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Farewell to the Spectator
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Tentative Praise for Ryan’s New Bipartisan Medicare Plan
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The Spectacle Blog
Philip notes that the news reported by Robert Pear in the New York Times — that the Obama administration has issued a regulation affecting Medicare that will amount to the infamous “Death Panels” provision originally in the Democrats’ health care bill — is simply “the reality of what happens when government is involved in medical care — suddenly the state gains an interest in individual decisions.” Philip also explains that the regulation was devised by Donald Berwick, who has a “self-professed love of Britain’s health care system and fondness for rationing….”
For all the talk of Death Panels, the kind of end-of-life counseling and advance directives that were stripped from Obamacare and are now funded in this regulation are good and worthwhile ideas on their own, separate from the question of government involvement. They can help dying patients and their loved ones avoid unhelpful trauma at the end of their lives, and prevent unnecessary spending on procedures that won’t help ease patients’ pain or prolong their lives. Given that a huge percentage of Medicare spending goes toward treating people in their last months of life, Berwick is only smart to try to cut costs there without harming anyone.
The charge that Berwick’s regulation constitutes — or could lead to — Death Panels arises because, as Avik Roy explained in what I think was one of the best posts on health care of the past year, “if the government is funding health care, and simultaneously funding end-of-life counseling, the government has a conflict of interest.” In other words, someone has to make decisions about the trade-offs between humane, life-prolonging health care and its costs, but that person shouldn’t be paid by the government or advised by someone paid by the government if the government is footing the bills.
Berwick would probably shrug off such concerns by arguing that the conflict of interest wouldn’t matter, considering how Medicare is organized, and he might be right for the near future. But Roy demonstrates that conservatives’ concerns that such policies will ultimately lead to something resembling Death Panels are well-founded: that is already the case in the U.K.’s government-run health care system, as well as in the Veterans Administration’s (please read Roy’s post for detailed examples).
The most humane health care system in the world would be useless if it were unaffordable. Right now Medicare is unaffordable and unsustainable, so it’s only logical to try to cut costs where possible. For now, saving money in end-of-life care is humane, but it’s only likely that at some point it will lead toward Death Panels. That reality makes the case for replacing Obamacare with a more free-market, patient-centered plan stronger.
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More Blog Posts by Joseph Lawler
http://spectator.org/blog/2010/12/27/the-inevitability-of-death-pan
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Cris Worth| 12.27.10 @ 5:59PM
"saving money in end-of-life care" that's the first evil step in a widespread government sponsored euthanasia policy. All ages will soon be in danger. Like abortion...first trimester led to unmitigated evil and legal partial birth abortion destroying full term healthy infants.
Chuck| 12.28.10 @ 7:58AM
You forgot to mention aborted babies are now used in medical experiments therefore they have monetary value. Also taxpayers money is used to subsidize this grisly "business" both here and overseas.
MikeD| 12.28.10 @ 8:43AM
I think nancy peloshit should be the first to go before the death panels. I wonder just how many Americans would enthusiastically trip the switch to make that bitch the first to go???
Dixie Pixie| 12.27.10 @ 7:32PM
The right to die will soon become a duty to die where the governmental money is involved.
After all the money to keep granny alive for 5 more years is in direct competition with Nancy Pelosi's travel budget and Michelle Obama's overseas shopping sprees. Guess who will win that decision.
Marconi| 12.27.10 @ 7:47PM
I see the confusion for the conservative goobers. They confuse something being made available to something being mandatory.
Gay marriage. If and when it becomes legal, you don't have to marry someone of your sex. You do so only if you want to and the other person consents.
Abortion. If you are pregnant, and want to give birth, please go right ahead. No one is demanding that you abort.
Same with end-of-life counselling. If you are OK leaving it to Jesus how you cope with your death, that's just fine. But in case you want to know your options, consider your survivors in any sense, you may avail of this program.
And another thing: see a doctor for your oral sodomy fetish. Perhaps then you won't see every legislation or executive order as something being rammed/jammed/shoved down your throat.
By a black man.
Mimi| 12.28.10 @ 7:41AM
Cruel words, Marconi. From a cruel, downright UN-AMERICAN...leftie.
There are 435 sections of this glorious country...and every 2 years " The People" elect a person to represent them in their federal GOVERNMENT. Decrees by fiat by a 20% minority...will and cannot be tolerated from a PURPLE, BLACK, RED, or BLUE man. Keep shoving it DOWN our throats at your PERIL!!!!
Marconi| 12.27.10 @ 7:51PM
Some bozo wrote:
"if the government is funding health care, and simultaneously funding end-of-life counseling, the government has a conflict of interest." In other words, someone has to make decisions about the trade-offs between humane, life-prolonging health care and its costs, but that person shouldn't be paid by the government or advised by someone paid by the government if the government is footing the bills.
----
You mean funding end-of-life care counseling will lead to ending funding of end-of-life treatment?
Really?
Like funding something that costs them more money will prevent them from funding it in the first place?
Like Medicare?
Dixie Pixie| 12.27.10 @ 8:26PM
My Dear Marconi
It is a simple moral equation.
Those people who risk all including their life to save others are called heroes and under special conditions are awarded the nations highest honors such as the Congressional Medal of Honor.
Those people who terminates a saveable life for money are murderers for profit.
The fact the government rakes in the profit does not mitigate the crime.
It just makes murder legal not right.
Rich Fisher| 12.27.10 @ 10:16PM
It's unfortunate that no one ever seems to take into account personal responsibility for decisions made at the end of life as to what is reasonable treatment. Two cases in point. I had an elderly (near 90) aunt who was already bed ridden in a nursing home and had no hope of ever leaving. The doctors convinced her to have double knee replacement so she could supposedly walk again, which was never going to happen. I was outraged at the expense to the taxpayer for this needless surgery and made my opinion known. Well, she had the surgery, never got out of the bed and died in less than a year. Second case, much closer. My mother went into the hospital for repair of a leaking heart valve at 85 years of age. I begged her not to do it since the operation would not improve her quality of life, which wasn't all that bad anyway, and the danger was real. She was in Florida and I in Missouri so I had no idea what had gone on until her husband called me to tell me they had performed "emergency" 8 bypass surgery on her during the operation. I was furious but had no say at that time even though I was the executor of her Living Will but only if her husband died first. Went to see her in the hospital a month later, she had been in a drug induce coma the entire time to help her "heal". Met with the doctors and they wanted to try a new "miracle" drug that would make her better. I asked if she would ever walk out of the hospital and they said no. So, I looked her husband and the doctor in the eye and said, no way. Let's let her die in peace. They brough her out of the coma long enough for me to speak to her and let her know that I was unplugging all treatment except oxygen and that she could die peacefully. She smiled, closed her eyes and went back into the coma. If family made the tough yet compassionate decisions then the government woudn't be in this mess. Until we get back to a nation that uses our brains for decisions rather than our emotions we are going to have more and more government involvement in our lives. Quit blaming government for our problems and put the blame where it belongs, squarely on our shoulders.
CopyKatnj| 12.27.10 @ 10:53PM
Everyone wants to go to heaven, but no one wants to die to get there.
kathrynmuniz| 12.28.10 @ 2:19AM
Starting this year your child (or children) cannot be denied coverage simply because they have a pre-existing health condition. If you don't have insurance for you and your children search "Wise Health Insurance" online they are the best.
Albaby| 12.28.10 @ 10:56AM
This Death Panel stuff is the equivalent to Al Gores Inconvenient Truth. Show me where in sect. 1233 of the Health Care bill that the ACD discussion is mandatory. Here is the text of sec.1233:
20 ‘‘Voluntary Advance Care Planning Consultation
21 ‘‘(hhh)(1) Subject to paragraphs (3) and (4), the
22 term ‘voluntary advance care planning consultation’
23 means an optional consultation between the individual and
24 a practitioner described in paragraph (2) regarding ad-
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642
•HR 3962 IH
1 vance care planning. Such consultation may include the
2 following, as specified by the Secretary:
3 ‘‘(A) An explanation by the practitioner of ad4
vance care planning, including a review of key ques5
tions and considerations, advance directives (includ6
ing living wills and durable powers of attorney) and
7 their uses.
8 ‘‘(B) An explanation by the practitioner of the
9 role and responsibilities of a health care proxy and
10 of the continuum of end-of-life services and supports
11 available, including palliative care and hospice, and
12 benefits for such services and supports that are
13 available under this title.
14 ‘‘(C) An explanation by the practitioner of phy15
sician orders regarding life sustaining treatment or
16 similar orders, in States where such orders or simi17
lar orders exist.
18 ‘‘(2) A practitioner described in this paragraph is—
19 ‘‘(A) a physician (as defined in subsection
20 (r)(1)); and
21 ‘‘(B) another health care professional (as speci22
fied by the Secretary and who has the authority
23 under State law to sign orders for life sustaining
24 treatments, such as a nurse practitioner or physician
25 assistant).
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1 ‘‘(3) An individual may receive the voluntary advance
2 care planning care planning consultation provided for
3 under this subsection no more than once every 5 years
4 unless there is a significant change in the health or health5
related condition of the individual.
6 ‘‘(4) For purposes of this section, the term ‘order re7
garding life sustaining treatment’ means, with respect to
8 an individual, an actionable medical order relating to the
9 treatment of that individual that effectively communicates
10 the individual’s preferences regarding life sustaining treat11
ment, is signed and dated by a practitioner, and is in a
12 form that permits it to be followed by health care profes13
sionals across the continuum of care.’’.
14 (b) CONSTRUCTION.—The voluntary advance care
15 planning consultation described in section 1861(hhh) of
16 the Social Security Act, as added by subsection (a), shall
17 be completely optional. Nothing in this section shall—
18 (1) require an individual to complete an ad19
vance directive, an order for life sustaining treat20
ment, or other advance care planning document;
21 (2) require an individual to consent to restric22
tions on the amount, duration, or scope of medical
23 benefits an individual is entitled to receive under
24 this title; or
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1 (3) encourage the promotion of suicide or as2
sisted suicide.
milesap| 7.21.11 @ 11:14AM
Obama care is definetly a death panel jy=ust look north in Canada how they treat patients with MS and a vascular disease called CCSVI. If you have MS your not allowed to have your veins unclogged even if means you can die from stroke or have kidney failure. But if you don't have MS your blockages can get fixed maybe. This is pure example of bureaucrates controlling health care by determining who gets it based on the dollar.