John Stossel has a piece today examining the use of the term “death panels” in relations to the provision to provide for end of life counseling.
He basically argues that it is crazy to call this provision a death panel — I agree. Sure, it is certainly possible that end of life counseling will lead to more people seeking less care at the end of life, but I think we should assume until we know otherwise that such decisions would be entirely voluntary. It is certainly possible that the end of life counselors could hector people into forgoing treatment, but I don’t think one can make that leap now without any evidence and certainly that doesn’t make them “death panels.” And it is probably very sensible for people to think through what they really want done when they are in the process of dying, and to understand the tradeoffs between life extension, pain, etc.
The death panel term — while probably still over the top — seems much more applicable to the proposed U.S. version of the UK’s “NICE” — the agency which will decide what treatments are efficient and what treatments aren’t and under what circumstances. Having the government decide that one treatment isn’t “efficient” in a certain circumstance and therefore won’t be provided through the public plan (and if believers in a single payer system have their way then won’t be available at all).
And yes, before the comments start coming, I know that insurance companies right now can decide that some treatments aren’t covered and what treatments are. But there is a big difference between having a private entity make those decisions. Most importantly, individuals can switch insurance companies if they don’t like the policies of the one that they have. And, yes, the current system makes it very difficult–often times nearly impossible–to switch insurance companies. We don’t “shop” for health insurance like we do car insurance. And that’s certainly a problem that needs to be solved — indeed that should be the focus of health care reform to make it so that we have a real, functioning insurance market. And if that means subsidies for those who can’t afford insurance on their own, then fair enough. That’s much better, and preserves much more of our freedom, than having government turn into a giant HMO.