In an effort to defend her earlier lie — that President Obama’s proposed health care bill would force senior citizens to go before “death panels,” and justify their existence, or be denied life-saving care — Palin adds more words, bigger words, and a few citations to her earlier folsky deception, but bumps up against identical results.
Palin leads by addressing President Obama’s explanation of the “death panel” lie, wherein he reminded audiences that end-of-life counseling was voluntary, merely paid for by Medicare if you wanted it, and that this counseling involved nothing scarier than information about how to draft a living will and manage pain. She proceeds to answer the first point, while dropping the second, arguably more important point:
With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.
Apparently, although the consultations are merely “authorized,” not required, doctors will force them down their patients’ throats, because they know they’ll get paid for it. She quotes a Washington Post editorial (which, incidentally, explicitly refutes her zanier point, but Palin’s cite-checking policies or lack thereof are for another night):
“Section 1233, however, lets doctors initiate the chat and gives them an incentive — money — to do so. Indeed, that’s an incentive to insist.”
Let’s accept her premise, however briefly. Admittedly, doctors have an incentive to push their patients to buy into more treatments, more care, more everything. But it’s hard to see how a public option exaggerates that danger. If we presume doctors to be money-grubbing liars, surely it doesn’t matter from whose pockets they draw their blood money. Further, Palin’s presumption that doctors would and could coerce their patients infantalizes the patient by presuming him incapable of refusing unwanted services, and treats doctors at the outset as a danger, not a help. Apparently, Palin would prefer more regulation of the doctor-patient relationship, to bar doctors from even discussing certain sensitive, life-related issues with their patients.
This is no surprise coming from Palin, but it flies in the face of the traditional conservative argument, that government management of healthcare risks intruding upon a patient’s right to choose a doctor or a procedure. She finds herself in the tricky position of arguing against government regulation of healthcare, because it would regulate too little, and free doctors too much. As Gilbert and Sullivan would say, “fallacy somewhere, I fancy.”
Further, even if doctors would somehow read in § 1233 an invitation to lure patients into “end-of-life counseling sessions,” it’s not clear how that brings about the “death panel” harm. Worst case scenario, a patient is given information about, but not asked to sign, a durable power of attorney. See § 1233(a)(1)(B)(B) (providing for “[A]n explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses.”) (emphasis added). Mendacious op-ed columnists notwithstanding, § 1233 no-where provides counselors with the authority to actually formulate a living will or power of attorney. Practitioners in these sessions provide information, only. One searches the statute in vain for any operative language to the contrary.
Palin’s note goes on for a while longer after that, but there’s little else of importance, apart from a particularly egregious “quote mine” of a doctor who suggests “rationing” only in the ultra-scarce field of organ transplants, and regardless of insurance scheme.
So, in summation — Palin’s “argument” (1) glosses over the voluntary nature of the consultation sessions, (2) depends upon a warped conception of doctors’ motives, (3) presumes patients incapable of making their own decisions, and (4) misstates what may actually happen in a consultation session.
It may be that this note — complete with citations, and an “Id.”! — represents Palin’s first attempt to reinvent herself, by grappling with actual facts, rather than reacting on uninformed instinct (her former Colbertian theory of politics, if you will). If so, it’s a step in the right direction, at least in theory, but remains horrifically flawed in fact. C+ for effort, D- for content.
To her credit, though, Palin at least stopped claiming that Trig would be the first to die. Apparently she read enough of the statute to realize that it purports to apply only to Medicare recipients. Let it never be said that I am not fair.