When will politicians be willing to conduct adult conversation about palliative care?

…when Barack Obama has left the presidency.

Bachmann and Gingrich’s comments [at the Republican presidential debate]—ridiculous though they are—reflect an uncomfortable reality. Politically speaking, President Obama now owns two of the biggest systemic problems in America today. He obviously owns our economic predicament. Somewhat less obviously, he owns our health care financing and delivery predicaments, too. ACA’s main pillars won’t be implements until 2014. Yet if insurance premiums rise, blame health reform. If the number of uninsured rises, blame health reform. If experts say that particular cancer screening test is less valuable than you were hoping it would be, blame health reform.

Everything that people find discomfiting about evidence-based medicine, about rising health care costs, about the inherent uncertainties of new medical interventions and diagnostic technologies, about the tragic dimensions of end-of-life care—each of these things becomes yet another reason to dislike the new law.

This isn’t fair or logical. Actually, it’s very stupid. It’s where we are. Don’t expect Republicans to hold adult political conversation about such matters until Barack Obama has left the presidency.

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Author: Harold Pollack

Harold Pollack is Helen Ross Professor of Social Service Administration at the University of Chicago. He has served on three expert committees of the National Academies of Science. His recent research appears in such journals as Addiction, Journal of the American Medical Association, and American Journal of Public Health. He writes regularly on HIV prevention, crime and drug policy, health reform, and disability policy for American Prospect, tnr.com, and other news outlets. His essay, "Lessons from an Emergency Room Nightmare" was selected for the collection The Best American Medical Writing, 2009. He recently participated, with zero critical acclaim, in the University of Chicago's annual Latke-Hamentaschen debate.

13 thoughts on “When will politicians be willing to conduct adult conversation about palliative care?”

  1. “Don’t expect Republicans to hold adult political conversation about such matters until Barack Obama has left the presidency.”

    Why do you think his having left the presidency will change anything?
    Do you recall Republicans holding adult poltical conversations about anything when Bush 2 was president?

    I don’t.

  2. Don’t expect Republicans to hold adult political conversation about such matters until Barack Obama has left the presidency.

    Fixt.

  3. “Won’t be implements”?

    Anyway, some portions of the law have already kicked in; For instance, not being able to use my HSA for OTC medications. It is most assuredly driving up health insurance costs already, by increasing mandated coverage.

  4. Don’t wait around for the “adult conversations” until we get some INTELLECTUALLY HONEST conversations from the likes of this modern day Republican party, or whatever it actually is (because this “party” may turn out to be a Milo Minderbinder-like templete of its own syndicate-like-tendencies)!

    Our democratic heritage is being made into caricature by our “friends” on the Republican side of the aisle! I say to whomever’ll pay attention:

    Political Death to the Republican party so we can truly live open and liberty-minded lives! If you’ve been paying attention, the Rovean form of Republicanism is to create, through whatever means available, and sustain a one party system here in America. That is the core intent of early 21st century Rovean (and I would also contend Kochian) Republicans!

  5. The “adult conversations” cannot happen as long as someone’s sacred cow is getting gored. If proposed laws will adversely affect large corporations (also called “campaign contributors”), the proposed laws will be attacked. This is not limited to a single corporation. Healthcare is currently about 16% of our nation’s GDP. That means a huge amount of money is involved and the corporations are very much shaking the leashes of their pet lobbyists.

  6. It seems absurd to pretend that all the oxen which are being gored are corporate, and non of them belong to private citizens who were quite happy with their previous coverage.

    1. That’s a fair point. But the adult conversation still needs to be had, regardless of private citizens who pretend they aren’t part of a larger society.

  7. @brett-i’m still using my flexible spending account for otc meds. my doctor has kindly provided prescriptions for the most expensive ones i use. you might talk to yours.

  8. By the time I’ve spent money on the office visit to get the prescription, it’s not very cost effective. Anyway, the point was that this law has already kicked in, in many respects, which are costing people money right now. Even if the worst of it was put off an election cycle or two, out of the knowledge that it would be political death to do otherwise.

    1. as an informed consumer, i asked my doctor for the prescriptions at my first regular check-up after i knew i needed them. it didn’t cost anything more than i would have spent in the first place. i admit that i’m a little disappointed in the upcoming lower cap on flexible spending accounts but i also understand that those who have had advantages may need to sacrifice for the greater good. i don’t really understand folks who live with such resentment and hostility to the larger public.

  9. Brett: “It seems absurd to pretend that all the oxen which are being gored are corporate, and non of them belong to private citizens who were quite happy with their previous coverage.”

    again: “…quite happy with their previous coverage.”

    This law is primarily for the nearly 50 million people without previous coverage.

    You “suffer” a minor change in some of the coverage you previously had, millions of people finally have access to insurance that can help save their lives. Yep, I can see why someone like you would consider this law bad: It helps other people.

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