If one reads Drudge, it sounds like things are getting nasty in the US about the push to quickly pass an unread Health Care bill before Fall.

Well, at least I finally found a copy of the bill on line, all 1000 plus pages of it, full of bureaucratic gobbledygook and corrections, via a blog on First Things, which points out that we seniors will indeed be mandated to receive “end of life” counseling by someone or other, and Smith points out the dangers of such vague language in the bill.

Discussing end of life care is something most of us docs do anyway, but this sounds like it makes such discussions a legal requirement, and it requires docs (and Nurse practitioners) to discuss “all” end of life options. Sounds benign, until you recognize that if one lives in a state with assisted suicide, that mandates doctors under law to tell people: “oh yes, and you have the right to off yourself if you think you are a burden”.

Never mind. I’m safe here in the Philippines, and unless I go to Manila, they aren’t too aggressive at end of life care. Indeed, as the death of Cory Aquino shows, usually you end up in the hospital so you can get decent pain relief during the dying process (in the USA, our hospice nurses and Home Health Care would have probably allowed her to die at home with her family).

But in the US, whether or not one should die at home when your time comes, or “rage against the dying of the light” in ICU is an intensely personal matter, and the idea of having a government mixed up in a decision that is none of their business (especially if some decisions are better for the bean counters) is something a lot of people instinctively reject.

But the reports of raucous town hall meetings, being stoked by right wing talk radio on one hand and the president’s progressive backers doesn’t sound helpful to democracy at all. There is a lot of panic and concern out there, but it is one thing for the Dittoheads to go to their townhalls to protest, and quite another thing for the White House to ask that protesters be reported to a federally funded site.

There is a lot of disinformation about health insurance reform out there, spanning from control of personal finances to end of life care.  These rumors often travel just below the surface via chain emails or through casual conversation.  Since we can’t keep track of all of them here at the White House, we’re asking for your help. If you get an email or see something on the web about health insurance reform that seems fishy, send it to flag@whitehouse.gov.

Hmm…notice that part about “disinformation” about “end of life care”? When I posted on that I was called a liar. Yet anyone who has bothered to read papers from “think tanks” on bioethics knows that limiting “end of life” care is one of the major themes, and has been for at least twenty years.

Nor are the elderly the only one worried about this: Not Dead Yet (a human rights organization organized by the disabled)  is worried too. They don’t quote Rushbo or Beck, but Forbes magazine (a magazine written by evil capitalists duh).

Marilyn Golden, of the Disability Rights Education and Defense Fund in Berkeley, Calif., has been active in opposing physician-assisted suicide at the state level. Many disabled people worry legalizing suicide would lead to euthanasia.

Golden points out that many doctors, when counseling patients, push for do-not-resuscitate orders or have them sign boilerplate documents that can lead to the premature denial of lifesaving medical care. “I don’t want to say we’re opposed to the language in the bill,” she says. “But there are legitimate concerns about how advanced directives are administered.”

“There is reason to be concerned,” says Diane Coleman, of Not Dead Yet, a group in Rochester, N.Y., that opposes physician-assisted suicide and what it calls medical killing. “The disability community,” she says, “often experiences pressure to sign treatment-withholding orders.”

It’s not just the handicapped: Most upper and middle class white folks already have health care proxies or living wills, but minorities don’t. I worked with Native Americans, who often did not opt for extraordinary care, but simply did not trust the (mainly white) medical community enough to sign a paper to say so.

We stopped pushing such discussions after one of our healthy nursing home ladies who did have a living will aspirated food while eating in the cafeteria. The ER doctor (from an outside organization) saw her “DNR” order and left her die, yet a quick transfer and bronchoscopy might have saved her life.

But end of life care is not the only worry in the Health care bill. The abortion issue is another one, and one that has gotten almost no publicity.

So add to those worrying about the bill the US Catholic bishops:

In a letter to members of the House Energy and Commerce Committee, which is working on the bill, Cardinal Justin Rigali, chairman of the bishops’ Committee on Pro-Life Activities, detailed several abortion-related objections to the bill.

Under the bill, the bishops’ letter says, some federal funds would not be covered by the Hyde Amendment, which has prevented direct federal funding of abortion for three decades. The bishops also contend that some provisions could be used by courts to invalidate state laws restricting abortion, such as parental-notification requirements. They also warn that the legislation must maintain federal protection for conscience rights, which has long shielded Catholic health-care workers who decline to provide abortion services.

But it doesn’t sound like the Bishops are going to have their voices heard on the hill.

According to the New Orlean’s Time Picayune, Henry Waxman used a parliamentary maneuver last Thursday night to overcome opposition by both Republicans and “Blue Dog” Democrats to have government health insurance fund abortions. And some Democratic congressmen are not happy about the trick.

…(Congressman) Melancon said. “As someone who is personally pro-life and represents a deeply pro-life constituency, I am also concerned that this bill does not do enough to ensure taxpayer dollars do not fund abortion.”

So there you have it.

We have a government trying to promote a good thing, but a lot of folks just don’t trust the government, and those worrying include many, like the bishops, who ordinarily would support the bill.

Here in the Philippines, we don’t get Fox news, Rush Limbaugh, or Glenn Beck.

But we do get EWTN, an independent Catholic network, and many guests discussing the bill on various shows there are worried about the cost cutting philosophy and stealth agendas in the bill too.

Father Mitch Pacwa writes:

Already Speaker Nancy Pelosi has proposed three hundred million dollars for condoms as a part of this congress’ first stimulus bill – a rather odd idea for a bill focused on stimulating the economy. However, her reason was to prevent births as a money saver for the states. That is one of the ways she sees the birth of children. There will be many more proposals for taxpayer funding of abortions and euthanasia, since early infancy and end of life are the most expensive periods in regard to health care. The proposed health care bill in the House of Representatives will require the elderly to consult with their doctors every five years about alternatives to long term care. The doctors may be required to inform the elderly about assisted suicide, or at least the need to refrain from long term, expensive procedures. “Grandma may just need to take a pain pill,” President Obama told us in a town meeting recently.

So, some of us who have worked with the poor and support a form of universal health care continue to worry about the hidden moral implications of the bill.

Again, from the Times Picayune:

“At the end of the day if the health care reform bill does not have strong language prohibiting the use of federal funding for abortion, then the bill is really a no-go for me,” said (Rep Joseph) Cao (R LA), who studied to be a Jesuit priest.

“Being a Jesuit, I very much adhere to the notion of social justice,” Cao said. “I do fully understand the need of providing everyone with access to health care, but to me personally, I cannot be privy to a law that will allow the potential of destroying thousands of innocent lives.

So the line in the sand is being drawn not only by political operatives, but by those who ordinarily would support the bill, but worry about it’s open inclusion of policies that impose what Pope John II called the culture of death.

Finally, no matter how much one supports or opposes universal health care, one has to worry about the degeneration of political discourse on both sides.


thanks for the “headsup” from GetReligion Blogspot, which noticed the lack of news coverage of the religious objections to the Health Care Bill.


Nancy Reyes is a retired physician living in the rural Philippines. She writes medical essays at HeyDoc Xanga blog.


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