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Death panel

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"Death panel" is a political term coined in August 2009 on the Facebook page of former Governor of Alaska Sarah Palin suggesting that health care legislation being debated in the U.S. Congress would create an America "in which my parents or my baby with Down Syndrome will have to stand in front of Obama's 'death panel' so his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care." There was no such term or explicit provision in the bill.[1] A provision including Medicare payments for voluntary counseling between a doctor and a patient on end-of-life issues and advance directives was the trigger for the 'death panel' concerns.

While some prominent conservatives supported Palin's allegation, PolitiFact.com called "death panels" the "Lie of the Year";[2] Palin said she had employed it as a metaphor for reduced access and diminished quality of care that she believed would follow the enactment of the federal legislation.[3]

The American Dialect Society, a group of English language scholars, reported that "death panel" was their "most outrageous" word for 2009.[4][5]

Provision identified by the charge

Main article: End-of-life care

When asked exactly what part of the proposed legislation[6] mandated death panels, Palin's spokesperson pointed to H.R. 3200, section 1233 Advance Care Planning Consultation.[7] On August 12, Palin wrote on Facebook that it was misleading for Obama to say the sessions were entirely voluntary; PolitiFact.com ruled that assertion false, writing that the sessions were voluntary.[8] The provision would have allowed physicians to receive payment from Medicare for voluntary counseling with patients regarding end-of-life issues so that personal preferences for care when the time comes would be known so that doctors and relatives would not have to make decisions about care on their behalf. The counseling would cover topics such as making living wills, enabling a close relative or a trusted friend to make health care decisions, hospice as an option for the terminally ill, and information about pain medications for chronic discomfort. The sessions would have been covered by Medicare every five years or more frequently for patients who became gravely ill.[9] The provision was inserted in the bill by Democratic lawmakers at the behest of La Crosse Wisconsin hospitals that had created a pioneering community program to get people who were not critically ill, to think about and choose the treatments they would want at the end of life.[10][11] Before H.R. 3200, Representative Earl Blumenauer (Democrat-Oregon) had submitted single purpose legislation with cosponsor Republican Charles Boustany (Republican, Louisiana), a cardiovascular surgeon, that similarly provided for Medicare payments for end-of-life counseling;[11][12] earlier bills in preceding years had also been submitted with bi-partisan support.[citation needed]

Consultation payments were removed from the Senate version of the bill[13] while remaining in the House version until November 2009, when they passed, but they did not pass in the final bill.[14] On December 25, 2010, The New York Times reported that effective January 1, a new Medicare regulation had been added for consultations during annual "wellness visits," instead of at 5 year intervals as the bill originally mandated.[14] Instead, on January 4, the The New York Times reported the payments would be struck from the regulations.[15]

Uses

A death panel sign with a Nazi reference at a Rep. Carol Shea-Porter town hall meeting

Health law and bioethics expert George J. Annas wrote that "the national discussion on death planning the president had hoped for focused instead on death denial. Make believe 'death panels' that would 'pull the plug on grandma' were used as a rhetorical device to block any rational discussion of either death generally, or end of life care in particular".[16] Brent J. Pawlecki, a corporate medical director, said the phrases death panels and "killing Grandma" were "used to fuel the flames of fear and opposition".[17][18] According to The Economist, the phrase was used as an "outrageous allegation" to confront politicians at town hall meetings during the August 2009 congressional recess.[19] According to The New York Times, the term became a standard slogan among many conservatives opposed to the Obama administration’s health care overhaul.[20]

  1. ^ Cite error: The named reference Is was invoked but never defined (see the help page).
  2. ^ Cite error: The named reference LieOfTheYear was invoked but never defined (see the help page).
  3. ^ Cite error: The named reference AUTOREF was invoked but never defined (see the help page).
  4. ^ For the purposes of its polling, the society defined a death panel as "a supposed committee of doctors and/or bureaucrats who would decide which patients were allowed to receive treatment, ostensibly leaving the rest to die".
  5. ^ Cite error: The named reference adspr was invoked but never defined (see the help page).
  6. ^ Cite error: The named reference AUTOREF8 was invoked but never defined (see the help page).
  7. ^ Cite error: The named reference ABCTapper was invoked but never defined (see the help page).
  8. ^ Robert Farley (August 13, 2009). "Palin claims Obama misled when he said end-of-life counseling is voluntary". St. Petersburg Times.
  9. ^ Cite error: The named reference AUTOREF9 was invoked but never defined (see the help page).
  10. ^ Cite error: The named reference reporter faces was invoked but never defined (see the help page).
  11. ^ a b Cite error: The named reference pioneering program was invoked but never defined (see the help page).
  12. ^ Cite error: The named reference lie machine was invoked but never defined (see the help page).
  13. ^ Cite error: The named reference SenateCommittee was invoked but never defined (see the help page).
  14. ^ a b Cite error: The named reference ObamaReturns was invoked but never defined (see the help page).
  15. ^ Robert Pear (January 4, 2011). "U.S. Alters Rule on Paying for End-of-Life Planning". The New York Times.
  16. ^ Cite error: The named reference Annas was invoked but never defined (see the help page).
  17. ^ Cite error: The named reference AUTOREF10 was invoked but never defined (see the help page).
  18. ^ Cite error: The named reference AUTOREF11 was invoked but never defined (see the help page).
  19. ^ Cite error: The named reference AUTOREF12 was invoked but never defined (see the help page).
  20. ^ Cite error: The named reference wish was invoked but never defined (see the help page).
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