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Don Berwick On The Rhetorical Nonsense Of ‘Death Panels’

Don Berwick, former administrator of the Centers for Medicare and Medicaid Services, addressed the need to better control health care costs in a panel at the Association of Health Care Journalists’ conference in Boston. Afterwards, he spoke with LMM about the political firestorm that erupted as a result of his proposals for end of life counseling.

Berwick, influential in the Affordable Care Act plan that would have allowed for Medicare coverage of a doctor-patient discussion about end of life care, said he was outraged his ideas would be labeled “death panels” by many on the political right. The Harvard University trained physician resigned in 2011 from his CMS post due to heavy Republican opposition.

Don Berwick
Don Berwick

“To think about the suffering and the disrespect that nonsense had for people in the terrible stages in their life,” Berwick recounted. “They need compassion, they need the help, they need plans, they need to be together, and this rhetorical nonsense- with no basis in science at all- hurt thousands,” he said.

Berwick said he does not know why that accusation caught on in the political and media dialogue. “I wish in my dreams that the communities in America had risen up and said, ‘Nonsense, no you won’t seize this terrain with rhetoric that makes no sense at all,’” Berwick said.

Despite support from many medical professionals and fellow Democrats, President Obama dropped Medicare funding for end of life counseling from the Act. When it was signed into law in 2009, Democrats wary of being identified with “death panels” dropped all proposals associated with end of life planning.

According to Politifact, a Pulitzer Prize winning fact checker, comparing end of life counseling to “death panels” was 2009′s “Lie of the Year.” Former vice presidential candidate and Alaska governor Sarah Palin was the first to coin the term “death panels” on her Facebook page after the release of an early draft of the Act.

Politifact notes: “This falsehood, our 2009 Lie of the Year, started after an early draft of the bill sought to allow Medicare to pay for doctors’ visits in which patients discussed end-of-life care, such as living wills. The critics labeled it suicide counseling.”

Berwick said he does not envision Republicans embracing the Affordable Care Act anytime soon. “This isn’t about the Affordable Care Act, it’s about a much deeper rift in American public belief in policy,” he said. “It’s the field of battle but not the reason for the war,” he said.

Berwick, who has an exploratory committee looking into a possible run for governor of Massachusetts, did not confirm or deny intentions to enter the race, despite repeated questions from journalists.