By Peter J. Smith

WASILLA, Alaska, August 13, 2009 ( – Former Alaska Gov. Sarah Palin has fired a returning salvo in the raging American debate over ObamaCare. She has taken on President Barack Obama's dismissal of legitimate concerns that the health care reforms may turn into “death panels” for the most vulnerable members of society.

The former vice-presidential contender's star has risen again since the election and already Sarah Palin has re-emerged as a powerful pro-life leader and a force to be reckoned with. Armed with web 2.0 savvy and massive popular following on Facebook, Palin has made heads in the media turn as she posts commentary on a profile that boasts 735,000 subscribers listed as “supporters.”

Late Wednesday evening, Palin fired back at President Barack Obama through her Facebook page for making light of her concern that the “sick, the elderly, and the disabled … could face the prospect of government bureaucrats determining whether they deserve health care.”

At a New Hampshire town-hall style meeting on Tuesday, Obama stated he wanted to dispose of a “rumor” that a provision in the House bill (HR 3200) “will basically pull the plug on grandma because we've decided that we don't, it's too expensive to let her live anymore.”

Instead, Congress intended, “to give people more information so that they could handle issues of end-of-life care when they're ready on their own terms. It wasn't forcing anybody to do anything,” insisted Obama.

However Palin refused to allow her concerns to be written off as fear-mongering, and her thought-provoking response and detailed foot-notes indicated the governor is no slouch when it comes to researching the issues.

“The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation. With all due respect, it's misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients,” wrote Palin. “The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.”

Under Sec. 1233, senior citizens on Medicare are offered these consultations every five years, and more often if they suffer a “significant change” in health, or “upon admission to a skilled nursing facility, a long-term care facility … or a hospice program.”

“During those consultations, practitioners must explain 'the continuum of end-of-life services and supports available, including palliative care and hospice,' and the government benefits available to pay for such services,” continued Palin, quoting and referencing the actual text.

“Now put this in context. These consultations are authorized whenever a Medicare recipient's health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending,” stated Palin. “Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care?”

Palin added that she is not alone in raising an alarm about the potential devastating consequences the bill might have pointing out that others “usually friendly pundits” such as Charles Lane of the Washington Post, columnist Eugene Robinson, and Democratic New York State Senator Ruben Diaz, Chairman of the New York State Senate Aging Committee, also have formed very similar conclusions.

On top of these concerns, Palin emphasize that her “original comments concerned statements made by Dr. Ezekiel Emanuel, a health policy advisor to President Obama … who also advocated basing medical decisions on a system which 'produces a priority curve on which individuals aged between roughly 15 and 40 years get the most chance, whereas the youngest and oldest people get chances that are attenuated.'”

Emanuel's approach, the “Complete Lives System,” has five principles which he lays out in “Principles for Allocation of Scarce Medical Interventions” published in The Lancet on January 31, 2009: “youngest first, prognosis, save most lives, lottery, instrumental value.” (read here)

While Emanuel's approach is a theoretical approach to rationing, a further concern is raised that CLS could make its way into rationing practices by either private insurers or the public option through protocols developed through a proposed Center for Comparative Effectiveness Research and the Commission overseeing its work (sec. 1401 of HR 3200).

The Center's duties would be “to conduct, support, and synthesize research … with respect to the outcomes, effectiveness, and appropriateness of health care services and procedures in order to identify the manner in which diseases, disorders, and other health conditions can most effectively and appropriately be prevented, diagnosed, treated, and managed clinically.”

Read Sarah Palin's Facebook Response to Obama “Concerning the Death Panels” 
Read H.R. 3200 “American Affordable Choices Act”  

Read more on Dr. Ezekiel Emanuel in New York Post “Deadly Doctors” 

Read Ezekiel Emanuel's article on Complete Lives System 

Read related coverage by

Palin Firestorm Brings Fresh Scrutiny to ObamaCare “Death Panels”
Dr. Emanuel, key Obama health care advisor, stated doctors take Hippocratic Oath too seriously


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