Sarah Palin’s Death Panels

Three years ago, my mother died after a long and painful illness. During her last months she was only partially conscious, and in her brief intervals of awareness was often distraught. At several points my father, sister, and I met with doctors to figure out how to ease her obvious suffering with pain medications, and how we could get her into a hospice facility. We could afford the counseling, but millions of other families cannot — which is why one of the useful heathcare reforms now moving through Congress authorizes Medicare to reimburse doctors for such voluntary end-of-life consultations. The American Medical Association and the National Hospice and Palliative Care Organization support the provision.

But in a cruel contortion, former Alaska Governor Sarah Palin calls these consultations “death panels,” and in a Facebook posting late last night charges that they’ll force the elderly to accept minimal end-of-life care in order to reduce health care costs: “It’s misleading for the president to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients,” and added, “It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing.”

In her short time on the public stage, we’ve come to expect this sort of thing from Governor Palin. But listen to other Republicans these days — and if you can bear it, tune in to right-wing Hate Radio — and you’ll hear more of the same.

Health care is already rationed, of course. Those who can’t afford health insurance don’t get much of it, except in emergency rooms. For those who have insurance, the rationing is done by prepaid medical groups, the legacies of HMOs, that decide what drugs and procedures their members will get. Or it’s done by insurance company personnel who decide what will be covered.

But for the scaremongers to say that under the healthcare reform proposals now being considered, government will do the rationing — and that government bureaucrats will decide whether people live or die — is odious. It’s a deliberate lie that preys upon the fears of many people who already scared as hell about loss of their jobs, healthcare, homes, and savings.

The “town meetings” that are now spewing such anger reflect deepseated fears that are welling up across America during this economic crisis. Healthcare reform may ease some of these fears. But the demagogues that are manipulating those fears for political gain don’t give a hoot.

Have they no shame?

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About Robert Reich 547 Articles

Robert Reich is the nation's 22nd Secretary of Labor and a professor at the University of California at Berkeley.

He has served as labor secretary in the Clinton administration, as an assistant to the solicitor general in the Ford administration and as head of the Federal Trade Commission's policy planning staff during the Carter administration.

He has written eleven books, including The Work of Nations, which has been translated into 22 languages; the best-sellers The Future of Success and Locked in the Cabinet, and his most recent book, Supercapitalism. His articles have appeared in the New Yorker, Atlantic Monthly, New York Times, Washington Post, and Wall Street Journal. Mr. Reich is co-founding editor of The American Prospect magazine. His weekly commentaries on public radio’s "Marketplace" are heard by nearly five million people.

In 2003, Mr. Reich was awarded the prestigious Vaclev Havel Foundation Prize, by the former Czech president, for his pioneering work in economic and social thought. In 2005, his play, Public Exposure, broke box office records at its world premiere on Cape Cod.

Mr. Reich has been a member of the faculties of Harvard’s John F. Kennedy School of Government and of Brandeis University. He received his B.A. from Dartmouth College, his M.A. from Oxford University, where he was a Rhodes Scholar, and his J.D. from Yale Law School.

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8 Comments on Sarah Palin’s Death Panels

  1. Your have actually presented valid reasons for not having more government intervention in healthcare. You are incorrect, rationing is only partially controlled by economics — geography, and the nature of the medical condition is often the primary issues. There will always be rationing of care since the demand is greater than the supply…the question is how much worse will rationing be with the introduction of more government controls and regulation.

    HR3200 introduces more rationing — by Government — Section 1151 pp 284-288, and political (Sec. 223).

    The section regarding end of life consultation (Section 1233) does not indicate it is voluntary. This proposed law appears to have the government recruit doctors (and their associated providers, professions and organizations), to sell the elderly on living wills, medical power of attorney, and hospice care. That approach does appear to be placing fiduciary interest of the government above the patient’s.

    As with much of HR3200 it is ambiguous…but the section does have the phrase “such consultation SHALL.” If it was to be voluntary, that wording could have been introduced many revisions ago.

    It’s shameful that you, the Obama Administration and the legislative leadership are deceiving the public about not only the financial burden, loss of access to care, and loss of individual freedom this law will create.

  2. I live in the UK, and suffer from a complex heritable connective tissue disorder named Marfan syndrome. In my case, expression is severe — I present with an ascending aortic aneurysm, levoscoliosis, prominent spur formation, prominent Schmorl’s node formation, facet joint arthropathy, disc desiccation (particularly at the L5-S1 region), multilevel annular bulges, severe osteoarthritis, osteoporosis, TMJ, high myopia, increased risk of retinal detachment, bone marrow signal changes indicative of fatty degeneration, bone infarcts above and below both knees, a pectus excavatum, skeletal abnormalities, and other manifestations of this syndrome. I have received, and continue to receive, extensive treatment at the hands of the NHS – and have nothing but praise for this institution. I have never had difficulty obtaining appointments to see the doctor of my choice – to the contrary, I am always seen whenever I need to discuss any issue with my general practitioner. I have received a series of echocardiograms to ensure that the aortic aneurysm has not expanded in size, have undergone ultrasound examinations of my torso to check the status of my descending aorta and vital organs that are impacted by this syndrome (e.g. the liver, heart, and kidneys), and have been seen by numerous specialists. The medications for the treatment of chronic pain would break me were I to have to pay for them myself – these medications include OxyContin 200 mg every 12 hours and OxyNorm 10 mg and 20 mg capsules as needed for breakthrough pain (the monthly cost of this medication alone is at least £800.00), and the British version of Tylenol #3 with Codeine (Co-codamol) (which costs about £30.00 per month). In addition, I receive hormone replacement therapy with Andropatch (testosterone patches) (which costs at least another £100.00 per month); anti-depressants (venlafaxine and mirtazapine) (which costs at least another £110.00 per month), a beta blocker and an angiotensin-II receptor blocker (ARB) (the combined cost of which comes to at least another £40.00 per month), and various other medications, the monthly cost of which probably totals about £300.00. The total monthly charge for medications alone is roughly £1,400.00. I receive these medications at no charge whatsoever – and my taxes are lower than those that I paid when I lived and worked in the US.

    The care I have received has been absolutely outstanding. Never has cost interfered with a treatment decision – the care that I receive is state of the art (I have read about Marfan syndrome extensively and am on cutting edge therapy with the ARBs).

    When Sarah Palin talks about “death panels”, she reveals only one thing – that she is pig-ignorant.

    There are no “death panels” that decide whether or not to treat elderly patients – this is a flagrant, defamatory invention, cut from whole cloth by those who cannot stand the thought that a socialist system actually beats the American health care system hands down. America may indeed have the best technology in the world – but it most certainly does NOT have the best healthcare system in the world, and those ignorant clowns who insist on making this statement, over and over again (as though it gains credence through sheer force of repetition) simply do not know what the hell they are taking about. America has the best healthcare system in the world if you are well insured or are independently wealthy – if you meet neither of these criteria and are diagnosed as suffering from a lethal disease that can be treated and cured only with aggressive long-term therapy, you are sent home to die. Emergency rooms do not provide “emergency chemotherapy sessions” and although an ER cannot turn a patient away, the hospital can and will attach every asset owned by a sick person who is admitted to the hospital by an ER doctor. Conservatives are fond of whining about “socialized medicine” – I have experienced a system of “socialized medicine” (the NHS is undoubtedly a socialist system) and can only say – LET’S HEAR IT FOR SOCIALIZED MEDICINE!

    I am repulsed and disgusted by protestors waving placard around that depict President Obama as Adolph Hitler, complete with a moustache, shouting about “socialized medicine” and about how the US healthcare system does not need fixing. Tell that to the 50 million (50 million) persons who lack health insurance in the US, and who live without the protective umbrella of such insurance, always aware of the fact that an unexpected illness can utterly ruin them.

    I was recently treated for a corneal ulcer, caused by wearing the wrong type of contact lens for too long. I attended an “eye hospital” and was treated on an outpatient basis. I was given eye drops containing ofloxacillin, and was instructed to apply these to the infected eye every half hour for the first day, then every hour for the second and third days. I saw state of the art ophthalmological equipment, and was seen by experts who then gave me prednisone drops to minimize the scarring that occurs when such ulcers heal after the infection has been eradicated. Again, although the system involved being relatively anonymous (the eye hospital sees literally hundreds of people every day), I received top drawer treatment, and cannot complain about any aspect of my care.

    The bottom line is that the NHS works, and works extremely effectively (notwithstanding the paid-for testimony of a disgruntled Member of Parliament who Fox TV managed to dredge up from under a rock somewhere). My father suffered a terrible, methicillin-resistant staphylococcus aureus (MRSA) infection of the spine in 2005, and spent a total of nine months in the hospital, following which he was sent to a “rehabilitation” hospital where he learned to walk all over again, following which he was sent to a care home until he regained his strength and was able to move into a small flat (apartment). The bill for his three surgeries, his nine month stay in the hospital, his three months of “rehabilitation”, and his care at the care home? — £0.00.

    There are few things that anger me more than being told that it is raining by a person who is pissing on my leg.


  3. Time and time again American commentators and those inclined to agitate in support of some biased opinion make statements based on zero knowledge of systems in overseas countries. It does make me wonder what form of inbreds these morons typified by Palin actually represent.

    Most Americans will have friends or family who are British or European and have direct experience of the British healthcare system. Obama himself has British relatives and only need make a phone call to get objective information. Until dumb Americans started using the phrase I had never heard our healthcare system described as ‘socialized’ and just because institutions are regulated and funded at a national level does not make them some kind of communist organization. Why do Americans not refer to their own military as ‘socialized’ ?

    The NHS is far from perfect but I would prefer to be faced with a serious illness on this side of the pond than even as a well-insured American. I do have options – my wife is American and I work with a Californian company but until the USA sorts out universal healthcare I’m staying in the UK. If you want to see the face of evil (aside from the ugly moose face of Sarah Palin), just take a look at the small print in the terms of your health insurance – if you are lucky enough to have it.

  4. Rob Smelt — thank you for your comments. What turns my stomach is the unbridled arrogance of those Americans who keep banging the drum and insisting that the US has the best healthcare system in the world. Tell that to the 55 million (55 million) Americans who lack health insurance entirely — or to the millions of Americans with insurance who find out, when they are at a time of great need, that there are huge holes in their coverage.

    I lived in New York, which has state regulation of the insurance sector that forces all insurance carriers that offer medical insurance to offer this insurance to all applicants, regardless of their medical status or pre-existing condition status. The result of passage of this legislation was to drive up the cost of medical insurance for everybody (as was expected when the legislation was passed); however, those persons who can afford medical insurance in New York can relax in the knowledge that their insurance cannot be terminated merely because they file one or more expensive claims, or need hospital treatment. On one occasion about five years ago, I developed a skin and soft tissue infection that was resistant to several of the major antibiotics, and which required treatment with a special new antibiotic named linezolid. This is a synthetic oxazolidinone antibiotic used to treat infections that are methicillin-resistant and vancomycin-resistant; as such, it is invaluable in treating the “superbugs” that are emerging (e.g. MRSA, VRSA) (four other oxazolidinone antibiotics are currently in development). When my doctor prescribed this for me, he anticipated that I would take a major financial hit and that I would have to pay for this antibiotic out of pocket due to its cost. I was lucky – my insurance covered 80% of the cost. However, a friend of mine living in Florida with an identical problem and different insurance was not so lucky – his carrier refused to pay for this drug, and he ended up having to pay more than $500.00 for this medication.

    This account is not uncommon. It is not even slightly atypical. This happens in the US all the time; those in need of help from their medical insurance frequently lose their insurance (they are dropped from coverage) upon filing one or more expensive claims. And this is supposed to be the “best” healthcare system in the world?

    Americans have a bizarre phobia of anything that has the label “socialist”, and this phobia overrides all other considerations. Does the reader remember George W. Bush’s disgusting veto of the SCHIP legislation at would have offered high-quality insurance coverage to many, many thousands of people (adults too) merely because he perceived this legislation to be “socialist” in nature?

    Yes, the NHS in the UK is a socialist system. Let’s hear it for socialism!


  5. It is disingenuous to write about “reimbursing” doctors for giving end of life advice, and the outrage about the claims of “death panels” is politically motivated and no one would tolerate an unknown person stopping by to guide them in the correct decision to make now that their life is “effectively” over. Sad cases about folks without other resources are always the bases for supporting some kind of government interaction, but that always comes at a cost of personal freedom. EVERY TIME. In addition, 1. Doctors are not qualified and not psychologically suited to advise people on when and how to die. 2. Doctors are not properly reimbursed for actual life-saving procedures as it is; who’s kidding whom about this “service”? 3. It is a conflict of interest for anyone involved in health care payment to counsel on end of life issues.

  6. Now that Medicare $ have been cut for payment to doctors, equipment and services and hospitalization and so has Tricare for military retirees the seniors will have to start to wonder and worry. Many doctors will refuse to see Medicare patients. Doctors that will still see Medicare patients will cut down on their office visit time. Gee whiz, from 5 minutes to what? Many services will not be paid for. We will probably have to pay out of our own pockets now aside from premium payments. If we can’t we don’t get treated. Does that sound like reformed health care? Maybe Sara was right?

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