Years after former Alaska Governor Sarah Palin was mocked for being concerned about “death panels,” the federal government may reimburse Medicare doctors for end-of-life consultations that critics say would only encourage sick patients to reject costly treatments to prolong life.
The New York Times reports that “Medicare may begin covering end-of-life discussions next year if it approves a recent request from the American Medical Association,” which is “the country’s largest association of physicians and medical students” and creates “billing codes for medical services, codes used by doctors, hospitals and insurers.”
According to the Times, the group “recently created codes for end-of-life conversations and submitted them to Medicare” and The Centers for Medicare and Medicaid Services is expected to make a decision in the fall that could “profoundly affect the American way of dying.”
As the Times notes, “end-of-life planning remains controversial,” especially after Former Alaska Governor Sarah Palin’s “‘death panel’ label killed efforts to include it” in Obamacare. The Obama administration tried to sneak in a provision in a 2010 regulation before it “had Medicare rescind that portion of the regulation” after intense political pressure.
Now, the federal government may try again.
Doctors and bureaucrats have insisted that end-of-life counseling would not lead to rationing, but “Burke Balch, director of the Powell Center for Medical Ethics at the National Right to Life Committee,” disagreed, telling the Times that many doctors actually believe in “hastening death for those deemed to have a ‘poor quality of life.'” He said that doctors and bureaucrats may use these sessions to pressure patients to “to reject life-preserving treatment,” according to the Times.
That was exactly the point Palin hammered during the “death panels” debate. She wrote that Obama’s “Advance Care Planning Consultation” would have a “coercive effect” on patients because consultations would be “unauthorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is ‘to reduce the growth in health care spending.'”
“Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care?” she wrote in 2009. She pointed out that even left-wing Washington Post “columnist Eugene Robinson, a self-described ‘true believer,'” agreed that “If the government says it has to control health-care costs and then offers to pay doctors to give advice about hospice care, citizens are not delusional to conclude that the goal is to reduce end-of-life spending.”
On August 7, 2009, Palin injected “death panels” into the Obamacare debate:
And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one 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. Such a system is downright evil.
“Though I was called a liar for calling it like it is, many of these accusers finally saw that Obamacare did in fact create a panel of faceless bureaucrats who have the power to make life and death decisions about health care funding,” Palin later reiterated. “It’s called the Independent Payment Advisory Board (IPAB), and its purpose all along has been to ‘keep costs down’ by actually denying care via price controls and typically inefficient bureaucracy. This subjective rationing of care is what I was writing about in that first post.”
Politifact, though, crowned her statement as its 2009 “Lie of the Year”: “We agree with Palin that such a system would be evil. But it’s definitely not what President Barack Obama or any other Democrat has proposed.”
A lot has changed since then.
Prominent liberals like <a href="“>Paul Krugman, Howard Dean, and former Obama adviser Steve Rattner have since conceded that “death panels” had to be added to Obamacare.
Rattner even lamented that Palin’s “rant about death panels even forced elimination from the bill of a provision to offer end-of-life consultations” and Obamacare “regrettably includes severe restrictions on any reduction in Medicare services or increase in fees to beneficiaries.”
“We need death panels,” Rattner simply wrote. “Well, maybe not death panels, exactly, but unless we start allocating health care resources more prudently — rationing, by its proper name — the exploding cost of Medicare will swamp the federal budget.”
Rattner continued by noting that “Medicare needs to take a cue from Willie Sutton, who reportedly said he robbed banks because that’s where the money was.”
“The big money in Medicare is not to be found in Mr. Ryan’s competition or Mr. Obama’s innovation, but in reducing the cost of treating people in the last year of life, which consumes more than a quarter of the program’s budget,” Rattner emphasized.