When former vice-presidential candidate Sarah Palin warned about the potential for “death panels” under ObamaCare that would make life and death medical decisions for patients, she was scoffed at and dismissed as off base.
Paul Krugman appeared on ABC’s “This Week with Christiane Amanpour” during a roundtable discussion about the economy and the recent conclusions from the U.S. Debt Reduction Commission.
Krugman said the death panels won’t come into play now but would down the road.
“Some years down the pike, we’re going to get the real solution, which is going to be a combination of death panels and sales taxes. It’s going to be that we’re actually going to take Medicare under control, and we’re going to have to get some additional revenue, probably from a VAT. But it’s not going to happen now,” he said.
Krugman said if the debt commission “were going to do reality therapy, they should have said, ‘OK, look, Medicare is going to have to decide what it’s going to pay for. And at least for starters, it’s going to have to decide which medical procedures are not effective at all and should not be paid for at all.'”
“In other words, it should have endorsed the panel that was part of the healthcare reform,” he added.
Krugman immediately came under fire for the comments on the Internet and he quickly posted a clarification on his blog.
“I said something deliberately provocative on ‘This Week,’ so I think I’d better clarify what I meant, which I did on the show, but it can’t hurt to say it again,” he wrote. “So, what I said is that the eventual resolution of the deficit problem both will and should rely on “death panels and sales taxes.”
“What I meant is that … health care costs will have to be controlled, which will surely require having Medicare and Medicaid decide what they’re willing to pay for — not really death panels, of course, but consideration of medical effectiveness and, at some point, how much we’re willing to spend for extreme care,” he added.
Krugman admitted death panels are “politically impossible” but said they may happen someday.
Some pro-life advocates are saying the ObamaCare bill, once implemented could put “death panels” in place now by using competitive pricing and cost analysis in a system similar to the British government-run health care system that make medical treatment decisions that have cost patients their lives.
Palin first wrote about death panels on Facebook in August 2009 and she elaborated on her first post a week later.
The provision that President Obama refers to is Section 1233 of HR 3200, entitled “Advance Care Planning Consultation.”  With all due respect, it’s misleading for the President to describe this section as an entirely voluntary provision that simply increases the information offered to Medicare recipients. The issue is the context in which that information is provided and the coercive effect these consultations will have in that context.
Section 1233 authorizes advanced care planning consultations for senior citizens on Medicare every five years, and more often “if there is a significant change in the health condition of the individual … or upon admission to a skilled nursing facility, a long-term care facility… or a hospice program.”  During those consultations, practitioners must explain “the continuum of end-of-life services and supports available, including palliative care and hospice,” and the government benefits available to pay for such services. 
Now put this in context. These consultations are authorized whenever a Medicare recipient’s health changes significantly or when they enter a nursing home, and they are part of a bill whose stated purpose is “to reduce the growth in health care spending.”  Is it any wonder that senior citizens might view such consultations as attempts to convince them to help reduce health care costs by accepting minimal end-of-life care? As Charles Lane notes in the Washington Post, Section 1233 “addresses compassionate goals in disconcerting proximity to fiscal ones…. If it’s all about obviating suffering, emotional or physical, what’s it doing in a measure to “bend the curve” on health-care costs?”
Noel Sheppard of the conservative media watchdog Newsbusters responded to Krugman’s comments.
“This may have been “deliberately provocative,” but so were Palin’s comments which he now seems to be somewhat agreeing with albeit without having the nerve to admit it,” he says.
“To cut Medicare costs in the future – an essential part of budget balancing according to Krugman – the government is going to have to decide which procedures it will cover and which it won’t. These decisions will admittedly involve a cost-benefit analysis. This means the individual’s rights are being subordinated to the government’s financial interest,” Sheppard said.
“As the government has deep budgetary problems, the cost-benefit analysis will naturally morph towards financial restraint thereby further limiting a patient’s options and therefore his or her rights,” he concluded. “If only such dangers were better explained to the public before Congress voted on this bill in March.”
Ethel Fenig also commented at the American Thinker blog about the Krugman remarks.
“They laughed when Sarah Palin said Obamacare would require death panels to control medical costs. But for some reason no one laughs when New York times columnist Paul Krugman says the same thing. Maybe because he won–inexplicably–the Nobel Prize for Economics,” she writes.