The most disturbing aspect of the Yoo memos, in my mind, was not the authorization of waterboarding, but rather, the incredibly limited definition given to what torture is. Yoo wrote (or one of his aides) that torture is “pain equivalent to organ failure.” That was my WTF moment right there. How can anyone in their right mind think you can go up to that line, and so long as you don’t cross it, say that torture never took place?

I actually do support prosecutions for actions taken by the previous administration. I think that trials and sentencing are an extremely important part of both repairing our country’s image and ensuring that no future administration ever tries to get away with the same sorts of actions.

By the way, a good article about John Yoo can be found here at salon.com

So let’s focus on waterboarding as one example from the Bush list of treatments that has been defined as torture by precedent. We now have at least two problems. First, our own troops and others in harm’s way are in danger of the same treatment. Second, some woefully inexperienced member of the Bush administration wrote a policy document that creatively rationalized the use of a criminal tactic.

I’d like to see the country go all the way down the road with prosecutions on this. It’s the only way we come out the better for the situation.

Vague definitions like the one in the Geneva convention make it impossible to prove torture happened in any but the most extreme cases. John Yoo attempted to give torture a specific, provable definition and then provide a guide for staying within the bounds of lawful interrogation. I personally believe that Yoo’s definition of torture was too limited, and would support a broader one, but until we have a clear and internationally accepted definition as to what level of physical or mental pain and suffering qualifies as torture, this issue is almost certain to come back.

My recommendation would be paying general care doctors more (so we get more than 2% of medical students taking that career path), and change insurance policies so that all preventative care has no deductible. Take advantage of the 40% increase in usage going in the right direction (away from emergency visits).

I don’t object to the idea of public hospitals operating in parallel, but I seriously doubt you’d be able to reduce costs by 2/3 without drastically cutting quality and supply of medical care. If anything, I would expect any government run program to be even less efficient than a private counterpart. The cost-supply equation will always balance, and in general, government agency are poor resource allocators as they tend to fix the price, which forces the supply to react in a detrimental way. Sometimes this extra cost is disguised through sucking money out of the general tax fund, operating on a deficit (stealing from your kids), or through inflation (printing money to steal value by reduce the worth of the money that others are holding).

Curbing ability to sue doctors should apply to public and private, with the recognition that our medical knowledge is not perfect and sometimes bad things happen that are anyone’s fault. There should only be civil liability for serious neglect, or damages done from overriding the patients wishes. And lawsuit award money shouldn’t be going primarily to the lawyers instead of the patient or family.

But my point about the 911 call was that you’re only supposed to call it when your life - or someone else’s - depends on emergency intervention. If someone near you collapses suddenly, you’re supposed to call for an ambulance and try to keep them alive until the paramedics arrive. Later, assuming they survive, that person is going to have to come up with the money to pay for that ride, but “receive rapid emergency care by EMT’s or die” isn’t really much of a choice.

As for the costs versus outcomes comparison, I think a lot of the reason our system is so expensive is that such a huge population can’t afford basic preventive care. When they do have problems, they may not see a doctor until they’ve got a genuine emergency, and that’s always the most expensive type of care.

In Debbie’s case, she’d been having some stomach pains on and off for a couple of months before we had to take her to the emergency room. It would last for a few hours at a time and then go away. She didn’t know what it was, but kept assuming (hoping, really) it was no big deal. What we should have done, of course, was see a doctor about it before she required emergency care. Problem was that our insurance had a high deductible and we knew we’d be liable for the full cost of the visit. And at that time, we were barely making ends meet.

As to your thought exercise, I think it misses the point of what I’m proposing. I don’t think the government needs to simply take over the payment side of health care - basically becoming the insurance company you imagine. Costs would still be the same, and $12K per family per year in taxes is the same as $12K per family per year in premiums and deductibles. I think the government needs to take over the supply side of health care and remove fee-for-service payment structures altogether. Maybe health care shouldn’t be free - people should bear at least some responsibility for not taking care of their own health. But people should never fear bankruptcy because they or their dependents get hurt or seriously ill.

Here’s a thought exercise in return. Imagine that there were both private and public hospitals operating in parallel systems. If you wanted to use a public hospital, you paid some additional amount in taxes, and it drastically curbed your ability to sue your doctor. But the amount you paid in taxes was barely a third of what private insurers charged in premiums, and your out-of-pocket costs were fixed per visit - not based on the specific service (if any) performed by your doctor. Which system would most people choose?

One, in the first comparison of 911 services, only one is an optional service. You can’t opt not to be arrested, or legally choose not to report a crime (accessory after the fact), and you can’t choose not to have the fire department put out a fire. There is a distinct lack of freedom of choice. We as a civilization, have chosen to forfeit these freedoms in exchange for the security of a system of law that is above any one person, and in exchange for the security of not having our house at risk because the neighbor refuses to deal with his house fire. The only truly analogous medical comparison would be dealing with infectious diseases. You don’t let someone with ebola or smallpox choose not to be treated. So naturally, I have no problem with CDC being a government agency, or in the tax money going to fund infectious disease treatment and research.

However, with normal injuries, people have the choice not to be treated, to treat themselves, to wait until normal doctor’s office hours, to drive themselves or have someone drive them to the emergency room, or have an ambulance pick them up. I don’t see what gives me the right to tell anyone else which price-service option he must choose. If this is in anyway unclear, let me know.

Two, as to the argument of motivation; not all interest parties should have the same motivation. In fact, for proper economic balance, they should NOT. I see the proper balance as being the individual’s motivation to be healthy and not in debt as balancing the hospital’s to run an effective business and make money by healing people. And in fact, individuals in America choose to spend 40% less on healthcare when they are paying for it than when they expect others to pay for it. This indicates that there is no special medical exception to the basic laws of economics with regards to supply-demand. And as long as there is no monopoly, natural market competition forces hospitals and doctors to balance their services with their prices and costs. I can see a logical argument for making the ambulance service itself into a local government entity, either separate or combined with the fire department, with only a few minor negatives.

An unhealthy balance has resulted from the weight of malpractice suits on the industry. Doctors now routinely order more extra tests and services in order to reduce their liabilities to keep their malpractice insurance cost down. These costs substantially increase cost and decrease response time for those who need the tests and services most. Put simply, to decrease price for those who need them, decrease the demand by those who don’t.

Three. Regarding the un-sourced graph, there are several problems. The first is simply correlation does not equal causation. Overall, there is a slight trend that higher spender tends to produce longer lives, but the degree of data point scatter indicates other major factors at play.

The second is that without a source and methodology, a graph is an unsubstantiated assertion. If the creators of the graph are dishonest, they can cherry pick data to support their bias (as I have seen gun-control advocates do time and time again), over-emphasize small differences to make a larger emotional impact (the total difference from best to worst is 6%). But even if they are completely honest, and transparent about their biases, without a methodology we cannot determine what other factors are at play.

I can think of several probabilities right off the top of my head. I think they simply charted some statistics without taking into account the largest contributing factors to health and long life; namely diet and exercise. And I’m sure you’re aware that Americans are known for doing poorly in both. In a controlled study, I bet that the impact of those two factors absolutely dwarfs the impact of the amount of money spent on health care. Other health factors could include average hours at work, general stress levels, education, environment, urban vs rural, etc. Obvious cost factors (besides the malpractice costs mentioned above) could include a failure to take into account the total spent rather than just the amount paid for healthcare rather than the average price by the individual, how much money went to new drug development (which unless I’m mistaken, the vast majority of which is done here), percentage difference between preventative and reactive treatments, scarcity of generalist vs. specialist doctors here, etc.

Lastly, even if we were able to make the health system system 10% more cost effective by removing the freedom of people being able to choose their own healthcare, I would still be against it.

As a thought exercise, imagine the government running a health insurance business that people could opt in to use and pay for in their taxes, or opt out of not pay taxes for. How do you think it would do in competition with the private insurance companies, and what reason do you have to think less competition would produce better price or service?

As for the moderation, it’s not moderation for censorship - I’ve simply had a bad experience in the past with getting slammed by robots. But don’t worry - once you’ve had a single comment approved, your future comments will go through without the extra step.

As for who I am - I’m Mason Wolf , the guy who runs hbblogs.com. I decided I wanted a new blog focused on issues like this one, so I remade the defunct “Press Room”. I’m not wedded to the name though. It may change in the coming days.