But reform is being sold not just as a moral obligation but also as a way to control rising health-care costs. That should have been a separate discussion. It is not illogical for skeptics to suspect that if millions of people are going to be newly covered by health insurance, either costs are going to skyrocket or services are going to be curtailed. ...
Yes, it's true that doctors order some questionable procedures defensively, to keep from getting sued. But it's a cop-out to blame the doctors or the tort lawyers. We're the ones who demand these tests, scans and surgeries. And why not? If a technology exists that can prolong life or improve its quality, even for a few weeks or months, why shouldn't we want it?
That's the reason people are so frightened and enraged about the proposed measure that would allow Medicare to pay for end-of-life counseling. If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending. It's irresponsible for politicians, such as Sarah Palin, to claim -- outlandishly and falsely -- that there's going to be some kind of "death panel" to decide when to pull the plug on Aunt Sylvia. But it's understandable why people might associate the phrase "health-care reform" with limiting their choices during Aunt Sylvia's final days.
We should be having two debates. One should be about the obligation to ensure universal access to health care, which will directly benefit millions of struggling families and make this a better society. The other -- a more complicated, difficult and painful discussion -- should be about the long-term problem of out-of-control health-care costs, which would be a looming crisis even if President Obama had never uttered the word "reform."
Conflating the two has made the nation's nerves jump and its skin itch. And now, anything can happen. [E.A.]
Right. A debate on long-term cost control and end-of-life care-- especially an emotional and acrimonious debate--is a highly useful debate to have. But it's not a useful debate to have right now. Right now it is killing Obama's universal care plans. ... And it wasn't a debate we had to have right now. It's a debate Obama has brought on himself by framing health care as an attempt to "bend the curve" of long term costs decades from now. He could have just said "Here's how I would guarantee health security for everyone. And here's how we're going to pay for it for the next ten years." ... P.S.: If, as Harold Pollack argues , "rationing of life-saving or life-extending care" would not really be a priority for the "effectiveness" panels--such as the Obama-endorsed IMAC --then it was all the more stupid to bring the topic up , no? Here's the first graf from a Bloomberg account of an early Obama health care foray back in April:
April 29 (Bloomberg) -- President Barack Obama said his grandmother’s hip-replacement surgery during the final weeks of her life made him wonder whether expensive procedures for the terminally ill reflect a "sustainable model" for health care.
Gee, where could the misinformed town hall crazies have gotten the idea that Obama was thinking about saving money by denying expensive procedures toward the end of life? ... [via Dish ] ... 1:49 P.M.