Just in time for Thanksgiving, Sen. Harry Reid has given us a giant turkey of a health-care bill. At 2,074 pages and more than 370,000 words, it’s officially “scored” as costing $849 billion over 10 years—$400 million per page, or $2.3 million per word.

But that doesn’t come close to measuring its true cost. The bill uses various accounting gimmicks to hide its true cost. For example the bill doesn’t include more than $200 billion needed to prevent a 21 percent cut in Medicare next year. [The CBO “score” actually assumes Reid cuts Medicare 23 percent—Ed.] That cost has been spun off into a separate bill, even though the Senate voted down that approach last month.

Moreover (as Jeffrey H. Anderson notes), much of the spending is back-loaded. The bill doesn’t start spending until 2014, and only costs $9 billion that year. But by 2019, the annual cost hits $196 billion. The minority staff of the Senate Budget Committee reports that, if you factor out all the budget gimmicks and look at the 10 years of actual implementation, the cost is closer to $2.5 trillion. ...

much of the cost has simply been shifted from the federal budget onto the backs of workers, businesses and state governments. Judging by previous reforms, as much as 60 percent of the cost won’t show up in government accounting.

To pay for all the new spending, Reid would enact at least 15 new or increased taxes totaling more than $493 billion.

But the cost alone doesn’t begin to describe how intrusive this bill would be for the average American. For instance, it would require everyone to buy a government-designed insurance plan, even if it was more expensive than their current policy. Failure to comply brings a penalty of up to $6,750 for a family of four.

Another provision would mandate that employers provide insurance to their workers. If they fail to do so, and if even a single worker qualified for federal subsidies, the employer could be fined up to $750 per employee. The CBO estimates that those penalties will amount to more than $28 billion.

Unemployment is now 10.2 percent, and the Senate bill will make it more costly to hire workers. And because the penalty only applies in the case of subsidy-eligible workers, it is low-wage and unskilled workers that will suffer the most.

Of course, the plan contains the government-run “public option” that many experts believe will ultimately crowd out private insurers. And don’t be misled by Reid’s “opt-out” provision: It comes with so many restrictions that it will be nearly impossible for a state to actually opt out.

Besides, there won’t be any opting out of the taxes that will ultimately be necessary to pay for it.

Finally, the bill sets the stage for government-imposed rationing. If you think the recent controversy over mammograms is something, just wait until the dozens of new boards, commissions and agencies created by this bill get to work. The “reform” also gives the secretary of Health and Human Services broad new powers to determine “quality,” “efficiency” and “appropriate utilization.”

At first, these restrictions would only apply to government programs like Medicare, but they’d create the framework for eventual extension to private insurance.

If Reid gets the 60 votes he needs to pass this, US taxpayers, businesses and patients can expect to pay a high price for this congressional feast.

From Gateway Pundit:

Senate Democrats will only deliberate 10 hours on Saturday before they vote to nationalize one-sixth of the US economy.

The bill will nationalize the nation’s health care industry, increase costs, ration care, tax cosmetic surgery, cut Medicare, charge a monthly abortion fee, and take away your freedom.

Please take time tomorrow and Saturday to call your US Senator.

HERE IS THE PHONE LIST.

Don’t let the democrats destroy our health care system.

Support for this disastrous bill is down to 40% with 52% opposing.

(T)he most worrying item is tucked into the CMS’s “caveats and limitations of estimates” section, which is well worth reading. They point out that they, like most other agencies, are assuming a sort of frictionless universe in which 34 million new people demanding more health services increases the supply of health services in order to meet that demand. That is not, notes the CMS, a very realistic assumption:

In estimating the financial impacts of H.R. 3962, we assumed that the increased demand for health care services could be met without market disruptions. In practice, supply constraints might interfere with providing the services desired by the additional 34 million insured persons. Price reactions—that is, providers successfully negotiating higher fees in response to the greater demand—could result in higher total expenditures or in some of this demand being unsatisfied. Alternatively, providers might tend to accept more patients who have private insurance (with relatively attractive payment rates) and fewer Medicaid patients, exacerbating existing access problems for the latter group. Either outcome (or a combination of both) should be considered plausible and even probable.

The latter possibility is especially likely in the case of the higher volume of Medicaid services. Despite a provision to increase payment rates for primary care to Medicare levels, most Medicaid payments would still be well below average. Therefore, it is reasonable to expect that a significant portion of the increased demand for Medicaid would not be realized.

We have not attempted to model that impact or other plausible supply and price effects, such as supplier entry and exit or cost-shifting towards private payers. A specific estimate of these potential outcomes is impracticable at this time, given the uncertainty associated with both the magnitude of these effects and the interrelationships among these market dynamics. We may incorporate such factors in future estimates, should we determine that they can be estimated with a reasonable degree of confidence. For now, we believe that consideration should be given to the potential consequences of a significant increase in demand for health care meeting a relatively fixed supply of health care providers and services.

In other words, while we are nominally increasing the number of “the insured”, it’s not clear we’re increasing their access to health care very much. The supply of health care services is actually pretty inelastic, because it depends on relatively scarce labor. There’s already a nursing shortage, and doctors already don’t want to become GPs because the pay is mediocre, the work is routine, and the hours aren’t particularly compelling. To some extent they can be replaced by nurse practitioners—but they are neither particularly cheap, nor in endless supply. And there’s a limit to how much of our health care costs we can fix by replacing current workers with less skilled labor.

When you increase the demand for something without increasing the supply, you either get price increases, or shortages. Neither is what the authors are promising for their bills.

(Yes, yes, I know what you’re about to say . . . end the AMA cartel’s artificial restrictions on entry into the medical profession! That’s a different post, but here’s the short version: the constraint on the supply of doctors isn’t the medical school slots, but the residency slots. And we’re already importing a substantial number of doctors to fill our family practice slots, because about a third of them go unfilled during the “match”. This does not suggest that there are hordes of eager potential doctors clamoring for a crack at family practice. There’s a lot of demand for specialist slots. But creating more cardiac surgeons will not put much downward pressure on health care costs.)

But this is not an indictment of the bill’s ability to control costs, as of the ability of any bill to control costs. Controlling costs means consuming less health care. There is no magic pot of money waiting to be painlessly seized from some undeserving wretch, preferably one that voters already hate. The only way we are going to cut costs is by cutting someone’s benefits.

Oregon democrat Earl Blumenauer made liberals happy with a New York Times editorial calling conservative critics of democrat Health Care Reform “liars” and ridiculing the very idea that what Sarah Palin referred to on Facebook as “death panels” could possibly be found in the bill passed by the House of Representatives.

The most bizarre moment came on Aug. 7 when Sarah Palin used the term “death panels” on her Facebook page. She wrote: “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.”

There is, of course, nothing even remotely like this in the bill.

The Wall Street Journal, in its lead editorial today, demonstrates rather effectively the falsity of Congressman Blumenauer’s self-proclaimed injured innocence. The editorial is specifically about those “death panels,” and explains exactly what they are, what they would do, and why they are a terrible idea.

Like most of Europe, the various health bills stipulate that Congress will arbitrarily decide how much to spend on health care for seniors every year—and then invest an unelected board with extraordinary powers to dictate what is covered and how it will be paid for. White House budget director Peter Orszag calls this Medicare commission “critical to our fiscal future” and “one of the most potent reforms.”

On that last score, he’s right. Prominent health economist Alain Enthoven has likened a global budget to “bombing from 35,000 feet, where you don’t see the faces of the people you kill.”

As envisioned by the Senate Finance Committee, the commission—all 15 members appointed by the President—would have to meet certain budget targets each year. Starting in 2015, Medicare could not grow more rapidly on a per capita basis than by a measure of inflation. After 2019, it could only grow at the same rate as GDP, plus one percentage point.

The theory is to let technocrats set Medicare payments free from political pressure, as with the military base closing commissions. But that process presented recommendations to Congress for an up-or-down vote. Here, the commission’s decisions would go into effect automatically if Congress couldn’t agree within six months on different cuts that met the same target. The board’s decisions would not be subject to ordinary notice-and-comment rule-making, or even judicial review.

Yet if the goal really is political insulation, then the Medicare Commission is off to a bad start. To avoid a senior revolt, Finance Chairman Max Baucus decided to bar his creation from reducing benefits or raising the eligibility age, which meant that it could only cut costs by tightening Medicare price controls on doctors and hospitals. Doctors and hospitals, naturally, were furious.

So the Montana Democrat bowed and carved out exemptions for such providers, along with hospices and suppliers of medical equipment. Until 2019 the commission will thus only be allowed to attack Medicare Advantage, the program that gives 10 million seniors private insurance choices, and to raise premiums for Medicare prescription drug coverage, which is run by private contractors. Notice a political pattern?

But a decade from now, such limits are off—which also happens to be roughly the time when ObamaCare’s spending explodes. The hard budget cap means there is only so much money to be divvied up for care, with no account for demographic changes, such as longer life spans, or for the increasing incidence of diabetes, heart disease and other chronic conditions.

Worse, it makes little room for medical innovations. The commission is mandated to go after “sources of excess cost growth,” meaning treatments that are too expensive or whose coverage will boost spending. If researchers find a pricey treatment for Alzheimer’s in 2020, that might be banned because it would add new costs and bust the global budget. Or it might decide that “Maybe you’re better off not having the surgery, but taking the painkiller,” as President Obama put it in June.

In other words, the Medicare commission would come to function much like the National Institute for Health and Clinical Excellence, which rations care in England. Or a similar Washington state board created in 2003 to control costs. Its handiwork isn’t pretty.

Read the whole thing.
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We already addressed the “no death panels in our bill” claim long ago, when the first wave of liberal denial crested, in this August 16th posting, which quotes this perfectly accurate analysis by Cornell Law Professor William Jacobsen.

Democrats don’t like it being called a “death panel,” but the idea all along has been that their version of health care reform would avoid public debate by passing the responsibility of meeting budgetary limitations to an unelected commission which would be empowered to ration services. Many of its decisions will inevitably deny medicines, treatments, and procedures whose absence will be the equivalent of a death sentence. Americans will die because government has foreclosed their medical options. The body making such decisions and condemning Americans to deaths which might have been prevented on monetary grounds will not be a “death panel?”

Only if you are a democrat, won’t it be.

Hat tip to Rich Duff.

Even Time magazine recognizes that democrat efforts to impose socialized health care on an unwilling nation are looking more anjd more like the hopeless and futile Banzai attacks made by suicidal Japanese units on well-prepared Marine positions on South Pacific islands during WWII.

Getting hopped up on left wing ideology instead of rice wine, waving 2000 page pieces of legislation instead of samurai swords, and shouting slogans of Envy instead of Banzai! is not going to make the outcome different.

Smart Democrats are thinking we’ve seen this movie before: Suicide by health care. Last week was the trifecta that may have sealed health care’s fate: 1) GOP wins Virginia and New Jersey (!) governor’s races. 2) Business comes out swinging. 3) Unemployment over 10.

“To make matters worse, they force Blue Dogs and front-liners to walk the plank on the Pelosi Plan that exceeds the symbolically important $1 trillion mark, includes the public plan and a big tax increase on small business—all of which are dead-on-arrival in the Senate. BTU2. The attack ads make themselves.

“Now Gallup finds a sudden and massive shift among Indies. And let’s be honest, it’s not that Indies have fallen in love with the GOP agenda, whatever that is. Far from it. They want to put a hard brake on the spending and the borrowing, and they don’t want Washington messing with their health care at a time of intense economic anxiety.

“Meanwhile, the abortion sideshow is the last thing that the White House needed. Gets activists on both sides to man the battle stations and makes the vote a no-win proposition for any Dem in Reddish territory. Worst of all, your typical middle-of-the-road swing voter watches politicians in Washington fighting over abortion and says: ‘I thought we were having a health care debate. I don’t want any part of this. I think I’ll change the channel.’ Oh, and next up: immigration. Which is sure to be a unifying discussion.

“And, at long last, the debate is now squarely focused on health care costs, the soft underbelly of this whole enterprise, the place they never wanted this to go because it’s the issue on which they have no answer. Most voters now believe the bill will raise their personal costs—not a good thing for a politician to be doing in the midst of a deep recession. And when the establishment (CBO, The New York Times, The Washington Post, Mark Warner, Susan Collins) all agree that the bills don’t contain costs, it’s hard to dismiss as a baseless attack.

Bird Dog asks: If the ObamaCare proposal is so good, why do you have to imprison people who don’t want to participate?

Dick Morris identifies the relevant portions of the Bill.

The nonpartisan Joint Committee on Taxation reported that the House version of the healthcare bill specifies that those who don’t buy health insurance and do not pay the fine of about 2.5 percent of their income for failing to do so can face a penalty of up to five years in prison!

The bill describes the penalties as follows:

Section 7203 — misdemeanor willful failure to pay is punishable by a fine of up to $25,000 and/or imprisonment of up to one year.

Section 7201 — felony willful evasion is punishable by a fine of up to $250,000 and/or imprisonment of up to five years.” [page 3]

That anyone should face prison for not buying health insurance is simply incredible.

And how much will the stay-out-of-jail insurance cost? The Joint Committee noted that “according to a recent analysis by the Congressional Budget Office, the lowest-cost family non-group plan under HR 3862 [the Pelosi bill] would cost $15,000 by 2016.”

What side of history do democrats want to be on? Not the side of Washington and Jefferson.

John Cassidy, in the New Yorker, identifies whose side they are on.

In extending our health-care system, all we are doing is catching up with Otto Von Bismarck’s Germany, which recognized a hundred and twenty-five years ago that universal health and disability coverage, along with old age pensions and a system of public education, were essential elements of a modern society.

Otto von Bismarck

Der Staatssozialismus paukt sich durch. (State Socialism will forcibly move forward.)—Otto von Bismark.

Democrats want to replace the Liberal American ideals of limited government, personal freedom, and individual responsibility with Mitteleuropean statism, socialism, and collectivism. Their “modern society” is, just like Bismark’s, centralized, bureaucratized, and dirigiste.

Socialism, statism, collectivism are all actually terribly old-fashioned ideas, representing nothing other than a variety of negative responses to the Liberal Enlightenment ideals of individual liberty and the restraint of state power in favor of voluntary and organic order. The would-be rulers of mankind simply ceased appealing to claims of Divine Right and hereditary superiority and began attempting to gain power by flattering and bribing the masses, while arousing their passions with fraudulent claims of injury and entitlement.

Human appetite for power is unlimited and the possession of power is always addictive. The Central European monarchies, Germany, Austria, Russia, which pioneered centralizing statism with unprecedentedly expansive regimes of taxation, regulation, and conscription, inevitably turned their power against one another, and destroyed themselves with the war they launched in 1914.

From its grand dynastic monarchies, the tradition of Continental European collectivism passed in 1917 to populist rule by cafe intellectuals, bringing within a generation an even greater war and murderous barbarism producing atrocities and deaths on a scale unprecedented in European civilization.

European exhaustion and the demoralization of the traditional leadership classes, after WWII, produced generally more benign socialist rule, but the European welfare state politics American liberals yearn to share produced nothing but European stagnation and decline. Britain was still rationing food as it had in wartime in 1954.

America surged dramatically ahead of Europe, economically and culturally, and (until the late 1960s) enjoyed decidedly less divisive and destructive politics.

Europe only began catching up to the United States in material prosperity, after many long years, when deference to market considerations on the basis of the American example significantly began to influence European economic policies.

Yet, despite the manifest superiority of the American political tradition and the American ideals of Liberty and Individualism, our domestic community of fashion continues to yearn to replace those with European-style statism. They seem to feel instinctively that, because French cheese, German cars, and Scandinavian design are such effective markers of class superiority that Europeans must also possess a more chic and desirable kind of politics. They are dead wrong.

Our liberals are like the Bourbons, and the Fall of Communism (whose anniversary, with respect to the opening of the Berlin Wall, we begin to celebrate tomorrow) is like the French Revolution, a historical watershed producing some definitive judgments on the Past. Like the Bourbons, American liberals have learned nothing about economics. And like the Bourbons, they refuse to relinquish their illusions and their ancient animosities.

The New York Times called it “their defining social policy achievement.”

I think it defines them alright, as socialists, collectivists, liars, frauds, and thieves.

Stephen Green speaks bitterly for the rest of us:

How do you cure high unemployment and sluggish growth?

Proven methods include reducing regulation and lowering taxes.

So it comes as no surprise that the House has just approved one of (if not the) biggest increases in taxes and regulation after virtually zero debate and in the middle of a weekend night when almost no one is paying attention.

They’re cowards. Shrewd cowards, but cowards still. ...

Which is the greater number: Pages in the bill the House just passed, or the minutes spent debating it?

Independents turned on the Republican Party because the MSM persuaded them that it was George W. Bush’s intransigent extremism which had poisoned American political life and produced bitter factionalism, and that it was Bush’s war spending and Republican banking deregulation that produced the economic crisis. They put democrats in charge, and our politics has not become bipartisan, the Middle East is not at peace, and the economy has not recovered. On the other hand, the deficit has quadrupled, the government owns General Motors, and Congress is trying to nationalize another one sixth of the economy while adding another trillion dollar entitlement, just before it proceeds to start working on carbon taxes.

Right now, independent voters are astonishingly volatile. Democrats did poorly in elections on Tuesday partly because of disappointed liberals who think that President Obama is moving too slowly, but mostly because of anxious suburban independents who think he is moving too fast. In Pennsylvania, there was an eight-point swing away from the Democrats among independents from a year ago. In New Jersey, there was a 12-point swing. In Virginia, there was a 13-point swing.

The most telling races this year were the suburban rebellions across the country. For example, in Westchester and Nassau counties in New York, Republican candidates came from nowhere to defeat entrenched Democratic county officials. In blue Pennsylvania, the G.O.P. won six out of seven statewide offices.

Middle-class suburban voters who have been trending Democratic for a decade suddenly lurched out of the Democratic camp — and are now in play.

Why? What do these voters want?

The first thing to say is that this recession has hit the new suburbs hardest, exactly where independents are likely to live. According to a survey by the National Center for Suburban Studies at Hofstra University, 76 percent of suburbanites say they or someone they know have lost a job in the past year.

The second thing to say is that in this time of need, these voters are not turning to government for support. Trust in government is at its lowest level in recent memory. Over the past year, there has been a shift to the right on issue after issue. According to Gallup, the percentage of Americans who believe that there is too much government regulation rose from 38 percent in 2008 to 45 percent in 2009. The percentage of Americans who want unions to have less influence rose from 32 percent to a record 42 percent.

Americans have moved to the right on abortion, immigration and global warming. Over the past seven months, the number of people who say government is doing too many things better left to business has jumped from 40 percent to 48 percent, according to a Wall Street Journal/NBC News poll.

According to that same survey, only 31 percent of Americans believe that the president and Congress “should worry more about boosting the economy even though it may mean larger budget deficits.” Sixty-two percent, twice as many, believe the president and Congress “should worry more about keeping the deficit down, even though it may mean it will take longer for the economy to recover.”

These shifts have not occurred because conservatives and liberals have changed their minds. They haven’t. The shift is among independents.

According to Gallup, the share of independents who describe their views as conservative has moved from 29 percent last year to 35 percent today. The share of independents who believe there is too much government regulation of business has jumped from 38 percent to 50 percent. Independents are in the position of a person who is feeling gravely ill at the same time he has lost faith in his doctor. ...

Independents support the party that seems most likely to establish a frame of stability and order, within which they can lead their lives. They can’t always articulate what they want, but they withdraw from any party that threatens turmoil and risk. As always, they’re looking for a safe pair of hands.

Daniel Henniger explains that economic fears drove independent voters to flee the Republican ticket and vote for Barack Obama, whose calm tones and competently-run campaign promised he could handle the crisis. The economic crisis was not resolved quickly. Democrats chose not to adopt the conventional policy of cutting taxes, preferring to regulate and spend. The public’s unease has been increased rather than assuaged by the Administration’s determination to advance an extreme partisan agenda, even in the face of declining public support.

Independent voters across the U.S. have become like the massive cattle herd John Wayne drove from Texas to Kansas in “Red River.” These voters are spooked and on the run, a political stampede that veered left in November 2008 and now right a mere year later. They will keep running—crushing incumbents, candidates and political models of the left and right—through November 2010 and onto 2012 until they find a person or party capable of leadership appropriate to our unsettled times. And yes, Virginia, the possibility of a man on a white horse in 2012 is not out of the question.

Exit polls in New Jersey and Virginia said the economy was on voters’ minds. Unemployment is near 10% and may stay there for a year. But it’s deeper than that.

This isn’t just another turn in the business cycle. On Sept. 15, 2008, the economic structure of the U.S. imploded. Lehman Brothers, a synonym for the American financial bedrock, filed for bankruptcy. On June 1, 2009, General Motors, once a synonym for American economic primacy, filed for bankruptcy and was effectively nationalized. In the nine months between these two iconic events, the American people were riveted to news of economic distress.

The signal event of the 2008 presidential election was the day in September when Sen. John McCain “suspended” his campaign to deal with the financial crisis. Within 48 hours, his candidacy stood naked. Mr. McCain’s instincts were right; The American people wanted leadership. But he didn’t have a clue how to provide it. The restless herd ran toward Barack Obama.

Now they’re ready to run toward someone else. They just did in New Jersey and Virginia.

This is not normal. A new American presidency, especially this one, should not be in this much trouble 10 months into a four-year term. Nor would it be if not for the economic events that fell out of September 2008.

Absent the immediate need to steady the credit markets and deal with a deepening recession, the Obama White House would have introduced—and passed—its restructuring of the U.S. health-care system in early spring. Instead, voters watched Congress create and pass a nearly trillion-dollar “stimulus” bill, and then erect the world’s tallest national budget—a towering $3.5 trillion. They watched the Obama Treasury, now hard-wired to the Federal Reserve, intervene massively in the structure of the private economy. There was an attempted federal climate-control bill, an attempted expansion of union organizing rights (card check) and second thoughts on free-trade agreements.

Only then, in June, was this hyperactive government able to introduce its health-care proposal—the public option, the remaking of the insurance industry, a 5.4% tax surcharge, the expansion of Medicaid.

After his election, Mr. Obama’s strongest attribute was limitless self-confidence. He was a man aglow with knowledge, control and . . . leadership. Now, with the scale and cost of Mr. Obama’s ambitions so clear, the question many voters are asking is whether the Obama government’s reach exceeds its grasp or abilities—or any government’s.

The most acute voters know these are not normal times. The Obama vision so far looks a lot like the social-market economic model of Europe, where leaders such as Nicolas Sarkozy and Angela Merkel give homilies about the “crisis” of capitalism. If American voters then look toward Asia, they see rising economies using capitalism to supplant Europe.

American voters know they’ve reached a long-term economic tipping point. Which way to go, old West or new East? They understand the challenges are growing while the politicians seem to be shrinking.

So the Republicans “won” Tuesday. Now what?

Just as the Democrats in 2008 ran mainly against “Bush,” the Republican political model seems to be to let Democratic failure dump states like New Jersey and Virginia into their control. But I think most voters, no matter their party registration, know that in the past 12 months the stakes for them have suddenly become larger than political “control.”

Unless leadership emerges equal to the new world voters see they have fallen into, volatility in America’s election returns is going to be the norm for a long time.

The moral is that personal charm and a reassuring manner are powerful tools in gaining middle-of-the-road support in American politics, but keeping the support of a coalition including the ideologically uncommitted requires a kind of leadership which Ronald Reagan had and which Barack Obama lacks.

Obama already seems already far more likely to go down in history as a surly extremist who achieved election by temporarily feigning a false bonhommie, à la Jimmy Carter, than a genuinely transformative president like Reagan.

Going for a New Deal-style massive entitlement program in the midst of recession, after quadrupling the deficit, will never persuade independents that this administration is responsible and pragmatic.

The Hill:

HATCH: That’s their goal. Move people into government that way. Do it in increments. They’ve actually said it. They’ve said it out loud.

Q: This is a step-by-step approach —

HATCH: A step-by-step approach to socialized medicine. And if they get there, of course, you’re going to have a very rough time having a two-party system in this country, because almost everybody’s going to say, “All we ever were, all we ever are, all we ever hope to be depends on the Democratic Party.”

Q: They’ll have reduced the American people to dependency on the federal government.

HATCH: Yeah, you got that right. That’s their goal. That’s what keeps Democrats in power.

Around 19:50 in the 33:57 video.
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Duncan Black speaks for the left blogosphere generally by parsing Hatch’s warning into a more flattering form.

Orrin Hatch says we can’t have health care reform because it will be awesome and everyone will love it and they’ll be so grateful that they will vote for Democrats for all eternity.

Health care delivered by government will actually, judging by the experience of other countries, be crappy, severely rationed, and lacking innovation. The rich and powerful will simply go outside US borders to obtain first class health care at luxury clinics located in convenient resort destinations. The ordinary middle class citizen will find himself standing in long queues behind welfare moms, junkies, gangbangers, and illegal aliens.

The quality will be low, the service will be slow, but lunch will come without a check.

Democrats are counting on human nature being on their side. Free goods and services at somebody else’s expense have a powerful appeal. Also, they are addictive.

Once anyone has contributed revenue into the system, he is going to feel he has a claim to get those promised benefits. Once one sixth of the American economy goes down the federal anaconda’s throat, it won’t be coming back up.

Duncan Black’s boast can be more accurately paraphrased that the heroin will be so awesome, and will be so effective that the suckers’ will love it and will be unable afterward to do without it, and they’ll be so dependent on their dealer that they will happily surrender to him all the money and power he ever asks for.

Free government services, like addictive drugs, are morally corrosive, enervating to the human character and will, and a sure path to dependency and slavery.

Bill Kristol suggests, if you want to see ObamaCare in action, just look at how well the federal government is doing passing out Flu vaccine right now.

With Barack Obama as her front man, House Speaker Nancy Pelosi—the real power in the Democratic party—has gone Clinton and Gingrich one better. Clinton tried to hike taxes. Gingrich sought to cut Medicare. Pelosi wants to do both at once. This is quite a feat: She’s combined the most unpopular Democratic and Republican proposals of the last generation in one piece of legislation.

And her timing is impeccable. Pelosi has decided to raise taxes and discourage employment just as joblessness approaches 10 percent. She’s decided to cut Medicare reimbursements just as seniors’ retirement accounts have shrunk. She’s decided to advance a huge spending bill just as the deficit is at historic highs. She’s decided to insist on federal funding of abortion just as the issue seems to have reached some sustainable middle ground. And she’s decided to put forward a 2,000-page piece of legislation with a mind-boggling array of scary instances of bureaucratic coercion and farcical examples of nanny-state liberalism—all nuggets of political gold for Republicans—at a time when the public is sick of statist overreaching and big-government meddling.

This is the Pelosi Plan to wreck our health care system and—the bright side!—the Democratic majority along with it. This week we’ll see whether enough of her fellow House Democrats intervene to prevent her from devastating their party. There will be no Republican votes for the Pelosi Plan of tax hikes and Medicare cuts. Will there be enough Democratic resistors so the bill is either withdrawn or defeated?

It’s hard to say at this point. The arm-twisting and palm-greasing haven’t yet produced enough Democrats to put the Pelosi Plan over the top. The substantive case against various versions of the legislation made for months by an army of nonpartisan experts and wonks has had an effect. The state of the American economy and the federal budget gives sane Democrats pause as they consider enacting a sprawling new entitlement. And as Americans read the legislation over the next week, they’ll find so much that is ill-considered, cumbersome, deceptive, and house-of-cards-like that it all just may collapse of its own weight.

Or it may collapse because of swine flu.

After all, we’re seeing a big government health care program in operation right now—the Obama administration’s effort to deal with the swine flu problem. No, come to think of it, it’s now the swine flu emergency. Last week, President Obama so legally designated it. How’s that test case in government-run emergency care going?

Turn on your local news to find out. You’ll see false reassurances, broken promises, rationing which doesn’t provide the promised rations, queues lengthening while supplies run out, and lots of bureaucrats explaining just why things aren’t working quite as their centrally planned plans had planned.

The swine flu emergency is a foretaste of life under the Pelosi Plan.

Hat tip to Bruce Kessler.

So now that the fifth bill on health care reform is out, here comes the next round of arguments. Meaning that Conservatives will have to restate everything we’ve already said because all the stuff we were opposed to in the first four bills has been combined into the new legislation.

Personally, I’m tired of giving Liberal idiots sources they never read, reminding them of political promises now being broken, and pointing out the gross hypocrisy of the liberal Congress. Lefties don’t care. They hear the word “free” and they’re sold. Which is kind of interesting when you consider that they dub anyone opposed to health care reform “greedy” and “selfish.”

Talk about “greedy” and “self serving.” Conservatives aren’t the ones out there demanding that someone else pay for their health care/school/retirement/whatever. Conservatives aren’t the ones out there demanding that the government use threats and coercion to force their neighbors into systems said neighbors might not like.

Libs want to defend themselves by claiming that they’ll tax “the rich” who “already have enough.” That’s funny when you consider that the Left marches around with that smug, holier-than-thou glow as they lecture the rest of us about being non-judgmental and forsaking stereotypes. Nice that they leave out a definition of “rich” so that poor, blue-collar, working-class Joes like Michael Moore can join their mob without having to feel bad.

A more obnoxious argument is, “You don’t like government? Then you should pull out of fire and police then.”

Yeah right, there is no difference at all between a 1,900-page Socialized Medicine law—which will affect all people inside the boundaries of the United States—and local law enforcement. Not one single difference. None at all. Thank you for pointing that out.

The King James version of the Bible runs more than 600 pages and is crammed with celestial regulations. Newton’s Principia Mathematica distilled many of the rules of physics in a mere 974 pages.

Neither have anything on Nancy Pelosi’s new fiendishly entertaining health-care opus, which tops 1,900 pages.

So curl up by a fire with a fifth of whiskey and just dive in.

But drink quickly. In the new world, your insurance choices will be tethered to decisions made by people with Orwellian titles (“1984” was only 268 pages!) like the “Health Choices Commissioner” or “Inspector General for the Health Choices Administration.”

You will, of course, need to be plastered to buy Pelosi’s fantastical proposition that 450,000 words of new regulations, rules, mandates, penalties, price controls, taxes and bureaucracy will have the transformative power to “provide affordable, quality health care for all Americans and reduce the growth in health care spending . . . .”

It’s going to take some time to deconstruct this lengthy masterpiece, but as you flip through the pages of the House bill, you will notice the word “regulation” appears 181 times. “Tax” is there 214 times. “Fees,” 103 times. As we all know, nothing says “affordability” like higher taxes and fees.

The word “shall” – as in “must” or “required to” – appears over 3,000 times. The word, alas, is never preceded by the patriotic phrase “mind our own freaking business.” Not once.

To vote for the bill, a legislator must believe a $1 trillion price tag is “revenue neutral,” or that it alleviates any of the pain higher costs bring to the average American. This would require alcohol.

While Americans feel increasingly disheartened, their leaders evince a mindless . . . one almost calls it optimism, but it is not that.

It is a curious thing that those who feel most mistily affectionate toward America, and most protective toward it, are the most aware of its vulnerabilities, the most aware that it can be harmed. They don’t see it as all-powerful, impregnable, unharmable. The loving have a sense of its limits.

When I see those in government, both locally and in Washington, spend and tax and come up each day with new ways to spend and tax—health care, cap and trade, etc.—I think: Why aren’t they worried about the impact of what they’re doing? Why do they think America is so strong it can take endless abuse?

I think I know part of the answer. It is that they’ve never seen things go dark. They came of age during the great abundance, circa 1980-2008 (or 1950-2008, take your pick), and they don’t have the habit of worry. They talk about their “concerns”—they’re big on that word. But they’re not really concerned. They think America is the goose that lays the golden egg. Why not? She laid it in their laps. She laid it in grandpa’s lap.

They don’t feel anxious, because they never had anything to be anxious about. They grew up in an America surrounded by phrases—”strongest nation in the world,” “indispensable nation,” “unipolar power,” “highest standard of living”—and are not bright enough, or serious enough, to imagine that they can damage that, hurt it, even fatally.

We are governed at all levels by America’s luckiest children, sons and daughters of the abundance, and they call themselves optimists but they’re not optimists—they’re unimaginative. They don’t have faith, they’ve just never been foreclosed on. They are stupid and they are callous, and they don’t mind it when people become disheartened. They don’t even notice.

Holman W. Jenkins, Jr., in the Journal, notes just how well the Obama Administration has done in turning the economy around.

Banks continue to fail at an alarming rate, the dollar is under assault, and Washington is looking at a future of trillion-dollar deficits. One might have guessed it would take a decade of Obamanomics to produce European welfare state levels of youth unemployment, but at 18.5% we’re there.

About the only positive sign is the price surge in normally uncorrelated assets—stocks, bonds, commodities, gold—as fund managers use cheap credit to play the carry-trade opportunity.

All this might be defensible if time were being bought to clean up an accumulation of past excesses. Instead, the president is creating a new one. It’s no exaggeration to say the Senate health-care bill taking shape is the equivalent of climbing aboard a train about to plunge into a canyon and deciding what it really needs is a bomb on board.

I found it distasteful to vote for a liberal democrat in the Connecticut Senate Race of 1988, but William F. Buckley Jr. had proposed that conservative Republicans do precisely that in order to rid the US Senate and the Republican Party of that odious skunk Lowell Weicker, and Buckley’s reasoning made sense.

At the time, of course, we hoped we would go on to capture back that Senate seat six years later with a real Republican, but that never happened.

Who would have ever have imagined that voting for Joe Lieberman all those years ago would again result in joy?

It is very possible that Bill Buckley’s delivery of conservative support to Joe Lieberman in 1988 may now, 21 years later, save the country from the democrat party left’s attempt to nationalize 1/6th of the US economy. That good man Joe Lieberman has announced that he will support the GOP filibuster in the Senate blocking passage of the public option.

Dan Riehl condescends to gloat.

Halp! Someone Call Ned Lamont

LMAO Watch the netroot’s heads explode.They betrayed Lieberman for Ned Who?, let’s not forget that. Now that failed Lefty power grab is coming back to bite them on the azz. There’s absolutely no reason for Lieberman to cave on this. They gave him the opportunity to show his strength as an Independent and he proved it. Choke on that, Libs.

Hat tip to the Barrister.

Bill Buckley smokes a celebratory cigar in heaven.

Even from across the Atlantic, the Telegraph has not failed to notice the terrible things happening to Barack Obama’s approval rating in the polls.

The decline in Barack Obama’s popularity since July has been the steepest of any president at the same stage of his first term for more than 50 years.

Gallup recorded an average daily approval rating of 53 per cent for Mr Obama for the third quarter of the year, a sharp drop from the 62 per cent he recorded from April.

His current approval rating – hovering just above the level that would make re-election an uphill struggle – is close to the bottom for newly-elected president. Mr Obama entered the White House with a soaring 78 per cent approval rating. ...

Jeffrey Jones of Gallup explained: “The dominant political focus for Obama in the third quarter was the push for health care reform, including his nationally televised address to Congress in early September.

“Obama hoped that Congress would vote on health care legislation before its August recess, but that goal was missed, and some members of Congress faced angry constituents at town hall meetings to discuss health care reform. Meanwhile, unemployment continued to climb near 10 per cent.” ...

Mr Obama is also facing widespread criticism for his drawn-out decision-making process over what to do next in Afghanistan.

Trying to nationalize health care during Clinton’s first term cost the democrat party a 40 year old Congressional majority in both houses. At times like these, one is obliged to quote Santayana, who observed that those who cannot learn from history are inevitably obliged to repeat it.

I’m not sure the White House can tell the difference between campaign mode and governing mode, but it is the difference between “us versus them” and “us.” People sense the president does too much of the former, and this is reflected not only in words but decisions, such as the pursuit of a health-care agenda that was inevitably divisive. It has lost the public’s enthusiastic backing, if it ever had it, but is gaining on Capitol Hill. People don’t want whatever it is they’re about to get, and they’re about to get it. In that atmosphere everything grates, but most especially us-versus-them-ism.

The biggest thing supporters of a health care overhaul do not understand about those who oppose their efforts, and who oppose the Baucus bill, which has triumphantly passed the Senate Finance Committee even though no one knows exactly what is or will end up in it, is the issue of context.

The Democratic Party and the White House repeatedly suggest that if you are not for the bill or an overhaul, you don’t care about your fellow human beings and you love and support the insurance companies. Actually, no one loves the insurance companies, including the insurance companies. ... But the Obama administration’s strategy of making (the insurance industry) “the villain” in “the narrative” will probably not have that much punch because . . . well, again, who likes the insurance companies? Who ever did?

People who oppose a health-care overhaul are not in love with insurance companies. They’re not even in love with the status quo. Everyone knows the jerry-built system of the past half-century has weak points. They just don’t think the current plan will shore them up. They think the plan would create new weak points and widen old ones. They think this because they have brains.

But even that doesn’t get to the real subtext of the opposition. Yes, the timing is wrong—we have other, more urgent crises to face, and an exploding deficit. And yes, a big change in a huge economic sector during economic crisis is looking for trouble.

But a big part of opposition to the health-care plan is a sense of historical context. People actually have a sense of the history they’re living in and the history their country has recently lived through. They understand the moment we’re in.

In the days of the New Deal, in the 1930s, government growth was virgin territory. It was like pushing west through a continent that seemed new and empty. There was plenty of room to move. The federal government was still small and relatively lean, the income tax was still new. America pushed on, creating what it created: federal programs, departments and initiatives, Social Security. In the mid-1960s, with the Great Society, more or less the same thing. Government hadn’t claimed new territory in a generation, and it pushed on—creating Medicare, Medicaid, new domestic programs of all kinds, the expansion of welfare and the safety net.

Now the national terrain is thick with federal programs, and with state, county, city and town entities and programs, from coast to coast. It’s not virgin territory anymore, it’s crowded. We are a nation fully settled by government. We are well into the age of the welfare state, the age of government. We know its weight, heft and demands, know its costs both in terms of money and autonomy, even as we know it has made many of our lives more secure, and helped many to feel encouragement.

But we know the price now. This is the historical context. The White House often seems disappointed that the big center, the voters in the middle of the spectrum, aren’t all that excited about following them on their bold new journey. But it’s a world America has been to. It isn’t new to us. And we don’t have too many illusions about it.

I do not think it’s so much because people want freedom and choice (altho they do) as it is because people have no confidence in government entitlement programs (which the Dem plans are all about, ultimately). Why?

Social Security – bankrupt
Postal Service – bankrupt
Welfare – had devastating unintended consequences for which the nation still pays and from which the nation continues to suffer (eg huge rates – up to 70% – of single motherhood among beneficiaries)
Medicare – bankrupt
Medicaid – bankrupting the states
Government-run (ie union-controlled) schools: are people thrilled with them?
Fannie Mae and Freddy Mac – bankrupt
The “stimulus” – a failure, but it did create 25,000 new government jobs!

The future tax consequences of the above are daunting to people, and the idea of adding another trillion or so frightens the heck out of people who are thinking about their own well-being, their kids’ futures – and also about the nation’s. ...

Abundant, high quality, and fairly expensive medical care is one of the great blessings and privileges of a prosperous society, and thus an important economic engine. Why kill it? People want these things.

Do Americans want to be grown-ups, or children? It’s our call.

My liberal classmates, I find, are simply members of a religious cult whose object of worship is the state. Everything enlarging state income, power, and authority is good. Anything you want done, just turn it over to the federal government.

The government is to them rather the the genie in the lamp. Want poverty eliminated? Want free health care for everyone? Want a perfect world? Just rub the lamp, let those democrats pass an appropriations bill, and voilà! your friendly government genie grants your wish.

They actually believe that the same government that buys $435 hammers, $640 toilet seats, and $7600 coffee makers, the same government whose lawmakers can neither read the healthcare bill they’re voting on or arrange to have it put on-line, is going to streamline delivery and make health care cheaper and more efficient. Pure insanity.

Who dictates what level of anger and dissent is allowable? Who decides what a clandestine racist sign looks like? Maybe someone like MSNBC’s Carlos Watson, who wondered if “socialism” was really about the nationalization of industry and hyper-regulation of the private market, or if it was just “becoming the new N-word.”

None of this has anything to do with the left’s paranoid belief that America is an inherently racist nation. It’s just that if you oppose more government dependency and expansion, you might as well be a Confederate infantryman. No, it doesn’t matter what you say, because we know what you really mean.

Read the whole thing.

Hat tip to John Cole. Thanks, John. It’s a good one.

The leftish political strategy for over 100 years has been

1. Regulate something 2. Blame the free market for inevitable disruptions caused by the regulation 3. Use the above to justify more regulation 4. Repeat

We have an artificial situation, created by government tax policy in the first place. Healthcare charges have been removed from market influence because the consumer has not been paying them, his insurance has. The consumer normally does not buy his own insurance. Tax policy has arranged for health insurance to be a benefit of corporate employment.

When you do get to buy your own health insurance is when you lose your job, and then, ouch! you tend to find out just how expensive being a member of a maginal, ill-serviced market can be, at the very time you can least afford it.

Reforming health care simply requires transferring the tax deduction to individuals, reducing the burden of litigation and consequent staggering malpractice insurance costs and defensive medicine, and removing state barriers to insurance competition. Democrats don’t like any of that. When Whole Foods’ John Mackey made several of these suggestions in the Wall Street Journal editorial, his company was subjected to a boycott.

Hat tip to the News Junkie.

Why has the Democratic Party become so arrogantly detached from ordinary Americans? Though they claim to speak for the poor and dispossessed, Democrats have increasingly become the party of an upper-middle-class professional elite, top-heavy with journalists, academics and lawyers (one reason for the hypocritical absence of tort reform in the healthcare bills). Weirdly, given their worship of highly individualistic, secularized self-actualization, such professionals are as a whole amazingly credulous these days about big-government solutions to every social problem. They see no danger in expanding government authority and intrusive, wasteful bureaucracy. This is, I submit, a stunning turn away from the anti-authority and anti-establishment principles of authentic 1960s leftism. ...

(A)ffluent middle-class Democrats now seem to be complacently servile toward authority and automatically believe everything party leaders tell them. Why? Is it because the new professional class is a glossy product of generically institutionalized learning? Independent thought and logical analysis of argument are no longer taught. Elite education in the U.S. has become a frenetic assembly line of competitive college application to schools where ideological brainwashing is so pandemic that it’s invisible. The top schools, from the Ivy League on down, promote “critical thinking,” which sounds good but is in fact just a style of rote regurgitation of hackneyed approved terms (“racism, sexism, homophobia”) when confronted with any social issue. The Democratic brain has been marinating so long in those clichés that it’s positively pickled.

Throughout this fractious summer, I was dismayed not just at the self-defeating silence of Democrats at the gaping holes or evasions in the healthcare bills but also at the fogginess or insipidity of articles and Op-Eds about the controversy emanating from liberal mainstream media and Web sources. By a proportion of something like 10-to-1, negative articles by conservatives were vastly more detailed, specific and practical about the proposals than were supportive articles by Democrats, which often made gestures rather than arguments and brimmed with emotion and sneers. There was a glaring inability in most Democratic commentary to think ahead and forecast what would or could be the actual snarled consequences—in terms of delays, denial of services, errors, miscommunications and gross invasions of privacy—of a massive single-payer overhaul of the healthcare system in a nation as large and populous as ours. It was as if Democrats live in a utopian dream world, divorced from the daily demands and realities of organization and management.

But dreaming in the 1960s and ‘70s had a spiritual dimension that is long gone in our crassly materialistic and status-driven time.

And, of course, they do. The supposed generosity of the bien pensants is really the purest selfishness. America’s pezzonovantes live limitlessly appetitive lives of aesthetic appreciation, worldly and even spiritual aspiration, of constant striving for success, power, personal advancement, and self affirmation. The sight of the poor, the uncomely, the disorderly, the untidied away aspects of cruel reality is disagreeable to them. Someone needs to do something about it. It is A PROBLEM. And all problems, from the viewpoint of the pseudogentsia, can be cleared away by simple transfer to the responsibility of the state with a generous allocation of other people’s tax dollars. Big Government is for the American left essentially just a larger-scale version of the building management they’re accustomed to calling upon to clean the elevator anytime someone has made a mess.

Charles Krauthammer muses over how exactly it came to pass that the Chosen One lost his mojo. His conclusion? As always, it was Hubris that brought the fortunate and previously successful man of destiny’s progress to a crashing halt.

What happened to President Obama? His wax wings having melted, he is the man who fell to earth. What happened to bring his popularity down further than that of any new president in polling history save Gerald Ford (post-Nixon pardon)?

The conventional wisdom is that Obama made a tactical mistake by farming out his agenda to Congress and allowing himself to be pulled left by the doctrinaire liberals of the Democratic congressional leadership. But the idea of Harry Reid and Nancy Pelosi pulling Obama left is quite ridiculous. Where do you think he came from, this friend of Chávista ex-terrorist William Ayers, of PLO apologist Rashid Khalidi, of racialist inciter Jeremiah Wright?

But forget the character witnesses. Just look at Obama’s behavior as president, beginning with his first address to Congress. Unbidden, unforced and unpushed by the congressional leadership, Obama gave his most deeply felt vision of America, delivering the boldest social democratic manifesto ever issued by a U.S. president. In American politics, you can’t get more left than that speech and still be on the playing field.

In a center-right country, that was problem enough. Obama then compounded it by vastly misreading his mandate. He assumed it was personal. This, after winning by a mere seven points in a year of true economic catastrophe, of an extraordinarily unpopular Republican incumbent, and of a politically weak and unsteady opponent. Nonetheless, Obama imagined that, as Fouad Ajami so brilliantly observed, he had won the kind of banana-republic plebiscite that grants caudillo-like authority to remake everything in one’s own image.

Accordingly, Obama unveiled his plans for a grand makeover of the American system, animating that vision by enacting measure after measure that greatly enlarged state power, government spending and national debt. Not surprisingly, these measures engendered powerful popular skepticism that burst into tea-party town-hall resistance.

Obama’s reaction to that resistance made things worse. ...

Read the whole thing.

Since we are moving toward socialism with ObamaCare, the time has come to do the same with other professions—especially lawyers. Physician committees can decide whether lawyers are necessary in any given situation. ...

Following are highlights of a proposed bill authorizing the dismantling of the current framework of law practice and instituting socialized legal care:...

Legal “DRGs.” Each potential legal situation will be assigned a relative value, and charges limited to this amount. Program participation and acceptance of this amount is mandatory, regardless of the number of hours spent on the matter. Government schedules of flat fees for each service, analogous to medicine’s Diagnosis Related Groups (DRGs), will be issued. For example, any divorce will have a set fee of, say, $1,000, regardless of its simplicity or complexity. This will eliminate shady hourly billing. Niggling fees such as $2 per page photocopied or faxed would disappear. Who else nickels-and-dimes you while at the same time charging hundreds of dollars per hour? I’m surprised lawyers don’t tack shipping and handling onto their bills.

 Legal “death panels.” Over 75? You will not be entitled to legal care for any matter. Why waste money on those who are only going to die soon? We can decrease utilization, save money and unclog the courts simultaneously. Grandma, you’re on your own.

Ration legal care. One may need to wait months to consult an attorney. Despite a perceived legal need, physician review panels or government bureaucrats may deem advice unnecessary. Possibly one may not get representation before court dates or deadlines. But that’ s tough: What do you want for “free”?

Physician controlled legal review. This is potentially the most exciting reform, with doctors leading committees for determining the necessity of all legal procedures and the fairness of attorney fees. ...

Electronic legal records. We should enter the digital age and computerize and centralize legal records nationwide. All files must be in a standard, preferably inconvenient, format and must be available to government agencies. A single database of judgments, court records, client files, etc. will decrease legal expenses. Anyone with Internet access will be able to search the database, eliminating unjustifiable fees charged by law firms for supposedly proprietary information, while fostering transparency. It will enable consumers to dump their clunker attorneys and transfer records easily. ...

New government oversight. Government overhead to manage the legal system will include a cabinet secretary, commissioners, ombudsmen, auditors, assistants, czars and departments.

Collect data about the supply of and demand for attorneys. Create a commission to study the diversity and geographic distribution of attorneys, with power to stipulate and enforce corrective actions to right imbalances. The more bureaucracy the better. One can never have too many eyes watching these sleazy sneaks.

Read the whole thing.

Here’s an account from the influential left Blogosphere Talking Points Memo quoting Karoli Kuns, a self-described eyewitness to the Thousand Oaks, California biting incident, who testifies that the leftwinger who bit off a 65-year-old’s finger had been immediately previously been assaulted by him.

So the biting incident becomes a somewhat bizarre, regrettable incident of justified retaliation for unprovoked violence.

The man in the orange shirt hit the pro-reform guy (I’m going to call him PR Guy just to keep the players straight). Hard. ( tweeted in real time) He punched him in the face, knocked him to the ground and into that thruway. As you can see from the photo, cars drive straight through that without stopping. The pro-reform guy could have been run over. He got up, tried to get back up on the curb, but Orange Shirt guy was in his face. Finger in his face, PR Guy standing, steps up to the curb, and there’s a scuffle. Orange shirt seemed to have PR Guy in a hold, but again, I was across the street, so won’t state that as absolute fact. Next thing I see is PR Guy’s hat being tossed into the street, both yelling at one another, then Orange shirt walks away, PR Guy picks up hat and crosses to our side.

When he gets to our side, he tells a story in one sentence: “He punched me hard, straight in the face, so I bit his finger off.”

Kuns obviously misidentified the biting victim. This Fox News 7:31 video demonstrates that the Ventura Counry Sheriff’s Department photo identification was correct and Kuns wrong.

Mary Katherine Hamm quotes an Obamacare opponent witness, who depicts the biter as the aggressor.

Scott Bush, an Obama critic who was standing next to Rice when the incident happened, said critics and supporters of Obama had had face-to-face, calm debates throughout the night without incident until the suspect in the biting crossed the street to confront critics. Of Rice’s behavior, he said:

“He didn’t even have a sign. He was just there to be a part of things. He’s a nice man.”

The suspect yelled at the group, “Are you for the public option?” When the crowd answered, “no,” Bush said he singled out Rice, one of the smaller men in the group, coming at him and yelling, “You’re an idiot, you’re an idiot!”

“I don’t think he had any intentions whatsoever of talking,” said Rice, who “popped him in the nose” when he got close to his face.

Bush called Rice’s move “defensive.” Bush said the incident became a scuffle, the public-option supporter pulled Rice into the street, and it was over very quickly after that. During the struggle, Rice said his finger ended up in the suspect’s mouth, and it was bitten off.

“William grabbed his hand and said, ‘Oh, he bit my finger off,” Bush said. “It was clear that the end of his finger was bitten off. It was a stump.”

Rice left for the hospital and the assailant ran away before police arrived. Bush looked for Rice’s fingertip and found it about 20 feet away from the scuffle, in the street.

“I got in my car and I took his finger to Los Robles and I found him, and I gave him back his finger,” Bush said, who carried the digit wrapped in a napkin.

Unfortunately, “it was of no use,” Rice said.

Mr. Rice, by his own account, evidently did strike the first blow, but “PR guy” clearly did advance upon Rice and confront him with close range verbal abuse. Traditional standards of self defense recognize the existence of fighting words, verbal insults seriously provocative enough to justify a physical response. If PR Guy really did grossly insult Mr. Rice, a punch in the nose could very well be a legitimate response. I’d consider a poke in the snout justification, too, for PR guy poking back, but the amputation of a finger is obviously a significantly greater escalation of violence, and there can be little doubt that PR guy is going to be prosecuted when the Ventura County authorities catch him.

Leftwing baby boomers will really have have something to look forward to under Obamacare, look at what Britain’s National Institute for Health and Clinical Excellence (Nice—You have to love the acronym!) is doing for patients there.

Telegraph:

In a letter to The Daily Telegraph, a group of experts who care for the terminally ill claim that some patients are being wrongly judged as close to death.

Under NHS guidance introduced across England to help doctors and medical staff deal with dying patients, they can then have fluid and drugs withdrawn and many are put on continuous sedation until they pass away. ...

The warning comes just a week after a report by the Patients Association estimated that up to one million patients had received poor or cruel care on the NHS. ...

The scheme, called the Liverpool Care Pathway (LCP), was designed to reduce patient suffering in their final hours.

Developed by Marie Curie, the cancer charity, in a Liverpool hospice it was initially developed for cancer patients but now includes other life threatening conditions.

It was recommended as a model by the National Institute for Health and Clinical Excellence (Nice), the Government’s health scrutiny body, in 2004.

It has been gradually adopted nationwide and more than 300 hospitals, 130 hospices and 560 care homes in England currently use the system.

Under the guidelines the decision to diagnose that a patient is close to death is made by the entire medical team treating them, including a senior doctor.

They look for signs that a patient is approaching their final hours, which can include if patients have lost consciousness or whether they are having difficulty swallowing medication.

However, doctors warn that these signs can point to other medical problems.

Patients can become semi-conscious and confused as a side effect of pain-killing drugs such as morphine if they are also dehydrated, for instance.

When a decision has been made to place a patient on the pathway doctors are then recommended to consider removing medication or invasive procedures, such as intravenous drips, which are no longer of benefit.

If a patient is judged to still be able to eat or drink food and water will still be offered to them, as this is considered nursing care rather than medical intervention.

Dr Hargreaves said that this depended, however, on constant assessment of a patient’s condition.

He added that some patients were being “wrongly” put on the pathway, which created a “self-fulfilling prophecy” that they would die.

In August our ubiquitous president became the nation’s elevator music, always out and about, heard but not really listened to, like audible wallpaper. And now, as Congress returns to resume wrestling with health care reform, we shall see if he continues his August project of proving that the idea of an Ivy LeagueHuey Long is not oxymoronic.

Barack Obama in August became a Huey for today, a rabble rouser with a better tailor, an unrumpled and modulated tribune of downtrodden Americans, telling them that opponents of his reform plan—which actually does not yet exist—are fearmongers employing scare tactics. He also told Americans to be afraid, very afraid of health-insurance providers because they are dishonest (and will remain so until there is a “public option” to make them “honest”). And to be afraid, very afraid of pediatricians who unnecessarily extract children’s tonsils for monetary rather than medical reasons. And to be afraid, very afraid of doctors generally because so many of them are so rapacious that they prefer lopping off limbs of diabetes patients rather than engaging in lifestyle counseling that for “a pittance” could prevent diabetes.

Read the whole thing. George Will is in good form.

The late New Yorker film critic Pauline Kael famously said after Nixon’s landslide reelection, “How can he have won? Nobody I know voted for him.” My proposition for today is that the entire White House suffers from the Kael syndrome.

It was the only explanation I could think of as I watched the news last night about the coming prosecution of CIA interrogators. When it comes to political analysis, I’m no Barone or Bowman or Ornstein, but this is not a really tough call. Attempts to put men on trial who obtained information that most Americans will believe (probably rightly) saved the nation from more terrorist attacks will be a political catastrophe, all the more so because I bet that the defendants will come across as straight-arrow good guys (and probably are), while the prosecutors come across as self-righteous wimps (and…). How could the White House not have thought this through? ...

(E)very white socioeconomic class in America has become more conservative in the last four decades, with the Traditional Middles moving the most decisively rightward. But the Intellectual Uppers have not just moved slightly in the other direction, they have careened in the other direction.

They won the election with a candidate who sounded centrist running against an exceptionally weak Republican opponent. But they’ve been in the bubble too long. They really think that the rest of America thinks as they do. Nothing but the Pauline Kael syndrome can explain the political idiocy of letting Attorney General Eric Holder go after the interrogators.

Read the whole thing.
—————————————-

Meanwhile in the Wall Street Journal, Fouad Ajami concludes that Barack Obama’s moment has passed. Health Care Reform finished it. Barack Obama is definitely not Ronald Reagan, and the American people who gambled on his governing as a centrist are gradually coming to recognize his real agenda and are growing increasingly frightened and appalled.

In one of the revealing moments of the presidential campaign, Mr. Obama rightly observed that the Reagan presidency was a transformational presidency in a way Clinton’s wasn’t. And by that Reagan precedent, that Reagan standard, the faults of the Obama presidency are laid bare. Ronald Reagan, it should be recalled, had been swept into office by a wave of dissatisfaction with Jimmy Carter and his failures. At the core of the Reagan mission was the recovery of the nation’s esteem and self-regard. Reagan was an optimist. He was Hollywood glamour to be sure, but he was also Peoria, Ill. His faith in the country was boundless, and when he said it was “morning in America” he meant it; he believed in America’s miracle and had seen it in his own life, in his rise from a child of the Depression to the summit of political power.

The failure of the Carter years was, in Reagan’s view, the failure of the man at the helm and the policies he had pursued at home and abroad. At no time had Ronald Reagan believed that the American covenant had failed, that America should apologize for itself in the world beyond its shores. There was no narcissism in Reagan. It was stirring that the man who headed into the sunset of his life would bid his country farewell by reminding it that its best days were yet to come.

In contrast, there is joylessness in Mr. Obama. He is a scold, the “Yes we can!” mantra is shallow, and at any rate, it is about the coming to power of a man, and a political class, invested in its own sense of smarts and wisdom, and its right to alter the social contract of the land. In this view, the country had lost its way and the new leader and the political class arrayed around him will bring it back to the right path.

Thus the moment of crisis would become an opportunity to push through a political economy of redistribution and a foreign policy of American penance. The independent voters were the first to break ranks. They hadn’t underwritten this fundamental change in the American polity when they cast their votes for Mr. Obama.

American democracy has never been democracy by plebiscite, a process by which a leader is anointed, then the populace steps out of the way, and the anointed one puts his political program in place. In the American tradition, the “mandate of heaven” is gained and lost every day and people talk back to their leaders. They are not held in thrall by them. The leaders are not infallible or a breed apart. That way is the Third World way, the way it plays out in Arab and Latin American politics.

Those protesters in those town-hall meetings have served notice that Mr. Obama’s charismatic moment has passed. Once again, the belief in that American exception that set this nation apart from other lands is re-emerging. Health care is the tip of the iceberg. Beneath it is an unease with the way the verdict of the 2008 election was read by those who prevailed. It shall be seen whether the man swept into office in the moment of national panic will adjust to the nation’s recovery of its self-confidence.

Read the whole thing.
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Barack Obama’s determination to govern de haute en bas, to impose on the rest of the country the ideological preferences of what Charles Murray calls the “Intellectual Upper,” really the community of fashion, places him in serious conflict with the uncommitted political center which gave him his margin of victory. Rather than giving Obama and the democrat party a mandate for Socialism and a blank check for revenge, the centrists mistakenly accepted Obama’s soft talk and tone of moderation. They voted for a calm and emollient presidency, desiring an end to the ideological furor of George W. Bush’s presidency. Barack Obama is fatally misinterpreting the voters’ message.

(US Health Care today) unites rich and poor in a common private insurance system.

Here’s how it works. When a rich person rolls into the operating room, the nurse asks him: “Would you like a warm blanket? How about a pillow?” The anesthesiologist numbs his skin before putting in the I.V. Every effort is made to make him happy.

People in the operating room pay attention to a rich patient’s wishes because they know a rich person can make their lives miserable. He can complain to the hospital president, or call the mayor. But the side effect is that their high quality care becomes habitual, and all patients receive it. When a poor person complains in most environments, no one listens. But in health care, through a common private insurance system, poor people go to the same hospitals and doctors as rich people and thus enjoy the benefit of rich people’s power.

The public option severs this link. Dissatisfied with government-run health care, the rich will exit the system. The poor and middle-class will be left to flounder alone inside the public system. Government-run health care will become like the public schools.

The best doctors will be opening luxury clinics in Carribean resort locations, and the wealthy will simply jet off for their health care, leaving everyone else experiencing the equivalent of inner city hospital emergency room service, endless queues, drastic rationing and triage.

Hedrick’s point, that Congress has absolutely no right to interfere with our right to chose our own health insurance, is dead on.

2:19 video

Mr. Hedrick was clearly far from alone in his sentiments. The crowd cheered his remarks.

From Simon at Classical Values via Bird Dog at Maggie’s Farm.

I think he’s right. Socialized health care is a goal that the left can neither relinquish nor hope to win.

As the prospects for bipartisan agreement in the Senate fade, the need for Obama to unify Democrats will increase. Right now, though, he is losing Democrats from both wings of the party, even as independents soften and conservatives mobilize. Obama’s ratings in the Pew survey declined slightly from July to August among moderate Democrats (down two percentage points) and sharply among liberal Democrats (down nine percentage points).

These poll numbers suggest that health care is becoming the classic issue that wounds a president: one that unites his opponents and divides his own side. Obama probably has little hope of changing the first half of that equation; when Congress returns he’ll probably need to focus more on improving the second.

Scott Wong, at PhxBeat, explains that the black guy with the gun outside the Obama Health Care Town Hall meeting in Phoenix was just affirming his Second Amendment rights.

Neatly dressed in a white shirt, black tie and gray slacks, the man, who only gave his first name as Chris, also had a pistol holstered at his side as he engaged in heated debates with those rallying in support of Obama’s heath-care reform plan.

A Phoenix police spokesman said plainclothes detectives were monitoring about a dozen protesters carrying guns, though no one broke any laws or was arrested.

Arizona is an “open-carry” state, which means anyone legally allowed to have a firearm can carry it in public as long as it’s visible. A permit is required if the weapon is carried concealed.

“Because I can do it,” Chris said when asked why he brought guns to the rally at 3rd and Washington streets. “In Arizona, I still have some freedoms left.”

On Tuesday, MSNBC’s Contessa Brewer fretted over health care reform protesters legally carrying guns: “A man at a pro-health care reform rally…wore a semiautomatic assault rifle on his shoulder and a pistol on his hip….there are questions about whether this has racial overtones….white people showing up with guns.” Brewer failed to mention the man she described was black.

Following Brewer’s report, which occurred on the Morning Meeting program, host Dylan Ratigan and MSNBC pop culture analyst Toure discussed the supposed racism involved in the protests. Toure argued: “...there is tremendous anger in this country about government, the way government seems to be taking over the country, anger about a black person being president….we see these hate groups rising up and this is definitely part of that.” Ratigan agreed: “...then they get the variable of a black president on top of all these other things and that’s the move – the cherry on top, if you will, to the accumulated frustration for folks.”

Not only did Brewer, Ratigan, and Toure fail to point out the fact that the gun-toting protester that sparked the discussion was black, but the video footage shown of that protester was so edited, that it was impossible to see that he was black.

1:34 video

The Hill:

Obama and top administration officials this weekend dropped the president’s longtime insistence that the health legislation include a government-run public plan amid widespread flare-ups of outrage at town halls across the country.

Matt Taibbi may have delivered the unkindest cut of all… a negative comparison to George W.

I’ll say this for George Bush: you’d never have caught him frantically negotiating against himself to take the meat out of a signature legislative initiative just because his approval ratings had a bad summer. Can you imagine Bush and Karl Rove allowing themselves to be paraded through Washington on a leash by some dimwit Republican Senator of a state with six people in it the way the Obama White House this summer is allowing Max Baucus (favorite son of the mighty state of Montana) to frog-march them to a one-term presidency?

Get out the shovels and start burying it, folks, before it starts to smell. It’s dead. The Obama Revolution is over. The high tide of American leftism has crested. The Retreat from Moscow is on.

In 2008, a glib and fortunate beneficiary of a massive legacy of liberal guilt was able to smooth talk his way into an electoral victory based on a sudden market crash created by the combination of long-standing democrat housing market interventions combined with well-founded fears of the possibility of his election.

Ironically, it was Mr. Market’s bipolar panic attack which actually assured that the nightmare of his own imaginings could and would become reality. The GOP turned chicken, too, and chose what the bosses thought must be the safest play, nominating the geriatric and politically incoherent John McCain, who ran an uninspired campaign, trying to oppose age to youth and promises of less to promises of everything paid for by somebody else. Everything fell apart at once. So the least qualified, most radical candidate ever, a community organizer and Alinskyite radical, whose best friends have been black Communist poets, Weathermen cop killers, and racist clergymen, waltzed into the White House, accompanied by a Star Wars bar’s assemblage of exotic representatives of the radical fringe, all bent of bringing Socialism to America.

He spent a few trillions in a matter of weeks, assuring a dimmer future to a generation of Americans, then gleefully nationalized General Motors delivering control of America’s largest auto maker to the UAW’s commissars. Barack Obama took to heart Rahm Emanuel’s dictum about using an economic crisis as an empowering opportunity. But that power was only on loan. The American people were frightened and willing to put their faith in the two party system, roll the dice, and give the party which had been out of power a chance. Their decision had only been based on the “we’re tired of A and unhappy, let’s try B for a while” approach. The assertion by democrats and by Barack Hussein Obama that the 2008 election gave them a mandate for Socialism has been proven wrong.

Obama in 2009 has wound up just like Napoleon in 1812. Flushed with a string of victories, armed with an unfilibusterable Congressional majority, backed by an enormous army of labor unions, interest groups, and activist organizations, funded by George Soros, allied to the mainstream media, and well-supported by the mass artillery of the leftwing blogosphere, the Obama Administration even succeeded in negotiating free passage for the invasion from large corporations like Walmart and the pharmaceuticals companies (no doughty Belgium in 1914, they). As always, capitalists will willingly sell the rope used to hang free enterprise to the bolsheviks for short term profit as long as the sellers get assurances that they themselves will be hanged last.

But the denoument is worthy of Tolstoy. The Grand Armee of Socialist Ideology, despite all its votes in Congress; its media support; its grand alliance of corrupt businesses, unions; the AMA and the AARP; ACORN and George Soros has been brought to a crashing halt. Its morale is crumbling. It is in complete disorder, and it will soon be in full retreat. Barack Obama has been dealt a devastating defeat, one which will permanently shatter his image of invincibility, and placing Barack Obama, the democrat party, and the American left on the defensive, struggling to avoid complete and total ruin.

The left is crying out that it was the weak and inferior forces of the Republican Party and the American Right that brought them low. I’m a Movement Conservative and a rock-ribbed Republican myself. I wish that it were so. But the truth is the Republican Party and the Conservative Movement have no such capabilities. What defeated Obamacare was the American People.

Barack Obama believed the American People are so stupid, so selfish, and so greedy that they would fall for democrat promises of health care free lunch, all the health care everybody needs or wants, paid for by the upper tiny few percent of staggeringly rich taxpayers (who won’t even miss it anyway). Uncle Sam will just nudge the taxes on Warren Buffett, Bill Gates, and the guys at Goldman getting those multi-million dollar bonuses up just a notch, essentially sneaking into their bedrooms and removing some extra spare change from the tops of their bureaus, and granny gets her hip replacement gratis, and Tiny Tim will walk again, even if Bob Crachit has no insurance.

None of these promises were true, of course. The democrat “health care reform” was never going to bring ordinary Americans the kind of care US Senators get, “just like me,” as Obama promised so persistently during the campaign. What it was going to do, obviously, was to create a new and enormous federal entitlement program necessitating a massive increase of government’s share of the US economy. Socialism would have made a scarce and desirable service, medical care, cost free, obviously dramatically increasing demand. Most Americans would inevitably pay more and get less, as the health care butter got spread by the federal knife onto ever more slices of bread.

America today is a rapidly aging nation. The time to offer the Woodstock Generation a nice socialist health care system was 40 years ago when we were young and perfectly healthy, and could not imagine ourselves ever really needing it. Today, there are lots of Boomer generation geezers out there who have a real personal interest in just how health care reform will affect them now and who are old enough to know better. A lot of people tried sharing the granola and peanut butter supply back on the commune in 1969. They know just how “sharing” works out.

It was not Dick Armey and Rush Limbaugh who showed up with greater strength and larger funding or who beat back the democrat advance with superior cunning. It was the American People, who are experiencing this country’s economy right now, who saw Obama’s stimulus package and his bailouts, who paid their income taxes, and who are beginning to become afraid, very afraid of where Barack Obama’s economic policies are leading us. It was the American People that said, No, we do not believe there is really such a thing as a free lunch. It is the American People who are turning out at those Town Halls, and whose negative opinions are showing up in all the polls. It is the American People, not the Republican Party, that has defeated Obamacare.

Nancy Morgan, at American Thinker, comments on the anger of the democrat elite at the common people daring to talk back.

The face-off between the ruling party and the people continues to unfold, as Democrat politicians hold town hall meetings across the country to build support for the Obama administration’s latest power grab, misleadingly labeled ‘health care reform.’

The faux outrage politicians manufacture on demand has been replaced by real outrage. Outrage at the American people for failing to understand the nuances, the broad outline of a 1,000 page plus bill that most politicians haven’t even read. Hey, that’s what staff is for, explained new Democrat, Arlen Spector.

Peons from fly-over country are daring to challenge the carefully scripted and (deliberately?) misleading talking points. Talking points which, by the way, have been endorsed by the media. Don’t these guys read the New York Times?

Harry Reid and Nancy Pelosi are using the standard liberal tactic of diverting attention from the issue by demonizing the dissenter, in this case, the American people. According to Pelosi and Reid, voicing objections to the federal government’s take over of 17% of the formerly free market economy is ‘un-American.’ Harry Reid has gone a step further, tarring dissenter’s as ‘evil mongers.’

White House spokesman Robert Gibbs has blithely dismissed the burgeoning dissent by informing one and all that these ‘townhalls are not representative of America.’ Obama, meanwhile, is trying to divert the issue by blaming the ‘headline hungry television networks’, accusing them of ‘enflaming an ugly backlash.’

Unused to any opposition that can’t be spun to their advantage or ignored, Democrats are desperately trying to convince Americans that the tidal wave of opposition is not genuine. Used to viewing every issue in political terms, our elected officials are actually convinced that the disruptive townhalls are merely the product of an evil conservative cabal. After all, every person these lawmakers know agree with them on this issue. Its called the ‘inside the beltway syndrome.’

Despite a new $12 million ad campaign designed to soothe Americans into relying on misplaced compassion instead of common sense, pesky Joe Six-Pack and Susy Homemaker still don’t get it. And adding insult to injury, American citizens are starting to question where all the money is coming from to run these ads. And by the way, who’s signing the paychecks for the new army of health care advocates who are being paid $12 to $13 an hour for their support? Inquiring minds want to know.

Answers to these questions are not forthcoming. Like the classic case of a wife catching her husband in bed with another woman, the question has become, “Who are you going to believe? Me, or your lying eyes?”

Leftists characteristically avoid openly advocating their goals. They don’t call themselves Marxists or socialists. These days they even avoid the label of liberal, and prefer to speak of themselves as “progressives.” Their reliance on deception, their preference for seeking power not via an open fight, but rather by a gradual process of subversion, have made traditionally the favored zoological metaphors for leftists, not major predators like wolves, but small and sneaky vermin like rats or roaches. Winston Churchill once even described Lenin (being transported to Russia from Switzerland in a sealed train by Germany) as resembling a plague bacillus.

This morning, however, Maureen Dowd is a bit more denunciatory than usual, accusing Sarah Palin of turning back country Alaska major predator control tactics on Rahm Emanuel’s brother, medical ethicist Dr. Ezekiel Emanuel.

At the moment, what she wants to do is tap into her visceral talent for aerial-shooting her favorite human prey: cerebral Ivy League Democrats.

Just as she was able to stir up the mob against Barack Obama on the trail, now she is fanning the flames against another Harvard smarty-pants — Dr. Zeke Emanuel, a White House health care adviser and the older brother of Rahmbo.

She took a forum, Facebook, more commonly used by kids hooking up and cyberstalking, and with one catchy phrase, several footnotes and a zesty disregard for facts, managed to hijack the health care debate from Mr. Obama.

Sarahcuda knows, from her brush with Barry on the campaign trail, that he is vulnerable on matters that demand a visceral and muscular response rather than a logical and book-learned one. Mr. Obama was charming and informed at his town hall in Montana on Friday, but he’s going to need some sustained passion, a clear plan and a narrative as gripping as Palin’s I-see-dead-people scenario.

She has successfully caricatured the White House health care effort, making it sound like the plot of the 1976 sci-fi movie “Logan’s Run,” about a post-apocalyptic society with limited resources where you can live only until age 30, when you must take part in an extermination ceremony called “Carousel” or flee the city.

Painting the Giacometti-esque Emanuel as a creepy Dr. Death, Palin attacked him on her Facebook page a week ago, complaining that his “Orwellian thinking” could lead to a “death panel” with bureaucrats deciding whether to pull the plug on less hardy Americans.

When democrats go ballistic like this, and pull out all the stops on denial, you can tell that someone has struck a nerve. For several days now, democrats everywhere have been screaming in pain over this one. Even my liberal classmates have been faithfully repeating the Gospel According to Talking Points Memo and Daily Kos: “Palin is lying about ‘Death Panels.’”

Was Palin lying? Let’s see.
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Sarah Palin’s Facebook entry said:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. 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.

Palin was repeating a point made in a House speech, Monday, July 27, 2009 (5:18 video), by Rep. Michelle Bachmann (R-6th district Minn.)
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Much of Michelle Bachmann’s speech consisted of her reading a July 24th column from the New York Post by Betsey McCaughey. McCaughey quoted Dr. Emanuel repeatedly:

Emanuel bluntly admits that the cuts (produced by democrat so-called health care reform) will not be pain-free. “Vague promises of savings from cutting waste, enhancing prevention and wellness, installing electronic medical records and improving quality are merely ‘lipstick’ cost control, more for show and public relations than for true change,” he wrote last year (Health Affairs Feb. 27, 2008).

Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, “as an imperative to do everything for the patient regardless of the cost or effects on others” (Journal of the American Medical Association, June 18, 2008). ...

Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.

Many doctors are horrified by this notion; they’ll tell you that a doctor’s job is to achieve social justice one patient at a time.

Emanuel, however, believes that “communitarianism” should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those “who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia” (Hastings Center Report, Nov.-Dec. ‘96).

Translation: Don’t give much care to a grandmother with Parkinson’s or a child with cerebral palsy.

He explicitly defends discrimination against older patients: “Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years” (Lancet, Jan. 31).

Cornell Law Professor William A. Jacobson observes that the argument Sarah Palin quoted from Rep. Bachman certainly is important and central to the debate of proposed health care reform.

The article in which Dr. Emanuel puts forth his approach is “Principles for Allocation of Scarce Medical Interventions,” published on January 31, 2009. A full copy is embedded below. Read it, particularly the section beginning at page 6 of the embed (page 428 in the original) at which Dr. Emanuel sets forth the principles of “The Complete Lives System.”

While Emanuel does not use the term “death panel,” Palin put that term in quotation marks to signify the concept of medical decisions based on the perceived societal worth of an individual, not literally a “death panel.” And in so doing, Palin was true to Dr. Emanuel’s concept of a system which

considers prognosis, since its aim is to achieve complete lives. A young person with a poor prognosis has had a few life-years but lacks the potential to live a complete life. Considering prognosis forestalls the concern the disproportionately large amounts of resources will be directed to young people with poor prognoses. When the worst-off can benefit only slightly while better-off people could benefit greatly, allocating to the better-off is often justifiable….

When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.

Put together the concepts of prognosis and age, and Dr. Emanuel’s proposal reasonably could be construed as advocating the withholding of some level of medical treatment (probably not basic care, but likely expensive advanced care) to a baby born with Down Syndrome. You may not like this implication, but it is Dr. Emanuel’s implication not Palin’s.

The next question is, whether Dr. Emanuel’s proposal bears any connection to current Democratic proposals. There is no single Democratic proposal at this point, only a series of proposals and concepts. To that extent, Palin’s comments properly are viewed as a warning shot not to move to Dr. Emanuel’s concept of health care rationing based on societal worth, rather than a critique of a specific bill ready for vote.

Certainly, no Democrat is proposing a “death panel,” or withholding care to the young or infirm. To say such a thing would be political suicide.

But one interesting concept which is central to the concepts being discussed is the creation of a panel of “experts” to make the politically unpopular decisions on allocating health care resources. In a letter to the Senate, Barack Obama expressed support for such a commission:

I am committed to working with the Congress to fully offset the cost of health care reform by reducing Medicare and Medicaid spending by another $200 to $300 billion over the next 10 years, and by enacting appropriate proposals to generate additional revenues. These savings will come not only by adopting new technologies and addressing the vastly different costs of care, but from going after the key drivers of skyrocketing health care costs, including unmanaged chronic diseases, duplicated tests, and unnecessary hospital readmissions. To identify and achieve additional savings, I am also open to your ideas about giving special consideration to the recommendations of the Medicare Payment Advisory Commission (MedPAC), a commission created by a Republican Congress. Under this approach, MedPAC’s recommendations on cost reductions would be adopted unless opposed by a joint resolution of the Congress. This is similar to a process that has been used effectively by a commission charged with closing military bases, and could be a valuable tool to help achieve health care reform in a fiscally responsible way.

Will such a commission decide to curtail allocation of resources to those who are not deemed capable of “complete lives” based on prognosis and age, as proposed by Dr. Emanuel? There is no way to tell at this point since we do not have a final Democratic proposal, or know who would be appointed to such a commission.

Ezekiel Emanuel’s paper: Principles for Allocation of Scarce Medical Interventions

Hat tip to the News Junkie.

Barack Obama discovers a leak under his sink, so he calls Joe the Plumber to come and fix it.

Joe drives to Obama’s house, which is located in a very nice neighborhood and where it’s clear that all the residents make more than $250,000 per year.

Joe arrives and takes his tools into the house. Joe is led to the room that contains the leaky pipe under a sink. Joe assesses the problem and tells Obama, who is standing near the door, that it’s an easy repair that will take less than 10 minutes.

Obama asks Joe how much it will cost.

Joe immediately says, “$9,500.”

“$9,500?” Obama asks, stunned. “But you said it’s an easy repair!”

“Yes, but what I do is charge a lot more to my clients who make more than $250,000 per year so I can fix the plumbing of everybody who makes less than that for free,” explains Joe. “It’s always been my philosophy. As a matter of fact, I lobbied government to pass this philosophy as law, and it did pass earlier this year, so now all plumbers have to do business this way. It’s known as ‘Joe’s Fair Plumbing Act of 2008.’ Surprised you haven’t heard of it, senator.”

Read the whole thing.

My jaw doesn’t often drop, but this story had it heading for the basement:

Thousands of Canadians who are infertile in Canada have to place all their hopes on just 33 men who are Canadian sperm donors.

What? A nation of 30 million people has just 33 sperm donors? Apparently so. Now why would that be?

At one time Canada had two dozen sperm banks but when the Assisted Human Reproduction Act made it illegal to pay for sperm or egg donors they dried up in 2004.
Today there are very few men willing to give up their sperm for nothing.

...

“Today, there is one South Asian donor for all of Canada,” he says, noting that couples are often shocked at the limited choices.

One donor for thousands of wannabe parents? He must be working round the clock. Well, not quite. For Canadian womenfolk have now been reduced to the ultimate indignity:

Doctors and patients have had little choice but to use sperm and eggs from south of the border.

One of the biggest suppliers of donor sperm is Outreach Health Services which imports and distributes semen for assisted reproduction clinics across Canada. The company imports sperm from an agency that collects primarily from men in Georgia and northern Florida, where donors are paid about $100 per visit.

With so much sperm coming from the States, some estimate that up to 80 per cent of babies conceived in Canada through donor sperm have American DNA.

Wow. This isn’t your father’s War of 1812. The poor Canucks never saw it coming. Millions of Yank sperm leaping like salmon up the Ontario side of Niagara Falls.

A wait for semen seems pretty much the logical reductio of “free at the point of demand” health care. But, as Kathy Shaidle says, how can this go wrong? Canada, circa 2050: Eighty percent drawling rednecks demanding grits with their maple-creme donuts, and the remainder a vast tribe of intermarried step-siblings riddled with genetic disorders descended from “one South Asian donor.”

Just how much trouble Obamacare and the democrat party are in can be seen by the fact that they have actually managed to lose the confidence, and the support for their health care reform bill, of not only a majority of the public, but of even such an icon of the intellectual left as Camille Paglia.

In Salon, right now, today, (in addition to praising a topless photo of the 50-year-old Sharon Stone) avante-garde cultural commentator Paglia is agreeing with Sarah Palin and calling for Nancy Pelosi’s head. I love it.

(W)ho would have thought that the sober, deliberative Barack Obama would have nothing to propose but vague and slippery promises—or that he would so easily cede the leadership clout of the executive branch to a chaotic, rapacious, solipsistic Congress? House Speaker Nancy Pelosi, whom I used to admire for her smooth aplomb under pressure, has clearly gone off the deep end with her bizarre rants about legitimate town-hall protests by American citizens. She is doing grievous damage to the party and should immediately step down.

There is plenty of blame to go around. Obama’s aggressive endorsement of a healthcare plan that does not even exist yet, except in five competing, fluctuating drafts, makes Washington seem like Cloud Cuckoo Land. The president is promoting the most colossal, brazen bait-and-switch operation since the Bush administration snookered the country into invading Iraq with apocalyptic visions of mushroom clouds over American cities.

You can keep your doctor; you can keep your insurance, if you’re happy with it, Obama keeps assuring us in soothing, lullaby tones. Oh, really? And what if my doctor is not the one appointed by the new government medical boards for ruling on my access to tests and specialists? And what if my insurance company goes belly up because of undercutting by its government-bankrolled competitor? Face it: Virtually all nationalized health systems, neither nourished nor updated by profit-driven private investment, eventually lead to rationing.

I just don’t get it. Why the insane rush to pass a bill, any bill, in three weeks? And why such an abject failure by the Obama administration to present the issues to the public in a rational, detailed, informational way? The U.S. is gigantic; many of our states are bigger than whole European nations. The bureaucracy required to institute and manage a nationalized health system here would be Byzantine beyond belief and would vampirically absorb whatever savings Obama thinks could be made. And the transition period would be a nightmare of red tape and mammoth screw-ups, which we can ill afford with a faltering economy.

As with the massive boondoggle of the stimulus package, which Obama foolishly let Congress turn into a pork rut, too much has been attempted all at once; focused, targeted initiatives would, instead, have won wide public support. How is it possible that Democrats, through their own clumsiness and arrogance, have sabotaged healthcare reform yet again? Blaming obstructionist Republicans is nonsensical because Democrats control all three branches of government. It isn’t conservative rumors or lies that are stopping healthcare legislation; it’s the justifiable alarm of an electorate that has been cut out of the loop and is watching its representatives construct a tangled labyrinth for others but not for themselves. No, the airheads of Congress will keep their own plush healthcare plan—it’s the rest of us guinea pigs who will be thrown to the wolves. ...

...(W)hat do Democrats stand for, if they are so ready to defame concerned citizens as the “mob”—a word betraying a Marie Antoinette delusion of superiority to ordinary mortals. I thought my party was populist, attentive to the needs and wishes of those outside the power structure. And as a product of the 1960s, I thought the Democratic party was passionately committed to freedom of thought and speech.

But somehow liberals have drifted into a strange servility toward big government, which they revere as a godlike foster father-mother who can dispense all bounty and magically heal all ills. The ethical collapse of the left was nowhere more evident than in the near total silence of liberal media and Web sites at the Obama administration’s outrageous solicitation to private citizens to report unacceptable “casual conversations” to the White House. If Republicans had done this, there would have been an angry explosion by Democrats from coast to coast. I was stunned at the failure of liberals to see the blatant totalitarianism in this incident, which the president should have immediately denounced. His failure to do so implicates him in it.

As a libertarian and refugee from the authoritarian Roman Catholic church of my youth, I simply do not understand the drift of my party toward a soulless collectivism. This is in fact what Sarah Palin hit on in her shocking image of a “death panel” under Obamacare that would make irrevocable decisions about the disabled and elderly. When I first saw that phrase, headlined on the Drudge Report, I burst out laughing. It seemed so over the top! But on reflection, I realized that Palin’s shrewdly timed metaphor spoke directly to the electorate’s unease with the prospect of shadowy, unelected government figures controlling our lives. A death panel not only has the power of life and death but is itself a symptom of a Kafkaesque brave new world where authority has become remote, arbitrary and spectral. And as in the Spanish Inquisition, dissidence is heresy, persecuted and punished.

Peggy Noonan went scurrying back toward what she perceived as the center in the last election, and she is finding, only months later, that Barack Obama and the democrat Congressional leadership are anything but centrist.

Peggy Noonan is not buying the left’s talking points about “astroturf” and hired senior operatives sent by the Insurance Industry and Rush Limbaugh. She thinks the American people are really becoming scared, scared of deficits, scared of irresponsible policies hastily enacted, and scared of the impact upon themselves of vast expansions of remote federal power.

To her, Obama and the democrats appear to be in serious trouble.

We have entered uncharted territory in the fight over national health care. There’s a new tone in the debate, and it’s ugly. At the moment the Democrats are looking like something they haven’t looked like in years, and that is: desperate.

They must know at this point they should not have pushed a national health-care plan. A Democratic operative the other day called it “Hillary’s revenge.” When Mrs. Clinton started losing to Barack Obama in the primaries 18 months ago, she began to give new and sharper emphasis to her health-care plan. Mr. Obama responded by talking about his health-care vision. He won. Now he would push what he had been forced to highlight: Health care would be a priority initiative. The net result is falling support for his leadership on the issue, falling personal polls, and the angry town-hall meetings that have electrified YouTube.

In his first five months in office, Mr. Obama had racked up big wins—the stimulus, children’s health insurance, House approval of cap-and-trade. But he stayed too long at the hot table. All the Democrats in Washington did. They overinterpreted the meaning of the 2008 election, and didn’t fully take into account how the great recession changed the national mood and atmosphere.

And so the shock on the faces of Congressmen who’ve faced the grillings back home. And really, their shock is the first thing you see in the videos. They had no idea how people were feeling. Their 2008 win left them thinking an election that had been shaped by anti-Bush, anti-Republican, and pro-change feeling was really a mandate without context; they thought that in the middle of a historic recession featuring horrific deficits, they could assume support for the invention of a huge new entitlement carrying huge new costs.

The passions of the protesters, on the other hand, are not a surprise. They hired a man to represent them in Washington. They give him a big office, a huge staff and the power to tell people what to do. They give him a car and a driver, sometimes a security detail, and a special pin showing he’s a congressman. And all they ask in return is that he see to their interests and not terrify them too much. Really, that’s all people ask. Expectations are very low. What the protesters are saying is, “You are terrifying us.”

Read the whole thing.

The White House, in addition to compiling its enemies list of people who say or write something “fishy” about its policies, has been urging its supporters to get out and “punch back twice as hard.” Obama flack Paul Krugman endeavored to do just that today, claiming that critics of the President’s plans for a government take over were — wait for it — motivated by “racial fear.”

Right. It’s another Dorthy Parker moment for the celebrated New York Times columnist. Let’s see if you have worked this out correctly. Presented with the bloated everything-but-the-kitchen-sink thousand-page obscenity that Rahm Emanuel is endeavored to shove down the collective gullet of America, why would you be critical? You might fear the government taking over another big chunk of the economy, since that way, you have learned “par expériences nombreuses et funestes,” is a prescription for waste, corruption, and inefficiency. You might be critical because you know that where similar systems have been tried, they have led to health care rationing and a denial of services to many vulnerable parts of the population, especially seniors> You might also be critical because you suspect that the plan will put a damper on medical innovation — one of the key ingredients that has made American health care the best in the world. You might further be critical because you have guessed the the price tag for this government sponsored boondoggle will be enormous and you do not relish paying yet higher taxes to fund it. I think you might be even more critical about the issue of freedom: the fact that, were anything like the Democrats’ plan to be passed, it would limit your freedom of choice in what doctors who see, what treatments you can get, and what sorts of insurance you choose to have (or, come to that, to forego). There are a dozen things you might not like about the Democratic plans. But what does Paul Krugman seize upon? “Racial fear.” Right. And I, as Miss Parker said, am Marie of Roumania.

Frustrated by questions and interruptions, and at a listening session, too! the AARP representatives naturally take their microphone and bail. That wasn’t supposed to happen.

And before you know it, those blasted geezers are holding a meeting of their own, and quoting Madison no less. Disgraceful. They’re obviously each and every one of them paid pharmaceutical company neo-Nazis hirelings sent by Rush Limbaugh to prevent Americans from having a successful dialogue on health care.

Hat tip to Moe Lane.

There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care. These rumors often travel just below the surface via chain emails or through casual conversation. Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.

Note that Phillips already knows, even before reading any such communications, that the other side of the story, counter-arguments or expressions of opposition to Obamacare, intrinsically represent “disinformation” and are “fishy.” Better start making a list of sources of all that wrongthink and identifying those responsible.

Support for President Obama’s overhaul of the American health-care system is dropping because he’s not doing enough to “sell” the effort, according to a growing number of liberal voices. The public is deeply sympathetic to what Obama and Democrats want to do; the task for them is simply to instruct the unknowing masses on what is best for them (see Andrea Mitchell’s commentary here). In fact, the problem with Obama’s effort isn’t a failure to communicate; it is his inability to refute health-care facts and figures that, as they become more salient, are undermining his effort.

The most important facts are related to health-care costs. Barack Obama made “bending the curve” the cornerstone of his efforts. The status quo is unacceptable when it comes to the increasing cost of health care, Obama insists; his plan will make health care cheaper. On the contrary, it will dramatically increase costs. According to the Congressional Budget Office, the House bill would cost in excess of $1.2 trillion over the next decade; the Senate Finance Committee bill, around $1 trillion over 10 years. In the words of the CBO, “relative to current law, the [House] proposal would probably generate substantial increases in federal budget deficits during the decade beyond the current 10-year budget window.”

The second set of figures has to do with the number of people insured in America — 85 percent, according to the 2007 Census — and the vast majority’s (83 percent, according to a recent Washington Post–ABC News poll) being either “somewhat” or “very” satisfied with the health care they receive, with 81 percent feeling the same way about their insurance. The same poll also found that 84 percent of respondents said they were “very” or “somewhat” concerned that reform would increase their health-care costs, 82 percent worried it would reduce their health-insurance coverage, and 81 percent worried it would hurt the quality of their care.

President Obama is predicating his overhaul of health care on the assumption that most people are profoundly unhappy with the health care they are receiving. But when an overwhelming majority of the nation are more or less pleased with the product they are receiving, a radical redesign of the system becomes problematic.

There is an old saying: “Everyone’s your brother ‘til the rent comes due.”

Free health care services for every indigent wino, junkie, and welfare recipient is a nice idea when somebody else is going to be paying for it, but as ordinary Americans come to their senses and realize that more health services for the uninsured really means less health services for those actually paying for it all, i.e. themselves, all that do-goody-good BS (as Pink Floyd puts it) looks a lot less attractive.