So here's the section, H.R. 3200 Section 1233, that she seems to think leads to "death panels". (I know she didn't use that phrase, but that's what she's been driving at.)

(b) Expansion of Physician Quality Reporting Initiative for End of Life Care-

(1) Physician'S QUALITY REPORTING INITIATIVE- Section 1848(k)(2) of the Social Security Act (42 U.S.C. 1395w-4(k)(2)) is amended by adding at the end the following new paragraphs:

`(3) Physician'S QUALITY REPORTING INITIATIVE-

`(A) IN GENERAL- For purposes of reporting data on quality measures for covered professional services furnished during 2011 and any subsequent year, to the extent that measures are available, the Secretary shall include quality measures on end of life care and advanced care planning that have been adopted or endorsed by a consensus-based organization, if appropriate. Such measures shall measure both the creation of and adherence to orders for life-sustaining treatment.

`(B) PROPOSED SET OF MEASURES- The Secretary shall publish in the Federal Register proposed quality measures on end of life care and advanced care planning that the Secretary determines are described in subparagraph (A) and would be appropriate for eligible professionals to use to submit data to the Secretary. The Secretary shall provide for a period of public comment on such set of measures before finalizing such proposed measures.'.

She seems to think that this measure will lead to incentivizing doctors to go through a whole huge long list of choices regarding end of life decisions, encouraging patients to refuse treatments, and then penalizing doctors if patients try to change their minds. Given she doesn't have any legal training whatsoever (although she is apparently good at throwing parties for wealthy Wall Street elites), I'd rather not hold it against her that she can't read and interpret legislation to save her life. But if she's going to imply that she's some sort of expert, I'm going to have to take her to task.

First, there is nothing in here that specifies any long list of choices that doctors must force their patients to make. First, the bill says that if patients want to, Medicare will pay for a consultation every five years. And there is no long list specified either, if the patient should choose to have that consultation.

Second, there is no incentive to encourage patients to refuse treatments. During the consultation, patients are free to say that they want the doctor to do anything and everything to save their life and resuscitate them. (Even including, if you go to Jon Stewart's doctor, gold plated enemas.) If you want to refuse treatment, you can. If you don't want to refuse treatment, you don't have to.

And that brings me to the third point: that somehow doctors will be penalized if patients change their minds. She comes up with this by noting that the quality rating of doctors will be partially determined by how well doctors follow the decisions set out in a patient's living will, if they have one. This is, quite possibly, the most disgusting claim she makes. Let me explain.

First, nothing in here says that a patient can't change their mind before a living will is needed. Draft one today, change your mind and draft a new one tomorrow. Only the most recent one will be followed. That's how they work; just like a regular will. But what if you're in the hospital? How do they work then? I, unfortunately, have had some experience with this and would like to explain.

If you're in the hospital, and you're conscious, then your living will doesn't come into effect. Make any and all decisions you want. It's only if you're not able to indicate what you want the doctors to do that your living will comes into effect. And doctors will regularly consult with the next of kin even when following a living will.

But for me, the worst part of her argument is that, for some reason, we should be encouraging doctors to ignore living wills. That, somehow, encouraging doctors to follow a patient's wishes is a bad thing. As someone who has had to help draft these documents and as someone who has had to watch procedures take place that were following a patient's wishes, I can say that is possibly the most disgusting thing I have ever heard.

As human beings, one of the most important freedoms we have is to control our own body and how it is treated. If a person chooses to ask for any all methods of life-saving treatment in situations where that person is incapacitated, we should follow their wishes. And if they choose to eschew those treatments, for whatever reason they choose, that choice should be honored. The thought that somehow we should not encourage doctors to follow the wishes of patients is ludicrous and, having known how painful an end of life decision is when doctors are following through on it, disgusting.

Betsy McCaughey is taking hyperbole and fearmongering deep into the heart of the health care debate. For this, she should be shunned and humiliated. I, for one, will not be happy until she is completely ignored in the public debate. And I have no doubt there are many who read this who agree with me.

UPDATE:

Not a really exciting update. I'm just going to bed so I won't be here to banter back and forth with you. Being unemployed is exhausting after all. ;-) Feel free to keep up the tips and recs though. I swear I'll figure out a way to trade them in for my Recliner of Rage.

UPDATE 2:

Wow! I made the rec list! I wish I hadn't been asleep when it happened. Thank you everyone!