'Death panels' are real -- brought on by budget pressures

By Norman J. Ornstein
WashPost
Saturday, January 1, 2011

During the debate over health reform, Rep. Michele Bachmann (R-Minn.), Sarah Palin and others railed against the "death panels" that would result from the bill. Government bureaucrats, critics said, would decide who would die and when. The bill passed - and indeed there are death panels. But they do not come from the Patient Protection and Affordable Care Act, a.k.a. "Obamacare." They come from Republican administrations in states such as Arizona and Indiana.

In Arizona, the government headed by Gov. Jan Brewer summarily stopped approving Medicaid payments for many organ transplants in October; one man had a liver virtually snatched away while he waited to go into the operating room. He couldn't get it unless he came up with $200,000 to pay for the procedure.

In Indiana, the state Medicaid program denied a lifesaving operation last year to a 6-month-old boy who lacked a thymus gland, which generates cells that the body uses to fight infection. The Indiana Family Social Services Administration said the procedure was "experimental" - even though it had been successful in 43 of the 60 cases in which it had been applied. The state twice denied the family's appeals, but fortunately the publicity caused by this case prodded two health-care companies to pay for the $500,000 operation.

These are real death panels. They are far from the Affordable Care Act's provision for end-of-life counseling for families to enable them to make rational decisions about their loved ones outside of the awful stress in a hospital or hospice. But these decisions are not being made by evil people reveling in the anguish of patients on Medicaid; they are the result of painful choices made by state governments struggling with a sluggish economy, balanced budget requirements and soaring Medicaid costs. States have to react, and one solution to their constraints is rationing care.

(More here.)

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