The Conversation

HHS: Mighty, and helpless

In response to Ace is Right, and so is Kathleen Sebelius, on Sarah Murnaghan:

It's not surprising that many reactions to the Murnaghan story are influenced by her youth.  We have both an emotional and social tendency to protect children.  Much personal conduct, and many public policies, take this into account.  (And politicians frequently use it to manipulate us.)

With allowances for the patient's youth made, some of the response to Sebelius goes beyond visceral revulsion at the callousness of her "someone lives and someone dies" attitude - which is, as you pointed out, logically valid.  The crisis at hand was caused by a bureaucratic restriction which doctors have argued convincingly (in my view) no longer makes sense, and should have been reviewed long ago.  The essential nature of the request from the Murnaghan family and their supporters was to remove a bureaucratic obstacle, not conjure a special opportunity by magisterial decree.  From what I've read, with this "Under 12 Rule" out of the way, Sarah would be at the top of the list under other criteria, so she wasn't really "bumped ahead" of others by judicial fiat.  I agree with the importance of having rules that aren't subject to pressure from politicians and the media, but in this case the rule itself was obsolete, and the little girl simply does not have time for a more drawn-out review to proceed at the usual glacial pace.  (This is, again, based on what I've read; I'm not a doctor, so the conclusion could be mistaken, or the information I've seen could be inaccurate.)

Hard cases make bad law, as they say.  Regardless of the circumstances surrounding this particular patient, the larger issue Ace discussed is troubling to me as well.  I'm not looking forward to a future of bending my knee before bureaucrats and begging for health care.  Given recent circumstances, I don't trust the nightmare bureaucracy Obama created to act with an acceptable level of wisdom and integrity.  And the bureaucracy which predated him needed work.

But as liberals constantly remind us, ObamaCare is the law of the land now, and it makes the U.S. Secretary of Health and Human Services the most powerful official in the history of mankind.  The law is riddled with thousands of clauses placing vast power at the personal discretion of Sebelius and her successors.  She will command a sizable portion of the largest economy on Earth.  The framework of "health care reform" has already gobbled up numerous peripheral agencies, from the IRS to student loans.  If all we get from this mega-official, with the life of a little girl at stake from a single obsolete rule, is a shrug and "everybody dies eventually," what was the point of accumulating all this power?  What can the rest of us expect when hardcore rationing inevitably kicks in - thus is the destiny of every socialist endeavor - and it's time to go before the death panels?  And does anyone really believe the rules won't be different for the great and powerful?

We may reasonably fear that future of judicial and bureaucratic medicine where we all become Sarah Murnaghan.  It won't work.  There isn't enough court time; there aren't enough congressmen to write letters to the HHS Secretary.  It's a strong argument against the premises of government-controlled health care.  But the government will always exercise some degree of control over medicine, even beyond the regulatory power it will always hold over all industry, even in the most libertarian construction.  The promise of all-powerful, compassionate officials wisely dispensing medicine is a fantasy.  Perhaps this case illustrates that what we really need is a leaner, faster regulatory apparatus that can keep a smaller set of rules more consistent with the latest technology, especially in the realm of fast-moving battles against fast-moving ailments.



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