Rep. Earl Blumenauer from Oregon suddenly finds himself in the media spotlight because of a provision he inserted into the health care legislation that allows Medicare to pay for consultations between doctors and patients about end of life care. It does not mandate such consultations nor in any way require advocacy on the doctor’s part of euthanasia. The proposal enjoys bipartisan support. It is also tone-deaf.
The focus of health care reform has to be two fold: It must contain insurance costs for those who already have it and it must extend insurance coverage to those who don’t already have it. Period. As a side benefit, and principal argument for the necessity of doing something now, the containment of costs will not only help average Americans, it will save the government money. If left unaddressed, the costs of Medicare and Medicaid will break the government’s budget irrevocably.
Blumenauer, heretofore known mostly as the founder of the Bike Caucus, argues that his idea is non-controversial, that the people objecting are just trying to sink health care reform more generally. He says that the opposition is making up lies, arguing that the provision will lead to pressure on patients to end their lives, making euthanasia more common. (Blumenauer is from Oregon where assisted-suicide is already legal.) That may be true, but he fails to see how his idea, and indeed any idea, that does not directly relate to cost-containment or the achievement of universal coverage must be set aside because it distracts people and it alarms them. In a large bill like this, people worry what will have been snuck in. Rep. John Conyers admitted that members do not actually read the entire legislation. So, even if Blumenauer’s idea is right, he still should not be giving the enemies of health care reform another cudgel.
Also, Blumenauer and liberals more generally should know that after Roe the rest of us learned that when one is considering a moral issue, you do not go to a doctor, you go to an ethicist. To say that abortion and end of life issues are medical issues, is to rig the game. Medicare should reimburse priests and rabbis and ministers for these discussions, not doctors. So, there are reasons to object to his proposal that are legitimate.
Of course, the administration spokesmen don’t always do better. On Sunday, on George Stephanopoulos’ show, Treasury Secretary Timothy Geithner, who clearly knows his stuff, got into a line of reasoning that, while true, is bad politics, arguing that our health care reform efforts would achieve what other nations have achieved, including the savings. Again, this may be true, but American exceptionalism remains so strong that it is a horrible argument to make. Pat Buchanan, every night of the week, sits across the table from Chris Matthews to say, in so many words, "Thank God we are not French." Sadly, Mr. Buchanan’s argument has more effective salience with the electorate than does Geithner’s.
Democrats are close to achieving a goal that has eluded them since Harry S. Truman sat in the Oval Office. They should not use health care reform to do anything except contain costs and extend coverage. Anything that smacks of social policy beyond those goals must be set aside, most especially abortion, but Rep. Blumenauer’s proposal too. Do not muddy the waters. The choice facing the Congress should be narrowed to this: Do we change the system to make it more affordable and accessible, or not? Change was the mantra that carried President Obama into the White House last year and so long as "change" remains a contentless noun, almost everyone is for it. Now, as the White House fills in what it means by change on health care, it should keep the focus narrow and avoid anything that suggests a change in mores. They have enough on their hands as it is.