Sorry, this is a cut and paste because I just posted this.
"Death panels" was snarky, but there was an issue there. Taking out end of life counseling is just a cosmetic change. The financial drivers still push for rationing, and the enforced compensation scheme to providers, required for public and private plans, is designed to enforce 'general compliance' with 'cost effective practices and procedures' determined by a government committee purposely insulated from congress so it will 'have the guts' to cut coverage for procedures.
This was discussed quite frankly before it became a public issue, and you can google it.
So long as they took out the compensation drivers to make doctors talk to patients about end of life counseling whether or not patients ask for it, and make it wholly an option for those who want it, I think it is a good thing to have. It is the idea that seniors or the terminally ill may choose to die rather than fight BECAUSE they have been denied quality of life treatment that might have made life worth living that makes this a very slippery slope. A Senator tried to put in an amendment saying there could be no rationing of medically indicated care, but it was voted down. And in actual questioning on this, Obama uses very careful wording that 'you may be asked to give up care that won't make you healthier'. Well, a hip replacement, for one example, can be very important in raising quality of life, but can you say it 'makes you healthier?' It's a stretch.
Also, he vaguely says the $500 billion in cuts from medicare will be made up with 'cost savings by cutting fraud and inefficiencies' but the bipartisan Congressional Budget Office has said those 'savings' provisions will save only $1 billion. The other $499 billion has to come from somewhere, and medicare's obligation to give service will drop to a 'cost effective standard'.
In short, removing the end of life provisions doesn't change the issue of rationing care, it just was creepy for doctors who are denying treatment because they won't be paid by the government to be pushing end of life counseling, and more creepy to base doctor compensation in part on how successful they were at having patients choose certain options.
But this plan was not created with us in mind, it was created for the insurance companies and drug companies which is why they were at the table drafting it, and we are demonized as 'astroturf' and 'selfish' if we object to this invasion of our rights.
http://www.gooznews.com/node/3045