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Gone Fishing:

I am currently in Bozeman, Montana. I did not come here to see the President. Rather, this past week I attended a conference for judges and law professors on Terrorism, Civil Liberty, and National Security, sponsored by the Foundation for Research on Economics and the Environment. The conference ended yesterday, so now I'm fishing. Today we had a rainy — though fairly successful — float on the Madison. My Dad had the biggest fish of the day — a portly, 18 inch Rainbow.

As for the President's visit, most of the national coverage I've seen stressed the generally favorable audience at the town hall. For what it's worth, the local coverage I've seen and heard out here has stressed that anti-ObamaCare protestors substantially outnumbered supporters outside the meeting. This should not be surprising — this is Montana.

UPDATE: Saturday started cold, but warmed up nicely in the afternoon. Floating on the Yellowstone south of Livingston we caught well over a dozen nymphing in the morning, and landed some beautiful Rainbows and Cutbows on hoppers after lunch, before the rain returned. I'm praying for sun on Sunday.

Related Posts (on one page):

  1. Monday Bear Bird Blogging:
  2. Gone Fishing:
huskerfan:
I'm doing a quick look of newspapers in MT and I can't find an example of the protesters outnumbering the supporters outside.
8.14.2009 9:36pm
newrouter (mail):
montana health care protest

here
8.14.2009 9:44pm
gwinje:
Even the wackiest neighbors I had growing up in Montana weren't stupid enough to protest against fictional death panels. I hope they had a more substantive agenda.
8.14.2009 9:45pm
newrouter (mail):

Montana weren't stupid enough to protest against fictional death panels.


yea peter singer and Ezekiel Emmanuel are pro life gurus you fool. and and the self proclaim commie the " ho ho ho green job czar"
8.14.2009 9:53pm
gwinje:
Huh?
8.14.2009 10:05pm
24AheadDotCom (mail) (www):
I'm sure there's no "death panels", as the MSM keeps telling us (after all, they'd never lie). In fact, what we might end up with are groups - not "panels" - deciding how to apportion resources. Complete different!

Meanwhile, if anyone in Montana or elsewhere would like to raise the level of debate about this issue above the baboon level as promoted by Instapundit, FreedomWorks, and all the rest, go to a townhall and ask a question like this (as long as the speaker has previously misled about that topic of course).

Rather than waving loopy signs or asking stupid things like, "did you read the bill?" or just ranting as your leaders encourage you to do, please focus your anger on something effective.
8.14.2009 10:28pm
Psalm91 (mail):
24.com, have you read the Republican 2003 Medicare reform act with the same "death panels"? Were they ok then?
8.14.2009 10:31pm
Cheesecake (mail):
Ezekiel Emmanuel authored an article earlier this year that advocated some sort of prioritized care for 15-40 year olds, and restricting care that the elderly, disabled, and other non-participating citizens get.

President Obama also spoke of the hip replacement his grandmother got a few weeks before she passed, and of the need for an "Independent Board" that could make the difficult decisions to keep elderly patients from extending their lives with treatment.

So, you're technically correct. They're not protesting fictional "Death Panels." They're protesting real ones. Giving the Government complete control over the entire system will allow them the luxury of deciding who gets care and who doesn't. At least with private insurance you could sue them if they didn't pay for something that was covered in your policy. You're not going to get to sue the government.
8.14.2009 10:31pm
Sarcastro (www):
Uh-oh. Last year I asked my friends who we'd eat first in a Donner Situation. Thus, I totally plan to eat all my friends.

I also like to make up quotes from Obama based on mixing things he's said with wild supposition.

Speaking of which, I have it on good opinion that the powerful euthanasia lobby is growing fast and needs new jobs, so Obaam's planning on killing a bunch of old Republicans as a "stimulus." Abortion fits in there somehow as well.
8.14.2009 10:38pm
huskerfan:
I still don't see any local articles claiming there to be a bigger anti health care crowd than pro. Can anyone point me in the right direction on this?
8.14.2009 11:03pm
Malvolio:
Are the anti-anti-Obamacare-ists really serious?

Yes, there are, I don't know, a dozen bills peristalsing their ways through the bowels of Congress. Nobody, on either side, knows exactly what's in them. Are you seriously suggesting that anti-Obamacare-ists refrain from criticism until at least one of them becomes laws?

Yes, Obama hasn't actually promised to come over and personally kill anyone grandmother. Are you seriously suggesting that anti-Obamacare-ists refrain from criticism until he makes such a promise, or until he carries it out?

Obamacare is a huge, vague, nebulous target, but once it solidifies, the time for stopping it will be long past.

Maybe Obamacare will be nothing worse than Medicare writ larger. Maybe it will be worse than NHS. I dunno. And I don't care -- it'll be worse that what we have now.
8.14.2009 11:10pm
D.O.:
Malvolio, you have an iron-clad right to be against all health care reform proposals and, for my money, you can even invent the provisions of those bills to critisize. Don't expect however people to take you seriously. If, on the other hand, you decide that some h.c. reform will be inacted and that you'd better make the best of bad (for you) situation than it might make sense to protest against real proposals you despise most. Just a thought!
8.14.2009 11:35pm
D.O.:
By the way, if what is now being discussed is Obamacare, can we rename Medicare Johnsoncare and Social Security FDR Security?
8.14.2009 11:37pm
James of England:
D.O. There are elements in common between all of the plans (mandates, which Obama rejected on the campaign trail, micromanaging of health insurance, etc.) Among these elements is the enlargement of state control over the sector.

As someone whose family free rides on the medical advances made partly because of the separation between cost cutters and regulators in the US, I'm pretty confident that any of the currently suggested forms would need to have a NICE equivalent, and that that could reasonably be described as a death panel. That the deaths that concern me most include foreigners as well as locals is just a personal twist.
8.15.2009 12:25am
Dan M.:
Yes, we have the right to protest any "reform" of the health care system that the Democrats will propose.

We don't want our premiums raise by having to "insure" people for care that they already need.

We don't want to mandates to buy insurance.

We don't want caps on lifetime out of pocket expenses that will raise our premiums even higher.

We don't want more taxes on small businesses.

We don't want more taxes on the middle class.

We don't want Obama to starve private charities to fund his health care proposals and to put an even greater share of charitable spending in the arms of the federal government.

We don't want government operating a non-profit insurance company across state lines while competing with other insurance companies that can not.

We don't want government bureaucrats setting the bar for doctor reimbursement rates that squeeze them out of business.

We don't want doctors to be mandated to treat Medicare patients when they lose money doing so.


Take just about any reform that Obama is proposing, and if people say that they support it, ask them if they want the higher premiums they will pay, ask them if they like the shortages that will occur as we drive insurance companies and doctors out of business, ask them if they like the freedoms we will lose as government tries to "control costs" by taking away all of our freedoms.

Do you think you'll ever end the war on drugs when the government has to bear the weight of health care costs?

Do you think the government will continue letting us eat fatty foods?

Will they let us own guns? Will they let us drink alcohol? Smoke cigarettes?

More federal regulation of health care is the path of diminishing freedom in this country.
8.15.2009 12:33am
Kazinski:
Here is Obama in his own words calling for independent panels to "get into some very difficult moral issues":


THE PRESIDENT: So that's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

LEONHARDT: So how do you - how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now.


Now admittedly these independent panels would not be making life or death decisions for individuals, they'd be making like or death decisions for tens of thousands at a time. That's certainly much more defensible.
8.15.2009 12:39am
Sarcastro (www):
Impaneling a Blue Ribbon study on a subject are a true sign of governmental support!
8.15.2009 12:47am
theobromophile (www):
Friday Fish Blogging has a very alliterative ring to it. Now that loyal VC readers have been denied a Sunday Song lyric (for an entire summer!) and teased with Monday Bear Blogging, can we at least expect a few ichthyal bloggings at the end of the week?
8.15.2009 1:02am
Dan M.:
Obama's not going to pull the plug on Granny, but he might deny her hip replacement.
8.15.2009 1:18am
Kazinski:
"Obama's not going to pull the plug on Granny, but he might deny her hip replacement." or chemotherapy, or radiation therapy, or surgery, or .... But he won't pull the plug.
8.15.2009 1:31am
Gregg Smith (mail) (www):
"He might deny her hip replacement..."

I think that depends on whose granny you're talking about. My guess is that the President's relatives will fare well under any reform plan.
8.15.2009 1:41am
Dan M.:
But, honestly, I don't really have so much of a problem with denying payment for treatments that are not cost effective. I don't think anyone is entitled to treatment that they can't pay for.

And I agree with Ezekiel Emanuel that regardless of any other sorts of shortages that may or may not occur, you can't just manufacture livers, so sometimes some entity with the power to decide will decide the recipient of a liver while others die needing it, and without donor input, the decision-making body needs criteria, but that criteria doesn't have to come from the government.
8.15.2009 1:53am
Kazinski:
Our current health care system puts quality before cost in making health care decisions. The system Obama would like to put in place would put cost before quality. I think that is the reason people are uncomfortable with the democratic proposals.
8.15.2009 2:13am
Teej (mail):
By the way, if what is now being discussed is Obamacare, can we rename Medicare Johnsoncare and Social Security FDR Security?

D.O.

I think the proper name is Madoffcare. He learned it from FDR and LBJ.
8.15.2009 2:25am
Malvolio:
If, on the other hand, you decide that some h.c. reform will be [enacted] and that you'd better make the best of bad (for you) situation than it might make sense to protest against real proposals you despise most. Just a thought!
I don't know if it's sophisticated enough to count as a "thought". Basically, the suggestion is that someone were proposing to cut off my hand, I should try to negotiate him down to just amputating four of my fingers.
8.15.2009 2:27am
Glenn W. Bowen (mail):

President Obama also spoke of the hip replacement his grandmother got a few weeks before she passed


fairly typical for a white woman, I'm afraid.
8.15.2009 5:04am
/:
Since it's reasonable and legal and efficient and moral for the state to control medicine, I don't see what harm would be done by having legislators aided by top experts make all medicial decisions.
8.15.2009 6:19am
D.O.:
Malvolio, I would not dream of telling you what you should do. My only idea is that fighting the real thing is generally more effective than fighting myths. If you don't like the whole thing it seems to me quite ineffective to invent an unexisting particular detail and then protest it. You do not like current reform projects in general, not fictitious death panels, right?
8.15.2009 6:25am
TCO (mail):
Very good wader company there. Check them out.
8.15.2009 7:50am
TCO (mail):
Either the computer is not holding a ban or you tough guys are not death penalty adherants for poster misbehaviour. I prefer to think of the softer side of Volokh...
8.15.2009 7:51am
davod (mail):
This conversation always has to start with

Remember - Obama wanted a bill on his desk by the end of July. The Democrats were laughing off the suggestion that the bill be read before being voted on.

If not for the protestors we would have a 1000 page unread bill signed into law.
8.15.2009 8:02am
JWFIII (mail):
D.O.
If passed, in a few years your much loved GovCo Health Care will be in the toilet along with the two programs you mentioned. Over the years I've noted that the Government couldn't manage a good bowl movement much less a major part of our economy. That said, ya'll have a nice day.
8.15.2009 8:05am
llamasex (mail) (www):
By the definitions put forth in this thread, don't we already have teams of HMO Death Panels?
8.15.2009 8:32am
Federal Dog:
"Over the years I've noted that the Government couldn't manage a good bowl movement"

Well, many courts around these parts are pretty skilled in that regard.
8.15.2009 9:25am
Daniel Chapman (mail):
For all of the people out there saying "We already ration care":

OF COURSE WE DO

Heath care is not an unlimited resource. If there wasn't scarcity, there wouldn't be a problem. The question is, what system should be used to allocate those scarce resources in the fairest, most efficient way possible?

We disagree with the idea of putting those decisions in the GOVERNMENT'S hands for obvious reasons.
8.15.2009 9:33am
karrde (mail) (www):
John Adler is not the only one going fishing in Montana.

I say it's a good idea.
8.15.2009 9:48am
Leo Marvin (mail):
JHA,

I suggest for tomorrow's Sunday Song Lyric, Take Me to the River.
8.15.2009 10:46am
einhverfr (mail) (www):
My grandparents used to teach at MSU and my grandfather lives in Bozeman.

That city has changed a lot in my lifetime. But the surrounding countryside is still as beautiful as ever. Enjoy your stay there.
8.15.2009 11:17am
Porkchop:

For what it's worth, the local coverage I've seen and heard out here has stressed that anti-ObamaCare protestors substantially outnumbered supporters outside the meeting. This should not be surprising -- this is Montana.


I'm not entirely sure what you mean by the last sentence.

Having grown up and gone to college in Montana, I think I have some idea what politics is like there. Remember that this is the state represented by Max Baucus -- in some ways the state is much more liberal than outsiders seem to think it is.

Health care is a really big issue, especially in small towns that have difficulty attracting and retaining general practitioners and that may be several hundred miles from medical specialists. While there is still a visceral distrust of government in many quarters, people do recognize that they are vulnerable within the current system.
8.15.2009 12:57pm
einhverfr (mail) (www):

Having grown up and gone to college in Montana, I think I have some idea what politics is like there. Remember that this is the state represented by Max Baucus -- in some ways the state is much more liberal than outsiders seem to think it is.


However, only in Montana would a candidate for Governor have to defend himself against unwarranted allegations that he was.....

a vegetarian.......

Montana, like every state, has its own conservatisms and its own liberalisms. Same with a state like New York, for example.
8.15.2009 1:11pm
Malvolio:
My only idea is that fighting the real thing is generally more effective than fighting myths.
There is no real thing. There are five or six drafts of bills that might become laws. The "real thing" would be life under the law that actually gets passed and as that law is actually interpreted.
If you don't like the whole thing it seems to me quite ineffective to invent an unexisting particular detail and then protest it.
If you're asserting that demonizing one's opponents and attacking straw-men is ineffectual, well, I have to disagree. Dishonest, yes, ineffectual, no.

Is that really what Obamacare opponents are doing though? Is it really incumbent on them to attack the best possible version of Obamacare? Or the most likely version? I honestly don't think so. If it weren't a debate, if one person were simply deciding what kind of law to impose, I would certainly want that person to scrutinize some of the worst-case scenarios very closely.
8.15.2009 1:13pm
David Hardy (mail) (www):
Egad. The questions raised are the core, hard issues. How do you cut costs when 80% of them are in the last short period before death, and do that while dealing with the moral issue of killing granny. And the answer:

"THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance."

As near as I can interpret this--the solution to the difficult issues is, we can talk a lot about them.
8.15.2009 2:11pm
/:
Nero talked while Rome lie in intractable pain.
8.15.2009 2:33pm
Off Kilter (mail):
Kazinski: "Our current health care system puts quality before cost in making health care decisions. The system Obama would like to put in place would put cost before quality. I think that is the reason people are uncomfortable with the democratic proposals."

As a physician, K, I regret to inform you that simply isn't true. Our current system has a lot of technical improvements from a generation ago, but quality is falling. It's not particularly surprising when you think about it. Doctors are paid by CPT codes. The codes are based on what is done, not how well it is done. Quality gains you nothing, and might hurt you if quality takes time, and lessens your productivity. If quality is your goal, better to have patients control payments rather than third parties.
8.15.2009 2:53pm
Putting Two and Two...:
Here's a suggestion that should mollify the "death-panel" worriers. When you sign up for insurance, you can indicate whether you want your health care in serious or terminal situations guided by the rules of a government panel of doctors, scientists and ethicists or by those of some anonymous bean-counters at corporate HQ.
8.15.2009 3:29pm
Kazinski:
Off Kilter,
You are a physician, so I'll have to defer to you as to what conditions are in your neck of the woods, however while I am not a Dr., both my wife and I are cancer survivors, and I can attest both our care was first rate, and no expense was spared.

I totally agree with your point:

If quality is your goal, better to have patients control payments rather than third parties.

I think the ideal solution, would be a universal catasrophic insurance, that would be suplemented with MSA's, private insurance, or merely going without insurance.
8.15.2009 4:03pm
troll_dc2 (mail):


Malvolio, I would not dream of telling you what you should do. My only idea is that fighting the real thing is generally more effective than fighting myths. If you don't like the whole thing it seems to me quite ineffective to invent an unexisting particular detail and then protest it. You do not like current reform projects in general, not fictitious death panels, right?




It would be helpful to get away from that death-panel nonsense. See
this article about Sen. Murkowski.
8.15.2009 4:06pm
Le Messurier (mail):
Davod said:

If not for the protesters we would have a 1000 page unread bill signed into law.

If we are to be saved from Obamascide it will be due to the elderly. But not entirely. Here's a Rasmussen pole that came out today:

"Thirty-five percent (35%) of American voters say passage of the bill currently working its way through Congress would be better than not passing any health care reform legislation this year. However, a new Rasmussen Reports national telephone survey finds that most voters (54%) say no health care reform passed by Congress this year would be the better option.

This does not mean that most voters are opposed to health care reform. But it does highlight the level of concern about the specific proposals that Congressional Democrats have approved in a series of Committees. To this point, there has been no Republican support for the legislative effort although the Senate Finance Committee is still attempting to seek a bi-partisan solution.

Not surprisingly, there is a huge partisan divide on this issue. Sixty percent (60%) of Democrats say passing the legislation in Congress would be the best course of action. However, 80% of Republicans take the opposite view. Among those not affiliated with either major party, 23% would like the Congressional reform to pass while 66% would rather the legislators take no action.

Voters who earn less than $20,000 a year are evenly divided but a majority of all other voters would prefer no action. Middle income voters, those who earn from $40,000 to $75,000 a year, are most strongly in favor of taking no action.

A plurality of voters under 30 say passage of the Congressional legislation is better. A majority of adults over 30 take the opposite view."
8.15.2009 5:12pm
Bob from Ohio (mail):
Lisa Murkowski is quoted in the local paper. Sarah Palin in every paper in the US. O has to start out his events with "I'm not killing Grandma". Unsure if Lisa Murkowski's political instincts are really that sound.

Hyperbolic political language does in fact work. Plenty examples on the left and right over the years. Social Security and national defense, for instance.

Support for "reform" continues to decline. Its just not Rasmussen. If the "astroturfers" and "palin lied" language was working, would not some national poll show increased support?

BTW, who ended Lisa Murkowski's dads political career. Her judgment might be a tad biased.
8.15.2009 5:28pm
pmorem (mail):
What follows is a collection of musings. Maybe someone can extract some value from it. It's not meant as criticism of anything or anyone.

Kazinski wrote:
... and no expense was spared...

To my mind, that fundamentally captures the shape of the health-care market.

That is to say, a large fraction of participants are willing to pay essentially any price for essential health care. On the other hand, the occurence of "pay any price" is limited, which is to say most of the time most people aren't actually looking for essential health care.

Given that, there are a limited number of options for cutting costs:
1) Reduce the number of people willing to "pay any price". End-of-life counseling would be one such element.
2) Reduce available options. This could be rationing. It could be obstructing development of more expensive treatments.
3) Reduce the per-patient cost.

Dan M wrote:
...you can't just manufacture livers...

Perhaps that captures the problem.

If we could manufacture a new liver, pancreas or kidney, how would that change the shape of the market? How much could a new liver cost and still be cheaper than on-going care?

Many of the medical treatments available today are "maintenance", like dialysis, insulin and many cancer treatments. The market is geared towards producing them.

Perhaps there is an opportunity to reduce costs by under-cutting existing treatments. One thing I've considered is something along the lines of "DARPA Challenge" or "Ansari X Prize" type bounties, with the bounties set according to potential saving from Medicare. It seems to me that there are probably several places where the potential bounties could be big money.

Individuals tend to act in ways to preserve their "rice bowls". Private research is generally directed towards creating "cash cows". Publicly funded research is generally aimed at creating more angles to research. Whoever is paying for health care, on the other hand, is actually paying for those rice bowls. It's in our interest to break them, and I'm suggesting we do just that.
8.15.2009 5:52pm
Leo Marvin (mail):
Le Messurier:

If we are to be saved from Obamascide

Thanks for alerting us so quickly that our time would be better spent moving on to the next comment.
8.15.2009 6:02pm
troll_dc2 (mail):
If people took care of themselves a little better (and this assumes that they realize that they have to and that they know how to do so), there would be less of a need for medical treatment at all, less of a need for elaborate medical teatment, and less of a need for expensive medical equipment.

By taking care of themselves, I mean things like getting regular checkups to detect possible problems early on, losing weight (which can be done with the help of a nutritionist), engaging in more exercise, and not using things like tobacco, alcohol, and ilegal drugs. People in good health are happier and more productive than those who are not.
8.15.2009 6:25pm
CDR D (mail):
I agree with troll_dc2 above.

Annual checkups with blood screenings are not expensive, and if timely, can head off serious problems down the line. I have a cancer insurance policy that refunds a good portion of my annual premium if I have a cancer screening of some kind during the year. PSA test, Colon scope, etc.

My mother died in the mid 90s of cancer. She had Secure Horizons, through Medicare (not sure how they make the deal), but after signing up, she NEVER went for a checkup. When she was hauled off to the hospital in terminal condition, her doctor had to go to his archives to find out who she was.
8.15.2009 6:56pm
CDR D (mail):
OBTW, Professor A, I hope you will provide a trip report on the fishing!
8.15.2009 7:09pm
Joan in Juneau (mail):
I agree with Dan M 12:33 am but I do not want any health care mandated by my government. I think there are many problems with our system right now but feel less government in the Medicare/Social Security systems would save money and provide better service instead of more.

I do not believe that throwing money and federal mandates at it will fix it, The underlying causes need addressed and fixed and then see where we are as opposed to where we want to be. Tort reform will go a long way, closing our borders and sending the illegals home so they are no longer a burden on our system. If they need medical help, let them apply for it as they should, we wouldn't turn them away. Stop illegals from crossing the border just to give birth, close that Constitutional loophole, bring drug costs down. Many we have already paid for through federal grants (our tax dollars) to develop. I see no need that we should have to pay more than our deductible for them and with no additional costs passed on to insurance companies. That alone would help keep premiums down.

Of course, few if any of our elected officials would have the guts to try to do some of these things because it would be political suicide for them because of all the big money behind the scene but two wrongs don't make a right and they would do it if they truly wanted to do what is right for America.

Bob in Ohio... not only did Palin unseat the one term Republican Murkowski... he gave up his Senate seat to take that position and appointed his daughter to it in the first place.
8.15.2009 8:13pm
Dan M.:
And seriously, if Lisa Murkowski doesn't think that the House health bill will ultimately lead to rationing vital services, why does she oppose the bill?
8.15.2009 8:35pm
J.R.L.:

But, honestly, I don't really have so much of a problem with denying payment for treatments that are not cost effective. I don't think anyone is entitled to treatment that they can't pay for.

And I agree with Ezekiel Emanuel that regardless of any other sorts of shortages that may or may not occur, you can't just manufacture livers, so sometimes some entity with the power to decide will decide the recipient of a liver while others die needing it, and without donor input, the decision-making body needs criteria, but that criteria doesn't have to come from the government.


I generally agree with not providing payments for anything and everything. What I don't like, however, is a mandate that doctors not be allowed to perform certain procedures under any circumstances. At least now, charities or private money can provide for non-cost effective procedures. Under Obamacare it won't be an option--either provide (or don't provide) care as Obama decrees, or lose your license.
8.15.2009 8:45pm
Fûz (mail) (www):
"Dan M wrote:
...you can't just manufacture livers...

Perhaps that captures the problem. "

Well, the death panel will have incentives to let Granny die, if that makes another functioning liver available.

And when the Government hires, pays, and promotes the surgeons, the Government will send that liver where it thinks best. Such as, say, Senator Kennedy.

If you want control over your end-of-life treatment, you need to be paying for it.

"Kazinski wrote:
... and no expense was spared...

To my mind, that fundamentally captures the shape of the health-care market. "

It's wonderful that some people are in the position to spare no expense. They are the ones making today's extravagant treatments tomorrow's not-quite-routine treatments. My children indirectly benefit.

When the Government is writing the checks, "spare no expense" will not officially happen any longer. It will unofficially happen for those patients it thinks best deserve them. Again, such as Senator Kennedy.
8.15.2009 9:00pm
Fûz (mail) (www):
"...you can't just manufacture livers... "

in a health purchasing system run by the Government, there is a perverse incentive to claim a form of ownership over the physical being receiving the healthcare.

What I was going for was, "Yes WE CAN manufacture livers." OK, maybe not manufacture them, but recycle them.

Granny doesn't need hers any longer. Expect incredible pressure on the survivors to donate the organs, up to and including hints at cutting corners on the survivors' medical care if they don't "engage in the conversation."
8.15.2009 9:11pm
name:
JRL,

What are you talking about? Nothing in any of the bills will ban non cost-effective procedures. Sure, the government plan may not pay for them, but that doesn't mean that private insurers or individuals can't pay for them themselves.

If you believe otherwise, I'd like to know the source for that belief.
8.15.2009 10:00pm
jellis58 (mail):
I like how a post mostly on fishing and a conference on terrorism, civil liberty, and national security with a brief aside on Obamacare has spawned 60 comments all about Obamacare.
8.15.2009 11:29pm
Dan M.:
Non cost-effective procedures will indeed still be available. But this bill is basically a huge tax on the middle class in the form of increased premiums, so less people will be able to afford vital non cost-effective procedures, resources will be allocated away from non cost-effective procedures, non cost-effective procedures will then become even less cost-effective and unavailable, and there will be fewer people well-trained in these non cost-effective procedures. Ultimately, we will move toward a minimal level of care offered to the general population and less and less non-standard care for the mega-rich and the well-connected.

And that's before the doctor shortage forces the feds to take over medical schools and has to institute a doctor draft and directly employ them. But at least then they won't need malpractice insurance.
8.16.2009 12:30am
Harry Lime:
After the bar but before I started working at my law firm, I traveled all over the western US and ended up in Montana, specifically, Glacier NP. My god -- what a beautiful country we live in. A bunch of my friends went to go explore Europe after the bar; I wanted to explore America and am so glad I did.

Anyways, I'm jealous that you're in Montana now fishing.
8.16.2009 1:01am
Pitman (mail) (www):
Who cares about Town Hall meeetings and health care, the fishing sounds great. I'll be doing some warm-water fly fishing in a few weeks and I can't wait.
8.16.2009 1:50am
cheap jordan shoes (mail) (www):
Your article is very interesting, I have introduced a lot of friends look at this article, the content of the articles there will be a lot of attractive people to appreciate, I have to thank you such an article.
8.16.2009 3:05am
JK:

Granny doesn't need hers any longer. Expect incredible pressure on the survivors to donate the organs, up to and including hints at cutting corners on the survivors' medical care if they don't "engage in the conversation."

Yeah, you'd never have pressure put on people in a free market system where you can buy and sell organs like conservatives want.

Not that I have a major problem with pressure being put on people to donate organs in either a free market or a government system. I'd vastly prefer that pressure be in the form of incentives (i.e. give ppl something to donate), but I'm not apposed to moral pressure. Blackmail is actually more likely in a private system where the potential blackmailer could get a financial reward.


What I don't like, however, is a mandate that doctors not be allowed to perform certain procedures under any circumstances.

What bill is this a part of? I know of no support for such a system in congress, and almost none in the American public. Certainly people should be able to purchase whatever health care they want with their own money, I know of no serious proposal that doesn't allow this.
8.16.2009 3:11am
Fûz (mail) (www):
JK wrote: "you'd never have pressure put on people in a free market system where you can buy and sell organs"

Perhaps I should distinguish between pressure and coercion.

The Government, if it comes to control how health care monies are spent, will resort to force. Force is what governments do.

FWIW, I have the little donor symbol on my MV operator license. But that should remain one's choice. If one so chooses, good for him or her.

I don't have much problem with the option of selling one's organs either. I find selling them preferable to having them stolen or taken by extortion.
8.16.2009 3:44am
D.O.:
I doubt that at this stage inventing "bad things" will work. Inflated language, sure. It's hard to imagine a political discussion without some inflation, but easily provable invention, no. See, Democrats have an easy target to critisize for several days, maybe a week, credibility of opponents is temporarily diminished and time is now of the essence. Some of the negativity may eventually sink in, but it's not like there is a couple of years to build on that. But that's all speculative, I agree.
8.16.2009 4:20am
/:
Yeah, you'd never have pressure put on people in a free market system where you can buy and sell organs like conservatives want.

Yes, coercian by the smell of money is much worce than force of government backed by taxes and guns. It's all about the Will of society.
8.16.2009 4:40am
SFH:
"Floating on the Yellowstone south of Livingston we caught well over a dozen nymphing in the morning,"

Am I the only one who immediately flashed on the image of a riverful of Lolitas?
8.16.2009 12:01pm
JPG:
At last, a law expert participating at a conference on important issues admits he means fishy business. I command Jonathan Adler for coming out of the closet.
8.16.2009 12:20pm
troll_dc2 (mail):
Are the fish as happy as Prof. Adler? Or don't they count?
8.16.2009 12:40pm
Oren:

I command Jonathan Adler for coming out of the closet.

You can 'command' him to come out of the closet.
You can commend him for coming out of the closet.
8.16.2009 3:15pm
SFH:
Unless it's the closet of Dr. Caligari.
8.16.2009 3:26pm
Dan Ensign (mail):
Do me a favor and give a friendly wave to Sheep Mountain when you leave Paradise Valley.

On another note, it's interesting that the fish you're catching are almost certainly state-owned (you might be able to convince Ted Turner to let you take his fish, but I doubt it). I wonder if there are shortages of state-owned fish, and if not, why not?

I also wonder if your fishing is subsidized by property taxes. Too lazy to do any research, my guess is that FWP is not self-sustaining. Or maybe it is, and your license fee goes partly to educate little Montanans, clean up Libby, or pay for health care on the reservations?

I don't mean to get all righteous libertarian-like, but there may be an apt (or corny?) analogy to health care. I mean, the Montana constitution DOES say that Montanans shall have the "opportunity" to hunt and fish.
8.16.2009 3:57pm
JPG:

You can 'command' him to come out of the closet.
You can commend him for coming out of the closet.


Doh! Somebody please hand me an 'edit' button!
8.16.2009 4:44pm
RPT (mail):
I saw Maddow hook a 200 lb Armey this morning. He wriggled a lot but could not get away.
8.16.2009 7:31pm
SuperSkeptic (mail):
I'm continually surprised and perplexed by the anti-anti-obamacare people who are attacking the anti-obamacare people on their argument against "death panels" as if it were always literal. Is it not obvious that it is a sort of reductio ad absurdum? or a variation of slippery-slope argument?


Not that anybody knows whats in the bill(s?) or anything, but...

As of today it seems that the democrats have backed from universal --> public option --> some sort of insurance pools, which I do not think bothers most of them with their fabian sensibilities.
8.16.2009 8:34pm
troll_dc2 (mail):

I'm continually surprised and perplexed by the anti-anti-obamacare people who are attacking the anti-obamacare people on their argument against "death panels" as if it were always literal. Is it not obvious that it is a sort of reductio ad absurdum? or a variation of slippery-slope argument?




It may be obvious to you, but a lot of the people who use the rhetoric come across as actually believing it.

By the way, have you seen this article?


The rowdy protests that threaten President Obama's health-care reform efforts have been spurred on by a loose network of activists -- from veteran advocacy groups with millions of dollars in funding to casual alliances of like-minded conservatives unhappy over issues from taxes to deficits to environmental laws.

Most of the groups helping to organize protests view the proposed health-care overhaul as just one part of a broader assault by government on free markets and individual liberty, their leaders say. Conservatives portray the movement as largely organic, fueled by average citizens alarmed at the direction the country has taken since Obama moved into the White House.

"I think what we've been able to do is reach out to an audience that no one has spoken with before, people who have never been involved," said Eric Odom, 29, a Chicago Web developer who heads a fledgling protest group called the American Liberty Alliance. "They've been pushed to the edge and feel they can no longer stay at home."

Several of the biggest efforts are led by established veterans in the conservative movement, whose organizations receive heavy funding from industry groups and sympathetic billionaires.

****
8.17.2009 9:35am
SuperSkeptic (mail):
Aright. Its not so surprising to see Armey et al egging them on. Frankly, I'm glad every time Specter gets reamed.
The literalists may just be ahead of their time, or perhaps they are astute historians capable of observing trends. In any event, VC people are or should be smart enough so that we don't have to (repeatedly) have the literalist converstation here, no?
8.17.2009 10:44am
troll_dc2 (mail):

In any event, VC people are or should be smart enough so that we don't have to (repeatedly) have the literalist converstation here, no?



Maybe not repeatedly, but some of us (like me) are not smart enough to avoid literalism completely.

BTW, I have now read Palsgraf (which is available online). It is as confusing to me now as it was back in the day. Maybe I am just not smart enough.
8.17.2009 11:15am
Joan in Juneau (mail):
Skeptic:RE:8:34

Public option and insurance pools are the same thing, they just gussied up the pig a little.
8.17.2009 8:07pm

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