Sarah Palin, Crazy Like a Fox

H/T to my blogging cohort Dave Gerstman, the Soccer Dad, for forwarding me the article that was inspiration for this post. This article recently appeared in the CATO institute's site.

The shameless hoax that Palin had confused individual consulting with rationing by a panel was repeated endlessly. By November, the Washington Post was treating this obvious canard as a established fact: “Proposed health-care reform legislation includes a provision that allows Medicare to pay for “end-of-life” counseling for seniors and their families who request it. The provision — which Sarah Palin erroneously described as “death panels” for seniors — nearly derailed President Obama’s health-care initiative.”

What Palin wrote about death panels clearly had nothing to do with counseling or with any other specifics in seminal House bill. What she wrote was: “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.”

How could anyone believe Palin’s sensible comment about rationing was, in reality, a senseless fear of counseling? To say so was no mistake; it was an oft-repeated big lie.

This was a defense of Palin's use of death panels. It's not the first and won't be the last. In fact, that term "death panels" has been among the most debated terms in the health care debate. The reason Dave sent me this article is that long ago, I made a similar defense.

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.

I also said this in the same piece.

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 states person like manner. That said, those that criticize Palin on the merits of the statement simply haven't read the bill carefully.

At the time, I thought her fiery language, the use of the term "death panel", would take away from the point she made. After reading this article from CATO, I've realized I was wrong.

In fact, the substantive point that Palin was making wasn't anything earth shattering. Health care reform will add tens of millions of patients but it won't add any doctors. If we have the same number of health care providers providing health care to more people then the health care will be rationed. Palin then went on to list several panels that would likely do the rationing. Had she simply made this substantive point she would have been one of many making the same point.

She didn't. Instead, she used the explosive term "death panel". That drove her point home and it invited attack. By extension, it invited debate. In fact, as the article indicates, we're still debating this point.

In fact, I've also criticized Palin for not being active enough in the health care debate. This criticism is likely overstated as well. After all, in her limited role in the debate, she contributed the single most explosive, most talked about, and debated part of the debate.

In fact, Kirsten Powers said it best when she said, "if you have to defend yourself against the accusation that your reform will kill grandma, then you're in trouble." Who created the perception that health care reform will kill grandma? It was Palin.

In fact, as I look back on the debate, her language was brilliant. It drew attention to the point she was making. This was a basic and oft repeated point. Yet, it is Sarah Palin that is now most identified with the issue of rationing in health care. She has in fact taking the lead in the health care debate. The more I follow Palin, the more it's clear that she's crazy like a fox.