Wednesday, August 12, 2009

If you listen to some people, health reform in the US means that we'll shoot the elderly to save money

Sarah Palin, the retired governor of Alaska and Vice-Presidential candidate in the 2008 election, recently issued an extremely bizarre statement on health reform on her Facebook page:

As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!

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.

Health care by definition involves life and death decisions. Human rights and human dignity must be at the center of any health care discussion.

Rep. Michele Bachmann highlighted the Orwellian thinking of the president’s health care advisor, Dr. Ezekiel Emanuel, the brother of the White House chief of staff, in a floor speech to the House of Representatives. I commend her for being a voice for the most precious members of our society, our children and our seniors.

We must step up and engage in this most crucial debate. Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back. Ronald Reagan once wrote, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth.” Let’s stop and think and make our voices heard before it’s too late.

Incendiary lies about a critical subject are downright evil. There is no such legislation on the table. Palin is either mistaken or lying.

There is a passage that would allow reimbursement for end-of-life counseling in Medicare, the social insurance program for the elderly in the US. Doctors would be able to counsel patients on what, if any, lifesaving measures they want taken, and may ask them about living wills. In contrast, futile care is generally the default; such care extends life only with great discomfort, for a short time and at great cost. As the Huffington Post reports, there is extant legislation to allow Medicare to reimburse for end of life counseling; several Republicans have co-sponsored the legislation in question. If Palin is mistaken, she is almost certainly thinking of the end-of-life counseling provision. However, it is not excusable for a former public official to read legislation this carelessly.

As a side note, Palin has a child with Down's Syndrome. She asked that her children be off-limits during the Presidential campaign, which was a reasonable request. However, she then paraded her children around and made a big fuss over how she had not chosen to abort Trig's pregnancy. Now she brings Trig up again, making the wild accusation that there are those who would are thinking that children with Down's Syndrome should be euthanized. Some parents choose to terminate a pregnancy with Down's Syndrome as they feel they cannot support a child with the condition; this is not an easy choice for them. Palin's cavalier words are an insult to parents who feel they have had to do so. Additionally, the end-of-life counseling provisions are in Medicare, and Medicare beneficiaries do not generally get pregnant due to age (albeit some people with disabilities are in Medicare).

Sadly, other Republicans such as Senator Charles Grassley (R-IA) and Rush Limbaugh have jumped on this false bandwagon. This behavior is irresponsible. Palin's contentions, whether made on purpose or by accident, are demonstrably false, and it is not an excuse for US legislators, who have large legislative staffs, to be mistaken.

Edit: After further consideration, Palin's misconceptions (or outright lies) may be based on a general fear that comparative effectiveness research will lead to excessive rationing of care. In fact, it's more likely she was thinking of that that of the end-of-life counseling provisions. In any case, her statement is still demonstrably false. There are no 'death panels'.

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