@realjohnboy,
realjohnboy wrote:
Good evening, all. Sarah Palin, back in 2oo9, I believe, came up with the phrase "Obama's Death Panel," which would decide who merited health care. Rep John Boehner proclaimed that we were heading down a "...treacherous path toward government-encouraged euthanasia."
In my mind, all that the new Medicare rule does is allow doctors to have the same frank discussions that we have had with regard to end of life decision-making in our own families.
What do you mean by "allow?"
The original Obamacare bill included a provision that encouraged doctors to have these discussions. The ensuing ruckus over "Death Panels" led the Democrats to withdraw that provision from the bill.
The new medicare rule will reimburse doctors who have this discussion.
How you view the earlier provision and the new Medicare rule depends, of course, on your point of view about government run healthcare and it's baked in assumptions.
No matter what any advocate of socialized medicine aka single payer system may say, demand will outstrip supply and some sort of
rationing will need to be implemented. Even fans of the Canadian and UK systems must acknowledge that this is the case under these systems.
In determining how to spread the wealth, so-to speak, it's elemental that administrators of the system must identify where most of the healthcare dollars are being spent, at least on a per capita basis.
That analysis inevitably leads to the very old and the very young.
It is possible that no healthcare system is financially sustainable if per capita levels of spending on the very old, and the very young continue or increase, but it is certainly the case with a socialized system.
This leads to tough choices which have been discussed quite openly, but, for the post part, have received little media attention. Medical ethicists can discuss this topic in the middle of Times Square, but unless the media reports on it, the public will remain uninformed.
We all know what the questions are though.
Does it make sense to devote enormous portions of a finite resource to people who are either already dying (e.g. diagnosed with a terminal disease) or who's quality of living is minimal at best (e.g. Alzheimer patients)?
Does it make sense to devote enormous portions of a finite resource on the low percentage chance to preserve a premature baby’s life---a life, which if successfully preserved will almost surely require an inordinate share of the healthcare pie.?
Some of the medical supporters have been quite frank in answering these questions. The brother of the former WH chief of staff, for example.
These questions, however, are not ones Americans want to consider, because even if logic can bring them to a point of accepting rationing they know that if circumstance change for them, they will want, if not demand, full care and resources for themselves or their loved ones.
It's all well and good to accept the logic of rationing until the system won't spend hundreds of thousands of dollars to preserve the life of your premature baby, or fund an only partially proven drug therapy for your dying wife.
In a system where healthcare services are controlled by the government, these decisions will be made and they will be made by politicians, policy advisors, and bureaucrats. Obviously there will be input from members of the medical profession, but on a general rather than case by case basis.
This need not be a bad thing. It is not certain that this cast of characters cannot fashion appropriate rules and regulations around rationing. Whether or not you are content with the notion will depend upon your experience to date with how the government runs things.
There is an inherent assumption within
End of Life Discussions that reduced or ceased treatment will be discussed. Otherwise why have the discussion? There is also an assumption, by those who support the rationing of care,
that more, not less patients will receive reduced or ceased treatment if
End of Life Discussions are commonplace. This is probably an accurate assumption.
So if you support rationing you will support
End of Life Discussions, and if you want to see more
End of Life Discussions you create an incentive for them to take place more frequently.
(Note: I am not passing judgment on
End of Life Discussions. They make sense in certain situations, and in such situations I'm all for them)
If
End of Life Discussions are so obviously a component of ethical medical care, why do we need incentives? Are we of the opinion that our country's physicians will withhold this important component of care simply because they are not getting paid for it?
And if we have a less than complete faith in the professionalism of our physicians why would we not think that some will conduct unnecessary or inappropriate
End of Life Discussions simply to get paid?
This is all very far from the notion of Death Panels, and I'm not a big fan of overheated rhetoric of getting people's attention with fear, but in this case it did cause people to think about the far more subtle implications of the legislation. It probably back-fired a bit too, and so I think the issue could have been raised more effectively, but as politicians seek serve their constituents, they seek to serve themselves. Sarah Palin drew attention to the ethical issues of rationing and to herself, which for her was a win-win.
It is unfortunate that this very serious issue of debate hasn’t received a fair and reasoned public debate. Instead, Americans have been provided:
Supporters: This bill is perfect. It gives you everything you need and reduces costs too!
Opposition: This bill is an abomination! It will set up Death Panels that will decide if your grandmother lives or dies.
Supporters: Death Panels?! How ridiculous, how crazy! Of course it doesn’t. Show me where the term Death Panel is used in the 2000 pages of this bill!
Opposition: It will lead to euthanasia of old folks, and besides they shoved it down your throats!
Supporters: They are crazy. It’s perfect, you’ll see.
The supporters of the legislation have dance past the serious questions and the opponents have made them farcical.
I’ve been against and remain against Obamacare for numerous reasons, and while Death Panels will only materialize if our darkest Orwellian nightmares are realized, I am concerned about life and death being treated in the same manner as motor vehicle registrations, building permits, income taxes, and road construction.
Supporters need to be honest and address the issue with the public, and opponents need to be equally honest and explain how their alternative plans will address the problem of demand exceeding supply in a way that doesn’t result in a huge swathe of Americans being priced out of healthcare.
