September 30, 2012

Steven Rattner: ‘We Need Death Panels’; Will PolitiFact Reverse ‘Lie of the Year’ Tag on Palin?

PalinAtFacebookPost0809For those who want the short answer to the question in this post’s title, the answer is almost definitely “no.” But in a New York Times op-ed piece in mid-September, former Obama “car czar” Steven Rattner effectively said that the so-called “fact-check” site known as PolitiFact should make amends to former Alaska Governor and vice-presidential candidate Sarah Palin.

In December 2009, PolitiFact’s Angie Drobnic Holan outrageously characterized the following statement made by Palin in an August 2009 Facebook post as its “Lie of the Year” (bold is mine):

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

What follows are several paragraphs from Rattner’s Times September 16 op-ed. Rattner understates the real-world power of ObamaCare’s Independent Advisory Board, which makes his citation of England’s version of death panels as something worthy of imitation a de facto admission (to the point where it doesn’t matter whether he himself admits it) that Palin is right about ObamaCare as it was proposed (at the time of her Facebook post) and ultimately enacted (bolds are mine):

WE need death panels.

Well, maybe not death panels, exactly, but unless we start allocating health care resources more prudently — rationing, by its proper name — the exploding cost of Medicare will swamp the federal budget.

But in the pantheon of toxic issues — the famous “third rails” of American politics — none stands taller than overtly acknowledging that elderly Americans are not entitled to every conceivable medical procedure or pharmaceutical.

Most notably, President Obama’s estimable Affordable Care Act regrettably includes severe restrictions on any reduction in Medicare services or increase in fees to beneficiaries. In 2009, Sarah Palin’s rant about death panels even forced elimination from the bill of a provision to offer end-of-life consultations.

Now, three years on, the Republican vice-presidential nominee, Paul D. Ryan, has offered his latest ambitious plan for addressing the Medicare problem. But like Mr. Obama’s, it holds limited promise for containing the program’s escalating costs within sensible boundaries.

… Mr. Obama’s hopes for sustained cost containment are pinned on a to-be-determined mix of squeezing reimbursements, embracing a selection of the creative ideas that have spewed forth from health care policy wonks and scouring the globe for innovations.

To Mr. Obama’s credit, his plan has more teeth than Mr. Ryan’s; if his Independent Payment Advisory Board comes up with savings, Congress must accept either them or vote for an equivalent package. The problem is, the advisory board can’t propose reducing benefits (a k a rationing) or raising fees (another form of rationing), without which the spending target looms impossibly large.

… No one wants to lose an aging parent. And with price out of the equation, it’s natural for patients and their families to try every treatment, regardless of expense or efficacy. But that imposes an enormous societal cost that few other nations have been willing to bear. Many countries whose health care systems are regularly extolled — including Canada, Australia and New Zealand — have systems for rationing care.

Take Britain, which provides universal coverage with spending at proportionately almost half of American levels. Its National Institute for Health and Clinical Excellence uses a complex quality-adjusted life year system to put an explicit value (up to about $48,000 per year) on a treatment’s ability to extend life.

In my view, if all Rattner could come up with as an example of “restrictions on care” is the end-of-life consultation controversy — where cost wasn’t the issue as much as the nature of such “consultations” — then there really aren’t any meaningful “restrictions or reductions in Medicare services” per se in ObamaCare. The real restrictions occur when someone in the trenches has to decide within a fixed budget who gets care and who doesn’t.

Enter the Independent Payment Advisory Board. ObamaCare deliberately insulated it from normal Congressional oversight and approval (its word is law unless Congress acts; IPAB shouldn’t be able act unless Congress approves its budget and priorities). By dictating overall spending levels, IPAB will restrict care without knowing who they’re doing it to, leaving the dirty work of deciding exactly who should and shouldn’t receive care to hospitals and other medical providers. Consider it death panel outsourcing. You can rest assured that providers will get the latest and greatest advice from the likes of “Zeke the Bleak” Emanuel and others with a utilitarian view of humanity on implementing “quality-adjusted life year system” and other schemes to decide who is unworthy of medical attention up to and including continued life.

Rattner has only admitted what anyone who has studied the situation already knows: ObamaCare will lead to rationing, which will lead to life-death decisions being made outside of patients’ and their families’ control. PolitiFact’s Halon was and is wrong. Palin was and remains right. Halon and PolitiFact should own up to their error. It’s an extremely safe bet that they won’t. Leftists rarely do.

Cross-posted at



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