(h/t David at VideoCafe)

Consistency and those niggling little details are the bugaboos to the conservative ideology. It's easy to say that you want to privatize Social Security for future recipients, but that leaves the very real budget problem of knowing how to pay for current recipients, doesn't it? Where does that money come from? And if you allow those 20 year olds to take those FICA taxes to some private, non-government backed entity, what exactly happens if at 70 years old, their 401ks (or whatever vehicle is chosen) are worthless because the financial institutions have failed, like they did just over two years ago? Do you tell those 70 year olds, "Gee, that's a shame, but thems the breaks?"

Likewise, when you're dealing with Medicare, it's very easy to say that it's more efficient to offer vouchers to recipients...but then those niggling details crop up. For as much as Indiana Gov. Mitch Daniels likens Medicare to a top down monstrosity, the reality is that Medicare is a non-profit enterprise. Unlike private insurance companies, whose sole purpose is to spend as little money on your medical costs as possible so as to offer a bigger profit to their executives and shareholders. So what happens when you need expensive care? For Daniels, maybe there needs to be a conversation about how your life just isn't worth the cash required. But who is in charge of making that decision, Mitch?

Daniels says that it should be up to the patient, but that isn't the way it would work. How many health insurance companies let their customers decide the care they want? So we come back to the absolutely unacceptable notion of rationing health care, based on what? Your income/socio-economic level? Your age? Even the statistical analysis of outcomes or underwriting depersonalizes and dehumanizes people in need of treatment. How would you feel if these companies told you your life isn't worth the expense?

WALLACE: You talked about Medicare 2.0, private vouchers, not a government program? DANIELS: It will be a government program, but instead of a top- down monstrosity that we have today, once again I would divide the program and say to those who are in it or who are about to be in it, nothing will change for you. But I think for the young people coming up who are going to shoulder the bill, we ought to trust them to make more of their own decisions. You could, again, concentrate the resources on the poorest people, and also in this case the least healthy people, people who are better off -- WALLACE: But you'd give them a private voucher so they could choose their own insurance plan? DANIELS: I would. WALLACE: You even say the government should put limits on end- of-life care. Are you talking about what Sarah Palin called the death panels? DANIELS: No, I didn't say government should put limits on this, but what I'm worried about is the government making these decisions. I just stated what I think is a simple fact. I wish it wasn't, but I think it is. We cannot afford in an aging society to pay for the most expensive technology every -- for every single person regardless of income to the very, very last day. WALLACE: Who makes that decision? DANIELS: I think it has -- at least a part of it has to be the family and the patient himself or herself. I mean there -- (CROSSTALK) WALLACE: Does the government at some point say we can't afford to give the 92-year-old the liver transplant? DANIELS: Chris, I've told you, I think with some specificity, what I think ought to happen in Social Security and Medicare. I just answered the question honestly. I think this problem will have to be addressed. I don't pretend to have an exact answer to this one, except that autopilot won't work.

And surprisingly, it's Chris Wallace who points this out to Daniels, who, realizing he's been caught in the very details that make his plan unworkable, just refuses to respond any more.

Transcripts below the fold