When you live at home with mom and dad, they get to tell you how to live. When a company pays you for work, they generally get to tell you what to do when you're there -- and in some cases -- what to do when you are not there.
Despite all the talk about health decisions being made by doctors and patients -- when government runs health care -- let's be honest -- government will get to make the decisions.
And so, with the economy slumping and more programs to be funded than money, government would presumably make strategic choices regarding where to find savings. Some have suggested this may mean that the old or feeble would be less likely to receive expensive operations and procedures. After all, the logic goes: why put new wine in old wineskins?
President Obama recently alluded to this when -- regarding a question about a 100 year old lady getting a pacemaker -- he said: "Maybe you're better off not having the surgery, but taking the pain killer."
Sarah Palin's controversial comments about a "death panel" were unfortunate, inasmuch as they probably did more harm than good to the cause she was advocating. I cannot find any "death panel" mentioned in any of the proposed health care bills, and so her rhetoric sounds extreme. Instead, what I can find is that we are in grave danger of creating a system in which the logical conclusion would be government rationing of care.
It's also fair -- and honest -- to say that there are, in fact, top scientists advocating that the government pick an choose health care winners and losers.
As I noted a while ago, in his appropriately titled column, 'Why We Must Ration Health Care,' noted bioethecist Peter Singer recently wrote,
"The death of a teenager is a greater tragedy than the death of an 85-year-old, and this should be reflected in our priorities."
While Singer is fortunately not advising the White House, Doctor Ezekiel Emanuel, is. Ezekiel, of course, is the brother of powerful White House Chief of Staff Rahm Emanuel. He is also Health Policy Advisor for the Office of Management and Budget (OMB).
As The New York Post recently wrote of Dr. Emanuel,
Savings, he writes, will require changing how doctors think about their patients: Doctors take the Hippocratic Oath too seriously, "as an imperative to do everything for the patient regardless of the cost or effects on others" (Journal of the American Medical Association, June 18, 2008).
Yes, that's what patients want their doctors to do. But Emanuel wants doctors to look beyond the needs of their patients and consider social justice, such as whether the money could be better spent on somebody else.
Many doctors are horrified by this notion; they'll tell you that a doctor's job is to achieve social justice one patient at a time.
Emanuel, however, believes that "communitarianism" should guide decisions on who gets care. He says medical care should be reserved for the non-disabled, not given to those "who are irreversibly prevented from being or becoming participating citizens . . . An obvious example is not guaranteeing health services to patients with dementia" (Hastings Center Report, Nov.-Dec. '96).
Translation: Don't give much care to a grandmother with Parkinson's or a child with cerebral palsy.
So while Sarah Palin's comments probably struck the average person as having come out of nowhere, those who mock the notion that government could -- and would -- eventually ration health care are either being intellectually dishonest -- or are simply not paying attention.