August 10, 2009

PALIN IS RIGHT ABOUT OBAMACARE'S POTENTIAL "DEATH PANELS" DENYING MEDICAL CARE; NRO'S WESLEY SMITH IS INCOHERENT WHEN HE ATTACKS HER FOR IT

Governor Sarah Palin picked up the gauntlet thrown down by the Obamacrats, and posted a criticism of the Obamacare ethos on her Facebook page:

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.


She naturally attracted a whirlwind of hostile flak from the Left. Nor surprising. As the bomber pilots used to say, if you find you are getting a lot of flak . . . you just might be over the target.

Speaker Gingrich defended Governor Palin's comments in a discussion with Obamacrat George Stephanopolous:



What has been surprising is the criticism Governor Palin has received from Wesley J. Smith.

Smith has written about the dangers of socialized medicine and the culture of death for years. He has written again and again about the perversion of medical ethics by death-infatuated assisted-suicide fans and about Ezekiel Emanuel's warning that doctors must abandon the Hippocratic Oath.

Governor Palin has just taken what he has written seriously, and put her opinions into a cogent and dramatic form.

And for this he attacks her? At Secondhand Smoke, a First Things blog, Smith wrote:

I think that [death panels] is a real danger, given the power of “quality of life” thinking among mainstream bioethicists likely to be on the centralized planning boards and, as we have noted here, the beliefs of some of President Obama’s primary health care advisers. But the term “death panel” is getting too heated to be effective in persuading, except with those who already agree.

Then, Palin takes the step too far:

“Such a system is downright evil.”

That was unduly incendiary, and unnecessary to her p0int. Consider: Nazism was downright evil. Slavery was downright evil. Obamacare–as wrong as I think it is–doesn’t come anywhere close to those levels of malign human behavior. Besides, if you present your case properly, it is wise to trust your audience reach their own conclusions. Such talk plays well to the gallery, but I don’t think it helps win the debate.

Today, at the Corner, Smith adds:

We don’t yet know what the final health-care reform bill will look like. But it appears certain that President Obama and his congressional allies hope to establish a centralized board or boards that would be charged with limiting costs by deciding which procedures and drugs would be covered, under what circumstances. The legitimate fear is that such boards, regardless of their benefits, would impose rationing based on invidious categories — such as age, disability, or other “quality of life” measurements. In other words, the boards would deny certain categories of patients treatment available to other categories of patients.

Palin is not being paranoid. Some of President Obama’s most influential health-care advisers have promoted rationing and quality-of-life judgmentalism. For example, Dr. Ezekiel Emanuel, White House chief of staff Rahm Emanuel’s brother, has suggested that we can no longer afford Hippocratic medicine, laid the intellectual groundwork for rationing based on age, and even stated that medical services “provided to individuals who are irreversibly prevented from being or becoming participating citizens are not basic and should not be guaranteed.” (My analysis of Emanuel’s proposals can be found at my First Things blog.) No wonder Palin is worried about the level of treatment her son Trig would receive under Obamacare.

True, Palin would be a more effective critic of Obamacare if she didn’t write like a college-student blogger. But her concerns are legitimate and substantive. And that shouldn’t be lost in the criticism of her lexicon.

What drivel. Drivel.

Governor Palin has had a phenomenally successful political career. She is more than an "effective critic," she is someone who can go out and get the votes, and win elections. Against tall odds.

And she can raise as much money and get higher TV ratings than Obama.

By comparison, Smith is nothing but a scribbler.

I don't want to go overboard here, either. Smith's ongoing and principled journalism has been very important in keeping the harsh light of truth focused on very nasty goings-on in the world of organized medical care. And he should keep doing what he does best.

But when a real leader steps up to the plate, and translates his journalism into a call for action, he should just get out of the way.

He admits, right off the bat, that Governor Palin is not being paranoid. He just thinks she would be a more effective critic, if she would just shut up.

That's just wrong.

Being more moderate, more like Senator Bob Dole or Senator John McCain is a one-way ticket to electoral defeat.

Elections in this country are not won by convincing the mushy middle to muddle over to your side. Elections are won by convincing your own voters to get up and go out into the voting booths. In order to do that, you have to have a strong, motivational message.

And you have to raise millions of dollars and be able to reach and attract millions of people.

The 2008 election did not see a phenomenally increased electorate. What it saw was a phenomenally increased black and lefty-youth electorate, and a depressed conservative electorate that did not get out and vote. And, McCain was outspent 8-1.

Governor Palin is someone who can energize the base, and transform the (less and less inchoate every day) feelings of vast numbers of people into an effective political movement. And raise enough money to remain competitive.

Smith is simply incoherent when he criticizes Governor Palin for taking his warnings seriously.

In addition, Governor Palin has added to her facebook page an excellent reading list of recent articles analyzing the health care debate:

Washington Post editorial, July 26, 2009
“The Health-Care Sacrifice: What President Obama needs to tell the public about the cost of reform”

But Mr. Obama's soothing bedside manner masks the reality that getting health costs under control will require making difficult choices about what procedures and medications to cover. It will require saying no, or having the patient pay more, at times when the extra expense is not justified by the marginal improvement in care.

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Betsey McCaughey, Wall Street Journal, July 30, 2009
“GovernmentCare’s Assault on Seniors”

But legislation now being rushed through Congress—H.R. 3200 and the Senate Health Committee Bill—will reduce access to care, pressure the elderly to end their lives prematurely, and doom baby boomers to painful later years.

The Congressional majority wants to pay for its $1 trillion to $1.6 trillion health bills with new taxes and a $500 billion cut to Medicare. This cut will come just as baby boomers turn 65 and increase Medicare enrollment by 30%. Less money and more patients will necessitate rationing. The Congressional Budget Office estimates that only 1% of Medicare cuts will come from eliminating fraud, waste and abuse.


[See also Dr. McCaughey’s rebuttal of PolitiFact’s Truth-O-Meter re: “End of Life Counseling” here.]

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Senator Sam Brownback, National Review, August 3, 2009
“Don’t Punish Seniors for Health-Care Reform: Denying care options to retirees is necessarily a part of the Democrats plan”

One particular provision in the Democratic bill has seniors worried, and rightly so. A new “Center for Health Outcomes Research and Evaluation” could ration access to medicines and treatments based on the government’s assessment of the value of a human life and the “cost-effectiveness” of treatment.

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Raymond Arroyo, EWTN, July 25, 2009
“What You Need To Know About the Health Care Reform Bills”

Here’s to your health, unless you are too old, too young, too disabled or any combination of the above. The health care reform bills wending their way through Congress should be focused on the well being of each citizen. Instead, it seems the bills, designed to contain costs while simultaneously extending health coverage to everyone, target certain vulnerable groups including the elderly, the pre-born, and the disabled. It all comes down to cost. How to pay for this colossus remains a question on the Hill. But the consensus seems to be: raise taxes and ration care. Both ideas have been woven into the current health care bills.

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Betsey McCaughey, New York Post, July 24, 2009
“Deadly Doctors”

[Obama health policy advisor Dr. Ezekiel] Emanuel, however, believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens... An obvious example is not guaranteeing health services to patients with dementia" (Hastings Center Report, Nov.-Dec. '96).

Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.

He explicitly defends discrimination against older patients: "Unlike allocation by sex or race, allocation by age is not invidious discrimination; every person lives through different life stages rather than being a single age. Even if 25-year-olds receive priority over 65-year-olds, everyone who is 65 years now was previously 25 years" (Lancet, Jan. 31).


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Thomas Sowell, Real Clear Politics, August 4, 2009
“Utopia Versus Freedom”

If we can be so easily stampeded by rhetoric that neither the public nor the Congress can be bothered to read, much less analyze, bills making massive changes in medical care, then do not be surprised when life and death decisions about you or your family are taken out of your hands-- and out of the hands of your doctor-- and transferred to bureaucrats in Washington.

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David S. Broder, Washington Post, July 26, 2009
“Our New Medical Judges?”

If President Obama has his way, another such unelected authority will be created -- a manager and monitor for the vast and expensive American health-care system. As part of his health-reform effort, he is seeking to launch the Independent Medicare Advisory Council, or IMAC, a bland title for a body that could become as much an arbiter of medicine as the Fed is of the economy or the Supreme Court of the law.

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The Heritage Foundation, July 30, 2009
“Obamacare: One Pill, Two Pill, Red Pill, Blue Pill; Top 10 Reasons Obamacare Is Wrong for America”

7. Who Makes Medical Decisions? What is the right medical treatment and should bureaucrats determine what Americans can or cannot have? While the House and Senate language is vague, amendments offered in House and Senate committees to block government rationing of care were routinely defeated. Cost or a federal health board could be the deciding factors. President Obama himself admitted this when he said, "Maybe you're better off not having the surgery, but taking the painkiller," when asked about an elderly woman who needed a pacemaker.

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National Review editorial, July 30, 2009
“Incurable”

The public option is certainly a weakness of the current House Democrats’ bill, one that could destroy the private-insurance market over time. But the rest of the bill takes the same federal-government-knows-best approach. It uses mandates on employers and individuals to force tens of millions of Americans to buy the level of insurance coverage the federal government demands. For those who cannot afford this level, it offers subsidies in the form of a new entitlement. And it increases the federal role in telling doctors and hospitals what constitutes appropriate medical practice.

The mandates -- effectively, they are taxes -- will reduce wages, limit new hires, and increase prices. The subsidies, enormously expensive from the outset, can be expected to grow with time to cover a larger and larger share of the population, just as Medicaid has done, and for the same political reasons. And having the government dictate medical practice worsens care and will inevitably lead to rationing.


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Thomas L. DiLorenzo, Mises Daily, July 28, 2009
“Socialized Healthcare vs. The Laws of Economics”

Price controls, or laws that force prices down below market-clearing levels (where supply and demand are coordinated), artificially stimulate the amount demanded by consumers while reducing supply by making it unprofitable to supply as much as previously. The result of increased demand and reduced supply is shortages. Non-price rationing becomes necessary. This means that government bureaucrats, not individuals and their doctors, inevitably determine who will get medical treatment and who will not, what kind of medical technology will be available, how many doctors there will be, and so forth.

All countries that have adopted socialized healthcare have suffered from the disease of price-control-induced shortages. If a Canadian, for instance, suffers third-degree burns in an automobile crash and is in need of reconstructive plastic surgery, the average waiting time for treatment is more than 19 weeks, or nearly five months. The waiting time for orthopaedic surgery is also almost five months; for neurosurgery it's three full months; and it is even more than a month for heart surgery (see The Fraser Institute publication, Waiting Your Turn: Hospital Waiting Lists in Canada). Think about that one: if your doctor discovers that your arteries are clogged, you must wait in line for more than a month, with death by heart attack an imminent possibility. That's why so many Canadians travel to the United States for healthcare.


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Thomas Sowell, Real Clear Politics, August 5, 2009
“Care Versus Control”

If this new medical scheme is so wonderful, why can’t it stand the light of day or a little time to think about it?

The obvious answer is that the administration doesn’t want us to know what it is all about or else we would not go along with it. Far better to say that we can’t wait, that things are just too urgent. This tactic worked with whizzing the “stimulus” package through Congress, even though the stimulus package itself has not worked.

Any serious discussion of government-run medical care would have to look at other countries where there is government-run medical care. As someone who has done some research on this for my book, “Applied Economics,” I can tell you that the actual consequences of government-controlled medical care are not a pretty picture, however inspiring the rhetoric that accompanies it.


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The Cato Institute Policy Forum
“What Government-Run Health Care Really Means”

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Michael D. Tanner, Cato Institute, August 2009
“Not Enough Health Care to Go Around”

The reality, however, is that every government-run healthcare system around the world rations care.

In Great Britain, the National Institute on Clinical Effectiveness makes such decisions, including a controversial determination that certain cancer drugs are "too expensive." The government effectively puts a price tag on each citizen's life...

Free-market healthcare reformers, on the other hand, want to shift more of the decisions (and therefore the financial responsibility) back to the individual.


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Arthur B. Laffer, Wall Street Journal, August 5, 2009
“How to Fix the Health-Care ‘Wedge’: There is an alternative to ObamaCare”

Rather than expanding the role of government in the health-care market, Congress should implement a patient-centered approach to health-care reform. A patient-centered approach focuses on the patient-doctor relationship and empowers the patient and the doctor to make effective and economical choices.

A patient-centered health-care reform begins with individual ownership of insurance policies and leverages Health Savings Accounts, a low-premium, high-deductible alternative to traditional insurance that includes a tax-advantaged savings account. It allows people to purchase insurance policies across state lines and reduces the number of mandated benefits insurers are required to cover. It reallocates the majority of Medicaid spending into a simple voucher for low-income individuals to purchase their own insurance. And it reduces the cost of medical procedures by reforming tort liability laws.


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Deroy Murdock, National Review, July 20, 2009
“Health-Care Reform: Why Not Try Ownership?”

Health-care reform should give Americans the option of using money tax-free to purchase whatever kinds of health insurance make them happy. If employers offer such plans, lovely. If not, individuals should be encouraged, through tax-free Health Savings Accounts, to buy their own policies and maintain them throughout their careers. This dramatically would reduce the tragedy of “job lock,” whereby employees put up with bosses and duties they cannot stand, merely to keep employer-furnished health coverage.

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Mark Steyn, Orange County Register, July 31, 2009
“No turning back from Obamacare”

How did the health-care debate decay to the point where we think it entirely natural for the central government to fix a collective figure for what 300 million freeborn citizens ought to be spending on something as basic to individual liberty as their own bodies?
How can you go wrong with Sowell, Laffer, DiLorenzo, and Steyn?

But she closes with this:

There is a lot of wisdom in the above articles, but I’m most impressed by the common sense of ordinary Americans, like the citizen from Pennsylvania who told Senator Specter:

“What I see is a bureaucratic nightmare, Senator. Medicaid is broke. Medicare is broke. Social Security is broke. And you want us to believe that a government that can’t even run a Cash for Clunkers program is going to run 1/7th of our U.S. economy?”

I couldn’t have said it better myself.
Governor Palin is bringing thoughtful analysis, a commitment to sound and basic values, compassion, and passion to the health care debate.

Wesley J. Smith ought to be thanking her, not taking pot shots at her diction.

She gets her point across quite effectively.

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