From The Washington Post:
A campaign on conservative talk radio, fueled by President Obama’s calls to control exorbitant medical bills, has sparked fear among senior citizens that the health-care bill moving through Congress will lead to end-of-life “rationing” and even “euthanasia.”
The controversy stems from a proposal to pay physicians who counsel elderly or terminally ill patients about what medical interventions they would prefer near the end of life and how to prepare instructions such as living wills. Under the plan, Medicare would reimburse doctors for one session every five years to confer with a patient about his or her wishes and how to ensure those preferences are followed. The counseling sessions would be voluntary.
But on right-leaning radio programs, religious e-mail lists and Internet blogs, the proposal has been described as “guiding you in how to die,” “an ORDER from the Government to end your life,” promoting “death care” and, in the words of antiabortion leader Randall Terry, an attempt to “kill Granny.”
For me, it goes without saying that this “kill Granny” scare campaign is the worst kind of demagogy. However, the Democrats should have seen this coming. Many bills have several hundred pages, but you can’t treat health care reform in the same way. For the forces of Reaction, this is a do-or-die battle. The more complicated the bill is, the more targets they have to snipe.
In the reality-based community, there is a debate about two models of health care – the national health insurance model (i.e., single payer) vs. the Bismarck model (i.e., heavily regulated competition). One concern is that with national health insurance (NHI), if the system is underfunded or has some other kinks, Congress will have to become involved again. Given how broken American politics is, that is an unwelcome prospect. In a Bismarck system, the insurers would at least make sure that income and outgo are balanced, while competition exerts downward pressure on premiums.
Another point, however, weighs in favor of NHI: it is much simpler. The concept is easy to understand – Medicare for everyone. Or, if it is politically necessary to be incremental, Medicare for anyone who doesn’t choose a private insurer. If the Republicans utter the word “socialism,” then the line of counterattack is clear: Republicans want to destroy Medicare (i.e., socialized medicine).
However, I hope that it is a subtle sign that serious regulation is back. For decades, Republicans worked to dismantle and cripple the regulatory regime that protects consumers, and Democrats too often lent a hand. Obama and the Democratic majority in Congress have disappointed progressives in almost every way, but perhaps they will return to pre-Reagan values on regulation.
