"End of life counseling" or "Death Panels"?

There has been a lot of talk lately about a proposed provision in the health reform legislation that is working its way through the House and Senate. The proposal is one that would enable a doctor to be paid to be a part of a family meeting about end of life situations.

This proposal has been attacked as a call for the institution of "Death Panels" wherein those paying the bills will be enabled to decide if a person is going to live or die based on purely financial considerations. Sarah Palin in particular seems to be leading this charge.

There seems to be a less strident form of this criticism that states that it is inevitable that these end of life decisions will be made by bureaucrats rather than the family as a means of controlling costs in the health care system.

What I find difficult in this line of reasoning is that the current system is already setup and predisposed to death panels. Who gets to decide what kind of treatment you get these days? Your doctor? Your family? Somewhat. Who is really generally in the drivers seat of these decisions? The insurance company, that's who.

Your insurance company is in business to provide you with the means to pay for your medical care if and when you need it. It is also in the business of making money. Having customers who need the insurance companies services is counterproductive to their goal of making money. This I think is the profound dilemma of insurance of any kind. Their two primary goals are in direct conflict.

Is it inevitable that a government run health care plan would of necesity have to deny treatment for some who are near the end of their life? I don't think it is, certainly no more so than it is inevitable that a private for profit health insurance company would have to do the same.

The argument that government should stay out of health care decisions and leave it to us and our doctors sounds good but it isn't anywhere near reality. The government and your health insurance company are already deeply involved in your health care decisions, and they will be whether health care reform is enacted or not.

In the end I would ask yourself this. "Do I want my health care to be controlled entirely by my for profit health insurer?"

My answer? A resounding HELL NO!