January 15, 2010

There's a reason the Tea Party crowd still believes in "death panels" -- namely, because Sarah Palin, who coined the term, keeps claiming that they really do exist still.

Nevermind, of course, that it has long been exposed as a complete falsehood, and was named "Lie of the Year" by PolitiFact. To right-wingers like Sarah Palin, though, you can lie through your teeth, tell the press that up is down, that a report finding you guilty of various abuses of power as Alaska's governor in fact actually "completely exonerates" you -- and everyone will stand around and pretend like it's just another point of view.

So she repeated it again last night on Hannity:

Hannity: You stand by those comments because you think it still exists in the bill.

Palin: I do. It's a commission, it's bureaucracy, it's bureaucrats who will ration care if the bill goes through as Obama wants it to go through. Yes -- it's modeled, in essence, after a British system that does have people to decide whether, based on your quality of life, your age, whether you're gonna deserve health-care coverage or not -- that's what's gonna happen in America if this health-care bill isn't stopped, and it needs to be stopped soon, and that's why the people of this land can't give up in demanding that their voice be heard, demanding that the White House understand that this is a representative form of government, we do expect that the will of the people is listened to and adhered to and implemented via our representatives, who we elect.

Eh? The British system has no such "commissions." As the AP recently reported, officials in Britain recently repudiated claims like Palin's:

The criticism, widely covered in the U.K. media, has clearly stung Britain's left-leaning Labour government. The Department of Health took the unusual step of contacting The Associated Press and e-mailing it a three-page rebuttal to what it said were misconceptions about the NHS being bandied about in the U.S. media – each one followed with the words: "Not true."

At the top of the list was the idea that a patient in his late 70s would not be treated for a brain tumor because he was too old – a transparent reference to Grassley's comments about Kennedy.

And what of Republicans' claim that British patients are robbed of their medical choices? False again, the department said.

"Everyone who is cared for by the NHS in England has formal rights to make choices about the service that they receive," it said in its rebuttal.

Then followed a fact sheet comparing selected statistics such as health spending per capita, infant mortality, life expectancy, and more. Each one showed England outperforming its trans-Atlantic counterpart.

The British government offers health care for free at the point of need, a service pioneered by Labour in 1948. In the six decades since, its promise of universal medical care, from cradle to grave, is taken for granted by Britons to such an extent that politicians – even fiscal conservatives – are loath to attack it.

Apparently Palin is referring to British cost-containment measures:

The NHS has a body called the National Institute for Health and Clinical Excellence (NICE) that decides which new treatments and drugs the NHS should pay for. One of the factors NICE considers when deciding whether to approve funding for a new treatment or drug is cost-effectiveness. To determine the dividing line between what is cost-effective and what isn't, it must set a threshold. Taking its lead from Britain's Department of Transport — which has a cost-per-life-saved threshold for new road schemes of about $2.2 million per life, or about $45,000 per life year gained — NICE rarely approves a drug or treatment that costs more than $45,000 per life year gained. In short, NICE does not want the NHS to spend more than $45,000 to extend a citizen's life by one year.

While NICE's decisions have angered some doctors and patient groups — particularly some oncologists who say they are unable to prescribe expensive, life-extending cancer drugs — mainstream politicians, the media and most Britons accept NICE's rare rejections as a necessary compromise to keep universal coverage affordable in the face of rising health-care costs. As NICE chairman Sir Michael Rawlins recently told TIME, "All health-care systems have implicitly, if not explicitly, adopted some form of cost control. In the U.S., you do it by not providing health care to some people. That's a rather brutal way of doing it."

Indeed, that's the point PolitiFact raised in its piece on Palin's lie:

Democrats responded by saying the accusation wasn't true and highlighting the actual Medicare provision and what it said.

That wasn't necessarily an effective strategy, said Drew Westen, a psychologist who studies political communication and advises Democrats on messaging. "Instead of stopping and asking themselves, 'What are Republicans trying to appeal to?' the Democrats rolled their eyes and said, 'Isn't this stupid,' " he said. "On one level, it was stupid, but on another level, it was hitting seniors very close to where they live."

People intuitively understand that health care reform is about lowering costs, and end-of-life care can be quite costly, he said. The "death panels" claim exploited fears that people already had. Rather than just saying the claim wasn't true, Westen said, a better response would be that there already are "death panels" — run by insurance companies.

Indeed, there is no doubt that "death panels" already exist. They're just called insurance-company policies.

For right-wingers like Sarah Palin, though, it's better to have people denied any coverage whatsoever than the possibility that a government insurance plan might ration access to expensive treatments.

Baldfacedly and defiantly lying about it, evidently, is just part of the deal.

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