Obama’s Death Panels

I have found myself saying, in conversation, “I’m afraid Obama is going to kill me.” Now, I’m not picturing him or one of his minions coming over to murder me, but I am afraid that as I get older and need expensive care to keep me alive that I will be told I cannot have it, because at my age, in the government’s opinion, there’s not enough life left in me to be worth the money that I would take from the system that needs to pay for everything. — Obama voter, Ann Althouse

Liberals have been caterwauling for days about Sarah Palin’s compelling description of the uglier parts of the health care plan they’re championing,

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.

How dare Sarah Palin use the words “death panel!” Well, when unaccountable bureaucrats will literally have the power to deny you an operation that may save your life, the words “death panel” seem apt.

Today, the insurance industry is heavily regulated. While its officials may be motivated to deny claims to save money, if they improperly deny a claim, they can and often do end up in court. That keeps them honest. What happens when the government runs everything and some bureaucrat in DC decides your life isn’t worth the money it would cost to save it? How do you keep them honest? You won’t be able to sue and how are you going to vote the people responsible out of office when you’re dead?

Moreover, Palins’s not wrong to suggest the disabled are going to be at greater risk. Notice what happened when the government took over Chrysler and GM: Suddenly, the government was poking around in places it never had before. It was hiring and firing executives, setting salaries, interfering with what dealerships and plants stayed open and closed, etc., etc.

The moment the government owns health care, suddenly the government will have an excuse to interfere in all sorts of decisions it hasn’t had much of a say in previously. Suddenly, what you eat will be its business. Are you engaged in “dangerous sports?” What kind of car are you driving and what’s its survivability rate in an accident? Getting back to Sarah’s point, are you, as a disabled citizen, going to make enough money in taxes to pay back what it costs the state to pay for your operation or, in its view, are you going to be a cost liability? If you don’t think mothers of disabled children are going to eventually be pushed to abort in situations like that, you’re kidding yourself. If you don’t think people who are disabled are going to be more likely to be turned down for operations, you’re living in denial.

Additionally, there has been a big argument about the end-of-life counseling in Section 1233 of the House bill. While it’s worth noting that it’s not mandatory, it’s still extremely troubling. As Charles Lane writes in the Washington Post,

Section 1233, however, addresses compassionate goals in disconcerting proximity to fiscal ones. Supporters protest that they’re just trying to facilitate choice — even if patients opt for expensive life-prolonging care. I think they protest too much: If it’s all about obviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?

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).

Admittedly, this script is vague and possibly unenforceable. What are “key questions”? Who belongs on “a list” of helpful “resources”? The Roman Catholic Church? Jack Kevorkian?

Ideally, the delicate decisions about how to manage life’s end would be made in a setting that is neutral in both appearance and fact. Yes, it’s good to have a doctor’s perspective. But Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party — the government — recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations. You don’t have to be a right-wing wacko to question that approach.

There’s a simple reason this is in the bill: it’s cheaper for people to take some pain pills and wait to die in a hospice than it is for the government to provide an expensive operation. Does it say the government is going to force anybody to choose that path? NOT YET — but, you take a non-college-educated person: he’s old, he’s scared, and he’s talking to a doctor who knows much more than he does about his health. It’s pretty easy to see how this person could be talked into taking the money saving option.

People who would live if they were treated in the United States die on a regular basis in countries with socialized medicine because they have to wait in line too long, because they’re denied operations, and because the government doesn’t want to spend the money on the best equipment. If you don’t think it will happen here if Obama gets his way, then you’re fooling yourself.

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