Héritage – It’s French for inheritance

So, kiddies. It’s a still, slightly damp morning down here at the other end of the world, but the light is yellowed and odd through the haze. The air is redolent of burning eucalypti and, sadly, a couple of hundred houses that went the same way, with more to come it seems. Spare a thought for those poor people, and the brave boys and girls of the volunteer Rural Fire Service.

But for the smoke, which is playing silly buggers with my asthma, I could be as far from the fires as you. My neighbour is pottering in her garden. A kookaburra is eying off the goldfish pond from his perch in the jacaranda. The kids next door are playing a bit too much hip hop for my taste, but it’s not too loud so I haven’t called down the wrath of the local constabulary upon them. (Ask for Constable Reilly – he’s the one with buttocks like a ripe, if slightly bruised, peach.)

I am reading, as I am wont, a scholarly work about healthcare reform, and the politics of healthcare reform. This one was linked to by Backwoods_Sleuth over at LGF. It’s a ripper.

I like to read all political books as if I knew nothing about the author (and let me tell you, with the amount I drink, I’m often not pretending). It’s wonderful. I read a book the other day by a young woman called Ann Coulter that was the funniest thing I had read in years. Who knew Americans could write satire that dark? Or Germans? Mein Kampf. Fucking. Hilarious.

Anyway, let’s see. A National Health System for America. Edited by Stuart M. Butler and Edmund F. Haislmaier. Good solid names, I thought. I imagined them as avuncular, charming types. Maybe a bit fusty, but a good night out if you got a few drinks into them early enough.

Published by the Heritage Foundation. Who doesn’t like heritage? I have a Louis Quinze armchair I’d sell my nephew to match, and that’s heritage. Heritage made me think that Stu and Ed are possibly a little more conservative than me and you, but so’s many of my friends. I imagined that the Heritage Foundation has a nice library, with lovely armchairs, where Ed and I could get happily shickered together on some of his undoubtedly fine scotch while we bantered about inpatient deductibles. It was all quite reassuring.

Now, being your dedicated blog-servant, I have read all 127 pages of Ed and Stu’s little book, and I am pleased to say that you pretty much only need to read the introduction, in which Ed and Stu quite helpfully summarise the whole thing.

Let’s see. Are you sitting comfortably?

Health 1

Sounds familiar. Not many laughs in there though. Well, if you’re not a Republican, anyway. Then it might raise a few guffaws. A good start though – Our health system is fucked. And has been since at least 1988, apparently. More amazingly, people expected Congress to do something about it. Who would have thought?

And why, pray, is it fucked up?

healthcare

Yep, that sounds about right.  Ed’s actual chapter 1 is helpfully titled, “Why America’s Healthcare System is fucked”, so you get the basic idea of it. It takes 33 pages to say, “It was politics and greed what done it”.

50 years or so of political dysfunction and corporate avarice has left us with a medical system that is second to none, a medical insurance system that operates like a dickensian cheese dream, and a lot of people who can’t afford to access either one of them. This is considered quite odd in countries where people have guaranteed access to good healthcare at a reasonable price.

Now, Stu and Ed, it must be said, seem to have a thing about Big Government which, almost inevitably, means they don’t think much of socialised medicine.

12

And let’s be frank – they have a point. Big Government always leads to socialism, which leads to Communism, which eventually leads to all of us living in yurts and surviving on potato peelings and all the hooch we can drink. You start out planning a stable, vibrant, free, democratic, capitalist society with universal welfare and instead you end up living in the three feet of space between the yaks and the fish drying racks, and only having parades to watch on the telly.

Moreover, it is clear that socialised medicine doesn’t work, given the many studies which demonstrate that universal healthcare always results in private doctors and insurers being driven into penury, and medical care being reduced to the level of leeches and opening holes in people’s skulls to let the bad thoughts out. Not to mention the seven month waiting list for a good leeching.

We’ll put aside such silly (nay, un-American) thoughts and move on.

3

“This not only gives conservatives a reputation of insensitivity…”. That’s gold, right there. It’s another of those irregular verbs, Minister – I know my own mind; you are a grumpy old git who hates poors and blacks; they have a reputation of insensitivity.

Thankfully, dear Haislmaier and dear Butler have a strategy that will keep us all healthy and, almost as importantly, our society free of the socialist taint, which they intend to outline in exhaustive detail.

Health 2

The remainder of the book looks at reform of Medicare and Medicaid, with a focus on state governments forming public-private partnerships to provide healthcare for the elderly, the poor and the chronically ill, before good ol’ Ed finishes us off with a rousing call to arms.

FinalWorks for me. A health insurance system where people (or their employers) are assisted to freely choose between a large number of competing providers to buy mandatory cover, backed up with price subsidies for some and guaranteed basic care for all.

I’m trying to remember where I read about something just like that over the last three years or so.

I am, of course exaggerating. Stu and Ed’s proposed system was different to the Affordable Care Act in many details. Despite the sweeping terms used in their introduction, the system they proposed was clearly aimed at protecting people from the costs of catastrophic injuries, based upon the primacy of the (almost) unregulated market, and enforced through tax breaks and vouchers.

Still, throw a few pre-existing condition protections, some minimum standards and a couple of bundled payments arrangements into Stu and Ed’s plan,  and you’ve got … well, Obamacare.  Even if it whiffs a bit of the gunpowder tang of socialism, it might, at worst and with a little bit of tinkering, form the basis of a future system more to their liking.

You would think, if you were as naive as I’m pretending to be, that while Ed and Stu might have concerns about the mechanics of the Affordable Care Act, they would would be broadly in favour of it.

I don’t think the ACA is perfect. I do think it’s a great stepping stone to an even better system. Something like this one. Or this. Or this. But that’s not going to happen for what, twenty years, the way we are going? In the meantime I will take what I can get.

Only dimwits, weasels or madmen would advocate digging our new system out, root and branch, returning us to the old one (which everyone one of us knows is helplessly broken), in the vain hope of then passing comprehensive health legislation through a fundamentally divided congress jammed full of dimwits, weasels and madmen.

Sadly, Ed and Stu have spent the last few years fulminating at length about how Obamacare will eat the souls of your little babies. Stu seems positively exercised that anyone might think that all this government mandate stuff might be his fault because that wasn’t what he meant, and even if it was he’s changed his mind and besides, he only came up with it in the first place to piss Hillary off.

Don’t Blame Heritage for ObamaCare Mandate

The confusion arises from the fact that 20 years ago, I held the view that as a technical matter, some form of requirement to purchase insurance was needed in a near-universal insurance market to avoid massive instability through “adverse selection” (insurers avoiding bad risks and healthy people declining coverage). At that time, President Clinton was proposing a universal health care plan, and Heritage and I devised a viable alternative.

Moreover, I agree with my legal colleagues at Heritage that today’s version of a mandate exceeds the constitutional powers granted to the federal government. Forcing those Americans not in the insurance market to purchase comprehensive insurance for themselves goes beyond even the most expansive precedents of the courts.

And there’s another thing. Changing one’s mind about the best policy to pursue — but not one’s principles — is part of being a researcher at a major think tank such as Heritage or the Brookings Institution. Serious professional analysts actually take part in a continuous bipartisan and collegial discussion about major policy questions. We read each other’s research. We look at the facts. We talk through ideas with those who agree or disagree with us. And we change our policy views over time based on new facts, new research or good counterarguments.

Thanks to this good process, I’ve altered my views on many things. The individual mandate in health care is one of them.

Meanwhile, dear old Ed really does have his knickers in a twist, telling everyone who he can make listen that Omamacare is a vile distortion of his beautiful words. Including Neil Cavuto, who I swear thought was fictional, like Damocles or William of Ockham.

No Way Out: How Conscience Gets Trapped in Obamacare’s Little Box of Horrors

Thus, however this particular issue is eventually resolved, the root problem will still very much exist. Given the enormous amount of discretion the law grants to unelected bureaucrats in numerous places, there are likely many other ways that Obamacare can conflict with religious freedom. We have yet to see, for example, how the essential benefits package rules will affect issues related to reproduction, end of life, and parental authority over medical care and testing for minor children.

Indeed, when it comes to religious freedom, the most fundamental problem with Obamacare is that it empowers an overweening federal government—often through a vast regulatory system administered by unelected bureaucrats—to micro-manage every corner of the health care system and everyone who participates in it. Furthermore, from the perspective of the legislation’s authors, this result is, in the parlance of software developers, not a bug but a feature.

When a building is so badly designed and built that no amount of renovation can fix it, the only solution is to call in the bulldozers and start over—preferably with different architects and engineers. The same is true of Obamacare.

Dimwits, weasels and madmen – it’s all the Republican party has left.

All picture quotes:

Health 17


Important issues concerning my lawn and your presence upon it

la_vielle_aux_loques-large

I love my iThings, but the iMessage bug is making me grumpier than a bulldog with one ball.

I use iMessage to chat with my lovely friend Sandra during the day.

At the moment our conversations seem to consist of three or four messages in a row from me (as I realise that none of the messages I sent in the last hour have been delivered, turn iMessage off, reset my network settings, turn iMessage on, and resend the messages that don’t, upon reflection, sound dumb, stoned or needy); followed about ten minutes later by seventeen from Sandra (as she realises that none of her messages have been delivered, stares at her phone in puzzlement for a good six, seven minutes, turns iMessage off, resets her fucking network settings, turns iMessage on, and then resends every single message because self-editing is not amongst Sandra’s skills); followed by one message from me responding to whatever actual content there was in Sandra’s messages; followed by about two dozen from Sandra explaining how she’s changed her mind about three quarters of the stuff she said in her first lot of messages; followed by a few minutes of normal chatting, an hour’s gap, and repeat.
It’s exhausting.

Also, young people.

Young men should stop wearing their jeans so tight it distorts their buttocks and makes them pointy and lumpy at the top and all flat at the bottom so it looks like they go down to their knees, because no girl really wants to fuck a boy who looks like he has a pointy, tumorous, shelf-bum. And they should either shave or grown a beard, none of this manky tufts in odd places and lines shaved into the side and a mustache that looks like they knitted it out of their nose hair and cat dander. I’m in Hong Kong this month, and I swear, dears, if I find myself stuck on the footpath behind one more kiddie who’s walking, wearing headphones, head down and typing on a Samsung, I’m going to push the little shit under a bus.

Also, too, Republicans. Dickheads.

[James Abbott McNeill Whistler (1834-1903) – La Vielle aux loques]


The Sad Long Life of David Brooks

An Arab and his Dogs - Jean-Leon Gerome (1824-1904)

Yesterday I posted a link to David Brooks’ most recent magnum vomitus in which he referenced an article by Dudley Clendinen called “The Good Short Life”. Clendinen’s article is a beautiful, brutal, prickly and funny thing, which you should read immediately, if you have not yet had the pleasure. It will be the best thing you read all day.

Then, if you will, come back and I’ll dare to append some of my own poor scribblings. And a bit of ranting about David Brooks. There will be swearing and David Brooks’s writing may even be compared in a very insulting fashion to baked goods.

Off you go.

See what I mean? That’s the sort of extraordinary writing that David Brooks will never succeed in producing – because the Clendinen article is written by a fine, honorable and self-aware human being and David Brooks’ articles are written by … well, by David Brooks.

I have never met Mister Clendinen, and it saddens me that I almost certainly won’t have the chance to know him. I wish him much joy of the time he has left, much dancing and much walking of dogs, and a quiet and happy death.

On the other hand, David Brooks is a person I would move continents to avoid. While I wish him a long life and little pain – because that is the decent thing to wish for anyone, no matter how morally bankrupt and intellectually turnip-like they may be – I don’t say I wouldn’t be happy if he was to suffer a little accident which removed his ability to write, such as it is. To be frank, I’d probably open a bottle of champagne to celebrate, but it’s generally not something I actively wish for. Actually, if I’m brutally honest, I will admit that rereading both articles made me angry, and that there were moments where I allowed myself to imagine graphic acts of violence against Mr Brooks, but that’s as far as it went, I promise. It was something lingering involving two kilos of anchovies in his pants and an hungry petrel, I seem to recall.

Most satisfying. Very Tippi Hedren.

There are a lot of things wrong with Brooks’ article.

However, I can ignore his willful blindness about the root causes of America’s related healthcare and budget crises (Hint: It’s not the fault of the sick people who would just like to not die in a gutter).

I don’t mind his blithe acceptance that the way to fix the system is to keep the broken system we have and reduce costs by encouraging people to die, rather than reforming (or even socializing) that system (Hint: In most countries with a form of socialized medicine, the political debates are about the details of the socialized system, not its existence, because every politician knows that to mention abolishing socialized medicine will lose you every election in a landslide. People like socialized medicine).

I can make my way through the most repellent Brooks prose without having my palms itch or my temperature rise.

Obviously, we are never going to cut off Alzheimer’s patients and leave them out on a hillside. We are never coercively going to give up on the old and ailing. But it is hard to see us reducing health care inflation seriously unless people and their families are willing to do what Clendinen is doing — confront death and their obligations to the living.

I love how he veers from those authoritative pronouncements of what “we” are going to allow, and what it will be hard to see “us” doing, straight into the declaration that “people and their families” (but presumably not “we” and “us” anymore) will have to stand eye to eye with rabid death and pay their dues to their nation.

I can forgive his mangled metaphors, his twee primness (or is it prim tweeness?):

But in large measure it’s about our inability to face death and our willingness as a nation to spend whatever it takes to push it just slightly over the horizon.

and his complete failure to engage with his subject or educate, inform and/or entertain with his prose. I can even forgive this:

There are many ways to think about the finitude of life.

Can’t you just imagine Davey typing “finitude”? Mouthing the word to himself under his breath, his lips pursed into a little moue of satisfaction, perhaps a wry smile at his own cleverness.

I can accept that, although in this article Brooks has veered dangerously close to inserting a valid point, lurking there beneath the layer of smugness that coats his every pronouncement like the royal icing on a particularly loathsome wedding cake, that point rises no higher than:

People might want to raise my taxes to pay for the poor and the dying. As I am fit, healthy and rich, someone else should do something to prevent their problems impacting on me. I like both free enterprise and cheese.

However, none of these egregious sins against good taste, intellectual rigor and human decency made me angry.

What made me mad, what sent me scuttling for my phone to order a batch of muffins for Mr Brooks*, is that, as the lovely Mr Levenson pointed out in the comments, Brooks appropriates Clendinen’s words and twists them:

Clendinen’s article is worth reading for the way he defines what life is. Life is not just breathing and existing as a self-enclosed skin bag. It’s doing the activities with others you were put on earth to do.

But it’s also valuable as a backdrop to the current budget mess. This fiscal crisis is about many things, but one of them is our inability to face death — our willingness to spend our nation into bankruptcy to extend life for a few more sickly months.

Brooks takes Clendinen’s words about friendship and family and joy and struggle and his right to die with dignity, about his choice (as Mr Levenson puts it):

to live the life he thinks worth and worthy of living, and not one moment that is not,

about his decision to say no to the operations and the pain and the blood and shit and piss and the loss of self that disease can bring, about planning his own death as honestly and lovingly as he can, and about how one’s right to die is necessarily also the right to choose to fight on …

David Fucking Brooks takes those wonderful, painful words and uses them in a prim little sermon on how the aged and the infirm and the poor should grit their teeth, think of the Stars and Stripes and just die already.

That is simply unforgivable.

* If you make very good friends with a New York baker, like I did, you can get laxative-laced muffins couriered to people you hate in the most gorgeous baskets you have ever seen, and at very reasonable rates. Nobody can resist a nice, fresh-baked muffin.

[Image – An Arab and his Dogs – Jean-Leon Gerome (1824-1904)]

[Cross posted at Balloon Juice.]


How long is it until we can leave David Brooks out on a hillside to die?

[Image: Cardinal Mazarin Dying - Paul Delaroche (1797-1856)]

As I have mentioned before, I try very hard not to read anything that David Brooks writes, just in case my brain becomes so revolted it tries to crawl out my ears.

His most recent excresence, however, is so appalling, such a pile of unthinking horror topped off with scads of twaddle masquerading as sympathy, that I can’t leave it alone.

The fiscal crisis is driven largely by health care costs. We have the illusion that in spending so much on health care we are radically improving the quality of our lives. We have the illusion that through advances in medical research we are in the process of eradicating deadly diseases. We have the barely suppressed hope that someday all this spending and innovation will produce something close to immortality.

Obviously, we are never going to cut off Alzheimer’s patients and leave them out on a hillside. We are never coercively going to give up on the old and ailing. But it is hard to see us reducing health care inflation seriously unless people and their families are willing to do what Clendinen is doing — confront death and their obligations to the living.

My only point today is that we think the budget mess is a squabble between partisans in Washington. But in large measure it’s about our inability to face death and our willingness as a nation to spend whatever it takes to push it just slightly over the horizon.

Read the rest of this entry »


Go back to where you came from

Over the last few days I have been privileged, by means of my various international connections, to have watched a reality TV show called “Go back to where you came from”, which has recently been broadcast over three consecutive nights on the Australian television channel SBS. (You probably won’t be able to watch the show at that link, but there is a massive amount of background information available.)

Immigration issues have been a matter of significant debate in Australia in one form or another since the 18th century. However, the debate is particularly heated in the context of what are called “boat people”.

The first boat people – an unauthorized boat carrying five Indochinese men – arrived in northern Australia in 1976, and was followed by a further 2059 Vietnamese refugees arriving by boat over the next five years. There was a further wave of predominantly Indochinese refugees from 1989 to 1998 at the rate of about 300 people per year. Since 1999, however, boat people arriving in Australia have been predominantly (and unsurprisingly) from the Middle East. It is worth noting that boat people have never made up more than a tiny percentage of migrants (or even refugees) reaching Australia.

Public reaction to boat people has been extremely polarized. The refugee issue was used successfully by the conservative Liberal government as a wedge issue in at least one election, finally resulting in the implementation of the so called “Pacific Solution” where boat people were prevented from landing on the Australian mainland (where they would have rights under the UNHRC rules) and instead were transported to detention camps on small island nations in the Pacific.

While these arrangements have come to an end, they seem in recent years to have been replaced by the “No One Has A Fucking Clue Solution”, and debate in Australia continues to rage.

In the SBS program, six ordinary (in some cases very ordinary) Australians were placed in the position of refugees, over 25 days retracing their steps backwards from Australia to the source countries of many refugees.
Read the rest of this entry »


Why does Peggy Noonan hate America?

I adore plane travel.

I love the sheer improbability of nine hundred thousand pounds of steel, people and fuel flitting through the air like Nijinsky on a coke binge. I love the fact that there are beautiful women and handsome gay men whose sole function for eight hours is to bring Grammy more champagne. I love not having to elbow incontinent old people in the head in order to watch what I want on TV.

Most of all, I love the fact that I can have a nap and wake up in Amsterdam or Barcelona or Sydney or Rio de Janeiro. I’ve spent most of my life trying to travel to as many foreign places and meet as many foreign people as possible, even if I’ve had to hock my shoes to get there.

One of the other advantages of plane travel is that the enforced down-time waiting in airport terminals gives me a chance to browse around those corners of the internets I usually don’t get to. For example, the other day, while I was at LaGuardia waiting for Gloria’s plane to be refueled, I stumbled across an unusually coherent article by little Peggy Noonan.

I’m not suggesting it is a great article. After all, when Peggy writes, you’re usually just happy if the piece uses recognizable words and the smell of vodka doesn’t filter all the way down through the printing process and transpire off the page. However, I thought her conclusion was interesting, if only because it looks like Peggy has managed to stumble in the gutter and land on her hands and knees next to half a truth:

The whole world is in the Hilton, channel-surfing. The whole world is on the train, in the airport, judging what it sees, and likely, in some serious ways, finding us wanting. And, being human, they may be judging us with a small, extra edge of harshness for judging them and looking down on them. We have work to do at home, on our culture and in our country.

My real problem with Peggy’s conclusion is that the real situation is much worse than she thinks.

The world doesn’t look at America and find it wanting. The world looks at America and worries what the hell it is up to now.

Now before anyone accuses me of being an America-hating Limey immigrant bitch, let me hasten to add that I love this country with all my heart. Any nation that produced bourbon whiskey, blues music, the cheeseburger and George Clooney’s ass can’t be all bad.

Further, many (perhaps even most) Americans are fine, generous, inventive, kind people.

I’m also not suggesting that the rest of the world isn’t messed up as well. One look at the Italian Parliament or the Japanese film industry or the slums of Brazil or anything involving Steve and Bindi Irwin or the Wiggles would suggest that the rest of the world has enough of its own problems to be getting on with.

America is supposed to be the land of the free and the home of the brave, the refuge of the homeless and the tempest-tost, that more perfect union whose alabaster cities gleam undimmed by human tears.

And yet, most of the time what the outside world sees is a nation of bloodthirsty war-mongers and religious dogmatists who think the way to world peace is more guns and more war, that democracy can be imposed at the end of a Gatling gun, and that drilling for oil, bringing on Armageddon or the fact that the indigenous population wears their handkerchiefs on their heads are legitimate reasons for invasion.

They read their papers and they read about a nation that went to war to throw off the shackles of a hereditary monarchy and then spent the next 200 years replacing it with the most dysfunctional political system this side of Pyongyang, a hereditary argentocracy in which the electoral prospects of a fat multiply-bankrupt television star with a triple combover can be seriously discussed, rather than being relegated to the funny pages.

They wonder at a nation that has the best medical system in the world in which 90% of the population can’t see a doctor without selling either a kidney or their oldest child into slavery – a nation that has the best education system in the world, and yet 72% of the population is so terminally incurious that it doesn’t have a passport and couldn’t find America on a map with a torch and a pointy red arrow marked “You are here”.

They deal with fat tourists from Texas in walk socks and flip-flops who travel overseas merely so they can shout at the locals in English in order to be understood and get directions to the Hard Rock cafe, and thereby avoid being exposed to anything remotely foreign while in a foreign land.

They fear America as a country of cultural imperialists, racists, Jesus freaks and Amway salesmen who want to turn the entire world into a sanitized theme park of sexless talking mice, big-eyed virgins, plastic cheese and expensive time-limited parking.

In the family reunion of nations, America is the crazy aunty with halitosis and a moustache who bails you up in the corner and tells you off because you need to lose weight and stop smoking, while all the while scoffing all the vol-au-vents and bogarting the joint.

America is a great nation. Americans rightly think so. The rest of the world rightly thinks so.

The real problem is that when much of America looks at itself all it sees is a great nation.

The rest of the world looks at America and, however much they may envy or love its wealth and its celebrity and its power, they see a great nation that is often demonstrably, certifiably fucking insane.

Grammy either needs a drink or to stop reading the newspapers. Probably both.

[Image from Artrenewal.org]