It Makes Them Nuts

…that Cheney was right:

There is a principled human-rights position on all this. You can say: “No one wants to see bad things happen to people, but I honestly believe abusive tactics are so corrosive of our society’s principles that it would be better for 10,000 Americans to be killed in a terrorist attack than for us to prevent the attack by subjecting a morally culpable terrorist to non-lethal forms of coercion that cause no lasting physical or mental harm.”

That would be the honest argument, but it is not going to persuade many people. Thus the continued pretense, against all evidence and logic, that the tactics don’t work. Fewer and fewer people are fooled.

No, this administration and its enablers (including some in my comments section) is having trouble continuing to fool us on many fronts.

[Update a few minutes later]

Thoughts on “the Narrative,” and the lies of both commission and omission of the leftist media.

[Update another few minutes later]

Fouad Ajami — Obama’s summer of discontent:

A political class, and a media elite, that glamorized the protest against the Iraq war, that branded the Bush presidency as a reign of usurpation, now wishes to be done with the tumult of political debate. President Barack Obama himself, the community organizer par excellence, is full of lament that the “loudest voices” are running away with the national debate. Liberalism in righteous opposition, liberalism in power: The rules have changed.

It was true to script, and to necessity, that Mr. Obama would try to push through his sweeping program—the change in the health-care system, a huge budget deficit, the stimulus package, the takeover of the automotive industry—in record time. He and his handlers must have feared that the spell would soon be broken, that the coalition that carried Mr. Obama to power was destined to come apart, that a country anxious and frightened in the fall of 2008 could recover its poise and self-confidence. Historically, this republic, unlike the Old World and the command economies of the Third World, had trusted the society rather than the state. In a perilous moment, that balance had shifted, and Mr. Obama was the beneficiary of that shift.

So our new president wanted a fundamental overhaul of the health-care system—17% of our GDP—without a serious debate, and without “loud voices.” It is akin to government by emergency decrees. How dare those townhallers (the voters) heckle Arlen Specter! Americans eager to rein in this runaway populism were now guilty of lèse-majesté by talking back to the political class.

We were led to this summer of discontent by the very nature of the coalition that brought Mr. Obama, and the political class around him, to power, and by the circumstances of his victory. The man was elected amid economic distress. Faith in the country’s institutions, perhaps in the free-enterprise system itself, had given way. Mr. Obama had ridden that distress. His politics of charisma was reminiscent of the Third World. A leader steps forth, better yet someone with no discernible trail, someone hard to pin down to a specific political program, and the crowd could read into him what it wished, what it needed.

I think the spell is finally breaking. The polls would certainly indicate it. And without his charisma, he is truly an empty suit.

Read the whole thing.

73 thoughts on “It Makes Them Nuts”

  1. Of course, it could just be that, as a human being and a professional, he’s also interested in your health.

    Un mas, please go look-up what “conflict of interest” means. Hint: it doesn’t mean a “bad person.”

  2. HR3200 determines what’s for sale, how much it costs and madantes that everyone buy in.

    No, it doesn’t. HR3200 does nothing to stop you from buying any medical service you want from any appropriately licensed professional with your own money. You can pay whatever amount is agreeable to you and the doctor/nurse/etc. Doctors won’t work for the government (unless they work for the VA, DOD, or Indian Health Service), and they won’t have to accept reimbursements from government insurance programs if they don’t want to.

    Does HR3200 restrict what sort of insurance can be sold? Yes. Such restrictions exist already — you can’t sell a health insurance policy in Wyoming unless it covers mammograms, for example. Does that mean that Wyoming’s state government has taken over health care?

  3. For whatever it’s worth, Roemer’s law is:

    In an insured population, a hospital bed built is a bed filled.

    I’m not sure how Titus the Namecaller and Leland get from that to doctors killing their patients.

  4. No, it doesn’t.

    Yes, it does. Again, read the bill.

    HR3200 does nothing to stop you from buying any medical service you want from any appropriately licensed professional with your own money.

    Yes, after spending ~$12K/year on HMO premiums because the government forced you to, you can spend whatever you have left over on discressionary health care. How generous of them. I’m sure that is is no big deal for Millionaire Jim. For the rest of us, however, that’s not chump change.

    If the government required us to buy a car every year, we’d have no qualms about calling a spade a spade. Anyone who pointed out that this didn’t prevent you from buying a second car would be laughed off the stage.

  5. Un mas, please go look-up what “conflict of interest” means. Hint: it doesn’t mean a “bad person.”

    I second this recommendation. My feeling is that if you ignore conflicts of interest, then you are ignoring deal-killers with the numerous proposals of the Obama administration. And someone who doesn’t understand conflicts of interest simply cannot contribute to this discussion.

  6. There is no conflict of interest with a doctor giving a patient advice on end-of-life treatment. The doctor is merely explaining what may and can happen when somebody dies. Death is inevitable – discussing what the patient wants to happen in certain situations is merely planning for the inevitable.

  7. There is no conflict of interest with a doctor giving a patient advice on end-of-life treatment.

    Yes, there is when he’s getting paid $X/month to treat you and you cost $(X+Y)/month to keep alive, and this is the bloke who’s helping you decide how much treatment you want to prolong your expensive life. Again, who pays the difference?

    Geez, you’d think the camp which screamed about Halliburton for 5 long years couldn’t possibly be this dense…

  8. Wow, you mean I should have gotten paid for all those discussions with my dad about what to do with his body once he kicked it

    No, unless you were his Doctor… anyway… as a friend of mine, who is a Doctor said, you don’t exactly get paid by medicare for a consultation with no clinical outcome. So she was for her being paid to discuss end of life issues.

    As Chris said, death is inevitable, at least at the moment. You can put it off, there are things that can be done, but, towards the end most of them are going to be palliative and not-curative.

    When my grandmother had her stroke there wasn’t any coming back from it, but those evil “death panel” driven NHS doctors just insisted on keeping her alive, trapped in her own body for almost 6 months before she finally lost to pneumonia. Lots of treatment, but the core issue, that they told us within a week of her arriving in hospital was there was no coming back from a stroke that big.

    So, everyday, for almost 6 months we went to watch her die while the cost driven healthcare nazis did their damnedest to keep her alive.

    It’s nothing to do with what to do with the body when your elderly relative’s are dead. But what to do with the body before it dies but when you’re in the final lap of life’s race and death is inevitable.

    And before people start talking about the pressure to end lives early, like with my Grandmother, you just don’t see that in any other healthcare system in the world, so I don’t buy the idea that it would happen in the US like that either.

  9. Not to be crude, D, but was grandma positive cash flow for those 6 months? The US isn’t NHS. Who pays the difference here? It’s a simple question, really.

    999,995…999,994…

  10. Titus – are you really that stupid or are you just rude? The NHS pays doctors a salary, and gets money from taxpayers. There is no financial incentive to keep people alive, other than the simple one of doing what you are paid to do.

    You are also working under a false assumption that capitation will be imposed. The House bill does not, and explicitly forbids life-time medical expense caps. Even under capitation, your scenario is bogus – the HMO gets paid a per-patient fee for all patients, so money needed to treat Person X is available to be pulled from Person Y.

    Your last logical fallacy is to assume that doctors (or anybody else) only does what they do for money. Pride. professionalism, and simple human decency are among the many factors that drive human behavior.

  11. Even under capitation, your scenario is bogus – the HMO gets paid a per-patient fee for all patients, so money needed to treat Person X is available to be pulled from Person Y.

    Finally you answer my question: it comes from the bottom line. My reasoning is not “bogus” at all — you’ve just supported it. No further questions from this witness.

  12. It comes from the insurance company’s bottom line, not the doctor’s. The doctor gets paid no matter what. The doctor does not have a conflict of interest.

  13. Titus – actually, no, I’m trying to say that from the doctor’s perspective, this is a service, just like a checkup. The doc has no idea if you are ever going to need a living will – you might just stroke out in your sleep, for instance, or die in a car crash. Your living will might even say “keep me alive no matter what.”

    You’re trying to pretend that end-of-life rationing doesn’t happen with the current system. In the current system, even high-end policies have lifetime benefit caps. When the cap’s gone, you’re dead. And no, you can’t get different coverage after the cap is gone – pre-existing condition, don’t you know.

  14. I’m trying to say that from the doctor’s perspective, this is a service, just like a checkup.

    And this is why one should seek out objective advice, not going to, say, a Kaiser doctor for death coaching while you’re paying premiums into Kaiser (not to pick-on Kaiser). It’s common sense like not buying stocks from the firm that’s doing your financial planning.

    …you might just stroke out in your sleep, for instance, or die in a car crash. Your living will might even say “keep me alive no matter what.”

    …or you might die of your risk factors/terminal condition under his firm’s watch, or the feds might tighten their belts wrt how much they’re going to pay as the Boomers start eating more medicine, etc.

    You’re trying to pretend that end-of-life rationing doesn’t happen with the current system.

    No, never said or implied any such thing.

  15. In an insured population, a hospital bed built is a bed filled.

    In an insured population, what happens when a bed filled is emptied?

    I mean, if this is a law, then it must be logically sound, right?

    And according to Gerrib: The doctor gets paid no matter what.

    So if a bed is already built, filled, and is emptied?

    I realize I’m using the arguments provided by Gerrib and Jim to make my point. Which is tricky because I neither agree that Roemer’s law is either logically sound or means anything what so ever (see Wyoming’s abortion clinics). And I know Doctors are not always paid, which is why AMA has ethics laws written in respect to those situations. But since both insist on believing these things, and not educating themselves; perhaps they can see the logical fallacy that exists in their own arguments.

  16. Titus – you can get end-of-life counseling from any doctor. All HR 3200 does is require Medicare to pay for it. This may come as a news flash to you, but under Medicare, you can have multiple doctors per patient (like my parents).

    Leland – so, somehow the fact that doctors get paid for providing end-of-life consultations means that they’ll churn patients by letting them die? Sounds like underpants gnome logic to me.

    Because, heaven knows that in our current system, there is no incentive to kick somebody out of the hospital when their insurance runs out. Or not even admit them if they don’t have insurance.

  17. …you can get end-of-life counseling from any doctor. All HR 3200 does is require Medicare to pay for it.

    I’ll pay for it myself, thanks. I don’t need Medicare’s input. BTB, HR3200 is moot, and this provision is now so hot that it’s unlikely to find its way before a vote.

  18. so, somehow the fact that doctors get paid for providing end-of-life consultations means that they’ll churn patients by letting them die? Sounds like underpants gnome logic to me.

    I agree, but that’s how Roemer’s Law works.

  19. Titus – you can get end-of-life counseling from any doctor. All HR 3200 does is require Medicare to pay for it.

    Why should the federal government pay for such counseling? I don’t see legitimate use of government here.

  20. Chris, you wrote:

    Titus – when you die, the doctor stops getting the per-patient fee. It’s in his interests to keep you alive as a patient.

    Think about what was said here. “Its in his interests to keep you alive as a patient. Suppose I don’t want to be a patient? Then we have a conflict of interest, the fundamental one that every health care system has to deal with. Then you wrote:

    There is no conflict of interest with a doctor giving a patient advice on end-of-life treatment. The doctor is merely explaining what may and can happen when somebody dies. Death is inevitable – discussing what the patient wants to happen in certain situations is merely planning for the inevitable.

    In other words, you don’t understand the problem. Moving on for another example:

    Titus – are you really that stupid or are you just rude? The NHS pays doctors a salary, and gets money from taxpayers. There is no financial incentive to keep people alive, other than the simple one of doing what you are paid to do.

    As I’ve noted in other threads, government entitlements are often paradoxical. My view is that there was no revenue earned from poor grandma. Instead, this was health care theatre. The doctors were acting all heroic, consuming quite a bit of the British public’s funds in the process, just so grandma’s relatives wouldn’t go whining to their representives. My bet is that grandma would have gotten a whole lot less heroic a treatment if she was a homeless nobody.

    It’s also worth noting that doctors aren’t the decision makers for the system. Remember the doctor might be paid a fixed rate, but the bureaucrats higher up on the food chain, who hire and fire doctors, get paid (in currency of bureaucratic power) by the patient. The UK system hides the conflicts of interest better than in the US system, but they are still there.

  21. The doctors were acting all heroic, consuming quite a bit of the British public’s funds in the process, just so grandma’s relatives wouldn’t go whining to their representives.

    You loathsome piece of &^*&FD.

  22. The doctors were acting all heroic, consuming quite a bit of the British public’s funds in the process, just so grandma’s relatives wouldn’t go whining to their representives. My bet is that grandma would have gotten a whole lot less heroic a treatment if she was a homeless nobody.

    Wow. You loathsome tosser. What a stuningly stupid statement. Wrong in almost every regard.

    Wow.

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