Are There Death Panels in the Affordable Care Act? (AKA Obama vs Palin)
April 9, 2011 § 3 Comments
In a nation characterized by freedom of choice and extreme variation in ideals and political view, President Barack Obama and former governor Sarah Palin find themselves on opposite ends of more than just the political spectrum. They do, however, have in common the fact that they are both very loved by their followers, and for the vast majority, very disliked–if not full on hated–by the other’s respective fan base. For our purposes here we will look at their comments in respect to end of life care as a part of the Patient Protection Plan and Affordable Care Act.
End of life care is a sensitive and often controversial issue because of its implications and cost (Estimates show that about 27% of Medicare’s annual $327 billion budget–$88 billion–goes to care for patients in their final year of life).
It refers to medical care not only of patients in the final hours or days of their lives, but also medical care of all those with a terminal illness or terminal condition that has become advanced, progressive and incurable. It may require a range of decisions, including questions of palliative care, patients’ right to self-determination (of treatment, life), medical experimentation, the ethics and efficacy of extraordinary or hazardous medical interventions, and the ethics and efficacy even of continued routine medical interventions. In addition, end-of-life often touches upon rationing and the allocation of resources in hospitals and national medical systems. Such decisions are informed both by technical, medical considerations, as well as economic factors. In addition, end-of-life treatments are subject to considerations of patient autonomy.
In March 2010, President Obama signed the Patient Protection and Affordable Care Act.
“Many of the sick and elderly are concerned that the Democrats’ proposals will ultimately lead to rationing of their health care by – dare I say it – death panels? Establishment voices dismissed that phrase, but it rang true for many Americans. Working through ‘normal political channels,’ they made themselves heard, and as a result Congress will likely reject a wrong-headed proposal to authorize end-of-life counseling in this cost-cutting context. But the fact remains that the Democrats’ proposals would still empower unelected bureaucrats to make decisions affecting life or death health-care matters. Such government overreaching is what we’ve come to expect from this administration.”
Soon after there was an explosion of opinions from detractors and fans alike. One month before Palin joined the talk and really made the term “death panel” famous, President Obama had this to say of what was then just a ”rumor”.
“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… 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, et cetera. 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. This is I guess where the rumor came from.”
President Obama also said the “irony” is that one of the chief sponsors of this idea was Sen. Johnny Isakson, R-Ga., who “sensibly thought this would expand peoples’ options.”
Isakson this week told the Washington Post
“someone said Sarah Palin’s website 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. …It empowers you to be able to make decisions at a difficult time rather than having the government making them for you.”
President Obama said that underlying this issue was the “legitimate concern” that people have “that if we are reforming the health system to make it more efficient that somehow that will mean rationing of care.” He painted a picture of “some bureaucrat” saying “’You can’t have this test, you can’t have this procedure’” because “some bean counter” said so.
The president said his health care reform would put these decisions in the hands of medical experts and doctors, rather than insurance company bureaucrats. He asked, “So why is it that people would prefer having insurance companies making those decisions rather than medical experts and doctors figuring out what are good deals for care?” He went on to say, “I want to be very clear” about the “underlying fear that people won’t get the care they need. You will have the care you need, but also care that is being denied to you right now – that is what we are fighting for.”
“Large shares of seniors mistakenly believe the law includes provisions that cut some previously universal Medicare benefits and creates ‘death panels.’ Half of seniors (50%) say the law will cut benefits that were previously provided to all people on Medicare, and more than a third (36%) incorrectly believe the law will ‘allow a government panel to make decisions about end-of-life care for people on Medicare.’”
The finding that more than 36% of seniors believe there are death panelscreated by the Affordable Care Act is of great concern. What an example this is of how politics and our very American tendency to support our favorite leaders can influence us. My intention is not to criticize Sarah Palin, nor fully endorse the President. My concern is in the lack of education of American Citizens about the existing health care reform bill of which so many have an opinion.
Only through learning will we empower ourselves to fix these problems, so let us learn…