Thursday, October 4, 2012

Death Panels and the Revenge of Sarah Palin

John O'Sullivan, a former adviser to Margaret Thatcher, has a great, succinct piece up at the National Review  following the presidential debate between President Obama and Mitt Romney:
 Romney’s answer on Obamacare was a model one: crisp, clear, authoritative; the president’s initial statement and reply were not dreadful, just rambling and nervous. And the longer he went on, the less confident (and so persuasive) he was. His attempt to argue away the importance of death panels was the nadir — call it the revenge of Sarah Palin.
Governor Romney never used the phrase "death panel" that Governor Palin famously used, though had he done so, President Obama's reaction would have no doubt been priceless. However, Romney knew well enough that the message that Governor Palin has been hammering on for over three years is one that resonates with voters. People do not want greater government involvement, much less from those whom they can't even elect, at the risk of rationing of care to Medicare patients. Romney referred to what he instead called an" unelected board" five times during the debate. See below from the debate transcript:
 Number three, [Obamacare] puts in place an unelected board that's going to tell people, ultimately, what kind of treatments they can have. I don't like that idea.  
 [..]  
 We didn't raise taxes. You've raised them by a trillion dollars under "Obamacare." We didn't cut Medicare. Of course, we don't have Medicare, but we didn't cut Medicare by $716 billion. We didn't put in place a board that can tell people ultimately what treatments they're going to receive.  
 We didn't — we didn't also do something that I think a number of people across this country recognize, which is put — put people in a position where they're going to lose the insurance they had and they wanted. Right now, the CBO says up to 20 million people will lose their insurance as "Obamacare" goes into effect next year. And likewise, a study by McKinsey & Company of American businesses said 30 percent of them are anticipating dropping people from coverage. So for those reasons, for the tax, for Medicare, for this board and for people losing their insurance, this is why the American people don't want — don't want "Obamacare." It's why Republicans said, do not do this.  
 [...]  
 But let's come back to something the president — I agree on, which is the — the key task we have in health care is to get the costs down so it's more affordable for families, and — and then he has as a model for doing that a board of people at the government, an unelected board, appointed board, who are going to decide what kind of treatment you ought to have. 
 [...]

 I used to consult to businesses — excuse me, to hospitals and to health care providers. I was astonished at the creativity and innovation that exists in the American people. In order to bring the cost of health care down, we don't need to have a — an — a board of 15 people telling us what kinds of treatments we should have. We instead need to put insurance plans, providers, hospitals, doctors on targets such that they have an incentive, as you say, performance pay, for doing an excellent job, for keeping costs down, and that's happening.
As O'Sullivan noted, when President Obama tried to defend his "death panel", he failed miserably. Obama's attempt at defending his plan is below:
So at — at Cleveland Clinic, one of the best health care systems in the world, they actually provide great care cheaper than average. And the reason they do is because they do some smart things. They — they say, if a patient's coming in, let's get all the doctors together at once, do one test instead of having the patient run around with 10 tests. Let's make sure that we're providing preventive care so we're catching the onset of something like diabetes. Let's — let's pay providers on the basis of performance as opposed to on the basis of how many procedures they've — they've engaged in. Now, so what this board does is basically identifies best practices and says, let's use the purchasing power of Medicare and Medicaid to help to institutionalize all these good things that we do.
Yep, that's right. President Obama tried to defend his "death panel" by referencing something that the private sector to make care better and more innovative. Later, President Obama claims " this board that we're talking about can't make decisions about what treatments are given. " However, the Cato Institute notes the uncontrolled power of the IPAB:
IPAB could deny access to care as it sees fit simply by setting Medicare’s prices for certain treatments and procedures so low that no providers will offer them.
This is rationing plan and simple, and it's doing exactly what President Obama claims the bill cannot do. However, Obamacare wrapped itself in so much rhetoric that it blurred the truth. Truth always wins, however, and as O'Sullivan said, this is the revenge of Sarah Palin. Much like O'Sullivan wrote regarding Sarah Palin following the 2008 election, "snobs are wrong about Sarah Palin". Crossposted here and here.

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