Month: September 2011

A reader writes:

This: "America, moreover, has a law on the books that makes it a crime not to treat and try to save a human being who walks into an emergency room" … is not precisely true. And it's not precisely true in a way that fits perfectly into the libertarian project.  

The Emergency Medical Treatment and Active Labor Act (EMTALA) requires "participating hospitals" to provide care to anyone needing emergency health care treatment, regardless of citizenship, legal status, or – most famously – ability to pay.  "Participating hospitals" are those who participate in the Medicare program.  In practice, virtually every hospital participates.  But, for example, Shriners Hospitals, Indian Health Centers, and VA Medical Centers are not subject to the law.  Nor would be any hospital that opted out of Medicare.  

EMTALA has to be structured this way to be constitutional. Congress can impose virtually any restriction, even ones that would otherwise be unconstitutional under the Tenth Amendment, through Medicare conditions of participation, with the result that it applies only to participating facilities.

The Ryan budget and other proposals from the libertarian/Tea Party right pledge to put the government out of the business of paying for healthcare.  If Medicare becomes a set of subsidies beneficiaries use to purchase private health insurance, then EMTALA is dead.  If hospitals no longer participate in the Medicare program, then there is no way for Congress to require such treatment in a manner that would survive constitutional scrutiny.  In this way, the GOP has put forward a proposal to end EMTALA.

Another writes:

Eliminating the emergency room care law does not seem practical. How would paramedics or doctors in an emergency room deal with an unconscious patient lacking ID who requires immediate lifesaving care? Even if the hospital could determine that the patient was insured, how would they know if the patient had enough money to pay the deductible?

I don't think this is a hypothetical question. And I'm pretty sure that anyone who needs emergency care wants and expects the paramedics/doctors to begin treating them immediately. This would end up affecting the insured as well as the uninsured, and it's not hard to imagine the outrage that would occur when someone whose life could have been saved dies because precious time was wasted verifying that the patient had adequate insurance.

Also, in Ron Paul's answer he claimed that churches and private charity would take care of the sick in the absence of government. I hear this a lot from libertarians, and private charities certainly do provide a great deal of care. It would be wonderful if private charity could solve our social problems without any need for government programs. But if they had been able to solve the problem on their own there wouldn't have been any need for government programs. And the idea that care for the poor is strictly the domain of churches and private charities isn't just pre-New Deal, it's practically pre-Renaissance.

Elizabeth Warren is running for Senate. Her pitch:

Ezra Klein says Warren will base her campaign on running against the banks rather than Scott Brown. Greg Sargent claims that "Warren’s run could test the electoral limits of true populism in a way other Dems haven’t been willing to venture." Dreher is excited:

Unless Jeff Jacoby tells me something bad I don’t know about her — and what I don’t know about Elizabeth Warren is a lot — I’m rooting for her. I can understand her holding her fire (for now) against the Democrats, for tactical reasons, but if she wins — and I hope she does — then I hope she goes to DC with both barrels blazing, and with the understanding that the enemy of the financial interests of ordinary Americans is the capture of both parties by Wall Street and the banks. If she goes to DC and gets captured by Democratic partisans, it will be a colossal waste.

There's a real chance that the HPV vaccine, the in-state tuition fees for illegal immigrants, and the generic charge of "crony capitalism" could hurt him with the Tea Party base. Let's assume his poll numbers decline a little. You have a narrative of yet another front-runner fading out of the gate. Which leads to a pretty obvious scenario. Paul Burka, a man who knows more than most people can forget about Texas politics, notes the remarkable Palin break from Perry and draws the obvious conclusion:

She’s going to have to time her entry into the race perfectly. But I think she’s the only Republican who doesn’t have to build an organization. It’s there, waiting for her, in Iowa, in New Hampshire, in every state. About those polls that say she can’t win: Many Republicans believe that the country is turning away from Obama, that he will not be electable come November of 2012, and whoever gets the GOP nomination wins. They may be right. I think Palin is playing her cards very smartly. She has the biggest following of any Republican, by far. She has 100% name identification. She is a free agent. I think she’s intent upon running, and I think Rick Perry had better watch out.

Bradley Burston, the conscience of the Jewish state, endorses "Abu Mazen's Hail Mary:"

It may prompt and encourage non-violent Palestinian protest in the West Bank and East Jerusalem. The prospect of non-violent protest is one that Israeli officials have acknowledged that they are ill-prepared to confront. As a recently released wikileaks cable revealed, "Less violent demonstrations are likely to stymie the IDF. As MOD [Ministry of Defense] Pol-Mil [Political-Military] chief Amos Gilad told USG [U.S. Government] interlocutors recently, "we don't do Gandhi very well." This, in turn, coupled with rising Israeli tensions with Egypt, Turkey, and the U.S., could at some point force Netanyahu to consider dropping Avigdor Lieberman's Israel Beiteinu in favor of Kadima, in order to resume peace talks.

Mark Goldberg argues the end result might be an ICC trial of a Palestinian national. Fine by me. Previous coverage here, here and here.

(Photo: Palestinian men wait to be collected by their Israeli employers after crossing from the West Bank town of Qalqilya to work in the Jewish state in the early morning of September 11, 2011 near the Israeli army's checkpoint at Kibbutz Eyal in central Israel. By Uriel Sinai/Getty Images.)

I've written that Obama is likely to best Perry should the Texas governor be the GOP's nominee. Larison counters:

[I]f the economy is in “steep recession” next year, the Republican nominee will almost certainly win. When the incumbent or his party is held responsible for poor economic performance, the electorate tends to be more willing to overlook things that might otherwise be considered a significant liability. In any case, unless he is trying to fail, Perry is not going to campaign for the abolition of Social Security or anything like it.

Point taken. I'd merely argue that Perry's "solutions" sound a lot like warmed over Bushism to me, with an even heavier Texas twang. His style is very regional. I can't see Catholics being comfortable with him. He's a potential gaffe machine. He is nowhere near as likable as Obama. And there are two electoral responses in very bad economic times. One is to throw the incumbent out; the other is to be so afraid of the unknown that you back the devil you know. It's far too early to predict anything that solid at this point, but these are the considerations I'd put on the table.

Then there's what empirical data we now have:

Barack Obama would beat Rick Perry by 11 percentage points in a head-to-head match up, while Romney would hold the president to a four-point lead, according to a poll released Tuesday by Public Policy Polling.

More to the point:

Obama has widened his lead since PPP’s last poll three weeks ago. Then, Obama led Perry by just 49 percent to 43 percent, and Romney and Obama tied at 45 percent.

The longer the public has gotten to know Perry, the wider Obama's lead has grown. And all the negatives against Obama are baked into the cake. Perry has yet to face a national assault.

Robbie George celebrates its role in the special election:

In the run up to the election, a group of Orthodox rabbis, most from Brooklyn, but including others, notably Rabbi Shmuel Kamenetsky and Rabbi Simcha Bunim Cohen, two nationally prominent Orthodox Jewish authorities, published a letter stating that "it is forbidden to fund, support, or vote for David Weprin."  The reason?  As a member of the New York state legislature, Weprin, despite his Orthodox Jewish beliefs, voted to redefine marriage to include same-sex partnerships.  This, the rabbonim declared, was chillul Hashem—a desecration, or bringing of shame, on God's name. The rabbis went on to say that "Weprin's claim that he is Orthodox makes the chillul Hashem even greater"…The letter from the rabbonim went farther than anything I recall Catholic bishops saying.

Naturally, K-Lo and Maggie Gallagher chime in. I'm sure some generic national factors – the economy primarily – played a role in the Democratic disaster here. But it may not be too wise to extrapolate too much from a population dominated by older, more paranoid Jewish voters and hardcore Orthodox homophobes.

… why did he do this?

One of the trickiest problems in this area in the past was finding the right vehicle to introduce genetically altered t-cells into a cancer patient's body. How awesome that a disabled form of HIV emerged as the most viable way to do this. The results are few and need replicating. But this is a proof of principle – and could help us cure the body of HIV as well.

The old debate – is funding for HIV research hurting cancer research – was always a bit of a canard. The methods developed to tackled AIDS can be and are deployed in many other areas and vice-versa.

Merav Michaeli has Tony Judt's last interview on Israel (recorded just after after the Flotilla raid disaster):

The characterization that comes to mind is "autistic." Israel behaved in a way that suggests it is no longer fully able to estimate, assess or understand the way other people think about it. Even if you supported the blockade (I don't) this would be an almost exemplary case of shooting oneself in a painful part of the anatomy.

Firstly because it alienates Turkey, who Israel needs in the longer run. Secondly because it was undertaken in international waters and largely at the expense of civilian victims. Thirdly because it was an overreaction. Fourthly because it had the predictable effect of weakening the case for a blockade rather than strengthening it.

In short, this is the action of a country which is fast losing touch with reality.

On Israeli fears of a two-state solution:

Israel should be much, much more afraid of the Israel it's creating for itself: a semi-democratic, demagogic, far-right warrior state dominated by racist Russians and crazed rabbis. In this perspective, an internationally policed and guaranteed federal state of Israel, with the same rights and resources for Jews and Arabs, looks a lot less frightening to me.

And on Jewish Americans' changing views of the Jewish state:

The world has changed since 1939. But Israel is a fact and there is no point debating whether it should exist. However, like many, many Jews outside of Israel, I feel a declining sense of identification with the place: its behavior, its culture, its politics, its insularity, its prejudices have nothing to do with being Jewish for me and I know that is especially true of younger Jews, excepting ultra-religious ones. So even if things went wrong for Jews today, I don't think most of us would want to go and live in Israel …

Another perspective, the long one, would be to say that Israel is behaving very much like the annoying little Judean state that the Romans finally dismantled in frustration. This classical analogy may be more relevant than we think. I suspect that in decades to come America (the new Rome) will abandon Israel as annoying, expensive, and a liability.

Jeffrey Goldberg doesn't like Judt's thoughts so much. The reflexive bile is staggering:

What comes through, more than anything else, is Tony Judt's contempt for Jews, his blatant dishonesty, and his support for the radical Arab vision of a Judenrein-Middle East.

Yes: Tony Judt was a lying anti-Semite. And a Nazi who wanted a Judenrein Middle East. Feel better after writing that?

The entire right side of the blogosphere is mercilessly pummelling Bachmann over her "HPV vaccine causes mental disability" nonsense. Here's Dr. Henry Miller at NRO:

Gardasil has one of the most favorable risk-benefit ratios of any pharmaceutical. Having spent 15 years at the FDA and having seen regulation — the good, the bad and the ugly — up close, I am as opposed to anyone (except perhaps Ron Paul) to non-essential government intrusion into our lives. But some interventions are good … I am discouraged by politicians who not only don’t know much about science, technology, or medicine (which is perhaps understandable) but also don’t know what they don’t know (which is unacceptable)

Even hyper-partisan Ace Of Spades takes her to task.