Obama and Co. have lost the trust of the American people.
There's a truism in politics that absolute power corrupts absolutely.
Like so many hackneyed phrases, it's both intuitively obvious, and easily dismissed. Obvious, in that it ranks right up there with "don't run with scissors," and easily dismissed in that it's hardly at the forefront of your mind as you go about your daily life.
How many times have we all done something incredibly stupid without giving its consequences the proper thought? Text or answer email while driving, climb a ladder without someone supporting it, answer your spouse truthfully when they ask "do I need to lose weight?" — we've all done these or similar things at one time or another. The fact that every text-while-driving and unsupported-ladder-climb doesn't automatically result in grievous personal injury doesn't mitigate the seriousness or innate stupidity of the action. Being lucky is not the same thing as being smart, because when dealing with stupidity, the odds are always stacked against you.
It's human nature to take shortcuts, act without always fully thinking an issue through, and substitute wishes and hope for reason and objective analysis. This accounts for most of the stupid decisions we make in our personal lives, and some of the ones we make collectively with our fellow citizens. I'm speaking of course now about electing a part-time United States Senator with virtually no previous political or real-world experience (academics doesn't count) to become the President of the United States, and along with that give him a filibuster-proof Democrat Congress to implement his programs.
As has become the trend in recent years, elections today are as much about what you don't want to have happen as it is about what you want to see accomplished. I doubt seriously that the legions of John Kerry supporters in 2004 really wanted him above all others to occupy the White House, just as those of us who voted for McCain in 2008 were hardly confirmed McCainiacs enamored by his talents and abilities. Rather, it's just as likely (perhaps moreso) that a majority of Kerry voters hated Bush in 2004, thus driving their decision much the same way that I and others feared Obama's stewardship of the nation more than we embraced McCain's political philosophy.
Add to the mix in 2008 the guilt-and-Camelot factors, and you have the makings of a perfect political storm. Guilt, in that in the minds of some voting for Obama atoned for the sins of our past; and Camelot, in that wouldn't it be really cool to have a modern-day version of JFK replace the old, tired, out-of-step policies of the past? This is why "Hope and Change" needed no actual real-world definition. The emotions themselves were sufficient to drive many voters, who simply filled in the missing details with their own personal policy preferences.
Since "change" was one of the dominant themes in Obama's campaign, and technically anything different than what we have at present is "change," the thinking was, we might as well throw in a filibuster-proof Democrat control of Congress to help Obama out. I mean, after all, what's a few more Senators and Congressmen among friends? We're all pulling in the same direction — the direction of "change" — and you can't have change without changing things around.
Which brings us to today. Barack Obama has been in office about seven months now along with his Democrat pals, and they've been busy implementing their change. The problem is, "their" change isn't necessarily the voters' change, many of whom bought into the transparent, post-racial, bi-partisan imagery of the Obama campaign.
The only thing transparent about the Obama Administration's transparency is that it isn't. Lobbyists continue to dominate the halls of power, 1,000-page bills are speed-read when Republicans object to passing them without adequate review, the need to act "immediately" (i.e. in hours and days) to forestall economic collapse translates into trillions of dollars in new debt for programs that won't begin to come on line until the months before the 2010 mid-term election.
Post-racial politics have gone out the window with repeated charges from the Left — none of which have been condemned by the Obama administration — that "Tea Baggers" are racist rednecks, and those objecting to Congress' health care program (Obama doesn't actually have a program, just rhetoric about a program) oppose this because they hate the black guy. And now, they apparently hate God too, since opposing the Democrats' version of health care "reform" means opposing all health care reform, and Jesus sides with Obama on this one. It's okay though. Appeals to God are perfectly fine when a Democrat is in office, but not a Republican. The difference is, Republican presidents actually incorporate their faith into their personal lives, while Democrat presidents use it to avoid impeachment, get their street-cred to run for elective office, and when the chips are down, use it to condemn their opponents as immoral. In other words, Republicans are dangerous because they might actually act on their religious beliefs, while no one really expects a Democrat to do anything other than give lip service to religion to promote their secular agenda.
Finally, the myth of bipartisanship has been put to rest under the Pelosi-Reed-Obama Administration. It's not because Republicans have refused almost unanimously to sign on to the patently political and economically irrational policies of the last few months. Pelosi has locked the Republicans out of the negotiating process in the House, and the Senate is hardly any better. Though a few Republican noses have been allowed inside the tent, it's only for show. When Republicans object to language in the Health Reform bill that could allow for government-subsidized abortions, Democrats maintain it's not part of the bill. Republicans then offer an amendment to the bill that will state this clearly, and Democrats object. "So I axe you," as Vinny Gambini is fond of saying, why not allow the amendment and incorporate that specific language — unless it really is there, just like the Republicans maintained.
This is why Obama is failing. There were enough idealistic independents and hopeful voters of both parties who wanted an historic, post-racial, bipartisan figure to assume office to elect Obama. But rather than lead this way, Obama has either not led at all (allowing Congress to do whatever it wants in a business-as-usual mentality), or when he has tried to demonstrate leadership, it's not at all what the hopie-feelie public thought they were getting.
Second, he and his fellow Dems have managed to piss off an extraordinarily important element of the Democrat party coalition. Pitching health care "reform" which is designed to cut costs and increase coverage in a "revenue neutral" manner (except for the "rich millionaires" who will presumably be taxed into oblivion) is only possible if health care is rationed. And since most of the costs of the present health care system are designed to keep grandma and grandpa alive, that's where the cuts will be made. After all, there are only so many unnecessary amputations and greed-driven tonsillectomies that Obama can kybosh; the rest of the savings has to come from the "pain meds" Obama himself proposed as an alternative to that expensive, life-sustaining surgery.
Finally, add to this mix the final thought that although we all make dumb decisions from time to time, people as a rule aren't stupid. They understand that the stimulus package wasn't a stimulus package as originally represented, but something very different. And very expensive. Add health care to this mix, and even the most apolitical housewife (aka "race-hating terrorist" as described by the media) gets a little concerned. Diminish or dismiss these people's concerns through the kind of Royal Indignation many members of Congress have displayed — from charges that these citizens like to wear swastikas, shoot black people (especially black presidents), or by simply taking a phone call while some cancer survivor is trying to ask a question at a town hall meeting — and you get the kind of vocal backlash we see today.
If John McCain, an old white guy, proposed the same exact policies that Barack Obama has, and acted in the same way President Obama has in selling those policies to Congress and the public, there would be an identical backlash to what we see today. If a filibuster-proof Republican Congress passed a multi-trillion dollar "stimulus" package that did little more than reward their political friends and grease the public trough for the 2010 mid-term elections, there would be an identical backlash to what we see today.
It isn't Obama's race that is causing him problems. It isn't the fact that Republicans don't like Democrats in power that is causing Congress its problems. Obama, Pelosi, Reed and the other True Believers have pissed off too many people who were prepared to give them the benefit of the doubt when they assumed power in January 2009.
The simple fact is, the American public knows it has been lied to by Obama and his party, and they no longer trust him. Therefore, they are no longer willing to fall lock-step behind any programs they offer, because they no longer believe what is being said about the purpose, cost, or possibility of success for those programs.
Obama and Co. have lost the trust of the voters who put them in office. This trust cannot easily be recovered. It must be earned anew. However, it takes time, and actual honesty, to reverse the course — two things which the Democrats today have in short supply.
Good article, refreshing to know that I can two books and a movie and sum up the Omessiah’s approach to almost everything. Here goes:
1. Animal Farm…all animals are created equal, some are more equal than others.
2. Atlas Shrugged: Just watch the exodus as we start paying for the already spent plus the remainder of the looting that is planned.
3. The movie, Soylent Green…showed Omessiah the way to end of life counseling.
Sorry for being so flip but I have actually read the full house version of the health care “reform” bill. Great use of words throughout aimed at obfuscation and confusion.
I love the part on illegal aliens which states they will not be covered but lacks any requirement of identification and does not make use of health care by illegals a felony. Watch the huge influx after this passes.
There are tons of others but the part that actually takes the prize is the media claim of no rationing, yet the Omessiah plans to reduce the $ for medicare at the same time that it is growing by millions of new entrants every year as the baby boomers hit 65. Am I being unreasonable in indicating I cannot understand how no rationing will occur in this situation?
Oh well, failing seems to be too mild but don’t underestimate the power of the media to follow the Goebels handbook on communitcation the most importand of which is if you tell a lie enough times it becomes the truth (perceived).
Mickey — the problem the O-man has is that while some people may believe the media lies, the older population (which has a direct vested interest in expanding, not contracting, their health care), knows that Obama’s no-rationing rhetoric is a lie.
Nothing quite focuses the mind like a gun pointed at your head!
wow my typing was awful this morning, left the word cite out of the first sentence, misspelled Goebbels, communication, and important.
Phil, and that gun is pointed at my head, as a 68 year old I am on medicare (secondary to my regular coverage) and very interested in the progress of a medical program that took a deduction on all of my income unlike social security that mercifully turned off at some point each year.
However having both children and grandchildren it is difficult to watch the destruction (no other word is sufficient) of our country. Strange that the country blamed world wide for the “brain drain” has made it easy only for the least competent to enter. The combination of massive debt, a declining economy, open borders, and disenfranchised citizens could go so far as causing armed insurrections in parts, if not all, of the country.
Things are getting scary, fortunately my cousin wrapped our house and the family farm before selling the construction business. We will survive but many others will not as the debt comes due. All of our family businesses have gone to no employees only contractors and owners. I suspect that our income will disappear as the tax rates go up. Surprisingly the only to catch off the grid folks is through sales taxes but we are fortunate that Democrats still cling to the socialist idea of graduated income taxes.
Who knows maybe the South will rise again, particularly since the United States has gone on record as approving secession (thank your Mr. Bush for Kosovo recognition).
Thank God Congress is on Vacation.
President Obama ran on a platform that included a promise to reform the health care crises we have faced in our country for many years. The crises can be viewed many ways with perhaps the largest chunks being the huge number of uninsured and the other the ever rising cost of health care. These two aspects do not comprise all of what we can refer to as the “Health Care crises” but they are at the heart of the current debate.
We’ve heard pleas to our compassion in support of a particular solution to our problem and for those who simply cannot get health insurance or those who really cannot afford it, they are deserving of our compassion. We may be tempted to think that anyone currently without health insurance is due our compassion but this, I believe, is not the case. Those who have the wherewithal to purchase health insurance but want to spend their money elsewhere do not get my compassion. Those who believe health care should be given to them likewise do not get my compassion.
The Obama plan has stirred up great emotion in a great many people and I believe the reason is very basic. He is challenging some long held core beliefs that Americans have perhaps taken for granted.
There are two primary debates in play here. The First debate comes even before we “talk details” on health care. We cannot have a “Federal Plan” to “solve the health care dilemma” that shifts trillions of dollars to the Federal government without changing the kind of governance we have. Many supporters of the Obama plan have argued that we need to focus on the details implying that this huge change in philosophy is not a core issue in itself. Not a core “Detail”? How could this NOT be a detail?
The Obama plan is, in itself, a crisis waiting to happen. Solving the health care crises “his way” will drive a very deep wedge between those with traditional views and those who believe we should create a federal giveaway to solve the problem. In this context, traditional views hold that you are responsible for yourself. You should not expect others to contribute to solve problems you can solve yourself. Enacting a “Public Option” will insure that Health Care is a divisive debate in every federal election in our lifetime.
It took me a bit to get to this point but I agree with you Phil. Why rush? There is a clear difference of opinion. Democrats in Congress clearly wanted to rush the plan thru before the ire of the American people could be stirred. The stirring has risen to a whippen…
President Obama won the election and can propose and support any changes he believes will lead to the basic kinds of changes he based his campaign on. If by “Change” he was referring to an attempt to change how we govern, if he was referring to an ever shifting transfer of wealth from those who have earned! their wealth, to those who need more he will find a wall, many walls. The RUSH approach does NOT make sense.
Obama’s plan would establish a framework for additional change down the road. It’s just the “The set-up”. There is no “Death Panel” in the proposed law. There are those who are looking for hot button topics that are just not there. The problem, as I see it, is this. The Obama plan, if fully implemented, would establish the “framework” allowing for an ever growing shift from the private insurance process we know today to a powerful public solution that would be in place in 12 to 20 years. Does anyone believe there would still be no health care rationing in 20 years when the private market for the masses has all but evaporated? There would, no doubt, be a tiered system of sorts where the rich could buy their own health insurance at exorbitant prices. If they had to, these doctors might even locate across boarders or offshore to provide service under these very lucrative heath care plans. Under the Obama plan they would be compensated based on the prices negotiated or set by the only “Payer” in the country, The U.S. Government. These “Off Shore” docs would service the rich and get richer while draining the pool of quality health care workers for those forced to live under the government plan. The government plan would forever be known as the Obama fiasco.
Many other “Unintended” results would, no doubt, arise as private health insurance disappeared.
I find a “Single Payer” solution more than a bit scary. What about competition. Can we lift the laws that keep Health insurers from competing across state lines??? Don’t we want to debate this in Congress for all to see?
Isnt’s debate a good thing?
Mickey: I’m 10 years behind you in age, but right next to you in strategy. My partners and I have stopped all wealth creation (read: new business and new jobs), and focused our efforts on protecting what we have.
I’ve accelerated my charitable contributions this year with major donations to the Frontiers of Flight museum in Dallas and University of Texas system, which will happily reduce my taxable income this year. That won’t help in 2010, but it will make a major difference in 2009. I’ve also formed an LLC which has positive, long term tax implications for me.
In short, where before my focus was on creating new businesses (which also created jobs), today I’m focused on identifying every possible way to legally reduce my tax obligation to the Federal Government, including maxing out my annual SEP contribution. The O-man and his buddies in Congress may raise the tax rate, but they won’t be collecting any more of my money.
By the way, if anyone is in the Dallas Texas area, the artifacts I gave to the Frontier’s of Flight museum are already on display. The exhibit is in the name of my late brother, Tim Anthony Jackson. Only a small percentage of the artifacts are out at the present time, but still large enough to occupy the entire display area next to the Apollo 7 capsule. The University of Texas at Tyler will many put the political items I’ve donated on display in October, also identified through my brother’s name. Within a year all 5,000 artifacts will be available for viewing on-line.
cmmcginnis: The Law of Unintended Consequences always works overtime whenever the government tries to ‘make things right’!
Any serious reform of Health care needs to begin with tort reform. Defensive medicine drives up the cost of services, along with high malpractice insurance costs.
Not every medical mistake is a reason to win the lottery. And, for true malpractice cases, we ought to be able to hold people and companies accountable without enriching lawyers. And, winning suits should cover the actual cost of past/future care to correct the egregious mistake, not toss in a few million more as “punishment”. Etc.
The fact that none of these issues are part of a 1000 page so-called Health Reform bill only underscores its true nature.
P
As usual, great analysis, but I must disagree with the conclusion that some hopey conservatives now have that some version of socialized healthcare will not now pass & it’s 1994 all over again.
Never before have so many important voices have so much invested in this incompetent to let him fail completely in his signature item, his raison d’être. I think we’ll get some bill leading to hopey/dopey socially backward health care.
And that as cmmcginnis notes it will be “a framework for additional change down the road… ‘The set-up’”.
As you & others have noted, there is nothing about abortion in the bill, or about coverage of illegal immigrants.
Not to worry, a federal judge will rule that under this law such coverage is mandatory lest we multi-culti discriminate.
P
And about what Sarah Palin has aptly described as “Death Panels”, which a friend of mine noted was just another piece of crap from the VRWC: snopes says it’s not true”.
Yawn.
His robotic reply reminded me of a story, I think from Leon Uris’s novel, “Exodus”. Seems the Nazi doctor at the desk at Dachau where they unloaded the trains full of Jews decided which Jews would go immediately into the ovens & which would go to the work camp. His justification at the Nuremburg trials was that he was a good guy for he had decided who would live!
Now The NYT says:
“The zeal for cutting health costs, combined with proposals to compare the effectiveness of various treatments and to counsel seniors on end-of-life care, may explain why some people think the legislation is about rationing, which could affect access to the most expensive services in the final months of life. “
Ya think?
Seems that
The NYT kept after people like you & me for days up to last week when it had one of its hissy-fit editorials telling you how (to use an Obama word) stupid you & people like us’n really were:
False ‘Death Panel’ Rumor Has Some Familiar Roots
Which roots, in case you haven’t guessed are from the slimy ooze; seemingly
reminiscent of the modern-day viral Internet campaigns that dogged Mr. Obama last year, falsely calling him a Muslim and questioning his nationality.
Specifically, they were
“openly emanating months ago from many of the same pundits and conservative media outlets that were central in defeating President Bill Clinton’s health care proposals 16 years ago, including the editorial board of The Washington Times, the American Spectator magazine and Betsy McCaughey, whose 1994 health care critique made her a star of the conservative movement (and ultimately, New York’s lieutenant governor).”
Well, the NYT now has a “row back”, you know where it knows it has erred &, without acknowledging such error, prints a contradictory story as if it has never published the original erroneous story. (What never? Well, hardly ever!). See:
A Basis Is Seen for Some Health Plan Fears Among the Elderly
http://www.nytimes.com/2009/08/21/health/policy/21seniors.html?_r=1
“White House officials and Democrats in Congress say the fears of older Americans about possible rationing of health care are based on myths and falsehoods. But Medicare beneficiaries and insurance counselors say the concerns are not entirely irrational.
“Bills now in Congress would squeeze savings out of Medicare, a lifeline for the elderly, on the assumption that doctors and hospitals can be more efficient.
“President Obama has sold health care legislation to Congress and the country as a way to slow the growth of federal health spending, no less than as a way to regulate the insurance market and cover the uninsured.
“Mr. Obama has also said Medicare and private insurers could improve care and save money by following advice from a new federal panel of medical experts on “what treatments work best.”
“The zeal for cutting health costs, combined with proposals to compare the effectiveness of various treatments and to counsel seniors on end-of-life care, may explain why some people think the legislation is about rationing, which could affect access to the most expensive services in the final months of life.”
(H/T JustOneMinute)
The NYT: Part of the VRWC!
Nevermind.
Inwood: We’ll definitely get something this year, and it will be called “Health Care Reform”, but I don’t think it will be anywhere as comprehensive as originally proposed — unless the Dems actually try to pass it via Reconcilliation (aka the Nuclear Option), and then all bets are off on what happens after that!
Another thought.
Most intelligent people “care” or “are concerned” about “health care” or “insurance reform”, whatever the latest phrase is. It’s just that not everyone thinks that we’re in need of “reform” into a government-operated Medical care plan, a/k/a, socialized medicine.
So I’m tired of clerics who appear on TV giving a sermon that implies that members of their faith, congregation, whatever, who do not support what such members, the fools, see as Socialized Medicine are, QED, uncaring about the health care of their fellow Americans, especially poor Americans, & are going to Hell (if these clerics still, you know actually believe in Hell).
I suggest that, besides being baseless, this is uncharitable toward their congregants & vainglorious.
I also wonder whether such nominal clerics are not so much Catholics/Protestants/observant Jews as robed socialists holding positions of power in a church/synagogue which they have adopted as better allowing them to express their political views than some other organization/profession.
From Gateway Pundit: 8/23
Ouch!… Obama Reaches New Double Digit Low in Popularity at -14!
This is awful– Just awful!
Maybe it’s the record unemployment, or his record spending, or his failed planning, or the climbing misery index, or his failed policies, or his record deficit, or his constant apologizing, or his trashing the cops, or his radical plans to takeover the health care industry…
Whatever the reason Dear Leader’s popularity has tanked. The radical leftist has seen his presidential index number drop an amazing 44 points since he took office!
OOPS left out my own last line:
Nevermind. Just a lot of folks all wee weed up.
A few interesting observations regarding Healthcare:
1. THe formatin of “Death Panels” isn’t in any piece of health care legislation currently before COngress. This is correct. THoise panels were formed as part of the already passes ‘Stimulus Package. THe Stimulus Bill calles for the formation of Health Information Technology Committees. One of the jobs of these HIT Comittees (Don’t ya’ just LOVe the acronym?)is to “Identify innivative approaches to senior health care in other countries and to break down barriers in order to implement those innovations here in the US. Couple that with the Veteran’s Death Book which the VA uses to ‘guide’ greviously wounded veterans in making ‘quality of life’ decisions and you have a euthanasia program already designed!
Abortion. Technicallyu, there are no specific clauses which say abortion will be covered. THat’s because there IS no benefits package of any type listed in the legislation. On page 30 of HR3200 it states that once this legislation becomes law, a government committee will be established to determine the range of benefits to be covered under the plan. None of the benefits have yet to be enumerated, or excluded. The words ‘Planned Parenthood’ don’t have to appear in the text. All benefits will be decided after the bill becomes law. If benefits are to be decided only after the plan becomes law; then literally any medical procedure, including abortion, can be placed on the list any time the committee desires. In this case NOT writing it down has everything to do with it. So I guess the government DOES expect the taxpayers to eventually fund abortion services on demand.
Another myth is that the ‘public option’ wont’ kill private insurance. OOn Page 149 of HR3200, in esoteric “contribution” language, any employer with a payroll of $400,000 or more, who does not offer the public option, pays an 8% tax on payroll as a penalty. I currently pay $100 per week for my wife’s policy. I assume my employer pays same for me. At $35,000 per employee and 32 employees; 8% of $1,120,000 is $89,600. At 32 employees; 32 times $5,200 is &166,400 per year in health care. They can ‘save’ $76,800 a year by cancelling everyone’s coverage and paying the tax. This effectively doubles my costs from $5,200 to $10,400 a year. I earn $35,000. This scenario moves my costs for health insurance from a manageable 14.8% of GEI to an unaffordable 29.7% GEI and places me on the public plan overnight. So apparently while HR 3200 does not make private health care illegal; it stacks the game against the continued existence of private insurance. This is effectively a BAN on private health care.
Finnally the ‘rationing’ myth’. Under the set of conditions we’ve outlined above; the only logical method of controlling cost IS to ration care. Health care decisions will HAVE to be made by applying some form of ‘cost vs. benefit’ analysis. One does not have to enter into the ‘conspiracy’ crowd in order to come to the reasonable conclusion that in order to prevent the country from becoming a ‘health care plan with an army’ that some restrictions will eventually HAVE to be placed upon the system in order to control costs.
Milbrat — your comments triggered a couple of thoughts. maybe we need to re-think how our side measures “success”.
Obama wants to measure his success by two factors: (1) the number of jobs his policies create, and the number of jobs his policies “save”.
If this is the new standard of evaluation, then we need to look at two factors that identify the success of our efforts: Lives created, and lives saved.
Every woman who doesn’t have an abortion results in a “life created”, and every old person who gets an operation instead of a pain pill is a “life saved”.
P
I would argue that when a woman does not abort a living baby in her womb, she is saving a life.
FI
PS You must be a rightwing nut since you don’t want to give The One credit for “saving” jobs. You know, like the Nazi Death Camp where the doctor claimed at Nuremburg that he was “saving” lives.(Aside, how come we can use the term “death” for these camps when, you know, “arbeit macht frei”?)
PPS Will transferring prisoner “interrogation” to the FBI from the CIA result in net lives saved? That is, will the number of Islamothugs whose lives are now saved exceed that of Americans lost as a result of inability to get info about impending attacks?
PPPS Did you hear that Russian subs are now off our coast because they misunderstood that the “Cash for Clunkers” program did not apply to subs?
TO Phil;
I agree. The old method of calculating the success of a federal program by how many people no longer ‘need’ it hasnt’ been gaining any traction lately.
Inwood;
I guess I must be one of those ‘right-wing’ nuts as I have no idea how to go about calculating a ‘saved’ job. I can follow Phillip’s logic regarding a created or saved life. A ‘saved’ job seems a rather ephemeral formula. I mean; couldn’t the current administration claim that the economic stimulus package has ‘saved’ 90.6 percent of the jobs in the US? An unqualified success if there ever was one! Every job ‘not lost’ is a job saved, correct? And more than enough reason to increase defecit spending.
Such a pitch could also be used to justify health care: I mean; if a $787 billion investment saved over 90% of the jobs in the US, just imagine what the application of $1.6 trillion would mean for the health care system! Why; the sky’s the limit! I really need to resist the urge to keep adjusting my medication.
Inwood — good point. I was mind-melding with Liberal Logic to make the point, since they don’t recognize aborted humans as human life. Thus, the only way to “create” a human life in Liberaland is to not abort the tissue mass so that one day it can “become” human.
On the matter of killing grandma and grandpa (or disabled veterans, or mentally challenged individuals, or otherwise less than perfect human beings), the Libs can recognize it as a human death. It’s just not an “important” one, since their view of another person’s basic worth is more important than any silly notion that people might actually have a intrinsic value in their own right, regardless of how well they can care for themselves, or how “valuable” they are to society, or whether you personally would want to live in a wheel chair, etc.
Milbrat
You’ve got it.
Calculating a “saved” job is easy under Obamanomics 101.
Say that
on 1/20/09 150 million were employed &
on 8/20/09 140 million were employed.
Rightwing nuts would say that
From 1/20 – 8/20, 10 million jobs had been lost.
Obamanomics would say that
As of 8/20, 140 million jobs had been saved.
All under the Presidency of The One.
That’s why I was reminded of the Death Camp story.
Also of the Obama expression: “The Glass is 90.6% full”.
And if you are one of those who has lost his job, you have to ask yourself questions like those in the VA, um, Domesday Book if all you’re doing is wasting your time reading & writing on disreputable sites such as this. If you do, & if you have a sense of shame, you will take yourself out of the civilian labor force. This will help the commonweal by lowering the percentage of unemployed in the labor force, which is what gets reported when we have a Dem President, tho not when we have a Republican one.
I know that all this is hard to follow which is why the Obama Administration is having such a hard time filling positions: it wants only The Best & The Brightest who can perform the mental gymnastics necessary for the profanum vulgus to remain happy & ready to vote properly.
Regards
Inwood
Milbrat
A dilemma.
If I’m on one of the Death Panels somewhere, sometime & your case comes up before me & I see that you have cheated on your taxes, what do I do?
Do I treat you like one of Obama’s appointees & let you have the new body part, or do I righteously condemn you as unworthy & leave you to suck it up or take pills?
Or do I have to take into consideration whether your tax info came from a CIA investigation, where, presumably, they used torture to get the info?
Just askin.
Inwood,
Well, actually I imagine there being ‘multiple’ death panel meetings before a case is decided. During the initial meeting, you would have to determine if I belonged to a special group singled out for head-of-the-line privileges such as GLBT’s, ACORN’s, UAW’s or AFL/CIO’s, members of the Communist Party; or a group singled out for scorn and back-of-the-line privileges such as George Bush supporters, Sarah Palin supporters, or anyone not a resident of New York, New Jersey, Illinois or California.
Once group affiliation was determined; there would have to be a one-on-one meeting where members of scorned groups were given the opportunity to ‘move up’ the ladder by denouncing their sin and performing repentence.
Once that meeting is completed, then there is a ‘closed door’ meeting where just the board discusses and votes on each medical treatment application in light odf the information gathered.
Finally there would be another ‘public’ meeting where each person who filed for medical treatment or procedure is informed of the board’s decision and is given directions as to the appeals process.
With 60 days in between meetings; the ‘fast track’ to treatment is 180 days. Scorned groups can be delayed up to 360 days before being begrudgingly ‘approved’ for treatment, usually posthumously.
No one can actually be refused. All are ‘eventually’ approved. Much like saving 90.6 % of jobs, the government’s medical approval rate will be 100%. The governmetn’s medical ‘survival’ rate however; will be ‘somewhat’ less!
Regarding health care, here’s an interesting link: http://thismodernworld.com/4871
It’s sobering to realize that the percentages of the population with access to health care haven’t changed all that much in 60 years. On the other hand, it’s also sobering to read the last part of that op-ed and see what the “fixed charge on the economy” was then… compared to now.
I’d also contest that “most of the costs of the present health care system are designed to keep grandma and grandpa alive”. Emergency, crisis care is definitely the largest expense – but it’s not just the elderly that need that. There’s a whole lot of prevention that isn’t done now – e.g. simple diet and exercise. And a whole lot of other crises can be averted if people go see a doctor before an illness reaches the crisis level. I haven’t seen a solid case made that the only possible savings latent in the present system – or even “most” of them – lies in euthanizing old farts.
RI
You say that you
“haven’t seen a solid case made that the only possible savings latent in the present system – or even ‘most’ of them – lies in euthanizing old farts.”
Strawman (OOPS, person) alert: Who’s making such case?
Rahm Emanuel’s brother, Dr. Ezekiel, one of the Big Thinkers behind this points to all drags on the system, regardless of age, as does the VA Booklet.
I hate to resort to argumentum ad Hitlerum, since the Leftist crazies did so every time Bush 43 said something, so let me resort to a lawyer’s rubric & say that it’s clear that all people, no matter what their age, who are chronically “sick, sore, lame, & disabled” will be given some form of end of life counseling a/k/a guilt trips that goes beyond “do your heirs know where the keys to the safe deposit box?”
What happened here was that Sarah Palin, with a “disabled” kid brought this to the fore with a Bumper Sticker remark about “Death Squads”. Bumper Stickers are considered déclassé when used by Republicans/Conservatives, my dear,& the nerve of that uneducated former Beauty Queen to use one so effective, that the profanum vulgus, especially the geezer profanum vulgus, who we can virtually always count on to panic, OOPS, support us overwhelmingly when we say such thoughtful things like “Republicans are going to take away your old-age benefits” are now, um, confused.
Sarah Palin “One” Obama “Zero”
*************
Milbrat
Point of Order: §1223 of HR 3200 also covers “Death Panels” as did the “stimulus” law.
Milbrat
I’m such a polymath that I sometimes confuse mere mortals with my wit, irony, satire, humor, sarcasm, whatever.
The tax reference in my #20 does refer to a serious point in the Bill: Socialism is Draconian. The only way to assure that things are done is to punish. See, e.g., today’s WSJ:
Tax Penalties and the Health-Care Bill
Under the House legislation, taxpayers will be fined for honest mistakes.
http://online.wsj.com/article/SB10001424052970203550604574358882642883214.html
Another non-arguable point is debated.
“Some 18 percent of lifetime costs for medical care is estimated to be incurred in the last year of life.” http://preventdisease.com/worksite_wellness/health_stats.html Also, “27% of Medicare’s annual $327 billion is spent on the last year of a person’s life
If you look at the period of life from 55 to death (the “Grandma and Grandpa” years), — which is a 20-30 year period — the frequency of doctor visits, medical costs and hospitalizations increase dramatically compared to the previous 55 years.
If 18 percent of total medical costs occur in the last year of life, and 27% of all Medicare costs are for the last year of a person’s life, it’s not unreasonable to conclude that at least 50% (and more) of an individual’s total costs occurs from 55-85. Thus, “since most of the costs of the present health care system are designed to keep grandma and grandpa alive, that’s where the cuts will be made.”
It’s all about money, per a recent Reuters article http://www.reuters.com/article/healthNews/idUSTRE5286EK20090309
“The goal of palliative care is to relieve suffering rather than to halt progression or cure the disease.
“If half of the estimated 566,000 American adult cancer patients who died in 2008 had the end-of-life discussion, the projected savings would conservatively be $77 million, according to a report published in the Archives of Internal Medicine.
“U.S. policymakers are hoping to find ways to rein in soaring healthcare costs, and researchers said end-of-life care merits a close look.
“The one in 20 Medicare patients who die each year use up almost one-third of expenditures by Medicare, the government health insurance program for the elderly and disabled.
“One third of expenses in the last year of life are spent in the final month, according to the report, with aggressive treatments in the final month accounting for 80 percent of those costs.
“This is a waste of money … The real cost differences could be substantial,” said Holly Prigerson of Dana-Farber Cancer Institute at Harvard, who helped perform the study.”
Throw in Quality of Life considerations (read: I wouldn’t want to live that way, so you must die), and you again get back to the core issue. The quicker we get rid of the old and disabled, the more there is for everyone else.
Preventive care is wonderful, but not a cure-all. My wife’s cancer and subsequent related health problems (and the more than $1 million bill that has followed since she was diagnosed a decade ago) was not the result of her lifestyle.
You can pseudointellectualize this debate all you want, but the people whose lives are on the line — those old farts (i.e. “Nazis”) who keep showing up at the town hall meetings — know what the real story is. There isn’t enough money, doctors, and medical resources to keep them alive and pass out subsidized health care to potential voters to keep the Democrats in power.
If I choose not to extend my life through heroic measures, it’s my (and my family’s) decision. It’s not someone else’s right to pull the plug (or give me the blue pill instead of the more expensive operation) because they think I’ve lived long enough.
Dr. Jackson – From the same link you drew your stats from, “Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs.”
I’m well aware that many cases of illness – such as your wife’s cancer – aren’t the result of lifestyle. But, according to the source of stats you’re using, those also aren’t the major contributors to medical costs.
Naturally I agree with you that choosing not to extend life through heroic measures is – and should be – a personal decision. An obvious followup question arises, though: Should heroic measures therefore also be a personal expense? I’ve seen nothing proposed that would forbid people from spending their own money (or private insurance money) on such things…
We can “prevent” the flu by inoculating every American (assuming of course the government is competent enough to actually provide the vaccine). This “prevention” would involve the cost of the vaccine (plus its developmental costs and testing), the cost of the delivery mechanism for the medicine, the distribution system for the inoculations [syringes and other medical devices], the increased personnel to administer the shots (even nurses and PAs are expensive), etc. That cost would then need to be compared to the cost of treating the people who actually get the flu.
This is how you do a cost comparison analysis.
Multiply this by every other preventive measure for every other conceivable illness, which also includes lifestyle regulation (we prevent diabetes by making people control their weight better, etc.). And don’t forget that this “prevention” needs additional up-front education, ongoing training and reinforcement related to that education, and enforcement where necessary. These costs would then need to be compared to the cost of treating the people who actually get the diseases or maladies in question.
This again is how you do a cost comparison analysis.
There is no real case that focusing on “prevention” — even if it was practical in a nation of 300 million+, some of whom are here illegally and not subject to the training and monitoring citizens would be forced to accept — would actually drive down costs. They are more likely to increase health care costs when all the relevant factors are considered.
A case can be made that some kind of increased prevention is beneficial to society. But the suggestion that done correctly, preventative measures would drive down health care costs is erroneous. Much like has happened with education about the use of tobacco, the net result is to increase costs for society. People who otherwise would have died younger — thus using fewer years of health care which saves money — — have lived longer. Not only do they consume more years of health expenditures, if they died earlier they would not have been given as much social security payouts as those who lived longer. Plus, the government would have gotten their inheritance tax money earlier.
None of what is being debated in Washington today is about saving money. If that was the real focus, tort reform would be an essential part of the bill to drive down the cost of defensive medicine (which leads to unnecessary tests), and causes higher medical fees than necessary to pay off high malpractice insurance premiums. The debate is about who will control 1/6 of the American economy.
If health care reform is supposed to be revenue (tax) neutral for those making under $250K a year as Obama promised, and cover another 40 million presently uninsured (which adds 40 million new patients to the system, requiring an increased infrastructure to support it), and allegedly will focus on “prevention” because that’s where the high costs are supposed to be (which again means more costs to the system), the only way to do this is to ration health care. Note to file: It doesn’t matter that the word “rationing” isn’t in the bill. The word “privacy” isn’t in the Constitution, and that hasn’t stopped it from being the foundation of many laws today.
And if you are going to ration healthcare, the one group which uses up the most resources is the 55 and older crowd.
We may be old, but we’re not stupid. Which is why we understand what’s really going on, and why we won’t let the pseudointellectualization of this debate distract us.
Phil,
“Preventive care is wonderful, but not a cure-all.” Nor is preventative care insurable.
By definition, something is insurable if it is
1)Accidental/unexpected. A known or imminent loss is not insurable.
2)Large enough to cause hardship to the insured. The purpose of insurance is to transfer risk.
3)Predictable. The loss arises out of a homogenous group large enough that the insurance company can estimate the total potential for loss.
4) Can be priced affordably in relation to the potential severity of loss. Some losses are so frequent or severe that the insurance premium would be very high. That is why there are exclusions in insurance policies – it is to make premiums affordable.
Probably too much information, but I say all of this to say that preventative care is a known, expected expense. Insurance cannot accomodate this. To put it another way, remember a couple of years when gas stations were required to replace their underground tanks at $50,000 a pop? Gas station owners were complaining that their insurance wouldn’t cover it.
(Making up some numbers here for illustration) So what would insurance cost to cover a $50,000 claim from 1000 insureds? Answer: The total amount of all claims ($5,000,000) plus expenses, administrative costs, and of course, profit (totals about 15%), divided by the number of insureds (1000) equals $57,500 per insured.
The problem is, when it comes to the health insurance debate, too many people expect that 100% of everything ought to be covered. Ain’t gonna happen, no matter who is running heath care.
MM: Exactamundo. It’s all about conducting a discussion in the real world, and leaving the pseudointellectualism behind.
Anyone can make any abstract case they want to support their position. However ultimately, like Obama’s $7 now $9 trillion deficit, the real world catches up with the fantasy.
Mouthing “prevention” as a way to address the problems of the current health care system which are driven by other factors (like tort law, archaic regulations that limit the insurance policies a consumer can purchase, etc.) is just political BS. Sure prevention is part of any comprehensive good health strategy; but that’s not what brought us to where we are today. [And by the way, if “prevention” ever becomes the watchword of the country, do you really think the Libs will press for the sexual activities of Gays to be curtailed to prevent the spread of AIDS?]
I’ve benefited by two real world forays into this issue. The first was the 6 months I spent re-organizing Parkland Hospital in Dallas (I headed a public-private sector task force). I understand what really drives a lot of these costs, and it isn’t “prevention”.
Second, my dissertation was on the economic and political decisions of the United Mine Workers 1900-1940 — obviously not a health care issue, but it dealt with whether the UMWA wanted to remain a part of the capitalist system during the Great Depression, or support a government take-over of the coal mines. Their livelihood was at stake, and to no one’s surprise their focus was on fixing what was really broken (because some aspects of the system still worked fine), instead of jettisoning it for a “new” way of doing things.
In the real world, when you have a problem you identify all the contributing factors (not just the politically acceptable ones), and see if the problem can be fixed first before introducing a new system. That solution is reserved for those who, like Rahm Emmanuel, don’t want to see a good crisis go to waste (i.e. want to use it to further a different agenda).
You are exactly right, Phil.
What is particularly frustrating for me is that I am an insurance agent, so the arguments amongst laymen (of which Obama is one) are largely, if not completely, missing the point.
There is an unfortunate tendency to conflate health with health care with health insurance. They are not the same. Now with the propaganda turning from health care as a “right” to health care as the “moral” thing to do, the issues are even further obscured.
We can resolve to remain dilligent about these things so that we might preserve the republic, but it seems like there are new proposals on the table almost every day intended to fix some sort of “injustice” (that of course can only be remedied by government).
I fear that the compromisers will hammer out a consensus on some issue in the dark of night that will get slipped past us. One thing these believers in big government are is determined.
P
Prevention
First, as you note:
“Mouthing ‘prevention’ as a way to address the problems of the current health care system which are driven by other factors (like tort law, archaic regulations that limit the insurance policies a consumer can purchase, etc.) is just political BS.”
Also, & more important, methinks, it will be a way of justifying the Death Panelists’ approach to, e.g., “expensive operation, etc. vs. take a pill & shut up.”: We, the members of the panel, are not like these gluttons, weaklings, this careless underclass my dear & they don’t deserve expensive treatment paid by our hard-working careful citizenry. One hears echoes of Mein Kampf’s “degenerate”.
Judging from admittedly anecdotal evidence, many of my fellow geezers who are in good health for their age attribute this, not to good fortune, but rather to their “I’m smarter than mere mortals, ’cause I took care of myself” approach to life. (What? Good Genes? Nevermind.)
Even some moralists who say that “it’s fiercely moral to adopt Obamacare today & we’ve lost 8 yrs in the Bush Interregnum, for goodness sake”, seem to be judgmental about their louche friends who, in the realm of health care have left undone those things they ought to have done & have done the things which they ought not to have done. As determined by these moralists, of course. Like our tobacco-addicted President
Also, “experts” (who says they are experts? Nevermind!) disagree wildly on preventative care “science” & change their advice, seemingly daily (Coffee/red wine = Good. Oh, wait, coffee/red wine = NG).
And then there’s Whole Foods which uses “natural” ingredients in its fatty, sweet (yummie, yummie) deserts & its bacon & sausages. And sells wine. Caloric desserts, bacon, sausages, & booze!!! No wonder I shop there.
Reminds me of the joke about the 90 yr old who says he attributes his longevity to wine, women, & song.
From the above article: “Add to the mix in 2008 the Camelot factor … in that wouldn’t it be really cool to have a modern-day version of JFK replace the old, tired, out-of-step policies of the past?”
From Chris Matthews today: Ted Kennedy has passed the baton to Barack Obama. His death means that Barack Obama “is the last Kennedy brother”.
Liberals are so predictable.
This is how you do a cost comparison analysis.
You mean like these? http://www.ncbi.nlm.nih.gov/pubmed/16678945 http://www.annals.org/cgi/content/abstract/121/12/947 http://content.nejm.org/cgi/content/abstract/331/12/778
Note the conclusions in the abstracts. We’ll be coming back to them later.
Much like has happened with education about the use of tobacco, the net result is to increase costs for society. People who otherwise would have died younger — thus using fewer years of health care which saves money — — have lived longer. Not only do they consume more years of health expenditures, if they died earlier they would not have been given as much social security payouts as those who lived longer. Plus, the government would have gotten their inheritance tax money earlier.
Okay, just so I’m straight here – are you seriously suggesting that the decrease of tobacco use over the last several decades has been a net cost to society? Are you suggesting that society would be better off if we encouraged smoking?
Apparently you’re claiming that the people who died younger would have made no further economic contribution? No extra social security contributions? No increased property values, increasing the later value of the inheritance taxes? And you’re assuming that, say, dying early in intensive care of pneumonic complications of lung cancer would be generally less expensive than dying later of less acute illness.
I really want to see your homework on this one. Have there been studies on this? What sources and figures are you basing your estimates on?
Recall the recent article bemoaning the decline in childbirth rates in the West. I suppose you could address that by killing off the excess elderly… but that seems awfully Mathusian. And I thought killing off the elderly was something you were against? But apparently preventing illness is a drain on society. Contrary to the studies I linked to above, we should immediately suspend influenza vaccination for the elderly…
Mountain Man – What if preventive care were a common good, like national defense? Insurance for the other stuff (I’m fond of the Dutch system) and subsidies for preventive medicine? As I’ve noted elsewhere, military contractors are hardly going bankrupt. Maybe there could be some profit in contractors providing preventive care…
>This is how you do a cost comparison analysis. You mean like these? http://www.ncbi.nlm.nih.gov/pubmed/16678945 http://www.annals.org/cgi/content/abstract/121/12/947 http://content.nejm.org/cgi/content/abstract/331/12/778
*** This is why you cannot have an honest conversation with Raymond.
I talked about a cost benefit analysis for a 300+ million population country (the United States). He links to (a) a study of Finland, (b) a cost-benefit analysis related to elderly people only in Portland Oregon (not the US as a whole, and not for all preventative diseases/measures as I cited), and (c) another for elderly population in Minneapolis St-Paul.
I repeat:
We can “prevent” the flu by inoculating every American (assuming of course the government is competent enough to actually provide the vaccine). This “prevention” would involve the cost of the vaccine (plus its developmental costs and testing), the cost of the delivery mechanism for the medicine, the distribution system for the inoculations [syringes and other medical devices], the increased personnel to administer the shots (even nurses and PAs are expensive), etc. That cost would then need to be compared to the cost of treating the people who actually get the flu.
This is how you do a cost comparison analysis.
Multiply this by every other preventive measure for every other conceivable illness, which also includes lifestyle regulation (we prevent diabetes by making people control their weight better, etc.). And don’t forget that this “prevention” needs additional up-front education, ongoing training and reinforcement related to that education, and enforcement where necessary. These costs would then need to be compared to the cost of treating the people who actually get the diseases or maladies in question.
This again is how you do a cost comparison analysis.
>Okay, just so I’m straight here – are you seriously suggesting that the decrease of tobacco use over the last several decades has been a net cost to society? Are you suggesting that society would be better off if we encouraged smoking?
*** Again, note the mixing of two issues. Remember, the issue Raymond originally raised in comment 24 was about money (“possible savings”), which I responded to.
According to http://www.tobaccofreekids.org/organization/, “every year, smoking and secondhand smoke kill about 440,000 people in the U.S.” To do a proper cost benefit analysis, you take the cost of caring for these people in their final years, and compare it to the additional costs of keeping them alive for another, say, 5-10 years. These include the additional health care costs these people incur (including their end of life costs for other than tobacco-related diseases which, assuming no “rationing”, would still result in the numbers I cited earlier. Instead of dying from emphysema, they now die of, say, colon cancer or kidney failure.)
You also add the increased social security payment to these people (440,000 year one, plus another 440,000 year 2 minus the people from year one who subsequently died of other diseases or accidents, etc.).
You also add the increased administrative costs of the government bureaucracy (state, local and national) that services them, from bureaucrats to bricks and motor (i.e. senior centers).
You also add the number of increased private sector demands (more geriatric physicians, nurses, care facilities, etc.) needed to care for these people.
You also subtract the death taxes the government would collect from their earlier death.
And so on, and so on.
This is how you do a real cost-comparison. If you are speaking purely about costs, knowing that the majority of health care expenses occur in your last 10-20 years of life, dying earlier “frees up” net resources. That’s a fact, regardless of what citing one study in Finland or a couple of US studies about the flu in select US cities says about a tiny aspect of this issue.
This is how a real discussion takes place using the real world as an example. You only concludes that we are “better off” if people die earlier if your focus is exclusively on money.
>Apparently you’re claiming that the people who died younger would have made no further economic contribution? No extra social security contributions?
*** “The truth is that smoking-related deaths, even under the generous definitions used by CDC, are associated with old age. Nearly 60 percent of the deaths occur at age 70 or above; nearly 45 percent at age 75 or above; and almost 17 percent at the grand old age of 85 or above!” http://www.cato.org/pub_display.php?pub_id=5472
Once people reach retirement age, they generally stop working. This, as a rule, is not a difficult concept to grasp.
>No increased property values, increasing the later value of the inheritance taxes?
*** You are familiar with the concept of inflation that adds zeros to the value of an item, but not necessarily additional buying power to those dollars?
>And you’re assuming that, say, dying early in intensive care of pneumonic complications of lung cancer would be generally less expensive than dying later of less acute illness.
*** No. I’m actually saying that it’s just as expensive. Instead of dying from tobacco-induced lung cancer at 60, which uses these resources, the person lives additional years (using additional health resources and drawing social security payouts, etc.). And then, in his final days, this person still incurs the same additional costs as if he died when he was 60. It’s simply more expensive to keep people alive past 55, from a purely cost analysis. If your focus is on cost like the government (a revenue/tax neutral plan that increases coverage for 40 million people), this is where the “savings” are. This is why people who think beyond platitudes understand intuitively that rationing will be involved.
This again is why I said “There is no real case that focusing on ‘prevention’ — even if it was practical in a nation of 300 million+, some of whom are here illegally and not subject to the training and monitoring citizens would be forced to accept — would actually drive down costs. They are more likely to increase health care costs when all the relevant factors are considered.
A case can be made that some kind of increased prevention is beneficial to society. But the suggestion that done correctly, preventative measures would drive down health care costs is erroneous. Much like has happened with education about the use of tobacco, the net result is to increase costs for society. People who otherwise would have died younger — thus using fewer years of health care which saves money — have lived longer. Not only do they consume more years of health expenditures, if they died earlier they would not have been given as much social security payouts as those who lived longer.”
No one (especially me) is proposing this. I’m simply illustrating the fallacy of looking only at costs in determining health care; and further, pointing out the dishonesty of looking only at one aspect of costs when offering a so-called cost-benefit analysis.
>I suppose you could address that by killing off the excess elderly… but that seems awfully Mathusian. And I thought killing off the elderly was something you were against? But apparently preventing illness is a drain on society.
*** Again, a great illustration why honest debate is impossible with Raymond. I’ve done nothing of the sort. I’ve simply challenged the silly notion that preventative care will “save” health care expenditures by illustrating many of the components of a real cost-benefit analysis.
Now that I’ve laid out the complexity of the issue, Raymond wants to suggest that I’m operating on a pure cost-benefit framework in analyzing the situation. I am not. I think human life (and freedom) has a value in its own right. I’m simply putting a lie to the simple-minded claim that “Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs.” And further, showing how looking only at “costs” would lead to rationing health care for those 55 and older (“since most of the costs of the present health care system are designed to keep grandma and grandpa alive, that’s where the cuts will be made,”) something Raymond also found hard to believe.
Re – 36:
“What if preventive care were a common good, like national defense?” What if I had 3 hands, then I could type 33% faster? Are you posing a hypothetical, or are you making an assertion?
There is a short list of things I would allow in the “common good” category. All of them can be found in the Constitution. Preventative health care doesn’t even come close. There is no shared interest, no unifying cause, no mutual benefit to be derived from mandating preventative care.
What makes you think I would even consider subsidizing (read: forcing other people to pay for) preventative health care? There certainly is profit to be made in preventative health care: I go in for a check up, the doctor gives me a bill, and I pay it. The doctor then gets to make his boat payment. The bank that carries the boat loan takes that money and loans it to someone else who buys things. And so on.
Everyone’s happy, and no intervening government was needed for people to engage in their private, legal transactions.
Hmm, I guess I would be typing 50% faster. Or maybe it’s 1/3 less slow.
MM: I can link to a study on left-handed typists in Finland to illustrate the cost-benefit ratio of immunizing 7-12 year olds against carpel tunnel syndrome, if that’s of any help. This seems to be the new standard for objective analysis.
Mountain Man – I’m mostly posing a hypothetical, but one to take seriously. It’s certainly less of a stretch than the majority of the policies that have been stuffed under the “general welfare” clause. You could even appeal to the Declaration of Independence with its “life, liberty, and pursuit of happiness” language if you were so inclined.
A lot of preventive care doesn’t follow the model of “I go in for a checkup, etc.” If you don’t have insurance, that checkup can cost hundreds of dollars. If the doc finds something wrong, early intervention can save tens or hundreds of thousands of dollars, but the up-front cost is, in practice, a major disincentive.
And then there’s the people who actually do know they’re sick, but don’t have insurance and wait, hoping it’ll get better, until it becomes a crisis and have to visit the ER…
P
You guys are missing the latest in alleged Preventative care: Circumcision.
Instapundit 8/26;
FORGET THE DEATH PANELS. Now we’re supposed to be worrying about Dick Panels? “Barack Obama has warned us of Tonsil Vultures and Foot Rustlers. So far, he hasn’t issued a warning on Foreskin Fiends.”
http://hotair.com/archives/2009/08/26/coming-up-circumcision-campaigns/
Inwood: another penetrating reason to be wary of Obamacare.
Dr. Jackson – I actually do have to concede that you’re right. A cost-benefit study for inoculating every American hasn’t been done, and would almost certainly show that it wasn’t worth the benefit. Of course, you’re the only one who’s proposed that as a test.
And that sidesteps the point. The fact that inoculating everyone isn’t always the best option doesn’t imply that there aren’t any potential savings in the system. Each of the studies I linked to pointed out actual cost savings – substantial ones – available if targeted inoculation were carried out. Younger, healthy people don’t usually have major (expensive) complications from the flu. Infants, pregnant women, and the elderly do. There are many more diseases and conditions than influenza, many which respond to preventive care.
It’s also not at all clear that the “savings” on Social Security due to early death are all that they are cracked up to be. More comprehensive studies have been done than the one Dr. Jackson cites: http://mitpress.mit.edu/catalog/item/default.asp?tid=10298&ttype=2
It’s true that everyone will die eventually. And it’s also true that costs at the “last year of life” are high – but that’s because, by definition, at some point in the “last year of life” some kind of fatal medical condition happens… and that’s when things tend to get expensive. But Dr. Jackson already agreed that deciding to go for “heroic measures” was a personal decision. I note he never answered my question about whether heroic measures should also be at personal expense?
What if, I dunno, we focused government expenses on prevention and routine medical care? And then let private insurance take care of the things that Mountain Man says it’s best at: large, predictable, accidental or unexpected medical expenses. (Very few people think it’s handling the routine stuff all that well.) And if people want to create “heroic measures” savings accounts, or purchase riders for “heroic measures” coverage, that’d be their “personal choice”. Seems like that’d satisfy nearly everybody. An increase in overall health of societ, a healthy private sector, personal choice of doctors and treatments.
If your focus is on cost like the government (a revenue/tax neutral plan that increases coverage for 40 million people), this is where the “savings” are. This is why people who think beyond platitudes understand intuitively that rationing will be involved.
I’d think the concept above sidesteps most of those issues. It’s no worse than the current system and better in several areas. It’s not the Obama plan, but I never said I was a fan of that. The debate these days, sadly, seems to be either between doing nothing or going the Obama route.
A cost-benefit study for inoculating every American hasn’t been done, and would almost certainly show that it wasn’t worth the benefit. Of course, you’re the only one who’s proposed that as a test. And that sidesteps the point.”
** Again, a perfect illustration why pseudointellectal debate is pointless. This is precisely the point. Preventative medicine includes vaccinations and, as I alluded to above, a whole lot of other things (education, infrastructure, delivery systems, etc.) If you are going to toss around inane statistics that “Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs,” — and do this as part of a comprehensive, nationwide strategy to ‘reform’ health care in the United States, and further discuss health care from a “possible savings” standpoint, you need to look at more than the cost-effectiveness of influenza vaccination of children 6 months to 13 years of age in Finland to make a judgment; or the elderly population in select American cities.
I’ve pointed to many — but certainly not all — of the constituent elements of such a true cost-comparison analysis. The fact that this has not been done by the people telling us that revamping our present system will ‘save money’ or provide better health care for less money or any other fatuous conclusion only underscores the foolishness of making emphatic statements like “Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs.” It’s entirely likely that “preventive care” — inoculations et.al. — would be more costly. This is the point I made. This is the point you objected to.
As for the further observation that “The fact that inoculating everyone isn’t always the best option doesn’t imply that there aren’t any potential savings in the system.” Duh! But these “other things” aren’t free, and need to be factored into any system-wide conclusion about “cost savings”.
>Each of the studies I linked to pointed out actual cost savings – substantial ones – available if targeted inoculation were carried out. Younger, healthy people don’t usually have major (expensive) complications from the flu. Infants, pregnant women, and the elderly do. There are many more diseases and conditions than influenza, many which respond to preventive care.
*** Another fatuous comment. Giving people at risk preventive medicine, for example, will certainly help stave off illnesses that would otherwise occur. But the cost of the pill purchased for this activity is only a minor part of the over-all cost of doing this. If more doctors, nurses, PA’s etc. are needed to reach/inoculate more people, that’s an additional cost. More bricks and mortar clinics may also be necessary. More educational materials and advertising as well to promote the program. More compliance monitoring and follow-up. More of everything associated with this issue — and every other preventative measure for every other potential disease or malady.
I will again type slowly to reinforce the point I have been making. The question on the table is not whether preventative measures can work, be beneficial, etc. It’s the cost of these measures relative to the status quo (or a refining of the status quo vs. a new system), and the impact these costs have on other needs and resources in other areas. This again is a key feature of a real cost-benefit analysis. Since the new program is being sold as a neutral impact or even net savings, then that’s what I’ve focused on.
>I note he never answered my question about whether heroic measures should also be at personal expense?
*** I thought this was a stupid question not needing an answer, given all that I’ve written. But if you really don’t understand, I’m happy to indulge you. This is why I and millions of others have private insurance and personal savings, so if I (or my family) decide to get that operation or take that expensive treatment, I can do it. I don’t want Obama care deciding that what I really need is a blue pill to ease my pain instead of an operation to save my life. I may still end up taking the pill, but it will be my choice. Anyone who doesn’t understand why this is important will never understand anything else about the issue.
>What if, I dunno, we focused government expenses on prevention and routine medical care?
*** Another hapless observation, given the real elements of this calculation I’ve repeatedly noted. Let’s all just say feel good things like “preventive care” with no real world understanding of how this would actually work, and the resources it would take to make it work. If all “preventive care” is is public education with no monitoring or enforcement, the budget is probably manageable. But if it becomes a substitute for current benefits, then it’s going to become mandatory, intrusive, and very expensive.
>If people want to create “heroic measures” savings accounts, or purchase riders for “heroic measures” coverage, that’d be their “personal choice”. Seems like that’d satisfy nearly everybody. An increase in overall health of society, a healthy private sector, personal choice of doctors and treatments.
*** And if my farts smelled like perfume, I wouldn’t have to blame the dog every time I ate Mexican food. This again is the problem with the pseudointellectualization of this debate. It’s taking place in a real world setting where there won’t be enough doctors, facilities, and/or medicine to treat your “heroic” needs. And there won’t be any real insurance to pay for it. Unlike today, where I can get a long-term care policy for $125/month, those policies either won’t be available — or will cost prohibitively. Only someone who thinks that massive, direct government intervention in Health Care will expand private sector insurance believes this. It makes absolutely no sense economically, as anyone who has ever managed a business or operated in the real world intuitively understands.
>The debate these days, sadly, seems to be either between doing nothing or going the Obama route.
*** Only for children and fools. The Obama-plan is designed to pursue an agenda of more government control over the economy. Health Care (like the “stimulus Package”) is just a means to that end; or in other words, an example of never letting a good crisis go to waste.
There are those of us who have seen problems for years, and want to fix them. I (and others) have proposed tort reform, expanded use of Medical savings accounts which introduce more personal accountability into health care decisions, etc. There is no need to abandon the present system, unless your political agenda demands it.
Personal accountability is one key factor in “fixing” health care. I’ll give you a great practical example of this. My daughter went to the emergency room about 10 times when she was in college for bad asthma attacks. Each trip cost me about $1000.00 (it was out of my coverage area). When she became employed with her own insurance, she was out of town visiting a friend and had another attack. That visit cost her $1000.00. She thought it would be only $45.00, her normal co-pay. That’s been her last visit to an emergency room. Now she’s paying much closer attention to what her asthma doctor has been telling her all along about not panicking during an attack and treating it with the medicine she already has when one occurs.
Nothing quite focuses the mind when it’s your money at risk. You improve the quality and delivery of health care by making people — not the government — more responsible for themselves. [Not only is my daughter healthy, she’s not spending as much money to do so, and freeing up resources for other people].
Just like you protect endangered species by eating them (chickens are not endangered; when something has commercial or personal value, it gets protected/perpetuated); just like you raise more taxes by lowering the tax rate, etc. Communalizing the personal cost of health care will not lead to a better system. Health care is a responsibility, not a right. And it’s a choice. My unemployed brother in law just spent $200 on a get-away weekend but has no health insurance. He also spends about $200/month on cable TV and cell phones for 4 people. He can afford health insurance even when he’s unemployed; he chooses not to do it. Instead, he wants you to pay the cost for him so he won’t miss his favorite HBO program.
This is what’s wrong with the present system. This is where the fix should begin. There are lots of real, and effective ways to refine the original system instead of throwing it out.
Mr. Ingles,
And I gave you a serious, detailed answer, most of which you avoided.
I was not suggesting that going to a doctor for a check-up was all-inclusive of preventative health care. Nor does the context require my statement to be definitive of same. It is perfectly fine to take an example of preventative care and extrapolate a scenario to illustrate my point, originally advanced by you, that there was profit to be made from preventative health care. My cumulative point was that government intevention was not required.
So I take it that since something simply costs “hundreds of dollars,” you think someone else should be forced to pay for it? And the prior misuse of the Commerce Clause is justification to misuse it yet again (as long as it is “certainly less of a stretch”)?
Thanks for reminding me, Dr. Jackson – a quick item I forgot to point out. You write, If you are going to toss around inane statistics that “Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs,”
Of course, as I wrote earlier, that stat’s “From the same link you drew your stats from”. So, tell me, how do you pick out which stats there are inane and which aren’t? Why are you willing to trust them for stats that you think back your case, but not the ones you don’t like?
“Pseudointellectual”, indeed…
Sigh. Okay, this is how adults do it.
“Some 18 percent of lifetime costs for medical care is estimated to be incurred in the last year of life” and “27% of Medicare’s annual $327 billion is spent on the last year of a person’s life” are actual statistics based on actual expenditures. They carry no value laden assertions. Other examples of statistics from the same source are, “The average cost of health care per person in the United States approximated $3,925 in 1997” and “Lifetime medical costs average approximately $225,000 per person.”
You will note that these statistics had footnotes tying them back to the relevant documentation. That is the “source” of my statistics. The link to that source is not the determining factor in judging the credibility of the statistic. It’s just a link … to a source. I didn’t “draw my stats” from the link. I drew my stats from the footnoted source in that link. Understand?
The word “preventable” is a subjective judgment. The phrase “Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs” was not footnoted. That’s because it is not a real statistic. It’s just someone’s opinion that tosses in some percentage figures to mimic a real statistic.
Some websites mix statistics and opinions. If you quote a statistic from an opinion journal, it doesn’t transform the statistic into an opinion any more than tossing around unrelated, disconnected statistics transforms other opinions into actual statistics.
Once again, you demonstrate an amazing facility to draw shallow, meaningless conclusions about things while side stepping the core issue of a question, namely, that a real cost-benefit analysis is necessary to determine is preventive care actually saves money, and what constitutes such an analysis for a comprehensive national health care program.
I know this is a difficult concept to grasp, but it’s what distinguishes someone from quoting a statistic and offering an opinion. Or making an analysis and pseudointellectualizing a point, which is something you are indeed good at.
You know Raymond, just once it would be refreshing for you to concede an obvious mistake instead of dissembling about it, re-defining the discussion, or ignoring it all together while you point to some other manufactured outrage you want to use to escape responsibility for your own words.
The non-footnoted phrase ““Preventable illness makes up approximately 80% of the burden of illness and 90% of all healthcare costs” is an obvious opinion, unlike “27% of Medicare’s annual $327 billion is spent on the last year of a person’s life”, which is a documented statistic.
Why don’t you just surprise us all and acknowledge this fact, instead of pretending they are both the same thing (“Why are you willing to trust them for stats that you think back your case, but not the ones you don’t like?”)
If I may interrupt the Raymond vs. Phillip broo-haha, all of you should read what The Economist (www.economist.com) has had to say about all of this over the past couple of months. Just search for “health care”
There are two funny cartoons by Bob Gorrell on the shrinking polls & unshrinking Townhall Meetings.
The 1st shows The One with a pointer & a summary of polls all trending down & has him saying:
“I am nationalizing all Public Opinion Surveys and placing them under the direction of a newly-appointed Survey Czar.”
The 2nd shows two congressmen, one holding a newspaper reporting on Townhall meetings, & the other saying:
“I liked the Public Option a lot better before the public got involved.”
Dr. Jackson – Huh. I guess I should have gotten used to this from the whole global warming discussion we had. The necessary precision to convince you is always a bit further than anyone can go.
All right then, it’s their opinion that “approximately 80% of the burden of illness and 90% of all healthcare costs” is “preventable illness”. What would it take to convince you that that opinion was well-founded? What would you want to see before you would accept that provisionally?
Would you believe 75%? (Feel free to read that in a “Maxwell Smart” voice.) What if these guys agreed? (Their pilot program saved an average of $500 per patient per year – if that single approach scales, that’s over $100 billion for whole the U.S. Of course, that was just a first stab – greater savings seem probable.)
I suspect your goal posts will be quite a ways off in the distance. For example, your comment that “It’s the cost of these measures relative to the status quo (or a refining of the status quo vs. a new system), and the impact these costs have on other needs and resources in other areas. This again is a key feature of a real cost-benefit analysis. Since the new program is being sold as a neutral impact or even net savings, then that’s what I’ve focused on.”
But, of course, you want this sort of data “for every other preventative measure for every other potential disease or malady.” People familiar with the system give estimates in line with the numbers I’ve cited – but apparently those estimates are entirely without merit. You ignore the possibility – probability, so far as I can see – that you don’t need to re-do the infrastructure for each and every malady. A system already set up to deliver one vaccine can deliver two for a lot less than twice the cost, for example. There are such things as economies of scale and synergies.
But here’s the key thing that I want explained to me, in small words if necessary. “I don’t want Obama care deciding that what I really need is a blue pill to ease my pain instead of an operation to save my life. I may still end up taking the pill, but it will be my choice… This again is the problem with the pseudointellectualization of this debate. It’s taking place in a real world setting where there won’t be enough doctors, facilities, and/or medicine to treat your “heroic” needs.”
But no one’s ever pointed out to me the part of the Obama plan that would forbid you from spending your own money on health care or insurance, even for “heroic measures”. (The government not paying for something isn’t the same thing as forbidding you from paying for it yourself.) No one’s ever pointed out to me the part of the plan that caps the number of “doctors, facilities, and/or medicine” to make sure “there won’t be enough”. If you’re willing to pay for a ventilator or whatever, why would the hospital refuse your money?
The closest thing I’ve seen to this from Dr. Jackson is: “Let’s all just say feel good things like “preventive care” with no real world understanding of how this would actually work, and the resources it would take to make it work. If all “preventive care” is is public education with no monitoring or enforcement, the budget is probably manageable. But if it becomes a substitute for current benefits, then it’s going to become mandatory, intrusive, and very expensive.”
But I haven’t seen this really developed on his part. We already know – and pilot studies like the one I linked to above have shown – that costs can be substantially reduced by preventive care. Without being mandatory, intrusive, or very expensive. I also don’t see where it was required to be “a substitute for current benefits”. Indeed, in the basic scheme I proposed back in comment 44, it would be an alternative to the current system. Insurance is for large, predictable, accidental medical expenses – I’ve got no problem taking Mountain Man’s word for that – and “heroic measures” are, as Dr. Jackson agrees, one’s personal responsibility.
Indeed, I even agree that “Personal accountability is one key factor in “fixing” health care.” I, too, favor savings accounts – as I said – but the problem is that people like your brother-in-law (and I’ve got relatives like that, too) don’t take care of themselves or their finances. Then they show up at the E.R. experiencing a heart attack. So, what do we do then?
Do we say to his family, “Sorry. He couldn’t pay for thinners and emergency angioplasty, and didn’t have insurance, so we let him die. You can pick him up in the morgue.”? Should this be a legal option for hospitals? That’d be the ultimate in personal responsibility, no?
But if not, then what? Currently, we pay more to hospitals to pay for their indigent patients. (A lot more.) Might it be more cost-effective in the long term to subsidize some preventive care early on and avoid that heart attack and its associated costs?
BTW, Dr. Jackson, if we’re really worried about evidence-based policies… I’m curious what statistics and evidence you can produce in support of your personal proposal, “tort reform”? I’m not aware of a single state in the U.S. where medical malpractice or health insurance premiums have come down by $0.01 since the introduction of any “tort reform” measure. But if you can point out some tort reform success stories, I’d be very interested. (I’m not even necessarily against tort reform, I’ve just seen no real-world evidence that it would drive any significant savings.)
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