As many predicted, Van Jones has resigned. Naturally, he picked the middle of Labor Day weekend to do it. That means minimal coverage, which is somehow fitting, seeing how little the mainstream media covered the whole thing. This has been the deftest handling of an Obama appointment miscue ever; by the time Labor Day cookouts end, this will be over and the average voter will have never heard of Jones.
Of course, Jones’ take on the whole thing is drearily predictable:
“On the eve of historic fights for health care and clean energy, opponents of reform have mounted a vicious smear campaign against me,” Jones said in his resignation statement. “They are using lies and distortions to distract and divide.” [Emphasis mine]
He somehow doesn’t manage to pinpoint any specific lies or distortions. I suppose you could maintain that the whole thing about him signing a Truther petition was a distortion since he maintains that it doesn’t represent his views, but you would then need the underlying assumption that he’s a lazy radical who doesn’t bother to read what his fellow radicals write, and then fails to take responsibility for the resulting mistakes. I don’t see how that helps much.
The New York Times has yet to weigh in as best as I can tell. But they did find time late last week for this article, which contains the following:
Mark Steyn, a Canadian author and political commentator, speaking on the Rush Limbaugh show on Wednesday, accused Mr. Obama of trying to create a cult of personality, comparing him to Saddam Hussein and Kim Jong Il, the North Korean leader.
This was picked up and repeated by newspapers from Ireland to Las Vegas, with the usual “he’s loony” side comments. Problem is, here’s the actual quote from Mark’s guest host appearance on Rush Limbaugh that the NYT is using as a source:
Obviously we’re not talking about the cult of personality on the kind of Saddam Hussein/Kim Jong-Il scale. [Emphasis mine]
Now I suppose you could be pedantic and say, “Well, he is comparing the two, in a sense.” No, actually he’s contrasting the two, and one would hope the august journalists at the Times would know the difference, after all those “compare and contrast” essays in English class.
In my mind, this qualifies as a true smear. Instead of quoting someone, a misquoting is used that modifies the meaning of the original to make someone look bad.
As far as I can tell, this never happened with Jones. People just put up his own words and videos.
But it doesn’t matter. The word “smear” has been debased by the left, just as “fascist”, “rationing“, and plenty of others. Their post-modernist, Red Queen, multiple truths, “I knew what I meant when I said it” worldview makes that a perfectly legitimate tactic as far as they are concerned. The word “smear” now means “saying something that makes a leftist look bad” regardless of whether that something is true.
*** Update 12:38 PM CST ***
Commenter Ernest Brown notes that the NYT finally says something about Van Jones. They delicately manage to avoid Jones’ “smear” allegations, but they do include this:
Mr. Jones apologized on Wednesday for derogatory words he directed at Republican opponents of Mr. Obama’s Congressional agenda during a lecture in February, calling his remarks “inappropriate” and noting that they were made before he joined the administration.
If all you read is the NYT, then you’ll have no clue what the heck they are talking about here. You won’t hear about the extent of Jones’ vulgarity or the cheering he got from the crowd for calling Republicans a$$holes. This is some beautifully done obfuscation for the benefit of the Obama administration.
But note that his vulgar depiction of Republicans was done before he was tapped by Obama. Well, I guess that makes it all right then!
Charlie Cook, one of the more respected political analysts, has a piece in the National Journal that patiently explains what the left and Democrats still don’t seem to understand – they won, but they didn’t win what they think they won.
In fact, they won much less than that. “Change”, as defined by many independents who put Barack Obama and the Democrats in office, had little to do with expanding government. And within a span of a few months, the entire political dynamic changed, but apparently the left missed it:
Independent voters — fired up by the war in Iraq and Republican scandals — gave Democrats control of both chambers of Congress in 2006. Two years later, independents upset with President Bush and eager to give his party another kick expanded the Democratic majorities on the Hill. Late in the campaign, the economic downturn, together with an influx of young people and minorities enthusiastic about Obama, created a wave that left the GOP in ruins.
That was then; this is now. For the seven weeks from mid-April through the first week of June, Obama’s weekly Gallup Poll approval rating among independents ran in the 60-to-70 percent range. But in four of the past five weeks, it has been only in the mid-to-high 40s. Meanwhile, Democrats and liberals seem lethargic even though Republicans and conservatives are spitting nails and can’t wait to vote.
Why? Cook explains the basics of what has happened:
While political analysts were fixated on last fall’s campaign and on Obama’s victory, inauguration, and first 100 days in office, two other dynamics were developing. First, the worst economic crisis since the Great Depression scared many voters, making them worry about their future and that of their children and grandchildren. And the federal government’s failure to prevent that calamity fundamentally undermined the public’s already low confidence in government’s ability to solve problems. Washington’s unprecedented levels of intervention — at the end of Bush’s presidency and the start of Obama’s — into the private sector further unnerved the skittish public. People didn’t mind that the head of General Motors got fired. What frightened folks was that it was the federal government doing the firing.
Many conservatives predictably fear — and some downright oppose — any expansion of government. But late last year many moderates and independents who were already frightened about the economy began to fret that Washington was taking irreversible actions that would drive mountainous deficits higher. They worried that government was taking on far more than it could competently handle and far more than the country could afford. Against this backdrop, Obama’s agenda fanned fears that government was expanding too far, too fast. Before long, his strategy of letting Congress take the lead in formulating legislative proposals and thus prodding lawmakers to take ownership in their outcome caused his poll numbers on “strength” and “leadership” to plummet.
These fears haven’t been allayed one bit. In fact, they’ve been ignored completely as Democrats continue their approach to the issue of health care. Americans are telling them, in every poll and every townhall meeting, to back off the direction they seem to be insisting on taking. One of the implications in Cook’s assessment of why Republicans were kicked out in 2006 and again in 2008 was a growing frustration with the deafness of the Repubicans. They weren’t listening. They moved ahead with their agenda and never seemed to consider what their constituents were saying.
The Democrats are in exactly the same sort of loop. They’ve finally got the power, they’ve either misinterpreted their mandate or are simply ignoring the people for the chance to pass what they’ve long wanted to pass and are very close to paying a huge political price for doing so. Cook addresses that point:
With 14 months to go before the 2010 midterm election, something could happen to improve the outlook for Democrats. However, wave elections, more often than not, start just like this: The president’s ratings plummet; his party loses its advantage on the generic congressional ballot test; the intensity of opposition-party voters skyrockets; his own party’s voters become complacent or even depressed; and independent voters move lopsidedly away. These were the early-warning signs of past wave elections. Seeing them now should terrify Democrats.
If you take an objective look at the situation under which the Republicans lost their power, Cook’s formula was precisely how it played out. If you take an equally objective look at how this situation is forming up, you can indeed see what Cook is talking about repeating itself for Democrats.
And that brings us to the Obama health care speech on Wednesday – many are calling it a “make or break” speech. I’m of the opinion that it is more likely to be too little too late. Popular support for any bill is trending down. Popular support for the Democrat’s version(s) has been trending down. Obama’s approval ratings concerning health care have been falling.
Unless Obama has some startling new ideas, never before discussed which will be introduced and promise to be pleasing to both sides, he’s stuck with attempting to repackage and spin the same old tired arguments which have, to this point, been pretty well rejected.
Wednesday’s speech could indeed still be a “make or break” speech, but not for health care. Instead it may make or break Democratic support (depending on the President’s stance on the public option) and sound the death knell for Democratic Congressional control and, possibly, the presidency. It is indeed an important speech – but not for the reasons Democrats think.
Since he didn’t forcefully enter the debate, the media reported on his news conferences and town hall meetings as if they were the White House’s failed attempts to set the agenda. Obama’s popularity has fallen and support for “his” bill — a bill that doesn’t exist — has plummeted.
Objectively, the fact that he hasn’t given a speech on health-care reform or defined his own bill or begun to really pressure the Congress means, in practice, that he has a lot left of tools left in his toolbox.
If Obama hasn’t “forcefully entered the [health care] debate” what was that ABC infomercial? What was the purpose of the series of town halls – if he wasn’t “forcefully entering” the debate.
In fact, Obama has been trying to push his health care agenda since he’s been in office.
Kaus reminds us of how involved to this point Obama has been in the topic of health care:
“Our CBS News tally shows that Mr. Obama has given 27 speeches specifically on his health care objectives. Add in other remarks, events and statements in which he mentioned health care and the number soars to 119.”
Those numbers flatly contradict Klein’s conclusion:
What’s not clear is whether he has the political capital left to use them effectively, or whether the last few months saw him robbed of something he hadn’t even had a chance to use.
Never had a chance to use? Hardly. Misspent, misapplied, squandered? More likely – it isn’t that he hasn’t taken the opportunities to “forcefully enter” the health care debate, it’s that he’s been completely ineffective when he has.
That’s why many don’t buy the David Axelrod spin which says, in effect, that has all proceeded as planned and now they’re merely going to “synthesize and harmonize these strands and get this done” with Obama’s upcoming speech.
Klein may believe that Obama is finally “forcefully entering” the debate with the upcoming speech, but I’d bet most Americans will see it as simply more of the same old ineffective nonsense wrapped in a new rhetorically glittering package that they’ve been hearing for months.
The battle lines are being drawn prior to the speech President Obama will deliver to a joint session of Congress next Wednesday. One group which has now put itself on record with an either/or demand is the House Progressive Caucus. In a letter delivered last night to Obama, the Caucus said:
Any bill that does not provide, at a minimum, a public option built on the Medicare provider system and with reimbursement based on Medicare rates-not negotiated rates-is unacceptable. A plan with negotiated rates would ensure higher costs for the public plan, and would do nothing to achieve the goal of providing choice and competition to keep rates down. The public plan with set rates saves $75 billion, which could be lost if rates are negotiated with providers. Further, this public option must be available immediately and must not be contingent upon any trigger.
The Progressive (they don’t like the word “liberal” anymore) Caucus, as I recall, has about 77 members. The lack of a public option, however, could cost Democrats upward of 100 votes and coupled with Republican votes against – not to mention Blue Dogs – would doom the bill in the House.
So what the Progressive Caucus is doing is drawing a line in the sand over which they claim they will not budge. In actuality they’ve put President Obama in what most would consider a no-win situation.
Of course word has it that a pubic option is very unlikely in the Senate version of a bill and if it is forced into a bill it will cost all Republican Senate support (even the usual 3 that go along with the Dems) and most likely a few Democratic Senators (Landreau, for instance, who has stated publicly that she won’t vote for a bill with a public option) . That would put them well below the 60 needed to end debate. It would also leave them with only the reconciliation process which needs a simple majority to pass a bill, with which to turn. And that is fraught with all sorts of dangers for the Democrats as the process allows parliamentary objections at almost every step and allows non-budgetary items (reconciliation is a budgetary process) to be stripped from the bill.
This has left the White House with few options. But one is an appeal to party loyalty and loyalty to President Obama as well as a smidgen of “post-racial” politics:
White House advisers will likely insist that liberals mustn’t deny the president a historic victory and enable a defeat that could cripple the first African-American presidency.
And cripple it we must – bad ideas are bad ideas, regardless of the race or party of those pushing them. This health
care insurance reform scheme is the penultimate bad idea – along with cap-and-trade, TARP, the unstimulative “stimulus” bill, the omnipork spending bill, the take over of GM and Chrysler, the bailout of the (selected) financial institutions and the projected 9 trillion in deficits. I wouldn’t care if the the president were purple, I’d want anyone pushing those sorts of ideas politically “crippled”. I’d figure that since the president and Congress had already managed to hobble the nation, hobbling their ability to do more damage is the only good idea to come along is quite some time.
Of course I’d also most likely be labeled a racist and obstructionist by them if I actually said such a thing, wouldn’t I?
It couldn’t possibly be independents and libertarians objecting as well could it?
School districts from Maryland to Texas are fielding angry complaints from parents opposed to President Barack Obama’s back-to-school address Tuesday – forcing districts to find ways to shield students from the speech as conservative opposition to Obama spills into the nation’s classrooms.
The White House says Obama’s address is a sort of pep talk for the nation’s schoolchildren. But conservative commentators have criticized Obama for trying to “indoctrinate” students to his liberal beliefs, and some parents call it an improper mix of politics and education.
“The gist is, ‘I want to see what the president has to say before you expose it to my child.’ Another said, ‘This is Marxist propaganda.’ They are very hostile,” said Patricia O’Neill, a Democrat who is vice president of the Montgomery County School Board, in a district that borders Washington, D.C. “I think it’s disturbing that people don’t want to hear the president, but we live in a diverse society.”
The White House moved Thursday to quell the controversy. First it revised an Education Department lesson plan that drew the ire of conservatives because it called for students to write letters about how they can help the president.
One more time for the slow and stupid, i.e. the media – this is about a president presuming to speak directly to our children without our permission. It’s not so much about the message, it’s the presumption. To me that’s a presumption which he has no right to make. If he wants to speak to the nation on national TV I, as an adult, have the ability to choose whether or not to watch him or instead a Braves’ game. If he wants to talk about education and address children, I’ll put mine in front of the TV if I think what he’ll have to say is useful and necessary. That’s a parent’s job and a politician – any politician – presuming he is above such parental control or choice is just flat wrong.
As this was originally planned, although it appears some school districts are now going to provide an alternate activity for those who object, this was to be a captive audience forced to watch the message. Many parents, not just conservative parents, understand the ability for something like this to be abused. Again, it’s not so much about the message as it is about the precedent.
Lastly, many of the objections haven’t been focused on the speech but the fact that this is an organized event with a lesson plan that, until the outcry, had some portions where were obviously political. And that’s the opinion of more than just conservatives (the White House dropped some of those more obvious portions from the lesson plan).
So to boil it down so even the media can figure it out – it isn’t just conservatives objecting to this. More importantly, it’s about the 3 “p’s” – presumption, precedent and politics.
Oh, and concerning the tu quoque?
Obama isn’t the first president to be criticized this way. O’Neill recalled President George H. W. Bush made televised address to students in October 1991 as campaign season was heating up. A handful of Democrats denounced Bush’s address as pure politics. Bush asked students to “take control” of their education and to write him a letter about ways students could help him achieve his goals, strikingly similar to Obama’s messages.
Yeah, that was wrong as well. Okay? This president as with any president has more than enough to do without presuming he’s welcome to become the national daddy. Why don’t we refrain from centralizing that too and concentrate on taking over another car company or something instead?
UPDATE: Speaking of outrage (and disengenuousness) – I have to ask, given this bit of outrage from the left (and speaking of tu quoque), would this line of reasoning have survived an attempt by George W. Bush to do the same thing?
More broadly, Obama is the leader of this entire nation. It doesn’t matter if you voted for him–or even if your head threatens to explode every time you think about him. He is the president, and, as such, it’s a big deal that he’s speaking directly to students about the importance of education.
Despite being called “brownshirts”, “un-American” and a “mob” of “astroturfers”, a Rasmussen poll indicates the public believes the townhall protesters to be a genuine reflection of the concerns of their neighbors:
Forty-nine percent (49%) have a favorable opinion of those opposing the health care reforms at town hall meetings. That’s up eight points from 41% a month ago. Thirty-five percent (35%) have an unfavorable view of the town hall protesters, unchanged from last month.
Fifty-nine percent (59%) now say the town hall protesters are citizens reflecting the concerns of their neighbors. That’s up ten points over the past month.
Thirty percent (30%) believe the protests are phony efforts drummed up by special interest groups and lobbyists.
Those are phenomenal numbers – within a month, the favorables for the protesters move up 8% despite an organized effort to demonize them while those who see the protesters unfavorably remains both flat and in the minority.
Another encouraging sign is the fact that most of those polled think that Congress members ought to shut up and listen:
Fifty-six percent (56%) of voters nationwide say that it’s more important for Congressmen to hear the view of their constituents rather than explain the proposed health care legislation. The latest Rasmussen Reports national telephone survey found that 37% hold the opposite view while 7% are not sure.
The desire for Congress to listen may stem from the fact that voters believe they understand the legislation better than Congress.
Apparently Americans are in the mood to remind Congress members it is they who are the hired help and it is time they remembered it.
People ask, “what is the utility of a poll like that”? It is a temperature check, a mood indicator, a warning, if you will, that whatever is being contemplated by legislators and the president had best be checked against this trend. It isn’t a favorable trend for what they want to do and the utility comes in realizing that an tailoring something which won’t see them ushered unceremoniously out of office in a year or so.
Like, for instance, ramming something through that their constituents don’t like, but the party base does. The point to be taken here is if the protesters are the tip of the iceberg and most feel they truly represent the feelings of their neighbors, what do you suppose might happen in November of 2010 if legislators disregard the very strong signals being sent?
The president’s speech next Wednesday should be very interesting given these polling indicators. Will he continue to plow ahead trying to force a square peg in a round hole (and pay the political consequences) or will he bow to political reality and radically modify and shrink his goals for health
care insurance reform?
Perhaps indicating why he has never been a politician, Van Jones lays a whopper on the American public (my emphasis):
A top environmental official of the Obama administration issued a statement Thursday apologizing for past incendiary statement and denying that he ever agreed with a 2004 petition on which his name appears, a petition calling for congressional hearings and an investigation by the New York Attorney General into “evidence that suggests high-level government officials may have deliberately allowed the September 11th attacks to occur.”
Van Jones, the Special Advisor for Green Jobs at the White House Council on Environmental Quality, is Number 46 of the petitioners from the so-called “Truther” movement which suggests that people in the administration of President George W. Bush “may indeed have deliberately allowed 9/11 to happen, perhaps as a pretext for war.”
In a statement issued Thursday evening Jones said of “the petition that was circulated today, I do not agree with this statement and it certainly does not reflect my views now or ever.”
He did not explain how his name came to be on the petition. A source said Jones did not carefully review the language in the petition before agreeing to add his name.
Jones’ statements are so laughable that one could be forgiven for thinking that this is a parody from The Onion (it’s not; I checked the URL … twice).
He and the Obama administration are really expecting us to believe that Jones didn’t know what he was signing? That just begs the question, what did he think it was? Why did Truther group come to him for a signature in the first place? What made them think he would sign it? Did they know of Jones’ apparent disdain for reading what he puts his name on and figure he would offer up his John Hancock without any issue? Or did they, being composed of several other statist weirdos (Cynthia McKinney, Howard Zinn), activists (Medea Benjamin and Jodie Evans of Code Pink), and radicals (Ed Asner, Ralph Nader), know full well that Jones would happily sign the petition because it fits in with his own radical views?
Don’t expect any answers to these questions to be forthcoming.
At this point, the White House isn’t answering any of these questions, but they will have a difficult time sticking with the “I didn’t read it” defense for very long. To be sure, lots of excuses will be offered up by the media in an attempt to provide cover for Obama’s administration, but this isn’t a story that can just go quietly away. They tried to do that with Rev. Wright, but the buzz from non-MSM sources kept it alive until Obama was forced to throw Wright under the bus (with his own grandma!). Expect the same here.
Nope, not another post about the kiddie speech. Instead the title is from an old protest song from the ’60s (by Buffalo Springfield I believe). The sound is the sound of real, honest to goodness change being driven by government excess – not the veneer of change pushed by a certain candidate in the last election.
Daniel Henninger writes about it today in the WSJ. He sees it happening everywhere (he uses Japan as an example) and he believes it all pretty much boils down to this:
No matter the ideological cast of these governments, they all hold in common one policy: the inexorable upward march of national indebtedness. It has arrived at the edge of the cliff.
It is the point the liberal left in this country still doesn’t understand. The looters have finally been noticed by looted and the looted aren’t at all happy.
That’s it. That’s the problem. And that’s why there’s so much unrest.
As measured by the OECD, the growth in gross debt as a percentage of GDP since the dawn of the new century is stunning. The data isn’t exactly comparable across individual countries, but the trend line is unmistakable.
In the U.S., debt as a percentage of GDP rose to 87% in 2009 from 55% in 2000. In the U.K., to 75% from 45%; Germany, to 78% from 60%; France, 86% from 66%. There are exceptions to this trend, such as Canada, New Zealand and notably Australia, whose debt has fallen to 16% of GDP from 25%. But for all the countries in the OECD’s basket the claim of indebtedness on GDP grew to 92% from 69% the past nine years.
In short, the lumpen electorate works, and the lumpen bureaucratariat spends. They get away with it because they have perfected the illusion that no human hand causes these commitments. The payroll tax just happens. Entitlements are “off-budget,” presumably in the hands of God. This is government without the responsibility of governance.
Unable to identify who or what has put them in hock to the horizon, national electorates are attempting accountability by voting whole parties out of power.
That, among other reasons, is why the Republicans are out of power. And, if the Democrats continue down the path they’ve charted, is why the Republicans may find themselves back it power. And it wouldn’t at all surprise me, given the gawd-awful track record of the Republicans, that they too will misinterpret their reinstatement and be gone again in 2 years.
It is about the size, cost and intrusiveness of government, stupid!
The “lumpen electorate” has finally had enough. They want to keep what they earn. They want less government. But that’s an anathema to politicians who have built whole lives and careers on providing more government. It’s like an addiction – they can’t stop what they’re doing or how they’re doing it.
And, unfortunately, even though the masses seem unhappy with the size and cost of government, they too are addicted to a certain level of government. They too have an addiction to break.
The question, of course, as far as libertarians are concerned, is how these two addictions can be addressed and overcome so that government’s size and cost can be scaled back to a proper and legitimate size? And where are the leaders to do this?
Until they emerge – and there is nothing to say they will – this cycle of unrest which sees the swapping out of political parties will continue. But you have to believe that at some point, the disenchantment with the current political regime (and both parties make up that regime) will come to a flash point. What that flash point will entail – the range of possibilities is vast – is anyone’s guess.
When it is reached, politics and government as we know it now, will change forever. I cautiously believe we’re moving in that direction. When and where are anyone’s to guess, but I’m beginning to believe we’ve moved beyond “if” and have a “when” in our future. Or at least I hope so – because it seems obvious that we need some very drastic changes in direction.
What we’ve got to work toward is a change that emphasizes freedom and enhances liberty. And that isn’t by any means the only possibility such change would bring.
The old Chinese curse seems to be in full bloom right now – “May you live in interesting times”. I can’t think of times, during my life, that have been any more interesting.
Yes, I’m again addressing presidential leadership, or the lack thereof. While it appears that President Obama has finally decided he has to “step up” in the health care insurance reform debate, he’s seems to be AWOL in that department concerning Afghanistan. Abu Muqawama lays it out pretty succinctly:
I do not think it would surprise any reader of this blog, though, to note the speed with which the debate has shifted on the war in Afghanistan. What was, 12 months ago, “the good war” has now become, for paleoconservatives and progressives alike, a fool’s errand. And the Obama Administration has thus far shown little energy for defending a policy and strategic goals (.pdf) they themselves arrived at just five months ago. I thought that once the president had settled on a policy and strategic aims, the rest of the administration would then go about executing that policy. That’s the way it’s supposed to work, right? Yet the policy debate seems to continue within the White House, with the Office of the Vice President apparently pushing for a much more limited approach than what was articulated in March by the president himself and following a lengthy policy review. No wonder, then, the uniformed military is getting nervous about the administration’s support for their war. Either the White House has been too busy with health care, or they have failed to notice how quickly the debate has shifted under their feet (as with health care).
Of course the assumptions Abu makes in his paragraph above are only valid if there’s someone in charge and leading the effort. A decision was supposedly made in March, in terms of policy and goals, and the assumption was made it would be executed. But apparently that’s not the case. And, as in the case of health
care insurance reform, the evident lack of leadership has caused there to be a noticeable shift in the debate and a tremendous drop in support for the war effort. Again, a major policy issue is left to twist in the wind for lack of a leader.
Abu Muqawama, obviously recognizing this problem, throws out a solution:
What needs to happen? Well, first off, I guess we should decide what we’re trying to do in Afghanistan. (Again, when we set about reviewing ISAF operations in June and July, we thought this question had already been resolved in March.) Once that question is settled, the administration needs to go about defending and explaining their policy. Until then, it’s understandable why everyone from voters in Peoria to Mullah Omar in Afghanistan (?) are confused as to what, exactly, U.S. policy is at the moment.
This is a very critical issue that needs to be resolved now. That means the Commander-in-Chief needs to act like one and do what is necessary to resolve this policy issue. He needs to make a decision, give guidance to the proper agencies which directs them in how he wants his decision implemented and, finally, take responsibility for the war.
As a certain someone is learning, governing and actually leading is much harder than standing off to the side and tossing bricks while regaling everyone with how much better you could do the job. Thus far, the job performance has been anything but impressive.
As the president gears up for a new push to pass health
care insurance reform with a “major speech” to a joint session of Congress this coming Wednesday, it’s always instructive to peek in periodically at a system that is the practical end state he’s claimed he’s always wanted – the single payer system.
Today, as usual, we take a look at the National Health Service in the UK.
In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.
Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away.
What’s the criticism of the insurance industry? That a bureaucrat somewhere is making a life or death decision, correct? Of course that’s precisely the same thing that happens in a single-payer system, except it is a government bureaucrat making the decision.
In an insurance system, what are your choices? Appeal. Or tell them to stuff it and pay for the care yourself. But in such a system it is highly unlikely that any insurance company is going to try to issue “guidance” to doctors telling medical staff how to deal with dying patients like what the NHS has done. They wouldn’t presume to do it (and if they did, the option is to find an insurance carrier that doesn’t).
However, when it’s a single payer system and, as in the case of the UK, everyone works for government, such as the UK, then such guidance is completely within reason given the system. After all the basic presumption of such a system is that, in fact, bureaucrats do have a right to call the shots.
The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.
Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.
It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004
And there is no appeal as there’s really no one else to whom you can go.
A number of doctors there are concerned about the guidance. Dr Peter Hargreaves, a consultant in Palliative Medicine at St Luke’s cancer centre in Guildford, is one of them:
He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.
He said: “I have been practising palliative medicine for more than 20 years and I am getting more concerned about this “death pathway” that is coming in.
“It is supposed to let people die with dignity but it can become a self-fulfilling prophecy.
“Patients who are allowed to become dehydrated and then become confused can be wrongly put on this pathway.”
He added: “What they are trying to do is stop people being overtreated as they are dying.
“It is a very laudable idea. But the concern is that it is tick box medicine that stops people thinking.”
He said that he had personally taken patients off the pathway who went on to live for “significant” amounts of time and warned that many doctors were not checking the progress of patients enough to notice improvement in their condition.
The key of course, and the reason for the “pathway” is contained in the second sentence I’ve put in bold – “overtreated”. Code for spending money on someone in the last stages of life. Obviously, it is much cheaper to put them in a drug induced coma and let them die than it is to attempt to keep them alive. Hargreaves sees that as a “self-fulfilling” process, where patients who would actually respond to more care and live “significant” amounts of time longer are condemned to death in an uncaring system more concerned about cost than life.
From the beginning one of the primary targets of health
care insurance reform has been cost. The claim is that government can help lower those costs. The further claim is it can do it by introducing “competition” into the system. But there’s little in the proposals that anyone can find that actually does that. Instead it appears to most that things like the “public option” are actually designed to move us toward the eventuality of a single-payer system. The NHS provides us almost weekly examples of the cost containment strategies it implements in which extending life takes second place to cutting cost.
If cutting cost is the top priority of a system, any system, those are the types of decisions someone is going to be making. Most likely, if the patient isn’t involved in paying for the service, it isn’t going to be the patient or his family making them. It is going to be some bureaucrat with a budget line busily engaged in the priority of “cutting cost” making the decision.