Questions and Observations

Free Markets, Free People

Health Care Reform – The Moral Argument Against

Joseph C Phillips writes an excellent post at Big Hollywood addressing the health care issue (it’s a comparison between Canada’s system and ours which goes beyond just the obvious differences). In it, he gets to the moral essence of what those who want the type of reform Democrats are promising are really asking for. It is, as you’ll see, a damning review:

I must remember to share this article with my friend Bryan. Bryan is a cancer survivor. I have had friends that have lost their battles with cancer so his continued presence on this earth is a great joy to me and a fact of which I am sure he is also no doubt ecstatic. Bryan is particularly interested in the current state of health care costs because his insurance paid for what he terms a “measly portion” of his treatment- he is currently burdened with the cost of what his insurance did not cover. He simply can’t afford the astronomical cost. His complaint is echoed by many clamoring for nationalized healthcare. What remains unclear is under what moral principle one man can demand that others pay for his healthcare and whether any policy not firmly grounded in a moral truth can be just.

Bryan’s story perfectly illustrates the truth that the rising cost of healthcare has coincided with the rising quality of healthcare. It is true that not too long ago he would have paid considerably less for his cancer treatment. The bad news is that he would not have been around long enough to spend his savings. New drugs and new technologies lengthened his life as it they have for hundreds of thousands of others. Progress comes with a price tag.

Bryan was not denied care. In fact no one in America is denied healthcare. He had insurance and he has an income with which to pay what the insurance didn’t cover. The fact is– he would much rather spend his money on something else other than hospital bills reaching into the thousands of dollars. What better solution than a system where cancer treatment is paid for by someone else? He may be interested to learn that the U.S. ranks first in the world in cancer survivor rates and that breast cancer survivors in Canada have filed a class action suit against several hospitals that forced them to wait 12 weeks for radiation therapy. Obviously neither Bryan nor other national healthcare advocates want to wait in lines or have others decide if they are to live or die. What they want is someone else to foot the bill even if children receiving a public education must suffer.

Those three emphasized lines are the crux of the battle. On one side, you have people who want the care but want someone else to pay for it. They’d like to call that “fairness” because they can’t afford (or don’t want to pay) the cost of the care necessary to save their lives. On the other hand, we have costly treatments being developed that save the lives of people who previously wouldn’t survive the disease. Those who develop and administer those treatments want to be paid what they’re worth. That is the incentive that drives further research and development of advanced treatments.

How, morally, do you demand others pay for your health care problems? We’d all scream and holler if we were required to help pay for our neighbor’s roof if it was damaged in a storm. Through no real fault of his own, his roof was damaged. And insurance only paid a portion of it. Would we accept the idea the government has a moral right to take our money to pay for his roof?

Of course not. We might help him voluntarily or we might not, figuring it was his responsibility to plan and save for such an eventuality. But we’d certainly never accept the premise that government had any moral right to demand we pay for our neighbor’s roof. Yet with health care, that premise remains front and center.

Phillips hits the nail right on the head when he notes his friend Bryan would “much rather spend his money on something else other than hospital bills reaching into the thousands of dollars.” Of course he would. So would we all. But that still begs the question of what moral right we have to obligate others to that duty? Notice I didn’t ask how we do it “legally”. As Nazi Germany and the Soviet Union should have taught us, the immoral can be made legal at the stroke of a pen.

The Democrat’s solution, of course, is to declare what Bryan wants to be a “right”. What it would really be is a legal privilege granted and enforced by the coercive power of the state. Morally, it would be no different than declaring that every citizen has a “right” to a sound roof and legally making it the obligation of every other citizen to pay to ensure that “right” is fulfilled.

We wouldn’t stand for that. Yet we’re watching that exact immoral premise being approvingly considered by a portion of the population which has no problem with the coercive obligation of their fellow citizens to their selfish wants in the name of “fairness”.

~McQ

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Making Health Care “Better”?

If health care is so darn terrible here, how does we manage rankings like this?

[T]he World Health Organization ranked the United States No. 1 out of 191 countries for being responsive to patients’ needs, including providing timely treatments and a choice of doctors.

Isn’t that the essence of good care?

Oh, but it is expensive and not everyone has insurance.

Well they have a plan to take care of the latter problem. Get it or government will fine you and assign you:

When you file your taxes, if you can’t prove to the IRS that you are in a qualified plan, you’ll be fined thousands of dollars — as much as the average cost of a health plan for your family size — and then automatically enrolled in a randomly selected plan (House bill, p. 167-168).

And of course the way to make it less expensive is to use less of it, right?

It’s one thing to require that people getting government assistance tolerate managed care, but the legislation limits you to a managed-care plan even if you and your employer are footing the bill (Senate bill, p. 57-58). The goal is to reduce everyone’s consumption of health care and to ensure that people have the same health-care experience, regardless of ability to pay.

Paying for all of this will be a breeze:

The price tag for this legislation is a whopping $1.04 trillion to $1.6 trillion (Congressional Budget Office estimates). Half of the tab comes from tax increases on individuals earning $280,000 or more, and these new taxes will double in 2012 unless savings exceed predicted costs (House bill, p. 199). The rest of the cost is paid for by cutting seniors’ health benefits under Medicare.

There’s plenty of waste in Medicare, but the Congressional Budget Office estimates only 1 percent of the savings under the legislation will be from curbing waste, fraud and abuse. That means the rest will likely come from reducing what patients get.

You did get that line in there where it says “the rest of the cost is paid for by cutting senior’s health care benefits?” And, as Dale pointed out, they have a wonderful idea of how to manage that:

One troubling provision of the House bill compels seniors to submit to a counseling session every five years (and more often if they become sick or go into a nursing home) about alternatives for end-of-life care (House bill, p. 425-430). The sessions cover highly sensitive matters such as whether to receive antibiotics and “the use of artificially administered nutrition and hydration.”

This mandate invites abuse, and seniors could easily be pushed to refuse care.

Because they’re usually in such robust physical and mental health at the time such “counseling” would take place that they’re sure to stick up for themselves and further treatment.

No matter how tight the cost though, you can count on layer upon layer of bureaucracy finding the money necessary to exist and flourish:

Shockingly, only a portion of the money accumulated from slashing senior benefits and raising taxes goes to pay for covering the uninsured. The Senate bill allocates huge sums to “community transformation grants,” home visits for expectant families, services for migrant workers — and the creation of dozens of new government councils, programs and advisory boards slipped into the last 500 pages.

Is it any wonder Obama wants all this passed quickly? It’s the jobs portion of his “stimulus” plan. Oh, wait, that can’t be right because none of this begins to take effect until 2013 (except the taxes, which begin in 2011), one year safely on the other side of the next presidential election. In fact it won’t be fully in effect until 2018.

So what’s the rush again?

This is a legislative turkey that needs badly to be led to the chopping block. We don’t have the problem we’re being told we have, nor is there such wide-spread dissatisfaction with what we have that the government must step in.

The most recent ABC News/Washington Post poll (June 21) finds that 83 percent of Americans are very satisfied or somewhat satisfied with the quality of their health care, and 81 percent are similarly satisfied with their health insurance.

There is absolutely no rush for any of this except politically. It comes under the heading of “using political capital while you have it” and right now Obama has it. The problem, and the reason for the rush, is there a hole in the political capital bag and the assets are draining out much more quickly than they thought they would.

I’m all for having them hold the bag and watch it empty without giving them the opportunity to wreck a system that for the vast majority of us seems to be working pretty well. If they want to do anything, they can remove the insurance mandates, pass the legislation to allow a real free insurance exchange to establish itself and get the hell out of the way.

~McQ

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Dems to Seniors: Drop Dead

And you can take that title literally, too.  Because that is where we are headed with the health care bill before Congress. As Erick Erickson points out:

I think, given that the member of Congress who drafted H.R. 3200 read and take seriously people like Klien, Yglesias, and Singer, we should be very troubled by Section 1233 of H.R. 3200. The section, titled “Advanced Care Planning Consultation” requires senior citizens to meet at least every 5 years with a doctor or nurse practitioner to discuss dying with dignity.

The section requires that they talk to their doctor, not a lawyer, about living wills, durable healthcare powers of attorney, hospice, etc. Given the progressive intelligentsia already being on the record in favor of euthanizing the elderly, it is no small leap to see where the Democrats are headed with this.

Legally forcing senior citizens to have “death with dignity schedules every few years is just another way to say the government wants to make sure seniors know it is time to commit suicide to save the system money.

If you can’t see this, then you’re just being intentionally obtuse.    Forget all the kind rhetoric about “dignity”.  Let’s call it what it is: Geriatric Euthanasia.  And let’s be very clear about why we want the old people to die:  We’ve sucked all the economic productivity we’re going to get out of them, and it’s more convenient to kill them than it is to assume the financial burden of their care.   You can pretty it up with all the flowery language you want, but at the end of the day, it comes down to, “You cost too much to keep alive. Just die.”

Frankly, it’d be far more honest just to have a “caretaker” just show up at the appropriate age, and double-tap the senior at the nape of the neck.  At least that would have the virtue of honesty, and would spare everyone the hypocritical stench of pretending to care about the “dignity” of the elderly when the real concern is to try to ensure they don’t become a drain on the public purse.

So forget any notion you have about producing wealth your whole life to save up for your golden years.  The new paradigm is to produce all the wealth you can, and when you’re done, you need to die so that those of us who remain can spend it instead.

And why should this come as a surprise?  This is the direction we’ve been going for a long time.  And it is, in fact, the logical end of the idea that health care is a “right”.  Because once the community as a whole has a “right” to the labor, property, or wealth of any individual member, then there are no rights at all.  There are only privileges that are extended at the wish of the community, and that can be withdrawn at will.

There is no liberty under any scheme of communal “rights”.  The highest value of community rights isn’t freedom, it’s democracy.  Whatever the “community” chooses is, by definition legitimate, as long as it’s democratically chosen.  No medical care for old people?  That’s fine, as long as the community decrees it.  The trouble is that democracy is value-neutral.  It is amoral.  if democracy is the highest expression of legitimacy, then it’s perfectly alright for black people to be slaves, as long as the majority thinks it’s OK.  Black people would vote against it, of course, but if they ended up in the minority, well, that’s the way the cookie crumbles.  Sorry, black people.  You lose.  By the way, your name is now “Toby”.

Thanks for participating in the democratic process, Toby.  Now get to work.

We see the same thing in the Honduran situation.  Mel Zelaya was elected president.  Therefore he’s legitimate, so it’s a very, very bad thing to depose him, even if he acts unconstitutionally.  Because we’ve fetishized democracy, the Obama Administration and the OAS, assume that deposing him is a way of illegitimately thwarting the people’s will, rather than preserving a legitimate constitutional order.

That kind of thinking forgets that democracy is not a value.  It is a process that is only legitimate insofar as it is animated by constitutional order that values human liberty.  Without that, it is merely a form of tyranny, different only in process, rather than kind, as compared to the tryanny of a single individual.

For the most part, we’ve abandoned the idea of individual liberty as the primary American value among the political class.  So, we see nothing wrong with counseling senior to “die with dignity”.  It’s better for everyone, really, except, perhaps in the proximate case of the individual senior.

We’re now seeing the fruits of collectivism starting to bloom fully in this country.  The country I was born in is gone.  But I’m glad I got to see it before it died.

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Nicaragua: And The Pattern Repeats

I have to wonder what our State Department and President, who seem completely enamored with process over actual democratic institutions, will have to say about this:

Nicaragua’s President Daniel Ortega announced Sunday, on the 30th anniversary of the leftist Sandinista revolution he led, that he would seek a referendum to change the constitution to allow him to seek reelection.

Following in the footsteps of elected regional allies, Ortega told thousands of supporters here that he would seek a referendum to let “the people say if they want to reward or punish” their leaders with reelection.

His close leftist allies who have had rules changed enabling them to remain in power include presidents Hugo Chavez in Venezuela, Evo Morales in Bolivia and Rafael Correa in Ecuador.

In the last month President Manuel Zelaya in neighboring Honduras was ousted in a coup by his own military after seeking similar action.

My guess is they’ll applaud this even while it has essentially established “democratic” dictatorships in Venezuela, Bolivia and Ecuador. And my guess is the “certified election results” are complete for Nicaragua, just as they were for Hodura’s Zelaya, even as I write this. They only need to be produced at the proper time to “validate” the referendum.

Call it the Venezuelan model.

And our puddin’ heads in Washington will again applaud this step toward totalitarianism as a wonderful exercise in democracy we should all support.

Meanwhile those meanies in Honduras who take their Constitution too seriously? Not so much.

~McQ

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State Governors Not Happy With Democratic Health Care Plan

At least not the Medicaid portion. The reason, of course, is states are on the hook to pay about 43% of Medicaid costs. Under the pending legislation, and depending on which plan you look at (House or Senate), Medicaid would expand 11% to 20%.

As you might imagine, that would impose a huge new mandate on the states already struggling with huge budget deficits and revenue shortfalls.

State governors, in Biloxi MS for the National Governors Association meeting, expressed bi-partisan disapproval of the plans.

“I think the governors would all agree that what we don’t want from the federal government is unfunded mandates,” said Gov. Jim Douglas of Vermont, a Republican, the group’s incoming chairman. “We can’t have the Congress impose requirements that we are forced to absorb beyond our capacity to do so.”

The House plan would pay for all of the costs of new enrollments and expand Medicaid the least (11%). The Senate version, however, would expand it the most (up to 20%) and would only pay full costs for 5 years. And the Senate’s answer to the states about how to fund the mandate?

Go into debt, of course:

One of the proposals being considered by the Finance Committee would encourage states to issue bonds to cover the costs of expanding Medicaid. Governors in both parties revolted, trumpeting their opposition in a conference call last week with Senator Max Baucus, the Montana Democrat who leads the committee.

The point is that not all costs are being surfaced when the total cost of this bill at the federal level is all that is cited. The House bill, for instance, would cost an estimated $438 billion over 10 years. I want to emphasize the word “estimated” and remind readers that there has never been an estimated cost I’m aware of that has come in on or under the projection.

Of course the Senate version, with expanded coverage, would cost more and shift the cost to states in 5 years. So you’ll not only be paying for this monstrosity at a federal level, but you can count on being tapped at a state level as well.

~McQ

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Death Of A Hero: SSG Darrell “Shifty” Powers

You know, the word “hero” gets tossed around a lot these days. That’s not to say there aren’t heroes in our midst, there certainly are, but sometimes it’s just a good idea to sit back for a second and reflect on the word and its real meaning.

If you’re a fan of the HBO series “Band of Brothers”, then you know what real heroes look like. The paratroopers of Easy Company, 2nd Battalion, 506th Parachute Infantry Regiment of the 101st Airborne Division were soldiers we got to know during that series through the depiction of their heroic actions throughout the unit’s fight through Europe.

They became real people on the screen. That’s because we got to know the real people the actors were portraying in a series of interviews with the survivors of the unit which were cut in at intervals throughout the film.

Well, with little notice or fanfare, one of Easy Company’s heroes made his final jump on June 17th of this year. SSG Darrell “Shifty” Powers has joined the 101st immortals, passing away last month as a result of cancer. Unfortunately, but not surprisingly, his death barely got a notice.

SSG Darell "Shifty" Powers, E Co, 2/506th PIR, 101st Abn Div WWII

SSG Darell "Shifty" Powers, E Co, 2/506th PIR, 101st Abn Div WWII

Today, members of the milblog community are holding a virtual memorial for Shifty Powers, a man who helps define the word hero. Here’s a portion of an email that has gone viral which does a much better job than I can in giving you an idea of who Shifty Powers was:

Shifty volunteered for the airborne in WWII and served with Easy Company of the 506th Parachute Infantry Regiment, part of the 101st Airborne Infantry.

If you’ve seen Band of Brothers on HBO or the History Channel, you know Shifty. His character appears in all 10 episodes, and Shifty himself is interviewed in several of them.

I met Shifty in the Philadelphia airport several years ago. I didn’t know who he was at the time. I just saw an elderly gentleman having trouble reading his ticket. I offered to help, assured him that he was at the right gate, and noticed the “Screaming Eagle”, the symbol of the 101st Airborne, on his hat.

Making conversation, I asked him if he’d been in the 101st Airborne or if his son was serving. He said quietly that he had been in the 101st.

I thanked him for his service, then asked him when he served, and how many jumps he made. Quietly and humbly, he said “Well, I guess I signed up in 1941 or so, and was in until sometime in 1945 . . . ” at which point my heart skipped.

At that point, again, very humbly, he said “I made the 5 training jumps at Toccoa, and then jumped into Normandy . . . . do you know where Normandy is?”

At this point my heart stopped. I told him yes, I know exactly where Normandy was, and I know what D-Day was.

At that point he said “I also made a second jump into Holland, into Arnhem.”

I was standing with a genuine war hero . . . . and then I realized that it was June, just after the anniversary of D-Day. I asked Shifty if he was on his way back from France, and he said “Yes. And it’s real sad because these days so few of the guys are left, and those that are, lots of them can’t make the trip.”

My heart was in my throat and I didn’t know what to say. I helped Shifty get onto the plane and then realized he was back in Coach, while I was in First Class. I sent the flight attendant back to get him and said that I wanted to switch seats.

When Shifty came forward, I got up out of the seat and told him I wanted him to have it, that I’d take his in coach. He said “No, son, you enjoy that seat. Just knowing that there are still some who remember what we did and still care is enough to make an old man very happy.” His eyes were filling up as he said it. And mine are brimming up now as I write this.

Today is a day to remember what he did and reflect on that. Of course his understated “I made the 5 training jumps at Toccoa, and then jumped into Normandy” doesn’t even begin to describe what jumping into Normandy entailed:

“I could hear bullets and shrapnel hitting the plane. As I jumped out the door, I could see that the left motor was on fire.” – Darrell Shifty Powers talking about jumping over Normandy, France, on D-Day.

Real heroes really don’t talk about it much, and they usually don’t include themselves when they do.

There are some real heroes that live among us and they deserve more than just a passing notice when they die. Shifty Powers was one of those heroes.

May he rest in peace and in the acclaim for his deeds he so richly deserves.

From this day to the ending of the world,
But we in it shall be remembered-
We few, we happy few, we band of brothers;
For he to-day that sheds his blood with me
Shall be my brother

~McQ

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The Transparent Administration

Except when locked in a battle in which it is trying to fool the public into accepting a 1 trillion plus spending program as a “money saver”. Then, apparently, it is quite all right to delay the scheduled release of its revised budget numbers (based on known economic indicators):

The White House is being forced to acknowledge the wide gap between its once-upbeat predictions about the economy and today’s bleak landscape.

The administration’s annual midsummer budget update is sure to show higher deficits and unemployment and slower growth than projected in President Barack Obama’s budget in February and update in May, and that could complicate his efforts to get his signature health care and global-warming proposals through Congress.

The release of the update – usually scheduled for mid-July – has been put off until the middle of next month, giving rise to speculation the White House is delaying the bad news at least until Congress leaves town on its August 7 summer recess.

And, of course, what it hopes to have in its pocket at that time is a health care reform bill passed by Congress. So why delay the budget update? Well, it isn’t going to be kind to the administration’s rosy speculation concerning deficit and growth, that’s why:

“Instead of a dream, this routine report could be a nightmare,” Tony Fratto, a former Treasury Department official and White House spokesman under President George W. Bush, said of the delayed budget update. “There are some things that can’t be escaped.”

The administration earlier this year predicted that unemployment would peak at about 9 percent without a big stimulus package and 8 percent with one. Congress did pass a $787 billion two-year stimulus measure, yet unemployment soared to 9.5 percent in June and appears headed for double digits.

Obama’s current forecast anticipates 3.2 percent growth next year, then 4 percent or higher growth from 2011 to 2013. Private forecasts are less optimistic, especially for next year.

Any downward revision in growth or revenue projections would mean that budget deficits would be far higher than the administration is now suggesting.

And then there’s the debt problem, which is headed to new and dizzying heights:

The nation’s debt – the total of accumulated annual budget deficits – now stands at $11.6 trillion. In the scheme of things, that’s more important than talking about the “deficit,” which only looks at a one-year slice of bookkeeping and totally ignores previous indebtedness that is still outstanding.

Even so, the administration has projected that the annual deficit for the current budget year will hit $1.84 trillion, four times the size of last year’s deficit of $455 billion. Private forecasters suggest that shortfall may actually top $2 trillion.

The administration has projected that the annual deficit for the current budget year will hit $1.84 trillion, four times the size of last year’s deficit of $455 billion. Private forecasters suggest that shortfall may top $2 trillion.

If a higher deficit and lower growth numbers are not part of the administration’s budget update, that will lead to charges that the White House is manipulating its figures to offer too rosy an outlook – the same criticism leveled at previous administrations.

Of course, if it does include the higher deficit and lower growth numbers, as it should, it would also most likely kill the costly push toward health care “reform”. And that is why it is being delayed.

How do I say that with such assurance? Because this is a routine and easily produced report despite what the administration is trying to claim.

White House officials say it is now expected in mid-August. They blame the delay on the fact that this is a transition year between presidencies and note that Obama didn’t release his full budget until early May – instead of the first week in February, when he put out just an outline.

Still, the update mainly involves plugging in changes in economic indicators, not revising program-by-program details. And indicators such as unemployment and gross domestic product changes have been public knowledge for some time.

As Ed Morrissey asks:

Consider this: if those budget numbers looked good, would the White House postpone revealing them? Obama could use all the good news he can get at the moment, especially with two big-spending bills stalling in Congress.

Ironically, the White House budget director was making the rounds claiming those trying to delay the vote on health care were trying to kill it, all the while the administration is delaying the budget report with the purpose of depriving law makers the information they need in their consideration of the cost of such legislation.

Meanwhile, we are apparently on course to eat our way into prosperity as the Recovery Act spends your hard earned dollars on … cheese.

~McQ

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Cap-And-Trade And Paying For China Too

Who are these people?

I’m obviously mistaken if I think they’re in office to represent the citizens of the United States of America.  Apparently, instead, they represent the Chinese:

“It’s important that those who consume the products being made all around the world to the benefit of America — and it’s our own consumption activity that’s causing the emission of greenhouse gases, then quite frankly Americans need to pay for that,” Commerce Secretary Gary Locke told the American Chamber of Commerce in Shanghai.

That’s United States Secretary of Commerce Gary Locke, folks.

Of course, after Locke shoots off his mouth and forgets for whom he works,  the Joe Biden treatment comes into play. Behold, the official disclaimer that makes it all officially okeydokey:

“Secretary Locke has been very clear on emphasizing the importance of fair trade as a part of the United States’ relationship with China. He believes U.S. companies should not be disadvantaged by Chinese imports not bound by responsible policies to reduce carbon emissions. China and the US must work together to ensure a level playing field and reduce our carbon footprints. The Secretary’s trip to China demonstrated his commitment to fair trade and his belief that both the United States and China can benefit from shared investments and cooperation in clean energy that will lead to commercial and environmental benefits for both countries.”

In other words, he didn’t say what he said and we say so.  Orwell would be freakin’ proud.

I swear – sometimes words just fail me when I watch the absolute travesty our government has become.  And no, not just since January.  But they sure have caused the process to speed up.

~McQ

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Podcast for 19 Jul 09

In this podcast, Bruce, Michael, Bryan, and Dale engage in the usual libertarian carping about government, and whether or not we “owe” the GOP something.  We don’t, by the way.

The direct link to the podcast can be found here.

Observations

The intro and outro music is Vena Cava by 50 Foot Wave, and is available for free download here.

As a reminder, if you are an iTunes user, don’t forget to subscribe to the QandO podcast, Observations, through iTunes. For those of you who don’t have iTunes, you can subscribe at Podcast Alley. And, of course, for you newsreader subscriber types, our podcast RSS Feed is here. For podcasts from 2005 to 2007, they can be accessed through the RSS Archive Feed.

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BlogTalk Radio – Tonight 8pm (EST)

Call in number: (718) 664-9614

Yes, friends, it is a call-in show, so do call in.

Subject(s): Libertarians and the GOP (do we “owe” them anything?), language and how the Obama administration is using and abusing it, and health care (that’s for you Dale), it continues to heat up as support appears to be weakening both in Congress and in the country. If we have time – the “certified” election that never was in Honduras.

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