But the American way of death is different. Our move toward physician-assisted suicide springs from the same quest for mastery over mortality that leads us to spend nearly twice as much on health care as any other developed nation.What leads America to spend nearly twice as much as any other developed country is overcompensation of doctors, the doubled and tripled layers of public-private bureaucracy partnership, other insurance-industry overhead, and profit taking.
-Mandolin superstar and Virgin-American Ross "Walt" "Chinstrap" "Buckminster" Douthat
Meanwhile the principle distinguishing characteristic of the "American way of death" is that it is irredeemably awful.
32 comments:
Naturally, plugging someone up to machines and preserving the most paltry symptoms of life represents no similar quest for mastery.
"Virgin-American" -- I like that.
I have no idea how you made it through that column. I was begging for euthanasia by the third paragraph.
From there, it would be an easy slide to euthanizing the incompetent: “Comfort would make us want to extend the option to others who, in society’s view, are suffering and leading purposeless lives.”
Maybe we should just euthanize Douthat. You know, out of pity.
Of course Americans spend more on health care. There's more of us to heal!
Profits are not costs.
There must be some way to get these stiffs off my property.
That's a novelly silly argument, TGGP, and it substitutes a textbook definition of "cost" for a popular usage. It's like quibbling with people who say, "It's just a theory" in order to signify significant uncertainty. I believe the expression is "apples and oranges."
It's plain that in addition to semi-private insurance cartels adding more administrative overhead to the cost of health care in America as expressed by dollars spent per capita, insurance industry profitability is a driver of our unusually high expenditures. Insurance cartels fix prices in order to maintain artificial margins.
But if you can find someone arguing that shareholder dividends represent a cost to publicly traded insurers, I will join you in pointing out that such an argument is incorrect.
I thought the "American way of death" was carpet-bombing. Oh the ambiguity of subject and object!
Aaron---
If I remember correctly, the American Way of Death was mandatory superfluous embalming to ensure enhanced costs for the benefit of the death-care industry. Now we'll explore the other side of the same coin with mandatory superfluous preventive "embalming", and costs and profits once again the political lubricant. Synchonicity---it took a sexy fascist lady to point out the sordid truth this time through as well!
That's odd. I always thought "The American Way of Death" (tm) involved dropping bombs of freedom on brown people in poverty stricken countries.
Does anyone die well? I was under the impression that dying universally sucked.
They may not die well but they can rest forever in an orbit of eternal grace.
I like the fact that he makes synonymous health care corporations and individuals.
Motherfucking Ross motherfucking Douthat.
Why the fuck does the fucking Times employ him? Who looks at shit like this and sees something other then insultingly stupid blather?
"Euthanize the rentiers."
-- J. Maynard Keynes
If profits aren't added expenses to the buyers, then why does the private sector fear the public option?
Of course, IOZ is right: "Cost" means two different things, to buyers and investors. The fact that smug "economists" miss this massively obvious point tells you what a hocus-pocus racket they run.
The European experience [with physician-assisted suicide] offers plenty of cautionary tales...
Not to mention that one time in New Orleans...
Oh, but that's just poor people, and being aware of events that take place in your own country was never a requirement for being a Times columumnist, so never mind.
What do you have against mandolins, dude?
I'm a finite state automaton. When I've finished my computation, please turn me off.
Thank you.
Yeah tell me about it, health insurance profits suck. Hey, cool, does this mean we can outlaw health insurance companies? Maybe we could price-control them to death? Because I'd support that MUCH more than this mandatory health insurance I've been hearing about. I'm healthier than you are, so don't come to me for cross-subsidies for your poor decisions.
As for the public option, all you have to do is look at the extant public options to determine: it isn't about price-controlling insurance companies to death so much as it is doing such for doctors. Do you know a dentist who accepts Medicaid? (Assuming you're in a state where dental Medicaid still exists!) Does he practice within 100 miles of where you live? How about a primary-care physician accepting new Medicare patients? I'd be surprised.
Everyone will be shocked, SHOCKED to see the mass exodus of doctors from their profession once compensation and treatment decisions for ALL patients are made in Washington. The only doctors left will be the ones who have been defrauding Medicare for a billion-plus a year for years now. Good luck getting anything other than painkillers out of those jokers.
Everyone will be shocked, SHOCKED to see the mass exodus of doctors from their profession once compensation and treatment decisions for ALL patients are made in Washington.
I can't wait to find out what new profession all those ex-doctors are going to choose. Maybe they'll all finally get to realize those childhood dreams and become firemen.
Those 50 and older might say, "fuck it, I've got enough money, I'm going fishing". Those younger than 35 will likely be interested in medical opportunities in non-extraditing-for-default-of-student-loan developing nations.
We can expect to see some variation in occupation for the barely-solvent cohort between these two extremes.
Although you and me and the average Joe are happy to scratch through life hand-to-mouth, these are capable people and they were promised wealth and respect dammit. They're not going to just grunt and take it when price controls destroy their livelihood and politically-appointed expert review boards destroy their autonomy.
Jess:
I hesitate to say that your point is stupid, but your point is actually so stupid that it's already been refuted by a Michael Moore movie.
In Sicko, Moore visits with a physician working under the British National Health system (a system that spends less per-capita on health care than virtually any other developed country.) He tours the doc's house in London, asking: "Oh, very nice... how many families do you have to share this with? Oh, just you, eh?" The we see the doc's new car, etc. You should rent it sometime (the movie, not the car, I mean.)
Maybe someone else wants to waste their time addressing your claim that physicians under our current HMO-dominated system have "autonomy." I'm guessing not, though.
Steverino, Rahm Emanuel's on the phone for you. He wants to know... do you want extra cheese on this week's DLC-bought pizza?
It's been pointed out to me that we don't really know what is in "the bill" or "the bills" or whatever eventually will get belched up from the bowels of K Street. For that reason and others, until I see otherwise I assume they'll "control" costs for this public option the same way they do for the current public options: paying shit. Perhaps "price control" is a misnomer, but doctors are going to receive less than the equilibrium price for their service (granted that the current health care market is fucked to the point that our "equilibrium" is a bit grotesque).
Sure we'll spend less on health care, at least at first, because we'll just slide down the supply curve. If that sounds harmless to you, maybe you should talk to a poor mother who can't get her kids' rotten teeth fixed because no dentists take Medicaid's shitty reimbursements anymore.
You seem to have some familiarity with the system here in the USA, hence your well-taken HMO autonomy comment. I started by saying I'm no fan of insurance companies , but even now a physician can hike down the street to work at the other evil HMO or can even hang out her own shingle. She won't have many patients at her private office after we're forced into whatever plan the experts decide upon.
You indicate that you find the British NHS to be best-in-class at holding down health spending. Do you imagine that the AARP would allow that shit here? Congress will screw everyone else twice before they think of feeling up the old folks. Do you have any reason to think that the system we'll get will in any way resemble the shining Camelot that is British health care?
As to the nice house thing, insofar as I can believe a Moore film I haven't seen, I suspect British doctors think less about malpractice and student loans than their American counterparts. There are probably other differences between the two nations.
Steverino, Rahm Emanuel's on the phone for you. He wants to know... do you want extra cheese on this week's DLC-bought pizza?
Quote Michael Moore, get accused of being a friend of Rahm Emmanuel. Sure, it all makes perfect sense, but why does it only happen here?
As to the nice house thing, insofar as I can believe a Moore film I haven't seen, I suspect British doctors think less about malpractice and student loans than their American counterparts. There are probably other differences between the two nations.
And here Jess demonstrates a tactic much-loved by "conservative" debaters, called: "Always hit the ball back over the net." Has Jess responded to my point that even the country that spends the least per-capita on health care doesn't seem to have any difficulty finding people who want to be doctors? Well, no, but s/he did come up with some response, so the ball's back in my court now, isn't it? Gosh, I'd better run and find some statistics on how much British doctors pay for malpractice insurance, or what's the average debt load of British med-school grads!
Ah, fuck it. I'm tired.
healthcare is an enormous racket
Jess is cute.
LEt's by all means lament the lowering of reimbursements the doctors will receive...or we can do something about the cost side of the equation that puts them right where they are now.
Tort reform, drug costs, middle men insurance companies to name a few.
'mericans need to get out of their myopia-infused arguments and see how others do it, and see if parts of other systems can be employed here. We are the country of innovation, right?
Steve, how seriously do you take yourself?
Ah, SteveB, you are a delight. Whether it's clamoring for more unions, approvingly citing a Michael Moore film, or claiming the financial disaster otherwise known as Medicare is a good system, I can rest assured that one of your comments will cure my daily blues.
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