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From Krauthammer’s column in today’s Washington Post:

“This is not about politics? Then why is it, to take but the most egregious example, that in this grand health-care debate we hear not a word about one of the worst sources of waste in American medicine: the insane cost and arbitrary rewards of our malpractice system?

“When a neurosurgeon pays $200,000 a year for malpractice insurance before he even turns on the light in his office or hires his first nurse, who do you think pays? Patients, in higher doctor fees to cover the insurance.

“And with jackpot justice that awards one claimant zillions while others get nothing — and one-third of everything goes to the lawyers — where do you think that money comes from? The insurance companies, which then pass it on to you in higher premiums.

“But the greatest waste is the hidden cost of defensive medicine: tests and procedures that doctors order for no good reason other than to protect themselves from lawsuits. Every doctor knows, as I did when I practiced years ago, how much unnecessary medical cost is incurred with an eye not on medicine but on the law.

“Tort reform would yield tens of billions in savings. Yet you cannot find it in the Democratic bills. And Obama breathed not a word about it in the full hour of his health-care news conference. Why? No mystery. The Democrats are parasitically dependent on huge donations from trial lawyers.”

Unlike too many conservatives, I recognize that the health care system’s financial problems are multi-faceted, and that tort reform will not be a cure-all by any means. But it is inexcusable that the subject of tort reform is not even on the table.  Heck, it’s not even in the same building as the table.

The Mayo Clinic posted this commentary on the Congressional plan that was released a couple of days ago:

“Although there are some positive provisions in the current House Tri-Committee bill – including insurance for all and payment reform demonstration projects – the proposed legislation misses the opportunity to help create higher-quality, more affordable health care for patients. In fact, it will do the opposite.

“In general, the proposals under discussion are not patient focused or results oriented. Lawmakers have failed to use a fundamental lever – a change in Medicare payment policy – to help drive necessary improvements in American health care. Unless legislators create payment systems that pay for good patient results at reasonable costs, the promise of transformation in American health care will wither. The real losers will be the citizens of the United States.”

I really dislike the Tri-Committee bill, so I agree with what Mayo says.  Their take also seems consistent with what Atul Gawande said in this New Yorker article, “The Cost Conundrum,” which I found presuasive.  I think, however, that the conservatives who are so gleeful about Mayo’s statement should keep in mind that Mayo’s criticism of the Tri-Committee bill is pretty narrow:  Medicare payment policy still encourages more care, rather than the right care.  It would not be hard to amend the Tri-Committee bill to at least attempt to do that, which would be a bad thing.  As a small-government guy, I worry about the federal government trying to exercise oversight over medical decisions.

I understand this YouTube video is gaining more and more attention.  I hope millions of American voters see it and let their congressmen and senators know they have seen it:

Slowly but surely, middle class, and upper-middle class Americans are being awakened to the fact that federal taxes are being skirted by at least half of all Americans.  Half.  Governor Mitt Romney, in a recent private meeting in Los Angeles, stated that it is more likely that only 40% of all Americans are carrying the enormous federal tax burden today.  Under the new codes being enforced by the Obama Administration, that figure will probably become 50%.   Is it any wonder that there are “tea parties” emerging around the country featuring fed-up Americans who recognize more and more that the very rich are escaping tax-free, as well as those in the low-income sectors of our economy.   There is no shortage of compassion among American earners, but there is a conviction in Democracy.

Right now, there are too few patriots paying the freight.

I think Today’s Wall Street Journal editorial, “The Palin Puzzle,” has the Palin situation about right:

“Our advice after the election last year was that Mrs. Palin spend two years out of the limelight, tending to her Alaskan duties and studying national issues. Last year’s campaign showed she didn’t understand economics any better than Mr. McCain — a very low bar — and her responses on too many issues sounded like half-baked spin rather than sincere judgments that she herself had reached or understood. No doubt Mr. McCain’s backbiting campaign team didn’t help her — we hope the next nominee bars them all — but every candidate is ultimately responsible for her own performance.

“Ronald Reagan changed the national debate, and for three decades Republicans have been able to utter bromides about “liberals” and “big government” and get away with it. After the financial meltdown and long recession, those days are over. The GOP nominee in 2012 will need an explanation for how we got into this mess that goes beyond mimicking Democrats about “Wall Street greed,” as well as an agenda for how to restore U.S. prosperity. President Obama will take credit for any recovery, however sluggish, and Republicans will need more than a critical riff about spending and budget deficits.”

Sara Palin is a charismatic and refreshing new voice and face in the GOP, but is not the answer — not yet, at least.

Update:  Ross Douthat crystallizes what may become the consensus view on Palin’s resignation:

A Sarah Palin who stepped down for the sake of her family and her media-swarmed state deserves sympathy even from the millions of Americans who despise her.  A Sarah Palin who resigned in the delusional belief that it would give her a better shot at the presidency in 2012 warrants no such kindness.

Despite those pointed words, Douthat’s piece is no anti-Palin rant.  Read the whole thing.