Original Link: http://www.nytimes.com/2009/08/14/health/policy/14panel.html
By JIM RUTENBERG and JACKIE CALMES
The stubborn yet false rumor that President Obama’s health care proposals would create government-sponsored “death panels” to decide which patients were worthy of living seemed to arise from nowhere in recent weeks.
Advanced even this week by Republican stalwarts including the party’s last vice-presidential nominee, Sarah Palin, and Charles E. Grassley, the veteran Iowa senator, the nature of the assertion nonetheless seemed reminiscent of the modern-day viral Internet campaigns that dogged Mr. Obama last year, falsely calling him a Muslim and questioning his nationality.
But the rumor — which has come up at Congressional town-hall-style meetings this week in spite of an avalanche of reports laying out why it was false — was not born of anonymous e-mailers, partisan bloggers or stealthy cyberconspiracy theorists.
Rather, it has a far more mainstream provenance, openly emanating months ago from many of the same pundits and conservative media outlets that were central in defeating President Bill Clinton’s health care proposals 16 years ago, including the editorial board of The Washington Times, the American Spectator magazine and Betsy McCaughey, whose 1994 health care critique made her a star of the conservative movement (and ultimately, New York’s lieutenant governor).
There is nothing in any of the legislative proposals that would call for the creation of death panels or any other governmental body that would cut off care for the critically ill as a cost-cutting measure. But over the course of the past few months, early, stated fears from anti-abortion conservatives that Mr. Obama would pursue a pro-abortion, pro-euthanasia agenda, combined with twisted accounts of actual legislative proposals that would provide financing for optional consultations with doctors about hospice care and other “end of life” services, fed the rumor to the point where it overcame the debate.
On Thursday, Mr. Grassley said in a statement that he and others in the small group of senators that was trying to negotiate a health care plan had dropped any “end of life” proposals from consideration.
A pending House bill has language authorizing Medicare to finance beneficiaries’ consultations with professionals on whether to authorize aggressive and potentially life-saving interventions later in life. Though the consultations would be voluntary, and a similar provision passed in Congress last year without such a furor, Mr. Grassley said it was being dropped in the Senate “because of the way they could be misinterpreted and implemented incorrectly.”
The extent to which it and other provisions have been misinterpreted in recent days, notably by angry speakers at recent town hall meetings but also by Ms. Palin — who popularized the “death panel” phrase — has surprised longtime advocates of changes to the health care system.
“I guess what surprised me is the ferocity, it’s much stronger than I expected,” said John Rother, the executive vice president of AARP, which is supportive of the health care proposals and has repeatedly declared the “death panel” rumors false. “It’s people who are ideologically opposed to Mr. Obama, and this is the opportunity to weaken the president.”
The specter of government-sponsored, forced euthanasia was raised as early as Nov. 23, just weeks after the election and long before any legislation had been drafted, in an outlet with opinion pages decidedly opposed to Mr. Obama, The Washington Times.
In an editorial, the newspaper reminded its readers of the Aktion T4 program of Nazi Germany in which “children and adults with disabilities, and anyone anywhere in the Third Reich was subject to execution who was blind, deaf, senile, retarded, or had any significant neurological condition.”
Noting the “administrative predilections” of the new team at the White House, it urged “anyone who sees the current climate as a budding T4 program to win the hearts and minds of deniers.”
The editorial captured broader concerns about Mr. Obama’s abortion rights philosophy held among socially conservative Americans who did not vote for him. But it did not directly tie forced euthanasia to health care plans of Mr. Obama and his Democratic allies in Congress.
When the Democrats included money for family planning in a proposed version of the stimulus bill in January, the socially conservative George Neumayr wrote for the American Spectator: “Euthanasia is another shovel ready job for Pelosi to assign to the states. Reducing health care costs under Obama’s plan, after all, counts as economic stimulus, too — controlling life, controlling death, controlling costs.”
Ms. McCaughey, whose 1994 critique of Mr. Clinton’s plan was hotly disputed after its publication in The New Republic, weighed in around the same time.
She warned that a provision in the stimulus bill would create a bureaucracy to “monitor treatments to make sure your doctor is doing what the federal government deems appropriate and cost-effective,” was carried in a commentary she wrote for Bloomberg News that gained resonance throughout the conservative media, most notably with Rush Limbaugh and the Fox News Channel host Glenn Beck.
The legislation did not direct the coordinator to dictate doctors’ treatments. A separate part of the law — regarding a council set up to coordinate research comparing the effectiveness of treatments — states that the council’s recommendations cannot “be construed as mandates or clinical guidelines for payment, coverage or treatment.”
But Ms. McCaughey’s article provided another opportunity for others to raise the specter of forced euthanasia. “Sometimes for the common good, you just have to say, ‘Hey, Grandpa, you’ve had a good life,’ ” Mr. Beck said.
The syndicated conservative columnist Cal Thomas wrote, “No one should be surprised at the coming embrace of euthanasia.” The Washington Times editorial page reprised its reference to the Nazis, quoting the Aktion T4 program: “It must be made clear to anyone suffering from an incurable disease that the useless dissipation of costly medications drawn from the public store cannot be justified.”
The notion was picked up by various conservative groups, but still, as Mr. Obama and Congress remained focused on other matters, it did not gain wide attention. Former Senator Tom Daschle of South Dakota, an advocate for the health care proposals, said he was occasionally confronted with the “forced euthanasia” accusation at forums on the plans, but came to see it as an advantage. “Almost automatically you have most of the audience on your side,” Mr. Daschle said. “Any rational normal person isn’t going to believe that assertion.”
But as Congress developed its legislation this summer, critics seized on provisions requiring Medicare financing for “end of life” consultations, bringing the debate to a peak. To David Brock, a former conservative journalist who once impugned the Clintons but now runs a group that monitors and defends against attacks on liberals, the uproar is a reminder of what has changed — the creation of groups like his — and what has not.
“In the 90s, every misrepresentation under the sun was made about the Clinton plan and there was no real capacity to push back,” he said. “Now, there is that capacity.”
Still, one proponent of the euthanasia theory, Mr. Neumayr, said he saw no reason to stop making the claim.
“I think a government-run plan that is administered by politicians and bureaucrats who support euthanasia is inevitably going to reflect that view,” he said, “and I don’t think that’s a crazy leap.”