If you are having trouble viewing this email, click here.

August 20, 2009

by Wesley J. Smith

side bar side bar side bar side bar side bar side bar side bar side bar side bar side bar President Obama's drive to remake the entire American health care system—dubbed "Obamacare" by friends and critics alike—has been seriously hobbled by fears of "death panels" and worries Grandma will be denied life-saving care by rationing boards or pushed by end-of-life counselors into "taking the pain pill" (to quote the president) rather than accepting life-extending treatment. 

With the Administration struggling to assure millions of worried Americans that Obamacare will not unleash such a culture of death, it seems exceedingly odd that at a recent town meeting in Grand Junction, Colorado, the president would tout the Netherlands' health care system as a "good example" for America to emulate.

The president mentioned Dutch health care while defending his "public option," claiming that its "government is involved [in health care] but you still have a thriving private insurance market." Talk about an understatement: The Dutch have what is known as a two-tiered system of financing care. Everyone must purchase insurance from heavy regulated private insurance companies that offer plans with benefits set by the government. While the plans compete with each other on price, each company's plans must be sold at the same price to everyone regardless of their age and state of health. It is illegal to refuse to sell anyone insurance, to create deductibles, or to refuse to fund treatments that a doctor has determined to be medically necessary. Employers pay 50% of the premiums and citizens 45%, and the government subsidizes people who can't afford premiums.  Long term care is paid by the government, as is chronic mental health treatment and end of life care, services that are financed through taxation. Insurance companies that have heavy payouts are compensated by the government and a competition regulator ensures that the companies don't act against the consumer's interests.

That's a lot more than just being "involved." In a country the size of the USA, instituting such a heavily regulated, universally mandated two-tiered system would, to say the least, be an administrative challenge. 

That matter aside, given the widespread public fear that Obamacare will destroy Hippocratic medical values, it is very odd that the president would pick that particular country as a template for emulation. You see, Dutch doctors are not just healers; many are also active killers. Since 1973 when a Dutch trial judge effectively decriminalized active euthanasia under supposedly "strict" guidelines (later legalized by the Parliament), doctors there have lethally injected or assisted the suicides of tens of thousands of their sick, disabled, elderly, and even physically fit but depressed patients.

Usually, euthanasia is voluntary. But according to several Dutch studies, physicians also engage in non voluntarily euthanasia, illegally lethally injecting hundreds of patients each year who never asked to die—a practice known as "termination without request or consent."  Even though such killings are technically murder under Dutch law, doctors who euthanize people who never asked to be killed are almost never prosecuted, and the few that are rarely receive any meaningful punishment.

Mercy killing has even entered Dutch pediatric wards, with doctors euthanizing scores of seriously disabled or terminally ill babies each year. Indeed, according to two studies published in the Lancet, Dutch doctors lethally inject about eight percent of all babies who die in the Netherlands annually, about 80 children.  Chillingly, the journal reported that 45% of Dutch neonatologists and 31% of pediatricians responding to the Lancet study questionnaires admitted committing infanticide. Not only are these crimes—also technically murder—only rarely punished, but infant-killing doctors from the Groningen University Medical Center boldly published the "Groningen Protocol" describing the guidelines they use in determining which babies to euthanize. And even though they admitted to killing about fifteen babies under the protocol, they were never prosecuted.

Of course, none of this means that if Obamacare passes, we too will fall off Euthanasia Cliff.  But it is worth noting that in Oregon—where assisted suicide is legal and Medicaid (the government funded insurance fund for the poor) is rationed— two terminally ill cancer patients were denied life-extending chemotherapy by bean-counting bureaucrats and then offered assisted suicide instead.

Moreover, given that the system's overhaul has been primarily sold to the public as a way of cutting costs, and given that the drugs to end life cost under $100, it is worth noting that Derek Humphry, founder of the Hemlock Society, called cost savings the "unspoken argument" in favor of legalization. In his book Freedom to Die, Humphry wrote:

There will likely come a time when PAS [physician-assisted suicide] becomes a commonplace occurrence for individuals who want to die and feel it is the right thing to do by their loved ones.  There is no contradicting the fact that since the largest medical expenses are incurred in the final days and weeks of life, the hastened demise of people with only a short time left would free resources for others.  Hundreds of billions of dollars could benefit those patients who not only can be cured but who want to live.
Don't get me wrong: There is no evidence that Obama plans for assisted suicide/euthanasia to become a means of easing our strained health care budget.  But his proposal would mark a major change in American law and morality. Thus, if Obamacare breaks down Hippocratic medical ethics—as I think it would—if its proposed centralized cost control board imposes health care rationing and a concomitant duty to die—which, given the views of his closest health care advisers, it very well might—and if assisted suicide/euthanasia ever becomes merely another medical treatment choice—it is now legal in three states—the Netherlands may turn out to be more of a model for American health care than even the president may now suppose.

Responses to Much Ado About Something

Question... My Health Care Insurance costs have gone up double digits for the past number of years. If we keep the health care the same in this country this will probably continue, since someone has to pay for the uninsured... or prohibit the uninsured from getting health care... but cost still go up - meds, new procedures, new hospital procedures. What is the plan of those against the present 1100 page health care proposals - what is your plan to deal with health care costs? - DW

Greetings. I find it fascinating as a US citizen who has lived in Canada for 35 years to hear the bruhaha about health care reform in the USA. Personally, we are grateful for the health care system in Canada, where everyone has access to health care. It boggles my mind that 40 million people in the United States (more than the whole population of Canada), surely one of the wealthiest countries in the world, do not have health insurance, and that many Christians, whose faith is anchored in the Great Physician, find that acceptable, and resist any efforts to bring those 40 million into a system that cares about their health. Some of the rhetoric I have heard, particularly those that bad-mouth Canada's system, reflect both ignorance of our system, and a self-centred agenda that certainly appears to lack compassion for those who do not have access to adequate health care. What has happened to the Church as a healing community? - Stephen P. Kristenson, Pastor

What about waiting lines for tests and procedures? The president assures us that there won't be any, but that seems an empty promise. When more than 40 million additional people obtain health insurance without materially increasing the number of physicians, nurses, and health care facilities, bottlenecks are sure to form—evidenced by the long waits for tests and some procedures in countries with universal coverage like Canada, the UK. I completely disagree with this entire article and find it offensive. Most egregious, it is telling me that as a Christian I am supposed to be opposed to bills to try to achieve universal coverage because someone who does not have health insurance will get coverage and I may have to wait or be inconvenienced. also based on my and my familes' experience and what extended family members who are physicians and my son who is a second year medical student tell me, there is way too much testing right now. They system could probably easily handle extra business. With out regard to inconvenience, arguing against Universal coverage on this basis is morally as defunct as opposing the government purchasing food to give to starving people because those who have food may experience an increase in price or might have to do with less... or worse, ingnoring the impact of making bio-fuels out of foodstuffs on other people's ability to afford food... - Michael Ebers Houston, Texas

Dear Editors: I have greatly appreciated and grown from your email over the years...many thought-provoking articles! Your new section on children, however, seemed to tout the book Redirecting Children's Behavior. I remember reading this text a while back and found it based on non-Christian philosophy, including branding any spanking as wrong and seeing no God-given basis for parental authority...the basis for redirecting is utilitarian only. Have you looked into the philosphy underlying this text, which of course, has some good counsel also? Cordially, - Rev. P. Ingeneri

Send your letter to the editor to feedback@tothesource.org.
Click for a Printer Friendly Version
about tothesource
We live complex lives. We strive to sort out priorities that sometimes conflict or seem incompatible. A moral framework is needed to help us understand the reality around us. Our Judeo-Christian heritage provides a framework to help us comprehend the choices we make and the conflicts that arise over them. It is not only the main source of our spiritual values, but also many of the secular values we depend on.

tothesource is a forum for integrating thinking and action within a moral framework that takes into account our contemporary situation. We will report the insights of cultural experts to the specific issues we face believing these sources will embolden people to greater faith and action.
subscribe email a friend
We invite you to subscribe to our free email service
that features informed opinion on current cultural issues.
wesley smith   Wesley J. Smith
Award winning author Wesley J. Smith, the associate director of the International Task Force on Euthanasia and Assisted Suicide, is a senior fellow in human rights and bioethics at the Discovery Institute and a special consultant to the Center for Bioethics and Culture. His book Forced Exit: The Slippery Slope from Assisted Suicide to Legalized Murder (1997), a broad-based criticism of the assisted suicide/euthanasia movement was published in 1997. His book Culture of Death: The Assault on Medical Ethics in America, a warning about the dangers of the modern bioethics movement, was named One of the Ten Outstanding Books of the Year and Best Health Book of the Year for 2001 (Independent Publisher Book Awards). He is currently writing a book about the animal rights movement.
tothesource, P.O. Box 1292, Thousand Oaks, CA 91358
Phone: (805) 241-3138 | Fax: (805) 241-3158 | info@tothesource.org