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Editorial: 'Death panel' claims, distortions

Don't let false claims dominate the health care debate.

Last update: September 1, 2009 - 3:40 AM

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"I think it's not only a distortion, but I believe it's a willful distortion of the issues -- to play on people's fears. I've read that bill, and really what the bill says is that we will reimburse providers who do this counseling."

Dr. Robert Nesse, president and CEO of Franciscan Skemp Healthcare in

La Crosse, Wis., which is part of the Mayo Health System

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A number of distortions have been driving, if not defining, the health care debate during this town hall summer of discontent. Among the most damaging has been the claim that reimbursing doctors for consulting with patients on end-of-life care directives would create so-called "death panels."

Mary Brainerd, president and CEO of HealthPartners, told the Star Tribune Editorial Board last week that all the talk of death panels has set back the health care industry's efforts to promote such directives by 20 years.

Unprompted by Brainerd's comments, Arthur Caplan, director of the University of Pennsylvania's Center for Bioethics, doubled down the damage done. "When critics began saying that this plan contains provisions for end-of-life care counseling, and that means that there's going to be a confrontation with a death panel, I thought that set back end-of-life care planning about a good 40 years."

Regardless of the timetable, what began as an effort to reimburse medical providers for having humane and appropriate conversations with patients about their medical care has been hijacked by opportunistic opponents and given too much volume in the partisan media echo chamber.

This is no way to have a debate on health care, which some estimate represents about 16 percent of the U.S. economy. But it's just one of the misrepresentations that's obscuring legitimate voices who bring badly needed perspective to the complex and critical discussion.

The health debate should be about the facts, not Facebook entries from Sarah Palin, said Stephen Parente, a University of Minnesota associate professor and director of the Medical Industry Leadership Institute at the Carlson School of Management, who was an adviser to the McCain campaign.

The fact is that none of the proposed legislation would create death panels or cut off care for the critically ill to trim costs. Rather, this is about rethinking an element of Medicare reimbursement and giving people the opportunity to voluntarily discuss end-of-life issues with their doctors. "We don't pay people to talk in our health care system," says Caplan. "We pay them to do things." That needs to change.

If a patient's advance directive calls for every possible procedure, so be it. It should be up to the individual patient to decide in advance whether to direct doctors to use every potentially lifesaving measure. And without a plan in place, the current system leads to the kinds of aggressive lifesaving measures that many people would not voluntarily choose.

Finally, the medical establishment is speaking out on the death panel falsehoods, even if doctors and medical organizations don't agree on many other aspects of health care reform. End-of-life directives are a quality of life issue, and we've lost years of progress to misinformation.

Regardless of what happens with Congress and the White House at a negotiating table -- the Senate has already removed the provision of its bill that sparked the controversy -- ultimately what occurs at the kitchen table is more important. End-of-life care discussions should start at home and eventually include consultations with trusted physicians. Families are often torn apart by issues related to end-of-life care -- a terrible situation that can be avoided if patients have the opportunity to make their wishes clear in advance.

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