posted
For anyone who thinks that Hentoff is some sort of neo-conservative, he bashed Bush non-stop over the Patriot Act, and has never shied away from criticizing anyone who violates civil liberties.
quote:President Obama's desired health care reform intends that a federal board (similar to the British model) — as in the Center for Health Outcomes Research and Evaluation in a current Democratic bill — decides whether your quality of life, regardless of your political party, merits government-controlled funds to keep you alive.
He's quite crazy. Every time Obama has mentioned end of life doctor consultancy -- which is a recommended best practice by doctor's organizations -- he has specifically mentioned that it would not be determinative.
So, where's the source from inside the Obama administration that the doctor consultation would be determinative or anything other than exactly the sort of thing recommended for families by physicians?
Or is trying to provide financial support for patient counseling considered very important for families dealing with difficult situations now a sign of evil?
I hope this isn't yet another case of your recent post and run habits, where you post something ridiculous and then don't bother to respond to the people who point out how ridiculous it is.
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I just got tired of replying again and again and again to the same baseless claims.
You know as well as I do that once legislation opens this up to bureaucrats, they will behave precisely like bureaucrats. Fact: voluntary consulations don't get initiated by the doctor. Calling that voluntary is dishonest. There's a power inequality that's the same thing that makes it inappropriate for professors to date students or for doctors to date their patients.
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And comments from Obama don't impress me. Let the law state, explicitly, that such consultations will, by statute, not be determinative. Otherwise, it's allowing the bureaucrats to make it so without so much as a vote. Though I think he's pretty much aware of that.
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Good luck figuring out what the law explicitly states about anything.. it was written by Tolstoy.
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The same baseless claims? Did you even read the responses in the corporate limitation thread?
As for your request, have you even read the segments in question?
All they say is that there will be funding for a doctor to "discuss" and provide "explanation". Where in discussing and providing explanation is there determination?
Please provide a single quotation from a bill that could be used in any way to justify the government making end of life determinations. Just one. They don't exist -- you can be sure the article you linked would have quoted one if they did. All the "evidence" for them being determinative in your article is quotations from other people opposed to the bill.
You can't just assert, "well, bureaucrats will make it happen!" That's a laughable assertion, and the courts would laugh at a bureaucrat who tried to use a section saying there would be a consultation involving discussion and explanation of choices as a way of determining whether further care would be given. Not every part of a bill can be used for anything. If that were the case, every bill ever written would have to declaim against the possibility of it being used to justify the government ending the life of another. Where's some real evidence?
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quote:Originally posted by fugu13: the courts would laugh at a bureaucrat who tried to use a section saying there would be a consultation involving discussion and explanation of choices as a way of determining whether further care would be given
I'll remind you that you said this. Though I'm sure that by that time, you'll have an excuse for why it's okay.
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Pixiest: Lisa is the one supporting the argument that the law will make it possible for physicians providing end of life consultation to choose whether or not to continue care, despite there being no such language in the bill, and statements by all involved in creating the bill that no such thing is intended or allowed by the language of the bill. Let her provide a shred of evidence that her position isn't a fantasy by actual language of the bill that could be interpreted to let the consultation be determinative. That part of the bills isn't even particularly difficult to read -- I've read it in several versions of the bill, and I ask now if she has.
Lisa, did you read the section of any bill that dealt with end of life consultancy before you started this thread? Even one?
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quote:Originally posted by Lisa: Fact: voluntary consulations don't get initiated by the doctor.
Please explain.
<blink> Uh... okay.
Calling that voluntary is dishonest. There's a power inequality that's the same thing that makes it inappropriate for professors to date students or for doctors to date their patients.
(It's like deja vu, all over again.)
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quote:I'll remind you that you said this. Though I'm sure that by that time, you'll have an excuse for why it's okay.
I don't much like the way the section has been phrased, myself, so I really doubt I'd think extending it to allow end of life consultants to make care decisions that are covered by insurance would be okay. In fact, I'm overall quite disappointed by the bills under consideration, so I really doubt I'll be cheering their results on.
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quote:Originally posted by fugu13: Pixiest: Lisa is the one supporting the argument that the law will make it possible for physicians providing end of life consultation to choose whether or not to continue care,
Not necessarily the doctors themselves. I'm sure the doctors will be put in the unenviable situation of having to give this bad news to the patients.
quote:Originally posted by fugu13: despite there being no such language in the bill, and statements by all involved in creating the bill that no such thing is intended or allowed by the language of the bill.
It's allowed. Damn, fugu, if it isn't specifically disallowed, how can you say it isn't allowed? That's what "allowed" means. I didn't say it was mandated; I said it was allowed. And sure as hell, when it's budget crunch time, what's allowed will be done.
quote:Originally posted by fugu13: Let her provide a shred of evidence that her position isn't a fantasy by actual language of the bill that could be interpreted to let the consultation be determinative.
That's not even slightly honest on your part. Show me any language in the bill that could be interpreted as barring having the consultations be determinative. You're handing a loaded handgun to a child and saying, "Well, I'm absolutely not telling the child to pull the trigger."
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quote:Calling that voluntary is dishonest. There's a power inequality that's the same thing that makes it inappropriate for professors to date students or for doctors to date their patients.
Lisa, it's inconsistent for a principled libertarian like yourself to claim that something like a "power inequality" can make an action involuntary.
If a disparity in power between parties to a decision (eg a contract) can remove the libery of one of those parties, then all of a sudden we have a situation where removing power disparities (like disparities in wealth) can increase liberty. And according to the libertarian, that's impossible.
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It occurred to me later that was your version of an explanation. Is it inappropriate for a professor to suggest that a student attend a (voluntary) review session?
quote:Originally posted by Lisa:
quote:Originally posted by natural_mystic:
quote:Originally posted by Lisa: Fact: voluntary consulations don't get initiated by the doctor.
Please explain.
<blink> Uh... okay.
Calling that voluntary is dishonest. There's a power inequality that's the same thing that makes it inappropriate for professors to date students or for doctors to date their patients.
posted
What I wrote above is too compressed to be clear, so let me elaborate.
According to me, it's possible to violate someone's liberty by offering them a contract in a situation where they are at a deep disadvantage. For example, if you are starving and I offer to sell you food at unreasonable prices, you don't have a choice about whether to accept. When you accept my offer, you lack a degree of liberty that you would otherwise have if you weren't starving and poor. In this way, entitlements (taking some money/food from me and passing it on to you) can increase your liberty.
The strict libertarian perspective must be that all this is complete bunk, because otherwise taxation for entitlements would be acceptable (and sometimes mandated) on libertarian grounds. The best place to disagree with my reasoning above, it seems to me, is to claim that your choice to buy my food or not is equally voluntary whether or not you're starving. In short, freedom can't be lessened by social or economic inequality. It seems to me that the libertarian has to believe this.
It comes in at a minor point in your own reasoning, compared with the overall scope of the health care debate. But all the same, I don't think it's consistent for you to say that being presented with a health care option by your doctor can make that option any less voluntary due to the power gap.
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Yes, I can point to specific language. The language that specifies what the consultations will consist of. The word "determine" does not exist, nor any synonym of it. If I say doctors are allowed to tell patients what options they have for pain medication, does that mean I am allowing doctors to decide whether or not to assist the suicide of the elderly?
Furthermore, it specifically mentions the consultation is so that the individual can make decisions about what they want to do. Funny that, if the measure is supposed to let the government make that decision (despite saying absolutely nothing of the sort).
Again, what in the language that people shall be told about ways people deal with end of life situations mean the government will decide for people? After all, since the government is paying for the insurance, in your fantasy land I am surprised it makes a difference whether the language saying people will be told.
What's really funny is you seem so sure Obama is set on the measure, but his administration has already abandoned the language.
Destineer: we already know Lisa isn't a libertarian. She's supported the government preventing private housing associations from setting rules for what can be posted on door posts, and has supported a measure that would ban groups of people from voluntarily agreeing to have shares of businesses that existed for too long.
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Finally, what is the difference between the Government deciding who's quality of life is worth paying for and Insurance Companies? You fear that the Government will decide via politics, who should live and who should die. Insurance Companies are already doing this, but via Social Class--or more accurately--who can afford to live and who can not--can die.
If I, as a voter, discover that my government is not behaving fairly in its decisions on who gets paid health benefits and who doesn't, I can vote them out of office.
If I as the insured, discover that my Insurance Company is not behaving fairly in it decisions on who gets paid health benefits and who doesn't, I can...change insurance companies? No, since that decision is usually made by my employer. I can try to convince my employer to change insurance companies? Not a lot of leverage there for what is a life and death matter for me.
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quote:Calling that voluntary is dishonest. There's a power inequality that's the same thing that makes it inappropriate for professors to date students or for doctors to date their patients.
Lisa, it's inconsistent for a principled libertarian like yourself to claim that something like a "power inequality" can make an action involuntary.
The example was given because it would be understood (I hoped) by others. But in this case, where the power is governmental, the inequality is certainly there. The government has a monopoly on the legal use of coercion.
But beyond that, you fundamentally misunderstand some things about libertarianism. I don't think there should be laws, for example, forbidding someone for firing an employee for being gay. That doesn't mean I don't think that such a person is a bigoted a**hole. I do.
The fact is, a doctor does have a power imbalance relative to his patients. That doesn't mean that there should be laws forbidding doctors from dating their patients (and I have no idea if there are such laws, or if it's only the government sponsored monopoly of the AMA that forbids it -- not that it's such a big difference), but for the government to essentially mandate that doctors broach this with their patients is both a violation of the rights of the doctor and of the patient.
Government is not a person. It doesn't have any rights. Not to life, not to liberty, not to the pursuit of happiness. You can't compare what a government does to what a person does. Not when you're giving the government perogatives that individuals don't have.
quote:Originally posted by Destineer: If a disparity in power between parties to a decision (eg a contract) can remove the libery of one of those parties, then all of a sudden we have a situation where removing power disparities (like disparities in wealth) can increase liberty. And according to the libertarian, that's impossible.
Wrong. In fact, encouraging the removal of power disparities actually can increase liberty. Such encouragement can be the result of persuasion or withholding commerce. All non-coercive activities. Because you don't increase liberty by taking away liberty.
I think that's the biggest problem with statists. They think that if X is wrong, X needs to be illegal. "There oughta be a law!" Hell, they should use that as a slogan on our money. It's certainly a better representation of the current mindset in this country than anything else.
Coercing the changes you want is a shortcut. A moral shortcut. It will always be wrong.
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quote:Originally posted by Lisa: The fact is, a doctor does have a power imbalance relative to his patients. That doesn't mean that there should be laws forbidding doctors from dating their patients (and I have no idea if there are such laws, or if it's only the government sponsored monopoly of the AMA that forbids it -- not that it's such a big difference),
The AMA?
If you are going to sit here and describe a voluntary organization representing less than 2 out of 10 practicing physicians in the united states as a "government sponsored monopoly" then it really doesn't bode well for the assumption that you can at all display any sane or measured appropriation of this issue.
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I am having some trouble envisioning these death panels actually working. I go to the doctor, he says, sorry, your quality of life is so low, it isn't worth treating you. Go sit in a corner and die. And then, since it is only my life, I do that.
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Yet again Lisa, you forgo any actual thinking on your own to quote someone else as if the mere introduction of his voice stands for your contribution to the debate.
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I find anyone who characterizes De-Privatized Health Care as 'scary' impossible to take seriously because I have it, and it's not scary.
I think people like that think that everyone living with Public Health Care must be incredibly stupid.
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quote:Originally posted by scholarette: I am having some trouble envisioning these death panels actually working. I go to the doctor, he says, sorry, your quality of life is so low, it isn't worth treating you. Go sit in a corner and die. And then, since it is only my life, I do that.
You would be sent home, and told to report to your local hospital on the first or the fifteenth of the next month, whichever comes first. On that day you would be euthanized by injection, directed by an order from the President himself.
--j_k, who actually did read that online somewhere
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quote:Originally posted by Teshi: I find anyone who characterizes De-Privatized Health Care as 'scary' impossible to take seriously because I have it, and it's not scary.
I think people like that think that everyone living with Public Health Care must be incredibly stupid.
My british buddies think that we're being hilarious but also offensively stupid. Apparently their system sucks really bad (despite working better than ours) and kills them (despite the fact that they live longer healthier lives despite having higher incidence of obesity) and it costs them so much (or half as much as ours whatever) and it's terrifying and they have to flee to America to get good health care (apparently they do this in their sleep and are not aware of it) and they hate it (but don't realize it yet) because of the death panels (which presumably exist, I guess, if a bunch of paranoid americans say so, it must be true) and the liberals want to make our system just like theirs (because there is apparently no difference between nationalized health care and a single-payer system)
no really.
we're laughingstocks to them right now.
They are amused by this when they don't find it uncomfortably juvenile behavior for a national populace.
I'm not even joking. We're a comedy routine to the other modern nations.
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I've seen them mentioned not only on the news, but referred to on shows from House to Scrubs.
Its that politically degenerate organization that is involved with organ donation.
If you have multiple diseases, or are a drug addict, you are low on the list for available organs such as Kidneys and Hearts.
And that is so biased. I mean, should it matter that a 90 year old man with three different forms of Cancer loses his place in line for a new heart to some 16 year old boy who needs it? That is just Age-ism. It is just wrong. And we should investigate this organization because it is likely that the 90 year old man was a conservative Republican, and the 16 year old kid may grow up to be a Democrat. Obvious political bias.
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I know Nat Hentoff, like him and - as just about anyone who reads his columns feels - don't always agree with him. This would be one of those times. Not that I don't have concerns about advance directives (some of the ones I've seen are dreadful - check off the box phrased along the lines of "you wouldn't want to live like this would, you?") Others are phrased in more neutral terms, and make careful distinctions between long-term and short-term interventions. Which one will a person be presented with? Who knows?
But that's a nuanced discussion - and the political climate and the media don't seem to favor that.
Anyway, here's an illuminating column on "death panels" that highlights some of the issues that should be getting more airing right now:
quote:Columnist Froma Harrop's experience with a "death panel" involved her husband, who had cancer. It didn't involve a government bureaucrat. It was run by their private insurer, and the experience was not a pleasant one.
Syndicated columnist
"Death panels"? I'll tell you about death panels. My husband faced one some years ago, and it didn't involve any government bureaucrat. It was run by our private insurer, the sort of corporate entity that foes of health-care reform say will give you anything you want.
My husband was diagnosed with liver cancer. We were "insured" by United Healthcare. The deal was as follows: You had to use doctors on its list, but if you needed specialized care outside the network, United's health-maintenance organization would pay for it. Fair enough.
A liver expert within the network said point blank that for my husband's case, there was but one place to go, a specialized chemotherapy program at Deaconess Hospital in Boston. Fortunately, it was only 50 minutes away.
But United Healthcare refused to pay for it. Instead, it directed us to a small, local hospital unequipped to deal with this kind of cancer. Our liver specialist warned, "Don't waste your time."
We naively tried to go through United Healthcare's appeals process. We would call the number and speak to a handler who said our case would be reconsidered. Days later, a one-sentence letter would arrive by slow mail saying that we were being denied, but call this number to challenge the verdict.
Around and around we went. We could never speak to anyone making the decisions. No one would even talk to our doctor, who at one point whispered to us, "Mortgage the house."
I became convinced that the insurance company was trying to run out the clock on my husband's life.
quote:Originally posted by Lisa: The fact is, a doctor does have a power imbalance relative to his patients. That doesn't mean that there should be laws forbidding doctors from dating their patients (and I have no idea if there are such laws, or if it's only the government sponsored monopoly of the AMA that forbids it -- not that it's such a big difference),
The AMA?
If you are going to sit here and describe a voluntary organization representing less than 2 out of 10 practicing physicians in the united states as a "government sponsored monopoly" then it really doesn't bode well for the assumption that you can at all display any sane or measured appropriation of this issue.
I figured that out just by looking at who started the thread.
Which is too bad, because at this point even if Lisa had something relevant to say, I'd probably not pay any attention. I usually just skip her posts because according to her, anyone who believes what I do is a horrible, ignorant, disgusting person.
quote:There are death panels: the insurance industry runs them:
I can't believe people don't realize this.
These people are trying to convince us that if we reform our healthcare we will have these "death panels" — ones that will let you die if they think they can get away with it in order to maintain profit by exploiting loopholes or a bad filling of a single application document — and the supreme irony is that we have them and the national systems we are so terrified of do not have them.
The conservatives and the libertarians who are the most hysterically afraid of these death panels are doing everything in their power to ensure that we keep them.
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Not to mention that the cost of healthcare for an individual ALREADY imposes rationing on us.
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Also, the people currently in charge of these decisions honestly tried to claim my pregnancy as a pre-existing condition starting over a year before I conceived. So, not only are they greedy, they are also idiots. That or I am an elephant.
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quote:Originally posted by scholarette: Also, the people currently in charge of these decisions honestly tried to claim my pregnancy as a pre-existing condition starting over a year before I conceived.
hahahahahahahahahahaha
It's like knife-stuck-in-head guy on the daily show.
"Well, they called it a pre-existing condition. Apparently, knives have been around long before my head was."
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quote:Originally posted by Lisa: Coercing the changes you want is a shortcut. A moral shortcut. It will always be wrong.
What about if the change I want is something like putting murderers and thieves in prison? You can't do that without coercion.
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quote:The example was given because it would be understood (I hoped) by others. But in this case, where the power is governmental, the inequality is certainly there. The government has a monopoly on the legal use of coercion...
The fact is, a doctor does have a power imbalance relative to his patients. That doesn't mean that there should be laws forbidding doctors from dating their patients (and I have no idea if there are such laws, or if it's only the government sponsored monopoly of the AMA that forbids it -- not that it's such a big difference), but for the government to essentially mandate that doctors broach this with their patients is both a violation of the rights of the doctor and of the patient.
I don't think I'm picking up on a distinction you seem to be drawing here. If there's a power imbalance between the doctor and patient, doesn't that mean it's coercive for the doctor to proposition the patient?
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quote:Originally posted by Teshi: I find anyone who characterizes De-Privatized Health Care as 'scary' impossible to take seriously because I have it, and it's not scary.
I think people like that think that everyone living with Public Health Care must be incredibly stupid.
Do you really want a health care system like *frightened whisper* Canada?
Yes, yes I do. I like it very much. It's not perfect but no one can deny me basic insurance because of a pre-existing condition. The lack of health care is one big reason I never even considered going to the States for grad school.
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quote:The example was given because it would be understood (I hoped) by others. But in this case, where the power is governmental, the inequality is certainly there. The government has a monopoly on the legal use of coercion...
The fact is, a doctor does have a power imbalance relative to his patients. That doesn't mean that there should be laws forbidding doctors from dating their patients (and I have no idea if there are such laws, or if it's only the government sponsored monopoly of the AMA that forbids it -- not that it's such a big difference), but for the government to essentially mandate that doctors broach this with their patients is both a violation of the rights of the doctor and of the patient.
I don't think I'm picking up on a distinction you seem to be drawing here. If there's a power imbalance between the doctor and patient, doesn't that mean it's coercive for the doctor to proposition the patient?
My best guess is that Lisa's drawing some distinction between government-derived power imbalances and other types. It's hard to tell, though, as her post is short on actual argument and long on libertarian platitudes.
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