Tuesday, July 26, 2011

Free-Market Capitalism and Death Panels: The Musical

How long ago it seems. While we await the final negotiations in Washington to figure out some solution to the budgetary battles--which will likely produce a bill, endorsed by the President, that will be either "very right" or "extremely right" but will somehow be billed as "centrist"--we at the Billy Rubin Blog are feeling nostalgic tonight for those heady days of the summer of 2009, when a health care bill was slowly working its way through Congress.

Remember that? What passed for reasonable dialogue got hijacked by a very noisy rabble of Know Nothings, a group for whom the descriptions "willfully ignorant" and "anti-intellectual" are taken as praise, who screeched at town hall meetings and demanded that "government get its hands off my medicare". But the meme that took the cake at the time, the Chant Of Nitwits as it were, was that somehow the government was secretly planning to arrange "Death Panels," and the paranoia from the imbecilic mob sent the few remaining sensible Republican politicians running for cover and pandering to save their souls (as Chuck Grassley of Iowa did here).

Between the media, who largely buy into the myth of false equivalence that every story must have two equally valid sides and thus reported on the protests without pointing out the basic stupidity of the protesters, and the politicians, too many of whom were spineless in shouting down the nonsense, the silliness carried the day. The Obama administration backpedalled in the Public Relations game, giving up ground to its political foes (sound familiar?), and the consequence was that the country ended up with two presents. The first was a not especially progressive healthcare bill. The second was the Tea Party.

Which brings us up to the present, more or less. So what did ever happen to the Death Panels? Well, they never left, argues the massively awesome blog Health Care Renewal. HCR links Bloomberg News reporter Peter Waldman's investigation into the for-profit hospices now littering the landscape. It makes for grizzly reading. For instance, Waldman relates the story of former social worker Misty Wall, who alleges in a lawsuit against Gentiva Health Services, Inc. that she was "assigned to convince people who weren't dying that they were." (A spokesman for Gentiva said that the allegations predate Gentiva's ownership of the hospice at which Ms. Wall worked. She was fired from the hospice in 2005 for refusing to continue such practices.)

Perhaps even more troubling--and that is saying something--are the allegations that for-profit hospices gave "financial kickbacks" to "referral sources" (in English, that usually means money to doctors) and tied employee bonuses to "enrollment goals". This easily has the potential to induce some employees to move the goalposts a bit and encourage hospice for some patients inappropriately. How's that for a "Death Panel"?! No grim bureaucrats in Washington doling out the Number of The Beast, but rather a "Death for Dollars" in which the most successful recruiters walk home with a tidy cash sum at the end of the day, along with the corporation supervising it.

One notes more than a touch of righteous indignation as HCR writes,

There has been a lot of blather from politicians in the US about "death panels" in debates about health care reform. Many such politicians seem worried that the US government has or will have death panels under the new health care reform legislation. We have criticized that legislation for not addressing many important health care problems. No one, however, has convincingly demonstrated how its provisions would convene "death panels."

I couldn't agree more.

Lest I am misunderstood, hospice has been a tremendous step forward in American medicine. It allows people to die in greater comfort and with greater dignity than before. We need hospice, which is precisely why we shouldn't sully it by making it the object of some corporation's greed. But if people don't want their government involved in their health care, the business of dying will be overseen by for-profit businesses, and the Death Panels will be convened in elegant board rooms with oak tables, plush carpeting, and executives enjoying record salaries. Sound appealing?

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