Townhall.com | George Will | July 8, 2007
WASHINGTON — Some mornings during the autumn of 1933, when the unemployment rate was 22 percent, the president, before getting into his wheelchair, sat in bed, surrounded by economic advisers, setting the price of gold. One morning he said he might raise it 21 cents: “It’s a lucky number because it’s three times seven.” His treasury secretary wrote that if anybody knew how gold was priced “they would be frightened.”
The Depression’s persistence, partly a result of such policy flippancy, was frightening. In 1937, during the depression within the Depression, there occurred the steepest drop in industrial production ever recorded. By January 1938 the unemployment rate was back up to 17.4 percent. The war, not the New Deal, defeated the Depression. Franklin Roosevelt’s success was in altering the practice of American politics.
This transformation was actually assisted by the misguided policies — including government-created uncertainties that paralyzed investors — that prolonged the Depression. This seemed to validate the notion that the crisis was permanent, so government must be forever hyperactive.
In his second inaugural address Roosevelt sought “unimagined power” to enforce the “proper subordination” of private power to public power. He got it, and the fact that the federal government he created now seems utterly unexceptional suggests a need for what Amity Shlaes does in a new book. She takes thorough exception to the government he created.
Republicans had long practiced limited interest-group politics on behalf of business with tariffs, gifts of land to railroads and other corporate welfare. Roosevelt, however, made interest-group politics systematic and routine. New Deal policies were calculated to create many constituencies — labor, retirees, farmers, union members — to be dependent on government.
Before the 1930s, the adjective “liberal” denoted policies of individualism and individual rights; since Roosevelt it has primarily pertained to the politics of group interests. So writes Shlaes, a columnist for Bloomberg News, in “The Forgotten Man: A New History of the Great Depression.” She says Roosevelt’s wager was that, by furiously using legislation and regulations to multiply federally favored groups, and by rhetorically pitting those favored by government against the unfavored, he could create a permanent majority coalition.
. . . more
Dean, have you checked into the manner in which VA hospitals are run?
Note 52 touches on a lot of different topics.
The standard straw man argument.
First, you create a straw man (straw woman?) by suggesting that I oppose every single kind of public assistance to the needy. This is not true and I find that I have to start nearly every single post which responds to you with this tedious exercise in clarification. I have pointed out many, many times that we, in America, have a mixed economy: some free market, some government regulation, some public assistance. As of today, Americans spend 40% of GNP on government on one level or another.
The true debate is not whether there should be some government assistance but the kind and the degree.
Of course, people want their “safety net?”
It doesn’t take alot of sophistication in polling to know that broad swathes of the U.S. population tend to see themselves as net consumers of government benefits and they most assuredly DO want their “safety net.” However, that does not mean that the programs in place are good for Americans or that they should be expanded. Each program needs to be evaluated in it own terms.
One of the dangers of democracy, is that voters are led to believe that they can “vote themselves rich.” This is a dangerous delusion and it eventually leads to economic stagnation and a poorer society for all. It also undercuts industry and thrift and encourages people to spend all of their disposable income today because they believe that government will take care of them tomorrow.
An American NHS service like that of Britain would be a debacle, just as it is in Britain, only bigger
The government is responsible for running VA hospitals. Ask your typical veteran how happy he is what that system. Wasn’t there just a scandal in Washington D.C. about the treatment of disabled vets in D.C?
Remember, the National Health Service in Britain does not, repeat does not, guarantee health care for all. Many people go without health care that they need. Many people die on waiting lists. Health care is still rationed, it is just rationed politically, by government.
We have had this same conversation over and over. First you accuse me of opposing all forms of government aid to the needy. Then to claim that everybody wants socialized medicine. Then you blithely ignore the glaring shortcomings of medical care in Britain and Europe.
Dean, repeat after me, “there is no such thing as a free lunch.” There is no such thing as “free medical care.” People in Britain just die on waiting lines.
People in the United States generally get medical care, they just have to declare bankruptcy if they can’t pay the bills.
By the way, your “humane” immigration policy just shifts health care from American taxpayers to illegal immigrant freeloaders. Very Christian, Dean, but it is only “humane” if you are in the right group. Taxpaying Americans fend for themselves but illegal aliens are “oppressed” and they get the benefits of other’s work.
32165
Dean, “universal health care” just like “universal public education”
The creation of a “universal health care” system will in fact just calcify economic classes. Well-to-do people will get private medical care. Less than well-to-do people will have to rely on the government health care system and they will receive shoddy medical treatment. Think VA hospitals on steroids.
Just as well-to-do people ( some other others) save their children from the increasingly incompetent public school system and send them to private schools.
Universal health care, is a lie. Health care will be rationed and some people will not get health care even though they have paid oppressive taxes all their lives. Plenty of people will die on waiting lists.
In Canada, the government will pay for sex change operations for some people while others literally die or suffer unnecessary amputations while waiting for other operations.
My the good Lord save us from “universal health care.”
Missourian: What we need to do is set broad objectives for our Health care system and then find our own American way to meet them. We need not emulate any specific country. The broad goals for health care should include the following:
1) Everybody in the Risk Pool.
a. As a matter of fairness and decency no one should be denied health care because of a pre-existing consition.
b. We all currently pay more for health care because the unreimbursed care for the unisured is passed on to the insured in the form of higher prices and premiums.
c. Adding healthy uninsured people to the risk pool will provide premiums to offset the costs of the sicker uninsured.
2. Eliminate bureaucratic redundancy and administrative overhead.
Too much money in the American private health care system goes to administrative overhead and profit. In the Medicare program administrative overhead represents only 5% of expenditures, while private insurance companies devote 15-25% of expenditures to administrative overhead.
3) Standardize treatment, employ electronic technology.
a. A survey called The Dartmouth Atlas continues to show that the volume of care and type of treatments for the same identical medical conditions continues to vary widely accross the United States. In some places, medical specialists who specialize in certain types of treatment, like Angioplasty or back surgery will provide it even when less expensive treatments are sufficient.
4. Incentivize Prevention and Wellness.
a. Primary Care doctors who provide basic preventative care are the lowest paid of physicians. The real money is in treating patients after they have already become sick. We need to find a way to reward doctors for keeping patients well and not letting them get sick.
b. Reward individuals for seeking healthier lifestyles. Perhaps people who don’t smoke and keep their weight and blood pressure within acceptable ranges ought to rceive a credit or rebate on their health care premiums or taxes.
Canada and Britain are not the only models we can study when redesigning our own health care system. France and Germany have hybrid public/private systems that produce very good results and far less cost than here in the US.
In Germany,
http://www.germanculture.com.ua/library/facts/bl_health_care.htm
In France,
http://www.civitas.org.uk/pubs/bb2France.php
We have to recognize that the current health care system we have in the United States is fiscally unsustainable, wasteful and inefficent, and cruelly unfair. We have to fix it but are free to choose are own prescription for doing so.
@ Dean S. #45
“….. At the same time, a new project of physical, technological, and urban social engineering will have to get under way.”
Oh yes, yes! That is exactly what we need. More government programmes, more social engineering. As I remember, the old projects all worked so well that we need a lot more.
Btw, what happened to all the “old” programmes? Oh yes, they worked so splendidly that we really want this new one…… like a hole in the head.
@ Missourian #54
“…In Canada, the government will pay for sex change operations for some people while others literally die or suffer unnecessary amputations while waiting for other operations”.
Missourian, that shows you that we up here in the Great White (liberal) North have our priorities in order. What would be more important than to (ex)-change our toys…. we are living in a liberal fantasy and sex is the great gift to all from the government…. ha, ha.
In reality, it is all very, very sick…..
See my next response when it comes out of moderation – I think it addresses your concerns.
Dean, some people will still die, they’ll just be waiting in line, there is no such thing as “universal health care.”
In the UK, the government banned a particular commercial broadcast by a egg company. The commercial stated something like “have an egg every day for breakfast, a good way to start the day.” This very old and very traditional commercial was banned, because the government had decided for people that they shouldn’t eat an egg every day.
Freedom doesn’t seem to be a value that you, Dean, ever mention. It isn’t in your lexicon. You have no antenna attuned to the dimunition of freedom.
Isn’t it clear that as soon as the government assumes (or claims to assume) most of the responsiblity for our health that there will be no aspect of our lives that they cannot regulate and control.
Government has a tendency to grow, to acquire more power. It is a result of the fallen nature of Man. People always want more power and they always believe that that when they as individuals have power everybody else is better off.
In the U.K., people are beginning to discuss denying health care to smokers and the obese, (note not to promiscuous people who contract venereal diseases though). Maybe there is some logic to this, but, it will be the NHS that will rule the British with an iron hand.
Every proposal you advance gives more and more power to the government. You claim to value the family and Church communities, but, when it comes down to it your only solution is more government. Our government must remain secular and as such, you are feeding a beast that is not governed by religious or moral principles. This cannot be seriously endorsed by any thinking Christian.
Our health system isn’t that bad, we don’t need socialized medicine. There are problems with socialized medicine that no country has solved. Again, there is no such thing as “universal health care.” Some people will get care, some people will always die waiting in line.
How did the Canadian supreme court put it, “universal access to a waiting list”.
Dean has no sense of human nature, thus he buys into the Marxist utopia…
It is interesting that many of the folks who support the killing of Terri Schiavo in the name of “individual autnonomy” also support governemnt run healh care because….well it sure isn’t individual autonomy. In fact, under governemnt run health care, defacto ethuanasia will become frequent as the most expensive, end of life care will be rationed.
In the Terri Schiavo thread Jim accused those of us opposing the killing of Terri of wanting to hand the decisions over to the the big bad boogy-man clerics. Like something right out of the so-called Enlightenment. And Jim calls himself “modern”? Even if Jim is correct, how is handing those decisions over to the governement or some hospital board any better. The problem with individual decisions is that they entail individual responsibility. The thrust of JimJamesDeanetal is to deny both.
Michael writes: “In the Terri Schiavo thread Jim accused those of us opposing the killing of Terri of wanting to hand the decisions over to the the big bad boogy-man clerics.”
Actually, Christopher suggested that, with his statement that the wishes of “Christianity” should control those situations.
My main point has been that if the wishes of the patient are not the controlling factor, then someone else’s wishes will be. That’s a simple fact. Who is that other person or persons?
Michael: “Even if Jim is correct, how is handing those decisions over to the government or some hospital board any better.”
We have to make an important distinction. In the Schiavo case, the task of the court was to determine what Terri Schiavo’s wishes would have been. It was not the job of Judge Greer to make a decision based on what he thought was best, or on what he would want for himself in that situation. In that sense the government can play a role, but the role should always be to try to determine what the patient would want, not what some other party would want.
The state of Texas has a law that allows hospital ethics committes to decide when to terminate medical intervention. This is not patient autonomy; it is the opposite of patient autonomy.
Jim, your bias is toward legalistic control which means some sort of bureauracracy either statist of professional. Christian control, at least from an Orthodox perspective doesn’t mean that. It means people voluntarily following the teachings of the Church because they beleive them.
Michael writes: “Jim, your bias is toward legalistic control which means some sort of bureaucracy either statist of professional.”
This is my fault for not being clear. Getting the courts involved in these cases is very unfortunate. Most of these cases never get to court, which is a good thing. The legal system is a resource of last resort, when all else has failed. In the vast, overwhelming number of cases the courts are not involved. But if the family simply cannot agree, the legal process is much better than no process at all.
The involvement of hospital ethics committees — outside of Texas, unfortunately — is a very good thing. Ethics committes — done the right way — can be extremely valuable. They bring a number of different perspectives to bear, including religious perspectives. It would surprise me if Fr. Hans has not been involved in a hospital ethics committee consult. If he has, I would like to hear about that from him. Ethics committees can help everyone understand the facts of the case. They consider not just the medical data, but also the perspective of the physician, the nursing staff, the family, and the patient.
Michael: “Christian control, at least from an Orthodox perspective doesn’t mean that. It means people voluntarily following the teachings of the Church because they believe them.”
When the patient and family are Orthodox Christians, then the Orthodox perspective should be the controlling factor. Absolutely no doubt about that, 100 percent.
But a system of medical ethics has to consider everyone. I want a system that works for all people, not just a few.
One does not have to be Orthodox to value life in a similar way. Whether one is Christian or not one does not have necessarily evaluate life on a utiliataian basis which those who support the killing of Terri do.
Note 64. Jim writes:
I have, and I have no problem with ethics committees as long as they are not ideologically or commercially driven, which would necessary require a usurpation of family authority. (I have never encountered this, BTW, but I can see where the “patient autonomists” want to go with it.)
Most medical decisions are clear cut — eventually. The difficulty is the time before things get certain. My job is to help the patient and family frame the experience, to give meaning to it so the proper decisions can be made. People move closer to God in times of suffering.
Note 64. Jim writes:
This is a recipe for anarchy. Medical decisions cannot be based solely on sociology. That’s how got into the confusion of struggling to save premies on one floor of the hospital while aborting healthy children on another.
Some people — euthanasia advocates for example, and some situations — a desire to die due to depression or other factors for example, cannot be allowed to prevail in the former, and need therapy in the latter.
Not every group or claim is legitimate.
Christopher, you’ve got to cool it. The blog is running the way I want it to run.
Perhaps you can clear the air – what is it you want from this blog? My problem is that “Orthodoxy” means something. If any idea is entertained (no manner how repetitively or rudely expressed) then what does “Orthodoxy” mean here in this context? Perhaps a bit of truth in advertising is in order. If not “OrthodoxyToday” then what, exactly????? “RoundTableofIdeasToday”? Perhaps a change in domain name is in order.
Not every group or claim is legitimate.
It is here. Jim can express his culture of death endlessly. What group or claim is NOT “legitimate”??????
Not every group or claim is legitimate.
It is here. For example:
When the patient and family are Orthodox Christians, then the Orthodox perspective should be the controlling factor. Absolutely no doubt about that, 100 percent.
But a system of medical ethics has to consider everyone. I want a system that works for all people, not just a few.
Is yet another way to express the Rawlsian “neutral veil”, which is always promoted by modernists, who don’t have the ability to examine their own premises and see that they are merely trying to usurp all disputes into their own world view. You can be nice and charitable and point this out, but Jim marches on to his own drum (i.e. being stubborn and dimwitted). You can point this out, and yet it continues on for a couple of hundred posts.
What does any of it have to do with Orthodoxy? Nothing…
What claims are NOT legitimate here????
Christopher, how do you go about determining what is correct “Orthodoxy” given the fact that you have denounced members of the OCA? Yes, you’ve referred to Seraphim Rose, but Rose was likewise critiqued for his near-Gnostic tendencies by others within the Orthodox church. So, really, who is Orthodox enough for you?
Against what written and/or spoken source of authority are you comparing it to? If you would like us to believe you are a reliable Orthodox resource, do everyone a favor and quote a sentence or a paragraph (instead of simply referring to an entire book in a vague manner).
Christopher, how do you go about determining what is correct “Orthodoxy” given the fact that you have denounced members of the OCA
Same as any other tradition. This is like asking “how do you go about determining what is correct “Catholicism”, given the fact that there are pro-choice Catholics groups, politicians, etc.” Simply because the OCA web master says something not thought out or not in line with Tradition does not cause a “crises of belief” – unless one is looking for legalistic answers.
Rose was likewise critiqued for his near-Gnostic tendencies
“critiqued” is going to far – more like hyperbole. If Fr. Seraphim is a Gnostic, then pigs fly. Apparently (as Michael already said) there was some personal animosity among certain ROCOR and OCA. Check out the history of both groups and you will understand.
So, really, who is Orthodox enough for you?
This is simply a diversion on your part. The problem you have is you want to debate Christians with non-Christian premises endlessly. Perhaps that’s what Fr. Jacobse wants also.
If you would like us to believe you are a reliable Orthodox resource, do everyone a favor and quote a sentence or a paragraph (instead of simply referring to an entire book in a vague manner).
Which is why I think you are a Troll (as Dean and Jim). Instead of LISTENING, you simply want to debate, not admit your presuppositions (Myself, Michael and even non Orthodox Christians like Missourian make ours plain each and every post). You turn this blog into a crude middle school debate. Your not interested in Orthodoxy in the least, or you might actually educate yourself (I know, it is work – bummer) instead of looking for sound bites, which as myself and others have said over and over and over again you are not going to find at this blog or any other…
So JamesK, how about moving past “debate” and actually getting to the heart of what you believe. We ask again, “What does PVS mean to you”?
JamesK,
IF you are sincerely interested in Orthodoxy, and you have a problem reading books – or simply want help with them – check out:
http://www.monachos.net/forum/showthread.php?t=3942
It’s an online reading group and they are starting with a very good catechism written by a Saint…
Christopher: to answer your question — my understanding of PVS is that it involves a termination of the higher brain function even as the lower brain maintains some activity. Though I am not a physician, I regard the lower brain survival as analagous to the fact that there has been shown a survival of cardiac function after total brain death. Through the unnatural use of medical technology, we can keep people in this state for a very long time, but I don’t see why one must necessarily view it to be “God’s will”, or that it is even the “just” thing to do.
If it is God’s will that people remain alive in a PVS state, then it is His will that they remain alive in this state whether they are poor or rich, yes? Thus, we are morally bound to preach that living wills are sinful when they allow a removal of a feeding tube (even if the person desires it), and we are also bound to provide the means of keeping the person alive whether the person is financially able to provide it for themselves or not. I don’t see any other way around it, unless you wish to assert that some people are more valuable than others purely by means of their assets. I doubt this is either Scriptural or true Orthodoxy.
If it is God’s will that people remain alive in a PVS state, then it is His will that they remain alive in this state whether they are poor or rich, yes? Thus, we are morally bound to preach that living wills are sinful when they allow a removal of a feeding tube (even if the person desires it), and we are also bound to provide the means of keeping the person alive whether the person is financially able to provide it for themselves or not. I don’t see any other way around it, unless you wish to assert that some people are more valuable than others purely by means of their assets. I doubt this is either Scriptural or true Orthodoxy.
Which is the crux of Fr. Jacobse’s warning about “commercialism” of “medical ethics committees”. You are right, disabled persons are expensive in so many ways to society. Question is, do we allow commercial interests (or God forbid government medical bureaucrats) to decide who lives and who dies, particularly when they are staffed with men such as Jim who are Death Eaters.
You sort of answered the question, PVS = death for you, no? I mean, the person who was “Terri” died, and the body is just kept alive no?
I ask because you also mentioned a dark story, one where you imagined Terri was still “Terri”, even in her PVS “state”, and that she was in horrible, agonizing pain, and wanted to die?
Which is it, was she alive or dead?
test
Fr. Hans writes: “This is a recipe for anarchy. Medical decisions cannot be based solely on sociology. That’s how got into the confusion of struggling to save premies on one floor of the hospital while aborting healthy children on another.”
Christopher writes: ” . . . Is yet another way to express the Rawlsian “neutral veil”, which is always promoted by modernists, who don’t have the ability to examine their own premises and see that they are merely trying to usurp all disputes into their own world view. ”
Ok, so you guys don’t like the idea of patient autonomy. So in the real world, how should these decisions be made? What is the process, in a world in which not everyone is a Christian, and only a few are Orthodox? Forget my premises. Forget patient autonomy. You can rewrite the process from scratch. What does it look like?
Christopher, I don’t think she was aware of anything, based on my limited understanding of PVS. I mentioned that scenario purely as a potential reason why someone may have argued that allowing her to die would be the merciful thing to do. However, I don’t think she was conscious of her own existence or of anything going on around her.
I’m not arguing for the termination of the “disabled” here. In other words, someone can still suffer brain damage but remain sufficiently alive. Were this the case, I would not be arguing for a removal of a feeding tube.
However, it seems we are all drawing lines here and are simply disagreeing as to where that line should be placed. Wherever that is, one should be able to articulate in medical and spiritual terms why it should be drawn there. This is not legalism. It’s forming a coherent system that can be relied upon to answer questions of this nature should situations like these arise.
Note 77. Jim writes:
Not speaking for Christopher (although he might likely agree), decisions would be made in large part like they are today: the patient’s wishes in consulation with the family and other trusted advisors (doctors, clergy,) etc.
Patient autonomy is already recognized today, although not in the sense you want it to be, which is: all decision making is stripped from the family and placed in the hands of medical beaurocrats. This certainly will never resolve the difficult issues surrounding cases of, say, PVS (which is not as prevalent or clear cut as you let on), although it will make these decisions more efficiently decided.
Whether such efficiences are desirable however, is one large, looming, question patient autonomists are loath to address because it gets us right back to the nub of these issues: how do we value life?
One resolution is to relativize the value, which is the result if we filter the decision through sociological categories alone, such as you proposed above. But that gets us into the problem of saving preemies on one floor of the hospital while aborting them on another, for example. This is hardly a coherent resolution.
The process does not have to be ‘rewritten’ as such, at least not in the way which you propose, which is not a ‘rewriting’ but rather a deflection of the question that vivifies the conflict. Some questions don’t have easy answers.
Note 79. James writes:
There are many things in life that defy categorization, James. Not everything in life can be wrapped in a box. If we try to box things that don’t fit into a box, we either wreck the box (not a bad thing necessarily), or we wreck the thing we are trying to push into the box (almost always a bad thing).
Fr. Hans writes: “Patient autonomy is already recognized today, although not in the sense you want it to be, which is: all decision making is stripped from the family and placed in the hands of medical bureaucrats.”
Decision-making should never be stripped from the family, but the purpose of the decision-making process should be to determine what the patient would have wanted through the active involvement of family. The only reason the Schiavo case ended up in court was because the family could not agree on what the patient wanted.
Even today, patient autonomy is not an absolute. Some years ago I spoke to one of the staff at the hospital where I worked whose job it was to talk to family about organ donation in the event of brain death. I asked what would happen in the event that the patient had approved organ donation, but the family opposed that. She replied “then the discussion is over. We don’t take the organs.” I asked “even if the patient’s wishes were clear?” She replied “if the family opposes it, no, absolutely not.”
owever, it seems we are all drawing lines here and are simply disagreeing as to where that line should be placed. Wherever that is, one should be able to articulate in medical and spiritual terms why it should be drawn there. This is not legalism. It’s forming a coherent system that can be relied upon to answer questions of this nature should situations like these arise.
I thought I had pretty clearly said why I thought, in this case, she should not have been killed. I said:
I also said:
This is my attempt to explain the “system” (realizing that word is problematic because, like Michael said, you might be looking for something not realy found in Orthodoxy) of spiritual “truth” as applied in this case. From this it should be clear as to why I find the statement on the OCA’s website problematic to say the least…
Even today, patient autonomy is not an absolute. Some years ago I spoke to one of the staff at the hospital where I worked whose job it was to talk to family about organ donation in the event of brain death. I asked what would happen in the event that the patient had approved organ donation, but the family opposed that. She replied “then the discussion is over. We don’t take the organs.” I asked “even if the patient’s wishes were clear?” She replied “if the family opposes it, no, absolutely not.”
This is correct, and as it should be. My wife sees this every week. The “living will” only serves as a reference. Doctor’s defer to the family, but use the “living will” as a tool to help the family think through what the person wants. “living wills” are never specific enough (nor can they be, as the situation is inherently unpredictable), and the family has more status morally and legally anyways. This is the personal aspect, the communal aspect (which includes God), the gut reaction “I would never want to live that way” is too easy, made from the comfortable, even irresponsible position, of being healthy and afraid of pain and suffering while sitting in front of some computer with a standard “living will” form in front of you (or sitting in the DMV easily checking off “organ donor”).
That’s the nature of life in this world. Sometimes, your “wishes” can and should change, even in the presence of great suffering. The reasons are many, but always personal. “living wills” are frozen, fundamentally “selfish” instruments that might not be what you really would wish for when you are in the thick of your trial…