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The persistence of the death panels myth


The Washington Post reports on a new Kaiser poll showing that the "death panel" myth that plagued debate (PDF) over health care reform is still a significant problem:

The poll found that misconceptions about the legislation persist, including the "death panel" falsehood propagated by opponents of the legislation.

"A year after the town meeting wars of last summer, a striking 36% of seniors said that the law 'allowed a government panel to make decisions about end of life care for people on Medicare', and another 17% said they didn't know," Kaiser Family Foundation chief executive Drew Altman wrote.

Here's the question Kaiser asked:

I'm going to read you a list of specific ways the new health reform law may or may not impact Medicare. For each, please tell me if you think it is something the law does or does not do... Would you say the law does or does not allow a government panel to make decisions about end‐of‐life care for people on Medicare?

The question references the charge, made originally by Sarah Palin, that the health care reform bill would create a "death panel" in which bureaucrats decide whether seniors are "worthy of health care." However, even experts who opposed the plan said the charges were false. While the health care reform law does create an independent board that will make proposals to Congress to restrain Medicare costs, the legislation specifically states that "The proposal shall not include any recommendation to ration health care... or otherwise restrict benefits" (as Media Matters points out). Moreover, these would be systemwide policy changes for Medicare, not specific decisions about end-of-life care for individual patients as Palin suggested.

Here are the crosstabs from the poll in graphical form -- it turns out that seniors have somewhat more accurate perceptions than those under 65:

Kaiser-dp

Among the population as a whole, 41% said they believed the law does allow a government panel to make decisions about end‐of‐life care for people on Medicare and an additional 16% said they didn't know. The corresponding figures were 43% and 16% for those under 65 and 36% and 17% for those who are 65 years or older.

As expected, motivated reasoning appears to play an important role in the persistence of the misperception. Kaiser found that "those [seniors] with an unfavorable view are ... more likely to incorrectly think the law includes cuts in benefits or that it allows a government panel to make end‐of‐life care decisions." 55% of seniors with an unfavorable view of the law believed in the death panel myth, while only 17% of those with a favorable view did so.

For more analysis of the development of the death panel myth and the reasons it is so difficult to correct, see my article "Why the 'Death Panel' Myth Wouldn't Die: Misinformation in the Health Care Reform Debate (PDF) from a recent issue of The Forum.

[Cross-posted at brendan-nyhan.com]

 

Comments
real_american:

A death panel by any other name is still a death panel.

Obama just appointed a director of Medicare that openly supports end-of-life healthcare rationing. He said it isn't if we ration - it is when. He buys into the theory that it is not worth more than $22,000 to extend a person't life by 6 months so - yes he will be in charge of the death panels. He is already setting the guidelines.

The only "falsehood" here is that there won't be any death panels. That's why people still believe in them - because they are designed into socialized medicine.

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AlanSnipes:

Real American. You are WRONG, WRONG, WRONG.
It is difficult to debate people who deliberately LIE about this issue for political benefit.
Obviously, you are not capable of reading the bill. I have read the relevant portion and it is not in there.
By the way, why would ANYONE want death panels?
Do other countries with universal health care have death panels?
Of course not, this is just another lie. I will call it what it is!

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real_american:

@AlanSnipes:

"By the way, why would ANYONE want death panels?".

To decide who gets to live and die as a way to contain cost. Don't want to waste all that money on old people who aren't going to vote for democrats.

"Do other countries with universal health care have death panels?"

Yes - all of them. In England they are called the NICE board (National Institute for Health and Clinical Excellence).

NICE is the rationing board and their decisions determine who lives and who dies. This is the system that Obama's director said that he loves and wants Obamacare to be exactly like it.

Call it whatever you want but any component of a healthcare plan that can deny drugs and treatment to ration healthcare is a death panel.

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AlanSnipes:

Real American:

Having a plan in place to decide end of life issues is not a death panel. Do you really think that people who want health care reform want people to DIE to control costs?

People are currently denied care in many instances where they don't have insurance and can't get needed medicine. This is the system you support. How many people are rationed today and are dying because of a health care system that you support?
Name me one country who wants to get rid of their universal health care and go to the system that America currently has.
No country that has universal health care has ever gone back to a system like ours.

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StatyPolly:

"I have read the relevant portion and it is not in there."

What page was that on, Alan?

You accuse other people of lies?

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StatyPolly:

"Death Panel" is a reverse euphemism for rationing.

In US, if you're 85 years old and you need a $200k heart valve replacement, that decision rests with you and your doctors, who will advice you weather or not you can survive that surgery and have a good chance of extending and improving the quality of your life.

In Canada, UK, or France, you AIN'T GETTING IT. Period. Death Panels rule that you're too old to waste so much money on. Here's a pain pill. Just go gently.

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real_american:

Look at this from the above article:

"Among the population as a whole, 41% said they believed the law does allow a government panel to make decisions about end‐of‐life care for people on Medicare"

This law requires a government panel to make not only "end-of-life" care decisions, it also makes "beginning-of-life" and "middle-of-life" decisions. What is so hard to understand?

What is up with all the mockery of people believing in death panels? You elitist liberals act like they have no basis in truth.

Would it make you feel better if you gave it a friendly sounding lable like England does with "NICE"? Would you stop the mocking if people start calling it a "Cost Justification Evaluation Board"?

Insurance companies try to do this now and would get away with it if there weren't laws against it. This healthcare bill makes it legal to let people die if a panel thinks that the cost of keeping them alive is not equal to their SVF (societal value factor). Children under the age of 3 and seniors over the age of 60 have low SVF's - according to the figures the healthcare designers used.

It is frightening that people who support this bill don't have a clue how much power the government takes away from the individual and gives to beauracrats and government panels. You people that support this monstrosity should at least learn what it does? You guys really don't have a clue how bad this is, do you? That's just plain scary.

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John:

""Death Panel" is a reverse euphemism for rationing."

Did you know euphamism is derived from the greek word euphemo? It's opposite (or reverse) is blasphemy!

Oh and I pretty sure you can still get the heart valve replacement on the NHS at 85 but often there are better options.

http://www.rbht.nhs.uk/patients/why-us/patients-stories2/keyhole-surgery/

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StatyPolly:

That's a great find, John. Congratulations!

So they used the old guy as a guinea pig for as a first ever experimental trial. It worked! Happy for him.

Most experts actually consider NHS to be the worst of all socialized systems in developed world.

Here are a couple DEATH PANEL examples.

http://www.dailymail.co.uk/health/article-1285343/Thousands-women-breast-cancer-denied-chance-drug.html

http://www.dailymail.co.uk/health/article-1281465/Hundreds-liver-cancer-patients-denied-drug-lifeline.html

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John:

Ah articles from the notoriously fair and accurate Daily Mail. I am afraid I am not going to read them as 90% of their stuff is drivel and besides I have already washed today. While they don't any longer support fascism, (they did in 1930s with a fun articles such as one called 'Hurrah for the Brownshirts'), I am afriad they haven't moved on too much.

The closest I want to get to the Daily Mail is this rather amusing headline writer.

http://www.qwghlm.co.uk/toys/dailymail/

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Farleftandproud:

As far as I am concerned the death panel believers are just as bad as those who think the holocaust didn't happen.

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StatyPolly:

Oh, you won't read Daily Mail because they wrote a positive article about Brownshirts in the 1930's?

Not fair, since I did read your NHS link even though HNS makes decisions to KILL PEOPLE on daily basis. Killed some today.

I guess I shouldn't bother posting links from other sources, since they may have written something bad in the 1930's that I ignoramusly know nothing about. Why don't you give me a list of acceptable sources to link to, and I'll look to see if there are any stories there.

Until you do,

http://www.dailymail.co.uk/news/article-1270160/Betrayed-NHS-Doctor-gave-life-health-service-refused-vital-cancer-drugs-save-her.html

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AlanSnipes:

Staty Polly:

You can find a link that says anything !
That doesn't make it so!

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AySz88:

On The Daily Mail: Back in my early teen days when I had a hand in the His Dark Materials fandom, The Daily Mail couldn't even cover teen fiction without absurd sensationalism and bias - and they did it so badly that the average literate 10-year-old could spot it without much effort (like, by checking a second source for the story). I wouldn't be surprised if the same "standard" applies today with any other topic. I don't really take them seriously, or at least not a face value.

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John:

@StatyPolly

I don't read the daily mail because most of the stuff they write is complete and utter nonsense with an ugly agenda. When they are not just making it up as they go along, they have so distored whatever facts that they started with, that their piece has no bearing on reality. I can understand if you are not from the UK, you might not realise the Daily Mail is a complete joke.

Here is a link to a pretty good rundown of British Papers

http://tvtropes.org/pmwiki/pmwiki.php/Main/BritishNewspapers

"Oh, you won't read Daily Mail because they wrote a positive article about Brownshirts in the 1930's?"

and because they haven't apologised for this or the blatantly anti-semitic campaign they ran before and during the 30s.

"Not fair, since I did read your NHS link even though HNS makes decisions to KILL PEOPLE on daily basis. Killed some today."

By kill do you mean decides what treatment should be free (or at least paid for by tax payers money)? Anyone who doesn't like the NHS care is still free to go private, just like in the US. (Btw are you trying to compare the NHS to fascism or merely the support of fascism I couldn't quite tell)

"Why don't you give me a list of acceptable sources to link to, and I'll look to see if there are any stories there."

Normally I willing to read any reasonable publication, I regularly buy the Telegraph and used to subscribe to the Spectator. While I disagree with many/most of their conclusion, I like to challenge my view points.

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jamesia:

Crazy that so many Americans misunderstand the NHS, and for that matter, the universal healthcare systems of most other countries.

Most of them decide which services are provided for everyone, paid by taxpayers. If you want something not included, you're free to go get what you need in the private market. That includes the NHS. So if people don't get the treatment they need, it's because they can't afford it, which is exactly what happens in the US.

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StatyPolly:

"If you want something not included, you're free to go get what you need in the private market."

And if they run out of bread, let them eat cake. DUH..

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StatyPolly:

Okay, so lets sum up what we have learned here so far:

1. Because the Daily Mail run a piece in the 1930's that was favorable to the Brownshirts, and couldn't even cover teen fiction without absurd sensationalism and bias back in AySz88's early teen days when AySz88 had a hand in the His Dark Materials fandom:

a)Their stories cannot be independently confirmed by a million of other sources with a basic internet search.

b)National Institute for Health and Clinical Excellence is a figment of conservative Americans' imagination.

c)British subjects have ready access to the latest and greatest medical care that 85+% of Americans do.

d)There is no rationing to government provided health care. Everyone gets what they need and when they need it.

e)Donald Berwick was not just nominated as Medicare Czar, nor has he ever uttered things like "I Think The NHS Is One Of The Great Human Health Care Endeavors On Earth. It Can Be An Example For The Whole World, An Example, I Must Say, That The United States Needs Now More Than Most Other Countries Do" or things like "The Decision Is Not Whether Or Not We Will Ration Care—The Decision Is Whether We Will Ration With Our Eyes Open." In fact, since the Daily Mail run a piece in the 1930's that was favorable to the Brownshirts, and couldn't even cover teen fiction without absurd sensationalism and bias back in AySz88's early teen days when AySz88 had a hand in the His Dark Materials fandom Donald Berwick probably doesn't even exist.

f)There will never be any rationing (commonly referred to as DEATH PANELS) in any government run health care programs in US, unlike every single other govt run healthcare system everywhere in the world. Nah-uh.

We'll get to Chapter II Monday.

http://www.timesonline.co.uk/tol/news/uk/health/article7061769.ece

http://www.telegraph.co.uk/health/7908742/Axe-falls-on-NHS-services.html

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John:

@StatyPolly

Woah, calm down there a little. All I said was I do not read the Daily Mail, not only because of its past but because; it is hideously biased, distorting and follows a fairly twisted agenda. This is well known in Britian. Any article that I did read I would have no idea if any point, fact or opinion was even remotely true. If you want to know how intellectually honest they are, at one point while their UK version ran a campaign against the HPV Vaccine, at the same time their Irish version ran one for its reintroduction.

http://www.layscience.net/node/507

If you want to link an article from any other publication I'll be happy to read it.

I never stated or suggested any of your following points.

NICE is an independent review body which states which treatments/drugs are required to be provided by the NHS (or at least supposed to be). The problem was before it was set-up that individual health trust decided what to provide (something more akin to the US system) which lead to a bid of a 'postcode lottery.' There are number of justifable complaints against it, such as it can be slow to endorse new drugs.(Although they do now have a fast-track procuderes)

The NHS is far from perfect as I have stated on multiple threads, but it certainly is not the disaster that you appear to be making out. While it is debatable which system (US or UK) provides the better care to all its citizens, it would be hard to argue that the British system is not more cost-effective. Or in other words the US system provides better health-care for those who can afford it but at a much higher cost. The UK provides coverage for all, at a lower costs but is slow to respond to advances and individuals.
(Of course if you can afford private health in the UK, then it about same).

Every country including the US and the UK rations health care to some extent. This happens no matter what type of system is run.

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Farleftandproud:

It is truly scary just what kind of crap peopl actually believe. If there is such a thing as Obama's death panel, I want to see it on Utuble. I liked what Chris Van Hollen in MD said to that crazy lady with no teeth, when she asked "does obama want to create a pill to kill old people".

Van Hollen was so disgusted with this misinformation he wised off and said "if you can prove to me that anything like this exists, please send a letter to my secretary".

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Farleftandproud:

Canada has one of the best health systems; no rationing at all, and 89 percent of it's population are satisfied. Great Britain is a very thickly settled country, and I am sure there are people waiting in emergency rooms, but nobody is denied.

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AySz88:

StatyPolly - hey, you're the one that posted so many articles that conspicuously all happen to link to the Daily Mail. I just explained why I don't find them a particularly convincing source. And I don't find the sort of extreme story that you present in independent sources. But I started by searching for the independent sources, and not the story, of course.

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StatyPolly:

"you're the one that posted so many articles that conspicuously all happen to link to the Daily Mail. I just explained why I don't find them a particularly convincing source."

I ran a search and all those stories were on the same one page. That's the reason for single source. Convenience. Most of those stories widely known in UK. Nikki Blunden case was even publicized in US and I knew about her from local sources.

Since I now know that the Telegraph is an acceptable source:

http://www.telegraph.co.uk/health/healthnews/7814505/Thousands-of-breast-cancer-patients-to-be-denied-life-prolonging-drug.html

"Thousands of breast cancer patients are to be denied a life-prolonging drug because it has been deemed too expensive for the NHS."

DEATH DEATH DEATH PANEL PANEL PANEL

Or this:

http://www.telegraph.co.uk/health/7908742/Axe-falls-on-NHS-services.html

"NHS bosses have drawn up secret plans for sweeping cuts to services, with restrictions on the most basic treatments for the sick and injured."

"Some of the most common operations — including hip replacements and cataract surgery — will be rationed as part of attempts to save billions of pounds, despite government promises"

It's in the Telegraph.

The debate is not whether DEATH PANELS are necessary or not. The debate here is whether they exist or not. They clearly do.

There is no phrase "DEATH PANEL" in US HC bill, but clearly the intend is there. Even BObama said in one of his HC speeches "Maybe you’re better off not having the surgery, but taking painkillers"

Private insurance will provide you the services that are written in you policy. Government insurance will always make arbitrary decisions on who gets to live and who gets to die.

Clearly, the author of the above piece, Brendan Nyhan, is an ineffective hack wannabe, and a lying sack of sh!t to boot. Kid was supposed to be cutting his teeth, not getting them knocked out.

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John:

@StatyPolly

Sorry, I should of asked this from the start but what on earth is your definition of 'death panel'?

"Most of those stories widely known in UK"

Maybe or maybe not, but the reputation of the Daily Mail certainly is.

"Thousands of breast cancer patients are to be denied a life-prolonging drug because it has been deemed too expensive for the NHS."

Yes, one of the roles of NICE is to assess if new drugs' benefits compared to current treatments is cost effective. It will then recommend or not if these drugs should be provided on the NHS. It is then up to individual Trust (regional areas) if they do provide them. These recommendations come de facto minimium requirements. The patient can also go private. Of course the downside to this, is (if you cannot afford to go private) sometimes you cannot get highly expensive new drugs which have limited or unproven benefit. The advantage is that everything else is provided by the NHS for free (outside taxes) and everyone gets it.

Britian spends much less on health-care than the US, this isn't about private/public, if the UK were to increase their spending on Health Care to (or anything near) US levels, then clearly drugs like this one would very likely be available on the NHS. But how much is spent overall on health-care is a completely different question.

If you think that any board which makes a judgement that a treatment, not matter how expensive it is and no matter how little benefit it gives to the patient, is not to be recommended, is in fact a 'death panel' then yes you are right. But you are just defining death panel to be something you do not like. Might I take you back to the original use of death panel by Palin, "My parents or my baby with Down syndrome will have to stand in front of Obama's death panel so his bureaucrats can decide ... whether they are worthy of healthcare."

This neither happens in the UK and, more importantly, in the US. As far as I know nothing in the bill even creates the equivilent of NICE.


Your second article is about a theoritical draft plan in one part of the NHS, which has not yet happened and (given the health minister response) is unlikely to ever go into effect.

"Government insurance will always make arbitrary decisions on who gets to live and who gets to die."
By arbitrary, do you mean a cost-benefit analysis?


"Clearly, the author of the above piece, Brendan Nyhan, is an ineffective hack wannabe, and a lying sack of sh!t to boot. Kid was supposed to be cutting his teeth, not getting them knocked out."
Charming, good arguement. What exactly was he lying about? (and not just having a difference of opinion from you)

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StatyPolly:

John,

I am not here to debate whose system is better or more cost efficient, or whether applying cost-benefit analysis is a reasonable endeavor.

I do call out the basic premise of this entire page - Death Panels as a persistent myth. You only have to look at the very first sentence in the comment section on this page.

"A death panel by any other name is still a death panel."

So, John, when you write "Might I take you back to the original use of death panel by Palin, "My parents or my baby with Down syndrome will have to stand in front of Obama's death panel so his bureaucrats can decide ... whether they are worthy of healthcare." do you really think that anyone in their right mind visualized her baby standing naked in a room in front of a panel of bureaucrats? I can provide a thousand references that people in charge of healthcare in administration do in fact advocate savings money on the very young, especially those they deem "less than perfect".

So call them death panel, national medical advisory boards (we defiantly have those) or cost-benefit analyzerists, but don't call them a myth. That is a damn lie.

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John:

"do you really think that anyone in their right mind visualized her baby standing naked in a room in front of a panel of bureaucrats?"

I thought Palin was implying that in the Health Care Bill there would be provisions for panels of 'bureaucrats' deciding for particular individuals if they should get healthcare with the none too subtle suggestion that if they were vulnerable they would be less likely to get it. Which is a myth.

The is nothing in the bill, as far as I know, which even provides for 'rationing' panels. As Brendan Nyhan points out.

I'm still not exactly sure of your definition of 'death panels' but I don't really see the sense of defining it as whatever you want, and then declaring anyone who states they do not exist, a liar.

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StatyPolly:

Oh, you thought "death panels" would be "deciding for particular individuals"?

I think it's wonderful that you have such a lively imagination, John. Brendan actually links to Palin's original death panel comment in the above piece.

http://www.facebook.com/note.php?note_id=113851103434&ref=mf

Here's what she wrote: "The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. 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."

She put "death panel" in quote, btw.

Let's get back to Brendan's piece again. 41% in this Kaiser poll believe in death panel while 43% do not. 16% do not know. For under 65 crowd, more believe than do not. Do you think that people who believe in death panels are less likely to support HC law than those who do not? I do. I imagine most of those who believe in death panels do not support the law. This Kaiser poll has support/oppose at 50/35. That's +15 for. They're only 27% off average of other polls, which are all extremely consistent. Is Kaiser off or the other four pollsters, who are all within 2 points of each other? Right, left or center.

http://www.realclearpolitics.com/epolls/other/obama_and_democrats_health_care_plan-1130.html

So only 35% disapprove of HC bill in this poll, while the rest of the polls show 50% disapproval. Which I imagine is a lot closer to reality, considering the wider spectrum of pollsters. That means that in reality, well over half of population believes in death panels. Mind-boggling, isn't it. How can that be, considering that President BObama, Secretary Sebelious, and all our brave Democratic men and women in Congress have refutiated such vicious claims ina loud, clear and repetitive manner. Not to mention our responsible media working endlessly to set us straight. I watch plenty of Fox News, and I can't recall even them pushing death panels as reality. Other than citing Palin's quote. Who is pushing DP's? Hard to blame the media. They've done their darnest to lump the deathers with the birthers. Still, no luck. Almost 50% of people with an opinion in Kaiser poll believe, which means well over 50% of population believe, should you ask a truly representative sample.

So we basically boiled it down to American People being majority stupid, while Brendan and John (I guess John may be a Brit) being lucky by not belonging to such a notorious majority, which in turn is a fortuitous circumstance for the rest of us, in the majority, since Brendan and John are willing to march on bravely and tirelessly to set us straight and to give us that which is good for us.

So, on behalf of that 60 or so percent of dumb Americans, allow me to offer you guys our deepest gratitude. Carry on.

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John:

Perhaps you can tell me your interpretation of Palins words, StatyPolly, and if your definition of death panels is different from that.

Not that it makes much difference but the three previous polls before the ones you mention were -4, +3, +3 (NBC/WSJ,Gallup/USA Today and AP/Gfk), so it not quite the clear picture you are implying although probably at least a purality are currently against the bill.

At least some of the opposition to the Health Bill comes not just from those who believe that it will bring in death panels/rationing, but also some who thought there should have been more cost controls, some who thought there should have been a public option and some who just hated the procedure and horse trading that went on.

As you guessed I am a Brit so I have no idea who, if anyone, has been pushing the death panel/rationing memo, but the bill was unpopular (both at the time and now) and it is easy to believe the worst in something which is not liked/hated, I know I have done it often enough in the past. If you think it is true, then quote the part of the bill or government plan which shows this.

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RAG2:

@ StatyPoly:

What's with the "DEATH PANEL DEATH PANEL DEATH PANEL" paragraph. All caps, 3 times, and w/o proper punctuation? That's the way a 3-year-old, who isn't willing to consider the remote possibility he's wrong, talks. And you keep repeating the same stuff with little new, no matter how manner counter-arguments made. It's clear that you have a closed mind--just like some other people who've made up their minds long ago and refuse to consider the facts:

1 Birthers (Obama-born-in-USA-deniers)
2 Truthers (9/11-deniers)
3 Holocaust-deniers (Pat Buchannon was one once!)
4 Creationists (evolution-deniers)
5 Moon-hoax-believers (funny, though, the same people who deny the moon landings also insist there's frequent alien abductions--like aliens can do anything from light-years away but we can't send a spacecraft 240,000 miles!)
6 Global-warming deniers

Are you any of these people? My advice to other bloggers: Stop trying to refute StatyPoly, except for the benefit of others besides him; nothing phases him.

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RAG2:

PS. BTW, I just LUVVVV the way you cons resort to name-calling, innuendo, and straw men--not to mention a bunch of other nasty stuff. What part of "Post an intelligent and civil comment" don't you understand? How about showing some respect to those who disagree with you? And arguing like ADULTS for a change?

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ndirish11:

I love how just because it is no where in the bill and because the government said there will not be death panels, it is accepted as a 100% truth. You know the government has never lied to us before or has never done something that has "unintended consequences" right? Haha.

Socialized medicine always leads to rationing eventually, to quote Obama's new health care director, "it is not if, it is when." Donald Berwick also has said this "...any health care funding plan that is just, equitable, civilized and humane must, MUST redistribute wealth from the richer among us to the poorer and the less fortunate."

Obama used a recess appointment to get this guy in as the Director of Medicare, if you don't believe that this guy openly wants socialism in healthcare and that our country is moving towards a socialized system than you are just as bad as a 9/11 truther, Moon-hoax believer or Birther.

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John:

"I love how just because it is no where in the bill and because the government said there will not be death panels, it is accepted as a 100% truth."

So just because death panels/rationing are not in the bill(and indeed the bill specifically forbids them) does not tell us whether the bill will allow death panels/rationing. Interesting argument. What exactly would it take to convince you that bill does not allow death panels/rationing? A message written in the stars signed by the Almighty perhaps?

"...any health care funding plan that is just, equitable, civilized and humane must, MUST redistribute wealth from the richer among us to the poorer and the less fortunate."

Medicare already does this, as does any health care funded from tax-payers money. Most government services will.

"if you don't believe that this guy openly wants socialism in healthcare"

Care to define socialism?

____________________

seg:

Death panels:
A preliminary comment:
It never ceases to amaze me how people chose a side and back whatever argument helps their team. Does it not occur to any libs here who are vigorously protecting the cherished new law that YOU and your loved ones also will suffer the consequences of the defects in that law and its enforcement. Will you have to wait until conservatives are in power to point with alarm to the same issues conservatives are trying to draw to your attention now?

On with the show:
It is amazing how important Sarah Palin is to libs. She makes a comment in a facebook (or was it twitter) posting, and we are still reading about it.

Like any politician dreams of doing, Palin turned a phrase that fit a growing concern held by the public. In this case, it lit a match to some very dry tender, with the rapid awareness of her comments due in no small part to heated and often intemperant comments by libs, much like the ones here.

The funny thing is, a few years ago libs commonly accused insurance companies of pronouncing death sentences on policy holder when they declined to pay for million dollar, highly experimental treatments that might prolong life 6 months. Likewise, drug companies pronounced death sentences on poor Americans, poor Africans, etc. by not making AIDS drugs affordable.

Now, when the US is embarking on a path very much like the NICE panel in the NHS, libs consider it preposterous that anyone would call failing to provide certain treatments the acts of a "death panel." Of course, the very conservatives who were quiet about insurance company decisions are now noisly denouncing similar decisions before they are actually made by the government.

Those decisions will be made. Dem congressfolks know that. That is why they went to great pains to set up the panels so that they can pretend that they have no control over them. Denying responsibility in advance certainly gives me pause.

The difference between the insurance companies and the shiny new US NICE panel, is that the latter will be made on the basis of epidemiology studies, pure and simple. As someone who is a consumer of epid studies, I can tell you that they often contradict each other, and every author of a study can point to gaping holes in studies done by others.

Epid studies will rarely be conclusive because it is nearly impossible to control the studies well enough to be conclusive without also making them so narrow that they have little application. Furthermore, it is impossible to do a study that is double-blind. Likewise, the researcher has to make many qualitative judgments about matching controls to subjects, classifying disease and outcomes, and on and on.

Much worse, epid studies can judge a treatment ineffective when it is still feeling its way. When individual physicians are making the decisions, the treatments go on. Sometimes they will never prove effective; sometimes they will become universally accepted lifesavers. How many such informal "studies" will we have in the future when the gov effectively decides whether the physician and hosp will be paid for doing them? More likely, only the politically connected will get costly treatments that just might help them (there is ALWAYS a way to favor the favored).

This is the mushy matt of reeds NICE will rely on. It WILL lead to many unnecessary deaths and premature deaths because of opportunity costs: the treatments not done, the new applications not discovered, the improvements not made. Those will be accounted as zero by the bean counters, who can only see errors of commission, not miscarriages that can be seen only when you look for them.

I will give one very personal example: several studies back to the 70s have shown that bypass surgery and angioplasties do not improve survivability when compared to beta blocker treatment. Somehow, in the same period the death rates from heart disease have been steadily falling despite the concurrent rapid rises in obesity and type II diabetes. Maybe those studies were WRONG or premature. In our brave new world, the early decision may be the last decision, despite reassuring bullshit from politicos and politico-physicians.

We will also get more and more politized "medical" recommendations, such as reducing testing for prostate cancer because patients may choose invasive treatments. God DAMN such an ass who would chose which risks I will take and which my loved ones will take. These same people will surely, beyond any doubt, make sure they and their loved ones get the very tests and treatments they rule out for others.

Bet on it. Wait, you ARE betting on it!

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seg:

Brendan Nyhan:
Just as experiment, why don't you try being neutral on an issue instead of pounding the boards for your side.

Calling these things "myths" and "misperceptions" is bias, pure and simple.

Perhaps the words you should look at are "elements of truth" or "potential" problems. Perhaps you should be hoping conservatives are wrong rather than dissing those who disagree with your smug certainties.

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seg:

Nylan:
I am sure others have said this, but it bears repeating: you are demolishing a straw argument. The concern is not for a star court condemning individuals. It is a bland group of bureacratic phyicians and others making decision that by affecting whole classes of people become death panels for individuals.

To take an extreme example: deciding that our blood supplies can no longer support repeated transfusions for winos on the street and therefore ending them WILL lead to the preventable deaths of said winos. Who know, many such a desperate decision will be necessary some day, maybe not. But there is no doubt that decisions will be made to not give MRIs under certain circumstances based on cost/benefit analyses, not for the patient, but for uncle sam. Those decisions are also life and death decisions, no matter how hard it is for you to understand.

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