The Road Not Mentioned
The scoffs that have been so prevalent in response to right-wing talk of “death panels” and such repeat a common liberal tactic of missing the point through deliberate myopia: “Why, this bill merely provides for consultations about end-of-life options, hardly a group of bureaucrats voting to pull the plug. As for rationing, show me one instance in which such a thing will occur.” This citation assists in response to both paraphrased points:
Hey, you know those Scooter commercials, where the owner of the company promises that Medicare will pay for 100% of the cost of your motorized wheelchair or they’ll eat the difference? In §1141, the phrase “power-driven wheelchair” shall now be replaced in the Social Security Act with “complex rehabilitative power-driven wheelchair.” In other words, if you don’t specifically need the motorized chair for complex rehabilitation, Obamacare says you can freaking walk or crawl from now on. Or pay for it yourdamnself. On the one hand, the Czar can see how this is a claim to save money—right, GOP? Why do those pesky elderly folks need taxpayers to help them live normal lives? On the other hand, there’s something wickedly disingenuous about this. If AARP lived up to its name, this would be the first thing to decry.
That’s the sound of rationing in a big government system. A couple of multisyllabic words added in the middle of a legal document so complex that it’s barely English and so heavily cross-referenced that it’s more like a kidnapper’s cut-and-paste ransom note than a coherent narrative. And as Mark Steyn explains, the “death panel” has more of a passive authority:
The problem with government health systems is not that they pull the plug on Grandma. It’s that Grandma has a hell of a time getting plugged in in the first place. The only way to “control costs” is to restrict access to treatment, and the easiest people to deny treatment to are the oldsters. Don’t worry, it’s all very scientific. In Britain, they use a “Quality-Adjusted Life Year” formula to decide that you don’t really need that new knee because you’re gonna die in a year or two, maybe a decade-and-a-half tops. So it’s in the national interest for you to go around hobbling in pain rather than divert “finite resources” away from productive members of society to a useless old geezer like you. And you’d be surprised how quickly geezerdom kicks in: A couple of years back, some Quebec facilities were attributing death from hospital-contracted infection of anyone over 55 to “old age.” Well, he had a good innings. He was 57.
The point is that criticism of healthcare reforms takes a longer view, accounting for that which the installed principles make inevitable. Technically, leaving a man floating in the mid-Atlantic on a 2×12 board isn’t killing him, but it’s likely a death sentence. Although progressives — who admit by their very name that they’ve got their eye on a broader project — may wish to hold the debate to the immediate effects of specific provisions, a wise electorate should workshop and brainstorm their lasting consequences.
A similar sleight-of-hand is behind the administration’s apparent change of tactic in backing away from “public option” talk. In the end, without that fundamental change, the legislation will only exacerbate bureaucracy and complicate a healthcare system already crawling under the weight of regulation. Both political parties will lift up their arms in a declaration of victory, but the necessary reform would merely have been postponed.
There are two paths to the future enabled by the current legislation: a single-payer system that impinges on freedom and ensures the erosion of healthcare around the world, or the gradually corrosive over-medication of a regulatory bonanza. The path that we ought to follow — decreasing regulation and allowing choice to blossom from fertile demand — has scarcely been mentioned.