In a new posting on her Facebook account, former Gov. Sarah Palin (R-AK) made a dire statement about health care reform -- that it could result in an Obama-created "death panel" killing her infant son with Down Syndrome...Here's the full text of her Facebook post. Excerpt:
The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. 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.She doesn't say that the government will kill disabled (or elderly) persons directly, but that death will occur as a result of the decisions of cost controlling bureaucrats with the power to determine who can receive various treatments. I don't know why "level of productivity in society" is in quotes, nor do I know whether it is the plan to ration care on this basis. Those are actually serious matters, and I'd like to know the answers. What Kleefeld is doing is trying to sweep Palin aside as a big crazy wacko.
Yes, she used a colorful expression "death panel," but it's a good and fair polemical expression if in fact life-saving care will be rationed on this basis. I have found myself saying, in conversation, "I'm afraid Obama is going to kill me." Now, I'm not picturing him or one of his minions coming over to murder me, but I am afraid that as I get older and need expensive care to keep me alive that I will be told I cannot have it, because at my age, in the government's opinion, there's not enough life left in me to be worth the money that I would take from the system that needs to pay for everything.
This isn't a phantom fear. It's a fear stoked by things like this:
(There's a longer version of that clip, plus discussion, here.)
And here's the end of the Palin post, which I think is cool-headed and manifestly sane:
We must step up and engage in this most crucial debate. Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back. Ronald Reagan once wrote, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth.” Let’s stop and think and make our voices heard before it’s too late.Kleefeld and others like him — the Andrew Sullivan post title is "Obama's Gonna Kill My Baby!" — would love to squelch that debate.
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247 comments:
«Oldest ‹Older 201 – 247 of 247Question: what was Obama talking about here? Who's this independent panel giving guidance? Guidance about...
What everyone is missing in this government take over of the health "care" industry through single payer insurance is of the most frightening implication.
If the Government OWNS the health industry and controls who gets coverage and HOW MUCH coverage, they also own the right to tell us what to do with our bodies.
They can tell us what to eat. How much to eat. Ban those things that they deem, in their infinite wisdom, that are bad for our health: thing such as smoking, drinking, eating high fat, high sugar foods......anything that they want. Not these things aren't bad, but they should be an individual free choice. They can mandate that we MUST excercise. They can take our children from us to be sure that they are indoctrinated in the 'proper' way of healthy thinking.
Think that won't happen? Take a look at China. Obama has already proposed such a system of "mandatory" attendence. What do you think our public school system is now? It is a method of indoctrinating our children. People who have fought tooth and nail for home schooling recognize this.
The government already intrudes into what we can and cannot do in the privacy of our own homes and tells us what cars to drive, what lightbulbs to use and what temperatures we should be heating and cooling our homes to.
When the government owns the health insurance/care industry they OWN our bodies and we become nothing more than slaves and serfs to the government.
We no longer have free will.
Be afraid.
Obama has assured us again and again that multiple options will remain available, that there will be more competition instead of less, but I can't see how. A promise that anyone who prefers their current insurance can keep it is an outright lie if your employer drops the insurance you prefer.
The problem is that companies are already dropping insurance. These things that you seem to fear about rationing and employers dropping insurance are already here.
Obama (or Democrats) plan isn't perfect but they are actually trying to do something about problems that already exist. By demagouging every nuance, every change you ensure that nothing will ever get done. Do you think at any future point that there will be any appetite at all to fix this, even if its a plan that Republicans like, if you torpedo this, especially in the way that its being done? Do you think that after demagouging even minor changes to benefits that a Republican or Democratic Congress will ever be able to stomach touching Medicare or Medicaid? You should read David Frum's latest on the future of ANY health care reform in the future.
"tea bagger!!!!" - A stupid liberal named downtownlad.
Well if you listen to some of the past musings of some of Obama's administration members...say like John Holdren, well it it not so crazy.
Andrew Sullivan should also worry, perhaps his medical treatment is not cost effective for society either.
I guess it depends on who you want rationing your healthcare, a private insurance company or a government bureaucrat. Personally I'll take the insurance company every day. However, I do think we need some reforms, just not the complete overhaul proposed by Obama and the Democrats, who have repeatedly stated, on tape, that their ulitmate goal is a single payer system. So to have any real debate, we need to look at what's really being offered.
BJM said...
Rich,
why not download H.R 3200, it's free and read it for yourself, I am doing so this weekend.
Then you will know what is or is not in the bill and how it will affect your and/or your family.
Contrary to Congressman Conyer's smarmy retort it doesn't take two lawyers to understand the bill, just time, patience and mad indexing skilz. I haz them.
Good, so tell me where in the bill it says “If you are covered by the govt insurance option it will be illegal to pay for drugs or procedures denied by the govt.” Perhaps I was being too coy in phrasing the question as I did, so let me be clear: I have been through the whole thing and I am saying it is not in there. You are the one saying it is. All you need to do to prove me wrong is to cite the section of the bill which provides “If you are covered by the govt insurance option it will be illegal to pay for drugs or procedures denied by the govt.” I must presume that you had already assimilated that part of the bill when you made the unqualified affirmative statement in question, so that should not be too difficult.
Further to the previous discussion about redress and access to the courts re the public option, section 221(g) of HB 3200 provides for access to the federal courts for enforcement of rights under the same protocols currently used for Medicare. So it does provide for access to the courts.
There is a necessity here and only one solution to this argument: peaceful secession.
Those states that want all this socialist crap go there way and those that don't go the other way.
If we don't g the peaceful route of deciding to separate and the Democrats are bound and determined to inflict all of this on everyone, then what we are going to end up with in this country will make 1861 -1865 look like a pillow-fight.
There is a necessity here and only one solution to this argument: peaceful secession.
Those states that want all this socialist crap go there way and those that don't go the other way.
If we don't g the peaceful route of deciding to separate and the Democrats are bound and determined to inflict all of this on everyone, then what we are going to end up with in this country will make 1861 look like a pillow-fight.
"Good intentions are not enough" Amen. It is frustrating that there are always so many who are willingly and easily seduced by the siren call of socialism as a cure for society's problems no matter how many factual examples of its failure we have to draw from.
It seems several of the commenters here can't understand why, if we were good people, we would not just provide "free" care for everyone. I don't see much evidence that anyone here has actually worked with the poor who they seem to feel lack care. I have spent most of my career as a nurse and then a nurse practitioner working in public health, the portion of our health system that services the poor. The poor certainly do receive care and pay relatively little for it since they have no insurance premiums to worry about (you and I pay for that with our taxes) and rarely pay off the bills they incur for their care. One clinic I worked at had two full-time people whose only job was to find which pockets of government money we could use to pay for their care. One of their jobs was to enroll patients in Medicaid since many eligible patients simply did not bother to apply. Why apply for Medicaid when you get the care you need for almost nothing anyway and without the bother? And these patients include those irresponsible non-contraceptive users that MadMan is so worried about. "Uninsured" has almost nothing to do with "without care". The reality is in front of your eyes if you were just willing to spend four weeks working in public health. It certainly isn't a perfect system but when you are trying to provide a service for people who don't pay, you have limits.
Ann
Are you that naive?
Older Americans have Medicare. Are you aware that Medicare is run by the government? Are you aware of the success of Medicare? Or more importantly how much people like Medicare?
The alternative is that YOU have would have to pay all the costs out of your pocket. Do you want that to be the ONLY alternative?
What's more, NO ONE is FORCING you or anyone to take government run healthcare [or Medicare]. You can keep your own doctor and pay the high prices if you want.
Please look at the facts and stop using GOP talking points and rhetoric.
I don't see the problem.
Some of us told ypu what he would do.
You voted for him because if it.
Pray tell, are you worried because you got what you wanted?
How childiwsh.
@Bear, the question of secession was settled for all time at Appomattox Court House in 1865. There is no right of secession. Period.
The text of Section 1233 can be found here.
For me the scary amendment is the one that reads "IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment."
This amendment could be interpreted in a perfectly benign way, or it could be used to set up quotas for doctors as to how many patients they talk out of expensive medical care and into a hospice.
It's a path we've been down before, and hardly any of us want to go there again. Affirmative action wasn't supposed to introduce quotas, but for a long time it did just that. Title IX wasn't supposed to introduce quotas, but it has done precisely that. @Rich, you may be technically correct, but I suspect that what you are really doing is playing stupid lawyer games to lie.
And no one believes you.
The Bear says: "There is a necessity here and only one solution to this argument: peaceful secession. Those states that want all this socialist crap go there way and those that don't go the other way."
I'm tempted to call you a traitor for saying that states of the Union should secede for any reason, but instead I'll just chalk it up to a type of immaturity - the political equivalent of a whiny child wanting to take his ball and go home when he is losing a game (in this case, the electoral process). Perhaps you should change your moniker to The Baby.
Big Mike said...
It's a path we've been down before, and hardly any of us want to go there again. Affirmative action wasn't supposed to introduce quotas, but for a long time it did just that. Title IX wasn't supposed to introduce quotas, but it has done precisely that. @Rich, you may be technically correct, but I suspect that what you are really doing is playing stupid lawyer games to lie.
And no one believes you.
“Technically correct” but no one believes it. OK. The problem is that we are failing to distinguish between what HB 3200 actually does and what people are afraid it might lead to. Being against it because you are afraid of what it might lead to makes perfect sense to me (you see I do not presume bad faith on the parts of those who disagree with me or conclude on that basis that they are playing games or lying), but it is inaccurate to say, for example, the bill would force people to undergo end-of-life counseling or that it would make it illegal to pay for uncovered services out-of-pocket. I will not argue against what you are predicting will come of it, because I do not pretend to have a crystal ball. But I can read the proposed bill and I can see that the things people are saying are in there are not. Sorry if that seems dishonest on my part.
2. What I find offensive about Palin's comment is exactly what revolted me about the TV coverage of the Republican convention -- you know, the "pass the Trig around the stage" scene. To allow your own infant child to be used to score political points: this alone, in my books, renders her morally unfit for public office. And she keeps on doing it, then regularly complains when bloggers take shots at the very children that she has chosen to thrust into the public eye. Absolutely unbelievable!
And why should the Palins hide Trig away as though they were ashamed of him? Or perhaps you're suggesting that all politicians should refrain from featuring their families--in particular, children--at political events, yes? Do you think that family members sharing a stage with a candidate automatically qualifies them as targets for media potshots?
Many liberals are frankly disgusted at the thought of bringing a Downs baby into the world and they certainly don't want to be confronted with the physical consequences of such an ill-conceived choice. I think they think there oughta be a law and ObamaCare will get them that much closer.
"The problem is that companies are already dropping insurance. These things that you seem to fear about rationing and employers dropping insurance are already here."
And this excuses the lie, how?
You're telling me that the assurances that people can keep the insurance they prefer, assurances repeated over and over and over by our President, are *lies* but that it doesn't matter that he lies because we might lose the insurance we prefer anyhow?
We're being promised that with the NEW program that we can keep our present policies if we want to keep them.
That's a lie.
"Are you that naive?"
Are you?
"Older Americans have Medicare. Are you aware that Medicare is run by the government? Are you aware of the success of Medicare? Or more importantly how much people like Medicare?"
Several people have mentioned unfunded liabilities for Medicare. Could you tell us about those a bit? How much and how will those liabilities be met? Since your assertion is that Medicare is a wonderful success, I'm sure you know all about this.
Several other people have mentioned all of the various supplemental insurance available to the elderly so that they don't have to rely only on medicare which really doesn't cover everything.
Why would people want to pay extra on top of a great program that is free?
The answer is, that as much as they appreciate and *like* the Medicare coverage it's not adequate in and of itself.
@Rich, you and I are starting to agree on a few things. Dang!
Synova
I have seen Medicare work in my very own family. I also know many people who are very happy with the services they get.
Yes, Medicare is not perfect. But unless you are someone who can shell out a ton of cash no system is perfect. And studies have shown patients are more pleased in Medicare programs than they are with Private plans.
http://bit.ly/H0gRD
What gets me is the general misunderstanding of the health care debate. Conservatives tell us we won't be able to choose our own doctors. Guess what? On many private plans you can't choose your own doctors anyway because not all doctors accept all plans.
The scare tactics are way off base and are being used because the GOP realizes if Universal Health Care passes they will be out of power for a generation. You know it's true.
And in a couple years many of the Town Hall protesters will actually start using the Public Option - but some will probably not even know it is run by the government.
It exists, yes, but it's not as frightening because there really is more flexibility so it doesn't *feel* as implacable.
Would you really feel less fucked over because you were denied a lifesaving procedure by an insurance company than by a government option? I don't believe that for a second.
In fact, comparing the two types of coverage (using government insurance options from countries that have it) I've yet to hear of a situation where treatment is denied. OTOH it is fairly common to hear of lifesaving procedures being denied by insurance companies. Where a liver transplant is needed but denied because the suddenly it's considered 'experimental'.
What will be interesting is when a patient under private insurance coverage is denied a procedure that the public option would cover, and vise-versa.
And in a couple years many of the Town Hall protesters will actually start using the Public Option - but some will probably not even know it is run by the government.
Some are using a form of it now, that being, Medicade.
@Beau, the difference is that insurance companies decline to pay for certain procedures, regardless of the age or status of the covered person. What we find objectionable in HR 3200 is that some people may receive treatment and others may be denied based on age or other factors.
Big Mike said...
@Rich, you and I are starting to agree on a few things. Dang!
OK, try this on for size then.
1. No public plan.
2. Guaranteed issue: insurers can’t decline coverage due to pre-existing conditions.
3. Mandatory coverage: everyone has to have coverage (similar to auto insurance).
(Note the insurance industry has already signed off on this; they are willing to give up declining converge of sick people in exchange for the universal coverage mandate).
4. Some sort of appropriate subsidy so lower-income people can afford the required coverage (which would certainly cost less than HB 3200). And/or favorable tax treatment for employers who provide coverage.
5. Mandatory minimum level of coverage in policies, so insurers can’t get away with building in limitations and exclusions which would render the coverage illusory (indeed I think perhaps they should be treated much like public utilities, although I have not yet thought that one through completely). More comprehensive coverage at higher cost available at the insurer’s/customer’s options.
6. Meaningful enforcement mechanism to help keep insurers honest; i.e. no more immunity from liability for fraud and bad faith, etc.
There. Am I so unreasonable?
Rich:
How would you mandate coverage?
Via tax returns?
Or social security # since everyone does not file a tax return?
If soc sec, would that mean everyone would now have to file a "health coverage" affadavit of some sort every year?
Would you require hospitals to ID people for legal residence?
Would you cover illegal immigrants?
You can always buy more.
The rational argument: No matter how you implement public health care, there is nothing preventing you to buy additional services. My republican, Limbaugh-listening father suggested as much (to my suprise).
The reality check: Let us not forget to celebrate the kind, caring HMOs which we have now. They would never influence medical decisions by cost considerations. You never have to call them up, pleading with them to get approval for legitimate procedures - that's completely unheard of. That's what HMOs are like in magical fairytale land.
"She doesn't say that the government will kill disabled (or elderly) persons directly, but that death will occur as a result of the decisions of cost controlling bureaucrats with the power to determine who can receive various treatments."
Ann, you're describing our current system. Insurance companies already have death panels, with a long list of conditions for which coverage is denied. Under the planned reform, you will no longer be denied for pre-existing conditions.
AJ Lynch said...
Rich:
How would you mandate coverage?
Via tax returns?
Or social security # since everyone does not file a tax return?
If soc sec, would that mean everyone would now have to file a "health coverage" affadavit of some sort every year?
I haven’t thought to this level of detail. I honestly don’t know how implementation might look. Certainly for the majority of people tax return time would be as convenient a time to confirm coverage as any. The insurers might also report SSNs of those whom they cover, and that could be cross-checked against all SSNs to see who is missing. But I honestly don’t know – I would bet someone smarter than me could come up with something workable though.
Would you require hospitals to ID people for legal residence?
If it were up to me yes I would, although that should not be a basis to deny critical or emergency care. I am not sure this necessarily needs to be a part of a health care bill, although I do agree it needs to be addressed at some point.
Would you cover illegal immigrants?
No. Or, more accurately, I would cover them only if doing so involved, say, an overall cost savings. Point is anything I would do for illegal immigrants I would do because it was better overall, and not out of concern for their well-being, other than critical and emergency care situations. It might be cheaper to cover them than to have them go bare and deal with them when they show up in the ER; I am not saying I know how it cuts only that we should do what is good for society, and if they end up with some benefit due to that it’s just an incidental by-product. Also I think this question is subsumed in the larger question of how to handle them generally. If we decided on mass deportation, for example, it moots the issue. If we consciously determine to keep them around I think it would behoove us to decide how they are treated and what we do about their various contributions, needs and such. When it comes to immigration policy I do not believe I am well enough informed to have an intelligent opinion.
Rich:
As they say, facts are stubborn things. I saw this comment (see below) somewhere else on the internets:
"Do you REALLY think the 12-20 million illegals ought to be our concern? What about young people who don't need insurance and opt out voluntarily? I guess that is the plan - force people to pay more for those who shouldn't be in the system anyway.
Another lie I am tired of - the "rankings" that say our system is 30th or 40th or whatever. Those numbers are not normalized for the health habits of our population vs. others. I lived in Denmark awhile, I am sure it is one of those countries "ranked" ahead of us. Well, the average person in Denmark probably weighs 30 lbs less than the average American. That sort of thing isn't factored in when people argue that our life expectancy being lower somehow equals worse health care.
Go to the Canadian border. Which way are people seeking health care procedures going?
gthog61, Dallas, TX"
@Jack, the answer to you is in my post at 3:36. Try reading a bit before regurgitating Democrat talking points.
Rich,
Can you find any provision in the bill for fee-for-service outside the national health care system? Perhaps I misunderstood or my indexing skills aren't quite as mad as advertised and I missed a section, could you provide a cite?
(I learned long ago that what is not explicitly detailed in a contract can be far more important than what is.)
Other questions I cannot resolve in the the bill:
1. If I opt out of national health coverage and pay the 2.5% tax on my gross income am I still required to accept a National Health Care ID card? If so for what purpose as I already have a SS#, passport and state ID.
2. Can I access services/drugs without the ID card?
3. Will Medicare be morphed into an Exchange plan and effectively cease to exist?
4. If so what becomes of the established body of law, regulations, controls and administrative procedures?
6. If Medicare remains a stand alone program will payroll deduction funding continue? How will pending shortfalls in the trust fund be addressed?
7. If Medicare remains intact will current and scheduled deductibles, access restrictions and copays remain the same?
8. From whom will I buy medigap insurance? I see no provision for supplemental Medicare coverage.
Obama promises that I can keep the Anthem PPO plan I currently have, but the bill doesn't square with his statements; again a few questions:
All private plans must be entered into the Health Care Exchange where plans, benefits, deductibles and premiums are to be regulated by a health care board.
1. Does this mean my current PPO plan will be morphed into a govt structured plan?
2. Will a menu of govt formulated plans be the only options?
3. Will benefit schedules and/or HHS regulations create ipso facto control of diagnostic facilities and hospitals? (Mayo seems to think so.)
Rich, another question, if all non-citizen residents are covered will illegals be issued a national health card ID card?
Millions of cloned/stolen SS#'s are being used illegally by both citizen scofflaws and illegals.
The employer audits and a national health care ID card would expose illegal use of SS#.
One can envision the civil rights issues that will arise from employer audits alone. How will we convince illegals to come forward and trust the govt when their experience with INS has been such a disaster for all concerned.
Another area of concern is the cash economy, millions of Americans live under the radar, paying little to no taxes, do not have bank accounts or credit. How will they be brought into the system?
the difference is that insurance companies decline to pay for certain procedures, regardless of the age or status of the covered person. What we find objectionable in HR 3200 is that some people may receive treatment and others may be denied based on age or other factors.
Is this an actual fact or what you fear that it may happen? If a fact, then I understand, I guess.
Okay , so you'd feel better about your child being denied a liver transplant on the false premise that the procedure is experimental but would have a problem with a public option denying the same procedure to an aged parent?
Given the choice, if you are correct that this is eligibility criteria for the public option, I'd go with the public option if it meant my child living to adulthood.
My mother who lives in New Zealand where health care is funded through taxation, similar to Canada, with independent physicians and hospitals, fell ten days after her 100th birthday, breaking her hip. I did wonder if her age would impact her medical treatment. This has not been the case at all. She received the best of everything, had surgery with full hip replacement, and rehabilitation.
I tell you this only to reassure you that public options in other countries are pretty decent.
Good article, Ann.
By the way, they are coming to kill us. Haven't you seen the FEMA camps, ads for internment staff by the armed forces to man them, the million coffins prepared for American citizens, and the government checking with cemetaries for mass grave sites??
Haven't you heard about the govt wants the army to force you to take "vaccinations" this fall - unsafe, untested vaccinations tainted with mercury and potentially capable of killing us??
I know that's not on the nightly news. It's taboo speech. Must speak doublespeak. Please don't look at factual evidence. No, speak doublespeak and call the truth - so easily documented if a person just looked - a "conspiracy theory".
It's 1984.
Palin's DS child is eligible for state and federal assistance from medicaid to disability to state programs AND her husband makes Trig eligible for free medical and dental care because he has 1/8 native blood.
Next hyperbolic claim?
Emmanuel does not advise President Obabma on Healthcare Issues. Medicare is a Government RUN program. We pay for it but the Government RUNS it. Yes, there is corruption in the Medicare program, people scamming to get payments from the Government, etc., but to say that it is completely corrupt is UNTRUE. If it were as corrupt as detractors are saying it is then the over 70% of seniors who say they are happy with it would be lying, and I don't think they are. My problem with Sarah Palin's post is that she is posting things that are simply untrue, there are no such things at Death Panels in the current bills in committee. She is playing politics and her only concerns seems to be to keep her name in the spotlight and to ramp up already anxious people in order to kill this legislation before it has a chance, solely for the chance to damage Democrats. If she and the detractors in the Republican Party are so concerned about what is being considered then pray tell where is their proposal? She is contributing nothing constructive to the debate and therefore should be ignored. And anyone who thinks that our government would openly advocate the abortion of babies simply because of abnormalities such as Down Syndrome should take a step back and calm down. NO ONE, and I mean NO ONE, in this country should believe that the citizens of this nation would allow such a thing to be done. Just because we have a President you didn't vote for in power does not mean that the Citizens of this Country do not still have a say in what their Government does. No laws have been considered or enacted that infringe on your Civil Rights since Obama took office. You are simply overreacting and need to calm down and actually take a rational look at what exactly has been done and is being considered. If you don't you will allow yourself to be lead by emotion rather than rationality.
Palin had her own Death Panel and the "Feds" had to shut down medicaid in Alaska to fix her mismanagement:
From the Alaska Daily News:
While under contract to govern the state of Alaska, Palin’s administration failed to keep up on the state’s Medicaid obligations and were ordered to cease signing up new patients. No other state in the country had been put under such a moratorium, according to the federal Centers for Medicare & Medicaid Services.
July 14, 2009 ADN:
A particularly alarming finding concerns deaths of adults in the programs. In one 2 1/2 year stretch, 227 adults already getting services died while waiting for a nurse to reassess their needs. Another 27 died waiting for their initial assessment, to see if they qualified for help.
Doctors and other health care providers wrote to the Centers for Medicare & Medicaid with concerns that the state wasn’t responsive. Some alleged that the lack of state controls “has resulted in the death(s) of the active clients,” the federal review said.
While the people served are frail and suffer from chronic health issues, the state never investigated to determine if any failure in service contributed to the deaths, the federal review found.
Peter Singer, the famous Princeton professor of bioethics, has an essay in the NY Times magazine explaining why healthcare should be allocated according to quality-adjusted life-years.This is the basis of the quality-adjusted life-year, or QALY, a unit designed to enable us to compare the benefits achieved by different forms of health care. The QALY has been used by economists working in health care for more than 30 years to compare the cost-effectiveness of a wide variety of medical procedures and, in some countries, as part of the process of deciding which medical treatments will be paid for with public money. If a reformed U.S. health care system explicitly accepted rationing, as I have argued it should, QALYs could play a similar role in the U.S. He gives the example of a drug called Sutent that slows the spread of kidney cancer and may give victims an extra six months of life, but at a cost of $54,000. He argues that the rest of society should not be burdened with that cost when the same money, spent elsewhere would do more good. In making this argument, Singer ignores the role of innovation in a free market.
It certainly doesn't cost $54,000 to manufacture enough Sutent to treat one patient for six months. The $54,000 has to cover the development cost of the drug, which could be tens or hundreds of millions of dollars, and the loss of profit when the patent on the drug expires and cheap, generic versions flood the market. Now, obviously, the cheap generics do not pose the same ethical quandary as the expensive proprietary version. It benefits society to have cheap generic drugs instead of hugely expensive proprietary drugs developed by the pharmaceutical industry. But the point the Singers and Ezekiel Emanuals of this world don't understand is that you can't get cheap generic drugs without first developing the expensive proprietary drugs. Pfizer would not develop Sutent unless it could recoup its R&D costs, FDA approval costs, etc. etc. and make a profit. And if Pfizer did not develop Sutent, there could be no generic version to follow. Moreover, developing Sutent likely opened other research avenues for developing even better drugs.
One could make the moral argument that is is better for society to invest in expensive drugs today so that it can get cheap drugs tomorrow. The US does that today. The rest of the world benefits, as US drugs are sold at marginal cost to socialist systems that fix prices, and as US drug patents expire.
The same argument applies to other areas of medicine. The initial costs of developing new treatments are high, but costs come down as the treatments become routine. The moral universe of Professor Singer ignores the beneficial impact of profit and innovation in a free market.
"I don't know why "level of productivity in society" is in quotes, nor do I know whether it is the plan to ration care on this basis."
It is not the plan to ration care on this basis. Now that you know that, you can update your post accordingly.
It's not just Obama's comments, but those of people associated with the admin as regards the "appropriate" way to ration care. Rahm Emanuek's brother Ezekiel has written on this, Obama sounded like he was echoing him, and it's not pretty. And let's not leave out their old buddy Pete Singer.
A key part of the admin's proposals is a commission responsible only to the making decisions on what is and is not covered for treatment. Palin's fears are perhaps remote, but hardly unjustified.
Legal Insurrection has more.
On Healthcare Costs and Deaths:
I grew up in the US and have also lived for an extended period in Britain, wehre there is a universal free healthcare system.
Sarah Palin talks about the issue of rationing care under a government system of expanded healthcare, and concludes that the weakest in society, such as her son with his serious health condition, won't get treatment and will therefore face shorter life expectancy, that they'll die.
It is worth pointing out that under the current system, on private healthcare, able bodied people are actually dying, or having to lead lives of real suffering because they got pricely that, a type of rationed healthcare: insurance, and this is something the economist who wrote in on her Facebook page also will know, because all economists receive this as part of their "basic training", insurance, in markets, have a difficult time insuring bad risks, meaning, people who need continuous high cost care, like Palin's son. Insurance companies make money off healthy people and people without chronic conditions like Palin's son, because they don't make claims. In addition, and this is really the key point, as it stands in the US, because healthcare insurance in private, the required level of coverage to make health standards claimed by developed countries possible is unaffordable - that is to say, the standard level of care I get in Britain by paying taxes appears to be out of reach to at least 50 million Americans. More critically still, even if you can afford good coverage in the US, it can be withdrawn: the case of an American woman, an educated professional, came down with cancer, had it treated, it went away, but sometime later it came back. Her insurance company refused to cover her the second time round. She ended up exhausting all her savings. In another still more shocking case, that makes you wonder whether the US is a developed country, a woman with serious head injuries was being denyed full emergencey room care because because she was not insured. She had to beg the ER doctor to give her a scan, which revealed that she had a serious internal injury that required immediate attention.
So it's clear that if the discussion on healthcare wants to turn to questions of unfair care provision killing people, there is no shortage material. So far, with my living in Britain, where healthcare policy is one of the top political issues for the British public, I haven't heard any stories of children like Ms Palin's dying for want of care due to costs. Where there is a debate in Britain about care costs is when it comes to fertility treatment which is often not very successful, and costs, when there are more pressing life or death conditions to treat.
What I find deeply troubling is that often when a necessary social policy discussion begins in the US, many of the participants bring in what can only be described as uninformed and easily discredited arguments, and in the case of refering to a "death panel", when the President is sincerly trying to help people who really are suffering due to lack of healthcare, is straightforwardly dishonourable behaviour. It seems as if Gov Palin is not capable of contributing meaningfully to public debate on such a serious issue. She also demeans her office, the quality of public figures should be higher, she should be raising the bar.
Wow, look at all these Fish Squadders coming out of the tidepool. Who's paying you guys? You've never been here before, half of you, and you'll never be back after you have done your best to beat any dissenting opinion into the ground.
My only question is, who ratted out Althouse to flag@whitehouse.gov, or is she already on some list? I don't go for Christianity much but:
JUDAS!!!
"we're not going to solve every difficult problem"
Obie, you can't even tie your own freakin shoes. If you believe we are gunna trust you with quality of life decisions, for AMERICANS. Then the applique deranged, is no longer hyperbole.
Get out of our hospital rooms. Out of our business'. Out of our lives. Just get the f*ck out.
WOW!! Althouse, what you've just said is one of the most insanely idiotic things I have ever heard. At no point in your rambling, incoherent writing were you even close to anything that could be considered a rational thought. Everyone who read this is now dumber for having read it. May God have mercy on your soul.
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