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Editorial: Health care scare talk doesn’t help the debate

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Comments (23)

Friday, July 31, 2009

(Updated 3:00 am)

President Barack Obama had some words for opponents of his health care reform proposal when he spoke in Raleigh Wednesday: “These folks need to stop scaring everybody.”

Could he have been referring to U.S. Rep. Virginia Foxx, the Republican from North Carolina’s 5th Congressional District?

Her party has a plan, Foxx said on the House floor Tuesday, that is “pro-life because it will not put seniors in a position of being put to death by their government.”

Meaning the Democrats’ plan will?

“Being put to death” by your government is about as scary as it gets when discussing health care.

Some of the rhetoric over health care is frightening, with the president’s critics sounding alarms about costs, government takeovers, “socialized medicine,” rationing and now even death.

Obama’s gotten carried away at times himself, such as during his nationally televised press conference last week when he broadly accused physicians of removing children’s tonsils unnecessarily just to make more money.

Discussions about this tremendously important issue need to be rational and well-informed.

Foxx’s comments didn’t meet those criteria, but they at least opened a small window into what really is proposed. A provision in a House bill authored by Democrats would require Medicare to pay for counseling on end-of-life issues, including living wills. No one would be forced to have such counseling, let alone to make any particular decisions. Nothing authorizes the government to put people to death.

Without Foxx’s distortion of that provision, it probably would not have come to light at all. Countless other details contained in health care reform legislation remain unknown to the general public, which hasn’t had time to learn about them. Ignorance can be exploited by politicians trying to win support by promising more than would be delivered or to build opposition by manufacturing dangers.

The president’s attempt to set a deadline for Congress to approve a health care bill before its August recess was unrealistic and fortunately did not succeed. It’s much wiser for senators and representatives to use their summer break to communicate with constituents and make sure people better understand what is proposed and how it would affect them. Constituents’ informed views might even influence the debate in Washington, if representatives are willing to be open-minded.

This is a massive undertaking that will affect people’s lives, federal finances and the entire economy far into the future — all for the better if it’s carried out well. That requires ample time and total openness. Possibly getting it wrong really is scary.

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Doug Johnson

July 31, 2009 - 5:33 am EDT

Wonder who the writer of this is?
I can not find a name.
A writer, I have read most of the bill, how many pages, have you read?
Wonder why the writer, did not include John Conyers remarks!
The writer also left out Obama reply, to page 425.
If page 425, does not count why have it in there
Just another attack on republicans by this paper.
Wonder if the writer, would ask, Kay Hagan if she would take this plan?
We have, and can not get a reply.
Since the congress has not read the bill, how can they explain it to us?
Never let facts and logic, get in the way!
By the way, Reid blamed the media, for sitting the deadline.

Panacea

July 31, 2009 - 8:18 pm EDT

It's called an editorial--meaning written by the editorial staff, the same way every editorial is written. Look at the information on the newspaper about the publisher and staff.

I've read the whole thing, Doug. It's a good bill, and doesn't do any of the things conservatives accuse it of doing.

Page 425 requires providers to have discussions with their patients about their wishes for end of life care. It requires them to tell their patients what the course of their illnesses is likely to take, so patients and families can make informed decisions about how far they want to go with aggressive care. It doesn't say providers have to or should withhold any kind of care for the terminally ill. If the terminally ill insist on heroic measures, they can still have them.

Hospice patients accept that they are dying. Their care centers on maintaining comfort, dignity, and quality of life as opposed to quantity of life. Palliative care patients aknowledge they have a terminal illness, but not necessarily that they are giving up on fighting that illness. The goals are similar, but palliative care patients often continue aggressive treatments. No one has to give up things like dialysis or chemotherapy, or radiation therapy. It is simply that the goals of those treatments change.

Far too often patients choose aggressive treatment out of fear, or belief that is the only option available to treat their pain. Doctors are often reluctant to admit a patient is dying. Many doctors view death as a "failure" on their part. So they push aggressive care that is futile, and might not be chosen had the provider had a frank discussion with the patient and the family.

Last November, my father went into the hospital unexpectedly. My mother thought he'd had a stroke because he was confused and had slurred speech. They live 5 hours away. Talking to Dad on the phone, I thought the same thing.

In reality, Dad had a fast growing and aggressive liver cancer (the liver filters ammonia out of the blood stream. In liver failure, it accumulates and causes confusion and slurred speech). His doctors agreed to call me to discuss his care because Mom was completely unable to do so, though she did tell me she thought chemo would just make him suffer and that she didn't want it. Neither did Dad when I talked to him again.

The doctor wanted a decision on Dad's "code status." I didn't hesitate. "No code," I told him. "Give him all the narcotics he needs for pain." At the time, I was in an airport, hurrying home to try and see him before he died. I didn't make it. I have no regrets about my decision. It wasn't worth it to me for Dad to suffer one more second than he had to just so I could get there before he died.

I tell this story to illustrate WHY it is SO important for EVERYONE to discuss their end of life wishes with their families. I have the red heart on my driver's license indicating my wish to be an organ donor when I die. Everyone in my family knows this, and I know they will honor my wishes. I also have a living will: no heroic measures in case of a terminal illness or injury.

Working part time in hospice, I often encounter families who are terrified when the moment of truth comes. They think they've prepared themselves for the death of their loved when. But when the time comes they panic. Part of my job is helping them through that fear, ensuring that pain is controlled, and supporting the patient and their family as death approaches.

This kind of support is a crucial part of health care reform. We need education on the benefits of hospice and palliative care to help people cope with what is, after all, a natural part of life.

I do not fear death. I fear pain while dying. Most patients fear this very same thing. Open discussions of the end of life can help patients and their families minimize both pain and fear, and make death a peaceful process in the comfort of ones home, rather than an invasive, loud, lonley one in a hospital tied to tubes and machines.

rmacz

August 1, 2009 - 12:41 pm EDT

Common sense says that this bill will fail. This administation has no good track record at anything. I suggest those who want more information go www.heritage.org.

Panacea

August 1, 2009 - 2:46 pm EDT

It's too soon to know how Obama's policies are ultimately working. He's been in office 7 months. We're still coping with fallout from Bush administration policies and from the Wall Street implosion.

Signs point to economic recovery. Unemployment will take some time yet to bounce back.

Signs show the country is getting better, but there's still a long way to go.

rmacz

August 1, 2009 - 3:47 pm EDT

I remember 1994. History will probly repeat. The polls show it. Time is running out. Barry wants to hurry. Only the blue dog dems have the common sense now.

Panacea

August 2, 2009 - 9:09 am EDT

I still have hope health care reform will pass.

The Blue Dogs have lost their collective minds. They ought to just stamp themselves as Republicans and be done with it.

unclefuzzy

July 31, 2009 - 6:24 am EDT

I think most Americans agree there needs to be health care reform, but don't want this plan being pushed on everyone by Mr. Obama. If most Americans don't want or agree with his plan for socialized health care, then why force it on American citizens when none of congress will be on the same plan? What is Mr. Obama's big rush? Something this big needs years of planning to get it right and agreeable to most Americans, but Obama insists on forceing his plan on America, whether we want it or not. Why does he want all aspects of American life controlled by the government?

miktay

July 31, 2009 - 8:39 am EDT

Actually, most Americans do want something very similar to what President Obama is proposing. Much has been made of polls showing support for his plan dropping. However, when the polls dig deeper on the issue, they find when people understand what is actually in the President's plan, they support it by a 54-38 margin.

Your comments on socialized medicine and government control is simply another example of the name calling and scare tactics the editorial is against. The whole point of such tactics is to muddy the waters to extent that folks will be so confused that they will be against changing anything.

I know folks like to complain about the government not being able to do anything right. Its kind of like complaining about the weather. Everybody does it. Still, when you get right down to it, people on Medicare (a government health care plan) are happier with their care than are people who are in private insurance plans. People who get care through the VA (another government health care plan) have the highest satisfaction of ANY health care plan in the whole country. As a matter of fact, a lot of folks in the American Legion are now lobbying the government to let their families join their VA plan.

Then there is military health care (another government run health care system). The other evening Bill Kristol was on The Daily Show and said our military personnel receive first class medical care. This is the same Bill Kristol who has been urging Republicans to stonewall health care reform so as to destroy the Obama Administration. By the way, he went on to say that regular Americans "did not deserve" the same first class medical care!

Illiterati

July 31, 2009 - 8:50 am EDT

miktay, please tell us what's in this plan, because nobody else will. A link would be helpful.

miktay

July 31, 2009 - 9:10 am EDT

www.barackobama.com

The League of Women Voters also has a lot of good information on their site at www.lwvpt.org. The Families USA site, www.familiesUSA.org is also a good source of information.

Illiterati

July 31, 2009 - 9:29 am EDT

Thanks, miktay, much appreciated. I'm a decent Googler, but was having a tough time coming up with anything recent. It would be great if the news outlets would at least link to the plan's contents so the debate could be about the plan and not about the debate itself.

Edited to give the specific link to the bill [PDF download]:
http://help.senate.gov/BAI09A84_xml.pdf

Sawdust

July 31, 2009 - 6:26 pm EDT

Here's the real thing http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-0...

tonymo

July 31, 2009 - 12:01 pm EDT

Dear Mr/Ms/Dr Miktay: I don't know what you're smoking but you might want to stop while writing letters. The public support for the takeover of our healthcare has plummeted since the people have begun finding out what's in the plans. Why do you think that Herr Obama was trying to force a quick vote before the August recess on this mess before the people had a chance to see it. I'd love to know just which poll says this disaster is supporterd by 54% of the people. If that were the case there would be no balking being done by the "blue dogs" and some members of the senate who are up re-election next year.

First, how brain dead must one be to believe that we can cover 30-50 million more people, offer more choices, and better care and reduce costs! The Congressional Budget Office debunked that lie during a congressional hearing recently, saying that only will the plan not save money, but will cost hundreds of billions more than we've been told it will cost!

The next lie, that if you like your current insurance (as do 80% of the 90% who have health insurance today) you can keep it. As Investor's Business Daily recently showed (listing the page in the bill where it was found) that if you are insured prior to the date the legislation takes effect you may keep the coverage, BUT if ANY change is made (co-pay, deductible, premium, carrier, you change jobs, or lose your job) your plan is terminated and a government bureaucrat will chose a plan that the bureaucrat deems best for you. After that same date no one will be permitted to purchase a private plan! This is not the great country in which I was brought up where individual liberty, and freedom was the hallmark.

This legislation is NOT about improving your health care, but gaining even more control over your life, including WHEN YOU WILL DIE! Does no one remember when one of the many unaccountable, unconstitutional Czars said that "people are just going to have to realize that they are not going to live forever!" Just as in other other government controlled systems, bureaucrats will do a cost-benefit analysis on the elderly to determine whether you deserve to get costly treatments. or medications. At a town hall meeting Herr Obama was aked by a woman whether her 100 year old mother would have gotten the pacemaker that she had implanted with her medical plan, he stated that sometimes it is probably better to just take pain pills!

Yes Medicare is a good plan for seniors, IF THEY HAVE A SUPPLEMENT to pay the potentially huge co-pays (20% for doctors, approximately $900 for hospital stays). Also, since the proposed plan is set to reduce the already miniscule payments to providers (which is why it is getting more an more difficult to find a primary care physician who will take new Medicare patients), and legally the provider can charge the difference between what they bill, and what Medicare, and your supplement pays. Thus far they don't do that, but on you EOB it shows the amount difference, and says that you may be billed for this amount! So if Mrs Pelosi gets her way and drives all the insurance companies out of business, where do you get your much needed supplement?

Finally, why do you think that the members of the Imperial congress, and the members of the adminstration are exempted from this disaster! They have a plethora of choices of PRIVATE plans. Do think we would be having this rammed down our throats if they had to participate, just as they don't participate in the massive Ponzi scheme called Social (in)Security! If Herr Obama were truly interested in reform he would do as some have suggested, he would cover the 10-15 million who want insurance, but for various reasons, cost, previous illnesses, rather than lying about 47 million being uninsured without explaining who they are, and why, and for how long they are uninsured. The cost to do that would be a fracion of the massive cost of destroyin the enite system, and the economy. Why didn't he simply put the money, some $25-50 billion in the so called, "stimulus" package of which only $67.5 billion of the $787 has been spent, and more than 2 million jobs have lost since it went into effect. Just askin!

tonymo

July 31, 2009 - 1:22 pm EDT

The poster who tried to tell us the 54% favor Herr Obama's healthcare takeover is either uninformed or dishonest. Here are the results of a Rasmussen Poll (Rasmussen called the presidential election more accurately than any polling organization): The poll was taken last week.

The latest Rasmussen Reports national telephone survey finds that 47% are in favor of the reform effort proposed by President Obama and congressional Democrats while 49% are opposed. Those figures include 25% who Strongly Favor the plans and 41% who are Strongly Opposed

Currently, 76% of Democrats favor the proposal and 76% of Republicans are opposed. Among the unaffiliated, 35% are in favor and 60% are opposed. Notably, just 16% of unaffiliateds Strongly Favor the legislative effort while 47% Strongly Oppose it.

Just 23% believe passage of the reform legislation will lead to lower health care costs. Most voters (53%) say it will lead to higher costs.

Panacea

August 1, 2009 - 2:47 pm EDT

Obama's plan is NOT socialized health care. The government is regulating the insurance industry, and competing with them. That's it.

dcolin

August 1, 2009 - 6:49 pm EDT

Thats ridiculous.
When people are starving we don't focus on balanced long term diets.
WE solve the problem in an expedient manner and continue to evolve towards optimum
nutrition.

First.
Insurance companies must accept all, cannot drop you because you get ill, cannot base your fees
on your health etc.

Second.
A Government option is absolutely needed to keep Insurance honest.
You don't have to buy it and it could be run by a pseudo government agency ( like Fed Reserve )

Actually I like single payer but it won't happen.

Sawdust

July 31, 2009 - 7:49 am EDT

John Stossel is doing a special tonight (10 pm, ABC) about the Canadian and British health systems. If past experience is any indication, it will probably be informative and entertaining. I urge everyone on both sides of this debate to watch.

Illiterati

July 31, 2009 - 8:49 am EDT

"Countless other details contained in health care reform legislation remain unknown to the general public, which hasn’t had time to learn about them."

It isn't that we haven't had time to learn about the health care reform plan, it's that all of the coverage, both by the media and the politicos, is about how we're talking about the plan, but there's no talk about what's actually in the plan! Does anyone know what's in the plan? Even Obama's speeches are only about how the opposition talks about the plan, or what's not in the plan, or why we need the plan, but he hasn't told us what this plan is or how much it will cost the individual taxpayer.

Also, for a reform that is fundamentally changing 1/6 of the national economy, why don't the people get to vote on it? This is a bigger decision even than choosing a president, since the effects will last much longer and resonate much deeper than the mere 4-8 years of any given POTUS.

Sawdust

July 31, 2009 - 6:31 pm EDT

Here's the plan, but as John Conyers said, you need 2 days to read it and 2 lawyers to understand it. http://edlabor.house.gov/documents/111/pdf/publications/AAHCA-BillText-0...

Panacea

July 31, 2009 - 8:21 pm EDT

I read it over a few hours, and it only took me that long because I read it carefully. I'm not a lawyer and I didn't need one to understand it. The language is actually quite clear.

ilvteaching

July 31, 2009 - 8:52 pm EDT

Panacea is absolutely right. While it is technically true that the bill is 1000 pages, the type is huge and the margins are more than half the page. It might be a 100 page bill if it were typed in double spaced 12 font type, but even that is a stretch. And she is right, the language is understandable.

No one should be voting on that bill (or any bill) before they have read it. It can't take more than a couple hours to read.
I found it very interesting to compare what the "talking heads" are saying and what is actually written in the bill. Everyone should read it.

Dogwood

July 31, 2009 - 2:23 pm EDT

I believe the remarks made by 5th District Congresswoman Virginia Foxx (Phd Education) regarding Living Will is total fear mongering. I do not know how to help millions and millions with health care, but I do know Living Wills help young terminal cancer, end stage renal disease humans decide their choice. Medicare elderly, freely fill out the forms with full recognigition that respirators feeding tubes and rotting to death is worse than natural death. Some elderly are not stupid. I think Phd Foxx needs to talk about education, her expertise. She gives me a headache with her party postering.

rmacz

July 31, 2009 - 5:23 pm EDT

I believe Foxx's comment is probly referring to Obama's remark to giving older people a pill instead of an operation, all of which is on tape,. and the white house is sweeping under the rug, I remember a few short years ago the press was scraring seniors about the social security trust fund. If they were scared then, now is different story.