The Jury Talks Back

8/12/2009

Death Panel?

Filed under: Uncategorized — Fritz @ 3:46 pm

In The Daily Beast article “Obama’s Euthenasia Mistake”, Lee Siegel makes the case that anti-Palin hysteria aside, the notion that the only effective way to reduce health care spending is to limit access to health care isn’t too far off the mark:

Make no mistake about it. Determining which treatments are “cost effective” at the end of a person’s life and which are not is one of Obama’s priorities. It’s one of the principal ways he counts on saving money and making universal healthcare affordable.

Siegel also connects the helaht care reform project to the writings of President Obama’s University of Chicago colleague Judge Richard Posner.  Siegel writes,

Judge Posner is both an enthusiastic advocate of euthanasia and an energetic eugenicist. He once wrote of Oliver Wendell Holmes’ ideas about eugenics—Holmes believed that a just society “prevents continuance of the unfit”—that “we may yet find [Holmes’] enthusiasms prescient rather than depraved.”

Cass Sunstein, who is Obama’s nominee for regulatory czar, is a disciple of Posner and believes in what Time magazine describes as “the statistical practice of taking into account years of life expectancy when evaluating a regulation.” In other words, Sunstein believes that the lives of younger people have a greater value than those of the elderly. This, obviously, would have a radical bearing on end-of-life considerations.

At Real Clear Politics, Eugene Robinson has a very good piece called “A Reason Behind the Rage” which I highly recommend.   Robinson’s point isn’t that opponents of Obama’s plan are evil, stupid, or dupes, it’s that the President hasn’t done a very good job selling it.  Robinson writes,

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.

The unvarnished truth is that services are ultimately going to have to be curtailed regardless of what happens with reform. We perform more expensive tests, questionable surgeries and high-tech diagnostic scans than we can afford. We spend unsustainable amounts of money on patients during the final year of life

What I haven’t seen much of, and this may be my own fault, is a discussion of how health insurance ought to function.  In a perfect world, how should we expect these businesses to be structured so as to make money and yet deliver services?

What I do know, when considering the argument regarding “greedy” insurance companies who don’t have the patient’s interest in mind, is that government bureaucracies are an interest too, and their goal is to expand their power.  We can hope that through effective regulation it’s possible to marry this impulse to what’s good for the American people, but, if history is any guide, I wouldn’t hold my breath.  In fact, in many ways a bureaucracy is more dangerous, insofar as they are structurally separated from any sort of direct political pressure (a feature, not a bug, for Progressives FWIW).  Theoretically, if not practically, you can switch insurance companies.  Politicians are responsible to their constituents.  Insurance companies can be sued and they can lose customers.  Government bureaucracy is notoriously insensitive to reform.


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