Mickey Kaus at Slate: something to that "death panel" thing after all. Also: good alternatives don't include these things.

Mickey Kaus over at Slate talks about an April interview Obama gave wherein the subject of those troublesome “death panels” came up. Quoting from the interview (high-lit in a report by Bloomberg’s Tom Maguire), Kaus follows up with this:

Yikes. … I’m sure the “not determinative” part was very important to Obama. Still!  He’s talking about a panel of independent experts making end-of-life recommendations in order to save costs that have an effect at an individual level. And he thought it would be in the bill that emerges. … It’s also pretty clear that something like the “IMAC” panel is what he has in mind. Whether or not the IMAC would actually do this–Harold Pollack says end-of-life issues are well down the curve-bender’s list, for example–Obama thought it would do it. . .

And if health care advisor Ezekiel Emanuel believes there’s actually not that much money to be saved on end-of-life care, he hadn’t gotten the message to the President back in April. …

P.S.: Hmm. If, say, Peter Orszag led Obama down the fatal path of talking about end-of-life-savings, and if Ezekiel Emanuel thinks Orszag is wrong about this, then who is Ezekiel’s own brother going to recommend throwing overboard when if health care reform stalls? Just speculating! …

Emphasis is in the original. Kaus hits it squarely: Obama’s under the impression that a panel of “independent experts” would be in place to “give guidance” on the matter of when you cut off spending additional money on medical treatments for a person judged (by the panel?) to be terminal. That’s what he thinks is – and should be – in HR3200, the House Obamacare bill. Now, he says “It’s not determinative” which is him saying that the panel can’t order someone to be cut off. But it’s not the panel’s job, in his obvious wording, to actually do anything at all; they’re in place to “give guidance.” But if this panel is empowered to give guidance and the regulators to whom they are offering the guidance are required by law to accept it, what’s the difference? The panel says that a new cancer treatment costs a lot so the 85-year-old with pancreatic cancer just isn’t a good cost-benefit model, ergo we recommend not doing it. The doctors are required by law to not dispense any treatments not approved by the panel and, so, the 85-year-old gets painkillers and an end-of-life counseling session but no cancer treatment.

Like Obama has said on many occasions, the reform’s gotta have teeth, right? I take that to mean that the reform has to be something that’s enforced, mandated. When a panel’s “guidance” is required to be accepted and enacted then it’s not really guidance, is it?

By the way, would such a panel be comprised the same way the “Health Benefits Advisory Committee” in section 123 of HR3200 is? Meaning, appointed by the President and a member of his Executive branch with no input from Congress and no accountability to the people of the United States?


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