Palin on the death panels:
Yesterday at 10:55pm
Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care.
The President made light of these concerns. He said:
“Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that we don’t, it’s too expensive to let her live anymore....It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready on their own terms. It wasn’t forcing anybody to do anything.” [1]
The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.
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. [4]
Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about alleviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]
As Lane also points out:
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. [7]
Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.” [8]
So are these usually friendly pundits wrong? Is this all just a “rumor” to be “disposed of”, as President Obama says? Not according to Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, who writes:
Section 1233 of House Resolution 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives.... It is egregious to consider that any senior citizen ... should be placed in a situation where he or she would feel pressured to save the government money by dying a little sooner than he or she otherwise would, be required to be counseled about the supposed benefits of killing oneself, or be encouraged to sign any end of life directives that they would not otherwise sign. [9]
Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]
President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.
Steve Maloney adds this, "It's important to understand the reasons why the death panels will become a reality: the liberals (mostly Democrats) have wildly overpromised seniors. Predictions of the "underfunded" liabilities are up around $50 trillion (and more). These are promises to older Americans, mainly Baby Boomers, that the government has no way of keeping. Many Baby Boomers and those youinger know this is the case, but they somehow can't believe it. To meet the liabilities the feds would have to double taxes ON ALL TAYPAYERS. Confiscating the income of people making $250,000 a year WOULD NOT DO IT. These aren't "my opinons"; they're the view of every actuary that has studied the situation. We are talking economic collapse, folks. The "cuts" Obama and other leftists talk about in Medicare are meat-axe cuts. In short, they are what Gov. Palin called them: refusals to pay for medical services. Doctors are just like us: if they don't get paid for their labors, they eventually refuse to do the work. Translation: patients won't get care. A "private" market will spring up -- even a black market for health care. You'll be paying a pretty price for health care that won't be available . . . unless you pay extra money out of your pocket. That isn't change we "can believe in." Its change we don't even want to imagine.
It's all basic economics. If, for some reason (terrible hurricane? War?) there was no way to get gasoline to your area, that doesn't mean there wouldn't be gasoline available. It might cost $10 a gallon -- or $20 a gallon. Suppliers, looking at hefty profits, would get gasoline to your region by hook or by crook. That would produce shortages in the regions where gas was selling at, say, $3 a region. Good news for them: gas is cheap. Bad news? There isn't any gas.
The analogue to health care? If you're willing to pay $300 extra for a simple office visit, hey, you'll have many doctors willing to take your money. Problem? The people who can't afford to pay extra will find it takes a six-month wait to see the doctor. If you're having chest pains, well, just suck it up.
What I'm describing is the situation for many Canadians. If they need breast surgey immediately, they can get it -- by going to the U.S. and paying out of their own pockets. I get criticized by Obamabots for saying these things; however, they take place in all nations at all times. Michael Jackson wanted a private doctor who would bend the rules for him. The cost to Michael was between $150,000 and $300,000 per month. The old saying that "everything is available at a certain price" is true.
The "public option" will drive private insurers out of the market. The reason is that a subsidized public option will cost "consumers" less than an unsubsidized private option. Yes, there will be "competition" as Obama claims, but it will be unfair competition because government subsidies will make it that way. If you throw enough wrenches in the gears, eventually the gears -- the private plans -- stop working.
At that point, we have exactly what Obama and the leftists want; a government-run, single payer system.
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