Obamacare and the Ghost of Terri Schiavo

NPR’s headline on yesterday’s town hall on health care by President Obama:

Obama Says His Health Plan Won’t ‘Pull The Plug On Grandma’

The NY Daily News had a similar headline using that quote in this morning’s print edition, as does this Reuters item; the NY Post less delicately shortens the headline to ‘WE WON’T PULL PLUG ON GRANNY’.

This is not the place the White House wanted to be in right now. Even George W. Bush, as many things as his opponents threw at him and as low as his approval ratings went at times, never felt compelled to … well, as Jake Tapper put it,

[I]f the president finds himself at a town hall meeting telling the American people that he does not want to set up a panel to kill their grandparents … perhaps, at some point, the president has lost control of the message.

I’ve previously covered one of the primary reasons why Obama is in this pickle: he doesn’t have a clearly defined, easily and consistently explained plan. There are still multiple bills, none of which has the unambiguous support of either the White House or a working majority in both Houses of Congress; the bills are massively long and complicated, yet for the most part they leave huge numbers of unanswered questions by deferring important decisions to vaguely-constructed and questionably supervised bureaucracies. Many of the worst things in the bills are not what they say they will do, but what by silence they would permit to happen. The absence of a ban on using federally-provided insurance funds for abortions is one example, as noted by the US Conference of Catholic Bishops in explaining why the USCCB (long a supporter of more government funding for universal health care coverage) can’t support the House bill:

Some seemed surprised at [a previous objection by the Bishops], since abortion was not specifically mentioned in draft health care bills until recently. Those with longer memories may recall that the Medicaid statute doesn’t mention abortion either, but it was funding 300,000 abortions a year in the 1970s until we put a stop to that with the Hyde amendment. In any case, numerous amendments to keep abortion out of health care reform have been defeated in committee, and it is now apparent that some leaders have every intention of threatening the health care reform process by forcing Americans to accept abortion mandates and/or fund unlimited abortion in their health coverage.

Camille Paglia, also a supporter in general of health care ‘reform’ but a critic of Obama’s approach, connects the same dynamic to the debate over whether Obamacare would create “death panels” empowered to cut off treatment for those deemed not worthy of continued life, as we have seen happen in European systems:

I simply do not understand the drift of my party toward a soulless collectivism. This is in fact what Sarah Palin hit on in her shocking image of a “death panel” under Obamacare that would make irrevocable decisions about the disabled and elderly. When I first saw that phrase, headlined on the Drudge Report, I burst out laughing. It seemed so over the top! But on reflection, I realized that Palin’s shrewdly timed metaphor spoke directly to the electorate’s unease with the prospect of shadowy, unelected government figures controlling our lives. A death panel not only has the power of life and death but is itself a symptom of a Kafkaesque brave new world where authority has become remote, arbitrary and spectral. And as in the Spanish Inquisition, dissidence is heresy, persecuted and punished.

Surely, the basic rule in comprehensive legislation should be: First, do no harm. The present proposals are full of noble aims, but the biggest danger always comes from unforeseen and unintended consequences.

Even beyond the particulars of the present bills, what Obama and his Congressional allies are confronting is the legacy of their own party’s deliberately constructed image. And a part of that image that they may least have expected to haunt them is the ghost of Terri Schiavo.

Political parties are not born anew each election cycle. The average voter, having limited time to devote to politics, very prudently comes to rely upon the general reputation of a party to form an impression of what its individual members stand for. A reasonably informed voter will try to learn at least a few things about particular candidates, but even political junkies rarely know A to Z on where all their elected representatives stand on every issue of public consequence (quick: what does your State Senator think about immigration? capital gains taxes? the minimum wage? gun control?). Thus, a party’s image is important and carries the baggage, for good and for ill, of the high-profile debates in which it takes a prominent position. Moreover, a party’s image is built not only by its leaders but its supporters inside and out of public office. People can usually filter out the crazies on the margins, but the battery of media commentators and activists involved in any given controversy add to that overall image.

Indelible images are hard to shake. During the last election, Obama ran ads criticizing John McCain for opposing federal funding for stem cell research and being an anti-immigrant hardliner. These were blatant lies, of course – the polar opposites of McCain’s actual positions, laughably in the case of the immigration ads given that McCain had risked his political career over his support for the comprehensive immigration bill – but Obama obviously assumed that the ads would be effective because the audience would identify McCain with his party’s reputation on those issues and would be unaware of his actual record.

Which brings us to Terri Schiavo. Now, I have previously discussed the immediate political cost to the Bush Administration’s agenda of the Schiavo brouhaha in March of 2005. Commentators have debated for some years now how much political damage the GOP suffered with moderates from its identification with the movement (headed largely by committed pro-lifers, many of them religious) to prevent the State of Florida from, essentially, starving the brain-damaged Schiavo to death. That controversy was an unsettling one: the issue was what to do about a woman who had no medically realistic prospects for recovery, was consuming expensive healthcare dollars, and had left no reliable instructions on what her wishes would be in that situation, and a lot of people were very uncomfortable with either option, continuing to pay for her care or depriving her of nourishment. Public opinion at the time was hardly unanimous on what should be done (indeed, even some high-profile left-wingers sided with those who opposed removing Schiavo’s feeding tube). The conventional wisdom in the pundit class was that the damage done was all to one side – that the flap revealed the GOP to be in the thrall of religious extremists. I don’t doubt that some such damage was indeed done. But little attention was paid to the fact that the Right vs Left narrative of the Schiavo episode – one willingly stoked by Democrats eager to capitalize on precisely the “Religious Right overreach” angle – painted the Left as the advocates of ‘pulling the plug’ on Terri Schiavo. Another anecdote had been added to the public’s collective memory of what the two sides stand for – an anecdote, I should add, that is consistent with other pieces of the puzzle, as the Left has clashed with the same pro-lifers again and again on abortion, assisted suicide, and the destruction of embryos for stem cell research. Sarah Palin’s invocation of her Down’s Syndrome son Trig is another flashpoint: it is the Left that insists that it is appropriate to abort a child when prenatal testing reveals such a condition, and it was from the Left that we heard cruder jibes suggesting that Palin should have done just that. A coherent pattern emerges, forms itself and takes root in the public’s mind.

In 2006 and 2008, nothing happened – at least, nothing visible that would interfere with the Democrats’ march to power, as other issues were at the fore and nobody on either side much wanted to discuss euthanasia. But now, with health care legislation at stake and the end-of-life issues it poses front and center, and with “cutting costs” a core part of his mantra for “reform,” Barack Obama is running into the legacy of Terri Schiavo and those other pieces of the pattern. Schiavo’s name isn’t heard much, but it doesn’t have to be, because it’s part of the public’s memory. The American people know that the same people who wanted to pull the tube from Terri Schiavo want to be trusted not to pull the plug on grandma. Which is why they are appropriately skeptical of any hint that Obamacare would leave any power in federal hands to make those decisions.

Four years ago, the Left was proud of its stance on withdrawing not just medical care but food itself from Terri Schiavo. That was their choice. If the price to be paid is a public in need of assurance that President Obama and his plan don’t share those values and won’t encourage the same thing, well, choices have consequences, and the voiceless dead can still haunt us in ways we had never foreseen.