Why People Think Obamacare Has Death Panels

DrRich | May 23rd, 2011 - 6:49 am

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In the epic debate that has played out recently between Shadowfax and DrRich over the transcendent implications of the IPAB (Independent Payment Advisory Board), Shadowfax accused DrRich of being one of those unsophisticates who refer to the IPAB  as a “death panel.”

Nothing could be further from the truth. DrRich does not use – has never used – the term “death panel” to refer to any of the multitude of expert commissions created by Obamacare, whose charge will be to dispassionately examine the scientific evidence in order to determine which patients will get what, when and how. These bodies, in fact, will be explicitly aiming to optimize the medical outcomes of the entire population (titrated to the amount of money we’re allowed to spend on healthcare), and not actively prescribing death for anyone.

Judging from the histories of governments which have adopted a collectivist philosophy, if death panels should appear on the scene they will not be aimed at determining which patients may live or die. That job, of course, will fall to the doctors at the bedside, who will offer or withhold medical services according to the dictates (i.e., “guidelines”) handed down by those sundry expert commissions. Rather, any death panels which eventually materialize will more likely be aimed at keeping those doctors themselves (and any other functionaries whose job is to do the bidding of the bureaucracy) in thrall.

So why has the term “death panel” caught on to such an extent that conservatives so often use it as shorthand to express what they see as the “sense” of Obamacare, and Progressives so often use it to accuse rational and mild-mannered critics of Obamacare (such as DrRich) of belonging to the Neanderthal persuasion?

While most would blame Sarah Palin for coming up with this unhelpful phraseology, it is DrRich’s view that President Obama himself must carry at least an equal part of the blame. If Progressives have not created death panels, they at least created the environment in which those words, when Ms. Palin first uttered them, immediately caught fire.

As readers will recall, Ms. Palin first used the fateful words, “death panels” as the Obamacare legislation was being slowly and painfully shoved through a surprisingly reluctant Democrat Congress. And as a result she caused many of our more complacent legislators to abruptly bestir themselves into a higher state of arousal, if not outright agitation. Palin’s accusation caught more than a few of them utterly unawares, and embarrassingly flatfooted.

They felt, no doubt, like they were in that dream where you unaccountably find yourself naked in a crowd. But this time, rather than reaching to hide their sadly exposed nether parts, they reached instead for their pristine copies of the monstrous Obamacare legislation which had been laid before them, and which they famously (and understandably and logically) never read. One could almost pity them, desperately rifling through the 2700 virgin pages, muttering to themselves, “Death panels? This damned thing has death panels?”

But in fact, their initial instincts were correct as regarded the advisability of actually reading the legislation. There was in truth no reason for them to waste their time. DrRich has subsequently read large swatches of the thing, and he can assure one and all that it was not designed for reading, comprehensibility, or (for that matter) imparting any actual information of any sort.

And besides, Obamacare contained no death panels, so had they read the bill they would not have discovered any. (In their state of sudden and stark panic, however, our newly-aroused legislators quickly moved to strike the section the bill that provided for end-of-life counseling, which, of course, had nothing to do with death panels.)

The very notion of death panels seems to have many supporters of Obamacare nonplussed. How can someone as inarticulate and obviously illiterate as Sarah Palin get away with accusing our highly-educated healthcare reformers of setting up such a thing as death panels?  And even more perplexingly why did so many Americans believe her – even, apparently, hundreds of thousands of Americans who had been enlightened enough to vote for President Obama less than a year earlier?

DrRich thinks it is this: When Sarah Palin said, “death panels,” she was dropping one last, tiny crystal into a supersaturated solution. Her words took what had been an amorphous and even chaotic sense of unease about healthcare reform, and immediately crystallized it into an organized latticework of directed rage and fear. So the real question is not how Sarah Palin came to be savvy enough to know just the right words. (Progressives know that even a distinguished panel of monkeys, given enough time and enough typewriters, will eventually produce King Lear.) Rather, the real question is: What put the rabble in such a supersaturated state to begin with? Why did the absurd-on-its-face idea of “death panels” so resonate with them? What made those words galvanize their shapeless disquiet into a solid mass of resistance?

DrRich is very sorry to have to tell his friends of the Progressive persuasion the sad truth. For it was President Obama himself who created this circumstance. Sarah Palin may have first named the death panels, but before she ever thought of the phrase the President had already described them in detail.

During his first year in office, President Obama offered several homilies relating just what a “death panel” would look like. He described their function, how they would operate, and who they would target. Perhaps the most instructive example is the one he gave on ABC television during his June 24, 2009 National Town Hall meeting.

DrRich refers, of course, to the famous question put to him by the granddaughter of a 100-year-old woman who had received a pacemaker. The questioner pointed out that her grandmother had badly needed this pacemaker, but had been turned down by a doctor because of her age. A second doctor, noting the patient’s alertness, zest for life, and generally youthful “spirit,” went ahead and inserted the pacemaker despite her advanced age. Her symptoms resolved, and Grandma was still doing quite well 5 years later. The question for the President was: Under Obamacare, will an elderly person’s general state of health, and her “spirit,” be taken into account when making medical decisions – or will these decisions be made according to age only?

President Obama’s answer was clear. It is really not feasible, he indicated, to take “spirit” into account. We are going to make medical decisions based on objective evidence, and not subjective impressions. If the evidence shows that some form of treatment “is not necessarily going to improve care, then at least we can let the doctors know that – you know what? – maybe this isn’t going to help; maybe you’re better off not having the surgery, but taking the pain pill.”

DrRich will give President Obama the benefit of the doubt regarding his suggestion that a 100-year-old women who needs a pacemaker might be better off with a pain pill. Mr. Obama is not actually a doctor, and cannot be expected to understand that using a “pain pill” to treat an elderly woman who is lightheaded, dizzy, weak and possibly syncopal because of a slow heart rate might justifiably be considered a form of euthanasia rather than comfort care. DrRich does not believe the President was intentionally suggesting the old woman’s death should be actively hastened by means of a pain pill. Indeed, given that repeated falls from lightheadedness would likely have led to a hip fracture, a pain pill might eventually have been just the thing for granny had the pacemaker been withheld.

Still, President Obama’s clear and unflinching answer in this case tells us several important things. 1) Under Obamacare, there will be at least one panel, or commission, or body of some sort, that is going to examine the medical evidence on how effective a certain treatment is likely to be in a certain population of patients. 2) This, let’s call it a “panel,” will “let the doctors know” whether that treatment ought to be used in those patients. (“Letting the doctor know” is a euphemism for “guidelines,” which itself is a euphemism for legally-binding and ruthlessly enforced directives.) 3) “Subjective” measures ought not to influence these treatment recommendations. Non-objective parameters – such as the doctor’s medical experience, intuition, or personal knowledge of the patient; or the patient’s “spirit,” or will to live, or likelihood of tolerating and complying with with the proposed proposed treatment; or even extenuating circumstances that might increase or decrease the success of the proposed treatment – simply cannot be evaluated or controlled by expert panels, and thus must be discounted. 4) But since our government is a compassionate and caring one, and wishes to reduce unnecessary suffering, palliative care will be made available in the form of pain control, even while withholding potentially curative care.

What the American public accurately heard the President say was that we will have an omnipotent “panel,” acting at a distance and without any specific knowledge of particular cases, that will tell a doctor whether he/she can offer a particular therapy to a particular patient – or whether, instead, to offer a “pain pill.”  His description of this process, repeated with variations over the next several months in several venues, obviously made quite an impact on the people.  Of course, Mr. Obama is widely known to be a gifted communicator.

In any case, all that remained was for Sarah Palin to give the President’s panel a catchy name. And when she did, the American people knew exactly what she was talking about. They knew, because President Obama himself had been spelling it all out for them in plenty of detail for six months.

Indeed, it seems to DrRich that, if not for President Obama’s having so carefully laid the groundwork,  Palin’s accusations of “death panels” would have fallen flat. It would have been regarded by most people as the absurdity that Progressives insist that it is, rather than the epiphany it turned out to be.

Progressives who strenuously object to its usage in reference to the expert commissions created by Obamcare can blame Sarah (or, for that matter, DrRich) if they want to – but by all rights they should actually be taking
up the matter with their dear leader, who is the chief source of the misapprehension, if misapprehension there be.

________

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10 Responses to “Why People Think Obamacare Has Death Panels”

  1. Jackie says:

    I would give the credit for the “death panels” to (advisor on Obamacare) Dr. Emmanuel and his theory that it is not age discrimination to discriminate against the aged.

    According to Dr. Emmanuel, the aged have already been 20 or 30, or whatever, years of age and so when resources are scarce, such resources should be allocated to the young. The old have already lived a good life. Of course, he won’t be on Obamacare so no rationing of his healthcare.

    The rest of us however can see what’s in store for us and it looks a lot like “death panels.”

  2. [...] this post, he makes some crucial points about how there may not be a government panel of experts deciding [...]

  3. J. Mcphie says:

    Put this in you pipe and smoke it!

    Congressional supporters of the new policy, though pleased, have kept quiet. They fear provoking another furor like the one in 2009 when Republicans seized on the idea of end-of-life counseling to argue that the Democrats’ bill would allow the government to cut off care for the critically ill.

    The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

    There is no way that government should be involved in any way, what so ever in the life and death decisions of an individual when it comes to health care. It behooves the government financially if people die sooner, thus not having to pay for the health care costs associated with medical conditions at the end of life.

  4. Speedy says:

    It is very tough to find out what is true and what is not with all the e-mails about Healthcare coming in on almost a daily basis.
    I would like to believe that there is no such thing as Death Panels, however, with this current administration doing whatever they can to “Take Over” and diminish our freedoms that so many fought and died for, I would certainly not put it past them. This administration has got to go. There are just too many things going on in Washington that are so questionable. And, we have been lied to time and time again.
    Enough is enough. I say vote them out in 2012!

  5. Darlene says:

    Why don’t people see what’s gonna happen to our constitutional right to
    Free . Obamacare takes away the whole meaning of being American. It’ll make us prisoners in our great Country. Which will no longer have Liberty,
    or have the right to make choices . It’s so scary ! Wake up !, people find out in detail , what Obamacare really is?!
    Read the Bill, , and everything that comes along with it….

  6. Sallie says:

    As a medical social worker, my interpretation of so-called “death panels” is a matter of physician reimbursement for the time spent explaining end of life options with patients and their families. None of us would want to be strapped to a bed, intubated with tubes handling nourishment and elimination. These folks are usually sedated and thus have no way to communicate their wishes to family members or their physicians. These matters should be discussed early on in a disease process so that the patient has an opportunity to choose palliative care and/or hospice services that provide pain free time to spend with loved ones.

    • VJ says:

      Your opinion is simply that; an opinion! Not ALL patients who are entebated are vegetables; it depends on their specific condition! When/if the doctor allows the patient to regain consciousness, many actually RECOVER and are able to communicate very well with language boards, by writing if they’re able or simply by answering yes/no questions … and if they’re lucky enough to get a trach and then weaned off the ventilator, many of these patients eventually gain a FULL recovery! That is, IF the doctors/insurance companies, etc will allow them the time to recover! Don’t make yourself feel better by lying to yourself … patients who can communicate very well get murdered everyday by doctors who decide it’s for the best, even when they’re WRONG! Doctors are NOT God! Miracles happen in God’s time; NOT the doctors! Sadly the almighty dollar is the decision-maker. If a patient has the money to pay for a longer hospital stay there is NO doctor or team of doctors who would throw them out! After all, the rich self-pay patient or one who has fantastic insurance pays the salaries for these over-paid doctors as well as the CEO! If the government (Medicare/Medicaid) pays for patient care, then the financially poor patient who needs the same lengthy medical care is denied adequate medical care in order to save the hospital money. It is what it is … MURDER! !-(

  7. sassy3000 says:

    Yeah, Yeah, They never USED the term “Death Panel” therefore nothing even remotely like that could possibly exist……so say the legal wranglers.
    LOL! And Bill Clinton never had sex with that woman either.

    The Democratic Party is the party of death! It’s like they have this sick love affair with it. They support Abortion which is the killing of an unborn baby! It is not just a bunch of tissue like some pathological lying crack-pots claim! That BS about it “Just being tissue” is a lie promoted to convince women to kill any more “unnecessary” mouths to feed.
    Eugenics where some sick pukes claim to care about the “Quality of Life” of the disabled?! Are you kidding me?! That has got to be one of the biggest and sickest jokes/lies they love to tell! while condescendingly denying it of course. RME
    And Euthanasia! Killing off those who are not deemed Viable or rather too expensive to keep alive.
    Ezekiel Emanuel is a true merchant of death if there ever were one for it originally appeared that it is upon his thinking that the Death Panels first were proposed. He wrote a scholarly work entitled Principles for allocation of scarce medical interventions in January, 2009 complete with 97 footnotes
    further research shows that much of the “Death Panel” concepts that originally arose come from an article that he co-wrote with his wife, Linda L. Emanuel, MD, entitled The Promise of a good death in May of 1998.
    In the Promise of a good death article, Mr. and Mrs. Emauel state, “To achieve a good death means using – or deciding not to use – relevant interventions
    Thus, later on in the article, the Emanuels aruge in favor of euthenasia, advanced death-decisions to be made by groups and promote a macabre standard of care entitled “Initiatives to make a good death the standard of care.”
    So maybe they won’t actively promote death, but they sure might want to allocate resources to the most viable patients. If there is a medical shortage.
    So it’s best to be on one’s toes. Maybe there is a death panel and maybe there isn’t. But given the Sadistic Nature of SOME on the Far-Left, One can’t be too careful!

  8. Mike Woods says:

    I read the article and it asserts that there will be no death panels. Then it goes on to describe two panels or boards that will indeed lay down the law on whether or not people of a certain age or condition will receive certain procedures. They may not call them death panels but when they do as President Obama suggested in 2009 “we won’t do the surgery we will put them in a wheel chair and give them a pill” it becomes a death panel since they are basically warehousing old people waiting for them to die.

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