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I am convinced that wisdom, apart from God, is self-taught. Rules of logic and methodology can be taught and repeated from rote memorization. But wisdom is a different beast...

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Underscoring the points made by Bishop Nickless, British writer Rupert Darwal weighs in on the manifest shortcomings [online.wsj.com] manifest shortcomings of the British National Health Service (NHS), long upheld as the Gold Standard of government-run health care systems:

Government Medicine vs. the Elderly
In Britain in 2007-08, 16.5% of deaths came after 'terminal sedation.'
By RUPERT DARWALL

London

Rarely has the Atlantic seemed as wide as when America's health-care debate provoked a near unanimous response from British politicians boasting of the superiority of their country's National Health Service. Prime Minister Gordon Brown used Twitter to tell the world that the NHS can mean the difference between life and death. His wife added, "we love the NHS." Opposition leader David Cameron tweeted back that his plans to outspend Labour showed the Conservatives were more committed to the NHS than Labour.

This outbreak of NHS jingoism was brought to an abrupt halt by the Patients Association, an independent charity. In a report, the association presented a catalogue of end-of-life cases that demonstrated, in its words, "a consistent pattern of shocking standards of care." It provided details of what it described as "appalling treatment," which could be found across the NHS.

A few days later, a group of senior doctors and health-care experts wrote to a national newspaper expressing their concern about the Liverpool Care Pathway, a palliative program being rolled out across the NHS involving the withdrawal of fluids and nourishment for patients thought to be dying. Noting that in 2007-08, 16.5% of deaths in the U.K. came after "terminal sedation," their letter concluded with the chilling observation that experienced doctors know that sometimes "when all but essential drugs are stopped, 'dying' patients get better" if they are allowed to.

The usual justification for socialized health care is to provide access to quality health care for the poor and disadvantaged. But this function can be more efficiently performed through the benefits system and the payment of refundable tax credits.

The real justification for socialized medicine is left unstated: Because health-care resources are assumed to be fixed, those resources should be prioritized for those who can benefit most from medical treatment. Thus the NHS acts as Britain's national triage service, deciding who is most likely to respond best to treatment and allocating health care accordingly.

It should therefore come as no surprise that the NHS is institutionally ageist. The elderly have fewer years left to them; why then should they get health-care resources that would benefit a younger person more? An analysis by a senior U.K.-based health-care expert earlier this decade found that in the U.S. health-care spending per capita goes up steeply for the elderly, while the U.K. didn't show the same pattern. The U.K.'s pattern of health-care spending by age had more in common with the former Soviet bloc.

A scarcity assumption similar to the British mentality underlies President Barack Obama's proposed health-care overhaul. "We spend one-and-a-half times more per person on health care than any other country, but we aren't any healthier for it," Mr. Obama claimed in his address to Congress last Wednesday, a situation that, he said, threatened America's economic competitiveness.

This assertion is seldom challenged. Yet what makes health care different from spending on, say, information technology—or any category of consumer service—such that spending on health care is uniquely bad for the American economy? Distortions like malpractice suits that lead to higher costs or the absence of consumer price consciousness do result in a misallocation of resources. That should be an argument for tackling those distortions. But if high health-care spending otherwise reflects the preferences of millions of consumers, why the fuss?

The case for ObamaCare, as with the NHS, rests on what might be termed the "lump of health care" fallacy. But in a market-based system triggering one person's contractual rights to health care does not invalidate someone else's health policy. Instead, increased demand for health care incentivizes new drugs, new therapies and better ways of delivering health care. Government-administered systems are so slow and clumsy that they turn the lump of health-care fallacy into a reality.

According to the 2002 Wanless report, used by Tony Blair's government to justify a large tax hike to fund the higher spending, the NHS is late to adopt and slow to diffuse new technology. Still, NHS spending more than doubled to £103 billion in 2009-10 from £40 billion in 1999-2000, equivalent to an average growth rate of over 7% a year after inflation.

In 1965, economist (and future Nobel laureate) James Buchanan observed of the 17-year old NHS that "hospital facilities are overcrowded, and long delays in securing treatment, save for strictly emergency cases, are universally noted." Forty-four years later, matters are little improved. The Wanless report found that of the five countries it looked at, the U.S. was the only one to be both an early adopter and rapid diffuser of new medical techniques. It is the world's principal engine driving medical advance. If the U.S. gets health-care reform wrong, the rest of the world will suffer too.

Mr. Darwall, a London-based strategist, is currently writing a book on the history of global warming, to be published by Quartet Books in Spring 2010.

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Let's take President Obama's proposal to its logical conclusion. He said that his health care "reform" would not aim to repair health problems of the elderly (he told the one lady on ABC that he would not give the elderly pacemakers or new knees but only pain medication). This means that they will not live as long. This gives the Democrats a way to deal with the trillions of unfunded mandates in Social Security payments and Medicare. If the elderly die much earlier they save lots of taxpayer money they can use to buy votes from other groups. And if he manages to socialize everyone's 401k plans (it's on the table) he can confiscate their retirement nest eggs once they are dead. So the Democrats kill them off before they are born with abortion (safe, legal and paid for by the taxpayer as part of "reproductive health care") and now want to kill them off before they are ready to die of natural causes. Not surprising.

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Well, if you want to cut down on social security and medicare payouts, then the government should also encourage people to eat more fatty foods, get less exercise, drink more alcohol, and take up smoking. As long as the drop dead before sixty five, people represent a net profit to the system/

Which is why Social Security worked in the first place: in 1933, there were not only something like a dozen people paying in for each one taking out, but the average life expectancy was just 59 years, so few people managed to collect anything, and the average length of time people were collecting was only about three years.

Today, only three people put in for each one taking out, the average life expectancy is 78 years, and most people will be collecting for about a decade. The math is inescapable.

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One other observation: as the Darwell article indicates,

Quote
the NHS acts as Britain's national triage service, deciding who is most likely to respond best to treatment and allocating health care accordingly.
All government health care systems must do so, because government has no other measure of effectiveness than economic efficiency (output per monetary unit input). In short, government in all areas (not just health care) of necessity takes a purely utilitarian view of human beings; they are judged by their economic value, and decisions are made accordingly.

It should be clear that this is utterly antithetical to Christian morality and ethics, which demand that human beings always be regarded as persons, not objects. Yet, by its nature, government bureaucracies must regard human beings as objects (numbers, case files, applicants, whatever). It is therefore impossible for the Catholic Church to make any endorsement of a government-run health care system without running afoul of massive logical inconsistencies. This seems finally to have hit home with some, at least, of the bishops.


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I should honestly like to see a national health care service in the USA - I lived with one in Canada for over twenty years, and vastly appreciated it. But I am not blind.

As an example of how bad it can get, there are charities (or were) which would send medicines to the needy in the Communist countries. It frequently happened that the Communists would summon the addressee, who was awaiting the medicine, only to be told that a package addressed to him contained a valuable medicine from the capitalist world, and the Communist government had decided to confiscate the medicine and give it "to a younger person whose need is greater than your own"! People among my own parishioners after a few such experiences preferred to buy the medicines (which they could do tax-free if the medicine was to be exported immediately) and send it with an accompanying letter to their relatives; that at least improved the chances of the addressee receiving the medicine. I've never forgotten assisting at the bed-side of a dying lady, who told her children regarding their relatives: "if they ask for luxuries, don't send them - but if they ask for medicine, never refuse".

Fr. Serge

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When my daughter was working in a Romanian orphanage, she and all the other kids who went with her loaded up on all sorts of medical supplies--not only all of their prescription drugs, but large amounts of over-the-counter medication, disinfectants, bandages, etc.--as much as could plausibly be needed for personal use (customs can be persnickety). They also went with multiple suitcases full of clothing, and came back with empty bags and the clothes on their backs. Everything else stayed behind.

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Stuart,

Thank you for the informative post regarding Rupert Darwall's comments. The Health Bill advocates are correct when they say the bill does not SPECIFICALLY include "DEATH PANELS." However, in every other way euthanasia and eugenics will be the logical outcome in time.

Assisted Suicide is in effect in Oregon and from there is proliferating into other states; the consequence is denial of medical care. A case is documented in the USCCB's respect life pamphlet Assisted Suicide: Death by "Choice?

In May 2008, 64-year-old retired school bus driver Barbara Wagner received bad news from her doctor. her cancer, which had been in remission for two years, had returned. Then she got some good news. her doctor gave her a prescription for medication that he said would likely slow the cancer's growth and extend her life. Wagner was relieved by the news and comforted by the fact that she had health care coverage through the Oregon Health Plan (OHP).
It didn't take long for her hopes to be dashed.
She was notified by letter that the OHP wouldn't cover the prescribed cancer drug. but the letter didn't leave it at that. I also informed her that, although it wouldn't cover the prescription, it would cover all costs for her assisted suicide.
Her case would not have been known if she had not told her story to a local Oregon television station. Wagner said she told the OHP, "Who do you guys think you are? You know, to say that you'll pay for my dying, but you won't pay to help me possibly live longer?"

Wagner's case was not isolated. Other patients received similar letters. After public outrage over Wagner's story, an OHP spokesperson said the letters were a public relations blunder. He said that, in the future, insurance officials will "pick up the phone and have a conversation" to avoid putting the decision in writing."


So there you go, the "end of life consultation" the present Health Bill so generously offers mad will give the dirty work to doctors, rather than a bureaucrat, that it's to expensive the treat you.

Fr Deacon Paul

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Originally Posted by Fr Serge Keleher
As an example of how bad it can get, there are charities (or were) which would send medicines to the needy in the Communist countries. It frequently happened that the Communists would summon the addressee, who was awaiting the medicine, only to be told that a package addressed to him contained a valuable medicine from the capitalist world, and the Communist government had decided to confiscate the medicine and give it "to a younger person whose need is greater than your own"!
This is almost exactly what President Obama and the Democrats are proposing. President Obama told the lady he would not treat her mother's health issues but instead limit her to pain medication. Socialism does not work. The government does not belong in health care. Anyone who proposes socialized health care needs to realize that they are advocating rationed care. They are giving the government permission to deny care and allow people to die. I think it is immoral.

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Everybody keeps throwing the term "socialism" around. This country will never be a socialist country, but it does already have socialized policies and programs. We have things such as educations grants, Medicare, Medicaid, Welfare, Social Security, etc... For those who keep saying that the government shouldn't be in the health care business, you're 44 years to late with the signing of the Social Security Act of 1965.

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Quote
Everybody keeps throwing the term "socialism" around. This country will never be a socialist country, but it does already have socialized policies and programs.

Actually, the economic policies being pursued by the Obama Administration, whereby the means of production remain (largely) in private hands, but the direction of economic development is controlled by the state through a combination of regulation and coercion, resembles nothing so much as Italian fascism under Benito Mussolini (the similarity of some Obama campaign posters to classic propaganda images of Il Duce apparently went unnoticed by many of his own supporters).

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Originally Posted by StuartK
Actually, the economic policies being pursued by the Obama Administration, whereby the means of production remain (largely) in private hands, but the direction of economic development is controlled by the state through a combination of regulation and coercion, resembles nothing so much as Italian fascism under Benito Mussolini (the similarity of some Obama campaign posters to classic propaganda images of Il Duce apparently went unnoticed by many of his own supporters).

Could you explain? This is rather incoherent.

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Well, Medicare, Medicaid, Welfare, Social Security, etc. are all socialist endeavors. As Christians one may legitimately argue that the government has no role in taking care of either the poor or the non-poor, be it their general welfare or their health care. The Lord did not give the task of caring for the poor to the government - He gave it to the Church. All too often the bishops seem very willing to abandon that obligation and place it on the government.

As a separate discussion maybe, it would be good to examine the moral question: "What right do individuals have to demand that others pay for their health care by confiscating their hard earned wages through taxes?" Christians would have an obligation to tend to those in need, but to pay for the routine health care (or anything) for others? There is no such obligation there.

Erie Byz is correct that socialism has been here for a long time. One can certainly make a moral case for pushing it back. Even if one can morally justify the transfer of wealth from one group to another (and I'm not sure one really can) can one justify forcing 1 person to pay the need of 3 retired individuals (when SS started there were 14 paying in for every one collecting). From the simply economic standpoint the future is unsustainable. And Congress wants to make it worse? By what moral justification do they enslave us and future generations to yet more debt?

And of course there are the Constitutional issues. The government does nothing well and should be kept tiny. Any such programs should be at the state or local level.

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The Left enjoyed caricaturing George W. Bush as an aspiring fascist dictator. Now that he's out of office, they look pretty dumb. A similar fate awaits the Right. No point in arguing with them- time will do the trick.

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In other words, "That government is best which governs least"?

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