Planning the Patient-Centered Health Plan for America


Current Issue:

Making health care free

Senator George: There is an increasing push to make health care Free-For-All!

Senator James: Why is this discussion even coming up? Isn’t health care the most expensive item in our budget?

Senator Franklin: Because of the liability of huge cost that Americans can’t pay.

Senator George: Insurance should be focused on covering those huge rare costs, not the usual costs that are less expensive when no run through an insurance company.

Senator Franklin: How would such a health insurance company differ from the standard health insurance coverage?

Senator James: It’s call high deductible health insurance. These policies are less than half of the standard health insurance policies.

Senator Franklin: How could we force individuals to purchase such a policy?

Senator George: If we would advertise these policies, people would purchase them. Everyone knows that huge hospital and surgical bills is a common cause of bankruptcy.

Senator James: No one wants to experience bankruptcy. When people spend their own money they are very cautious.

Senator Franklin: But the government makes it free and so they don’t have to worry about this.

Senator George: Doesn’t it cost the government a lot of money?

Senator Franklin: The people pay taxes which covers our costs in the Senate.

Senator James: Let’s just back up a minute and take a hard look at the cost. The Senate is frequently looked on the Rich Man’s Club. We don’t manage the people’s money for nothing. We get well paid and have a huge staff that helps us that have to get paid. We have to pay the doctors to take care of the patients. We have to pay the hospitals which are a super high rent enterprise. We have to pay the nurses that work in the hospitals and make the home care visits. We have to pay the pharmacies that deliver the medications to the hospitals or to the patients. We have to pay the physical therapists, occupational therapists, respiratory therapists that take care of the patients that we force to be discharge early so that they can be treated at a lower level of care. We have to pay the nurses that do the discharge planning on every ward in every hospital to keep the doctors on their toes and push them to discharge their patients ASAP.

Senator Franklin: But we cut the fees that doctor’s charge, we cut the hospital charges. In fact the CMS cuts everyone.

Senator George: Do you feel that all these health care people that we cut involuntarily are happy with us?

Senator Franklin: Should we care?

Senator James: I think we better. There always comes a day of reckoning.

Senator George: I’m sure the Feudal Lords of Europe thought they were sitting in the catbirds seat and nothing could dislodge them. And then America was discovered. And their oppressed subjects established and migrated to this land of Freedom.

Senator James: America was the grandest experiment in human freedom ever. This has caused a prosperity that the world has never known existed.

Senator Franklin: I don’t think there is another land on the face of the earth that Americans could escape to.

Senator George: You’re right about that. But the Americans could vote you out of office and free themselves from the tyranny of Washington.

Feedback . . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .

What is Congress Really Saying?

Previous Issue:

The Regulation of Doctors

Senator George: It appears that our regulation of Doctors, Hospitals, and Insurance companies has not reduced health care costs. What are we missing?

Senator James: You suppose we are over regulating?

Senator Franklin: We should be able to proceed on our present course and eventually reach the point where the goose no longer can lay those expensive golden eggs.

Senator George: But I understand that no goose continually lays golden eggs. The majority are still eggs with an ovum producing new geese which are resistant to our regulations.

Senator James: Or are smarter than we.

Senator Franklin: We should be able to put a noose around the medical profession and cut their money so low that they don’t have a choice.

Senator George: Isn’t it the hospital charges that are killing Medicare?

Senator Franklin: The hospitals can’t charge Medicare unless the doctors do the prescribing.

Senator James: So how are you going to keep the doctors from ordering tests and prescribing medications?

Senator Franklin: There will come a point in continued tightening the noose around the doctors so tight that they will feel the noose tightening with every expensive test they order.

Senator George: Come on Frank. Let’s be rational. Aren’t you being vindictive? Or even being cruel?

Senator Franklin: Come on yourself, George. How else are you going to knock the Prima Donna Profession down a few notches?

Senator James: I don’t think you like doctors. Who will be the captain of the health care team?

Senator Franklin: Isn’t that the real problem? Doctors think they’re in charge of health care. Not only are they expensive, they are also rich.

Senator James: Who else would you like to have in charge of your life/death struggle should you have to be hospitalized?

Senator Franklin: There are a lot of other folks around. When I make an appointment with my doctor, I frequently see a Nurse Practitioner or a physician assistant.

Senator George: Do you think they are about equal in providing quality of care?

Senator Franklin: I think they’re about on the same level. In fact my Nurse Practitioner will order more tests than my doctor will. Now isn’t that checking me more thoroughly?

Senator James: Goodness, have we come around the bend. A few moments ago when we started this topic, you’re entire approach was that doctors spend too much on ordering tests, x-rays, etc. Now when a lower level of care orders more tests, you think that is beneficial.

Senator George: So when a doctor spends money on more tests on the public, they should be regulated more harshly. But when a PA or NP orders the tests that just means better healthcare.

Senator James: At least if Frank gets the extra tests.

Senator Franklin: You guys just don’t understand the big picture. We’re talking about the overall cost.

Senator George: But isn’t the overall costs simply the sum of all the individual parts?

Senator Franklin: I was talking about the individual parts that doctor run.

Senator James: Looks like we’ve left the world of logic and rational thinking.

Senator Franklin: Yes, we have if you don’t think doctors are the problem with healthcare in the United States.

Feedback . . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .

What is Congress Really Saying? What don’t they understand?

Previous Issue:

TAX/SPEND/REGULATE vs LIBERTY/FREEDOM

Between a TSR senator and a Liberty/Freedom Senator

Senator LF (Liberty/Freedom): You have given doctors the legal right to extinguish the life of their patients. Are you pleased?

Senator TSR (Tax/Spend/Regulate): Certainly. Isn’t that the humanitarian thing to do?

Senator LF: To give anyone that right is not protecting the poor and disadvantaged.

Senator TSR: Who else should we give that right to?

Senator LF: Why should anyone have the right to take another’s life?

Senator TSR: But the patient requested it.

Senator LF: Doesn’t that open up to abuse the taking of one’s life or even helping someone to take his own life?

Senator TSR: I think we have taken the appropriate safeguards to have another physician also approve this.

Senator LF: That just mean that two people have to agree to this suicide, which should be rather easy to do and then basically make two physicians accomplists.

Senator TSR: But doesn’t that protect the patient?

Senator LF: Well no. I’ll venture to say that there are more than two people that would love to see you dead. Am I correct?

Senator TSR: You’re making me very nervous. There are a lot of people that don’t like me. But do they want to see me dead?

Senator LF: They certainly wouldn’t want to risk their freedom and a prison term for direct involvement. But don’t you think there are more than two that would love to get rid of you if prison were not a possibility?

Senator TSR: Don’t we all make enemies during our lifetime?

Senator LF: I think we do. But the challenge is to get through life with the fewest enemies.

Senator TSR: I guess you’re right. They could hurt you.

Senator LF: And if you got sick, maybe kill you.

Feedback . . .
Subscribe to HealthPlanUSA . . .
Subscribe to MedicalTuesday . . .

What is Congress Really Saying?

Previous Issue:

TAX/SPEND/REGULATE vs LIBERTY/FREEDOM

Between a TSR senator and a Liberty/Freedom Senator

Senator LF (Liberty/Freedom): Now that Obama Care has been implemented, and I understand you voted for it, do you still feel that you have advanced the freedom of the American People?

Senator TSR (Tax/Spend/Regulate): Senator, you have couched your question in a self- incriminating manner. I should plead the fifth. We have given the American people what they have wanted for nearly a century: never having to worry about their healthcare.

Senator LF: But now as Obamacare has been implemented, many patients aren’t enjoying this freedom not to worry. Many can’t find a health plan that they can afford or a physician that accepts Obamacare.

Senator TSR: We have accomplished the very best possible plan.

Senator LF: If the very best plan that we politicians have devised doesn’t improve healthcare, wouldn’t we have been better off to let the former system be continued and revised as necessary?

Senator TSR: But senator, everyone was unhappy with the prior system.

Senator LF: With nearly everyone being really unhappy with the new Obama system, what have we gained?

Senator TSR: Haven’t we accomplished achieving universal health care?

Senator LF: With 25% to 35% of doctors not accepting Obamacare, isn’t that even worse than the prior system of the 25% to 35% being uninsured?

Senator TSR: But look at what we have accomplished, those 25% to 35% now have insurance?

Senator LF: The latest estimate is that 25 to 35 million Americans will still be uninsured when Obamacare is fully implemented.

Senator TSR: I can’t believe that will be true. It just doesn’t make sense.

Senator LF: Canada is very proud of having 100% of its citizens covered by their Medicare. But they don’t have access to healthcare.

Senator TSR: It they are covered by their Medicare Plan, what do you mean they don’t have access to healthcare?

Senator LF: Senator, don’t you read the papers? People are dying in Canada while suffering on waiting lists waiting to be seen.

Senator TSR: But their politicians have given them universal coverage. That’s all that we politicians can do, isn’t it?

Senator FL: Maybe, but aren’t you confusing universal coverage with universal access?

Senator TSR: When we give the American People universal health care, that should cover everyone, doesn’t it?

Senator FL: Well, no. It doesn’t. Obamacare has been dumping many of the poor and helpless and homeless on Medicaid into HMOs under the pretext of giving the poor health insurance. Many doctors felt an obligation to have a certain percentage of their practice be on Medicaid patients as an act of charity. When their Medicaid patients became HMO type of patients they were inundated with so many new rules and regs that they stopped seeing their self-imposed quota of Medicaid patients. This caused a greater loss of access even though we patted ourselves on the back for giving them insurance. Then these same doctors would no longer see Medicaid referrals, which many consultants did out of courtesy to the referring physician. Hence, these former Medicaid patients were given a double whammy: Loss of their personal physician and loss of specialty care. How do you see us as having universal health care when so many don’t have access to care?

Senator TSR: I’ve never heard of anyone complaining as you have stated.

Senator FL: Then you may not have heard of the law suit in Canada where a patient was in great pain from hip arthritis and after two years brought suit against Canadian Medicare. It went all the way to the Canadian Supreme Court which sat on it for over a year before they were finally had to admit that this patient had a case and then ruled: Canada does not have universal healthcare, they only have universal access to a waiting list.

Senator TSR: Then maybe we need another LAW: Force doctors to see Medicaid patients?

Senator FL: Wouldn’t that be involuntary servitude? Didn’t our forefathers come to this country to escape that sort of bondage? Why do you want to revert to a past from which we escape for the most advanced freedom that human beings have ever experience?

Senator TSR: Maybe Hillary Clinton was right: American’s have too much freedom.

Feedback . . .
Subscribe to HealthPlanUSA . . .
Subscribe to MedicalTuesday . . .

What is Congress Really Saying? Or do they even know what they are doing?

Previous Issue:

TAX/SPEND/REGULATE vs LIBERTY/FREEDOM

Between a TSR senator and a Liberty/Freedom Senator

Senator LF (Liberty/Freedom): Now that Obama Care has been implemented, and I understand you voted for it, do you still feel that you have advanced the freedom of the American People?

Senator TSR (Tax/Spend/Regulate): Senator, you have couched your question in a self- incriminating manner. I should plead the fifth. We have given the American people what they have wanted for nearly a century: never having to worry about their healthcare.

Senator LF: But now as Obamacare has been implemented, many patients aren’t enjoying this freedom not to worry. Many can’t find a health plan that they can afford or a physician that accepts Obamacare.

Senator TSR: We have accomplished the very best possible plan.

Senator LF: If the very best plan that we politicians have devised doesn’t improve healthcare, wouldn’t we have been better off to let the former system be continued and revised as necessary?

Senator TSR: But senator, everyone was unhappy with the prior system.

Senator LF: With nearly everyone being really unhappy with the new Obama system, what have we gained?

Senator TSR: Haven’t we accomplished achieving universal health care?

Senator LF: With 25% to 35% of doctors not accepting Obamacare, isn’t that even worse than the prior system of the 25% to 35% being uninsured?

Senator TSR: But look at what we have accomplished, those 25% to 35% now have insurance?

Senator LF: The latest estimate is that 25 to 35 million Americans will still be uninsured when Obamacare is fully implemented.

Senator TSR: I can’t believe that will be true. It just doesn’t make sense.

Senator LF: Canada is very proud of having 100% of its citizens covered by their Medicare. But they don’t have access to healthcare.

Senator TSR: It they are covered by their Medicare Plan, what do you mean they don’t have access to healthcare?

Senator LF: Senator, don’t you read the papers? People are dying in Canada while suffering on waiting lists waiting to be seen.

Senator TSR: But their politicians have given them universal coverage. That’s all that we politicians can do, isn’t it?

Senator FL: Maybe, but aren’t you confusing universal coverage with universal access?

Senator TSR: When we give the American People universal health care, that should cover everyone, doesn’t it?

Senator FL: Well, no. It doesn’t. Obamacare has been dumping many of the poor and helpless and homeless on Medicaid into HMOs under the pretext of giving the poor health insurance. Many doctors felt an obligation to have a certain percentage of their practice be on Medicaid patients as an act of charity. When their Medicaid patients became HMO type of patients they were inundated with so many new rules and regs that they stopped seeing their self-imposed quota of Medicaid patients. This caused a greater loss of access even though we patted ourselves on the back for giving them insurance. Then these same doctors would no longer see Medicaid referrals, which many consultants did out of courtesy to the referring physician. Hence, these former Medicaid patients were given a double whammy: Loss of their personal physician and loss of specialty care. How do you see us as having universal health care when so many don’t have access to care?

Senator TSR: I’ve never heard of anyone complaining as you have stated.

Senator FL: Then you may not have heard of the law suit in Canada where a patient was in great pain from hip arthritis and after two years brought suit against Canadian Medicare. It went all the way to the Canadian Supreme Court which sat on it for over a year before they were finally had to admit that this patient had a case and then ruled: Canada does not have universal healthcare, they only have universal access to a waiting list.

Senator TSR: Then maybe we need another LAW: Force doctors to see Medicaid patients?

Senator FL: Wouldn’t that be involuntary servitude? Didn’t our forefathers come to this country to escape that sort of bondage? Why do you want to revert to a past from which we escape for the most advanced freedom that human beings have ever experience?

Senator TSR: Maybe Hillary Clinton was right: American’s have too much freedom.

Feedback . . .
Subscribe to HealthPlanUSA . . .
Subscribe to MedicalTuesday . . .

What is Congress Really Saying? Or do they even know what they are doing?

Previous Issue:

American Exceptionalism

Is America Exceptional?

The following is adapted from a speech delivered on September 20, 2012, in Washington, D.C., at Hillsdale College’s third annual Constitution Day Dinner.

ONCE UPON A TIME, hardly anyone dissented from the idea that, for better or worse, the United States of America was different from all other nations. This is not surprising, since the attributes that made it different were vividly evident from the day of its birth. Let me say a few words about three of them in particular.

First of all, unlike all other nations past or present, this one accepted as a self-evident truth that all men are created equal. What this meant was that its Founders aimed to create a society in which, for the first time in the history of the world, the individual’s fate would be determined not by who his father was, but by his own freely chosen pursuit of his own ambitions. In other words, America was to be something new under the sun: a society in which hereditary status and class distinctions would be erased, leaving individuals free to act and to be judged on their merits alone. There remained, of course, the two atavistic contradictions of slavery and the position of women; but so intolerable did these contradictions ultimately prove that they had to be resolved—even if, as in the case of the former, it took the bloodiest war the nation has ever fought.

Secondly, in all other countries membership or citizenship was a matter of birth, of blood, of lineage, of rootedness in the soil. Thus, foreigners who were admitted for one reason or another could never become full-fledged members of the society. But America was the incarnation of an idea, and therefore no such factors came into play. To become a full-fledged American, it was only necessary to pledge allegiance to the new Republic and to the principles for which it stood.

Thirdly, in all other nations, the rights, if any, enjoyed by their citizens were conferred by human agencies: kings and princes and occasionally parliaments. As such, these rights amounted to privileges that could be revoked at will by the same human agencies. In America, by contrast, the citizen’s rights were declared from the beginning to have come from God and to be “inalienable”—that is, immune to legitimate revocation.

As time went on, other characteristics that were unique to America gradually manifested themselves. For instance, in the 20th century, social scientists began speculating as to why America was the only country in the developed world where socialism had failed to take root. As it happens, I myself first came upon the term “American exceptionalism” not in Alexis de Tocqueville’s Democracy in America, where it has mistakenly been thought to have originated, but in a book by the sociologist Seymour Martin Lipset, who used it in connection with the absence in America of a strong socialist party. More recently I have discovered that the term may actually have originated with Joseph Stalin, of all people, who coined the term in the same connection but only in order to dismiss it. Thus, when an American Communist leader informed him that American workers had no intention of playing the role Marx had assigned to the worldwide proletariat as the vanguard of the coming socialist revolution, Stalin reputedly shouted something like, “Away with this heresy of American exceptionalism!” And yet Stalin and his followers were themselves exceptional in denying that America was exceptional in the plainly observable ways I have mentioned. If, however, almost everyone agreed that America was different, there was a great deal of disagreement over whether its exceptionalism made it into a force for good or a force for evil. This too went back to the beginning, when the denigrators outnumbered the enthusiasts.

At first, anti-American passions were understandably fuelled by the dangerous political challenge posed to the monarchies of Europe by the republican ideas of the American Revolution. But the political side of anti-Americanism was soon joined to a cultural indictment that proved to have more staying power. Here is how the brilliant but volatile historian Henry Adams—the descendent of two American presidents—described the cultural indictment as it was framed in the earliest days of the Republic:

In the foreigner’s range of observation, love of money was the most conspicuous and most common trait of the American character . . . . No foreigner of that day—neither poet, painter, or philosopher—could detect in American life anything higher than vulgarity . . . . Englishmen especially indulged in unbounded invective against the sordid character of American society . . . . Contemporary critics could see neither generosity, economy, honor, nor ideas of any kind in the American breast.

In his younger days, Adams defended America against these foreign critics; but in later life, snobbishly recoiling from the changes wrought by rapid industrialization following the Civil War, he would hurl the same charge at the America of the so-called Gilded Age.

We see a similar conflict in Tocqueville. Democracy in America was mainly a defense of the country’s political system and many of its egalitarian habits and mores. But where its cultural and spiritual life was concerned, Tocqueville expressed much the same contempt as the critics cited by Henry Adams. The Americans, he wrote, with “their exclusively commercial habits,” were so fixated “upon purely practical objects” that they neglected “the pursuit of science, literature, and the arts,” and it was only their proximity to Europe that allowed them “to neglect these pursuits without lapsing into barbarism.” Many years later, another Frenchman, Georges Clemenceau, went Tocqueville one better: “America,” he quipped, “is the only nation in history which miraculously has gone from barbarism to decadence without the usual interval of civilization.”. . .

Like Tocqueville and the foreigners cited by Henry Adams, moreover, these more recent works attribute this crassly philistine attitude to the love of money and “the exclusively commercial habits” that went with it—in other words, to the species of freedom that has done more than anything else ever invented to lift masses of people out of poverty and that would later be known as capitalism. America, these critics were declaring, was exceptional all right—exceptionally bad, or even downright evil.
On the other hand, there have always been defenders of American exceptionalism as a vital force for good. Thus, several decades before switching sides, Henry Adams charged America’s foreign critics with blindness to the country’s amazing virtues. Whereas, Adams wrote, European philosophers and poets could see only rapacity and vulgarity here, the poorest European peasants could discern that “the hard, practical money-getting American democrat was in truth living in a world of dream” and was “already guiding Nature with a kinder and wiser hand than had ever yet been felt in human history.” It was this dream, Adams went on to say, that beckoned to the poor of the old world, calling upon them to come and share in the limitless opportunities it offered—opportunities unimaginable anywhere else.
For a long time now, to speak personally, I have taken my stand with the young Adams, to whom America was exceptionally good, against his embittered older self, to whom it had become exceptionally bad. In my own younger days, I was on the Left, and from the utopian vantage point to which leftism invariably transports its adherents, it was the flaws in American society—the radical 1960s trinity of war, racism, and poverty—that stood out most vividly. It rarely occurred to me or my fellow leftists to ask a simple question: Compared to what is America so bad?

From our modern perspective, much more was wrong with Periclean Athens, or the Italy of the Medicis, or England under the first Queen Elizabeth, or 19th-century Russia under the Romanovs. But this has not disqualified them from being universally ranked among the highest points of human civilization and achievement. After more than 40 years of pondering the question “Compared to what?” I have come to believe with all my heart that the United States belongs on that exalted list. It is true that we have not earned a place on it, as the others mainly did, by our contribution to the arts. Yet it is worth pointing out that even in the sphere of the arts, we have not done too badly. To speak only of literature, names like Walt Whitman, Mark Twain, Edith Wharton, Robert Frost, and many others attest that we have, in fact, done far better than might generally have been expected of a nation conceived primarily to achieve other ends. These ends were social, political, and economic, and it is in them that we have indeed excelled the most.

We have excelled by following our Founding Fathers in directing our energies, as our Constitution exhorts us to do, to the preservation of the blessings of liberty to ourselves and our posterity, as well as to the pursuit of happiness tacitly understood by the Declaration of Independence to require prosperity as a precondition. (In his original draft of the Declaration, of course, Jefferson used the word “property” instead of “pursuit of happiness.”) By remaining faithful in principle—and to a considerable extent in practice—to the ideas by which the Founders hoped to accomplish these ends, we and our forebears have fashioned a country in which more liberty and more prosperity are more widely shared than among any other people in human history. Yes, even today that holds true, despite policies unfaithful both to the letter and to the spirit of the traditional American system that have resulted in a series of political and economic setbacks.

So far as liberty is concerned, until recently no one but libertarians have been arguing that we were insufficiently free in the United States. If anything, some conservatives, dismayed by such phenomena as the spread of pornography and sexual license, thought that we had too much freedom for our own good. But thanks to modern liberalism’s barely concealed hostility to the free market, not to mention the threat posed by Obamacare to religious and economic freedom, many conservatives are now echoing these libertarian arguments, if in a milder form.

Judging by what they say and the policies they pursue, modern liberals are not all that concerned about liberty. What they really care about, and what they assign a higher value to, is economic equality (as reflected in the now famous phrase, “spread the wealth around”). Yet here is what the late Daniel Patrick Moynihan wrote in 1976 about this very issue in connection with the redistributionist ideology then regnant at the United Nations:

And equality . . . what is the record? The record was stated most succinctly by an Israeli socialist who told William F. Buckley, Jr. that those nations which have put liberty ahead of equality have ended up doing better by equality than those with the reverse priority . . . . This is our case. We are of the liberty party, and it might surprise us what energies might be released were we to unfurl those banners.
Four years later, Ronald Reagan came along to unfurl those banners. And just as Moynihan predicted, the result was the release of new political and economic energies that reversed the political and economic decline of the Carter years and that led to our victory in the Cold War.

Of course, the party of liberty Moynihan was talking about was the United States of America and the party of economic equality was the socialist countries of what was then called the Third World. But within America today, an analogous split has opened up, with the Republicans constituting the party of liberty and the Democrats more and more becoming the party of redistribution. Hence the Democrats never stop claiming that the rich are failing to pay their fair share of taxes. Yet after surveying the numbers, the economist Walter Williams of George Mason University asks an excellent question: “What standard of fairness dictates that the top ten percent of income earners pay 71 percent of the federal income tax burden while 47 percent of Americans pay absolutely nothing?” To which an editorial in the Wall Street Journal replies: “There is nothing fair about confiscatory tax policy that reduces growth, denies opportunity, and keeps more people in poverty.”

Then too there is the assumption, blithely accepted by the party of economic equality, that the gap between rich and poor—or even between the rich and the middle class—self-evidently amounts to a violation of social justice. Yet far from being self-evident, this assumption stems from a highly questionable concept of social justice—one that rules out or minimizes the role played by talent, character, ambition, initiative, daring, work, and spirit in producing unequal outcomes in “the pursuit of happiness.”

Furthermore, both the assumption and its correlative concept of social justice run counter to the American grain. As study after study has shown, and as the petering out of the Occupy Wall Street movement has recently confirmed, what Tocqueville observed on this point in the 1830s remains true today: Americans, unlike Europeans, he wrote, “do not hate the higher classes of society” even if “they are not favorably inclined toward them . . . .” Which is to say that most Americans are not prone to the envy of the rich that eats away at their self-appointed spokesmen on the Left.

Nor are most Americans subject to the accompanying passion for economic egalitarianism that made for the spread of socialism in other countries. What explains the absence of that levelling passion is that it has been starved by the opportunities America has afforded millions upon millions to better their lot and the advantage they have been free to take of those opportunities—which in turn explains how unprecedented and unmatched levels of prosperity have been created here and how they have come to be shared more widely here than anywhere else.

Tocqueville also put his finger on a second and related reason for the persistence of this particular feature of American exceptionalism: “The word poor is used here in a relative, not an absolute sense. Poor men in America would often appear rich in comparison with the poor of Europe.” A story I was once told by a Soviet dissident provides an amusing illustration. It seems that the Soviet authorities used to encourage the repeated screening of The Grapes of Wrath, a movie about the Great Depression-era migration of starving farmers from the Dust Bowl to California in their broken-down pickups. But contrary to expectation, what Soviet audiences got from this film was not an impression of how wretched was the plight of the poor in America. Instead they came away marvelling that in America, “even the peasants own trucks.”

Tocqueville further observed that in America, “the poor, instead of forming the immense majority of the nation, as is always the case in aristocratic communities, are comparatively few in number, and the laws do not bind them together by the ties of irremediable and hereditary penury.”

As the great economist and social critic Thomas Sowell has demonstrated time and again, it is still the case that the poor in America “are comparatively few in number.” And except for the black underclass—whose size is generally estimated at somewhere between two and ten percent of the black community and whose plight has thus far resisted every attempt at alleviation over the past 50 years—it is also true that penury in the United States is neither irremediable nor hereditary. As Sowell shows, of those who live on the next rung of the economic ladder, more of whom are white than black, only three percent get stuck in the bottom fifth of the income distribution for more than eight years.
Elaborating on Sowell’s analyses, the economist Mark Perry writes:

In the discussions on income inequality and wage stagnation, we frequently hear about the “top 1%” or the “top 10%” or the “bottom 99%” and the public has started to believe that those groups operate like closed private clubs that contain the exact same people or households every year. But the empirical evidence . . . tells a much different story of dynamic change in the labor market—people and households move up and down the earnings quintiles throughout their careers and lives. Many of today’s low-income households will rise to become tomorrow’s high-income households, and some will even eventually be in the “top 10%” or “top 1%.” And many of today’s “top 1%” or top income quintile members are tomorrow’s middle or lower class households, reflecting the significant upward and downward mobility in the dynamic U.S. labor market.

No such mobility can be found in any of the member countries of the European Union, or anywhere else for that matter. Even in the dismal economic state our nation has fallen into today, it is still exceptional where the degree and the distribution of prosperity are concerned. But to this, modern liberals are willfully blind.

With all exceptions duly noted, I think it is fair to say that what liberals mainly see when they look at America today is injustice and oppression crying out for redress. By sharp contrast, conservatives see a complex of traditions and institutions built upon the principles that animated the American Revolution and that have made it possible—to say yet again what cannot be said too often—for more freedom and more prosperity to be enjoyed by more of its citizens than in any other society in human history. It follows that what liberals—who concentrate their attention on the relatively little that is wrong with America instead of the enormous good embodied within it—seek to change or discard is precisely what conservatives are dedicated to preserving, reinvigorating, and defending.

A similar divide separates liberals and conservatives as to the role America has played in world affairs. Consider the many apologies President Obama has issued for the misdeeds of which he imagines Americans have been guilty in our relations with other countries in general and the Muslim world in particular. Never mind that the United States has spilled blood and treasure to liberate and protect many millions of people from the totalitarian horrors first of Nazism and then of Communism, and that since 9/11 we have spilled yet more blood and treasure fighting against Islamofascism, the totalitarian successor to Nazism. And as to the Muslim world in particular, never mind that, as the columnist Mona Charen puts it, “of the last six wars in which the United States was involved (Kuwait, Bosnia, Kosovo, Afghanistan, Iraq and Libya), four were undertaken to rescue Muslims and the other two (Afghanistan and Iraq) had the side benefit of liberating Muslims —to what end remains an open question.”
In spite of all this, the liberal community seems to think that the rest of the world would be better off without the United States, or at least with it following the policy of “leading from behind.” Admittedly there are paleoconservatives like Pat Buchanan and libertarians like Ron Paul who agree on this point, but most conservatives do not believe that a radical diminution of American power and influence would be good for us or for the world.

Shortly before the election of 2008, then-candidate Obama declared that his election would usher in “a fundamental transformation of America.” The desirability of such a transformation—which would entail the wiping away of as many more traces of American exceptionalism as it will take to turn this country into a facsimile of the social-democratic regimes of western Europe—is the issue at the heart of our politics today. And in the long run, I hope and trust, Americans will reject such a transformation, and elect instead to return to the principles that have made this nation so exceptional—yes, exceptional—a force for good both at home and abroad.


NORMAN PODHORETZ served as editor-in-chief of Commentary magazine from 1960-1995. He was a Pulitzer Scholar at Columbia University, earning his Bachelor of Arts degree in 1950. He also holds bachelor’s and master’s degrees from Cambridge University, England, where he was a Fulbright Scholar and a Kellett Fellow. In addition, he has a bachelor’s degree in Hebrew Literature from the Jewish Theological Seminary. He has written for most major American periodicals and is the author of twelve books, including My Love Affair With America and Why Are Jews Liberals?


Copyright © 2012 Hillsdale College. The opinions expressed in Imprimis are not necessarily the views of Hillsdale College. Permission to reprint in whole or in part is hereby granted, provided the following credit line is used: “Reprinted by permission from Imprimis, a publication of Hillsdale College.” SUBSCRIPTION FREE UPON REQUEST. ISSN 0277-8432. Imprimis trademark registered in U.S. Patent and Trade Office #1563325.
Read the entire adapted speech . . .

Feedback . . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .

What is the Tax, Spend, & Enslave your Children Party Saying?

Previous Issue:

Rumors from Texas

New Whispers of Perry 2012 Bid for the White House

For months, Texas Gov. Rick Perry has told potential donors and Republican higher-ups he has no interest in running for the White House in 2012.

But over the past two weeks, political advisers and friends say, Mr. Perry has changed his tune on a possible presidential campaign. In private conversations, they say, the three-term governor said he worries that the current GOP contenders have yet to stir real excitement within the party and may struggle when facing President Barack Obama.

“He thinks there is a void [in the current field of candidates], and that he might be uniquely positioned to fill that void,” said one Perry confidant who talked to the governor last week.

In these conversations, the governor has emphasized his own track record in bringing jobs to Texas, which has created more jobs than any other state in recent years. That success, he has told supporters, would position him well in an election that will likely pivot on jobs.

The conversations add detail on Mr. Perry’s thinking. He generated political buzz two weeks ago when he told reporters he planned to “think about” a presidential run after the Memorial Day weekend. He added, with a smile, “But I think about a lot of things.”

In these conversations, the governor has emphasized his own track record in bringing jobs to Texas, which has created more jobs than any other state in recent years. That success, he has told supporters, would position him well in an election that will likely pivot on jobs.

The conversations add detail on Mr. Perry’s thinking. He generated political buzz two weeks ago when he told reporters he planned to “think about” a presidential run after the Memorial Day weekend. He added, with a smile, “But I think about a lot of things.” . . .

At the same time, Mr. Perry, 61 years old, is making a number of national appearances this month, including an address next week to an annual dinner of the New York Republican Party. Last week he announced an August summit in Houston and invited all the nation’s governors to attend. He described the event as a “day of prayer and fasting” focused on “the healing of our country.”

A former Air Force pilot, Mr. Perry served six years in the Texas state legislature before becoming the state agriculture commissioner. He was lieutenant governor for one year before taking over as governor when his predecessor, George W. Bush, became president in 2001.

Mr. Perry has recently built a base among tea-party groups and conservatives by hammering on state’s rights and attacking the Obama administration for its health-care overhaul and interventions in the economy. This year, he backed an array of measures appealing to social conservatives, including a requirement that all women considering an abortion have a sonogram first. . .

Mr. Perry’s record has brought him raves from the likes of Rush Limbaugh, who told his national radio audience last month that if Mr. Perry jumps in, “it’s a brand-new day, and it starts all over again.”

Few dispute that assessment. “There is no question if he got in the race he would change the dynamic very quickly,” said Henry Barbour, a prominent GOP operative and nephew of Mississippi GOP Gov. Haley Barbour. “He is central casting, he can raise the money, and he has deep ties with the grass-roots.” . . .

Read the entire article on Rick Perry in the WSJ, subscription is required . . .

Feedback . . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .

What the Governors are Telling Congress?

Past Issue:

After the Welfare State

The moral price of dependence on government is even higher than the financial cost.

That crashing sound you hear? It’s the sound of welfare states in collapse. From Albany to Athens, all but the dimmest observers now recognize that the model we’ve been following has run aground—morally, socially and fiscally. Less clear is what’s going to replace it.

Today, House Budget Committee Chairman Paul Ryan gives a hint at the possibilities. Over the next few weeks, the Beltway will consume itself defending or defenestrating his numbers and projections. Yet Mr. Ryan’s budget is less about dollars and cents than the assumption behind them: that the best way to help Americans is to increase their access to the market rather than try to shield them from it.

The implications of that assumption are fleshed out in a prescient essay in the spring issue of National Affairs called “Beyond the Welfare State.” Written by a former White House colleague of mine, Yuval Levin, it argues that the moment is ripe for conservatives to address the primary failure of the welfare state: a vision of man that is too narrow, tethered to a trust in government that is too high.

Conservatives, he says, reject the notion both that capitalism is dehumanizing, and that you increase social solidarity by increasing middle-class dependence on government. A conservative vision would consequently put a premium on upward mobility, promote personal responsibility, and in general regard institutions such as church and family as assets to be embraced rather than obstacles to be overcome. In short, as Mr. Levin says, it would “insist on the distinction between a welfare program and a welfare state.”

You can see what Mr. Levin is driving at in Mr. Ryan’s pitch for Medicare reform. Under the existing system, the government simply pays for its recipients’ health care. The result is an increasingly unwieldy bureaucracy that sets prices, imposes thousands of pages of regulation, and is growing far faster than our ability to pay for it.

Mr. Ryan proposes a simple but dramatic shift: helping people afford private coverage. Under this reformed system, seniors would have their private premiums subsidized, and the poorest would get the largest subsidies. The hope is that over time it would have the opposite effect of the present system. Instead of increasing the dependence of the middle class, it would help make all seniors consumers.

Alas, bringing the middle classes into government programs has been a key aim of the social democratic state. We all know that has helped raise the financial costs to levels we can no longer afford. The moral and social price of expanding government, however, has been even more costly.

In a remarkable blog post at the American Interest, Walter Russell Mead notes that today African-Americans are fleeing the “urban paradises of liberal legislation and high public union membership” for the suburbs and job-creating red states. Another way of putting it is that the progressive policies and programs that were supposed to advance equality and opportunity have instead left blighted communities and blighted lives in their wake. This he calls “the most devastating possible indictment of the 20th century liberal enterprise in the United States.”

It didn’t have to turn out this way. Somewhere along the line, liberals came to accept that the only path to their goals was through government. Huge bureaucracies and powerful constituencies grew up around that idea, turning the private sector into something that existed only to be squeezed for the necessary funding.

Ironically, in their obsession with government, American liberals continue to overlook their greatest strength: their ability to set goals for our society. . .

Liberals tend to oppose even these improvements. Sadly, they’ve become wed to the welfare state’s most debilitating premise—that the sole provider for some of the most important goods and services must be the most inefficient institution in American life: the government. . .

Read the entire article in the WSJ – subscription required . . .
Feedback . . .
Subscribe MedicalTuesday . . .
Subscribe HealthPlanUSA . . .

Is Congress Listening?

For other issues, please visit our archives

top