I Got Your Death Panels Right Here

It’s ok when Republicans and the “free market” do it:

Even physicians with decades of experience telling patients that their lives are nearing an end are having difficulty discussing a potentially fatal condition that has arisen in Arizona: Death by budget cut.

Effective at the beginning of October, Arizona stopped financing certain transplant operations under the state’s version of Medicaid. Many doctors say the decision amounts to a death sentence for some low-income patients, who have little chance of survival without transplants and lack the hundreds of thousands of dollars needed to pay for them.

“The most difficult discussions are those that involve patients who had been on the donor list for a year or more and now we have to tell them they’re not on the list anymore,” said Dr. Rainer Gruessner, a transplant specialist at the University of Arizona College of Medicine. “The frustration is tremendous. It’s more than frustration.”

Where are those loudmouth liars Sarah Palin and Betsy McCaughey now?

95 replies
  1. 1
    Svensker says:

    Being strangled by the invisible hand is good!

  2. 2
    NonyNony says:

    They would just say that this proves their point – if you get government involved in health care, “death panels” are inevitable. Nevermind that the cause of the “death panels” are Republican politicians and Republican policies – that isn’t important. The important thing is that it’s the government that’s doing it.

    Republicans love to do this kind of shit. Think of horrible things that the government could do and then when they get into power do it to prove to the world how horrible government is so that they force their way onto everyone else. (This is how they got rid of the post-Nixon Special Prosecutor laws – once they got enough power to appoint their own they appointed Ken Starr who went on a useless and pointless witch hunt against Clinton until even the folks who supported the idea of a Special Prosecutor watching out for corruption in the Oval Office could no longer support it.)

  3. 3
    dr. bloor says:

    Silly blogger, it’s not healthcare rationing if brown people are involved.

  4. 4
    Xenocrates says:

    Where are those loudmouth liars Sarah Palin and Betsy McCaughey now?

    Rehearsing their speeches on Faux Snooze about how it’s all the fault of Obama and the Democrats. Any other questions?

  5. 5
    danimal says:

    @NonyNony: So the real Republican concern about death panels is that they don’t want to be directly responsible for killing people.

    They’d rather work through their insurance company proxies.

  6. 6
    IrishGirl says:

    John, I wrote about this on my own blog on Nov. 17th
    https://drangedinaz.wordpress.com/2010/11/17/az-health-care-death-panels/

  7. 7
    Dave C says:

    Arizona is the new Texas.

  8. 8
    nevsky42 says:

    Well, last I heard Palin was bringing cookies to schoolkids because Michelle Obama promoting healthy eating to children is socialist or something. I didn’t quite follow her logic, but one of us may have been drunk.

  9. 9
    Judas Escargot says:

    They should have saved up $250K, just in case. Stupid proles.

    Freedom!

  10. 10
    Bulworth says:

    These are all lazy people made more lazy by Democrat party soshulism who didn’t take advantage of our wonderful competitive price based free market system to find the right policy at the right price.

  11. 11
    gene108 says:

    Look damn it, poor people are meant to die because they are poor and a drain on societies resources.

    If they had money, they would be productive and could find the means to obtain the needed operation.

    What do you people want America to become? A socialist-fascist-communist state where the lazy blood-suckers leech off the hardworking people? That worked really for Russia.

    Bunch of liberal losers.

    {end snark rant}

    I think that about sums up the conservative attitude towards the poor. Very Dickensian.

  12. 12
    jayackroyd says:

    Might wanna take “this is how realignments happen” out of the mix. Sorta depressing.

  13. 13
    MagicPanda says:

    @NonyNony: You are exactly right.

    To anyone not following the news closely, this will be perceived as “death panels” that happened as a result of financial pressure put on AZ by “obamacare”.

    Never mind the fact that it makes absolutely no sense. Remember, people thought we should be in iraq “so we can fight them over there instead of over here” for years after we found that Saddam had no weapons of mass destruction, etc.

    It’s not logical. It’s emotional. And Democrats are bad at explaining things in those terms.

  14. 14
    Resident Firebagger says:

    I guess he’s a hypocritical douche-bag, but one thing I appreciated about John Edwards during the ’08 primaries was that he’d actually talk about this kind of shit. Deeds, not words of course, but it’d be nice if some pol, somewhere, would take notice of these poor people dying for no reason other than they’re poor. But I guess not while Assange roams free…

  15. 15
    J.W. Hamner says:

    Ah, I see the confusion… this is about Medicaid… which is for poor people… not old people. For poor people we know that government support makes them unemployed and sick. Hayek probably said that somewhere. Old people on the other hand vote… and sometimes have money. Which I believe was a principle advanced by Burke.

  16. 16
    MsSkwEsq says:

    Don’t forget the good Senator Grassley R-IA and his republican sister to the North, Michelle Bachmann. They are big death panel liars as well. During Grassley’s reelection campaign this past fall Grassley had the balls to claim HE got drug coverage for seniors and wanted to go even further to get drug companies to reimport from Canada and close the donut hole!!!! He promised to close the donut hole in the future and even implied his support for health care reform. Such lying by the ‘gentleman farmer’ – makes me so furious. I’m ashamed of him and crazy Steven King… Iowa deserves so much better than those two nuts!

  17. 17
    Brachiator says:

    Where are those loudmouth liars Sarah Palin and Betsy McCaughey now?

    Poor people got no reason,
    Poor people got no reason,
    Poor people got no reason,
    To live….

    With all due apologies to Randy Newman

  18. 18
    Howard says:

    “Low-income”? Medicaid? Nobody cares about those people!

  19. 19
    Janet Strange says:

    @NonyNony: Exactly. Medicaid = government health care = death panels.

    That will be precisely the message from Fox “News.” Expect a “see I told ya!” tweet from Sarah any minute.

  20. 20
    chopper says:

    Where are those loudmouth liars Sarah Palin and Betsy McCaughey now?

    they played their part perfectly – ‘accuse the other guy of trying to do what you yourself plan to do’. page 10 in the gooper playbook.

  21. 21
    gene108 says:

    @IrishGirl: I read your blog and you miss an obvious point:

    It’s like taking candy from a baby–literally. For example, the state got rid of “all day” kindergarten. Who does that affect? The poor and their children. Child care is very expensive and if both parents have to work to keep the family afloat, who takes care of the kids? And don’t give me that stupid argument that it’s not the government’s responsibility to babysit our children. I wholeheartedly agree it isn’t. Yet from a practical standpoint how does the state expect the poor to work several jobs and care for their children? How does the state expect our kids to be ready for the first grade without a proper full-time education? How do they gain knowledge but also the social skills if they are latch-key kids? Hundreds, if not thousands of studies have shown the benefits to children and to society in general of full-day kindergarten.

    The problem for what to do with these kids would be ended overnight, if we got rid of irresponsible child-labor laws, which force families to become dependent on the government because they can’t have their children work.

    No wonder the poor are so lazy and have such low marriage rates. The incentive to be supportive members of their families is taken away from them by the government in kindergarten.

    {/snark}

    I really do think there are people on the right, who wouldn’t mind going back to the 19th Century, post-Civil War, labor laws and I think they are working to make it happen as soon as possible.

  22. 22
    Zifnab says:

    @Dave C:

    Arizona is the new Texas.

    Slow down there. Don’t sell us short just yet. Our Congress just isn’t in session right now.

    Many doctors say the decision amounts to a death sentence for some low-income patients, who have little chance of survival without transplants and lack the hundreds of thousands of dollars needed to pay for them.

    Fuck them. I’ve got mine. This just means more spleens for the rest of us.

  23. 23
    Thoughtcrime says:

    Death by a thousand tax cuts.

  24. 24
    Zifnab says:

    @gene108:

    I really do think there are people on the right, who wouldn’t mind going back to the 19th Century, postpre-Civil War, labor laws and I think they are working to make it happen as soon as possible.

    Fix’d.

  25. 25
    Don K says:

    @dr. bloor:

    You beat me to it. Anyone on Medicaid is by definition a lazy layabout, probably black or Mexican (or at the very least not a real Murrican), and not deserving of medical care at taxpayer expense (but for now they’ll just disallow the transplants).

  26. 26
    Culture of Truth says:

    Hey Obama just landed in Afghanistan.

  27. 27
    mikefromArlington says:

    JUST IN TIME FOR X-MAS!

  28. 28
    Davis X. Machina says:

    It is blasphemous to substitute the fallible, human judgments of legislatures for the ineffable dispositions of God.

    How He distributes the outward signs of His election, and whom He chooses to save or damn from from before the beginning of all time is His Own damned — so to speak — business — so to speak.

    This is why lowering the top marginal rate of income tax, and of capital gains tax, is always a holy thing to do. Deprived, even in part, of those outward signs of election, His Chosen will live in fear and trembling, unsure of whether they are in fact among the elect. And a just and merciful Deity would not, could not, make His elect suffer so.

    And as for the preterite damned — ‘tough noogies’, I believe, is the phrase Calvin preferred. Or was it Augustine? Or was it David Stockman? (I get them confused…)

  29. 29
    James K. Polk, Esq says:

    It’s the invisible hand giving critically ill patients the middle finger.

  30. 30
    General Stuck says:

    I wonder if there’s a death panel for blogs

  31. 31
    gene108 says:

    @Zifnab: Nah…I don’t think reopening the West African slave trade is viable and the political consequences of reintroducing slavery aren’t worth the financial gains there’d be.

    I think you can get more out of the work force and make more money for corporations, by eliminating the minimum wage, for example, since many minimum wage workers don’t have the skills to do anything else or make it so you can pay workers in company credits / scrip, so the employer maintains total domination over their labor pool.

  32. 32
    David Hunt says:

    @gene108:

    The irony of suggesting this Modest Proposal to someone named IrishGirl is not lost on me.

  33. 33
    dr. bloor says:

    @General Stuck:

    Nope. Only for commenters.

  34. 34
    dr. bloor says:

    @James K. Polk, Esq:

    It’s the invisible hand giving critically ill patients the middle finger

    Rectal exams are much cheaper than transplants.

  35. 35
    danimal says:

    @General Stuck: You better hope not, Mr. Popularity.

  36. 36
    Ailuridae says:

    @J.W. Hamner:

    Amazingly most of Medicaid funds are spent on old people for nursing homes after they have gone broke trying to die with dignity (natch, they don’t qualify for Medicaid subsidized nursing home care until they are in poverty).

    Front pager kay did a nice piece on Medicaid’s finances in the last 3-6 weeks.

    But you’re right. Young people on Medicaid are basically viewed as welfare queens. And Arizona, the last state to adopt Medicaid, has had the most draconian Medicaid policies and there is a very simple reason for this: Arizona’s voting is dominated by seniors from the midwest whose retiring to AZ is just a second iteration of white flight where “their” neighborhoods were ruined by “those people” in Canton and Chicago and Milwaukee and St Louis.

    Now, if we want to talk progressive policy about the best thing we can do for the poor is to make Medicaid a wholly federal program so that in recessions states with very real budget issues don’t have Medicaid as an option to cut. On the politics side that is likely a loser for Democrats (Medicaid is the classic “them” program when vies in an “us versus them” sense) though.

  37. 37
    daveNYC says:

    Don’t forget the good Senator Grassley R-IA and his republican sister to the North, Michelle Bachmann. They are big death panel liars as well.

    The sad thing is that Grassley used to be an OKish senator. There’s no real reason for him to have to go all right-wing crazy talk either. He could pretty easily coast to victory regardless, and knocking him out in a primary wouldn’t be that easy either.

  38. 38
    Davis X. Machina says:

    @Culture of Truth:

    He’s just running away from his problems in Washington. I learned this from DemocraticUnderground.com, where real progressives hang out.

    Viva Kucinich Clinton Grayson Sherrod Sheehan Weiner Dean Warren Mosley Kucinich!

  39. 39
    Apathy says:

    The argument on death panels was there would be an insidious group who would decide if you were to live or die based on Orwellian concepts of societal worthiness.

    This shows the disagreement was merely Republicans felt we had a perfectly good metric for that already and your net wealth provided the perfect free market death panel.

  40. 40
    4tehlulz says:

    Sarah Palin is too busy snickering at the poor trash who, unlike her, made it through swindling hard work to notice.

  41. 41
    mclaren says:

    Don”t worry, those sick dying patients will accept their death sentences meekly and they’ll crawl away to die without uttering a peep of protest.

    Americans will stand for anything now. We’ve turned into cringing crawling serfs, eager to bend over for the TSA goons, pathetically delighted to kiss the cop’s baton even as it beats us to death. We apologize to the SWAT team member’s boot as it kicks us in the head during a medical marijuana raid and even wounded and dying from a gutfull of double-ought buckshot from a DEA shotgun, we crawl like animals to kiss the hands of the killers who blow us away.

    Americans used to stand tall. Now they whimper like whipped dogs and weep tears of gratitude when a mugger with a badge tasers them 19 times.

    So why shouldn’t the state government of Arizona kill ’em slow and laugh about it? When you crawl and cringe before a bully, you only invite more of the same…and worse.

    If, every time a doctor told some patient “Sorry, there isn’t enough money to treat your fatal disease,” the patient pulled out a .357 loaded with hollow points and blew the doctor’s head off, you can bet your ass the state of Arizona would suddenly and magically find a whole boatload ‘o special funding for those transplants.

  42. 42
    General Stuck says:

    @dr. bloor:

    then you might as well line me up against the wall then, because I will not join this hi tec lynching.

    @danimal:

    Mr. Polularity? LOL, I’m the fly in your reactionary ointment – I don’t really exist, and neither do you.

  43. 43
    Ailuridae says:

    @daveNYC:

    No offense, but that is crazy talk. The Iowa GOP is absolutely, unapologetically bat shit crazy and Grassley is plenty vulnerable from the right. Now it couldn’t be a tea party candidate who was arguing to end farm subsidies (remember Iowa is basically just a leech on the rest of the country) but there was plenty of talk in 2008 and early 2009 that Grassley had drifted too far left and could see a primary challenge.

  44. 44
    Judas Escargot says:

    @gene108:

    Nah…I don’t think reopening the West African slave trade is viable and the political consequences of reintroducing slavery aren’t worth the financial gains there’d be.

    I hear that the Irish might be available, at bargain prices too.

  45. 45
    Davis X. Machina says:

    @Judas Escargot: How soon we forget the lessons of Blazing Saddles

    You don’t take the Irish!

  46. 46
    vtr says:

    The interesting aspect of to me is that back in 2004, when Moore’s “Sicko” was making the rounds, audiences seemed to agree that the corrupt “free market” health care system needed to be changed. It is a failure of news organizations that, since then, people fell for the death panels lie.
    Betsy McCaughey was on the Daily Show about a year ago. Stewart dunced her quite well, but in discussing the death panels with her, he never made her defend the death panels that actually exist in the insurance industry. Stewart does fake news, but did any news outlet point this out? It’s pretty easy to understand – there’s no excuse for it not to have been debunked.

  47. 47
    Martin says:

    Well, the meta game is boring, so I’ll be the dick. Snowbilly Snookies comments aside, nobody is really commenting on the policy in a meaningful way. Who fucking cares if they’re hypocrites – they always are. But if progressives want a single payer system, then they’re going to have to tackle the thorny issue of how to determine what will and won’t be paid for.

    Neither government nor insurance companies can or should fund every possible procedure. A line will always have to be drawn. I’ve read about a number of these Arizona cases and it’s clear to me the state is drawing the line in the wrong place here, so what mechanism should government use to determine where that line is?

    Ultimately, all such decisions boil down to some kind of survival analysis – a procedure that costs $x will return y years of lifespan. It’d be a simple thing to chuck all of these things into a computer and have it pop out an answer – the state will fund anything where $x/y is below a certain number. Should there be a penalty for procedures that are the result of a preventable decision? Should there be a bonus for children?

    One of the new health care problems the US faces, that didn’t exist 30-40 years ago, is that thanks to life support and a very deep R&D bench, there’s never ‘nothing’ that can be done any more. There’s always a use for the next healthcare dollar. There’s literally an infinite use for healthcare spending, even if it’s keeping every single person on life support until some cure for their condition can be found. So given that, there has to be bureaucratic barriers to spending, even if those barriers are handed off to doctors or statisticians or whoever. The cutoff need not be in the hands of the people trying to keep the budget in check, but it needs to be in someone’s hands. So whose?

  48. 48
    Davis X. Machina says:

    @Martin: Oregon tackled this problem more than a decade ago. So it’s not like it’s completely uncharted territory, or one where a state role is unprecedented.

  49. 49
    Zifnab says:

    @gene108: When the minimum wage is abolished and we’re all back to buying from the Company Store and managers can beat their employees at their leisure, it’s six of one and half a dozen of another.

    What’s the difference between slavery and the free market when half a dozen businesses own all the jobs?

  50. 50
    Judas Escargot says:

    @mclaren:

    We’ve become a nation of House Elves. Without the magic skills.

    Most House-elves would be devastated if freed, for it would mean that they had failed to serve their masters properly

  51. 51
    NonyNony says:

    @danimal:

    So the real Republican concern about death panels is that they don’t want to be directly responsible for killing people. … They’d rather work through their insurance company proxies.

    Not quite. It’s not that they want to dodge responsibility for killing people, it’s that they want the Invisible Hand of the Free Market to decide who lives and who dies.

    By doing it that way the folks with more money are more likely to survive and folks with less money are more likely to die off, freeing up resources for folks with more money and for folks with less money who don’t have health problems (and are there for still potentially useful members of society).

    It’s just your basic class warfare, dressed up in a populist motif to get a majority behind it. Being poor is a sin in this country, what with our weird Evangelical prosperity gospel roots, so it really isn’t terribly hard to get poor-ish people angry at people who are poorer than they are, given that “people poorer than me” are clearly “less worthy than me/lazier than me/worse than me” otherwise they wouldn’t be so damn poor.

  52. 52
    curious says:

    oh, their families are fine. thanks for asking.

  53. 53
    David Brooks (not that one) says:

    @Martin: What he said. Buried in the article is some hint of evidence-based decisions coming into play:

    State Medicaid officials said they recommended discontinuing some transplants only after assessing the success rates for previous patients.

    But the article later goes on to say they screwed up the analysis.

    @Janet Strange and others: They’re already doing it:

    The Republican governor has in turn blamed “Obamacare,” meaning the federal health care overhaul, for the transplant cuts even though the Arizona vote came in March, before President Obama signed that bill into law.

    And you know they will get away with it.

  54. 54
    4tehlulz says:

    @mclaren: Cool story, bro.

  55. 55
    Martin says:

    @MsSkwEsq: Don’t lump Grassley in there. Bottom line he’s a realist about this even if I disagree with his positions. Yeah, he’s unfortunately gone down the ‘death panel’ path on occasion out of some misguided political sense, but he’s not going to bang that drum anywhere near how Bachmann will.

    Grassley was reasonably on board with everything at the outset – seeing ACA as an entitlement bill and working hard to achieve that goal, though with GOP sensibilities. His ideas were reasonable but he couldn’t sell his caucus on them and inevitably he had to tack more and more right to try and get their support. As ACA expanded somewhat beyond entitlement cost reduction at the insistence of the Democratic base into entitlement benefit expansion and other reforms, he had to cut his support for the bill given the nutty direction of his base and the quickest way for him to do that was with that death panel mention in August 2009 (which people conveniently still credit him for today). He’s not since returned to that position to the best of my knowledge.

    I know his position pretty well on healthcare. Individually, I wouldn’t call him an ally on healthcare, but he’s definitely not an enemy. If you needed an honest broker out of the GOP, I’d still go back to him. Problem is he can’t bring his party along.

  56. 56
    Silver says:

    My grandma in Canada turns 90 in a week. One of her hips is going to be a month old at that point in time.

  57. 57
    twiffer says:

    ah, but you see, this is how the free market is supposed to work. it’s part of a plan. see, if you can’t pay for your organ transplant, you can still barter. need a heart and can’t pay for it? swap it for one of your functioning kidneys! or a lung! that’s why you have two, isn’t it.

    or was the plan to simply harvest the working organs after the patient dies? i forget.

  58. 58
    Judas Escargot says:

    @Zifnab:

    This just means more spleens for the rest of us.

    Braised Spleen goes quite well with Beaujolais.

  59. 59
    Culture of Truth says:

    @Davis X. Machina: You hate Russ Feingold, don’t you?

  60. 60
    debbie says:

    @ Martin:

    Banging the drum at all is why Grassley’s nothing more than an old, used up whore. I don’t understand anyone who thinks that betraying your principles can still leave you a principled man.

    Grassley’s destroyed his legacy every bit as much as John McCain has. Neither of them has the slightest bit of credibility any more. How can you see Grassley as anything other than a hypocrite?

  61. 61
    Odie Hugh Manatee says:

    This is why I will never vote for a Republican for the rest of my life, they don’t care about people. They only care about money and power. They know that they aren’t the people who are going to die because of this decision so it must be a good decision for them to make.

    Karma, the Republicans are overdue for a bit of it. Long overdue.

  62. 62
    Michael says:

    @mclaren:

    If, every time a doctor told some patient “Sorry, there isn’t enough money to treat your fatal disease,” the patient pulled out a .357 loaded with hollow points and blew the doctor’s head off, you can bet your ass the state of Arizona would suddenly and magically find a whole boatload ‘o special funding for those transplants.

    A thing of beauty.

  63. 63
    debbie says:

    @mclaren:

    If you’ve ever seen Michael Moore’s “Bowling for Columbine,” you’d understand that the single thread running through all of American history isn’t the love of freedom or even of the dollar, but of fear pure and simple.

  64. 64
    Martin says:

    @Davis X. Machina: Everyone has tackled it, most especially the insurers that Democrats are so eager to lay blame on. I’m not going to pretend that the insurers are any kind of standard to follow here, but any criticism of insurers as ‘free market death panels’ is going to apply equally to a public option or single payer unless people acknowledge that there has to a mechanism to cut off payment, understand that mechanism, and agree with it.

    I’m not ignoring Oregon and others. I’m saying that eventually, health care advocates are going to have to become aware of this issue, educate themselves on it, and support it. One of the main objections to public healthcare among thinking conservatives that focus on this area is precisely this issue. It’s not so much that government will make these decisions poorly, or won’t balance the budget, or whatever, but that government moves slowly, particularly as DougJ noted last night when it’s full of people that don’t know what the fuck they’re talking about, and that after the medical industry has come up with a more successful or cheaper procedure, that government won’t recognize and pay for the improved procedure. Then you do have a real problem – then you have government preventing care that meets their own criteria, simply out of bureaucratic incompetence.

    It’s a reasonable concern and one that the left should be prepared to address. So rather than more whining about how stupid Republicans are – something we fill every single thread with – I’m trying to get something productive and educational going here.

  65. 65
    Willing ex-pat to be says:

    I love this country and I hate this country. Lately, I have been hating it more than loving it, and this article didn’t help.

    The wingers say, love it or leave it. Well, I am indeed voting with my feet. I’ve been searching for a job in Munich where I used to live for the last few months, and I just got a job offer there. I’ll be back to visit, but I don’t forsee a future in which I will ever live in this country again. It may not be all that much better over there, every country has its problems, but at least my taxes won’t go to pay for illegal wars and society is less unjust and more equal.

  66. 66
    Erikthe Red says:

    Where are those loudmouth liars Sarah Palin and Betsy McCaughey now?

    They’d likely make the argument that it’s the mean ol’ State that’s doing this and that if we had more wonderful, efficient PRIVATE health insurers (who, of course, aren’t regulated) then these people would have some coverage. After all, everybody knows that private insurers never fuck over their clients, right?

  67. 67
    WereBear says:

    What is it? 60% of our health care expenses go for the last three months of life?

    For an existence no one with all their powers and faculties would opt for in the first place?

    That’s the hidden nugget of truth in “death panels.” It ignores the fact that we’ve painted ourselves into a corner where someone does have to pull the plug at the end of life… only no one has the guts to say so.

    My father is in the end stages of vascular dementia, stopped recognizing his children several months ago, and is 75 years old.

    And they still wanted to do a heart bypass on him.

    There’s your problem.

  68. 68
    blondie says:

    And just in time for Christmas …

    “If they would rather die,” said Scrooge, “they had better do it, and decrease the surplus population.”

    Being poor is the biggest sin in America.

  69. 69
    Cat says:

    @Michael:
    @mclaren:

    Please…

    They’d fund a new Department of Hospital Security with metal detectors, back scatter scanners, and security guards to give you the special pat down.

    To add insult to injury the funding would come out of Medicaid.

  70. 70
    YellowDog says:

    Here’s the difference between the Democratic and Republican responses to issues like this. The Democrats would do nothing. The Republicans would be all over Faux Noise with the talking points entitled “Brewer’s Death Panels.” Meanwhile, there would the title on the screen “BrewerCare.” The Republicans are very good at putting a face on whatever issue is the subject of today’s demagoguery. (e.g., HillaryCare, ObamaCare). Is Alan Grayson the only Democrat with the balls to call out Republicans on this crap?

  71. 71
    Martin says:

    @debbie:

    How can you see Grassley as anything other than a hypocrite?

    Well, I did say it was misguided. I didn’t agree with it, just that I recognized his rationale for doing it.

    I’m pretty sure that he actually supports the final bill and will work privately to prevent that it gets repealed. His focus was always on eliminating waste and fraud and opening up accountability in what CMS does, and he got a lot of that in ACA – probably more than in anything the GOP would ever have supported.

    His problem is that the GOP base is radicalized and has the power to primary strong players out of the party. Look at what happened to Castle in DE, and Castle is way more of a fixture than Grassley is and Grassley’s approvals fell quite a bit following the death panel summer. This kind of radicalism in the electorate forces politicians to be unprincipled. I’m not going to excuse the behavior, but that’s the reality of politics.

  72. 72
    Davis X. Machina says:

    after the medical industry has come up with a more successful or cheaper procedure, that government won’t recognize and pay for the improved procedure.

    Insofar as the medical industry’s telling us that x is more successful or cheaper may be orthogonal to reality, the government’s not recognizing it or paying for it may be prudence, and not inertia.

  73. 73
    RobertB says:

    I’m with Martin on this. _Any_ system has to draw a line of covered/not covered somewhere. There isn’t an infinite supply of money out there for health care. I’m not saying AHCCCS made the right call here, or that death panels are an awesome keen idea. But any payer is going to have x dollars to spend and no more, which means that somehow a call has to be made as to whether or not a treatment is covered or denied.

    This isn’t a rhetorical question: how is this currently handled now in existing single-payer countries?

  74. 74
    Jim, Once says:

    @Ailuridae:

    The Iowa GOP is absolutely, unapologetically bat shit crazy and Grassley is plenty vulnerable from the right.

    And to prove this point, just read their party platform:

    http://www.iowagop.org/site/c......atform.htm

    It’s a masterpiece. There’s not a single teahadist idea they’ve left out.

    And Martin – in your attempt to ‘enlarge our understanding’ of Grassley, you argue against yourself. You say he is an ‘honest broker’ – yet note his willingness to reverse himself on fundamental issues so that he can suck up to the crazies in western Iowa. I am so done with him. He has placed himself firmly in the ranks with Steve King, who makes me vomit.

  75. 75
    Jim, Once says:

    @debbie: You said it far better than I did. An ‘old, used up whore,’ indeed. Thank you.

  76. 76
    kay says:

    @WereBear:

    That’s the hidden nugget of truth in “death panels.” It ignores the fact that we’ve painted ourselves into a corner where someone does have to pull the plug at the end of life… only no one has the guts to say so.

    It’s true. But Palin fucked even that small nugget of truth up, when she went after advanced directives (‘living wills”).

    A lot of people DO have the guts to say how much medical intervention they want at the end of life, and states have been quietly working for 20 years to make it easy for them to do just that.

    We were having a rational discussion. It was going well.

    Until conservatives joined in. Then it went all to hell. 20 years public education on this blown in 3 weeks.

  77. 77
    JCT says:

    @WereBear: +20 — there you go.

    Your father’s experience is where it’s at. Boatloads of money poured into futile care because no one says “enough already”.

    As a *physician* I had a full-scale argument with the head of an ICU (an old colleague, no less) when I insisted that they shut off my 90-yr-old father-in-law’s ventilator after he was mistakenly intubated in an ER despite a DNI/DNR order. It was beyond infuriating.

    But look, at least the Republicans are consistent for once, they value quantity of life over quality at all levels.

  78. 78
    Pongo says:

    ‘Brewercare.’ It was inevitable. I battled with AZ Medicaid on behalf of patients with a rare lung disease for years. AZ consistently ranks in the bottom 5 for healthcare and education. It is essentially a third-world state–lots and lots of wealth side-by-side with miserable poverty. This was the shining example of management John McCain wanted us to follow.

    AZ Medicaid disputes are heard in a kangaroo court made up of a revolving roster of family court judges with no special medical training. The state’s Medicaid medical director is either really dumb or pathologically deceitful (probably both) and she puts on quite a display of dissembling and outright lying to get out of paying for needed therapies. During one of many of these hearings I attended, the judge had to remind her repeatedly that what she was saying in open court violated state laws. The law says that Medicaid decisions need to be made solely on the medical merits of the case–not on concerns about costs to the program. She repeatedly stated that providing an expensive antibiotic (for a one-year old who had picked up a rare infection that almost always is fatal if not treated) would set a bad ‘financial’ precedent. We won that case, but in AZ, Medicaid rulings rarely are applied to the whole patient community, so every family has to go to court to fight for every therapy. I guess that at least provides job security for the judges.

    There has been an exodus of pulmonary doctors from AZ (probably others, too. I just am more in tune with the lung folks). It’s tragic. The AZ Republic has had some coverage of how this new Medicaid policy is affecting real people (and not all of them are brown, so Sarah Palin really should care about this): http://www.azcentral.com/sport.....-tiff.html

  79. 79
    Kathy Gianneschi says:

    Don’t you see that the end result of ANY government run health care will result in the same thing?

  80. 80
    dr. bloor says:

    @mclaren:

    If, every time a doctor told some patient “Sorry, there isn’t enough money to treat your fatal disease,” the patient pulled out a .357 loaded with hollow points and blew the doctor’s head off, you can bet your ass the state of Arizona would suddenly and magically find a whole boatload ‘o special funding for those transplants.

    As if. That’s what first-year residents are for.

  81. 81
    Davis X. Machina says:

    @Pongo: There has been an exodus of pulmonary doctors from AZ

    Not just tragic — ironic. One of the backbones of Anglo migration to AZ in the first place was the wave of TB and asthma cases seeking dry, clean, warm air cures in the days before modern pharma.

  82. 82
    Ohio Mom says:

    Delurking to say, sorry to hear about your dad, Werebear, Hope you’re able to find a way to make his last days as comfortable as possible.

  83. 83
    debbie says:

    @werebear:

    There’s your problem.

    PBS recently ran a Frontline on end-of-life issues. A bunch of people in ICU, obviously beyond recovery, and everyone was struggling with the decision to let go. Sometimes it was the patient who wanted to keep fighting, sometimes it was the family. Of course the doctors knew the inevitable had set in, but they couldn’t seem to (or didn’t want to) communicate that to the patient/family. Instead of preparing for a “good” death, they let them fumble towards the future. How is that better than a compassionate but honest discussion about one’s death?

  84. 84
    IrishGirl says:

    @gene108: Thanks for reading my blog! Yes, they absolutey want to go back to the 1800’s. Have you read the stuff over at OsborneInk about kulturekampf? It’s all a pattern of going back to the good ol days when we were all white, landowners, and privileged and the rest, well the rest were slaves/serfs/non-existent.

  85. 85
    IrishGirl says:

    @David Hunt: I’m going to propose a new Repub slogan — “A baby in every pot” wink wink

  86. 86
    Jim, Once says:

    @IrishGirl: Funny! I used to love introducing that essay to my high school seniors. The responses were priceless.

  87. 87
    Cam says:

    @Kathy Gianneschi: Ummmmmmm, no I don’t.

    Or is my snark-meter off today?

  88. 88
    Zak44 says:

    Before any senator or representative is allowed to vote on tax cuts, they should be required to meet with Randy Shepherd’s daughter and explain to her, face-to-face, why that money would be better spent on someone with a seven-figure income than on a transplant for her father.

  89. 89
    Rekster says:

    MOTHERFUCKERS!!!!!

    I am near suicidal over the lack of spine by ANYONE in this piece of shit administration.

    I have said that if that POS Palin wins the 2012 election I would leave the country. I am starting to pack right now since I am sick of the Bullshit that is coming from the White House.

    Let’s not stop with renewing the tax cuts for the ultra rich. Why don’t we just give them the Fucking Federal Reserve!

    We certainly don’t want to inconvenience the “Job Creators”

  90. 90
    Karen says:

    @Rekster:

    Yes this is all Obama’s fault. Yes he could rule by fiat and none of this would happen if Hillary Clinton was President!

    You’re like a bloody broken record.

  91. 91
    Rekster says:

    @Karen: Karen. I will be kind to you since you seem to be a little understanding challenged.

    I don’t think I mentioned anything about the present Secretary of State. I merely mentioned that no one in the Administration has a Spine.

    I rarely ever comment on this blog, so why don’t you just Bite Me.

  92. 92
    Triassic Sands says:

    @Karen:

    Yes this is all Obama’s fault.

    Question: Is there anything that you think is Obama’s fault?

    Just curious.

    @Rekster:

    Criticizing Obama on Balloon Juice is just begging to be abused. Don’t expect a reasoned response. What you will get is a straw man on steroids — anything to divert attention away from the man behind the curtain. You hate America; you hate Obama and always have; you want him to fail; you blame everything on Obama; you’re a racist; blah, blah, blah. It’s very sad.

  93. 93
    Calouste says:

    @RobertB:

    __

    This isn’t a rhetorical question: how is this currently handled now in existing single-payer countries?

    I remember reading that someone from the National Health Service in the UK said that their formula was about #30,000 per additional year of life expectancy, althought that might only have applied to major operations and not to ongoing care.

    Other than that it is pretty much the same, there are waiting lists for major operations, some of them are long, and people on those waiting lists die before they get a chance. It’s a major political issue typically.

  94. 94
    Rekster says:

    @Triassic Sands: I am a lifelong Dem. I have NEVER voted for a Republican in my 62 years of living. I guess Karen must have access to my computer history and sees that I also read FDL.

    How else could she “know” that I blame Obama for everything?

    I actually voted for him and support him but that support is rapidly dwindling away. If the Administration caves in on the tax cuts, what am I to do? Just continue to blindly cheer on these “leaders”.

    I certainly don’t put the present Speaker of The House in the same bucket as those working in The White House. She is one of the few Democrats that has actually exhibited a spine.

    I think the Democrats are still in the Majority, at least, for a while longer. It is time to stand up and do the right thing on these Tax Cuts.

    As far as this craziness going on in Arizona, It is only fitting that a state where the entire government is led by crazies that they have instituted “death panels”. Can’t wait til the leaders here in Texas where I live pull out of Medicaid entirely.

    They will show those Fed’s that “Don’t Mess With Texas” is not just a bumper sticker. Just wait till the Tea Baggers get the call from the Nursing Home that they need to come down and pick up Nana and PaPa since the funds to pay for their stay just went away.

  95. 95

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