False charges about Obamacare don't help.
Like the end-of-life tempest. Former Alaska Gov. Sarah Palin
popularized the term "death panels." She said: "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".
The charge that the House and Senate health care bills would
mandate end-of-life counseling hence "death
panels" caught on. Rush Limbaugh, defending Palin's charge, said,
"(D)eath panels … it's a great way to phrase this end-of-life counseling".
Republican Sen. Chuck Grassley of Iowa piled on: "You have every
right to fear. … We should not have a government program that determines
if you're going to pull the plug on grandma".
But no bill in Congress mandates end-of-life counseling, much less "death panels." And there's a deeper
problem. When opponents of nationalization make such easily refuted charges,
supporters of nationalization gain the upper hand. All criticism is
undermined. Neutral observers can easily conclude, "If the death-panel claim
is false, why believe anything else the critics say?"
That would be a disaster.
There's is reason to be concerned about end-of-life counseling,
but the truth is more complicated. Here's the story.
The House bill does deal with the issue. (The Senate Finance
Committee bill did until the provision was removed the other day.) Section
1233 amends the Medicare law to add "advance care planning consultation"
(counseling about living wills and the like) to the list of reimbursable
The provision defines "consultation,"
but nowhere does it require Medicare beneficiaries to participate or
authorize death panels. (Grassley voted for a similar provision in 2003 when
his Republican-controlled Congress added drug coverage to Medicare.)
But even if some conservative Republican critics are wrong about
Section 1233, there is good reason to worry about Obama's nationalization
The reason can be found in Econ 101. Medical care doesn't grow
on trees. It must be produced by human and physical capital, and those
resources are limited. Therefore, if demand for health care services
increases which is Obama's point in extending health insurance prices
must go up. But somehow Obama also promises, "I won't sign a bill that
doesn't reduce health care inflation".
This is magical thinking. Obama,
talented as he is, can't repeal the laws of supply and demand. Costs are
real. If they are incurred, someone has to pay them. But as economist Thomas
Sowell points out, politicians can control costs by
refusing to pay for the services.
It's called rationing.
Advocates of nationalization hate that word because it forces
them to face an ugly truth. If government pays for more people's health care
and wants to control costs, it must limit what we buy.
So much for Obama's promise not to interfere with our freedom of
This brings us back to end-of-life consultation. As the
government's health care budget becomes strained, as it must and, as
Obama admits, already is under Medicare the
government will have to cut back on what it lets people have.
So it is not a leap to foresee government limiting health care,
especially to people nearing the end of life. Medical "ethicists" have long
lamented that too much money is spent futilely in the last several months of
life. Are we supposed to believe that the social
engineers haven't read their writings?
And given the premise that it's government's job to pay for our
heath care, concluding that 80-year-olds should get no hip replacements
makes sense. The problem is the premise: that taxpayers should pay. Once you
accept that, bad things follow.
In the end, perhaps the biggest objection to nationalized health
care is the "principal-agent problem." For whom does the doctor work?
Ordinarily, the doctor is the agent of the patient. But when government
signs the checks and orders doctors to reduce spending, it is not crazy to
think that this won't influence their "advance care planning consultation".
Freedom is about self-determination. Obama's health care scheme
would undermine both.