Volte

Volte:

It's time for some more early music:



If you have eighty-nine cents to spend, try track nine here. If you've double that, and you want to hear a medieval drinking song worth the price, try track thirteen. "Istud vinum, bonum vinum, vinum generosum!"

Ex-soldiers burden

"Ex-Soldiers Don't Need to Be Told They're a Burden on Society"

So says the sub-title of this report, looking at "living wills" from the perspective of the VA.

If President Obama wants to better understand why America's discomfort with end-of-life discussions threatens to derail his health-care reform, he might begin with his own Department of Veterans Affairs (VA). He will quickly discover how government bureaucrats are greasing the slippery slope that can start with cost containment but quickly become a systematic denial of care.

Last year, bureaucrats at the VA's National Center for Ethics in Health Care advocated a 52-page end-of-life planning document, "Your Life, Your Choices." It was first published in 1997 and later promoted as the VA's preferred living will throughout its vast network of hospitals and nursing homes. After the Bush White House took a look at how this document was treating complex health and moral issues, the VA suspended its use. Unfortunately, under President Obama, the VA has now resuscitated "Your Life, Your Choices."

Who is the primary author of this workbook? Dr. Robert Pearlman, chief of ethics evaluation for the center, a man who in 1996 advocated for physician-assisted suicide in Vacco v. Quill before the U.S. Supreme Court and is known for his support of health-care rationing.

"Your Life, Your Choices" presents end-of-life choices in a way aimed at steering users toward predetermined conclusions, much like a political "push poll." For example, a worksheet on page 21 lists various scenarios and asks users to then decide whether their own life would be "not worth living."

The circumstances listed include ones common among the elderly and disabled: living in a nursing home, being in a wheelchair and not being able to "shake the blues." There is a section which provocatively asks, "Have you ever heard anyone say, 'If I'm a vegetable, pull the plug'?" There also are guilt-inducing scenarios such as "I can no longer contribute to my family's well being," "I am a severe financial burden on my family" and that the vet's situation "causes severe emotional burden for my family."

Let's all factor that in to our concept of what the Obama adminstration was thinking about with its push to universalize 'end of life' planning.

Co-ops

Profits in Health Care:

The AP has an odd Q&A piece on the "co-op" idea that ObamaCare advocates are floating, now that they've lost the fight to have the single-payer system they wanted, or the "public option" that was their second-best wish. The piece states that such co-ops have a "checkered" history, and that it is "unclear" if they would drive private insurers out of business. None of that is very helpful.

The oddest thing to me, though, is the question about how a co-op might be better. The answer is that the co-op advocates presume it could eliminate some costs, "including profits."

Profits are costs? That's a remarkably awful understanding of a basic economic concept.

Profits are revenue minus costs -- they're what is left over after you've paid for everything. Taking out the profits doesn't reduce the costs, which are the same either way. You can reduce profits by increasing costs, or by reducing revenue.

"But," one might object, "if you eliminate profits, you can make do with lower revenue. So, the price to the consumer is lower, because they don't have to provide profits for the co-op. It's enough that revenues meet costs, rather than surpassing the costs."

That revised concept still fails to grasp what profits are for. Profits are not costs, and the wise man doesn't seek to eliminate or reduce them.

Rather, profits are incentives. They encourage you to do something good for society, by providing you with something good in return. We want health care, right? Therefore, when someone offers to provide us with health care, we want to make it worth their while.

If we do that, more people will want to provide health care. They will be smarter people, too, the sort of people who could choose to do something else instead. That's good for everyone.

Profits are also responsive. Mark Steyn's point in his piece below was that, in a for-profit system, if your hospital isn't clean you can move to the one down the road. In the mandated, socialist system, that's not an option. Even if it were, though, why would the one down the road be any cleaner? There's no money in it. In America, being the cleanest hospital could quickly become a point of competition if attention were focused on it -- a competition leading to rapid improvements.

Lacking profits, the only way to motivate people is through negative consequences. If there's no positive incentive, you're left with regulations, punishments, and drafting unwilling people into service. You have a stick, but no carrot.

Profits are not costs. They're incentives. They're good. We should want more of them.

Hopsitals Kill

Hospitals Kill:

The Atlantic has an article that blames a father's death on the American health system.

Almost two years ago, my father was killed by a hospital-borne infection in the intensive-care unit of a well-regarded nonprofit hospital in New York City. Dad had just turned 83, and he had a variety of the ailments common to men of his age. But he was still working on the day he walked into the hospital with pneumonia. Within 36 hours, he had developed sepsis. Over the next five weeks in the ICU, a wave of secondary infections, also acquired in the hospital, overwhelmed his defenses. My dad became a statistic—merely one of the roughly 100,000 Americans whose deaths are caused or influenced by infections picked up in hospitals. One hundred thousand deaths: more than double the number of people killed in car crashes, five times the number killed in homicides, 20 times the total number of our armed forces killed in Iraq and Afghanistan. Another victim in a building American tragedy.

Oddly enough, that was precisely Mark Steyn's complaint with the Canadian health care system.

My father is currently ill, and the health "system" is doing its best to ensure it's fatal. When an ambulance has to be called, they take him to a different hospital according to the determinations of the bed-availability bureaucrats and which facility hasn't had to be quarantined for an infection outbreak. At the first hospital, he picked up C Difficile. At the second, MRSA. At the third, like the lady above, he got septicaemia. He's lying there now, enjoying the socialized health care jackpot — C Diff, MRSA, septicaemia. None of these ailments are what he went in to be treated for. They were given to him by the medical system.

Now, the first fellow says that those 100,000 deaths are "caused or influenced" by secondary infection. That "influenced" muddies the waters quite a bit. We don't know how many of those deaths are from the infection, versus from the original disease (with the infection just 'influencing' the course of that disease).

This study shows that the Canadian system infects 250,000 people a year with diseases. It lists only 8,000 deaths caused by those infections -- but it doesn't say how many are "influenced" by the infections. It's quite possibly rather more than 100,000.

The solutions being proposed in both cases are remarkably similar: clean your hands. Go through a basic checklist to make sure instruments are clean. A fair number of doctors aren't doing it in either country.

The problem isn't the payment system, then. The problem is the fact that hospitals collect people whose immune systems are already taxed by one disease or injury, and expose them to many other people with different diseases, many infectuous. The problem is that a number of sanitary techniques are not fully implemented. The Atlantic asserts that a government-run system would do it better, but the evidence suggests that there is no reason to believe that is the case.

Zombies

The Zombie Menace:

A screen shot from Memeorandum:



Hmm...

170th Infantry

170th Infantry Brigade:

Perhaps the Army's newest unit heraldry -- technically, it isn't even active yet, since it's approval date is not until 16 October, 2009 -- was designed by a friend of mine. The 2nd Brigade Combat Team, 1st Armor Division, reflagged as the 170th Infantry following their recent mission in Iraq. A new 2/1 AD will stand up here at home. The soldiers of the old 2/1 AD ("Iron Brigade") remain forward-deployed in Germany. Designing the new distinctive unit insignia was one of very many tasks handled by a certain lieutenant I could name (who was a captain by the time he left).



As tasks go, I thought that was a pretty cool one.

NO FAT CHICKS

A new PETA billboard campaign that was just launched in Jacksonville reminds people who are struggling to lose weight -- and who want to have enough energy to chase a beach ball -- that going vegetarian can be an effective way to shed those extra pounds that keep them from looking good in a bikini. "Trying to hide your thunder thighs and balloon belly is no day at the beach," says PETA Executive Vice President Tracy Reiman.

Yup, I think that's going to convince people. Really.

(via American Digest)

Man on Fire:

Dennis, over at Dennis the Peasant, has been laid up of late, and is using his convalesence to blog up a storm, principally on the failure that the Obama administration is becoming.

Just keep scrolling.

Like anybody should be surprised at this:
For the Left, war without Bush is not war at all

Remember the anti-war movement? Not too long ago, the Democratic party's most loyal voters passionately opposed the war in Iraq. Democratic presidential candidates argued over who would withdraw American troops the quickest. Netroots activists regularly denounced President George W. Bush, and sometimes the U.S. military ("General Betray Us"). Cindy Sheehan, the woman whose soldier son was killed in Iraq, became a heroine when she led protests at Bush's Texas ranch.

That was then. Now, even though the United States still has roughly 130,000 troops in Iraq, and is quickly escalating the war in Afghanistan -- 68,000 troops there by the end of this year, and possibly more in 2010 -- anti-war voices on the Left have fallen silent.

I remember the same sort of thing happening after the abolishment of Apartheid in South Africa, too.

Skara Brae

Skara Brae in Peril:

Not the cold, as you'd expect, but the sea threatens the oldest city in the North.

The city was abandoned five thousand years ago: a thousand years before this extraordinary find of an early British hero.

The carved capstone had sealed the grave so well that organic materials including wood, bark and leather survived intact as well as various metal objects. The man, who is believed to have been an important figure, had been laid out on a bed of quartz pebbles in sand, in a birch coffin, inside a larger stone chamber. He was buried with a valuable bronze dagger with a gold band — still in its leather sheath. There was also evidence of the remains of wooden possessions and floral tributes.

Whenever you find soft, organic material in one of these sites, it's exciting. To find it from four thousand years ago is amazing.

Conservatives

Conservative Nation:

I'm working on a piece on Federalism v. Progressivism; self-described "progressives" seem to be the chief enemy of the idea of pushing government down to lower levels. As that solution allows people with fundamentally different ideas about right and wrong to live in peace, it's a difficulty for a divided nation.

That said, and as I've often noticed, conservatives are the ones with the most to gain by concentrating Federal power. At the moment, though, it makes sense -- liberals have few friends anywhere except the Federal bureaucracy:

Self-identified conservatives outnumber self-identified liberals in all 50 states of the union, according to the Gallup Poll.

At the same time, more Americans nationwide are saying this year that they are conservative than have made that claim in any of the last four years.

In 2009, 40% percent of respondents in Gallup surveys that have interviewed more than 160,000 Americans have said that they are either “conservative” (31%) or “very conservative” (9%). That is the highest percentage in any year since 2004.

Only 21% have told Gallup they are liberal, including 16% who say they are “liberal” and 5% who say they are “very liberal.”

The 2008 exit poll, showing a disaster for Republicans, had a conservative advantage by 34/22.

Now, if only there were a conservative party.

Speaking in defense of my status as a lifelong Democrat, by the way, I'd like to point out that the effective opposition to the health care bill is largely coming from conservative Democrats. I've seen a few Republicans trying to claim credit, but the only one who seems to have done anything demonstable is Mrs. Palin -- now retired to private citizenship. The guys who are actually forcing the change in the policy are wearing D's.

A Crocodile

A Crocodile in Frolic:

I don't know what I like better about this story: the second photo, or the comment by Woz from York.

"Tick tock."

(H/t: Fark.)

Ayers != Emmanuel

Dr. Emmanuel:

In the comments to a post below, a commenter called "RV" stated that "Emmanuel is the new Ayers." Both Ymar and I objected to the characterization, and for good reason. Ayers was a terrorist, and to this day remains an unrepentant and proud one. Knowingly associating with him is a black mark on anyone's character, because he is an enemy of us all. The fact that he escaped judgment is not due to his lack of guilt, which he confesses -- proclaims! -- freely; and wishes only that he might have "done more" of the bombing and killing on which he built his name.

Dr. Emmanuel -- who states, Mrs. Palin noted in her piece, that his 'thinking has evolved' since his piece on rationing became public -- is someone who has a philosophy with which we disagree. He arranged for a friendly journalist to provide his version of the business here. The issues are laid out precisely as the Doctor -- and the President -- would like them understood, without questioning of any sort; but we've seen the other side, so read theirs also.

A final aside: I didn't realize he was Rahm Emmanuel's brother. I knew the Obama White House was a Chicago Way operation, but I didn't know it was quite that... ah, close-knit.

Or perhaps it's just more of that Obama luck, that his chosen medical advisor just happens to be his chief of staff's brother. The President has moved in very small circles here in America: the Ivy League, the Chicago machine, not much else.

Gene Wolfe

Gene Wolfe on J. R. R. Tolkien:

In the last days of my second tour in Iraq, I found myself with a sudden excess of time on my hands. I was done; all that remained was shipping myself home, giving a few last 'lessons learned' lectures on the way. Where there had been fifteen to eighteen hour days, though, I suddenly had a few hours each day to myself.

At the MWR, looking for anything at all to read, I saw a little yellow book called The Knight, by an author named Gene Wolfe. I normally cannot abide fantasy novels written after the death of Fritz Leiber; but it turns out that Gene Wolfe is of an age to still be writing good old fashioned ones.

That is to say, they are books that have the courage to believe in what they are telling you.

I see why, having run across this piece today. He speaks of Tolkien's ability to use art to convey an ethical vision of beauty:

As a child I had been taught a code of conduct: I was to be courteous and considerate, and most courteous and most considerate of those less strong than I -- of girls and women, and of old people especially. Less educated men might hold inferior positions, but that did not mean that they themselves were inferior; they might be (and often would be) wiser, braver, and more honest than I was. They were entitled to respect, and were to be thanked when they befriended me, even in minor matters. Legitimate authority was to be obeyed without shirking and without question. Mere strength (the corrupt coercion Washington calls power and Chicago clout) was to be defied. It might be better to be a slave than to die, but it was better to die than to be a slave who acquiesced in his own slavery. Above all, I was to be honest with everyone. Debts were to be paid, and my word was to be as good as I could make it.

A story that conveys that artistically is indeed a thing of beauty. This is what the old sort of writing was about. The dragon might be legendary, but the virtues were as real as stone.

How Strange!

How Strange!

What could account for this?

But the president, whose popularity and powers of persuasion may well make him the reform effort's most effective spokesman, encountered the same difficulty he faced at a town hall meeting this week in New Hampshire: For the most part, the critics were nowhere to be seen.

Goodness, how odd. It's like how last week he asked a little girl at random, who turned out to be the child of someone who had donated thousands of dollars to Obama. Just bad luck, I guess.

Afghanistan's Women

The Shia Women of Afghanistan:

Some of you may recall that earlier this year, the Afghan government came under fire for approving a Shia marriage law that was unfair to women. It resulted in some protests by Afghan women, which are unusual, and so the government promised to go back to the drawing board.

The new law is reportedly not much better. Unfortunately, the text is not available online as yet. Human Rights Watch, which has taken quite a bit of criticism over the years, claims to have seen a copy of the final law.

The law gives a husband the right to withdraw basic maintenance from his wife, including food, if she refuses to obey his sexual demands. It grants guardianship of children exclusively to their fathers and grandfathers. It requires women to get permission from their husbands to work. It also effectively allows a rapist to avoid prosecution by paying "blood money" to a girl who was injured when he raped her....

The law regulates the personal affairs of Shia Muslims - who make up between 10 and 20 percent of the population - including divorce, separation, inheritance, and the minimum age for marriage. The initial version of the law included articles that imposed drastic restrictions on Shia women, including a requirement to ask permission to leave the house except on urgent business, and a requirement that a wife have sex with her husband at least once every four days.

This law sits in a very strange place in the Afghan legal system. The Afghan Constitution has some fairly clear and explicit statements about the rights of its citizens.

Article Twenty-Two

Any kind of discrimination and distinction between citizens of Afghanistan shall be forbidden. The citizens of Afghanistan, man and woman, have equal rights and duties before the law.

The Shia "exception" is here:

Article One Hundred Thirty-One

The courts shall apply the Shia jurisprudence in cases involving personal matters of followers of the Shia sect in accordance with the provisions of the law. In other cases, if no clarification in this Constitution and other laws exist, the courts shall rule according to laws of this sect.

Finally, there is a relevant article in the section on changing laws.

Article One Hundred Forty-Nine

The principles of adherence to the tenets of the Holy religion of Islam as well as Islamic Republicanism shall not be amended. Amending fundamental rights of the people shall be permitted only to improve them.

It would seem that Article 22 is exactly the kind of "clarification in this Constitution" that Article 131 considers. It seems reasonable to believe that the law should be unconstitutional for that reason.

Article 149 complicates the matter. To the degree that it declares Islam to be the model for Afghanistan, it harmonizes with 131 but clashes with 22. Shia jurisprudence is certainly Islamic, and certainly admits to the model the law proposes. On the other hand, it states that anything that could be considered an amendment to basic liberties is not constitutional -- unless it improves those liberties. (We could use a version of that language in our own Constitution!)

I don't know how Afghanistan's government resolves a constitutional clash like this. I'm guessing, since it is patterned on our own form of government in key respects (like having a nine-member Supreme Court), that it would look to its court system. The oath of office repeats the verbiage from 149, with two additional invocations to underline the importance of adhering to Islam: "In the of God, Most Gracious, Most Merciful, I swear in the name of God Almighty to attain justice and righteousness in accordance with tenets of the Holy religion of Islam, provisions of this Constitution as well as other laws of Afghanistan, and to execute the judicial duty with utmost honesty, righteousness and impartiality."

So: what wins out? The 'tenets of Islam,' or the Constitution's explicit text? They appear to be in direct conflict.

One Man Shall Drive a Hundred

Mrs. Palin Presses the Fray:

One man shall drive a hundred,
As the dead kings drave;
Before me rocking hosts be riven,
And battering cohorts backwards driven,
For I am the first king known of heaven
That has been struck like a slave.

The lady was handled as roughly and unfairly as anyone could dream, when she first came onto the scene; not only her, but her children. Yet Senators and Presidents recoil from her, and she presses her claim.

I join millions of Americans in expressing appreciation for the Senate Finance Committee’s decision to remove the provision in the pending health care bill that authorizes end-of-life consultations (Section 1233 of HR 3200). It’s gratifying that the voice of the people is getting through to Congress; however, that provision was not the only disturbing detail in this legislation; it was just one of the more obvious ones.

As I noted in my statement last week, nationalized health care inevitably leads to rationing. There is simply no way to cover everyone and hold down the costs at the same time. The rationing system proposed by one of President Obama’s key health care advisors is particularly disturbing. I’m speaking of the “Complete Lives System” advocated by Dr. Ezekiel Emanuel, the brother of the president’s chief of staff. President Obama has not yet stated any opposition to the “Complete Lives System,” a system which, if enacted, would refuse to allocate medical resources to the elderly, the infirm, and the disabled who have less economic potential. Why the silence from the president on this aspect of his nationalization of health care? Does he agree with the “Complete Lives System”? If not, then why is Dr. Emanuel his policy advisor? What is he advising the president on?....

In the fall, when the Senate and the House must come together in conference, perhaps it may not matter. Yet if it does, she will have won this battle as a private citizen, writing arguments on her Facebook page. She's nothing more than that: not a governor any more, not a candidate for any office. Just a blogger, really; another citizen, like any of us.

Like any of us but for one thing: she has a bigger audience, paid for with the slanders and cruelty aimed at her children. They struck her, and now they must answer her.

Music, Story

Change the Music, Change the Story:

The New Axis of Evil

The New Axis of Evil:

It's you, according to the Senate Majority Leader. He does have the good grace to be slightly ashamed of having said it out loud.

Palin on Death Panels

Palin on "Death Panels":

Mrs. Palin -- who, as a private citizen, has the honor of having the President address her arguments by name -- responds to certain claims today.

A few days ago, when we were discussing her earlier letter, I said that I didn't think she was talking about Sec. 1233. In today's piece, she discusses her reading of 1233 at length, since the President interpreted her comments as pertaining to it; but adds at the end:

My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.”

I had a feeling that was where she was pointed, because that's where you get a "panel" whose job it is to make recommendations about who lives and who should be let to die. Pro-health-care-reformist Mickey Kaus notes that Obama's own words strongly indicate that he favors such a panel:

He's talking about a panel of independent experts making end-of-life recommendations in order to save costs that have an effect at an individual level. And he thought it would be in the bill that emerges. ... It's also pretty clear that something like the "IMAC" panel is what he has in mind. Whether or not the IMAC would actually do this--Harold Pollack says end-of-life issues are well down the curve-bender's list, for example--Obama thought it would do it. . .

Indeed, what the President said was that "the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill." If that's true, any savings would almost have to come out of care for them: almost all the money is being spent there to start with. Add in the fact that his advisor, Dr. Emmanuel, is pushing to focus our efforts on the remaining 20% of cases, and you can be pretty clear about what the President is thinking. We're going to save money, and we're going to do it by cutting the amount we spend on "the chronically ill and those toward the end of their lives."

Mrs. Palin is right about that. In spite of the arm-waving, she's quite correct to say that this is the vision being advocated.