New Medicare Regulation

In the AM my Middle Brother sent me an article from The San Jose Mercury on a Medicare Health Regulation "to encourage end-of-life planning".  This under-the-radar bureaucratic switch was bound to cause some comment when it finally surfaced.  And it did.  Both the Instapundit and Ann Althouse posted on it.  The report from Professor Reynolds is quick, but the discussion from Professor Althouse is long and deprecating and insightful and a good read.

Earlier today I wrote back to my Brother with my own thoughts.  (Why, yes, I did take the opportunity to correct some of my more egregious mistakes.)

I am not in the least worried about this item, except for two small points.  The first is that it is terrible that we need a regulation for a physician to consult with his or her patient about something so important, especially considering the suspicion on the part of some of us that physicians have been helping folks slip across the bar for many, many years.  This regulation mentality means that there are so many rules out there that the physicians either don't know them all or are spending too much time on them and thus neglecting their patients.

My second concern is that the Executive Branch is using regulations to achieve what cannot be achieved in the legislative process.  How does that play to separation of powers? Not well, I would think.  Does this mean that we, like the Europeans, think that bureaucrats in the capitol are smarter than the legislators?  That would be a bad path to go down.

This goes to the fact that what is great about federalism is that it accommodates the idea that we are not all alike.  What is seen as good social policy in Oregon is not necessarily seen as good social policy in Indiana.  Sure, the folks in Indiana may be idiots, but that is the beauty of democracy.  You are allowed to be an idiot, and to vote that way.

But, my concern focused on this regulation itself is not this regulation, but rather the one that comes after it.  What will that one say?  The drift from considering the idea of useless eaters to doing something about it is not a sure thing and it can take a couple of decades, but do you think the folks who accepted, in 1920, the idea of "Life Unworthy of Life" (as the book was titled), by 1943 or 1944 or 1945, wished that they had stood up and said "bad idea"?

When I became a member of the Cadet Wing at the Air Force Academy, in the summer of 1960, the Honor Code was pretty straight forward..."We Will Not Lie, Steal Or Cheat, Nor Tolerate Among Us Anyone Who Does".  In the day there were no exceptions.  Break the code and you were expected to resign and go home, as did one of my roommates.  Enforcement was not administrative but by the Cadet Wing, through silencing.  That meant none of your classmates would talk to you, except in the performance of official business.  It could be endured, but it would be tough.

But, by 1963 we were more enlightened and understood that people make mistakes and that someone who turns himself in for breaking the Honor Code might be more honorable than someone who doesn't and just stays out of trouble.  Plus, there were young men coming in from environments where lying, cheating and stealing were a way of life—kids in off the streets.  Thus, we introduced "discretion".  It only existed for the first semester and we were promised by those who proposed this—the Honor Committee—that this would be a one time thing and would not be taken any further.  But, within a couple of years it was taken further and now "discretion" extends further into the four years and the sanctions have changed from silencing by one's fellow cadets to disenrollment approved by the Superintendent of the Academy.  Things drift.

And there is the real danger.  To me, the term "progressive" is sometimes like the term termite.  It is an inevitable eating away.  Not always, but who knows which cases?

But, I have no strong feelings on this particular regulation, aside from asking why it is needed in the first place.

Regards  —  Cliff