American Elephants

Your Government, Hard At Work. Capable of Handling Emergencies? by The Elephant's Child

On  April 20, the BP Deepwater Horizon oil rig exploded in a catastrophe that killed eleven rig workers, and began gushing unknown quantities of oil into the Gulf of Mexico.  On May 11, the State of Louisiana submitted an emergency permit request for a Barrier Concept to the United States Army Corps of Engineers.  From the 12-14 of May, an interagency review meeting was held by the Corps of Engineers.

Do click on the link, and click through the 37 pages.  You don’t need to read any of it, just scan it, and of course read anything you want, but general impressions will do fine.  Note the number of bureaus, offices, agencies represented on page 11.

Here are comments cited as having been received by the U.S. Army Corps of Engineers from those “grievously concerned” about the Gulf Coast ecosystem — so much so that they hope to block construction of barrier isles to block oil from reaching sensitive ecosystems of coastal marshes, wetlands and beaches.  You don’t need to read this one either — just skim it, reading what you choose.

As Chris Horner says “No wonder things got straightened out so quickly.  Imagine if they weren’t flexible in their single-minded determination to do whatever was needed to mitigate the damage?”

This IS Big Government responding to a crisis that is affecting the lives of millions of residents of the Gulf Coast, destroying their livelihoods, and their hopes for the future.  This is how bureaucracy responds. Lots of good, well-meaning government workers doing their jobs, following the regulations, dotting the i’s and crossing the t’s.  Do you suppose they worked around the clock, knowing that time was of the essence?  Do you suppose they struggled to find ways to speed up the process?  This is how bureaucracy works.  It’s that simple, and that deplorable.  It’s also Day 78.

Death Panels? You Betcha! Obamacare is Downright Dangerous to Your Health! by The Elephant's Child

President Obama has nominated Dr. Donald Berwick to head the Center for Medicare and Medicaid Services (CMS).  Like far too many other Obama nominees, Dr. Berwick is a far-left ideologue.  He is in love with the deplorable British National Health Service (NHS).  He is outspoken in his admiration for NHS, and its rationing arm — the National Institute for Clinical Effectiveness (NICE):

“I am romantic about the National Health Service.  I love it,” Berwick said during a 2008 speech to British physicians, going on to call it “generous, hopeful, confident, joyous, and just.”  He compared the wonders of British health care to a U.S. system that he described as trapped in “the darkness of private enterprise.”

One would consider this a clue to his ideology.   He was referring to a British health care system where 750,000 patients are awaiting admission to NHS hospitals.  The government’s official target for diagnostic testing was a  wait of no more than 18 weeks by 2008.  The reality does not come close.  The latest estimates suggest that for most specialties only 30 to 50 percent of patients are treated within 18 weeks.  (That’s over 4 months!)  For trauma and orthopedics patients, the figure is only 20 percent. Overall, more than half of British patients wait more than 18 weeks for care.  Every year, 50,000 surgeries are canceled because patients become too sick on the waiting list to proceed.   These figures come from Michael Tanner, who is a scholar at the Cato Institute, where he specializes in health care.

Obama plans to appoint Dr. Berwick as a “recess appointment,” which means that he doesn’t have to get Senate confirmation.  Whether Obama knows that Republicans would fight confirmation, or whether he knows that a partisan fight would make headlines and revive his increasingly despised health care plan in public attention and increase the number (now over 60 percent) who want the health care bill repealed, we don’t know.  Maybe both.

Under the Patient Protection and Affordable Care Act, the CMS administrator does more than make sure that Medicare and Medicaid pay claims in a more or less accurately and timely fashion.  The office defines the equality of health care for every insurance plan, sets reimbursement rates for physicians in Medicare and Medicaid, and decides what treatments are more “valuable” than others

Berwick would be given control of the practice of medicine. Can he or anyone be trusted with such power?  He believes that “Up to half of the more than $2 trillion that the U.S. spends on health care does nothing to relieve suffering.” In fact, “much of it adds to suffering.” It may not be joyous or hopeful  or configured correctly but for nearly every disease, particularly cancer stroke and heart attacks Americans live longer and healthier than the English because of better care.  Americans spend less time in the hospital, have fewer doctors, and see doctors less often per capita than people in Great Britain.

Dr. Berwick wants to bring NICE-style rationing to this country.  It is not a question of whether we will ration care,” he said in a magazine interview for Biotechnology Healthcare, “It is whether we will ration with our eyes open.” What he considers absolutely essential to reform of health care is government control over health care spending, not just for government programs but by patients themselves.  If the government refuses you a drug you are willing to pay for, and you can pay for it yourself, too bad, you’re out of luck.   The hallmarks of proper financial management in a system,” he wrote,  “are government policies, purchasing contracts or market mechanisms that lead to a cap on total spending, with strictly limited year-on-year growth targets.  That way “rational collective action overrides individual self-interest.”

Through NICE, the British government has put an effective dollar amount on how much a citizen’s life is worth.  Each year of added life is worth approximately $44,305.  This is a general rule and the agency has occasionally approved treatments costing as much as $70,887 per year of extended life.  For Dr. Berwick, this is exactly how it should be.  “NICE is not just a national treasure, it is a global treasure.” That is the voice of an ideologue, able to look casually on all sorts of  cruelty and killing in the name of the ideal he holds pure and ‘joyous’  in his dreams. We saw examples of that type in the old Soviet Union and in Red China. For in Britain, people are being killed every year by government denial of service, or or by the long wait for care, or by the poor caliber of care.

Jeff Jacoby of the Boston Globe says:  ” But if Berwick’s credentials cannot be doubted, neither can his ideological commitment to centralized state power over health care, or his disdain for the ability of markets and competition to improve the quality and lower the cost of medical services.  Here are some recent headlines from British papers that give a sense of the coverage.

“Overstretched maternity units mean mothers face a 100-mile journey to have baby.’’

“Hundreds of patients died needlessly at NHS hospital due to appalling care.’’

“Cash-strapped NHS trust introduces rationing for common children’s conditions.’’

“Standard of care in some wards ‘would shame a third world country.’ ’’

“Stafford Hospital caused ‘unimaginable suffering.’ ’’

So, if you plan to get to be old, or if you get to be poor, which may happen to most of us, you really need to go to work to get Obamacare repealed.  Because this is what the headlines will be in this country in a few years.

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