Friday, October 30, 2009

Better But Not Best: "Pro-Lifers" Criticize End of Life Provisions in Health Care Bill.

Wesley J. Smith considers the end of life counseling provisions in the announced health care bill and finds them improved - giving credit to Palin and McCaughey for bringing attention to this aspect of the bill.

The new text blunts the criticisms about end of life counseling made here at SHS and elsewhere. I am especially pleased that the counseling is not to be directed toward a particular result and that the option of receiving care is to be included in the directives. However, the bill does not, as far as I can tell, guarantee that the provider cannot be sanctioned for not pursuing the issue. Moreover, as Rita Marker told me in a conversation this morning, the language is far from air tight and regulators may interpret it in ways that take back what appears to have been gained. For example, the requirement not to “promote” assisted suicide certainly doesn’t preclude it from being brought up or discussed in the counseling sessions. And let us not forget, there is still a pending Senate Bill that would deprive providers of payment if they did not offer the counseling.

While Smith still says he thinks the bill should be defeated, he and other "pro-life" activists have backed off criticism of end of life counseling because, well, they got over their unnecessary hyperventilating from the summer. Smith still has a beef with counseling because he sees it a coercion of the elderly and ill to even think about how they wish to die.

And he has a vested interest in preventing discussion of Death with Dignity (legal in some form in three states). A requirement already built into Oregon and Washington's bills moots his point. Patients must bring up Death with Dignity; doctors are prevented by law from doing so.

End of life counseling makes sense for so many reasons and on so many levels that opponents had to temper their rabid "death panel," "government-encouraged euthanasia" claims.

It's laughable that they made a stink about nothing this summer and now take the time to credit their own disingenuous concerns. Even more laughable is the fact that the White House didn't see McCaughey's "euthanasia" talk coming and better prepare for it.

Ultimately, we'll have a much weaker health care reform bill because the administration and Democrats, very much in power at the moment, neglected to better manage the messaging about reform or assume that power. They let Republicans, social conservatives and "pro-life" groups railroad their proposals, were swayed by a lot of the noise - without refuting the lies! - and delivered a watered-down bill that is ultimately an unnecessary compromise.

Generous commentators are calling it compromise, bipartisanship, and a political victory. While many of the improvements reform represents are necessary and right, the weakened public option, the chance that women who are currently covered (50 to 85%) for abortion services may lose that coverage, and the fact that end of life care has been battered all make this bill an unnecessary compromise that leaves the medical industry too much power over our health.

Republicans and conservatives, in other words, worked out of bad faith to destroy a bill that had potential to bring greater benefits to the public at large. And for that we have Palin, Smith, McCaughey, and both parties to thank.

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