The Promise of ObamaCare: Hospice for the Healthy

I find it sadly illustrative of the liberal state of mind that liberals would see the death penalty forever banned for fear that one innocent person be executed, yet they enthusiastically support the concept of euthanasia, where there is a proven likelihood that a great number of people will die prematurely, and even unnecessarily.

In Great Britain, where the medicine has been administered by the government for nearly three-quarters of a century, a pattern has emerged that should be troubling to even the most deadened senses of decency.  A recent audit by the Royal College of Physicians has revealed that in one hospital group alone, more than 50% of the patients who were put on a palliative care protocol known as the "Liverpool Care Pathway" (LCP) have had those decisions made solely by the attending physicians, without consult or notification of the patients family.  In another group of hospitals, only 1 in 3 were informed of the life-ending decision.

The LCP is intended to provide terminally ill patients (in their final days) with a dignified death, free of unnecessary medical intrusion from hospital staff.  In practice, however, it is becoming a greased slide to an economical exit, hastened along by the removal of nutrition, hydration, and all medications, except for heavy sedation which serves to mask the ugliest of the effects.  This is not hospice care as we know it in America, where efforts are made to ease the natural transition to the end of life.  The LCP is a protocol to end the life of a patient -- to hasten that moment -- in the interest of economy.

The LCP is growing in popularity with cash-strapped National Health Service hospitals, nearly doubling in use in just the last two years alone.  While end-of-life care can be controversial in any system of medicine, such controversy becomes unreasonable in a socialized model, owing to the natural opposition between the state's interest in reducing budgets and the citizens' desire to prolong their own lives or those of their loved ones.  In the case of a palliative care scheme such as the LCP, the process grows positively grotesque when the state chooses to hit the "delete" button without even informing the family or the patient of the patient's condemned status.

To avoid the pitfalls of ObamaCare, it's not enough for those of us in America to see the egregious abuses of government-run health care; we must also recognize the inherent limitations.  For example, anyone who has been a patient of an American hospital in the last decade or so is familiar with the bar-coded wristband each patient wears.  Before medications are given or tests performed, the band is read with a handheld scanner to ensure accuracy.  The British NHS is only just now introducing this ubiquitous technology to its hospitals.  Mind you, grocery stores in our country have been conducting business by barcode for more than 20 years.

Government will never be a nimble enough player to equal the agility and hunger of the private sector, and government always remains several steps behind when attempting to duplicate the services available in the for-profit realm.  This has been demonstrated across all eras so often as to have become axiomatic, yet again and again, we allow bureaucrats to attempt to build a better mousetrap using the power of government and the funding of taxpayers.

In 2005, the British Parliament passed a monstrosity of legislation known as the "Mental Capacity Act," allowing doctors to withhold medical treatment from patients deemed incapable of making decisions for themselves.  For the first time, the MCA defines "food and water" as medical treatments, enabling physicians to withhold these from the patient with protection of law.  Moreover, doctors alone are granted the power to declare a patient incapable, without input from or consultation with the family, or even the patient themselves.

The Mental Capacity Act has led to a dramatic increase in the number of elderly and disabled being placed on the Liverpool Care Pathway.  Once the decision has been made that the patient is incapacitated under the Act, doctors may withdraw fluids immediately via the twisted reasoning that it is "in the best interests" of the patient to die.  If the patient's family attempts to intervene, the hospital can, and often does, summon the police to remove the family from the premises.

A chilling angle to this already cold picture is that oftentimes, the examination to determine "capability" under the MCA is conducted after the patient has been heavily sedated or given a drug with a common side-effect of disorientation, such as morphine.  The unfortunate reality of socialized medicine is that the driving force behind treatment regimes is no longer the patient/doctor relationship, but rather the government/cost relationship.  This necessitates rationing, all the while dismissing the will to live among the elderly and disabled.

The death of a family member is one of the more difficult and emotionally charged circumstances most of us face in life, and to have that process dictated by the cold crunching of an accountant's numbers transforms the experience from difficult to devastating.  It is one thing to have a parent, spouse, or child die, despite our best efforts, from an accident or disease.  It is quite another to have that family member discarded, considered insufficiently valuable to the decision-makers -- and possibly even inconvenient to them -- for taking up a bed that could go to another patient deemed more worthy by the rationer's formula.

This is the world of collectivist bureaucrats, giddy with their personal notions of superiority.  Liberals believe deep down that they have it all figured out, or at least that they are on the right track, more evolved, better-equipped to make decisions that our culture had rightfully reserved to God alone.  ObamaCare is our American gateway to this "tick-box" statist realm.

The true nature of the Liverpool Care Pathway and the Mental Capacity Act is deftly hidden behind the glowing words of promise used to sell these phenomena to the citizens.  The statist bureaucrat unceasingly demands just a little more power and money, a greater measure of control, and with those he will provide an amazing wealth of peace and justice for all.  Of course, should the statist fail, it means only that he was granted insufficient control and money, never that his ideas are fundamentally flawed.

Our current president, Barack Obama, is an adept practitioner of this form of snake-oil sales.  Not surprisingly, he has surrounded himself with like-minded people, drawn from a myriad of left-wing think-tanks, university faculty, and activist foundations.  I've written previously about Dr. Donald Berwick, the recess-appointed head of the Centers for Medicare and Medicaid Services, who has since resigned rather than face the tough questioning of a nomination hearing in the Senate.

Berwick is an architect of Britain's medical rationing scheme, and his patron organization, the Commonwealth Fund, has published numerous articles and papers touting the Liverpool Care Pathway as a fine model for end-of-life cost-containment.  Berwick's replacement, Marilyn Tavenner, is by most accounts an ideological acolyte of Berwick's rationing mindset, promising little change in administrative direction.  For those readers who doubt the applicability of British health care examples on our system, remember that ObamaCare is modeled as the next-generation improvement to Britain's NHS, and the Liverpool Care Pathway is considered by these "experts" the gold standard of end-of-life care.  We ignore this reality at the peril of our very lives. 

Joe Herring writes from Omaha, NE, and invites readers to his website,  He can be reached at

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