Category Archives: Health Care

Death Panels and Who Will Die

Amy Sullivan has a remarkably deceptive piece on her blog in which she attempts to debunk this as a “myth:”

I’m very, very concerned about the elderly. I don’t know if this is also correct, but I understand that a federal health board will sit in judgment of medical procedures and protocols to impose guidelines on all providers — when to withhold certain types of care — like, what is the point you get to when we say, I’m sorry that this cannot happen.

Except for quibbling over the word “all,” the “myth” is of course true.

To control costs, any sensible health care reform needs to create a Federal Health Reserve which uses science (as opposed to politics) to determine what we spend our limited resources on. Should a patient be reimbursed for $50 worth of drugs if it keeps her alive another year? What if the cost is $500? $5000? $50,000? $500,000? $5,000,000?

The Federal Health Reserve would be the Life Panel. It would be the Death Panel.

In a real way, experts will control who lives and who dies.

This will mean that some people will be driven to euthanasia because the government will not pay for life-sustaining treatment. There is simple to demonstrate. Some life-sustaining treatments will not be given because technocrats who the patient never sees have determined that it is an inefficient use of funds. Euthanasia is already legal in several places. Therefore, some patients, given the choice between dying painfully from neglect and dying peacefully through euthanasia, will choose euthanasia.

The only alternative to a Death Panel is the Congress. That is, we can listen to those who trust politicians and have politicos decide whether $40,000 on chemotherapy is better spent than $40,000 on a new treatment. Of course, Congress will be driven by polls as opposed to medicine or science. The only alternative to a Death Panel is even worse than a Death Panel.

Now, this is only a nightmare if Obama gets his socialist Public Option through as part of reform. If the Public Option is created, it will never be allowed to fail. Its inefficiencies will take down the rest of the health insurance industry with it.

Create the Federal Health Reserve. Stop the Public Option.

The Exploding Cost of Health Care (and Death Care)

With Lexington Green, Ginny, myself, and many others talking about deathcare, it is worthwile to say a few things on why healthcare costs are becoming so unaffordable.

We are better at making sick people well (which decreases morbidity and mortality) and making dead people sick (which increases morbidity and decreases mortality).

To the extent the government increasingly interfers in the healht care market (as is already happening), it should be further societal well-being.

This scares a lot of people.

Former Alaska Governor Sarah Palin worries about her son, who will be aflicted with morbidity all his life.

Others worry about the aged, the care of whom is a conversion of mortality into morbidity.

Some worry about young couples.

Some also worry about the economy as a whole, and note that while turning the sick into the well helps the economy (and thus all of us together), transforming mortality into morbidity hurts the economy (and thus all of us together).

If we are going to get costs under control, we will need a Federal Health Reserve which uses scientific approaches to minimizes both mortality and morbidity, and is protected from politics so that the rage of the berieved does not hurt all of us together.

Update: Courtesy MyDD, an example of the emotion of this issue

What will the ObamaCare equiavelent of Cash-for-Clunckers be?

While I support national health care, Obama’s handling of the “cash for clunkers” problem raises a question: if the Public Option for ObamaCare goes through, what will the equivalent to this snafu be? And what recourse would be possible?

The White House and Congress may be giving the “cash for clunkers” program a reprieve, but one can’t help wondering how many dealers and customers will have the confidence to go forward at this point. Things sound like a total mess in the showrooms.

“There is absolute frustration across the board,” Alex Kurkin, a lawyer based in Miami who represents several car dealerships, tells The Lede today. “As of this morning, they’re not really confident about any deals, and no one can give them advice about what they should be telling their customers.”

One thing still not clear is how many older cars have actually been sold and scrapped with the original $1 billion, and how many more the new $2 billion will be able to cover. Mr. Kurkin tells us that the government Web site where dealers are supposed to register their deals has been crashing, and the dealers haven’t been able to plug in their information.

via Dealers Race to Get Their Clunkers Crushed – The Lede Blog – NYTimes.com.

Every large program makes mistakes. And we know the flaws of our current system. Obama and his allies should explain the ways in which the ObamaCare Public Option is likely to blow up, so we can have an honest debate.

Cancer victims or Wall Street bankers?

Obama’s campaign fundraisers at Goldman Sachs, AIG, and Citi seriously harmed the world economy through their greed, recklessness, and arrogance.

Cancer, neuropathy, and victims of other debilitating diseases live in constant pain.

Obama takes serious political risks to help one of these classes. Care to guess which?

More than 100,000 questions were submitted, with the idea Obama would answer those that were most popular. But after 3.6 million votes were cast, one of the top questions turned out to be a query on whether legalizing marijuana might stimulate the economy by allowing the government to regulate and tax the drug.

“I don’t know what this says about the online audience,” Obama said in the session in the East Room, drawing a laugh from his live audience, which included teachers, nurses and small-business people. “The answer is no, I don’t think that is a good strategy to grow the economy

Editorials in favor of the legalization of marijuana recently appeared in Time and The Economist. However, Obama is too busy mocking cancer victims and bailing out his Wall Street friends to do much about it.

Update: On Twitter, John Robb notes that Obama is using “special entities” to avoid complying with Congress’s laws regarding bailouts. No such innovation when it comes to providing pain relief to those with terminal diseases.

The Future of Modifying our Genes to Improve our Health

I agree with Christine Rosen’s 2005 op-ed that the stem-cell debate and the eugenics debate are parrallel issues. Of course, I disagree with Rosen about the conslusions of this. In the debate between health and sentimentalities, and support the former. She goes for the latter.

Christine Rosen on Eugenics and Stem-Cell Research on National Review Online
Praise for the forward march of science; progressive and liberal leaders championing new scientific techniques that promise to cure disease, eradicate illness and suffering, and advance the progress of the human race; elite institutions of higher education embarking on their own initiatives, training students, and supporting researchers in the new science; California’s self-described progressive citizenry passing a law granting state funding and support to the cause, with other states preparing to follow suit; the intellectual elite of the country decrying the obstructionist, anti-modern views of the people who oppose or publicly challenge the underlying ethical rationale of the new science.

   This might sound like our contemporary debate over embryonic stem cells, but it’s actually an apt description of the eugenics movement in the United States in the early 20th century. Eugenics, a term coined by British scientist Francis Galton in 1883, was the movement to “improve the human race through better breeding,” and in the first few decades of the early 20th century in the United States it found a ready and eager audience. California and many other states passed compulsory eugenic sterilization laws that led to the sterilization of tens of thousands of Americans. Congress passed an Immigration Restriction Act in 1924 based on the testimony of eugenicists and fears about the fitness of new immigrants from southern and eastern Europe. And the U.S. Supreme Court, in 1927, upheld the sterilization of a supposedly “feebleminded” woman as constitutional, with progressive Justice Oliver Wendell Holmes Jr. declaring, “three generations of imbeciles are enough.” Underwritten by the wealth of some of the country’s most prestigious families, such as the Carnegies and the Harrimans, eugenics was something every enlightened American believed in, since the movement promised to end needless suffering, increase economic prospects by alleviating the burden placed on the state by the feebleminded and their many illnesses, and generally improve health and well-being for all citizens. Eugenics was the future.

Although there are vast differences between the eugenics movement of the past and the stem-cell research of the present, there is an eerie similarity to their rhetoric and tactics. Like eugenics, promoters of embryonic-stem-cell research talk of its endless promise, declaring it the scientific “path to the future,” as two state senators from Massachusetts wrote in a recent opinion piece. Embryonic-stem-cell promoters claim that their science will lead to cures for a range of diseases and the alleviation of much human suffering. And they denounce those who question the ethics of their pursuit as backward or blindly religious. But as we continue to debate the ethics of embryonic-stem-cell research, it is worth recalling that movements waged in the name of scientific progress often leave a troubled legacy.

Three recent stories can be connected, I think, to look ahead a few years to the future…

Imagine if we could knock out genes that regulate the body in such a way that it would reduce a criminal’s propensity to rape, murder, theft, burglary, financial embezzlement, or other anti-social behaviors. It would be merciful, and (if such therapy was heritable) would pay off for future generations, as well.

Thankfully, our current President is doing more to usher in an age of eugenetical therapies than any other American, in at least a century.

Serious steps toward National Health Care

The Wall Street Journal is upset, though I am glad. These are good moves:

Democratic Stealth Care – WSJ.com
Initially designed for children of working-poor families, this new Super-Schip will be double in size, and even kids whose parents make $65,000 a year will be eligible. The program will also now cover pregnant women and automatically enroll their new arrivals. The Congressional Budget Office estimates 2.4 million individuals will drop their private coverage for the public program.

Still, it’s the “stimulus” that has proven the real gift horse — a behemoth that has allowed Democrats to speed up the takeover of health care under cover of an economic crisis. They initially claimed, for instance, the “stimulus” would provide Medicaid money to states struggling to pay existing bills. What in fact it does is dramatically expand the number of Americans who qualify for Medicaid.

Under “stimulus,” Medicaid is now on offer not to just poor Americans, but Americans who have lost their jobs. And not just Americans who have lost their jobs, but their spouses and their children. And not Americans who recently lost their jobs, but those who lost jobs, say, early last year. And not just Americans who already lost their jobs, but those who will lose their jobs up to 2011. The federal government is graciously footing the whole bill. The legislation also forbids states to apply income tests in most cases.

House Democrat Henry Waxman was so thrilled by this blowout, it was left to Republicans to remind him that the very banking millionaires he dragged to the Hill last year for a grilling would now qualify for government aid. His response? A GOP proposal to limit subsidies to Americans with incomes under $1 million was accepted during markup, but had disappeared by final passage. In this new health-care nirvana, even the rich are welcome. CBO estimates? An additional 1.2 million on the federal Medicaid dime in 2009.

The “stimulus” also hijacks Cobra, a program that lets the unemployed retain access to their former company health benefits — usually for about 18 months. The new stimulus permits any former employee over the age of 55 to keep using Cobra right up until they qualify for Medicare at age 65. And here’s the kicker: Whereas employees were previously responsible for paying their health premiums while on Cobra, now the feds will pay 65%. CBO estimates? Seven million Americans will have the feds mostly pay their insurance bills in 2009.

If Barack Obama can use the financial crisis to bring about a better national health care system, I will be very impressed. I wish him well!

Socialization of Risk

The government interferes in the economy in two basic ways: to plan it and to socialize risk. In general, the political economy of the 20th century was the decline of economic planning and the rise of the socialization of risk. Planned economies such as the Soviet Union, post-War Britain, and post-War China collapsed in on themselves, ending with Winters of Discontents, failed coups, or economic revolution.

The socialization of risk, however, has been the basis of much of our economic growth. Public pensions such as social security allowed families to leave their farms and businesses, knowing that they would not starve in old age. The Federal Deposit Insurance Corporation families reinvest in the economy, rather than storing their cash under their mattresses. We seem to be on the verge of a Federal Bond Insurance Corporation, which will socialize much of the risk of bond markets away from large private institutions such as AIG. The solution may even be international.

If there is a silver lining to the financial cloud over Wall Street, it is hopefully a greater acceptance of the socialization of risk in our economy. While we should minimize moral hazard where possible, we must also realize that programs such as social security and FDIC are part of the solution, not merely a burdensome federal responsibility. The next step will probably be national health care.

Reading recommendation: A Future Perfect, by John Micklethwait and Adrian Woolridge.

McCain at the National Urban League

The moderator said that McCain was the first Presidential candidate to accept questions at the National Urban League to take questions. And McCain took a lot of them. John is clearly fast on his, and it’s not surprising that Barack does not want to debate McCain in an informal setting.

Two major issues caught my attention. One McCain answered very well. The other less so.

On Crime, McCain emphasized Rudy Giuliani’s success in New York. He went a step beyond that to emphasize that similar tactics are working in Iraq, and they work for the same reasons: without security nothing is possible, but once security exists, the foundations for growth and trust exist. Obama, by contrast, opposes urban counter-insurgency operations. Obama supports a ‘Rumsfeld Doctrine’ of minimal policing both at home and abroad. I think that is dangerous, and McCain’s response is the way to go.

Unfortunately, McCain was weak on health care. He said he wanted every Ameriacn to have the opportunity to purchase health care, but did not emphasize the need for universal coverage that is required to keep America. Fareed Zakaria described this dynamic well in The Post American World (which I previously reviewed). We already have socialized health care in this country, and if we’re going to have this degree of massive government interference, we can at least create a system where losing your job doesn’t mean losing your health.

Republicans for National Health Care

Glad to see that Half Sigma is on board:

Half Sigma: Republicans should support socialized medicine
The current system sucks. It’s not free market medicine. No sector of the economy is more heavily regulated than medicine. For the typical working American, it’s almost as if medicine is socialized. Your healthcare plan is chosen by someone else, your employer. No matter how many healthcare services you consume, it doesn’t cost you any extra money (or only nominally more money). The government is already paying for part of your healthcare in the form of a tax break.

More:

Socialized medicine would be a government benefit that helps the middle class. Poor people already get free healthcare in the form of Medicaid and free emergency care whenever they show up at a hospital emergency room. Old people get nearly free healthcare in the form of Medicare. Fully socialized medicine would merely give middle class wage earners some government benefits for the taxes they are already paying.

Would people still want to go to medical school under the new plan? Yes, because the government should provide free medical school education for anyone who qualifies. If doctors get paid the highest salary in the GS system, which is around $150,000 per year, there will be a lot of takers. Also, we can institute reforms here, such as combining medical school with undergraduate school in order to accelerate education and lower costs. Anyway, doctors aren’t really the system’s biggest cost.

I’ve previously pushed for national health care and national insurance on this blog. It’s the free-market thing to do!