Economic Intersectionality between Death with Dignity and Community Inclusion for People with Disabilities

 The following paragraph from a letter opposing the 2016 assisted suicide law in the District of Columbia from Ryan T. Anderson, senior research fellow at the Institute for Family, Community and Opportunity at the Republican-leaning Heritage Foundation was problematic.




We should respond to suffering with true compassion. We should offer appropriate psychiatric care and human presence. For those in physical pain, palliative medicine can manage symptoms effectively. For those for whom death is imminent, hospice care and fellowship can accompany them in their last days. Anything less falls short of what human dignity requires.

https://www.washingtonpost.com/opinions/debating-what-death-with-dignity-means/2016/11/04/6aac7310-a1e5-11e6-8864-6f892cad0865_story.html


 The paragraph was problematic by erasing the economic intersection/public policy question of 'who pays the costs that individuals cannot pay themselves or with individual or group health and long term care insurance' to allow individuals to make the choice not to choose to hasten their own deaths.  


 Who pays for, as Mr. Anderson describes, the "palliative medicine," the "hospice care and fellowship"  and "appropriate psychiatric care and human presence?"  The CLASS Act would have paid for LTC (long term care) and LTSS (long term services and supports) in community-based settings by ending the Medicaid 'institutional bias' against paying for HCBS (home and community based services) not services provided in an RTC (residential treatment center).  Possibly people would have been subsidized into a required purchase of individual LTC (long term care) insurance.  That model was supported by the Heritage Foundation, creator of the very Institute Mr. Anderson works for/is paid by, in their 'alternative' for what became the Affordable Care Act as a counter to President Bill Clinton's 'health care (insurance) reform' bill of 1994 that had an employer mandate to offer health insurance instead of an individual mandate to buy health insurance.  The CLASS Act was originally known as the Community Choice Act that was itself derived from the MiCassa (medicare/medicaid attended services and supports act) and was rooted in the 1999 USA Supreme Court decision Olmstead v. LC and EW.

  

 That USA Supreme Court decision required people with disabilities to be allowed to choose their own housing in communities of their own choosing instead of being forced to live in nursing homes/residential treatment centers that accepted medicaid payments if the person with a disability (or their families) couldn't pay for long term care.  Republicans in Congress singled the CLASS Act out for 'cutting government spending' to pay for a raise in the federal debt ceiling in the July 31, 2011 'sequester bill' (Budget Control Act).  The CLASS Act was officially killed off in Jan 2013 as part of the 'fiscal cliff' FY 2013 budget 'deal,' delayed by Republican majority obstruction during a presidential election year, with a study commission also known as (AKA) 'paralysis by analysis.' 

 According to the footnotes on the presentation text below one litigant Elaine Wilson EW died on Dec 5, 2004.  


 The cost of raising a child with a severe disability, 

paid mostly by the child's parents in both money and time applying for financial aid from social safety net programs at local, state and federal levels of government can reach five figures ($10 million in cases of severe intellectual and cognitive disability caused by zika virus infections) over the life of a person with a disability, defined as an inability to carry out what the ADA defines as Major Life Activities.  


  Applying for private sector 'mini-grants,' supplementing individual and family income to fund ABLE Accounts, combined with 'crowd-funding' which, when used to pay for basic human needs of food, clothing, education, shelter and medical care, essentially turns people with disabilities into 'high technology panhandlers/beggars.'  

 Search for the text of the UN Universal Declaration of Human Rights for a list of the international consensus on necessities for a thriving human life. 


  The linked blog post opposing the same freedom to choose death with dignity law in Maryland, as the District of Columbia (Washington, D.C) passed, nearly erases the same intersection/public policy question of 'who pays the costs of community inclusion if the individual cannot.'  


Links within the post include in case the link dies 

Where The Prescription For Autism Can Be Death
http://tinyurl.com/hjleqwk

House Bill HB0404
http://mgaleg.maryland.gov/2016RS/bills/hb/hb0404f.pdf

The Furor Over Death Drugs and the Cases of Barbara Wagner and Randy Stroup
http://abcnews.go.com/Health/story?id=5517492&page=1

Disability Rights Education and Defense Fund Policy on Assisted Suicide
http://dredf.org/public-policy/assisted-suicide/




   The link below could be harshly characterized as 'inspiration porn.'  The link could be more kindly characterized as overgeneralizing one person's lived experience to the possibility of replication as other peoples' lived experiences after not changing laws to allow people the freedom to choose death with dignity, in the absence of LTSS delivered in HCBS settings, to allow life with dignity on the terms of the person concerned.
 






My Terminal Illness Survival Story as testimony before Maryland Congress  

  

 The continuing Republican majority in Congress passed a Congressional Review Act bill 

to block the Washington, D.C. freedom to choose death with dignity law from taking effect.  President Don Trump has until February 17, 2017 to sign it if the bill also passes the continuing Republican majority-controlled Senate.  

Washington, D.C. must submit all of their laws, including budgets, to Congress for prior approval before taking effect.  D.C. residents deeply oppose the lack of respect for 'home rule' shown mostly by Republican House and Senate majorities by calling D.C. 'the last colony.'