The “death panels” are back. In the last week three Republican congressmen have characterized advanced care planning and palliative care as efforts to hasten an elderly person’s death. You may remember the comments Sarah Palin made in 2009 on her Facebook page when she stated the proposed legislation for Affordable Care Act contained provisions for “death panels”. Politifact called Palin’s claim the 2009 “Lie of the Year”.
Fortunately Sarah Palin has all but vanished from the political scene and the Affordable Care Act was enacted into law, without death panels.
Ultimately, beginning in 2016, Medicare started covering advance care planning as a separate billable service by clinicians. In the first half of 2016 over 220,000 Medicare beneficiaries voluntarily received advance care planning services from their healthcare providers. There is widespread agreement amongst medical, social and religious leaders that advance care planning discussions are critical aspects of high-quality medical care and allow patients to receive treatment that is consistent with their values and goals. Published research confirms these conversations reduce depression and anxiety and are well received by patients.
Steve King, a Republican congressmen from Iowa introduced a bill in congress in January called “Protecting Life Until Natural Death Act”. The proposed legislation would revoke Medicare reimbursement for advance care planning discussions. The legislation is based in the lie that reimbursing a physician’s time for voluntary advance care planning discussions represents the government’s attempt to shorten the lives of old people. In January Representative King said, “Allowing the federal government to marry its need to save dollars with the promotion of end-of-life counseling is not in the interest of millions of Americans who were promised life-sustaining care in their older years”.
Republican legislators seem to be trying to gain momentum with this rhetoric. In a recent Town Hall meeting in Florida with Representative Gus Bilirakis, Bill Akins the secretary of the Pasco County Republican Party characterized the Affordable Care Act as having a provision that “anyone over the age of 74 has to go through a death panel”.
Finally, Senator Ted Cruz added his perspective on palliative care when he stated in a recent Town Hall debate with Senator Bernie Sanders “you know, you look at the elderly in much of Europe. The elderly here, when the elderly faey’re often put in palliative care, essentially doped up with some drugs, and said, ‘Well, now is your time to go’.”
These comments about advance care planning and palliative care are not founded in ignorance. They are intentional, with an aim to convince people that the government is in the business of encouraging physicians to deny healthcare. It is a shameful strategy by the Republicans to incite fear and engender support for their healthcare legislative agenda. If passed, the King legislation would harm countless people and unfairly damage critical concepts of high quality medical care.
I have many conservative friends and colleagues who I’m sure share my outrage at this political distortion. Let’s come together on this shared value and contact our legislators to implore them to reject this legislation and to stop characterizing palliative care as a “death panel”. Go to this link to retrieve your legislators’ contact information.