'Death Panels' Fabricator Linked With Big Tobacco

The apparent developer of the term "death panels" has been linked with . . . ummm . . . one of the biggest promoters of death: Big Tobacco. Here's the report from The Raw Story. Presented below are some links to information on Betsy McCaughey, including a hilarious appearance recently on "The Daily Show."

Report: ‘Death panels’ author worked with big tobacco to scuttle health reform

By Daniel Tencer
Published: September 20, 2009

The person credited with inventing the “death panels” claim about health care reform worked with tobacco giant Phillip Morris to railroad health care reform in the Clinton administration, Rolling Stone magazine reports.


In an article in the magazine’s October 1 issue, not yet available online, writer Tim Dickinson reveals that Phillip Morris “worked off-the-record with … writer Betsy McCaughey as part of the input to the three-part expose in The New Republic on what the Clinton plan means,” Rolling Stone reports.

McCaughey, a conservative columnist and former deputy governor of New York, penned a 1994 article in The New Republic that was credited with helping to kill the Clinton-era health reforms. As RS noted, the magazine later retracted the story. And The Atlantic magazine ran a story in 1995, entitled “A Triumph of Misinformation,” debunking McCaughey’s arguments at TNR.

Now McCaughey appears to be playing a pivotal role in efforts to shut down this year’s health reform efforts. ABC News credited McCaughey earlier this summer with being the person behind the “death panel” falsehood, when she said in a July appearance on the radio program The Fred Thompson Show that the health care reform effort was “a vicious assault on elderly people, all to … cut your life short.”

In that interview, McCaughey asserted that senior citizens would have to face “death panels” to determine their worthiness to continue living every five years.

Last month, Gawker blogger Pareene listed off a number of McCaughey’s more questionable assertions surrounding the health care debate, including her claim in a New York Post article that Dr. Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel, wants doctors to forego the Hippocratic oath and focus on “social justice” rather than healing patients. That article was entitled “Deadly Doctors.”

Susie Madrak, in her blog at Crooks and Liars, cites key parts of the Rolling Stone article:

[W]hat has not been reported until now is that McCaughey’s writing was influenced by Phillip Morris, the world’s largest tobacco company, as part of a secret campaign to scuttle Clinton’s health care reform. (The measure would have been funded by a huge increase in tobacco taxes.) In an internal company memo from March 1994, the tobacco giant detailed its strategy to derail Hillarycare through an alliance with conservative think tanks, front groups and media outlets. Integral to the company’s strategy, the memo observed, was an effort to “work on the development of favorable pieces” with “friendly contacts in the media.” The memo, prepared by a Phillip Morris executive, mentions only one author by name:

“Worked off-the-record with Manhattan [Editor's note: At the time, McCaughey was a fellow at the Manhattan Institute] and writer Betsy McCaughey as part of the input to the three-part expose in The New Republic on what the Clinton plan means to you. The first part detailed specifics of the plan.”

McCaughey served as lieutenant governor of New York from 1995 to 1998, under Republican Governor George Pataki. She recently resigned from the board of directors of Cantel Medical Corporation, saying she didn’t want her involvement with the firm to color her credibility on the health care reform debate. But many observers say the resignation was in reaction to an unfavorable appearance on Comedy Central’s The Daily Show.

Some misrepresentations--and the people who promote them--seem to be like cockroaches. No matter how many times you step on them, no matter how many times you spray them, they always seem to come back.

Here's more on Betsy McCaughey:

The Daily Show With Jon Stewart	Mon - Thurs 11p / 10c
Betsy McCaughey Pt. 1
www.thedailyshow.com
Daily Show Full Episodes Political Humor Healthcare Protests

Wikpedia on Betsy McCaughey

Gawker posting

Mark Ambinder posting on The Atlantic site

Betsy McCaughey resume

Blow Up Medicare and Start From Scratch

Medicare is so horribly screwed up, so out of control, that the best thing to do might well be to blow it up and start again from scratch. Honestly, I don't know if that's possible. But it sure is necessary.

The following is based on a report issued August 9 by the Office of Inspector General, Department of Health and Human Services, on "Prevalence and Qualifications of Nonphysicians Who Performed Medicare Physician Services." [OEI-09-06-00430] Sounds dry, I know. But stick with me for just another paragraph. Get this:

The study examined services provided by physicians "for days that Medicare allows more than 24 hours of services billed by a single physician." Now, that's not even the news. But read that again: Medicare allows a physician to bill for more than 24 hours of services in a single day.

So we start with the premise that it's legal, that it's acceptable, that it's within regulatory bounds for a single physician to bill for more than 24 hours of service in a day.

Now, Medicare Part B pays for services that are billed by physicians but are performed by nonphysicians. These services are often called "incident to" services. The HHS OIG report dryly notes: "'Incident to' services may be vulnerable to overutilization and may put beneficiaries at risk of receiving services that do not meet professionally recognized standards of care." You think? And maybe it puts the taxpayer at risk, too?

And here we start getting to the root of the problem. The report found that "When Medicare allowed physicians more than 24 hours of services in a day, half of the services were not performed personally by a physician." The report elaborates:

Physicians who were allowed services that exceeded 24 hours of physician worktime in a day personally performed approximately half of these services. Nonphysicians performed the remaining services, which physicians may have billed as "incident to" services.

The numbers, from the study's sample of 202 physicians for a 3-month period in 2007, found that "Medicare allowed $105 million for approximately 934,000 services that physicians personally performed and approximately $85 million for approximately 990,000 services that nonphysicians personally performed."

But, OK. At least, maybe, the services were performed by qualified non-physicians? Uh uh. No way. Again from the report:

Unqualified nonphysicians performed 21 percent of the services that physicians did not perform personally. In the first 3 months of 2007, Medicare allowed $12.6 million for approximately 210,000 services performed by unqualified physicians. These nonqualified physicians did not possess the necessary licenses or certifications, had no verifiable credentials, or lacked the training to perform the services. Nonphysicians with inappropriate qualifications performed 7 percent of the invasive services that physicians did not perform. [emphasis added]

So: Medicare allows physicians to personally bill for more than 24 hours of services in a day. It allows for billing by nonphysicians. And this study found that 21% of those services were performed by unqualified nonphysicians.

Out of curiosity, you might be wondering what sort of services these nonqualified nonphysicians were performing that the physicians then billed to Medicare.

Let's take "Invasive Procedures." Nonphysicians performed 62% of all invasive procedures: 96% of routine venipunctures, 73% of non-oral drug administration and chemotherapy, and 12% of surgical procedures. And how many of these were performed by nonqualified non-physicians? Fifteen percent were performed by nonphysicians with "no formal medical training" (which includes both on-the-job training and no relevant qualifications).

Let's take "Noninvasive Procedures." Nonphysicians performed 46% of all noninvasive procedures. Examples: Nonphysicians performed 81% of physical and occupational therapy evaluations, 46% of opthalmological diagnostic imaging and eye photography, and 48% of noninvasive cardiovascular services. And how many of these were performed by nonqualified non-physicians? Opthamology: 37% Rehabilitation therapy: 49%. Cardiovascular: 15%.

And I know I'm overwhelming you with facts and figures. But here's something interesting. Remember that this survey sampling looked at physicians who personally billed more than 24 hours of services in a day (which is permissible by Medicare). Still, what did they bill? 25 hours? 30 hours? No way. The average (the mean) billed by these 202 physicians was 37 hours. One billed 157 hours.

And how much did they bill for? The average amount billed by these 202 physicians was $9,816. The maximum billed was $45,055.

So let's recap:

• Physicians are allowed to bill for more than 24 hours of services performed in a day. Many do.
• Many of these services are performed by non-physicians.
• Over 20% of these services are performed by nonqualified non-physicians.

And a footnote: The number probably really is a lot higher. The OIG sample started off with 221 physicians. Four of those 221 were already part of an active OIG investigation, so they were removed from the sample. Another 15 physicians didn't respond to the OIG's request for information. (Hmmm. Wonder why?) So a full 10% either already were in trouble or may have felt hesitant about supplying the information.

You can find the report at http://oig.hhs.gov/oei/reports/oei-09-06-00430.pdf

Sarah Palin's "Death Panels" Already Exist

Did we really--really--almost place Sarah Palin one heartbeat away from the Presidency? Nah. It must have just been a nightmare. Kind of like Dorothy's visit to Oz, but without the beauty. Let's consider Ms. Palin's August 7 posting on Facebook.

As more Americans delve into the disturbing details of the nationalized health care plan that the current administration is rushing through Congress, our collective jaw is dropping, and we’re saying not just no, but hell no!

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Health care by definition involves life and death decisions. Human rights and human dignity must be at the center of any health care discussion.

Rep. Michele Bachmann highlighted the Orwellian thinking of the president’s health care advisor, Dr. Ezekiel Emanuel, the brother of the White House chief of staff, in a floor speech to the House of Representatives. I commend her for being a voice for the most precious members of our society, our children and our seniors.

We must step up and engage in this most crucial debate. Nationalizing our health care system is a point of no return for government interference in the lives of its citizens. If we go down this path, there will be no turning back. Ronald Reagan once wrote, “Government programs, once launched, never disappear. Actually, a government bureau is the nearest thing to eternal life we’ll ever see on this earth.” Let’s stop and think and make our voices heard before it’s too late.

Sarah, oh Sarah! Where to begin? Maybe with the wide-quoted statement: "The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care."

Tell me more, oh Sarah, about this death panel. So they'll be bureaucrats, and not, say, Presidential appointees. That suggests they'll come from the Executive branch of government, rather than legislative or judicial. Probably drawn from an agency like Health and Human Services. Except how could you create a "death panel" from an agency with "Health and Human Services" as its name? Seems like a name change is in order, though "Disease and Human Suffering" might not go over so well. Still, if the pro-abortionists are "Pro Choice" and the anti-abortionists are "Pro Life" (hey, both sound great!), someone certainly can come up with a name that'll get support. No, no. An even better example: The USA PATRIOT Act. Sounds so, umm, patriotic. That's actually an acronym for "United and Strengthening America by Providing Appropriate Tools Required to Intercept and Obstruct Terrorism Act." Pretty much decimated large parts of the Constitution, but it sure sounds great.

So, let's come up with a name. Hey, I've got it! The "DIGNITY and PEACE" Panel. Don't you love it? Dignity? Peace? Perfect! But let's see what the acronym is: Death Is Growing Near In The Young Person, Elderly, Aged, Crippled Everywhere.

OK, let's try to get serious again. And here, Sarah, you throw out a non-sequitor to beat all non-sequitors. You observe (correctly, as much as it may pain me to agree with you) that "Health care by definition involves life and death decisions." And you fear government death panels making those decisions. Fair enough. But who makes them now? The kindly, generous insurance companies? I feel better already. The pharmaceutical companies with their pricing and distribution strategies and policies? Doctors who are willing to treat when they're paid to do so, but may not even give you a moment if you wish to discuss a non-reimburseable topic (such as, umm, living wills or end-of-life decisions).

The life and death decisions are already being made. Sometimes through health care. Sometimes by the deprivation of care. It's happening today. It will continue to happen. We're not living in an idyllic era that's being threatened by Obama's death panels. Those death panels--as you might call them--already exist. They're at the pharmacy with pills that cost more than their weight in gold. They're at the other end of the phone line when an insurance company denies a claim. They're in your doctor's office when the first appointment you can get for a potentially life-threatening condition may be three months from now.

I'm no fan of government bureaucracy, nor am I an advocate for it. But let's get real. Death panels already exist.

Behind The Walls

The one-story building is tucked off a busy road in a residential area of Annandale about 12 miles from downtown Washington, D.C. Most people don't notice it as they pass by to a nearby church, grocery store, or restaurant, and that's the way it was intended.

You can drive up to the building, but getting inside is another matter. Outside, there's an electronic keypad, with the combination changed at random intervals. Once inside, visitors are faced with another secured door and another electronic keypad. Only if the current correct combination is entered both times can a visitor enter.

An entering visitor first notices the smell. It's not distinct--not clearly feces, not clearly body odor, not clearly cleaning liquid. But it's a sour, pervasive scent. The air itself is warm and moist. The next thing a visitor may notice are the cries in the distance: "Let me out of here." "I want to go home."

Security here is two-way. Those inside need to know the combination to exit, and none does. They're here for life. All but the front entrance is also surrounded by a tall security fence. The only telephones inside are under the control of security personnel. The meals are nutritionally adequate, but tasteless. They're usually accompanied by a small cupful of pills. Some behind the walls try to hide the pills, either in their hands, or in their mouths. But the security personnel are experienced in searching the hands and mouths for the secreted pills.

Each room has a bed and a dresser. Each also has a window and a toilet and sink. But they don't have baths or showers. Those are down the hall, and used only with supervision.

What is this place? A prison, perhaps? Well, maybe, in a manner of speaking. It's an "assisted living facility." Specifically, a facility for those with Alzheimer's. Oddly, though, many of those behind the locked doors don't seem to be declining mentally. Bring a soda to one and she remembers it for months. She'll tell you about her home nearby, and how she raised her family there. Talk to another one at dinner and she'll tell you about her service in World War II, and what her children and grandchildren are doing now. Now, it's true that most probably are better off with "assisted living." Some have difficulty dressing or bathing themselves. Most probably wouldn't remember to take their pills. Few of them would be able to drive safely.

But they didn't anticipate spending their final years in a prison. Ask them.

Some ended up here after "successful" extreme medical interventions that saved their lives. Others continue living here with such medical interventions occurring periodically.

And understand: This is a good facility. Good in that the residents aren't mistreated. Good in that the residents aren't uniformly drugged into a near comatose condition, making it far easier for the attendants to manage them. Good in that the attendants all speak English, though for most it's their second or third language. But "good" costs money--roughly $6,500 a month, plus some extras. Sometimes it's paid for by long term care insurance. Sometimes by the resident's assets. Sometimes by the children or relatives.

And here we're talking about assisted living facilities. Not nursing homes. That's another matter--one that deserves its own discussion.

But the issue here isn't one of cost. It's quality of life. It's respect for individual dignity. And it's respect for the wishes and desires of those who must face difficult decisions about their remaining years.

Ask yourself whether that's how you'd like to spend your remaining years. There's no correct answer. For some, it'll be "yes." For others, it'll be "no." For some, it'll be "I'll cross that bridge when I come to it."

Then visit one or more of these facilities. Talk with the residents. Listen to what they say.

In today's health care debate, there's no shortage of so-called and often self-proclaimed "experts" speaking for others. Granted: There are enormous complexities surrounding the health care debate, as well as many philosophical chasms. But when it comes to the elderly and how they wish to spend their final years--and even their definition of "final years"--those chasms shrink and those complexities simplify. Just talk with them. Then listen.