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Advertise on the Tentacle

August 20, 2009

Government under Siege

Patricia A. Kelly

No one could miss the recent uproar in America over health care reform. People are standing up during Town Hall Meetings and yelling things like, “I’m a patriotic American!” and “I don’t want the government running my life!”


Then there are others, often well dressed and wearing carefully pursed lips, saying, “People need to stop yelling. They need to listen and learn. They need to be part of a dialogue.” These people are saying, “There are no Death Panels.” “That’s a ridiculous idea.” From President Barack Obama on down, many assert “this is not about pulling the plug on Grandma.”


Then there’s the argument about quality vs. price in our health care system. Some say we pay too much for too little. Others assert that our less-than-stellar health care outcomes are related to our dietary and lifestyle choices, rather than to problems with our health care.


Then there are the arguments about attendees at these meetings. Who got paid, or ordered, or invited to appear and where to say what? And who, if anyone, saved them seats?


On August 9, in a column in The Frederick News Post about lowering the volume of the health care debate, Karen Heller said: “Those fools can shout at [Secretary of Health and Human Services Kathleen] Sebelius until they’re hoarse, but it won’t alter the inadequate situation we have now.” So much for lowering the volume.


Some writers, attempting to appear restrained and wise, comment that they find this excessive emotion befuddling or sad. Don’t you just love righteousness? There was a recent cartoon showing former Alaska Gov. Sarah Palin with a bat flying out of her ear. Again, so much for lowering the volume.


I saw a clip of President Obama, in his campaign-style shirtsleeves, at his own town meeting. When he refuted the questioner’s view and was asked what is really proposed, he did not answer, except to say, essentially: “I had a grandma, too, and I felt sad when we watched her dying. I would never pull the plug on grandma.”


But would he ration health care?


Dr. Ezekiel Emanuel, brother of Rahm who is the president’s chief-of-staff, and a medical ethicist, is advising the Mr. Obama on health care matters, and has been writing about rationing.


He wrote an article that included the concept of rationing based on a person’s likely contribution to society. In another, he suggested that, in a situation of scarcity of a medical product or service, physicians should use a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance of receiving treatment.”


He is apparently not in favor of euthanasia, as he has been accused. He says it would not be necessary if we didn’t waste so much money on futile care.


Then there’s the issue of physicians being paid to counsel people on end of life issues. As a nurse interested in preventing needless suffering among the seriously ill, I am in favor of this, if it is billed as a voluntary counseling session. We don’t get enough counseling from physicians now. Many people are receiving painful treatments that they would not choose if they knew the expected outcome.


In my view, this should be an educated choice, not a rationing mandate. Education and physician courage in declining to provide futile care would make a huge difference in health care expenditures, empower people, and decrease suffering. But, in America, it must be voluntary.


This whole thing highlights the importance of another campaign promise – that of transparency in government. Now that people have arisen from in front of their televisions to involve themselves in government, that is what we should demand.


We are all arguing about bills that very few people have even read, including the legislators negotiating them. There should never be a bill too complicated – or too long – for everyone, from those voting for it to the “common” man, to understand it perfectly. As things stand, we have no idea exactly what our representatives are doing.  Thus, there is no accountability. This needs to change now.


I am no fan of shouting or incivility, but I am delighted that America is off the couch. If we’ve learned nothing else in the past few years, we’ve learned that we need to carefully observe and participate in our government. If we want freedom, we’ll have to accept the responsibility.


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