The health-care shuffle

Public option is a Trojan horse to be concerned about

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Who you gonna believe? Me ... or your lying eyes?

President Barack Obama in effect issued this challenge during a town hall meeting on health-care reform in Portsmouth, N. H. last Tuesday.

In response to a question asking whether he still supports a single-payer system (one in which the government is the sole provider of health-care services, as in Canada), Mr. Obama said:

"I have not said that I was a single-payer supporter because, frankly, we historically had an employer-based system in this country with private insurers, and for us a transition to a system like that I believe would be too disruptive."

But in a speech to the Illinois AFL-CIO on June 30, 2003, Mr. Obama said: "I happen to be a proponent of a single-payer health care program." You can watch a video of his remarks here:

Had the president said: "I used to support a single-payer system, but I changed my mind because ...," more people might give credence to the claims he's making for his health-care reform plan. Instead, he told an outright lie.

So when Mr. Obama says his reform plan will save money, but the Congressional Budget Office says it will cost at least $1 trillion over the next 10 years, people are inclined to believe the CBO.

Senior citizens wonder how $313 billion can be cut from the Medicare program, as President Obama proposes to do, without affecting the quality of the health care they'll receive.

And when Mr. Obama says people who like their private insurance will be able to keep it, but the Lewin Group estimates the "public option" would force 88 million people with private insurance into the government program, people worry.

They should. In a speech April 18, Rep. Jan Schakowsky, a Chicago Democrat allied with the president, described the "public option" as a Trojan horse.

"Next to me was a guy from the insurance company saying 'a public option will put the private insurance industry out of business and lead to single payer,' " Ms. Schakowsky said. "He was right! The man was right!" You can watch the video of her remarks here:

Ms. Schakowsky is content to boil the frog slowly. So too, apparently, is Mr. Obama. "I don't think we're going to be able to eliminate employer coverage immediately," he said at a health-care forum sponsored by the Service Employees International Union in 2007. "There's going to be potentially some transition process."

People who lie about some provisions in the health-care bill will lie about others. So some worry the provision for end-of-life counseling in the House bill is not as innocuous as the president says it is.

"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," former Alaska Gov. Sarah Palin said in a post on Facebook.

Hyperbole? You betcha! But wrong? Maybe not.

Washington Post columnist Charles Lane, a moderate liberal, read section 1233 of the House bill, and concluded:

"The measure would have an interested party -- the government -- recruit doctors to sell the elderly on living wills, hospice care and their associated providers, professions and organizations," Mr. Lane wrote. "You don't have to be a right-wing wacko to question that approach."

In a 1998 article in the New England Journal of Medicine, Ezekiel Emanuel, President Obama's health-care adviser, touted the fiscal benefits of physician-assisted suicide. In January, Dr. Emanuel outlined his "principles of allocation of scarce medical interventions:"

"When implemented, the complete lives system produces a priority curve on which individuals aged between roughly 15 and 40 years get the most substantial chance, whereas the youngest and oldest people get chances that are attenuated," Dr. Emanuel said.

If the "public option" is a Trojan horse for a single-payer system, might not section 1233 be a step toward what would be -- in fact if not in name -- a death panel?

Jack Kelly is a columnist for the Post-Gazette and The (Toledo) Blade ( , 412-263-1476).


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