Even Doctors Believe in Obamacare's Death Panels

| Thu Dec. 19, 2013 10:19 AM PST

I learned something new this morning. Two things, actually. First, Sarah Kliff points us to a recent study telling us that even a lot of doctors believe that Obamacare institutionalizes death panels:

This is just a survey of head and neck doctors, so maybe they're just especially ignorant among the MD set. But probably not.

So what else did I learn? Well, Obamacare has never had death panels in the sense of the question above, but it does reimburse physicians for having end-of-life conversations with their patients. You know, so they can decide about things like DNR notices, how much extraordinary care they want, living wills, and so forth. All perfectly sensible, except that it's what prompted the death panel nonsense in the first place.

And it's gone. I didn't know that. Apparently, after the New York Times put it on the front page in 2011, this provision was eliminated. So the yahoos won another victory, and it didn't stop the death panel talk anyway. Hooray.

UPDATE: Thanks to a tweet from Austin Frakt, I did a little more digging and it turns out that a weakened version of end-of-life counseling remained in the bill and was implemented by a new regulation adopted in 2010:

The final version of the health care legislation, signed into law by President Obama in March, authorized Medicare coverage of yearly physical examinations, or wellness visits. The new rule says Medicare will cover “voluntary advance care planning,” to discuss end-of-life treatment, as part of the annual visit.

Under the rule, doctors can provide information to patients on how to prepare an “advance directive,” stating how aggressively they wish to be treated if they are so sick that they cannot make health care decisions for themselves.

So if a patient asks about end-of-life treatment, doctors are allowed to talk about it and bill the time as an office visit. Death panels!

UPDATE 2: Oh hell. It turns out that a couple of weeks after putting this rule in place, the Obama administration reversed itself. So I was right the first time: Reimbursements for end-of-life counseling have been eliminated after all. Thanks, yahoos.

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