the week in review

Yesterday, driving through Seattle’s Eastside, we spotted a minivan with this scrawled across the rear window: “No Government Health Care!” And that’s fairly civil when compared to the general tone that has infected health care reform efforts of late. Extremists have ignited rumors about government- sponsored “death panels” and are showing up at town hall meetings packing heat. People are comparing the government’s efforts to expand health care benefits with Nazism.

The level of confusion and misinformation truly amazes me. For one thing, it’s about forty years too late for no government health care; the government insurance programs Medicare and Medicaid now cover about 1 in 3 Americans. The question is how to manage the unsustainable growth of these programs; Medicare may go bankrupt in the next dozen years without serious intervention.

And we desperately need serious public dialogue on end-of-life care, not sound bites about ‘death panels’. Most of the patients I take care of — and believe me, they’re not all liberals — desire dignity and comfort at the end of life and not the intensive, life-prolonging efforts that are the current default. The latter are incredibly expensive, generally futile, and not very pretty to watch. That’s why you’ll often hear providers describe such efforts as ‘floggings’.

As for Nazi health care, Robert Proctor’s Nazi War on Cancer (Princeton University Press, 2000) describes Hitler’s efforts to provide superior health care in the service of a superior race. If parallels can be drawn to our current situation, I’m not entirely sure how.

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