It'll start with old folks and those with terminal diseases or conditions, but it will spread (quickly, too) to every medical decision in every facet of every American's life. Send this to people you know and kindly prompt them to think about this and get involved. Nothing less than America's literal well-being is at stake.
Should Michael J. Fox be put to death?
Celebrities and death. Now there's a potent cocktail.
Several parts fame, a few jiggers of Hollywood and a splash each for sports, business and journalism. Did I mention politics and government bureaucracy? Sorry. Without that essential element the mixture has no wallop. And a wallop this concoction surely will have, particularly if you believe actor Michael J. Fox has overstayed his welcome on the planet.
Let's pour the dry ingredients of politics and government bureaucracy into the pitcher first, beginning with the politics of death and dying.
Laws in America come into being because someone somewhere saw a problem, devised a would-be answer and then persuaded politicians to pass the law based on the philosophy and politics one group or another saw as underlying that answer. Need revenue? Raise taxes. Global warming? Shut down the coal plants. Dopey kids? Pay more to teachers. Everyone knows how this works.
So what is the driving philosophy underpinning the Obama health care plans for all of us? Let's begin with a few short quotes and one definition that outlines the idea succinctly.
• President Obama; "There is a whole bunch of care that's being provided that every study, every bit of evidence that we have indicates may not be making us healthier."
• Peter Singer, Professor of Bioethics at Princeton University: "Life as a whole has no meaning. Life began, as the best available theories tell us, in a chance combination of gasses; it then evolved through random mutation and natural selection. All this just happened; it did not happen to any overall purpose."
• America's Affordable Health Choices Act of 2009 as introduced in the U.S. House of Representatives (H.R.3200) by Congressmen Dingell, Waxman, Rangel, Stark and others: "The Secretary shall establish within the Agency for Healthcare Research and Quality a Center for Comparative Effectiveness Research…with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures."
• QALY: Quality-Adjusted Life Year. A formula devised by left-wing policy wonks that purports, as David Catron has so ably illuminated on these pages, to measure the worth of your life by assigning a numerical value to each year of your existence. In Catron's words: "A year of perfect health, for example, is given a value of 1.0 while a year of sub-optimum health is rated between 0 and 1. If you are confined to a wheelchair, a year of your life might be valued at half that of your ambulatory neighbor. If you are blind or deaf, you also score low. All that remains is to assign a specific dollar value to the QALY and, voilà, your life has a price tag."
This is all a bit dry to the taste, isn't it? QALY, Center for Comparative Effectiveness Research, HR 3200. Blah blah blah. Let's add the fizz to this baby.
So. Who will tell Michael J. Fox he needs to die?
Which health care mouse out there will have the guts to bell the cat who is one of the most famous Parkinson's Disease sufferers in America? Who is going to tell him that the treatments that are associated with Parkinson's -- drugs like Sinemet, Symmetrel, Eldepryl, Parlodel, Permax, Mirapex, Requip, and surgery with the quaint name "deep brain stimulation" -- are just no longer possible for Fox because, well, Mike, your QALY just isn't up to snuff, babe. You have Parkinson's. You boozed (according to you). As a result, the government has decided treatment for you, Mike, lacks "appropriateness." The "outcome and effectiveness" of treating you -- which is to say the worth of your 47-year old life -- just isn't worth it for the rest of us.
Sorry Mike. Say Goodbye to Hollywood. Close your Parkinson's Foundation (waste of scarce resources, to wax Singeresque). Just go home to the wife and kids, cut off these expensive meds and please die. Quietly. And for heaven's sake, get yourself buried in private. We don't want any of this Michael Jackson type-hoopla disrupting our favorite programs. We have lives to get on with.
A bit harsh?
Heck, we haven't begun to shake this cocktail. There's more to mix.
You see, the philosophy behind ObamaCare, as promoted just a week ago in the New York Times Sunday Magazine by Professor Singer, is the hard cold necessity Obama sees for government to ration health care for people like, well, Michael J. Fox. As Mr. Singer says: "Health care is a scarce resource, and all scarce resources are rationed in one way or another." And quite obviously, with Mike Fox's QALY being what it is (and Singer is a big proponent of using QALY to judge the worth of a life), the time to cut his treatment off was... yesterday. Actually, a lot of yesterdays ago.
This is what President Obama believes when he says "there's a whole bunch of care" that someone -- this would be the government -- will have to decide not to employ in treating someone like Mike Fox. What about the idea that Michael J. Fox -- not to mention his wife and children, extended family and friends who might actually love the little lug -- think Mike's spirit should count for something here? After all, he did an entire documentary on The Adventures of an Incurable Optimist. In the President's words: "I don't think that we can make judgments based on peoples' spirit. That would be a pretty subjective decision to be making. I think we have to have rules...."
Right. Rules. Got it. Government rules. Which is another way of saying decisions on Mike Fox's life will, if Obama and company get their way, be resting in the hands of this whiz bang group of policy wonks and bureaucrats called the Center for Comparative Effectiveness Research. Located, but of course, within the Agency for Healthcare Research and Quality. Where the Rule of QALY will reign. Did I leave out that this will all be established by The Secretary?
Let's get rid of the bureaucratese here and just call this agency what it really is: The U.S. Bureau of Death (or "BOD" in the acronym form loved by bureaucrats everywhere).
Now let's toss in all the rest of this cocktail's ingredients and give it a shake. Take a real, deep drink.
So. Whose bod in Hollywood will BOD be coming for? Who in celebrity land -- and here we can add in journalism, sports and business -- will be on the BOD Squad's hit list when the information is received that well, sadly, like poor old Michael J. Fox, their QALY just doesn't make the grade? Let's take a look into this perilously close future for all of us as the BOD Squad makes its rounds.[Lord next lists a number of Hollywood personalities: Elizabeth Taylor, David Letterman, Patrick Swayze, Magic Johnson, Larry King, Regis Philbin, David Hasselhoff, and Joan Rivers, and an explanation of why health care should be withheld from them according to QALY rules. I have removed them for brevity's sake, but hit the link to see the details.]
And now, one last report. Perhaps the most interesting in the celebrity death struggle with ObamaCare.
Steve Jobs: A liver transplant for the creator of Apple? Well, well, well. Now this celebrity death struggle is particularly interesting. Why? Because Mr. Jobs had his transplant only three months ago, just as the ObamaCare toxin was seeping into the political atmosphere. This has already resulted in news stories speculating that the secrecy of the operation, the fact that Jobs traveled unannounced and unknown to Tennessee to have it, means that Jobs was, in the words of an actual news report, "gaming the system." How? The wait-time for a liver in Tennessee is about 48 days, on average. The United Network for Organ Sharing says the national wait time is 306 days. In other words, before the BOD Squad legislation has even passed Congress, one prominent American celebrity is under fire for "gaming the system" when it comes to transplants. Another couple of months and Mr. Jobs would have been either dead because of instructions on his QALY or brought up on charges for getting around "the rules." There will be penalties for trying to save your life, right?
Gaming the system. An interesting concept. You mean government rules can be manipulated? Nooooooo! Really?
Perhaps you've heard of a federal agency called the IRS? Like the soon-to-be bureaucrats at the BOD Squad, the Internal Revenue Service is in theory designed to be a "just-the-facts" kind of agency. And yet….hmmm.
In 1952, a controversial Senator from California named Richard Nixon found his tax returns leaked from the Truman-run IRS to a virulently anti-Nixon columnist named Drew Pearson. (In those days, candidates did not release their tax returns as they frequently do today.) In 1963, a few months after Nixon lost a humiliating race for governor of California, his political life was presumed by all seers of the day as dead. Yet low and behold, private citizen Nixon found himself subject to a lengthy and exhaustive audit by the IRS. Years later, the IRS supervisor of the case admitted that, well, his Washington superiors in the Kennedy administration had ordered him three times to re-open the original audit and try and get Nixon for tax evasion.
Thus, when Nixon became president at last, he tells us he was so furious at his treatment by the IRS when in the hands of Democrats that he personally and repeatedly "urged Haldeman and Ehrlichman [the Rahm Emanuel and David Axelrod of the day] to have IRS checks made on [1972 Democratic nominee] McGovern's key staff and contributors."
In other words, power can be abused. In a blink. You think David Letterman is sorry now for the things he said about Sarah Palin's daughter? Wait 'til ole Dave discovers he has a recurrence of heart problems down the road and appeals for a little Obama-esque empathy from the BOD Squad -- and the response he receives telling him to go pound sand and die is coming from an appointed bureaucrat of President Palin's. FYI to the Reverend Jeremiah Wright: Watch your QALY, brother.
Or imagine the current kerfuffle with Harvard's Professor Henry Gates and Cambridge police Sergeant James Crowley. Let's change the story a bit. Instead of Crowley being a policeman, let's make him Dr. James Crowley, a member of the BOD Squad. He and his fellow bureaucrats have told the sick Professor Gates that, gee, sorry. Your QALY just isn't that good. Please file an Extinction Application. To which Professor Gates snaps off from his hospital bed exactly the same reply he gave to Sergeant Crowley in his house: "Why…because I'm a black man in America?"
What's the racial composition of the BOD Squad? How many Wise Latinas are there to decide on the worth of a brown-skinned life over the worth of a white-skinned life? Have Al Sharpton and Jesse Jackson gotten wind of this yet? If civil rights activists believe there are too many blacks in American prisons, what will they say if the number of blacks being sent off by the BOD Squad is, percentage wise, higher than the number of whites? Whose life has more -- or less -- value? A white? Or a black, brown, yellow or red life? Does the black guy live or the Latina? The American Vietnamese or the Native American? Just what Washington, D.C. needs -- more lobbyists. Not to mention the QALY law practices that will quadruple the size of the trial bar.
You think the gay community is upset over same-sex marriage prohibitions? This is as nothing compared to the fuse that will be lit when gays come to believe the BOD Squad is filled with homophobics intent on claiming AIDS is such a disqualifying QALY feature that simply being gay means a death sentence ASAP.
We haven't even gotten to Senator Kennedy's brain surgery, the latest hospitalization for West Virginia's 91-year old Senator Robert Byrd, Lance Armstrong's testicular cancer or Tiger Woods's knee operation. Needless to say, the agonized Farrah Fawcett would never have been allowed to struggle on as she did from the moment of her cancer diagnosis, Ed McMahon's QALY, with a broken neck and two neck surgeries in his eighties on file, would have had him announcing himself to God long before the other week. And Michael Jackson? Maybe the Bod Squad already made their first call.
Which returns us to Michael J. Fox. Remember the dust-up a while back when Mr. Fox was appearing in political ads supporting stem-cell research? One can agree with Mr. Fox, or not. But without doubt his opponents on the issue believed the importance underlying the issue was the larger point of respect for human life. The issue was at play in Missouri, where state funding was under discussion, and it elicited this fairly standard response from a Missouri State Senator: "I believe that a human embryo is worthy of legal protection," said state Sen. Matt Bartle (R), who vows to press the fight. "Western medicine has been founded on a principle: First, do no harm."
For Fox, this issue now falls precariously close to the old caution about being careful what you wish for. Once upon a time in America the issue of "life" was about the death penalty for murderers. Then it was abortion. Next it was about stem cell research. Now, it's about whether Michael J. Fox's life has sufficient QALY points to justify letting him live.
Does Michael J. Fox's life deserve respect? Of course.
But if they can come for Michael J. Fox, they can come for you.
And they will.
There's my two cents.