Death Panels

The latest capitulation to the far right, came this week, when the Obama administration opted to revise the Medicare regulation covered in the new health insurance law, the regulation concerning end of life planning. This regulation would have enabled Medicare recipients to choose to discuss end-of-life care with their physicians during their annual physical. The discussion would have been covered (paid for) by Medicare. This was a choice. No one was going to be forced to have this conversation. The far right, in the person of half-term ex-governor Sarah Palin, began bleating about death panels, in 2009, a bleat picked up by her political and media acolytes. Having the option for a discussion with one’s physician was turned into the “certainty” of seniors being killed by the government. This week, Obama caved in to the liars.


The Medicare reimbursement rate for the annual physical is $54, which means that the system penalizes a doctor for engaging in a long discussion about end of life treatment with a patient. Ironically, that same system provides financial reward to a doctor for implanting a pacemaker in an elderly, addled, stroke patient. It’s absolutely breathtaking that the option for a voluntary conversation could have been blown so far out of proportion by the lunatic fringe.

Somewhere along the way to our societal obsession with youth, death became a taboo subject. We’re so afraid of death and dying that we’ve created a whole language of euphemism for it. No one dies any more. They “pass.” Heaven must be one big high school hallway. The death taboo is so powerful that children are afraid to have conversations about death with their aging parents. Anyone who dares to suggest they may not live forever is met with a chorus of protests. I’ve never heard anyone say, “If something happens to me, I want to be hooked up to life support for the rest of my natural life, even if I’m brain dead and drooling.”

Death has been a large part of my life for the last few years. As many readers know, my husband died in 2009. He had multiple myeloma, a cancer of the blood plasma and bone marrow. There is no cure for it, and by the time David was diagnosed, the disease was advanced. His bones were weakened and breaking. We had to talk about living, dying, and medical treatment all the time. Every time something new came up, we discussed it endlessly. The big question was, “is it necessary?” We also had to contend with official paperwork, like the durable power of attorney, the do not resuscitate orders, and a will. He knew that not having those conversations wouldn’t change the outcome. He was still going to die; it would just be harder for everyone involved. Sadly, he did not have the legal option of medical marijuana, which would have made some of his treatments more bearable. He also did not have the option of assisted suicide. He would have chosen to die about six months before he actually did, and been spared a lot of suffering. In the live free or die state, living on our own terms is a virtual mandate, and something to strive for – yet dying on our own terms is forbidden.

The far right claims that they love life! They venerate life! What they really love are fetuses. They love the preborn and the yet-to-be-conceived with a fierce passion. The already born – well, they don’t love them so much. They are opposed to the health insurance reform bill that gives more people access to health insurance. Insurance companies can’t turn folks down any more because of pre-existing conditions. One would think that these self-professed lovers of life would want the living to have good health care. One would be wrong. The cry of “death panel” successfully obscured the fact that those on the far right were very happy with the death panels that were actually in place. Death panels with names like Wellpoint, Anthem Blue Cross, and Cigna. These insurance companies make decisions about who gets what treatment all the time.

In 2007, my husband’s left hip was riddled with cracks and tumors. Radiation didn’t solve the problem, or eradicate the pain. He was barely able to walk. A rather bizarre accident ended with him lying on the floor with a broken hip. The doctors decided that hip replacement surgery was called for. He had the surgery, made a brilliant recovery, and was able to walk again, pain free. That broken hip was a gift, in a peculiar sort of way. His insurance company didn’t view the surgery as necessary. They fought hard to deny payment by calling it “elective” surgery. This resulted in some colorful telephone exchanges with the insurance company. I walked in one day to David explaining that yes, he supposed he could have elected to spend the rest of his life lying on the floor, moaning in pain. They paid.

Of course it’s the lucky ones who have access to the insurance company death panels. The unlucky get the informal death panel – dying from preventative diseases because they couldn’t afford preventative care.

Our seniors deserve better than the baloney that the liars of the far right have peddled. They deserve better than the spineless Obama administration, caving in to the liars. As we wait to see what kind of trickle down death panels the Teahaddis will devise for the rest of us, we can take comfort in knowing that our newly minted NH Senator and both of our Congressmen will be getting the kind of “gummint healthcare” they claim to despise.



This was published as an op-ed in the January 7, 2011 edition of the Conway Daily Sun.
© sbruce 2011