Free Markets, Free People

“End-Of-Life”, Bureaucrats and Freedom – More Straight Talk

The Senate Finance Committee, which is drafting its version of health care legislation, will not include the “end of life counseling” provision found in the House bill.

Why?

Sen. Chuck Grassley (R-Iowa) said in a statement. “We dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly.”

You see, these provisions being written into law won’t be implemented by our lawmakers, but instead by the bureaucracies the law establishes. Yes, unelected, unaccountable bureaucrats will interpret and implement the law and you, dear drone, are expected to bow to their interpretation and implementation.  That’s reality.

Of course that’s the case not only with that particular provision but with the entire legislation being proposed. It is going to be a government bureaucracy that decides what this all means and how it should be implemented.

Now, Grassley sort of tries to make that point but still exempt what he’s working on from it:

“The bill passed by the House committees is so poorly cobbled together that it will have all kinds of unintended consequences, including making taxpayers fund healthcare subsidies for illegal immigrants,” Grassley said. The veteran Iowa lawmaker said the end-of-life provision in those bills would pay physicians to “advise patients about end-of-life care and rate physician quality of care based on the creation of and adherence to orders for end-of-life care.

“Maybe others can defend a bill like the Pelosi bill that leaves major issues open to interpretation, but I can’t,” Grassley added.

The charge, of course, is that the House bill is loaded with poorly written legislation open to bureaucratic interpretation which will have many unintended and negative consequences. The implication is that Grassley and crew are carefully cobbling their version together to make clear how everything must the interpreted and implemented thereby avoiding all the negative and unintended consequences found in the House bill.

To which I say, “nonsense”. We’re talking about an attempt to take over a very complex system that goes far beyond “insurance” reform. Anyone who believes that Grassley and the Senate Finance Committee’s version will avoid negative unintended consequences needs a reality check badly. Certainly it may be marginally better than the monstrosity the House is touting, but it is still an overt government power grab that will have dire consequences down the line.

What’s even more disturbing, of course, is the fact that you have a senior Republican involved in doing this, meaning of course that he has swallowed the premise that the Democrats have offered, i.e. that the solution involves more government, not less.

And, of course, that’s exactly the opposite of what Republicans, philosophically at least, are supposed to stand for. Dale has outlined the direction Republicans and those who believe in liberty and free markets should be demanding we go.

Is there a workable model out there that Republicans should be offering? You bet there is. Dale talked about it, and so has John Mackey, the CEO of Whole Foods:

* Remove the legal obstacles that slow the creation of high-deductible health insurance plans and health savings accounts (HSAs).

* Equalize the tax laws so that employer-provided health insurance and individually owned health insurance have the same tax benefits.

* Repeal all state laws which prevent insurance companies from competing across state lines.

* Repeal government mandates regarding what insurance companies must cover.

* Enact tort reform to end the ruinous lawsuits that force doctors to pay insurance costs of hundreds of thousands of dollars per year.

* Make costs transparent so that consumers understand what health-care treatments cost.

* Enact Medicare reform.

* Finally, revise tax forms to make it easier for individuals to make a voluntary, tax-deductible donation to help the millions of people who have no insurance and aren’t covered by Medicare, Medicaid or the State Children’s Health Insurance Program.

It may not be the total free market answer most libertarians would like to see, but it is a far better approach than what Democrats and Republicans out there are offering now.

Here’s the bottom line, as stated by Mackey:

Rather than increase government spending and control, we need to address the root causes of poor health. This begins with the realization that every American adult is responsible for his or her own health.

The solution is to make them responsible by giving them that responsibility, not having government further usurp it and make decisions for them. The most fundamental aspect of freedom and liberty is individual responsibility. The system we have now, as well as the one that is being proposed, works against that fundamental requirement and thereby lessens both our freedom and our liberty.

That’s what people protesting these proposed laws are finally realizing. This isn’t just about health care – its about our freedom.

~McQ

5 Responses to “End-Of-Life”, Bureaucrats and Freedom – More Straight Talk

  • The “end of life counseling” provision, frankly, is the more benign end of this argument.
    It’s all about the IMAC …

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

    At this point, I am confident that both the House and the Senate bills will contain what we’ve been calling MedPAC [Medicare Payment Advisory Commission] on steroids, the idea that you continually present new ideas to change incentives, change the delivery system, understanding that because this is such a complex system we’re not always going to get it exactly right the first time, and that there have to be a series of modifications over the course of a series of years, and we have to take that out of politics and make sure that an independent board of medical experts and health economists are providing packages that are continually improving the system.

    … the IMAC has the potential to become the medical “Star Chamber”

  • “The charge, of course, is that the House bill is loaded with poorly written legislation open to bureaucratic interpretation which will have many unintended and negative consequences.”

    I would argue that the intended consequences will be every bit as bad as the unintended consequences.

    This is not about reform. It never has been. It is about power and the further elevation of the governing class. This is epidemic throughout governments in the U.S. now, and one of the chief allies in all of this are the government worker unions. Cf. California and New York.

    Just as a for instance, in my small town in upstate New York, the average salaries for teachers in the public schools is $70,000, and that’s for a ten-month year. Pro-rate that for twelve months and add in the luxurious benefits and pension package and that average salary is up close to $100,000 per annum.

    The average spent per student in the district is $23,000, more than twice the national average.

    Now, imagine how that will play as medical worker unions increasingly exert political control of government allocations to health care. The costs will increase as the standard of care decreases as care is increasingly rationed to accomplish what? Why, to reduce the exploding costs!

    “The implication is that Grassley and crew are carefully cobbling their version together to make clear how everything must [be] interpreted and implemented thereby avoiding all the negative and unintended consequences found in the House bill.”

    Impossible. Impossible from the get-go. But even more impossible if the intitial step is taken and then periodically “updated” via administrative law and “fixed” by future Congresses.

    “We’re talking about an attempt to take over a very complex system that goes far beyond “insurance” reform. Anyone who believes that Grassley and the Senate Finance Committee’s version will avoid negative unintended consequences needs a reality check badly.”

    We’re talking about taking over an industry and turning it into a system through central planning, already demonstrated as the road to nowhere.

    It is not about health care. It is about power and control.

  • McQ – “What’s even more disturbing, of course, is the fact that you have a senior Republican involved in doing this, meaning of course that he has swallowed the premise that the Democrats have offered, i.e. that the solution involves more government, not less.”

    When all you have is a hammer, every problem starts to look like a nail.

    Grassly, like most Americans, has been conditioned to believe that Washington is responsible for EVERYTHING (hence, we have the spectacle of members of Congress investigating steroids in baseball, the BCS system, and even the price of breakfast cereal). So, naturally people – including members of Congress who get reelected by giving things to their constituents – think that it’s DC’s responsibility to fix health care in our country even though it can be persuasively argued that DC is a major cause for why it’s screwed up in the first place.

    It may be that ObamaCare will be stopped. However, there is little doubt in my mind that we will have some sort of federal takeover of health care. Too many people think that this is the only way to “reform” a “broken” system. The poor fools have no idea how much trouble this will cause, and that there will be no turning back once we find what a mistake we’ve made.

  • I’m stunned by the outpouring of anger at John Mackey.  “Boycott Whole Foods — doesn’t he know who his customers are?!?” and the like.  People calling him “reactionary”(!) without a hint of irony.
    I’m becoming more and more convinced that American health care has been riding the fence between socialism and libertarianism, and falling off in either direction would be a vast improvement.  The question is, do we want to err on the side of more freedom or more government?
    Based on poll numbers and the protests of the general public, I’d say the answer to that question is pretty clear.  There’s an opportunity to make a positive change here, but I’m still afraid we’ll be arguing for “health care vouchers”, privatizing health care and and “medical choice” in twenty years.

  • Of course there are no “death panels” in the healthcare bill, they were set up in the Stimulus Bill:

    /“SEC. 804. FEDERAL COORDINATING COUNCIL FOR COMPARATIVE
    EFFECTIVENESS RESEARCH. (a) ESTABLISHMENT.—There is hereby
    established a Federal Coordinating Council for Comparative
    Effectiveness Research (in this section referred to as the
    ‘‘Council’’). /

    /(b) PURPOSE.—The Council shall foster optimum coordination
    of comparative effectiveness and related health services research
    conducted or supported by relevant Federal departments and agencies,

    with the goal of reducing duplicative efforts and encouraging
    coordinated and complementary use of resources.
    (c) DUTIES.—The Council shall—
    (1) assist the offices and agencies of the Federal Government,
    including the Departments of Health and Human Services,
    Veterans Affairs, and Defense, and other Federal departments
    or agencies, to coordinate the conduct or support of
    comparative effectiveness and related health services research;
    and
    (2) advise the President and Congress on—
    (A) strategies with respect to the infrastructure needs
    of comparative effectiveness research within the Federal
    Government; and
    (B) organizational expenditures for comparative
    effectiveness research by relevant Federal departments and
    agencies.
    “/

    This sounds innocuous, and for now it is.

    /“(1) COVERAGE.—Nothing in this section shall be construed
    to permit the Council to mandate coverage, reimbursement,
    or other policies for any public or private payer.
    (2) REPORTS AND RECOMMENDATIONS.—None of the reports
    submitted under this section or recommendations made by the
    Council shall be construed as mandates or clinical guidelines
    for payment, coverage, or treatment.
    “/

    Someone needs to ask Grassley when he’s introducing legislation to repeal this thing.