“Soft despotism is a term coined by Alexis de Tocqueville describing the state into which a country overrun by "a network of small complicated rules" might degrade. Soft despotism is different from despotism (also called 'hard despotism') in the sense that it is not obvious to the people."

Wednesday, February 25, 2009

Got Hope Yet?

Obama Budget Would Create $634 Billion Health-Care Fund

By Ceci Connolly
Washington Post Staff Writer
Wednesday, February 25, 2009; 4:22 PM

President Obama intends to release a budget tomorrow that creates a 10-year, $634 billion "reserve fund" to partially pay for a vast expansion of the U.S. health care system, an overhaul that many experts project will cost as much as $1 trillion over the next decade.


  1. I have to laugh at the idiot party of Republicans. They just don't get it.

    When Obama ran in Illinois because the scum-bag Republican candidate had to drop out because he took his wife to sex clubs in France so that he could watch a stranger fuck her, the party of morons decided they had to fight black with black and they selected the truly certifiable Alan Keyes to run against the chosen one. That did not work out as planned.

    Last night the Regunantcans, using the same play book, sent another skinny dark guy into the ring with Obama. He managed to put everyone to sleep and this diminutive dark hope will never have a chance against Obama.

    Meanwhile Obama is introducing another trillion dollar program. What is this the second or third one this week?

    And what do we have between us and ruin? Nothing.

  2. 44 Senators, loyal and true ...

    A bridge to far for the GOP.

    Or the "Center-Right", where all the Republican pundits said the country was, right aftr the election.

  3. And what do we have between us and ruin? Nothing.

    Wed Feb 25, 06:16:00 PM EST


    That's the beauty of the plan.

    Obama fucks up so badly, the country comes crying back to the GOP.

    Rufus laid this all out. Where were you?

  4. Republican insiders are hedging their bets on the fate of Sen. Jim Bunning's 2010 re-election bid as the rift between Kentucky's junior senator and GOP leaders widens.


    In a telephone press conference with reporters on Tuesday, Bunning had just four words for naysayers:

    "I'm going to run."

    Concerns in GOP

  5. We can save a bunch of money by bumping the old folks off fast, by Ash's 'rationing medicine' scheme. 'Tis in the bill.

  6. Then if budget problems pop up, you just lower the age brackets, and pop off some more, until balance is restored.

  7. Obama fucks up so badly...

    Right, bob?

    Soon enough we're all gonna be sitting back in the big hot tub of schadenfreude. Sipping umbrella drinks.

  8. The Hidden Healthcare Horror
    By Lawrence A. Hunter

    Much of the criticism of the $787 billion stimulus bill is focused on its cost. But what's really at issue is a matter of life and death. Buried deep in the package, there is an expensive new healthcare program that could jeopardize the health, even the lives, of millions of patients.

    The bill funnels about $1 billion into government-run "comparative effectiveness research" (CER). Sounds innocuous enough -- that's a relatively paltry sum given the package's $800 billion-plus price tag. But CER will have profound effects on the availability of top-notch treatments in this country. Stripped of bureaucratic jargon, it is the precursor for a national healthcare rationing board.

    CER basically involves comparing different pharmaceutical drugs, medical devices, and other treatments in order to determine which is most cost-effective for fighting a particular disease. Theoretically, that sounds like a good program. But, in practice, CER will likely be used to justify rationing and restrict patient treatment options.

    That's been precisely the result of CER programs in other countries.

    Britain's comparative effectiveness agency, the National Institute for Health and Clinical Excellence (NICE), recently denied approval for the osteoporosis drug Protelos. NICE officials claimed that it was too pricey to be covered by the country's public insurance system. Never mind that research shows that Protelos's cheaper alternatives aren't effective for one out of every five osteoporosis patients. Countless Britons will now suffer from preventable bone fractures.

    Canada's government-run healthcare system is equally stingy about approving state-of-the-art medical treatments. One recent example: A 57-year-old man living in Alberta went in for treatment for an arthritic hip. A specialist recommended he receive a cutting-edge surgery known as "Birmingham" hip resurfacing. Public bureaucrats denied the man coverage for the procedure, claiming he was "too old" for it. Worse still, they forbade him from paying for the procedure himself on the private market.

    Virtually every government-run CER program ends up closing off patient access to the best treatments in the name of "cost consciousness." When bureaucrats are put in charge of medical care, cutting down on bills is prioritized over fighting disease.

    So it's imperative that this CER proposal be closely scrutinized and that, at the bare minimum, appropriate checks be put in place to insure the program doesn't compromise patient health. The deeper the government's involvement in the healthcare sector, the more life-or-death decisions are handed over to callous budget analysts instead of individual physicians and patients.

    It's important to note that CER wouldn't just determine the care options for patients covered under public health insurance. The program's determinations will affect everyone. The federal government is the single biggest buyer of pharmaceutical drugs in the country. If, based on CER findings, the government decides to stop covering a particular medicine, public programs will stop buying it from its manufacturer. But medical companies will have a hard time turning a profit on a particular treatment if the government isn't a customer, and many will be forced to simply stop producing it altogether.

    There are plenty of proposals included in the stimulus package that aren't actually tied to economic recovery. But CER is the only one that threatens the lives of countless Americans. It's too dangerous to be ignored.

    from 'The American Spectator'

  9. I didn't listen to any of it last night, but I hear Jindal didn't come over too well, and I'm sorry to hear it.

  10. It's all Jerri Ryan's Fault for being too good looking.

    "The woman that brought the United States of America to its knees"

  11. Are we skinny dippin'? Or do we have suits on?

  12. If it's all off, I'm in. As long as the book club wimmin are there too.

  13. Just to be clear: Trish doesn't really mean that soon enough we'll all be sitting back (naked or not) in the hot tub of schadenfreude, sipping umbrella drinks.

    My dad had the surge pretty well pegged when he said, months before, "Sometimes, just doing *something* is the most important thing."

    Or words to that effect.

  14. So he would support the stimulus then. Or should I say, stimuli.

  15. The book club girls? In a schadenfreude hot tub? Well, I guess we can dream about it....

  16. 4 BILLION for ACORN, Trish.
    20 MILLION New Democrat voters.
    We ain't seen nuthin yet, Trish.
    ...and Rufus ain't never been right yet!

  17. Top Obama Contributors

    Goldman Sachs $753,430
    University of California $629,086
    JPMorgan Chase & Co $501,819
    Harvard University $482,469
    Citigroup Inc $478,999
    University of Chicago $448,939
    UBS AG $432,045
    Google Inc $426,174

    Not a bad return for the Universities, when they get $60 BILLION More for Pell Grants, compulsory college ed, and etc.

  18. Whit,
    Did you see my link showing CA and Florida are largely responsible for the "Nationwide" Real estate crash?

    ...and California is still 50 percent HIGHER than 5 years ago!

  19. And what do we have between us and ruin? Nothing.

    It is in times like this that you want government coalition to fall apart and new coalitions to make themselves known. Instability and fluidity become a good thing.

  20. Bob,

    I don't know how it would work on a scale like that of the US, but the health care program in Israel seems to be managing pretty well considering the meager resources and extraordinary pressures put on it. Maybe someone ought to look into it.

  21. Sweep your home or office free of bugs with Techinical Surveillance Countermeasures--TSCM

    Get details on Coast To Coast tonite.

    You'll rest easy knowing you are not being filmed, photoed, or recorded in your own hot tub.

    A 'must' purchase for any modern American. Serves you well vis a vis the government, too.

  22. I'm in favor of more medical infrastructure and well educated docs, Mat. We need to start with that here. Don't know anything about Israel and medicine. My hunch is it's pretty good due to the nature of the society.

  23. North Korea prepares to Flip Off Obama and Hillary

    Say they are going to put up a satellite, South Koreans say it's a ballistic missile test.

    Probably lob it over Japan, to rub it in.

    Maybe it'll crash in Tokyo. What would O do then?

  24. Bobal,

    How can I get this through your thick friggin' skull?

    Health care is rationed, necessarily. The question is how do you ration it, not if you should. Currently, in the US, the rationing is done according to who has the money to pay for it. Is this the best method of rationing in you view? Take a look at the stats of the 'efficiency' of the US system - that is - how much do you get for your dollar. The general rule of thumb is that the bestest most cutting edge technology is available for those who have loads of bucks in the US but, on a per captia basis, the US pays far more than others. You can bellyache all you like about 'rationing' but you are simply acting like an ostrich and burying your head in the sand.

    your truly from Costa's up!! but it's dark...

  25. We're led by incompetents.

    And they're still better than most of the rest of the world.

  26. It's also about QUALITY, Ash, and timely availability, which is why Canucks that need those two attributes for their particular case, travel south.

  27. Yeah, Deuce is gonna like that, Sam!

  28. Luckily, there's only 1 Ash.

  29. yes Doug, those are definitely issues that need be confronted but it is a Canard to argue the either or of rationing or not. The Canadian health care system is not utopia delivered upon the earth. In Canada the main debate revolves around whether the rich should have access to a different level of care simply because they can pay for it. This is referred to as a "two tier system". The other main debate in Canada revolves around 'wait times' and how to keep them short.

    But to my point to Bobal - health care is rationed necessarily.

    p.s. Me and 2164th the same!!!! He'd be HORRIFIED to think someone could even entertain that notion (I think) though I'm flattered...

    I am currently in Costa Rica though. Cool place this!!

  30. Another health care issue in Canada (though health care is Provincially run but mandated federally) is whether the Gov. should pay to ship a person to the US for a procedure that isn't available in Canada (with the Gov. paying of course).

    Yet another issue rearing its ugly head here revolves around using drugs to fix something. Drugs are privately insured for the most part yet physical procedures are covered by the gov. New cancer treatments use expensive medication taken orally and not generally covered under the provincial health care plans. Kemo covered but pills not...

  31. You guys could do a post TOGETHER! a sacrificial service to the EB Patrons!

  32. Speaking of Costa Rica did you know that Costa Rica is the only democratic government here in Central America? Did you also know that of all the countries herein Central America Costa Rica is the only Country where the US has not intervened in its governance? Ironic that!!

  33. ...the US being the prime *cough cough* spreader of freedom and democracy in the world.

  34. 2164th wrote:

    "Meanwhile Obama is introducing another trillion dollar program. What is this the second or third one this week?

    And what do we have between us and ruin? Nothing"


    ...government, in America, seem to be the new religion...

  35. Regarding Peters below. Although I advocate it as the best of all currently available options - aside from perhaps outright exit - there are also major problems with a reduced presence and less ambitious strategy in Afghanistan. To the point where I doubt we could carry it out coherently, and wonder if it is also a pipe dream.

    A significantly reduced conventional presence would spend more time trying to protect itself and figuring out what was going on than would actually accomplishing anything. The bigger it is, the more you retain our current problems with logistics, and the need for regional support. The smaller it is, the higher the risks it could find itself overwhelmed by sheer geographical space, and perhaps find itself effectively undersiege like the British were toward the end of their stay in Basra. On the bright side, it is unlikely that anything battalion size or larger, with attendant air support, would be overrun. On the other hand, they probably aren't going to accomplish much to justify their continued presence.

    What's going to happen when we significantly reduce our presence? First, the national government and its institutions are probably going to fall apart. I could be wrong, but I can't see it holding on like the Communist government did. It's too fragile and dependent on our presence.

    It's more likely the country would devolve into a fluid and murky multi-faction civil war similar to that which occurred in the early 1990s. Intervening would involve real unconventional warfare - small teams working alongside indigenous factions with varying political goals on a week-to-week or month-to-month basis. You'd want it to be directed locally, not from Washington, with its short-term directives, many of which are based on political factors completely unrelated to the mission. Good luck with that.

    In theory, it'd be an environment for special operating forces, CIA paramilitaries, and similar assets. Army Special Forces, in particular, were supposedly established for this stuff. But they've never operated as far as I know in an environment as messy as this one could get. The closest was training the tribes in Laos, but that was a long time ago and relatively simple in comparison with Afghanistan.

    The best case I can think of would be the OSS and Special Operations Executive in the occupied Axis territories (i.e., Yugoslavia). But that was a long time ago in obviously a completely different political environment. I wonder how much a couple score small teams are actually going to be able to accomplish on the ground. There's also a sigificant chance of betrayal and the loss of various groups.

    Furthermore, general Afghan patience for Coalition forces is going to drop significantly once you get rid of the high-profile reconstruction projects, and general promise of a better future. We're much more likely, though I think we're already headed there, to reach the point where we're a national scapegoat hated by all parties, justly or unjustly, for aggravating ongoing violence. Once that happens our presence in the country is going to be completely untenable.

    Moreover, the smaller our presence, the less influence we're going to have on our "allies." In other words, it's going to be Afghan-style, carried out alongside sectarian/ethnic/tribal lines - bloody and indiscriminate.

    Is this country ready to see that on their newspapers everyday, knowing we're involved, and that there isn't going to be any happy ending for Afghanistan? Are they ready to watch us take sides in that fight? I doubt it. There's not going to be many feel good stories coming out of it. Sometimes we can get away with things in theaters that are under the radar, but this one won't be. Certainly you can forget about the international troops. These countries will barely take part in a feel-good reconstruction mission.

    And even that relies on the assumption that we can latch up with some identifiable factions that share enough of our goals to make it worthwhile. National politics in Afghanistan is going to be dead. You're going to have to pick out the guys who have real power on the regional and provincial levels, and who are not just Parliamentary figure heads. Then you have to factor in the fact that places like Afghanistan (see Lebanon in the 1970s) have an exaggerated tendency of chewing groups up and spitting out new ones like a sausage machine. Are we going to be able to keep up and still carry out constructive missions against Al Qaeda?

    Speaking of Al Qaeda, we're probably going to pull back from the South and East. Which is probably going to significantly reduce our own ability to gather intelligence on high-value Al Qaeda targets in Southern Afghanistan and Pakistan. Forget about whatever relationships we've forged down there. We're probably going to wind up working up North alongside the non-Pashtuns, which may aggravate relations with the country's majority, backed as it is by an even larger Pashtun population in Pakistan.


    It's too late, I'm going to bed. The bottom line is the entire thing's a fucking nightmare, even ignoring whatever problems come out of Pakistan. And that's why the nation-builders are probably going to win, for now. The nation-building strategy, pipe-dream that I think it will prove to be, at least provides policy-makers with an all-encompassing long-term solution to the problem. Everyone else is left advocating various flavors of crap. More realistic crap, but crap nonetheless.

  36. You people have led sheltered lives. You have no idea how bad health care is in the United States if you're poor. Or how much we, the tax-payers, and premium-payers pay for this substandard treatment for the "uninsured."

    Mitt Romney gave us the answer; but, we wouldn't take it. And we lost the House, the Senate, Veto-Power in the Senate, and the White House.

    We truly are "The Party of Stupid."

  37. And the Bush Drug Giveaway is great, until it, like EVERY other govt program, eventually hits the Ponzi Wall.

  38. I don't know, Doug. We can pay for a lot of generic Zocor for the cost of a triple bypass.

  39. You turkeys better figure it out. Women have the vote. Blacks have the vote. 18yr olds have the vote; and all those little Mexicans that the Republicans wanted to work as maids, and chicken-pluckers have the vote.

    You're going to have "Socialism." The only question is, "Will it be socialism With a Strong National Defense, or without?

    Stay Stupid, and keep losing elections. You'll just "Love" it.

  40. Small world this planet. There was a guy in an expat bar in Escazu that loved a political argument. Mostly I would not engage him when he threw the bait in my direction, but every once in a while... inspired by what I had to drink, we would engage in a smart sharp respectful debate.

    Lo and behold this same guy shpws up at the Belmont and I recognized him immediately. I think his name was James Kieland. He never made the connection in person.

  41. It ain't me. My name ain't "James."

  42. Steers, and Queers is named, "James."

    And, "Texicans."

    But, I'm startin to "repeat, myself."

    And, Hawaiians, I hear.

  43. Never heard of none from Ideho, though. Or, Mississip

  44. I did know a Mississippi girl one time that went to a college in Gulfport whose name was Jamie, a lovely lass with amazing blue eyes and copper hair and porcelain skin. Lost track of that angel when I left Biloxi on a troop train to Texas.

  45. She is probably sitting on a couch somewhere eating Cheeto's and asking herself what ever happened to that handsome young what's his name.

  46. Yeah, all them "fancy girls" had that "college in Gulfport" story.

  47. My wife taught in Gulfport for a year or so.

  48. Before I swept her off her feet and outta the east.