Part One: The Consultation

You have a life-threatening illness, right? You are over 65 years old, right? I am a doctor and am being paid by the Government to give you counseling about your end-of-life decisions. This consultation is entirely voluntary on your part, and is merely to provide you with information to help you decide now how you will want to be treated in advanced stages of your illness. The information concerns living wills, health care proxies, hospice, and pain medication.

Do I have your attention? Then let’s proceed.

1. ‘Living wills.’ You sign a document that declares which treatments you do or do not want applied to you if you have a terminal illness or lapse into a permanent vegetative state. Be assured that your living will would only be used when recovery is impossible. Who will decide that it’s impossible? A couple of (Government paid) doctors would have to certify that you are in this hopeless condition. Trust them.

2. ‘Health care proxy.’ This is for when you cannot speak for yourself – because you become demented, for instance – while your physical condition is not so dire that it would justify immediate action on your living will. You name a person who will make decisions for you about what care you should be given – within the parameters of what the Government would let you have, that is. You will of course name someone you really trust. Someone who loves you. Someone you know will only act as you would want him or her to act. Okay? Good. Just one thing to bear in mind – if the Government considers his or her decision to be not the right one, it can overrule him or her. So you see, you have a sort of upper guardian who will keep an eye out for misunderstandings or misjudgments. It’s a fail-safe arrangement, you might say. Your son or daughter decides as long as he or she chooses sensibly for you. If he or she doesn’t, no worry, the Government will make the right and final decision.

3. ‘Hospice.’ Hospices are comfy places to die. They are very nice death houses. No one will hurry you to shuffle off your mortal coil. (Only you won’t be let in if you’re likely to take an unreasonable stretch of time about what you’re in there for.) Medical staff will be very kind to you. You can sit on a cushion and sew a fine seam, and you may – if your digestion allows it – eat strawberries, sugar-substitute and cream. But remember, dear, you will be there to die.

4. ‘Pain medication.’ This is what you may have instead of an operation that could save your life. No, sorry, you cannot have the operation. It is expensive and the Government cannot pay for everyone with your illness to have this surgery. Just think: say we pay for it and then you go and die of complications soon afterwards. I mean, you’re old and your powers of recovery are not what they used to be. And even if you did recover, you wouldn’t be much use to Society, now would you? Be reasonable. Be selfless. Be patriotic. The Dear Leader made it perfectly clear that this would be Government policy. He said, ‘Take the pill instead of having the operation’. You remember now? Good. That’s clear then. And by the way, it’s true that there are some drugs that might help you to recover, but they’re also very expensive and as I said we have to think about who can best use their saved life for the good of Society – you who are old, or someone else who is young and vigorous. It stands to reason, doesn’t it, when you think about it? You are – if you don’t mind my putting it this way, just for clarity’s sake – a useless old bag, and somewhere there’s a young person with the same disease as you who can still be, let’s say, a brilliant community organizer if he gets the chance to live. So the drugs are for him, not you, dear. You understand? Fine. That’s settled then.

Oh, no dear! No one’s dictating to you what to do. It’s your choice, absolutely. You don’t have to make a living will, or appoint someone to act as your proxy, or go into a hospice, or take a pill to help your pain. No one’s forcing you. All we’re saying is that we’re not going to pay for you to have surgery or expensive drugs that might cure you. But all the rest is your choice, not ours, not anybody’s but yours. Doesn’t that make you feel that you’re in control dear?

You’re really having the best of all worlds, you know. You have all this choice as a free citizen of this free country. And at the same time you can feel safe, watched over, looked after to the last breath. What more could you ask?

Who are the people who will decide whether you’re too old for the surgery or the drugs? Well, there will be general guidelines, rules.

You say some individuals are stronger and more able to work at a late age than others, so will they have their cases examined individually? Yes. By whom, do you ask? By doctors – at least two doctors who will report to the authorities that you are an exception. Or not. And yes, the authorities will make the final decision.

Yes, the very young who have disabilities and have not yet had much money spent on them would also have to forego the expensive surgery and drugs, but their parents would have the same careful consideration given to their cases by the Government-paid experts as you will have.

You ask, would they not – these doctors, these authorities, these various experts and officials – constitute a panel deciding whether you may or may not have certain life-saving treatments? Yes, in effect. You could put it that way.

Sarah Palin did? Oh, you mustn’t believe Sarah Palin. She went much too far. She actually called it a ‘DEATH PANEL’. That’s entirely wrong. That’s just hysterical. Nutty. Way out. Totally inaccurate and misleading. A wicked distortion. A dangerous lie.

Calm down, please. I’m not prepared to carry on with this argument. It’s got out of hand. You’re crazy. She’s crazy. How can you think that Barack Obama, of all people, would want to set up a ‘death panel’? Perhaps you‘re suffering from incipient dementia, dear. Would you like to have a little chat with another Government-paid doctor about preparing for when it gets worse?

Part Two: A News Item

This week, reacting to the clamor from many angry and confused people, the Senate Finance Committee dropped the idea of including ‘advance care planning consultations’ in its health care bill.

Part Three: A Democrat Meditates

Why did so many react so unreasonably to a provision that was merely designed to allow Medicare to pay doctors who counsel patients about planning for end-of-life decisions? The consultations would have been entirely voluntary and would simply provide information about living wills, health care proxies, hospice, and pain medication. It’s mystifying how such a simple service could be so misinterpreted!

Part Four: The Denial

The Obama administration has been forced to react to a ridiculous rumor launched by Sarah Palin.

It has put this up on its website (excuse the clumsy wording but the clarification had to be posted in a hurry):

It’s a malicious myth that reform would encourage or even require euthanasia for seniors. For seniors who want to consult with their family and physicians about end-of life decisions, reform will help to cover these voluntary, private consultations for those who want help with these personal and difficult family decisions.

Part Five: The Climb-down?

Associated Press report August 16 2009:

Bowing to Republican pressure and an uneasy public, President Barack Obama’s administration signaled Sunday it is ready to abandon the idea of giving Americans the option of government-run insurance as part of a new health care system.

Part Six: Chorus of Old People and Children

Two words have saved us – ‘DEATH PANEL’.

We need no longer fear.

The Government will not insure our care.

It cannot say ‘care granted’ or ‘denied’.

Who’ll live or die it won’t decide.

Thank you, Sarah Palin!

Jillian Becker  August 2009

‘He who knots a noose might get his neck caught in it.’ – Anon.

Ezekiel Emanuel

(with apologies to Leigh Hunt)

Ezekiel Emanuel, who’s known

As Doctor Death, or Doctor Heart-of-Stone,

Woke to see by moonlight in his room,

Smoking, and writing in The Book of Doom,

The Angel Barry, halo round his head,

Who’d come to note who, this week, should be dead.

And to the Presence in the room he said,

While half asleep, but sitting up in bed:

‘What are you writing, Barry? Speak to me!’

And Barry answered, ‘Checking out, I see

That you’ve established something of a test

To help us heavenly rulers to decide

Who’ll be allowed to live and who must die.

But you yourself are going o’er the hill,

You’re over fifty and you may be ill.

Thing is, are you worth keeping on your toes?

I’m noting who’s been tested, stays or goes.’

The Angel wrote, and vanished. The next night

He came again, with a great awakening light,

And showed the names of those who’d failed the test –

And lo! Emanuel’s name led all the rest!

Here is an Israeli report of the battle between Hamas and an al-Qaeda linked group in Gaza (see post below):

A senior Hamas commander is reported among the nineteen dead and 120 injured in the gun battles between Hamas forces and hundreds of members of the al Qaeda offshoot Jund Ansar Allah in the southern Gaza Strip town of Rafah Friday Aug. 14. DEBKAfile’s military sources report that Hamas special units fired mortars and heavy machine guns into the Ibn Thaymas mosque where the Jund leader, Abdullah al Latif Mussa earlier proclaimed the enclave an al Qaeda emirate. He urged all its inhabitants to defy Hamas rule and take an oath of allegiance to al Qaeda and Osama bin Laden. After storming the mosque, Hamas forces blew up the Jund leader’s four-storey home with all its occupants. [As our reader aeschines says in a comment on the post below, if the Israelis tried something like that there’d be ‘global fireworks’ – JB.] His death was reported but not confirmed.

Our counter-terror sources report that in recent months terrorist groups identified with al Qaeda are spreading out through the southern Gaza Strip, establishing their influence with plentiful cash, weapons and explosives. They accuse Hamas of failing to establish Islamic law in the enclave.

Which report is the more accurate we’ll have to wait and see. This account puts the episode in a believable context. Credible reports of al-Qaeda groups establishing themselves, well armed, in the southern Gaza Strip have been circulating for some months now. Of course Hamas feels threatened. Which terrorist group will dominate the other? Will war decide the issue? Meanwhile, let crocodile eat crocodile.

From the Telegraph:

Six people were killed and 55 wounded in Gaza fighting on Friday when Hamas police stormed a mosque where radicals had declared an Islamist “emirate” in the Palestinian territory, emergency services said.

Shooting was continuing after dark, witnesses said, after clashes began in the afternoon following weekly prayers in the southern city of Rafah, which straddles the Egyptian border.

Among the dead was Mohammed al-Shamali, head of the Hamas military unit for southern Gaza, emergency services said, adding that bodies of some other victims could not be reached because of the intensity of the fighting…

An Egyptian security official said a three-year-old boy was critically wounded by a bullet from the fighting across the [Egyptian] border.

Witnesses said that following the prayers, a group of Palestinians announced the formation of the Islamist “emirate,” defying the authority of Hamas, which has ruled Gaza’s 1.5 million people for the past two years.

“We are today proclaiming the creation of an Islamist Emirate in the Gaza Strip,” Abdul Latif Musa, a representative of Jund Ansar Allah (Soldiers of the Partisans of God), said at the Bin Taymiyya mosque, the witnesses reported.

Musa was surrounded by armed fighters when he made his statement, according to the witnesses.

Rafah is the Gaza stronghold of the so-called Salafist movement, of which Jund Ansar Allah is said to a part and which is ideologically close to al-Qaeda.

An AFP photographer reported that Hamas police dynamited Musa’s house. It could not be established whether the Islamist was there at the time.

Hamas police blocked all entrances to Rafah, the photographer said.

The Hamas interior ministry warned that those violating the law would be pursued and arrested.

“Everyone outside the law and carrying arms in order to spread chaos will be pursued and arrested,” a ministry statement said.

At the same time, Hamas premier Ismail Haniya denied that the group exists.

“No such groups exist on the ground in Gaza,” he said at prayers in the northern Gaza town of Beit Lahiya. He blamed the “Israeli media for spreading this information with a view to turning the world against Gaza.”

Hamas seized power in Gaza in June 2007 after a week of vicious fighting with forces of the secular Fatah movement of Palestinian Authority President Mahmoud Abbas.

From an article by Alan Oxley in Investor’s Business Daily:

Environmental NGOs (nongovernmental organizations) Greenpeace and Worldwide Fund for Nature have just released the “NGO Climate Change Treaty.” It’s their wish list for terms of a treaty to replace the expiring Kyoto Protocol, and they’re pushing it this week at a U.N. meeting in Bonn, Germany.

Environmental activists have always believed governments should put the environment ahead of every other issue, including economic growth. The NGO Treaty is a blueprint for this.

In addition to soliciting the same sort of tough emissions targets they’ve demanded in the past, this latest document maps out a strict plan to restructure the global economy into their “Brave New World.” Yet it reads like an old Soviet 20-year plan.

The negotiators who inked the original Kyoto treaty envisaged that the agreement would create an open global market for emissions trading which would efficiently distribute the cost of reducing emissions among the world’s economies.

Under the NGO plan, a form of global government supplants national sovereignty, and a central committee of international officials allocates the proceeds from the sale of carbon emission, not the market. The activists lay out, in no uncertain terms, just who should bear the costs and how high those costs should be.

Worldwide Fund for Nature and Greenpeace also want industry in developed nations to pay $160 billion every year for the first five years. Their Treaty creates a “Committee” of backroom officials selected from parties to the Treaty which approves a plan by each member to reduce emissions.

If the plans are deemed unacceptable, countries would be forced to go before two other regulating bodies (the Facilitation Branch and then the Compliance Branch) to “correct” their strategies or be penalized for not doing so.

From Power Line:

We’re used to Barack Obama doing it, but this time it’s Hillary Clinton–our Secretary of State!–spreading lies about America overseas:

Hillary Clinton then drew some negative attention for comparing a disputed Nigerian election with the 2000 U.S. stalemate that ended with George W. Bush winning out over Al Gore, who served as Bill Clinton’s vice president.

“Our democracy is still evolving,” Clinton said. “You know we had some problems in some of our presidential elections. As you may remember, in 2000 our presidential election came down to one state where the brother of one of the men running for president was governor of the state. So we have our problems too.”

Clinton’s clear implication was that Jeb Bush had somehow stolen the election on behalf of his brother. This is an outrageous slander, not only of Governor Bush, who had nothing to do with the outcome of the election, but against the United States. What could possibly have possessed our country’s top diplomat to think that it would serve our interests to tell the world, falsely, that we have corrupt Presidential elections?

Once again, the incompetence of the Obama administration is remarkable.

‘Incompetence’? What became of the word ‘treachery’?

What ‘possessed’ her? Why, ‘smart power’ of course.

Charles Krauthammer writes:

Think of it this way. Assume that a screening test for disease X costs $500 and finding it early averts $10,000 of costly treatment at a later stage. Are you saving money? Well, if one in 10 of those who are screened tests positive, society is saving $5,000. But if only one in 100 would get that disease, society is shelling out $40,000 more than it would without the preventive care.

That’s a hypothetical case. What’s the real-life actuality in the United States today? A study in the journal Circulation found that for cardiovascular diseases and diabetes, “if all the recommended prevention activities were applied with 100 percent success,” the prevention would cost almost 10 times as much as the savings, increasing the country’s total medical bill by 162 percent. Elmendorf additionally cites a definitive assessment in the New England Journal of Medicine that reviewed hundreds of studies on preventive care and found that more than 80 percent of preventive measures added to medical costs.

This doesn’t mean we shouldn’t be preventing illness. Of course we should. But in medicine, as in life, there is no free lunch. The idea that prevention is somehow intrinsically economically different from treatment — that treatment increases costs and prevention lowers them — is simply nonsense.

Prevention is a wondrous good, but in the aggregate it costs society money. Nothing wrong with that. That’s the whole premise of medicine: Treating a heart attack or setting a broken leg also costs society. But we do it because it alleviates human suffering. Preventing a heart attack with statins or breast cancer with mammograms is costly. But we do it because it reduces human suffering.

However, prevention is not, as so widely advertised, healing on the cheap. It is not the magic bullet for health care costs.

You will hear some variation of that claim a hundred times in the coming health care debate. Whenever you do, remember: It’s nonsense — empirically demonstrable and CBO-certified.

Laura Hollis writes an article in Townhall summing up the disaster that is the Obama presidency along with the Democrat-dominated Congress, and reminding the electorate that they can save their country. The whole thing is a must-read.  Extract:

At certain times in history, events seem to inexplicably conspire to bring about disaster. Watching Obama’s administration unfold is like watching a documentary about the Titanic, World War I, the Russian Revolution of 1917, Hitler’s rise to power, or the Great Depression. Knowing already what is to come, the viewer is nevertheless transported into retrospective incredulity: How could all these things happen at the same time? How could no one see what was coming? Where were the voices of warning? Did no one know any history? Couldn’t this have been averted? Why did the people allow themselves to be led like sheep to the slaughter?

What we have been hearing during Congress’ August recess (and well before) are the voices of our would-be overlords, attempting to herd and reign in and lash Americans into the chutes they have designed for us. But this is not inevitable. The only weapons they have now are humiliation, insults, and opprobrium. We the People, however, have far more powerful weapons in our arsenal: voices expressed in dissent, our own financial resources, and our votes. If the media will not serve as an outlet for our legitimate protests, then we will squeeze them financially as we could any other corporation, by refusing to support them or the companies that advertise on their networks. If Congress will not listen to us, then we vote them out next year. And if Obama insists upon foisting his Marxist transformation of this country over the will of the American public, then we must marginalize him by saddling him with a new Congress that obstructs his every collectivist move, until he himself can be replaced in 2012.

The self-appointed societal elites think they can shut us up by ignoring or insulting us. But the American public, in keeping with the history of our nation, must refuse to be cowed by those who would mock us into submission. If we cannot withstand name-calling, insults, and false accusations, we will find ourselves shackled by far worse.

The Secretary-General of the United Nations, Ban Ki-moon, demands world-wide redistribution of wealth and the curbing of economic activity in order to ‘save the planet’ from poverty, hunger, disease, and insecurity. This must be done within four months he says, or  else…

We have just four months. Four months to secure the future of our planet.

Any agreement must be fair, effective, equitable and comprehensive, and based on science. And it must help vulnerable nations adapt to climate change…

The science is clear… What is needed is the political will. We have the capacity. We have finance. We have the technology. The largest lacking is political will. That is why I will convey some meetings focused on climate change. I have invited all the leaders of the world … Two years ago, only a handful of world leaders could talk about climate change. Today, leaders of all the world, all the countries on every continent are aware of the threats we face now. This is great progress, for we need leadership of the very highest order. Awareness is the first step. The challenge now is to act. Since my first day as Secretary-General, I have spoken out about the grave climate change threat. My words, at times, have been blunt. When the leaders of the G-8 agreed in July to keep the global temperature increase within two degrees centigrade by the year 2050, that was welcomed and I welcome that statement. But I also said again, it was not enough. But leaders have agreed to cut green house gas emissions by 80 per cent by 2050. That is welcomed again. But that must be accompanied by the ambitious mid-term target by 2020 as science tells us to do. There I said, while I applaud their commitment, that is not enough. I called for matching these long-term goals with ambitious mid-term emission reduction targets.

Let me be clear about what we need to do.

There are four points [of] very important key political issues.

First industrialized countries must lead by committing to binding mid-term reduction targets on the order of 25 to 40 per cent below 1990 levels. Unfortunately, the mid-term emission targets announced so far are not close enough to this range…

Second, developing countries need to take nationally appropriate mitigation actions in order to reduce the growth in their emissions substantially below business as usual…

Third, developed countries must provide sufficient, measurable, reportable and verifiable financial and technological support to developing countries… Significant resources will be needed from both public and private sources. Developing countries, especially the most vulnerable, will collectively need billions of dollars in public financing for adaptation. I am talking here about new money – not re-packaged Official Development Assistance…

Fourth, we need an equitable and accountable mechanism for distributing these financial and technological resources, taking into account the views of all countries in decision-making.

Accomplishing all of this requires tough decisions. It will take flexibility and hard work to negotiate the most difficult issues. Trust between developed and developing countries is essential. When governments succeed in sealing a deal in Copenhagen, we will have shown the spirit of international solidarity. We will have shown leadership – political will…

Roll on, Copenhagen. Only, while they’re at it, why don’t they agree to make gold out of moonbeams? The science is clear.

For years now North Korea has been hoping for direct talks with the US. By granting ex-president Clinton the release of two illegally held American journalists that he had to come and beg for, Kim Jong Il now gets just what he wanted. The one-on-one negotiations will legitimize the North Korean regime. (They ought to delegitimize the Obama presidency.)

Hillary Clinton lies about what happened. Is anyone taken in? Is anyone surprised?

From the New York Post

One week after North Korea released two imprisoned American journalists, the Obama administration announced its willingness yesterday to hold direct talks with the rogue nation over its nuclear weapons. “The ball is in their court,” said America’s UN ambassador, Susan Rice, on CNN’s “State of the Union” yesterday.

Secretary of State Hillary Rodham Clinton, along with the rest of the administration, insisted that former President Bill Clinton’s trip to North Korea to secure the release of the two journalists was not a negotiation with the country, led by dictator Kim Jong Il, but she said she hoped it would improve relations with them. “What we’re hoping is that maybe, without it being part of the mission in any way, the fact that this was done will perhaps lead the North Koreans to recognize that they can have a positive relationship with us,” Secretary Clinton said on CNN’s “GPS.”