Answering Why Palin’s "Death Panels" Charges Have Legs, But Nothing Solid On Which To Stand

From, Christ Church Elder Dale Courtney’s blog (which only rarely includes anything written by the Blogmeister himself), August 27, 2009. My comments are in parantheses –

Sarah Palin’s charge has legs

Scott Ott argues that Sarah Palin’s charges (about “death panels,” etc.) have legs because:

1.) The only way to save money in a government-run health system is to ration care.

(Which means “Don’t automatically call for an MRI if an X-ray is sufficient for diagnosis,” for example. “Rationing” doesn’t mean “herd up the old, sick, and disabled and kill ‘em now,” a point Courtney surely must know and one that can be demonstrated by pointing out the evolution of advanced diagnostics and treatment offered to the elderly through Medicare. Even when my father, for example, was slipping away, he had a CT scan to see if there was a neurological reason for his illucidity. Right ’til the end, the ICU doctors were focused on trying to figure out why he wasn’t getting better, bringing in an infectious disease specialist, a nephrologist, a cardiologist, and a vascular surgeon. “Rationing” means that Trig Palin, my father, and my mother-in-law, who has a persistent, as yet-undiagnosed foot injury, get the care they need, and not the care they don’t).

2.) The majority of health care expenditures for most people come near the end of life, and thus the elderly present the greatest opportunity for cost savings.

(Again, the billions spent annually for seniors on Medicare, and the incredible advances in life-extending care they enjoy, are a testimony not only to the medical profession’s successes in helping people manage chronic illness; acute, life-threatening catastrophic illness; and simple aging that even five years ago would have resulted in death, but also to this nation’s commitment to enabling access to that care through Medicare. Unfortunately, too many people — the poor and otherwise disenfranchised — don’t make it to 65 because they lack access to anything but too-little, too-late emergency care. The biggest cost to this country’s medical system is the astonishing frequency of largely preventable chronic diseases like diabetes, COPD, heart disease, obesity, and hypertension — conditions that can be managed, even reversed, with early and consistent medical care. Which, of course, usually isn’t available to the people who need it most — poor people, for example, whose diet of cheap starches and fats contributes to obesity. Lacking political power, they lack proper medical care. Sick people seen late get sicker, cost more, and die earlier. It’s an effective argument for universal healthcare, but because so many of those voices come from the political, religious, economic and social “other,” they’re easy to drown out — even, ironically, in discussions about “the sanctity of life”).

3.) Special-needs people, like Palin’s son Trig, who has Down’s Syndrome, also require spending — another opportunity for economizing.

(Forgetting for a moment the gross cynicism of Palin’s use of her son to lie about healthcare policy, it’s a fact that this country spends more money, with better results, than ever before in the treatment of those born disabled. But the steadily-advancing life expectancy, independence, and comprehensive care Americans with Down’s Syndrome, muscular dystrophy, cystic fibrosis, cerebral palsy and other congenital disabilities could hypothetically benefit from is doled out on the basis of health insurance and access. While Trig Palin may ultimately suffer from the indignity of being used as a prop and a pony by his mother, her prominence and wealth, however unfortunate, will guarantee him the kind of care that every child deserves — but that few will get. Society and science rejoice that Trig’s life expectancy is higher now than it would have been even 20 years ago, but most people would find it a tragedy that Trig and others born to privilege will benefit while others won’t, because their mothers aren’t rich, powerful women like Sarah Palin).

4.) The government, and too many in our society, believe …

a) infants in the womb to be less worthy of protection than Michael Vick’s dogs,

b) Trig Palin’s life to be Sarah’s foolish choice, and

c) the elderly to be a burden on society.

(Yes, abortion is a tragedy, and yes, too many people believe the elderly to be a burden on society and on their own families. And yet if the entire State of Alaska and every member of Congress went on record condemning Palin’s choice to continue her pregnancy after Trig’s Down’s Syndrome was diagnosed, it wouldn’t matter one whit. No adult can EVER be forced to undergo ANY surgical treatment, including abortion, and, to what must be the great relief of Sarah Palin, no jurisdiction is ever likely to press charges against a 43-year-old woman with four previous births who flies from Dallas to Juneau to Wasilla, Alaska, after her amniotic sac ruptures. Every mother I know would’ve been horrified to hear that she put her baby at risk that way, but we’re all glad that the legal system doesn’t typically get involved even when pregnant women behave stupidly — most of us revere the private relationship we have with our doctors, and nothing about Obama’s healthcare plan would interfere with it. No government auditor in the room during your Pap smear, no doctors phoning legislators to see if Mr. Smith can have a knee replacement, and no patient assigned treatment on the basis of political affiliation — Palin’s lies, and her prodigious anger and imagination, can’t make it happen).

5.) Other governments which run health care operations have a track record of delaying and denying coverage based on the limited supply of medical professionals and equipment, as well as cost-containment considerations.

(Yes, coverage in all of the other industrialized nations that have universal, single-payer healthcare — which, by the way, isn’t anywhere close to Obama’s plan — is sometimes delayed or denied because of physician availability and even cost containment. That’s a fact of life; there isn’t one doctor, one MRI machine, and one hospital dedicated solely to, say, me and my family — anywhere. But while knee replacements and hysterectomies may have to wait if doing so isn’t a threat to life, emergency and immediate surgical needs are regularly, promptly, and effectively offered to everyone — in Vancouver, B.C., at least, but not in Vancouver, Washington. In Canada, Aunt Betty’s problem is that she’ll often have to wait three months for her hip replacement, although Uncle Carl will get his diagnostic CT scan immediately if the doctors suspect a stroke, or cancer, or something else. In the U.S., if Betty isn’t insured and isn’t rich, she may never get her hip replaced, and Carl’s family will too often just watch him fade away while they try to find care they can afford — if it exists, and if they can find it in time. The conservatives’ deriding of Canadian healthcare has much more to do with their own positions of privilege and security than with the faults of “socialized” medicine. The fact that millions of Americans have little or no access to ANY medical, dental, or mental health care is of little consequence to them as they nestle in a cocoon of relative privilege that permits no empathy or kindness, just a safe place to comfort themselves with smug anecdotes and whimpers of injustice).

6.) The end-of-life counseling language appeared in a section of a bill on cost-containment.

(And it’s language approved by those wild-eyed crazy liberals in the Bush administration, for example, for use in VA hospitals. It’s the same evil language your lawyer discusses with you when you draw up your will, or that’s on the form the nurse hands you as you prepare for surgery. It’s the “language” that allows you to specify that you DO, for example, want doctors and nurses to go to the most heroic means possible to prolong your life — or to indicate that you don’t. It’s not alarming then, and it isn’t alarming now — unless you hear it from Palin, who, to be fair, hasn’t demonstrated much understanding of tiny print and big words, but who should accordingly pipe down ’til she does).

7.) The American people don’t trust politicians, and would rise up in unified opposition if the federal government had a plan to take over and run little league athletics, let alone health care, which does involve life and death decisions.

(Actually, most Americans DON’T see politicians — who wouldn’t, of course, be involved in their private health concerns under Obama’s plan anyway — as individual foot soldiers in the service of Evil. The federal government’s “taking over” of healthcare, it should be noted, is already a blessing enjoyed by millions on Medicare and Medicaid and has resulted further in such noxious horrors as the virtual eradication in this country of polio, smallpox, and dental decay. These examples of federal intervention in your healthcare and mine are seen by reasonable people as positives, but there are those who, it would seem, miss the good old days of iron lungs, the casual commonness of childhood death, and a near-inevitable mouthful of rotting bone and flesh by the age of 40. Perhaps they could move to the Sudan, where all of those things remain a scourge).

8.) Americans love freedom.

(Yes, we do. But Christians love justice even more, and God’s people are to be focused on what’s best for the other, especially the poor and oppressed “other,” not on what violates our idolatrous political views, reinforces unjust power structures, and maligns the Gospel witness of a “Christian” nation).

As others have argued: there won’t be any need for formal death panels. The rationing of healthcare will accoplish that goal just fine.

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