Their political antennae raised high and buzzing on alert, White House officials have moved to junk a health reform rule, written in the less politically savvy offices at HHS, that would have paid doctors to discuss end-of-life options with patients.
The provision had been stripped out of the health care bill as it made its way through Congress amid an outcry that it could lead to rationing of health care for the aged – that is, de facto death panels.
The rule, a creature created in the laboratory of Medicare chief Dr. Donald Berwick, was an egregious attempt by unelected government bureaucrats to sneak a major provision into the bill that was explicitly NOT INCLUDED by the democratically elected legislature. Sneaky, sneaky, sneaky.
This is exactly what Republicans are talking about when they rue the expansion of government. One officious satrap, the esteemed Dr. Berwick, who KNOWS WHAT’S BEST, decided to substitute
THE WILL OF THE PEOPLE with THE WILL OF DR. BERWICK.
Not only did the provision circumvent the intent of Congress, it wasn’t even included in the proposed federal rulemaking process for the law, which would have allowed people to comment on it.
IT WAS SIMPLY PROMULGATED WITHIN THE FINAL RULE BY DR. BERWICK, because he KNOWS WHAT’S BEST.
Would you tolerate this type of sneakiness from your five year old?
In the New York Times article on the change, which I’ve linked to above, reporter Robert Pear sympathetically calls this a “mix-up” and subtly suggests opponents of the provision are uniformed zealots. It’s clear the White House chose to leak the story to someone they felt they could trust to handle it right. Pear writes,
The renewed debate over advance care planning threatened to become a distraction to administration officials who were gearing up to defend the health law against attack by the new Republican majority in the House.
This is much more than a mix up and a distraction. It’s a recognition of a huge mistake, an acknowledgment that the public doesn’t want this provision and that its inclusion could undermine the law by stoking even greater opposition to it. It’s a tactical retreat until such time as the White House feels it can put the measure back in.
Pear writes that the people who understand these things believed it was a good idea.
Many doctors and providers of hospice care had praised the regulation.
Well, yeah, this would pretty good for business over at the local hospice.
No one believes it’s not smart to start planning early for what we all might face. The concern here is that getting the government into it, given the tremendous new powers the government will have under the new law, provides an avenue for bean counters to begin pressuring for less expensive options.
And the least expensive option is to drop dead.
Dr. Berwick, a leading proponent of health care rationing and an infatuee of the British health care system, presumably has lots more legislating to do as he continues to write the regulations for the health care bill.
Remember, this is what’s going on ABOVE the radar. God only knows what’s doing below it.