Hentoff seems more right than left these days. Anti-abortion activist. Columnist for the WSJ. Used to write for Washington Times, too.

It's also untrue that a government board will mandate treatment options:

Rep. Tom Price of Georgia says the measure creates "a national health care rationing board." Not true. What it creates is a council to coordinate research into which treatments work best, and are most effective for the money. And in fact, the new law states quite specifically that the council has no power to "mandate coverage" and that its recommendations are not to be construed as "clinical guidelines for ... treatment."

http://www.newsweek.com/id/185643

Rep. Tom Price of Georgia says the measure creates "a national health care rationing board." Not true. What it creates is a council to coordinate research into which treatments work best, and are most effective for the money.

You say tomato, Price says tomahto.

And from what I see from my epidemiologist friend, who spends a bit of his time testifying against research abuse, is that few people can read and evaluate data well.

If they don't ration, how will they keep costs for health-welfare for everyone from going stratospheric?

If they don't ration, how will they keep costs for health-welfare for everyone from going stratospheric?

I believe the proper answer to your question is mu.

The current system of private insurance already rations. It rations in the form of keeping 47m uninsured, in the form of denying service to those with pre-existing conditions, in the form of denying service for treatments a bureaucrat and not a doctor deems unworthy of payment, it rations in the form recission.

And under the current system prices already are skyrocketing and have been for sometime.

If you look at the John Stossel article I linked to earlier, you can see John Stossel, no lefty, discussing how insurance is a badly inefficient system financially, and is a way of organizing for shared risk of UNLIKELY events, not a good way of organizing shared risk for likely events.

Medicare is quoted as having something like a 4% overhead, while private insurance is more like 18%, if I pull these numbers out of my ass correctly (IIPTNOOMAC). There's a lot that can be paid for with a difference of 14% overhead.

"Both" sides (scare quotes because I think there are more than two sides) are full of shit here. The private industry rations, and the Obama public option will ration too. The rationing will be exactly the same in many ways by predetermining what treatments will be paid for, and what drugs.

However, it is likely that the Obama rationing plan will be more transparent, and more open to public appeal processes and public discussion and Congressional oversight, so in that respect, the Obama rationing will be more democratic than the private option.

And that's not to say I like Obama-care, because I would much much prefer the Ron Wyden plan which seems to aim to end the employer link to health care. That employer link to health care leaves millions of Americans at risk of unemployment and fearful of losing their job and tied to jobs and employers they probably dislike.

And it makes American companies uncompetitive.

It seems very odd though to hear people make some sort of claim that comparative treatment research is somehow dangerous or improper for the government to do. I wonder what Theodoric of York, Medieval Barber would say to that.

Medicare is quoted as having something like a 4% overhead, while private insurance is more like 18%....

The thing that isn't reported in that 4% is the fraud, waste & abuse that makes actual costs about 20%.

Whatever - distinction without a difference. When the government is the one paying the bills, they government isn't going to pay for or authorize anything the CER panel says is ineffective of wasteful. Oh, that's right, you still foolishly believe Obama when he says that this isn't going to be a government insurance program.

Jerry - there aren't 47 million uninsured. It's actually closer to 9 million who want insurance but for whatever reason are unable to get it.

Jim - it's actually higher than that. Most of Medicare's overhead is borne by the physician's offices. They don't count that in their operating overhead.

"The thing that isn't reported in that 4% is the fraud, waste & abuse that makes actual costs about 20%"

The same markup would apply to the 18% in the current system. You don't think anyone tries to abuse or fraud an insurance comany?

Karen -

First, it's easier to find and fight fraud in a private company. Second, there is always more fraud in government.

When's the last time a bureaucrat did a perp walk for fraud? How about a private-sector drone?

Q.E.D.

Let me return to some basics here for a minute, so we can all marvel at how far away the issue gets during the arguments.

Rationing is a fact. Any time a "free" product or service is offered, mobs arrive, whether they are after dentistry or TV sets. It does not matter what you call the governing body which determines who gets the service or product: someone will be left out, and that someone will be determined by the governing body.

"Government" is not a magic word. It is not possible to compel people to work for free. Where this is tried, the unskilled are called "slaves". The skilled merely look for other work which will be more rewarding. This leaves lesser-qualified people in the program. This is the reason there are penalties for not using the program.

I don't care if you love the President. The ideas he's pushing are just plain wrong, and fundamentally.

You are not going to get the care you want unless you pay, and directly.

You pay taxes. How's that going?

Buy into "Obamacare", or anything that can be morphed into it, and you're just adding thousands of government hands into the line between your paycheck and your doctor.

Do you have a mental problem? No? Then why do you think it's normal, even expected, to pay in advance for a service you don't use? That's your insurance setup now.
Why do you think that a government agency will let you determine your medical care needs?

I hear people talk all the time of things their insurance won't cover. They say that's rationing. It's not. I personally have yet to find something my insurance won't cover. if it existed, I'd have the option of paying for it myself. With the government, you won't get to, because that wouldn't be "fair" (for anyone except themselves).

Healthcare is not a right. Like every other service, it has to be paid for. The government can not magically lower the amount people in that industry expect to get paid. I'm in a nursing masters program (very part time). Heck if I'll go to work for less than $30 an hour when I'm done. I'll choose not to work before I'd work for less, and frankly I expect much more under our current system. I doubt I'm alone there. Which means, quality people will leave the profession. It's not just Ds. Which nurse you get has a big effect on your survival rate in the hospital as well, since nurses do most of the actual patient-contact and care. I know an RN in Nashville who makes $80 an hour, because she has the lowest patient mortality rate in Tennessee. That's no accident. And it's people like her that we'll lose if this goes through.

Medicare and Medicaid make doctors pay a good part of the cost of caring for people. And that's going to work as our whole system?

I've mentioned my ex-boyfriend who does liver transplants. When it's a government deal, he gets $30/hr. Hardly worth waking up in the middle of the night and going through years of training for.

A few points about this attempted nationalization of health care that have been nagging:

-- Obviously, one can argue, when reading the proposed bills on their face, that nowhere does it say that the government WILL ration, that the government WILL drive private enterprise out of health care, or that the cost of all of this WILL go up. However, one needs to assess what is LIKELY to happen, given the language and intent of the legislation.

It is LIKELY that the government will ration to keep costs down, since (using Medicare, Medicaid, etc. as relevant historical evidence) it will not be able to raise enough taxes, borrow enough money, or print enough money to cover the medical needs of 300+ million people.

It is LIKELY that there will be no practical recourse to appeal government rationing decisions. When government makes up its mind on something, you're not going to change it. That's because to the bureaucrats sitting in an office somewhere, you are a number, and they are not answerable for anything. Oh, I know that we're only numbers to insurance adjusters, too, but the difference is, if an insurance company screws over too many people, word gets out, coverage is moved to someone else, and the offending company suffers. Not so with government. It's the only game in town. Oh, you could try to use the courts. Only one problem: while the lawyers are doing their circle-jerk for months and years, grandma (or whoever) is getting worse.

It is LIKELY, given the language of the legislation, that private companies will be forced out of the market, and government will gain a monopoly on health care and its decisions. Given a choice of going to the trouble of maintaining its plan for a lot more than 8% of payroll, or paying 8% to the government on its payroll tax returns, it is LIKELY that any rational business that wants to compete will rather quickly choose the latter. And it's LIKELY that anyone who loses their insurance after the first year of enactment will be required to go on the government plan.

Given the government's history of cost overruns on everything, and its propensity for mismanagement (SS going bankrupt, Medicare going bankrupt, postal service hemorrhaging money year after year, IRS with outdated computer systems that hinder revenue collection, etc., etc.), it is LIKELY that it will mismanage this, too, particularly since, unlike trained insurance people and medical personnel, it brings no special expertise to the table.

And, while nowhere is full control over your life and all your habits mandated, it is LIKELY, given their past history and their propensities, politicians that are given legislative authority to run all aspects of your health care will take the opportunity to monitor and exercise control over ALL your habits that impact such health care; that is to say, ALL your habits. If you want that, be my guest and support this for yourself. You don't have a right to impose all this mess on me, however. Whether it's government, or the do-gooding busybodies out there, better keep your hands out of my life, or there'll be beau coup unpleasant pushback.

Charles Krauthammer, who I respect and often agree with, chastised Sarah Palin for her use of the term "death panels". But I think her direct language cut through the rhetorical claptrap to the heart of the issue.

Turns out that Mark Steyn agrees with her. So does Ann Althouse. And so does Nat Hentoff.

cpabroker, you should examine the Ron Wyden plan.

Uninsured illegals certainly could purchase catastrophic insurance with those remittances
sent to Mexico. But they do not. They rely on the ER for medical needs. Since I ( and you ) will be paying for Obamacare with taxes and illegals will be covered, maybe the U.S. can regulate or capture some of those remittances to help pay for their care.

maybe the U.S. can regulate or capture some of those remittances to help pay for their care.

RACIST!

Mark Steyn has more on the death panels ... in Canada.

The current system of private insurance already rations. It rations in the form of keeping 47m uninsured, in the form of denying service to those with pre-existing conditions, in the form of denying service for treatments a bureaucrat and not a doctor deems unworthy of payment, it rations in the form recission.

Those things are not examples of rationing.

Real health care reform would work to increase health care supply, which would decrease wait times and costs. None of the government's plans talk about this. The government isn't interested in actual reform.

> maybe the U.S. can regulate or
> capture some of those remittances

Shit, do you really think about this issue in those terms? Christ, Nick... You're a vindictive, intrusive, fascist, nationalistic rat bastard with jingo-ist, zero-sum reflexes.

And I like you very much!

One of the United States' biggest problems is that Mexico is so corrupt. If Mexican wretchedness really is the product of Gringo manipulation (and that's one of the few conspiracy theories I make time to consider), I don't understand why our Old White Guys with Cigars in the Hidden Room don't put a stop to it... It's not working out any more.

> Real health care reform would work
> to increase health care supply,
> which would decrease wait times
> and costs.

Well... I mean... How would that go? More people can get into the health care field if they want to, right? But they (apparently/obviously) wouldn't make as much money as they want to make. Should government make them do it anyway?

Dear Amy People:

Please view this podcast.

Roger Ebert called it "The feelgood hit of the summer: A breezy but heartfelt conversation between two essentially conservative thinkers about appropriate government involvement in the most personal matters of our lives." Gene Siskel said "I've been dead for years!... Whatever." Two thumbs up... Two thumps way up!

The mass of our bodies is discussed. Frum makes a bad joke about eating disorders, and McArdle calls him on it. Most poignant line (paraphrase): 'There's no excuse for the obsession American women have with their weight from age 14-40.'

Well... I mean... How would that go? More people can get into the health care field if they want to, right?

That's the dirty little secret. There are limits imposed on the numbers of people who can become doctors, and what kinds, etc. This is done to prevent dilution and keep prices high.

In other words, even if a person was willing to be a doctor for slightly less, the guild (AMA) prevents this from happening.

Which is why any talk of a nursing shortage falls on deaf ears.

Crid

You, sir, are a low-rent,incestuous, scum-sucking, after birth, douche bagging, butt wipe.

And I like you, too.

I'm not incestuous.

Oh. Well. Sorry. How about "curmudgeon" ?

Are French women as freaked about their weight? Answer carefully.

To Crid et al: David Frum is NOT a Conservative. He the textbook example of a RINO.

I guess I fooled by his years in the Bush White House.

Crid -

Like so many conservatives and libertarians that go to DC, he "went native". It became more important to be socially acceptable in Georgetown than it was to be ideologically consistent.

When ideals are traded for party invitations, only Bad Things happen.

And yet I admire his thinking much more than, say, yours.

He must have insurance.

And other blessings. For example, he's able to connect meaningfully and productively with other human beings (here's a favorite) while clearly recognizing and respecting the boundary between his interests and theirs. Insurance is just one way that this fundamental conservative excellence is expressed in his life.

His barking dog pisses me off, though.

And yet he spoke glowingly of a known statist.

Not terribly conservative there. In fact, I'd say his preference for "shared responsibility" puts him squarely on the left.

> he spoke glowingly of a
> known statist.

Imagine!

> This is done to prevent dilution
> and keep prices high.

Oh, for fuck's sake. Does the fantasy view of yourself as a poor, oppressed rodent tortured by oppressive forces have no end? Brian, you pathetic little deary, is there anyone ON THE SURFACE OF THIS GLOBE WHO EVER LIVED to whom you should feel any gratitude, or has your entire, wretched existence been promulgated by a sinister, Darwinian cabal that needs the flesh on your bones as dinner meat?

For fuck's SAKE, son.

Wait, you want for I should express GRATITUDE to a group of people whose sole purpose for existing is to prevent people from becoming doctors?

What the fuck are you smoking?

You're right, Brian! It's not about summoning excellence through competition, it's about keeping prices high!... To make you miserable, and most especially, to keep you poor.

You see, Brian, ours is a world of treachery and deception. The only thing, the only thing that civilization wants from you is the three dollars and change in your pants pocket. No brains ever grew in anyone's heads for any purpose but to cheat you, Brian, and to make you pay too much. There is no creative impulse, there is no achievement, there are no aesthetics, there are no systems of balanced responsibility, and of course, there's no affection between people: The whole cocksucking enchilada exists only to make sure that you're kept as poor and defenseless as possible. Intelligence is an illusion, and admiration is for suckers. And you're too clever for that, aren't you?

Be suspicious! Tell no one you saw me!

Crid, you fool, do you know nothing of unions?

In order to become an electrician in Connecticut, you must first attend school, which is available to anyone. Then you must become a journeyman to an established (read: licensed) electrician. There are a fixed number of these, and a fixed number of journeyman spots available.

This creates a certain bottleneck in the creation of new electricians. And the requirement was written into law at the request of the IBEW. About 10 years ago, the IBEW lobbied the state to create a new license class for low-voltage wiring (network and telephone). They did this because non-union unlicensed guys like me could underbid union electricians to do this kind of work.

Now, you need to pay a licensed electrician (I forget the license class) to do this simple kind of wiring, and because of the costs associated with getting the license it now is significantly more expensive to have a network wired.

I mean, you're free to believe that the licensing requirements were simply to promote excellence, but you'd be talking out your ass.

The AMA does the same thing for doctors, and the ABA for lawyers. Create high barriers to entry, and you create an artificial shortage.

Of course, we could just do like England and import our doctors from India and Pakistan.

Brian, there's only one certain defense from this heartless, isolating world of cunning, connivance, and intrigue. And I want to help you. So I'll spring for the instructional DVD, and have it sent to your front door via express service: Just give the word. You absolutely must protect yourself from this torment, Brian: Do it soon!

It's just not possible to be too small-minded. LIVE IN FEAR. HAVE NO TRUST.

Crid, you need to lay off the ganja. It's really making you say some fucked up shit.

You make me feel sane.

Brian, just be sure you're not a "fool". EVER. OK? Because everyone's going to cheat you. If you let your guard down and think about anyone else's interest for a fleeting second, they'll take you for all your worth. Live alone, in fear, trusting no one.

Who are you, and what have you done with Crid?

Exactly! Perfect!

BE AFRAID, Brian!

Yeah, I'm pretty much certain at this point that OneTwoPunch is your alter ego, and you just forgot to switch on the sockpuppet this time.

Because the shit you just spewed here is weapons-grade stupid.

good goodthis post deserves nothing hahaha just joking nice post