Matt C. Abbott
December 28, 2010
Obama's 'death panels': what lies ahead
By Matt C. Abbott

From a Dec. 27 blog post by Philip Klein of the American Spectator:

    'The New York Times reports that the administration has brought back the end-of-life planning provision that triggered last year's 'death panel' debate. The measure allowed doctors to be paid for providing voluntary counseling to patients about deciding what kind of life-sustaining treatment they'd want if they were no longer in a condition to make decisions about their own care. As I wrote at that time, this is the reality of what happens when government is involved in medical care — suddenly the state gains an interest in individual decisions....'

I thought I'd ask Ron Panzer, head of Hospice Patients Alliance (and a nurse), to comment on the story. Panzer, who's working on a book on the subject, says that "this is all about pushing forward the hospice utilization to 100 percent, or as close as they can get it."

A person entering hospice could then be one of many patients quietly euthanized under the guise of end-of-life pain management. (See my April 29, 2010 column.)

Panzer writes (edited):

    'What is the new regulation about? Yes, it's about encouraging the use of advance directives, DNRs, Living Wills, and appointing someone as power of attorney to help make medical decisions should you not be able to do so at some point. But what it's mostly about is getting people into hospice sooner, and, with rationed care being uniformly applied to the elderly per President Obama's health advisor's Complete Lives System, the rationed-care rejects will be pushed forcefully into hospice. Dr. Ezekiel Emanuel protests that it's not discrimination since all elderly will get the same treatment under his (the new health law's) system.

    'The government wants to promote hospice. It's a good way to manage the population. It balances the budget and provides services for the elderly at the cheapest price. Even better, it will be the chosen vehicle to provide hastened deaths for the disabled, dementia patients and others selected for end-of-life treatment by the bureaucrats who use the Complete Lives System. Will the criteria for being considered as having lived a 'complete life' be expanded in the future? You can be sure....

    'Several years ago, Sen. Charles Grassley told one of our Hospice Patients Alliance board members that Congress knows all about the medical killings — and that they're not going to stop these killings because they know the government saves at least $100,000 for every person who dies early. Today the savings are much more.

    'Rationed care and hastened death are already here. HMOs already ration care in order to promote 'efficiency' and there are many steps where physicians are restricted as to what they can order. If they go against the guidance of the HMO and order certain treatments anyway, they risk being disqualified from participating as an 'in-network' provider with that private HMO or insurance company. If they loss classification as an 'in-network' physician, they lose patients and income.

    'If private insurers deny coverage or treatment to a patient, they can appeal to government regulators or arbitrators. If there is only a single government-controlled health system, there will be no effective place to appeal to. And as they say, 'You can't fight city hall.' Try fighting the federal government. It's much worse than 'not easy.' It's virtually impossible. This is the situation in the United Kingdom, where the National Health Service is the source of thousands of complaints and horror stories, almost all with no relief.

    'When the health care reform plan goes into full effect, regulators, bureaucrats, and Medicare/Medicaid fiscal intermediaries will decide. These are the nameless government workers who will decide not to fund Grandma Suzie's needed pacemaker or medication. They're going to do their part to balance the budget for these government programs without any fuss or fanfare. How they do their job will be decided by elite-level management, according to a secular, utilitarian approach. Publicly they will talk about the need to cut costs, reduce expenditures, and spend money 'wisely.' But their decisions may be based on what's 'best' for society as they see it, not what's best for Grandma's survival....

    'With payments to physicians being reduced by the federal, state and even private insurers, physicians are being squeezed on all sides. You may think it's a picnic, that physicians are all rich, but they pay huge sums just to go through school for so many years. They often have hundreds of thousands of dollars in student loans when they graduate. Some greedy lawyers are just waiting to sue any physician who makes any mistake, or even appears to have made a mistake, so physicians have to pay huge premiums for liability insurance. Then there's the overhead they incur running a practice.

    'My uncle, Martin Panzer, M.D., was a dedicated family physician who practiced many years and served as President of the New York State Academy of Family Physicians in 1992. He told me that if he had known how bad it would get, he would have thought twice about becoming a doctor. There was so much paperwork, red-tape, regulation and so on. My father, Stewart Panzer, M.D., has talked about the unnecessary tests doctors have to order nowadays as part of 'defensive medicine,' just so they cover all the bases and don't give some lawyer an excuse to sue. And those unnecessary tests and procedures increase the cost of health care for everyone.

    'Many doctors have shut their offices and opted to find employment in a health care system; they can't make it on their own anymore. Physicians are looking for any revenue source they can get to stay afloat. If the government will pay them to push hospice, or advanced directives, that's what many will do. The doctor won't tell Grandma Suzie that her life just doesn't count any more to the government or HMO.

    'The number crunchers? They really do prefer that Suzie die. It's all about the numbers, budgetary numbers for the state and the federal government. What the public doesn't realize is that the 'Do Not Resuscitate' (DNR), the Advance Directive and the Living Will were promoted originally by the successor organizations of the Euthanasia Society of America, such as Society for the Right to Die and Choice in Dying. What the public also doesn't realize is that one of the biggest pro-assisted-suicide groups in the country, Compassion and Choices — formerly the Hemlock Society — helped write the language in the health care reform law that pertains to these strongly-encouraged 'counseling' sessions with the elderly.

    'Since physicians are screaming about funding cuts by Medicare, they will be sure to provide 'end-of-life counseling' to get more revenue coming into their practices. They may suggest, 'Don't you think hospice is a good option for you?' Eventually incentives will be built into the government's system (just like HMOs already do) so that doctors who order fewer tests, treatments, surgeries or other services will get paid more each year. They'll know that the government plan won't approve certain surgeries or treatments for the elderly. They'll know that it won't make any sense to even try to get certain procedures approved for the elderly. They'll know that at a very advanced age, the only thing that will be approved is hospice.

    'Going into hospice could be a good option if the patient is actually terminally ill. And it could be a good option if the hospice eventually used respects life and does not hasten death through misuse of terminal sedation or other means. Yes, the advanced care planning sessions that the government said would not be included in the law was added back on November 29, 2010. They really want everyone to have an Advance Directive (that limits care to be provided) and to be encouraged to use end-of-life care services (hospice) when the time comes. See Section 410.15: 'Annual wellness visits providing Personalized Prevention Plan Services: Conditions for and limitations on coverage.''

© Matt C. Abbott

 

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Matt C. Abbott

Matt C. Abbott is a Catholic commentator with a Bachelor of Arts degree in communication, media and theatre from Northeastern Illinois University. He's been interviewed on MSNBC, NPR, WLS-TV (ABC) in Chicago, WMTV (NBC) in Madison, Wis., and has been quoted in The New York Times and the Chicago Tribune. He can be reached at mattcabbott@gmail.com.


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