August 11, 2009

Disagreeing Over Things That Aren't Real

[Click image to enlarge.]

In what is - to date, anyway - the peak of increasingly deranged rhetoric coming from opponents of health care reform, former GOP candidate for Vice President, Sarah Palin posted the following note 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.
Such a system IS - very definitely - evil. It is also complete fantasy.

When ABC News queried the former Alaska governor about her comments, Mrs. Palin's spokesperson, responded by eMail: "From HR 3200 p. 425 see 'Advance Care Planning Consultation'." An examination of that part of the House bill (Section 1233), however, yields the following:
Advance Care Planning Consultation
(1) Subject to paragraphs (3) and (4), the 7 term ‘advance care planning consultation’ means a consultation between the individual and a practitioner described in paragraph (2) regarding advance care planning, if, subject to paragraph (3), the individual involved has not had such a consultation within the last 5 years...
The language that follows includes further detail, and it is very clearly about patients making their own end-of-life and living will arrangements so their families don't have to. It's about putting more control in the hands of patients themselves, not placing the lives of the elderly in the hands of faceless government drones.

In fact, no one was more shocked by Governor Palin's freely associative reading of Section 1233 than the author of an amendment to include similar language in the Senate version of the bill, pro-life Georgia Republican Senator Johnny Isakson. Here's what he had to say in a telephone interview with the Washington Post's Ezra Klein:

KLEIN: How did this become a question of euthanasia?

ISAKSON: I have no idea. I understand - and you have to check this out - I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up.

KLEIN: You're saying that this is not a question of government. It's for individuals.

ISAKSON: It empowers you to be able to make decisions at a difficult time rather than having the government making them for you.

KLEIN: The policy here as I understand it is that Medicare would cover a counseling session with your doctor on end-of-life options.

ISAKSON: Correct. And it's a voluntary deal.

Given that Senator Isakson is a conservative member of Governor Palin's own party, I think it is fair to say - if it wasn't already before - that she is either a liar or an idiot. There really are no other choices, and Post columnist Steve Pearlstein certainly seems to agree, as his column from last Friday amply illustrated:
As a columnist who regularly dishes out sharp criticism, I try not to question the motives of people with whom I don't agree. Today, I'm going to step over that line.

The recent attacks by Republican leaders and their ideological fellow-travelers on the effort to reform the health-care system have been so misleading, so disingenuous, that they could only spring from a cynical effort to gain partisan political advantage. By poisoning the political well, they've given up any pretense of being the loyal opposition. They've become political terrorists, willing to say or do anything to prevent the country from reaching a consensus on one of its most serious domestic problems.
President Obama, speaking at town hall forum in New Hampshire, had this to say:
This is not about putting the government in charge of your health insurance. I don't believe anyone should be in charge of your health insurance decisions but you and your doctor. I don't think government bureaucrats should be meddling, but I also don't think insurance company bureaucrats should be meddling. That's the health care system I believe in.
And I have to say, this is personal for Lori but it's also personal for me. I talked about this when I was campaigning up here in New Hampshire. I will never forget my own mother, as she fought cancer in her final months, having to worry about whether her insurance would refuse to pay for her treatment. And by the way, this was because the insurance company was arguing that somehow she should have known that she had cancer when she took her new job - even though it hadn't been diagnosed yet. So if it could happen to her, it could happen to any one of us.
Under the reform we're proposing, insurance companies will be prohibited from denying coverage because of a person's medical history. Period. They will not be able to drop your coverage if you get sick. They will not be able to water down your coverage when you need it. Your health insurance should be there for you when it counts - not just when you're paying premiums, but when you actually get sick. And it will be when we pass this plan.

Now, when we pass health insurance reform, insurance companies will no longer be able to place some arbitrary cap on the amount of coverage you can receive in a given year or a lifetime. And we will place a limit on how much you can be charged for out-of-pocket expenses, because no one in America should go broke because they get sick.

And finally - this is important - we will require insurance companies to cover routine checkups and preventive care, like mammograms and colonoscopies - because there's no reason we shouldn't be catching diseases like breast cancer and prostate cancer on the front end. That makes sense, it saves lives; it also saves money - and we need to save money in this health care system.

So this is what reform is about. For all the chatter and the yelling and the shouting and the noise, what you need to know is this: If you don't have health insurance, you will finally have quality, affordable options once we pass reform. If you do have health insurance, we will make sure that no insurance company or government bureaucrat gets between you and the care that you need. And we will do this without adding to our deficit over the next decade, largely by cutting out the waste and insurance company giveaways in Medicare that aren't making any of our seniors healthier.
...There's been a long and vigorous debate about this, and that's how it should be. That's what America is about, is we have a vigorous debate. That's why we have a democracy. But I do hope that we will talk with each other and not over each other - because one of the objectives of democracy and debate is, is that we start refining our own views because maybe other people have different perspectives, things we didn't think of.

Where we do disagree, let's disagree over things that are real, not these wild misrepresentations that bear no resemblance to anything that's actually been proposed. Because the way politics works sometimes is that people who want to keep things the way they are will try to scare the heck out of folks and they'll create boogeymen out there that just aren't real.
That sounds about right to me. We've got enough problems to solve without arguing the imaginary.


Jeff said...

Thanks again, Paul for your very smart blog!
I'd love it if the anti-socialists out there would give up the socialized medicine that is emergency care, including being able to call 911, have an ambulance show up, and being taken to an ER where you will be treated without regard for your ability to pay. To say nothing of Medicare/Medicaid. How 'bout giving up Social Security Disability? Cheers

PBI said...

Dr. Gall!

I didn't know you were reading my stuff - thanks very much for the kind feedback!