Palin says death panel remarks not about end-of-life care

The verbal tennis match regarding H. R 3200, or Obamacare, has lead to confusion amongst American citizens. The most recent round concerns Palin, Obama, and "Death Panels." Which leaves citizens asking," What are the facts?"

After weeks of discussion it seems the provisions of what is now labeled as “Obamacare” are still relatively mysterious to the population. The 1000+ page bill titled H.R. 3200 has been confusing citizen and public servant alike, but this confusion has not stopped the obfuscation of facts where punditry is concerned. The most recent and widely publicized debate surrounding “Obamacare” involves accusations made by Sarah Palin on August 7 that H.R. 3200 afforded the opportunity for Death Panels. Her reasoning centered on President Obama’s Health Advisor, Ezekiel Emanuel and statements he made in a pamphlet concerning rationing health care in times of limited resources. In response to her Facebook “Death Panel” statement, Barack Obama and progressive pundits stated that Sarah Palin was in deliberate use of scare tactics over a 10 page portion of the bill which laid out plans for end of life care discussion between physician and patient. President Obama responding at a Townhall meeting in New Hampshire on August 11

The rumor that’s been circulating a lot lately is this idea that somehow the House of Representatives voted for "death panels" that will basically pull the plug on grandma … this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, et cetera. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they’re ready, on their own terms. It wasn’t forcing anybody to do anything. This is I guess where the rumor came from.

The Democrats were also quick to point out what was considered the hypocrisy of Republicans over end of life care counseling measures and indicated that Republicans have introduced similar provisions in the past. Sarah Palin responded, again on her Facebook page, and touched on the new direction of the debate regarding end of life discussion in which she quoted sources saying that it was not exactly a voluntary discussion and that physicians would be paid incentives to initiate the discussion which could lead to a slippery slope effect. Palin then went on to clarify that her original premise was not centered on that portion of the bill, but on the words of Ezekiel Emanuel in an Academic pamphlet titled Principles for allocation of scarce medical interventions which he co-authored with two other colleagues. The academic paper describes the ways of rationing health care in instances of limited resources and the eventual decision that the Complete Lives System proposed by the authors would be the least discriminatory. Excerpt:

Allocation of very scarce medical interventions such as organs and vaccines is a persistent ethical challenge. We evaluate eight simple allocation principles that can be classified into four categories: treating people equally, favouring the worst-off , maximising total benefits, and promoting and rewarding social usefulness. No single principle is sufficient to incorporate all morally relevant considerations and therefore individual principles must be combined into multi-principle allocation systems. We evaluate three systems: the United Network for Organ Sharing points systems, quality-adjusted life-years, and disability-adjusted life-years. We recommend an alternative system—the complete lives system—which prioritises younger people who have not yet lived a complete life, and also incorporates prognosis, save the most lives, lottery, and instrumental value principles.. ... When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated.

The verbal tennis match between Republicans, the White House, and the Democrats has caused heads to turn frantically in search of the ball, or in this case the point. Polls indicate that Americans in general are for health care reform, but have showed little confidence in Congressional health care reform. The political tactics such as the tit for tat between the White House and Palin may be accounting for the lack of faith held in Congress and the President concerning this matter.