Sunday, August 16, 2009

Senate Pulls Plug on Death Panels

Health Care Obamacare Death Panels cartoon

This would be a victory for our side except there never was any “death panels.” Talk of death panels is more than rhetorical excess, it is downright untruthful scare tactics and fear mongering and I fear it poisons the atmosphere for any future health care reform discussion.

While I don’t subscribe to it, I understand the logic of how one gets from what is in the bills to talk of death panels. It goes like this: One of the health care bills before us provides for end of life counseling. One bill also sits up a panel to evaluate best practices that determine which treatments work best and which are most cost-effective. The bills provides for a “public option” which is a government health insurance program. Private insurance will not be able to compete against the public option and overtime, private insurance will disappear and we will all be on the government plan. We must cut cost of healthcare. To cut cost, the government insurance will determine what is the best use of limited healthcare dollars and which practices are best and who is worth saving and who is not. The elderly will be advised to go ahead and die when their time comes. Others will be denied expensive treatment that may only extend their life a short while and others who may not be elderly but have incurable conditions that make for a poor quality of life may be denied treatment. A panel would meet to determine if a particular procedure was cost-effective and weather sick people would get to live or die. Thus the “Death Panels.”

That is the logic, and talk of death panels is an inference from what is in the bills. It is a stretch and there never were any “death panels” in any of the bills before us. What the bill actually provided for was voluntary Medicare-funded end-of-life counseling.

We have long had government backed end-of-life counseling and disclosure requirements. What was different about the Senate health care bill was a provision to pay doctors for this session so it would get more serious attention and doctor and patient would spend more time seriously discussing these issues rather than these issues getting a cursory check-off on an initial visit. The conversation between the patient and the doctor would include discussion of living will, learning about appointing someone to make your health care decision for you if you can’t and learning about hospice care for the terminally ill. There was no requirement to attend regular end-of-life counseling sessions, and there was no provisions encouraging euthanasia

This end-of-life counseling provision has now been removed from the bill. I think this is a hollow victory for opponents of the current health care proposals. Removing this provision from the bill is one “victory” that should have not been won and a concession that I wish the other side had not made. This was an easy concession for the Democrats to make since it is not anything that is essential to their health care program anyway and giving it up removes a potent argument of the opponents.

I think the end-of-life counseling should be available. It is hard for the family to let go of a loved one. It is hard to tell the doctor that after the third time of resuscitating the patient that next time, let them go. I have not had to make those decisions myself, but I have had close family that had to make them. With the modern miracle of medicine it may be possible to keep a body living in a vegetative state long after there is any hope of recovery. Counseling the patient on these issue while they are still healthy would give the patient more say in how they wanted to be cared for in their final days.

Many people needlessly surfer, impoverish their families and die comatose plugged into machines and only gain a few weeks or months of miserable time on earth. There ought to be better ways to die.

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