Tuesday, August 11, 2009

A Rational Voice in the Wilderness

The health care debate is too important for name calling and lies, yet that's what a lot of the opposition has come to. Sarah Palin recently wrote on her Facebook page:

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.

There's no other way to say it: her comments about "death panels" is a lie. It's not a difference of opinion. It's not a matter of perspective or context. She made it up out of whole cloth for her own political purposes, which is reprehensible, no matter which side she comes down on. Downright evil, even.

For the facts of this aspect of the health care debate, here's the transcript from today's Washington Post of an interview between Post blogger Ezra Klein and Senator Johnny Isakson (R-GA). That's right; he's a Republican.

EK: Is this bill going to euthanize my grandmother? What are we talking about here?

JI: In the health-care debate mark-up, one of the things I talked about was that the most money spent on anyone is spent usually in the last 60 days of life and that's because an individual is not in a capacity to make decisions for themselves. So rather than getting into a situation where the government makes those decisions, if everyone had an end-of-life directive or what we call in Georgia "durable power of attorney," you could instruct at a time of sound mind and body what you want to happen in an event where you were in difficult circumstances where you're unable to make those decisions.
This has been an issue for 35 years. All 50 states now have either durable powers of attorney or end-of-life directives and it's to protect children or a spouse from being put into a situation where they have to make a terrible decision as well as physicians from being put into a position where they have to practice defensive medicine because of the trial lawyers. It's just better for an individual to be able to clearly delineate what they want done in various sets of circumstances at the end of their life.

EK: How did this become a question of euthanasia?

JI: I have no idea. I understand -- and you have to check this out -- I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts. You're putting the authority in the individual rather than the government. I don't know how that got so mixed up.

EK: You're saying that this is not a question of government. It's for individuals.

JI: It empowers you to be able to make decisions at a difficult time rather than having the government making them for you.

EK: The policy here as I understand it is that Medicare would cover a counseling session with your doctor on end-of-life options.

JI: Correct. And it's a voluntary deal.

EK: It seems to me we're having trouble conducting an adult conversation about death. We pay a lot of money not to face these questions. We prefer to experience the health-care system as something that just saves you, and if it doesn't, something has gone wrong.

JI: Over the last three-and-a-half decades, this legislation has been passed state-by-state, in part because of the tort issue and in part because of many other things. It's important for an individual to make those determinations while they're of sound mind and body rather than no one making those decisions at all. But this discussion has been going on for three decades.

EK: And the only change we'd see is that individuals would have a counseling session with their doctor?

JI: Uh-huh. When they become eligible for Medicare.

EK: Are there other costs? Parts of it I'm missing?

JI: No. The problem you got is that there's so much swirling around about health care and people are taking bits and pieces out of this. This was thoroughly debated in the Senate committee. It's voluntary. Every state in America has an end of life directive or durable power of attorney provision. For the peace of mind of your children and your spouse as well as the comfort of knowing the government won't make these decisions, it's a very popular thing. Just not everybody's aware of it.

EK:What got you interested in this subject?

JI: I've seen the pain and suffering in families with a loved one with a traumatic brain injury or a crippling degenerative disease become incapacitated and be kept alive under very difficult circumstances when if they'd have had the chance to make the decision themself they'd have given another directive and I've seen the damage financially that's been done to families and if there's a way to prevent that by you giving advance directives it's both for the sanity of the family and what savings the family has it's the right decision, certainly more than turning it to the government or a trial lawyer.

No comments: