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Death Panels Fact and Fiction

“Death panels” are back in the news, and Congress is turning its attention to them once again. The problem is, lawmakers are looking in all the wrong places.
The House Energy and Commerce Committee, now headed by Republicans, sent a letter to Health and Human Services Secretary Kathleen Sebelius last week demanding to know how a controversial provision that was excised from last year’s health reform bill wound up — briefly — in a government “rule” on physician reimbursement.
The proposed provision would have allowed Medicare to pay doctors to counsel patients about their end-of-life medical wishes. That idea originally had bipartisan support, but when the provision was brought to Sarah Palin’s attention, she accused Democrats of wanting to create “death panels” that would decide when to pull the plug on granny and grandpa.
The claim was utterly false, but it was such an irresistible soundbite that Palin posted it on her Facebook page. She and many other Republicans quickly made it a central part of their efforts to scare people away from health care reform. They were so successful — it spread like wildfire through the online and cable news worlds — that PolitiFact.com, the fact-checking website of the St. Petersburg Times, chose it as the “Lie of the Year” for 2009.
Worthy as the idea of paying for end-of-life counseling might be, cowed Democrats pulled it from the reform bill before it reached President Obama. Last November, however, the provision was included in a rule that was issued by Medicare on physician payment rates. When the rule became public, Republicans pounced once again. The Obama administration pulled the provision immediately, dropping it like the political hot potato it had become.
In their letter to Sebelius last week, Republicans on the Energy and Commerce Committee charged that the administration had attempted “a political maneuver designed to avoid public scrutiny.”
Raising this issue again is part of a larger strategy by Congressional Republicans to further erode public support for reform, to keep it alive as a divisive political issue. Meanwhile, the business of real death panels is proceeding as usual, outside of any public scrutiny or apparent interest on Capitol Hill.
Yes, death panels do exist. They exist inside the big health insurance corporations that every day make decisions on whether or not people enrolled in their health benefit plans will get the care their doctors believe might save their lives. I know this firsthand from nearly two decades inside the insurance industry.
You don’t have to take my word for it. Just ask Hilda and Grigor Sarkisyan, who very possibly would be helping their daughter, Nataline, plan her 21st birthday about now had a corporate medical director not refused to pay for a liver transplant Nataline’s doctors believed would save her life.
Nataline was diagnosed with leukemia at 14. Initial treatments were successful and the disease went into remission. It came back a couple of years later, though, and the sort of treatments she’d had previously were not working. She had to have a bone marrow transplant, which weakened her liver. In mid-December 2007, her doctors at UCLA Medical Center said she needed a liver transplant.

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