The power of propaganda

THE POWER OF PROPAGANDA…. The idea was once so obvious and uncontroversial that it was one of those rare health care policies that enjoyed broad bipartisan support. As the proposal goes, doctors would be reimbursed for speaking to Medicare patients who choose to consider end-of-life care options.

The whole point of the idea was to ensure that these decisions are made by individuals in consultation with their doctors. As Sen. Johnny Isakson, a conservative Republican from Georgia, explained last year, having end-of-life directives or a living will “empowers you to be able to make decisions at a difficult time rather than having the government making them for you.”

We know, of course, what happened next — professional liars characterized this as a proposal for “death panels,” and the provision was ultimately removed from the Affordable Care Act.

Last week, we learned the Obama administration was quietly pursuing the same policy through regulatory means. Once the media picked up on this, it apparently caused the administration to reverse course.

The Obama administration, reversing course, will revise a Medicare regulation to delete references to end-of-life planning as part of the annual physical examinations covered under the new health care law, administration officials said Tuesday.

The move is an abrupt shift, coming just days after the new policy took effect on Jan. 1.

Many doctors and providers of hospice care had praised the regulation, which listed “advance care planning” as one of the services that could be offered in the “annual wellness visit” for Medicare beneficiaries.

While administration officials cited procedural reasons for changing the rule, it was clear that political concerns were also a factor. The renewed debate over advance care planning threatened to become a distraction to administration officials who were gearing up to defend the health law against attack by the new Republican majority in the House.

In other words, officials knew the truth, but weren’t prepared to go up against the right’s propaganda machine, which had already begun making waves on this. The administration has enough on its plate — they’re already fighting hard to defend the Affordable Care Act against congressional Republicans — and seems to have concluded that it wasn’t worth the trouble.

But that’s a genuine shame. Backing down on this not only rewards professional liars and punishes seniors who’d benefit from the policy, but it encourages the liars to pull similar stunts in the future. As far as the frauds and charlatans are concerned, the moral of this story is that their attempts at deception work.

Rep. Earl Blumenauer (D-Ore.) recently said the regulatory policy will “give people more control over the care they receive,” but urged policy advocates to celebrate “a quiet victory.” Why? Because he feared right-wing hacks might “try to use this small provision to perpetuate the ‘death panel’ myth.”

Indeed, in an email in November to people working on end-of-life care, Blumenauer specifically said, “We would ask that you not broadcast this accomplishment out to any of your lists, even if they are ‘supporters’ — e-mails can too easily be forwarded.”

He was right to be concerned.