Policy-ish

Current 'Death Panel' Uproar Echoes Decades-Old Controversy

It was early summer. A senior federal health official wrote a memo suggesting that living wills — documents that can convey patients' wishes about when to end life support — could help curb health-care costs.

Robert Derzon, former HCFA administrator.

Robert Derzon, former HCFA administrator. UCSF hide caption

itoggle caption UCSF

The memo leaked to the media. By August, a New York Times' column said the official "likes euthanasia."

Sound like this year's angry August? Well, this story unfolded in 1977, and the official in question was Robert Derzon, the first administrator of the Health Care Financing Administration, now the Centers for Medicare and Medicaid Services.

Derzon's memo said, "The cost-savings from a nationwide push toward 'Living Wills' is likely to be enormous." But, it also warned of "some negative public reaction." (Read the full memo here.)

In an August 14, 1977, column, a Times writer called the note an "amazing disclosure of the extent to which some in the Government would go to reduce medical costs."

But that's not exactly what Derzon, who died in June from swine flu, had in mind.

At his recent memorial service, Clifton Gaus, an associate administrator at HCFA and co-author of the controversial memo, explained. "The hysteria, misinformation and accusations were vicious and lasted for weeks," Gaus recalled at the memorial service. "What is more surprising is that this country has made big strides in [patients'] rights to living wills and in making death more comfortable," he said. "Yet the fringe critics still are able to command huge media attention."

Former New York Lieutenant Governor and health-care firebrand Betsy McCaughey leveled similar accusations about death panels and current White House adviser Ezekiel Emanuel, who has written about end-of-life care, in the New York Post this summer. Former Alaska Gov. Sarah Palin modernized the hysteria over end-of-life care when she popularized the term death panel" in an August Facebook post.

The claims went viral in August town halls around the country, but were quickly debunked by news reports, including in the New York Times, which called the rumor "false" in a headline.

But, back in the '70s, "The New York Times did exactly what the crazies have done years later," Gaus said in an interview. Gaus, who also shared his eulogy notes with us, added that he brought up the unfortunate chapter in his boss's career in order to set the record straight. "It's chillingly parallel" to today's debate, he said.

The House Democrat's health care bill — which passed Saturday — preserved the provision to pay for end-of-life counseling, with some extra caveats emphasizing that the counseling is voluntary and not meant to "encourage the promotion of suicide or assisted suicide." The Senate Finance Committee scrapped it altogether after complaints by leading Republicans and August protests.


Weaver is a reporter for Kaiser Health News, a nonprofit news service.

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