Dying at 75

Ezekiel Emanuel has written a somewhat controversial piece in The Atlantic on his hopes to die at the age of seventy-five. He doesn’t hope to be able to live to that age. He hopes he won’t live much past it.


That’s how long I want to live: 75 years.

This preference drives my daughters crazy. It drives my brothers crazy. My loving friends think I am crazy. They think that I can’t mean what I say; that I haven’t thought clearly about this, because there is so much in the world to see and do. To convince me of my errors, they enumerate the myriad people I know who are over 75 and doing quite well. They are certain that as I get closer to 75, I will push the desired age back to 80, then 85, maybe even 90.

I am sure of my position. Doubtless, death is a loss. It deprives us of experiences and milestones, of time spent with our spouse and children. In short, it deprives us of all the things we value.

But here is a simple truth that many of us seem to resist: living too long is also a loss. It renders many of us, if not disabled, then faltering and declining, a state that may not be worse than death but is nonetheless deprived. It robs us of our creativity and ability to contribute to work, society, the world. It transforms how people experience us, relate to us, and, most important, remember us. We are no longer remembered as vibrant and engaged but as feeble, ineffectual, even pathetic.


He does not intent to commit suicide on his seventy-fifth birthday, to be sure.

Let me be clear about my wish. I’m neither asking for more time than is likely nor foreshortening my life. Today I am, as far as my physician and I know, very healthy, with no chronic illness. I just climbed Kilimanjaro with two of my nephews. So I am not talking about bargaining with God to live to 75 because I have a terminal illness. Nor am I talking about waking up one morning 18 years from now and ending my life through euthanasia or suicide. Since the 1990s, I have actively opposed legalizing euthanasia and physician-assisted suicide. People who want to die in one of these ways tend to suffer not from unremitting pain but from depression, hopelessness, and fear of losing their dignity and control. The people they leave behind inevitably feel they have somehow failed. The answer to these symptoms is not ending a life but getting help. I have long argued that we should focus on giving all terminally ill people a good, compassionate death—not euthanasia or assisted suicide for a tiny minority.

I am talking about how long I want to live and the kind and amount of health care I will consent to after 75. Americans seem to be obsessed with exercising, doing mental puzzles, consuming various juice and protein concoctions, sticking to strict diets, and popping vitamins and supplements, all in a valiant effort to cheat death and prolong life as long as possible. This has become so pervasive that it now defines a cultural type: what I call the American immortal.

He will not take any active means to extend his life any further.

Once I have lived to 75, my approach to my health care will completely change. I won’t actively end my life. But I won’t try to prolong it, either. Today, when the doctor recommends a test or treatment, especially one that will extend our lives, it becomes incumbent upon us to give a good reason why we don’t want it. The momentum of medicine and family means we will almost invariably get it.

I must say that I am at least somewhat sympathetic to this point of view. Anyone who has ever watched a loved one growing older into senescence and decay must wonder if longevity is really something to be desired. What good is it to live to be ninety if the last decade is spent chronically ill and miserable? There is also something unseemly and even futile about this quest we have to live ever longer. We cannot be immortal. No matter how healthy our lives, we will die eventually.

If I eat the right sorts of foods and get the right amount of exercise, perhaps I will live to be eighty rather than seventy. So what? Compared to eternity, ten or twenty years is an infinitesimal amount of time. If I ate a diet of bean curd, perhaps I might live to be one hundred. What good is that if I am miserable every day because I am eating food I hate? Of course, I am being a fool. Living in a healthy body is more pleasant than living in an unhealthy body. But, then this is a matter of quality of live as opposed to quantity of life.

For a Christian, it is especially unseemly to cling to this life. We believe, in theory, that this life is only a prelude to a greater life to come. Why cling to the shadow when we can have the substance? Perhaps our attitude should be that of Pope Pius IX on his deathbed. When told that people around the world were praying for his recovery, he jokingly rebuked his advisors saying, “Why do you want to stop me from going to Heaven?”. Why are we determined to stay out of Heaven? Many other religions have similar views.

I don’t quite agree with Ezekiel Emanuel’s position, all the same. For one thing, I do not have the authority to choose the time of my death any more than I had to choose the time of my birth. It is common to say that this is “my body” or “my life”, but it really isn’t. None of us created ourselves. It would take a PhD in several fields to even begin to understand the processes that keep us alive. If any of us were given conscious control of every biological and chemical reaction in our bodies, we would die within seconds. Properly speaking, my body and my life belongs to the One who made them.

Perhaps Mr. Emanuel might agree with me, although I have no idea what his religious views are. As I noted, he does not plan to actively seek death.

This means colonoscopies and other cancer-screening tests are out—and before 75. If I were diagnosed with cancer now, at 57, I would probably be treated, unless the prognosis was very poor. But 65 will be my last colonoscopy. No screening for prostate cancer at any age. (When a urologist gave me a PSA test even after I said I wasn’t interested and called me with the results, I hung up before he could tell me. He ordered the test for himself, I told him, not for me.) After 75, if I develop cancer, I will refuse treatment. Similarly, no cardiac stress test. No pacemaker and certainly no implantable defibrillator. No heart-valve replacement or bypass surgery. If I develop emphysema or some similar disease that involves frequent exacerbations that would, normally, land me in the hospital, I will accept treatment to ameliorate the discomfort caused by the feeling of suffocation, but will refuse to be hauled off.

Surely there is something to be said for this attitude. Yet again, I do not quite agree with him. I do not and cannot know what my ultimate fate will be and it seems presumptuous to decide that after a certain age I am finished. For all I know the plan might be for me to live to ninety-five in reasonably good health. It would be foolish not to take reasonable steps to keep myself well. If one must accept Mr. Emanuel’s reasoning, surely a consideration of overall health and quality of life is a better basis for deciding when to stop getting checkups, etc, than an arbitrarily chosen age. In any case, I will simply take what comes.

Ezekiel Emanuel states that he is opposed to euthanasia or physician assisted suicide, and I see no reason to doubt his word. He does not even recommend that every one agree to his ideas.

Again, let me be clear: I am not saying that those who want to live as long as possible are unethical or wrong. I am certainly not scorning or dismissing people who want to live on despite their physical and mental limitations. I’m not even trying to convince anyone I’m right. Indeed, I often advise people in this age group on how to get the best medical care available in the United States for their ailments. That is their choice, and I want to support them.

And I am not advocating 75 as the official statistic of a complete, good life in order to save resources, ration health care, or address public-policy issues arising from the increases in life expectancy. What I am trying to do is delineate my views for a good life and make my friends and others think about how they want to live as they grow older. I want them to think of an alternative to succumbing to that slow constriction of activities and aspirations imperceptibly imposed by aging. Are we to embrace the “American immortal” or my “75 and no more” view?

He wants medical research to focus on better treatments for the diseases of old age rather than simply prolonging life or extending the process of dying. But, does he not see that he is actually making some very good arguments for euthanasia? He spends the middle part of his article noting that creativity tends to decline with age, even when there is no dementia. The minds of the elderly no longer work as well, just as their bodies no longer function as well.

Even if we aren’t demented, our mental functioning deteriorates as we grow older. Age-associated declines in mental-processing speed, working and long-term memory, and problem-solving are well established. Conversely, distractibility increases. We cannot focus and stay with a project as well as we could when we were young. As we move slower with age, we also think slower.

It is not just mental slowing. We literally lose our creativity. About a decade ago, I began working with a prominent health economist who was about to turn 80. Our collaboration was incredibly productive. We published numerous papers that influenced the evolving debates around health-care reform. My colleague is brilliant and continues to be a major contributor, and he celebrated his 90th birthday this year. But he is an outlier—a very rare individual.

American immortals operate on the assumption that they will be precisely such outliers. But the fact is that by 75, creativity, originality, and productivity are pretty much gone for the vast, vast majority of us. Einstein famously said, “A person who has not made his great contribution to science before the age of 30 will never do so.” He was extreme in his assessment. And wrong. Dean Keith Simonton, at the University of California at Davis, a luminary among researchers on age and creativity, synthesized numerous studies to demonstrate a typical age-creativity curve: creativity rises rapidly as a career commences, peaks about 20 years into the career, at about age 40 or 45, and then enters a slow, age-related decline. There are some, but not huge, variations among disciplines. Currently, the average age at which Nobel Prize–winning physicists make their discovery—not get the prize—is 48. Theoretical chemists and physicists make their major contribution slightly earlier than empirical researchers do. Similarly, poets tend to peak earlier than novelists do. Simonton’s own study of classical composers shows that the typical composer writes his first major work at age 26, peaks at about age 40 with both his best work and maximum output, and then declines, writing his last significant musical composition at 52. (All the composers studied were male.)

Perhaps he does not intend it, but this is dangerously close to valuing individuals not as human beings created in the image of God but on a utilitarian basis according to what they can be expected to contribute to society. If we are going in that direction, we might as well open up the death panels right now. We had also better be honest enough to admit that most of us are not going to contribute very much to the arts and sciences and might be fair game for such a panel at any age.

As for me, I will take whatever comes



I wonder if a lot of the conservatives who written about his article have actually read it.


Hobby Lobby Outrage

Today, the Supreme Court  ruled that a company need not cover contraceptives if it is against their religious convictions. This is a victory for religious freedom in this country, and really for freedom generally. If Hobby Lobby does not wish to pay for their employees’ contraceptives, they shouldn’t have to. If someone wishes to have their employer pay for their contraceptives, they should consider working for a company that does cover them.

Naturally the Democrats don’t see it that way. I have already received fund raising e-mails telling of their disgust and outrage over this decision and asking for money to elect Democrats to make sure it doesn’t happen again. Either they are quick writers, or they had already pre-written their appeals in the event of this decision.

Here is one from Stop the GOP.

Friend — It’s outrageous: Just hours ago, the Supreme Court handed corporations the power to deny women birth control coverage. It’s a sad day for America.

Mitch McConnell’s reaction? He’s gloating, and he just vowed to vote on “limiting abortions if Republicans take control of the Senate in November,” according to Rachel Maddow.

But mark our words: If we let the GOP steal the momentum in the wake of this decision and take the Senate, we will DEEPLY regret it. You MUST stop McConnell and the GOP.

With just 12 hours to go before the most critical FEC deadline of this election, please pitch in to stop a GOP Senate takeover. Your gift will be triple-matched.

Supporter Record: VN96C28FDA1
Mid-year Deadline: 12 hours

If you’ve saved your payment information with ActBlue Express, your contribution will automatically be processed when you click the links below:






Or donate another amount.

Republicans are ALREADY seizing on this ruling to push even more extreme policies.

Their Tea Party candidates are fighting for EVEN MORE radical policies — a COMPLETE ban on some forms of birth control and EXTREME abortion restrictions.

Don’t let them take the momentum and deliver a crushing blow to women’s rights.

Pitch in immediately to fight back against extreme Republicans before the deadline hits in 12 hours.

Thanks for your support,
Stop the GOP

But the Supreme Court didn’t vote to allow corporations to deny women birth control nor was this a crushing blow to women’s rights. They simply said a corporation could not be forced to pay for something that is against its religious convictions. There is nothing to stop a woman, or man for that matter, from paying for their own contraceptives. Hobby Lobby is not preventing them from doing  whatever they want with their own money. Why should Hobby Lobby, or any other company, pay for contraceptives if they don’t want to? Where did these people get the idea that if I choose not to pay for something someone else wants, I am preventing them from getting it?

Here is another, this one from the Democratic Senate Campaign Committee.

Friend — It’s disgusting: The Supreme Court just ruled that corporations can deny women insurance coverage for birth control.

It’s a shameful day for our country. But we CAN’T let the GOP use this to steal the momentum, erase our lead, and take over the Senate. The consequences would be dire.

With just 14 hours to go before the most critical FEC deadline of this election, please pitch in to stop a GOP Senate takeover. Your gift will be triple-matched.

If you’ve saved your payment information with ActBlue Express, your contribution will automatically be processed when you click the links below:






Or donate another amount.

This outrageous decision shows that some Supreme Court justices are just politicians in robes. They’re simply another wing of the Republican Party.

It’s revolting — but if we let the Republicans take the Senate because of this, we’ll never forgive ourselves. PItch in immediately — before the most crucial deadline of the election.

Thanks for your support,
DSCC Breaking News

I am getting just a little tired of the phony outrage these people are always writing about. They seem to be eternally outraged and disgusted by the latest foul deeds and extreme positions of the Republicans, conservatives, the Tea Party, or the Koch Brothers. It has a little of the 1984 Hate Week mentality behind it.

As for what happens next with Hobby Lobby, they have dared to oppose the State and Leader and have resisted the process of Gleichschaltung. I am sure they will be punished for it. I would guess that next year the IRS will find all sorts of irregularities in their taxes. Meanwhile, attempts to drive Hobby Lobby out of business, threats of boycotts, etc. Now might be a good time to shop there.

Team Obamacare

Organizing for Action‘s  Truth Team wants me to spread the truth about Obamacare’s amazing success far and wide.

David —

Here’s an Obamacare number that’s hard to argue with:

1.2 million.

That’s how many Americans have signed up for coverage so far since October, according to new data released this week.

This is exactly why people like us fought so hard for reform for so long — to actually help people get better, more affordable care. These are results worth writing home, or at least on Facebook and Twitter, about.

Share this number far and wide today:

The anti-Obamacare crowd might have more money than our side does, but they don’t have numbers like this. This is great news, and shows we’re definitely moving in the right direction — but we’re not done yet. So while they keep running their messaging wars with deception and scare tactics, there’s nothing better than fighting back with facts like this.

Share the news about these 1.2 million Americans with your friends and family on Facebook:


Or tweet it out:


Seriously, thanks for all your help.


Erin Hannigan
Health Care Campaign Manager
Organizing for Action

They also want me to join Team Obamacare.

David —

It’s almost unthinkable that some people wake up every day determined to take away access to affordable health care from millions of Americans.

But it’s happening. Interest groups have spent almost $10 million against health care reform just this year.

They’re outspending us — but they’re not going to beat us. If you’ve ever cared about health care reform before, you should step up again right now.

Join Team Obamacare, and let’s fight back:




Lindsay Siler
National Director of Issue Campaigns
Organizing for Action

I notice that they are trying to portray themselves as just a plucky little group of activists fighting the big money interests and I have to wonder who they think they are trying to kid. Organizing for Action is just Barack Obama’s campaign team renamed and made over to help enact Barack Obama’s agenda. It’s head, Jim Messina, was Obama’s campaign manager and it’s executive director, Jon Carson, was a White House staffer. The whole operation is practically run from the White House. Maybe they are being outspent, I wouldn’t be too sure about that, but with the kind of connections they have, they really don’t need to raise much money, except to pay the salaries of their top officials.


The Truth Team Tackles the Obamacare Fail

In the latest message that I have received from the Truth Team, they straighten out the lies and misconceptions that so many people have about the recent introduction of Obamacare, especially the silly idea that people are hurting because their insurance plans have been cancelled.

David —

This one’s important:

We’re hearing a lot of hot air out of Washington these days about some insurance plans that are changing — for the better — because of Obamacare. It can be pretty confusing to follow, and some people on the other side aren’t making it any easier by being intentionally misleading.

Let’s be clear: What they’re talking about is the fact that if insurance companies decide to downgrade or cancel an insurance plan that doesn’t include the minimum consumer protections legally required, they must offer you an alternative plan that does include those protections — like the guarantee that you won’t run up against lifetime caps on coverage, you won’t have to pay for preventive care, and you can’t be denied coverage due to a pre-existing condition.

We think President Obama said it best on Wednesday — share what he said with your friends and family and help clear the confusion:

When you boil it all down, the “controversy” here is really about the fact that — thanks to Obamacare — Americans are going to get better, more affordable coverage.

The people who want you to think that it’s some scandal are going to have a tough time explaining it, once everyone knows the facts.

Share the truth about this on Facebook:


Or tweet it out now:




Erin Hannigan
Health Care Campaign Manager
Organizing for Action

When you boil it all down, the very real controversy is that the President specifically said that if you like your plan, you can keep it. That has turned out not to be true. Either President Obama did not know what was in the most important legislation of his administration, or he was lying.

I have noticed that in their defense of these insurance cancellations, the Progressives have been letting the mask slip a little bit to reveal them for the power hungry authoritarians they really are. If your insurance got cancelled it was because they have decided it was not good enough for you. If you want a choice between a cheaper plan that doesn’t cover so much and a more expensive plan that covers everything, well too bad. Your betters will decide what kind of coverage you need.

And again, as I have kept saying, nobody will get more affordable coverage if the insurance companies are obliged to accept anybody with any pre-existing condition and are compelled to offer mandated levels of coverage, whether or not their customers want or need them. If health care reform makes it more expensive for insurance companies to operate, they will have to pass on the costs to their customers, or go out of business. If health care reform increases demand for health services without a corresponding increase in the supply available, health will get more expensive. Barack Obama may believe that he can control the tides. He and the Democrats cannot simply ignore the laws of supply and demand indefinitely.

Update: This is what I was talking about.

Appearing on Piers Morgan’s CNN program on Tuesday night, HBO’s Bill Maher explained that while President Obama did indeed lie to the American people about keeping their insurance, he had to do so in order to help the dumb Americans. “I think the country in general is on a decline,” Maher explained. That’s because, Maher said, Americans are getting “stupider.” And that means that they must be lied to: “It sure is hard if you’re a politician—not that I’m really that sympathetic to them—to try to get information into people’s heads. I don’t think Obama should’ve lied to people…”

Maher then explained that it was insurance companies’ faults that Americans were losing their insurance programs. Then he continued, “But, yeah, he probably should’ve not been so blatant about saying you…iron clad guarantee. On the other hand, since he got no Republican votes and no Republican help. And since three years after it’s a law, they’re still fighting it, can you imagine what it would be like if he said, ‘Yeah, some people, your rates are going to go up.’ I mean the thing passed by this much. If they had said that, they might’ve lost the whole thing.”

I can’t imagine what watching a show with both Bill Maher and Piers Morgan must be like.

Ezra Klein Admits it’s a Disaster

It has become so clear that the introduction of the Affordable Care Act,
or Obamacare, as it has become known, is such a disaster that even
liberals have to admit it. I found Ezra Klein‘s thoughts
on the subject to be more than a little interesting. At least, he
is honest about the problems that have developed and the likely
causes. He does do his share of Republican bashing, though.

1. So far, the Affordable Care
Act’s launch has been a failure.
Not “troubled.” Not
“glitchy.” A failure. But “so far” only encompasses 14 days. The
hard question is whether the launch will still be floundering on
day 30, and on day 45. As Sarah Kliff noted, Medicare Part D was, at
this point in its launch
, also considered a
disaster.”When online shopping for prescription drug programs
launched back in 2005, things went so badly that the federal
government didn’t even get off the ground until three weeks after
its scheduled launch.” Today, Medicare Part D is broadly considered
a success. But Medicare Part D had something the Affordable Care
Act doesn’t: An opposition party that decided
to be constructive
. The federal health-care law’s not
going to get much help from the Republican

Obamacare passed without a single
Republican vote in either house of Congress. Throughout the process
neither Obama nor the Congressional Democrats ever even tried to
get any support from most Republicans. Because they had large
majorities in both Houses, they believed that they need not
consider the Republicans opinions. The problem is that our
constitution is expressly designed to keep any one party or faction
from simply ramming legislation through. The Democrats’ attitude
and the irregularities by which the bill was passed antagonized the
Republicans and between that and their base being against the act,
they were determined not be be constructive. I should note that
President Johnson also
had a large Democratic majority in Congress, yet he
was able to get Medicare and civil
rights legislation passed with substantial support from both
parties. Indeed, Republican support was crucial for the civil
rights acts, since the Southern Democrats were set against them.

2. Are there problems behind the
In the weeks leading up to the launch I
heard some very ugly things about how the system was performing
when transferring data to insurers — a necessary step if people
are actually going to get insurance. I tried hard to pin the rumors
down, but I could never quite nail the story, and there was a wall
of official denials from the Obama administration. It was just
testing, they said. They were fixing the bugs day by

There really shouldn’t be many bugs in the
system. They have had years to plan and implement this. This is not
filling anyone with confidence. I will skip number three and go on
to four.

4. One thing has gone
abundantly right for the Affordable Care Act: The Republican
Their decision to shut down the government on
the exact day the health-care law launched was a miracle for the
White House. If Republicans had simply passed a clean-CR on Oct. 1
these last few weeks would’ve been nothing — nothing at all —
save for coverage of the health-care law’s disaster. Instead the
law has been knocked off the front page by coverage of the
Republican Party’s disaster. Six weeks later, there would’ve been
another opportunity to close the government. And it’s entirely
possible the federal health-care law still wouldn’t be working. At
that point, the Republican Party would’ve had a very good argument
for delay — and certainly a very good argument for delay of the
individual mandate. It would be the logical outgrowth of both their
messaging and the reality of the law. But that’s not what happened.
Instead, Republicans managed to make themselves so unpopular that
they’ve actually
made the law more popular
. Many Americans believe,
reasonably but wrongly, that the reason Obamacare isn’t working is
that the Republicans shut the government down. And if the
Affordable Care Act does begin to improve in the coming weeks
Republicans will have lost their chance to harm it. And it’s not as
if nobody tried to warn the Republican Party that this was exactly
what would happen

All right, gloat.
I don’t think there is much danger of Obamacare getting any more
popular, at least not if many people experience rising costs and
increasing frustration with their healthcare. I am also not sure
how much the shutdown diverted attention from the disaster. It’s
not like the mainstream media would have devoted much coverage to
it. Number five is the important point.

5. This isn’t about
A lot of liberals will be angry over this
post. A lot of conservatives will be happy about it. But it’s
important to see the Affordable Care Act as something more than a
pawn in the political wars: It’s a real law that real people are
desperately, nervously, urgently trying to access. And so far, the
Obama administration has failed them. The Obama administration’s
top job isn’t beating the Republicans. It’s running the government
well. On this — the most important initiative they’ve launched —
they’ve run the government badly. They deserve all the criticism
they’re getting and more.

This is actually the
whole problem. I have never gotten the impression that Barack Obama
is very interested in the day to day job of actually running the
government. In his brief careers in the Illinois State Senate and
the US Senate, he was not too involved with the details of the
legislative process. His colleagues commented that all he ever
wanted to do was make speeches. I know that in politics you want to
beat the other party. This is natural and expected. The idea that
both parties should put aside partisanship and work for the common
good is a fantasy because different people, even with the best
will, have different ideas of what constitutes the common good and
how to obtain it. Nevertheless, at some point you do have to work
together and govern. Obama’s experience as a community organizer
has taught him to divide people and demonize his opponents. It has
not taught him to bring people together or to lead. Related

Americans Love Obamacare

When I first saw the article titled The Truth is, Americans Love Obamacare in the Los Angeles Times, courtesy of Real Clear Politics, I thought that the author, Michael Hiltzik, must be delusional. After all, almost every poll has shown that Americans hate Obamacare, usually by fairly wide margins. As I read the article, I saw that Mr. Hiltzik is not delusional, but instead is displaying the sort of condescension often seen on the left when large numbers of Americans do not support their policies. This is the sort of attitude that leads them to write books called What’s the Matter with Kansas, in which they explain that the people who oppose them simply are too stupid to know what is good for them. Here is the article.

Among the many delusions guiding the Republican campaign against the Affordable Care Act, surely the most consistent is the idea that the public detests the law and is clamoring for repeal.

Here’s the truth: The American public loves Obamacare, with as many as 88% in favor, according to one survey.

How can that be, when polls regularly show a plurality of respondents with an “unfavorable” view of Obamacare? (In a September Kaiser Family Foundation tracking poll, the difference was 43% unfavorable to 39% favorable.)

The answer, of course, is that most Americans have no idea what’s in the law. In the Kaiser survey, 57% said they didn’t have enough information to know how it would affect them. When they’re asked how they feel about specific provisions, however, they’re almost always thunderously in favor.

Here are figures from Kaiser’s March 2013 poll:

Tax credits for small businesses to buy insurance: 88% in favor.

Closing the Medicare drug benefit doughnut hole: 81% in favor.

Extension of dependent coverage to offspring up to age 26: 76% in favor.

Expanding Medicaid: 71% in favor.

Ban on exclusions for preexisting conditions: 66% in favor.

Employer mandate: 57% in favor.

If you agree with those provisions, congratulations: You love Obamacare. Yet when respondents are asked how they feel about “Obamacare,” they’re against it.

The one provision that always polls negatively is the individual mandate. Unfortunately, the mandate is necessary if you’re going to outlaw exclusions for preexisting conditions. Without it, you’d bankrupt every health insurer in the country, because people wouldn’t enroll until they’re sick.

The only possible conclusion from all this is that the law’s opponents have succeeded brilliantly in marketing “Obamacare” as something it’s not, and its defenders have failed miserably at communicating what it is.

But that defines the history of Republican-versus-Democratic messaging over the last couple of decades. It’s the same stunt that brought us “death panels,” or that redefined the estate tax as the “death tax.”

The key moment was the 2010 midterm election, when Democrats ran away from their healthcare achievement as if it were poison, leaving it to their GOP opponents to place their own brand on the law; they should have stood up proudly for their handiwork.

The harvest is today’s government shutdown, which is predicated on the voters’ supposed hatred for a law they actually support.

See? Americans love Obamacare. They are all just too dumb to know it.

Mr. Hiltzik is correct in stating that without the individual mandate, none of the rest of Obamacace works. Insurers do not exclude people with preexisting conditions because they are run by mean people who like to torture puppies and kittens. They might very well be mean people who torture animals, but they know perfectly well that if they didn’t exclude preexisting conditions, no one would bother to get health insurance until they had such a condition. If you are going to make health insurance available to all, you are going to have to make people get it while they are healthy.

It is possible that rather than being fools who have been taken in by the Republican’s brand on the law, the Americans who oppose Obamacare may be quite reasonably concluding that however much they may like certain aspects of Obamacare, they are not willing to be compelled to purchase health insurance, whether they want it or not, in order to gain those parts they like. They may have all too clear an idea of what the law entails. The Democrats who ran away from their achievement might have known a thing or two about what the people thought that Hiltzik has been missing. After all, they jobs depend on how well they know what the voters want.

As for the death panels, I have stated before that death panels are going to have to be part of any healthcare system in which the government provides “free” healthcare. If Obamacare works out the way I think it will, it will not make healthcare more affordable. The combination of increasing demand and stable or decreasing supply will cause costs to skyrocket. If the free market is not used to balance supply and demand through pricing close to the actual costs, than healthcare will have to be rationed by the government or by the providers. This means that people will have to be refused treatments that are not deemed worthwhile, thus death panels. It doesn’t matter if Obama and every single Democrat supporting Obamacare have no intention of ever instituting death panels. The economics of the situation will ultimately demand it.

Defunding Obamacare

I got a message from Organizing For Action.

David —

It’s Friday afternoon and you’re probably not watching C-SPAN, so I want to fill you in on what just went down.

House Speaker John Boehner has handed the reins over to an extreme group of Republicans who are willing to sabotage the economy over Obamacare — and they just got to push their plan through.

We’re 10 days from a government shutdown, and John Boehner just brought us closer to the brink.

This is heading for a showdown — now is the time to add your name to the Americans who are saying, “Enough already.”

We can see that this group in the House is so intent on playing games over Obamacare — today’s vote was their 42nd attacking it — that they’re willing to shut down the government over it.

Maybe John Boehner thinks the American people will just chalk this all up to “how Washington works,” but from what I can tell, we’re smarter than that. At a press conference right after the vote, Speaker Boehner said, “We had a victory today for the American people, and frankly, we also had a victory for common sense.”

Really? It’s not common sense to take away affordable health care from millions of Americans — and it’s definitely not common sense to risk a government shutdown over it.

Congress has until September 30th to work together to pass a budget — and instead of being a leader who finds common ground, John Boehner has put the people with the crazy plan in charge.

He’s basically daring you to fight back.

Add your name to tell Speaker Boehner that we can — and will — hold Congress accountable:


Thanks — more on this soon.


Lindsay Siler
National Director of Issue Campaigns
Organizing for Action

Considering how unpopular Obamacare still remains, I am not sure the people who want to defund it are exactly the extremists. It seems to me that Obama is the one who put the people with the crazy plan in charge. I think there are a lot of people who wouldn’t mind shutting down the government to stop Obamacare.

All the same, I am not sure if the attempt to defund Obamacare is the best way to go about things. The problem is that the Democrats still control the Senate and any bill that passes the House of Representatives which repeals Obamacare will not even be considered in the Senate and certainly will not be signed By the President. It may be the best strategy for the Republicans might be to attempt to change or reform the bill in such a way as to remove the more odious features of the bill. On the other hand, perhaps they should let it go forward. It is only going to get more unpopular as people get to know it better.

It is dangerous, though, to shut down the government. People might learn how useless the government really is.



Free Obamacare!

The Truth team wants me to let all my friends and family to know the truth about Obamacare. Well, I have tried my best.

David —

It’s crazy to think that there are groups in this country whose existence is based purely on hiding the facts about Obamacare from the American people.

So, from time to time, we’re going to call on the Truth Team to fight back by shining a light on the very real, very awesome facts about Obamacare.

This week, we’re talking about how the law is already lowering health care costs for millions of Americans by providing preventive care — without any out-of-pocket expenses. Yup, that’s right — free preventive care in ways that are potentially live saving: FREE annual check-ups, FREE mammograms and other cancer screenings, FREE blood pressure screenings, FREE diabetes screenings, FREE contraception, and FREE vaccinations.

This might not be news to you — but way too few of our friends and family members know about this.

If you’re proud that Obamacare guarantees that health care plans provide this kind of preventive care, share this infographic on all the ways Obamacare is providing care for millions of families:

There’s a reason the other side wants to keep these facts under wraps: When people find out about these benefits, they’re happy about it.

They start to realize that all the hot air about Obamacare might be nothing more than partisanship.

And most importantly, people start to take advantage of the law — because preventive care isn’t about the money saved, it’s about saving lives.

Obamacare is about helping people get the better health care they need — to keep us well by providing preventive care, and help us when we’re sick by lowering what folks spend on doctors, hospitals, prescriptions, and more.

That’s truly great news — and it’s up to us to make sure people know about it.



Erin Hannigan
Health Care Campaign Manager
Organizing for Action

The thing is that none of those benefits are actually free. The recipients may not be paying for them, but someone is. Now, when you are paying for something out of your own pocket, you are naturally concerned about the cost. You might decide you don’t really need that blood pressure screening or that contraception. You might shop around to find the most reasonable deal. If you are not paying for something yourself, you don’t really care what the cost is. Maybe you don’t need that check up, but who cares, it’s free. Maybe your health care provider is overcharging for procedures. Who cares, you’re not paying for it. That is the problem with providing anything for free. People will naturally want more of it that they would if they are paying for it. Economists call this increasing the demand for that good or service.

Under normal circumstances, increasing the demand for a good or service tends to increase the price for that service. As the price increases, demand starts to decrease while the providers of that good or service, sensing profit, will try to produce more of the good or service. Eventually the price and amount produced will reach an equilibrium, until something happens to change the supply or demand.

Under Obamacare, the demand for healthcare will increase, thus causing the price to increase. I am not sure if there will be any real incentive for healthcare providers to increase the supply of services, especially if there is some sort of price cap to control expenses, so there may not be anything that might slow down or reverse the increase in price due to the increase in demand.  Obamacare will not make healthcare more affordable in the long run because it cannot make it more affordable in the long run. You cannot defy the laws of economics any more than you can defy the law of gravity.

To make matters worse, eventually there will have to be some method of controlling costs imposed. As the cost of healthcare increases, it will start to occur to people, even in Washington, that the government cannot spend an infinite amount of money on healthcare. This means that either they are going to have to stop offering free healthcare and start charging something close to the actual cost of each test or procedure, or they are going to have to impose rationing. This means that the government will tell you whether or not you need that blood pressure screening or that cancer treatment. In order to control costs, they may very well decide to deny you treatment if you are old or handicapped. Looking at the matter cold bloodedly, it is difficult to justify spending money on  chemotherapy for a man who is 75 years old. He is going to die within a few years anyway, so why not just fill him with pain medication and let him go?

People mocked Sarah Palin for announcing that death panels would be a part of Obamacare. She was more astute than her attackers. I doubt if anyone who wrote the laws that make up Obamacare ever intended to create death panels, but it doesn’t matter. Something like death panels are going to have to be a feature. The economic logic of the situation makes them inevitable.

So, there you go. I have done as Erin asked and made sure everyone knows the truth about Obamacare.

Some More Thoughts about the IRS

I hope that it will not be the case, but I would suspect that there are some liberals out there who would support the idea of the IRS auditing the Tea Party. If you are reading this and agree with that sentiment then consider if the situation were reversed. What if a Republican administration were targeting liberal advocacy groups for extra attention? You really don’t have to use your imagination; Presidents Johnson and Nixon used the IRS to harass anti-Vietnam War protestors. Using the power of the state to intimidate dissenting organizations is simply unacceptable regardless of party or ideology.

It might be a good idea to consider alternatives to the income tax. Neal Boortz and other libertarians have proposed a “fair” tax, an national sales tax to replace the income tax. I have tended to oppose this since I believe that such a tax would be regressive in nature, placing a greater tax burden on the poor than the rich, not to mention that the political difficulties enacting such a tax would be insuperable. A fair tax wouldn’t be subject to the kind of abuse that the income tax has proved to be and it would not require individuals to provide personal information about their finances that the income tax does. There may be other alternatives to consider.

The IRS is expected to play a major role in implementing Obamacare. According to Americans for Tax Reform

When Obamacare’s individual mandate takes effect in 2014, all Americans who file income tax returns must complete an additional IRS tax form.

The new form will require disclosure of a taxpayer’s personal identifying health information in order to determine compliance with the Affordable Care Act’s individual mandate.

As confirmed by IRS testimony to the tax-writing House Committee on Ways and Means, “taxpayers will file their tax returns reporting their health insurance coverage, and/or making a payment”.

So why will the Obama IRS require your personal identifying health information?

Simply put, there is no way for the IRS to enforce Obamacare’s individual mandate without such an invasive reporting scheme.  Every January, health insurance companies across America will send out tax documents to each insured individual.  This tax document—a copy of which will be furnished to the IRS—must contain sufficient information for taxpayers to prove that they purchased qualifying health insurance under Obamacare.

This new tax information document must, at a minimum, contain: the name and health insurance identification number of the taxpayer; the name and tax identification number of the health insurance company; the number of months the taxpayer was covered by this insurance plan; and whether or not the plan was purchased in one of Obamacare’s “exchanges.”

This will involve millions of new tax documents landing in mailboxes across America every January, along with the usual raft of W-2s, 1099s, and 1098s.  At tax time, the 140 million families who file a tax return will have to get acquainted with a brand new tax filing form.  Six million of these families will end up paying Obamacare’s individual mandate non-compliance tax penalty.

As a service to the public, Americans for Tax Reform has released a projected version of this tax form to help families and tax specialists prepare for this additional filing requirement. Taxpayers may view the projected IRS form at www.ObamacareTaxForm.com.  On the form, lines 3-4 show where taxpayers will disclose their personal health ID information.

With the recent revelations concerning the IRS, do you think you can trust them to keep your personal health information secret? What if whatever bureaucracy that is set up to administer our health care system becomes politicized? It is not too difficult for me to imagine a situation in which members of a death panel, or whatever they are going to call it, make decisions on who gets on the organ transplant waiting list, or who gets chemotherapy, based on political affiliation. But, maybe I am just being paranoid.


The Grownup


Here is a clip of that dangerous Tea Party extremist Paul Ryan explaining to Barack Obama that given the fact that we can’t afford our current entitlements, adding a huge new entitlement program like Obamacare might not be a good idea.


Obama clearly doesn’t like what he is hearing. It is a strange world we live in if asserting that 2 plus 2 does always equal 4 gets you labeled as an extremist.

On that note, the latest edition of the Truth Team deals with the lies that Paul Ryan has been saying.

#1 Ending Medicare as we know it
Romney and Ryan are committed to a plan that would end Medicare as we know it. They would create a voucher system that would increase seniors’ health costs. Ryan even proposed a plan, which Romney endorsed, that would increase costs for seniors by $6,350 a year. To cover for their own plan, they have been distorting the President’s record. They have labeled the $700 billion that Obamacare saved from trimming excessive payments to corporate insurance companies as “Medicare cuts.” That’s false, as Paul Ryan should know — he includes these savings in his own budget. Check out this video of Florida voters responding to the Romney-Ryan plan to end Medicare as we know it to pay for a tax break for millionaires and billionaires, and share it with others:

Medicare is going to have to be ended as we know it or it won’t be there at all. Right now the program is unsustainable in the long term and even in the medium term. If action is not taken soon the money to fund it just won’t be there. The Chinese have problems of their own and won’t be willing or able to lend us money we can’t pay back forever. If the Democrats don’t like Paul Ryan’s plan, then where is their plan? At least he has a plan. The Democrat controlled Senate hasn’t even passed a budget in three years. There are few Republicans willing to face the fact that we are headed toward the abyss. So far, I haven’t seen any Democrats at all who are willing to acknowledge the problem and act like adults to solve it. Instead, they just make commercials showing Paul Ryan throwing an old woman off a cliff.

It would be nice to have two parties trying to solve our problems.


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