What if Those Crazies Are Right?

Americans are looking for a bail-out from reality - some actions the President and Congress can take to restore the United States to its former economic glory, so we can all go on living the high life.

But opinion leaders are peering into the future and making different sorts of predictions. In fact, theirs often sound like the apocalyptic visions of the crazy people protesting at those town hall meetings around the country.

Discussing unemployment rates, Bob Herbert, Times columnist, wrote in A Scary Reality: "The American economy does not seem able to provide enough jobs -- and nowhere near enough good jobs -- to maintain the standard of living that most Americans have come to expect." If you believe this, then the American lifestyle is going to decline from here on out. Try to sell that to voters.

Discussing the American health crisis in the Washington Post, Pulitzer columnist Eugene Robinson titled his piece Behind the Rage, a Cold Reality (notice similarities in these titles?) : "The unvarnished truth is that services are ultimately going to have to be curtailed regardless of what happens with reform. We perform more expensive tests, questionable surgeries and high-tech diagnostic scans than we can afford. We spend unsustainable amounts of money on patients during the final year of life. "

In other words, even if the health care legislation doesn't include "death panels" and refusing treatment people would like to receive, nonetheless some things like these are likely consequences. Thus, those "crazies" who describe such results of reform aren't really crazy, according to Danielle Allen, of Princeton's Institute for Advanced Study, who wrote in the Post:

Their claim is that, whatever the stated goals of policymakers, the concrete outcomes that will flow from the policies on the table will include experiences that feel like rationing and conversations that sound like "death panels."

While we're at Princeton, note economist Uwe Reinhart's description of the coming deluge in re payments for doctors' fees and other medical costs - and I mean coming soon: "We will not emerge out of this decade with this lunacy."

Back to the Post, Robert Samuelson, economics columnist points the long boney finger of death at our burgeoning health care expenditures:

Expand benefits and talk about controlling costs. That's the status quo, and Obama faithfully adheres to it. While denouncing skyrocketing health spending, he would increase it by extending government health insurance to millions more Americans. . . .

Meanwhile, open-ended reimbursement by government and private insurance has ballooned health spending despite repeated pledges to "contain" costs. For example, health payments for individuals rose from less than 1 percent of federal spending in 1965 to 23 percent in 2008. . . .

Obama's program would do little to reduce costs and would increase spending by expanding subsidized insurance. . . . "You'd be adding a third medical entitlement on top of Medicare and Medicaid," says James Capretta, a top official at the Office of Management and Budget from 2001 to 2004.

I don't know, maybe all these people are just too damn pessimistic. On the other hand, maybe they're right. In that case, the nuts protesting Obama's plans aren't wrong, even if they are nuts. And all of us sane people need to get prepared for the coming hard times.

Comments

[condieshoes]

Why is this any different than people deciding that they don't want to be put on ventilators when they are either terminal or 92 years old and in the process of dying and have living wills drawn up, Medical Power of Attorney and other documents that address how they want to be treated at the end of their lives?

I believe that this so called panel is looking at the same issues. Obama's plan also puts into play the concept that as a person is aging they are asked if they have signed living wills, Medical Power of Attorney in the very obvious event when they are dying of old age or a terminal illness.

How is this limiting health care and treatment?

There is a time, when you are terminal or dying of old age that you need to go to hospice where they can keep you pain free. My father at and earlier the age signed a living well, health care directive and a Medical power of attorney. He died at the age of 95 in hospice.

[natriley]

Stanton surprise me.
First, any medical reform must include provisions controlling medical care during serious illness. Even with a living will, I can not trust that my wishes will be carried out unless I have a strong willed advocate. Unless this person can stand up to the doctors and support my wish to avoid months of unwanted care, I will end up being another patient forced to stay in a hospital bed with no quality of life. Like many persons over 65, I worry about doctors prolonging my ability to breathe when I can't enjoy myself or the company of my friends. In a country like Holland or Switzerland, I wouldn't have to worry.

Secondly, why bring up this issue now? The great advantage of medical reform is that the government will be responsible in the future. We won't have to negotiate with an insurance company for changes we can go to government officials and ask for changes. The most important thing is to pass the bill. Modifying this section or that section will be a constant of life after the initial package is passed. Too many people are suggesting that the new law will be written in stone. Once the rubber hits the road, and we see how the law actually works, there will be improvements that have to be made, and a Congress willing to support change.