Red Pill or Blue Pill?

Ezekiel Emmanuel doesn't want to live beyond the age of 75. That shouldn't really be anyone's concern besides his own, and, perhaps his immediate family's. 

Unfortunately, it is our concern, because Ezekiel Emmanuel isn't just some random guy, living in flyover country. He's Dr. Ezekiel Emmanuel, director of the Clinical Bioethics Department at the U.S. National Institutes of Health. He also heads the Department of Medical Ethics and Health Policy at the University of Pennsylvania. He's also one of the chief architects of the Affordable Care Act, otherwise known as Obamacare. 

So when Dr. Emmanuel says he doesn't want to live beyond the age of 75, after which he won't accept medical intervention for illness or use preventive health care screenings, and presents his reasoning in a lengthy article in The Atlantic called "Why I Hope to Die at 75," he's not just waxing poetic or nostalgic. He's shaping policy. He may claim otherwise ("I am not advocating 75 as the official statistic of a complete, good life in order to save resources, ration health care, or address public-policy issues arising from the increases in life expectancy"), but he's fooling nobody. 

On the heels of his piece in the Atlantic comes this article, "Panel Urges Overhauling Health Care at End of Life," in the New York Times reporting on the recommendations of (wait for it) The Committee on Approaching Death (I guess we need a committee for this). Their book, Dying in America: Improving Quality and Honoring Individual Preference Near the End of Life, contains the panel's recommendations. 

OK, so people who work with the elderly (and I know a few) might regard the committee's suggestions with equanimity. What's wrong with reimbursing health care providers for "conversations with patients on advance care planning?

Yet, from where I sit, it's impossible, when juxtaposing the seemingly benign suggestions of The Committee with Dr. Emmanuel's sunny rejection of old age, not to see where this is headed. And yes, I'm talking about that slippery slope. Good call, Ms. Palin.


That's how it works, folks. It begins with a "suggestion," moves into a "conversation," veers into debate, creeps into policy, seeps into mores, metastasizes into worldview. Before long, the right thing to do is not only to nudge the aged to choose an early exit, but to deprive them of the choice to extend their lives altogether, at least from the standpoint of insurance benefits. 

So here we are, 2014, in Obama's America. It is, as promised, fundamentally transformed. Ezekiel Emmanuel may be cool with it, and Michelle Obama, positively giddy. But, of course, that's what it's like when you're plugged into the Matrix. Peace and joy and light and sunshine and flowers. 

 The red pill for me, if you please, Morpheus.

Private Health Care for Veterans?

This just in: 

More veterans are being allowed to obtain health care at private hospitals and clinics in an effort to improve their treatment following allegations of falsified records and delays in treatment. In a statement issued Saturday, Veterans Affairs Secretary Eric Shinseki also said VA facilities are enhancing capacity of their clinics so veterans can get care sooner. In cases where officials cannot expand capacity at VA centers, the Department of Veterans Affairs is "increasing the care we acquire in the community through non-VA care," Shinseki said.

(VA Approves More Private Care for Veterans, Associated Press, May 24, 2014.

So . . . government health care doesn't work? But Paul Krugman and Ezra Klein said socialized medicine does work! Were they mistaken???

"If liberals want to toast the Veterans medical system as an example of government-run health care done right, they are going to have to seriously grapple with its tragic failures."

Liberals Touted Veterans Affairs Hospitals as Evidence Government-Run Health Care Works, Philip Klein, Washington Examiner,  May 22, 2014).

Not So Fast, Your Majesty?

The Chicago Tribune editorial board wrote the following in yesterday's paper: 

But in this country we don't change bad laws by presidential fiat. We change them by having Congress rewrite them or by starting from scratch. Obama doesn't want to reopen this law for fear that Republicans and some Democrats will substantially rewrite it. But that's what has to happen.

Nice to hear some objectivity from a mainstream paper. True, the Tribune's editorial philosophy leans conservative, but they did endorse Obama for president in 2008 and again 2012. So kudos to them for somehow managing to remain detached ideologically in both their endorsements and their analysis of policies.

Wish my paper (Los Angeles Times) would take a page from their playbook; its board members continue to insist, for example, that the Affordable Care Act is fine, just give it a few months, a year, max. Indeed, their guy can do no wrong. Here's what they wrote on the same day regarding Obama's "decree" that consumers should be allowed to keep their current insurance policies for another year: 

The move is a desperate attempt to fulfill a promise President Obama never should have made, and the legal authority for it is sketchy. What's more, it may not be possible at this point for insurers to revive policies they've already canceled. Worst of all, Obama merely punted to next year the fight over the law's insurance reforms, which he has done a remarkably poor job of explaining and selling. The only good thing about the delay is that it might stop Congress from making a more damaging change to the law.

A gentle rebuke, yes. But scrap (rewrite or repeal) the law? Nothing doing. The real bad guys in that scenario would be in Congress. Nope. Good, bad, or ugly, keep your cotton-picking hands off the ACA, thus saith the LAT.

Stop Digging. Start Over (Chicago Tribune editorial, November 15, 2013. 

Sarah Palin Was Right

Remember when Sarah Palin was mocked for suggesting that ObamaCare contained what she called death panels?



It appears Miss Henny Penny was right all along. Here are a few excerpts from an article that appeared this week in the Wall Street Journal, written by David Rivkin and Elizabeth Foley ("An ObamaCare Board Answerable to No One")"

Signs of ObamaCare's failings mount daily, including soaring insurance costs, looming provider shortages and inadequate insurance exchanges. Yet the law's most disturbing feature may be the Independent Payment Advisory Board. The IPAB, sometimes called a "death panel," threatens both the Medicare program and the Constitution's separation of powers. At a time when many Americans have been unsettled by abuses at the Internal Revenue Service and Justice Department, the introduction of a powerful and largely unaccountable board into health care merits special scrutiny. . . 

The ObamaCare law also stipulates that there "shall be no administrative or judicial review" of the board's decisions. Its members will be nearly untouchable, too. They will be presidentially nominated and Senate-confirmed, but after that they can only be fired for "neglect of duty or malfeasance in office" . . . 

The IPAB's godlike powers are not accidental. Its goal, conspicuously proclaimed by the Obama administration, is to control Medicare spending in ways that are insulated from the political process. . . 

The power given by Congress to the Independent Payment Advisory Board is breathtaking. Congress has willingly abandoned its power to make tough spending decisions (how and where to cut) to an unaccountable board that neither the legislative branch nor the president can control. The law has also entrenched the board's decisions to an unprecedented degree. . . 

ObamaCare mandates that the board impose deep Medicare cuts, while simultaneously forbidding it to ration care. Reducing payments to doctors, hospitals and other health-care providers may cause them to limit or stop accepting Medicare patients, or even to close shop. These actions will limit seniors' access to care, causing them to wait longer or forego care—the essence of rationing. ObamaCare's commands to the board are thus inherently contradictory and, consequently, unintelligible. 

Once again, the Obama people speak from both sides of their mouths: no, you may not ration; yes, you will in all likelihood be forced to ration. 

Read full article here. And below is an ad where Nobel Prize-winning economist Paul Krugman is seen essentially concurring with Sarah Palin, albeit from a cynically leftist point of view. 

I don't expect any apologies to Ms. Palin will be forthcoming; I do, though, expect Congress to take the WSJ writers' advice to "act quickly to repeal this particular portion of ObamaCare or defund its operations." That would be a start.