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'Death panels' controversy: Is Obama avoiding Congress?

The Obama administration is set to expand options for 'end of life' counseling for Medicare recipients. The White House says it's practical. Sarah Palin says it's akin to 'death panels.'

By Staff writer / December 27, 2010

President Obama talks with Health and Human Services Secretary Kathleen Sebelius in the Oval Office Nov. 4. Health and Human Services has included expanded 'voluntary advance care planning' consultations in the rules it is writing for the health-care reform law. Critics deride the idea as 'death panels.'

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In a move that could resuscitate the partisan battle over what Sarah Palin dubbed "death panels," the Obama administration is set to implement a controversial federal health-care provision by executive authority.

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The new rule would pay doctors to consult with Medicare patients who want voluntary counseling about health-care options in the case of terminal illness.

The Obama administration casts the change as minor, saying that these are common-sense discussions that doctors are already having with patients – and doctors should be reimbursed for them. Critics like Ms. Palin suggest that it is a step toward limiting care for those with terminal illnesses, which can be enormously expensive.

The shape of the debate in Washington is a hint of things to come during the next two years. With Republicans gaining new clout on Capitol Hill after the 2010 elections, President Obama could seek to bypass the Congress by executive authority. Other flash points concern new rules for greenhouse-gas emissions, mortgages, education, and credit cards.

“You’ll see a lot of game playing between the House and White House in the new Congress,” says Larry Sabato, a political scientist at the University of Virginia. “The Republican House will try to squeeze and restrict through the law, and Obama will try to expand and augment through rulemaking.”

On this issue, however, Mr. Sabato sees potential political peril for Mr. Obama. “It’s an issue made-to-order for the Republican House in trying to counter 'ObamaCare,' and for Republican presidential candidates who will cite this as the first implementation outrage of many to come in health-care reform,” he says.

The power of Palin

A similar provision was dropped from the health insurance reform package in 2009 after Palin's "death panels" comment stoked a public backlash. But administration officials say the change is "a straightforward extension of policies adopted by the Bush administration."

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