The Bloggacuda Returns: Sarah Palin and the Problem With "Common Sense"

The Bloggacuda is back with a new (ghostwritten?) op-ed in the Wall Street Journal that laments the prospect of healthcare reform proposed by "the Democrats." Palin's "new" essay offers more distortions and more hypocrisy.



Palin and the Problem of "Common Sense"

Palin describes the Democrats' proposals as resting on the notion that "increased government involvement" can fix the healthcare system. She then contests this view, arguing that:

Common sense tells us that the government's attempts to solve large problems more often create new ones. Common sense also tells us that a top-down, one-size-fits-all plan will not improve the workings of a nationwide health-care system that accounts for one-sixth of our economy. And common sense tells us to be skeptical when President Obama promises that the Democrats' proposals "will provide more stability and security to every American."

Adolph Reed, a Professor of Political Science at the University of Pennsylvania, once said during a lecture that "the problem with common sense is that people use it as an excuse not to read." Apparently, Palin falls into this category. If Palin had actually read the various proposals, she would not have seen a "one-size-fits-all plan." But Palin and other conservatives have consistently resorted to deception when discussing Democrat-sponsored proposals for healthcare reform.



Palin Seemingly Unaware of Insurance Company Bureaucrats

Palin also cannot resist mentioning her infamous death panel distortion, proudly stating that the argument resonated with many Americans. True -- but many of the same people fell for the bogus claim that Saddam Hussein had weapons of mass destruction. That lie cost thousands of lives and hundreds of billions of dollars.



Palin argues that Obama wants to create a nongovernmental bureaucracy to make decisions regarding life and death Medicare treatments. Apparently, the Bloggacuda lives in a parallel universe where insurance company bureaucrats do not already determine the treatments that companies will cover for plan participants. Instead, in Palin's world, doctors and patients make these decisions exclusively. Insurance companies simply pay the bill.



Palin's argument rests on a stunningly inaccurate understanding of the nation's healthcare system. Private bureaucrats already determine what treatments to cover, and doctors who desire reimbursement (i.e., all doctors) comply with those guidelines.



Also, Palin seems to criticize the nongovernmental nature of a proposed Medicare advisory panel, but this objection conflicts with her "more government is bad" narrative. In any event, the advisory group would only "advise" the federal government; any actual changes in Medicare coverage would require the approval of Congress.



Palin Blames Democrats for Expensive Policies That Bush Created

Palin also accuses Democrats of creating the very "waste and inefficiency" and "unwarranted subsidies" that Obama has pledged to cut from Medicare. Palin's argument, however, proves that the "common sense" crowd does not read.



When Obama proposed cutting wasteful subsidies to Medicare providers, he was referring to President Bush's implementation of the privately administered Medicare Advantage program, which costs 13% more than the traditional governmental plan. A Republican -- not a Democrat -- introduced the Medicare subsidies that Obama has promised to cut.



Here's an even more stunning fact: Senator John McCain -- the leader of the McCain/Palin ticket -- also proposed reversing Bush and cutting these subsidies in order to reign in the expense of the program. During the presidential campaign, this proposal had wide bipartisan support. Palin's flawed analysis suggests that she did not pay attention to or did not understand the very issues she faced as a candidate for Vice President.



Palin's Shameful Cherry-Picking of Congressional Budget Office Reports

Palin continues to engage in blatant cherry-picking of data to support her claims. She cites a CBO study that shows the House proposal would add over $200 billion to the deficit over 10 years (but it would also insure 47 million more people). But as the Liberal Values Blog thoroughly details, Palin ignores a CBO study which concludes that tort reform -- something she has embraced as an essential component of healthcare reform -- will not reduce medical costs.



Palin's Contradictory Embrace of "Big Guv'ment"

Finally, while Palin's op-ed decries "big guv'ment," the Bloggacuda wants to expand the reach of the national government. Palin advocates tort reform, which, as I have previously argued, would add a new layer of federal control over the judicial systems in 50 states, constrain jury decisions, and limit the ability of private litigants to seek justice as they deem appropriate.



Palin also favors "giving all individuals the same tax benefits received by those who get coverage through their employers," but the favorable treatment of employer health plans already represents the largest tax expenditure. Palin's proposal would cause an even greater revenue loss and increase the deficit.



Palin also supports replacing Medicare with vouchers, a plan proposed by the conservative Cato Institute. Without the government or other centralized entity to negotiate cheaper costs, the price of health insurance for seniors would likely soar, causing them to exert their political power and demand annual voucher increases. The spending implications are tremendous. On the other hand, a refusal to support higher vouchers would sound a lot like the "rationing" of care, disguised as individual decisionmaking.



Palin's op-ed offers a more thoughtful approach than her previous commentary, but it does not provide any viable solutions to the problems that plague the nation's medical services markets.

Vast Rightwing Conspiracy Theorists

Vast rightwing conspiracy theorists have taken over political discourse, and the results are absolutely disturbing. Rather than focusing on substantive matters, policymakers and analysts have expended precious time debunking the latest round of projectile vomiting over some imagined attempt by Obama/Pelosi/Democrats/Liberals/Communists/Socialists/Nazis to end life as "we" know it.

During the earliest part of Obama's presidency, Republicans lacked a coherent voice. They have found this voice, however, by organizing around rightwing conspiracy theories. Consequently, they have created some unity and garnered attention from the public. But they have accomplished these goals by embracing some of the most outlandish and deceitful "theories."

Here are just a few shameful items promoted by vast rightwing conspiracy theorists.

1. Obama is not a "natural-born citizen." The "birthers" are the only group of conspiracy theorists who can compete with the "truthers" (Bush knew about 9/11 before it occurred) in terms of utter creepiness. The birthers inexplicably and stubbornly believe that Obama is not a natural born citizen of the United States and that he does not meet the constitutional requirements for President of the United States.

The birthers' belief is immune to facts but highly accommodating of blatant lies and inaccuracies. For example, birthers recently experienced a collective orgasm after they received "smoking-gun evidence" that Obama was born in Kenya -- rather than the United States. There was a terrible problem with the evidence, however: It was a web-doctored Australian birth certificate created and sent to birthers by a conniving liberal blogger. Despite numerous letdowns and no proof, the birthers continue to spread their conspiracy theory and to search for new believers. They have also managed to garner support and sympathy from Republican politicians.

2. Obama = Socialist. During the presidential campaign, the McCain team floated the notion that Obama is a socialist. Rightwingers jumped on board, perhaps because nothing else was helping to improve McCain's campaign numbers. Since the election, this conspiracy theory has reemerged with great force.

Unfortunately, the socialism conspiracy theorists are just as bankrupt as the birthers. First, the group fails to offer a coherent definition of socialism. As with many economic theories, including capitalism, socialists embrace varying policy positions. Typically, however, socialism involves the advocacy of government and worker ownership of the means of production and centralized planning of output. Rather than proving that Obama is a socialist, current White House policies place Obama strongly within the capitalism camp.

Karl Marx would probably roll his eyes in his grave if he knew that socialism involved dumping a trillion dollars into the United States banking system in order to save global capitalism. In addition, if the banking or automobile bailout makes Obama a socialist, then Bush is a socialist as well because he proposed and lobbied for the passage of TARP and interpreted it as covering auto manufacturers.

Furthermore, if the creation of a public health plan to cover a specific slice of the population that lacks insurance qualifies Obama as a socialist, then he is simply carrying out the socialist policies of his predecessors. Medicare, Medicaid, the Veterans Administration and SCHIP are all public health plans for specific slices of the population. Moreover, because states co-administer Medicare, Medicaid, and SCHIP, then all 50 states are socialist economies as well. Also, because the GOP has been promising seniors that it will protect Medicare and the VA, then the GOP apparently supports socialism as well.

3. Death Panels. This idea has received a lot of respect from conservatives. The Bloggacuda Sarah Palin initiated this troubling discourse by attacking a provision in the House legislation that authorizes governmental reimbursement of end of life counseling for certain classes of people who hold public-sponsored health plans. The provision, however, only authorizes coverage; it does not mandate the counseling.

Medical groups -- including the American Medical Association -- endorse this type of counseling. Medical providers actually lobbied for the provision. Equating "coverage" of counseling with "mandatory" counseling is irrational and deceptive. Insurance policies list coverage of many procedures. Applying the logic of the death panel theorists, an insurance policy that covered abortion services would actually mandate abortion. But if the same policy covered childbirth services too, it would mandate childbirth and abortion for the same pregnancy! Perverse logic inevitably leads to perverse outcomes.

4. Government Is Taking Over Medicare. Conservatives have exploited Obama's proposed cuts in Medicare costs to scare some seniors into believing that the Democrats want to cut Medicare itself. This argument often gets collapsed into a general assertion that Obama wants to take over Medicare and make decisions on behalf of doctors and patients.

Ironically, this is one conspiracy theory that has some truth to it. The government does have its hands on Medicare. But there is a good explanation: Medicare is a government-run health plan! Despite spewing against the perils of "socialized medicine," Republicans have tried to portray themselves as the guardians of Medicare beneficiaries. These individuals, however, are covered by a public health plan -- which Republicans describe as socialism.

The Medicare conspiracy theories have led to some perverse results. For example, some angry conservative seniors have criticized "public plans," while benefiting from Medicare (the nation's largest public plan). Recently, a senior was violently injured (finger bitten off) while protesting healthcare reform. Although conservatives promoted the story as an example of the evils of socialized medicine/Obamacare, the injured man went to a hospital and received treatment. Ironically, the injured man was insured by Medicare, even though he came out to protest the creation of a public plan.

Furthermore, a recent poll shows that 62% of Republicans believe that the government should "stay out of Medicare," which is factually impossible. Facts and logic, however, are irrelevant to vast rightwing conspiracy theorists. To be fair, however, nutty leftwing conspiracy theorists do not prioritize facts either.

Final Take
This blog used to publish far more essays defending Republicans and criticizing liberals. But now that the Republicans have decided to embrace the partially successful -- yet intellectually bankrupt -- strategy of promoting rightwing conspiracy theories, I have had very little to offer in defense of Republicans. I suspect that if the public continues to shine light on these conspiracy theories and the media decides to tackle matters other than political strife, then the strategy will backfire. So long as these deceitful and factless theories define contemporary conservative discourse, serious analysts will not take conservatives seriously.

NYT: More Obama, Less Ambition in Healthcare Reform

More Obama
The New York Times reports that President Obama will become much more involved in healthcare debates. For most of August Obama was mysteriously silent while conservatives offered a bucket of lies and distortions regarding various Democratic reform proposals.

According to the NYT article, Obama will deliver a speech to Congress outlining his agenda next Wednesday evening. He will also travel to Ohio to address a Labor Day event organized by the AFL-CIO, which is a strong supporter of Obama and healthcare reform.

Less Ambition?
Although President Obama will become more visible, the NYT reports that he will indicate that Congressional Democrats could slice some controversial elements from their proposals, including the intentionally distorted provision that provides coverage for "end-of-life" counseling between medical providers and patients.

Many medical professional groups, including the American Medical Association, strongly endorse end-of-life counseling and believe that the current level of such counseling is inadequate. Providing coverage could incentivize medical providers to help their patients make important decisions while they are competent to do so -- not when they are incapacitated and unable to do so.

Throwing out the beneficial provision because Neanderthals have distorted it is a terrible reminder of the country's acute fear of honesty. The same nutjobs who think that informing patients about living wills and medical directives constitutes a death panel also believed that Saddam Hussein was running across the globe looking for Uranium to add to his nonexistent arsenal of WMDs. These same people sacrificed the lives of thousands of Americans to uphold a lie. So, it is easy to see why they would sacrifice good medical decisions to support another lie.

Although Obama is willing to toss out these innocuous provisions, the NYT article reports that "for now" he remains committed to universal coverage and to a public plan. CNN, however, reports that Obama is talking with moderate Senator Olympia Snow regarding a compromise position that would drop the public plan. Stay tuned.

The Deceit and Hypocrisy of Minister Mike Huckabee

Mike Huckabee -- Baptist minister and politician -- has some repenting to do. Huckabee joined a chorus of conservatives who warned Democrats not to politicize Kennedy's death during debates over healthcare reform. Apparently, unmoved by his own words, Huckabee then hypocritically suggested that under "Obamacare," Kennedy would have been urged to take his life:

Proponents deny that this bill will devalue older people’s lives or encourage them to except less care to save money. But it was President Obama himself who suggested that seniors who don't have as long to live might want to consider just taking a pain pill instead of getting an expensive operation to cure them. Yet when Sen. Kennedy was diagnosed with terminal brain cancer at 77, did he give up on life and go home to take pain pills and die? Of course not. He freely did what most of us would do. He choose an expensive operation and painful follow up treatments. He saw his work as vitally important and so he fought for every minute he could stay on this earth doing it. He would be a very fortunate man if his heroic last few months were what future generations remember him most for.

Huckabee is not alone in his hypocrisy.

Huckabee's comments are also deceitful. Patients have a constitutional right to refuse life-sustaining medical treatment (even conservative Supreme Court justices agree with this). Medical professionals already provide this information to their patients, but organizations like the American Medical Association have concluded that they should do so with even greater frequency.

When people refuse life-sustaining measures, medical professionals often give them palliative treatment to ease their pain and discomfort. I do not know what happened to Kennedy during his last months or days, but it is probably safe to assume he was given prescription painkillers following surgery and probably during the last days of his life. It is also likely that Kennedy's doctors told him at some point prior to his death that they could not do anything else to treat his cancer. It is also possible that they told him last year that surgery would only momentarily delay the inevitable consequences of the cancer.

The proposed healthcare reform would facilitate these types of healthy conversations between patients and medical providers, and President Obama has never stated anything to the contrary. The pending measure would not devalue seniors or urge them to end their lives, as Huckabee's comments suggest. The minister is simply exploiting the public's discomfort with issues related to death and dying for political purposes.

Huckabee, Death Panels and Rationing of Care
Finally, I find it appalling that Huckabee states that "most of us" would have elected the expensive surgery that Kennedy chose to undergo once he discovered he had cancer. It is abundantly clear that most people without health insurance would not have chosen the path that Kennedy followed. They would not have been able to pay for it.

Moreover, it is not even clear that most people with health insurance would have pursued this treatment option, given the stage and type of cancer Kennedy had. This is exactly why it is important for people to receive counseling concerning their medical options. Huckabee does not know how most Americans would have responded to the information that Kennedy's physicians gave him.

Kennedy strongly supported liberal healthcare reform. Although Huckabee discusses Kennedy's "heroic last few months," his distortion of the pending legislation undermines Kennedy's legacy. If conservatives block universal coverage, millions of Americans will continue to live without health insurance. When these uninsured individuals become severely ill, they will not have the ability to demonstrate their "heroic" drive to live. Medical care in the United States will remain drastically different for the "haves" and "have nots" (have = insured). If conservatives truly want to condemn people who support "death panels" and "rationing" of care, they need to look in the mirror.

I'll Take the "Wise Latina" Over Two "Death Panelists"

People who opposed the appointment of Sonia Sotomayor to the Supreme Court often cited her discussion of race, gender and judging. Although Sotmayor's analysis of this issue was tentative and layered, critics assailed her for suggesting that a "Wise Latina" would analyze issues better than other judges.

After less than one week on the bench, I definitely prefer the Wise Latina to Justice Antonin Scalia and Justice Thomas, who are clearly vying for positions on the imaginary "Death Panels" that the Obama administration is supposedly creating. In two recent death penalty cases, Scalia and Thomas voted against the inmates and in favor of execution. Sotomayor only voted in one case -- joining the liberal dissenters and voting for a stay of execution. The Supreme Court split in the cases, with a majority voting for the inmate in one case and against the inmate in the other.

The Troy Davis Case
The Justices gave more analysis in the Troy Davis appeal. In the Davis case, the Court ordered the trial judge to give Davis -- a Georgia black man convicted of killing a police officer -- the opportunity to present newly discovered evidence that was unavailable at the time of his trial. Davis argues that this evidence would prove his innocence.

Since the time Davis was convicted, most of the lead prosecution witnesses, including several individuals who identified Davis as the shooter, have recanted. Several of them assert that another prosecution witness, who was at the scene of the crime and who identified Davis as the killer, was in fact the shooter.

The Davis case has attracted the attention of many powerful individuals, including Jimmy Carter, Pope Benedict XVI, and former prosecutors and judges -- who believe Davis should have the opportunity to present newly discovered evidence that establishes his innocence.

We Do Not Care If You Are Actually Innocent: You Must Die
Justice Scalia and Thomas disagree with Davis and his supporters. Scalia's characteristically passionate dissent in the case makes him look like a bloodthirsty reaper. Scalia's dissent (in which Thomas joins) contends that even if Davis could establish his "actual innocence," this would not create a basis for a federal court to prevent his execution.

Scalia contends that federal statutory law would preclude any relief for Davis, even if he established his innocence. Accordingly, he concludes that ordering the district court to conduct an evidentiary hearing is foolish.

But as Justice Stevens argues, the statute cannot trump a constitutional violation. I suspect that several of the justices believe that knowingly executing a person who has sufficiently established his innocence would violate the constitution.

This Is Not Scalia's First Execution-Hungry Statement
This is not the first time that Scalia has expressed callousness towards a person facing execution. In McCleskey v Kemp, another Georgia case involving a black man convicted of killing a police officer, Scalia sided with the majority, which held that McCleskey failed to show that race impacted his own sentence. A study of the Georgia death penalty, however, made a strong case that race impacted the general application of capital punishment in Georgia (see prior blog posts here, here, and here).

Although the majority held that McCleskey failed to show racial discrimination in his particular case, during the Court's deliberation, Scalia sent a memorandum to the other justices that contained a shocking argument. Scalia conceded that juries and prosecutors make decisions based on race and that he did not need any more "proof" in McCleskey's case.

Scalia, however, argued that racism among jurors and prosecutors was "ineradicable." In other words, Scalia described racism as a natural part of the criminal justice system that courts could not end -- or, presumably, even remedy. Although I agree that racism is a serious problem in the criminal justice system, I also believe that courts have a constitutional obligation to remedy it.

PS: I never heard any conservatives reconcile their support of Scalia with their dislike of Sotomayor due to her vote against the Ricci plaintiffs. Voting against a party seeking a promotion is one thing; voting to send someone to the death chamber -- while conceding that race mattered -- epitomizes injustice.

Update: In the original post, I inadvertantly omitted a link to Scalia's dissent. I have updated the post to provide a link to the opinion -- which you can read here: Scalia's Dissent in Davis.

Medical Experts Respond to "Death Panel" Deception

For the last two weeks, Sarah Palin has been acting like a creepy version of Dr. Quinn Medicine Woman, with her creepier sidekick Senator Charles Grassley. The two have repeatedly stated that the proposed healthcare legislation would create "death panels" to decide whether patients could live or die.

Many commentators have debunked the horrible distortion (see, e.g., here) and have exposed the hypocrisy of Palin and Grassley on this issue. Nevertheless, the fearless and factless duo continue their assault on the truth.

Palin -- obviously believing that adding footnotes to a lie transforms it into the truth -- released yet another Facebook statement on the perils of liberal death squads. And Grassley invoked the image of the government pulling "the plug on grandma" in order to scare constituents into believing his deceit.

Two Medical Experts Rebut Palin and Grassley
CNN has published a very thoughtful essay written by two medical experts who, based on their area of expertise, probably have a lot of experience with patients who could benefit from end-of-life counseling. Douglas W. Blayney, MD and Brenda Nevidjon, RN have authored an op-ed for CNN that rebuts conservative distortion of the legislation and that explains why the provision would advance patient care.

Blayney "is president of the American Society of Clinical Oncology and professor of internal medicine at the University of Michigan. He specializes in the treatment of breast cancer and lymphoma and was in private practice for 17 years in California." Nevidjon "is president of the Oncology Nursing Society and clinical professor of nursing at Duke University School of Nursing. She was the first nurse and first woman to be chief operating officer of Duke University Hospital."

Responding to the Deception
Blayney and Nevidjon argue that the conservative depiction of the provision is "completely false":

This provision simply provides for Medicare to pay for voluntary conversations between patients and their health care practitioners on the difficult but important subject of planning for care at the end of life.

The provision is purely optional, and patients would be able to choose whether to discuss the issue with their practitioners. For those who decide to do so, there would be clear benefits.

Medical Benefits of End-of-Life Counseling
Blayney and Nevidjon also discuss the medical benefits of having advanced end-of-life counseling -- something critics of the healthcare proposal universally ignore. This type of counseling, as the American Medical Association has concluded (see AMA policy E225), can ensure that end-of-life treatment will reflect the patient's intent:

We discuss end-of-life care with patients to fulfill our commitment to them throughout the course of their care. When a disease cannot be cured, we can assure our patients that we can make them comfortable in their last days. When these conversations are done in advance and done well, everyone benefits -- patients, families and all members of our care teams.

As practitioners, we know from experience that discussions with patients in the end stages of their cancers and with their family members may be long and emotional, but ultimately lead to end-of-life care centered on the patient's wishes. We have seen many patients who were well-cared-for by their families, with professional help, and were comfortable in their surroundings.

Rebutting Palin and Grassley's lies has wasted precious time and energy. There are many aspects of the proposed legislation that warrant debate. Palin and Grassley have disserved the public with their intentional distortion of the proposed healthcare legislation.

Ditto. . . .

Here's the latest on death panels, courtesy of Time Magazine:

Remember the 2003 Medicare prescription drug bill, the one that passed with the votes of 204 GOP House members and 42 GOP Senators? Anyone want to guess what it provided funding for? Did you say counseling for end-of-life issues and care? Ding ding ding!!

Let's go to the bill text, shall we? "The covered services are: evaluating the beneficiary's need for pain and symptom management, including the individual's need for hospice care; counseling the beneficiary with respect to end-of-life issues and care options, and advising the beneficiary regarding advanced care planning." The only difference between the 2003 provision and the infamous Section 1233 that threatens the very future and moral sanctity of the Republic is that the first applied only to terminally ill patients.

Oh, and guess who voted "yea": Senator Grassley!

PS: "Ditto" simply means, more hypocrisy. . . .

For earlier articles on death-panel hypocrisy, see:

Sarah Palin Sponsored "Euthanasia Day" as Alaska Governor

Dumb and Dumber on Death and Dying

Today's Shameless Hypocrite Award Winner: Senator Charles Grassley

Sarah Palin Sponsored "Euthanasia Day" as Alaska Governor

Sarah Palin sponsored "Euthanasia Day" as Alaska governor. Well, actually, it was called "Healthcare Decisions Day." The day was specially recognized to encourage Alaska residents to get information about end-of-life issues. Yes, hypocrisy prevails -- with even greater force than I initially believed. Think Progress has the messy details, but I visited the Alaska government website to get the full breadth of Palin's rancid hypocrisy:

WHEREAS, Healthcare Decisions Day is designed to raise public awareness of the need to plan ahead for healthcare decisions, related to end of life care and medical decision-making whenever patients are unable to speak for themselves and to encourage the specific use of advance directives to communicate these important healthcare decisions. [...]

WHEREAS, one of the principal goals of Healthcare Decisions Day is to encourage hospitals, nursing homes, assisted living facilities, continuing care retirement communities, and hospices to participate in a statewide effort to provide clear and consistent information to the public about advance directives, as well as to encourage medical professionals and lawyers to volunteer their time and efforts to improve public knowledge and increase the number of Alaska’s citizens with advance directives.

WHEREAS, the Foundation for End of Life Care in Juneau, Alaska, and other organizations throughout the United States have endorsed this event and are committed to educating the public about the importance of discussing healthcare choices and executing advance directives.

WHEREAS, as a result of April 16, 2008, being recognized as Healthcare Decisions Day in Alaska, more citizens will have conversations about their healthcare decisions; more citizens will execute advance directives to make their wishes known; and fewer families and healthcare providers will have to struggle with making difficult healthcare decisions in the absence of guidance from the patient.

So, it was fine for the State of Alaska to encourage its residents and medical professionals to talk about end-of-life issues and to prepare medical directives and living wills. But, as an annoying rabble-rouser seeking to prevent honest debate about healthcare reform, this same policy amounts to a "death panel." Good one, Sarah. Real cute.

On the utter hypocrisy of Palin and Grassley regarding this issue, see: Dumb and Dumber on Death and Dying.