Some commentators are indignant over the charge that "the public option", and, indeed, the bulk of the ideas loosely aggregated in the House and Senate as "health reform", would lead to rationing. It infuriates them also that the bill is criticized for end-of-life counseling for senior citizens. After all, the provision--still in the bill in several of its forms--would be "voluntary."
Our senior fellow, Wesley J. Smith, repeatedly has explained how "voluntary" in law can get translated into "mandatory" over time in the tender care of government bureaucrats writing implementing regulations. Anyone who has read C. S. Lewis' idea novel, That Hideous Strength, remembers the lovely-sounding government organization, "N.I.C.E.", the National Institute for Coordinated Experiments, that takes the therapeutic approach into the realms of compulsion and, finally, catastrophic evil.
What protestors to ObamaCare know at some level, whether they are articulate it or not, is that many older people already feel useless and unwanted. Some are clinically depressed. It doesn't take much to appeal to their self-sacrificing instincts and to elicit the sentiment, "I don't want to be a burden." Working with that concern, and also with the concurrent fear of pain, it isn't hard to get old people to sign documents that will shorten their lifespan when "the burden" becomes too great. In prospect, it seems the responsible thing to do.
We all face the end-of-life treatment choices, either because of someone we love, or, ourselves. Families, doctors, hospitals all do the best they can and situations vary. But when the government is involved and has built-in cost-cutting incentives, there is a tremendous incentive to warp the decision-making process and make it a financial triage issue. That is what President Obama was hinting at in several of the comments he has made in the past about end-of-life care. He thinks that the government cannot afford to take care of all the old and terminally ill and still give full care to the young and fit.
As I say, this subject is tough enough when it really is about voluntary decisions. But when one of the decision-makers--the one that writes the checks--is in the room and has another interest--a financial one--the whole story of life in all its gritty reality becomes a horror movie.
Smith is having a major influence on this topic. Civil liberties activist Nat Hentoff writes of it in the Jewish World Review. I myself encountered it in discussion with a Catholic priest last weekend at a christening. The word is getting out.
Congress and the White House should not imagine that the public outcry is manufactured by right wing groups, let alone the Republican Party. The blunt truth is that the Republican Party usually can't get 30 people out to attend its meetings. Right wing non-profit groups are great at riding a wave created by someone else. Likewise, talk radio.
No. The wave is being generated by ordinary people who are terrified that one of the most private parts of their lives, and one of the most important, is going to be invaded and controlled by the federal government. They don't think that the government, however benign it claims to be (and maybe especially when it claims to be benign), can be trusted. Not to really control costs without serious rationing. Not to keep new equipment and treatments coming. Not to handle patients with even the modest bedside manner provided under the current system. In fact, nothing has made the present system look better than the government's attempt to take it over.
It seems that the past weekend's hope that the Obama Administration was going to drop the public option (the nationalization option) was in vain. The struggle for public support goes on.
