by Benjamin Sarlin
The much-discredited yet widely-believed “death panels” Sarah Palin warned about are back in the news this week as the White House is set to approve health-care regulations that she falsely characterized as mandated euthanasia last year. Or maybe they aren’t. It depends which Palin quote you’re going by.
Palin coined the “death panel” phrase in August 2009 with a now infamous Facebook post that was rated “Lie of the Year” by the nonpartisan Politifact. But she’s actually had a lot of trouble since then keeping her claims straight as to which part of the health-care bill she was attacking, so much so that it’s hard to say whether the regulations the White House is working on even qualify as a “death panel” on the myth’s own terms. In her initial post on the issue she wrote:
“The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s ‘death panel’ so his bureaucrats can decide, based on a subjective judgment of their ‘level of productivity in society,’ whether they are worthy of health care. Such a system is downright evil.”
This was pretty confusing at the time since nothing even vaguely resembling such a group existed in the health-care bill. Making things even weirder, Palin “clarified” in a footnoted post that she was referring to Section 1233 of the House’s health-care bill, which contained a previously uncontroversial measure backed by Republican lawmakers (who were horrified at Palin’s claim) in which Medicare would reimburse doctors to meet with patients voluntarily to discuss end-of-life care. But at no point in the provision would any “panel” or “bureaucrat” become involved at all, let alone determining anyone’s “level of productivity in society” or imposing any kind of health-care decision against the patient’s will. To the contrary, the provision was designed to encourage the patients to make their own decisions ahead of time so there wouldn’t be any ambiguity about their intentions if they were unable to communciate later. Palin herself had even encouraged Alaskans to consult their doctors about advance directives and living wells as governor. Nevertheless, the falsehood spread fast enough to cause the provision to be removed. Palin acknowleged later that “steps were taken to take the ‘death panels’ out.” Problem solved, right?
Nope. Palin then retroactively expanded the “death panel” claim to include the Independent Medicare Advisory Council, an institution created by the Senate bill that she never mentioned in her original Facebook posts. The IMAC, which at least constituted a panel of some kind, helps determine Medicare payments to doctors for various procedures based on their effectiveness, but the language of the bill specifically bars it from “any recommendation to ration heatlh care.” Nor does it look at individual patients, as Palin originally asserted.
But no matter there. Palin clarified yet again a couple of months later that despite her previous uses of the “death panel” line, which honed in on very specific provisions of health-care legislation, she meant it more as a literary device, freeing herself from ever having to get too specific. In an interview with ABC she compared it to Ronald Reagan’s use of the phrase “Evil Empire” to describe the Soviet Union: “It’s kind of like what Reagan used to do, though, when he talked about, say, the ‘evil empire.’ You’re never going to find the evil empire on a map of the world,” she said. In a subsequent Facebook post, which focused again on the IMAC (now known as the Independent Payment Advisory Board), she said she meant the phrase as a “metaphor.”
The most generously coherent interpretation of her “death panel” crusade is that she’s against any kind of Medicare cuts whatsoever, because they will lead to, as she puts it, “rationing.” However, we don’t have to guess what her plan is for health care — she recently announced her support for Paul Ryan’s deficit-slashing proposal to turn Medicare into a privatized voucher system then cap government spending on the program, thus majorly reducing its funding over time. Oddly enough, Ryan has acquired a reputation as one of the more honest brokers in the health care debate in part because he’s willing to openly talk about “rationing,” that same scare word Palin has linked to “death panels” from the start, as a necessary part of his plan.
So is “rationing” still the death panel now, unless its part of a privatization scheme for Medicare? Is the Medicare board the death panel? Or are the end-of-life provisions that bear no resemblance to anything Palin first described the death panel? Either way, the “death panel” canard is still as false now as it was the day it was first uttered.