How a GOP senator's proposal gave rise to 'death panels'

McClatchy NewspapersAugust 12, 2009 

WASHINGTON — When U.S. Sen. Johnny Isakson, R-Ga., takes the floor at a meeting at Vineville United Methodist Church in Macon on Thursday, he's expected to face tough questions about why President Barack Obama credits him as the inspiration behind the Democrats' push for end-of-life counseling efforts that former Alaska Gov. Sarah Palin and some fellow conservatives call "death panels."

Both the president and Palin have it all wrong, Isakson said, seeking to distance himself from potentially inflammatory associations in this season of hot-tempered town hall scuffles. Just this week, staffers of Georgia Rep. David Scott, a moderate "Blue Dog" Democrat, found a swastika painted outside his Smyrna district office after one heated town hall meeting.

A remark by the president Tuesday cast Isakson, a conservative lawmaker from a red state, as an unwitting and unwilling poster child for the administration's plea for bipartisanship in writing health care legislation.

At a town hall meeting in Portsmouth, N.H., Obama sought to respond to what he called "misinformation" from critics of his health care efforts, particularly a provision that would allow patients to receive counseling on living wills and end-of-life care.

Palin charged last week that the provision would create "Obama's 'death panel,' " where "his bureaucrats can decide, based on a subjective judgment of their 'level of productivity in society,' whether they are worthy of health care."

"The irony is that actually one of the chief sponsors of this bill originally was a Republican — then House member, now senator, named Johnny Isakson, from Georgia — who very sensibly thought this is something that would expand people's options," Obama told the Portsmouth crowd.

Not so fast, Isakson said.

"This is what happens when the president and members of Congress don't read the bills," Isakson said in a statement issued Tuesday. "The White House and others are merely attempting to deflect attention from the intense negativity caused by their unpopular policies."

In giving the White House a wide berth, however, Isakson, who's long advocated end-of-life counseling and assistance in drafting living wills, points to a nuanced difference between his amendment and a similar House of Representatives version.

In 2007, Isakson helped spearhead a failed attempt to provide Medicare coverage for end-of-life planning consultations as part of physical examinations. In July, during Senate Health, Education, Labor and Pensions Committee hearings on the Senate version of the health care bill, Isakson added an amendment that says that anyone who participates in the long-term care benefit provided in the bill may use that benefit to obtain assistance in formulating his or her own living will and durable power of attorney.

Isakson says he vehemently opposes the House and Senate health care bills and played no role in drafting similar language that Democrats added to the House bill.

"My Senate amendment simply puts health care choices back in the hands of the individual and allows them to consider, if they so choose, a living will or durable power of attorney," Isakson said. "The House provision is merely another ill-advised attempt at more government mandates, more government intrusion and more government involvement in what should be an individual choice."

Both the House and Senate versions of the bills address the topic of advance directives, legal documents that allow people to convey their decisions about end-of-life care ahead of time. The Senate version focuses on allowing patients to decide whether to seek advice on advance directives, when to seek it and with whom.

Isakson argues that the House version expands an existing Medicare program by providing a financial incentive to doctors to give end-of-life counseling to Medicare patients every five years and requires a mandatory list of topics to discuss with patients.

Isakson and the White House diverge on this interpretation.

White House Press Secretary Robert Gibbs argued Wednesday that the differences between Isakson's and the president's positions on end-of-life counseling as part of health care are minute at best.

"He's offered and co-sponsored other amendments with Senator Rockefeller in dealing with this," Gibbs said Wednesday. Sen. Jay Rockefeller is a Democrat from West Virginia. "I think, whether this is uncomfortable or not, I think he and the president agree."

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