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The politics of dying: part two

Adam Newman | Tuesday, February 5, 2013

In my last article, I wrote on a pretty heavy subject: end-of-life care. End-of-life care in America is very expensive and threatens our nation’s future solvency. Not only that, the exorbitant amount we spend on health care does not produce better outcomes due to a lack of coordination and due to incentives to perform unnecessary tests and procedures. This usually leads the patient to die in a hospital, instead of dying at home surrounded by loved ones.
The politics of death is very complicated, and the 24-hour news cycle filled with 30-second sound bites has done an atrocious job of explaining it to people. Even though our health care system is expensive and confusing, people are used to it, and as a result are very sensitive to reform, especially coming from the government.
For example, there was a minor provision in the Affordable Care Act that allowed Medicare to reimburse physicians for providing end-of-life counseling to seniors. This counseling was intended to allow seniors to discuss and plan end-of-life treatment with their physicians.
Most were not familiar with this provision within the health care bill as described. Many know it by a different name: “death panels.” Indeed, this small provision meant to tackle one of the most important health care problems we face was given this title, even though it is similar to calling a butter knife a “weapon of mass destruction.” However, this did not stop former Alaska Gov. Sarah Palin from writing on her Facebook wall in August 2009, “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.”
The term “death panels” quickly swept across America and was used by many others to oppose reform. Even sensible Republicans stooped to Palin’s level. The end-of-life reimbursement provision was removed from the health care bill, but its memory still lives on: The death panels were the non-partisan fact checker Politifact’s “Lie of the Year” in 2009.
Quotes like Sarah Palin’s are the reason why controlling health care spending is so difficult, because it requires an adult conversation and a stable political climate. As Mark Twain once said, “A lie can get half way round the world while the truth is still tying its shoes”.
The politics of health care affects seniors the most. Seniors are a very important voting group because they benefit more than any other group from government services – Social Security for their pension and Medicare and Medicaid for their health care. Unfortunately, seniors are more easily scared and fooled by political ads. Republicans and Democrats are both guilty of attempting to scare seniors into voting for them. The Republicans became known for promoting Democratic initiatives as death panels and rationing. Democrats used Paul Ryan’s plan to privatize Medicare to scare seniors by suggesting, “Medicare would be ended as we know it.” Probably the lowest point was a one-minute commercial created by a Democratic group, showing a tall man in a suit with black hair whose face is not revealed – but who is obviously supposed to be Paul Ryan – pushing an elderly woman in a wheelchair along a trail through a forest. Upon arriving at the edge of a cliff, the man proceeds to push the senior off. The commercial then ends with an appeal against privatizing Medicare.
One would think the principles of both parties would make them more responsive to the end-of-life crisis. Republicans favor a smaller government, so they should want to do everything they can to ensure unnecessary end-of-life care does not gobble up the federal budget. Thus, while Sarah Palin may believe in a smaller government, her “death panel” comment killed an opportunity to lower unnecessary government spending. Democrats are known as the party that protects the elderly, and thus should prove it by working to curb unneeded medical care and by providing a better alternative to lowering health care costs than Paul Ryan’s Medicare plan. This does not make for good political sound bites but does make for good policy.
The end-of-life care challenge we face is a uniquely American challenge: Reforming a system so it provides better and cheaper care for those at the end of life, while steering American families, businesses and the government away from bankruptcy. But if we are going to accomplish this, there have to be changes to how we talk about end-of-life care. Otherwise, the terms “death” and “taxes” may well become synonymous.
Adam Newman is a senior finance major. He can be reached at
anewman3@nd.edu
    The views expressed in this column are those of the author and not necessarily those of The Observer.