Now, first off….
There. That’s a link to a little piece on the Huffington Post explaining how Joe Lieberman’s willingness to vote against health care reform illustrates that we need to fix the rules for filibusters. Why? Because filibusters give “outsized power” to single individuals to hold up legislation – because Lieberman is saying he might vote against it, making the potential vote 59-41 (assuming party-line votes), he holds all the cards and gets all the attention and say-so on the bill.
Now… let’s take a more careful look at what they say there, because it’s very telling.
“To pass the most important elements of the progressive agenda, the Senate must change its filibuster rules.”
If the Republicans had 59 votes, and were saying that the filibuster rules needed to be changed for the purpose of passing the most important elements of the conservative agenda, the Dem’s would be screaming bloody murder. They don’t want the filibuster rules changed – that’s the last thing they want… except when they’re in power. Then change the rules all you want – get those d#$%ed dinosaurs out of the way and let us at the levers of power, because that’s the way things should be!
Because we’re right, they’re wrong, and there’s no possible way that this could ever go wrong.
Those of you who are long-term readers might remember that I had words about this in my previous diatribes about binary thought disorder. I’m confident that I’m right in saying that the Democrats would scream bloody murder if it was a Republican bullet point that was going to be pushed through for one simple reason.
They did, just a couple years ago. Again, this isn’t a Democrat thing – the Republicans grumble about needing to change the rules every time they want to do something that the Democrats want to filibuster too. And then? Then the Democrats and the lib’s in the media and the blogosphere start screaming as though the world were about to come to an end.
There y’go, folks. Think about it – the filibuster is meaningless if the rules to break it are adjusted willy-nilly by a simple majority (which they can be). That very fact has meant that changing the filibuster rules is often referred to as the nuclear option – using it is a court-of-last-resort move, because it lets the proverbial genie out of the bag. It’s true – the Constitution doesn’t say a thing about filibusters being allowed. You can change them however you want… but guess what. It doesn’t just change for you.
Of course, there’s a simple way around that too. Just change the rules back before you lose power. Of course, that makes it an even more baldfaced power grab, but is that a bad thing? After all, it’s really only a symbolic gesture, one that lets you scream at the other guy when he changes the rules back so you don’t have a say in anything.
The filibuster exists for the purpose of making sure that the minority can stop the majority from pushing things through without an overwhelming majority. That’s the entire reason it exists. And that’s why, for very well over a hundred years, it has remained an option in the Senate. There is only one reason to change it – because you want to take more power. Forget the fact that they’re talking about health care. That’s not what they’re talking about.
Changing the rules of the filibuster has nothing to do with health care reform.
It’s just a smokescreen.
Changing the rules of the filibuster is something that you only do for one reason. Because you’re trying to ram something down the throats of the public, opposition be damned. If the Democrats go and change the rules for the filibuster, they’ll allow themselves to force a simple majority vote on anything that goes through. Don’t kid yourself about Point #3 in that little article calling for the change – do you really think that the change wouldn’t, effectively, mean that a simple majority of democrats can vote anything through? Even the system suggested there simply makes the filibuster a formality to wait through – go ahead and go home while the other guys rant and speechify to keep you from voting. Then come in a week later, and push for cloture with 51 votes, before you go ahead and pass whatever legislation you want with 51 votes.
Health care would be the first thing pushed through, sure. But would it be the last? I don’t think so. They’d promptly push through every single liberal talking point, one week at a time.
Gun control restrictions? There y’go. It’ll cut down on the bill for our health care reform, after all.
Expanded welfare? Well, hey, we just put you all on Government health care, why not on the Government payroll too?
Gay marriage? Well… no, probably not, since The One has come out saying he’s against it. But, if he’d agree to sign it, why not?
On-demand abortion? It’ll be harder, but we can probably pull it off.
A special Presidential police force, to make sure those dangerous Right Wing lunatics stay in line? Well of course! We’ve taken away their chance to do anything through the system, we’d better make sure they don’t do anything outside the system too.
The list can go on, getting increasingly ridiculous all the way along. Eventually, they’ll probably lose power… at which point, blast it. The Republicans take over, and use the same rules to go ahead and change back parts of the system (abortion and gay marriage, probably… maybe gun control.)
Congratulations. The system has become completely controlled by whichever side scores 51 votes, unless the Constitution specifically says you need more.
Yes, that’s a slippery slope argument. It probably wouldn’t go that far, that fast. But it illustrates the way that it could go. If you think that pushing through those points, 1 week at a time, by virtue of having temporarily claimed a slim majority, is a good idea? Congratulations. You’re not a Democrat.
You’re a fascist.
And I mean that by the real definition of a fascist – somebody who believes that the government should control the people, that the people exist for the service of the state, not the other way around. You just only believe it when the government agrees with you, and you’d be screaming that every one of your rights is being violated if the Republican flavor of fascist were doing it instead.
So don’t go getting hacked off about the other side wanting a little control even when they’re the minority… because one of these days, you probably will be too, believe it or not. And when that happens, you’ll bitch all the louder about any attempts to further limit your power.
That’s just how politics seems to work these days. And that’s why the important question isn’t Republican or Democrat, it isn’t left or right – it’s politician or civil servant.
And those of us on the civil servant side have a smaller number of representatives than any other party you could name.
It’s official. The world is suffering from a pandemic.
No, not H1N1. That’s on its way there, but that’s a disease you can medicate, and they’re finding better medications already. The real pandemic that’s destroying society has been around for millenia, if not since the beginning of time… but that doesn’t make it any less destructive.
This disease is known as BTD – binary thought disorder. It’s that disease that everybody who reflexively disagrees with you suffers from… and that you probably do too. The symptoms include a steadfast belief that you are right, and everybody who disagrees with you is wrong, which can result in feelings of pity, irritation, or even hostility towards them.
Of course, BTD isn’t an actual disease. Instead, it’s a way of being for much of the world. A closed-minded inability to accept that people have the same information as you do but disagree with it – all without being misguided, stupid, or outright evil – is something that manifests among people of all political, religious, and racial stripes. The right falls into it – witness the last 8 years or so. The left falls into it – witness the last 8 years or so. Religious people fall into it – look at the Crusades, the Holocaust, and the very concept of jihad, among other things. Atheists fall into it too – just look at the vitriol that’s sometimes been vented at people like Dave Ramsey, who simply express that they have religious views, or the legal battles over so much as mentioning the concept of God at a school.
Why is BTD a problem? Well, I hope that’s obvious. It’s pretty well responsible for a good number of the wars and atrocities throughout history. It’s responsible for any of several thousand other crimes, fights, injuries, and ruined relationships. But it falls apart under logic.
BTD involves a thought process that demonizes the ‘other.’ It assumes that all criteria are equal – for example, the valuation of the afterlife. Let’s take a look at religion, shall we? Here’s the standard argument.
There is no scientific proof that God exists, let alone that the afterlife does.
Following religious doctrine involves making choices in life that restrict our enjoyment of life, in exchange for the promise of a utopic afterlife.
That’s immensely simplifying things, but it’s the basics. Now, if you believe, in defiance of the lack of empirical proof, that the afterlife exists and that your God is real, then you’ll be a religious person. Why wouldn’t you? You’ve got an eternity of paradise promised to you, in exchange for a short-term restriction on your activities. Further, when you work in the concept of Hell, you have a duty to try and convert others – failure to do so is to condemn the souls of non-believers.
Anybody who has the knowledge that following God’s rules and accepting His faith will bring you to paradise, while failure will condemn you to Hell, but who fails to convert, must be either foolish or actively evil, serving the great evil of their faith of choice.
However, if you don’t believe? There is no proof of an afterlife – all we know really exists is the here and now. Therefore, following religious strictures is inherently foolish. You’re exchanging your freedom in life for absolutely nothing. Without scientific proof that God or the afterlife exists, you’re trading in the only life you’re going to have for squat… and even if the afterlife does exist, you’re gambling on whether or not any given book is actually correct about how to get the good seats when you get there. If you’re wrong – and you’ve got no way to know you’re not – then you’ll end up in Hell anyways.
Anybody who tries to promulgate religious belief, given these facts, must be foolish at best, or evil at worst, trying to manipulate the beliefs of people to control them.
But ultimately, it’s a matter of varying values. The person who believes in God and religion and accepts these teachings whole-heartedly places greater value on their potential afterlife – which they do believe exists – than the atheist does – who doesn’t believe it exists.
There’s no actual proof that either person is right or wrong… simply an absence of such proof. Atheists have as much blind faith in their beliefs as the religious fanatic does. And yet, both sides will cite endless amounts of ‘proof’ that they are right, the other is wrong, until such a point in time as they decide that the stubborn refusal of the other to so much as accept that they might be wrong drives them to give up… or to blows.
BTD has also created the vast quantities of hypocrisy we tend to see. Remember a few years ago, when protesting what the government was trying to do was considered the highest form or patriotism? Great, when you were protesting W and the Iraq war. Now, when the other side is protesting Obamacare, it’s unamerican or a sign that you’ve been duped by The Great Evil… exactly the same things that the Right said about the Left during those protests. What’s the difference? Well… now it’s the Right protesting, and the Left being told they’re wrong.
BTD is the greatest threat to modern civilization. And if we can’t get past it, our society is doomed to tear itself apart, just as every civilization that has come before has eventually fallen to pieces. How do we do that? I’m not sure… but I’ve got some ideas. I’ll be getting into those over the next few weeks.
First of all, let me say that we do need to look at our health care system and start fixing things.
However, the options that are being called for right now aren’t the way to do it.
How do I know this? Because we’ve been trying it in some places, and it has this nasty habit of having unintended consequences.
Consider Barbara Wagner, who’s covered under Oregon’s public health options. And who was denied life-prolonging medication in favor of vastly cheaper comfort care, including ‘physician aid in dying.’ I understand that they only have so many dollars. And I understand that this means they have to make some difficult choices. But gradually shifting everybody onto that system will stretch those dollars further and further.
But, the proponents point out, it won’t force everybody onto that system. Why am I spreading fishy messages? Do I need to be reported to Big Brother the government?
Allow me to explain. Establishing a truly competitive public option – i.e., a public option that actually covers everything the private ones do, like I keep hearing battle cries for – will result in shifting to a single payer system. Why? Because the government isn’t trying to make a profit. Hell, the government can operate at a loss and nobody bats an eye. Therefore, they can charge less. That’s where economics kick in, especially considering that they’re not just charging their customers. They’re charging everybody.
Let’s say that they push their current system of reform through. They’re going to have to pay for it somehow – the only way to do it is going to be through taxes, since they want an option that allows people who don’t have money to get health care. So they’ll probably tax on employer-based health care. If not, then on employers themselves and on the wealthy (sorry for the redundancy there – remember folks, rich people tend to have employees).
Let’s say that I’m paying more for my employer based healthcare, courtesy of the new taxes. It’s a simple economic decision – I’m reasonably healthy (believe it or not). I have a handful of prescriptions, most of which are available as generics. I could use dental coverage (no word that I’m aware of on whether or not that would be covered, but it’s not covered in my current plan). My main concern, in terms of insurance, would be that my company might drop my coverage if they decide I’m too expensive. So, what should I do? Continue paying for coverage that I don’t need to use, and that might not be there when I need it? Or stop paying for it, and go to the federal system? Even if you’re only taxing the rich, why should I be paying for health care when I could be getting it for free?
It’s simple economics – for me, and the vast majority of profitable insurance customers, the federal system would be the way to go. From there, the insurance companies can’t stay in business. They’re forced to drop more customers, or to go out of business entirely, and their customers end up on the federal system. The burden on the federal system increases, along with either the price that people have to pay to prop it up, or the pressure to pull costs down.
Now, reducing costs is a great idea. Our payment and information systems, as they stand, are horribly inefficient and need an overhaul. Go ahead and do that, it’s only sensible. Try not to think about the fact that when you say “inefficient and burdened with excessive bureaucracy,” most people think about the federal government, not their health insurance.
But after you do that, you’re running out of ways to reduce costs. So, let’s say that we eliminate the inefficiencies, and leave ourselves with simple cost of services provided. You’re still going to need to pull that down further, which leaves you with only two options.
When you have to pay less, you have two choices. You pay less for the same amount of service, or you pay for fewer services.
If you pay for fewer services, there’s no way around it other than rationing health care. Your dental insurer already does this, by applying lifetime maximums on your benefits. Your health insurer might well be doing it too, officially or otherwise. But we’ve got people swearing up, down, and sideways that they’re not going to do that in the government. So what’s the other option? Cut the reimbursement rates. Which means that people are going to have to either pay out-of-pocket to make up the difference, or that you’re going to have to mandate reductions in price. Establish a government price tag for services – you can’t charge more, or you’ll be punished in one way or another.
By establishing price limits, you’re going to reduce the number of providers willing to stick with it. What’s worse, you’re going to eliminate the good providers, not the poor ones. A good doctor, whose skills go for higher prices on the market, is going to question why he should stay in the public system when he’s not getting paid any better than the sixth-rate schmoozer who barely made his way through med school and drinks on his lunch break even when he’s on call and might have to operate any minute. Those providers will be encouraged to go elsewhere – either outside of the country entirely, to the places where there is a market-based medical economy, or to drop the public patients and begin providing their services purely to those who can afford them personally. And then we’re back in the position of the rich getting the best care, and the poor getting substandard care… or, at least, getting a level of standard care that’s lower than what it should be.
No, not every good provider is going to quit working in the system, but more and more of them will.
Now, I said at the beginning of this that I think reform is necessary, but here I am coming out pretty firmly against the public system. So, what would I recommend?
First off, improve those systems I mentioned. Get us up to snuff on records and improve the bureaucracy. That’ll reduce health care costs across the board.
Then? Fix the tort system, as it currently stands. Right now, some doctors are estimating 20-25% of health care services they recommend are ‘defensive medicine’ – they know what the problem is, but they need more tests and specialists in order to minimize the risk of losing a lawsuit. The estimates I’ve seen indicate anywhere between $41 billion and $178 billion in savings from simply reforming the tort system, and that’s just in the medical savings. When you add the overhead costs associated with all of it, and the price of defending against lawsuits, and the numbers go up even higher.
How do I recommend fixing the tort system? I’ll admit, I’m not an expert here, so I’m not sure. But one system that does occur to me is putting the malpractice system in the hands of medical experts, rather than a dozen randomly chosen laypeople who’ve been trained by the media to view pharmaceutical companies, insurance companies, and doctors as the bad guys (think about it – when was the last time you saw an episode of… oh, anything… where the bad guy was a blue-collar worker milking money out of his insurance company by faking an injury? Now, when was the last time the bad guy was an insurance company that didn’t cover the medicine the gunman, or his wife, needed to survive?)
Another way to do it would actually be to nationalize the licensing. As it stands, I could have a license to practice medicine in Wisconsin that gets revoked for gross negligence, go to Oregon, and get a new license, then start practicing as though nothing had happened. Indeed, thanks to privacy laws, it might even be virtually impossible for folks to know that I killed a patient by sending them home with a roll of Tums when any intern would have known they were having an actual heart attack. If you put the malpractice system in the hands of medical experts, and then put in threshholds where a certain level of incompetence means they take your scalpel away and won’t give it back, you’ll maintain punishments for malpractice, but reduce the lottery system of malpractice payments, where some people end up paying for the privilege of calling themselves part of a class action lawsuit and others retire because the jury felt that the company should have tested to see if their medicine would have a disastrous effect on people with a rare genetic quirk.
Further, the government could offer to pay for people who honestly can’t pay. Allow an emergency backup for when you’ve got needed medical treatment that you can’t cover, and insurance pools for people who are ‘uninsurable’ by the private system’s standards. But don’t offer this system to absolutely everybody, only to the people who need it.
Oh, Barbara Wagner? In case you didn’t read that link up above, she got her medicine. Not from the state system, but from the ‘evil’ pharmaceutical company, who gave her the fabulously expensive medication for free when they were asked to. Just like most pharmaceutical companies will cut deals with people who can’t afford their medicine – these companies give away a lot of meds at reduced or eliminated price (I should know – I’ve got friends who benefit greatly from those plans).