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.