Paul Krugman Recommends 'Death Panels' and 'VAT Tax' to Help Balance Budget

Quote from Epiphyte : So no one can tell me why it's ok for private insurance to have "death panels" but not Medicare? Does that mean that we're finally through with this absurd double standard?

Silly right-wingers need to stop throwing around the "death panel" term and realize that doctors and patients need to be more realistic about the limits of modern medicine.

Here's a great read on the subject (a bit lengthy but well worth it IMO): http://www.newyorker.com/reportin...ct_gawande

Quote from Epiphyte : So no one can tell me why it's ok for private insurance to have "death panels" but not Medicare? Does that mean that we're finally through with this absurd double standard?

Chill with the death panels, mon amie. I'm willing to bet you know full well that the term "death panel" implies some sinister organization that sits about deciding, on regular bases, who will die of an arbitrarily selected group of people in much the same way that Nazi officials might have decided every Wednesday whose turn was up for the gas chamber. That's not what this is about. Not even close. People die. Don't like it, take it up la Creador Grande.

The fact about medicine is that, while it can save some of these people in some situations, it is unrealistic to think it can save all of them in all situations. Further, every attempt at medical treatment consumes a piece of the proverbial pie (freshly baked annually though it may be). An unfortunately practical problem exists when there are more mouths to feed than their are pieces in the pie, and one feature of this problem as it applies to medicine is that rationing is not possible. Inadequate treatment have you die just as dead as no treatment at all. Ergo, selective medical treatment is, to the extent necessary, entirely appropriate and, well, necessary.

To call the people who make those decisions members of "death panels," however, is reckless, spiteful, and intellectually dishonest. The term is inaccurate and distracts readers and listeners from the crux of the problem (as those who use the term should see it). These decision panels (which are nothing new--they've been doing their thing in hospitals for a great long while) aren't required because the people who compose them revel in the joy of condemning poor souls to torturous demises. They are required because each individual instance of health care incurs a cost. In America, those costs come all too frequently on account of the prevalence of unhealthy habits (especially concerning the foods we tend to eat and the unhealthy habits such as smoking and drinking we tend to practice), and that problem is compounded by the litigious and bureaucratic nature of the system, which of course emboldens and magnifies each individual expense. Those are the problems. Kindly redirect your flapping, ye olde sanguine herrings.

Quote from Epiphyte : So no one can tell me why it's ok for private insurance to have "death panels" but not Medicare? Does that mean that we're finally through with this absurd double standard?

The problem with government "death panels" is inherant in the nature of Government.

As a citizen, you make up a part of your government and paying taxes into it is mandatory. We perceive it as immoral for government (which we consider representing the people, including the sick needing treatment) to deny treatment because we force individuals to pay into the 'system', we consider the 'system' as being run on behalf of those who pay into it, and considering no one would deny themselves access to the medical needs, it doesn't make sense that the government that represents them would deny it.

Private insurance is different in this because private insurance is a completely seperate entity that you enter into an agreement with (it's voluntary) and part of the agreement you recognize that the insurance company has the final say in what treatments you receive.

Quote from Danman114 : The problem with government "death panels" is inherant in the nature of Government. As a citizen, you make up a part of your government and paying taxes into it is mandatory. We perceive it as immoral for government (which we consider representing the people, including the sick needing treatment) to deny treatment because we force individuals to pay into the 'system', we consider the 'system' as being run on behalf of those who pay into it, and considering no one would deny themselves access to the medical needs, it doesn't make sense that the government that represents them would deny it. Private insurance is different in this because private insurance is a completely seperate entity that you enter into an agreement with (it's voluntary) and part of the agreement you recognize that the insurance company has the final say in what treatments you receive.

e.g. it's an entitlement.

We're very fond of creating entitlements in this country, even though they have a tendency to explode cost-wise, and of course they're all sacred cows so the politicians stick their heads in the sand and hope the problems "go away".

Quote from Danman114 : The problem with government "death panels" is inherant in the nature of Government. As a citizen, you make up a part of your government and paying taxes into it is mandatory. We perceive it as immoral for government (which we consider representing the people, including the sick needing treatment) to deny treatment because we force individuals to pay into the 'system', we consider the 'system' as being run on behalf of those who pay into it, and considering no one would deny themselves access to the medical needs, it doesn't make sense that the government that represents them would deny it. Private insurance is different in this because private insurance is a completely seperate entity that you enter into an agreement with (it's voluntary) and part of the agreement you recognize that the insurance company has the final say in what treatments you receive.

But, why such high expectations for Medicare, but not for other programs we're forced to pay for, yet often choose not to utilize? I don't expect every public school to offer the resources of Exeter.

Also, it's curious that most of the people who deride the so-called "death panels" seem to be conservatives. It takes quite a level of cognitive dissonance to be opposed to big government entitlements while simultaneously demanding that if there are going to be entitlements, that they need to be nearly limitless in scale. I guess it makes it easy to accuse government of being inefficient when you don't allow government programs to cut-costs in ways that private industry does.

Quote from Epiphyte : I could say that I'm somewhat forced to use the insurance my employer provides because otherwise I wouldn't get a tax break on it. Are parents somewhat forced to send their children to public schools? Does that mean that public schools should offer more resources than any private schools? Edit: If you're against Medicare "death panels" then you're for big government and for a larger national debt.

No, not because of that. You can't collect Social Security without also signing up for Medicare.

Quote from Epiphyte : But, why such high expectations for Medicare, but not for other programs we're forced to pay for, yet often choose not to utilize? I don't expect every public school to offer the resources of Exeter. Also, it's curious that most of the people who deride the so-called "death panels" seem to be conservatives. It takes quite a level of cognitive dissonance to be opposed to big government entitlements while simultaneously demanding that if there are going to be entitlements, that they need to be nearly limitless in scale. I guess it makes it easy to accuse government of being inefficient when you don't allow government programs to cut-costs in ways that private industry does.

You're right. I'd rather abolish Medicare entirely.

Quote from Danman114 : The problem with government "death panels" is inherant in the nature of Government. As a citizen, you make up a part of your government and paying taxes into it is mandatory. We perceive it as immoral for government (which we consider representing the people, including the sick needing treatment) to deny treatment because we force individuals to pay into the 'system', we consider the 'system' as being run on behalf of those who pay into it, and considering no one would deny themselves access to the medical needs, it doesn't make sense that the government that represents them would deny it.

Would this same logic apply to other govt-funded "systems" and benefits?

In other words, since no poor person would deny themselves additional SNAP benefits or additional Section 8 benefits, does it make sense that the govt that represents them would deny it?

The problem w/this argument is that it is not the function of govt to represent the interests of each individual person (who all, likely, have competing interests), but to represent the interests of the people as a whole.

Quote from tbuccaneer : No, not because of that. You can't collect Social Security without also signing up for Medicare.

But, you can still get supplemental insurance or pay out of pocket. Just like how you can choose to pull your kids out of public school and pay for private school while simultaneously paying taxes for the public school you're not using directly.

Quote from tbuccaneer : You're right. I'd rather abolish Medicare entirely.

I'm far more receptive to arguments about abolishing Medicare than arguments against "death panels."

Quote from Epiphyte : But, you can still get supplemental insurance or pay out of pocket. Just like how you can choose to pull your kids out of public school and pay for private school while simultaneously paying taxes for the public school you're not using directly. I'm far more receptive to arguments about abolishing Medicare than arguments against "death panels."

Yes, but you've already paid the taxes to Medicare, which is more akin to what goes on in public schooling. You're asking someone to pay the taxes, then also pay the tuition supplement, and then be forced to pay for private school. That seems a little unreasonable doesn't it? I see no reason why the elderly should be forced to sign up for Medicare if they don't want it, especially being that most of the funding comes from payroll taxes anyway.

Quote from Epiphyte : I'm far more receptive to arguments about abolishing Medicare than arguments against "death panels."

And for the record, I oppose the death panels arguments too. I just don't like the tying of Social Security with Medicare.

The article posted is good, but leaves out the whole picture.

"Market purists blame the existence of insurance: if patients and families paid the bills themselves, those expensive therapies would all come down in price. But they’re debating the wrong question. The failure of our system of medical care for people facing the end of their life runs much deeper. To see this, you have to get close enough to grapple with the way decisions about care are actually made."

The issue isn't that the therapies would come down in price, although they probably would somewhat. It's that most families wouldn't be willing to sell their houses and everything they own to prolong treatments that just have no realistic chance of working.

The problem is one of a disconnect between the people paying and those receiving. It's the same reason that parents of school age children want the world for their kids in terms of education spending. All non parents are forced to subsidize and indulge their excess fantasies.

Quote from tbuccaneer : Yes, but you've already paid the taxes to Medicare, which is more akin to what goes on in public schooling. You're asking someone to pay the taxes, then also pay the tuition supplement, and then be forced to pay for private school. That seems a little unreasonable doesn't it?

That's my point, that it's similar to public schools. You're not forced to pay for your kids to go to private schools. Just as you're not forced to pay for supplemental insurance to go along with Medicare.

I'm open to arguments that Medicare or public education are unreasonable. But, I think it's silly to expect Medicare to offer nearly limitless resources just because we're forced to pay for it. We don't have the same expectations for public schools and we're forced to pay for them too.

Edit: Many conservatives want to limit public school funding. Yet, many conservatives are against limiting Medicare spending. How come?

Quote from Epiphyte : That's my point, that it's similar to public schools. You're not forced to pay for your kids to go to private schools. Just as you're not forced to pay for supplemental insurance to go along with Medicare. I'm open to arguments that Medicare or public education are unreasonable. But, I think it's silly to expect Medicare to offer nearly limitless resources just because we're forced to pay for it. We don't have the same expectations for public schools and we're forced to pay for them too. Edit: Many conservatives want to limit public school funding. Yet, many conservatives are against limiting Medicare spending. How come?

You're not following what I'm saying. Medicare isn't free. Public school is, if you live in that community. Public schools are supported by tax money alone. Medicare is supported by payroll taxes AND the premiums the elderly must pay. If you want to go to private school, you still have to pay the taxes, but there is no tuition you must also pay for the public school that you won't use. Once you start to collect Social Security, you must also pay the Medicare premium, even if you do not desire to use it.

See what I'm saying now?

Quote from Epiphyte : That's my point, that it's similar to public schools. You're not forced to pay for your kids to go to private schools. Just as you're not forced to pay for supplemental insurance to go along with Medicare. I'm open to arguments that Medicare or public education are unreasonable. But, I think it's silly to expect Medicare to offer nearly limitless resources just because we're forced to pay for it. We don't have the same expectations for public schools and we're forced to pay for them too. Edit: Many conservatives want to limit public school funding. Yet, many conservatives are against limiting Medicare spending. How come?

As to why many conservatives are against cutting Medicare spending, it's probably that for many, they'd love to see the whole system crash and fail. I've teetered on that idea before, but ultimately, the joy I would get in watching the entire liberal regime come crashing down forever is outweighed by my desire to see a return to traditional America, without the violence and fiscal ruin.