Obamacare's Inevitable Logic
8.18.09: It's magical thinking.
August 18, 2009 — -- False charges about Obamacare don't help.
Like the end-of-life tempest. Former Alaska Gov. Sarah Palin popularized the term "death panels." She said: "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".
The charge that the House and Senate health care bills would mandate end-of-life counseling -- hence "death panels" -- caught on. Rush Limbaugh, defending Palin's charge, said, "(D)eath panels ... it's a great way to phrase this end-of-life counseling".
Republican Sen. Chuck Grassley of Iowa piled on: "You have every right to fear. ... We should not have a government program that determines if you're going to pull the plug on grandma".
But no bill in Congress mandates end-of-life counseling, much less "death panels." And there's a deeper problem. When opponents of nationalization make such easily refuted charges, supporters of nationalization gain the upper hand. All criticism is undermined. Neutral observers can easily conclude, "If the death-panel claim is false, why believe anything else the critics say?"
That would be a disaster.
There's is reason to be concerned about end-of-life counseling, but the truth is more complicated. Here's the story.
The House bill does deal with the issue. (The Senate Finance Committee bill did until the provision was removed the other day.) Section 1233 amends the Medicare law to add "advance care planning consultation" (counseling about living wills and the like) to the list of reimbursable services. The provision defines "consultation," but nowhere does it require Medicare beneficiaries to participate or authorize death panels. (Grassley voted for a similar provision in 2003 when his Republican-controlled Congress added drug coverage to Medicare.)
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