Thursday, September 29, 2005

The Magic Words Are "Squeamish Ossifrage"...

Not really. Just trying to get your attention.

But a laurel, and hardy handshake, to anyone who can identify the provenance of this peculiar locution without using a search engine...

No, a more apt, and more felicitous, title for this post would have been "A Reverent Awareness of Human Folly."

That nice turn of phrase appears early on in a book I am enjoying right now, First Democracy, by Paul Woodruff. In spite of being a professor of philosophy, Mr. Woodruff writes with wonderful clarity, and explains his thinking in a way even I can follow. He contends that "...democracy was born out of a reverent awareness of human folly," in fifth century B.C.E. Athens. Not being an expert in either political science or history, I will take his word for it.

Now I know our republic is not a (pure) democracy, but it does embody important features of such a democracy, and the model the Athenians bequeathed us, as described in Professor Woodruff's book, can be usefully applied in the criticism of our republic's efforts to live up to the ideal of a government by and for the people.

Yesterday I was treated to a detailed description of the fruits of Congress's passage of the "prescription drug benefit." This will be implemented (at least for my workplace) as Medicare Part D.

For about two hours I sat through a PowerPoint presentation, given by a rather smart individual, about how this plan, Medicare Part D (see also), will enable (or should enable) elderly patients, and a subset of disabled patients, to afford the drugs that they need to keep alive or, more often in my psychiatric practice, the drugs that they need to keep out of the hospital.

During and after the presentation I was able to ask questions, and later at home I studied the sheaf of handouts I'd been given.

Now I do not hold myself up as a paragon of wisdom or insight, and I am almost disabled myself in my abilities to understand complicated bureaucratic programs, but I am probably about average, as a citizen, in my abilities to make political judgments, and to vote as a "reasonable person."

But even if I had been asked to vote (I wasn't) on the implementation of this plan, I would have been unable to do so in an intelligent way. I simply had trouble understanding how, if implemented, everything in this plan would shake out, both for the purported beneficiaries, and for the republic as a whole.

Let me confess at the outset that my work inclines me to support the idea of helping indigent and/or elderly patients get the medications they need, even when such an inclination is at variance with my general tendency to be a fiscal conservative. But I just cannot determine whether the outcome of this whole effort might be, among other possibilities, both that the needy patients don't get their drugs, and the country goes bankrupt in a failed effort to get them their drugs.

Furthermore it is my impression (as wretchard would say, speculation alert) that the solons who voted on this behemoth didn't have the faintest idea either.

Read here* about "The Doughnut Hole" and see if you don't agree.



*(Lasciate ogni speranza voi ch'entrate!)

8 comments:

Rick Ballard said...

Well, finding myself nel mezzo del cammin di mia vita I made a pass at the selva oscura of 'The Doughnut Hole'. After a careful and close reading I find my primary reaction to be one of stunned incomprehension. Did Kaiser hire a cross trained HHS/IRS bureaucrat to write this?

Betting on the proposition that our Congresscritter don't know what the large print (let alone the fine print) means for any particular piece of legislation would be a good way to make money - if you could find a fool to take the bet.

The prescription drug benefit was rushed through rather precipitously in order for the Reps to remove any possibility that the Dems could use the "they wanna throw Granny in the dumpster" tactic again. Instead, the Dems can now throw the "profligate spender" tag out at the group that wants only to be known as "compassionate conservatives".

DC is always a three ring circus. Personally, I think that new clowns need to be hired all round.

Jamie Irons said...

Rick,

You inquire:

Did Kaiser hire a cross trained HHS/IRS bureaucrat to write this?

Actually, it wasn't Kaiser but rather the Henry J. Kaiser Family Foundation (same Henry Kaiser memorialized in both, but no real connection), that is responsible for this obscure, almost impenetrable prose masterpiece.

But Kaiser's attempts to decipher the law, which I yesterday witnessed firsthand, are if anything worse.

The people who write regulations for the IRS could learn a thing or two from these geniuses.

Charlie Martin said...

You mean it's a prime example of good old, old-fashioned frontier gibberish?

Rick Ballard said...
This comment has been removed by a blog administrator.
Unknown said...

jamie:

I have clients who get medicaid and it pays for their drugs.

I have other clients with coverage that pays and I have a few clients who pay hundreds of dollars out of pocket for medicine every month.

I have known people to buy drugs from Canada. I have known people who made choices between the light bill and drugs.

But I don't know anyone who really seems to know if they are qualified for this program and what it will mean for them.

I don't think there is anyway to really know until it is implemented.

I really do not know the best way to handle this.

It is easy to say it is not the government's job when you don't have to see people suffer.

But then again, I have never seen a program like this that was not abused.

It is too bad that common sense and government are mutually exclusive.

truepeers said...

Just a guess on the provenance: Hitchiker's Guide to the Galaxy

Charlie Martin said...

Nicely cryptic, there, Jamie.

Charlie Martin said...

Why 129 digits isn't enough.