secret-planAnyone who has been watching the news lately has been subjected to video of crowds of people trying to shout down their elected representatives who are trying to forge a health care reform plan.  Events in Tampa, St. Louis, Michigan, and Texas have been disrupted by angry protesters who are pumped full of bravado by such “astroturf” organizations as Freedom Works, chaired by former Republican congressional leader Dick Armey. A speaker from Patients First, associated with the conservative group Americans for Prosperity, told activists. “Adolf Hitler issued six million end of life orders – he called his program the final solution. I kind of wonder what we’re going to call ours.”  Rush Limbaugh, himself closer to fascism than he realizes, also likens the Democratic push for health care reform to the Third Reich.  Sarah Palin refers to the plan, which she clearly hasn’t read, as “evil.”

The strategy behind these protests and the inflammatory (and misleading) rhetoric is to raise the specter of “socialized medicine,” “rationing,” and “death panels” allegedly sitting in judgment on the futures of sick Americans. What escapes these people is that all three are here and have been for some time. Only we call them “Medicare,” “Medicaid,” and “managed care.” Those who don’t realize this haven’t been paying attention for the past 35 years.

Protesters, those of you over the age of 65 who receive Medicare benefits, please sit down.  OK, now those of you who hope to live to 65 and take advantage of Medicare ( a government-run, taxpayer-supported program) you may also sit down.  Those of you who expect to be wealthy enough to rely entirely on private health insurance without government help for the rest of your life, be seated. Those of you who are absolutely positive that you will never lose your job and need health insurance benefits, take a load off your feet. Silence reigns.

With the exception of the independently wealthy, and I frankly doubt that any are attending these rallies, every American will, at some point, have to rely on government-sponsored, managed health care. Those of us who are fortunate to have employer-supported health insurance are quite familiar with “rationing.” It hides under different names and procedures: “pre-approval,” usual, customary and reasonable reimbursement,” and my favorite, “utilization management,” which is administered by a “utilization management committee.” These and many other procedures are focused on the reimbursement process, which in turn determines how and which health care services are delivered.  If you think we don’t have rationing now, drop into your primary care physician’s office, present your insurance card, and announce that you’d like to have liposuction, and that you’re happy to pay the $35 deductible but no more.

The nonsense about “death panels” is a reference to the proposed plan’s provision of end-of-life counseling mixed in with the U.K.’s approach to utilization management, which is not in the American proposal.  End-of-life counseling is a mental health service for those with a terminal illness. It is a routine part of hospice care, another service many of us may need. It is not roving squads of Death Angels issuing termination orders for of sick Americans.

Whatever their opinion of the current health care reform plans, these protesters mistake their free speech rights with irresponsible public discourse.  To claim that their representatives are not listening to them is ludicrous.  They’re listening, they’re just not hearing anything but misdirected, misinformed fury.

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