The clip below requires a little unpacking: In answering a flip, but it turns out quite good, question about “death panels,” Paul Krugman claims accurately that the cost/benefit board established over private medicine by Obamacare will be able to impose “more or less binding judgments” refusing care, and moreover, that these refusals will save “a lot of money” in the context of treating the elderly (and others, such as people with disabilities and terminal illnesses). He says that the panel will prevent treatment that isn’t “medically” useful. But private insurance companies already do that. So do Medicare and Medicaid.
No, the money won’t be taken out of the hide of patients who want physiologically useless treatment, it will come at the lethal cost to patients whose treatment will be refused because it could work, based on the invidious judgment that the patient’s life is not worth the money to support. In short, Krugman has admitted that contrary to the many mendacious denials by Obamacare supporters, the new regime will impose rationing–just as in the UK with NICE, which is why I bring it up all the time.
This is akin to imposing a duty to die because when we reach a certain point in life, we will not be able to obtain treatment we want that could keep us going. Indeed, for me, this centralized federal control over what will and will not be provided in medicine–and to whom–is the biggest reason (among so many) why Obamacare is wrong. Repeal. Reform. Replace. First target–putative death panels.
April 2nd, 2010 | 11:28 am
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April 2nd, 2010 | 11:58 am
Wesley: More disingenuous BS. You’ve taken it upon yourself to define cost-containment efforts as “death panels.” Not only is that patently absurd; it’s blatantly hypocritical, since you consistently fail to condemn private insurance carriers who engage in exactly the same behavior.
Since you fancy yourself an ethicist you might want to consider lightening up on pro-Republican pandering, and working instead on one of the most basic ethical matters: telling the truth.
April 2nd, 2010 | 1:54 pm
Health Security Hysteria! Death Panel Edition.
Professor Paul Krugman (Nobel Price for Economics) clearly states that an advisory board could withhold ineffective and expensive treatments thus saving money.
Do the actual words that he spoke not count?
You interpret somehow interpret his words to mean “death panels” will promote the death of the elderly and disabled because they are not important enough to live.
You’re not stupid, therefore we must conclude you are either mendacious or blinded by ideology.
Wesley J. Smith Reply:
April 2nd, 2010 at 2:04 pm
He said what I wrote he said, not what you wrote he said, Jeffrey. Treatments with no medical benefits are already refused payment. This rationing board is about refusing treatments that could provide benefit but are deemed not worth the money. That is rationing. Rationing leads to people dying who might otherwise not die with treatment. That is sometimes provocatively called a death panel. Own it.
April 2nd, 2010 | 2:02 pm
I get it! This post was a late April Fool’s joke! Good one.
Wesley J. Smith Reply:
April 2nd, 2010 at 2:05 pm
It’s April 2. The April Fool’ joke, although it isn’t funny and it’s not really a joke, is Obamacare.
April 2nd, 2010 | 4:51 pm
Wesley,
In short, you’re saying that society should have no limits in terms of sustaining life. Your position is that a 94 yr old man with terminal bone cancer expected to live another year but who develops acute liver failure should receive equal consideration to the 37 yr old who needs a liver transplant. You further believe that a 63 yr old with terminal lung cancer should receive every experimental therapy available at government expense to satisfy your personal religious beliefs. And your belief that over $400,000 of tax money should be spent to give a 71 yr old a 5% chance of living an extra 2 mos makes no sense.
But worst of all, your insistence that an anencephalic baby be kept alive in perpetuity by the state by artificial means is beyond grotesque. You should be ashamed.
Is there any limit on how much of other’s peoples money you would spend to support your religious beliefs?
Wesley J. Smith Reply:
April 2nd, 2010 at 5:02 pm
Jeffrey, you aren’t even worth bothering to answer.
April 2nd, 2010 | 5:43 pm
I know the feeling…
April 2nd, 2010 | 5:51 pm
There’s also an important distinction between rationing by private insurance companies and the government controlled bureaucracies.
With the free market system, you at least have the possibility to get the treatment if you a) get a loan b) get help and donations from a community, such as your local church. The cost of the treatment falls entirely to you, but also, its nobody else’s business.
With the government in charge, you have no such options, except you are or happen to have friends in high political office. The cost of the treatment falls to the society as a whole, and refusing expensive treatment to strangers is beneficial to you.
April 2nd, 2010 | 8:06 pm
Krugman used to be an economist before he became a shill for the left.
This proves he can at least sometimes still “follow the money.” What he is describing has to happen with any form of socialized medicine, whether the bill specified any triage boards or not. Either this kind of forced rationing must happen or the system goes bankrupt quickly–instead of slowly.
Which is one reason among many why, even if the bill had been “corrected” of the specific flaws (like funded abortions) which various groups identified, the whole concept of government-directed health care must be opposed hammer and tongs, and now must be repealed or strangled.
April 2nd, 2010 | 8:33 pm
I’m not an intellectual but it appears to me that if someone that you love is denied treatment and/or meds, it is surely a death panel but if it doesn’t touch you personally, it is merely medical rationing. Nuanced terminology worked well in Germany in the 30′s & 40′s.
Wesley J. Smith Reply:
April 2nd, 2010 at 11:06 pm
irishsmile: Being intellectual is not necessarily a virtue. You said it all.
April 2nd, 2010 | 10:47 pm
Wesley, is Krugman admitting also that people who could afford to get life saving or life extending health care with their own money or with insurance supplemental to the rations the government is going to give? I’m pretty sure the law gives the secretary of HHS the authority to deny certain supplemental insurance plans if he or she wants to. That is, it’s not mandatory but the secretary has discretion. That would be denying people the right to use their own money to get life saving treatment. I wonder if Krugman is owning up to that.
Wesley J. Smith Reply:
April 2nd, 2010 at 11:05 pm
He is saying that the cost control board will save a lot of money. He said it would stop us from paying from treatment that is of no medical use. But that is already not paid for. My point is that what it will institute rationing based on quality of life, invidious categorical rationing in which individual patients get lost. I don’t think we will be like Canada in which no private pay is allowed. In fact, I think a lot of the best doctors might opt out of Obamacare for strictly fee for service private pay. I know one very wealthy man in a sort of private system like that right now.
April 3rd, 2010 | 12:11 am
Joe, the bill has NOT been corrected regarding abortion. Please see: http://www.nrlc.org/AHC/Release032110.html
The cost savings to be able to afford this “affordable” health “care” act are to come from both ends of life, or rather, death, but no one could dare admit that prior to the bill passing, (though we should thank Stupak for revealing that Waxman finally admitted to him that they indeed WANTED the bill to pay for abortions), and will be careful not to admit it now, but not too careful, as we see from Krugman’s comments. (It to just so hard not to show how smart one was the whole time wasn’t it Mr. Krugman–especially when everyone from O’Reilley to Stephanopolus wondered aloud how in the world Obama thought this could cover so many more people and still be afforded.)
April 3rd, 2010 | 12:23 am
And one last thing. Don’t forget the cost savings from the loaded advance care directives like the one designed by the Center for Practical Bioethics (practicalbioethics.org) where denial of artifically provided nutrition and hydration are the default position on the form, unless on crosses it out and initials it, all of which is preceeded by pages of leading the witness questions/comments. This wouldn’t be so disturbing were not the CEO and President of Practical Bioethics a friend of Kathleen Sebelius from back here in Kansas. Sebelius appointed her to the KS Board of Healing Arts where she remains as a citizen member. The same woman was on Planned Parenthood’s citizen advisory board here. (Practical Bioethics, headquartered in KC, is the group that worked with Sen. Danforth to pass the Patient Self-Determination Act requiring all health care institutions nationwide to offer the opportunity for an ACD to every patient admitted.) It is now also common for the NO CODE conservation to be had with every, even relatively minor hospital admittance of an older person. I had to get forceful sounding to get a nurse to back off on that the night we admitted my mom for a urinary tract infection. I told her we would cross that bridge when we were approaching it, not a continent away. She is fine now thank you.
April 3rd, 2010 | 9:13 am
irishsmile:
You said: “Nuanced terminology worked well in Germany in the 30’s & 40’s.” It still works well everywhere. The act of making fine distinctions in the use of language doesn’t make people Nazis. If one considers (a) who’s making a statement and (b) its context, there’s usually little difficulty making a distinction between information and propaganda, between facts and “spin.”
April 3rd, 2010 | 10:26 am
There’s a provision to allow the secretary of SHS to reject those supplemental plans. “Nothing in this section shall be construed as requiring the Secretary to accept any or every bid submitted by an MA organization under this subsection.” Section 3209.
April 3rd, 2010 | 12:15 pm
All this high-falutin’ theory, conjecture, hypotheses and opinion makes an empiricist like me long for evidence. Got any?
How have other wealthy nations fared after instituting universal healthcare? Are these nations euthanizing the elderly and handicapped to cut costs? Or by omission are they allowing the elderly and the infirm to die by withholding expensive life-saving treatments? Do the citizens of these nations clamor for a for-profit American-style system? Please present the evidence that supports your contention that death panels are being proposed to let Americans die.
Do the anti-Obamacare folks approve of any limit at all on health care costs? Should cost ever enter in the decision? Ever? Who should decide if and when to “pull the plug” on unconscious grandpa on life support? If private insurance won’t pay, who should? If no one will pay, what should be done?
April 3rd, 2010 | 6:29 pm
You mean like Canada where one in three doctors have sent patients to the USA for treatment? Or Great Britain where people died for the want of ambulances that existed but still held the last patient they picked up, because getting them out of the ambulance would have started to the clock, and the hospital had to see them within a few hours?
April 3rd, 2010 | 6:50 pm
Jeffery,
Have you seen all the posts Wesley has put up re: the situation with NICE in the UK? Lots of evidence there for euthanizing and/or denying treatment to the elderly and handicapped to cut costs.
The point Wesley is trying to make about Krugman’s statement is that Krugman believes Obamacare’s advisory boards will do something that private insurance doesn’t do, which will save more money in the future. The argument is over what that “something” is. If it’s rationing, it’s not the same sort of rationing that insurance companies have done up to this point. Krugman apparently doesn’t think it’s the same as what insurance companies have done; he thinks the advisory boards are bringing something new to the table. That’s the point.
April 4th, 2010 | 5:19 pm
Mary,
Canadian physicians do not send one in three of their patients to the US. Your statement is false. It’s right-wing mythology. Please point me to the conservablog where you found that piece of tripe and I’ll trace it to a dead end for you. You’re welcome.
Kathleen,
I read Wesley’s posts but rarely agree with his biased conclusions.
http://www.nice.org.uk/
Here’s the NICE website. Would you or Wesley please be so kind as to point out the “death panel” related sections for me? I would be interested in discussing the specifics of how the UK NHS allows their patients to die to save money. I may be be wrong.
April 6th, 2010 | 4:29 pm
Mary says:
“…Canada where one in three doctors have sent patients to the USA for treatment”
Jeffrey says:
“Mary,
Canadian physicians do not send one in three of their patients to the US. Your statement is false. It’s right-wing mythology”
My question is:
Jeffry, can you read? Or do you think others can not?
April 7th, 2010 | 4:24 am
Jeffrey,
Your evidence, as requested:
Rationing care to save costs:
http://www.timesonline.co.uk/tol/life_and_style/health/article6401002.ece
http://www.telegraph.co.uk/health/healthnews/5955840/Patients-forced-to-live-in-agony-after-NHS-refuses-to-pay-for-painkilling-injections.html
http://www.guardian.co.uk/society/2004/jul/17/longtermcare.money
http://www.telegraph.co.uk/comment/personal-view/3634362/Twisted-priorities-that-let-the-elderly-suffer.html
http://www.guardian.co.uk/society/2009/may/16/health-nhs
http://www.guardian.co.uk/society/2006/jan/07/health.familyandrelationships
http://strata-sphere.com/blog/index.php/archives/10286
http://obama-oversight.blogspot.com/2009/08/uks-nhs-rationing-and-death-panels.html
Clamoring for private health care:
http://www.nytimes.com/2006/02/28/international/americas/28canada.html
http://www.city-journal.org/html/17_3_canadian_healthcare.html
http://blog.heritage.org/2010/02/09/the-canadian-patients%E2%80%99-remedy-for-health-care-go-to-america/
How other nations fare with universal health care:
http://www.firstthings.com/blogs/secondhandsmoke/2009/07/21/most-cancer-survival-rates-in-usa-better-than-europe-and-canada/
The opposition to Obamacare, as it relates to the subject of death panels, is generally that it moves us in a direction that may require rationing. When there is rationing, someone must make decisions at some point regarding who gets covered and who doesn’t. Many Americans are uncomfortable with the idea that the same people managing the post office and the dmv would ever make life and death medical decisions.
“Do the anti-Obamacare folks approve of any limit at all on health care costs?”
Thank you for asking. No. I can’t speak for everyone. However, I would prefer not to have any limit on how much I can spend trying to keep myself alive. Do you want that?
“Should cost ever enter in the decision? Ever?”
I don’t see why not. However, it should be the person who makes the decision for themselves.
“Who should decide if and when to “pull the plug” on unconscious grandpa on life support?”
The person granted that authority in grandpa’s will. Maybe the worries of Obamacare advocates could have been more efficiently addressed with a relatively inexpensive campaign to educate people about the importance of wills.
“If private insurance won’t pay, who should? If no one will pay, what should be done?”
For these extremely rare circumstances, private charity gives more than enough to such causes to cover the expense.
I look forward to you addressing the evidence I have given.
April 7th, 2010 | 7:02 am
[...] similar things. First up television analyst, and Obama supporter, Paul Krugman is saying that Obamacare WILL lead to government rationing of health care, in order to save money in the system for healthier individuals. Yesterday the Administration’s [...]
April 7th, 2010 | 12:52 pm
To those who say Mr. Smith is interpreting Krugman’s words to mean death panels, here is what happened before Krugman spoke: Another panelist interjected, “Death panels would save money,” to which Krugman responded the way he did about the “advisory board.”
May 9th, 2010 | 4:18 pm
[...] “Krugman Admits Rationing (Death Panels) From Obamacare“ Wesley J. Smith, First Things [...]
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