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'Death Panels': Beliefs and Disbeliefs in Health Care

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A few days ago I interviewed Virginia, a 74-year-old woman who was several months into recovery from back surgery.'  I had come to chat about food---whether she was getting enough to eat since cooking was nearly impossible.'  Each weekday the local Meals-on-Wheels program in her Connecticut town delivered hot dishes, which she enjoyed.' '  Our conversation quickly turned to health care politics, death panels, and Medicare.'  She had heard politicians want to cut programs she needs for survival.' '  'Meals-on-Wheels is a wonderful program,' Virginia said.'  'I hope they never get rid of it.'' '  Then she asked:'  'Is Obama wanting to get rid of this, too?

The more we talked, it became clear she really was worried about obtaining and paying for health care, and her comments said a lot about the misinformation and disinformation reaching seniors.'  ' Virginia was particularly concerned that she would not get medical treatment after she turns 75.' ' '  She had heard at that age, 'they send you a letter.' '  They are going to start sending you literature on death.'

Who is the 'they,' I wanted to know.'  'It's the insurance companies,' Virginia replied.'  'I have heard that if you need surgery, they will determine whether you get it.'  It's scary, scary.''  How did Virginia know all this?' '  'From everybody,' she explained, especially the friends she played cards with.

The notion of death panels still resonates with seniors.' '  'Death panels' was the label some health reform opponents gave to a provision in Obama's health reform legislation that called for doctors to earn payments from Medicare for end-of-life counseling that included discussions of treatment options, and legal documents such as advance directives and living wills.'  Advocates for the elderly advise them to take these precautions so family, doctors and hospital personnel know their wishes if they're seriously ill.

Hysteria surrounding 'Obamacare' led seniors to believe they would be denied care by what one man told me was 'the end-of-life committee.'' '  Death panels became such a hot potato, legislators dropped the counseling provision from the final bill.'  The Obama administration later tried to resurrect it through regulations, but dropped that too; the potato was still too hot.

Policy wonks do a lot of hand wringing over this one.'  In their minds, the death panel claim is false and so ridiculous; they can't understand why the myth lives on.' '  After visiting with Virginia, I think I know why.' '  A lot of it has to do with the public conversation regarding health care'how much it costs and who should pay for it.

Politicians tell us that health care is too expensive and something must be done to cut services.'  They tell us that patients must pay more for their care out-of-pocket as a way to discourage them from seeking medical treatment.'  We hear Medicare is 'unsustainable,' and needs drastic reform.' '  We hear something must be done about entitlements---and Medicare, of course, is one.'  We hear that too much money is being spent on 'useless' end-of-life treatments and care.

No wonder the myth of death panels makes the rounds at church on Sunday and the bridge club.'  Where will cuts come from?'  The elderly believe they'll come from them.' '  Virginia wonders: Where else would cuts come from except from those who need care the most and who are the most expensive to treat? If Medicare's budget is in trouble, then there must be some cut-off point where those now receiving benefits will no longer get them. ' Virginia's worries flow logically from public health care discussions.'  That's the problem.'  Conversations over coffee offer bits and pieces without context, coherence, and explanation.

The real issue for seniors is not fictitious death panels but a move afoot in Congress to make them pay more for their care at the same time that their Medigap policies are paying less.'  But many seniors are still distracted by death panel fears.' '  Why hasn't she heard more about this, Virginia asked.'  It hasn't been in the interests of politicians to tell them, I explained.

Hyping non-existent death panels scores political brownie points for some partisans, telling seniors on fixed incomes they will have to pay more does not.' '  If they can't afford to pay the increased price, they may go without.'  That's a different kind of rationing than what Virginia worried about.'  How ironic, I thought.'  The death panel myth lives on, but legislative proposals that might really bring on the dreaded rationing have so far escaped seniors' attention.

More Blog Posts by Trudy Lieberman

author bio

Trudy Lieberman, a journalist for more than 40 years, is an adjunct associate professor of public health at Hunter College in New York City. She had a long career at Consumer Reports specializing in insurance, health care, health care financing and long-term care. She is a longtime contributor to the Columbia Journalism Review and blogs for its website, CJR.org, about media coverage of health care, Social Security and retirement. As a William Ziff Fellow at the Center for Advancing Health, she contributes regularly to the Prepared Patient Blog. Follow her on twitter @Trudy_Lieberman.


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Health Insurance   Trudy Lieberman   Pay for your Health Care   Aging Well   Medicare   Inside Healthcare  


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