The Madness Of King Krud

Vaunted liberal hack poser and gerbil molester Paul Krugman comes out with one of the most twisted, logically falacious arguments about Health Care that I’ve ever seen, floating with the other turds over at the NYSlimes. This one was WAAAAYYYY to juicy to let go, besides I haven’t dood-me a good fisking in quite awhile.

Earlier this week, The Times reported on Congressional backlash against the Independent Payment Advisory Board, a key part of efforts to rein in health care costs. This backlash was predictable; it is also profoundly irresponsible, as I’ll explain in a minute.

So the Death Panel Independent Payment Advisory Board shouldn’t be a cause for concern to most folks? I mean it’s not like we don’t have Canada and the UK for a good sample of what these panels do. Where are you going for a minute? I suppose that embarrassing gerbil itch needs some Preparation-H. We’ll still be here when you get back.

But something else struck me as I looked at Republican arguments against the board, which hinge on the notion that what we really need to do, as the House budget proposal put it, is to “make government health care programs more responsive to consumer choice.”

We’d like to see your smarmy socialist ass struck, but I imagine your and our thoughts about what is striking are somewhat at odds. There is nothing sacrosanct about medicine as a consumer choice. We all have differing ideas about what we expect from a doctor or practice or hospital. I’ve been in quite a few doctor’s offices over the last month or so and they all had a gimmick near the check-out areas that allows a patient to complete a customer satisfaction survey. They are obviously responding to patients as customers in an effort to provide the highest level of service and satisfaction. Why shouldn’t we view our choice in medicine as a consumer issue? Of course, I can see where you’re going with this immediately. To accept socialized medicine we must accept what we’re given, when, where and how we get it. We can’t let the proletariat to be bitchin’ about Obama’s ‘free’ health care right?

Here’s my question: How did it become normal, or for that matter even acceptable, to refer to medical patients as “consumers”? The relationship between patient and doctor used to be considered something special, almost sacred. Now politicians and supposed reformers talk about the act of receiving care as if it were no different from a commercial transaction, like buying a car — and their only complaint is that it isn’t commercial enough.

Oh my, where to start with you Paul? The doctor-patient relationship is something special. The decisions that we make concerning our personal health are something that should be this way. That makes it imperative that we have choices. A choice to see a particular doctor or use a certain hospital, what we as individuals determine. That’s not a major reform, that’s common sense being injected into the debate. Something this piece is entirely devoid of.

What has gone wrong with us?

52% of the populace decided that hope n’ change, skittles and unicorn farts, were more important than qualifications and ideology.

About that advisory board: We have to do something about health care costs, which means that we have to find a way to start saying no. In particular, given continuing medical innovation, we can’t maintain a system in which Medicare essentially pays for anything a doctor recommends. And that’s especially true when that blank-check approach is combined with a system that gives doctors and hospitals — who aren’t saints — a strong financial incentive to engage in excessive care.

Alrighty then, we went from having a ‘special’ almost sacred relationship with our doctors to it being a bad thing when doctors recommend something specifically for us. That recommendation came about what was medically prudent, with careful consideration of the patients needs and wants as well. You just can’t have it both ways Kluckman. Perhaps a little research is needed there Perfesser K. Just a few factors drive up health care costs. The primary factor is the way we pay for health care costs. The negotiated prices between the medical insurers and providers is almost top-secret. We as consumers aren’t really involved with these deals. Most of us using an employer sponsored system aren’t even the immediate consumer, our employers are. This secretive set-up limits we as end-users from having any say as to what is reasonable, we merely pony-up the deductible. I can say that if we knew beforehand what our portion was, we would shop around for this too. Here’s an example as to why this holds true, take a look at Lasik eye surgery and cosmetic plastic surgery. These procedures are not typically covered by health insurance and the actual costs for them have dropped massively in the last few decades. This is a perfect example of consumer driven choice. Folks are going to shop, and shop hard for the best deal they can for this service because they’re paying the full price. That obviously pushes providers to keep costs down. Probably the next major factor that pressures increasing costs is that of medical litigation. Doctors are paying outrageous malpractice premiums responding to this and that forces the system into practicing defensive medicine. As a result, we use every bit of technology and testing available in patient care, when a 3rd year medical student could make a decision right off the patient’s history and complaint. Reform the tort system, to limit punitive damages and that problem goes the way of the DoDo bird. Krugman is a busy boy, really whomping that straw man together now. He’s completely discounted factual evidence in favor of evil profit making. The real truth is just too damn inconvenient for his sophomoric arguments.

Hence the advisory board, whose creation was mandated by last year’s health reform. The board, composed of health-care experts, would be given a target rate of growth in Medicare spending. To keep spending at or below this target, the board would submit “fast-track” recommendations for cost control that would go into effect automatically unless overruled by Congress.

So now, that sacred relationship of yesteryore has been passed on to health-care ‘experts’? Who gets to pick what kind of expert we’re talking about? He certainly used ‘expert’ intentionally here. That term allows all sorts of mischief. Hell, even an economist would qualify if I could write the job description. Now ole’ Pauly the Phony Prophet of all things Progressive is really coming unglued. He left cogency behind a paragraph ago and is heading to bat-shit insane street. Either that or his inner child is taking over the KB at every other sentence.

Before you start yelling about “rationing” and “death panels,” bear in mind that we’re not talking about limits on what health care you’re allowed to buy with your own (or your insurance company’s) money. We’re talking only about what will be paid for with taxpayers’ money. And the last time I looked at it, the Declaration of Independence didn’t declare that we had the right to life, liberty, and the all-expenses-paid pursuit of happiness.

Just a brief stop at Silly Town on his Excellent Adventure™. We were talking about spending and consumer choice driven medicine. In typical socialist fashion, he gives his pals the rich Uber-Liberals (as opposed to evil wealthy conservatives) an out. Of course, they can spend what they like on their own private policies or even just pay out of pocket. If that wealthy conservative does it, it’s flaunting their wealth stolen from the poor. It’s the rest of us that shouldn’t raise hell about rationing and death panels (one in the same, mind you). It never ceases to amaze me looking at pretzel logic that progressives extract from their colons in an attempt to sound smart. Since when did a lib give a shit about spending taxpayer money? We can pay for crucifixes immersed in urine and anti-semitic broadcast journalism, but hell no, we can’t just pay for all the health care money will buy for the unwashed masses. In the same vein, when was the last time any LC in these parts even mentioned that pliable, outdated Constitution get quoted by a turd like Krugman? Something is going on. We MUST finish work on this man of straw.

And the point is that choices must be made; one way or another, government spending on health care must be limited. [Emph mine]

Piss on government helping us by getting out of the way for individual costs we need to save government bucks for really important things like murdering fetuses and of course, cowboy poetry. Yes choices must be made one way or another, but the plan you’re peddling is a non-starter. It’s almost as if he’s never read anything about lessons learned from the UK’s NHS.

Krugman finishes his construction project a few more paragraphs down, but using an absolutely breathtakingly stoopid construct by casting that somehow emergency decisions are the majority of health care decisions. Simply stunning in it’s lazy logic. Then as an encore he wants us to believe that medical ethics can apparently, only be practiced by government panels. With a finish that something is wrong with us because want to ‘reduce this (health care) to costs. He started this drivel insisting that we must control costs. He then proposes that only government is capable of re-creating that special doctor-patient relationship by inserting panels of bureaucrats into the system in the flippin’ MIDDLE. Then he doubles back on himself and slapping at us for wanting to use consumer choices into the system, to control costs. He really needs to stand back from the burning straw, it might catch that beard on fire and force him into this horrid pre-ObamaCare Hell Care system.

Only in Liberal Land can we both have the same idea, but you are right and we are wrong, simply because you are you.

I could take this one apart almost sentence by sentence, but I’m tired, pissed-off and worst of all having to work tomorrow, so y’all can just go read the rest. Take your Bonine first, that is if your panel has approved it.

Anyone else have a migraine too?

20 comments

  1. 1
    LC Xystus growls and barks:

    Begs the whole question of Medicrap, Medicrud & Medifraud.

  2. 2
    LC fxpcpa growls and barks:

    Once upon a time I used to read Krugman and he actually made sense. That is until he let success go to his head as the economist to the screeching moon bat left.

    He never considers the behavior that each of his points will manifest.

    1) Price Controls aka theft of services- This is already occurring under both Medicare and Medicaid as doctors refuse to see patients because they can’t recover their costs. When applied to the economy as a whole it will just create shortages and black markets as doctors will make the rational decision to either operate(no pun intended) clandestinely or take their stethoscopes and go into a more lucrative field…like community activism.

    2) Opt outs for those paying out of pocket- When those altruists in the government see how doctors are more likely to treat patients willing and able to pay the market price for their services the government will then just outlaw private service(as was the case in Canada and may still be, the NHS in England has a parallel system for private payers) and force everyone into the governmental cattle chute under the dubious notion of “fairness”.

    Doctors in emergency rooms are required to treat anyone walking through the doors(although I know of at least one hospital in my area that gets around this because they have political pull). This is a regulation that puts a high strain on hospital finances and drives up consumer costs to pay for the bad debt incurred treating by the indigent. The indigent being subsidized by increased user fees on those able to pay. Since this extra cost is government mandated it acts as a hidden tax on the productive to finance the under and non-productive. The only thing even more unfair than the system we use now is the idea of socializing these costs through increased taxes and the typically bumbling government intervention, greed and sloth.

    Once upon a time we had charity hospitals run by the Catholic church and the poor were supported voluntarily by the community. This needs to be re-instituted as the current method is infested by people both on the service side and consumer side who think it’s alright to abuse the system because it’s only “government money” or “insurance company money”. No assholes that’s my money you ungrateful, thieving criminals and I’m tired of shelling it hand over fist.

    3) A Panel of Health Care “experts”- obviously he either forgot or never read Hayek. A panel of experts do not have anywhere near the required knowledge to set prices and procedures that for efficiency’s sake should be left to localized conditions. And nothing is more localized as medical care as realistically it varies in almost infinite combinations depending any one of 7 billion different sets of DNA. Of course as LC Jackboot IC/A ably points out “expert” is an highly subjective and malleable concept. After all in some circles Paul Krugman is still considered an expert on economics. Once upon a time he may have been but by his lack of consideration of incentives in this piece I think maybe he ought to give his Nobel Prize back. He becomes more Chomskyite with every column, it seems, including columns on his purported specialty.

    Government by experts and elites tends to end badly. In the case that Krugman tries to make he advocates increasing government dependency then cutting off government support just when the citizens, who dutifully follow this “expert” Judas goat, need it the most. He advocates that the most intimately personal decisions be made for the rabble by presumed moral exemplars under ever increasing cost pressures exerted by an all powerful government which may have other priorities in the here and now.

    Since when is the assumption that a government bureaucrat more caring, benevolent and morally superior to anyone else? Is it because of the specious assertion that they make less money than the private sector? Just because they may make less money than a doctor does not make them more altruistic as they may be motivated some other less concrete incentive such as power or potentially revenge. Having less money does make you any purer of heart. As David Bowie said once on a subject totally unrelated to health care “poverty isn’t purity”. You are just as likely to find venal self serving jackasses in the permanent government and the political appointee class as anywhere else. More so in fact as many of them either support or are protected by the oligarchic governmental employee unions.

    It’s easy to be an asshole when you can’t be fired. And since the way the IPAB is structured precludes changes except by super majority acts of congress and then only on the initial submission, these people are the ultimate assholes.

    If you think that it is the regimes plan to stop at just Medicare and Medicaid you haven’t been paying attention. It is their clear agenda to suck as many people into this maw to create a critical mass of takers and then institute the full takeover by plebiscite and thus yoke the rest of us to the wagon of the state.

  3. 3
    mousseman growls and barks:

    Aren’t these panels full of healthcare ‘experts’ the equivalent of the T4 panels that put the “+” on their file, thus condemning them to death?

  4. 4
    LC Draco growls and barks:

    Anyone else have a migraine too?

    Nope…I popped a ZOMIG half way through the fisking!! :em02:

  5. 5
    Grammar Czar growls and barks:

    Why should a panel decide what Medicare pays for? I PAY INTO IT. They are determining, then, what MY MONEY pays for. Also, were I to have Lasik, I would work a deal with my ophthalmologist, of whom I have been a patient for 30+ years. At my last visit before I could get new insurance, he didn’t charge me anything.

    As for these so-called “experts”…my physician has been in the business over 30 years. He’s an “expert” at family practice. My ophthalmologist is an “expert” on eyes. A panel of doctors is no more “expert” than the guys I see on a regular basis.

    That would be like a bunch of “expert” faculty telling other faculty what is a proper sentence or what is proper punctuation…just because they all have MA’s or PhD’s after their names.

  6. 6
    Grammar Czar growls and barks:

    Grammar Czar says:

    That would be like a bunch of “expert” faculty telling other faculty what is a proper sentence or what is proper punctuation…just because they all have MA’s or PhD’s after their names.

    I wish to amend this. It would actually be more like administrators (who may have once been in the classroom, but not usually, but consider themselves experts on education) telling faculty what and how they should be teaching.

  7. 7
    Library Czar growls and barks:

    We already have Death Panels they just call them the DHS inspector. The libs are just seeking to expand their power base and lots of people are going to die.

  8. 8
    Cricket growls and barks:

    The money sentence was this: ” We’re talking only about what will be paid for with taxpayers’ money. And the last time I looked at it, the Declaration of Independence didn’t declare that we had the right to life, liberty, and the all-expenses-paid pursuit of happiness.” (Paul Krugman) Since when did Paul Krugman become a fiscal conservative? It bears repeating because that is precisely why Americans do NOT want goverment in health care, because of the ‘selectivity’ issues the government will face. Or, dare I say it…discriminate against the sick because government can’t afford it? Izzn’t that one of the things I did say when government doesn’t have money; they are SUPPOSED TO CUT BACK?

  9. 9
    Cricket growls and barks:

    @ LC fxpcpa: STOP MAKING SENSE! *fingers in ears* “I’m not listening…lalalalalalalalala…I can’t hear you”

  10. 10
    Cricket growls and barks:

    One more thing: Patients are not supposed to be consumers of medicine? That we are all a bunch of hypochondriacs that need to be told by Mr. Subliminal on the Death Panel ‘This isn’t the procedure you need.” “This is experimental” and “You will be assimilated?” I wonder if PK is tarring the other 230 million Americans who do have health care with the entitlement brush. He speaks of consumers as whiny entitlement seeking pill poppers, but those who are ‘in need’ as patients. Can’t.have.it.both.ways. There is a patient Bill of Rights. Of course, if PK had his way, alla youse who are ill can opt out so there is more care for the rest of them.

  11. 11
    Cannon Fodder growls and barks:

    On the subject of “expert” advisory panels. My brother has been suffering from back issues for quite some time now. Recently he was at a breaking point and wanted to try to get some of it taken care of so his doctor made some recommendations and placed him in the “out of work” status. Of course, his employer wasn’t going to pay him while he was unable to perform his job function. He filed for his short term disability to compensate him during his treatment. One of those supposed “expert” panels looked at his medical file, saw only the words that they wanted to see and denied him. They didn’t even read the entire reports beyond what they wanted to see to justify their denial. So, he had no choice but to return to work in a bad state.

    What the hell makes anyone think that these government “advisory” panels will be any different in that respect? Not to mention the panel deciding if you are worthy. I don’t care what anyone says, they will eventually be deciding our worthiness based on our value to society. This IS headed to a single payer system after all, so eventually the panel will cover everyone.

    Then there is the question of, how many panels are going to be spread across the country? A single panel can’t handle the entire country. So, then it becomes a question of where is the best place in the country to live to get the best decisions from the panels. We all know there won’t be any consistency in the decision making from these boards. One will invariably be more lenient than others.

    The next question is, just how long will you have to wait for that all too important. possibly life saving, decision before you can even receive that treatment?

    This can just go on and on, can’t it?

    As for the doctor/patient relationship being “sacred”; should we not STILL be allowed to seek a different “sacred” doctor/patient relationship if we determine that out current provider is an absolute moron\quack?

  12. 12
    ZeektheCruel growls and barks:

    Response to Cricket @:

    Well, not to mention who gives a flying fuck at a rolling doughnut at what the Declaration of Independence says? It’s not a binding document. It’s more important that it is not covered in the the enumerated powers of the federal government in the Constitution. But then again, “health care” is not really covered in there either.

    Of course, these people will always reach for the “general welfare” clause, but what can be done about it? It was a bad idea to include it the first time around and it will be a bitch to get it removed. But I think the general welfare clause needs to be removed. It would be a good start.

    I think the part that just has me slightly out of sorts with this asshole (Krugman…not Cricket…Cricket seems nice enough) is that whole “let them eat cake if they can afford it after we’ve driven the cake makers out of business” bullshit attitude. That fucker needs to be beat with a rubber hose.

  13. 13
    Cannon Fodder growls and barks:

    Shit, I guess I need to read the Constitution. Never knew there was a general welfare clause. I knew the preamble says,”PROMOTE the general welfare.” But, I have never seen a definition of the word promote that said regulate or control, etc. So, how does it even get to that point? Isn’t that what they refer to as “jumping the shark?”

  14. 14
    ZeektheCruel growls and barks:

    Response to Cannon Fodder @:
    It shows up again in Article One – Section 8:

    The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

    I like the part about “pay the debts”. Like we’re going to get around to that any time soon.

  15. 15
    Cannon Fodder growls and barks:

    Well, in either case “general welfare” is a broad term and doesn’t necessarily include forcing bad healthcare on us.

  16. 16
    LC Ogrrre growls and barks:

    CF, the term “general welfare” is indeed a broad term. It is not broad enough, however, to mean “redistribution of wealth”. Nor does it mean that anyone is “entitled” to a piece of someone else’s paycheck, or that the federal government is to provide food, clothing, shelter, medical care, legal services, etc. to the indigent. That was what charities and the churches were for.

  17. 17
    LC Jackboot IC/A growls and barks:

    ZeektheCruel says:

    The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;

    The General Welfare clause and the Commerce Clause are the two biggest handles the left has used over the years to ram their agenda up our ass. While pretty non-specific in their construction, the founders had specific ideas about what they meant.

    The Commerce Clause is the concept that has been twisted for egregious purposes more than any other lately. ObamaCare for one. They’ve used that to setup regulations forcing an individual to purchase health care. You have to wonder why really think the founders would have intended the clause to force citizens into purchasing anything. Since when was non-participation a regulated activity?

  18. 18
    ZeektheCruel growls and barks:

    Response to Cannon Fodder @:
    Preacher, your voice sounds loud and clear up here in the choir loft. :em93:

  19. 19
    ZeektheCruel growls and barks:

    Response to LC Jackboot IC/A @:
    Yep. We need a new constitutional convention. But, I don’t know how that will happen. Right now, neither side would have enough trust to try it. People like me don’t want it written by Marxist and the leftoids will want to game the system as much as possible (like starting off with keeping people like us from having a say). So, I don’t think it will happen in the current climate. But I agree that both of those items need to be more closely defined or dropped.

  20. 20
    Samsapeel1 growls and barks:

    LC Jackboot IC/A says:

    ZeektheCruel says:
    The Congress shall have Power To lay and collect Taxes, Duties, Imposts and Excises, to pay the Debts and provide for the common Defense and general Welfare of the United States; but all Duties, Imposts and Excises shall be uniform throughout the United States;
    The General Welfare clause and the Commerce Clause are the two biggest handles the left has used over the years to ram their agenda up our ass. While pretty non-specific in their construction, the founders had specific ideas about what they meant.
    The Commerce Clause is the concept that has been twisted for egregious purposes more than any other lately. ObamaCare for one. They’ve used that to setup regulations forcing an individual to purchase health care. You have to wonder why really think the founders would have intended the clause to force citizens into purchasing anything. Since when was non-participation a regulated activity?

    As far as the General Welfare clause goes, it’s not as if nobody saw it coming:

    The Anti-Federalist Papers
    “Brutus”, Dec. 27, 1787

    “It is as absurd to say, that the power of Congress is limited by these general expressions, “to provide for the common safety, and general welfare,” as it would be to say that it would be limited, had the constitution said they should have the power to lay taxes, etc. at will and pleasure. Were this authority given, it might be said that under it the legislature could not do injustice, or pursue any measures but such as were calculated to promote the public good, and happiness. … it would be found, in practice, a most pitiful restriction. The government would always say, their measures were designed and calculated to promote the public good; and there being no judge between them and the people, the rulers themselves must, and would always, judge for themselves.”

    Or
    The Anti-Federalist Papers
    “Centinel” Number 1 (Oct. 5, 1787)

    “By sect. 8, of the first article of the proposed plan of government, ‘the Congress are to have power to lay and collect taxes, duties, imposts and excises, to pay the debts and provide for the common defence and general welfare of the United States, …’ Now what can be more comprehensive than these words; not content by other sections of this plan, … moreover the absolute control over the commerce of the United States and all external objects of revenue, such as unlimited imposts upon imports, etc. — they are to be vested with every species of internal taxation; — whatever taxes, duties and excises that they may deem requisite for the general welfare, may be imposed upon the citizens of these states, levied by the officers of Congress, distributed through every district in America; … however grievous or improper they may be. The Congress may construe every purpose for which the state legislatures now lay taxes, to be for the general welfare, and thereby seize upon every object of revenue.”

    As for the Commerce Clause, you’re right; but it seems to me that it boils down to the INTENTIONAL misreading of the single word “regulate” by the SCOTUS under FDR.