SARAH PALIN’S DEATH PANELS ALREADY EXIST

Sarah Palin was wrong when she said the provision for end of life counseling in the health care reform bills pending in Congress is a first step toward government "death panels" which will decide who gets expensive medical care and who doesn’t.

The death panels — there are two of them — already have been voted into law as part of the stimulus bill Congress passed in February.  President Obama has appointed members to them, and they have been funded to the tune of $20.6 billion.

The death panels are not, of course, called death panels.  They are the Federal Coordinating Council for Comparative Effectiveness Research (hereinafter "Federal Council"), which will set policy, and the National Coordinator for Health Information Technology (hereinafter "Coordinator"), who will enforce it.

The stimulus bill – Obama’s "American Recovery & Reinvestment Act" of $787 billion – authorizes $1.1 billion for the Federal Council and $19.5 billion for the Coordinator.

The Federal Council will perform essentially the same functions as the National Institute for Health and Clinical Excellence (NICE), which rations care in Britain‘s National Health Care system.  (Note the grotesque irony of  the British Death Panel having "nice" as its acronym.)

One member is Dr. Ezekiel Emanuel, brother of White House Chief of Staff Rahm Emanuel.  Dr. Emanuel has written that American physicians take the Hippocratic Oath (do no harm) too seriously, and that priority in health care should be given to those most useful to society, which he defined as those between the ages of 15 and 40.

"Comparative Effectiveness Research" bases approval or rejection of the treatment of patients on a formula that divides the cost per treatment by the number of years the patient is expected to live after having received the treatment. 

Language authorizing the Federal Council to set a cost effectiveness standard for treatment can be found on pages 73 and 74 of the final text version of the stimulus bill, which you can read here: http://www.readthestimulus.org.

The health care bill pending before the House would create a subordinate Center for Comparative Effectiveness Research whose purpose, according to Dr. David Janda MD, is "to slow the development of new medications and technologies in order to reduce costs." 

This provision is in Section 1181 on page 502 of the bill, which you can read here: http://edlabor.house.gov./documents/111/pdf/publications/AAHCA-BillText-071409.pdf. 

Dr. Janda, who alerted me to these provisions, is an orthopedic surgeon in Michigan who is one of the world’s leading authorities on injury prevention and health care cost containment.

Britain‘s NICE has a rule of thumb that it is inappropriate to spend more than $22,000 to extend life by six months.  Consequently, British cancer patients do not have access to drugs readily available in the United States.  Dr. Karol Sikora, formerly head of The World Health Organization’s cancer section, has estimated that 25,000 Britons die prematurely each year because of these restrictions.

The Coordinator will "guide medical decisions at the time and place of care." Doctors and hospitals that are not "meaningful users" of the new system will face penalties.  Dr. Janda says Members of Congress told him this means doctors could be fined or imprisoned if they provide more care than the guidelines call for.

The éminence grise behind the death panels seems to be former Senate Majority Leader Tom Daschle (D-SD), who was slated to be President Obama’s Secretary of Health and Human Services until his nomination was derailed by the revelation he’d failed to pay some $100,000 of taxes owed on a car and driver provided him by a private equity firm. 

Daschle has been a frequent visitor to the White House since Mr. Obama took up residence there.

In his 2008 book "Critical: What we can do about the health care crisis," Mr. Daschle proposed a health care equivalent to the Federal Reserve Board, which the Federal Council resembles.  And he offered tips on how to get his vision enacted into law.

President Clinton made two critical mistakes when he tried to revamp the health care system in 1993, Mr. Daschle wrote.  He put too many details about his plan in his bill, and allowed the public too much time to find out what was in it.  And he followed regular procedure, which required 60 votes for approval in the Senate.

Mr. Daschle recommended President Obama be vague about what he wants to do, to put key provisions in budget bills, and to rush the measure through during his "honeymoon" period. 

This may be why the president is saying the time for debate on health care reform is over.  The debate was over when the death panels were snuck into the stimulus bill and passed into law in the dark of a February night.

Jack Kelly is a former Marine and Green Beret and a former deputy assistant secretary of the Air Force in the Reagan administration. He is national security writer for the Pittsburgh Post-Gazette.