Thursday, July 9, 2015

Last Call For Zombie Death Panels

Medicare end-of-life care is back in the news, and that's a good thing.

Six years after end-of-life planning nearly derailed development of the Affordable Care Act amid charges of "death panels," the Obama administration has revived a proposal to reimburse physicians for talking with their Medicare patients about how patients want to be cared for as they near death.

The proposal, contained in a large set of Medicare regulations unveiled Wednesday, comes amid growing public discussion about the need for medical care that better reflects patients’ wishes as they get older.

Expect Republicans to start screaming that Obama wants to murder your grandmother again. Well...maybe not all Republicans...

Two months ago, former Florida Gov. Jeb Bush, one of the front-runners for the Republican presidential nomination in 2016, suggested that Medicare patients should sign so-called advance directives that spell out the care they want if they become incapacitated.

So Jeb Bush is pro-"death panels" huh.  This should be fun.

In all seriousness, as James Joyner points out, palliative care is a legitimate Medicare issue and should be discussed by doctors and their senior patients.

Aside from the cleverness of “death panels” as a mobilizing tool, capitalizing on longstanding American fears about government control of healthcare, I’ve never understood the argument against the practice. Of course physicians ought to discuss with their patients what their end-of-life options are once they become terminally ill or sufficiently advanced in age. And, so long as we maintain a fee-for-service model, of course they ought get paid for it. 
To the extent that government is a prime payer of healthcare expenses—and for those over 65, there’s little controversy over the fact that it is—there is something of a conflict of interest at work, in that care for terminal patients eats up an inordinate percentage of lifetime costs. But it strikes me as absurd that doctors are going to talk their patients into ending their lives prematurely mostly on the basis of cost savings.

Oh, an absurd idea that Republicans aren't going to run with at full throttle?  That would be a first. Because that's exactly the fear Republicans stoked in voters in 2009 and 2010 and they won huge.

Sarah Palin, the former governor of Alaska, urged her supporters to oppose Democratic plans for health care reform on her Facebook page. 
"As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!" wrote Palin in a note posted Aug. 7, 2009. 
She said that the Democrats plan to reduce health care costs by simply refusing to pay for care. 
"And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care. Such a system is downright evil."

It was PolitiFact's Lie of the Year, remember?

Republicans still won 60+ House seats.

I fully expect this Medicare rule change to be quietly pulled once again.  Republicans will keep winning that PR battle until the end of time.

Not Feeling The Bern

I've said this before and I'll say it again:  Bernie Sanders will not get my vote if he continues to attack President Obama's policies and his administration (Warning, Daily Caller story).

Vermont U.S. Sen. Bernie Sanders undermined a key Obama administration talking point Monday when he said the actual unemployment rate in the U.S. is double what the federal government claims. 
“When you talk about the economy we also have to have an honest assessment of unemployment in America,” Sanders told a crowd of 7,500 gathered at a presidential campaign rally in Portland, Maine. 
“Once a month the government publishes a set of figures, and the last figures they published said that official unemployment was 5.4 percent,” the Democratic nominee continued, slightly misstating the Labor Department’s most recent report which put June’s unemployment rate at 5.3 percent. 
But there is another set of government statistics,” Sanders continued, “and that that real unemployment if you include those people who have given up looking for work and the millions of others who are working part-time 20, 25 hours a week when they want to work full-time, when you all of that together, real unemployment is 10.5 percent.

Wow.  Straight out of the GOP playbook.  Obama is lying to you about unemployment!  Reeeeeeeeal unemployment is in double digits!  Wake up, sheeple!

Dear Bernie Sanders:  you will never raise yourself up as a Democrat by trying to bring Barack Obama down.  This is the kind of glibertarian nonsense I expect from Rand Paul or Jeb Bush.  If Bernie Sanders is using it too (and it turns out he's been using that "real unemployment" right-wing talking point for a while now) then I have yet another problem with the Sanders campaign.

The Freedom To Discriminate

Republican lawmakers are gearing up their response to the Supreme Court's same-sex marriage ruling: a federal law that would effectively eliminate punishment for discriminating against same-sex marriage.

U.S. Representative Steve Scalise, the chief Republican vote-counter in the House, has signed-on as a co-sponsor of legislation described as an effort to protect people opposed to gay marriage from being penalized by the government.

The Louisianan, who as majority whip ranks No. 3 in the his party's leadership ranks, after Speaker John Boehner and Majority Leader Kevin McCarthy, added his name Tuesday to the bill dubbed the "First Amendment Defense Act." The two Republican lawmakers who wrote the bill, Representative Raul Labrador of Idaho and Senator Mike Lee of Utah have cast it as a way to clarify and strengthen religious liberty protections in federal law, "by safeguarding those individuals and institutions who promote traditional marriage from government retaliation."

The Senate version, S. 1598, has 24 co-sponsors, including Republican presidential aspirants Marco Rubio of Florida, Ted Cruz of Texas, and Lindsey Graham of South Carolina. Scalise is among 20 House Republicans who have become new co-sponsors of the bill since the Supreme Court's ruling last month legalizing same-sex marriage—bringing the total to 87.

In statement his office provided Wednesday to Bloomberg News on his decision to co-sponsor the bill, Scalise alluded to the high court's decision.

"Religious freedom is a fundamental right established in the Constitution. Especially in the wake of the Supreme Court’s recent judicial activism, defending religious liberty has become an even more pressing priority," said Scalise.

Scalise added the First Amendment Defense Act "helps ensure that Americans are not punished or discriminated against for exercising their constitutionally-protected religious beliefs.”

The measure, introduced in the House on June 17, nine days before the Supreme Court's ruling on same-sex marriage, has been referred to the committees on Ways and Means and Oversight and Government Reform. It is unclear if the bill has any chance to advance. But Scalise's co-sponsorship gives it an imprint of some House Republican leadership backing.

So the game plan is clear: sure, you can get married, but if Republicans have their way in November 2016, expect legislation that would allow all kinds of open discrimination against same-sex couples in the name of "religious freedom".  Hell, it might allow all kinds of discrimination, period.  Who draws the line and says that a person's beliefs that black people are inferior aren't worthy of protection under this legislation?  This is Indiana's comically bad law all over again. and Republicans know it.

But that's the point: nearly two-thirds of Republicans remain against same-sex marriage at all.  It's bigots like this who will decide the Republican nominee, and this nominee will almost certainly be willing to sign this legislation into law.

Republicans remain the party of legalized discrimination. That's their platform in 2016.


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