"I just lost my grandmother last year. I know what it's like to watch somebody you love, who's aging, deteriorate and have to struggle with that," an impassioned Obama told a crowd as he spoke of Madelyn Payne Dunham. He took issue with "the notion that somehow I ran for public office or members of Congress are in this so they can go around pulling the plug on grandma."
"When you start making arguments like that, that's simply dishonest—especially when I hear the arguments coming from members of Congress in the other party who, turns out, sponsored similar provisions," Obama said.
In a debate in which he often sounds professor-like, Obama spoke with a rare bit of emotion that seemed to counter that of vocal health care opponents as he referenced the beloved grandmother who helped raise him and who he called "Toot." She died of cancer at age 86 on Nov. 2, two days before he won election to become the nation's first African-American president.
He talked about her death while answering a question about misinformation being spread about Democratic health care efforts during a town hall style gathering in a high school gymnasium.
"Health care is really hard. This is not easy. I'm a reasonably dedicated student to this issue. I've got a lot of really smart people around me who've been working on this for months now," he said. "There is no perfect painless silver bullet out there that solves every problem, gives everybody health care for free. There isn't. I wish there was."
But he said that because there's no perfect solution to solving health care, opponents "start saying things like we want to set up death panels to pull the plug on grandma."
The president is seeking to put to rest claims that the health care overhaul he seeks would set up "death panels" to rule on life-sustaining care for ailing seniors. It would not, and Obama has stressed that point repeatedly over the past week.
Obama reiterated his contention that the Democratic health care legislation would not create "death panels" to deny care to frail seniors. Obama has explained that the provision that has caused the uproar would only authorize Medicare to pay doctors for counseling patients about end-of-life care, living wills, hospice care and other issues, if the patient wants it.
He was attempting to dispel the notion that the health care bills contained the so-called "death" panels.
The reason this is such a charged issue is that end of life care is where much of the supposed savings in Obama's health care plans comes from since most people consume 80% of their health care dollars in the last year of life (necessarily so - primarily because as we age, medical conditions tend to accumulate and become progressively more expensive to treat).
My grandma passed away earlier this week, and she had been in a nursing home for the past three years, and had been in and out of hospitals ever since falling and breaking a bone in her leg - requiring major surgery. I hazard to guess how the voluntary panels would have figured out whether it was "cost-effective" to provide such treatment or provide mere palliative care.
She was 92 years old when she died. She got to live three more years, during which time my nephew was born, making her a great-grandmother, but it was an expensive three years in terms of her care, including medication, rehabilitation, and nursing costs. Should we have been denied that opportunity to spend three more years with loved one?
My concern is not so much that there's a voluntary panel, but that the voluntary nature of the panels will become much more than mere suggestion. It will creep into the doctor's treatment decisions. Voluntary will no longer be viewed as voluntary because of pressures on cost control.
Now, the counterargument is that insurers already do much of the same - but you can fight insurers - and win. Can you say the same about a government bureaucracy? More often than not, the government bureaucracy will crush the spirit of those who oppose them.
And don't get me started on how government will be more efficient than the private sector - just look at the cash for clunkers program for proof of how efficient government can run things costing $1 billion. And we're supposed to entrust the government to run a huge chunk of the economy?
Consider that if the idea of saving billions of dollars could come from simply advising patients on the need for advance directives, living wills, and alternative treatment options that do not include heroic measures, then wouldn't it be cheaper for all Americans simply for states to require that all people write up such documents ahead of time, rather than attempting to foist a trillion dollar health care overhaul on the nation at a time when we simply can't afford any such change? Let's see if providing for clear intentions on end-of-life care will provide any kind of cost containment.
Moreover, there are other alternatives to Obamacare that would do more to increase the number of people covered by health insurance than what Obamacare proposes.
Simply demand that states allow any health insurance policy already approved by any other state in the nation. In other words, if you live in New Jersey currently, you can only purchase health insurance that is approved in New Jersey. You can't buy a bare-bones policy that was approved in Nebraska or Rhode Island or anywhere else for that matter. States that require additional coverage as a matter of public policy necessarily increase the cost for basic coverage. Many people do not need such coverage.
Instead, such people could opt for basic coverage as provided by policies approved for purchase elsewhere, that would cover catastrophic care costs. Moreover, it would allow for portability, which is a key issue for a nation whose citizens move on average of once every seven years. Giving people those options would fulfill one of Obama's intentions of providing universal coverage. Is it cost-effective to impose a trillion dollar overhaul to attempt to increase coverage above the existing 85%? I don't think so, and the President has been unable to make the case that he can deliver on any of his promises relating to the cost; namely where the money is coming from to provide such coverage and for how long those people who have existing coverage will be able to keep it.
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