So Jimbo decided that we ought to do a Freefly interview while we were sitting at the hotel patio. After he set the camera up, I asked what he wanted to talk about and he said “Afghanistan”…

Sadly, the video ended before I could really make the points I’ve been musing over. So here we go…

I’ve been working on a long post about Afghanistan, inspired in large part by Andrew (Abu Muquama) Exum’s blog challenge asking:

Is the war in Afghanistan in the interests of the United States and its allies? If so, at what point do the resources we are expending become too high a cost to bear? What are the strategic limitations of U.S. counterinsurgency doctrine and operations? And if the war is not in the interests of the United States and its allies, what are U.S. and allied interests in Central Asia – and how do you propose to secure them?

There were seven days of answers (1,2,3,4,5,6,7), culminating in Exum’s own response (read the whole thing, but here’s the nub):

That unknown colors my own thoughts. I believe, contrary to many of this blog’s readership, that Steve Biddle really does get our interests right in Afghanistan:

The United States has two primary national interests in this conflict: that Afghanistan never again become a haven for terrorism against the United States, and that chaos in Afghanistan not destabilize its neighbors, especially Pakistan. Neither interest can be dismissed, but both have limits as casus belli.

I also believe that both interests can be secured, and I believe that neither interest is worth unlimited U.S. and allied blood and treasure.

Go read forward from this post, and see a lot of other chatter about Afghanistan.

So?

Once I read all this, I’m left deeply anxious and concerned. These are among the smartest people in the country who are engaged around this issue; they are all people who have significant experience in foreign and military policy.

And it just seems to me like they are missing the most important point.

A resurgence of terrorist violence across Southeast Asia has exposed links between various Islamist terror organizations that have proved resilient despite a yearslong U.S.-funded crackdown by authorities in the region.

The rise of terrorism has come into focus in the wake of a series of attacks in the Philippines, southern Thailand and, most recently, the suicide bombing here July 17 on the JW Marriott and Ritz-Carlton hotels that killed nine people including the two bombers. The terror resurgence comes after years when authorities appeared to be gaining the upper hand.

As the terror groups expand their activities, investigators are uncovering connections that show how the main organizations across Southeast Asia, many of them inspired by al Qaeda, are providing militants, training and shelter to each other. That has increased their effectiveness and made them especially difficult for authorities to crack.

As this story points out, our conflict is not with a country (Afghanistan or even Iraq); it’s with a movement (that is, to be sure partly fed by state sponsorship – but the most important states doing the sponsoring, in money, manpower, and ideas have been Saudi Arabia, Iran, and Egypt). And as long as we keep defining our strategic objectives in the context of a single country, or maybe a country and its geographic neighbors, we’re misaligning our objectives with the problems we face.

What matters in Afghanistan is how our prosecution of the conflict there impacts the broader movement of radical, violent Islam. Outside of this effect, the conflict in Afghanistan is strategically meaningless.

What matters here is not a spatial geography or Westphalian interaction between states who have authority over their own geography and people; we’re talking about a cultural and intellectual geography – a map of relationships and beliefs.

And as long as were fighting on the wrong map, no matter how hard we try or how smart we are, I worry that we are bound to lose.
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(I know Jules Crittendon already has this kind of handled, but I saw this on my newsfeed and couldn’t resist).

Sockpuppetmeister Glenn Greenwald (yes, our sins do stick to us) just slammed the hiring of Jenna Bush as a TV personality in a post titled:

It’s time to embrace American royalty

The lede is:

They should convene a panel for the next Meet the Press with Jenna Bush Hager, Luke Russert, Liz Cheney, Megan McCain and Jonah Goldberg, and they should have Chris Wallace moderate it. They can all bash affirmative action and talk about how vitally important it is that the U.S. remain a Great Meritocracy because it’s really unfair for anything other than merit to determine position and employment. They can interview Lisa Murkowski, Evan Bayh, Jeb Bush, Bob Casey, Mark Pryor, Jay Rockefeller, Dan Lipinksi, and Harold Ford, Jr. about personal responsibility and the virtues of self-sufficiency. Bill Kristol, Tucker Carlson and John Podhoretz can provide moving commentary on how America is so special because all that matters is merit, not who you know or where you come from. There’s a virtually endless list of politically well-placed guests equally qualified to talk on such matters.

Go read the whole thing, if you haven’t already. Then go read Crittendon’s scathing takedown.

Then go over to ABC News and read this:

Another Kennedy May Head to the Senate:
Will the Famed Family’s Legacy Linger on?

The race to succeed Kennedy has been effectively frozen in place as a handful of ambitious Democrats wait to see what Kennedy’s family members might do.

As reported by George Stephanopoulos today and confirmed by Patrick in a news conference in Boston this afternoon, Vicki Kennedy, the senator’s widow, is not interested in an interim appointment, if state law is changed to allow the governor to appoint a stand-in until the election.

and

With Kennedy’s widow apparently out of the running, attention has turned to the senator’s nephew, Joseph P. Kennedy II, who was a House member for Massachusetts for 12 years, in the emerging race to fill out the rest of the late senator’s term. One Massachusetts Democrat with close ties to the Kennedys said Joe Kennedy would make up his mind by the end of this week, and that he’s “about 50-50” on whether he will run.

Now I’ve got to tell you that I’m deeply disturbed by the notion that elective office is somehow heritable; but you know it’s funny – I don’t limit my disdain for those who politically agree with me.

In Update III, Greenwald hides behind a figleaf:

That said, today’s post is about a particular strain of royal succession: those who inherit their position and and whose achievement is attributable to their mommies and daddies and yet ludicrously purport to be Stern Advocates for (and Beacons of) Meritocracy and become righteous opponents of “unfair” affirmative action on the ground that only merit should determine advancement. Not everyone who inherits their influence is guilty of that.

So if you’re left, it’s OK to practice dynastic politics because, you know, you don’t really believe in freedom or achievement or anything like that. What an utter pile of crap.
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I’m off to DC tonight for much of next week. I’ve got two draft posts I’ll try and get out – one on Afghanistan, and one on Bacevitch – I’m going to try and do a post a week on “The Limits of Power” and deal with it chapter by chapter.

After we left Bragg, TG wondered about the M4’s she’d seen the soldiers carrying.

On the way home, we stopped to visit some friends, one of whom was my old shooting mentor:

TG thought the rifle was pretty neat.

There’s an interesting debate to have on gun rights about “assault rifles.” On one hand it’s naive to state that they don’t have tactical advantages over other kinds of rifles – meaning that they are, in fact, more dangerous.

On the other, it’s virtually impossible to define them in a way that makes any sense, and it’s also impossible to quantify how much more dangerous they really are – a lever-action cowboy rifle in the right hands can shoot and reload pretty quickly as well.

Switching back, I can’t imagine gang kids developing that level of skill.

Ten years ago, I probably would have shrugged and said “meh. go ahead and restrict ownership to them if you can figure out how” Today, not so much. But it’s still true that to me the debate about regulating these guns is the most interesting and meaningful debate about firearms regulation. because what we’re talking about in a serious way is “why” it’s OK for civilians to own firearms.
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Harvard-educated Matt Yglesias obviously skipped classes on Public Choice (which explains a lot about his views, actually):

At the same time, I’ve come to be increasingly baffled by the high degree cynicism and immorality displayed in big-time politics. For example, Senators who genuinely do believe that carbon dioxide emissions are contributing to a global climate crisis seem to think nothing of nevertheless taking actions that endanger the welfare of billions of people on the grounds that acting otherwise would be politically problematic in their state. In other words, they don’t want to do the right thing because their self-interest points them toward doing something bad. But it’s impossible to imagine these same Senators stabbing a homeless person in a dark DC alley to steal his shoes. And what’s more, the entire political class would be (rightly!) shocked and appalled by the specter of a Senator murdering someone for personal gain. Yet it’s actually taken for granted that “my selfish desires dictate that I do x” constitutes a legitimate reason to do the wrong thing on important legislation.

I just happen to have a copy of James Buchanan’s collected works ‘Politics as Public Choice‘ on the shelf…Matt, just click the link and buy the book – it’ll open your eyes to all kinds of things.

(h/t Tyler Cowan, who probably has read Buchanan)
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It’s been interesting over the last few weeks, to try and suss out the turbulent political waves and to begin to see some clarity emerging. I’ll suggest (shockingly) that what we’re seeing reinforces a belief that I’ve had for quite some time – meaning it’s good for me to put it out there to be challenged.

Looking at why Obama seems to be having such a popularity collapse suggests that models of the polity that were bipolar – i.e. D’s and R’s – probably don’t represent reality as models that are tripolar – D’s, R’s, and I’s. And while the I’s may be largely ideologically rooted in one side or the other, their “brand attachment” is weak, meaning that they can be flipped easily or else that they aren’t necessarily going to come out and vote unless they are engaged.

Both GWB and Obama managed to engage a large group of these I’s; in each case for a variety of historical reasons, but also, I’ll suggest because they presented as postpartisan – as essentially independent-friendly candidates.

No Republican is going to seriously chase Henry Waxman’s support, and no Democrat is going to seriously chase Newt Gingrich’s. The folks clustered at the ends of the spectrum are essentially locked in via brand attachment. But there’s a ever-increasing cloud of people in the middle – call it for grins the Althouse – Danziger – Kaus – Reynolds axis, who are tippable. And not just tippable once and then stable (in the manner of Southern Democrats facing a McGovern candidacy), but tippable election to election, issue to issue (almost week to week).

Eric Alterman suggests today that Obama won because he appealed to us:

Robert Kuttner, co-founder and co-editor of The American Prospect, asks, on The Huffington Post, “Will somebody please explain to me why Barack Obama is still on his bipartisan kick…What do these guys think they are getting by continuing to kiss up to the Republicans?”

I think the answer to Mr. Kuttner’s conundrum can be found in an article, ironically enough, by one Mark Schmitt, who happens to be executive editor of, you guessed it, The American Prospect. Way back in December 2007, when supporters of both Hillary Clinton and John Edwards were pummeling Obama on what they deemed was the wishy-washiness of his bipartisan appeal in the face of so nasty an opponent, Schmitt published an influential (among liberals) argument, “The ‘Theory of Change’ Primary“. In it, Schmitt argued that liberals were “too literal in believing that ‘hope’ and bipartisanship are things that Obama naively believes are present and possible, when in fact they are a tactic, a method of subverting and breaking the unified conservative power structure. Claiming the mantle of bipartisanship and national unity, and defining the problem to be solved (e.g. universal health care) puts one in a position of strength, and Republicans would defect from that position at their own risk.”

Obama invited me to dinner shortly after he became a senator, and I got exactly the same impression. This man is, like FDR, a genuine liberal, but also a serious politician. He is not interested in moral victories or noble defeats. He wants to win. What he’s figured out, however, is that – particularly after two full decades of Bush/Clinton/Bush wars – the American people feel more comfortable with a politician who appears to reach out to the other side, who gives them a chance to play ball. This works both as an electoral strategy and a governing strategy. He gave in a little on the stimulus, but just enough to keep the ball rolling. He could always come back for more, later if necessary.

The change is real:

The slippage among college-educated whites also helps explain Obama’s troubles with independent voters, another more troublesome trend for him. All of the most recent national surveys have placed his approval rating among independents below 50 percent, although his positive ratings with them still generally exceed his negative marks.

The NBC/Wall Street Journal national survey also released this week offers some insight into that decline. It found that just 31 percent of independents now approve of Obama’s handling of health care, while 54 percent disapprove, according to crosstabs from the poll provided by Public Opinion Strategies, one of the pollsters. Asked their view of Obama’s health care plan, just 28 percent of independents said they consider it a good idea, while 43 percent described it as a bad idea, and the rest said they didn’t know.

So the core difference between me and a typical Netroots blogger is that they passionately, deeply, believe that as soon as ‘truly pure’ candidate steps forward, a vast ‘hidden majority’ will appear. (Note that conservative purists and Paulistas believe the same thing). I think that’s a delusion, and that what we have is a multpolar electorate with three major poles; liberals, conservatives, and moderates (who may be moderate because their views can’t be encapsulated in either camp – like mine [pro-gun, pro-environmental regulation etc.] or because their views genuinely stand between the poles of ideology). If they are right, Obama should turn hard left and wait for the support to explode. If I’m right, when he does that, his support will collapse.

I’ll suggest that recent events offer more evidence that my model is right than theirs.

There’s another important issue. Althouse thinks that:

Basically, Obama has a big problem. He got lots of people to trust him, chiefly by doing exactly what Krugman now complains about: speaking in vague generalities. It only works from a distance.

I’ll suggest a corollary: That he took the positions that would have worked (albeit with a lot of sweat, labor, and compromise) and tried to use them as a fig leaf for more traditional power politics. It doesn’t work.

In my work life I caution clients about using community and the explicit promise of empowerment, dialog, and engagement as a fig leaf for traditional marketing. It really, truly, deeply pisses people off. If that’s really what Obama is doing, it’s going to end badly for him and for all of us.

The reality is that the game is still in early innings, and Obama is going to be President for more than three more years. He’s got time to course correct, and to do two critical things:

Understand that the base isn’t big enough to win, and that what’s needed is to both placate the base and reach out to the swing voters. That can be both via substance and process (and we’re not getting much of either just now).

Really get it that promising transparency and engagement and delivering machine politics is an absolute route to early retirement. Be transparent, and be engaged. Obama is smart and eloquent enough to be able to hold his own with audiences that haven’t been packed; his handlers need to trust him a whole lot more. And trust the American people to engage with honesty when treated with respect.
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…fixed typo in Mickey Kaus’ name…

Commenter Beard reached out and asked me what I thought of the folks who are practicing open carry at healthcare townhalls and other political events these days.

Over the years, my position on gun rights has hardened somewhat; I’ve moved from “oh, there are a lot of reasonable restrictions…” to “no, there are very few reasonable restrictions.”

So looking at the phenomenon as purely a gun rights issue, I think the people are idiots and counterproductive but within their rights. They are idiots and counterproductive because what they intend to do is inflame reaction. We’re not talking about someone wearing a gun as a matter of course and showing up at a coffee house somewhere. We’re talking about someone (a black someone, by the way) who straps on a holster and handgun and then slings an AR15 shorty over his shoulder – and one with a magazine in it.

Folks, that’s exhibitionism, and while on one hand I get it that “Martin Luther King is only as powerful as the crazy nigger with the Molotov cocktail standing behind him” (as I believe Abbie Hoffman was quoted), on the other real progress in civil rights was made by men and women who dressed in their Sunday best and quoted scripture.

But this isn’t just an issue of gun rights.

It is an issue of many people’s insecurities about the role government intends to play in their lives, and their feeling that we’re at a “this far and no further” moment. There’s an obvious locus between people who believe passionately and seriously in gun rights, with all that entails – personal responsibility, individual empowerment – and people who don’t like the idea of a National Health Service and are worried that the current healthcare plans might take us there (just as there’s an obvious locus between people who don’t believe in gun rights and who do believe in a NHS).

So I’m not shocked by this.

But I do disapprove of it – strongly. And I do encourage my shooting friends not to do it, and when at events like this, to take the armed folks aside and talk to them, shooter to shooter.

Let’s have open-carry days and weeks as a way to firm up gun rights, and to demolish the notion that gun ownership is somehow abnormal or marginal. But I’d be very damn careful about bringing a gun to a political argument.

Why? Two strong reasons.

First, as a shooter I’m someone who considers the responsibility I take on by being armed to be massively significant. Bringing a gun to someplace where argument or even – god forbid – shoving might break out is asking for tragedy to happen. The worst possible place I can imagine being is armed and facing a situation that is emotionally heated and where shoves or fists are possibly going to be thrown. I’m not someone who is likely to get punched or shoved – but I can tell you that I’m not going to shoot someone for shoving me, period. There’s a reason states with CCW often forbid carrying into bars.

Second, as a citizen, because the point of being one of the few armed people in a larger group of unarmed people can only be – on some level – to intimidate. It’s not about defending yourself; you’re not really at risk in a public group setting like this. It’s about making a statement, and that statement is in part “don’t eff with me.” One point I hope I’ve been absolutely constant on is that anything that drives people out of debates is bad. And somehow I can’t see myself walking into a meeting with a M4 over my shoulder, a few magazines in a tac vest, and a handgun on my waist and sitting down and telling someone that I welcome disagreement – and being taken seriously.

Now the liberals who have their boxers in a bunch over this have absolutely no standing with me, and should have none more broadly on this issue; for where were they when the Jews are shut down at Concordia or UCSF by violent protest, and we were told “it’s just kids”. When conservative or right-wing speakers are forced offstage or their speeches canceled ‘to preserve order.’ that’s just fine. Sorry, no it isn’t…or, if you think it is, you don’t get to whine when the other side ups the ante.
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The buses pulled away for the airfield about 12:30 am Saturday morning.

Up until then, we’d been scattered in little company-centered groups across Fury Field, a grassy quad in the middle of modern office buildings and barracks, some hiding from the intermittent rain under temporary canopies, some of us just standing in the warm rain. Mostly it was soldiers in ACU’s; peering at lists illuminated by red-lensed flashlights, moving huge rucks or duffel bags onto flatbed trucks like ant swarms carrying large crumbs or just sitting alone or with wives and children or girlfriends or the occasional parent.

We parents had evolved a standard greeting; a handshake, a tight smile, a compliment to each other’s kids, a soft “…they look good, don’t they…they’ll do just fine.” line of reassurance. The wives and girlfriends allowed themselves emotion; we kept ours to ourselves. Biggest Guy’s sergeant sat on the wet pavement with his small, ACU-clad son asleep in his lap, leaned into an hour-long hug with his young wife who grabbed him tighter every time he started to lean away from her.

The weapons were casually set on the ground, laying on their sides, or on bipods, or leaned against small assault packs. They seemed – insignificant – in the swarm of people, kind of an afterthought that no one paid any attention to except the soldier assigned to watch over them and the people walking past who delicately stepped over them.

Up until then, it had been a kind of unreal; it felt more like the kind of away games I remember from high school sports, except that instead of girlfriends, there were wives and small children. The level of emotion and tension – until late in the evening – was kept in check.

Then the soldiers went to the armory and drew and prepared their weapons.

The parents sat watching and waiting.

Then they were called into ranks and counted; the counts were never right and there was a light buzz of confusion “why are you here? you’re not on the manifest! where’s Cooper…anyone seen Cooper?”

That somehow died down and led to the young soldiers answering “Moving!” to a name, picking up their packs and weapons and walking off to the idling busses as the families ran forward and grabbed them for one last hug. TG gave Eric a long hug, kissed his cheek and then I grabbed him by the back of the head, pulled him to me, let go and he was suddenly walking away into the dark toward the waiting bus.

We drove past the idling busses back to the Airborne Inn and a restless sleep.

But he’d given us his phone, and at 4:30 am it ran out of battery and started beeping; I got up to turn it off and realized that his plane for Manas, Kyrgyzstan was just leaving, and that was it for sleep for me.

We’re in Charlotte, visiting friends and relaxing for a bit. Home end of the week and our routine starts again; maybe just a little different.
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BID a strong ghost stand at the head
That my Michael may sleep sound,
Nor cry, nor turn in the bed
Till his morning meal come round;
And may departing twilight keep
All dread afar till morning’s back.
That his mother may not lack
Her fill of sleep.
Bid the ghost have sword in fist:
Some there are, for I avow
Such devilish things exist,
Who have planned his murder, for they know
Of some most haughty deed or thought
That waits upon his future days,
And would through hatred of the bays
Bring that to nought.
Though You can fashion everything
From nothing every day, and teach
The morning stats to sing,
You have lacked articulate speech
To tell Your simplest want, and known,
Wailing upon a woman’s knee,
All of that worst ignominy
Of flesh and bone;
And when through all the town there ran
The servants of Your enemy,
A woman and a man,
Unless the Holy Writings lie,
Hurried through the smooth and rough
And through the fertile and waste,
protecting, till the danger past,
With human love.

– ‘A prayer for my son,’ by William Butler Yeats

Over at TNR, in an article titled ‘Have You No Decency?‘ Harold Pollack engages in some gratuitous Palin-basing in his commentary on healthcare policy:

Palin and Bachmann remind no one of Hillary Clinton in their success in grasping complex policy issues, or in their desire to do so. It may be too much to expect them to trace the origin and veracity of these talking points.

…but politics ain’t beanbag, as they say, and I’m not in the Palin-defending business (or in the business of defending any other public figure).

I am in the trying to get people to be honest and consistent in their arguments business, and so – given that the thrust of his argument is that Palin and Bachmann are being dishonest when they say that one of the consequences of healthcare reform is that:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

– he needs to show just a little honesty himself.

Instead he responds by making five points:

1) “I can’t find the words “death panel” in any administration position paper, the stimulus package, or the House and Senate draft health reform bills.”

2) “First, these issues are quite separate from the main issues being debated in health reform.”

3) “Second, health reform would address an equally fundamental dilemma of human dignity and human rights: millions of people’s lack of access to basic care.”

4) “Third, people genuinely worry that comparative effectiveness research (CER) is a stalking horse for rationing or for curtailing care for the sick, elderly, or disabled. This is a misplaced concern.”

5) “Fourth and finally, publicity-seeking politicians subtract a lot from these conversations. Palin, Bachmann, and others score cheap points by scaring people and by spreading falsehoods.”

To which I respond:

1) When the bill calls for Medicare to make ‘end of life counseling’ part of the healthcare process, we’re talking about some kind of change. And when administrative decisions are made about what will and won’t be covered – when government and law reaches deeper into personal medical decisions as it will have to in order to rationalize them – the point he’s making is somewhere between niggling and deceptive.

2) Yes and no; as I noted in my personal story about this, these are brutally difficult decisions that are wrenching at a personal level and massively expensive to us socially. As my cohort ages, they will get far more wrenching and far more expensive. By shifting the locus of decision from social norms and personal choice (and yes, personal means) toward an administrative handbook, we are changing the game. There’s no way around that.

3) Straw man. Careful you don’t catch fire carrying that around. It’s perfectly possible to propose a health care plan that doesn’t touch end of life care; it just won’t be as ‘curve bending’ as it would be otherwise.

4) Liar, liar, pants on fire. Here’s Pollack later in the same paragraph:

None of the identified high-priority items involved anything approximating the rationing of life-saving or life-extending care. End of life care ranked 28th in their chart of priority areas for CER research. This may be a mistake. Better approaches to palliative care often look very good when evaluated against the standard benchmarks of medical cost-effectiveness.

(emphasis added)

5) The answer to bad arguments is better debate. If Pollack weren’t so concerned with shutting his ideological opponents out of the argument (“I wish the Post would exercise greater quality control over what appears in its pages.”), he might plausibly be making a case for a higher level of debate. But to him – no debate is necessary.

Which makes him the most dishonest person in this argument.

Because on an issue this big, complex, and important, we need lots and lots of debate.

I honestly don’t know where I stand on Obama’s bills. I believe we need to make changes in our healthcare system. I even – shudder – think it’s legitimate to talk about how much of other people’s money we’ll use on treatments that are certain to be fruitless (I’ll go stand over in the corner with the UK National Health bureaucrats now).

But the idea that we’ll do something like this in 90 days to get it done before midterms is a f**king joke. And makes me as inherently suspicious as the used-car salesman who says that I can have this deal on the car, but only if I sign right now.

Let’s work on health care without buying any clunkers, if we possibly can.

UPDATE: Here’s the Charles Lane of the teabagging Washington Post on the issue:

On the far right, this is being portrayed as a plan to force everyone over 65 to sign his or her own death warrant. That’s rubbish. Federal law already bars Medicare from paying for services “the purpose of which is to cause, or assist in causing,” suicide, euthanasia or mercy killing. Nothing in Section 1233 would change that.

Still, I was not reassured to read in an Aug. 1 Post article that “Democratic strategists” are “hesitant to give extra attention to the issue by refuting the inaccuracies, but they worry that it will further agitate already-skeptical seniors.”

If Section 1233 is innocuous, why would “strategists” want to tip-toe around the subject?

Perhaps because, at least as I read it, Section 1233 is not totally innocuous.

…

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive — money — to do so. Indeed, that’s an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic.

What’s more, Section 1233 dictates, at some length, the content of the consultation. The doctor “shall” discuss “advanced care planning, including key questions and considerations, important steps, and suggested people to talk to”; “an explanation of . . . living wills and durable powers of attorney, and their uses” (even though these are legal, not medical, instruments); and “a list of national and State-specific resources to assist consumers and their families.” The doctor “shall” explain that Medicare pays for hospice care (hint, hint).

Go read Section 1233 yourself…
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