Monday, November 28, 2011

ObamaCare "Death Panel" Targeting 70-Year-olds?

For anyone who doubted Sarah Palin’s charge that ObamaCare would lead to government “death panels”, more evidence supporting her charge has surfaced. We Stand Firm, the website of Freedom and Individual Rights in Medicine, has posted excerpts of a conversation between an Illinois neurosurgeon and radio talk show host Mark Levin discussing “upcoming new guidelines from the Obama administration restricting how doctors can deliver medical care.”

In the FIRM post, Dr. Paul Hsieh compares this neurosurgeon’s comments to another neurosurgeon, Dr. Hendricks, a character in Atlas Shrugged who rebels against socialized medicine. The full transcript of the segment of the Mark Levin show can be found here. Notably, patients are referred to by government bureaucrats as “units”. This is the rhetoric of bean counters, not doctors.

In the transcript, the neurosurgeon, who called himself Jeff, said:

I just returned from Washington, DC, where we were reading over what the Obama health care plan would be for advanced neurosurgery for patients over 70, which we all found quite disturbing. As our population gets older, the majority of our patients are getting over 70. They'll require stroke therapy, aneurysm therapy, and basically what the document stated is that if you're over 70 and you come into an emergency room... if you're on government-supported health care, you'll get "comfort care".

You know, we always joke around -- 'it's not brain surgery' -- but I did nine years after medical school, I've been in training ten years, and now I have people who don't know a thing about what I'm doing telling me when I can and can't operate.

Apologists for the new healthcare law strenuously deny the death panel charge. But they are correct only in the very narrowest sense. ObamaCare does not specifically establish actual Death Panels, but it does establish the broad scope of power to do so, which is laced throughout the law. As John David Lewis explains in his Winter 2009-2010 Objective Standard article, What the “Affordable Health Care for America Act,” HR 3962, Actually Says, “This legislation empowers the executive branch, namely the Secretary of Health and Human Services and a ‘Health Choices Commissioner,’ to write thousands of pages of regulations, and to force Americans to comply with them.” In other words; death panels by a thousand edicts.

One of the apologists is which calls the death panel charge the "Lie of the Year." Yet buried within its own article debunking the charge, it unintentionally points to how the nature of the law proves Palin right:

History professor Ian Dowbiggin, who has written several books on medical history, euthanasia and eugenics, said he had never heard the term before Palin used it. He said the phrase invokes images of Nazi Germany, which denied life-saving care to people who were not deemed useful enough to broader society. Adolf Hitler ordered Nazi officials to secretly register, select, and murder handicapped people such as schizophrenics, epileptics, disabled babies and other long-stay hospital patients, according to Dowbiggin.

"It's not far-fetched to make the historical argument that as you get government more and more involved in health care, you create an environment that is more hospitable to the legalization of forms of euthanasia," Dowbiggin said. "But the Nazi example should be used very advisedly."

No, it's not far-fetched given the nature of ObamaCare and of government-run medicine generally. When the government coercively takes over responsibility for paying for something, it acquires the power to control. Who pays the bill, sets the terms, ultimately. When the government pays for healthcare, it will assume the power to make healthcare decisions for the patient and medical judgements for the doctor, including life and death decisions. And it’s not only about end-of-life situations (See my posts of 10/19/11 and 11/20/11).

Obama is not Hitler, and ObamaCare is not Nazism. But both empower government with the same kinds of authoritarian mechanisms as Germany had. Hitler drew upon the established German government powers of Bismarck’s 19th Century welfare state. The Obama administration is already on record - through a key adviser - as advocating overriding the Hippocratic oath with “social justice.” Just as Hitler placed the collective (the race, in his case) over the needs and rights of actual individual human beings, so “social justice” places the collective (society) over the needs of individuals. This means, in essence, that healthcare decisions must be weighed against “whether the money could be better spent on somebody else” – those, according to a key presidential adviser, who may be better qualified for “being or becoming participating citizens”. ObamaCare, like Hitler, will favor those “deemed useful enough to broader society.” When the responsibility for dealing with the cost of healthcare is stripped away from the individual, where it rightfully and morally belongs, and turned over to the government under the guise of calling it a national problem, which clearly it is not, the individual patient is reduced to a “unit” – expendable on the whims of bean counters and the alter of “communitarianism”.

[Important Note: FIRM has an update alerting us to the fact that the claims of Levin's talk show guest are being refuted. See Snopes Disputes Neurosurgery Rationing Claim. However, whether or not the claims of the guest are false, the fact remains that ObamaCare empowers government with such controlling authority.]

Sunday, November 20, 2011

Forbes: "Death Panels ... We already have one"

Last month, I cited the U.S. Preventive Services Task Force's downgrading of PSA testing for prostate cancer as evidence that Sarah Palin's ObamaCare "Death Panels" charge was coming true. In that post, I quoted from a NJ Star-Ledger letter-to-the-editor correspondent who came to the same conclusion.

Recently, that viewpoint received some prominent support. In The Department of Health and Human Services' Death Panel, Steve Forbes wrote:

[T]he U.S. Preventive Services Task Force, a committee of “experts” appointed by the Department of Health & Human Services ... recently de-clared that men should not be routinely screened for prostate cancer. The most common test is the PSA, which is part of a blood test. The panel also said no to rectal exams and ultrasounds, claiming that testing does no good, that it doesn’t save lives.

The emphasis is mine. So, it's worse than I thought. Just as in my previous post on the subject I cited numerous examples of the success of regular screening, so Forbes points to his own:

After skin cancer, prostate cancer is the most common form of cancer found in men. Last year it killed 32,000 people in the U.S. The panel’s tortured reasoning is that oftentimes traces of cancer in the prostate don’t lead to a full-blown attack that can kill the patient. True enough, as far as that goes. But the panel ignored the inconvenient fact that physicians have a measurement called the Gleason score to determine how dangerous the disease is. If that score is low doctors will take a watchful attitude; if it gets high they’ll recommend action.

I know. A routine rectal exam last spring resulted in an alarming finding, subsequently confirmed by an ultrasound and a biopsy. The Gleason score was flashing red, so my prostate was removed, and—knock on wood—it seems the disease was caught early and successfully.

The task force makes a big deal about the unpleasant side effects in treating prostate cancer. But with a disease like cancer I’ll take the side effects of treatment over letting nature take its course.

In other words, the government - if and when these recommendations are adopted - will come between the doctor's judgement and his patient's fundamental right to make his own decisions about his health. Where would Mr. Forbes be if doctors were probibited from doing rectal exams and ultrasounds, let alone PSA tests?

When Palin made her famous Death Panel charge, ObamaCare defenders were quick to point out that nowhere in the bill are anything resembling Death Panels explicitly called for. Some opponents of ObamaCare concurred. In his Summer 2011 Objective Standard review of Why ObamaCare is Wrong for America, Jared M. Rhoads writes:

[I]n the section titled bluntly "Are There Death Panels In ObamaCare?" (to which they answer "no"), the authors explain how the contraversy arose and what protections are in place to prevent the emergence of death panels - and then acknowledge the legitimate basis for concern over this issue, which is the conflict of interest introduced when the federal government makes decisions about coverage while simultaneously trying to control costs (p. 92).

The emphasis in the above quote is mine. This is why, in my 10/19/11 post, I said that "these government studies can not be trusted" because:

The Federal government now controls almost 90% of healthcare spending, both directly through programs like Medicare and Medicaid and indirectly through its crony arm, the quasi-private health insurance industry. Consequently, the government now has a vested interest in controlling costs. The deep, inherent conflict of interest is apparent, and should scare all of us.

It is a mistake to take Sarah Palin literally. But that doesn't mean she was wrong. The truth is much more subtle and sinister than that. In John David Lewis's Winter 2009-2010 Objective Standard article, What the “Affordable Health Care for America Act,” HR 3962, Actually Says, Lewis writes:

This bill is 1,990 pages of mind-numbing legalese. It will reach deeply into federal and state regulations and laws, on a scale that will require years for experts to interpret. It will establish institutions that will be effectively irreversible. It will grant arbitrary powers to bureaucrats, who will have to interpret and enforce its dictates. A full analysis of its impact would require a commentary at least as long as the bill itself. American citizens cannot be expected to read and understand such legislation. But they should be aware that this is the nature of the laws being written by their (alleged) representatives in Washington.

This legislation empowers the executive branch, namely the Secretary of Health and Human Services and a “Health Choices Commissioner,” to write thousands of pages of regulations, and to force Americans to comply with them. For every line in this bill, many pages of regulations will be written. As a result, the bureaucracy will expand, the final cost will be many times more than the original estimates—and the impact on American medicine will be devastating.

Death Panels will arrive through the "arbitrary powers [of] bureaucrats" writing "thousands of pages of regulations" implementing policies often based upon the recommendations of reports such as the PSA study issued by the benign-sounding U.S. Preventive Services Task Force. The devastating results may not occur immediately. As Forbes writes:

Two years ago this task force said wom-en under the age of 50 shouldn’t get annual mammograms—a “finding” so preposterous even the Department of Health & Human Services ran away from it.

This latest dictate is meeting the same fate.

Though they may not yet be able to get away with this particular attack on prostate cancer screening, it is an indication of the kinds of hidden forces being unleashed against American healthcare. The dictatorial power over our health care being accumulated by our government will lead inexorably to Death Panel results sooner or later, if not repealed. It is our children and grandchildren who will ultimately pay the full price.

Echoing others, Forbes concludes:

If the government succeeds in dominating health care, as it’s now on its way to doing, we can expect more of these weird and lethal findings. The focus will be on rationing and saving money. What we need in health care is more free enterprise, not Soviet-style controls.

Monday, November 14, 2011

School Choice, Collectivist Style

Recently NJ Star-Ledger columnist Joan Whitlow wrote:

When Facebook founder Mark Zuckerberg donated $100 million to improve education in Newark [New Jersey], and it was announced that the city would seek matching funds, Newark residents were told they would decide how the money would be spent.

Newarkers would decide? Well, it's more like Newark residents may get to suggest. Unless they can plunk down a $10 million donation, they won't be on the board that does the deciding — not as it stands now.

That needs to change.

According to Whitlow, the Foundation for Newark's Future will dispense the money. That board is made up of Mayor Corey Booker and anyone who donates $10 million bucks or more. The trouble is, thinks Whitlow, the board members don’t have to be – and apparently aren’t – from Newark. It is “hoped” that “the group will [eventually] include Newark people”.

But apparently “Newarkers” won’t have much to say on who sits on the board and on how the money is spent, because according to Gregory Taylor, the foundation's president and CEO, “letting the people have their say is not how professional philanthropy works.”

Whitlow concedes that “When people put up big money, they want — and have a right — to have a say over how the money is spent to protect those assets." But she still believes this represents a broken promise. Her solution?

If the goal is to improve education in Newark, the board should be expanded to include voting members from and of Newark, with a direct say in how the money is spent. That fund needs people who have a sense of what has worked and already failed, people who have a stake in the outcome. The board needs balance against any preconceived notions about education that might motivate someone to give $10 million, or more.

Yes, it's their money. But it's Newark's kids.

I’ve left the following comments:

October 07, 2011 at 10:22PM

Newarkers should decide. I agree. Soliciting tens of thousands of residents to each put their two cents in is not the power to decide. But neither is handing out seats on some board to a few people “from and of Newark” letting “Newark residents … decide how the money would be spent.” It is an end run around the freedom to decide.

How about real decision-making power? Start by turning Zuckerberg’s grant and the matching funds into tuition scholarships for parents who want to decide in which school, public or private, to enroll their kid. But don’t stop there. Supplement parents’ decision-making powers with tuition tax credits, so they can apply their own education dollars according to their own judgement. If letting Newark residents decide is truly the goal, then how about universalizing the tax credits, so every resident that pays school taxes can finance any child’s education – a niece, grandchild, neighbor – or pledge his/her credits to the Zuckerberg scholarship fund?

A centrally planned, government-run monopoly by any other name is still a centrally planned, government-run monopoly. Fighting over who gets to impose their ideas on everyone else does not change the nature of the beast. Does it really make a difference whether or not the planners have a Newark address or not? No, because we are not talking about “Newark’s kids”. They are the parents’ kids.

Ultimately, only a free market empowers parents, because the fundamental truth is, whoever pays sets the terms. Creating scholarship funds is a step in the right direction, because it at least brings parents directly into the process, giving them a voice. If the conditions donors place upon their money do not satisfy the beneficiaries, there will be no beneficiaries. Handing their money over to the same establishment that currently runs failing schools is not the solution, no matter who sits on what board.

Tuesday, November 8, 2011

Bank of America Rescinds Debit Card Fees

Bank of America has rescinded its plans to impose monthly fees of $5 on its debit cards. The fees were a legitimate response to political meddling into private bank/merchant business transactions. Once again we see politicians escaping blame for the consequences of their meddling, while the victims face vicious and unjust attacks. The NJ Star-Ledger recently editorialized:

Debit cards and ATMs were supposed to save everyone — banks and customers — time and money. Bank officials, including those at Wells Fargo and Chase, tossed that rationale out the window in the face of federal regulations to rein in excessive fees. No longer able to charge high fees to merchants, the banks pouted and announced they had no choice but to extract the fees from consumers. It was all Congress’ fault, you see.

Rep. Frank Pallone (D-6th Dist.) called out Bank of America for attempting to circumvent regulations, and noted the bank’s president took home nearly $2 million in compensation last year. He called the fee “a surcharge on working people.”

The editors attribute B of A’s retrenchment to “mounting consumer outrage” and competition from “other banks and credit unions”. “So credit not just consumer rage, but the free market,” the editors brazenly assert, just a few paragraphs after they approvingly cite “regulations to rein in excessive fees…to merchants”!

In an epilogue to my previous post on the subject, I’ve left the following comments:

Did B of A respond to consumer and competitive pressures? Or were they knee-capped by thug politicians like Pallone, Durbin and other Democrats’ mob-like threats of antitrust prosecutions and regulatory reprisals?

The double standard here is obvious. Those “regulations” referred to are the price controls forcing banks to lower “excessive” fees charged to merchants – fees mutually agreed to through voluntary contracts and legitimized by widespread market acceptance. When “consumers” attempt to “circumvent” the $5 fee, it is hailed as a “small revolution”. When B of A attempts to “circumvent regulations” to recoup legitimate profits stolen at the behest of the merchant lobby - through an equally moral and legal addition of fees on debit cards - they are threatened, demonized, and ridiculed as “pouters” who dared to defy the imperial congress.

Philosopher Ayn Rand warned half a century ago that “We are fast approaching the stage of the ultimate inversion: the stage where the government is free to do anything it pleases, while the citizens may act only by permission; which is the stage of the darkest periods of human history, the stage of rule by brute force.” It appears we have reached that stage, at least in finance. This congressional micro-managing of financial transactions and the political bullying of B of A shows that economic fascism is here.

As a final word, let me add that this episode puts the lie to the Left's propaganda that the financial crisis was caused by the "free market". A market in which government can impose pricing regulations such as those cited here is anything but "free".

Thursday, November 3, 2011

“Occupy Wall Street” Sharpens the Ideological Battle Lines

From the first I heard about “Occupy Wall Street”, I knew it was a Left Wing movement. The name itself speaks volumes to its nature: It implies disdain for the property of others. The spirit of it suggests to me the barbarians who sacked the remains of the Roman Empire. Notice I said “spirit”. Not everyone in it is a barbarian.

But the second thing I heard about OWS is its opposition to big bank bailouts. No disagreement there. Some latched onto this aspect as evidence of its similarity to the Tea Party. There is some superficial truth to this. Like the Tea Party, OWS contains a wide diversity of often-contradictory ideas. And it is driven by a belief that something is fundamentally wrong in America. Also like the Tea Party, OWS is a movement – one driven by a fundamental view of human existence.

But the similarities end there. OWS is much deeper and broader than a mere protest. At root, it explicitly represents collectivism – and it has plenty of heavyweight ideological support. The Tea Party, on the other hand, only implicitly represents its birthright - individualism, based upon its general insistence on a return to this country’s Founding Principles. Both OWS and the Tea Party represent the tip of very big and irreconcilably hostile philosophical icebergs.

Politically, OWS is a direct outgrowth of Barack Obama’s incessant demonization of the “rich”, or the “top 1%”. Every advancing statist movement needs a societal scapegoat: Hence, the OWS’s self-description as “the 99%” as victim of “the 1%’. But this demonization depends upon a view of “the rich” that was quite true throughout most of human history, and is still largely true perhaps in much of the world – the reality that the rich became so by looting the masses. I am talking about looting rulers, of course, who simply steal under cover of taxes. In this view, the “top 1%” is a static caste or class. In free, or even semi-free, societies, however – and especially America - the opposite is true: people get rich by productive work, or the application of intelligence to physical labor. Unlike the looters, they enrich everyone by their productive genius, as they flood the culture with mass-market products while creating jobs by the bucketsful. Trade, not confiscation, is the source of riches. But, the collectivist view leaves no room for the truth. It depends upon the tribal view of wealth. In this view, it makes no difference whether someone acquires his wealth by government favor of by earning it in the private marketplace. Either way, he got more than his “fair share” of the “economic pie”. In Obama’s world, the “top 1%” is a static caste of privileged individuals who, along with the rest of us, are locked into a particular lot in life – a world without individual social or economic mobility. This view is epitomized by NJ Star-Ledger columnist Tom Moran, who said “In the past 20 years, all of the economic gains we’ve made were captured by the top 10 percent of earners”. (See my post of 10/15/11).

But Obama isn’t the only big ideological gun underpinning the OWS movement. The ethical root of collectivism is altruism, and now OWS has the blessing of modern altruism’s biggest sponsor – the Catholic Church:

The Vatican called on Monday for the establishment of a “global public authority” and a “central world bank” to rule over financial institutions that have become outdated and often ineffective in dealing fairly with crises. The document from the Vatican’s Justice and Peace department should please the “Occupy Wall Street” demonstrators and similar movements around the world who have protested against the economic downturn.

It condemned what it called “the idolatry of the market” as well as a “neo-liberal thinking” that it said looked exclusively at technical solutions to economic problems. “In fact, the crisis has revealed behaviours [sic] like selfishness, collective greed and hoarding of goods on a great scale,” it said, adding that world economics needed an “ethic of solidarity” among rich and poor nations.

This sounds a lot like communism’s one-world proletarian dictatorship. Athough not communist, the church has long upheld implicitly the ideal of socialism, and disdain for capitalism:

The recent Council reiterated this truth: "God intended the earth and everything in it for the use of all human beings and peoples. Thus, under the leadership of justice and in the company of charity, created goods should flow fairly to all." (20)

All other rights, whatever they may be, including the rights of property and free trade, are to be subordinated to this principle [of a global welfare state].

It is for the public authorities to establish and lay down the desired goals, the plans to be followed, and the methods to be used in fulfilling them [i.e., totalitarianism]; and it is also their task to stimulate the efforts of those involved in this common activity. But they must also see to it that private initiative and intermediary organizations are involved in this work. In this way they will avoid total collectivization [?] and the dangers of a planned economy [?] which might threaten human liberty and obstruct the exercise of man's basic human rights.

What is the state of affairs when property and free trade rights are subordinated to need, and governments establish the goals and plans and the methods and means toward “common activity”? An intelligent and prescient intellectual of the Left, E.J. Dionne, states:

The report spoke of “the primacy of being over having,” of “ethics over the economy,” and of “embracing the logic of the global common good.”

In a knock against those who oppose government economic regulation, the council emphasized “the primacy of politics — which is responsible for the common good — over the economy and finance.” It commented favorably on a financial transactions tax and supported an international authority to oversee the global economy.

Moreover, the Vatican office’s intervention shows that those protesting against a broken and unjust financial system are not expressing some marginal point of view.

It is always entertaining for those of us who are liberal Catholics to watch our conservative Catholic friends try to wriggle around the fact that, on the matters of social justice and the economy, Catholic social teaching is, by any measure, “progressive.”

What do you call a state of affairs in which politics takes “primacy” over “the economy and finance”? Dionne is oh-so-right: OWS is “not expressing some marginal point of view”, but – wittingly or not – the core elements of totalitarianism. Dionne correctly points to the bridge that connects the worldview expressed in this latest Church statement back to its mid 20th century origins, when Catholic leaders embraced world collectivism. “[T]his document,” writes Dionne, “is firmly rooted in papal teaching going back to Popes John XXIII, Paul VI and John Paul II.”

I’ve nicknamed OWS “The March of Greed”, based upon its call for an eternal something for nothing. Some OWS demands read a lot like the Nazi Party platform of the 1920s or FDR’s “Economic Bill of Rights” in their calls for authoritarianism and expanded entitlements. But OWS must not be viewed merely as a political phenomenon or as a Left Wing reaction to the Tea Party. It is essentially a manifestation of collectivism and altruism, and it has very deep roots, as we have seen.

The antidote to statism/socialism is of course capitalism. But the antidote to statism/socialism’s roots – collectivism/altruism – is capitalism’s roots; individualism/egoism. Today’s battle between socialism and capitalism is at root a battle between collectivism/altruism and individualism/egoism, and that is where the battle needs to be fought. The forces of socialism are much more bold and consistent in upholding their roots. The forces of capitalism, as represented by the Tea Party, have yet to firmly embrace their roots. But there are signs that it is starting to happen, and it can’t come too soon.

The rise of OWS will sharpen the fundamental clash between collectivism and individualism. I believe – with a dash of hope, perhaps – that with its individualist wing taking center stage, the Tea Party will rise to meet the collectivist challenge. Just as Obama’s ideological clarity added fire to the rise of the Tea Party, so OWS will probably trigger a reinvigoration of the Tea Party. We are entering new territory, and 2012 is going to be an interesting year.

See also The Vatican’s assault on capitalism (part 1)
, The Vatican’s assault on capitalism (part 2)
, my 3-part essay "Obama's Collectivist Manifesto" parts 1, 2, and 3, and Ayn Rand's "Requiem for Man" in Capitalism: The Unknown Ideal .