Wednesday, April 16, 2014
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Death panels live on

Remember death panels? Many people not only remember them but apparently still believe they are part of Obamacare. Yet no one has been able to identify any provision in the law that would create such panels.

Death panels live on

In an Associated Press-GfK poll reported this week, 41 percent of respondents agreed that Obamacare will “Create committees of people who will review the medical histories of some people and decide whether they can get medical care paid for by the federal government.” (AP Photo/Bela Szandelszky)
In an Associated Press-GfK poll reported this week, 41 percent of respondents agreed that Obamacare will “Create committees of people who will review the medical histories of some people and decide whether they can get medical care paid for by the federal government.” (AP Photo/Bela Szandelszky)

Welcome to The Field Clinic, where our mission is to explain and interpret the laws, policies and politics that drive our health care system. The topics we cover have been part of the Check Up blog for the past three years, and they now have a blog of their own. We are also adding a new contributor, Erica Cohen, a third-year law student who concentrates in health law. We hope you find the entries informative and thought-provoking and look forward to presenting cogent and rational debate on issues at the heart of American health care - Robert I. Field

Remember death panels? Many people not only remember them but apparently still believe they are part of Obamacare.

Death panels are the government boards that opponents claimed would review the medical status of elderly Americans under health reform. Those found undeserving would be left to die without access to care.

The charge was first raised by Sarah Palin in 2009. She claimed the law would let bureaucrats use subjective judgments to decide who was worthy of health care. The accusation gained a lot of attention in the press.

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However, it had no basis in fact. Neither she nor anyone else was able to identify any provision in the law that creates such panels. 

But that doesn’t seem to have affected public perceptions. In an Associated Press-GfK poll reported this week, 41 percent of respondents agreed that Obamacare will “Create committees of people who will review the medical histories of some people and decide whether they can get medical care paid for by the federal government.” Even more remarkable, the percentage that believes this has actually risen since 2010, when it was 39 percent.

Respondents misconstrued several other aspects of the law, as well. Only 14 percent were correct most of the time in judging whether it actually included a series of sample of provisions. Thirty-nine percent believed that a government health care identification card will be required in order to receive care. And 54 percent believed that some doctors and hospitals will be required to treat illegal immigrants for free.

However, on a number of points, public knowledge seems to be solid. Sixty-nine percent were aware that there is a penalty for not having health insurance, 80 percent that large employers face a penalty for failing to offer coverage to their workers, 67 percdent that small companies can get tax credits for offering coverage, 72 percent that insurers must issue policies regardless of an applicant’s health status, and 80 percent that young adults can stay on their parents’ policies up to age 26.

None of these percentages have changed much since 2010. And neither have public attitudes toward the law. In 2012, 32 percent supported it and 37 percent were opposed. In 2010, the score was 30 percent in favor and 40 percent opposed.

Put all of this together, and the poll shows that after all of the political and legal battles of the last two years, the public has moved very little either in its understanding of or support for health reform. About the same proportion of people like it, think it does too much, and think it should do more. And knowledge (or lack of it) concerning what the law actually says remains about the same.

However, on one point, public attitudes have changed. A majority now expects Obamacare to be implemented with no or only minor revisions. Only 12 percent think it will be completely repealed. In other words, the law is now widely viewed as a permanent part of American health care. 

Obama has focused much of his energy since health reform was enacted on defending it against political and legal attacks. He has devoted surprisingly little attention to explaining what his law actually says.

Now that the public sees implementation as inevitable, it may be more open to receiving full and accurate information. The only thing Obama has to lose from better communication is some of the misunderstanding and opposition.

The sooner people forget about death panels, the better.

Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
About this blog

The Field Clinic reports and analyzes health care laws, government policies, and political trends that are transforming the care we receive and the way we pay for it. Read more about our panel of bloggers here.

This blog is produced in partnership with Kaiser Health News, an editorially independent program of the Henry J. Kaiser Family Foundation, a nonprofit, nonpartisan health-policy research and communication organization not affiliated with Kaiser Permanente. Portions of this blog may also be found on Inquirer.com and in the Inquirer's Sunday Health Section.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, School of Law & Drexel School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
Neil I. Goldfarb President & CEO of the Greater Philadelphia Business Coalition on Health
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson School of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson School of Population Health
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Donald Schwarz, MD, MPH Deputy Mayor for Health & Opportunity and Health Commissioner for the City of Philadelphia
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
Krystyna Dereszowska A third-year law student concentrating in health at Drexel
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