Sunday, December 26, 2010

Medicare and End of Life

The NY Times reports on the current Administration's practice of using Administrative practices of circumventing the law. Case in point is the end of life planning mandated by an earlier version of the Health Care Bill but removed after outcries of erstwhile death panels. Now counseling is most likely a good thing, and it is often a cultural issue more than a moral issue. Terminal disease, cancer or ALS, Parkinson, MS and the list goes on oftentimes requires prior patient planning. Yet there are cultures who want to do whatever necessary to keep the tubes in place and of course we all pay, even the patient.

Yet the issue here is not end of life, it is the fact that be it health care or CO2 control by the EPA or the regulation of the Internet by the FCC, a President can use the Administrative Law process to go around Congress and the people. That indeed is the issue and the fear. People may think they voted for X and then they get Y, and ask how? It is in the writing of the code. Then you must bring it to court. And pray for an ethical judge.

The true problem with this example is the gross arrogance of an appointed person who avoided Senate oversight  having the extreme arrogance and sense of apparent self importance to issue a directive during the Holiday, yes Christmas, season. I believe that prior planning prevents poor performance and that advanced directives have substantial merit. Thus there is no disagreement on the merit it is disagreement on the practice, namely the practice of giving the people a nasty hand sign.