Backdoor “Death Panels”?

Tait Trussell is a national award-winning writer, former vice-president of the American Enterprise Institute and former Washington correspondent for The Wall Street Journal.


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In a stealthy move, the Obama administration has slipped end-of-life planning, famously criticized as “death panels,” back into the law by means of a new Medicare regulation. The action was exposed, equally stealthily, by The New York Times on Christmas Day when few would be reading the paper. The rule was issued by Dr. Donald M. Berwick, administrator of Medicare and Medicaid Services (CMS) and an advocate of cost-cutting and rationing of health care. The rule takes effect Jan. 1.

When the health care overhaul was stumbling its way through Congress early this year, Sarah Palin was excoriated by Democrats for suggesting that the nascent law included “death panels” for the elderly in order to save costs of treating the oldest and most expensive patients. In a Wall Street Journal op-ed, Palin wrote that Obama had asked Congress to create an independent Medicare Advisory Council-–an unaccountable group of experts charged with containing Medicare costs. She pointed out that in an interview with The New York Times, the president suggested that such a group “should guide decisions regarding that huge driver of cost…the chronically ill and those toward the end of their lives[.]”

Palin went on to write, “Is it any wonder that many of the sick and elderly are concerned that the Democrats’ proposals will ultimately lead to rationing of their health care by—dare I say it—death panels?” That phrase rang true for many Americans.

Palin’s charge and building criticism touched off a torrent of confusion among Democrats. The end-of-life planning was cut from the legislation. But never-to-be-denied cost saving over quality, the Medicare potentate, Dr. Donald Berwick, has secretly restored the end-of life provision through a Medicare regulation. It says Medicare will cover “voluntary advance care planning” to discuss end-of-life treatment as part of the annual doctor’s visit. Doctors will be given federal money to have such talks with patients. And discussions are to include such topics as palliative measures and hospice (the last step on the way to death). The original provision (Section 1233) would have allowed a health care provider other than a doctor to sign end-of-life papers. Having doctors bring up the subject at every annual physical may well suggest to some patients that they must decide on when they want to have “the plug pulled.”

The attitude of backers of the end-of-life provision is most revealing. After learning that the administration had reached up its sleeve to retrieve the controversial provision, Rep. Earl Blumenauer (D-OR), an enthusiastic supporter of Oregon’s physician assisted suicide law, is quoted in the Times story as calling it “a quiet victory” but urged supporters not to be overly vocal about it. “We won’t be shouting from the rooftops because we aren’t out of the woods yet….this regulation could be modified …if Republican leaders try to use this small provision to perpetuate the ‘death panel’ myth.” Hush, hush, Blumenauer cautioned in an e-mail, the Times reported. ”We would ask that you not broadcast this accomplishment out to any of your lists, even if they are supporters—e-mails can too easily be forwarded.”

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  • Jim

    How can a decree become a law. Something is wrong.

    • sflbib

      Laws passed by the government include a statement to the effect, "The administrator shall be responsible for writing regulations to accomplish the intent of this law."

      Thus, the regulations have the force of law.

  • kathrynmuniz

    You guys should stop complaining because, one the health care we have now isnt as good as it was supposed to be. also the law has just been signed so give it some time. so if u want to say u have the right to choose tell that to ur congress men or state official. If you do not have insurance and need one You can find full medical coverage at the lowest price search online for "Wise Health Insurance" If you have health insurance and do not care about cost just be happy about it and trust me you are not going to loose anything!

    • Annie

      You are an illiterate jackalope!

    • Cuban Refugee

      Yes, Kathryn, and if we follow the Yellow Brick Road, we will secure an audience with the Wizard of Oz. Wake up, and smell the communism! Can you see deprivation and smell death on your way to the pot of gold at the end of the rainbow? Yes, we will LOSE something — we will lose freedom, we will lose our sovereign republic, we will lose the best health care in the world, and we will lose our minds through the panoply of pharmacopia that our citizens are being fed. Trust you? How could I trust someone who voted for this nightmare?

      • tagalog

        Why do you want me to pay for your health insurance? Why don't you earn the money to purchase your own?

    • davarino

      Odd, this is exactly the same thing you wrote several weeks ago. This proves you have nothing to add and are brain dead. Have you ever seen the tv series The Walking Dead? Your one of them and these death panels will be just what you need.

      Enjoy

    • http://www.thecrankyhousewife.com crankyhousewife

      I'm loving that phrase, "the health care we have now isn't as good as it is supposed to be." Just how good WAS it supposed to be? Oh, and how about this little gem – "Just trust me. You are not going to lose anything!" I mean, what could go wrong? We have Kathryn's word that it will all be okay and that's good enough for me. I'm glad that I've got Kathryn looking out for my family's best interests.

    • Pati

      No, you won't loose 'ANYTHING' just freedom, life of family members, life of friends and life it self, as we know it. No, you won't loose anything, you've already lost all there is to loose, your mind, your abilitty to think for yourself. Kathryn, what will the doctors loose? Their right to practice without the worry of being fined or imprisoned. Really, really? Nothing to loose, huh. Give it some time, how much time do you suppose we give it? Wow, you are amazing.

  • Reason_For_Life

    We have our own "Death Panels". They are "Political Death Panels" better known as Tea Parties and they provide "End of Career Counseling" for politicians favoring Obamacare.

    • MBANJ

      I love creativity and I award you a prize for it. Thanks for the guffaw that i did not expect to find on this website. Happy old year.

      • Stephen_Brady

        Reason-for-Life can prove what he said. Can you prove that he is wrong? (Hint: 2010 Midterm Elections) …

        • MBANJ

          No, I agree with the sentiment of Reason and you….it was accidentally an indirect praise…I was praising the ZANY STYLE chosen to convey the thoughts. That style is meritorious and the reason he won the award–no negativity here. Happy Old Year and Happy New Year to all.

          • MBANJ

            or "she" won the award…again no insults implied or directed to any…

  • http://kinialohaguy.wordpress.com/ Kini

    George Bernard Shaw once said:

    "I think it would be a good thing to make everybody come before a properly appointed board, just as they might come before the income tax commissioners, and say every 5 to 7 years, just put them there, and say, sir or madam, now will you be kind enough to justify your existence?

    If you're not producing (taxation) as much you consume, or perhaps a little more, THEN, clearly, we cannot use the big organization of our society, for the purpose of KEEPING YOU ALIVE, because your life does not benefit us and it can't be of any use to yourself either"

    IF the value of life is reduced to a justification of consumption, against the weight of your taxable worth, THEN by all means, pass the hand of SOCIAL JUSTICE over the unworthy, the undesirables, the unclean, the ones that are born lacking the intellectual gifts you've been blessed with. The skin color, the racial makeup, the political preferences, the gender ambiguity, the elderly, and even the one's yet to be born.

    In the end, it will be the Birds of Prey that will eat the carrion, of what's left of mankind.

  • Andres de Alamaya

    We need an amendment to the Constitution that would have every law or rule foisted on the citizenry applied equally without exception to all members of Congress and the Senate and, of course, to the president and to all civil servants. When these Jackals then sit down to figure out how to screw us, they'll remember that they are doing it to themselves, too. In that manner and only in that manner will we get equitable laws.

    • davarino

      Good point Andres. You know, now that I think about it, that one piece of legislation should probably be the first thing on the new congress' list of things to pass. You are right, this one thing could halt a lot of bad, stupid laws from being passed. This is only right and fair and just that all laws applly equally to all citizens of the US. Maybe that could be one of the arguments before the Supreme court, that this "health care" legislation doesnt apply to all.

      • davarino

        I just realized an amendment to the Constitution would not involve congress perse, but more the American people, which would sidestep congress and render them moot because you know how they would vote.

  • jacob

    Isn't it time already to pull the brakes on the ANNOITED ONE, his clique and the
    whole DEMOCRAP Party…?????

    Isn't the root of what happened and keeps on happening to the economy, the
    invention of every American entitled to have his own home, including those who
    didn't have a pot to pee in and a window to throw it from ????

    • Pati

      It's more like the APPOINTED ONE than the ANNOINTED ONE. All the time sensitive praise went to the head and now we all pay for the self-inflated damage it has and will cause.

  • Frank

    Evidently Kathryn,you know exactly squat about Obamacare,except that it is free.News flash–whenever the government tells you how much it will cost-multiply that number by about five-that's usually the true cost.This has been going on forever.Please tell me why the government won't step in and open up purchasing healthcare nationwide or maybe passing some kind of tort reform to stop the frivolous lawsuits.Do you realize that when you go to the doctor,they test you for just about everything including what you went there for.You think that they are being thorough,but they are actually covering their butts from a lawsuit.A simple exam for a cough, turns into a multitude of tests–did you think that they are free.And lastly,have you noticed that healthcare has gone up this past year,to the tune of forty percent and will continue until Obamacare is enforced and I do mean enforced.Yes, mandated.So what's next-what car to drive-what food to eat–oops,they've done that already,thanks Michelle–what clothes to wear or how big a house to live in–not to mention how much money you make–oh you forgot about redistribution of wealth.Freedom,oh freedom–the smell is eroding—-can you smell it Kathryn?

    • alexander

      Very true, Frank..the multiplier of 5 or so…like my estimate of illegals (read: new citizens/Bama voters) is 50 mln versus "official" 12 (X4.66 in this case).
      Why bother with pushing the laws through the Congress, if his tzars will do the job, quietly?
      10% of gove dough is enough to run it – the other 90% is croonism – all families and friends need jobs, thus myriads if idiotic commissions and laws e.g. "polution check" – new cars, but don't test old ones……

    • jacob

      FRANK :

      You forgot to take into consideration the fact of JOBS.
      The country is in the shape it is in not only because of FREEDIE and FANNIE
      but because of the total dissappearance of the MADE IN USA tag, nowadays
      as scarce as hen's teeth, as EVERYTHING (perhaps even American babies)
      comes from BEIJING…

      So you see, OBAMACARE is not precisely the panacea to MEDICARE woes..

      About the tests :
      Having shaved on my own beard, I can attest to the fact that the prices
      charged for most tests and drugs are plain RIPOFFS, all the way from a
      simple urine test/culture to an MRI or CATSCAN

  • Hardball

    The Left has already justified killing millions of humans strictly on a cost-benefit ratio schema… "It's too economically challenging for the young lady to raise her child, ergo, kill it."

    It's only logical to extend that line of reasoning to other unwanted beings within society.

    Me thinkest I doth remember this mentality in a history class I took.

  • Murtad

    Obamanation and his thugs are living proof that "…stupid is as stupid does!" At 72 I will thank ALL socialist thugs to mind their own business and leave me alone!

  • davarino

    The democrats are liars. They cannot be truthfull about their intentions and let those ideas stand on their own merits. They have to misrepresent themselves as moderates in order to get elected them switch liberal/leftist once in. This is why we have a constitution, which is supposed to put checks and balances on these knuckle heads to prevent things from getting out of hand. There should be no laws passed by decree of the great and mighty president, democrat or republican. The laws should apply to everyone, not just us lowly people begging for the scrapps from congress. These people in Washington need to be taken down a notch or two.

  • Jane Baer

    illegal aliens covered by taxpayers' tax money will mean something has to give…how about (since there are a larger percentage of whites in the older generation) anti-white sentiment to limit care of old whites. Picture a non-white physicians assistant advising a depressed perhaps say newly widowed old white to limit end of life care,since non-whites have been educated to belive whites are the enemy of the People. Sad how reverse racist we've become.

  • SwampFox2U

    For those with any experience in Deer Herd Management should realize those Managing our Welfare and Health Issues know best what is needed to manage the human herd. In order to keep and sustain the proper Buck to Doe Ratio one must not discriminate against age or size in culling the Doe Herd. Ditto for the human herd. One must weed out and terminate those who do not contribute to the herd. The Fed has been terminating the unborn for years.Next will be the old,infirm, mentally ill and terminally ill. After the public warms up to the process maybe the Government can start elliminating the Welfare Caste they created along with those who contribute nothing to the workers paradise.

  • Lori

    We The People,,,,,,,,,,,,,,, The Constitution being forgot? Right To Life? I see that We The People better decide if we want liberty or Death. Who are the people behind all this? Maybe we need To Truly find out who are calling all the shots? For It seems to be Like Hitler days were Death was silent but yet very deadly.

  • USMCSniper

    With cuts in Social Security and Medicare, there won't be enough money to take care of the tremendous number of senior to come. There will have to be an age limit on how long one can live. Don't believe me? Then read or watch the dvd's of Logan's Run, Soylent Green and Clockwork Orange.

    • Charles

      How old are you? And do you have some insurance policy different from Medicare to see you through your retirement? I'll be watching for your reply.

    • Charles

      USMC Sniper:

      I have read your comment on various blogs and believe we agree on most issues. But not on healthcare. Please disclose your insurance coverage for your age after age 65. I can understand that you might want to reduce Medicare coverage for average citizens if you believe that your own coverage would be adequate as a result.

  • Richard

    If everybody knew the facts behind the "Death Panels" then they would probably agree that they are one of the best parts of the Health Care act. I realize most people on this site accept or reject ideas based solely on which party it comes from, but it’s worth educating yourself.

    It's all a matter of how you want your life to end. Do you want be surrounded by doctors and nurses rapidly failing to save you while you die alone or do you want to die in piece with your family by your side? At some point, most people will say enough is enough and spend what little time they have left with those they love.

    How do you know when further treatment is no longer worth it? Well, maybe you could talk to your doctor for a few hours about when you should throw in the towel. Under Medicare and Medicaid, you can’t. These so called “Death Panels” would allow patients under Medicare and Medicaid to have more say in how they die.

    Here is a great article about this topic. It’s 13 pages, but well worth the read. http://www.newyorker.com/reporting/2010/08/02/100

  • David Eisenberg

    Richard is correct – I have been a registered nurse for 31 years and this proposal is all about choice. Letting patients know that they have options on how they can be treated. Some people may decide that they want every intervention medical science has to offer, no matter how intrusive or ultimately futile. Others may use this knowledge to write their own durable power of attorney for health care – giving instructions on what they do and do not want. This is an empowering opportunity for patients, their families and the medical professionals who care for them.

    • Eliot

      That does not take into account that starting in 2013, doctors will be fined $100,000 for the first time that they make a decision that goes contrary to what the panels advise, and the 2nd time, it's PRISON. Doctors will not be allowed any choices, and neither will their patients. Read "Obamacare Endgame" for the truth about what is happening to our healthcare system. CHOICE has NOTHING to do with it. http://biggovernment.com/egeorge/2010/10/30/obama

      • Pati

        Let it be one of his family members needing medical intervention and his mind will quickly 'change'. The high cost of 'change' is now so evident that many probably regret falling for all that 'EMESIS'. No doctors or PAs to care for you, better start practicing holistic methods because we might have to treat ourselves and our families soon.

  • Stephen_Brady

    Richard & David: I will not doubt the sincerity with which you express your thoughts, or the experiences which lead you to say what you do.

    But "choice" is not what the rest of us are worried about. We believe that the government, under Obama, is establishing a system in which they de-value human life, by determining … on a cost-efficiency basis … who deserves to live and who must die. It is te impersonal nature of this that bothers us, and the very real possibility of a slippery-slope to darker deeds.

    I have a loving and wonderful wife who spent 30 years as a registgered nurse. She also has undifferentiated schizophrenia. When will someone in the bureaucracy decide that her life is no longer worth living? And note, her treatment, though very effective, is also quite expensive. I can pay for it, thank God. But what about other people?

    This is my concern …

  • Rifleman

    Repeal this nonsense and start over. It's not what they said it was, is what they said it wasn't, and doesn't cost what they said it would.

    • Stephen_Brady

      Amen to that, brother!

  • Eliot

    Starting in 2013, doctors will be fined $100,000 for the first time that they make a decision that goes contrary to what the panels advise, and the 2nd time, it's PRISON. Doctors will not be allowed any choices, and neither will their patients. Read "Obamacare Endgame" for the truth about what is happening to our healthcare system. CHOICE has NOTHING to do with it. http://biggovernment.com/egeorge/2010/10/30/obama

  • Charles

    I am a retired physician. Physicians have been doing "end of life" discussions with family and patients forever. That has seemed to work out well. There has been no controversy.

    While I believe that physician time spent on this issue should be reimbursed, I believe that physicians have already billed for this time under some other billable service code.

    Clearly, then, this is a first step towards encouraging physicians to propose to their patients that they elect death over continuing to live at the expense of the government.

    As Obama said, "at some point you have made enough money. The government is now saying, "At some point you have lived long enough."

    • Lori

      You Being A Physician, Can End all this Quit your profession! If they ask you to kill walk away! are is the Dollar holding you Back? You As A Patient, Do all you can to maintain your life! I have been sick all my life, And The Best way I have found freedom from sickness Is to always find other solutions! Truth!Beside your Doctor!Check him out! as well as A Nurse putting A needle in you! We all need To Do Our Part I agree and let Not One thing get in our way! We The People need To face the Truth we all Die! But I am not putting my life into the hands of Government Or The health Care Professionals! I am going to let God Determine when I die Not Man-Kind! The Money is gone and It Is about deflated Out! Face It Folks we are all going to have to face The facts! The death Of the Dollar Will Be The test!~ Who in the world can really sustain?

  • Philosopherking

    They are really determined to kill grandma. We use to say 'hide your walets' when the left got into power but now it is 'hide your grandmothers'.

  • Gale

    Is it surprising that the crowd that cried "don't trust anyone over 30" back in the 60s would figure out a way to dispose of Mom and Dad now?

    But don't worry about the death panels – they still have the FDA in their back pockets.

  • Lightning Jack

    The federal medical bureaucracy knows that Medicare and Medicaid have always been in financial trouble, if not actually insolvent, and that the cost of maintaining both systems will skyrocket as baby boomer's begin drawing benefits from their questionably limited resources.

    The above situation exists, wholly in part, because the Democratic Congress under President Lyndon Johnson decided to include the Social Security Trust Fund as part of the general fund thereby allowing Congress to finance its agenda using not only the SSI trust fund, but Medicare and Medicaid funds as well.

    It appears now that the time of reckoning has come to face reality that both systems will not have the resources available to provide for elderly quality of life care, so federal bureaucrats must find a plausible excuse to cut these services to those who will need them the most. What better vehicle than using ones potential quality of life years as justification for diminished care or denial of expensive, life prolonging treatments.

    This is what happens when a nation allows its executive, legislative and Judicial branches to rein unaccountable to anyone and exempt themselves from not only their own mandates, but the Constitution and the Rule of Law

    • American_Flag

      Are there no checks and balances anymore? Our forefathers explained the need for it…today, the DC dolts run the show. What ever happened to "we the people?"

      WTF man!?

  • American_Flag

    George Orwell 1984?

  • Lori

    I Like Front Page Mag, It seems to always tell The truth most of the Time, I am so glad I can enjoy Freedom! for Truth sets me free! In spite of all the Lies going around and Justifications, I can be Free, This is A way I seek truth, and at times miss It. But when all is out on the Table! my head is out of the world wind! It is only the sneak lies, that are annoying! Little lies here and there, God Save us from ourselves! I Have A terminal Illness at the least, I Have A Choice Daily In My Life, Choose Life Or Death? I Choose life That sets me free! Front Page Thanks for truth It Bites at Times, But Truth gives me Hope, And Hope is A good thing.

  • readerjohn

    Your suggestion that coverage of the regulation by the New York Times was "stealthy" may play well with dittoheads and paranoid folks, but it strikes me as absurd. I saw the story, high on the NYT Website, immediately.
    I dare say you wouldn't know about this yet had the NYT not covered it, including the murmurings among those who approved the regulation to keep the victory under their hats for now.

  • Stonefellow

    Here is how it will work. The elderly patient or the patient debilitated by disease will be "educated" (harassed)constantly by his or her doctor to end it, even though they could live with care for months and years. If this is not discussed (harassed), the doctor will be fined or imprisoned. All of these discussions will be documented. The costs to their loved ones will be stressed. This will continue until the fatigued patient gives up. Obamacare will get their consenting victims, and the uninsured, his constituency, will get the lip service of free care. This plan will be opposed to the days when doctors had the patient's interest foremost, and when they were not threatened by the government with major fines and jail if they did not do the government's bidding. It will all be put on the doctors, and they government will look good on paper, which is where it counts. What rational person would want to go into medicine with these kinds of threats by the government? I am a retired physician. I know how the government works.

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    Health sector could be important issue for Obama

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    Death panels, Medicare and all about is never ending story. Unfortunately sometime we want more than life is ready to give us and sometime for law regulations we can't get what we really need, for us or for our relatives which are not able anymore to decide due their illness.

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  • http://www.dentistsinpoland.com Pete

    This is a subject that's been going on for ages. I personally think that all governments around the world should be protecting the lives of their citizens. This should always be a priority!

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    Your suggestion that coverage of the regulation by the New York Times was "stealthy" may play well with dittoheads and paranoid folks, but it strikes me as absurd. I saw the story, high on the NYT Website, immediately.
    I dare say you wouldn't know about this yet had the NYT not covered it, including the murmurings among those who approved the regulation to keep the victory under their hats for now.

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