Sunday, August 23, 2009

On Those Death Panels

Former Alaska Gov. Sarah Palin's discussion of so-called "death panels" to describe end-of-life counseling requirements in the Obama health care plan doesn't appear to be off the mark after the recent disclosure of VA policies on the subject adopted by the Obama administration only last month. An end-of-life planning document, "Your Life, Your Choices", had been proposed as the preferred living will for VA officials to utilize in counseling veterans until the Bush White House caught wind of it and pulled the plug on it (no pun intended). This document takes the "hurry up and die" approach to counseling veterans with questions like these that are analogous to a push poll:

  • "I can no longer walk but get around in a wheelchair."
  • "I can no longer get outside-I spend all day at home."
  • "I can no longer contribute to my family's well being."
  • "I live in a nursing home."
  • "My situation causes severe emotional burden for my family (such as feeling worried or stressed all the time."
  • "I am a severe financial burden on my family."
  • "I cannot seem to shake the blues."

Former Bush White House official Jim Towey drew attention to this little-noticed development at the VA after the Wall Street Journal published an opinion piece this past week entitled, "The Death Book For Veterans." The author of the VA document, Dr. Robert Pearlman, is an advocate for physician-assisted suicide as Towey notes. Towey has authored his own end-of-life counseling booklet that sells for $5. During a discussion of this issue on FOX News Sunday this morning, Assistant VA Secretary Tammy Duckworth suggested that Towey is simply interested in peddling his own booklet on which the VA wouldn't spend money. Duckworth disputed whether the Pearlman-authored directives had been adopted as official VA policy; however, FOX News' Chris Wallace confronted her with evidence on the VA's own website suggesting otherwise, and that the VA had posted a disclaimer on its website only after Towey's column was published indicating that the policy was still undergoing further revisions.


Patriot Paul said...

The Death Panels are for real. It isn't so much what the bill per se calls for; it is what the associated players such as Ezekiel Emanuel have written regarding the plan and how they would institute a program for those who have both a disability and an unproductive life. A decent following of the death panel can be found on the ny times Obama has picked people who will put these applications into place in all the areas where vague language can be interpreted to their overall goal of depopulating the U.S. in order to save money. As horrible as it sounds, it's even worse after reading what his Czars have written. The public option is a misnomer for public requirement.

Vox Populi said...

Death Panels do exist, and they are called insurance companies.

End of life counseling is important if you want to control your destiny and relieve your family of incredibly tough end of life decisions.

I think if Republicans were really against a public option, they'd 1) make sure they and their staffs dump their insurance and pay the government plan back for any prior use, and 2) call for the immediate elimination of Medicare, Medicaid and Social Security.

But they don't care about principle, they care about victory.

Concerned Taxpayer said...

I know! Let's have a policy that dictates the following:
1)POOR people are put to death.
2)People on WELFARE or FOODSTAMPS longer than 90 days are put to death.
3)People who don't get a job are put to death.
NOW let's listen to the hue and cry from the liberals!
(No, I'm not serious, but if you don't see my point, you are one of THEM.)

Concerned Taxpayer said...

Vox, you know well and good the Republicans are NOT against a public option. They are against the GOV'MINT "promising" us there will be a public option when we well know it will be eliminated by force later, and EVERYONE (except Congress and POTUS) will be forced into a poorly-run government system.
And the Republicans have been trying to fix Medicare/Medicade/Social Security for YEARS, but the liberal democrats keep blocking reform.

You KNOW this unless you only get your "news" from MSNBC or Chris "Leg Tingle" Matthews.

IndyPaul said...

1. There are no end-of-life counseling requirements in the health plan currently being debated in Congress. The plan would cover voluntary end of life counseling with a professional.

2. The VA phamplet is an informational piece on preparing a living will. The portions quoted are from part of the phamplet described as "thought provoking excercises" on 'what make life living', and also include things such as unable to recognize family and friends and unable to talk or communicate. Apparently Mr. Towey would prefer that elderly or infirm not think through the possibilities in preparing a living will. There is nothing in the phamplet that advocates a 'hurry up and die' approach. It could be helpful to veterans' in preparing living wills, which lawyers of all stripes have been advocating for years in order to give people some power and choice over the medical care they recieve.

There are no 'death panels', and a VA informational phamplet on living wills has nothing to do with the health plan's coverage of volunatary end-of-life counseling

POPA said...

Right or wrong? Republicans, such as Patriot Paul, who believe these "death panels" are real believe our government will actually kill people who don't want to die? Is that what you're saying?

Gary R. Welsh said...

Paul, I don't know any attorneys who pose those types of questions to clients when preparing a living will for them. Attorneys are focused on life-sustaining medical care when a person is unable to perform any life-sustaining activities for themselves. Contrary to your suggestion, the booklet was not put out simply as an informational piece. VA officials were directed to use it in counseling VA patients. The Obama administration immediately began to backpedal when they realized how difficult it would be to defend the living will guide.

What Paul and others are suggesting, Chris, is that a government-run plan will ration care. Prevailing liberal attitudes tell us that the unborn and elderly are considered disposable. Government should provide payments for abortion on demand and health care services to younger people is always favored over expenditure of health care services for the elderly based on their life expectancy. There are many men, for example, in their 70s who are allowed to have surgery and other treatment for prostate cancer. Under a government-run plan, if your life expectancy is 78 and a 75-year-old presents with prostate cancer, the government health care bureaucrats are not likely to put a priority on paying for that service, since he would be expected to attain a normal life expectancy without the expenditure of government funds.

POPA said...


Do you actually believe that the Obama healthcare plan will prohibit people with means from having prostate surgery? I don't want to do injustice to your position, but I'm not sure if you're upset that government would make such a priority list at all, or just that it could compel adherence to the list, regardless of what financial resources people have available.

In other words, while I don't reach the same draconian conclusion of forced death you do from the language in the bill, could you support the bill if it explicitly said: "Private payors may pay whatever they want to whomever they want to receive whatever care they want."

I guess I'm shocked that you don't think these decisions are being made already in other contexts. For example, if you were running an organ donor program, would you go with highest bidder? First on the list only? Or might you consider how alcohol abuse? What about the fact indigent and homeless don't likely have the diet and housing necessary to keep a transplanted organ up to snuff? In those cases, shouldn't the federal government put the donors up in hotels to ensure their transplants work?

My point is that you act like liberals are the only people making value judgments. Are they really?

Seriously, would you flip a coin to see if you give a kid a new liver before a 75-year-old who also has prostate cancer gets one?

Now, you will say to me, "That's different, Chris, because you're talking about a scarce good. We can do unlimited cancer surgeries."

And I'll say, "Sure we can. As soon as either the Republican party agrees with "the liberals" that healthcare is a right and that the government will pay for all treatments doctors feel are necessary to preserve a life, even if for a day, or until you ban policy caps on health insurance and restrictions on "experimental" treatments, prohibit pre-existing condition limitations, and subsidize the costs of these policies so everybody can afford them.

I look forward to your support of either of these ideas as you and the Republican party value human life more than your tax dollars.
(tongue firmly in cheek).

Gary R. Welsh said...

People of means, Chris, will always get the health care they want. We see that with the wealthy people from other countries with socialized medicine coming to the U.S. to get the better health care they desire. You basically acknowledge that the average joe will be stuck with the choices the government makes for him. In case you haven't noticed it, the government is constantly mandating specific coverages for government and private health insurance plans. There are many things wrong with the current health care system that can be addressed without creating a single payor, government-run system.

Anonymous said...

The problem with most (not all) of the arguments here is that they ignore the crux of the issue: The government has no right to determine, budget, control, dominate, mandate, or legislate how healthcare can or will be delivered to private citizens by private organizations.

The issue is NOT health care for the elderly, reduced costs, or any of the other line items that folks are wasting their time bickering over. The issue IS that government can kiss my royal f^<&!#@ a$$ if they think that they can mandate the limitations and minimum requirements that anyone in my family is eligible for or that they must meet.

Our health is our own private business. Show me somewhere in the US Constitution where it states that the federal government can dominate my health care choices.

And that opens the doors to the very crux of the issue: Do you want a Constitutional government that gauruntees your individual liberty, or do you prefer to reject the Constitution as written in favor of increasaed government control over your life.

So it's not about health at all. When siding for or against the health bill, that is the decision you are making: Protection of your individual liberty, or surrender of it.

POPA said...


I agree that there are alternatives to a single-payer system. But none of them will: (a) cover everybody; (b) give us the cost savings associated with (i) yanking out insurance industry profits; (ii) efficiencies of having one payor; (iii) price discounts negotiated by having one payor.

But let's put that aside for a second. What disturbs me is when somebody (to wit, AI) tries to derail a proposal by acting like its concerned that it doesn't ensure every American can have every procedure covered that might extend a person's life, even for a day, when you know full well you would NEVER support anything that required that kind of cash. See, you seem to see a difference between a system that has a panel of government folks saying, "No, we won't pay for that service," and a system that leaves a bunch of people unable to pay for a service. To the guy or gal who can't get it done, the result is the same. My point is, if you're not REALLY for an "every service you want" approach, pick another reason to fault Obamacare.

Concerned Taxpayer said...

No, Shorebreak, and the gov'ment can't fire executives of private corporations, or fix the salary of people in private employ, or take over banks....what? OH....are you sure? ...........NEVER MIND! /s off

Anonymous said...

Ayn Rand has a perfect, sound, Constitutional argument against Obama care. This is the argument that FOX and CNN don't want in the mainstream:

POPA said...

Shorebreak: I watched the Ayn Rand clip. Holy cow! What a nutjob! Holy cow! I hadn't actually heard her talk before, but she thinks that the labor movement was a response to government intervention?!?!

It was a complete response to laissez-faire, sweat-shop abuses. Ever read The Jungle? I have. Government wasn't doing ANYTHING. Employers were. The market failed to "correct" any of these abuses, and we had a whole third-world labor class. Had the labor movement not come to fruition, we probably would have had a revolution. We also wouldn't have anywhere NEAR the prosperity we do now because you wouldn't have seen a middle class. The entire middle class was built and sustained by the New Deal, the GI Bill, labor-union negotiated, high-wage factory employment, and student loans, all things Ayn Rand would have NEVER supported.

Not coincidentally, the chasm between rich and poor is exploding now, as labor union membership and power decreases in the face of a growing global economy that, within three decades, will force everyone who doesn't have two advanced degrees into Walmart greeter jobs as the rest of the world industrializes and works for dimes on our dollars.