Will You/Won't You Be on My "Death Panel"?

Will You/Won't You Be on My "Death Panel"?

Will You/Won't You Be on My "Death Panel"?

A mostly political weblog.
Aug. 12 2009 11:37 PM

Will You/Won't You Be on My "Death Panel"?

My friend Bob Wright posts a persuasive  "partial list" of the "false and misleading things"  he argues a recent New Republic  book review said about The Evolution of God .

If [reviewer Jerry] Coyne wants to write a devastating review of my book-and there can be little doubt that he wants to-he's going to have to start over.

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The disputes are grouped into six substantive issues. My guess is that #4 and #5 are the hottest areas of contention. ... My own non-devastating attempt to grill Wright on his view of Islam comes toward the end of this interview . ... 9:54 P.M.

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So You Have A Death Panel in That Basket! Tom Maguire digs further into that April Bloomberg story --and the David Leonhardt NYT  interview behind it--and discovers that Obama came a lot closer to talking about "death panels" back in April than I'd thought. Here's the key passage [ emphasis added by Maguire ]. It comes as Obama is talking about the hip replacement his grandmother got a few weeks before her death:

THE PRESIDENT: ... I don't know how much that hip replacement cost. I would have paid out of pocket for that hip replacement just because she's my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else's aging grandparents or parents, a hip replacement when they're terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn't have a hip replacement and she had to lie there in misery in the waning days of her life - that would be pretty upsetting.

LEONHARDT: And it's going to be hard for people who don't have the option of paying for it.

THE PRESIDENT: So that's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

LEONHARDT: So how do you - how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative , but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now.

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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! ...

Update: Timothy Noah argues that you really need all three parts of Uwe Reinhardt's "three-legged stool" to make insurance reform work. 1) Insurance companies accept all comers; 2) Individual mandate to buy insurance; 3) Subsidies so poor people can fulfill that mandate. Fine. Let's do those three things! They pointedly do not include Peter Orszag's long-term game-changers, or Obama's "very difficult democratic conversation" about end of life care. Even Reinhardt, who supports the long-term Orszag agenda, doesn't think it's something we can do in this round of reform--that's "a much longer-run effort that may take an entire decade or more." Why didn't someone tell that to Obama (who actually pledged to veto a bill that didn't do the long-term curve-bending that Reinhardt says can't be done )?  'Sir, we can achieve universal coverage.' 'No, let's have a very difficult democratic conversation first." ... P.S.: Orszag's politically disastrous "game changers" are also the piece of Obama's reforms mysteriously left off Ezra Klein's list of health care areas of agreement and disagreement. ...   9:52 P.M.

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A second talented editor leaves the L.A. Times Entertainment section in as many weeks . Kate Aurthur, who's going to the Daily Beast , was--according to kf 's well-informed source--

the one top editor with any sense of innovative spirit, creativity or awareness of the internet left in the Calendar section.

Do Times employees not find Entertainment chieftain Sallie Hofmeister's leadership inspiring? ... P.S.: I used to enjoy mocking the LAT , but it's so doomed there's no point anymore. If there were a death panel for newspapers, it would issue a DNR order. ... 9:48 P.M.

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