Dr. Krauthammer, on the “Death Panel” Allegation

by Little Miss Attila on August 21, 2009

I do adore Krauthammer. I know that some consider him to be a part of “the D.C. establishment,” and characterize him as one of those conservatives who Want To Be Liked by the Liberal Literati, but I’ve never seen it that way, even when I disagree with him, which happens a fair amount.

And his voice is even more important now in the healthcare debate, as he has been a practicing physician; he knows the drill. And he knows medical malpractice costs, one of the driving forces behind skyrocketing medical costs.

Now, after acknowledging Sarah Palin’s “political talent,” but asking her to please “leave the room,” he gets down to brass tacks about Section 1233 of H.R. 3200, brushing the issue of living wills aside as an unhelpful red herring—after all, you’ll be making your own end-of-life decisions, and if you are too incapicated to do so, your family will do so, based on knowing you, rather than the mood you happened to be in one day in your attorney’s office some years back:

Except for the demented orphan, the living will is quite beside the point. The one time it really is essential is if you think your fractious family will be only too happy to hasten your demise to get your money. That’s what the law is good at — protecting you from murder and theft. [Editor’s note: or interminable arguments between different loved ones who cannot put their own philosophies aside.] But that is a far cry from assuring a peaceful and willed death, which is what most people imagine living wills are about.

So why get Medicare to pay the doctor to do the counseling? Because we know that if this white-coated authority whose chosen vocation is curing and healing is the one opening your mind to hospice and palliative care, we’ve nudged you ever so slightly toward letting go.

It’s not an outrage. It’s surely not a death panel. But it is subtle pressure applied by society through your doctor. And when you include it in a health-care reform whose major objective is to bend the cost curve downward, you have to be a fool or a knave to deny that it’s intended to gently point the patient in a certain direction, toward the corner of the sickroom where stands a ghostly figure, scythe in hand, offering release.

There is another way to put it, and I think I can get by with this as a person who would like abortion to be statutorily permitted, but very much reduced, and who feels that many women are hustled into abortions for no good reason whatsoever: if the state were mandated to pay for counseling that explicitly were to include (1) the option of making an adoption plan, with all the practical details that entails; and (2) the resources available to single mothers—how would you feel about it? (“You” here being my family and my high school/college friends, most of whom roam leftward in the grand American political landscape.)

You would be concerned that the counseling wouldn’t be neutral, right? You would worry that the woman or girl might be pressured.

And that has been the concern with Section 1233 and similar provisions. Whatever one thinks of Governor Palin’s rhetorical methods, she certainly got people to think about the issue.

Meanwhile, Mrs. Palin is on to the next issue, which is a pet peeve of mine, along with Medicare and Medicaid reform—what gets me all squeaky and shrill is the notion that the Feds can reduce costs across the entire medical establishment while doing more expensive things for more people, but there won’t be rationing. And instead of demonstrating with Medicare, Medicaid, the VA and medical services to the U.S. military that they are capable of controlling costs and then extending that to the rest of healthcare, they would like to simply give them control over it now.

It’s as if a 12-year-old, instead of asking for an allowance, were to explain that it’s time for her to live on her own now, and she’d like you to pay her a stipend so she can get her own apartment. And she’ll be fine: she knows how to bend the cost curve downward, after all. Why are you balking that way?

But now Sarah Palin has gone on the offensive, and is articulating an alternative vision of what conservative healthcare reform would look like. Naturally, it includes tort reform, which Krauthammer himself has advocated.

So one would hope that the two of them have kissed and made up.

h/t for both Palin and Krauthammer: Hot Air.

{ 4 comments… read them below or add one }

Peter August 21, 2009 at 5:22 pm

If only Sarah had graduated from Vassar or Smith or one of those other elite schools she would be a heroine. Instead she has a western twang to her speech and she (gasp) identifies with the people these elites claim to lead. None of them, Krauthammer included, can stand it when ordinary people say that we’re doing just fine and do not need to be led by you. Why the next thing you know, ordinary people will want to come in the front door of our clubs.

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Azmat hussain August 22, 2009 at 12:35 am

Bring Cheney Back I hear he was involved with Benazir Bhutto.

http://www.chowk.com/gallery/1794/51098

Cheney for 2016.

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Helian August 23, 2009 at 4:06 pm

You have to be careful when you say malpractice lawsuits drive up health care costs, because the trial lawyers will just cite reports like this one by the CBO,

http://www.cbo.gov/ftpdocs/49xx/doc4968/01-08-MedicalMalpractice.pdf

and say, “see, these lawsuits account for less than 2% of the total.” In fact, it’s irrelevant to compare malpractice costs to total healthcare costs, because they only effect a fraction of those expenditures; namely, physicians and clinical expenses. They are a very substantial fraction of those costs, driving them up substantially. For the lawyers to claim that they only account for less than 2% of the total makes about as much sense as if a common thief (with whom they are closely related) justified his crimes by claiming they only represent a tiny fraction of the overall defense budget. The comparison is similarly irrelevant.

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Foxfier August 23, 2009 at 6:28 pm

Helian-
that’s also, less inflamitorilly (;^p) like saying “lawsuits of one driver against another are only a tiny fraction of the costs of buying and owning a car!” It totally ignores the money spent on insurance, that insurance pays without going to trial, that car companies spend to defend against lawsuits, all kinds of things…..

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