Death of a Public Plan? Or: The Problem With the Revenge-Against-the-Morons Strategy
There's still a chance that health reform could pass with a public plan. But, despite the muffled squeaks of "I'm not dead yet!", the liberal commentariat seems ready to toss their beloved government-run insurance plan onto the death wagon with the rest of the corpses that have succumbed to the plague of politics.
In Salon, Thomas Schaller asks "what went wrong?" and suggests that, horror of horrors, Obama might have negotiated the public option away because of politics. Paul Krugman is claiming that the public option was killed by Washington's zombie Reaganism (which I desperately hope to someday find as a plot element in a Michael Moore/George Romero crossover film). Matt Yglesias says that criticisms of the reformers' strategy miss the point, which is that lots of liberal presidents have tried and failed before, and thus what we really need to understand is that health-care reform, like the final round in Guitar Hero, is just really stinkin' hard.
Yglesias lays part of the blame on the Senate, which seems like the sort of "problem" that's not likely to be fixed any time soon. But he's right about the fundamental difficulty of these sorts of reforms. And if liberals want to take from all this the lesson that, for liberal presidents, attempting health-care reform is like doing the drink-a-gallon-of-milk-in-an-hour challenge—endlessly tempting, but equally guaranteed to end in a mess—that's fine by me. But I think it's more likely that the view expressed in the Guardian by Michael Tomasky will prevail: Sure, major reforms are hard, but that just means that progressives need to fight harder, even if swallowing a public-planless bill ends up less savory than three-day-old Taco Bell:
A health bill will likely have a very weak public option or it won't have one at all. But liberals will have to battle for that bill as if it's life and death (which in fact it will be for thousands of Americans), because its defeat would constitute a historic victory for the birthers and the gun-toters and the Hitler analogists.
So we've moved from the moral case to the fiscal case to the "the-other-side-is-made-up-of-crazed-and-despicable-idiots" case. Republicans don't deserve any sympathy for their numerous distortions, exaggerations, and forays into hysterical nonsense. But Tomasky's revenge-against-the-morons strategy seems like an awfully convenient way of both avoiding addressing the substantive problems with liberal reform and ignoring the significant role moderate Democrats have played in making reform difficult. And it reveals, I think, a bigger—and ongoing—problem for a lot of diehard liberal activists currently seeking reform: As satisfying as rallying against the other side's lunacy might be to the left's feisty base, it's not much of an outreach strategy.
Read Reason's health-care archive here.
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because its defeat would constitute a historic victory for the birthers and the gun-toters and the Hitler analogists.
Mmmmm, I love the smell of hyperbole in the morning.
They should've tried to get it passed before the trillion dollar giveaways to the banking elite.
"Republicans don't deserve any sympathy for their numerous distortions, exaggerations, and forays into hysterical nonsense."
Really? What would those be? Oh yes death panels. Is it your position that one facebook post by a former governor who you no doubt think is insane killed the public option?
What else? Pointing out that you can't cover 47 million uninsured people and cut costs without cutting care to someone who is getting it now? Pointing that the government can't run the DMV yet they are supposed to run healthcare? Pointing out that a public option with the ability to print its own money would run private insurance out of business? Pointing out the Obama was an ardent advocate for a single payer system for his entire career? What?
Suderman has become the new Weigel. Any post where he has to admit fault among the Democrats must be accompanied by a sentence or clause mentioning that Republicans are worse.
"But Tomasky's revenge-against-the-morons strategy seems like an awfully convenient way of both avoiding addressing the substantive problems with liberal reform and ignoring the significant role moderate Democrats have played in making reform difficult."
So is anyone who objects to the plan besides the moderate Democrats, a birther and a gun toating hate monger? Suderman you really never respond to the slam. It is like you agree with it and think that anyone who is not a Democrat is a birther and a moron.
Nice Monty Python reference. 🙂
Shut the fuck up, Michael Tomasky.
i can haz revolushun now?
"As satisfying as rallying against the other side's lunacy might be to the left's feisty base, it's not much of an outreach strategy."
And we all know the other side are just lunatics right? No one could ever have a principled objection to Obamacare. We are all just a bunch of gun clinging birthers.
John, you're being way too defensive. I don't think Peter is saying all Republicans are loonies, and he's not saying they're worse than Democrats. I think he's saying focusing on the more embarrassing elements of right wing opposition and ignoring intra-party difficulties isn't going to accomplish much.
Any post where he has to admit fault among the Democrats must be accompanied by a sentence or clause mentioning that Republicans are worse.
It helps a lot that they are.
And that's a good thing, by the way. Not getting anything done is about the best we can hope for these days.
"It helps a lot that they are."
Becuase GW Bush had trillion dollar deficits and plans to take over the healthcare system.
Please pull the plug now!
I think that the post would be better if this part, like the rest, had links, no?
Some of the "distortions" appear to be more of less correct; some of them are quite difficult to determine, like, say, abortion or the related illegal immigrant issue.
In both, amendments to prevent public money being used have been rejected along party lines. At the same time, most bills don't mandate full coverage of abortion or of illegal immigrants, but leave that decision up to HHS. (And, of course, to judges.) It's entirely reasonable to think that abortion and/or illegal immigrants might end up being covered in actual application, just as it's reasonable to suspect that drug price controls would eventually happen even if not in the bill initially thanks to PhRMA's deal.
There are, of course, lunatics on both sides, and the side out of power tends to have more visible lunatics, all things being equal. And, as always, actual elected officials are less loony than activists. Yet somehow Rep. Paul Ryan's reasonable criticism gets ignored.
One lesson, of course, is that yelling and screaming works, on all sides. Sensible measured criticism doesn't.
"John, you're being way too defensive. I don't think Peter is saying all Republicans are loonies, and he's not saying they're worse than Democrats. I think he's saying focusing on the more embarrassing elements of right wing opposition and ignoring intra-party difficulties isn't going to accomplish much."
We will see if Peter comments. But it doesn't appear that way to me.
You have to admit Zombie Reagan is a lot cooler than living Reagan was.
Pointing that the government can't run the DMV yet they are supposed to run healthcare?
Then why do we trust them with a nuclear arsenal?
I'm I the only one thinking maybe a Rovian 50%+1 strategy isn't such a bad thing after all? A smaller majority is much easier to control, it would seem.
Johns,
Some distortions off the top of my head, death panel, the death book, covering illegal immigrants and fears that government will run Medicare*. And that's off the top of my head as an Obamacare opponent.
* As opposed to the current, unicorn run Medicare.
Then why do we trust them with a nuclear arsenal?
We don't. You might. I don't.
"Pointing that the government can't run the DMV yet they are supposed to run healthcare?
Then why do we trust them with a nuclear arsenal?"
Bacuse that is a lot easier and a completely different sort of task than providing healthcare.
Peter, what if you, as you seem to do, find substantive problems with the chosen liberal reform, but you can only get a small minority of people to agree with your objections? Would you prefer that it pass, or would you prefer, e.g,. alliances with pro-lifers, anti-immigrant forces, and seniors who don't want their Medicare subsidy cut in order to stop it?
Suderman you really never respond to the slam. It is like you agree with it and think that anyone who is not a Democrat is a birther and a moron.
John, he never said that you were a birther.
I thought living Reagan was Zombie Reagan.
"Then why do we trust them with a nuclear arsenal?"
Because reducing costs really isn't a priority, that and the Constitution.
More Obamacare news.
The illegal immigrants one is not exactly a distortion. It's a distortion to say that the bill right now covers illegal immigrants, but it's entirely reasonable to expect that unless the bill specifically has measures to prevent it from covering illegal immigrants, that illegal immigrants will be covered. Especially when some people (like Yglesias) admit that they'd prefer illegal immigrants be covered.
If that's a distortion, then the libertarian complaining that a subsidized public option will lead to single-payer is also a distortion, for exactly the same reasons. Indeed, supporters of Obamacare make exactly that claim.
The "death panel" and "death book" are intemperate terms and exaggerations of things with a kernel of fact. Nasty tactics, but nothing new from either side (or from libertarians, for that matter.)
A statement of "keep the government's hands off my Medicare" from a senior sounds dumb, but their concerns that the reform will alter their Medicare for the worse, making them pay for expanding coverage to others are entirely justified.
"I thought living Reagan was Zombie Reagan."
It's hard to tell. Alzheimers Reagan muddies up the waters.
(Re: illegal immigrants, especially when amendments to that effect are continually rejected on party-line votes.)
"Some distortions off the top of my head, death panel, the death book, covering illegal immigrants and fears that government will run Medicare*. And that's off the top of my head as an Obamacare opponent."
I don't think the death panel was a distortion. Obama himself said that 80% of medical costs were for end of life care and that "people were going to have to stop taking treatments that didn't make them better." You combine that with Dr. Emmanual's writings about evaluating care based on life years and life quality and the reality of the claims of cutting costs while expanding coverage, it there is a pretty good circumstantial case that they are going to have to have some kind of death panel. It is not an unreasonable argument. And it is an argument that deserves a better response than the ad hominim attacks it has gotten.
Second, I don't think it is an unreasonable fear that once you have a public option, liberals will want to cover illegals. It may not be in the plan right now, but it is a pretty good bet a lot of liberals would like it to be and that it could very well end up there eventually. In the end, the only response to the charge is "trust us we would never do that". Sorry I don't find that very convincing.
I am not sure what you mean by "the government will run Medicare". I think people were afraid that the government will no longer support medicare in the same way and provide the same dumbed down crappy service to everyone.
Bacuse that is a lot easier and a completely different sort of task than providing healthcare.
Managing a $650 billion/year military in over 100 countries, with over 1.5 million personnel and crazy amounts of equipment is easier than providing health care? Are you on crack?
BTW, I think the military is a huge waste of taxpayer money and is inefficient to boot, but easy to run is not how I would describe it.
You have to admit Zombie Reagan is a lot cooler than living Reagan was.
Way totally cooler.
"Managing a $650 billion/year military in over 100 countries, with over 1.5 million personnel and crazy amounts of equipment is easier than providing health care? Are you on crack?"
As opposed to managing the healthcare of 300 million people? Are you on crack? Also, the military has the luxury of throwing anyone wearing a uniform in jail if they don't do what they are told. That makes a huge difference.
As far as distortions go, one of the ones that as a mathematician annoys me the most is President Obama repeatedly claiming that a $800 billion dollar bill over ten years would be $80 billion a year. That's extremely misleading and distorts the long-term picture; all the bills before Congress spend nothing in the first three or four years and them ramp up to full effect by year six. It ends up being $202B in the tenth year, not $80B or $100B.
Managing a $650 billion/year military in over 100 countries, with over 1.5 million personnel and crazy amounts of equipment is easier than providing health care?
It certainly calls for totally different skill sets.
Also, the military has the luxury of throwing anyone wearing a uniform in jail if they don't do what they are told.
Umm, and the government doesn't?
"Umm, and the government doesn't?"
As it currently stands no. There is something called the SIEU that keeps that from happening.
Then why do we trust them with a nuclear arsenal?
To their credit they mostly take that seriously, and they know it's their own asses that will be burned off (if they can't get to the bunker in time) if something goes really bad.
But personally, I still don't. If I had my way, I'd split them between Ron Paul and Zombie Reagan.
I have a difficult time distinguishing these slippery slope public option means inevitable single-payer health care articles from the claims about illegal immigrants or abortion made by the actual organizations involved.
True, people who only half-comprehend arguments get misled and aren't coherent in protests, but that's equally true of the public option leading the a single health care plan or Megan McArdle's argument about inevitable price controls and innovation.
They can throw the ruled in jail, sure. They can't throw the "public servants" themselves in jail; well, unless they have security clearances or are one of those nasty contractors.
As far as distortions go, one of the ones that as a mathematician annoys me the most is President Obama repeatedly claiming that a $800 billion dollar bill over ten years would be $80 billion a year.
John, I agree with you. But FTL: "Each billion matters." That's the distortion/kicker -- as far as these guys are concerned, each billion does *not* matter.
I like Daniel Henninger's views in the WSJ (Thursday). He believes, with reason, that the American people (or most of them anyway) no longer trust the government or politicians. The people see Cal. and NY "the two most economically important and famous of the 50 states" with incompetent legislatures. They saw the housing bubble burst. They see Medicaid "wrecking state budgets," Medicare going broke in eight years and Social Security "flatlining" soon after. Then the Obamessiah writes, in the NYT, "We'll cut hundreds of billions in waste and inefficiency in federal health programs like Medicare and Medicaid." Say Henninger: "Hundreds of billions? Just like that? This is nothing but an assertion by one man. It's close to Peter Pan telling the children that thinking lovely thoughts will make them fly."
John,
I'd invite you to search my archives. I've been consistently been skeptical of reform, and I've written far more about the left than the right, and spent far more time criticizing liberals and Democrats than Republicans (because the left is where the important players are).
Still, a short list of Republican distortions:
-The death panels, most obviously: The provision in question just isn't a "death panel." It's a voluntary doctor consultation. IMAC might be closer, and I wonder why it hasn't attracted more criticism. But the phrase is still totally over-the-top.
-Republicans have consistently gotten the numbers wrong -- confusing cost, debt, and deficit, talking about the costs of a public plan before there was any cost attached to it, etc.
-The Nazi talk. Yes, a lot of it comes from La Rouchies. But not all of it.
-The talk of a "government takeover" of medicine. It would mean giving the government more control than the roughly 50% stake it currently has in our medical system, but a menacing overthrow isn't what's being proposed. Again, some of the Republican rhetoric is needlessly hysterical and over the top.
But as I've written before, I think Republicans are mostly botching their opposition efforts, and reform is flailing because of liberal infighting and because of systemic issues with the political process that are bound to infuriate those on the left who think that Obama ought to be able to just wish away opposition and dissent.
So Thacker, you are essentially saying that the first year is base spending (nothing) and adding more money each year to a sum total of "800 billion dollars" for that ten year period?
So why the incremental spending, unless someone is expecting the the other shoe to drop during that first three or four years, like Medicare/Caid/SocSec reaching insolvency?
Assuming this Akira-sized mutation of the current system is voted in before 2010, those three or four years would be the time I would least like to be a senior or an invalid/total care patient.
In theory, the Obama plan to have a public option compete against private insurers seems no different to me than having the social security system compete against an opt out program like the one Chile started in the 1980s. By all accounts, the vast majority of Chileans opted out of government social security in favor of the private plans. Why would this be any different under the Obama health care plan? Shouldn't we expect that most people would still go for the private options (after some initial flurry of interest in the government plan)? And over time, if free market theory is correct, private health plans would gradually attract more and more people away from the public option.
"-The death panels, most obviously: The provision in question just isn't a "death panel." It's a voluntary doctor consultation."
Peter considered within the context of the program being run by the government with all of its coercive power and the actual statements of Obama and his chief healthcare policy advisor, your statement is laughable. Truly laughable if not Orwellian.
"Republicans have consistently gotten the numbers wrong -- confusing cost, debt, and deficit, talking about the costs of a public plan before there was any cost attached to it, etc."
Considering that no government program has ever come in on budget, I would say everyone has gotten the numbers wrong. Further, the inflated numbers are much more likely, considering history, to be true.
"The Nazi talk. Yes, a lot of it comes from La Rouchies. But not all of it."
Links? Exapmles?
"The talk of a "government takeover" of medicine. It would mean giving the government more control than the roughly 50% stake it currently has in our medical system, but a menacing overthrow isn't what's being proposed. Again, some of the Republican rhetoric is needlessly hysterical and over the top. "
Bullshit. That is exactly what the President's stated goal was right up until he started to be held accountable for it. Additionally, when you have a public option that is backed by the government's ability to tax and coerce combined with the creation of an incentive for businesses to dump people on the public plan, it is a pretty rational assumption that the public option will end up becoming a complete takeover. Further, between Medicare and the public option, the government would become a monopsony able to effectively control healthcare the way Texas and California control high school textbook production.
Why can't you just admit the Dems have a horrible plan that is going to cost a fortune and is designed to produce a single payer system?
from the Website of Compassion & Choices (formerly known as the Hemlock Society), a pro-euthanasia organization:
'As Congress debates health insurance reform, Compassion & Choices is leading the charge to make end-of-life choice a centerpiece of any program that emerges.
'We are working hard to reach our goal to make end-of-life choice a centerpiece of national health insurance reform. The technical term for our goal is "Physician Order for Life Sustaining Treatment" (POLST). In practical terms, it's a new requirement for Medicare to provide coverage for the "conversation" - the dialog between doctor and patient about a patient's wishes and options for end-of-life treatment.
'POLST is one way to get these conversations started. POLST forms allow patients to document with their physician their end-of-life treatment wishes. A decade of research has demonstrated that orders for life-sustaining treatment effectively convey treatment preferences and guide medical personnel to provide or withhold interventions. These orders contain the individual's treatment decisions, signed by a physician, and follow the patient through all end-of-life health care settings. Without these medical orders, emergency medical personnel may be required to provide treatments that aren't consistent with the individual's preferences.
'Right now, Medicare does not cover this pivotal conversation. As a result, most doctors don't suggest it. And most elderly patients don't get the opportunity to talk about their questions, values and decisions about the kind of care they want at life's end.
'Winning Medicare coverage to fund the discussion will be transformational. It will lay the groundwork for coverage in the other plans that will be part of health care reform, secure a valuable right for every American, and keep millions of people from being trapped in agonizing and futile medical interventions in their final weeks of life.
'HR 1898, the Life Sustaining Treatment Preferences Act of 2009, introduced by Congressman Earl Blumenauer (D-OR) and Charles Boustany (R-LA), would provide coverage under the Medicare Program for consultations regarding POLST.
'. . . HR 1898 will lay the groundwork so all seriously ill Americans have the tools to make informed medical care decisions. The bill will also help patients convey their care plans as clearly as possible and feel confident their wishes will be known and respected by health care personnel. These tools will help the dying choose between acute care and hospice care, avoid unwanted medical interventions and do a much better job of explaining why and when to choose hospice care.'
" (which I desperately hope to someday find as a plot element in a Michael Moore/George Romero crossover film)."
You are so cool!
"Suderman has become the new Weigel."
No, Weigel-Lite. At least Weigel had a good education.
"Right now, Medicare does not cover this pivotal conversation. As a result, most doctors don't suggest it. And most elderly patients don't get the opportunity to talk about their questions, values and decisions about the kind of care they want at life's end."
That is just complete horseshit. Everyone who has ever lost a close relative knows very well the conversation about DNRs. Why do you need to go to a pannel of experts when you have one with your doctor? I can see no other reason than the government wanting to pressure people into ending their lives earlier.
The comments over at Salon last weekend have been really sweet. The "liberals" are already starting to talk about throwing Obama under a bus in 2012.
John,
I think you have managed to see into the Hemlock Society mentality. Not particularly pleasant, is it?
"Some of the "distortions" appear to be more of less correct; some of them are quite difficult to determine, like, say, abortion or the related illegal immigrant issue."
Here's what I find funny. The Administration has said that illegal immigrants WILL NOT BE covered by the healthcare bill. So my question is, what will happen to them then? Will I be seeing them coughing up blood in the streets on my way into work?
It's all just lies.
(discosure: I'm fine with covering illegal imigrants)
"Then why do we trust them with a nuclear arsenal?"
Just try taking it away...
dammit, reading all this crap by John makes me miss joe so much more.
Consider the "public choice option" as analogous to Amtrak; what private operator is going to try to offer a passenger rail service which directly competes with Amtrak? Amtrak, because of their ability to get the Congress to make up their operating losses, can set prices at a level which will prevent anybody from making money; it could conceivably be possible to compete on quality, but it would be extremely difficult.
If the public "competitor" doesn't have to worry about covering claims with their own money, who will be able to compete with them over the long term?
No it is not Mad Max. Thank you for the post.
The "liberals" are already starting to talk about throwing Obama under a bus in 2012.
Waters/Waxman 2012!
Wheee!
"Managing a $650 billion/year military in over 100 countries, with over 1.5 million personnel and crazy amounts of equipment is easier than providing health care? Are you on crack?"
Heathcare - $1T
Patients - 300 million
P Brooks,
No kidding. But according to Sudderman, there is no public takeover being proposed and anyone who says otherwise is a birther or a nut. People are not stupid. They can see the second order effects of the public option and revolted against it.
Surely Suderman sees it to. That means he either wants single payer, in which case I can't see how he can call himself a Libertarian, or he is so hung up on how much he can't stand the people who also see through the Obama plan, he is willing to deny the obvious to avoid having to admit they are right.
P Brooks,
Didn't Northern Pacific, which competed against the other lines (government funded), actually do better than the government rail lines and services?
Malto Dextrin | August 24, 2009, 12:52pm | #
They should've tried to get it passed before the trillion dollar giveaways to the banking elite.
Bingo!!
or considering the reccession they should have simply run the county well for a couple of years then done the reforms. Now it looks like they will lose seats in congress.
Woohoo!!! Think I'll go to the range tonight and let loose a few mags in opposition to the pubic option.
'Some of the "distortions" appear to be more of less correct; some of them are quite difficult to determine, like, say, abortion . . .'
Difficult to determine? When the administration isn't even *trying* to deny that the bill will cover abortion?
the White House's (taxpayer financed) Web page dedicated to refuting supposed right-wing falsehoods about the health-care proposal does not (as of 2:17 PM August 27) even bother to refute the claim that the proposal would cover abortions. (This omission has been duly noted by pro-lifers).
August 24, not 27th
"Bingo!!
or considering the reccession they should have simply run the county well for a couple of years then done the reforms. Now it looks like they will lose seats in congress."
What I find funny is that after 9/11 we set up an allegedly bipartisian commision to determine what went wrong and how to improve things.
Obama errored greivously by failing to follow that model.
I doubt even the Northern Pacific could profitably compete (today) head-to-head with Amtrak, particularly on passenger service.
Suderman has become the new Weigel. Any post where he has to admit fault among the Democrats must be accompanied by a sentence or clause mentioning that Republicans are worse.
I think they all do that...or at least make an effort to point out how they both suck.
In the case of Weigle i think you would be hard pressed to find an article that actaully does critisize the Demecrats and you will find quite a few that critisizes big L Libertarians.
I've been watching the coverage over at Salon. Various articles have stated that the "public option" was used to placate the rabid liberal wing of the Democratic party who were demading a single-payer sytem. "Everyone" on the left recognized that the public option was a Trojan horse to bring in single-payer.
Of course, in public, the administration says that the public-option was never intended to be a gateway to single-payer.
Then Obama spills his guts on TV and says private insurers shouldn't fear the public option -- just look at the post office.
Now we're seeing analysis that says the public option was never important to the administration, it was only a bargaining chip to get the opposition to accept the "real" objectives of the reformers.
What a bunch of clueless amateurs.
How is having the "conversation", or more specifically, having the "conversation" covered by insurance inconsistent with libertarian philosophy? I would think that libertarians would support the right of a person to make his/her own decision about how to end their life. Indeed, how is the Hemlock Society not a libertarian organization?
Socrates, you ignorant slut,
Taxpayer subsidies and government incentives for doctors to nudge patients towards death? Yes, indeed, a worthy libertarian cause!
Ray,
The difference is that Social Security would have to provide good financial returns and exercise sound money management to compete against a private option, while public health care can spend as much money as it wants and operate with a deficit, undercutting private companies that must profit to survive.
If end of life isn't death, what is it?
In theory, the Obama plan to have a public option compete against private insurers seems no different to me than having the social security system compete against an opt out program like the one Chile started in the 1980s.
The bill in no way followed your theory.
1. The public plan was subsidized (to be cheaper than private plans)
2. Private plans only lasted as long as you didnt change anything - there was no switching between private plans or back and forth from public to private. Pure mathematics shows that everyone would have eventually ended up in the public plan.
If end of life isn't death, what is it?
The beginning of society to live without the drain of resources needed to keep up your feeble existence.
I have a difficult time distinguishing these slippery slope public option means inevitable single-payer health care
What slippery slope? Obama has said publicly he prefers and desires single-payer. Whether he gets there in pieces or in one fell swoop is irrelevant. Should we not take him at his word?
'"Right now, Medicare does not cover this pivotal conversation. As a result, most doctors don't suggest it. And most elderly patients don't get the opportunity to talk about their questions, values and decisions about the kind of care they want at life's end."
That is just complete horseshit. Everyone who has ever lost a close relative knows very well the conversation about DNRs. Why do you need to go to a pannel of experts when you have one with your doctor? I can see no other reason than the government wanting to pressure people into ending their lives earlier.'
Very true John, not only regarding end of life issues, but also standard protocol during a surgical consult and discussed before an operative consent is signed. Other DX where AD/DNR are discussed is (and can be very touchy) is when dementia/Alzheimer's, especially when the patient requires LTC/Alzhiemer's care. This is germane as neurological deficits can occur before end of life is discussed with the patient while he or she is is still 'compus mentus'.
There is no need for a bill like this under the current system.
Here's an article written by Charles Krauthammer highlighting AD/DNR's.
http://article.nationalreview.com/?q=ZTk3ODM3MWFjNDQyMTFiOWI5ZTAwYWY5ZmIwZmUzMzY=
Mad Max, show me again where it says the government will be nudging people towards "death"? If the government is going to be in the insurance business (which it is and will be) should it not be offering people the widest array of choices possible to empower them to make their OWN end of life decisions? I for one would like to have the OPTION of selecting to discuss such issues with my health care provider and having that option covered by my free government run insurance. Choosing when to die is a laudable libertarian ideal even if being made in the context of a big government run insurance program. Bitch.
And we all know the other side are just lunatics right? No one could ever have a principled objection to Obamacare. We are all just a bunch of gun clinging birthers.
I have no doubt at all that SOME of the town hall participants are total loonies and nuts, but most of them are just deeply concerned and angry citizens. And they aren't all Republicans either; any implication that they are is B.S.
Here's the deal: being nice, polite, and respectful got the TARP bailout and the stimulus package rammed down our throats, so those days are pretty much over now.
If you give a guy the middle finger enough times, I guarantee that eventually he's going to respond back to you in an extremely hostile manner.
Jesus Christ John could you suck GOP cock any harder? You do know they prefer their boys young?
I believe I speak for all here when I say, if this bill passes, I hope to be on Tony's death panel.
Once again, Tony shows that he can't grasp that this isn't a GOP website. Nice job!
-The death panels, most obviously: The provision in question just isn't a "death panel." It's a voluntary doctor consultation. IMAC might be closer, and I wonder why it hasn't attracted more criticism. But the phrase is still totally over-the-top.
Am I correct that the president has already signed legislation authorizing the creation of a "comparative effectiveness research" council, which will have some level of authority in offering "incentives" and possibly "penalties" to doctors who prescribe treatment that is/is not "cost effective"? If so, then Sarah Palin's 'death panels' are a bit of a misnomer; a more accurate description would be a 'death council'. But who knows how long it would be before the council becomes a panel?
The provision in question was a reimbursement for voluntary 'end-of-life' counseling (there's that word again) sessions. Unclear in a casual reading of the law was who exactly was supposed to initiate said sessions, or who would be charged with initiating a communication to the patient that such a session is available. Perhaps the CER council could incentivize such sessions? Does the law say they can't?
The law prescribed what was to be discussed in such sessions, so it was already way out of line. But the "voluntariness" of the provision was also in question.
Then what is John doing here?
How is having the "conversation", or more specifically, having the "conversation" covered by insurance inconsistent with libertarian philosophy?
Well, first off, we're talking about having a conversation paid for by the government, so there's a libertarian problem right there.
Second, libertarians aren't so naive as to believe that the government won't apply pressure to (a) make sure this conversation gets held and (b) make sure it includes certain content. More libertarian problems.
Finally, those of us who have actually dealt with Medicare know how it works, and you can be sure that there will be financial incentives, first, to get living wills or whatnot signed and, second, to get the "right kind" of living wills signed, those that abjure heroic measures. Big libertarian problems.
Peter,
John's H&R commenting m.o.:
1) If it is negative post about the Democrats, pile on.
2) If it is negative post about the Republicans, point out that the Democrats did the same thing, or at least something equivalently bad.
3) If it is a negative post about both parties, question the negativity about Republicans, and accuse the poster of being soft on the Democrats.
4) Argue over the irrelevant, never cop to a mistake, take conversations down elusive tangents, and win by attrition.
Engage in dialogue at your own risk. Even if I am on his side of an issue, I typically don't want to read his comments.
All these libertarian commenters, but John makes it a GOP site?
Yeah. OK. Aren't you late to eat paint chips or something?
It's been explained to you time and again Tom. If you don't like being mistaken for GOP cocksuckers then stop sucking GOP cock.
"Engage in dialogue at your own risk. Even if I am on his side of an issue, I typically don't want to read his comments."
Then don't.
Tony, you ignorant slut.
You see GOP cock so much you must have been born kneeling in front of Karl Rove.
So why don't you go take a flying fuck. The GOP is about as useful as an escape hatch on a football, just like the democrats, and plenty have told you the exact same thing. You're just to fucking stupid to comprehend it.
"It's been explained to you time and again Tom. If you don't like being mistaken for GOP cocksuckers then stop sucking GOP cock."
Because God forbid we wouldn't want that reputuation among the Obama cocksuckers.
If you don't like what I have to say, then engage me the way Suderman did. If all you can do is scream "GOP cocksucker" then you are an idiot unworthy of responding to and you can go fuck yourself.
I just expect anyone with half a brain to dismiss the GOP for the corrupt, theocratic, budget-busting, bill of rights dismantling, phony warmongering nutjobs they are. Once you do that, bash the Dems all you want. But don't whine to me about being mistaken for a rightwing hack when that's exactly how you present yourself.
Right. Because all the stupid being done currently is all on Republicans. Plenty of us have argued against distortions on health care from the GOP...we just haven't been in favor of the public option.
Tony, do you stay awake at night looking for ways to look stupid?
Yes Tony just scream that anyone who doesn't 100% agree with you is stupid and crazy. I am sure among the crowd you run in that counts as serious, reasoned argument. But, it really doesn't cut it around here.
John,
I am perfectly aware that eye-rollingly stupid GOP propaganda shat directly from the flabby jowls of Sean Hannity is treated with more respect here than even mainstream factual information. My question the entire time I've been posting here is why the fuck is this the case.
mark, Nat Hentoff, in a column this past Saturday, pointed out that the Center for Health Outcomes Research and Evaluation is already signed into law in the stimulus bill.
I haven't taken the time to find it and verify his claim.
"Tony | August 24, 2009, 3:36pm | #
It's been explained to you time and again Tom. If you don't like being mistaken for GOP cocksuckers then stop sucking GOP cock."
Methinks the lady doth protest too much.
Tony, you passed the point of self-parody long, long ago, and now you're just embarrassing yourself. Quit acting stupidly, for your own sake.
"I am perfectly aware that eye-rollingly stupid GOP propaganda shat directly from the flabby jowls of Sean Hannity is treated with more respect here than even mainstream factual information. My question the entire time I've been posting here is why the fuck is this the case."
You just don't get it because you are a narrow minded moron. No one treats anything with any respect. It is just that people actually look at the facts and arguments and disagree with them based on their merits rather than engaging in ad homonym attacks based on the source. Idiots like you, who can't grasp the subtleties of arguments, have to rely on attacking the source of things. Thinking people, since they can understand the arguments, don't have to obsess about that as much. I dare say no one on this board watches Hannity or listens to Rush Limbaugh. You just think they do because you have convinced yourself that anyone who disagrees with you does so because they are listening to unapproved news sources.
Will this public option work like the public option in primary education? We are all perfectly welcome to purchase a private education for our kids using whatever money is left over after being forced to pay for the inferior public option.
That's where I see this heading. What we see today will not be what we could end up with tomorrow. Well, maybe tomorrow, but a few tomorrows later things could look just like what we were promised wouldn't happen yesterday. This is why Obama wants to pass something, anything, doesn't matter what - just pass it.
"That's where I see this heading. What we see today will not be what we could end up with tomorrow. Well, maybe tomorrow, but a few tomorrows later things could look just like what we were promised wouldn't happen yesterday. This is why Obama wants to pass something, anything, doesn't matter what - just pass it."
Medicare was supposed to be small state program overseen by the Feds and costing only $12 Billion by 1989. Liberals just have to get the nose in the tent. But remember according to Suderman anyone who thinks this is a Trojan Horse is a birther gun clinging nut.
John, Peter says:
So we've moved from the moral case to the fiscal case to the "the-other-side-is-made-up-of-crazed-and-despicable-idiots" case.
That's clearly a statement deriding that way of thinking. Note the scare quotes.
Medicare was supposed to be small state program overseen by the Feds and costing only $12 Billion by 1989.
Given that these government programs that already exist have put us right at the cusp of national bankrupcty, this whole debate has a surreal Alice-in-Wonderland quality to it all, like doubling down on pure insanity.
For goodness sakes, the government can't even reimburse the auto dealers on time for the relatively small-potatoes "Cash for Clunkers" program that is mercifully ending in a few hours. Furthermore, they just came out and announced that there won't be a COLA increase in Medicare for the first time ever!
So we've moved from the moral case to the fiscal case to the "the-other-side-is-made-up-of-crazed-and-despicable-idiots" case.
That's clearly a statement deriding that way of thinking. Note the scare quotes."
I agreee. I think he is saying that. But he also seems to be saying that everyone, beyond the moderate Democrats (whoever they are) who is objecting to Obamacare are crazies or saying untrue things. Suderman seems to be saying, stop blaming the crazies even though all your opponents really are crazy.
Idiots like you, who can't grasp the subtleties of arguments, have to rely on attacking the source of things.
So Tony is Barry Soetoro?
"Given that these government programs that already exist have put us right at the cusp of national bankrupcty, this whole debate has a surreal Alice-in-Wonderland quality to it all, like doubling down on pure insanity."
Maybe someone should just say, "we can't afford for the government to pay for everyone's healthcare."
But we CAN afford to "bend the curve" of cost inflation. You can trust me on that because only I understand the root causes of health care cost inflation.
fixed link
Fucking proposition 13...
Anonymous | August 24, 2009, 2:39pm | #
If end of life isn't death, what is it?
The beginning of society to live without the drain of resources needed to keep up your feeble existence.
Yeah cuz we all know that research and development implicit in the massive spending we put out toward keeping old people alive and healthy will have no effect in keeping people productive at ever older ages in the future.
Hogwash.
Yes Tony just scream that anyone who doesn't 100% agree with you is stupid and crazy. I am sure among the crowd you run in that counts as serious, reasoned argument.
to be fair as a semi-regular consumer of the comments i prefer the sceams of "everyone-is-a-fucking-idiot" mixed in with the serious reasoned argument.
But yeah the serious reasoned argument is the meat...the sceams just add spice.
Tony, you seem to believe that anything emanating from a "right-wing" source should be automatically regarded as discredited, prior to any evaluation of the arguments. How about evaluating each side's arguments in good faith, without regard to the source?
"I just expect anyone with half a brain to dismiss [Obama & the Dems] for the corrupt, theocratic, budget-busting, bill of rights dismantling, phony warmongering nutjobs they are. Once you do that, bash [the gubmint] all you want.
FTFY
"Mad Max, show me again where it says the government will be nudging people towards "death"? If the government is going to be in the insurance business (which it is and will be) should it not be offering people the widest array of choices possible to empower them to make their OWN end of life decisions?"
Well, nudging people toward death is helpful toward achieving government cost-saving objectives (not important or productive people, mind you -- just the elderly, the disabled, criminals, political dissidents, and other social undesirables).
When there's a will, there's a way. And when's there's a will backed up by police, soldiers, a cult of zealous believers, and a limitless credit card, there's a very powerful way.
"
Yeah cuz we all know that research and development implicit in the massive spending we put out toward keeping old people alive and healthy will have no effect in keeping people productive at ever older ages in the future."
The problem is that we haven't changed our idea of when people should be supported by society from the time when most people were broken down and at the end of their lives in their 7th decade. Their health only contributes to productivity if they're actually using that healthy time being productive.
"It's been explained to you time and again Tom. If you don't like being mistaken for GOP cocksuckers then stop sucking GOP cock."
Lenin's been dead too long, Tony. Sucking his cock, alas, isn't going to happen for you.
Tony, why do you hang out here? You hate the private sector, and likely your only concerns re: choice are abortion and gay issues.
Suderman you really never respond to the slam. It is like you agree with it and think that anyone who is not a Democrat is a birther and a moron. Yes, another libertarian who is a libtard in disguise. I think Suderman agrees with Michael Tomasky, who is probably a Maoist death cult Pol Pot wannabe like most Guardian hacks.
The "public option" is the camel's nose under the tent for single payer. Everyone with an IQ over room temp has figured that out, and Barney Frank admitted it a while ago in a unique moment of candor. Pubic [!?!] Option drives insurance companies into the ground by undercutting private sector companies with taxpayer dollars, then single payer comes in to finish off the corpse of the Republic. And we have a socialist autarky in the White House, with a bicameral peanut gallery applauding Dear Leader when he make a State of Disunion appearance.
So, when did Tony start copying Episiarch? The verbiage is there, but it does not seems correct somehow.
Call me a left wing libertarian. I do think libertarian economic ideas are simplistic, anti-human, outdated, and generally nothing but a collection of euphemisms for corporate feudalism, but I'm very strong on civil liberties. I hang out here because I like arguing with people who disagree with me.
Free choice is anti-human, therefore "civil liberties" exist at the behest of a dictator.
Let's see:
"simplistic" = "doesn't tax the bat-fuck out of rich people"
"anti-human" = "doesn't tax the bat-fuc out of rich people"
"outdated" = "taxing the bat-fuck out of rich people isn't an oudated, simplistic, or anti-human idea"
"corporate feudalism" = "people are allowed to own their own means of production, as in small-business entrepreneuers who clearly step on the necks of their ten or fifteen employees just like Big [insert evil corporation] does"
"I'm very strong on civil liberties" = "except when it comes to people over an arbitrary income level, keep more than fifty percent of said income, and I'm only concerned about civil liberties when it comes to gay marriage and abortion, because I want government to dictate what kinds of cars people drive, ban them from eating trans-fat-soaked fried food, where they can smoke, and make it illegal for radio-show hosts to use 'the public airwaves' to dissent against the current sitting government"
Y'know, Tony, thirty years ago, I actually raised eyebrows in junior high when I told a career counselor I wanted to learn Russian so I could help spread the good news of the Soviet Union way of life.
Then I grew the fuck up, and stopped hating the rich folks who lived in the swanky neighborhoods, even though I will likely never live in one myself.
Get over it, man. That's my advice.
TLG,
That's a lot of psychoanalysis to explain a lot of views I don't hold.
Also, it's not a civil liberty not to be taxed! There wouldn't be any liberties without taxes funding an apparatus to "secure" them.
Well, if you're not like virtually every other Democrat who's crossed my path, color me surprised.
We have to have SOME way to pay for what gets done, I'll admit - it's just that we're paying for shit we don't need.
We could shitcan half of the Alphabet Agencies, and America would be just fine. Good start, anyway.
THAT'S a goddamn civil liberty for ya.
Why isn't 34 cents on the dollar, not enough? Why do you morons want to punish anyone with a half-decent paycheck?
Wait, I know this... it's because you're in the party that openly despises the private sector, and can't wait to administer the rest of the Death of a Thousand Cuts to bleed it dry and let the vultures pick at the bones.
The gist is: While you, Tony, may not hold all of those views described a few posts back... YOUR PARTY DOES.
Republicans suck cock, too, mind you. But at least some of them are capitalists who aren't in the business of micromanaging our lives in or out of the bedroom. MAYBE a few Democrats fit that bill, but they're probably so few I could count them on one hand and have a finger left to hoist at the rest.
Same for the right, same finger, different hand.
I watch a friend of mine make out a monthly check to the IRS for a back-taxes plus interest and penalties, that he will NEVER get caught up with because the IRS won't settle for a lump-sum payoff. He's not alone - I know three other people in the same boat.
Is that "civil liberties", for our own tax-collection agency to act like fucking loan sharks?
I watched a former colleague have everything he owns taken because he grew a few pot plants in a closet. Forfeiture, endorsed by Republicans AND Democrats who are so fucking hot-to-trot Drug Warriors that they'll stand by and let a jar full of loose change be counted as "drug sale proceeds".
My boss and I - the sole employees of a local delivery company - are scrounging for business because our clients are scrimping, worrying that Obamacare is gonna fuck them, that cap and trade is gonna fuck gas prices, electric bills to run the presses at the print shops we deliver for, offices are scrimping on toner and office supplies because they don't know if the other proverbial boot is going to drop on their bottom lines.
Get the picture? It's a trickle-everywhere effect - the more uncertain the private sector is that Obama won't stick another fondue fork in the eye of the thing that keeps this country running - business, big and small - the longer it takes for our economy to finally turn the corner. Cause/effect.
This country spends billions complying with a tax code that even Einstein couldn't figure out in HIS day. That's billions that could be spent on real things, tangible items, services, EMPLOY people that don't push fucking tax forms for a living.
But, hey, by all means... let's keep the current system. Hell, let's ADD to it. Just to poke a broom handle in the ass of "rich people".
Y'damn right I'm pissed. I can't get a side gig because the economy is still screwed - no thanks to the gang of criminals that replaced the PREVIOUS gang of criminals.
Fuck 'em all.