Under Obamacare, the doctor might kill you now
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Not all of conservatives’ fears about end-of-life treatment for seniors under proposed health insurance reform are baseless. Some are. As progressive Igor Volsky points out, the provision championed by Rep. Earl Blumenaeur does not require that seniors report to doctors about how they wish to be cared for. But a few aren’t.
As Wesley J. Smith notes, if Blumenauer’s provision becomes law, more than a few doctors would be influenced by publications such as the “Caring Conversations” workbook of the Center for Practical Bioethics. It assumes that unless patients can achieve “quality of life” they should not receive care.
In addition to “quality of life” considerations, other doctors will add one more consideration: cost containment. Many progressives deny or reject this claim, but some liberal ethicists admit that it’s true, though they don’t say so explicitly. In The Washington Post last week, a bioethicist had this to say about end-of-life care:
“I don’t think it’s about cutting costs; it’s about quality,” said Tia Powell, director of the Montefiore-Einstein Center for Bioethics. Pointing to extensive research, she said: “The good news is if you get people in an environment that is of their choosing, where there is support and they have good pain control, it is very likely to extend their life.”
Powell did not elaborate on her definition of “support,” but it’s safe to conclude that financial support is part of it. In other words, if a patient cannot afford the treatment, he or she won’t receive it. That’s reassuring. Also, note the two preconditions: if seniors have support and they have good pain control. Apparently both conditions must be operable; one alone will not suffice.
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Hate to brake the news to you but doctors have been making “quality of life” vs cost decisions regarding end of life care for the elderly. Conservatives should attend an ethics committee at their local hospital. I’ve worked in both acute and long term care for 20 years and these decisions are routinely made for the incompetent on a daily basis.
You may make a good point. And my post didn’t examine how private insurers make end-of-life decisions. However, I have two questions:
Does a typical hospital committee make end-of-life decisions just for incompetents? If not, Blumenauer’s provision would extend death to new groups of people.
Surely some “incompetents” aren’t killed by doctors. At my local convalescent hospital one woman I know was in a coma for at least two years. How do you explain that?
In response to another comment. See in context »Mark, Ethics committees typically make end of life decisions for individuals who are either incompetent or incapacitated and cannot make their wishes known. The key is to have an Advance Directive. Put your wishes in writing!!! You linked a site which addresses this issue.
If you wish to have everything done, and I have seen those cases, then doctors and other healthcare professionals will abide by your wishes.
In response to another comment. See in context »More right wing scare tactics and lies, adds nothing meaningful health care reform, just lies to try to slow down reform or kill it all together.
Brian,
Do you mind fleshing out your assertion about the “lies” in my post?
Mark
In response to another comment. See in context »First of all your title is a lie, there is no such thing as “Obamacare”. There is nothing coming out of the Hill that in anyway could be construed as granting doctors permissions to kill the elderly poor. Your piece is all speculation and half truths at best. The truth is health care reform will save lives, not end lives. Where is that Catholic social justice you’re always talking about? If you really were concerned about the plight of the poor as you claim you are you’d be fighting tooth and nail for health care reform, more than any other group it’s the poor who suffer at the hands of our health care system. Instead you are attempting to scare with right wing hyperbole, baseless speculation, and at very best half truths.
A couple of points:
1) I thought of “Obamacare” as a catchall term, but in looking at stories that use it, I see that all hail from the right. So the term may well be perjorative. However, I don’t think of it as a “lie.” After all, the president made health insurance reform one of his signature priorities during the campaign and after.
2) So what about the quotes from Tia Powell and the Center for Practical Bioethics: those have nothing to do with euthanasia?
3) Any health insurance reform, like any legislation, that seeks to terminate certain populations (the unborn and very old) at the expense of the sick and uninsured is not social justice; it’s making tradeoffs.
In response to another comment. See in context »“3) Any health insurance reform, like any legislation, that seeks to terminate certain populations (the unborn and very old) at the expense of the sick and uninsured is not social justice; it’s making tradeoffs”
Since there is nothing coming out of any committee in congress that even addresses those issue your point is built on a lie and has only one purpose, to scare people. Is there anything coming out of the committees that would overturn the Hyde Amendment? No, there is not! The only end of life issue being address by congress is to pay for end of life counseling. I would think that would be right in keeping with Catholic teaching. Doesn’t your church have many stands on end of life with dignity? So how about being honest with us Mark and telling us exactly why you oppose health care reform instead of these trumped up and false charges of yours.
You know Mark when I first started reading your blog I did believe that you were a conservative that was different from the run of the mill GOPer, but this post and your prior two posts are telling me I was sorely mistaken.
In response to another comment. See in context »I find your points to be little more than conclusory. They don’t address my specifics.
The Capps Amendment represents an end run around the Hyde Amendment: Americans could select insurance plans that cover abortion. It would represent an expansion of the abortion license. Consider the federal employees health plan, the one that members of Congress received. It prohibits insurance plans that cover abortion.
Some of my positions line up with the GOP. Others with the Democratic Party. Others with neither. I guess lately some have aligned more with the GOP, though I haven’t heard any conservatives or Republicans make the “yo mama” point that I did.
In response to another comment. See in context »The Capp Amendment does no such thing:
“The amendment, proposed by Democratic Rep. Lois Capps, prohibits the federal government from compelling private providers participating in the federal healthcare exchange to cover abortion. But it also bars the government from prohibiting those plans from offering such coverage. And it requires that at least one of the private plans participating in the exchange cover abortion—and at least one of the plans to not. Read the amendment here.”
(http://www.usnews.com/blogs/god-and-country/2009/07/31/does-healthcare-bill-really-ban-federal-funding-for-abortion.html)
In no way does it channel tax payer funds to abortion. And my point about your prior two posts has nothing to do with your rational for supporting the cops, it’s the fact that you went out of your way to support the cops over the middle aged African American Harvard professor.
I’ve seen you post more than once about the church’s call for social justice, but when a matter of real social justice arises, health care reform do we read outrage from you over the 10s of millions who don’t have health coverage, not a peep out of you. No we you blog about a canard of an issue euthanasia and abortion. Typical party-liner.
In response to another comment. See in context »In your fantasy cosmos, there may be a difference between tradeoffs and life itself, but in the real world, life is tradeoff. Even when you breathe, you take the oxygen from your neighbor.
In response to another comment. See in context »Of course, there’s no provision in any upcoming legislation to cause healthy seniors to fear that they will be executed by government fiat. The purpose of your fear-mongering is to eliminate the ability for a debilitated but cognizant individual to choose death with dignity. You are on the wrong side of history as your church has been for the last 600 years.
[...] every five years about their end-of-life care. Some are bogus. Others are not. Over at True Slant, I argue that the provision does open the door to euthanasia: As Wesley J. Smith notes, if Blumenauer’s [...]
Now Mark, the funny thing is that in the post you lied to for your “evidence,” there’s a detailed explanation for why you are completely and utterly wrong as well as a very prominent note that this is nothing more than a scare tactic on right wing talk radio.
Wow, I can see the tough, objective Washington Times standards really kicking in. At least one would think that you’d have the good sense to link to an article that somehow obscures your blatant and baseless fear mongering. But no, you’re too absorbed spouting off how the ideas regarding quality of life for senior citizens are an immediate advocacy for euthanasia when your “evidence” says nothing of the sort, but simply points out that people should be free to decide what they want to do in case they’re diagnosed with a terminal illness.
Do you guys at the Washington Times just make things up as you go along or is there a lost of things to make up by the end of the day?
Quick corrections. I meant “in the post you linked to” and “a list of things to make up by the end of the day.”
In response to another comment. See in context »Mr Stricherz, it seems if you want to make a case for your position against health care reform, you must be consistent with the philosophies you have openly espoused, or explain the exception without using the nay-sayers packaged talking points. I would really like to know what it is those in opposition are opposing, but all I can see is hate- and fear-mongering, hyperbole and snark-isms. Too bad.
I love your photo Great touch.
I’m not clear about the significance of ‘a few doctors would be influenced by…’ A few doctors are influenced by Rush Limbaugh. A few are influenced by Obama. Your point is? What’s always missing in these discussions of this possible provision is any text from the proposed bill.
And while it’s great to reference what other’s opinions may be about the text and meaning of a bill you don’t share here…I’m not sure it’s pertinent to healthcare reform other than to confuse, obfuscate and encourage a sense of fear and dread of the unknown change awaiting us. Maybe, next time, your post can include text of the bill. And we call all discuss it. And, maybe you can share your opinion of the text and its meaning rather than vague allusions to others who may or may not have read the proposed bill.
Mark
I’ve read your post a few times attempting to understand if there is a point that is, somehow, eluding me. It’s really hard to disagree with what you are saying – I think – but I just can’t seem to work out how your point speaks to Blumenauer’s provision in the House bill.
There certainly are people out there who believe in euthanasia, along with a whole bunch of other theories about end of life. So what? I may not agree with them any more than you, but I don’t see how this is relevant to the issue at hand.
If I understand you correctly, you appear to be saying that by providing Medicare participants with an opportunity to discuss end of life situations, circumstances and plans with their physician, at government expense every five years, the legislation would increase the opportunity for physicians to push cost controlling solutions on their patients or, somehow, attempt to influence their patients with their own belief system.
I guess that’s possible …. but do you really think that a patient, when contemplating how they might wish to structure their advance directive, is going to negate their own thoughts and believes in deference to the philosophies of the physician?
I have to tell you that, as a lawyer, I have been advising people for years on their advance directives and I can’t recall anyone ever giving a damn about my own philosophies. After all, we’re talking about their life – not an abstract ethical argument. While you might suggest that people would be inclined to listen to their physicians more than a lawyer in that situation, do you really think this is likely that a person cares about the physician’s believe structure any more than they would care what you and I have to say about it? I find that there are, basically, two approaches. There are those who intend to fight every step of the way to extend their life as long as humanly possible and those who do not wish to extend their life if it isn’t going to be worth living. I’ve encountered very few who are on the fence on this question.
How can it be a bad thing to cause people to think about this ahead of time? By avoiding and delaying, they are only pushing agonizing decisions onto their families at a time when their families will be ill equipped to make these decisions.
While I do support health care reform, I well understand the arguments of those who do not. So, with lots you can argue as to why you think what is on the table is the wrong way to go, why pick on something that so obviously benefits everyone, especially when nobody is putting a gun to their head and ordering them to engage in the practice. If people want to continue to ignore the inevitable, there is absolutely nothing in any legislation that orders them to do otherwise…and I think you are bright enough to know this. So, why not argue where there is room for reasonable people to disagree rather than get into this foolishness?
By the way – do you see the benefits of an advance directive for your own plans and intentions? Don’t you want your desires to be followed, whatever they may be, rather than put it on your family? I’m betting you would. Why not encourage others to do the same?