Forbes ‘ Karlgaard alleges funereal message in Obama’s black tie — which wasn’t black
On the June 27 edition of Forbes on Fox, host David Asman introduced a segment about “saving lives versus saving money,” and then aired a clip of President Obama stating during the June 24 ABC health care forum, “At least we can let doctors know and your mom know, that you know what, maybe this isn’t going to help. Maybe you’re better off not having the surgery but taking the painkiller.” Later in the segment, Forbes publisher Rich Karlgaard claimed of Obama’s remarks: “[W]hat he’s indicating is that government health care involves rationing. It’s kind of funny that he let it slip out. It was kind of funny he signaled it by wearing a black tie, the color of funerals. There’s going to be more funerals for old people going ahead.” However, as the full context of the remarks Asman aired make clear, Obama, who was not wearing a black tie at the event, was specifically referring to medical procedures that are “not making anybody’s mom better” and “additional tests or additional drugs that the evidence shows is not necessarily going to improve care.”
From the ABC special, with the portion of Obama’s remarks that Asman aired in bold:
[W]hat we can do is make sure that at least some of the waste that exists in the system that’s not making anybody’s mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery but taking the painkiller.
And those kinds of decisions between doctors and patients, and making sure that our incentives are not preventing those good decision, and that — that doctors and hospitals all are aligned for patient care, that’s something we can achieve.
Contrary to Karlgaard’s claim that Obama “w[ore] a black tie, the color of funerals,” the tie Obama wore during the ABC forum was not black:
From the June 27 edition of Fox News’ Forbes on Fox:
DAVID ASMAN: But first, saving lives versus saving money. To the most controversial statement President Obama’s ever made about national health care. Take a listen.
OBAMA [video clip]: At least we can let doctors know and your mom know, that you know what, maybe this isn’t going to help. Maybe you’re better off not having the surgery but taking the painkiller.
ASMAN: Now, is the president saying he wants government-run health care to make that call? Hi, everybody, I’m David Asman. Welcome to Forbes on Fox. Let’s go “In Focus” with Steve Forbes — by the way, don’t miss his great new book about making great leaders, Power, Ambition, Glory. also here, Rich Karlgaard, Elizabeth MacDonald, Neil Weinberg, along with John Rutledge and Quentin Hardy. Steve, let’s start with you.
FORBES: Hey, money is always going to triumph lives. We’ve seen that in socialized medicine in other countries. In Britain, for example, if you’re above a certain age, you need kidney dialysis, you’re not going to get it. They always put — in Holland, they have euthanasia. And in this country, they’re all going to point out, well, in of the last three months, you spend most of the money — or in the last six months, why not just take that painkiller and be done with it, and look at all the money we’ll save? So, yes, money will — and with government, unlike business sector, in government, money will trump over lives.
ASMAN: So, E-Mac, was the president saying that government will call the shots?
MacDONALD: I don’t think right in that quote, but he better not be saying that. But you know, I personally have seen, you know, doctors with their interns scribbling on clipboards trying out, test-driving new medical equipment on the indigent poor who don’t have the families there to tell them to stop — resuscitative machines, all sorts of things. And, you know, we know that fee-for-service has driven surgery rates up higher because they get paid on the amount of surgeries you do.
I agree with Steve, though. You know, Tom Daschle talking about a health care, you know, a health federal reserve. What are they going to set, health inflation targets? The issue is, David, do you want bureaucrats deciding the rules here and who gets to spend the money, who gets to be the beneficiaries of the money? And it could get politicized.
ASMAN: Rich Karlgaard, is the president saying that government will be calling the shots here?
KARLGAARD: Well, what he’s indicating is that government health care involves rationing. It’s kind of funny that he let it slip out. It was kind of funny he signaled it by wearing a black tie, the color of funerals. There’s going to be more funerals for old people going ahead.
The thing that worries me most is whenever the government gets involved, you know, it apportions things by political favors. I mean, that’s the Chicago way. So we’re going to see certain political groups getting more health-care favors than others.
From ABC’s June 24 Primetime Questions for the President: Prescription for America:
SAWYER: And we have with us a couple of people who really represent the opposite ends on this spectrum too. I want to talk, if I can, to Jane Sturm. Your mother, Hazel - Hazel Homer –
JANE STURM: Yes.
SAWYER: — 100 years old and she wanted –
STURM: She’s 105 now, over 105. But at 100, the doctor had said to her, I can’t do anything more unless you have a pacemaker. I said, go for it. She said, go for it. But the arrhythmia specialist said, no, it’s too old. Her doctor said, I’m going to make an appointment, because a picture is worth a thousand words. And when the other arrhythmia specialist saw her, saw her joy of life and so on, he said, I’m going for it.
So that was over five years ago. My question to you is, outside the medical criteria for prolonging life for somebody elderly, is there any consideration that can be given for a certain spirit, a certain joy of living, quality of life? Or is it just a medical cutoff at a certain age?
OBAMA: Well, first of all, I want to meet your mom, and I want to find out what she’s eating. But, look, the first thing for all of us to understand is that we actually have some — some choices to make about how we want to deal with our own end-of-life care. And that’s one of the things I think that we can all promote, and this is not a big government program. This is something that each of us individually can do, is to draft and sign a living will so that we’re very clear with our doctors about how we want to approach the end of life.
I don’t think that we can make judgments based on peoples’ spirit. That would be a pretty subjective decision to be making. I think we have to have rules that say that we are going to provide good, quality care for all people.
GIBSON: But the money may not have been there for her pacemaker or for your grandmother’s hip replacement.
OBAMA: Well, and — and that’s absolutely true. And end-of-life care is one of the most difficult sets of decisions that we’re going to have to make. I don’t want bureaucracies making those decisions, but understand that those decisions are already being made in one way or another. If they’re not being made under Medicare and Medicaid, they’re being made by private insurers.
We don’t always make those decisions explicitly. We often make those decisions by just letting people run out of money or making the deductibles so high or the out-of-pocket expenses so onerous that they just can’t afford the care. And all we’re suggesting — and we’re not going to solve every difficult problem in terms of end-of-life care. A lot of that is going to have to be we as a culture and as a society starting to make better decisions within our own families and for ourselves.
But what we can do is make sure that at least some of the waste that exists in the system that’s not making anybody’s mom better, that is loading up on additional tests or additional drugs that the evidence shows is not necessarily going to improve care, that at least we can let doctors know and your mom know that, you know what? Maybe this isn’t going to help. Maybe you’re better off not having the surgery but taking the painkiller.
And those kinds of decisions between doctors and patients, and making sure that our incentives are not preventing those good decisions, and that — that doctors and hospitals all are aligned for patient care, that’s something we can achieve. We’re not going to solve every single one of these very difficult decisions at end of life, and ultimately that’s going to be between physicians and patients. But we can make real progress on this front if we work a little bit harder.
