In an appearance on the MSNBC program “Morning Joe,” hosted by former Repub Congressman Joe Scarborough, Gov. Pawlenty gave a complicated, nuanced, not-really-but-sort-of-yes defense of those who fear that federal bureaucrats may eventually decide who will get lifesaving health care treatments and who will not.
Before you get all excited, you should probably hear the whole exchange, and I’ll embed the video below. But, after listening to it a couple of times myself, I’d also like to set up a couple of analysis points (and you can check me, if you watch the video).
Pawlenty explicitly states that there is nothing in any of the health care bills to set up “death panels,” and nothing that empowers anyone to pull the plug on granny in order to save money. In that sense, he is repudiating the essence of the “death panel” lie that he otherwise seems to be defending.
Pawlenty’s calm, pseudo-rational defense of the Palinesque “death panel” hysteria is based on things that have almost nothing to do with Obamacare. He is concerned that ultimately the health care system will become so expensive that everyone will not be able to have every treatment or procedure they want, because there will not funds to pay for it. This is true, but it is true of every health care system in the world.
It is very unfashionable to acknowledge this, but there is no society so wealthy that it can guarantee to all its citiziens every health care procedure that they want, and not even every procedure that might do them some good. Unless the patient is Bill Gates or a Saudi prince who has essentially unlimited personal resources, every system has to take cost into account. The rationing-or-no-rationing portion of the health care policy debate is fundamentally ludicrous, but I don’t hear this explained very often.
Opponents of the current proposals also do not acknowledge this, but they are, at some level, saying that they do not want any government employees involved in rationing health care (the government is already deeply involved in it since the government already pays for a huge portion of U.S. health care), but that they are fine with a system in which bureaucrats who work for private insurance companies do the rationing.
I don’t get this, although I suppose the key is to never admit that the care is being rationed now. There is little reason to believe that, at its core, the rationing decisions of a private for-profit insurance company will be based entirely on what’s best for me, and not at all on what’s best for the company’s profits.
With that preface, here’s the full interview (length 7:31). The death panel stuff starts at about 1:30. (Although in the first minute, Pawlenty, who says several times that he wants his presentation to be based on facts, makes a pretty factual mistake. I’ll discuss that at the bottom.
The two key spots, for me, are:
Scarborough: “How does this bill get us to quote unquote death panels? You don’t believe it does, do you?”
Pawlenty: …”What if it becomes so expensive and the trajectory of it is even close to what’s being predicted, 10 years out, that they can no longer afford all that they promised and somebody has to scale back the care, and the federal government is now empowered to do that? If you look at examples around the world where that takes place, there are concerns about care being cut back by a federal government institution. And we can have a legitimate debate about whether that’s good or not. I don’t think it is.”
and then, when panelist Mike Barnicle asks Pawlenty if he wants a do-over, and here’s the second try:
“It is not irrational to say if this thing becomes so unaffordable and you put the fed government in charge of it, somebody is going to have to limit either the cost or the volume of procedures. If that someone is the federal government, that concerns people. That is not a crazy idea. Now, does the bill say: ‘There’s ‘death panels’? No. Does the bill say that somebody’s actually going say whether you can live or die. No. But the indirect concerns that I’m raising and that others have raised are not irrational.”
Lastly, you heard Pawlenty say that there is a difference of opinion, which he seems to consider valid and fact-based, about whether the current proposal provides health care for illegal aliens. And Pawlenty says:
“There’s an easy way to address that, and that is to say specifically what you mean in the bill. The fact that they refuse to do it causes concerns.”
In the House bill, H.R. 3200, Section 246 is TITLED: NO FEDERAL PAYMENT FOR UNDOCUMENTED ALIENS. And it states:
“Nothing in this subtitle shall allow Federal payments for affordability credits on behalf of individuals who are not lawfully present in the United States.”
Under current law, illegal aliens are ineligible for federal health care benefits (although many undocumented workers do get health insurance if they work for private companies that provide private health insurance). But every neutral analyst seems to agree that this bill will not legalize benefits for undocumented aliens and, contrary to the guv, the bill says so quite explicitly.