Current Events Health Insurance

The Death Panel

Is Obamacare going down in flames? Is Sarah Palin’s “Death Panel” comment the culprit? Is the government going to start killing its own citizens?

In Sarah Palin’s Facebook post, she explains her concerns by quoting from section 1223 of HR 3200:

Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual … or upon admission to a skilled nursing facility, a long-term care facility… or a hospice program.” [3] During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services.

How does one interpret this Section? Some extremists have claimed that this section will encourage or require euthanasia among sick patients. If you support ObamaCare, you likely think of these consultations will proceed as follows: a benevolent nurse will advice patients of their health care outcomes and may recommend care best suited for the patient. If you do not support ObamaCare, then you may still believe that these nurses are good hearted, but pressure from their superiors to cut cost may cause these consultations to become distorted. Practitioners may push for more hospice care and less invasive medical treatment–not because it is in the patients best interest–simply to save costs.

The truth is, no one knows exactly how these consultations will play out in reality. Some pracitioners may feel pressured to recommend less invasive care to save money and some may not. However, believing that this type of rationing does not occur in the private sector is incorrect. Let us look at another Sarah Palin statement:

“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.”

Palin fears that government rationing will deny care to certain groups. But as Robert Reich understands, health care is already rationed. In the private sector, different insurance companies cover different treatments. When an insurance company decides not to cover some type of end-of-live medical treatment, these private sector administrators can be considered just as much of a death panel as in Obama’s public sector plan.

We need politicians to now to offer real solutions to the health care problems in America. Pandering to American’s fears by using terms such as “death panel” and “rationing” will likely help the Republicans win votes, but it will not improve health care. If Republicans were truly opposed to any government-run healthcare, then their hyperbole could be seen a ploy to end government-run healthcare. However, very few politicians (even Republicans) endorse ending Medicare. Even the supposed anti-government George W. Bush enlarged Medicare by added prescription drug coverage (Part D).  Thus, I see lots of criticism, but few proposals for improvement.

Arnold Kling makes a provocative case for real reform: end Medicare and institute vouchers. Kling proposes that insurance be deregulated and Medicare ended. Won’t individuals with pre-existing conditions pay more for health insurance? Yes. However, in order to make this proposal fair, Kling would make the voucers conditional. The amount of the vouchers would be “based on need. Need would depend on income and pre-existing conditions.” With more people paying for their own health care and the government leveling the playing field, a fairer, more efficient system would emerge. For more on vouchers, see my post on vouchers in the U.S., as well as vouchers in Chile.


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