Rationing Health Care

Rationing Health Care

John Lott points out that the Obama Administration is finally admitting that part of how they are going to get healthcare costs down involves rationing:

Last Sunday on “Meet the Press,” Larry Summers, Obama’s chief economic adviser, let the cat out of the bag on health care. In explaining why universal health care wasn’t going to increase the deficit, Summers said that people are just getting too much unnecessary care. Summers claimed: “whether it’s tonsillectomies or hysterectomies . . . procedures are done three times as frequently [in some parts of the country than others] and there’s no benefit in terms of the health of the population. And by doing the right kind of cost-effectiveness, by making the right kinds of investments and protection, some experts that we — estimate that we could take as much as $700 billion a year out of our health care system.”
This sure seems like rationing. Total health care expenditures in the United States in 2008 came to $2.4 trillion, implying that Summers believes that the proper government regulations can cut health care expenditures by almost 30 percent. That would cut back health care a lot. Summers softened the blow by saying that right now the government wouldn’t have to cut expenditures by more than a third of that $700 billion.
Tonsillectomies have primarily been done because of acute or chronic throat pain. Where different people are willing to draw the line between pain and surgery is a choice that we have traditionally left up to patients, but unless you know something about the patient’s preferences it is hard to claim that a surgery was a “mistake.”

Rationing is part of how those "superior" government run health systems in Canada and Britain save money--by simply not providing the quality of care that the U.S. enjoys. (They may cover the whole population, but at a substantially inferior level.)

Lott also points out that one of the areas where there is clearly a lot of surgery that isn't medically necessary is....abortion. And whether you are pro-choice or pro-life, I think that we can agree that if the federal government is going to start defining what medical procedures are "necessary" and which are not, we're opening up the door to either significant restrictions on abortion in the interests of costs...or we're treating an elective procedure as "special" because it's a political football.

There's good reason to worry about the political football aspects of government control of healthcare. For example, Britain's National Health Service, which has been taking increasingly strict steps to deal with poor lifestyle choices to cut costs is poised to start paying the enormous costs of in vitro fertilization for gay couples. And at a time when Ontario province was rationing surgery so that a woman had to have her bladder removed (with, as you might expect, horrendous post-surgical results), the gay Minister of Health was promising (and probably lying) that the government was going to start paying for sex change operations.

Moldy Oldies

Moldy Oldies

I was looking for a book that I didn't find, and happened upon a copy of Reason magazine in which my very first paid article appeared, in February of 1985. So I scanned it in, and added it to my web page.

"Spare Tires Cause Flats!", Reason, February 1985, 46.

Yeah, I know that I haven't done the same for the last six months of Shotgun News articles. I'll get to that real soon now.

Homosexual Chauvinism

Homosexual Chauvinism

I've been having a discussion with a homosexual law professor about the Matthew Shepard murderers. Among the more astonishing statements:

I know a lot of gay men who are as masculine as McKinney and I know a lot of uneducated ones as well. I'm just thinking in averages. On average, the community seems more artistic, intelligent, urbane, and more likely to exhibit gender non-conforming mannerisms.

...

I'm pretty much convinced that "real homosexuals" for whatever reason (like Jews) have on average higher IQs than heterosexuals.

This isn't the first time that I've heard the "we're smarter than you straight people" argument. It's also a pretty good sign that you are dealing with a fanatic. (Substitute the words "white" or "Protestant" above, and see where it leads you.) I've got better things to do than to argue with homosexual chauvinists.

Extortion

Extortion

This probably rises to the level of criminal behavior, although proving that Obama knew that this was going on might be difficult. Some of the Chrysler bondholders who refused to give up most of the value of their bonds, so that the UAW could get ownership of Chrysler, were directly threatened by an Obama official with the full force of the White House press corps. (So much for the press as a protector of our liberties--but you knew that wasn't the case already.)

The audio of one of the lawyers involved, directly describing what happened, and naming names, is here. Here's a transcript. Instapundit asks:

How does the supposedly independent White House Press Corps feel to know that it’s being wielded as a weapon by Obama’s operatives? Might it at least be interested in looking into these allegations?

One might as well ask prostitutes how they feel about being accused of having sex for money. Chicago government, for at least the last several decades, has always had a significant element of extortion involved. I remember in the late 1970s or early 1980s seeing a 60 Minutes report where they used hidden cameras to catch Chicago health inspectors bluntly and directly demanding payment from restaurant owners to pass inspection. Obama's operatives operate on the same model of government. No wonder Democrats love this guy so much.

Gun Safety Class For Women

Gun Safety Class For Women

I love these little reminders that I don't live in California anymore! From the April 29, 2009 Idaho World:

Mental Illness & Brain Chemistry

Mental Illness & Brain Chemistry

I mentioned a couple of days ago that I am reading J. Allan Hobson and Jonathan A. Leonard, Out Of Its Mind: Psychiatry in Crisis (Cambridge, Mass.: Perseus Publishing Group, 2001) at the moment. They make an interesting point: that there are strong similarities between dreams and psychosis. This is not only in the sense that both dream state and psychosis involve irrational ideas being accepted by the brain, and seeing things that aren't there, but even at the biochemistry level.

They point out that four neurochemicals play a major part in what happens during dreaming--and in the psychotic brain: serotonin, norepinephrine, acetylcholine, and dopamine. Many of the psychiatric drugs fiddle (with varying degrees of precision) with the levels of these chemicals in the brain. Similarly, alcohol, cocaine, and amphetamines also fiddle with the levels of these chemicals in the brain (pp. 120-3). They make the case that where dreaming is driven by signals from within the brain (perhaps part of the process by which the day's inputs are processed and sorted by the hippocampus pp. 142-3), psychosis is driven by external signals.

Some years back, Drs. Hoffer & Osmond, two Canadian psychiatrists, were arguing for a model of schizophrenia in which the failure of the brain to properly convert norepinephrine played some part in the sensory confusion schizophrenics suffer. One of the doctors took norepinephrine for asthma--and a spoiled batch of it put him in his own hospital with schizophrenic like symptoms for several days, before he recovered. My research for my next book indicates that this theory is now pretty well discounted, but some of the current research is at least in the neighborhood--and fits well with Hobson and Leonard's discussion.

Federal Hate Crimes Bill

Federal Hate Crimes Bill

I was saying a while back that my Congressman, Walt Minnick (D-ID), was so conservative that I could wonder if his predecessor, Bill Sali, had just changed his name. Well, Minnick just voted in a way that reminds he is not Bill Sali. I'm disappointed but not surprised.

The bill in question is misnamed after Mathew Shepard. As ABC's 20/20 demonstrated some years ago, Matthew Shepard's murder was not because Shepard was homosexual, but because he was an easy mark for two robbers. Indeed, one of the two men convicted of Shepard's murder was bisexual:

O'Connor had known Aaron McKinney for years. In flush times, McKinney partied in O'Connor's limos, and, in fact, McKinney and his girlfriend lived for a while in an apartment on O'Connor's property.
O'Connor says he never heard McKinney express any anti-gay attitudes. In his interview with Vargas, O'Connor reveals his belief that McKinney is bisexual. "I know of an instance where he had a three-way, two guys and one gal," he said. "Because he did it with me."
O'Connor added, "I know he's bisexual. There ain't no doubt in my mind. He is bisexual."
McKinney's former girlfriend Price says she now believes that as well. "He was always into trying to talk me into having a three-way with one of his guy friends," she said.
In her prison interview with McKinney, Vargas asked McKinney directly whether he had had any sexual encounters with men. McKinney said no.
Displaying a strong aversion to homosexual sex was a tactic McKinney tried at his trial. His lawyers developed a so-called "gay panic defense," claiming homosexual abuse McKinney suffered as a child caused him to overreact to a sexual advance by Shepard and triggered the violent attack.
Hoping a Wyoming jury would be sympathetic to gay panic did not pay off. McKinney was found guilty and wound up with two life sentences, assuring he'll spend the rest of his life in prison, the same sentence received by his accomplice Russell Henderson.

There are a lot of concerns about this bill. Some of the concerns seemed far-fetched to me (and that's being polite). I agree with David Freddoso's observation at National Review Online:

Several attorneys and lawmakers have pointed out deficiencies and vague language in the bill, but it is important to note up front that some concerns are spurious. The specter of preachers being arrested for sermons against homosexuality appears to be one of them. (Unless, perhaps, the preacher happens to be committing a federal crime and using firearms to threaten someone in a protected class with violence at the same time he gives his sermon.)

I also don't find particularly persuasive the claim that such a law violates freedom of thought, because it ties punishment for a criminal act to statements or beliefs that the criminal holds, thereby punishing what the criminal feels. But many of our laws do that.

Mr. X shoots and kills Mr. Y. If Mr. X was being reasonably careful in his actions, this might be an accident, and a jury will return excusable homicide. If Mr. X gets into argument with Mr. Y who he doesn't know, and shoots Mr. Y, the jury will look at the absence of malice aforethought, and perhaps find Mr. X guilty of manslaughter. Add in malice aforethought (perhaps expressed in a series of progressively more vigorous disputes over a period of time), and it becomes second degree murder. If Mr. X is stupid enough to leave a trail of evidence showing that he planned to kill Mr. Y, or was lying in wait to shoot Mr. Y, Mr. X may be convicted of first degree murder. In each case, statements that Mr. X has made in advance could be used to raise the charge.

There are concerns that the failure to define "sexual orientation" means that not only homosexuality, but pedophilia would be a protected class. The example that I heard on the radio on my way back from Bend this morning is a woman who slaps a creep who taking an unhealthy interest in her child. If she calls him a pervert while doing so, she could find herself at risk of federal prosecution. Far-fetched? A little, but the one thing that I've learned is that if a law can be abused, it will, at some point, be abused. And pedophiles are the next victim group for liberal lawyers to find are being abused by our "discriminatory" laws.

A bit more plausible of a concern is the danger of double jeopardy, in which a person who was found innocent of a state hate crime charge was then prosecuted by the federal government. Yeah, yeah, liberals are full of excuses for why this is a good thing (at least, for civil rights violations), but I actually take the double jeopardy provision seriously. At least when federal civil rights charges are filed (as in the Rodney King case), there is at least a claim that the federal civil rights violation is a different crime than the state law under which the police officers were prosecuted and found innocent. This doesn't seem to be the case with a federal hate crime law.

Freddoso's concern about:

hate crimes laws effectively place society's valuation of some victims' lives and well-being above that of others

is I think a rather strong one. Yes, in theory, if homosexuals beat up a straight person for being straight, they could be prosecuted under the federal law. But I'm a bit skeptical that federal prosecutors would actually do that. Wouldn't it make more sense just to make violent attacks on others (regardless of whether bias drove the attack) into a serious crime? I think one of the reasons that homosexuals have pushed for these hate crime laws is that in places like California, violent crime has historically not been seriously punished, and the rage about gay-bashing has obscured the fact that if a straight guy used a baseball bat on another straight guy, it wouldn't be treated very seriously.

Probably the biggest problem with this proposed laws, however, is the one area where I am most disappointed by Walt Minnick's vote for it: federalism. At the Town Hall Meeting about the Second Amendment a couple of weeks ago, someone asked Minnick his feelings about laws that effectively create "victims only" zones, by making it unlawful for concealed weapon permit holders to carry on campus, or in malls, etc. Minnick's response was that he believed that the federal government should leave such questions to local control, and specifically used the word "federalism."

But by that reasoning, this federal hate crimes should have been rejected. Criminal law, unless it involves crossing state lines, is left to the states. The Matthew Shepard bill has one of those imaginative excuses for why this is a federal concern:

(B) CIRCUMSTANCES DESCRIBED- For purposes of subparagraph (A), the circumstances described in this subparagraph are that--

`(i) the conduct described in subparagraph (A) occurs during the course of, or as the result of, the travel of the defendant or the victim--

`(I) across a State line or national border; or

`(II) using a channel, facility, or instrumentality of interstate or foreign commerce;

`(ii) the defendant uses a channel, facility, or instrumentality of interstate or foreign commerce in connection with the conduct described in subparagraph (A);

`(iii) in connection with the conduct described in subparagraph (A), the defendant employs a firearm, explosive or incendiary device, or other weapon that has traveled in interstate or foreign commerce; or

`(iv) the conduct described in subparagraph (A)--

`(I) interferes with commercial or other economic activity in which the victim is engaged at the time of the conduct; or

`(II) otherwise affects interstate or foreign commerce.

This is an extraordinarily broad definition. The phrase "occurs during the course of" is pretty clear; this means that one or the other crossed a state or international boundary during the course of the crime. This is a legitimate exercise of federal jurisdiction. But "or as the result of, the travel of the defendant or the victim": what does that mean? If the defendant drove from Oregon to California to do some gay-bashing, that's clear enough. But what if the defendant drove to San Francisco on Monday, and Friday night, got drunk, and attacked someone? What if he drove there six months earlier? Is that "as the result of"?

Similarly, if a victim goes to Portland for the weekend, and gets attacked, is that "as the result of" his travel? What if the victim drives to Portland on January 1, and gets attacked on January 31? Is that "as the result of" his travel?

Similarly, the magic phrase "the defendant employs a firearm, explosive or incendiary device, or other weapon that has traveled in interstate or foreign commerce." Does that mean that Congress could federalize every robbery where "the defendant employs a firearm, explosive or incendiary device, or other weapon that has traveled in interstate or foreign commerce"? Obviously not. But homosexuals are so special that they deserve special treatment, apparently.

And what economic activity doesn't, at some level, "otherwise affect[] interstate or foreign commerce"? Even a kid's lemonade stand probably fails the intrastate test (unless they are using lemons from the backyard).