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The Many Lives Of The 'Death Panel'
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The Many Lives Of The 'Death Panel'

Policy-ish

The Many Lives Of The 'Death Panel'
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MICHELE NORRIS, host:

And as we mentioned earlier this hour, House Republicans are getting ready for a vote next week to try to repeal the new health care law. That effort is not likely to succeed in the long run, but that's not stopping the Obama administration from beefing up efforts to defend its top domestic achievement.

Among the things the administration is doing, it has dropped a reference to end of life counseling in a health rule. You may remember this as the idea that was erroneously called death panels.

To explain now, we're joined by NPR's Julie Rovner. Julie, with this issue of end of life counseling, I thought this was all taken care of. The final health bill that passed last spring did not include them.

JULIE ROVNER: That's right. Well, for starters, let's start with the fact that they're not death panels. What we're talking about are voluntary visits for Medicare patients to discuss with their doctors what they would like to happen at the end of their lives. Now, this can mean that doctors could take all measures possible to keep them alive or they can have the plug pulled or anything in between. And they can also discuss how to create the legal documents to make sure that those wishes are carried out.

Now, what was originally in the health bill called for doctors to be paid for separate visits to have these discussions. And it got controversial, as you mentioned. And they called it, you know, these death panels and it was dropped from the bill before the bill became law. And so that is not in the law.

NORRIS: Now, we heard a few weeks ago the administration put those counseling sessions back in by regulation. How were they able to do that?

ROVNER: Well, it gets a little bit confusing, so you have to bear with me. Back in 2008 there was a law, and this was when George Bush was president, so before this current debate. Congress specifically said that Medicare doctors could talk about end of life counseling as part of the Medicare physical. And that law passed with bipartisan backing.

Now, until last year's health law passed, people going into Medicare only got one free physical ever. That was when they first signed up for Medicare. The new health law changed that one-time physical to an annual event. So in writing these latest regulations for these now annual physicals, the administration mentioned the end of life counseling, the counseling that was authorized in the 2008 law.

But when the administration realized it could reignite all this controversy over the death panels, then they pulled the language. Of course that wasn't the original - the official reason. The official reason was that there was a process problem, but they realized that they were going to have a political problem too.

NORRIS: So they could essentially just write it in there.

ROVNER: That's right.

NORRIS: So, the bottom line - can doctors and patients still talk about end of life care during those annual physicals?

ROVNER: Absolutely they can. It's still in that 2008 law and it's specifically authorized.

NORRIS: Now, that's kind of defensive move for the administration and we're also hearing about more of their offensive moves. It seems the administration has brought a Google search term that they plan to use. This is very interesting. Tell us about this.

ROVNER: Yes, it's raised a lot of eyebrows. What the administration has done is they bought the term Obamacare, which is what most of the opponents called the health care law...

NORRIS: And not kindly.

ROVNER: Not kindly, that's right. It's usually combined with terms like government takeover or job killing. But now when you search the term Obamacare on Google, the first thing that comes up is a link that connects you to healthcare.gov, which is the official HHS site for the law. The administration says the idea is to give Web surfers a place to get accurate information about health care laws.

NORRIS: And they are using taxpayer funds for this?

ROVNER: Yes. I talked to administration aides and they say it's not the first time the government has spent money to direct people to federal websites by purchasing search terms. This one's costing about a dollar a click, which is not that expensive as these sorts of things go.

What's not clear, however, is whether this is the first time the government has tried to redirect people who are searching for a term used by people who don't like what it is the government's offering, or as one aide said to me, we're taking their term and we're turning it against them.

NORRIS: Thank you, Julie.

ROVNER: You're welcome, Michele.

NORRIS: That's NPR's Julie Rovner.

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