On Movement Conservatism and Labor… (no, the other kind of labor)

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Tod Kelly

Tod is a writer from the Pacific Northwest. He is also serves as Executive Producer and host of both the 7 Deadly Sins Show at Portland's historic Mission Theatre and 7DS: Pants On Fire! at the White Eagle Hotel & Saloon. He is  a regular inactive for Marie Claire International and the Daily Beast, and is currently writing a book on the sudden rise of exorcisms in the United States. Follow him on Twitter.

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37 Responses

  1. Avatar Patrick
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    > a risk management specialist

    I want a copy of your library list.Report

  2. Avatar Tom Van Dyke
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    I’d have liked to see Lars Larson or whoever quoted directly, to hear their argument in their own words. Then I’d have liked some reason why “movement conservatism” should be held to task for the blatherings of certain individuals.

    I mean hey, I don’t blame all liberals for Paul Krugman.

    😉Report

    • Avatar Patrick in reply to Tom Van Dyke
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      Premium content. I went looking for a transcript, and you can’t even get the audio unless you pay the vig.Report

      • Avatar Tod Kelly in reply to Patrick
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        Patrick –

        I actually did pay for one month to get it, and have asked the site for permission to embed, but have yet to hear back.

        That being said:

        Tom, if you would like me to send you to mp3 directly I didn’t agree in my subscription not to do that.

        Also your point about all conservatives vs. a representative few is a good one – I certainly get tired of people telling me I believe something because Christopher Hitchens once wrote something.

        In my state, though, I am not so sure that those that are against the hospitals aren’t a good representation of those that drive the movement. (We’re a pretty liberal state, and because of this our conservatives tend to be very galvanized and very passionate.)

        And you should well know by now that I don’t think of this disconnect of following a ideology in words but not deeds is limited to any particular group.

        Also, when is your Sub going up? Reading your own comments on the Perry posting about things you’ll be writing about is making me impatient.Report

        • Avatar Tom Van Dyke in reply to Tod Kelly
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          Aw, TK, I’m sure mgmt will let us know about the sub-blog. Code and all that.

          As for Lars Larson, I’m just not understanding his argument. I’ve caught him and not been impressed, but he’s usually not as incoherent as he comes off in your report.

          As for “movement conservatism,” that makes me think Gingrich, 1994. They haven’t sent me a newsletter since; mebbe they just voted me out without telling me.Report

          • Avatar Tod Kelly in reply to Tom Van Dyke
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            “mebbe they just voted me out without telling me.”

            Shhhhh! We’re about to send Tom to the store for milk, and when he’s gone we’re going to move away and hide. No one tell!Report

          • Avatar Will Truman in reply to Tom Van Dyke
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            I’m speculating here, but I would guess Larson’s argument to be the following:

            The federal government and insurance companies are pressuring the hospitals to take these kinds of actions because it costs the federal government and insurance companies money when labor is induced prematurely. Therefore, these third parties are interfering in what should be strictly a doctor-patient decision. This makes it less a matter of free markets and more a matter of public policy.

            To me, of course, this shows a complete disregard for two things: First, unnecessary inductions create problems. Second, insurance companies and the government only have influence insofar as they are paying the bill. There are cases where the federal government might use its Medicare and Medicaid influence to wield undue influence (forcing hospitals to provide abortion services, for example), but it’s far from clear that’s what is going on here. If Larson wants to suggest that the government is behind this, he would need to demonstrate it more clearly than he seems to have.Report

    • Avatar Barry in reply to Tom Van Dyke
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      Awwwwwwwwwwwwwwwwwwwww.
      Does it hurt when he’s right time after time?Report

  3. Avatar Alan Scott
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    One of my co-workers had labor induced in late December because it was advantageous, insurance-wise, to have her baby in the current calendar year.Report

  4. Avatar Barry
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    Todd: “In other words, what is most galling to me about this story isn’t that movement conservatives are willing to throw the free market under the bus; it’s how little it takes to get them to do so.”

    IMHO conservatism/right-wingism has never been about the free market; it’s a convenient excuse and pretty banner to wave. .Report

    • Avatar Tod Kelly in reply to Barry
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      It is pretty, though.Report

    • Avatar Murali in reply to Barry
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      IMHO conservatism/right-wingism has never been about the free market

      I mean we should know this right? Movement conservatives are not libertarians period.

      That said the conservative reaction is still puzzling as the decision made by the hospitals is a pro-life decision! Let me repeat this: Hospitals decided that they ought not to harm unborn persons and to a very limited degree, placed some constraints on women’s reproductive rights. I know that in some ways it makes me glad that even movement conservatives are standing up for reproductive rights but still… WTF???Report

      • Avatar Jaybird in reply to Murali
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        There is a branch of conservativism that opposes Democrats for the sake of opposing Democrats.

        If a handful of Democrats wrote a law opposing abortion, this branch would immediately begin to argue that Obama knows that he can’t tax dead fetuses.Report

        • Avatar Murali in reply to Jaybird
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          Obama knows that he can’t tax dead fetuses.

          We call this the Fiscal Stimulus argument against abortion. The state has a compelling interest in increasing the size of its economoy as well as its tax base. The increase in consumption will kick in quickly (less than nine months) and said increase is a permanent increase.

          Against this view someone will have to point out that

          1. Broken window fallacy. Preventing abortion merely means that those who would have spent their money on other stuff now have to spend their money on the baby. Consumption does not necessarily increase.

          2. Many people especially those who tend to be unwanted on average consume more in taxes than they produce. i.e. they contribute to the public debt. A fiscally serious administration would not go around creating more mouths to feed.Report

        • Avatar Barry in reply to Jaybird
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          And a bunch of right-wingers who deeply hate science and rational thought – the hospitals’ decision undoubtedly was based on Evul Librul Math and stuff.Report

  5. Avatar Will Truman
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    I’m not Russell, and I’m not a doctor, but Clancy has been delivering babies for several years now. She is also of a decidedly non-interventionist medical philosophy (low C-Section rate, letting nature run its course, etc.). So this topic comes up quite a bit.

    Up to now, it has been possible for either a doctor or a patient to request non-medically necessary induced labor or c-section in the 38th week.

    Though it can be requested by either, it requires to consent of both. If a woman doesn’t want an induction, the doctor won’t do it. If her doctor won’t do it, she’s unlikely to get it (she could go to another doctor, but if Doctor A won’t do it, Doctor B probably won’t, either, because if anything goes wrong it raises uncomfortable questions). The system can be gamed, more easily by the doctor (by implying medical necessity), but it’s generally a mutual thing.

    The #1 reason why patients seem want an induction is TPBism (Tired of Being Pregnant – getting the damn thing over with). If it’s scheduling, it typically involves family plans or a desire for the baby to be delivered by the obstetrician that has seen the mother through the pregnancy and the obstetrician is about to go on vacation. That sort of thing. Sometimes, if the first baby came out early, they will worry that the second baby needs to come out early, too.

    On the doctor’s side, scheduling is often going to be the issue. Another is money. A doctor gets paid to induce labor, but not to hover over a soon-to-be-mother for 10 hours who may or may not be starting labor really soon. This sounds kind of mercenary, but I don’t think that doctors expressly think of things in this way so much as it sometimes colors their judgments. Their motivations are speculation, as nobody knows but them why they do what they do. There’s also the issue of miserable soon-to-be-mothers begging for induction, and how long are you going to say “no” when it’s in your best interest to induce as well?

    This is sort of tangential, but interestingly enough among Clancy’s past colleagues, it’s men that tend to induce and women that hold back. This could be because male docs are more mercenary, or it could be because women feel more qualified to tell other women to suck it up. Or it could be that my wife’s experiences are atypical and/or a product of coming through heavily Mormon areas.

    Because my wife is only one doctor, and tends to lean heavily on one side of the discussion (loathe to induce without medical necessity even after 39 weeks), I really don’t know how often the appeal is coming from the doctor, from the soon-to-be-mother, or both. In her case, obviously, the pressure comes from the patient. But when she was a resident, she would come home red-faced at docs pushing for induction in what she viewed as circumstances where intervention was irresponsible and for the wrong reasons.Report

  6. Avatar Kyle Cupp
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    Oregon wants bigger babies. It’s a sports thing.

    Actually, this hospital policy sounds like a very good thing. I’m very curious about the arguments against it and who is making the arguments. Do you know if any prominent pro-lifers have taken a stand one way or another? One would think they’d be for it, as it’s better for the babies, but if conservatives are up in arms about the change, well…I’m curious.Report

    • Avatar Tod Kelly in reply to Kyle Cupp
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      Those that are against the change seem to be pro-life, but I am not sure if this is part of the reasoning.

      The most connection I have heard is comparative, as in “they’re OK with you killing your own baby at 38 weeks, but God forbid you deliver it then!”

      And again, I am not entirely sure what the reasoning is, except that it seems to be emotionally connected to people’s fears about the government stepping in and telling you that you and your physician must adhere to the guidelines of a bureaucrat.Report

      • Avatar Kyle Cupp in reply to Tod Kelly
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        Well that’s unfortunate. And not exactly consistent. Pro-lifers pretty much by definition want the government or other bureaucracies to step in and tell expectant mothers and their physicians that the procedure of abortion is not an option.Report

    • Avatar Will Truman in reply to Kyle Cupp
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      See my above comment (6:35) for what I think the main argument to be. Basically, that it’s a third-party intrusion on what ought to be a decision made by doctors and their patients. And (baseless) speculation that the government and insurance companies that are the intruders.Report

      • Avatar Tod Kelly in reply to Will Truman
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        I think that it is in turns more deliberately cynical, and existential than your argument. (Your argument is far more rational.)

        I say cynical because those stirring the pot are telling their listeners/constituents that this is an Obamacare seizure of their rights, without also telling them the reasons for the change. They clearly know better, so the fact that they choose to paint an inaccurate picture irritates me.

        I say existential for reasons that are along the same lines you drew, except I think they are not so well thought out; I think it is a feeling of dread of all the changes people know are coming.Report

        • Avatar Tom Van Dyke in reply to Tod Kelly
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          Nobody knows what’s in the Obamacare bill; not only free contraception but free abortifacients as well “seem” to just have been decreed by the executive branch.

          I say “seem” as a weasel word because it’s on right-wing websites and I don’t feel like looking up on whatever those here gathered deem admissible sources. [And it seldom makes much difference anyway.]

          Fact is, per the “existential” meta-argument, Mr. Kelly, damn right there’s a “feeling of dread” about a bill that is now law that was never meant to be the final version. Much was left up to the executive branch’s discretion and decree, including even poor Rep. Bart Stupak’s [D-MI] pro-life objections, which stand as an “executive order” and not actual law.

          Perhaps Lars Larson, a minor-league mouth on talkradio, an employee of America’s Toy Dept., is incoherently demagoguing this [although we do not yet have his argument except for Mr. Truman’s educated guess].

          But the fact is, much of this bill is as of yet undetermined; as written, it leaves even substantive details up to the bureaucratic apparatus.

          America is rightfully dreading its impact.Report

          • Avatar Tod Kelly in reply to Tom Van Dyke
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            Tom, I am no fan of the HRC; this is not because I think there are no problems with our current system. I am no fan because there are no mechanisms to control costs, which is the crux of the problem(s).

            On the other hand, I recognize that those that got the bill through didn’t put those measures in because they didn’t think it could pass if they did. It did leave a lot of leeway to iron those issues out later – hence our currently coming up on issues like birth control that we have yet to make determinations about.

            There is nothing – and I mean nothing – that I hear that I like on either side of the HC debate, on either side. I view it as a very serious issue that needs to be dealt with, and get irritated beyond belief when we refuse to deal with the actual problems because each side figures they can use the issue to score political points. This is one of those issues that is not flailing because of one side of the aisle, but because of both sides of the aisle.

            That being said…

            Telling people that a reasonable *voluntary* policy that a hospital (actually, 17 of 53) chooses to make is a function of Obama care that is being pushed on the public at the cries of horror by their health care providers isn’t “not knowing what’s in Obamacare.” It’s dishonest personal opportunism that will ultimately make it even harder to deal honestly with issues that need honest and transparent discussion.Report

            • Avatar Tom Van Dyke in reply to Tod Kelly
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              Even if WillT’s guess is correct, we have a minor-league talkshow host demagoguing some faulty facts. Dog Bites Man.

              As for the bill itself, its vagueness opens the door for charges like this, some of them will turn out to be well-founded. Then what shall we say about “movement conservatism”?

              http://reason.com/archives/2009/09/10/obamas-lies-matter-tooReport

              • Avatar RTod in reply to Tom Van Dyke
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                No doubt. And the point you make with your link is not wasted on me, obviously.

                Sooner or later, though, “the other side does it” isn’t enough.Report

              • Avatar Tom Van Dyke in reply to RTod
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                RTod, it’s that I don’t troll the left’s Toy Dept. for the dumbest MFer I can find and somehow use it to indict the left as a whole.

                I pick the real people, the elected officeholders, preferably the leadership and not the backbenchers, or the chair of the Dem Party [“This is a struggle between good and evil and we’re the good”] before my outrage meter goes off.

                There’s a substantive [word of the day] difference between Lars Larson and President Obama.Report

              • Avatar Tod Kelly in reply to Tom Van Dyke
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                Tom –

                I’m not sure that I find this insincere, or if I think you just see the world that radically different than I.

                That Obama is someone to take more seriously and expect more of than a low level conservative media grunt is entirely true. Not because of who is is, but because of his position. There is absolutely no comparison.

                But movement conservatism’s strategy has been, since the election of 2008, to maintain a constant barrage of low level absurdity at the other side. And the leaders always seem to be willing to play the fence, letting the lower ranking folks say the actual words that frighten people, while giving “non-answers” about those subjects that are designed to fan the flames.

                I can’t even remember all of theses “issues” that get pressed into the big-time mainstream media, let alone the ones (like this one) that are test-ballooned daily by the dozens. The president is a muslim. He is not even a US citizen. He’s a mole from Kenya. He’s creating a panel to decide who lives and dies. He’s going to make talk radio illegal. He’s for killing cops. He’s married to a communist shill. He wants to destroy white people. He’s a Jewish puppet. He is out to destroy Israel. He never really went to Harvard. He did go to Harvard, but white radicals wrote all his papers and took all his tests. He’s giving most of our land back to the Native Americans. The money for TARP is actually going to slavery reparations. He is setting up concentration camps that you will have to go live in. He’s going to euthanize children if they are developmentally disabled.

                This list is just stuff about Obama, is just the stuff I am remembering off the top of my head, and is the tiniest fraction of what gets to the *top* of the megaphone pile. They go from the trenches, to the national media, to the lower ranking congressional big mouths, and eventually to the all-stars. It may not have started out as a strategy, but it certainly is now.

                You should not take this as a pro-Dem rant. I have no doubt that they would do this in a heartbeat if they were remotely good at it. (They do try, I’ve heard Air America. They just can’t succeed.)

                You are correct that the issue I wrote about is being trumpeted by a bunch of tinpot wannabes. But you’re not being honest -or are far too credulous – if you say that this has nothing to do with movement conservatives’ larger strategy.Report

              • Avatar Tom Van Dyke in reply to Tod Kelly
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                RTod—Shut up and eat your Satan sandwich.Report

          • Avatar Barry in reply to Tom Van Dyke
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            ‘Abortifacient’: anything at all which the right-wingers don’t like.Report

  7. Avatar Jonathan
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    I don’t have much to add (at least not right now), but this is a solid post, Tod.

    By the way, are you familiar with theunnecesarean. I know it’s not the thrust of your post, but it’s tangentially interesting.Report

    • Avatar RTod in reply to Jonathan
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      Very cool, Jonathan. Thanks.

      I admit that the thrust of my post was my irritation (even anger) at the political opportunism surrounding our local controversy. A decade ago I would think nutty movements like this would quietly done out and have no adverse effect on a hospital’s ability to improve services. Now? Who the hell knows.

      But I have to admit beyond that, I was shocked that inducing or c-sectioning prior to a due date for scheduling reasons was a thing. I find it a little creepy – though that may just be because I know the health risks and am being a Monday morning quarterback (or whatever you guys call such a thing in Canada).

      Coming from the insurance side of it, I recognize that the change these hospitals are making requires a monetary sacrifice. That $1 million dollars a year saved is all billable to carriers. There’s far more revenue to be had with a c-section and all of it’s large-dollar CPT coded tasks then waiting for a week for the sproutlet to decide it’s time to come say hello. So good on them, I say.Report

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