Examining the Harm Done by Sarah Palin’s “Death Panel” Rhetoric

April 9, 2012
53 Views

 

 

Give a dog a bad name and hang him

 

 

Give a dog a bad name and hang him

There is a great opinion piece, “The Retreat from Advanced Care Planning,” in the March 7, 2012 issue of JAMA.  Mary Tinetti, a Geriatrician at Yale School of Medicine writes about what has happened to Advanced Care Planning – the process of  encouraging patients to communicate their values and preferences about the type of care they wish to receive at the end of life – since the infamous words, “death panels,” were posted on Sarah Palin’s Facebook account in August 2009:

“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.”

The idea that the Affordable Care Act would authorize death panels went viral.  The uproar ultimately led to the provision that authorized Medicare to reimburse physicians for the time they spend discussing end-of-life preferences with their patients being yanked from the Affordable Care Act.  Such is the power of famous people in an age where remarks are taken at face value and attempts to set the record straight are dismissed as partisan or twisted for political gain:

 

Dr. Tinetti describes being accused by family members of two of her patients of being “part of a government-backed plan to save money by not offering expensive care to frail older patients” because she raised the issue of end-of-life preferences with them. She goes on to say, I was simply doing “what I have always done – ask what the patient’s goals of care were so that I could make care decisions congruent with those goals.”  She said after these attacks, she was reluctant to raise the issues with her patients and she says she heard similar stories from her colleagues.

Doctors were not the only ones intimidated by the response to the death panel rhetoric.  In the fall of 2010, an attempt to include voluntary advanced care planning as a part of the new Medicare annual wellness visits thwarted, possibly because of media-fueled furor about the topic.  This despite evidence that advanced care planning is, at its core, exactly what we all say we want – patient-centered care.

Now, it doesn’t seem to bother the propagators of the “death panels” myth, that  the provisions in the ACA and annual visit regulations related to advanced care planning was to authorize payment for physicians providing this type of counseling.  Per Dr. Tinetti, “over the past year, CMS has published several additional rules and regulations including new payment rules and the Hospital Conditions of Participation….None of these rules or regulations included mention of voluntary advanced care planning.”

She goes on to say “To repair the harm done by discussion of death panels and by the administration’s apparent retreat on this issue, this important patient need must be depoliticized.” [emphasis added].  She closes by stating, “CMS should assess physicians on how well they perform one of medical care’s most important activities, and physicians should be reimbursed for doing it right.”

 

 

 

You may be interested

What to Look for in Patient Solutions Software
eHealth
365 views
eHealth
365 views

What to Look for in Patient Solutions Software

Robert Cordray - August 17, 2017

The medical sector is one area where technology has had a significant impact, largely by providing tools that simplify many…

Can Natural Remedies Like RediCalm Decrease Stress and Anxiety?
Wellness
2 views
Wellness
2 views

Can Natural Remedies Like RediCalm Decrease Stress and Anxiety?

Ryan Kh - August 16, 2017

According to research from the National Institute of Mental Health, anxiety disorders are the most common mental illness in the…

How to Alleviate Stress Related Insomnia
Specialties
400 views
Specialties
400 views

How to Alleviate Stress Related Insomnia

JohnHenning - August 15, 2017

Do you have difficulty falling asleep or staying asleep every night? You aren't alone. According to multiple studies, including one…