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.