Lockerbie bomber Al Megrahi released by Scots: the limits of compassion

The New Neo Posted on by

Abdel Basset Ali Al Megrahi , who remains the only person ever convicted for the Lockerbie bombing, was released today by Scottish authorities for compassionate reasons. He is said to be suffering from advanced prostate cancer and to have only a few months to live, and Scottish law allows compassionate release under such circumstances.

In his statement justifying Al Megrahi’s release to return home to Libya, Scottish Justice Secretary Kenny MacAskill explains his decision:

In Scotland, we are a people who pride ourselves on our humanity…The perpetration of an atrocity and outrage cannot and should not be a basis for losing sight of who we are, the values we seek to uphold, and the faith and beliefs by which we seek to live.

Mr Al Megrahi did not show his victims any comfort or compassion…But that alone is not a reason for us to deny compassion to him and his family in his final days. Our justice system demands that judgment be imposed but compassion be available. Our beliefs dictate that justice be served, but mercy be shown. Compassion and mercy are about upholding the beliefs that we seek to live by, remaining true to our values as a people. No matter the severity of the provocation or the atrocity perpetrated.

For these reasons—and these reasons alone—it is my decision that Mr Abdelbaset Ali Mohmed Al Megrahi, convicted in 2001 for the Lockerbie bombing, now terminally ill with prostate cancer, be released on compassionate grounds and allowed to return to Libya to die.”

Shorter MacAskill: we’re showing what good people we are by being kind to the cruel.

Perhaps MacAskill has never heard of the old saying:

All who are made to be compassionate in the place of the cruel
In the end are made to be cruel in the place of the compassionate.

More colloquially translated: Those who are kind to the cruel, in the end will be cruel to the kind.

MacAskill’s decision is but another example of the West’s tendency to elevate mercy over justice. The two are both desirable in a system of law, but in many parts of the West and especially Europe, the all-important balance has tilted towards the former over the latter. Although there is talk of shady oil deals with the Libyan government as underlying MacAskill’s decision, I will discount that aspect for now and take him at his word that it was his desire to show the world that the Scottish are a people of compassion that led to his decision.

If so, it was a very misguided desire, one that can only rebound negatively on our fight against Islamicist terrorists, letting them know once again (as if they needed reminders) that the West is a very weak horse indeed.

As one might expect, a great many of the families of victims of the Lockerbie crash are outraged—for them, this mercy is misplaced and justice has not been served:

Bert Ammerman, whose brother Tom was killed in Lockerbie, told The Associated Press, “It’s insane, it’s a travesty of justice and totally unacceptable.”

But a few applaud the decision, on grounds similar to those of MacAskill:

British Rev. John Mosey, whose daughter Helga, 19, died in the crash, told the AP, “It is right he should go home to die in dignity with his family. I believe it is our Christian duty to show mercy.”

I wonder why the mercy of allowing Al Megrahi to live in the first place, feeding and clothing him in a prison facility where he was visited by wife and children, allowing him to defend himself and even to appeal his conviction, and treating his cancer for years with the best Western medicine could offer until it finally became more aggressive and hormone resistant and therefore terminal, is not enough mercy for the Reverend Mosey. It is for me—and I leave the rest of the compassion and mercy to the deity.

I am pleased to report that the Obama administration is on the side of justice in this matter. Although the rhetoric is weaker then I would have liked, Obama stated that he is opposed to Al Megrahi’s release and calls it “a mistake.” However, in another example of Obama’s inability to influence international policy, we learn that all his efforts—to influence the Scottish government not to release Al Megrahi, as well as to pressure the Libyan government not to allow him a hero’s welcome and to instead place him under house arrest—have been ignored.

Al Megrahi, of course, has consistently proclaimed his innocence. But his conviction was based on the fact that, in addition to having been identified as the person purchasing clothing and an umbrella exactly like the ones in the suitcase in which the bomb was placed:

At the time of the bombing, Mr. Megrahi was head of security for Libyan Arab Airlines, the state carrier. But an F.B.I. investigation concluded that his job was a cover for his work as an intelligence officer for the Libyan intelligence service, which Mr. Megrahi denied but which the court accepted in finding him guilty. Prosecution evidence showed he had used false passports on trips between Tripoli, the Libyan capital, and two destinations linked to the bombing, Malta and Zurich, where the timing device for the Flight 103 bomb was bought.

The Libyan people disagree that Al Megrahi was guilty; no surprise there. Thousands have welcomed Al Megrahi at the Tripoli airport with heartfelt joy and celebration, in a manner exactly the opposite of Obama’s request. And as for the example set by the Scottish government of its compassion, the Libyans are deeply skeptical:

Many are blaming the Scottish authorities for not taking care of Megrahi’s health while in prison and speculate that he was left, on purpose, to die of his cancer…Libyans are now convinced that the Megrahi case could be viewed as a premeditated murder on the part of the Scottish prison authorities.

So much for Western compassion. As for Western justice, the common Libyan assumption is that Al Megrahi’s release was not on the grounds of compassion, but on the grounds of innocence and miscarriage of justice:

Megrahi’s imprisonment was a political one and had nothing to do with the Lockerbie but what has been done has already been done,” remarked Imad Taib. “If they consider themselves humans, they should have considered the situation from the beginning, but what we discovered is that, they are just pretenders.”

Apparently, some of the compassion and the justice got lost in translation.

[ADDENDUM: Yaacov Ben Moshe has more on “savage compassion” at Breath of the Beast.]

Jelly vs. jam

The New Neo Posted on by

Although regular readers here are well aware that I have a certain fascination with the aesthetic aspects of jello, my feelings do not extend to jelly.

No, I much prefer jam. Why eat a strained and enervated version of the thing when you can have actual succulent pieces of fruit to chew on in the mix?

Let’s have jam today! But no, not possible:

‘I’m sure I’ll take you with pleasure!’ the Queen said. ‘Twopence a week, and jam every other day.’

Alice couldn’t help laughing, as she said, ‘I don’t want you to hire ME – and I don’t care for jam.’

‘It’s very good jam,’ said the Queen.

‘Well, I don’t want any TO-DAY, at any rate.’

‘You couldn’t have it if you DID want it,’ the Queen said. ‘The rule is, jam to-morrow and jam yesterday – but never jam to-day.’

‘It MUST come sometimes to “jam to-day,”‘ Alice objected.

‘No, it can’t,’ said the Queen. ‘It’s jam every OTHER day: to-day isn’t any OTHER day, you know.’

‘I don’t understand you,’ said Alice. ‘It’s dreadfully confusing!’

The problem with health care reform—and Waterloos

The New Neo Posted on by

Some have said that health care reform is Obama’s Waterloo, or will be soon.

The analogy is far from perfect; for example, Napoleon’s defeat at Waterloo was followed by his abdication, surrender, and exile, and it’s hard to believe this will happen to Obama even if the bill fails. But if “Waterloo” is shorthand for a big and important loss, than it would be an apt description for the situation the administration and its allies would face if this bill (or something like it) goes down to defeat.

This is because Obama has already placed so very much emphasis on it. Even though most Americans feel no special sense of urgency about it, this administration has chosen the issue as the linchpin of hope and change, and has talked and acted as though legislation must pass now or something terrible will happen.

But that “something terrible” might just be that the public will catch on to the manifold problems inherent in the proposal before it can be passed. In fact, that is exactly what may have already happened, although it’s still possible that the Democrats will twist enough Blue Dog arms (or would it be legs?) to ram something through anyway, in order to avoid the embarrassment and face loss that would flow from a failure to pass any health care reform bill during the next Congressional session.

As Q and O writes, the Democrats have a dilemma on their hands:

They believe, now that they’ve brought it up and the president has made it one of his signature issues, that unless they pass it (or something they can call “health care reform”) they’ll have set him up for failure. However, they are also coming to realize that passing something now despite a majority of Americans saying slow down and start over could be hazardous to their political health ”“ and majorities.

Whether it leads to Waterloo or ultimate victory, this particular Democrat battle is one of their own making. Napoleon was faced with a coalition army massing against him, and so he had to fight; although he chose to attack sooner rather than later, there was no avoiding the confrontation. But the Democrats have taken this task upon themselves without any outside prompting or pressure other than the fact that it was a vital part of Obama’s campaign rhetoric.

They should have been wary if they had studied history (although not Napoleonic history), because health care reform has been a Waterloo of sorts before. Just remember Bill and Hillary. Like Obama, Bill Clinton had made campaign promises about health care reform, and Congress was similarly heavily Democratic for his first term (although not quite as enormously so as at present).

It seemed that passage should have been easy, but it wasn’t. As Hillary later said [emphasis mine]:

I learned some valuable lessons about the legislative process, the importance of bipartisan cooperation and the wisdom of taking small steps to get a big job done.

Well, Hillary may have learned those lessons. But Obama, Pelosi, and other leading Democrats appear to have playing hooky that day in history class.

They also may have thought that the fact that they had slightly larger Democratic majorities in Congress than the Clintons enjoyed would make their efforts more likely to succeed. But the Clinton effort was a model of transparency and bipartisanship compared to Obamacare; at least they had a coherent bill to defend, and they took a bit of time to try to explain and then sell it to Congress and the American people.

But health care reform wasn’t a problem just for the Clintons. For example, although it couldn’t really be called a Waterloo because George Bush managed to fulfill a campaign promise and get a Medicare prescription bill passed, he was criticized roundly for it by both sides—Democrats because it didn’t go far enough and was thought to unduly reward pharmaceutical companies, and Republicans because it was not fiscally responsible.

Let’s listen once again to Hillary on health care reform. Speaking in 2007, she said [emphasis mine]:

I think that both the process and the plan were flawed. We were trying to do something that was very hard to do, and we made a lot of mistakes.

Perhaps the reason that so many proposals for health care reform go down to either defeat or disappointment, follow the laws of unintended consequences, and/or face the prospect of running out of money (take a look at Medicare today) is that, just as Hillary said, health care reform is “very hard to do” successfully. And despite Democrat rhetoric, that’s not because mean old Republicans get Harry and Louise to tell terrible lies about it, or Angry White Men are racist yahoos who reflexively hate Obama and every proposal that comes out of his mouth. No, it’s inherent in health care reform itself. These are some of the very basic problems with any health care reform bill:

(1) Good health care is extremely expensive, and cutting costs will always mean denial of benefits. And even if the rhetoric says that only the unnecessary fat will be cut, medicine is not a good enough science that we can tell in advance what’s a necessary test or procedure and what is not.

(2) People logically assume that insuring everyone will have to cost more money, and they also know that there’s no magic way to get that money. People are also aware that government estimates of the cost of programs are usually underestimates, sometimes by a large factor.

(3) People are especially wary of government control over this particular aspect of their lives because it is so personal and so vital at the same time.

(4) Government-run enterprises are generally distrusted, and considered inefficient and intrusive. People know that from past and present experience.

(5) In this country there is still a widely-held philosophical strain of belief in personal initiative and responsibility rather than nanny-statism. This is in contrast to the belief system of European populations, and so it’s no surprise that European governments have encountered far less resistance to government involvement in health care than is found in this country.

Therefore it’s no surprise that the US has failed to pass universal health care so far, and especially a public option. And it’s also no surprise that there’s been a great deal lot of opposition to Obamacare, since the basic problems presented by the five points above have been compounded by the fact that the rhetoric of those pushing the bill has been entirely unconvincing in its attempts at reassurance.

In fact, the behavior of Obama and the Democratic Congress around the present proposals have made things far worse. It is statements such as the following (from Obama’s recent Portsmouth appearance) that ring alarm bells for that portion of the public paying attention:

[A]sked…how private insurance companies can compete with the government, the president said the following:

“If the private insurance companies are providing a good bargain, and if the public option has to be self-sustaining — meaning taxpayers aren’t subsidizing it, but it has to run on charging premiums and providing good services and a good network of doctors, just like any other private insurer would do — then I think private insurers should be able to compete.”

Self-sustaining? The public option? What has Obama been doing during those daily 40-minute economic briefings coordinated by uber-economic-adviser, Larry Summers?…

Government programs aren’t self-sustaining by definition. They’re subsidized by the taxpayer. If they were self-financed, we’d be off the hook.

It doesn’t take an economist to know that, either. It’s a basic fact of government life that most people are privy to.

So, what did Obama mean when he said that? I certainly couldn’t say. Once again, the questions appear to be: is he that ignorant? Or is he that much of a liar, and does he think the American public is that ignorant?

And does it really matter which it is at this point?

Trusting Obama: fooled us once, fooled us twice, fooled us…

The New Neo Posted on by

President Obama may not understand what’s been happening to him lately, as his disapproval ratings climb and his approval ratings sink.

After all, Obama made and broke promises during the campaign, and he learned that it didn’t seem to matter. Campaign financing was the biggest one, but he asked us to trust him and plenty of people did.

The press didn’t press him. His opponents—be they Hillary Clinton or John McCain, Democrat or Republican—couldn’t seem to find an approach that worked for them or a charge that would stick to him. They found Obama to be a moving and slippery target, protected by a personality many found attractive, an impervious coolness, a steamrolling money-raising machine, an army of starry-eyed acolytes, a blankness that invited people to project onto him whatever qualities and goals they found attractive and desirable, and an identity as a black man that made people want to give him the benefit of the doubt lest they be accused of racism.

All in all, a winning combination, electorally speaking.

But winning an election is not the same as winning support in Congress, and a campaign is not a presidency. One of the main differences between a campaign and an administration is that presidents, unlike candidates, must produce more than rhetoric. Although they may take credit for their successes, they must ultimately also take responsibility for their failures.

If they like you, the public forgives—but not everything, and not forever.

The other day I compared disillusioned Obama voters to disappointed lovers. This is true whether they are on the Left, and disappointed because Obama hasn’t turned out to be radical enough to suit their tastes; or more to the center, and frustrated because he’s been insufficiently moderate. The betrayed lover metaphor is strangely apt (even Obama-supporter Ed Koch seems to be using it; see his recent piece entitled “Falling out of love with Obama”) because it contains elements that match what has happened and is still happening to a growing segment of Obama supporters: a relationship begun in the glow of the fantasy of perfection and wish-fulfillment meets the flawed and sometimes deeply disappointing reality of who the lover actually is. Sometimes, that lover even turns out to be a con artist, a narcissist, and/or a liar.

But because love is deep and love can be very irrational, it can take time—and a lot of lies and a lot of deception—to break the illusion. But once a person internalizes the idea that he/she has been betrayed, then the trust so basic to a relationship is broken and it’s almost impossible to earn it back.

And so it appears to be dawning on an increasing number of Americans that President Obama cannot be trusted. There are two reasons for this. The first is that so many of the things he promised during the campaign—transparency, bipartisanship, unity and an end to blaming, a post-racial presidency, no catering to special interests and lobbies, and posting of bills in a timely fashion online, to name just a few—have not only been violated, but have been boldly, flagrantly, and shamelessly violated. The second thing is that his pre-election stance as a moderate is seen to have been a lie as well, and that’s even more basic—at least for the moderates and Independents who gave him the support he required to put him over the top and guarantee his election.

One can talk about this policy of Obama’s or that one, and agree with certain elements of his program and disagree with others. But although these are very important issues, they are not the issue. Trust is.

During the campaign, Obama’s personal characteristics accounted for much of the bedrock of his appeal, despite the fact that he had almost no track record of action to point to. Now that he has amassed an actual record of sorts, albeit a short one—especially the stimulus bill, its false promises and then the false spin about how it’s helped, as well as the health care reform proposals and the failure to explain the details of the policy involved or why it would help—the public is left with a sense of distrust and unease. And the public is now able to connect the dots because we’ve been treated to more than a repeating stump speech. We’ve experienced the man over time.

Will Obama be able to win trust back, as commenter huxley posits when he writes: “Today I read an interesting theory that Obama will spend the first year or so swinging for the leftist fences then tack back to the center in time for the economy to get better and for him to be re-elected in 2012?”

I don’t think it’s about Obama’s tacking to the Left and then to the Right, although I suppose he may end up performing that maneuver if he feels he has absolutely no choice. Clinton—who was less ideologically committed to the Left in the first place—did so, but he managed it before he’d been caught in a flagrant lie that the American people could not ignore. And even later, when Clinton was busted, the lie was about his personal life rather than policy, so quite a few people considered it more between him and his wife rather than between him and us.

It’s almost incomprehensible that Obama would cheat on his wife; he’s too controlled, for one thing. But he’s cheated on the rest of us time and again, and it’s my belief that the American people will take that far more personally—as they should.

obamapinocchio.png

They’re White. They’re Men. They’re Angry at Obama. Why, they must be…

The New Neo Posted on by

Angry White Men.

Which means that they must also be Racist Angry White Men—if not overtly racist then certainly covertly so. I mean, what other reason would they have to be angry at our President?

According to Michael Crowley, a New Republic editor writing in the Guardian, Angry White Men who have been at the forefront of the conservative movement for years have a special beef against Obama:

Today, white men again symbolise the conservative resistance to a Democratic president. And with a black man in the White House, the racial element is even more pronounced…Implicit in the celebration of Joe the Plumber, whether intentional or not, was also a racial contrast with the African-American Democratic candidate.

Obama’s race is the gift that keeps on giving. It will continue to do so until we see the unlikely spectacle of hordes of Angry Black Men rising up against him. That’s the only thing that will get those poor Angry White Men off the hook—and maybe not even that.

The fact that the opponents of health care reform speaking up at the town hall meetings are clearly motivated by extremely substantive issues other than racial hatred of Obama is irrelevant to Michael Crowley. In fact, many of them are also at least as furious at Congress and the person of one White Woman Nancy Pelosi, as well as a number of Very White CongressMen.

But repeat after me: they are White. They are Men. They are Angry at Obama. They are Angry White Men.

And don’t let the fact that some of them are women confuse you, either. Those women (for example, Sarah Palin) are Angry White Men too, albeit honorary ones. After all, there is no Angry White Man more racist than an Angry White Woman.

And the fact that there are even a few Angry Black Men speaking out at the town halls against Obama’s health care reform plan is irrelevant. For example, although Kenneth Gladney—who may or may not have been physically attacked and beaten at a town hall meeting by a black Obama supporter and SEIU member—is unquestionably a black man, and unquestionably a vocal opponent of the President’s health care reform, for the purposes of our discussion we will consider him an Angry White Man too.

After all, since Obama’s approval rating among black Americans remains steady at 95% (the only group in which it hasn’t declined), that most definitely makes Gladney an outlier. He’s been branded a liar as well by the Left. What could be Angrier and Whiter and Manner than than an outlieing liar?

But Michael Crowley, although white and a man, and rather angry at the Angry White Men who are angry at Obama, is not an Angry White Man. That’s because he’s on the Left and an Obama supporter, so that makes him immune to the charge.

Crowley’s not to blame for fanning the flames of racism, either. Anyone who cries “racism” against Obama opponents, even if he writes an entire column emphasizing their white race, can’t be a racist himself because he supports Obama, who in case you haven’t noticed (and Obama and Crowley and the Left will make sure you notice, every step of the way) is black.

Of course, if we wanted to get really technical, we might say that Obama is half white and half black. And he’s a man. So, when he gets angry, does that make him an Angry Half-White Man?

Don’t be silly. Obama never gets angry.

[NOTE: As for other Angry White Men of the past, here’s Twelve of ’em—including one of my all time favorite Angry White Men, Henry Fonda, the guy sitting on the left-hand side (to the right in the photo) of the Angry White Man with the hat:

12-angry-men2-2.jpg

And since I’m an unrepentant Henry Fonda fan, let’s have another photo, a portrait of the almost-beautiful younger Fonda in the film “The Grapes of Wrath:”

joad.jpg

Now you might say that Tom Joad, Fonda’s character in that movie, was another Angry White Man. But he gets a pass as well, since back in those days Angry White Men were part of the Great Oppressed, and at any rate Joad turns into a crusader for social justice and the Left [emphasis mine]:

Wherever you can look, wherever there’s a fight, so hungry people can eat, I’ll be there. Wherever there’s a cop beatin’ up a guy, I’ll be there. I’ll be in the way guys yell when they’re mad. I’ll be in the way kids laugh when they’re hungry and they know supper’s ready, and when the people are eatin’ the stuff they raise and livin’ in the houses they build, I’ll be there, too.]

The Canadian health care system: hope and change

The New Neo Posted on by

The Canadian health care system is sick, says the new head of the Canadian Medical Association:

Dr. Anne Doig says patients are getting less than optimal care and she adds that physicians from across the country – who will gather in Saskatoon on Sunday for their annual meeting – recognize that changes must be made.

“We all agree that the system is imploding, we all agree that things are more precarious than perhaps Canadians realize,” Doing said in an interview with The Canadian Press.

“We know that there must be change,” she said.

The prescription? Part of the fix would be “a role for private health-care delivery within the public system.”

Fancy that.

Coffee, tea, and me

The New Neo Posted on by

[NOTE: I’ve decided to take a short break from ragging on Obama today.]

So, do you agree that Eight O’Clock coffee is better than Starbucks? Consumer Reports says it is.

I have no opinion on the subject, because I never touch the stuff. Yes folks, today we have still another in a long series of shocking beverage confessions from neo-neocon: I hate coffee.

I don’t like coffee black. I don’t like it milked and sweetened and tarted up and I don’t like it expressoed. I don’t like it decaffed and I don’t like it supercharged. I don’t like the frappuccino mochachino whateverchino million-calorie extravaganzas at Starbucks.

I don’t like coffee’s taste. I don’t like the jittery feeling I get after I take just a few sips. I don’t like what it does to my GI tract. I don’t like the bitter aftermath, which seems to coat my entire alimentary canal with a thin layer of clinging grime. I don’t like the fact that it makes me thirsty, of all things.

I do like the smell. And I like the idea of drinking coffee, the conviviality of sitting with friends after a meal to savor the lingering moment.

And while we’re at it, it’s time to get a few other things off my chest. I don’t like tea.

Actually, I don’t like any caffeinated drinks, not even Coke.

Oh, what the heck, I may as well get it all out. True confessions: I don’t like any sort of sweetened soda, sugared or artificial.

And I absolutely detest the milky icky stickiness of milk—always have, even from childhood.

To make matters worse, I don’t like fruit juice. Even orange juice. Or maybe especially orange juice.

Okay, I’m going to level with you. I don’t like any sweetened or flavored beverage much, except for a sip now and then. The most I’ll do is a shot of peppermint tea, or one of those thingees with the bubbly water and a touch of vanilla or amaretto syrup.

My favorite beverage? You guessed it: water—and not necessarily that bottled stuff. From the tap is okay, too, especially on ice. Ahh! I like it carbonated, as well—the fancy foreign mineral type or the plain domestic.

And if there are any other carbonated water aficionados among my readers, have you ever noticed that the decree has been handed down that there will be no chilled individual bottles of carbonated water sold in a market?

Every now and then a little mini-Perrier will sneak into the cooler in the quickie grocery at the rest stop. But most of the time you will find nothing resembling soda water there, although nearly every other type of carbonated and non-carbonated drink will be present and accounted for—diet and sugared and caffeinated and non, as well as juices and teas and beers and flavored coffees, beverages to restore your sweat and balance your minerals and get your mojo working so you can drive all night, or to mellow you out. Plain water will always be there, too, and plenty of it. But you will have a long, long search before you find you can quench your thirst on the road with a cold bottle of the plain bubbly.

There. I feel better now.

Obama opens mouth, inserts foot: on diabetic amputations and preventative medicine

The New Neo Posted on by

By now you’ve probably seen or read a transcript of this excerpt from Obama’s healthcare talk in Portsmouth NH:

The American College of Surgeons has come back with a critique and correction that points out that a surgeon actually gets only between $740 and $1,140 for a leg amputation rather than the $30,000 to $50,000 stated by our non-detail-oriented President: “This payment also includes the evaluation of the patient on the day of the operation plus patient follow-up care that is provided for 90 days after the operation.”

No surgeon is going to get rich doing that sort of thing. And in fact, if you actually think about it, Obama’s assertion that preventive care for diabetes—involving helping a patient “lose weight, modify diet, [monitor] whether they’re taking their medication in a timely fashion”—reimburses at “a pittance” doesn’t seem to be true either. Last time I checked, doctor visits are rather expensive, and frequent ones do add up, reaching fees equal to that surgeon’s reimbursement rather quickly.

Most people who’ve written negatively about the Obama amputation quote have focused on the fact that he’s insinuating (although not quite saying outright, as he did earlier about tonsillectomies) that doctors seek out such amputations and perform them unnecessarily in order to get the extra money. They also assert that, as the ACS says about Obama’s tonsillectomy claim, “That remark was ill-informed and dangerous, and we were dismayed by this characterization of the work surgeons do. Surgeons make decisions about recommending operations based on what’s right for the patient.”

But in thinking about Obama and the amputation remarks, there’s a great deal more that’s troubling in what he said. His statement was part of a tendency of his to speak out authoritatively on matters about which he knows nothing or almost nothing.

One of the most off-putting things about Obama is his arrogance. And it’s not just a personal arrogance, it’s an intellectual arrogance as well. The most dangerous ignorance is the ignorance of a person who doesn’t know what he/she doesn’t know. And it’s even more dangerous when someone who fits that description—Barack Obama—is in a position of great power and filled with the righteousness of his cause, as well as the ruthlessness of the true believer.

So let’s not be arrogant or ignorant ourselves, and let’s read about diabetic amputations and how to prevent them (see also this). I think you’ll observe, as I did, that it’s a very complex subject to which doctors have devoted a great deal of thought and attention. In essence, much of the prevention involved (as is true with nearly all of diabetes care and treatment) depends on the patient him/herself taking charge of his/her own self.

Diabetics, even if they strictly follow all the difficult behavioral rules that go with their sometimes cruel disease, often have problems with neuropathy in the extremities such as the feet, as well as poor circulation. The net effect is that they are subject to having serious infections from even minor wounds and abrasions that in a non-diabetic would tend to heal quite easily. The key for many diabetics is to follow a regimen of inspecting their feet every day, taking immediate steps when they find a problem, reporting all abrasions that fail to heal in a timely fashion, and going for medical help when needed.

No amount of increased reimbursement for preventive care is going to significantly change the fact that the management of diabetes is up to the patient as the first and most important line of defense. Non-surgeons who treat diabetics are dedicated to helping them do this, but there is no way to compel a non-compliant patient, since we haven’t reached that level of police state yet (and please see this for a description of the exceptionally thorough and very impressive job that is currently done by physicians working with private health insurers on the matter of the medical care of diabetes).

So, what did Obama actually mean by his ignorant and somewhat cryptic statement? Surely there was a grain of coherent thought there. My guess is that part of what he meant to say is that preventing diabetes, and/or controlling it as well as possible, would be preferable to doing a lot of amputations. That’s a rather noncontroversial statement on which I think we can all agree.

Unfortunately, we have no more effective ways of doing so than are already in place, because it involves patient lifestyle choices that we cannot control through medicine (even preventative care), such as making large numbers of people lose weight and keep it off. Medicine has virtually no idea how to do this, any more than it can make people exercise more (which would probably help as all).

If Obama was attempting to talk about facilitating better control of diabetes in terms of blood sugar levels, this is already done as best as medicine can currently accomplish it. And once again it depends on patients taking charge of their own lives and health habits, and compliance with things like glucose monitoring and diet.

Quitting smoking is another thing that would help mightily. If you read the links on diabetic amputations you’ll see that smoking is a huge risk factor and implicated in many of the amputations. But surely President Obama, of all people, is well aware as a smoker of how difficult that task is, even with the best of medical care. He hasn’t quite been able to do it himself yet.

If Obama was meaning to say that he favors extending good non-emergency medical care to more of the diabetics and pre-diabetics who are currently uninsured, that’s certainly a laudable goal. I believe that was another part of his intended message. But it has nothing to do with the differential between reimbursement for this type of care (which is certainly not a “pittance”) versus the reimbursement for surgeons for an amputation (which is certainly not exorbitant). Doctors who treat diabetes are already fully dedicated to preventing amputation surgery, and his insinuation that the relative amounts of reimbursement for prevention vs. amputation have anything to do with how diabetes is actually treated in this country is another example of his now customary slander against the medical profession.

The fact is that we are already “reimbursing the care that prevents the amputation,” except for many of those who are uninsured. If Obama wants to extend that same preventive care to the now-uninsured by insuring them (as I definitely believe he does), that’s fine. Just say so clearly, and don’t slander doctors when you do it.

And don’t pretend it will cost less, either—it will cost more. That’s just common sense. Whether it’s worth that increased cost is a separate issue, one of the cost-effectiveness of preventive medicine, a complex matter which Charles Krauthammer (doctor Krauthammer to you, President Obama) tackles in this excellent piece.

It’s clear that Obama’s statement about diabetic care is riddled with difficulties, some of them obvious and some of them only emerging after deeper reflection. Are Obama’s critical thinking skills really that poor? Is his judgment that bad? Is his grasp of these really rather elementary concepts that weak? Or is it that he just cannot stop lying to the American people in order to attempt to reach his health care reform goals?

[ADDENDUM: I wanted to add some further thoughts from commenter “E,” who has Type 1 diabetes:

But if [Obama] is so concerned about preventive care, then why does Medicare only authorize reimbursement for 100 test strips for three months for Type II patients, and 100 test strips for one month for insulin dependent patients like me? That’s three strips a day – when (on a good day) I routinely use 6-8 to monitor my daily blood glucose ups and downs.]

[ADDENDUM II: Commenter “MrsWhatsit” has a suggestion worth pondering:

How about if we cancel the [unspent stimulus bill] pork and use that money, instead, to subsidize insurance coverage for those who can’t afford it, right now? It would pump a lot of money into the economy through the health care gateway and, perhaps, actually help to get things back on track the way we were told the stimulus would back in January. It would temporarily, solve the problem of getting people insured without driving up the deficit any more than the ungodly amount that we have already had imposed upon us. And it would give us time to have a serious, deliberate, patient conversation, without lies, scams and hysteria, about how we are going to increase access to health care for all Americans without bending that cost curve in the wrong direction.]

A doctor speaks out on Obamacare

The New Neo Posted on by

Dr. Zane F. Pollard has a penetrating article up at American Thinker on Obamacare. It’s a must-read, and a must-send to all your friends, Left and Right and in-between.

Here’s a key excerpt (but please read the whole thing; there’s much more where that came from):

I have taken care of Medicaid patients for 35 years while representing the only pediatric ophthalmology group left in Atlanta, Georgia that accepts Medicaid. For example, in the past 6 months I have cared for three young children on Medicaid who had corneal ulcers. This is a potentially blinding situation because if the cornea perforates from the infection, almost surely blindness will occur. In all three cases the antibiotic needed for the eradication of the infection was not on the approved Medicaid list.

Each time I was told to fax Medicaid for the approval forms, which I did. Within 48 hours the form came back to me which was sent in immediately via fax, and I was told that I would have my answer in 10 days. Of course by then each child would have been blind in the eye.

Each time the request came back denied. All three times I personally provided the antibiotic for each patient which was not on the Medicaid approved list. Get the point — rationing of care.

Over the past 35 years I have cared for over 1000 children born with congenital cataracts. In older children and in adults the vision is rehabilitated with an intraocular lens. In newborns we use contact lenses which are very expensive. It takes Medicaid over one year to approve a contact lens post cataract surgery. By that time a successful anatomical operation is wasted as the child will be close to blind from a lack of focusing for so long a period of time.

Again, extreme rationing. Solution: I have a foundation here in Atlanta supported 100% by private funds which supplies all of these contact lenses for my Medicaid and illegal immigrants children for free. Again, waiting for the government would be disastrous.

[Hat tip: Commenter “John.”]