August 12, 2009
Attn: Johnny Isakson... Please Call Your President!
Yesterday, we wrote about Sen. Johnny Isakson's (R-GA, 76%) lunkheaded misunderstanding of Sarah Palin's "death panel" remark: In his anti-Palin hysteria, he imagined she was talking about "living wills" and the "end of life directive." Isakson thought that Palin was saying those amounted to euthanasia -- when in fact, she was talking about the health-care rationing that inevitably results from a single-payer, government-run system... which itself is the inevitable and intentional end result of the putative government "option."
It was an incredibly humiliating mistake for Isakson, exacerbated by its provenance: Isakson never even troubled to read what Palin herself actually wrote on her Facebook page, relying instead on the caricature by an anonymous telephone caller. (Perhaps Isakson should be made to sit in a corner of the Rotunda with a conical dunce-cap on his head, and write a hundred times on the chalkboard, "I will not rely upon unknown third parties when a primary source is available.")
I read a fantabulous Power Line post yesterday that accurately explained what Palin was talking about; alas, I cannot give credit either to John Hinderaker, my favorite blogger on my favorite blog, because the best part of the post was written by an unnamed "knowledgeable reader" corresponding with Hinderaker:
[S]o the only choice is limiting choice and quality....and that in turn requires a de facto single payer accomplished through the subterfuge of dictating the terms of "private" insurance, turning them into all but public utilities, engineering the transfer to the "public option" over a relatively short period of time, and then dictating payment terms to providers through rate setting, service bundling and, most important in this context, the MedPAC council which will determine "quality-adjusted effective" treatment protocols. The net effect is that an elderly person won't get a hip replacement or a coronary bypass....and will have nowhere --- in the US --- to turn.
The disingenuousness of the left on this point is breathtaking. Perhaps some are just too stupid to get the point....but the issue is NOT euthanasia, living wills etc....that's a pure straw man however insidious the proposal is and however dishonest they have been in covering it up or describing it. The real issue is the MedPAC council....there won't be any actual "death panel" adjudicating case-by-case....there won't need to be!....the MedPac council will set up criteria and rules, more or less in secrecy....rules determined by "experts" and by design removed from Congress to prevent pressure to approve expensive protocols at the end of life....or for "life unworthy of life"....a faceless bureaucracy with a maze of rules will simply be built into the system....diffused responsibility, nobody accountable, just the way it will be, no one can do anything about it.
Well, yeah. What Mr. Anonymous said.
MedPAC -- the Medicare Payment Advisory Commission -- already exists; it was created in 1997 by the Balanced Budget Act of that same year. Its purpose, in its own words, is "to advise the U.S. Congress on issues affecting the Medicare program."
The Commission's statutory mandate is quite broad: In addition to advising the Congress on payments to private health plans participating in Medicare and providers in Medicare's traditional fee-for-service program, MedPAC is also tasked with analyzing access to care, quality of care, and other issues affecting Medicare.
MedPAC sets a government-enforced price-control system for doctors and hospitals. It's important to understand that medical providers lose money on Medicare reimbursements, which they're forced by law to accept; they make it up by jacking up charges to all other patients. If they didn't have the lifesaver of non-Medicare, non-Medicaid patients on private insurance plans, many doctors, medical groups, and even hospitals would have to shut down, because they simply couldn't afford to practice medicine: We would have fewer health-care providers.
Under the House bill, patients shunted into the "goverment option" will be treated the same as current patients in Medicare; this requires exactly the same sort of price-control commission -- whether called MedPAC or by any other name, say ObamaPAC -- to make the same sort of decisions:
Get it? When ObamaCare engorges itself, like the Blob, to engulf and devour all health care, then the new ObamamPAC will make all decisions on what treatments will be covered. An unelected handful of wise men will pick and choose what medical treatment and procedures you and I and everyone else is allowed to receive.
(Everyone but presidents, senators, and congressmen, of course; they will always have their own system -- with unlimited treatment, no premiums, and no deductable -- at least, none paid by top federal officials; it will be our generous, if involuntary gift to the One and his minions.)
As demand for medical care skyrockets ("it's freeeee!"), and as the number of doctors and hospitals plummet, we will no longer have enough doctors to provide all that demand. Since prices will be controlled by ObamaPAC, the only remaining solution will be rationing, literal rationing. As in, no hip replacements for Granny, no expensive long-term care for Down Syndrome babies, and suchlike.
When Sarah Palin warned of "death panels," she was talking about the miserly ObamaPAC commission, staring at a staggering mismatch between demand and supply, deciding what care will be allowed to which class of patient -- not that stupid end-of-life counseling directive.
Well, today we have two followups: First, another charter member of the Duncecap Delegation, Ricardo Alonso-Zaldivar of the Associated Press; and second, a perfect illustration of exactly what Sarah Palin meant -- and why she was right all along.
In AP's inaptly labeled "FACT CHECK," Alonso-Zaldivar smirks that there is no "death panel" in the House ObamaCare bill -- as if he expected to find a title or section with the name DEATH PANEL, and that its absence is ipso facto proof that Palin is an idiot. But he ruins his own flame by making (you guessed it) the exact, same mistake that Isakson made:
Former Republican vice presidential candidate Sarah Palin says the health care overhaul bill would set up a "death panel." Federal bureaucrats would play God, ruling on whether ailing seniors are worth enough to society to deserve life-sustaining medical care. Palin and other critics are wrong.
Nothing in the legislation would carry out such a bleak vision. The provision that has caused the uproar would instead authorize Medicare to pay doctors for counseling patients about end-of-life care, if the patient wishes. Here are some questions and answers on the controversy:
Q: Does the health care legislation bill promote "mercy killing," or euthanasia?
Q: Then what's all the fuss about?
A: A provision in the House bill written by Rep. Earl Blumenauer, D-Ore., would allow Medicare to pay doctors for voluntary counseling sessions that address end-of-life issues. The conversations between doctor and patient would include living wills, making a close relative or a trusted friend your health care proxy, learning about hospice as an option for the terminally ill, and information about pain medications for people suffering chronic discomfort.
The Q&A drones on and one, smugly lecturing the (presumably moronic) Sarah Palin -- and everyone else worried about ObamaCare -- that there is absolutely no cannibalism in the British Royal Navy (kudos and a self-administered backpat to anyone who gets the reference).
I hate to tell Mr. Alonso-Zaldivar... oh, who am I kidding? I love telling him! I rejoice in giddy glee to inform Mr. Alonso-Zaldivar that it is he, not Sarah Palin, who is the dumbass here... because she was not talking about euthanasia, the end-of-life counseling directive, or living wills. She probably has a living will. She was talking about -- exactly this, from Bloomberg:
President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a “sustainable model” for health care.
The president’s grandmother, Madelyn Dunham, had a hip replaced after she was diagnosed with cancer, Obama said in an interview with the New York Times magazine that was published today. Dunham, who lived in Honolulu, died at the age of 86 on Nov. 2, 2008, two days before her grandson’s election victory....
Obama said “you just get into some very difficult moral issues” when considering whether “to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill.
“That’s where I think you just get into some very difficult moral issues,” he said in the April 14 interview. “The chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health-care bill out here.”
Speaking later in the same interview about a different subject, banking regulations, Obama said the following:
Obama also said his economic advisers aren’t constrained by ideology or connections to former Treasury Secretary Robert Rubin. “What I’ve been constantly searching for is a ruthless pragmatism when it comes to economic policy,” he said in the interview.
That is precisely what Americans of all ages, political persuasions, and economic conditions are frightened of, what drives the anger and anguish at town-hall meetings, and what has ground polling support for ObamaCare into the dirt: We fear that when health-care policy becomes "economic policy," due to vastly increased government meddling, leading at last to a complete federal takeover of health care, "ruthless pragmatism" will push ObamaPAC to deny Granny her hip replacement, because she's going to die soon anyway.
It may start by throwing only the terminally ill under the bus (as if that itself were morally acceptable); but when ObamaPAC is mugged by economic reality, it will end by throwing us all under those same wheels... just as similar councils have done in every other country that implemented government-run, government-controlled health care, from Great Britain, to Canada, to Japan, to most of Europe, to Cuba, to China, to the old USSR -- and the "new" Russia.
Is this starting to sink into the brains of U.S. Sen. Johnny Isakson and Ricardo Alonso-Zaldivar of the Associated Press? It's certainly already percolating through the brains of most Americans (excuse me, mobs of fascist thugs toting Nazi paraphernalia and intimidating the poor victims in the Service Employees International Union)... which is why they're showing up in droves to town-hall meetings, demanding that their representatives listen to them and not vote on either the House or Senate bill... that Congress tear it up and start over. (And I have a suggestion of how, exactly, to "start over.")
Sadly, our congressional "leaders" are neither leading nor even following their constituents; the Democrats who control Congress and la Casa Blanca have chosen instead to get in the way of real health-care reform.
Cross-posted to Hot Air's rogues' gallery...
Hatched by Dafydd on this day, August 12, 2009, at the time of 6:07 PM
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Tracked on September 23, 2009 6:34 PM
The following hissed in response by: Chris Hunt
I'd much rather eat Johnson, sir.
With a gammy leg?
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