Wednesday, August 5, 2009


By Robert Harkins J.D.

What shall we do with our parents who have sacrificed to give us life, love, care, an education and a good home? We may recall our parents’ tough love when as teenagers we did not think our parents knew much at all. The teenagers of my generation would occasionally refer to their parents as “The Squares.” Of course we would not dare say this to their face. However, like Mark Twain, as we entered our twenties, we could not believe how smart our parents had become in just a few years.

I remember my parents when they were in their prime. My mother Blanche was beautiful; she laughed a lot, loved her man, my dad, and kept an immaculate home. On weekends, she would bake bread in an iron cream-colored enameled stove with curled Victorian legs. Mom used a dictionary to increase our vocabulary. My brothers, sister and I, starting with the letter A, were forced weekly to write down and learn the meaning of six new words. I still remember writing, and then again, writing, “Habitation, Habituate, Habiliment, etc. We wondered then, with a child’s sense of unbearable injustice what on earth our mother had in mind by her intentional diminution of our natural, God-given freedoms. Well, we never asked. And now with gratitude we know and understand.

My father, Robert Sr. fought in World War II, worked for the New Haven and Hartford Railroad for thirty-five year and was hopelessly in love with my mother Blanche. He liked to strum his dad’s favorite song Daisy, Daisy on his banjo; and sometimes when the mood took them up, Mom and Dad would pull back the living room rug, put a record on the phonograph and dance the jitterbug. My but they were impressive when they boogied.

Mom passed quickly when we were still young. Afterwards, Dad weakened over time. We lived with him, saw him work hard, grow old and at last die. The Navy draped his casket in a flag; I have it still. At the funeral an Asian friend who is Buddhist explained the measure of Buddhist gratitude children owe their parents. The Buddha taught that the moral debt of gratitude is so great that it could not be paid even if we were to carry our parents forever on our shoulders. It is also true to say that our debt of gratitude, written with exquisite, biblical simplicity, is to honor our father and mother. It’s time now to ask what will be the measure of our national gratitude?

What then is to be done? President O’bama and his Congress have promised that under the new health care plan, (the Plan); the care of parents will not be rationed or compromised. They assure us that the government will not intervene in the medical care decisions of patient and doctor. They promise that theories of rationing based on Cost Effectiveness and Quality of Life will never be used to evaluate or ration the care of elderly men and women.

Under Cost Effectiveness and Quality of Life rationing, a calculus used in Europe, the government takes unto itself the power to deny critical medical care to the elderly. The theory is that if one counts the number of years that an elderly man or woman has lived, one may conclude by the numbers that they have so used up the better part of their life that they are not worth the cost of further care. While the terms Cost Effectiveness and Quality of Life resonate with scientific and economic gravitas; in fact, they are lifeless, bureaucratic euphemisms calculated to masque a brutal and dictatorial euthanasia, (a Greek word meaning a “good death”). We now face a bizarre challenge. It is that however many questions we ask of the President and Congress so as to understand the impact of the Plan on the elderly, the President and his Congress, quite shockingly, pitch us falsehoods.

The truth is that health care systems throughout the world have reached the point where they deny care to the elderly on theories of cost effectiveness and quality of life.

“In Britain, for example, medical care officials determine who can and cannot receive certain expensive treatments, based on the official’s judgment or on formulas or guidelines about how much quality of life is likely to be achieved and for how many years. Thus an eighty-year--old-man is unlikely to be approved for receiving a heart transplant.” [1]

Presently before Congress is a bill to create a new Center for Health Outcomes Research and Evaluation. Notwithstanding the President’s promise that the elderly will not be compelled to submit to Cost Effectiveness and Quality of Life evaluations Congress has vested in the Center the power to ration access to medicines and treatments based on the government’s assessment of the value of a human life and the cost-effectiveness of treatment.

Senator Mike Enzi (R., Wyo.) introduced an amendment designed to prohibit the Center’s use of quality of life and cost-effectiveness measures for the denial of Medicare benefits to patients against their wishes. I am certain that someone told the President that Democrats rejected the amendment in a party-line vote. The new bureaucratic entity will have the power, to repeal the will of patient and doctor; to impose restrictions on access to treatment, as is common in European countries with socialized medicine. Elderly, disabled, and medically dependent patients would be at greatest risk of being denied necessary care.[2]

If the Quality of Life and Cost Effectiveness theory of medical review should become law, there will come a time when a bureaucrat whose primary mandate is cost effectiveness, will have the power to declare void a doctor’s treatment plan and in the interests of fiscal responsibility, urge the doctor’s elderly patient to do the right thing and get out of the way.

Pursuant to the Plan, Congress intends to transfer billions dollars from Medicare, billions primarily directed to care of the elderly. The money will then be used to treat 47 million new Plan members. The new members include the very young who because of their youth choose not to be insured, and people who, while financially able to buy a private health insurance policy, choose to spend that money elsewhere. Finally, Congress will use the billions stripped from Medicare to treat millions of people, who will not contribute financially to the Plan, and unknown millions who are not citizens of the United States.

The President and Congress who, after all, are responsible for the administration of Medicare have recklessly incurred 61.6 trillion in unfunded liabilities, that is, 61.6 trillion in treatment obligations for which Congress cannot pay. Moreover, the President and Congress, over the course of the last decade, have shown themselves powerless to prevent theft and outright fraud that every year strips billions of dollars from Medicare and Medicaid funds. It is this nearly bankrupt Medicare that the President and Congress will raid to finance a national health care plan. Indeed, it is this same nearly bankrupt Medicare that the President and Congress hold up to Americans as a model for their national health care.

Finally, the President and his Congress cannot create doctors out of thin air.

Where then,” will President Obama find the doctors to treat 47 million new people?.... More, all the bills come up with cash to cover their huge costs by ordering cuts in Medicare….

Basically, the government will be paying doctors and providers even less to treat the elderly -- at a time when countless doctors are starting to refuse new Medicare patients…. For the elderly, it means less care, period. A federal health board will sit in judgment of medical procedures and protocols and impose guidelines on all providers for when to withhold certain kinds of care. Emphasis added.[3]

The President and Congress have promised that the elderly will see no decline whatever in the quality of health care services. But how can they say such a thing in light of the experience of other countries. Let’s look at other national health care plans.[4]

“A study by the Organization for Economic Co-operation and Development found that 23 percent of the patients having elective surgery in 2001 in Australia waited more than 4 months for that surgery. So did 26 percent of the patients in New Zealand, 27 percent of patients in Canada, and 38 percent of the patients in Britain. In the United States, only 5 percent of patients had to wait that long.”[5]

“In Canada, according to a provincial government website, 90 percent of Ontario’s patients needing hip replacements waited 336 days. In Britain, the wait is a year.”[6]

“Excessive prescriptions were reported as ‘routine’ under China’s government-provided medical care and patents there 'leave the dispensary with bags rather than bottles, full of pills.’ China has subsequently moved away from government-provided medical care”

The President and Congress promise that parents will continue to receive the same care or better care than they are presently receiving. However, national health care plans do not by their very nature maintain quality.

People can die from conditions that were initially not very serious, but which grow progressively worse while they are on waiting lists, to receive medical care. A celebrated example in Britain involved a woman whose cancer surgery was repeatedly postponed until it had to be cancelled, because the cancer had become inoperable in the course of all the delays. To call this quality deterioration is, if anything, an understatement.”[7]

“British hospitals not only lack technological advanced medical equipment that is more common in the United states, for example, but lack even elementary cleanliness, leading to deaths by infection for patients whose maladies before entering hospital care are not life-threatening.”

By the way on Monday, August 3, 2009 Breitbart Video posted some old videos of President O’Bama taken years before the election. There he pledged to constrain national health care to a Single Payer system. He also assured his audience that government control of private health plans would ultimately assure their extinction. Isn’t this the same president who told us that if we liked our private plan we could keep it?

The President’s national health care plan transcends the idea of universal access to health care. It is also an ideological screed bent on the imposition of a dictate repugnant to Americans. We hold our parents sacred. Nothing more than this need be said: We will not tolerate the counting of their years and in the counting be told by government that our parents have used up their life, that in the service of cost effectiveness they are disposable.

What do you think?

[1] Tomas Sowell, Applied Economics, Thinking Beyond State One, (Basic Books, 2009). P. 56

[2] Sam Brownback, Don’t Punish Seniors for Health-Care Reform. (NRO.August 3, 2009).


[5] Ibid. P. 58.

[6] Ibid. P. 59.

[7] Sowell. P.61

1 comment:

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