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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.
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:
Kyle Jordan|8.14.09 @ 10:09AM|#
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.
Warty|8.14.09 @ 10:16AM|#
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|8.14.09 @ 10:18AM|#
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|8.14.09 @ 10:25AM|#
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|8.14.09 @ 10:28AM|#
In other news, why do so many people give a shit that some Shriver broad died?
Spartacus|8.14.09 @ 10:31AM|#
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.
|8.14.09 @ 10:32AM|#
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|8.14.09 @ 10:38AM|#
OK, Spartacus, I take back all the mean jokes I've made about you on my blog. Well, most of them, anyway.
|8.14.09 @ 10:39AM|#
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|8.14.09 @ 10:39AM|#
I have it on good authority that Alan Vanneman only resists perfunctorily when Steve Smith rapes him.
|8.14.09 @ 10:40AM|#
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.
|8.14.09 @ 10:41AM|#
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?
|8.14.09 @ 10:46AM|#
Ooooooooo, Whole Foods is in trouuuuuble...
...and where exactly are the boycotters going to go? Wal-Mart?
|8.14.09 @ 10:56AM|#
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.
|8.14.09 @ 10:59AM|#
"Death Squads"?
Sounds like a work-release program for newly freed Squeaky
Fromme.
Fluffy|8.14.09 @ 11:02AM|#
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|8.14.09 @ 11:02AM|#
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|8.14.09 @ 11:07AM|#
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|8.14.09 @ 11:09AM|#
Fluffy just explained why i'm a libertarian.
Fluffy, you may not be a fascist after all.
|8.14.09 @ 11:13AM|#
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.
|8.14.09 @ 11:16AM|#
If you're fat, smoke, take illegal drugs, or vote Republican, you will be denied ☺
<strike>strike through</strike|8.14.09 @ 11:21AM|#
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|8.14.09 @ 11:25AM|#
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|8.14.09 @ 11:27AM|#
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.
|8.14.09 @ 11:28AM|#
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|8.14.09 @ 11:29AM|#
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|8.14.09 @ 11:30AM|#
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|8.14.09 @ 11:30AM|#
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|8.14.09 @ 11:30AM|#
John, that is a good point that has been entirely left out of the discussion.
hmm|8.14.09 @ 11:31AM|#
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|8.14.09 @ 11:33AM|#
BARRY-O LOVE KILL WRINKLE MAN WRINKLE WOMAN
SAD SAD FAMILY BARRY-O HAPPY BANANA
|8.14.09 @ 11:36AM|#
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.
|8.14.09 @ 11:36AM|#
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|8.14.09 @ 11:39AM|#
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.
|8.14.09 @ 11:40AM|#
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.
|8.14.09 @ 11:42AM|#
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.
<strike>strike through</strike|8.14.09 @ 11:43AM|#
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|8.14.09 @ 11:44AM|#
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|8.14.09 @ 11:45AM|#
@ 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."
|8.14.09 @ 11:49AM|#
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.
squarooticus|8.14.09 @ 11:54AM|#
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.
¢|8.14.09 @ 11:55AM|#
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.
Solanum|8.14.09 @ 12:00PM|#
Why do people keep calling me a fascist?
Your name begins with an X. A cross, if you will. A
burning cross. FASCIST!
Rich|8.14.09 @ 12:03PM|#
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|8.14.09 @ 12:04PM|#
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.
|8.14.09 @ 12:19PM|#
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|8.14.09 @ 12:22PM|#
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.
|8.14.09 @ 12:31PM|#
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.
|8.14.09 @ 12:36PM|#
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|8.14.09 @ 12:47PM|#
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.
|8.14.09 @ 12:50PM|#
"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.
|8.14.09 @ 12:51PM|#
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|8.14.09 @ 12:53PM|#
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|8.14.09 @ 12:54PM|#
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.
|8.14.09 @ 12:57PM|#
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|8.14.09 @ 12:57PM|#
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|8.14.09 @ 12:59PM|#
Who gives a shit what old people think? They already are sucking at the government teat of free health care.
Worker\'s Paradise |8.14.09 @ 12:59PM|#
" 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 |8.14.09 @ 1:00PM|#
"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.
|8.14.09 @ 1:00PM|#
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.
|8.14.09 @ 1:02PM|#
"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|8.14.09 @ 1:03PM|#
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.
|8.14.09 @ 1:05PM|#
"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.
|8.14.09 @ 1:08PM|#
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|8.14.09 @ 1:08PM|#
Ah, but you forget that in Logan's Run you get to see Jenny Agutter's tits.
|8.14.09 @ 1:08PM|#
John, so the complexity of the system is the dtermining factor in the usefullness of speculation?
jhn|8.14.09 @ 1:09PM|#
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|8.14.09 @ 1:09PM|#
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.
|8.14.09 @ 1:10PM|#
"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.
|8.14.09 @ 1:12PM|#
"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.
|8.14.09 @ 1:13PM|#
"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.
|8.14.09 @ 1:15PM|#
"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|8.14.09 @ 1:21PM|#
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.
|8.14.09 @ 1:30PM|#
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|8.14.09 @ 1:33PM|#
"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!
|8.14.09 @ 1:36PM|#
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."
|8.14.09 @ 1:42PM|#
"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|10.22.09 @ 1:01PM|#
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.
|8.14.09 @ 1:45PM|#
"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.
</|8.14.09 @ 1:46PM|#
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?
|8.14.09 @ 1:46PM|#
"You know if we would just ban healthcare, we wouldn't have any
healthcare costs."
Works for me.
|8.14.09 @ 1:49PM|#
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.
|8.14.09 @ 1:55PM|#
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.
|8.14.09 @ 1:57PM|#
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.
|8.14.09 @ 2:39PM|#
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|8.14.09 @ 2:40PM|#
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.
|8.14.09 @ 2:45PM|#
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|8.14.09 @ 2:59PM|#
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/
|8.14.09 @ 3:10PM|#
R C Dean, the proponents of health care reform include doctors and insurance companies. See the thread upstream.
|8.14.09 @ 3:17PM|#
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|8.14.09 @ 3:20PM|#
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|8.14.09 @ 3:47PM|#
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.
Government Run Heathcare in a |8.14.09 @ 4:11PM|#
Everyone in America has a god given right to heathcare (until we determine otherwise)
Enyap|8.14.09 @ 4:11PM|#
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|8.14.09 @ 4:20PM|#
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?
|8.14.09 @ 4:32PM|#
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|8.14.09 @ 4:38PM|#
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.
|8.14.09 @ 5:00PM|#
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.
|8.14.09 @ 5:21PM|#
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|8.14.09 @ 6:52PM|#
"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?
|8.14.09 @ 8:34PM|#
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?
|8.15.09 @ 8:28AM|#
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|11.20.09 @ 10:32PM|#
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|11.20.09 @ 10:32PM|#
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.
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