Saturday, October 13, 2012

Death Panels

It's the lie that doesn't die. Or maybe lie is too strong, it is clearly a mischaracterization but perhaps not totally false. There will be a board, it will make decisions about what care is covered and what care isn't. It's just unlikely that the decisions will be specific, like with a doctor on the other end of the phone line waiting for the board to vote on some imminent procedure.

Republican candidates love to bring up the Death Panels when they are trying to whitewash the ACA. Over and over again: "Obamacare will create an unelected board of non-medical bureaucrats to decide what is covered."

This is presented as if it is the end of modern medicine as we know it. That each time a doctor makes a decision there will be some government specter hovering over their shoulder cramping their style. I just don't understand how this is a problem. Or rather that is also a misstatement, what I don't understand is how this is a new problem.

Will someone please explain to me how this is different than it is right now?

I can think of only one circumstance where there isn't already a faceless board controlling all the decisions and that would be if for some reason the patient was uninsured and well to do. If you were paying cash then you could have totally unfettered care.

But if you are paying with insurance, well then you already have a faceless board of unelected non-medical bureaucrats making decisions about what your insurance will cover or not. Do ACA opponents really think insurance companies just pay for everything? Surely they know better. Every single insurance company is looking to minimize costs - that's the benefit the ACA opponents are trying to sell us: that private insurance will be more competitive and manage costs better. But how do they do that? By not paying for things. And who decides what to pay for and what not to pay for?


Your doctor?

Or could it be your private insurance company's very own death panel?

Death Panels are nothing new. At least if it were a government committee there might be some hope of transparency and accountability to patients. As it stands right now, how ACA opponents want it to remain, the process can be totally opaque and is only responsible to corporate interests.

How could that possibly be better?

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