I think the phrase is "sympathetic magic".

You know, take an umbrella if it looks like rain, and it won't rain, but if you didn't you'd get soaked.

So my first reaction on seeing this was: "But it will."

Healthcare Reform Named After Ted Kennedy Must Not Suck.

I suspect that the naming of things is still has power.

Well, Now, Lads:

Let's have a look at the Near Cosmos:



Each one of those dots is 100 billion stars. Have a drink or three with my compliments; and God Send Us A Merry New Year.

H/t: Dad29.

Hey for Christmas

"Hey for Christmas!"

Late August is probably the wrong time for Christmas; but as I missed the last feast, if not the holiday, perhaps you will excuse me.

One of my favorite early music groups, The Baltimore Consort, has a wonderful Christams album that I've recently discovered. The ultimate song is exactly the kind of merry brawl that so characterizes traditional music, when our feasts were sweetened by fasting.

Then they sat down to their good cheer
And pleasant were both maids and men,
And having dined and drunk good beer,
Then they rose to dance again,
And thus did they did dance from woman to man...

Then they went to the little thatch house,
And played at cards a game or two,
And with the good liquor did so carouse...

The pots blew out, the glasses were broke,
the game was scattered all by the fife,
Richard was pull'd down by the throat,
At which the hostess drew her knife!

They took the fiddler and broke his pate,
And threw his fiddle into the fire,
And drunkenly went home so late
That most of them fell in the mire...

I have fasted too, and perhaps I have learned something thereby. One thing I think I have learned is that the older music is better, and stronger, than what passes for music today.

That, of course, is just what you expect an old man to say: that the music of his youth is far sweeter and stronger than the music of today. If so, my youth was a thousand years ago. And maybe that is right.

Elizabeth Edwards

On Elizabeth Edwards:

My beloved mother refuses to watch sad movies. For a long time, even a sad scene in an otherwise happy movie was enough to convince her to refuse it. This was part of her method of turning off depressing or sorrowful thoughts, and focusing her life on happiness and joy. She has had more luck than most I know in taking control of her life, so there is probably something to the method.

A genuine tragedy, however, has the potential to be powerfully uplifting. There is a reason the "song of the goat" has been so popular since Ancient Greece, and it is the same reason that Shakespeare's greatest works are his tragedies. It is the same reason that the mountains are most majestic when you stand at the lowest place beneath them.

Alas, the life of Elizabeth Edwards has been a tragedy. I mean no offense by saying so. J. R. R. Tolkien's beautiful work on "subcreation" is best realized in his Silmarillion, with its description of the creation as a work of art: creation as a song. The tragedy also can be a song, and in fact reaches one of its peaks in the songs of opera. It may be that God wants to hear such songs, and asks them of us, from time to time.

Some who have heard that song have written well of it lately. It is a tribute to that sorrowful lady that pieces of almost unbearable sadness have been written in her name. Two such are here, and here. But they are not equal pieces. The sadness of the one is her own. The sadness of the other is the author's, a good man, and a blind.

Conservative Philosophy

Conservative Philosophy:

Cassandra had a post yesterday examining conservative philosophy, and there was some interesting discussion around its history. Via Arts & Letters Daily today, a review of a book hostile to conservatism. The author of the review was unimpressed, but cites an earlier book that made the point better:

A decade earlier, Raymond English had touched upon a similar theme in an article in The American Scholar titled “Conservatism: The Forbidden Faith.” Their point was that conservatism as a political philosophy runs against the American grain and thus will always play something of an incongruous and subordinate role in a revolutionary nation dedicated to equality, democracy, and restless change. While the conservative case for order, tradition, and authority may be useful as a corrective for the excesses of democracy, it can never hope to supplant liberalism as the nation’s official governing philosophy. As Rossiter put it, “Our commitment to democracy means that Liberalism will maintain its historic dominance over our minds, and that conservative thinkers will continue as well-kept but increasingly restless hostages to the American tradition.”

We often talk about Jefferson as liberal (classically so, not a part of the modern 'social liberal' movement), and Hamilton as the conservative. It's easy to forget, though, that Hamilton was extremely liberal compared to English conservatives of the day.

What conservatives want is the right kind of person.

For example, one of the thing American conservatives insisted on was restricting the franchise to men; who were white; and also had property in the community of a certain value. That was shorthand for the kind of person they thought could be trusted to exercise power.

But the American Revolution was fought against Europe's version of Traditional Conservatism, which is a philosophy much older than this country. Even the most conservative of the American revolutionaries were wildly liberal (in the Classical sense) compared to English conservatives of the day. Recall that the English, in those days, had a similarly restricted franchise; but it only elected the House of Commons; and that parliament had a House of Lords that could flatly override the Commons, as they trusted nobility of blood more than any commoner; and there was a King who could, in some circumstances, ride herd on parliament.

That situation had only been produced by a series of liberalizing revolutions: the original power had been concentrated in the person of the king and his loyal nobility alone. It spread to the class of knights (who were not nobility) only because of the absolute need of such men in the wars of the period; the lower nobility and their knights won rights from the Crown during the reign of King John, whose barons forced the Magna Carta from him. But that gave rights mostly to the barons and the King: it was only over time that it came to be interpreted more broadly.

Etc., through the Wars of the Roses, which was followed by a conservative re-concentration of power under the Tudors and the "Divine Right of Kings" vision that predominated under the Stewart kings. That led directly to the English Civil War, which was the first major expansion of commoner power; but there was a counterrevolution under Charles II, followed by a re-counter-revolution under James II, followed by several attempted re-re-revolutions under the Jacobites.

So, yes, Hamilton was a conservative next to Jefferson; but neither of them were conservative next to the English conservatives. They believed that "the right kind of man" wasn't just any common man, but a man of noble blood and descent.

Education couldn't make a nobleman of a commoner. Right? They didn't have the upbringing.

That's the position that conservatives hold here. Education can't make the right kind of man: only upbringing can do that. And they're right, exactly to the degree that Aristotle was right.

The question -- and for Americans, a very difficult question -- is exactly where you draw the line. How do you say, in a land that is sworn to 'liberty and justice for all,' that only the right kind of man can be trusted with power?

More, the lines have shifted so far and so often that it's hard to see where we draw them now. It wasn't true that only the king and high nobility could handle power: Washington handled it, and he was a tradesman. It isn't true that only white men can handle it: Dr. King handled it with great finesse. You can run this line down as far as you like.

Yet there is a basic truth there, one that Aristotle saw and that remains true. Not everyone is trustworthy, and it really is a combination of blood and upbringing that makes you so. That is, some people are born wicked, for reasons that presumably have a physical cause; and some are raised so that they can't see the right, but have notions of "justice" that include killing innocents to bring about the Caliphate, or aborting children that interfere with their pursuit of gratification, or the idea that lying is OK if it's for a good cause. Etc.

That's the conservative position: that there is a kind of natural nobility among men, who are the right ones to lead. They need to be (at least) free of 'bad blood,' such as leads to wickedness; and they need to be given the right upbringing from an early age. If you get that person, they can become a good ruler and a wise leader once they are educated.

But not just anyone will do.

The American experiment is a liberal experiment, which has made inroads expanding the franchise easy. Indeed, it's made them seem like simple justice:

As for the culture war—well, most conservatives would be glad to have it over with, if only cultural liberals and radicals would call a halt to their provocations. The historical record is clear that the first shots fired in every engagement of the culture war came from the left in the form of school busing, the abortion decision of the Supreme Court, the Mapplethorpe exhibition, political correctness on the campus, and (now) gay marriage. Indeed, what many call the “religious right” came into existence in the late 1970s in response to the Carter administration’s effort to deny tax exemption to religious schools on the grounds that they were segregated. Absent liberal provocations, there would have been no culture war and probably no “religious right” to wage it.

"Busing" and the Carter administration's attempt to force integration at religious schools are a good example of how the extension of the franchise was only part of the liberal project of empowering everyone equally. That's exactly the kind of democratic impulse that leads to the mob, to the tyranny of the majority, and to all the things that Cassandra warns against.

In the context of America, though, it's very hard to argue against them. The English could point to a nobility of blood or the divine right of kings; we threw all that out from the start. So what's left? We started with race (white) and property (you should own some): but racism hasn't proven healthy, to say the least that may be said; and while the focus on property worked well in some respects, it cannot be justified in an economic system that can sometimes overwhelm your ability to own property through no fault of your own.

In the decades after the Civil War, for example, fewer and fewer people in the South, black or white, owned their own farms. This was not because they were not working hard, but because the price of cotton was declining every year due to overproduction. Yet the farmers were not free to farm something else, because they could get no loans from the banks if they did not agree to grow cotton. The banking policy was set in New York, by national banks not the least bit interested in the question of whether farmers owned their lands, or lost it; or if they had any interest, it was in taking over the farm and reducing the owner to a tenant. Under such a system, you could quickly disenfranchise good, hard working yeoman farmers of the sort that were the backbone of Jefferson's vision: exactly the kind of people he wanted to have the right to vote. The bankers would retain their right.

It is crucial to be able to get 'the right kind of person' into office, if only to balance the worst instincts of the machine politicians, the various interest groups and lobbies. This is why Reagan was in fact a conservative: he was very much the right kind of man. It is why Sarah Palin was exciting to many conservatives, even though she plainly needed quite a bit of education to be ready for the role she was asked to assume. It was at the heart of McCain's candidacy, especially in 2000. It doesn't bear up well against machine politics, though: democracy is its enemy, because the right kind of person is not like everyone. They won't promise just anything, nor deliver all the wealth of the nation in return for votes.

The Republican machine hasn't been able to produce these kind of people: what we've gotten from them instead is "Compassionate Conservatism," which is just more promising up the wealth of the nation. Nor is it easy to see how a party of such people could prosper in a hyper-democratic environment. Virtue is not popular, and calls to virtue even less so. Yet what is even harder than getting the right kind of person elected in this environment is changing the environment: there is simply no practical way to restrict the franchise, to repeal the 17th Amendment, or to do anything else to make America less democratic. Even to say the words "Let's make America less democratic" sounds like treason -- democracy was the whole point, wasn't it? Isn't that why we went to Iraq?

Well, no, opposition to tyrants is not necessarily an endorsement of unlimited democracy: but, as the reviewer points out, George W. Bush's use of Woodrow Wilson's language makes it seem like it was. The Republican party, including its last real leader, adopted the language of the liberal rather than the conservative movement. In their domestic spending spree, they adopted its method as well.

Conservatism may be, not quite dead, but relegated to the fringe. Republicans may return to power, but they will no more be able to enact sweeping changes than the Obama administration has been able to do. What will produce the change is the coming collapse of the government, as it bankrupts and fails to meet its sovereign debt obligations. That day is ever closer. It is time to start thinking about what we would like to do when it arrives.

Now, the Bible

Now, the Bible:

The other matter was the Bible and its use in American politics and culture.

President Obama... has said that he hopes to be “an instrument of God.” (Shouldn’t we all.) And, the other day, I saw a photo of him next to a neon cross (pretty garish). I also read what he said about critics of his health-care plans: They were “bearing false witness.”

...

Kind of a funny country we’re living in. A beauty-pageant contestant says that she is opposed to gay marriage, believing that marriage is between a man and a woman — and she is pilloried as some kind of modern-day witch. But when Barack Obama, Hillary Clinton, Joe Biden, John Kerry, Bill Clinton — pretty much all major Democrats — express the same opinion: Everyone’s cool.

I know the standard answer: The Left (broadly speaking) realizes those Democrats don’t mean it; and they’re pretty sure that Miss California does.

He has more examples, but these are enough.

I think the issue is that the Left (again, broadly speaking) tends to hear religious rhetoric as a kind of bipartisan outreach. They forgive it in their own because they think 'well, the President has to reach out to the Right, and explain things in terms they'll understand.' They assume the speaker (being a left-wing politician) is 'with them' on questions of right and wrong, and don't get nervous that his faith might lead him to something they wouldn't like.

From a Right-wing politician, the Left tends to receive the rhetoric as outsiders. They assume the speaker isn't one of them, and he's speaking to others who are also not 'one of them.'

For the Right, the division isn't about whether the speaker is 'one of you' or not; it's about whether he's sincere or not. I assume most politicians who invoke God are doing so for purely cynical reasons, like a used car salesman telling you that he used to be a minister. While these people are annoying, they are not worrisome: I expect politicians to lie and wheedle, so it seems entirely within the nature of the beast if they do it.

However, a few men of genuine faith do become involved in politics. George W. Bush seems to have been one of those men. He spoke little about faith, and I think it was less to avoid scaring people, than because sincere faith isn't trumpeted. "Love is patient, love is kind. It does not envy, it does not boast, it is not proud."

That kind of faith reassures the Right, when it is present; but it terrifies those who do not share it. I can understand why. It is what the philosopher Soren Kierkegaard wrote about: what do you do if God calls you to something? What if that something is awful?

They were afraid that Bush was following his faith into Iraq -- remember the stories about how Bush believed it was the land of Gog and Magog? They were afraid he was following it everywhere. That would mean he was making decisions for reasons they couldn't understand or predict, and given the power of the office, that was terrifying.

In any event, this leaves us here:

1) Politicians who are insincere leftists may freely quote the Bible without scaring anyone, but they won't convince anyone, either.

2) Politicians who are insincere rightists would be better off not quoting the Bible, as it convinces the Left they are insane and the Right that they are liars.

3) Politicians who are genuine believers on the Left may freely quote the Bible, but probably won't. It won't scare anyone if they do, because the Left will assume they are 'one of them,' and will therefore receive the religion as unthreatening; the Right will respect the sincerity of the faith, even if they disagree about where it lead the believer.

4) Politicians who are genuine believers on the Right may freely quote the Bible, but probably won't: and they will terrify the Left regardless of their choice in this matter.

Scottish Heraldry

Scottish Heraldry:

Jay Nordlinger asks, "Who can wave the Bible?" I'd like to discuss that, and will do so above. However, first we must deal with another important matter.

Later in the piece, he makes the shocking admission that -- though part Scot -- he doesn't know what the flag of Scotland looks like. I hope that none of you are in that same category, but if so, let us fix it! The flag is the St. Andrew's Cross, the white cross saltire on a blue field. It appears in the upper left of this achievement:



Probably all of you have seen the Royal Arms of the United Kingdom, which quarter the arms of England (Richard I's three lions), Scotland, and Ireland. Did you notice, however, that -- when displayed as they are in Scotland -- the Scottish arms are given precedence? The Scottish lion rampant is doubled, instead of the English lions of Richard I. The Scottish national motto is also used, and the supporters are reversed. The crown of England steps aside when it comes to Scottish soil.

Here is how you have probably seen the arms, as they are displayed in England and elsewhere:



The Scottish flag partially inspired two additional famous flags. The Union Jack includes the Scottish flag (as well as the St. George's cross of England, and the St. Patrick's cross of Ireland). Also, the old Confederate battle flag was a nod to Scotland in its choice of the St. Andrew's cross, as many of its soldiers were of Scottish heritage. The battle flag's colors, and the use of stars-for-states, were inspired by the American tradition. The Confederates, after all, believed they were defending American traditions of independence and rebellion against overweening authority.

With all of that handled, we can deal with the other matter.

Puff

Subregionalism:

This is one of those puff-pieces that could only have been written by a career diplomat, unless it was by a "visiting scholar" who depends on both the State Department and the White House for access. If you dig down past about seven paragraphs of flattery and excuse-making, however, you do learn something about the direction of US foreign policy under the new administration.

The United States has abandoned the idea of working with its traditional allies. The author mentions the failure of the G8 as a vehicle for our policy: those nations, excepting Russia, are Cold War allies. NATO is barely mentioned in the article, but its continuing difficulty fielding real fighting forces in Afghanistan has shown how weak it has become in its original role -- that of a military alliance. The new vehicle? The author states that this is not clear: "the administration has an effort underway to determine whether the successor to the G-8 will be the G-20, or perhaps some other grouping."

The questions that Sec. Clinton is described as asking have been of interest to the military for some time. A model for addressing the question of building networks of sub-regional partners was considered here, in a piece from the US Army's War College. That model is not entirely theoretical: the US Pacific Command leveraged our relationship with Singapore to assert US interests on a Singapore-Malaysia-Indonesia alliance to patrol the Malacca Straits.

The Malaysians and the Indonesians both have reasons to wish to avoid a formal alliance with the United States. Malaysia, in particular, has a longstanding foreign policy that balances several local third-world governments against any great powers operating in the region. Direct partnership isn't an option for that reason: Malaysia won't have it, not with us. Yet they will partner with the Sings, and our strong alliance with Singapore allows us to exert indirect influence.

Indonesia, meanwhile, is a partner of extraordinary importance as both the largest Muslim nation on earth and a modernizing force within Islam -- but it is also a noted human rights abuser, and a competitor in some respects to a genuine ally, Australia. We would like to work more closely with Indonesia, but political pressures prevent it.

In spite of that, by building strong sub-regional partnerships, we are able to influence the entire area. We have the alliance with Australia, which allows for the good-cop/bad-cop influence on Indonesia; we have the partnership with Singapore, which allows us to influence and keep apprised of the patrolling of the Straits; we have the alliance with the Republic of the Philippines, to whom we provide direct military support in the form of the Joint Special Operations Task Force there, and diplomatic support also to their peace process; and we have another strong ally in Thailand.

One reason the relationship between Sec. Clinton and the military is as good as it is, is that many of the solutions she has been looking for were pioneered by the DOD. The piece makes a sketch of a bow to that fact, noting that a lot of 'statecraft' resources are currently at the Pentagon. Why would that be? Because the Pentagon was the one having the success in creating the desired effects.

This is true even for her signature focus on getting State to attend to 'nonstate' actors, especially those focused on 'women's issues': one of the key places for State officials to learn that is with an ePRT or PRT in Iraq, where the military has been setting up women's committees for several years. These committees are often initially resourced by American money -- formerly CERP, but these days State may be involved from the beginning -- and may meet at US-secured facilities (though that is also increasingly unnecessary).

I'm not sure I agree with the author that the Obama administration has had any notable foreign policy successes. The Clinton State Department, however, may be poised to have some internal successes. If so, the lady does deserve the credit for having both the sense to recognize practical solutions, and the personal power to move the bureaucracy to adopt them.

However, the piece seems to overstate the effects achieved so far. For example:

Even just a few months in, it's clear that these appointments are far from window dressing. Lew, Slaughter and the acting head of the U.S. Agency for International Development are leading an effort to rethink foreign aid with the new Quadrennial Diplomacy and Development Review, an initiative modeled on the Pentagon's strategic assessments and designed to review State's priorities.

Confer that assertion with this piece by Matt Armstrong, at Small Wars Journal, on the serious problems with USAID at State. USAID is one of the most effective arms of the State Department. Also relevant is Mr. Armstrong's commentary on State's failures at re-establishing a role in Public Diplomacy. You might say that he agrees that the Clinton State Department is an improvement, but with less effusive praise:

I'm not sure where Pincus has been, but until the recent year (ie. this year), the leadership at the State Department was out to lunch....

It is worthwhile to recall that it was the Secretaries of Defense (both Donald Rumsfeld and Gates) and not the Secretary of State Condoleezza Rice that frequently and seemingly continuously fielded questions about the need of resurrecting the United States Information Agency. It was Rice who raided the public diplomacy budget to help fund the Embassy in Baghdad.

Dr. Rice was indeed a disappointment, both as Secretary of State and as National Security Adviser. Sec. Clinton does seem to be an improvement over her, but there is a very long way to go. If State wants to begin reasserting its traditional perogatives, it can do worse than to start by trying to "buy back" some of those DOD strategic communication assets, and re-building USAID.

Now it's getting serious.

WASHINGTON (Reuters) - A U.S. Senate Democrat asked the top 15 health insurers to explain what portion of premiums go to profits versus patient care, putting further pressure on the companies to explain their business practices as Congress considers sweeping health reform legislation.

It's going to get real interesting, real quick, I think.

Rating Stars

Rating Stars:

I really have no idea why Haloscan is popping up this annoying "rating stars" code. I'll try to shut it off. In the meanwhile, if you have an opinion on what I have to say, please continue to express it in writing. :)

Ouch

A Rhetorical Slap:

Yesterday we noted the President's odd use of religious rhetoric. Professor Althouse slapped down one piece of that rhetoric.

BARACK OBAMA, PRESIDENT OF THE UNITED STATES: These are all fabrications that have been put out there in order to discourage people from meeting what I consider to be a core ethical and moral obligation. That is that we look out for one other, that I am my brother's keeper, I am my sister's keeper. And in the wealthiest nation on earth right now, we are neglecting to live up to that call.

Now, we know that Barack Obama doesn't "keep" his actual brother — we remember George Hussein Onyango Obama, the brother who lives a hut....

Did you ever see a football player tackled so hard that it made your teeth hurt, just to watch it?

A true and fair stroke, though.

Smack

Smack!

Our friend Lars Walker does not generally believe in signs and portents.

I won’t go so far as to say that signs never come in our day, but I’m leery of them. Whenever I’ve thought I’ve seen a sign in my own life, it’s turned out to be an embarrassment. My church body believes that, in our time, those who have the Scriptures don’t need any further input on divine matters.

And yet, sometimes…

Sometimes, like today.

Oddities in Rhetoric

Oddities in Rhetoric:

Religious rhetoric from the Left: "We are God's partners in matters of life and death."

From the Right: 'Keep your laws off my body!'

Both are fairly reasonable sentiments, which is why they see use in rhetoric. The latter is a very powerful rhetorical trick in its normal usage, since it elides right past the fact that the laws aren't really interested in your body, but rather the one belonging to the child. The former admits that we normally hope to be aligned with God when we make decisions about life or death: we invoke God's blessing over births and executions.

The Honorable Mrs. Bachmann actually proposes a conservative concept for health care reform during her call. It's a sketch -- you don't get detailed ideas in this kind of format.

The Future of the Past:

In the early 1960s, curators at the Philadelphia Museum of Art noticed something funny about one of their modern-art sculptures: It smelled like vinegar. Worse, the once-clear plastic sculpture had begun browning like an apple, and cracks had appeared on its surface. By 1967, Naum Gabo's translucent, airy Construction in Space: Two Cones looked like Tupperware that had gone through the dishwasher too often.

I think I've talked about this before.

Trust

Trust:

I can see only good in this:

The left likes to say that conservatives hate government. The truth, and it holds for many people beyond conservatism, is closer to what Alfred Hitchcock said when he was accused of hating the police. "I'm not against the police," Hitchcock said, "I'm just afraid of them."

Congress's approval rating sits at 30%. This is a remarkable vote of no confidence in the representative branch of a national government.

In California and New York, the two most economically important and famous of the 50 states, the legislatures have been revealed as incompetent to manage the public's money. The budget crises in California and New York aren't just a normal turn in the fiscal cycle. Those governments have finally hit the wall.

Oblivious to manifest failure, the liberal-progressive idea keeps itself afloat on intellectual water wings—insisting that most people still believe that if government commits itself to accomplishing a public good, it will more or less succeed despite the difficulties and inefficiencies of these great projects. Needed good gets done.

That civics-book faith in the good intentions of government has been on the bubble with a broad swath of the American people who don't know left from right but only public performance. The Obama health-care proposal arrived at a particularly bad moment to be asking voters to "trust us."

Ezra Klein writes:

Americans Hate Everyone, Believe Everything

Wednesday's Wall Street Journal/NBC poll is disappointing stuff. It's not so much that the American people have turned against Obama's health-care reform effort as they've turned against the legislative process in general.

Yes, exactly. The American people trust government with nothing.

That distrust is well earned, and past due. We must solve our problems ourselves, not only without the government, but in defiance of its wish to intermesh itself with our concerns. It's 'the man in the arena,' as Theodore Roosevelt put it, that matters. He is the one fully engaged, heart as well as mind. A bureaucracy can, at best, devote only its mind. These critical, difficult questions are best solved at the lowest possible level, where the heart can be tapped as well.

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...