President’s choice to head Medicare

The more I hear about President Obama’s choice to head Medicare, the scarier it sounds.

I know we talk a lot about health care, but it’s a big chunk of our economy and now the President has chosen a man to head up Medicare who is downright scary. Why is Dr. Donald Berwick so scary?

He’s the guy who thinks Britain’s National Health Service is something to be admired. In fact, he says he’s virtually “in love” with it. That’s a little bit scary considering that it’s the kind of place health care rationing meets the “death panel” definition that folks made fun of Governor Palin for talking about.

This is a doctor who says 50% of American medicine today is waste.

Now I’m certain there is waste, but some of what this guy is going to call waste is what you and your family call medical treatment. He’s going to say that the government is here to help you stay away from that waste.

That’s not going to be good for America. It’s not going to be good for health care.

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  • Jim

    In order for the health care reforms to work, health care will need to be rationed. Anyone who doesn’t see this is a fool.
    Rationing is good, as many Americans see their doctors way too often.
    Home remedies are a good way to go for most people and most illness.
    Let the doctors do the heavy lifting and quit running to them with every little imagined ache or pain.
    Rationing will be good for all of us.
    I applaud the Obama healthcare plan.

    • John in Oregon

      Jim. Rationing is not the noble thing your comments suggest.

      All free markets allocate product based on the free choice of sellers and buyers.

      Rationing simply destroys free choice and substitutes the demands of the Government elite for the desires of the people.

      • Steve Buckstein

        John, I like to say that individuals “budget” our own health care dollars, which is a good thing. Government “rations” other people’s health care dollars, which as you suggest is not a noble thing.

    • Steve Plunk

      Jim, When HMOs tried a little rationing in a common sense manner to combat overuse of medical facilities they were called evil by liberals. Why is it now not evil when the government bureaucracy does it? Rationing can take place in the free market through insurance options not available because of government mandates and political pressure. We have not had true free market health care for decades.

      High deductibles, high co-pays, and good catastrophic coverage good cure a lot of what ails us. Without government inefficiency.

      • Rupert in Springfield

        >Why is it now not evil when the government bureaucracy does it?

        Because nothing is evil to a liberal if it results in the expansion of government. They will say anything, do anything, and compromise any moral affectation they may have once manifested to achieve it. Liberals are essentially conscienceless in this regard.

        Example – Remember GITMO?

        Remember the moral outrage of liberals? How funny and righteous they got?

        Well, laugh at them now – As I predicted from day one of this administration, no closing of GITMO.

        Do you see any of the righteous outrage?

        Of course not, liberals have no principles, other than devotion to government. They will prostitute themselves just as much as they pimped out the prisoners at GITMO to achieve their ends.

        Think you will see any straight up condemnation from liberals on this issue they once claimed was an abrogation of human rights? unconstitutional? a war crome?

        Not on your life, they will give Obama a pass because liberals stand for nothing except government expansion.

        • valley p

          “Do you see any of the righteous outrage?”

          Yes, plenty. Read Glenn Greenwald for starters. He has been on Obama’s case over Gitmo for a long time. As have been many others.

    • mary’s opinion

      I wonder how old you are. If you’re young and healthy – wonderful. But are you ready to have treatment rationed or denied to your parents or grandparents?

      I was very recently at the local ER with a person who had had a stroke. As we waited for him to have his turn with a doctor (4.5 hours), I saw folks who perhaps should have waited until morning and gone to the local urgent care clinic.

      Sometimes folks do go to the doctor too often or for little reason so I’ll agree with you there.

  • John in Oregon

    Free markets allocate products every day based on price, willing sellers and willing buyers. When price is high willing buyers choose not to buy and willing competitors see an opportunity to enter the market and produce lower cost product.

    The vibrant cell phone market is an example, with an array of products from simple low cost phones with large buttons for the elderly to more costly highly complex devices.

    But for Obama, Pelosi, and Reed some markets are too important to be in the hands of buyers and sellers. For statists such as Obama, Pelosi, and Reed markets must be operated by “leaders with plans,” who will make the correct choices for the people.

    Dr. Donald Berwick is a perfect fit to the statists wet dream. Berwick has said that the people must not be allowed to believe in “market forces.” He tells us he is the “leader with plans.” He is the man for the position of Doctor Stands in the Door of the exam room. The administrator who decides who may pass and who shall not. The administrator who will “redistribute” health.

    In the health care system willing buyers and sellers have a special name. They are Patients and Doctors. When Obama, Pelosi, Reed, and Doctor Stands in the Door oppose market forces they oppose Patients and Doctors.

    Doctor Stands in the Door will make the decisions for millions of patients. He has no need to consult the patient or look at any medical chart. The patient who finds a doctor which has a different opinion is irrelevant. Doctor Stands in the Door’s decision is final with no appeal.

    For statists such as Obama, Pelosi, Reed, and Doctor Berwick it is no accident that a thesaurus synonym for control is the word Government.

    • dartagnan

      Conservatives just adore these simplistic “free market” analogies, but typically — as in this case — they don’t hold up.

      Your cell phone analogy is flawed because there is no “free market of willing buyers and sellers” in health care. Patients who need a life-saving medication or surgical procedure do not realistically have the option of “choosing not to buy,” and there is no meaningful price competition among physicians, hospitals and other health care services. Patients also do not have the highly specialized expertise necessary to shop around and make informed health care purchases, so typically they do what their doctors tell them to do.

      Analogies like the one you presented are an insult to the intelligence of any rational person.

  • Bob Clark

    The whole end game of healthcare reform may have been to largely cut the government’s unfunded medicare liabilities. A much more efficient way of doing this would have been to phase in a means test for medicare reimbursement. But instead we get a 2,700 page Obama Care blob, which will no doubt escalate private health insurance premiums even faster than otherwise. Another nightmare brought to you by the Dumocratic party.

  • dartagnan

    We already have rationed health care in this country. The difference is that it’s rationed according to money instead of according to need.

    Take our former vice president. He just had a special auxiliary pump implanted to keep his failing 69-year-old heart ticking a while longer. The technology is considered experimental, so insurance companies won’t pay for it. But because Cheney can pay for it himself, he’s still alive. I’m also betting he’ll eventually get a transplant, even though there are younger and healthier candidates who should be a higher priority. Why? Because he has money and connections.

    The money being spent to keep this one old man alive could probably provide basic health care services to a thousand children.

    Now take the example of my niece’s husband in Britain. For many years he has had a severe chronic digestive disorder for which he has had more surgeries and hospitalizations than I can remember, all covered by the National Health Service. If he was a US resident he would be dead by now.

    Resources are not infinite, so we will always have “rationing” of health care in one way or another. The only question is what criteria we use.

    • Steve Plunk

      If he were a US resident he probably would have been cured by now. The British system is inhumane and inefficient.

      • Anonymous

        “If he were a US resident he probably would have been cured by now.”

        Steve, most chronic digestive disorders (coeliac disease, crohn’s disease, IBS) are not curable.

        “The British system is inhumane and inefficient.”

        What an empty remark! Are you suggesting the U.S. system is humane and efficient? (Now there’s a joke for you.) I’d bet that 9 out of 10 brits would tell you they love the NHS, and if the UK government tried to dismantle the system there would be riots.

        • dartagnan

          “Steve, most chronic digestive disorders (coeliac disease, crohn’s disease, IBS) are not curable.”

          Exactly. The disease my niece’s husband suffers from is ulcerative colitis. I’m always amazed at how willing some people are to pop off when they know nothing about the specifics of the case.

          Oh, and another thing: Because of Britain’s generous medical leave policy he and his wife have been able to hold onto their house although he hasn’t been able to work in about two years. If they were in the United States they most likely would be bankrupt and homeless.

          • Steve Plunk

            I didn’t ‘pop off’. You speculated he would be dead if he lived in the US. That’s not based upon any facts but merely your guess. Make wild accusations like that and you should expect a retort like you got. I see you’re still making speculative predictions that are baseless.

            When you’re ready to debate with reason and facts give it try.

          • dartagnan

            It was based on my knowledge of his medical condition and the treatment he has needed. It’s a lot less “speculative” than your assertion (based on nothing) that he “probably would have been cured” if he lived in the US — especially considering that he has an INCURABLE disease.

          • Steve Plunk

            You said he would he would be dead by now if a US resident. How is that any less speculative? You can’t have it both ways in a debate. You can’t speculate yourself and then criticize others for playing your game.

            My statement was a defense of the US medical care system versus the UK. I’ll take this one over theirs any day. We can debate the merits and flaws of each system but to take a single person’s illness and use it to indict the health care of the US was illogical and baseless. My sympathy to your niece’s husband but it was simply irresponsible of you to claim he would be dead if he lived here.

          • dartagnan

            Okay, okay, maybe he wouldn’t be dead. I believe he PROBABLY would be dead … and if not he most certainly would have been bankrupted by medical bills. Satisfied now?

  • valley p

    “He’s the guy who thinks Britain’s National Health Service is something to be admired.”

    Maybe that is because they deliver good health care to every citizen at half the cost of the US. Try finding a Brit who would exchange systems with us.

    “This is a doctor who says 50% of American medicine today is waste.”

    That might explain why our costs are twice the cost of other nations that have as good or better care than we do.

    John writes: “All free markets allocate product based on the free choice of sellers and buyers. ”

    Yes, based on ability to pay. Few have the ability to pay for the care that Dick Cheney is currently getting, paid for by the government by the way. 20% of people use 80% of medical services. There is no way that 20% could afford to pay for this in a free market. And given that as a modern society we have chosen to not let (most) people simply die in the streets, we have to find a way to socialize the expense. We do this primarily through work related insurance, but there are a whole lot of people at any given time without jobs, or with jobs that neglect to provide insurance. This is a system with too many holes, and it is too expensive for what it delivers, which is why it was just reformed.

    Comparing health care to cell phones? This is what gets free market fundamentalists into trouble.

    Steve P writes: “If he were a US resident he probably would have been cured by now. The British system is inhumane and inefficient. ”

    Or dead by now if he lacked insurance due to having a pre existing condition.

    • dartagnan

      “Try finding a Brit who would exchange systems with us.”

      “44% of Americans are very dissatisfied with the availability of affordable healthcare, and nearly three-fourths (72%) are either somewhat or very dissatisfied. The 44% in the United States who are very dissatisfied with healthcare availability is significantly higher than corresponding figures in either Canada (17%) or Great Britain (25%).” — Gallup poll, 2003.

      The number of Americans who are dissatisfied with the health care system probably is much higher now.

  • Bob Tiernan


    In order for the health care reforms to work, health care will need to be rationed.

    *Bob T:*

    Beware of programs that require such rationing in order to work.


    Anyone who doesn’t see this is a fool.

    *Bob T:*

    Anyone who sees this and still supports it is a fool.

    Bob Tiernan
    NE Portland

    • valley p

      “Rationing” is in the eye of the beholder. 40 million Americans sans insurance is a form of rationing, and they are the ones presently rationed out. A good chunk of the population (i.e. military, vets, over 65, and poor) get fully paid or subsidized coverage. Make it ALL free market or extend insurance availability to everyone. Don’t make it free market for some and not others, because the others end up paying for the some, and that ain’t fair.

      Ron, health care economics experts have been analyzing and commenting on government coverage since day one. You haven’t been paying attention. There were varying analyses on your question of projected future cost to consumers by bringing more people into the pool. All that has been factored in. How it all comes out remains to be seen.

  • Ron Marquez

    Interesting reading about Dr. Berwick from an article by Daniel Henninger in the WSJ.


    I’d like to hear somebody knowledgeable in healthcare economics comment on how government mandated coverages impact the cost of healthcare. Specifically, how much do the mandates increase the premium cost to the consumer.

  • Rupert in Springfield

    The thing to not lose sight of here are the totalitarian impulses from the administration and understand that it is not a symptom of just the administration, but unchecked liberalism itself.

    Democrats thought they had been given Carte Blance by the election, and thus felt free in revealing their true selves – people who cared about running the lives of others, raw power for its own sake and not the good of the country. The result was skyrocketing deficits, our foreign policy a disaster with Europe as the recent G20 summit showed and a domestic populace that, were the option of a “do over” election available, would probably jump at the chance.

    With health care they insisted on forcing through an unpopular health care bill that will explode the deficit since we all know a big chunk of its costs were contained by future Medicare cuts that won’t happen. It was practically spelled out that Obama didn’t care what sort of health care legislation he signed, just that he wanted something, anything. The clear implication being that he really didn’t care about the plan itself, just the power over peoples lives that would come from it. Well, he got it, and people don’t like it.

    Did Democrats learn? Yes, in a sense.

    They installed this guy Berwick in a recess appointment because they knew that no one who was in love with the most flawed national health care system out there, the British one, was going anywhere on confirmation. The horrendous nature of the British system is both well known and of such a profound level that most will remember that Hillary Clinton, when she was charged with devising national health care during her husbands tenure, went to great lengths to point out that the British model was to be avoided.

    Berwick apparently didn’t pick up on that back then as he still is a fan of the system even most socialized health care fans studiously eschew. Did it occur to the administration that maybe nominating a loon was not a good idea? Probably, but they wanted their guy in there so it was damn the torpedoes all the way with a recess appointment. That should, and clearly has, given pause to a populace already concerned with the roughshod way Democrats have operated the past 18 months.

    So the bottom line here is given the way Democrats have approached this matter, as well as many others, there is little reason to believe that health care will be run in any different, or less dictatorial, manner. The comparison between national health care and the DMV is often made – with the way Obama care was passed, and now the way it is to be administered the comparison is now more relevant than ever.

    With their “screw you” attitude towards the American people its easy to see why Democrats are in such trouble.

    This appointment, along with other recent events, makes clear the intentions – to continue the scorched earth policy as long as possible to get away with as much as possible before the elections. With that on full display Americans are ever more wary of every utterance from Washington. Distrust of the administration in particular, and Washington in general, is rampant That’s one of the few bright stars out there, and it is most assuredly a good thing.

    • valley p

      “The thing to not lose sight of here are the totalitarian impulses from the administration and understand that it is not a symptom of just the administration, but unchecked liberalism itself. ”

      Are you really this delusional or is it an act? If its an act, its a good one, I’ll give you that.

      • Rupert in Springfield

        You are seriously going to contest this point? Would you care to also argue from which direction the sun rises?

        That liberalism tends to totalitarianism is pretty much a truism, I cant believe even you would have contention with that.

        Oh well, here we go, shootin’ fish in a barrel time with Dean

        Liberalism is generally totalitarian in nature as it tends towards Socialism. Thus no coincidence that the past centuries the vast majority of totalitarian countries – USSR, China, North Korea, Cambodia, Nazi Germany have all been countries with a Socialist as well as genocidal bent.

        Liberals generally excuse and triumph totalitarian regimes at any opportunity.

        Example one – Who excused the horrors of Socialism and Communism? Conservatives? Hardly. When Reagan said “Mr. Gorbachev, Tear down this wall”, liberals threw a hissy fit, angered by Reagan, conservatives cheered him.

        Example two – Cambodia? Liberals loved the Khmer Rouge until the killing became all to obvious. When we left Cambodia liberals actually believed the Khmer Rouge was not a killing machine.

        Example three – The UN – Liberals in this country love the UN, conservatives tend to hate it. Who populates the UN? Largely dictators. Who is it that is angered when the US does not accede to the UN, liberals.

        Example four – The UN funded Pol Pot into the eighties, well after the killing fields were known. The single biggest genocidal murderer as a percentage of population in modern history and the UN funded them. Are liberals outraged at that? Of course not, they were too busy hating Reagan.

        Example five – The WHO (World Health Organization), a UN organization that liberals tend to love, lauds the North Korean health care system.

        Keep in mind, in North Korea, surgery is generally performed without anesthesia and amputations are usually done with a hack saw. But, they are praised by WHO. Why? Because so long as it is centrally controlled thats all that matter to liberals.

        Example six – You yourself have admitted you would like more Socialism as part of the mix in this country. Since Socialism is more totalitarian than Capitalism is by definition then you would be exhibit one presented for evidence.

        Example seven You again – you laud the British health care system. A system so failed even Hillary Clinton said should not be emulated here, as noted above.

        So, obviously I am not delusional, but probably you are, since you seem to have forgotten your own words which hung you here.

        Oh well, better luck on your next ill thought out pop off!

        • dartagnan

          “That liberalism tends to totalitarianism is pretty much a truism”

          You saying that something is true doesn’t make it a truism, Rupe. Incredible as that may seem to you.

          “Oh well, here we go, shootin’ fish in a barrel time with Dean”

          Hmm, that expression is very familiar. You wouldn’t happen to be “Coyote” from “NW Republican,” would you?

        • valley p

          OK, you have confirmed you are delusional. Or at best intellectually confused.

          You mix up “liberalism,” which by definition is the antithesis of anything totalitarian, with extreme left, which can manifest itself in totalitarian communism, or private property free anarchism, or various forms of socialism that are hardly totalitarian. The argument about Nazi Germany being a creature of liberalism is so ridiculous it does not merit a counter argument. But you should at least honor those few Germans who actually resisted Naziism, who came from the Social Democratic Party and were nearly all “liberals.’

          You ignore the long history of liberalism here in the US that extended freedoms and basic citizenship rights to women, Indians, Orientals, African Americans, and gays among others. You somehow draw a line from the 40 hour work week, ending of child labor, provision of social security, expansion of health care, and other liberal projects to a complete takeover of everything. Its Glenn Beckish of you. He is cynical about it and makes money peddling this nonsense. You simply bloviate for free about it. Or are you angling for a paid gig? Is that what this is about?

          Your examples are nonsense. Liberals supporting Pol Pot? Please. The UN? The fact that some UN member states still have dictators is the fault of liberals? Eeek. You can’t be serious.

          My support for more socialism in this country means I support totalitarianism? So you prove your initial nonsensical claim, that liberalism leads to totalitarianism, with a supporting claim that since liberals like Dean support expanded health care or stronger unions or higher taxes on rich people, that means he supports totalitarianism. This is beyond ridiculous.

          But if you want to play that game, ok. Lets draw a similar line between conservatives and dictatorship.

          South African apartheid, supported by the Reagan Administration, opposed by liberals.

          Nazi Germany, supported by racist right wing radio jocks like father Coughlin and conservative industrialists like Henry Ford, opposed and defeated by liberals like Roosevelt and Truman.

          Saddam Hussein, supported and armed by the Reagan Administration (while he was giving speeches about tearing down walls).

          Ayatollah Komeni, supported by Reagan with arms.

          Pinochet, brought into power with the help of the Nixon Administration.

          Torture and holding prisoners without charge or trial, supported by you, Dick Cheney, and every “conservative” Republican in Congress other than Ron Paul.

          Francisco Franco, totalitarian dictator of Spain and torturer. beloved and defended by William F Buckley, who also defended white racists and denial of civil rights in the United states.

          Now since you have stated may times your admiration for Buckley and for torture, how hard is it to conclude that you also support totalitarian dictatorships? Not hard by your own twisted logic.

          And by the way, I don’t “laud” the British Health care system. Among the models out there, it is one I would not recommend adopting, even though it is better than ours in a number of ways. The French model, Medicare for all with supplemental private insurance as an option, is the best.

          As for fish in a barrel, you my friend, taking careful aim at the barrel at close range with a shotgun, would instead hit your own foot.

          • Rupert in Springfield

            >You mix up “liberalism,” which by definition is the antithesis of anything totalitarian, with extreme left,

            No I don’t. You are trying to do the old liberal trick of “conflating”.

            This is a good illustration of one of the more rudimentary tactics liberals take – to claim another is “conflating” or in this case “mixing up”. This the allows you to substitute another argument for the one at hand. Obviously this is an incredibly easy tactic to defeat, the mystery being why liberals continually try it. It never works and weakens the liberals argument because he is instantly shown to be dodging the issue.

            So lets not do the childish mix up thing, lets stick with the topic at hand and hang you by tyour own words, again. OK?

            Here we go.

            Liberalism in this country, and how it is discussed here in common parlance is the left wing of the Democratic party. It is that group who tends more towards a Socialist mix and you yourself have defined it as that in the past. Now you run from your own words.

            Liberalism in terms of its outlook may also be judged in terms of that which it finds coincidence with – if we look there we find the appalling behaviour I cited above.

            You might want to run from what you are – but as I said before, your own words hang you.

            It is for that reason – that you yourself have said on numerous occasions that liberals would like more Socialism – and the fact that it is on the verge of a truism to say liberalism tends towards totalitarianism since liberalism by definition encourages stronger centralized government control – that I am amazed you would even argue the point.

          • valley p

            “It is for that reason – that you yourself have said on numerous occasions that liberals would like more Socialism – and the fact that it is on the verge of a truism to say liberalism tends towards totalitarianism since liberalism by definition encourages stronger centralized government control – that I am amazed you would even argue the point. ”

            More socialism? Yes. Infinite or extreme socialism? No. Denmark, not the USSR ok? Get it? Is Denmark totalitarian? No. Is it any more totalitarian than the US? No. How can this be if it is more socialistic? Because the Beck/Rupert theory is hogwash. It is dis-proven by fact. An entire European Union is more socialistic than the US but no more totalitarian. Case closed.

            Does Denmark sanction torture? No it doesn’t. Does it lock people up without charge and hold them for years? No. Does it have anywhere near the proportionate jail population we have? No again. Do they have capitalism? Lots. A more free version of it than we have in many ways. Do they have a more centralized government? Maybe, but they only have 5 million people so there isn’t as much need to decentralize.

            I’ll sum it up this way. I’d rather be a liberal and be associated with our accomplishments than be a conservative and part of the movement that has resisted every effort to expand human and civil rights in this nation, and continues to do so every day of the week.

            And why did you like Franco Rupert? You didn’t bother to answer that one.

          • dartagnan

            Franco’s Spain had a capitalist economy and a totalitarian government. Nazi Germany and Fascist Italy had capitalist economies and totalitarian governments (and please don’t try to feed me any nonsense about Nazis being “liberals”). Pinochet’s Chile had a capitalist economy and a totalitarian government. Today’s China has a capitalist economy and a totalitarian government. Many, many other examples might be given.

            OTOH Japan and the nations of western Europe have what Rupert would call “socialist” economies (they’re really not socialist, but I’m not going to quibble about that now) and are representative democracies whose citizens enjoy political freedom.

            Capitalism is not a political system; it is an economic system. It is not synonymous with “freedom” or “democracy” and is perfectly capable of co-existing with totalitarianism. In fact it often seems to prefer it.

  • John in Oregon

    dartagnan as much as you complain that free markets are simplistic, the statist view is much more childish and sinister. That is the view that if only we had a progressive in charge then things would be equitable and fair.

    I will paraphrase Milton Friedman to answer. “The world runs on individuals pursuing their separate interests. … In the only cases in which the masses have escaped from the kind of grinding poverty … they have had capitalism and largely free trade. … So that the record of history is absolutely crystal clear: that there is no alternative way so far discovered of improving the lot of the ordinary people that can hold a candle to the productive activities that are unleashed by a free enterprise system.”

    And who will be those progressive leaders with plans? Friedman asked “Is it really true that political self-interest is nobler somehow than economic self-interest? … Just tell me where in the world you’re going to find these angels who are going to organize society for us? I don’t even trust you to do that!”

    Phil Donahue had no answer for Friedman because there is no answer.

    As to the larger points of which you made three. The second first.

    > *Patients also do not have the highly specialized expertise necessary to shop around and make informed health care purchases, so typically they do what their doctors tell them to do.*

    Translation: People are dumb so they need an administrator to tell them what to do. Clearly you did not intend to put it that bluntly. Just the same that is the meaning.

    Clearly some patients may choose to do what an administrator demands. They have that choice. Having faced ATN up close and personal its not the choice John Nolte made. Choice is the operative word. Dr. Berwick the administrator offers NO choice. Your choice is what he chooses for you. Never more and often less.

    As to the first point. > * there is no “free market of willing buyers and sellers” in health care. Patients who need a life-saving medication or surgical procedure do not realistically have the option of “choosing not to buy.”*

    Unfortunately, today, that statement is quite true. Under Government lesscare you get what the Government chooses. You get only the care your Government allows. And you don’t even get the option to not choose. You choose the Governments choice or a ticket to jail.

    Prior to Obamacare the government only controlled 67 percent of the US health care system. People could budget their health dollars. Two popular choices were high deductible insurance and out of pocket for day to day care, often at a convenient care setting for one third to one half the cost of a doctors office. Another was HSAs.

    Now where are some interesting points here. Isnt it interesting that convenient care facilities actually earn a profit and pay taxes?

    Isnt it interesting that people make that choice to get better care at less cost?

    Isnt it interesting that politicians point at these very people and say OHHHH MY GOD THEY AREN’T INSURED, THEY ARE ALL GONNA DIE!!!

    AND isnt it interesting that in order to FIX THIS DISASTER the politicians found it necessary to FORCE those people to buy the government solution?

    If the Government solution is so good why is force necessary? Oh I get it. Because people are stupid and need the government to run things. Doc Berwick told us so and he must know.

    Lastly. As to the cell phone example being stupid. I chose that example quite deliberately. I chose that example because at one time the US had a government controlled telephone system. Don’t remember that? Well back in 1980 I could get one government approved telephone connected to government approved wires which connected me to a government approved company. Just think, for only $79, less taxes, a month in today’s dollars I could call anywhere in the lower 48 for only $5,30 a minute. WOW that Government telephone plan was such a deal wasn’t it?

    Those who think the government telephone plan was no big thing should rent a copy of the movie “The President’s Analyst” to get an idea of peoples feelings at the time. James Coburn plays an analyst for the president who gets caught up in spy intrigue involving the KGB, US agents, Canadian spies and more. At the end Coburn meats the real power in the form of TPC agents. The closing scene is the TPC automatons smiling approvingly at the world they run. Ohhh I forgot. Who is TPC you ask. Well, my friend TPC is “The Phone Company.” Which gives you some idea what people thought of the Government telephone plan.

    Very often one can get a feel for the “zeitgeist” the spirit of the times of the peoples thinking simply by looking at the expressions in use. I suspect this is one of those times. Beginning some 8 weeks ago even the legacy media has taken up the slang “The Great Recession”.

    • Steve Buckstein

      John, readers might like to see and hear Friedman talking about greed with Phil Donahue. The 2:24 minute video is at:

    • John in Oregon

      Thanks Steve, I agree. Seeing the full clip will allow viewers to see Phil Donahue make his side of the argument to which Friedman responds.

      Its also worth a few minutes to read John Nolte’s thoughts in “After Facing the Very Worst of Our Healthcare System”. Nolte blasts some he dealt with in the system, referring to Dr. Clueless, Dr. Useless, and Dr. Deserves-To-Burn-In-Hell.

      It wasn’t Nolde’s primary point but I did notice one money quote when he said;

      “But the mistake I made was in not taking charge. Stupidly and lazily I trusted that everyone would do their jobs, do what they were supposed to do, and because of that – because I was too unassuming and unwilling to challenge and question and push – things were much more difficult than they had to be.”

      That brought home to me the importance of patients having and using their voice. His comments can be found at

      • valley p

        John and Steve, how does uncle Miltie explain Denmark or the Netherlands or Germany? All have capatalist economies happily co-existing with progressive liberal government policies that set lots of rules (work week, benefits, vacation time, child care) and yet have plenty of freedom and creativity.

        The binary choice both of you promote here, capitalism or socialism, is nonsense. There are plenty of middle ways. The health care reform that we just passed is a middle way. It maintains the mostly private sector insurance system but establishes a new set of operational rules. Much like Germany and the Netherlands have done for years.

        • Steve Buckstein

          Middle way? Here’s what then Czech finance minister and now Czech Republic President Vaclav Klaus had to say about what he called “the third way” while on a trip to the US in 1990:

          “The message is the same for whatever group. We want a market economy without any adjectives. Any compromises with that will only fuzzy up the problems we have. To pursue a so-called Third Way is foolish. We had our experience with this in the 1960s when we looked for a socialism with a human face. It did not work, and we must be explicit that we are not aiming for a more efficient version of a system that has failed. The market is indivisible; it cannot be an instrument the hands of central planners.”

          It’s from an interview at:

        • John in Oregon

          Steve’s answer is spot on and probably better than mine. However I would add.

          We are presently seeing the collapse of the European welfare state. Greece is gone and being followed by Spain and Portugal.

          Don’t think that collapse hasn’t been noticed. Chancellor Merkel in Germany is cutting spending. France is steering a new course. The UK put Prime Minister David Cameron in charge to cut spending. In Canada Prime Minister Harper said NO to spending.

          At the last G8 / G20 Obama was told in no uncertain terms NO.

          I suspect that was quite satisfying for Harper after the White House released the photo of Obama lecturing and wagging his finger in Harper’s face.

          But Harper gets the last laugh. From an all time employment high in 2008 of 17.2 million Canadian employment fell to a low of less than 16.8 in 2009. Well the latest information from Canada is employment is now nearly back to the all time high at 17.1. Imagine that, and none of Obamas spending either.

      • Steve Buckstein

        Thanks John, that story by Nolte is heartbreaking, but instructive. Those who believe “public servants” would manage our health care system better than “Dr. Clueless”, “Dr. Useless”, and “Dr. Deserves-To-Burn-In-Hell” would do well to study a little public choice economics.

        People are people, whether in the private or public sector. Replacing one set of less-than-perfect private individuals with less-than-perfect public employees is no formula for health care nirvana; it’s a formula for moving decision-making much farther away from the individuals whose lives are being planned and controlled. Nolte was able to navigate the private system and get real help for his wife. In the looming government system he worries that even if he could navigate it, the breakthrough technology he found would never even be invented because it didn’t fit the bureaucrat’s vision of “progress.”

        • valley p

          “We want a market economy without any adjectives.”

          Too bad for him and you there is no such thing. And isn’t it ironic to bring up the Czech Republic, which is quite “middle way,” including a universal health insurance program, a terrific public transit program, a new subway in Prague, multiple new highways financed by the EU, and a lot else that is pretty socialistic.

          “We are presently seeing the collapse of the European welfare state.”

          In your dreams. We are seeing adjustments made necessary by an economic recession, and in the case of Greece a pretty corrupt system that, as Angela Merkel will remind you, FAILED TO COLLECT TAXES OWED. Had Greece simply collected the taxes owed they would have had no financial crisis.

          “But Harper gets the last laugh. From an all time employment high in 2008 of 17.2 million Canadian employment fell to a low of less than 16.8 in 2009. Well the latest information from Canada is employment is now nearly back to the all time high at 17.1. Imagine that, and none of Obamas spending either. ”

          Yes, imagine that. And imagine that Canada has a highly regulated financial sector that did not take part in the risky investments ours did that brought the house down, so they never had the unemployment run up we had in the first place. And imagine they have a highly socialized health insurance system that costs 1/2 of ours, and they spend a fraction of what we do on defense, leaving them in much better financial shape than us. Go Canada eh?

  • John in Oregon

    Steve I agree that Nolte’s major point is exactly as you put it ‘the breakthrough technology he found would never even be invented because it didn’t fit the bureaucrat’s vision of “progress”.’

    The barrier of the bureaucrat’s “vision of progress” is but one edge of a double edged sward. The trailing edge is just as sharp and every bit as destructive.

    In order to defray the costs of bringing a new treatment to market, wide distribution of the treatment will reduce the cost per patient. Just as they do today in the UK and Canada the bureaucrat will reject the treatment as “costly”.

    Since the US population is so much larger the UK and Canada can successfully wait until Americans amortize development costs before allowing the treatment. Once the bureaucrat closes the American market even those new treatments that pass the bureaucrats “vision test” will die for lack of funding.

    VP your answer to my mention of the collapse of the European welfare state was, uh,,,,, interesting. So the bankruptcy of Greece, Portugal, Spain, Iceland, ETC are merrily “adjustments”. As you say the only problem is not taxing enough.

    But you are correct about one thing. The Canadians didn’t have rules that required no income lending and didn’t have rules that required Canadian Banks to invest in Fannie Mae and Freddie Mac derivatives. Then you didn’t mention that the Canadian Supreme Court ruled the Canadian socialized health insurance system violates the Canadian Constitution, because access to a waiting list is not access to care. Which explains why Windsor Ontario heart attacks are treated across the border in Detroit Michigan.

    I really liked your ethnocentric view of Canada. They didn’t loose as many jobs as the US did. Well duahhhh, the Canadian population is about 10 percent of the US. Canadian job loss was no less ugly than the south 48.

    Still you can’t think of anything that is destructive to job creation. Not one thing. Well let me help.

    > Overturning bankruptcy law to exclude bond holders with collateral in favor of those with no claim.

    > Huge tax increases in less than 6 months.

    > Bullying a company without statutory or constitutional authority for a $20 billion slush fund while overturning the rule of law.

    > How about a fine of 55% of revenue for White Castle a company that provides health insurance. Color those jobs gone.

    > Or the IG report that 100,000 lost jobs because dealerships were closed to meet Obamas mandate for shared sacrifice.

    Would you like more?

    • valley p

      “VP your answer to my mention of the collapse of the European welfare state was, uh,,,,, interesting.”

      No. It was “in your dreams.” The European welfare state is in no danger of collapsing. Some European states are having to cut back due to the current economic conditions. And yes, in Greece’s case the core problem was a failure to collect on taxes owed. Look it up.

      In Spain’s case, it is like the US in Arizona and Nevada. A huge real estate bubble based on sun and sand, not on a productive economy. In Iceland’s case their banking sector took in huge outside deposits, mainly from the UK, and had nowhere near the capacity to make good when the bill came due. Spain and Iceland were both free market failures. And you left our Ireland, also a present basket case not due to its welfare state but due to an over heated real estate bubble. You probably left Ireland out because you yourself were touting it last year as a great example of how an economic boom happens when you lower corporate tax rates. Some boom.

      European welfare states like Germany, Denmark, the Netherlands, Norway and Sweden tax plenty and they are doing pretty well comparatively.

      Unemployment is relative. Canada did not experience the PERCENT change in unemployment we did. Duh John.

      Your analysis is weak. There haven’ been any huge tax increases. Obama cut taxes as part of the stimulus. BP was “bullied” into paying compensation to its victims. I am shedding no tears for them. I don’t know about White Castle, but they have he worst burgers in the known world. If they are going down, the health improvements alone will more than pay for the job losses.

      Blaming lost dealership jobs on Obama is funny. If he had not acted there would be ZERO GM and Chrysler dealerships in business today. And you and other free market fundamentalists would think that was just fine.

    • Steve Buckstein

      John, thanks for pointing out the other edge of the sword dealing with how costs for new medical treatments are reduced. If America has been a driving force of new treatments and cost reduction, nationalizing our health care system will quickly dry up those benefits.

      As we watch people from around the world come here for the health care they can’t get at home, we should be concerned that once America’s system looks just like that of other “developed” countries, where can we go when we can’t meet our needs here at home?

      • John in Oregon

        Steve, I haven’t looked at this subject for a while. Most of the information is organized for other purposes so its utility is suggestive rather than quantitative. Here is what I found.

        > The Nobel Prize in medicine or physiology has gone to American residents more often than recipients from all other countries combined. In only five of the past 34 years did a scientist living in America not win or share in the prize.

        > Of a group of highly important medical innovations;
        >> 70% had a US origin. The next closest is;
        >> 30% in which the UK was involved.

        >> 38% were of exclusive US origin.
        >> 23% were exclusive of all foreign countries combined.
        >> 7% were exclusive to any single foreign country

        > In terms of clinical research and trials the 5 largest US hospitals conducted more trials than all hospitals in any other country.

        > The most recent study concludes that the average R&D cost of for a new drug is $802 million.

        I have noticed the growth of drug and medical device manufacturing in developing countries. These growing companies concentrate in expired patent products for which development costs were paid by others.

        All this is suggestive that the US health care system is central to new and innovative treatments.

        I haven’t seen any analysis of the medical products contribution to US foreign exchange. It will be a shame to export those jobs and loose that expertise. The ripple into academia has got to be large. Worse I see no one on the horizon to pick up slack. India, possibly?

  • John in Oregon

    OK if you didn’t like my first response to your fantasy that the European welfare state isnt collapsing; Feel free to pick one of the following multiple choices.

    Then your answer was uh,,,,, uninteresting.
    Then your answer was uh,,,,, silly.
    Then your answer was uh,,,,, irrational.
    Then your answer was uh,,,,, myopic.

    What part of Huge tax increases in less than 6 months did you not understand? That’s huge tax increases in 22 weeks. Huge tax increases in 162 days. Does that help?

    However since you slammed Arizona, you might consider the news from The Arizona Republic. A news item indicates that State and university employees with families can expect to see their monthly health-insurance costs rise as much as 37 percent next year. Health plans for families and single adults with children will shoulder the most-expensive monthly premium increases beginning Jan. 1. Single individuals will pay modest increases.

    ‘The Department of Administration cited federal health reform as the reason the state’s health plans will carry “greater expenses and higher premiums for members,”‘

    Figures provided by the Arizona Department of Administration show ‘two provisions that the state expects will drive health-insurance costs higher. One is a [Obamacare] requirement that insurance plans provide coverage for dependent children up to age 26. The other is the federal legislation’s ban on lifetime limits.’

    As to changing the Canadian information, I am preparing to forward your corrections to Statistics Canada. It would help if you would provide a picture of your wagging finger so the Canadian Government truly understands the error of their ways. If however you would like to actually, you know, look at the offending graph then feel free to go to

    Now you tell us that > *BP was “bullied” into paying compensation to its victims. I am shedding no tears for them.*
    Translation: Overturning the rule of law without constitutional power or statutory authority is OK as long as we don’t like the company or individual.

    And > * I don’t know about White Castle, but they have he worst burgers in the known world.*
    Translation: If leaders with plans don’t like the product its OK to tax a company out of business.

    But the real howler is > *Blaming lost dealership jobs on Obama is funny.*

    You really should read what people tell you. Step By Step.

    1] An Inspector General is a part of the Federal Government.
    2} An Inspector General is a watch dog of government operations.
    3} The TARP legislation established an Inspector General for the program.
    4] Neil M. Barofsky is a Special Inspector General.
    5] Neil M. Barofsky is the Inspector General assigned to TARP
    6] Neil M. Barofsky has made his report to congress as required.
    7] Neil M. Barofsky in his report stated:

    ‘[W]hen asked explicitly whether the [Obama] Auto Team could have left the dealerships out of the restructurings, Mr. [Ron] Bloom, the current head of the Auto Team, confirmed that the Auto Team “could have left any one component [of the restructuring plan] alone,” but that doing so would have been inconsistent with the President’s mandate for “shared sacrifice.”‘

    Inspector General Barofsky continues.

    (a) should have taken every reasonable step to ensure that accelerating the dealership terminations was truly necessary for the long-term viability of the companies and
    (b) should have at least considered whether the benefits to the companies from the accelerated terminations outweighed the costs to the economy that would result from potentially tens of thousands of accelerated job losses.
    The record is not at all clear that Treasury did either. … Treasury’s [The Obama Treasury Department’s] letter seems to imply that Treasury was faced with the decision either to encourage the acceleration of dealership terminations substantially, as it did, or let the companies fail altogether. This is a false dilemma with no factual support: no one from Treasury, the manufacturers or from anywhere else indicated that implementing a smaller or more gradual dealership termination plan would have resulted in the cataclysmic scenario spelled out in Treasury’s response.’

    Yet as the New York Times noted the mystery for White House is where the Jobs went.

    The real question is how any of the administrations actions allow job creation?

    • valley p

      John, you are all over the map here. You love Canada but hate its single payer medical insurance system. You buy into every rumor about what health insurance premium costs will be, ignoring the fact that they doubled in the 8 years prior to Obama’s election. You assume that Obama’s negotiation with BP violated the constitution. If true then let BP make their case, why are you making it for them?

      And my crack about White Castle amounts to give me a break. They are all of a sudden going out of business because of Obama care, which has not even kicked in any extra costs for them yet?

      And these massive tax increases. What are they exactly? Who will pay them? The handful of people who earn over $250K a year? Hardly massive, either in amount or extent.

      And the auto dealership fiasco. You missed my entire point. I’ll try it in all caps for you.


      Did they make some errors? Probably. But the larger error would have been following your and Steve’s advice and letting the US auto industry go belly up. No cars, no car sales. No nothing. Get it?

      What you are doing is armchair quaterbacking. Nothing more.

  • John in Orgon

    You are in no position to make a comment about my romantic life. My romantic feelings are mine not yours to comment about.

    As to Canada, they have pursued a financially responsible course for nearly a decade. Credit given where credit earned. The Canadian health care system, not so much. Discredit where discredit is due. All over the map? Nope, just reality on the ground.

    Then you go off on “the rumor” about what health insurance premium costs. I thought that we already tried that political stunt when Senator Chuck Schumer left a brown streak on the floor in his rush to the nearest camera to screech HOW DARE THEY.

    When Rep. Henry Waxman summoned AT&T, John Deere, and Caterpillar to a public hearing and crucifixion at which Waxman intended to draw and quarter. That is until Waxman / Schumer learned the companies were complying with the demands of law and the calculated government extraction was correct. Once said Waxman learned he would be the one eviscerated at the hearings they were canceled. No retraction of the denunciation or correction of the Waxman / Schumer slur, can’t have that.

    Like peas in the same pod Waxman reminds me of Snidely Whiplash. Alike in appearance, temperament and ethics. That is to say Schumer / Wazman have none.

    So about that “premium cost rumor”. Just as with AT&T, John Deere, and Caterpillar, White Castle’s announcement had nothing at all to do with premiums. White Castle simply observed the penalty contained within Obamacare, and noted the number of dollars in punishment demanded by Obamacare. Multiplied by the number of employees that’s equal to 55% of revenue. End of story.

    Yet again you justify distraction of the rule of law by pronouncing BP a bad guy. Why would any one make their case?

    Here in the United States we believe, and the constitution establishes, that no person may be deprived of life, liberty or property except by due process in a court of law. We further hold and the constitution demands equal treatment under law and equal protection of the laws.

    When the blow out occurred BP faced the pending litigation that would determine its liabilities via due process in a court of law equally treated as any alleged transgressor.

    When President Obama bullied BP he did so without statutory jurisdiction or constitutional authority. He simply wrote for himself law, which he then executed as prosecution, defense, plaintiff, defendant, the courts, the judge, and the jury. Such actions ought be opposed whether the subject is ones best friend or worst enemy.

    You attempt to whitewash Obama’s actions by characterizing them as “Obama’s negotiation with BP”. Well he doesn’t have that authority either. The President simply cannot interpose his office between the people and the courts. But was this a negotiation? Lets consult Obama’s own words. In his address to the nation he said;

    “Tomorrow, I will meet with the chairman of BP and inform him that he is to set aside whatever resources are required to compensate the workers and business owners who have been harmed as a result of his company’s recklessness.’ In other words Obama summoned BP to the White House to instruct BP of his punishment decision.”

    Well I do admit that does sound like an Obama diktat, ohh sorry, correction, that does sound like an Obama negotiation.

    Now about the auto dealership fiasco. I didn’t miss your entire point. All caps doesn’t change anything. Shouting only results in gibberish spoken more loudly.

    Look at the simple time line;
    1] Congress made yet another mandated design change. The third or fourth, I have lost track.
    2] The industry said we can’t afford these costs of repeated retooling demanded by the government.
    3] Congress said the demand retooling stands and no loans.
    4] George Bush rushed in and improperly used TARP funds to make loans to GM and Chrysler.
    5} Obama became President.
    6] Obama said the government loaned the money and the administration will run GM and Chrysler.
    7] Obama imagined a statute and appointed a Car Czar.
    8} Obama’s car czar took charge saying don’t do this, do that other thing instead, fire this guy, hire those guys, don’t pay that guy, pay some other guy, drop this model, build the cars that way, put this guy on the board, kick that guy off.
    9] Obama summoned GM and Chrysler to inform them that he, Obama, had decided that they, GM and Chrysler, had decided to go into bankruptcy.
    10] Obama imagined another stature and his car czar wrote bankruptcy decisions.

    All this brings up a series of questions.

    I] Obama rescued the auto industry from bankruptcy HOW?
    II] What statute or constitutional authority gave Obama the authority to run GM and Chrysler?
    III] Had GM and Chrysler gone into bankruptcy without the Bush loans that would destroy the auto industry how? The bankruptcy courts have the experience restructuring large companies and returning them to profitability.
    IV] What gives Obama or the car czar Ron Bloom the authority to ignore the bankruptcy laws?
    V] What statute or constitutional authority gives Obama or the car czar Ron Bloom the authority to make bankruptcy decisions? The constitution states that Congress will write the bankruptcy laws and the courts the authority to administer the laws. The Presidency is given exactly NO role. None.

    So now we are back to the question. The Inspector General report of the Obama / car czar Ron Bloom bankruptcy decision to close dealerships. The IG report said:

    {QUOTE} [W]hen asked explicitly whether the [Obama] Auto Team could have left the dealerships out of the restructurings, Mr. [Ron] Bloom, the current head of the Auto Team, confirmed that the Auto Team “could have left any one component [of the restructuring plan] alone,” but *that doing so would have been inconsistent with the President’s mandate for “shared sacrifice.”* [UNQUOTE]

    So there you have it. Obama wanted to spread the misery around.

    You asked about the tax increases. Here is a partial list.

    The income tax goes up as follows, lowest to highest bracket

    > The $33,950 tax bracket up 50%
    > The $82,250 tax bracket up 12%
    > The $171,550 tax bracket up 10%s
    > The $372,950 tax bracket up 9%
    > The greater than $372,950 tax bracket up 12%

    death tax returns — at a rate of 55%
    The marriage penalty will be reinstated
    The capital gains tax will jump 33%
    The tax on dividends will go up 164%
    The child tax credit will be reduced to half
    Standard deduction for couples reduced by half
    The AMT tax penalty will be reinstated

    The Next Wave

    Savings account withdrawal for medicines disallowed.
    Legal tax deductions disallowed on a case by case basis.
    Medications taxed.
    Medical equipment taxed.
    Tax on gold.
    Expensing business equipment purchases above $25,000, gone.
    The research tax credit gone.
    The deduction for work related tuition and fees gone.
    Teachers won’t be able to deduct their classroom expenses
    Employer-provided educational aid will be restricted.
    Student loan interest deductibility eliminated.
    3.8% tax on real estate transactions

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