Obama, 'Death Panels' and The Cold Hard Truth

You're making a large accusation, so lets see your evidence. Come on, cough it up.

*Cough*Section 123*Cough*

And while your at it, try figuring out what Section 151 means.

Even the Republicans on the Senate Finance Committee don't comprehend it.  They today managed to get the 'end-of-life consultation' provision dropped from their mark-up of the bill, ascribing the motive for the change to the 'death panel' characterization backlash.  The sad thing is that this is a meaningless concession.  We already have provisions for end-of-life counseling and 'giving this up' in the bill will be touted as 'listening to the people' without dealing with the real issue embodied in the 'death panel' moniker.

Of course, there's no indication they've taken another look at Section 123.  The 'death panel' is still there.  They've attempted to treat a symptom without bothering to treat the disease (which would require major surgery - a deathpanelectomy).

You're talking about this one right:

docs.house.gov/edlabor/AAHCA-BillText-071409.pdf

They are probably the same, but this is the one I'm referencing.

Hey AJ, since you asking for information as proof, I am curious as to how knowledgeble are you on the subject or the bills themselves. Here is something I would like for you to look at and tell me what you believe it means, especially the last part I made in bold:

The Secretary shall limit the requirement for explanations under clause (i) to consultations furnished in a State--CommentsClose CommentsPermalink

‘(I) in which all legal barriers have been addressed for enabling orders for life sustaining treatment to constitute a set of medical orders respected across all care settings; andCommentsClose CommentsPermalink




‘(II) that has in effect a program for orders for life sustaining treatment described in clause (iii).CommentsClose CommentsPermalink

‘(iii) A program for orders for life sustaining treatment for a States described in this clause is a program that--CommentsClose CommentsPermalink

‘(I) ensures such orders are standardized and uniquely identifiable throughout the State;CommentsClose CommentsPermalink

‘(II) distributes or makes accessible such orders to physicians and other health professionals that (acting within the scope of the professional’s authority under State law) may sign orders for life sustaining treatment;CommentsClose CommentsPermalink

‘(III) provides training for health care professionals across the continuum of care about the goals and use of orders for life sustaining treatment; andCommentsClose CommentsPermalink

‘(IV) is guided by a coalition of stakeholders includes representatives from emergency medical services, emergency department physicians or nurses, state long-term care association, state medical association, state surveyors, agency responsible for senior services, state department of health, state hospital association, home health association, state bar association, and state hospice association.

Zeke Emanuel has responded via ABC News, courtesy of HuffPo.

He, too, resorts to the misdirection play and pretends it's all about end-of-life counseling, avoiding any mention of what's really in the bill, as in Section 123.  I also thought it was interesting that Tapper just matter-of-factly refers to Palin's comment about 'death panels' as 'discredited.'  Hmm, wonder by whom.  Certainly not by BO or Zeke.  Certainly not if anyone actually reads the bill.

But Zeke is certainly distressed that he's been 'maligned' by his own words.  Of course, as usual, they were 'taken out of context.'  I will cut the guy some slack as being well-motivated and a compassionate physician and oncologist - his specialty carries a greater emotional burden than any other - but that doesn't mean his ideas on placing denial-of-care and rationing decisions in the hands of a group of unelected 'experts' is any better or more just than having those decisions made by those closest to them, those with the greatest breadth and depth of knowledge of the individual's circumstances.  The fact of the matter is, such a panel will never, in a country of 300 million souls, consider any individuals and will make all their decisions based on such things as 'comparative effectiveness research' and 'quality-life-years.'

I know that denial-of-care and rationing decisions are already being made, voluntarily by private organizations created to deal with limited medical resource allocation (transplant care, for example) and by commercial insurance companies.  At least these evaluate the actual individual's circumstances, and their decisions are appealable.  There is no appeal process for the decisions of the proposed 'expert panel.'

On a more general 'smell test' note, just trying to wade through even a small portion of the bill tells you it will be a worst-case-scenario marriage of Alice in Wonderland and Rube Goldberg.  Such finely granular control of our lives just feels wrong.

I know that the "death panel" concept was originally suggested by Senator Isakson, a Republican from Georgia. That the house went with it's own little version (i believe), of which the language has - apparently (maybe) - been stripped from the bill.

Isakson: “My Senate amendment simply puts health care choices back in the hands of the individual and allows them to consider if they so choose a living will or durable power of attorney,” Isakson said in a statement. “The House provision is merely another ill-advised attempt at more government mandates, more government intrusion, and more government involvement in what should be an individual choice.”

As for the part you have, at first it sounds like an advisory panel. I'm going to dwell on a it further though, but it will take me awhile since I have to focus on my finals this term, all right?

You know what I find funny (not ha-ha funny), is that there already is an institution that decides what things it will pay for, what conditions they'll cover, and what medical things you can have done - it's call a medical insurance company. Insurance companies are just as bureaucratic and self serving as any government program would be. It's no different really. Personally, I'm skeptical of the mantra that the private sector will take care of everything...

Wrong.  You haven't been paying attention (although you're not alone on that score - neither have the media or most of the politicians, Democrat or Republican).  The end-of-life-counseling provision (already a mandatory part of the Initial Preventive Physical Examination, also known as the Welcome to Medicare Physical) and the 'death panel' provision (as it has come to be called) are totally separate provisions of the bill.

The end-of-life-counseling provision of the bill is/was, by itself, not objectionable, provided it really is/was voluntary.  Those defending BO's plan (and, sadly, many Congressional Republicans who don't seem to get the distinction) are focusing on the end-of-life counseling provision, presumably because that's more reasonable and easier to defend, as a way of deflecting attention from the actual provisions that prompted the phrase 'death panels.'  While Palin specifically rebutted the end-of-life counseling criticism she's received, she also made it clear that wasn't what she was originally referring to.

I believe you are wrong about that first sentence - if insurance were to be de-coupled from employment and insurance companies were forced to compete for the business of individuals as opposed to negotiating with corporate HR departments, you'd find them much less 'self-serving' as you put it.

I'm skeptical of both.  But once there is no private sector, the public sector will exist to justify its own existence, like all the other vampirical bureaucracies we already have.

http://www.cnn.com/2009/HEALTH/08/14/blayney.death.discussions/index.html

http://www.cnn.com/2009/HEALTH/08/14/britain.america.nhs/index.html

Both worth a read.

BO's still using the misdirection play and using that recalcitrant tic of his, setting up strawmen & knocking them down.

As in: "the notion that somehow I ran for public office or members of Congress are in this so they can go around pulling the plug on grandma."

BO was the first to use that phrase, far as I know.  I linked to that article to also show how the AP is in the tank.  This Liz Sidoti also calls the 'death panel notion' 'debunked' - guess she hasn't read the bill, particularly section 123, or connected the dots, either.

Besides, the issue is less the plug getting pulled on grandma than getting grandma plugged in in the first place.

From a comment by a Mr. Cecil Turner, in reply to this blog post.  The 'earnest confusion' reference is to a lament, in a column by Washington Post writer Rick Perlstein, that only liberals are rational.

The left is perfectly OK with BO using his grandmother as an example in the debate over 'death panels' but is abhored that Trig Palin was mentioned in the course of the same debate.

Of course, BO is talking out of both sides of his mouth, but that's becoming increasingly obvious to everyone, even the NYT, though they still cling to the fiction that the 'guidance' promulgated by the 'expert panel' to be established will be entirely 'voluntary.'  It'll end up about as 'voluntary' as the tax code if history is any guide.

http://online.wsj.com/article/SB125043830465934883.html#mod=todays_us_nonsub_page_one

Where I read about the likely gop insertions in the (my bad) senate one, at the least.

http://www.slate.com/id/2223023/

Thomas Sowell has done a nice job, much more eloquently and succinctly than I could, of getting at the essence of the 'death panel' issue in a two-part column -

#1 here and #2 here.