Monday, August 10, 2009

Sometimes I think

Sometimes I think I should confine my blogging - and commenting on other blogs - to waiting for bloggers like Villainous Company and Megan McArdle to say things best and then put in links to what they say. They each have a sparkler up this morning.

VC ghostwrites “A Few Words From Nan Pelosi on Health Care” which sums up brilliantly how those of us who oppose the vast overhaul of health care (or insurance or whatever we’re calling it now) think we are perceived by our Democratic officials:

We welcome your comments... so long you're not a Republican (they got us into this mess) or an Independent (a bunch of idiots duped by clever demagoguery). Real Americans understand the need for health care reform.

Meanwhile, Megan McArdle has the most intelligent post I’ve seen on why Section 1233 is not worrying in and of itself but the drive to cut costs should be - particularly when the government is the only or the dominant player:

But though the implication that the Democrats are heartless technocrats is thoroughly wrong, I think the worry underlying it is legitimate.

She called the post “The Politics of Cost Control”; I’d call it “Balance of Power” or simply “Quis custodiet ipsos custodes?”

Had I known these posts existed I could have replaced most of the comment I made at progressive Blue Lyon this morning with those two links - although I would still have kept my last two paragraphs:

I certainly agree that Section 1233 (the end of life counseling provision) in HR3200 (the House health care bill) does not mandate this counseling, much less mandate producing a living will or an OLST, much less mandate choosing less end of life care rather than more. I've written (and written and written) about this on my blog. I think making people scared of end of life planning is a really bad idea and I think Betsy McCaughey who seems to have started the whole "it's required" lie should never again be considered an expert on anything remotely having to do with health care.

However (you knew this was coming, right?) the Democrats really shot themselves in the foot with this issue. They put a provision for end of life counseling (including lots of detail about stuff like being sure to talk about withholding antibiotics) in a bill they're selling as a good way to cut health care spending. Duh. As if that's not enough, they're proposing to take about $200 billion out of Medicare funding plus they're proposing the IMAC whose specific purpose is to cut Medicare spending. And as if all that isn't enough, the brother of the President's chief of staff loves to write scholarly articles that are about making medical care “not guaranteed” for those "who are irreversibly prevented from being or becoming participating citizens" - which Sarah Palin is understandably reading as “Down syndrome children”. Throw in the confusion between Comparative Effectiveness Research and Cost Effectiveness Analysis (I believe the former was in the stimulus, the latter is not legislated but may be implied by IMAC), stir well with the concept of QALY (not in our bills but Dems really need to never talk about how wonderful Britain’s health care system is), and let's face it. If a vile Republican operative had set out to create the perfect climate for whipping up opposition to the health care bill he couldn't have done better than this.

Furthermore the Democrats seemed amazed that anyone would oppose this bill. Once they got over their amazement they decided that those opposing it were either minions of the evil insurance companies (or big pharma or ear, nose, and throat docs) or minions of Karl Rove or minions of the VRWC. If someone who opposed the bill was none of the above then he or she must be someone who was so stupid they bought the propaganda of one of those groups. This gave those on the Right the freedom to wonder aloud why dissension was great when Bush was President but not now and it gave people watching TV the freedom to wonder just how likely it is that some old guy in Bermuda shorts with a go-cart from the Scooter Store is a tool of the VRWC.

Then Nancy Pelosi started talking about Astroturf swastikas and all hell broke loose - including that tirade from Limbaugh which was only one small piece of a much longer tirade which started as a pushback against Pelosi’s comment. This does not excuse Limbaugh (talking about Nazis wasn’t constructive under Bush and it’s not constructive under Obama) but then he doesn’t speak for Republicans or conservatives any more than Keith Olbermann (he of accursed name) speaks for Democrats or progressives.

If I may be even more nakedly partisan for a moment, I think this is a fundamental problem with Democrats/liberals/progressives being absolutely convinced that their way is right, just, and rational - and is the only way that is. It leaves them totally unprepared for opposition and totally unable to respond to that opposition effectively. They are so certain that any decent, thinking person would agree with them they have no mechanism for dealing with those who don’t except to insist such people are either evil or idiotic. This can be an excellent tactic when you’re out of power, a lousy one when you’re in. And it’s never a good tactic when the opposition starts to approach 50% in the polls.

Finally, for a man who ran such a successful Presidential campaign, Obama is doing a lousy job getting important legislation passed. Perhaps the only thing he’s really good at selling is himself.

Part of Blue Lyon’s response to this was:

Furthermore the Democrats seemed amazed that anyone would oppose this bill.

Especially people supposedly on their side. All the Dems in power can seem to do is dismiss, as you said, anyone who isn’t in Obama’s thrall or who are not willing to blindly follow them into — I don’t know what.

Is there anybody outside the Federal government who likes what’s going on with health care, er, insurance reform?

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