Berwick, Unshackled, Blasts “Death Panels”
Freed from the shackles of his Washington job, last week former CMS Administrator Don Berwick described for an audience of health policy wonks Washington’s cynicism, epitomized by the “hogwash” claim that health reform included “death panels.”
“The outrageous rhetoric about death panels — the claim, nonsense, fabricated out of nothing but fear and lies, that some plot is afoot to, literally, kill patients under the guise of end-of-life care. That is hogwash,” Berwick said Wednesday to his old think tank, the Institute for Health Improvement’s annual conference in Orlando. He went on to say that the death panel rhetoric “is purveyed by cynics; it employs deception; and it destroys hope. It is beyond cruelty to have subjected our elders, especially, to groundless fear in the pure service of political agendas…It is one of the great and needless tragedies of this stormy time in health care that the ‘death panel’ rhetoric has denied patients the care that they want, denied caregivers the information they need to give that care, and denied our nation access to a mature, open, informed, and balanced discussion of the challenge of advanced illness and the commitment to individual dignity. It is a travesty.”
It was a stunning departure in tone for Berwick, who was unfailingly polite throughout his 16-month tenure at CMS. And I couldn’t agree more. End-of-life care is a personal crusade of mine and my mother, Dr. Susan Black, a prominent family physician and palliative care advocate.
You’ll recall the ridiculous notion of death panels erupted when former Alaska Governor and GOP vice presidential candidate Sarah Palin said the health care law would mean seniors would have to stand in front of a panel of Federal regulators to find out if they were worthy of health care. It was beyond preposterous, but it stuck — and arguably set the debate on end-of-life care back a decade. The issue dogged the administration long after the ACA was passed: in January, the administration yanked language on end-of-life planning for seniors from a Medicare regulation on annual physicals.
As I’ve said here before, since the Terri Schiavo circus we have lived in an age of distortions like “Death Panels,” where open dialogue on end of life is politicized and limits on what Medicare will cover are demogogued as rationing. The only way out of Medicare’s fiscal mess is a mature discussion about how we’re going to address the 1 in 4 dollars Medicare spends today in the last 6 months of life. Let’s hope the 2012 elections will bring us a fresh crop of “grownups” to have that dialogue.