Globe Editorial

When the truth won’t stop health reform, try lies

August 8, 2009

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BY ALL MEANS, members of Congress should hold town hall meetings in their districts to discuss Capitol Hill’s proposals for health reform. Included in the major bills are significant changes in the system: mandates that individuals get insurance and that employers provide it, provisions in some bills for a Medicare-like public option for consumers, and calls for new taxes to pay for expanded coverage. But the necessary debate will not take place if obstructionists who oppose any reform raise public ire by grossly distorting the proposals.

A case in point is a clause in the House bill that would have Medicare reimburse doctors who sit down with elderly patients to discuss end-of-life services. House Republican leader John Boehner has said this “may start us down a treacherous path toward government euthanasia.’’

Betsy McCaughey, a former lieutenant governor of New York and health expert who has been critical of both the Clinton reform plan of the 1990s and more recent proposals, said the provision mandates elders to have such conversations. It clearly does not, nor does it require a patient to sign a living will after a consultation. According to John Rother, vice president of AARP, the measure “would not only help people make the best decisions for themselves but also better ensure that their wishes are followed.’’ But the seniors group’s endorsement has not kept such right-wing commentators as Rush Limbaugh and Fred Thompson from echoing McCaughey’s willful misreading.

Since 1990, federal law has required hospitals and nursing homes to give patients information on their state laws regarding living wills. The House bill would simply ensure payment for doctors who spell out end-of-life services for seniors. These discussions should be standard procedure. That special legislation is needed to make sure doctors get paid for them merely underscores the flaws in the current fee-for-service system. Only in the fevered imaginations of diehard health reform foes is this a mainline to mercy killing.

The mischaracterization is intentional: Opponents are trying to scare the public away from any overhaul of the system. They might succeed. Or they might distort the discussion so completely that vital issues such as new mandates on individuals and employers, creation of a public insurance option, or new taxes slip by without debate. Opponents of healthcare reform should have enough faith in their views to argue them squarely, without resorting to distractions and distortions.

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