About Those Obama Medical Death Squads...

Health care reform may be the topic topic of the day/week/month, but we've really barely scratched the surface of all the weirdness that will come out when people start hashing out the details (and it's all pretty much details). Frequent Hit & Run commenter and blogger Alan Vanneman responds to the response to comments by Dr. Ezekiel Emanuel, brother to Rahm and a health-care advisor to the prez in his own right. Emanuel is in the spotlight for having written in the past about questioning treatment for folks with chronic conditions. Conservatives, particularly former New York Lt. Gov. Betsy McCaughey in a New York Post op-ed, says that Emanuel and those around him propose to cut health-care costs by ending treatment for whole swaths of folks. Liberal defenders of the doctor say he was only philosophizing on various topics and that his past thoughts on the matter can't be taken seriously.

Vanneman:

Dr. Emanuel goes on to say the following about this "conception of the good," which he absurdly pretends he isn't pumping for: "Substantively, it suggests services that promote the continuation of the polity-those that ensure healthy future generations, ensure development of practical reasoning skills, and ensure full and active participation by citizens in public deliberations-are to be socially guaranteed as basic. Conversely, services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia."

So why is it wrong to say that the good doctor is saying that we ought to let the demented wander the streets-if they can-unless they or someone else can pay for their health care with private funds? And the same for anyone else "irreversibly prevented from being or becoming participating citizens"? Such as a child with Down syndrome, for example? Or my brother, when he was dying of multiple sclerosis, unable to move and scarcely able to speak. He wasn't a "participating citizen," not really, and he clearly wouldn't be getting better.

In his article, Dr. Emanuel calls for "public forums that present citizens with opportunities to enter into public deliberations on social policies." Well, doc, you're in one. And if you can't stand the heat, get out of the kitchen.

Would you like to see Dr. Emanuel heading up a national panel that would determine which services "promote the continuation of the polity"? I wouldn't.

Whole thing here.

The exchange above underscores the need to maintain viable health care options beyond any sort of "public option" that will most certainly cap care based on notions of ability to "participate" in various sort of political and civic arenas (first and foremost, the ability to hector your congressman into getting your needs taken care of). If the public option goes through, and (predictably) takes over all or most of health care coverage, it will be harder and harder to escape a system that is fully determined by politics. Which is never a good development.

My two cent bet on health-care reform: At the end of the day, due to sagging polls and annoyance at all the political players involved and the resolute lack of sense of emergency among Americans for a complete overhaul of the system, we see some sort of legislation that will "cover" (finally) the 20 million to 50 million Americans who are supposedly uninsured for reasons beyond their control. It will be expensive, but not as expensive as a bigger reform and everyone will claim victory, either for passing it or defeating something worse.

Here's a simpler plan, one that could go into effect today, to cover half the nation's uninsured:

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  • Kyle Jordan||

    Is anyone else kind of awestruck by some of Emanuel's writings and ideas here? And I don't mean awestruck in a good way.

  • Spoonman||

    Kyle, yes. They're pretty mindblowing.

  • Warty||

    Ooooooooo, Whole Foods is in trouuuuuble...

    Also, this:

    "public forums that present citizens with opportunities to enter into public deliberations on social policies."

    is clearly what Team D wants. You can tell because they welcome the town hall protestors' contributions.

  • Tomcat1066||

    Always remember that Team Blue loves vigrous debate...




    ...so long as you agree with them. Team Red isn't any better though.

  • <strike>strike through</strike||

    So a prominent Jew floats a euthanasia trial balloon and gets away with it because he's a Democrat? I wonder how Pat Buchanan would fare under similar circumstances?

  • Warty||

    In other news, why do so many people give a shit that some Shriver broad died?

  • Spoonman||

    Clearly strike through is a fascist.

  • Spartacus||

    In his article, Dr. Emanuel calls for "public forums that present citizens with opportunities to enter into public deliberations on social policies." Well, doc, you're in one. And if you can't stand the heat, get out of the kitchen.



    Mr. Vanneman, that is magnificent. I hereby take back every negative thought I have ever had about your previous postings. Most of them, anyway.

  • ||

    What strikes me is the moral inversion of this: the worth of the individual's life is measured by that person's utility to the state.

    This is an essential part of the philosophy of O's initiative and is the one which is most poisonous for a truly liberal democracy - the state is in charge of evaluating the worth of it's citizens, and the end result is some are worth more than others based on what pleases the state's minions.

  • Alan Vanneman||

    OK, Spartacus, I take back all the mean jokes I've made about you on my blog. Well, most of them, anyway.

  • ||

    I still like the idea of Skynet-like hunterkiller machines with built-in diagnostic equipment flying around and eliminating the old, weak and feable minded. Of course Senators will have imbedded rfid's to avoid termination.

  • Warty||

    I have it on good authority that Alan Vanneman only resists perfunctorily when Steve Smith rapes him.

  • ||

    Actually there is something to the "academic words" defense. Having been in grad school recently, there are discussions all the time where people take things out to their logical conclusion, with the implicit understanding that the speaker doesn't necessarily advocate what they're saying.

    That said, writing something like that in a paper and assuming that the devil's advocate bit goes without saying is a foolish practice, as shown here.

  • ||

    services provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed.

    But we can still harvest their organs, can't we?

  • ||

    Ooooooooo, Whole Foods is in trouuuuuble...

    ...and where exactly are the boycotters going to go? Wal-Mart?

  • Xeones||

    Yo, fuck the Emanuel brothers.

  • ||

    In other news, why do so many people give a shit that some Shriver broad died?

    A zombie dies of natural causes and you aren't interested? Just the basic science alone could help us survive Z-War.

  • ||

    "Death Squads"?

    Sounds like a work-release program for newly freed Squeaky Fromme.

  • Fluffy||

    I would say this:

    I don't believe for one second that anyone involved in creating this bill is consciously thinking to themselves, "Let's put something in here that allows us to kill off all the old people."

    But it's not appropriate to analyze the bill using the intentions of the people writing the bill as your starting point.

    What is appropriate is to look at the bill's overall structure and say, "Assuming complete bad faith on the part of the bureaucrats who will have to implement this bill, what are the worst possible outcomes?" The reason this is appropriate is because every other bill passed into law eventually degenerates to its worst bad faith outcome.

    End of Life counseling + bureaucratic boards entitled to prioritize care + bureaucratic pressure to cut costs + "bad faith worst case outcome" = system bias towards pressuring old people to stop costing everyone so much money. That's just the way it will work itself out.

    Radley likes to post stories on this blog about police shooting dogs. When police departments sit down to write policies about police conduct while serving warrants, no one sat there thinking to themselves, "Hmmm…how can I write these policies so that assholes who are pumped to discharge their weapons will be able to finally shooting something and get away with it? I know, I'll make it OK to shoot dogs if you feel 'threatened'." That's just not what happened. What happened is that policies were crafted largely in good faith but implemented in bad faith, because all state systems are implemented in bad faith. That is what will happen with any health care policy we devise, too.

  • Ray Gardner||

    These things are worthy of debate, but even if a reasonable system of government healthcare could be worked out at this expansive level, it still doesn't justify the state having that much control over the lives of its citizens.

  • Alan Vanneman||

    Re Stacy,

    Emanuel's paper, which you can read here

    http://www.ncpa.org/pdfs/Where_Civic_Republicanism_and_Deliberative_Democracy_Meet.pdf

    is not an abstract discussion of possible "goods" and the possible implications of those goods. Rather, it's a response to the failure of the Clinton health package. What Emanuel says is that whenever we propose universal health care people say it will cost too much. So we need to figure out a way to make universal health care affordable. Here's how to do it: limit guaranteed services to those who are or who can become "participating citizens."

    He isn't advocating euthanasia, but he is advocating cutting off public funding for those who seem hopeless, according to some undefined standard for current or potential ability to "participate," whatever that would mean.

    Maybe Dr. Emanuel doesn't agree with his old position, but if so, he hasn't said so. He's just said that he's been quoted out of context. But he hasn't.

  • Xeones||

    Fluffy just explained why i'm a libertarian.

    Fluffy, you may not be a fascist after all.

  • ||

    Serious question: What ever happened to the Oregon public health experiment (many years ago) with a specific list of "approved" treatments? I remember a great hue and cry at the time about heartless rationing.

  • ||

    If you're fat, smoke, take illegal drugs, or vote Republican, you will be denied ☺

  • <strike>strike through</strike||

    He isn't advocating euthanasia, but he is advocating cutting off public funding for those who seem hopeless

    Indeed. Euthanasia needn't be instantaneous to be ultimately successful. Withhold treatment through rationing and long waiting periods and voilà, dead people! This subtlety is lost on the left.

  • TallDave||

    Right, we're not supposed to believe Emanuel's policy musings, just like we're not supposed to believe Barack's own words: "I would like to see us move to a single-payer system."

    It's stunning watching Obama tell an enormous number of untruths, ranging from significant exaggerations to baldfaced lies (you won't lose your health insurance or your doctor, Medicare won't be cut, greedy doctors want to take your tonsils, the AARP has endorsed this plan, greedy doctors charge $50k for a leg amputation, we didn't make a deal with the drug companies, our plan will reduce costs, there won't be rationing, there are no death panels, I never said I wanted a single payers system) and then aggressively accuse his critics of dishonesty.

    The mind boggles.

  • TallDave||

    He isn't advocating euthanasia, but he is advocating cutting off public funding for those who seem hopeless, according to some undefined standard for current or potential ability to "participate," whatever that would mean.

    THis is worse than euthanasia. Instead of a quick painless death, this is often mandating a slow painful death.

  • proud libitard||

    No, Xeones he's a racist Nazi...You're the fascist!

  • ||

    I have been thinking about "end of life" costs people keep talking about. There is the very deceiving statistic about how most of a person's health care costs coming in the last year of life and most healthcare costs in general come in the last year of life. People use this figures to imply that all of our healthcare costs are the result of giving hopeless treatment. That doesn't make any sense when you think about it. This is a very disingenuous statement. Literally it is true. Of course most of your medical care comes in your last year of life; that is when you are sick. If I am in a car crash and they spend $50,000 trying to get me to the hospital via life flight and I end up dying shortly after arriving, that 50K is end of life care. How does anyone plan to cut that cost?

    The raw number is deceiving because it implies that all of the care given in the last year of life is obviously useless at the time it is given. We only know it was useless because the person died. At the time it was given, it didn't seem useless at all. To give you another example; my mother died of cancer after just over a year of illness. All of that treatment was given in the "last year of life" and falls into the figures. Of course, when she found out she had the cancer; she had a decent chance of beating it. And she almost did. At the time it seemed a good bet. Indeed, I am sure that for every person who faced my mother's diagnosis and like her did not make it there was at least one other person who did. I would hazard to say that a lot or even most of the expenses in the last year of someone's life are just like my mother's expenses, i.e. we didn't know they were going to be useless until after they didn't work.

    It is not going to be so easy to "cut benefits" by curtailing end of life costs. Generally speaking, you don't know when the costs are incurred which costs are going to be end of life costs and which costs are going to be life saving costs. My fear and I am sure a lot of other's fear is that the smug and self assured health "experts" of the world are going to come down from on high and decided what is end of life and useless care and what is not and end up killing a lot of people.

  • <strike>strike through</strike||

    When you've demonstrated a talent for getting away with all the little lies, taking a shot at the Big Lie is very tempting. That's what Herr Obama is doing now. He's going after the brass ring.

  • TallDave||

    this is often mandating a slow painful death.

    Also fun to point out: this kind of treatment would be very illegal... if appplied to terrorists.

  • Rich||

    What is appropriate is to look at the bill's overall structure and say, "Assuming complete bad faith on the part of the bureaucrats who will have to implement this bill, what are the worst possible outcomes?"

    I believe you've determined why congresscreatures don't read the legislation: plausible deniability.

    Seriously, Fluffy, well said.

  • Spoonman||

    John, that is a good point that has been entirely left out of the discussion.

  • hmm||

    The brothers grimm are a scary bunch. You have the "bag man" and the "dr. evil." It's like a comic book.

  • Barry-O the ASL Ape (transcrib||

    BARRY-O LOVE KILL WRINKLE MAN WRINKLE WOMAN

    SAD SAD FAMILY BARRY-O HAPPY BANANA

  • ||

    John,

    I'll play devils advocate for a minute. People who survive after getting a year of expensive medical care would ipso facto NOT have most of their medical expenses coming during the last year of life (since they would die at a later time). So we would expect the effect of such occurrences to show up in the statistics if they were common.

  • ||

    Euthanasia needn't be instantaneous to be ultimately successful. Withhold treatment through rationing and long waiting periods and voilà, dead people!

    I prefer to visualize special teams of masked medical "technicians" roaming the halls of old age homes, clubbing helpless little grannies in their beds like baby seals.

  • TallDave||

    If I am in a car crash and they spend $50,000 trying to get me to the hospital via life flight and I end up dying shortly after arriving, that 50K is end of life care. How does anyone plan to cut that cost?

    Before they call the hospital, an expert government bureaucrat will be called in to assess your condition and determine whether it is cost-effective for care to be given.

    Your bureaucrat should be available within four to six weeks. Please bring copies of all past medical records, arrest records, tax payment records, other legal records and voting record so the State can accurately assess the value of your life. Please do not be late to this meeting as it may invalidate your claim to service.

  • ||

    I am absolutely astonished that the disability rights group haven't turn on Obama and the Dems like rabid dogs.

    They are ordinarily hyper-sensitive to any hint of an emanation of a penumbra of an implication that health care will be rationed based on the status or likely outcomes, because in an Emmanuel-like calculation of "participating citizen" or "Quality-Adjusted Life Years", they know they will draw the short straw.

    Their apparent silence on this reminds me somewhat of NOW during the Clintonian gropefest.

  • ||

    I believe you've determined why congresscreatures don't read the legislation: plausible deniability.

    The "I'm too stupid to be evil" defense. Amazing how often it works.

  • TallDave||

    P Brooks,

    Hey, leave the unions out of this.

  • <strike>strike through</strike||

    I prefer to visualize special teams of masked medical "technicians" roaming the halls of old age homes, clubbing helpless little grannies in their beds like baby seals.

    Kinky!

  • <strike>strike through</strike||

    The "I'm too stupid to be evil" defense. Amazing how often it works.

    Nancy Pelosi has made a career out of it.

  • Abe Lincoln||

    @ R C Dean, wrt QALY:

    "In the end it is not the years in your life that count. It is the life in your years."

  • ||

    Why don't disability rights groups say anything? Same reason lots of other groups don't squawk when their party steps on them. They bet the farm, and on top of that, they think the opposition are evil, ignorant, racist nuts, out to get them.

  • Xeones||

    Why do people keep calling me a fascist?

  • squarooticus||

    What happened is that policies were crafted largely in good faith but implemented in bad faith, because all state systems are implemented in bad faith.


    QFT, Fluffy. Well said.

  • ¢||

    The reason this is appropriate is because every other bill passed into law eventually degenerates to its worst bad faith outcome.

    Everyone knows that, or can know it, so there's no basis for a presumption good faith on the part of any law's proponents. At best, they're willfully deluded. That's not good.

  • ||

    Why do people keep calling me a fascist?

    If you smell BO everywhere you go...

  • Solanum||

    Why do people keep calling me a fascist?

    Your name begins with an X. A cross, if you will. A burning cross. FASCIST!

  • Rich||

    I am absolutely astonished that the disability rights group haven't turn on Obama and the Dems like rabid dogs.

    Good point. Where's Eunice Kennedy Shriver?

  • Spartacus||

    OK, Spartacus, I take back all the mean jokes I've made about you on my blog. Well, most of them, anyway.

    I haven't seen them. Are they funny? At least keep the funny ones.

  • ||

    In first grade I learned about how Eskimoos would take their old people out into the snow to die alone. As a child I was shocked by the knowledge that a society could be so heartless, but I fear that by the time I'm an old man the kind, caring, compassionate liberals will be dragging me out into the snow on a sled. That's called "progressivism".

  • Spartacus||

    I forgot to mention...

    Isn't this:
    "Liberal defenders of the doctor say he was only philosophizing on various topics and that his past thoughts on the matter can't be taken seriously."

    pretty much lifted directly from the Defenders of Bork? Whether one thinks this is a valid argument or not, I'll bet a search would turn up some of the same people saying pretty much exactly the opposite during the Bork hearings.

  • ||

    John,

    "I'll play devils advocate for a minute. People who survive after getting a year of expensive medical care would ipso facto NOT have most of their medical expenses coming during the last year of life (since they would die at a later time). So we would expect the effect of such occurrences to show up in the statistics if they were common."

    That is true. But you can't tell who will survive and who won't. The fact remains that a lot of treatment that occurs in the last year of life is not "futile" treatment. It is just treatment that didn't work in one case. So, even if you discontinue all "futile treatment" the money you save is not going to be anywhere close to the money spent in the "last year of life". I dare say nearly all of the medical costs spent in the last year of life was anything but "futile". It was instead, good treatment given to very sick people who just didn't make it. Invariably what will happen after the bureaucrats find out that there isn't that much "futile" treatment being given is that the definition of "futile" will be expanded to include any treatment that is not practically guaranteed to work. That will save you some money. But it will also kill a lot of people who would have otherwise survived.

  • ||

    There is also a real logical fallacy to the idea that you can determine treatment based on efficiency without radically discriminating against old people and handicapped people. An older person who is retired is doing noting from an economic perspective beyond living on the wealth he already produced. A severely handicapped person is doing nothing but consuming wealth. From an efficiency perspective, an older person or handicapped person will never be able to compete with a young productive person.

    If you ration care by efficiency, young productive people will always get priority and the old and the handicapped will get whatever is left over. In the end, socialism, because it is a utopian ideal, can't help but be about killing the old and the different.

  • Tony||

    John so you're protesting against a dystopian slippery slope possibility of what might happen if we touch health care, but not what is actually being proposed. Just so we're clear.

  • ||

    "John so you're protesting against a dystopian slippery slope possibility of what might happen if we touch health care, but not what is actually being proposed. Just so we're clear."


    That is exactly what is being proposed. The Obamasiah has said it on numerous occasions. He talks about how "we need to stop doing stuff that doesn't make us better" and how "old ladies in a coma don't need a hip relacement" and so fourth. His case for health care reform lies in no small part on reducing end of life costs. It has to. That is where most of the costs lie. Of course, what he is going to find out, if he doesn't already know, is that very little of the end of life treatment going on is actually futile or known to be futile at the time it is being given. So in the end, either he won't save any money or he will have to start denying treatment unless it is very certain that it will work.

    That is why old people are going crazy over this. They know they are the ones who are going to end up on the wrong end of Obamacare.

  • ||

    Since we actually don't know what is being proposed, because it's a huge bill we see bits and pieces of, it's hard to be clear. Some of the bits and pieces we have seen have, when taken in the light of past legislative reality, been pretty scary.

  • EscapedWestOfTheBigMuddy||

    Fluffy says:

    What is appropriate is to look at the bill's overall structure and say, "Assuming complete bad faith on the part of the bureaucrats who will have to implement this bill, what are the worst possible outcomes?"



    Nicely put.

    We need a elevator speech version of this. Bad.

  • Tony||

    John nothing you just said is factual in any way. Step away from the Hannity show.

    Old people are afraid because they already have their single-payer system and they don't want it fucked with. Yet nobody is proposing doing anything to weaken the single-payer system they enjoy.

    It's really pathetic how many people buy into the rightwing's swiftobat tactics time after time.

  • ||

    I posted this on the redpill/blue pill thread. I think it is appropriate again, given the conversation here/

    brotherben | August 12, 2009, 10:49pm | #
    Here's that asshole brotherben with another observation: healthcare threads here are shot full of speculation about the government's intentions. They want to eventually make it single payer. They want to make it socialist. They want to punish and bankrupt doctors and the damned greedy insurance companies. Then there's all the speculation about what the results might be if this bill is implemented.

    When the Global Warming zealots come in here and offer these types of speculative arguments, they are shouted down and ridiculed and belittled.

    Why is it okay for you fellas to argue speculatively, but wrong for anyone that opposes your position to do the same?

  • Anonymous||

    It's really pathetic how many people buy into the rightwing's swiftobat tactics time after time.

    He keeps saying this, that he doesn't want the facts to stand in the way, so why are you biting?

  • jhn||

    Who gives a shit what old people think? They already are sucking at the government teat of free health care.

  • Worker\'s Paradise ||

    " I am absolutely astonished that the disability rights group haven't turn on Obama and the Dems like rabid dogs."

    It's bad enough being disabled. You think they want to add racist on top of that?

  • Worker\'s Paradise ||

    "John so you're protesting against a dystopian slippery slope possibility of what might happen if we touch health care, but not what is actually being proposed. Just so we're clear."

    Ignore the troll people.

  • ||

    Brotherben,

    There is a world of difference between speculating about the bad intent of politicians and bureaucrats than it is speculating about a natural system as complex the world's weather.

    That posting is sub-retarded. You should retire it.

  • ||

    "John nothing you just said is factual in any way. Step away from the Hannity show.

    Old people are afraid because they already have their single-payer system and they don't want it fucked with. Yet nobody is proposing doing anything to weaken the single-payer system they enjoy."

    Tony you are an idiot. At least try to read the posts before responding with boilerplate. If you can comprehend my points about the fallacy of beleiving all end of life costs being the same thing as "futile" costs, feel free. But otherwise, stop wasting people's time.

  • jhn||

    Also, I fail to see what's so bad about denying free care to people who are going to die anyway in a few months.

    They can go ahead and pay for it themselves if they want, the selfish bastards.

  • Worker\'s Paradise ||

    STOP IT, John.

  • ||

    "Also, I fail to see what's so bad about denying free care to people who are going to die anyway in a few months.

    They can go ahead and pay for it themselves if they want, the selfish bastards."


    Because we magically know who is going to die in a few months and who will not. It is really easy. It is just like Logan's Run. If the gem in their hand is blinking, the treatment isn't going to work.

  • ||

    Fluffy @ 11:02 am
    What Fluffy said

    John@11:28 am
    What John meant philosophically. I disagree a little bit - most of the literature I have read on the subject states that the cost of end of life care is exaggerated.
    I could use myself as an example - cancer as a young man, triple by-pass at 39, and on going adult onset diabetes (Lord, I'm costing you guys a fortune - I hope my internet address isn't traceable). Now maybe I will be on life support for a 364 days before I die, but it is more likey I will drop dead (Hopefully) or die within days of a medical event. It will be a pittance compared to lifetime costs.

    One other point - no one knows when they are getting cancer treatment that the expensive treatment will only extend their life for a month. A very few people will go into remission (cured - yahoo!!!), a few more may live a few years, some will receive no benefit, and some may die sooner.

    Who would say, "Let's not spend the money - I'll go ahead and die!" The most cost effective thing is death.

  • Anonymous||

    Ah, but you forget that in Logan's Run you get to see Jenny Agutter's tits.

  • ||

    John, so the complexity of the system is the dtermining factor in the usefullness of speculation?

  • jhn||

    Look, John, all I'm saying is that if you're not contributing to society (i.e. paying taxes or working as an activist) you don't deserve the government's help.

  • Tony||

    John,

    Even if your paranoia about government rationing end-of-life care in its own plan had any factual merit, they still aren't doing away with private healthcare!!!

    If someone finds granny's plug being pulled by a government bureaucrat they can just pay for the extra care out of their own pocket like a good libertarian would have it. But they're not going to do that anyway so I don't really understand what you're ranting about.

  • ||

    "One other point - no one knows when they are getting cancer treatment that the expensive treatment will only extend their life for a month. A very few people will go into remission (cured - yahoo!!!), a few more may live a few years, some will receive no benefit, and some may die sooner.

    Who would say, "Let's not spend the money - I'll go ahead and die!" The most cost effective thing is death."


    I totally agree. That is why anyone who says they can cut medical costs by ending useless end of life treatment is either lying or planning on killing a lot of people who would have otherwise survived.

  • ||

    "Look, John, all I'm saying is that if you're not contributing to society (i.e. paying taxes or working as an activist) you don't deserve the government's help."

    Which is another way of saying fuck old people and handicapped people. Further, what about all of the money old people paid into the system during their working years? In your world I pay taxes my entire life, but when I get old and actually want to benefit from those taxes, I am told to fuck off I am no longer productive.

  • ||

    "If someone finds granny's plug being pulled by a government bureaucrat they can just pay for the extra care out of their own pocket like a good libertarian would have it. But they're not going to do that anyway so I don't really understand what you're ranting about."

    This is not about pulling the plug on granny you dipshit. It is about deciding what care sick people get. Once the government starts making that decision based on things like efficiency or futility, the old and the handicapped are fucked.

  • ||

    "John, so the complexity of the system is the dtermining factor in the usefullness of speculation?"

    The complexity and our understanding of the system. We understand very little about the world's climate and weather. In contast, we have five thousand years of civilization showing the depravity of politicians. One is not like the other.

  • jhn||

    The only handicapped people I think should be "fucked" are hot amputees. But other than that, yeah, society doesn't owe anything to them. Alternatively, people who aren't paying taxes can just work at government camps or something.

    The olds will continue to get their Socialist Medicare, but of course, part and parcel of any meaningful reform should include... well.. think Seneca. I know it sounds callous but it's the only way to clamp down on out-of-control bureaucrats.

    Plus, think of all the revenue that can be raised to care for productive members of society by increased inheritance tax revenue.

  • ||

    LEONHARDT: And it's going to be hard for people who don't have the option of paying for it.

    THE PRESIDENT: So that's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right?
    I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

    LEONHARDT: So how do you - how do we deal with it?

    THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now.


    There you go Tony. The government deciding end of life care issues is exactly what Obama wants.

  • perilisk||

    "If someone finds granny's plug being pulled by a government bureaucrat they can just pay for the extra care out of their own pocket like a good libertarian would have it."

    Not under a true single payer system. If just any asshole could slip a doctor cash and get treated, it becomes a "single big payer plus a lot of tiny payers system", which is unfair to the poor.

    And then doctors might want to provide health care for profit motivations rather than pure altruism, so the medical care they provided would be all twisted and capitalistic and would actually make everyone sicker!

  • ||

    In an interview with the New York Times last spring, he acknowledged that oldsters are a "huge driver of cost." The "chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health-care bill out here," Obama explained. Which is why he advocated an advisory panel of experts to offer "guidance" on end-of-life care and costs. But don't you dare call it a "death panel."

  • ||

    "Who would say, "Let's not spend the money - I'll go ahead and die!" The most cost effective thing is death."

    I would. And so would Zeb.

    Man up and die.

  • frank||

    My father in law did when facing pancreatic cancer. Of course adverse quality of life impact and unlikely success of the proposed massive radiation and chemo was also an issue.

  • ||

    "Who would say, "Let's not spend the money - I'll go ahead and die!" The most cost effective thing is death."

    I would. And so would Zeb.

    Man up and die."

    You know if we would just ban healthcare, we wouldn't have any healthcare costs.

  • </||

    If they're dying, they're a strain on society, because society is paying for it. Then it's for the good of society for them to die. Eugenics is simply about cost. You don't want your children going hungry in public school because a coma patient is being kept alive another day, do you?

  • ||

    "You know if we would just ban healthcare, we wouldn't have any healthcare costs."

    Works for me.

  • ||

    All good reasons why the government shouldn't pay for any healthcare beyond granting tax breaks to and encouraging charities. Once the government starts paying for our healthcare, we are all just machines that work for the state until we depreciate to the point that we are no longer worth the maintenence.

  • ||

    Here's that asshole brotherben with another observation: healthcare threads here are shot full of speculation about the government's intentions. They want to eventually make it single payer. They want to make it socialist. They want to punish and bankrupt doctors and the damned greedy insurance companies.

    brotherben, that's not speculation.

    That's taking the proponents of this healthcare reform plan at their word. Obama himself has said that he wants to get to single-payer, and he and his minions have attacked and demonized insurance companies and physicians.

  • ||

    Who would say, "Let's not spend the money - I'll go ahead and die!" The most cost effective thing is death.

    If the money at stake is coming out of the pockets of my family, I could see making that decision in all seriousness.

    If the money is coming out of a government printing press or from a Chinese bondholder, not so much.

  • ||

    Under Canada's single-payer system, private health insurance had to be banned.

    Here's why:
    If a doctor can go outside the government run fee-for-service system, then he is taking resources away from the "public" system. Canada has a doctors and nurses shortage because their wages are controlled under the government system - many leave for the US where they get paid much more. That's largely what results in the long waits to see specialists. But if someone in that waiting list were to, say, PAY EXTRA, to see a specialist fee-for-service immediately, he would effectively be jumping to the head of the line.

    The net result would be that everyone who could afford it would pay specialists outside the system extra money, which would cause specialists to leave the system, and result in greater shortages within the government run system. Sorta what happens with Medicaid, where few doctors are willing to accept medicaid patients.

    To prevent this, Canada essentially had to outlaw private insurance and fee-for-service. They couldn't have the private market sucking resources away from the price and wage controlled government system, so they made it illegal.

  • T||

    If the money is coming out of a government printing press or from a Chinese bondholder, not so much.

    The 3d type of spending: other people's money on me. Who cares what it costs, gimme teh drugs.

  • ||

    er ... I should say "government run SINGLE-PAYER" system.

    Brain malfunction.

  • ||

    Not under a true single payer system. If just any asshole could slip a doctor cash and get treated, it becomes a "single big payer plus a lot of tiny payers system", which is unfair to the poor.


    Exactly. In a true single-payer system, like Canada's, it is ILLEGAL to pay for treatment outside the system. It HAS to be, or it wouldn't work.

  • Mike Licht||

    Dr. Ezekiel Emanuel hasn't told OMB anything about Advance Care that Newt Gingrich hasn't proposed himself.


    See:


    http://notionscapital.wordpress.com/2009/08/14/20317-newt-gingrich-advance-directive-advocate/

  • Tony||

    Does Canada euthanize the old and sick?

  • ||

    R C Dean, the proponents of health care reform include doctors and insurance companies. See the thread upstream.

  • ||

    Does Canada euthanize the old and sick?

    If you die on a waiting list, that's one form of rationing.

    When I was in high school, in Canada, one of my friends mother's got cancer. She was on a waiting list for the surgery, but she chose to shell out about $50,000 and go to a hospital in Minnesota right away instead, rather than wait and risk the tumor becoming inoperable.

    Many Canadians choose to spend their own money to go to the US for specialized procedures or treatments that are not available in Canada. Some cannot afford it.

  • Tony||

    In other words, no they don't. One of my best friend's cousin's dear auntie had a tumor on her vagina, and she went to Canada and a unicorn shat a rainbow on it and it went away and she didn't have to pay a dime!

    That's about how useful your anecdote is to me.

  • CatoTheElder||

    How can one disagree with Dr. Emanuel? His article addresses "allocation of health care resources" and "theories of distributive justice for health care", which only make sense if one has already accepted the premise that the State should provide health care services. His article identifies as a "substantive insight" that "services that promote the continuation of the polity ... are to be socially guaranteed as basic". In other words, the basic purpose of the State health care services is to maintain the health of the State. "Conversely, services provided to individuals [who do not promote the continuation of the State] ... should not be guaranteed."

    I vehemently disagree with the Emanuels's communitarian philosophy, but at least he's got a coherent position on the topic. To the Obamas, Clintons, and Emanuels of the the world, the individual counts for nothing unless he or she contributes to the greater good of the collective.

  • Sandi||

    I took a shit in Tony's mouth once.

  • Government Run Heathcare in a ||

    Everyone in America has a god given right to heathcare (until we determine otherwise)

  • Enyap||

    Anybody read the comments on the LA Times article about Whole Food, I found this one priceless.

    i'm a healthy guy. i eat plenty of vegetables, i rarely drink alcohol and i don't eat meat. i exercise on a regular basis and i take vitamins and other nutritional supplements.
    but if i'm walking down the street (it's healthy to walk) and some billionare CEO runs me over on his SUV, my bones will still break. i will still have to go to the emergency room and i will still get billed thousands --even if nothing broke and i'm sent home that day.
    so if i don't have health insurance, what does Mackey recommend? wait until he decides to put some money in for me in the hat he proposes passing around? wouldn't it just be more efficient to tax billionares like him, just to make sure that hat is full?

    anyway, i will never shop at whole food again.

  • T||

    a unicorn shat a rainbow on it

    Can't happen. Everybody following the health care debate know unicorns pee rainbows. They shit puppies and kitties. Where the hell are you getting your unicorn information from, the DNC?

  • ||

    i'm a healthy guy. i eat plenty of vegetables, i rarely drink alcohol and i don't eat meat. i exercise on a regular basis and i take vitamins and other nutritional supplements.
    but if i'm walking down the street (it's healthy to walk) and some billionare CEO runs me over on his SUV, my bones will still break. i will still have to go to the emergency room and i will still get billed thousands --even if nothing broke and i'm sent home that day.
    so if i don't have health insurance, what does Mackey recommend? wait until he decides to put some money in for me in the hat he proposes passing around? wouldn't it just be more efficient to tax billionares like him, just to make sure that hat is full?

    anyway, i will never shop at whole food again.



    Holy shit, I hate to even respond to this kind of stupid, but has this asshole never heard of liability insurance?

    Not to mention the fact that even sans Liability Insurance, LA is so full of ambulance chasers that he'll have a dozen at his door the next morning, any one of which will have him owning the "billionare CEO['s]...SUV" and his Bellair mansion as well.

    Fuck, there really are people this fucking ignorant, aren't there?

  • Anonymous||

    In other words, no they don't.

    So the existence of an extra-territorial market proves the effectiveness of the system? This once again proves my theory that communism is a death cult, and its application to totalitarian one-worldism is rather near.

  • ||

    In other words, no they don't. One of my best friend's cousin's dear auntie had a tumor on her vagina, and she went to Canada and a unicorn shat a rainbow on it and it went away and she didn't have to pay a dime!


    In other words, Tony has run out of rational arguments.

  • ||

    I don't have an argument, I have a question. Do Canadians euthanize the old and sick?

    Is this question one we really should be worried about, or is it just another in a very long line of swiftboat-style lies meant to scare people into being against something?

  • perilisk||

    "Do Canadians euthanize the old and sick?"

    No, euthanasia means "good death", i.e. causing people to die quickly and painlessly.

    Legally banning people with cancer from getting treatment in a timely manner causes them to die slowly and painfully. Presumably, you consider this an improvement over euthanasia?

  • ||

    Tony, functionally what is the difference between having a medical board decide what treatments to pay for, and merely restricting supply so that only so many sick people can get treated, on a first-come first-serve basis?

    If you're the dying person at the end of a waiting list, or if the government sponsored review board decides not to pay for your treatment, the effect is the same: you don't get treated.

    Now, why is either of the above supposedly morally superior to people not getting treated because they can't afford it, or the insurance doesn't cover it?

    Answer: there is no fucking moral difference. The question isn't whether rationing will occur. The question is WHO DECIDES. You, or the government. Would you rather be denied treatment because you can't pay, or because you don't have an inside connection to bump you to the front of the waiting list?

  • ||

    Kyle and Spoonman, Exactly. If Emanuel's mindblowing ideas are not the same principle upon which the NAZIs in the 30s based their 'get rid of the useless on', what is? I see the German boot strap-kick coming on the horizon. Fogerty, I see a bad moon a-rising. I see bad times today. It's bound to take your life. I see trouble on the way.

  • weight||

    While I'm a Ron Paul supporter, I also do my best not to look at things with rose-colored glasses. That's how I can read this article and applaud its honesty, even if I don't like the words from my biased perspective. Oh who am I kidding? I actually have my own idea why he lost like he did.

    Aside from the reasons listed (since they're good reasons), one reason I didn't see what something that happened at the ABC debates. While I read comments from co-supporters deploring the verbal attack on Paul during the war discussion, they failed to realize that Paul dug himself in a bit in his retorts to the attack. He didn't defend his stance well and I think that was a key factor in the end result.

  • coach||

    While I'm a Ron Paul supporter, I also do my best not to look at things with rose-colored glasses. That's how I can read this article and applaud its honesty, even if I don't like the words from my biased perspective. Oh who am I kidding? I actually have my own idea why he lost like he did.

    Aside from the reasons listed (since they're good reasons), one reason I didn't see what something that happened at the ABC debates. While I read comments from co-supporters deploring the verbal attack on Paul during the war discussion, they failed to realize that Paul dug himself in a bit in his retorts to the attack. He didn't defend his stance well and I think that was a key factor in the end result.

  • ||

    So, basically, Dr. Emmanuel is a good old fashioned Eugeneticist? (he certainly sounds like it)

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