Right Wing Nut House



Filed under: Government, Politics, health care reform — Rick Moran @ 9:43 am

I was actually going to write a post today on the kinds of health care reform proposals that I would support, and that I believe a majority of Americans could get behind as well. (Perhaps tomorrow if I have the time.)

But in researching various proposals, it occurred to me that the problem with conservative critiques of Obamacare - at least from pop conservatives like Rush Limbaugh and professional scare mongers like Sarah Palin - is the logical fallacy of their “slippery slope” arguments, and the sheer impossibility of many of their most dire warnings about what will happen if we adopt Obamacare.

Don’t get me wrong (although I know many of you will). There are indeed legitimate slippery slope arguments that can be made about these proposals that meet the stringent test of being logically thought out, and buttressed by facts. Reasonable assumptions can be extrapolated from what the Democrats are proposing that aren’t so slippery that they fall off a cliff into the netherworld of nonsense.

But in truth, many of the worst slippery slope arguments being employed in this debate on the right are full of logical fallacies that assume too much, ignore alternative arguments to explain facts, and stretch logic and reason to the breaking point in order to present half baked notions of the future of American health care under what Democrats are proposing.

What makes a good or bad slippery slope argument? I like the Wikpedia entry that explains a valid slippery slope argument:

Modern usage includes a logically valid form, in which a minor action causes a significant impact through a long chain of logical relationships. Note that establishing this chain of logical implication (or quantifying the relevant probabilities) makes this form logically valid. The slippery slope argument is only a fallacy if such a chain is not established.

A slippery slope argument that evolves into logical fallacy can take many forms; to my mind, failing to rigorously test your own assumptions that define the argument itself is the easiest trap in which to fall. Essentially, trying to impose a false assumption invariably leads to a crumbling of the whole edifice.

Again, Wikpedia has a pretty good definition for those arguments that crumble into logical fallacies:

The heart of the slippery slope fallacy lies in abusing the intuitively appreciable transitivity of implication, claiming that A lead to B, B leads to C, C leads to D and so on, until one finally claims that A leads to Z. While this is formally valid when the premises are taken as a given, each of those contingencies needs to be factually established before the relevant conclusion can be drawn. Slippery slope fallacies occur when this is not done — an argument that supports the relevant premises is not fallacious and thus isn’t a slippery slope fallacy.

Often proponents of a “slippery slope” contention propose a long series of intermediate events as the mechanism of connection leading from A to B. The “camel’s nose” provides one example of this: once a camel has managed to place its nose within a tent, the rest of the camel will inevitably follow. In this sense the slippery slope resembles the genetic fallacy, but in reverse.

Let’s take Sarah Palin’s “Death Panels” statement as a perfect example of a slippery slope argument that degenerates into logical fallacy the moment one looks at it in a rational manner.

Palin doesn’t even bother with any intermediate steps; she goes from A directly to Z without so much as a logical assumption between them. Even those who support her statement admit that there is nothing that the Democrats are proposing that even remotely approaches some kind of board where individuals are sorted out based on how productive they are, or potentially can be. The fallacy of this thinking then, is that any incremental steps that could, in the end, lead to death panels are simply ignored and a kind of intuitive logic is employed to go directly from A to Z.

It is those incremental steps that are the key to the fallacy. In order to accept her statement, one would have to believe that no one would recognize anything untoward in these incremental steps to death panels (the “boiling frog” analogy), or that no one would attempt to change course and prevent the death panels from forming in the first place (a “momentum” argument that is easy to disprove).

Of course, Palin wasn’t making a logical slippery slope argument. That was not her intent. It was to polemecize the debate by throwing rhetorical bombs at Obamacare, hoping to rile up her supporters, and strike fear into seniors and others.

I find it amusing that many of those who seek to explain Palin’s argument go so far afield to justify her logic that they actually prove how patently ridiculous her statement was.

Let’s take the normally reasonable and objective William Jacobsen of Legal Insurrection who makes spaghetti of Palin’s arguments by stretching logic beyond reason:

These critics, however, didn’t take the time to find out to what Palin was referring when she used the term “level of productivity in society” as being the basis for determining access to medical care. If the critics, who hold themselves in the highest of intellectual esteem, had bothered to do something other than react, they would have realized that the approach to health care to which Palin was referring was none other than that espoused by key Obama health care adviser Dr. Ezekial Emanuel (brother of Chief of Staff Rahm Emanuel).

The article in which Dr. Emanuel puts forth his approach is “Principles for Allocation of Scarce Medical Interventions,” published on January 31, 2009. A full copy is embedded below. Read it, particularly the section beginning at page 6 of the embed (page 428 in the original) at which Dr. Emanuel sets forth the principles of “The Complete Lives System.”

No doubt Rhambo II is nutty as a fruitcake. The question we have to ask is where in the alphabet between A and Z does Mr. Potential Death Panel Chief fit?

The next question is, whether Dr. Emanuel’s proposal bears any connection to current Democratic proposals. There is no single Democratic proposal at this point, only a series of proposals and concepts. To that extent, Palin’s comments properly are viewed as a warning shot not to move to Dr. Emanuel’s concept of health care rationing based on societal worth, rather than a critique of a specific bill ready for vote.

Certainly, no Democrat is proposing a “death panel,” or withholding care to the young or infirm. To say such a thing would be political suicide.

But one interesting concept which is central to the concepts being discussed is the creation of a panel of “experts” to make the politically unpopular decisions on allocating health care resources.

As Bill himself admits, the Democrats are not proposing a death panel and Mr. Death Panel doesn’t fit anywhere on the A to Z continuum because frankly, there are no A to Z dots to connect at the moment. There’s only a vague mention of a “panel of experts” who would not have anything to do with the “Complete Lives System” of allocating health care resources. Instead, the proposed Commission would make decisions on treatment options and, according to the letter from Obama to Congress that Bill quotes, “These savings will come not only by adopting new technologies and addressing the vastly different costs of care, but from going after the key drivers of skyrocketing health care costs, including unmanaged chronic diseases, duplicated tests, and unnecessary hospital readmissions.”

Not a hint of a death panel. Not even a hint of a “complete lives” determinant for allocating health care resources. Bill is using one bogus slippery slope argument to support Palin’s equally curious polemic.

Sorry, but just because conservatives combine a genuine distrust of government with the real potential for unintended outcomes by using some valid slippery slope arguments about Obamacare, that doesn’t mean we can go off half cocked and, by sheer intuition rather than facts and logic, imagine the absolute worst nightmares about nationalized health care. All slippery slope arguments against Obamacare are not valid. And Palin’s might be the worst of the lot.

A possibly valid slippery slope argument about this “Medicare Payment Advisory Commission” is that it would result in a “one size fits all” treatment regimen for specific diseases. Instead of coming up with the best course of treatment for what ails you, in consultation with your doctor, a third person will be sitting in the room with you - your friendly, neighborhood government health bureaucrat from MedPac - who will have a specific outline of treatments and drugs that would be approved for payment by the government.

Currently, you can tailor your private insurance plan to cover those “unnecessary tests” that Obama is so concerned about. And, of course, the counterargument is that if you want those tests, you can always pay for them out of your own pocket.

But given what I believe to be a valid slippery slope for what Obamacare could eventually mean - a virtual end to private insurance and all but the richest Americans forced onto the government plan - we should be very concerned with any board or commission set up to make one size fits all decisions on treatment.

In fact, let’s examine the reasonable argument that, by moving steadily from A to Z, Obamacare will for all intents and purposes destroy the general health insurance industry and eventually mandate that almost all Americans join the government plan.

Lindsey Graham, in an interview with Ezra Klien, fills in some of the A to Z gaps:

My belief is that no private-sector entity can survive over a long period of time competing against the government. The public option will be written by politicians. It will be generous. Nobody in my business worries about the bottom line. Eventually, the public option will dominate the marketplace because the political forces in the public sector are different than the economic forces in the private sector. Eventually, the private sector will give way.

You know, we already have Medicaid and Medicare. The private sector covers the middle. If a public option becomes part of that mix, you’ll have the whole deal covered by the government. That’s why I’m against it. And what I’d like to do long-term is enhance the options available to the retirement community and reform Medicare.

Is it logical to assume that because private insurance companies are beholden to market forces and government is not, that eventually - unless government deliberately keeps its premiums high - these companies will simply be forced out of business because they can’t compete?

I believe the answer to that is a great big yes. The government already skews market forces in the health insurance industry because 6 out of every 10 dollars spent on health care in America is spent by government.

Graham’s argument has some holes (the boiling frog, remember?). Is it reasonable to assume that government wouldn’t lift a finger to save private insurance companies from going the way of the dinosaurs?

This is trickier because it would depend on who might be in power. Would Republicans risk the wrath of their base to bail out Prudential, or Allstate? Lots of little guys make a living selling insurance as independent agents. What would happen to them if that part of their business went up in flames?

If Democrats are in power - as I am assuming they will be given the fact that the GOP is prostrate right now and in such a shambles leadership-wise that it is probable the Dems will be in power for the foreseeable future - I think they have made their feelings clear about “greedy” insurance companies. Based on their attitude toward business in general and specifically, the insurance industry,I doubt whether Democrats would lift a finger to help insurance companies remain in the business of selling health care policies.

That is a reasonable assumption drawn from known facts. Attitudes and statements by the Democratic leadership about health insurance companies leads to the logical conclusion that their elimination would not be a catastrophic occurrence. Hence, no private insurance would mean virtually all Americans would be forced on to the government plan.

This is an example of a valid slippery slope argument. Will it really happen? Counterarguments similarly based on facts and logic must, by definition, refute the market forces that would be at work as well as statements made by liberals about evil insurance companies. I don’t think it can be done but anyone willing to try will get a hearing from me.

Unfortunately, too many conservatives use fantastical and illogical slippery slope arguments to posit the absolute worst outcomes for Obamacare. Old folks being forced into signing DNR orders and living wills based on the proposal that Medicare will be paying for doctors visits to discuss these options is a similarly nonsensical idea. To extrapolate people being “forced” to do anything remotely like signing their own “death warrants” just from this simple, common sense idea is beyond the pale of rational discourse. Those who advance the argument are not concerned about anything except ginning up fear among senior citizens over Obamacare.

Slippery slope arguments about rationing are a little different. It has been pointed out that there already is a form of rationing used by private insurance companies who routinely deny some treatments as too experimental or not necessary in their view. The question of how draconian it might get under Obamacare is, I believe, unanswerable at this time. Much depends on whatever ideas they eventually come up with to control costs. If it looks like they won’t do diddly, then a rationing regime will be absolutely necessary. How bad it could get just isn’t logically foreseeable at this time.

If we stick with those slippery slope arguments that are valid and discard the nonsensical ones, we can win this debate. But using logical fallacies and outright imaginary outcomes meant to scare people rather than make them think about the consequences of passing Obamacare only makes conservatives look like hysterics.

And that may be Sarah Palin’s brand of conservatism, but it’s not mine.


  1. Thanks for keeping a cool head. Won’t get you a lot of love though.

    Comment by funny man — 8/11/2009 @ 9:55 am

  2. Are you a comment-masochist?

    Comment by angulimala — 8/11/2009 @ 10:29 am

  3. The Progressive project, to which you seem tacitly sympathetic, is the single most expensive, un-Constitutional, slippery slope argument available.
    See Perot charts for the pretty (ugly) picture version.
    The 10th Amendment mocks the last 80-ish years of US history, and I pray that a full-on, peaceful Constitutional crisis ensues. We can live like Americans or die like Europeans.

    Comment by smitty — 8/11/2009 @ 10:30 am

  4. The problems of selling this plan to the American people is entirely due to the Obama administration. They’ve been trying to sell it on the idea of cost savings.

    Take two different systems, Canada and the US. They both suffer from the same problem to different degrees. Canada’s costs are increasing by 6% a year, and the US by 9%. It is recognized that it is primarily due to aging populations. Since most of the costs occur in the last few years of life, where else are meaningful cuts going to come from?

    Sure, some money might be saved by the mechanisms Obama identified, but for significant savings there is only one place to cut. People realize this even though they might not have articulated well.

    Comment by Allen — 8/11/2009 @ 11:01 am

  5. I think everyone on both sides realizes we need some reform e.g emergency rooms for uninsured patients. This can’t go on. However, I also think that Pat Buchanan is on to something in his latest article although I think he is a bit too focused on race. However, it is this rage that some on the right happily feed and I’m glad some of us would like a debate rather than a shouting match.

    Comment by funny man — 8/11/2009 @ 11:15 am

  6. I find it interesting that Republicans are loving these town hall meetings but what they don’t seem to understand is that Insurance companies, Corporations and Big Pharma don’t hold town hall meetings. These entities only understand profits at our expense.
    The free market has not produced affordable healthcare up to now. Obama’s proposals are trying to change this.
    But this kind of change freaks some people out. Namely corporations and insurance companies and a few who think it is communism - which it isn’t.
    But trying to explain this to people in civil tones seems not to work. And opposing it in civil tones also seems not to work. But using terms like ‘death panels’ and ‘fascism’ seems to work. It’s not accurate but it sure gets a lot of folks fired up.

    Comment by ML — 8/11/2009 @ 11:45 am

  7. Take a ride down this slope. Be warned, it is not so much slippery as it is razor sharp.:


    “Death panels” (or at least one death panel) is a reality already within the confines of the USofA. Point Z is real in Oregon. A PANEL really is authorizing DEATH.

    Listen to the woman’s view versus the PANEList’s view:


    Approximately 10 years ago I sat with my wife for her many chemotherapy treatments. 10 years later she is alive and well because there was no panel like this one standing between her and her doctor. Our private health insurance never balked at providing her treatment. It is/was NOT a “Cadillac” type plan. So, yeah, color me skepticle at the notion that any state run (public plan) solution is the answer. My real life’s experience tells me what the obvious choice should be for me.

    I AM NOT a Palin apologist, but to deny her statement is without ANY merit is disingenuous at best. Knowing president zero’s advisers toward this regard should give us all pause.

    Unlike some on this blog I am not a self-professed “intellectual”, “critical thinker”. I am just a common sense person, who has at least somewhat a command of the English language, and an understanding of how political games are play. I believe I can use deductive reasoning as well as the next guy/gal. I am of the opinion that some of these peoples’ thinking will only be critical to my choice in health care and/or access to providers.

    H.R. 3200, as written, however, on pages 15 and 16 set the terms of what insurance is permissible. Under “SEC. 102. PROTECTING THE CHOICE TO KEEP CURRENT COVERAGE,” (HOW CLEVER. IT HAS THE OPPOSITE EFFECT ALSO) sets the perameters of who will be eligible for the private option. Falling out of the governmental perameters will disqualify you for private coverage. That includes changing jobs, retiring, and the list goes on and on. Bottomline, you cannot tranfer from one private provider to a different private provider, period. You’re stuck with the provider you were with on the day before a bill goes into effect should this provision attach to the final product. That is total bovine excrement! YOU CANNOT CHANGE AND PAY FOR ANY OTHER PRIVATE PROVIDER OUT-OF-POCKET even. I think it was ‘glasnost’ who suggested this was NOT the case. ‘glasnost’ is/was wrong. SEC. 102 does eliminate choice!

    Common sense and history tells me the cost of the ‘not yet proposed’ nobamacare healthcare plan will spiral out of control, like all governmental plans do. He lectures us on the dos and don’ts, wills and won’ts on his yet unwritten plan? Give me a break. I have all the snake oil I want or need.

    An excellent article, IMO:


    Comment by sninky — 8/11/2009 @ 12:19 pm

  8. I think Graham does make a reasonable slippery slope argument.

    There are profit pressures on private insurers. There are taxpayer pressures on a public option. Graham’s right that a public option will be pressured politically to expand in every direction, but it’s also true that the public option would have countervailing pressures to limit its cost.

    The public option is likely to be one size fits all. Private insurers can peel of niches — gold-plated policies, for example. But they aren’t wrong to fear the public option.

    Still, it’s far from a given that public would drive out private. Public will certainly increase pressure on private but that’s a good thing, up to a point.

    I have to say, though, that the private companies brought this on themselves. They all followed the same approach: cherry-pick the most profitable (healthiest) customers, dump the most expensive (sickest) and lie like hell to obfuscate their core business model. They could have made choices that yielded reasonable profits, but like lemmings they had to pursue maximum profit, regardless of the cost in lives.

    Maybe what we’re coming to here is an area where government is simply superior. Or maybe we’ll be good with a hybrid system like some European nations where government and private insurance function side by side.

    But neither I, nor much of anyone, is going to shed many tears if Aetna or Blue Cross find they can’t compete and go under. They made this bed. They made the decision that a billion dollar profit and health insurance for sick people was not good enough and that they needed 2 billion and to hell with sick people.

    Comment by michael reynolds — 8/11/2009 @ 12:21 pm

  9. Doesn’t Graham’s analysis prove him wrong?

    As I read it, he’s claiming that if the private insurance sompanies have to compete with the public insurance, they’ll get undercut and be forced to fold. As an example of public insurance, he cites Medicare.

    But private insurance companies compete with Medicare to insure elderly Americans. They haven’t gone out of buisness, and Medicare has been around long enough that if its pricing was undercutting private insurance the financial impact would have already been felt by the private companies.

    It is like saying that public transportation will drive auto makers out of buisness, because public transportation is cheaper. True, paying a buck for the bus is cheaper than getting a car . . . but having private transportation offers advantages that make it worth the cost to people that can afford it.

    My elderly relatives all have private insurance. They are qualified for Medicare, but prefer to pay for better coverage. How is “middle-age Medicare” any different?

    Perhaps public insurance will destroy the private companies . . . but the only example I see is Medicare, and the result hasn’t been that dire.

    Comment by busboy33 — 8/11/2009 @ 12:29 pm

  10. Ml-
    you said:

    “The free market has not produced affordable healthcare up to now.”

    How has the last 50 years of healthcare in this country in any way, shape or form resembled a free market?

    Healthcare is orders of magnitude more regulated than any other industry. In free markets, multiple companies are allowed to compete for your business in a fair and transparent way. In our current healthcare system, the tax structure ensures that you have exactly one (1) choice, the one your employer offers you. Even if you want to endure the financial beating the tax code will deal you and shop for insurance on your own, you aren’t allowed to shop over state lines!

    Granted, its not socialism, but how is this a free market?


    How does medicare compete against private insurance in any way shape or form? seriously?

    medicare premium = $0
    (not counting a lifetime of payroll taxes, of course)

    The fact that your family members are lucky enough to have private insurance has everything to do with their financial status or their employment history, not with them CHOOSING it over medicare.

    Comment by ken.mcloud — 8/11/2009 @ 2:06 pm

  11. I enjoyed the article, but I believe the slippery slope is valid. If 40 years ago, an abortion protestor had said, “One day we’ll legally pull a baby out of the womb, leaving it’s head in the birth canal, stick scissors in it’s brain and suck out the contents and call it abortion,” that person would be labeled a fearmonger and out of touch with reality. Look how far our society has coarsened in 30 or 40 years. And yet, you think it couldn’t happen it 30 or 40 more? Sorry, I’m not buying it. We’ve lost many of our moral underpinnings in a very short period of time. I see no reason to believe we’ll not continue on this course.

    Comment by SJ in WV — 8/11/2009 @ 2:12 pm

  12. SJ

    In the last 40 years we extended full legal equality to women and African-Americans. We’ve begun to do the same with gays.

    And 40 years ago late term abortions were being carried out. They just weren’t being carried out by doctors.

    It is not true that society has coarsened. 40 years ago my family was threatened because we had black friends in our home. That was pretty coarse.

    Comment by michael reynolds — 8/11/2009 @ 2:37 pm

  13. A nice post. I agree that Palin’s comments were very much over the top. The irony in her comments is that they were (at least partially) based on the provision in the bill to pay for end-of-life planning. we’ve forgotten that end-of-life issues (i.e. the living will ) grew out of the desire of individuals to refuse health care when their doctors and hospitals insisted they MUST have it. Its an autonomy issue (”you can’t make me take this treatment). Individual autonomy was once thought of as a core conservative principle.

    As far as Graham’s slippery slope there is (as you pointed out) some validity. Crowd out leads to diminishing bottom lines for private health insurance companies. As they feel greater financial pressure they might find it even harder to compete against the “loss leader”. Particularly since that loss leader has some unique tools (i.e. you hospital MUST accept my health plan)

    And to Michael, I understand I will never dissuade you of your conviction that insurance companies are EVIL.

    cherry-pick the most profitable (healthiest) customers, dump the most expensive (sickest) and lie like hell to obfuscate their core business model.

    The big insurance companies get their biggest profit from signing up large employers. They don’t have “pre-existing condition” issues with these large contracts. In other words, if United is picked by IBM to care for all of their employees, United doesn’t get to say “Mrs. Jones in accounting has an abnormal mammogram and so we won’t cover her”. By and large “pre-existing condition” is only an issue with individual policies; that’s less than 15% of the insured.

    And as for their core business model. their core business is managing the health benefits of large employers. Employers want healthy employees; that’s why they look for wellness programs, disease management programs etc when they consider signing up with a particular insurer.

    Comment by c3 — 8/11/2009 @ 2:55 pm

  14. @SJ:

    The problem is, that argument can be made against anything.

    Propose fixing bridges? In 40 years the government might force you to get a barcode tatooed on your arm to use it.

    Funding schools? In 40 years the government might try to force implants into students heads.

    Support the police? In 40 years the government might burn the Constitutuion and send armed thugs into your house to kill you.

    All these things COULD happen. Are you against bridges, education, the military, and the police? Probably not.

    What on earth does late-term abortion have to do with insuring the uninsured? Whether late-term abortions should be illegal or not is totally, completely, and utterly irrevelant to the debate.

    . . . but it does make a great emotional grenade. In my experience, people only resort to emotion in a debate when they have nothing substantial to argue.

    Are you saying that providing healthcare to the uninsured is immoral? Jesus would be so proud of you. What moral(s) is under attack here? Remeber, we’re talking about health insurance . . . not abortion. If your argument is that abortion is immoral, therefore health insurance that pays for abortion is immoral, are you for banning private health insurance as well? It would certainly seem to fall into your definition of morality.

    Comment by busboy33 — 8/11/2009 @ 3:07 pm

  15. Public health insurance will unleash a massive wave of entrepreneurship and progress throughout the country.

    Comment by Chuck Tucson — 8/11/2009 @ 3:22 pm

  16. C3:

    The employer-provided model is fading. Many of us — a growing number — are on our own dealing with the insurance comapanies. Your defense of the insurance industry conveniently ignores all of us.

    Comment by michael reynolds — 8/11/2009 @ 3:24 pm

  17. Chuck Tucson Said:
    3:22 pm
    Public health insurance will unleash a massive wave of entrepreneurship and progress throughout the country.

    CZ: Sure thing bub, similar to the “massive wave of entrepreneurship and progress throughout the country” that the federally funded AMTRAK did for passenger rail travel. You lefties are such pigeons for rancid government cheese. Sell the dream and deliver the turd. Would you like fries with that?

    Comment by CZ — 8/11/2009 @ 3:37 pm

  18. michael reynolds Said:
    3:24 pm

    Your defense of the insurance industry conveniently ignores all of us.

    CZ: Yawn.

    Comment by CZ — 8/11/2009 @ 3:38 pm

  19. From reading the bill I take it that the Feds want employer based health insurance to continue. I don’t think the administrative machinery of medicare could absorb all the non-Medicare population plus the uninsured. At least, not right away. The problem with the bill is the tremendous expense. It can’t succeed by simply taxing the wealthy, though it tries. The testimony from the CBO was a torpedo to the idea that change can come at no additional expense. Rationing already exists, and would continue. Want to get the market involved? End the tax deduction for employers and let individuals have it. You can try insurance mandates to force healthy people to buy insurance, but then you’ll have another revolt on your hands.

    Comment by Dan Smith — 8/11/2009 @ 3:41 pm

  20. c3, (-P0?)

    your statement that:

    “By and large “pre-existing condition” is only an issue with individual policies”

    is not true.

    I have a family friend that recently stated working for Wegmans (A grocery store here in the northeast that is ranked in the top 5 of FORBES “Best companies to work for” list with Google every year)

    She found out she was pregnant, went to the doctor to start a prenatal regiment. She later got a letter from Wegmans’ insurer that her prenatal care and the hospital stay for the baby’s delivery would not be covered. They took the doctors “expected birth date”, subtracted 9 months, declared that conception happened a week or two before her coverage had become active. So they didn’t have to pay for anything involving the birth because the pregnancy was…

    …wait for it!…

    A pre-existing condition!

    …food for thought

    Comment by ken.mcloud — 8/11/2009 @ 3:55 pm

  21. Ken;
    Note the by and large. i speak from experience from within a large health insurance company. Now that doesn’t mean that all the times and with all companies. so yes, there are examples of this not being true. My experience tells me that most large corporations/employers ask that you “take their employees” as they are.


    As I said “I understand I will never dissuade you of your conviction that insurance companies are EVIL.” so I didn’t expect you to see that side of the discussion. At least you didn’t call them evil this time just passe.

    And no I was not suggesting that the uninsured were not an issue worth considering. therein lies one of the biggest issues in this healthcare debate. Are the failures of employee-based health care such that we should leave them behind and start from scratch. I’d be curious of your opinion on that.

    Comment by c3 — 8/11/2009 @ 5:50 pm

  22. Can anyone tell me what the ratio is of people contributing Medicare and Medicaid vs. the people that utilize it? I’ve had a hard time coming up with actual numbers of enrolled and contributors. Or tax dollars going toward Medicare/Medicaid vs. its expenses on a yearly basis?

    I wonder if the difference between Medicare/Medicaid and a nationalized health plan that would attempt to cover everyone is that the ratio of contributors to enrollees would render it unsustainable almost instantly.

    Comment by sota — 8/11/2009 @ 6:10 pm

  23. 1) Why do people who believe in entrepreneurship fight for a system that obstructs it by artificially raising the risks of leaving non-entrepreneurial employment?

    2) Why do so many people seem to believe that a public option is both going to cost obscene amounts of money -AND- refuse all care to anyone whose treatment would be remotely expensive?

    3) What is conservative about disputing the notion that, if forced to choose between life-saving surgery for an 80 year old and an 18 year old, it should probably be given to the person who still has a chance at a long life and raising a family?

    Comment by angulimala — 8/11/2009 @ 6:22 pm

  24. How many people have actually read H. R. 3200, even part of it? The issue that I believe Sarah Palin is concerned about is a genuine issue. If you are on Medicare, per this bill, you are required to have an “advance care planning consultation” every 5 years to ensure you understand advanced care planning. There are some nuances here that concern people that they may be forced to refuse health-care that could sustain their life simply because their “quality of life” is less than that of a healthier person and thereby they should not have access to limited resources that a healthier person “should have”. This is not a new debate, but putting it in a major healthcare bill has raised concerns.

    Imagine if Christoper Reeves was still alive and this provision was law? Would he get the same level of health care that he got?

    Something to think about.

    There is a lot in this bill, and many senators and members of congress have said they have not read the bill and some who have read parts of it say they don’t totally understand it. Supposedly, the President himself has not read the bill. The bill needs to be the focus, what does it really say, how will it really affect American health care. The “town meetings” are not doing that. All that occurring is damage control.

    Get your elected officials to actually read the bill and understand it before they come out to tell us what the bill is going to do or not going to do. Don’t put up with “talking points”, get real answers. Then and only then, should we have discussions about health-care reform.

    Comment by John — 8/11/2009 @ 6:22 pm

  25. John-

    I have actually read section 1233 of HR3200. (for real, it hurt!)

    The dreaded “death panel” section of bill.

    This section of the bill allows medicare to pay doctors to consult their patients on end of life issues. Everyone seems to agree on this much.

    The part that I do not see at all after reading the section several times is that these consultations are “required” or “mandated” every 5 years.

    I see where it says these consultations cannot be paid for if they happen more than once in a five year period, unless there are dramatic changes to the patients health status. But nowhere do I see where it says anything even remotely implying that they are mandated.

    can you please quote to me, the exact line of section 1233 where a term like “mandate” or “requirement” is used?

    Comment by ken.mcloud — 8/11/2009 @ 6:46 pm

  26. C3:

    At least you didn’t call them evil this time just passe.

    Actually I never called them evil.

    Are the failures of employee-based health care such that we should leave them behind and start from scratch.

    No one is proposing any such thing. Can you point to any of the bills that make that suggestion? It’s a straw man, and you’re presumably well enough informed that you know it.

    So you engage me on the subject by misquoting me, condescending to me as regards said misquote, and then throwing up a straw man.

    Dishonesty, arrogance and manipulation. Yeah: I can believe you work for an insurance company.

    Comment by michael reynolds — 8/11/2009 @ 7:46 pm

  27. @John:

    I’ve also read most of it (since its freely available on the web). Just read it again.

    Section 1233 doesn’t have any mandated meetings that I can see. I’ll echo KenMcCloud . . . care to give a sub-section # where the meetings are required?

    The meeting is between the doctor and the citizen . . . where is the “death panel” involved in it? The issue in the bill is to pay the physician for their time for the meeting, no more often than once every 5 years. You are perfectly free to meet with your doctor more often than that, as often as you like — the plan just won’t pay for those extra meetings.

    The plan doesn’t require a result from the meetings. You are free to decide that your living will and DNR directives should be “keep my ass plugged in no matter what, up to and including if I get decapitated”, that’s fine and the doctor still gets paid for the meeting. It is your decision.

    That’s what I see. Please . . . educate me. Where or what have I missed?

    Have you read the bill?

    Comment by busboy33 — 8/11/2009 @ 10:37 pm

  28. Michael;
    True you did not use the word “evil” however, this phrase “like lemmings they had to pursue maximum profit, regardless of the cost in lives. ” is not particularly endearing.

    “No one is proposing any such thing.” I didn’t say anyone was proposing that. I wasn’t trying to get you to state or respond to something that I could criticize. I was simply trying to understand how “you” felt. It was something called dialogue.

    I’m sorry if you saw my comments as dishonest, arrogant and manipulative. so let me rephrase. In your opinion are the problems with an employee-based system such that ideally we would do away with that system altogher.

    And in case you’re suspicious of where I’m going with this, there is no trick. The English conservative has the ability to believe in many of the same “conservative principles” as the of American conservative. And yet they would not suggest doing away with their government run health system. So as a matter of interest in other people’s opinions I have asked. If the asking can only lead to more fighting then I apologize.

    Comment by c3 — 8/11/2009 @ 11:04 pm

  29. CZ said:

    Sell the dream and deliver the turd.

    Shit. I just fell for eight years of that from you guys. You’re telling me I’m falling for it again from the other guys now? Thanks for the heartfelt warning man, much appreciated.

    Comment by Chuck Tucson — 8/12/2009 @ 12:19 am

  30. Ken & busboy,

    At the present time, I do not believe there is any limit to consultations with your physician regarding end of life issues for Medicare patients, which includes medicare paying for the more frequent consultations.

    Within the context of the bill talking about the 5 years, there is nothing I read that says medicare will not pay a physician that meets with their patient more frequently. I read it as an addition to current practices that consultations may be more frequent depending upon patient condition, but should not be more than 5 years between them. Why 5 years, I do not know why, but the 5 years was added as a time limit.

    If the added material is intended to be understood as you both understand it, then this becomes a limitation, since the 5 year limit is a change to current practices.

    (I could suggest we contact the writers of this bill to get the real meaning, however, to the best of my knowledge, this is a committee bill that no one has fully read or fully understands.)

    BTW, I do not subscribe to the “death panel” belief. What I do believe is this is an attempt to do more with what we have, even if that means “rationing” or limiting health-care.

    Allowing more competition in the health care insurance business could reduce cost of insurance for all of us. Tort reform could reduce costs, so that doctors don’t have to cover all their bases every time they operate or see patients in their office. Good doctors covering for poor or horrible doctors, that practice has to stop in order to reduce health-care costs. There are many different things that can be done to cut waste and unnecessary practices without destroying the medical system the rest of the world envies. Our medical system needs an over haul, not a complete redo.

    (BTW - before you ask - I worked in a multi-hospital health-care system for 14 years. You learn a lot about health-care, the good, the bad and the ugly. There are many, many health-care professionals who want changes to current practices, but don’t want change just for change sake; they want real changes that makes health-care better. I personally do not believe this bill reaches that standard.)

    Comment by John — 8/12/2009 @ 12:32 am

  31. @John:

    I truly appreciate the response.

    you said in comment #24:
    “The issue that I believe Sarah Palin is concerned about is a genuine issue. If you are on Medicare, per this bill, you are required to have an ‘advance care planning consultation’ every 5 years to ensure you understand advanced care planning.”

    As I said above, I don’t think the word “required” is correct.

    In comment #29, you said:
    “If the added material is intended to be understood as you both understand it, then this becomes a limitation, since the 5 year limit is a change to current practices.”

    No I’m confused. In the first example, the tone of your comment implied to me that “requiring” the meeting was a negative. Now it seems like you are implying its a negative that those same doctor-patient meetings would only be reimbursed once every five years. What is the issue with this aspect of the bill that concerns you?

    In Comment #24, you said:
    “There are some nuances here that concern people that they may be forced to refuse health-care that could sustain their life simply because their ‘quality of life’ is less than that of a healthier person and thereby they should not have access to limited resources that a healthier person ’should have’. This is not a new debate, but putting it in a major healthcare bill has raised concerns.

    Imagine if Christoper Reeves was still alive and this provision was law? Would he get the same level of health care that he got?”

    To answer your question . . . would Christopher Reeves be on public insurance instead of private insurance? If he was on private insurance . . . then the provisions of the bill would be totally irrevelant.
    There have been many comments against the bill that have been in the vein that government insurance might not cover some treatment. As somebody who has experience in the healthcare industry, do you know of any insurance that unilaterally covers any and all procedures regardless of circumstances or cost?

    Again, this bill is attempting to provide insurance for the uninsured. How can limited healthcare coverage be worse than no healthcare coverage? As far as I can see, “some” is better than “none”.

    “[T]hey want real changes that makes health-care better. I personally do not believe this bill reaches that standard.”

    A fair opinion . . . but again, from my perspective the strength of the current healthcare reform movement is in providing insurance to uninsured, not in re-vamping existing healthcare insurance. Does this bill accomplish that? In some way, yes.
    I would be more open to other ideas if I saw a real desire to reform healthcare from other venues. However, instead I see only a desire to kill reform. As I have said in other threads, if my two choices are this reform and no reform, then supporting the reform movement is a no-brainer.

    Comment by busboy33 — 8/12/2009 @ 1:43 am

  32. Rick -

    Please address an actual argument, e.g. this:


    Despite your efforts it is just not possible to come to a reasonable opinion with only a superficial knowledge of the facts.

    There is no mandate for seniors to receive this counseling. None. Zero. Zilch. You can’t find it. You can’t spin it. You can’t twist it. It’s just not there. Hence, you start with a bogus premise - seniors will be forced to attend end of life counseling sessions every five years - and take off on a flight of fancy that posits all sorts of dire things that government could do or might do, but for which you have absolutely no evidence that they will do.

    Extrapolating outcomes from facts not in evidence (except in the fevered, overwrought imaginations of some) is not a valid slippery slope argument. It is a logical fallacy - light on the logic - and contributes nothing but fear mongering to the debate.


    Comment by cranston — 8/12/2009 @ 4:08 am

  33. John-

    Your argument at first seemed to be:

    end of life consultations are bad and the government is going to force them on everyone

    then, when you couldn’t find any language requiring them, it seems like you changed your argument to:

    end of life consultations are good, people can have an unlimited number of them now, and this bill limits them to once every 5 years.

    (fyi, the bill actually allows for the consultation to happen more than once every five years if the patients health condition significantly changes, or if they move into a nursing home)

    So which is it? I’m confused as to what your argument is.

    Comment by ken.mcloud — 8/12/2009 @ 8:41 am

  34. cranston-

    I read Sandy’s blog, and I have to agree with rick.

    Horrible things could happen if there was a mandate, but there simply isn’t one.

    Sandy asserts that:
    “It directs healthcare providers that they ’shall’ ensure every Medicare patient receives such counseling every five years. ‘Shall’ means must.”

    After reading the section 1233 several times and not finding the language she is referring to, I did a ctrl-f word search for “shall” and read every sentence in section containing the word.

    not a single one says anything like:
    Medicare shall ensure every patient receives such counseling every five years.
    Not even close.

    If I’m just showing my lack of reading skills, please correct me. Quote the section of bill where it says what she claims it does. Its kind of curious that she doesn’t quote the bill herself.

    Please, don’t take my word for it. Read the section yourself, or at least do the word search yourself.

    She makes lots of great points, but her entire argument is based on a false assertion.

    Comment by ken.mcloud — 8/12/2009 @ 8:53 am

  35. I’ll need to read the bill to understand the specifics but I wonder why they had to purposefully write in the “end of life consultation”. (I assume its for physicians?) Physicians already have the ability to bill for a visit that is primarily for counseling (end of life or otherwise). While, as a physician, I’d say doctors still have a long way to go in terms of how well we discuss advanced care planning, I’m unclear how stipulating it in such a large health care bill will change that much. And it certainly has brought a lot of “heat” into the discussion.

    Comment by c3 — 8/12/2009 @ 8:56 am

  36. c3-

    We are the ones who actually introduced the term “end of life counseling”

    The bill uses the term “advance care planning consultation”

    I just didn’t use the bills terminology because I felt is was both vague and lengthy. (like oh so many government terms)

    Comment by ken.mcloud — 8/12/2009 @ 9:52 am

  37. @c3:

    “I wonder why they had to purposefully write in the ‘end of life consultation’”.

    Odd . . . I was under the impression that this section was introduced by a Republican.

    Comment by busboy33 — 8/12/2009 @ 12:46 pm

  38. busboy, curiously, who is the Republican, and what’s your source?

    Comment by sninky — 8/12/2009 @ 12:55 pm

  39. It was Johnny Isakson. (R) from Georgia:

    “Isakson’s amendment to the Senate bill says that anyone who participates in the long-term care benefit provided in the bill – if they so choose – may use that benefit to obtain assistance in formulating their own living will and durable power of attorney.”


    He is now distancing himself from the issue, saying that the bill now incentivises doctors to have the conversation with their patients . . . which “pushes” them to do it.
    I still don’t see any mandate for the counseling in the bill . . . and if the fact that doctors get paid for the meeting “pushes” them to have it against their patient’s wishes, how is that different from health insurance “pushing” doctors to do ANYTHING that they get reimbursed for?

    btw . . . when I practiced law one of the most popular form documents we produced were Advanced Care Directives (DNR, Living Will, and Durable Power of Attorney For Health Care). Regardless of what the decisions for the clients were (pull the plug or keep me plugged in), EVERYBODY should have these documents. Everybody should have a will(at least) as well. Otherwise, well . . . remember Terry Schiavo? A large part of that court case involved what Terry would have wanted. A living will would have avoided all of that.

    Comment by busboy33 — 8/12/2009 @ 12:58 pm

  40. Let me make clear . . . Isakson is loudly denying that he had anything to do with the Advanced Care Planning in the bill in its current form. The link above should make that very clear.

    He’s claiming he has nothing to do with it . . . but at the same time admits he introduced the amendment for the planning. Whether the Democratic party is full-on blatantly lying, or whether Isakson is trying to cover his backside with the Republican base, is not clear to me at this point.

    Given that he acknowledges that he DID introduce the amendment, my personal opinion is that he’s backpedaling for the base . . . but at the moment that’s just my opinion.

    Comment by busboy33 — 8/12/2009 @ 1:06 pm

  41. Found some further Isakson details . . .

    I had first heard his name from Claire McCaskil, but apparently Obama named him in his town hall meeting the other day (I didn’t watch it), and apparently Rush has lit into Isakson as a result. I don’t listen to Rush so I can’t say that from 1st hand knowledge . . . that’s the word floating around the InterTubes.

    The comment linked above was released after Rush targeted him, which leads me more than ever to think he’s backpedaling for the base.

    Here’s a video of Isakson from April 08. He says he thinks people should be REQUIRED (his word) to get a Living Will.


    Comment by busboy33 — 8/12/2009 @ 1:23 pm

  42. Ken,

    you are misreading what I wrote.

    I said the advance care planning as written is new and can have two meanings — it depends upon the audience. As currently written, some understand it as a mandate other people understand it as an option. Ambiguity like this is why people are upset about it. (I read it as saying advanced care planning consultation is required. On this, we just need to agree to disagree — if this bill becomes the law of the land, then we will finally know what the intended meaning was.)

    Why was this added?

    Was advanced care planning something that was being neglected and the authors of this bill wants to ensure everyone has the opportunity to understand what resources are available for them when they get terminally ill?

    Or is it to protect the patient from unnecessary procedures that a doctor may do to in order to show they did all they could do to keep the patient alive (known as heroic measures) so they don’t get sued by an unhappy family member who believed the doctor didn’t do enough for the patient (yes, this does occur.)

    (For some there is a 3rd meaning — one I do not subscribe to).

    Some see this as a good thing - others see this as a bad thing. I question its addition as I do not know what the intended purpose is. Advance care planning has always been available, why is it mandated in this bill?

    BTW - “advance care planning consultation” is not a bad phrase. It has been around for years and has generally had a positive meaning. It was generally provided to a terminally ill person, and its purpose was intended to help the patient’s family understand what the options were, and to help the patient ensure that no unnecessary procedures (commonly known as heroic measures) would be done. What could/would be done was put into writing and this became a legal binding document. Nothing new, but never before mandated.

    Comment by John — 8/12/2009 @ 1:44 pm

  43. Ken;

    “The bill uses the term “advance care planning consultation”

    I just didn’t use the bills terminology because I felt is was both vague and lengthy. (like oh so many government terms)”

    Advance Care Planning is not a government term. It was “coined” to encapsulate that planning/discussion that can occur between a patient and his/her physician (with or without family involvement) on not just “end of life” planning but other health care advanced directives about the sort of care the patient would want in the future.

    I’ve had patients tell me that if they have a stroke and were not able to have meaningful interaction with those around them they would not want ____________ (fill in the blank, among the answers folks have told me is “CPR”, “a breathing machine”, “surgery”, “anything”)

    Now the “anything” answer is tough to follow up on so it usually requires a lot of follow up questioning.

    But the essential point is that “advanced care planning” allows a patient to express their preference for a possible time in the future when they can’t. It allows preservation of an individual’s right to refuse care.

    Comment by c3 — 8/12/2009 @ 1:51 pm

  44. @John:

    “Ambiguity like this is why people are upset about it.”

    If you are saying that bills are written confusingly, you are preaching to the choir. I often think they must get paid by the word, as no sane human would write in such a sloppy fashion. Ambiguity is the hallmark of legal language.

    HOWEVER, for language to support two ambiguous interpretations, the language must be logically able to sustain both interpretations. I can read the sentence “I like cheese” to mean “Bananas are explosive”, but that doesn’t mean the original sentence is ambiguous.
    On the other hand, a sentence like “The biggest car goes first” could be ambiguous. What does biggest mean? Volume? Mass? Length? Height? Those are all ideas that could be synonamous with “biggest”, and so whether my 2-ton mini Cooper or your 400 pound minivan should “go first” is debatable. Both can reasonably claim to be the “biggest” (although it more likely means size rather than mass, so my side of the argument is pretty weak).

    My point is, for you to read the bill as mandating meetings there needs to be language that suggests that. You said:

    “I read it as saying advanced care planning consultation is required. On this, we just need to agree to disagree”

    What language did you read that led to that interpretation? Granted, the bill is a mess . . . but I can’t find ANY language that could be interpreted to suggest that. Apparently Palin read it to suggest death panels (or she’s a flat-out liar), but just because she thinks that is what is says doesn’t mean that it says that, or suggests that, or is ambiguous about that.

    I may well be wrong. I often am. That’s why I’m asking for a reference. Page number, line number, subsection number . . . anything I can look at. What words did you read that led to your conclusion? You must have read something that implied mandated meetings. If you don’t want to cut-and-paste the text, just cite where it is and I’ll look it up myself.

    Comment by busboy33 — 8/12/2009 @ 2:46 pm

  45. #7, you can’t pull 1 section from the bill w/o reading the entire bill. Basically this is what is going on:
    The bill creates a health care exchange. That means, any health insurance company in your state can belong to this exchange. What employees will be offered is a cafeteria style choice of health plans, which will include their current carrier, but also give them the option of other plans, as well.
    Now, if your employer has had the same insurance for the last 10 years, and chooses to keep the same insurance plan forever, that plan is grandfathered in. But if there are any major CHANGES in the plan, then your employer must offer the cafeteria-style plan. That selection WILL contain your current insurance company, and if you’re happy with that, you don’t have to change. But there is NOTHING forcing you to switch to the public insurance plan.
    In fact, right now, almost no one has a choice of insurance plans. Their employer chooses a plan for them, signs a contract, and open enrollment is basically a choice of nothing. This will give you a choice of every health insurance company operating in your state, and each one has to offer three levels of plan.
    In other words, ask yourself which private insurance company you chose to be with, and what will you do if his employer switches to a different company next year? The company I was with until recently changed insurance companies every couple of years; I never had a choice. And this was a billion dollar company.
    The plan gives people more choice, not less, and NO ONE will be forced to take public insurance if they don’t want to. And it doesn’t say anything like that…

    Comment by Brian — 8/12/2009 @ 2:59 pm

  46. John,

    I just have one simple question, and I promise its a respectful good faith question, stemming from the fact that I REALLY want to understand all my fellow conservatives.

    In order for the “mandate” issue to be ambiguous, there must be a noun or verb somewhere that could be interpreted as either optional or mandatory.

    Sandy Szwarc’s example of “shall” is perfect for this! I could see how “you shall do x,y and z” could be interpted either way. Unfortunately, no such “shall” sentence exists anywhere in section 1233.

    please just provide us with the statement that some people are interpreting one way and other people are interpreting the other way.

    Comment by ken.mcloud — 8/12/2009 @ 3:45 pm

  47. “Sandy Szwarc’s example of “shall” is perfect for this! I could see how “you shall do x,y and z” could be interpted either way. Unfortunately, no such “shall” sentence exists anywhere in section 1233.”

    Page 425:

    •HR 3200 IH
    1 not had such a consultation within the last 5 years. Such
    2 consultation shall include the following:”

    Might not be in the context either person implied, but there is a “shall” sentence.

    Comment by sninky — 8/12/2009 @ 4:15 pm

  48. sninky-

    the work “shall” appears exactly 12 times in section 1233 of HR 3200. I never contested that.

    I just asserted that there is no sentence that says that medicare patients “shall” receive these consultations.

    Comment by ken.mcloud — 8/12/2009 @ 5:42 pm

  49. sorry, by “the work” I mean “the word”

    Comment by ken.mcloud — 8/12/2009 @ 5:43 pm

  50. @sninky:

    What Ken said was “no such ’shall’ sentence exists”. The term “such” means that there is no sentence using “shall” in the style that Sandy Szwarc used: “you shall do x,y, and z”.

    As you noted, the “shall” sentence that you quoted defines what shall be included in the meeting . . . not whether the meeting shall occur or not.

    That isn’t ambiguous or vague. There isn’t any honest way to interpret that sentence as applying to anything other than what is included in the meeting. That isn’t what Ken is talking about, since this entire conversation deals with mandatory (you shall/must have a meeting) meetings.

    Comment by busboy33 — 8/12/2009 @ 5:49 pm

  51. Re: SJ (#11) & Busboy (#14)


    Your question “What on earth does late-term abortion have to do with insuring the uninsured?” missed the point I was trying to make. I guess my “grenade” blinded you to the fact that the article was about the “slippery slope,” rather than the actual arguments about health care.

    I guess I made the same mistake the author speaks about - I went from A to Z without explaining the logical steps in between. I was trying to compare how abortion was sold to mainstream America: as a way to prevent thousands of women from dying from back alley abortions, that only first trimester fetuses would be aborted, and that abortion would be mainly for rape and incest victims. Had someone stood up and said, “One day we’ll legally pull a baby out of the womb, leaving it’s head in the birth canal, stick scissors in it’s brain and suck out the contents and call it abortion,” that person would be labeled a fearmonger and out of touch with reality, much like people are labeled today. They would have been told to shut up, sit down, and that Americans would never let that happen. And yet, we have slid down that slippery slope.

    You make my point about the accusations, sir. You said, “In my experience, people only resort to emotion in a debate when they have nothing substantial to argue.” Again sir, this article was about the SLIPPERY SLOPE, not the arguments themselves.

    So, what emotion are you bringing to the argument? Sounded like anger to me. Seems you’re throwing your own grenades. Maybe I’ve watched a program from that far-right outfit National Geographic called “In the Womb” and learned that life may really begin before birth. What’s with the Jesus remark? I may be Jewish or Muslim, you don’t know.

    But it’s OK. Mock us and dismiss us. Push the bills through that no one will read, no one can figure out, and put lots of pork in there for your Liberal special interest groups. You know what’s best for the mob of stupid Jesus lovers. We’ll sit down and shut up. You may not hear from us again until November of 2010 or 2012. I guess we’ll see.

    Comment by SJ in WV — 8/13/2009 @ 11:03 am

  52. For all:

    from today’s online New York Times:

    “There is nothing in any of the legislative proposals that would call for the creation of death panels or any other governmental body that would cut off care for the critically ill as a cost-cutting measure. But over the course of the past few months, early, stated fears from anti-abortion conservatives that Mr. Obama would pursue a pro-abortion, pro-euthanasia agenda, combined with twisted accounts of actual legislative proposals that would provide financing for optional consultations with doctors about hospice care and other “end of life” services, fed the rumor to the point where it overcame the debate.

    On Thursday, Mr. Grassley said in a statement that he and others in the small group of senators that was trying to negotiate a health care plan had dropped any “end of life” proposals from consideration.

    A pending House bill has language requiring Medicare to finance beneficiaries’ consultations with professionals on whether to authorize aggressive and potentially life-saving interventions later in life. (I believe this is H.R. 3200 - John)

    Though the consultations would be voluntary, and a similar provision passed in Congress last year without such a furor, Mr. Grassley said it was being dropped in the Senate “because of the way they could be misinterpreted and implemented incorrectly.”


    Let’s let this be the final word on the intent of the amendment.


    Comment by John — 8/13/2009 @ 9:08 pm

  53. @SJ:

    Looks like I stung you with the “Jesus” remark.

    You’re right . . .I am angry. I’m angry over all of the “debate” over healthcare reform. I’m angry at the misinformation, confusion, and outright lies being “debated”. This is a serious topic, and it deserves serious debate.

    You said your comment about abortion was to illustrate the “slippery slope” danger of this bill. I asked it before, and now I’ll ask it again: Does that mean you are against the government doing anything? If the argument against the bill is “I’m against X, this bill has nothing to do with X, but who knows what might happen in the future so I’m opposing the bill”, then there really isn’t any bill, on any topic, that could pass that standard. That’s not discussion.

    You refer to your use of abortion as a “grenade”. I agree. It’s a powerfully emotional topic (btw — I’ve posted on this site often, and I feel confident saying you will not find a single comment of mine that endorses or supports abortion). The purpose of a grenade is to destroy a target. The purpose of throwing the “abortion grenade” into a discussion about this bill is the same — to enflame passions and stop any rational debate. It is a deliberate tactic to stop conversation, made more manifest since this conversation has nothing to do with abortion. It is the same tactic as saying “Obamacare will euthanize the elderly” or “the healthcare logo is a Nazi icon”. I don’t say this to be rude — it is cheap and shallow, and it is an insult to everybody on both sides trying to learn from each other.

    The remark about Jesus was a deliberate slap in your face, and it was clearly effective. That was me throwing a “grenade” right back at you. You didn’t like it? I’m not suprised. I didn’t intend for you to. I didn’t like your grenade either. You clearly are opposed to abortion. You think it is killing a person. That means people who support it are murderers. By tying your beliefs about abortion to this bill, and by extention to those that support it, you intentionally backhanded them (I am one of “them”) by implying they are morally bankrupt baby killers. Don’t like it? Think about that the next time you cook a grenade.

    “Push the bills through that no one will read. . .”

    I read it. KenMcCloud read it. Rick read it. Have you? If you haven’t, maybe you should before you decide if its a good bill or not.

    “. . .no one can figure out . . .”

    It is certainly a mess, confusing, and downright boring, but it ain’t hard to figure out. Have you tried?

    “. . .and put lots of pork in there for your Liberal special interest groups.”

    Newsflash — I’m not a Liberal. Nor do I have any special interest groups (except the Hallowed Brotherhood of What’s Best for Busboy, of course). Nor do I have any input on what goes into the bill. This might also suprise you . . . I’m a spiritual person, and as such I have no animosity for “Jesus lovers”, and I don’t think that makes anybody stupid. Loving Jesus doesn’t make a stupid person any less stupid, though.
    I didn’t call you stupid, before or now. Seems like I’m not the only one here with a little anger.

    Comment by busboy33 — 8/14/2009 @ 6:39 am

  54. Busboy:

    OK, you want a discussion. How about a civil one? I’m all for it. I’m glad we can find common ground on that!

    I am sorry that I brought Abortion into the debate. My intent was NOT to upset you, honestly. To my way of thinking, it is a good example of a slippery slope. However, instead of making the assumption that I was purposely trying to upset you, maybe you could have answered this way:

    SJ, please don’t use abortion in this debate. It is an extremely emotional subject that made me mad, and I’m sure others like me. Could you please use another example of the slippery slope so I can understand where you are coming from?

    That would start a dialog between us, rather than throwing grenades, don’t you think? I’m not trying to get into a touchy-feely kind of situation here, but it seems right now that if the goal is Bi-Partisanship, maybe the side with power would be wise to ask what issues they could agree with the other side of the aisle.

    From your answer in #14 about bridges, schools, and the police, it sounds to me that you think all slippery slope arguments are invalid. That means you have a problem with the original article, in which the writer describes good slippery slope arguments and bad ones. Would that be fair to say?

    In fairness to you, my comments about not reading the bill are directed at the Congress and White House, who didn’t read the Stimulus Bill or the Cap and Trade Legislation before passing it. It appears to me that they wanted to do the same with this bill and rush it through without giving anyone a chance to really know what’s in it. Can you understand where I get that idea? I think much of the frustration being directed at the Health Care bill is the snowball effect of those actions.

    Maybe that’s a slippery slope?? I just thought of that. A = they didn’t read the stimulus bill before passing it + B they didn’t read the Cap & Trade before pushing it through the House, = They’ll do the same with this Health Care Bill. I haven’t thought it through, so I hope it doesn’t sound too bad. (Please go easy on me if it does!)

    Your thoughts??

    Comment by SJ in WV — 8/14/2009 @ 7:36 pm

  55. @SJ:

    I thank you for your reply.

    Work has demanded my attention, so my response is being delayed. You deserve more than a one line comment. I will reply as soon as I can.

    Comment by busboy33 — 8/15/2009 @ 10:34 pm


    Pingback by Right Wing Nut House » THE SLIPPERY SLOPE REVISITED — 8/17/2009 @ 8:07 am

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