JDD,

True! And I guess it is not stopping me now. Let me say at the outset that the very first claim in the NRLC document is a complete and total misrepresentation of what the law actually says. They have misinterpreted the task of the IPAB to be to hold Medicare spending to within certain targeted limits. This is not the case at all. They have also implied that IPAB is responsible for holding private (nonfederal) spending to within certain limits, which is untrue, and in fact IPAB has no authority at all over nonfederal spending.

From the NRLC document:

HOW THE OBAMA HEALTH CARE LAW WILL LIMIT WHAT HEALTH CARE PROVIDERS CAN DO TO SAVE THE LIVES OF YOUR FAMILY MEMBERS

A Powerful Rationing Commission:

An 18-member “Independent Payment Advisory Board” is given the duty, on January 15, 2015 and every two years thereafter, with regard to private (not just governmentally funded) health care, to make “recommendations to slow the growth in national health expenditures” below the rate of medical inflation

The text that I have put in italics is just dead wrong. Go to the link and look at the chart on page 3.
NRLC is claiming, for example, that for 2015, IPAB must limit healthcare spending growth to the lesser or (A)”halfway between medical and general inflation” and (B) 0.5%. That is a completely mistaken interpretation. What is actually the case for 2015 is that IPAB does nothing unless projected Medicare spending is going to exceed “halfway between medical and general inflation,” something which for 2015 is unlikely to happen (see below). If it does indeed happen, IPAB will be required to make proposals to cut costs by no more than 0.5%.

From 2018 onward, the trigger is the rate of growth of GDP per capita plus 1%. As long as Medicare spending projections do not increase faster than GDP plus 1%, the IPAB does nothing. If projected Medicare spending does exceed GDP plus 1%, IPAB makes recommendations to cut Medicare costs by no more than 1.5%.

Here is an explanation of what is actually the case, and which NRLC misrepresents:

While IPAB is generally required to make recommendations to lower growth in Medicare spending if the growth in per capita spending exceeds the target growth rates, the law imposes a limit on how much savings it can achieve, expressed as a percentage of total program payments, known as the ―applicable percent . . . . This means the ACA does not require IPAB to recommend proposals to keep Medicare spending below target growth rates; instead, it requires IPAB to reduce Medicare spending by the amount of the excess over the target but only up to the specified “applicable” percentage for a particular year.

According to ACA: “The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost sharing (including deductibles, coinsurance, and co-payments), or otherwise restrict benefits or modify eligibility criteria.” It is a strange “rationing commission” that is forbidden by law to make recommendations to ration health care.

The Medicare recommendations work as follows:

The board’s proposal (or that of the Secretary) may not include any recommendation to ration health care, increase Medicare premiums or cost-sharing, cut Medicare benefits, or restrict eligibility. It must focus exclusively on proposals for achieving savings in the payment and delivery of health care services — not shifting costs to beneficiaries.

The board’s recommendations will go into effect automatically unless Congress passes, and the President signs, legislation to modify or overturn them. Congress may consider, on a fast-track basis, an alternative proposal that achieves the same amount of savings; if the alternative proposal achieves a smaller amount of savings, approval requires a three-fifths vote of the Senate. If the board recommends changes that the President supports, the President can veto legislation to block them, and as is always the case, a two-thirds vote of the House and Senate would be required to override a veto.

According to Ezra Klein in the Washington Post, Medicare costs are rising at less than the rate that triggers IPAB recommendations. If that continues, the IPAB makes no Medicare recommendations at all.

As for recommendations on nonfederal medical spending:

Starting in 2015, the board is also required to make advisory recommendations at least every other year for slowing the growth of non-federal health care spending while preserving or enhancing the quality of care. These recommendations do not go into effect automatically and can be implemented only through discretionary actions by the federal government, state or local governments, or private-sector entities.

So NRLC has it entirely wrong. IPAB is required to make recommendations to cut Medicare spending by at most 1.5% a year no matter how fast Medicate grows. IPAB is not tasked with keeping Medicare spending below any certain level, as NRLC suggests. And as for nonfederal spending, it makes only recommendations. It has no power to implement them.

“Then someone comes along and, providing only a link, says, “Oh, but read this . . . ” Now, I don’t mind spending a long time responding to other posters’ comments, but it is beyond the scope of what I am prepared to do to read, research, and try to debunk a document from an advocacy organization that was no doubt put together by a team of people. That is the job of other advocacy organizations.”

David, this has NEVER stopped you before !

“If someone wants to make a case here and link to NRLC to help document that case, I will probably read what they have to say, what NRLC has to say, and comment. But if someone relies solely on posting links, what they are doing is basically saying, “Let’s you and NRLC fight, and I’ll sit back and watch.” … There are various ways of hopelessly tying up people in a blog discussion, and one of them is to expect people (like me) to read long documents and spend hours researching them and trying to refute them.”

Yes, I get that. The problem is, that’s not what happened here. No one singled you out. No one asked you personally to dig in and defend. You chose to respond personally with an admonition to dismiss the link out of hand, and when pushed a little, in your response said this: “I did actually read what was linked to at NRLC, and I think it is biased and in some cases factually wrong.”

So you’re not being asked to do any more reading or research than you already have. Tell me what you *already* found that supports *your* statement. Anything else at this point looks like a knee-jerk reaction based on the organization not supporting your point of view.

Regards,
JDD

I do not see why government-sponsored health care cannot fulfil its primary purpose of reducing the number of working days lost through sickness without being ruinously expensive. One simply has to use the sort of triage system that the military has been employing since Napoléon’s time.

That would include both prophylactic and therapeutic measures.

Yes, within reason, of course.

“Now that we all agree that socialized health care is incapable of fulfilling the one thing that justifies its existence”

But who agrees that socialized health care (universal health care of some kind) is incapable of delivering?

Let’s compare the US to other developed countries such as Australia, France, Norway, Sweden, etc. All these countries successfully provide variants of “socialized health care,” and their citizenry live longer and have fewer childbirth death than the US. Not perfect, but certainly better (and cheaper) than in the US. So it can work quite well.

One thing is to oppose universal health care out of ideological reasons. It is quite another to claim that it cannot work. The latter is simply false.

That is the entire justification for socialized health care, and the situation that is supposed to be fixed.

Everyone is supposed to get health care needs met.

Now that we all agree that socialized health care is incapable of fulfilling the one thing that justifies its existence, what is the advantage again?

The truth is there is no way for society to pay for everyone to have everything they need, let alone everything they want. And it’s already clear that the government plans on pandering to what people want – the fact that it will not make people responsible for their own birth control pills means either that (a) we are entering into a model where we are abandoning the idea that people can or should be responsible for anything at all and/or (b) the government is using medical benefits to bribe voters.

(A) indicates that the government will increasingly be forced to cover all preventive measures, while (b) means corruption.

Whether it’s (a) or (b) (or both), neither is an improvement over free market economics. At least under free market economics the government can provide protection (in the form of a safety net and/or in the form of a court to appeal to), but who provides protection when the government is the one refusing your claim?

You may be interested to read NRLC’s analysis . . .
–Megan

There are various ways of hopelessly tying up people in a blog discussion, and one of them is to expect people (like me) to read long documents and spend hours researching them and trying to refute them.
–David Nickol

And another tactic is to claim the other guy’s documentation is “blatant propaganda” and “pre-packaged ammunition,” that you can’t be sure isn’t “totally distorted,” and then hint that the one offering it probably hasn’t even read it and just likes “tying up people in a blog discussion.” This tactic is most often used when one doesn’t have a substantive answer to the argument being made, and cannot refute the facts provided by the documentation.

I don’t disagree with most of what you say. I read almost everything people link to, no matter unhelpful I expect the source to be.

[DN] I did actually read what was linked to at NRLC, and I think it is biased and in some cases factually wrong.”

[JDD]Fine – then please show me where.

Here’s the problem with that. We’re having a discussion here in which I take the time to express my position, often doing a fair amount of research and providing links to back up what I say. Then someone comes along and, providing only a link, says, “Oh, but read this . . . ” Now, I don’t mind spending a long time responding to other posters’ comments, but it is beyond the scope of what I am prepared to do to read, research, and try to debunk a document from an advocacy organization that was no doubt put together by a team of people. That is the job of other advocacy organizations.

If someone wants to make a case here and link to NRLC to help document that case, I will probably read what they have to say, what NRLC has to say, and comment. But if someone relies solely on posting links, what they are doing is basically saying, “Let’s you and NRLC fight, and I’ll sit back and watch.” There’s no way to be sure they have even read the NRLC document themselves, or understood it, or are capable of defending it.

There are various ways of hopelessly tying up people in a blog discussion, and one of them is to expect people (like me) to read long documents and spend hours researching them and trying to refute them.

Happy Fourth to you, too!

“Please note that I said, “Linking to blatant propaganda on either side of these issues is not helpful.” If I try to counter what NRLC says by giving links to NARAL or Planned Parenthood, do you think that would be helpful in getting at the truth here?”

Yes, I would. Perhaps this is a difference between the way you and I go about things, or maybe you’ll find yourself agreeing with some of how I word this: I hope you agree that the definition of ‘propoganda’ is inherently difficult to lock down. What one once sees as ‘propoganda’, one later might begin to be convinced by – perhaps on ‘either side’ of the arguments.

I believe everything is ‘biased’ to some extent, by virtue of coming from human beings. We discard information which we deem to be irrelevant, inconsequential… while someone on the other side of the argument believes that what we’ve discarded is actually a critical marker, an indication of a trend, etc.

We could have a whole conversation on that, I’m sure.

Part of the absolute pursuit of truth is daring to let yourself be exposed to all the arguments without qualification. It’s a difficult enough undertaking for one who might be an Atheist or at least a Relativist, for example. I confess it is even more challenging for a person who believes in a real spiritual realm, and who believes in a real spiritual Adversary who wishes to separate me from truth – which is to say to ultimately separate me from God.

I long ago was impressed by the story told of Karol Wojtyla, how he read the works of Communist authors while in Seminary, and how this scandalized certain friends. To which he proclaimed, “I want to know what the other side thinks.” Yes, okay, he was being diligent and offering an example of intellectual diligence, etc., But there was also a risk there, if one believes that, a) not all arguments are made in good faith, b) not all philosophies and viewpoints are ‘equally good’ for the human person, and c) I am not intellectually invulnerable to being persuaded – no matter how sharp I think I am.

I’ve tried to take all of this to heart, as I’ve listened to Planned Parenthood’s (for example) arguments for certain causes – not the least of which is the healthcare law. I wondered indeed if I might find some good reasoning there, and expected there should be. I have instead been utterly unimpressed by PP’s methods of reasoning, and utterly unconvinced by their arguments. – and THAT is why I don’t hold them myself.

By the way, you can tell a lot about a law by the way different sides react to it. The reaction to the healthcare law decision of various national groups across the board who support various ‘rights’, should tell you a lot about what ‘freedoms’ the law expands upon and what entities are likely to benefit.

“I did actually read what was linked to at NRLC, and I think it is biased and in some cases factually wrong.”

Fine – then please show me where. My Rock is not the NRLC – and everyone has a rock. You might be surprised to know that I don’t take the NRLC as absolute Gospel, and in fact don’t check in with it particularly often. But it was you who first wrote, “No actually not.” and threw out the ‘propoganda’ label, seemingly out of the blue since the weblink was offered to everyone, not you in particular. I think had the roles been reversed, you would have slapped your responder silly. :)

In any case, I hope you have a great – and safe – Independence Day.

JDD

See also:

Quiet Euthanasia

Catholic nurse recounts hospice horror, says doctor euthanized priest

Are Euthanasia Advocates Taking Over America’s Hospice Industry?

And take a look at this web page on the Physicians for Life web site:

http://www.physiciansforlife.org/content/view/1958/75/

It is a 2010 article mentioning the Liverpool Care Pathway protocol discussed in the article I posted a link to above, “Top doctor’s chilling claim: The NHS kills off 130,000 elderly patients every year.”

Here is an excerpt from the Physicians for Life article:

Under Pathway protocols, which are now implemented nationwide, all food and fluids are removed from seriously ill patients who are then put under continuous sedation until they die. According to researchers at the Barts and London School of Medicine and Dentistry, 16.5 percent of Britain’s deaths in just one year (2007-2008) resulted from this method.

And visit:
http://www.hospicepatients.org/

JDD,

Please note that I said, “Linking to blatant propaganda on either side of these issues is not helpful.” If I try to counter what NRLC says by giving links to NARAL or Planned Parenthood, do you think that would be helpful in getting at the truth here? If you quote from Fox News and I quote from MSNBC, or if you quote from The National Review and I quote from The Nation, will that get us anywhere?

I did actually read what was linked to at NRLC, and I think it is biased and in some cases factually wrong.