Friday, August 28, 2009

Not to put too fine a point on it, but...

Death Panels and the Politics of Death - George's Bottom Line: "Mike Huckabee tossed a hand grenade into the debate over who's politicizing Ted Kennedy's death Thursday morning when he told his radio audience that under Obamacare, Kennedy would be told to 'go home to take pain pills and die.'"
But instead he received for his brain tumor the most intensive and expensive treatment available, including an operation, radiation, and chemotherapy. Fine with me. But Huckabee is pointing out that at age 78 and with a tumor that was said to be "inoperable" and certainly fatal, Kennedy was exactly the kind of patient who would not be deemed worthy of such expensive end-of-life care under the system being proposed by Obama and the other Democrats...including Kennedy himself. It will be interesting to see how Democrats respond to this. I am no Huckabee fan, and I hope he never runs for public office again, but this cuts right to the core of the division over these proposed reforms.


Don Nordeen said...

Perhaps what Mike Huckabee said is an exaggeration, but it is a feasible interpretation of the language in HR 3200 beginning on page 431.
(1) PHYSICIAN’S QUALITY REPORTING INITIA TIVE.—Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w–4(k)(2)) is amended by adding at the end the following new paragraphs:
‘‘(A) IN GENERAL.—For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life sustaining treatment.
‘‘(B) PROPOSED SET OF MEASURES.—The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.’’.

Basically, the language does not place any limits on the Secretary who can do what he/she believes to be appropriate. Also note the use of the word "orders" which are not defined.

Protection for citizens from government occurs only when the powers of government are well-defined, specific and limited. The powers in HR 3200 are ill-defined, general and unlimited.

The above is only one of many examples of the expansive powers proposed for government in HR 3200.

Beth said...

Don, the language you quote simply outlines what sort of end-of-life counseling the government plan would reimburse. I, for one, do not expect any insurance program, government-run or otherwise, to pay for everything no matter what it is.

Also, the provisions you cite provide for such things as a public comment period. (I'd be very interested to know how many private insurance companies follow such a public process when deciding what they will pay for.) It doesn't make sense to stuff the bill with details about procedures and treatments because then, as medicine discovers new things, it'll take a legislative act to update the coverage. It makes much more sense to legislate a fair process that allows for change.

I've always liked Mike Huckabee. I agreed with much of what he said in the last campaign about economic issues and immigration issues (though I disagree with his stand on evolution!) It's very sad to see him joining this "race to the bottom" along with Sarah Palin and others.

I find it particularly offensive that Huckabee would use the occasion of Kennedy's death to scare people away from health insurance reform. For one thing, as far as I know, Kennedy participated in a "government-run" program himself. For another, Kennedy has long an advocate for health reform. I thought Huckabee had more class.

Anonymous said...

I think the point was that the plan the politicians want to foist on the rest of Americans would not be applicable to the politicians themselves.

Evan McKenzie said...

The point is that Kennedy had every conceivable procedure done to prolong his life, even though he was 78 and his tumor was undoubtedly fatal. Yet, he and Obama and others push a system on the nation that would deny expensive end-of-life treatment to the very old in some circumstances. It would be less doctor-patient and more federal government-doctor.

Don Nordeen said...

The article by George Stephanopoulos mis-characterizes what Mike Huckabee said. Listen to the radio segment, Huckabee: Kennedy Would Have Died Earlier Under Democrats Health Plan.

Huckabee gives tribute to Senator Kennedy for his advocacy and his surgery and treatment for trying to extend his life.

The criticism is directed at President Obama who has suggested that such a patient should "go home to take pain pills and die."

As to any protection offered by public comment, I am skeptical that it will have any influence on a government administration given sole discretion without standards or limits. It only takes one zealot. My personal experience is with Joan Claybrook who was administrator of the National Highway Safety Administration. I had a number of meetings with her during her term of office. She overturned agreements negotiated with the prior administration. She clearly had a personal agenda which remained unchanged after public comments on proposed rule making.

In its detail. HR 3200 is a disaster in the making. Powers are authorized to the Secretary, committees and commissions without clear definition and without limitations and standards.

I am a strong believer in "If it can happen, it will sooner or later." It takes only one zealot. The Obama administration has many zealots identified as czars who are in positions of power without vetting and approval by the Senate.