On August 7th, 2009, Sarah Palin posted a “Statement on the Current Health Care Debate” which included the following comment:
“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.”
As expected when first published, Palin was roundly critized and once again vilified for have the audacity of thinking she had something substantive to say about anything. However, it stirred the pot of debate and prompted her on August 12th, 2009 to publish another comment on her Facebook page entitled “Concerning The ‘Death Panels’” in which quotes directly from HR 3200:
“Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual … or upon admission to a skilled nursing facility, a long-term care facility… or a hospice program.” [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services.”
Liberals screamed that “Death Panels” simply were not in the bill to start with and that the bill never included the actual words “Death Panel” and therefore any reference to those words was misleading or hyperbolic. However, whether you believe that HR 3200 supported the idea of “death panels” or not, The LA Times published an article on August 14th, 2009 that announced the following:
“Though the claims are widely discredited, the Senate Finance Committee is withdrawing from its bill the inclusion of advance care planning consultations, calling them too confusing.”
Which begs the question, why drop the clause if it didn’t say what Palin and others claimed it said? Why worry about it? Why be concerned that the confusing language in the bill would be misinterpreted or implemented incorrectly if it clearly didn’t include suggestions to provide information to patients about end-of-life decisions?
After the Senate announced it was dropping the clause, the Huffington Post had to report that Palin was “gratified” to see that the Senate dropped the clause from the bill they were working on. Then, the HuffPo article when on to link to an opinion piece that makes the case that health care was already being rationed in America and we shouldn’t be afraid of the concept.
While it is true that market forces have some rationing effect on health care, it does not prevent anyone from getting health care in emergencies regardless of whether they can pay or not. Are there cases where Medicare denies a patient access to certain non-life threatening procedures and forces the patient to decide on whether they will pay for the procedure themselves or not? Absolutely, and I would argue that is not necessarily a bad thing. I would also argue that doctors already have an end-of-life care option for patients and it is called Hospice Care.
The men and women who work in this field are angels but there are some things you should know about hospice: 1) Hospice is only recommended for patients who are terminal and whom the doctor believes has only six months to live. 2) Hospice focuses on maintaining the quality of life of terminal patients, and most importantly, 3) Even hospice workers will tell you that there are often patients who live far beyond the six month period the doctors expect them to live. The difference between Hospice and End-Of-Life Consulting is that Hospice Care does not actively seek to end a patient’s life, while ending a life is the primary goal of End-Of-Life Consulting. Just because HR 3200 does not include the words “Death Panels” doesn’t mean that this type of discussion wouldn’t take place with many patients and the discussion won’t be between a patient and a doctor, it will be between a patient and a bureaucrat. In fact, the President’s constant focus on health care cost containment almost guarantees that this would occur.
Want proof? Last year the following news story ran on KATU Channel 2 in Portland, Oregon. Oregon has a law that allows doctor assisted suicide and apparently now it is offered routinely by the Orgeon Health Plan. In 2008, after weeks of bad news, things turned worse for Barbara Wagner. Her lung cancer, in remission for about two years, was back. But after her oncologist prescribed a cancer drug that could slow the cancer growth and extend her life, Wagner was notified that the Oregon Health Plan wouldn’t cover it because the drug cost as much as $4,000 per month. However, the Oregon Health Plan WOULD cover the $100 cost of medicine and any comfort and care that she needed if she chose doctor-assisted suicide.
I attempted to find out if Barbara Wagner is still alive and though I did find a comment on one source that indicated that she lived another four months after the story ran, I was unable to confirm that bit of information. But that doesn’t change the fact that if Wagner had accepted the offer of doctor assisted suicide, she would not have had even those four months. Would she have lived the four months without the expensive medicine? Who knows?
I don’t know of a single doctor who discounts the value of approaching an illness with a positive attitude and even if the medicine only provided Barbara Wagner with the “belief” that the medicine was helping can we discount the value of that effect on her attitude? We can never compare the outcomes of various treatments on patients because each patient is different and because once the patient is dead, we can’t go back and try another method to see if it works better. What we can compare are the results of treatment versus suicide and when we do treatment always wins.
The Inconvenient Truth I mentioned in the title of the story is this: the clause identified by Sarah Palin and dropped by the Senate Committee is irrelevant. Palin isn’t wrong about death panels, the bill definitely contains death panels but the Senate dropping the clause she identified will not stop death panels from forming. Maybe they won’t exist exactly the way we can imagine them with a patient standing before a long table of blank faces of government officials deciding who gets what treatment, when they get it and for how long. But the focus on cost containment and the rationing which will naturally occur when the free market is completely removed from the health care equation, will inevitably lead to classifying patients by their “return on investment.”
In the story of Barbara Wagner, the drug company decided to give Wagner the drugs because they believed the drug worked and they felt compassion. Compassion is one of the first things that will be lost should HR 3200 be signed into law. Want to know why? Because the decisions won’t be left to the doctors and drug manufacturers. All of those decisions will be made by the Government under this plan, and in spite of all their high-minded expectations, liberals never seem to understand that Government by definition is the opposite of compassionate. It cannot be compassionate because everyone has to be treated exactly the same regardless of individual situations. Rules are rules and no government employee ever was fired for following the rules. It was in the best interest of the drug company to assist this woman for many reasons, not the least of which was the publicity they have received from this story. While Barbara was not able to pay for the medicine out of her pocket, she paid for it with her story which has now gone around the globe. That concept of value even when money is not involved is lost on Government. It is one of the unintended consequences of Government and cannot be ignored.
My great-grandmother had both her hips replaced when she was in her eighties and she regained her mobility and lived until she was almost 96 years old. My question to the President and anyone else supporting his health care/insurance reform or whatever they are calling it today is this: If my great-grandmother had gone to her doctor with this plan in effect at the age of 85, living in a wheelchair most of the time as she had been, could she have gotten her hips replaced under this plan? The reason I ask is I’m convinced that had she not regained her mobility, she would have died long before the age of 96.
Then I would not have gotten to know her as well as I did, learned as much from her as I did nor enjoyed her company for nearly as long as I did. To me and her other great-grandchildren, the value of those extra years can’t even be counted.
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