About Those Death Panels

July 18, 2012

By Shawn Kennedy, AJN editor-in-chief

Diana Mason, former editor-in-chief of AJN, wrote a post on July 9 on the JAMA Forum blog that’s well worth reading. In it, she talks about the resurgence of “death panels” rhetoric to stir opposition to the Affordable Care Act (ACA), specifically in relation to the Independent Payment Advisory Boards, which are to issue binding recommendations for controlling costs if Medicare grows too rapidly.

In a nutshell, these boards will determine where to reduce costs. If Congress opposes the plan, it will have to come up with same-size cost cuts if it doesn’t want to institute what the board recommends. The message that opponents of the ACA want the public to hear is that their fates will be determined not by them but by an arbitrary committee.

But IPABs are about reducing costs of programs, not passing judgment on individuals.  (As Mason notes, the death panel rhetoric was “declared the “2009 Lie of the Year” by PolitiFact, a project of the Tampa Bay Times and partner news organizations.”)

People should have conversations about how they wish to be treated in their last moments, but these should occur with loved ones and direct care providers and be supported by the legal system. People shouldn’t have to worry that they will be rushed along to death if they’re not ready—in fact, this seems to be the opposite of what usually happens.

According to a report from NPR, on Monday, July 9, the Republicans, for the 31st time, introduced a bill to repeal the ACA (this bill is called “The Repeal of Obamacare Act”). It’s political posturing—it will pass the House but will fail in the Senate, as all the prior bills have. One Connecticut representative, Rep. Rosa DeLauro, commented like this: “Mr. Speaker, instead of working to create jobs, reduce the deficit, and do the business of the American people, this majority has been consumed for months now with trying to repeal health care reform.” 

But the Republicans will continue to do this to send a political message. And the rhetoric will likely continue and only get worse as we approach the November election. Mason’s post points back to a message in my post from last week: nurses, take the time to learn the facts, for your own and for your patients’ sake. Politicians have not been known to be especially truthful, but outright lies to instill fear in the very people they are supposed to care so much about—shame on them.

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  1. This provokes a question, as someone on the outside looking in: “Independent Payment Advisory Boards are to issue binding recommendations for controlling costs if Medicare grows too rapidly.”
    My family doctor has new signs in her office stating that due to the low reimbursement amounts, they can no longer afford to treat Medicare patients, and they refer those patients to a facility in another town. This doesn’t affect me directly, as I’m insured, but I can only imagine how I’d feel in a medicare patient’s shoes: the limited choices, the restrictions… and one day I may be in those shoes.
    So my question is: isn’t either true that these boards may decide not to cover certain procedures, or may cover them at such low reimbursement rates that doctors may not accept these patients? Isn’t that a real risk? I sincerely want to understand if I’m perceiving these risks incorrectly. Thank you.


  2. Thanks, John – liked your post. Especially liked your link to Death Death Panels Redux [http://www.factcheck.org/2012/04/death-panels-redux/] at the Annenberg FactCheck.org site. Good site for fair coverage.


  3. I came upon this only hours after posting my own blog post about this exact subject (http://ourhealthcaresucks.com/healthcare-reform-2/obamacare-death-panels-must-die/). Now they’re calling them “ethics pane;ls”, but the pitch is the same. it’s a dirty political trick that’s needlessly scaring many seniors.

    This same deception has already deprived dying patients and their families of the benefit of physician counseling about their end-of-life options. These political games have human consequences that should, but won’t, embarrass their proponents. Thanks for writing about this as nurses and doctors both are in the best position to reassure patients that this is untruthful and should be ignored.


  4. We nurses should learn as much as we can about everything that involved our profession. When money is on the line, lies, manipulations, and “scare tactics” are rampant. Take the fiasco with Glaxo-Smith-Kline just recently….how many more pharma, food, manufacturing, and other companies have downright FAKED research and LIED in order to make a buck? And the punishment is not severe enough…GSK made 27 billion off their meds in question, and were only fined 3 billion… So, a fine of only 10% of profits? Yeah, I’d probably lie too, if I could make off with the other 90%.


  5. And those ACA repeal efforts cost American taxpayers $48 million, which could have been better spent elsewhere.


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