The New “Dr. Death”

The old “Dr. Death,” Jack Kevorkian, had the permission and approval of each individual who requested his services. For this, of course, he was incarcerated. Philosophically, I always took that case as the very worst trial of our time. It was the explicit declaration that your life is not yours to decide. If you believe in individualism, or liberty or even just plain ol’ America, it can’t get any worse than that.

But it can. You see, once your life isn’t yours, then it remains to be decided exactly whose it is. And on that point, there can be quite a spectrum. So meet the new “Dr. Death.” His name is Dr. Donald Berwick, and he was just named as the head of the Centers for Medicare and Medicaid Services (CMS), overseeing (at least) an $850 billion budget.

Named? Not nominated? Why no, of course he was just named. It was a recess appointment, you see, while Congress was on a break over the recent holiday. Shockingly (not), the New York Times backed both the appointment and making the appointment during a recess. The paper also advises us that Berwick’s “appointment is backed by the American Medical Association, the American Hospital Association and scores of other health organizations and patient advocacy groups. He has been endorsed by three predecessors who held the same job in Republican administrations.” Hopefully the Tea-Partiers notice that last and will remember this when their gang goes to Washington. It turns out that Americans don’t like socialism, not one little bit, but it remains to be seen how well they’ll cotton to fascism.

So what of Dr. Berwick? What does he believe? Well, for starters you have to know what the “Dartmouth Atlas of Health Care” is. This was a two-bit research report invoked by President Obama in his drive to pass so-called “Health Care” legislation earlier this year. And according to the Times, Dr. Berwick “called it the most important research of its kind in the last quarter-century.” But what is it and what does it say?

What is says, is that health care can be improved by cutting expenditures. What it is, is faulty research using uncorrected data to imply a conclusion that isn’t there. Even the Times, on its non-editorial pages, divulged this as recently as June 2. Here is the full article, as well as a subsequent response to challenges brought by the researchers. This should be sufficient to explain the issue, though many more detailed articles are readily available via search engine.

But never mind implication and inference. Let’s take a look at a series of quotes, all of which were attributed to Dr. Berwick by the Wall Street Journal, in a piece by Daniel Henninger just last week. If you can’t figure out what Dr. Berwick believes, and what he plans to do, by these quotes, then you yourself ought to seek some “health care,” and quickly. Meet Donald Berwick, the new “Dr. Death”…

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“I cannot believe that the individual health care consumer can enforce through choice the proper configurations of a system as massive and complex as health care. That is for leaders to do.”

“You cap your health care budget, and you make the political and economic choices you need to make to keep affordability within reach.”

“Please don’t put your faith in market forces. It’s a popular idea: that Adam Smith’s invisible hand would do a better job of designing care than leaders with plans can.”

“Indeed, the Holy Grail of universal coverage in the United States may remain out of reach unless, through rational collective action overriding some individual self-interest, we can reduce per capita costs.”

“It may therefore be necessary to set a legislative target for the growth of spending at 1.5 percentage points below currently projected increases and to grant the federal government the authority to reduce updates in Medicare fees if the target is exceeded.”

“About 8% of GDP is plenty for ‘best known’ care.”

“A progressive policy regime will control and rationalize financing—control supply.”

“The unaided human mind, and the acts of the individual, cannot assure excellence. Health care is a system, and its performance is a systemic property.”

“Health care is a common good—single payer, speaking and buying for the common good.”

“And it’s important also to make health a human right because the main health determinants are not health care but sanitation, nutrition, housing, social justice, employment, and the like.”

“Hence, those working in health care delivery may be faced with situations in which it seems that the best course is to manipulate the flawed system for the benefit of a specific patient or segment of the population, rather than to work to improve the delivery of care for all. Such manipulation produces more flaws, and the downward spiral continues.”

“For-profit, entrepreneurial providers of medical imaging, renal dialysis, and outpatient surgery, for example, may find their business opportunities constrained.”

“One over-demanded service is prevention: annual physicals, screening tests, and other measures that supposedly help catch diseases early.”

“I would place a commitment to excellence—standardization to the best-known method—above clinician autonomy as a rule for care.”

“Health care has taken a century to learn how badly we need the best of Frederick Taylor [the father of scientific management]. If we can’t standardize appropriate parts of our processes to absolute reliability, we cannot approach perfection.”

“Young doctors and nurses should emerge from training understanding the values of standardization and the risks of too great an emphasis on individual autonomy.”

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You’ve heard the saying, “The writing is on the wall.”

News flash—you’re the wall and Dr. Berwick aims to be the author.

“You asked for it, brother.”

“You Say You Want A Revolution”

Then sorry, get in line. There already was a Revolution, and I don’t mean back in the 1770s. Generally, I don’t seek to just post up links. There are zillions of web sites and blogs with some great insight into political matters. But the following two are invaluable IMO, as far as allowing us the ability to integrate exactly what the hell happened to this country. The first was written in 1938, by a man named Garet Garrett. It’s titled “The Revolution Was,” and is archived at the Ludwig von Mises Institute: http://mises.org/daily/2726

The next one appeared just recently in The American Spectator. I’m not big on really long essays, but sometimes length is necessary to get the point across. If you haven’t read this and seek to understand the historical context in which we find ourselves, then I recommend it highly. Thanks to WRSA for the link…

http://spectator.org/archives/2010/07/16/americas-ruling-class-and-the/print

Sometimes it seems that we’re doomed. The insanity in the political realm combined with pervasive ignorance, seem like the classic “immovable object.” The justification for despair is obvious and it can be overwhelming. But we are dealing in the human realm, where all things imaginable are possible. I offer these links not for the purpose of, “Read ‘em and weep,” but rather for the purpose of understanding the nature of the reality in which we find ourselves. It is only with such understanding that we may rationally move forward, and discover the false premises that led us down this tragic road. Tempus fugit. Prepare yourself.

The Economics of Social Security

Each person who works, gains a slight financial benefit when each person who doesn’t, dies young.  With Medicare and Health Care, add “and quickly.”

This is a fact.  Is it clear enough?  This is altruism in practice.

What We Got Wrong

With “we” here, I mean the so-called “freedom lovers.” I mean those of us who understood what’s been going on for a very long time, and who didn’t like it one little bit. I mean those who’ve been citing the Founding Documents, with a focus on the ideas involved. I mean those who knew all along that reality admits of no contradictions…not in the physical realm and not in the human realm.

We saw all this and we saw even worse. We knew all along that production wasn’t a series of numbers to be tracked. We knew–from principle as well as experience–that statism simply can’t last. We know the nature of the entities involved, and we know that something can’t come from nothing…no matter how deep your wish nor how long your whip. We understood the whole time, the last few decades and the next few years, what simply must happen if collectivism and statism rule the day.

And that’s the part we got wrong. Thank goodness. We see things how they are and we conclude to where they must lead. Hence, the picture in our minds is usually one of collapse. We see fools thinking they may sit at home and somehow live a long, happy life. We see fools thinking that if they tweak the whip just right, then they may be happy too. We see thugs all around us, honestly believing that they are doing the moral good, because they’ve been taught nothing else, not ever. We understand the errors, and we know that logic simply commands–that is, reality simply commands–that somehow all of this must collapse and somehow a new world must be built on the ashes and bodies so wastefully piled.

That was our error, for a human life is not a structure. There are no bricks to tear down, nor foundations to be dismantled. Human life is built on time, and the time is always what it is…now. There is no time in which action can be done, nor is there any time for which we may willfully choose, except the present.

It’s not that the foundation mustn’t be properly built; of course it must. Luckily that’s a piece of cake, so easy that it doesn’t even take any physical building. The foundation is what’s already there, and in fact was the only thing there all along. The foundation is what decent people choose, and decent people are chomping at the bit to choose what’s right. They just never heard it, that’s all. And from what I can tell, they’re about to hear it, in spades.

I guess the message here is simple. We’ve known this all along too, but these are the times when it must become clear as a bell, and not a single mistake can be made when imparting it. Human life is about creation and building, and we must remain ever-conscious in remembering that the only thing a human life can directly create and build, is the single life itself.

The correct message is not, “Tear it down.” The correct message is, “Build it up.”

Was America Great?

Why no, of course not.  What a silly notion.

Americans were great…lots and lots of them, for a very long time.

What would it even mean, for a country to be great?  When pushed, most will say, “Well, obviously that means that the people who lived there were successful, however that’s measured.”

And when you use any sensible measures, the people who lived in America were more successful than any humans at any time.  So doesn’t this mean that America was a great country?

Maybe it would, if that were really what you’re saying.  But it’s not.  You’re saying as the words literally read—that America, as an existent called a country, was itself great.  That’s wrong, and that’s why you’re so afraid of losing it.  You think it was the country that made the people great, when of course it was the other way around.  The good news is that it was never there in the first place.  Only people were there, and you get to be one of those.

Countries can’t be great.  They can be borders, they can be institutions, they can be dictates, laws, decrees, treaties, constitutions, agreements, all these things and more…but they can’t be great.  Sorry, but that’s a simple fact.  You can tell me what you meant to mean–that it’s the people who live there that are great–but it’s not what you mean.

On top of about 20 billion other actions that you’ll take–and words you’ll use, and arguments you’ll offer–to prove what you really mean, you’ll go so far as to pretend how good it is when a 20-year-old loses his life to make the country that much better.  This tells me, in no uncertain terms, that you find something “great” about the country.

Here’s some good news…the country isn’t bad either.  Nor are any other countries, or states or localities or school boards or commissions or anything else that is an object other than a single human individual.  Good, great, bad and rotten all describe a single sort of existent, and the super-neat thing is that the existent itself gets to control whether it’s good or bad.  Had we designed this all ourselves, we couldn’t have made it any easier than that.

Sorry I can’t make it sound grander, but it really is that simple.  You want America back?  Then do what Americans did.  Americans worked, and Americans worked in one single pursuit…that’s why they were great.

We hold what truths to be self-evident?