The essence of the American debate was captured for once and always in this exchange:
Someone reportedly told Inglis, "Keep your government hands
off my Medicare."
"I had to politely explain that, 'Actually, sir, your health care is being
provided by the government,'" Inglis told the Post. "But he wasn't having
any of it."
Huffington Post
By the Republicans definition, any attempt to prevent people from choosing expensive but ineffective treatments, is a "death panel".
It is a tribute to how badly outfoxed on public relations the Democrats have been: the public associates "Death Panels" not with congressmen determined to prevent them from accessing health insurance, at a sustainable cost, but with the Democrats who want to provide it. That is an amazing accomplishment.
As far as I can tell, the Republicans greatest concern about health care is the rising costs. It has been rising, rising, rising for fifty years under the Republican system: private insurance. Did I say the Republicans are concerned about these rising costs? Yes they are. They have a solution. Do nothing. As Ross Douthat in the New York Times admits, the conservative solution to the uncontrolled cost of health care is "modest reforms that would help the hardest-pressed among the uninsured". Isn't that inspiring? That covers a multitude of nothings.
As the health care industry expands to meet it's central dynamic: we are a society that looks at itself in the mirror and says, "we believe life is more valuable than money". Therefore, if someone's life needs saving, we will spend as much as necessary to save it. The health care industry understands this. There is no reason why they should ever find cheaper, more efficient treatments: it is contrary to their fundamental interests.
It is not contrary to the real interests of the government and the people they represent to place some reasonable controls over how much should be spent on any particular disease or injury. But it's something all the parties have to agree on or else one particularly stupid or ruthless party can exploit the fact that most people appear to refuse to believe what they see. An unfortunately large percentage of the population can be led to believe that one party can provide all the health care they want and need without bankrupting the country while cutting taxes.
So I'll bet more than a few rational Republicans -- if any are left-- regret the choice of the word "death panels". Because they have attached the phrase to the idea of limiting the relentless increase in health care costs. Because the potential cost of health care is infinite. The last twenty years of astonishing increases have proven it.
Come on, Democrats! Seize the term and turn it on the Republicans! They are the party that doesn't want you to have affordable health insurance. They are the party of war, of unregulated industry, of tort reform: they are the Drop Dead Party.
The Republican approach will inevitably lead to a system where only the rich can afford proper treatment. By the Republicans definition, any attempt to prevent people from choosing expensive but ineffective treatments, is a "death panel". Any attempt to limit treatments performed on people who are going to die soon anyway is a "death panel".
Do you want to be the politician who tries to explain to the American people that too much health care is provided to people in the last few months of their lives, and that this is making the whole system unsustainable?
Here's the naked truth: what the U.S., and most western countries need or already have, is something the Republicans have labeled as "death panels".
As Douthat correctly noted, health care costs rise at astronomical rates. New treatments come on board constantly, new drugs, new techniques, and pharmaceuticals and doctors and hospitals charge enormous sums for these goods and services. Unfortunately, all this new technology has had the opposite effect that it had on computers: medical costs have risen steadily. Why? Really, in a nutshell, because people will pay anything to get better. Anything. Whatever it costs. People will sell everything they own to pay for it because nothing you own matters to you if you're dead. And the medical industry knows it.
There really as an infinite amount of money we can spend on health care. Unconstrained, it will eventually consume most of the financial resources of the entire nation.
The health care industry also knows that people don't go shopping around the cheapest cancer surgery, to see if they can get a discount. They don't turn down an incredibly expensive operation just because they also have cancer and failed kidneys and diabetes and a heart condition, because they are 80 years old, or because they are Republican.
With this logic in place, there is no ceiling on medical expenditures, and eventually it will consume more and more and more of the economy, until it breaks. Or until Republicans, having created an unsustainable system, declare that no system is sustainable and announce their new policy for the uninsured: drop dead.
Most other developed countries simply negotiate what they will pay for particular treatments, which treatments will be available, and how much over-all spending will go into health care. What the Republicans call "death panels" are really nothing more than educated people trying to balance needs against resources, and so far it works pretty well Europe, Australia, and Canada.
I have no problem accepting a system that declares that it will not spend an infinite amount of money on health care. I have no problem believing that we can still have a pretty good system that provides effective essential treatments for almost every illness. I accept that when I am 80 years old and suffering from all the ailments a typical 80 year old suffers from that I will not be a candidate for a kidney or heart transplant.
The only way to have a sustainable and effective health care system is with death panels.
