Austin-tatiously Disingenuous

Years ago, my old friend Moonbeam Birkenstock – who is much farther left than I am to the right – announced, with great noise and fury, that he was through paying the portion of his taxes to the Feds that went to defense.

“I refuse to contribute to the US military, which exists only to murder children and bomb innocent people” bellowed Birkenstock as we talked at a party.

I grinned a smug grin, pulled a pocket-sized copy of the US Tax Code from my pocket, and announced “You are teh LIER!!!  Nowhere in the IRS Tax code can you find a single reference to rifles or bombers or bombs or any sort of military hardware at all!”.

Moonbeam pulled a can of mace and gave me a long, wet blast in the face.  And as I coughed and hacked and wiped tears from my eyes, I knew I deserved it.


Eric Austin is a liberal blogger from somewhere in central Minnesota.  We’ve run into him before – in one case, admitting in an audio passage that he condoned the bullying of the child of a conservative legislator because, in his words (seriously – follow the link and listen to the audio, if you can stomach it – it may be one of the most vile, reprehensible things I’ve ever heard) her mother had voted against a bill making bullying gay kids extra special illegal.

But that was then.  This is now.  Perhaps Austin’s rhetoric has improved with time and maturity?


Local conservative layabout, Gary Gross, has been churning out quite a few posts since the Supreme Court ruled that the Affordable Care Act is, in fact, Constitutional. Any one of those posts could be the subject of another episode of Gross Inaccuracies but who has the time to keep up with a single childless unemployed blogger who lives off the government he loathes.

OK, ixnay on the whole “improvement” and “maturity” thing,  I’d say I’m curious how Mr. Austin thinks this sort of ugly, personal name-calling advances his, or any, argument…

…but I’m not curious.  It’s easy.  The fact is, it’s incredibly easy for Minnesota liberals to grow to what passes for “adulthood” these days – through their feminized public schools, a university system that marginalizes and expunges conservative dissent from the dominant narrative, and a media that accepts liberalism as the baseline for good and, via its leading figure Jon Stewart, “snark” as its main rhetorical cudgel – without having the foggiest idea how to debate a conservative, or even what real civilized debate is.

Which is why most liberals’ “arguments” start with ad hominem and tu quoque (“Look! My opponent said or did something that is inconsistent with something else he says or does!  That invalidates his entire argument!”) and proceed through…


Today’s episode of Gross Inaccuracies concerns the most ludicrous of these most recent posts about how terribly awfully no good it is to now have Romneycare (oops, I mean Obamacare). Gross fawns over an exchange on Fox News between Sarah Palin and the token Democrat on the show about how there really are DEATH PANELS in the Affordable Care Act.

Here is the relevant part of the exchange from Palin:

There’s a faceless bureaucratic panel and the acronym is the IPAB and the I-P-A-B, what that will be is that is a board that will tell you, Bob, whether your level of productivity in society is worthy of receiving the rationed care that will be the result of Obamacare.

Now there is a board called the Independent Payment Advisory Board but its purpose isn’t anywhere close to what Palin suggests. The duty of the board is to find ways to keep Medicare spending from growing out of control. However, one of its provisions specifically states that it may not recommend “rationing” care.

Right.  So – like my friend Moonbeam Birkenstock in the example at the top of this post, Palin has completely botched the entire factual basis of the argument…

…well, no.  She has assigned a role to one piece of the bureaucracy that will be practiced by another piece of the bureaucracy.  It might be a government agency, or as Austin notes from the mandate tax law…

From the Affordable Care Act:

‘‘(ii) The proposal shall not include any recommendation to ration health care, raise revenues or Medicare beneficiary premiums under section 1818, 1818A, or 1839, increase Medicare beneficiary cost- sharing (including deductibles, coinsurance, and co- payments), or otherwise restrict benefits or modify eligibility criteria. [emphasis mine]

So what this means – if you accept it at face value – is that the law will not deal, in and of itself, with rationing.  That can is being kicked down the road.

Which brings us to a key fact of this debate, one that Obama and Obamacare’s supporters either don’t know or don’t want you to know.  It’s true that there will likely never be a room somewhere in northern Virginia with a brass plate on the door engraved with the title “Death Panel Conference Room”, and that nobody in whatever bureaucracy takes over Obamacare will have “Death Panelist” on their job description.

But in modern health care insurance parlance, the term you look for is “Case Management” (sometimes “Care Management”).  The term was spawned in the eighties, in the HMO industry, to cover the intersection of insurance, medicine and actuarial science.  And it’s the part of the health care insurance industry that goes through the utterly rational process of answering the question “if we have one transplantable liver, do we give it to the 43 year old guy with the curable degenerative enzyme disorder whose productive life expectancy will be increased by (on the average) ten years, or do we give it to the 70 year old chain-smoking diabetic alcoholic who has already run past her life expectancy given her current state of health”

To the 43 year old who gets the liver, it’s how the system works.  I suspect to the family of the 70 year old, the body that made that decision could be viewed as a “death panel”.

The facts, however, are…:

  • Neither the ACA nor Medicare nor Medicaid will need to “Create” any such “panels”, because Case Management has been a fact, and a key part, of health care insurance, for three decades now.
  • As Governor Palin notes, as the side-effects of the ACA drive more physicians from the industry and raise the cost (in terms of scarcity versus demand) of many of the more dramatic procedures, “Case Management” (a much drier and less dramatic term than “Death Panel”) will need to decide more and more who will get first crack at the limited supplies of medical miracles – livers, chemotherapy, hours on dialysis machines, whatever – and who will get “Palliative care” to make the slow degeneration to death (or disability, or whatever the end result of the condition being treated, liver disease, cancer, kidney failure or  actually is) more tolerable.
  • Lest you missed it, this is a fact of life in the health insurance business today.   The difference, of course, is that most people can find alternate paths to treatment today; there’s more than just the one, government, path to the treatment they need, if the insurance industry gives them flak.  When private insurance is inevitably priced out of the market – as it will be after a few years of Obamacare undercutting them with losses underwritten by taxpayers – then there’ll just be one avenue for getting care.  That’s it.

While Palin continues to use a lie that has been repeatedly debunked by fact checking organizations and was even named the Lie of the Year by one,

Not by “one” – by “Politifact”, which has been pretty well shown (via the “Lie of the Year” canard and some even more egregious episodes) to be less a “fact checking” organization and more a Democrat propaganda mill.

Austin takes issue with Gross’ explanation of the various bureaucratic roles involved, and reaches some conclusion:

Let’s take a couple things here, Gary. First, the Independent Payment Advisory Board doesn’t look at any “individuals” but rather looks at the Medicare system as a whole and it explicitly states in its mission that it shall not recommend “rationing” health care. Second, the phrase “quality adjusted life years” is not used ANYWHERE in the Affordable Care Act.

This, Austin calls a “lie”.  At the most, of course, it’s an “error” – “Lying” requires some intent to deceive.

And, like my friend Moonbeam at the top of the story, the only immediate error (or, if you’re a liberal talking about a conservative, “lie”) is in mixing up different layers of administrators.

Sophistic niggling about different layers of the bureaucracy is the kind of thing that sends tingles up law students and bureaucracy-nerds’ legs.  But in terms of the actual effect of Obamacare on real people, they’re all distinctions without differences.  They are all parts of a system that will, inexorably, lead to increased shortage, hiked costs and diminished availability.

Which will be arbitrated by some body, somewhere.

And you can call it a “Case Management Process”, a “Death Panel”, or a “Happy Time Commission” for all anyone cares.  The result in terms that real people, real taxpayers, care about is always, and can only be, the same.

And with those immutable facts in place, I suppose responding to dissent with snark and ad-hominem is better, to some, than just admitting you’re wrong and addressing that whole “why do you promote the bullying of children?” thing.

14 thoughts on “Austin-tatiously Disingenuous

  1. Here is WaPo’s “fact checker”, Glenn Kessler, on Palin & IPAB:

    Palin is seizing on a completely different entity to justify her provocative use of the phrase “death panel” three years ago. But the IPAB in no way resembles the “death panel” that she claims would decide whether her parents or her baby with Down Syndrome are worthy of care. Instead, it is a tool—subject to oversight and approval by Congress—to try to rein in the soaring cost of Medicare.
    Words have consequences, and Palin is fooling herself if she thinks she can justify such inappropriate terminology to describe an effort, however imperfect, to address a serious problem that politicians on both sides of the aisle say they want to solve.

    So where is the lie? Where is Palin wrong on the facts?
    This is clearly a difference of opinion. This is at the end of the piece, in the section titled “pinocchio test”, and Kessler can only accuse Palin of using “inappropriate” and “provocative” terminology.

    The first bullet point in Kessler’s “Statement of Principles” for his fact-checking column is “This is a fact-checking operation, not an opinion-checking operation. We are interested only in verifiable facts, though on occasion we may examine the roots of political rhetoric”.

  2. The very fact that the IPAB is “…subject to oversight and approval by Congress…” certainly fills me to the very brim with confidence as to its efficacy, honesty and fairness.

  3. I wonder if libidiot Austin has:
    1. followed the marching orders of his dear leader and purchased his health insurance?
    2. a regular doctor, has he asked that doctor, is he staying in the profession?
    3. an elderly loved one that may become a victim of the rationing that will definitely come.
    4. ever had an original thought.

  4. I do try to avoid name-calling. so I’ll just answer the questions to the best of my ability (although Eric is certainly invited to answer for himself):
    1) He gets insurance through his work. And I’m going to guess that his particular union is going to get a big fat exemption from Obamacare.
    2) Don’t know, but the lefties do have a ready supply of doctors who just love Obamacare.
    3) Good question.
    4) Even better one.

  5. Bureacratic abuse is inherent in this type of system. In the UK one of protocols is the “Liverpool Care Pathway.”

    While it is described as, or intended to be, a palliative care approach, it is regularly used to shunt expensive or difficult older patients to terminal treatment on a doctor’s orders. Now, palliative care is a smart and ethical option for terminal patients. My father and our family chose it in his last days, as did my uncle and his family a few months ago. The thing is, the doctors and staff presented it to us as an option and made sure we knew what it meant, and the decision was totally (and sensitively) left up to us. (It is also why you should have a Healthcare Directive). In Britain, the call is made by doctors or hospital boards, regardless of what the patients or families want.

    One stat I saw indicated some 130,000 patients in one year in the UK terminated under the Liverpool Care Pathway. As in the US, I’m sure most were happy to have the option. Another percentage, however, had no choice. You only need to look up the Charlotte Wyatt case for an example of the institutional mindset, or read the “I dont want to go on the cart” piece I wrote a few years ago with the invaluable assistance of the Monty Python troupe:

  6. What the NHS does is no different than what HMO’s do as Mitch pointed out. And when you ask a lefty how the IPAB will be any different you get crickets.


  7. About a week back I got a letter from my doctor saying he was leaving the clinic to “pursue other options”. My clinic is Park Nicollet. My doctor was slightly older than me (late 50s). Considering what Park Nicollet will be forced to do to maintain a profit margin (I.E. work their doctors like plow horses), I’m sure this was just an amazing coincidence.

  8. Hubert Humphrey swore up and down the Civil Rights Act would not lead to hiring and admissions quotas for Blacks. He was right – they’re not quotas, they’re “goals” which are filled by “affirmative action” and “set asides.” No quotas, no sir. Not one quota. Yet amazingly, the more we obscure the wording, the more remarkable it is that the result is the same.

    So, too, when Obamacare is implemented there will be no Rationing, there will be Allotments. There will be no Death Panel, there will be a Care Committee. But the result . . . .

  9. Austin has always liked to be a thorn, but remember when he and some others on the left started a new blog until one named “Snark” proceeded to disparage every Democratic candidate for Governor in 2010? Their blog was quickly taken down and Austin apologized and said he was out of politics and blogging and took down his own personal blog. That lasted for about 45 days where he archived his old blog and opened a new one under a different name. He just can’t help himself.

  10. Kermit, that is the reason that I raised the question for Mr. Austin. My Doctor, who is 3 years younger than I am and is the best Doctor that I ever had, told me shortly after Obumblercare was passed, that he was planning his exit strategy. It seems that, unlike the morons that approved it, he and several of his colleagues actually read all 2,005 pages of it. When I went for my physical in April, he told me that he and those same colleagues were ready to leave the profession if SCOTUS ruled incorrectly.

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