I didn't believe that Obama had succumbed to this false depiction of something so valuable as providing those facing debilitating disease a greater understanding of their options. It takes a certain conspiratorial mind set to believe that physicians treating Medicare patients, would be attempting to cause their death, which denies their own economic and humanitarian interests.
I fully understand the limits of a Presidents power, the idea that "political capital" is a limited commodity and that power is much more widely distributed than the media presents. I can even understand how a Commander in Chief really can't go against his top Military officials in withdrawing from Afghanistan. But this issue is not one where he would be facing wide spread public condemnation.
The vast majority of people understand that for those in the final throes of Cancer, heart failure or dementia; extending life is a type of torture that happens all too frequently in today's America. I have been, and still am, opposed to the Health Care Bill that was passed last year, for reasons I have written about extensively summarized on my personal website.
Yet, promoting this process of discussion with those with impending death was a sign of hope for me, that some good could come out of this legislation. My opposition to the Health Care Bill was that without such changes in public attitude and systemic relationships among the vast Medical Industrial Complex, the worst parts of our dysfunctional system would become crystallized, and not even be subject to the natural control of lack of affordability. And the belief that spending more money means better outcome, longer life and less suffering is clearly refuted in this article of mine, End of life care: torture for the patient, bankruptcy for the country
President Obama's withdrawal of support for this provision will not only decrease such valuable conversations, but it has become an affirmation of the insidious calumny that such doctor-patient interactions will not be in the patient's interest. Doctors who may have been willing to help their patients and their families accept the inevitable, and guide them towards hospice care may now decide that there is not the social support for this. So, suffering will increase, as will the expense of last ditch treatment, which will hasten the time when really useful modalities will not be available.
The White House has stated that this was a technical correction and will still allow the end of life conversations. While this may be factual and most doctors will continue to be willing to have these conversations, the conclusion that I reached was shared my many professional journalists of both parties, as exemplified by this from Richard Cohen of the Washington Post, Obama gives in to Sarah Palin's Dishonesty.
If this was a technical correction it should have been described as such, with a clear statement by the President that doctors will be paid and patients should avail themselves of this conversation. This is part of a larger battle to profoundly change medical care in this country, not of the meaning of the fine print of Medicare regulations. Even if the existing law were not to survive the legal and legislative challenges being mounted, there are principles that must be revised, and the taboo against rationally thinking about end of life, of replacing the current suffering we all will face with a "good death" must be at the top of the list.