Budget Cuts and “Death Panels”January 2, 2011 at 6:59 pm | Posted in Uncategorized | 2 Comments
Tags: "death panels", "end of life" provisions, "Obamacare", advance directives, Medicaid, Medicare
Well, the snow is melting, a week after it arrived. There’s nothing like a blizzard to make some of us, at least, grateful for central heating, and here in the Ronan-Russell household, for having finally found a hardware store with a shovel to sell.
But now that the local population has calmed down about the blizzard, I’m afraid the next great cause of popular enragement is headed our way: “death panels.” According to the newspaper of record, on January 1 the Obama administration established by regulation “end of life” provisions that were so enraging when first proposed that they had to be excised from the health care legislation that finally passed. And even after those end of life provisions were removed, according to the Times, 30% of all Americans over sixty still believed that “Obamacare” stipulated “death panels,” by which they mean that it gives doctors the right to mandate euthanasia for those deemed no longer worthy of living. Never mind that the very need for these new regs refutes their convictions. There’s trouble coming.
Let me first acknowledge that the prospect of being condemned to death, at any age, is a terrifying one. But that such a fear should translate into belief on the part of many, in the face of evidence to the contrary, that the new health care legislation gives the government the power to do so–this deserves a little analysis, don’t you think?
First of all, let’s get clear about what the regulations actually do stipulate: they allow payment to physicians who “advise patients on options about end of life care,…( including) advance directives to forego aggressive life-sustaining treatment.” A number of people I’ve consulted, including a Catholic RN friend who worked in a hospice for many years, believe that “advance directives” are the only sure way for seriously ill people to protect themselves from being forced to go on living in great discomfort after an otherwise fatal event such as a massive heart attack. People over 70, my friend argues, should have “do not resuscitate” orders.
So why do so many people believe that the new health care law mandates killing them and their friends, when it actually helps them to protect themselves from unnecessary prolonged agony? One explanation might be that here in the US, in contrast to many other democracies, we really do have “death panels,” that is judges and juries who condemn people to death. It’s called the death penalty. Maybe some of us older folk are unconsciously projecting onto the new health care law our knowledge that the government certainly does order people killed, just not privileged white people.
And of course, we have another kind of “death panel” in the US: insurance companies, which regularly decide whether people are allowed to have life-or-death surgery, tests, or treatments. I distinctly recall being coached by an oncologist in San Francisco a few years back about how to get the company that covered me to pay for the regular colonoscopies I needed to prevent the recurrence of the genetically-linked colon cancer that had already killed four close family members. “They’re going to say you need the test every five years,” he said, “so I’ll say you need it every year, and they’ll let you have it every other year.” And that’s what happened.
The third kind of “death panel” here in the US is the one operated by individual states. Before “Obamacare” these functioned by not providing health care to lots of people who then became seriously ill and died because they weren’t diagnosed until it was too late. And during the economic downturn, according to the Times, almost every state has had to make painful cuts to the Medicaid it does offer. In Arizona, this includes ending Medicaid coverage for heart, liver, lung, pancreas and bone marrow transplants–life-or death procedures–in order to save $1.4 million of the state’s $8.9 billion budget.
So if anyone asks you about US death panels, you can assure them that such things exist and are functioning–but they’re not the kind of death panels that a third of the over-60 set seems to envision. And then perhaps you will join me in praying that “Obamacare” survives the anticipated Congressional onslaught and dismembers as many of these death panels as it can.