'Death panel' controversy remains very much alive

The “death panel” debate – it’s still alive.

The White House has pushed back hard against the notion – spread by former Alaska Gov. Sarah Palin, among others – that healthcare reform legislation might set up “death panels” that would control access to end-of-life care for the elderly.

“The president’s made some discernible progress on the mistruth about government making end-of-life healthcare decisions for seniors, which obviously isn’t going to happen,” said White House Press Secretary Robert Gibbs on Friday. “It’s not in the bill.”

But some liberal groups have flipped the argument on its head, saying that private insurance firms, with their power to deny claims by policyholders, are the real “death panels.” And some Republicans have used the “death panel” term as a jumping-off point to discuss a larger issue – government rationing of services, which they say might be the result of healthcare reform’s passage.

“When Sarah Palin said that the emerging healthcare reform legislation would lead to ‘death panels’ and government rationing of care, her language was explosive, but her premise about rationing was not,” wrote former Speaker of the House Newt Gingrich in a Los Angeles Times opinion article this week.

Palin’s “death panel” charge pointed at a provision in the House version of health legislation that would fund voluntary end-of-life counseling sessions. It has been widely debunked by fact-checking journalism organizations. The Pulitzer-prize winning site Politifact gave Palin a “Pants on Fire” designation for the remark.

Still, Senate Democrats quickly pulled the counseling provision from their version of the bill. For some voters, this may have confirmed their suspicions of the provision’s intention.

A Pew Research Center poll released Aug. 20 found that 86 percent of respondents had heard of the “death panel” controversy. Of those people, 50 percent thought the charge to be false. Thirty percent said it was true.

However, a plurality of Republican respondents, 47 percent, thought that the health legislation would indeed create “death panels.”

While Palin’s charge was over the top, it was just an extreme example of the overall rhetoric surrounding the healthcare reform effort, says Thomas Schaller, a professor of political science at the University of Maryland, Baltimore County.

“There is a lot of heavily loaded, coded language being thrown around, of which ‘death panels’ is at the top of the list,” says Mr. Schaller.

President Obama has called the allegation an “extraordinary lie.” On Friday, the liberal group Americans United for Change launched a cable TV ad calling insurance companies “the real ‘death panels’ ” for allegedly denying care in the past to patients with life-threatening conditions.

Conservatives have denounced the charge, too – the conservative magazine National Review ran an editorial calling the “death panel” discussion “hysteria.”

Some Republicans, however, quickly pivot from “death panel” discussion to the subject of “rationing.” It’s an issue on which they may feel that opponents of healthcare reform are on much firmer ground.

Asked whether he believed the health bills would set up “death panels,” Republican National Committee Chairman Michael Steele in an Aug. 19 broadcast interview said that House members were putting in place a structure that could cause concern about people’s end-of-life decisions.

“You can call [it] a panel. I call it rationing,” Mr. Steele told interviewer Joe Scarborough on MSNBC.

The debate over possible rationing of care usually involves different sections of the pending legislation than does the “death panel” controversy.

The House bill would set up a comparative effectiveness panel, for instance – a government-appointed board of experts to try to determine what treatments are better than others. In addition, a separate panel would advise Medicare and Medicaid officials of ways in which they might approve the efficiency of their treatment delivery.

Combine these elements in an environment in which the government is looking to cut future costs, and you might have a recipe for rationing care, according to critics of the legislative effort.

Administration officials reject this charge, however. They say there is already rationing in the healthcare system. Denying someone private health insurance because they have a preexisting condition is “rationing, to me,” said Vice President Joe Biden at a panel discussion Thursday on healthcare reform in Chicago.

“We’re not rationing anything. We’re trying to eliminate what is a de facto rationing that’s [already] going on,” said Mr. Biden.

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