Your family or the government? At least, that was ‘Puter’s takeaway after reading this Megan McArdle piece over at The Atlantic.

Ms. McArdle looks at the significant problems New York has with state run facilities for the elderly and the mentally retarded n/k/a developmentally disabled. Ms.McArdle correctly diagnoses the problem as one of funding.

Patient care would certainly be better if we could build top of the line nursing homes, and pay caretakers far better. But there’s only a finite amount of money to go around.

But what do you cut to do so? Education? Highway maintenance? Environmental protection? Police? Fire and rescue? There’s no good answer, and the previously slowly rising tide of old folks is set to quickly become an overwhelming tsunami. Do we sacrifice the young to pay for the old, because that’s where our current path is taking us?

And before any delusional lefties jump on ‘Puter, in New York raising taxes is not a viable option. New York’s taxes are already exorbitant, causing young people and the mobile rich to flee the state in droves. “Raising revenues” (i.e., raising taxes) will only exacerbate the problem and result in lower net collections.

By way of example, ‘Puter pays in state income taxes nearly two-thirds of what he pays in federal income taxes. Add to that annual real property taxes of nearly four percent (4%) of assessed value and a county sales tax of eight percent (8%) and you will see why New York is a (public) workers’ paradise and hell on Earth for everyone else.

To ‘Puter, part of the problem is one of funding, as Ms. McArdle notes. But only one part. There are other parts such as disintegration of the family unit and government usurpation of charitable functions. Those factors, coupled with rapidly improving medical treatments and commensurate increased longevity further complicate the problem. If people live longer, you’re going to get more old people, further stressing the system.

In the past, families cared for their aged relatives up until death. When families couldn’t provide care, charities such as those run by the Catholic Church picked up the slack. The tag team of familial duty and charity worked well in this country for a couple of hundred years.

When government determined it would provide for everyone’s needs (New Deal, Great Society), families no longer felt obligated to take care of grandma. She’s got Medicare and Social Security. She can take care of herself. We’ll help pick out a nice nursing home, but after that, she’s on her own.

Not only did government intervention drive families out of the caretaking business, it drove charities out as well. People quickly equated paying taxes with charitable giving. There’s no need to give to the Red Cross or to Catholic Charities if I’m paying my taxes. I’m already paying the government to meet these needs. As funding for charities has decreased, so too has their ability to provide the essential services they once did.

To be sure, some government money still flows to charities. The government will contract with charitable providers to provide services it is unwilling or unable to provide. But in so doing, charities agree to work under government rules. Ask Catholic hospitals what it means to either forego government money or provide abortions. It’s a no-win situation for many providers. Go out of business or sell your soul.

Back to the main point. When government provides health care, it will of necessity make the ultimate decision about what care, and how much of it, is provided. In New York, this reality has resulted in crappy conditions for those least able to care for themselves.

‘Puter doesn’t believe that government drones (or even evil legislators) are sitting in their smoke-filled rooms cooking up new ways to stick it to the old and retarded. These folks are faced with competing and equally important interests, and have to make miserably difficult decisions with real-life impacts on real-life people. How much care does grandma get in order that little Billy gets to go to school next year? Does grandma get a new hip, or do the drivers in Yonkers get repaved roads? Can Uncle Joe make do with a generic blood pressure medication so Buffalo can plow its roads?

So ‘Puter asks again. Who gets to kill Grandma?

The government currently makes the decision, in the quality of care it provides and the extent to which it will provide treatment at all. And when the government is providing the treatment, it’s easy to answer the question “How much should we pay to save 97 year old obese, diabetic, blind, senile Granny’s life?” with “EVERYLASTDAMNEDPENNYGUBBAMINTHAS, YOUHEARTLESSBASTARD!!1!” Mostly, because the people answering the question don’t directly feel the pain of writing the check.

But ask the question again to family members when they are paying for treatment. Maybe the answer becomes “Granny’s not getting any better and her quality of life sucks. She’s lived 97 years and doesn’t even know she needs a new heart. Can we keep her comfortable as she dies in as dignified a setting as possible?” This is not advocacy for euthanasia, but rather for a responsible examination of quality of life and a meaningful cost/benefit analysis. ‘Puter hopes that his kids have the stones to apply the same sort calculus to him when he’s old and decrepit.

Our country was founded on the notion of limited government. To ‘Puter, limited government is similar to the Catholic concept of subsidiarity. That is, the decision should be made at the lowest level where it can competently be made. In ‘Puter’s health care examples, the lowest responsible unit at which that decision can be made is the family.

At the end of ‘Puter’s days, he sure as heck hopes it’s his family making the decisions on his care, rather than some bureaucrat far removed from ‘Puter’s deathbed. At least he’s got a fighting chance with his kids.

Maybe Dr. J, the Royal Surgeon, would like to weigh in on the topic.

'Puter

Always right, unless he isn’t, the infallible Ghettoputer F. X. Gormogons claims to be an in-law of the Volgi, although no one really believes this.

’Puter carefully follows economic and financial trends, legal affairs, and serves as the Gormogons’ financial and legal advisor. He successfully defended us against a lawsuit from a liquor distributor worth hundreds of thousands of dollars in unpaid deliveries of bootleg shandies.

The Geep has an IQ so high it is untestable and attempts to measure it have resulted in dangerously unstable results as well as injuries to researchers. Coincidentally, he publishes intelligence tests as a side gig.

His sarcasm is so highly developed it borders on the psychic, and he is often able to insult a person even before meeting them. ’Puter enjoys hunting small game with 000 slugs and punt guns, correcting homilies in real time at Mass, and undermining unions. ’Puter likes to wear a hockey mask and carry an axe into public campgrounds, where he bursts into people’s tents and screams. As you might expect, he has been shot several times but remains completely undeterred.

He assures us that his obsessive fawning over news stories involving women teachers sleeping with young students is not Freudian in any way, although he admits something similar once happened to him. Uniquely, ’Puter is unable to speak, read, or write Russian, but he is able to sing it fluently.

Geep joined the order in the mid-1980s. He arrived at the Castle door with dozens of steamer trunks and an inarticulate hissing creature of astonishingly low intelligence he calls “Sleestak.” Ghettoputer appears to make his wishes known to Sleestak, although no one is sure whether this is the result of complex sign language, expert body posture reading, or simply beating Sleestak with a rubber mallet.

‘Puter suggests the Czar suck it.