Chief Justice Roberts will visit the first politically charged case in his young career today, when the SCOTUS hears arguments regarding the Oregon physician-assisted suicide provision:
The Supreme Court will revisit the emotionally charged issue of physician-assisted suicide in a test of the federal government’s power to block doctors from helping terminally ill patients end their lives.
Oregon is the only state that lets dying patients obtain lethal doses of medication from their doctors, although other states may pass laws of their own if the high court rules against the federal government. Voters in Oregon have twice endorsed doctor-assisted suicide, but the Bush administration has aggressively challenged the state law.
The case, the first major one to come before the new chief justice, John Roberts, will be heard by justices touched personally by illness. Three justices Sandra Day O’Connor, Ruth Bader Ginsburg and John Paul Stevens have had cancer, and a fourth Stephen Breyer has a spouse who counsels young cancer patients who are dying.
Their longtime colleague, Chief Justice William H. Rehnquist, who once wrote about the “earnest and profound debate” over doctor-assisted suicide, died a month ago after battling untreatable cancer for nearly a year.
Pretty obviously, I support the right for people to end their misery, or at least have the option to end their misery, and if we want to talk about basic rights, I feel that individuals should have the basic right to control their own destiny (whether or not that is reflected in the Constitution is another matter). That isn’t what this case is about, per se, as this is really about whether federal drug laws can dictate how state authorities behave.
In other words, it is another example of the so called advocates of ‘states rights’ throwing principle out the window to cater to their pet issues and radical base. That in and of itself is enough to irritate me, but when you couple this attitude with the fact that the same crowd has been waging war on physicians through the DEA’s war on doctors and patients (and if you do not read Radley Balko’s The Agititator, you are really missing out- he has done a tremendous job following the prosecution of doctors), and you understand why this issue makes me even angrier.
For whatever reason, vocal advocates within the ‘pro-life’ community are against assisted suicide, but are also against adequate pain treatment- or at least the real worry is that dying patients might get addicted to pain medicine. The attitude of some, it seems, is that you are supposed to die, in pain, helpless, desperate, and without proper relief, because that is how Christ would have wanted you to go.
And that sends me into what can only be described as a volcanic rage.
Lines
Hate leads to violence.
Violence leads to suffering.
Suffering leads to volcanic rage?
Stay with the Bush Side, young blogger.
airmail
Volcanic rage is exactly the right sentiment. My late step-father was a physician who dealt with the permanently and terminally ill and I remember the paranoia he had about prescribing pain medication for fear of prosecution and/or loosing his license. Mostly, his patients were geriatric to say the least and the idea of addiction was the furthest thing from their minds. The most important thing to them was living out their final days in relative comfort, as pain free as possible. Although he did not support assisted suicide, because of the Hippocratic Oath, he was very sympathetic to those who were. Considering the option of suicide when one was terminal was something he could not advocate but in no way could he condemn.
Mr Furious
“volcanic rage”
Did you mention that to the doctor yesterday?
Seriously.
Don’t underestimate the cumulative effects of stress and anger…
Shalimar
The principles are just justification for some of the pet issues. When they clash with other pet issues, the principles get thrown out the window. It is hard to avoid the conclusion that the radical base doesn’t really have underlying principles. They are guided by an underlying belief in their own superiority and infallibility.
Lines
Well, to actually weigh in on the subject:
I have 4 friends currently diagnosed with cancer. Of those, 1 is undergoing active chemotherapy and is on her 4th round. She can’t eat, she can barely drink, her nausia and pain are so great that it sends her into seizures.
When I mentioned that she might want to try marijuana she replied “I can’t, I’d lose my kids”
Why must we force those undergoing the greatest pain to suffer and threaten them with punishments that vastly outweigh whatever the crime seems to be?
ET
AHHHH when 2 principles collide….
states rights v. anti-abortion/anti-euthanasia
John S.
I agree with you completely, John. What makes this case even more ridiculous is that Oregon voters passed this law not once – but twice. And yet, unlike the Clinton administration, the Bush administration has decided to challenge the state primarily on moralistic grounds (though of course it won’t be presented that way).
I guess yet another conservative principle (the supremacy of the state over federal government) gets thrown under the bus in favor of ideology.
jill
Just another example of hypocrisy from the right. Isn’t the argument they make that if Roe is overturned then it will be left to the states to decide? Yeah right.
Demdude
After watching my Father die a long and painful death, this issue sends me into an unmitigated rage. His hospice care workers (they should all go straight to heaven, no matter what sin they have committed on earth) did the best they could in trying to lessen the pain. We were fortunate in that I know they stepped over the line to dose him beyond what they were suppose to. These nut cases in the far right would have been able to press charges against them in a court of law.
We all know that if something were wrong in their families, they would justify it somehow and get away with it (Delay and him shutting off his father’s machines, a la Terry Shiavio). I think that Barney Frank was correct, life (and compassion – my addition) begins at conception and ends at birth for these groups.
metalgrid
These are the same people who are against abortion, and against birth control, and against single parenthood. Obviously they can’t hold to a logical line of reasoning.
jill
Metalgrid, their line of reasoning is for us to check with them before we do anything with our own bodies.
metalgrid
You may be right. I just saw this: http://www.in.gov/legislative/interim/committee/prelim/HFCO04.pdf
The folks in Indiana are trying to stop unmarried women from using any assisted methods to become pregnant. It must really suck to have the state own your uterus.
Another Jeff
Damn, i wish someone would’ve told me that yesterday before I sat down with my new issue of Maxim.
Ancient Purple
I have tried and tried to understand the reasoning behind why you would want to make someone stay alive in pain, suffering and in a quality of life that is next to zero. The only conclusion I can reach is that these individuals really think that they are going to score points with God.
Honestly, what is the rationale? Like most people, I have had my fair share of watching people deteriorate to the point where you can see they look and feel as though they are trapped in a prison for some crime they never committed.
I really wish someone could explain to me how the Republic is saved/made better/enhanced by not allowing doctor-assisted suicide.
Darrell
Can you please show us where these advocates are against adequate pain treatment? I would like to read what has been said on that topic as there is a big difference between ‘adequate’ pain treatment and lethal dosages.
This is a frustrating issue with no easy answers. Physician assisted suicide is a tricky issue as we see in Holland that doctors with that power have used it including UNAUTHORIZED euthanasia for infants or to the elderly whom they deem ‘unworthy’ to live. I’m for giving euthanasia decision making powers to immediate family members, but putting it all in the hands of the doctors?
Lines
Darrell:
Medical Marijuana for one.
jill
The scare tactics of the right say that doctors will be euthanizing without authorization.
capelza
Ashcroft hated this law…he tried to go in the front door, challenging it on it’s face and when that didn’t succeed, he and now his successor went for this route…
The assisted suicide law came about for a number of reasons…number one is the right to die with dignity. It also arose as a response to the utterly inadequate pain treatment for terminally ill patients…the fear that an 83 year old man with terminal illnesses would become “addicted” to pain-killers.
The law is very specific, Darrell, it is the paitent who decides in Oregon.
And yes, I live here…
Gratefulcub
The links in the original post are about doctors not being able to give adequate treatment for pain.
Ancient Purple
Darrell,
I think you are confusing two issues here. Physician-assisted suicide is very different from euthanasia.
The Oregon law being reviewed by the SCOTUS is very specific in that the person dying is the only person who can request the assistance. Family members are not allowed to request the assistance on behalf of a family member.
Additionally, the Oregon law has strigent criteria that must be met by the patient and the doctor before the assistance can be rendered, including a 15-day waiting period once the request is made.
The Oregon law does not allow “unauthorized” euthanasia and never has.
Darrell
Not ‘scare tactics’, but reality
What’s more, it puts pressure on those most vulnerable, the elderly and sick, to just give in so that they will not be a ‘burden’.
I do believe in the use of euthanasia, but putting that decision power in the hands of immediate family rather than doctors. I admit I’m not so familiar with this Oregan case
Ancient Purple
BTW, a very good FAQ about the Oregon law can be found here.
Darrell
Thank you for the clarification. I’m at a loss though why immediate family members opinions are not considered here, as often the case at the end of life, the patient themself is either in a coma or drifting in and out of consciousness
Darrell
If that’s true about the fear of “addiction” at the end of life preventing adequate pain relief, that is truly outrageous
jill
Darrell, the reality is that jury after jury condemns innocent people to the death penalty. I think we should be revisiting the constitutionality of the death penalty before this Oregon law that was voted for twice by the citizens of Oregon.
Lines
Its a good thing Texas doesn’t euthenize babies, then. Or pull their feeding tubes because the mother can’t pay her bill. Because, well, that would be like Holland! Those communistic socialist bastards in Holland!
demimondian
Darrell, do you know jack-shit about what you’re talking about?
Oregon took those figures very seriously, and has collected the corresponding figures in the seven years since the law was passed. 208 patients asked for terminal doses of medication, against 60K+ who did not. Of those 208, all but 5 were white, 85% had health insurance, and 87% were enrolled in hospice at the time of the request. That’s a skewed population, all right: but it’s exactly the opposite of the one your “study” (which has never been replicated, by the way) would predict.
I hated Ashcroft from the get-go, but I wasn’t in a volcanic rage until now. At the end, have you no shame?
jill
Darrell, also, I do not find the National Review to be a reliable source of facts, especially when the facts are coming from a member of an Anti-Euthanasia group.
Darrell
What in the hell does that info have to do with anything?
Darrell
It cited a PBS report, and ABC documentary, a British medical Lancet survey and several other sources
John S.
Yay! Darrell is here.
Let the queering of yet another thread commence.
Darrell
When those on the left pooh-pooh the very possibility that unauthorized euthanasia could occur here as it does in Holland, that’s when you need to watch out
Steve S
And once again, John Cole proves that he is easily bamboozled.
Republicans don’t believe in “states rights”. What they believe in is individual pet issues.
They were all for ‘states rights’, when the fed was trying to impose ‘civil rights’ on the states. And they claim to be all for ‘states rights’ when we’re talking abortion… that is, right up until California makes abortion legal and then they will be all for forcing states to abide by their authority.
There are few people any more who base their opinions on an overwhelming ideology of smaller government, states rights, liberty, freedom, justice, etc. This is what the founding fathers did, and they spent great time arguing back and forth these principles.
Today, it’s all politics. What can I say to get people to vote for me? What can I say to distract my critics?
jill
just like when those on the right pooh-pooh the very possibility that innocent people are put to death via the death penalty…
Darrell
Uh that would be the southern DEMOCRATS of that time advocating so strongly for states rights. Get you facts straight dumbass
Darrell
Study after study showing that unauthorized euthanasia has taken place. Any such evidence of innocents killed by the death penalty? No? well then, we can all certainly see the validity of your analogy
jill
Darrell, uh, those southern democrats became republicans to try and save their “white rights”. Don’t even try to say that the modern republican party was the impetus for the civil rights movement.
Darrell
Behold the intellectual depth and historical knowledge of the left
jill
Darrell are you saying no one has been unjustly put to death by the death penalty? The Justice Project has a different view and they are fighting everyday to make sure that exonerating evidence is put forth to stop this barbaric act.
capelza
Darrell, “unauthorised euthanasia” has been going on forever…The quiet shot to end the suffering of a lung cancer patient, with the silent nod from the family. Hell, I think it was George V or VII who went that way…as did one of my ggfs…
Not saying it is “right”, but this has existed always.
Steve
I grew up in the same Michigan county as Dr. Kevorkian, who made assisted suicide quite the controversial issue. County residents supported his side of the assisted suicide issue by a 2-1 margin, and even threw the county prosecutor out of office for hounding him.
This county, which was always rock-ribbed Republican, voted for Kerry in 2004, and just keeps getting more blue. It’s a perfect symbol of how Republicans have transformed from the small-government party to the party “just small enough to fit inside Terri Schiavo’s bedroom,” as Howard Dean says. And more and more traditional conservatives are realizing that they no longer have a home.
Darrell
Show us the modern day cases in which it has been demonstrated that an innocent was unjustly executed.
Standing up for the rights of child killers and other cold blooded murderers.. way to get your priorities straight
jill
What this comes down to is no choice. Those who believe in euthanasia are not trying to force it on anyone. Those who do not believe in euthanasia want to force their view on everyone.
Darrell
I don’t disagree with you there. Problem is, the Dems have moved hard left. I’m homeless!
CJ
Many on the right believe that suffering is ‘redemptive’ and that it is a good thing in its own right. Add this to the fear of addiction and you get the counterintuitive position of the right.
This is actually the position of at least one doctor I know. Luckily, she tends to recuse herself when dealing with terminal patients whose beliefs do not line up with hers.
I also wanted to make the point that where a patient is not decisional, that is, where the patient is not legally capable of making decisions for themselves, that patient doesn’t have the right to chose what they will have for breakfast let alone the right to choose to hasten their own death. I believe that is why the Oregon law requires two corroborating opinions from psychiatrists; they don’t want people who are not capable of making decisions making such important decisions.
CJ
John S.
Darrell says:
Yes, here John and Darrell have something in common. No matter how [insert pejorative] the modern GOP gets, they just cannot bring themselves to vote for a bunch of tree-hugging hippies.
I can’t begin to express how cheap I find this refrain to be.
Darrell
No question you’re right about many patients not even being able to decide what to eat, much less make life-or-death decisions. My problem, however, is what seems to be the knee jerk reaction to place that power in the hands of doctors/psychiatrists rather than immediate family
jobiuspublius
Because the individual cannot make a decision, but, others can. Somebody has to be assumed infalible, but, not the individual in regards to himself.
I don’t understand what you expect from SCOTUS. You want them to legislate from the bench that family members should be given authority in these issues?
Darrell
I hope you’re wrong about “many” on the right believing that suffering is redemptive. I’m not aware of any passages in the bible which make that point.
jobiuspublius
Can someone remind me what Roberts’ socio-political philosophy is supposed to be? I hope he doesn’t change it. hehehe.
Darrell
I never said that. If the individual is capable of making such a decision, let them, assuming the decision is not made out of depression, but for relief of suffering. My point was that at the end of life many are incapable of making that decision. I think the decision to assist their end of life should be put in the hands of immediate family who know and love the dying patient, rather than doctors.. while acknowledging that such family decisions are not always infallible either
jobiuspublius
Do the words Jesus and crucifixion ring a bell?
Darrell
Ok then, I forgot about those suffering a messianic complex who might think that way
Ancient Purple
What if the family’s decision is counter to your wishes?
Darrell
What are suggesting are my ‘wishes’? That decision would be none of my damn business
Ancient Purple
Darrell,
I am not sure I understand your response, but let me be plain here.
Let’s say you go in for a surgical procedure and something goes terribly wrong and you permanently end up on a respirator. You made it clear that you did not want to live like that, but your family has decided that, in spite of your wishes, they want to keep you on that respirator until you die of old age. They go to court and get an order keeping you on that respirator.
Again, what if your family’s decision is counter to your wishes? Too bad for you?
ET
Metalgrid – ahhh but how many of those same people are pro-dealth penalty? And for those that are pro death penalty, do they hold a consistant philosophy?
Darrell
Ok, sorry for misunderstanding you before. If the patient did in fact “make it clear” that they didn’t want to live the rest of their life on a respirator, that wish should of course trump all others IMO.
over it
As far as a biblical reference for suffering strengthening one’s faith: James 1:2-3
“2Consider it pure joy, my brothers, whenever you face trials of many kinds, 3because you know that the testing of your faith develops perseverance”
Now, I do not believe that what that verse says means that those that are elderly/terminal should not get proper/higher doses of drugs……but you can bet your bottom dollar that there are those that do believe this biblical snippet would apply.
Unfortunately, far to many who use the Bible to uphold their views….cut and paste the Holy Book to fit THEIR purpose not God’s.
If you put your mind to it….you could probably find scripture to validate anything you want. Not the way that it is supposed to be used….but used that way all too often.
Mike S
I’m avoiding a flame war with Darrell. Instead I’ll try to address a few points.
Unfortunately that is true in many, I don’t know that I could say most, cases.
As far as I know there is no call for the ability of a doctor to make the decision unilaterally. If there were I would also be dead set against that. It is a decision that should only be made by the patient and when the patient has family present the family should not have any say in the matter. They can make their feelings known to the patient but the final decision should be his/hers. All decisions should be made under consultation with at least one doctor.
I have personal experiance with this matter. I spent many nights sleeping in a chair at the foot of my fathers hospital bed in the last year of his life. I can’t count how many times I was woken up in the very early hours of the morning by my fathers screems of pain. That is not something I would wish on my most extreme enemy. I made care decisions when he was incoherant and in coma like states. Some of the hardest decisions I have ever made.
In the end, about a month before he died, he asked the Dr. to end his misery. The Dr. was unable to for obvious reasons. I offered to take him to his home in the mountains and help him do it myself. Another one of those decisions that were all but unbearable. He refused because of the legal danger it would put me in. This was right around the time that Kevorkian was arrested and convicted and that weighed heavily on his decision.
Instead he was forced to die a slow and extremely painfull death. Thankfully the last 4 or 5 days he was in a coma and if in pain I was unable to tell.
Everybody else is discounting your worries about the slope this leads down. I won’t do that. I think it is an honerable and valid worry. Everything I know about the Oregon law, limited admittedly, shows that they have taken care to take your worries into account. If the Fed is not satisfied with the protections given, they should find a way to fix those problems. But stopping the whole thing is a travesty as far as I am conserned.
over it
I know that this is a great simplification of the issue…but…I have always wondered why it is considered HUMANE to put down a beloved pet when it is terminal and in pain…but it is against the law to put a loved one out of their misery when they are terminal and in pain. I guess it is the word Humane (def: Marked by an emphasis on humanistic values and concerns) that strikes me as ironic. If it is wrong to allow our family member to move on and leave the pain behind….it must INHUMANE to put down our pets.
Random. I know. Just what is running through my head. Sorry.
Mike S
A “DNR” can be placed on the chart in most instances like that. The Doctor is not allowed to over ride that regardless of what the family wants.
Ancient Purple
Of course, and I am truly thankful for that.
This would be a great time to remind everyone that they should have a Living Will, Power of Attorney, Health Care Proxy, Mental Health Care Proxy, and other documents filled out and available at all times.
over it
Reading my last post…I do not think I made much sense.
What I was trying to say is: If it is HUMANE to help your loved pet move on in peace and leave the pain behind…it must mean that it would be INHUMANE to let it continue to suffer.
How is not inhumane to let a family member suffer needlessly? Especially when they are all but begging their doctors/their nurses/you to help them move on?
I also agree with John on this….Krakatoa level of anger inducing, to say the least.
Mike S
Yes. But make sure that the person with “Power of Attorney” understands your wishes and will carry them out regardless of how difficult that will be.
Darrell
Good post Mike. Good but poignant. It was painful to read about how your dad had to go out like that. This is precisely the type situation where patients should be able to make the decision to end the pain, and if they’re in a coma, then let their loved ones make that difficult decision.
Another excellent point
Mike S
Thanks Darrell. It’s 11 years this month but feels like yesterday. I don’t agree with you often but you have made some very valid points in this thread yourself.
These types of laws don’t happen in a vacume. They shape other laws and public policy. It’s important that people look for the far ranging effects of laws like this before making them.
Bill
Until healthcare is a right for all Americans, I can never truly get behind assisted suicide, because many suicides will be essentially economic decisions. But it takes an insanely cruel person or a religious fanatic to deny a dying person all the heroin he or she needs to stop the pain.
Defense Guy
I understand why the feds are taking this stand, I just don’t happen to agree with it. The again, I’ve always felt that one of the strengths of our nation is it’s ability to have varying sets of rules in different geographic locations, so that an individual can choose the one that best meets his/her needs. Within limits.
So this heavy-handed nanny state crap the fed is trying to pull puts me in the same rage camp as John, and I happen to think that the Catholics are right regarding suicide, it’s a mortal sin.
Not that I’m holding up Canada as beacon for anything, but you can still get Tylenol codeine 1’s over the counter up there and now you can smoke dope. I’d be interested to know what impact that has on those with terminal illness or just nausea related quality of life issues.
Tim F
Another problem with palliative care (pain relief) is that people with terminal illnesses don’t necessarily respond to drugs like healthy adults of the same body weight, particularly when they’re already taking a substantial cocktail of other medications. An unusually high dose of opiates for a healthy patient could very well bring on a premature death in the terminally ill. In many cases the danger is not that great, but I believe that a small risk is enough to discrourage most health care providers from acting.
So IMO we will have a hard time providing proper palliative care until we resolve the question of whether patients can choose to die. Hospitals will be in a much more protected position if the patients can agree to palliative care in return for a waiver in case it brings on their premature death
Darrell
In the case of a depressed teenager committing suicide, I agree with you. But some deaths are slow and painful. I find it difficult to believe that a merciful god would condemn someone for ending extreme suffering
John S.
From a purely biblical standpoint, the life that God gave you in the first place isn’t yours to take away, hence the accurate classification of suicide as a ‘sin’.
Of course, only God knows how to judge people, and the bible is clear that mere sins alone aren’t enough to warrant an unfavorable judgment.
Com Con
That is how Christ himself died. It is too much to ask of us, his followers, that we go that way too?
Lee
Someone asked for an example of an innocent man executed
here. ya go.
Com Con
Lee, there are numerous examples of executions in the bible. Of course, it is wrong to execute in innocent person, but if the proper laws were followed than the accidental execution of an innocent man is not a sin the eyes of the Lord.
Lee
I’m sure that is quite the comfort to the dead guy and his family. Isn’t that scarily similar to the Nurmberg defense?
FYI, I’m FOR capital punishment, but to say innocent people have been executed is rather naive.
Darrell
Then call me naive. There do seem to be legit doubts as to Willingham’s guilt although his wife is convinced he killed his daughters. Any other examples in the past 50 years?
Lee, Com con = DougJ = parody poster.
Lee
Sorry not DougJ. Not even close
Missed a word in the sentance which is vitally important
Should have read
“FYI, I’m FOR capital punishment, but to say innocent people have NOT been executed is rather naive”
Darrell
Lee, I think you misunderstood me. I’m not saying YOU are DougJ, I’m pointing out that Com Con is Doug J
Lee
D’OH. Got it.
David Rossie
John Cole: not-so-secret libertarian.
I share your rage.
Bill,
“Until healthcare is a right for all Americans, I can never truly get behind assisted suicide, because many suicides will be essentially economic decisions.”
So until the government supports your political agenda, the freedom for other people to choose how they run their lives isn’t as important? Do you not support doctors and drug-developers because their efforts are largely influenced by material considerations?
Lee
Here is a link with a list.
I knew of this one because it occured around where I live. This is one where I really felt bad for killing the guy.
Com Con
Lee, Darrell = ppgaz, also a parody poster ;)
John S.
David Rossie: not-so-secret inhumanitarian.
Why should you even care about whether or not people off themselves? It seems that allowing people to die would fit in with your ‘vision‘:
Bill
David, when I said I can’t get behind it, that’s all that I meant. I don’t think the government should make it illegal for states to have assisted suicide laws, but I don’t support the practice, especially in an environment where people have to make medical decisions under economic clouds. I don’t like a society which forces people to make decisions like this under the threat of bankruptcy and economic ruin for their family. No other citizen of any industrialized country on the planet has to worry that medical problems will ruin their family’s finances. You dumbing that position down to “my political agenda” in general is intellectually dishonest. Let’s not bullshit around here. What I support is a single-payer health plan which insures that healthcare is a right for all Americans. Period.
John Gillnitz
There is only one really serious philosophical question, and that is suicide. Deciding whether or not life is worth living is to answer the fundamental question in philosophy. All other questions follow from that.
-Albert Camus (1913-1960)
Lines
William Bennett would be ok with black people being legally allowed to end their own lives. After all, the guilt from all that stealing and murder must weigh heavily on their souls, and death would be a good release for them. Of course, that would be morally repugnant, but it would also reduce the crime rate.
Dak
John S. and Com Con — you give excellent examples from the Bible about why ending extreme suffering is wrong and why dying the way Christ did is the least we can do. These are powerful statements of faith.
And that is why you, the individual, can choose to follow them. But government has no place legislating such morality. These are ideas that come from a book written a long time ago that has gotten very popular, but a book (and a people) that most people on Earth were completely unaware of.
Your personal beliefs and your faith in the unprovable and unknowable are yours to have, but don’t quote your book to me when I’m following my strong morality in allowing my loved ones to die in peace and with dignity.
Mike S
Sorry, not an issue that lends itself to dumb snark. It’s an issue of huge significance to a great number of people and deserves to be treated as such.
Bill’s point is an interesting one that I hadn’t given much thought to. What do you do in a situation when there is some chance of a cure but is unaffordable for the patient? Do you force them into bankruptcy? Or do you allow a curable man to commit suicide?
I don’t know but I’ll definately be giving it some thought.
CJ
Darrell
The Oregon law is all about making sure that it is the patient making the decision. Oregon is not Holland and these decisions are not in the hands of the doctors.
I am also quite leery of the amount of trust you seem to place in a patient’s immediate family. I would agree that more often than not, the family follows the patient’s wishes. Unfortunately, that is all too often not the case. I don’t have enough digits to count the number of stories I have heard from doctors I know about a family rescinding DNR orders and otherwise making decisions diametrically opposed to what the patient wanted. As a practical matter, I know very few doctors that are going to argue with a distraught, soon to be widow(er) that wants their loved one put on a ventilator to avoid their loss.
Run a quick search on google using the keywords “suffering is redemptive end of life”. I hope you are not offended if I say that this attitude is more than a little twisted. A quick sample:
CJ
David Rossie
John S.,
“Why should you even care about whether or not people off themselves? It seems that allowing people to die would fit in with your ‘vision‘:”
That’s patently dishonest. Why don’t I call you a humanity-hating communist since you oppose property rights? Because I have no foundation for such a personal attack. If you understood anything about economics, the nature of health insurance, and why I dislike HI in general, you might not make such boldly ignorant statements.
Bill,
“No other citizen of any industrialized country on the planet has to worry that medical problems will ruin their family’s finances. You dumbing that position down to “my political agenda” in general is intellectually dishonest. Let’s not bullshit around here. What I support is a single-payer health plan which insures that healthcare is a right for all Americans. Period.”
Are you kidding me? Why don’t we travel to France and Germany where their welfare states are crumbling because they can’t pay for all of the entitlements? They want to consume more than they produce, and a huge chunk of that is “free” health care. No financial hardships? Give me a break. It is purely a political agenda because your wishes cannot happen any way other than by politics. In civil society, people tend to produce before they consume.
Lines
Mike:
it may be a dumb snark, but it points to the same hidden issue. If someone is poor and can’t afford healthcare or a cure, even if the government pays to cure them, they’ll still be poor and more likely to commit crimes.
And as Bennett knows, thats sure to be the black population.
Cassidy
Okay…someone answer me this. If we’re talking terminal, hospice level illnesses (incurable, suffering, about to die), is the concern over addiction really that big? That seems to be a pretty lame reason to oppose assissted suicide.
Defense Guy
Lines
Are they more likely to commit crimes because they are poor or are they more likely to commit crimes because of the same issues that have found them to be poor? That is is there an underlying factor that can link the willingness to commit crimes with the inability to climb out of poverty? This is an all race inclusive question.
Lines
Well, amidst my snarks I tend to try to put serious questions. Why would conservative class-warfare based politicians want the poor living longer than they can pay taxes or suck off the government teat? Providing national health care would only increase the burden on government, creating a longer living leech, instead of helping those that produce, like our moderately paid CEO’s.
I’m being intentionally harsh, as the reality can be very harsh and may be going on right now. Subsidized health care will make a longer living elderly and poor class of citizens, is that why Republicans like David R are so against it?
John S.
David Rossie says:
Your entire post there is patently dishonest.
1. Unlike your analogy that I am against property rights (which you point there is no foundation for), I have your own words that you are against everyone having health insurance. That gives me a fairly good foundation for claiming that you are an inhumanitarian.
2. Your appeal to ridicule fallacious argument does little to inspire a belief that you know anything about health insurance or economics for that matter.
If you had more of a legitimate argument to offer, you wouldn’t be compelled to make such boldly ignorant statements.
Northern Observer
Darell
Southern Democrats of the 1960s are the Republicans of today and have been more and more so since the 1972 elections and the activation of the Republican Southern Strategy.
You know it, I know it, We all know it.
So don’t be so darn misleading in your replies.
David Rossie
If that gives you a good foundation for anything other than “david rossie doesn’t think everyone must or should have haelth insurance,” you think too highly of your capabilities.
If you didn’t make arguments personal we wouldn’t be bothered with this silly dispute about your magical abilities to determine what kind of person I am.
Bill
David Rossie says: “In civil society, people tend to produce before they consume.”
On the issue of a single-payer healthcare plan for all, which I would advocate, this statement is irrelevant. A single-payer plan would be far more effient than our current insurance industry-middleman system. We would, as a society, pay far less per capita than we do now. People would have total choice as to where they go for care. Nobody would have to worry that a medical condition would send their family to the poorhouse. And, for the purposes of this discussion, if a dying person chose suicide, I would know that the choice was not made to save his family from bankruptcy. In a civil society, we don’t leave sick people to the whims of the marketplace.
Lines
America is the home of the free, land of the brave. They have the freedom to pull themselves up by their bootstraps and make as much money as they want. They must have chosen to be poor, in such a vibrant land so rich with opportunity. Therefore, if they can’t afford the cost of living, they should get busy dyin.
Right David?
John S.
David Rossie dishonestly says:
I love your knack for the ironic. If you didn’t make your arguments personal, then you might have a soapbox with which to lecture me upon.
Northern Observer
Freedom is freedom. You should restain it only for specific and limited reasons. If you beleive in freedom, then giving people the right to control the quality of their lives and their death is straightforward; you support individual autonomy and control and you tell the Federal government to butt out.
I mean the States are supposed to have competitive policy freedom so that people can compare and contrast the results. How else do we learn? It is arrogant beyond reason to think tha we have all the answers and must not allow this. Whatever happened to giving the voters the benefit of the doubt? Let us trust their democratic wisdom and have faith that if it becomes an evil and abusive practice, that they will have the ability and desire to stop it by changing the law.
Defense Guy
It is doubtful that simply moving to a single payer system will be the magic bullet that it’s proponents seem to think it is. That said, allowing others to go uninsured or to be saddled with crippling health care debt isn’t the answer either.
nyrev
Darrell, Here’s another link about questionable executions. And this is an interesting study about exonerations by DNA evidence since 1989.
David Rossie
Bill, that’s an infinitely optimistic prediction. Name for me some other government programs that work so perfectly. I not only think such a system is immoral, but it is wholly unworkable. The only method by which you could approximate that goal is with health-care vouchers for the poorest.
Lines, being poor is not a choice. Sometimes the actions that lead to poverty are. And whether or not you think helping the poor is the right thing to do, as I do, that is in no way related to the morality of forcing others to help the poor. And that I oppose.
John S, I wouldn’t be referring to things personal if I wasn’t defending myself against your ad hominems. If you really wanted to talk about something like, say, health care, you could start by ceasing your ridiculous routine with me.
David Rossie
Oh and Bill, as for the cost of health-care… it will go up as demand goes up. You’re not removing the middle-man, which has already created this price-inflating effect… you are replacing him with the government.
Bill
Defense Guy, I don’t argue that it is a “magic bullet.” I argue that it is a more fair, efficient and cost-effective way to deliver healthcare to a society. “Out of many, one,” was all about the collective power of government of, by and for the people. What better way to demonstrate that concept than by pooling our numbers through government to negotiate lower prices through quantity. The insurance industry loses one of its profit centers, and the top tax rate is about what it was under Clinton. That’s how we can deal with this uniquely American climate of fear throughout the population — living on the edge of disaster.
Lines
If you believe helping the poor is the right thing to do, who will do it if not the federal government? Who will help ALL of the poor? The church? HAHAHA! The corporations? HAHAHAHA! Who else has the money or resources? Individuals may believe in helping the poor, but very few of them do. At the current time, the only entity that is trying to help ALL without bias is the federal and state governments, and the state is doing less and less and less as time goes on. And if you believe that the demand for health care would only increase if there were subsidies, then you’re not paying attention. By getting preventative and early care the cost of health care decreases.
But go ahead and call me a socialist, a communist and tell me to go to Canada if I think its so great.
Bill
David Rossie says “You’re not removing the middle-man, which has already created this price-inflating effect… you are replacing him with the government.”
Exactly! I would replace the profit-driven crony-capitalist large corporations and their representatives with public servants working to deliver healthcare to the public at no profit. Doctors and Nurses still get paid. Hospitals still get paid. Drug companies get paid. But, no $10 million salaries to CEO’s, no legions of clerical workers whose only job is to deny payment, no insurance adjusters making medical decisions for doctors. Of course some people will say it’s unworkable, we can’t do it, it’s impossible. By some strange coincidence many of those people will work for the insurance industry.
Defense Guy
Bill
I’m not conceding it’s a great theory, but for the sake of argument say I am. The problem then becomes look who you are putting in charge of it, among others. In addition, any program that removes choice from either the provider or the beneficiary is NOT a better system.
I think there can be a middle ground, something that allows us the best of both worlds and removes the ‘living on the edge’ feeling you are talking about.
DougJ
I have a pretty simple proposition for the John Coles of the world: if you don’t want the country to turn into a theocracy, stop voting Republican.
Personally, I am not that troubled by the theocratic turn the country has taken. I think it’s just a phase. I stopped voting Republican (at the federal level) when I realized they were more fiscally irresponsible and because I couldn’t take the lying about Iraq anymore.
But maybe it’s time to stop whining about theocracy and start voting against it, or at least stop voting for it.
David Rossie
Why do you distrust people so much? Corporations have done a million times more for you than the government has, unless of course, you’re not busy using a computer, consuming cheap food, wearing clothes that you purchased at a store, driving a car, etc. Churches do much as well, without stelaing from their nieghbors to do it. Why do you love the only organization that must manipulate and coerce in order to give things to people? Even if I agreed with you morally, I wouldn’t support government redistribution of health-care because it is not efficient, it does not offer choice, and it does not encourage innovation.
John S.
David Rossie cries me a river:
My ad hominems? That’s interesting, because outside of accurately describing you as an inhumanitarian, I don’t think I have resorted to calling you names (or describing your commentary as ‘ridiculous’ or ‘magical’).
I know plenty about what you think from your post here, so I don’t really think there is anything about healthcare reform that I feel is necessary to discuss with the likes of you.
When you get out of college (and your textbook mindset) and join the real world, then perhaps we may have something to discuss.
David Rossie
Bill, I certainly do’t have any interest in the insurance industry but I oppose your proposal because its a pipe dream. You speak of incentives as a disgrace. I counter that they are what makes capitalism work. Health care wouldn’t be as incredible as it is today without various types of incentives, profit being an important one. If you remove profit, you harm progress.
Defense guy, there IS a middle way: vouchers, as I have mentioned before. It is the most efficient means of allowing government to transfer wealth to those who need health-care and the least intrusive, which pleases free-market types such as myself. It still allows some form of welfare and is the best system for the recipient, which should please people like Bill.
Defense Guy
Fairly heavy accusation, kind of surprising from you. I get that you despise this kind of crap from the Reps, join the club. Still a loooooooooong way from a theocracy though.
Lines
The computer wouldn’t have been created without government. Corporations don’t provide roads, they don’t provide protection, they don’t provide at all. You must provide them with more than the cost of the item to get it. Yay.
Churches only help those that go to church. Thanks, but no thanks. They also screw children, then prosecute gays. Congratulations on competing with the government for corruption and nepotism.
Just because government isn’t working right now doesn’t mean it can’t work. You currently have a set of elected failures in the highest offices, failing left and right and then saying “look, government is too inefficient to provide for you, so we’re cutting social programs”. Given the right design and the right legislation, I believe it would work, and work a lot better than the fixed prices we get from our current insurance company (not “companies”, they are all fixing prices and working together on pricing models).
Current health insurance is the greatest fraud and corrupt form of capitalism there is, yet you continue to go to bat for them, just like the apologists that still cover for Bush’s blunders.
Lines
To David Rossie, progress in the health insurance industry is the supplying companies finding new and innovative ways to not pay for health care, to put more cost onto the insured and to shift other costs back on the doctors. Its also having the drug companies working with the insurance companies to find exact price points where the patients will pay the most and get the least.
Progress! Ya baby, you know you want some.
David Rossie
John S. you are a complete fool. In that post which you cannot stop linking, I stated why I dislike health-insurance: because it drives up the price of health-care. And after that, I said that I would be fine with a compromise that eased the concerns of both sides in the argument. If that makes me an “inhumanitarian,” your commentray might as well make you a pop-tart, for it makes the same amount of sense.
Bill
David, I don’t agree that a single-payer plan is not efficient. As I have stated, I think it’s inherently more efficient, primarily because millions of people are not being paid to NOT deliver healthcare. And, you must know that we pay about double the average among industrialized nations per capita for healthcare.
I don’t know why you keep getting back to “morally.” Why would you keep harping on that when it’s just as arguable that it is immoral to let citizens struggle without healthcare? And please don’t conflate my distrust of corporations with a distrust for people. Corporations today exist solely for the profit of their shareholders and mainly board members. The corporation is certainly a fairly efficient model for business. But, why on earth should I trust a corporation to look out for my well-being. What have corporations ever done to give you the impression we should trust them any farther than their profit goals? A public servant, on the other hand, does not in any way profit by my NOT getting healthcare. By the way, the first proponent of a progressive tax system was Adam Smith, the Father of Capitalism, in Wealth of Nations. In that book, he also made it clear that everything a society does for its citizens is not necessarily done best in the free market.
David Rossie
Adam Smith was also confused about why water was cheaper than diamonds… hardly in command of all economic knowledge.
You’re tackling too many issues at once to allow for a serious discussion of government-funded health-care. Which one would you want to start first? One on corporations? One on public economics? One on progressive income taxes? One on Adam Smith’s philosophy? One on why other countries seem to pay less for health-care?
My point, really, evolves around the public economics issue. I don’t think public officials have some special quality about them that makes them more caring, or helpful. Government plans have been shown to be costly in so many ways which revolve around the basic problems that they deny choice and they discourage innovation. If you want to look at other countries with systems that you’d prefer, why not start with France and Germany where politicians are clashing with their constituents because the people want more handouts but the government can’t afford the handouts they’re giving already. Nationalisation only works, in some places, in the sense that people with handicaps still work. It’s not the best situation, but not the worst either.
Lines
Preventative health care is cheaper and more efficient than catastrophic health care. Given that, providing affordable health care to every citizen in an encouragement of preventative health care becomes essential to a healthy population.
Of course, corporations can always determine that a healthy population buys more goods and services, increasing profitability, but thats never going to happen.
Bill
Stay with me David. This is not as hard as you’re making it out. I said progressive taxes because I obviously think we should go where the money is: the top 1 or 2 percent. Clinton’s tax rates on the wealthy didn’t ruin the nation. They got richer under Clinton, and we had a SS surplus, and poverty rates declined and we were beginning to pay down the debt, so don’t act like marginally higher rates on the wealthiest among us are some kind of crime against nature.
Millions of workers in our insurance-driven system are employed with the express purpose of DENYING healthcare. This is, of course, inefficient. This is, of course, no help to the majority of our citizens. All I’m proposing is to make government the middleman between a citizen and his healthcare. This will drive drug prices down, bolster preventative care and remove a lingering fear that dominates our society. Note to all those busy building straw men: I never said it would be a perfect system, just more efficient, more cost effective and better for America.
over it
Pop-tart. Heh….gonna have to file that one away. ;)
David Rossie
You need to explain “denying health-care” and then explain “drive drug prices down.” If you’re getting at what I think you’re getting at, then there’s some contradictions there.
As for taxing the rich… sure it isn’t as tragic as taxing the poor, but I see no justice in it. The only reason I can live with taxes at all is because they appease the masses. Unfortunately its a slippery slope. I don’t see where there will be an end to people demanding more transfers from the rich.
Bill
David Rossie says “If you remove profit, you harm progress.”
Let’s not obfuscate the issue here. The only profit I’m talking about removing is part of the insurance industry’s. Drug companies, clinics, hospitals, hospice care, doctors, etc. etc. will still be able to turn a profit. And, it is a distortion to conflate insurance industry profit with medical industry profit. Medical industry profits are made by finding new drugs, treatments and technologies. Insurance industry profits are made by NOT delivering product.
DougJ
I agree, but there are a lot of old-school, fiscally conservative Republicans (like John) who seem very worried about this. And I think they’re right that the restrictions on right-to-die and so on *do* come from a theocratic impulse. What I’m saying is that there comes a time to fish or cut bait.
Bill
If you have a problem with “driving drug prices down,” then you have a problem with what every other industrialized nation does. Big pharma is one of the 3 most profitable industries in America. As long as they’re spending 10’s of millions on TV ads promoting boner drugs, I don’t have a lot of concern for their economic well-being. On a related subject, tell me: how does a libertarian deal with the fact that pharmaceutical companies will not spend a lot of effort and money on vaccines because they are not as profitable as prosac and viagra? Should we just let a few million Americans die in the coming bird flu pandemic? Should we trust that corporations will see the light and do the right thing? Or, should we, as a society, do something?
Lines
DougJ, you seem to indicate a need for single-issue voting, which I, and I believe many here, abhor. Of course, it is reality, in that single issue voting is what led to the current crisis-in-chief. Be it abortion, gay-marriage or the Iraq war, it seems that most voters would rather have their way on a single issue.
Jimmy Jazz
Chief Federalist Roberts is off to a roaring start:
Roberts then screamed: “Kelo, bitches, Kelo!” and slammed his fist on the desk in glee. OK, I made that up.
DougJ
Lines, it’s not about one-issue voting, it’s about accountability.
David Rossie
Haha, Bill, I have no problem with driving prices down. I wanted you to explain your position on how that will happen within the confines of switching to single payer health-care.
How does a libertarian deal with (insert private decision here).. however he damn well wants. I can only speak for myself, though I assure you most of us don’t want to regulate private business transactions and decisions.
Oh, and trust me, if millions of people were in a reasonable danger of Bird Flu, there would not only be a huge profit motive to develop a vaccine,the only thing keeping as many vaccines as possibile being produced is the federal war on all drugs, prescription and narcotic.
John Cole has linked to Radley Balko, who can tell you more about that subject.
John S.
David Rossie says:
Waaaah! Ad-hominem! Ad-hominem!
So, health insurance is bad because it makes healthcare more expensive? That’s an interesting premise, but alas, I am too much of a fool to understand such things. Here I thought profit-driven insurance companies, doctors’ exorbitant malpractice costs and skyrocketing drug prices were responsible for the increases in health insurance…
Like I said, when you get out of MacroEconomic Theory 101 and start living the principles that are discussed in your textbooks, then you may have something to contribute that is worth acknowledging.
Until then, you are just another collegiate popinjay who thinks that he knows everything because he got an ‘A’ on his last test.
John S.
David Rossie says:
So, in your perfect world, a pandemic outbreak of bird flu is a good thing – from a morally-free capitalistic viewpoint – because drug companies will make huge profits, and that will help boost the economy.
And of course, only those who are able to afford the vaccine will survive, which of course can be viewed as a market correction on an out of control population of impoverished people who shouldn’t have healthcare.
jcricket
My favorite quote regarding the first day of deliberations on this issue:
OK, so I substituted my own text for “asked no questions”, but it’s basically the same thing.
Whether or not I agree with Chief Justice Roberts, I prefer my Supreme Court judges to ask questions and at least appear to be paying attention.
Bill
John Rossie says, “if millions of people were in a reasonable danger of Bird Flu, there would not only be a huge profit motive to develop a vaccine,the only thing keeping as many vaccines as possibile being produced is the federal war on all drugs, prescription and narcotic.”
I hate to break it to you old man, but millions are in reasonable danger already. It is a matter of fact that pharmaceutical companies do not work on vaccines because they are not continuing profit centers just as they would not be a continuing profit center in the case of a pandemic. This is the main reason why there are only 4.3 million doses of the only drug we think may help with bird flu. The “war on drugs” has absolutely nothing to do with this. Drug companies want recurring customers, not one-time shots of vaccine. Face facts: the libertarian model does not offer a legitimate solution to a problem like this. We need more vaccines and corporations don’t want to make them. The market is too short-term to care.
David Rossie
It would only be ad hominem if you hadn’t been posting such nonsense. You have proven yourself to be a great caricature of a fool if you aren’t one.
health-insurance makes health-care more expensive because it inflates demand. There are, of course, many other factors that raise prices. It’s not merely an interesting premise, it’s simply a non-starter for argument. Do you know how insurance companies rose to such prominence and why they stuck around? It’s important to know because it goes a long way in explaining why prices of health-care are much higher than they could be.
Your last comment doesn’t deserve a response because it’s a malicious misrepresentation of what I said.
Bill
David Rossie, do you really need me to explain how a single-payer health system would drive drug prices down? Really??!! Are you here to add to the discussion or to obfuscate the discussion?
jcricket
Bingo! Someone hits the nail on the head. All companies make money by bringing in more money than they pay out (duh), but only in the insurance industry does this often this mean denying people access to things that might make their health better, as often as possible.
Of course, it doesn’t have to be that way. Good (i.e. customer focused) insurance companies manage their risk portfolio appropriately to ensure they don’t have losses while returning any occasionally over-sized surpluses to their customers. USAA, for example, does this with its auto insurance.
All this is happening while insurance companies try to convince the public for the need to “cap” malpractice awards despite no proven increase in the number or size of malpractice payouts. Or making the public believe that greedy doctors, Big Pharma and regulations are what’s behind the rise in healthcare costs, despite the evidence that most general practitioners are working harder and getting reimbursed less and patients are coverage is continually eliminated/reduced for things that were covered in the past.
Ah, the magic of marketing.
David Rossie
That’s conjecture, Bill, and you know it.
Drug companies happen to know a lot more about pandemics than we do. If they only have some small amount its because they’ve made a reasonable calculation that producing many moreof them is not necessary.
I know what you’re going to think.. that there is another example of the profit motive and that’s whats wrong with the whole industry. But that doesn’t fly. Innovation happens most naturally when private entities make risk assessments. You want to take the risk out of living. Well that’s nice, but we have to deal with scarce resources and that pesky thing called property rights. Once you ignore scarcity and tear apart property rights, progress will stagnate and there will be much less incentive to develop things like Bird Flu vaccines.
David Rossie
Yes, Bill, you must explain because the statement ” a single-payer health system would drive drug prices down” is not inherently true, if its true at all.
Willing it does not make it happen. You must take into account actual, living people and the way they act.
jcricket
BTW, Japan, Canada, the UK, France and Germany are all evidence of how single payer health care (in all its forms) drives health care costs down, especially for prescription medication. More access to health care doesn’t automatically drive costs up.
The Japanese, for example, pay so little for prescription medication that there’s a genuine issue with them being over-prescribed (for any sort of minor issue). So much for demand artificially inflating prices.
I’m not arguing that each of those countries has a perfect health care system, or that there are no cost pressures. Simply that they spend less per citizen and far less as an overall percentage of GDP to insure 100% of their citizenry, all while (largely) maintaining at least as good access and health care as we have now.
In some cases, their health care is better (e.g. when compared to the “benefits” the 42,000,000 uninsured in this country receive, or Japan’s prescription drug costs, or the lack of the “pre-existing condition” rule in Canada, or any “wait periods” in Germany).
The combination of greedy insurance companies and a lack of comprehensive preventative-focused health care in this country is what drives prices up (whether through taxes or premiums). Every time someone visits an emergency room who is uninsured, it costs everyone. Every time someone avoids seeing a doctor because they don’t have insurance and lets a fixable problem become an emergency, it costs all of us.
Seems like a no-brainer to build a single-payer healthcare system that combines the lessons learned by those other nations along with the freedom for add-on private insurance plans (similar to Canada).
John S.
David Rossie says:
I believe the other posters have gotten a good look at what sort of caricature you are David, and I daresay any of them find you to be in a position to be making such arrogant statements as this.
Which is what I find so amusing.
Bill
Does a dedicated libertarian ever tire of defending corporate power? My post is not conjecture. It is a matter of fact that large pharmaceutical companies have cut back or completely eliminated their vaccine development and production programs in the last 10 or 15 years. They admit this is because it is not as profitable as repeat sales drugs. In fact, I think if you check you will find that most American pharmaceutical companies have cut out vaccines all together. You can stick to your libertarian dogma or open your eyes to a problem for which libertarianism has no answer.
John S.
David Rossie says:
Where is it documented that drug companies are the authority on pandemics?
I guess that explains last years flu vaccine shortage. They made a reasonable calculation that proved to be wrong.
Care to further expalin the logic behind this, or did you copy it directly from one of your economic textbooks?
Would you explain your abrupt segue from vaccine development to property rights? There doesn’t seem to be any cogent correlation.
Bill
OK, David. Our own Veterans Administration gets lower prices on drugs for its veterans by negotiating volume purchases. Since the entire population represents a greater number than veterans, I assume that a single-payer plan could negotiate at least as good pricing as our Veterans Administration. Does that make sense to you — volume pricing, volume discounts, etc. I wouldn’t have guessed that I’d have to explain that one.
Darrell
US pharma companies do the world’s heavy lifting on R&D and put the cost on the backs of Americans. I know Canada and France have threatened to break our companys’ patents if they don’t meet their price. Because the US govt refuses to crack down on this (extortion?), US pharma companies run their economic models such that Americans unfairly pay the lions share. If this practice was stopped, the costs could be more evenly distributed, lowering drug costs for Americans. It’s not that other countries have a ‘better’ system, it’s that they are using unscrupulous means.
What’s more, I don’t believe other nations have access to all the same cutting edge drug treatments that we have here in the US
John S.
Bill-
Your thoughts on the subject – like mine – stem from real world scenarios. David’s on the other hand stem from the fantasyland of libretarian ideology that he is currently studying in school, and though it makes for interesting philosophical discussion, has little bearing on reality.
Just thought I’d mention that.
Darrell
FDA’s demands were costly and lawsuit risks were high (even if 1 in a million have negative reactions). All but one(?) US manufacturer decided to get out of the business. Are you suggesting that we should nationalize the drug business? Not trying to put words in your mouth, but given your criticism of the drug industry, what is your solution if not to nationalize it?
David Rossie
Ugh, ten million questions. Bill, it’s simple; you’re confusing what veterans pay with the market-cost. Those are two seperate values. And you cannot make such a simple assumption. If the government were to finance all health-care consumption, consumption would SKYROCKET. To pay for it, the government would be forced to divert resources from somewhere. It sounds like you’re saying because someone else pays for it, it’s cheaper. And that is wrong.
John S, last year’s shortages were purely the fault of gov’t regulation. They couldn’t stop themselves from confiscating vaccines at the border, which was the icing on the cake of their regulatory nightmare.
Drug companies have a profit motive to be authorities on such subjects… what, you thought they merely sold sugar-water and people have bought into the lie that they are being healed by medicine for so long… OF COURSE they know about disease.
As for innovation and risk… if you want to contend that risk is somehow something that can be avoidable without costs in innovation, make an argument. The history of entrepreneurship and its traits are widely understood. To deny its importance is profound and deserves more than a “thats textbook” refutation.
Bill
Darrell, the fact that we have to beg pharmaceutical companies in other countries, mainly Germany and Britain, for vaccines kind of cuts into your argument. Another problem with your argument is that currently, American pharma companies spend about 10 times the amount that they do on R&D for television advertising. They’re pushing mind-altering and boner-strengthening drugs on television, or haven’t you noticed.
John, I’m pretty sure you’re on target, but their dogma is being challenged in many ways these days. For instance, how does a libertarian fight the war on terror. Container companies checked just 5% of containers in U.S. harbors on 9-10-01. They still are checking just 5%. Libertarians ask nicely, please check more. Corporations chuckle and send them on their way with some good talking points.
David Rossie
Thank you Darrell… If the US were to nationalize the health-care industry, R&D would have nowhereto go. That other socialized countries piggyback on US progress is just another application of my assertion that increased demand raises prices… costs to be more exact. It only raises prices for those who don’t have third payers and the third payers themselves, eventually. If the US did nationalize, every other country would face repercussions as their house of cards falls down.
Darrell
I believe this is largely a red herring issue. When a company imports a container, if it is that country’s 1st importation, it is opened for a full examination, every box is opened. After that, the company is registered with customs and its shipments of containers are reviewed by customs. The freight lines also provide country of origin information regarding the containters themselves. If you look at a container passing by you, you will see an alpha numeric code KKCE 12345 or something along those lines. Before a container enters the the US, it and the Bill of Lading along with the original Bill of Lading are sent to the broker and then to Customs for review. The freight company provides the place of origin for the container as well as the country of origin for the goods. For the first year, a company that is a new exporter recieves several random examinations. After a while cargo is allowed to have different exams, where the container is simply opened and some random boxes examined. In other examinations (called tailgate) only the back doors are opened and the boxes are examined.
If the premise is that every container should be examined, then you have an issue because such a level of security is a red herring and you become no safer while spending billions more. Its a question of judgement by those who know the ports and what goes on. Of course the gullible and easily manipulated are often used as a political poking stick by those who want to make points instead of progress.
David Rossie
John S,
I’m not sure why you believe I learn “libertarian ideology” in school. Anyone who has attended college recently knows that libertarianism is not only unpopular, but ill-recieved in acedemia. Most of my professors tend to support things like nationalized health care. No, I actually research these things myself thank you.
Darrell
Good article on results of pharma policy in Canada. Consider this example from Canadian health care utopia:
How would you like to be on the short end in another country where over half the drugs aren’t even available?
David Rossie
Darrell,
” Physician assisted suicide is a tricky issue as we see in Holland that doctors with that power have used it including UNAUTHORIZED euthanasia for infants or to the elderly whom they deem ‘unworthy’ to live. I’m for giving euthanasia decision making powers to immediate family members, but putting it all in the hands of the doctors?”
Regarding the discussion that was happening earlier: your comments are reasonable. Doctors should not be in the business of ending life. The Hippocratic Oath seperates healing from practices such as abortion and euthanasia because there are conflicts of interest involved.
Krista
Just to address that point, though…as far as being allowed to smoke dope, anybody with an illness that would require marijuana for pain relief has to apply for a license from the government, which can take years to obtain due to all of the red tape. Then, they provide you with state-grown weed, which, from what I’ve heard, is of very poor quality and potency, doesn’t do squat for your pain, and just makes you feel sick. My friend’s father was dying of cancer, and was in extreme pain. His wife, a very lovely, sweet, sheltered woman, had to dig around to find someone who would sell her some weed for her dying husband. She wound up with some seedy-looking character at her house, and wasn’t able to even wind up getting the marijuana, because the dealer recognized the husband as being the fungus expert who had testified against him at his trial for dealing magic mushrooms, and he ran out of there.
The moral of this long digression was just to emphasize that it’s pitiful that dying people and their families have to go through so many indignities and so much suffering, because governments seem to think that dying people shouldn’t get addicted to anything (weed, morphine, whatever). Hello??? They’re freakin’ DYING, people!
Yeah, the Vesuvius-type rage is within a lot of us on this topic.
Bill
Rossie: “If the US did nationalize, every other country would face repercussions as their house of cards falls down.”
Excuse me, David, but didn’t you just accuse me of conjecture? This new libertarian argument of yours doesn’t hold water either. What is the difference to a medical equipment manufacturer between money coming from an individual and money coming from the government? We already have the biggest socialist system the world has ever seen and it hasn’t led to a collapse in R&D there. It’s called the military industrial complex. Large companies make products almost solely for the government and financed by the people’s money. R&D flourishes. There is very little competition. That’s how we made the world’s most deadly fighters and bombers. Why can’t we make medical equipment and drugs like that?
And, please go back to your textbook. Increased demand has little effect on costs. The response to increased demand usually lowers cost with higher volume — that’s the only substantial link. In addition, as you must know, many drugs have a completely inelastic demand curve. People need them no matter what they cost. The only drugs with elastic curves are elective drugs like boner-helpers and hair-growers.
Bill
Darrell, please, no straw men. I didn’t say check every container, I said more than 5%. Every terrorism expert in the country thinks this is a hot spot so I’ll leave it at that. My point is that if you are unable or unwilling to make even the slightest demands on corporations, you are going to have a hard time fighting terrorism. Do you really need a nuclear device to be detonated in a U.S. harbor to see this is true?
David Rossie
“That’s how we made the world’s most deadly fighters and bombers. Why can’t we make medical equipment and drugs like that?”
There’s a vast difference between military production and health-care production. With the military, there is really only one consumer called “government” that must be pleased. And the one consumer has unlimited funding through taxes. Hardly a market model.
“Increased demand has little effect on costs. The response to increased demand usually lowers cost with higher volume”
You’re denying reality. Rising demand always raises prices. Its the higher prices that encourage more investment to produce more health-care. If the state were to finance all health-care, and if people consumed more than they do now, the costs would rise very much, but you wouldn’t see them directly because you’re not footing the bill. The government would see them, and raise taxes. Either that, or they would force companies to accept lower payment, in which case quality goes down.
Darrell
In fairness, regarding other nations threatening to break the patents of our drug companies if they don’t meet their prices, I remember one similar case here.. during the anthrax scare, leftist Sen. Chuckie Schumer threatened German company Bayer to break their Cipro patent if they didn’t meet “our” price.
Darrell
I think I made the case pretty well that your demand that we check a higher percentage of containers would not make us safer, but end up costing a lot.
John S.
David Rossie says:
It is a minor point where you learn your libertarian ideology. Some of it obviously came from taking up economics in school, since we can assume that you did not research all these things yourself in a vacuum. The point was that you are a libertarian.
I believe you are confusing the purported hatred of conservatism by ‘academia’ (10 pts. for using a buzzword) with libertarianism, which according to this lovely chart is closer to anarchy than conservatism. And while neither is terribly popular in most universities, it is a fairly common meme in economics, which as we’ve ascertained is your thing.
And you think they are all idiots.
John S.
Darrell says:
Yeah, that is why it costs more in the United States than in Canada – cause we were holding out for shittier prices.
Defense Guy
Darrell is right, up to a point, regarding the cost of drugs and how US companies carry an extra burden. I stil think they spend far more on R&D then ads, although I have nothing to back this up. Vaccines became unprofitable due to regulations during an administration I am not going to point out in this thread.
In many ways, Canada, or rather it’s drug industry is a perfect example of the downside of a single payer system. They used to contribute far more, now, not so much.
All my previous statements stand, regarding choice and the need for some change.
In addition, nanny stateism is still the same old crap whether it is coming from the left or the right. Live free or die.
Shygetz
Vaccines are largely unprofitable because they are fire and forget medicines, with little to no repeat customers, that actually cut into their other drug sales by keeping people healthy. Defense Guy, you better have some stats to back up your “decline of Canadian pharma due to single payer health care” or knock it off. David Rossie, in your supply and demand take on health care, you miss out on the fact that the demand for health care is essentially boundless, regardless of the actual number of sick people. Why? Because people will pay any amount of money and go into any amount of debt to live. The patent system in place for the drug industry, as well as the high barriers for entry into the market, make competition essentially nil for a particular drug. With limited suppliers, and demand only bounded by a person’s wealth and credit, how should an unlimited free market system work to keep the world out of the pocket of the drug companies?
And everyone also needs to realize that the drug companies get enormous government subsidies for R&D–they are called the NIH, the CDC, and the NSF. Staggering amounts of free research that they do not have to pay for, but that they are free to use to develop their product.
John S.
Shygetz says:
I’m still waiting for him to back up his claim that Benjamin Franklin was a chickenhawk, so good luck with that one. After all, baseless opinions are like assholes…everyone has one.
dlnevins
Depends on which half. One of the things most poeple don’t realize is how many of those “new” drugs are just “me too” drugs: medications which have the same mode of action and essentially the same theraputic effects as another drug already on the market, but which differ just enough in their chemical structure to be patentable. I can certainly understand why a Canadian province wouldn’t rush to approve a new (and more expensive) statin or NSAID or proton pump inhibitor when there are already a several other drugs in those categories on their approved list which work equally well. Hospital pharmacies here in the US do exactly the same thing as those Canadian provences, by the way. It’s a perfectly rational approach to controlling costs without significantly compromising patient care.
Defense Guy
John S.
There is no need to even try with you. I didn’t give you Franklin because you are an asshole who is in no way interested in anyting other than ‘winning’.
Defense Guy
ShyGetz
I’m still trying to find the article I read on this subject, in the mean time here are 2 that touch on it.
First
Second
David Rossie
John S,
That is the difference between you and I. I do not think of my professors as idiots and don’t see differences in opinion as a foundation for personal attacks. I do, however, object to wrong facts and bad ideas, and of course seek to correct the former and advance my own ideas. What’s so odd about that.
David Rossie
Shygetz,
“David Rossie, in your supply and demand take on health care, you miss out on the fact that the demand for health care is essentially boundless, regardless of the actual number of sick people. Why? Because people will pay any amount of money and go into any amount of debt to live.”
This is not true. Demand is not boundless, it is indeed bounded by cost constraints. People will not pay any amount of money because they face tradeoffs. Aggregating people into one large pool of consumers doesn’t change this fact, it only shifts and distorts the burden of financing health-care.
Darrell
Misleading as hell. Fact is, some drugs are more effective than others and often have less dangerous side effects although they treat the same affliction. Glucophage XR is generally considered a superior treatment for type II diabetes but is not available in most Canadian provinces. Enbrel and Remicade for severe arthritis treatment has been available to Americans for years.. but not to most Canadians
Why? Because the Canadian govt is preventing the patients and doctorsthere from deciding which medications really make a difference and which ones are ‘me too’
Darrell
And it’s not just drugs for diabetes and arthritis. Life saving AIDS medication Reyataz, hasn’t even begun the approval process in Canada yet has been available in the US for years. Pegasus, a drug that treats Hepatitis C, already has a new an improved version in the US. Canadians still don’t have the original less effective version. Incentives drive any system. And incentives are what is lacking in the Canadian system. 10 week wait to see a specialist, Canada is 20th out of 25 industrial nations in per capita number of MRI machines. At least one of the provinces refuses to pay for the new more effective PET scan machines. The US system has problems, but Canada’s system is not the solution
Eric
There was a great report on NPR of the people who have successfully used the law. It shows how a terminal patient can die with their family around them and in a loving atmosphere. Far better than waiting weeks for death to take you at 2 am in the morning.
Yet I take umbridge to the statements of the war on doctors. I am a recovering addict and know that any chronic pain or back pain clinic is the easiest way o get a fix. Most of these people end up on heroine as they run out of money. Many doctors may believe they are helping relieve pain because they are. Yet, almost all opiate addicts have excruciating pain when going through withdrawal. The only way to eliminate the pain is to suffer for a back braking three weeks in a hospital feeling as if a thousand hippos were jumping on your spine. Eventually the brain recovers and the pain goes away. Yet too maany doctors are willing to endlessly prescribe pain meds to addicts. As an addiction counciler I know that man addicts are the most charming people I hav ever met in my life. They often come from abused family systems where they develop the ability to manipulate others as a way of avoiding abuse. I found doctors and nurses were easiest to manipulate because they have an inherent ability to empathize with others.
Believe me, outside of meth in the heartland, prescription opiates have come to dwarf any and all other addictions i see. Well over half of the addicts I meet daily were opiate addicts eventually turning to heroine as they run out of money. It is a major problem in America today. Much worse than marijuana which seems to get the ire of the government nowadays.
If only there were a cheap genetic test to find if a patient has the genetics for addictions. It could give doctors a reference to see if their patients have the genes necessary to become addicted.
Don’t ever forget though, the pain is always real, but doctors are often blind as to how to get rid of the pain.
David Rossie
Eric,
Serious appraisals of pain-killer addictions cannot develop unless doctors have the leeway to treat their cutomers as they see fit. If there is no practice, there is no advance. Even though your stories are tragedies, they don’t take away from the horror of denying someone the right to buy painkillers and either die, or recover, in peace.
CJ
Darrell:
If this is your point, then you must agree that Iraq is a complete failure, no? The problem with GWOT in general (I much prefer T.W.A.T myself), is that we’re spending ludicrous amounts of money on things that will not make us safer. Why draw the line at containers?
Sirkowski
Don’t question the Leader!
The Leader is always right!
The Leader hurts you for your own good!
X-|
jitter
Eric
The problem, as you describe it, seems to be all that free heroin.
Maybe if drug dealers started charging money for it then the addicts would stick to prescribed pain meds.
Seriously, the government police have no business practicing medicine. Putting pain patients in prison only compounds something that is already a problem.
Just as most drug laws do.
Drug law enforcement does much more damage than drugs do. And there are better uses for our tax dollars.
EconAtheist
Is the prolific Darrell posting by himself or is he being helped by his other brother Darrell?
Nelson Muntz
Love them Booshies you do!!!! You reap what you sow!!!! Why should Boosh care what you think?
Ha Ha!
Pope Bandar bin Turtle
Darrell — You said:
“Physician assisted suicide is a tricky issue as we see in Holland that doctors with that power have used it including UNAUTHORIZED euthanasia for infants or to the elderly whom they deem ‘unworthy’ to live.”
Could you please provide some links to substantiate (not trans-substantiate) that statement?
BTsBWY!
decorticator
“The attitude of some, it seems, is that you are supposed to die, in pain, helpless, desperate, and without proper relief, because that is how Christ would have wanted you to go.”
According to an article I read some time ago, this was basically the attitude of Mother teresa.
She was willing to provide a nice safe place for people to to writhe in agony until they died, but wouldn’t even provide so much as aspirin to relieve their pain.
God’s will, and all that.
Roger Drowne EC
To: All Citizens On Planet Earth… Sept/2005
From: Roger Drowne EC
President
Of Planet Earth
A,1. Join In… OneGlobalCommunity.com Restoration of Planet Earth
________________
…Proclamation # 1
Set Up A Local and Global Network of Community Centers in ( Y/Our ) Every Neighborhood, Village, Town, Tribe, City on Planet Earth, All Connected Together Using… Web Sites and Blogs… All Over OUR Planet Earth.
________________
…Proclamation # 2
Teach ESPERANTO, a second language in all schools, starting at age 1.
So that All People on the Earth can speak with one another.
Along with speaking their indigenous, home language.
________________
…Proclamation # 3
Learn, Use and Do the EARTH CITIZEN HAND-SHAKE/SIGN
To Great Each-Other Around Our Earth
Thank you,
President Of Planet Earth
Roger Drowne EC
c/o
http://www.OneGlobalCommunity.com
Eric
You can go that way if you want to. If you don’t believe in Christ, shouldn’t you be able to go however you want? Why is _your_ religion right for me?
KEVIN SCHMIDT
There is a bigger issue than State rights vs Federal rights and that is the issue of individual rights.
Just who does my body belong to anyway? Does it belong to me? To the state? To the federal government? To God?
If I am of reasonable sound mind and my acts will be victimless, who gets to decide what drugs used for what purpose get put into my body?
It makes no difference if the drugs are legal or illegal. There are some legal drugs that are quite dangerous to one’s health and there are some illegal drugs that are less dangerous than many legal drugs.
And it also makes no difference if the purpose for taking the drugs are for ethical or unethical reasons, because it can be hard to distinguish just what is ethical and what is unethical.
The key word is “victimless”. That should be the deciding factor. Is the act victimless.
The federal government has failed to protect us from the harmful effects of legal drugs and the FDA approves new prescription drugs with extremely harmful side effects. That’s not victimless. Plus, they have failed in their battle against recreational mind altering drugs, by punishing rather than assisting drug abusers. That’s not victimless either. I can hardly believe that 50 states collectively could do any better.
Because of the state and federal governments’ failings, the decision to take any drug must be left up to the individual. People must be allowed to do what they want to do to their own bodies, otherwise their bodies do not belong to them, they belong to the government.
Besides, you can’t legislate morality for victimless behavior, but you can politicize it.
KEVIN SCHMIDT
About 20 years ago, I worked with an old guy who migrated to America from Germany in the 1930’s. He carried a pocket knife around with him in his pocket. He called the knife his security. He told me that if ever this world got too painful for him to live in, he would take a hot bath and slit his wrists with his security, his pocket knife.
Since recorded history began, people have committed suicide for noble reasons, because of physical injuries, and because of old age. I see no reason to outlaw a practical tradition that is approved by most people around the world. They have a good reason for wanting to leave this world. I see no good reason for denying them their right to decide when they will die.
However, for people who want to commit suicide simply because they suffer from profound depression, in all cases they should be stopped and receive therapy.
timnayar
The law is quite clear in the fact that states rule over medical care laws… I really don’t understand the federal legal basis for getting involved in this.
Vesuvius
After reading the story of Cameron Willingham, as posted upthread, I have come to one major conclusion:
I’m totally against palliative care for Governor Rick Perry. Let him suffer.
Steve J.
Not ‘scare tactics’, but reality
Study after study of Dutch euthanasia practice have shown that Dutch doctors routinely kill patients who have not asked to be poisoned
=========================================================
Too bad not even ONE study was cited. Oh, I forgot, it was in the National Review of Agit-Prop.
Kent
Consider the mind-boggling idiocy of addiction in the terminally ill. What part of “terminal” do they not understand. As for the suffering: wasn’t the reason they say Christ suffered, is that we wouldn’t have to?
Fade
There is another side to this beyond “States Rights” and the link to abortion. Preventing people from dying with dignity and keeping them constantly in hospitals, dying oh so slowly, but also oh-so-SURELY makes pharmaceutical companies and the medical profession lots and lots of money. All those additional drugs and extra care for people who dont even want to live one more day in pain is racking up quite a profit for some. Letting Americans have the freedom to end their life in such situations would cause them millions of dollars.
Mac
Getting back on the topic, the Oregon law is quite explicit on who is covered and when. During the first time we voted on the law many groups opposed it saying it would lead to a slippery slope and that tens of thousands of people would be coming to Oregon to end their lives. In the 11 years since passage, 208 people have ended their lives with dignity and peace, on their terms. Hardly a Landslide.
Sinequanon
John: I’m with you all the way on this one – it makes me sick thinking of people suffering when all they want is to be let go…it makes no sense at all to prolong someone’s agony over other people’s religious belief.
N-
goonie bird
Oregon protects mountian lions as oversized kitty cats but allows persons to kill themselves what kind of poppycock is this?