Two pieces today contrast health care in the U.S. and Europe, and beyond that the rest of the world. Peter Pitts relates a personal story of quality and efficient care in the U.S.:
The Europeans -- who suffer under socialized medicine -- were mostly amazed.
Amazed that we didn't wait hours for an emergency-room bed.
Amazed that we saw a doctor in less than five or eight hours.
Amazed that we weren't told to go home and come back at a later date -- because her white-blood-cell count was only slightly elevated and the appendix wasn't in danger of bursting.
And not amazed but astounded that the surgery was done immediately. That there was actually a room available and that it was vacant -- at a large urban hospital -- they couldn't even fathom.
Here is one verbatim comment from a continental comrade: "I waited three days in London to see a GP and 20 hours at ER for an 'exploratory op.' It burst and I nearly died (to say nothing of the two life-threatening incidents whilst I was being 'cared' for). But hey! The public option is better . . . right?"
Meanwhile Mark Constantian notes that's the general story:
The comparative ranking system that most critics cite comes from the U.N.'s World Health Organization (WHO). The ranking most often quoted is Overall Performance, where the U.S. is rated No. 37. The Overall Performance Index, however, is adjusted to reflect how well WHO officials believe that a country could have done in relation to its resources.
The scale is heavily subjective: The WHO believes that we could have done better because we do not have universal coverage. What apparently does not matter is that our population has universal access because most physicians treat indigent patients without charge and accept Medicare and Medicaid payments, which do not even cover overhead expenses. The WHO does rank the U.S. No. 1 of 191 countries for "responsiveness to the needs and choices of the individual patient." Isn't responsiveness what health care is all about?
Update: Added the link for the second story.
I have long believed that everyone (of consequence) in the world is either a Beatles of Elvis person. And the decision between the two expresses a deep insight into the cultivation and state of a person's soul. I was always a Beatles guy, but admit that, as time has passed, to have undergone the sort of inner crisis Allen Bloom would well understand.
Nevertheless, today would be Elvis Presley 75th birthday.
Powerline runs a must-read annual post on Elvis which pays particular attention to his 1970 meeting with President Nixon. The altruistic patriotism and almost child-like innocence in his letter to Nixon (in which he requests to be secretly deputized by the federal Bureau of Narcotics and Dangerous Drugs) permits an endearing and ultimately tragic (given his eventual demise from drug-use) glimpse into his uncanny character.
So here's to the King! If only he'd reigned a bit longer....
From today's Wall Street Journal:
The office market in Washington, D.C., is poised to topple New York as the nation's most expensive, reflecting the declining fortunes of the nation's financial center and the government expansion under way in the U.S. capital.
Rents declined in almost all of the 79 American cities tracked by Reis Inc., a New York based-research firm, in the fourth quarter of 2009. The largest fall was in New York, where average effective rents -- or the net amount tenants pay after landlord concessions -- fell nearly 20% to $44.69 per square foot annually. It was the sharpest decline in rents ever recorded by Reis since it began compiling data in 1981.
By contrast, average rents in Washington were $41.77 per square foot, down 3% annually. Reis estimates that by the end of this year, rents in New York will come down to around $41.07, slightly below their estimates for Washington of $41.27.
"The financial crisis hit New York hard, which is why it's down so much, whereas the government is one of the few sectors that has actually added jobs," said Robert Bach, chief economist for Grubb & Ellis, a Santa Ana, Calif.-based brokerage firm.
Many conservative commentators have noted that President Obama often blames Americas problems, at home and abroad, on President Bush, (often with some justice). The irony is that at the start of his term he did not go as far as would have been politically wise. A year ago, when he took office, he could have said, "Our economy is in very bad shape. It is quite likely that we will face 10% unemployment and slow growth for quite some time. On top of that, the deficit has expanded greatly. It will take several years for us to fix things, and it will get much worse before it gets better . . ."
But Obama did not go that far, however much he blames on Bush. Instead, he sold a huge stimulus bill by saying it would keep that from happening. Hence he is currently taking some of the heat.
There is one point that might appear superficial but is hard to miss. Quite simply, the students of Directed Studies and the Humanities appear very happy. . . . They show a love of college and learning that I do not see from the students brooding over econometric regressions or deconstruction.and this:
Part of the reason students (like me, initially) don't pursue traditional liberal arts education is that they simply don't know why they might want to. . . . Nobody doubts the value of the sciences or the utility of the social sciences. But freshmen aren't so sure about the liberal arts. As such, the duty should fall to university administrators to ensure that freshmen at least give it a try and can find classes about literature that aren't actually about politics.Of course, what Shaffer is talking about is the pursuit of something worthy and serious--a pursuit inspired, above all, by love. Because so many people today think that love is just a feeling that comes of its own accord and offering no explanation or justification for itself, our educational system is loath to suggest to students that they can develop better and higher loves than those their adolescent brains suggest to them. These more fleeting passions and temporary rushes of excitement--necessary, perhaps, to spark an interest--are not in themselves sufficient or satisfactory to the work of the human mind. Thus, a kind of passing interest in anatomy or mechanics will not sustain a man in long career focused on those things--no matter how "expert" he becomes in that field. Human beings need to love.
Men and Women
The fur is beginning to fly inside the beltway.
Then, asked if such closed-door meetings were not a violation of Obama's campaign promises, Speaker Pelosi attacked the President: "There are a number of things he was for on the campaign trail." The quip (as a Pelosi aide coined the phrase) charges Obama with betraying his campaign promise not to tax the middle class by supporting the Senate bill's "Cadillac tax" (which would tax the lavish health-care packages enjoyed, for example, by many labor unions - a vital Democratic voting block).
Tempers are flaring as final negotiations near. Obama wants a health-care "victory" (read: anything will do) for his state-of-the-union speech in February. Senate Dems have already discarded the public-option centerpiece of their health-care ambitions and House Dems are likely helpless but to follow suit. And all of the infuriating compromises are being forced by dissenting Democrats!
All a Republican can do is sit back and try to enjoy the hissing and clawing.
The public is not only shifting from left to right. Every single idea associated with the educated class has grown more unpopular over the past year.
The educated class believes in global warming, so public skepticism about global warming is on the rise. The educated class supports abortion rights, so public opinion is shifting against them. The educated class supports gun control, so opposition to gun control is mounting.
Very suggestive. (I'm reminded of Peter Jennings' famous comment that in the 1994 elections, the people "threw a temper tantrum.") Brooks, although he sometimes makes light of the prejudices and lemming-like behavior of America's elite class, ultimately fits comfortably in that group. Many liberals define their positions as those that intelligent people take. Hence any critique is uninformed, by definition. But what happens when what is called "intelligence" is something else? (I suppose it might be something similar to what happens when what is called "science" is defined as nothing more than calculations and correlations).
P.S. It might also be worth noting that the "educated class" is probably much less unified in opinion than it was thirty years ago. (Back then, there were many fewer conservative law professors, journalists, magazines, and think tanks). Perhaps that's partly where the anger comes from. It is becoming harder and harder to claim that there is a unified "educated class." As that becomes the case, the myth that smart people agree on issues becomes harder and harder to maintain. As that happens, the myth of technocracy (build on Pragmatism) is exposed. I suspect that it is disagreement about that ideal that gets under Brooks' skin.
P.P.S. Brooks writes "The Obama administration is premised on the conviction that pragmatic federal leaders with professional expertise should have the power to implement programs to solve the country's problems." An I thought they believed in diversity? Only a truly federal system would allow that. But technocrats don't want there to be fifty different sets of laws regarding health care, etc.
Is it ironic that the push for universal health insurance is NOT being driven primarily by concern for the poor? The truly poor already have Medicaid. In other words, this is not a safety net issue. It's about the relationship between citizens and the government. Should government guarantee health care for people other than the very poor? (It already does so, of course, with Medicare, and that might be part of the story too).
As I understand it, What's the Matter with Kansas suggests that lower-middle class whites in rural America ought to vote for liberals who will give them hand-outs, rather than conservatives with whom they agree on social issues. By the similar logic, shouldn't the AFL-CIO support reducing or eliminating immigration into the U.S.? On the other hand, in The Road to Serfdom, Hayek wrote, "the erroneous belief that there are purely economic ends separate from the other ends of life. Yet, apart from the pathological case of the miser, there is no such thing."
Is it possible that the tax on "Cadillac health plans" if it goes into effect will be, ultimately, a way of means testing the health care hand-out, rather than making it an entitlement of all Americans? In principle it could, over time, create a situation where a certain, basic items are covered for all Americans, but, above that line, individuals and families (other than the truly poor) have to pay, either out of their own pocket, or through insurance for which they pay themselves. Given bracket creep, and some inflation, in time most health insurance will be in the "Cadillac" category. I know this seems unlikely, and probably is, but more ironic things have happened.
The answer won't surprise you, coming from the Danes, but the reading is fantastic. (The byline of the article reads: "The U.S. president - the practical saviour of our times.")
I guess not everyone overseas has grown disenchanted with Mr. Obama.
Speaking to the United Nations in September, Barack Obama stated, "I am well aware of the expectations that accompany my presidency around the world." No doubt, Obama believed that such high expectations would be accompanied by a concominent commitment of cooperation from a sympathetic world community. Indeed, global praise greeted the news of Obama's election, and a new era was promised by the harbinger of "change."
Of course, political rhetoric, even when sincerely spoken, and $5 will buy you a cup of Starbuck's Joe. The news seems to daily multiply the countries which have become disillusioned, if not outright defiant, of America's all-talk president.
Iran, for example, has shown the most boldness in rebuking and seeking every opportunity to humiliate America. Over the weekend, Iran announced that Sen. John Kerry had sought to meet with members of the Iranian parliament - a request which Kerry had hoped to keep quiet until Iran had agreed to the visit. In broadcasting the news, Iran also stated that the request would likely be denied.
In response to a U.S.-led, UN-sanctioned ultimatum with a 2009 year-end deadline to use Iran's own stockpiles of enriched uranium as the raw material for producing nuclear fuel rods for Iranian research reactors, Iran responded with its own ultimatum to buy the fuel outright or swap in small installments (preserving sufficient uranium in Iran for weapon-grade conversion). Obama may have agreed to support the regime in opposition to demonstrators for democratic reform in exchange for Iran's secret consent to the plan it has now rejected.
Iran has now declared it will hold massive war games to coincide with the deadline it has set for the West to decide upon its counter-proposal. Not an entirely subtle message. If the West fails to concede to the Iranian ultimatum, the rogue nation has threatened to produce its own nuclear fuel - which would require the sort of uranium enrichment methods used to produce nuclear weapons and which the West is desperate to halt.
Even among our allies, Great Brittain has announced that information relating to the Christmas day underwear-bomber was passed along to the U.S. prior to the flight. In this breach of protocol, which would usually have matters of intelligence gathering and dissemination remain undisclosed, the British government seems to have intentionally thrown the Obama administration to the wolves.
Further, many countries have simply ignored Obama's call for heightened security measures on all U.S.-bound flights. Such resistance might have been expected from the likes of Lebanon, Syria and Libya, but the uncooperative countries also include Germany, France and Spain.
As noted in Robert Lieber's similarly themed L.A. Times article criticizing Obama's well-intended but inept operational style on foreign policy, nations on every continent "have failed to accept Obama's outstretched hand." In fact, some of these countries are trying to bite the hand that feeds. Russia is again asserting itself over Eastern Europe while stalling progress on Iranian sanctions, China sent Obama home with absolutely nothing to show for his visit, all of Europe is reticent to support Afghanistan or to accept Gitmo inmates, Israel is beginning to simply ignore U.S. peace talks while it is likely preparing to strike Iran in direct defiance of U.S. requests and Obama was personally scolded at the UN on the issue of nuclear proliferation by the French.
Lieber blames Obama's foreign engagement failures upon his penchant for projecting himself as the personification of U.S. policy, his belief that our adversaries simply react to U.S. rhetoric rather than pursuing their own self-interests and Obama's inexperience and aloofness. All of these causes are likely valid, as is Lieber's tally of Obama's many foreign policy blunders. The question is whether Obama will learn from his mistakes and adjust.
I wouldn't expect much in the way of improvement in year two. On the one hand, people simply do not quickly undergo the sort of fundamental ideological change needed by Obama. His naivety toward human nature and its expressions in global diplomacy requires a complete reassessment of first principals and reformulation of political doctrine. Such revolutions of thought are not swiftly resolved.
Furthermore, it has not become at all clear that Obama is aware of his failings. Perhaps he believes the process of his rhetorical diplomacy is slow but sure, and time will justify any perceived shortcomings. Bush adopted this view as a matter of conviction, as was clearly observed in his ordering of "the surge" in Iraq. Events in Iraq have favored Bush, but his faith was justified by a belief in the U.S. military. Will Obama's faith in Putin, Chavez, Ahmadinejad and Assad be similarly rewarded?
With all the ruckus of the presidential election, two wars and an economic recession, America has been preoccupied with the President and Congress over the past year or so - allowing the Supreme Court to enjoy a period of relative peace and quiet. Most of the fervor surrounding judicial issues has arisen from the trial court level, reflecting Obama's decision to try terrorists in civil courts rather than military tribunals.
Tocqueville observed, however, that political controversies inevitably turn into legal controversies in America. WaPo is reporting that opponents of the health-care bill are likely to bring immediate challenges in federal courts as to the constitutionality of the bill's individual mandate clause (which requires that people purchase health insurance or pay a fine of 2% or more of their income).
Conservatives make two primary arguments against the mandate. The first is that an individual's inactivity -- in this case, the failure to buy health insurance -- does not qualify as interstate commerce, and thus Congress does not have the power to regulate it under the Commerce Clause. The second is that the financial penalty the law would impose goes beyond Congress's ability to lay and collect taxes.
Randy Barnett has an article at The Heritage Foundation advancing this opinion. The article begins by quoting a 1994 memorandum from the Congressional Budget Office:
A mandate requiring all individuals to purchase health insurance would be an unprecedented form of federal action. The government has never required people to buy any good or service as a condition of lawful residence in the United States. An individual mandate would have two features that, in combination, would make it unique. First, it would impose a duty on individuals as members of society. Second, it would require people to purchase a specific service that would be heavily regulated by the federal government.
I have doubt as to the viability of such a claim in the Supreme Court. As is customary, the result may depend upon the swing vote of Justice Kennedy. (For a noble attempt to dispel the prevailing notion that Kennedy's centrism is the result of a lack of actual judicial philosophy, see Frank Colucci's newly released Justice Kennedy's Jurisprudence: The Full and Necessary Meaning of Liberty).
When questioned as to Congress' constitutional authority to impose individual mandates, majority leader Nancy Pelosi responded by repeatedly asking in mocking disbelief, "Are you serious?" While I have reservations that even the Robert's Court can reign in the unlimited power of Congress under the Commerce Clause, I expect that Pelosi's arrogance reflects something in her character and statesmanship other than a profound sense of juridical certainty.
Liberal justices on the Supreme Court are responsible for discarding judicial deference in favor of an expansive judicial review of legislative policies. It would be ironic if this activist trend were to derail the liberal centerpiece of the Democrat's health care reform.
The [state's civil service] system was set up so politicians like me couldn't come in and fire the people (relatives) hired by the guy they beat and replace them with their own friends and relatives.
Over the years, however, the civil service system has changed from one that protects jobs to one that runs the show.
The deal used to be that civil servants were paid less than private sector workers in exchange for an understanding that they had job security for life.
But we politicians, pushed by our friends in labor, gradually expanded pay and benefits to private-sector levels while keeping the job protections and layering on incredibly generous retirement packages that pay ex-workers almost as much as current workers.
Talking about this is politically unpopular and potentially even career suicide for most officeholders. But at some point, someone is going to have to get honest about the fact that 80 percent of the state, county and city budget deficits are due to employee costs.
Either we do something about it at the ballot box, or a judge will do something about in Bankruptcy Court.
It's about time.
The Transportation Security Administration (TSA) has belatedly realized that acts of terror are often conducted by people from terror-sponsoring states. According to the NYT, TSA has ordered a "'full body pat-down and physical inspection of property' for all people who are citizens of or are flying through or from nations with significant terrorist activity." The list of countries seems to include Cuba, Iran, Sudan, Syria, Afghanistan, Algeria, Iraq, Lebanon, Libya, Nigeria, Pakistan, Saudi Arabia, Somalia and Yemen. Savory places, all.
As was to be expected, protests have issued. While most Americans no doubt scratch their head in bewilderment that travelers from these destinations were not previously subjected to elevated security checks, civil-rights groups and the government of Nigeria have both cried foul, citing racial-profiling as the basis for opposing these new security standards.
And, in truth, they are correct. In fact, it is racial/religious/cultural-profiling, dressed up in a more palatable disguise. Most of the listed countries are predominantly Muslim (Cuba is a communist aberration), and they are on the list because they are dominated by Islam. The connection between Muslims and terrorism may be unfortunate, but it is a simple reality. The Religion of Peace website estimates 14,626 acts of Islamic terrorism since 9-11, and Religious Tolerance notes that Muslims are involved in 21 of 25 current global religious conflicts.
While technological and behavioral methods of locating a would-be airline-terrorist should be fully endorsed, it seems absurd that other characteristics which are almost universally common to all terrorists should be ignored: Ethnicity (Middle Eastern), Religion (Muslim), Age (20s-30s), Gender (Male). TSA's new security implementation is a good beginning, but it should immediately be expanded to include a full spectrum of relevant characteristics - of which nationality and country of departure are only two examples.
Such criteria have been successfully implemented by a country which has never boarded a would-be terrorist onto a plane, despite unparalleled terror threats: Israel.
The left's fear of profiling should be shared by Obama, but for a different reason. At present, the TSA's heightened measures will only be applied to foreign flights (which require a national passport). But should another act or terror arise upon a domestic flight, a flight which did not implement TSA's foreign security profiling guidelines, would I be premature in calling for the broadest series of executive resignations in the history of the United States?
As my good friend Christopher Armstrong wisely noted, my favorite civil liberty is the one that says I get to not be blown up. Here's to lingering common sense.
After years of relentlessly humorless comics attacking conservatives and the GOP, the WaPo finally shifts its sights and strikes gold:
So reads the "above the fold" on Drudge Report this morning, proving that the 1970's "global cooling" scare might have been a better angle for the environmental movement than the global warming charade they finally settled upon. (I spent the past weeks traveling between Italy and Czech - the former was paralyzed by the worst blizzard conditions in 20+ years and the latter was so cold that it must certainly be the ground-zero epicenter of global - if not universal - cooling.)
The Australian predicts that, following Copenhagen's collapse, the odds of producing a post-Kyoto treaty at the next conference in Mexico City are "virtually zero." Four reasons are provided, all relating to the "changing climate in Washington":
1. Democrats have other priorities.
2. Americans are rapidly "losing faith in the science of man-made climate change."
3. If the rest of the world can't agree on a global warming strategy, why should America disadvantage itself by going-it-alone?
4. Massive energy taxes are unpopular in election years.
Coinciding with the international halt on climate change initiatives, the Democrat's domestic initiatives have also stalled. Obama's only recourse now is to ignore the popular outcry which has frozen cap-and-trade in the Senate and to use the EPA's carbon-as-a-pollutant designation to unilaterally implement a national regulation.
I can't see environmental issues becoming more popular among America voters in the next few years. A growing number of skeptics are reminding people that "it didn't start with Climategate." (See also, "Global warming is too big to fail.") The deceptive manipulation of evidence and corrupt suppression of dissenting opinions have been staple practices of the environmental lobby since its inception. The foundation of global warming policy from Kyoto to the present day rests upon the scientific consensus of the UN's 1996 IPCC climate report - even though we now know that, following final consensus, the document was secretly altered by a leading alarmists to remove language and evidence casting doubts on man-made climate change. A sample of the redacted language:
"None of the studies cited above has shown clear evidence that we can attribute the observed [climate] changes to the specific cause of increases in greenhouse gases."
"No study to date has positively attributed all or part [of the climate change observed to date] to anthropogenic [man-made] causes."
Rather spoils the whole "scientific-consensus" mantra, doesn't it? But then, suppression of dissent has long been synonymous with universal consent among the petty tyrants of the world.
Further, I don't expect the Democrats to walk away from next November unscathed. While they will likely retain control of Congress, their filibuster-proof super-majority in the Senate will likely vanish.
Hence, the good money rides on a respite in climate change initiatives for at least the next few years. And as the world continually fails to end as continually predicted by the experts, popular opinion will continue to sway against the urgency and credibility of a climate-related catastrophe.