Death Panels, Palliative Care, and the Dangers of Modern McCarthyism

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.

Is this modern McCarthyism? Klein argues that it may be worse, because in those times:

… the crazies were a faction — often a powerful faction — of the Republican Party, but they didn’t run it. The neofascist Father Coughlin had a huge radio audience in the 1930s, but he didn’t have the power to control and silence the elected leaders of the party that Limbaugh — who, if not the party’s leader, is certainly the most powerful Republican extant — does now. Until recently, the Republican Party contained a strong moderate wing. It was a Republican, the lawyer Joseph Welch, who delivered the coup de grâce to Senator McCarthy when he said, “Have you no sense of decency, sir, at long last?” Where is the Republican who would dare say that to Rush Limbaugh, who has compared the President of the United States to Adolf Hitler?

Good on you, Barney Frank, for silencing the loony woman at his town hall meeting after she made such a comparison. As for our President, it is time for him to channel a little Barney Frank – and Machiavelli – and get tough. There can, and should, be reasonable disagreements about health reform, but the Fox News/Town Hall crowd is not interested in negotiation, or progress, or bettering the lives of our citizens – they are ideologues hell bent on destruction, gamesmanship, and Neilsen ratings. It is time to use all the tools at the Administration’s disposal to out the truth and fix what’s wrong with American healthcare.

It can be done, but it’ll take a fight. So let’s have one.

Robert Wachter is widely regarded as a leading figure in the modern patient safety movement. Together with Dr. Lee Goldman, he coined the term “hospitalist” in an influential 1996 essay in The New England Journal of Medicine. His most recent book, Understanding Patient Safety, (McGraw-Hill, 2008) examines the factors that have contributed to what is often described as “an epidemic” facing American hospitals. His posts appear semi-regularly on THCB and on his own blog “Wachter’s World,” where this post first appeared.

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43 replies »

  1. I used to have a girlfriend who was a palliative care nurse. She was very emotionally involved in her work. She cared very much for the patients who were in her ward. She took it very personally when they died. I think that when a patient is admitted into the palliative care unit, they are in the best care that they can possibly receive. The people who work in these units understand that this is the end for the people who come into their care and they treat them like they’re royalty because they need it. They have enough crap, health-wise to go through without having to deal with normal daily pressures. These people need to get their rest and focus on themselves and their families in their, sometimes, last hours together and in palliative care, they are allowed this.

  2. As a hospice nurse for 6 years, I can attest to the need for end -of -life counseling. And it needs to occur long before it’s needed.
    Those unfamiliar with end-of -life issues and decisions need to become educated on the facts for themselves. These issues have nothing to do with “death panels”. Advance directives are based on each person’s individual choice in the kind of care desired at the end of life.
    I have met so many patients and families that have not made plans for end-of-life care. There are many decisions to be made and much information is needed in order to make thoughtful and intelligent choices. Advance directives are decisions made by the individual and carried out by those they trust to do so. It can be very difficult to make these decisions when in the throes of living with a life-threatening illness.
    Age 18 is not too soon to have advance directives in place. Too young? Think of those who go to war and of the high rate of death and severe injuries that occur in the 18-25 year age group.
    The kindest thing we can do for ourselves and our families is to have advance directives in place, keep them updated, and give copies to those we trust.

    My father died 2 years ago last month. Collectively, as a family, we chose to care for him at home for the last 2 months of his life. We enlisted Hospice for end of life counseling which was a God sent. Hospice walked us thru ever step of death, what we should expect and how to care for our father during this time. Hospice was available at all hours of the day and night to answer questions and squelch our fears.
    This is end of life counseling. At a time when all medical options have been exhausted, end of life counseling is available for those that choose to spend their last days at home, comfortable, surrounded by their loved ones.
    Melodie Miller

  4. Amen, Bob. The health care reform debate has been turned into a fetid dumping ground not just for right-wing fanatics and the disgruntled fools who follow them, but for the sprawling, unconscious anxieties of people who know nothing about medicine or how health care financing and delivery really works. Death panels? Puh-leeze!
    Aside from those transparently on the anti-Obama warpath, what is really driving the hysteria about the belated modernization of reimbursement for end-of-life care is nothing more complicated than fear: an unalloyed fear of death, a primordial revulsion at the gruesome reality that awaits all of us sooner or later and, more broadly, the infantile fear we all have regarding the loss of control of our bodies, minds, and lives.
    Unfortunately, it’s far easier to rage against government (or against health plans, or drug companies, if you’re left-wing and equally unconscious) than it is to rage against mortality, or God’s silence, or one’s self for decades of smoking, eating garbage, and exercising nothing more than one’s mouth. The “death panel” nutjobs seem to be laboring under the weird self-delusion that their categorical tirades against “government health care” might somehow mitigate the hardest fact of life, i.e., that life ends, no matter who we vote for, or what nonsense we choose to believe about health care and government’s role in the system.
    The government may or may not be able to fix a broken health insurance market with regulation even the health insurers now acknowledge is necessary. But in the end, government no matter how large, small or non-existent, will not be able to bail us out of the saddest fact of life. Instead of muddying up the reform debate, these folks need to grow up, see a therapist, take a philosophy course, or actually read their Bibles…

  5. It’s the Liberal Math, no wonder I don’t understand your support for Medicare. It’s like the new Math the left tried to teach in schools for awhile. Everyone should be forced to pay into an insolvant plan even though everyone knows it is insolvant. In Private Insurance when a plan is deemed insolvant they immediatly have to stop adding business, otherwise you exasperates the insolvancy, and the plan is quickly disbanded. Healthy risk is moved to other functioning plans, along with some of the bad risk as a requirement to take the good. Any toxic business is wound down and funded through surcharges on other plans. Only with public plans would you kill off the healthy plans to keep the insolvant one alive. Does that make sense to anyone?

  6. “Why is my grandmother opting out of Medicare?”
    No she wouldn’t, or any other grandma, but if you and thousands of others opt out where will the money come from to pay grandma? The fund is already underfunded.
    “I rather die because I can’t afford to buy care then die becuase the government outlaws me buying it.”
    Does this make sense to anyone?

  7. d’cm, I have no idea how the GOP plan would do anything they claim nor do I care for the GOP plan, it’s almost as worthless and the Democrat’s plan. My point was disproving the blatant lies from the left that the GOP doesn’t have any plans. That is why I copied and pasted the quote and put ” and ” around it. I never commented nor supported it. Joe Klien is full of BS as is almost all of the reporting comming from the media. I have seen multiple “journalist” make this same claim.

  8. In response to Nate: I just read the GOP’s outline for healthcare reform aaaannd how is this all that different than the Dem’s? One thing that struck me was paragraph 6 under the Cost Savings section: ” Provides Medicare and Medicaid with additional authority and resources to stop waste, fraud, and abuse that costs taxpayers billions of dollars every year”. Nate, how is the GOP going to do that AND stay true to the promise to “4.Ensure that medical decisions are made by patients and their doctors, not government bureaucrats.”? Nate, who do you think generates the most waste, fraud and abuse? Doctors, Nate, doctors with the passive ignorance of their patients and trust me Nate, they are legion.

  9. I was looking at a patient in my hospital today, she is in unresponsive even to painful stimuli from a massive stroke, she is kept alive by a ventilator and hemodialysis. The family insists we “do everything possible”. And I thought, “death panels sound like a good idea.” I mean why should the taxpayer shoulder the financial burden of this futile technology. It isn’t healthcare, it’s death prolonging pathology and it would be great to hand the decision to some faceless panel to decide to pull the plug – or hand the bill to the family.

  10. just so you don’t put any more words in my mouth let me make it clear for you;
    I rather die because I can’t afford to buy care then die becuase the government outlaws me buying it. Or outlaws a provider from selling it to me, or any of the other numerous ways politicians can find to ration care.

  11. Peter you need to stop being an idiot. Why is my grandmother opting out of Medicare? Care to share that with me?
    When did I ever say people are not subject to death for the lack of ability to pay for care?
    Who are you arguing with you idiot?

  12. is the future of our healthcare really not worth 4-5 paragraphs? One of the contributing factors to what allowed things to get where they are is a public informed by 30 second sound bites. If the public is going to be educated, debate setteled, and legislation passed on 10 line summaries we are doomed.

  13. Nate…this really was your worst series yet–I dont even read these any more. You really are just wasting space here. 10 lines buddy, everyone else seems to be able to do it in that amount. TRY to marshall your thoughts…..

  14. My point really was only that I don’t think any real answers will come from the extreme right or left. There is certainly waste and abuse in medicine as a result of that free market, so that can’t be the total fix.
    Recently the FDA approved Avastin in combination with interferon for the treatment of metastatic renal cancer. Interferon, cheap, not very effective. These patients don’t ever do well. Avastin is relatively new, exceedingly expensive. It was approved by the FDA because it was shown to improve progression free survival by about 3 mo. IT DID NOT IMPROVE OVERALL SURVIVAL BY A SINGLE DAY. Further your average oncologist will give you your last treatment just before they take you to the morgue. Literally thousands of dollars without giving the average patient anything except side effects.
    A single example, I know, but there are hundreds of others. This also illustrates the problem of waiting far too long to have the palliative care discussion if it occurs at all.
    Physicians should be compensated for their management, coordination and counseling. They should not be in the drug, imaging or device business. We have all the wrong motivators in place in healthcare. Nothing will change until we figure out how to motivate the behaviors we want.

  15. I notice every single lefty skipped right past the argument they can’t address. The entire retort from the left is the bill doesn’t specifically create death panels so it shouldn’t even be mentioned. I point out a perfect example, losing your SS if you opt out of Medicare, of how government creates “law” without there actually being a law, and you all just bury your head in the sand.
    Peter even has the gall to still claim the public option is an option. Peter have you read nothing? Medicare use to be an option, now they take away your Social Security if you refuse to participate. But because Obama, who has lied about everything since the day he started to run for office, says you can keep your insurance we are suppose to ignore the facts that HR 3200 puts all the pieces in place to do the exact opposite?
    Are the Republicans really showing any brilliance at all in this debate? I would disagree and say one of two things is happening;
    1. Democrats are the biggest idiots in the world for including the section on end of life, then taking it out, if they really didn’t mean to use early death as cost control. Obviously it would be a sensitive issue, why even bring it up in the manner they did, very sloppy.
    2. They really did plan on reducing cost by getting seniors to take an early canoe ride.
    I wouldn’t give Republicans any credit for this at all, Democrats are either evil for what they had planed or stupid for shooting themselves in the foot. Either of those people are not who I want running my Healthcare.
    In regards to “option” the bill clearly says insurance companies must offer an approved set of benefits which right there means some people will lose their plan. Further it also says after 5 years self funded plans must be approved by the federal government. Anyone tell me why if there is no possibility of a plan being denied the Democrats would make it go through the expense and hassle of being approved. That makes no sense at all, obviously the democrats intend to steer coverage and benefits in specific ways that require them to control every aspect of benefits. Proof that not everyone will be allowed to keep the plan they have. Again the bill authors are either liars or idiots.
    david, bev, and who ever else that takes issue with my rants. I have never seen any of you complain about the lefty rants of Peter or anyone else that is for health care reform. My comments are filled with more facts and solid arguments then all of those combined. That tells me it is not the manner of my speak you despise but the content. If you’re scared of opposing argument that disproves your ideology then please by all means bury your head in the sand and hum till it’s all over. If you really believe in the reform proposed why don’t you respond to how Medicare takes away your SS and why the government requires plans get approved. Could it be you have no answer for these facts so you just pretend they aren’t real? That’s a great way to treat 16% of our economy! Why should we be at all scared of the left taking over healthcare when they are scared to even debate and address the facts, what could possibly go wrong here. In what sort of countries does the public roll over in lustful infatuation like that to the government? It sure ain’t America.

  16. Peter,
    Here is what I had in mind in my last comment. Suppose a patient is in an end of life situation and is not sure what care he/she wants or doesn’t want. Perhaps the family members aren’t sure, can’t decide or can’t agree. Rather than leave it up to the attending to bring up the possibility of the palliative care discussion of options and the implication of each, I don’t see why a nurse, social worker, clergyman or even a close friend couldn’t say something like, would you like me to contact the palliative care group and see if I can arrange a consultation for you. This doesn’t require any expertise aside from the recognition that the patient and/or family are having trouble deciding what care they want or don’t want. Under the current system, the biggest obstacles are encroaching on what the attending physician considers to be his or her territory and the issue of payment for the services.

  17. Bev MD is right. I’ve been reading THCB for a few months now. I have read some of the most intelligent conversation on healthcare reform. But, Nate, really? You often start with some insight, but it always turns in to pure far right ideology (rant). We all recognize it and it adds nothing to the debate. Also, “then” and “than” are not interchangeable. A guy who thinks he knows everything should certainly know that. From now on, I’ll just scroll past your rants.

  18. If we wind up with a government-controlled health care delivery system, the fears about “death panels” could actually come to pass – albeit in modified ways.
    There already is much trickery afoot in the promotion of the health care bills before Congress. For example, despite strenuous denials, they are designed to, over time, eliminate private health care insurance by attrition.
    For more information, go to: http://doc2dochealthcarereform.com

  19. The sheer fact that the “death panel, palliative care” discussion is even taking place now is a brilliant Republican PR move. I think the Obama administration has been beaten at its own game – grass roots public relations.
    We all know this death thing has absolutely nothing to do with health insurance reform, but we keep hammering on death with dignity and pros and cons of palliative care. All America hears is death panels imposed by government run health care. Liberals are making this really easy for those opposing health care (insurance) reform.
    And why are we talking about the VA? What does that have to do with a public option for health insurance? I don’t believe Democrats are proposing government owned providers for all.
    Sadly, we probably squandered yet another opportunity to reform health care in a significant way.

  20. Peter,
    If Borg Obama is saying it, then it will be something entirely different.

  21. By Nate:
    “There is no Republican health-care alternative in 2009.”
    “Please explain what this website is then;”
    “The House Republican Health Care Solutions Group has been working for months on a plan”
    The health care reforms outlined are designed to:”
    “(1)Make quality health care coverage affordable and accessible for every American, regardless of pre-existing health conditions.”
    Using taxpayer funds to subsidize insurance premiums (overall healthcare) and not taking into consideration the premium incease that would occur when pre-existing is factored in. If it includes a mandate then doesn’t that limit choice? It does nothing to lower system costs. In fact it simply does what the financial system bailout does – transfer tax wealth to corporations and the bonused execs that run them.
    “(2)Protect Americans from being forced into a new government-run health care plan that would:
    a) eliminate the health care coverage that more than 100 million Americans currently receive through their job; b) limit your choice of doctors and medical treatment options; and c) result in the federal government taking control of your health care.”
    That’s why it’s called a public “option” Nate. Doesn’t a PPO “limit your choice of doctors and medical treatment? How much choice do working americans have when they are forced to sign on to the ONLY company plan offered?
    “3)Let Americans who like their health care coverage keep it, and give all Americans the freedom to choose the health plan that best meets their needs.”
    Isn’t that what Obama has been saying? I (and many others) would like a public option choice, do Republicans want to deny me that choice?
    “4)Ensure that medical decisions are made by patients and their doctors, not government bureaucrats.”
    Where is that in the proposed legislation? Would you prefer insurance company bureaucrats? Would that include the doctors in McAllen TX who have taken over-utilization to more disgusting heights?
    “5)Improve Americans’ lives through effective prevention, wellness, and disease management programs, while developing new treatments and cures for life-threatening diseases.”
    Lofty statement, where’s the beef.
    “In fact those on the right have thousands of ideas on how to improve our systems,”
    Where were those ideas during the Bush years? Have you looked at the defecit lately?

  22. “I think anyone from the patient to the family to a nurse, social worker, clergyman or even a close friend should be able to initiate a discussion about palliative care to determine whether or not the patient and/or family is interested in hearing out the options…”
    Barry, patient, family or clergy (not likely) would be safe if they can overcome emotion, but nurse and social worker would be liable for law suit, either from family member or from their respective governing board. And how’s a close friend to approach this when they have no training or medical knowledge?

  23. “or the Republican that says you should be free to live anywhere you want and can afford.”
    Like those nice white neighborhoods in the suburbs.

  24. Bob,
    Personally, I think the more information patients have about their health, their diagnosis, their prognosis, their options, and the quality of life implications of those options, the better off both the patient and the family are. So, I like the idea of providing palliative care consults and providing reasonable and appropriate compensation to the care team for their expertise.
    What I didn’t care for in the link you provided discussing UCSF’s palliative care program is the key role of the attending physician in determining whether or not such a consult is even offered. There are plenty of attendings, especially among oncologists, that want no part of it. Maybe it’s part money driven and maybe the doctor views the patient’s ultimate death as a personal failure of his or her part. I think anyone from the patient to the family to a nurse, social worker, clergyman or even a close friend should be able to initiate a discussion about palliative care to determine whether or not the patient and/or family is interested in hearing out the options without having to worry about whether the attending physician might be offended or not.

  25. Bev M.D.,
    “From what you have read”, that sounds to me like you have not studied the matter in all the depth and there is a very good chance there is more that you have not read then you have. Now lets expand on that a bit, I’m willing to wager you haven’t studied the history of insurance, how Medicare was passed, effects of COBRA and HIPAA on their operation and many other issues relevant to why things stopped working. This being said how do you feel qualified to sit there and state without a doubt what the outcome of this legislation would be? If I read an article or two about surgery would you let me operate on you? Where does your omnipresent knowledge of the outcome from the proposed reform come from? I work in the system every day. For 20 years I have studied and lived the results of past legislation. I have seen first hand how an innocent, and good, idea like COBRA turns into a multi billion boondoggle that bankrupts small businesses and drives up the cost of care for no gain. I see how HIPAA and ADA are over applied and prevent employers and insurance companies from assisting employees in being more healthy. To be blunt, when I deduct from 20 years of experience that the current legislation opens the door to death panels who the heck are you to question me? If I walked into your office and started diagnosing your patients would you sit back and be ok with that? Maybe before you go making such solid statements of facts you should read a little more and understand what your talking about?
    Yes the language in the VA material was there long before Obama, past administrations when they found out about it had the entire pamphlet pulled form use because it was so offensive. Obama’s administration reinstated it, why? There is nothing great about this pamphlet, there was no legitimate reason to start using it again. Further only a complete moron would over look the controversial material in it and start using it again in the middle of a huge debate about rationing unless they intended to use it. This was worse then Obama using the USPS as an example of how great public competition can be. But don’t listen to me, go on some Vet websites and see what they think about it. Heck for starters why don’t you read it before you comment?
    You really deserve to be embarrassed for saying such stupid stuff. Let me ask you a simple question that hopefully will help you grasp the ignorance here. If you ran a suicide help line would you discuss the option of following through as just another option? That’s is what we are talking about here, telling a potential suicide victim that actually doing it is one way to go, only on the left can you justify that, then wrap your self in moral superiority for it.
    Who said anything about denying palliative care? You make up strawman arguments then get offended about them. Do you not see the difference between someone seeking palliative care and the government forcing it on them? Palliative care should be the decision of the patient and their family. If you are so clueless of history to not see the slippery slope of government pushing such care your hopeless. Please do skip my comments as you obviously aren’t intelligent enough to get them. I don’t have time to argue with people that argue with themselves.
    Bob would those be the same people that thought they could opt out of Medicare? Again has anyone on the left ever studied history, are you all that uneducated? It’s not an option when 5 years from now due to a budget crisis the government makes every person pay mandatory premiums to the public plan. If your 65 you can buy other insurance, you just have to continue paying Medicare premium or they will take away your Social Security. Oh and you doctors can’t treat you or charge you outside Medicare guidelines because you are paying that premium, even if your not using it. Is that really an option Bob? Is that what you call choice?

  26. Actually, I agree with Nate when he says that patients should take more responsibility for their own health, and insurers need to be allowed to offer their plans across state borders. I also support the idea of tort reform.
    What I strongly disagree with, is that government has absolutely no role in the economy. How would our business landscape look today without the antitrust law, preventing monopolistic “black holes” from being formed?

  27. Thats not really logical because there are lots of people that disagree with the public option and are free to continue to be riped off by some insurance companies so I believe that there are plenty of people out there that will continue to fund the private insurance companies for what ever reason. The public option is just that an option if you prefer to pay $800 – $1000 dollars a month to private insurance this is America by all means pay it. I urge everyone that disagree with the public option to send a message and refuse it onces its available and keep your private insurance.

  28. I know the VA system. I have worked in the VA and watched first hand the level of neglect and indifference brought on by the beaurocracy of the government run system. If this is how the Governemnt seeks to care for the people by way of the public option I would move to Russia where the healthecare system does not reek of hypocracy. The public option will undermine the free market and put insurance companies out of bussiness. When Obama says you can keep your current plan he is writing a check from a bank that will soon be out of bussiness. With the public option we are insuring the death of the ptivate option.
    John E Moore MD

  29. “I just got off the phone with my grandma who was talking about her $530 a month in SS benefits”
    Would that be grandma using Medicare – one of the “public options”?
    “Congress tells me every year in my statement at best I will be lucky to get 70% of what I was promised.”
    Actually the statement says, “In 2017 we will begin paying more in benefits than we collect in taxes. Without changes, by 2041 the Social Security Trust Fund will be exhausted and there will be enough money to pay only about 78 cents for each dollar of scheduled benefits. We need to resolve these issues soon to make sure Social Security continues to provide a foundation of protection for future generations.”
    Where is the lie?
    Speaking of lies, how’s grandma’s stock investments doing lately?

  30. Ya know, Nate, I don’t disagree with all of your ideas – but just give me a break with the rants. First of all, from what I read, the death panel stuff in the VA booklet was put there way before Obama and consists of nothing more than review of all the options of end of life care, similar to what a lawyer would say to you when you come to him to draw up an advance directive.
    Second, you miss the entire point of this post – that this “death panel”, “pulling the plug on Grandma” crap – I don’t care WHAT party is comes from – is just plain disgusting. When my dad was dying of terminal cancer, I and my family wanted him at home, with palliative care in a familiar environment and enough morphine to keep him comfortable. Would you have wanted to force me to keep him in the hospital and put him on a ventilator and die 3 weeks later? And oh, control the amount of morphine he could get because John Ashcroft proclaimed doctors who prescribed narcotics to terminal patients should be crimininally prosecuted?
    Just – just – oh, never mind; I’m speaking to a wall. Like Popster, I’m just fast forwarding over your comments after this. Bye.

  31. My estimation is the these obvious distortions will result in the eventual end of the Republican Party, or a renewal with renewed ethics (more honesty). This isn’t a light analysis. The hard part is guessing how long it will be until the chicken come home to roost. I’m thinking it could be sooner than usual, maybe even just 1-3 years.

  32. Don’t read much history do you Drew?
    Let us play another round of Drew’s game…
    Let us say your a poor person, most likely black, with limited job opportunities, who do you trust to make your housing decision? The Liberal that wants to give you free housing in a segregated high rise along with 5000 of your closet neighbors or the Republican that says you should be free to live anywhere you want and can afford. So Drew how did public housing turn out for 3-4 generations of America’s most vulnerable?
    Up for another round?
    Let us say your poor and can’t find a job and just had a kid. The Liberals want to give you just enough money to feed the two of you with less then desirable nutritional choices but not enough that you could ever dream of getting out of the situation. Republicans aren’t willing to give you a handout but will assist you in getting a job, there is no guarantee you will make it but if you try hard and put in the effort most likely you will not only make it but lift yourself and your new child out of the cycle of poverty you were born into. Want to discuss the success of our previous welfare systems Drew?
    I just got off the phone with my grandma who was talking about her $530 a month in SS benefits before any deductions and how they don’t expect any increases in the next few years. Want to discuss how great our compassionate SS system is Drew? And she was lucky that her generation actually received the benefits they were promised. Congress tells me every year in my statement at best I will be lucky to get 70% of what I was promised.
    You mistake honesty for lack of caring. Unlike the left who will gladly promise you the world even though they know they can’t deliver us on the right don’t like to give grandma false hope and lead her to believe she will get something we have no intention of delivering. If you really get off feeling morally superior based on lies there really is no hope for you nor do you deserve any. Why don’t you live up to the promises you already made before making new ones?

  33. Forget McCarthyism. What it boils down to is this: who do you trust at your deathbed? Give me the compassionate Democratic liberals any day over the dispassionate Republican “my way or the highway” extreme rightist minorities any day. Klein is correct when he compares their myopic lack of caring to the common weal to the extremist techniques of the neo-McCarthy crowd: Better dead than Red indeed! They would rather bring down the hated Obama liberals than hold their dying grandmother’s hand. Truly sad. I’ll continue to try to hate their sin and not the sinner prescription for a happy death. God Bless!

  34. It is not McCarthiesm…it is just usual politics by all sort of politicians.
    We have not held people accountable…We get upset with their one personal indiscretion but when they are indiscrete with us, we tend to have short memory.
    Some might be interested in the video on my blog about the debate on Dealth Panel. See how the words are being twisted.

  35. Wow Bob filling a post about supposed right wing McCarthyism and lies with McCarthyism and lies. The real problem is your to lazy to even come up with decent lies. The left use to rely on the ignorance of their supporters for power, as the dissemination of information has broadened even the stupid can’t avoid the truth all the time.
    “There is no Republican health-care alternative in 2009.”
    Please explain what this website is then;
    In fact those on the right have thousands of ideas on how to improve our systems, you just don’t like them and god forbid your supports actually read any of them they would abandon you in a heart beat so you propagate the lie that there is no plan from the right. Really Bob you make this to easy.
    “Where is the Republican who would dare say that to Rush Limbaugh, who has compared the President of the United States to Adolf Hitler?”
    The left has made far more comparison of Bush to Hitler then what Rush has and that never bothered anyone, in fact the politicians on the left supported and repeated it. I think that is called Hypocrisy Bob.
    Why do you fail to mention Obama’s support for the VA death panels? Have you even read the material they want to distribute to our vets? The fact is many people far smarter then you and that actually know healthcare see these policies leading to death panels. The bill might not contain the words death panel but any intelligent person knows that doesn’t prevent it.
    To prove your dishonesty and McCarthic debate please show me anywhere in any Medicare Legislation that it says you will lose your Social Security Benefits if you opt out of Medicare. It is a fact you will lose your benefits so how can that be if the Medicare Bill doesn’t have a section titled “Lose of SS benefits when opting out”? It doesn’t have to, the intended and unintended consequences of legislation are always worse then the legislation. That you deny this and pretend just because Death Panel isn’t in the index it can’t happen is either ignorance or rank partisan McCarhtyism. I’ll give you the benefit of the doubt and say your both.
    If you want to go throwing labels and names around I hope you where preapred to get the truth back.

  36. If I think the House bill will eventually become federal wonks telling me what end of life care will or won’t be paid for — I oppose “palliative care”?
    If I oppose the House bill I am not just wrong; I’m Joseph Mcarthy? I’m equating O’bama with Hitler?
    Wow. That’s some nuanced thinking. That should be effective.