Eugene Robinson also wonders about Section 1233

posted at 12:15 pm on August 12, 2009 by Ed Morrissey

No one will mistake Washington Post columnist Eugene Robinson as a conservative shill, or a conservative anything.  In his latest column, Robinson goes out of his way to slam Sarah Palin for her “death panels” criticism of the ObamaCare bill coming out of the house.  However, Robinson agrees with Charles Lane that something smells, well, fishy about mandating end-of-life counseling sessions for the elderly and seriously ill in a bill whose backers claim the purpose of bending the cost curve downward:

We know that there are crazies in the town hall mobs — paranoid fantasists who imagine they hear the whop-whop-whop of the World Government black helicopters coming closer by the minute. We know that much of the action is being directed from the wings by cynical political operatives, following a script written by Washington lobbyists. But the nut jobs and carpetbaggers are outnumbered by confused and concerned Americans who seem genuinely convinced they’re not being told the whole truth about health-care reform.

And they have a point. …

If a technology exists that can prolong life or improve its quality, even for a few weeks or months, why shouldn’t we want it?

That’s the reason people are so frightened and enraged about the proposed measure that would allow Medicare to pay for end-of-life counseling. If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending. It’s irresponsible for politicians, such as Sarah Palin, to claim — outlandishly and falsely — that there’s going to be some kind of “death panel” to decide when to pull the plug on Aunt Sylvia. But it’s understandable why people might associate the phrase “health-care reform” with limiting their choices during Aunt Sylvia’s final days.

Which is why I will have to disagree with King Banaian in his otherwise-excellent post this morning in the series of questions for town-hall forum attendees we’ve published at Hot Air.  King asked:

I’d ask you this: Suppose it was your private insurance provider who was incentivizing the counseling. Would you object? I think it’s hard for a doctor, trained to save lives, to talk about what happens when they decide you can’t be saved. I’m going to go out on a limb — you’re welcome to saw it from under me — to say this service is underprovided in the private sector.

There is a large difference between a private entity incentivizing it and the government taking the same action as part of a nationalized system.  Consumers would have other choices in the private-sector scenario, including using their own funds to find doctors less willing to sell you a bouquet of flowers and a shovel as part of your diagnosis, thanks to good commissions.  In a government-run system, those choices get stripped from consumers, both directly and indirectly.  If the ObamaCare system incentivizes all doctors through cash payments to make the hospice pitch, it’s effectively unavoidable.  Thanks to the tax bite a national health-care system takes, most consumers won’t have the resources to opt for private care, just as we see in Canada and the UK.

Besides, as both Robinson and Lane acknowledge, having the government sell hospice care to people who are at particularly vulnerable moments in their lives smacks of a softer way of government attempting to tell citizens when they’ve become burdensome to the younger members of society.  Is that a role Americans envision for a government of free people?  And once we step down that road and find that patients and their families won’t acquiesce to the surrender sales pitch and the cost curve isn’t bending downwards, what happens next?


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BurmaShave on August 12, 2009 at 3:38 PM

Yes … and thank the politically dead, inept, incompetent ex-Governor from Alaska for bringing ti to his attention.

darwin on August 12, 2009 at 3:44 PM

Sorry, dudes, but when twits like Pelosi, Dodd and Frank sit on a panel to decide what treatment one will receive at end of life based on economics what the hell would you call that?

Hello?

Bueller?

drjohn on August 12, 2009 at 3:47 PM

Before Medicare? People had nothing and just died from very treatable reasons, very early in life.

Medicare isn’t constitutionally guaranteed. However, as a society, we decided that it was how we wanted to handle the problem of healthcare in the elderly.

And that most definitely is allowed by the constitution.

AnninCA on August 12, 2009 at 2:18 PM

Where is health care in the constitution?
.
10th amendment: The powers not delegated to the United States by the Constitution, nor prohibited by it to the States, are reserved to the States respectively, or to the people.

sannhet on August 12, 2009 at 3:47 PM

If you know that you want to be kept alive, regardless of the quality of your life, for as long as possible, then get the end-of-life counseling and get it down on paper that that’s what you want! Thus, there’s no confusion, and your wishes will be granted.

Practitioners, as defined in the bill, will be either a physician, a nurse practitioner or a physician’s assistant.

Your practitioner and the choices available to you will be limited to what a panel of stakeholders decides to tell your practitioner. Whose interests are these (highlighted below) stakeholders looking to protect and advance?

SEC. 1233. ADVANCE CARE PLANNING CONSULTATION.
Pg.427-428
‘‘‘(iii)A program for orders for life sustaining treatment for a States described in this clause is a program that

‘‘(IV)is guided by a coalition of stake-holders 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
.

liontooth on August 12, 2009 at 3:49 PM

The problem with the insurance industry is that it is over regulated.
Count to 10

Actually I believe the unaffordability of health care can be DIRECTLY tied to lawyers and illegal immigrants. When you get these two together it forms a tornado of havoc on the health system.

If there were no such thing as insurance (I wish this were true) EVERYTHING would be so much more affordable…and guess what…. we would still have medical care and we could still drive cars and people would still live in homes. We just wouldn’t have insurance companies taking half of our paychecks. I bet you could still pay to have things fixed and people would take better care of the things that are valuable in life.

If it were not for insurance companies and courts willing to award multi-million dollar judgements at every perceived wrong move an overnight stay at a hospital wouldn’t be $10,000

Goodeye_Closed on August 12, 2009 at 3:51 PM

Somebody better report this guy to flag@whitehouse.gov so he can be turned in.

Mojave Mark on August 12, 2009 at 4:09 PM

Medicare isn’t constitutionally guaranteed. However, as a society, we decided that it was how we wanted to handle the problem of healthcare in the elderly.

No it sure isn’t. But when you take 8% from the employee and 8% from the employer for 40 years in the promise that you are going to provide Medicare – it’s the morale thing to honor that – don’t ya think?

katablog.com on August 12, 2009 at 4:10 PM

Remember the example of Oregon- woman with cancer wanted treatment but the State said no way, too expensive. Offered to pay for her euthanasia instead.

There might not be explicit “death panels” but the results will be much the same. Just look at the survival rates of the US and the UK for serious illnesses. Here in the UK we don’t have a Death Panel but we do have NICE, a group which approves which treatments and drugs can be used by the NHS. We have a much smaller pool of treatments to choose from and of those some are limited- if you live in one area you might get it but if you live in another you won’t. It all depends on how well run your particular health trust is run, if they’re over budget or not.

Palin hyped the language she used but her point is a valid one- recently too in the British press a woman told of how every single health professional she met during her pregnancy advised her to kill her Downs Syndrome baby before it was born. One even specifically cited the cost to the NHS as a reason for the abortion.

Jay Mac on August 12, 2009 at 4:21 PM

… when … Pelosi, Dodd and Frank sit on a panel … what the hell would you call that?

drjohn

I give up, but for some reason I’m thinking of the old three stooges movies.

respectamerica on August 12, 2009 at 5:41 PM

The bill, if passed, should be easily discarded as unconstitutional. Pursuit of life, liberty,…

The end of life counseling weasel words are the thin edge of a wedge, and it is entirely correct to put an abrupt halt to this.

Is anyone offering Pelosi “end of life” counseling I wonder (I refer to political life, of course).

shaken on August 12, 2009 at 5:42 PM

Seems to me this all has a very eerie Logan’s Run feel to it. Where do we report to get our palm flowers?

Dominion on August 12, 2009 at 5:54 PM

What would be the end result of “limiting…choices” to “technology…that can prolong life” in order to “reduce end-of-life spending” if not…well…”death”?

And if such decisions are not to be made by a “panel”, then by whom? A spin of the Thunderdome wheel?

Yes, the term “death panel” is inflammatory. But so was the slogan “Bush lied, people died.” At least the former is, by at least one Washington Post liberal’s reckoning, grounded in truth.

csmats on August 12, 2009 at 6:41 PM

Has anyone yet made the connection between “end of life counseling” and the immediacy of the Baby Boomers soon to be of “counseling age”? This must be where the savings come in, that projected Social Security expenditures will take a nose-dive when the Boomers are allowed to just go away rather than get expensive medical treatments and no longer receive a monthly check.

Robert17 on August 12, 2009 at 8:06 PM

Has anyone yet made the connection between “end of life counseling” and the immediacy of the Baby Boomers soon to be of “counseling age”? This must be where the savings come in, that projected Social Security expenditures will take a nose-dive when the Boomers are allowed to just go away rather than get expensive medical treatments and no longer receive a monthly check.

Robert17 on August 12, 2009 at 8:06 PM

2 birds; 1 stone
it is blatant

Willie on August 12, 2009 at 8:25 PM

Before Medicare? People had nothing and just died from very treatable reasons, very early in life.

How did Medicare fix that? Medicare is for the elderly, not people who are very early in life. Therefore, the people who were dying very early in life from so-called very treatable reasons would still be dying early in life from those same very treatable reasons.

But that point aside, your entire premise is wrong. People were not going without care before Medicare came along. I guess in your world, the streets were littered with the bodies of the elderly dead until the benevolent hand of big government stepped in to save the day. I’m guessing Santa Claus and the Easter Bunny live there too.

xblade on August 12, 2009 at 8:50 PM

But when you take 8% from the employee and 8% from the employer for 40 years in the promise that you are going to provide Medicare – it’s the morale thing to honor that – don’t ya think?

katablog.com

More importantly, if you stopped taking that money from people, there would little need for medicare.

xblade on August 12, 2009 at 8:53 PM

By the way, can anyone tell me how many medical innovations, cures, treatments, etc for all those now treatable diseases Ann speaks of that medicare is responsible for?

xblade on August 12, 2009 at 8:57 PM

But I already discuss issues like this with my doctor for all treatments….why do they need to be paid extra, it is part of a regular visit….and WHY does the government want to make it a 5 year obligation?????? Yes, I will be using my social security in the next 5 years….

plainjane on August 12, 2009 at 9:14 PM

You force them to acquiesce. You see the government has police power and power of the purse. So if you don’t want to play by the rules…well what happens when you don’t pay your taxes?

You end up in the President’s Cabinet.

MassVictim on August 12, 2009 at 9:17 PM

There is a HUGE difference between the government advising you to off yourself (and providing the means to do it) and a doctor telling you that you are terminal and laying out end of life care, including palliatives and hospice, then letting you decide what you want.

HUGE difference.

Mommynator on August 12, 2009 at 10:23 PM

sanitation engineer = garbage worker

pre-owned vehicles = used cars

full-figured = fat

coalition of stake-holders = death panel

Knott Buyinit on August 12, 2009 at 11:46 PM

Pelosi Frank & Dodd…Winkin’ Blinkin’ & Nod…yeah, that works.

BadShot on August 13, 2009 at 1:43 AM

Soylent Green is people!

Khun Joe on August 13, 2009 at 2:17 AM

Interestingly, it only took Sarah Palin two words to make understandable the debacle which the entire cabal of Democrats needed 1000 pages to describe!!

So who’s really smarter??

(HINT: It ain’t the Washington crowd.)

landlines on August 13, 2009 at 2:57 AM

President Obama, making soylent green a reality. He IS the one.

Aylios on August 13, 2009 at 5:49 AM

Living Wills are a good idea, but I fear that their motives are not good ones.

idahoconservative on August 12, 2009 at 12:33 PM

I’m not convinced that Living Wills are a good idea, since they were developed through the efforts of euthanasia advocates such as the Hemlock Society. Old folks are still under the impression that hospitals and insurance companies will move heaven and earth to keep them alive, but a Living Will spells out how little care they are required to provide.

It seems to me that a better alternative is the Will to Live that is available through the National Right to Life Committee (nrlc.org) and its affiliates in every state (such as mine, the Kentucky Right to Life Association).

One problem with Living Wills is that the language in them can be re-defined by one’s state legislature over time. What you spell out in a Living Will may not hold up over time, if your legislators redefine, say, “heroic measures” or other terms.

Another problem is that people sign them when they are comparatively healthy and think that they would never want to be “hooked up to a machine,” only to find that when that day comes, they want very much to remain alive long enough to see their just-born great-grandchild. Conditions that seem intolerable now may become acceptable to us when they are all that stands between us and the grave.

An elderly relative of mine has been saying that he does not want to receive nourishment or water through a tube, but wants to die “peacefully,” like Terry Schaivo. Although I’ve explained to him that Terry died a horrifying, painful and slow death, he refuses to believe it. He says, “Well, when that time comes, if it’s that awful for me, the doctors will listen to you and not what I signed.”

Don’t believe it, I tell him. The mother of a co-worker signed a Living Will that prohibited nutrition and water by tube; and even though she begged for food and water, the doctors stuck by the document. It took her six days to die, and for much of that time, she was crying. There wasn’t a damn thing her loved ones could do for her. Not legally, anyway.

KyMouse on August 13, 2009 at 8:03 AM

After a lifetime of dieting, I actually, agree with Rush on the exercise myth for losing weight…it’s about limiting calorie intake.

This is one of the extremely rare things I disagree with Rush about. Rush dismisses exercise but the truth is that Rush is an extremely active person. He plays alot of golf and is constantly on the go. Sure you can say that he’s being flown around the country and chaufferred around in luxury but it is still a very active life. Keep in mind that Rush also has a personal chef and the money to buy the best, healthiest food. I would bet Rush’s chef understands his current diet as well if not better then Rush. When he dismisses exercise he is talking to people who may not have the active life he enjoys. Sure, limiting intake will effect weight but exercise and movement are very important to overall health and to lasting weight loss.

peacenprosperity on August 13, 2009 at 8:56 AM

End of life decisions are made all the time. Today, they are made by the family in concert with a doctor. I put in place a do-not-resuscitate order for a loved one and am perfectly at peace that it was the right decision.

The difference is that Dear Leader wants that decision made earlier. He can then use the money to insure those who are in the country illegally or are too irresponsible to buy their own insurance, even though they have the means. This group accounts for roughly 40 of the 47 million uninsured.

sclemens on August 13, 2009 at 9:06 AM

The bill, if passed, should be easily discarded as unconstitutional. Pursuit of life, liberty,…

. . .
Is anyone offering Pelosi “end of life” counseling I wonder (I refer to political life, of course).

shaken on August 12, 2009 at 5:42 PM

First of all, you are neglecting to take into account that a WISE LATINO WOMAN is now on SCOTUS..

As far as your point about Pelosi, judging from her face, she died about 10 years ago.

bullseye on August 13, 2009 at 4:17 PM

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