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Posted at 1:24 PM ET, 01/ 5/2011

Supposedly non-existent death panels removed from ObamaCare

By Jennifer Rubin

The New York Times reports:

The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.

Many doctors and providers of hospice care had praised the regulation, which listed "advance care planning" as one of the services that could be offered in the "annual wellness visit" for Medicare beneficiaries.

While administration officials cited procedural reasons for changing the rule, it was clear that political concerns were also a factor. The renewed debate over advance care planning threatened to become a distraction to administration officials who were gearing up to defend the health law against attack by the new Republican majority in the House.

In other words, the administration "refudiated" its own regulation. Oh, yes, you have to read down to the eleventh paragraph (a classic case of burying the lede) to find out that it was Sarah Palin who "said in the summer of 2009 that 'Obama's death panel' would decide who was worthy of health care." (She more widely referred to the prospect of rationing, which severe cuts in Medicare and price controls would, in her view, inevitably entail.)

The Times notes that the measure, in a firestorm of criticism, was pulled by the bill but then slipped back in as a regulatory provision. But once again, it proved to be more trouble than it was worth.

The New York Sun editorializes that the about-face should be dubbed "the Palin patch" in honor of the gal who raised the issue in the first place. I would suspect that unlike those who object to "ObamaCare," Palin would gladly accept that designation as a badge of honor.

But the larger issue with regard to ObamaCare is not whether this specific provision would have transformed itself from a voluntary service into a coercive one. Rather, it is whether, as Palin and other conservative critics argued during the debate over the bill, the inevitable result of ObamaCare (indeed, a necessary component of this and other government-directed plans) will be to squeeze providers, eliminate services and ultimately deny coverage to those who in the past would have received care. Last April James Capretta, a fellow at the Ethics and Public Policy Center and a former White House budget adviser on health care, wrote:

Look at the recently enacted health-care bill. It includes large cuts in Medicare's payments to hospitals, nursing homes, and others. These cuts aren't calibrated based on quality or efficiency. They are across-the-board cuts hitting every service provider. And the bill also stands up a new independent board that is charged with essentially enforcing a cap on overall Medicare spending beginning in 2015. But the only changes in Medicare the board can recommend to stay within the cap are more reductions in provider-payment rates. The board can't touch the Medicare benefit, much less propose a Ryan-style move toward more choice and market competition. No, the only option is more and deeper price controls.

So, it is entirely predictable where Democrats will turn when they need show their willingness to cut entitlement spending. They will push to broaden the reach of Medicare's price controls to parts of the health system currently beyond their reach, including prescription drugs and the federally subsidized insurance arrangements enacted as part of the new health-care law. It will be one more step toward their ultimate goal, which is a fully government-run health system, with all that entails - including waiting lists and restricted access to care


In the scramble to jam through a bill, the Democrats declined to fully air these and other concerns about the "historic" legislation. We were told the time for debate was "over." Actually, it's just begun.

By Jennifer Rubin  | January 5, 2011; 1:24 PM ET
Categories:  Obamacare  
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Next: It's a big day


Jennifer, good subject for debate with some accurate points on your side, as long as we all agree that there are not now, nor ever were any death panels proposed or enacted by anyone.

All that has happened is that a service that might have proved useful to some people some times will no longer be offered because the current administration is in still really scared of what they see on Fox!

Posted by: 54465446 | January 5, 2011 2:07 PM | Report abuse

It's a slow work day here so I took a look at your bio. It states that one of the things you believe in is "calling things by their proper names." But you're still using the "death-panel" misnomer, one of the most egregious political obfuscations in recent years. Either you really believe they exist (which does not reflect well on your intellect) or you are just another garden variety conservative hypocrite.

Posted by: rgray | January 5, 2011 2:36 PM | Report abuse

End of life planning is not the same as the so-called "death panels" that the GOP was claiming existed. Classic fear-mongering. When Dems fear-monger people like Jennifer Rubin go nuts and criticize, but when they do it, it's A-OK!

You are a bit of a disappointment. Having a lively debate is one thing but just spewing the latest GOP talking points makes you, what? A journalist? No. A propagandist? Yes. You never even stray just a little bit from the ultra-conservative party line, even if just to make it interesting and provide us with a little element of surprise.

Our health care system is broken- costs are sky high and the insurance companies compete for healthy people who dutifully pay their premiums, only to then slime out of their contractual obligations when they get sick. Insurers love to play the risk game so long as it benefits them, but then when it doesn't....

Honestly, it would be one thing if the system were working, costs were down and we weren't low on key determinants of population health like infant mortality. By the way, we are (or were) actually tied with Hungary, Malta, Poland and Slovakia in infant mortality rates despite being the world's richest country.

So, what does the GOP offer up to help with the problem. Nothing. They wait until a democrat gets in office and tries to fix things then they complain about socialized medicine (it's not) and give us platitudes and bumper-sticker slogans about health care knowing full well they don't give a damn and have no intention of trying to fix anything. That's nothing to be proud of Jennifer.

Posted by: Stacyx | January 5, 2011 2:41 PM | Report abuse

Jen, you make some accurate points. It's just important to remember that there are not now, nor have there ever been any proposed death panels. All that has happened is that a service that could have been useful to some people will no longer be included in the package, because the current administration is till deathly afraid of Fox News.

Posted by: 54465446 | January 5, 2011 3:11 PM | Report abuse

sorry for the repost

Posted by: 54465446 | January 5, 2011 3:12 PM | Report abuse

Great comment Stacyx. I'm also disappointed with Right Turn. I've checked it out a few times and its been a steady regurgitation of hyper-partisan talking points. No depth, no analysis. I'm very surprised the post could not have done better. Is there not one thinking conservative left in this country?

Posted by: rgray | January 5, 2011 3:16 PM | Report abuse

"Death panels" did not refer primarily to the end-of-life counseling provisions, but to the Medicare Comparative Effectiveness Advisory -something- set up to decide which treatments were "worth the money" and would be reimbursed. The Dems took the EOL provisions out of the bill in order to pretend to be responding to the issue, but the actual panels stayed in. BTW, essentially everyone agrees that there need to be sensible decisions made about end of life care; the issue is who makes them - patients and doctors, or remote bureaucratic panels. "Death Panels" is a particularly provocative name for the latter, but not really unfair.

Posted by: Mahon1 | January 5, 2011 4:30 PM | Report abuse

Mahon1 wrote: something- set up to decide which treatments were "worth the money" and would be reimbursed.

This is the current system that you describe. Insurance company bureaucrats currently make reimubursement decisions. Call them "death companies" if you like.

Posted by: rgray | January 5, 2011 5:00 PM | Report abuse

Re: rgray | January 5, 2011 2:36 PM

"Death panels" was not a misnomer. "Death panels" were exactly what Obama was talking about when he gave NY Times reporter Leonheardt this interview on April 2009.

The President: ... 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.

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

THE PRESIDENT: Well, I think that there is going to have to be a con-versation 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 is part of why you have to have some independent group that can give you guidance.,

Incidentally, death panels exist today and have existed for a long time. For example, decades ago, when dialysis machines were few, hospital committees decided which patient had the greatest right to treatment, by virtue of age, or number of dependents, or could benefit most, and which, usually the old with advanced disease, would have to be allowed to die.

Posted by: nacllcan | January 5, 2011 6:27 PM | Report abuse

Mahon, your interpretation is completely incorrect. There are numerous articles all over the internet many by right of center periodicals detailing exactly the opposite of what you right.

There is already an existing mechanism to do exactly what you refer to and it's not a death panel, it's the FDA. What they approve Medicare pays for. For instance they recently approved a "vaccine" called Provenge which costs $73,000 for a treatment series, which has been proven to extend the life of terminal prostate cancer sufferers by a whopping three months.

It is insane of course, but nothing in the new ACA will stop this kind of fiscal suicide from continuing.

Posted by: 54465446 | January 5, 2011 9:51 PM | Report abuse

naclican wrote:

"For example, decades ago, when dialysis machines were few, hospital committees decided which patient had the greatest right to treatment, by virtue of age, or number of dependents, or could benefit most, and which, usually the old with advanced disease, would have to be allowed to die"

As they still do with organ transplants today. Is there something wrong with that system?

Posted by: 54465446 | January 5, 2011 9:55 PM | Report abuse

"Supposedly non-existent death panels removed from ObamaCare"

WHY OH WHY can't the Washington Post hire a conservative blogger who can offer serious, alternative points of view to Sargent/Klein?

Posted by: Echo21 | January 6, 2011 9:16 AM | Report abuse

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