At about the same time I was writing about Singer's article, The Washington Times was accusing Congress and the President of seeking to emulate the Nazi extermination of people with disabilities by creating a system of mandatory euthanasia.

This characterization of voluntary end-of-life counseling is conceived, of course, as a way to defeat health insurance reform and, in doing so, the present administration.

Then came Bill O'Reilly, who told viewers that Oregon has one of those "government-run universal health plans" that denied a dying woman coverage for a treatment that would prolong her life, but would pay for her to kill herself.  This, he said, was an example of a heartless government that would rather save money than lives. 

Although O'Reilly got virtually every fact wrong in his story, he did inspire one viewer to send the Chair of the Oregon Health Services Commission a Jello box filled with a mixture of blood and excrement.  Other less creative souls have resorted to the more mundane email and web-posted threats.

In a letter printed in today's New York Times Magazine, F.M. Kamm -- professor of Philosophy and Public Policy at Harvard's Kennedy School -- criticized Singer's analysis of disability and the value of life. Kamm made the same (albeit more sophisticated) point about disability discrimination that I did right here on the DRO Blog.  In doing so, he cites the "discredited rationing plan in Oregon" as the product of "morally mistaken reasoning" that can lead to prioritizing the treatment of relatively minor health problems over those that are life threatening.

I did a bit of research and found that Kamm was referring to the Oregon Health Plan (OHP) before it altered its methodology in response to concerns by the first President Bush's administration that it violated the Americans with Disabilities Act. Kamm's letter, in fact, was not an attack on "rationing"; rather it was an appeal to "allocate scarce resources" in a way that is "morally better" than that suggested by Singer.

Herein, I think, lies the problem faced by proponents of health insurance reform: Those who support health care reform debate the finer points of philosophy, finances and moral nuance. Opponents of reform can simply yell that they should get what they want: immortality, or at least, to not be reminded that living forever is not on the menu.  Opponents capitalize on the same impulses that keep people from writing wills: fear and avoidance of the unpleasant. You see, if we don't write it down, it might not happen and if it does happen, surely someone else will do the right thing by us.  It reminds me of something Woody Allen said: "Death doesn't really worry me that much, I'm not frightened about it... I just don't want to be there when it happens."

The lady in the O'Reilly story really did have terminal cancer and wanted the OHP to pay for a treatment that had a five percent chance of extending her life for a modest period.  Her story reminded me of my step-mother who, some time ago, was diagnosed with end-stage lung cancer.  Her doctor said there was a medication that might extend her life, but it was still experimental.  She had very good private insurance and Medicare. Neither would pay for the treatment.  My father, who felt obligated to do whatever was possible, laid out about $20,000 for the medications, which had no effect.  September 12 will be the fifth anniversary of her death.

Unlike the OHP lady, my stepmom did want end-of-life counseling.  She didn't think that having the ability to make choices meant that she was being subjected to a "death panel".  My dad chose to use his money (he didn't ask for mine) on a long-shot that no objective viewer, public or private, would gamble on.  His money, his choice.

And so to my point: laws to prevent discrimination against people with disabilities must be fully enforced to achieve both legal and moral outcomes in health care reform.  Lies, distortions, threats and fear-mongering do not promote the opportunity, access and choice that are fundamental to disability rights.  Opponents say that people cannot be allowed to choose the type of health plan they want and cannot decide whether or not to receive end-of-life counseling, which leads me to my final celebrity quote for the day.  Perhaps opponents of health reform think like Jack Nicholson's character in this exchange with Tom Cruise from the 1992 film A Few Good Men: