Just when you thought politics could not get worse, we get the health care debate. I have written previously about my favorite 3 debate techniques:
- Obfuscation
- Hyperbole
- Sophistry
Both sides have adopted all 3 techniques.
Shame on the Republicans for claiming false concepts in the bill. There are no “death panels”. The bill does not explicitly endorse rationing. The bill does not state, nor imply that you will lose your current insurance or physician.
Shame on the Democrats for providing over 1000 pages of bill. The longer the bill the more confusing, and thus the more fodder for misinterpretation. Shame on the Democrats for not understanding how to sell the important concepts in this bill. They should read the book – Made to Stick.
Shame on Obama for allowing Congressional Democrats to “go crazy” for the 3rd time (stimulus bill, cap and trade, and now health care). This take reminds us that this may be Obama’s greatest weakness – Where Obama should look to influence the debate
So from this comfortable vantage point, I see incredible lack of vision, leadership and honesty. We may yet get some health care reform, but only if the Dems become more attuned to the possible.
My favorite TV new analyst – Joe Scarborough – warned early in Obama’s tenure that the Dems should be careful to not succumb to arrogance. He opined that the Republicans fell to this tendency when they had a huge majority. The Democrats could have done some important things if they acted less partisan and less ideological. But they have not, and that is the first half of the problem.
The Republicans have become the party of no. Democrats should not criticize so much, because they had the moniker in the early years of the Bush administration. The hostility and lack of partnership in Washington is disgusting, and not good for our country.
As a medical blogger, they will not take heed to this screed. Neither side has true leadership at this time. Perhaps Max Baucus will save the day, I can only hope so. Obama does not know how to influence Congress, and that is a huge problem.
Back to patient care this morning. Once you are in the room with a patient, you can block all this idiocy out of your mind and get back to something that matters.
{ 3 comments… read them below or add one }
Yes, I’ll be with patients soon and leave the health care reform morass for a few hours. While I agree that the GOP has been the party of ‘nyet’, what choice did it have? The public option (read: prelude to government takeover) attacks a core GOP existential value. Bipartisanship is not worth any price. In addition, the Dems, including the president, are threatening to pass health care without any Republican votes by a simple majority vote. Personally, if the reform effort actually gets airborne, and GOP (and conservative Dems) ideas are incorporated, then the final product will be more palatable to the country. Of course, none of this matters if we can’t pay for it or we do not significantly bend the cost escalation curve. Now, I’m off for an ‘enlightening’ morning of colonoscopies!
“The bill does not explicitly endorse rationing.”
But if we are to give care to even more people with the same resources, there will have to be rationing. And that’s what’s happened in other countries which have adopted effectiveness councils, and other means to control costs.
Which leads to your first point: “There are no “death panels”.”
There is nothing by that name of course, but Ezekiel Emmanuel, one of Obama’s key health care advisors said in a Lancet article in January, that rationing based on the “complete lives system” should be adopted. This is a younger over older rationing, but he also recommends modifying it to put adolescents and young adults over younger children and infants, since they may “lack the potential to live a complete life.” Having glanced through the Lancet article (Jan 31-Feb 6, 2009) a complete life seems to be defined as one which is the most societally useful, i.e. (to the cynical among us) a life which can pay the most taxes; if a person is unlikely to reach that age, or has passed it, they don’t merit anything more than basic care, and perhaps not even that. So I can see why some would use the term “death panels” to the describe the panels which would decide a person’s usefulness under the euphamistic name of “complete lives” and allocate care based on that.
“The bill does not state, nor imply that you will lose your current insurance or physician.”
By the beginning of 2018, if your plan (whether you have it through your employer, or as an individual) doesn’t have exactly match the government’s definition of a “Quality Health Benefits Plan” you can’t keep it. If you change employers, or become self-employed, you can’t keep your plan even if you are willing to pay for it yourself unless it’s in the Exchange, because the insurance companies aren’t allowed to enroll any new members after Dec 2012, if the plan isn’t a QHBP. Since we don’t know what they are going to mandate for for these plans, (and we won’t for at least a year after the passage of this bill) we don’t know if our plans are going to be considered QHBPs, so we don’t know if we’ll be able to keep them. And with footage of Obama from both 2003 and 2007 saying that his goal is a single payer system, as well as Barney Frank admitting on camera just a few weeks ago that a public option plan is a good first step to single-payer, it’s hard for those of us who do like our current set-up to believe that it will be left alone.
Doc, you yourself engage in those very things with regard to political issues. Don’t act so shocked that others do as well. It’s politics, after all.