Sarah Palin's new death panel
Sarah Palin popped up again today on the Wall Street Journal's Op-Ed page to renew her accusation that President Obama was advocating "death panels." Never mind that lawmakers have already abandoned the proposal that gave rise to the original "death panel" hysteria, namely, a provision allowing Medicare to pay doctors no more than once every five years to counsel patients about their options for "end of life" care. (Some top geriatricians think such counseling would actually give the elderly more control by encouraging them to declare their preferences while they're still capable of doing so. But I digress.) This time, Palin attacked Obama's proposal to beef up MedPAC -- the Medicare Payment Advisory Commission. The 17-member MedPAC makes recommendations to Congress about how much doctors and hospitals should be paid for the services they provide. To insulate these decisions from political pressure, Obama has proposed giving a new version of MedPAC the power to set reimbursement levels, with Congress retaining the power to veto those decisions before they take effect. To Palin, though, this amounted to giving "an unelected, largely unaccountable group of experts" the power to make life-and-death decisions about care.
As much as I appreciate the former governor's concern for her elders, myself included, her argument smacks of pandering to those who don't want the federal government to rein in Medicare costs. The program's trust fund for hospital care is going bankrupt; with no change in policy, it will be insolvent in eight years. In addition, the program's rising costs are consuming an ever-growing percentage of the U.S. economy. The ship is sinking, and Palin's solution is to cap malpractice awards and give Medicare recipients "vouchers that allow them to purchase their own coverage." That's just an invitation to a more vicious form of rationing than anything a beefed up MedPAC might do.
Think about it for a minute. The cost of private health insurance is rising faster than Medicare expenses (in part because private insurers pick up part of the tab for the uninsured and underinsured, such as Medicaid patients). If the government increased the value of the vouchers over time to keep pace with that growth, the program would cause a bigger financial headache than Medicare does today. But if Congress held down the value of the vouchers below the rate of medical inflation -- an idea that former House Speaker Newt Gingrich and President George W. Bush both backed -- the program would force seniors to pick up an increasing share of the tab or sign up for more restricted (i.e., more heavily rationed) coverage. Unless, of course, some meaningful changes were made in Medicare to limit the increases in healthcare costs -- like, say, Obama's MedPAC proposal.
It's dishonest to suggest we can bend the curve on Medicare spending without sacrificing something. It's past time for politicians to own up to the people who receive subsidized healthcare -- to wit, anybody with Medicare, Medicaid or a group plan from their employer -- that the system is unsustainable. Done right, the changes made to control costs will come mainly at the expense of those profiting from the inefficiencies of the system. Those inefficiencies, however, often translate into services that are desired but not really needed -- for example, having an MRI to make absolutely sure your orthopedist correctly diagnosed your joint pain as tendonitis. That's the part of the healthcare reform debate that neither Palin nor Obama seem willing to acknowledge.
Photo credit: AP Photo / Al Grillo
-- Jon Healey








So you point out all the problems with the medicaire program...to give credence to the argument that a public "option" also run by the same bureaucracy would function more efficiently or effectively? Well, I think that was entirely Palin's point, if you cared to hear out her argument. And, we're not only talking about costs here-- we're talking about actual availability of resources as well. When we spread those resources as if they are unlimited, and designate a central "panel" to make decisions about the allocation of those resources, individuals lose all power in the system. Not to mention, the need to actually ration, not costs but treatment, becomes an obvious reality. That's the concern, who gets treatment and who doesn't. It's *clear* in Palin's op-ed that the costs are of secondary concern. So address that, and quit making her argument what you want it to be. And Palin does acknowledge the insanity and excessivity of testing and "defensive medicine" that takes place...want to know where those problems come from? Malpractice protocol and government mandate. Individual judgment has already been largely undermined, and Palin *does* address that.
Posted by: Patrick | September 09, 2009 at 12:54 PM
Once again an extremist with limited intelligence is mouthing off about what she can never comprehend....
Posted by: abby | September 09, 2009 at 01:12 PM
More people need to look very carefully at what she's saying. The insurance companies would LOVE this idea floated by Palin. They want lots of federal money just as they did under Ws big giveaway and they found their naughty monkey wearing sycophant to do it for them. If anyone thinks that Palin, not even a one term governor and quitter, is honestly invested in helping to solve problems, remember that this woman has thrown everyone who helped her climb the ladder under the bus. She is seriously disturbed and now jobless, has to hide behind a ghost writer to hide behind her facebook to put out this crap. Uncle Rupert Murdoch has invested a lot on Palin as have industry corporations from oil to health care because she's just ambitious enough to make this a quid pro quo, "values" schmalues. She could care less about you.
Posted by: Nin | September 09, 2009 at 01:13 PM
Did she even write the op-ed? Nuff said
Posted by: Mohan Nair | September 09, 2009 at 01:50 PM
Palin, Bachmann, Beck, Limbaugh, Malkin. That's what free speech is all about. Even loonies get a voice.
Posted by: ericmiami | September 09, 2009 at 02:30 PM
Why does anyone give this woman the time of day? Sure, she looks good, but she's a know-nothing empty suit shilling for whatever GOP drivel she's asked to.
Posted by: Steve | September 09, 2009 at 02:31 PM
@Patrick -- We're talking about Medicare here, a government-run healthcare program. A central panel -- Congress -- already makes critical decisions about it. So, too, do bureaucrats at HHS. So what individual power are you trying to protect, exactly? Not sure what you mean by your comment re: costs being Palin's secondary concern -- I'd agree with you if by "secondary" you meant "minimal." Finally, tort reform and medical malpractice caps would be helpful, but they don't make a big difference in costs. Look at the experience in the numerous states that have adopted caps on malpractice damages. California has the toughest in the country, but it's healthcare costs are rising in line with every other state's.
Posted by: Jon Healey | September 09, 2009 at 02:45 PM
"her argument smacks of pandering to those who don't want the federal government to rein in Medicare costs." -- Uh buddy, they can't rein in costs now. What makes you think another bureaucracy will do the same?
Posted by: Brian | September 09, 2009 at 02:47 PM
@ Nin: First of all, you conveniently ignore the fact that Palin took on corruption and big business in Alaska, and will treat the insurance companies the same. She's not a Republican corporatist - she believes that the playing field should be level and nobody gets special gov't treatment or subsidies. Also the insurance companies are controlled by the free market. 2nd of all, Palin actually ran a state and has had to deal with Medicaid and healthcare services for the indigenous people of Alaska (before Obama's goons forced her out of office by filing bogus ethics violations). She has more experience with healthcare than the current President and most members of Congress. Seriously disturbed and jobless? LOL. The woman has over 1,000 speaking invitations that will net her millions of dollars. If she's so disturbed why do people keep paying attention to her?
Posted by: Brian | September 09, 2009 at 02:53 PM
of all the government people out there, it was PALIN who CAUGHT the proposal now abandoned. PALIN wins the points!
Posted by: polly | September 09, 2009 at 03:00 PM
@Brian -- It's not the *bureaucracy* that can't control medicare costs -- it's the politicians. Congress, to be exact. That's why so many healthcare policy analysts like the idea of a beefed up MedPAC, one that was insulated from political pressure. Think of the base-closing commission, which overcame the stalemate in Congress over closing unneeded military bases.
@Polly -- If by "caught" you mean "created an irrational hysteria over," then you're are right, Palin gets credit for that. Please follow the link to the piece in Health Affairs -- in it, you'll read why geriatric specialists like the idea of end-of-life counseling. It's about helping protect the elderly from having their wishes trampled on after they become incapacitated or non-lucid. That's why the "death panel" thing was so irresponsible and counterproductive.
Posted by: Jon Healey | September 09, 2009 at 03:08 PM
You fail to point out that the cost savings for capping malpractice outcomes could be an enormous savings. Tort Reform would be a major plus to everyone except the Lawyers. And all those who believe that a government run health care system would be more efficient and cost less please stand on your heads.
Posted by: RichmondRob | September 09, 2009 at 03:10 PM
If we get real lucky, maybe we could get Sarah to test the Secret hidden Euthanasia Chambers for us. I think that Moron would try to condemn God as a Nazi if it suited her agenda! We know where The Wicked Witch of Wasilla is, now where the hell is Dorothy with that House? Talk about your basic BB in a boxcar, for a brain! She comes from a different "Looneyverse"!
Posted by: John | September 09, 2009 at 03:19 PM
dear mr. healey, why would i write "created" when i MEANT "CAUGHT"? a "death panel" in the health care bill that needs to be dealt with, is the "death panel" for babies at the abortion clinics that the taxpayers, or gramps, should NOT be forced to pay for. abortion has slithered in under "health care". sneaky. sneaky.
Posted by: polly | September 09, 2009 at 04:29 PM
@Polly -- The taxpayer-funded abortion argument has been debunked. None of the bills in Congress would provide any direct support for abortions. See http://bit.ly/OxBNK. BTW, if you're really committed to ending taxpayer support for abortions, you should urge Congress to tax employee health benefits -- an unmistakable, albeit indirect, subsidy for insurance policies that finance abortions. Of course, that would amount to about a $3 trillion tax increase over the next decade....
Posted by: Jon Healey | September 09, 2009 at 04:43 PM
The Ultra-conservative right wing nuts like Palin are frothing at the mouth yet again. Why does Obama think there can be anything resembling "bipartisanship" when the opposition is bent on total destruction of his administration? He needs to wake up and smell the napalm. these crazies on the right are strictly Slash and Burn. He needs to use his office to jam down their throats what the country needs: Health care reform; banking reform and an end to corporate control of elections. You can't play footsie with a bunch of die-hard liars and propagandists.
Posted by: jefflz | September 09, 2009 at 04:44 PM
Interesting that the media's obsession to lean on "death panel" in its continued failure to debunk or convince the public otherwise. Liberals crouched in their corner can't quite figure out why their screams of pain (Palin) don't register with the public. Well their fearless ( and deaf ) leader of the trolls will plead and drown in his own socialist bile tonight. Best keep the kids out of the TV room.
Posted by: Harold | September 09, 2009 at 04:55 PM
Oh Sarah. Please don't speak. Don't write. Just go home. You are clearly not a thought leader on this issue or anything else.
Posted by: Amy | September 09, 2009 at 05:37 PM
More and more Palin's sounding like the "cousin" everyone whispers about and calls "special". I'd call he a moron, but that would be insulting morons across the board.
Posted by: sburgess | September 09, 2009 at 06:52 PM
I just saved my insurance company and myself, many thousands by going to Mayo Clinic for a second (actually 3rd) opinion about a knee replacement. i wonder how many people, no worse than me, have had knee replacements, also cataract surgery, etc. that were unnecessary and may cause much worse problems.. Medicare does need to pay more for general practicianers. gerontologists, etc.
Posted by: carol | September 09, 2009 at 06:54 PM
I agree with Steve that "once again an extremist with limited intelligence is mouthing off about what she can never comprehend".... please just go home Palin....
Posted by: Jim | September 09, 2009 at 09:32 PM
God, how I love Freedom of Speech. It's what keeps America ticking. I hope we never lose it. It doesn't matter whether you're on the Far Left, Far Right, or somewhere in between. Each and everyone of them has something to contribute. Some don't have great track records, but they keep on pursuing, and that's what it's about. Every now and then, someone from somewhere in the soup, points out something important. So, I say to you Sarah, and everyone else, from every angle possible, keep plugging away. Quite the contrary to popular belief, Americans actually are used to this system, and smart enough to figure out what's right for them. Let's not ever suppress Freedom of Speech. Data is key now days, and those who focus on it, have an edge on reporting, and dischiphering the rhetoric.
Posted by: My2cents | September 09, 2009 at 11:33 PM
i am an Austrailian and we do have a health plan and believe me the good USof A needs one so badly. its a total outrage the health system you have honestly get a life people please dont just turn your back on everyone else that is how the world is going it is very obvious that the lack of basic care for the next door person is so driven by the moranic outrage i read about healthcare in america and it make me sick. for christ sake your President is I hope a man who can convince you to look outside your tiny little bowl and discover there is w whole world out there ok already. yes i am casting not bad words towards you but honestly you actually dont have a health plan at all you pay heaps for a pretty poor system do a little research and look at what we have and believe me you will shudder at your pathetic crap system is a joke mate and i speaking frankly now is a total joke
Posted by: john | September 10, 2009 at 12:24 AM
2 words amount to what Palin is "SICK JOKE"
Posted by: karanne | September 10, 2009 at 06:05 AM
If Sarah Palin is insane enough to make a White House bid in 2012, her "death panel" rhetoric will become a self-fulfilling prophesy: that will be a good name for her campaign staff.
And for the record, the Palin-inspired shaking and shrieking among Democrats is from laughter, not fear.
Posted by: Ironman Carmichael | September 10, 2009 at 06:13 AM
The majority of seniors know that they will be the losers, should the government be allowed to extend their reach into people's lives.
As long as obama continues to insist in reducing medicare and medicaid payments to pad his health care scheme, and allow illegal immigrants access to insurance paid by Americans, then people like Sarah Palin and myself will work tirelessly to point out that this administration's goal is a bloated, socialized style government like there is in europe.
Americans do not want socialism infecting the fabric of this great country. With help from good Americans like Sarah Palin and Glenn Beck, we can sweep the blight of obama back into the hole that he came from. His incompetence continues to degrade this country and hope for job recovery will only come by taking back the Congress by Republicans and Independents.
With massive taxes awaiting businesses, thanks to obama and the liberal democrats, job creation in this country will not occur until a more favorable and business friendly approach is taken.
Posted by: Smitty62 | September 10, 2009 at 06:22 AM
With the goverment in control of "rationing" we at least have some input by using our vote to control what the government does. We have no such control over insurance companies whose only loyalty is, and should be, to there shareholders.
Posted by: William Maloney | September 10, 2009 at 07:10 AM
The Ultra-conservative right wing nuts like Palin are frothing at the mouth yet again. Why does Obama think there can be anything resembling "bipartisanship" when the opposition is bent on total destruction of his administration? He needs to wake up and smell the napalm. these crazies on the right are strictly Slash and Burn. He needs to use his office to jam down their throats what the country needs: Health care reform; banking reform and an end to corporate control of elections. You can't play footsie with a bunch of die-hard liars and propagandists.
Posted by: jefflz | September 09, 2009 at 04:44 PM
I do not have the vocabulary to come up with this, but off all the points made this is the one that was burning in my head last night. I would like our President to stop being so patient and mature! You can not be rational with an irrational person or people for that matter
Posted by: Daniel | September 10, 2009 at 11:02 AM
My god will this fear tactic never end. It's like the song that never ends. The time to act is now. You don't wait til the birth of the baby to prepare the nursery.You know he or she is coming, so you want to be ready for it, because ready or not it is coming.
Posted by: Phyllis | September 10, 2009 at 12:54 PM
Why is anyone even paying attention to this woman?
She's NOT a lot of things: A governor (you need to finish a term to be considered anything- A man going to Army boot camp is NOT a soldier until he completes boot camp). Just because she held the office for half the term, then quit suddenly, bespeaks a lack of ethical responsibility. This is not a governor.
Political hopeful. With the way she muddies the waters on everything she has an opinion about (and there are an unending list), I find it hard to understand where she is coming from. If she ever tries to run for office again, will the people even understand what the heck she says? She'll need a ghost writer with her at all times, so she can read a ready-made response.
courageous. Spouting disinformation through Facebook? She can't stand the light of the media, so she must hide behind her keypad.
But she IS a lot of things: A prostitute. Selling yourself via E-Bay? Yeah, yeah, I know it's a dinner, but she's hawking HERSELF. And not just anybody will be accepted, now that's a PICKY prostitute. Because she is donating to charity, does that also make her a picky prostitute with a heart of gold?
A liar. I suppose by now, she HAS had time to read H.R.3200, and STILL the death panel hogwash. Doesn't she know that WE know what the truth is? Or maybe she's just pandering to the "Orwellers", like Glenn Beck does.
A shill. I suppose if you look at her finance records, you'll see deposits made by the healthcare insurance industry. This would come as no surprise, as hard as she's pushing this nonsense.
A drama queen. Hardly two days can pass before she's spouting more nonsense. The fight with Letterman? That's what clinched it for many,many Americans. She could have been gracious, and accepted his first apology, but she couldn't get enough blood, so she kept it up until she got her way.
A fake. Yeeaah. She knows how to shoot. Like I know brain surgery. She fishes? does she even know which end of the rod she needs to hold? I'm not so sure, considering she's never been.
So, I ask again, why is anyone even paying attention to this woman?
Posted by: Bad Karma | September 10, 2009 at 01:23 PM
A runner-up in a beauty contest a few decades ago, Sarah Palin is now a Facebook spokesmodel, with a ghost writer to write her "speeches."
Posted by: fashionplate | September 10, 2009 at 04:06 PM
She's enraged with jealousy that Ellen got to be the judge on Idol. They're all death panels to Sassy.
Posted by: FoodFighter | September 10, 2009 at 04:56 PM
What other national political figure is given press coverage for comments written in FaceBook who at the same time engages in none of the normal give and take of the political process such as making and receiving phone calls, giving interviews, delivering public speeches, participating in discussion panels, gathering support, and so on? Palin's current mode of reclusive, electronic existence makes her resemble any number of fictional characters known for hiding themselves in the attics of vine-covered houses. Why does the news media report on the actions of someone who insists on self-imposed seclusion? Palin's behavior might be understandable had she opted to return to private life. Since it's obvious that she strives to be a leading voice of the conservative Republican right, Palin should be visible and audible. Moreover, Palin needs to demonstrate in three dimensions what makes her qualified to be a leader. Until she does that, we really don't need reports of what was written under her name on FaceBook.
Posted by: wendy | September 10, 2009 at 06:25 PM
To all concerned Americans; Whould you want Palin to go to Def Con 1 then launch? Think about it!!!!! Very worried about 2012!!!! Smitty.
Posted by: Smitty | September 11, 2009 at 09:21 AM
If you put into context what Sarah Palin is saying and read HR3200 AND know the history of the writers of the health care bill the "death panel" comments are in fact true! Tort reform could save over a Billion dollars in medical insurance, loser pays would cut lawsuits in half if not more. (according to the AMA) The reason California has not seen a dramatic cut in Medicare expense is simple...illegals. The Obama plan says "illegals" are not covered yet no one is allowed to ask whether a person IS illegal. The republicans tried to get a provision put into the bill where the question could at least be asked, but it was shut down by the democrats. Thus the "LIAR" comment. It makes me laugh that people freak out about what Sarah Palin says, down to the president calling her a liar. She really scares the left, she must be on to something!
Posted by: LK | September 11, 2009 at 07:16 PM
She's a self-aggrandising nincompoop.
Posted by: Linda Leigh | September 11, 2009 at 08:34 PM
The WSJ piece is one of several purportedly written by Palin. I don't believe she wrote that for a second. The writing styles in these compared to her actually known writing is not even close. Someone, the GOP, a PAC, or some organization is writing this garbage and using her name I believe. These articles are far too well written to be Sarah Palin's work. She know doubt agrees with he opinion.
Posted by: John Wilkins | September 12, 2009 at 09:51 AM
Mr. Healey, it's also dishonest (or, as we conservatives now call it, a lie) to not actually link to Palin's piece in the WSJ, nor to mention the several constructive ideas mentioned in her article which are worthy of serious consideration. She mentions, as just one example, repeal of the federal laws preventing healthcare providers from operating across state lines.
So lets address, instead, your fixation -- Palin does indeed mention "death panels" (the Medicare Advisory Panel) -- unelected officials who will have life-and-death decision making powers over what is or is not covered in your medical plan, and life-and-death decision making powers over what is (or is not) in your formulary (the pharmaceuticals you are allowed to obtain under the plan). If these guys don't think it ought to be covered, it will not be. By setting rules on Government reimbursement under privately run health plans, and using the enforcement instruments Obama has put forth in his speech (the "cadillac tax" on healthcare plans whose benefits go beyond what the "death panels" think ought to be standard), they will stifle our ability to choose a healthcare plan which suits us by making such plans costly to us -- possibly to the point that we cannot afford them.
Given that just a few years ago, CAT scans and MRIs were "cadillac" but are now routinely offered, one can see where our quality of healthcare will suffer. Innovation in the form of new technologies will not be capitalized fast enough (because the "death panel" sees them as "cadillac"), and hence their movement into the mainstream will be slowed.
To fully understand the problems associated with government-run healthplans here in the USA, we don't need to look at the problems in Canada, or in the UK, one merely needs to look at the existing healthcare plans the United States administers for the common folk, such as the Indian Health Service. Here's what the Senators on the Democratic Policy Committee themselves have to say about nationalized healthcare in Indian Country:"For many critical services, patients are subjected to a literal "life or limb" test; their care is denied unless their life is threatened or they risk immediate loss of a limb. Care is denied or delayed until their condition worsens and treatment is costlier or, all too often, comes too late to be effective. " Next up, the Veterans' Administration, which the Times itself has noted in one article had problems: "The stories detailed the substandard facilities and confusing bureaucracy that wounded troops faced once they were released from their initial treatment."
This is the type of treatment we all will be enduring if ObamaCare is passed -- substandard services and confusing bureaucracy.
If liberals want to tout success stories about government medical plans, they merely have to point to either the Congressional or the Presidential treatment plans, and, for example, tout the treatment afforded Senator Edward Kennedy under one of those plans. The conservative response is obvious -- these plans are not presided over by a "death panel", nor are they subject to a "cadillac tax". Maybe they ought to be, but that's a whole 'nuther topic. In any case, do not expect that this type of plan will be the standard under ObamaCare -- remember the "cadillac tax"?
The best moderator of costs and utilization in a healthplan is the marketplace. We currently produce enough doctors and enough medicines and enough equipment to service those who can pay now, and such payments are currently at a level which prevents abuse. If we attempt to increase utilization of any of this infrastructure without significant investment into it beforehand [more doctors, increased pharmaceutical and medical equipment production], we must either ration it, raise the costs of using it, or set penalties for "abuse" -- of which the "death panels" Palin touts will be only a minor case. Those of us who can pay will be competing for services with those who cannot pay, and those who cannot pay will have no incentive to self-ration, so something will have to be done to us all (including those of us paying) to prevent oversubscription.
I'm a senior like you, Mr. Healey, and I happen to like things the way they are, even if I, like everyone else, have had occasional problems with my provider. With my current health plan, I'm the "death panel" -- I make the decisions as to how much healthcare to buy, and I buy the best I can afford. I have options, like anyone else does who needs treatment, but because I pay into the system, I have more options, and I think that's completely fair. If there's going to be a "death panel" deciding my care, I want all the votes, and that's fair too. It's what I have, and what your side would change.
Posted by: unclesmrgol | September 13, 2009 at 07:47 AM
Sara Palin is wrong and out of line, she has not reat the bill and should not comment util she has read every word.
Posted by: Richard | September 13, 2009 at 08:09 AM
@unclesmrgol -- You're right, I should have included a link to Palin's Op-Ed. That was really bad Netiquette on my part. My apologies to my peers at the Journal.
You are wrong, however, about the proposal for an enhanced MedPAC. It won't have any control over private plans. Just Medicare. And if you're on Medicare, by your definition of "death panel," you're already subject to two of 'em -- HHS and Congress. They set reimbursement levels. The only control you may exert is through the out-of-pocket dollars you may have the ability to spend to buy things Medicare won't pay for. If you've got 'em, good for you.
The question isn't whether government should decide how Medicare dollars are spent -- it already is deciding. The question is whether those decisions should be made by politicians or by medical experts based on what treatments are shown to be most effective. I think most people would agree that the latter approach would be better, although we can certainly debate what's the best way to go about it.
Posted by: Jon Healey | September 13, 2009 at 10:10 AM
Jon,
Thank you for fixing the entry to allow people to see the article upon which you are basing your comments. I think many were commenting based solely upon your article without reading the primary source first.
I'm not yet on medicare, but I am close. When I am, I will try to buy one of those "cadillac" bridge policies which take the Medicare money and give me a lot more choice. When I do so, I don't want to wind up like the retirees at GM, who, under Obama's auspices, have lost all of their retirement medical so that Obama's friends the UAW could get $9B in cash to spend on the next election cycle. I don't want to be charged a "cadillac tax" for expanding my healthcare choices over those who choose not to. I don't want the Government meddling in anything other than enabling the best competition that can be enabled.
Besides, I, unlike you, do not hold Medicare up as any kind of a gold standard -- listen to the complaints of people on Medicare, and compare to those who have Kaiser or even Blue Cross/Anthem. In the end, if the White House has its way, all health insurance policies will be subject to the bureaucrats, just as Medicare is now. Here's an interesting talking point from the White House stated on MSNBC on September 11 (NBC's Mike Viqueira at http://firstread.msnbc.msn.com/archive/2009/09/11/2065287.aspx): "Undocumented immigrants would be able to buy insurance in the non-exchange private market, just as they do today. That market will shrink as the exchange takes hold, but it will still exist and will be subject to reforms such as the bans on pre-existing conditions and caps."
I don't care as much about undocumented/illegal immigrants as some of my conservative peers (in fact I'm more in line with Abe Lincoln's feelings about immigrants than those), but the second part of the paragraph bears close scrutiny -- the White House obviously views the proposed exchanges as a "camel's nose" which will eventually force healthcare providers to standardize. When they standardize, what will they standardize toward? What "reforms" are envisioned by the White House other than the two politically non-sensitive (to the uneducated) talking points mentioned. Once we have a government corporation guiding the healthcare industry, we will have the same situation as the mortgage industry, which was guided by Fannie Mae and Freddie Mac into supporting ever-higher home prices and zero-down loans as banks took the "red pill" and figured out they didn't need to carry any loans on their books because Freddie/Fannie stood ready to buy them all. What will happen to our healthcare costs in such an environment, when pre-existing conditions must be covered by an insurer, and there cannot be any cap on coverage? Will the White House invent Dr. Mac or Dr. Mae to take insurers off the hook for risky policies, and what will happen to them when they inevitably become oversubscribed, as Medicare appears to now?
Since I'm pro-life, the other question that immediately comes to mind is whether I will be required to purchase a policy which covers abortion. I'd like that choice -- to not support via my premiums any procedures with which I ethically or morally disagree. With the exchanges the White House envisions, that will certainly not be possible.
Exchanges wouldn't be needed if Congress hadn't decided to not allow healthcare sales across state lines. If Congress and the President were to allow truly national competition for healthcare, we would have far better policies, I suspect, than the state-only ones we have now (my dependent son is in Connecticut, and needs to come back to California whenever he needs medical care).
Posted by: unclesmrgol | September 13, 2009 at 01:35 PM
@unclesmrgol -- I think you and I have a basic disagreement on what the problem is with the healthcare system. To me, it's the growing number of people who can't obtain or afford care; a corollary is people bankrupted by healthcare bills. Those are structural problems -- rising costs (fueled in part by improper incentives for providers *and* patients) lead to insurers charging more, covering fewer people perceived as bad risks, and limiting what their policies will pay for. Even people who are happy with their current insurance policies are affected, and not just through higher premiums. Runaway medical spending is a drag on the economy and, soon, a nightmare for taxpayers.
Letting insurance companies compete across state lines does nothing about the problems of cherry-picking or insufficient coverage. It might help healthy people get better deals, but it won't help anyone denied coverage today because they have asthma or had a cancerous skin lesion removed a few years back. The one sure effect would be to promote consolidation among insurance companies. I'm not bothered by such a change, given the efficiencies it might create, but some liberal consumer groups argue that it would reduce competition in the long run, defeating the purpose of the deregulation.
Posted by: Jon Healey | September 13, 2009 at 04:38 PM
How is this possible? Seniors have an option to use Medicare (the public option), buy private insurance, or use Medicare and by supplemental insurance. Guess what, most of them use Medicare (the government option) and some of them buy supplemental insurance. SOCALIZED MEDICINE. NOOOOO.
All the doctors are still private, as are all of the hospitals, hospices, etc. Nothing proposed by Congress or Obama socializes the health care delivery system.
The GOVERNMENT isn't going to hire doctors and build hospitals to take over 1/6th of our economy. These people are either ignorant or purposefully lying to scare everyone into rejecting any plan that the Dems come up with.
This stinks. It is technically free speech to allow others to lie and distort to accomplish their political goals but it damages our democracy when the thing they say are credible.
Posted by: DougH | September 13, 2009 at 08:26 PM
What don't you understand about NO. The President said NO. NO illegal immigrant health care.But let me tell you if a illegle came in with a ill child we will take care of that child. No qustions asked, and you and I will be happy to pay for it!
Posted by: Russ 8 | September 13, 2009 at 09:42 PM
Why is it this shallow witted moron gets any press is beyond me. On the other hand, with people like that 'leading' the conservative elements in the country I couldn't be happier. Have a nice time in the woods,...
Posted by: mtnthc | September 15, 2009 at 12:17 PM
Sarah Palin is the best thing to happen to the progressive movement since Dick Cheney. Keep those gums flappin' Sarah, we love everything you say!
Posted by: William Bergmann | September 15, 2009 at 03:58 PM
Sarah Palin is the Paris Hilton of politics.
Posted by: William Bergmann | September 15, 2009 at 04:18 PM
Breaking news, Ms. Palin: much of what you apparently believe are new proposals represent what has been going on in the federal health care programs for decades. Perhaps now that you've abandoned your day job half-way through its term, you could study health care history and economics? That's usually required of op-ed writers, though the WSJ seems to make an exception in your case.
Posted by: Peg | September 15, 2009 at 06:03 PM
Anything to stay in the public eye. She talks about death panels maybe she has her own idea about forming a death panel
Posted by: Ben Doup | September 16, 2009 at 10:11 AM
What makes you think that folks who don't know that HAwaii was a state when President Obama was born there cna read well enough to look at the healthcare bills? Ignorance is bliss and we have a lot of really happy but woefully ignorant people.
Posted by: liz | September 17, 2009 at 11:26 AM