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Well, I’ll tell you. On July 7, President Obama appointed Dr. Donald Berwick to be “Administrator of the Center of Medicare and Medicaid Services,” aka, the Medicare Czar. Obama did so while Congress was in recess, thereby bypassing the Senate confirmation hearing, requisite for the position. Now, why would he do that?

President Obama wanted to slide Berwick into his position with little fanfare, as Donald Berwick is a radical leftist with a radical vision for America, with a certain affect for centrally socialized health care.  Berwick, like most leftists these days, has an impressive resume, topped off with a degree from – and subsequent stint at – Harvard University, and as such, is of the President’s ilk. To the dismay of the President, Berwick’s nomination ignited such an uproar within the conservative community that Obama relented and will indeed send Berwick to the Senate for confirmation. I say, let the games begin.

Herein I wish to expose this fellow, Donald Berwick, so you, the reader, can get to know him, because, in any other circumstance of “getting to know him,” it may be too late.

Berwick’s Views

Like the President, Donald Berwick must be smarter than you and me. I mean, just look at his resume!  He must know better than us dummies. So, what do dummies like you and I actually know about Medicare?

Well, we know Medicare comprises 20% of the federal budget.  We know Medicare now constitutes an unfunded liability of $36 trillion.  We also know Medicare has a “high-risk pool” that has been declared “underfunded,” much more than the $5 billion estimated by Congress.

Hmm.  What would Berwick do with the expensive portions of Medicare?  Besides being an accounting trick used to hide the true costs of Medicare, “high-risk pools” are at “high risk” as targets for cutting costs.  As Medicare is mandatory, this surmounts into a sinister scenario, characterized by the term “death panels,” i.e., a board which determines the “metrics” as to whether or not your “pool” will be funded.

“Wait!  Death panels again?!”  Methinks thou doth protest too much.  Fine – allow me to justify my assertion.

For starters, just look abroad; countries where government has complete control of health care inevitably have to ration, particulary when facing tough decisions over debt. In America, conservatives fear rationing in both Medicare and Medicaid due to these impending economic shortfalls due to our enormous unfunded liabilities. Liberals say rationing already occurs, compliments of the insurance companies.  With private health insurance, however, you still have the abilitiy to shop around.  The public sector lacks the profit motive that keeps industries – if not businesses – afloat.  Costs are hidden and neglected for years.  Without these market forces, how will our government pay for Medicare’s inherent inefficiencies?

Enter Comparative Effectiveness.  The definition of this term, provided by Wikipedia, is as follows:  “Comparative Effectiveness Research is the direct comparison of existing health care interventions to determine which work best for which patients and which pose the greatest benefits and harms.”  Thus the interventions deemed unnecessary will be eliminated, regardless of whether the patient wants it or not, or is able to pay for them independently.  Those of you familiar with ethics studies will recognize this as a sort of “health care utilitarianism,” in which the greatest good is sought for the greatest number.

You can call it Comaparative Effectiveness, collectivism, or utilititarianism; it facilitates rationing.  Berwick, said so himself, when he said in an interview about “Comparative Effectiveness Research” with the American National Institute of Health:

Interviewer: “Critics of CER have said that it will lead to the rationing of health care.”

Berwick: “We can make a sensible social decision and say, ‘Well, at this point, to have access to a particular additional benefit [new drug or treatment] is so expensive that our taxpayers have better use for those funds.’ The decision is not whether or not we will ration care—the decision is whether we will ration with our eyes open.”

Berwick’s ambitions for American health care, however, don’t stop with rationing.  Heck, they don’t even stop at health care.  His slobbering – I mean, glowing – speech to Great Britain’s National Health Service (NHS) helped illuminate Dr. Berwick for what he is:

“You (Great Britain) could have protected the wealthy and the well, instead of recognizing that sick people tend to be poorer and that poor people tend to be sicker and that any health care funding plan that is just, equitable, civilized and humane must, MUST redistribute wealth from the richer among us to the poorer and the less fortunate. Excellent health care is, by definition, redistributional.”

Donald Berwick is also a big supporter of ”Patient-Centered Care.”  Sounds good, right?  This term usually deals with palliative, or end-of-life, care.  In Berwick’s world, this care takes place in medical ‘homes,’ deemed appropriate for Medicare payments, therefore minimizing “rehospitalizations” while cutting costs.  Could these, or would these, nursing homes be mandatory for everyone on Medicare?  What kind of quality of life would be expected at these facilities?

Enter QALY.  In his praise for Great Britain’s National Institute of Health and Clinical Excellence (NICE), Berwick commended NICE, who “developed very good and very disciplined, scientifically grounded, policy-connected models for the evaluation of medical treatments from which we ought to learn.”

These “models” Berwick speaks of are controlled by Quality-Adjusted Life Years, or QALYs, and are described on the NICE website:

To ensure our judgements are fair, we use a standard and internationally recognised method to compare different drugs and measure their clinical effectiveness: the quality-adjusted life years measurement (the ‘QALY’)…  A QALY gives an idea of how many extra months or years of life of a reasonable quality a person might gain as a result of treatment (particularly important when considering treatments for chronic conditions)….  A number of factors are considered when measuring someone’s quality of life, in terms of their health.  They include, for example, the level of pain the person is in, their mobility and their general mood.

Cost effectiveness, is in this regard, would be measured in units of “Dollars per QALY.”  This rationing method is implemented in Great Britain, and Dr. Berwick would wish to bring it to America’s palliative care facilities.  But Donald Berwick’s Postmodern Socialist views don’t end with Medicare, or health care, for that matter.  In the same speech to the NHS, he denounced profits as immoral:

“Our insurance companies try to predict who will need care, and then to find ways to exclude them from coverage through underwriting and selective marketing. That increases their profits. Here, you know that that is not just crazy; it is immoral.”

Berwick decided to take his denunciation of the free market a step even further.  Berwick said, “Don’t put your faith in market forces” - instead, trust “leaders with plans.”

Dr. Berwick, as the newest and most ambitious member of America’s Ruling Class, will be calling the shots (or lack of shots) for Medicare.  Then what?  Remember, statists like this are never satisfied with simply a taste of power.  They eventually want it all.  He sees himself as “a leader with a plan,” for you and your family.

What It All Means

If you’re like me, you first heard of Berwick a couple of months ago when Obama nominated him, as he was controversial even waaay back then, four months ago. Like I said, Obama had to use a recess appointment, which is, albeit deceptive, Constitutional (Article II, Section II, Clause 3).  The minority has little power to prevent recess, and no power to prevent recess appointments.  They will have power in the confirmation hearing, though, and it will interesting to watch our new “Rationer-in-Chief,” or as others are calling him, a “One Man Death Panel,” try to defend his stances on health care and socialism.

So, on a macro-level, we know that full implementation of Obama’s agenda for health care would result in the abolition of private health care.  I won’t get into that now.  The fact that he tried to slide Berwick in under our noses – and then had to rescind when both Republicans and Democrats protested – illuminates something greater happening here.

In the wake of Obama’s election, Americans were generally filled with one of three emotions:  Hope on the Left (and in the center); Apathy among some; and Despair on the Right.  As time went on, and as a Progressive wave of legislation is at writing washing over this nation, both Hope and Despair are beginning to be displaced by Cynicism and Apathy.  Nobody believes the Administration anymore, illustrated by the lack of faith in Obama’s Orwellian “Summer of Recovery.”

In his heart, Obama believes he can glorify his Administration and demonize his opponents with carefully leveraged speeches.  Admittedly, combatting Obama’s Trotsky-meets-Alinsky campaign methodology of “Permanent Revolution” will be difficult in both 2010 and 2012.  Systematically, that battle has already begun, at the behest of the wings of the liberal establishment.  More on that later.

Until then, don’t get distracted by their flagrantly false arguments aimed to marginalize your energy.  Remember their plans for America.  Remember their disdain for the tenets of individual freedom.  Remember their incompetence.  Remember their deceptions.

Remember November.

“It is vain to talk of the interest of the community, without understanding what is the interest of the individual.”

~ Jeremy Bentham, early advocate of utilitarianism

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Let me try to make this short and sweet; that very phrase must surprise all you within a closer circle of trust, those subject to my ramblings in the wake of Obamacare, the single greatest step towards state control in American history.  The good news is, American has been closer to socialism before under FDR, who moved slower and more incrementally in getting us there.  The bad news is, Obamacare did more to get us there quicker than any we’ve seen before, with unprecedented restrictions upon the individual, in one massive reconciliation package.

So, here’s to your health - paid for by the American taxpayer.

There is much to say about Obamacare, but for now, I won’t focus on it in its entirety; I’ve written enough on it already, and I stand by every word I have already said.  So with little regard toward the actual impact of their legislation, the Democrats passed their key piece in their social agenda.  Part of me refuses to believe it actually happened, but it did.

For the Left, it is equally unfathomable that opposition to their legislation remains fermented.  The Democrats cannot understand the billion dollar write-downs of corporations such as AT&T and Caterpillar, and John Deere.  All said, the bill may cut $14 billion from corporate profits, in the words of Speaker Pelosi, “Jobs, jobs, jobs, and more jobs,” notwithstanding.  While piecemeal destruction of the private sector may indeed be their intention, who will pay for these cuts in profits?  That’s right, the individuals; the employees.  Echoing what 17th Century British philosopher Jeremy Bentham once said, “It is vain to talk the interest of the community, without understanding what is the interest of the individual.”

But I digress.  I promised short and sweet, so I’d like to point out how (some of) this bill will (theoretically) be paid for, by utilizing a deliberate form of fiscal drag known as “Bracket Creep.”  Allow me to explain.

As you know, Obamacare will subsidize Health Care for families who cannot afford it, commonly referred to as “the poor.”  The new standard of “poor” (a deliberate phrase, for you econonerds) is “four times the poverty level,” or $88,200 for a family of four.  The “poverty level,” as you know, is indexed to the Consumer Price Index, as to keep up with inflation.

Obamacare will be (theoretically) paid for with revenue increases, including (theoretical) cuts to Medicare, and taxes.  Among the many taxes (seventeen, total) within Obamacare, the ”Hospital Insurance Tax” of Section 9015 levies an excise tax on income and investments of “High Income Taxpayers,” defined as an individual making more that $200,000 ($250,000 for joint filers) a year in Adjusted Gross Income; that is, the proverbial “rich.”

So let’s recap:  $88,200 is the new poor, and $250,000 is the new rich…  this year.  You see, as the dollar is devalued and inflation kicks in, the standard of poor will rise, while the standard of rich stays the same.  The new rich are ”the rich” today, “the rich” tomorrow, and “the rich” forever.  This is not speculative; this is statutory language, signed into law last week.

Do you see what’s happening here?  More and more people will enter the “High Income” tax bracket, acquiescing their income to government, with more and more people receiving a subsidy for Health Care.  This is a form of Bracket Creep, which occurs when middle income levels move into higher tax brackets as income rises with inflation.  Scoff, you may – Obama’s strengthening the middle class, right?  Yeah, and it’s been done before; Cuba, for instance, only has two classes:  the Middle and the Bureaucrat.  And, as Michael Moore told you, Cuba also has universal Health Care.  Little wonder Obamacare garnered the endorsement of none other than Fidel Castro: It’s a “miracle!”

And so goes the American empire; it sure was a good run.  Really?  Well, with no one left to pull the cart, how can it move?  As Josh Fisher of Bloomberg News puts it,  “With easy access to abundant government handouts, it’s no wonder so many jobless people have stopped looking for work.”  He blames our swollen entitlement programs for the impending “meltdown ahead,” following in the footsteps of the Roman Empire.

“Oh, come on!” you may say.   As long as there is no inflation, nobody will “creep” into the “High Income” tax brackets, right?  Oh, wait…  Record increases to the money base (to pay for handouts) will result in record inflation, which will result in higher taxes on the middle class.  It’s just a matter of time.  Increasing dependence accelerates the United States down the same plank from which Greece just walked.  Which, if you ask me, was precisely the point.

Who cares, though?  Not my generation; no, sir.  I mean, get a grip, Travis!  Even if it is the law of the land, who will actually police our health care taxes and penalties?  The IRS?  Surely you jest!  Oh, wait…

In a 2008 Rolling Stone interview, then-candidate Barack Obama answered the question “Three books that really inspired you” with the following:  “Toni Morrison’s Song of Solomon, the tragedies of William Shakespeare and probably Hemingway’s For Whom the Bell Tolls.”

So, in reference to the reference of the reference, I’ll close with the following; John Donne’s Meditation XVII, 1624:

“No man is an island, entire of itself; every man is a piece of the continent, a part of the main.  If a clod be washed away by the sea, Europe is the less, as well as if a promontory were, as well as if a manor of thy friend’s or of thine own were:  any man’s death diminishes me, because I am involved in mankind, and therefore never send to know for whom the bell tolls; it tolls for thee.”

It tolls for thee.  The 2010 (and 2012) elections are right around the corner.  We are not Cuba yet.  There is hope for our country.  It starts with repeal of Obamacare.  That hope is found in the voting booth.

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During the President’s speech last night on health care, I was amazed by two little words that were unleashed; no, I’m not referring to Representative Joe Wilson’s outburst of, “You lie,” which, while maybe deserved, was indeed a breach of protocol.

You can contribute to Wilson’s now up-hill battle against the Statists here.  You would think that after nearly six weeks of raucous town hall meetings, nobody in that chamber would have been surprised to hear the echoing of American sentiment from one of 535 Congressmembers, but nay, it shocked (shocked!) the left, most visibly Madame Pelosi, and they’re calling for action against Representative Wilson.

No, those two words, “You lied,” weren’t the two words that shocked me last night.  After plain distortions and covert deceptions, the President actually used the words “social justice.”  During a moving evocation of a letter written by the late Senator Ted Kennedy, the President read from his teleprompter:

He expressed confidence that this would be the year that health care reform — “that great unfinished business of our society,” he called it — would finally pass.  He repeated the truth that health care is decisive for our future prosperity, but he also reminded me that “it concerns more than material things.”  “What we face,” he wrote, “is above all a moral issue; at stake are not just the details of policy, but fundamental principles of social justice and the character of our country.”

My shock over this issue should not subsequently shock you; it wasn’t two days ago that I wrote on my last post, “I have never believed in social justice.”  What do I mean by that?  As we work towards a just society, what’s so bad about social justice?

Social justice is an endorsement of social and class warfare, and is today disguised as reform.  Again, please, don’t believe me.  The sainted Wikipedia defines “social justice” thusly:  “The term ‘social justice’ is often employed as a euphemism by the political left to describe a society with a greater degree of economic egalitarianism, which may be achieved through progressive taxation, income redistribution, or even property redistribution, policies aimed toward achieving that which developmental economists refer to as equality of opportunity and equality of outcome.”  Now; are you shocked?  How have we gone so wrong to prefer social justice over just society?

A Destructive Agenda

In his classic The Republic, Plato coined the famous adage, “Necessity is the mother of invention.”  I would offer that in a prosperous, capitalist society, Want qualifies as the surrogate mother of invention.  Whatever a person could want or need is developed, produced, and traded freely for the benefit of all parties involved.  The opulence of the parties involved has always irked the left; it’s simply not ‘fair’ that some succeed while some fail.  They do not contend that equal opportunity, a goal on the left and the right, renders a wide range of results, based on the efforts and talents of those parties involved.  They believe trade should be fair, not free, because free trade rewards some, and not all.

These sentiments heightened recently to scary levels in the wake of our economic crisis.  Public opinion prompted a strong disdain for capitalism, as we know it, in America.  The slow destruction of our system now comes from within, and serves as testament that our society lacks any real, fundamental wants, or for that matter, any foundational needs.  Our age of prosperity lifted all classes, to the point where Escalades sit parked outside Section 8 housing, and the homeless in food lines have Smartphones.

Our government refuses to address the underlying source of our current economic situation, which is our lack of Homeland Production.  Due in large part to lofty corporate taxes and a federal standard for wages, we sublet labor to China and India, who now hold much of our debt.  No, instead, the current regime has decided to demonize the very industries that provide for the Wants and Needs of this country, in particular energy and health insurance companies.  Immediately lowering corporate taxes would provide an incentive for industries to move back home, where jobs are scarce.

Do not be confused:  The proposed reforms are not about energy security, improved education, or health care at all.  The agenda of the left is about control:  energy control, education control, and health control, not unlike the agendas of other leftist regimes before them, littered throughout world history.

Historical data on state-run health care lends credence to the claims of potential rationing and “death panels” within the bill.  Think about this:  Mrs. Palin’s two little words, “death panels,” incited a firestorm of criticism.  Why?  Because they rang true.  A quick glance at the practices of the University of Chicago Hospital, First Lady Michelle Obama’s former employer, to divert patients in order to cut costs, support such concerns.  Palin’s dissent rang true, and that’s why Representative Joe Wilson’s words resonated today.  Since many feel the President is lying to them, as a representative, Wilson spoke up.  Now, under this regime, he faces an unknown future.

So what is Obama’s ultimate agenda on health care?  He admitted he supported a single payer system in 2003, and waaay back in 2007, he tipped his hand on how to get there:

I think that we’re going to have to have some system where people can buy into a larger pool. Right now their pool typically is the employer, but there are other ways of doing it. I would like to — I would hope that we could set up a system that allows those who can go through their employer to access a federal system or a state pool of some sort. But I don’t think we’re going to be able to eliminate employer coverage immediately. There’s going to be potentially some transition process. I can envision a decade out or 15 years out or 20 years out where we’ve got a much more portable system.

I believe the public option, a policy proposal unheard of until this year, is a Trojan Horse for the kind of single payer system Obama supports.  Through such means, the federal government would assume control of sixteen percent of the economy, with the public sector taking money out of the private sector to do so, redistributed, dollar for dollar.

How is justice rendered, then, if not through the reallocation of wealth?  Well, Article III of the Constitution leaves it to Supreme Court to administer blind justice based on the fairness in a transaction, regardless of its outcome.  Contrary to the theories of President Obama’s fellow professor John Rawls‘, “Equal Justice Under the Law,” implicit in the Fourteenth Amendment, is not apathetic to the parties involved, and thusly free and fair trade is guaranteed.

Likewise, contrary to President Obama’s beliefs stated here, waaay back in 2001, the Constitution should not be addressed on the basis of what “government must do on your behalf,” nor should the Supreme Court “venture into the issues of redistribution of wealth.”  Equal justice, when properly rendered, ignores upshot, and leaves social justice a theory banished to the far, far left.  Hereunto, proper reform of our health care system depends on abandoning these ideas.

“How can limited government and fiscal restraint be equated with lack of compassion for the poor?  How can a tax break that puts a little more money in the weekly paychecks of working people be seen as an attack on the needy?  Since when do we in America believe that our society is made up of two diametrically opposed classes — one rich, one poor — both in a permanent state of conflict and neither able to get ahead except at the expense of the other?  Since when do we in America accept this alien and discredited theory of social and class warfare?  Since when do we in America endorse the politics of envy and division?”
~ President Ronald Reagan

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