Why ‘death panels’ are a necessary evil

Source: http://www.visualeconomics.com

Source: http://www.visualeconomics.com

Controlling health-care costs, not just in government programs but throughout the American economy, is essential to a prosperous future. As the chart above illustrates, we already spend considerably more on health care as a percentage of our GDP than any other industrialized nation, and with the Baby Boom generation about to retire, those numbers are almost certain to climb.

The health-care debate, then, is not merely a debate over who will pay for it and how. It is also a debate over who will control costs and how.

U.S. Rep. Paul Ryan and his GOP colleagues prefer to use economic scarcity as their rationing agent. And the truth is, a purely capitalistic system, driven solely by profit considerations, perhaps could control costs to a degree. But it would do so only by ignoring issues of humanity, morality, justice and fairness — considerations that pure capitalism is not equipped to handle, but that are inherent in matters that are literally life and death.

Under the GOP approach, health insurance and the health care it provides would be available only to those who can afford to buy it, with private insurance companies making the necessary decisions to deny coverage of certain patients or procedures. Government efforts to inject humanity and justice into that for-profit system, either through laws or regulation, would be barred on the grounds that they would also inject inefficiency, which they undoubtedly would.

They also propose to dismantle Medicare, replacing it with a system in which senior citizens would be provided with a voucher to allow them to purchase that private insurance.
Over time, that voucher by design would cover less and less of their insurance costs, making them more and more vulnerable to economic pressures, which is how Ryan “bends the curve” of Medicare expenditures.

In his recent speech on the deficit, President Obama proposed the alternative of relying on the Independent Payment Advisory Board, a panel of 15 experts created under ObamaCare to recommend ways to control Medicare costs. By law, the panel is prohibited from recommending health-care rationing; its role is simply to find the most cost-effective approaches to health care, with Congress given the power to override its decisions.

Inevitably, that proposal revived talk of “death panels.” It’s an emotionally powerful phrase, but only because it strips things down to uncomfortable truth: Death panels exist, they will exist in any conceivable system of health-care delivery, and we all know they are necessary but prefer to ignore it.

Somebody has to say no to the terminal patient who refuses to acknowledge that he or she is terminal and demands hopeless if expensive treatment. Somebody has to have the power to rule that Procedure A or Drug A is more cost-effective than Procedure B or Drug B, despite the fact that Procedure B or Drug B has a strong lobby. Even Heaven has a gatekeeper.

But it’s too easy to try to deny that reality. As the New York Times reports, Ryan is now complaining that under Obama’s proposal, the panel would have the power to “impose more price controls and more limitations on providers, which will end up cutting services to seniors.” That’s pretty rich, considering what Ryan’s own plan has in mind for seniors.

But some Democrats are no better on the issue. The Times also quotes Rep. Allyson Y. Schwartz, D-Pa., who like Ryan wants to legislate the payment advisory panel out of existence but for very different reasons:

“It’s our constitutional duty, as members of Congress, to take responsibility for Medicare and not turn decisions over to a board. Abdicating this responsibility, whether to insurance companies or to an unelected commission, undermines our ability to represent our constituents, including seniors and the disabled.”

Great. Congress sitting as the death panel. I wonder how that one’s going to work out?

Hospitals, doctors and other industry interest groups also oppose the IPAC, which itself tells you something about its potential impact. They see it as a threat to their bottom line, which of course it must be if it’s to be effective. For example, the head of the American Health Care Association, representing nursing homes, said that his group opposes the panel because it would allow Congress and the president to “subcontract out difficult decisions.”

In other words, the panel couldn’t be lobbied as effectively as Congress, which is exactly the point in creating it.

Again, somebody has to be the gatekeeper. Patients lack the knowledge to do so and confronted by death or illness are not capable of self-rationing. The medical industry won’t do it; it has a considerable economic incentive to keep throwing treatment at a patient as long as the bills are being paid.

Private industry will do it, but only if we are willing to submit ourselves and our loved ones to its not-so-tender and arbitrary mercies. And Congress? Please no.

In the end, while a panel of experts has problems and drawbacks of its own, it is also the approach most likely to find that difficult balance between efficiency and humanity.

– Jay Bookman

568 comments Add your comment

Southern Comfort (aka The Man)

April 20th, 2011
10:31 am

Congress sitting as the death panel.

:shock:

We’re all focked!!!!!

Keep Up the Good Fight!

April 20th, 2011
10:31 am

In a “lesser of all evils” choice, this appears the better decision but far from ideal.

Bosch

April 20th, 2011
10:34 am

Good article Jay — truth is, we are all gonna die.

Jimmy62

April 20th, 2011
10:35 am

Geez, and according to Obama and most of the left (probably Jay, too), there are no such things as death panels, and Palin is a liar.

Turns out, she was just being more honest about it. It’s one thing to say death panels are necessary, I am happy to discuss that. But it was another thing for you dishonest lefties to act like Palin was crazy, and now come back and admit it was all true.

jm

April 20th, 2011
10:35 am

I think I’ve concluded we need socialized well managed medicine for those who can’t afford it, and let everyone else work on their own. In other words, revamped Medicaid where Medicaid actually hires the docs (like with the VA system) and the government elects to do whatever it will and will not cover (with a lot of attendant risks with that). Meanwhile, everyone else who can afford healthcare can acquire market based coverage on their own through the exchanges.

Bosch

April 20th, 2011
10:35 am

Somebody has to say no to the terminal patient who refuses to acknowledge that he or she is terminal and demands hopeless if expensive treatment. Somebody has to have the power to rule that Procedure A or Drug A is more cost-effective than Procedure B or Drug B, despite the fact that Procedure B or Drug B has a strong lobby. Even Heaven has a gatekeeper.

Oh and Bravo for this paragraph.

Bosch

April 20th, 2011
10:36 am

“she was just being more honest about it.”

Oh please Jimmy — her rhetoric was absurd.

El Jefe

April 20th, 2011
10:37 am

Let me get this straight – when Sarah Palin denounced “Death Panels” the left ridiculed her. Now the lefties are saying there will be “Death Panels”?

So, I guess Sarah was right all along and this administration lied to us.

Southern Comfort (aka The Man)

April 20th, 2011
10:37 am

Jimmy

There is no “Death Panel”. That panel would basically tell someone to go eat a banana and die. The board chooses whether or not a medical treatment is cost effective. That doesn’t always equate to someone dying as there may be a less expensive alternative.

jm

April 20th, 2011
10:38 am

“the Independent Payment Advisory Board” will accomplish very little.

CJ

April 20th, 2011
10:38 am

Without acknowledging that Republicans are capitalists, they’re not, the capitalist argument for health care doesn’t work for another reason not frequently mentioned: lack of choice.

In a pure free market, the buyer can choose to purchase a service from one of several vendors or choose not to purchase the service. That doesn’t work with health care. A rational person could never choose not to purchase health care services.

In a pure free market, the buyer can choose to give up quality for a lower price. That doesn’t work with health care. A rational person could never choose inferior health care services, regardless of the savings.

Anytime, somebody tells you that the market will drive down health care costs, ask them to call around to see how much each emergency room charges for a heart attack and then get back to you.

Bosch

April 20th, 2011
10:39 am

” I guess Sarah was right all along ”

Um no El Jefe – she wasn’t:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.– Sarah Palin

El Jefe

April 20th, 2011
10:39 am

Bosch,

Well played – leftie

Very astute observation. When you can’t counter the claim, ridicule the source. Very mature.

martin the calvinist

April 20th, 2011
10:41 am

Number one, Palin said there were death panels in Obama care but she was ridiculed. Now liberal writers such as Tucker and Bookman are advocating such entities. To quote Doc Holliday, you’re hypocrisy knows no bounds!

With that being said, it isn’t the governments business determining what treatments a patient should or shouldn’t have, it’s the patient and the family. Not some government bureaucrat! If the person paid their premiums and purchased their insurance, they should have final say. Yes I understand there are limits placed in insurance plans, that’s why you should read the plan before you purchase it.

jm

April 20th, 2011
10:41 am

If the “death panel” focuses on making the rational application of procedures (ie, denying procedures to those that are terminally ill), then the DP will bend the cost curve. If it focuses on “price controls”, it will accomplish nothing more than cost shifting.

I think the DP, ultimately a political animal, will try to use price controls instead of “rational care”, which means it will accomplish little. We’ll see.

Bosch

April 20th, 2011
10:41 am

El Jefe,

I just did counter the claim — her version of “death panels” was way off mark.

Normal

April 20th, 2011
10:43 am

Well,
I guess that it will end up with a doctor writing a perscription for a pistol and one bullet…

Southern Comfort (aka The Man)

April 20th, 2011
10:43 am

Very astute observation. When you can’t counter the claim, ridicule the source. Very mature.

Pot meet kettle…

How does “my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society” equate to deciding whether a medical treatment is cost effective? Productivity in society has about as much to do with medical treatment costs as the GOP has to do with sponsoring gang initiations in Compton, CA.

jm

April 20th, 2011
10:43 am

The panel is going to be lobbied anyway. We’ve just added the watchers to watch the watchers that watch the watchers…..

No amount of watching is likely to fix the problem as much as actual self interest would. And I understand the attendant hardships that would accompany that. .

Kamchak

April 20th, 2011
10:43 am

Oooooooh, a chart.

Death panels have existed for decades.

Wonder why nobody got poutraged until now.

ty webb

April 20th, 2011
10:44 am

“The medical industry won’t do it; it has a considerable economic incentive to keep throwing treatment at a patient as long as the bills are being paid.”

Good point Jay. Reminds me of the great Henny Youngman Joke:

“A doctor gave a man six months to live. The man couldn’t pay his bill, so he gave him another six months.”

Jimmy62

April 20th, 2011
10:44 am

If you read Jay’s column, he CLEARLY calls them death panels. And he’s right. That doesn’t mean it’s a bad idea, but let’s call a spade a spade.

Public relations used to be called propaganda, but they changed the name to make it more palatable. Calling these anything other than a death panel is just finding a way to make it more palatable. And that’s not necessarily a bad thing. The bad thing is the ridiculous way Sarah Palin gets bashed, but here Jay is calling them death panels, too, and y’all are all patting him on the back.

CJ

April 20th, 2011
10:44 am

I wrote my last paragraph without the explanation.

In a pure free market, buyers could compare prices for services. That doesn’t work with health care. No matter how transparent health care providers become, for major or catastrophic care, comparing prices is nearly impossible.

I’m more of a capitalist than the faux-capitalists who represent the Republican Party. But I’m a capitalist where capitalism can work. When it comes to health care, capitalism can’t work. Impossible.

Bosch

April 20th, 2011
10:45 am

“Productivity in society has about as much to do with medical treatment costs as the GOP has to do with sponsoring gang initiations in Compton, CA.”

Damn SoCo, that was my last sip of coffee too….

jm

April 20th, 2011
10:45 am

Bosch 10:34 – morbid. The question is, how well will we get to live as a society before we die?

Southern Comfort (aka The Man)

April 20th, 2011
10:46 am

Jimmy

I think there is a difference in calling something a death panel versus calling it a “death panel”. One would be an outright label, but putting it into quotes could be taken as a sarcastic remark. Ask Jay exactly what he means before you go trying to put words into his mouth. I’m sure he’ll answer your question.

Left wing management

April 20th, 2011
10:46 am

jm: “The question is, how well will we get to live as a society before we die?”

Who’s “we” ?

jm

April 20th, 2011
10:46 am

And if you put Singapore on there, its even more amazing.

Oh yes, and this highlights a point, we’re in the middle of a health care bubble perpetuated by the federal government. Government tends to create bubbles, how sad.

Jefferson

April 20th, 2011
10:47 am

Health care should be as simple as a payroll tax paid by both sides.

Southern Comfort (aka The Man)

April 20th, 2011
10:47 am

Bosch

My bad. :oops:

TaxPayer

April 20th, 2011
10:48 am

Republicans prefer to simply allow the free market to price the ill out on the streets to be run over by their buses. That way their hands are “clean.” No death panels. The people were FREE to decide whether or not to fall under the GOP bus. :roll:

Bosch

April 20th, 2011
10:48 am

“The bad thing is the ridiculous way Sarah Palin gets bashed,’

No, Jimmy not really — back during the HC debate — I for one, was in no way under the impression that death panels did not already exist — as Kamchak has pointed out, most of us know decisions like this have been made for decades.

It was her description that was ridiculed. No panel would actually grant or deny services due to their “level of production in society.”

Bosch

April 20th, 2011
10:49 am

“The question is, how well will we get to live as a society before we die?”

Well jm, that’s totally up to you now isn’t it?

Midori

April 20th, 2011
10:49 am

Southern Comfort: substituting for md

April 20th, 2011
10:50 am

The question is, how well will we get to live as a society before we die?”

Well jm, that’s totally up to you now isn’t it?

The choice is yours…

CJ

April 20th, 2011
10:51 am

JB: “Great. Congress sitting as the death panel. I wonder how that one’s going to work out?

We know the answer to that. Look at Arizona: “Patient Cut From Transplant List Dies…30 Arizonans will die this year because of the state’s decision to cut certain transplants.” http://www.cbsnews.com/8301-504763_162-20027668-10391704.html

jm

April 20th, 2011
10:51 am

LWM 10:46 – everyone in our country

Peadawg

April 20th, 2011
10:52 am

“Somebody has to say no to the terminal patient who refuses to acknowledge that he or she is terminal and demands hopeless if expensive treatment. Somebody has to have the power to rule that Procedure A or Drug A is more cost-effective than Procedure B or Drug B, despite the fact that Procedure B or Drug B has a strong lobby.”

So the United States gov’t and this panel of 15 “experts” are going to play God now? No thanks.

jm

April 20th, 2011
10:52 am

“Well jm, that’s totally up to you now isn’t it?”

Not as long as the government is involved.

TaxPayer

April 20th, 2011
10:52 am

The question is, how well will we get to live as a society before we die?”

Well jm, that’s totally up to you now isn’t it?

The choice is yours…

And there’s excuses. Don’t forget the excuses.

ty webb

April 20th, 2011
10:53 am

“No panel would actually grant or deny services due to their “level of production in society.”

Fair point Bosch, just wondering what you think about this “train” that granny is going to be thrown under by the GOP and their plans for medicare?

Southern Comfort (aka The Man)

April 20th, 2011
10:53 am

off topic:

Seems like the market is really worried about ths S&P thingie. An hour and a half in and it’s up 1.5% so far.

Left wing management

April 20th, 2011
10:53 am

El Jefe: “So, I guess Sarah was right all along and this administration lied to us.”

C’mon now, subtle thinking required here. Better sit down so you don’t break something.

Of all the things that were said during the health care debate, what Sarah said was the one thing that was a venomous, outrageous, whopping lie from start to finish, precisely because it presupposed that there’s a way around “death panels” in a society with a modern health system and that her way, the GOP way, the status quo in effect, was the only way to avoid that. She cried “death panel!” to divert attention from the fact that the one sure way to one colossal death panel, the Mother of All Death Panels, is the Status Quo of health care left to the ravages of the markets, which the GOP is just fine with.

You follow, chief?

jm

April 20th, 2011
10:53 am

Peadawg 10:52 – just a question of which God…..

I personally don’t think a panel will do a great job, but I’m all for it if they’re restricted to helping the destitute and only get to make volume decisions, not pricing decisions.

Mick

April 20th, 2011
10:54 am

The more I read about health care in the future, the more I’m motivated to exercise daily and focus on a good diet. Then, pray by the grace of god that cancers, accidents, and other assorted malady’s stay clear of my path.

jm

April 20th, 2011
10:54 am

SoCo 10:53 – intel earnings. Plus the Savego plan.

eddie

April 20th, 2011
10:55 am

Enter your comments here

Bosch

April 20th, 2011
10:56 am

SoCo substituting for md,

That was hilarious. She would be so proud of you!

getalife

April 20th, 2011
10:56 am

Ending Medicare is one huge de ath panel.

ty webb

April 20th, 2011
10:56 am

and wouldn’t “Death Commission” be a better name…or better yet, “Bipartisan Death Commission”.

TaxPayer

April 20th, 2011
10:57 am

So the United States gov’t and this panel of 15 “experts” are going to play God now? No thanks.

Fifteen experts trumps 5 to 10 political hacks, depending on the year, with the same power.

Mick

April 20th, 2011
10:57 am

bosch

md is a she?

eddie

April 20th, 2011
10:58 am

And I’d really trust the gov’t to appoint people (their experts) to the death panel….sarcasm off. Maybe Van Jones could be one of O’s experts since he is a czar looking for throne.

Bosch

April 20th, 2011
10:58 am

ty,

What train? :-)

Jay

April 20th, 2011
10:58 am

“Government tends to create bubbles, how sad.”

That’s silly, jm.

Bubbles have been inherent in the capitalist system since its inception.

Southern Comfort (aka The Man)

April 20th, 2011
10:59 am

jm

I think its other things. The US didn’t get to be the #1 economy by being cautious gummi-spined investors. We think, act, and dream big. We just need to get the 535 to understand that this is one situation where partisan politics need to be squashed and jackassery should be relegated to the National Association of Donkey Breeders.

Bosch

I follow and agree for the most part with the choices ideology. There’s a good bit of truth to it. :)

getalife

April 20th, 2011
10:59 am

SC pretending to be a doctor too like md?

I am not a doctor but I played one on a blog.

Zedd

April 20th, 2011
10:59 am

So now the shoes on the other foot and now the lefties are decrying a need for death panels after ridiculing the right for saying they would exist under Obamacare. The hypocrisy is blinding, but right on que. I would expect nothing less from the likes of Bookman. “Somebody has to say no to the terminal patient who refuses to acknowledge that he or she is terminal and demands hopeless if expensive treatment. Somebody has to have the power to rule that Procedure A or Drug A is more cost-effective than Procedure B or Drug B, despite the fact that Procedure B or Drug B has a strong lobby. Even Heaven has a gatekeeper.” The only people that need be involved in making critical health care decisions is the patient and the doctor, definitely not any government appointed agency. End of story! The fact that the Democrats continue to lie about the Republican plan doing away with Medicare for the elderly is nothing but fear mongering plain and simple. The Republican proposal changes nothing for those that are 55 or older, but it’s the same old Democrat lies about how the Republicans are trying to kill granny off.

Lil' Barry Bailout

April 20th, 2011
10:59 am

Death panels exist, they will exist in any conceivable system of health-care delivery, and we all know they are necessary but prefer to ignore it.
——–

False. In a free market everyone purchases all the health care they want. It is only when government interferes that prices get out of control.

Jay

April 20th, 2011
11:00 am

“So the United States gov’t and this panel of 15 “experts” are going to play God now? No thanks.”

Fair enough, Peadawg. So who do YOU nominate for the job?

Finn McCool

April 20th, 2011
11:00 am

The death panel has been made up of insurance people in the past. Do you think that is better than what the govrnment can come up with?

The insurance company’s bottom line is what’s important to them, not you or your grandma. What will save them the most? What allows them to keep the greatest share of granny’s premiums she paid in?

Left wing management

April 20th, 2011
11:01 am

jm: “LWM 10:46 – everyone in our country”

Which is precisely what is being thwarted from happening by the GOP’s dogmatic adherence to an ideology of market purity in this matter.

If we’re truly interested in EVERYONE living well, we’ll move decisively towards a plan that offers truly universal coverage.

Bosch

April 20th, 2011
11:01 am

Mick,

I’m pretty sure of that fact, but I could be wrong.

SoCo @ 10:59

Oh yeah, me too — existentialism is cool….but the only problem is that there is theory and then there is reality — and while we do all make our own decisions, we don’t all start at the same place and have the same resources, and we all can’t be hedge fund managers. ;-)

Bosch

April 20th, 2011
11:02 am

“So now the shoes on the other foot and now the lefties are decrying a need for death panels after ridiculing the right for saying they would exist under Obamacare.”

Is it just me, or is the point just whizzing past the wingnuts her today?

Mick

April 20th, 2011
11:03 am

bosch@11:01

Great caesars ghost!!

Comrade

April 20th, 2011
11:03 am

Mr. Bookman: You need to relocate to California. Any city in California will fit your socialist and communist beliefs. You will have the opportunity to pay very high taxes and be regulated at work and at home. Also, if we have a panel of men to decide who lives and who dies, are you willing to submit yourself and any of YOUR family members to such a “panel of experts?” I already don’t trust the government and insurance companies, and you want to add a panel of so called experts. You have go to be joking.

(ir)Rational

April 20th, 2011
11:03 am

So the Congress and this panel are left to play god. It doesn’t matter whom you refer to as god, they get to play them all. I don’t trust Congress or any panel enough to decide my fate for me. As far as death panels go, would this only be for government subsidized health insurance, private insurance, or would they control how much of my personal wealth I got to spend on health care? And I know this is probably just me being a crazy right winger here, but I can see the government making the decision that I’ve spent enough of my own money on keeping myself alive, and telling the doctors to pull the plug while I still have enough money left in my bank account for them to tax after I’m dead. No matter how much we try and regulate it, the government is always going to act in the best interests of the government, or those governing. If being able to take more of my money after I’m dead than they would be able to take from a hospital that I paid it to while I’m alive serves them better, don’t think they wouldn’t figure out a way to do it.

Oh, and I changed my name because so many of you seem to think that I am irrational.

Bosch

April 20th, 2011
11:03 am

Here today, not her today…

Mr. Holmes

April 20th, 2011
11:03 am

There is an excellent case to be made that a single-payer health care system helps ensure a more pure form of capitalism. Counter-intuitive, yes, but consider: Laissez faire capitalism is analogous to economic Darwinism, is it not? Survival of the (marketplace) fittest?

Until relatively recently, the quality of human medicine did not significantly tip the socioeconomic scales. Yes, there have always been public health considerations that ensured longer, healthier life: diet & exercise. But, famines aside, I’m guessing diet-related health problems did not vary up and down the socioeconomic too much until relatively recently. Same with the state-of-the-art in medicine.

But now things are different. Modern medicine can *significantly* prolong life, and the more expensive the care, the greater its effect. This is a cheat on the invisible hand; the markets themselves no longer are the sole determinant of financial success. Now the human factor of improved health care plays a much greater role–indeed, it artificially influences the market. It simply cannot be argued that everyone has an equal or even near-equal chance.

Imagine a pill invented tomorrow that could double the human lifespan, including quality of life (i.e., 40-year-olds with the health & fitness of 20-year-olds, 80 as the new 40, etc.). But the pill cost $10 million per dose and could only be administered within the first year of life to be effective. How would the U.S. health system handle that? Would government step in & provide the pill to all, or would the rich now live twice as long as the rest of us? Who in their right mind would consider that last scenario “fair,” in terms of market capitalism?

That’s an exaggeration of the current reality. More equal access to health care equals a more equal playing field and the chance for everyone’s innate talent, smarts and perseverance to determine their success. What true-blue capitalist could argue with that?

Kamchak

April 20th, 2011
11:03 am

So who do YOU nominate for the job?

John Galt, Dagny Taggart, Henry Reardon, Howard Roark, or Dominique Francon would be my guess.

Peadawg

April 20th, 2011
11:04 am

“Fair enough, Peadawg. So who do YOU nominate for the job?”

The job of making critical health decisions about a patient? I would say the patient, they’re family, and the patient’s doctor. Certainly not some panel of “experts” appointed by Congress of the President.

Lil' Barry Bailout

April 20th, 2011
11:04 am

Further, it is only when government interferes with the free market that supply is controlled.

Bottom line: government interference f’s up health care.

getalife

April 20th, 2011
11:04 am

Our death panels are the insurance companies and the gop trying to end Medicare.

Fact.

I have spent too much time in our health care system and the only problem is the bills.

As the Presidential candidate that dresses like a penguin said, the bills are too da mn high.

larry

April 20th, 2011
11:05 am

Have just gone through this with an uncle who is termanally ill, it was the doctor and the patient who decided that no more treatment was neccessary. He was on Medicare and private retiree insurance but it was the doctor and my uncle who made the decision.

Personally , i think the term ” Death Panels” is a wee bit overblown myself.

Keep Up the Good Fight!

April 20th, 2011
11:05 am

Ohhhh…..are we taking applications for blog god now? Perhaps whoever wrote this job ad can take on the posting of the ad:

We want to add some talent to the Sarasota Herald-Tribune investigative team. Every serious candidate should have a proven track record of conceiving, reporting and writing stellar investigative pieces that provoke change. However, our ideal candidate has also cursed out an editor, had spokespeople hang up on them in anger and threatened to resign at least once because some fool wanted to screw around with their perfect lede.
We do a mix of quick hit investigative work when events call for it and mini-projects that might run for a few days. But every year we like to put together a project way too ambitious for a paper our size because we dream that one day Walt Bogdanich will have to say: “I can’t believe the Sarasota Whatever-Tribune cost me my 20th Pulitzer.” As many of you already know, those kinds of projects can be hellish, soul-sucking, doubt-inducing affairs. But if you’re the type of sicko who likes holing up in a tiny, closed office with reporters of questionable hygiene to build databases from scratch by hand-entering thousands of pages of documents to take on powerful people and institutions that wish you were dead, all for the glorious reward of having readers pick up the paper and glance at your potential prize-winning epic as they flip their way to the Jumble… well, if that sounds like journalism Heaven, then you’re our kind of sicko.
For those unaware of Florida’s reputation, it’s arguably the best news state in the country and not just because of the great public records laws. We have all kinds of corruption, violence and scumbaggery. The 9/11 terrorists trained here. Bush read My Pet Goat here. Our elections are colossal clusterfocks [focks not in original edit]. Our new governor once ran a health care company that got hit with a record fine because of rampant Medicare fraud. We have hurricanes, wildfires, tar balls, bedbugs, diseased citrus trees and an entire town overrun by giant roaches (only one of those things is made up). And we have Disney World and beaches, so bring the whole family.

Left wing management

April 20th, 2011
11:05 am

jm: “Government tends to create bubbles”

There’s one thing and one thing only which creates “bubbles” : Capital.

Adam Smith knew it. Marx knew it. Keynes knew it. Lenin knew it. And even Milton Friedman knew it.

The politics of our time is characterized by, among other things, the violent imposition of a policy of forgetting this basic truth, even at (perhaps BECAUSE it’s) at a time when we have just been served up the most unmistakable demonstration of this truth that we’ve seen since the 1920s.

williebkind

April 20th, 2011
11:05 am

So no one would ask or create a charity to help those in need? How about the “Humane Society”? Could we spend less on deserted animals and more on “deserted seniors”? Really, can we just come together and put humans over animals and provide for them as private citizens?

TaxPayer

April 20th, 2011
11:05 am

In the con’s Utopian free market, I suppose we would see things like doctor’s services being traded like commodities on ICE. That’ll surely keep prices cooled down, in the Hamptons. Riiiight.

AmVet

April 20th, 2011
11:05 am

And the truth is, a purely capitalistic system, driven solely by profit considerations, perhaps could control costs to a degree. But it would do so only by ignoring issues of humanity, morality, justice and fairness — considerations that pure capitalism is not equipped to handle, but that are inherent in matters that are literally life and death.

And there’s the rub.

What we have had foisted on us in the past thirty plus years is NOT the proper evolution of American capitalism. Wall Street has become little more than a den of rampant, imperious and self-obsessed avarice. Or as the Dallas Fed Chairman called it, “a sustained orgy of excess and reckless behavior”.

But before perverted and enthroned corporations tried to destroy capitalism, there was an over-riding concept called Enlightened Self-Interest. There was honor and justice and duty. There was service before self.

This was a era when “controlling corporate interests was the task of organized civic interests, law and order, quality competition, shareholder power over executives, true consumer information, judicial remedies and environmentally benign technologies.”

Now modern tyranny rules the day as “the global corporation has no problem dealing with dictators, in return for lucrative contracts, concessions over raw materials, and free reign to exploit people (in exchange for customary kickbacks).”

And more than ever, entire clueless, have-not segments of our society are enabling the destruction of the American way of life and the implementation of an American plutocracy. Government of the super-rich, by the super-rich and for the super-rich.

Welcome to the Corporate States of America.

(ir)Rational

April 20th, 2011
11:06 am

Peadawg – exactly. Why should it be the government or some board that has no knowledge of the individual that makes the decision on whether he or she dies? Leave it to the person and the person’s family.

No Artificial Flavors

April 20th, 2011
11:06 am

Jay, when you reach the end of your rope please blog one last time about your feelings on the expert death panel.

Bosch

April 20th, 2011
11:06 am

Mr. Homes,

Polite golf clap for that post — well done, sir.

eddie

April 20th, 2011
11:07 am

Jay, your time will come. You are probably in good health and I don’t wish upon you or your family any health maladies……but the people who are always so vocal and staunch supporters of the death panel are not sitting in a recliner with an IV in your arm waiting while the chemo drips slowly in so that it MAY slow the spread of your cancer. Oh by the way, the drug costs $30-40,000/month. Someone will say that this is just too expensive for this person and oh by the way the clinical trials only gave the average person another 3 months. The ones who speak the loudest will be calling for their Mamas to come save them when their time comes and it is coming. Let’s see just how you feel then. I know from whence I speak. I am a cancer patient.

Doctor Death

April 20th, 2011
11:07 am

As a person who has led an extensive career in health care, health care policy arenas, and (gasp!) as a consultant to insurance companies – I CAN WITHOUT A DOUBT STATE THAT DEATH PANELS DO EXIST. They have existed for a long time – guess who makes the decisions whether or not insurance covers a procedure, a claim, a prescription? Oh, yeah… a panel of people that make these decisions all the time.
Changes are coming to health care delivery systems and that means the benefits and insurance industry are going to change as well. Insurance carriers are having to assess the costs of doing business under this new regulatory scheme – while SELF-FUNDED benefit plans are taking advantage of reform whenever and wherever possible.
What does this mean? Unless we trim the system, get rid of waste, get rid of fraud, and get rid of crap expenses…. WE ALL ARE GOING TO SUFFER UNDER THIS NEW PLAN.
But I guess the good news is, as a patient, you are going to be required to pay more for your health care… which means you are actually going to be more involved in the process and more demanding in the services you received. Which means…. dum dum dum… you MIGHT actually try to take care of yourself because it will be too expensive NOT to!

Note to all you PARENTS out there: how about you make your 4-year-old put down the cheeseburger and juice box, drop the remote control game player – and go OUTSIDE and get some EXERCISE?! And maybe even get them to like broccoli? If not, they’ll end up on a surgical table in about 3 decades and we’ll be supplying them with taxpayer provided generic blood pressure and cholesterol pills for the rest of their lives. Baby steps folks. Take some personal responsibility and accountability for your lifestyles. The government CAN NOT and SHOULD NOT take care of you!

Oh, gosh… I can just feel Mr. Bookman itching to press delete when this comment comes in.

Don't Tread

April 20th, 2011
11:08 am

Let’s see…Republicans were being fear-mongers and liars by suggesting that “death panels” existed a few months back. Oh, but wait…seems now, they do exist. I guess the Rs weren’t lying after all…

I seem to remember something about the stimulus holding unemployment below 8% if it were passed…oops, we seem to be somewhere in double digits. (not counting the long-term unemployed which are no longer counted)

Hmm, then there was the one about Obamacare reducing the deficit….oh, wait….oopsie

Then we have the problem with the Mexican gangs getting most of their guns from the US…oh wait…

Then we have the GM bailout which was supposedly going to produce a positive return on investment for the Treasury…uh-oh, something went wrong there…

Then we have the global warming stuff and all the new jobs from “green” energy … Guantanamo … something about bringing all the troops home … getting the waste out of government … illegals are beneficial for the country … the list goes on and on.

So forgive me if I don’t accept any liberal talking points as fact, or even plausible at this point.

Lil' Barry Bailout

April 20th, 2011
11:08 am

The death panel has been made up of insurance people in the past.
————

False. The insurance company only decides what THEY will pay for. You are still free to purchase non-covered services. Until fascist Obozocare is implemented, and then you’re at the mercy of the death panel.

carlosgvv

April 20th, 2011
11:08 am

If we are really the greatest country in the world then our “death panels” should be the most compassionate and humane in the world. Are they? If not then maybe we are not so great after all.

TaxPayer

April 20th, 2011
11:09 am

Is it just me, or is the point just whizzing past the wingnuts here today?

Whizz past, trickle down. What’s the difference.

CJ

April 20th, 2011
11:10 am

Peadawg: “The job of making critical health decisions about a patient? I would say the patient, they’re family, and the patient’s doctor.

I hear you Peadawg. I don’t want a government panel, Congress, or some profit-driven insurance company executive making decisions for me or my family. Therefore,…

I, CJ, hereby pledge not to accept funds from any private or public insurance program—including, but not limited to Medicare, Medicaid, Peach Care, Blue Cross/Blue Shield, Aetna, United Healthcare, and Kaiser. I further pledge to pay for all of my family’s health care costs out of my own pocket.

Problem solved. Are you with me Peadawg?

Halftrack

April 20th, 2011
11:10 am

Jay; We don’t need no death panels. Congress can pass laws / regulations to clear up some of the negatives to death panels that would apply to Ins. Co.s. Government needs to stay outof doctor / patient care. Today we have too many hoops to jump through. You wind up with a bill for every variable procedure. Cost could be controlled if when you were hospitalized that the hospital billed for everything. Doctors, specialist, radiologist, etc. would be sub-contractors for the hospital. As it is now; all health practioners bill you for individual costs. There is too much red tape due to the system as now practiced. Also Ins. Co.s do not need to deal with every health supplier for a price to do certain procedures,etc. Further tort reform is required also. Lawyers have ruined this country for reasonable pricing on most everything. To sue or not to sue is the question.

Bosch

April 20th, 2011
11:10 am

“Wall Street has become little more than a den of rampant, imperious and self-obsessed avarice.”

My vocabulary increases everytime AmVet posts. :-)

TaxPayer

April 20th, 2011
11:10 am

You are still free to purchase non-covered services.

Because everyone keeps that sort of spare change stuffed in their pockets, right lil BB.

Finn McCool

April 20th, 2011
11:11 am

What true-blue capitalist could argue with that?

Well, the Republicans sure aren’t interested in capitalism. They want subsidies for all the businesses – small and large. They don’t want industry regulations even though one consequesnce of industry regulations is a balanced playing field (capitalism).

Republicans will say they loathe socialism because they have no clue as to how much they actually rely on it.

Del

April 20th, 2011
11:11 am

“Somebody has to say no to the terminal patient who refuses to acknowledge that he or she is terminal and demands hopeless if expensive treatment.”

That is just a huge exaggeration and insulting to both doctors as well as their terminally ill patients.

Jay

April 20th, 2011
11:11 am

The job of making critical health decisions about a patient? I would say the patient, they’re family, and the patient’s doctor. Certainly not some panel of “experts” appointed by Congress of the President.

That’s a nice, sweet thought.

Unfortunately, it’s not the system we have today, and it’s not a system that is conceivably workable. The doctor — and by extension the medical industry — has an economic incentive to always do more. The patient and his or her family — motivated by the sheer human instinct for self-preservation — also has an immense incentive to do more and more, out of desperation often, because they are not paying for it.

devildog0300

April 20th, 2011
11:12 am

I’m surprised you stopped at death panels. Why not use the Soylent Green approach; boil us down and make little green cookies out of us. Bookman just convinced me that Dr. Strangelove was a liberal.

USinUK

April 20th, 2011
11:13 am

I’m in … I’m out … I am the wind …

just wanted to say HI!! hope everyone is having a great mid-week!

Finn McCool

April 20th, 2011
11:13 am

Whizz past, trickle down, Niagra up….what’s the difference?

Lil' Barry Bailout

April 20th, 2011
11:13 am

Because everyone keeps that sort of spare change stuffed in their pockets, right lil BB.
———–

Responsible people do. Parasites conditioned to expect others to pay their bills for them might not.

George W

April 20th, 2011
11:13 am

Holy Crap Jay……you guys are less passionate and reasonable than I thought. I am sure Saddam approved “death panels” as well. WOW!