Nat Hentoff on the Death Panels

Obama Fear

Nat Hentoff has always been my favorite Leftist atheist.  A strong pro-lifer in a New York milieu where pro-lifers are regarded with less tolerance than cannibals, Nat Hentoff is a man of the Left who always has been a strongly independent voice and mind.  In an article today, which is here, Hentoff confesses to being scared of the Obama administration:

“I was not intimidated during J. Edgar Hoover’s FBI hunt for reporters like me who criticized him. I railed against the Bush-Cheney war on the Bill of Rights without blinking. But now I am finally scared of a White House administration. President Obama’s desired health care reform intends that a federal board (similar to the British model) — as in the Center for Health Outcomes Research and Evaluation in a current Democratic bill — decides whether your quality of life, regardless of your political party, merits government-controlled funds to keep you alive. Watch for that life-decider in the final bill. It’s already in the stimulus bill signed into law.”

When Sarah Palin on the Right and Nat Hentoff on the Left both view with alarm the idea of government panels having the final say on medical treatment, it is time for all citizens to take this issue quite seriously.  Far fetched?  Not at all if consideration is given to the N.I.C.E. experience in Great Britain.  Turning over control of your medical care to the government, what could possibly go wrong?

17 Responses to Nat Hentoff on the Death Panels

  • S.B. says:

    All that any government panel would do here is say what the government pays for; you’d be free, as always, to buy your own medical care above and beyond that. It’s quite odd to see so many conservatives acting as if a government welfare program absolutely must pay for anything and everything that someone wants, without regard for necessity, quality, or usefulness.

  • Donald R. McClarey says:

    SB under ObamaCare there would rapidly be no private insurers. Without private insurance there would be no effective recourse from denial of coverage for treatment except for the independently wealthy which is precisely the case in Great Britain. This is of course why the US routinely is the destination for medical treatment by wealthy idividuals seeking treatment in this country that will not be paid for by the national health care plans in their country. This leaves aside the issue that many national health care plans forbid private payment for health treatment.

  • Having just returned from Europe, I can report a great exasperation over the US debate. For what it’s worth, the NHS is by far the most popular part of the welfare state. When a Tory MEP went on American media to criticize it, Cameron stronly rebuked him. Europeans are absolutely disgusted that there can be opposition to the simple goal, the human right, of providing healthcare for all.

    And as for “death panels”, it is precisely the for-profit system that weighs human life by cost. In states today, hospitals have the power (even if family does not agree) to terminate life in cases where they deem not worth living. And for a direct comparison of the US and UK, consider what happened to Elizabeth Anscombe’s daughter.

  • Donald R. McClarey says:

    We will simply have to bear up under the disapproval of Europeans.

    In regard to the British National Health System here is a section of an article written in defense of that system which appeared in the New York Times recently:

    “But there are limits. Without an endless budget, the N.H.S. does have to ration care, by deciding, for instance, whether drugs that might add a few months to the life of a terminal cancer patient are worth the money. Its hospitals are not always clean. It is bureaucratic. Its doctors and nurses are overworked. Patients sometimes are treated as if they were supplicants rather than consumers. Women in labor are advised to bring their own infant’s diapers and their own cleaning products to the hospital. Sick people routinely have to wait for tests or for treatment.

    Because resources are finite and each region allocates care differently, waiting times can vary widely from place to place. So can treatment, as in the United States, regardless of how it is paid for.

    Limited in what treatments they can offer, doctors sometimes fail to advise patients of every option available — or every possible complication. American doctors, conversely, often seem strangely alarmist about your future and overeager to prescribe more expensive treatment.”

    http://www.nytimes.com/2009/08/16/weekinreview/16lyall.html

  • DMinor says:

    Donald,

    I fully expect that in this iteration, there will be a market for non-approved care (and perhaps insurance to pay for it). Should non-approved care be deemed illegal in the next iteration, as was proposed in Hillarycare, this would be a black market. This, of course, would be the exclusive province of the wealthy.

    What I yet fail to grasp about the whole proposal is how doctors will stay in business with malpractice risks remaining static, and thus malpractice insurance premiums remaining high, while approved compensation is reduced.

    The “right” to healthcare becomes more difficult to obtain when there are fewer doctors.

  • Ray O says:

    Death Panel a Lie? The bill stipulates 11 people, none a spiritual advisor, come up with the guidelines for what a “provider” (not necessarily a Dr.) will be required to tell you regarding end of life counseling then record your wishes (answers) in a database. The goal is to quit spending money to keep people alive. “Death squad” is strong language, but not entirely out of line.

    Funny I have never heard any real evidence that people would actually chose to quit suffering. Certainly you could argue that families are keeping people alive that may have opted out of critical life support, but equally there are people who’s loved ones pulled the plug, where the patient may have decided not to. What makes anyone think the margin of error is not 50/50. Additionally what about the people like me that let my wife know my wishes, but have given her the permission for final say so. I worry about her burden more then my suffering. Suffrage is part of our salvation.

    Can you see it now, a spouse arguing “keep him alive” and the government computer with a DNR checkmark next to the patient’s name, which was made by a government worker put in a database built overseas to the lowest Bidder? National rent a car just charged my business rental to my home credit card. They blamed a “software refresh”.

  • Donald R. McClarey says:

    “The “right” to healthcare becomes more difficult to obtain when there are fewer doctors.”

    Oh DMinor, ye of little faith! His Obamaness will simply bring forth new legions of doctors through government fiat: complete government control of their practice, less money, longer hours, who could resist that!

  • Donna V. says:

    I have been following the uproar in the British press regarding MEP Daniel Hannan’s comments. The thing that struck me was that both his critics and supporters seem to agree that mixed sex wards are a bit much.

    I think most Americans would balk at the very idea of wards, nevermind mixed sex ones! I have had more experience of being a patient than I would have liked over the past few years. Being an inpatient is not fun, even if you have a private room. Being in a ward with 29 strangers of both sexes – oh, yes, that’s quite “progressive” – by the standards of 1870.

  • S.B. says:

    Anyone who thinks that citing European snobs is helpful when arguing with Americans is letting his passion get the better of his ability to make an argument.

    Anyway, I don’t get the passion here. I care about whether people are healthy. But, as any literate person knows, insured-status is a very poor proxy for whether someone gets healthcare, and then getting healthcare is a very poor proxy for whether someone is actually made healthy.

    For the information of people not blinded by ideology and rage, listen to this amazing fact: The number of people killed by getting healthcare (hospital infections, doctor error, etc) is 43 TIMES the number of people who die for lack of health insurance. (Compare http://www.lef.org/magazine/mag2004/mar2004_awsi_death_02.htm and http://www.usatoday.com/news/health/healthcare/2002-05-22-insurance-deaths.htm).

    43 times the number of dead people. Killed by healthcare.

    Too startling a figure, you say? A more conservative estimate comes from Barbara Starfield’s JAMA article in 2000, which estimated that 225,000 people die every year from getting too much healthcare. That’s 12 times the number allegedly killed for a lack of health insurance.

    But people who wouldn’t know a JAMA article from a NEJM article are all whining about how to give more healthcare to more people.

  • Elaine Krewer says:

    S.B.’s argument that from 12 to 43 times as many people die FROM healthcare as from a lack of health insurance would seem to indicate that we should be arguing for LIMITING health insurance coverage instead of expanding it.

    Or, rather, it would if you followed the same logic as those who insist that the allegedly vast numbers of people dying from lack of health insurance proves we need a national or universal health care system.

  • Art Deco says:

    Ivan Illich was something of a crank, but he did have a point to make about the degree to which life expectancy is fairly insensitive to the sophistication of medical practice and the degree to which illness can be iatrogenic. I have a wretched example in my immediate family.

  • MM,

    Did you see fit to inform your European interlocutors that Americans are (when they bother to think of the continent) totally disgusted with the collapse of religion and the family in Europe, with the overall low wages and economic opportunity, and with the social acceptability of sport event violence and public drunkeness? Or do you only convey disapproval one way — from former colonial masters to their ex-subjects who better stop dragging their knuckles and bloody-well get with the program? Overall, the fact that more Europeans relocate to the US than Americans relocate to Europe probably tells us more about how people really feel than your discussions with like-minded friends across the pond.

    SB,

    In a sense, the comparison is a bit simplistic. I think a better analysis might be the percentage of people admitted to hospital who die from (or are seriously injured by) hospital contracted diseases and malpractice versus the percentage of the uninsured who die from lacking essential mediate care.

    Still, the overall point is very important: Health care and health are not synonymous. For example, if you eliminate accidents, suicides and homicides, the US actually has a higher life expectancy than any of the countries our health care system is usually compared to. And although everyone (except apparently MM) recognizes the UK’s NHS is a total cluster, and death rates from nearly all specific ailement (especially preventable hospital-contracted diseases resulting from lack of sanitary conditions) are much higher in the UK than elsewhere in Europe, their life expectancy is actually pretty much the same as in countries with much more functional health care systems.

    Medical care can help individual people life longer, but the effect of health care provision on overall population life expectancy is much more remote. (I suppose because how long you live _after_ beign diagnosed with cancer doesn’t have all that much effect on the overall population life expectancy — as compared to factors like how common cancer and heart disease are overall.)

  • S.B. says:

    Elaine — that’s an interesting idea. For example, there is a very good case for having the government implement a Pigouvian tax or a fine on the use of antibiotics. The overuse of antibiotics has led to resistant superbugs, such as MRSA, which then kill or maim people. It’s a public health hazard. It’s surreal that we’re talking about making the health hazard worse (i.e., helping people pay for antibiotics).

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