What Obama should have done in 2009

[Torie]

Sean Trende (man the guy has produced a lot of excellent material this year imo) has written what I think is a most insightful piece about rewriting Obama's past with a view of buttressing his future ... if only.  He also I think does an excellent and quite "fair and balanced" analysis of the stimulus, and where it went wrong, when with different packaging and some tweaks it might have went right, and been far less controversial.  He also does a fly by deconstructing and reconstructing Obamacare, but that bit has less beef in it.

What do you think?

[Torie]

One thing - the most important thing going away - that Obama has not even been talking about, much less "compromising" on, is entitlement reform. That is the major reason we are in irons. This is one issue where the POTUS must lead. He hasn't been.

[Torie]

I am not sure just how the death panels work, and you may have a point. Some elements of Obamacare will surely survive in some form in the end, and have to come back.

But the lower hanging fruit is simply cutting out unnecessary medical procedures, or those with a very marginal benefit. Medicare needs to be converted to an HMO system ASAP.

Then, as you suggest, we get to the heavy lifting that some medical procedures are just too expensive, and cannot be given to everyone, no matter how old, and no matter how much they will really impact the quality of life.

And then we get to the ticking time bomb, of how to deal with the demented, a number which will triple over the next 30 years. The problem is that folks are living too long, and after 80, the rate of dementia of various forms zooms up, particularly for men (by the late 80's, nearly half of the males are demented). And right now, we don't really have the medical technology to arrest that very effectively, as opposed to just stretching out the period of dementia, which only adds to rather than subtracts from the problem.

It would help if more had the Torie attitude, of when you see dementia just over the horizon, you just off yourself. In my case, assuming I have advance notice of my leaving this mortal coil, I plan my final exit to be in the form of a massive heroin overdose.