Useless Eaters

While Americans worry over government insurance plans, longer waits for treatment, and "healthcare rationing," a more sinister agenda lurks in the shadows of the healthcare bill now before the House of Representatives.  Today's Medicare recipients could be the first to experience our government's new solution to America's "useless eaters."

Section 1233 of HR 3200, the healthcare reform measure under consideration, mandates "Advance Care Planning Consultation."  Under the proposal, all senior citizens receiving government medical care would be required to undergo these counseling sessions every five years.  Further reading of the law reveals that these sessions are nothing more than a not-so-veiled attempt to convince the elderly to forego treatment.  HR 3200 calls outright for these compulsory consultations to recommend "palliative care and hospice."  These are typically administered in the place of treatment intended to prolong life, and instead focus on pain relief until death.  These are, of course, reasonable and beneficial options for terminally ill patients and their families.

But this legislation doesn't stop there.  Section 1233 requires "an explanation by the practitioner of the continuum of end-of-life services and supports available, including palliative care and hospice, and benefits for such services and supports that are available under this title." But, under the terms of the section, the federal government can compel more frequent end-of-life sessions if it declares a "significant change" in the health of the Medicare recipient, a change that the bill does not confine to fatal illness, but which encompasses broad and abstract conditions described as "chronic," "progressive," or "life-limiting."  The bill even empowers physicians to make an "actionable medical order" to "limit some or all specified interventions..."  In effect, the government can determine that a "life-limiting" condition demands the withholding of treatment.

The bill puts the Secretary of Health in charge of life and death decisions coming out of these sessions.  Under the heading,  "QUALITY REPORTING INITIATIVE," the bill says, "For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment."

These measures are merely an extension of the healthcare provisions hidden in the stimulus bill, which contained alarming new guidelines that required medical practitioners to judge whether or not treating certain patients was "comparatively effective."  These decisions were to be based on the findings of a presidential advisory council on the costs of varying treatments.  As a result of these changes, treatment is now a question of "cost" and humans are viewed as potential "liabilities" instead of patients.  

Doctors up in arms over these radical changes have been attacked with the worst kind of demagoguery imaginable.  Rep. Jim McDermott (D-WA) lacks any shame, saying that doctors who oppose this legislation have "lost sight of the common good and the pledge they took in the Hippocratic oath."  Last time I checked, the Hippocratic oath didn't say anything about refusing to treat patients on the basis of cost.  And somehow, whenever the words "common good" are thrown around, individuals are about to be hurt.  McDermott even went on to accuse anti-reform doctors of "practicing fear without a license," saying that "they should be subject to a malpractice suit." 

President Obama has even been so disingenuous as to accuse Republicans of denying medical treatment to people that need it, saying, "The opponents of health insurance reform would have us do nothing. But think about what doing nothing, in the face of ever increasing costs, will do to you and your family."  This is a classic false choice scenario.  Either we pass Obama's legislation, or people will die.   In fact, doing nothing is infinitely preferable to doing the wrong thing, especially when we're being pushed to move too quickly.

It was the same with the stimulus package.  And we all know how that turned out: 9.4 percent unemployment and a budget deficit four times larger than when President Bush was in office.  Obama has become a master at using false urgency to achieve hidden goals completely unrelated to the issue at hand.

The real concern is not the imaginary people who might die without this legislation, but rather those real people who might die because of it.  Never before have we been this close to making federal law that formalizes procedures for limiting the care we will provide to certain categories of citizens.

Never before have we been this close to adopting a system that will tell certain citizens to forego treatment for the good of their country.

Totalitarian regimes approach matters of human worth in this way.  But this is America, and our Constitution says that, "No person shall be deprived of life, liberty, or property without due process." 

But if HR 3200 becomes law, "due process" regarding someone's life will become a question for bureaucrats.  When all is said and done, the ultimate result of the proposed bill is to transfer to government the unprecedented power of determining who lives and who dies. 

Once a government adopts this utilitarian stance toward human life, anything becomes possible.  Suspend for a moment your jaded response to Hitler references, and note that in Germany, Order T4 required physicians to kill 70,273 people[i] "judged incurably sick, by critical medical examination"[ii] or those "unworthy of life."[iii]  5,000 of these victims were children.  The elderly, the mentally infirmed, the deformed, and the racially impure, were put to death by teams of "medical experts."  Thousands were sterilized.  By 1939, 360,000 people had been sterilized to prevent the reproduction of the socially "unfit." 

Although the methods have grown more subtle and the language more libertarian, our attitudes are not so very different in America today.  We casually discuss whether people with certain afflictions merit the costs necessary to keep them alive.  Quality of life trumps sanctity of life in most quarters.  Dr. Jack Kevorkian's assisted suicide methodology, once unthinkable, is now an acceptable topic for polite conversation.

In America, a rising number of parents abort children on the basis of tests indicating imperfections or disorders, the effective slaughter of the mentally ill.  In fact, over 80 percent of fetuses diagnosed with Down syndrome are aborted.  

Once a nation that cherished the right to life, America is now a nation that cherishes the right to death.  50 million dead unborn children testify to this fact.   Prior to the ban in 2003, partial birth abortion-effective infanticide-claimed the lives of 5,000 children every year.  

The language of Obama's healthcare reform bill should be a warning to us.  This is only the first step in a process that spells death to our way of life.  This bill is a test to see what the American people will allow.  If you treasure the elderly and the wisdom of previous generations, if you value human worth and care about equality for all Americans, oppose this bill.

[i] Robert N. Proctor, Racial Hygiene: Medicine under the Nazis, (Harvard 1988), 191.

[ii] Ibid., 177.

[iii] Dr. Robert Jay Lifton, The Nazi Doctors: Medical Killing and the Psychology of Genocide by (
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