Palin Responds to Her Critics on Death Panels

cnredd · #1 (**permalink**) 08-13-2009, 03:40 AM

Palin came out on Facebook to explain her earlier comments regarding Death Panels...

Concerning the "Death Panels"

Quote:

Yesterday President Obama responded to my statement that Democratic health care proposals would lead to rationed care; that the sick, the elderly, and the disabled would suffer the most under such rationing; and that under such a system these “unproductive” members of society could face the prospect of government bureaucrats determining whether they deserve health care.

The President made light of these concerns. He said:

“Let me just be specific about some things that I’ve been hearing lately that we just need to dispose of here. The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for death panels that will basically pull the plug on grandma because we’ve decided that we don’t, it’s too expensive to let her live anymore....It turns out that I guess this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, etc. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready on their own terms. It wasn’t forcing anybody to do anything.” [1]

The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.

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. [4]

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.” [5] Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones.... If it’s all about alleviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?” [6]

As Lane also points out:

Though not mandatory, as some on the right have claimed, the consultations envisioned in Section 1233 aren’t quite “purely voluntary,” as Rep. Sander M. Levin (D-Mich.) asserts. To me, “purely voluntary” means “not unless the patient requests one.” Section 1233, however, lets doctors initiate the chat and gives them an incentive -- money -- to do so. Indeed, that’s an incentive to insist.

Patients may refuse without penalty, but many will bow to white-coated authority. Once they’re in the meeting, the bill does permit “formulation” of a plug-pulling order right then and there. So when Rep. Earl Blumenauer (D-Ore.) denies that Section 1233 would “place senior citizens in situations where they feel pressured to sign end-of-life directives that they would not otherwise sign,” I don’t think he’s being realistic. [7]

Even columnist Eugene Robinson, a self-described “true believer” who “will almost certainly support” “whatever reform package finally emerges”, agrees that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.” [8]

So are these usually friendly pundits wrong? Is this all just a “rumor” to be “disposed of”, as President Obama says? Not according to Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, who writes:

Section 1233 of House Resolution 3200 puts our senior citizens on a slippery slope and may diminish respect for the inherent dignity of each of their lives.... It is egregious to consider that any senior citizen ... should be placed in a situation where he or she would feel pressured to save the government money by dying a little sooner than he or she otherwise would, be required to be counseled about the supposed benefits of killing oneself, or be encouraged to sign any end of life directives that they would not otherwise sign. [9]

Of course, it’s not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President’s chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those “who are irreversibly prevented from being or becoming participating citizens....An obvious example is not guaranteeing health services to patients with dementia.” [10] Dr. Emanuel has also advocated basing medical decisions on a system which “produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.” [11]

President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.

[1] See President Obama Addresses Sarah Palin ?Death Panels,? ?Wild Representations? - Political Punch.
[2] See http://edlabor.house.gov/documents/1...ext-071409.pdf
[3] See HR 3200 sec. 1233 (hhh)(1); Sec. 1233 (hhh)(3)(B)(1), above.
[4] See HR 3200 sec. 1233 (hhh)(1)(E), above.
[5] See http://edlabor.house.gov/documents/1...ext-071409.pdf
[6] See http://www.washingtonpost.com/wp-dyn...80703043.html].
[7] Id.
[8] See http://www.washingtonpost.com/wp-dyn...81002455.html].
[9] See Letter to Congressman Henry Waxman re Section 1233 of HR 3200 | New York State Senate.
[10] See http://www.ncpa.org/pdfs/Where_Civic...cracy_Meet.pdf
[11] See Principles for Allocation of Scarce Medical Interventions.

Doesn't mean you have to agree or disagree with her...

But the fact that she was mocked shows the ignorance and distain some have for her without realizing that she brings up the very same issue that Obama's own supporters have brought up...

But she's Sarah palin, so the kneejerk reaction of ridicule trumps actually understanding the comments...

MrLiberty · #2 (**permalink**) 08-13-2009, 11:48 AM

The elderly when they have no family left or ones that care and are scared and alone will usually defer to a doctor on what he thinks is best, so it's not a reach to say the elderly could easily be persuaded to "pull the plug" sooner rather than later.

I said before that I certainly would not want my elderly mother in nursing home and have nurse Cratchet and Dr. Strangelove approach her and start talking about end of life decisions.

The elderly are easily confused and would be easy prey to nursing home administrators eager to show how much money they save by distrubuting an "L" pill to help things along.

The supporters of this can sing and dance all day long about how compassionate this is, but as we all know that the bills that are passed by congress never work the way they are intended and it only takes a few who will bastardize the meaning under you have death squads under the guise of government workers "helping" the elderly decide what is best.

foundit66 · #3 (**permalink**) 08-13-2009, 02:35 PM

Quote:

The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.” [2] With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.

And all of this discussion on "context" is established where?
You are kind enough to link to the bill in question, but do absolutely nothing to quote where it supposedly provides any semblance of the fear that you are trying to create.

You talk about "context".
So SHOW THE CONTEXT, Palin dear...

Quote:

Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.”

Wow.
So the bill's effort, IN PART, is to help with health care costs...
So despite the fact that section 1233 makes NO MENTION on the patient being coerced into making health care decisions based on cost, you assume it has to be about cost...

By that logic, I could say that since the "Patriot Act" is about finding terrorists and threats to the nation, and its actions cover me, they must consider me a terrorist and a threat to the nation...

Freakin' unbelievable the mental gymnastics some people perform in order to pretend the bill will do something IT NEVER EVEN MENTIONS.

Quote:

As Lane also points out:...

I'm sorry, but parading out a bunch of bobble-heads who share this fear, or say something you can exploit to pretend this fear is justified, IS STILL NOT showing how the actual bill will do what you claim...

Quote:

Originally Posted by cnredd

Doesn't mean you have to agree or disagree with her...But the fact that she was mocked shows the ignorance and distain some have for her without realizing that she brings up the very same issue that Obama's own supporters have brought up...

What I find really amazing is that there is absolutely nothing in the bill to make this happen.
There is absolutely nothing IN THE CURRENT SYSTEM to prevent a doctor from talking to a patient with these issues in mind.

WE ALREADY have all the pieces in place which create this type of problem, at least in Palin's mind.
We have hospitals that are trying to cut costs. We have people who rack up health expenses beyond their capability to pay, and a doctor can CURRENTLY recognize a situation where the hospital would be better off financially if this person (who won't be able to pay the tens or hundreds of thousands in bills) would just die.

Obama's plan does nothing to make that more of a problem.
Yet that's what the health plan detractors claim.

Let's rewrite one of these statements and see how true it is...

Quote:

“If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.”

If the hospital says it has to control costs and then the doctors are giving advice on hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life-spending...

OMG!
WE ALREADY HAVE the death panels...
We ALREADY have doctors giving advice on hospice care, paid by hospitals trying to control costs!!!

Everybody **** themselves!

In a nut-shell, the obvious goal of living wills and the like is to make sure the patients wishes are respected.
But for some reason, people think that in Obama's plan, that purpose gets magically redefined, with no real explanation as to how that would supposedly happen.

Creating fear out of nothing.
Palin's at it again...

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