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Saturday, August 8, 2009

Deconstructing Palin's Health Care Statement

Former Governor Palin weighed into the health care debate with a controversial Facebook statement. Here's the part that's causing the most controversy.

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course.

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Now, she's taken criticism from all quarters. Jake Tapper wrote a blistering attack of this statement.

One can question whether there will by necessity be any rationing decisions that will need to come as a part of health care reform (and, in fact, we have) but pictures of government bureaucrats forcing euthanasia upon seniors -- and, now, children with Down syndrome -- because they're not productive members of society are not part of any reasonable debate on the facts of the matter. (And frankly, I agreed with
Palin previously, when she was asking members of the media to keep her children
out of any public debate.)

Asked specifically what the former governor was referring to when painting a picture of an Obama "death panel" giving her parents or son Trig a thumbs up or down based on their productivity, Palin spokeswoman Meghan Stapleton responded in an email: "From HR3200 p. 425 see 'Advance Care Planning Consultation'."

Charles Johnson, of LGF, also criticized Palin. Now, Palin's statement was far too provocative. There's of course no death panel that will decide who lives and who dies. The language she used went from proper criticism to fear mongering. She should have phrased her comments in a much more statesperson like manner. That said, those that criticize Palin on the merits of the statement simply haven't read the bill carefully.

There is no question that this bill will create rationing, and there's no question that eventually care will be cut from those that are deemed "unproductive" like her son. In fact, those that criticize misconstrue her reference to page 425 which either mandates or makes optional planning for death. In fact, pages 425-430 do a lot more than merely suggest "advanced care planning". In fact, it's much more complicated than that. The rationing starts on pages 27-30 where "essential benefits" are discussed. A new bureaucracy, the Health Benefits Advisory Committee, will be created to decide what insurance and procedures are deemed "necessary". On page 335, there is a section on "Outcomes Based Measures" which will have the same Health Benefits Advisory Committee do a cost benefit analysis of which procedures are cost effective. As such, if a procedure is deemed "unnecessary" and "not cost effective", it will be regulated out of existence. If you happen to need that procedure to live, get in front of the "death panel" and beg.

Then, within pages 425-430, there is language regulating the type of care that those near death will get. Combine that with "Outcomes Based Measures" and "essential benefits" and suddenly 80 year olds won't get a hip replacement. If you only have a month to live anyway, your care will be minimum.

This bill will also regulate pay and make it independent of specialty. This will drive doctors out of the business. (page 241) So, with 50 million more patients, less doctors, and the tools necessary to ration, that's exactly what the government will do. Furthermore, Palin correctly points out that one of the advisors to President Obama is Dr. Ezekial Emanuel (brother of the Chief of Staff) Dr. Emanuel has famously said this.

Health services should not be guaranteed to] individuals who are irreversibly prevented from being or becoming participating citizens. An obvious example is not guaranteeing health services to patients with dementia

Now, if the White House creates a system with not enough medical professionals to cover all the new patients, mechanisms to ration care, and has advising it someone that has openly stated that the "unproductive" need to have their care cut off, how else should Sarah Palin read this but that her son won't get care.

If you want to criticize Sarah Palin for her provocative language, scare tactics, and lack of statesmanship, I would agree. That said, on substance, Sarah Palin is absolutely correct.


rachel said...

sounds like a Death Panel to me. The whole bill is Orwellian, so why can't she call it what it is? Had Obama's bill referred to it as a Death Panel instead of the more sanitized 'Advance Care Planning Consultation' panel. Either way....granny is going to get dead.

Anonymous said...

I still don't see by a long shot how any of this constitutes rationing. Rationing is making sure people don't get too much out of their insurance plan. Obama's plan makes sure people don't get too little.

Now, taxing people's health care benefits, THAT is rationing!

mike volpe said...

Actually, rationing in health care is when health care gets doled out in small quantities because there isn't enough medical professionals for the number of patients. It isn't about what your insurance is. It's about coming to the doctor and the doctor saying that there's been too much of your operation already and so you can't get it.

Anonymous said...

I agree with you Mike.

Palin's comments are downright disgusting - pure and simple.

She is using her down-syndrome child as a tool to drum up anger amongst her wing-nut followers

mike volpe said...

That's not actually what I said about Palin's comments. I didn't say they were "disgusting" but provocative and not statesperson like. I also said that they were accurate. So, I don't think you agree with me.

Anonymous said...

Page 425 and the "Death Panel" actually wants to make it so that patients on Medicaid that are going through planning their 'end of life care' will have available to them therapy sessions. It is mandating that if they are upset they can talk to someone about the fact that they are dying. Sounds empathetic to me.

And leave it to Palin to drag her son back in the spotlight. If you want the media to leave your kids alone, Sarah, you need to leave your kids alone.

Bielie said...

Rationing will happen, and it will be in the form of waiting lists. In Britain you wait up to six months for a specialist appointment. By then you are either healthy again or dead. You can wait 5 years for a hip replacement. By then you are too old for the operation ("operative risk" which in many cases is BS) or dead anyway.

Some bureaucrat will decide whether you live or die, and you will have no say in the process.

Anyone who says otherwise is a liar or a moron.

mike volpe said...

What about 426-430 where there are new regulations for end of life treatments? You know ironically enough, the president just invoked his mom in selling health insurance. All politicians do what Palin did, that doesn't mean you make fun of their kids.

Like I said, I don't like the words she used but she is 100% accurate in characterizing the plan.

Anonymous said...

Realistically, Mike. None of what you have said has come close to countering the fact that health care is ALREADY rationed. It is rationed by your ability to pay.

Wolf said...

Why bother with the song and dance about disagreeing with her "overblown language," when in the end you say she's "100% correct." If you really believe that, then just keep it simple and admit it from the start, along with your desire to suck on her twat.

The truth is that it is far more often the case than it needs to be that the private health insurance company "death panels" will deny payment, even rescind coverage when their clients get sick. We have rampant rationing today, even if you call it by a different name, the essence is the same. If the CEO's of private companies can get more obscenely rich off the needless deaths of multitudes of their clients, then that's what they will do. The pattern of incentives in the current system leaves far too many who need care out in the cold to die. There are ways to reform health insurance and give incentives to the private companies to lower costs and provide better coverage. It seems to me there is no rational argument against having a hybrid system where public insurance is an option along with insurance from private companies; if you are correct and private insurance companies function far superior to the government, the public option will just fail. Why deny people the choice?

Anonymous said...

You have to forgive Mike, Wolf.

His rationality leaves him when it comes to Palin.

mike volpe said...

First of all, watch the language. Second, no one said our system isn't perfect or not in need of reform. Like I have said, here's my proposal.

Of course, things are rationed by expense. The whole entire world is rationed by expense. I would be on a big island in a huge yacht if I could afford it. Don't they teach economics at Vanderbilt?

There's a massive difference between not being able to afford top quality care and the government simply cutting off procedures and forcing wait because there are too many patients for the system.

I didn't like her language however she is right in her point. That isn't me bowing down to her. That's me criticizing her language which destroys the message. I said the exact same thing about the premier of the Czech Republic and I agreed with his sentiment.

The president has set up a straw man argument. It's either his plan or nothing. That's simply not the case. There are plenty of ways to reform the system without the government take over that he's asking for.

Wolf said...

"There's a massive difference between not being able to afford top quality care and the government simply cutting off procedures and forcing wait because there are too many patients for the system."

But the point is the current system has far too many people who can't afford insurance that will cover what they need than needs to be the case. Your so called alternate plan would make that only far worse, forcing those with preconditions to by insurance on the private market individually, which in effect for millions would make insurance to treat their conditions too expensive to afford period. It's you creating the strawman; in a hybrid system the government plan would be a choice, so if you think you can get better coverage from private companies and can afford it you would go there. Though it doesn't apply to the hybrid plan actually under consideration, I'll focus on the last part of your statement, and how it reveals an implicit social-darwinistic, twisted view of morality. Well I'll do that at another time; for now, off to get a burrito.

mike volpe said...

Again, I think the current system is plenty troubled. No one is saying the current system can't be fixed. I believe that the current system is problematic because of too much government control, not enough health insurance competition, and far too much litigation. Furthermore, there is corruption all throughout the system. None of those things are addressed in this bill. Just because the system has flaws doesn't mean the government should take it over.

sweets said...

That is the part of the controversy nothing more..

Anonymous said...

AHEFT shows African American health care has long been rationed by breeding us to limit our lives, so why should we pay for all those boomer pensions we will never benefit from? After all, it was the boomer pensions which caused the market to crash.

mike volpe said...

AHEFT being a heart test done in the early part of the decade.

I'm not sure that this is what the test proves, and furthermore, even if it doesn, what that proves.

Anonymous said...

England,ethicists meet and determine the amount of care you receive. Less than 2 yrs ago ,a 12 yr died in his room,his parents ran out into the hallway and were told the 'ethicists'
said do not resuscitate. They went back in and did. HE died one day later. Pete Singer will be the new face of anti-religious values.One of his views is that a child doesn't become a person until much later after birth. Perhaps 2 yrs later so parents, if the child is
'defective' should have the right to terminate the the non-person.

mgbcpa said...

Wolf, do you know of anyone that has died because a hospital refused to treat them? I know it probably happens occasionally, but if I'm not mistaken most hospitals are forbidden from treating critical patients due to lack of funds or insurance. The fact is that right now, people who cannot otherwise afford health insurance can and do, go the hospital and get treatment without any thought of ever paying the bill. Sure, they have to wait extremely long times sometimes, but hey, it ain't like they are working anyway! We don't see people dieing in the streets from lack of attention or care. While many may choose to lie and die, that is there choice, not lack of insurance.

ojmo said...

The Palin scenario is only made plausible by using some slippery slope argument that passing legislation to insure more Americans, and obliging insurance companies to cover people with pre-existing conditions, will somehow inexorably lead to a complete "phasing out" of private health insurance. No one, especially Palin, has explained that mechanism -- how will we get to "a government health care system", as she puts it? And why is it inevitable?

mike volpe said...

It's not a slippery slope. With 50 million more people receiving regular treatment, there won't be enough doctors. Care will have to be rationed.

How is a private company supposed to compete with the government? The government has the unlimited power of the treasury behind them. They have the unlimited power of taxes behind them. Do you think that if the post office was private that it would still be in business?

ojmo said...

What does "rationing of care" have to do with "phasing out" of private corporations? How does one automatically follow from the other? You haven't explained how the American health care system will turn into one that is government-run, based on the proposed plan. How will the private health care corporation disappear from the American economic landscape? You seem to be saying that the competitive advantage of government-run health care is so great that all Americans will choose the public plan, even though it’s certain their parents and unproductive children will be euthanized or rationed or whatever…it’s just too farfetched.

mike volpe said...

It's very interesting that you acknowledge that single payer is the goal. That's not what Obama says. That said, every country that has single payer, England, Canada, etc. all have rationed care.

That's because once government takes over the system, you no longer pay for anything. So, everyone gets care for everything and then there aren't enough doctors for all the care.

John Galt said...

The Senate Finance Committee will drop a controversial provision on consultations for end-of-life care from its proposed healthcare bill, its top Republican member said Thursday.

The committee, which has worked on putting together a bipartisan healthcare reform bill, will drop the controversial provision after it was derided by conservatives as "death panels" to encourage euthanasia.

"On the Finance Committee, we are working very hard to avoid unintended consequences by methodically working through the complexities of all of these issues and policy options," Sen. Chuck Grassley (R-Iowa) said in a statement. "We dropped end-of-life provisions from consideration entirely because of the way they could be misinterpreted and implemented incorrectly."

The Finance Committee is the only congressional committee not to report out a preliminary healthcare bill before the August congressional recess, but is expected to unveil its proposal shortly after Labor Day.

Grassley said that bill would hold up better compared to proposals crafted in the House, which he asserted were "poorly cobbled together."

"The bill passed by the House committees is so poorly cobbled together that it will have all kinds of unintended consequences, including making taxpayers fund healthcare subsidies for illegal immigrants," Grassley said. The veteran Iowa lawmaker said the end-of-life provision in those bills would pay physicians to "advise patients about end-of-life care and rate physician quality of care based on the creation of and adherence to orders for end-of-life care.