Monday, July 27, 2009

A sting, a smell, an apology, and a really long footnote

[I have more to say about Section 1233 of HR3200 and will be doing so in a series of (probably) four posts. This is the first in the series although it serves as more of a prologue than an integral part. I also highly recommend reading the Jane Galt article linked here before beginning this series.

All the posts in the series will be filed under the category “Me And 1233”.

In my “Cry wolf” post I added an update to link to a post by Grim in which he argues that claiming Section 1233 of HR3200 requires end of life counseling every five years for those on Medicare does not, in fact, pose a risk of loss of credibility when the public discovers such a claim is incorrect. As he explains, the claim fits in with preconceived notions of what Democrats support and - equally important - the only way to refute the claim is to start talking about divisions, sections, sub-sections, paragraphs, sub-paragraphs, and sub-sub-paragraphs. At which point people’s eye simply glaze over. Or as Grim puts it:

the people will see a claim that echoes with their existing perception (and which they are therefore inclined to believe); and then they will hear for an answer a bureaucratic mish-mash that sounds like gibberish if it isn't read thoroughly and digested. 99% of humanity will simply assume from that the claim is true, and the counterclaim is an attempt to hide the truth behind layers of lawyer-speak.

Although I found that both depressing and discouraging, I was forced to concede that Grim might well be correct.

So far, so good. However, as I’ve visited Grim’s site over the last few days and scrolled through the text of his post to see if there are any new comments, my eyes have repeatedly snagged on this paragraph:

I still think it is less likely that the Post is attempting to leverage lies in this way, than that they aren't as careful and methodical as Elise. It's very easy for someone with a precise and clever mind not to understand how other people can be so slow and careless.

A nice compliment albeit one with a bit of a sting in the tail. It’s not the first time I’ve been called some variant of, shall we say, impatient although it’s certainly the gentlest way anyone has ever put it. What troubles me though is Grim’s belief that I believed the Post “is attempting to leverage lies”. Since I have found Grim to be careful and accurate, I am forced to conclude that the closing paragraph in my earlier post was not as clear as I had hoped. Thinking about that led me to a missing piece of knowledge and some realizations about my own political beliefs and how I view the rest of the political landscape.

Here’s how I closed my “Cry wolf” post:

It’s distressing how much the claim that Section 1233 compels end of life counseling reminds me of the claim that Sarah Palin quit as mayor of Wasilla without finishing out her term. The story about Palin is a deliberate lie, of course, while the story about Section 1233 seems to have started as an honest error, but the two stories share many of the same characteristics. Both fit perfectly into desired images: Palin is a quitter; the Democrats want to euthanize old people. Both spread quickly, repeated over and over by people who didn’t bother to check the accuracy of what they were saying - including people who should have known better. Neither one passes the most rudimentary smell test. And there’s no place to go to say, “But that’s not right” with any hope that the truth will be spread as far as the lie. Or even any hope that those doing the spreading are interested in knowing what the truth really is.

I’ll deal with the last two lines in my next post in this series. What the rest of that paragraph was intended to convey was that I believed the Post had honestly misinterpreted Section 1233; the misinterpretation spread through people who took the Post at its word without checking the story themselves; and some people who spread it should have known better. At the time I wrote my original post, the person who I felt should have known better was Betsy McCaughey. Not only is she considered enough of an expert on health care legislation to write editorials on the subject for both the Wall Street Journal and Bloomberg, she also made by far the most extreme claims of anyone I had read on this matter.

What I missed when I wrote that post is the fact that McCaughey wrote the original Post piece. Her name didn’t mean anything to me at the time and so it didn’t stick with me. It was not until after I heard her piece on the Fred Thompson show that I did some looking around and realized she was considered an expert on this type of legislation. I can see that it must have been odd for me in one place to say that I was willing to believe the original “required” argument was an honest misinterpretation while in another singling out the author of that original article as someone who should have known better.

While I was clearing that up, I was also realizing that my last paragraph made it clear I was unhappy that anyone reported the misinterpretation without checking its accuracy even if they claimed no special expertise in health care or legislation. In retrospect, this was odd even without my realizing who the author of the Post article was. The Post is, after all, a newspaper. All of us who think about politics have to assume someone at some point is getting things right because we have neither the time nor the inclination to hunt down the bedrock source of every single thing we’re told. So while it makes sense that I would think badly of an expert not checking her facts, it does not make sense I would be distressed that non-specialized bloggers reported as fact something they had read in the newspaper. Heck, I do it all the time.

What I realized when I thought about it is that there was simply no way the claim about mandatory end of life consultations for old people passed the smell test for me. I was literally unable to believe it. I was therefore unable to understand that it could pass the smell test for anyone else. Surely no one could actually believe that Congressmen would insert into a bill a provision that required the elderly to receive end of life counseling? Apparently they could. As Grim says (emphasis mine):

As for me, that's why I asked, "Seriously?" It sounded incredible (though not impossible, given the clear displays of arrogance by the government these last few years).

So if someone as sensible as Grim found it possible - however barely - to believe in the “mandatory” interpretation of Section 1233, why was it so impossible for me to do so? Three reasons, the last of which does me no credit at all.

First, I don’t believe those on the Left* actually want to euthanize old people or the ill to save money. What I do believe is:

- They honestly believe the old and the ill would prefer not to be kept alive artificially, suffering when there is no hope of recovery.

- They thus believe that if offered counseling most of the old and the ill will elect fewer extreme measures rather than more.

- They believe this will be a boon to the old and the ill rather than a burden.

- They also believe that this will save money on health care in the long run.

In other words, they believe they are marrying compassion and cost savings in one pretty package. They may be mistaken about what the elderly prefer and they may be misguided morally (although I’m not aware of any way in which their beliefs about end of life counseling run contrary to most religious teachings) but they are not soulless bean counters, rubbing their hands together in gleeful anticipation of being able to pull the plug on their parents and grandparents. They do show a distressing tendency to want to force people to do things “for their own good” but they also buy all that sensitivity stuff including the idea that old people shouldn’t be bossed around like children.

The second reason the “mandatory” interpretation of Section 1233 was impossible for me to believe was because I could not think of any way in which someone who supported this bill could credibly defend himself if asked about requiring mandatory end of life counseling. I’m not so naive I think politicians only vote for bills that are good and right and true. I do, however, think they do a rough mental calculation which comes down to: If I vote for this, can my re-election opponents get an attack ad out of it and, if so, can I make any kind of explanation that will convince (or, if you prefer, fool) the voters?

It’s quite easy to defend voting for a bill which provides senior citizens a new benefit in the form of an opportunity to sit down for a session dedicated to making sure their end of life wishes are followed. One can pontificate about preserving dignity. Tell horror stories of someone who lingered in agony for weeks while all his friends knew he wouldn’t have wanted that but couldn’t do anything but there was no advance directive. Tell more horror stories of someone who was denied treatment because some conniving second wife told the doctors to pull the plug even though all his friends knew he wanted every minute of life he could get but couldn’t do anything because there was no advance directive. Bring actual senior citizens up on stage to talk about how much they wanted someone to take the time to help them understand their options but doctors are so rushed these days they never get to it in a regular appointment and it’s just wonderful that now they can have someone take the time and trouble to help them figure out what it is they really want - not what some faceless, soulless hospital administrator thinks they should want. How is the opponent going to answer that? “Unlike the incumbent, I’m opposed to seniors making their own choices about end of life care”? I don’t think so.

If, on the other hand, the politician has voted for a bill that requires counseling rather than simply offering it, then the politician can tell all the stories and parade all the grateful seniors he wants. All the opponent has to do is find a couple of seniors who are opposed to end of life counseling - whether on religious grounds or simple curmudgeonliness - and send them out to tell their stories of being forced, forced I say, to talk about all this horrible stuff like, well, like all the stuff in McCaughey’s rant to Fred Thompson:

... how to end their life sooner. How to decline nutrition, how to decline being hydrated, how to go into hospice care. ... All to ... cut your life short.

Every senior citizen, every seriously ill voter, and everyone who loves an old, ill person will immediately get a mental image of themselves or their loved ones dying of thirst in some place that plays New Age music and hangs crystals over the patients’ beds but doesn’t believe in antibiotics or pain killers. The politician who voted for mandatory end of life counseling would be toast.

The third reason the “mandatory” interpretation didn’t pass my smell test is because if I wanted to make sure seniors elected less end of life care, I wouldn’t be that obvious about it. Clearly, this is not to my credit but there you are. For all the talk of frogs in simmering water, the Right was awfully quick to believe Section 1233 was a flame-thrower. It’s much more likely that even if the Left really did want to euthanize old people, they’d put together something like what Section 1233 really says rather than something like what people on the Right were claiming it did. Why tip your hand before you have to?

It seems, then, that I give the Left more credit for valuing life than do many on the Right; consider politicians on the Left more self-interested than do many on the Right; and am far more devious than many on the Right. Perhaps it’s because - although I’ve seen the light - I did lean Left for a long time; perhaps it’s because I have some extremely Left-leaning friends. Whatever the reason, it is clear that my smell test and that of much of the Right are quite different things. To the extent I unfairly implied that bloggers who were reporting Section 1233 required end of life counseling could not possibly believe what they were saying, I apologize.

However, experts like Betsy McCaughey and major media outlets like Fox should know better.


* A note about the phrases “the Right” and “the Left”. For me “the Right” is a catchall for the usual media suspects like Fox News and National Review Online as well as many of the bloggers I read (although they would object to being lumped together and with good reason). A quick definition would be: If forced at gunpoint to run for political office, they’d never get backing from the DNC. In the context of posts on health care, “the Right” can simply be taken to mean those who object vociferously to further massive government intervention in health care. It roughly equates to Republicans.

Conversely, “the Left” is the province of outlets like MSNBC and Huffington Post along with blogs like Obsidian Wings. They’d never get backing from the RNC and they are enthusiastic about further massive government intervention in health care, usually favoring a single-payer system. It roughly equates to Democrats.

Grim said I was:

elaborating a fear she has that the Right -- meaning the professional Right, I think, its think-tanks and journalists and advocates -- is intentionally making overly strong claims about the bill. She worries that the claims will undermine the Right's credibility, making it harder to convince people of the less-strong-but-still-very-serious problems.

I have a tendency to lump the Right-leaning bloggers into “the Right” although as Grim points out - and as I hope this post makes clear - I’ve realized that’s not entirely fair. The professional Right has far more of a duty to get their facts straight than do bloggers who must derive their information from the professional Right - and the professional Left for that matter. The line does get fuzzy, of course. At this point, I consider Huffington Post to be part of the professional Left even though they are not a traditional media outlet nor are they entirely made up of the sort of talking heads that appear with monotonous regularity on the Sunday morning shows.

This whole issue is very interesting. Consider the writer at Huffington Post who put up the disgusting satire about Trig Palin after Sarah Palin resigned; the post was taken down by HuffPo quite quickly. One rather cynical analysis of this sort of occurrence is that it is extremely useful to the professional Left to have those who are willing to do the dirty work but can be disavowed when the work they do is a little too dirty. This approach was used with great success - and often remarkable viciousness - by the Obama campaign last year. Their “netroots” could be vile, sexist, defamatory, and cruel while the “professional” part of the campaign insisted they knew nothing and were responsible for less.

Please note that I am not saying the bloggers who passed along McCaughey’s misinterpretation were acting as the dirty work auxiliary. They received information from a major media outlet, it passed their smell test, and they sent it along. That’s very different than receiving talking points from a campaign manager or deliberately being as offensive as possible.

On the other hand, I also don’t think this tactic is confined to the Left. I just think they’re a lot better at it. Personally, I consider that a good thing but it’s clear many who read my original post do not agree. I’ll speak to that in the next post in the series.


Anonymous said...

In far too many words, the author made his point - politicians are mostly bad but not totally bad as to advocate euthanistic policy.
Heaven help us to stay clear of politicians as much as possible. They seem to take a turn for the worse soon after being elected.

Elise said...

If by "the author" you mean me, the person who writes this blog, then I can assure you that I never use more words than I consider necessary.

Doggie said...

Perhaps the issue of 'mandatory" counseling is the smoke screen. The real issue is that when Medicare finds itself bankrupt completely, seniors will not have any other choice. Mandatory or not, the counseling will then be the treatment. The intention to take a huge sum from Medicare to pay for this new approach is justified by "lower costs in the future." Right! With the counseling becoming the treatment, down go the costs!

Elise said...

Doggie, counseling is just counseling. Those on Medicare are free to not take advantage of the counseling and if they do take advantage of it, they are free to walk out without a living will, advance directive, or OLST. Even if they do walk out with end of life documents, those documents can just as easily say, "Do everything possible" as they can say, "Do nothing".