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How are you paying for all the no-cost stuff again?

Barack Obama: "Reducing the waste and inefficiency in Medicare and Medicaid will pay for most of this plan."
Arnold Kling: "And if we don't pass this plan, does he intend to keep the waste and inefficiency, out of spite?"

This little exchange illustrates a couple of problems with Obama's logic. First, notice the false dichotomy implied by Obama and exposed by Kling's comment. It's implied that the savings and the plan must go together, when nothing actually requires them to. Second, notice the implication his plan costs money, even though he elsewhere claims it doesn't.

It's not a sacrifice or a trade-off if it's something you wouldn't want to do anyway. "I'm going to give up paying someone to poke me in the eye so that I can afford to eat out for lunch" just doesn't have the same compelling sense of sacrifice as "I'm not off buying new shoes so that I can afford to eat out for lunch".

Obama's comment also nicely illustrates how progressives can get away with things that the media will never call them on, when their opponents would be instantly demonized. If a Republican president or congressman had suggested that we should reduce "the waste and inefficiency in Medicare and Medicaid", most of the press would be reporting this under a headline like, "Obama advocates budget cuts to programs that provide health care to millions of poor and elderly!"

See this Washington Post Story as an example. You'd have quotes in news articles like the actual news quote "... proposed cuts to Medicare would hurt older and disabled Americans and take a wrecking ball to many essential hospitals across the country". That was for a proposal to slow the rate of growth from 7% to 5% by eliminating waste, not even an actual cut.

What you won't hear Obama nor the Democrats talk about is what their plan will cost you in insurance premium increases. Most of the "reforms" in their "exchange" plan have already been implemented in several states. They've driven premiums up in those states. The government cost analysis of the bill won't reflect those costs, since you pay that directly, not indirectly to support the federal budget.

Pull the plug on "Your Life, Your choices"

Jim Towey, founder of Aging with Dignity, brings up an interesting point in the Wall Street Journal. Health care reform advocates like to point to the VA as an example of an existing system similar to the proposed public option, but the VA has their own version of the "Death Panels" idea, a planning document called "Your Life, Your Choices".

Apparently the VA has found it necessary to do a little subtle cost controlling by influencing veterans towards a "life is not worth living" and "don't be a burden" mentality.

Read it for yourself on the VA's web site.

A large portion of the document consists of describing various horrible health situations in detail, then asking the veteran if in that situation, would life be difficult, just barely worth living, or not worth living. After that cheery thought, they list possible treatments and are asked to check a box if they'd rather die naturally or receive each treatment. The only treatment that is pre-checked for all the questions is "Comfort care', meaning painkillers and cleanings.

That isn't the only way to present this information and get people thinking about their options and wishes. Compare "Five Wishes". It's shorter, more focused, and much more positive.

So why has the VA chosen to use one over the other? After all, under the Bush administration the VA stopped using "Your Life, Your Choices" because of some of these very issues. The Obama administration started using it again.

It would be interesting to hear the discussion that led to that decision. Did it include a discussion of steering veterans away from expensive life-preserving treatments in favor of a "natural death" and how much money the VA could save as a result?

We don't need government health care providers trying to convince veterans that life may not be worth living.

We certainly don't need new government health care providers.

What we need is more freedom for individuals to contract for their own care and options. The progressives need to stop using regulations to stop people who want to do something different than the "experts" have decided is best for them. That's one of the problems with political solutions to economic problems. One size must fit all.

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