Thursday, September 3, 2009

Shorters

comparatively speaking. There's way too much on the plate for each post to get an extended treatment.

Numbers Game:

Yes, I am aware that reality television is not "real", but heavily stage managed. I have no idea if the show is representative of their life, much less life in their very religious subculture--indeed, I have some idea what the editors are slicing out, so I'm quite sure it isn't an accurate representation. Nonetheless, when I'm really exhausted, few things are quite as soothing as the champions of the baby olympics.
I like pretty lies.

The Gift of Life:

Megan reads us;
I think one of the genuine problems that liberals will face if they get the comprehensive system they want with some sort of cost-effectiveness review board, is that cost-benefit analyses break down at the margins of life. I'm not concern trolling here; it's just an intellectually fascinating, and politically thorny, problem, which is why Ezra Klein wrote the original post that Julian linked. [my emphasis]
Her point is that when us libruls have taken over health care and set up our death panels we're going to find we have to do cost benefit analysis, and Medicare and the VA provide no examples of how to do this, so we'll have no choice but to ration by killing grandma. She's actually trying to use dying people as props to argue we can't change the system, because.

The Problem With Talking About Health Care:
This comment to my last post is so central to the debate about health care issue that I had to share it:
I'm not sure I wholly understand the argument here.
The idea is that were the government to make some cost-benefit analysis and decide this drug didn't give enough of a benefit to be worth paying for, that would be a bad outcome, yes? How would this differ from a private insurance company making the same choice?
In both cases individuals able to raise the money through outside means would be able to purchase the drug anyway.
No offense to the commenter who I'm sure is a fine and clever human being. But: huh?
She's not paid to understand this kind of incredibly abstract nuance n shit.
I write a post on why superficially bad sounding tradeoffs--$3,500 a month for an extra 12 days of life--might actually be good uses of money. I tried, and I thought succeeded, in keeping the debate entirely on the terms that progressives looking to build a CER agency with some power would be interested in. And I nowhere mention whether this would be better or worse if a private entity were doing it.
Am I wrong to think her goal in writing these last couple of weeks is to provide Susan and us here with good material? The question, dumb lib, is what Megan thinks we should think about her hypothetical situation that is a closed system where nobody can buy extra care out of their own pocket, because. She feels good about her question, why don't you?
I mean, I think that, to a much greater extent than most liberals think, insurance companies have largely dealt with this problem by throwing up their hands and erring on the side of approval, which is why health care costs are going up so fast. But one could certainly argue that private insurers are going to have to crack down harder on this stuff soon.
Those poor insurers have to protect their quadrupled profits. Won't someone think of the dividends?
But I did not comment on the relative awesomeness of private versus public, because regardless of their comparative fabulosity, a public agency is probably a more useful thought experiment to discuss the question Julian asked, which is the limits of the treatments that we think people have a reasonable right to.
It seems almost impossible to get anyone to engage in this kind of discussion. As I replied to him, you have to try to enter an imaginary thought world where not all discussions are instrumental in some larger argument about the level of government intervention in the economy. Where it is possible that I am not simply attempting to subtly maneuver my opponent into accidentally embracing my position so that I can jump out from behind a tree and scream gotcha!
I know, this isn't really a shorter, but holy bugfuck. The failure is on us for not accepting her terms and coming to her conclusions because we're stuck in an imaginary world called reality where private insurers are already engaging in the behaviors Megan describes, while charging so much for coverage most can't afford to buy further treatment out of their own pocket. If we'd just ignore all that we'd naturally come to see she's completely right.
But I wasn't concern trolling, or trying to set up a gotcha.
Hey Megan, let's do a bloggingheads together, it'd be fun and you could show me how you're not concern trolling. My one demand is I get to wear a Dick Cheney mask.
If she's going to reference us so often, she might as well link to us, dammit.
Anyway, again, apparently Medicare and the VA provide no insight into or potential sources of experience with cost benefit analysis. People are too happy with those programs.
Oh, but she's still offended about the concern troll crack;
Sometimes a blog post on cost-benefit analysis is just a blog post on cost-benefit analysis.
It'll be ok, Megan. Ezra will respond to this pity party nicely because theGarance feels bad for you and makes him and you'll get a guest fucking editorial in the WaPo out of it where you can tell many more people that you're not concern trolling while you concern troll.

You Might Be a Lunatic If . . . :

Megan once had a totally real email conversation with a lefty who thought bad things about good daddy Bush and who, after she pretended she agreed with some nitpicking objections, told her how they thought the 08 election would be canceled. She's not going to give you further details like when this convo happened, like if, say, the lib happened to be a former resident of New Orleans emailing her from a toxic FEMA trailer, because only Megan gets to reference massively traumatic events as excuses for saying stupid things like we should physically assault people she disagrees with.
But anyway, this conversation means the left is just like the right. Sure, an overwhelming majority of self described Republicans say they're not sure whether or don't believe that Obama was born in Hawaii, but Megan gets annoyed when you mention stuff like that so it doesn't count. One crazy belief equals and effectively negates the ability to draw any conclusions from the other, no takebacks.

The Government's Role in R&D:

She's not going to talk about rationing, except for a few paragraphs;
I'm sheerly worried about the fact that rationed markets function badly on all levels, including providing for the needy.
I responded to people who were saying that "We have rationing now" to point out that this is a silly reading that has nothing to do with the two major concerns people have with rationing.
You can lead a horse to water, but you can't make it acknowledge its own reflection.
After not talking about rationing Megan gets back to R&D, and wow she makes a great argument. You see, the gubbermint is better at providing a social safety net for the poor than the scattershot efforts of private charity, therefore private industry is better at R&D than the gubbermint. The gubbermint would just worry about developing effective treatments, and not get all caught up in worrying about profitability. That's communist, wrong, evil, bad, and makes Megan cry, so it cannot be. Shit, the government probably wouldn't even consider the marketability of a new drug, and what color the pill should be.
After all, these noble non scientist executives who have already cut R&D outlay in favor of profit taking and dividend issuing are only so noble, and if we were to threaten them with reduced profits they'd make us pay for it by not letting their scientists continue researching promising new drugs, which would be our fault. Even if the Rand paper is right in no way does it argue for a change in the system that these pigfuckers would deny the consumers they claim to be motivated primarily by concern for .7 years of life out of spite. No Gulfstreams, no cure for cancer. This is not extortion, this is a happy market.

Point being, she's not concern trolling.

1 comment:

Mark said...

"I'm sheerly worried..."

Is she under the impression that that's how the British use that word?