WSJ misrepresents Obama interview to fearmonger about end-of-life rationing

››› ››› ADAM SHAH

Claiming that it's "[n]o wonder so many seniors rebel" at President Obama's health care proposals, a Wall Street Journal editorial misrepresented a New York Times interview of Obama to claim that Obama seems to believes that end-of-life "medical issues are all justifiably political questions that government or some panel of philosopher kings can and should decide." In fact, in the interview the Journal cited, Obama made clear that an advisory panel that would issue guidance on end-of-life issues would "not [be] determinative, but I think has to be able to give you some guidance."

Journal misrepresents Obama NY Times interview

Citing Times interview, Journal claimed that Obama "seems to believe" "government or some panel of philosopher kings can and should" make end-of-life decisions. The editorial added: "No wonder so many seniors rebel at such judgments that they know they could do little to influence, much less change." From the Journal editorial headlined, "Obama's Senior Moment":

From the point of view of politicians with a limited budget, is it worth spending a lot on, say, a patient with late-stage cancer where the odds of remission are long? Or should they spend to improve quality, not length, of life? Or pay for a hip or knee replacement for seniors, when palliative care might cost less? And who decides?


Before he got defensive, Mr. Obama was open about this political calculation. He often invokes the experience of his own grandmother, musing whether it was wise for her to receive a hip replacement after a terminal cancer diagnosis. In an April interview with the New York Times, he wondered whether this represented a "sustainable model" for society. He seems to believe these medical issues are all justifiably political questions that government or some panel of philosopher kings can and should decide. No wonder so many seniors rebel at such judgments that they know they could do little to influence, much less change. [Wall Street Journal, 8/14/09]

In fact, in the Times interview, Obama made clear an advisory panel is "not determinative, but ... has to be able to give you some guidance." From the Times interview:

THE PRESIDENT: I don't know how much that hip replacement [that Obama's grandmother received shortly before her death] cost. I would have paid out of pocket for that hip replacement just because she's my grandmother. Whether, sort of in the aggregate, society making those decisions to give my grandmother, or everybody else's aging grandparents or parents, a hip replacement when they're terminally ill is a sustainable model, is a very difficult question. If somebody told me that my grandmother couldn't have a hip replacement and she had to lie there in misery in the waning days of her life -- that would be pretty upsetting.

And it's going to be hard for people who don't have the option of paying for it.

THE PRESIDENT: So that's where I think you just get into some very difficult moral issues. But that's also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

So how do you -- how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that's part of why you have to have some independent group that can give you guidance. It's not determinative, but I think has to be able to give you some guidance. And that's part of what I suspect you'll see emerging out of the various health care conversations that are taking place on the Hill right now. [The New York Times Magazine, 4/28/09]

Fox News previously misrepresented Obama's Times interview. Citing the same New York Times interview on Fox News, Special Report host Bret Baier and correspondent Shannon Bream claimed that Obama's "own words may have contributed to the atmosphere of fear" surrounding "talk about possible government mandates in so-called end-of-life issues" or "what critics call 'death panels.' " [Fox News' Special Report, 8/12/09]

Journal acknowledged that rationing currently exists but asserted that "in the end no one is denied actual care"

From the editorial:

Yes, the U.S. "rations" by ability to pay (though in the end no one is denied actual care). This is true of every good or service in a free economy and a world of finite resources but infinite wants. Yet no one would say we "ration" houses or gasoline because those goods are allocated by prices. The problem is that governments ration through brute force -- either explicitly restricting the use of medicine or lowering payments below market rates. Both methods lead to waiting lines, lower quality, or less innovation -- and usually all three.

However, there are accounts of people not being able to receive care if they don't have cash

In congressional testimony, woman said hospital told her "unless your brother brings in cash, he is not going to get the procedure without insurance." Attorney Peggy Raddatz stated in congressional testimony that her brother Otto was diagnosed with non-Hodgkin's lymphoma and, after several rounds of chemotherapy, was scheduled for a stem cell transplant. In the midst of the preparation for this procedure, his insurance company canceled his insurance. Raddatz testified that when she called the hospital to see if she could still schedule the procedure for her brother, she was told: "[U]nless your brother brings in cash, he is not going to get the procedure without insurance." From Raddatz' testimony:

My brother was told he was canceled during what they called a "routine review" during which they claimed to discover a "material failure to disclose". Apparently in 2000 his doctor had done a CT scan which showed an aneurysm and gall stones. My brother was never told of either one of these conditions nor was he ever treated for them and he never reported any symptoms for them either.

After months of preparation, the stem cell transplant could not be scheduled. My brother's hope for being a cancer survivor were dashed. His prognosis was only a matter of months without the procedure.

When I called the hospital to see if I could schedule the stem cell transplant for him I was callously told "unless your brother brings in cash, he is not going to get the procedure without insurance."


After two appeals by the Illinois Attorney General's Office, Fortis Insurance Company overturned their original decision to rescind my brother's coverage and he was reinstated without any lapse.

Without the help of the office of the Illinois Attorney General, this would not have been possible. [Prepared testimony of Peggy Raddatz before the House Energy & Commerce Committee, 6/16/09]

Congressional testimony: "The hospital wanted a $30,000 deposit." Another person, Robin Beaton, testified that her breast cancer surgery was delayed by several months after her insurance company revoked its pre-clearance for her surgery and announced an investigation of her medical history that it said would last for months. Beaton testified that the hospital demanded a "$30,000 deposit" to schedule the surgery immediately, which Beaton was unable to afford. Beaton testified that her surgery was delayed several months until her insurance was reinstated, and due to the delay, her tumor had grown from two centimeters to seven centimeters and she was forced to have a double mastectomy and have all her lymph nodes removed. From Beaton's testimony:

In June 2008 I was diagnosed with invasive HER-2 genetic breast cancer, this is a very aggressive form of breast cancer. In the beginning, I was told I needed immediate surgery. The doctor told me you have a lumpectomy if the tumor is small enough. In the beginning the doctor said the tumor was 2 centimeters.

When the surgeons scheduled my surgery I was pre-certified for two days hospitalization and surgery. The Friday before the Monday I was scheduled to have my surgery Blue Cross red flagged my chart due to dermatologist chart. The dermatologist called Blue Cross directly to report that I only had acne (pimples) and to please not hold up my cancer surgery. Blue Cross called me on the Friday before I was to have cancer surgery on Monday and informed me that they were launching a 5 year medical investigation into my medical history and this would take approximately 3 months.

I was frantic. I was totally alone as my family lives in Jacksonville Florida. The hospital wanted a $30,000 deposit, and I knew I could not pay this or for the surgery myself. I had no idea what to do or where to turn. I met a lady who told me you need to call your congressman Joe Barton for help.


I began going everywhere looking for help, county hospitals, Foundations, agencies. Everywhere I went I was placed on a waiting list. When you have aggressive invasive cancer you have no time to wait as the cancer grows everyday. I went back to the county hospital where they lost my medical records three times. The process was unending searching for help for cancer. I did everything to get help. Everywhere you go takes time. No help was found until Joe Barton and his staff, after working a very long time, got Blue Cross to reinstate my insurance after being diagnosed with aggressive invasive breast cancer in June 2008. I was then placed back on the surgeons list to receive my cancer surgery. I finally was operated on October 2, 2008. My tumor grew from 2 centimeters all the way to 7 centimeters. Also, I had to have both breasts removed and all my lymph nodes due to waiting from June to October for treatment.

Delaying treatment for cancer only worsens the condition, costing more to treat and treatment much more intensive. Also the outcome is not as good. [Prepared testimony of Robin Beaton before the House Energy & Commerce Committee, 6/16/09]

Media reports of people pulling their own teeth. There are media reports of Americans gluing and extracting their own teeth due to the costs of dental care.

Posted In
Health Care, End of Life Issues, Health Care Reform
Wall Street Journal
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