As usual, Thomas Sowell cuts to the chase: “Why does it take more than 1,000 pages of legislation to insure people who lack medical insurance?”
Take your time.
Let’s grant for the moment something that I do not in fact think is true: that it is (pick your level of shrillness) 1) a problem 2) a disgrace and an outrage that millions of people in the United States do not have health insurance.
As I say, I do not think it is a very big problem, much less a “disgrace” — Why? One reason is that our compassionate society provides medical care whether or not you have health insurance. But let’s grant the premise for the nonce.
Why take a 1000 pages to fix it? As Sowell points out, those who have bothered to read the bills have discovered two things 1) they contain “all sorts of things . . . that have nothing whatever to do with insuring the uninsured.” And 2) they contain an abundance of things designed to take “medical decisions out of the hands of doctors and their patients, and [transfer] those decisions to Washington bureaucrats.”
Pork, on the one hand, and the usurpation of individual freedom, on the other hand. That’s really what Obama care is all about.
Partly, it’s an application of “the Chicago Way” to the nation as a whole: take care of your constituents and supporters. An AP headline today: “Firms with Obama ties profit from health push”: you don’t say?
Even more worrisome, though, is the second part. The further expansion of government bureaucracy. Let me once again quote what Ronald Reagan had to say about the use of “health care reform” to further socialism: “One of the traditional methods of imposing statism or socialism on a people,” Reagan observed, “has been by way of medicine. It’s very easy to disguise a medical program as a humanitarian project.”
My only quibble is with the word “disguise.” Tom Sowell is right that “deception” is at the heart of the Democrats’ health care proposals. They say they are trying to “fix” health care. Really they are attempting to extend government control over a bigger part of the economy and your life. But the effort to further socialism by means of a government takeover of health care is not something disguised as a humanitarian project. It is a humanitarian project in its purest left-wing form: a humanitarian project imposed on the unwilling “for their own good” — a “good,” naturally, that is defined by a government bureaucracy.
One of the most rebarbative features of this new effort to bring government-control to a life near you is its combination of the antiseptic rhetoric of utilitarian social science with old-fashioned central planning. Consider Dr. Ezekiel Emanuel, the brother President Obama’s Chief of Staff Rahm Emanuel, who is a top White House advisor on health care reform. Dr. Emanuel has famously argued that doctors “take the Hippocratic Oath too seriously.” Dr. Emanuel wants to concentrate medical services not on those who need it most — the elderly, seriously impaired children, etc. — but on those who are likely to contribute to “the continuation of the polity,” “ensure healthy future generations,” etc. “Services provided to individuals who are irreversibly prevented from being or becoming participating citizens,” he argues,
are not basic and should not be guaranteed. An obvious example is not guaranteeing health services to patients with dementia. A less obvious example is guaranteeing neuropsychological services to ensure children with learning disabilities can read and learn to reason.
Got a loopy grandparent or a kid who is playing with half-a-deck? What can they contribute to “the continuation of the polity” or “healthy future generations”? (Catch that whiff of Ziclon B? I did too.)
Cass Sunstein, the University of Chicago lawyer who also advises President Obama, combines the antiseptic language with the nihilistic utilitarian conclusions even more blatantly. “At least since 1976,” he wrote in one coma-inducing policy paper,
“analysts [analysts!] have suggested the possibility of focussing regulatory policy on either life-years or quality-adjusted life-years (QALYs). Through the latter measure, the issue is not merely the number of life-years saved by regulation; attention is also paid to qualitative improvements in health. An aggregate measure of QALYs would catalogue all of the health-related benefits of regulation. And for many years, some agencies have experimented with the idea that cost-benefit analysis should consider either QALYs or life-years, not merely the number of lives saved.”
QALYs, eh? And what does the above-quoted gibberish portend? Elementary, my dear Watson:
“A program that saves younger people is better, along every dimension, than an otherwise identical program that saves older people . . .”
All animals are equal, Comrade, but some are more equal than others. I hope you feel better that folks like Cass Sunstein and Dr. Ezekiel Emanuel get to say which is which.
Glenn Reynolds made the observation, amusing and scary in equal measure, that what we’re dealing with here bears an awful similarity to the troubled “cash for clunkers” program: “First Grandma’s Caprice, then Grandma.”
‘Why take a 1000 pages to fix it? As Sowell points out, those who have bothered to read the bills have discovered two things 1) they contain “all sorts of things . . . that have nothing whatever to do with insuring the uninsured.” And 2) they contain an abundance of things designed to take “medical decisions out of the hands of doctors and their patients, and [transfer] those decisions to Washington bureaucrats.”’
Obviously Sowell is a genius who has ferreted out the closely guarded secret that the health insurance bill contains”all sorts of things” besides those dealing with the uninsured. As to his – and your – second point, it comes down to a debate between those who fear Washington bureaucrats and those who know the very real nightmare of dealing with insurance company bureaucrats who are paid to say No.
As to your slurs against Dr. Emanuel, they are the kind of vile misrepresentations to be expected from someone with no sense of honor.
Another example of the “Chicago way”:
The TV network NBC, which has been obviously and strongly supportive of candidate and now President Obama, is owned by General Electric Company, which received 140 billion dollars in bailout money.
Some of that bailout money was used to raise the salary of Keith Olberman (a shameless Obama slut) of MSNBC from $4 million to $7.5 million.
etc.
Excellent post Roger. Ezekiel Emanuel’s defends his views by saying that he is simply working toward “a just allocation of health care resources.”
To invoke a Sowellian argument, this phrase, “just allocation,” assumes that health care resources are finite, that health care spending is a zero sum equation. Of course it is not. Health care resources are limited only by the willingness of consumers to spend and the availability of doctors, neither of which are finite.
It also assumes that “just allocation” can be formulated by a panel of experts. Of course it cannot. Objective justice resides in equality of opportunity and not equality of outcome. Equality of outcome is subjectively just. This distinction is indispensable as the preference for subjective justice is, as you’ve stated, the Chicago way.
I don’t understand why liberals don’t understand that a free market allocates resources justly because anyone can buy access, whether to insurance or through cash for care. The fact that some people don’t have the resources to purchase the care they want or need care may be regrettable but is not inherently unjust.
As long as zero sum and “just allocation” assumptions are operative, Palin’s “death panel” is a reasonable conclusion about the course that government care could take as outlined in the current legislation.
Regarding bibio44,
I believe there are indeed insurance company bureaucrats who strive to obstruct care as a cost saving measure. Counter balanced against this is the competitive market, wherein one can change to another company that is less obstructionist, and the government, which closely regulates insurance companies. Now suppose the competitive market is limited to a single insurance monopoly and the interests of the insurers and the regulators are melded together. And consider the press as a cheerleader in this transition. What chance do you think a patient would have to get a denial of coverage reversed? Much less than they would now.
And if quoting at length Dr. Emanuel represents a “vile misrepresentation” of the man perhaps he should be more thoughtful before he speaks.
At first I was skeptical about Obama’s health care program, as I imagined having to drive to a clinic in the projects for my medical care. Then I thought, how stupid of me, security will be handled by ACORN. After all, ACORN’s cadre is being heavily armed with the Obama billions they’re getting, so why not expect helpful, uniformed and armed black men on duty, ensuring that the neediest get seen first and providing valet parking, since there obviously won’t be nearly enough parking spaces. And, despite the minor inconvenience of driving into the projects, the charming ACORN women at the reception desks should ensure fairness and make for a delightful experience all around. If I’ve said anything that’s offensive to Mr. Obama or ACORN, I didn’t mean it, so please don’t turn me in to the White House. I just want to get along by going along.
bibbio44,
How about a system where you and I can choose to be free of both incompetent beurocrats AND greedy insurers? We’ll call it “Freedom.”
“Let’s grant for the moment something that I do not in fact think is true: that it is (pick your level of shrillness) 1) a problem 2) a disgrace and an outrage that millions of people in the United States do not have health insurance.”
Spoken like a man with a good health insurance policy.
#4: ‘And if quoting at length Dr. Emanuel represents a “vile misrepresentation” of the man perhaps he should be more thoughtful before he speaks.’
Before I spoke I studied Dr. Emanuel’s work. It is exemplary and worthy only of praise. Kimball’s quotes were taken out of context. This “death panel” libel is nothing more than end-of-life counseling that has long been supported by both Democrats and Republicans — including ex-Governor Palin.
#6: ‘How about a system where you and I can choose to be free of both incompetent beurocrats AND greedy insurers? We’ll call it “Freedom.”’
No, we’ll call it: Stay healthy!