The Birth of the “Death Panels”

Those noxious lies about “death panels” being part of Democrats’ health care reform legislation proposals — where do they come from?

According to Jim Rutenberg and Jackie Calmes in the New York Times, they come from the same well-heeled conservative media sources that helped to kill health care reform in former Pres. Bill Clinton’s first term, ” including the editorial board of The Washington Times, the American Spectator magazine and Betsy McCaughey, whose 1994 health care critique made her a star of the conservative movement.”

There is nothing in any of the legislative proposals that would call for the creation of death panels or any other governmental body that would cut off care for the critically ill as a cost-cutting measure. But over the course of the past few months, early, stated fears from anti-abortion conservatives that Mr. Obama would pursue a pro-abortion, pro-euthanasia agenda, combined with twisted accounts of actual legislative proposals that would provide financing for optional consultations with doctors about hospice care and other “end of life” services, fed the rumor to the point where it overcame the debate.

Nevertheless, conservatives like Tom Maguire find it entirely understandable that Republicans in Congress and conservative media organizations would encourage the public to believe such claims (emphasis is mine):

Let’s see – as candidate and President Obama has talked endlessly about the need to reduce health care costs, although his plans for doing so are opaque.

And in the course of talking about runaway costs and ways to reduce them, Obama actually advocated end-of-life panels issuing voluntary guidelines with Timesman David Leonhardt, as reported in the Times; by way of introduction, Obama had been discussing the story of his grandmother, who was terminally ill with cancer when she had an expensive hip replacement procedure so that she would not be bed-ridden for the last three to nine months of her life:

THE PRESIDENT: So that’s where I think you just get into some very difficult moral issues. But that’s also a huge driver of cost, right?

I mean, the chronically ill and those toward the end of their lives are accounting for potentially 80 percent of the total health care bill out here.

LEONHARDT: So how do you — how do we deal with it?

THE PRESIDENT: Well, I think that there is going to have to be a conversation that is guided by doctors, scientists, ethicists. And then there is going to have to be a very difficult democratic conversation that takes place. It is very difficult to imagine the country making those decisions just through the normal political channels. And that’s part of why you have to have some independent group that can give you guidance. It’s not determinative, but I think has to be able to give you some guidance. And that’s part of what I suspect you’ll see emerging out of the various health care conversations that are taking place on the Hill right now.

So as of April 2009 Obama himself expected the final legislation to include some sort of group (but NOT a “death panel”!) that would produce voluntary guidelines for end of life care with an eye towards saving money.

And now Obama is plagued by scurrilous rumors that his legislation will include groups that issue guidelines for end of life care with the goal of saving money.  Fortunately, the Times has looked everywhere but their own candidate and their own website and firmly concluded that the rumors are false.

In addition to “death panels” not being a terribly accurate way to describe “groups that issue guidelines for end of life care with the goal of saving money,” the latter phrase also does not accurately convey either the actual provision in the actual proposed bill (before Grassley took it out) or the distorted version of the actual provision that many conservative activists, lawmakers, and pundits have been repeating over and over.

Here is PolitiFact on what supposedly respectable politicians have been saying (emphasis mine):

Republicans have found many reasons to oppose the Democrats’ health care proposal, but this is one of the oddest.

Betsy McCaughey, chairman of the Committee to Reduce Infection Deaths and former lieutenant governor of New York state, says the bill goes too far to encourage senior citizens to end their lives.

On the radio show of former Sen. Fred Thompson on July 16, 2009, McCaughey said “Congress would make it mandatory — absolutely require — that every five years people in Medicare have a required counseling session that will tell them how to end their life sooner.”

She said those sessions would help the elderly learn how to “decline nutrition, how to decline being hydrated, how to go in to hospice care … all to do what’s in society’s best interest or in your family’s best interest and cut your life short.”

Her point has caught on with conservative pundits. On his July 21 show, Rush Limbaugh said the following:

“Mandatory counseling for all seniors at a minimum of every five years, more often if the seasoned citizen is sick or in a nursing home. … That’s an invasion of the right to privacy. We can’t have counseling for mothers who are thinking of terminating their pregnancy, but we can go in there and counsel people about to die.”
… McCaughey said the language can be found on page 425 of the health care bill, so we started there. Indeed, Sec. 1233 of the bill, labeled “Advance Care Planning Consultation” details how the bill would, for the first time, require Medicare to cover the cost of end-of-life counseling sessions.

“Require Medicare to cover the cost of the sessions” — not require doctors to HAVE the sessions or patients to sit through them.


According to the bill, “such consultation shall include the following: An explanation by the practitioner of advance care planning, including key questions and considerations, important steps, and suggested people to talk to; an explanation by the practitioner of advance directives, including living wills and durable powers of attorney, and their uses; an explanation by the practitioner of the role and responsibilities of a health care proxy.”

Medicare will cover one session every five years, the legislation states. If a patient becomes very ill in the interim, Medicare will cover additional sessions.
In no way would these sessions be designed to encourage patients to end their lives, said Jim Dau, national spokeman for AARP, a group that represents people over 50 that has lobbied in support of the advanced planning provision.

McCaughey’s comments are “not just wrong, they are cruel,” said Dau. “We want to make sure people are making the right decision. If some one wants to take every life-saving measure, that’s their call. Others will decide it’s not worth going through this trauma just for themselves and their families, and that’s their decision, too.”

Both Keyserling and Dau were particularly troubled that McCaughey insisted — three times, to be exact — that the sessions would be mandatory, which they are not.

For his part, Keyserling said he and outside counsel read the language carefully to make sure that was not the case.

“Neither of us can come to the conclusion that it’s mandatory.” he said. “This new consultation is just like all in Medicare: it’s voluntary.”

“The only thing mandatory is that Medicare will have to pay for the counseling,” said Dau.

Obviously, McCaughey is not the only conservative activist out there who has been grossly irresponsible and untruthful about what Sec. 1233 says. And Maguire is quite right to put the word “rumors” in quotes, because that word does not fit what craven politicians like Grassley, McCaughey, and Palin (among others) have been doing. They haven’t been spreading rumors; they’ve been setting fires — deliberately setting fires. They’re not gossips or rumor-mongerers — they’re political arsonists.

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