If you know nothing at all about “end-of-life counseling,” “living wills,” or “advance directives,” then you’re the target audience for Betsy McCaughey, who brings back Sarah Palin’s immortal “death panels” canard in response to the news that Medicare intends to pay doctors for offering such services and for consulting with patients about their medical and palliative preferences.1
Ms. McCaughey, no stranger to distorting the truth, calls Medicare’s plan “dying for dollars” and insists it’s a ploy to simultaneously eliminate inconveniently expensive senior citizens while enriching the greedy hospice industry:
It’s being sold as “death with dignity,” but it’s more like dying for dollars. Seniors are nudged to forego life-sustaining procedures and hospital care to go into hospice. That enriches the booming hospice industry and also frees up dollars for the left’s favored social causes.
It’s the perfect storm of ideology and industry greed, with hospice providers lobbying lawmakers to make end-of-life counseling the standard. And not just once. Hospice advocates want to drill their morbid message into patients’ heads.2 “It has to be a series of recurring conversations over years,” an industry representative insists.
Why are conservatives in favor of profit-seeking businesses until it comes to businesses they don’t like? Suddenly, the profit motive itself ("industry greed"!) becomes suspect:
Imported from Europe, the hospice industry has boomed — and taken a sharp turn from nonprofit to aggressively for-profit. Revenues are up 500 percent since 2000, and the industry is flexing its muscle in state capitols and Washington, DC.
What a surprise, that the hospice industry should make more money as the population ages--who'd have guessed? Ms. McCaughey fails to mention that hospitals—which she prefers over hospice—also make money, often substantial amounts of it, from the care they provide:
Trouble is, some seniors who could survive their illness and go home are pressured into forgoing medical care. Advocates parrot the statistic that 25 percent of Medicare hospital expenditures are for the last year of life. That’s like harping on how often Babe Ruth struck out.
Three-quarters of the time, this care is helping seniors. A major study of 208 California hospitals proves that spending more on Medicare patients leads to substantially higher survival rates. More seniors in these higher-spending hospitals make it home and resume their lives.
Babe Ruth’s strike-out stats (and they are legendary) notwithstanding (because WTF?), end-of-life counseling compels no one to forego medical care; the whole point of such counseling is that it enables individuals to make decisions for themselves, with input from doctors and loved ones, while they are healthy enough and competent enough to do so.
Ms. McCaughey implies that the insidious but disguised purposes of such counseling, and of advance medical directives, are to get people to authorize “Do Not Resuscitate” orders and to ship people off to the nearest hospice, possibly in cattle cars.3 She mentions that New York State passed a law mandating end-of-life counseling in 2010; interestingly, she offers no statistics (or even anecdotal evidence) that the result has been any increase in preventable deaths. Are elderly New Yorkers being terminated against their will or better judgment? Are families in the Empire State colluding with doctors to kill Grandma in order to divvy up her estate before it’s all spent on expensive long-term care? I assume that Ms. McCaughey would offer some evidence of that, if any existed; her failure to do so speaks volumes.4
The reality-challenged Sean Hannity cited Ms. McCaughey’s column on his radio show today; he dismissed hospice care as “nothing but a morphine drip, drip drip drip, that’s how they put you to death.” That much malevolent ignorance (coming from someone other than Donald Trump) is startling, but both Hannity and McCaughey are determined to mislead Americans into thinking that end-of-life counseling—a practice supported by every medical group in the country as well as by the AARP—is the equivalent of enforced euthanasia: “dying for dollars,” indeed. Sadly, even tragically, the demographic reached by such conservative blowhards is precisely the demographic (60 years old and up) that needs to be making the hard choices now about living and dying.
Let’s be fair, then, and allow Betsy McCaughey and Sean Hannity to share today’s “Worst Pundit in the World” award. Really, it couldn't go to two more despicable people.
2 The “morbid message” to which Ms. McCaughey refers amounts merely to acknowledging the simple fact that we’re all going to die someday—and that we ought to be planning for it.
3 She may also believe, for all I know, that signing up as an organ donor authorizes the State to kill you immediately in order to harvest your heart and your kidneys.
4 For a summary of the New York State legislation, go here: http://www.compassionandsupport.org/index.php/legislation
It sure sounds awful, what with stuff like this:
- When a patient is diagnosed with a terminal illness, an attending health care practitioner shall offer to provide the patient with information and counseling on palliative care and end-of-life options appropriate to patient.
- It shall include but not limited to: [providing] the patient with information and counseling on the prognosis, risks and benefits of the various options; and the patient's legal rights to comprehensive pain and symptom management at the end of life.
- Information and counseling can be provided to a person with authority to make health care decisions for the patient if the patient lacks decision making capacity.
Yeah, we’re one short step from death camps, aren’t we?