Health care debate turns nasty

The third rail of American politics is healthcare reform. And President Obama is looking distinctly singed after stepping on it. "Socialist", "evil", and "Orwellian" are a few of the kinder adjectives.

As proposed by the House of Representatives, the bill reforming the health system, HR 3200 is well over 1,000 pages long and no one appears to have read all of it. So most of the debate has centred on a few sections which people claim to understand.

The noisiest and nastiest of these has concerned allegations of government support for euthanasia. This first emerged with a Facebook entry from gone but not forgotten Republican vice-presidential candidate Sarah Palin.

She wrote that the "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."

Since then, the Obama administration has been on the back foot defending the legislation against the idea that section 1233 of HR 3200 will require everyone over 65 to sign his own death warrant.

As Washington Post journalist Charles Lane points out in a thoughtful analysis, this is surely not what its authors intended, but it can be interpreted in this way. Section 1233 would authorise paying doctors to give Medicare patients end-of-life counseling every five years — or sooner if the patient gets a terminal diagnosis.

"Ideally, the delicate decisions about how to manage life’s end would be made in a setting that is neutral in both appearance and fact. Yes, it’s good to have a doctor’s perspective. But Section 1233 goes beyond facilitating doctor input to preferring it. Indeed, the measure would have an interested party — the government — recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations. You don’t have to be a right-wing wacko to question that approach." ~ Washington Post, Aug 8

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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