In reading through my collection of news items, I found myself directed to an article in the Daily Mail referencing a new study published in the Canadian Medical Association Journal which reviewed the status of assisted suicide in Belgium.  The study raises some important questions about the policies necessary to allow for an effective assisted suicide program and may fundamentally challenge the idea that such a program can be administered at all.  With “death panels” still fresh in the minds of many Americans, this study is a sober reminder of what’s at stake when we begin to confront the wide expanse of issues related to end of life planning.

To clarify one point right up front: I do favor assisted suicide and would probably vote to legalize the practice if given the chance.  I say probably because I also believe that any acceptable assisted suicide program will require meaningful (state) government involvement to be implemented appropriately, including creating civil and criminal liability for medical professionals who stray too far in blurring the line between euthanasia and murder.

According to the study, of 208 physician-assisted deaths within their study group, 142 occurred with the explicit consent of the patient, while 66 were performed without patient consent.  The study noted that most of the deaths conducted without patient consent occurred in patients over 80 years old who were hospitalized, and the vast majority were patients who were either comatose or who had dementia.  In over 75% of all cases, the decision to end life was discussed with the patient’s family, and in only a few cases was the decision to end the patient’s life discussed with nobody.

The greatest concern has naturally gravitated toward the patients whose lives were ended without having given their express consent.   Such concerns all share in the same core belief that there is something wrong about other people deciding for us when it is time for us to die.  Without a strong principle of restraint, it is easy to see how lives my be ended for medical or political expediency, to help doctors meet bureaucratically imposed death quotas, or to pinch out a population with disfavored political views.

As assisted suicide continues to gain traction in the United States as an acceptable end of life practice, it is important for all of us to think about the practice in terms of our own end of life planning.  Just as we have grown accustomed to “advanced directives” which instruct hospitals and doctors on when to terminate life-saving care, Americans should begin to think about adding some “really advanced directives” concerning if and when it may be appropriate to medically terminate our lives.  For those without a legal directive on record, we should be able to fall back on the experience and policies which, so far, have been mostly successful at balancing the interests of individuals against their prognosis for life.

With a significant number of assisted suicides being performed in the absence of the patient’s consent, the Belgium study points out the need to be clear about our desires at the end of our lives, preferably long before we get there.  With appropriate protections and respect for patient wishes, there is no reason to think that assisted suicide will become a tool of murder against the unwilling.

Ever since his interview with Rachel Maddow, Rand Paul’s comments about the Civil Rights Act of 1964 have been the centerpiece of an unfortunately predictable one-sided conversation that the media appears to be having with itself about how thoroughly racist Paul’s comments are.  Even more unfortunate (though just as predictable) has been the media’s effort to discredit the tea party as racist by emphasizing that Rand Paul is, in some sense, their champion from Kentucky.  Whatever the merits of his position, the entire episode has left us with two important points which even conservative commentators have been tending to ignore.  The first is that nobody who understands Libertarianism will be able to find a racist motive in what Rand Paul said.  The second is that what Rand Paul said had nothing to do with the Tea Party.

Even if nothing else comes of his comments, what Paul has given us is an interesting starting point for a serious discussion about what it means to be a Libertarian.  To begin with, Libertarianism as a political concept is one that we know from Ron Paul’s 2008 campaign is a philosophy which Liberals can’t stand, and Conservatives tend to have difficulty swallowing.  In a nutshell, Libertarians believe that the government should do no more than it absolutely must.  In support of their philosophy, Libertarians tend to be skeptical of any government institution, even those with long and highly praised histories.  Libertarians also tend to be a bit irreverent when it comes to government institutions.  The skepticism certainly grates on the Left, and the irreverence tends to make the Right nervous.

Both traits, however, were certainly on display during the interview with Rachel Maddow.  In this case, the institution is the Civil Rights Act itself — in particular, the bits that make private sector discrimination illegal.  Even the most simple-minded understanding of the interview reveals that Paul has absolutely no love of discrimination in any form.  I find it inconceivable that he would allow discrimination to go on in any business that he owned, and I think it would be interesting to ask if he would frequent businesses which he knew to have discriminatory practices.  Yet, in his skepticism he clearly sees something improper about outlawing private sector discrimination, and in his irreverence he’s actually willing to say so.

However understandable his statement may be within the realm of Libertarian thought, what has been clear for a very long time is the fact that Libertarian thought does not dominate Conservatism, even the “radical” sort expressed by the Tea Parties.  Indeed, from what I’ve observed, the Tea Parties have been willing to mostly gloss over the deep divide between Republicanism¹ and Libertarianism by uniting on the common ground issue of fiscal responsibility in government.  Whether willful or not, the Tea Parties have done an excellent job of staying away from social issues and focusing intensely on the government’s role in the economy.  Were the Tea Parties a social-issues movement rather than an economic-issues movement, I doubt Rand Paul would have enjoyed much success.

In sum, most of the mainstream commentary about the Maddow interview has gotten the core issue predictably wrong.  However, I hope that Conservatives, at least, will look past the immediate spin from the mainstream commentators and use Rand Paul’s comments to think a bit more deeply about the role of government in society.  After all, we will only be able to put off for so long the evil day on which the Republican/Libertarian divide comes to a head.  The Civil Rights Act provides an outstanding starting point for having an adult conversation about the duties and obligations of our government.

1. For lack of a better term.  Think about the kinds of things Sean Hannity, Mike Huckabee, and other prominent Conservative commentators might say to get a feel for what I mean. [↩]

In what one could only wish was an April Fool’s joke, the EPA and NHTSA have released their new standard for Corporate Average Fuel Economy (CAFE) on American automobiles.  Based on the new standards, it appears that CAFE now joins the growing list of government names which don’t actually mean what they say.  Forget fuel economy, CAFE is now all about Carbon Dioxide.

To understand exactly what’s going on, it’s worth a brief history lesson in the history of vehicle output regulations.  In the US, vehicle regulations have essentially taken on two basic forms, one dealing with emissions, and the other dealing with efficiency.  Emissions based regulations focus, as the name suggests, on the chemicals being emitted from the vehicle’s tailpipe, and are designed to eliminate atmospheric pollutants which are directly harmful to human health, believed to cause global warming, or both.  Efficiency regulations, by contrast, are designed to reduce the amount of fuel used by vehicles in light of the fact that petroleum is a scarce resource.

The history of CAFE can be tied pretty much directly to the Arab Oil Embargo of the early 1970s.  At the time, fuel was not a particularly scarce resource, and the average motorist had little reason to be overly concerned about the amount of money being spent at the pump.  Auto makers, accordingly, focused on features that consumers were interested in; things like power and luxury.  This, of course, became a problem when the fuel supply shrank rapidly, causing people to become suddenly conscious of how far they could drive on a tank of gas.  In modern politics, fuel efficiency has been linked primarily to concerns over energy independence and the price of gasoline.

The new CAFE standard abandons that history entirely.  By refocusing CAFE on CO₂, the EPA has transformed an efficiency regulation into an emissions regulation.  Rather than regulating fuel efficiency directly, the EPA is now regulating the number of grams of CO₂ emitted per mile.  To maintain the illusion that CAFE remains about fuel efficiency as opposed to CO₂ efficiency, the EPA has put together a chart showing both grams of CO₂ per mile and the “equivalent” traditional miles per gallon.

The equivalence between Carbon Dioxide and fuel mileage, however, is based on a set of assumptions about how vehicle manufacturers design their cars and trucks.  In essence, it assumes that a standard vehicle emits a certain number of grams of CO₂ per gallon of gasoline.  Unfortunately for consumers who care about fuel economy, there is nothing magical about that number.  Manufacturers could, for instance, install a heavy CO₂ scrubber which adds weight to the vehicle, thus reducing its miles per gallon, even as it drives CO₂ emissions toward zero.  That approach is, in essence, exactly the approach taken to reducing other pollutants to comply with emissions regulations.

At present, consumers have become reasonably conscious of fuel efficiency and consider the number of miles their vehicle will travel per gallon of gas as a factor in buying a new car or truck.  As such, it’s an open question whether this revision to CAFE will have any effect on fuel efficiency overall.  It is important to be aware, however, that the government will no longer be in the business of driving up fuel efficiency.  They have now set their entire focus on carbon.

A post today by Michelle Malkin brings to light an interesting provision of Obamacare which will apparently target funding at racial minorities.  As she details with a good deal of clarity, this would seem to be an invitation for generating illegal racial preferences in healthcare.  While this, itself, is not a violation of the Civil Rights Act (which Congress may modify or ignore at will), it may present a legal conundrum within the world of medicine.  It also reminded me of concerns that I expressed privately months ago about healthcare being used as a vehicle for political preferences; concerns which are now certainly credible enough to be worth active discussion.

While I do not recall when it first occurred to me, I have been concerned since sometime last summer about the possibility that the healthcare bill would eventually be used as a tool to leverage votes for Democrats.  The basic scenario works as follows: When healthcare rationing inevitably begins, funds will be directed preferentially toward states, counties, and cities which routinely vote Democrat.  The more insidious scenario looks a little bit different: Medical records will be paired, secretly or explicitly, with rolls of party affiliation, campaign contributions, and political activism, and those individuals who support Democrat candidates and policies will receive care more quickly and completely than individuals who are opposed.  However unlikely those scenarios seem, neither one is impossible, and the first appears to be already happening.

Regardless of which scenario ultimately plays out, the result is that voters will be placed into a voting system built from a framework of oppression.  While politicians are well known to offer money to favored constituencies, this becomes the first time in America’s history that politicians can literally begin to equate votes to matters of life and death.  Most voters would not find it a difficult choice to select between supporting some policy that they don’t like, or a politician that they would otherwise oppose, when the alternative is that they will not be able to receive a life saving cancer treatment in time.

No neutral observer could call trading votes for life anything other than false liberty.

Strangely, though, this potential avenue for abuse has been almost entirely absent from the debate over health care.  Throughout the entire debate, I can only recall having seen the question show up once, in a survey published by the RNC asking if voters were concerned “that the government could use voter registration to determine a person’s political affiliation, prompting fears that GOP voters might be discriminated against for medical treatment in a Democrat-imposed health care rationing system.”  My vote, of course, would have been (and is) quite affirmative, especially as the full blown public option was still alive and well as a possibility in August when that survey was published.  The flash of furor, though, was apparently strong enough that the impotent GOP backpedaled, said that the question was “inartfully worded,” and tried to re-frame it as being about privacy rather than political gamesmanship.  With the GOP’s apology issued, the issue promptly disappeared from the debate.

But as we are already beginning to see, the GOP was right the first time.  Trading healthcare for votes is a serious issue about which Americans need to seriously engage.  Even liberals, who may think they’re safe with Obama in charge, should be scared of the potential for abuse.  Imagine, after all, if George W. Bush had been in charge of making your medical decisions; imagine the future of medicine under President Karl Rove.  Tying political support to medical treatment is far more dangerous than the financial quid pro quo that Americans have, unfortunately, gotten used to.

Perhaps Michelle discovering this first attempt will finally shed some light on a looming problem that should have been discussed months ago.

All of the major news outlets have been filled with reports of President Obama’s new promise to provide loan guarantees for the creation of new nuclear plants.  The promise comes amid efforts by Obama and Democrats to make forward progress on their effort to impose cap and trade legislation on the energy sector.  Obama’s bid, clearly targeted at Republicans who he feels may be willing to compromise on cap and trade in exchange for nuclear energy, appears to be little more than yet another empty promise by him and his administration.  Republicans should ignore the President’s meaningless promise and continue to oppose cap and trade.

Nuclear power is a source of energy which has been advocated by conservatives and energy producers for years.  Nuclear power offers an opportunity to significantly increase energy production in America, reduce dependence of foreign resources, and meet the politically expedient desire to avoid increasing carbon production.  The economics of nuclear energy are relatively straightforward, involving a significant upfront investment with significant payout over the life of the power station.  This is something that power companies have been ready to jump at for decades, and for which they would have no problem securing funding from the usual private sector debt markets.

Far from economics, the primary problem with nuclear energy has been from the environmental arena.  By citing concerns about the potential danger from nuclear facilities, environmentalists have managed to build a strong NIMBY sentiment in the areas where nuclear power has been considered.  Additional concerns over the disposal of reactor waste have further complicated the issue, primarily because of political resistance to building a properly designed disposal facility.  The regulatory system has further compounded the political issues by developing a process which borders on impenetrable for the approval of permits to construct new nuclear facilities.

By guaranteeing loans for the construction of nuclear facilities, Obama proposes to extend government investment to solve a non-problem.  His position allows him to portray himself as supporting nuclear power to Republicans in hope of winning their support on cap and trade legislation, all without running any risk that new nuclear power plants will actually be permitted.  Obama’s promise is, in short, a ruse to win support from gullible conservatives with no downside for his liberal base.

Republicans should see through and reject Obama’s empty promise.

Over on Time Magazine, Barbara Kiviat asks the question, “Can the Federal Government Really Create Jobs?“  The answer she comes to is a bit surprising, in that it’s as close as I can imagine anyone from a major news outlet other than Fox News will come to saying that Obama is on a fool’s errand with his latest push to create new jobs.  In an article which is compellingly lucid, Ms. Kiviat concludes that “there are few obvious steps for a government looking to create jobs.”  Along the way, she things which are interesting, and which are certainly worth a closer look.

If we want firms to go out and hire, why not give them an economic incentive to do so? This could be done by flat-out paying companies to hire, or by reducing their share of payroll taxes (the money that gets withheld from workers’ paychecks to pay for Social Security and Medicare). Either way, adding a new worker becomes cheaper.

A position such as this one fits extremely well with what we know of the remarkable benefits of reducing taxes on businesses.  As we have seen repeatedly throughout history, lower taxes lead to a healthier and more productive economy.  There is, however, a noteworthy difference between lowering taxes and “paying companies to hire.”

Lowering taxes provides a sustainable benefit to businesses which they can rely on and pass along to employees in the form of greater hiring, higher wages, or to consumers in the form of lower prices.  “Paying companies to hire,” however, provides no such sustainable benefit.  Giving an incentive to hiring may cause a sudden rise in hiring, but it also keeps the tax burden high (indeed, probably higher, to pay for the payments) and encourages companies to hire people for terms which are effectively temporary, only permanent enough to qualify the company for the benefit.  Companies may profit, at the expense of greater noise in the job market and few new long term jobs.

Of course, what is certain is that the Texas approach of raising unemployment taxes is nowhere close to the right answer.  For companies which are already having trouble making payroll, adding additional costs will only further push businesses past the red line and generate further layoffs.  For companies that are uncertain whether or not to hire employees, the greater tax places a definite thumb on the “no” side of the scale as the penalty for overestimating their labor needs increases.

The conundrum: demand in the U.S. is overwhelmingly consumer-driven and people need to have jobs to feel like it’s once again safe to spend money. It’s a classic chicken-or-egg problem. Direct hiring by the government could, theoretically, sidestep the impasse. The question then becomes whether such a program creates more economic benefit than it does economic inefficiency by having the government dictate job creation. Consider that one criticism of the WPA was that it prevented people from moving to jobs where they would have been more economically productive — and actually slowed down the post-Depression recovery.

Much has been made throughout the recession of this so-called “chicken-or-egg” problem being a disaster of contrary incentives resulting in a death spiral to total economic collapse.  At every step along the way, that “conundrum” has been a justification for invasive government action: The only economic rules the federal government needs to follow are the ones that it doesn’t feel like ignoring.  By spending when nobody in their right mind would spend, by hiring when nobody in their right mind would hire, the government is in a unique position to prime the economy.  Or so the argument goes.

But like all good paradoxes, there are two sides to this story.  While the stock market downturn may have been a disaster for people who recently retired or who intended to retire in the near future, it was a boon to a younger generation of investors who are just beginning their economic journey.  In the age old adage of “buy low, sell high,” what better time could there be to buy than at the bottom of a recession?  What better time could there be for hiring than when labor rates are low?

In a free market, one person’s problem is another person’s opportunity.  As prices fall and investment becomes more attractive, new investors enter and prices eventually level off.  As the private sector creates value, that value fuels future growth in the economy.  From future growth comes future jobs, and long term recovery.

The government, by contrast, cannot participate in that process.  They produce no goods and they provide few services. Every dollar the government spends paying its employees came from taxing the private sector; taxing companies which could have given that person a productive, value creating job.  The idea of government hiring to create jobs is a broken window fallacy: Instead of having an employee who makes suits, you merely have an employee.  Nobody is better off.

As the international hyperventilation over swine flu continues, it appears that the disease is now a national emergency.  As absurd as the declaration, and its associated language, are, the stated reason for the declaration now is fairly revealing of different issues with the US government.

According to Jennifer Nuzzo of the University of Pittsburgh’s Center for Biosecurity, the national emergency declaration is “just a precautionary move so if need be we can focus on the care of patients rather than focus on administrative hurdles. In disasters, you often don’t have the time or luxury to keep the paperwork in order. You want hospitals focusing on patients.”  White House spokesman Reid Cherlin echoed this sentiment, stating that “If granted a waiver [under the declaration], hospitals would be freed from some regulations that guide their behavior during normal day-to-day operations.”

To phrase all of that somewhat differently, it sounds as if normal government regulations are getting in the way of doctors and hospitals providing effective medical treatment by default, and the state of emergency is needed to allow patients to be cared for in ways more in line with how medical professionals, rather than government bureaucrats, feel is most appropriate.

If a state of emergency is considered necessary for the management of such a benign illness, that fact alone should raise serious questions about the impact of government regulation during times of normal operation.

Saw an article today saying that the Obama administration may be backing off its push for a public option in health care.  If this is true, it is good news.  But it makes me a bit nervous to see conservatives talking this up as some kind of victory.  As I posted in the comments section of another blog:

Without having done a lot of research, I can think of a few things to consider:

1. Depending on how the thing is set up, there may still be increased federal involvement. One article talks about government insurance whenever there are fewer than two private alternatives, and Schumer has said that he feels any co-op would need to achieve the same goals as the public option.
2. The co-op would probably need to be started by the federal government, probably with federal dollars. As we saw with the car companies, when the federal government gives money away, it thinks it owns the thing it gave money to. How independent is a federally funded co-op really going to be?
3. If these were such a good idea, why hasn’t private industry created its own co-op system yet?
4. The public option is only part of the government’s health care plans. A co-op may kill that, but it won’t keep the government from expanding its reach in other ways.
5. To me, it feels like socialized health care on an installment plan. They reached too far, and are now willing to make concessions and meet in the middle. If this passes, expect the next health care go-around to focus explicitly on single-payer, with concessions to get us back to about what we’ve rejected today.

With the left apparently on the run, now is the time to press the attack.  When fighting Medusa, one does not quit after removing only the first snake.

It took some work for me to find a video of the question posed by Katy Abrams to Senator Arlen Specter which included his response, but the reward was well worth the effort.  Katy’s question is interesting not only for its power (which is obvious enough from the response she got), but because it is the most crystal clear delivery to date of the question Americans should be asking.

At so many of these town halls, citizens are standing up and asking tough questions to their politicians about the proposed health care reforms.  Many come prepared with questions about the House bill, some speak more in general.  There are questions of taxes, of who pays, of what will happen to private insurance, and all of the other details.  These are important questions which must be asked.

What Ms. Abrams asks, though, is a question which is far more important.  She says it herself, that what she wants to know is not just about this, or that, or the other thing.  Her question — the one all of us need to ask — is what any of these things mean for the foundation of the country.  Even if the health care plan was perfect, as Americans and proud believers in constitutional government, we cannot neglect to ask ourselves if the government is acting within its constitutional authority.  As believers in liberty, we must not neglect to ask ourselves if the government is acting within its appropriate role.  If either of those two questions are answered in the negative, then none of the rest even matters.

Senator Specter’s response is telling in a number of ways.

After stammering around for a bit, he offers a platitude about his work defending the Constitution, then instantly changes the subject completely away from health care.  I do not believe, Senator, that however zealously you may have defended the Constitution in the past, that you or any other government official may be excused from defending the Constitution now or in the future, as long as you continue to serve.  The oath you swear is always and everywhere; it has no provision for “I did good last time,” or “I’ll get the next one.”

From there, Senator Specter proceeds to talk about how our “social compact” has a “provision to take care of people who need some help.”  Whatever his “social compact” may be, I guarantee that it is not the Constitution.  Nowhere can I find in the Articles or Amendments a “help those in need” clause.  Not that they needs one, of course.  The Founders knew what history has shown time and again: The best way for a government to help those in need is to stand back and get out of their way.  The people themselves can — should — take care of their own, and that’s what a “social compact” is all about.  It is an agreement of and among the people, far different from a constitution which is a contract between the people and their government.

Our Constitution, of course, is not one that is admitting of government operated health care.  The power to provide health care is certainly not “delegated to the United States by the Constitution,” which means that it must be “reserved to the States … or to the People.” (US Constitution, Amendment 10)  As that language makes clear, it is impossible to uphold and defend the Constitution and support government health care at the same time.

When the government has no authority to do something, the vote should be simple and  clear.  “No.”  The people understand this, and they proclaim it proud and true from every side of the aisle.  But to get the answer, we must do as Ms. Abrams and ask the question.  Defending our freedom is at the pinnacle America’s “social compact.”