’ and ‘take all of my money taking care of freeloaders’…

The hyperbole is a mile thick in here. The system in place now is, best case, broken. In reality, the system is barbaric. It excludes tens of millions of citizens and exists not to provide comfort but profit.

Change must come and there are many models in existance that provide far superior coverage to it’s citizens than the US system provides now. My model, the Canadian one, while it has flaws is a wonderful thing. While I may pay more taxes, I know that now matter whether I have a job making 250k a yr or am broke and penniless, if my family ever needs care they will get it…and it won’t cost me anything.

Jul 10, 2009 - 12:12 pm

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