Mike Huckabee's Latest Lie: "Death Panels"

Blog ››› ››› JEREMY SCHULMAN

In the last couple weeks, Mike Huckabee has done a lot of lying. He lied about President Obama's childhood, and then he lied to cover up his original lies. He even lied about his attacks on Natalie Portman.

So perhaps it's not a surprise that in his new book, Huckabee fully embraces what the non-partisan Politifact once dubbed the "lie of the year": Death Panels.

In A Simple Government, Huckabee insists that the creation in the stimulus bill of the Federal Coordinating Council for Comparative Effectiveness Research "planted the seeds from which the poisonous tree of death panels will grow":

Tucked away in the $787 billion stimulus was the establishment of the Federal Coordinating Council for Comparative Effectiveness, which will become our version of Britain's National Institute for Health and Clinical Excellence, the ironically and Orwellian-named NICE. NICE decides who lives and who dies based on age and the cost of treatment. So the stimulus didn't just waste your money; it planted the seeds from which the poisonous tree of death panels will grow.

[...]

Who will get rationed? Well, the very old and the very young, obviously, the most helpless and vulnerable among us. But it will also be those who don't live politically correct lives -- those who have too many cigarettes or cocktails or cans of soda. "Death by Chocolate" won't just be a cute name on the dessert menu. [Pages 86-87.]

Virtually every word of that is wrong.

Back when Sarah Palin first coined the "Death Panel" phrase, Politifact explained that comparative effectiveness research actually "has nothing to do with evaluating patients for 'worthiness.' Rather, comparative effectiveness research finds out which treatments work better than others." Elsewhere, Politifact pointed out that "comparative effectiveness research has been done by the government for years and years."

As for Huckabee's claim that the Federal Coordinating Council "will become our version of Britain's National Institute for Health and Clinical Excellence," Polifact previously explained the council was "very different from the British system, where government entities run the health care system and [NICE] determines whether particular treatments are covered or not. The stimulus emphasized that the board is not meant to 'mandate coverage, reimbursement, or other policies for any public or private payer' and that the none of the board's reports or recommendations 'shall be construed as mandates or clinical guidelines for payment, coverage, or treatment.' "

Perhaps more importantly, Huckabee is apparently unaware that the Federal Coordinating Council no longer exists -- it was eliminated by the health care reform law.

Asked for comment, Paul Van de Water, a heath care expert at the Center on Budget and Policy Priorities, told Media Matters that "Huckabee seems to be suggesting that we shouldn't do research to find out what medical procedures work best just because that research could conceivably be misused. The new law makes every effort to assure that won't happen."

Van de Water noted that the health care law creates "a new Patient-Centered Outcomes Research Institute governed by a public-private sector board to provide for the conduct of comparative outcomes research. The provision prohibits any research findings from being construed to mandate practice guidelines or coverage decisions, and it contains safeguards to protect against discriminatory coverage decisions by HHS based on age, disability, or terminal illness."

Huckabee also grossly distorts statements made by Donald Berwick, the top Medicare and Medicaid official, in order to warn that health care reform "did not bode well for Grandma's life expectancy." Huckabee writes:

When we conservatives warned that ObamaCare did not bode well for Grandma's life expectancy, we were accused of fearmongering. But nothing is more frightening than the words of President Obama's choice to head Medicare, Donald Berwick: "The decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open." [Page 86.]

But Berwick wasn't saying that we should begin rationing care in order to deny treatment to elderly people. Rather, he said in the June 2009 interview that the U.S. medical system already rations care and that increased comparative effectiveness research would allow for decisions to be made based on accurate information:

Q: Critics of CER have said that it will lead to the rationing of healthcare.

A: We can make a sensible social decision and say, "Well, at this point, to have access to a particular additional benefit [new drug or medical intervention] is so expensive that our taxpayers have better use for those funds." We make those decisions all the time. The decision is not whether or not we will ration care -- the decision is whether we will ration with our eyes open. And right now, we are doing it blindly.

Later, Huckabee misrepresents yet another Berwick statement -- this time to falsely claim that under Berwick's "un-American" belief system, "your child, your parent, you" may have to be "sacrificed" for the good of "society":

Dr. Berwick's belief system is fundamentally un-American: "The complexity and cost of health care delivery systems may set up a tension between what is good for the society as a whole and what is best for an individual patient." That's what happens under socialism. Individuals -- your child, your parent, you -- don't matter and may have to be sacrificed. By contrast, we have always believed that every life is precious; we have built the freest and most prosperous society in human history precisely by championing the individual. Americans believe that society exists to serve the individual, not the other way around. [Page 87.]

This is actually the opposite of what Berwick wrote. What Huckabee quoted from was a proposed "statement of ethical principles for those who shape and give health care" written in 1999 by Berwick and 15 other experts. In the specific quote Huckabee used, Berwick and his co-authors weren't arguing that the interests of individual patients should be sacrificed in pursuit of the needs of "society as a whole." Rather, they were listing the tension between individual and societal needs as one of several "problems" that occur in health care systems across the world:

Over the past 150 years, health care delivery has expanded from what was largely a social service provided by individual practitioners, often in the home, to include a complex system of services provided by teams of professionals, usually within institutions and using sophisticated technology. As a result, problems develop, such as the following:

[...]

-The complexity and cost of health care delivery systems may set up a tension between what is good for society as a whole and what is best for the individual patient.

In response to the problems they identified, Berwick and his co-authors proposed a set of "ethical principles" in which they stated that "the principal focus of the health care delivery system must be individual patients and their families or support groups" -- the opposite of what Huckabee claimed:

2. The care of individuals is at the center of health care delivery but must be viewed and practiced within the overall context of continuing work to generate the greatest possible health gains for groups and populations.

-The personal experience of illness is generally the principal concern of individual patients; therefore, the principal focus of the health care delivery system must be individual patients and their families or support groups.

-Those who provide medical care for individual patients are not, in that role, directly responsible for the care of populations. Although the duty of individual health care workers is primarily to the individual patients whose care they assume, caregivers must be aware that the interrelationships inherent in a system make it impossible to separate actions taken on behalf of individual patients from the overall performance of the system and its impact on the health of society.

-Physicians and other clinicians should be advocates for their patients or the populations that they serve but should refrain from manipulating the system to obtain benefits for them to the substantial disadvantage of others.

Posted In
Health Care, Health Care Reform
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