Joust The Facts

Elitist ... And Simultaneously Shallow

NY Times "conservative" columnist David Brooks on President Barack Obama:

"I divide people into people who talk like us and who don’t talk like us."

Curious.  I divide people into two two types as well: those whose thoughts make sense based on all of the available facts (and who don't ignore the inconvenient ones), and those who don't.

When you acknowledge about $7 Trillion $9 Trillion cumulative projected additional deficits (possibly more - the White House uses unrealistic growth numbers for the next several years) and are still pushing for an additional trillion in spending on health care, that doesn't make sense.

8/31/09 1855: Ace of Spades lists the Top Ten reasons for Mr. Brooks' gushing enthusiasm.  He's missing the best one - the pecs.

8/31/09 2230: Allahpundit:

it’d be hard to find a more loathsome expression of intellectual elitism than “I divide people into people who talk like us and who don’t talk like us,” especially given the extent to which people like Brooks and Frum disdain the “one of us” appeal that inspires so many of Palin’s fans.

Traded, For A Few Barrels Of Oil

There have been some bad trades in history.  Babe Ruth traded for financing for No No Nanette, Jeff Bagwell for Larry Anderson, Curt Schilling for Mike Boddicker, John Smoltz for Doyle Alexander, Jason Varitek and Derek Lowe for Heathcliff Slocumb, and "who can forget Milt Pappas for Frank Robinson, for gosh sakes".  But baseball is a game, and a bad trade offends the fans, but doesn't devalue their lives.  Other trades can.  I don't think I've seen a worse trade than this.

The British government decided it was “in the overwhelming interests of the United Kingdom” to make Abdelbaset Ali Mohmed al-Megrahi, the Lockerbie bomber, eligible for return to Libya, leaked ministerial letters reveal.

Gordon Brown’s government made the decision after discussions between Libya and BP over a multi-million-pound oil exploration deal had hit difficulties. These were resolved soon afterwards.

The letters were sent two years ago by Jack Straw, the justice secretary, to Kenny MacAskill, his counterpart in Scotland, who has been widely criticised for taking the formal decision to permit Megrahi’s release.

The correspondence makes it plain that the key decision to include Megrahi in a deal with Libya to allow prisoners to return home was, in fact, taken in London for British national interests.

After less than 12 days per murder the convict is set free, based upon the false representation of impending death and for the commercial interests of BP.  My brother's life, traded for a few barrels of oil.  Before I was disturbed.  Now I'm pissed.  British PM Gordon Brown should be ashamed, and I, for one, want an abject apology.

8/30/09 1235: At Protein Wisdom, Darleen Click points out that this really is, finally, blood for oil.  And Jules Crittendon wants everyone to consider the possibilities.  Also: Moe Lane

... Megrahi’s back in Libya and Gadaffi doesn’t particularly care what Brown thinks about things.  And if you’re wondering why they waited two years… well.  Gadaffi cared a great deal about what George W. Bush thought about things.

This new guy in the Oval Office?  Eh.  not so much.

Pathetic.

8/30/09 1320: After reading, for example, Eleanor Clift and Melissa Lafsky excuse Ted Kennedy in the matter of Mary Jo Kopechne and Chappaquiddick because, politically, he did so much with which they agreed, perhaps it's just a leftist flaw that considers human life only worth as much as any other political football, to be punted around for field position.

8/30/09 1345: Ed Morrissey, who has been right on top of this:

What happens to Brown’s government now?  Will Parliament issue a vote of no confidence and force his resignation and new elections?  After this debacle, men of honor wouldn’t wait for a vote of no confidence but resign in disgrace, not just for the grubby commercial bargain but for their contemptuous lies afterward.

He should resign in disgrace, but only after issuing that abject apology.

9/6/09 2315: First we find out from that the Obama administration was kept in the loop throughout on the negotiations for the release of al-Megrahi.  Via Allahpundit at Hot Air:

The US was kept fully in touch about everything that was going on with regard to Britain’s discussions with Libya in recent years and about Megrahi,’ said the Whitehall aide.

‘We would never do anything about Lockerbie without discussing it with the US. It is disingenuous of them to act as though Megrahi’s return was out of the blue.

'They knew about our prisoner transfer agreement with Libya and they knew that the Scots were considering Megrahi’s case.’

Mr Obama said Megrahi’s release on compassionate grounds was a ‘mistake’ while Mrs Clinton phoned the Scottish administration to complain in person.

This doesn't make the case that the release was approved by the Obama administration, though I do note that when the documents relating to this matter were released, those involving the US were held back at the request of the administration.

Here's a photo essay on the 20th anniversary of the bombing, at TIME.

Maybe It's Because They Lie

Let's leave aside the information that NY Times columnist Charles Blow has, in today's column, borrowed an idea expressed eloquently by Daniel Henninger of the Wall Street Journal on August 20, that Americans in substantial numbers just don't trust the government to do the right thing.  First, Mr. Henninger.

To explain why the Obama health-care proposal pitched the nation’s politicians into town-hall hell, we would like to call to the stand an expert on how things in life can sometimes go wrong—Mr. Billy Joel.

Using a song years ago to sort through the complexities of a relationship in trouble, the Piano Man repeated the same simple one-word truth: "It's a matter of trust."

Now, from Mr. Blow:

What gives?

Is it partly the utter gullibility of some people? Sure. Is it partly deep-seated resentment of the black man in the White House? No doubt. But it’s also about something more fundamental: fluctuations of basic trust in the federal government...

That said, it stands to reason that many people probably don’t trust Washington on health care reform because, right now at least, they just don’t trust Washington.

Instead, let's have a look at the setup for Mr. Blow, who starts with the premise that an awful lot of Americans are buying into "myths" about the health care reform proposal.

Liberals are flummoxed by the fact that obviously false and widely discredited claims about health care reform have not only taken root, but appear to be growing in acceptance.

According to a poll ... most Americans now believe that if health care reforms pass, health care services will be rationed and taxpayers will be required to pay for abortions. And although Republicans are the most likely to believe this, they aren’t the only ones. Nearly a third of Democrats and more than half of independents also believe it.

"Obviously false and widely discredited," eh?  He cites two examples, so we'll examine those.

Today, In Government Health Care ...

The Telegraph reports on "cruel and neglectful" care provided to 1 million NHS patients in Britain.

In the last six years, the Patients Association claims hundreds of thousands have suffered from poor standards of nursing, often with 'neglectful, demeaning, painful and sometimes downright cruel' treatment.

The charity has disclosed a horrifying catalogue of elderly people left in pain, in soiled bed clothes, denied adequate food and drink, and suffering from repeatedly cancelled operations, missed diagnoses and dismissive staff.

The Patients Association said the dossier proves that while the scale of the scandal at Mid-Staffordshire NHS Foundation Trust - where up to 1,200 people died through failings in urgent care - was a one off, there are repeated examples they have uncovered of the same appalling standards throughout the NHS.

Medicare is not "government care," in that the government, while setting the prices, is not hiring the nurses and doctors, maintaining and supplying the hospitals, or controlling the flow of care.  That's one of the reasons Medicare (and by extension Medicaid) will run into financial straits in the future.  The explosion of senior care necessary without the ability to ration has set a financial path that is unsustainable.

In Britain we can see what will eventually happen when the "government option" is implemented.  This is particularly true - as the rationing will be more severe - given the increasing large projected deficits over the next ten years.  There won't be the money, and holding costs down will inevitably lead to rationing of care, reductions in services and staffing, and quality issues - all with the tort bar sitting like vultures atop the precipice salivating over the carrion in view.

Those who propose reducing payments from the already low Medicare levels will need to remember that employees need raises and a reasonable wage, energy prices will rise, maintainence costs will rise, the cost of supplies and equipment will rise, and physicians and nurses will not accept day laborer wages for their dedicated professional skills.  The only solution that will work and will not lead to "cruel and neglectful" care or outright rationing is to involve market forces.  "Competition" from a "government option" is not competition, particularly if the governement controls what must be provided by private plans.

In place of the variety of products that competition would generate, we would be forced "choose" among virtually identical insurance plans. Government would define these plans down to the last detail. Every one would have at least the same "basic" coverage, including physical exams, maternity benefits, well-baby care, alcoholism treatment and mental-health services. Consumers could not buy a cheap, high-deductible catastrophic policy. Every insurance company would have to use an identical government-designed pricing structure. Prices would be the same for sick and healthy.

In this respect, it wouldn't matter whether or not Congress created a "public option," a government insurance plan. In either case, bureaucrats would dictate virtually every aspect of the health-insurance business.

That's called central planning.  And it doesn't work.

Tell Me This Isn't True

When al-Megrahi, the terrorist convicted in the bombing of Pan Am 103, was released to Libya I assumed that the one piece of information that had been fully checked out was the medical status of the prisoner.  After all, why would one even consider "compassionate release" if compassion need not even be considered? Hot Air:

It turns out that other doctors had been consulted in the case, none of whom were willing to say that Megrahi was even dying from the disease.  In fact, one said he seemed suspiciously asymptomatic for a patient with the kind of diagnosis that Scotland asserted:

Of course, if the physician who makes the call is "in the bag," it would explain a lot.

And suggestions that the doctor who gave the prognosis may have been employed by the Libyan government emerged in the report’s notes. It said that a professor from Libya had been involved in Megrahi’s care and the medical officer who wrote the report had been “working with clinicians from Libya over the past ten months”.

If so, this demonstrates gross incompetence in the administration of the case, and venality by the UK and possibly the Scots if financial considerations trumped the murder of 270 innocents.

On The Passing Of Senator Edward M. Kennedy

Senator Ted Kennedy has died after roughly 18 months fighting brain cancer.  He was 77.  The Boston Globe, predictably, is effusive, with dozens of stories already posted.

“Teddy,’’ as he was known to intimates, constituents, and even his fiercest enemies, was an unwavering symbol to the left and the right - the former for his unapologetic embrace of liberalism, and latter for his value as a political target.

He will be eulogized as the consummate "legislator," but his legislative efforts were directed always at moving the nation to the left.  His unfulfilled (to this point) passion for universal health care is yet another example.  That he dedicated his life to public service is admirable.  That he was wrong in so many areas on the direction the country should move is not.

As with any passing, I wish his family peace.  But I think the lead paragraph in the Globe story says something worth repeating.

Senator Edward M. Kennedy, who carried aloft the torch of a Massachusetts dynasty and a liberal ideology to the citadel of Senate power, but whose personal and political failings may have prevented him from realizing the ultimate prize of the presidency...

First, I think we can all come up with some of those "personal and political failings" as we ponder his life.  Second, it speaks volumes that the Kennedys and the Globe considered the presidency the "ultimate prize."  It is not.  It is the ultimate honor.

8/26/09 1500: Paragraph 17.  That's how long it took the Associated Press to mention the hypocrisy of changing the succession law back to allow Massachusetts Democratic Governor to appoint Sen. Kennedy's successor.  Paragraph 17.  That's a whole lot of reading to find out why the law is the way it is.

I Am Tiger Woods?

Today I played golf.  Well, not really golf.  At least, not a full round of golf.  My five year old daughter has a zest for the game, and wants to be "like the professionals."  So we hit the links together, playing four holes at the local course, 15 through 18.

We'd both tee off, then she'd hit a second shot, then we'd pick up her ball and move it to where my tee shot landed, and we'd both play from there.  Once on the green we'd both putt out, dropping her ball at a convenient location near mine.  She had a blast.  And I?  Not only did I have a blast, but I played my best golf of the year for those four holes.  Even par, and on the one par five we played I was just off the green in two.  (Missed a four footer for birdie - rats!)  Three of the four greens in regulation, and up and down on 18 from the rough just off the green.

So, as we're driving up the fairway on the last hole, approaching my tee shot and about 150 yards from the green, we spoke.

"Are you having fun today?

"Yes, dad.  I want to be a real good golfer, like the professionals.  Like Tiger Woods.  And you."

And that, my friends, is the only time you'll find Tiger Woods and I mentioned in the same breath in a discussion of golf.  Though I'd have been happy to help him out with the knee problem last year.

Disturbed

That would be me.

• First, a "hero?"

Abdel Basset Ali al-Megrahi, the only man ever convicted of the 1988 Pan Am 103 bombing, which killed 270 people, received a hero's welcome back home in Libya today just hours after being released from a Scottish jail.

He was greeted by a large enthusisatic crowds at the airport in Tripoli, according to The Associated Press.

• Then, more joy, and rumors of commercial reasons from Gaddafi's son.

Saif al Islam Gaddafi said that Abdelbaset Ali Mohmed al Megrahi’s return was a “victory” for all Libyans.

He made the claims in a television interview for Libyan television recorded as he accompanied Megrahi on the flight back from Scotland to Libya on Thursday.

The claims were vehemently denied. A Foreign Office spokesman said: “There is no deal. All decisions relating to Megrahi’s case have been exclusively for Scottish ministers, the Crown Office in Scotland and the Scottish judicial authorities.

“No deal has been made between the UK Government and Libya in relation to Megrahi and any commercial interests in the country.”

• Denials all around, but more suggestions of improved "relations" from Libya's leader.

Meeting Abdel Basset al-Megrahi and his family late on Friday, Gaddafi thanked British Prime Minister Gordon Brown and Queen Elizabeth for "encouraging" Scotland to release the dying prisoner from a Scottish jail, Libyan news agency JANA reported.

After receiving a warm embrace from Gaddafi, Megrahi bent forward and kissed the leader's hand, TV images showed.

"This step is in the interest of relations between the two countries ... and of the personal friendship between me and them and will be positively reflected for sure in all areas of cooperation between the two countries," the Libyan leader said.

Gaddafi's comments drew a flat denial from Britain that Megrahi's release was in any way linked to business deals with Libya, which has Africa's largest proven oil reserves. Britain said all responsibility for his release rested with Scotland, which runs its own judicial affairs.

al-Megrahi claims he will prove his innocence before he dies.  I would be willing to listen if he does, but if not, then let's hope the three months he's been given on his release is an overestimate.  And the I'll be keeping an eye on BP for any new contracts.

The JTF "Quotes of the Day"

From Todd Zywicki, at Forbes.com:

The phony sense of crisis, the inattention to the details and the transparent dishonesty of many of the claims have made voters question not only the program but the president. What does Obama have to hide? Why won't he level with us? The discovery that there are hidden, controversial provisions in the plan has sparked rumors about imaginary provisions. Denouncing the false concerns as "lies," as the White House has done, doesn't redeem the apparent effort to obfuscate certain details of the plan. And the now-abandoned request of loyalists to report "suspicious communications" to the White House did nothing to assuage voters' distrust.

It is this distrust, more than anything, that is eroding Obama's popularity. Voters no longer see him as a grown-up, straight-shooter and basically good guy who is trying to do his best, but as a political opportunist taking advantage of their charity and trust.

This echoes Daniel Henninger from a few days ago, which contains another snippet deserving of "Quote of the Day" status.

These people [Democratic strategists] seem to think that if a popular president can just find the right way to describe this entitlement, the American people will take his word for it. Maybe there was a time when a strong presidential personality could sell big things. Those days are gone. The government frittered them away.

Hence the town hall anger and falling poll numbers.  Recall also that the falling support is can in no way be attributed to George W. Bush, as Mr. Obama is often inclined.  The high poll numbers and expectations at the start of his administration were his and his alone.  The waning support is due to actions taken since January 20, 2009, including a non-stimulating emergency "stimulus", Cap & Trade, and now health care reform, each laced with dishonesty, hidden provisions, attempted or actual rushed passage, and arrogant and non-responsive proponents.

A Fellow New Hampshire Physician Looks South

Dr. Kevin Pho, an internist in Nashua, NH and blogger at KevinMD.com, has an opinion piece published at CNN of all places (CNN?!!) adding to information that I've previously noted.  His point in this piece is that a physician shortage, which is already present in some specialties, particularly in some geographic areas (due to a state's tort laws), will likely be exacerbated in internal medicine by the proposed health reform.  For evidence he has a look at the state to his (and my) south.

Today, 97 percent of Massachusetts residents have health insurance, the highest in the country. But less publicized are the unintended consequences that the influx of half a million newly insured patients has had on an unprepared primary care system.

The Massachusetts Medical Society reported that the average wait time for a new patient looking for a primary care doctor ranged from 36 to 50 days, with almost half of internal medicine physicians closing their doors entirely to new patients. And when you consider that Massachusetts already has the highest concentration of doctors nationwide, wait times will likely be worse in other, less physician-abundant parts of the country, should universal coverage be enacted federally...

Massachusetts is finding out just how difficult it is to fiscally maintain universal coverage. In part due to soaring health costs, the state Legislature has proposed reducing health benefits for 30,000 legal immigrants and cutting funding to inner-city hospitals like Boston Medical Center, which, according to the Boston Globe, may "force it to slash programs and jeopardize care for thousands of poverty-stricken families."

It's important to remember that the pipeline of physicians is like a huge submarine.  It doesn't turn on a dime.  And so if there is a sudden and dramatic increase in patient volume or an increased need in a certain specialty it will take a minimum of 10 years to begin to fill the deficit.  Dr. Pho credits the draw of "more lucrative" specialty practice for nurse practitioners, physician assistants and MD's for worsening the shortage, but many of those "more lucrative" specialties have or anticipate their own shortages.

It's said that the definition of insanity is to repeatedly perform the same action and expect a different result.  President Obama can have a look at Massachusetts, and also Maine.  Maybe he thinks that if the federal government takes control of the situation for the entire nation the physicians, hospitals and other providers will be forced to accept the dictates handed down.  Perhaps, but then we're back to the underlying question.  Where will the needed physicians come from?

A Liberal's Liberal

Troy Senik at Real Clear Politics discusses the central problem of ObamaCare and elaborates something that I touched on briefly last night.  My words:

He's governing from the far left, and raging against anything that is not far left.  Mr. Hope & Change better hope for a change.

Mr. Senik:

But as the first act of his presidency has played out, he has shown himself to be anything but transcendent. Instead, he is an utterly predictable creature - a conventional liberal who mixes the weakness of Jimmy Carter with the ideological rigidity of George McGovern. And he is thus engaged in a conversation that the rest of the country concluded decades ago...

Unabashed liberalism has homes in cosmopolitan pockets throughout the nation. But left-wing presidents don't rest their head in the White House for long. Either they change or their housing arrangement does.

Presidential candidate Barack Obama would hardly recognize the political passions of President Barack Obama after running as a moderate driven by hope and change and disavowing all past radical associations.  The American people can now see the contrast as well.

Furtive Glances - "Fisk 'Em Hard" Edition

Time for a look around the blogosphere and intertubes at some work by others.  A couple of brilliant fiskings lead us off.

• First up is James Taranto and today's Wall Street Journal 'Best of the Web.' Mr. Taranto takes apart a fact check by the Associated Press' Calvin Woodward.  Best thing about it?  He does it with the words of Democrats and progressives themselves.  The coup de grace:

There's one more difference between Obama and the AP: He is a politician trying to get a piece of legislation passed. One expects him to shade the truth, to downplay inconvenient facts. Politicians have even been forgiven for outright lies. By contrast, of what use is a news service that is not rigorously impartial and factual?

• Next up at Verum Serum, Time Magazine's Joe Klein is beaten down by a brutal fisking.

Well, it’s true there is no Republican plan. Of course it’s also true that there is no Democratic plan. In fact there are several plans making their way through various committees in the Senate and a couple more in the House. Republicans have offered hundreds of amendments to those bills, most of which have been voted down party line. Republicans can’t be blamed for not playing the game so long as the party in power is hogging the ball to themselves.

Here's the thing.  Barack Obama, the Democraticc leadership in Congress, the DNC, the progressive blogs, and the mainstream media are outraged that Republicans won't sign onto a dishonestly sold expansion of government which will cause future tax increases of biblical proportions and cost millions of Americans both the health care they value and their freedom in many ways.  Well, either you stand for something or you don't.  Why would they sign onto something that in principle and in practice violates free market economics, the exceptionalism of American health care, and the freedom of the American people.  Joe Klein doesn't understand.  Or, rather, it's likely he does, but he wants his guys to win anyway.

• Hey, guess whose poll numbers have sunk even further?   That was fast.  Forty-five percent overall, and only 38% of independents, with 59% of independents disapproving.  Do you think there might be some connection to the deceptiveness of his health care sales job?  He's governing from the far left, and raging against anything that is not far left.  Mr. Hope & Change better hope for a change.

• The progressive meme is that racist white conservatives, just like they have always done, are rebelling to protect unregulated capitalism and white power.  Via Instapundit, Damon Root at ReasonOnline fills in some contradictory details.  Who knew the labor unions discriminated until forced to give it up? (via Instapundit)

Damned If You Do, Damned If You Don't

At The Note we find SEIU president Andy Stern musing that Democrats will lose majorities in Congress if health care reform doesn't pass.

A top Obama ally predicted Wednesday in an interview with ABC News that Democrats will lose their congressional majority in next year's midterm elections if they fail to put a health-care reform bill on President Obama's desk.

"I think we're talking losing control of Congress," said Andy Stern, the president of the Service Employees International Union.  "[The failure of health-care reform] would totally empower Republicans to kill all change."

"It's hard to imagine the Democrats convincing the public that Republicans are to blame for health-care reform going down when the Democrats have such large majorities," he added. "After last year's promise of change, voters will start feeling buyer's remorse."

Yes, but not exactly.  The Democrats stand to lose majorities in Congress in next years elections whether health care reform passes or not.  A majority of the people are against what the Democratic Congress is putting forth for reform, and already the Republicans have a +5 on the generic ballot.  If it doesn't pass, it will not only show that Democrats couldn't move their ball down the field even with such majorities, but also that they were trying to do so against the will of their constituents.  When that happens generally players are traded and the coach fired.

And if reform passes?  The reform will be found to be far more reprehensible and true to Republican criticisms than many even now believe, and Americans will punish the Dems for inflicting this nonsense on the people with the best health care in the world.  It would be as if the Dems threw the game, a la the Chicago Black Sox.

The JTF "Quote of the Day"

From Daniel Henninger, channeling Billy Joel* in today's Wall Street Journal, on trust, government options, and the President.

President Obama in his public pleas for the plan appears to be truly upset that his benign view of it isn't obvious to all. In his op-ed Sunday for the New York Times he said, "We'll cut hundreds of billions in waste and inefficiency in federal health programs like Medicare and Medicaid." Hundreds of billions? Just like that? This is nothing but an assertion by one man. It's close to Peter Pan telling the children that thinking lovely thoughts will make them fly.

Read the whole thing.  In Government We Trust?  Is there any evidence to suggest that we should?

*aside: I previously used the same Billy Joel song to make a point about trust in the government, only it was the NY Times lacking trust in Bush administration terrorism policies.

Al-Megrahi And Pan Am 103

This happened today, but the hearings have been going on for a while.

EDINBURGH (Reuters) - A former Libyan agent jailed for life for the 1988 Lockerbie bombing that killed 270 people, most of them Americans, is to be freed on Thursday, the Scottish government said.

Abdel Basset al-Megrahi, who has terminal cancer, will return to Libya on compassionate grounds, despite pressure from the U.S. government to keep him in prison.

"Megrahi now faces a sentence imposed by a higher power," Scottish justice minister Kenny MacAskill told a news conference. "It is terminal, final and irrevocable. He is going to die."

A Libyan government spokesman said Megrahi was being flown home by a son of Libyan leader Muammar Gaddafi.

"Megrahi has been released and is on his way home," the spokesman said.

Megrahi, 57, is the only person to be convicted over the bombing of Pan Am Flight 103 in mid-air above the Scottish town of Lockerbie. He lost an appeal against his conviction in 2002.

(pause for effect)  My brother was aboard Pan Am 103 that fateful evening, and so this I can say with certainty.  After conviction for the calculated murder of 270 individuals by terrorist bombing the key to al-Megrahi's cell should have been melted and then thrown away.  I'm quite certain the Scottish prison is capable of providing compassion to a dying man while still keeping him incarcerated.

8/20/09 1315: The Moderate Voice has a roundup, linking to this in The Telegraph.

I’m sorry, but I don’t care a jot whether Abdelbaset Ali Mohmed al-Megrahi has terminal cancer.  So long he remains the only person to have been convicted of the worst terrorist atrocity committed on British soil he should remain in prison for the rest of his life, whether he dies this year or in 20 years’ time.

It’s all very well for Kenny MacAskill, the Scottish Justice Secretary, to talk about releasing Megrahi on compassionate grounds. But where was the compassion he showed the victims of the terrorist attack on flight Pan Am 103 in December 1988 when he planted the bomb that killed 270 people?

Hypocrisy And Massachusetts Senators

In 2004, Democratic Senator John Kerry of Massachusetts was running for President against George W. Bush's re-election bid, and Republican Mitt Romney was Governor of the state.  The state legislature sensing that if Sen. Kerry won the election Gov. Romney might appoint a - gasp -Republican to fill the seat, passed a law to provide that such vacancies would remain unfilled until a special election could be held in safely Democratic Massachusetts.

Because of a law Massachusetts lawmakers passed when Senator John F. Kerry ran for president in 2004, when they sought to blunt the effect of a possible Senate appointment by then-Governor Mitt Romney, a Republican, there is no appointment process to replace a vacancy in a US Senate seat. Instead, like only two other states, Oregon and Wisconsin, a special election would be held within several months to fill a seat.

Now, though, the shoe being on the other foot, there is movement to rescind the law, pushed by the ailing Sen. Kennedy* himself. The Boston Globe, predictably, portrays this as a selfless act.

Senator Edward M. Kennedy, in a poignant acknowledgment of his mortality at a critical time in the national health care debate, has privately asked the governor and legislative leaders to change the succession law to guarantee that Massachusetts will not lack a Senate vote when his seat becomes vacant.

In a personal, sometimes wistful letter sent Tuesday to Governor Deval L. Patrick, Senate President Therese Murray, and House Speaker Robert A. DeLeo, Kennedy asks that Patrick be given authority to appoint someone to the seat temporarily before voters choose a new senator in a special election.

Although Kennedy, who is battling brain cancer, does not specifically mention his illness or the health care debate raging in Washington, the implication of his letter is clear: He is trying to make sure that the leading cause in his life, better health coverage for all, advances in the event of his death.

Then, when Gov. Patrick loses to the Republican challenger in 2010 (his approval rating in May was 28%) we can play more games with the process and revert to the 2004 law.  I suggest a simpler solution - a new law.

"Given that Commonwealth of Massachusetts is a wholly-owned subsidiary of the Democratic Party, and given further that the staunchly Democratic Kennedy family is a Massachusetts treasure, no Republican shall be allowed to hold a federal elected position representing the people of the Commonwealth."

Problem solved.

*I have no ill will towards the Senator personally as he and his family deal with his illness, though I disagree with him strongly on health care, and further think that his career should not have survived his past.  His illness does not change the hypocrisy demonstrated here.

8/20/09 1240: More from Ed Morrissey at Hot Air.

However, actions by a state legislature and demands by partisan hacks to keep going back and forth depending on the party registration of the Governor makes a mockery of the rule of law and underscores the fact that machine politics runs Massachusetts.

Hence my suggested new law.

BTW, welcome Ace Of Spades readers.  Thanks, Drew.

The JTF "Quotes Of The Day"

From The Telegraph, of Britain, and columnist Gerald Warner.

The one glimmer of realism he [Obama] displayed was when he recently told an audience in Montana that, with regard to health care, he was “not in favour of the British system”. Perhaps he had just seen the latest figures from the Office of National Statistics revealing that more than 30,000 people have died in England and Wales from hospital infections in just five years. Translated proportionately into American demographics, that would be 150,000 fatalities. Not the best advertisement for socialised health care.

And now a word from Bloomberg's Caroline Baum.

The proliferation of Obama’s gaffes and non sequiturs on health care has exceeded the allowable limit. He has failed repeatedly to explain how the government will provide more (health care) for less (money). He has failed to explain why increased demand for medical services without a concomitant increase in supply won’t lead to rationing by government bureaucrats as opposed to the market. And he has failed to explain why a Medicare-like model is desirable when Medicare itself is going broke.

The public is left with one of two unsettling conclusions: Either the president doesn’t understand the health-insurance reform plans working their way through Congress, or he understands both the plans and the implications and is being untruthful about the impact.

Neither option is good; ignorance is clearly preferable to the alternative.

Quod Erat Demonstratum

You see, if you find the "Obama as Joker" poster both truthful and amusing, the one with the single-word caption "Socialism," then you are a racist.

Oh, so you object to being characterized as racist?

That, my friend, is simply proof of your racism.

To be honest, though, I do believe the poster appeals to people who see in it a validation of their own racial prejudices, even if they can't acknowledge them. That my short post hit such a deep, raw nerve clearly shows that race was very much part of the illustration's attraction.

Because, after all, why would anybody object to being tarred with the wholly unacceptable and marginalising pejorative "racist" if one wasn't, in fact, racist?

Circular logic noted.  Remind me again why people on the left think they're smarter?

via Hot Air's Allahpundit.

Zombietime Reminds The Left ...

... that Nazi imagery related to a president of the United States has a longer history than 6 weeks.*

*That's not to say that for the left it even has that 6 week history, because the prime example of this doesn't come from the right.

We've Seen This Before

Via Glenn Reynolds, Robert Reich tries the "vast right-wing conspiracy" meme, and fails for several reasons.  First, from Mr. Reich.

Why are these meetings brimming with so much anger? Because Republican Astroturfers have joined the same old right-wing broadcast demagogues that have been spewing hate and fear for years, to create a tempest.

But why are they getting away with it? Why aren't progressives—indeed, why aren't ordinary citizens—taking the meetings back?

Mainly because there's still no healthcare plan. All we have are some initial markups from several congressional committees, which differ from one another in significant ways. The White House's is waiting to see what emerges from the House and Senate before insisting on what it wants, maybe in conference committee.

But that's the problem: It's always easier to stir up fear and anger against something that's amorphous than to stir up enthusiasm for it.

He's wrong about the astroturfers, he's wrong about the "broadcast demagogues" "spewing hate and fear."  He wants "ordinary citizens" (the "proles"?) to "take the meetings back."  But let's look also at substance.  Mr. Reynold's assumes that Mr. Reich is honest about there not being a bill to oppose, and responds.

Hmm. So it’s like this:

Obama: I’m going to turn healthcare upside down. Not sure how.

People: I don’t think I’ll like this.

Obama: Haters!

Remember how Bush was supposed to be the idiot who went into Iraq without a plan, while Obama was supposed to be the cool methodical one? But Reich is admitting that despite all the Administration hoopla, there’s still no plan. Or, possibly, that the White House has a plan, but won’t tell us what it is. And yet the people who don’t want to see a bill — some bill, doing who-knows-what — rammed through in the dead of night are somehow the ones who are ignorant and being manipulated. Right.

Because, you see, we're supposed to be so convinced that a) health care in America is so irretrievably deficient that only a wise and competent federal intervention/takeover can save it, and b) Mr. Obama and the Democrats are just the people to do it, unsupervised.  Right, I didn't think so either.

Mr. Reich's solutions for the Obama Administration are two-fold.

(1) Admit that taxes will have to be raised and that cost-savings won't be sufficient to achieve nearly universal care. But be absolutely clear that taxes will be raised only be raised on the very top.

Because class warfare, pitting a larger number of Americans against a smaller number of Americans is really where it's at.

The modern bourgeois society that has sprouted from the ruins of feudal society has not done away with class antagonisms. It has but established new classes, new conditions of oppression, new forms of struggle in place of the old ones.

Our epoch, the epoch of the bourgeoisie, possesses, however, this distinct feature: it has simplified class antagonisms. Society as a whole is more and more splitting up into two great hostile camps, into two great classes directly facing each other -- bourgeoisie and proletariat.

Mr. Reich's second suggestion.

(2) Say unequivocally that the public option is essential for controlling costs and getting private insurers to offer people better deals, not at all a step toward a government takeover of health care.  (to which he makes the following point)

• While it's true that the public won't have to show profits, plenty of private plans are already not-for-profit. And if nonprofit plans can offer high-quality health care more cheaply than for-profit plans, why should for-profit plans be coddled? The public plan would merely force profit-making private plans to take whatever steps were necessary to become more competitive. Once again, a plus.

i.e., to forego profits.  By "coddled" he really means "allowed to exist."  Because, of course

The distinguishing feature of communism is not the abolition of property generally, but the abolition of bourgeois property. But modern bourgeois private property is the final and most complete expression of the system of producing and appropriating products that is based on class antagonisms, on the exploitation of the many by the few.

But, let's assume Mr. Reich is instead wrong, that despite there being several versions of the incompletely marked up bills, the bills that majority Democrats have allowed to progress through Democratic majority committees, they all do have certain unifying characteristics.  Such as, for example, a public plan that would eventually crowd out private plans, that such public plans would be subsidized with tax dollars competing unfairly, that "containing costs" is merely a euphemism for health care rationing via advisory panels, and that costs would, in fact, increase as the CBO has said.  Repeatedly.  And that once the house passes a plan and the Senate passes a plan, a conference committee could pretty much put in whatever the Democratic leadership, and Mr. Obama, wanted, and with 60 votes in the Senate and a large majority in the House stand a good chance of passing it.

Is it therefore still unreasonable for Americans to be edgy about the direction and the tenor of the bill(s)?  I think not.  This is, clearly, the time to protest.  Because once the Congress becomes safely ensconced back in Washington in September, amid the adoring Washington political media  and with Hope and Change all around it like a big Snuggie, it's doubtful they'll hear the voices saying "No, no, a thousand times, no."

Medicare Rates And The Truth

I spotted something fishy last night at Powerline.  The President was quoted from his Portsmouth, NH town hall on health care musing about diabetes and amputations.

All I'm saying is let's take the example of something like diabetes, one of --- a disease that's skyrocketing, partly because of obesity, partly because it's not treated as effectively as it could be. Right now if we paid a family -- if a family care physician works with his or her patient to help them lose weight, modify diet, monitors whether they're taking their medications in a timely fashion, they might get reimbursed a pittance.

But if that same diabetic ends up getting their foot amputated, that's $30,000, $40,000, $50,000 -- immediately the surgeon is reimbursed. Well, why not make sure that we're also reimbursing the care that prevents the amputation, right? That will save us money. (Applause.

There's so much that is fishy in these two paragraphs that I just don't know where to begin.  Let's start with the reimbursement for foot amputations, which is never "immediate."  Since the President was in New Hampshire, we'll use the New Hampshire rates that, for example, I might get paid as an orthopaedic surgeon.  

The code for amputation through the mid-tarsal joint, or midfoot, is CPT 28800  Reimbursement?  $526.75.  The code for amputation through the forefoot, or trans-metatarsal, is CPT 28805, paid at $694.14.  A ray amputation of one gangrenous toe, including the metatarsal, is CPT 28810, paid at $406.12.  So reimbursement for a variety of foot amputations for serious diabetic infections, which can be life-threatening if left treated inadequately, range from roughly $400-$700.  I only wish it was $40,000.  Maybe he's thinking of the amount his trial lawyer friends might make from suing the surgeon.

Next, let's recall that that $400-$700 is not just for the surgery.  No, that reimbursement is under a 90 day global.  "What's that," you ask?  Well, the 90 day global means that the reimbursement covers not only the surgery, but also the follow-up care, to be certain that healing occurs, for the next three months.  No additional office reimbursement is paid for post-op care during that time, and most patients in this situation would require at least three visits to the office during that post-op period

So how much is a pittance?  The reimbursement for a complex Level 4 visit with an established patient, the kind where diabetic counseling and monitoring might take place, is CPT 99214 reimbursed at $92.68.  Preventive Care code CPT 99397 for an established patient 65 or older is a code that, unfortunately, I don't have the Medicare rate for, but I'm trying to locate it.

Personally, all of those amounts are pittances.  There aren't a lot of high quality personal consultations that directly affect your well being that cost less than $100 in the private sector.  And after years of training, accepting the risks of surgery, the necessary followup care, taking into account all of such a patient's co-morbid medical conditions for $400 or so is also a steal.  There are software programs that cost more.  And books.  And gee, a European facial runs $80-$130.

The American College of Surgeons, in which I happen to be a Fellow, pointed out this disinformation as well, giving the slightly higher reimbursements for leg amputations, not foot. (Original link here.)

The American College of Surgeons is deeply disturbed over the uninformed public comments President Obama continues to make about the high-quality care provided by surgeons in the United States. When the President makes statements that are incorrect or not based in fact, we think he does a disservice to the American people.

8/13/09 1015: Let's not forget that Mr. Obama's wife, Michelle, didn't think $600 is all that much, either.

"You're getting $600 - what can you do with that? Not to be ungrateful or anything, but maybe it pays down a bill, but it doesn't pay down every bill every month," she said. "The short-term quick fix kinda stuff sounds good, and it may even feel good that first month when you get that check, and then you go out and you buy a pair of earrings."

But it's too much for a necessary, perhaps even life-saving, medical procedure.

8/13/09 1210: And it's the Obamateurism of the Day!

8/13/09 2150: Early this morning my partner called the AAOS, the American Academy of Orthopaedic Surgery, about the factual lapses in Mr. Obama's presentation and was told that the AAOS was unaware of the controversy but would look into it.  Voila, a statement has been produced.  Hey, my group gets results!

Statement from the American Academy of Orthopaedic Surgeons Regarding Comments from President Obama

The American Academy of Orthopaedic Surgeons (AAOS) is profoundly disappointed with President Obama’s recent comments regarding the value of surgery and blurring the realities of physician reimbursements. The AAOS represents over 17,000 US board-certified orthopaedic surgeons who provide essential services to patients every day. As President Obama has said, “Where we do disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that's actually been proposed.” (my emphasis)  In that spirit, we would like to bring some clarity to his comments and underscore the value that orthopaedic surgeons bring to Americans every day of every year.

First, surgeons are neither reimbursed by Medicare, nor any provider for that matter, for foot amputations at rates anywhere close to $50,000, $40,000 or even $30,000. Medicare reimbursements to physicians for foot amputations range from approximately $700 to $1200 which includes the follow up care the surgeon provides to the patient up to 90 days after the operation. Moreover, orthopaedic surgeons are actively involved in the preventive care he mentions. We are a specialty that focuses on limb preservation whenever possible and when it is in the best interests of the patient. Our approach to amputation follows the same careful, thoughtful approach, always with the patients best interest as the primary focus.

What My Kids Are Watching

I mean, besides the destruction and flooding of 30% of our home, and the impending health care train wreck.

 

It's the Pink Panther!

Sometimes I think there's hope for them.  By the way, they also love the Christmas present I bought myself last year.  Ah, the classics.

The Definition Of Chutzpah

Via House Speaker Nancy Pelosi and Democratic Majority Leader Steny Hoyer:

These disruptions are occurring because opponents are afraid not just of differing views — but of the facts themselves. Drowning out opposing views is simply un-American.

No.  With all due respect, and leaving aside the fact that such tactics on the left are at minimum nodded at and at worst encouraged, these disruptions are occurring because congressional representatives are misrepresenting facets of the bill, either dishonestly because they know what's in there, or honestly because they haven't really read and understood it.  And they're occurring because we're being told that money will be saved when the CBO has told congress differently.  And these disruptions are occurring because of the uber-arrogant nanny attitude "we know best what you need."  Drink the Kool-Aid, indeed.

However, I'm angry also about this.

And it will free doctors and patients to make the health decisions that make the most sense, not the most profits for insurance companies.

Oh, this is much better.  Instead of managing patient problems to line my own pockets, as President Obama accused, I'm working to enrich insurance companies.  Thank you, I feel much better about my calling.  And I'm sure neither of these individuals have ever slipped a pork project into the budget to reward a campaign contributor or friend.

More from Ace of Spades, Hot Air, Legal Insurrection, Blue Crab Boulevard, Patterico's Pontifications, Jammie Wearing Fool, and other usual suspects.

So Let's Trust Them With One-Sixth Of The Whole Ecconomy

"Follow the money?"  Yeah, right.  The entire phrase is actually "Follow the money, if you can."

Despite a new oversight panel, a new special inspector general, the existing Government Accountability Office and eight other inspectors general, those charged with minding the store say they don't have all the weapons they need. Ten months into the Troubled Asset Relief Program, some members of Congress say that some oversight of bailout dollars has been so lacking that it's essentially worthless.

"TARP has become a program in which taxpayers are not being told what most of the TARP recipients are doing with their money, have still not been told how much their substantial investments are worth, and will not be told the full details of how their money is being invested," a special inspector general over the program reported last month. The "very credibility" of the program is at stake, it said.

Recall, also, that one of the concerns that makes Mr. Obama want to crack down on the health sector is substantial Medicare and Medicaid - government payor - fraud.  This kind of thing with TARP gives one the impression that the word "competent" means something different in bureaucrat-ese.

I'm certain, though, that they'll know exactly where this money goes.

The Pentagon had only asked for one jet, which it intends to use for its new Africa Command.

Money for the other two was inserted by the House Appropriations Committee, which also inserted a requirement that the jets be used by the Air Force's 89th Airlift Wing which is based at Andrews Air Force Base in Maryland, and provides transportation for government VIPs -- including members of Congress.

The JTF Quotes of The Day - 8/9/09

From Mark Steyn at National Review, discussing the left's contempt for the right's disdain for the left's plans and tactics in reorganizing the right and left's health care.

If only we’d stuck to the president’s August timetable and passed a gazillion-page health-care reform entirely unread by the House of Representatives or the Senate (the world’s greatest deliberative body) in nothing flat, we’d now have all the time in the world to sit around having a “serious discussion” and “real debate” on whatever it was we just did to one-sixth of the economy.

And a two-fer, from Glenn Reynolds (Instapundit).  "Hey, remember when protest was patriotic?"

The truth is that for my adult lifetime, "protest" has been a kind of Kabuki engaged in by  organized groups on the Left with help from the press...

Funny how fast the worm -- or maybe it's the pitchfork -- has turned. Now that we're seeing genuine expressions of populist discontent, not put together by establishment packagers on behalf of an Officially Sanctioned Aggrieved Group, we're suddenly hearing complaints of "mob rule" and demands for civility.

As always, read both whole things.

To Townhall, Or Not To Townhall, That Is The Question

A couple of days ago I received a computerized call on my home phone from former NH governor/now Senator Jeanne Shaheen, notifying me that I would have the option of sitting in on a conference call/pseudo-townhall meeting to discuss healthcare.  As a physician who lives and works in NH I thought I might have some useful information for Sen. Shaheen as she tries to make up her mind on the current health care reform process in Washington.  I was instructed that if I wished to participate I needed to pick up my phone when it rang between 6 pm and 6:10 pm Thursday evening (tonight).

Then today it hit me.  This is no way to run a townhall.  There are problems galore with this format.  I'll list just a few.

• I've got lots of questions, and lots of information to impart.  In a real townhall meeting the most informed and persuasive will be deferred to often by others in the room, others who can then calibrate their questions by what has already been asked, and what needs more explanation.  This won't happen here.  Sure, you'll be able to listen in, but if you've already gone, good luck getting in a followup to one of the later responses.

• Senators can filibuster in Washington, and they certainly can do so on the phone, particularly when their minions are preventing anyone from breaking into the conversation when nonsense is put forth.

• Having done this one other time I know that the questions are screened.  If I ask something uncomfortable for the Senator my question won't get chosen.  Furthermore, even if my question (singular) gets selected, do you think I'll get to followup if the Senator evades or fails to adequately answer?

• The last word.  I'm sure questions will be allowed.  But no citizen will be allowed the last word on a topic, even one who is fully informed.

• She's already made up her mind.  She has not been one of the Senators mentioned trying to find workable solutions, and she has been a reliable Democratic soldier in Majority Leader Harry Reid's army.

And, sure enough, I'm right.  The telephone format really is a dodge. (link is to Ace of Spades, story CNS News)

Members of Congress are increasingly turning to virtual townhall meetings--conducted by telephone--in an effort to reach more constituents while avoiding the potential that informational meetings might be disrupted by angry and persistent questioners or protesters.

One advantage to these telephone townhalls, whether any particular member of Congress actually has this intention, is that the Member of Congress can control the audience and the questioning.

On the other hand, at a real townhall meeting I, as an opponent of the current health care reform proposals, might be profiled as a "thug", part of a "mob" organized by "right wing extremists."  Somebody might even tape a swastika to my sleeve, particularly if I was too well-dressed.  Some professional thugs might even show up to act as the muscle.

So here are a few of my questions that Sen. Shaheen might not get to hear:

Well, Duh! No Kidding

Robert Samuelson writing something in the pages of the Washington Post that conservatives have maintained for years.

Here's the national lesson. There's a collision between high and rising demands for government services and the capacity of the economy to produce the income and tax revenue to pay for those demands. That's true of California, where poor immigrants and their children have increased pressures for more government services. It's also true of the nation, where an aging population raises Social Security and Medicare spending. California is leading the transformation of politics into a form of collective torture: pay more (higher taxes), get less (lower services).

[...]

So California is stretched between a precarious economy and a strong popular desire for government. The state's wrenching experience suggests that, as a nation, we should begin to pare back government's future commitments to avoid a similar fate. But California's experience also suggests we'll remain in denial, prisoners of wishful thinking, until the fateful reckoning arrives in the unimagined future.

The President is just such a prisoner of wishful thinking.  Sure, we can increase government spending by trillions of dollars and still only tax "the wealthy."  Of course we can.  And that won't affect employment.  And it won't create avoidance behavior.  And freedom won't be compromised.  And the economy will grow just like before.  And doctors, nurses and hospitals will still work just like before.  And new drugs and miracle cures will continue to flow.  And a recession that causes tax revenues to fall won't be any problem whatsoever.  And so on, and so on, and so on.  A large part of this current economic downturn is attributable to the government encouraging economic irresponsibility.

Conservatives are, by and large, for small(er) government.  Part of that is because of this realization that huge promises of government largesse, similar to Bernard Madoff's ponzi scheme, are bound to fail when you eventually run out of other people's money.

Economic Newspeak For The Political Class

We're all familiar by now with the concept that "letting the Bush tax cuts expire" is not the equivalent of a "tax increase."  Here's a good example, from Reuters:

WASHINGTON (Reuters) - President Barack Obama will allow tax breaks given to wealthier Americans under his predecessor, George W. Bush, to expire as scheduled rather than eliminate them sooner, an administration official said on Saturday.

Obama, who promised during his White House campaign to roll back tax cuts on people earning more than $250,000, also plans to boost tax collections from about 16 percent of the economy this year to 19 percent in 2013, the official said, confirming a Washington Post report on Obama's budget proposals for the 2010 fiscal year.

Nowhere does the reporter indicate that a "boost" in tax collections constitutes a tax increase, even if it's occurring by allowing built-in rate increases to occur.  As I've written previously, there is no "natural" rate for taxes at any income level.  They are what they are; if they go up, it's a tax increase, and if they go down it's a tax cut.  But "letting the Bush tax cuts expire" allows politicians who expouse it to avoid using the words "tax increase," and this is particularly true when the expiration is automatic, not requiring an additional vote.

Here's another example of economic newspeak from the political/media class.  Medicare payments to physicians are determined by what is known as the SGR, or sustainable growth rate formula.  (You can read more here). That formula has not been kind to physician payments, threatening ever larger cuts each year.  Those cuts have been prevented on a year to year basis by Congress, but they have not revised the formula.  For next year the formula threatens a 21% cut in reimbursement.  The Associated Press produced a fact check on health care that could use some fact-checking itself:

CLAIM: Overhauling health care will not expand the federal deficit over the long term.

Obama has pledged that "health insurance reform will not add to our deficit over the next decade, and I mean it."

THE FACTS: Obama's pledge does not apply to proposed spending of about $245 billion over the next decade to increase Medicare fees for doctors. The White House says the extra payment, designed to prevent a scheduled cut of about 21 percent in doctor fees, already was part of the administration's policy

It absolutely does not increase Medicare fees for doctors.  It prevents the cut of fees.  That is not an increase.  When you hear that doctor fees are being increased $245 billion remember that this is not an increase in fee rates - those are the same.  What the $245 billion represents is an increase from what the government would like to be paying.*  Imaging going to the grocery store planning to buy 10 items for $15.  When the clerk totals those items the bill comes to $20.  Did the grocery store make $5 extra?  No, they received their proper reimbursement.  Your plan was faulty, thinking you could get those items for less at that market.

I often tell my children that the English language is very precise.  Words mean what they mean, and if you choose your words carefully you can make yourself understood to pretty much anyone.  I hope those writing in the media will take that to heart also and begin to select their words a bit more carefully.

Hey, I can hope.

*By the way, how do you suppose the President got the AMA on board with reform?

8/3/09 0011: Speaking of the President and the AMA, and, particularly, of newspeak...

Even In The People's Republic

So last week I'm vacationing on The Cape and playing the back nine of one of the mid-cape golf courses on one of the few beautiful sunny days all week.  Dry, breezy, mid 70's temps.  Perfect for golf.   Then I spot this as I'm strolling up the fairway after hitting my tee shot, and I just had to interrupt that blissful round and snap a couple of photos.  I felt a bit like Spicoli at the end of Fast Times.

"Awesome!" 

"Totally Awesome!"