Sarah Palin

In August of 2009, Sarah Palin claimed that the health legislation being crafted by Democrats at the time would create a “death panel,” in which government bureaucrats would decide whether disabled and elderly patients are “worthy of healthcare.”  Despite being debunked by fact-checkers and mainstream media outlets, this myth has persisted, with almost half of Americans stating recently that they believe the Affordable Care Act (ACA) creates such a panel.

The death panel myth killed neither the ACA nor Obama’s reelection bid.  But persistence of this myth could threaten the Obama administration’s efforts to implement the law, because many of its most controversial features are scheduled to be implemented over the next few years. Why is the death panel myth so hard to shake and why is its persistence relevant to the unfolding of Obamacare?

In part, the myth is hard to shake because most people have a very poor understanding of the complex law.  The ACA tries to increase access to health insurance through a bewildering combination of Medicaid expansions, private insurance subsidies, health insurance exchanges, and the infamous health insurance mandate.  It attempts to improve healthcare quality through things such as reimbursement reforms and promotion of electronic medical records.  And it encourages the formation of more efficient healthcare organizations, with inscrutable names like “accountable care organizations” and “medical homes”.

The myth is also likely to persist because the law calls for the establishment of a 15 person committee– the independent payment advisory board (or IPAB)–which is given the job of recommending cost-saving measures to the Secretary of Health and Human Services if Medicare expenses rise too quickly.  The IPAB will consist of independent healthcare experts who are forbidden, by law, from proposing changes that will affect Medicare coverage or quality.

Continue reading “The Independent Payment Advisory Board: Why It Is So Difficult to Kill the Death Panel Myth”

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Sarah-palin
Former Alaska governor Sarah Palin, who played a major and highly   controversial role in the health reform debate last year, published her response to the Obama plan on her Facebook page yesterday. In the spirit of debate, THCB is republishing the full text of her remarks.

The President has wrestled control of the health care debate away from Nancy Pelosi and Harry Reid by finally introducing his own plan. Unfortunately, the White House’s proposal includes everything we found untenable about the old Senate bill – only this one is even more expensive! This is what you might call putting “perfume on a pig.”

What’s in this “new” proposal? It has the unpopular (and arguably unconstitutional)individual mandate that forces people and employers to purchase health insurance – only this time with much harsher fines on employers who choose not to go along with another expensive government mandate. It has provisions that will make employers think twice before expanding their workforce. It has cuts to Medicare Advantage, a popular program which allows seniors to pay a little more money out of pocket for better coverage. And, of course, it still has sweetheart deals – only this time they’ve been extended even more.

We don’t know what the final long-term cost of this will be because the Congressional Budget Office hasn’t had a chance to calculate costs. We do know that the White House recognizes that its proposal will cost tens of billions more over the next ten years than the already-expensive $2.5 trillion Senate bill. The Presidentpromised last July that he won’t sign a health care bill if it “adds even one dime to our deficit over the next decade.” But he’s now proposing a health care bill withuncertain fiscal repercussions that could lead to endless deficits.

Continue reading “More of the Same, Only More Expensive”

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Sarah-palinFormer Alaska Governor Sarah Palin’s widely publicized comments on death panels and  rationing this August were among the opening shots of an unprecedented national fight over health care reform. At the time, few sober analysts would have predicted that Palin’s criticisms would gain traction. Yet, they found a receptive audience among conservative opponents of the Obama administration’s health care reform plans, triggering an ugly battle between supporters of reform and right wing opponents.This weekend, Gov. Palin returned to the healthcare debate with another post to her official Facebook page that touches on the talking points you’re likely to hear in the months to come from Republican critics of the Obama administration’s health care reform efforts.  In the spirit of debate we are republishing the post in its entirety. — John Irvine

Now that the Senate Finance Committee has approved its health care bill, it’s a good time to step back and  take a look at the long term consequences should its provisions be enacted into law.

The bill prohibits insurance companies from refusing coverage to people with pre-existing conditions and from charging sick people higher premiums. [1] It attempts to offset the costs this will impose on insurance companies by requiring everyone to purchase coverage, which in theory would expand the pool of paying policy holders. Continue reading “Good Intentions Aren’t Enough with Health Care Reform”

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McCarthy and CohnIt’s time to fight back. The “death panel” nonsense is not a harmless and amusing political canard – it is modern McCarthyism: the shameless, heinous use of lies and distortions to scare and confuse people. The tide will only turn if all of us begin speaking up for the truth.

Read NY Times piece on palliative care, and you get a sense of the power and beauty of the modern movement to provide patients and families with information and support at the end of life. The piece chronicles the decline and ultimate death of Deborah Migliore, a former topless dancer from the Bronx, from metastatic carcinoid, and the efforts of palliative care specialist Sean O’Mahony to support the patient and her husband through her painful final weeks. The article describes palliative care providers this way:

They are tour guides on the road to death, the equivalent of the ferryman in the Greek myth who accompanied people across the river Styx to the underworld. They argue that a frank acknowledgement of the inevitability of death allows patients to concentrate on improving the quality of their lives, rather than lengthening them, to put their affairs in order and to say goodbye before it is too late.

This has been precisely my experience working with our extraordinary palliative care team at UCSF. So I was pleased to see some support for palliative care embedded into the early versions of health reform legislation.

Then came Sarah Palin and the other hypocritical asses who have managed to take a serious, even profound, issue and turn it into a mockery. Read Joe Klein’s article in this week’s Time magazine to get your blood boiling. Klein begins with a poignant discussion of the end-of-life issues he’s grapping with for his elderly parents, but then – after the obligatory “there are still a few reasonable Republicans out there… somewhere” riff – gets to the point:

… But they have been overwhelmed by nihilists and hypocrites more interested in destroying the opposition and gaining power than in the public weal. The philosophically supple party that existed as recently as George H.W. Bush’s presidency has been obliterated. The party’s putative intellectuals — people like the Weekly Standard’s William Kristol — are prosaic tacticians who make precious few substantive arguments but oppose health-care reform mostly because passage would help Barack Obama’s political prospects. In 1993, when the Clintons tried health-care reform, the Republican John Chafee offered a creative (in fact, superior) alternative — which Kristol quashed with his famous “Don’t Help Clinton” fax to the troops. There is no Republican health-care alternative in 2009. The same people who rail against a government takeover of health care tried to enforce a government takeover of Terri Schiavo’s end-of-life decisions. And when Palin floated the “death panel” canard, the number of prominent Republicans who rose up to call her out could be counted on one hand. Continue reading “Death Panels, Palliative Care, and the Dangers of Modern McCarthyism”

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Sarah-Palin-smile The strange plot of the national debate over health reform this took another twist over the weekend, after  (now suddenly ex- Alaska governor)  Sarah Palin posted a statement on her Facebook page on Friday denouncing the Obama administration’s plan to reshape the healthcare system as “downright evil.”

In a statement referencing Ronald Reagan and the economist Thomas Sowell, Palin warned of bureaucratic “death panels” that would decide “if my parents (or yours) or my baby with Down Syndrome” are “worthy of healthcare based on their level of productivity in society.”

The full text of the post:

“As more Americans delve into the disturbing details of the nationalized
health care plan that the current administration is rushing through
Congress, our collective jaw is dropping, and we’re saying not just no,
but hell no.

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.

Continue reading “Palin: Obama Health Plan “Evil””

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