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Friday, February 26, 2010

Countdown to Health Insurance Nationalization

Keith Olbermann on health care.

The “debate” over what to do about the serious problems in the medical system has been pretty lame, with strange economics, chicanery, and demagoguery run rampant. The minority party’s pitiful offerings and compromises are documented in an article I wrote here. The majority’s several variations on a nationalization theme have provided grist for many other articles. (See this list.)

Watching each side’s advocates on television gives one the impression that they would say anything to score points with the uncritical viewing public.

Case in point: Keith Olbermann of MSNBC. I only single him out because I happened to catch his “special comment” Wednesday night, the night before the big bipartisan show — excuse me, summit. Olbermann has much in common with his fellow progressive talkers, though he does add an extra dash of self-righteousness that sets him apart.

At any rate, Wednesday night Olbermann told the sad story of his seriously ill father, which I will not go into except to say I wish him a speedy recovery. (You can read the text or watch the video here.)

I will, however, comment on the parts of the television host’s story that veer into public policy. Olbermann has made no secret of his wish for the government to assume control of the medical system, and he has not hesitated to demonize anyone who takes the opposing position. (He calls them “ghouls.”)

“Death Panels”

His first truly perplexing contention relates to the “death panels” that some Republicans and conservatives made such a big deal over when the medical overhaul bills were first trotted out. You’ll recall that several prominent critics of the bills claimed that the government would be authorized to set up an entity with life-and-death decision-making power over the elderly. It wasn’t true. No such entity was called for. What the House bill did was add end-of-life counseling to the list of Medicare-covered services. By the letter of the bill, a patient would have to request such consultation from a doctor, but would not have to pay for it out of pocket. This was hardly mandatory counseling, much less a death panel, but it should be noted that nonconservatives Nat Hentoff, Charles Lane, and Eugene Robinson were troubled by even that small degree of government involvement in this sensitive area.

Robinson of the Washington Post (a frequent friendly guest on Olbermann’s program) wrote last year:

If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending…. [I]t’s understandable why people might associate the phrase “health-care reform” with limiting their choices during Aunt Sylvia’s final days.

In his Wednesday comment Olbermann, who does think such fear is delusional, couldn’t resist taking one more shot at the death-panel mongers, but he stretched the point beyond recognition. After relating that he had discussed end-of-life care with his father and then with a doctor in the hospital after his father said he wanted no more treatment, Olbemann said:

And as I left that night the full impact of these last six months washed over me. What I had done, conferring with the resident in ICU, the conversation about my father’s panicky, not-in-complete-control-of-his-faculties demand that all treatment stop, about the options and the consequences and the compromise — the sedation — the help for a brave man who just needed a break… that conversation, that one — was what these ghouls who are walking into Blair House tomorrow morning decided to call “death panels.”

Your right to have that conversation with a doctor, not the government, but a doctor and your right to have insurance pay for his expertise on what your options … that’s a quote “death panel.”

Okay, deep breath, Keith. No one has used the term “death panels” in connection with what you did that night. No one opposed consultation about end-of-life care. The fear-mongering about death panels was reprehensible, but it referred to something real: government’s declared intention to assume control of health insurance in order to lower the country’s medical bill. If the government pays for the medical services of the elderly (and many others) and is determined to lower that bill, it is reasonable to wonder if it will apply pressure to deny care in cases where it may appear that further services are pointless. After all, it was Barack Obama who first raised the issue last year when he told the New York Times Magazine, after his elderly grandmother, who had terminal cancer, got a hip replacement shortly before dying,

Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else’s aging grandparents or parents, a hip replacement when they’re terminally ill is a sustainable model, is a very difficult question. … I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here…. Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance.

Praise Medicare

Finally, Olbermann had this to say about the financing of medical care in general:

[My father has] got Medicare and a supplemental insurance and my out-of-pocket medical bills over the last six months have been greater than my Dad’s have.

And why in the hell should that not be true of everybody, in every hospital, in every sick room, in every clinic, in this country? What is this country for if not to take care of its people? Because whatever I’ve been through these last six months and whatever my Dad’s been through, not once were our fears or our decisions amplified by the further horror of wondering how in the hell we would pay for this. What about families having these conversations tonight about kids? Or about uninsured adults?

Here Olbermann pretends the “country” is something separate — complete with a separate bank account — from the individuals who comprise it. Has he not heard that Medicare has a $37 trillion unfunded liability and will be broke before too long? Does he think putting everyone on Medicare would make it fiscally sound?

Olbermann must be unfamiliar with the law of scarcity, for he shows no sign of realizing that even if the government devoted 100 percent of GDP to paying medical bills, some people would end up going without “enough” and a “death panel” would have to be set up to ration services. He can’t be bothered with such details when people are suffering. (No, the free-market alternative would not ration care. See this.)

More important, when Olbermann says the purpose of the “country” is to take care of its people, has it occurred to him that his proposal requires the use of physical force against peaceful individuals? No, I’m sure it hasn’t.

  • Sheldon Richman is the former editor of The Freeman and a contributor to The Concise Encyclopedia of Economics. He is the author of Separating School and State: How to Liberate America's Families and thousands of articles.