Thursday, August 13, 2009

Kausfiles : Will You/Won't You Be on My "Death Panel"?

Kausfiles : Will You/Won't You Be on My "Death Panel"?: "THE PRESIDENT: So that's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

LEONHARDT: So how do you - how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now."

And Mickey Kaus thinks calling that "independent group" a "death panel" (Sarah Palin's term) might not be such a stretch. The point, as Kaus puts it, is that "he's talking about a panel of independent experts making end-of-life recommendations in order to save costs that have an effect at an individual level."

And by "independent" he means people who don't care about your Mom--not her MD, not her family members, and not Mom herself. Right now, these decisions are largely made by the MD and the patient, with family input. But under Obama's plan, there would be a government panel making cost-benefit decisions about cases like this.

My Mom is 87 and has a chronic painful condition--osteoporosis of the spine. She just had an expensive surgical procedure done on her spine to relieve the pain of multiple stress fractures. As a result she is now back on her walker moving around. For how long? I don't know. Maybe not long. Is it worth the expense? You bet. And I don't like the idea of some "independent" people having the power to recommend denial of Medicare payment for that procedure on the basis that it isn't a good allocation of government resources, given her age and condition, so let her just take pain killers and lie in bed (until she gets pneumomia and dies). And I am completely convinced by everything Obama and others have said that this is exactly the kind of cost-benefit decision they want the government to make.

Clearly, many people are furious and terrified about this prospect. That doesn't surprise me. What does surprise me is that so many people stubbornly refuse to acknowledge that this is what is being proposed. Obama has said over and over that he wants to do this. He just sugar-coats it with a lot of talk about "difficult choices," and then he fobs that whole mess off onto a mysterious panel of academic and governmental experts who will make "recommendations" about life and death.

It is no wonder people are blowing their tops at these meetings with their elected representatives.


Beth said...

No, it's no wonder, with all the irresponsible chatter about "death panels" and the like, that people are blowing their tops.

I agree with Mickey Kaus that the "not determinative" part was probably very important to Obama, because that's what Obama has said in other venues, too--that he he does not want bureaucrats to be making these decisions, that he wants people to have the information they need to make good decisions for themselves, and that government can set up an independent panel to help provide guidance on which procedures actually work.

You say that you are "completely convinced" that Obama actually means something different from what he has plainly (if wordily) said. That's your right. But Obama is not a legislator. Do you honestly believe that a majority of legislators also want to deny your mom the treatment she needs?

HR 3200 is easy to find on I didn't see anything in it that forbids people from paying for tests or treatments they want to have. If you have seen anything like that in the bill, I hope you will share it with your loyal readers.

Or are you arguing that insurance must pay for any treatment a patient may want, regardless of whether it works? If so, I hate to be the one to break it to you, but insurance doesn't do that now.

Beth said...

Politifact just published a guide to the various health care bills:

Here's what they say about rationing: "• "Rationing." Critics say the program will lead to health-care rationing. They attribute that to various elements of the plans, such as the government's new role running a public option and an approach known as comparative effectiveness research that seeks to find the most efficient treatments. The bills being considered now don't allow for the comparative research to be binding on health-care plans or dictate treatment. Still, it seems reasonable to assume that health insurers will begin to act on the government information, refusing to fund treatments considered experimental or ineffective. Supporters say health care is rationed already, by insurance companies. Your comfort level on this probably depends on whom you trust most: the government or insurance companies."

Anonymous said...

There is no way in hell that I want my health care designed and managed by the "community organizer" who has never run anything in his life except a rabble rousing organization like ACORN. No matter what is in HR 3200, I don't trust this liar, and I don't trust the imperial federal government with my or anyone else's healthcare. The old comment about IRS bedside manner and postal efficiency went for HillaryCare and also goes for ObamaCare!

If they force this legislative garbage through, despite strong public opinion against it, it is time for revolution in this country.