Klavan, "Health" Panels & Goldsteins – UPDATED

I’m still in a retreat after-glow that has me only half attending to the world around me, and I am still pushing politics away in the manner of a King’s daughter being offered boiled tripe: “- ewww, away with that!”

But this piece by Andrew Klavan floated across my email and by the second paragraph I wished I’d written it. It needs a deft touch, though, and can’t you just see the movie version?

…the logic of this moment was inevitable. Once government got its fingers on the health-care system, it was only a matter of time before it took it over completely. Now there’s one limited pool of dollars while the costs are endless.

“You have the luxury of thinking only of yourself, but we have to think about everyone,” says the professor of ethics. He’s a celebrity and waxes eloquent every Tuesday and Thursday on Bill Maher Tonight. “This isn’t the free market, after all. We can’t just leave fairness to chance. We have to use reason. Is it better for society as a whole that we allocate limited resources for your operation when we might use the same dollars to bring many more high quality years to someone, say, younger?”

“I’m only 62.”

He smiles politely.

“Look, it’s not just about me,” you argue desperately. “My daughter’s engaged to get married next year. She’ll be heartbroken if I’m not there for it.”

“Maybe you should have thought of that before you put on so much weight,” says the medical officer. “I mean, you people have been told time and again . . .”

But the chairwoman is uncomfortable with his censorious tone and cuts him off, saying more gently, “Perhaps your daughter could move the wedding up a little.”

When you get to the end of Klavan’s piece, “this is evil!” then the natural jump will be to this piece by David Warren:

Candour is when you tell a truth that is disturbing, in language so unambiguous that persons in polite company will not want to hear you. It is a way to lose the respect of the genteel — of those who are “respectable” in the shallowest sense. Rude language is quite unnecessary to this end: the hard truth itself, spoken plainly and publicly, will give sufficient offence.

Thuggery is unrelated to this. It consists not of candid argument but of naked intimidation.

Thuggery is such a harsh word. But unambiguous, no?

Yes, Sarah Palin’s “death panel” remark was deliberately provocative and unambiguous, but it was not rude. Wasn’t intimidating, either. But the notion that so many have needlessly died in the UK due to their socialized medical program deserves consideration. Ted Kennedy’s dreadful prognosis was delivered in May of 2008. One cannot help but wonder what the last 15 months of his life would have been like under such a system – or if, indeed, he would have managed another 15 months in the bosom of his family.

But what am I saying? Clearly, our “public servants,” (like our academic betters, our sparkling celebrities and the sabbath gasbags of our pundit-class) will not be subjected to the same lines and limitations as we great unwashed, we the hoi polloi. I have an image in my head of Nancy Pelosi, Rep. Jerrold Nadler (to whom your opinions are unwelcome) and Obama’s creepy “science czar” (of whom the press remains incurious) all comfortably seated in a taxpayer-supplied limo, zipping along to yet another Obamaganda Rally (which you will watch, from your lines, on the nearest jumbotron). Pelosi, Nadler and Creep-Czar will deign to make power fists out their darkened windows, enjoining the masses to “keep it real” on those long lines for shoes, toilet paper and antibiotics. “Fight the nazis who want to rile you up and shout us down,” Nadler may encourage.

Nadler was rather busy back when students at Columbia university and elsewhere were shouting down invited speakers with whom they disagreed, but he now knows a nazi when he sees one, and a hawk from a handsaw!

Moving on – you’ll want to read this bit from yesterday.

Wes Pruden writes:

The president signals a change in tactics, not objectives. His concession that the so-called “government option” is temporarily dead does not mean the dream of “postalizing” health care, of making it as responsive as the Post Office, is dead.

Hey, the government cash for clunkers program is running so well, we should all be reassured. Shouldn’t we? And um…we should also feel perfectly secure about our private information. Of course we are.

We’re in for a long battle, but we’re learning to deconstruct the language and the shifting terminologies, and we’re finally updating the tactics.

Too late for permanently-demonized George W. Bush, and some others, people are also – finally – catching on to the 2-minutes Hate. Bush is still their Emmanuel Goldstein, of course, but as Kimball notes, anyone can become Goldstein as a situation requires. You can be Goldstein. I can be Goldstein. Our McCarthy-izing press can make it happen in a flash. Zap! You’re today’s Goldstein, reviled and ultimately ignored.

On the horizon: More czars and “Diversity Officers.” Does it seem to you that the Obama administration makes up titles and offices the way Bluto made up new names for Animal House Pledges?

“You’ll be…the Chief Diversity Officer!”

“Why?”

“Why the hell not?”

Indeed. When you’ve “won” and you’ve got both houses, (and soon the SCOTUS) and you’ve taken control of the census, why the hell not? Now go shut those guys up!

We’ll just have to be each other’s Huckleberries.

Or, as Dalrymple suggests, put cameras on the leadership. Someone, after all, must guard the guardians.

UPDATE I: The just-passed Robert Novak said: “Always love your country — but never trust your government!”

Seems to me a lot of mediafolk used to think that way.

UPDATE II:
Read the summary and more when you have time.

But my father was not the customer; Medicare was. And although Medicare has experimented with new reimbursement approaches to drive better results, no centralized reimbursement system can be supple enough to address the many variables affecting the patient experience. Certainly, Medicare wasn’t paying for the quality of service during my dad’s hospital stay. And it wasn’t really paying for the quality of his care, either; indeed, because my dad got sepsis in the hospital, and had to spend weeks there before his death, the hospital was able to charge a lot more for his care than if it had successfully treated his pneumonia and sent him home in days.

Should be a must-read.

Related:
American Papist: Bishop Nickless Critically Evaluates Obamacare (H/T New Advent)
Yes, the goal: is to end private insurance
Obama’s 2 faces: Yes, he wants to protect you from your doctors
Our Incurious Press: Shameful Propagandists
Don’t Understand: what’s so hard to understand
Free Speech: We likes it
Refresher: NY Times: “Why We Must Ration Health Care”
Andy McCarthy: Palin was right, after all
Kaus: That’s some Plan B
Pavement Babies: Those wacky Brits & their Healthcare!
Gaius: Iceberg, straight ahead
JPod: Those Death Panels & Obama
James Pethokoukis: A Health Care Plan to Save a Presidency
Sisu: Gov’t Behaving Badly
Wesley J. Smith: We need more primary care doctors
Mona Charen: Canada, Health Care and More Less surgery
Frank J: Aren’t Obamites tired of calling people racists? More on that here and here, but read Frank’s last line.
WSJ: Why is Obama underwriting Offshore Oil Drilling for Brazil? Can we say “incoherent policies?”
Deacon Greg: More on Novak

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  • Joseph

    This isn’t the free market, after all. We can’t just leave fairness to chance. We have to use reason. Is it better for society as a whole that we allocate limited resources for your operation when we might use the same dollars to bring many more high quality years to someone, say, younger?

    You and your cohorts are incredibly self-deceiving and naive. Do you think that private insurers don’t already do this, and play God, through biased coverage? Or private doctors? Or private hospitals? Or that there is any way to stop them as long as we treat care and coverages as controllable by the same market forces as buying groceries?

    They do. All the time. With no one and nothing to stop them. Most especially not the superstition of “market forces” working by magic in the same way for everyone no matter what the real economic conditions involved.

    I know. I was in the medical insurance business. There is such a thing in this country as “representative government” subject to popular elections and thus held relatively responsible for its actions. There is no such thing as “representative insurance”, “representative medicine”, “representative pharmaceutical supply”, or “representative hospital care”.

    The only curb to their activities are the laws of that same government you so demonize. Period.

    Go tell it to my neighbor who sits and waits to die because of the replacement liver that will never come. Why? Not because she is on Medicare and Medicaid and the government won’t let her have one to improve someone else’s quality of life.

    But because the people who can afford to pay cash and carry get them first, and the people lucky enough to have insurance for them get them after that, and everybody else takes potluck.

    That’s how it works in the real world. And when you are as ill, as poor, and as desperate as she is or I was, you go by the real world.

    You don’t talk yourself and your like–minded friends into some nitwitted paranoid fantasy of how government might get out of control and play God with your “choice”.

    Why “nitwitted”? Because we have, in fact, the government most responsive to popular will that this planet has ever seen. Don’t believe me? How about suggesting some alternate candidates?

    And it is far more responsive to popular will than any private person, private corporation, or private entity anywhere. Period. Don’t think so? Well, I’m also open to suggestions about what other institution might be more responsive. Got any?

    Finally, your health care “choices” are solely a function of what you can afford to pay, and not of how sick or how well you are. Period.

    That’s how it works in the real world.

    My neighbor has no choice. She sits and waits to die. And she loses just the least little bit of her mental coherence with her monthly blackout that forces her to be hauled off in the squad to the Emergency Room to be revived once again so she can wait to die a little longer.

    Or you could tell it to me. I couldn’t even get in to see a private psychiatrist when I had insurance coverage for it. In my town it is purely a seller’s market and you pay by session, at the time of service, $200–$300 a visit and resubmit your bills to the carrier. No one below a certain income level will ever be able to do this for serious and persistent mental illness–coverage or not.

    Why? Because of informal collusion by the providers themselves in order to keep the need for office staff to a minimum.

    It takes at least five such visits to cleanly diagnose bipolarity and test a multiple medication program to see if it is effective–and the odds are against the first shot at it working that well. It is purely a dead reckoning and seat of the pants process.

    So that’s $1000-$1500 to pay, up front, at a minimum, for what it took me two full years to achieve trying to rely on the charity care of county mental health levies. And I’m lucky. I live in a state that has them. Most don’t.

    And up until last year, do you know what would have happened after about six months worth of fiddling around with diagnosis and medication management? Insurance coverage would have simply stopped for the life of the policy and you couldn’t even pay up front and submit those bills for reimbursement. And not just for service, but also for medications.

    Sorry, Charlie. Starkist only covers the richest tunas. That’s how it works in the real world.

    Do you think any responsible doctor is going to keep renewing my psychoactive drugs indefinitely without my ever visiting him again? Do you think I would be able to afford it at $200 a crack? Or that I could pay for the medications anyway?

    Give me a break.

    So what’s left? I’ll tell you what’s left from direct experience working contract for the Ohio Department of Mental Health as well as being a consumer.

    What’s left is self-medication: alcohol, weed, crack, meth, or heroin–depending on market prices and fashions where you live. And the old joke about the mental patient who said to the doctor, “Why should I take your drugs? What I buy on the street is cheaper, more fun, and works better.” really is quite true.

    This just changed. Why? Because both my state and the Federal government passed “mental health parity” laws mandating that mental health conditions be treated as chronic illnesses, which most of them are, in the same fashion as diabetes or COPD.

    Without government intervention it would never have changed. Never.

    That’s the way the real world works.

    I have often suggested [with fair gentleness, mostly] that the views you espouse are largely uninformed by the facts of the real world. But on this matter you and your cohorts actually fly in the face of what actually is happening in thousands of doctor’s offices, insurance company cubicles, Emergency Rooms, State Mental Institutions, Homeless Shelters, Prisons, and Jails.

    I know. I’ve seen many of them first hand. And I’ve dug up most of the rest of them professionally, as a researcher, for pay.

    What do they tell us in sum? For over 20 years the “market forces” have been slowly squeezing all of us, prioritized by wealth or lack of it, out of being able to afford any “choice” whatsoever. Period.

    This has occurred because we have done nothing to stop it. Because of an overblown paranoid fantasy, in contradiction to plain facts and common sense, you still refuse to let anything be done to stop it.

    Anything. Not just the “wrong” things. Anything.

    For there is no real problem with health care in the United States…if you don’t go by the real world.

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  • Micha Elyi

    Hey Joseph (1:21PM), “the way the real world works” also includes people who covet their neighbor’s goods. But that doesn’t make covetousness moral. Nor does it make putting locks on doors a “superstition.”

    The free market is real. It’s the slave market that is the artificial, the unjust, and the false.

    I looked at your “experience” Joseph and noticed that as plain as the nose on your face, the fact is that all of your experience is from institutions that grew out of government edicts, rules, regulations, and laws intended to block the operation of the free market.


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