Rationing Life Itself
“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.”
Of Sarah Palin it may be said: The lady knows how to frame an issue.
And while she has been fairly criticized for hyperbole about the end-of-life counselors in the House bill, she drew such attention to the provision that Democrats chose to dump it rather than debate it
And understandably so. For if Congress enacts universal health care coverage, we are undeniably headed for a medical system of rationed care that must inevitably deny care to some terminally ill and elderly, which will shorten their lives, perhaps by years. Consider:
Democrats call Medicare the model of government-run universal health care. But Medicare is a system whereby 140 million working Americans pay 2.9 percent of all wages and salaries into a fund to pay for health care for 42 million mostly older Americans. And Medicare is already going bust.
If Obamacare is passed, the cost of health care for today’s 47 million uninsured will also land on those 140 million. And if Obama puts 12 million to 20 million illegal aliens on a “path to citizenship,” as he promises, they, too, will have their health care provided by taxpayers.
Here is the crusher. The Census Bureau projects that, by 2050, the U.S. population will explode to 435 million. As most of these folks will be immigrants, their children and grandchildren, the cost of their heath care would also have to be largely born by middle-class and wealthy taxpayers.
Now factor this in.
In 2000, the average American male in a population of 300 million lived to 74; the average female to 80. But in 2050, the average male in a population of 435 million Americans will live to 80 and the average female to 86. And, according to U.N. figures, 21 percent of the U.S. population in 2050, some 91 million Americans, will be over 65, and 7.6 percent, or 33 million Americans, will be over 80 — and consuming health care in ever-increasing measures.
Now if a primary purpose of Obamacare is to “bend the curve” of soaring health care costs, and half of those costs are incurred in the last six months of life, and the number of seniors will grow by scores of millions, how do you cut costs without rationing care? And how do you ration care without denying millions of elderly and aged the prescriptions, procedures and operations they need to stay alive?
Consider two beloved Americans: Ted Kennedy and Ronald Reagan.
Since he was diagnosed with brain cancer more than a year ago, Sen. Kennedy has had excellent care, including surgery and chemotherapy, which have kept him alive and, until very recently, active.
For a decade, President Reagan, because of round-the-clock care, lived with an Alzheimer’s that had robbed him of his memory and left him unable to recognize his own family and close friends.
In the future, will a man of Kennedy’s age, with brain cancer but without the means of offsetting his own health care costs, be kept alive, operated on, given chemotherapy — by a government obsessed with cutting health care costs?
Will a bureaucracy desperate to cut costs keep alive for years the tens of thousands of destitute 80- and 90-year-old patients with Alzheimer’s, as was done with Ronald Reagan?
What if, in 2050, Palin and her husband are not here. And 42-year-old Trig, with Down syndrome, has been in an institution for years, and the cost of his care and that of hundreds of thousands like him with Down syndrome is draining the resources of the health care system?
Will there not be voices softly suggesting a quiet and merciful end?
In Oregon, the law permits doctors to assist in the suicide of terminal patients who wish to end their lives. Let us assume numerous patients have Alzheimer’s and, so, cannot be part of the decision to end their lives. Who then makes the decision to continue or end life? Would it be unfair to call the decision-makers in those cases a death panel?
Almost a third of all unborn babies in America have their lives terminated each year with the consent of their mothers. Fifty million since Roe v. Wade have never seen the light of day. For many, the quality of life now supersedes in value the sanctity of life. That is who we are.
Between 2012 and 2030, 74 million baby boomers will retire, cease to be the major contributors to Medicare and become the major drain on Medicare. How long will an overtaxed labor force in a de-Christianized America be wiling to pay the bill to keep all those aging boomers alive?
Rationed care is coming, and the death panels will not be far behind.
Patrick Buchanan is the author of the new book Churchill, Hitler, and ‘The Unnecessary War,’ now available in paperback.
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In 1990, the Dutch government launched a study to see how euthanasia was being carried out in the country. A year later, it issued the Remmelink Report, named after Professor J. Remmelink, then attorney general of the Dutch Supreme Court. Although it narrowed the definition of euthanasia considerably, what it found wasn’t pretty. In 1990, of the approximately 90,000 people who did not die suddenly, 11.1 percent were euthanized and more than half of these killings were involuntary. Fourteen percent of those involuntarily euthanized were fully competent to make their own medical decisions.
Pat Buchanan wrote:
“Rationed care is coming, and the death panels will not be far behind.”
Interesting in that even assuming this is the future (which seems a reasonable prediction at least, although I don’t think Oregon’s law allows what he says because I think it requires one to be of sound mind to end one’s life), what’s left unmentioned is that presumably a person could alway use their own resources to pay for whatever care they were denied.
Of course by definition almost those whose care was being rationed will already have been found too indigent to pay for their own care, but nevertheless the point remains: the “rationing” that Pat speaks of would be a rationing of welfare just as much as a rationing of “care.”
Interesting then to see that those who traditionally very much liked the idea of rationing welfare now being vehemently against same when that welfare is end-of-life care, and I’m not sure I understand it. We say to people “go to school and don’t fall into addiction or else you might end up on welfare and we certainly are going to ration that subsidy to you.” But why is it different when everyone knows that death in inevitable and its form is uncertain and yet with those who haven’t saved to address the issue we should say “no no, even though you are very very near to death in any event go ahead and charge us as many millions of dollars as you want in care to keep yourself alive for as many additional minutes as possible.”
I’m not saying I’m against that, just wondering why traditional “conservative” principles seem to find an end to their road here, just where it seems the liberals and the Left find them sensible.
Cheers,
[...] the entire post from The American Conservative; “The America I know and love is not one in which my parents or my baby with Down syndrome will [...]
Look over on this wall. Neatly handlettered, it says, 2010.
First, they “euthanized” our freedom, by taking over all major institutions, news and entertainment, and services such as healthcare.
Second, they convinced us that the only alternatives were nutjobs like McCain and Ron Paul, and used this on us like a good dose of ipacac.
Third, they very reluctantly discovered that just like promises of bipartizanship, transparency, no new taxes, and end to war, …they discovered they would also have go back on that promise about not “unplugging grandma”.
See, it”s written over on this wall…
Dear Pat Buchanan,
The question that no one is asking on the left, right or talk radio is why we dont fix medicare, medicaid and social security first before we try to expand a program to socialized medicine where everyone is covered. Tackling these back into solvency would show responsibility and build trust but it doesnt seem as though they want responsibility or trust…it seems they want wallpaper over high nefarious euthanasia and rationing behind the mantra of a giveway to voting immigrants who will keep them in power for another generation. So then one must ask…if this was the democrats strategy then why did Reagan, BushI and BushII keep the borders open?
Then again, the question should be asked why we have such high immigration rates and open borders?
Mr. Buchanan makes a good point though- in a huge, all powerful government system which will inevitably ration care, some people will be left out. I think the point should be we should cut all these programs substantially- the way we provide health care through government has more similarities to systems like France and Germany than differences in the first place. We need individually purchased health care, with legal access across state lines, more like the Swiss.
If there isn’t enough of something to go around, you’re going to have to ration. If our society does not provide the money to see that there is enough healthcare for all in 2050 under a government run program, there is every reason to believe we will not provide enough under a continuation our current system.
If, because of your financial wherewithal, you think your chances of receiving unlimited care are better under today’s system, that’s a perfectly rational choice. But rationing by price is still rationing, and will result in untreated conditions and early deaths just as surely as bureaucratic rationing. Claiming any moral superiority private insurance is unwarranted.
After two PJB columns in a row without a laudatory comment about Sarah Palin how refreshing to have her back! I quite honestly don’t get a lot of this. PJB is representing a Catholic view, that all human life is to be protected all the time and under all circumstances, but healthcare is a finite commodity. It seems clear that no country or society has the resources to provide unlimited access to it for all citizens under all conditions, even if it were free.
Healthcare is already rationed for many by access to insurance or ability to pay. Even for the well insured one has to question the viability of extremely expensive treatments to prolong life for only a short time when those same resources might be used to actually save the life of someone else. I would not, however, want to make that decision and would not want a government panel to do it either. To avoid a government hand, I think the solution is to make it easier and more affordable to obtain private insurance by establishing more accessible group plans and eliminating pre-existing conditions as a barrier. Those who want coverage that is virtually without limit could, if they choose, buy expensive policies out of their own resources while the rest of us could find alternatives that might not be perfect but which would cover us under most circumstances.
Hell Philip, that just too logical! Are you trying to stop the debate or something?
PJB may be representing a Catholic view, but then so am I. If you, mrmetrowest and Philip Giraldi, were to find yourselves sufffering from Alzeimer’s in your 70s, or even 60s, how would you feel about being “put down”? I spend $7000 a year or more on medicine and doctors and hospitals, and it isn’t fun. Mostly I do get by okay. I can’t drive and I am having trouble since I lost my last job–how do I get around to companies to interview if the train doesn’t get me there? I suppose I will find something eventually, but I can see myself having some doctor-bureaucrat decide on my fate, and I don’t like the idea. I don’t have any suggestions, but I don’t want that to happen to me.
When one talks about the fear of government rationing, it is a bit disingenuous to exclude a discussion of private insurance rationing which is a frequent fact of life under our present system.
I agree 100% with Mr. Buchanan that rationing healthcare is inevitable in the long-run.
Whole Medicare concept was unjustifiable from capitalist viewpoint. Taking money from one group of tax-payers to give to another group of citizens in the name of “Healthcare” is antithetical to capitalism.
FDR invented Medicare to appease socialists in America during his tenure as the President of the U.S.
FDR was a very intelligent fellow. He knew that majority of Americans despise socialism; but, loves socialist security benefits.
Today, American taxpayers of younger age are bearing the huge burden of paying for the healthcare of elderly Americans.
Therefore, there is a gross injustice rooted in original “Medicare” idea.
Justice is not easy to find when American presidents call themselves “Capitalists”, but act actually as “Socialists”.
Regardless of any harsh future scenario, I totally agree with Mr. Patrick J. Buchanan for his erudite understanding of the current mess.
Once again, if sufficient facilities do not exist to handle all medical needs, there will be rationing of some kind. To take the example of Alzheimer’s patients, if there are not enough day care, nursing etc facilities available for all, then in some manner that care will be rationed, whether by conscious decision or happenstance. The idea that such patients might be euthanized is unlikely in the extreme. Either their families will have to shift for them, or they’ll be warehoused in some manner. I have more faith in Americans than does Sarah Palin. We aren’t going to morph into a country that puts oldsters to sleep. Neglect? You bet. Active euthanasia – not going to happen.
I’m astounded that “TomT” would have the gall to libel Ron Paul and in the same breath as John McCain. Paul is the
sanest member of Congress. Of course socialized medicine will lead to end of life rationing as well as in all other areas.
That death panel tag has a LaRouchite ring to it and I am concerned if these genuine nutcases are taking over the townhalls.
modonnell, first let me say that I sympathize with your situation. I have no idea where you live or of your general circumstances. In my experience, most county governments have mobility programs for seniors and people in need. Usually this consists of small buses or vans that will take you to medical treatments and perhaps, work.
A thought on more general matters seems appropriate. The collapse of large families as the ideal, leaves many of us without a support system. How have we gotten to the point where people either do everything for themselves or they are thrust into the hands of the government? Modonnell, please understand that this is in no way a criticism of you. By virtue of being the youngest of my family, I too will face your situation. eventually. We seem to be a people who no longer create bonds. I suggest you start making genuine friendships based on mutual support and affection. In the end we all depend on each other.
I take it you prefer rationing by insurance companies.
What alot of people dont talk about in this country is the fact that Euthanasia happens every day in large numbers. Don’t you know what they do in hospice care? They kill you with morphine. put you out of your misery and alot of time the patient and families dont even understand that is why they dont have any appetite. They are sleeping all the time. Their organs are shutting down. Oh it must be the cancer progressing. Duuuuhhhh. It is the morphine stupid.
I don’t know all the merits and demerits of Obama’s plan, but what I do know is that something is terribly wrong with our basic system given the way it and so many other initiatives are being treated.
On another health-care thread awhile back some Canadian commented about how surprised he was at the high and decent level of conversation that was had on this blog about the issue. And the same applies to the comments to this thread. And yet in the wider public sphere it can seem that the level of conversation about it is at the lowest point imaginable. And now I see Drudge linking to a story about some Republican Congressman from California whooping up some town hall meeting by saying of Obama’s health-care plan “Our democracy has never been threatened as much as it is today.”
Of course the Dems do it too with Republican proposals, with the idea of both parties simply being to hurt the other side no matter the damage done to the country. But it’s now done so blatantly and with such important issues that it just leaves one aghast at where it will all lead.
This is no way to run a railroad, that’s for sure.
It’s not like the current system is great either- a true conservative or libertarian wouldn’t say that, because we don’t have a free market in health care.
People continue to misuse the term “ration”, and people continue to debate whether government or government sponsored cartels are the best means for paying for medical services and supplies instead of striking at the root of the problem.
Have you ever tried to ask a hospital to quote you a delivered price for a simple surgical procedure? They can’t. Why does a band-aid cost $25 in a hospital? The problem– and the reason that prices are distorted– is that there is generally no financial relationship between the providers of medical care and the recipients of care. You are not their customer; Medicare, Medicaid and Blue Cross are their customers. Providers have no way of knowing what price end consumers would pay, and you have no way of knowing what price is a good value. Pricing conveys information that helps people make decisions, but there is currently a fog between the provider and the consumer, and there are powerful vested interests (public and private) that are benefitting from the confusion.
Expanding the role of government, or any other middleman, is not going to reduce the waste that exists in this distorted system. What percentage of the staff at your family practitioner is actually engaged in rendering care? What percentage of the money spent on health “care” is burned up by the health industry (private and public)?
I have no idea if you can get a quote for health care in the way you can get a quote for construction. For certain types of elective procedures you can certainly get a quote – Lasik, for instance. If hospitals are reticent about quoting, perhaps it’s because of the nature of the beast – in other words, the human body can produce complications that can’t be predicted. Also, the nature of acute medical care, and the desire for patients to use a facility nearby, mitigate against shopping.
Hospitals most assuredly do have fee schedules. Just go to the ER without insurance – you’ll get a bill. I had an ER visit a few years ago and I received a bill with charges based on my insurance group rate as well as what the charges would have been out-of-pocket. Obviously, the insurance company had negotiated a lower rate.
Administrative overhead is a fact of life. Even if the patient pays, the hospital still has to produce a bill, collect funds, resolve disputes etc. The problem with our current system is the myriad of insurance companies and their multiple products. This is a costly administrative nightmare for people in medicine.
The insurance company had negotiated a lower rate? Lower than what? Lower than the rate that open competition for patients would produce, or lower than what hospitals would charge in an environment in which they are disconnected from patients? When and how did they present you with this “out-of-pocket” option? As a real option prior to service, or afterwards, when you could say, “Wow, thank God I have insurance?”
You’re just trying to talk up the promised benefit of simpler options and collective price “negotiation” with providers under a single payer system without using the phrase. You’re response (as usual) is a set up based on talking points. Single payer -> leveraged spend and simpler insurance options -> lower costs for everyone.
Unfortunately, no one person or organization is able to come up with the right price for anything. This only occurs through human interactions that include many providers innovating and competing for many consumers who are making choices based on their individual perception of value. This isn’t occurring now with insurance companies or government. Individuals who don’t fit into their models for acceptable financial risk or into the correct social category can be excluded. These people are then left to be individual consumers in a world that is, by law, oriented to meet the needs of society’s largest organizations.
If government were the only middleman, it would simply be setting a price that promotes its collective political objectives. That is how government works, in spite of the tireless dedication of the guy/gal on the front lines.
Forcing insurance companies to keep liabilities (sick people) and limit assets (premium collection) would just wreck their finances and result in these companies becoming wards of the state that are too big to fail.
The promise of simpler bureaucracy is not one that government has a track record of achieving. Let’s face it; under a government scheme, taking red-tape out of doctors’ offices would really just move it into government offices, and simplifying the red-tape by eliminating the many different insurance products is by definition a reduction in options.
Why not remove the red-tape all together? There is no comparison between the simple administrative costs of writing and collecting on invoices and the current mess. There are entrepreneurs out there who would love to make money AND save lives by creating a whole new way to run a hospital or doctor’s office. If they fail, they will be replaced by other actors that want to do something innovative and profitable. Let them have a real financial relationship with the end-consumer, and you will see an explosion in innovation, productivity and efficiency AND quality of care. This is how a free economy and society works.
First of all, government and large corporate entities negotiate bulk contracts for goods and services all the time. An agreement for purchase in bulk between to large entities is as effective a price setting mechanism as any other.
Trying to create a marketplace for healthcare similar to the market for tires is absurd. You are not going to start price shopping when you have acute appendicitis. Moreover, you will almost certainly want to use a provider geographically near your home, which for many would limit the choice to one or two entities. It could easily be argued that health care at the level of hospital services constitutes a natural monopoly.
The administrative overhead for charging a single entity could easily be higher than charging individual consumers.
Why is it that when insurance companies ration health care, as they do now. PJB and all his compatriots think it is just fine. Yet at every opportunity the “rationing” straw man is played to prevent anything that would potentially force the hand of the insurance business.
How much health insurance stock do you own Pat?
Also, if you are so concerned with rationed care and socialized medicine, they why not propose to abolish Medicare, Medicaid, and Bush’s prespriction drug boondoggle?
I guess hypocrasy and gotcha politics knows no bounds.
When the corporations speak, the mindless listen. The only people to gain from our system of healthcare are corporations and their stockholders. The rest of us just get a drubbing. A single payer system is the one true, just way to handle this, but the money grubbers don’t want that. They want money, so they get the mindless up in arms and screaming. Hence where we are right now!
http://mises.org/story/3657
More complaints from Mr West Wing about how a free market won’t work in the currently distorted environment. “But there’s only one government approved medical center in my neighborhood. There’s no such thing as choice!”
Negotiating in bulk is fine as long as you are buying in bulk. How much can an insurance or government agency do that with dozens of different providers just within a single geographic area? Yes, it does work for prescription drugs. That’s why you can buy your scrips at Wal-Mart for $4.
Read the Mises article.
Is there a medical term for obsessing about something that theoretically might happen in the future…but not being concerned a whit that it’s actually taking place NOW?
The author’s distress is misplaced. Perhaps he could redirect his sense of urgency to the tens of thousands of Americans who will die this year when their insurance companies refuse to pay for medical treatment.