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August 14, 2009

Live Or Let Die - The Truth About The "Death Panel" section

Topics: Political News and commentaries

Philip Klein writes at American Spectator that somewhere in between warnings of a "death panel" and promises of a utopian medical future, there is an honest discussion to be had about ethics, human mortality, and the role of government in our nation's health care system. He specifically addresses the notorious section 1233 of the "America's Affordable Health Choices Act" - the so-called "death panel" section that would create a new Medicare benefit paying for senior citizens to talk to a doctor or nurse about how to prepare for end-of-life medical decisions. As Klein aptly points out, it has emerged as one of the most controversial elements of the legislation, and although section 1233 does not create a "death panel," mention euthanasia, or mandate that senior citizens participate in counseling sessions, the provision has to be viewed within the larger context of the changes that President Obama envisions for the health care system as a whole.

Here are some of the key excerpts from Klein's must-read article:

[...] Though he denies it now, Obama was once a proud advocate of a single-payer system in which government is the sole purchaser of health care. Throughout the health care debate, he has cited erroneous statistics to promote the idea that government-run systems get better value for their health care spending. And through a web of subsidies, mandates, regulations, and the creation of a government-run plan, Obama hopes to make America function more like the foreign health care systems he prefers. Those systems do not control costs by using magic wands, but by rationing care to the sick.

Britain, for instance, has a panel of experts called National Institute for Health and Clinical Excellence that performs cost-benefit analysis to help determine what sorts of treatment the government will pay for, and for whom. According to a report in the New York Times, NICE "has decided that Britain, except in rare cases, can afford only £15,000, or about $22,750, to save six months of a citizen's life."

NICE was one of the inspirations for Tom Daschle's vision for a Federal Health Board, an idea Obama praised before originally tapping Daschle to lead his health care push. The idea for an expert panel has already manifested itself in the form of Obama's Federal Coordinating Council for Comparative Clinical Effectiveness Research, created by the economic stimulus bill.

While Obama argues that his council will just be providing expert research to doctors and patients, if you read Tom Daschle's book Critical: What We Can Do About the Health-Care Crisis, in the context of describing a Federal Health Board, he outlined how government could compel wider adoption of such a body's recommendations. For instance, Daschle explained, there could be a requirement that all government programs would have to abide by its recommendations and that requirement could extend to any private insurer participating in the government health insurance exchange. And as Daschle wrote, "Congress could opt to go further with the Board's recommendations. It could, for example, link the tax exclusion for health insurance to insurance that complies with the Board's recommendations."

And while the bill doesn't include any provision about euthanasia, which remains illegal in almost every state, the idea of government subsidized suicide is not as far-fetched as it sounds. In Oregon, for instance, the state's health care plan sent a letter declining to pay for cancer patient Barbara Wagner's expensive chemotherapy drug, but offered to cover the cost of doctor-assisted suicide. This was not an isolated incident, as similar letters were sent to terminally ill patients throughout the state last year.

This, of course, is the inevitable result of thinking of health care as a collective good that should be allocated by the state. If health care operates on a global budget, then it becomes a zero-sum game in which providing more care to one patient means depriving another patient of care. And suddenly life and death health decisions evolve from something that is between you, your faith, your family, and your doctor, into highly-politicized issues that are the business of government and your fellow taxpayers.

Instead of being honest about the natural tradeoffs involved in trying to "bend the health care cost curve," Obama has promised Americans a utopia in which everybody is covered, quality improves, our debt actually decreases over time, only the very rich have to pay a tiny amount of extra taxes, and there will be no rationing of care. As Obama promised this week while in full salesman mode, "You will have not only the care you need, but also the care that right now is being denied to you -- only if we get health care reform."

Take the time to read it all. As Klein goes on to point out, the debate we're having over the implications of end-of-life counseling is just a harbinger of problems to come, which Obamacare would only exacerbate.

Related must-read: A Reading From Ezekiel (Ezekiel, as in Ezekiel Emanuel, brother of White House chief of staff Rahm Emanuel, is on the Obama team as a special advisor on health policy to the director of the White House Office of Management and a member of the Federal Council on Comparative Effectiveness Research. )

Also Related: It's Not A Death Panel. Its A Death Guidance Conversation

Posted by Richard at August 14, 2009 6:36 AM

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