Author Archives: Rob Harrison

Health care hypocrisy

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One of the key facts about the push to nationalize our healthcare system is that it’s coming from people who have absolutely no intention to live under the system they’re trying to produce. Barack Obama even admitted as much last month, though the media has done its best to ignore the fact. Give Jake Tapper and Karen Travers credit, though, for refusing to sweep the president’s admission under the rug:

President Obama struggled to explain today whether his health care reform proposals would force normal Americans to make sacrifices that wealthier, more powerful people—like the president himself—wouldn’t face. . . .

Dr. Orrin Devinsky, a neurologist and researcher at the New York University Langone Medical Center, said that elites often propose health care solutions that limit options for the general public, secure in the knowledge that if they or their loves ones get sick, they will be able to afford the best care available, even if it’s not provided by insurance.

Devinsky asked the president pointedly if he would be willing to promise that he wouldn’t seek such extraordinary help for his wife or daughters if they became sick and the public plan he’s proposing limited the tests or treatment they can get.

The president refused to make such a pledge, though he allowed that if “it’s my family member, if it’s my wife, if it’s my children, if it’s my grandmother, I always want them to get the very best care.”

That’s telling. Would the president be willing to accept limitations on the care his wife and children could receive for the sake of the greater good? Dr. Devinsky asked. No, the president would not. He evaded the question for as long as he could with a non sequitur about his dying grandmother, but when he finally came back around to answering it briefly, that was his answer: no.

And after all, he won’t have to accept the limitations of his plan—he’s the President of the United States. He’s famous, he’s powerful, he defines well-connected . . . and he’s a member of a government which routinely exempts its own members from the limitations of the laws it passes. Obamacare for thee, but not for me and mine, is indeed his attitude—he’s too important and valuable a person for that. That’s only for us ordinary barbarians.

For my part, I agree with Ed Morrissey:

If ObamaCare isn’t good enough for Sasha, Malia, or Michelle, then it’s not good enough for America. Instead of fighting that impulse, Obama should be working to boost the private sector to encourage more care providers, less red tape and expense, and better care for everyone.

But that’s not what he’s doing, and it’s not what he’s going to do; that’s how he wants it to work for him and his family, but not for everyone else. Unless, of course, they’re political allies whose support he needs and to whom he owes favors—then they can get special treatment too:

Who will decide when medical care is just too expensive to bother with? Who will be left to perish because they just aren’t worth the lifesaving effort? Well, for sure it won’t be any members of Congress or anyone that works for the federal government because they won’t be expected to suffer under the nationally socialized plan. It also won’t be Obama’s buddies in the unions who are about to be similarly exempted from the national plan, at least if Senator Max Baucus has his way.

Insisting on standards for others to which one is unwilling to hold oneself? The word for that, I believe, is “hypocrisy”—and the forces of Obamacare are rife and rank with it. As James Lewis pointed out recently on the American Thinker website, one of our leading advocates of socialized medicine makes a pretty good poster boy for it.

Senator Ted Kennedy, who is now 76 years old and was diagnosed with brain cancer in May of last year, is telling the world that nationalized medical care is “the cause of his life.” He wants to see it pass as soon as possible, before he departs this vale of tears.

The prospect of Kennedy’s passing is viewed by the liberal press with anticipatory tears and mourning. But they are not asking the proper question by their own lights: That question—which will be asked for you and me when we reach his age and state in life—is this:

Is Senator Kennedy’s life valuable enough to dedicate millions of dollars to extending it another month, another day, another year?

Because Barack Obama and Ted Kennedy agree with each other that they of all people are entitled to make that decision. Your decision to live or die will now be in their hands.

Ted Kennedy is now 76. Average life expectancy in the United States is 78.06. For a man who has already reached 76, life expectancy is somewhat longer than average (since people who die younger lower the national average); for a wealthy white man it may be somewhat longer statistically; but for a man with diagnosed brain cancer it is correspondingly less. As far as the actuarial tables of the Nanny State are concerned, Kennedy is due to leave this life some time soon. The socialist State is not sentimental, at least when it comes to the lives of ordinary people like you and me.

The socialist question—and yes, it is being asked very openly in socialist countries all around the world, like Britain and Sweden—must be whether extending Senator Kennedy’s life by another day, another month or year issocially valuable enough to pay for what is no doubt a gigantic and growing medical bill. Kennedy is a US Senator, and all that money has been coughed up without complaint by the US taxpayer. Kennedy is already entitled to Federal health care, and it is no doubt the best available to anyone in the world. . . .

There might be a rational debate over the social utility of Senator Kennedy’s life. We could all have a great national debate about it. Maybe we should do exactly that, to face the consequences of what the Left sees as so humane, so obviously benevolent, and so enlightened.

Consider what happens in the Netherlands to elderly people. The Netherlands legalized “assisted suicide” in 2002, no doubt in part for compassionate reasons. But also to save money. . . .

There’s only so much money available. The Netherlands radio service had a quiz show at one time, designed to “raise public awareness” about precisely that question. Who deserves to live, and who to die?

But nobody debates any more about who has the power to make that decision. In socialist Europe the State does. It’s a done deal. . . .

In the socialist Netherlands Kennedy would be a perfect candidate for passive euthanasia.

Has anyone raised this question with Senator Kennedy? I know it seems to be in bad taste to even mention it. But if ObamaCare passes in the coming weeks, you can be sure that that question will be raised for you and me, and our loved ones. And no, we will not have a choice.

One set of standards for the rich and the powerful, and another for the rest of us. One set of medical options for those who write the laws (and those who influence them), and another for those of us who live under them. That’s liberalism? It seems to me there’s something seriously wrong with that.

Which is why, to my way of thinking, Rep. John Fleming (R-LA) is a hero of the fight over Obamacare. Rep. Fleming, a physician, is the author and sponsor of House Resolution 615, which he describes this way:

I’ve offered a bill, HR 615, to give them a chance to put their “health” where their mouth is: My resolution urges members of Congress who vote for this legislation to lead by example and enroll themselves in the public plan that their bill would create.

The current draft of the Democratic bill curiously exempts members of Congress from the government-run health care option: The people’s representatives would get to keep their existing health plans and services on Capitol Hill—even though the people wouldn’t.

If members of Congress believe so strongly that government-run health care is the best solution for hardworking American families, I think it only fitting that Americans see them lead the way. . . .

Congress has the bad habit of exempting itself from the problems it inflicts on the American people. From common workplace protections to transparency and accountability measures, lawmakers always seem to place themselves and their staffs just out of reach of the laws they create.

Americans don’t know that there is an attending physician on call exclusively for members of Congress, or that Congress enjoys VIP access and admission to Walter Reed Army Medical Center and Bethesda Naval Medical Center.

It is past time that we make the men and women making the laws be exposed to the same consequences as the American public.

Public servants should always be accountable and responsible for what they are advocating, and I challenge the American people to demand this from their representatives.

We deserve health-care reform that puts a patient’s well being in the hands of a doctor, not a bureaucrat.

I think he’s right on. If it’s good enough for us, it’s good enough for the members of Congress, the employees of the Executive Branch (all the way up to the POTUS and his family), and the judges and staff of our courts. If you agree, you might want to go to Rep. Fleming’s official website and sign the online petition in support of HR 615. Well done, Rep. Fleming; trust a doctor to know a boil when he sees it, and know how to lance it—even a spiritual one.

Further thoughts on the health care deform bill

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As I noted in the previous post, there’s been a real lack of active leadership from the president on the whole issue of health care “reform,” which has been quite frustrating to his party. Unfortunately, instead of that, we’re getting more of his patented harangues. This is a bad thing because for all the praise he receives as an orator, Barack Obama is a remarkably lazy and juvenile rhetor; he has a terrible weakness for cheap rhetorical tricks, tending to lean on them heavily whenever he needs to make his case. One he particularly likes is to set up false, simple-minded dichotomies, which he can then use to either a) paint himself as offering a more enlightened third way forward, or b) portray his own position as obviously correct and that of those of us who disagree with him as obviously wrong.

As David Freddoso pointed out, that’s exactly what he did yet again in his prime-time press conference last week:

With his example of the red and blue pills, and another about whether a child’s hypothetical tonsils should be removed, President Obama unwittingly presents the real problem with his plan for reform. Here is a well-meaning government official who so fails to grasp the problem in health care that he can present such absurd oversimplifications and suggest that this sort of thing is the real problem—doctors simply lack the common sense to make obvious medical decisions. President Obama wants us to solve this problem by putting himself and other government officials in charge of rescuing medicine from the medical profession. If medical doctors with a decade of schooling cannot distinguish between good cures and ineffective ones that must be discontinued, then by gosh, we’re lucky that the good folks from the government can.

President Obama thus frames the issue as a false choice between doing nothing at all and handing over to Washington complicated, case-by-case medical decisions that cannot possibly be legislated or dictated by government.

Freddoso’s wrong about one thing: “complicated, case-by-case medical decisions” can in fact be “legislated or dictated by government”—in one way, which he mentions:

There is exactly one thing that government can do to control costs in health care: it can insist on paying below cost.

Granted, he’s thinking here of government short-changing insurance companies and medical providers, which is a significant problem in our current system:

This shifts the cost burden to private insurance companies, which in turn pass along higher premiums to their patients. This is what government-run Medicare does today for many treatments, including cancer. Government will do more of this kind of “saving” when it assumes greater responsibility for funding citizens’ health care, particularly if a government-option health care plan is established.

What he’s missing, though, is that this form of “saving” only has this particular effect when there’s still a sizeable public sector in existence to bear that burden and compensate for it with higher premiums. Kill off that private sector, as the president’s preferred approach will pretty much do, and you get a different result—which is what the Mayo Clinic is worried about:

Under the current Medicare system, a majority of doctors and hospitals that care for Medicare patients are paid substantially less than it costs to treat them. Many providers are therefore already approaching a point where they can not afford to see Medicare patients. Expansion of a Medicare-type plan without a method to define, measure, and pay for healthy outcomes for patients will move many doctors and hospitals across this threshold, and ultimately hurt the patients who seek our care.

You see, when the government bureaucrats need to make “complicated, case-by-case medical decisions,” they’re not going to make them on the basis of the things that truly make them “complicated” and “case-by-case”; they’re going to make them on the basis of the actuarial tables, on a cost/benefit analysis run purely from the perspective of the federal government, and the way they’ll make them is by telling doctors, “We won’t pay that much for that procedure” (if indeed they’re willing to pay anything for it at all). If the figure they set is low enough, the procedure won’t get done. The only variable for medical decisions will be government cost control. In his usual role as the ghoul at the party, Peter Singer has been the only one to come right out in public and tell everyone what that means: rationing of health care.

As cost issues come to dominate the government’s interest in the health care system—which is to say, as the rosy and unrealistic projections of cost savings which the Democrats are currently using to try to build public support for their plan quickly give way to reality, creating a budget crunch—this will also necessarily mean increased taxes. After all, Democrats never have the stomach for huge budget cuts (except from defense budgets), and certainly won’t be willing to embrace the kind of truly draconian rationing of medical care that would be necessary to solve that budget crunch without tax increases. That’s why, despite the promises the president made back when he was trying to get elected, the House’s health care bill already includes a significant tax on the uninsured.

As expected, the House bill would mandate that individuals and families have or buy health insurance.

But what if they don’t buy it?

Then Section 401 kicks in. Any individual (or family) that does not have health insurance would have to pay a new tax, roughly equal to the smaller of 2.5% of your income or the cost of a health insurance plan. . . .

I assume the bill authors would respond, “But why wouldn’t you want insurance? After all, we’re subsidizing it for everyone up to 400% of the poverty line.”

That is true. But if you’re a single person with income of $44,000 or higher, then you’re above 400% of the poverty line. You would not be subsidized, but would face the punitive tax if you didn’t get health insurance. This bill leaves an important gap between the subsidies and the cost of health insurance. CBO says that for about eight million people, that gap is too big to close, and they would get stuck paying higher taxes and still without health insurance.

Ed Morissey adds that “the mandate in the bill would force people to choose between paying the taxes or paying as much as three times as much for health insurance, assuming a family plan.” Still, isn’t that better than having 45.7 million uninsured people? Not necessarily; the crowning irony to this is that, as Deroy Murdock points out, the number of people for whom lack of medical insurance is truly a serious problem is actually about . . . eight million.

Obamacare is propelled by the oft-repeated Census Bureau statistic that 45.7 million Americans lack health insurance. Even if that number were accurate, why would Washington turn the health-care industry upside down for all 300 million Americans in order to help 45.7 million? In fact, as Pacific Research Institute president Sally Pipes demonstrates, public policy should concentrate on a far smaller group of hard cases.

From those 45.7 million uninsured, subtract 17.5 million who earn more than $50,000 annually. Though they can afford coverage, they evidently have other priorities. Of the remaining 28.2 million uninsured, some 14 million are eligible for, yet have not enrolled in, the Medicaid and S-CHIP programs. Meanwhile, as many as 10 million uninsured may be illegal aliens. All told, Pipes estimates that only about 8 million Americans are uninsured due to chronic illness or working-poor status. The latter have incomes too high for assistance and too low for insurance.

In other words: if the House bill passes, it will throw a huge amount of money at the problem of people who can’t afford medical insurance, and the result will be that the same number of people will be unable to afford medical insurance, except that they’ll be paying higher taxes for the privilege. Even for D.C., that will be an amazing accomplishment.

Barack Obama is no Napoleon Bonaparte

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For all the real problems with our country’s health care system, the current fight in Congress is more about Barack Obama’s agenda than it is about what this country needs; you can see that in the way he’s tried to argue that bringing in massive new regulation of our health care system is necessary to fix the economy (a line which, to judge by current polling, most voters aren’t buying). That’s why Sen. Jim DeMint declared that if the president can’t get this bill passed, “it will be his Waterloo. It will break him.” President Obama knows it, too, as an anecdote in a recent National Journal story, told by Sen. Charles Grassley (R-IA), the ranking Republican on the Senate Finance Committee, shows:

“Let’s just lay everything on the table,” Grassley said. “A Democrat congressman last week told me after a conversation with the president that the president had trouble in the House of Representatives, and it wasn’t going to pass if there weren’t some changes made . . . and the president says, ‘You’re going to destroy my presidency.’”

Which makes the president’s lack of real leadership on this issue telling. CNN’s Political Ticker noted last week that Democrats on the Hill are unhappy with his failure to do his part to get a health care bill passed:

One Democratic senator tells CNN congressional Democrats are “baffled,” and another senior Democratic source tells CNN members of the president’s own party are still “frustrated” that they’re not getting more specific direction from him on health care. “We appreciate the rhetoric and his willingness to ratchet up the pressure but what most Democrats on the Hill are looking for is for the president to weigh in and make decisions on outstanding issues. Instead of sending out his people and saying the president isn’t ruling anything out, members would like a little bit of clarity on what he would support—especially on how to pay for his health reform bill,” a senior Democratic congressional source tells CNN.

How did he respond? By going out and picking a fight with the Cambridge, MA police, which “sucked the oxygen out of the health care debate at the very moment Democrats were pleading for him to become more involved.”

President Obama clearly recognizes that in making a huge statist health care bill central to his agenda and staking a great deal of political capital on it, he has made it a bill which he must get passed if he’s to be able to lead effectively; if it fails, it will demonstrate significant political weakness to conservatives, to voters more generally, to the political class, to our nation’s allies, and to our enemies abroad. That’s why he told his party’s congressional wing that they will “destroy his presidency” if they don’t pass it without major changes; that’s why Sen. DeMint called it potentially his Waterloo.

In one sense, of course, that comparison is overstated, because the Obama administration isn’t going to fall if the Democratic health care bill fails; the president will be weakened politically, but he’ll still be the president. In another sense, though, Sen. DeMint’s comparison might not even be strong enough, because the most telling thing about this whole situation is that when faced—by his own admission—with the possible destruction of his presidency, Barack Obama has left it in the hands of Congress to prevent that. He’s happy to go on TV and host a press conference, but when it comes to the nitty-gritty work of leadership, he’s completely hands-off. For whatever reason, he just can’t or won’t do that.

This is the great difference between President Obama and Emperor Napoleon: Napoleon wason the field at Waterloo. He wasn’t on the front line itself, leading a charge, but he was right there with the army, giving orders and calling the shots. President Obama, by contrast, has left that job to Marshal Pelosi and General Reid—he’s back in Paris canoodling with Josephine. I’m not sure what that says about his ability and willingness to be a real leader, but whatever it is, it ain’t good.

Obamacare prescription: the hair of the dog

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Wikipedia: “Hair of the dog is a colloquial English expression predominantly used to refer to ingestion of alcohol as treatment for a hangover. It is occasionally used with respect to dealing with the after effects of use of other recreational drugs.”

As I’ve already said, I agree that our health care system in this country is dysfunctional—it’s inefficient, uncompetitive, too expensive, too unaccountable, and not at all transparent. Unfortunately, we have a bunch of politicians (to whom the whole thing is personally irrelevant since they have a superb taxpayer-funded health care plan which won’t be affected at all by anything they pass) whose desire is to solve these problems by feeding it the hair of the dog: making our healthcare system even more inefficient, uncompetitive, expensive, unaccountable, and opaque by adding a vast new tangle of government bureaucracy to the existing vast tangle of government bureaucracy that’s already gumming up the works. If you haven’t seen the organizational chart for this, it’s beyond belief:

If you’re wondering how that will function in practice, here’s a working model:

HT: Aaron Gardner

One of the great problems with a government-centric approach to “reforming” health care is almost theological, the same problem the early church had with the Pharisees (and the church has had throughout the centuries with those who would rather live by law than by grace): if you try to define and control anything through law, then you need a law for every bit of minutiae. This is is why government control is never the most efficient way to run anything, because it’s impossible to fine-tune the law well enough to make it truly efficient; it’s why government control stifles innovation, because all those laws lock innovation down. It’s also why, whatever the overarching principle of any law might be, the devil is always in the details.

As the above organizational chart shows, the details of the current Democratic health care bill are myriad, complicated, and confusing; and as a closer examination of some of those details shows, for this bill, they add up to a mighty big devil. Check out the Economic Policy Journalblog for a list that may very well curl your hair, including a massive expansion of government incursion into individual rights and economic freedom. Then consider that while one of the other big factors driving up the cost of healthcare is runaway litigation, this bill won’t do anything to rein that in—in fact, it will expand it. (HT: Mark Hemingway)

This is the kind of reasoning James Hirsen dubbed “Bidenomics” after our ever-quotable vice president told the AARP,

AARP knows and the people with me here today know, the president knows, and I know, that the status quo is simply not acceptable. It’s totally unacceptable. And it’s completely unsustainable. Even if we wanted to keep it the way we have it now. It can’t do it financially. We’re going to go bankrupt as a nation. Now, people when I say that look at me and say, ‘What are you talking about, Joe? You’re telling me we have to go spend money to keep from going bankrupt?’ The answer is yes, that’s what I’m telling you.

It doesn’t really deserve its own name, though, because it’s not new to VP Biden at all; it’s the same old folk logic of the hair of the dog: to fix a problem, just pile on lots more of what created the problem to begin with. Apply it to drinkers, you get drunks, who then use it to justify becoming worse drunks. Now, a government drunk on tax money and a political party supported in large part by trial-lawyers drunk on lawsuit money are using it to try to justify getting even drunker. We need to tell them to sober up.

Perhaps too much credit?

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The other day, I tipped the hat to Barack Obama for his gracious response to Cambridge, MA police officer Jim Crowley. At the time, I hadn’t really thought about the fact that his motivation for doing so might be purely political—namely, that he might have significant political reasons for wanting the flap over his response to Henry Louis Gates’ arrest to go away as quickly as possible. Jennifer Rubin lays it out:

The president’s decision to weigh in on the arrest of his Harvard law professor friend Henry Louis Gates Jr., who mouthed off to a Cambridge cop threw a grenade into his health care PR offensive and revived questions about his promises of a post-racial presidency. He tried to defuse matters with a Friday appearance in the White House briefing room, but like his predecessor, he found it impossible to say “I am sorry” or “I was wrong.”

It is not surprising that the cable TV news and the Sunday talk shows continued to chew over the story. Unfortunately for the president, the comment was harmful on multiple levels. We can count at least five ways in which the story is a loser for Obama.

First, it suggests he is an uninformed busy-body. . . .

Second, he sucked the oxygen out of the health care debate at the very moment Democrats were pleading for him to become more involved. . . .

Third, Obama indisputably fanned the flames of racism and rekindled animosity on both sides by assuming or making this all about race. . . .

Fourth, the underlying fault line in Obama’s presidency and his agenda is the growing sense that government is getting too big and is accumulating too much power. It is not just core Republicans who think government is doing too much, but an overwhelming number of independents who are irked by the Washington power grab. . . .

Fifth, Obama has fallen into the unfortunate habit of blaming others.

Perhaps the most damaging thing of all this is the way it shows a reflexive assumption of racism on the president’s part.

Juan Williams, on Fox News Sunday, did the country an immense service by recounting what exactly occurred: “The president spoke without the facts. You can’t have a ‘teachable moment’ if it’s based on a lie.”As Williams explained, in this case, the neighbor called the police, Gates began to berate the officer (“Do you know who I am?”), trash-talking about the officer’s mother and pursuing him out of the house. The black and Hispanic officers confirmed Gates’ abusive behavior, and Sergeant Crowley took out the handcuffs and warned Gates before finally having to cuff him.

Williams asked, “Is this an instance of a poor black kid being beaten by the cops?” No. And in converting this into a tale of police misconduct (he acted “stupidly,” Obama said) and racial injustice, Obama only reinforced the country’s racial divide. Whites often think blacks scream racism at the drop of a hat; blacks think whites are out to get them. Good work, Mr. President.

This sort of reaction on President Obama’s part directly undermines the foundation of his appeal among moderates and independents—namely, his promise of a post-racial America, free from this sort of conflict. That’s why, though this flap in and of itself is a minor thing, he might find it much harder to put behind him than his strongest supporters believe.

As Williams argued, his knee-jerk reaction to cry racism “hurt the country and it hurt him.” It was, to put it mildly, exactly what Obama didn’t need. A polarizing event—confirming the worst fears that he is arrogant, not at all post-racial, and prone to play last-and-loose with the facts—is not what he needed in the midst of the biggest political challenge of his young presidency. The stimulus is working, he is teaching us about race, and now he wants to run your health care. Not an attractive picture.

HT: Sister Toldjah

On the way to a functional health care system

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Like most folks, I agree that our health care system in this country is dysfunctional and needs serious treatment. I agree with those who say that we need to uncouple medical insurance from employers and employee benefits, for a lot of reasons; that linkage was a 1940s expedient that has done more, I think, to distort both the cost of health care and the functioning of our medical system than anything else. I think if we recognize and accept this, a real bipartisan reform is possible on that basis, providing that the Democratic Party is willing to stand up to the unions on that point.

Where I part company with the current administration is its analysis of where we go from here. To my way of thinking, the great functional problem with our health care system is that it’s an anticompetitive mess. The majority of us don’t choose our medical insurance; instead, they get what comes with their situation (in most cases, their current or former job). We sort of choose our doctors, but from a limited list preselected by our (unchosen) insurer, and based on a far more limited set of data than we might use to choose, let’s say, a new washing machine or coffeemaker. (Side note: the Cuisinart DCC-2000 carafeless coffeemaker is wonderful if you don’t mind the electrical system dying every year or so; they’re very good about replacing it free of charge when it does.) And when we need to go to the hospital, we don’t do a price comparison, we go where they send us.

Indeed, we can’t do a price comparison, because hospitals don’t make that information available; as my wife rightly insists, requiring hospitals to be transparent about their rates and tell you in advance what they charge for everything is an essential element in any meaningful health care reform. Without that information, it’s impossible for the market economy to function, because it’s impossible for people in need of healthcare to make economically-informed decisions; there is only the upward pressure on costs produced by the desire for more and better and more elaborate services (because after all, there’s just a chance that this or that test might tell us something we don’t already know) with no countervailing downward pressure on costs produced by the desire to save money (because after all, those tests are horrendously expensive and not worth the cost when they’re not really necessary). If we want to bring costs down while preserving the quality of our health care system, what we need to do is open up the system to market forces, not close it still further by making it a part of our highly-inefficient government apparatus.

Deroy Murdock argued this case well last week on the National Review website.

Rather than endorse such big-government overkill, pro-freedom members of Congress should promote a simple concept: Let every American own and control an individual health-insurance policy that can be transported among jobs, self-employment, graduate school, and life’s other twists and turns. . . .

There is no need for a gargantuan health plan that spends $1.5 trillion—as the Congressional Budget Office estimates House Democrats want—nor for the 29 new federal boards, panels, and agencies that Senate Democrats envision. As for creating a “government option” for health insurance, why not create a government option for grocery stores and clothing shops, lest famine and nudity erupt across the land?

What Americans need is a thriving market in individually owned and controlled health-insurance plans. When you book an airline flight, PriceLine.com does not ask, “What is your group number?” You decide when and where to fly, and then buy your ticket. At least with personal travel, your boss does not fund this. The same is true for car insurance, home insurance, and often life insurance. Why must Americans shop for health insurance at work, rather than online or through independent agents?

Health-care reform should give Americans the option of using money tax-free to purchase whatever kinds of health insurance make them happy. If employers offer such plans, lovely. If not, individuals should be encouraged, through tax-free Health Savings Accounts, to buy their own policies and maintain them throughout their careers. This dramatically would reduce the tragedy of “job lock,” whereby employees put up with bosses and duties they cannot stand, merely to keep employer-furnished health coverage.

As Rep. John Shadegg (R., Ariz.) has argued, Americans also should be free to buy health plans across state lines. Today, such policies usually must be purchased within consumers’ own respective states, subject to state-level insurance regulations. If New York residents may arrange home loans through Illinois-based banks, for example, why are we only allowed to buy health plans through insurers who operate in the Empire State?

Creating a massive government bureaucracy to control health care will only be good news for bureaucrats; for all that this is couched in the language of “making health care a right,” the actual result will be the opposite. After all, as Peter Singer has already said (I won’t say “admitted,” because he doesn’t view it as an admission), the inevitable result of government funding of healthcare will be government control of your health care decisions, and government rationing of healthcare. If government money is necessary for you to live, then the government will make the decision whether you live or die—and the government cares more about your money than it does about you.

This is inevitably what happens when the government takes something over. Robert Wenzel sums it up well in his comment on Dr. Singer’s piece:

The big problem with Singer’s argument is that he makes the mistake of assuming a fixed pool of healthcare services. This is a world where the evidence shows that in a free market economy, innovations are a daily occurrence. Cell phones, big screen televisions and personal computers get better and cheaper. Expensive new products that only the rich can afford are in many ways simply inferior “test” products before they get to the masses in better quality and much cheaper. Would you rather have the current cheaper jumbo screen televisions, cell phones and personal computers or the much more expensive clunkier jumbo TV, cell phones and PCs of yesteryear that only the rich could afford?

By rationed healthcare, and limited bureaucratic controlled access to “expensive” healthcare, new innovations, creativity and advancements in the healthcare industry will be greatly reduced, perhaps eliminated. The incentives will be gone. Remember, there are never any stats on what innovations, discoveries and advancements will have never been created. Those who argue that medical care works in national health care countries fail to understand the innovations that are killed off. This is, of course, in addition, to the usual problems of rationing and bureaucratic distortion of prices—and the government taking the role of decider on whether you deserve to walk or not, or whether you calculate out for life or death.

Rather than moving our medical system toward the world dominated by Moore’s Law (that drives innovation rather than suppressing it), Obamacare would move it into the world of government procurement that gave us the fabled thousand-dollar hammer, and the world of government financial management that has put us trillions of dollars in debt. Given that government has consistently proven itself poor at running anything efficiently and under budget, there’s no justification for the claim that the government can improve our health care system by taking it over (especially when there’s plenty of evidence to the contrary from other countries that have tried it).

Government-run health care systems are no more functional than the one we have now—economically or morally; if anything, they’re less so, especially as they inevitably lead in the end to the government putting a dollar value on people’s lives according to how much they’re worth to the state. If we truly want to make things better (as opposed to transferring large amounts of our personal freedom and autonomy to yet another unaccountable bureaucracy), we need to turn away from this approach and toward the one Murdock lays out, one which has already been shown to work. We need to break the health care bureaucracy that already exists, rather than multiplying it, and give people the information and autonomy they need to make their own decisions with their own money. We need to let the market drive efficiency, as it already does in so many other parts of life. We need to set health care free.

Fitness

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(1 Samuel 17:32-40; 1 Timothy 4:6-5:2)

Our passage from 1 Samuel this morning is, of course, from the middle of one of those Bible stories that the church knows and loves—the story of David and Goliath. At first blush, it might seem odd to take this story and pair it with this morning’s text from 1 Timothy; but there are a few things in this story worth thinking about as we consider Paul’s words in this letter. First, there’s something in the backstory here that David knows and Saul doesn’t, which is critical to understanding what’s going on. You see, in chapter 15, Saul disobeys God, and Samuel declares that God has rejected Saul as king of Israel. Saul of course knows that, but what he doesn’t know is that God has already chosen his replacement: David, whom Samuel anoints as king of Israel in chapter 16. What we see here in chapter 17, then, is David taking his first steps into the new call and the new responsibility God has given him, stepping into the leadership vacuum left by Saul’s unfaithfulness. In other words, this story isn’t just about who’s going to kill the big bad giant—it’s about leadership, and what it means to lead the people of God.

Second, both Saul and David know that leadership requires training. When David volunteers to go out against Goliath, Saul says, “You can’t do that—he’s a trained, experienced warrior, and you’re an inexperienced, untrained boy.” David responds, “I’m not that inexperienced. You might think being a shepherd doesn’t count for much, but God has been using it to train me for this new responsibility to which he’s called me. As a shepherd, I’ve had to fight lions and bears single-handed to protect my flock, and I’ve killed them every time and rescued the sheep they tried to carry off. I’m no stranger to fighting, and so far, I’ve never lost a fight; I have been prepared by God to fight Goliath.”

Third, and most important, is one more thing that David knows and Saul really doesn’t: the battle belongs to the Lord. Saul puts his faith in the strength of his armor and the edge of his sword—which is why he’s hiding in his tent, afraid of Goliath, instead of leading his people. David, by contrast, puts his faith in God, trusting that “the Lord who delivered me from the paw of the lion and the paw of the bear will deliver me from the hand of this Philistine.” Why? Because the Philistine has mocked and dishonored the name of God, and God won’t let that slide; the Philistine must be defeated, and God is going to make that happen. As the world normally judges these things, young shepherd vs. experienced warrior giant is a severe mismatch—Hoosiers has nothing on that one; but David understands that the world is missing something, and that if the Lord of creation is on the side of the shepherd, then it’s the giant who’s out of his weight class.

In these first and third points, I believe, in the things Saul didn’t understand, we see the basic reason for his failure as king of Israel. He didn’t really know what it means to be a leader under God—he didn’t understand what leadership really is, or what it’s about. That’s a common mistake, to be sure; we tend to look at leadership positions as a chance for people to make sure things are done their way, to realize their own vision and make their priorities everyone else’s priorities. That’s certainly how we see things done time after time in our politics—frequently with disastrous results, especially for politicians who are unwilling to listen to those who disagree with them and take their concerns seriously. The results were certainly disastrous for Saul, bringing both his reign and his life to a premature end. That’s the kind of thing that happens when you see leadership as a form of self-expression and self-actualization.

What David understood that Saul didn’t is that in God’s view, being a good leader is first and foremost about being a good follower—specifically, a follower of God. He was confident against Goliath not primarily because of his own skills—though they played their part—but because he was close enough to God to recognize what God was doing in that situation, and what God wanted him (as the newly anointed king of Israel) to do. Godly leadership isn’t about imposing our will on our circumstances, but about seeking and following God’s will in our circumstances, and doing so in a way that makes it clear to others so that they can follow us in turn. It’s the sort of thing Paul’s talking about in 1 Corinthians 11:1 when he says, “Follow my example as I follow the example of Christ.” That’s it in a nutshell. In the Christian view, leadership is mimetic—which is to say, it’s all about imitation. We learn to follow Christ by imitating others who have learned to follow him more closely than we do, who in turn are following others who are yet further along in their Christian walk, who in turn are following others who went before them; and each of us, as we learn to follow Christ more nearly, lead others in turn to do the same. That’s leadership; that’s discipleship; that’s the Christian life right there.

Of course, as human beings, we need structure, and the Christian community needs leaders with certain skills—the interpretation of Scripture, administration, leading worship, teaching and caring for children, and the like—and so we establish certain specific positions to insure that we have set leaders who bring those skills to the table; so it has been ever since the beginning, which is why Paul had established Timothy in Ephesus. God gives those gifts to the church, and they’re important—I’m much better at this job than I ever would be at Pam Chastain’s, for example, and while Alice Seiman is a wonderful deacon, that doesn’t mean she’d be happy to come up and preach—and continued use and development of our gifts through training is important as well; but you can see here the same thing we saw in chapter 3, that Paul’s primary concern for Timothy and for the other leaders of the Ephesian church is not their skillset but their character. Implicitly, Paul would rather have a pastor who’s a mediocre preacher but whose life shines with the love and goodness and holiness of Christ than a brilliant preacher living in serious unrepentant sin—and so would I, and so I’m sure would any of you. The most important thing about our leaders is not that they talk well, but that they live well.

This is why Paul says, “Train yourself to be godly. For physical training is of some value, but godliness has value for all things, holding promise for both the present life and the life to come.” Train yourself to be godly. This is something of an unfamiliar concept for much of the American church. We tend to have the “In His Steps”/WWJD sort of mindset that says, the way to live a godly life is whenever you come up to a decision, ask yourself what Jesus would do and then do that. That’s great in theory, but it doesn’t really work all that well in practice. Sometimes, it’s not really that obvious what Jesus would have us to do; and when we face temptation, we probably know full well that Jesus wants us to resist it, but that doesn’t make it any easier for us to turn and walk away—especially if we’ve developed a pattern of giving in to that particular temptation. Then too, there are lots of times when the decision goes by too quickly for conscious thought—one of your kids misbehaves, or someone cuts you off in traffic, or a co-worker insults you, and you react, just the way you always react when that happens. Looking back, you might well realize that that wasn’t what Jesus would have wanted you to do, but you’re not thinking about that at the time—you’re not thinking beyond the situation.

The truth of the matter is, performance requires preparation—and this is true of any kind of performance. If you want to go out and compete in our little mini-triathlon here, you need to train your body to be able to go the distance. One of my favorite colleagues out in Colorado, Rob Wilson, is the pastor at Eagle River Presbyterian Church, out west of Vail. He’s also an avid triathlete who used to keep himself in shape by biking the 24 miles back and forth from his house to the church; when we had meetings in Summit County, the next county east of Vail, sometimes he’d bike there, going up and over Vail Pass, which is about 12,000 feet. One summer he went up and did the triathlon in Coeur d’Alene, Idaho, and as he was telling us about this, he mentioned off-hand that they’d moved the triathlon from Salt Lake City to get away from the bad publicity after one of their racers died. We wondered if he was sure he wanted to be competing in an event that killed its participants, but he shrugged it off, because he knew he was up to it.

Or take another test of endurance, of a sort—think of MasterWorks. Poor Gert, with a major recording project right in the middle of that—I can’t imagine how he stayed on his feet the whole time. I don’t know how many of the concerts you made (for me the answer was the same as last year: “Not enough”), but there were some truly brilliant performances. The closing weekend was especially memorable, with Tchaikovsky’s Fourth and Mahler’s First—I was rather amused, actually, that Saturday night, because it didn’t look like the audience wanted to let the orchestra out of the building. I know Dr. Kavanaugh was exclaiming for months over how good this year’s students were, and there’s no question from their performances that their talent was amazing. But they didn’t just show up each weekend and play; they spent long, long hours rehearsing, alone and together, to get the music right so that they could perform at that rarefied level.

We understand this, when it comes to physical disciplines. Certainly, if I announced that I was going to go out and do a triathlon this week, you’d be justified in questioning my sanity, since there’s no way on God’s green Earth I’m up to that. We get that for a Michael Phelps or a Michael Jordan, for a Peyton Manning or a Michael Johnson, that their athletic success in the big moments is just the visible part of a massive iceberg labeled “training”; we understand that if they don’t put in the work the other six days, when it comes to game day or race day, they’re not going to get the results.

The problem is that too often, we forget that this applies to our performance as spiritual beings, too. If we’re going to perform when our faith is tested, when temptation hits us, when we have the chance to talk about Jesus with a non-Christian friend—if we’re going to be like Jesus in those moments when we can see it matters—then we need to lay the groundwork for that with the rest of our lives. We can’t just roll out of bed and go out and live like Christ; we need to train our minds and our bodies to operate in that way, to let him reshape our ways of thinking and reacting, to let him remake our habits and our patterns and our accustomed behaviors in his image.

That’s why Paul tells Timothy to reject the myths and nonsense of the false teachers. Their twisted version of the gospel empty, vacuous, devoid of anything of value—it was little more than a trap to catch the credulous and the foolish. There was simply nothing in it to build spiritual strength and wisdom. Instead, Paul tells Timothy to continue to nourish himself, to continue to feed himself spiritually, on the words of the faith and sound teaching—which is to say, on the true gospel of Jesus Christ, and the teachings of Paul and the other apostles—and then to put that to work by teaching and leading the church in Ephesus accordingly. Just as we develop physical fitness by eating good food to give our muscles the energy and the nutrients they need, then using that energy and those nutrients to strengthen them through exercise, so we develop spiritual fitness by feeding our souls on the truths of God and his word, and then teaching those truths to others and working to put them into practice in our own lives.

This is what it means to train ourselves to be godly—it’s to organize our lives in such a way that everything we do and everything on which we spend our time contributes to the goal of making us more like Christ. Is that book, or that magazine article, or that TV program, good food or junk food? Is it contributing in any way to our growth in Christ and the strength of our spirits, or is it weakening and undermining us? As Dallas pastor Matt Chandler rightly says, it’s not just a matter of whether something is sinful or not—it’s a broader question: does this feed our love for Jesus, or does it draw our love away from Jesus? Most of the things that cause us to love Jesus less aren’t sinful in and of themselves—but our love for them overgrows its proper bounds, and they take an improper place in our lives. Baseball was a big one for me that way, as I used to plow a great deal of time and effort and mental energy into following the game; I had to prune it back a long way, I had to redirect a lot of that time and effort and energy, because baseball—which I continue to affirm is a good thing—was taking my heart away from God, and also from my family, and interfering with my spiritual growth.

The responsibility of leaders like Timothy, then, is to model this: to train ourselves in godliness so that others can see the value of such training in our lives, and be inspired to follow us. It’s not enough just to say that this is good and worth doing, especially when the culture around us is saying otherwise, because quite frankly, the culture has a bigger megaphone than the church. People need to be able to see that training in godliness has value in this life; the culture needs to see that from the church, which means that the church needs to see that from its leaders. It’s essential to preach the gospel of Jesus Christ, but it’s not enough just to say it; how we live needs to back up what we say if we want anyone to believe it, or to care.

This is especially true when we face opposition, as Timothy was. It seems pretty clear that his relative youth was being used by the false teachers as an excuse not to listen to him, when the real problem was that they didn’t want to hear what he was saying; this was no doubt highly frustrating, and it was a real challenge to figure out how to respond in a way that was actually constructive. Paul gives him three answers to that challenge. One, don’t give in—continue to preach the gospel, and to call the church to live in accordance with the true will of God. Two, don’t give up—don’t let anyone look down on you, but be diligent in doing what you’ve been called to do; hold on, hold fast, persevere. And three, rise above the fray—don’t try to fight fire with fire, but instead, set an example that your opponents can’t ignore.

It all comes back to this: Timothy’s job is to preach the gospel faithfully, whatever may come, doing everything possible to make sure that people get the message, which means living in such a way that they can see the gospel at work in his life. This is why he needs to be spiritually fit, and why I need to be spiritually fit, and the elders, and all of us, because we have a job to do, and a mission to carry out: to be a pillar to uphold the truth of the gospel, to keep it as the vision before our own eyes and to lift it high for all the world to see. We are called to proclaim to all the world, in our words and in our silence, in our actions and in our stillness, the mystery of our faith, who was revealed in a body, vindicated in spirit, seen by angels, proclaimed among the Gentiles, believed in throughout the world, taken up in glory. We are called to hold up this truth and shine his light; we’re called to preach this good news, that Jesus Christ came into this world to save sinners, of whom I am the foremost, to proclaim it and live it out, until in the end, Jesus Christ alone is our vision, and our wisdom, and our wealth, and our home.

Parents, children, and sin

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Heidelberg Catechism
Q & A 7
Q. Then where does this corrupt human nature come from?

A. From the fall and disobedience of our first parents,
Adam and Eve, in Paradise.1
This fall has so poisoned our nature2
that we are born sinners—
corrupt from conception on.3

Note: mouseover footnote for Scripture references.

Our first ancestors fouled the well, and poisoned our inheritance. Kuyvenhoven puts it well, I think, when he says (27),

[The catechism] intentionally calls Adam and Eve our “parents,” thereby teaching that, just as black parents get black children and white parents get white children, so sinful parents get sinful children, whether they are yellow, red, black, or white. None of us can escape this poison, for all of us have parents. That’s the teaching.

And none of us can avoid passing it on, for all of us are sinners. As the father of three, I can testify that I am far more aware of my own depravity now than I ever was before they came along.

I will give the President credit

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after responding to the arrest of Henry Louis Gates in something of a knee-jerk fashion—which is understandable, since Dr. Gates, one of the high-profile members of the Harvard faculty, is a friend of his—has now acted quite graciously to defuse the situation and to defend the officer who arrested Dr. Gates, Sgt. Jim Crowley of the Cambridge police. While of course he continues to insist that the arrest was an “overreaction”—something which is easy to say from a distance, since from an outside perspective it’s clear that Dr. Gates didn’t actually intend Sgt. Crowley any harm—he has also unbent far enough to admit that “Professor Gates probably overreacted as well.” While that’s something of an understatement, given the professor’s loud, arrogant and abusive behavior (not surprising from a Harvard prima donna), it’s still a welcome admission. More than that, President Obama called Sgt. Crowley “a good man . . . who has a fine track record on racial sensitivity,” and admitted of his initial reaction,

In my choice of words, I unfortunately gave an impression that I was maligning the Cambridge Police Department, or Sergeant Crowley specifically. I could have calibrated those words differently, and I told this to Sergeant Crowley.

As well, President Obama gave the press another reason to feel good about Sgt. Crowley:

By the way, said Obama, at the end of his conversation with Crowley, there was some discussion of Obama, Gates, and Crowley having a beer in the White House. “I don’t know if that’s scheduled yet,” Obama deadpanned, “but we may put that together. But he also did say that he wanted to find out if there was a way of getting the press off his lawn.”

“I informed him,” Obama said, “that . . . I can’t get the press off my lawn,” drawing big laughs from the gathered reporters.

Since he’s now been the cause, in a friendly and familiar way, of a presidential joke, as well as the recipient of an official presidential pat on the back it seems unlikely that Sgt. Crowley should have to worry about any further attacks on his character . . . though he may still want to swing wide of Dr. Gates in future. But this is a guy who could easily have been savaged, given the way things go in this country, and who really didn’t have it coming; kudos to President Obama for his gracious handling of the situation to keep that from happening.