Sunday, May 03, 2009

“Health care” — government will decide when enough is enough

As you may or may not know, I just sent the last week touring the houses of Thomas Jefferson, James Madison and James Monroe - three of this nation’s founding fathers. So when I glanced through the following interview with Barack Obama I tried to picture any of these three men ever contemplating this question or a role for government in the context of the question and frankly, it’s unimaginable.

The only vision I could even begin to imagine is the three of them looking on sadly and shaking their heads “no” in unison as they tried to grasp the size of government and the depth of its intrusion into the lives of citizens the questions and answers indicated. I’m sure they’d also be trying to figure out where it all went wrong. The questions have to do with “end of life care”:
Q:…where it’s $20,000 for an extra week of life.

THE PRESIDENT: Exactly. And I just recently went through this. I mean, I’ve told this story, maybe not publicly, but when my grandmother got very ill during the campaign, she got cancer; it was determined to be terminal. And about two or three weeks after her diagnosis she fell, broke her hip. It was determined that she might have had a mild stroke, which is what had precipitated the fall.

So now she’s in the hospital, and the doctor says, Look, you’ve got about — maybe you have three months, maybe you have six months, maybe you have nine months to live. Because of the weakness of your heart, if you have an operation on your hip there are certain risks that — you know, your heart can’t take it. On the other hand, if you just sit there with your hip like this, you’re just going to waste away and your quality of life will be terrible.

And she elected to get the hip replacement and was fine for about two weeks after the hip replacement, and then suddenly just — you know, things fell apart.

I don’t know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she’s my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn’t have a hip replacement and she had to lie there in misery in the waning days of her life — that would be pretty upsetting.

“…society making those decisions to give my grandmother … a hip replacment?” Above that he points to a doctor giving who that choice?

His grandmother.

Below that who is Obama talking about making that decision or having that choice? Well it isn’t his grandmother. And although he uses the term ’society’, he means government. Note he says that if someone had told him no he’d be upset, but he’s setting up the table to be ‘upset’. This is an old Obama trick - acknowledge the downside in a very personal way while still pushing for that downside.
Q: And it’s going to be hard for people who don’t have the option of paying for it.

THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right? I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

Anyone who hasn’t quite figured out the rationing model Obama is talking about with his answers to these two questions needs to take a remedial reading course. Anyone - where does he see the opportunity to “cut costs” in the medical field?

And, how will he do it. Unless you’re still hungover from celebrating Guinesses’ 250th birthday, he is talking about denial of service especially to the elderly. Government will determine whether or not you’re worth that $20,000 operation. And the “moral issue” he’s talking about is all wrapped up in egalitarianism. What he’s implying may be “immoral” is allowing those who can pay access to the service while those who can’t pay (and for whom government won’t pay) are denied it.

Again, contemplate the model Obama talks about - reducing the cost of health care - and tell me which way that “moral issue” would be decided? Got the money? Too bad - it would be “immoral” to let you buy the service others are denied.
Q: So how do you — how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

What a question. The assumption is swallowed whole. Where was the question “what if ‘we’ don’t want others making those decisions?”

And apparently you guys in fly-over country are too emotionally involved to make that sort of a decision through “normal political channels” so government have some unelected outside group develop the “guidance.” Only the elite can answer these questions properly.

Three questions, stunning in their implications. Three answers which should make the skin of all lovers of liberty crawl. I’m again left imagining Jefferson, Madison and Monroe listening in on this with unbelieving looks of horror on their faces. The irony is, their opposition to this incredible power grab by government would again leave them in the category of “radical”.


The Hospital: We are all in the emergency room

Comment from Britain

Channel 4 is currently showing a documentary called The Hospital which takes a frank look at the effect that teenagers have on our nation’s health service. In this three part special they speak to the doctors working on the frontline dealing with the uneducated accidents that barrel through their doors on a regular basis. The first looked at the carnage that alcohol has unleashed, the second teenage pregnancies and the final show will examine obesity. It is an eye-opener and gives a truly shocking insight into the thinking of a sub-section of society.

Politicians have created a monster. It is clear to see that the health service in this country is having an impact on behaviour as there is little or no recognition of the consequences of actions: people have been desensitized. For example, a teenage pregnancy on the NHS typically costs around £10,000 to £15,000 due to the higher than normal risks because of the natural stresses on an under developed body. The teenagers in question have no awareness of these costs. Society as a whole would probably behave differently if only the individuals/families concerned had to bear the costs.

The politicians have created a new breed of teenager who typically come from a family that has little desire to be concerned about their offspring’s education and consequentially show little emotion towards them. This could perhaps be a reason why teens have descended upon alcohol and have such a bad relationship with it. These fault lines are a politicians’ creation, yet they will claim that only they can fix them. Sadly the time has come to shock people into behaving in a ‘normal’ manner by exposing them to the true costs of their behaviour: we should do without politicians. Or at least only hold in high regard those politicians who can say no and explain why a person will be stronger by learning from their mistakes. Until that time we are all in A&E.


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