Death Panels Without the Panels

by Robert Wright

Atlantic

10 Aug 2009 10:11 am

What more is there to say about Sarah Palin’s now-famous claim that President Obama’s health-care plan features “death panels” that will give patients the thumbs up or thumbs down? Just that, if this were Obama’s plan, it would have more in common with our current system than you might think.

In Palin’s fantasy, the death-panel “bureaucrats” were going to pick winners and losers based on a judgment about their “level of productivity in society.” Well, if you view income as a gauge of a person’s productivity in society—and God knows there are Republicans who do—then the quality of health care is already correlated with “productivity in society.” Obama’s plan, by making health care more affordable to lower income people, would make that less true.

This is just another way of making a point already made by Peter Singer in response to less delusional concerns about the possibility of rationing under Obama’s plan: we already ration health care; we just let the market do the rationing.

Any government health care plan will bring some new form of “rationing,” since no government can afford to guarantee everyone all possible medical treatment. But let’s be clear: the people who are trying to sabotage reform by telling mind-boggling lies about its hidden rationing agenda seem, in fact, pretty content with rationing; they seem happy with a system in which the least “productive” members of society get bad health care, including, occasionally, health care so bad that it leads to death.

And if these opponents of health-care reform are going to conjure up images of fascism to caricature the pro-reform side, it seems fair to conjure up a comparably hyperbolic symbol of their side of the argument—social Darwinism. As Herbert Spencer put the social Darwinist credo, “The poverty of the incapable, the distresses that come upon the imprudent, the starvation of the idle, and those shoulderings aside of the weak by the strong, which leave so many ‘in shallows and in miseries,’ are the decrees of a large, far-seeing benevolence.” But I guess a picture of Herbert Spencer on a placard doesn't pack quite as much punch as a picture of Hitler.