Sunday, August 23, 2009

Sarah Palin's "Death Panels"

I was vaguely aware of this debate, but wasn't following it closely. After all, I had more important things to do. I had tentatively concluded, from secondary sources alone, that Sarah Palin had grossly distorted HR 3200's provisions on advanced care planning. But prompted by a comment thread at Jockeystreet, I have dug into the text of the bill and compared it to Sarah Palin's comment.

It's fair to call Palin's statement a lie:

The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

The bill contains a provision for government regulation of advance care planning and it mildly incentivizes the practice. But there are no panels which determine whether or not an individual should die, nor is the individual's value to society measured and weighed as part of that panel's deliberations.

At that point, Palin is simply horrendously wrong about the bill. What makes her statement transcend from wrong to lie is her use of quotation marks. Who is she quoting? It's not clear, but their presence and placement within the post suggest that she's quoting the bill. She's not. Those words and and phrases do not appear anywhere in the bill. And to suggest that they do is a lie.

Palin's follow-up post is more reasonable and quotes the bill. But it is directly at odds with the wild and baseless allegations that she made in her initial post.

There are good reasons to oppose HR 3200. Imaginary death panels determining whether very sick or disabled people live or die is not one of them.

21 comments:

Lisa Graas said...

With all due respect, you were apparently reading the wrong page of the bill. If memory serves, it is on page 30 of HR3200, the bureaucrats who will determine what the benefits are for both private plans and the public option because all will be under the "exchange". It's impossible to give care without rationing and Obama's health care advisor who is advising the budget office (yes, this health plan is being billed as a saviour of the economy, not people's lives) advocates the Complete Lives System. I don't think knee-jerk reactions devoid of scholarship are appropriate for this very serious debate. I read about the death panel and knew it was a death panel before Sarah Palin ever even called it a "death panel"......and when she did, I cheered her for it because I had already seen it for myself in the bill. Do some research, will ya?

John said...

I don't see "death panel" on p.30, or anything like it. Where in the text of the bill did you find this phrase?

Divers and Sundry said...

"there are no panels which determine whether or not an individual should die"

You are wrong. There are, too, "death panels": the insurance companies already have them in current operation. You're correct that they are not in the bill, of course.

Lisa, I checked your blogs, and you are quite the Palin fan!

doodlebugmom said...

Sarah Palin scares me. But what scares me more is that people belive the half truths and out right lies she tells.

Health care is already rationed in this country. Those who can afford it have it, those who can afford nothing have it. But there are countless in between. We all know someone in the middle.

bob said...

We can all agree that the words death panel don't appear in the bill. Palin was using these words to drive home a point because sometimes you need harsh words to motivate the electorate. While I don't agree with the end of life counseling I don't think this is where the death panel idea comes from. There is supposed to be a board of medical people analyzing the cost benefits of some procedures. While not spelled out as such I think taken as a whole the bill does state that the government will be making some life and death decisions.


People who see the government as beneficent and the answer to all our problems tend to be for the bill.People who don't trust the government tend to be against it.

Anonymous said...

"There are, too, 'death panels': the insurance companies already have them in current operation." The words quoted don't actually appear in the insurance policy; that doesn't make Divers-and-Sundry a liar.

There seem to be competing talking points. Opponents say ObamaCare inevitably requires rationing. Supporters either say it doesn't, or that we already have rationing. Maybe the promoters of the new plan have been telling different groups of people what they want to hear.

Divers and Sundry said...

"There is supposed to be a board of medical people analyzing the cost benefits of some procedures."

The insurance companies are already doing that. I'm not sure what the uproar is about from people horrified that this practice is being suggested.

"People who see the government as beneficent and the answer to all our problems tend to be for the bill.People who don't trust the government tend to be against it."

That's not it. I don't particularly trust the government (though my mom seems satisfied enough with Daddy's government pension and her medicare, I graduated from a public school, I drive on those highways the government funded...), but I don't particularly trust the insurance companies, either.

The status quo is not acceptable. Clouding the issue with emotionally charged phrases like "death panels" and suggestions that Hawking and Palin's baby will die at the hands of evil government bureaucrats doesn't help us reach clarity.

Divers and Sundry said...

""There are, too, 'death panels': the insurance companies already have them in current operation." The words quoted don't actually appear in the insurance policy; that doesn't make Divers-and-Sundry a liar."

Oh, I agree. Just because Palin's words "death panels" are not in the bill doesn't mean there won't be people making decisions about allowable treatment options similar to those groups the insurance companies already have.

My point is that this is not new. People can't go out and get whatever treatment they want and have their insurance company pay for it. There are limits. Right now the limits are determined by profit-based companies whose CEOs make more money in a month than I'm likely to make over my entire lifetime. Right now insurance company practices seem more interested in making more money than in insuring people.

Palin's use of the phrase "death panels" in this discussion is not helpful in understanding the current bills under consideration. It just whips up emotions and stirs up fear.

My Rice Paddy Office said...

You're wrong. The Senate Finance Committee, removed section 1233 from the house bill 3200 after Palin's statement. Why? Because Palin was correct!!! A Death Panel by any other name is still a death panel. You just don't want to admit that Palin was right.

John said...

Rice Paddy, where in the text of the bill do you find the phrases "death panel" and "level of productivity in society"?

Jeff the Baptist said...

"My point is that this is not new. People can't go out and get whatever treatment they want and have their insurance company pay for it. There are limits."

Agreed, but you miss the point.

At the moment an insurance company makes a financial decision on what they will cover. This is a decision about money and if you still want the procedure, you can still get it if you can find the money. The insurance industry panels therefore ration coverage not care. For some people this amounts to the same thing, but not for all people or even necessarily most people. I've known people of very modest means who mortgaged their house to pay for a family member's treatment.

If we move to a single-payer system via the public option, does this still hold true? Can you still spend your own money on care? I'm not so sure.

John said...

Bob wrote:

We can all agree that the words death panel don't appear in the bill. Palin was using these words to drive home a point because sometimes you need harsh words to motivate the electorate.


Harsh words? Sure. Distorting words? No. Misquoting the bill? Absolutely not.

Divers and Sundry said...

"The insurance industry panels therefore ration coverage not care."

When they say they won't pay for more than 2 weeks in the ICU I agree they are rationing coverage, but I think they are also rationing care because ICU for any extended period would be more than most people could pay out-of-pocket. I'm not saying this is inappropriate. At some point, insurance companies refuse to pay for more care, and their "death panel" (if that's what we're going to start calling these decision-making bodies) effectively sends these terminal patients home to die. Limits on care are not new. Many times the patient him/herself rejects life-extending treatments. I still don't get the, "I'm shocked, _shocked_" attitude I hear from Palin, et al.

It's nice that some people who get denied coverage have homes they can mortgage for enough money to pay for needed medical care and good enough jobs to pay off that debt. I rejoice for them. Many are not in that position.

I'm not arguing in favor of any of the various plans under consideration in either the House or the Senate. I'm arguing against the reactionary screaming from the right. I'm arguing against the idea that the status quo is ok.

Divers and Sundry said...

and just in an attempt at clarity... Isn't the section of that bill that Palin suggested included "death panels" actually a section put in to reimburse physicians for having conferences with patients about living wills and hospice care options? It's been awhile since I read up on all this, but that's what I'm remembering. If not, exactly what is the phrasing that's being characterized as "death panels"?

I'm also remembering that it was proposed by a Republican, but, again, I'd have to re-research it to be sure.

bob said...

John wrote that distorting the bill would be a wrong. I agree if this truly is a distortion that would be wrong. The question then is what Sarah Palin said a distortion or a semantically loaded phrase. Taken as whole the claim to reduce costs and evaluate cost effectiveness leads to the government making decisions regarding life and death. The end of life counseling is another issue if doctors are being paid by the government I'm not sure they won't start advocating more for the group that's footing the bill than the person their treating.

Anonymous said...

Quotes, no quotes. Sarah Palin was telling people that Obama and his crew plan to kill old people and retarded children. Right? I mean, this is, quite simply, the message she was trying to get across. "Don't let them vote for this bill, because they want to euthanize old people and mentally retarded children!!!" And that is just plain nonsense. There can be legitimate arguments about government rationing versus current market rationing, about the ability to pay out of pocket, and the wisdom of giving the government another responsibility when they don't necessarily have a great track record on a couple of other things. Sure. That debate is great. But... Sarah Palin (and Rush Limbaugh and others) is (was) out there telling people that Obama wants to kill old people and retarded children. Anyone who has a problem with it, please feel free to attack the reform plan... but don't defend that sort of base, repugnant fear-mongering and personal slander.

Beyond that... I agree with pretty much everything D&S is saying here. Good job, D&S.

Larry B said...

In my view, regardless of whether you believe Palin's statement was factually accurate or hyperbole, it draws attention to the idea of a government panel being involved in health decisions and this panel derives it's authority from a bureaucratic reading of legislation. It's been proven throughout history that original documents can take on vastly different interpretations through the lens of future bureaucrats. And the people become powerless to change that. A death panel can conceivably come into existence with the language of the bill as it is.

I much prefer the free market and economics to dictate conditions and terms and have available legal remedies through lawyers and courts if necessary to enforce contractual agreements with private for profit companies. Failing that I can draw on whatever private resources I may have to remedy my situation.

A bureaucracy does not respond to these measures and leaves the individual powerless. So Palin may be shrill and grating, but her assessment of how a bureaucracy will run healthcare isn't illogical.

John said...

I agree that the free market is the best way to deliver goods and services, including health care. I don't believe that lying about the text of the bill is an effective way to argue for the free market, or anything else.

Divers and Sundry said...

"I much prefer the free market ...."

The free market is what we've got. and it needs a bit of tweaking, imo. Refusal for pre-existing conditions, rescission, and the inability to negotiate drug prices are huge problems that need addressing, and the free market has had plenty of unfettered time to solve them.

"...I can draw on whatever private resources I may have to remedy my situation"

That's nice, but plenty can't, having insufficient resources to begin to cover the extravagant costs involved in medical care.

I just finished watching Frontline's "Sick Around the World" online at their site and found it fascinating. It was interesting to see one man's view of the health care systems of several other countries.

bob said...

Divers and Sundry said a free market is what we have right now. Not really it's legislated so that states keep out competition and limit who can sell insurance in each state. We also have medicare and medicaid which operate out side the rules changing the way the market would function if truly free. We also have the government mandating certain coverages that drive the cost up.

Divers and Sundry said...

Bob said, "Not really"

Yes, I concede your point. I guess I was just revealing my prejudice against what would be an unregulated free market. I just get so frustrated with the way the insurance companies operate, and I think _more_ regulation would be a good thing.