Monday, August 17, 2009

An Open Letter to National Review

From an National Review editorial today:

“To conclude from these possibilities to the accusation that President Obama’s favored legislation will lead to “death panels” deciding whose life has sufficient value to be saved — let alone that Obama desires this outcome — is to leap across a logical canyon. It may well be that in a society as litigious as ours, government will err on the side of spending more rather than treating less. But that does not mean that there is nothing to worry about. Our response to Sarah Palin’s fans and her critics is to paraphrase Peter Viereck: We should be against hysteria — including hysteria about hysteria.”

Fortunately all the hysteria about those death panel provisions of the House bill caused them to be knocked out of the Senate’s version. Neither senators Hatch nor Grassley sounded particularly hysterical in their opposition to the provisions.

My friends at NR, I wonder how well you understand real world facts. Even without the “end of life” decision helps in these health care reform bills, the society is swinging against even regular sort of fixing-broken-bones care and hospice care for the elderly.

In the last couple of years friends of mine were asked if they wanted their mother to have hip surgery after she fell and fractured her hip . The doctor said the surgery would allow her better freedom of movement and make her life more comfortable for the rest of her days. She has Alzheimers and has slipped into dementia, but doesn’t have a terminal illness in the normal sense of the phrase. They were told she probably could withstand the surgery and that it would probably succeed. Without it she would probably be a bit more uncomfortable, not very mobile and probably her physical condition would decline more rapidly without it.

Imagine asking me if I fractured my hip or arm or knee if I wanted it fixed. How many of NR’s editors would keep their doctors after receiving personal medical advice like that? How many of you would choose (have chosen?) for yourselves the much less expensive no fix but almost no mobility and some pain option?

Just recently my friends' mother's condition has started to decline. They talked to the hospice people who said that under the current federal policies which are geared to cost savings her condition does not yet allow for hospice–though it did under 2008 rules. The federal government is already tightening spending on true “end of life” care. They are cutting back there too.

Neither of these examples is a “leap across a logical canyon.” They are facts. Fears that federal administrators seeking to cut costs might withhold needed care from the aged and those with less than rosy physical futures in a way leading to a quicker and more painful death is more likely than not (like happened with my state’s Oregon Health Plan).

NR’s editors don’t live in Oregon where assisted suicide is both legal and societally sanctioned. Apparently none of you think it telling that the state plan offered $50 for suicide drugs though sadly denying the $4,000 per month in treatment drugs (which the kindly drug manufacturer ended up supplying). All this was done by nice Oregon Health Plan people who were just trying to make the Oregon system cost effective. Why shouldn’t federal employees be similarly nice and similarly concerned?

I just shake my head in wonder that your judgment is so distant from real world experience–or at least the real world experience I know here in Oregon. And all of this under the current system. No major changes have yet been made.

Maybe a little healthy fear is not hysteria but is really the clear view.

As for Sarah Palin, she got provisions that might be “misinterpreted and implemented incorrectly” (Sen. Grassley) removed in a week’s time and forced the President and his surrogates to address clearly (if not accurately) the question of federal administrators deciding about health care for the elderly ("grandma") rather than patients themselves in consultation with their doctors. Has NR had any similar sort of success in either the House or Senate bills in a week or even a month? What change in the national discussion has NR clearly introduced?

Those who believe in the free market lean toward the idea that short of the word of the Lord success is the best validator of ideas and actions.

Could it be that NR’s understanding of what is and is not hysteria is a bit clouded? My experience in Oregon leads me to believe so, and Governor Palin's stunning success should lead you to examine the possibility.

UPDATE: Andy McCarthy has a terrific dissent against NR's editorial stance on the Palin/hysteria issue at NRO.

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