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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