Death Panels? What Death Panels?

[dreadfulpenny81.livejournal.com]

During the heated debate last summer over the proposed health care legislation, Sarah Palin and Barack Obama kept bringing to the media the phrase 'death panels', groups of people that would decide whether or not to "pull the plug on Grandma". While Palin was misguided in her analysis (as she was trying to say that end-of-life care or the living will system was the 'death panel' when it actually wasn't), she may not have been entirely off-base.

Stories have been featured recently through several media outlets of patients in Arizona and Indiana who have been denied life-saving surgeries in the past several weeks and months due to cuts in state Medicaid budgets. In Indiana, a six-month old infant named Seth Petreikis has complete DiGeorge syndrome. A surgery that was deemed "experimental" by Medicaid was denied to him, but the company that manages Indiana's Medicaid program has offered to pay for the surgery themselves. [Source]

In Arizona, 98 people who were already approved for transplants were later told they couldn't receive the surgeries because of recent cuts to Arizona's Medicaid budget. One man was set to receive a new liver, which was donated to him by a friend who'd recently passed away. Because he couldn't pay for the $200,000 surgery, the liver went to another patient. [Source] The reason for this? On October 1, 2010, the state of Arizona removed transplants from a list of medical services that can be funded through the Arizona Health Care Cost Containment System (AHCCCS). Keith Olbermann is asking viewers of his show Countdown to donate in the hopes of funding the transplants. Meanwhile, Democrats in Arizona are now using the 'death panel' analogy as an attack against Gov. Jan Brewer and Arizona Republicans, who agreed to Medicaid cuts to balance their budget, despite protests from Democrats. [Source]

The 'death panels' Palin referred to have little to do with federal government action and more to do with state government blunders. There should be some legislation on the table to mandate organ transplant surgeries be paid for through all health care providers, public and private.Transplant boards are still necessary to sort through the amount of transplant candidates but at least someone who's promised a chance at renewed life wouldn't have to worry about that promise being taken away.

Comments

No such things as a free organ transplant

[ed-rex.livejournal.com]

I live in Canada, where major medical care is "free" — that is, when an irate drunk shattered my right orbital bone a few years back, I went to my doctor who took one look at me and sent me to Emerge. From there I was soon in company of a specialist who told me I'd be staying in the hospital until they found a space in the operating room for me. Took another two days.

But, that doesn't really address the issue you not really addressing in your post. Namely, that any medical system has limits.

We live in a world of finite resources and no system will provide organ transplants to any and everyone who wants/needs one.

The public/private debate really boils down to this. Do you want the decision to rest in the hands of an anonymous financial agent who is responsible (ultimately) to his or her share-holders, or do you want it in the hand of a civil servant who is responsible (ultimately) to you as a voting citizen?

Hard decisions will still have to be made, but I know I trust people I can vote out of office a little bit more than whoever it is that is looking at the three-month bottom line of Aetna.

Re: No such things as a free organ transplant

[a-new-machine.livejournal.com]

Yep. The "death panels" thing is already going on in the US. It's just decisions being made by insurance companies with varying levels of risk-tolerance and profitability, and incentives that encourage them to do less rather than more.

Re: No such things as a free organ transplant

[merig00.livejournal.com]

The public/private debate really boils down to this. Do you want the decision to rest in the hands of an anonymous financial agent who is responsible (ultimately) to his or her share-holders, or do you want it in the hand of a civil servant who is responsible (ultimately) to you as a voting citizen no one?

fixed that for you.

An Aetna clerk that denies your request is as nameless and has no responsibility as Medicaid/Medicare clerk that denies your request.

Re: No such things as a free organ transplant

[rasilio.livejournal.com]

That's funny I don't remember voting for medicare adjudicators.

Oh that's right, they are not elected positions and as they are protected by a union the elected officials can't even fire them.

I mean really, the idea that a Civil Servant is actually beholden to the public. Next thing you know you'll be telling us that corporations hate regulations.

Re: No such things as a free organ transplant

[mrbogey.livejournal.com]

'The public/private debate really boils down to this. Do you want the decision to rest in the hands of an anonymous financial agent who is responsible (ultimately) to his or her share-holders, or do you want it in the hand of a civil servant who is responsible (ultimately) to you as a voting citizen?'

A private insurer can lose your business if you find out they're not keen on certain procedures. Good luck getting another government.

Re: No such things as a free organ transplant

[jerseycajun.livejournal.com]

"or do you want it in the hand of a civil servant who is responsible (ultimately) to you as a voting citizen?"

Politicians aren't any more connected to your medical situation simply because of a vote. The myriad of political and structural mechanisms between him and you are too much to expect the accountability desired.

Now, insurance companies it can be argued aren't really all that much better in that regard. This is true.

The problem is that in many ways we are over-insured. The third-party payer (whether public or private) skews and/or destroys the natural mechanism which brings down cost and increases availability to more people. Insurance for anything should be the weapon of last resort, saved for only truly high-end procedures. Instead we expect insurance to cover treatments for both the mundane and the exceptional, so essentially there is no longer a financial relationship between the person most directly responsible for delivering medical services (the doctor) and the person most responsible (otherwise) for payment, the patient. When those two are reduced to dealing only with one another, there is a much greater motivation to work with one another to come to a price that the doctor can live on and the patient can afford. It's this process, repeated countless numbers of times which allows any market to function as intended.

Re: No such things as a free organ transplant

[mijopo.livejournal.com]

but in fact, I think you misrepresent the situation in Canada. How frequently do civil servants intercede in medical decision making in Canada? Well, it must happen, but I've never heard of it, I've never heard of OHIP or Health Canada saying "no" to a doctor's recommended medical procedure, nor even of subjecting it to review. But have I ever heard of a US insurance companying vetoing a doctor's recommended procedure? Why yes. Three times in the last fucking year within my family as a matter of fact.

Re: No such things as a free organ transplant

[mybodymycoffin.livejournal.com]

A+, and bonus points for ending the post with the first comment.

[http://users.livejournal.com/-wanderer-/]

Why should the government be able to rob someone of their hard-earned money to pay for someone else's transplant?

[http://users.livejournal.com/-wanderer-/]

Sarcasm aside, I agree and disagree. Transplants are a great miracle of modern medicine and should be encouraged, but people tend to pay so much attention to flashy technology. In a world of limited resources, where we can be sure that something will get the short stick (whether it is the government or a private insurer handling it), I am not sure that transplants should be highest on the list. Take some of that money and attract physicians into primary care and work on retaining nursing staff in hospitals, and you'll save a lot more lives.

That isn't to say I am against transplants or anything, just that people like them a lot because they provide an emotionally compelling narrative. I also realize that they aren't spending that cut money on the above things necessarily, I just thought it was interesting that you would say "There should be some legislation on the table to mandate organ transplant surgeries be paid for through all health care providers, public and private" as if this were the most important thing to be spending our money on.

Except of course she was raving incoherently

[fizzyland.livejournal.com]

Palin: Obama's "Death Panel" Could Kill My Down Syndrome Baby

Re: Except of course she was raving incoherently

[usekh.livejournal.com]

Not to mention that other commentator talking about how Stephen Hawking would have been killed off under socialised Medicine :)

Re: Except of course she was raving incoherently

[dreadfulpenny81.livejournal.com]

I mentioned that in the OP:

While Palin was misguided in her analysis (as she was trying to say that end-of-life care or the living will system was the 'death panel' when it actually wasn't), she may not have been entirely off-base.

Let me fix that RAGE RAGE RAGE for you

[reality-hammer.livejournal.com]

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.

—Sarah Palin (http://www.facebook.com/note.php?note_id=113851103434)

Contemporary and subsequent events have proven this statement to be true.

[malasadas.livejournal.com]

The "Death Panels" meme -- constantly in search of validation. I think this meme really needs to seek counseling because the persistent public effort to justify itself just isn't healthy. I keep hearing rumors that death panels is sleeping around with the football team too.

[malasadas.livejournal.com]

Oh, and by the way -- this once again, has bupkas to do with "death panels". This has to do with the fact that medicaid is federally mandated but largely paid for by the states -- most of which are in fiscal crisis and none of which are able to float deficits like the federal government can.

This bears as much resemblance to the 2009 "death panels" meme as a toilet bears resemblance to cotton gin.

[dreadfulpenny81.livejournal.com]

Oh, and by the way -- this once again, has bupkas to do with "death panels". This has to do with the fact that medicaid is federally mandated but largely paid for by the states -- most of which are in fiscal crisis and none of which are able to float deficits like the federal government can. No duh! Really? That was the whole point in the first place.

This bears as much resemblance to the 2009 "death panels" meme as a toilet bears resemblance to cotton gin. I know. The title of the post is meant to be sarcastic.

[underlankers.livejournal.com]

Love how you ignored that the medical insurance companies promised to obey all parts of the new Healthcare law and then with all their usual shame and self-consciousness broke every bit of that promise. Not that one should expect honesty from the "God picked out my curtain colors" crowd.

[dreadfulpenny81.livejournal.com]

What are you babbling about?

[anosognosia.livejournal.com]

We Canadians know the rest of the world looks down on death panels, and so we pretend that we don't have them up here, but the facts is we've used death panels for decades and they work great. At first we were worried about leaving so much power in the hands of the government, so for a few years we had them all organized in a grass roots manner. Everyone in a given city would write someone's name on a shard of broken pottery, and whoever got the most votes, well... But this was really time-consuming, so eventually we just let our MPs form a committee which took care of the whole thing for us. Again, you'd think that would be a source for worry, right? But you know politicians... within a few months euthanasia was a tool for getting bills passed. Some pesky independent holding up your new budget? Hmm... better review the stats on his health care costs, oh what's this? He's a smoker? Yeah, we as a society can't insure that risk. Assemble the death panel!

So the whole thing works great, we're passing more legislation than ever--our government is like a finely oiled machine--and every couple months we get to off some politicians. Win-win.

Win-win, yes - until you had to expose the damned secret!

[ed-rex.livejournal.com]

You realize, of course, that until you've experienced the joys of death panels at first hand, they sound kind of fishy?

Now, because of your intemperate voice, our southern cousins are sure to continue in their sad and heathen ways!

Re: Question for OP

[ed-rex.livejournal.com]

Thanks - it's a colour-manipulated photo I took of Toronto's Queen Street West, from the north on John Street.

[reality-hammer.livejournal.com]

It's as easy for government empowered entities to draw arbitrary lines for (non) treatment as it is for government empowered entities to spend other people's money.

[light-over-me.livejournal.com]

Well 'death panel' is a sensationalized way to phrase it. It's not that literal. But whether it's a private company or the government someone's going to have to manage available funds and resources, and make the hard decisions about what's covered and what isn't.

The thought with private care is that, potentially, if one company denies you coverage for something, you could at least theoretically try another competing company...and keep shopping around until you find one who give you a better deal. If there is one single centralized authority, however, that makes this shopping around more difficult.

Now, take for example, the recent controversial government recommendation about mammograms: http://www.scientificamerican.com/blog/post.cfm?id=government-panel-recommends-fewer-a-2009-11-17

Suppose, based on this, government run health care programs decide to stop covering mammograms and breast cancer screening under the age of 50.

These are the types of 'panels' people are talking about.

[paft.livejournal.com]

I could just as easily ask what's to prevent someone from shopping around for a private company if the government disallows the aid?

I'd love to hear you explain to some of the people who now find themselves cut off from the transplants they need to live that they have to die in order to save the state money.

[penguin42.livejournal.com]

Well good thing the budget for medicaid is going up in the health care legislation.

[paft.livejournal.com]

http://thinkprogress.org/2010/12/14/brewer-medicaid-money/

“How many people have to die before you are prepared to reverse your decision on the transplant operations?” seemed like the obvious question.

She (Brewer) said she thought that was unfair and started to explain how dire the state’s financial situation is. If people are so worried about the transplant patients then they should ask the federal government in Washington to send us more money, she said. But she would not explain to me, or to any Democrats in the state capitol, what she has done with the nearly $200 million she was already given in ‘stimulus funds’ to spend on anything she liked.


As this article points out, Brewer opposes the Affordable Care Act -- which would involve the federal government sending her more money to cover such cases.

Compassionate conservatism in action.
.