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The lead section of this page seems to mis-represent both the origin of the term "Death panel", and the description provided in its main source, Nangia and Wilson's Foreign Policy article. Most of the problematic content appears to have been added by an editor or editors at IP 209.6.238.201, possibly in violation of WP:SOAP. I will call on the other editors, as well as the IP editor, to revisit this issue and either come to a consensus on the proper content of this issue, or propose it for deletion. Cnilep ( talk) 16:02, 13 September 2009 (UTC)

Can you explain how my gloss differs from the source? -- 209.6.238.201 ( talk) 16:15, 13 September 2009 (UTC)

For example, your version read, "A death panel is a state-sponsored group established to determine whether the elderly and infirm deserve life-saving medical treatment." Yet Nangia and Wilson describe the term as, "vice-presidential nominee Sarah Palin's assertion that the Obama administration plans to implement state-sponsored 'death panels' to determine whether the elderly and infirm deserve life-saving medical treatment," and describe the assertion as "outlandish". They do not claim that such panels existed under this description prior to Palin, Cindy McCaughey, and other opponents of the US law. In short, you suggest that such panels exist; Nangia and Wilson merely suggest that the term features in political rhetoric. Cnilep ( talk) 16:24, 13 September 2009 (UTC)

The title of the article is "Real Life Death Panels" but your contention is they don't claim such panels exist? Did you read all four pages of the article? If you are saying a better title would be List of panels making life or death decisions my only complaint would be that's too verbose, and Death panel would either have to be a disambig or redirect here anyway. -- 209.6.238.201 ( talk) 16:29, 13 September 2009 (UTC)

Yes, I read the article, including the description of assisted suicide, capital punishment, etc. Importantly, though, the article states, "Foreign Policy took a close look around the world, in places where something akin to death panels is alive and well" (emphasis added). That is, these are government programs that the term "death panels" might call to mind, not programs that are called death panels as such.

Note from the description of assisted suicide, "Countries like the Netherlands and Switzerland do not have 'death panels' to determine eligibility." From the section on extraordinary treatment, "Though nothing at all like the living-will counseling erroneously portrayed in the United States, the British National Health Service (NHS) does have a panel appeal process that is sometimes accused of giving people an 'early death sentence.'" (The program is given a subjective "Death panel factor" of 15 out of 100.) Capital punishment is administered by "literal death panels", and of course this is not what the term evokes in the US during the current debate. Cnilep ( talk) 16:57, 13 September 2009 (UTC)

The project encourages a {{ worldwide}} POV in articles, not merely a view specific to one region or debate. I did give Sarah Palin's view the second paragraph though. -- 209.6.238.201 ( talk) 17:10, 13 September 2009 (UTC)

(edit conflict)Perhaps this lead would be better:

A death panel is any group of persons which makes decisions on whether or not to kill a civilian. In medicine, death panels have been theoretically defined as a state-sponsored group established to determine whether the elderly and infirm deserve life-saving medical treatment. As an extension of government power, a variety of panels worldwide regularly make decisions regarding executions.

I don't think I'd strictly need a ref for the first sentence as it's basically a tautology. What do you think? -- 209.6.238.201 ( talk) 17:07, 13 September 2009 (UTC)

The whole article as written up recently has no merit. It was clearly intended to justify the death panel argument by implying that there are places where such panels exist. I read the four pages and they do not come close to making peoples decisions for them, though the closest was probably the Texas example. And there is no indication that Palin was taliking about Texas. In similar situations in the UK (and of course they do exist in almost every country), when a hospital wanting to terminate life support against the wishes of the family or the known view of the patient, the court of protection appoints an attorney to represent the interests of the patient. The attorney, the relatives and the hospital trust then go to court seeking a judicial review of the case. The judge's decision, which has to based on law, including the Human Rights Act, is usually final, though in theory it too can be appealed all the way to the European Court of Human Rights. The NHS certainly has no powers to end a life willy-nilly. The only example that came close to the health care system setting up a "death panel" to decide who shall live and who shall die in the cause of saving money is the Texas example, but this panel is not known as a "death panel" but rather an "ethics or medical committee" so it is disingenuous of the editor to claim that it is the same thing as a "death panel" as . Neither is NICE a "death panel". It just says what costs the public system will meet and which it will not and the appropriate circumstances. It does not prevent a person from getting treatment but just sets a coverage rule. One can get out-of-system care in in England if you can fund the care personally or carry additional insurance because there are providers outside the public system. It NEVER considers individual cases, just the research data about success rates in various circumstances.-- Hauskalainen ( talk) 17:41, 13 September 2009 (UTC)

There are some articles, like this and this, that discuss the phrase "death panel" in terms of private insurace companies' practices. -- Evb-wiki ( talk) 17:46, 13 September 2009 (UTC)

The panels in Texas regularly decide to stop treating sick patients against their will. I'm just going by the source material which groups these various death panels together. I'll have to take a look at those sources, Evb, thanks -- 209.6.238.201 ( talk) 18:11, 13 September 2009 (UTC)

Wikipedia can legitimately cover such topics as physician-assisted suicide, euthanasia, living wills, Bush's "futile care" law that permitted the death of Sun Hudson, capital punishment, procedures for the evaluation of the effectiveness of new drugs, etc.

None of these topics, however, involves a "death panel". That phrase was coined by Palin to refer to an alleged (but actually nonexistent) provision in the health-insurance reform bill that would allow government bureaucrats to deny care to people deemed unworthy of it.

209.6.238.201 writes: "The project encourages a {{worldwide}} POV in articles, not merely a view specific to one region or debate. I did give Sarah Palin's view the second paragraph though." This has it precisely backwards. The term "death panel" is exclusive to U.S. political discourse, and this article is attempting to use the term as a coatrack for a whole bunch of worldwide practices that have nothing to do with the outlandish "death panel" allegation by Palin and her ilk.

The extraneous material should be eliminated. When it's eliminated, there's probably not enough left to justify a full article, so the redirect to the relevant section of America's Affordable Health Choices Act of 2009 should be restored. The only reasonable alternative would be a short article that concerned solely Palin's statement and the controversy about it. JamesMLane  t  c 17:48, 13 September 2009 (UTC)

Addendum: While I was writing the foregoing, Hauskalainen was making that very change. Obviously, I approve of Hauskalainen's edit. JamesMLane  t  c 17:53, 13 September 2009 (UTC)

It seems clear to me that a death panel is any group given the power of live and death over an individual. That is how it the term is used in the Foreign Policy magazine, and that definition would encompass a worldwide viewpoint as well. -- 209.6.238.201 ( talk) 18:31, 13 September 2009 (UTC)

This whole article is a big PoV fork. I restored the redirect which was very appropriate. Simonm223 ( talk) 18:34, 13 September 2009 (UTC)

What point of view do you think is being expressed here? -- 209.6.238.201 ( talk) 18:37, 13 September 2009 (UTC)

The correct redirect should be Political_positions_of_Sarah_Palin#Health_care, since apparently Palin coined the term and the term is explained and debunked there. Directing the link to America's Affordable Health Choices Act of 2009 suggests Palin's characterization has merit. -- Evb-wiki ( talk) 21:44, 13 September 2009 (UTC)

I am unconcerned which of the two pages "death panel" redirects to. Satisfied as long as it redirects to appropriate, neutral, material rather than being a PoV fork. Simonm223 ( talk) 22:04, 13 September 2009 (UTC)

It appears to me that the term "death panel" in the sense of "a panel of people who make decisions related to the death of other people" did not exist prior to the current political debate in the US. So far, the only uses of the phrase that I can find prior to 2009 have the sense of "a panel in a diptych depicting Life and Death". Of course, searching is complicated by the fact that the current usage is so prominent and widely repeated. There may be older uses that I haven't found yet. Cnilep ( talk) 17:52, 13 September 2009 (UTC)

If there's no objection, and since I've been the only constructive contributor, I'll move the content to List of panels making life or death decisions. I've never seen so many editors violate WP:PRESERVE with such eagerness before. Some of us are just trying to write an encyclopedia. -- 209.6.238.201 ( talk) 18:41, 13 September 2009 (UTC)

For anyone interested, I have raised the abuse of this article by the anonymous (IP) user at the NPOV noticeboard.-- Hauskalainen ( talk) 20:47, 13 September 2009 (UTC)

It'd be helpful to provide a link: Wikipedia:Neutral_point_of_view/Noticeboard#Death_panel. -- Evb-wiki ( talk) 21:59, 13 September 2009 (UTC)

[copied from above]The correct redirect should be Political_positions_of_Sarah_Palin#Health_care, since apparently Palin coined the term and the term is explained and debunked there. Directing the link to America's Affordable Health Choices Act of 2009 suggests Palin's characterization has merit. -- Evb-wiki ( talk) 21:44, 13 September 2009 (UTC)

The discussion at the NPOV noticeboard (see above) suggests consensus may favor changing the redirect. -- Evb-wiki ( talk) 22:04, 13 September 2009 (UTC)

I do not agree. The redirect to the article about the bill is more likely to serve the needs of a reader who types in the phrase "Death panel". JamesMLane  t  c 02:24, 14 September 2009 (UTC)

The fact is the concept of a "death panel" is a political position held by Palin. It is not an element of the Affordable Health Choices Act of 2009. IMO, to indulge such misrepresentation is unencyclopedic. -- Evb-wiki ( talk) 02:31, 14 September 2009 (UTC)

A reader who follows the link to the article about the bill will find that (1) the term "death panel" is part of Palin's criticism of that particular provision in the bill, and (2) her criticism is misleading because that provision is actually about something completely different. I don't see how either of those points is a misrepresentation. JamesMLane  t  c 03:05, 14 September 2009 (UTC)

Another option would be to redirect this page to Health_care_reform_debate_in_the_United_States#Arguments_regarding_rationing_of_care. -- Evb-wiki ( talk) 19:43, 17 September 2009 (UTC)

Edit war at redirect target

Redirecting to Political_positions_of_Sarah_Palin#Health_care, whatever its long-term merits might be, doesn't work right now. That section is the subject of an edit war. Information about the truth of Palin's "death panels" charge is routinely expunged from the article, with some editors insisting that the article must contain nothing that disagrees with Sarah Palin's views in any way. Another editor is fighting to add extensive information about Dr. Ezekiel Emanuel (Rahm Emanuel's brother).

When and if things stabilize there we can revisit the issue. In the meantime, I'm changing the redirect back to where Hauskalainen had it on September 13: America's Affordable Health Choices Act of 2009#Reimbursement for counseling about living wills. The necessary content is there and is apparently more stable at the moment. JamesMLane  t  c 17:10, 23 September 2009 (UTC)

Since there is no actual "death panel" provision in America's Affordable Health Choices Act of 2009, I think Health care reform debate in the United States#Arguments regarding rationing of care is the more appropriate redirect. I previously suggested this above. -- Evb-wiki ( talk) 17:23, 23 September 2009 (UTC)

Redirecting back to Palin article until something resembling consensus comes about here. Simonm223 ( talk) 17:43, 23 September 2009 (UTC)

I almost understand what you say about consensus. Anyone that clicks on a link does so for one reason - to learn more. Editors at the Political positions of Sarah Palin page strongly prefer the less is more approach. They have their reasons, but there is extreme tension between what they desire, and what anyone who wants to learn more would want. It's impossible to poll people who click on links, but it's possible to get a very good guess as to their consensus, which is to learn. Jimmuldrow ( talk) 17:33, 29 September 2009 (UTC)

I don't think consensus supports anything other than it should redirect... somewhere. However a plurality of editors seem to prefer the Palin redirect to the other options. I am keeping it at the Palin redirect until such time as there is a clear consensus that this is not appropriate. If that is the case I will support keeping the redirect at whichever article consensus prefers. Simonm223 ( talk) 17:52, 29 September 2009 (UTC)

To be more specific, I prefer America's Affordable Health Choices Act of 2009#Reimbursement for counseling about living wills unless another is more in line with WP:PRESERVE. The best redirect would provide the most information. Jimmuldrow ( talk) 18:02, 29 September 2009 (UTC)

The political positions thing will quite likely get truncated, which will make it less useful for this specific purpose than before. Jimmuldrow ( talk) 18:06, 29 September 2009 (UTC)

Precisely how much detail is needed for Palin's fanciful claims anyway? Simonm223 ( talk) 18:12, 29 September 2009 (UTC)

Since there is no actual "death panel" provision in the Bill, and others besides Palin have taken up the misnomer flag in that regard, I believe Health care reform debate in the United States#Arguments regarding rationing of care is the appropriate redirect. After all, "death panels" are merely part of the debate and have no basis in any objective analysis of the Bill. Granted, the section there could be fleshed out more, which would actually be better than adding more debate stuff to the Bill's article. For the record, I was one of those people who previously urged this to be redirected to Palin's political positions' article. -- Evb-wiki ( talk) 19:12, 29 September 2009 (UTC)

There's nothing wrong with the Health care reform debate in the United States#Arguments regarding rationing of care redirect. I would go along with that approach. The only need for information, imo, is to clear up some misinformation. Jimmuldrow ( talk) 19:38, 29 September 2009 (UTC)

If Evb-wiki and I both support Health care reform debate in the United States#Arguments regarding rationing of care, would that be close enough to consensus? The current redirect makes it sound as though there is no evidence against death panels, which is not quite true. I think more detail is needed than that Palin says that death panels exist. Jimmuldrow ( talk) 12:13, 30 September 2009 (UTC)

To clarify, I and Evb-wiki both changed our minds about the redirect. Jimmuldrow ( talk) 14:51, 30 September 2009 (UTC)

I have to agree with the Principle of least astonishment when it comes to redirects and User:Jimmuldrow in that "the best redirect would provide the most information". I support redirecting Death panel as it currently stands to Health care reform debate in the United States#Rationing of care. It should not redirect to Political positions of Sarah Palin, even if she first put "death" in front of "panel", simply because she appears have gotten these ideas from someone else and also because others soon picked up on the new term; soon everyone has a political position on the rationing of health care. Should we scatter them amongst all the politicians' pages or gather them at the Health care debate article? Come to think of it, shouldn't the positions of Palin article somehow link to this subsection? Ruodyssey ( talk) 07:09, 8 January 2010 (UTC)

Since the result of the above discussion appears to be unclear, and the target continues to be changed back and forth, possibly due to at least two editors (me being one) starting at opposite opinions the changing to support a third option, I propose taking a poll.-- Evb-wiki ( talk) 17:51, 24 January 2010 (UTC)

• I support redirecting to Health care reform debate in the United States#Rationing of care. -- Evb-wiki ( talk) 17:51, 24 January 2010 (UTC)

That would seem to be a particularly POV redirect, akin to redirecting "biased reporting" to Fox News. The whole notion of a "death panel" is opinion, not fact. We should direct it towards the source(s) of that opinion, not reinforce the opinion by redirecting towards its target. -- Loonymonkey ( talk) 04:19, 26 January 2010 (UTC)

• I still think that it should link back to Palin's opinion. She's the source for that nonsense anyway. Simonm223 ( talk) 19:55, 24 January 2010 (UTC)
• The article should link to the article on the political opinions of Palin and in particular to the section labelled "death panels", i.e. here Political_positions_of_Sarah_Palin#Death_panels This has all the relevent information about this particular piece of news fluff. The fuss was about the bill paying for end of life care which has absolutely nothing at all to do with health care rationing and all to do with enabling people to make sensible decisions about their wishes for care at the end of life. To point this to the place Evb-wiki is indicating would be an attempt to milk more propaganda value and disinformation and should be strongly resisted. If this option gets voted for in this discussion I will insist that this is referred again to the WP:POV noticeboard.-- Hauskalainen ( talk) 21:16, 24 January 2010 (UTC)

• Wow. We don't have issues, do we? -- Evb-wiki ( talk) 04:48, 25 January 2010 (UTC)

If the redirect is such a persistent problem, maybe we should go back to having a standalone article, but without all the extraneous stuff (like physician-assisted suicide) that was in at least one earlier version. JamesMLane  t  c 20:39, 25 January 2010 (UTC)

That would be a very bad idea. WP:NAD, WP:NEO for an applicable policy and an evn more applicable guideline. Simonm223 ( talk) 16:04, 26 January 2010 (UTC)

This whole article is such a crock of shit, and its existence is a almost a violation of NPOV.

If and when true universal health care is adopted in the US, it is simply a FACT that care will have to be rationed. It is rationed already--but by jerks in the insurance industry. If and when the federal government takes over health care, then they will have to be the ones doing the rationing. What do I mean by "rationing"?

Like it or not, there are just so many dollars to go around. Not everyone can have everything they want--that's the singular truth behind economics--both right and left wing versions. So sometimes, someone who has a terminal illness gets denied treatment because it's judged not to be a good use of money to spend $500,000 adding another month onto some old geezer's life. And there's nothign wrong with that! Palin condemned it, others condemned her for naming it, but the FACT is that it happens now, and it'll happen later, no matter who runs health care.

An objective media would have recognized the truth behind this and condemned Palin for her economic ignorance. But instead, because she accidentally revealed a nasty truth that the pols (especially on the left) want to keep hidden, they condemned her for "lying". But she only showed her stupidity--she did not "lie". 98.82.190.226 ( talk) 06:55, 5 December 2010 (UTC)

Yawn. Derekbd ( talk) 22:15, 5 December 2010 (UTC)

98.82.190.226, " Article talk pages should not be used by editors as platforms for their personal views on a subject". For what it is worth Uwe Reinhardt in his July 2009 blog posting " 'Rationing' Health Care: What Does It Mean?" said "As I read it, the main thrust of the health care reforms espoused by President Obama and his allies in Congress is first of all to reduce rationing on the basis of price and ability to pay in our health system". Perhaps this perspective should be included in the rationing and defense of claim section. Also, we reflect what media says in order to remain neutral. If you have an axe to grind with the media then take that up with them. =) Thanks. Jesanj ( talk) 23:38, 5 December 2010 (UTC)

I've added the {{ Unbalanced}} template to the page for now - the POV presented from the given sources is almost entirely from proponents of the health care reform legislation, with little space given to statements made by Palin herself and other opponents of the initiative. Right now the article (and especially the lede) reads like an attempt to discredit Palin's position rather than a neutral presentation of the origins and use of the term, as well as reactions to it from notable sources of various ideological persuasions.

In the process of gathering sources now, but one issue I can open with is that the article and criticism focuses almost entirely on the end-of-life counseling provisions that were removed from the legislation following this controversy, rather than the health care rationing concerns that Palin consistently has said were her motivation for coining the metaphor. Examples:

Palin's original FB note, 7 Aug 2009:

The Democrats promise that a government health care system will reduce the cost of health care, but as the economist Thomas Sowell has pointed out, government health care will not reduce the cost; it will simply refuse to pay the cost. And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care. Such a system is downright evil.

Clarification to her original post, 14 Aug 2009.

President Obama can try to gloss over the effects of government authorized end-of-life consultations, but the views of one of his top health care advisors are clear enough. It’s all just more evidence that the Democratic legislative proposals will lead to health care rationing, and more evidence that the top-down plans of government bureaucrats will never result in real health care reform.

Written Testimony Submitted to the New York State Senate Aging Committee - 8 Sep 2009

It is unclear whether section 1233 or a provision like it will remain part of any final health care bill. Regardless of its fate, the larger issue of rationed health care remains.

Hong Kong speech - 23 Sep 2009

I seem to have acquired notoriety in national debate. And all because of two words: death panels. And it is a serious term. It was intended to sound a warning about the rationing that is sure to follow if big government tries to simultaneously increase health care coverage while also claiming to decrease costs.

Comments on passage of the bill - 22 Dec 2009

Though Nancy Pelosi and friends have tried to call “death panels” the “lie of the year,” this type of rationing – what the CBO calls “reduc[ed] access to care” and “diminish[ed] quality of care” – is precisely what I meant when I used that metaphor.

Take back the 20 - 24 Sep 2010

And remember when the Obama administration said they would not be “rationing care” in the future? That ol’ “death panels” thing I wrote about last year? That was before Obamacare was passed. Once it passed, they admitted there was going to be rationing after all.

Election Day post - 1 Nov 2010

Every day we hear about doctors leaving the Medicare system; increased premiums with talk of price controls; rationing becoming standard practice; and panels of faceless bureaucrats deciding which categories of treatment are worthy of funding based on efficiency calculations (which I called a “death panel”).

That's probably enough of a wall of text regarding this point. :) Kelly ^hi! 03:23, 15 December 2010 (UTC)

There's a huge difference between trying to get people to believe that the bill includes death panels (the lie that Palin originally vended) and arguing that sometime in the future there's going to be rationing. There's also the point that rationing goes on NOW, at the decision of the big for-profit insurance companies rather than with any public accountability.

Coming down to specifics, it's extremely dubious under Wikipedia practice for you to put such a tag on when you've proposed no specific change in the article. I'll leave it up temporarily so as not to get in a silly edit war about that, but this can't go on very long.

As to the edits you've already made, they display a clear POV. For example, you want us to assert in the introductory section that "death panels" was a metaphor. It wasn't presented that way originally. Palin may now be trying to spin it that way to cover up her blatant disregard of the facts, and we can quote any post hoc explanation by her to that effect, but that's because we report facts about opinions. We do not state such opinions as facts.

I don't have time now to examine the rest, such as the point you make above about the Isakson quotation, so I'll have to return to this later.

In general, there's no reason not to add opinions from opponents of the health care legislation, provided that they're about the specific subject of the supposed "death panels" (not about the evils of the bill in general) and provided that opinions are reported and attributed, not adopted. JamesMLane  t  c 01:08, 16 December 2010 (UTC)

Addressing the point of the term being a metaphor for rationing, since the term is attributed to Palin in the lead sentence, then presumably the definition is what she claims it to be and belongs there as well. If others have assigned a different definition to the term, then those other definition(s) should be attributed and cited. To my knowledge, Palin has used the term strictly in the context of government-dictated rationing - if others have used it in the term in the context of private-sector rationing, I certainly don't have any objection to examples being included so long as they meet Wikipedia guidelines. Kelly ^hi! 01:25, 16 December 2010 (UTC)

That Palin uses a term doesn't mean that she gets to decide what it means. Example: I call Palin a "pension pickpocket", a term I invented. When I'm queried about it, my authorized spokesperson explains that it refers to Palin's theft of public employee pensions while she was Governor. Palin sues me for defamation. I then claim that it was merely a metaphor for the way her short-sighted policies were robbing Alaskans of their future. What result? Palin wins. The statement was defamatory regardless of how I later try to spin it.

I don't object to including Palin's subsequent spin, properly attributed. It's included in my edit. You reshuffled the material to put it out of chronological order, giving high prominence to Palin's spin and conveying the impression that her use of the term "metaphor" was contemporaneous with her use of the term "death panel" rather than coming some months later. I've reverted to my version, which reports the criticism (attributed) and then Palin's response.

I put the word "metaphor" in quotation marks to indicate that it's a direct quotation from Palin. I didn't intend it as an instance of scare quotes. My guess is that the average reader wouldn't read it that way -- especially given that, contrary to the most common Wikipedia practice, you've given the full Palin quotation in the footnote, instead of merely linking -- but if this explanation doesn't satisfy you, go ahead and remove the quotation marks. JamesMLane  t  c 14:18, 16 December 2010 (UTC)

Actually, Palin did make an extensive contemporaneous explanation explaining that her concern in making the original statement was health care rationing, making extensive citations to her sources (though granted, she didn't use the word "metaphor"). To my knowledge, she's never given the definition that appears to be attributed to her in the lead sentence. If someone has given that definition, it needs to be attributed and cited. With respect - Kelly ^hi! 14:50, 16 December 2010 (UTC)

<--Redent. Wow, this discussion is already 1,400 words long. I didn't see any huge issues with balance when I read the article, and I haven't had time to read the discussion above thoroughly yet. But I tend to think some of the issues can be resolved by a simple clean up and then by reference to WP policies on balance, NPOV, undue weight, etc. But in the meantime, I would like to ask Kelly if she could summarize the main issues she is raising, just for the sake of conciseness, please. Thank you.- KeptSouth ( talk) 12:32, 17 December 2010 (UTC)

I took a couple [1] [2] suggestions of yours Kelly. I'm hesitant to quote much from Facebook though, as it is self-published. Here is something Palin said on FB titled "Obama Is Being Misleading About 'Death Panels'" that was published on an NPR blog:

It appears clear to me that Palin blends rationing with end of life consultations in this quote. So, perhaps Palin has consistently focused on rationing, but not because she has never addressed the end of life consultations. Are there any remaining concerns about balance? Perhaps it would be OK to take down the tag. Jesanj ( talk) 13:52, 17 December 2010 (UTC)

It's OK to quote Facebook if you're only using that as a source to represent Palin's views and statements, per WP:ABOUTSELF. I don't have any objection to taking off the "unbalanced" tag. I'll do some further work on the article this weekend if I get time. Kelly ^hi! 16:49, 17 December 2010 (UTC)

I agree with Jesanj that Palin interpreted end of life consultations as being death panels, but I think there is a potential for abuse in such consultations, so Palin was not totally incorrect to confabulate the two. Since the lead is just a summary of the important points usually limited to 3 or 4 paragraphs, I don't think we have to draw all the distinction in the lead, but this could be pointed out a little better in the body of the article, using RSs of course.

I agree with most of the condensing of the lead that Jesanj did, and I followed up with a bit more. I do think the current version is now more balanced and fair to Palin especially since some repetition has been eliminated such as describing the liar of the year designation and then saying she was criticized.

As far as the quote from the oncologist goes, I think it is ok, but I believe it should follow the quote from the linguistic experts, as they are probably more authoritative and in a better position to define the current usage of the term. I also think Facebook should be mentioned in the lead, because it is notable, but my feelings aren't strong on this, and I would not object to the Facebook reference being removed from the lead.

I strongly disagree that the balance tag should come off --more work is need to be done on the body of the article, imho. -Regards- KeptSouth ( talk) 17:30, 17 December 2010 (UTC)

It appears that the term "death panel" has been used in the past, though not in a widespread fashion, to refer to a panel of judges authorized specifically to issue or review a judicial death sentence. Example. In light of this, I'm wondering if the opening sentence should changed from "Death panel is a phrase coined by...Sarah Palin" to "Death panel is a phrase popularized by...Sarah Palin". Kelly ^hi! 00:40, 17 December 2010 (UTC)

It is a phrase co-opted by Palin, since she didn't popularize the existing usage. 184.144.165.37 ( talk) 04:01, 17 December 2010 (UTC)

The other uses of the phrase are, as far as I can tell, nonnotable. They wouldn't merit the prominence of being included in the introductory section (maybe a passing mention somewhere in the body). You can read about some other non-Palin "death panels" at this old version of the article; the consensus was that all that stuff wasn't relevant to this article. JamesMLane  t  c 04:58, 17 December 2010 (UTC)

Ah, thanks! Yeah, I agree on notability. I need to to look at the sources currently being used for this article to see if any of them say Palin "coined" the term. Kelly ^hi! 05:01, 17 December 2010 (UTC)

Under the section Coining the first sentence is "On August 7, Palin coined the term on her Facebook page..." and there are NYT and NEJM sources for the word. Jesanj ( talk) 12:45, 17 December 2010 (UTC)

Kelly and others have raised some interesting questions about balance in this article, but I find that it's sometimes best to clean up the article first, before getting into the heavier and most disputable issues of POV, balance, etc. Some issues that can later turn into disputes can be taken care peremptorily by, for example, simple fact checking and verifying the existing references, removing or summarizing repetitious material. So, I am going to do some housekeeping, (boldly), but note it all here. I have placed the clean up tag on the article, while clean up is in progress, to alert readers and editors that clean up issues exist and to the discussion on this page.- KeptSouth ( talk) 12:21, 17 December 2010 (UTC)

Well, I wound up making so many edits that I can't possibly note them all here, as I said I would, but I did provide detailed edit summaries and I will do my best to describe the edits generally and will add a few diffs here. So far, I have major-edited the article up to the section titled "Sarah Palin". Basically I don't think I removed any references - or possibly I removed one - and what I did was read sources, then summarize or re-summarize the main points based on my reading and the previous text. There are a couple of short but total rewrites because I felt the main points-- the points that the authors were making about the health care law and death panels - had been missed. I will hunt for these now and post diffs here in a little while. -Regards- KeptSouth ( talk) 13:19, 18 December 2010 (UTC)

• In this edit I removed a quote from 1975 by someone - I don't see how it applies to the death panel term minted in 2009 - did they even have an insurance crisis back then?
• As I went through the article I found a couple of phrases I thought were repetitious or that added little or nothing, and I commented them out rather than removing them for now. [4] and [5]
• I re-wrote the discussion of what Dr. Corn said here, because based on my reading of the article, it seems to me that these are his major themes that relate to this article. It's probably easier to see if I put the change in column form

Well, I think those are all the main changes. I have spent the time and wall space discussing this for the sake of transparency, because I know this is a controversial article. I think there is more clean up work to be done, but this is the bulk of it. -Regards- KeptSouth ( talk) 14:23, 18 December 2010 (UTC)

Date formatting

Why is the international format, day before month being used? This is a US subject. Although normally the consistent format shouldn't be changed, this is the exceeption to the rule. Per MOS, WP:STRONGNAT, so I have changed the dating. KeptSouth ( talk) 12:21, 17 December 2010 (UTC)

I used it because I didn't know any better. Thanks for changing it. Jesanj ( talk) 12:48, 17 December 2010 (UTC)

Sure, no big deal. KeptSouth ( talk) 13:12, 18 December 2010 (UTC)

Archiving

It is beginning to seem that this talk page will be getting lengthy. So I will be setting up an auto-archive for old posts every 30 days. Of course, it can always be adjusted it to a longer time frame if necessary. KeptSouth ( talk) 12:25, 17 December 2010 (UTC)

The JAMA piece states

Currently the article reads "Psychiatrist Paul Kettl noted that the attention-catching phrase death panels became a lightening rod for several objections to the health care bill". I think this cuts Kettl's sentence short so as to remove its full meaning. I formerly summarized Kettl with this: "Paul Kettl, MD, MHA, writes that it was 'a phrase that caught attention and served as a lightning rod for objections to a series of ideas about health care besides' end of life discussions." But, the bolded text above appears to be the best representation of how Kettl thought the term was being used. I plan on making some edits on this. Jesanj ( talk) 14:49, 21 December 2010 (UTC)

It seems there is a minor dispute about the relevance of this quote that presently appears in the article.

Annas writes that " Ivan Illich seems to have gotten it right in his 1975 Medical Nemesis: 'Socially approved death happens when man [sic] becomes useless not only as a producer but as a consumer. It is at this point that [the patient] ... must be written off as a total loss. Death has become the ultimate form of consumer resistance'

I think it is obviously irrelvant, and removed it with an explanatory edit summary earlier, [6] but my action was reverted [7] with a discussion on my talk page that was not responded to, so I am stating my reasons for removing the quote again here in more detail. The passage was written in 1975, and is apparently quoted with approval in an introduction to a text written in 2010 by a bioethicist who does not even discuss the meaning of the quote. I do not think it is relevant at all or helpful to the average reader who wants to know what the 2009-10 death panel controversy has been about. I think the quote has been condensed to the point where only someone who is familiar with the bioethical issues or who has read other works by Illich would be able to either fully understand what Illich was saying in 1975 or why the 2010 author was putting it in his intro. I will hazard a guess on the meaning which is that Illich was saying 35 years ago that once someone stops buying things, stops being a consumer, then society is ready to deny medical treatment and that this will happen with elderly people because they have stopped buying things. But, not only is the argument far afield from the topic of this article, it is antiquated in many respects. Why? Because a person now can actually be quite a huge consumer of medical products and services while they are on life support or while they are taking all kinds of experimental cancer treatment drugs or undergoing all kinds of cognitive and physical therapies as for example, Terri Schaivo was. And let's not forget the medical industry is 1/6th of the U.S. economy. From the point of pure capitalism, dying and debilitated people are great cash cows. If this article was an academic discourse on euthanasia or do not resussitate orders or the like, rather than a Wikipedia article on the death panels political term, then perhaps the Illich quote would deserve mention here. But it is WP:NOT The quote has very little bearing on the arguments Sarah Palin made in 34 years later, does not aid the reader in understanding the recent death panels political controversy, or the current use of the death panels term - which is what this article is about. Because I see absolutely no reason to keep it here, and because after 2 or 3 days I have not gotten a response to my discussion of this that was begun on my talk page, I am removing this passage, and will look back here for further discussion, even though I really don't see how reasonable people can disagree that the quote is irrelevant. KeptSouth ( talk) 10:41, 22 December 2010 (UTC)

Sorry I didn't make it more clear on your talk page why I thought the quote was relevant. Some of this is already on your talk page but here is my explanation. Gawande says "In late 2004, executives at Aetna, the insurance company, started an experiment. They knew that only a small percentage of the terminally ill ever halted efforts at curative treatment and enrolled in hospice, and that, when they did, it was usually not until the very end. So Aetna decided to let a group of policyholders with a life expectancy of less than a year receive hospice services without forgoing other treatments. A patient like Sara Monopoli could continue to try chemotherapy and radiation, and go to the hospital when she wished—but also have a hospice team at home focussing on what she needed for the best possible life now and for that morning when she might wake up unable to breathe. A two-year study of this concurrent care program found that enrolled patients were much more likely to use hospice: the figure leaped from twenty-six per cent to seventy per cent. That was no surprise, since they weren’t forced to give up anything. The surprising result was that they did give up things. They visited the emergency room almost half as often as the control patients did. Their use of hospitals and I.C.U.s dropped by more than two-thirds. Over-all costs fell by almost a quarter". [8]

Martenson says "half the money that we spend in this country on Medicare is spent on patients in the last six months of their lives ... [And that] There are a lot of financial interests who don't want to have this propensity to treat and treat and treat - that's lucrative, subject to close examination". [9]

In LaCrosse Wisconsin "more than 90 percent of people in town have directives when they die, double the national average. The reliance on directives has an impact on the type of care people receive: Gundersen patients spend 13.5 days on average in the hospital in their final two years of life, at an average cost of $18,000. That is in contrast with big-city hospitals such as the University of California at Los Angeles medical centers (31 days and $59,000), the University of Miami Hospital (39 days, $64,000) and New York University's Langone Medical Center (54 days, $66,000)". [10]

(Gawande [11] and Martenson also detail in depth how dying in a hospital is not pleasant, nor is it what people often desire.)

So, it is pretty clear to me that, in response to the death panels charge, Annas is stating there were societal interests that did not want their consumers to stop consuming. That he quoted Illich from 1975 to make this point is, forgive me for being blunt, what I find irrelevant. When I started reading Annas on page 12 at "Finally, and most importantly..." I found it pretty easy to conclude Annas was continuing on the same thread as Gawande and Martenson. Annas notes Obama talking about his grandmother and cost. Annas quotes Goodman of the Boston Globe, who says "The end of life is the one place where ethics and economics can still be braided into a single strand of humanity". In other words, some think Americans are not getting the death services they want, but if they did, it would just so happen to also cut medical expenditures. Annas is, so far, the only person I’ve seen who has touched on the potential relationship between the phrase and the demand for medical services. Gawande notes that when people have options explained to them, demand for medical services declines. How would you recommend incorporating Annas into the article to make this clear? Perhaps we should take things out from his earlier pages. I agree that in 1975 there weren't as many medical technologies to artifically extend biological function. Perhaps the second sentence should not be reincorporated. In general, it appears Annas implies that because people are afraid of death, the medical system makes money off of this fear, and wants to this income stream to continue. It also appears that Annas suggests the phrase helped keep that money flowing. I think the meaning of Annas's quote of Illich may not be immediately clear to readers without some more explanation, but, in my opinion, it is certainly relevant. And if we disagree on a way to help explain its relevance with absolute certainty, then being subject to some interpretation seems admissible. Annas is an established expert in the field and his book was published by Oxford University Press; scholarly sources are highly respected on Wikipedia, after all. Jesanj ( talk) 14:17, 22 December 2010 (UTC)

• 'Obamacare' tackles health care costs. Will Congress? CSM Commentary/David R. Francis. "Those opposed to Obamacare, usually Republicans, have likened the Medicare diversion to "killing Granny." The conservative Liberty Counsel calls it a "euthanasia bill." The demagoguery "makes it almost impossible to do anything without having Hitler [and Nazi-style death panels] rubbed in your face," says Reinhardt".
• The Perennial Quest to Lower Health Care Spending Uwe Reinhardt. "The future trajectory of the volume variable, QG, might possibly be bent down ever so slightly through cost-effectiveness analysis of alternative therapeutic approaches, or by more widespread use of living wills – an idea once actively promoted by Newt Gingrich. But those ideas were met in the past year by dark allusions to rationing,' to Nazi-style death panels and to ' killing Granny.' Therefore, strike lowering QG, as well, from a strategy for bending the cost curve".
• 'Rationing' Health Care: What Does It Mean? July 2009. Uwe Reinhardt. "To suggest that the main goal of the health reform efforts is to cram rationing down the throat of hapless, nonelite Americans reflects either woeful ignorance or of utter cynicism. Take your pick."
• Kill Grandma? Debunking A Health Bill Scare Tactic Julie Rovner. "So why have the demonstrably false claims about death gotten so much life? Harvard public opinion expert Robert Blendon says it's because seniors are very sensitive about their health care. 'Seniors worry more about their health care than any other group in American life,' Blendon says. 'They feel more vulnerable.'"
• 'Death Panels' Revisited: Studies Show Seniors Seek End of Life 'Comfort Care'
• Palliative care found to extend life of cancer patients "It shows that palliative care is the opposite of all that rhetoric about 'death panels'", said Dr. Diane E. Meier, director of the Center to Advance Palliative Care at Mount Sinai School of Medicine and co-author of an editorial in the journal accompanying the study. "It’s not about killing Granny; it’s about keeping Granny alive as long as possible — with the best quality of life."

Provision section

• End-of-life uncertainty; Americans need to be more assertive in detailing the medical treatment they want as they age LA Times editorial. 29 November 2010. quote: "Another challenge is finding the right advocate for this kind of planning. Health insurers don't have the requisite credibility, given their obvious interest in cutting costs. Doctors and hospitals, meanwhile, have little incentive to do so. Medicare pays more for aggressive treatment than for 'palliative' care that's aimed only at relieving pain and reducing symptoms. And physicians can't seek extra dollars from Medicare for the time they spend counseling patients about end-of-life options; when Democrats included such a provision in the healthcare reform bill, critics said they were trying to create 'death panels.'"
• Frank Talk About Care at Life’s End "A similar provision in the original federal health care overhaul proposal, which would have reimbursed doctors for the time it takes to have such conversations, was withdrawn when it was erroneously labeled by conservatives as a 'death panel' option." Jesanj ( talk) 19:28, 23 December 2010 (UTC)

No one has responded the lack of relevance tag I placed on the section I have copied below, so I am removing the last two paragraphs of vague quotes that possibly say something about American culture being anti-death and that refer to someone worrying or being expected to worry about being accused of setting up death panels --none of which, even if was comprehensible, is actually relevant to this WP article or helpful to the general reader. I am certainly amenable to further discussion, if someone wants to try to explain how these quotes are relevant.

===Professional===

"In the wake of the 'death panel' controversy, Atul Gawande, a physician who writes on health care topics for The New Yorker, was asked to refrain from writing about palliative care by physicians who were concerned the article might be manipulated to create another political controversy—and as a result, hurt their profession. ^{[3] [4]}

Bishop et al. authored "Reviving the conversation around CPR/DNR" published in the January 2010 issue of the American Journal of Bioethics. Scripko and Greer commented that while

Bishop et al. replied that this was cautioning them

I will be removing the quotes from Scripko (great name!) and Bishop and combining the first paragraph into the preceding section. KeptSouth ( talk) 11:18, 22 December 2010 (UTC)

The last quote comes from the following source: Bishop JP, Brothers KB, Perry JE, Ahmad A (2010). "Finite knowledge/finite power: 'death panels' and the limits of medicine". Am J Bioeth. 10 (1): W7–9. doi: 10.1080/15265160903493070. PMID  20077324. {{ cite journal}}: Unknown parameter |month= ignored ( help)CS1 maint: multiple names: authors list ( link) Perhaps my style of presenting the back and forth in the literature was not encyclopedic. I remain confident that at least the something from the reference above deserves mention in the article. The article states "In the era of rhetoric centered on fictional “death panels,” we have grown fearful for how our paper would be heard" & "Scripko and Greer (2010) likewise find our diagnosis to be accurate and concur with Truog that strong cultural forces are at work that make changing culture extremely difficult. Scripko and Greer note: “While Bishop et al accurately describe the strength of the American culture that drives fighting death, even when it is not indicated, they fail to emphasize the resistance that is likely to be met should we present our efforts for change as trying to overhaul policies regarding end of life decisions” (74). It is here that they caution us to be very careful in how we address the quest for immortality implicit in US culture, a culture of “life-at-all costs” that medical technology has advanced. They seem to suggest, without saying so, that land mines of “death panels” await us." & concludes by referencing historical aspects of medical culture, religious approaches, a fear of death, medical technology, and a call for medical humility as "the medical establishment resists admission to finitude". How about this?: "Bishop et al. were fearful how their paper on CPR/DNR would be received, because it addressed "the quest for immortality implicit in US culture, a culture of 'life-at-all costs' that medical technology has advanced" in "the era of rhetoric centered on fictional 'death panels'". Bishop et al. interpreted comments from their peers as a suggestion that "that land mines of 'death panels' await us". I find this material relevant because 1) it documents an impact of the death panels myth on medical professionals 2) it documents scholarly opinion on what could trigger further 'death panels' concerns. Also Bishop is not merely an "academic"; he is also a MD/trained internist. Jesanj ( talk) 13:44, 23 December 2010 (UTC)

This article is about the death panel term coined by Sarah Palin. Before Palin introduced the term, Betsey McGaughey made some statements. One of the statements was about Rahm Emanuel's brother. It is going quite far afield to discuss what Rahm Emanuel's brother said. In other words, it is irrelevant to this article, which is about the term death panel that was introduced by Sarah Palin. I have commented it out this material, and refactored the sentence that mentions Palin being inspired, so it is clear that the NYT said the charges against Emanuel were false. Most of what I have commented out is perhaps best discussed in the Emanuel article. Otherwise, we are getting into six degrees of Kevin Bacon type of irrelevancies here. Maybe that's the point, I don't know, but I will continue to AGF - KeptSouth ( talk) 00:01, 21 December 2010 (UTC)

Not if the article is to make it clear what death panels are, and are not, the difference between fact and fiction. Also, Wikipedia has requirements for mention of a living person in any article. See WP:BLP for details. Jimmuldrow ( talk) 02:04, 21 December 2010 (UTC)

If there are enough well-documented reasons why the idea is false, and there are, it is inaccurate to avoid the issue, and very relevant to include the facts about this. The rest of the article includes lots of opinion, but few specific facts about them. Jimmuldrow ( talk) 02:09, 21 December 2010 (UTC)

Thanks for removing what someone thought was the very relevant (not really) misrepresentation that the quote in question was from Emanuel and not McCaughey. You didn't object to that up till now. Jimmuldrow ( talk) 02:12, 21 December 2010 (UTC)

Actually Palin herself said that the statements of Ezekiel Emanuel were one of the main reasons she coined the term. [12] Kelly ^hi! 03:07, 21 December 2010 (UTC)

Very true. Let's get all the referenced facts to that. Those that disagree can add there own very well referenced facts as well, which is fine, as Wikipedia encourages more than one point of view. Jimmuldrow ( talk) 03:14, 21 December 2010 (UTC)

After all, I'm certainly not the censor, the endless mass-deleter, of such issues, and those individuals certainly do exist. Jimmuldrow ( talk) 03:19, 21 December 2010 (UTC)

Jim, I'm sorry, but I think you added just one piece of good content. (And yes, the article should say RS characterized Betsy's statements as false.) But I have to say, I don't think most of it belongs.

Emanuel is an opponent of legalization of doctor-assisted suicide or euthanasia. ^[5] FactCheck.org said, "We agree that Emanuel’s meaning is being twisted. In one article, he was talking about a philosophical trend, and in another, he was writing about how to make the most ethical choices when forced to choose which patients get organ transplants or vaccines when supplies are limited." ^{[6] [7]} An article on Time.com said that Emanuel "was only addressing extreme cases like organ donation, where there is an absolute scarcity of resources ... 'My quotes were just being taken out of context.'" ^[8] Regarding page 425 of a health care bill Blumenauer (who sponsored the legislation) said the measure would block funds for counseling that presents suicide or assisted suicide as an option, and called references to death panels or euthanasia "mind-numbing". ^[9]

The good: 1) Blumenauer sponsored the legislation (but that belongs in the provision section). 2) You added a FactCheck.org source (but it can just go behind a NYT source and I don't see content that should stay, perhaps there is some there that should be expanded upon.)

The bad: 1) Emanuel is not the topic of this article.

I am going to remove the material. Jesanj ( talk) 13:05, 21 December 2010 (UTC)

Both McCaughey and Palin said a great deal about Ezekiel Emanuel, and most of it was selective and misleading, and it's not honest to pretend otherwise. Jimmuldrow ( talk) 15:00, 21 December 2010 (UTC)

I don't mind things being added in the "Prelude" section about what was said before Palin coined the term. In fact I think more about Emanuel would be helpful. I am saying (as did KeptSouth) that you didn't add content in a productive way. Jesanj ( talk) 18:22, 21 December 2010 (UTC)

I would assume good faith if possible. It's not possible. Before, the article misrepresented Ezekiel Emanuel as saying, "medical care should be reserved for the nondisabled," which was a very big lie. Now mass-deletions enforce another, equally big mistatement that "Emanuel is not the topic of this article" even though a huge mass of ink was spilled by McCaughey and Palin describing Ezekiel as part of what Palin called a "death panel."

Honest people have as much a right to edit this article as the rest. Way it is. Get used to it. Jimmuldrow ( talk) 16:05, 21 December 2010 (UTC)

For anyone who didn't read up on the subjsect, Palin said that Ezekiel Emanuel was the architect of a "downright evil", "Orwellian", "disturbing", "shocking" "death panel." She got this from Bachmann's description of a Betsy McCaughey editorial, according to Palin. Jimmuldrow ( talk) 16:45, 21 December 2010 (UTC)

I think that kind of stuff Palin said would probably be after her Aug. 7th coining. So I think it should go under Death_panels_(political_term)#Sarah_Palin. Jesanj ( talk) 18:22, 21 December 2010 (UTC)

Likewise, Blumenauer's reaction would go under Death_panels_(political_term)#Politicians, and not in the Prelude section. Jesanj ( talk) 18:27, 21 December 2010 (UTC)

Only if you like amazing coincidences. McCaughey and Palin mentioned the same Ezekiel Emanuel / page 425 arguments for euthanasia / rationing / death panels. Jimmuldrow ( talk) 03:57, 24 December 2010 (UTC)

Look up how the word sophist started, if you don't know. Some people still split closely related things apart, and pretend to make sense. Jimmuldrow ( talk) 03:59, 24 December 2010 (UTC)

About the "strays from the topic" remark for the Prelude section:

There were NO complaints about a flagrant lie implying that McCaughey's statement was made by Ezekiel, which is false.

Endless complaints about sourced facts showing that McCaughey (her Deadly Doctors editorial was only one example) and Sarah Palin (repeatedly and at length) made Ezekiel Emanuel a large part of what Palin called a death panel.

Provide proof that many, many statements made by McCaughey and Palin about alleged euthanasia and rationing claims related to Ezekiel Emanuel were forged somehow, or admit that the "strays from the topic" claim is another flagrant lie. You have until New Year's day. Jimmuldrow ( talk) 13:07, 28 December 2010 (UTC)

Thanks, Jesanj, for reminding us to use reliable sources. However, please keep such suggestions from becoming too inside-out by actually reading such reliable sources. The lady doth protest too much, methinks. Jimmuldrow ( talk) 04:08, 29 December 2010 (UTC)

The "extremely tangential" info is extremely mentioned repeatedly and in detail by both McCaughey and Palin to describe what Palin said was a "downright evil," "Orwellian," "disturbing," "shocking" "death panel." Many references verify this. Read the references. Jimmuldrow ( talk) 04:08, 29 December 2010 (UTC)

Here are some sources which may be useful: http://healthcarereform.procon.org/view.answers.php?questionID=001528 http://www.mcknights.com/new-congressional-report-lends-credibility-to-end-of-life-provision-in-house-reform-bill/article/146444/ Angel's flight ( talk) 17:47, 28 December 2010 (UTC)

In two places in the article (the lede and further down), I'm removing a one-word quotation from Johnny Isakson which states that he "called Palin's interpretation 'nuts'". The presentation is problematic and definitely needs to be reworked if it's to be re-included, because he never said that. From the Ezra Klein interview:

I understand -- and you have to check this out -- I just had a phone call where someone said Sarah Palin's web site had talked about the House bill having death panels on it where people would be euthanized. How someone could take an end of life directive or a living will as that is nuts.

The problem here is that Palin never said anything about people being euthanized. From her original FB post:

And who will suffer the most when they ration care? The sick, the elderly, and the disabled, of course. The America I know and love is not one in which my parents or my baby with Down Syndrome will have to stand in front of Obama’s “death panel” so his bureaucrats can decide, based on a subjective judgment of their “level of productivity in society,” whether they are worthy of health care.

Palin never mentions euthanasia - to my knowledge, she never has throughout the healthcare debate, consistently stating that her concern has been health care rationing. It's apparent that Isakson is reacting to inaccurate information he received second- or third-hand, not to anything Palin actually said. Kelly ^hi! 02:39, 15 December 2010 (UTC)

On the same day that Palin made her Facebook statement, 8/7/09, the prolife publication, Life News posted this story: "Sarah Palin Opposes Health Care Bill Over Abortion, Euthanasia Components" [13]. (emphasis added) So whether she actually said this in an interview with the prolife publication or whether they read it into her words, it certainly looks like both sides of the debate thought she said this from day one. It is certainly a very reasonable interpretation of the term death panels=euthanasia panels. (I don't, however, have a problem with your removing of the particular quote) KeptSouth ( talk) 11:10, 17 December 2010 (UTC)

I tend to agree, also, I will note, as I did below: the WSJ reported that "Other Republicans, including former Alaska Gov. Sarah Palin and former House Speaker Newt Gingrich, have suggested the Democrats' plans could lead to euthanasia, a notion dismissed as ludicrous by the bill's authors." from "U.S. News: Emanuel's Brother Draws Criticism" Bendavid, Naftali. August 13, 2009. Eastern edition. page A.4. Jesanj ( talk) 16:42, 30 December 2010 (UTC)

Is it worth noting that Palin has also applied the term to the Independent Payment Advisory Board? [14] Kelly ^hi! 20:03, 20 December 2010 (UTC)

Yes, I think so, but the additional new uses, and any sort of cogent presentation of the issues or history of the term, are likely to be buried.

By the way I took a quick look at your Sandbox list of new sources and that guy from St. Vincents - not too reliable as he wanted to sell his own kit of end of life forms to the VA at $5/each. After explaining the situation on the Sunday talk shows, Duckworth pulled the re-issued Bush era publication off the shelves immediately, as I recall. -Regards- KeptSouth ( talk) 23:53, 20 December 2010 (UTC)

I did a newspaper search after this Facebook posting and no article in my database covered this association by Palin. The media was much more enamored with the her "lie of the year" designation. I did a newspaper search of all articles with both of terms and had some hits, leading me to add this to the article. But I think I'll move that down to "contintued use", and I think that would be a good spot for it. Jesanj ( talk) 16:12, 30 December 2010 (UTC)

From the Wall Street Journal editorial staff, today:

There additional analysis there on coinage and reception of the term. Kelly ^hi! 21:12, 29 December 2010 (UTC)

Thanks for posting that narrative here. It reminds me of what I pointed to above ( diff), in that it appears to run counter to Palin's own words. Jesanj ( talk) 22:04, 29 December 2010 (UTC)

For what it is worth, the WSJ reported that "Other Republicans, including former Alaska Gov. Sarah Palin and former House Speaker Newt Gingrich, have suggested the Democrats' plans could lead to euthanasia, a notion dismissed as ludicrous by the bill's authors." from "U.S. News: Emanuel's Brother Draws Criticism" Bendavid, Naftali. August 13, 2009. Eastern edition. page A.4. Jesanj ( talk) 00:55, 30 December 2010 (UTC)

I agree that this should be included and have added a link to http://www.politicsdaily.com/2011/01/01/death-panels-and-maxwells-silver-hammer-end-of-life-planning/ although I'm not picky about what sources are used. What I am concerned about is a laundry list of every instance of the term's use, which is why I've trimmed a considerable amount of that. If anyone has any issues with what I've done, I'll happily discuss the merits of each case under Wikipedia's weight guidelines. Dabnag ( talk) 00:20, 3 January 2011 (UTC)

The WSJ article is opinion though not attributed (surprise surprise). The clue being the link at the bottom (next in opinion).-- Hauskalainen ( talk) 07:38, 3 January 2011 (UTC)

In the past day or so the article has been completely reorganized in a way that I think was detrimental. Material that had been usefully organized into topical sections was restructured into a giant, unreadable list of "reactions." I am adding the "controversial" template and I would like to request that major changes be discussed before they are made. Delia Peabody ( talk) 15:52, 3 January 2011 (UTC) sock of banned user   Will Beback  talk  07:55, 28 February 2011 (UTC)

I didn't exactly like the idea to move what I saw as organization into a lumped reactions section either. Jesanj ( talk) 16:04, 3 January 2011 (UTC)

In the coining section, under Palin's original quote, this has been added again (I reverted it once and placed it in Palin's section). This addition has nothing to do with Palin's coining of the term, and, in my opinon, is in the wrong place. The edit summary reads "Palin's correction of the misimpression given by her spokeswoman needs to be explained early on". The text added includes the sentence "In November 2009 Palin corrected the impression that had been given that the source of the claim against Obama was connected to the advanced health directive rewards in Medicate [sic]." As far as I can tell, the ideas that there was a "misimpression" that was "corrected" are unsupported. I think they are harmful to the article. I propose scrapping the text added by this edit, as I have incorporated Palin's explanation elsewhere. Jesanj ( talk) 18:30, 3 January 2011 (UTC)

I'm unsure as to why the movie critic Roger Ebert's blog posting is encyclopedic here. I removed it once but it was reinstated with an edit summary that said it was accidentally removed, but my removal was purposeful. Jesanj ( talk) 23:53, 3 January 2011 (UTC)

Because he explains the nature of what it is (a meme) and offers an interesting perspective. I assumed it was accidentally removed somewhere along the way, but I didn't know this article was going to be such a mess to try to manage. I'll stay away. Dabnag ( talk) 01:41, 4 January 2011 (UTC)

I don't see why he should be any less qualified to speak on this subject than Sarah Palin. He is probably more intelligent and certainly makes sense in what he writes and can make an argument. I am still waiting for Palin's explanation of how Obama has a death panel in front of which her granny or her grandchild coud appear.-- Hauskalainen ( talk) 01:55, 4 January 2011 (UTC)

Agree with Jesanj. Ebert is not known as an expert regarding health care. His opinions are not notable in this arena. Additionally, the ad-hominen's against Palin are a violation of WP:BLP. Hauskalainen you should refactor your comments regarding Palin's intelligence. Arzel ( talk) 02:08, 4 January 2011 (UTC)

You are right.I retract.Sorry Sarah.-- Hauskalainen ( talk) 02:40, 4 January 2011 (UTC)

If there's a need to explain what a meme is, perhaps Ebert's words could be cited. Don't we already have an article on that subject, though? ← Baseball Bugs ^{What's up, Doc?} carrots→ 03:54, 4 January 2011 (UTC)

Should this page be moved to Death panel? Currently that title is just a redirect to here. WP:TITLE says that names should be kept concise...I could see the parenthetical "political term" being used for disambiguation if necessary, but currently there is nothing to disambiguate from. WP:PRECISION seems to indicate the parenthetical isn't needed. Kelly ^hi! 21:18, 14 December 2010 (UTC)

Requested move

Linked the section title for some reason. †TE† Talk 05:47, 26 December 2010 (UTC)

I hope by "They're baaaaack!" you mean doctors will be paid via Medicare to have conversations that can take an hour with patients and families to explain end of life issues, instead of volunteering this work. I added this story to the Provision section. Jesanj ( talk) 15:53, 26 December 2010 (UTC)

Well, Think Enemies could mean any number of things as there appear to be several shifting defs of DP's. KeptSouth ( talk) 08:16, 27 December 2010 (UTC)

I was just referring to what some ^{weasel words} have called the "Death Panels." †TE† Talk 17:43, 5 January 2011 (UTC)

I also added that Blumenauer was planning to reintroduce the provision in the summer of 2010. I am not aware he actually reintroduced it to the House though. Jesanj ( talk) 16:02, 26 December 2010 (UTC)

Not sure why you added an obscure ref to what one source said Rep. Blumenauer was planning to do, but actually never did, but I certainly agree it's a reg or proposed reg now. KeptSouth ( talk) 08:23, 27 December 2010 (UTC)

I added it because it includes more background on the politics behind consultation payments. There are more sources besides the 7/7/2010 Hill piece. I might find them and pull them together to make a half sentence. News organizations found it important enough to write about. Perhaps the re-litigating threat pressured the administration to regulate. Jesanj ( talk) 13:42, 27 December 2010 (UTC)

You're welcome. Here do you think it is best to separate out and ask for the citation for "bills"? Perhaps you didn't see that WaPo said "After sporadic bipartisan attempts in recent years to add consultation payments to Medicare". That's why I had the previous wording. Thanks. Jesanj ( talk) 13:54, 28 December 2010 (UTC)

I made this edit. Jesanj ( talk) 14:19, 28 December 2010 (UTC)

And FYI here is a random diff I think is important on the talk page that concerns renaming. Jesanj ( talk) 15:50, 28 December 2010 (UTC)

Well there were bills introduced, they were not just attempts as your edit summary says. I don't believe in immediately removing or revising something that has a cite needed tag, (as you just did) when I suspect there is information out there in support, and I believe that is consistent with WP guidelines/policy, and behaving this way - looking for a cite needed or giving time for others to do so - leads to article improvement. As there were numerous very similar in nature bills introduced in both the House and Senate between 2005-2009, I will correct the language again, but this time include a few cites. -Regards- KeptSouth ( talk) 17:09, 28 December 2010 (UTC)

My edit summary was just emphasizing what was in the source. I see what you're saying though. I thought you might have been thinking something different. I'll change it back. I was thinking if you can immediately address a tag that's the best. Jesanj ( talk) 21:27, 28 December 2010 (UTC)

Maybe not

U.S. Alters Rule on Paying for End-of-Life Planning †TE† Talk 17:38, 5 January 2011 (UTC)

Added, thanks. Jesanj ( talk) 22:52, 5 January 2011 (UTC)

The article is somewhat confusing. As far as I can tell, there are two basic aspects to the death panel allegation. They are rationing of care, and allegedly coercive "end of life" counseling. The lede emphasizes only rationing, and the "Provision identified by the charge" section emphasizes only "end of life," when it seems to me that both are of equal importance (some might argue that they are more or less the same thing.) Then the section on rationing has an "undue weight" tag, which seems inappropriate. There is also a lack of clarity about the arguments being made in defense of IPAB (which may be unavoidable) -- the defenders seem to both be saying that it's not rationing, while also saying that a degree of rationing is necessary and that if aid recipients don't like it they should find some money and buy their own health care. Delia Peabody ( talk) 15:52, 6 January 2011 (UTC) sock of banned user   Will Beback  talk  07:55, 28 February 2011 (UTC)

Good point, I think the lead could have some end of life material incorporated. My rationale for the tag is above. The gist is that I think there is too much IPAB stuff. Maybe a pharmacuetical company getting a lower payment for a drug from Medicare is dubbed "rationing" by the industry? [21] Not sure. Jesanj ( talk) 17:26, 6 January 2011 (UTC)

::That might be an interesting issue to discuss, but it's off-topic. The point of the "death panel" term is that when certain therapies, such as dialysis or cancer drugs, are denied due to budgetary considerations, people die. All sorts of arguments could be made in the name of "scarce resources" or "fiscal responsibility," but the patient is still dead. Ultimately, the debate is about priorities, such as bank bailouts vs. patients with expensive diseases. Angel's flight ( talk) 17:50, 6 January 2011 (UTC)

That concept is not the only 'death panel' issue identified. I'd say Delia is right about the "allegedly coercive 'end of life' counseling". In that diff I point to a report noting this: "'With all due respect,' the former Alaska governor and 2008 GOP vice presidential nominee writes, 'it's misleading' for President Barack Obama to say that provisions in one of the health care overhaul bills simply increase the information offered to Medicare recipients about end-of-life issues. 'The issue is the context in which that information is provided and the coercive effect these consultations will have in that context. ... 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?" Jesanj ( talk) 18:06, 6 January 2011 (UTC)

I boldly removed a decent amount of things to clear up a variety of issues that have been identified on this talk page, such as clarity/organization/should we mention the IPAB/Arizona/etc. by observing what I see as a fairly strict call for notability in WP:NEO. Jesanj ( talk) 03:18, 7 January 2011 (UTC)

Some editors clearly edit with the POV that "death panel" refers to a mythological creature like the unicorn. And, there are reliable sources that promote that POV. However, there are also reliable sources which say the term refers to very specific agencies which do exist in the real world, i.e. NICE and IPAB, and under NPOV, that point of view must also be included. Removal of sourced material should always be done with caution, and after seeking consensus. I see that there are two editors making an unusually high volume of edits -- I recommend reading WP:OWN. 99.190.166.55 ( talk) 13:47, 7 January 2011 (UTC)

::Please stop with the deletions. They appear to be based on POV rather than some procedural guideline. The article is not overly long. Angel's flight ( talk) 17:46, 7 January 2011 (UTC)

Could you address my concerns that I raised above? Jesanj ( talk) 18:11, 7 January 2011 (UTC)

In this edit and this edit, an editor says he deleted sourced material because he disagreed with the source. This is unacceptable. These deletions should stop. If someone wants to argue that the source is unreliable, the proper venue is to go to the reliable sources noticeboard. 99.60.52.7 ( talk) 15:44, 8 January 2011 (UTC)

:This article is about a political controversy. Clearly, editors may feel that one or the other side of the controversy is the correct one. However, under NPOV, it is not permitted to delete the side that you disagree with, provided the material comes from reliable sources. If you believe that National Review and Wall Street Journal are unreliable, the noticeboard is here: Wikipedia:Reliable sources/Noticeboard. Angel's flight ( talk) 17:20, 8 January 2011 (UTC)

For sources to be used they have to be reliable. One does not have to go first to the reliable sources noticeboard. In the case of Avik Roy I am quite prepared to defend my claim that Avik Roy is not a reliable source. He makes assertions time and time again that are not true and expects us to accept them as fact. Journalists almost always cite their sources. All Avik Roy does is to make assertions, link them to tabloid "horror stories" in the UK press (for example, which are not in fact horror stories when you get deep down into them) and assume that the reader will not notice. The American public is full of the notion that health care in the UK is controlled by queuing and that people die waiting because health care is not properly funded. It is a false rumour spread by certain politicians and politically biased web sites. The only difference between the "rationing" that happens in the UK and that in America is that in England, health care is rationed first according to need whereas in America it is rationed according to the size of your pocket or rationed by your insurance companies against their bureaucratic rules.-- Hauskalainen ( talk) 19:58, 8 January 2011 (UTC)

There are clearly editors at work on this article who are desperately trying to lend justification to the idea that Sarah Palin was right in her claim about Obama's America is a place where her elderly parents or her disabled son could one day be dragged before some panel,a so-called "Death Panel" and have to plead for their lives on the grounds that the panel felt their life night not be worth living.

The strategy is to conflate several ideas and tap into a deep fear implanted in the heads of the American public many years ago about so-called socialized medicine.

It is argued on two false premises in order es to come to a false conclusion. The false premises are (1) there are death panels in England with bureaucrats determining people’s access to medical services, but not yet in America (2) that America's new health reform is creating a panel or board with a similar structure or purpose to that in England, and the false conclusion is (3) that very soon therefore Palin could well be right that people (maybe not her her parents or her son, but someone covered by "government run insurance") will one day find themselves in front of such a panel.

The use of Wikipedia to promote this ideas based on this type of construct IS TOTALLY AGAINST THE RULES OF EDITING.

Before we consider the rules, we need to consider the premises on which this house of cards has been built.

Premise 1. There are “Death Panels” in England and not in America

Clearly this is nonsense. There are NO panels in England before which a person can be dragged and have to prove that his or her life is worth the spend on the care they need. That is not to say that there is no evaluation as to when and how an intervention to defend a life is justifiable and when it is not or how collective funds can be spent. The clearly is, as there is any collective insurance system a process by which there are checks and balances to ensure that collective funds are spent wisely. The loss adjuster who checks my auto insurance claim does this. In America’s private medical insurance system it is done by insurance company clerks armed with insurance company rule books about what is and why is not accepted medical practice in certain situations, and by the caps and restrains within the policy (annual limits, applications of deductibles and co-pays and whether o not a policy has access to a level of drug formulary which can fund a pharmaceutical intervention. Every insurance company has these formularies and has rules about when and whether a drug in that formulary can be used. These are all intended to “ration” the spend of the insurance company’s funds. The NHS in Britain is, in effect, a publicly owned insurer and makes the same kind of decisions but in practice this kind of care over spending is easier to exercise by the medical profession because medical profession knowns that it has to weigh out costs and benefits, and for the most part the rationing done by insurance company bureaucrats in America is done by the medical profession in England and Wales in every possible medical setting, based on medical judgment. When it comes to assessing expensive new technologies, the NHS has going to extraordinary lengths to ensure that there is an even handed approach in every region of the country and that there is no “postcode lottery” where some regions pay for services that are not funded elsewhere. NICE (which is a comparative effectiveness body) has taken on the challenge of examining costs and benefits of expensive medical intervention and determining, based on real clinical evidences, what works and what does not. The QALY is an effective tool in comparing outcomes, and costs can be associated to a QALY gained based on clinical effectiveness. This determines the upper spend limit for an intervention. It is highly scientific, based on evidence, and the people of England and Wales generally support the aims of both NICE and the NHS as evidenced by the overwhelming support the British public have for the NHS. The NHS is not a rationing body in the way that food or petrol(eum) may be rationed in times of shortage, with a body deciding who can have coupons to get what they need and how many. This is the American fear factor about health care “rationing” and it is totally wrong. The only “rationing” that goes on in the NHS is a cost/benefit analysis, with the intention of getting the best quality of outcome at the lowest price. Some things that NICE does not do is to determine doctor and hospital re-imbursement levels (this is what the MEDPAC does now, subject to congressional approval, and what the new IPAB will do with only congressional oversight (to get the politicians OUT of the decision making loop). This is what Britain did with the NHS years ago and it has been unversaly admired and copied around the world. It does this in full cooperation with the medical profession, the medical devices and pharmaceutical industry, and with ´representation from patient bodies. Its about as public and transparent as you can get. Contrast this with the coverage rules of American medical insurance companies whose rules are Byzantine, as was amply demonstrated in the Michael Moore documentary Sicko! which lifted the lid on the secret world of insurance company denial letters. So getting back to the premise that there are death panels in England with bureaucrats determining people’s access to medical services, but not yet in America, this is clearly not only FALSE, but it is actually the other way around. There are bureaucratic decisions made in AMERICA of a kind that simply do NOT happen in England.

Now lets look at premise 2.

Premise 2 America's new health reform is creating a panel or board with a similar structure or purpose to that in England.

Lets assume that the panel or board in England is NICE, I.e. a comparative effectiveness body making decisions about what treatments work and deliver benefits and which do not, and, (very infrequently) determine whether a new drug delivers benefits worth the high cost the pharmaceutical company wants to charge and in what circumstances. NICE does not determine doctors contractual reward (salaries or hourly rate for bough in services). Doctors salaries in England and Wales are set at market rates in order to attract sufficient doctors to the service, just as some US hospitals do, America is a bit weird internationally in terms of hospital care as doctors there are a separate billing entity.. Therefore insurers like Wellpoint and United Health Care, and public ones such as Medicare, have to set limits on what they are prepared to pay for their services. All that IPAB does for Medicare is to set that rate. It is the same price rationing that Blue Cross and Blue Shield and thousands of other insures do, It is not a unique activity and it is nothing like what NICE does. Following the references there are sóme stories relating to the cancer drug Avastin. This had been approved by ´the medicines regulators in the US and in Europe but NICE had not found benefit for it in all the circumstances for which it had been approved, or if there was, not enough benefit to justify the cost in every circumstance. So it had set limitations on its use within´the NHS. Although the drug companies managed to get a lot of noisy articles in the right wing press, by and large, the government stood firm and backed NICE, as I suspect would the British public. Recently, the US regulator has looked again at new clinical data from the use of Avastin and have found it to deliver much less benefit than had previously been found. Because the drug also has negative consequence, the US regulator has now withdrawn some of its earlier recommendations. Some have claimed WITHOUT ANY EVIDENCE that this was a rationing decision, and did this IN SPITE OF A STRICT DENIAL FROM THE REGULATOR THAT COST HAD ANY ROLE TO PLAY IN THE DECISION. Such claims should not be made and they should certainly not receive any recognition by Wikipedia unless the claims can be substantiated.

So what are we left with? Two false premises and one false conclusion. It really is not acceptable to use Wikipedia to spread this kind of ridiculous notion.

The question now is who is trying to push these two false premises and its conclusion (apart from the editors here of course)? Well we have a chappie by the name of AvikRoy who writes for an line journal. What is his expertise? He works as a “health care analyst” for a company called “Monness, Crespi, Hardt & Co.”. Well, health care analyst makes him sound like he should know what he is talking about, and if his firm was in the health care business he could be just the man to make us question where the analysis above went wrong, But in fact Monness, Crespi, Hardt & Co. is actually a stock broking firm and what he analyzes in health care stocks and the health care money making machine, not the effectiveness of medicines and treatments but their effects on the bottom lines of medical insurance companies and medical service providers. Ultimately, he is partisan, representing those who own pharmaceutical companies, insurance companies, and medical services groups. He writes on medical matters in political journals presumable to sway political opinions. Quite simply, he cannot be considered to be a neutral or a reliable source when it comes to determining the rights and wrongs of this case. This is quite clear when you read any of the stuff he has written which is biased and clearly intended to pull at emotional strings rather than taking a hard headed analytical and detached approach to his subject. Take a look at this article which is carried in a link from the NRO story titled “what the British NHS does today”, to his own blog web page. The first story is about Avastin (surprise surprise) in which it is claimed that doctors are pressurized by the system NOT to tell patients about a drug not approved for use by the NHS but which the patient could buy privately. The story is totally anecdotal and cannot point to any place where there is a policy in place not to tell patients about such drugs, And why should it? The NHS would save money if the patient instead checks into to a private hospital for treatment. It looks tome like a story planted in the press by the makers of Avastin. Personally I am not surprised that doctors do not recommend patients to seek these expensive treatments, If they are bad value for the NHS they are presumably going to be bad value for the vast majority of NHS patients seeking to pay for them out of pocket. The second story is titled “Sentenced to Death on the NHS “, a wonderful headline for those already convinced that you might go into a NHS hospital on your feet but likely to come out in a box. On closer inspection it is about what to do when all the people with medical responsibilities, consultants, doctors, nurses and other are all in agreement that end of life is near, They instigate a protocol to ease the persons last days without taking steps to cure the patient, Every doctor all around the world has seen this and I don't have any reason to think what happens in England is any different to what happens in America. The best palliative care is offered. But what is new here is that some UK doctors are saying “but what if we all got it wrong when we said death was close and inevitable”? As the article says, forecasting death is an inexact science, and we should expect that sometimes the initial diagnosis will be wrong and they are arguing that there ought to be ways to review´and revise that initial decisions. That is all that this doctor is saying and presumable the very same argument could be made in every health care setting, including those in the U.S. I feel absolutely sure that the procedures the UK doctors and and nurses is fundamentally no different to that which goes on the the US, It is natural that the whole team agree before putting a patient on a pathway intended to ease their passing with palliative care only. In the final analysis, the headline “sentenced to death” was pure tabloid sensational plash hardly worthy if the label “journalism”,

Or this one in which he makes a classical mistake of equating medical services consumption with other forms of consumption. He says here that “The entire reason death panels exist in Britain is because, when the NHS was founded in 1948, few people understood that making health care “free at the point of care” would lead people to use more of it: much more. To the point that today, in Britain, the U.S., and nearly every other country, health care is sinking the budget.” Again he makes an unsubstantiated claim (there there are death panels in England) but then he goes on to make a classic mistake, equating medical services consumption the same as the consumption of cars or chocolate,; an assumption that people will want more of something the cheaper it becomes, In fact, any medical economist will tell you that medical services have “a negative utility of consumption”.. i.e. a person who consumes lots medical services is generally worse off than someone who consumes none. These are fundamental errors and makes this guy's opinions worthless.

Conclusion: Avik Roy is not a reliable source

This man works for a stockbroker and thus represents medical industry. He is not a journalist but a health care analyst in the financial world. He is not a reliable source.-- Hauskalainen ( talk) 19:46, 8 January 2011 (UTC)

:Hauskalainen, you are operating on a mistaken assumption about how Wikipedia policy works. Mr. Roy is not the source. We don't evaluate Mr. Roy. We evaluate the National Review -- it is their job to evaluate Mr. Roy's qualifications. If you go to WP:RSN and enter "National Review" in the search box, you will see that there have been numerous discussions about the use of that publication as a source. I would suggest that you read them, and then if you like, start a new thread regarding NR as a source in this article. But keep in mind that under WP:V which is a core policy: The threshold for inclusion in Wikipedia is verifiability, not truth; that is, whether readers can check that material in Wikipedia has already been published by a reliable source, not whether editors think it is true. Delia Peabody ( talk) 22:08, 8 January 2011 (UTC) sock of banned user   Will Beback  talk  07:55, 28 February 2011 (UTC)

I didn't read all of Hauskalainen's text, but Delia, I don't think it is that simple. I think this editor put it exactly as I see it. To what they said, I would also like to add that the "article" is a blog posting. While he appears to be an established blogger, I doubt Avik Roy can be considered to be "an established expert on the topic of [this] article whose work in the relevant field has previously been published by reliable third-party publications" (WP:BLOGS). By contrast, I would consider Brendan Nyhan's blog postings to be reliable, as he has published on this exact topic. Jesanj ( talk) 02:22, 11 January 2011 (UTC)

I find this section to be totally biased by its very presence.

In the article we establish that Palin was originally influenced by Bachmann who was influenced by what she misread in Emmanuel's papers. Emmanual was not at all talking about "rationing" but about the problems of getting consent for End of Life care AFTER the person needing care is unable to communicate their preferences. Getting an advanced care directive is intended to alleviate the stress on relatives, cares and doctors and not save money and certainly not to deny care to people who would prefer to receive it.

Then we establish that Palin's spokesperson confirms that this is about advance care directives.

Then Palin seems to change her mind. She then starts talking vaguely about how to contain costs in a system where everyone has access to care (as if the problem does not arise even in the present situation when not everyone is insured. Because she cannot connect it to Obama and the specific legislation, she then admits that she is talking in only very vague terms rather in the same way Regan did about the Evil Empire - long on rhetoric but nothing of any substance.

So far so good. But now the article takes a highly POV turn. First of all it introduces a section called "Rationing of care". The Christian Science Monitor article makes the general point that the claims had been found to be false but that therhetoric over rationing was carrying on. Not that this was based on anything concrete, but just the vague notion that if the government got involved it would begin rationing. And it is fairly even handed giving examples of claims of rationing both specific examples of rationing in the present health care system as well as claims that the new health care system would have more (though as I say, not backed up with anything concrete. So the article is fairly balanced but it is used to introduce the idea that Republicans say this is about rationing.

Gingrich is then quoted making the same vague claims.

The Nyhan article is less vague but comes down firmly on the side of the rationing being mostly myth. He cals it "a myth" and "highly inflammatory". There is one sliver of a quote that might be twisted to make it seem the contrary. Nyhan says "While efforts to reduce growth in health care costs under Obama’s plan might lead to more restrictive rationing than already occurs under the current health care system, that hardly justifies suggestions that reform legislation would create a “death panel” that would deny care to individual seniors or disabled people" Whoever inserted that quote missed off the first words of the quote that I show in italics, thus making it seem much more certain than it really is. Cannon's point that the "rationing" if any coming from Advanced care directives is not "government rationing" but consumer directed rationing --- i.e. the patient decides and not the bureaucrat.

None of the above has anything to do with anything to do with anything that Palin has said and nothing to do with "a panel of bureaucrats deciding who gets treatment or not", the so-called "death panels" (And if anyone wants to claim that NICE is a "death panel" it is no more a death panel than the bureaucrats in America's private insurance companies that say which drugs and treatments that they will fund. You only have to read a little about the movie Sicko! to know that these bureaucrats exist. NICE does NOT deny anyone access to care. People are free to insure themselves over and above the coverage provided by the NHS (such policies do exist but there is virtually no demand for them) or to pay out of pocket for private treatment. Other bodies in the NHS fund care, not NICE so even the notion that it is a rationing body is far from the truth.

So what we have is quite a large section on the topic of "rationing of care " which gives little or no evidence of any health care rationing, real, planned. Only that in the mind Palin, Gingrich, and Michael Steele. I conclude therefore that the section is there only to give the lazy reader the impression that this is about rationing and there is enough of it to warrant its own section. Sorry folks, but this is all too POV for me. I do not mind the text appearing and I kept it in before when deleting the section title. But now that someone has added it all back so thjis time I am just going to delete the whole section on the grounds of POV pushing. If the person wants to add the content back, that is fine and I may reserve the right to balance it out somewhat. But that section titles of "rationing of care" has to go.-- Hauskalainen ( talk) 18:46, 3 January 2011 (UTC)

For the very reason that it— Preceding unsigned comment added by Hauskalainen ( talk • contribs) 18:46, 3 January 2011 (UTC)

Please read up the page, we have been discussing this. Despite the statement by Stapleton, Palin discussed rationing in all her writings on the subject, both contemporaneously and since then. Kelly ^hi! 19:06, 3 January 2011 (UTC)

I think it is worth nothing that a NYT blog states "While the board is not supposed to be able to cut benefits, industry groups fear that its actions would result in rationing care. The board, known as IPAB, could cut payments to health care providers." [22] I think it would be great to incorporate Nyhan's full quote. And Dentzer has described rationing as "The 'R' word" [23] but we can use profanity. I notice you also removed comments by Cannon or Storey Jr. without specific reasons. Jesanj ( talk) 19:36, 3 January 2011 (UTC)

User:Kelly I just noticed it was you that reverted, but are not taking account of the argument I have made for the delete. I quite accept that Palin has implied she is talking about rationing. That can be stated quite simply in the text. None of the examples in the section that I deleted contains ANY example that could fit "Obama's death panels" and it is therefore simply misleading to have a section which writes it up as though it is discussing the issue. As far as I can see there is no argument made for the presence of rationing in the bill or in any of "Obama's" plans (tho he did not write the Bill as I understand it). There is in Palin's words, and Steele's words, and Gingrich's words, and in Boehner's words, just some vague notion that if the government is involved then there will be rationing. And of course that is nonsense because EVERY HEALTH CARE SYSTEM IN THE WORLD RATIONS CARE. In this sense I do agree with the editor above who said that the health insurance industry rations care.

Which brings me nicely to Jesanj's point with his NYT quote that "While the board is not supposed to be able to cut benefits, industry groups fear that its actions would result in rationing care. The board, known as IPAB, could cut payments to health care providers." It may come as news to you, but all public bodies in the USA as well as in most other countries can only act with the powers delegated to them. If they have no power to cut benefits then they cannot do it. To me it would be illogical if the IPAB was not able to determine rates because otherwise health care providers could charge what they like. Maybe this is why the US has the highest health care costs in the world and why American doctors are paid so highly compared to those in other countries. In any case I do not see that this has anything to do with terminating Grandma or not valuing baby Trig or whatever he is called. If we are to have a section with the word rationing in it, it must be related to a "death panel" - a body of bureaucrats which decides who gets treatment and who does not and it must be labeled neutrally such as "alleged rationing" or "claims of rationing" because as it is, it is totally POV and I will take this as far as it needs to get it corrected. WP is NOT here to mislead its readers but to inform them. Palin's claim of rationing is not justification for a section titled "health care rationing" without substantial evidence that this is justifiable.-- Hauskalainen ( talk) 20:47, 3 January 2011 (UTC)

And having said all that, perhaps Kelly will be kind as to respond to the issues I have raised in this section.-- Hauskalainen ( talk) 20:47, 3 January 2011 (UTC)

It's not our role here at Wikipedia to determine THE TRUTH about death panels. It's only to provide a neutrally-worded summary of what reliable sources say about the term. Kelly ^hi! 21:11, 3 January 2011 (UTC)

There are reliable sources noting supporters of reform said insurance companies were the real rationing death panels. We should/you could add those types of sources to the article in that section. I think the POV "problem" you perceive with the title of the section is also rebutted above regarding the title of the article. Jesanj ( talk) 21:36, 3 January 2011 (UTC)

I know I can provide reliable sourcing to provide balance but this just gets messy. And just because there was some attention to fair play with the article name is no excuse for playing fast and loose with the section titles. I am very dubious about "rationing" because all finite resources are rationed. Its just a question of how you do it. By price and ability to pay, or by some other criterion such as your how sick you are. There is no right or wrong answer but it is disingenuous to think that there is health care rationing in England but not yet in America. As far as i can see, Obama is sticking with a limited cost containment within the price rationing model. Americans will be grappling regularly with balancing out the generosity in subsidies versus the tax burden, but they have done this for years with Medicaid so nothing new there then.-- Hauskalainen ( talk) 22:57, 3 January 2011 (UTC)

Please indent your talk page replies - see WP:TALK. Anyhow, the sources show that Palin used the "death panel" terminology to refer to government rationing decisions, not private sector ones. Though there may have been others that applied the sobriquet to insurance companies, etc. Kelly ^hi! 23:06, 3 January 2011 (UTC)

But Kelly, she has not said by what mechanism the rationing will happen or given any justification for why it is likely to happen other than some fanciful notion that if the government gets involved it will be rationed. And there is NO REFERENCE to Palin in this section except for a brief mention in relation to Gingrich and one reference to Death Panel in relation to NICE which in fact makes far fewer "rationing" decisions than even the smallest US private health insurer. The section is lacking ANY substantive content justifying its existence. We do not need a section to say that Sarah Palin has all along claimed that "Death Panels" were about rationing. What we are lacking is any substantial explanation of how and why this will happen and why she thinks the government will be wresting rationing decisions away from insurance companies and cash buyers of health care providers, and secondly why she thinks that this is something to be preferred. Personally I would rather trust the doctors running NICE (who live and die by the same rules as everyone else) than a insurance company bureaucrat who is paid a bonus for declining claims and increasing company profits. If Palin has something to say, lets hear it in this section, not some stupid irrelevant material. You are the one who added this content back into this section after I deleted it. So far, your only justification is that Palin claims that there will be rationing. But Palin's claims are not even part of this section. What is this section's function? And that of the other content that I have criticized and deleted and which you have posted back? You have given me a mild warning on my talk page. But I am the one making the justifications for deleting this section and so far your only reply has not addressed the main issues I have raised. -- Hauskalainen ( talk) 00:03, 4 January 2011 (UTC)

Palin said/predicted/speculated rationing would occur when she coined the term. Other people have discussed the merits/possibilities of that claim. That is the function of the section. Jesanj ( talk) 01:00, 4 January 2011 (UTC)

It is OR to connect IPAB and NICE and rationing. IPAB determines physician reimbursement. NICE does not. IPAB is not engaging in rationing. No physician is obliged to sign a Medicare contract or do Medicare work, so a physician signing up for Medicare has to accept Medicare's rates. My employer sets my pay rate and I either choose to work at that rate or work for some other employer. Nobody would engaging in "rationing" at the IPAB - i.e. determining who gets treated and who does not. The ONLY thing it can set is the reimbursement rate. Nor is NICE primarily a rationing body, though it is true that many in the US (including a certain Canadian gentleman, for some reason seems to think it is. Its primary function is the same as the Comparative Effectiveness Board in the U.S. Neither does NICE determine which medicines are available in the UK and which are not. That used to be the task of a wholly separate body, which I think I am right in saying, has now been merged into a Pan European medicines approval agency. It does, very occasionally, make decisions on whether or not the NHS should refuse approve a drug to be funded from the public purse in certain clinical situations. This is no more "rationing" that the "rationing" that already happens in US Health Insurers when they draw up their own list of medicines that may be funded by their policies. When I decided not to buy a 50 inch HDTV for the family recently I was not engaging in "rationing", just performing a value for money judgment. It may come as a surprise to you BUT EVERY HEALTH CARE SYSTEM IN THE WORLD WHICH REPRESENTS THE INTERESTS OF JOINT FUNDERS EXERCISES THIS KIND OF SELF DISCIPLINE.Private insurers, public insurers alike. Without it, the foxes would be in charge of the hen house. -- Hauskalainen ( talk) 19:49, 7 January 2011 (UTC)--

It is only OR if an editor draws a conclusion that is not present in the published sources. The rationing section as it presently stands accurately reflects what is in the published sources. You may disagree with what they say, and in the eyes of God what they say may be incorrect, but following Wikipedia guidelines we put what is in the sources in the article. The recourse that is available to you is to find some reliable sources that say there is no rationing and that budgetary pressures or incentives never, ever play a role in the allocation of medical resources. 99.122.154.161 ( talk) 21:47, 7 January 2011 (UTC)

IPAB and NICE

There are many reliable sources that have made the connection between NICE and "death panels," between IPAB and "death panels," and between IPAB and NICE. Whether Sarah Palin has made these connections is not really important (although apparently she has.) The article not a bio of Sarah Palin. Reliable sources have connected "death panels" with rationing, and therefore it belongs in the article -- it is the effort to delete this material that is POV, not the effort to include it. Also, I object to this revert, which was done without explanation. It is clear that NICE and IPAB are very similar agencies, and reliable sources have commented on this. Any effort to obscure or suppress the connection should be regarded as POV-mongering. 99.109.197.144 ( talk) 00:21, 4 January 2011 (UTC)

I previously placed the editorial I removed with that revert in the section I felt was appropriate but it was removed as irrelevant as it did not use the phrase 'death panel'. I don't necessarily think that is the best move, but I don't see how an editorial from a politician is a RS to show the IPAB and NICE are closely related, as your edit summary said was so. You are right, the article is not a bio of Palin. But the term is circulated most notably in the summer of 2009, prompting articles to be published in medical and academic journals. I haven't been able to find "many reliable sources" for NICE & DP or IPAB & DP. You could list them above in the first section "possible sources". If there are "many reliable sources" for IPAB & NICE that would be interesting, and maybe they would be worth incorporating, but this is the death panels article after all. Jesanj ( talk) 00:54, 4 January 2011 (UTC)

NICE is nothing like IPAB. It is more like the Comparative Effective Research body set up under Obama. Only a handful of treatment regimes ever come close to making a budget impact on the NHS. Most decisions are made on the basis of what works and not what it costs. Of course, some are, but these are very few and far between. IPAB does not do Comparative Effectiveness research. NHS doctors are paid according to a tariff that is not determined by NICE. Neither is the reward structure paid to specialists verses generalists in the NHS a decision made by NICE. IPAB in effect does this for doctors of all kinds in relation to their Medicare and Medicaid patients. Most decisions regarding treatment fundings are made by local NHS trusts which have no equivalent in the US except perhaps the VA medical system. IPAB decisions affect the whole of Medicare/Medicaid spending. So it matters not a jot that you have reliable sources making a connection, it can only be tenuous at the very least. If you insist on those claims I will insist on substantive evidence going into the article which demonstrates that it is not true. Even the Telegraph report only said "claimed" but did not say it really was. It did not even say WHO claims this so it is, at most, a very weak reference.

Whilst I am at it we can also include the truly appalling claims of insurance company "death panels" in which people who have paid premiums are then denied funding; the case of Michael Napientak, who obtained pre-authorization rfom UnitedHealthCare for back surgery to relieve agonizing back pain only to be left on the hook for the $148,000 the hospital charged. "Pre-authorization", the insurance company explained, "didn't necessarily guarantee payment on a claim would be forthcoming". And we can [[File:have the case of the parents of a severely brain damaged baby when Blue Cross of California stopped paying for his nursing care, initially on the grounds that the annual limit was bust (which it wasn't) and then later on the grounds that the " nurse's services weren't medically necessary". And the Kentucky löady whose death panel insurance company canceled her coverage after she was diagnosed with breast cancer. The "death panel" (yeah, lets call it what it is) initially refused to pay for the MRI to locate the tumors, saying her family medical history didn't indicate she was likely to have cancer and only did so after forcing on her a painful biopsy. Eventually, it approved the MRI, but only after she'd undergone an additional, painful biopsy. She ended up needing a double mastectomy and additional surgery after getting MRSA in the hospital. Her cancer drugs cost her $2,000 a month (in England, she would pay nothing) and her MRSA infection is costing $280 for each appointment now that she's lost her insurance coverage. This sort of thing is IMPOSSIBLE in Europe. Sure, you can get MRSA anywhere in the world, but in Europe you are always assured of not being uninsured for drugs and medical treatment. No "government"´would DARE to deny treatment in the way the USA health insurance companies do. So yes, by all means we can include the "claims" of similarities between the UK and what is being proposed in the US, but lets also look at the figures to see if the claim can be substantiated. And lets look at the bureaucrats who today are making life and death decisions, some of whom are collectivized to deny claims. (My information is from HHS via Salon.com. What about yours?)-- Hauskalainen ( talk) 01:28, 4 January 2011 (UTC)

With respect, this talk page is not a forum for discussion of various editors' opinions of this subject. We only care about cited opinions from reliable sources and how best to incorporate them into the article. Kelly ^hi! 01:31, 4 January 2011 (UTC)

While we're on that topic, we should also mention that Wikipedia articles do not endorse any particular viewpoint included under NPOV. This edit summary by Hauskalainen asserts that there are no death panels. The article does not and should not make that claim. It may only cite reliable sources, with attribution, that do make that claim. 99.118.148.9 ( talk) 01:43, 4 January 2011 (UTC)

[24] Here's a historical 'death panel', or as NPR called it, a "death committee" that rationed dialysis before the US passed "socialized medicine for an organ". Jesanj ( talk) 02:46, 4 January 2011 (UTC)

IPAB and NICE II

There has been some interest in connecting NICE with the IPAB in the section that discusses rationing. [25] [26] And above the IP said "It is clear that NICE and IPAB are very similar agencies". Above I noted 1) the first diff had a politician's editorial as the source so i didn't think it was a reliable source for that connection and 2) this is the death panels page. The second time it is added we get another opinion cited that only says "[IPAB] may be borrowing an unfortunate model from overseas [(NICE)]" (my emphasis). The conservative thinktank unambiguously associates the two, granted. But here's the problem: entire sections of the death panels article are devoted entirely to the summer 2009 episode. This new content seeks to place 2010 murmurs ahead of a 2009 yelling. But 2009 is the only reason we have an article, because it was notable. So, I don't find it appropriate to keep moving things to the top of a section header that are not associated with why this term is notable. Jesanj ( talk) 20:08, 4 January 2011 (UTC)

:I am puzzled by this claim, which is also reflected in the way the article is written, that the only reason the term "death panel" is article-worthy is because of events in 2009. It looks to me like it is appearing now with greater and greater frequency now in the press. The term is notable because reliable sources refer to it, generally, not because of Sarah Palin or some other particular event. Angel's flight ( talk) 20:14, 4 January 2011 (UTC)

I don't think you should be puzzed. Take, for example, the fact that we have a definition of 'death panel' given by a group of English-language scholars in the WP:LEAD, which is grounded in Palin's coining/the political myth that swirled in the summer of 2009. Jesanj ( talk) 20:27, 4 January 2011 (UTC)

:::The definition supplied refers to it as a "new term" in 2009. It is no longer a new term. It is now more widely in use, and it is abundantly clear that the term has been widely applied to the aforementioned rationing boards. I think that this deletion and topic split are unacceptable -- every reference to IPAB that is cited is in the context of the rationing controversy. What is your rationale for moving it out of the section on that controversy? Angel's flight ( talk) 02:26, 5 January 2011 (UTC) ::::Since I am getting no response, I'll put it back. I also found a cite from the London Times that says Palin's initial use of the term was a reference to NICE. Angel's flight ( talk) 17:05, 5 January 2011 (UTC)

Thanks for adding the Times source. I understand the concern that motivated your question. I have been attempting to keep the article organized by sectioning it off into notable coverage (concepts that could tie together to have a stand alone article) vs. instances when those uses were not yet notable. I am unhappy with the way the current structure of the rationing section, but I am not sure how to address all concerns. My concerns are that, for one, we are giving undue weight to ideas that aren't mirrored in mainstream press or academic publications. Consider (as I mentioned above) that when Palin associated death panels with the IPAB in December of 2009, I couldn't find any news source that covered her. She was completely ignored, as far as I can tell. I added everything I found in my database search that associated the IPAB with death panels. Orzag says the IPAB is prohibited by law from rationing, but above you say "aforementioned rationing boards". It appears you're saying the IPAB will ration care, which would be a contentious point of view, and that viewpoint may be getting into the article inappropriately as a minority one (or fringe?, I am not sure -- this is the IPAB we're talking about after all) with too much placement. I'd prefer finding some sources in a mainstream journals/experts (like Health Affairs/ Uwe Reinhardt) regarding this IPAB–rationing concept instead of relying on op-eds from politicians and ideologically driven sources. I don't think your prominent placement of the first few sentences in the section is balanced with Orzag's claims. And we're getting into the issue, with the section, of comparing and contrasting the IPAB and NICE, which is outside of the scope of this article, in my opinion. That would be better off at the respective articles and appropriately sourced. WP:NEO says "To support an article about a particular term or concept we must cite reliable secondary sources such as books and papers about the term or concept, not books and papers that use the term." In general, I think you are adding sources (with a narrow POV) that use the term to an article that was written more with sources that are about the term. Jesanj ( talk) 20:04, 5 January 2011 (UTC)

Around here, we like mainstream newspapers, because Mainstream news sources are generally considered to be reliable. However, even the most reputable news outlets occasionally contain errors. Whether a specific news story is reliable for a specific fact or statement in a Wikipedia article is something that must be assessed on a case by case basis. When using news sources, care should be taken to distinguish opinion columns from news reporting. The USA Today reports "To the extent that death panels of a sort do exist, they're composed of state officials who must decide whether each state's version of Medicaid will cover certain expensive, potentially life-saving treatments." I'm not saying that should be included in the article. I'm pointing out that here's a mainstream newspaper pointing out how its editorial stance differs from those writing op-eds who try to mention the IPAB. Citing non-expert op-eds isn't how we typically write an encyclopedia, in my opinion. In other words, I think the section is giving undue weight to a minority (fringe?) viewpoint with a touch of originial research by linking all these agencies together so prominently in the rationing section. Jesanj ( talk) 18:45, 7 January 2011 (UTC)

::::::Let me remind you that until recently, this article was called "Death panels (political term.) There is a controversy about the concept, and that is the topic of the article. For you to argue that the Wall Street Journal or the London Times do not qualify as mainstream sources seems like an effort to exclude them based on POV. This is not primarily a medical controversy, it is a political one, because (as most sources seem to agree) some level of rationing is inevitable since resources are not infinite. Therefore the question becomes, under conditions of economic collapse, whether to take measures to revive the economy, or attempt to solve the problem by cutting entitlements, government services of all kinds, and medical care. The material which you have repeatedly deleted is well-sourced, and there is plenty of room for it in this moderately-sized article. Under NPOV, viewpoints which differ from the ones you prefer must be included if they appear in reliable sources, and they do. Angel's flight ( talk) 18:56, 7 January 2011 (UTC)

I also object to the practice throughout the article of characterizing viewpoints as "conservative." Unless there is a reliable source that specifically makes that assertion, I would consider it to be original research. Angel's flight ( talk) 19:00, 7 January 2011 (UTC)