Some have said that the phrase DEATH PANELS was a silly attempt to scare the daylights out of the public. The real problem is that it was immediately paired with a provision in the bill for end of life counseling. That muddied the water to where no one knows what anyone is talking about. Good trick for the media.
End of life counseling is not the provision that will cause the mass death of older folks with expensive illnesses. It will actually help them deal with things when that happens. The real problem comes from a provision for a study of "comparative effectiveness". Initially this will be a data gathering panel that will publish statistics on the cost and results (in terms of additional months or years of life) offered by many possible treatments. There are a bunch of problems with this.
First is the usual issue with anything done by government. It will not be updated very frequently and will not include newly developed treatments for years after they are available.
Secondly, and far worse is that it will become the standard of care. If it is shown that a particular treatment only buys an average of 12 months of additional life at a cost of more than some standard-let's use $20K per year, then it will be declared not sufficiently effective and be made unavailable under the government paid system. This will happen without regard to individual circumstances which might make it far more effective for you.
We know this is the intention of the plan. Obama has stated so. Howard Dean has stated so and our friends in England already do this in their wonderful public health plan. So, prepare to become like poor Bessy the cow who is too old to give milk anymore. Why should the farmer spend any vet money to keep her alive. When the government runs your health care, you are reduced to a farm animal who has to justify your continued life by productivity. If you can't work, no longer pay income tax, what is the point of spending money to keep you alive. After all, it is their money now.
Only idiots who think that are going to get something for nothing will give up this control of their lives.
Sunday, August 30, 2009
Sunday, August 23, 2009
Obama's Goal
In politics, things are rarely done in a straight forward manner. By that I mean the goals stated are usually not the whole story. There is almost always another motive that they don't dare state. You have to divine this from the details of the proposal as it relates to the stated goals.
So for example, we are told that we need health care reform because we have 47 million uninsured. No discussion how many of those have made an intentional choice to save the premium costs. For the purposes of this discussion, let's take that number as correct. That is roughly 15% of the population. That means that 85% of the population is insured and probably satisfied with their insurance coverage.
So now, is the new plan the best and cheapest way to get that 15% insured. Clearly not!! The dictum "First do no harm" should be kept in mind always. It seems pretty foolish to upend the whole system and mess around with the satisfied 85% when we need only subsidize the 15% and be done. To understand what I am saying, think how we help those who cannot buy enough food. The government did not take over the food industry. They gave money to poor people who met certain criteria, via the mechanism of food stamps. They buy their food like everyone else, in a free market with all the efficiency and innovation that comes with it.
The equivalent method for health insurance is "HEALTH STAMPS. Just set up a needs based requirement for getting a voucher which I like to call health stamps and the stated problem is solved and the 85% are not affected or disturbed.
So the stated reason is not the true reason for this massive 'reform'. What might the true reason be? I am assuming that there are two driving forces for this. We know that Obama has spent his whole life espousing big government intervention and the Marxian dictum, "From each according to his ability and to each according to his needs". Apparently he wants a monstrously expensive system that will justify raining taxes even further on the already most taxed group of high income earners. When experience shows this as still inadequate, let's go after those comfortable middle class folks. Let's share every one's poverty. Socialists do not understand incentives and disincentives very well.
Rationing is also inevitable in an always cash short system so this will give the leaders the power of life and death over the populace. I hope that is not a driving force but it cannot be discounted.
In any case, the plan is idiotic since the problem can be solved much more simply with "health stamps".
Please don't take this as an endorsement of a broadening of the welfare state. I merely point out that health stamps would solve the problem without creating a disaster. A still better but longer term solution is eliminating the state and federal laws and rules that make health care more expensive than it needs to be. Thus I offer as an alternative the HEALTH STAMPS PLAN as a short term fix with a deregulation move to follow. That will have a goal of lowering the costs so that nearly everyone will be able to afford good insurance and fewer will need health stamps.
So for example, we are told that we need health care reform because we have 47 million uninsured. No discussion how many of those have made an intentional choice to save the premium costs. For the purposes of this discussion, let's take that number as correct. That is roughly 15% of the population. That means that 85% of the population is insured and probably satisfied with their insurance coverage.
So now, is the new plan the best and cheapest way to get that 15% insured. Clearly not!! The dictum "First do no harm" should be kept in mind always. It seems pretty foolish to upend the whole system and mess around with the satisfied 85% when we need only subsidize the 15% and be done. To understand what I am saying, think how we help those who cannot buy enough food. The government did not take over the food industry. They gave money to poor people who met certain criteria, via the mechanism of food stamps. They buy their food like everyone else, in a free market with all the efficiency and innovation that comes with it.
The equivalent method for health insurance is "HEALTH STAMPS. Just set up a needs based requirement for getting a voucher which I like to call health stamps and the stated problem is solved and the 85% are not affected or disturbed.
So the stated reason is not the true reason for this massive 'reform'. What might the true reason be? I am assuming that there are two driving forces for this. We know that Obama has spent his whole life espousing big government intervention and the Marxian dictum, "From each according to his ability and to each according to his needs". Apparently he wants a monstrously expensive system that will justify raining taxes even further on the already most taxed group of high income earners. When experience shows this as still inadequate, let's go after those comfortable middle class folks. Let's share every one's poverty. Socialists do not understand incentives and disincentives very well.
Rationing is also inevitable in an always cash short system so this will give the leaders the power of life and death over the populace. I hope that is not a driving force but it cannot be discounted.
In any case, the plan is idiotic since the problem can be solved much more simply with "health stamps".
Please don't take this as an endorsement of a broadening of the welfare state. I merely point out that health stamps would solve the problem without creating a disaster. A still better but longer term solution is eliminating the state and federal laws and rules that make health care more expensive than it needs to be. Thus I offer as an alternative the HEALTH STAMPS PLAN as a short term fix with a deregulation move to follow. That will have a goal of lowering the costs so that nearly everyone will be able to afford good insurance and fewer will need health stamps.
Sunday, August 16, 2009
Government Run Health Care Part 4
Today, let's talk about tactics. In the mid 1990s, when the Clinton clan decided to save the world from freedom, they presented their health care reform as a complete package. All the details were available with all the flow charts, payment methods and new crimes defined fully. They were so proud of their monstrosity, they published a book with all the details.
Obviously, this gave the opposition the opportunity to read, understand and explain the contents. A lot of people thought it was unstoppable, so they started making plans to live through it. Several entrepreneurs announced plans to build floating hospitals several miles offshore all around the US to treat people who could not or would not wait for the system to care for them. The main lesson that Obama took from this was to go lightly on the details. Sell it as a somewhat vague concept and maybe you will get it through. It is very difficult to fight a phantom plan that can change or redefine terms as the opposition attacks.
That is why I feel we need to battle the basic assumptions, not the details. Let us stress the basic idea that some bureaucrat will decide if we get a particular treatment based on our life expectancy is a horrible idea and no matter how they laugh, rationing is inherent in any government run system. It cannot be otherwise because all our money has been placed in one pot and it is not bottomless. It is suddenly of no consequence that we scrimped and saved all our working lives to have a comfortable retirement with good medical care. Our resources got thrown into that same pot with the person who was a spendthrift all his life and we will get the same care, for better or worse. We might point out that this puts us in the position of pets brought to a vet. The vet and the owner decide if the treatment is cost effective or if the patient should be put down. Is that how you would like to be treated-like a pet or farm animal?
Another important issue for us is to decide what alternate we propose. We could take the position that the Status Que is far better than this plan. This is true but the Status Que is not great. I have seen alternate plans from so-called conservatives that astound me. I have seen plans that include full price controls and mandated purchase of insurance actually suggested by these so called conservatives. I have seen a Republican plan that is mostly double talk, i.e. platitudes about taking care of yourself.
My favored solution is, of course, individual freedom. We know that the system currently suffers under reams of state and federal regulation that drastically increase the cost of medical care and medical insurance. The direction to go is to undo those regulations.
One other thought. Have you all noticed the logical contradiction that we hear all the time from the politicians pushing this? We have to pass this to control costs but we also have to raise taxes to pay for this cost saving improvement. Makes by cognitive dissonance (BS) alarm sound.
Obviously, this gave the opposition the opportunity to read, understand and explain the contents. A lot of people thought it was unstoppable, so they started making plans to live through it. Several entrepreneurs announced plans to build floating hospitals several miles offshore all around the US to treat people who could not or would not wait for the system to care for them. The main lesson that Obama took from this was to go lightly on the details. Sell it as a somewhat vague concept and maybe you will get it through. It is very difficult to fight a phantom plan that can change or redefine terms as the opposition attacks.
That is why I feel we need to battle the basic assumptions, not the details. Let us stress the basic idea that some bureaucrat will decide if we get a particular treatment based on our life expectancy is a horrible idea and no matter how they laugh, rationing is inherent in any government run system. It cannot be otherwise because all our money has been placed in one pot and it is not bottomless. It is suddenly of no consequence that we scrimped and saved all our working lives to have a comfortable retirement with good medical care. Our resources got thrown into that same pot with the person who was a spendthrift all his life and we will get the same care, for better or worse. We might point out that this puts us in the position of pets brought to a vet. The vet and the owner decide if the treatment is cost effective or if the patient should be put down. Is that how you would like to be treated-like a pet or farm animal?
Another important issue for us is to decide what alternate we propose. We could take the position that the Status Que is far better than this plan. This is true but the Status Que is not great. I have seen alternate plans from so-called conservatives that astound me. I have seen plans that include full price controls and mandated purchase of insurance actually suggested by these so called conservatives. I have seen a Republican plan that is mostly double talk, i.e. platitudes about taking care of yourself.
My favored solution is, of course, individual freedom. We know that the system currently suffers under reams of state and federal regulation that drastically increase the cost of medical care and medical insurance. The direction to go is to undo those regulations.
One other thought. Have you all noticed the logical contradiction that we hear all the time from the politicians pushing this? We have to pass this to control costs but we also have to raise taxes to pay for this cost saving improvement. Makes by cognitive dissonance (BS) alarm sound.
Friday, August 14, 2009
Government Run Health Care Part 3
It amazes me that this Health Care discussion has simply ignored the constitution. This is our founding document and creates the pact between the people, the state governments and the Federal government. In fact, this is what brought the federal government into existence. Its every word and phrase is designed to clearly limit the authority of the federal government to a short, explicit list of functions, leaving all else to the states or the people.
That short list, embodied in Article 1 Section 8 absolutely does NOT contain health care as a federal function. Of course, that has never stopped them from doing the myriad things they do under the "elastic" clause as they have misnamed the commerce clause. Most of the things they have done in this vein have been terrible for the nation and it is time we started demanding compliance with the founding charter of the government. A government that ignores its founding charter is not a legitimate government but just a gang of thieves writ large.
Are the following things appropriate for a nation that considers itself free?
1. Force, at gun point, all employers to buy health insurance for all employees or pay a large penalty fee based on payroll.
2. Force, at gun point, anyone not otherwise covered to buy a government approved health insurance policy or pay a penalty tax.
3. Take money from people, deemed to rich to complain, at gun point, extra taxes, over and above what everyone else pays to supply health insurance to others.
4. Prevent people, at gun point, from spending their own money to buy health care if refused by the government system. Refusal based on something called comparative effectiveness or, in effect, setting a maximum payout per year of extended life. (I think this is what Sarah Palin meant by death panels except there will be no panel to argue with. Just a bureaucrat with a calculator.)
That short list, embodied in Article 1 Section 8 absolutely does NOT contain health care as a federal function. Of course, that has never stopped them from doing the myriad things they do under the "elastic" clause as they have misnamed the commerce clause. Most of the things they have done in this vein have been terrible for the nation and it is time we started demanding compliance with the founding charter of the government. A government that ignores its founding charter is not a legitimate government but just a gang of thieves writ large.
Are the following things appropriate for a nation that considers itself free?
1. Force, at gun point, all employers to buy health insurance for all employees or pay a large penalty fee based on payroll.
2. Force, at gun point, anyone not otherwise covered to buy a government approved health insurance policy or pay a penalty tax.
3. Take money from people, deemed to rich to complain, at gun point, extra taxes, over and above what everyone else pays to supply health insurance to others.
4. Prevent people, at gun point, from spending their own money to buy health care if refused by the government system. Refusal based on something called comparative effectiveness or, in effect, setting a maximum payout per year of extended life. (I think this is what Sarah Palin meant by death panels except there will be no panel to argue with. Just a bureaucrat with a calculator.)
Government Run Health Care Part 2
Now let us assume you are adamant that the government must DO SOMETHING about the 10 or 15% of the population that does not have health insurance. Shall we revamp the entire system and put it all under government control, even for the 85% that is happy with what they have?
If we had followed that same plan when we were worrying about food security, we would have handed the entire food industry over to the government and then we would all get our food from government run warehouses. I am sure it would be delicious. Instead we gave money (via food stamps) to the poor and disabled so they could buy their food where everyone else does. We did not bother the self sufficient very much at all (except for the taxes) and did not interfere with normal market forces that create good quality and innovation.
The equivalent function in the health care realm already exists-Medicaid. It seems we should only be discussing changes to the qualifications to receive Medicaid.
Now I in no way endorse Medicaid, food stamps or any other aspect of the welfare state. I am just pointing out the total lack of necessity to revamp the whole system when small and comparatively cheap adjustments will meet the goal. The fact that the welfare state and the high taxes it causes is a self perpetuating disaster should be obvious to all. But that is how government grows. It messes things up with a foolish intervention and then uses the consequences of that intervention to justify the next. And so it goes on a spiral into fascist or socialist hell.
If we had followed that same plan when we were worrying about food security, we would have handed the entire food industry over to the government and then we would all get our food from government run warehouses. I am sure it would be delicious. Instead we gave money (via food stamps) to the poor and disabled so they could buy their food where everyone else does. We did not bother the self sufficient very much at all (except for the taxes) and did not interfere with normal market forces that create good quality and innovation.
The equivalent function in the health care realm already exists-Medicaid. It seems we should only be discussing changes to the qualifications to receive Medicaid.
Now I in no way endorse Medicaid, food stamps or any other aspect of the welfare state. I am just pointing out the total lack of necessity to revamp the whole system when small and comparatively cheap adjustments will meet the goal. The fact that the welfare state and the high taxes it causes is a self perpetuating disaster should be obvious to all. But that is how government grows. It messes things up with a foolish intervention and then uses the consequences of that intervention to justify the next. And so it goes on a spiral into fascist or socialist hell.
Subscribe to:
Posts (Atom)