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Thursday, August 20, 2009
Health Care Debate Rx: Stop Yelling
By Leslie Linthicum
Journal Staff Writer
Some rules for today's column: Your questions and comments are important, so please raise your hand and wait your turn to speak. When you're called on, don't say things you know aren't true.
Don't interrupt, shout or point your finger while chanting, "Tyranny! Tyranny! Tyranny!"
If you were bused in from another state to read this column, please take your "Don't tread on me" signs with you when your bus leaves.
We're not going to run this column like we've run the national health care debate because, I'm proud to say, I got through first grade with high marks. If you also absorbed those elementary lessons — no name calling, good sportsmanship, share your toys, wait your turn — welcome, and let's get on with today's work.
It's been hard to hear much as this wave of summer shouting matches has rolled across the country during the congressional recess. Most recently, it was New Mexico's Jeff Bingaman, one of the most polite, self-effacing men in the U.S. Senate, getting shouted down in Clovis.
What has caught my ear over the din has been the high-pitched yowling over the nonexistent "death panels" that the health care proposals in the works in the House and Senate are accused of funding.
And what has caught my attention is how making something up and yowling about it can actually influence the debate.
And what has surprised me the most about the odd maneuvering around the nonexistent death panels is how scared people are of talking about the one thing we all — Republicans, Democrats, socialists, neocons — have in common: death.
The death panel hobgoblin, as my colleague Winthrop Quigley patiently explained in these pages last week, was an inflammatory label attached to a provision in both the House and Senate versions of the health care bill. It was a new Medicare provision that would compensate physicians for the delicate and time-consuming discussions with elderly or terminally ill patients about end-of-life care.
You know former Alaska Gov. Sarah Palin's opinion of this provision if you're her friend on Facebook: "Downright evil."
Now let's hear from someone who understands the importance of providing people with information about the choice between continuing medical treatment or ceasing medical treatment as their lives draw to a close.
"It's a very necessary discussion to have," says Stacey Williams Abdalla, a registered nurse at Hospice of the Sandias. "It's not a fun conversation to have, but it's a proactive way to address your health care."
Talking about end-of-life issues and explaining that some steps that might prolong your life won't necessarily make those remaining months or weeks pleasant is different from advocating the end of life, Abdalla says.
"It's not offering euthanasia. It's not encouraging decisions in either way. It's showing options."
Having the conversation in a relaxed atmosphere before a crisis, which the Medicare payment change would encourage, "is definitively beneficial for both the patient and family, because they absolutely have more control," Abdalla says. "They are able to express their issues ahead of time when they have a clear head and are able to really think through the other options without being under duress."
No one doing the yelling seems to have bothered to consider that some people, lots of people, accept the end of their lives as a natural consequence of having lived them. Or that those people might prefer unhooking from the expensive health care machine when it's time to go. Or that 30 minutes of a doctor's careful time to explain the pros and cons of that choice can allow a dignified end, one that a patient has some say in and a family can feel a part of.
Instead, the shouters confuse talking about death with hastening it. And they actually seem to be winning. The provision is now out of the Senate draft, with committee members saying it could be "misinterpreted." Don't be surprised if the entire Congress is shouted down on the end-of-life counseling payments and drops them.
These days in American politics, the votes are close. That means that a smidge more than half of us get the president we want and a smidge less than half of us don't.
Democrats who spent the years between 2000 and 2008 locked in a dark closet of pain know that it's no fun to be on the losing side. (Remember the protests against the Iraq war?) Now Republicans know that same pain.
So what to do when you lose? These days you shout, lie, push and make sure you don't hear a thing the other side is saying. And amazingly, you tend to get your way.
"I don't think we have bad attitudes," one shouter at Sen. Arlen Specter's debacle of a town hall in Pennsylvania said. "We're just being Americans."
More toast
In my, er, romp through the joys of Toastmasters last week, I failed to mention that there are, um, lots of Toastmasters groups in New Mexico. Go to www.district23.org to find a group meeting near you.
UpFront is a daily front-page opinion column. You can reach Leslie at 823-3914 or llinthicum@abqjournal.com.
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