Palin revives “death panel” claim

Sarah Palin, sports anchor, 1988. You actually don’t need to put siding on the inside of the building.

Remember when Sarah Palin—fresh from her stint as the thing that proved John McCain was no longer reasonable—said that the Affordable Care Act would create “death panels”? That’s a service she provides. When the country can’t decide how it feels about an important piece of legislation, Palin is there to give us a false understanding of what it does. Her claim that faceless government bureaucrats would decide whether Grandma’s blood thinner is worth it was Politifact’s 2009 Lie of the Year. Pretty much everyone agrees that it exemplified the worst of contemporary politics, which makes it odd that she brought it up yesterday. Just in time for the Supreme Court’s ruling on Obamacare, Palin says her infamous lie was true all along.

Here’s the full Facebook post. I am almost to the point where it does not blow my mind that the preferred communications medium of a former candidate for the vice presidency is Facebook, but I’m not quite there yet. On her goddamned wall or whatever, Palin explains that although several professional journalists pointed out she was lying in 2009 and cited the text of the law to prove it, what she said was in fact true:

Though I was called a liar for calling it like it is, many of these accusers finally saw that Obamacare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about health care funding. It’s called the Independent Payment Advisory Board (IPAB), and its purpose all along has been to “keep costs down” by actually denying care via price controls and typically inefficient bureaucracy.

Years from now, when we are programming robots to detect when a person is lying, we will teach them to look for the word “many.” Palin claims that “many” of her former critics now realize that she was telling the truth, but she does not name one. That is probably because there aren’t any. It appears that the imaginary response of her imaginarily contrite “accusers” is a rhetorical device to get us to her real argument, which is that the Independent Payment Advisory Board is what she was talking about all along.

That is also a lie. In 2009, her death panel claim cited section 123 of HR 3200, which would have made end-of-life counseling available through Medicare. The section was ultimately removed from the Affordable Care Act, and in 2010 Palin switched her “death panel” to the Medicare Advisory Board. As of yesterday, however, the thing Palin was talking about in 2009 is the Independent Payment Advisory Board.

It so happens that the IPAB is described in detail in this essay from the New England Journal of Medicine. The board is required to submit detailed reports regarding actual and projected growth in health care costs, and it also suggests ways to reduce those costs. There’s a lot of stuff about actuaries, and then we get to the money shot:

The effects of the IPAB’s proposals, however, may not be to “ration health care,” raise costs to beneficiaries, restrict benefits, or modify eligibility criteria. Proposals may not, before 2020, target the rates of particular providers—primarily hospitals and hospices—that are already singled out by the ACA for extraordinary cuts.

Even after the IPAB submits its draconian recommendations re: Down Syndrome babies, its proposals must be approved by Congress. So even though it cannot make decisions about individual patients, change who is eligible for care or determine what benefits Medicare covers—and even though it can only recommend policies to Congress—the IPAB proves Palin was right about death panels all along. Or she is lying. Take your pick based on the evidence at hand.

Chances are no one reading this blog post though Sarah Palin was an honest person before the first paragraph anyway. The question is, what to do about her? Arguably, her sociopathic adherence to the death panel lie is only damaging because people keep covering her. Yet Palin is a medium unto herself, as her insistence on using Facebook to communicate directly to her followers suggests. Her false statements about what federal legislation does are going to reach people no matter how much we ignore them.

As far as prevention goes, the monkey with virulent TB is already out of the lab. At this point, correction seems to be our only option. Please, when your aunt or whatever reposts Palin’s re-lie about death panels, link to the NEJM article. Pull the quote about how the IPAB can’t ration care, increase costs or determine patient eligibility. It cannot decide who lives or dies. Only a bunch of voters who have been fed false information by a beauty queen turned politician can do that.

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  1. The problem of Sarah Palin will be resolved when she gains ten or twenty pounds. Because that’s America.

    The “faceless bureaucrats” making life and death decisions about health care? Health insurance company underwriters. Because that’s America, too.

  2. Your post mentions that the IPAB can’t make decisions about individual patients … and that is an example of the problem you have when you let government have total control over health care. The decision-makers will be presented with “averaged” guidelines from the IPAB, which means that if your needs are outside the “average” and the decision-makers have to allocate scarce resources, tough luck.

    There’s your IPAB, operating as a de facto “death panel” … every bit as impersonal as private-sector insurance, except you won’t be able to work around their decision at all once the system degenerates/is pushed into single-payer.

    Sarah Palin isn’t lying … not at all.

    Cash payment for care … charitable care … all will be subject to the decisions of your government, with no other recourse. Do you really want to trade away your ability to work around your insurer to obtain care, just so you don’t have to worry about obtaining it through your own initiative?

    Look past the accusations of private-sector “greed”, and look past what the law says today … look to where it can go as we have seen Social Security, Medicare, Medicaid and other government programs.

  3. @Rich, I appreciate your attention to likely implications of legislation. I agree we should consider such things. But I don’t think I agree with your interpretation of likely implications.

    Am I right that you think presently people have the freedom to “work around your insurer” by paying cash out-of-pocket for a service if the averages that private firm establishes don’t benefit you?

    If I am, I would respond by saying I don’t think that is much of a freedom, and I don’t think it at all likely that health legislation would evolve to the point that individuals couldn’t pay cash as an alternative to government-sponsored care. Wealthy people pay cash for greater benefits than provided by Medicare all of the time. How is that an example of your fear?

  4. “Sarah Palin isn’t lying … not at all.”

    Except that she is, quite obviously, lying. She is lying about the current system, whereas you, Rich Casebolt, are referring to a system that does not exist, but which you imagine might some day exist “once the system degenerates/is pushed into single-payer.” If your argument is that Palin isn’t lying because her lies about the current system might come true if the current system eventually gives way to another system, then I have to think you are starting with a conclusion and then circling back to find a justification.

    She’s totally lying. Or, if we want to be generous, she was simply wrong before, and is now lying when she says she wasn’t wrong.

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