‘Death panel’ demagogues win, you lose

One of the sorriest lies told in the health care reform debate last year was about end-of-life counseling for terminally ill people.

The proposed reform law provided that such counseling, routine and widely advocated by professionals, would now be specifically covered by Medicare, and thus encouraged.

Demagogues invented the phrase “death panels” to describe this counseling, claiming they would pressure elderly patients and other patients to cease medical treatment to save money. This put bill backers on the defensive.

That was despite the insistence of health care professionals that end-of-life counseling was already a routine part of the conversation between doctors and terminally ill patients, covering such issues as treatment options; when a patient wants to end life-saving treatment, if he or she does; how much pain they want to endure; and where a patient prefers to spend the time left.

The provision was removed from the law, one of several compromises deemed necessary to get it passed. Now, a directive in Medicare rules that would have allowed doctors to be reimbursed for this counseling as part of a beneficiary’s yearly exam, has been removed. The counseling can and will continue; it’s hard to imagine doctors and patients dealing with terminal illness otherwise. But the reimbursement is not specific, and this common sense and routine practice will not be explicitly encouraged in the rules.

The reason is political. The Obama administration is trying to blunt efforts from opponents who want to repeal the health care law.

The Democrats will fight to prevent repeal, but they presumably don’t want the “death panel” slander bogging down any discussions that do take place. It’s a shameful abandonment of good policy and good medicine.