Socialist Death Panels

From the blog "Texas on the Potomac," reporting on the comments of U.S. Congressmen from that state's delegation concerning the House vote to "Repeal the Job-Killing Health Care Law Act:" 

Rep. Jeb Hensarling, R-Dallas, chairman of the House Republican Conference:

"The American people don't want it. It's personal.

"Here's my story, two days ago, I was in San Antonio, Texas, and my mother had a large tumor removed from her head. They wheeled her away at 7:20 in the morning, and by noon, I was talking to her along with the rest of our family. It proved benign, thanks to a lot of prayers and good doctors at the Methodist hospital in San Antonio. My mother's fine. I'm not sure that would be the outcome in Canada, the U.K., or anywhere in Europe.

"No disrespect to our President, but when it comes to the health of my mother, I don't want this President or any President or his bureaucrat or commissions making decisions for my loved ones. Let's repeal it today, replace it tomorrow."

Now, first of all, this holder of one of the highest offices our nation has to offer believes that the reason his mother's tumor was benign was "thanks to a lot of prayers and good doctors ..." Prayers? Well, okay; if they'd been doing a better job of praying maybe the lady wouldn't have had the tumor in the first place. But good doctors? I know a lot of doctors, but I don't know of any who can make a malignant tumor benign. So we have to question Rep. Hensarling's understanding of how things work. Not in medicine; I mean, in the Universe in general.

But to move on, Hensarling, 53, doesn't want Obamacare. Specifically, he doesn't want the government making decisions about his mother's health care. Presumably, his mother is at least twelve years older than he, and so is most likely a Medicare beneficiary. Medicare, unlike private health insurance would have done, did not require that her surgery be pre-approved in order for the hospital and the surgeon to be paid. It did not, as some private insurers do, place limits on the pain medication or other drugs she could have in connection with the surgery. And unlike most private insurers, Medicare will in all likelihood pay the physician within 30 days.

Hensarling was pretty happy with his mother's government-provided health care. And, of course, as a congressman, he also has government-provided health care, and top-quality care at that, just like Mom. 

He just doesn't want the rest of us to have it. 

Universal Coverage: A Suggestion

As I understand it, the argument in the big lawsuit being brought against the President's health care plan is this: Under the Commerce Clause (in Art. I, Sec 8 of the U.S. Constitution), the federal government has the right to regulate commerce among the states.

This has been interpreted very broadly, to reach almost all economic activity that occurs within the U.S.

The lawsuit, however, argues that this rule provides only the power to regulate commercial activity that is taking place, or might take place; there is no power to compel that any particular activity be undertaken by anyone.

Example: You can be forced, if you, say, sell beef at wholesale, to abide by various federal restrictions on how beef cattle are slaughtered, packaged, graded for quality, and so forth. But if you grow vegetables, or just have some idle acreage, you cannot be compelled to begin raising and selling beef cattle.

To a layman, this argument makes some sense. Of course, the government has the power to tax; but by definition, taxes apply to economic activity, not inactivity. [this may need a separate examination]

It would be unfortunate, from my perspective, if this argument were to prevail. The individual mandate is key to the Affordable Care Act, for well-rehearsed reasons that go like this:

1. The system will depend on the availability of private insurance for everyone not covered by Medicare, Medicaid, or similar government programs; and the lack of a "public option" means that tens of millions will not be so covered, and so will have to seek private insurance.
2. Private insurers are required to offer coverage to all comers, on substantially comparable terms, so that everyone will have access to coverage.
3. To avoid "adverse selection" --a situation in which healthy people stay away because of the cost of insurance-- everyone not only can, but must, buy insurance. Subsidies exist to support those who may not be able to pay for the coverage.

This third point needs elaborating: If the cost of insurance is high, and I am healthy, why not just forego the insurance? After all, because of item #2, I can always buy in if I get sick, or start to age, and so forth. The result, of course, would be that (1) only the sick would sign up, (2) this would drive costs up, and so (3) even more people would begin to drop their insurance.

They key point in all this is that you can sign up whenever you want to. And this is a mistake. First of all, it's not true now even for Medicare participation: if you don't sign up within a specified time after you become eligible, you will be charged more to join; and if you miss the window for signing up, it will remain closed for a time.

This could easily be applied to private insurance under the Affordable Care Act:

• Everyone is allowed, but not required, to sign up for health insurance;
• If you fail to sign up, any insurer with whom you subsequently sign up can charge you a premium based on how long you went without coverage.

But there's more: If you don't sign up, you won't have another opportunity to sign up for five years. And, when you do apply, your application cannot be approved prior to the date that is 12 months after your application is received. So, if you don't sign up when the program is first available, you are guaranteed to be uninsured for a long time.

There are details to be ironed out, including notification, what to do with people who don't sign up but then join a company that provides coverage, and so forth. These are, I think, administrative matters that can be resolved fairly easily.

What's the catch? It's a big one: What do we, as a society, do with the person who fails to sign up, and then has a catastrophic accident, or a stroke, or gets cancer?

I'm sorry; but I suggest that we have to be harsh here: these people are on their own.

No, we won't leave them to die in the alley outside the ER entrance. But they will receive maintenance care ("palliative care") only, unless they pay, in advance, for any extensive treatment, curative or otherwise. And they (or their estates) will be billed for that care.

So, you don't have to have health insurance. But you do have to face the consequences, just as those who now rail against this requirement would presumably prefer.

The Gamble

The Congressional Republicans, clearly, have drunk the venomous Kool-Aid that has poured forth in an ever-increasing torrent from the likes of Limbaugh and Beck. [Q: why are the most listened-to voices on the radio not, somehow, part of the "mainstream media?"] They have accepted anger and denial as their governing philosophy. Having done so, they now must substitute symbol for substance, spectacle for plot (although "character," in the personae of some of the wing-nuttier new members of the House, looks promising as well).


Among the first items in the order of business:

• Read the Constitution on the House floor. The Constitution has become, for the Tea Party, what Mao's little Red Book was to the Cultural Revolution. It is Holy Writ, inerrant, universal, timeless. It's every word is sacrosanct. Well, okay, not every word: they skipped the part about slaves counting for 3/5 of an actual human being in determining population for purposes of Congressional apportionment. [It occurs to me to wonder: if a slave was the bastard child of his owner and an unfortunate slave-girl, would that child be counted as 1/2 x (1 + 3/5)?] Only the parts we like (or must pretend to like, such as the 13th Amendment) are holy.
• Pass "The Repealing the Job-Killing Health Care Law Act." And whatever we do, let's not record any votes on the specific provisions of the Law, which everyone likes.  We'll just repeal the whole thing. And the CBO's analysis that such repeal will add to the deficit? The CBO is wrong, because its conclusion is inconvenient. So we don't have to find the cuts we promised to find to match any and all increases in the deficit.

These are just two of the growing list of things the Republicans in the House will spend their time on. There are others, and they fall into two categories: Symbolic gestures, and reformulating their own campaign promises, including the Pledge to America, so that they can be excised from the public mind like gangrenous tissue.

The symbolic gestures won't hurt anyone. Sure, some of them will make some people look ridiculous; but that's in keeping with what has become the Republican style of late. No, the symbols are fine, and it's hard to avoid the suspicion that they are getting so much play just now, in part, out of a fervent hope that symbols will be enough.

And here is where the gamble comes in. Having cynically used the most extreme of the excesses of an ignorant, jingoistic, hopelessly confused minority as their rallying cry, the Republicans must now hope that they won't actually have to deliver. They'd like to; but they can't. They can't lower taxes and balance the budget. They can't cut  spending, win in Afghanistan, and bring back full employment. They cannot remove the regulations (whatever poor shades those might be) that are "killing jobs" and stifling entrepreneurship while helping the middle class return to prosperity. They can't turn back the clock.

Unfortunately, this is what they have promised to do. The risk is that those who voted them in will expect them actually to deliver. The gamble is that, as voters often do, these voters will forget what they asked for, and accept instead the clever naming of bills that will go nowhere, the subtle but persistent disrespect for, and de-legitimizing of, a president who won 53% of the popular vote, and the fulminating against socialism in the form of government regulation.

The gamble is the Republican hope that Republican voters don't really care about substance.

Equal Protection of the Law

Here’s the deal (as our Vice-President is fond of saying):

Every defendant in any criminal trial in the U.S. may have representation in the courtroom by only one attorney: the legal counsel appointed him, by lot, from the Office of the Public Defender.

Oh, and attorneys in said office must be paid on the same (average) salary scale that pertains to the lawyers in the nearest offices of the two largest private law firms in the country.

Now, go ahead and do your worst, budget-cutters, in stripping the courts of the means of functioning properly. At least we’re all equal in the eyes of the law, now.

The Founders and their Genius

We hear a lot these days about the Constitution, often from people who, clearly, have only a sketchy acquaintance with what it actually says. The context is typically a call for the removal from office (occasionally by violent means) of a “liberal” politician or judge who has said or done something, usually unspecified --or, if specified, erroneously so, such as the creation of “the bank bailout” of 2008 by President Obama, who took office in 2009—, that places him or her outside the category of the fully American, if not that of the fully human.

The Constitution is virtually interchangeable, in this rhetoric, with “the Founders.” The word “Founders” is always capitalized, like the name of Jesus, but not because it is a proper noun; rather, the Founders constitute American divinity. Right-thinking (in both senses of the phrase) people believe that every word of the Constitution, every parochial conceit of “the Founders” –forget that they were a rather diverse group of individuals who often disagreed vehemently—is Holy Writ, as immutable as the Torah (again, ignore  the marginal hints contained in the scrolls of which, that are intended to suggest what is supposed to be meant by a word in the text proper that has no colorable meaning where it appears; odd though it may be for the Author of the Universe to have made these spelling errors).

If the Founders did not say it, this line of thinking goes, it cannot be true; and it certainly cannot be enshrined in our laws; all attempts to do so constitute secular (a word that is not often used by Patriots) blasphemy, and should be dealt with like, well, like blasphemy.

They don’t say what, if any, respect should be given to Amendments to the Constitution; perhaps the Bill of Rights has pride of place, having been put together by the Founders.

This, simply put, is the basis for an entire political movement in the U.S. The “Contract From America,” a Tea Party founding document, would require that every law passed by Congress contain a citation to the specific provision in the Constitution that authorizes it.

Good-by, Air Force: the Army and the Navy are specifically authorized by the Constitution, but no such luck for the fly-boys. Good-by, Telecommunications Act. Moving to the sacred cows of the Right, so long Defense of Marriage Act (actually, marriage is never mentioned in the Constitution), Partial-Birth Abortion Ban Act, and even (no, especially, as it authorizes the federal government to intervene in a purely state matter) the Act for the Relief of the Parents of Theresa Marie Schiavo (remember her? And her physician, Senate Majority Leader Dr. Bill Frist?).

I’d like to point out just a couple of things that are true of the Constitution, and of the Founders.

The Constitution explicitly endorsed the practice of slavery; indeed, all the talk of Liberty notwithstanding, the Constitution puts forth a formula for how to count slaves in determining the population of a state for purposes of allocating Congressional representation. Our British friends had a great deal of fun with this over several decades during and after our Revolution.

The Founders themselves, as a group, generally did not expect the Constitution to be immutable; they regarded it, like all products of negotiation among differing interests, to be a provisional, approximate statement of the kind of government they wanted to establish. that's why they provided a means to amend it.

None of the Founders would have agreed with the notion of a speed limit; it wouldn’t have made sense to them. And placing a limit on immigration would probably have seemed silly, or meaningless, to them.
Contrariwise, the notion that an adult male, having been born in, say, Massachusetts, should automatically be allowed to vote for President, would also have been an odd proposition in their eyes. In fact, the notion that any citizen could vote directly for President was regarded as inadvisable by the Founders; and of course their wisdom in this regard prevails today.

They pretty much unanimously, however, agreed that the States had too much power, as opposed to that of the federal government –they were writing a Constitution, after all, because the Articles of Confederation weren’t working. They wanted something that worked better.

The point is this: the Constitution is a remarkable document, and it has worked pretty well. It is not immutable, not Holy Writ (whatever that may be). It's purpose, again, is to serve our needs, not for us to worship at its immutable feet, not to be handled, like a palimpsest, with velvet gloves under glass and never, ever to be disturbed. It will only work if we respect its purpose, and not enshrine its every word. If we so enshrine it, it will become a talisman, a symbol that will lose, over time, its connection to reality.

Wiki-Luddites

I have a dilemma: I feel a sort of relish in the disclosures, by Wiki Leaks, of hundreds of thousands of documents, mostly diplomatic dispatches (“cables”) that, read in small groups, sometimes seem to resemble nothing so much as (more or less) grammatical Facebook postings. OK, I’m being extravagant; they often contain real information, coherently presented, and very interesting, to boot..

My reaction, my smug satisfaction at this worldwide dumping of our diplomatic laundry, is troublesome to me. I’ve always considered myself a responsible adult, reasonably knowledgeable in, and accepting of, the ways of the world, or at least of serious adults. I know we need a government; I even know –this threatens to put me in the minority, it sometimes seems—that we need trained, educated, seasoned experts in this or that aspect of governing. And I believe that governing, let alone international relations, involves the occasional devil’s bargain, that principle can guide us, but sometimes has to be a signpost rather than a highway: we need to go in a certain general direction, but there may have to be stops and detours, because the world does not pose choices always involving the pure case of anything.

Believing all this, I ought to abhor what Mr. Assange has done, which is to dump, indiscriminately it seems, hundreds of thousands of unrelated bits of information on the table, as it were, for the world to paw through. The haphazardly accumulated reports and comments of hundreds of individuals laboring in the trenches of American policy and international politics, each with its own context, intended audience, and fallible author, are laid out for the –titillation, really—of the world’s readers.

Damage was, clearly, done as a result. People were embarrassed, relations were disrupted, trust was broken, the reputations of individuals, and of the United States, suffered. There is nothing good about this.

So why do I feel, well, sort of pleased, at moments, about all this?

What is the nature of this pleasure? I think it is schadenfreude, the pleasure we derive at the misfortunes of others. Naming it condemns it; it’s unworthy. But why do I feel this way? I have been a supporter of President Obama; I don’t have a particular axe to grind, I think, in this arena; I wish my country well in its foreign relations, and I am, at least broadly, supportive of its strategic goals if not of every initiative.

But the feeling persists, and it can be reduced to this: the bastards had it coming. Not the individuals whose cables, however foolish, trivial, or mendacious they might have been, but they, the people (or the institutions) who are always above it all.

Who are they? They are the men and women in power suits on the Sunday talk shows who speak knowledgeably and casually of the deaths of thousands, of the impoverishment of millions, as of chess problems with theoretical solutions that are, unfortunately, impractical or unwise today no matter how salutary they may be in the long run. You see, action today might hurt the economy, or might discourage our intended ally, might deny us the fly-over rights or the refueling base we need. So, sorry, but the peasants will just have to die a while longer. We can’t risk hurting the fortunes of the people two lockers over at the country club, so there’s no help for the unemployed until, maybe, spring, if things haven’t improved on their own by then.

Governments lie. We all know this; it is why presidential news conferences are seldom worth tuning in. We are not told the truth, but rather artful untruths intended to boost morale or markets or one’s negotiating stance.

But didn’t I just say, above, that sometimes prevarication is necessary? Yes; but it has become the primary mode of government discourse in this country.

Want to win an election? Construct a false narrative about your opponent: that he believes homosexuals are perverts who should be denied basic rights; that he wants to impose socialism –never mind what that is, it’s bad-- on us all; that he’s a philanderer; that she has sex with campaign workers, or casual acquaintances, or animals; that she’s an illegal alien, a liar, a cheat. If that doesn’t work, make sure the voting machines are screwed up, or the ballots are lost, or stop the count –go to court, to the Supreme Court, if necessary. We must win, and if the other guy wins anyway, then he or she is not legitimate and our primary responsibility is to oppose him. Not his policies: him.

Want to oppose a policy, but don’t want to reveal your actual motives? Make some up.

The facts don’t support your view? Lie about the facts; change what you said on your website last year so that it says the opposite, or nothing. Experts disagree with you? Anoint your own experts.

No one, anywhere in government, seems just to tell the truth. And if someone does, well, then, he is fired, if he’s at a low enough level, or, if not, pilloried in the press. Obama says the police made a stupid decision? Then he doesn’t support law enforcement. We don’t like the policies of the current administration? Threaten to secede from the Union, or sue the federal government, or threaten “second amendment solutions.”

Anything goes.

Ultimately, those in power seem to care more about their petty careers than they do about their responsibilities. They care more about the symbols and perquisites of power than about governing. So we have weeks of hearings about whether an athlete stuck a needle in his vein, but no hearings on vital issues: we can summon a majority, but a majority is not sufficient even to debate questions of war and peace, or justice, or how we ought to handle the great matters that concern us. Just hold out until the Sunday talk shows, and we can create our own world.

This is the great betrayal that we have come to expect from our elected leaders. Those in the civil service are pawns, mistreated as much as the rest of us are. The leaders who depend on them to do the hard things do not respect them, or even stand up for them when they are caught; why should we? Send the privates and corporals to jail; just make sure the generals and cabinet officers get high-paying jobs when they retire suddenly, “to spend more time with their families.” Condemn the tax cuts as blackmail, on Monday; then on Wednesday hail them as “bipartisan,” with the Minority Leader smiling behind you as you sign the bill you said you’d never sign.

Okay, so be it. If we are to have anarchy, then why should the guys in the $5,000 suits get all the fun? If we are to be at the mercy of those with the biggest bank accounts, we should get to laugh at something. We can at least show them, using their own words, looking silly, or dishonest, or stupid. Never mind if they also, often, look hardworking, or responsible, or thoughtful. After all, we aren’t really after the front men; it’s their handlers we want to reach. And we know we reach them by how upset they get. Supposedly responsible men have argued for the assassination of Mr. Assange: then bravo: he's hit a nerve! That's the most we can expect, on our own behalf, it sometimes seems. After all, why should the citizens be more responsible than their leaders?

We know it won’t work for long; it’s not just the late President Reagan who was Teflon-coated. They all are. So let’s do it over and over again.

And if I feel this way, do you need any further explanation of the Tea Party phenomenon?