Terri Schiavo close to death as I write, let me say that what I
say here is not going to affect the outcome. She is going to die.
But so are 50
million unborn infants this year and every year, worldwide.
For them, there are no headlines.
are representative cases that, for unpredictable reasons, do get
headlines. The Schiavo case is one. Such cases are important as
representative cases that point to where we are headed: judicially,
morally, and economically.
Schiavo is going to die because the state is paying for her, and
it wants off the hook. But it does not want to admit defeat, so
it will not allow private parties to pick up the feeding tube and
thereby pick up the tab. Such an action would challenge the state’s
monopolistic authority to provide life or deny it.
is not stated publicly. To do so would point out that all those
who rely on Medicare and Medicaid, or who will be pressured into
the system soon, and whose families may find themselves in similar
financial circumstances, are going to get the plug pulled when red
ink overwhelms the Medicare system.
is cost effective, assuming that God is not the Accountant.
Wanniski quoted a rhetorical hand grenade tossed by Daniel Henninger
in a Wall Street Journal column.
25 years, the baby boomers will be on the cusp of 85, becoming
what a physician friend has called “history’s healthiest generation
of Alzheimer’s patients.” As the tsunami of red ink collapses
the struts beneath the tar-paper shacks of Medicare and Social
Security (which the Congressional elders say isn’t broken) the
“scarce resource” argument will re-emerge, with soothing persuasiveness,
for triaging the most ill among us, very old or very young.
Henninger has used the correct word: triage. In a military battlefield
hospital, doctors make a three-part decision in each case, identifying:
(1) those who will survive without treatment, (2) those who will
not survive with treatment, and (3) those who may survive with treatment
but will die without it. The third group gets treatment. This is
the reality of scarce resources. At zero price, there is more demand
tsunami of red ink really is going to collapse the struts beneath
the tar-paper shacks of Medicare and Social Security. Those who
favor these tax-funded struts and are paying today for millions
of old people who live in these tar-paper shacks, do not want to
admit this publicly. They do not want to admit that Terri Schiavo
is the poster child of Medicare triage. But she is.
they hide behind legality: court authority, state’s rights, no federal
interference. No federal interference? Their self-delusion is matched
only by their hypocrisy. Most of them have spent their entire adult
lives demanding more federal interference. But the bills are about
to come due. The issue now is: Who pays? The guy behind the tree,
TO LIFE = OBLIGATION TO PAY
are no free lunches. This is the scarce resource issue.
say that Terri Schiavo has a right to life is to say that someone
else has a legal obligation to pay to keep her alive.
obligation to pay is an inescapable concept. It is never a matter
of “obligation to pay vs. no obligation to pay.” It is always a
question of “who has the obligation to pay and which jurisdiction
of civil government has the obligation to say who has the obligation
horror of the Schiavo case is not that the state has pulled out
the feeding tubes. The state was paying for those tubes. He who
pays the piper calls the tune. To deny this is to adopt tooth-fairy
economics and ultimately tyranny. The state must be under law to
spend money in predictable ways. If it is not under law, then the
politicians will take our money and spend it on anything they choose.
horror of the Schiavo case is that the state will not allow anyone
else to pay in order to stick the feeding tube back in. Police are
arresting people who attempt to give her water.
on either side wants to put the issue in these stark terms. The
pro-Schiavo forces want tooth-fairy economics, and the anti-Schiavo
forces want to reduce the red ink, which is not good public positioning
for advocates of the healer state.
defenders are not willing to say up-front: “The state has a legal
obligation to put the tube back in.” That would make them appear
to be advocates of socialized medicine. They do not want to appear
in public as advocates of socialized medicine.
executioners are not saying up front: “If you become a vegetable,
we will vote for those who will pull the plug on you, so you had
better stay healthy enough to feed yourself.” That announcement
would make it appear as though the state will run cost-benefit analyses
on you if you crap out in the Alzheimer’s game, which of course
it will. This is the rogue elephant in the living room.
can’t put a price on life,” we hear moralists say: sometimes pro-lifers
and sometimes pro-welfare statists. This phrase is utter nonsense.
put a price on life every time we buy a life insurance policy or
a health insurance policy. That price is a matter of enforceable
put a price on life when we say in marital vows, “in sickness and
in health, till death do us part.” That price used to be a matter
of enforceable legal contracts. The fact that it is no longer predictably
enforceable is a big part of the Schiavo case. Her husband, who
is about to become to be ex-husband, has what used to be called
a mistress and two children — what used to be called bastards —
by her. Times change. Language changes. Laws become unenforced by
is always a price on life. The question is: Who pays?
I want from the pro-Schiavo people is a signed public document:
the undersigned, assert the right of Terri Schiavo to live. This
means that someone must pay. We hereby pledge to pay for her care
until she dies.
we stand on moral principle against socialized medicine and all
taxpayer money going to keep people like Terri Schiavo alive,
we hereby also pledge to support every other victim like her —
every Alzheimer’s patient who can no longer feed himself, every
brain-dead victim of a stroke or accident, and every other American
in her condition — just as soon as the insurance money runs out
and her immediate family has declared bankruptcy. This is a blank
check. Representatives of victims may cash it at any time
I want from the anti-Schiavo people is a signed public document:
We, the undersigned, hereby acknowledge that government-funded
medical care has limits, that there are no free lunches in life,
and therefore that public authorities must put limits on open-ended
fiscal bloodletting, such as Terri Schiavo represents. We call
the President to appoint a Medicare Triage Commission, which will
lay down guidelines on what kinds of patients will get the plug
in order to keep the human vegetables of rich families from getting
special advantages, we hereby demand that the Schiavo ruling be
extended, so that no one with private funds be allowed to keep
alive those on whom the state has just pulled the plug.
John Wayne used to say, “That’ll be the day!”
pro-Schiavo forces are looking for the tooth-fairy unless they face
the implications of what they are saying, namely, that those who
maintain life must present the bills for life to someone. Who is
to collect payment? Who is to make payment? Who is to enforce payment?
Until these issues are faced squarely and publicly, the Schiavo
case is just one more emotion-laden opportunity to raise funds by
non-profit ministries through posturing.
anti-Schiavo forces are in the process of publicly abandoning tooth-fairy
economics. The tooth fairy is always the state for these people,
and she has a pair of pliers. They are beginning to see what the
tooth fairy has been doing with those pliers since FDR’s presidency,
and they have begun to pay more attention to their teeth.
GOOD SAMARITAN WAS AN EXPLOITER!
I was in graduate school, a pro-welfare state fellow grad student
told me that he opposed all private charity. “It makes rich people
feel good about themselves.” The issue for him was envy. He would
rather see no one helped than see rich people feel good about themselves
by helping. In the Stalinist era, there were laws against private
charity in the USSR. That grad student was a faithful representative
of the Stalinist outlook regarding non-state activities.
police are arresting people who want to give Terri Schiavo a drink
of water. Such charitable actions would indicate that the state
does not have the right to determine who among the legally innocent
will live or die. Such lawlessness must be prohibited!
Schiavo is a representative figure for both sides. On the side of
Mrs. Schiavo stands a confused group of people who think the state
should remain the Good Samaritan. On the side of the courts that
have determined that she must die stands a much larger group of
people who hate private charity because it makes donors feel good.
These people want the state to control charity, so charity must
become compulsory. To keep the red-ink tsunami limited, they now
demand the right to cut off the losers from the state’s feeding
tube. To assert the final authority of the state in matters of life
and death, they insist that others not be allowed to pay for a feeding
tube with their own money.
fundamentalist Christians who make up the bulk of Terri Schiavo’s
defenders have no social philosophy. They never have. They hate
such “academic stuff.” “We love Jesus. We have no time for social
philosophy!” They are deeply emotional. They want to Do The Right
Thing. Their idea of the Right Thing is to Be Nice — with taxpayers’
money. They are welfare statists for Jesus. What would Jesus
do? Raise taxes!
welfare state secularists who oppose Terri Schiavo’s right to life
see the red ink coming. They see that the bankruptcy of the Medicare
system could create a massive political reaction against the promises
of politicians to provide tax-funded healing at below-market prices.
The myth of the state as healer is about to have its feeding tube
pulled by a lack of funds. Let it never be! So they are silently
admitting that triage must be performed. But nobody in the private
sector must be presented with the bill, because the anti-Schiavo
people themselves may someday have the bills presented to them for
close relatives in her condition. Better to invoke euthanasia
by court order. It’s cost-effective, and it also reduces guilt.
“Sorry, Doctor, I won’t be paying this bill. I’ll miss momma, of
course, but the judge has made his decision. It’s final.”
God help us all. When the red ink tsunami hits, the state surely