Right Wing Nut House

I suppose it is too much to expect that either party could deal effectively with the health care crisis. In fact, I would argue that our system was not set up to make such massive changes in American life so quickly, that the very nature of the legislative process prevents prudent lawmakers from overreaching and trying to do too much, too soon.

Part of that is the dance that occurs between the majority and minority. True, the atmosphere in Washington has been testy the last couple of decades. But beyond that, there are systemic checks on the majority - most of them built in to the very fabric of the House and Senate rules while others can be found in the Constitution. The Founders saw the People’s House as a place where men were governed by raw passion, and that the supposed elitists in the senate (chosen by state legislators), would put a brake on any imprudent measures passed in the lower chamber.

No, the filibuster is not in the Constitution. But I have no doubt the majority of the Founders would have approved of how it has been used in the past as well as how it is being employed now. When the GOP wanted to ram through some judges who were seen as being either poor jurists, or too extreme, the Democrats balked. The New York Times favored the tactic back in November of 2004:

The Republicans see the filibuster as an annoying obstacle. But it is actually one of the checks and balances that the founders, who worried greatly about concentration of power, built into our system of government. It is also, right now, the main means by which the 48 percent of Americans who voted for John Kerry can influence federal policy. People who call themselves conservatives should find a way of achieving their goals without declaring war on one of the oldest traditions in American democracy.

And they were right. Of course, now that the shoe is on the other foot, the filibuster is evil incarnate if you listen to many on the left. But the principle is sound; legislation that either doesn’t have the support of the people, or is flawed thinking, or whose consequences cannot be easily seen, deserves the “check” that the senate can place on it.

Does this mean that there shouldn’t be health care reform at all? Some on the right would argue this but I think I’ve made my own position clear over the last few months; when millions who want insurance, or need insurance, who are either too poor to afford it or can’t get it because of a chronic condition, something is wrong with the system. The other big reason for reform is the cost of health care - and thus, the cost to government who spends about 40 cents of every health care dollar - are out of control and desperately need to be reined in.

We can’t simply say to those who can’t get insurance, “Too bad if you get sick or hurt. Try bankruptcy, OK?” I don’t see health insurance as a “right” but neither is it fair for families to be burdened for the rest of their lives with a health care bill from a car accident or a serious childhood illness. It is the same reasoning we use for assistance to the poor. If through no fault of their own, someone finds themselves unable to pay for food or shelter, the government must step in. Again, do we say “Too bad you can’t eat. Try a church pantry, OK?”

I am of the school that sees government as an agent to fill in gaps where doing so is prudent and makes sense. Clearly, there is a role for government to play in addressing the health care problem. A purely free market solution does not prevent itself, although certainly applying market forces to the cost curve would seem to make a good deal more sense than the arbitrary manner in which the House and Senate bills address this aspect of the problem.

But government alone cannot address these problems - a position utterly rejected by the far left in the Democratic party who are driving this reform bill over a cliff. If the bill simply addressed the problem of insuring the uninsured and trying to “bend the cost curve” in health care spending, I have no doubt that many Republicans would have enthusiastically thrown themselves into the process. But the overreach written into the bill guaranteed from the beginning that the GOP would be on the sidelines.

You don’t need comity between warring parties to get something done on health care. What is needed is the application of common sense and a little prudence. Indeed, prudence has been sacrificed on the altar of process - the abandonment of the principle of “good government” in order to achieve a purely political triumph for the majority.

As a civic virtue, prudence is underrated.

Russell Kirk:

Burke agrees with Plato that in the statesman, prudence is chief among virtues. Any public measure ought to be judged by its probable long-run consequences, not merely by temporary advantage or popularity. Liberals and radicals, the conservative says, are imprudent: for they dash at their objectives without giving much heed to the risk of new abuses worse than the evils they hope to sweep away. As John Randolph of Roanoke put it, Providence moves slowly, but the devil always hurries. Human society being complex, remedies cannot be simple if they are to be efficacious. The conservative declares that he acts only after sufficient reflection, having weighed the consequences. Sudden and slashing reforms are as perilous as sudden and slashing surgery.

I don’t see how anyone can apply the principle of “prudence” to this legislation. And please note that Professor Kirk is inferring the existence of a body like the United States Senate to place a check on the passions of the imprudent.

In truth, the senate has traditionally been a “conservative” body in that its rules and traditions allow for a more thoughtful and measured approach to legislation. After all, it used to be that these cloture votes would occur after hundreds of hours of talking, as an even smaller minority than the 40 GOP senators (the rules used to call for 66 votes in favor of cloture) could tie up the “World’s Greatest Deliberative Body” for weeks by reading cookbooks, the Congressional Record, and other time consuming tomes.

Cloture itself is a relatively recent invention. It was created prior to our entry into World War I when just a couple of senators could hold up the business of the senate simply by not yielding the floor (See Jimmy Stewart’s one man filibuster in Mr. Smith Goes to Washington).

The practical effect of all this talking was that bills were considerably watered down in the senate before going to conference. In order to achieve passage in the senate, the minorities concerns were addressed. And it prevented the kind of wholesale changes in American society that we are seeing with health care reform.

President Obama is not a prudent man. He is a reckless, arrogant ideologue who is so concerned with his legacy and his place in the history books, that he is willing to foist this very bad bill on the American people and damn the consequences. It is so big, so broadly drawn, encompasses so much, that it would be impossible for any group of bureaucrats to write rules and regulations that wouldn’t horribly infringe upon the liberties of the people.

There is no blueprint, no roadmap that would reveal what the long term consequences of passing this bill might be. Guessing at its cost is akin to looking into a crystal ball. And Harry Reid ain’t no gypsy. In fact, the Democrats have tried to hide the costs of the bill:

For starters, as CBO notes, the bill presumes that Medicare fees for physician services will get cut by more than 20 percent in 2011, and then stay at the reduced level indefinitely. There is strong bipartisan opposition to such cuts. Fixing that problem alone will cost more than $200 billion over a decade, pushing the Reid plan from the black and into a deep red.

Then there are the numerous budget gimmicks and implausible spending reductions. The plan’s taxes and spending cuts kick in right away, while the entitlement expansion doesn’t start in earnest until 2014, and even then the real spending doesn’t begin until 2015. According to CBO, from 2010 to 2014, the bill would cut the federal budget deficit by $124 billion. From that point on, it’s essentially deficit neutral — but that’s only because of unrealistic assumptions about tax and Medicare savings provisions. By 2019, the entitlement expansions to cover more people with insurance will cost nearly $200 billion per year, and grow every year thereafter at a rate of 8 percent. CBO says that, on paper, the tax increases and Medicare cuts will more than keep up, but, in reality, they won’t. The so-called tax on high cost insurance plans applies to policies with premiums exceeding certain thresholds (for instance, $23,000 for family coverage). But those thresholds would be indexed at rates that are less than health-care inflation — forever. And so, over time, more and more plans, and their enrollees, would bump up against it until virtually the entire U.S. population is enrolled in insurance that is considered “high cost.”

Chicanery in budgeting is not limited to the Democratic party. But it’s a question of scale, isn’t it? We’re not talking about fudging some numbers on a new jet fighter that might show a couple of tens of billions of dollars less over 5 years. We are discussing trillions of dollars in federal spending that are being covered up because if the true cost of this bill were known, it would be even more unpopular than it is now.

Prudence is a lost virtue in Washington. Neither party adheres to its meaning or even its spirit. Profligate, wastrel, wasteful, uncaring of the future - there is more broken in Washington than what passes for political discourse between the parties.

I used to laugh at some of my fellow conservatives who believed that the United States should withdraw its membership in the United Nations. The notion belonged in the Robert Taft era when visions of Bilderbergs and Trilateral Commission conspiracies haunted the dreams of the paranoid right. (They still do but not half as bad as it used to be.)

Sure, it’s full of anti-American brutes and thugs, but you can’t go anywhere in the world without tripping over people who hate us. You have to be daffy to like the US in a lot of places on this planet — something that was true even after our Lightwalking Messiah became president.

Corruption? There was a time that I believed simple bureaucratic inefficiency at the United Nations was the price we paid to participate in a forum where at least we had the veto in the Security Council. And even with all its drawbacks, there was a time I believed that the United Nations mattered as a place where the superpowers could talk about problems in a neutral forum that contributed to stability and peace.

Yes, I was young and stupid once. Perhaps the UN was never any of those things, that it was a mirage, a convenient fantasy that was designed to cover up the world body’s fatal flaws.

Whatever the UN was, it is no longer. I wrote this a few years ago when I wondered whether it was time to withdraw from the organization:

The United Nations is not a serious place. It is a place where people pretend. It is a place where people pretend to address the serious issues of the day when they have no desire to do so nor seriously engage any process that would begin to solve them. It is a place where people pretend that what they do or say matters one whit to the gimlet eyed thugs whose murderous designs on the rest of humanity are downplayed and even rationalized. And it is a place where people pretend that all of this is so despite knowing full well that it is not.

Adults do not pretend. Adults deal with the world as it is not as they would like it to be. In this, the UN then has become a playground, a fantasyland for childish notions of “peace” and “stability.” It has become the number one enabler of genocidal maniacs, brutish aggressors, and fanatics with an eye on Armageddon. And since the consequences of facing down the evil is too painful, they pretend the evil doesn’t exist.

Add to this a breathtaking cynicism that has now made the UN not only fatally flawed, but dangerous to human liberty as well. Is it my imagination or has the United Nations gotten infinitely worse over the last two decades? Maybe it’s that I’m paying attention more but it seems to me that there have been some massive examples of personal and institutional corruption publicized in the last few years relating to the UN which prove that this is an organization that does not deserve US taxpayer monies, nor is it any longer in the interest of the United States to belong.

Oil for Food - possibly the biggest bribery case in the history of human civilization with up to $20 billion in bribes and kickbacks, also ensnaring former SG Kofi Annan and his son; the UN “peacekeeper” scandals involving selling underage girls for sex - these are just the more egregious examples of the shocking corruption that passes as business as usual for the world body.

The day to day waste is incredible. Nobody knows how much the UN Secretariat spends because it doesn’t have a budget in the real sense of the word. It is estimated at around $5 billion a year - just for the secretariat. That doesn’t include all the funding for WHO, peacekeepers, and other UN functions.

And now, the clincher.

The Chairman of the Intergovernmental Panel on Climate Change (IPCC) - the UN office that is ramrodding the entire planet-wide effort to cut emissions, do the science, and transfer massive amounts of cash from rich countries to poor countries, has a conflict of interest so profoundly corrupting as to be beyond belief.

Dr. Rajendra Pachauri is involved in dozens of companies who benefit directly from his panel’s decisions on climate change:

Although Dr Pachauri is often presented as a scientist (he was even once described by the BBC as “the world’s top climate scientist”), as a former railway engineer with a PhD in economics he has no qualifications in climate science at all.

What has also almost entirely escaped attention, however, is how Dr Pachauri has established an astonishing worldwide portfolio of business interests with bodies which have been investing billions of dollars in organisations dependent on the IPCC’s policy recommendations.

These outfits include banks, oil and energy companies and investment funds heavily involved in ‘carbon trading’ and ‘sustainable technologies’, which together make up the fastest-growing commodity market in the world, estimated soon to be worth trillions of dollars a year.

Today, in addition to his role as chairman of the IPCC, Dr Pachauri occupies more than a score of such posts, acting as director or adviser to many of the bodies which play a leading role in what has become known as the international ‘climate industry’.

A guy who has the fate of the western world’s economies pretty much in his hands has a direct, personal, financial interest to portray climate change as gruesome, terrifying, and inevitable a reality as possible?

Should it surprise us that this is, indeed, how the IPCC views climate change when the man responsible for leading the world toward a responsible future is involved with “more than a score” (20) of companies who are set to become fabulously wealthy because of his say so?

A guy who doesn’t know his ass from a climate model is overseeing the biggest cooperative international effort in history. The only thing comparable that comes to mind was the nearly successful effort by the WHO to eradicate smallpox. But the world was much smaller back in the 1970’s and no one had to gin up fear about the effects of that disease.

Are we to believe our government is unaware of these connections? Of course not. You can bet they are also fully aware of the consequences now that these connections are out in the open.

Here’s just a couple of those pies in which Dr Pachauri has dipped his fingers:

The original power base from which Dr Pachauri has built up his worldwide network of influence over the past decade is the Delhi-based Tata Energy Research Institute, of which he became director in 1981 and director-general in 2001. Now renamed The Energy Research Institute, TERI was set up in 1974 by India’s largest privately-owned business empire, the Tata Group, with interests ranging from steel, cars and energy to chemicals, telecommunications and insurance (and now best-known in the UK as the owner of Jaguar, Land Rover, Tetley Tea and Corus, Britain’s largest steel company).

Although TERI has extended its sponsorship since the name change, the two concerns are still closely linked.

In India, Tata exercises enormous political power, shown not least in the way it has managed to displace hundreds of thousands of poor tribal villagers in the eastern states of Orissa and Jarkhand to make way for large-scale iron mining and steelmaking projects.

[...]

TERI-NA is funded by a galaxy of official and corporate sponsors, including four branches of the UN bureaucracy; four US government agencies; oil giants such as Amoco; two of the leading US defence contractors; Monsanto, the world’s largest GM producer; the WWF (the environmentalist campaigning group which derives much of its own funding from the EU) and two world leaders in the international ‘carbon market’, between them managing more than $1 trillion (£620 billion) worth of assets.

All of this is doubtless useful to the interests of Tata back in India, which is heavily involved not just in bio-energy, renewables and insurance but also in ‘carbon trading’, the worldwide market in buying and selling the right to emit CO2. Much of this is administered at a profit by the UN under the Clean Development Mechanism (CDM) set up under the Kyoto Protocol, which the Copenhagen treaty was designed to replace with an even more lucrative successor.

Under the CDM, firms and consumers in the developed world pay for the right to exceed their ‘carbon limits’ by buying certificates from those firms in countries such as India and China which rack up ‘carbon credits’ for every renewable energy source they develop – or by showing that they have in some way reduced their own ‘carbon emissions’.

How can anyone take anything the IPCC says about climate change seriously? What kind of cynical, corrupt, power hungry organization would place this man in charge in the first place?

Look, I am not a warming denier. But Holy Mother of God people - we’re about to spend trillions of our own money and many trillions more from other industrialized countries based on this crook’s say so. And don’t bother to tell me that the IPCC isn’t affected by what Pachauri wants. It is he who shaped the IPCC statements in 2003 and 2007 that sounded such a shrill alarm about global warming. Would the warnings have been so dire without him as chairman? Don’t you think we should find that out before committing economic sepaku?

If Climategate didn’t convince reasonable people to take a second look at the science upon which global warming is based, perhaps these revelations will force even some believers to be a little more skeptical.

And this should also be the last straw as far as our participation in the United Nations. Sure, keep giving money to WHO, to the refugee commission, maybe even to the peacekeeping operations.

But our contributions to keep the United Nations secretariat functioning should be stopped and we should clear out our offices and let the kleptocrats have it. When having sex, I like to know who’s screwing me - something you can’t say about the UN.

It would be so easy to write about Christmastime this year and turn it into a Scrooge-like rant about how awful things are, how America is going to the dogs, how the economy has made everyone fearful and grouchy, or how America is past its zenith and has begun a frightening decline from which she will never recover.

The truth is, I could write that post with my eyes closed. And those familiar with this site know that I don’t need the occasion of Christmas to make similar points.

Instead, maybe we should look beyond the day to day and focus in on the big picture.

What is really the most important thing in your life? The standard answer is “my family,” or “God,” or perhaps “my community.” All of those are nice, safe answers and probably true to one degree or another.

I was thinking about this question last night as Zsu-Zsu and I put up our outside decorations for Christmas. And it struck me that there is something perhaps even more fundamentally important in my life than any of those; it is “luck” or, the Greeks would call it “fate” without which the rest simply wouldn’t be very important at all.

Many would ascribe “fate” to the plans of a Supreme Being. If that gives you comfort, I will not argue with you. But being an atheist and a secularist, I think it absolutely incredible that I find myself here in America, alive in what is surely the most exciting time in the history of human civilization in what is still the greatest nation on earth, living a life that billions around the globe and many tens of millions in America can only dream of living, while being surrounded by the warmth and comfort of people that love me.

We generally refer to this as “counting our blessings.” I look at it as pure chance, the product of the random spinning of atoms, molecules, matter, and the mystical, unknowable vagaries of life influenced by the choices we make as well as simple biology.

There is something unsettling about this, which no doubt led to the belief that our lives unfold according to a divine plan. Whether it’s some kind of “God gene” or a specific place in the brain that predisposes our species to ascribe to the supernatural what is actually the result of fate, there is a natural human tendency to take comfort in believing that even with “free will,” our life path can only be made relevant by adhering to the plan some deity has laid out for us to follow.

Again, I intend no disrespect to people of faith. But when I think about where I might have ended up for my stay of three score and ten years on this planet, who I might have been, the kind of family I could have been born into, and the alternate consequences that would have befallen me if I had made different choices in my life, I feel a sublime oneness with with, for lack of a better term, the “universe.” Rather prosaic of me, I know but the point is, the very randomness that caused all of this to occur is quite humbling and makes one aware that putting forth an effort to take from this life every possible joy - which includes giving joy to others - is the best way one can be true to themselves and their concept of living a moral life.

The Greeks believed that a person’s “fate” was in the hands of three goddesses; the Moirae:

THE MOIRAI (or Moirae) were the goddesses of fate who personified the inescapable destiny of man. They assinged to every person his or her fate or share in the scheme of things. Their name means “Parts.” “Shares” or “Alottted Portions.” Zeus Moiragetes, the god of fate, was their leader,.

Klotho, whose name meant ‘Spinner’, spinned the thread of life. Lakhesis, whose name meant ‘Apportioner of Lots’–being derived from a word meaning to receive by lot–, measured the thread of life. Atropos (or Aisa), whose name meant ‘She who cannot be turned’, cut the thread of life.

At the birth of a man, the Moirai spinned out the thread of his future life, followed his steps, and directed the consequences of his actions according to the counsel of the gods. It was not an inflexible fate; Zeus, if he chose, had the power of saving even those who were already on the point of being seized by their fate. The Fates did not abruptly interfere in human affairs but availed themselves of intermediate causes, and determined the lot of mortals not absolutely, but only conditionally, even man himself, in his freedom was allowed to exercise a certain influence upon them. As man’s fate terminated at his death, the goddesses of fate become the goddesses of death, Moirai Thanatoio.

The Moirai were independent, at the helm of necessity, directed fate, and watched that the fate assigned to every being by eternal laws might take its course without obstruction; and Zeus, as well as the other gods and man, had to submit to them.

We like to think the Greeks and Romans “superstitious.” But a careful reading of the tasks set out for the Moirae’s reveals a subtly of logic that, while still dependent on the supernatural, nevertheless offers the beginnings of a humanistic response to questions of why I am here, now, and not somewhere else at some other time in history. The element of randomness is part of their belief system which is a recognition that there is some unseen force that plays a role in the affairs of man.

You might legitimately ask why this sudden interest in randomness especially at Christmastime? Despite all that has gone on in recent years that I have written about with passion, energy, and mustering whatever common sense and knowledge I have to bring to bear in illuminating the events that have roiled our nation and the world, nothing is as important as being reminded of the basic notion that I am extremely lucky to have what I have, both material and spiritual in this life. All else flows from that premise, and the concept of “fate” that is responsible for all this should engender awe at the unknowable vagaries of life that have reached out and touched who and what I am to fill me to the brim with happiness.

And isn’t that what Christmas (in the secular sense), at bottom, is all about? Spreading joy by sharing, getting close to your family, making an effort to give more than you receive - in the classical Christian sense, we do this because by recognizing our blessings, we are praising God for his gifts.

But for me, it is enough that I accept the idea that in order to be true to myself, I should celebrate my good fortune by being the best person I can be and share what I have with those close to me, as well as those who deserve better.

I know this won’t come as a shock to many of you. For months, I have been urged to prove how smart I am by abandoning conservatives to their own fate. Inspired by such luminaries as David Corn, Charles Johnson, John Cole, Andrew Sullivan, and Sylvester Stallone, I have decided to take the plunge - or walk off the cliff - and do it. From here on out, I am no longer a conservative.

My problem is, what should I call myself now? “Independent” is too much like RINO. Ditto “moderate.” Moderate what? I suppose I could swallow hard and refer to myself as a “liberal,” but frankly, I don’t think I have what it takes. I would need brain surgery to get my synapses firing the politically correct way, not to mention the alteration of brain chemistry necessary to reduce my cognitive abilities to the requisite level.

So, in desperation, I am announcing my conversion to Communism.

Being a commie is easy. No need to think hardly at all. All you have to do to become a Communist is sprinkle your conversations with a few identifying words and phrases and you’re in.

“Power to the proletariat!” is a good start. This is an all purpose phrase and is especially effective when people smarter than you (everybody) make a point in an argument you can’t refute, such as “Communism doesn’t work, ninny.”

Other words and phrases I will find that come in handy will be “religion is the opiate of the masses,” - especially effective against Christians. In fact, never ever use the term “the people” when talking about large groups. Always refer to them as “the masses.” No one will ever mistake me for anything but a redbelly, Lenin loving communist as long as I use the word “masses” to describe my fellow citizens.

And, of course, always call your friends “comrade.” If you want to impress people you’ve just met, call them “comrade” too. If someone disagrees with you, it can be an enormous amount of fun to refer to them as “capitalist, imperialist pig.” Communism is the only ideology of which I am aware where you can call someone you don’t even know a “pig” and it will sound perfectly normal.

I suppose I am going to have to get used to spouting about the “class struggle” too. This phrase is a little trickier to inject into casual conversation but I’m sure I’ll get the hang of it.

Whatever…it sure beats thinking about stuff. And there are ancillary benefits too. Ever notice how gorgeous women are always hanging around pimple faced, straggly bearded communists? Being a commie is a babe magnet. It probably has something to do with the fact that some women are suckers for losers, or have a soft spot for lost puppy dogs. Whatever, once a chick knows your a communist, they can’t wait to jump your bones.

So there’s that to look forward too. Then there’s the fact that my job prospects will improve enormously - in some quarters. Just think about all the teaching positions that would open up if I were to become a commie? Why, there would be dozens of colleges lining up to bid for my services. I could write my own ticket at Berkeley. Ditto CUNY. And Columbia would roll out the red carpet for me - literally. Hell, I wouldn’t even have to know anything about the subjects I’d be teaching. Just read a few lines from Das Kapital or Dreams from my Father and open the class for discussion. The kids know the routine and would bulls**t their way to “A’s” and “B’s.”

I’d probably win “Teacher of the Year.”

Other opportunities besides teaching would present themselves if I declared Red, of course. Would I be setting my sights too high to try for a position at the White House? I know the competition for commies in government is something fierce these days, but I think I have a lot to offer. Like the rest of the Obama administration, I wouldn’t have a clue about what I should be doing. And I think I’d be very good at designing ruinous economic programs, writing bad legislation, and generally mucking things up.

The only drawback is that I am not a member of an oppressed minority. Perhaps once national health insurance is a reality, I can get a sex change operation paid for by the taxpayer. Or perhaps the strategic application of a little shoe polish would get me past the Gatekeepers in personnel. Maybe both.

Naturally I discussed my conversion to Communism with Zsu-Zsu. As always, she listened thoughtfully to what I had to say. Her eyes narrowed a bit when I got to the part about the young hippie chicks falling all over me but other than that, her face registered no emotion.

It wasn’t until I called her “comrade” that I got any reaction at all. It was at that point that she whopped me upside the head with a rolled up newspaper.

“Oh for God’s sake Ricky,” she said as I vigorously rubbed the knot growing on my forehead. “You’ll never make a good commie, ya dope.”

“Why not?” I asked through the pain. Zsu-Zsu knows of what she speaks, having spent the first few years of her life living in Communist Hungary.

“You hate standing in line for anything, you have no patience with bureaucrats, and you don’t say ‘comrade’ with half enough conviction.”

She’s probably right. I’d make a lousy communist. Looks like I have no alternative but to remain a conservative for the time being.

Rare have been the opportunities in recent years to reach around and pat myself on the back, and this self congratulatory event warrants a small post of recognition.

Right Wing Nuthouse is ranked #70 on the Bloglines Top 1000 Feeds. One might legitimately ask how in God’s name was I able to secure nearly 20,000 subscribers to my feed - especially considering the fact that my sitemeter shows average daily visits of about 1500?

Simple. I cheated.

Well, not really. It seems that 4 years ago, Bloglines placed RWNH in their “Recommended” conservative political feeds. A new Bloglines subscriber could simply hit the “Subscribe” button and all the conservative blog recommendations would be included. I wrote them several times expressing my undying gratitude but never heard back from them. Let this serve as a public acknowledgment of thanks for their foresight and fabulous sense of taste and discernment for including this little site in their “Recommended” list.

This brings up a serious question. I know that many of you come here via some kind of feed reader. Is it better for you to have me authorize the display of the entire blog post in my feed? Or do you prefer the current set up where I whet your appetite by displaying only the first couple of hundred words?

Next to Bloglines, the single largest feed reader that visits the site is Google. Other than those two, I don’t get many visitors who use any of the major feed readers. I am wondering if I switched to displaying the entire post if that wouldn’t change.

Let me know your preferences in the comments.

My latest at PJ Media is up - a midday special guaranteed to win me lots of friends and get me a lot of lovin’ from all you Palinbots out there.

I write, of course, about Palin’s most spectacular stupidity to date; mainstreaming paranoids:

I didn’t want to write about Sarah Palin anymore.

Really, I didn’t want to. God, I didn’t want to. But every time I think I’m out, she pulls me back in.

Face it, my friends. If Sarah Palin’s nugatory understanding of everything from foreign affairs to economic matters doesn’t cause you concern, if her predilection to expand, exaggerate, or fudge the truth about herself and her past statements hasn’t yet convinced you that she is a lightweight prevaricator and doesn’t deserve your support, then this exchange with conservative talker Rusty Humphries should change your mind:

[...]

Those who live on the fringes of American politics usually don’t realize how wacky they truly are. For the last time: The state of Hawaii issued a statement confirming that Obama was born there, thus making him a U.S. citizen. Why is that so hard to accept? There are no “questions” left to answer except in the minds of simpletons and paranoid conspiracy freaks.

No, it is not a “fair question.” It is a silly, stupid, ignorant question. No, “the public” is not making this an issue — only looney tune numbskulls are pursuing it. No, there aren’t “enough (whatever that means) members of the electorate who still want answers.” Only a small subset of the entire electorate cares.

And her whining declaration that she didn’t go after Obama hard enough on his radical associations fails to mention that the reason McCain dropped it was because nearly 2/3 of voters couldn’t have cared less. It was a losing strategy, period.

No - she didn’t say that she believes the birthers or that she wants to see Obama’s birth certificate.

All she did was say that those who questioned the president’s legitimacy were themselves, legitimate.

Read what she said and come back here and tell me that she wasn’t legitimizing the Birthers. Convince me of it and I will write an apology.

Otherwise, run away. Run far away from Sarah Palin.

UPDATE

More than 100 comments over at PJM - I’d say it’s 20 to 1 against me. Better than I expected.

Allow me to add something; Does opposing a conservative make me less of a conservative? For some, the answer is yes.

In which case, I would say they are cultists rather than conservatives. If you think opposing a personality determines one’s adherence to conservative principles, might I suggest you get ready because the Mother Ship is close now and you don’t have much time.

It is pure idiocy to judge the depth of one’s belief in anything in the first place. But to include one’s devotion to an individual as a litmus test of orthodoxy? Those who think this way may want to re-examine their assumptions.

It’s a shame for history’s sake that Germans didn’t follow that advice 75 years ago.

If you haven’t seen it yet, you should go over to Little Green Footballs and read this J’accuse post by Charles Johnson where he briefly lists some of the reasons why he has now, officially “parted ways” with the right.

Irony abounds for me in this situation. The fact is, Johnson and I are in lockstep agreement when it comes to many of our criticisms of the right. We both despise the cotton candy conservatism of Beck, Limbaugh, and Coulter et. al. that is occasionally tinged with sniffs of bigotry. We both bemoan the paranoid conspiracies - birthers, and other theories about Obama - that have risen up to inject some of their sickness into mainstream conservatism.

We both see an anti-science, anti-intellectual undercurrent in some of the critiques of liberalism employed by the base, including an inexplicable denial of Darwinism, and a “the science is settled” argument toward global climate change (the science is wrong and the whole thing is a conspiracy). And we both agree that the anarcho-conservatism expressed by many on the right is unrealistic and dangerously wrong.

Therefore, having established my bona fides, I can say flat out that Charles Johnson, in his wildly exaggerated, hyperbolic, injudicious, ad hominem, unreasonable, and illogical attacks on the right, has abandoned any claim to prudent analysis and temperate understanding, and has instead, joined the ranks of those on the right and left who don’t deserve to be taken seriously by anyone with half a brain.

To wit: (”Why I Parted Ways with the Right:)

1. Support for fascists, both in America (see: Pat Buchanan, Robert Stacy McCain, etc.) and in Europe (see: Vlaams Belang, BNP, SIOE, Pat Buchanan, etc.)

Johnson’s use of the epithet “fascist” shows that he is ignorant of the history, the philosophy (such as it was), and the tenets of that odious ideology. He is as ignorant as the brain dead lefties who employed the smear against Bush and the moronic righties who use it to describe Obama.

Using the term immediately identifies one as an excessively ideological partisan. He condemns the entire right for the wayward beliefs of a few. There is hardly a mainstream conservative blog that has not skewered Buchanan at one time or another for his stupidity and bigotry. And the tenuous connections Johnson has sought to draw to the genuine article in Europe - neo-Fascists - is laughable. Six degrees of separation does not “connect” American conservatives to those putrid personalities and parties in Europe except in the overactive, fevered, and unbalanced imagination of Johnson.

2. Support for bigotry, hatred, and white supremacism (see: Pat Buchanan, Ann Coulter, Robert Stacy McCain, Lew Rockwell, etc.)

If you are going to accuse someone of “hatred” or “white supremacism,” I suggest you take proving those charges very seriously. Johnson doesn’t and never has. In the case of McCain, he has quoted extensively from some of McCain’s postings around the internet through the years. The problem is that many of those entries that he so proudly features were not left by McCain, and many of the quotes he uses to crucify RSM are not even his.

McCain is quirky. He can be insufferable. His constant self promotion can be wearing. But I have met and come to know this man and I can state categorically that there isn’t a racist bone in his body and anyone who says otherwise doesn’t know what they’re talking about. Not recognizing that McCain was targeted by professional smear merchants only shows Johnson’s unreasoning hatred of McCain to be the product of rank emotionalism and not rational analysis.

(McCain can, and has, defended himself. I don’t agree with some of his published writings, but I have an idea of how his mind works. It is an expansive, sometimes brilliant instrument that plays with concepts and ideas as a child plays with blocks. Seizing upon out of context ramblings by McCain is a cottage industry for some of his detractors and unfortunately, RSM is also afflicted with a naivete about how some of what he writes is perceived. He actually believes his honesty and perspicacity should be rewarded. Pity it isn’t.)

3. Support for throwing women back into the Dark Ages, and general religious fanaticism (see: Operation Rescue, anti-abortion groups, James Dobson, Pat Robertson, Tony Perkins, the entire religious right, etc.)

The numbers of conservatives who Johnson is talking about could hold a convention in a Marriott conference room. The mainstream right may be devout, but I hardly think the exaggerated term “fanaticism” applies to all but a very small percentage. And the charge that the religious right supports “throwing women back into the Dark Ages” does not deserve acknowledgment except that it reveals Johnson’s overweening, ideological partisanship. No rational critic would make such a charge. An irrational mountebank would.

4. Support for anti-science bad craziness (see: creationism, climate change denialism, Sarah Palin, Michele Bachmann, James Inhofe, etc.)

Ooooh - “anti-science bad craziness?” Ladies and Gentlemen, I give you the very deep thoughts of Charles Johnson.

5. Support for homophobic bigotry (see: Sarah Palin, Dobson, the entire religious right, etc.)

Is there really “support” for “homophobic bigotry” among mainstream conservatives? There is support for DOMA. There is support for an anti-gay marriage amendment. There is opposition to including gays as victims in current hate crime legislation. As I have laid out, while there is a conservative case to be made for gay marriage, there is a secular conservative case to be made against it. There are also perfectly legitimate legal arguments to be made against any hate crime statute.

At issue is whether a pressure lobby can dictate the parameters of what constitutes “bigotry.” The GLBT lobby constantly injects politics into this question, screaming “Bigot!” at anyone who fails to support their agenda. I happen to support equal rights for gays but denounce their politicization of gay marriage and their attempts to circumvent the will of the people by calling on the courts to adjudicate what is, at bottom, a political question.

Are there homophobes and bigots on the right? Yes there are. But Johnson, as he does constantly throughout his Zola-esque rant, inflates their numbers to justify his own, narrow, rigid, ideological reasons for abandoning his former allies.

6. Support for anti-government lunacy (see: tea parties, militias, Fox News, Glenn Beck, etc.)

Here, I have to agree with Johnson that there is a very large plurality of conservatives who not only distrust government, but despise it as well, and would like nothing better than to roll back both the New Deal and the Great Society to achieve “limited” national government.

(I do not include committed Federalists in this group who are much more serious minded in their approach to government and recognize many of its modern responsibilities.)

This anarcho-conservatism, where some kind of 19th century government is envisioned as the optimal solution to our problems, is a throwback to pre-Buckley days. It is unthinking, illogical, and oblivious to how the world has changed since the heyday of Robert Taft. Ultimately, it is a fearful kind of conservatism that can’t recognize or deal with change and seeks the safety of an idealized past.

But Johnson falls off the rails by lumping the “tea partyers” in with the anti-government zealots. Certainly, some in the Tea Party movement fit the description. But having observed several of their events, I was surprised at the restraint showed by most marchers, their very ordinariness giving weight to their protests. As an echo of the anti-war movement, I would say there are many telling parallels as far as the average American who felt strongly enough to commit to a cause.

7. Support for conspiracy theories and hate speech (see: Alex Jones, Rush Limbaugh, Glenn Beck, Birthers, creationists, climate deniers, etc.)

Yes, in addition to the Birthers, there’s the “Obama is a Moooslim” crap, and “Obama wants to impoverish us all so that we become dependent on government” stupidity. But again, prove to me that this kind of thinking represents a majority of conservatives who are spouting this nonsense and I will gladly join in the cussing.

8. A right-wing blogosphere that is almost universally dominated by raging hate speech (see: Hot Air, Free Republic, Ace of Spades, etc.)

“Almost universally?” Heh - that’s something a freshman in high school might use in an essay. It’s either “universal” or not. Sorry Charles, back to English composition 101 for you.

As for the rest - not even worth commenting on. Simple sophistry.

9. Anti-Islamic bigotry that goes far beyond simply criticizing radical Islam, into support for fascism, violence, and genocide (see: Pamela Geller, Robert Spencer, etc.)

This is something of which Johnson knows a lot about. I stopped visiting his site 4 years ago because of the nauseating, anti-Muslim bigotry spewing forth in his comments - cataloged many times by those on the left who are currently making him out to be some kind of honest conservative. And Johnson was their greatest enabler, if not inventing, then popularizing the denigrating mongram R.O.P. (Religion of Peace) to describe Islam.

How many pictures of Palestinian kids dressed in fatigues and armed with toy guns did Johnson publish, usually with the caption “ROP Child Abuse?” How many 7th century practices of Islam did Johnson mock on his website? How many times did he make fun of women dressed in the chador?

All of this enabled his legions of “Lizardoids,” many of whom felt no compunction in airing their out and out bigotry of Muslims. For Johnson to use this as a reason for “parting ways” with the right is the height of hypocrisy.

10. Hatred for President Obama that goes far beyond simply criticizing his policies, into racism, hate speech, and bizarre conspiracy theories (see: witch doctor pictures, tea parties, Birthers, Michelle Malkin, Fox News, World Net Daily, Newsmax, and every other right wing source)

How can you take anyone seriously who uses the phrase “every other right wing source” to describe “hatred” of President Obama among all conservatives? Kind of a broad brush you’re using there Charles. Would the Volohk Conspiracy be a hate site? The Belmont Club? Outside the Beltway? Betsy’s Page? Q & O? I could keep going down my favorites page and add a couple of dozen of the larger blogs who offer reasoned analysis, and, if not always respectful, certainly rational critiques of the Obama administration.

And I certainly hope you don’t cast you lot with liberals. The fact that the leftysphere mirrors the right in the number of blogs who express virulent, unreasoning hatred of their political opponents would put you in the awkward position of going from the frying pan into the fire.

As a final thought, I would ask how adult is it to throw a tantrum in public in order to bask in the approbation of your former opponents? I have no reason to question Johnson’s sincerity, just his emotional maturity. Why make an announcement at all except to garner attention like some two year old who throws himself on the floor when he doesn’t get ice cream for dessert? Why not allow your opinions to shine through during the normal course of your writing rather than playing the drama queen and inflicting your exaggerated, insipid ill-reasoned diatribe on the rest of us?

Only Johnson can answer that. And since it is evident that he has neither the temperament, or intellect to engage in any kind of introspective analysis that would reveal his reasons to his own conscience, we’ll probably never know.

With the unraveling of the temperature aspect of global warming, what about the other half of the equation?

What about the rise in CO2 levels in the atmosphere.

The AGW theory rests on two pillars; the rise in CO2 levels in the atmosphere correlated with the rise in temperatures over the previous several decades. As even Ken Trenberth of CRU pointed out in one of the hacked emails:

The fact is that we can’t account for the lack of warming at the moment and it is a travesty that we can’t. The CERES data published in the August BAMS 09 supplement on 2008 shows there should be even more warming: but the data are surely wrong.

Since 1998, temps have flatlined while CO2 levels in the atmosphere have continued to rise. No amount of massaging the models can make that singular fact go away.

But let’s leave temperature problems behind and concentrate on CO2 levels. Are these measurements a fraud too? Are dozens of independent measuring centers in collusion to show a dramatic rise in CO2 levels in the troposphere?

This is the problem that deniers have when they say the entire AGW theory has been “debunked.” There isn’t a “consensus” that CO2 levels are rising. It is a measurable fact, independently confirmed around the world.

The problem for AGW advocates has always been to answer the question, what does it mean for climate? Most atmospheric physicists will not hazard a guess in that direction. Temps don’t concern them. They are interested in the chemical and molecular makeup of the atmosphere.

And right now, CO2 levels are about double what they were before industrial civilization.

(How scientists measure CO2 levels is one of those jaw dropping little tricks that impress to no end laymen like me. They measure gasses that have been trapped in air bubbles on the Antarctic ice sheet. They can date the samples using a fairly simple formula and are reasonably certain of their accuracy.)

Is this rise in CO2 a cause for concern? About 500 million years ago, CO2 was 20 times higher in the atmosphere. The average temp was much hotter (no polar ice caps) and oxygen content was also much higher. Life flourished in these hotter temps and the extra oxygen allowed for gigantic growth of the dinosaurs.

What’s different today is that the oceans are acting like a carbon sink, absorbing up to 70% of man made emissions. While the IPCC has said it is uncertain what effect this will have on the biosphere, there are already some indications that lower life forms - algae, plankton, coral - are slowing in growth.

If you understand that about 70% of the world’s humans depend on the oceans for their lives, you begin to see the outlines of disaster. Plankton and algae are absolutely vital to the food chain in the oceans and if they start disappearing, so do a lot of other life forms. The coral are also a huge part of life in the ocean and their colonies are slowing in growth dramatically in some parts of the ocean where there are reliable measurements.

It is too soon to blame this on rising levels of CO2 exclusively but the correlation is troubling. There is also the chance that warming oceans would change the almost magical currents that recycle ocean water around the world, bringing warm water from the south Atlantic and Gulf of Mexico to the northern latitudes in Europe and America which makes the climate much milder than it otherwise would be.

(Ocean temps are another question and that data too, has suffered from inaccurate and suspect measurements.)

But the doubling of CO2 levels in the atmosphere cannot be ignored, nor can the rise of the gas in the oceans. That’s why it makes sense to make a concerted effort to reduce our emissions even if the temperature isn’t rising. There may or may not be a direct relationship between rising temps and rising CO2 levels. But dramatically rising atmospheric and ocean levels of the gas require us to take steps that are prudent, and that won’t destroy our economies in the process.

First and foremost we must wean ourselves from oil and coal as our primary source of energy. Whether we are at peak oil is not an issue. Demand is rising incredibly fast and supplies will be very tight. This is not a temporary problem. Globalization has allowed many third world economies to begin growing at astronomical rates while China and India’s energy requirements are also off the charts. Supply simply can’t keep up with demand even if we drilled every drop from our own coasts and wring every molecule out of what we have on land while demanding OPEC companies dramatically increase their output.

The way out of our bind is not through solar power, or wind power, or nuclear power, but a combination of all three with a little geothermal thrown in for good measure. If we started now with a crash course, we could build 100 nuclear power plants in the next 20 years. Sure, we’d have to bite the bullet and find the political will to store the waste. But perhaps somewhere in the next 20 years, Breeder reactors would be perfected where the fuel could be recycled. All it needs is political leadership and the will to make it work.

Solar and wind power are much more problematic. Industrial scale solar is not feasible at the present time. Neither will wind power be anything more than a local solution for decades to come. But the process of changing that must start now. Weaning ourselves from foreign oil should have been a top national security concern for the last 30 years and we could cut our reliance in half by 2030 if we started now.

The president’s alternative energy plans are, for the most part, sound. The goals are unrealistic (10% energy produced by alternative energy by 2020 where we produce less than 3% today), but there’s plenty of money for research and development. More than $80 billion over the next 5 years will be spent developing everything from new solar cells to batteries that will power the next generation of electric cars.

Even without global warming, these ideas are sound investments in our future. No cap and trade. No silly carbon gimmicks. No UN takeover of our economies. And no destruction of the oil and coal industries. In fact, we should step up our exploration and drilling while finding ways to burn fossil fuels more cleanly. That last is necessary so that we don’t choke on our own industrial waste, while making our cities healthier places to live.

We don’t need global warming catastrophism to see that it is simple common sense to find ways to lower our emissions of greenhouse gases like CO2. Draconian targets are not necessary nor would they likely be achievable anyway.

Perhaps it’s time to separate the concept of CO2 emissions from rising temperatures. If we could address CO2 as an independent issue, we might see the efficacy of lowering emissions for its own sake rather than have the issue get mixed up in the messy politics of global warming.

The meltdown continues among those who sought to stifle scientific debate about man made global warming by claiming the science proving such was “settled,” or “solid,” or undeniable.”

Latest to make an ass of himself is Alan Combs who is a few days behind the curve as far as what the CRU hack has revealed:

Climate scientists who just released “The Copenhagen Diagnosis” say ice sheets are melting at an increased rate, and future sea-level rise will be higher than previously forecast. But scientific evidence means nothing to those with an anti-global warming agenda, who point to illegally hacked mails to try to prove that global warming is a hoax. Sadly for them, the anti-global-warming hysteria isn’t all it’s cracked up to be.

Sadly for Alan, the emails constituted about 5% of the total information that has been spilling out on to the internet for nearly a week now. Charlie Martin went into the “Harry Read Me” file that was kept by a harried programmer who couldn’t replicate the “scientific” findings of Mann and Jones because the computer code they used to reach their conclusion was such a mess. Earth to Alan: If you or others can’t duplicate your experimental results - in this case, temperature data - then your theory doesn’t pass muster.

Then there’s Marc Sheppard’s piece that delves more deeply into the codes and finds enormous problems with them. Evidence of fraud? The jury is out on that. But even giving the scientists in question the benefit of the doubt any fool can see that their theory on millenial temps is in deep, deep trouble.

Except the science is settled, right? Al Gore said so back in 2007:

Even once-skeptical Republicans are coming over to Gore’s side — and it seems the debate has shifted from arguing whether there is a climate crisis to disagreement over how to fix it.

The science is settled, Gore told the lawmakers. Carbon-dioxide emissions — from cars, power plants, buildings and other sources — are heating the Earth’s atmosphere.

Others agreed:

John Quiggin, economist

* “There’s no longer any serious debate among climate scientists about either the reality of global warming or about the fact that its substantially caused by human activity…” [2]

David Milliband, UK Environment Minister

* “I think that the scientific debate has now closed on global warming, and the popular debate is closing as well”[3]

Camilla Cavendish

* “The science debate is effectively over. The Stern review means that the economic debate is all but over. Only the political debate is left…”[4]

The science has never been “settled,” or “closed, or “effectively over.” There is good evidence that supports the theory and good evidence that rejects it. What is so hard about accepting that fact? What is so difficult about having an open debate without having skeptics compared to Holocaust deniers and Nazis?

Colmes and others who are seeing the ground shift under their feet as their long held beliefs are revealed as not set in stone, are dealing with this situation by saying they were for open debate all along and it is the skeptics that were for closing it!

RealClimate - a creature of the very lab where the emails and other data emerged - is now sounding a reasonable note:

More interesting is what is not contained in the emails. There is no evidence of any worldwide conspiracy, no mention of George Soros nefariously funding climate research, no grand plan to ‘get rid of the MWP’, no admission that global warming is a hoax, no evidence of the falsifying of data, and no ‘marching orders’ from our socialist/communist/vegetarian overlords. The truly paranoid will put this down to the hackers also being in on the plot though.

Instead, there is a peek into how scientists actually interact and the conflicts show that the community is a far cry from the monolith that is sometimes imagined. People working constructively to improve joint publications; scientists who are friendly and agree on many of the big picture issues, disagreeing at times about details and engaging in ‘robust’ discussions; Scientists expressing frustration at the misrepresentation of their work in politicized arenas and complaining when media reports get it wrong; Scientists resenting the time they have to take out of their research to deal with over-hyped nonsense. None of this should be shocking.

They sound almost reasonable, don’t they? Of course, the real skeptics in the scientific community did not accuse the CRU or any other lab of being communists, or part of a global conspiracy. That’s for the nutcases who are saying today that the entire warming theory has been “disproved.” No responsible skeptic has made that claim as far as I can tell. If they have, they are as bad as Colmes and his ilk who are ignoring the probability of at least some fraud and certainly an effort to stifle dissent in the crudest way imaginable at the CRU lab.

George Monbiot blames…the skeptics!

It is true that much of what has been revealed could be explained as the usual cut and thrust of the peer review process, exacerbated by the extraordinary pressure the scientists were facing from a denial industry determined to crush them. One of the most damaging emails was sent by the head of the climatic research unit, Phil Jones. He wrote “I can’t see either of these papers being in the next IPCC report. Kevin and I will keep them out somehow - even if we have to redefine what the peer-review literature is!”

One of these papers which was published in the journal Climate Research turned out to be so badly flawed that the scandal resulted in the resignation of the editor-in-chief. Jones knew that any incorrect papers by sceptical scientists would be picked up and amplified by climate change deniers funded by the fossil fuel industry, who often – as I documented in my book Heat – use all sorts of dirty tricks to advance their cause.

Yes - all that “extraordinary pressure” from fellow scientists determined to “crush them” brings out the momma in me. I just want to wrap my arms around Jones et. al. and protect them from those mean old meanies who disagree with them.

Proof that deniers are all funded by oil companies - or even prominent ones like Lindzen or McIntyre - is a little scarce from George. And how ironic is it to accuse skeptics of “dirty tricks” when the emails show that Jones and Mann used every trick in the book to keep dissenting views out of important journals?

But Monbiot sees a “crisis” for the global warming community. I don’t see it as a crisis at all. This is the absolute best thing that could have happened to the debate over climate change.

When I asked Charlie Martin on my show the other night whether I thought this would slow down cap and trade and other AGW gimmicks he thought it wouldn’t, although cap and trade may already have been dead in the US senate. But I have to disagree. The story is out there despite an amusing refusal by the major media to cover it. What makes it amusing is that they still believe they are the gatekeepers with the ability to keep a story they don’t like under wraps. But people get a lot of their news now from the internet and there is just no way this story will die anytime soon.

This will give new impetus to skeptics who may find the atmosphere to publish their findings a little friendlier. And if their papers are bogus, or flawed, they will be handled the way all science should be handled; their peers will vet their findings ruthlessly and thoroughly. If they can’t stand up to scrutiny then they will be rejected. And the same goes for the other side in the debate.

It won’t be perfect. One thing those emails honestly show is that the scientists are human. They are as susceptible to human emotions like jealousy, anger, and envy as non-scientists. They are not robots and therefore, the process will not be without problems.

But it is a process that has served us well for 500 years and has led to astonishing breakthroughs in knowledge despite the problems. Eventually, the observed phenomenon and measured data will give us enough facts to honestly reach conclusions about AGW - hopefully without much political pressure. That last may be a pipe dream but if anything can teach the scientific community to leave politics to the side, it is this scientific scandal that is as much about the politics of global warming as anything else.

I watched this 60 Minutes segment last night on “The Cost of Dying” with extraordinarily mixed emotions. From anger to fear to horror, I have rarely had such an emotional reaction to an issue.

But once past the knee jerk outrage, I began to assess the moral and ethical dimensions of the problem and am extremely unsettled in where these questions lead me.

Some background on the segment:

Last year, Medicare paid $50 billion just for doctor and hospital bills during the last two months of patients’ lives - that’s more than the budget of the Department of Homeland Security or the Department of Education.

And it has been estimated that 20 to 30 percent of these medical expenditures may have had no meaningful impact. Most of the bills are paid for by the federal government with few or no questions asked.

You might think this would be an obvious thing for Congress and the president to address as they try to reform health care. But what used to be a bipartisan issue has become a politically explosive one - a perfect example of the costs that threaten to bankrupt the country and how hard it’s going to be to rein them in. Dr. Byock leads a team that treats and counsels patients with advanced illnesses.

He says modern medicine has become so good at keeping the terminally ill alive by treating the complications of underlying disease that the inevitable process of dying has become much harder and is often prolonged unnecessarily.

“Families cannot imagine there could be anything worse than their loved one dying. But in fact, there are things worse. Most generally, it’s having someone you love die badly,” Byock said.

Asked what he means by “die badly,” Byock told Kroft, “Dying suffering. Dying connected to machines. I mean, denial of death at some point becomes a delusion, and we start acting in ways that make no sense whatsoever. And I think that’s collectively what we’re doing.”

Now for the moral questions raised by the piece; How much do we, as a society, value individual life? At what point does what’s good for the many outweigh what’s good for the one? Should anyone - insurance companies, government, or a “death panel” - have the right to tell a patient and their family when it is time to let go of life and allow the natural progression of their disease to kill them?

All of these questions and more like it are asked with the costs associated with end of life treatment always in the background. And it isn’t just the costs. It is the tremendous amount of health care resources devoted to people who have no hope of recovery but make choices like this patient:

Charlie Haggart is 68 years old and suffering from liver and kidney failure. He wants a double transplant, which would cost about $450,000. But doctors have told him he’s currently too weak to be a candidate for the procedure.

At a meeting with Haggart’s family and his doctors, Dr. Byock raised the awkward question of what should be done if he got worse and his heart or lungs were to give out.

He said that all of the available data showed that CPR very rarely works on someone in Haggart’s condition, and that it could lead to a drawn out death in the ICU.

“Either way you decide, we will honor your choice, and that’s the truth,” Byock reassured Haggart. “Should we do CPR if your heart were to suddenly stop?”

“Yes,” he replied.

“You’d be okay with being in the ICU again?” Byock asked.

“Yes,” Haggart said.

“I know it’s an awkward conversation,” Byock said.

“It beats second place,” Haggart joked, laughing.

Should someone make the decision to resuscitate this gentleman for him? Who?

This is what end of life caregivers are asking these days. And the solution, in an echo of Sarah Palin’s “death panels,” may be hard and fast rules on what kind of care the terminally ill can demand of the system:

By law, Medicare cannot reject any treatment based upon cost. It will pay $55,000 for patients with advanced breast cancer to receive the chemotherapy drug Avastin, even though it extends life only an average of a month and a half; it will pay $40,000 for a 93-year-old man with terminal cancer to get a surgically implanted defibrillator if he happens to have heart problems too.

“I think you cannot make these decisions on a case-by-case basis,” Byock said. “It would be much easier for us to say ‘We simply do not put defibrillators into people in this condition.’ Meaning your age, your functional status, the ability to make full benefit of the defibrillator. Now that’s going to outrage a lot of people.”

“But you think that should happen?” Kroft asked.

“I think at some point it has to happen,” Byock said.

Is Byock a ghoul? Or is he talking sense? This is a compassionate conflicted man if you watch the segment. The chasm he has opened beneath our feet is both a moral and practical one and the tightrope he is asking us to walk is very thin indeed. If we decide to take these circumstances and apply universal guidelines for the treatment of the dying, won’t individuals “slip through the cracks” and be condemned to die who might otherwise outlive a doctor’s expectations with treatment? How many people who are given 2 months, three months, six months to live end up amazing their physician by surviving for years?

And then there’s the question of resources devoted to the dying. Here’s a Dartmouth researcher who did a detailed study on patients in the last two years of their lives:

The institute did a detailed analysis of Medicare records for patients in the last two years of their lives. Fisher says it is more efficient for doctors to manage patients who are seriously ill in a hospital situation, and there are other incentives that affect the cost and the care patients receive. Among them: the fact that most doctors get paid based on the number of patients that they see, and most hospitals get paid for the patients they admit.

“The way we set up the system right now, primary care physicians don’t have time to spend an hour with you, see how you respond, if they wanted to adjust your medication,” Fisher said. “So, the easiest thing for everybody up the stream is to admit you to the hospital. I think 30 percent of hospital stays in the United States are probably unnecessary given what our research looks like.”

[...]

“In medicine we have turned the laws of supply and demand upside down,” Elliot Fisher said. “Supply drives its own demand. If you’re running a hospital, you have to keep that hospital full of paying patients. In order to, you know, to meet your payroll. In order to pay off your bonds.”

And, of course, the fact that these costs are rising at a frightening pace is also driving the debate over end of life care:

“The perverse incentives that exist in our system are magnified at end of life,” David Walker, the government’s former top accountant told Kroft.

Walker used to be the head of the Government Accountability Office. He now heads the Peter G. Peterson Foundation, which is a strong advocate for reducing government debt. He says that 85 percent of the health care bills are paid by the government or private insurers, not by patients themselves. In fact most patients don’t even look at the bills.

“Does that make any sense to have, I mean, most things you buy, the customer has some impact,” Kroft remarked.

“We have a system where everybody wants as much as they can get, and they don’t understand the true cost of what they’re getting. The one thing that could bankrupt America is out of control health care costs. And if we don’t get them under control, that’s where we’re headed,” Walker said.

What all of this adds up to is that America is headed for the most difficult ethical and moral dilemmas in its history - questions that go to the very heart of what our country stands for, how we see ourselves; questions that deal with our deeply held religious beliefs, and perhaps most uncomfortable of all, cultural questions about the nature of life and death.

In all of this, the individual, and choices they have been able to make in the past about how they wish to exit this world, may very well be taken from them for the “good of the many.”

(Note: I hasten to add that there is nothing in either the Senate or House bill that directly deals with these questions, although the Medicare Cost Control panel certainly has that potential.)

When a society is faced with a crisis that may lead to its dissolution, is it a higher moral choice to abandon individual ethics and morality to save it? Are we really facing this kind of moral conundrum or am I setting up a “false choice” where another solution is available but I am refusing to acknowledge it?

I would like to think I have fairly presented the questions asked in the 60 Minutes segment. My personal belief is that the issues raised are impossible to discuss at this point because of the debate over reform and the political ramifications of discussing end of life treatment that would necessarily play into the fear mongering that arises whenever “unplugging grandma” is mixed in.

Here’s Doctor Byock on that subject:

“Well, this is a version then of pulling Grandma off the machine?” Kroft asked.

“You know, I have to say, I think that’s offensive. I spend my life in the service of affirming life. I really do. To say we’re gonna pull Grandma off the machine by not offering her liver transplant or her fourth cardiac bypass surgery or something is really just scurrilous. And it’s certainly scurrilous when we have 46 million Americans who are uninsured,” Byock said.

One thing that can be done was removed from the House bill because of Palin’s fearmongering; family doctors being paid to sit down with their Medicare patients to discuss living wills, end of life options, and educating their patients on the death process. The number of people who are unaware of these simple, common sense options are staggering. The idea that this is somehow cruel or would lead to doctors recommending that patients simply allow themselves to die was idiotic when the argument was made and, if you watch this segment closely, even more idiotic now.

A word about “rationing” which is the 800 lb gorilla in the room that I have avoided because of the idea that many opponents of health care reform can’t face the fact that we are already rationing resources. What’s interesting - and gives a depth of understanding to the moral dilemma we face - is that according to the Dartmouth study, rationing would be unnecessary if we dealt with end of life issues:

After analyzing Medicare records for end-of-life treatment, Fisher is convinced that there is so much waste in the present system that if it were eliminated there would be no need to ration beneficial care to anyone.

Multiple studies have concluded that most patients and their families are not even familiar with end-of-life options and things like living wills, home hospice and pain management.

“The real problem is that many of the patients that are being treated aggressively, if you ask them, they would prefer less aggressive care. They would prefer to be cared for at home. They’d prefer to go to hospice. If they were given a choice. But we don’t adequately give them a choice,” Fisher said.

“At some point, most doctors know that a patient’s not likely to get better,” Kroft remarked.

“Absolutely,” Fisher agreed. “Sometimes there’s a good conversation. Often there’s not. You know, patients are left alone to sort of figure it out themselves.”

I can’t stand people who approach these issues as if there is no real moral or ethical dilemma; that people should either be forced to die or that they should get any care they wish in order to hang on to life even after hope for recovery has expired. We are fast approaching a time when we will forced to make this choice and there is nothing easy or pat about it.

Those so certain of the moral ground beneath their feet are oblivious to the fact that they are really standing in quicksand. And their arrogant certainty about right and wrong is exposed as the sophistry it truly is.