Death Panels

There’s been a lot of blathering about this, so I want to throw my two cents in:

Short version:

It is not possible to have a government run / controlled / funded /managed health care system without having death panels. That is one of the many reasons why government health care is a bad idea.

Longer version:

Any and every health care system must have ways of deciding who will get what care. In a totally private system, it’s decided by money: if you’re willing and able to pay, you get the service, if you aren’t / can’t, you don’t. In our current system, if you have health insurance, your insurance company makes decisions about what it’s willing to cover, and may you have to fight with it / jump through its hoops in order to get the treatment you want. Or you can sue it, or you can just pay for it yourself, or you can not get the treatment, and continue to suffer through the problem (or just die).

As someone (who I can’t remember) pointed out: in this system , the government serves as “umpire”, deciding who should win each argument. The other “umpire” is “the market”: if a company’s insurance provider is routinely stiffing its employees, the company is likely to drop that provider, and switch to a different one.

In a government health care system, the government will have to decide what treatments are covered, and what aren’t. Which conditions justify the expensive red pill, which ones only get the cheaper (but less effective) blue pill, and which ones get you a trip to the hospice, or an aspirin and a call back in two weeks (if you’re still alive then). And since our political representatives are chickenshits who do their best to avoid having to make decisions, there will be a “panel” to decide what gets covered, and what doesn’t. In Britain, that panel is called NICE (National Institute for Health and Clinical Excellence: “NICE is an independent organisation responsible for providing national guidance on promoting good health and preventing and treating ill health”) President Obama is pushing for IMAC, (“Yesterday, a group of some of the most distinguished health economists in the country sent a letter to the President and Congress in support of the Administration’s proposal for the establishment of an independent board of doctors and health experts to guide Medicare policy. This Independent Medicare Advisory Council (IMAC) would make recommendations on Medicare reimbursement policy and other reforms – playing a critical role in allowing health care policy to adjust flexibly to a dynamic health care market, thereby helping contain costs and improve quality over time. As the authors note, ‘a properly structured Independent Medicare Advisory Council (IMAC), with a congressional mandate and authority to do so, can reduce the rate of growth of health expenditures substantially.‘”) He already had the Federal Coordinating Council for Comparative Effectiveness Research added to Porkulus. Both of those, by any reasonale definition of the term, are “death panels”. Panels that will decide whether you are worth treating, or if you should be left to die.

Will they decide it for you, personally? No. Will they “send death squads out to round up Trig Palin“? No. Might they decide it’s not worth the effort to fund “extreme” health care for people with Down’s Syndrome? Yes. Might they decide that your grandma doesn’t need that hip replacement, or pacemaker? Oh Hell yes!

Now, if you’re really rich, you can fly someplace else and get treatment, or, if your government allows it, you can pay for it yourself in your country (if, of course, your country has the ability to provide what you want. After all, the main way of government rationing will be to simply not provide the capability, or not provide enough of it, in the first place). But for the rest of us, those government panels will be deciding whether or not we get treated. Not the market, not an insurance company that can be dumped if we don’t like it’s choices, the government.

You know, the same government that has to pay for the care if it decides it’s “appropriate”.

Would you like to play baseball when all the umpires have been hired, and paid, by the other team? If not, then you don’t want those government death panels deciding when it’s not longer “cost effective” to keep you alive.

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