“Pulling the plug” is shorthand for denying otherwise available health care. It covers a multitude of possibilities, from taking Granny off life support, to denying such support in the first place, to denying all of us the benefits of existing medical technology without which our lives would be short, brutal, and nasty.
Actually, Thomas Hobbes said that about a society with too little government. Too much government can make it even worse.
According to President Obama, all the nasty things being said about ObamaCare are lies, spread by the enemies of “change” and those disrespectful of the late lamented Senator Kennedy, whose iconic status may be worth a lot. This has nothing to do with the merits of ObamaCare. President Obama also says that he and God are partners on health care — maybe his divine partner is Phobos, the God of Fear. Phobos has been very busy with climate change, but apparently has limitless time and energy.
Lacking divine advice, I don’t understand what ObamaCare means. Neither, I suspect, does anyone else.
Among many other things, HR 3200 provides for a comparative effectiveness research group. The research group was created as part of the stimulus package and includes the well-known Ezekiel J. Emanuel, and it may or may not decide when, whether, and how to pull lots more plugs than Granny’s. The euphemism “rationing” may well mean the same thing; as under the Oregon plan, it would be dreadful.
Although there may be no need to get all wee-weed up, explained by the White House press secretary to mean “bedwetting,” it would be best for all sides to try to understand what the various proposals actually say. Any bill which eventually passes will have consequences unknown to most of us and unanticipated even by those who vote for it. The focus should be on anticipating and avoiding those consequences — particularly the bad ones.
This is not an easy task.
According to an article in the New York Times, Mr. Obama has been unable to dispel the concerns of older Americans because the health care bills in Congress are long, complex, and evolving.
Moreover, if a bill becomes law, no one can say for sure how it may be applied or extended.
The key words are “bills” (plural) and “evolving” — contradictory promises and changes are being made daily. For example, a $10 billion “reinsurance program” has been added to benefit union and corporate health insurance funds. Nobody, not even President Obama, knows what the legislation would say or, more importantly, what it would mean or what impact it would have, for good or ill.
In these circumstances, the best that President Obama has been able to say is that these things don’t really matter. We must trust him! When someone says “trust me, I wouldn’t lie to you,” my first thought is that he is about to lie to me some more.
The important thing seems to be to “rahm” something, anything (except one of the three Republican-sponsored bills which have attracted little notice) through Congress so that President Obama can sign and claim credit for it. Something must pass. If it proves to be worse than nothing, that won’t become clearly apparent for months. President Obama and his party will find lots of others to blame; they have lots of practice. But it may also be too late to repair the damage.
Rep. John Conyers Jr., Michigan Democrat and chairman of the House Judiciary Committee, thinks it’s ludicrous to expect members of Congress to read legislation before voting:
I love these members, they get up and say, “Read the bill.” What good is reading the bill if it’s a thousand pages and you don’t have two days and two lawyers to find out what it means after you read the bill?
He might have a point if fewer than two days and insufficient lawyers were available. However, there are more than enough (probably too many) lawyers, and civilization won’t come to a screeching end if more than two days are devoted to understanding legislation and voting on it. If it stinks, it should be voted down and further efforts made until something that doesn’t stink evolves. The fearsome “Gotta Do It Right Now” monster took control when the “stimulus package” was voted upon. If that debacle didn’t demonstrate the need for more time and thought then nothing will. The “Gotta Do It Right” monster needs to assert himself.
Regulations expand upon and “interpret” authorizing statutes; for the most part, they have the force of law. Unlike the congresscritters who vote for statutes, the unelected and generally faceless civil “servants” who write the implementing regulations can’t be voted out of office. Any complex and lengthy legislation must be read, not only to understand what it says, but at least to try to foresee what the many more thousands of pages of agency regulations certain to be promulgated based upon it may say.
This is even more important with health care legislation than it was with the stimulus package. If the stimulus doesn’t work, then “only” a trillion or more dollars and a year or so will have been wasted while the economy tanks. If ObamaCare becomes law and the results are horrible, people will actually die or suffer great physical misery because of it — and it will take far longer than the stimulus package mess to fix, if it can be fixed at all.
Despite the abysmal lack of “red meat” to digest, President Obama claims that there are four sacred and unalterable parts to his “plan:” reducing the cost of health care, protecting consumers from insurance abuses, providing affordable coverage to uninsured Americans, and not adding to the deficit.
That’s like promising good weather with just the right amount of snow and lots of toys for all the kids next Christmas without spending anybody’s money to make it so. It’s reminiscent of campaign promises interpreted by Obama’s true believers to mean that they wouldn’t have to worry about buying gasoline or paying their mortgages. Unfortunately, there are folks who believed that sort of garbage, and that’s probably true about his health care message as well.
President Obama’s four bumper sticker points don’t stand up:
1. Reducing the cost of health care. Any fool can do that; just limit drastically whatever is available. Give everybody who gets sick an aspirin and say “go home and get better, live with it or die.” That (I hope) is just silly. But under the “public option” there would definitely be rationing and cutbacks. The amounts paid for anesthesia, for example, would be cut by more than 50 percent. Other similar cuts would also be made.
Perhaps Obama simply means he will reduce waste and inefficiency without diminishing the nature, quality, or availability of medical care. But the government has lots of experience with waste and inefficiency, and most of it lies in creating it and being unaccountable for it.
2. Protecting consumers from insurance abuses. Abolish private medical insurance companies outright, or more likely, structure the subsidized public option to quickly drive them out of business. If the government sold subsidized tires for $15.00 and a privately owned and operated firm sold unsubsidized tires for $100.00, guess who would survive.
If that doesn’t work, create a national insurance victim agency, funded through special user fees levied on insurance companies and staffed with experts from … well, it doesn’t matter where, so long as they can be labeled “experts.” That benign public agency certainly would not abuse anyone.
3. Providing affordable coverage to uninsured Americans. U.S. citizens, legal residents, illegal aliens, little green men from Mars, or whatever, it doesn’t matter much. It fits in neatly with the first two points. At least it could then be said with a straight face that everybody gets identical medical care, except those unpatriotic folks who go to Cuba or Venezuela for medical treatment. Perhaps some Canadians who now travel to the United States for medical care will go there as well. Some may even go to Panamá, where health care is pretty good and widely available at a very reasonable cost. I’ve used it and think that for all but cutting-edge technology, it is superior to that in the United States.
4. Not adding to the deficit. The estimated national debt for the next ten years is over nine trillion dollars. “More than the sum of all previous deficits since America’s founding. … By the next decade’s end the national debt will equal three-quarters of the entire U.S. economy.”
Gosh darn! A trillion dollars here and there soon adds up to real money, and the United States is running out of sources from which to borrow or from whom to get additional tax revenues. It doesn’t matter much, however, because it all dovetails with points one through three — if they are implemented, even the Congressional Budget Office may get on board and agree that ObamaCare won’t increase the national debt.
The only thing which is (or should be) entirely clear to everyone is that the health care rhetoric has become a hopelessly deranged, damaged, and deflated political and emotional football. The death of Senator Kennedy will not change this. It must be recalled from the game and immediately replaced with something capable of being kicked around meaningfully. That’s pretty much what President Obama says he wants. If so, he should cap the crap and tell the truth.
This idea is gaining traction. Senate Republican leader Mitch McConnell said Republicans would like to start over:
The American people will be very troubled by a single political party’s “my way or the highway” attitude to overhauling their health care, especially when it means government-run health care, new taxes on small businesses, and Medicare cuts for seniors.
To provide superior health care to everybody in the United States is a wonderful dream. It probably sends tingles down the legs of some. However, money, physicians, other health care professionals, and medical facilities are all necessary and finite. Not even a perfect government could do much to augment them substantially and quickly, much less make them infinite. Modest incremental changes are possible, but vague promises of massive and far-reaching solutions to everything all at once are mendacious. To take such promises seriously is stupid.
It is time for President Obama to sit back, have a smoke, reflect on what’s possible, and wipe the fairy dust from the eyes of those who demand the impossible — probably from his own eyes as well. Only then will he be in a position to get something worthwhile accomplished. I hope that is his goal, but it does not appear to be. At least it can be hoped that the president and his Congress will not act in haste, forcing all of us to repent at leisure and in misery.
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