Month: August 2009

The GOP’s false claim that the House health care bill includes a provision that would set up a death panel that would decide whether the elderly and handicapped should receive treatment was propagated initially by Betsy McCaughey, the former lieutenant governor of New York, who is a professional shill for the health-care industry. She first floated the lie in radio interview with Fred Thompson, the right-wing former television actor:

And one of the most shocking things I found in this bill, and there were many, is on Page 425, where the Congress would make it mandatory — absolutely require — that every five years, people in Medicare have a required counseling session that will tell them how to end their life sooner, how to decline nutrition, how to decline being hydrated, how to go in to hospice care. And by the way, the bill expressly says that if you get sick somewhere in that five-year period — if you get a cancer diagnosis, for example — you have to go through that session again. All to do what’s in society’s best interest or your family’s best interest and cut your life short. These are such sacred issues of life and death. Government should have nothing to do with this. [fredthompsonshow.com, interview archives, 07/16/09]

None of that is true. First of all, just imagine the logistics of “requiring” tens of millions of Medicare recipients to undergo counseling. The staffing costs alone would likely exceed whatever cost benefit that might be derived from euthanizing that many people. Secondly, euthanasia — also known as assisted suicide — is illegal in every state but Oregon, Washington and Montana.

What page 425 in the House bill — more formally known as Section 1233 — actually does is expand Medicare coverage to pay for counseling when people choose to set up living wills and make other decisions about end-of-life issues.

On July 23, House Minority Leader John Boehner of Ohio and Rep. Thaddeus McCotter (R-Mich.) helped spread the lie in an offical statement from the House Republican leadership:

This provision may start us down a treacherous path toward government-encouraged euthanasia if enacted into law… [It] is a throwback to 1977, when the old Department of Health Education and Welfare proposed federal promotion of living wills for cost-savings purposes described as ‘enormous.’ At that time, the late Cardinal Joseph Bernardin of Chicago decried this effort by saying: “The message is clear: government can save money by encouraging old people to die a little sooner than they otherwise would. Instead of being regarded with reverence, and cherished, human life is subject in this view to a utilitarian cost-benefit calculus and can be sacrificed to serve fiscal policy and the sacred imperative of trimming a budget.”

[…]

Here’s a fundamental fact, maybe the fundamental fact, that has been obscured in the debate over health insurance reform: We wouldn’t need a government option if the private sector had a plan for covering everyone, and the only reason the plans don’t cover everyone is greed.

Think about it. The health companies have had since they killed the Clinton plan in 1993 to get their collective act together. Instead, premiums are up, fewer people are covered and the public’s collective health and well-being is in decline.

Conservatives assert that only the private sector can solve the insurance crisis — an assertion that ignores the fact that the military, veterans, federal workers and members of Congress, including even Republican congressmen — are covered by government-run plans that perform comparatively well.

Still, let’s assume for a moment that what conservatives say is true — that only the private sector can fix the problem — then here is a question:

What is stopping it?

[…]

In every argument I hear against so-called health care rationing, I think of this very well-said piece by the editor of The Week magazine, William Falk, about his own father’s ordeal.

When my father went back to the hospital a year ago, he was clearly close to the end: His lungs and liver were barely functioning, his abdomen was filling with fluid, and he could no longer lift himself out of bed. The hospital’s doctors none­theless treated him aggressively, punching a hole in his chest to insert a drainage tube, which quickly led to uncontrolled bleeding, an infection, and a plunge in blood pressure. Within 12 hours, my father was in a coma, with no chance of recovery, sustained only by a ventilator and a tangle of multiple IV drips. He spent four days in the ICU, until I overcame the resistance of two doctors and had the machines turned off, as per my dad’s living will. Medicare paid upward of $20,000 for these last days of my father’s life, during which he received little comfort, moments of agonizing pain and fear, and all the medical care in the world, and then some.

In the historic debate over health-care reform now beginning in this country, we will hear much talk of “rationing.” If health care is rationed, we’ll be told, we may be denied drugs or surgeries or treatments based on cost, effectiveness, or the patient’s condition or age. It sounds cold and heartless, except when you consider that the only real alternative to rationing is unlimited medical treatment—including a refusal to “lose” the battle with death even when death is near. Unlimited care, of course, requires unlimited spending, which is not viable. Rationing in some form is inevitable; the only question is when we’ll finally be able to admit to ourselves that even in America, there are limits to everything.

My father had a close call about a year and a half ago, and was put on a ventilator for a day. After that, he made my sister and me promise he would never be ventilated again, ever. What worries me is that with the mind-set we see now in health care — to do everything, even when it’s no longer therapeutic but just dragging out the dying process — we might not be able to keep our promise.

So many older people save their whole lives and plan to leave something to their families. Instead, at the very end, in the last few days, every penny is spent on stupid, useless procedures because the loved one was admitted to a hospital instead of signing up with a hospice or just dying suddenly. It shouldn’t be this way. Many of the people who resist changing this system aren’t thinking it through because they haven’t (yet) seen this side of medicine as it’s practiced today. The rest have something to gain from keeping things the way they are, usually a slice of the massive profits.