A new AP story says that, according to Obama's own deficit commission, Obamacare isn't going to bend the cost curve without some serious cuts from the top down:
Sarah Palin take note: For the first time, the government would set — and enforce — an overall budget for Medicare, Medicaid and other federal programs that cover more than 100 million people, from Alzheimer's patients in nursing homes to premature babies in hospital intensive care.
Palin attracted wide attention by denouncing nonexistent "death panels" in Obama's overhaul, but a fixed budget as the commissioners propose could lead to denial of payment for medical care in some circumstances.
In regard to "death panels" the AP makes the same mistake made by every other commentator on this issue. It's time to set the record straight. Yes, it's true there were no "death panel" provisions in the Affordable Care Act, but it's also true Palin's statements were never, ever aimed at a specific provision in the bill. They were always intended as statements about the dangers of turning health care over to government bureaucrats. Let's lay out the facts in detail and try to put down this pernicious media created myth.
Sarah Palin's "death panels" comment appeared on Facebook on Friday August 7th, 2009. The post makes no mention of any specific element of the bill. Instead it directs readers to view this clip of Michele Bachmann on the the house floor:
As you can see, Bachmann is referencing this article by Betsy McCaughey which brought to light remarks made by Dr. Ezekiel Emmanuel. Palin mentions Dr. Emmanuel's remarks in the midst of her Facebook post, but both her opening and concluding paragraph makes it clear that her "death panels" statement is ultimately her worry about what could happen after a government takeover of heath care:
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…
Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back.
Later the same day, Dave Weigel noted part of Palin's Facebook post. He did not cite "death panels" but did copy the part about Dr. Emmanuel. Liberal site TPM picked it up from Weigel but chose to highlight the paragraph about "death panels" instead. By 7PM that day, blogger Andrew Sullivan was linking to TPM and highlighting the death panels statement, labeling it a "mix of camp and high farce." Crooks and liars was even more outraged, though mostly that Palin would use her son to make a political point.
By the next day, conservative Ann Althouse was writing to counter the wave of liberal outrage by attempting to put Palin's statement back in context:
She doesn't say that the government will kill disabled (or elderly) persons directly, but that death will occur as a result of the decisions of cost controlling bureaucrats with the power to determine who can receive various treatments. I don't know why "level of productivity in society" is in quotes, nor do I know whether it is the plan to ration care on this basis. Those are actually serious matters, and I'd like to know the answers.
That same day conservative blogger William Jacobson explained how the idea of value based health rationing could be derived from Dr. Emanuel's published work:
These critics, however, didn't take the time to find out to what Palin was referring when she used the term "level of productivity in society" as being the basis for determining access to medical care. If the critics, who hold themselves in the highest of intellectual esteem, had bothered to do something other than react, they would have realized that the approach to health care to which Palin was referring was none other than that espoused by key Obama health care adviser Dr. Ezekiel Emanuel (brother of Chief of Staff Rahm Emanuel). The article in which Dr. Emanuel puts forth his approach is "Principles for Allocation of Scarce Medical Interventions," published on January 31, 2009.
A day later, top conservative blogger and author Michelle Malkin posted a series of links to published horror stories about the NHS (Britain's socialized health service). Malkin echoed Palin's original Facebook posting when she wrote "the effects of socialized medicine in Britain — engineered by government-run cost-cutting panels on which Obamacare would be modeled — continue to wreak havoc on the elderly and infirm."
The same day as Malkin's post (Sunday), George Stephanopolous asked Newt Gingrich to defend Palin's comments on This Week. George advances what would become the liberal line saying "it's not in the bill" but Newt responds that this is not about a single provision, it's about trusting the government to make health spending decisions. You can watch the exchange here.
There were many prominent voices on the right who understood that Palin was expressing a fear about nationalized health care in general and not a criticism of a specific proposal. But the liberal media continued to miss the point. By the next day, August 10th, 2009, two powerful media outlets solidified the false idea that Palin's "death panels" comment was a reference to specific provisions in the bill. First Ezra Klein posted an interview on his Washington Post blog which began:
Sarah Palin's belief that the House health-care reform bill would create "death panels" might be particularly extreme, but she's hardly the only person to wildly misunderstand the section of the bill ordering Medicare to cover voluntary end-of-life counseling sessions between doctors and their patients.
This could be an honest mistake. Klein may have simply conflated two separate criticisms which were making the rounds around the same time. But Klein wouldn't have had to go very far for a hint that something was amiss. In fact, in the interview that followed that opening Senator Isakson expressed confusion about the idea that "death panels" could possibly be used as a description of end-of-life counseling:
I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts.
Whatever his intent, the effect of Klein's post was to solidify in many reader's minds that Palin had said something demonstrably false about a specific provision of the bill. Later the same day, Politifact published a fact check article titled "Sarah Palin falsely claims Barack Obama runs a death panel." From the headline on, Politifact assumes that Palin was making a factual claim about a specific provisions in the bill:
We have read all 1,000-plus pages of the Democratic bill and examined versions in various committees. There is no panel in any version of the health care bills in Congress that judges a person's "level of productivity in society" to determine whether they are "worthy" of health care…
Only at the very end of their article to they entertain another possibility:
Conservatives might make a case that Palin is justified in fearing that the current reform could one day morph into such a board. But that's not what Palin said. She said that the Democratic plan will ration care and "my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel'…"
She did say the Democratic plan would ration care and as the AP story at the top of this post shows, the first part of what Palin warned about is already on the horizon. But Palin did not specify a date when her parents or her baby would face the prospect of "death panels." The overall context of her statement makes clear that this is somewhere down the line (the bill hadn't even passed yet), but by sticking to this one sentence of her multi-paragraph Facebook post, Politifact twists her warnings about the future of nationalized care into a definitive, time-limited statement.
The next day, August 11th, the White House pounced on Palin. Speaking at a town hall even in New Hampshire, President Obama said:
The rumor that's been circulating a lot lately is this idea that somehow the House of Representatives voted for "death panels" that will basically pull the plug on grandma … this arose out of a provision in one of the House bills that allowed Medicare to reimburse people for consultations about end-of-life care, setting up living wills, the availability of hospice, et cetera. So the intention of the members of Congress was to give people more information so that they could handle issues of end-of-life care when they're ready, on their own terms. It wasn't forcing anybody to do anything. This is I guess where the rumor came from.
Like Ezra Klein, the President was wrong about where the phrase "death panels" came from. It's certainly possible that this was another honest mistake, a matter of accidentally conflating two separate criticisms of the bill. Then again, it may be that the White House chose to embrace Politifact's line of reasoning because it allowed them to make a categorical statement, i.e. Palin is wrong, rather than discuss the more nuanced future of socialized medicine.
The next day, 08/12/09, Palin responded to President Obama and clarified the meaning of the phrase "death panels." After a discussion of the end-of-life counseling present in the bill, she went on to say:
Of course, it's not just this one provision that presents a problem. My original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama and the brother of the President's chief of staff. Dr. Emanuel has written that some medical services should not be guaranteed to those "who are irreversibly prevented from being or becoming participating citizens….An obvious example is not guaranteeing health services to patients with dementia." [10] Dr. Emanuel has also advocated basing medical decisions on a system which "produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated."
But her explanation was overlooked by the press, which was sold on the narrative about "death panels" not appearing in the bill. A month later, Palin tried again to clarify what she meant by the term. Speaking at a high profile event in Hong Kong on 09/23/09, the Wall Street Journal reported her saying:
I seem to have acquired notoriety in national debate. And all because of two words: death panels. And it is a serious term. It was intended to sound a warning about the rationing that is sure to follow if big government tries to simultaneously increase health care coverage while also claiming to decrease costs. Government has just got to be honest with the people about this…
To this day, the press ignores the clear history and Palin's multiple statements about what she meant. Perhaps that's because, taken in context, she has a point. Even Politifact, which labeled "death panels" the lie of the year, wrote this:
History professor Ian Dowbiggin, who has written several books on medical history, euthanasia and eugenics, said he had never heard the term before Palin used it. He said the phrase invokes images of Nazi Germany, which denied life-saving care to people who were not deemed useful enough to broader society. Adolf Hitler ordered Nazi officials to secretly register, select, and murder handicapped people such as schizophrenics, epileptics, disabled babies and other long-stay hospital patients, according to Dowbiggin.
"It's not far-fetched to make the historical argument that as you get government more and more involved in health care, you create an environment that is more hospitable to the legalization of forms of euthanasia," Dowbiggin said. "But the Nazi example should be used very advisedly."
Unfortunately, Politifact's distortion of Palin's statement went largely unchecked by other watchdogs. Even Annenberg FactCheck, which usually does a better job, dropped the ball. They reference Palin's original Facebook clarification, but completely leave out the paragraph where she explains her broader meaning. Wouldn't this be germane in an article about the meaning of the phrase? (Annenberg also leaves out any mention of her clarification in the Hong Kong speech.)
Palin and many other conservatives made clear at the time that "death panels" was not a criticism of a specific provision in the bill. From the moment she wrote it, "death panels" was a catch all phrase designed to highlight the real danger of putting government in charge of deciding what can be spent on health care. It was the left from the Post to the President which (accidentally or not) conflated this with claims about specific provisions in the bill. Their motive in doing so, i.e. being able to call Palin a liar, is understandable. They are, after all, partisans who wanted to see the bill pass. But one wonders why supposedly independent news organizations like the AP continue to echo this demonstrably false claim right up to today.
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