Two years ago, as Con­gress was engaged in heated debate over the leg­is­la­tion that would even­tu­ally become the Patient Pro­tec­tion and Afford­able Care Act (PPACA, also called, dis­parag­ingly, “Oba­macare”), ex-​​half-​​Governor and failed Vice Pres­i­den­tial can­di­date Sarah Palin weighed in with her view: the leg­is­la­tion would include, in her famous phrase, “death panels”.

Of course, it’s not just this one pro­vi­sion that presents a prob­lem. My orig­i­nal com­ments con­cerned state­ments made by Dr. Ezekiel Emanuel, a health pol­icy advi­sor to Pres­i­dent Obama and the brother of the President’s chief of staff [cur­rent Chicago mayor Rahm Emanuel]. Dr. Emanuel has writ­ten that some med­ical ser­vices should not be guar­an­teed to those ‘who are irre­versibly pre­vented from being or becom­ing par­tic­i­pat­ing citizens…An obvi­ous exam­ple is not guar­an­tee­ing health ser­vices to patients with demen­tia.’ Dr. Emanuel has also advo­cated bas­ing med­ical deci­sions on a sys­tem which ‘pro­duces a pri­or­ity curve on which indi­vid­u­als aged between roughly 15 and 40 years get the most chance, whereas the youngest and old­est peo­ple get chances that are attenuated.’

Unfor­tu­nately, the ensu­ing debate over end-​​of-​​life issues and the financ­ing of health care for all Amer­i­cans was char­ac­ter­ized by an increas­ing amount of heat (“You Lie!”) and very lit­tle light from that point forward.

Was Sarah Palin right? (more…)